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Critical Care

A team approach to STEMI treatment protocols

A community hospital’s initiative improves patient outcomes. Takeaways: Few practice guidelines focus on in-hospital ST-elevation myocardial infarctions (STEMIs). Challenges related to inpatient STEMIs include delays in several areas—including recognition, electrocardiogram interpretation, STEMI team or rapid...

The role of adult gerontology acute care nurse practitioners

This growing field offers opportunities in a variety of settings. Your perspective of the nurse practitioner (NP) role may be shaped by the NPs you encounter at work. Perhaps you think that adult-gerontology acute care...

Cystocerebral syndrome

Rapid recognition leads to a quick reversal. Takeaways: Assess the full medical history of patients on admission, including bowel and bladder issues to reduce risk of delirium. Note that conditions other than the primary diagnosis...
sports drills prevent concussions

Adjusting sports drills to prevent concussions

A study in the Journal of Neurosurgery: Pediatrics reports that interventions such as reducing the speed of players engaged in contact, correcting tackling technique, and progressing to contact may be more effective in reducing...

Education improves ED care of children with behavioral special needs

A study in the Journal of Emergency Nursing reports that providing an education module improved the care of children with special health care needs who have behavioral issues. Read more

Nurse spent 28 years collecting medical waste to create a massive medical art mural

Tilda Shalof spent 28 years as an ICU nurse treating some of the sickest people in Toronto. Over the years she collected medicine caps and lids, IV tubes and syringe covers that she turned...

In-bed cycling safe for ICU patients

In-bed cycling starting within the first 4 days of mechanical ventilation is safe and feasible for ICU patients who are hemodynamically stable, according to a study in PLOSOne. Read more

Family satisfaction with ICU care

Emotional/interrelational aspects of care are integral to family member satisfaction with care provided in an intensive care unit (ICU), reports a study in Nursing Research. Read more
ICU

Implementing a mobility program for ICU patients

More than 5 million patients are admitted to intensive care units (ICUs) every year, with survival rates approaching 80%. But when they leave the ICU, many patients experience muscle weakness from bed rest and...

What works: An ED goes vertical to improve patient flow and satisfaction

In the midst of unprecedented change in health care, hospitals and emergency departments (EDs) are attempting the impossible — increase both patient volume and satisfaction without increasing the budget. My hospital is a busy 329-bed,...
hyponatremia

Recognizing acute hyponatremia

Sam Johansen, age 42, is admitted to the medical-surgical unit after 3 days of acute nausea, vomiting, and watery diarrhea associated with acute abdominal pain. His nurse, Megan, obtains initial vital signs: blood pressure...

New guidelines for resolving decision conflicts in the ICU

The American Thoracic Society has released “An Official ATS/AACN/ACCP/ESICM/SCCM Policy Statement: Responding to Requests for Potentially Inappropriate Treatments in Intensive Care Units.” Read more.
chest tubes

Managing chest tubes: Air leaks and unplanned tube removal

Once treated only in high-acuity settings, patients with chest tubes now receive care in inpatient medical-surgical floors, outpatient procedural areas (such as interventional radiology), and other settings. More recently, to help shorten hospital stays...