intro to ccn.pptxNJLDKDDSMDSMDSMDMDMDDMMDM

CCN

1. Introduction to Critical Care Nursing Rehana Tabbasum BSN POST RN PBS CCN (ICU) MSN Scholar

2. Objectives At the end of this session students will be able to: ▶ D e f i n e C r i t i c a l c a r e , unit, Nurse & N u r s i n g ▶ E n l i s t 7 C ’ s o f C r i t i c a l C a r e nu r s i n g ▶ ▶ D e s c r i b e l e v e l s o f c r i t i c a l c a r e un i t Rules of working in icu Icu staffing Organization of icu

3. CRITICAL CARE : Critical care is a term used to describe as the care of patients who are extremely ill and whose clinical condition is unstable or potentially unstable.

4. Critical unit: it is defined as the unit in which comprehensive care of a critically ill patient which is deemed to be recoverable stage is carried out .

5. Critical care nurse : Critical care nurse is a Licensed professional nurse who is responsible for ensuring that acutely and critically ill patients and their family receive optimal care.

6. Critical Care Nursing Critical care nursing is the delivery of specialized care to critically ill patients, that is, ones who have life-threatening illnesses or injuries. Such patients may be unstable, have complex needs, and require intensive and vigilant nursing care.

7. Critical illness : Illnesses and injuries commonly seen in patients include: gunshot wounds traumatic injuries from such events as automotive collisions and falls cardiovascular disorders, such as heart

8. Conti, failure and acute coronary syndromes (unstable angina and [MI]

9. SEVEN Cs OF CRITICAL CARE ▶ Compassion ▶ Communication (with patient and family). ▶ C o n s i d e r a t i o n ( t o p a t i e n t s , r e l a t i v e s a n d colleagues) and avoidance of Conflict. ▶ Comfort: prevention of suffering ▶ Carefulness (avoidance of injury) ▶ Consistency ▶ C l o s u r e ( e t h i c s ).

10. HISTORICAL PRESPECTIVES ▶ Florence nightingale recognized the need to consider the severity of illness in bed allocation of patients and placed the seriously ill patients near the nurses station. ▶ 1923, John Hopkins University Hospital developed a special care unit for neurosurgical patients . ▶ Modern medicines boomed to its higher ladder after world war 2

11. LEVELS OF ICU : ▶ Level I: This can be referred as high dependency is where close monitoring, resuscitation, and short term ventilation <24hrs has to be performed .

12. L e v e l II : C a n b e l o c a t e d i n g e n e r a l h o s p i t a l , un d e r t a k e m o r e prolonged ventilation. Must have resident doctors, nurses, access to pathology, radiology, etc.

13. Level III: Located in a major tertiary hospital, which is a referral hospital. It should provide all aspects of intensive care required. Demonstrated commitment to academic education and research.

14. ICU STAFFING : Medical staffing ,including an ICU Director/ Intensivist , with sufficient experience to provide for patient care , Administration , teaching , research , Audits etc.

15. Trained nursing staff: 1:1 for ventilated patients and 1:2 for other patients , Nurse in charge with ICU qualification Allied health and ancillary staff : Respiratory services , physiotherapist ,dietician , bio-medical Engineer , technicians , computer programmer, social worker ,counselor , House keeping staff etc.

16. PRINCIPLES OF CRITICAL CARE NURSING Anticipating nursing care Early detection and prompt treatment Expertise Supportive care Communication Collaborative practice Preservation of patients physiological defenses

17. Prevention of Infection Crisis intervention Stress reduction Ethical principles

18. This Photo by Unknow n author is licensed under CC BY-NC . ROLES AND RESPONSIBILITIES OF CRITICAL CARE NURSE: Assessing a patients condition and planning and implementing patient care plans Provides direct comprehensive bedside care to patients Treating wounds and providing advanced life support Assisting physicians in performing procedures

19. Able to attach equipments on patients as ordered and interprets the data , graphs on monitors etc. Observing and recording patients vital signs Ensuring that ventilators , monitors and other types of medical equipment function properly Administering intravenous fluids and medications

20. Collaborating with fellow members of the critical care team Responding to life-saving situations ,using nursing standards and protocols for treatment Acting as patient advocate Documents appropriately Ensures patient safety Follows the policies and procedures of the unit and the institution Is an expert in nursing knowledge and practice

21. Promotes quality assurance in nursing Providing education and support to families

22. ORGANIZATIONAL MODELS OF ICU

23. ORGANIZATION OF ICU Each Intensive care unit should be a geographically distinct area within the hospital with controlled access No through traffic to other departments should occur Supply and professional traffic should be separated from public/visitor traffic

24. Location should be chosen so that the unit is adjacent to, or within direct elevator travel to and from , the Emergency department , Operating room , Intermediate care units and Radiology department.

25. THERAPEUTIC ELEMENTS IN ICU ENVIRONMENT Window and art that provide natural views, views of nature can reduce stress , hasten recovery , lower blood pressure and lower pain medication needs Family participation, including facilities for overnight stay and comfortable waiting rooms Providing a measure of privacy and personal

26. Control through adjustable curtains and blinds , accessible bed controls Noise reduction through computerized pagers and silent alarms Medical team continuity that allows one team to follow the patient through his or her entire stay

27. CENTRAL NURSING STATION Patients must be situated so that direct or indirect (eg.by video monitor) visualization by health care providers is possible at all times . This permits the monitoring of patient statusunder both routine and emergency circumstances .

28. The preferred design is to allow a direct line of vision between the patient and the central nursing station.

29. EACH INTENSIVE CARE UNIT MUST HAVE Electric power Water supply Oxygen, Compressed air, Vacuum Lighting Environmental control systems