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Acute and critical care.

This issue of CJNR arises from a call for papers on research conducted in tertiary/high-acuity and critical care settings. Increasingly, we are recognizing that optimal management of the acutely and critically ill spans a continuum related to progression through physical locations within an acute-care institution. For example, interventions such as early goaldirected therapy for severe sepsis and septic shock emphasize the important role played by early recognition of critical illness in the emergency department (Rivers et al., 2001). Critical Care Outreach Teams (also known as Medical Emergency Teams or Rapid Response Teams) recognize the potential for critical illness to develop in any location within the hospital and the need for timely intervention. However, critical illness also spans a continuum related to progression from the acute event to physical and neurocognitive rehabilitation, interventions to promote psychological well-being, and educational strategies for health promotion, as reported in the study by Fredericks and colleagues in this issue of CJNR on educational interventions for culturally diverse patients following cardiac surgery. For non-survivors of critical illness, optimizing end-of-life care is an important consideration. The articles selected for this issue of the Journal reflect this continuum but offer greater insights into the events experienced at its end as opposed to at its beginning. Another important emphasis in the selected contributions is the role that nursing plays as one of the professions represented on the interprofessional team managing acute and critical illness. Lack of role integration and potential stressors associated with the functioning of the interprofessional team are noted. Frank and colleagues describe a nurse-led quality-improvement intervention using a previously validated questionnaire (Canadian Health Care Evaluation Project, or CANHELP) to measure the quality of end-of-life care for patients at high risk of death admitted as acute medical inpatients. Health-care teams were informed of potential improvement opportunities identified by the questionnaire as well as patient symptom profiles using the Edmonton Symptom Assessment Scale. The study’s results indicate small improvements in satisfaction with high-priority CJNR 2012, Vol. 44 No 1, 3–6