Advertisement

Evolution of Intensive Care Unit Nursing

  • Stefano Bambi
Chapter

Abstract

The specialties of critical care medicine and critical care nursing arose to provide special treatment and care to the most severely ill hospital patients. However, critical care medicine does not seem to have made any major therapeutic progress in the past 30 years. The reduction of mortality in intensive care units (ICUs) is due essentially to improvements in both supportive care and the relevant technologies. In future, increases in the number of ICU beds relative to bed numbers in other hospital wards will probably be contemplated, even in a scenario of decreasing costs; clinical protocols will be computerized and/or nurse-driven; more multicenter and international trials will be performed; and organizational strategies will concentrate ICU personnel in a few large units, to promote the flexible management of these healthcare workers. Moreover, extracorporeal organ support technologies will be improved; technology informatics will cover all the bureaucratic aspects of healthcare work, aiding the staff in workload assessment; and critical care multidisciplinary rounds and follow-up services for post-ICU patients will be implemented. Lastly, a better continuum of care between the pre-hospital phase, the emergency care phase, the ICU phase, and the post-ICU phase should be achieved.

Also, policies should be drafted to manage sudden large demands for critical care beds in mega-emergencies.

The main lines of discussion in critical care nursing research should include nursing research priorities in critical care patients, holistic approaches to the patient, the humanization of care, special populations of ICU patients, and challenges related to critical care nursing during emerging outbreaks of infectious diseases.

Keywords

Quality improvement Health resources Workload Biomedical technology Nursing Research Obesity Geriatric nursing Oncology nursing Infection 

References

  1. 1.
    Vincent JL, Singer M, Marini JJ, Moreno R, Levy M, Matthay MA, et al. Thirty years of critical care medicine. Crit Care. 2010;14:311.  https://doi.org/10.1186/cc8979.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Vincent JL. Critical care – where have we been and where are we going? Crit Care. 2013;17:S2.  https://doi.org/10.1186/cc11500.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Vincent JL, Singer M. Critical care: advances and future perspectives. Lancet. 2010;376:1354–61.  https://doi.org/10.1016/S0140-6736(10)60575-2.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Costa DK, Kahn JM. Organizing critical care for the 21st century. JAMA. 2016;315:751–2.  https://doi.org/10.1001/jama.2016.0974.CrossRefPubMedGoogle Scholar
  5. 5.
    Matthay MA, Liu KD. New strategies for effective therapeutics in critically ill patients. JAMA. 2016;315(8):747.  https://doi.org/10.1001/jama.2016.0661.CrossRefPubMedGoogle Scholar
  6. 6.
    Deutschman CS, Ahrens T, Cairns CB, Sessler CN, Parsons PE, Critical Care Societies Collaborative/USCIITG Task Force on Critical Care Research. Multisociety task force for critical care research: key issues and recommendations. Am J Respir Crit Care Med. 2012;185:96–102.  https://doi.org/10.1164/rccm.201110-1848ST. CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Blackwood B, Albarran JW, Latour JM. Research priorities of adult intensive care nurses in 20 European countries: a Delphi study. J Adv Nurs. 2011;67:550–62.  https://doi.org/10.1111/j.1365-2648.2010.05512.x.CrossRefGoogle Scholar
  8. 8.
    Giusti GD. The priorities in the nurse research in critical care. Scenario. 2015;32:3.Google Scholar
  9. 9.
    Davidson JE, Powers K, Hedayat KM, Tieszen M, Kon AA, Shepard E, et al. Clinical practice guidelines for support of the family in the patient-centered intensive care unit: American College of Critical Care Medicine Task Force 2004-2005. Crit Care Med. 2007;35:605–22.  https://doi.org/10.1097/01.CCM.0000254067.14607.EB. CrossRefPubMedGoogle Scholar
  10. 10.
    Giannini A. Open intensive care units: the case in favour. Minerva Anestesiol. 2007;73:299–305.PubMedGoogle Scholar
  11. 11.
    Giannini A. The “open” ICU: not just a question of time. Minerva Anestesiol. 2010;76:89–90.PubMedGoogle Scholar
  12. 12.
    Cappellini E, Bambi S, Lucchini A, Milanesio E. Open intensive care units: a global challenge for patients, relatives, and critical care teams. Dimens Crit Care Nurs. 2014;33:181–93.  https://doi.org/10.1097/DCC.0000000000000052.CrossRefPubMedGoogle Scholar
  13. 13.
    Cabrini L, Landoni G, Antonelli M, Bellomo R, Colombo S, Negro A, et al. Critical care in the near future: patient-centered, beyond space and time boundaries. Minerva Anestesiol. 2016;82:599–604.Google Scholar
  14. 14.
    Peris A, Bambi S. Family presence during cardiopulmonary resuscitation could make more natural organ donation. Int Emerg Nurs. 2014;22:234.  https://doi.org/10.1016/j.ienj.2013.04.002.CrossRefPubMedGoogle Scholar
  15. 15.
    Bambi S, Bombardi M, Bonizzoli M, Migliaccio ML, Giovannoni L, Minardi A, et al. Open visiting policies in intensive care units may not affect consent to organ donation. Br J Anaesth. 2015;115:142–3.  https://doi.org/10.1093/bja/aev179.CrossRefPubMedGoogle Scholar
  16. 16.
    Tracy MF, Chlan L. Nonpharmacological interventions to manage common symptoms in patients receiving mechanical ventilation. Crit Care Nurse. 2011;31:19–28.  https://doi.org/10.4037/ccn2011653.CrossRefPubMedGoogle Scholar
  17. 17.
    Martin S. What criteria should be used for pet therapy in critical care? Are you aware of any hospitals doing this? Crit Care Nurse. 1993;13:74.PubMedGoogle Scholar
  18. 18.
    Cole KM, Gawlinski A. Animal-assisted therapy in the intensive care unit. A staff nurse’s dream comes true. Nurs Clin North Am. 1995;30:529–37.PubMedGoogle Scholar
  19. 19.
    Cole KM, Gawlinski A, Steers N, Kotlerman J. Animal-assisted therapy in patients hospitalized with heart failure. Am J Crit Care. 2007;16:575–85.PubMedGoogle Scholar
  20. 20.
    Calcaterra V, Veggiotti P, Palestrini C, De Giorgis V, Raschetti R, Tumminelli M, et al. Post-operative benefits of animal-assisted therapy in pediatric surgery: a randomised study. PLoS One. 2015;10:e0125813.  https://doi.org/10.1371/journal.pone.0125813.eCollection 2015.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Alameddine M, Dainty KN, Deber R, Sibbald WJ. The intensive care unit work environment: current challenges and recommendations for the future. J Crit Care. 2009;24:243–8.  https://doi.org/10.1016/j.jcrc.2008.03.038.CrossRefPubMedGoogle Scholar
  22. 22.
    Miracle VA. Suggestions for handling anger in the workplace. Dimens Crit Care Nurs. 2013;32:125–7.  https://doi.org/10.1097/DCC.0b013e318286477e.CrossRefPubMedGoogle Scholar
  23. 23.
    Alexanian JA, Kitto S, Rak KJ, Reeves S. Beyond the team: understanding interprofessional work in two north American ICUs. Crit Care Med. 2015;43:1880–6.  https://doi.org/10.1097/CCM.0000000000001136.CrossRefPubMedGoogle Scholar
  24. 24.
    Parker MM. Teamwork in the ICU-do we practice what we preach? Crit Care Med. 2016;44:254–5.  https://doi.org/10.1097/CCM.0000000000001524.CrossRefPubMedGoogle Scholar
  25. 25.
    Kelso LA. Teamwork in the ICU: from training camp to the super bowl. Crit Care Med. 2015;43:2026–7.  https://doi.org/10.1097/CCM.0000000000001177.CrossRefPubMedGoogle Scholar
  26. 26.
    Blake N. The nurse leader’s role in supporting healthy work environments. AACN Adv Crit Care. 2015;26:201–3.  https://doi.org/10.1097/NCI.0000000000000089. CrossRefPubMedGoogle Scholar
  27. 27.
    Blake N. The healthy work environment standards: ten years later. AACN Adv Crit Care. 2015;26:97–8.  https://doi.org/10.1097/NCI.0000000000000078. CrossRefPubMedGoogle Scholar
  28. 28.
    Darvas JA, Hawkins LG. What makes a good intensive care unit: a nursing perspective. Aust Crit Care. 2002;15:77–82.CrossRefPubMedGoogle Scholar
  29. 29.
    Azoulay E, Timsit JF, Sprung CL, Soares M, Rusinová K, Lafabrie A, et al. Prevalence and factors of intensive care unit conflicts: the conflicus study. Am J Respir Crit Care Med. 2009;180:853–60.  https://doi.org/10.1164/rccm.200810-1614OC.CrossRefPubMedGoogle Scholar
  30. 30.
    Grant M. Resolving communication challenges in the intensive care unit. AACN Adv Crit Care. 2015;26:123–30.  https://doi.org/10.1097/NCI.0000000000000076. CrossRefPubMedGoogle Scholar
  31. 31.
    Hartog CS, Benbenishty J. Understanding nurse-physician conflicts in the ICU. Intensive Care Med. 2015;41:331–3.  https://doi.org/10.1007/s00134-014-3517-z.CrossRefPubMedGoogle Scholar
  32. 32.
    Bambi S, Mattiussi E, Giusti GD, Lucchini A, Manici M, Comisso I. The strange and conflicting world of nursing. Intensive Care Med. 2015;41:1372–3.  https://doi.org/10.1007/s00134-015-3843-9.CrossRefPubMedGoogle Scholar
  33. 33.
    Bambi S, Becattini G, Giusti GD, Mezzetti A, Guazzini A, Lumini E. Lateral hostilities among nurses employed in intensive care units, emergency departments, operating rooms, and emergency medical services. A national survey in Italy. Dimens Crit Care Nurs. 2014;33:347–54.  https://doi.org/10.1097/DCC.0000000000000077.CrossRefPubMedGoogle Scholar
  34. 34.
    Camerino D, Estryn-Behar M, Conway PM, van Der Heijden BIJ, Hasselhorn H. Work-related factors and violence among nursing staff in the European NEXT study: a longitudinal cohort study. Int J Nurs Stud. 2008;45:35–50.CrossRefPubMedGoogle Scholar
  35. 35.
    Moayed FA, Daraiseh N, Shell R, Salem S. Workplace bullying: a systematic review of risk factors and outcomes. Theor Issues Ergon. 2006;7:311–27.CrossRefGoogle Scholar
  36. 36.
    Vessey JA, Demarco RF, Gaffney DA, Budin WC. Bullying of staff registered nurses in the workplace: a preliminary study for developing personal and organizational strategies for the transformation of hostile to healthy workplace environments. J Prof Nurs. 2009;25:299–306.  https://doi.org/10.1016/j.profnurs.2009.01.022.CrossRefPubMedGoogle Scholar
  37. 37.
    Purpora C, Blegen MA. Horizontal violence and the quality and safety of patient care: a conceptual model. Nurs Res Pract. 2012;306948.  https://doi.org/10.1155/2012/306948.
  38. 38.
    Roberts SJ. Oppressed group behavior: implications for nursing. ANS Adv Nurs Sci. 1983;5:21–30.CrossRefPubMedGoogle Scholar
  39. 39.
    Vessey JA, De Marco R, Di Fazio R. Bullying, harassment, and horizontal violence in the nursing workforce. The state of the science. Annu Rev Nurs Res. 2010;28:133–57.CrossRefPubMedGoogle Scholar
  40. 40.
    Roberts SJ, Demarco R, Griffin M. The effect of oppressed group behaviours on the culture of the nursing workplace: a review of the evidence and interventions for change. J Nurs Manag. 2009;17:288–93.CrossRefPubMedGoogle Scholar
  41. 41.
    Brinkert R. A literature review of conflict communication causes, costs, benefits and interventions in nursing. J Nurs Manag. 2010;18:145–56.  https://doi.org/10.1111/j.1365-2834.2010.01061.x.CrossRefPubMedGoogle Scholar
  42. 42.
    The Joint Commission. Behaviors that undermine a culture of safety. Sentinel Event Alert. Issue 40. 2008. https://www.jointcommission.org/assets/1/18/SEA_40.PDF. Accessed 15 Feb 2016.
  43. 43.
    American Association of Critical Nurses (AACN). Standards for establishing and sustaining healthy work environments. A journey to excellence. Executive Summary. AACN. 2005. http://www.aacn.org/wd/hwe/docs/execsum.pdf. Accessed on 15 Feb 2016.
  44. 44.
    Barrett A, Piatek C, Korber S, Padula C. Lessons learned from a lateral violence and team-building intervention. Nurs Adm Q. 2009;33:342–51.  https://doi.org/10.1097/NAQ.0b013e3181b9de0b.CrossRefPubMedGoogle Scholar
  45. 45.
    Deltsidou A. Undergraduate nursing students’ level of assertiveness in Greece: a questionnaire survey. Nurse Educ Pract. 2009;9:322–30.  https://doi.org/10.1016/j.nepr.2008.08.002.CrossRefPubMedGoogle Scholar
  46. 46.
    Begley CM, White P. Irish nursing students’ changing self-esteem and fear of negative evaluation during their preregistration programme. J Adv Nurs. 2003;42:390–401.CrossRefGoogle Scholar
  47. 47.
    Royal College of Nursing (RCN). Dealing with bullying and harassment at work—a guide for RCN members. 2015, Revised December 2005. http://www2.rcn.org.uk/__data/assets/pdf_file/0009/643482/Bullying-at-work-short.pdf. Accessed 15 Feb 2016.
  48. 48.
    Dimarino TJ. Eliminating lateral violence in the ambulatory setting: one center’s strategies. AORN J. 2011;93:583–8.  https://doi.org/10.1016/j.aorn.2010.10.019.CrossRefPubMedGoogle Scholar
  49. 49.
    Kleinert S, Horton R. Rethinking and reframing obesity. Lancet. 2015;385:2326–8.  https://doi.org/10.1016/S0140-6736(15)60163-5.CrossRefPubMedGoogle Scholar
  50. 50.
    Jones SB. Preface: obesity. Int Anesthesiol Clin. 2013;51:xi–xii.  https://doi.org/10.1097/AIA.0b013e3182988c98.CrossRefPubMedGoogle Scholar
  51. 51.
    Koba P. Identifying obstacles for the obese trauma patient. J Trauma Nurs. 2016;23:45–8.  https://doi.org/10.1097/JTN.0000000000000178. CrossRefPubMedGoogle Scholar
  52. 52.
    Erstad BL. Obesity in critical illness: what weight or why weight? Crit Care Med. 2012;40:1657–9.  https://doi.org/10.1097/CCM.0b013e3182411720. CrossRefPubMedGoogle Scholar
  53. 53.
    Shearer E. Critical care management of obese patients. Int Anesthesiol Clin. 2013;51:164–78.  https://doi.org/10.1097/AIA.0b013e31829813a8.CrossRefPubMedGoogle Scholar
  54. 54.
    Bambi S, Ruggeri M, Becattini G, Lumini E. Bariatric patients in emergency department: a challenge for nursing care. Scenario. 2013;30:4–15.Google Scholar
  55. 55.
    Flaatten H, Garrouste-Orgeas M. The very old ICU patient: a never-ending story. Intensive Care Med. 2015;41:1996–8.  https://doi.org/10.1007/s00134-015-4052-2.CrossRefPubMedGoogle Scholar
  56. 56.
    Crippen DW. Very elderly patients in the ICU: should there be a line in the sand? Crit Care Med. 2015;43:1527–8.  https://doi.org/10.1097/CCM.0000000000001044. CrossRefPubMedGoogle Scholar
  57. 57.
    Zivot JB. Elder care in the ICU: spin bravely? Crit Care Med. 2015;43:1526–7.  https://doi.org/10.1097/CCM.0000000000001055. CrossRefPubMedGoogle Scholar
  58. 58.
    Heyland D, Cook D, Bagshaw SM, Garland A, Stelfox HT, Mehta S, et al. The very elderly admitted to ICU: a quality finish? Crit Care Med. 2015;43:1352–60.  https://doi.org/10.1097/CCM.0000000000001024. CrossRefPubMedGoogle Scholar
  59. 59.
    Heyland DK, Garland A, Bagshaw SM, Cook D, Rockwood K, Stelfox HT, et al. Recovery after critical illness in patients aged 80 years or older: a multi-center prospective observational cohort study. Intensive Care Med. 2015;41:1911–20.  https://doi.org/10.1007/s00134-015-4028-2.CrossRefPubMedGoogle Scholar
  60. 60.
    Stevens CL, Torke AM. Geriatric trauma: a clinical and ethical review. J Trauma Nurs. 2016;23:36–41.  https://doi.org/10.1097/JTN.0000000000000179.CrossRefPubMedGoogle Scholar
  61. 61.
    Deeny P. Care of older people in critical care: the hidden side of the moon. Intensive Crit Care Nurs. 2005;21:325–7.  https://doi.org/10.1016/j.iccn.2005.09.005. CrossRefPubMedGoogle Scholar
  62. 62.
    Hardin SR. Vulnerability of older patients in critical care. Crit Care Nurse. 2015;35:55–61.  https://doi.org/10.4037/ccn2015995.CrossRefPubMedGoogle Scholar
  63. 63.
    Ampélas JF, Pochard F, Consoli SM. Psychiatric disorders in intensive care units. Encéphale. 2002;28:191–9.PubMedGoogle Scholar
  64. 64.
    Pochard F. Psychiatric issues during and after intensive care (ICU) stays. Bull Acad Natl Med. 2011;195:377–85.PubMedGoogle Scholar
  65. 65.
    Bienvenu OJ, Neufeld KJ, Needham DM. Treatment of four psychiatric emergencies in the intensive care unit. Crit Care Med. 2012;40:2662–70.  https://doi.org/10.1097/CCM.0b013e31825ae0f8.CrossRefGoogle Scholar
  66. 66.
    New AM, Nelson S, Leung JG. Psychiatric emergencies in the intensive care unit. AACN Adv Crit Care. 2015;26:285–93.  https://doi.org/10.1097/NCI.0000000000000104.CrossRefPubMedGoogle Scholar
  67. 67.
    Brennan CW, Prince-Paul M, Wiencek CA. Providing a “good death” for oncology patients during the final hours of life in the intensive care unit. AACN Adv Crit Care. 2011;22:379–96.  https://doi.org/10.1097/NCI.0b013e31823100dc.CrossRefPubMedGoogle Scholar
  68. 68.
    Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, Rosso S, Coebergh JW, Comber H, et al. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer. 2013;49:1374–403.  https://doi.org/10.1016/j.ejca.2012.12.027.CrossRefPubMedGoogle Scholar
  69. 69.
    Daly BJ. Caring for the critically ill patient with cancer. AACN Adv Crit Care. 2011;22:321–2.  https://doi.org/10.1097/NCI.0b013e31822f57b5. CrossRefPubMedGoogle Scholar
  70. 70.
    Demshar R, Vanek R, Mazanec P. Oncologic emergencies: new decade, new perspectives. AACN Adv Crit Care. 2011;22:337–48.  https://doi.org/10.1097/NCI.0b013e318230112b.CrossRefPubMedGoogle Scholar
  71. 71.
    Azoulay E, Soares M, Darmon M, Benoit D, Pastores S, Afessa B. Intensive care of the cancer patient: recent achievements and remaining challenges. Ann Intensive Care. 2011;1:5.  https://doi.org/10.1186/2110-5820-1-5.CrossRefPubMedPubMedCentralGoogle Scholar
  72. 72.
    Wiencek CA, Ferrell BR, Jackson M. The meaning of our work: caring for the critically ill patient with cancer. AACN Adv Crit Care. 2011;22:397–407.  https://doi.org/10.1097/NCI.0b013e318232c6ef.CrossRefPubMedGoogle Scholar
  73. 73.
    Dondorp AM, Iyer SS, Schultz MJ. Critical care in resource-restricted settings. JAMA. 2016;315:753–4.  https://doi.org/10.1001/jama.2016.0976.CrossRefPubMedGoogle Scholar
  74. 74.
    Makamure M, Makamure M, Mendiola W, Renteria D, Repp M, Willden A. A review of critical care nursing and disease outbreak preparedness. Dimens Crit Care Nurs. 2013;32:157–61.  https://doi.org/10.1097/DCC.0b013e318299801f.CrossRefPubMedGoogle Scholar
  75. 75.
    Garnacho-Montero J, Dimopoulos G, Poulakou G, Akova M, Cisneros JM, De Waele J, et al. Task force on management and prevention of Acinetobacter Baumannii infections in the ICU. Intensive Care Med. 2015;41:2057–75.  https://doi.org/10.1007/s00134-015-4079-4.CrossRefPubMedGoogle Scholar
  76. 76.
    Colatrella S, Clair JD. Adapt or perish - a relentless fight for survival: designing superbugs out of the intensive care unit. Crit Care Nurs Q. 2014;37:251–67.  https://doi.org/10.1097/CNQ.0000000000000029.CrossRefPubMedGoogle Scholar
  77. 77.
    Chertow DS, Palmore TN, Masur H. Critical care medicine after the 2014–2015 Ebola outbreak: are we ready if it happens again? Crit Care Med. 2016;44:457–9.  https://doi.org/10.1097/CCM.0000000000001590. CrossRefPubMedGoogle Scholar
  78. 78.
    Casalino E, Astocondor E, Sanchez JC, Díaz-Santana DE, Del Aguila C, Carrillo JP. Personal protective equipment for the Ebola virus disease: a comparison of 2 training programs. Am J Infect Control. 2015;43:1281–7.  https://doi.org/10.1016/j.ajic.2015.07.007.CrossRefPubMedGoogle Scholar
  79. 79.
    MacIntyre CR, Chughtai AA, Seale H, Richards GA, Davidson PM. Uncertainty, risk analysis and change for Ebola personal protective equipment guidelines. Int J Nurs Stud. 2015;52:899–903.  https://doi.org/10.1016/j.ijnurstu.2014.12.001.CrossRefPubMedGoogle Scholar
  80. 80.
    York NL, Kane C. Caring for the critically ill patient with tuberculosis. Dimens Crit Care Nurs. 2013;32:6–11.  https://doi.org/10.1097/DCC.0b013e3182768045.CrossRefPubMedGoogle Scholar
  81. 81.
    Johnson SS, Barranta N, Chertow D. Ebola at the National Institutes of Health: perspectives from critical care nurses. AACN Adv Crit Care. 2015;26:262–7.  https://doi.org/10.1097/NCI.0000000000000103.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Stefano Bambi
    • 1
  1. 1.Emergency & Trauma ICU, University Hospital CareggiFlorenceItaly

Personalised recommendations