1/10. 'Climbing the walls' ICU psychosis: myth or reality?The extent of the effect of the ICU environment on the psychological functioning on the ICU patient is explored. There is a need to understand all potential causes of disruption in psychological functioning in ICU patients. Co-ordination of all care carried out by multi-disciplinary team can help re-orientate patients and re-establish normal routines.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
2/10. The use of music and colour theory as a behaviour modifier.For many centuries various aspects of healing have been linked to the use of the arts, in particular music and colour because of their innate ability to bring about a mental, emotional and physical calmness. Although much has been written on the use of colour and music as relaxants specifically within a nursing/medical context, there appears to be little information available as to why music and colour have this calming effect. This article examines music and colour as relaxants by briefly describing the neurological and physical mechanisms that bring about the effect of relaxation. This brief exploration is placed within the context of learning disability care. The aim is to provide ideas for a more peaceful and relaxing environment for an adult with learning disabilities who also has autism and exhibits severe challenging behaviour. The results of a small case study and implications for other areas of nursing are discussed.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
3/10. Managing acutely disturbed behaviour.Managing acutely disturbed behaviour is difficult, particularly in environments which are not designed for dealing with such conduct. An understanding of factors which can lead to this behaviour and clear management policies and procedures are needed.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
4/10. Functional analysis of challenging behaviour in dementia: the role of superstition.BACKGROUND: Intervention for challenging behaviour of residents living in care homes is a neglected area of research. Pharmacological methods of management are widespread, although support for their efficacy is, on the whole, poor. AIMS: There is little research on non-pharmacological methods of management and the present study aimed to add to the small literature in this area, by examining the meaning of behaviour for a given resident, within a functional analytic experimental framework. methods: The study involved a systematic manipulation of specific trigger situations to evaluate their influence on challenging behaviour, using a single case experimental design. RESULTS: Five residents with agitated and aggressive behaviour were successfully managed. The difficulties in engaging staff in the use of non-pharmacological, rather than pharmacological, methods and the scope for future randomised trials using psychological and environmental interventions to manage challenging behaviour, are discussed.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
5/10. Use of antecedent control to improve the outcome of rehabilitation for a client with frontal lobe injury and intolerance for auditory and tactile stimuli.KM, a single 23-year-old male, sustained a severe traumatic brain injury in a motor vehicle accident. Aggressive and uncooperative behaviour, resulting from the client's cognitive deficits and hypersensitivity to stimuli, made him unmanageable in a subacute rehabilitation setting. Minimizing sources of agitation reduced the client's outbursts and facilitated the completion of functional tasks, such as bathing and dressing. Modifying his environment also increased the client's participation in social and leisure activities. These changes improved the outcome of the client's rehabilitation.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
6/10. Agitation assessment in severe traumatic brain injury: methodological and clinical issues.The aim of this single case study was to evaluate the applicability of a graphic and statistical time-series analyses in the observation of an agitation disturbance in a 16-year-old patient who had sustained a severe traumatic brain injury. The agitation was measured using the Agitated Behaviour Scale. The experimental model was of the A-B type: phase A corresponded to the period of vegetative state, and phase B to the period following the reawakening from coma. The data were submitted to visual and statistical analysis by the split-middle trend line method, function of autocorrelation, and C statistic. The results show the different nature and frequency of the agitated behaviour during the vegetative state and after reawakening from coma. The application of a statistical analysis to establish whether the behavioural disturbance is random or a response to the environment allows the adoption of specific and potentially more efficacious treatments.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
7/10. Benzodiazepine sedation in critically ill patients.Agitation is a common phenomenon in critically ill patients. This multidimensional challenge can prolong illness, interfere with treatment, and harm the patient. The nurse must assess the cause of the agitation and provide effective, timely intervention. Agitation is defined as motor restlessness secondary to possible physiologic, psychologic, environmental, and pharmacologic causes. The nurse has many effective assessment tools to systematically determine the cause of the agitation, including an agitation algorithm and sedation scale. With astute assessment and intervention, agitation can be prevented and treated to enhance recovery from critical illness. benzodiazepines are an effective treatment intervention for agitation. With thorough knowledge of the actions and potential effects of these drugs, the nurse can provide the best pharmacologic intervention to treat agitation in the critically ill patient.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
8/10. An algorithm to distinguish the need for sedative, anxiolytic, and analgesic agents.This article discusses the use of an algorithm developed by nurses at the University of minnesota Hospital and Clinic in Minneapolis, that can be used to distinguish the need for sedative, anxiolytic, and analgesic agents for patients in the medical intensive care unit (MICU). Many problems associated with patient sedation and analgesia exist within the critical care environment. These problems include undersedating patients with neuromuscular blockade; rapidly tapering or abruptly discontinuing high-dosage sedation, which often results in withdrawal symptoms; over-use of high-dosage continuous intravenous infusions of short-acting benzodiazepines and analgesics; failure to recognize delirium; and resistance to modifying drug regimens when patient outcomes are not satisfactory.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
9/10. Difficult dementia: six steps to control problem behaviors.For patients with a confirmed diagnosis of dementia, your challenge is to promote a quality life during their remaining years. This task often includes managing problem behaviors. A systematic approach starts with pinpointing the nature of the specific behavior, reviewing possible physical and emotional stressors, and checking for coexisting affective or psychotic disorders. It often helps to reduce environmental stimulation and to simplify the patient's tasks. drug therapy with an antipsychotic or benzodiazepine is indicated if a clear-cut behavioral strategy has not proven fully effective, the behavior has been well documented, and the behavior presents a clear danger to the patient or others or prevents necessary care from occurring.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
10/10. Preventing agitated behaviors during bath time.Bathing people with Alzheimer's disease or other dementia is frequently associated with agitated and resistive behaviors. Bathing involves multiple competing stressors, and persons with dementia have a decreased threshold for tolerating stress from the environment. This article provides practical suggestions for decreasing environmental stressors and agitation during the bathing activity. Communicating respect and supporting the dignity of the person are emphasized.- - - - - - - - - - ranking = 2keywords = environment (Clic here for more details about this article) |
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