ACCCN's Critical Care Nursing by Doug Elliott

By Doug Elliott

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1 The need for prudent and rational allocation of limited financial and human resources was as important for Australia’s first ICU (St Vincent’s, Melbourne, 1961) as it is for the 200 or more now scattered across Australia and New Zealand. This chapter explores the influences on the development of critical care and the way this resource is currently viewed and used; describes various organisational, staffing and training arrangements that need to be in place; considers the planning, design and equipment needs of a critical care unit; covers other aspects of resource management including the budget; and finishes with a description of how critical care staff may respond to a pandemic.

Strategies and criteria for clinical decision making in critical care nurses: a qualitative study. J Nurs Scholarship 2009; 41(4): 351–8. Resourcing Critical Care 2 Denise Harris Ged Williams Learning objectives After reading this chapter, you should be able to: ● describe historical influences on the development of critical care and the way this resource is currently viewed and used ● explain the organisational arrangements and interfaces that may be established to govern a critical care unit ● identify external resources and supports that assist in the governance and management of a critical care unit ● describe considerations in planning for the physical design and equipment requirements of a critical care unit ● describe the human resource requirements, supports and training necessary to ensure a safe and appropriate workforce ● explain common risks and the appropriate strategies, policies and contingencies necessary to support staff and patient safety ● discuss leadership and management principles that influence the quality, efficacy and appropriateness of the critical care unit ● discuss common considerations from a critical care perspective in responding to the threat of a pandemic.

Thompson, 200867 [various countries] 245 Dutch, UK, Canadian and Australian registered nurses working in surgical, medical, ICU or HDU Vignettes with decision whether or not to contact a senior nurse/doctor. The proportion of true positives (the patient is at risk of a critical event and the nurse takes action) and false positives (the nurse takes action when it was not warranted) was calculated. Time pressure significantly reduced the nurses’ decision tendency to intervene. There were no statistically significant differences in decision-making ability between years of generic clinical experience.

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