Archive for year: 2015
Project 1
Good People and Detroit
We done setup the site
Yeehaw
Start of the Semester
This is the first course that technology is truly being utilized into the classroom setting. I personally like it and wished we had CIKeys earlier in the program. I haven’t had the chance to really blog before so creating my page has been slightly challenging, but it has been fun learning along the way. I am excited to begin the semester and learn about what technology can offer me! 
Just added a new category…
It’s called nurs420
Informed Patient: Changing the Sedation Status Quo in the ICU
The article states that new treatment methods are being adopted to combat the length of time patients remain ventilated in the Intensive Care Unit (ICU). When patients are ventilated, they are almost always heavily sedated, and this has been shown to cause prolonged delirium “which can have a devastating and long lasting effect on cognitive function” (Landro, 2011). These new treatment methods are backed by the National Institutes of Health, the Veterans Health Administration, and John Hopkins University. New research has shown that “ at least some part of brain injury is preventable by lowering exposure to potent sedative medications and shortening the duration of delirium in the ICU with new monitoring and management techniques” (Landro, 2011). Another study shows that muscle weakness can be preventable if the patient gets up and moving while still on the ventilator. Critical care experts are holding conferences and reaching out to their colleagues in hopes of shedding light on new care techniques in the ICU. Hospitals have been aware for many years that prolonged ventilation was having negative effects on their patient’s well-being. Many institutions began adopting strategies to wean patients from heavy sedatives and to get them up walking.
In one account, a 51 year old musician was hospitalized in the ICU for pneumonia. The patient recalls having hallucinations while on sedation medication and had to be restrained multiple times. After being released from the hospital, the man claims to have difficulty singing and playing his music, and he reports having difficulty finding follow-up care from home.
I agree with the author. She arms her readers with irrefutable evidence that ventilation protocols need to be changed. First, health care professionals must become aware of this problem and the extent of consequences the patients suffer even after being released. Once there is a general awareness and understanding of the problem, solutions will start to be implemented.
Landro, L. (2011, February 15). Informed Patient: Changing the Sedation Status Quo in the ICU.
Hello
Testing =)
A Whole New World
Well, I never would have imagined that the first thing we do in Critical Care Nursing is make our own websites, but I am actually really excited about it! This is something I would NEVER do on my own, so I am glad we are required to do it for class. I’m excited to see how they all turn out by the end of the semester. Here we go!
ICU Delirium
According to Vanderbilt University (2013), delirium is the inattention and confusion that presents like the brain is temporarily failing. Delirium is a common problem in the ICU and 7/10 critical patients usually experience it (Vanderbilt University, 2013). Patients who are on sedation, older, cognitively impaired, recovering from surgery, septic, or suffering from heart failure have been found to be more susceptible to developing delirium in the ICU. It appears to be caused by lack of oxygen to the brain, medications, infections, pain, and other chemical changes in the brain. If not identified and cared for, delirium can cause lasting cognitive impairment, post-traumatac stress disorder (PTSD), and depression (Vanderbilt University, 2013). To prevent or treat ICU delirium, the care providers should continuously reorient patients, provide stimulating activities, mobilize patients early, treat their pain, reduce noise and stimuli, and provide sedation vacations (Vanderbilt University, 2013). It is important for nurses to assess their sedated patients for delirium because early recognition can prevent a lifetime of psychological distress.
The article titled, “Sedation and Its Psychological Effects Following Intensive Care,” reviews and explores the relationship between sedation and psychological disorders after recover and discharge from the ICU. The review of literature found that lighter sedation reduced the length of stay in ICU and length of time on mechanical ventilation. However, lighter sedation generally did not reduce the outcomes of PTSD and more research is needed to identify more specific relationships between sedation and psychological distress (Croxall, Tyas, & Garside, 2014). More research should be done on the specific psychological effects of sedation and ICU delirium. Also, more research could be done on the specific types of sedation and which ones are the most psychologically impairing. I found that ICU stays can be shorted with lighter doses of sedation to be very interesting. This means that patients can wean from mechanical ventilation earlier and recover in a faster amount of time, which is beneficial to both the patients and care providers.
References
Croxall, C., Tyas, M., & Garside, J. (2014). Sedation and its psychological effects following intensive care. British Journal of Nursing, 23. Retrieved from http://web.b.ebscohost.com.summit.csuci.edu:2048/ehost/detail/detail?vid=3&sid=522b8a73-3c8f-4f87-9893-e2ba89b4bbe4%40sessionmgr114&hid=101&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=rzh&AN=2012702846
Vanderbilt University. (2013). ICU delirium and cognitive impairment. Retrieved from http://www.icudelirium.org/index.html
