Discharge planning for the patient with a new tracheostomy

1990 ◽  
Vol 10 (7) ◽  
pp. 73-79 ◽  
Author(s):  
EB Wilson ◽  
N Malley
Keyword(s):  
Critical Care ◽  
Planning Process ◽  
Discharge Planning ◽  
Signs And Symptoms ◽  
Critical Care Nurses ◽  
Care Plan ◽  
Discharge Care ◽  
Increased Risk ◽  
Hospital To Home ◽  
Discharge From Hospital

A patient with a new tracheostomy will face threatening changes upon discharge from hospital support. Nurses, particularly in the critical care unit, frequently and closely support a patient and family through new and often difficult situations during hospitalization. The patient leaving the hospital with a new tracheostomy will face problems with secretion management, increased risk of infections, alterations in body image, and impaired vocalization. To ensure a safe transition from the hospital to home, the patient and family must demonstrate competence in all aspects of tracheostomy care, must be able to recognize signs and symptoms that should be reported to the physician, and must have adequate support at home (such as homecare nurses, properly functioning equipment, and access to necessary supplies). These "musts" form the basis of the discharge care plan. Nurses can help a patient successfully manage these problems through comprehensive discharge planning. Although the critical care nurses who initiate the multidisciplinary discharge planning process may not remain involved in that process throughout the patient's hospitalization, their early efforts can provide an orderly, comprehensive discharge plan optimally suited to ensure that the patient and family acquire the necessary skills, confidence, supplies, and support for the eventual transition home. The information, encouragement, skills demonstrations, and referrals to other resources that critical care nurses provide help the patient adjust to a new tracheostomy.

How do critical care nurses define the discharge planning process?

2005 ◽  
Vol 21 (1) ◽  
pp. 39-46 ◽  
Author(s):  
Rosemary J. Watts ◽  
Jane Pierson ◽  
Heather Gardner
Keyword(s):  
Critical Care ◽  
Planning Process ◽  
Discharge Planning ◽  
Critical Care Nurses

Pulmonary Edema in Obstetrics: Essential Facts for Critical Care Nurses

2018 ◽  
Vol 29 (3) ◽  
pp. 327-335 ◽  
Author(s):  
Rebecca L. Cypher
Keyword(s):  
Critical Care ◽  
Pulmonary Edema ◽  
Pregnant Women ◽  
Clinical Management ◽  
Pulmonary Complications ◽  
Pregnancy Complication ◽  
Critical Care Nurses ◽  
Adverse Outcomes ◽  
Increased Risk ◽  
Physiologic Changes Of Pregnancy

Pulmonary edema is an acute pregnancy complication that, if uncorrected, can result in increased maternal and fetal morbidity and mortality. Although pulmonary edema is relatively rare in the general obstetrics population, pregnant patients are at increased risk for pulmonary edema because of the physiologic changes of pregnancy. The risk may be exacerbated by certain pregnancy-related diseases, such as preeclampsia. Prompt identification and appropriate clinical management of pulmonary complications is critical to prevent adverse outcomes in pregnant patients. This article reviews the collaborative treatment of pulmonary edema in pregnant women with complex critical illnesses.

Discharge from hospital and early supported discharge

2020 ◽  
pp. 345-352
Author(s):  
Catherine Gaynor
Keyword(s):  
Discharge Planning ◽  
Models Of Care ◽  
Effective Discharge ◽  
The United Kingdom ◽  
Early Supported Discharge ◽  
Hospital To Home ◽  
Discharge From Hospital ◽  
Applied Health Research

‘Discharge from hospital and early supported discharge’ provides some useful guidance and outlines the issues that we encounter in facilitating effective discharge from hospital following a stroke. Hospital discharge is an important milestone in a stroke patient’s journey. It marks the end of the acute hospital episode, and the start of a new life living with and adjusting to their stroke and its sequelae. It can be a stressful time for patients and their carers, but careful and thorough discharge planning can help to ease the transition from hospital to home. The chapter explores the timing of discharge, models of care after discharge, early supported discharge, the evidence from SSNAP (Sentinel Stroke National Audit Programme) in the United Kingdom, the initiative of CLAHRC (Collaborative for Leadership in Applied Health Research and Care), guidance from the National Institute for Health and Care Excellence (NICE), institutionalization, role of capacity, role of IMCA (independent mental capacity advocate), communication with primary care, and follow-up after discharge from hospital.

A survey of pediatric critical care nurses' knowledge of pain management

1997 ◽  
Vol 6 (4) ◽  
pp. 289-295 ◽  
Author(s):  
C Pederson ◽  
D Matthies ◽  
S McDonald
Keyword(s):  
Critical Care ◽  
Pain Management ◽  
Signs And Symptoms ◽  
Educational Interventions ◽  
Critical Care Nurses ◽  
Toxic Metabolite ◽  
Pediatric Critical Care ◽  
Related Information ◽  
Item Scale ◽  
Nurses Knowledge

BACKGROUND: Although nurses are accountable for pain management, it cannot be assumed that they are well informed about pain. Nurses' knowledge base underlies their pain management; therefore, it is important to measure their knowledge. OBJECTIVE: To measure pediatric critical care nurses' knowledge of pain management. METHOD: A descriptive, exploratory study was done. After a pilot study, an investigator-developed Pain Management Knowledge Test was distributed to 50 pediatric ICU nurses. Test responses were collected anonymously and coded by number. Item analysis was done, and descriptive statistics were calculated. Modified content analysis was used on requests for pain-related information. RESULTS: The test return rate was 38%. The overall mean score was 63%. Mean scores within test subsections varied from 50% to 92%. Other mean scores were 85% on a nine-item scale of drug-action items and 92% on a two-item scale of intervention items. However, no nurse recognized that cognitive-behavioral techniques can inhibit transmission of pain impulses; only 32% indicated that meperidine converts to a toxic metabolite, only 47% recognized nalbuphine as a drug that may cause signs and symptoms of withdrawal if given to a patient who has been receiving an opioid; and only 63% indicated that when a child states that the child has pain, pain exists. Thirteen nurses requested pain-related information, and all requests focused on analgesic medications. CONCLUSIONS: Testing nurses' knowledge of pain indicated gaps that can be addressed through educational interventions. Research is needed in which the test developed for this study is used as both pretest and posttest in an intervention study with pediatric critical care nurses or is modified for use with nurses in other clinical areas.

Nursing Considerations for Patients Requiring Cardiopulmonary Support

1991 ◽  
Vol 2 (3) ◽  
pp. 500-514 ◽  
Author(s):  
Terry K. Bavin
Keyword(s):  
Critical Care ◽  
Nursing Care ◽  
Critical Care Nurses ◽  
Care Plan ◽  
Background Information ◽  
Nursing Management ◽  
Cardiopulmonary Support ◽  
Complex Patients ◽  
Number Of Patients

The number of patients receiving cardiopulmonary support (CPS) is increasing, requiring critical care nurses to be better prepared to care for these complex patients. Background information on CPS along with considerations for nursing management are presented. A case study of a patient requiring CPS and a suggested nursing care plan are included to assist in providing quality nursing care

Continuous fentanyl infusion in children following open-heart surgery

1996 ◽  
Vol 16 (2) ◽  
pp. 113-118 ◽  
Author(s):  
C Jensen ◽  
S Cabeza
Keyword(s):  
Critical Care ◽  
Stress Responses ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Critical Care Nurses ◽  
Care Plan ◽  
Open Heart ◽  
Care Nurse ◽  
Nursing Diagnosis ◽  
Fentanyl Infusion

Fentanyl can be an effective drug for managing sedation and blunting the stress responses in children who have pulmonary hypertension after undergoing open-heart surgery. However, expert nursing care is required to anticipate and assess complications associated with fentanyl infusion. The critical care nurse must be prepared to identify symptoms of narcotic withdrawal and intervene appropriately. In an effort to minimize the complications associated with fentanyl infusion, a care plan was developed that emphasizes the nursing diagnosis related to the care of an anesthetized infant or child in the intensive care unit (Table 2). This care plan is a guide to help critical care nurses care for an infant or child receiving a continuous fentanyl infusion.

Hereditary Hemorrhagic Telangiectasia: A Primer for Critical Care Nurses

2016 ◽  
Vol 36 (3) ◽  
pp. 36-48 ◽  
Author(s):  
Kathleen M. Sacco ◽  
Thomas W. Barkley
Keyword(s):  
Critical Care ◽  
Health Care Providers ◽  
Genetic Disease ◽  
Hereditary Hemorrhagic Telangiectasia ◽  
Arteriovenous Malformations ◽  
Early Death ◽  
Signs And Symptoms ◽  
Critical Care Nurses ◽  
Care Providers ◽  
Abnormal Growth

Hereditary hemorrhagic telangiectasia is a rare, autosomal dominant genetic disease that causes abnormal growth of blood vessels and, subsequently, life-threatening arteriovenous malformations in vital organs. Epistaxis may be one of the initial clues that a patient has more serious, generalized arteriovenous malformations. Recommended treatment involves careful evaluation to determine the severity and risk of spontaneous rupture of the malformations and the management of various signs and symptoms. The disease remains undiagnosed in many patients, and health care providers may miss the diagnosis until catastrophic events happen in multiple family members. Prompt recognition of hereditary hemorrhagic telangiectasia and early intervention can halt the dangerous course of the disease. Critical care nurses can assist with early diagnosis within families with this genetic disease, thus preventing early death and disability.

Improving patient care after a suicide attempt

2018 ◽  
Vol 26 (2) ◽  
pp. 145-148 ◽  
Author(s):  
Fiona Shand ◽  
Laura Vogl ◽  
Jo Robinson
Keyword(s):  
Suicide Attempt ◽  
Discharge Planning ◽  
Psychosocial Assessment ◽  
Coordinated Care ◽  
Effective Discharge ◽  
Effective Care ◽  
Increased Risk ◽  
Discharge From Hospital ◽  
Improving Patient Care ◽  
Risky Patients

Objectives: Improving the care that patients receive after a suicide attempt will reduce the risk of a subsequent suicide attempt. We described how care for these patients can be improved and identified the available guidelines. Methods: We reviewed the literature on crisis and aftercare, psychosocial assessment, risk assessment, brief contact interventions, and brief interventions. Results: People who have made a suicide attempt are at increased risk of suicide, and the period immediately after discharge from hospital is particularly risky. Patients require an empathic response at their first point of contact, comprehensive psychosocial assessment, effective discharge planning, rapid and assertive follow-up, and coordinated care in the subsequent months. Conclusions: Empathic and effective care that begins in the emergency department and extends through to community care is imperative. Enough is known about the risks of inadequate care and the key ingredients of effective care to proceed with changes to Australia’s healthcare response to a suicide attempt.

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