Enfermeria intensiva最新文献

{"title":"Gender perspective in the implementation of hygiene in cardiology intensive care","authors":"S. Pérez-Ortega RN, MSc, PhD ,&nbsp;M. Parellada-Vendrell RN, MSc, PhD ,&nbsp;E. Querol RN, MSc ,&nbsp;J. Prats RN, MSc ,&nbsp;M. Venturas RN, PhD ,&nbsp;A. Zabalegui RN, PhD, FEANS","doi":"10.1016/j.enfie.2023.12.004","DOIUrl":"10.1016/j.enfie.2023.12.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Hygiene in critical patients is an essential daily care, provided under safe conditions, to promote comfort and maintain the integrity of skin and mucous membranes, however, it can generate feelings of dependence and vulnerability in patients.</div><div><span>The aim of this post hoc study is to know the differences in satisfaction and lived experience regarding bed hygiene in an </span>intensive care unit<span> according to biological sex and gender perspective.</span></div></div><div><h3>Methods</h3><div>Observational, descriptive and prospective study in which an ad hoc questionnaire was administered to 148 conscious and oriented patients of legal age. The questionnaire was completed 24−48 hours after admission to the unit, once the initial bed hygiene had been performed.</div></div><div><h3>Results</h3><div>Males experienced conformism (51%), embarrassment (31%) and relief (9%); Women felt conformism (35.4%), embarrassment (18.8%) and relief (29.2%) (p &lt; 0.05). Women experienced a feeling of cleanliness in 89.1% compared to 56.1% of men (p &lt; 0.05).</div><div>Men were offered to wash their genitals in 72.9% compared to 35.7% of women (p &lt; 0.05).</div><div>34.3% of men would prefer a family member to assist them during hygiene (62.9% by their wives), compared to 27.1% of women who would prefer a family member (84.6% by their daughters).</div></div><div><h3>Conclusion</h3><div>Women tolerate bed hygiene better than men and appreciate more the feeling of cleanliness.</div><div>Women are identified as caregivers, both professionally and in the family, and patients prefer them to collaborate in the performance of hygiene, being wives preferred by men and daughters preferred by women.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"35 4","pages":"Pages 278-286"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140141309","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":"Interprofessional interventions and factors that improve end-of-life care in intensive care units: An integratory review","authors":"S.M. Hernández-Zambrano PhD ,&nbsp;A.J. Carrillo-Algarra MSN ,&nbsp;O.E. Manotas-Solano RN ,&nbsp;S.E. Ibáñez-Gamboa RN ,&nbsp;L.M. Mejia-Mendez RN ,&nbsp;O.H. Martínez-Montoya RN ,&nbsp;M. Fernández-Alcántara PhD ,&nbsp;C. Hueso-Montoro PhD","doi":"10.1016/j.enfie.2023.08.009","DOIUrl":"10.1016/j.enfie.2023.08.009","url":null,"abstract":"<div><h3>Introduction</h3><div><span>The changes in health dynamics, caused by the SARS-COVD-2 pandemic and its consequences, generated a greater need to integrate palliative care in the </span>ICU to promote a dignified death.</div></div><div><h3>Objective</h3><div>Identify interprofessional interventions and factors that improve the care of patients at the end of life.</div></div><div><h3>Methodology</h3><div><span>Integrative review, including experimental, quasi-experimental, observational, analytical, and descriptive studies with correlation of variables, published from 2010 to 2021, identified in COCHRANE, </span>CINAHL, CUIDEN, LILACS, SCIELO, Dialnet, PsychInfo, PubMed, PROQUES, PSYCHOLOGY, JOURNALS, SCIENCEDIRECT, with MeSH/DECS terms: “Critical Care”, “IntensiveCare” “Life support care”, “Palliative care”, “Life Quality”, “Right to die”. 36,271 were identified, after excluding duplicate title, abstract, year of publication, design, theme, methodological quality, objectives, and content, 31 studies were found.</div></div><div><h3>Results</h3><div><span><span>It included 31 articles, 16.7% experimental, 3.3% quasi-experimental, 80% observational, analytical, and descriptive with correlation of variables, 38% published in the United States, 38%, and 19% in Brazil. The pooled sample was 24,779 participants. 32.2% of the studies had level of evidence 1 recommendation (c), and 25.8% level of evidence 2 recommendation (c). This paper synthesises evidence to promote Interprofessional Collaborative Practice in the </span>ICU, improve end-of-life care, and interventions to achieve established therapeutic goals, implement effective care policies, plans, and programmes for critically ill patients and their families; factors that affect </span>palliative care and improve with training and continuing education for health personnel.</div></div><div><h3>Conclusion</h3><div>There are interventions to manage physical and emotional symptoms, training strategies and emotional support aimed at health personnel and family members to improve the quality of death and reduce stays in the ICU. The interdisciplinary team requires training on palliative and end-of-life care to improve care.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"35 4","pages":"Pages 352-367"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443893","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":"Ultrasound-guided puncture vs conventional technique for arterial blood gas analysis sampling in adults: A systematic review","authors":"P. Romo-Miguel RN ,&nbsp;S. Ballesteros-Peña RN, MPH, PhD","doi":"10.1016/j.enfie.2023.10.003","DOIUrl":"10.1016/j.enfie.2023.10.003","url":null,"abstract":"<div><h3>Aim</h3><div>To compare the efficacy of conventional puncture versus ultrasound-guided puncture for arterial blood gas sampling in adults.</div></div><div><h3>Method</h3><div>A search protocol was developed and applied to three databases (Medline, Cochrane, and Dialnet). Clinical trials published between January 2013 and January 2023, in Spanish or English, were considered. Outcomes in terms of first-attempt success, number of attempts until success, time taken, self-reported iatrogenic pain, and patient or professional experience were collected. The risk of bias for each included study was assessed.</div></div><div><h3>Results</h3><div>Five randomized clinical trials were selected, with sample sizes ranging from 50 to 238 adult patients treated in emergency settings. Three out of four studies showed higher first-attempt success rates when using ultrasound, and 2 out of 4 studies reported a decrease in iatrogenic pain. Discrepant findings were observed among the studies in terms of time taken and the number of attempts required for success.</div></div><div><h3>Conclusions</h3><div>Although current evidence is limited and the findings are heterogeneous, ultrasound-guided arterial puncture may have advantages over conventional puncture in terms of first-attempt success and in reducing iatrogenic pain.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"35 4","pages":"Pages 368-375"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061592","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 care plan for a patient with Fournier’s gangrene: Clinical case","authors":"","doi":"10.1016/j.enfie.2023.12.003","DOIUrl":"10.1016/j.enfie.2023.12.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Fournier’s gangrene, a relatively rare form of necrotizing fasciitis, is a rapidly progressive disease affecting the deep and superficial tissues of the perineal, anal, scrotal, and genital regions. Despite the significant evolution in medical knowledge, there is still scarce evidence regarding the nursing care plan in patients affected by this pathology, which hinders its correct management. For this reason, we present the following clinical case of a 53-year-old male patient with Fournier’s gangrene who was admitted to the emergency department for 3 days of pain in the perineal area and fever.</p></div><div><h3>Objective</h3><p>The objective was to establish an individualized care plan for the patient detailing the diagnoses, expected outcomes and interventions through nursing taxonomies.</p></div><div><h3>Case development</h3><p>A systematic assessment was performed using Marjory Gordon’s model of functional health patterns as a reference. After drawing inferences, three collaborative problems and two nursing diagnoses were established with their outcome criteria and interventions. Once the plan was executed, the results obtained highlighted that the interventions were consistent in achieving the objectives set out in the problems present in the case patient.</p></div><div><h3>Conclusions</h3><p>The development of an individualized plan made it possible to detect problems, establish realistic objectives and define interventions that optimized nursing care in this patient with Fournier’s gangrene.</p></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"35 3","pages":"Pages 242-249"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2529984024000120/pdfft?md5=387f9a8f5b8b57e195de845878a6541d&pid=1-s2.0-S2529984024000120-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140069024","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":"Postoperative management and nursing care after implantation of a total artificial heart: Scoping review","authors":"","doi":"10.1016/j.enfie.2023.08.006","DOIUrl":"10.1016/j.enfie.2023.08.006","url":null,"abstract":"<div><h3>Introduction</h3><p>End-stage heart failure (HF) is a condition whose only successful long-term treatment, with a survival of more than 10 years, is heart transplantation. However, limited organ availability and the progressive increase in the number of patients with advanced HF have served as an impetus for the development of implantable mechanical assistive devices.</p></div><div><h3>Aim</h3><p>To provide an overview of postoperative management and nursing care after the implementation of a Total Artificial Heart (TAH).</p></div><div><h3>Methods</h3><p>A scoping review was carried out by consulting the PUBMED, CINAHL, and COCHRANE databases. From all the documents located, information was extracted on the date of publication, country of publication, type of study, and results of interest to answer the research question. In addition, the degree of recommendation was identified.</p></div><div><h3>Results</h3><p>Twenty-three documents were included in the scoping review. Results were classified in relation to: 1) description of the CAT SynCardia®; 2) nursing care in the immediate postoperative period (management of the device and management of hematological, infectious, nephrological, nutritional complications, related to immobilization, sleep-rest disturbances, psychological disorders, and patient and family education); and 3) follow-up at home.</p></div><div><h3>Conclusions</h3><p>The complexity of implantation of the TAH, the multiple related complications that can arise during this process, both in the immediate post-operative and late, require a standardised and multidisciplinary management. The absence of standardised protocols raises the need for future studies to measure the effectiveness of care in patients with TAH. A multidisciplinary approach is crucial. Nurses must acquire autonomy and involvement in decision-making and develop competencies to address the patient's and family's physiological and psychosocial needs.</p></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"35 3","pages":"Pages 213-228"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2529984023000496/pdfft?md5=24355e1eedf3564712245306cb0e8a63&pid=1-s2.0-S2529984023000496-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41159900","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":"49th National Congress of Sociedad Española de Enfermería Intensiva y Unidades Coronarias","authors":"Miguel Ángel Giménez Lajara","doi":"10.1016/j.enfie.2024.07.001","DOIUrl":"10.1016/j.enfie.2024.07.001","url":null,"abstract":"","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"35 3","pages":"Pages 159-160"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141732082","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":"Promotion of self-efficacy in mothers with infants discharged from neonatal intensive care units","authors":"","doi":"10.1016/j.enfie.2023.10.001","DOIUrl":"10.1016/j.enfie.2023.10.001","url":null,"abstract":"<div><h3>Introduction</h3><p>The mothers of newborns who are discharged from a neonatal intensive care unit (NICU) experience stress and anxiety due to the specialized care their child requires at home, affecting their perception of maternal self-efficacy.</p></div><div><h3>Objective</h3><p>To evaluate the effect of the nursing intervention called Hospital Discharge Plan (HDP) on the promotion of self-efficacy in mothers of newborns discharged from the NICU.</p></div><div><h3>Method</h3><p>Quantitative study, quasi-experimental design with pre-test/post-test in a single group, using the Parental Evaluation Scale applied to a convenience sample of 72 mothers of high-risk newborns from a NICU located in the city of Villavicencio (Colombia). The first measurement was taken between days 3 and 4 before discharge and at 15 days’ post-discharge. Data processing was carried out using the statistical program SPSS, version 21. The intervention was based on the four concepts of self-efficacy by Barbara Resnick.</p></div><div><h3>Results</h3><p>The perception of maternal self-efficacy before the intervention showed a median of 8.9 points (RI 7.6–9.5); after the intervention it showed a median of 9.6 points (RI of 10–8.7); a statistically significant p-value &lt; 0.001 was obtained before and after the intervention with the Wilcoxon rank test.</p></div><div><h3>Conclusions</h3><p>Education and follow-up promoted the development of knowledge and skills in mothers for the care of high-risk newborns. This contributed to the experience of mastery and vicarious experience from the teaching-learning process and contact with the experience of other mothers, which contributes to the effective development of motherhood.</p></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"35 3","pages":"Pages 171-177"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138049018","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":"The diary in the intensive care unit: Concept analysis","authors":"","doi":"10.1016/j.enfie.2023.08.010","DOIUrl":"10.1016/j.enfie.2023.08.010","url":null,"abstract":"<div><h3>Introduction</h3><p>Admission to an intensive care unit can cause sequelae to both patients and family members. In some countries, the use of diaries is a preventive action.</p></div><div><h3>Aim</h3><p>This research proposes to critically examine the concept of ‘Intensive Care Unit Diary’ by analysing the current state of the scientific literature to develop a precise conception of this phenomenon in nursing practice, since there are multiple unknowns regarding its use and content.</p></div><div><h3>Method</h3><p>A bibliographic search was carried out in the PubMed, Cochrane Library, Scopus and CINAHL databases in January 2023. The terms used to search for their use and definitions in the databases included Nurse, Concept analysis, Family, Uci Diary, Patient Critical, Intensive Care Unit. We use Wilson’s concept analysis, later developed by Walker and Avant.</p></div><div><h3>Results</h3><p>The concept analysis shows that the ‘ICU Diary’ is a record made in colloquial language by health workers and relatives of the patient admitted to the intensive care unit. Aimed at the patient, with an empathic and reflective style, which offers a narrative of the process, daily life and the conduct or behaviour of the patient during his stay.</p><p>It is a therapeutic tool led by nurses accepted by patients, families and professionals. Its use benefits the recovery process, reducing post-traumatic stress in family members and patients. It favours communication and the bond between nurses, family members and patients, helping to express feelings and emotions.</p></div><div><h3>Conclusions</h3><p>The concept of ‘UCI Diary’ is complex. Through Wilson’s model, a clarification of the concept has been achieved, creating a starting point for more precise research on this phenomenon and its effects on patients, family members, professionals and the health system.</p></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"35 3","pages":"Pages 178-187"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139479708","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":"The advancement of critical care nursing as a response to the current demands","authors":"","doi":"10.1016/j.enfie.2024.01.002","DOIUrl":"10.1016/j.enfie.2024.01.002","url":null,"abstract":"<div><p>The current demand on health services requires that nurses play a key role, by adapting their competencies to different fields and complexity levels. The approach of situations presented by critically ill patients underpins the need for development of specialised competencies in specific areas such as patient safety, prevention and control of healthcare-associated infections, performance of specific techniques and interventions, autonomous medication management or the use of technology, among others. Spain relies on a specialist training programme that is unique worldwide. Training admission is managed through a contract as a “Resident Nurse Intern” (EIR, <em>Enfermera Interna Residente</em>), provided by regional healthcare services. Only 6 specialities have been established and developed, in an uneven manner and with a short provision of places, annually. Given that the specialization in critical care nursing does not exist, nurses usually self-fund their postgraduate training to enhance their opportunities career development. The development of a speciality for critical care nursing is a priority. The models proposed advocate for creating nursing roles that could cover the systemic gaps through the expansion of their competencies and the introduction of procedures that fit nursing into advanced practice, which could be achieved through Advanced Accreditation Diplomas. Simultaneously, it would be convenient to analyse how and why such a dynamic discipline in some countries became stuck in anachronistic models of the Spanish healthcare system. This analysis might contribute to move forward on the development of areas of improvement in terms of service access and quality of care.</p></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"35 3","pages":"Pages e23-e29"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141162964","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":"Intensity of Interprofessional Collaboration and related factors in Intensive Care Units. A descriptive cross-sectional study with an analytical approach","authors":"","doi":"10.1016/j.enfie.2023.10.002","DOIUrl":"10.1016/j.enfie.2023.10.002","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the Intensity of Collaboration between the intensive care professionals of a third level hospital.</p></div><div><h3>Method</h3><p>Descriptive cross-sectional study with an analytical approach. Setting: 6 intensive care units of a third level hospital. Sample: nurses and doctors. Consecutive type non-probabilistic sampling. Data collection: sociodemographic, economic, motivation and professional satisfaction variables, and the intensity of collaboration using the “Scale of Intensity of Interprofessional Collaboration in Health.”</p></div><div><h3>Results</h3><p>A total of 102 health professionals (91 nurses and 11 doctors) were included. The mean overall Intensity of Collaboration (IoC) was moderate. Men showed higher scores in all factors (p<!--> <!-->&lt;<!--> <!-->.05). The IoC global score was higher in the group of professionals with ≤10 years of experience (p<!--> <!-->=<!--> <!-->.043) and those who were highly satisfied with the profession (p<!--> <!-->=<!--> <!-->.037). Physicians presented higher scores in the global IdC (p<!--> <!-->=<!--> <!-->.037) and in the Collaboration mean (p<!--> <!-->=<!--> <!-->.020) independently in the multivariate models. A negative linear relationship (rho: −0,202, p<!--> <!-->=<!--> <!-->.042) was observed between age and the overall IoC score. Professionals aged ≤30<!--> <!-->years reported a higher perception of Shared Activities (p<!--> <!-->=<!--> <!-->.031). Negative linear relationships were observed between years of experience and total IoC score (rho: −0,202, p<!--> <!-->=<!--> <!-->.042) and patients' Perception score (rho: −0.241, p<!--> <!-->=<!--> <!-->0.015). The research activity also showed to be a variable related to a greater degree of Collaboration at a global level and in some of the factors (p<!--> <!-->&lt;<!--> <!-->.05). The scale of IoC obtained a Cronbach’s α of 0,9.</p></div><div><h3>Conclusions</h3><p>The intensity of interprofessional collaboration in ICUs is moderate. Professionals with experience of ≤10 years, a higher level of satisfaction and participation in research activities show a greater intensity of collaboration. Doctors perceive collaboration more intensely than nurses. All factors contribute equally to the internal consistency of the questionnaire.</p></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"35 3","pages":"Pages 188-200"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141473881","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}