Recent ucsd_nursing_articles items

Validation of Caregiver-Centered Delirium Detection Tools: A Systematic Review

Wed, 9 May 2018 00:00:00 +0000

Abstract

Objectives: To summarize the validity of caregiver‑centered delirium detection tools in hospitalized adults and assess associated patient and caregiver outcomes.

Design: Systematic review

Setting: We searched MEDLINE, EMBASE, PsycINFO, CINAHL, Scopus from inception to May 15, 2017

Participants: Hospitalized adults

Intervention: Caregiver-centered delirium detection tools

Measurements: We drafted a protocol from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two reviewers independently completed abstract and full-text review, data extraction, and quality assessment. We summarized findings using descriptive statistics including mean, median, standard deviation, range, frequencies (percent), and Cohen's Kappa (κ). Included studies reported on...

Testing a Strategy to Identify Incidence of Nurse Suicide in the United States.

Thu, 26 Apr 2018 00:00:00 +0000

The aim of this study was to test a strategy for quantifying incidence of nurse suicide using San Diego County data as a pilot for national investigation.

Worldwide, 1 person dies by suicide every 40 seconds; more than 1 000 000 suicides occur yearly. Suicide rates for nurses in the United States have not been evaluated. This methodological article tested a strategy to identify incidence of nurse suicide compared with those of physicians and the general public.

Deidentified San Diego County Medical Examiner data from 2005 to 2015 were analyzed with a descriptive epidemiologic approach.

Overall RN (18.51) and physician (40.72) incidences of suicide per 100 000 person-years were higher than the San Diego general population, excluding nurses (15.81) normalized to 100 000 person-years.

Establishing incidence of nurse suicide is confounded by variation in reporting mechanisms plus incomplete availability of nurse gender data. Relatively small outcome numbers...

Nurse Suicide: Breaking the Silence

Wed, 7 Feb 2018 00:00:00 +0000

The purpose of this paper is to raise awareness of and begin to build an open dialogue regarding nurse suicide. Recent exposure to nurse suicide raised our awareness and concern, but it was disarming to find no organization-specific, local, state, or national mechanisms in place to track and report the number or context of nurse suicides in the United States. This paper describes our initial ex-ploration as we attempted to uncover what is known about the prevalence of nurse suicide in the United States. Our goal is to break through the culture of silence regarding suicide among nurses so that realistic and accurate appraisals of risk can be established and preventive measures can be developed.

Improving partnerships with family members of ICU patients: study protocol for a randomized controlled trial

Wed, 7 Feb 2018 00:00:00 +0000

Background

Over the last decade, health care delivery has shifted to partnering with patients and their families to improve health and quality of care, and to lower costs. Partnering with family members (FMs) of critically ill patients who lack capacity is particularly important for improving experiences and outcomes for both patients and FMs. How best to apply such partnering strategies, however, is yet unknown. The IMPACT trial will evaluate two interventions that enable partnerships with families of critically ill patients, each in a distinct content area, but similar in that they empower and support FMs.

Methods

This multi-center, open-label, randomized, phase II clinical trial aims to randomize 150 older, long-stay ICU patients and their families into one of three groups (50 in each group): (1) The OPTimal nutrition by Informing and Capacitating FMs of best practices (OPTICs) group, a multi-faceted intervention to engage and empower FMs to advocate for,...

Clinical practice guidelines for support of the family in the patient-centered intensive care unit: American College of Critical Care Medicine Task Force 2004-2005.

Wed, 7 Feb 2018 00:00:00 +0000

To develop clinical practice guidelines for the support of the patient and family in the adult, pediatric, or neonatal patient-centered ICU.

A multidisciplinary task force of experts in critical care practice was convened from the membership of the American College of Critical Care Medicine (ACCM) and the Society of Critical Care Medicine (SCCM) to include representation from adult, pediatric, and neonatal intensive care units.

The task force members reviewed the published literature. The Cochrane library, Cinahl, and MedLine were queried for articles published between 1980 and 2003. Studies were scored according to Cochrane methodology. Where evidence did not exist or was of a low level, consensus was derived from expert opinion.

The topic was divided into subheadings: decision making, family coping, staff stress related to family interactions, cultural support, spiritual/religious support, family visitation, family presence on rounds, family presence at...

Suicide Prevention: A Healer Education and Referral Program for Nurses.

Wed, 7 Feb 2018 00:00:00 +0000

The aim of this study was to describe the pilot expansion of a proactive suicide risk-screening program, initially designed for physicians, to nurses.

The Healer Education, Assessment and Referral (HEAR) program detects at-risk physicians and facilitates referral to mental healthcare. Nothing similar has been available for at-risk nurses. Local nurse suicides served as the catalyst to extend the HEAR program to nurses.

Education, outreach, and an encrypted, online, anonymous, proactive risk screening were conducted to identify and refer nurses with depression and suicide risk.

During the 1st 6 months of the program, 172 of 2475 (7%) nurses completed questionnaires; 74 (43%) were rated as high risk, and another 98 (55%) as moderate risk; 12 (7%) reported current active thoughts or actions of self-harm, and 19 (11%) reported previous suicide attempts. Forty-four (26%) received in-person or verbal counseling, and 17 accepted referral for continued treatment.

An...

Suicide Prevention

Fri, 5 Jan 2018 00:00:00 +0000

Objective: To describe the pilot expansion of a proactive suicide risk-screening program, initially designed for physicians, to nurses.

Background: The Healer Education, Assessment and Referral (HEAR) program detects at-risk physicians and facilitates referral to mental health care. Nothing similar has been available for at-risk nurses. Local nurse suicides served as the catalyst to extend the HEAR program to nurses.

Method: Education, outreach and an encrypted, online, anonymous, proactive risk screening were conducted to identify and refer nurses with depression and suicide risk.

Results: During the first 6 months of the program, 172 (7%) of 2475 nurses completed questionnaires; 74 (43%) were rated as high risk and another 98 (55%) as moderate risk; 12 (7%) reported current active thoughts or actions of self-harm and 19 (11%) reported previous suicide attempts. Forty-four...

Guidelines for Family-Centered Care in the Neonatal, Pediatric, and Adult ICU

Wed, 3 Jan 2018 00:00:00 +0000

Objective: To provide clinicians with evidence-based strategies to optimize support of the family of critically ill patients in the ICU.

Methods: We used the Council of Medical Specialty Societies principles for the development of clinical guidelines as the framework for guideline development. We assembled an international multidisciplinary team of 29 members with expertise in guideline development, evidence analysis and family-centered care to revise the 2007 Clinical Practice Guidelines for Support of the Family in the Patient-Centered Intensive Care Unit. We conducted a scoping review of qualitative research that explored family-centered care in the ICU. Thematic analyses were conducted to support Population, Intervention, Comparison, Outcome (PICO) question development. Patients and families validated the importance of interventions and outcomes. We then conducted a systematic review using the Grading of Recommendations, Assessment,...

Exploring Distress Caused by Blame for a Negative Patient Outcome

Wed, 3 Jan 2018 00:00:00 +0000

Purpose of this research was to explore the incidence, characteristics and consequences of blame-related distress and its relationship to moral distress. An instrument was created and validated and a conceptual model proposed for relating blame to similar constructs among clinical staff working in acute care.