RESUMO
Research provides compelling evidence that supports the current and future utilization of critical care nurse practitioners (CCNPs) in pivotal roles as providers of cost-effective, quality patient-centered care for critically ill and technology-dependent adults. This paper gives a historical perspective and describes the current national need for CCNPs to practice in expanded roles both within and outside the boundaries of intensive care. An existing CCNP program is described. In addition, guidelines for CCNP program development and role implementation are discussed.
Assuntos
Cuidados Críticos , Descrição de Cargo , Profissionais de Enfermagem , Adulto , Certificação , Currículo , Educação de Pós-Graduação em Enfermagem , Humanos , Profissionais de Enfermagem/educação , Profissionais de Enfermagem/organização & administraçãoRESUMO
This study assessed the bacteriologic safety of room-temperature injectate used for cardiac output measurement in a surgical ICU, and compared its cost/benefit relationship to that of prefilled packaged syringes and a closed-loop injectate system. Ninety-five samples of injectate were obtained at four time intervals from staff-prepared syringes, and cultured for microbiologic growth. About 29% (27/95) of samples yielded bacterial growth, ranging from two colony-forming units to those too numerous to count. All positive samples contained skin flora, including coagulase-negative staphylococci and coryneforms. Additionally, five plates contained colonies of Gram-negative bacteria. Extended storage time increased the risk of contamination: 16.2% were contaminated within the first 24 h, whereas 45% were contaminated when stored for more than 72 h. Switching to a closed injectate system significantly (p less than .001) decreased the incidence of contamination by 1.2%, and also allowed a cost savings of $1.52/patient.
