Background: Ventilator-associated pneumonia rates in me medical-surgical intensive care unit first exceeded the 90th percentile in September 1997 and were significantly (P < .05) higher than National Nosocomial Inf...
详细信息
Background: Ventilator-associated pneumonia rates in me medical-surgical intensive care unit first exceeded the 90th percentile in September 1997 and were significantly (P < .05) higher than National Nosocomial Infections Surveillance System pooled mean data. In January 1998, a multidisciplinary "Critical Care Bug Team" was developed by the Infection Control Committee to review 1997 National Nosocomial Infections Surveillance System data for four adult intensive care units in a 583-bed tertiary care hospital. Methods: Membership included clinical nurse specialists, a dietitian, a pharmacist, a respiratory therapist, an infection control professional, a research specialist, and a physician adviser. Having the team report directly to the hospital's Infection Control and Adult Critical Care Committees maximized support for recommendations and provided a direct link from patient care to hospital administration. By identifying issues, evaluating patient care processes, performing literature searches, and monitoring compliance, the team implemented numerous interventions, including policy and procedure changes, purchasing of equipment, and implementation of various education tools. Results: Each member of the Critical Care Bug Team contributed to a synergized effort that may have produced the desired outcome of decreasing ventilator-associated pneumonia rates. Except for August 1998, ventilator-associated pneumonia rates have been below the 75th percentile since May 1998. Conclusion: This study illustrates the effectiveness of a multidisciplinary team approach devised to reduce and stabilize ventilator-associated pneumonia rates in a medical-surgical intensive care unit.
Perioperative nurses have options in advanced practice instead of leaving the acute care setting. One of the newest advanced practice roles is the acute care nurse practitioner (ACNP). This role may be ideal for perio...
详细信息
Perioperative nurses have options in advanced practice instead of leaving the acute care setting. One of the newest advanced practice roles is the acute care nurse practitioner (ACNP). This role may be ideal for perioperative nurses who want to remain in perioperative practice and grow clinically by pursuing advanced practice. This article presents two collaborative practice examples for the ACNP in the perioperative setting. The authors describe new frontiers in advanced perioperative practice and analyze the emerging advanced practice role of the ACNP. This challenging and exciting role is well suited to perioperative practice in a general and trauma surgery practice. The academic preparation, certification, and credentialing necessary to practice as an ACNP are explained.
Progressive DSM programs in the outpatient setting have positively influenced HF patient QOL as reflected in improved exercise tolerance and a reduction in emergency care and hospital admissions. For programs to be ef...
详细信息
Progressive DSM programs in the outpatient setting have positively influenced HF patient QOL as reflected in improved exercise tolerance and a reduction in emergency care and hospital admissions. For programs to be effective, pharmacologic and nonpharmacologic therapies must be incorporated. Nurses are active team members and can influence the success of the program, especially if they are knowledgeable and technically capable in management processes. Use of practice guidelines, standards of care, or algorithms allow for increased nurse autonomy and improve patient access to care and response times. The need to expand the DSM concept throughout the continuum of care is great. Future program development and outcomes research is necessary to provide direction in the implementation of high-quality, cost-effective programs.
暂无评论