1_INTRODUCTION Flashcards
deals with human responses to life threatening health problems
Critical care nursing
The specialty of critical care has its roots in the ______ when polio victims were cared for in critical care units.
1950’s
In the _____ recovery rooms were established for the care of patients who had gone into surgery and _________ were instituted for the care of individuals with cardiac problems.
1960’s
coronary care units
3 Transformational Changes in Healthcare Delivery System ( IWE)
Issues in managing neglected health care services
Work force
Emergency preparedness
3 New Expectation in Nursing Practice
Display a professional attitude, skilled and equipped
Challenges in patient care.
Complexities of globalization.
is the specialty within nursing that deals specifically with human responses to life-threatening problem
Critical care nursing
Critical Care Nursing is focused on:
(CRRMP)
Curative
Restorative
Rehabilitative
Maintainable
Palliative care
(PRC-BON) Meaning
Professional Regulation Commission – Board of Nursing
is dedicated to provide the regulation for an effective and efficient nursing care service.
Professional Regulation Commission – Board of Nursing (PRC-BON)
PRC-BON developed the __________in the year _____
Nursing Specialty Framework (1996)
PRC-BON developed the Nursing Specialty Framework (1996).
Committee includes: (PEM)
nurse educators, nurse practitioners and nurse managers.
(CCNAPI) meaning
Critical Care Nursing Association of the Philippines (
TRUE/FALSE
The CCNAPI Core Competencies of a Critical Care Nurse are stated according to the levels of expected behavior defining the actual knowledge, skills and abilities in the practice of critical care by a nursing professional.
True
levels of CCNAPI Core Competencies of a Critical Care Nurse
Nurse Clinician 1
Nurse Clinician II
Nurse Specialist
11 CORE COMPETENCIES (BON 2025)
Safe & quality nursing practice
Management of resources & environment
Health and education
Legal responsibility
Ethico- moral responsibility
Personal & professional development
Quality improvement
Research
Record management
Communication
Collaboration & teamwork
Philosophy of Critical Care Nursing:
Critical Care Nursing reflects a holistic approach in caring for patients. It places great emphasis on the caring of the __________________ of human beings and their responses to illnesses rather than salary on the disease process.
bio-psycho-social-spiritual nature
Philosophy of Critical Care Nursing:
It helps maintain the individual patient’s identity and _____.
dignity
The focus of caring includes ________, _____________;and _________to decrease future patient admissions to acute care facilities.
preventive care,risk factor modification ,education
(ICN) meaning
International Council of Nurses (ICN)
The International Council of Nurses (ICN) views health care as the rights of every individual regardless of financial, political, geographical, racial and religious consideration.
The Right of Critically Ill Patient
This right includes the right to choose or decline care, including the right to accept or refuse treatment or nourishment; informed consent; confidentiality and dignity, including the right to die with dignity. It involves both the rights of those seeking care and the providers
6The Right of Critically Ill Patient
The Right of Critically Ill Patient(Enumerate)
This right includes:
the right to choose or decline care,
including the right to accept or refuse treatment or nourishment;
informed consent;
confidentiality and dignity, including the right to die with dignity.
It involves both the rights of those seeking care and the providers.
Goals of Critical Care Nursing
(P, C, U, P)
To promote optimal delivery of safe and quality care to the critically ill patients and their families by providing highly individualized care so that the physiological dysfunction as well as the psychological stress in the ICU are under control;
To care for the critically ill patients with a holistic approach, considering the patient’s biological, psychological, cultural and spiritual dimensions regardless of diagnosis or clinical setting
To use relevant and up-to-date knowledge, caring attitude and clinical skills, supported by appropriate technology for the prevention, early detection and treatment of complications to facilitate recovery.
To provide palliative care to the critically ill patients in situations where their health status is progressing to unavoidable death, and to help the patients and families go through their painful sufferings.
Goals of Critical Care Nursing
To promote optimal delivery of safe and quality care to the critically ill patients and their families by providing _______________ so that the physiological dysfunction as well as the psychological stress in the ICU are under control;
providing highly individualized care
Goals of Critical Care Nursing
To care for the critically ill patients with a __________, considering the patient’s biological, psychological, cultural and spiritual dimensions regardless of diagnosis or clinical setting
holistic approach
T/F
Goals of Critical Care Nursing
To use relevant and up-to-date knowledge, caring attitude and clinical skills, supported by appropriate technology for the prevention, early detection and treatment of complications to facilitate recovery.
TRUE
Goals of Critical Care Nursing
To provide _________ to the critically ill patients in situations where their health status is progressing to unavoidable death, and to help the patients and families go through their painful sufferings.
palliative care
LEVELS & CATEGORIES OF CRITICAL CARE PROVISIONS WITHIN PHILIPPINES
LEVEL 1
LEVEL 2
LEVEL 3
LEVELS & CATEGORIES OF CRITICAL CARE PROVISIONS:
Able to provide immediate resuscitation ( CPR) for critically ill
Level 1
LEVELS & CATEGORIES OF CRITICAL CARE PROVISIONS:
Monitoring complications of “at risk” MS patients
LEVEL 1
LEVELS & CATEGORIES OF CRITICAL CARE PROVISIONS:
Providing mech vent and simple invasive cardiovascular monitoring
LEVEL 1
LEVELS & CATEGORIES OF CRITICAL CARE PROVISIONS:
Formal organization of medical staff ( at least 1 RN)
LEVEL 1
LEVELS & CATEGORIES OF CRITICAL CARE PROVISIONS:
Staffing 1:1 ratio
LEVEL 1
LEVELS & CATEGORIES OF CRITICAL CARE PROVISIONS:
Should be capable of providing a high standard of general critical care for patients who are stepping down from higher levels of care or requiring single organ support/support post-operatively;
Level 2
LEVELS & CATEGORIES OF CRITICAL CARE PROVISIONS:
Capable of providing sustainable support for mechanical ventilation, renal replacement therapy, invasive hemodynamic monitoring and equipment for critically ill patients of various specialties such as medicine, surgery, trauma, neurosurgery, vascular surgery;
LEVEL 2
LEVELS & CATEGORIES OF CRITICAL CARE PROVISIONS:
Has a designated medical director with appropriate intensive care qualification and a duty
LEVEL 2
LEVELS & CATEGORIES OF CRITICAL CARE PROVISIONS:
A nurse: patient ratio is 1:1 for all critically ill patients.
LEVEL 2
LEVELS & CATEGORIES OF CRITICAL CARE PROVISIONS:
Is a tertiary referral unit, capable of managing all aspects of critical care medicine (This does not only include the management of patients requiring advanced respiratory support but also patients with multi-organ failure);
LEVEL 3
LEVELS & CATEGORIES OF CRITICAL CARE PROVISIONS:
Has a medical director with specialist critical / intensive care qualification and a duty specialist available exclusively to the unit and medical staff with an appropriate level of experience present in the unit at all times;
Level 3
LEVELS & CATEGORIES OF CRITICAL CARE PROVISIONS:
A nurse in-charge and the majority of nursing staff have intensive care certification; and
LEVEL 3
LEVELS & CATEGORIES OF CRITICAL CARE PROVISIONS:
A nurse: patient ratio is at least 1:1 for all patients at all times.
LEVEL 3
Rules/Guidelines to follow
Three L’s to NOT DO:
Lie (especially parts of physical exam that you did not do)
Be Lazy
Be Late
These are the habits to ICU success:
(O,I, E,T,I,O)
Be Organized
Be Involved
Be Efficient
Be Thorough
Take Initiative
Take Ownership of Your patients
Daily Routine/Patient Care
Every day each person should have the following addressed:
(C,S,G,D,F,D)
- Code Status
- Sedation (held in am, when stopping, etc.)
- GI Prophylaxis (most important, when intubated)
- DVT Prophylaxis
- Fluid, electrolytes, nutrition
- Disposition
Other daily tasks to always keep in mind:
(MIDDD)
- Monitor I/O on EVERY PATIENT with 24h totals
- Know their IV access including dates central lines have been placed
- Duration of antibiotics use
- Duration of steroid use for shock patients
- Date and type of suction and other catheter inserted
For Mechanically Ventilated Patients, always know the following
Date Intubated
Size of Tube
Vent Settings (mode/rate/volume/pressure/PEEP/FiO2)
Peak/Plateau Pressure
Life Threatening Health Problems:
CVA, MI, Electrolyte Imbalances. Burn, Chest Pain etc.
poliomyelitis year ____
1950-1953
Do not CPR
Maintain IV fluids, meds and therapy
Family members are the ones that will remove contraptions (catheters, cannula, etc.) from the patient.
DNR (Do Not Resuscitate)
PUT BACK TO LIFE (FLAT LINE)
NEED CONSENT
DEFIBRILLATION
> 200 CARDIAC RATE
DON’T NEED CONSENT
POSSIBLE: ARRHYTHMIA/DYSRHYTHMIA
CARDIOVERSION
