Cross mapping between clinical indicators for assistance in intensive care and nursing interventions

ABSTRACT Objective: Identify the main clinical indicators for assistance in the Intensive Care Unit (ICU) and map them in the nursing interventions described by the Nursing Interventions Classification (NIC). Methods: Integrative literature review study, followed by cross-mapping between clinical indicators for assistance in the ICU care and NIC nursing interventions and activities. Results: 36 articles were identified, which resulted in 285 clinical indicators for ICU care, with mechanical ventilatory assistance, pain, sedation, psychomotor agitation, delirium, anxiety, altered heart rate, diet by naso tube / oroenteral and diarrhea the clinical indicators for assistance in the ICU the most prevalent. These were mapped in 12 Nursing Interventions Classification interventions and 130 nursing activities. Final considerations: It is concluded that the clinical indicators for ICU care associated with Nursing Interventions Classification are concrete data that assist intensive care nurses in their clinical practice.

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Nursing Interventions in the Clinical Practice of an Intensive Care Unit

Revista Latino-Americana de Enfermagem ◽

10.1590/s0104-11692010000500006 ◽

2010 ◽

Vol 18 (5) ◽

pp. 873-880 ◽

Cited By ~ 16

Author(s):

Amália de Fátima Lucena ◽

Maria Gaby Rivero de Gutiérrez ◽

Isabel Cristina Echer ◽

Alba Lucia Bottura Leite de Barros

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Clinical Practice ◽

Nursing Care ◽

Cross Sectional Study ◽

University Hospital ◽

Nursing Interventions ◽

Sectional Study ◽

Cross Sectional ◽

Respiratory Management

This cross-sectional study was carried out at a university hospital to describe the nursing interventions most frequently performed in the clinical practice of an intensive care unit, based on nursing care prescriptions, and to investigate their similarity to the Nursing Interventions Classification (NIC). The sample consisted of 991 hospitalizations of patients. Data were retrospectively collected from the computer database and analyzed through descriptive statistics and cross-mapping. A total of 57 different NIC interventions frequently used in the unit were identified; most of them in the complex (42%) and basic physiological (37%) domains, in the classes ‘respiratory management’ and ‘self-care facilitation’. Similarity between the nursing care prescribed and nursing interventions/NIC was found in 97.2% of the cases. The conclusion is that the interventions/NIC used in the clinical practice of this intensive care unit reflects the level of complexity of nursing care, which is mainly directed at the regulation of the body’s physical and homeostatic functioning.

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Nursing Interventions to Prevent Delirium in Critically Ill Patients in the Intensive Care Unit during the COVID19 Pandemic—Narrative Overview

Healthcare ◽

10.3390/healthcare8040578 ◽

2020 ◽

Vol 8 (4) ◽

pp. 578

Author(s):

Dorota Ozga ◽

Sabina Krupa ◽

Paweł Witt ◽

Wioletta Mędrzycka-Dąbrowska

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Critically Ill Patients ◽

Current Knowledge ◽

Personalised Medicine ◽

Nursing Interventions ◽

Evidence Based ◽

Current State ◽

Scientific Disciplines ◽

Reliable Methods

It has become a standard measure in recent years to utilise evidence-based practice, which is associated with a greater need to implement and use advanced, reliable methods of summarising the achievements of various scientific disciplines, including such highly specialised approaches as personalised medicine. The aim of this paper was to discuss the current state of knowledge related to improvements in “nursing” involving management of delirium in intensive care units during the SARS-CoV-2 pandemic. This narrative review summarises the current knowledge concerning the challenges associated with assessment of delirium in patients with COVID-19 by ICU nurses, and the role and tasks in the personalised approach to patients with COVID-19.

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Domain Adaptation for Heart Rate Extraction in the Neonatal Intensive Care Unit

2020 IEEE International Conference on Bioinformatics and Biomedicine (BIBM) ◽

10.1109/bibm49941.2020.9313123 ◽

2020 ◽

Author(s):

Diogo Malafaya ◽

Sara Domingues ◽

Helder P. Oliveira

Keyword(s):

Intensive Care Unit ◽

Heart Rate ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Domain Adaptation

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

Sensors ◽

10.3390/s21030999 ◽

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.

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Shortening the Application Time of Alcohol-Based Hand Rubs to 15 Seconds May Improve the Frequency of Hand Antisepsis Actions in a Neonatal Intensive Care Unit

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2017.217 ◽

2017 ◽

Vol 38 (12) ◽

pp. 1430-1434 ◽

Cited By ~ 9

Author(s):

Axel Kramer ◽

Didier Pittet ◽

Romana Klasinc ◽

Stefan Krebs ◽

Torsten Koburger ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Clinical Practice ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Application Time ◽

Improve Hand Hygiene ◽

Independent Observer ◽

Hand Antisepsis

BACKGROUNDFor alcohol-based hand rubs, the currently recommended application time of 30 seconds is longer than the actual time spent in clinical practice. We investigated whether a shorter application time of 15 seconds is microbiologically safe in neonatal intensive care and may positively influence compliance with the frequency of hand antisepsis actions.METHODSWe conducted in vitro experiments to determine the antimicrobial efficacy of hand rubs within 15 seconds, followed by clinical observations to assess the effect of a shortened hand antisepsis procedure under clinical conditions in a neonatal intensive care unit (NICU). An independent observer monitored the frequency of hand antisepsis actions during shifts.RESULTSAll tested hand rubs fulfilled the requirement of equal or even significantly higher efficacy within 15 seconds when compared to a reference alcohol propan-2-ol 60% (v/v) within 30 seconds. Microbiologically, reducing the application time to 15 seconds had a similar effect when compared to 30-second hand rubbing, but it resulted in significantly increased frequency of hand antisepsis actions (7.9±4.3 per hour vs 5.8±2.9 per hour; P=.05).CONCLUSIONTime pressure and workload are recognized barriers to compliance. Therefore, reducing the recommended time for hand antisepsis actions, using tested and well-evaluated hand rub formulations, may improve hand hygiene compliance in clinical practice.Infect Control Hosp Epidemiol 2017;38:1430–1434

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

Human Factors The Journal of the Human Factors and Ergonomics Society ◽

10.1177/00187208211040889 ◽

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.

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Antiseptic use in the neonatal intensive care unit - a dilemma in clinical practice: An evidence based review

World Journal of Clinical Pediatrics ◽

10.5409/wjcp.v5.i2.159 ◽

2016 ◽

Vol 5 (2) ◽

pp. 159 ◽

Cited By ~ 23

Author(s):

Sundar Sathiyamurthy ◽

Jayanta Banerjee ◽

Sunit V Godambe

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Clinical Practice ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Evidence Based

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INVESTIGATING EFFECT OF NURSING INTERVENTIONS, BASED ON WELLS SCORE RESULTS, ON THE INCIDENCE OF DEEP VEIN THROMBOSIS IN PATIENTS ADMITTED TO THE INTENSIVE CARE UNIT

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2018.v11i5.24939 ◽

2018 ◽

Vol 11 (5) ◽

pp. 377

Author(s):

Morteza Habibi Moghadam ◽

Marzieh Asadizaker ◽

Simin Jahani ◽

Elham Maraghi ◽

Hakimeh Saadatifar ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Deep Vein Thrombosis ◽

Intervention Group ◽

Control Group ◽

Nursing Interventions ◽

Vein Thrombosis ◽

Wells Score ◽

Deep Vein ◽

Pitting Edema

Objective: Venous thromboembolism, including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common complaint in critically ill patients. Therefore, the present study was conducted to determine the effect of nursing interventions, based on the Wells results, on the incidence of DVT in intensive care unit (ICU) patients.Methods: The present clinical trial was conducted on 72 ICU patients without DVT and PE who met the inclusion criteria according to Wells score in Dr. Ganjavian Hospital, Dezful in 2012. The participants were investigated and randomly divided into intervention (n=36) and control groups (n=36). The intervention group received preventive nursing measures based on the risk level determined by the Wells score, and routine therapeutic interventions were performed for the control group. Then, patients were evaluated using Wells score, D-dimer testing, and Doppler sonography on the 1st, 5th, and 10th days. Data were finally coded and entered into SPSS version 23. Data analysis was performed using Chi-square, Fisher’s exact, and Mann–Whitney U tests.Results: The incidence of DVT in both groups showed that 2 patients of the control group who were identified to be at risk using the Wells score were diagnosed with DVT while none of the patients of the intervention group experienced DVT. The present study showed that 22.2% of the patients of the control group suffered from non-pitting edema, which was significantly different from the intervention group (p=0.005).Conclusion: The results of the present study showed that using the Wells score for early identification of the at-risk patients and nursing interventions based on this score’s results is helpful in the prevention of DVT. Appropriate nursing interventions were also effective in reducing the incidence of non-pitting edema in the lower extremities.

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Paediatric nonbronchoscopic bronchoalveolar lavage overview and recommendations for clinical practice

South African Journal of Physiotherapy ◽

10.4102/sajp.v62i1.149 ◽

2006 ◽

Vol 62 (1) ◽

Cited By ~ 1

Author(s):

B. M. Morrow ◽

M. J. Futter ◽

A. C. Argent

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Clinical Practice ◽

Respiratory Tract ◽

Bronchoalveolar Lavage ◽

Pulmonary Disease ◽

Paediatric Intensive Care Unit ◽

Lower Respiratory Tract ◽

Paediatric Intensive Care ◽

Coagulation Defects

NB-BAL is an effective procedure for the diagnosis of pulmonary disease processes in ventilated infants and children. This procedure is, however, not without risks to both patients and staff. Numerous complications of NB-BAL exist, with hypoxia being themost common. As a result, care should be taken in performing NB-BAL on haemodynamically unstable patients; patients with coagulation defects; and patients with cardiac or brain abnormalities.This paper presents an overview of paediatric nonbronchoscopic bronchoalveolar lavage (NB-BAL) including: the rationale for NB-BAL; the complications associated with the procedure; indications and contraindications. It also recommends an evidence-basedclinical guideline for performing the procedure in the paediatric intensive care unit. By following the NB-BAL guidelines presented in this paper, one can ensure that an effective specimen is obtained from the lower respiratory tract, whilst minimising the risk to the patient.

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