Objectives This article aimed to describe the development,implementation,and evaluation of the model’s effectiveness to facilitate self-care of professional nurses caring for critically ill patients in ICUs.Methods T...Objectives This article aimed to describe the development,implementation,and evaluation of the model’s effectiveness to facilitate self-care of professional nurses caring for critically ill patients in ICUs.Methods The methods of Chinn and Kramer,Walker and Avant were utilized to generate this model.The study included four steps to develop,implement and evaluate the model:Step 1-concept analysis;Step 2-placing the concept in relationship statements;Step 3-description and evaluation of the model;and Step 4-implementation and evaluation of the model.The implementation and evaluation of the model included two phases:a one-day workshop to present the model,and three months of model implementation.The study was conducted in a specific tertiary hospital in Gauteng Province,South Africa.Twenty-five participants were identified amongst the five ICUs,and only eight participants accepted the invitation.Out of the eight participants,only six professional nurses working in different ICUs in the public sector were interviewed.Results The model was divided into three stages:relationship,working,and termination;it comprised the primary and secondary contexts in which the facilitation of self-care occurs.The model process occurred in a spiral form.The registered nurses benefitted holistically from the three presenters at the workshop,and the social worker contributed to their emotional self-care activities.Three themes emerged:The model brought positive experiences,change,and self-awareness;the model benefitted the registered nurses holistically;role modeling self-care practices motivated and benefitted others.Conclusion The model implementation assisted the registered nurses’in developing self-awareness and resilience.They gained more knowledge regarding self-care,and the model encouraged them to implement improved self-care practices.They became role models of self-care and motivated their friends and families.展开更多
Objective： To sum up our experience in percutaneous dilatational tracheostomy （PDT） in ICU patient with severe brain injury. Methods： Between November 2011 and April 2014, PDTs were performed on 32 severe brain i...Objective： To sum up our experience in percutaneous dilatational tracheostomy （PDT） in ICU patient with severe brain injury. Methods： Between November 2011 and April 2014, PDTs were performed on 32 severe brain injury patients in ICU by a team of physicians and intensivists. The success rate, efficacy, safety, and complications including stomal infection and bleeding, paratracheal insertion, pneumothorax, pneumomediastinum, tracheal laceration, as well as clinically significant tracheal stenosis were carefully monitored and recorded respectively. Results： The operations took 4-15 minutes （mean 9.1 minutes±4.2 minutes）. Totally 4 cases suffered from complications in the operations： 3 cases of stomal bleeding, and 1 case of intratracheal bloody secretion, but none required intervention. Paratracheal insertion,pneumothorax, pneumomediastinum, tracheal laceration, or clinically significant tracheal stenosis were not found in PDT patients. There was no procedure-related death occurring during or after PDT. Conclusion： Our study demonstrats that PDT is a safe, highly effective, and minimally invasive procedure. The appropriate sedation and airway management perioperatively help to reduce complication rates. PDT should be performed or supervised by a team of physicians with extensive experience in this procedure, and also an intensivist with experience in difficult airway management.展开更多
文摘Objectives This article aimed to describe the development,implementation,and evaluation of the model’s effectiveness to facilitate self-care of professional nurses caring for critically ill patients in ICUs.Methods The methods of Chinn and Kramer,Walker and Avant were utilized to generate this model.The study included four steps to develop,implement and evaluate the model:Step 1-concept analysis;Step 2-placing the concept in relationship statements;Step 3-description and evaluation of the model;and Step 4-implementation and evaluation of the model.The implementation and evaluation of the model included two phases:a one-day workshop to present the model,and three months of model implementation.The study was conducted in a specific tertiary hospital in Gauteng Province,South Africa.Twenty-five participants were identified amongst the five ICUs,and only eight participants accepted the invitation.Out of the eight participants,only six professional nurses working in different ICUs in the public sector were interviewed.Results The model was divided into three stages:relationship,working,and termination;it comprised the primary and secondary contexts in which the facilitation of self-care occurs.The model process occurred in a spiral form.The registered nurses benefitted holistically from the three presenters at the workshop,and the social worker contributed to their emotional self-care activities.Three themes emerged:The model brought positive experiences,change,and self-awareness;the model benefitted the registered nurses holistically;role modeling self-care practices motivated and benefitted others.Conclusion The model implementation assisted the registered nurses’in developing self-awareness and resilience.They gained more knowledge regarding self-care,and the model encouraged them to implement improved self-care practices.They became role models of self-care and motivated their friends and families.
文摘Objective： To sum up our experience in percutaneous dilatational tracheostomy （PDT） in ICU patient with severe brain injury. Methods： Between November 2011 and April 2014, PDTs were performed on 32 severe brain injury patients in ICU by a team of physicians and intensivists. The success rate, efficacy, safety, and complications including stomal infection and bleeding, paratracheal insertion, pneumothorax, pneumomediastinum, tracheal laceration, as well as clinically significant tracheal stenosis were carefully monitored and recorded respectively. Results： The operations took 4-15 minutes （mean 9.1 minutes±4.2 minutes）. Totally 4 cases suffered from complications in the operations： 3 cases of stomal bleeding, and 1 case of intratracheal bloody secretion, but none required intervention. Paratracheal insertion,pneumothorax, pneumomediastinum, tracheal laceration, or clinically significant tracheal stenosis were not found in PDT patients. There was no procedure-related death occurring during or after PDT. Conclusion： Our study demonstrats that PDT is a safe, highly effective, and minimally invasive procedure. The appropriate sedation and airway management perioperatively help to reduce complication rates. PDT should be performed or supervised by a team of physicians with extensive experience in this procedure, and also an intensivist with experience in difficult airway management.
