Enfermeria Intensiva最新文献

{"title":"Asociación entre el vínculo madre-hijo y los síntomas depresivos en madres de la Unidad de Cuidados Intensivos Neonatales: estudio caso-control","authors":"A. Karamanou CNM, MSc ,&nbsp;P. Varela CNM, MSc, PhD(c) ,&nbsp;C. Nanou RN, RM, MSc, MPH, PhD ,&nbsp;A. Deltsidou RN, RM, MSc, MPH, PhD","doi":"10.1016/j.enfi.2021.07.003","DOIUrl":"10.1016/j.enfi.2021.07.003","url":null,"abstract":"<div><h3>Objectives</h3><p>Maternal perinatal depression has been associated with impaired mother-infant bonding. The adverse effect of this impaired bonding has been reported. This study aimed to investigate and compare the posnatal depressive symptoms and the mother-infant bonding in a Neonatal Intensive Care Unit (NICU) and of mothers with healthy newborns respectively. Secondly, was to explore the association between depressive symptomatology and bonding in both groups.</p></div><div><h3>Methods</h3><p>In this case study, mothers in the early pospartum period who gave birth in the same perinatal center of Greece were recruited to participate. The cases consisted of 88 mothers of neonates who were hospitalized in the NICU and controls were 100 mothers of full-term healthy neonates. For the collection of the data questionnaires including demographics and perinatal variables were used. For the bonding and posnatal assessment, the Mother to Infant Bonding Scale, the Postpartum Bonding Questionnaire, and the Hospital Anxiety and Depression Scale were used.</p></div><div><h3>Results</h3><p>There was a significant difference between the mean of bonding scores of NICU mothers and the control group (t<!--> <!-->=<!--> <!-->-2.696, <em>P</em>=.008). NICU mothers presented lower scores in bonding with the newborn compared to the control group and presented higher depression scores compared to those of controls (χ² <!-->=<!--> <!-->28.588, <em>P</em>=.000). The depression scores were correlated with bonding scores in both groups.</p></div><div><h3>Discussion</h3><p>A NICU admission has an impact on bonding and in some way interacts with maternal pospartum mental health, therefore more research is needed.</p></div><div><h3>Conclusions</h3><p>NICU mothers have been presented as more vulnerable than mothers of healthy infants since they expressed a lower mother-infant bonding and higher depression scores. The support of these vulnerable mothers and the facilitation of mother-infant bonding by the NICU staff is of utmost importance.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123536895","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 clasificación de la lesión renal aguda: una herramienta para las enfermeras de críticos","authors":"Y.G. Santana-Padilla RN, MSN, PhD ,&nbsp;J.A. Fernández-Castillo RN, MSN ,&nbsp;A. Mateos-Dávila RN, MSN, PhDc","doi":"10.1016/j.enfi.2022.05.007","DOIUrl":"10.1016/j.enfi.2022.05.007","url":null,"abstract":"<div><p>In acute illnesses, patients may present associations between several pathologies. Kidney failure is one of the most common in critically ill patients.</p><p>Urea, creatinine and potassium blood levels, among others, are indicative of renal function and the health professionals need to be acted upon to maintain the patients’ internal functions without vital risk. Addressing these elements become a central element in the management and treatment of critically ill patients.</p><p>The assessment of this disorder in early stages is complicated. Therefore, continuous monitoring is a key element in the prevention of worsening due to various clinical situations such as, for example, renal dysfunction secondary to nephrotoxic drugs in frail patients. This clinical assessment, carried out correctly, enables health professionals to perform early intervention. This text will provide an approach to the classification of acute kidney injury as a tool to promote the prevention and to detect the incidence. For critical care staff, these concepts are essential to ensure high quality healthcare.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133494807","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":"Participación de la familia en el cuidado del paciente crítico: un estudio exploratorio","authors":"D. Sepúlveda-Hermosilla (RN) ,&nbsp;L. Irarrázabal-Vargas PhD ,&nbsp;N. Rojas Silva MNS, CCNS","doi":"10.1016/j.enfi.2021.07.004","DOIUrl":"https://doi.org/10.1016/j.enfi.2021.07.004","url":null,"abstract":"<div><h3>Objectives</h3><p>To determine the level of readiness of the healthcare team regarding family participation in the care of the critically ill adult and their relationship with the individual characteristics of the participants in a medical-surgical intensive care unit (ICU) in Santiago de Chile.</p></div><div><h3>Method</h3><p>A cross-sectional correlational study using a quantitative method and including a focus group to explore the perception of healthcare staff of family participation in the care of the critically ill patient.</p></div><div><h3>Results</h3><p>The level of readiness of the healthcare team for family participation in the care of the critically ill patient is medium, at 13.81 out of a total 20. The greater the readiness, the lower the age (r=−.215; <em>P</em>=.019), the higher the rating of previous experience working with families (r=.304; <em>P</em>=.006), and the higher the perception of being comfortable with different activities in the care of the critical patient (r=.495: <em>P</em>&lt;.001). The participants also state that the work environment of the unit, the patient's condition, the relatives’ characteristics, personal judgement, and the preparedness of relatives affect their readiness.</p></div><div><h3>Conclusions</h3><p>The results contribute towards determining the healthcare team's level of readiness in a setting where the subject of the study has not been implemented. The readiness of the healthcare team is medium, and is related to individual characteristics of the healthcare staff, and to organizational and family aspects. Therefore, strategies are required to address these aspects that might increase readiness.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91645186","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":"Seguridad en el manejo de los sensores de presión en terapia renal depurativa continua","authors":"F.J. Berrocal-Tomé RN ,&nbsp;E.M. Guix-Comellas RN, MSN, PhD ,&nbsp;A. Mateos-Dávila RN, MSN, PhDc","doi":"10.1016/j.enfi.2022.01.001","DOIUrl":"10.1016/j.enfi.2022.01.001","url":null,"abstract":"<div><p>Continuous evaluation of treatment pressures on extracorporeal therapy monitors is very useful in critically ill patients. All the monitors on the market offer five pressure tapings distributed appropriately along the circuits, also calculating the transmembrane pressure. The importance of each of these sensors and the interpretation of the data offered by the monitor are described in this review. Arriving on time for its correct analysis offers a lot of security in the therapy and the patient is treated more effectively and efficiently.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121553423","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":"Uso de contenciones mecánicas en unidades de cuidados críticos: caracterización, estándares de aplicación y factores relacionados. Resultados de un estudio multicéntrico","authors":"M. Acevedo-Nuevo RN, MsC, PhD ,&nbsp;M.C. Martín-Arribas RN, MsC, PhD ,&nbsp;M.T. González-Gil RN, PhD ,&nbsp;M. Solís-Muñoz RN, MsC, PhD ,&nbsp;S. Arias-Rivera RN, MsC ,&nbsp;A. Royuela-Vicente PhD","doi":"10.1016/j.enfi.2021.12.001","DOIUrl":"https://doi.org/10.1016/j.enfi.2021.12.001","url":null,"abstract":"<div><h3>Objectives</h3><p>To describe and characterise the use of mechanical restraint (MR) in critical care units (CCU) in terms of frequency and quality of application and to study its relationship with pain/agitation-sedation/delirium, nurse:patient ratio and institutional involvement.</p></div><div><h3>Method</h3><p>Multicentre observational study conducted in 17 CCUs between February and May 2016. The observation time per CCU was 96<!--> <!-->h. The main variables were the prevalence of restraint, the degree of adherence to MR recommendations, pain/agitation-sedation/delirium monitoring and institutional involvement (protocols and training of professionals).</p></div><div><h3>Results</h3><p>A total of 1070 patients were included. The overall prevalence of restraint was 19.11%, in patients with endotracheal tube (ETT) 42.10% and in patients without ETT or artificial airway it was 13.92%. Adherence rates between 0% and 40% were obtained for recommendations related to non-pharmacological management and between 0% and 100% for those related to monitoring of ethical-legal aspects. The lower prevalence of restraint was correlated with adequate pain monitoring in non-communicative patients (<em>P</em> <!-->&lt;<!--> <!-->.001) and with the provision of training for professionals (<em>P</em> <!-->=<!--> <!-->.020). An inverse correlation was found between the quality of the use of MR and its prevalence, both in the general group of patients admitted to CCU (r<!--> <!-->=<!--> <!-->−.431) and in the subgroup of patients with ETT (r<!--> <!-->=<!--> <!-->−.521).</p></div><div><h3>Conclusions</h3><p>Restraint is especially frequently used in patients with ETT/artificial airway, but is also used in other patients who <em>may</em> not meet the use profile. There is wide room for improvement in non-pharmacological alternatives to the use of MC, ethical and legal vigilance, and institutional involvement. Better interpretation of patient behaviour with validated tools may help limit use of MR.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91645184","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":"Conocimientos de las enfermeras acerca de los cuidados paliativos en un área de críticos","authors":"A. Sesma-Mendaza RN ,&nbsp;M. Aranguren-Sesma RN ,&nbsp;F. Estraviz-Pardo RN ,&nbsp;E. Lizarazu-Armendáriz RN ,&nbsp;R. Goñi-Viguria MSN","doi":"10.1016/j.enfi.2021.10.003","DOIUrl":"https://doi.org/10.1016/j.enfi.2021.10.003","url":null,"abstract":"<div><h3>Introduction and objetive</h3><p>Patients admitted to the Critical Care Unit (CCU) have a high mortality rate due to their complexity. Palliative care (PC) is a key aspect that can improve patient care. Because of the essential role of the nurse in providing this care, training, and including it in daily practice are needed.</p><p>Our objective was to review the level of knowledge among the nurses in the CCU regarding PC and assess whether there is an association between each of the study variables.</p></div><div><h3>Methodology</h3><p>We performed a descriptive observational cross-sectional study in the CCU of a tertiary level university hospital. The questionnaire Palliative Care Quiz for Nurses, previously validated and translated into Spanish, was used. This is a self-administered questionnaire consisting of 20 multiple-choice questions (True/False/Do not Know-Do not answer) which evaluates three aspects of PC: philosophy, psychosocial and control of pain and other symptoms. In addition, sociodemographic data was collected. Descriptive and inferential statistics were used, a p<!--> <!-->&lt;<!--> <!-->.05 was considered statistically significant in all cases.</p></div><div><h3>Results</h3><p>The questionnaire was administered to 68 nursers, with an average age of 34.98<!--> <!-->±<!--> <!-->12.12 years, and 13.00<!--> <!-->±<!--> <!-->11.75 years of professional experience. Twelve nurses have Master studies and 28 nurses have received training in PC. The percent of correct answers of the questionnaire was 56.98%. There were no statistically significant differences between the total average score and the variables studied. However, looking at each aspect on the scale, an association was found between PC training and control of pain and other symptoms (p<!--> <!-->=<!--> <!-->.033).</p></div><div><h3>Conclusion</h3><p>Critical care nurses have a basic knowledge of PC, it being insufficient in the psychological sphere. Developing a training programme which identifies misconceptions and training deficits might improve the management of symptom control in palliative care patients, quality of care and its application.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1130239922000244/pdfft?md5=cbe6a1c942e0585d88c374dc531afb8d&pid=1-s2.0-S1130239922000244-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91645277","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":"Información enfermera en las unidades de cuidados intensivos españolas: ¿rol formal o informal? Estudio multicéntrico","authors":"J. Valls-Matarín PhD. MSR.RN,&nbsp;M. del Cotillo-Fuente MSR.RN","doi":"10.1016/j.enfi.2021.10.002","DOIUrl":"https://doi.org/10.1016/j.enfi.2021.10.002","url":null,"abstract":"<div><h3>Objectives</h3><p>To evaluate the brochure provided to relatives on admission to Spanish Intensive Care Units (ICU) regarding nursing information.</p></div><div><h3>Methodology</h3><p>Descriptive, cross-sectional, multicentre study from September-December 2019. A total of 280 adult ICUs were included, according to the list of the Spanish Society of Intensive Care. The brochure was requested through personal contact, phone call, twitter, or hospital website.</p></div><div><h3>Analyzed variables</h3><p>Hospital (public/private), university (yes/no), visiting (open/closed), medical and nurse information. Descriptive statistics and X² test (relations nurse information and other variables).</p></div><div><h3>Results</h3><p>Data were collected from 228 ICU(81.4%), of which 25(11%) did not have a brochure. A total of 77.8% were public and 49.8% university hospitals. Of the hospitals, 94.1% had closed visiting hours, although 42.4% supplemented it with flexible. All the hospitals included daily medical information with an established timetable, 21.7%(n<!--> <!-->=<!--> <!-->44) contained nurse information, 27.3% with established hours and 38.6% during visits. Of the nursing information, 79.5% referred to care, 29.5% to needs, 13.6% to well-being, 15.9% to the patient's condition, 11.4% to the environment, 9.1% to observations, and 29.5% to clarifications. A total of 17.2% of all ICU offered to collaborate in care. Of the brochures with nurse information, 90.9% were public hospitals and 9.1% were private (<em>P</em> <!-->=<!--> <!-->.02). Of the hospitals, 65.9% were university compared to 34.1% who were not (<em>P</em> <!-->=<!--> <!-->.02).</p></div><div><h3>Conclusions</h3><p>While medical information is consistently reflected in all brochures, only a few contain nursing information with generic and non-homogeneous and specific content. These results contrast with the reality of the ICU, where the nurse is the professional with the greatest contact with the family. The official provision of nursing information occurs more frequently in public and university hospitals. It is necessary to standardise this information, since as a responsible part of the care process, nurses must communicate their care in a formal manner, and thus help make their work visible.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91645278","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":"Anticoagulación en circuitos de terapias continuas de reemplazo renal","authors":"A. Mateos-Dávila RN, MsN, PhDc ,&nbsp;J. Martínez Pérez RN, MsN ,&nbsp;M.E. Prieto Arriba RN, MsN ,&nbsp;R. Macho López RN ,&nbsp;E.M. Guix-Comellas RN, MsN, PhD","doi":"10.1016/j.enfi.2022.01.002","DOIUrl":"10.1016/j.enfi.2022.01.002","url":null,"abstract":"<div><p>Continuous renal replacement therapies are used as a means of blood clearance in critically ill patients with acute renal failure. Its effectiveness depends on the permeability of the extracorporeal circuit and filter coagulation is the most frequent cause of treatment interruption. This situation carries a risk of blood loss for the patient.</p><p>Sodium heparin is the most widely used anticoagulant in these therapies, but it can increase the risk of bleeding. Regional citrate anticoagulation is a safer method compared to sodium heparin.</p><p>Citrate is a substance that works by inactivating ionic calcium that participates in the coagulation cascade. It's infused at the inlet of the circuit and neutralized before reaching the patient with calcium replacement. For this reason, it is considered a regional and non-systemic anticoagulant.</p><p>However, this anticoagulation system, despite being indicated as the first option by the KDIGO guidelines (Kidney Disease Improving Outcomes), is not yet widespread due to the complexity of its use. It requires specific training for healthcare personnel, especially nurses, who will be responsible for maintaining the circuit while the therapy lasts.</p><p>In this article we want to provide the necessary knowledge about anticoagulation to carry out these procedures safely and effectively.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123876600","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":"Fracción de filtración en terapias convectivas continuas","authors":"M.E. Prieto-Arriba RN, MsN ,&nbsp;A. Mateos-Dávila RN, MsN, PhDc ,&nbsp;Z. Iñiguez-de-Ciriano-Aldama RN, MsN ,&nbsp;L. Martín-Cuadrado RN, MsN ,&nbsp;E.M. Guix-Comellas RN, MsN, PhD","doi":"10.1016/j.enfi.2022.07.003","DOIUrl":"10.1016/j.enfi.2022.07.003","url":null,"abstract":"<div><p>Extracorporeal purification treatments are a very usual techniques in the intensive care units. Those treatments are essential for critical patients. Their knowledge and skill leads to a more efficient and effective treatment for the patient and the calculation of the filtration fraction adds to all these objectives.</p><p>This paper offers some simple calculations of this parameter, taking into account blood flow and fluid in the pre- or post-filter replacement.</p><p>If it's possible to simulate the kidney in these treatments, we will be able to work in the most optimal filter conditions and increases the filter lifespan. Finally, and as a consequence of the above, avoid complications derived from the increase in transfusions to these critical patients.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123790605","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":"Trastornos hidroelectrolíticos. Manifestaciones clínicas y tratamiento","authors":"J.A. Fernández-Castillo RN, MsN ,&nbsp;M. Carrasco-Campos RN, MsN, PhDc ,&nbsp;A. Mateos-Dávila RN, MsN, PhDc ,&nbsp;Y.G. Santana-Padilla RN, MsN, PhD","doi":"10.1016/j.enfi.2022.07.005","DOIUrl":"10.1016/j.enfi.2022.07.005","url":null,"abstract":"<div><p>The concept «homeostasis» is related to a normal and relatively constant maintenance in the total volume and distribution of water in the body. For its maintenance it is very important that the excretion of water and electrolytes correspond precisely to its input.</p><p>A description of the most important ions is developed in this article. It is structured by describing optimal levels, followed by their main role in the body.</p><p>The situation of excess or deficiency of each ion is described. Associated with each situation of abnormality, the most frequent causes, the clinical manifestations, and the appropriate treatments are listed.</p><p>It is considered very important to know the function of potassium, calcium, magnesium, phosphorus or sodium and the problems that their imbalances can generate, aiming at the precise application of each of the extracorporeal therapies and the most appropriate treatment bags in each case.</p><p>Finally, a table of the composition of some treatment bags in continuous purifying therapies is offered based on the description offered by their own laboratories.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124853966","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}