Editorials:

Christopher W. Bryan-Brown and Kathleen Dracup

Keeping the Turf (Wars) Trimmed
Am J Crit Care 2002 11(5): 408-410. [Full Text] [PDF]  

Corrections:

CORRECTION
Am J Crit Care 2002 11(5): 411. [Full Text] [PDF]  

Guest Editorials:

Ruth M. Kleinpell

Rediscovering the Value of the Journal Club
Am J Crit Care 2002 11(5): 412-414. [Full Text] [PDF]  

Pain Management in Critical Care:

Kathleen A. Puntillo, Lorie Rietman Wild, Ann Bonham Morris, Julie Stanik-Hutt, Carol Lynn Thompson, and Cheri White

Practices and Predictors of Analgesic Interventions for Adults Undergoing Painful Procedures
Research is limited on analgesic practices associated with the commonly performed procedures of turning, inserting central venous catheters, removing wound drains, changing dressings on nonburn wounds, suctioning the trachea, and removing femoral sheaths. The authors evaluated data on 5957 patients undergoing these procedures to determine the types of analgesics administered, the prevalence and amounts of drugs given, and factors predictive of analgesic administration.
Am J Crit Care 2002 11(5): 415-429. [Abstract] [Full Text] [PDF] [CE Test]  

William J. Fox and Thomas A. Hughes

Use of Intercostal Bupivacaine With Epinephrine After Surgery to Decrease Use of Narcotics and Duration of Intubation
Postoperative pain plays a significant role in the recovery of patients after open heart surgery. In this study, the authors determine if the use of intercostal bupivacaine with epinephrine is associated with decreases in use of narcotics and intubation times in 2 groups of patients (25 in the treated group and 22 in the control group) after open heart surgery.
Am J Crit Care 2002 11(5): 433-435. [Abstract] [Full Text] [PDF]  

Critical Care Nursing Practice:

Sharon Saunderson Cohen, Nancy Crego, Richard G. Cuming, and Melinda Smyth

The Synergy Model and the Role of Clinical Nurse Specialists in a Multihospital System
The Synergy Model, developed by the AACN Certification Corporation, was introduced as a way of linking certified practice to patients' outcomes. These authors describe how the Synergy Model assisted a group of CNSs in determining how to best serve the needs of an organization while continuing to generate positive outcomes for patients and maintain fiscal responsibility.
Am J Crit Care 2002 11(5): 436-446. [Abstract] [Full Text] [PDF]  

Jill N. Howie and Mitchel Erickson

Acute Care Nurse Practitioners: Creating and Implementing a Model of Care for an Inpatient General Medical Service
Changes in medical education and healthcare reimbursement are recent threats to most academic centers' dual mission of patient care and education. Financial pressures stem from reduced insurance reimbursement, capitation, and changes in public funding for medical residency education. The authors present a framework for addressing the need for innovation in the medical service at a large academic medical center. The framework enables ACNPs to provide inpatient medical management in collaboration with a hospitalist.
Am J Crit Care 2002 11(5): 448-458. [Abstract] [Full Text] [PDF] [CE Test]  

Family Concerns in Critical Care:

Sandra M. Swoboda and Pamela A. Lipsett

Impact of a Prolonged Surgical Critical Illness on Patients’ Families
Long-term effects on patients' families after a prolonged stay in a surgical ICU are unclear. These authors examined data on families who were interviewed at baseline, at 1 month, at 3 months, and at 6 months to ascertain economic and psychosocial burdens on family members and the impact on family members to provide caregiving assistance to patients after hospitalization.
Am J Crit Care 2002 11(5): 459-466. [Abstract] [Full Text] [PDF]  

Critical Care Economics:

John M. Welton, Anthony A. Meyer, Larry Mandelkehr, Samir M. Fakhry, and Sandra Jarr

Outcomes of and Resource Consumption by High-Cost Patients in the Intensive Care Unit
Little is known about high-cost patients in the ICU or their outcomes of care. The authors of this study analyzed the costs of care and use of ICU resources for adult patients at a single academic medical center during a 4 1/2-year period. An ICU database, the hospital discharge data set, and a cost-accounting data set were used to determine the total ICU cost for hospitalization. Hospital and ICU outcomes for patients in the top decile were compared with those of patients in the other deciles.
Am J Crit Care 2002 11(5): 467-473. [Abstract] [Full Text] [PDF]  

Leslie C. Hussey, Sonya Hardin, and Christopher Blanchette

Outpatient Costs of Medications for Patients with Chronic Heart Failure
The outpatient costs of medications prescribed for chronic heart failure are high and are often borne by individual patients. These authors set out to compare the outpatient costs of medications with different NYHA classes of chronic heart failure. To do this, they retrospectively reviewed 138 charts of patients with CHF and obtained outpatient costs of medications from the Web sites of commercial pharmacies for comparison.
Am J Crit Care 2002 11(5): 474-478. [Abstract] [Full Text] [PDF]  

Current Controversies in Critical Care:

Patricia Benner

Caring for the Silent Patient
Am J Crit Care 2002 11(5): 480-481. [Full Text] [PDF]  

Cardiology Casebook:

Laurie G. Futterman and Louis Lemberg

High-Sensitivity C-Reactive Protein Is the Most Effective Prognostic Measurement of Acute Coronary Events
Am J Crit Care 2002 11(5): 482-486. [Full Text] [PDF]  

ECG Puzzler:

Mary G. Adams and Michele M. Pelter

Intermittent Conduction Disturbances
Am J Crit Care 2002 11(5): 487-488. [Full Text] [PDF]  

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