Understanding, recognizing, and managing chronic critical illness syndrome

Abstract

To obtain CE credit for this activity, go to www.aanp.org and click on the CE Center. Locate the listing for this article and complete the post-test. Follow the instructions to print your CE certificate. AbstractPurpose: No evidence-based guidelines exist for the care of patients with chronic critical illness syndrome (CCIS), a growing population of patients being cared for by nurse practitioners (NPs). The purpose of this article is to provide NPs with a beginning physiological framework, allostasis, to guide their understanding and management of patients with CCIS.

Rethinking the intensive care environment: considering nature in nursing practice

“…Problems include recurrent infections, malnutrition, neuropathy and myopathy, loss of lean body tissue, delirium, depression and suffering (Bellar et al . , Camhi & Nelson ).…”

“…The body cannot endure prolonged stress for long and eventually the allostatic load will show from the over‐activation of the regulating system (Bellar et al . ). Bellar et al., in developing an evidence‐based conceptual framework for recognising and managing chronic critical illness syndrome in ICU patients, argued that this over‐activation can occur in patients who have been critically ill for a long period and who have sustained multiple organ and tissue damage from an ineffective allostatic response.…”

“…This argument is also congruent with allostasis, further supporting the need to reduce patient stressors from all sources, which has the potential to improved outcomes and decreased length of stay (Bellar et al . ). Patients’ interaction with a biophilic built environment, that includes natural elements that provide positive distractions, is one way to modify stress levels (Grinde & Patil ; Terrapin Bright Green, ).…”

Stress, Psychoneuroimmunology and Self-care: What Every Nurse Needs to Know

“…AL is a sign of aging related to stress and the higher the AL, the more likely one is to become ill and struggle with healing. AL has been translated into a measurable index, and it is used to gauge the physiological effects of chronic stress in the workplace; high physiological stress and low job control, have been shown to be a risk factor for a higher AL and multiple system dysfunctions [10], as well as chronic critical illness syndrome [11]. Additionally, as one ages, the effects of stress on AL seem to increase, particularly after the age of 45 .…”

“…Psychoneuroimmunology (PNI) is the trans disciplinary field of study concerned with how behavior, the central nervous system, the endocrine system, and the immune system interact; the field examines how consciousness impacts one's central nervous system and immune systems, and examines the complex flow of information across body systems [11]. PNI is focused on this interaction of behaviors, emotions, psychological responses, the central nervous system, and the immune system, and how these interactions can lead to illness or wellness.…”