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This article written by baccalaureate nursing students briefly discusses the use of music therapy in clients on mechanical ventilation in intensive care units. The article explores the possible benefits of music therapy and its use in other aspects of health care. [ABSTRACT FROM AUTHOR]

Introduction: Extended periods of bed rest and mechanical ventilation (MV) have devastating effects on the body. Background: Early mobility (EM) for patients in respiratory failure is safe and feasible, and an interprofessional team is recommended. Using simulation to train EM skills improves student confidence. The purpose of this study was to enable health care student collaboration as an interprofessional team in providing safe management and monitoring during an EM simulation for a patient requiring MV. Methods: Nursing (n = 33), respiratory (n = 7), occupational (n = 24), and physical therapist students (n = 55) participated in an EM interprofessional education (IPE) simulation experience. A mixed-methods analytic approach was used with pre/post quantitative analysis of the Student Perceptions of Interprofessional Clinical Education--Revised, Version 2 instrument and qualitative analysis of students' guided reflection papers. Results: Pre/post surveys completion rate was 39.5% (n = 47). The Student Perceptions of Interprofessional Clinical Education--Revised, Version 2 instrument indicated a significant improvement (P = .037) in students' perceptions of interprofessional collaborative practice. Qualitative data showed a positive response to the EM simulation IPE. Themes reflected all 4 Interprofessional Education Collaborative competencies. Discussion: This study demonstrated improved perception of interprofessional collaborative practice and better understanding of the Interprofessional Education Collaborative competencies. Conclusion: Students collaborated in the simulation-based IPE to provide EM for a patient requiring MV and reported perceived benefits of the experience. [ABSTRACT FROM AUTHOR]

Background: Critical care nurses who care for postoperative cardiac surgery patients need such specialty knowledge as atrial electrograms (AEGs). An inadequate audit trail exists for psychometric performance of instruments to measure knowledge of AEGs. Objectives: The aim of this study was to revise a previously tested instrument and assess evidence for content validity (content validity index), internal consistency (Cronbach α), and stability (correlation coefficient, r) reliability against the a priori criterion of 0.80. Methods: The multiple-choice response, self-administered, paper-and-pencil instrument was revised to 20 items and named the Drake Atrial Electrogram Assessment Survey (DAEGAS). A panel of 6 AEG experts reviewed the DAEGAS for content validity evidence. The instrument was further revised to 19 items (13 knowledge and 6 AEG interpretation) and tested with 76 critical care nurses from the greater Houston metropolitan area. Results: The content validity index was 0.93. Cronbach α was.51, and test-retest r was 0.74. Cronbach α increased to.60 and r was 0.73 with removal of 3 items: 2 items with a negative item-total correlation and 1 item that was transitioned to a sample question. Discussion: Content validity evidence exceeded the a priori criterion. Internal consistency and stability reliability estimates did not meet the criterion, albeit the latter met the criterion recommended by psychometricians for a new instrument. Recommendations include further development of the DAEGAS to improve internal consistency estimates and testing for evidence of other forms of validity. Reliable and valid assessment of critical care nurse knowledge of AEGs will require improved psychometric performance of the DAEGAS. [ABSTRACT FROM AUTHOR]

Background: Pain assessment and management are imperative parts of nursing care and considered as one of the most fundamental patient rights. The role of pain management education is well established in improving knowledge and attitude among nurses. Objectives: This study aims to evaluate the impact of pain management educational program on the knowledge and attitudes of intensive care unit (ICU) staff nurses toward pain assessment and management. The baseline score of pain assessment and management knowledge and attitude of ICU nurses has been identified in a previous research, and the result showed immense lack of knowledge and poor attitudes among ICU nurses toward pain assessment and management when dealing with ICU patients. Methods: This is a pretest-posttest experimental study, utilizing a self-reporting questionnaire tool to obtain information about nurses' knowledge and attitudes toward pain assessment and management after implementation of new pain management educational program for critical care nurses. Data were collected using the Knowledge and Attitudes Survey Regarding Pain tool that measures knowledge with 22 question items and measures attitude with 17 question items. Paper-based questionnaire was distributed to nurses for data collection. Results and Conclusion: The results showed significant improvement in knowledge and attitudes about pain assessment and management among ICU nurses; it was evident after delivering pain management education program. At baseline, 204 ICU nurses gave consent and completed the questionnaire and thus included in Background: Pain assessment and management are imperative parts of nursing care and considered as one of the most fundamental patient rights. The role of pain management education is well established in improving knowledge and attitude among nurses. Objectives: This study aims to evaluate the impact of pain management educational program on the knowledge and attitudes of intensive care unit (ICU) staff nurses toward pain assessment and management. The baseline score of pain assessment and management knowledge and attitude of ICU nurses has been identified in a previous research, and the result showed immense lack of knowledge and poor attitudes among ICU nurses toward pain assessment and management when dealing with ICU patients. Methods: This is a pretest-posttest experimental study, utilizing a self-reporting questionnaire tool to obtain information about nurses' knowledge and attitudes toward pain assessment and management after implementation of new pain management educational program for critical care nurses. Data were collected using the Knowledge and Attitudes Survey Regarding Pain tool that measures knowledge with 22 question items and measures attitude with 17 question items. Paper-based questionnaire was distributed to nurses for data collection. Results and Conclusion: The results showed significant improvement in knowledge and attitudes about pain assessment and management among ICU nurses; it was evident after delivering pain management education program. At baseline, 204 ICU nurses gave consent and completed the questionnaire and thus included in baseline measurement before implementing the intervention. In the postintervention measurement, the questionnaire was distributed to the same participants included in the baseline phase from which 181 participants completed the questionnaire for the second time, with a response rate of 89%; the deficits and preconception in pain assessment and management can be improved through implementing pain management educational programs. [ABSTRACT FROM AUTHOR]

Background: Evidence-based practice (EBP) has become of great interest to policymakers, health care practitioners, and researchers. Objective: This study aimed at assessing knowledge associated with, attitudes toward, and implementation of EBP among Jordanian registered nurses (RNs) in critical care units. Method: A descriptive, correlational, and cross-sectional study was conducted in 5 hospitals: 3 public and 2 private. A convenience sample of 200 RNs was invited. Data were collected using a paper-based and self-administered questionnaire, in 2 sections; the first section was the demographic and contextual characteristics and the second was the Evidence-Based Practice Questionnaire (J Adv Nurs. 2006; 53(4):454-458) to measure RNs' knowledge, attitudes, and EBP. Results: A total of 187 RNs were included in this study. Findings revealed that Jordanian RNs in critical care units perceived themselves as having a satisfactory level of knowledge and practice of evidence-based interventions. In addition, RNs strongly recognized the value of EBP. There were significant positive associations between EBP and knowledge associatedwith EBP (r = 0.708, P < .001) and attitude toward EBP (r = 0.490, P < .001). Conclusion: Knowledge associated with EBP, a positive attitude toward EBP, higher educational qualifications, and training in EBP all increased the implementation of EBP. It is recommended that continuing education programs on EBP for nurses be conducted. Nursing educators in clinical settings have to consider a number of strategies to improve EBP. A qualitative research design and/or including open-ended questions are encouraged to gain more in-depth views about EBP. [ABSTRACT FROM AUTHOR]

In the article, the author calls for papers or manuscripts on critical care topics like critical care technology, career development, and leadership strategies.

Purpose: The purposes of this study is first, to investigate intensive care patients' perceptions of stressors; second, to investigate the health care provider's perception of what constitutes a stressor from the patient's perspective; and third, to describe how health care providers manage their patients' stressors. This was a mixed-methods study; the quantitative section replicated Cornock's 1998 study of stress in the intensive care unit (ICU), with difference in sampling to include all health care providers in the ICU, in addition to nurses. The qualitative section added information to the current literature by describing how health care providers manage their patient's stressors. This article reports the quantitative findings of this study, as the qualitative section is presented in a separate article. Background and Significance: It is important to describe ICU patients' stressful experiences to assess patient's stressors, provide holistic care to eliminate stressors, and provide feedback to health care providers. There is a need to describe the clinical practice related to stress perception and management of stressors in the critical care environment. Methodology: A mixed-methods comparative descriptive design was used for the quantitative section, and a phenomenological approach guided the qualitative section. Lazarus and Folkman's theory formed the bases for integrating all variables investigated in this study. The sample included 70 ICU patients and 70 ICU health care providers. After consenting to participate in this study, subjects were given a demographic form and a paper-based tool, the Environmental Stressors graphic data form Questionnaire. Questionnaires were filled out by subjects anonymously in the ICU and returned to the researcher in the same setting. Findings: Descriptive statistics were analyzed using SPSS data analysis software. The top 3 most stressful items ranked by the patients included "being in pain," followed by "not being able to sleep" and "financial worries"; on the other hand, health care providers perceived "being in pain" followed by "not being able to communicate" and "not being in control of yourself" as the top 3 stressors perceived by their patients. Implications for Practice: The findings of this study are crucial and may inform nursing assessments and care of the ICU patient. In addition, this information may encourage the ICU staff to manipulate and redesign the ICU environment to be less stressful. Also, the findings of this study guided the development of an ICU stressor control policy. [ABSTRACT FROM AUTHOR]

Aim: The aims of this study were to describe the current status of intensive care unit (ICU) visiting hours policies internationally and to explore the influence of ICUs’ open visiting policies on patients’, visitors’, and staff perceptions, as well as on patients’ outcomes. Methods: A review of the literature was done through MEDLINE, EMBASE, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. The following keywords were searched: ‘‘visiting,’’ ‘‘hours,’’ ‘‘ICU,’’ ‘‘policy,’’ and ‘‘intensive care unit.’’ Inclusion criteria for the review were original research paper, adult ICU, articles published in the last 10 years, English or Italian language, and available abstract. Results: Twenty-nine original articles, mainly descriptive studies, were selected and retrieved. In international literature, there is a wide variability about open visiting policies in ICUs. The highest percentage of open ICUs is reported in Sweden (70%), whereas in Italy there is the lowest rate (1%). Visiting hours policies and number of allowed relatives are variable, from limits of short precise segments to 24 hours and usually 2 visitors. Open ICUs policy/guidelines acknowledge concerns with visitor hand washing to prevent the risk of infection transmission to patients. Patients, visitors, and staff seem to be inclined to support open ICU programs, although physicians are more inclined to the enhancement of visiting hours than nurses. Discussion: The percentages of open ICUs are very different among countries. It can be due to local factors, cultural differences, and lack of legislation or hospital policy. There is a need for more studies about the impact of open ICUs programs on patients’ mortality, length of stay, infections’ risk, and the mental health of patients and their relatives. [ABSTRACT FROM AUTHOR]

Cardiac surgery remains one of the most commonly performed surgeries in the world. Intensive insulin therapy has shown to reduce infection in patients under going open-heart surgery and is considered standard of care. New technologies are available to achieve and maintain recommended blood glucose goals. These include computer-driven intensive insulin protocols(vs paper-based algorithms) and continuous blood glucose monitors. Managing tight glucose control in cardiac surgery patients has been shown to decrease costs in terms of measurable outcomes including infection, mortality, and length of stay. The advanced practice nurse is uniquely qualified to implement new technologies and can be instrumental in increasing compliance with clinical practice guidelines while decreasing hospital costs. [ABSTRACT FROM AUTHOR]

The purpose of this paper was to briefly define sepsis, severe sepsis, and septic shock and discuss evidence-based guidelines for implementing a sepsis protocol in the critical care setting. In addition, this article will further educate critical care nurses about sepsis and strategies to improve outcomes in this group of patients. [ABSTRACT FROM AUTHOR]

A transdiciplinary team is crucial for Healthcare systems to act based on evidence in responding to the global demand of the business of caring and patient safety. The purpose of this paper is to outline a transdisciplinary team led by nurses that examines linkages between moot malpractice cases filed against a healthcare system and to the quality of the healthcare system's ecology, caregiver, and patient safety outcomes. Keywords: Malpractice, Moot court Transdisciplinary team, Legal issues [ABSTRACT FROM AUTHOR]