Easy as ABC: How Staff Nurses Transformed Unit Culture to Assess and Manage Delirium in the Intensive Care Unit

2016 ◽  
Vol 36 (5) ◽  
pp. 73-76 ◽  
Author(s):  
Kaitlyn A. Gregory
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Staff Nurses ◽  
Unit Culture

Implementing Potentially Better Practices for Multidisciplinary Team Building: Creating a Neonatal Intensive Care Unit Culture of Collaboration

PEDIATRICS ◽  
2003 ◽  
Vol 111 (Supplement_E1) ◽  
pp. e482-e488
Author(s):  
Mark S. Brown ◽  
Judy Ohlinger ◽  
Connie Rusk ◽  
Paula Delmore ◽  
Patricia Ittmann ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Focus Group ◽  
Cultural Change ◽  
Multidisciplinary Team ◽  
Neonatal Intensive Care ◽  
Team Building ◽  
Neonatal Intensive Care Units ◽  
Unit Culture ◽  
Multidisciplinary Teamwork

Objective. Part of the process of deriving and refining the CARE (communication, accountability, respect, empowerment) focus group’s potentially better practices (PBPs) for multidisciplinary teamwork was to evaluate and experience the PBPs through implementation. Methods. The 4 neonatal intensive care units (NICUs) in the CARE focus group each worked with implementation of the PBPs. The choice of initial PBP and method of implementation was left up to each NICU’s core team. Results. The experience of each of the PBPs that is reported was selected from only 1 of the NICUs. These are summarized and described in a plan-do-study-act type of format. Conclusions. There was no ideal PBP with which to start. The intertwined nature of all of the PBPs provided additional opportunities to implement other PBPs. A change seemed to be a matter first of vocabulary, then of tentative acceptance, followed by gradual integration into the culture. Change was facilitated when there was acknowledgment of a need to do things differently by the NICU leadership. Although the validity of the PBPs and their importance in cultural change have yet to be confirmed, once there was a persisting intent to change, the makeup of the NICU culture moved to embrace change as part of its culture.

Intensive care unit staff nurses: predicting factors for career decisions

2008 ◽  
Vol 17 (14) ◽  
pp. 1886-1896 ◽  
Author(s):  
Hui-Ling Lai ◽  
Ya-Ping Lin ◽  
Hui-Kuan Chang ◽  
Shu-Chen Wang ◽  
Yun-Ling Liu ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Career Decisions ◽  
Staff Nurses ◽  
Intensive Care Unit Staff ◽  
Predicting Factors

scholarly journals Assessing Nursing Enteral Nutrition Practices and Perspectives in An Intensive Care Unit of A Level Six Hospital in Kenya

2020 ◽  
Vol 8 (6) ◽  
Author(s):  
DANIEL KOMEN
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Enteral Nutrition ◽  
Study Design ◽  
Enteral Feeding ◽  
Tube Feeding ◽  
Staff Nurses ◽  
Comprehensive Management ◽  
Nutrition Practices ◽  
Ryle’S Tube

Background: Adequate nutritional support is important for the comprehensive management of patients in intensive care units (ICUs). Aim: The study was aimed to survey prevalent enteral nutrition practices in the general intensive care unit, nurses' perception, and their knowledge of enteral feeding. Study Design: The study was conducted in the ICU of a level 6 hospital in Kenya. The study design used was crosses sectional descript study. Materials and Methods: thirty four questionnaires were distributed and the results analyzed. A database was prepared and analyzed.Results: all (100%) questionnaires were filled and returned. A majority (32) of staff nurses expressed awareness of nutrition guidelines. A large number (27) of staff nurses knew about existence of nutrition protocols in the ICU. Almost all nurses (82.4%) chose enteral nutrition as their preferred route of nutrition unless contraindicated. All staff nurses were of the opinion that enteral nutrition is to be started at the earliest (within 24-48 h of the ICU stay). Half (50%) were of the thought that the absence of bowel sounds is an absolute contraindication to initiate enteral feeding. Passage of a nasogastric tube (Ryle’s tube) was considered mandatory before starting enteral nutrition by 86% of the respondents. Everyone knew that the method of Ryle's tube feeding in their ICU is intermittent boluses. Only 4 staff nurses were unaware of any method to confirm Ryle's tube position. The backrest elevation rate was 70%. Gastric residual volumes were always checked, but the amount of the gastric residual volume for the next feed to be withheld varied. The majority said that the unused Ryle's tube feed is to be discarded after 24 h. The most preferred (48%) to upgrade their knowledge of enteral nutrition as a personal initiative and CME.Conclusion: Information generated from this study can be helpful in identifying nutrition practices gaps and may be used to review and revise enteral feeding practices where necessary. Keywords: Enteral nutrition, intensive care, nursing, tube feeding

Understanding Collaboration Between Nurses and Physicians as Knowledge at Work

2007 ◽  
Vol 16 (5) ◽  
pp. 470-477 ◽  
Author(s):  
Jane Stein-Parbury ◽  
Joan Liaschenko
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Work ◽  
Organizational Structures ◽  
Clinical Problem ◽  
Knowledge Use ◽  
Class Differences ◽  
Types Of Knowledge ◽  
Nurses And Physicians ◽  
Unit Culture

Background Collaboration between nurses and physicians is linked to positive outcomes for patients, especially in the intensive care unit. However, effective collaboration poses challenges because of traditional barriers such as sex and class differences, hierarchical organizational structures in health-care, and physicians’ belief that they are the final arbiter of clinical decisions. Objective To further analyze the results of an investigation on how intensive care unit culture, expressed through everyday practices, affected the care of patients who became confused. Methods A model of the types of knowledge (case, patient, and person) used in clinical work was used to analyze the breakdown in collaboration detected in the original study. Results Breakdown of collaboration occurred because of the types of knowledge used by physicians and nurses. Certain types of knowledge were privileged even when not applicable to the clinical problem, whereas other types were dismissed even when applicable. Conclusion Viewing collaboration through the conceptual lens of knowledge use reveals new insights. Collaboration broke down in the specific context of caring for patients with confusion because the use of case knowledge, rather than patient knowledge, was prominent in the intensive care unit culture.

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