Volume 29, Number 2, Summer 2018 ISSN: 2368-8653 IN thIS ISSue: 6 Position Statement Healthy Work Environments 20 Dynamics of Critical Care 2018 NURSING ABSTRACTS 62 A standardized structured approach to improving sleep quality in the intensive care unit: SLEEP-MAD The Canadian Journalof Critical Care Nursing Volume 29, Number 2, Summer 2018 editor editorial Review Board Paula Price, PhD, RN Adult Consultants: Director, School of Nursing and Midwifery, Marie Edwards, PhD, RN, Winnipeg, MB Mount Royal University, 4825 Mount Royal Gate SW, Calgary, AB Sandra Goldsworthy, PhD, MSc, RN, CNCC(C), CMSN(C), T3E 6K6 Calgary, AB phone: 403-440-6553; fax: 403-440-6555; email: [email protected] Martha Mackay, PhD, RN, CCN(C), Vancouver, BC Mary Mustard, MN, NP-Adult, CNCC(C), CNC(C), Etobicoke, ON Managing editor Mae Squires, PhD, RN, Kingston, ON Heather Coughlin, Pappin Communications, Pembroke, ON Pediatric Consultant: Franco Carnevale, MSA, MEd, PhD, RN, Montréal, QC Neonatal Consultant: Debbie Fraser, MN, RNC, Winnipeg, MB Canadian Association of Critical Care Nurses Board of Directors CACCN National Office President: Kathy Bouwmeester, RN, ACCN, Calgary, AB Chief Operating Officer: Vice-President: Mélanie Gauthier, M. Int. Care N., BScN, RN, Christine R. Halfkenny-Zellas, CIM CNCC(C), Montréal, QC P.O. Box 25322, London, Ontario N6C 6B1 Treasurer: Sarah Crowe, MN, RN, CCCN(C), Langley, BC www.caccn.ca Directors: email: [email protected] Peter Anderst, BN, RN, Edmonton, AB phone: 519-649-5284 Lissa Currie, BN, RN, CNCC(C), Winnipeg, MB toll-free: 1-866-477-9077 Angela Foote, BSc, RN, CCNP(C), New Glasgow, NS fax: 519-649-1458 Brandi Vanderspank-Wright, PhD, RN, CNCC(C), Ottawa, ON TheCanadian Journal of Critical Care Nursing is the only peer-reviewed critical care journal in Canada, and is published four times annually by Pappin Communications, Pembroke, Ontario. Printed in Canada. ISSN: 2368-8653 (Print). Advertising information: For advertising enquiries, contact Heather Coughlin, Pappin Communications, The Victoria Centre, 84 Isabella St., Unit 2, Pembroke, Ontario K8A 5S5, telephone: 613-735-0952, fax: 613-735-7983, email: [email protected], website: www.pappin.com Author enquiries: Send manuscript enquiries or submissions to Paula Price, ACCN Program, Faculty of Health and Community Studies, Mount Royal University, 4825 Mount Royal Gate S.W., Calgary, Alberta T3E 6K6, email: [email protected] Subscription Rates for 2018: The Canadian Journal of Critical Care Nursing is published four times annually, Spring, Summer, Fall and Winter— Individual Subscriptions (within Canada): $90.00 CDN plus applicable taxes; Individual Subscriptions (outside Canada): $100.00 CDN (no taxes); Institutional Subscriptions (within Canada): $115.00 CDN plus applicable taxes; Institutional Subscriptions (outside Canada): $125.00 CDN (no taxes). To order subscriptions, please contact CACCN National Office, P.O. Box 25322, London, Ontario N6C 6B1 or [email protected] Article reprints: Photocopies of articles appearing in the Canadian Journal of Critical Care Nursing are available from the CACCN National Office, P.O. Box 25322, London, Ontario N6C 6B1, at a cost of $15 (plus GST/HST, as applicable) per article. Back issues can be purchased for $18 (plus GST/HST, as applicable). Copyright 2018 by the Canadian Association of Critical Care Nurses, P.O. Box 25322, London, Ontario N6C 6B1. No part of this journal may be reproduced in any manner without written permission from CACCN. The editors, the association and the publisher do not guarantee, warrant or endorse any product or service mentioned in this publication. The Canadian Journal of Critical Care Nursing is indexed in the Cumulative Index to Nursing and Allied Health Literature, EBSCO, the International Nursing Index, MEDLINE, and RNdex Top 100: Silver Platter. The Canadian Journal of Critical Care Nursing is printed on recycled paper. Canadian Association of Critical Care Nurses Vision statement Pathways to success All critical care nurses provide the highest standard of patient 1. Leadership: and family centred care through an engaging, vibrant, educated • Lead collaborative teams in critical care interprofessional and research driven specialized community. initiatives • Develop, revise and evaluate CACCN Standards of Care Mission statement and Position Statements We engage and inform Canadian Critical Care nurses through • Develop a political advocacy plan education and networking and provide a strong unified national identity. Values and beliefs statement Our core values and beliefs are: • Excellence and Leadership ■■ Collaboration and partnership ■■ Pursuing excellence in education, research, and practice • Dignity and Humanity ■■ Respectful, healing and humane critical care environments ■■ Combining compassion and technology to advocate and promote excellence 2. Education: • Integrity and Honesty • Provision of excellence in education ■■ Accountability and the courage to speak for our beliefs • Advocate for critical care certification ■■ Promoting open and honest relationships 3. Communication & Partnership: • Networking with our critical care colleagues • Enhancement and expansion of communication with our members 4. Research: • Encouraging, supporting, facilitating to advance the field of critical care 5. Membership: • Strive for a steady and continued increase in CACCN membership 4 The Canadian Journal of Critical Care Nursing • Canadian Association of Critical Care Nurses Critical Reflections am very excited to begin my two-year term as president of hearing the hum of the engine, as we became the rhythm of the the Canadian Association of Critical Care Nurses. I enjoy road, the words started to come together. Be in the moment, be working with such a dedicated and dynamic group of indi- engaged, because you can... Be the One. Yes, this makes sense. Ividuals who are passionate about critical care nursing. Are they the perfect words? Am I the ‘one’ to hold a patient’s hand, to wipe away a tear when they are going though diag- One of the many experiences I have been fortunate to partic- nostic procedures that will alter their life in unknown ways? ipate in, as the vice-president of the Canadian Association of Am I the one to use my voice to advocate for my patient and Critical Care Nurses, was to attend the American Association their family when they continue to have questions about their of Critical Care Nurses – National Teaching Institute (NTI). condition. In the times of cutbacks and constant assault to the Attending NTI along with the other 6,000 Registered Nurses healthcare system, we are the ‘ones’ to have that steady hand, (RNs), Licensed Practical Nurses (LPNs), Registered Nursing despite the pressures that arise from doing more with less. We Assistants (RNAs), and healthcare providers working in both are the constant and we must Be the One to Be the Difference. critical care and progressive care units was truly an amazing experience. At the time of writing this Critical Reflections, the tragic event near Tisdale, Saskatchewan, is still only a few weeks old. Fourteen The presenters over the week, including current AACN young lives, which soon became 16, were tragically taken from President Christine Schulman, spoke of their passion for this world. Our heartfelt condolences to the families who have nursing and of their association theme “Guided by Why”. lost a loved one. I think many of us have thought about these After attending NTI, the questions and the challenge for me events, both on a personal and professional level. I would like became, how do we pick a theme that speaks to us about to thank the critical care Registered Nurses, Licensed Practical everything that the profession of nursing, and especially criti- Nurses, Nurse Attendants, Respiratory Therapists, and mem- cal care nursing, is? bers of Allied Health of the Royal University Hospital (RUH) of Many of us are reaching the twilight of our nursing and criti- Saskatoon for being the Ones and being there for their patients cal care careers, while others may be beginning their journey, and their families. In this time of difficulty, it is important to and these things are not static. I entered the critical care world remember to care for each other and to care for yourselves. We in my 20th year of nursing as a Registered Nurse and now have thank you for your caring, compassion, and expertise. spent most of my career as a bedside nurse in critical care. I I would also like to thank the staff from the Foothills Medical have toyed with venturing outside of the four walls, but I know Centre, Calgary, Alberta, for caring for their colleagues in this I belong here… I think I might be a lifer. tragic event. Tanya Harvey, a member of the registered nurs- So, how do you choose three words that encompass your pas- ing staff, previously worked at the RUH. Tanya wanted to let sion for your patients and your engagement of family, and how the RUH staff know they were in our thoughts. Through Tanya do you honour the hours of mentoring we have received from and the generosity of the Trauma Centre, FMC staff, sufficient our colleagues or provided? What three words would speak to funds were raised to provide meals for the staff who were pres- 1,400 members of the Canadian Association of Critical Care ent on this tragic day and in the days that followed. Thank you, Nurses, or maybe one of the many 100,000 critical care nurse Tanya, and FHM, for Being the One to care, not only about the across Canada? How can those three words make an impact on patients and their families who enter our ICUs, but also for critical care, registered nurses and the art and science of critical your colleagues several hundred miles away. care nursing? On behalf of the Board of Directors, we also send our heart- It was important for me to have the right words. Does that felt condolences to the victims of the tragic attack in Toronto, sound familiar? In this world, we want perfection, yet we deal Ontario.