scholarly journals Tradução e adaptação cultural para a língua portuguesa falada no Brasil da Canadian survey of mobilization of ICU patients

2021 ◽  
Vol 28 (2) ◽  
pp. 201-207
Author(s):  
Ana Flávia Gesser ◽  
Juliana El Hage Meyer de Barros Gulini ◽  
Karen Kin-Yue Koo ◽  
Kelly Cattelan Bonorino
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Icu Patients ◽  
Terapia Intensiva ◽  
Canadian Survey

RESUMO Este estudo teve como objetivo traduzir e adaptar culturalmente o questionário Canadian survey of mobilization of intensive care unit patients para a língua portuguesa falada no Brasil. Este instrumento avalia profissionais de unidade de terapia intensiva (UTI) em relação aos conhecimentos sobre a mobilização precoce (MP) e sua importância, as percepções sobre barreiras e as práticas de reabilitação com o paciente crítico. O protocolo incluiu as etapas: autorização e cessão de direitos de uso; tradução do instrumento para a língua portuguesa; reconciliação; retrotradução para a língua original; revisão e harmonização da retrotradução; aprovação da autora principal do questionário original; revisão da versão em português; desdobramento cognitivo; e reconciliação e elaboração da versão final. Devido a algumas diferenças conceituais e culturais entre os dois países, algumas dúvidas foram discutidas com a autora principal do instrumento, a qual concordou com as alterações sugeridas. No desdobramento cognitivo, os 10 profissionais selecionados testaram a clareza, compreensão e aceitabilidade do questionário, e demonstraram suas dificuldades quanto ao conteúdo deste. Muitos entrevistados evidenciaram que o instrumento desperta reflexões importantes sobre as práticas diárias e os benefícios com a realização da MP. O questionário intitulado Pesquisa de mobilização de pacientes em unidade de terapia intensiva: conhecimento, perspectivas e práticas atuais encontra-se traduzido e adaptado culturalmente para a língua portuguesa falada no Brasil, podendo ser utilizado para avaliar aspectos da MP por profissionais que participam deste processo em UTIs adulto e pediátricas. Estudos futuros utilizando esta versão serão necessários para verificar se o questionário fornece medidas reprodutíveis e válidas.

Communication in the process of humanization of the assistance at intensive care unit: experience of relatives and cares

2010 ◽  
Vol 4 (4) ◽  
pp. 1587
Author(s):  
Natália Celião Leite ◽  
Josilene De Melo Buriti Vasconcelos ◽  
Wilma Dias de Fontes
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Family Members ◽  
Structured Interview ◽  
Communication Process ◽  
Icu Patients ◽  
Efficient System ◽  
The Family ◽  
Terapia Intensiva ◽  
Nursing Professionals

ABSTRACTObjectives: to report the experience of the nursing team and family members of ICU patients as regards communication; to learn the meaning they attribute to the communication process. Methodology: a quantitative and qualitative exploratory study carried out at the Intensive Care Unit of the school hospital. Consisting of 15 family members and 15 nursing professionals who happened to be available there during the data collection, the sample resulted from semi-structured interview guidance. The data were analyzed by means of descriptive statistics, taking into account the absolute and percentage numbers, and the technique of the Collective Subject Discourse, with presentation throughout graph, table and charts. Results: the data showed gaps in the communication, which are inherent to some professionals who neither practice nor value the communication process with the family, mainly as regards the need to prepare them for the ICU environment and the real conditions of their family members. Conclusion: the need to adopt an efficient system of communication with relatives of ICU patients is widely known. Thus, the nurse will be adopting new ways of caring, which include valuing the family members as integrating part of the nursing care, with view to humanizing the assistance. Descriptors: communication; humanization of the assistance; intensive care unit. RESUMOObjetivos: relatar a experiência da equipe de enfermagem e de familiares de pacientes internados em uma UTI, na perspectiva da comunicação; apreender o significado por eles atribuído ao processo de comunicação. Métodologia: estudo exploratório, quantiqualitativo, realizado na Unidade de Terapia Intensiva de hospital escola. A amostra foi formada por 15 familiares e 15 profissionais de enfermagem que se encontravam no local, por ocasião da coleta de dados, a qual ocorreu por meio de um roteiro de entrevista semi-estruturado. Os dados foram analisados por meio da estatística descritiva, levando-se em conta os números absolutos e percentuais, e da técnica do Discurso do Sujeito Coletivo, com apresentação em gráfico, tabela e quadros. Resultados: os dados mostram lacunas na comunicação, as quais são inerentes a alguns profissionais que não praticam e não valorizam o processo de comunicação com a família, principalmente no que diz respeito à necessidade de prepará-los para compreender o ambiente da UTI e as reais condições de seus familiares. Conclusão: é notória a necessidade de se adotar um sistema eficaz de comunicação com os familiares de pacientes internados na UTI. Assim, o enfermeiro estará adotando novas formas de cuidar, que incluem a valorização dos familiares como parte integrante do cuidado de enfermagem na perspectiva da humanização da assistência. Descritores: comunicação; humanização da assistência; unidade de terapia intensiva.RESUMENObjetivos: relatar la experiencia del equipo de enfermería y parientes de pacientes de UTI, en cuanto a la comunicación; aprender el significado que ellos atribuyen al proceso de comunicación. Metodología: estudio exploratorio, cuantitativo y cualitativo, realizado en la Unidad de Terapia Intensiva del hospital escuela. Formada por 15 parientes y 15 profesionales de enfermería que se encontraban disponibles en el sitio durante el recogimiento de los datos, la muestra resultó de la rutina de una entrevista semi-estructurada. Los datos fueron analizados a través de la estadística descriptiva, llevándose en cuenta los números absolutos y porcentajes, la técnica del Discurso del Sujeto Colectivo, con presentación en gráfico, tabla y cuadros. Resultado: los datos enseñan brechas en la comunicación, las cuales son propias de algunos profesionales que no practican y no valoran el proceso de comunicación con la familia, principalmente en cuanto a la necesidad de les preparar a entender el ambiente de la UTI y las reales condiciones de sus parientes. Conclusión: es notoria la necesidad de adoptarse un sistema de comunicación eficiente con los parientes de pacientes de UTI. Así, el enfermero estará adoptando nuevas maneras de cuidar, las cuales incluyen la valoración de los parientes como parte del cuidado de enfermero, con vista a la humanización de la asistencia. Descriptores: comunicación; humanización de la asistencia; unidad de terapia intensiva. 

Saúde ocupacional dos profissionais de enfermagem em unidade de terapia intensiva

2013 ◽  
Vol 4 (2) ◽  
pp. 115 ◽  
Author(s):  
Natasha Marques Frota ◽  
Lívia Moreira Barros ◽  
Luana Nunes Caldini ◽  
Thiago Moura De Araújo ◽  
Joselany Áfio Caetano
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Occupational Hazards ◽  
Inclusion Criteria ◽  
Occupational Risks ◽  
Worker Health ◽  
Final Sample ◽  
Terapia Intensiva ◽  
Health Nursing ◽  
Nursing Professionals

Resumo: Objetivou-se identificar os riscos ocupacionais em profissionais de enfermagem em Unidade de Terapia Intensiva. Trata-se de uma revisão integrativa realizada no período de fevereiro a março de 2012. A amostra final do estudo contou com 12 artigos que atenderam os critérios de inclusão. Foi possível identificar que os riscos ocupacionais mais presentes na UTI estão associados aos riscos de acidentes, seguido do biológico, químico e ergonômico. Frente a esta realidade é necessário a implementação de medidas para a prevenção dos riscos, para diminuição do absenteísmo e a promoção da saúde do trabalhador de enfermagem.Palavras-Chave: Enfermagem do trabalho, Riscos ocupacionais, Unidades de Terapia Intensiva.Occupational health of nurses in the Intensive Care UnitAbstract: This study aimed to identify occupational hazards in nursing professionals in the Intensive Care Unit. It is an integrative review carried out during February-March 2012. The final sample included 12 articles that met the inclusion criteria. It was possible to identify the occupational hazards present in the ICU are more associated with the risk of accidents, followed by biological, chemical and ergonomic. Faced with this reality is necessary to implement measures to prevent risks, to reduce absenteeism and promote worker health nursing.Keywords: Occupational Health Nursing, Occupational Risks, Intensive Care Units.Salud en el trabajo de las enfermeras en la Unidad de Cuidados IntensivosResumen: Este estudio tuvo como objetivo identificar los riesgos laborales en los profesionales de enfermería en la Unidad de Cuidados Intensivos. Se trata de una revisión integradora llevada a cabo durante febrero y marzo de 2012. La muestra final incluyó 12 artículos que cumplieron los criterios de inclusión. Fue posible identificar los riesgos laborales presentes en la UCI son más asociado con el riesgo de accidentes, seguido por agentes biológicos, químicos y ergonómicos. Frente a esta realidad es necesario aplicar medidas para prevenir los riesgos, para reducir el absentismo y fomentar la enfermería profesional de la salud.Palabras Clave: Enfermería del Trabajo, Riesgos Laborales, Unidades de Cuidados Intensivos.

scholarly journals Lung ultrasound predicts clinical course but not outcome in COVID-19 ICU patients: a retrospective single-center analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stephanie-Susanne Stecher ◽  
Sofia Anton ◽  
Alessia Fraccaroli ◽  
Jeremias Götschke ◽  
Hans Joachim Stemmler ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Lung Ultrasound ◽  
Clinical Course ◽  
Point Of Care ◽  
Clinical Deterioration ◽  
Normal Lung ◽  
Icu Patients ◽  
Standardized Protocol ◽  
Ultrasound Score

Abstract Background Point-of-care lung ultrasound (LU) is an established tool in the first assessment of patients with coronavirus disease (COVID-19). Purpose of this study was to evaluate the value of lung ultrasound in COVID-19 intensive care unit (ICU) patients in predicting clinical course and outcome. Methods We analyzed lung ultrasound score (LUS) of all COVID-19 patients admitted from March 2020 to December 2020 to the Internal Intensive Care Unit, Ludwig-Maximilians-University (LMU) of Munich. LU was performed according to a standardized protocol at ICU admission and in case of clinical deterioration with the need for intubation. A normal lung scores 0 points, the worst LUS has 24 points. Patients were stratified in a low (0–12 points) and a high (13–24 points) lung ultrasound score group. Results The study included 42 patients, 69% of them male. The most common comorbidities were hypertension (81%) and obesity (57%). The values of pH (7.42 ± 0.09 vs 7.35 ± 0.1; p = 0.047) and paO2 (107 [80–130] vs 80 [66–93] mmHg; p = 0.034) were significantly reduced in patients of the high LUS group. Furthermore, the duration of ventilation (12.5 [8.3–25] vs 36.5 [9.8–70] days; p = 0.029) was significantly prolonged in this group. Patchy subpleural thickening (n = 38; 90.5%) and subpleural consolidations (n = 23; 54.8%) were present in most patients. Pleural effusion was rare (n = 4; 9.5%). The median total LUS was 11.9 ± 3.9 points. In case of clinical deterioration with the need for intubation, LUS worsened significantly compared to baseline LU. Twelve patients died during the ICU stay (29%). There was no difference in survival in both LUS groups (75% vs 66.7%, p = 0.559). Conclusions LU can be a useful monitoring tool to predict clinical course but not outcome of COVID-19 ICU patients and can early recognize possible deteriorations.

scholarly journals Should the CIWA-Ar be the standard monitoring strategy for alcohol withdrawal syndrome in the intensive care unit?

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Tessa L. Steel ◽  
Shewit P. Giovanni ◽  
Sarah C. Katsandres ◽  
Shawn M. Cohen ◽  
Kevin B. Stephenson ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Alcohol Withdrawal Syndrome ◽  
Patient Characteristics ◽  
Response To Treatment ◽  
Alternative Measure ◽  
Icu Patients ◽  
Verbal Responses

Abstract Background The Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-Ar) is commonly used in hospitals to titrate medications for alcohol withdrawal syndrome (AWS), but may be difficult to apply to intensive care unit (ICU) patients who are too sick or otherwise unable to communicate. Objectives To evaluate the frequency of CIWA-Ar monitoring among ICU patients with AWS and variation in CIWA-Ar monitoring across patient demographic and clinical characteristics. Methods The study included all adults admitted to an ICU in 2017 after treatment for AWS in the Emergency Department of an academic hospital that standardly uses the CIWA-Ar to assess AWS severity and response to treatment. Demographic and clinical data, including Richmond Agitation-Sedation Scale (RASS) assessments (an alternative measure of agitation/sedation), were obtained via chart review. Associations between patient characteristics and CIWA-Ar monitoring were tested using logistic regression. Results After treatment for AWS, only 56% (n = 54/97) of ICU patients were evaluated using the CIWA-Ar; 94% of patients had a documented RASS assessment (n = 91/97). Patients were significantly less likely to receive CIWA-Ar monitoring if they were intubated or identified as Black. Conclusions CIWA-Ar monitoring was used inconsistently in ICU patients with AWS and completed less often in those who were intubated or identified as Black. These hypothesis-generating findings raise questions about the utility of the CIWA-Ar in ICU settings. Future studies should assess alternative measures for titrating AWS medications in the ICU that do not require verbal responses from patients and further explore the association of race with AWS monitoring.

scholarly journals Beta-Lactams Toxicity in the Intensive Care Unit: An Underestimated Collateral Damage?

2021 ◽  
Vol 9 (7) ◽  
pp. 1505
Author(s):  
Claire Roger ◽  
Benjamin Louart
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Manifestations ◽  
Acute Interstitial Nephritis ◽  
Convulsive Status Epilepticus ◽  
Beta Lactam ◽  
Beta Lactams ◽  
Drug Induced ◽  
Icu Patients

Beta-lactams are the most commonly prescribed antimicrobials in intensive care unit (ICU) settings and remain one of the safest antimicrobials prescribed. However, the misdiagnosis of beta-lactam-related adverse events may alter ICU patient management and impact clinical outcomes. To describe the clinical manifestations, risk factors and beta-lactam-induced neurological and renal adverse effects in the ICU setting, we performed a comprehensive literature review via an electronic search on PubMed up to April 2021 to provide updated clinical data. Beta-lactam neurotoxicity occurs in 10–15% of ICU patients and may be responsible for a large panel of clinical manifestations, ranging from confusion, encephalopathy and hallucinations to myoclonus, convulsions and non-convulsive status epilepticus. Renal impairment, underlying brain abnormalities and advanced age have been recognized as the main risk factors for neurotoxicity. In ICU patients, trough concentrations above 22 mg/L for cefepime, 64 mg/L for meropenem, 125 mg/L for flucloxacillin and 360 mg/L for piperacillin (used without tazobactam) are associated with neurotoxicity in 50% of patients. Even though renal complications (especially severe complications, such as acute interstitial nephritis, renal damage associated with drug induced hemolytic anemia and renal obstruction by crystallization) remain rare, there is compelling evidence of increased nephrotoxicity using well-known nephrotoxic drugs such as vancomycin combined with beta-lactams. Treatment mainly relies on the discontinuation of the offending drug but in the near future, antimicrobial optimal dosing regimens should be defined, not only based on pharmacokinetics/pharmacodynamic (PK/PD) targets associated with clinical and microbiological efficacy, but also on PK/toxicodynamic targets. The use of dosing software may help to achieve these goals.

scholarly journals Contamination of Propofol Infusions in the Intensive Care Unit: Incidence and Clinical Significance

1998 ◽  
Vol 26 (2) ◽  
pp. 162-164 ◽  
Author(s):  
S. A. R. Webb ◽  
B. Roberts ◽  
F. X. Breheny ◽  
C. L. Golledge ◽  
P. D. Cameron ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Observational Study ◽  
Nosocomial Infection ◽  
Wound Infection ◽  
Clinical Significance ◽  
Low Grade ◽  
Clinical Infection ◽  
Icu Patients

Epidemics of bacteraemia and wound infection have been associated with the infusion of bacterially contaminated propofol administered during anaesthesia. We conducted an observational study to determine the incidence and clinical significance of administration of potentially contaminated propofol to patients in an ICU setting. One hundred patients received a total of 302 infusions of propofol. Eighteen episodes of possible contamination of propofol syringes were identified, but in all cases contamination was by a low-grade virulence pathogen. There were no episodes of clinical infection or colonization which could be attributed to the administration of contaminated propofol. During the routine use of propofol to provide sedation in ICU patients the risk of nosocomial infection secondary to contamination of propofol is extremely low.

Comparing Vitamin A and Moist Chamber in Preventing Ocular Surface Disorders

2017 ◽  
Vol 27 (6) ◽  
pp. 714-729 ◽  
Author(s):  
Hassan Babamohamadi ◽  
Monir Nobahar ◽  
Jalaladin Razi ◽  
Raheb Ghorbani
Keyword(s):  
Clinical Trial ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Vitamin A ◽  
Ocular Surface ◽  
Slight Reduction ◽  
Moist Chamber ◽  
Icu Patients ◽  
Schirmer’S Test

The present study was conducted to determine the effectiveness of vitamin A eye ointment (VAEO) and moist chamber (MC) in preventing ocular surface disorders (OSD) in intensive care unit (ICU) patients. A total of 38 eligible patients were selected for participation in the present clinical trial. All the patients were randomly administered VAEO in one eye every 6 hr for 5 days and had a polyethylene cover (PC) placed on their other eye to create an MC that was replaced every 12 hr as well. The results of Schirmer’s test also increased by 2.06 mm in the VAEO group ( p < .001), while they showed a slight reduction by 0.15 mm in the MC group ( p = .669). VAEO was more effective in preventing OSD in ICU patients than MC and is, therefore, recommended to be used as a method of preventing OSD.

scholarly journals Comparison of Non–Intensive Care Unit (ICU) versus ICU Rates of Catheter-Associated Urinary Tract Infection in Community Hospitals

2013 ◽  
Vol 34 (7) ◽  
pp. 744-747 ◽  
Author(s):  
Sarah S. Lewis ◽  
Lauren P. Knelson ◽  
Rebekah W. Moehring ◽  
Luke F. Chen ◽  
Daniel J. Sexton ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Urinary Tract Infection ◽  
Intensive Care ◽  
Urinary Tract ◽  
Tract Infection ◽  
Community Hospitals ◽  
Icu Patients ◽  
Important Target

We describe and compare the epidemiology of catheter-associated urinary tract infection (CAUTI) occurring in non-intensive care unit (ICU) versus ICU wards in a network of community hospitals over a 2-year period. Overall, 72% of cases of CAUTI occurred in non-ICU patients, which indicates that this population is an important target for dedicated surveillance and prevention efforts.

scholarly journals Patterns of Antimicrobial Resistance Among Intensive Care Unit Patients of A Private Medical College Hospital in Dhaka

2015 ◽  
Vol 25 (2) ◽  
pp. 47-51 ◽  
Author(s):  
Quazi Tarikul Islam ◽  
Md Mahmudur Rahman Siddiqui ◽  
Farhana Raz ◽  
Mohammad Asrafuzzaman ◽  
Md Robed Amin
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tracheal Aspirate ◽  
College Hospital ◽  
Icu Patients ◽  
Gram Negative ◽  
Pseudomonas Spp ◽  
Medical College ◽  
Acinetobacter Spp ◽  
Klebsiella Spp

Because of importance of Hospital acquired infections (HAIs), it is critical to conduct surveillance studies to obtain the required data about the regional microorganisms and their susceptibility to antibiotics. This study to investigate antimicrobial resistance pattern among Intensive Care Unit (ICU) patients in a private medical college hospital setup. In a cross sectional study, 100 specimens from patients admitted in the ICU who had signs or symptoms of nosocomial infection were collected from 2012 - 2013. For each patient, samples of blood, urine, tracheal aspirate, sputum, wound swab, pus, and endotracheal tubes were obtained, cultured and analyzed with antibiogram. The most common primary diagnosis were aspiration pneumonia (49%) and UTI (20%) respectively. The most common locations for infection were tracheal aspirate (54%). The most frequent gram negative microorganisms derived from samples were Acinetobacter spp (29%), Klebsiella spp (26%) and Pseudomonas spp (18%). Klebsiella spp, Acinetobacter spp and Pseudomonas spp were most common resistant organisms among all. Klebsiella spp were resistant against Ceftriaxone (84.6%), Ceftazidime (82.6%), Amikacin (46.1%), Gentamicin (66.6%) and Quinolones (65-66.6%) respectively. Acinetobacter spp were resistant against Ceftriaxone (85%), Ceftazidime (88.8%), Cefotaxime (85.7%), Meropenem (79.3%),Amikacin (86.2%), Gentamicin (84.5%) and Quinolons (86.2-89.2%) respectively. Pseudomonas spp were resistant against Ceftriaxone (70.5%), Ceftazidime (66.6%), Amikacin (68.7%), Gentamicin (58.8%), Meropenem (52.9%) and Quinolones (81.2-86.6%) respectively. Meropenem was the most sensitive antibiotic against Klebsiella spp (84.6%) but Cotrimoxazole in case of Acinetobacter spp (60%) respectively. Escherichia coli were mostly isolated from urine, which was sensitive to Amikacin (73.3%) and Meropenem (86.6%) respectively. Gram-negative pathogens obtained from ICU patients in our settings show high resistance to antibiotics. Regular monitoring of the pattern of resistance of common pathogens in the ICUs is essential to up-to-date the use of rational antibiotics regiments.Bangladesh J Medicine Jul 2014; 25 (2) : 47-51

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