Chamberlain College of NursingNR 340NR 340 Week 3 Exam 1 Studyguide

Critical Care Nursing  Deals with human responses to critical illness or injury o Physiological o Psychological  Focus on both the patient’s and family’s responses  Critical Care Overview  Not always centered in an “ICU setting” o Inpatient o Outpatient o Home Care o eICU o Tele-stepdown o Post anesthesia o Flight nursing-transport  Professional Organizations o American Association of Critical-Care Nurses o Society of Critical Care Medicine Trends and Issues  Critical care patients more complex  Increasing costs for care  Facilities for long term ventilators  Reduces stays in hospitals: more risk for infection  Better for patient to be at home Focus on Quality and Safety  Errors and harm must be prevented o Communication is a big error o On record where to find items o Medication errors o Documentation errors o Handwashing o Falls  Nurses are challenged to reduce errors and promote a safe environment  Several initiatives o Joint Commission National Patient Safety Goals o Institute for Healthcare Improvement o Quality and Safety Education for Nurses (QSEN) National Patient Safety Goals  The Joint Commission National Patient Safety Goals  Examples relative to critical care nursing o CommunicationNR340 Exam 1 Chapters 1, 2, 3, 5, 7, 9, 14, pgs 228-324 Page 2 of 36 o Medication safety o Reduce infections o Reconcile medications o Telephone orders- SAY BACK o TALL letters for similar drug names Harms Targeted for Reduction  Adverse drug events  Infections o Catheter-associated urinary tract infections (CAUTI) o Central line–associated bloodstream infections (CLABSI) o Surgical site infections o Ventilator-associated pneumonia (VAP)  Injuries from falls and immobility  Obstetric adverse events  Pressure ulcers  Venous thromboembolism (VTE) Communication  Communication important for safe care  Standardized approaches o SBAR and SBAP  Situation  Background  Assessment  Recommendation (Plan)  Collaboration o Nurse/ doctor o Debreifing Other Trends and Issues  Reducing hospital readmission rates o Chronic illness (HF)  Increasing use of technology o Electronic medical records o Physician order entry  Ethical issues associated with prolonging life and futile treatment  Telemedicine and eICU  Aging population and workforce  Shortage of CC nurses The Critical Care Environment  Stressful  Noisy  Sleep Deprivation  Concerns of the Critically Ill Patient o Patients responses do vary  Loss of control (even breathing)  ↓ Communication (d/t vent)  ↓Mobility, ↓Comfort