Concept of Critical Care 2012 120406061222 Phpapp01

7/29/2019 Concept of Critical Care 2012 120406061222 Phpapp01

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CONCEPTS

OF

CRITICAL CARE


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Introduction

The intensive care unit is not merely a

room or series of room filled withpatients attached to interventional

technology; it is the home of an

organization: the intensive careteam.


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Critical Care Nursing

Critical care nursing is that specialtywithin nursing that deals specifically with

human responses to life-threatening

problems.


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Critical Care Nurse (CCN)

CCN is responsible forensuring that acutely and

critically ill patients and their

families receive optimalcare .


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Aim of the Critical Care

is to see that one provides a care

such that patient improves andsurvives the acute illness or tides

over the acute exacerbation of the

chronic illness.


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Nurse Staffing

The number of nurses ideally required for suchunits is 1:1 ratio.

In complex situations they may require twonurses per patient.


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The Evolution of Critical Care

Forty years of development in critical

care and critical care nursing has given

rise to a recognized specialty in nursingpractice.

Critical care units have evolved over thelast four decades in response to medical

advances .


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Historical Prespectives

1923, John Hopkins University Hospital

special care unit for neurosurgical patients .


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1950

epidemic of poliomyelitis necessitatedthousands of patients requiring

respiratory assist devices and intensive

nursing care.


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1953, Manchester Memorial Hospital

four bedded unit

1957

20 units in USA

1958

the number increased to 150 units.


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During 1970s,the term critical care unit

came into existence which covered alltypes of special care.


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Progressive Patient Care

It is systematic classification and

segregation of patients based on their

nursing and medical needs.

Patient care. PPC has been defined as

"the right patient, in the right bed, with the

right services, at the right time.

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Progressive Patient Care

Intensive care units

Intermediate care units

Self care units

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Florence Nightingale

placed the seriously ill patients near the

nurses station.

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http://upload.wikimedia.org/wikipedia/commons/c/c9/Hospital_at_Scutari_2a.jpg


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Organizational Models for ICUs

Open model

Closed model

Hybrid model


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Types of ICUs

An open:

In this type, physicians admit, treat and

discharge

A closed:

In this type, the admission, discharge andreferral policies are under the control ofintensivists.


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ICUS can be CLassified

Level I:

This can be referred as high

dependency is where close

monitoring, resuscitation,

and short term ventilation


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Level II:

undertake more prolonged

ventilation. Must have

resident doctors, nurses,access to pathology,

radiology, etc.

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Level III:

It should provide all aspects

of intensive care required.

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True

Collaboration

Skilled

Communication

Healthy Work Environment

Nursing Practice

Authority Accountability Autonomy

Nurse

Competences Patient Needs

Evidence

Based

Practice

Optimal

Patient

Outcome

Culture

of

Inquiry

Safe Passage AuthenticLeadership

Meaningful

Recognition

Appropriate

Staffing

Decision

Making

AACN Synergy Model

Clinical

Experience
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Intensive Care Unit Equipments:-

Patient monitoring

Life support and emergency resuscitationdevices

Diagnostic devices


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28Doctor and Nurse with ICU Monitoring Equipment, 1965


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Therapeutic Elements in ICU

Environment


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Conclusion

Progressive patient care

Collaboration

Organization

Cost effectiveness

Preventive strategies

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Reference

http://www.archbronconeumol.org/bronco_eng/ct

l_servlet?_f=40&ident=13079312

http://hsc.unm.edu/emermed/cpr/Adult_Crash_C

art.shtml

http://www.aorn.org/News/September2008News/

HealthyWork

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Concept of Critical Care 2012 120406061222 Phpapp01