International Journal of Critical Care 2022-09-20T15:54:41-06:00 Professor Elisabeth Papathanasoglou & Professor Ged Williams Open Journal Systems <p><em>International Journal of Critical Care</em> is the official journal of the World Federation of Critical Care Nurses. It builds on the legacy and successes of <em>Connect,</em> the former Journal, and endeavors to be a truly global vehicle for sharing the latest research, initiatives, policy advice, and achievements in critical care. </p> Raising Awareness of the Benefits of a Standardized (2222) Telephone Number for In-Hospital Cardiac Arrest 2022-09-20T13:41:00-06:00 Isabel Coetzee Marlize Kuhn Ged Williams David Whitaker Karin Klas Oscar Cabrera <p>This paper calls for the use of a standardized number, 2222, for cardiac arrests that occur in medical centers. Currently, 14 countries so far have adopted this recommendation. It is thought that many more lives could be saved with this simple intervention. </p> 2022-09-20T00:00:00-06:00 Copyright (c) 2022 Isabel Coetzee, Marlize Kuhn, Ged Williams, David Whitaker, Karin Klas, Oscar Cabrera A Patient Safety Solution: Evaluation of a 24/7 Nurse-led Proactive Rapid Response Program 2022-06-30T14:09:49-06:00 FIONA WINTERBOTTOM Heather Webre Kala Gaudet Jeff Burton <p><strong>Background</strong>: Rapid Response Systems are patient safety programs that have been implemented around the world to reduce preventable patient harm and failure to rescue.</p> <p><strong>Problem:</strong> There was a high rate of cardiac arrests outside the intensive care unit and absence of a structured system to identify and rescue patients with signs of clinical deterioration prior to cardiac arrest.</p> <p><strong>Objectives:</strong> To evaluate the impact of a structured 24/7 nurse-led proactive rapid response program on clinical deterioration and cardio-pulmonary arrests.</p> <p><strong>Methods:</strong> This study took place in a 650-bed quaternary academic regional referral center. The study period was between January 2014 and February 2020. A rapid response system redesign was initiated in early 2017 and a 24/7 nurse-led proactive rapid response program launched in December 2017.</p> <p><strong>Results:</strong> A statistically significant decrease in rates of critical care cardio-pulmonary arrests, non-critical care cardio-pulmonary arrests, rapid response consults, unplanned ICU transfers, and hospital deaths occurred following implementation of the 24/7 nurse-led proactive rapid response program.</p> <p><strong>Conclusions:</strong> Implementation of a structured 24/7 nurse-led rapid response program can decrease cardio-pulmonary arrests, unplanned transfers to ICU, and hospital deaths.</p> 2022-09-20T00:00:00-06:00 Copyright (c) 2022 FIONA WINTERBOTTOM Implementing and Evaluating a Pilot Therapeutic Music Program in the Intensive Care Unit 2022-09-19T19:33:05-06:00 Joseph Schlesinger Melissa Pearson Deborah O’Briant Javin Bose Sean Yang Judy Li Todd Rice Ruth Kleinpell <p><strong>Background:</strong> Therapeutic music has been shown to provide significant physical and mental health benefits to patients, yet limited information is available on the impact of live classical music in the intensive care unit (ICU) setting.</p> <p><strong>Objective:</strong> The purpose of this initiative was to implement and evaluate a therapeutic music program in the ICU.</p> <p><strong>Methods:</strong> A descriptive survey methodology was used to obtain information from volunteer musicians and clinical nurses. Researchers used a 12-item anonymous web-based survey to collect information on the therapeutic music program's acceptability, appropriateness, and feasibility. The survey also included questions addressing potential barriers to and facilitators of implementing therapeutic music in the ICU.</p> <p><strong>&nbsp;Results:</strong> A total of 15 nursing staff and 6 volunteer musicians completed the online survey. Of the 15 nurse respondents (9 clinical nursing staff, 3 advanced practice, 3 other), a majority (n=10, 66.7%) identified that therapeutic music was acceptable in the ICU. Similarly, a majority (n=11, 73.3%) indicated that therapeutic music was appropriate and feasible. Of the volunteer musicians, all (n=6, 100%) identified several factors that helped to facilitate the program including having an upright piano with large casters (wheels) for enhanced mobility to play music. Most (n=5, 83.3%) identified having a patient and family-centered care environment and supportive ICU staff, and four (66.7%) identified private ICU rooms and trained musicians as useful. Several barriers were also identified, including severity of patient illness and infection prevention concerns (n=5, 83.3%), space limitations in the ICU and patient privacy concerns (n=2, 33.35%), and patients being asleep (n=1, 16.75%).</p> <p><strong>Conclusions:</strong> The results of this initiative indicated that therapeutic music in the ICU was rated as acceptable, appropriate, and feasible. Volunteer musicians reported the ability to provide live music in the ICU to be a beneficial and enjoyable experience. The program has been transitioned to a virtual format using a large iPad on wheels due to COVID-19-related visitation restrictions.</p> 2022-09-20T00:00:00-06:00 Copyright (c) 2022 Joseph J. Schlesinger, MD, FCCM, Melissa Pearson, DNP, AG-ACNP, FNP, ENP, Deborah O’Briant, DNP, RN, Javin Bose, Sean T Yang, Judy Li, Todd Rice, MD, MSc, Ruth Kleinpell, PhD, RN, FCCM Unit Knowledge and Practice of Emergency Nursing Interventions at a Tertiary Public Cardiac Health Center in Uganda 2022-09-20T14:04:01-06:00 Harriet Namukwaya Cliff Aliga Mary Nakate Judith Mutyabule <p><strong>Background: </strong>Research suggests that many of the millions of deaths and long-term disabilities resulting from acute cardiovascular events and other emergency conditions are preventable if effective emergency care services were readily available. Effective emergency care requires trained and competent staff, including registered nurses. Most educational pathways do not adequately prepare nurses to deliver sensitive health care services for those with acute illness and injury. This includes Uganda, where few capacity-building initiatives have targeted emergency nursing care delivery, leading to knowledge and practice gaps.</p> <p><strong>Purpose</strong>: This study aimed to assess emergency nursing knowledge and clinical practice at a tertiary public cardiac health facility in Uganda.</p> <p><strong>Method: </strong>This was a single-center, descriptive cross-sectional survey of a convenience sample of nurses working in the emergency department.</p> <p><strong>Results: </strong>A total of 49 emergency care nurses completed the survey (response rate of 81.6%). Among the participants, 75.5% were females, 65.3% had a bachelor's degree, 28.6% had Basic Life Support training, and 12.2% were certified in Advanced Cardiac Life Support. Additionally, 75% of the respondents had low proficiency in assessing critically ill patients, 100% could not perform safety checks, 50% were unable to maintain patent airways or complete patient handover, and only 50% could connect a patient to a defibrillator.</p> <p><strong>Conclusion: </strong>We report that the most significant gap in nurse-provided emergency care is the application of practical skills. Capacity-building initiatives are required to improve the knowledge and practice of nurses in emergency care delivery.</p> 2022-09-20T00:00:00-06:00 Copyright (c) 2022 Harriet Namukwaya, BScN, RN1, Cliff Asher Aliga, PhD, EN, CCN, Fellow (UNISA), Mary Grace Nakate, PhD. RN, MNS, Fellow (FHEA), Judith Mutyabule, PhD, MPH, BCuR, Fellow A Scoping Review of the Impact of Emergency Department Nurse Practitioners on Healthcare Outcomes in Canada Patient Safety Solution 2022-09-19T19:23:05-06:00 Timur Bazavluk Usha Pant Krooti Vyas Kathleen Hunter Elisavet Papathanasoglou <p><strong>Background:</strong> Nurse Practitioners (NPs) are a valuable yet untapped resource in Canadian healthcare – especially in the emergency department (ED). Multiple international studies showed positive outcomes associated with NPs working in EDs, but limited Canadian studies are available.</p> <p><strong>Aim:</strong> The objective of this study was to review the literature available in Canada on the outcomes associated with having NPs in the ED. These outcomes include wait times, length of stay (LOS), rates of patients who left without being seen (LWBS), willingness to be treated by an NP, and patient satisfaction with their treatment by an NP.</p> <p><strong>Methods:</strong> This scoping review was informed by the procedures outlined by the Joanna Briggs Institute. Reporting was guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Two independent reviewers systematically searched CINAHL, EMBASE, SCOPUS, Cochrane Library, and MEDLINE in January 2022. All peer-reviewed articles that met the eligibility criteria were included. A pair of independent reviewers completed the selection process, screening, and data extraction. The reviewers discussed disagreements until they reached a consensus.</p> <p><strong>Results:</strong> A total of five studies met the inclusion criteria. Decrease in wait times, LOS, rates of patients who LWBS, and increase in patient throughput were noted. One study did not find significant improvement in wait times, LOS, and rates of patients who LWBS. There was also a high rate of patient satisfaction and willingness to see an NP.</p> <p><strong>Conclusion:</strong> This review shows evidence of positive change on the outcomes of decreased wait times, LOS, rates of patients who LWBS, and patient satisfaction associated with having NPs in EDs. However, there is limited up-to-date evidence in the Canadian literature leaving room for future research. Future research needs to address outcomes associated with NPs working in the ED in Canadian provinces other than British Columbia, Alberta, and Ontario, research that is more in line with the current political climate of the pandemic and lack of resources, and how NPs can be best integrated into EDs</p> 2022-09-20T00:00:00-06:00 Copyright (c) 2022 Timur Bazavluk, Usha Pant , Krooti Vyas, Kathleen Hunter, Elisavet Papathanasoglou Where to now with Rapid Response Systems? 2022-09-19T17:09:04-06:00 Ged Williams Elizabeth Papathanasoglo Patricia Zrelak <p>In this editorial, journal editors highlight the importance of articles, such as the one by Winterbottom et al (2022),&nbsp; that demonstrate the impact of rapid response systems (RRS) in improving patient outcomes.&nbsp;</p> 2022-09-20T00:00:00-06:00 Copyright (c) 2022 Ged Williams, Elizabeth Papathanasoglo, Patricia Zrelak