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.

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.

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.

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.

In consultation with Consulting Editor, Dr. Jan Foster, Dr. Brian Boling has put together a state-of the-art issue of the Critical Care Nursing Clinics devoted to Cardiothoracic Surgical Critical Care. Clinical review articles are specifically devoted to the following: Fast Track Cardiac Surgery; Options for Minimally Invasive Valvular Surgery; Surgical Interventions for the Treatment of Advanced Heart Failure; Lung Transplantation; Surgical Treatment of Lung Cancer; Post-Operative Management of Tetralogy of Fallot; Advanced Hemodynamic Monitoring in Cardiothoracic Surgery; Vasoactive Infusions in Cardiothoracic Surgery; Common Post Cardiothoracic Surgery Arrhythmias; Pain Control in the Cardiothoracic Surgery Patient; Renal Complications of Cardiothoracic Surgery; The Role of ECMO in Post Cardiotomy Shock; Resuscitation of Patients Who Arrest After Cardiac Surgery; and End of Life Care in Cardiothoracic Surgery. Readers will come away with the latest information they need to improve improves of cardiothoracic surgical patients.

In this issue of Critical Care Nursing Clinics, guest editor Dr. Melissa Nunn, Instructor of Clinical Nursing at LSU Health New Orleans School of Nursing, brings her considerable expertise to the topic of Pediatric Intensive Care Nursing. Top experts in the field present systematic, evidence-based processes for decision making and care, addressing topics such as palliative communication in the PICU; dialysis care in the PICU; caring for hematology/oncology emergencies in the PICU; nurse-led rounds in the PICU; asthma care protocol implementation in the PICU; and more. - Contains 12 relevant, practice-oriented topics including acute pain management protocols in the PICU; kangaroo care implementation; unplanned extubations in the PICU; pediatric delirium screening in the ICU; battling alarm fatigue within the PICU; and more. - Provides in-depth clinical reviews on pediatric intensive care nursing, offering actionable insights for clinical practice. - Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

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.