ABSTRACT
Obese patients have complex needs that complicate their care during hospitalization. These patients often have comorbid conditions, including hypertension, heart failure, obstructive sleep apnea, pressure ulcers, and difficulty with mobility. Obese patients may be well served in the progressive care setting because they may require more intensive nursing care than can be delivered in a general care unit. Progressive care nurses have core competencies that enable them to safely and effectively care for obese patients. A plan of care with interdisciplinary collaboration illustrates the integrative care for obese progressive care patients. (Critical Care Nurse 2016; 36[4]:58-63).
Subject(s)
Body Mass Index , Comorbidity , Critical Care Nursing/organization & administration , Hospitalization/statistics & numerical data , Obesity, Morbid/nursing , Critical Care/methods , Female , Humans , Middle Aged , Obesity, Morbid/diagnosis , Obesity, Morbid/therapy , Prognosis , Risk Assessment , Treatment OutcomeABSTRACT
With changing health care, progressive care nurses are working in diverse practice settings to meet patient care needs. Progressive care is practiced along the continuum from the intensive care unit to home. The benefits of early progressive mobility are examined with a focus on the interdisciplinary collaboration for care in a transitional care program of a skilled nursing facility. The program's goals are improved functional status, self-care management, and home discharge with reduced risk for hospital readmission. The core culture of the program is interdisciplinary collaboration and team partnership for care of patients and their families.
Subject(s)
Health Services for the Aged/organization & administration , Mobility Limitation , Patient Care Planning/organization & administration , Patient Readmission/statistics & numerical data , Transitional Care/organization & administration , Activities of Daily Living , Aged , Aged, 80 and over , Critical Care/organization & administration , Female , Geriatric Assessment/methods , Humans , Male , Middle Aged , Patient Care Team/organization & administration , Patient Discharge/statistics & numerical data , Prognosis , Risk Assessment , Treatment OutcomeABSTRACT
This article discusses a woman who collapsed and landed in a puddle of water in a park near a horse trail. Her rescue and resuscitation started an extraordinary effort by her body to heal from multiple insults. This case study highlights the diagnosis and support of polymicrobial pneumonia secondary to near drowning and the multisystem complications throughout the 3-month hospitalization. It highlights the evidence for treatment of the polymicrobial nature of submersion injury, acute lung injury, and benefits of progressive mobility. Social media as a tool for the family's communication and coping are also discussed.
Subject(s)
Coinfection/etiology , Near Drowning/complications , Pneumonia, Bacterial/etiology , Respiratory Distress Syndrome/etiology , Adult , Coinfection/therapy , Female , Humans , Pneumonia, Bacterial/therapy , Respiratory Distress Syndrome/therapy , Social Media , SurvivorsSubject(s)
Frostbite/nursing , Seasons , Wounds and Injuries/nursing , Climate , Cold Temperature , HumansABSTRACT
Meeting the nutritional needs of the bariatric (severely obese) patient in acute and critical care can be a challenge. Assessment of metabolic needs and energy expenditure is imperative to calculate nutritional needs. Achieving adequate nutrition is a result of multidisciplinary team collaboration, with the nurse providing important data for the dietitian to calculate needs. This article reviews aspects of nutritional support of the bariatric patient including assessment, planning, implementation, and evaluation.
Subject(s)
Critical Care/methods , Critical Illness/therapy , Nutritional Requirements , Nutritional Support/methods , Obesity, Morbid/therapy , Acute Disease , Bariatrics/methods , Body Mass Index , Dietetics , Energy Metabolism , Fatal Outcome , Humans , Male , Middle Aged , Nurse's Role , Nursing Assessment , Nutrition Assessment , Nutritional Support/nursing , Obesity, Morbid/diagnosis , Obesity, Morbid/metabolism , Patient Care PlanningABSTRACT
Caring for the bariatric patient in the acute care environment poses many challenges to the team delivering care. The management of obstructive sleep apnea with noninvasive ventilation is one priority. Treatment options, including bi-level ventilation and continuous positive airway pressure, and delivery strategies are reviewed in conjunction with other aspects of care that ensure a holistic, comprehensive plan of care. The most effective plan of care for the bariatric patient is one that uses a multidisciplinary coordinated team effort.
Subject(s)
Critical Care/methods , Obesity, Morbid , Sleep Apnea, Obstructive/therapy , Adult , Body Mass Index , Gastric Bypass , Humans , Male , Obesity, Morbid/complications , Obesity, Morbid/surgery , Oxygen Inhalation Therapy , Patient Care Planning , Patient Care Team , Patient Selection , Perioperative Care/methods , Perioperative Care/nursing , Polysomnography , Positive-Pressure Respiration , Respiratory Mechanics , Sleep Apnea, Obstructive/diagnosis , Sleep Apnea, Obstructive/etiologyABSTRACT
Progressive care units provide care to stable, critically ill patients of varying acuities. Managers of these diverse units must consider care delivery systems, staffing, technology, acuity measurement, and regulatory issues.
