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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)

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 peoples health, welfare and
rehabilitation through community involvement and development.

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

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

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



- Caused by a disease / illness that produces - Caused by a disease / illness that prod
symptoms and signs as soon after exposure symptoms and signs within a variable tim
to the 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

- 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
- Diagnoses should be prioritized in a way that helps to formulate a plan of

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.

AACNs 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.