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1.
AACN Adv Crit Care ; 34(4): 343-349, 2023 Dec 15.
Article in English | MEDLINE | ID: mdl-38033211

ABSTRACT

Advanced practice registered nurses and physician assistants, collectively termed advanced practice providers (APPs), have been part of telehealth for many years. During the COVID-19 pandemic, APPs experienced the growth in roles, responsibilities, and tools used for telehealth care delivery. This article uses examples from 3 health systems to highlight the ways in which telehealth use was expanded due to the pandemic, how APP roles were altered across the United States during and after the pandemic, and implications for future practice.


Subject(s)
COVID-19 , Telemedicine , Humans , United States , Pandemics , Critical Care , Delivery of Health Care
2.
AACN Adv Crit Care ; 34(4): 350-358, 2023 Dec 15.
Article in English | MEDLINE | ID: mdl-38033213

ABSTRACT

The COVID-19 pandemic exacerbated staffing challenges in intensive care units, with increased burnout and moral distress cited as major problems. A healthy work environment is critical to nurses' success and wellbeing. During the pandemic, a survey by the American Association of Critical-Care Nurses revealed decreased composite scores in each of the 6 critical elements of a healthy work environment. Hospital units that improved even 1 critical element reported higher job satisfaction. The use of telehealth tools by expert nurses expanded care delivery during the pandemic by improving response to acutely and critically ill patients while supporting hospital-based nurses. All of the critical elements of a healthy work environment are relevant to the tele-critical care nurse's role and challenges. This article describes how tele-critical care nurses were affected by the pandemic and how healthy work environment strategies promoted successful nurse and patient outcomes.


Subject(s)
Burnout, Professional , Critical Care Nursing , Nursing Staff, Hospital , Humans , Working Conditions , Pandemics , Intensive Care Units , Job Satisfaction
3.
Augment Altern Commun ; 37(4): 261-273, 2021 12.
Article in English | MEDLINE | ID: mdl-35023431

ABSTRACT

Nonvocal alert patients in the intensive care unit (ICU) setting often struggle to communicate due to inaccessible or unavailable tools for augmentative and alternative communication. Innovation of a hand-operated non-touchscreen communication system for nonvocal ICU patients was guided by design concepts including speech output, simplicity, and flexibility. A novel communication tool, the Manually Operated Communication System (MOCS), was developed for use in intensive care settings with patients unable to speak. MOCS is a speech-output technology designed for patients with manual dexterity impairments preventing legible writing. MOCS may have the potential to improve communication for nonvocal patients with limited manual dexterity.


Subject(s)
Communication Aids for Disabled , Communication Disorders , Communication , Humans , Intensive Care Units
4.
Clin J Oncol Nurs ; 24(1): 99-102, 2020 02 01.
Article in English | MEDLINE | ID: mdl-31961838

ABSTRACT

Sepsis has a higher incidence of hospital stays and poorer morbidity and mortality outcomes in patients with cancer. The development of infection in weakened immune systems and prolonged treatment courses increase the risk for sepsis in patients with cancer. The causes of infection that can lead to sepsis in patients with cancer are further complicated by disease- or therapy-related neutropenia. Early recognition of sepsis is critical for prompt treatment to prevent tissue damage, organ failure, and mortality. The Surviving Sepsis Campaign recommends the Hour-1 bundle as best practice for sepsis management.


Subject(s)
Neoplasms/complications , Neoplasms/mortality , Oncology Nursing/standards , Sepsis/diagnosis , Sepsis/etiology , Sepsis/nursing , Sepsis/physiopathology , Hospital Mortality , Humans , Neoplasms/nursing , Practice Guidelines as Topic , Retrospective Studies , Risk Assessment , Symptom Assessment
5.
Nurs Outlook ; 68(1): 5-13, 2020.
Article in English | MEDLINE | ID: mdl-31376986

ABSTRACT

Telehealth is an acknowledged strategy to meet patient healthcare needs. In critical care settings, Tele-ICU's are expanding to deliver clinical services across a diverse spectrum of critically ill patients. The expansion of telehealth provides increased opportunities for advanced practice providers including advanced practice nurses and physician assistants; however, limited information on roles and models of care for advanced practice providers in telehealth exist. This article reviews current and evolving roles for advanced practice providers in telehealth in acute and critical care settings across 7 healthcare systems in the United States. The health system exemplars described in this article identify the important role of advanced practice providers in providing patient care oversight and in improving outcomes for acute and critically ill patients. As telehealth continues to expand, additional opportunities will lead to novel roles for advanced practice providers in the field of telehealth to assist with patient care management for subacute, acute, and critically ill patients.


Subject(s)
Critical Care , Interdisciplinary Communication , Nurse Practitioners , Patient Care Team , Telemedicine , Advanced Practice Nursing , Delivery of Health Care , Health Services Needs and Demand , Humans , Organizational Case Studies , United States
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