scholarly journals Assessing whether COVID-19 patients will benefit from critical care, and an objective approach to capacity challenges during a pandemic: An Intensive Care Society clinical guideline

2020 ◽  
pp. 175114372094853 ◽  
Author(s):  
J Montgomery ◽  
HJ Stokes-Lampard ◽  
MD Griffiths ◽  
D Gardiner ◽  
D Harvey ◽  
...  
Keyword(s):  
Decision Making ◽  
Critical Care ◽  
Clinical Decision Making ◽  
Clinical Guideline ◽  
Resource Limitation ◽  
Clinical Decision ◽  
Mutual Aid ◽  
Ethical Frameworks ◽  
Available Information ◽  
Case Basis

This national professional society guidance lays out operational and ethical principles for decision-making during a pandemic, in the immediate context of COVID-19 in the early 2020 surge iteration but with potential ongoing relevance. It identifies the different phases of a pandemic and the implications for capacity and mutual aid within a national healthcare system, and introduces a revised CRITCON-PANDEMIC framework for shared operational responsibilities and clinical decision-making. Usual legal and ethical frameworks should continue to apply while capacity and mutual aid are available (CRITCON-PANDEMIC levels 0-3); clinicians should focus on current clinical needs and should not treat patients differently because of anticipated future pressures. In conditions of resource limitation (CRITCON-PANDEMIC 4), a structured and equitable approach is necessary and an objective Decision Support Aid is proposed. In producing this guidance, we emphasise that all patients must be treated with respect and without discrimination, because everyone is of equal value. The guidance has been put together with input from patient and public groups and aims to provide standards that are fair to everyone. We acknowledge that COVID-19 is a new disease with a partial and evolving knowledge base, and aim to provide an objective clinical decision-making framework based on the best available information. It is recognised that a factual assessment of likely benefit may take into account age, frailty and comorbidities, but the guidance emphasises that every assessment must be individualised on a balanced, case by case, basis and may inform clinical judgement but not replace it. The effects of a comorbidity on someone's ability to benefit from critical care should be individually assessed. Measures of frailty should be used with care, and should not disadvantage those with stable disability.

Benner’s Framework and Clinical Decision-Making in the Critical Care Environment

2016 ◽  
Vol 30 (1) ◽  
pp. 52-57 ◽  
Author(s):  
Kristi J. Stinson
Keyword(s):  
Decision Making ◽  
Critical Care ◽  
Clinical Experience ◽  
Strong Correlation ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Decision Making Process ◽  
Clinical Experiences ◽  
Care Environment ◽  
Decision Making Processes

Completed as part of a larger dissertational study, the purpose of this portion of this descriptive correlational study was to examine the relationships among registered nurses’ clinical experiences and clinical decision-making processes in the critical care environment. The results indicated that there is no strong correlation between clinical experience in general and clinical experience in critical care and clinical decision-making. There were no differences found in any of the Benner stages of clinical experience in relation to the overall clinical decision-making process.

Understanding critical care nurses’ autonomy in Jordan

2017 ◽  
Vol 30 (4) ◽  
pp. 432-442 ◽  
Author(s):  
Mahmoud Maharmeh
Keyword(s):  
Decision Making ◽  
Critical Care ◽  
Clinical Practice ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Critical Care Nurses ◽  
Cross Sectional Survey ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Content Type

Purpose The aim of this study was to describe Jordanian critical care nurses’ experiences of autonomy in their clinical practice. Design/methodology/approach A descriptive correlational design was applied using a self-reported cross-sectional survey. A total of 110 registered nurses who met the eligibility criteria participated in this study. The data were collected by a structured questionnaire. Findings A majority of critical care nurses were autonomous in their decision-making and participation in decisions to take action in their clinical settings. Also, they were independent to develop their own knowledge. The study identified that their autonomy in action and acquired knowledge were influenced by a number of factors such as gender and area of practice. Practical implications Nurse’s autonomy could be increased if nurses are made aware of the current level of autonomy and explore new ways to increase empowerment. This could be offered through classroom lectures that concentrate on the concept of autonomy and its implication in practice. Nurses should demonstrate autonomous nursing care at the same time in the clinical practice. This could be done through collaboration between educators and clinical practice to help merge theory to practice. Originality/value Critical care nurses were more autonomous in action and knowledge base. This may negatively affect the quality of patient care and nurses’ job satisfaction. Therefore, improving nurses’ clinical decision-making autonomy could be done by the support of both hospital administrators and nurses themselves.

Practice and clinical decision-making autonomy among Hellenic critical care nurses

2005 ◽  
Vol 13 (2) ◽  
pp. 154-164 ◽  
Author(s):  
ELIZABETH D.E. PAPATHANASSOGLOU ◽  
MARIA TSERONI ◽  
ATHENA KARYDAKI ◽  
GEORGIA VAZAIOU ◽  
JOANNA KASSIKOU ◽  
...  
Keyword(s):  
Decision Making ◽  
Critical Care ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Critical Care Nurses

Strategies and Criteria for Clinical Decision Making in Critical Care Nurses: A Qualitative Study

2009 ◽  
Vol 41 (4) ◽  
pp. 351-358 ◽  
Author(s):  
Farhad Ramezani-Badr ◽  
Alireza Nikbakht Nasrabadi ◽  
Zohre Parsa Yekta ◽  
Fariba Taleghani
Keyword(s):  
Decision Making ◽  
Critical Care ◽  
Qualitative Study ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Critical Care Nurses

scholarly journals Recovery from profound acidosis (pH 6.685) in multi-organ dysfunction syndrome

2019 ◽  
pp. 175114371987010
Author(s):  
Eryl A Davies ◽  
Christopher Saleh ◽  
Jonathan Bannard-Smith
Keyword(s):  
Decision Making ◽  
Emergency Department ◽  
Cardiac Arrest ◽  
Critical Care ◽  
Organ Dysfunction ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Circulatory Shock ◽  
Arterial Ph ◽  
Multi Organ Dysfunction Syndrome

Acidosis is a common feature of patients referred to critical care from the emergency department. We present the case of a 49-year-old female with multi-organ dysfunction syndrome (MODS) and an arterial pH of 6.685 on arrival to the emergency department. This case is unique as the patient was in circulatory shock with MODS from rhabdomyolysis on arrival and had not suffered a cardiac arrest. We believe this to be the first reported case of full recovery from such an extreme metabolic disturbance in this context, and discuss the relevance of profound acidosis to early clinical decision-making.

scholarly journals Focused echocardiography: a systematic review of diagnostic and clinical decision-making in anaesthesia and critical care

Anaesthesia ◽  
2016 ◽  
Vol 71 (9) ◽  
pp. 1091-1100 ◽  
Author(s):  
J. Heiberg ◽  
D. El-Ansary ◽  
D. J. Canty ◽  
A. G. Royse ◽  
C. F. Royse
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Critical Care ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Focused Echocardiography
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