Download Complete Issue PDF

84 Pages·2016·2.89 MB·English

O C T O B E R 2 0 1 6 • V O L U M E 3 6 N U M B E R 5
CriticalCareNurse
The j our na l fo r h i g h acu i ty, progress iv e, and cr itical care nursing
CE
Managing Morbidly
Obese Patients

Esophageal
Pressure
Measurements
Cardiovascular
Disease
and HIV
CE
Hybrid
Stage I
Palliation
CE
Withdrawal
of ECMO
EXPAND YOUR SKILLS AS
AN EMERGENCY ROOM
NURSE IN THE U.S. ARMY.
When you become a nurse and officer on the U.S. Army
health care team, you’ll be surrounded by health care
professionals who share your passion for providing
quality patient care. Explore groundbreaking medical
procedures, work with innovative equipment in
high-tech Army medical facilities. And, if you choose
the Army Reserve, you’ll continue to work in your
community and serve when needed.
For more information visit healthcare.goarmy.com/fy29.
©2016. Paid for by the United States Army. All rights reserved.
Take your
knowledge
to the
next level
(cid:64)(cid:86)(cid:92)(cid:89)(cid:3)(cid:87)(cid:72)(cid:91)(cid:80)(cid:76)(cid:85)(cid:91)(cid:90)(cid:3)(cid:75)(cid:76)(cid:87)(cid:76)(cid:85)(cid:75)(cid:3)(cid:86)(cid:85)(cid:3)(cid:80)(cid:91)(cid:21)(cid:3)
(cid:40)(cid:40)(cid:42)(cid:53)(cid:3)(cid:86)(cid:584)(cid:76)(cid:89)(cid:90)(cid:3)(cid:91)(cid:79)(cid:76)(cid:3)(cid:83)(cid:72)(cid:91)(cid:76)(cid:90)(cid:91)(cid:3)(cid:74)(cid:76)(cid:89)(cid:91)(cid:80)(cid:196)(cid:74)(cid:72)(cid:91)(cid:80)(cid:86)(cid:85)(cid:3)(cid:89)(cid:76)(cid:93)(cid:80)(cid:76)(cid:94)(cid:3)(cid:74)(cid:86)(cid:92)(cid:89)(cid:90)(cid:76)(cid:90)(cid:3)(cid:91)(cid:86)(cid:3)(cid:72)(cid:90)(cid:90)(cid:80)(cid:90)(cid:91)(cid:3)(cid:96)(cid:86)(cid:92)(cid:3)(cid:94)(cid:80)(cid:91)(cid:79)(cid:3)(cid:91)(cid:79)(cid:76)(cid:3)(cid:85)(cid:76)(cid:94)(cid:3)(cid:42)(cid:42)(cid:57)(cid:53)(cid:19)(cid:3)(cid:42)(cid:42)(cid:57)(cid:53)(cid:20)(cid:44)(cid:3)(cid:72)(cid:85)(cid:75)(cid:3)(cid:42)(cid:42)(cid:57)(cid:53)(cid:20)(cid:50)(cid:3)
(cid:76)(cid:95)(cid:72)(cid:84)(cid:90)(cid:3)(cid:91)(cid:79)(cid:72)(cid:91)(cid:3)(cid:94)(cid:76)(cid:85)(cid:91)(cid:3)(cid:80)(cid:85)(cid:91)(cid:86)(cid:3)(cid:76)(cid:584)(cid:76)(cid:74)(cid:91)(cid:3)(cid:80)(cid:85)(cid:3)(cid:83)(cid:72)(cid:91)(cid:76)(cid:3)(cid:25)(cid:23)(cid:24)(cid:28)(cid:21)(cid:3)(cid:55)(cid:89)(cid:76)(cid:90)(cid:76)(cid:85)(cid:91)(cid:76)(cid:75)(cid:3)(cid:73)(cid:96)(cid:3)(cid:85)(cid:72)(cid:91)(cid:80)(cid:86)(cid:85)(cid:72)(cid:83)(cid:83)(cid:96)(cid:3)(cid:82)(cid:85)(cid:86)(cid:94)(cid:85)(cid:3)(cid:90)(cid:92)(cid:73)(cid:81)(cid:76)(cid:74)(cid:91)(cid:3)(cid:84)(cid:72)(cid:91)(cid:91)(cid:76)(cid:89)(cid:3)(cid:76)(cid:95)(cid:87)(cid:76)(cid:89)(cid:91)(cid:90)(cid:19)(cid:3)(cid:86)(cid:92)(cid:89)(cid:3)(cid:86)(cid:85)(cid:83)(cid:80)(cid:85)(cid:76)(cid:3)
(cid:89)(cid:76)(cid:93)(cid:80)(cid:76)(cid:94)(cid:3)(cid:74)(cid:86)(cid:92)(cid:89)(cid:90)(cid:76)(cid:90)(cid:3)(cid:94)(cid:80)(cid:83)(cid:83)(cid:3)(cid:79)(cid:76)(cid:83)(cid:87)(cid:3)(cid:96)(cid:86)(cid:92)(cid:3)(cid:87)(cid:89)(cid:76)(cid:87)(cid:72)(cid:89)(cid:76)(cid:3)(cid:77)(cid:86)(cid:89)(cid:3)(cid:91)(cid:79)(cid:76)(cid:3)(cid:76)(cid:95)(cid:72)(cid:84)(cid:90)(cid:21)
(cid:58)(cid:87)(cid:76)(cid:74)(cid:80)(cid:72)(cid:83)(cid:3)(cid:54)(cid:584)(cid:76)(cid:89)(cid:33)(cid:3)(cid:40)(cid:40)(cid:42)(cid:53)(cid:3)(cid:80)(cid:90)(cid:3)(cid:86)(cid:584)(cid:76)(cid:89)(cid:80)(cid:85)(cid:78)(cid:3)(cid:80)(cid:85)(cid:75)(cid:80)(cid:93)(cid:80)(cid:75)(cid:92)(cid:72)(cid:83)(cid:3)(cid:76)(cid:95)(cid:72)(cid:84)(cid:3)(cid:74)(cid:72)(cid:85)(cid:75)(cid:80)(cid:75)(cid:72)(cid:91)(cid:76)(cid:90)(cid:3)(cid:28)(cid:23)(cid:3)(cid:87)(cid:76)(cid:89)(cid:74)(cid:76)(cid:85)(cid:91)(cid:3)(cid:86)(cid:584)(cid:3)(cid:91)(cid:79)(cid:76)(cid:3)(cid:74)(cid:86)(cid:90)(cid:91)(cid:3)(cid:86)(cid:77)(cid:3)(cid:91)(cid:79)(cid:76)(cid:3)(cid:77)(cid:86)(cid:83)(cid:83)(cid:86)(cid:94)(cid:80)(cid:85)(cid:78)(cid:3)(cid:85)(cid:76)(cid:94)(cid:3)
(cid:86)(cid:85)(cid:83)(cid:80)(cid:85)(cid:76)(cid:3)(cid:89)(cid:76)(cid:93)(cid:80)(cid:76)(cid:94)(cid:3)(cid:74)(cid:86)(cid:92)(cid:89)(cid:90)(cid:76)(cid:90)(cid:3)(cid:94)(cid:79)(cid:76)(cid:85)(cid:3)(cid:87)(cid:92)(cid:89)(cid:74)(cid:79)(cid:72)(cid:90)(cid:76)(cid:75)(cid:3)(cid:72)(cid:91)(cid:3)(cid:91)(cid:79)(cid:76)(cid:3)(cid:91)(cid:80)(cid:84)(cid:76)(cid:3)(cid:86)(cid:77)(cid:3)(cid:96)(cid:86)(cid:92)(cid:89)(cid:3)(cid:76)(cid:95)(cid:72)(cid:84)(cid:3)(cid:72)(cid:87)(cid:87)(cid:83)(cid:80)(cid:74)(cid:72)(cid:91)(cid:80)(cid:86)(cid:85)(cid:33)(cid:3)
(cid:2094)(cid:40)(cid:75)(cid:92)(cid:83)(cid:91)(cid:3)(cid:42)(cid:42)(cid:57)(cid:53)(cid:22)(cid:42)(cid:42)(cid:57)(cid:53)(cid:20)(cid:44)(cid:22)(cid:42)(cid:42)(cid:57)(cid:53)(cid:20)(cid:50)(cid:3)(cid:42)(cid:76)(cid:89)(cid:91)(cid:80)(cid:196)(cid:74)(cid:72)(cid:91)(cid:80)(cid:86)(cid:85)(cid:3)(cid:57)(cid:76)(cid:93)(cid:80)(cid:76)(cid:94)(cid:3)(cid:25)(cid:23)(cid:24)(cid:28)
(cid:2094)(cid:55)(cid:76)(cid:75)(cid:80)(cid:72)(cid:91)(cid:89)(cid:80)(cid:74)(cid:3)(cid:42)(cid:42)(cid:57)(cid:53)(cid:22)(cid:42)(cid:42)(cid:57)(cid:53)(cid:20)(cid:50)(cid:3)(cid:42)(cid:76)(cid:89)(cid:91)(cid:80)(cid:196)(cid:74)(cid:72)(cid:91)(cid:80)(cid:86)(cid:85)(cid:3)(cid:57)(cid:76)(cid:93)(cid:80)(cid:76)(cid:94)(cid:3)(cid:25)(cid:23)(cid:24)(cid:28)
(cid:2094)(cid:53)(cid:76)(cid:86)(cid:85)(cid:72)(cid:91)(cid:72)(cid:83)(cid:3)(cid:42)(cid:42)(cid:57)(cid:53)(cid:22)(cid:42)(cid:42)(cid:57)(cid:53)(cid:20)(cid:50)(cid:3)(cid:42)(cid:76)(cid:89)(cid:91)(cid:80)(cid:196)(cid:74)(cid:72)(cid:91)(cid:80)(cid:86)(cid:85)(cid:3)(cid:57)(cid:76)(cid:93)(cid:80)(cid:76)(cid:94)(cid:3)(cid:25)(cid:23)(cid:24)(cid:28)
www.aacn.org/ccrnreviewcourse 800-899-AACN
(cid:2094)
| |
(cid:41)(cid:89)(cid:86)(cid:92)(cid:78)(cid:79)(cid:91)(cid:3)(cid:91)(cid:86)(cid:3)(cid:96)(cid:86)(cid:92)(cid:3)(cid:73)(cid:96)(cid:3)(cid:40)(cid:40)(cid:42)(cid:53)(cid:3)(cid:3) (cid:3) (cid:3)(cid:51)(cid:76)(cid:72)(cid:75)(cid:76)(cid:89)(cid:90)(cid:3)(cid:80)(cid:85)(cid:3)(cid:72)(cid:74)(cid:92)(cid:91)(cid:76)(cid:3)(cid:72)(cid:85)(cid:75)(cid:3)(cid:74)(cid:89)(cid:80)(cid:91)(cid:80)(cid:74)(cid:72)(cid:83)(cid:3)(cid:74)(cid:72)(cid:89)(cid:76)(cid:3)(cid:85)(cid:92)(cid:89)(cid:90)(cid:80)(cid:85)(cid:78)(cid:3)(cid:3) (cid:3) (cid:3)(cid:59)(cid:89)(cid:92)(cid:90)(cid:91)(cid:76)(cid:75)(cid:3)(cid:76)(cid:95)(cid:87)(cid:76)(cid:89)(cid:91)(cid:80)(cid:90)(cid:76)
CriticalCareNurse
The journal for high acuity, progressive, and critical care nursing
Editor JoAnn Grif Alspach, RN, MSN, EdD
Editorial Board
THOMAS AHRENS, RN, PhD, CCRN, CS BONNIE M. JENNINGS, RN, PhD, FAAN
Clinical Specialist/Research Scientist, Nursing Department Professor, Nell Hodgson Woodruff School of Nursing
Barnes-Jewish Hospital, St Louis, Missouri Emory University, Atlanta, Georgia
SUSAN D. BELL, RN, MS, CNRN, CNP SUSAN G. TREVITHICK, RN, MS, CNA
Nurse Practitioner, Neurosurgery Clinical Support Manager, Specialty Care Center
Ohio State University Medical Center, Columbus, Ohio Salt Lake City Veterans Administration Medical Center, Utah
SUZETTE CARDIN, RN, DNSc, CNAA GLENNA TRAIGER, RN, MSN, CCRN
Adjunct Assistant Professor, Graduate Nursing Administration Clinical Nurse Specialist, Pulmonary Arterial Hypertension
Program UCLA School of Nursing, Los Angeles, California Program Greater LA VA Medical Center, Los Angeles, California
Contributing Editors
Advanced Practice Evidence-Based Practice Nutrition Progressive Care
ANDREA M. KLINE-TILFORD, CPNP-AC/PC, CCRN, FCCMMARCIA BELCHER, RN, MSN, BBA, CCRN-CSC, CCNS COLLEEN O’LEARY-KELLEY, RN, PhD, CNE MARGARET M. ECKLUND, RN, MS, CCRN, ACNP-BC
Bariatric Care Family-Centered Care Pain Management Pulmonary Care
BANRP-BECN, CCDRNA K. HIXON VERMILLION, RN, DNP, ACNS-BC,PATRICIA BROWN, DNP, APN, CNS, CCRN DIANE GLOWACKI, RN, MSN, CNS, CNRN-CMC DEBRA SIELA, RN, PhD, ACNS-BC, CCNS, CCRN, CNE, RRT
BPRasIiScC aInLdL AA dKv.a GnAceZdA LRifIeA SNu,p RpN, oPhrDt GROasStEroMinAtResYt iKn.a Ll EDEi,s oDNrPd, AeRNrPs, ACNP-BC, CCNS, CCRN PFaLtOieRnEt NECduEc Mat.i oSnIM anMdO DNiSsc, hRNa, MrgSNe, C PCRlNanning QJUuLaIlEit My I.m STpAroUvSeMmIeRnEt ,R ReNp, MoSNr, tACsNS-BC
CCeArRtiOfiLc aRtiAoUnE TNes, tR NP, MreS,p CCRN, PCCN, CEN, RN-BC GSOerNiaYtAri Rc .C HarAeRDIN, RN, PhD, CCRN, ACNS-BC, NP-C PEaLtIiZeAntB SEaTfHet yMATTOX, RN, MSN, ARNP RCHurAaRl SLeEtNtinEg As. WINTERS, PhD, APRN, ACNS-BC
Healthy Work Environments Sepsis
CDoAcPhHraNnEe SRTeAviNewN ASuRmD,m RNa, rPhyD, CCRN, CCNS VIRGINIA C. HALL, BSN, CCRN PMaEtiLeInStS TAr aRnAsCpHor,t RN, BSN, CCRN, CMC TERESA A. WAVRA, RN, MSN, CCRN, CNS
Heart Failure Simulation
CDoEmBpRleAm KenRtaArMy TLhIeCraHp, iReNs, MSN, CCRN KAREN L. COOPER, RN, MSN, CCRN, CNS PDeOdRiaOtrTiHc CYa Mrd. iBoEvaKsEc,u RlNa, rM SS, uCPrNgP-ePrC/yAC KATE MOORE, RN, DNP, CCRN, CEN, AGACNP-BC, AGPCNP-BC
CCrLiAtiIcRalE C CaUreR ARpApNs, RN, MSN, CCRN MMCCRaNA,n NREa-BIgCAe mCHenRt/IASdTAmBinELisLtEra CtiAoSnTRO, RN, MSHA, SPAedNiaDtRriAc CSaTrAeV ESKI, RN, PhD, CPNP-PC/AC MSLStENa,S CfLCfR INDE, Ce CSNvWSe lAopDmENenEtR-CULPEPPER, APRN-CNS,
Cultural Diversity Military Critical Care Nursing: Air Force JODI E. MULLEN, RN-BC, MS, CCRN, CCNS Tele-ICU
MAJELLA S. VENTURANZA, RN, MA, CCRN BENJAMIN SCHULTZE, RN, ACNP-BC, MEd, MSN Pharmacology PAT JUAREZ, APN, CCRN, CCNS
ECGs and Pacemakers Military Critical Care Nursing: Army KELLY THOMPSON-BRAZILL, RN, MSN, ACNP, Toxicology
JANE N. MILLER, RN, DNP, CCRN, CCNS LINDA A. VALDIRI, COL, ANC, USA, RN, MS, CCNSCCRN-CSC, FCCM DANA BARTLETT, RN, MSN, MA, CSPI
Postanesthesia Recovery
EDmOeRrOgeTnHcYy DDeUpNaCrtAmNe,n RtN, DNP, ACNP-BC, CCRN, CEN MCAiRlitLa GryO CFrOitRicTaHl ,C RaNr, MeS NN, CuCRrNsing: Navy TCENITO D. TUBOG, RN-BC, CRNA, APRN, CCRN-CSC-CMC, TMraICuHmAaEL W. DAY, RN, MSN, CCRN
End-of-Life Care Neonatal Care Precepting
KATHLEEN OUIMET PERRIN, RN, PhD, CCRN RACHEL A. JOSEPH, PhD, CCRN LIZ ROGAN, RN, EdD-c, CNE
Editorial Office
American Association of Critical-Care Nurses
101 Columbia, Aliso Viejo, CA 92656
[phone], [phone]
President CLAREEN WIENCEK, RN, PhD, ACHPN, ACNP Website: www.ccnonline.org e-mail: [email protected]
President-elect CHRISTINE SCHULMAN, RN, MS, CNS, CCRN
Secretary KIMBERLY CURTIN, RN, DNP, APRN, ACNS-BC, CCRN, CEN, CNL Publishing Manager MICHAEL MUSCAT
Managing Editor REBECKA WULF
Treasurer MEGAN BRUNSON, RN, MSN, CNL, CCRN-CSC
Art and Production Director LeROY HINTON
Directors ELIZABETH BRIDGES, RN, PhD, CCNS, FCCM, FAAN Copy Editors BARBARA HALLIBURTON, PhD
NANCY FREELAND, RN, MS, CCRN KATIE SPILLER, MS
WENDI FROEDGE, RN-BC, MSN, CCRN-K Book Review Editor LINDA BELL, RN, MSN
Graphic Artist MATTHEW EDENS
MICHELLE KIDD, RN, MS, ACNS-BC, CCRN-K
Senior Publishing Associate SAM MARSELLA
DEBORAH KLEIN, RN, MSN, ACNS-BC, CCRN, CHFN, FAHA Peer-Review Coordinator DENISE GOTTWALD
MARY BETH FLYNN MAKIC, RN, PhD, CNS, CCNS, CCRN-K, FAAN, FNAP
PAULA McCAULEY, RN, DNP, APRN, ACNP-BC, CNE Advertising Sales Office
LOUISE SALADINO, RN, DNP, MHA, CCRN-K SLACK Incorporated
ROSEMARY TIMMERMAN, RN, DNP, CCNS, CCRN-CSC-CMC 6900 Grove Road, Thorofare, NJ 08086
[phone], [phone]
Chief Executive Officer DANA WOODS
National Account Manager NICOLE RUTTER
Recruitment Sales Represenative BERNADETTE HAMILTON
Administrator ASHLEY SEIGFRIED
WESTERPNR PUINBLTIS. HDINIGG IATSASOLC. IAETVIOENNTS
2 CriticalCareNurse
Vol 36, No. 5, OCTOBER 2016 www.ccnonline.org

CriticalCareNurse
The jour nal for high acuity, progressive, and critical care nursing
O C T O B E R 2 0 1 6 • V O L U M E 3 6 N U M B E R 5
CE
The ABCDs of
Managing Morbidly
Obese Patients in
Intensive Care Units
Luis A. Berrios
17
Page
OnlineNOW
Use of Ventilator Bundle and
Staff Education to Decrease
Ventilator-Associated Pneumonia in
Intensive Care Patients
Maria Parisi, Vasiliki Gerovasili, Stavros Dimopoulos,
Efstathia Kampisiouli, Christina Goga, Efstathia Perivolioti,
Athina Argyropoulou, Christina Routsi, Sotirios Tsiodras,
and Serafeim Nanas
e1
Page (Page 14)
Educating Health Care Providers
in Treatment of Patients With
Ebola Virus Disease
Cover illustration by Kimberly Martens Ellen J. Eckes, Debbie Gutierrez, Ann Peterson,
Melissa Hubbard, Kevin Barrett, and Ann Marie Matlock
Critical Care Nurse (ISSN 0279-5442, eISSN 1940-8250) is published bimonthly (February, April, June, August, October, December) e8
by the American Association of Critical-Care Nurses (AACN), 101 Columbia, Aliso Viejo, CA 92656. Telephone: [phone]. Fax: Page (Page 14)
[phone]. E-mail: [email protected]. Copyright 2016 by AACN. All rights reserved. Critical Care Nurse is an offi cial publication
of AACN. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical,
including photocopying, recording or by any information storage retrieval system without permission of AACN. For all permission CCN FAST FACTS
requests, please contact the Copyright Clearance Center, Customer Service, 222 Rosewood Drive, Danvers, MA 01923, [phone].
The statements and opinions contained herein are solely those of individual contributors and not of the editor or AACN. The editor Esophageal Pressure Measurements in Patients
and AACN assume that articles emanating from a particular institution are submitted with the approval of the requisite authority,
With Acute Respiratory Distress Syndrome
including all matters pertaining to human studies and patient privacy requirements. Advertisements in this journal are
not a warranty, endorsement, or approval of the products by the editor or AACN, who disclaim all responsibility for any injury to Page 36
persons or property resulting from any ideas or products referred to in articles or advertisements.
Individual subscriptions (print and online): US, $39; outside of US, US$69. Student rates: US, $25; outside of US, $38.
Cardiovascular Disease and HIV:
Institutional rates (print and online): US, $464; outside of US, US$594. Institutional rates (print only): US, $331; outside of US,
US$455. Institutional rates (online only): US, $311; outside of US, US$311. Single copies and back issues: US, $40; outside of Pathophysiology, Treatment Considerations,
US, US$50. Fax requests to CCN Back Issues at [phone] or write to CCN, 101 Columbia, Aliso Viejo, CA 92656, or phone
and Nursing Implications
[phone]. Prices on single copies or bulk reprints of articles are available on request from AACN at [phone], ext 532.
Printed in the USA. Periodicals postage paid at Laguna Beach, Calif, and additional mailing offi ces. Postmaster: Send address changes to Page 47
Critical Care Nurse, 101 Columbia, Aliso Viejo, CA 92656. Allow 4 to 6 weeks for change to take effect. For subscription questions please
call toll-free: AACN members, [phone] or [phone]; nonmembers, [phone] or [phone].
The name and title Critical Care Nurse are protected through a trademark registration in the US Patent Offi ce. Critical Care Nurse
is indexed in Cumulative Index to Nursing & Allied Health Literature (CINAHL), MEDLINE/PubMed, and ISI Alerting Services.
4 CriticalCareNurse
Vol 36, No. 5, OCTOBER 2016 www.ccnonline.org
D A L E ® A C E C O N N E C T O R ® W I T H
E N F i t ™ C O N N E C T I O N S Y S T E M
WE’RE READY WHEN YOU ARE
THE ACE ADVANTAGE
• FULLY COMPATIBLE WITH THE NEW ENFit ISO 80369-3 STANDARD
•SUPPORTS CLOSED ENTERAL FEEDING SYSTEMS
• ON-OFF HANDLE CONTROLS FLUID FLOW—TURN “ON” FOR FEEDING OR “OFF”
FOR TUBE IRRIGATION, MEDICINE ADMINISTRATION, GASTRIC RESIDUALS,
OR PATIENT AMBULATION
• AUTO-SEAL SYRINGE MED PORT ACCEPTS MOST 60ML ENFit SYRINGES
FOR MEDICATION DELIVERY, IRRIGATION AND GASTRIC RESIDUALS
•PROTECTS CLINICIAN FROM SPLASH-BACK
•PROTECTS PATIENT FROM EXTERNAL CONTAMINATION
•NO SOILED LINENS OR FORMULA LOSS DUE TO OPEN CONNECTIONS
FOR MORE INFORMATION PLEASE VISIT
WWW.DALEMED.COM
DALE MEDICAL PRODUCTS, INC.
800-343-3980
WWW.DALEMED.COM
Dale® and ACE Connector® are registered trademarks of Dale Medical Products, Inc.
in the USA and EU. ENFit™ is a trademark of GEDSA and used with their permission.
© 2016 Dale Medical Products, Inc. AD-051
COLUMNS FEATURES
Esophageal Pressure
CE
PEDIATRIC CARDIOVASCULAR Measurements in Patients
SURGERY
With Acute Respiratory
Understanding the Hybrid Stage I
Approach for Hypoplastic Distress Syndrome
Left Heart Syndrome
Grace Hofmann, Lutana Haan, and Jeff Anderson
Sharon L. Cheatham and Grace M. Deyo
27
Page 48 Page
Cardiovascular Disease
CE
and HIV: Pathophysiology,
ETHICS
Treatment Considerations,
Clarification and Mitigation of Ethical
Problems Surrounding Withdrawal of
and Nursing Implications
Extracorporeal Membrane Oxygenation
Justin M. Cournoyer, Aven P. Garms, Kimberly N. Thiessen,
Susan B. Williams and Michael D. Dahnke
Margaret T. Bowers, Melissa D. Johnson, and Michael V. Relf
Page 56
37
Page
DEPARTMENTS
EDITORIAL
The Toxic Wake of Rudeness: Why It Matters
Page 27 Page 48 Page 77
JoAnn Grif Alspach, Editor
Page 10 ALSO IN THIS ISSUE
Contributors
CERTIFICATION TEST PREP
8
Good Witch or Bad Witch? Page
Carol Rauen, Maranda Jackson-Parkin, Carol Jacobson, OnlineNOW Abstracts
14
Karen M. Marzlin, and Cynthia L. Webner Page
Page 66 Book Reviews
77
Page
ASK THE EXPERTS
Education Directory
Scope of Practice
79
Page
Carol Hartigan
I Am a Critical Care Nurse
Page 70
80
Page
IN OUR UNIT AACN Practice Alert: Assessment and
Easy as ABC: How Staff Nurses Transformed Management of Delirium Across the Life Span
Unit Culture to Assess and Manage Delirium Page e14
in the Intensive Care Unit AACN Practice Alert: Preventing Venous
Kaitlyn A. Gregory Thromboembolism in Adults
Page 73 Page e20
6 CriticalCareNurse
Vol 36, No. 5, OCTOBER 2016 www.ccnonline.org
She’s heading home.
Happy and healthy.
3M can help you reduce the risk of I.V. site complications
that can extend hospital stays.
• 3M™ Tegaderm™ Dressings
• 3M™ Curos™ Disinfecting Port Protectors
• 3M™ Avagard™ Hand Hygiene Products
• 3M™ Cavilon™ Skin Care Solutions
Learn more at 3M.com/IVcare
© 3M 2016. All rights reserved. 3M, “3M Science. Applied to Life.” Avagard, Cavilon, Curos,
and Tegaderm are trademarks of 3M Company. Used under license in Canada.
Contributors
C
oauthor of Esophageal Pressure clinical nurse specialist, National Institutes
Measurements in Patients With of Health, Bethesda, Maryland.
ARDS, Jeff Anderson is an associ- Coauthor of Cardiovascular Disease
ate professor in the respiratory care program and HIV, Aven P. Garms is a clinical nurse
at Boise State University. I in the intensive care nursery, Duke Uni-
Athina Argyropoulou, coauthor of Use versity Hospital.
of Ventilator Bundle and Staff Education to Vasiliki Gerovasili, coauthor of Use of
Decrease VAP in Intensive Care Patients, is a BOWERS GOGA Ventilator Bundle and Staff Education to
consultant and director, Evangelismos Hospi- Decrease VAP in Intensive Care Patients,
tal, Athens, Greece. is a pulmonologist, National and Kapodis-
Coauthor of Educating Health Care trian University of Athens, Evangelismos
Providers in Treatment of Patients With Hospital, Greece.
Ebola Virus Disease, Kevin Barrett is the Christina Goga, coauthor of Use of
National Institute of Allergy and Infectious Ventilator Bundle and Staff Education to
Diseases nurse specialist, National Institutes Decrease VAP in Intensive Care Patients,
of Health. COURNOYER GUTIERREZ is a pulmonologist, National and Kapodis-
Author of The ABCDs of Managing trian University of Athens, Evangelismos
Morbidly Obese Patients in ICUs, Luis A. Hospital, Greece.
Berrios is the director of nonphysician Coauthor of Educating Health Care
practitioners at Baptist Health System, Providers in Treatment of Patients With
San Antonio, Texas. Ebola Virus Disease, Debbie Gutierrez is
Margaret T. Bowers, coauthor of Car- a senior nurse manager, National Institutes
diovascular Disease and HIV, is an associ- of Health.
ate professor and the faculty coordinator DAHNKE HOFMANN Coauthor of Esophageal Pressure Mea-
at Duke University School of Nursing, surements in Patients With Acute Respira-
Durham, North Carolina. tory Distress Syndrome, Lutana Haan is an
Sharon L. Cheatham, coauthor of assistant professor, Boise State University.
Understanding the Hybrid Stage I Approach Grace Hofmann, coauthor of Esopha-
for Hypoplastic Left Heart Syndrome, is the geal Pressure Measurements in Patients
interventional cardiology nurse practitioner, With ARDS, is a respiratory therapist at
The Heart Center, Nationwide Children’s Massachusetts General Hospital, Boston,
Hospital, Columbus, Ohio. DIMOPOULOS JOHNSON Massachusetts.
Coauthor of Cardiovascular Disease Coauthor of Educating Health Care Pro-
and HIV, Justin M. Cournoyer is a clinical viders in Treatment of Patients With Ebola
nurse I, Duke University Hospital, Virus Disease, Melissa Hubbard is the clini-
Durham, North Carolina. cal manager in the special clinical studies
Michael Dahnke, coauthor of Clarifi- unit, National Institutes of Health.
cation and Mitigation of Ethical Problems Coauthor of Cardiovascular Disease
Surrounding Withdrawal of ECMO, is a and HIV, Melissa D. Johnson is an associate
bioethicist and adjunct instructor in the ECKES KAMPISIOULI professor in medicine, Duke University Med-
School of Nursing at the College of New ical Center, Durham, North Carolina.
Rochelle, New York. Efstathia Kampisiouli, coauthor of
Coauthor of Understanding the Hybrid Use of Ventilator Bundle and Staff Educa-
Stage I Approach for Hypoplastic Left Heart tion to Decrease VAP in Intensive Care
Syndrome, Grace M. Deyo is a nurse practi- Patients, is a nursing specialization man-
tioner, Nationwide Children’s Hospital, ager and surgical nurse specialist, National
Columbus, Ohio. and Kapodistrian University of Athens,
GARMS MATLOCK
Stavros Dimopoulos, coauthor of Use Evangelismos Hospital, Greece.
of Ventilator Bundle and Staff Education to Coauthor of Educating Health Care Pro-
Decrease VAP in Intensive Care Patients, is an viders in Treatment of Patients With Ebola
internal medicine-intensive care specialist, Virus Disease, Ann Marie Matlock is the
Addenbrookes Cambridge University Hospi- service chief, National Institutes of Health.
tal, United Kingdom. Serafeim Nanas, coauthor of Use of
Ellen J. Eckes, coauthor of Educating Ventilator Bundle and Staff Education to
Health Care Providers in Treatment of Decrease VAP in Intensive Care Patients,
GEROVASILI NANAS
Patients With Ebola Virus Disease, is a is a professor of intensive care medicine,
8 CriticalCareNurse
Vol 36, No. 5, OCTOBER 2016 www.ccnonline.org