CRITICAL CARE NURSING CONCEPT

INTENSIVE CARE

DEFINITION THE PRACTICE OF ADMINISTERING

IMMEDIATE AND CONTINUOUS CARE TO CLIENTS WITH ACTUAL OR POTENTIALLY LIFE-THREATENING HEALTH DISORDERS

MORE THAN 5 MILLION CLIENTS ARE ADMITTED ANNUALLY TO INTENSIVE CARE UNITS IN THE UNITED STATES

COMMON ACUTE OR CRITICAL DISORDERS Brain injuries Cardiovascular dysfunctions Pulmonary dysfunctions Childbirth Complications Infection/sepsis Shock and trauma Endocrine abnormalities Multisystem alterations Complex surgical procedures

PRIMARY ADMITTING DIAGNOSES Society of Critical Care Medicine Respiratory failure Postoperative management Ischemic heart disorder Sepsis and heart failure

CRITICAL CARE POPULATIONS Increasing number of adults 65 yrs of age 80% of older adults have at least one

chronic condition 50 % have at least 2 >50 % are filled with clients ages 65 yrs

old and above Projections : as the baby boomer

generation ages , there will be: a corresponding rise in chronic illness

and hospitalizations Increase need for critical care

WHY IS THIS IMPORTANT TO CRITICAL CARE NURSE? The aging process is characterized

by physiologic changes These changes, with prevalence of

chronic conditions, contribute to increased

Morbidity and mortality in critical care units

CRITICAL CARE NURSING AACN defines critical care nursing as The specialty that deals with human

responses to life – threatening problems

Entry level nurses – function as generalists

Must possess a specialized body of knowledge and skills

- assessment (advanced), pharmacology , pathophysiology , biotechnology ,advanced communication skills , problem-solving skills and advocacy skills

SKILLS ARE ESSENTIAL To provide holistic or humanistic care to clients and their significant others.

THE PURPOSE OF NURSING to meet the needs of clients and

their families (physical, emotional, social and psychological needs )

provide safe transition through the health care system during a time of crisis

- admission in the unit is a crisis

- critical illness stimulates the stress response

NOTE THIS : The more compromised the client , the

more severe or complex are their needs .

ADVOCACY ROLE Must be able to assess key client

characteristics –

Span the health – illness continuum and are influenced by many factors :

educational background, resource availability , cultural background

These factors , along with the clients ability to make decisions , and level of strength during crisis , impact the client’s ability to participate in decision-making

IMPACT OF CRITICAL ILLNESS

Can generate strong emotions in family members

Shock , disbelief, denial , anger, despair, guilt, and fear of losing the client

CRITICAL CARE NURSE : THE CONTINUUM OF CARE SPECIALIZED NURSING CARE - Once considered the field of critical

care nurses, is now being assumed by nurses in progressive care units

- Progressive care is, therefore considered part of the continuum of critical care nursing

CONTINUOUS NURSING VIGILANCE Is significant to nursing the critically

ill Can make a substantial difference in

client outcomes To meet the changing needs of the

client , Both critical care and progressive

nurses must create an environment that -

- promotes the best health outcomes in a caring, competent manner to

ensure positive optimal outcomes for the

clients and families.

CLIENT CHARACTERISTICS For the nurses caring for the critically

ill : Resiliency Vulnerability Stability Complexity Resource availability Participation in care Participation in decision making Predictability

ESSENTIAL NURSE COMPETENCIES Clinical judgment Advocacy Caring practices Collaboration Systems thinking Response to diversity Clinical inquiry Facilitation of learning

CERTIFICATIONS PROGRAM Validates based upon predetermined

standards A nurse knowledge and qualifications

for practice in a defined functional or clinical area of nursing

AACN Certification Corporation supports critical care nurses by administering specialty certification programs

Measures what is pertinent to the care of critically ill clients today

NATIONAL CERTIFICATION Most up-to-date knowledge Promotes continuing excellence in the

nursing profession Standardizing care thru the use of

practice guidelines, practice alerts and protocols

Consistent evidence-based practice guidelines help to reduce errors and improve quality of care delivered

CONCLUSIONS Critical care nursing occurs in a

variety of settings . Health care will be pressed to provide

efficient and cost-effective services. Government subsidies of health care

may not be able to keep up with the demand.

Aging nurses are retiring or leaving critical care

Young or new nurses must step up to meet the exciting challenges of critical care nursing

FINALLY, Despite all the challenges of the future,

the center of all health care will still be the CLIENT, and the critical care nurse will

be the client, and the critical care nurse will be there at the client’s side.

CONCEPT OF HEALTH AND ILLNESS Nursing practice is directed and guided by an

understanding of the definition of health

WHO definition of health HOLISTIC QUALITIES

HIGH – LEVEL WELLNESS

HEALTH Each person in viewed as being part of

a complex , interconnected social, biologic, and environmental system