scholarly journals Animation supported communication on intensive care; a service improvement initiative

2021 ◽  
pp. 175114372110318
Author(s):  
Marta Wachtl ◽  
Frances Ledesma ◽  
Hannah Malcolm ◽  
Connor Toal ◽  
Charlotte Kavanagh ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Substantial Improvement ◽  
Service Improvement ◽  
Complete Understanding ◽  
Wide Range ◽  
Recovery Pathways ◽  
The Impact ◽  
Telephone Questionnaire

Objective COVID-19 has created unique challenges for families of patients admitted to intensive care units. Restricted visiting, language barriers and time constraints have limited communication, resulting in a lack of understanding and anxiety. We introduced digital animations to support communication and assessed the impact on families of patients admitted to intensive care. Methods Multi-language animations explaining mechanical ventilation, ( www.explainmyprocedure.com/icu ) were introduced at two London intensive care units during the COVID-19 pandemic. Web-links were sent by email. Reported understanding of the treatment, its benefits, risks and alternatives was assessed among family contacts of 71 consecutive patients admitted to intensive care; 39 before the animations were introduced (no animation group) and 32 afterwards (animation group). Reported understanding in the two groups was assessed by telephone questionnaire and compared. Results Following introduction, all relatives reported they had watched the animation. The proportions who reported complete understanding of mechanical ventilation, its benefits, risks and alternatives, in the no animation group (n = 39) were, respectively, 15%, 28%, 0% and 3% and in the animation group (n = 32), 94%, 97%, 84% and 66% (p < 0.0001 for all comparisons). Conclusion Family use of online multi-language animations explaining mechanical ventilation is feasible, acceptable and associated with substantial improvement in understanding. The approach is not limited to mechanical ventilation, or to use in a pandemic, and has the potential to be applied to a wide range of treatment and recovery pathways on intensive care.

scholarly journals Impact of nursing guidelines on nurses’ knowledge and performance regarding to prevention of ventilator associated pneumonia in neonates

2019 ◽  
Vol 9 (10) ◽  
pp. 15
Author(s):  
Safaa Abdel Fattah Abou Zed ◽  
Amira Adel Mohammed
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Ventilator Associated Pneumonia ◽  
And Performance ◽  
Nursing Guidelines ◽  
The Impact ◽  
Nurses Knowledge

Background: Ventilator Associated Pneumonia (VAP) is a common syndrome in pediatrics primarily in infants and early childhood. Mechanical ventilation is one of the leading supportive modalities of management in the intensive care unit, but it conveys a lot of threats and complications. This study aimed to assess the impact of nursing guidelines on nurses’ knowledge and performance regarding to prevention of ventilator associated pneumonia in neonates through the following: 1) Assessment of nurses’ knowledge and performance regarding to prevention of ventilator associated pneumonia in neonates. 2) Designing, implementing and evaluating the impact of nursing guidelines on nurses’ knowledge and performance regarding to prevention of ventilator associated pneumonia in neonates.Methods: Research design: A quasi-experimental design was utilized to conduct this study.  Settings: The study was convoyed at Maternity & Gynecological and Children’s Hospitals affiliated to Ain shams University Hospitals from neonatal intensive care units. Sample: A convenient sample method of forty three (43) nurses, and fifty (50) neonates’ infants on mechanical ventilation was included in the study as a single study group. Tools: The questionnaire format, the observation checklist and implementation of nursing guidelines was assessed the nurses’ knowledge and performance regarding to prevention of ventilator associated pneumonia in neonates. The implementation of nursing guidelines was premeditated as reference guidelines for nurses.Results: There were statistically significant differences between mean scores of the pre and post test as regards nurses’ knowledge and performance regarding to prevention of ventilator associated pneumonia in neonates.Conclusions: Application of the nursing guidelines has a positive outcome on improving nurses’ knowledge and performance regarding to prevention of ventilator associated pneumonia in neonates. Recommendations: The current study recommended that directing a written protocol for prevention of ventilator associated pneumonia in neonates to support satisfactory knowledge, and competent practices are actually required at neonatal intensive care units.

scholarly journals Bundle de prevenção da pneumonia associada à ventilação mecânica: revisão integrativa

2020 ◽  
Vol 10 (29) ◽  
pp. 48-57
Author(s):  
Eliana Brugin Serra ◽  
Isaura Leticia Tavares Palmeira Rolim ◽  
Aline Sharlon Maciel Batista Ramos ◽  
Rafael Mondego Fontenele
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Health Sciences ◽  
Integrative Review ◽  
Ventilator Associated Pneumonia ◽  
Terapia Intensiva ◽  
Multidisciplinary Staff ◽  
The Impact

Trata-se de uma revisão integrativa que tem como objetivo destacar o impacto do bundle na prevenção de pneumonia associada à ventilação mecânica (PAVM) em unidades de terapia intensiva, utilizando descritores em ciências da saúde (DeSC): Pneumonia, Protocolos e Unidades de Terapia Intensiva. A busca pelos artigos foi efetuada nas bases de dados SciELO, e BVS (LILACS e BDENF). Obtiveram-se 179 estudos, sendo selecionados 7 artigos para análise nesta revisão. As medidas mais comuns na constituição dos bundles encontradas foram: higiene oral com clorexidina, elevação da cabeceira e verificação da pressão do cuff, sendo que uma maior adesão às bundles resulta numa diminuição da taxa de pneumonia associada à ventilação. Os bundles de prevenção de PAVM têm sido recomendados para substituir as medidas isoladas de prevenção, mas requer adesão e treinamento periódico da equipe multidisciplinar para que possam ser considerados indicadores de qualidade.Descritores: Pneumonia, Protocolos, Unidades de Terapia Intensiva. Bundle to prevent ventilator-associated pneumonia: an integrative reviewAbstract: This work is an integrative review wich the main objective is highlighting the impact of bundle in the prevention of pneumonia associated to the mechanical ventilation (PAVM) in intesive care units using descriptors in health sciences (DeSC): Pneumonia, Protocols and Intensive Care Units. This search for articles was based on SciELO and BVS (LILACS and BDENF). Through one hundred seventy-nine (179) studies, seven (7) articles were selected to be analyzed in this review. The most common arregement found in the constitution of bundles were: oral cleanliness with Clorexidina, headboard elevation and pressure verification of cuff, considering that a greater adhesion to the bundles results in a decrease of pneumonia tax associated to ventilation. The prevention bundles of PAVM have been recomended to replace the isolated arrangements of prevention, but it is necessary periodical adhesion and practice by the multidisciplinary staff to be considered quality indicators.Descriptors: Pneumonia, Protocols, Intensive Care Units. Bundle de prevención de neumonía asociada a ventilación mecánica: revisión integrativaResumen: Se trata de una revisión integrativa que tiene como objetivo resaltar el impacto del bundles en la prevención de la neumonía asociada a la ventilación mecánica (VAP) en la unidad de cuidados intensivos utilizando descriptores de ciencias de la salud (DeSC): Neumonía, Protocolos y unidades de Cuidados Intensivos. La búsqueda de artículos se realizó en las bases de datos SciELO y BVS (LILACS y BDENF). Se obtuvieron 179 estudios y se seleccionaron 7 artículos para análisis en esta revisión. Las medidas más comunes en la constitución de bundles encontradas en los estudios fueron: higiene oral de clorhexidina, elevación de la cabeza y verificación de la presión del cuff, y una mayor adherencia a los bundles resulta en una disminución en la tasa de neumonía asociada al ventilador. Se han recomendado bundles de prevención de VAP para reemplazar las medidas de prevención aisladas, pero requieren adherencia y capacitación periódica del equipo multidisciplinario para ser considerados indicadores de calidad.Descriptores: Neumonía, Protocolos, Unidades de Cuidados Intensivos.

scholarly journals 375. COVID 19 infection in a Massachusetts community hospital

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S257-S258
Author(s):  
Raul Davaro ◽  
alwyn rapose
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Essential Hypertension ◽  
Severe Acute Respiratory Syndrome ◽  
High Mortality ◽  
Case Series ◽  
World Health ◽  
Minimal Risk ◽  
The Impact

Abstract Background The ongoing pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections has led to 105690 cases and 7647 deaths in Massachusetts as of June 16. Methods The study was conducted at Saint Vincent Hospital, an academic health medical center in Worcester, Massachusetts. The institutional review board approved this case series as minimal-risk research using data collected for routine clinical practice and waived the requirement for informed consent. All consecutive patients who were sufficiently medically ill to require hospital admission with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by positive result on polymerase chain reaction testing of a nasopharyngeal sample were included. Results A total of 109 consecutive patients with COVID 19 were admitted between March 15 and May 31. Sixty one percent were men, the mean age of the cohort was 67. Forty one patients (37%) were transferred from nursing homes. Twenty seven patients died (24%) and the majority of the dead patients were men (62%). Fifty one patients (46%) required admission to the medical intensive care unit and 34 necessitated mechanical ventilation, twenty two patients on mechanical ventilation died (63%). The most common co-morbidities were essential hypertension (65%), obesity (60%), diabetes (33%), chronic kidney disease (22%), morbid obesity (11%), congestive heart failure (16%) and COPD (14%). Five patients required hemodialysis. Fifty five patients received hydroxychloroquine, 24 received tocilizumab, 20 received convalescent plasma and 16 received remdesivir. COVID 19 appeared in China in late 2019 and was declared a pandemic by the World Health Organization on March 11, 2020. Our study showed a high mortality in patients requiring mechanical ventilation (43%) as opposed to those who did not (5.7%). Hypertension, diabetes and obesity were highly prevalent in this aging population. Our cohort was too small to explore the impact of treatment with remdesivir, tocilizumab or convalescent plasma. Conclusion In this cohort obesity, diabetes and essential hypertension are risk factors associated with high mortality. Patients admitted to the intensive care unit who need mechanical ventilation have a mortality approaching 50 %. Disclosures All Authors: No reported disclosures

Exploring the impact of 12-hour shifts on nurse fatigue in intensive care units

2019 ◽  
Vol 50 ◽  
pp. 151191 ◽  
Author(s):  
Fiona Yu ◽  
Deborah Somerville ◽  
Anna King
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Nurse Fatigue ◽  
The Impact

Communicating with parents in neonatal intensive care units: The impact on parental stress

2017 ◽  
Vol 100 (4) ◽  
pp. 710-719 ◽  
Author(s):  
Christian Enke ◽  
Andrés Oliva y Hausmann ◽  
Felix Miedaner ◽  
Bernhard Roth ◽  
Christiane Woopen
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Parental Stress ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
The Impact

Mucormycosis: A Black Fungus- Post Covid Complications

2021 ◽  
Author(s):  
Prithiv Kumar KR
Keyword(s):  
Mechanical Ventilation ◽  
T Cells ◽  
Intensive Care ◽  
Fungal Infection ◽  
Intensive Care Units ◽  
Respiratory System ◽  
Cd8 T Cells ◽  
Transmitted Disease ◽  
Global Pandemic

Human to human transmitted disease is the game of coronavirus disease (COVID-19) transmission and it had been declared an emergency global pandemic that caused major disastrous in the respiratory system to more than five million people and killing more than half a billion deaths across the globe. Besides lower acute respiratory syndrome, there is damage to the alveolar with severe inflammatory exudation. COVID-19 patients often have lower immunosuppressive CD4+ T and CD8+ T cells and most patients in intensive care units (ICU) need mechanical ventilation, hence longer stay in hospitals. These patients have been discovered to develop fungal co-infections. COVID-19 patients develop what is known as mucormycosis a black fungal infection that is deadly leading to loss of sight and hearing and eventually death. This chapter will focus on mucormycosis, a black fungus caused during post covid complications.

scholarly journals Candidemia in an intensive care unit

Medicina ◽  
2008 ◽  
Vol 45 (5) ◽  
pp. 351
Author(s):  
Dalia Adukauskienė ◽  
Aida Kinderytė ◽  
Asta Dambrauskienė ◽  
Astra Vitkauskienė
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Risk Factor ◽  
Intensive Care ◽  
Urinary Bladder ◽  
Intensive Care Units ◽  
Severe Disease ◽  
Candida Spp ◽  
Lethal Outcome ◽  
Bladder Catheter

Candidemia is becoming more actual because of better survival of even critically ill patients, wide use of antimicrobials, and increased numbers of invasive procedures and manipulations. Diagnosis of candidemia remains complicated, and costs of treatment and mortality rates are increasing. Objective. To evaluate the pathogens of candidemia, risk factors and their influence on outcome. Material and methods. Data of 41 patients with positive blood culture for Candida spp., who were treated in the intensive care units at the Hospital of Kaunas University of Medicine, were analyzed retrospectively. Results. Candidemia was caused by Candida albicans (C. albicans) in 48.8% (n=20) of patients and by non-albicans Candida in 51.2% (n=21) of patients. The main cause of candidemia was C. albicans in 2004 (83.3%, n=5), but in 2005 (63.6%, n=7), in 2006 (57.1%, n=4), and in 2007 (52.9%, n=9), the main cause was non-albicans Candida spp. The number of candidemia cases caused by C. albicans was decreased in 2005, 2006, and 2007 as compared with 2004, and the number of candidemia caused by non-albicans Candida spp. was decreased, respectively (P<0.05). More than 65% (n=34) of patients had severe disease (P<0.05). Lethal outcome was recorded in 58.5% of patients with candidemia. Mechanical ventilation was used in 76.9% (n=20) and urinary bladder catheter in 72.1% (n=19) of non-survivors and in 23.1% (n=6) and 26.9% (n=7) of survivors, respectively (P<0.05). Conclusions. There is an increase in the prevalence of candidemia in the intensive care units during the 4-year period; half of candidemia cases were caused by non-albicans Candida spp., and patients with candidemia caused by non-albicans Candida spp. are at higher risk of mortality. Therefore, for the empirical treatment of septic conditions in an intensive care unit, when invasive fungal infection is suspected, we recommend using an antifungal agent of non-azole class until a pathogen of candidemia is determined. Severe disease is evaluated as a risk factor for candidemia. Patients with oncological diseases are at significantly higher risk for candidemia caused by non-albicans Candida spp. Use of mechanical ventilation and urinary bladder catheter is a risk factor for lethal outcome.

Spectrum of practice in the diagnosis of nosocomial pneumonia in patients requiring mechanical ventilation in European intensive care units

2009 ◽  
Vol 37 (8) ◽  
pp. 2360-2369 ◽  
Author(s):  
Despoina Koulenti ◽  
Thiago Lisboa ◽  
Christian Brun-Buisson ◽  
Wolfgang Krueger ◽  
Antonio Macor ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Nosocomial Pneumonia

The rate and impact of substance misuse in psychiatric intensive care units (PICUs) in the UK

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Hattie Catherine Ann Moyes ◽  
Lana MacNaboe ◽  
Kate Townsend
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Substance Misuse ◽  
Well Being ◽  
Training Programme ◽  
Content Type ◽  
National Quality ◽  
Improvement Programme ◽  
The Uk ◽  
The Impact

Purpose This paper aims to understand the current scale of substance misuse in psychiatric intensive care units (PICUs), identify how substance misuse affects members of staff, patients and the running of wards and explore with staff what resources would be most useful to more effectively manage substance misuse and dual diagnosis on PICUs. Design/methodology/approach The paper used a mixed-methods approach, using a quantitative survey to determine the extent of substance use in PICUs and a co-design workshop to understand the impact of substance misuse on PICU wards, staff and patients. Findings The estimated rate of substance misuse in PICUs over a 12-month period is 67%, with cannabis the most frequently used substance. Despite the range of problems experienced on PICUs because of substance misuse, the availability of training and resources for staff was mixed. Research limitations/implications The findings may not be fully generalisable as research participants were members of a national quality improvement programme, and therefore, may not be representative of all PICUs. Data was collected from clinicians only; if patients were included, they might have provided another perspective on substance misuse on PICUs. Practical implications This paper emphasises the importance of substance misuse training for PICU staff to adequately respond to patients who misuse substances, improve the ward environment, staff well-being and patient outcomes. Originality/value This paper provides an updated estimation of rates of substance misuse in PICUs over a 12-month period and make suggestions for a training programme that can better support staff to address substance misuse on PICUs.

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