Endotracheal tube cuff pressure must be kept within an optimal range that ensures ventilation and prevents aspiration while maintaining tracheal perfusion.To test the effect of intervention (adding or removing air) on proportion time was between 20 30 cm H(2)O to evaluate changes in over time.A repeated-measure crossover design used study 32 orally intubated patients receiving mechanical for two 12-hour shifts (randomized control conditions). Continuous monitoring initiated, adjusted a...

• Background Ventilator-associated pneumonia, common in critically ill patients, is associated with microaspiration of oropharyngeal secretions and may be related to suctioning airway management practices. Objectives To describe institutional policies procedures closed-system intubated compare practices registered nurses respiratory therapists. Methods A descriptive, comparative, multisite study facilities that use devices on most adults was conducted. Nurses therapists who worked at the...

Objective: This study tested the effectiveness of brief primary care provider interventions delivered in a college student health center to sample students who screened positive for high-risk drinking. Method: Between November 2005 and August 2006, 8,753 presented as new patients service at large public university were drinking, 2,484 (28%) on 5/4 gender-specific drinking question (i.e., five or more drinks per occasion men four women). Students consented participate (N= 363; 52% female)...

Endotracheal tube cuff pressure must be maintained within a narrow therapeutic range to prevent complications. Cuff is measured and adjusted intermittently.To assess the accuracy feasibility of continuous monitoring pressure, describe changes in over time, identify clinical factors that influence pressure.In pilot study, data were collected for mean 9.3 hours on 10 patients who orally intubated receiving mechanical ventilation. Sixty percent white, age was 55 years, intubation time 2.8 days....

• Background Contamination of equipment, colonization the oropharynx, and microaspiration secretions are causative factors for ventilator-associated pneumonia. Suctioning airway management practices may influence development Objectives To identify pathogens associated with pneumonia in oral endotracheal aspirates to evaluate bacterial growth on suctioning equipment. Methods Specimens were collected from 20 subjects who orally intubated at least 24 hours required mechanical ventilation. At...

Critically ill patients who need mechanical ventilation require endotracheal suctioning. Guidelines recommend coarse crackles over the trachea and/or presence of a sawtooth pattern on flow-volume loop ventilator waveform as best indicators.To determine clinical cues for suctioning in ventilation.A descriptive study 42 adult receiving ventilation. After baseline with closed-system device, were assessed hourly up to 4 hours guideline-based and lung sounds auscultated. Endotracheal was done...

Background Enteral feeding intolerance, a common type of gastrointestinal dysfunction leading to underfeeding, is associated with increased mortality. Tracheal pepsin A, an indicator microaspiration, was found in 39% patients within 24 hours enteral feeding. A potential biomarker intolerance. Objective To identify predictors microaspiration (tracheal or oral A). It hypothesized that variables predicting the presence tracheal might be similar Methods In this secondary analysis, machine...

Background Critical illness may weaken muscles, with long-term consequences. Objective To assess physiological responses to an early standardized passive exercise protocol prevent muscle weakness in adults receiving mechanical ventilation. Methods A quasi-experimental within-subjects repeated-measures design was used. Within 72 hours of intubation, 30 patients had 20 minutes bilateral leg movement delivered by continuous-passive-motion machines at a rate and flexion-extension. Heart rate,...

Nosocomial infections are a major health problem for hospitalized patients and their families. Since the 1800s, hand hygiene has been recognized as single best method to prevent spread of pathogens nosocomial infections. Despite this fact, many healthcare workers do not adhere policies. The Centers Disease Control Prevention issued guideline practices in 2002. Multifaceted approaches improve have shown increase compliance among subsequently reduce A performance improvement project was...

Patients' self-management of heart failure (HF) is associated with improved adherence and reduced readmissions. Nurses' knowledge about HF may influence their ability to adequately perform discharge education. Inadequate nurse lead insufficient patient education, education decrease patients' self-management. Prior developing interventions improve clinical specialists should assess nurses' HF. The purpose this study was determine principles.This a prospective, exploratory, descriptive online...

Post‐intensive care syndrome (PICS), a condition found in survivors of critical illness, is characterized by persistent physical, cognitive, and psychological sequelae that impact the quality life after discharge from an intensive unit (ICU). At present, there are no International Classification Disease (ICD) billing codes for this condition. Without financial alignment, clinicians cannot diagnose PICS, hindering tracking its prevalence impeding policy development Clinicians should be...

The authors compare institutional policies and procedures related to closed suctioning airway management, describe practices of registered nurses respiratory therapists concerning closed-system management intubated patients. Included is a look at the use oral care instillation isotonic sodium chloride solution.This pilot study was done gather preliminary data refine instruments for large multisite Suctioning Techniques Airway Management Practices (STAMP). purposes STAMP are...

Continuous monitoring and download of endotracheal tube cuff pressure for a 12-hour period were required to collect data an ongoing program research related airway management the critically ill patient.On basis reports from anesthesia literature, continuous via traditional transducer monitor was identified as best method data.Although many physiologic variables is routine in critical care settings, application technology measurement has not been reported outside operating room.The team...

Background Aspiration of secretions that accumulate above the cuff endotracheal tube is a risk factor for ventilator-associated pneumonia. Routine suctioning oropharyngeal may reduce this risk; recommended frequency unknown. Objectives To quantify volume suctioned from oropharynx critically ill patients at 2 different intervals to assist in identifying suctioning. Methods A prospective, repeated measure, single-group design was used. Twenty-eight who were orally intubated and treated with...

BACKGROUND The American Association of Critical-Care Nurses practice alert on verification feeding tube placement makes evidence-based recommendations to guide nursing management adult patients with blindly inserted tubes. Many bedside methods do not allow detection improper positioning a within the gastrointestinal tract, thereby increasing aspiration risk. OBJECTIVES To determine how expected practices from were implemented by critical care nurses. METHODS This study was part larger...