Enfermeria Intensiva最新文献

{"title":"El hambre invisible en la Unidad de Cuidados Intensivos. Estrategias de Cuidado y Consideraciones Esenciales","authors":"Ignacio Zaragoza-García","doi":"10.1016/j.enfi.2024.01.001","DOIUrl":"https://doi.org/10.1016/j.enfi.2024.01.001","url":null,"abstract":"","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 1","pages":"Pages 1-4"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139549557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurses’ perceptions of the obstacles and supportive behaviors of end-of-life care in intensive care units","authors":"Majd T. Mrayyan ,&nbsp;Nijmeh Al-Atiyyat ,&nbsp;Ala Ashour ,&nbsp;Ali Alshraifeen ,&nbsp;Abdullah Algunmeeyn ,&nbsp;Sami Al-Rawashdeh ,&nbsp;Murad Sawalha ,&nbsp;Abdallah Abu Khait ,&nbsp;Imad Alfayoumi ,&nbsp;Mohammad Sayaheen ,&nbsp;Mohammad Odeh","doi":"10.1016/j.enfi.2023.04.006","DOIUrl":"https://doi.org/10.1016/j.enfi.2023.04.006","url":null,"abstract":"<div><h3>Purpose</h3><p>This study examined the Jordanian registered nurses’ perceptions of the obstacles and supportive behaviors of End-of-Life Care in Intensive Care Units and examined the differences in the concepts based on the samples’ demographics.</p></div><div><h3>Methods</h3><p><span>A cross-sectional and comparative study was conducted using a convenience sample of 230 Intensive Care Unit registered nurses in Jordan. Data were analyzed descriptively, and differences were measured using the independent sample </span><em>t</em><span>-test, the one-way Analysis of Variance, and Scheffe’s post hoc test.</span></p></div><div><h3>Results</h3><p>The registered nurses’ scored moderately on obstacles (74.98 ± 14.54) and supportive behaviors (69.22 ± 4.84). The commonly perceived obstacle and supportive behaviors to End-of-Life Care in Intensive Care Units s were reported. The perceived obstacles differ based on the registered nurses’ certification as an Intensive Care Units nurse (3.04 ± 0.58 vs. 2.74 ± 0.49, p = 0.008), type of Intensive Care Unit (3.28 ± 0.34 vs. 2.86 ± 0.62, p &lt; 0.001), type of facility (3.16 ± 0.59 vs. 2.77 ± 0.61, p &lt; 0.001), number of beds in the unit (3.07 ± 0.48 vs. 2.69 ± 0.48, p = 0.020), and the number of hours worked per week (3.06 ± 0.56 vs. 2.81 ± 0.60, p = 0.005). In contrast, supportive behaviors only differ based on the registered nurses’ age (3.22 ± 0.69 vs. 2.90 ± 0.64, p = 0.019).</p></div><div><h3>Conclusions</h3><p>The common End-of-Life Care perceived obstacle in Intensive Care Units was the lack of nursing education and training regarding the studies concept, which warrants immediate intervention such as on-job training. The common End-of-Life Care perceived supportive behavior in Intensive Care Units was when family members accepted that the patient was dying when nurses offered support to family members; motivational interventions are needed to sustain such behavior. Differences in the perceived obstacles and supportive behaviors should be leveraged for the benefit of patients, nurses, and hospitals.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 1","pages":"Pages 23-34"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139549556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eficacia y seguridad de un compuesto de ácidos grasos hiperoxigenados en la mejora de la microcirculación de la púrpura fulminante en pacientes pediátricos con sepsis: estudio piloto","authors":"G. Pérez-Acevedo RN, PNP, MSc, PhD(c) ,&nbsp;A. Bosch-Alcaraz PhD, RN, PNP, MSc ,&nbsp;J.E. Torra-Bou PhD, RN, MSc","doi":"10.1016/j.enfi.2023.04.003","DOIUrl":"10.1016/j.enfi.2023.04.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Purpura fulminans (PF) is a serious complication of sepsis resulting from a set of alterations characterised by the development of ecchymotic haemorrhagic lesions and skin necrosis.</p></div><div><h3>Aim</h3><p>To analyse the efficacy and safety of the topical application of HOFA compound, in the cutaneous microcirculation of PF lesions in paediatric patients affected by sepsis<strong>.</strong></p></div><div><h3>Material and methods</h3><p>A prospective quasi-experimental pre-test/post-test single-group conducted in a Paediatric Intensive Care Unit of a third level hospital was performed. Paediatric patients aged 0-18 years with sepsis were included. Somatic oximetry values were measured before and after application of HOFAs every 4<!--> <!-->hours over the first three days of the patients’ hospitalisation. Patient's socio-demographic and clinical variables and somatic oximetry by placing a sensor for measuring tissue perfusion on the area with PF were determined.</p></div><div><h3>Results</h3><p>Four patients were recruited, with a median age of 98 months. The purpuric lesions measured were mainly located on both feet and hands and, in two patients, also on the lateral malleoli and calves of both lower extremities. A total of 225 measurements were obtained, with mean pre-intervention scores of 71.17<!--> <!-->±<!--> <!-->15.65% versus 73.68<!--> <!-->±<!--> <!-->14.83% post-intervention. Statistical significance (p<!--> <!-->&lt;<!--> <!-->0.001) was observed upon comparison of the pre- and post-intervention measurements.</p></div><div><h3>Conclusions</h3><p>Early and continued application of HOFAs in the management of sepsis-induced PF is an effective and safe practice in the cases analysed. In more than half of the episodes analysed, an increase in tissue microcirculation was observed after the application of HOFAs, with no adverse events.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 1","pages":"Pages 13-22"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1130239923000585/pdfft?md5=567974bc275f28e851488639087fe473&pid=1-s2.0-S1130239923000585-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116334987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"¿Movilizamos de forma activa y temprana durante la ventilación mecánica a los pacientes ingresados en una unidad de cuidados intensivos?","authors":"A. González-Castro PhD, MD ,&nbsp;R. Ferrero-Franco RN ,&nbsp;C. Blanco-Huelga MD","doi":"10.1016/j.enfi.2023.03.001","DOIUrl":"10.1016/j.enfi.2023.03.001","url":null,"abstract":"","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 1","pages":"Pages 73-74"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126108654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efectos adversos relacionados con la administración de norepinefrina por accesos venosos periféricos cortos: una revisión de alcance","authors":"J. García-Uribe RN, MSc ,&nbsp;D. Lopera-Jaramillo RN, MSc ,&nbsp;J. Gutiérrez-Vargas Bióloga, PhD ,&nbsp;A. Arteaga-Noriega RN, MSc, PhD ,&nbsp;O.A. Bedoya RN, MSc, PhD","doi":"10.1016/j.enfi.2022.09.001","DOIUrl":"https://doi.org/10.1016/j.enfi.2022.09.001","url":null,"abstract":"<div><p>Peripheral administration of norepinephrine is restricted due to the association of extravasation with tissue necrosis.</p></div><div><h3>Method</h3><p>scoping review with the objective of describing the adverse effects related to the administration of norepinephrine through short peripheral venous access and the characteristics of drug administration in patients hospitalized in ICU, surgery, and emergency services.</p></div><div><h3>Results</h3><p>12 studies with heterogeneous characteristics by size and type of population were included. The proportion of complications associated with peripheral norepinephrine administration was less than 12% in observational studies and it was less than 2% in those that used doses less than 0.13<!--> <!-->μg/kg/min, and concentrations less than 22.3<!--> <!-->μg/ml. The main associated complication was extravasation and there were no cases of tissue necrosis at the venipuncture site, some extravasation cases were treated with phentolamine, terbutaline or topical nitroglycerin. The drug administration time ranged between 1-528<!--> <!-->hours with a weighted mean of 2.78<!--> <!-->h.</p></div><div><h3>Conclusion</h3><p>The main adverse effect was extravasation, no additional complications occurred, phentolamine and terbutaline seem to be useful, and its availability is a necessity. It is essential for the nursing staff to carry out a close assessment and comprehensive care in patients receiving norepinephrine by peripheral route.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"34 4","pages":"Pages 218-226"},"PeriodicalIF":1.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71775555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidencia de úlceras por presión secundarias al decúbito prono en pacientes ingresados en unidades de cuidados intensivos por SARS-CoV-2","authors":"E. Pérez-Juan RN ,&nbsp;M. Maqueda-Palau RN ,&nbsp;C. Feliu-Roig RN ,&nbsp;J.M. Gómez-Arroyo RN ,&nbsp;D. Sáez-Romero RN ,&nbsp;A. Ortiz-Monjo RN","doi":"10.1016/j.enfi.2022.12.001","DOIUrl":"https://doi.org/10.1016/j.enfi.2022.12.001","url":null,"abstract":"<div><p>The appearance of pressure ulcers (PU) is one of the frequent complications of prone position (PP), due to prolonged pressure and shear forces.</p></div><div><h3>Objectives</h3><p>To compare the incidence of pressure ulcers secondary to prone position and describe their location among four Intensive Care Units (ICU) of public hospitals.</p></div><div><h3>Methods</h3><p>Multicenter descriptive and retrospective observational study. The population consisted of patients admitted to the ICU between February 2020 and May 2021, diagnosed with Covid-19 who required prone decubitus. The variables studied were sociodemographic, days of admission to the ICU, total hours on PP, PU prevention, location, stage, frequency of postural changes, nutrition and protein intake. Data collection was carried out through the clinical history of the different computerized databases of each hospital. Descriptive analysis and association between variables were performed using SPSS vs.20.0.</p></div><div><h3>Results</h3><p>A total of 574 patients were admitted for Covid-19, 43.03% were pronated. 69.6% were men, median age was 66 (IQR 55-74) and BMI 30.7 (RIC 27-34.2). Median ICU stay was 28 days (IQR 17-44.2), median hours on PD per patient 48<!--> <!-->h (IQR 24-96). The incidence of PU occurrence was 56.3%, 76.2% of patients presented a PU, the most frequent location was the forehead (74.9%). There were significant differences between hospitals in terms of PU incidence (p<!--> <!-->=<!--> <!-->0.002), location (p<!--> <!-->&lt;<!--> <!-->0.001) and median duration of hours per PD episode (p<!--> <!-->=<!--> <!-->0.001).</p></div><div><h3>Conclusions</h3><p>The incidence of pressure ulcers due to the prone position was very high. There is great variability in the incidence of pressure ulcers between hospitals, location and average duration of hours per episode of prone position.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"34 4","pages":"Pages 176-185"},"PeriodicalIF":1.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71775546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral care with chlorhexidine: One size does not fit all","authors":"M. Llaurado-Serra RN, MSc, PhD ,&nbsp;E. Afonso RN, MSC ,&nbsp;J. Mellinghoff RN, BSc (Hons.), MSc ,&nbsp;E. Conoscenti RN, MNSc ,&nbsp;M. Deschepper PhD","doi":"10.1016/j.enfi.2023.03.002","DOIUrl":"https://doi.org/10.1016/j.enfi.2023.03.002","url":null,"abstract":"","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"34 4","pages":"Pages 227-228"},"PeriodicalIF":1.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71775557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estrés y ansiedad perioperatorios en padres de niños intervenidos de cardiopatías congénitas","authors":"F. Alonso-Lloret MSN ,&nbsp;A. Mendoza-Soto PhD ,&nbsp;S. Gil-Domínguez RN ,&nbsp;V.M. Fontecha-Merino RN ,&nbsp;C. Romero-Ferreiro PhD","doi":"10.1016/j.enfi.2023.03.003","DOIUrl":"https://doi.org/10.1016/j.enfi.2023.03.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Levels of stress and anxiety suffered by parents of children with congenital heart disease (PCUCS) during their children's admission for cardiac surgery may be higher than those suffered by other parents who go through the same experience.</p></div><div><h3>Objective</h3><p>General objective of this study was to measure the stress and anxiety suffered by PCUCS and parents of children undergoing renal surgery (PCURS) in relation to the intervention of their children. The specific objective of the quantitative study was to compare global stress and anxiety according to sex, time of the perioperative period, and cohort. The general objective of the qualitative section is to explore the experience that PCUCS and PCURS have during their hospital stay and to identify the specific factors that influence the genesis of stress and anxiety.</p></div><div><h3>Method</h3><p>A cohort study was carried out in which PCURS and PCUCS were included. The quantitative part was performed by comparing the scores of 3<!--> <!-->questionnaires that measure stress levels (PSS-14), state anxiety (STAIE) and trait anxiety (STAIR) throughout 3<!--> <!-->perioperative moments. At the same time, a qualitative study was carried out with semi-structured interviews and collection of diaries on which a descriptive phenomenological analysis was carried out, according to Munhall. The analysis of the text was carried out according to Colaizzi.</p></div><div><h3>Results</h3><p>Stress and anxiety levels were significantly higher in PCUCS compared to PCURS. Mothers in the cardiac cohort were those with the highest scores on all scales. In the qualitative study, 4<!--> <!-->themes emerged: “stress and anxiety from the moment of diagnosis”, “surgical intervention as a critical moment”, “harshness of the postoperative period in the Intensive Care Unit” and “joy and gratitude versus dependence and fear for the future”.</p></div><div><h3>Conclusions</h3><p>PCUCS suffer higher levels of stress and anxiety than PCURS, being the mothers of the cardiac cohort those who suffer these disorders with greater intensity. This study can constitute a starting point to develop strategies that cover these parental needs.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"34 4","pages":"Pages 205-217"},"PeriodicalIF":1.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71775549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LA DISFAGIA, LA GRAN DESCONOCIDA PARA LAS ENFERMERAS DE CUIDADOS CRÍTICOS","authors":"Yeray Gabriel Santana-Padilla RN, MSc, PhD,&nbsp;Luciano Santana-Cabrera MD, PhD","doi":"10.1016/j.enfi.2023.10.001","DOIUrl":"https://doi.org/10.1016/j.enfi.2023.10.001","url":null,"abstract":"","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"34 4","pages":"Pages 173-175"},"PeriodicalIF":1.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71775537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diseño de un modelo de ronda de seguridad para unidades de cuidados intensivos","authors":"M.E. Rodríguez-Delgado RN ,&nbsp;A.M. Echeverría-Álvarez RN ,&nbsp;M. Colmenero-Ruiz MDPhD ,&nbsp;R. Morón-Romero PharmD. PhD ,&nbsp;A. Cobos-Vargas RN ,&nbsp;A. Bueno-Cavanillas MDPhD ,&nbsp;en nombre del Grupo de trabajo de rondas de seguridad en UCI","doi":"10.1016/j.enfi.2023.01.002","DOIUrl":"https://doi.org/10.1016/j.enfi.2023.01.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Safety Rounds (SR) are an operational tool that allow knowing adherence to good practices, help identify risks and incidents in patient safety (PS), allowing improvement actions to be implemented. The objective of this work was the design of a procedure to perform SR in an Intensive Care Unit (ICU).</p></div><div><h3>Methods</h3><p>Preparation of a checklist for the development of SR in the ICU through the nominal group technique, with the participation of managers, middle managers and professionals from different disciplines and categories. In the first place, a group of experts agreed, based on the recommendations on good practices in PS, the definition of items, their coding, the criteria for compliance and the impact of non-compliance. Subsequently, its viability was determined through a cross-sectional study through the piloting of two SRs to adjust the items in real clinical practice conditions.</p></div><div><h3>Results</h3><p>A specific SR model for ICUs has been obtained through a checklist. The group of experts prepared a first list made up of 39 items of 6 essential dimensions and defined the method of implementation. Mean time to complete the two SRs was 85<!--> <!-->minutes, including the briefing and subsequent debriefing. After the validation pilot, the dimensions were reduced to 5, 3 items were deleted, 2 items were transferred to another dimension and 3 items related to nosocomial infections and informed consent were modified. In addition, the data sources, the compliance criteria and their relative weight were redefined. The final list was considered useful and relevant to improve practice.</p></div><div><h3>Conclusions</h3><p>Through a consensus methodology, a checklist has been built to be used in the RS of an ICU. This model can serve as a basis for its use in healthcare services with similar characteristics.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"34 4","pages":"Pages 186-194"},"PeriodicalIF":1.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71775541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}