This document discusses the concept of critical care nursing. It defines critical care nursing as caring for seriously ill patients from the point of injury or illness until discharge from intensive care. It involves dealing with human responses to life-threatening problems through comprehensive and specialized nursing care. A critical care nurse provides direct one-on-one care for critically ill patients at high risk of health issues and makes important decisions. The document outlines the roles, goals, principles, and challenges of critical care nursing.
This document discusses the concept of critical care nursing. It defines critical care nursing as caring for seriously ill patients from the point of injury or illness until discharge from intensive care. It involves dealing with human responses to life-threatening problems through comprehensive and specialized nursing care. A critical care nurse provides direct one-on-one care for critically ill patients at high risk of health issues and makes important decisions. The document outlines the roles, goals, principles, and challenges of critical care nursing.
This document discusses the concept of critical care nursing. It defines critical care nursing as caring for seriously ill patients from the point of injury or illness until discharge from intensive care. It involves dealing with human responses to life-threatening problems through comprehensive and specialized nursing care. A critical care nurse provides direct one-on-one care for critically ill patients at high risk of health issues and makes important decisions. The document outlines the roles, goals, principles, and challenges of critical care nursing.
This document discusses the concept of critical care nursing. It defines critical care nursing as caring for seriously ill patients from the point of injury or illness until discharge from intensive care. It involves dealing with human responses to life-threatening problems through comprehensive and specialized nursing care. A critical care nurse provides direct one-on-one care for critically ill patients at high risk of health issues and makes important decisions. The document outlines the roles, goals, principles, and challenges of critical care nursing.
Download as PPTX, PDF, TXT or read online from Scribd
Download as pptx, pdf, or txt
You are on page 1/ 154
CONCEPT OF CRITICAL CARE
NURSING
By Hidayat Khan MSN, MPH, BSN, RN, DCH, IP&C & CHPE CRITICAL • Crucial • Crisis • Emergency • Serious • Requiring immediate action • Thorough and constant observation • Total dependent (Oxford Dictionary) CRITICAL CARE NURSING • The care of seriously ill clients from point of injury or illness until discharge from intensive care CRITICAL CARE NURSING • Deals with human responses to life threatening problems -trauma /major surgery
(Mary,L.S., Deborah, G.K. & Marthe, J.M. 2005)
CRITICAL CARE NURSING • Comprehensive, specialized and individualized nursing care services which are rendered to patients, with life threatening conditions and their families.
(Shuva, D. G.2005) CRITICAL CARE NURSE • care for clients who are very ill • provide direct one to one care • Responsible for making life-and death decision • At high risk of injury or illness from possible exposure to infections • Communication skill is of optimal importance CRITICALLY ILL CLIENT • At high risk for actual or potential life- threatening health problems • More ill • Required more intensive and careful nursing care CLASSIFICATION OF CRITICAL CARE PATIENTS • Level O : normal ward care • Level 1: at risk of deteriorating , support from critical care team • Level 2 : more observation or intervention, single failing organ or post operative care • Level 3; advanced respiratory support or basic respiratory support ,multiorgan failure HIGH DEPENDENCY CARE • Coronary care units (CCU) • Renal high dependency unit (HDU) • Post-operative recovery room • Accident and emergency departments (A&E) • Intensive care units (ICU) CONTINUUM OF CARE • General ward • High dependency areas : CCU,Renal HDU, recovery • Intensive care unit INTENSIVE CARE UNIT • Area where the critically clients are cared for • Filled with stress • Loss of privacy • Artificial lighting 24 hours • Constant noise • Physical pain • Discomfort PRINCIPLES OF CRITICAL CARE • Continuous monitoring and treatment • High intensity therapies and interventions • Expert surveillance and efficiency • Alert to early manifestation of other organ failure • Recognition of parameters denoting progress or deteriorating GOALS OF CRITICAL CARE • Towards the survival of the critical ill patients and restoring quality of life • Restoring optimal physiological, psychological, social and spiritual potential • Helping the families of the critically ill patients in coping with crises ROLES OF CRITICAL NURSE • Care provider : help the client to obtain necessary care and supporting the basic needs • comprehensive direct care to the patient and family • Educator: based on patient’s needs and severity of the condition • Manager: coordinates the care provided by various health care • Advocate: protects the patient’s rights CRITICAL CARE NURSING • Constant and rapid assessment: close monitoring and respond to treatment • Providing appropriate nursing interventions • Documenting and reporting • Observing mental state of family state • Maintaining a spiritual attitude PATIENT ASSESSMENT • Know : medical history, social history, medical interventions • See : airway patency, pallor, sweating, mental state, posture, facial expression, general condition • Find : respiratory care, adequacy of oxygenation, pulse, blood pressure, urine output, conscious level, monitor for changes in any of the above
( Norman & Cook, 2000)
A, B, C, D, E MODELS • Airway: patent • Breathing: respiratory rate • Circulation: pallor, hemorrhage • Disability:altered conscious level • Expose to examine: unseen haemorrhage, wound leakage ( Smith, 2000) PATIENT MONITORING • Information from monitoring equipment • Accuracy of equipment • Compare with manual recordings • Assess ,record and analyze findings frequently / continuously PATIENT SAFETY • errors due to hectic and complex environment • compromised physiologic interventions • multiple technologic and pharmacologic interventions, care provider • Work at a fast pace IMMEDIATE CARE • Administer oxygen via face mask • Maintain client safety • Maintain fluid replacement • Monitor cardiac instability • Monitor urine output hourly • Arterial blood gas analysis • Referral to critical care INVESTIGATIONS • Haematology • Biochemistry • X-ray SUBSEQUENT CARE • Monitor continuously • Position : upright • Conscious level • Intravenous therapy • Medication :Analgesia and antibiotics • Nil by mouth blood sugar levels • Oral and tube feeding • Document client’s response ETHICAL ISSUES • ethnic and religious doctrines that limit treatment options • allocation of resources that may limit admission or promote premature discharge • Use of critical care beds for terminally ill clients • Discontinuation of resuscitation or life support measures CLINICAL MAPPING 24 hour assessment Individualized plan
CRITICALLY ILL CLIENT
medication
Collaborative care
Monitoring evaluation
intervention Trends and Issues • Critical care patients more complex – Multisystem organ dysfunction – Complicated by aging population • Increasing costs for care – Challenged to reduce costs and length of stay – Transfer of higher acuity patient from the critical care unit to other units or home
150 reserved. Other Trends and Issues • Reducing hospital readmission rates • Increasing use of technology – Electronic medical records – Physician order entry • Ethical issues associated with prolonging life and futile treatment • Telemedicine and eICU
152 reserved. Trends and Issues (Cont.) • Shortage of critical care nurses – Importance of recruitment, orientation, and retention – Ongoing debate about hiring new graduates to work in critical care units
