Foundations of Critical Care Nursing PDF

Foundations of Critical Care Nursing CRITICAL CARE NURSING COURSE (NRS422)  OUTLINE ❑ History of critical care ❑ Critical care nursing ❑ Contemporary critical care ❑ Critical care nursing roles ❑ Critical care professional accountability. ❑ Holistic critical care nurs...

Foundations of Critical Care Nursing CRITICAL CARE NURSING COURSE (NRS422)  OUTLINE ❑ History of critical care ❑ Critical care nursing ❑ Contemporary critical care ❑ Critical care nursing roles ❑ Critical care professional accountability. ❑ Holistic critical care nursing ❑ Interprofessional collaboration practice ❑ Quality, safety, and regulatory issues in critical ❑ Healthy work environment  Overview ❑ Critical care involves managing life- threatening conditions requiring advanced technology and highly trained professionals. ❑ Critical care focus on achieving positive outcomes through efficiency, quality care, and interdisciplinary approaches.  History of Critical Care Evolved from patient’s need for distinct area for better care ❑ Critical care originated with Florence Nightingale's idea of specialized postoperative recovery care in the 1800s. ❑ World War II introduced shock wards for the critically injured. ❑ By the 1950s, ICUs for ventilated patients emerged. ❑ The Society of Critical Care Medicine (SCCM), established in 1970, advanced guidelines, education, and collaboration.  Critical Care Nursing “CCNg” ❑ CCNg became a specialty in the mid-20th century. ❑ Nurses transitioned from general wards to dedicated ICUs. ❑ They provided expert monitoring and intervention, assuming roles like patient advocacy and initiating emergency care. ❑ The American Association of Critical Care Nurses (AACN) defines CCNg as the specialty that manages human responses to actual or potential life-threatening problems. ❑ Critically ill patients (CIPs): Those who at high risk for actual or potential life-threatening health problems thereby requiring intense and vigilant nursing care.  Contemporary Critical Care ❑ Modern critical care integrates multidisciplinary teams including intensivists, specialized nurses, and other clinicians. ❑ Settings range from adult and pediatric ICUs to transitional units. ❑ Focus areas include continuity of care, advanced technology, and progressive patient monitoring models.  Critical Care Nursing Roles Roles ranges from basic through expanded to advanced roles ❑ Restore & promote the physiologic & psychosocial stability of patients. ❑ Take immediate, prioritized & decisive evidence-based, patient-focused action. ❑ Anticipate and respond to rapidly changing patient conditions. ❑ Respond to the unique needs of patients and families as end-of-life issues. ❑ Establish and maintain safe, respectful, healing, and caring environments. ❑ Lead quality, safety & research teams. ❑ Integrating evidence-based care / safety programs. ❑ Address complex clinical issues as acute care nurse practitioner. ❑ Health education (staff, patient & family).  Critical Care Professional Accountability ❑Professional organizations support critical care practitioners by providing numerous resources and networks. ❑Organizations like AACN and SCCM provide education, certification, and practice standards.  Holistic Critical Care Nursing ❑ Holistic care integrates physical, emotional, and spiritual needs. ❑ Patient-centered care emphasizes individualized interventions and family involvement. ❑ Humanizing the critical care unit fosters better outcomes by addressing psychosocial aspects of healing.  Interprofessional Collaborative Practice Collaboration among health professionals improves quality and reduces costs. Core Competencies for Interprofessional Collaborative Practice 1. Values/Ethics for Interprofessional Practice: maintain a climate of mutual respect and shared values. 2. Roles/Responsibilities for Collaborative Practice: Use the knowledge of one’s own role and the role of other professions to address the needs of patients. 3. Interprofessional Communication: Communicate with patients, families, and other health care professionals. 4. Interprofessional Teamwork and Team-Based Care: Apply relationship-building values and principles of team dynamics.  Quality, Safety, and Regulatory Issues in Critical Care Critically ill patients are risky for safety issues due to: ❑ Compromised physiologic status / consciousness. ❑ Multiple technologic and pharmacologic interventions. ❑ Multiple care providers who work at a fast pace. Many organizations foster the adoption of safety culture rather than blame culture as The Joint Commission (TJC), The Institute for Healthcare Improvement (IHI) &The Institute for Safe Medication Practices (ISMP).  Quality, Safety, and Regulatory Issues in Critical Care Measures used to ensure safety in CCNg practice. ❑ Barcode medication administration procedures. ❑ Multiple bedside testing devices. ❑ Computerized medical records. ❑ Bedside monitoring. ❑ Computerized physician order entry. ❑ Regulations governing health care. ❑ Safe medical device.  Healthy Work Environment Contribute to less errors and stress. AACN's Healthy Work Environment standards 1. Standard I: Skilled Communication: proficiency in communication skills. 2. Standard II: True Collaboration: fostering true collaboration. 3. Standard III: Effective Decision Making: valued and committed partners in making policy, directing and evaluating clinical care, and leading organizational operations. 4. Standard IV: Appropriate Staffing: effective match between patient needs and nurse competencies. 5. Standard V: Meaningful Recognition: recognized and recognize others for their value in the work. 6. Standard VI: Authentic Leadership: accept, live & engage with others in a healthy work environment. Interdependence of Healthy Work Environment, Clinical Excellence, and Optimal Patient Outcomes. (From American Association of Critical-Care Nurses), Standards for establishing and sustaining healthy work environments