Subject(s)
Family/psychology , Intensive Care Units , Nurse's Role , Patient Advocacy , Critical CareABSTRACT
Guidelines, protocols, and standards have gained attention as clinical tools designed to enhance clinical decision-making and practice. Yet, evidence has emerged that clinicians are having difficulty integrating new knowledge presented by these tools into practice. This article explores the benefits and barriers to using guidelines and protocols, probes the issues of producing these tools, and examines processes that are critical to constructing valid tools. The key functions important in successful development and implementation of guidelines and protocols are presented, as well as the direction these clinical adjuncts will take in the future.
Subject(s)
Critical Pathways/standards , Evidence-Based Medicine/standards , Outcome Assessment, Health Care/standards , Practice Guidelines as Topic/standards , HumansABSTRACT
The patient with acute pancreatitis requires constant assessments and interventions to minimize pancreatic inflammation and promote early detection and treatment of systemic complications. The onset of acute pancreatitis is most commonly initiated by biliary or alcohol disease, although many other causes have identified. The course of the disease may range from mild to fulminant based on the degree of pancreatic necrosis. Significant clinical symptoms include abdominal pain, nausea, and vomiting. The patient may present with signs of hypovolemic shock, with associated sequestration of fluid in the peritoneum as a result of inflammatory and mediated responses. Laboratory evidence of the disease includes increased levels of amylase and lipase, although a definitive diagnosis cannot be made without radiographic tests. Multisystem failure can occur in necrotizing acute pancreatitis as a result of mediators that are activated by the proteolytic enzymes, normally produced by the pancreas, and released into the peritoneum by injured cells. Collaborative management of the patient includes therapies directed at correcting initiating events, hemodynamic stabilization, and supportive measures to rest the pancreas and resolve presenting clinical symptoms. The management of multisystem organ failure that can result from necrotizing pancreatitis is a multidisciplinary challenge.
Subject(s)
Critical Illness , Pancreatitis , Acute Disease , Humans , Pancreatitis/diagnosis , Pancreatitis/nursing , Pancreatitis/therapyABSTRACT
Team building does not occur by chance; it involves using techniques to make it easier for members to contribute their expertise while working with others to achieve quality results. Evaluation of team effectiveness involves assessing both the processes (team interactions and work processes) and accomplishment of goals (out-comes; see box). Productivity and quality that could not be accomplished by individual efforts may be enhanced by effectively working teams.
Subject(s)
Group Processes , Interprofessional Relations , Patient Care Team/organization & administration , Humans , Leadership , RoleABSTRACT
The Joint Commission on Accreditation of Health Care Organizations standards require the inclusion of all major clinical functions performed by nurses in the nursing quality assurance (QA) program. To achieve this goal, nurses must first define the scope of care, which includes articulating the specific activities performed in the critical care unit, who provides the care, where and when nursing care is provided, and to whom nursing care is provided. Interventions directed toward families are recognized as falling within the scope of nursing practice. This article addresses how family research was used to develop a QA tool to evaluate family satisfaction with nursing interventions to meet their identified needs in an intensive care unit setting.
