Empowering the "Cheerers": Role of Surgical Intensive Care Unit Nurses in Enhancing Family Resilience

2015 ◽  
Vol 25 (1) ◽  
pp. 39-45 ◽  
Author(s):  
L. Ellis ◽  
J. Gergen ◽  
L. Wohlgemuth ◽  
M. T. Nolan ◽  
R. Aslakson
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Family Resilience ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Intensive Care Unit Nurses

Staphylococcus AureusRectal Carriage and its Association with Infections in Patients in a Surgical Intensive Care Unit and a Liver Transplant Unit

2002 ◽  
Vol 23 (9) ◽  
pp. 495-501 ◽  
Author(s):  
Cheryl Squier ◽  
John D. Rihs ◽  
Kathleen J. Risa ◽  
Asia Sagnimeni ◽  
Marilyn M. Wagener ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Liver Transplant ◽  
Nasal Carriage ◽  
Pulsed Field Gel Electrophoresis ◽  
Surgical Intensive Care Unit ◽  
Transplant Recipients ◽  
Surgical Intensive Care ◽  
Liver Transplant Recipients

Background:The role of rectal carriage ofStaphylococcus aureusas a risk factor for nosocomialS. aureusinfections in critically ill patients has not been fully discerned.Methods:Nasal and rectal swabs forS. aureuswere obtained on admission and weekly thereafter until discharge or death from 204 consecutive patients admitted to the surgical intensive care unit and liver transplant unit.Results:Overall, 49.5% (101 of 204) of the patients never harboredS. aureus, 21.6% (44 of 204) were nasal carriers only, 3.4% (7 of 204) were rectal carriers only, and 25.5% (52 of 204) were both nasal and rectal carriers. Infections due toS. aureusdeveloped in 15.7% (32 of 204) of the patients; these included 3% (3 of 101) of the non-carriers, 18.2% (8 of 44) of the nasal carriers only, 0% (0 of 7) of the rectal carriers only, and 40.4% (21 of 52) of the patients who were both nasal and rectal carriers (P= .001). Patients with both rectal and nasal carriage were significantly more likely to developS. aureusinfection than were those with nasal carriage only (odds ratio, 3.9; 95% confidence interval, 1.18 to 7.85;P= .025). By pulsed-field gel electrophoresis, the infecting rectal and nasal isolates were clonally identical in 82% (14 of 17) of the patients withS. aureusinfections.Conclusions:Rectal carriage represents an underappreciated reservoir forS. aureusin patients in the intensive care unit and liver transplant recipients. Rectal plus nasal carriage may portend a greater risk forS. aureusinfections in these patients than currently realized.

Determinants of Nurses’ Use of Physical Restraints in Surgical Intensive Care Unit Patients

2017 ◽  
Vol 26 (5) ◽  
pp. 373-379 ◽  
Author(s):  
Jeanne Dolan ◽  
Sara E. Dolan Looby
Keyword(s):  
Intensive Care Unit ◽  
Content Analysis ◽  
Intensive Care ◽  
Patient Specific ◽  
Surgical Intensive Care Unit ◽  
Physical Restraints ◽  
Surgical Intensive Care ◽  
Critical Thought ◽  
Patients At Risk ◽  
Intensive Care Unit Nurses

Background Physical restraints are used in intensive care units, particularly among patients at risk for self-terminating necessary treatment interventions, including endotracheal tubes and invasive catheters. Assessments conducted by intensive care unit nurses often influence the collaborative decision to initiate and discontinue restraints in critical care patients. However, little is known about factors that influence the critical thought processes of intensive care unit nurses in determining use of restraints. Objectives To describe nurses’ determinants of initiation and discontinuation of restraints in surgical intensive care unit patients. Methods Semistructured interviews were conducted to identify and describe determinants of initiation and discontinuation of physical restraints. Demographic and employment data were collected via questionnaire. Interviews were recorded, transcribed, and analyzed by using conventional content analysis to establish categories and identify themes. Results A total of 13 nurses (mean age 43 [SD, 12] years, 92% female, mean of 18 [SD, 12] years of practice as a registered nurse, 69% bachelor of science in nursing) participated in the study. Content analysis revealed 3 general categories and 8 themes that indicated the thoughtful reflection processes nurses in a surgical intensive care unit use to determine use of restraints. Conclusions Top priorities were ensuring patient safety and comfort. Nurses synthesized factors including practice experience, patient-specific behaviors and risk, and patients’ need for devices in determining use of restraints.

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