Sedation Management Essay

Justin is the registered nurse that has been given the handover for Kelly Malone’s postoperative care in the surgical unit. Kelly Malone is a 49 female patient who has had a septoplasty and a right ethmoidectomy. Justin is working with Kelly to identify Kelly’s needs in order for Kelly to be discharged from the hospital. Kelly’s postoperative observations were a temperature of 36.2 degrees celsius; heart rate of 68 beats per minute; respiratory rate of 18 breaths per minute, blood pressure of 111 systolic over 73 diastolic millimetres of mercury; oxygen saturation at 93 percent of room air and a self-rated pain score of two out of ten. Kelly has a history of ‘not being able to breathe well through her nose’ and a history of disturbed sleep.

Sheriff and Van Sell are nursing professors at the Women’s Texas University and Strasen is a nursing director at the University of Texas Southwest. Sheriff, Van Sell and Strasen present research that suggests nurses and physicians are more likely to encourage family presence during resuscitation (FPDR) if there is a written policy addressing specific criteria for the inclusion and exclusion of family during these procedures. The authors provide a framework to use when writing a hospital policy regarding FPDR. The authors identified several common barriers healthcare professionals have about FPDR and found educational programs about the positive outcomes of FPDR could drastically increase the number of physicians and nurses who would encourage

ICU patients are at an increased risk of developing delirium, a significantly underdiagnosed neurologic condition (Gusmao-Flores, Salluh, Chalhub, & Quarantini, 2012). CAM-ICU is effectively incorporated into daily assessments by clinical staff. This process allows for clinicians to appropriately identify and treat delirium before there are adverse

Were there more deaths related to not following the Moderation Sedation policy? No additional deaths were found related to Moderate Sedation because the plan has worked. If additional deaths were found we would evaluate charts of patients who had a procedure done at bedside to see if the Moderate Sedation policy was followed. If not follow up would be needed to see why it was not followed, which would include speaking with the physician and nurse at bedside who performed the procedure.

Definition and History of Evidence-Based Practice In the field of nurse anesthesia there are always clinical advances and an explosion of new information. So how does an anesthesia provider put all this new knowledge to good use in a clinical setting?

Lao-Tzu once said, “Life and death are one thread, the same line viewed from opposite sides.” While the safety of patients lives hang by a thread in the hand of a nurse anesthetist who only have a nursing degree in anesthetics, these certified registered nurse anesthetist’s (CRNA) are training hard, studying extra hours, and being shoved deeper into debt to be able to handle any anesthesia case with expertise. Nurse anesthetist should be allowed to practice without the supervision of a physician or anesthesiologist. There have been a number of court cases against the unsupervised practice of CRNA, and they were all dismissed in favor of the nurses. Nurse anesthetist is one of the oldest nursing specialties in the United States, and the schooling

Mr. A is admitted to the critical care unit post bowel resection, splenectomy, acute respiratory distress syndrome (ARDS) and patient-ventilator dyssynchrony (PVD). He is an eighteen-year-old African American man who is placed on an IV infusion of Norcuron and Ativan. The major outcomes expected for Mr. A would be for him to be able to wean of the ventilator, be hemodynamically stable, heal adequately, tolerate his diet, have adequate bowel elimination, and be able to adjust to his life with optimal functioning. The problems that are to be manage include, being on the ventilator, being sedated, having an elevated temperature, having a low hemoglobin, post surgical bowel resection, splenectomy, hypoxia and diet intolerance.

The CIWA evaluation tool is sometimes replaced with the Richmond Agitation-Sedation Scale (RASS) and Confusion Assessment Method (CAM) assessment tools when patients reside in the ICU.24 These are well validated tools that evaluate the level of a patient’s agitation versus sedation and presence or absence of

Underlying causes Jill is new to the ICU unit. This places stress on the more experienced nurses to take time out of their busy schedule to teach Jill ICU patient care and procedures. The frustration that the ICU nurses feel is warranted to an extent, due to the fact that the ICU is for the most acutely ill patients, those who are unstable, in critical condition and needing very intensive nursing care

American Association of Colleges of Nursing. (2006). Essentials of doctoral education for advanced nursing practice. Retrieved from: http://www.aacn.nche.edu/publications/position/DNPEssentials.pdf Beck, L., & Johnson, C. (2008). Implementation of a nurse-driven sedation protocol in the ICU.

What an Anesthesiologist Is An anesthesiologist is, as defined by Mosby’s Dictionary of Medicine, is “a physician who completes an accredited residency program in anesthesiology. Anesthesiologists may administer anesthesia directly or as part of an anesthesia team consisting of nurse anesthetists or anesthesiologist's assistants.” These physicians, however, have not been around since the beginning of surgery. Surgery back then was painful for the patient and more stressful for the doctor because with the patient aware the doctor had to be extra careful of every single move; because of the discomfort caused by a patient and stress that built by operators, anesthesiologists emerged and became a vital necessity in the medical field. If they had not existed, surgery would still be primitive and excruciating.

2 Sleep Deprivation in the Nursing Profession Sleep deprivation is known as a condition of not getting enough sleep that can affect the brain and cognitive functions. "It occurs when a person sleeps for fewer hours than necessary over multiple days or week" (Eanes, 2015). When we think of nurses we are reminded of people who promote the health of others. However, many are unknowingly compromising their own health by working those 12-hour shifts. Many times, its more than 12 hours when they are finally able to go home.

• During conscious sedation policies were not followed properly. It is required to have vital signs, continuous pulse ox. and ECG monitoring. This needs to be done pre and post procedure. • Post sedation procedures were not followed accurately.

The anaesthetist removed the ETT and proceeded to place a tight fitted mask on patients face. (REF)She then alerted the team that there was a problem with the patient airway (REF). The mask did not mist up – indicating of no air movement return, there was no carbon dioxide trace on the capnography and the patient oxygen saturation dropped steadily from 100% to 90%. He instigated vigorous jaw thrust to improve oxygenation, and using continuous positive airway pressure(CPAP) to deliver 100% oxygen flow through the breathing bag attached to the anaesthetic machine but all this effort was not having any effect on the ventilation. He then asked my mentor the Operating Department Practitioner (ODP) to administer 50mg/5ml of intravenous Propofol.

CHAPTER THREE 3.0 RESEARCH METHODOLOGY 3.1 Research Design A cross sectional descriptive study design was used in order to give a detailed description of the nurse’s knowledge, practice and challenges on the care of critically ill patients. In a cross sectional study, data were collected at one point in time, the phenomena under the study was captured during one period of data collection (Polit and Beck, 2008). Quantitative approach was used to collect and analyze data from the study participants; data was quantified in numerical values, percentages to enable statistical inferences. A quantitative method was chosen because it enables the researcher to test the relationship and examine cause and effect among dependent and independent variables.