MS 3 - CU 1

According to the ——-, the assessment of critically ill patients and their families is an

essential competency for critical care practitioners.

AACCN (2019)

4 Critical

• crucial

• crisis

• emergency

• serious

care of the seriously-ill clients from point of injury/illness until discharge from intensive care

Critical Care Nursing

Deals with human responses to life-threatening problems

Critical Care Nursing

Comprehensive, specialized, and individualized nursing services which are rendered to patients with life-threatening conditions

Critical Care Nursing

• Survival of the critically-ill patients and restoring QUALITY of LIFE

• Helping families of critically-ill patients in coping with stress

Goals

Roles of a Critical Care Nurse:

• Care provider

• Educator

• Manager

• Advocate

Tasks

• Care for clients who are very ill

• Provide one-to-one care

• Responsible of making life and death decision

• At risk of injury and illness

• COMMUNICATION SKILL is of optimum importance

• At risk for actual or potential life-threatening health problems

Classification of Critical Care Clients

• Post-operative clients with major surgery

• Illness involving vital organs

• Stable clients with signs of impending doom

Classification of Critical Care Clients; normal ward care

Level 0

Classification of Critical Care Clients; at risk of deteriorating

Level l

Classification of Critical Care Clients; needs more observation or intervention

Level ll

Classification of Critical Care Clients; multisystem failure

Level lll

Principles of Critical Care

• Continuous monitoring and treatment

• High intensity therapies

• Expert surveillance and efficiency

• Alert to early manifestations and recognition of parameters denoting progress and

deterioration

Four Stages of the Assessment Framework:

1. Pre – arrival assessment

2. Admission-quick check

3. Comprehensive admission assessment

4. On – going assessment

- determines the possible picture of the client and his or her needs. (anticipate possible

resources needed by the patient)

- starts as soon as the nurse becomes aware of a patient coming in the ICU, whether from the

ward, operating room or emergency room

- usual documentation – abbreviated report on patient (age, gender, chief complaint, diagnosis,

pertinent history, physiologic status, invasive devices, equipment and status of laboratory or

diagnostic tests)

Pre – arrival assessment

- obtained immediately after the arrival and assessment

- based on the parameters represented by ABCDE

A – airway

B – breathing

C – circulation, cerebral perfusion, chief complaint

D – drugs and diagnostic tests

E – Equipment

Admission-quick check

- determines the physiologic and psychosocial baseline for comparing data and to determine

whether the status is improving or deteriorating)

- physical assessment is usually by system approach

- psychosocial assessment is performed, too, as this could determine prognosis

- defines the status of the patient prior to the illness

- assessment data includes:

a. Past Medical History

b. Social History

c. Psychosocial history

d. Spirituality

e. Physical Assessment

f. Psychosocial assessment

g. General communication

h. Coping styles

i. Anxiety and Stress

j. Family needs

k. Unit orientation

l. Referrals

Comprehensive admission assessment

- Determines response to therapy, progression of improvement of his or her condition

- Performed as long as the client is in the hospital,

- Continuous assessment is necessary to determine outcome of the client’s disease

On – going assessment

Admission-quick check

- obtained immediately after the arrival and assessment

- based on the parameters represented by ABCDE

A – airway

B – breathing

C – circulation, cerebral perfusion, chief complaint

D – drugs and diagnostic tests

E – Equipment

Comprehensive admission assessment

- determines the physiologic and psychosocial baseline for comparing data and to determine

whether the status is improving or deteriorating)

- physical assessment is usually by system approach

- psychosocial assessment is performed, too, as this could determine prognosis

- defines the status of the patient prior to the illness

- assessment data includes:

a. Past Medical History

b. Social History

c. Psychosocial history

d. Spirituality

e. Physical Assessment

f. Psychosocial assessment

g. General communication

h. Coping styles

i. Anxiety and Stress

j. Family needs

k. Unit orientation

l. Referrals

care of individuals who are seriously ill, including their families and/or significant others

Critical care

– a complex, challenging area of nursing practice, where clinical expertise is

developed over time by integrating critical care knowledge, clinical skills, and caring practice

(AACCN, 2019)

Critical care nursing

an individual who requires more intensive and careful nursing care

Critically-ill client