Intensive and Critical Care Nursing RSS feed: Current Issue. The aims of Intensive and Critical Care Nursing are to promote excellence of care of critically ill patients by specialist nurses and their professional colleagues; to provide an international and interdisciplinary forum for the publication, dissemination and exchange of research findings, experience and ideas; to develop and enhance the knowledge, skills, attitudes and creative thinking essential to good critical care nursing practice. The journal publishes reviews, updates and feature articles in addition to original papers and significant preliminary communications. Articles may deal with any part of practice including relevant clinical, research, educational, psychological and technological aspects.http://www.intensivecriticalcarenursing.com/?rss=yesElsevier Inc.en © 2010 Published by Elsevier Inc. All rights reserved. Intensive and Critical Care Nursing0964-3397264August 2010 © 2010 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.intensivecriticalcarenursing.com/article/PIIS0964339710000479/abstract?rss=yesEditorial Board10.1016/S0964-3397(10)00047-9Intensive and Critical Care Nursing 26, 4 (2010)2010-08-01Intensive and Critical Care Nursing2010-08-01264S0964-3397(10)X0004-0iihttp://www.intensivecriticalcarenursing.com/article/PIIS096433971000039X/abstract?rss=yesSummary: In this article, sedation protocol research in the intensive care environment is critically examined, focusing upon the differences in outcomes from research conducted on mechanically ventilated patients in various countries. Limitations of the current research are discussed, with suggestions of how sedation protocol research may be conducted in future. Also, the monitoring of important clinical factors is discussed so that clinicians can assess the impact upon patients of changes to sedation management practices within their own ICU.International variations in outcomes from sedation protocol research: Where are we at and where do we go from here?Mark O’Connor, Tracey Bucknall, Elizabeth Manias10.1016/j.iccn.2010.05.002Intensive and Critical Care Nursing 26, 4 (2010)2010-08-01Intensive and Critical Care Nursing2010-08-01264S0964-3397(10)X0004-0International Research Series189195http://www.intensivecriticalcarenursing.com/article/PIIS0964339710000212/abstract?rss=yesSummary: Objective: To validate two physiological track and trigger systems; the early warning score () and the trust observation chart on a haematology unit. The study aimed to determine whether either of these systems could be used to identify developing critical illness in haematology.Research design: A prospective validation study where all patients’ physiological observations were recorded, the level of care they were receiving assessed and after data collection finished, the triggers and EWS calculated.Setting: A haematology unit in an inner London hospital.Results: 71 patients took part in the study; 17 of these became critically ill. The sensitivity of both systems compared favourably with other studies. However, specificity was lower. This will mean a number of false negative results within this patient group.Conclusion: The study concluded that the systems are useful adjuncts to identify developing critical illness in haematology patients but cannot be used in isolation due to the high number of false negative results that occur. Any plan to introduce either system should acknowledge the increase in workload that will result.Validation of a physiological track and trigger score to identify developing critical illness in haematology patientsAlison Mulligan10.1016/j.iccn.2010.03.002Intensive and Critical Care Nursing 26, 4 (2010)2010-08-01Intensive and Critical Care Nursing2010-08-01264S0964-3397(10)X0004-0Original Articles196206http://www.intensivecriticalcarenursing.com/article/PIIS096433971000042X/abstract?rss=yesSummary: Influenza is a common seasonal viral infection that affects large numbers of people. In early 2009, many people were admitted to hospitals in Mexico with severe respiratory failure following an influenza-like illness, subtyped as H1N1. An increased mortality rate was observed. By June 2009, H1N1 was upgraded to pandemic status. In June–July, Australian ICUs were experiencing increased activity due to the influenza pandemic. While hospitals implemented plans for the pandemic, the particularly heavy demand to provide critical care facilities to accommodate an influx of people with severe respiratory failure became evident and placed a great burden on provision of these services. This paper describes the initial experience (June to mid September) of the pandemic from the nursing perspective in a single Australian ICU. Patients were noted to be younger with a higher proportion of women, two of whom were pregnant. Two patients had APACHE III comorbidity. Of the 31 patients admitted during this period, three patients died in ICU and one patient died in hospital. Aerosol precautions were initiated for all patients. The requirement for single room accommodation placed enormous demands for bed management in ICU. Specific infection control procedures were developed to deal with this new pandemic influenza.Early experience with influenza A H1N109 in an Australian intensive care unitTim Leen, Teresa A. Williams, Lorraine Campbell, Jenny Chamberlain, Andree Gould, Geraldine McEntaggart, Gavin D. Leslie10.1016/j.iccn.2010.05.005Intensive and Critical Care Nursing 26, 4 (2010)2010-08-01Intensive and Critical Care Nursing2010-08-01264S0964-3397(10)X0004-0Original Articles207214http://www.intensivecriticalcarenursing.com/article/PIIS0964339710000418/abstract?rss=yesSummary: Background: The death of a family member in the intensive care unit (ICU) is often sudden and unexpected and may have a strong impact on family members.Objective: To describe the characteristics of bereavement, to find out if there is a need for follow-up bereavement service and to determine if the information and care in the ICU is sufficient for relatives of deceased ICU patients.Methods: An exploratory cross-sectional study using a structured telephone interview in 51 relatives, in a 10 bed adult mixed medical-surgical ICU. Respondents were selected according to three criteria; (1) their relative had died between June 2008 and June 2009 in the ICU, (2) they were involved during the ICU stay preceding death and (3) had sufficient knowledge of the Dutch language.Results: A majority (77%) was satisfied with the delivered ICU-care and the information provided. Most common complaints concerned communication and the information provided. Almost all the respondents (90%) understood the fatal sequence of events during the dying process. Subsequently, a substantial portion of the respondents (37%) complained about ‘sleeping problems’. The need for a follow-up bereavement service was reported by 35% of the respondents.Conclusions: Despite a high level of satisfaction with the care provided in the ICU many respondents considered a follow-up bereavement service potentially useful to deal with the death of the family member and to get remaining questions answered.Survey into bereavement of family members of patients who died in the intensive care unitMarjoleine A. van der Klink, Liza Heijboer, José G.M. Hofhuis, Aly Hovingh, Johannes H. Rommes, Marjan J. Westerman, Peter E. Spronk10.1016/j.iccn.2010.05.004Intensive and Critical Care Nursing 26, 4 (2010)2010-08-01Intensive and Critical Care Nursing2010-08-01264S0964-3397(10)X0004-0Original Articles215225http://www.intensivecriticalcarenursing.com/article/PIIS0964339710000431/abstract?rss=yesSummary: New management models develop; one of them is shared leadership where two nurse managers share tasks and responsibility for a unit. The overall aim of this study was to describe the view of the staff about shared leadership at an ICU in Sweden and to study if there were any differences in perceptions between staff groups. This unit had changed the management organisation from single leadership (one nurse manager) to shared leadership (two nurse managers). Sixty-four (79%) registered nurses and assistant nurses responded to a 72 item questionnaire measuring social and organisational factors at work, especially leadership and shared leadership.The results showed that staff reported positive views in relation to the dimensions ‘Organisational culture’, ‘Social interactions’, ‘Work satisfaction’, ‘Leadership’, ‘Shared leadership’ and ‘Work motives’. Registered nurses reported more positive views than assistant nurses in relation to the dimensions: ‘Organisational culture’, ‘Social interactions’, ‘Work satisfaction’ and ‘Leadership’. Further, females had more positive views than males on the dimension ‘Social interactions’. Staff described that shared leadership positively influenced the work in terms of confidence. In conclusion, staff reported positive views of work and the model shared leadership in the investigated ICU. One implication is that nurse managers have to be conscious of different health professionals in the unit and it is important to offer a good working environment for all staff. However, more research is needed within the area of shared leadership. A future research project could be to add a qualitative research question about how work and shared leadership affects different health professionals in the day to day practice both at the managerial as well as the team level to improve health care.Nurses’ views of shared leadership in ICU: A case studyKristina Rosengren, Terese Bondas, Lena Nordholm, Gun Nordström10.1016/j.iccn.2010.06.001Intensive and Critical Care Nursing 26, 4 (2010)2010-08-01Intensive and Critical Care Nursing2010-08-01264S0964-3397(10)X0004-0Original Articles226233http://www.intensivecriticalcarenursing.com/article/PIIS0964339710000364/abstract?rss=yesThis first UK edition of this popular US textbook is an excellent and comprehensive resource for a critical care or high dependency nurse, it is written by nurses for nurses. The book's format is well structured and easy to read. The first two chapters focus on critical care basics which include best practice, infection control, pain control and ethics, which discuss end of life care. Subsequent chapters are divided into body systems and the final chapter focuses on multi-system issues which neatly conclude the book.Anthea Allen10.1016/j.iccn.2010.05.001Intensive and Critical Care Nursing 26, 4 (2010)2010-08-01Intensive and Critical Care Nursing2010-08-01264S0964-3397(10)X0004-0Book Reviews234234http://www.intensivecriticalcarenursing.com/article/PIIS0964339710000236/abstract?rss=yesThis book delivers to the reader ‘exactly what it says on the tin’ and much more. The nursing assessments and interventions are clearly described in a manner that a novice nurse would find easy to follow, this is enhanced with practical advice throughout the book. It is nicely grounded down to minutiae in most chapters (such as avoiding use of a pen torch whose bulb extend beyond the torch) and written in an accessible style. The only possible practice tip I wanted to see but could not find is perhaps the ‘how to’ administer fluid challenges.Sarah Leyland10.1016/j.iccn.2010.03.004Intensive and Critical Care Nursing 26, 4 (2010)2010-08-01Intensive and Critical Care Nursing2010-08-01264S0964-3397(10)X0004-0Book Reviews235235http://www.intensivecriticalcarenursing.com/article/PIIS0964339710000352/abstract?rss=yesThe Publisher regrets that in the above published paper we did not acknowledge that this article was originally published in Australian Critical Care 2008 21(3)127–140. The article is republished with permission from Australian Critical Care.Erratum to “What factors influence suboptimal ward care in the acutely ill ward patient?” [Intensive & Critical Care Nursing 25 (2009) 169–180]Debbie Massey, Leanne M. Aitken, Wendy Chaboyer10.1016/j.iccn.2010.04.003Intensive and Critical Care Nursing 26, 4 (2010)2010-08-01Intensive and Critical Care Nursing2010-08-01264S0964-3397(10)X0004-0Book Reviews236236http://www.intensivecriticalcarenursing.com/article/PIIS0964339710000406/abstract?rss=yesResearch reviews10.1016/j.iccn.2010.05.003Intensive and Critical Care Nursing 26, 4 (2010)2010-08-01Intensive and Critical Care Nursing2010-08-01264S0964-3397(10)X0004-0Book Reviews237238http://www.intensivecriticalcarenursing.com/article/PIIS0964339710000340/abstract?rss=yesChest X-ray quiz10.1016/j.iccn.2010.04.002Intensive and Critical Care Nursing 26, 4 (2010)2010-08-01Intensive and Critical Care Nursing2010-08-01264S0964-3397(10)X0004-0Book Reviews239240