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Biomedical subjects

Patricia Hynes-Gay

Publications and source records attributed to Patricia Hynes-Gay.

7 recordsLinked to original sources
PubMed2003

E-Nursing: electronic nursing resources on your desktop.

E-Nursing represents an innovative approach to nursing education that has the potential to support professional practice throughout the institution. This paper details the benefits, design and promotion of an electronic nursing resource collection. How to divide responsibility, cost and expertise in such a project is also discussed. Preliminary usage statistics validate E-Nursing as a point-of-care education tool for nurses at Mount Sinai Hospital. A planned approach to implementation has been an effective means of introducing E-Nursing in an institution that previously relied on traditional hard-copy resources housed in the hospital's library.

Computer Communication Networks↗
PubMed2003

Optimizing sedation and analgesia in mechanically ventilated patients--an evidence-based approach.

Critically ill, mechanically ventilated patients experience pain and anxiety related to a number of factors, including underlying disease processes, invasive procedures, therapeutic devices, immobility, and even routine nursing care such as turning and positioning. Failure to provide adequate analgesia and sedation has been shown to have detrimental physiological consequences, including an increase in sympathetic nervous activity and ventilator dyssynchrony (Young, Knudsen, Hilton & Reves, 2000). Over-sedation has also given rise to concerns related to prolongation of mechanical ventilation, intensive care unit (ICU) length of stay, and cost. The challenge for the ICU team is to provide comfort while avoiding the consequences of both over- and under-sedation. New strategies show promise and focus on a team approach for the management of sedation and analgesia in critically ill, mechanically ventilated patients. These strategies include the use of sedation protocols, which incorporate nurse-driven dose titration directives, sedation scoring systems, and daily interruption of sedative infusions. This article provides a review of three recent studies evaluating these new approaches to the administration of sedation and analgesia in the adult ICU.

Analgesia↗
PubMed2002

ACLS 2000: overview of changes to the guidelines.

Emergency treatment measures in the setting of a cardiopulmonary arrest have recently been reclassified according to the strength of evidence in support of their use. As a result, there are new recommendations that must be incorporated, both in the management of patients in cardiac arrest and those with clinical findings that have the potential to deteriorate and become life-threatening. This article provides an overview of the 2000 ACLS guidelines, with particular emphasis on new developments in the management of patients with acute coronary syndromes, changes in the tachycardia algorithms, and recommendations pertaining to endotracheal intubation.

Anti-Arrhythmia Agents↗
PubMed2002

Understanding sepsis: from SIRS to septic shock.

Sepsis remains the leading cause of death in non-coronary ICU patients, despite improvements in supportive treatment modalities such as antimicrobial drugs and ventilation therapy. Further, the incidence of sepsis is projected to increase in years to come, related to factors including a rise in immunosuppressed patient populations and more widespread use of invasive lines and procedures. In this article, the authors seek to advance nurses' understanding of sepsis by reviewing the SIRS to septic shock paradigm and using a case study to illustrate how a patient progressed along the continuum. The role of the critical care nurse is an important aspect of the care of these patients. Early identification of patients at risk for, or who are developing, sepsis is crucial in order to improve patient outcomes.

Adult↗
PubMed2002

The influence of DNR orders on patient care in adult ICUs: a review of the evidence.

BACKGROUND: Although do-not-resuscitate (DNR) orders have been used in health care for many years, there is controversy about their use and the implications for patient care. A common perception in the intensive care unit (ICU) setting is that life-sustaining interventions such as dialysis or mechanical ventilation may no longer be provided or should be withdrawn on patients who are assigned DNR status. In order to gain insight into the impact of DNR orders on the care provided to adult patients in the ICU, a review of the research conducted on this topic within the last decade was undertaken. OBJECTIVE: To provide an integrated review of recent research examining the effects of DNR orders on the care of adult ICU patients. METHODS: Two large databases, CINAHL and MEDLINE, were used for the search as well as the reference lists from relevant research articles. The search terms used were: DNR orders in adult ICUs, resuscitation orders, critical care, and nursing and/or medical care provided to these patients. Studies were not limited to any one specific research design. The search was restricted to research conducted over the last decade. RESULTS: Five studies were found that met the search criteria. CONCLUSIONS: While the care that critically ill adult patients receive in ICUs is, in some way, influenced by DNR orders, there is no evidence that patients are abandoned as a result. Given the inconsistency in the findings of the five studies and certain weaknesses in methodology, it is not possible to identify a direct impact of DNR orders on patients care at this time. Further investigation is needed.

Adult↗