Minimizing Post-Intensive Care Syndrome to Improve Outcomes for Intensive Care Unit Survivors.

TOPIC: Post-intensive care syndrome is a collection of symptoms that more than half of patients who survive a critical illness, and their family caregivers, experience after the illness. Those symptoms include weakness/ fatigue, sleep disturbances/insomnia, cognitive dysfunction, posttraumatic stress disorder, other mental health conditions, and a lack of effective coping strategies. CLINICAL RELEVANCE: To minimize the risk of a patient developing post-intensive care syndrome, intensive care unit nurses must adopt practices that reduce the severity of disability and optimize patient outcomes. They must also advocate for patients who need additional expert care. PURPOSE: To describe interventions that critical care nurses can implement to minimize a patient's risk for post-intensive care syndrome. CONTENT COVERED: This article describes patients who have a high risk of developing post-intensive care syndrome and interventions that are within nurses' purview.

Increasing the Effectiveness of Targeted Temperature Management.

TOPIC: Targeted temperature management and therapeutic hypothermia are essential components of the multimodal approach to caring for compromised patients after cardiac arrest and severe traumatic brain injury. CLINICAL RELEVANCE: The continuously evolving science necessitates summation of individual facets and concepts to enhance knowledge and application for optimally delivering care. Targeted temperature management is a complex therapy that requires fine-tuning the most effective interventions to maintain high-quality targeted temperature management and maximize patient outcomes. PURPOSE: To describe the underlying pathophysiology of fever and the importance of manipulating water temperature and of preventing and treating shivering during that process. CONTENT COVERED: This article discusses nursing considerations regarding the care of patients requiring targeted temperature management that are necessary to improve patient outcomes.

Behavioral and physiological indicators of procedural and postoperative pain in high-risk infants.

Nurses play a critical role in the assessment and management of infant pain. In this article, infant pain assessment tools that are valid, reliable, clinically sensitive, and developmentally appropriate are discussed. Their purpose, use in acute pain, and applicability for premature and newborn infant populations are described. Behavioral and physiological indicators of pain, sleep-wake states, and infant development are discussed as important considerations in pain assessment. Recommendations for improving pain assessment practices are offered in conclusion.