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Patricia A. Kritek
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Journal Articles
CE Article
Rache Marie Mureau-Haines, DNP, ACCNS, AGPCNP, Mandy Boes-Rossi, MSW, LICSW, Susan Christine Casperson, RN, DNP, ARNP, ANP-BC, CCRN, Basak Çoruh, MD, Amy M. Furth, MTS, MDiv, BCC ...
Journal:
Critical Care Nurse
Critical Care Nurse (2017) 37 (6): 14–23.
Published: 01 December 2017
Abstract
BACKGROUND Despite increasing support for family presence during cardiopulmonary resuscitation, a review of the literature revealed no published protocols or training curricula to guide hospitals in implementing a family support provider role. OBJECTIVES To develop a curriculum and train dedicated resuscitation team members whose role is to provide family support during in-hospital resuscitation events. METHODS An interdisciplinary team developed a 4-hour training session for the family support staff. The session included an introduction to the evidence for family presence during resuscitation and local data on resuscitations. The training was composed of 4 sections: (1) clinical aspects of resuscitation, (2) integration into the resuscitation team and steps for providing family support during resuscitation, (3) responding to families in distress, and (4) self-care practices. Before and after the training session, the participants completed surveys of self-rated knowledge and attitudes toward family presence during resuscitation. RESULTS Fifty-nine social workers and 8 spiritual care providers were trained in 2015. There was a significant increase in all rated aspects of knowledge of the family support role and self-care strategies. CONCLUSION Through the creation of an interdisciplinary curriculum, an institution can effectively train health care providers in a new resuscitation team role: the family support provider.
Journal Articles
CE Article
Joya D. Pickett, RN, PhD, ARNP-CNS, CCNS, ACNS-BC, CCRN, Elizabeth Bridges, RN, PhD, CCNS, Patricia A. Kritek, MD, EdM, JoAnne D. Whitney, RN, PhD
Journal:
Critical Care Nurse
Critical Care Nurse (2017) 37 (2): 32–47.
Published: 01 April 2017
Abstract
Fluid boluses are often administered with the aim of improving tissue hypoperfusion in shock. However, only approximately 50% of patients respond to fluid administration with a clinically significant increase in stroke volume. Fluid overload can exacerbate pulmonary edema, precipitate respiratory failure, and prolong mechanical ventilation. Therefore, it is important to predict which hemodynamically unstable patients will increase their stroke volume in response to fluid administration, thereby avoiding deleterious effects. Passive leg-raising (lowering the head and upper torso from a 45° angle to lying supine [flat] while simultaneously raising the legs to a 45° angle) is a transient, reversible autotransfusion that simulates a fluid bolus and is performed to predict a response to fluid administration. The article reviews the accuracy, physiological effects, and factors affecting the response to passive-leg raising to predict fluid responsiveness in critically ill patients.