1. Warner, Carmen G. MSN, RN, MDiv, FAAN
  2. Issue Editor

Article Content

This issue focuses on timely clinical problems and introduces some novel solutions. The authors represent the best contributions from nurses, physicians, and pharmacists who practice within the intensive care environment.


The first article, "Heparin-Induced Thrombocytopenia: A Management Review for Nurses," by Smith and Bullard emphasizes the role that nurses play in recognition and management of this condition. Guidelines for risk assessment, laboratory testing, and treatment are discussed. Nonheparin anticoagulation options are also considered.


Durack, Chen, Imran, and Halpern alert intensive care nurses to the differences between the IR-PAC (interventional radiology pulmonary artery catheter) used for thrombolytic infusions and the T-PAC (traditional pulmonary artery catheter) that has been used for decades. The authors emphasize that intensive care unit (ICU) team members must become familiar with the nuances of the IR-PAC insertion, its unique physical components, special features of monitoring and imaging, and other characteristics in order to provide optimum care for the patient with this type of catheter that is being used for treating pulmonary emboli and facilitating other reperfusion therapies. The authors present a case study to illustrate key differences between these two devices.


This is the year of COVID-19 insights. Shiner, Bock, Simpson, and Skorupski present their recommendations for safeguarding the COVID-19 patient in the ICU. Kim and Rankin follow with their article that considers mental health coping strategies for staff caring for these challenging patients.


The next 4 articles focus on quality improvement projects. Laux and colleagues focus on emergency department initiatives to improve core measure compliance; Hassanpour-Dehkordi and his associates share their findings about the impact of the Roy Adaptation Model on nursing care enhancements. Loberg, Smallheer, and Thompson offer their ABCDEF Bundle approach for improving outcomes for patients with sepsis. Eastman and Kernan explain the special characteristics of the progressive care unit and offer a custom tool for measuring patient acuity as it relates to staff assignments and care routines.


Karkhah and his associates have written about nursing attitudes regarding euthanasia in Iran. They discuss the various aspects of assisting patients to experience a peaceful death through both active and passive measures. The legal, ethical, religious, and other factors within Iran are considered and are compared with other cultures throughout the world.


Early mobility is an important and lofty goal for care planning. Rezvani, Esmaeili, Maroufizadeh, and Rahimi discuss the challenges inherent with mechanically ventilated patients, and McCarty and colleagues present their work on a protocol in use at a level II trauma center. Wang, Owens, Johnson, and Duffy share their perspectives on the value of a diary for the families of pediatric patients. This tool has proved to be of value in reducing the risks of developing post-intensive care syndrome. Finally, AL-Sagarat. Al Hadid, Barmawi, and Al-Khawaldeh share their insights about university students' in Jordan in regard to their acceptance of the COVID-19 vaccine.


Although this issue has a broad range of topics, the articles continue to illustrate that nurses can create solutions to many clinical problems through targeted study and research within their own settings. Readers can appreciate that nurses throughout the world are faced with many unique challenges and it is worthwhile to learn from one another.


-Carmen G. Warner, MSN, RN, MDiv, FAAN


Issue Editor