Critical nursing concepts

Critical care nursing

- it is the field of nursing with a focus on the care of the critically ill or unstable patients.
- Critical care nurses can be found working in a wide variety of environments and
specialties, such as emergency departments and the intensive care units.
- Critical care nurses must work in environments where patients are constantly monitored

American Association of Critical Care Nurses

It is the main organization for critical care nurses

It published an overview of the scope and standards of practice for critical care nurses. This
includes a six-part standard of care, as well as Ethics of Care.

Critical care nursing (AACN)

Aspecialty within nursing that deals specifically with human responses to life-threatening
problems. A critical care nurse is a licensed professional nurse who is responsible for ensuring that
acutely and critically ill patients and their families receive optimal care.

Critically Ill Patient

patients who are at high risk for actual or potential life-threatening health problems. The
more critically ill the patient is, the more likely he or she is to be highly vulnerable, unstable and
complex, thereby requiring intense and vigilant nursing care.

CCNAPI (Critical Care Nurses Association of the Philippines Inc.)

is the national organization of nurses interested in the field of critical care nursing. It was
founded in February 1977 with approved SEC registration (CN 200813601), a founding member of
the World Federation of Critical Care Nurses (2001) and accredited as a Provider of Continuing
Professional Education by the Professional Regulation Commission (Provider Number 2009-019)

Vision
CCNAPI strives for a culture of quality and safety in all endeavors;
CCNAPI believes in building competencies, career advancement and proactive evidenced
informed nursing practice;
CCNAPI is committed in fostering the people’s health, welfare and rehabilitation through
community involvement and development.
Mission

CCNAPI is dedicated to:

C = Competencies and Standards of Care

C = Career Advancement through Certification and Credentialing
N = Nurturing Community Involvement and Development
A = Accessibility of critical care nursing education
P = Progressive Technological Support and Advancement
I = Informed Nursing Practice

What Critical Care Nurses Do?

Foremost, the critical care nurse is a patient advocate. AACN defines advocacy as respecting
and supporting the basic values, rights and beliefs of the critically ill patient. In this role, critical care
nurses:

•Respect and support the right of the patient or the patient's designated surrogate to autonomous
informed decision making.
•Intervene when the best interest of the patient is in question.
Help the patient obtain necessary care.

•Respect the values, beliefs and rights of the patient.

•Provide education and support to help the patient or the patient's designated surrogate make
decisions.
Represent the patient in accordance with the patient's choices.
•Support the decisions of the patient or designated surrogate, or transfer care to an equally
qualified critical care nurse.
Intercede for patients who cannot speak for themselves in situations that require immediate
action.
•Monitor and safeguard the quality of care the patient receives.
•Act as a liaison between the patient, the patient's family and other healthcare professionals.

Roles of Critical Care Nurses

Critical care nurses work in a wide variety of settings, filling many roles including bedside
clinicians, nurse educators, nurse researchers, nurse managers, clinical nurse specialists and nurse
practitioners.

With the onset of managed care and the resulting migration of patients to alternative
settings, critical care nurses are caring for patients who are more ill than ever before.

Acute illness / injury

 It is typically characterized by severe symptoms of relatively short duration

  Its symptoms often appear abruptly and subside quickly
 Depending on its cause, it may or may not require intervention by health care professionals
 Following an acute illness/injury, most people return to their normal level of wellness

ACUTE VS. CHRONIC

ACUTE CHRONIC

- Caused by a disease / illness that produces - Caused by a disease / illness that produces symptoms
symptoms and signs as soon after exposure to the and signs within a variable time period
cause
- Runs a long course
- Runs a short course
- There is only partial recovery
- There is usually a full recovery or an abrupt
termination in death

Nursing process applied to the critically ill

1. Assessment

O The nurse must collect data relevant to the patient's condition.

- This can come from the patient, family or health care providers, as well as other sources in
the community.
- Certain data are given priority depending on the patient's health situation.
- Instruments and other evidence-based techniques can also be used to gather information
about the patient's current state.
- The nurse should use his experience and powers of analysis to find the best information
available.

2. Diagnosis

O Working with other health care providers, the nurse should come up with an appropriate
diagnosis or diagnoses based on the information gathered about the patient.

- Talking with the patient, family and other health care providers can help in the formation of
the diagnosis, and help to validate it after it's been determined.
- Diagnoses should be prioritized in a way that helps to formulate a plan of care.

3. Identify Outcomes
- Using the diagnoses she has already come up with, the critical care nurse should determine what
the patient's outcome should be.

- This outcome should be a measurable goal and have a target date, and should be made with regard
to available resources, such as local expertise, cost, risk vs. benefits and available research.

- Outcomes are modified as the patient's situation changes.

4. Planning

- A patient care plan details how the nurse will help the patient achieve the desired outcome.

- He must tailor the care plan to the patient's individual needs, and work in collaboration with other
health care providers, the patient and family.

- The plan must reflect current best evidence and research. It will establish the priorities for care,
and provide for continuity of care, making sure the patient can care for herself with the help of
family, and knows how to prevent further illness and injury.

- The plan must also take into account the resources available, both to the nurse and to the patient
after leaving the hospital.

5. Implementation

- The nurse coordinates the delivery of care, with interventions that minimize complications,
promote comfort and prevent suffering.

- The patient and family may participate in implementing the plan according to their abilities.

- The nurse must document all parts of the implemented plan, and use the plan as a teaching tool for
the patient, family, nursing staff and other members of the health care team.

6. Evaluation

- The nurse checks the patient's progress toward attaining the right outcome.

- She may use evidence-based techniques and instruments to evaluate care, and assessment is
ongoing and can be used to revise the diagnoses, outcome or care plan as needed.

- The nurse carefully documents the results of the evaluation.

AACN’s ethics of care

The AACN's ethics of care includes three main principles.:

Respect for persons is a moral obligation to honor the worth of each person, and to respect their
dignity, self-determination and privacy.

Beneficence means to promote good and prevent harm, and to improve the welfare of individuals
and society.

Justice is an obligation to be fair and promote equity, and to distribute resources based on need and
availability, as well as to advocate on the patient's behalf.