Nurses' perceptions of the impact of a computerized information system on a critical care unit.

Critical care nurses work in complex environments and encounter a vast amount of information daily. To learn how a computerized information system (CIS) impacted nursing practice on a critical care unit, this foundational research was conducted before and after implementation of a CIS. Qualitative methods using interviews and open ended questions were employed. Results showed that nurses felt positive overall about the implementation of a bedside CIS. Nurses liked the readability of the information and having the CIS near the bedside. They disliked the periodic slowness or downtime. Broad themes of reflection, questioning and action emerged from the content analysis. The themes were in accord with the theoretical framework that guided the study. Recommendations for future research included exploring nursing medication documentation, use of hand held devices, and having resource databases within the CIS.

Actualizing theory to practice: preparing for computerized information system research on a critical care unit.

In preparation for conducting research on the work of nurses before and after the installation of a computerized information system on a critical care unit, an actualizing process was applied. This process, derived from Actualizing Theory, provided the researchers with an opportunity to study congruence and appropriateness among the components of the intended research. Actualizing Theory uses twelve main strategies to assist in linking theory to a concrete situation. These strategies were employed as the research proposal was being developed and helped both to clarify the fitness of the main components of the research and in representing them in operational form.

The role of the nurse educator in the development of critical pathways.

This article focuses on the role of the nurse educator in developing critical pathways. It serves as a guide for the nurse educator by defining how critical pathways support managed care, identifying the goals of critical pathway education, and reviewing the importance of organizational commitment to the critical pathways before their use. The nurse educator serves as instructor, facilitator, and consultant in critical pathway development.

Oxygen uptake-oxygen delivery alterations in the isolated liver after hydrogen peroxide challenge.

Acute, diffuse lung injury is frequently complicated by systemic organ injury and alterations in the relationship between oxygen uptake (VO2) and oxygen delivery (QO2). In this regard, systemic organ neutrophil accumulation and morphologic alterations consistent with systemic organ injury often occur in nonpulmonary organs in these settings. However, whether VO2-QO2 matching is also altered in these injured systemic organs remains unproven. Thus, the present study was designed to test the hypothesis that hydrogen peroxide (H2O2), a product of neutrophil oxidative metabolism, will cause systemic organ structural abnormalities and alter VO2-QO2 matching. To test this hypothesis, VO2-QO2 relationships, morphologic changes, and organ water content were evaluated in both uninjured, isolated perfused rabbit livers and in isolated perfused rabbit livers after injury with 5 mmol/L H2O2. Following H2O2 injury, peak VO2 fell from 1.36 +/- 0.35 mL/min/100 g to 0.79 +/- 0.16 mL/min/100 g (P < .05) and peak O2 extraction fell from 0.83 +/- 0.09 to 0.66 +/- 0.04 (P < .05). In addition, VO2 was lower for any given level of QO2 in the H2O2-injured livers compared with the control livers (P < .01). Finally, liver extravascular water content was increased in H2O2-injured livers compared with the control livers (0.79 +/- 0.02 v 0.71 +/- 0.05; P < .05). These observations indicate that H2O2, a product of neutrophil oxidative metabolism, is capable of producing both morphologic changes as well as gas exchange alterations in the isolated, perfused liver.