The focus of this edition of Critical Care Nursing Quarterly is on patient-centric quality improvement initiatives that have positively influenced outcomes in the critical care environment. The manuscripts chosen for this issue address several aspects of critical care nursing that identify best practices to overcome the challenges identified with the intensive care population.
The first article in the issue, "Reduction of Catheter-Associated Urinary Tract Infections: A Multidisciplinary Approach to Driving Change," Baker, Shiner, Stupak, Cohen, and Stoner initiate the discussion centering on the importance of collaboration to decrease hospital-acquired, catheter-related infections. Included in this article is the viewpoint from the lens of an infection prevention specialist nurse on the process to decrease catheter-associated urinary tract infections.
Following along from a hospital-acquired infection standpoint, Laux, McGonigal, Yaglowski, and Vietmeier share the impact of involving frontline staff to create an approach to prevent and reduce central line infections. "Engaging the Front Line: A Case Study on Implementing Lean Methodology to Improve Central Line-Associated Bloodstream Infections" spotlights positive patient outcomes by aligning quality improvement process with frontline nursing involvement.
Leininger, Rinaldi, Hite Philip, and Birdsong further explore the impact of implementing an interdisciplinary approach focused on best practices to prevent venous thromboembolism (VTE) in the article, titled "Using an Institute Model to Reduce the Incidence of Venous Thromboembolism Within a Large Hospital System."
In the article, "Evidence-Based Approach to Decrease Incidence of Hospital-Acquired Pressure Injuries," Bartolowits, Morran, Eisenhooth, and Criste explore best practices to impact the challenging patient safety issue of pressure injuries. The article spotlights the importance of peer education and utilization of Lean Methodology to improve this nurse-sensitive indicator for quality by engaging the frontline staff.
"The Challenges of Managing Pain in the Intensive Care Unit" provides a review of symptom type and the different characteristics associated with pain in the critical care environment. Leininger shares best practices and a pathway for treatment along with the importance of utilizing a pain assessment tool.
Stamper, Kerr, and Sporter introduce the discussion on the importance of supportive care in the article, titled "The Evolution of Palliative Medicine in Intensive Care." The authors share the importance of the specialty and the positive contribution in the critical care environment.
Patient lifting and transferring is one of the most injury-prone procedures for the intensive care unit nurse. Stoddart describes the implementation of patient transport technology to improve staff and patient safety in "Air-Assisted Technology: A Quality Endeavor to Reduce Employee Injury and Hospital-Acquired Pressure Injuries."
In the article "A Nursing Approach to Improving Critical Care Compliance With Vital Signs and Neurological Assessments in Post-IV-Alteplase Stroke Patients," Cohen, Anderson, Noah, and Super outline their recommendations on improving poststroke nursing care and focusing on best practices within this patient population.
The final contribution in the issue, "The Future of Assessing Frailty in the Patient With Advanced Heart Failure: A Review of Current Literature," Leininger and Micco deliver a comprehensive review of the literature on the assessment of frailty and the impact on patients with heart failure.
The goal of this issue is to spotlight patient-centric solutions to the safety and quality challenges that critical care nurses encounter and provide best practices that involve an interdisciplinary approach to improvement.
-Margaret Hardt-DiCuccio, PhD, RN, NEA-BC
Michelle McGonigal, DNP, RN, NE-BC
Issue Editor