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1. COMPETENCIES OF NURSES CARING FOR THE CRITICALLY ILL: • Clinical judgment
and clinical reasoning skills
• Advocacy and moral agency in identifying and resolving ethical issues
• Caring practices that are tailored to the uniqueness of the patient and family
• Collaboration with patients, family members, and healthcare team members
• Systems thinking that promotes holistic nursing care
• Response to diversity
• Facilitator of learning for patients and family members, team members, and the community
• Clinical inquiry and innovation to promote the best patient outcome
2. The nurse caring for acute and critically ill patients:: Systematically evaluates the quality
and ettectiveness of nursing practice
• Evaluates own practice in relation to professional practice standards, guidelines, statutes, rules, and regulations
• Acquires and maintains current knowledge and competency in patient care
• Contributes to the professional development of peers and other healthcare providers
• Acts ethically in all areas of practice
• Uses skilled communication to collaborate with the healthcare team to provide care in a safe, healing, humane, and
caring environment
• Uses clinical inquiry and integrates research findings into practice
• Considers factors related to safety, ettectiveness, cost, and impact in planning and delivering care
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• Provides leadership in the practice setting for the profession
3. REDUCING ALL-CAUSE HARM: Adverse drug events
• Infections
• Catheter-associated urinary tract infections (CAUTI)
• Central line-associated bloodstream infections (CLABSI)
• Surgical site infections
• Ventilator-associated pneumonia (VAP)
• Injuries from falls and immobility
• Obstetric adverse events
• Pressure ulcers
• Venous thromboembolism (VTE)
• Other hospital-acquired conditions
4. AMERICAN ASSOCIATION OF CRITICAL-CARE NURSES' LEVELS OF RESEARCH
EVIDENCE: A
Meta-analysis of multiple controlled studies or metasynthesis of qualitative studies with results that consistently support
a specific action, intervention, or treatment
B
Well-designed controlled studies, both randomized and nonrandomized, with results that consistently support a specific
action, intervention, or treatment
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C
Qualitative, descriptive, or correlational studies; integrative reviews; systematic reviews; or randomized controlled trials
with inconsistent results
D
Peer-reviewed professional organizational standards, with clinical studies to support recommendations
E
Theory-based evidence from expert opinion or multiple case reports
M
Manufacturer's recommendation only
5. BARRIERS TO EFFECTIVE HANDOFF COMMUNICATION: • Physical setting: background
noise, lack of privacy, interruptions
• Social setting: organizational hierarchy and status issues
• Language: ditterences between people of varying racial and ethnic backgrounds or geographical areas
• Communication medium: limitations of communications via telephone, e-mail, paper, or computerized records versus
face-to-face
6. SBAR APPROACH: S—Situation: State what is happening at the present time that has warranted the SBAR
communication.
B—Background: Explain circumstances leading up to this situation. Put the situation into context for the reader/lis-
tener.
A—Assessment: State what you think is the problem.
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R—Recommendation: State your recommendation to correct the problem.