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Questions and Answers
What is the main focus of critical care nursing?
What organization was established to support nurses in the critical care field in the Philippines?
When was the CCNAPI founded?
What are the core competencies of critical care nursing based on?
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Which of the following aspects is emphasized in critical care nursing practice?
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What year did CCNAPI revise its Standards of Practice to align with the Core Competencies?
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Which behavior does the core competency for Nurse Clinician I emphasize?
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Which aspect does critical care nursing practice NOT focus on?
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What is the primary capability of Level 1 critical care facilities?
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Which is a requirement for Level 2 critical care units?
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What does Level 3 critical care facilities specialize in?
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Which of the following best describes the staffing requirements at Level 3 critical care units?
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What is the mandated nurse: patient ratio for all levels of critically ill patients in Level 1 and Level 2 facilities?
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What role does a medical director play in Level 2 critical care units?
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Which critical care facility level is characterized by a significant focus on monitoring and preventing complications in at-risk patients?
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What is a unique feature of Level 3 critical care facilities compared to Level 1 and Level 2?
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What is a primary goal of critical care nursing as defined by CCNAPI?
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In a closed system of critical care units, who assumes clinical and administrative responsibility?
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Which of the following dimensions is NOT considered in a holistic approach to patient care in critical nursing?
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What is essential for the prevention and treatment of complications in critical care nursing?
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What is the role of the Critical Care Specialist in an open system?
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Which is NOT a characteristic of nursing interventions expected in critical care?
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What is the focus of palliative care in critical nursing?
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How does CCNAPI define the interactions in critical care nursing?
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What is the main concern addressed by the concept of medical futility?
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Which factor is NOT included in the development of a holistic picture of a patient's needs?
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In critical care nursing, what is crucial for communicating relevant data with other healthcare providers?
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Which of the following best describes a common nursing diagnosis related to deficient fluid volume?
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What is essential for making decisions in critical care nursing?
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What is the recommended total bed strength range for a hospital unit?
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Which of the following is NOT one of the Seven C's of Critical Care?
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Which ethical principle emphasizes the importance of allowing patients to make their own healthcare decisions?
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What is considered a key responsibility of a critical care nurse?
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What does the principle of non-maleficence involve in healthcare?
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Surrogate decision-making is primarily concerned with which of the following?
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Which of the following principles deals with fair treatments and equitable access to healthcare resources?
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What aspect of critical care relates to maintaining the privacy of patient information?
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Study Notes
Critical Care Nursing
- Critical care nursing is a specialized nursing field that focuses on caring for critically ill patients experiencing life-threatening problems.
- The nursing process is used, along with scientific knowledge and professional competencies.
- Critical care nursing encompasses restorative, curative, rehabilitative, maintainable, or palliative care, based on the patient's needs.
- The Critical Care Nurses Association of the Philippines (CCNAPI) was established in 1977 to unite nurses working in critical care settings in the Philippines.
- It is a founding member of the World Federation of Critical Care Nurses (WCCN).
- CCNAPI is accredited as a Provider of Continuing Professional Education by the Professional Regulation Commission.
- CCNAPI defined Standards of Practice in 1982 that were revised in 2005 to align with the 11 Core Competencies for Entry Level for Safe and Quality Nursing Care, outlined by The Board of Nursing.
Levels & Categories of Critical Care Provisions
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Level 1 - Provides basic cardio-respiratory support.
- Functions: Resuscitation, short-term cardio-respiratory support, monitoring, preventing complications, mechanical ventilation, basic cardiovascular monitoring.
- Requirements: Formal organization of medical staff and at least one registered nurse with post-registration qualifications in critical care or related clinical specialties.
- Nurse: Patient Ratio: 1:1.
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Level 2 - Provides advanced critical care services, including invasive hemodynamic monitoring and specialized equipment.
- Functions: High standard of general critical care for patients transitioning from higher levels of care or requiring single organ support, mechanical ventilation, renal replacement therapy, mechanical ventilation, invasive hemodynamic monitoring, and equipment for various specialties.
- Requirements: Designated medical director with intensive care qualification and a dedicated duty specialist, nurse in-charge with critical care certification, critical care certification for a significant number of nursing staff.
- ** Nurse: Patient Ratio**: 1:1.
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Level 3 - Tertiary referral unit capable of managing all critical care needs.
- Functions: All aspects of critical care medicine, including advanced respiratory support and multi-organ failure management.
- Requirements: Medical director with specialist critical/intensive care qualification and a duty specialist, medical staff with extensive experience, nurse in-charge and majority of nursing staff with intensive care certification.
- Nurse: Patient Ratio: 1:1.
Scope of Nursing Practice
- The scope of critical care nursing is determined by the complex interactions between the critically ill patient/family, the critical care nurse, and the critical care environment.
- The goal is to achieve optimal patient outcomes through nursing proficiency in a specialized environment conducive to critical care.
Goals of Care
- Promote safe and high-quality care to critically ill patients and their families by providing individualized care to manage physiological dysfunction and psychological ICU stress.
- Care for critically ill patients with a holistic approach by considering the patient's biological, psychological, cultural, and spiritual dimensions.
- Use up-to-date knowledge, caring attitude, and clinical skills, supported by technology, for preventing, detecting early, and treating complications to facilitate recovery.
- Provide palliative care to critically ill patients in situations where their health status is progressing to unavoidable death, supporting patient and family through suffering.
- Patient-centered, safe, effective, efficient, timely, and equitable care delivery.
Systems Operations of Critical Care Units
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Open System:
- Admitting and attending doctors dictate management, change management, or perform procedures without consultation or communication with a Critical Care Specialist.
- Critical Care Specialists may be consulted for advice or to perform interventions.
- No designated "gatekeeper" role.
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Closed System:
- Management is coordinated by a qualified Critical Care Specialist.
- Critical Care Specialist has clinical and administrative responsibility.
- A multidisciplinary team of specially trained critical care staff works together.
- The intensivist makes the final medical decisions, including admission and discharge.
CCNAPI Standards
- Proximity to Diagnostic Services: Close and easily accessible diagnostic areas, blood bank, pharmacy, etc.,
- ICU Bed Strength: Total bed strength in a hospital should range between 8-12 beds, not less than 6 or more than 24.
Concept of Holism
- The holistic approach in critical care emphasizes considering the patient's physical, psychological, social, cultural, and spiritual needs.
The Critical Care Nurse
- A licensed professional nurse responsible for ensuring that acutely or critically ill patients and their families receive optimal care.
The Seven C's of Critical Care
- Compassion: Demonstrating empathy and concern for patients and their families.
- Communication: Effective exchange of information with patients, families, and the healthcare team.
- Consideration: Showing respect and thoughtfulness towards patients, relatives, and colleagues, and avoiding conflicts.
- Comfort: Preventing and alleviating suffering to provide comfort to patients.
- Carefulness: Exercising caution to avoid injury to patients.
- Consistency: Providing reliable and uniform care practices.
- Closure: Addressing ethical considerations and managing the withdrawal of care when necessary.
Clinical Judgment
- Advocacy/Moral agency
- Caring practice
- Collaboration
- Systems thinking
- Response to diversity
- Clinical inquiry
- Facilitator of learning
Ethical Principles in Healthcare
- Autonomy: Respecting a patient's right to make their own health care decisions.
- Beneficence: Always aiming to do good for the patient and improve their health.
- Non-Maleficence: Avoiding causing harm to patients.
- Justice: Treating all patients fairly and ensuring equal access to care and resources.
Common Ethical Issues in Critical Care
- Autonomy and Informed Consent: Respecting patients' rights to make informed decisions about their own care.
- Surrogate Decision-Making: Navigating situations where decisions are made on behalf of patients who are unable to make decisions themselves.
- Confidentiality: Maintaining the privacy of patient information.
- Resource Allocation: Ensuring fair and equitable distribution of limited medical resources.
- Advance Care Planning/End-of-Life Care: Facilitating discussions and decisions regarding patients' preferences for end-of-life care.
- Conflicts of Interest: Identifying and managing situations where personal or professional interests may conflict with patient care.
- Medical Futility: Addressing situations where medical interventions are unlikely to benefit the patient.
Assessment: Measurement Criteria
- Development of a holistic understanding of patient needs.
- Prioritization based on immediate condition and anticipated needs.
- Use of evidence-based assessment techniques and instruments.
- Use of analytical models and problem-solving tools.
- Matching formal knowledge with clinical evidence.
- Relevant data documentation.
- Sharing relevant data with other healthcare providers.
Common Nursing Diagnoses
- Impaired Gas Exchange related to ventilation perfusion mismatch.
- Decreased Cardiac Output related to impaired myocardial contractility or reduced preload.
- Dysfunctional Weaning Response related to neuromuscular dysfunction.
- Deficient Fluid Volume related to massive vascular losses or increased insensible water loss.
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Description
This quiz explores the fundamentals of critical care nursing, focusing on the specialized care for critically ill patients. It covers the nursing process, standards of practice, and the role of critical care nurses in the Philippines. Gain insights into restorative, curative, rehabilitative, maintainable, and palliative care.
