scholarly journals Nurses’ Perceived Barriers to and Facilitators of Pain Assessment and Management in Critical Care Patients: A Systematic Review

2021 ◽  
Vol Volume 14 ◽  
pp. 3475-3491
Author(s):  
Mohammad Rababa ◽  
Shatha Al-Sabbah ◽  
Audai A Hayajneh
Keyword(s):  
Systematic Review ◽  
Critical Care ◽  
Pain Assessment ◽  
Perceived Barriers ◽  
Critical Care Patients

Nonpharmacological Interventions to Prevent Delirium: An Evidence-Based Systematic Review

2015 ◽  
Vol 35 (1) ◽  
pp. 39-49 ◽  
Author(s):  
Ryan M. Rivosecchi ◽  
Pamela L. Smithburger ◽  
Susan Svec ◽  
Shauna Campbell ◽  
Sandra L. Kane-Gill
Keyword(s):  
Systematic Review ◽  
Mechanical Ventilation ◽  
Critical Care ◽  
Length Of Stay ◽  
Adverse Effects ◽  
Hospital Costs ◽  
Evidence Based ◽  
Inpatient Settings ◽  
Stay Hospital ◽  
Critical Care Patients

Development of delirium in critical care patients is associated with increased length of stay, hospital costs, and mortality. Delirium occurs across all inpatient settings, although critically ill patients who require mechanical ventilation are at the highest risk. Overall, evidence to support the use of antipsychotics to either prevent or treat delirium is lacking, and these medications can have adverse effects. The pain, agitation, and delirium guidelines of the American College of Critical Care Medicine provide the strongest level of recommendation for the use of nonpharmacological approaches to prevent delirium, but questions remain about which nonpharmacological interventions are beneficial.

scholarly journals Impact of Enteral Nutrition Formulations Containing Dietary Fiber on Diarrhea Outcomes in Hospitalized Critical Care Patients: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 842-842
Author(s):  
Kelly Cara ◽  
Andrew Beauchesne ◽  
Taylor Wallace ◽  
Mei Chung
Keyword(s):  
Systematic Review ◽  
Critical Care ◽  
Enteral Nutrition ◽  
Dietary Fiber ◽  
Critically Ill ◽  
Random Effects ◽  
Critically Ill Patients ◽  
Outcome Data ◽  
Meta Analyses ◽  
Critical Care Patients

Abstract Objectives The objective is to conduct a systematic review on the safety of using enteral nutrition formulations containing dietary fiber in hospitalized critical care patients. Methods This systematic review was conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions (Version 6.1,2020). Searches were implemented in four databases on 4/20/20. Results were limited to English language studies conducted in humans. Any clinical study design or case study measuring adverse events (e.g., diarrhea and mortality) or health outcomes (as defined in each study) associated with enteral nutrition interventions containing dietary fiber in adult critically ill patients was considered. Random effects meta-analyses were conducted on outcomes assessed by three or more included studies. Results Altogether, 18 articles were included, and 11 randomized controlled trials assessed diarrhea outcomes (i.e., diarrhea score and number or frequency of events). Six studies used the Hart and Dobb (1988) diarrhea score, and random effects meta-analyses showed the mean diarrhea scores were lower for fiber compared to non-fiber groups (n = 4, pooled mean difference: −2.78, 95% confidence interval: −4.10, −1.47). Five of seven reported group comparisons showed fewer diarrhea events for fiber compared with non-fiber groups, although the overall difference was not statistically significant (n = 7, pooled risk ratio: 0.68, 95% CI: 0.45, 1.02). For three studies using other or unspecified scoring methods, pooled results showed significantly fewer diarrhea events in the fiber groups compared to non-fiber groups (n = 3, pooled RR: 0.42, 95% CI: 0.20, 0.89). Studies reported no difference in incidence of mortality due to fiber interventions (n = 7, pooled RR: 0.99, 95% CI: 0.66, 1.48). Risk of bias for diarrhea outcomes was high due to missing outcome data, and there was some concern for bias due to randomization, measurement of the outcome, and selection of reported results. Conclusions Enteral nutrition formulas with fiber may help reduce incidence and severity of diarrhea in critically ill patients without increasing incidence of mortality. As these results are subject to bias, more high-quality studies are needed to verify this conclusion. Funding Sources This study was supported by funding from an unrestricted educational grant from Nestle Health Sciences.

Clinical judgment and management of postoperative pain in critical care patients

1996 ◽  
Vol 5 (6) ◽  
pp. 433-441 ◽  
Author(s):  
D Stannard ◽  
K Puntillo ◽  
C Miaskowski ◽  
S Gleeson ◽  
K Kehrle ◽  
...  
Keyword(s):  
Critical Care ◽  
Postoperative Pain ◽  
Pain Assessment ◽  
Clinical Judgment ◽  
Postanesthesia Care Unit ◽  
Clinical Judgments ◽  
Interpretive Phenomenology ◽  
Thinking Aloud ◽  
Respiratory Conditions ◽  
Critical Care Patients

BACKGROUND: Acute pain is a significant problem in critical care patients. Although many barriers to successful assessment and management of pain in critical care patients have been noted, little is known about how critical care nurses make clinical judgments when assessing and managing patients' pain. OBJECTIVE: This qualitative analysis is part of a pilot study evaluating nurses' use of a pain assessment and intervention notation algorithm in patients in critical care areas who have limited communication abilities after abdominal or thoracic surgery. METHOD: Transcribed audiotapes of nurse participants' "thinking aloud" while using the pain assessment and intervention notation algorithm were analyzed by using interpretive phenomenology. The interpretive account is based on 31 tape recordings of 14 nurses caring for 41 patients (12 patients in the ICU and 29 patients in the postanesthesia care unit). FINDINGS: The two domains of clinical judgment found were (1) assessing the patient and (2) balancing interventions. CONCLUSIONS: Many nurses' reports showed that they accurately assessed their patients' needs for analgesics. Through testing of and learning from their patients' responses, nurses were able to give amounts of analgesics that diminished patients' postoperative pain. Additionally, nurses had to balance analgesic administration against the patients' hemodynamic and respiratory conditions, medical plan and prescriptions, and the desires of the patients and the patients' families.

scholarly journals Risk factors for pressure injuries among critical care patients: A systematic review

2017 ◽  
Vol 71 ◽  
pp. 97-114 ◽  
Author(s):  
Jenny Alderden ◽  
June Rondinelli ◽  
Ginette Pepper ◽  
Mollie Cummins ◽  
JoAnne Whitney
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Critical Care ◽  
Critical Care Patients

scholarly journals Gastric tonometry guided therapy in critical care patients: a systematic review and meta-analysis

Critical Care ◽  
2015 ◽  
Vol 19 (1) ◽  
pp. 22 ◽  
Author(s):  
Xin Zhang ◽  
Wei Xuan ◽  
Ping Yin ◽  
Linlin Wang ◽  
Xiaodan Wu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Critical Care ◽  
Meta Analysis ◽  
Gastric Tonometry ◽  
Critical Care Patients ◽  
Guided Therapy

scholarly journals Fluid Overload and Mortality in Adult Critical Care Patients—A Systematic Review and Meta-Analysis of Observational Studies*

2020 ◽  
Vol 48 (12) ◽  
pp. 1862-1870 ◽  
Author(s):  
Anna S. Messmer ◽  
Carina Zingg ◽  
Martin Müller ◽  
Joel Loic Gerber ◽  
Joerg Christian Schefold ◽  
...  
Keyword(s):  
Systematic Review ◽  
Critical Care ◽  
Observational Studies ◽  
Fluid Overload ◽  
Meta Analysis ◽  
Critical Care Patients
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