Nursing Considerations in Pediatric Cardiac Critical Care

Abstract

Pediatric cardiac critical care nurses manage complex and vulnerable patients requiring various levels of support. Effective care of these patients requires knowledge about the complex anatomy and physiology associated with congenital and acquired heart disease, as well as the effects of mechanical ventilation, mechanical circulatory support, and vasoactive medications. Strong physical examination skills, accurate interpretation of hemodynamic and laboratory data, active participation in bedside rounds, excellent communication skills, meticulous care of invasive monitoring catheters and tubes, and compassionate support of families are among the skills that distinguish a cardiac critical care nurse.

Communication in Pediatric Critical Care Units: A Review of the Literature

“…30,31 Of the 26 remaining studies, 16 were deemed high quality 1,2,6,7,8,[10][11][12]14,18,[22][23][24][25][26][27][28] and 10 were considered good quality. 9,13,[15][16][17][19][20][21]26,29 Eight studies reported significant results related to increased communication, satisfaction, and compliance. 6,7,11,20,[22][23][24]28 In the examination of level of evidence, 16 articles were deemed to be level III, which includes nonexperimental studies, qualitative studies, and meta-synthesis.…”

“…Continued projects and descriptive reviews. 1,2,6,8,11,13,20,21,27,28,31 Of the included studies, 4 focused on provider communication, 8 focused on parent/caregiver communication, 6 focused on patient communication, and 10 focused on communication tools.…”

“…1,7,11 Several studies focused on the quality and experience of nursing providers (bedside registered nurses unless otherwise noted nurses who have completed robust orientation and have a strong knowledge base related to the specific care of these patients. 1,12,13 One study found that a nursing staff in which 20% or more of the nurses have 2 years or less of experience in a cardiac ICU increased the odds of patient mortality. However, the use of quality benchmarks, presence of nurses with bachelor of science in nursing degrees and CCRN certification, high-volume units, and a high percentage of nurses with 11 or more years of experience significantly improved outcomes and decreased mortality.…”

“…15 For example, record keeping related to quality bundles requires considerable time away from patients to comply with quality measures. 13,15 Additional tasks include providing high-quality bedside care and monitoring, coordinating care with the multiple services that intensive care patients require, providing education to family members, and documenting the education. 13,15 By reducing time spent in task-oriented decision-making, nurses could increase the time devoted to communication with families and providers.…”

Training Needs Assessment for Practicing Paediatric Critical Care Nurses in Malawi To Inform The Development of A Specialized Master’s Education Pathway: A Cohort Study

“…It will be important to identify the underlying cause of nurses' lack of con dence as a matter of patient safety. [23,24] High patient volumes could affect the nurses' ability to con dently perform assessments. Half the nurses care for 1-3 or 4-6 patients on a shift, which is comparable to some high-income settings such as California, USA, where state law requires a ratio of 1:2 for critical care wards and up to 1:6 in medical/surgical wards.…”