Quantifying Occupational Stress in Intensive Care Unit Nurses: An Applied Naturalistic Study of Correlations Among Stress, Heart Rate, Electrodermal Activity, and Skin Temperature

2021 ◽  
pp. 001872082110408
Author(s):  
Nima Ahmadi ◽  
Farzan Sasangohar ◽  
Tariq Nisar ◽  
Valerie Danesh ◽  
Ethan Larsen ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Heart Rate ◽  
Intensive Care ◽  
Skin Temperature ◽  
Electrodermal Activity ◽  
Laboratory Research ◽  
Prior Literature ◽  
High Level ◽  
Intensive Care Unit Nurses ◽  
Skin Temperatures

Objective To identify physiological correlates to stress in intensive care unit nurses. Background Most research on stress correlates are done in laboratory environments; naturalistic investigation of stress remains a general gap. Method Electrodermal activity, heart rate, and skin temperatures were recorded continuously for 12-hr nursing shifts (23 participants) using a wrist-worn wearable technology (Empatica E4). Results Positive correlations included stress and heart rate (ρ = .35, p < .001), stress and skin temperature (ρ = .49, p < .05), and heart rate and skin temperatures (ρ = .54, p = .0008). Discussion The presence and direction of some correlations found in this study differ from those anticipated from prior literature, illustrating the importance of complementing laboratory research with naturalistic studies. Further work is warranted to recognize nursing activities associated with a high level of stress and the underlying reasons associated with changes in physiological responses. Application Heart rate and skin temperature may be used for real-time detection of stress, but more work is needed to validate such surrogate measures.

Answering the Call: Impact of Tele-ICU Nurses During the COVID-19 Pandemic

2020 ◽  
Vol 40 (4) ◽  
pp. 25-31 ◽  
Author(s):  
Sandy L. Arneson ◽  
Sara J. Tucker ◽  
Marie Mercier ◽  
Jaspal Singh
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Holistic Approach ◽  
Critical Care Units ◽  
Work From Home ◽  
New Strategy ◽  
High Level ◽  
Intensive Care Unit Nurses

Background The coronavirus disease 2019 pandemic has exacerbated staffing challenges already facing critical care nurses in intensive care units. Many intensive care units have been understaffed and the majority of nurses working in these units have little experience. Objective To describe how the skilled tele–intensive care unit nurses in our health system quickly changed from a patient-focused strategy to a clinician-focused approach during the coronavirus disease 2019 crisis. Methods We modified workflows, deployed home workstations, and changed staffing models with the goal of providing additional clinical support to bedside colleagues while reducing exposure time and conserving personal protective equipment for those caring for this highly contagious patient population. The unit changed focus and granted more than 300 clinicians access to technology that enabled them to care for patients remotely, added nearly 200 mobile carts, and allowed more than 20 tele–intensive care unit nurses to work from home. Results Tele–intensive care unit nursing provided clinical knowledge to the nurses covering current and expanded critical care units. Using technology, virtual rounding, and increased collaboration with nurses, tele–intensive care unit nursing minimized the risk to bedside nurses while maintaining a high level of care for patients. Conclusion Tele–intensive care unit nurses provided a proactive, holistic approach to caring for critically ill patients via camera as part of their routine workflow. In addition, during the coronavirus disease 2019 pandemic, these nurses created a new strategy in virtual health care to be implemented during a crisis.

scholarly journals Comparison of Heart Rate Variability between Shift and Rest Days in Nurses Working at Coronary Intensive Care Unit

Acta Medica ◽  
2021 ◽  
pp. 1-7
Author(s):  
Mehmet Ozgeyik ◽  
Taner Sen ◽  
Mehmet Ali Astarcioglu ◽  
Mufide Okay ◽  
Abdulkadir Uslu
Keyword(s):  
Intensive Care Unit ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Intensive Care ◽  
Circadian Rhythm ◽  
High Frequency ◽  
Low Frequency ◽  
Significant Difference ◽  
Intensive Care Unit Nurses ◽  
Cortisol Release

Objective: Stress of working conditions change the circadian rhythm and body’s autonomic functions. Heart rate variability is a simple and noninvasive method that reflects the heart’s autonomic system. In this study, we analyzed the rhythm differences of intensive care unit nurses between 24 hours shift and rest days. Materials and Methods: 51 nurses working in intensive care units of our center were included in the study. The nurses were divided into two groups as study and control groups according to the shift and rest days for 24 hours holter recordings, respectively. Results: Heart rate parameters were under parasympathic and sympathic dominance in rest and shift days, respectively. Although normalized high frequency, normalized low frequency and low frequency/high frequency ratio values were parallel to the shift and rest days at 24-hour intervals, inverse correlations were observed between 03.00- 08.00 hours. No statistically significant difference was seen in circadian rhythm between shift and rest days. Heart rate parameters generally showed similar pattern of circadian rhythm irrespective of the working status of the participants. Sympathetic activity was significantly higher in the day period than the night period in the shift days however there was no difference within resting group. Conclusion: Slight increase in sympathetic system activity and marked decrease in parasympathetic activity during 03-05 o’clock were apparent in shift days. This increase was attributed to early cortisol release.

scholarly journals Intensive Care Unit Nurses' Uncertainty and Patient Safety Culture

2017 ◽  
Vol 3 (1) ◽  
pp. 110
Author(s):  
Safaa M. El-Demerdash ◽  
Heba K. Obied
Keyword(s):  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Safety Culture ◽  
Negative Correlation ◽  
Patient Safety Culture ◽  
Significant Negative Correlation ◽  
Team Work ◽  
High Level ◽  
Intensive Care Unit Nurses

Intensive care unit (ICU) nurses face many uncertain situations that may affect their patient care decisions and jeopardize patients’ safety.Aim: This study aimed to explore the relationship between uncertainty and patient safety culture among intensive care unit nurses at Tanta Main University Hospital.Study subject: included (155) nurses worked in intensive care units at Tanta University Main Hospital. Two tools were used Tool (I): Nurses’ Uncertainty Questionnaire. Tool (II): Patient Safety Culture Questionnaire.Results: 74.2% of participant ICU nurses’ experienced high levels of uncertainty. Above half (56.1% and 56.1%) of them always experienced being uncomfortable and confused& loss of control when facing uncertain situations in ICUs. 84.5% and 76.8% of them always used team work; and learn from past experience to deal with uncertainty. 47.1% of them evaluated patient safety in their ICUs as acceptable and bad. There was a high statistical negative correlation between the levels of patient safety culture and experiencing uncertainty by ICU nurses at p= 0.000.Conclusions: ICU nurses experienced high level of uncertainty; they rely on experience and teamwork rather than evidence-based practices to manage clinical uncertainty. High statistical significant negative correlation was found between patient safety culture and experiencing uncertainty by ICU nurses.

scholarly journals Characterisation of Textile Embedded Electrodes for Use in a Neonatal Smart Mattress Electrocardiography System

Sensors ◽  
2021 ◽  
Vol 21 (3) ◽  
pp. 999
Author(s):  
Henry Dore ◽  
Rodrigo Aviles-Espinosa ◽  
Zhenhua Luo ◽  
Oana Anton ◽  
Heike Rabe ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Heart Rate ◽  
Intensive Care ◽  
High Resolution ◽  
Neonatal Intensive Care Unit ◽  
Real Time ◽  
Neonatal Intensive Care ◽  
Delivery Room ◽  
Proof Of Concept ◽  
Heart Rate Monitoring

Heart rate monitoring is the predominant quantitative health indicator of a newborn in the delivery room. A rapid and accurate heart rate measurement is vital during the first minutes after birth. Clinical recommendations suggest that electrocardiogram (ECG) monitoring should be widely adopted in the neonatal intensive care unit to reduce infant mortality and improve long term health outcomes in births that require intervention. Novel non-contact electrocardiogram sensors can reduce the time from birth to heart rate reading as well as providing unobtrusive and continuous monitoring during intervention. In this work we report the design and development of a solution to provide high resolution, real time electrocardiogram data to the clinicians within the delivery room using non-contact electric potential sensors embedded in a neonatal intensive care unit mattress. A real-time high-resolution electrocardiogram acquisition solution based on a low power embedded system was developed and textile embedded electrodes were fabricated and characterised. Proof of concept tests were carried out on simulated and human cardiac signals, producing electrocardiograms suitable for the calculation of heart rate having an accuracy within ±1 beat per minute using a test ECG signal, ECG recordings from a human volunteer with a correlation coefficient of ~ 87% proved accurate beat to beat morphology reproduction of the waveform without morphological alterations and a time from application to heart rate display below 6 s. This provides evidence that flexible non-contact textile-based electrodes can be embedded in wearable devices for assisting births through heart rate monitoring and serves as a proof of concept for a complete neonate electrocardiogram monitoring system.

The (Absence of a) Role of Venous Duplex Scan in the Diagnosis of Pulmonary Embolism after Severe Trauma

2006 ◽  
Vol 72 (1) ◽  
pp. 7-10
Author(s):  
George C. Velmahos ◽  
Carlos V. Brown ◽  
Demetrios Demetriades
Keyword(s):  
Intensive Care Unit ◽  
Pulmonary Embolism ◽  
Intensive Care ◽  
Sensitivity And Specificity ◽  
Clinical Suspicion ◽  
Severely Injured ◽  
Duplex Scan ◽  
Severely Injured Patients ◽  
High Level ◽  
Injured Patients

Venous duplex scan (VDS) has been used for interim bedside diagnosis of pulmonary embolism (PE) in severely injured patients deemed to be at risk if transported out of the intensive care unit. In combination with the level of clinical suspicion for PE, VDS helps select patients for temporary treatment until definitive diagnosis is made. We evaluate the sensitivity and specificity of VDS in critically injured patients with a high level of clinical suspicion for PE. We performed a prospective observational cohort study at the surgical intensive care unit of an academic level 1 trauma center. Patients were 59 critically injured patients suspected to have PE over a 30-month period. The level of clinical suspicion for PE was classified as low or high according to preset criteria. Interventions were VDS and a PE outcome test (conventional or computed tomographic pulmonary angiography). The sensitivity and specificity of VDS to detect PE in all patients and in patients with high level of clinical suspicion was calculated against the results of the outcome test. PE was diagnosed in 21 patients (35.5%). The sensitivity and specificity of VDS was 33 per cent and 89 per cent, respectively. Among the 28 patients who had a high level of clinical suspicion for PE, the sensitivity of VDS was 23 per cent and the specificity 93 per cent. In this latter population, 1 of the 4 (25%) positive VDS was of a patient without PE and 10 of the 24 (42%) negative VDS were of patients who had PE. VDS does not accurately predict PE in severely injured patients, even in the presence of a high level of clinical suspicion.

Experiences of intensive care unit nurses with COVID-19 patients

2021 ◽  
Vol 55 ◽  
Author(s):  
Claudete Aparecida Conz ◽  
Vanessa Augusta Souza Braga ◽  
Rosianne Vasconcelos ◽  
Flávia Helena Ribeiro da Silva Machado ◽  
Maria Cristina Pinto de Jesus ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Physical Space ◽  
Physical And Mental Health ◽  
Public And Private ◽  
Professional Recognition ◽  
Public And Private Hospitals ◽  
Training And Support ◽  
Continuous Use ◽  
Intensive Care Unit Nurses

ABSTRACT Objective: To understand the experiences of intensive care unit nurses who provide care to patients with COVID-19. Methods: Qualitative study grounded in Alfred Schütz’s social phenomenology in which 20 nurses who work in intensive care units at public and private hospitals were interviewed between July and September 2020. Data were analyzed according to the adopted theoretical-methodological framework and the literature related to the subject. Results: The interviewed nurses mentioned demands about working conditions, professional recognition and training, and support to physical and mental health, which proved necessary considering the care intensity experienced by these professionals during the COVID-19 pandemic. Conclusion: Learning the nurses’ experiences evidenced the need to adjust to a new way of providing care that included the physical space, new institutional protocols, continuous use of protective equipment, and patients’ demand for special care. This originated the necessity to be around situations that interfered with their health and motivated them to carry out professional projects after the COVID-19 pandemic.

Magnitude of Low Back Pain and Associated Factors Among Nurses Working at Intensive Care Unit in Amhara Region Public Hospitals, Ethiopia  

2021 ◽  
Author(s):  
Bitew Tefera ◽  
Haymanot Zeleke ◽  
Abebe Abate ◽  
Haimanot Abebe ◽  
Zebene Mekonnen ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Low Back Pain ◽  
Back Pain ◽  
Public Hospitals ◽  
Assistive Device ◽  
Low Back ◽  
Amhara Region ◽  
Patient Handling ◽  
Intensive Care Unit Nurses

Abstract Background Low back pain is a common public health problem throughout the world with the global prevalence from 28–86%. Nurses working in intensive care units are handling people who are critically ill and helpless, which requires more assistance for transferring and handling activities. This possesses a risk for low back pain but little is known about it in Ethiopia. The aim of this study was to assess the magnitude of low back pain and associated factors among nurses who work at an intensive care units in Amhara region public hospitals, North Ethiopia. Methods A multi-centered institution-based cross-sectional study was conducted at Amhara region public hospitals from March 1–30/2020. Simple random sampling technique after proportional allocation was used to select the study participants. Data were collected using a standard modified Nordic musculoskeletal assessment tool. After data were checked for completeness and consistency, it was entered into Epidata version 3.1 and exported to Statistical Package for Social Science software version 26 for analysis. Descriptive statistics were computed. A binary logistic regression model was used to identify factors associated with low back pain. Finally, those variables with a p-value of < 0.05 in multivariable analysis were considered statistically significant. Result -The study was conducted among 412 intensive care unit nurses giving a response rate of 97.6%. The magnitude of low back pain was 313 (76 %) [95% CI: (71.6%-79.9%)]. Being female [AOR = 2.674 (1.404, 5.076)], unavailability of assistive device for patient handling [AOR = 2.139 (1.035, 4.410)], lack of training on intensive care [AOR = 2.017 (1.092 ,3.943)], lack of regular exercise [AOR = 2.164 (1.164 ,4.108)] and job stress [AOR = 3.66 (1.955, 6.498)] were factors significantly associated with low back pain. Conclusions In this study the magnitude of low back pain was high. Being female, unavailability of assistive device for patient handling, lack of training on intensive care, lack of regular exercise and job stress were factors associated with low back pain. Policy makers and concerned bodies should give emphasis on accessability of assistive devices for patient care, provision of training on intensive care and adaptive working environment for intensive care unit nurses.

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