This issue contains a series of articles focused on various initiatives aimed at improving the quality of patient care delivery and promoting safe passage across the continuum of care. Exemplary, evidence-based nursing practice is the cornerstone of quality care, and this issue highlights many ways in which nurses have led changes to optimize patient outcomes. In addition, quality care enhances cost-effectiveness by reducing avoidable complications and diminishing avoidable hospital readmissions, a concept more important than ever due to value-based purchasing and the Affordable Care Act. Articles are specifically devoted to prevention of delirium in critical care patients, palliative care in the intensive care unit, prevention of pressure ulcers, fall prevention in high-risk patients, prevention readmissions, preventing sepsis mortality, and nursing interventions in the elderly critical care patient, to name a few.

In consultation with Consulting Editor, Dr. Jan Foster, Drs. Garbee and Danna have put together a state-of the-art issue of the Critical Care Nursing Clinics devoted to Quality Outcomes and Costs. Clinical review articles are specifically devoted to the following: Information Technology, Electronic Medical Records, and Practice Alerts; Telehealth Use to Promote Quality Outcomes and Reduce Costs; Impact of a Mobility Team on ICU Patient Outcomes; MACRA and MIPS Impact on Quality and Cost Outcomes; Leadership’s Impact on Quality, Outcomes, and Costs; Big Data Sets Use for Quality, Outcomes, and Cost; Pediatric Quality Metrics Related to Quality Outcomes and Cost; Geriatric Outcomes Related to Quality and Cost; Mental Health/Behavioral Health Metrics; Obstetric Quality Outcomes and Cost; Emergency Department Throughput; and Veteran Outcomes. Readers will come away with the latest information they need to improve quality and improve out comes in critically ill patients.

Dr. Chapa has assembled top-notch authors to write clinical reviews on the important topic of psychologic issues in the ICU. The issue focuses not only psychologic issues of patients in the ICU but also on issues facing critical care nurses working in the ICU. Articles are devoted to the following topics: Caring for the Caregiver in the ICU; Delirium vs. Dementia in ICU; Pediatric Delirium in ICU; Sarcopenia and Psychosocial Variables in ICU; Impact of Early Mobility in ICU on Psychological Issues; Intensive Care Syndrome; PTSD in ICU Nurses; Burnout Syndrome; Management Strategies in the ICU to Improve Psychosocial outcomes; and Psychologic Issues of Patient Transition from Intensive Care to Palliative Care. Readers will come away with current information they need to provide quality care with positive patient outcomes.

Intensive care units (ICUs) provide comprehensive, advanced care to patients with serious or life-threatening conditions and consequently, a significant amount of end-of-life care (EOLC). Indeed, approximately 20% of deaths in the U.S. are associated with an ICU stay, and nearly half of U.S. patients who die in hospitals experience an ICU stay during the last 3 days of life. Despite the commonality of the ICU experience, ICU patients typically suffer from a range of distressing symptoms such as pain, fatigue, anxiety, and dyspnea, causing families significant distress on their behalf. Thus, there is a growing imperative for better provision of palliative care (PC) in the ICU, which may prevent and relieve suffering for patients with life threatening illnesses. Effective palliative care is accomplished through aggressive symptom management, communication about the patient and family’s physical, psychosocial and spiritual concerns, and aligning treatments with each patient’s goals, values, and preferences. PC is also patient-centered and uses a multidisciplinary, team-based approach that can be provided in conjunction with other life-sustaining treatments, or as a primary treatment approach. Failure to align treatment goals with individual and family preferences can create distress for patients, families, and providers. If implemented appropriately, palliative care may significantly reduce the health care costs associated with intensive hospital care, and help patients avoid the common, non-person centered treatment that is wasteful, distressing, and potentially harmful. Due to the success of many PC programs, administrators, providers, and accrediting bodies are beginning to understand that palliative care in the ICU is vital to optimal patient outcomes.

In Collaboration with Consulting Editor, Dr. Jan Foster, Drs. Martin and Badeaux have created an issue where top authors in critical care nursing provide current updates on sepsis care and management. Authors have written clinical reviews on the following topics: International Sepsis Guidelines 2016; Pros and Cons of Early Administration of Intravenous Fluids; PTSD After ICU Stay; Role of Vitamin C and Carbon Monoxide in Sepsis; Neonatal Sepsis; Use of Etomidate in the Septic Patient; Simulation to Manage the Septic Patient in the ICU; Cardiogenic Shock Complicating Sepsis management; Hospital Costs associated with Sepsis Compared to other Medical Conditions; Special Considerations for the Septic Patient Going to the Operating Room; Management of the Septic Patient in the Emergency Room; and Management of Sepsis in the Obstetrical Patient. Reader will come away with the information they need to improve patient outcomes.

Optimizing Sleep in the Intensive Care Unit, An Issue of Critical Care Nursing Clinics of North America , E-Book

Pain Management, An Issue of Critical Care Nursing Clinics of North America

In collaboration with Consulting Editor, Dr. Cynthia Bautista, Dr. Judy Davidson has put together a comprehensive issue on family and patient experience in the ICU. Expert authors have contributed clinical review articles on the following topics: Humanizing Intensive Care: From Theory to Practice; FiCare; Patient's Own Pets in the ICU; Sleep in the ICU; Implementation of a Patient and Family-Centered ICU Peer Support Program at a Veterans Affairs Hospital; Understanding the Experiences of Patients and Families in the ICU: More than Engagement; Implementing a Patient and Family Communication Bundle in the ICU; Integrating Primary Palliative Care into the ICU: The Critical Care Nurse Communicator Program; Bereavement Care in the Adult ICU: Directions for Practice; A review on the Use of Diaries; Supporting Families of Patients with Rare or Unusual Critical Illnesses; and Meeting the Special Needs of Families of CTICU patients. Readers will come away with the information they need to improve family and patients experiences in the ICU.

With collaboration from Consulting Editor, Dr. Jan Foster, Dr. Beth Diehl has created a current issue that updates the topic of neonatal nursing. Expert authors have contributed clinical reviews that address the following topics: Family Centered Care and Multidisciplinary Rounding in the NICU; Standardized Feeding Protocols and NEC; Preventing Hypoglycemia: Finding the Sweet Spot; The EMR and Big Data in Neonatology; Fetal Surgery and Delayed Cord Clamping: Neonatal Implications; Neonatal Encephalopathy: Current Management and Future Trends; Modes of Neonatal Ventilation; Neonatal Resuscitation: NRP 7th Edition Practice Integration; Neonatal Pain: Perceptions and Current Practice; Neuroprotective Developmental Care for the Preterm Infant in the first 72 Hours of Life; NAS: An Uncontrollable Epidemic; and Neonatal Transport: Current Trends and Practices. Readers will come away with the current clinical information they need to improve patient outcomes in the NICU.

Dr. Wung is addressing an important component of critical care nursing: the role of technology in patient care. She has assembled top authors to provide current clinical information in the following areas: Sensory overload and technology in critical care; Alarm fatigue; Nurse-technology Interactions; Safety steps to prevent Infusion errors; Product design and medical devices for nurses ; Technologies to assess physiologic parameters (hemodynamics/cardio output); Technologies to support hemodynamics (e.g., balloon pump. ECMO, etc); Interactive computer programs for application of critical thinking skills; Information technology Electronic health records (EHR); Real-time detection of clinical care deviations in ICU; Medication safety technology; and eICU/iCARE. Readers will come away with the updates they need to improve patient outcomes.