CRITICAL CARE

NURSING CONCEPT
INTENSIVE CARE

DEFINITION

THE PRACTICE OF ADMINISTERING

IMMEDIATE AND CONTINUOUS CARE TO
CLIENTS WITH ACTUAL OR POTENTIALLY
LIFE-THREATENING HEALTH DISORDERS

MORE THAN 5 MILLION CLIENTS ARE

ADMITTED ANNUALLY TO INTENSIVE CARE
UNITS IN THE UNITED STATES

COMMON ACUTE OR CRITICAL

DISORDERS

Brain injuries
Cardiovascular dysfunctions
Pulmonary dysfunctions
Childbirth
Complications
Infection/sepsis
Shock and trauma
Endocrine abnormalities
Multisystem alterations
Complex surgical procedures

PRIMARY ADMITTING
DIAGNOSES

Society of Critical Care Medicine

Respiratory failure
Postoperative management
Ischemic heart disorder
Sepsis and heart failure

CRITICAL CARE POPULATIONS

Increasing number of adults 65 yrs of age

80% of older adults have at least one
chronic condition
50 % have at least 2
>50 % are filled with clients ages 65 yrs old
and above
Projections : as the baby boomer generation
ages , there will be:
a corresponding rise in chronic illness and
hospitalizations
Increase need for critical care

WHY IS THIS IMPORTANT TO

CRITICAL CARE NURSE?

The aging process is characterized by

physiologic changes
These changes, with prevalence of chronic
conditions, contribute to increased

Morbidity and mortality in critical

care units

CRITICAL CARE NURSING

AACN defines critical care nursing as

The specialty that deals with human
responses to life threatening problems
Entry level nurses function as generalists
Must possess a specialized body of
knowledge and skills
- assessment (advanced), pharmacology ,
pathophysiology , biotechnology ,advanced
communication skills , problem-solving skills
and advocacy skills

SKILLS ARE ESSENTIAL

To provide holistic or humanistic care

to clients and their significant others.

THE PURPOSE OF NURSING

to meet the needs of clients and their

families (physical, emotional, social and
psychological needs )
provide safe transition through the health
care system during a time of crisis
- admission in the unit is a crisis
- critical illness stimulates the stress
response

NOTE THIS :

The more compromised the client , the

more severe or complex are their needs .

ADVOCACY ROLE

Must be able to assess key client

characteristics

Span the health illness continuum and are

influenced by many factors :
educational background, resource
availability , cultural background
These factors , along with the clients ability
to make decisions , and level of strength
during crisis , impact the clients ability to
participate in decision-making

IMPACT OF CRITICAL ILLNESS

Can generate strong emotions in family

members
Shock , disbelief, denial , anger, despair,
guilt, and fear of losing the client

CRITICAL CARE NURSE : THE

CONTINUUM OF CARE

SPECIALIZED NURSING CARE

Once considered the field of critical care
nurses, is now being assumed by nurses in
progressive care units
Progressive care is, therefore considered
part of the continuum of critical care
nursing

CONTINUOUS NURSING
VIGILANCE

Is significant to nursing the critically ill

Can make a substantial difference in client
outcomes
To meet the changing needs of the client ,
Both critical care and progressive nurses
must create an environment that - promotes the best health outcomes
in a caring, competent manner to ensure
positive optimal outcomes for the clients
and families.

CLIENT CHARACTERISTICS

For the nurses caring for the critically ill :

Resiliency
Vulnerability
Stability
Complexity
Resource availability
Participation in care
Participation in decision making
Predictability

ESSENTIAL NURSE
COMPETENCIES

Clinical judgment
Advocacy
Caring practices
Collaboration
Systems thinking
Response to diversity
Clinical inquiry
Facilitation of learning

CERTIFICATIONS PROGRAM

Validates based upon predetermined

standards
A nurse knowledge and qualifications for
practice in a defined functional or clinical
area of nursing
AACN Certification Corporation supports
critical care nurses by administering
specialty certification programs
Measures what is pertinent to the care of
critically ill clients today

NATIONAL CERTIFICATION

Most up-to-date knowledge

Promotes continuing excellence in the
nursing profession
Standardizing care thru the use of practice
guidelines, practice alerts and protocols
Consistent evidence-based practice
guidelines help to reduce errors and
improve quality of care delivered

CONCLUSIONS

Critical care nursing occurs in a variety of

settings .
Health care will be pressed to provide
efficient and cost-effective services.
Government subsidies of health care may
not be able to keep up with the demand.
Aging nurses are retiring or leaving critical
care
Young or new nurses must step up to meet
the exciting challenges of critical care
nursing

FINALLY,

Despite all the challenges of the future, the

center of all health care will still be the
CLIENT, and the critical care nurse will
be the client, and the critical care nurse
will be there at the clients side.

CONCEPT OF HEALTH AND

ILLNESS

Nursing practice
is directed and guided by an
understanding of the definition of health

WHO definition of health

HOLISTIC QUALITIES

HIGH LEVEL WELLNESS

HEALTH

Each person in viewed as being part of a

complex , interconnected social, biologic,
and environmental system