scholarly journals Healthcare professionals in COVID-19-intensive care units in Norway: preparedness and working conditions: a cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e049135
Author(s):  
Irene Lie ◽  
Siv Stafseth ◽  
Laila Skogstad ◽  
Ingvild Strand Hovland ◽  
Haakon Hovde ◽  
...  
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Working Conditions ◽  
Work Experience ◽  
Healthcare Professionals ◽  
Team Training ◽  
Multivariate Logistic Model ◽  
Registration Number ◽  
High Degree

ObjectiveTo survey the healthcare professionals’ background and experiences from work with patients with COVID-19 in intensive care units (ICUs) during the first wave of the COVID-19 pandemic in Norway.DesignObservational cohort study.SettingCOVID-ICUs in 27 hospitals across Norway.ParticipantsHealthcare professionals (n=484): nurses (81%), medical doctors (9%) and leaders (10%), who responded to a secured, web-based questionnaire from 6 May 2020 to 15 July 2020.Primary and secondary measuresHealthcare professionals’: (1) professional and psychological preparedness to start working in COVID-ICUs, (2) factors associated with high degree of preparedness and (3) experience of working conditions.ResultsThe age of the respondents was 44.8±10 year (mean±SD), 78% were females, 92% had previous ICU working experience. A majority of the respondents reported professional (81%) and psychological (74%) preparedness for working in COVID-ICU. Factors significantly associated with high professional preparedness for working in COVID-19-ICU in a multivariate logistic model were previous ICU work experience (p<0.001) and participation in COVID-ICU simulation team training (p<0.001). High psychological preparedness was associated with higher age (p=0.003), living with spouse or partner (p=0.013), previous ICU work experience (p=0.042) and participation in COVID-ICU simulation team training (p=0.001). Working with new colleagues and new professional challenges were perceived as positive in a majority of the respondents, whereas 84% felt communication with coworkers to be challenging, 46% were afraid of being infected and 82% felt discomfort in denying access for patient relatives to the unit. Symptoms of sweating, tiredness, dehydration, headache, hunger, insecurity, mask irritation and delayed toilet visits were each reported by more than 50%.ConclusionsHealthcare professionals working during the first wave of COVID-ICU patients in Norway were qualified and prepared, but challenges and potential targets for future improvements were present.Trial registration numberNCT04372056.

scholarly journals Road to healthcare professional’s burnout: poor empathy and impaired work ability, are they cause or effect?

2019 ◽  
Author(s):  
Alija Sadiković ◽  
Azra Kurtić ◽  
Olivera Sadiković ◽  
Maida Mulić ◽  
Amela Džubur- Alić ◽  
...  
Keyword(s):  
Intensive Care ◽  
Occupational Stress ◽  
Intensive Care Units ◽  
Working Conditions ◽  
Work Ability ◽  
Healthcare Professionals ◽  
Working Environment ◽  
Research Groups ◽  
Working Capacity ◽  
Clinical Departments

Introduction: Occupational stress is inevitable, but prolonged and intense can lead to serious health problems. Neglecting this significant aspect of work and inadequate treatment of the first indicators results in the reduced working capacity of healthcare professionals. Material and methods: Assessing working conditions of 100 healthcare professionals regarding stress impact on empathy and workability was the primary goal of this study. A survey was conducted to identify differences between work in intensive care units and other clinical departments all related to empathy, workability, and stress perceiving to determine what is a better predictor of workability. Results: In the research group “intensive care units”, significantly lower empathy quotients, poorer workability, and different stressors were registered compared to research groups named “other departments”. Conclusion: The main conclusion of the study states different dynamics in the working environment of intensive care units compared to other departments that could potentially harm the personal capacity of healthcare professionals. 

scholarly journals Nurses’ knowledge of the medication management at intensive care units

2018 ◽  
Vol 17 (1) ◽  
pp. 18-23
Author(s):  
Jana Heczková ◽  
Alan Bulava
Keyword(s):  
Intensive Care ◽  
Nursing Education ◽  
Intensive Care Units ◽  
Work Experience ◽  
Healthcare Professionals ◽  
Medication Management ◽  
Medical Doctor ◽  
Point Of View ◽  
Medicine Management ◽  
Additional Qualification

Abstract Introduction. The medicine management is considered an important area of health care, which is ensured by various healthcare professionals including nurses. Nurses gain the competence of medicines administration immediately after graduation. This competence can be applied to any area of healthcare. Even in specialized settings such as intensive care units, any additional qualification e.g. specialized education is not required. On the contrary, appropriate education is considered an important factor that could help to reduce the risk of adverse events related to medication management. Aim. The aim of this study was to analyse the students’ knowledge in this field at the end of nursing studies at bachelor level (n = 67) and specialized intensive care nursing studies at master level (n = 42). Methodology. Knowledge was assessed using a written test, which was related to the management of medicinal products administered commonly at intensive care units by qualified nurses as well as nurse specialists without distinction. From the point of view of the formal competencies of healthcare professionals, the questions were divided into three categories. Results. The mean success rate on the test was 53.4%. The highest range of knowledge was demonstrated by already qualified students at the end of specialised studies with prior work experience in ICU, the lowest by students just before graduation. The highest rating was achieved by all students in the activity-oriented category for which the responsibility lies primarily with the medical doctor, but nurses were expected to have this knowledge and participate at related activities on the basis of a physician’s order. This knowledge included also the area of clinical pharmacology. On the other hand, the lowest score was achieved by all groups of students in the category of activities that are not treated by the physician’s order, and the use of diverse knowledge from different areas was usually necessary. Conclusions. Clinical practice has an irreplaceable role for nurses in the process of qualifying education as well as lifelong learning. The extent of nursing education in medicine management, the manner of nursing training, as well as the proportion of nursing specialists in the nursing team at specialised workplaces, deserves much greater attention in terms of ensuring safe care in this area. Shifting some competencies and duties in medicine management, especially related to intravenous (IV) therapy, to less qualified healthcare professionals appears to be highly controversial and risky.

Variation in antibiotic use across intensive care units (ICU): A population-based cohort study in Ontario, Canada

2020 ◽  
Vol 41 (9) ◽  
pp. 1035-1041
Author(s):  
Erika Y. Lee ◽  
Michael E. Detsky ◽  
Jin Ma ◽  
Chaim M. Bell ◽  
Andrew M. Morris
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Ventilatory Support ◽  
Severity Of Illness ◽  
Antibiotic Use ◽  
Patient Factors ◽  
Days Of Therapy ◽  
Level 3 ◽  
Level 2

AbstractObjectives:Antibiotics are commonly used in intensive care units (ICUs), yet differences in antibiotic use across ICUs are unknown. Herein, we studied antibiotic use across ICUs and examined factors that contributed to variation.Methods:We conducted a retrospective cohort study using data from Ontario’s Critical Care Information System (CCIS), which included 201 adult ICUs and 2,013,397 patient days from January 2012 to June 2016. Antibiotic use was measured in days of therapy (DOT) per 1,000 patient days. ICU factors included ability to provide ventilator support (level 3) or not (level 2), ICU type (medical-surgical or other), and academic status. Patient factors included severity of illness using multiple-organ dysfunction score (MODS), ventilatory support, and central venous catheter (CVC) use. We analyzed the effect of these factors on variation in antibiotic use.Results:Overall, 269,351 patients (56%) received antibiotics during their ICU stay. The mean antibiotic use was 624 (range 3–1460) DOT per 1,000 patient days. Antibiotic use was significantly higher in medical-surgical ICUs compared to other ICUs (697 vs 410 DOT per 1,000 patient days; P < .0001) and in level 3 ICUs compared to level 2 ICUs (751 vs 513 DOT per 1,000 patient days; P < .0001). Higher antibiotic use was associated with higher severity of illness and intensity of treatment. ICU and patient factors explained 47% of the variation in antibiotic use across ICUs.Conclusions:Antibiotic use varies widely across ICUs, which is partially associated with ICUs and patient characteristics. These differences highlight the importance of antimicrobial stewardship to ensure appropriate use of antibiotics in ICU patients.

scholarly journals Influenza in patients with respiratory failure admitted to intensive care units in Poland and the use of extracorporeal respiratory support: a survey-based multicenter study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jakub Smiechowicz ◽  
Barbara Barteczko-Grajek ◽  
Barbara Adamik ◽  
Jozef Bojko ◽  
Waldemar Gozdzik ◽  
...  
Keyword(s):  
Intensive Care ◽  
Respiratory Failure ◽  
Organ Failure ◽  
Intensive Care Units ◽  
Sofa Score ◽  
Influenza Infection ◽  
Winter Season ◽  
Respiratory Support ◽  
Costly Treatment ◽  
High Degree

Abstract Background In Poland, little is known about the most serious cases of influenza that need admittance to the intensive care unit (ICU), as well as the use of extracorporeal respiratory support. Methods This was an electronic survey comprising ICUs in two administrative regions of Poland. The aim of the study was to determine the number of influenza patients with respiratory failure admitted to the ICU in the autumn–winter season of 2018/2019. Furthermore, respiratory support, outcome and other pathogens detected in the airways were investigated. Results Influenza infection was confirmed in 76 patients. The A(H1N1)pdm09 strain was the most common. 34 patients died (44.7%). The median age was 62 years, the median sequential organ failure assessment (SOFA) score was 11 and was higher in patients who died (12 vs. 10, p = 0.017). Mechanical ventilation was used in 75 patients and high flow nasal oxygen therapy in 1 patient. Extracorporeal membrane oxygenation (ECMO) was used in 7 patients (6 survived), and extracorporeal carbon dioxide removal (ECCO2R) in 2 (1 survived). The prone position was used in 16 patients. In addition, other pathogens were detected in the airways on admittance to the ICU. Conclusion A substantial number of influenza infections occurred in the autumn–winter season of 2018/2019 that required costly treatment in the intensive care units. Upon admission to the ICU, influenza patients had a high degree of organ failure as assessed by the SOFA score, and the mortality rate was 44.7%. Advanced extracorporeal respiratory techniques offer real survival opportunities to patients with severe influenza-related ARDS. The presence of coinfection should be considered in patients with influenza and respiratory failure.

Moral distress among healthcare professionals working in intensive care units in Spain

2021 ◽  
Author(s):  
E. Rodriguez-Ruiz ◽  
M. Campelo-Izquierdo ◽  
P.B. Veiras ◽  
M.M. Rodríguez ◽  
A. Estany-Gestal ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Healthcare Professionals ◽  
Moral Distress
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