Intensive Care Nursing

 

 

INTENSIVE CARE NURSING SuBMitted by: KIMberly P. BARRedo Bsniv-4

A. General information  information 

 

1. Critical

care nursing deals with human responses to life-threatening problems and includes the critically ill patient, patient, the critical

care nurse, nurse, and the critical care environment. 2. It is the field of nursing with a focus on the care of the critically ill or unstable patients. 3. Care is provided to patients of all ages with alterations in physical or emotional health. 4. The critical care nurse coordinates interventions aimed at resolving life-threatening problems. 5. Critical care nurses can be found working in a wide variety of environments and specialties, such as emergency departments and the intensive care units. B. Critically Ill Patient  Patient  1. Critically

ill patients are defined as those patients who are at high risk for actual or potential life-threatening health problems.

2. The critically ill patient is at high risk for developing life-threatening problems and requires constant, intensive, multidisciplinary assessment and intervention to restore stability, prevent complications, and achieve and maintain optimal responses 3. The more critically ill the patient is, the more likely he or she is to be highly vulnerable, unstable and complex, thereby requiring intense and vigilant nursing care. care.  C.

History of Critical Care Nursing  Nursing  Critical care evolved from an historical recognition that the needs of patients with acute, life-threatening illness or injury could be better treated if they were grouped into specific areas of the hospital. Nurses have long recognized that very sick patients receive more attention if they are located near the nursing station.

 

Florence

 

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During World War II, shock wards were established to resuscitate and care for soldiers injured in battle or undergoing surgery. The nursing shortage, which followed World War II, forced the grouping of postoperative patients in recovery rooms to ensure attentive care. The obvious benefits in improved patient care resulted in the spread of recovery rooms to nearly every hospital by 1960. In 1947-1948, the polio epidemic raged through Europe and the United States, resulting in a breakthrough in the treatment of patients dying from respiratory paralysis. In Denmark, manual ventilation was accomplished through a tube placed in the trachea of polio patients. Patients with respiratory paralysis and/or suffering from acute circulatory failure required intensive nursing care.

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Nightingale wrote about the advantages of establishing a separate area of the hospital for patients recovering from surgery. care began in the United States when Dr. W.E. Dandy opens a three-bed unit for postoperative neurosurgical patients at the Johns Hopkins Hospital in Baltimore. In 1927, the first hospital premature-born infant care center was established at the Sarah Morris Hospital in Chicago.

 

During the 1950s, the development of mechanical ventilation led to the organization of respiratory intensive care units (ICUs) in many European and American hospitals. The care and monitoring of  mechanically ventilated patients proved to be more efficient when patients were grouped in a single location. General ICUs for very sick patients, including postoperative patients, were developed for the similar reasons.

 

Johns Hopkins Bayview Medical Center became the first multidisciplinary intensive care unit ( ICU) in the United States. Created in 1958 at Baltimore City Hospitals, now Johns Hopkins Bayview, this first multidisciplinary ICU in the country led the way for optimal medical and nursing care to critically ill patients 24 hours a day. It was also the first ICU covered by an in-house physician (anesthesia resident) 24/7. By the late 1960s, most United States hospitals had at least one ICU. In 1970, 28 physicians with a major interest in the care of the critically ill and injured met in Los Angeles, California to discuss the formation of an organization committed to meeting the needs of critical care patients: the Society of Critical Care Medicine (SCCM). In 1986, the American Board of Medical Specialties approved a certification of special competence in critical care for the four primary boards: anesthesiology, internal medicine, pediatrics, and surgery.

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Between 1990 and the present, critical care significantly reduced in-hospital time as well as costs incurred by patients with diseases such as cerebrovascular insufficiency and respiratory failure. o  The development of new and complicated surgical procedures, such as transplantation of the liver, lung, hearts, small intestine, and pancreas, created a new and important role for critical care following transplantation. o  Widespread utilization of non-invasive patient monitoring has further reduced the cost and medical/nursing complications, such as infection, associated with care of critically ill and injured patients. Widespread utilization of pharmacologic therapy for critical care patients with specific organ o  system failure reduced time spent in both critical care units and in the health care facility.

 

In

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1997, more than 5,000 ICUs were operational in intensive care units across the United States.

Trends in Pediatric Critical Care Nursing

 

Trends

in Pediatric Critical Care Nursing By Debra Donahue In

the interest of providing cost-effective and high-quality care, a growing number of health care organizations are enhancing their pediatric critical care nursing staff, by hiring nurses with an even higher professional scope of  practice. Two such examples include; the pediatric clinical nurse specialists (CNS) who tends to work within the hospital setting and the pediatric nurse practitioner (NP), who often works in outpatient clinics. The

need for more specialized pediatric critical care nursing stems from changes in health care delivery systems and the fact that patients are having more dynamic and complex health care needs. In an effort to create a more seamless, synchronized and effective method of care delivery, some health care professionals are advocating that these two roles, the CNS and NP, be merged into one advanced nursing role.

Pediatric critical care nursing is specialized, in that it focuses on the pediatric patient. However an advanced practice nurse, such as the NP, has further training and the knowledge required for taking histories, performing physical exams, making a dia gnoses, and prescribing medications. The CNS focuses more on patient and staff  education; they are valued for their unique contributions to case management, care coordination, and patient teaching. he exact scope of the CNS and NP roles can be governed by the policies and procedures of their employer, as well as their state licensing board. Advocates for merging these roles, suggest that an advanced pediatric critical care nurse should be able to p erform both of these roles, of CNS and N P. Health care organizations are concerned about containing costs, ensuring patient and family satisfaction and improving quality of care. Pediatric critical care nursing benefits by having access to these higher level specializations. Some specialty physicians, such as pediatric cardiologists, recognize that employing a pediatric NP may support the expansion of his/her current practice. However, not all professions will necessarily be supportive of a merger between the CNS and the NP roles; some Physician Assistance may perceive the new Advanced Practitioner role as a threat to their current positions. Moving forward with this proposed merger will require restructuring at the academic and institutional levels. Educational administrators will be required to find innovative ways of facilitating the enrollment process for nurses who wish to progress from pediatric critical care nursing, toward advance practice nursing. Offering these courses via distance education or through evening courses, may facilitate the nurse's ability to pursue professional development and career advancement, while at the same time balancing work, family and school. Beyond physiology, pathophysiology, pharmacology and diagnostics, the APN is expected to be knowledgeable in the areas of health promotion, counseling, and management of common pediatric conditions from birth through adolescences. The APN is also expected to support the administration team. Therefore,

the course curriculum is expected to cover management principles such as budgeting, creating and developing corporate policies and procedures and managing human resources; each of these issues a ffects the APN's role. Pediatric critical care nursing has become increasingly complex. The merging of the CNS and NP roles into one advance practice nursing role is expected to produce a more efficient and effective form of care delivery. However, the benefits of such a merger continue to be hotly debate d amongst academic circles. Time will tell whether the CNS and NP roles merge or remain distinct and separate positions; in either case, these advanced level roles play a critical role in providing cost-effective and e fficient quality of care.

REEFERENCES: http://nursingcrib.com/nursing-notes-reviewer/critical-care-nursing/

http://www.myicucare.org/Pages/HistoryofCriticalCare.aspx   http://www.myicucare.org/Pages/HistoryofCriticalCare.aspx http://www.peytonspassion.com/Pediatric-Critical-Care-Nursing.html  http://www.peytonspassion.com/Pediatric-Critical-Care-Nursing.html