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Poor physician communication was the main obstacle noted by CCNs during ICU EOL care, followed by physicians giving false hope. Heavy patient workloads with inadequate staffing were also a major barrier in CCNs providing EOL care.

Poor physician communication was the main obstacle noted by CCNs during ICU EOL care, followed by physicians giving false hope. Heavy patient workloads with inadequate staffing were also a major barrier in CCNs providing EOL care.

Moral dilemmas and ethical conflicts occur in critical care. Negative consequences include misunderstandings, mistrust, patient and family suffering, clinician moral distress, and patient safety concerns. Providing an opportunity for team-based ethics assessments and planning could improve communication and reduce moral distress.

The aims of this study were to explore whether an early action ethics intervention affects intensive care unit (ICU) clinicians' moral distress, ethics self-efficacy, and perceptions of hospital climate and to compare nurses' and physicians' scores on moral distress, ethics self-efficacy, and ethical climate at 3 time points.

Intensive care unit nurses and physicians were asked to complete surveys on moral distress, ethics self-efficacy, and ethical climate before implementing the ethics protocol in 6 ICUs. We measured responses to the same 3 surveys at 3 and 6 months after the protocol was used.

At baseline, nurses scored significantly higher than physicians in moral distress self-efficacy. This, in turn, can potentially promote teamwork and reduce burnout.

Understanding and facilitating the seamless and safe transitions of patients across high-acuity hospital settings are important for students to grasp in order to meet patient and family care needs.

Clinical placements do not always give students the opportunity to care for patients in various hospital settings or apply complex knowledge and skills learned in their didactic courses. Furthermore, the global pandemic has limited student clinical experiences in health care settings, underscoring the need for simulated clinical learning opportunities.

A multiscenario simulation using a high-fidelity human patient simulation manikin was incorporated into a senior-level capstone course. Simulated hospital settings included the (1) emergency department, (2) critical care unit, and (3) progressive care unit.

Student evaluations revealed positive perceptions of learning, enhanced proficiency of clinical skills, and increased confidence regarding transitions of care. Faculty held agreeable opinions of the simulation's ease of facilitation and effectiveness as a teaching tool.

Application of complex knowledge and skills, understanding the use of bundles of care, and an appreciation for transitions of care hospitalized patients were successfully achieved.

Application of complex knowledge and skills, understanding the use of bundles of care, and an appreciation for transitions of care hospitalized patients were successfully achieved.

Ventilator bundles have been reported to reduce the risk of ventilator-associated pneumonia. However, data concerning the role of the education of the intensive care unit (ICU) staff regarding the items in the bundle and the importance to adhere to its items on the development of ventilator-associated events (VAEs) are limited. This study aimed to compare the frequency of VAEs in subjects admitted to the ICU before and after the education of the ICU staff.

A total of 105 subjects were enrolled in this retrospective study. The ICU staff, including the physicians, respiratory therapists, and nurses, received a 2-day educational lecture regarding items in the bundle as well as the need to adhere to its items. AOA hemihydrochloride in vitro The study population was divided into two according to the admission date subjects who were admitted before the education of the ICU staff regarding the ventilator bundle (preeducation) and subjects who were admitted after the education of the ICU staff regarding the ventilator bundle (posteducation). T a significant reduction in the rate of the VAEs in patients receiving mechanical ventilator support in the ICU.

A low hemoglobin level, commonly referred to as anemia, is frequently encountered in the acute care setting among patients with different comorbidities. It is essential that clinicians understand the pathophysiology of anemia to develop a practical differential diagnosis of the cause of the low hemoglobin level. A systematic approach should be used when determining the diagnosis to provide the correct treatment for the patient.

This article highlights the equal importance of the patient's history and laboratory values in arriving at the correct diagnosis of low hemoglobin level. The approach to diagnosis is described along with an algorithm to enable the clinician to quickly and effectively diagnose their patients.

The differential diagnosis of low hemoglobin level is extensive, and some may be overlooked if an organized approach is not taken. For unstable patients, the diagnosis is usually clearer to the clinician. However, for a stable patient, the diagnosis may be difficult to obtain owing to the many causes of low hemoglobin level. The algorithm allows for easier navigation of the diagnostic process.

The differential diagnosis of low hemoglobin level is extensive, and some may be overlooked if an organized approach is not taken. For unstable patients, the diagnosis is usually clearer to the clinician. However, for a stable patient, the diagnosis may be difficult to obtain owing to the many causes of low hemoglobin level. The algorithm allows for easier navigation of the diagnostic process.Obstructive sleep apnea and hypopnea syndrome is associated with decreased quality of life, poor school performance and, in up to 40 % of children, behavioral problems such as hyperactivity, enuresis, anxiety and depression. Several studies have shown that adenoamygdalectomy is effective in improving or resolving sleepdisordered breathing. While this surgery has beneficial results, it is not without risks. Postoperative pain and bleeding are the two main causes of morbidity. Other complications of surgery include postoperative nausea and vomiting, delayed feeding, dehydration, referred earache, voice changes, and, rarely, death. Recommendations on postoperative care for children undergoing adenoamygdalectomy are mentioned in this article.