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- Southern African Journal of Critical Care
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- Volume 22, Issue 2, 2006
Southern African Journal of Critical Care - Volume 22, Issue 2, 2006
Volume 22, Issue 2, 2006
Source: Southern African Journal of Critical Care 22 (2006)More Less
Caring for a person facing death is not an easy undertaking - but it is a privilege. It has been pointed out in the literature that nurses' anxiety in caring for the dying is strongly related to fear of their own death. Cumulative nursing experience has not been found to be a significant factor in dealing with such a fear. In fact, there are indications that the opposite holds true; uneasiness associated with interaction with the dying has increased with nursing experience.
Author W.L. MichellSource: Southern African Journal of Critical Care 22 (2006)More Less
'To err is human' is the title of a landmark document by the Institute of Medicine, which highlights the high incidence of medication errors occurring in hospitals and the consequent complications, costs and deaths. Extrapolating from two large hospital studies, medication errors may result in between 24 000 and 98 000 deaths per year in the USA, making this their 8th most common cause of death. Preventable drug events occur in 2% of hospital admissions and cost $2 billion per annum.
Source: Southern African Journal of Critical Care 22, pp 50 –56 (2006)More Less
Background. A global shortage of registered nurses (RNs) has been reported internationally, and confirmed in South Africa by the National Audit of Critical Care services. Critical care nurses (CCNs) especially are in great demand and short supply.
Purpose. The purpose of this study was to quantify the nursing workforce and compare it with requirements of critical care units (CCUs) in hospitals of the Western Cape province as at 1 January 2005, and to quantify potential recruits from nursing education institutions.
Design. A descriptive survey conducted on site in CCUs of the private and public sector hospitals of the Western Cape, using a structured questionnaire.
Results. Data were obtained from questionnaires (96.5% return rate) from 77 of the 80 CCUs surveyed in 35 hospitals (12 public; 23 private). Intensive care units (ICUs) and high-care units (HCUs) were classified in the questionnaire. Findings revealed: 39 adult ICUs (12; 27), 2 paediatric ICUs (public), 14 neonatal ICUs (4; 10), 13 adult HCUs (11, 2), 1 paediatric HCU (public), 3 neonatal HCUs (public) and 5 high-dependency units (HDUs) for adults (public), with 720 functional unit beds in total (359; 361). A registered nurse/ventilated patient ratio of 1:1 was used in 5.26% of public sector units but in all private sector units. Of the 768 nurses of all categories in public sector units 118 (15.4%) were trained CCNs and 289 were RNs (37.6%). In private sector units 204 (38.1%) of 535 nurses were trained CCNs and 204 (38.1%) were RNs. According to a consensus-driven method developed in Australia to measure the required number of ICU nurses, the Western Cape has a deficit of 72% and 80%RNs respectively in public and private sector CCUs, amounting to an actual total shortage of 2 711 RNs. Data from 7 educational institutions revealed that during 2004, 300 undergraduate nurses and 80 postgraduate CCNs graduated.
Conclusion. The current supply of nurses does not meet the needs of CCUs in the Western Cape, and the number of educators and clinical mentors is inadequate.
Source: Southern African Journal of Critical Care 22, pp 58 –65 (2006)More Less
Ethical theories have been posited since the dawn of civilisation. We all approach moral decisions informed by our historical, family and cultural backgrounds, augmented in turn by our personal and professional experience. Theories and practice reflect the beliefs, values and knowledge of the ages, refined, modified and reinstated to address present ethical concerns. Platonic and Aristotlean ethics were modified in the ensuing centuries: theorists constructed models based on natural law, seeing humankind as a link in the chain of being - stretching from God Himself to the smallest of inanimate beings.
Support to critical care nursing personnel, Southern African Journal of Critical Care 20(2) 2004 : pp. 95-100 : erratumAuthor W.E. NelSource: Southern African Journal of Critical Care 22 (2006)More Less
Source: Southern African Journal of Critical Care 22, pp 65 –67 (2006)More Less
Critical care is associated with a high mortality rate. While this varies, overall it is likely to be between 15% and 25%. In some cases death occurs almost immediately after an emergency admission and there is little time to prepare either the patient or the family. In the majority of cases, however, death occurs after a period of time. It may be an expected outcome, or it may become evident that further intervention and continuation of treatment is futile and distressing for the patient, the family, and especially the nursing staff.
The effectiveness of in-hospital psycosocial intervention programmes for families of critically ill patients - a systematic reviewSource: Southern African Journal of Critical Care 22, pp 68 –76 (2006)More Less
Background. A review of in-hospital psychosocial intervention studies for families with a relative in a critical care unit was conducted.
Purpose of review. To review the literature on studies addressing the topic, discuss research methods critically, describe clinical outcomes and make recommendations for future research efforts. In doing so, empirically tested interventions producing positive outcomes may be applied to support families who have a relative in a critical care unit.
Data sources. Research citations from 1991 to 2006 from CINAHL, Medline, Pubmed, PsycInfo, SABINET, Cochrane and SCOPUS databases, Internet search engines and unpublished abstracts through NEXUS were searched.
Review methods. Citations were reviewed and evaluated for sample, design, intervention, threats to validity and outcomes. Review studies were limited to those that evaluated in-hospital interventions in family members of patients in a critical care unit.
Results. Six studies were reviewed. Positive outcomes were reported for all of the intervention strategies. All but one of the studies reviewed studied small samples and single critical care units, and were poor in design.
Conclusions. The paucity of interventional studies and the lack of systemic empirical precision to evaluate effectiveness of these interventions necessitate that future studies be methodologically rigorous.
Source: Southern African Journal of Critical Care 22, pp 78 –84 (2006)More Less
It is an accepted premise today, nationally and internationally, that critical care nurses are accountable for setting standards of quality with regard to critical care nursing, and should contribute to the body of critical care nursing practice by undertaking and implementing research. Critical care nursing research contributes to the advancement of critical care knowledge and promotes better patient care and the adoption of best or better practices, 3 all of which address important challenges currently faced by critical care nursing in South Africa.