2013

JOURNAL READING
Critical Care Nursing
Submitted by:

Renz Robert A. Sombong

BSN 4-A

Submitted to:

Jason Juanico,R.N.
(Classroom Instructor)

Acer [Type the company name] 1/1/2013

SUMMARY:
Critical thinking is essential to the conduct of safe aesthetic practice. Knowing the critical thinking ability of the learners help the educators tailor curriculum to enhance critical thinking. Nurse anaesthesia program faculty strives to foster critical thinking by creating learner engagement activities throughout the academic and clinical curriculums. Notably, critical thinking is linked to improved clinical performance as well as performance on examinations. Thus, this study offered one approach to examining critical thinking in nurse anesthesia students. The anesthetic environment is dynamic. An intervention aimed at helping a patient might be ideal at one moment and inappropriate just a few moments later. The goal of nurse anesthesia education is to prepare the students for clinical practice. Effective critical thinking is require to integrate many skills into an anesthetic customized to each patient and circumstance. In order to promote safe and quality nursing care to patients, many nursing schools have sought to develop a working definitions of critical thinking. Although, diverse definitions were made, an important component appears to be common throughout and it is the development and application of critical thinking in the area. The study aims to measure the development of critical thinking skills at specific curricular points in the nurse anesthesia educational process. This study assessed critical thinking ability for students at two district point in a nurse anestheisa program curriculum. Critical thinking was examined at the beginning and at the end of the first year of didactic instruction. The results demonstrated no statistically significant difference in critical thinking ability for students at two distinct curricular points. The development of critical thinking skills is imperative to nurse anesthesia education. The results contrast with earlier nursing studies where critical thinking ability improved over the course of a curriculum in undergraduate nursing. The study results suggest that we assess the students critical thinking ability at the beginning of the program. Faculty must develop teaching strategies that promote critical thinking. Identifying strong and weak critical thinking attributes early may prompt faculty and students to explore study strategies to enhance reasoning ability. Finally, faculty may consider adding strategies to lesson planning throughout the curriculum that include active engagement exercises to promote critical thinking ability.

REACTION:
In the nursing profession, more now than ever, the ability to think critically is essential. Critical thinking is essential to skilled nursing and is therefore essential to nursing education. When a teacher gives his students the facts or information they require, they will memorize these facts and can use them for their short term goals such as passing their quizzes or graduating on time. But when you give them or help them develop the critical thinking skills, they will be able to find necessary information for themselves and these information will be able to evaluate the merits and consequences of that information and they will be able to utilize that information to solve any problems at hand.Critical thinking helps a person in solving problems. It brings about a clarity of perception that also makes a person capable of re-appraising his own core values, opinions and calculations. With critical thinking, thus, a person can continually reach new planes of self-improvement and self-actualization. I strongly believe that critical thinking in the nursing profession is very important. It is one of the most important skill a nurse must develop in order to provide safe, and quality nursing care to patients. By utilizing the critical thinking skills, a nurse can be able to prioritize what nursing care will be given to the patients and will be able to use sound judgment on what really is important to patient and disregard those that will hinder in rendering patient care. A nurse with critical thinking ability can weigh various facts and points of view and identify errors. Critical thinking must be inculcated among student nurses. Critical thinking skills cannot be learned by memorization. It must be developed and nurtured. It is very good when you expose student nurses in the area in order to develop the critical thinking ability. During exposure, a student nurse can develop this skill. He/she can process obtain information in order to evaluate the advantages and disadvantages. With this ability, he/she can prioritize the most appropriate for the patient and with clarity of perception, he/she can make sound judgment and decisions. With this ability, the student nurse can develop independence and initiative and he/she can be an effective registered nurse as compared to those that do not have a good critical thinking ability.

SUMMARY:

Hospitals are supposed to be a place that provides patients a safe and quiet environment for treatment and recovery. However, hearing contamination in the Intensive Care Unit (ICUs) as a result of the continually growing use of medical instruments and equipment was found to have an impact on patients sleep and recovery as proved by some studies. Noise refers to a powerful, unorganized, irregular or unwanted sound. It can be considered as hazardous since it may affect performance and cause physiological and psychological stress. Cardiovascular disease is the leading cause of mortality in most developed countries. Cardiac surgery has become a standard treatment for some patients with heart disease. Post cardiac surgery patients are monitored closely in the ICU. Unfortunately, the noise generated by the instruments used in monitoring post-cardiac surgery patients in the ICU has become a potential stressor to patients and might cause adverse complications regarding patients recovery. This study was conducted to measure the noise level in the ICUs and to investigate the influences of noise on post-cardiac surgery patients. There are a total of forty patients who participated in this study after recovering from the anesthesia post-cardiac surgery. The researchers used a sound meters and were placed on the bedsides of the participants and they measure all the noise made by the equipments for 42 hours. The heart rate and blood pressure of the patients were then monitored and recorded in every 5 minute intervals. Interviews were also made in order to assess their perceived psychological/ physiological responses. The noise level was determined after the 42 hour monitoring of the noise in the ICU. The most often reported physiological and psychological responses of the patients were annoyance and insomnia respectively. Although noise level, irrespective of measure, was not observed to be significantly associated with the self- assessed

psychological and physiological responses, it was significantly associated with both heart rate and blood pressure. The study concluded that the noise in ICUs may adversely affect the heart rate and blood pressure of the patients and this signifies that the hospital administrators and health care providers to provide or create strategies or interventions to effectively control the noise level in the ICUs.

REACTION:

Noise is more than simply unwanted sound. The US Environmental Protection Agencys definition of noise, any sound that may produce an undesired physiological or psychological effect in an individual or group, is quite appropriate when considering the hospital environment. Noise affects patients and staff. Not only does it disrupt rest and impede concentration and cognition, but it also interferes with communication and increases the risk of accidents. Noise can really cause several adverse effects on a healthy human being. How much more if the one affected is a post-cardiac surgery patient in the ICU and was just recovering from anesthesia? Patients in the ICU require adequate recovery from the cardiac surgery. But noise coming from the equipments could really cause sleep deprivation, insomnia, stress and annoyance. These are just some of the effects of noise and these could really hinder the healing and recovery process of the post-cardiac surgery patients in the ICU. As suggested by the result of the study, the noise level coming from the equipments could affect the heart rate and blood pressure of the patients. This would be a caution since those two vital signs should be within normal range for patients who underwent cardiac surgery. Also, the participants reported that annoyance and insomnia are the physiological and psychological responses they reported. We all know that annoyance and insomnia would really lead to stress. By lack of sleep, one could be irritable, would have mood swings and the vital signs will be affected. Not only that, patient interaction would also be affected. We all know that sleep is very important in the healing process and for the fast recovery of the patients post-surgery. As the researchers suggest, the hospital caregivers as well as the hospital administrators should make a strategy or a plan with regards to an effective noise control in the Intensive Care Unit. Nurses should also take part on this by

behaving properly inside the ICU because some nurses are noisy and are not careful with regards to giving care to patients. This usually results to noise or a disturbance which could affect the patients. Nurses should also provide interventions if the patients experience disturbance or insomnia while in the ICU. Nurse must take note that on the
purposes of hospitals is to provide a safe and quiet environment for the treatment and fast recovery of patients.