scholarly journals Delivery of a psychological intervention to assess and reduce workplace stress among intensive care staff

2020 ◽  
pp. 175114371988485
Author(s):  
Dorothy Wade ◽  
Milena Georgieva ◽  
Hein Gunnewicht ◽  
Jacqui Finnigan ◽  
Niall MacCallum
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Stress Management ◽  
Psychological Intervention ◽  
Health And Safety ◽  
Workplace Stress ◽  
Care Staff ◽  
Service Improvement ◽  
Post Intervention ◽  
Staff Support

Introduction Intensive care staff have high levels of stress. We conducted a service improvement initiative to assess workplace stress levels among staff in one adult general intensive care unit and deliver a stress management intervention. Methods A psychological intervention of four stress management sessions, and fortnightly staff support drop-in groups, was developed and delivered within a year. Pre- and post-intervention, workplace stress in the unit was assessed using a Health and Safety Executive tool. Results Pre-intervention assessment of 76 (47.2%) staff indicated that improvement was needed in all domains of workplace stress. 125 staff (77.6%) participated in the intervention and gave positive ratings for content, relevance, practicality and personal value (median 4 (1–5); interquartile range 3.8–4.6). Post-intervention assessment of 71 staff (41.3%) demonstrated improvements in all workplace stress domains. Conclusion A reduction in workplace stress was observed following a service improvement intervention in one intensive care unit although no causality can be assumed. Similar interventions should be evaluated using robust study designs.

Transition from an Open Bay to a Private Room Neonatal Intensive Care Unit Design — A Human Factors Evaluation

2005 ◽  
Vol 49 (11) ◽  
pp. 974-978 ◽  
Author(s):  
Thomas J. Smith ◽  
Sandra Clayton ◽  
Kathleen Schoenbeck
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Human Factors ◽  
Neonatal Intensive Care Unit ◽  
Patient Care ◽  
Neonatal Intensive Care ◽  
Patient Care Team ◽  
Care Staff ◽  
Care Technology

This report summarizes findings from a human factors evaluation of a change in the design of a neonatal intensive care unit (NICU) from an open bay (OBNICU) to a private room (PRNICU) patient care environment. The objective was to compare and contrast effects of this design change on the perceptions and performance of NICU patient care staff. Results indicate that, relative to work on the OBNICU, staff perceived that work on the PRNICU resulted in notable improvements in the quality of physical environmental conditions, their jobs, patient care and patient safety, interaction with parents of NICU patients, interaction with patient care technology and their life off-the-job. In contrast, staff perceived that the quality of interaction among different members of the NICU patient care team worsened substantially after the move to the PRNICU. The latter finding prompted the recommendation that a virtual open bay environment be implemented in the PRNICU.

The Impact of Implementing a “Pain, Agitation, and Delirium Bundle” in a Pediatric Intensive Care Unit: Improved Delirium Diagnosis

2021 ◽  
Author(s):  
Lise D. Cloedt ◽  
Kenza Benbouzid ◽  
Annie Lavoie ◽  
Marie-Élaine Metras ◽  
Marie-Christine Lavoie ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Post Intervention ◽  
Number Of Patients ◽  
Implementation Period ◽  
Short And Long Term ◽  
The Impact

AbstractDelirium is associated with significant negative outcomes, yet it remains underdiagnosed in children. We describe the impact of implementing a pain, agitation, and delirium (PAD) bundle on the rate of delirium detection in a pediatric intensive care unit (PICU). This represents a single-center, pre-/post-intervention retrospective and prospective cohort study. The study was conducted at a PICU in a quaternary university-affiliated pediatric hospital. All patients consecutively admitted to the PICU in October and November 2017 and 2018. Purpose of the study was describe the impact of the implementation of a PAD bundle. The rate of delirium detection and the utilization of sedative and analgesics in the pre- and post-implementation phases were measured. A total of 176 and 138 patients were admitted during the pre- and post-implementation phases, respectively. Of them, 7 (4%) and 44 (31.9%) were diagnosed with delirium (p < 0.001). Delirium was diagnosed in the first 48 hours of PICU admission and lasted for a median of 2 days (interquartile range [IQR]: 2–4). Delirium diagnosis was higher in patients receiving invasive ventilation (p < 0.001). Compliance with the PAD bundle scoring was 79% for the delirium scale. Score results were discussed during medical rounds for 68% of the patients in the post-implementation period. The number of patients who received opioids and benzodiazepines and the cumulative doses were not statistically different between the two cohorts. More patients received dexmedetomidine and the cumulative daily dose was higher in the post-implementation period (p < 0.001). The implementation of a PAD bundle in a PICU was associated with an increased recognition of delirium diagnosis. Further studies are needed to evaluate the impact of this increased diagnostic rate on short- and long-term outcomes.

scholarly journals Perceived and sources of occupational stress in surgical intensive care nurses

2020 ◽  
pp. 201010582096329
Author(s):  
Semra Bulbuloglu ◽  
Gurkan Kapikiran ◽  
Serdar Saritas
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Stress Management ◽  
Intensive Care Units ◽  
Organ Transplant ◽  
University Hospital ◽  
Spiritual Support ◽  
Surgical Intensive Care ◽  
Computer Environment ◽  
Bonferroni Test

Aim: The study aimed to determine sources of stress and stress levels of nurses working in surgical intensive care units in addition to understanding the stress level in nurses, drawing attention and raising awareness. Material and methods: The study was conducted using a descriptive design with the participation of nurses ( n=132) working in surgical intensive care units of a university hospital. The data were collected through the source of stress identification form and perceived stress scale. The data obtained in the study were transferred to a computer environment, and for statistical analyses, the package for social sciences for Windows 25 software was used. In the analyses of the data, descriptive statistics, independent t-test, one-way analysis of variance and regression analysis, and the Bonferroni test were employed. Results: It was also determined that 28.8% of the surgical nurses were working in an organ transplant intensive care unit and 25% worked in an anaesthesia intensive care unit, that 49.3% had professional experience of between 6 and 11 years and that 92.4% worked on both day and night shifts. In the study, the rate of nurses who perceived a high level of stress was found to be 45.5%, and it was identified that 78.8% needed training in stress management. Conclusion: Imperative funding and human resources should be provided in order to give nurses problem-solving abilities and a stress management course. The financial support of the managers and spiritual support of health professionals and organising regular meetings with nurses can help nurses to experience less stress.

scholarly journals Project Console: a quality improvement initiative for neonatal abstinence syndrome in a children’s hospital level IV neonatal intensive care unit

2021 ◽  
Vol 10 (2) ◽  
pp. e001079
Author(s):  
Kathryn L Ponder ◽  
Charles Egesdal ◽  
Joanne Kuller ◽  
Priscilla Joe
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Improvement ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Neonatal Abstinence Syndrome ◽  
Quality Improvement Initiative ◽  
Abstinence Syndrome ◽  
Post Intervention ◽  
High Acuity

ObjectiveTo improve care for infants with neonatal abstinence syndrome.DesignInfants with a gestational age of ≥35 weeks with prenatal opioid exposure were eligible for our quality improvement initiative. Interventions in our Plan–Do–Study–Act cycles included physician consensus, re-emphasis on non-pharmacological treatment, the Eat Sleep Console method to measure functional impairment, morphine as needed, clonidine and alternative soothing methods for parental unavailability (volunteer cuddlers and automated sleeper beds). Pre-intervention and post-intervention outcomes were compared.ResultsLength of stay decreased from 31.8 to 10.5 days (p<0.0001) without an increase in readmissions. Composite pharmacotherapy exposure days decreased from 28.7 to 5.5 (p<0.0001). This included reductions in both morphine exposure days (p<0.0001) and clonidine exposure days (p=0.01). Fewer infants required pharmacotherapy (p=0.02).ConclusionsOur study demonstrates how a comprehensive initiative can improve care for infants with neonatal abstinence syndrome in an open-bay or a high-acuity neonatal intensive care unit when rooming-in is not available or other comorbidities are present.

Yoga for Stress Management Among Intensive Care Unit Staff: A Pilot Study

2015 ◽  
Vol 21 (3) ◽  
pp. 111-115 ◽  
Author(s):  
Adam M. Bernstein ◽  
Alison Kobs ◽  
Judi Bar ◽  
Susan Fay ◽  
Jonathan Doyle ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pilot Study ◽  
Stress Management ◽  
Intensive Care Unit Staff

The Descriptive Epidemiology of Central Line–Associated Bloodstream Infection among Patients in Non-Intensive Care Unit Settings

2014 ◽  
Vol 35 (2) ◽  
pp. 164-168 ◽  
Author(s):  
Rudy Tedja ◽  
Steven M. Gordon ◽  
Cynthia Fatica ◽  
Thomas G. Fraser
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Prevention ◽  
Health And Safety ◽  
Central Line ◽  
Data Sets ◽  
Crude Mortality ◽  
Tertiary Center ◽  
One Year ◽  
Significant Mortality

Objective.To review and describe device utilization and central line-associated bloodstream (CLABSI) events among patients in a non-intensive care unit (ICU) setting and to examine the morbidity and mortality associated with these events.Design. One-year descriptive review.Setting.A single tertiary center with a 1,200-bed hospital and 209 adult ICU beds.Patients.Hospitalized patients identified as having a CLABSI event attributed to a non-ICU setting.Methods.The cohort was identified from a prospective infection prevention database. Charts and administrative data sets were reviewed to further characterize the patients. Device utilization ratios (DURs) and CLABSI rates were calculated using National Health and Safety Network (NHSN) CLABSI definitions. Need for ICU stay and crude mortality rates were recorded.Results.A total of 136 patients with 156 CLABSIs were identified, of whom 78 (57%) were being treated for a hematological malignancy (HM). The overall DUR was 0.27. A tunneled line was in place for 118 (76%) of the CLABSI events, and a peripherally inserted central catheter was in place for 32 (21%) of the CLABSI events. The non-ICU CLABSI rate was significantly higher than the concurrent ICU rate (2.1 CLABSIs per 1,000 catheter-days vs 1.5 CLABSIs per 1,000 catheter-days; P = .02). Hospital mortality was 23% in the affected group and was significantly higher in patients with HM.Conclusions.CLABSI rates over a 1-year period were higher in patients outside the ICU at our hospital and were associated with significant mortality.

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