NR340 Exam 1
(Complete solutions and resources for the course exam)
Overview of CC
Critical Care Nursing
Deals with human responses to critical illness or injury
o Physiological
o Psychological
Focus on both t
...
NR340 Exam 1
(Complete solutions and resources for the course exam)
Overview of CC
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
onlystudents
NR340 Exam 1 Chapters 1, 2, 3, 5, 7, 9, 14, pgs 228-324 Page 2 of 33
o Communication
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)
onlystudents
NR340 Exam 1 Chapters 1, 2, 3, 5, 7, 9, 14, pgs 228-324 Page 3 of 33
↓Mobility, ↓Comfort
Psychosocial Support (HI
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