Reply to the classmate.
I picked an article about CRRT (Continuous Renal Replacement Therapy) because it is one of the practices in the ICU that is more interesting to me. This peer-reviewed scholarly article is about the key safety concerns identified by nurses who care for patients who require CRRT in the ICU. CRRT is a practice that is used in the ICU that allows for slow continuous removal of fluids and waste 24 hours per day, compared to rapid removal with intermittent hemodialysis (IHD) (Bourbonnais, et al., 2020). Out of all of the Canadian hospitals that participated in the survey, they came up with the most common concerns. 47% of the hospitals in the survey revealed they had adverse events with heparin induced thrombocytopenia (HIT) ((Bourbonnais, et al., 2020). Other common concerns among nurses were poor vascular access, machine malfunctions, and medication errors. After reviewing all the concerns they discovered that the most common concern above all is the concern of poor vascular access. “Managing occlusions and decreasing infection are necessary for vascular access best practice” (Verde, 2019, as cited in Bourbonais, et al., 2020 p. 17). CRRT is a very cool tool we have for our patients as healthcare providers, but we have to know how to properly use and troubleshoot the process so we can provide the best care possible for our patients. “Providing complex technological care and ensuring patient safety are foundations of nursing in intensive care environments” (Bourbonnais, et al., 2020).
Bourbannais, F. F., Slivar, S., & Malone-Tucker, S. (2020). Caring for patients on CRRT– Key safety concerns identified by nurses.
Canadian Journal of Critical Care Nursing,
Reply to the classmate ( health Assessment)
Paragraph One: What went well for me for this simulation was recognizing the signs of a stroke and knowing the interventions when a stroke is called. I have had patients with prior strokes and had a patient have a stroke in front of me at work, for which we had to intervene immediately. I feel like this scenario is mostly realistic with a couple exceptions. With the patient who is having an active stroke, sometimes the symptoms of the stroke will wax and wane. For example, I had a patient on my unit who had just recently had a baby and her husband was talking to her at bedside and noticed the patient become unresponsive. We called a Stroke Alert and by the time we had gotten the patient to the CT (approximately 10 minutes after symptom onset), the patient was responsive and able to communicate with us again. I don’t know if the scenario could have portrayed that or not, but realistically, symptoms of stroke can vary and change throughout the assessment.
Paragraph Two: Next time I would spend less time trying to gather the information I already had from the patient again. There were some assessments that I performed that were unnecessary and because of that, I ran out of options to complete my neuro assessment. I need to improve on prioritizing certain assessment questions during the focused assessment.
Paragraph Three: I learned about the NIH Stroke Scale. I honestly did not know about that assessment. I am more versed in BEFAST. In my job, it is rare, but not impossible, to have a stroke patient, considering my patients are all postpartum mothers and newborns. However, due to the rarity of the occurrence of strokes on my unit, it is important to brush up on the assessment skills. I will definitely be brushing up on my NIH Stroke Scale questions so I am more prepared for the next stroke I witness. Hopefully, that won’t happen for a while, if ever again.
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