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    Evidence Based Critical Care

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    SreetamSaha
    Near about 60 years ago, nursing was organized on a critical position. Before that, critical care nursing was mainly focused on wherever there were critically ill patients. As the years pass the development of new medical intervention and technology make us realize that monitoring and observation for critically ill patients are a really important matter of nursing. Many physicians on these days greatly depended on a nurse for taking care of critical changes of the patients in the absence of physicians. Many times physicians also depend on the nurse for initiating emergency medical treatment. The modern medical technologies and interventions have greatly developed and, for this reason, many hospitals are organizing separate units for making efficient use of equipment with the trained staff. Medical and surgical intensive care units transfer the critically ill patients to the nurse who has the specialized knowledge regarding on that area of care. Every hospital should have the specialized nursing care units where the physicians formerly reserved for the critically ill patients and it should be built on the virtue of their knowledge and expertise.

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    Evidence Based Critical Care

    Uploaded by

    SreetamSaha
    242 views6 pages
    Near about 60 years ago, nursing was organized on a critical position. Before that, critical care nursing was mainly focused on wherever there were critically ill patients. As the years pass the development of new medical intervention and technology make us realize that monitoring and observation for critically ill patients are a really important matter of nursing. Many physicians on these days greatly depended on a nurse for taking care of critical changes of the patients in the absence of physicians. Many times physicians also depend on the nurse for initiating emergency medical treatment. The modern medical technologies and interventions have greatly developed and, for this reason, many hospitals are organizing separate units for making efficient use of equipment with the trained staff. Medical and surgical intensive care units transfer the critically ill patients to the nurse who has the specialized knowledge regarding on that area of care. Every hospital should have the specialized nursing care units where the physicians formerly reserved for the critically ill patients and it should be built on the virtue of their knowledge and expertise.

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    Near about 60 years ago, nursing was organized on a critical position. Before that, critical care nursing was mainly focused on wherever there were critically ill patients. As the years pass the development of new medical intervention and technology make us realize that monitoring and observation for critically ill patients are a really important matter of nursing. Many physicians on these days greatly depended on a nurse for taking care of critical changes of the patients in the absence of physicians. Many times physicians also depend on the nurse for initiating emergency medical treatment. The modern medical technologies and interventions have greatly developed and, for this reason, many hospitals are organizing separate units for making efficient use of equipment with the trained staff. Medical and surgical intensive care units transfer the critically ill patients to the nurse who has the specialized knowledge regarding on that area of care. Every hospital should have the specialized nursing care units where the physicians formerly reserved for the critically ill patients and it should be built on the virtue of their knowledge and expertise.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    242 views6 pages

    Evidence Based Critical Care

    Uploaded by

    SreetamSaha
    Near about 60 years ago, nursing was organized on a critical position. Before that, critical care nursing was mainly focused on wherever there were critically ill patients. As the years pass the development of new medical intervention and technology make us realize that monitoring and observation for critically ill patients are a really important matter of nursing. Many physicians on these days greatly depended on a nurse for taking care of critical changes of the patients in the absence of physicians. Many times physicians also depend on the nurse for initiating emergency medical treatment. The modern medical technologies and interventions have greatly developed and, for this reason, many hospitals are organizing separate units for making efficient use of equipment with the trained staff. Medical and surgical intensive care units transfer the critically ill patients to the nurse who has the specialized knowledge regarding on that area of care. Every hospital should have the specialized nursing care units where the physicians formerly reserved for the critically ill patients and it should be built on the virtue of their knowledge and expertise.

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    The key takeaways are that critical care nursing has evolved over the past 60 years with developments in medical technology and interventions, leading to the establishment of specialized critical care units. Evidence-based practice is also discussed as an important framework for improving quality and outcomes in critical care.

    Over time, critical care nursing has developed from ad hoc care of critically ill patients wherever they were, to the establishment of specialized medical/surgical intensive care units with trained nursing staff using specialized equipment. Guidelines and standards of practice have also been established.

    Evidence-based practice has provided an important framework for integrating research evidence with clinical expertise to improve quality and cost-effectiveness of care for critically ill patients. It has moved practice away from traditional methods based on folklore and trial-and-error towards standardized, evidence-informed guidelines.

    Evidence Based

    Practice on Critical
    Care
    A DISCUSSION ON NURSING
    PREETAM SAHA

    Evidence Based Practice on Critical Care

    Table of Contents
    Introduction..................................................................................................................................2
    Evidence-based practice on critical care......................................................................................2
    Conclusion...................................................................................................................................4
    References....................................................................................................................................5

    Evidence Based Practice on Critical Care


    Introduction
    Near about 60 years ago, nursing was organized on a critical position. Before that, critical care
    nursing was mainly focused on wherever there were critically ill patients. As the years pass the
    development of new medical intervention and technology make us realize that monitoring and
    observation for critically ill patients are a really important matter of nursing. Many physicians on
    these days greatly depended on a nurse for taking care of critical changes of the patients in the
    absence of physicians. Many times physicians also depend on the nurse for initiating emergency
    medical treatment. The modern medical technologies and interventions have greatly developed
    and, for this reason, many hospitals are organizing separate units for making efficient use of
    equipment with the trained staff. Medical and surgical intensive care units transfer the critically
    ill patients to the nurse who has the specialized knowledge regarding on that area of care. Every
    hospital should have the specialized nursing care units where the physicians formerly reserved
    for the critically ill patients and it should be built on the virtue of their knowledge and expertise.

    Evidence-based practice on critical care


    The promotion of quality and cost effective outcome of the health care system for the families
    should not be the ultimate goal of the evidence-based practice (Lawson, 2009). Evidence-based
    practice is the evolution form of the integrated research evidence with the best clinical expertise,
    values and needs for the critically ill patients (Morton & Fontaine, 2009). The best research
    evidence in generating the quality study is the feelings to address a practical problem.
    Standardized guidelines for clinical practice are developed by the policy makers, professionals,
    and consumers. A framework of critical care for nurses which is followed globally is established
    by the AACN (American Association of critical- care nurses). Nursing practice significantly
    3

    Evidence Based Practice on Critical Care


    depends on the condition of the patient and on the setting in which the nurses mainly belong to
    (Brady, 2013).
    In the early time medical and nursing as based on the non-traditional way. According to Specht
    (2012), the traditions were folklore, trial, and error, gut instinct, and personal preference etc. At
    many cases, the practice was often passed down from one generation to other. Non-scientific
    critical care practice includes the use of a rectal tube to manage gastric residual volume and
    aspiration risk, facial incontinence, an accuracy of assessment of body temperature, and
    suctioning artificial airways for every 2 hours. If nurses want to deliver the highest quality of
    care to their patients, EBP (Evidence Based Practice) is essential (Deutschman & Neligan, 2010).
    Nowadays there are multiple changes in the healthcare system. Many hospitals are installing 5 to
    10ml of normal saline before the endotracheal suctioning is done (Drain & Odom-Forren, 2009).
    Although no research can find out the benefits of installing the normal saline and in many cases
    researchers have found that the practice is potentially harmful. Many studies consider the
    normal saline before endotracheal suctioning as the primary end point (Morton & Fontaine,
    2009). These studies show that the level of oxygen on the installation of normal saline is
    significantly lower than no installation of saline. An interesting finding on the base of these
    studies is that the level of oxygen is returned to the baseline after 3 to 5 minutes at the end of the
    suction process (Egerod, 2006).
    Endotracheal intubation can be installed on the orotracheal or nasotracheal route. Every route has
    its own advantages and disadvantages. The orotracheal route is mainly preferred because it is
    rapid and a large tube can be used and it is frequently successful (Bucknall, Copnell, Shannon, &
    McKinley, 2015). On the other hand blind nasotracheal route, however, in this route is also
    preferred because of the comfort of the critical patient and it is usually tolerated by the critically
    4

    Evidence Based Practice on Critical Care


    ill patient because it does not require any anesthesia. The recent introduction of non-invasive
    positive-pressure ventilation (NPPV) is very successful and its use is widespread on the chronic
    ventilator management. NPPV process has become the treatment for the patients who would be
    managed by intubation or perhaps did not receive the ventilation at all. (Specht, 2012). The
    advantages of the NPPV are- the improvement of the patient comfort avoid the complication of
    endotracheal intubation and reduce needs for sedation. NPPV is very successful in the case of
    respiratory failure and for the patients who are suffering from chronic obstructive palimony
    disease (COPD). In a study nasal, ventilation is much more successful than controversial therapy
    in lowering the Paco2 and reversing acidosis. But the ability to lower the percentage of NPPV
    (9% vs. 30%; P=0.01) process is much higher. A number of studies have been demonstrated that
    the need of intubation is reduced with the use of NPPV process and also the critically ill patients
    can easily tolerate this process when acute respiratory failure situation occurs. (Rauen, Chulay,
    Bridges, Vollman, & Arbour, 2008).

    Conclusion
    Many researchers have developed the EBP process for critically ill patients. Frequent questions
    are asked about the scientific process, practice to the nurses to find out the answers. Once the
    answer is found it left to nurses for the implementation. At last, the quality of health care system
    will not improve by discovering new therapies but from discovering therapies that we are very
    much aware.

    Evidence Based Practice on Critical Care


    References
    Deutschman, C., & Neligan, P. (2010). Evidence-based practice of critical care. Philadelphia,
    PA: Saunders/Elsevier.
    Drain, C., & Odom-Forren, J. (2009). Perianesthesia nursing. St. Louis, Mo.: Saunders/Elsevier.
    Morton, P., & Fontaine, D. (2009). Critical care nursing. Philadelphia: Wolters Kluwer
    Health/Lippincott Williams & Wilkins.
    Brady, H. (2013). EVIDENCE-BASED PRACTICE. Dimensions Of Critical Care Nursing,
    32(6), 287. doi:10.1097/dcc.0000000000000003
    Egerod, I. (2006). Evidence-based practice and critical care nursing. Nursing In Critical Care,
    11(3), 107-108. doi:10.1111/j.1362-1017.2006.00168.x
    Lawson, P. (2009). Bringing evidence-based practice to the bedside. Nursing Critical Care, 4(5),
    13-14. doi:10.1097/01.ccn.0000360666.10274.c8
    Specht, D. (2012). Encourage evidence-based practice in direct care. Nursing Critical Care, 7(4),
    14-16. doi:10.1097/01.ccn.0000415617.02321.77
    Bucknall, T., Copnell, B., Shannon, K., & McKinley, D. (2015). Evidence based practice: are
    critical care nurses ready for it? - PubMed - NCBI. Ncbi.nlm.nih.gov. Retrieved 4 September
    2015, from http://www.ncbi.nlm.nih.gov/pubmed/11899640
    Rauen, C., Chulay, M., Bridges, E., Vollman, K., & Arbour, R. (2008). Seven Evidence-Based
    Practice Habits: Putting Some Sacred Cows Out to Pasture. Critical Care Nurse, 28(2), 98-123.
    Retrieved from http://ccn.aacnjournals.org/content/28/2/98.full
    6

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