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CONCEPTS
OF
CRITICAL CARE
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Introduction
The intensive care unit is not merely a
room or series of room filled withpatients attached to interventional
technology; it is the home of an
organization: the intensive careteam.
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Critical Care Nursing
Critical care nursing is that specialtywithin nursing that deals specifically with
human responses to life-threatening
problems.
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Critical Care Nurse (CCN)
CCN is responsible forensuring that acutely and
critically ill patients and their
families receive optimalcare .
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Aim of the Critical Care
is to see that one provides a care
such that patient improves andsurvives the acute illness or tides
over the acute exacerbation of the
chronic illness.
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Nurse Staffing
The number of nurses ideally required for suchunits is 1:1 ratio.
In complex situations they may require twonurses per patient.
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The Evolution of Critical Care
Forty years of development in critical
care and critical care nursing has given
rise to a recognized specialty in nursingpractice.
Critical care units have evolved over thelast four decades in response to medical
advances .
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Historical Prespectives
1923, John Hopkins University Hospital
special care unit for neurosurgical patients .
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Historical Prespectives
1950
epidemic of poliomyelitis necessitatedthousands of patients requiring
respiratory assist devices and intensive
nursing care.
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Historical Prespectives
1953, Manchester Memorial Hospital
four bedded unit
1957
20 units in USA
1958
the number increased to 150 units.
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Historical Prespectives
During 1970s,the term critical care unit
came into existence which covered alltypes of special care.
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Progressive Patient Care
It is systematic classification and
segregation of patients based on their
nursing and medical needs.
Patient care. PPC has been defined as
"the right patient, in the right bed, with the
right services, at the right time.
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Progressive Patient Care
Intensive care units
Intermediate care units
Self care units
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Florence Nightingale
placed the seriously ill patients near the
nurses station.
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http://upload.wikimedia.org/wikipedia/commons/c/c9/Hospital_at_Scutari_2a.jpg -
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Organizational Models for ICUs
Open model
Closed model
Hybrid model
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Types of ICUs
An open:
In this type, physicians admit, treat and
discharge
A closed:
In this type, the admission, discharge andreferral policies are under the control ofintensivists.
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ICUS can be CLassified
Level I:
This can be referred as high
dependency is where close
monitoring, resuscitation,
and short term ventilation
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ICUS can be CLassified
Level II:
undertake more prolonged
ventilation. Must have
resident doctors, nurses,access to pathology,
radiology, etc.
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ICUS can be CLassified
Level III:
It should provide all aspects
of intensive care required.
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True
Collaboration
Skilled
Communication
Healthy Work Environment
Nursing Practice
Authority Accountability Autonomy
Nurse
Competences Patient Needs
Evidence
Based
Practice
Optimal
Patient
Outcome
Culture
of
Inquiry
Safe Passage AuthenticLeadership
Meaningful
Recognition
Appropriate
Staffing
Decision
Making
AACN Synergy Model
Clinical
Experience
http://localhost/var/www/apps/conversion/tmp/scratch_9/AACN%20Competencies.dochttp://localhost/var/www/apps/conversion/tmp/scratch_9/AACN%20Competencies.dochttp://localhost/var/www/apps/conversion/tmp/scratch_9/AACN%20Competencies.dochttp://localhost/var/www/apps/conversion/tmp/scratch_9/AACN%20Competencies.doc -
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Intensive Care Unit Equipments:-
Patient monitoring
Life support and emergency resuscitationdevices
Diagnostic devices
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28Doctor and Nurse with ICU Monitoring Equipment, 1965
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Therapeutic Elements in ICU
Environment
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Conclusion
Progressive patient care
Collaboration
Organization
Cost effectiveness
Preventive strategies
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Reference
http://www.archbronconeumol.org/bronco_eng/ct
l_servlet?_f=40&ident=13079312
http://hsc.unm.edu/emermed/cpr/Adult_Crash_C
art.shtml
http://www.aorn.org/News/September2008News/
HealthyWork