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Check out the article in International Journal of Nursing Studies on Patient participation in surgical wound care in acute care settings: An integrative review https://lnkd.in/gUxmp7g4

Copy link to this summary Preload and Afterload Nursing | Stroke Volume, Cardiac Output ExplainedRegisteredNurseRNOverview: The lesson discusses the concepts of cardiac preload and afterload and their influences on cardiac output.Key Events:Cardiac preload refers to the volume of blood that ventricles stretch during diastole.Cardiac afterload is the pressure that ventricles have to work against to open semilunar valves.Increasing preload can be achieved through IV fluids, vasopressors, and diuretics. Decreasing preload involves diuretics and vasodilators.Increasing afterload can include pulmonary hypertension and valve problems. Decreasing afterload involves vaso dilators.Lessons Learned:Understanding preload and afterload is crucial in determining cardiac output and adjusting therapy for patients.Palliative or supportive therapies may be needed to improve patient outcomes.Long-term management of serious conditions like heart failure often requires a combination of therapies from multiple disciplines.Advice: Familiarize yourself with the concepts of preload and afterload and their implications on clinical management.Conclusion: The  emphasizes the importance of considering preload and afterload in managing cardiac function and adjusting treatment for patients with various cardiac conditions. @Yasminsuhanikath75@gmail.com 

👶🌡️ **Unlocking Insights: Pediatric Intensive Care & Cardiopulmonary Therapy!** 🏥👩⚕️ **Title: Cardiopulmonary PT in Pediatric ICU** **Purpose:** - 🩺 Exploring the role of physical therapists in pediatric cardiac critical care & intensive care units. **Methods:** - 📊 Chart review of 111 pediatric cases in PICU & CCCU. - 📋 Examined admission reasons, CPT practices, and chest X-ray interpretation availability. **Key Findings:** - 📈 Common reasons for admission: congenital cardiac conditions (34.2%) & respiratory deterioration (27.9%). - 🌬️ Most common CPT treatment: Manual hyperinflation with expiratory vibration. - 👶 50% of children had associated diagnoses, e.g., developmental delay. - 💡 Chest X-ray interpretation available in 72% of cases. **Conclusions:** - 🤔 Manual hyperinflation's effectiveness needs further study across diagnostic groups. - 📊 Standardized recording of chest X-rays crucial for future clinical research. **Takeaway:** - 🌐 Insights pave the way for enhancing pediatric intensive care through tailored physiotherapy. #PediatricICU #CardiopulmonaryPT #HealthcareInnovation 👩⚕️👶🏥

A U.S. Department of Veterans Affairs Medical Center in Colorado paused heart surgeries for 13 months, and its leaders failed to inform higher-ups. The Department of Veterans Affairs, Office of Inspector General found that the VA medical center in Aurora, Colorado, paused cardiac surgeries for over a year in 2022-2023. The leadership cultivated a "culture of fear" at the hospital, leading to the departure of critical nursing staff. The pauses in heart surgeries were not directly linked to patient harm, but the toxic work environment jeopardized patient safety. The facility was forced to pause heart surgeries again two months later after continued efforts to attract permanent personnel failed. During the second pause, the hospital's entire cardiac surgical staff left. The hospital was able to resume procedures only 13 months later after it contracted with the University of Colorado to provide surgical teams. This incident highlights the importance of effective leadership, staff retention, and transparent communication within healthcare organizations. It underscores the need for a positive work culture that prioritizes patient safety and well-being. #VAhealthcare #PatientSafety #LeadershipFailure #CultureofFear #StaffRetention #HealthcareManagement

How much U.S. healthcare bills for 7 hour pediatric ED stay: $11,712 Back in March, my son had a bad infection after getting cold-related dry cuts on his hands. He became uncharacteristically weak over few hours and when I came back from working outside, he started to have a fever, with his wound starting to pus locally. (Morning dressing change it wasn’t). Looked like bad impetigo going rogue. I have a ridiculously high threshold for suggesting friends and family go to the ED, but this was one of those “pediatricians nowadays can do emergency visits” and it was 4PM and maybe ever borderline sepsis. Reluctantly decided to bring him to ED at NewYork-Presbyterian Hospital, where I visited the exact peds ED many times as a resident. Workup included: - surgical consult for wound care - derm consult for lesion and swab - hand xray (I should’ve honestly refused this, but we were just waiting and waiting) - dressing with xeroform - various wound cultures Admittedly I feel like it’s more than a usual pediatric URI watch and release but I feel like there’s everything wrong with this $11,700 bill that was “adjusted” for $8,900 leaving me w a $3000 bill. I somehow saw 4 doctors (ED resident, attending, derm resident, surgery resident) and stayed in the ED for about 7hours (4-11PM), for something that I knew could’ve been easily addressed with dressing change materials. This is an example of over utilization in US healthcare. 🔹+$12k for hospital revenue. 🔹Insurers can claim they paid out $9000, so they can claim next year’s budget line it’ll cost $9500 for the same service with inflation and all. 🔹Patients are on the hook for some random amount.

Concise content for busy nurses. In this issue, read how ATTs may limit stroke and bleeding in trauma patients, AFib guidelines for a more aggressive therapy approach, refresher training to boost pediatric code skills, and more.

International Prehospital Medicine Institute Literature Review, April 2024 1. Completeness of Pediatric Versus Adult Patient Assessment Documentation in the National Emergency Medical Services Information System. 2. National analysis of motorcycle associated injuries and fatalities: wearing helmets saves lives. 3. Accuracy of the American College of Surgeons Minimum Criteria for Full Trauma Team Activation for Children. 4. Video Laryngoscopy versus Direct Laryngoscopy for Orotracheal Intubation in the Out-of-Hospital Environment: A Systematic Review and MetaAnalysis. 

An insightful article on GBM that highlights the gaps between patient needs and caregiver capacity and commitment, and offers strategies for creating a tailored plan to enhance caregiver preparedness

Thank you Greater Ohio Vascular Access Network GOVAN for shifting the paradigm! It was nice to present on the adult patient perspective of living with long-term vascular access devices alongside, Tara, who is a PICU nurse and a parent to her son with TPN, and Mickey Hawes, nurse, researcher, consultant, previous Home Infusion Company exec., and PICC patient. The presentation was titled, “The Story Behind the Line: The Journey You Don’t See.” Todd Heslep BSN, RN, Paramedic, VA-BC, President, and the Executive Team at GOVAN made sure a patient and family perspective was shared in a meaningful way at their network meeting by: 1. Having us as the first speakers for the day. Doing so respects our time as the rest of the content is catered to clinicians and allows us to speak to audience members after having shared the bulk of our story so we do not have to repeat or experience any repeated trauma in resharing. Starting with the patient and family perspective can help set the desired tone and provides a good reminder of our why. 2. Valuing our time and energy as individuals and as a group. 3. Giving us autonomy in our slides and our call to action to the audience. I also thought putting questions from the audience in the middle of the presentation changed up the style and pace nicely and allowed the audience to feel included and have their questions answered. Great questions were asked pushing us to a good panel discussion. It was a joy to present and be a voice alongside Tara and Mickey’s thoughtful and direct insights. We shared the education we received to care for our lines in the home that has been most useful and the hardest to implement, and tips on how to communicate with us as adults, children, and caregivers, in the hospital at different points of access and the resources we may or may not have in the home. We truly asked everyone to understand this is our life not our job and we want you to take ownership of care delivery WITH us. We must work as partners. Being in a more intimate audience I got to see more closely for the first time clinician reactions of shaking heads, jaw drops and big eyes, when they learn I have had 31 central lines, 26 CLABSIs, 15 yrs no infection, same line for >5 yrs, and too many sticks w/o ultrasound. This is my why. This is why I continue to educate and travel to present. I get similar reactions in the hospital as an adult, especially at non-subspecialty hospitals stating I am the problem instead of asking why I had infections and line placements, what has been and is currently working well, and how can we continue that for you in this hospitalization and moving forward beyond these 4 walls. No one else should go through what I have gone through. We all have to learn from mine and the larger patient and family community experience for the next generation, for my gutsy peers, and for my friends who I have not met yet. #vascularaccess #vascularhealth #centralvenouscatheter #rarediseases #isavemyline

I read an article today on the American Heart Association website about an escape room designed to train nurses in stroke protocol and I think it's a brilliant idea! "The researchers developed the escape room in response to two key needs. Nurses at Tufts Medical Center Comprehensive Stroke Center gave feedback in recent years that they were looking for more interactive ways to meet their continuing education requirements through in-person formats. And those educational opportunities must be provided without requiring that nurses spend too much time away from their patients." I'm sharing a link to the article below and also thinking about how the idea of play as a way to learn could be applied to a sterile processing department. What if the game of Clue was crossed with the chain of infection? I could make a couple characters like Tanya Tuberculosis or Carlton C-Diff and assign teams of techs that character/microorganism. I could then "spread" that character through the department in some obvious and less obvious places along the 1 way work flow. Then give each team 10 minutes to trace that pyrogen's path through the department and at the end score each team based on if they found where the chain of infection broke down. It was Carlton, in the endo suite with a damaged channel brush! Based on how competitive our SPD Jeopardy game got, I think this would be so fun. What games do you think could be used to teach and build community in your sterile processing department? https://lnkd.in/gCzSsF3J #breakthechain #handhygiene #1wayflow #yeghealthcare