Evidence Supporting Major Recommendations

Major Outcomes
the Preadmission Considered
Recommendations Comprehensive assessment of a critically ill older
References Supporting adult's preadmission health status, cognitive and
functional ability, and social support systems
Hemodynamic
the Recommendations helps identify risk factors for cascade stability
iatrogenesis, the development of life-threatening
American Association of Critical Care Nurses. Ventilator-associated pneumonia. Aliso Viejo (CA): American
Association of Critical Care Nurses; 2004.
conditions, and frequently encountered geriatric Complications
syndromes.
Nursing
American Thoracic Society, Infectious Diseases Society of Care Strategies
America.
Preadmission
Guidelines for the management of adults Functional status
with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med.
2005 Feb 15;171(4):388-416. PubMed Based on their preadmission assessment
findings, nurses should consider the Pain
Balas MC, Deutschman CS, Sullivan-Marx EM, Strumpf NE,
following: Alston RP, Richmond TS. Delirium in older
patients in surgical intensive care units. J Nurs Scholarsh. 2007;39(2):147-54. PubMed Quality of life
Obtaining appropriate consults (i.e.,
Broyles LM, Colbert AM, Tate JA, Swigart VA, Happ nutrition,
MB. Clinicians' evaluation and management of mental
physical/occupational/speech (QOL)
health, substance abuse, and chronic pain conditions intherapist)
the intensive care unit. Crit Care Med. 2008 Jan;36(1):87-
93. PubMed Implementing safety precautions Intensive care unit
Using pressure-relieving devices
Dezfulian C, Shojania K, Collard HR, Kim HM, Matthay MA, Saint S. Subglottic secretion drainage for
Organizing family meetings
(ICU) utilization
preventing ventilator-associated pneumonia: a meta-analysis. Am J Med. 2005 Jan;118(1):11-8. [37
references] PubMed Providing the older adult with a rate
consistent primary nurse
Garrett KL, Happ MB, Costello J, Fried-Oken M. AAC in intensive care units. In: Beukelman DR, Garrett KL, Mortality rate
Yorkston KM, editor(s). Augmentative communication During ICU Stay
strategies for adults with acute or chronic medical
conditions. Baltimore (MD): Brookes Publishing; Multiple
2007. Organ Systems
Encouraging early, frequent
mobilization/ambulation
Providing proper oral hygiene
Ensuring adequate pain control
Reviewing/assessing medication
appropriateness
Securing and ensuring the proper
functioning of tubes/catheters
Actively taking measures to maintain
normothermia
Closely monitoring fluid volume status

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