Enfermeria Intensiva最新文献

{"title":"Internal consistency, minimal detectable change, and sensitivity to change of the Spanish version of the Barthel Index at intensive care unit discharge and three months later","authors":"Esther Cecilia Wilches-Luna PT, PhD ,&nbsp;Vilma Eugenia Muñoz-Arcos PT, MSc ,&nbsp;Paula Benavides-Candezano PT ,&nbsp;José Julián Bernal-Sánchez PT, PhD, MSc ,&nbsp;Ada Clarice Gastaldi PT, PhD","doi":"10.1016/j.enfi.2025.500539","DOIUrl":"10.1016/j.enfi.2025.500539","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the internal consistency (IC), minimal detectable change (MDC), and sensitivity to change of the Barthel Index (BI) at ICU discharge and three months post-hospital discharge.</div></div><div><h3>Methods</h3><div>A prospective longitudinal study was conducted between November 2016 and July 2017 in a medical-surgical intensive care unit (ICU). A total of 149 patients over 18 years with a BI score &gt;90 prior to ICU admission were included. The COSMIN checklist was utilized to evaluate the measurement properties. Clinical and demographic variables, BI scores, IC, MDC, and sensitivity to change were analyzed. The Cronbach's alpha coefficient (<em>α</em>) was calculated to determine the IC of the BI by domain and for the overall scale. Effect size (ES) indices and standardized mean response (SMR) were used for sensitivity to change. The MDC was identified using a distribution-based method, calculating the standard error of measurement (SEM). Floor and ceiling effects were assessed, with a threshold of less than 15% considered acceptable.</div></div><div><h3>Results</h3><div>A total of 141 patients were evaluated at discharge from the ICU. Of these, <em>n</em> <!-->=<!--> <!-->77 (41.7%) were men, with a mean age of 58.5<!--> <!-->±<!--> <!-->16.8 years; <em>n</em> <!-->=<!--> <!-->62 (41.6%) required invasive mechanical ventilation. One hundred twelve patients were reassessed three months after discharge. The overall IC was: <em>α</em> <!-->=<!--> <!-->0.70 at ICU discharge and <em>α</em> <!-->=<!--> <!-->0.96 at three months. Ninety two percent (<em>n</em> <!-->=<!--> <!-->103) of the patients showed values greater than or equal to the MDC of 10 points, with statistically significant differences identified in the type of weaning, tracheostomy, and length of stay in the ICU (<em>p</em> <!-->&lt;<!--> <!-->0.005).</div></div><div><h3>Conclusions</h3><div>The items of the Spanish version of the BI demonstrate acceptable IC at ICU discharge. The MDC was 10 points, validating its responsiveness and utility for monitoring the functional independence of critically ill patients at ICU discharge and three months after hospital discharge.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 2","pages":"Article 500539"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777253","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":"Análisis de la carga de trabajo enfermero e impacto del volumen y flujo de pacientes en una UCI quirúrgica","authors":"Amaia Gutiérrez-Abarca MSN,&nbsp;Alberto Casado-Álvarez MSN,&nbsp;Sare Espinosa-Carcabilla MSN","doi":"10.1016/j.enfi.2025.500535","DOIUrl":"10.1016/j.enfi.2025.500535","url":null,"abstract":"<div><h3>Introduction</h3><div>A poor Nurse-to-Patient (N:P) ratio has a negative impact on the health of both patients and professionals. There are several tools to quantify the Nurse Workload (NW) and adjust nurse staffing. The use of such tools in the Intensive Care Units (ICU) can facilitate the adaptation of Nursing resources to patients’ real needs and improve working conditions.</div></div><div><h3>Objective</h3><div>To determine the NW in a Surgical ICU.</div></div><div><h3>Methodology</h3><div>Descriptive, transversal and unicentric study during March and April 2023. Determination of the operative N:P ratio adequated to the NW using the “Nursing Activities Score” (NAS). Measurement of the NW using NAS and “Valoración de Cargas de Trabajo y Tiempos de Enfermería” (VACTE) scales, together with the proposed NW indicators. Management and efficiency analysis of the Nursing Resources using the “Work Utilization Ratio” Index (WUR). Identification of work days and shifts with greater workload. Bivariate analysis relating NAS and VACTE to reason for admission. NW calculation relating number of scales and NAS and VACTE average of each reason for admission. Correlation analysis between scales.</div></div><div><h3>Results</h3><div>1705 records per scale were collected. NAS per patient median: 55.70 (IR: 51.30-60.38) (95%CI: 54.74-56.66). NAS per patient mean: 56,67 (SD:<!--> <!-->±<!--> <!-->8,28) (95%CI: 55.72-57.63). NW per bed NAS: 63.39, VACTE: 652.93. NAS per nurse: 135.23%. B:P Ratio: 1:1.09. Operative N:P Ratio: 1:1.76. WUR<!--> <!-->&gt;1. Correlation coefficient between scales: 0.45.</div></div><div><h3>Conclusions</h3><div>There is a shortage of nurses in relation to the work generated. An update in the scales is required. The NAS per nurse is more effective than the NAS per patient for the adequacy of the Nursing workforce. The new proposed indicators might be suitable to determine the NW and to optimize the calculation of Nursing resources.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 2","pages":"Article 500535"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739212","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":"Asociación entre competencia del cuidador familiar y dependencia en pacientes que egresan de Unidad de Cuidado Intensivo","authors":"Natalia Esquivel-Garzón RN, PhD,&nbsp;Dora Inés Parra RN, MSN","doi":"10.1016/j.enfi.2025.500540","DOIUrl":"10.1016/j.enfi.2025.500540","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the association between the competence (knowledge, skill and preparation) of the family caregiver and the degree of dependency of patients discharged from Intensive Care Unit.</div></div><div><h3>Method</h3><div>A descriptive, cross-sectional study was carried out to characterize family caregivers and patients discharged from the ICU with moderate, severe or total dependence according to Barthel score. Competence was measured with the application of the CUIDAR instrument and caregiver performance (execution of activities in a specific situation) with an instrument that evaluated the performance of actions aimed at supplying basic needs of feeding, elimination, body hygiene, skin care, oxygen therapy and medication administration in a sample of 140 caregivers.</div></div><div><h3>Results</h3><div>A positive association was found between patient functionality and caregiver performance (Spearman rho: 0.38; <em>P</em>&lt;.001). In contrast, no significant correlation was observed between the self-perception of caregiver competence assessed with the CUIDAR instrument and the patient's functionality, measured by the Barthel scale (Spearman rho: 0.12; <em>P</em>=.16). The 69.3% of the participants had a medium or low competence, only (30.7%) were classified at a high level. The lowest scores were obtained in knowledge (62.9%), followed by uniqueness (32.9%).</div></div><div><h3>Conclusion</h3><div>There is a significant association between patient functionality and objectively assessed caregiver performance; thus, caregivers of more dependent patients have significant challenges to achieve adequate performance in their role.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 2","pages":"Article 500540"},"PeriodicalIF":1.1,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697137","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":"Recovery and severity of acute kidney injury in critically ill clinical and surgical patients","authors":"Raquel Teles-Mesquita Graduated ,&nbsp;Natália Vieira-Araújo-Cunha MSN ,&nbsp;Marcia Cristina-da-Silva-Magro PhD ,&nbsp;Kamilla Grasielle-Nunes-da-Silva MSN","doi":"10.1016/j.enfi.2025.500545","DOIUrl":"10.1016/j.enfi.2025.500545","url":null,"abstract":"<div><h3>Introduction</h3><div>The identification of patients at risk has implications on the management of clinical and surgical patients. The severity of acute kidney injury (AKI) has a negative impact on the patient's prognosis and effects on kidney function recovery.</div></div><div><h3>Objective</h3><div>To determine the cases of renal recovery and level of severity of AKI in clinical and surgical patients admitted to the intensive care unit. (ICU).</div></div><div><h3>Method</h3><div>Prospective, observational, longitudinal, and quantitative analytical study. It was carried out in an ICU of a teaching hospital. The sample was non-probabilistic, consisting of 59 surgical and clinical patients. A structured questionnaire consisting of 38 questions subdivided into sections was used for data collection such as hospitalization data; surgery data; history of current hospitalization; hemodynamic and laboratory parameters; AKI severity. Variable analysis was based on non-parametric tests. Two-sided <em>p</em> values<!--> <!-->&lt;<!--> <!-->0.05 were considered statistically significant.</div></div><div><h3>Results</h3><div>The most severe AKI according to the classification KDIGO (Kidney Disease: Improving Global Outcomes) was 3 and mainly affected clinical patients (34.5%). Surgical patients predominantly developed AKI – KDIGO 2 and 3 (23.3%). The length of hospital stay (<em>p</em> <!-->=<!--> <!-->0.04), and ICU stay (<em>p</em> <!-->=<!--> <!-->0.001) was significant in patients who developed AKI. Renal recovery occurred predominantly in surgical patients (20.3%).</div></div><div><h3>Conclusions</h3><div>Clinical patients admitted to the ICU are more affected by more severe AKI (KDIGO 3). Renal recovery was observed in approximately two out of every five patients, being more significant in surgical patients.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 3","pages":"Article 500545"},"PeriodicalIF":1.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681322","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":"Percepción del paciente en relación con la valoración de la fragilidad en las unidades de cuidados intensivos: estudio fenomenológico","authors":"María Teresa González-Gil RN, MsC, PhD ,&nbsp;Susana Arias-Rivera RN, MsC, PhDc","doi":"10.1016/j.enfi.2025.500548","DOIUrl":"10.1016/j.enfi.2025.500548","url":null,"abstract":"<div><div>Frail patients admitted to the Intensive Care Unit (ICU) have a poorer outcome that may be related to Post ICU Syndrome, readmissions or death within a year of discharge. Assessing frailty can help guide decision-making and care planning.</div></div><div><h3>Objective</h3><div>To explore the perception of patients in relation to the assessment of frailty in the ICU.</div></div><div><h3>Methodology</h3><div>Qualitative phenomenological study through semi-structured interviews in the ICU of a public hospital of intermediate complexity. Thirteen patients with experience of admission to the ICU participated. A thematic analysis of the discourse was carried out following Braun and Clarke's proposal.</div></div><div><h3>Results</h3><div>Three themes and seven subthemes were identified as pivotal in describing the patients’ experience: perception of own frailty, coping styles and resources for dealing with frailty, and the value of monitoring the evolution of frailty. Participants understand frailty as opposed to strength, from a multidimensional perspective and linked to the idea of loss of capabilities. They try to deal with fragility by coping and struggling with it, drawing on intrapersonal and interpersonal resources. They place value on monitoring the evolution of frailty insofar as they feel considered and supported.</div></div><div><h3>Conclusions</h3><div>The patients’ narratives evidence the important repercussion that an ICU admission has on the physical and psycho-socio-emotional dimensions of patients and caregivers. The assessment of frailty and the monitoring of its evolution at discharge is valued as important to be able to adapt care and significant as a facilitator of emotional support. There is a clear need for support at discharge in the different spheres and for accompanying the patient throughout their recovery to enable an early return to their life prior to admission.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 2","pages":"Article 500548"},"PeriodicalIF":1.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680619","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":"Satisfacción laboral e intención de abandono de la unidad de cuidados intensivos de las enfermeras","authors":"Marta Santana-Martín RN ,&nbsp;José Manuel López-Álvarez MD, PhD ,&nbsp;Yeray Gabriel Santana-Padilla RN, MSN, PhD ,&nbsp;Luciano Santana-Cabrera MD, PhD ,&nbsp;Borja Nicolás Santana-López RN, MSN, PhD","doi":"10.1016/j.enfi.2025.500537","DOIUrl":"10.1016/j.enfi.2025.500537","url":null,"abstract":"<div><h3>Introduction</h3><div>Nurse turnover increases the shortfall in coverage of different health services. Research studies have found high quitting intention rates related to low levels of job satisfaction among nurses in different areas, including intensive care units (ICU). The aim of this study was to compare the level of job satisfaction of ICU nurses according to the population of critically ill patients they care for (paediatric vs. adult) and their intention to leave the ICU.</div></div><div><h3>Method</h3><div>A cross-sectional descriptive study in which nurses from public ICUs on the island of Gran Canaria, 2 adult units and one paediatric unit, participated. An electronic questionnaire was sent out, which included questions on socio-demographic and occupational variables, the validated Font Roja job satisfaction survey and a final question on the participant's own intention to leave. Comparative analysis was performed using Chi-square for qualitative variables and Mann-Whitney U for quantitative variables.</div></div><div><h3>Results</h3><div>A total of 152 nurses were recruited, 55.9% of whom expressed their intention to leave the ICU. Although both types of units had a higher number of nurses who wanted to leave the ICU, there was a higher proportion in the paediatric ICU who had this intention in the short period of time (30.4 vs. 7.0%) (χ² <!-->=<!--> <!-->11.691; p<!--> <!-->=<!--> <!-->0.003). Job satisfaction was generally good (3.37/5), being lower among those who did intend to leave (3.97 vs. 2.91; p<!--> <!-->&lt;<!--> <!-->0.001).</div></div><div><h3>Conclusions</h3><div>There is a high intention to leave among the professionals consulted. Paediatric ICU nurses had the highest intention to leave the ICU in the short term (&lt;<!--> <!-->6 months). An inverse relationship was found between intention to leave and job satisfaction.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 2","pages":"Article 500537"},"PeriodicalIF":1.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680621","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":"Trabajo en equipo a través del programa de entrenamiento basado en TeamSTEPPS® mediante una experiencia de escape room: una investigación mixta","authors":"Oscar Arrogante RN, Psy, MSc, PhD ,&nbsp;Marta Raurell-Torredà RN, MSN, PhD ,&nbsp;Elena Maestre-González RN, MsC ,&nbsp;Francisco Javier Sánchez-Chillón RN, MSN ,&nbsp;Martín Torralba-Melero RN, MSN ,&nbsp;Anna Maria Aliberch-Raurell RN, MSN ,&nbsp;Andrés Rojo-Rojo RN, PhD ,&nbsp;Ignacio Zaragoza-García RN, PhD","doi":"10.1016/j.enfi.2025.500536","DOIUrl":"10.1016/j.enfi.2025.500536","url":null,"abstract":"<div><h3>Introduction</h3><div>The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS®) program has been shown to improve teamwork among critical care professionals. The <em>escape</em> room as an educational strategy is effective for the learning process of professionals according to recent evidence.</div></div><div><h3>Objectives</h3><div>To analyze the degree of satisfaction and explore the perceptions of intensive care nurses after an <em>escape</em> room experience based on the TeamSTEPPS® program.</div></div><div><h3>Methods</h3><div>Cross-sectional descriptive and phenomenological study using a mixed methodology. A specific and adapted satisfaction survey was applied to the participants of the <em>escape</em> room, including at the end an open-ended question for them to make comments and thus analyze their perceptions of the experience. A thematic content analysis of the comments was carried out using the interpretative paradigm. Quantitative and qualitative data were analyzed using IBM® SPSS® Statistics 29.0 and ATLAS.ti 24™ respectively.</div></div><div><h3>Results</h3><div>Fifty-five nursing professionals from different intensive care units in Spain participated, with a median age of 34 years (RIC = 12) and 9 years of experience in intensive care (RIC = 11), most of them being women (89.1%). The participants expressed high overall satisfaction with the activity, with a median of 47 points out of 50 (RIC = 4). Three main categories with their respective subcategories emerged from their comments: learning through the <em>escape</em> room (learning new tools; fun way to learn); usefulness of TeamSTEPPS® strategies (communication skills, patient safety and teamwork); implementation in clinical practice (applicable strategies and ease of implementation).</div></div><div><h3>Conclusions</h3><div>The <em>escape</em> room can be a dynamic, interactive, engaging, and fun way to promote teamwork training and education in intensive care nurses through the TeamSTEPPS® training program.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 2","pages":"Article 500536"},"PeriodicalIF":1.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680620","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":"Caracterización del perfil profesional y condiciones laborales de personal de enfermería en unidades de cuidado intensivo","authors":"Diana Marcela Achury-Saldaña (MSN) ,&nbsp;Luisa Fernanda Achury-Beltrán (MSN) ,&nbsp;Sandra M. Rodríguez-Colmenares (MSN) ,&nbsp;Herly Ruth Alvarado-Romero (MSN) ,&nbsp;Martha Consuelo Romero-Torres (RN) ,&nbsp;Diana Lucero Pardo-Camacho (RN) ,&nbsp;María Teresa Diaz-Muñoz (RN) ,&nbsp;Marcela Moran-Vargas (RN) ,&nbsp;Janeth Daza-Ramírez (RN) ,&nbsp;David Andradre-Fonseca (MSN)","doi":"10.1016/j.enfi.2025.500525","DOIUrl":"10.1016/j.enfi.2025.500525","url":null,"abstract":"<div><h3>Introduction</h3><div>The development of political and academic actions aimed at increasing the quality of care and the outcomes of health care requires knowledge of the conditions of the nursing workforce in intensive care units.</div></div><div><h3>Aim</h3><div>To characterize the professional profile and working conditions of Intensive Care Unit nurses in Colombia.</div></div><div><h3>Methods</h3><div>Multicenter, cross-sectional observational study. A total of 433 Intensive Care Unit nurses in Colombia participated, the information was collected through an online survey. The information was analyzed with RStudio statistical software. Descriptive statistics were used for the presentation of results.</div></div><div><h3>Results</h3><div>79.4% of the nursing professionals were women with a mean age of 35.6 (±<!--> <!-->9,6) years. A total of 63.9% worked in private adult Intensive Care Units and only 22.4% had a degree in Critical Care. The competencies that are permanently applied are care management, problem solving and communication; however, those related to teamwork and personal development are not fully developed. Regarding working conditions, it was found that: 71.6% have a nurse-patient ratio of 1:6 or more; only 47.5% have an indefinite term contract; 62% work have a salary remuneration of 3.5 minimum wages and only 23,5% are satisfied with their work.</div></div><div><h3>Conclusion</h3><div>The profile of nurses shows the need to strengthen specialized training, while skills and working conditions must be improved to guarantee quality care and the well-being of staff.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 2","pages":"Article 500525"},"PeriodicalIF":1.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680617","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":"Nursing diagnoses for patients hospitalized with COVID-19 in critical care units in Brazil: A cross-sectional study","authors":"Giovanna Maria de Lima-Medeiros RN ,&nbsp;Caio Rodrigo Menezes-dos-Santos RN ,&nbsp;Thiago de Jesus-Santos MSN ,&nbsp;Edilza Fraga-Santos RN ,&nbsp;Andreia Centenaro-Vaez PhD ,&nbsp;Fernanda Gomes de Magalhães Soares-Pinheiro PhD ,&nbsp;Damião da Conceição-Araújo PhD","doi":"10.1016/j.enfi.2025.500541","DOIUrl":"10.1016/j.enfi.2025.500541","url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 pandemic had a significant global impact, particularly on patients hospitalized in critical care units. Studies addressing nursing diagnoses in the context of the pandemic are essential to strengthen the evidence and contribute to the development of clinical practice.</div></div><div><h3>Objective</h3><div>Analyze the prevalence of nursing diagnoses in hospitalizations of critically ill adult patients with COVID-19 in northeastern Brazil.</div></div><div><h3>Method</h3><div>This is a cross-sectional study conducted in a university hospital in northeastern Brazil. The sample included 117 hospitalizations between 2020 and 2021. Data were retrospectively collected from electronic medical records and analyzed using absolute frequencies, percentages, and bivariate and multivariate analyses.</div></div><div><h3>Results</h3><div>The results revealed a predominance of nursing diagnoses such as risk for falls in adults (95.7%), risk for infection (94%), and bathing self-care deficit (89.7%). Patients on mechanical ventilation had higher prevalence rates of imbalanced nutrition, diarrhea and impaired physical mobility.</div></div><div><h3>Conclusions</h3><div>The prevalence of nursing diagnoses in critically ill COVID-19 patients highlights the complexity of care required and the importance of evidence-based practice to improve clinical outcomes.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 2","pages":"Article 500541"},"PeriodicalIF":1.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680618","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":"Moral distress in critical care nurses caring for patients undergoing ECMO: A cross-sectional study","authors":"Elisangela da-Conceição-Jorge RN ,&nbsp;João Paulo-Vitorino RN ,&nbsp;Donna M-Wilson RN, PhD ,&nbsp;Filipe Utuari-de-Andrade-Coelho RN, PhD","doi":"10.1016/j.enfi.2025.500533","DOIUrl":"10.1016/j.enfi.2025.500533","url":null,"abstract":"<div><h3>Background</h3><div>Extracorporeal membrane oxygenation (ECMO) is commonly used now in cases of refractory cardiac and pulmonary failure. Moral distress among nurses is often present; nevertheless, the literature regarding this topic is scarce.</div></div><div><h3>Objective</h3><div>To identify the level of moral distress among nurses providing direct care to patients undergoing ECMO by applying the Moral Distress Scale Revised (MDSR).</div></div><div><h3>Method</h3><div>This is a cross-sectional study conducted in an Adult Intensive Care Unit (ICU) in Brazil, involving nurses providing direct care to patients undergoing ECMO. Data on nurse sociodemographic and professional characteristics were collected, along with MDSR data and Moral Distress Index (MDI).</div></div><div><h3>Results</h3><div>A total of 30 nurses were included, of whom 80.0% were female, with an age of 32 (27.7–38.2) years, professional experience time of 5 (3.0–11.2) years, duration of direct support care experience of 2.5 (1.4–4.0) years, and 83.3% had completed an institutional ECMO course. The questions in the MDRS with the highest mean scores which indicate moral distress were 3 (8.57<!--> <!-->±<!--> <!-->4.83), 6 (7.20<!--> <!-->±<!--> <!-->4.73), 16 (6.10<!--> <!-->±<!--> <!-->6.13), 2 (5.87<!--> <!-->±<!--> <!-->4.39) and 7 (5.77<!--> <!-->±<!--> <!-->4.26), with these collectively resulting in a mean MDI of 70.7<!--> <!-->±<!--> <!-->48.02, indicating a significant intensity and frequency of moral distress experienced by the research participants.</div></div><div><h3>Conclusion</h3><div>Moral distress for nursing professionals caring for ECMO patients appears to be linked to the need for ongoing questioning, discussions, and reflections among the working teams. The greatest intensity and frequency of moral distress were attributed to adhering to the family's wishes to sustain life even when it might not be in the best interest of the patient. The study highlights the importance of developing educational programs to identify and mitigate the presence of moral distress and its triggering factors in critical care teams, aiming to reduce its impact over time.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 2","pages":"Article 500533"},"PeriodicalIF":1.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143636510","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}