New visiting policy: A step toward nursing ethics

2017 ◽  
Vol 26 (1) ◽  
pp. 293-306
Author(s):  
Shiva Khaleghparast ◽  
Soodabeh Joolaee ◽  
Majid Maleki ◽  
Hamid Peyrovi ◽  
Behrooz Ghanbari ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
P Value ◽  
Structured Interviews ◽  
Ethical Considerations ◽  
Advantages And Disadvantages ◽  
Significant Difference ◽  
Before And After ◽  
Hospital Ethics ◽  
Visiting Policy

Background: Patients’ rights arise from their expectations of the healthcare system, which are rooted in their needs. Visitation is seen as a necessary need for patients and families in intensive care units. Objectives: The authors attempted to design, implement, and evaluate a new visiting policy in the intensive care units. Research design: This study was an action research, including two qualitative and quantitative approaches. Participants and research context: The viewpoints of 51 participants (patients, families, doctors, nurses, and guards) on how to change the limited visiting policy were explained through semi-structured interviews and focus groups. The new visiting policy (contractual visitation) was designed, implemented, and evaluated with the involvement of participants. Ethical considerations: The hospital ethics committee approval was gained and the informed consent was obtained from all the participants. Findings: The content of interviews was analyzed and classified into four categories: advantages and disadvantages of visiting policies, and barriers and facilitators of changing the limited visiting policy. After implementation of the new policy (contractual visitation), a significant difference observed in satisfaction status before and after the changes (p value < 0.001). Discussion: Nowadays, many countries’ clinical guidelines recommend flexible visiting policy, which is consistent with the results of this study. Conclusion: Changing the limited visiting policy was a necessary need for patients and families that established with the involvement of them and staff.

scholarly journals 2312. Mortality of Severe Dengue Patients Admitted to Intensive Care Units over 15 Years: Have We Improved?

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S792-S792
Author(s):  
Fernando Rosso ◽  
Luis Gabriel Parra-Lara ◽  
Ana M Sanz ◽  
Gustavo A Ospina-Tascon ◽  
Marcela Granados
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Healthcare Management ◽  
Severe Dengue ◽  
Early Admission ◽  
Early Access ◽  
Monitoring Strategies ◽  
Significant Difference ◽  
Before And After ◽  
Over Time

Abstract Background Dengue mortality can be preventable in endemic regions. However, access to intensive care units (ICU) and continuous monitoring strategies are limited in developing countries. In 2010, WHO dengue clinical practice guidelines (CPG) were implemented in the Americas region which strengthened hospital healthcare management and prioritized early ICU admission in severe dengue cases. We hypothesized that early access to the ICU might decrease the mortality of patients with dengue. This study aimed to describe trends in dengue cases and mortality in the ICU for 15 years in Cali, Colombia. Methods An observational retrospective study about dengue cases treated in adult ICU was conducted, in the Fundación Valle del Lili. We included cases between 2001 to 2015 years. Clinical data were collected from the ICU database and medical charts. A Cochran-Armitage test for trend was used to assess the presence of an association between fatal cases and total cases in dengue patients at ICU during the study period, and to evaluate differences in the mortality cases before and after the implementation of the dengue CPG. Results A total of 49,962 episodes of attention in ICU were analyzed, and 70 cases with severe dengue and dengue shock attended in ICU were included. The median age was 42 years (IQR = 24–60), eight cases were older than 65 years, and 54% were male. Five fatal cases were reported during this period. The fatal cases had a length of stay in ICU of 2 days (IQR = 1–4) vs. 2 days (IQR = 1–3) for nonfatal cases. Overall mortality for dengue cases in the ICU was 7.14%. The highest mortality was presented in 2007 with 33.33% (1/3), and after 2010 there were no fatal cases. Dengue mortality showed a decreasing linear variation over time in the ICU (p = 0.047); also there was a statistically significant difference over time in adults mortality before and after of implementation of dengue CPG (P = 0.029). Conclusion Dengue mortality cases in the ICU have decreased in the last 15 years, which is related to early admission to the ICU and continuous clinical monitoring. Disclosures All authors: No reported disclosures.

scholarly journals Virtual Reality Hypnosis for Anxiety and Pain Management in Intensive Care Units. A Prospective Randomized Trial Among Cardiac Surgery Patients.

2020 ◽  
Author(s):  
Floriane Marie Rousseaux ◽  
Nadia Dardenne ◽  
Paul B Massion ◽  
Didier Ledoux ◽  
Marie-Elisabeth Faymonville ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Intensive Care Units ◽  
University Hospital ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Significant Difference ◽  
Before And After ◽  
French Speaking

Abstract Background: Although non-pharmacological tools are nowadays commonly used in medical settings, virtual reality and hypnosis are little studied in complex contexts such as intensive care, where patients need significant physical and psychological assistance. The aim of the project is to evaluate the benefits of hypnosis, virtual reality (VR) and the combination of hypnosis and virtual reality (VRH) on anxiety and pain on patients before and after a cardiac surgery.Methods: This prospective randomized and controlled clinical trial was conducted in the University Hospital of Liege (Belgium). Participants are adults undergoing cardiac surgery, French speaking. Exclusion criteria are patients with psychiatric diseases, claustrophobia, acrophobia, heavy hearing impairment, visual impairment, extreme fatigue, verbal incoherence, surgery cancelled or postponed. The day before the surgery, patients were randomly assigned to four arms (control, hypnosis, VR and VRH) and had 20 minutes of one of the technique. They received the same intervention one day after surgery, in intensive care units. Anxiety, pain, fatigue, relaxation and physiological parameters were evaluated before and after each session.Results: 100 patients (66.38 ± 11.48 years; 76 men, 24 women) were included. Results showed that anxiety decreased from baseline to postoperative day in all groups. Relaxation increased in all groups in preoperative (p = .000) and postoperative period (p = 0.03). There were no significant results for pain and fatigue (p > 0.05). There was no significant difference between control group and hypnosis, VR or VRH.Conclusion: Anxiety decreased and relaxation increased in all groups, including control group. We cannot affirm that one technique is better than another is. Nevertheless, this study helps to expand the knowledge regarding application of virtual reality, hypnosis and virtual reality hypnosis in the specific contexts of cardiac surgery and intensive care units. Additional studies are required to compare and evaluate the costs-effectiveness of these techniques for critical care patients and caregivers (see Figure 1).Trial registration: ClinicalTrials.gov: NCT03820700. https://clinicaltrials.gov/ct2/show/NCT03820700. Registered on January 29 2019. Retrospectively registered.

scholarly journals Incidence of Central Venous Catheter-Related Bloodstream Infections: Evaluation of Bundle Prevention in Two Intensive Care Units in Central Brazil

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Thais Yoshida ◽  
Ana Elisa Bauer de Camargo Silva ◽  
Luciana Leite Pineli Simões ◽  
Rafael Alves Guimarães
Keyword(s):  
Intensive Care ◽  
Central Venous Catheter ◽  
Intensive Care Units ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Incidence Density ◽  
P Value ◽  
Central Venous ◽  
Central Brazil ◽  
Before And After

Background. Central venous catheter-associated bloodstream infections (CVC-BSIs) have been associated with increased length of hospital stay, mortality, and healthcare costs, especially in intensive care units (ICUs). The aim of this study was to evaluate the incidence density of CVC-BSIs before and after implementation of the bundle in a hospital of infectious and dermatological diseases in Central Brazil. Methods. A retrospective cohort study was conducted in two ICUs (adult and pediatric) between 2012 and 2015. Two periods were compared to assess the effect of the intervention in incidence density of CVC-BSIs: before and after intervention, related to the stages before and after the implementation of the bundle, respectively. Results. No significant reduction was observed in the incidence density of CVC-BSIs in adult ICU (incidence rate ratio [IRR]: 0.754; 95.0% CI: 0.349 to 1.621; p-value = 0.469), despite the high bundle application rate in the postintervention period. Similarly, significant reduction in the incidence density in pediatric ICU has not been verified after implementation of the bundle (IRR: 1.148; 95.0% CI: 0.314 to 4.193; p-value = 0.834). Conclusion. Not significant reduction in the incidence density of CVC-BSIs was observed after bundle implementation in ICUs, suggesting the need to review the use of process, as well as continuing education for staffs in compliance and correct application of the bundle. Further studies are needed to evaluate the effect of bundle in the reduction of incidence density of CVC-BSIs in Brazil.

scholarly journals Sources of stress in high performance healthcare organization: A study comparing intensive care and general ward nurses

2020 ◽  
Vol 3 (1) ◽  
pp. 3-9
Author(s):  
Tamoor Gill ◽  
Gideon Victor ◽  
Raisa Kousar ◽  
Noman Iqbal
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
High Performance ◽  
General Ward ◽  
Working Environment ◽  
P Value ◽  
Care Organization ◽  
Workplace Stressors ◽  
Ward Nurse ◽  
Significant Difference

Objective: To compare stressors of nurses working in intensive care units and general wards of a high-performance health care organization. Methodology: A comparative cross-sectional survey was conducted. Using stratified random sampling, 121 intensive care and 121 general ward nurses, cumulatively 242 were offered to participate in the study. IRB and EC approvals were obtained. A self-administered questionnaire with structured responses was used for data collection. The data were analyzed for descriptive and inferential statistics in SPSS 23. Results: The study participants were predominantly 152(62.8%) female; 182(75.2%) having diploma in nursing and 169(69.8%) RN-I; 38(31.4%) intensive care and 35(28.9%) general ward nurse who were performing 12-hours shift duty; 50(41.3%) intensive care and 65(51.2%) general ward nurses were dissatisfied with their salary. The average patients assigned to intensive care nurse were two and six to a general ward nurse. Independent t-test and ANOVA revealed significant difference of stressors in intensive versus general ward nurses, gender, working hours, satisfaction with salary, professional qualification, experience and shift work (P-Value <0.05). Common stressors were unclear demands, pressured to work long hours, not having control at workplace and being not able to talk to line managers about something that has upset or annoyed them at workplace. Conclusion: The general ward nurses face more stressors than intensive care units’ nurses. Workplace stressors could compromise healthy working environment and patient safety whereas favorable environment could increase job satisfaction, staff productivity, and quality of care. Workplace-oriented stress management strategies must be adopted.

scholarly journals Detection of SARS-CoV-2 and Other Infectious Agents in Lower Respiratory Tract Samples Belonging to Patients Admitted to Intensive Care Units of a Tertiary-Care Hospital, Located in an Epidemic Area, during the Italian Lockdown

2021 ◽  
Vol 9 (1) ◽  
pp. 185
Author(s):  
Adriana Calderaro ◽  
Mirko Buttrini ◽  
Sara Montecchini ◽  
Giovanna Piccolo ◽  
Monica Martinelli ◽  
...  
Keyword(s):  
Intensive Care ◽  
Respiratory Tract ◽  
Intensive Care Units ◽  
Lower Respiratory Tract ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Infectious Agents ◽  
Epidemic Area ◽  
Significant Difference

The aim of this study was the detection of infectious agents from lower respiratory tract (LRT) samples in order to describe their distribution in patients with severe acute respiratory failure and hospitalized in intensive care units (ICU) in an Italian tertiary-care hospital. LRT samples from 154 patients admitted to ICU from 27 February to 10 May 2020 were prospectively examined for respiratory viruses, including SARS-CoV-2, bacteria and/or fungi. SARS-CoV-2 was revealed in 90 patients (58.4%, 72 males, mean age 65 years). No significant difference was observed between SARS-CoV-2 positives and SARS-CoV-2 negatives with regard to sex, age and bacterial and/or fungal infections. Nonetheless, fungi were more frequently detected among SARS-CoV-2 positives (44/54, 81.4%, p = 0.0053). Candida albicans was the overall most frequently isolated agent, followed by Enterococcus faecalis among SARS-CoV-2 positives and Staphylococcus aureus among SARS-CoV-2 negatives. Overall mortality rate was 40.4%, accounting for 53 deaths: 37 among SARS-CoV-2 positives (mean age 69 years) and 16 among SARS-CoV-2 negatives (mean age 63 years). This study highlights the different patterns of infectious agents between the two patient categories: fungi were prevalently involved among SARS-CoV-2-positive patients and bacteria among the SARS-CoV-2-negative patients. The different therapies and the length of the ICU stay could have influenced these different patterns of infectious agents.

scholarly journals Experiences of Patients With COVID-19 Admitted to the Intensive Care Units: A Qualitative Study

2021 ◽  
Vol 8 ◽  
pp. 237437352110073
Author(s):  
Reza Norouzadeh ◽  
Mohammad Abbasinia ◽  
Zahra Tayebi ◽  
Ehsan Sharifipour ◽  
Alireza Koohpaei ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Health Care Providers ◽  
Spiritual Support ◽  
Care Providers ◽  
Structured Interviews ◽  
Icu Patients ◽  
Life Challenges ◽  
Care Models ◽  
The Face

This study aimed to describe the experiences of patients with COVID-19 admitted to the intensive care units (ICU). The data were analyzed by content analysis on 16 ICU patients with COVID-19. Data were collected by semi-structured interviews. Three categories were identified: (a) captured by a challenging incident with subcategories: perceived sudden and challenging death, fear of carelessness in overcrowding, worry about the family, and frustration with stigmatizing; (b) the flourishing of life with subcategories: spiritual-awakening, resilience in the face of life challenges, promoting health behaviors, and striving for recovery; and (c) honoring the blessings with subcategories: understanding the importance of nurses, realizing the value of family, and realizing the value of altruism. COVID-19 survivors experienced both positive and negative experiences. The results of this study could help health care providers identify the needs of ICU patients with COVID-19, including psychological, social, and spiritual support and design care models.

scholarly journals PENGARUH TERAPI AKUPRESUR TERHADAP PENINGKATAN PRODUKSI ASI PADA IBU POST PARTUM DI PKU MUHAMADIYAH BANTUL

2020 ◽  
Vol 8 (4) ◽  
pp. 416
Author(s):  
Anita Liliana ◽  
Melania Wahyuningsih
Keyword(s):  
Breast Milk ◽  
Milk Production ◽  
Post Partum ◽  
Control Group ◽  
P Value ◽  
Breast Milk Production ◽  
Significant Difference ◽  
Before And After ◽  
Increase Milk Production ◽  
Postpartum Mothers

Abstract Adequacy of milk production in the newborns will affect the success of exclusive breastfeeding. Not all postpartum mothers are able to increase milk production in the postpartum period. Acupressure at the meridian points is one way to increase milk production in postpartum mothers. This study aims to determine the effect of acupressure therapy on increasing breast milk production in postpartum mothers at PKU Muhamadiyah Bantul. This study was a quantitative study  a quasi-experimental research design with pre-test and post-test nonequivalent control group. The number of respondents in each group was 17 people. The treatment given was acupressure at the meridian points for 5 minutes on days 2 and 3of poatpartum. Breastfeeding adequacy was assessed before treatment and on day 4 postpartum. Data were analyzed by Mc Nemar analysis. The results showed that there was a significant difference in breast milk production before and after acupressure with p value of 0.000 (p value <0.05). There was a significant difference in breast milk production in the control group before and after being given the breastfeeding technique leaflet p value 0.001 (p value <0.05). Conclusion: There is no significant difference in breast milk production after being given acupressure and after being given leaflets about breastfeeding techniques at PKU Muhamadiyah Bantul p value 0.100 (p value> 0.05).  Keywords: acupressure, breast milk production, postpartum

scholarly journals The Effect of Extract Supplements of Moringa Oleifera Leaves Plus Royal Jelly on Hemoglobin (Hb) Levels of Anemia Pregnant Mother in Takalar Regency

2020 ◽  
Vol 1 (2) ◽  
pp. 22-29
Author(s):  
Yulni Yulni ◽  
Veni Hadju ◽  
Burhanuddin Bahar ◽  
Citrakesumasari Citrakesumasari ◽  
Rahayu Indriasari ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Leaf Extract ◽  
Moringa Oleifera ◽  
Royal Jelly ◽  
P Value ◽  
Double Blind ◽  
Significant Difference ◽  
Before And After ◽  
The Difference ◽  
Double Blind Design

The aim of this study was to determine the effect of Moringa oleifera leaf extract supplements, Moringa oleifera leaf extract plus royal jelly and placebo on hemoglobin levels in anemic pregnant women. This research is a randomized controlled double blind design study which was conducted in Polombangkeng Utara District, Takalar Regency for 2 months. The subjects of this study were pregnant women with anemia, the majority of which were 20-35 years old, primigravida parity, income less than UMR, unemployment, higher education, pregnancy distance of more than 2 years with p value> 0.05. Then divided into three groups, namely Moringa capsules plus royal jelly (KRJ) (n = 24), Moringa capsules (KTR) (n = 24) and placeco (PLC) (n = 21). Before and after the intervention, measurements of hemoglobin levels were carried out using the Hemocue tool and interviewing the characteristics of the respondents. The results showed that the average Hb level increased from each group (mean SD): KRJ 10.06 ± 0.75 to 11.42 ± 1.23, P = 0.001, KTR 10.40 ± 0.46 to 11.15 ± 0 , 90 P = 0.001 and PLC 10.43 ± 0.42 becomes 11.14 ± 0.88 P = 0.002. but there was no significant difference from the difference in the average increase in Hb levels in the three groups, but there was a tendency that KRJ was superior to the KTR and PLC groups with an increase of 1.36 gr / dl, KTR 0.75 gr / dl and PLC 0.71 gr / dl. So it can be concluded that KRJ is better than KTR and PLC in increasing Hb levels in anemic pregnant women in Takalar Regency.

scholarly journals Improving The Knowledge Of Primary School Children On Fourth Grade Stundents About Vegetables And Fruits And Attraction Of Puzzle Media In SDN Mekarjaya I

2017 ◽  
Vol 8 (2) ◽  
pp. 134-145
Author(s):  
Wiena Arynda ◽  
Rosmida M Marbun
Keyword(s):  
School Children ◽  
Fruits And Vegetables ◽  
Fourth Grade ◽  
Primary School Children ◽  
P Value ◽  
Significant Difference ◽  
Fourth Grade Students ◽  
Before And After ◽  
The Media ◽  
Vegetables And Fruits

In Indonesia, 93.5% of the population aged ≥10 years still consume less fruits and vegetables 5 servings per day for 7 days a week (RISKESDAS, 2013).  The preliminary study conducted at SDN Mekarjaya I shows that the level of knowledge of school children about vegetables and fruits by 60% is still low and 93.3% of vegetable and fruit consumption is still lacking. In addition, SDN Mekarjaya I has never been used as a place of prior research. Therefore, it is necessary to conduct research on the knowledge of fruit vegetables in the fourth grade students of SDN Mekarjaya I. One of them is by doing counseling with the media of puzzle game. This research was conducted to know the increase of knowledge about vegetables and fruits before and after given counseling with puzzle game media in fourth grade students of SDN Mekarjaya I. This research was conducted by Pre-exsperiment method using "One group pretest and posttest" research design. Sampling by purposive sampling is 66 people. The statistical test used is paired sample t-test. Based on the results of the analysis shows that there is a significant difference of knowledge where p-value 0.000 or p <0,05 means there is a meaningful difference between before and after given counseling with puzzle game media.This puzzle game media can be developed by the teachers as a medium of learning in the classroom so that students are more motivated in following the learning process and make students do not feel bored

scholarly journals Effectiveness of application of a manual for improvement of alarms management by nurses in Intensive Care Units

2021 ◽  
Vol 39 (2) ◽  
Author(s):  
Amirhossein Yousefinya ◽  
Camellia Torabizadeh ◽  
Farid Zand ◽  
Mahnaz Rakhshan ◽  
Mohammad Fararooei
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Blood Pressure Monitoring ◽  
Post Intervention ◽  
Alarm Management ◽  
Effective Interventions ◽  
Significant Difference ◽  
Quasi Experimental ◽  
And Control ◽  
Time Type

Objective. To evaluate the effects of application of a manual on the improvement of alarms management in Intensive Care Units (ICU). Methods. This quasi-experimental study evaluated the effectiveness of the introduction into of a manual for alarm management and control in the ICU of a hospital in southeastern Iran. The intervention was a 4-hour workshop was on topics related to the adverse effects of alarms, standardization of ECG, oxygen saturation and blood pressure monitoring systems, and the use of ventilators and infusion pumps. Data were collected thorough 200 hours of observation of 60 ICU nurses (100 hours’ pre-intervention and 100 hours’ post-intervention). Response time, type of response, customization of alarm settings for each patient, the person responding to an alarm, and the cause of the alarm were analyzed. Alarms were classified into three types: false, true and technical. Results. The results showed a statistically significant difference between the pre- and post-intervention frequency of alarm types, frequency of monitoring parameters, customized monitoring settings for patients, and individuals who responded to alarms. The percentage of effective interventions was significantly higher for all parameters after the intervention (46.9%) than before the intervention (38.9%). Conclusion. The employment of a manual for management of alarms from electronic equipment in ICUs can increase the frequency of appropriate responses to alarms in these units.

Sign in / Sign up

Export Citation Format

Share Document