scholarly journals COMMUNICATION NOISE DURING THE NURSING TEAM HANDOVER IN THE INTENSIVE CARE UNIT

2019 ◽  
Vol 28 ◽  
Author(s):  
Grazielle Rezende da Silva dos Santos ◽  
Fabiana de Mello Barros ◽  
Priscilla Valladares Broca ◽  
Rafael Celestino da Silva
Keyword(s):  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Communication Process ◽  
Care Plan ◽  
Direct Patient Care ◽  
Observation Data ◽  
Systematic Observation ◽  
Thick Description ◽  
Nursing Team

ABSTRACT Objective: to describe the communication process among the professionals of the intensive care nursing team during the handover, analyzing the existence of noise and its repercussions on patient safety. Method: qualitative and exploratory study, in the light of Berlo, carried out at the intensive care unit of a federal hospital with 42 nursing professionals participating in the handover and/or acting in direct patient care. An audio recording of the handover was performed, as well as its systematic observation and the care practices of the nursing team. The audios were transcribed for an instrument and analyzed through descriptive statistics regarding the presence, completeness and correction of the information. The observation data were submitted to thick description. Results: the noises were related to the absence/incompleteness of information about the patient, with focus on the communication about intercurrences and clinical evolution of the last 24 hours and little valuation of the data on evaluation, care plan and clinical condition of the patient; in addition to late arrivals, speaking with a low tone of voice, parallel conversations, and the use of cell phones. Such noises have caused unnecessary, wrong procedures or prevented procedures from being performed. Conclusion: noise in the communication process negatively affects nursing and patient safety.

scholarly journals VIOLATIONS OF NURSES IN THE USE OF EQUIPMENT IN INTENSIVE CARE

2017 ◽  
Vol 26 (2) ◽  
Author(s):  
Gabriella da Silva Rangel Ribeiro ◽  
Rafael Celestino da Silva ◽  
Márcia de Assunção Ferreira ◽  
Grazielle Rezende da Silva
Keyword(s):  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Safety Culture ◽  
Qualitative Approach ◽  
Direct Care ◽  
Systematic Observation ◽  
Hospital Data ◽  
Thick Description ◽  
Data Production

ABSTRACT Objective: to identify situations of violation in the use of equipment by nurses in the intensive care unit and analyze their implications on patient safety. Method: a descriptive field study with qualitative approach was carried out from March to December 2014, with the use of James Reason's violation concept. The participants were nurses from the day shift, working in direct care at an intensive care unit of a federal hospital. Data production was carried out through systematic observation and interviews, and were analyzed based on thick description of scenes and content of responses. Results: violations in planning care regarding the checking of the equipment functioning before its use and alarms were found, when nurses disconnect them to reduce the effects caused by the overload of noise on the team. Conclusion: the situations reported compromise safety and cause serious risks to patients. Therefore, implementation of strategies to promote a safety culture is required.

scholarly journals Handover communication in intensive therapy: nursing team meanings and practices

2020 ◽  
Vol 41 ◽  
Author(s):  
Grazielle Rezende da Silva dos Santos ◽  
Fabiana de Mello Barros ◽  
Rafael Celestino da Silva
Keyword(s):  
Intensive Care Unit ◽  
Content Analysis ◽  
Intensive Care ◽  
Nursing Care ◽  
Intensive Therapy ◽  
The Other ◽  
Communication Process ◽  
Thematic Content Analysis ◽  
Nursing Team ◽  
Handover Process

ABSTRACT Objective: To analyze the meanings built by the nursing team regarding communication at shift handover in intensive care units. Method: A qualitative study, grounded on the theoretical framework of Berlo, was developed in the intensive care unit of a hospital in Rio de Janeiro with the nursing team participating in the handover process or working with patient care. Observation and interviews were conducted, with a thorough description of the data and thematic content analysis. Results: There is acknowledgment of the meaning of handover in nursing care, which is expressed in behaviors aimed at avoiding inefficacy or the incorrect perception of communication; on the other hand, there is little participation of nursing technicians, with side talks, lack of attention and incomplete information, which compromises their effectiveness. Conclusion: Professionals should understand their role in the communication process by playing it with active participation to reduce handover noises.

scholarly journals EXPERIENCE OF NURSES IN THE MANAGEMENT OF CONTINUOUS HEMODIALYSIS AND ITS INFLUENCES ON PATIENT SAFETY

2019 ◽  
Vol 28 ◽  
Author(s):  
Bianca Ribeiro Porto de Andrade ◽  
Fabiana de Mello Barros ◽  
Honorina Fátima Ângela de Lúcio ◽  
Juliana Faria Campos ◽  
Rafael Celestino da Silva
Keyword(s):  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Exploratory Research ◽  
Structured Interviews ◽  
Collaborative Model ◽  
Complete Evaluation ◽  
Thick Description ◽  
The Impact ◽  
Continuous Hemodialysis

ABSTRACT Objective: to analyze the professional experience of intensive care nurses and its influence on their work activities in the continuous hemodialysis process and patient safety in the intensive care unit within the scope of the collaborative model. Method: qualitative and exploratory research, based on the systemic paradigm of patient safety, developed at the Intensive Care Unit of a private institution in the city of Rio de Janeiro, Brazil. There were 23 nurse participants who had been working for more than three months in study scenery and in direct contact with continuous hemodialysis. The data were produced from June to October of 2016 by means of observation, analyzed using thick description as well as semi-structured interviews, and then submitted to the content analysis technique. Results: were organized in two categories: the first one portrays the influence of the professional working experience on the safety of nurses' performance, which verified that in relation to continuous hemodialysis, inexperienced nurses follow guidelines and manuals, without a complete evaluation of this care situation and face difficulties in the performance of everyday care. The second category demonstrates the impact of the nurse´s inexperience on the occurrence of active errors, evidencing actions that result in the occurrence of adverse events. Conclusion: the insertion of inexperienced nurses is a latent condition in the investigated system that results in the occurrence of incidents in the continuous hemodialysis process, requiring the improvement of the collaborative model through the systematic monitoring of the performance of these professionals, such as the proposal of a safety barrier.

scholarly journals Nursing Activities Score by assistance sites in Intensive Care Units

2017 ◽  
Vol 22 (1) ◽  
Author(s):  
Claudia Maria Silva Cyrino ◽  
Magda Cristina Queiroz Dell'Acqua ◽  
Meire Cristina Novelli e Castro ◽  
Elaine Machado de Oliveira ◽  
Sérgio Deodato ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Retrospective Study ◽  
Confidence Interval ◽  
Clinical Characteristics ◽  
Surgical Patients ◽  
Nursing Workload ◽  
Work Process ◽  
Nursing Team

Abstract Objective: To compare the Nursing Activities Score (NAS) between the Assistance Sites in an Intensive Care Unit. Method: Descriptive, retrospective study, carried out in the Intensive Care Unit of a teaching hospital. The patients were organized in Assistance Sites according to their clinical characteristics and the nursing team's composition was organized in accordance with the Nursing Activities Score (NAS). The confidence interval was set at p < 0.05. Results: the majority were male surgical patients with a mean age of 56.8 years. The postoperative care Site presented the greatest patient turnover. The overall average NAS was 71.7%. There was a difference in the nursing workload between the different Assistance Sites. The shorter length of stay and the nonsurvivors contributed to increasing the workload in the ICU. Conclusion: Comparing the NAS in the different Sites made it possible to organize the work process of the nursing team according to each group, contributing to patient safety.

scholarly journals Equipment failure: conducts of nurses and implications for patient safety

2018 ◽  
Vol 71 (4) ◽  
pp. 1832-1840
Author(s):  
Gabriella da Silva Rangel Ribeiro ◽  
Rafael Celestino da Silva ◽  
Márcia de Assunção Ferreira ◽  
Grazielle Rezende da Silva ◽  
Juliana Faria Campos ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nursing Care ◽  
Public Institution ◽  
Direct Care ◽  
Monitoring Systems ◽  
Equipment Failure ◽  
Systematic Observation ◽  
Thick Description ◽  
Equipment Failures

ABSTRACT Objectives: To identify equipment failures during handling by nurses and analyze the conduct of the professionals when these failures occur. Methods: Descriptive, exploratory and qualitative study, whose field was the intensive care unit of a public institution, and the participants were day nurses that worked providing direct care to patients. Data were produced in 2014 through systematic observation and interviews and were examined with thick description and content analysis. Results: The outcomes evinced the inadequate functioning of infusion bombs, users' errors related to the design of equipment and problems with batteries of artificial fans. These failures related to the management of equipment in the unit. Final considerations: It is necessary to strengthen the monitoring systems of safety conditions of equipment in intensive nursing care to prevent incidents.

scholarly journals Contamination of Healthcare Worker Personal Protective Equipment with MRSA Outside the Intensive Care Unit Setting

2020 ◽  
Vol 41 (S1) ◽  
pp. s27-s28
Author(s):  
Gita Nadimpalli ◽  
Lisa Pineles ◽  
Karly Lebherz ◽  
J. Kristie Johnson ◽  
David Calfee ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Patient Care ◽  
Direct Patient Care ◽  
Care Group ◽  
Surveillance Culture ◽  
Care Hospital ◽  
Contact Precautions ◽  
Patient Interactions ◽  
The Right

Background: Estimates of contamination of healthcare personnel (HCP) gloves and gowns with methicillin-resistant Staphylococcus aureus (MRSA) following interactions with colonized or infected patients range from 17% to 20%. Most studies were conducted in the intensive care unit (ICU) setting where patients had a recent positive clinical culture. The aim of this study was to determine the rate of MRSA transmission to HCP gloves and gown in non-ICU acute-care hospital units and to identify associated risk factors. Methods: Patients on contact precautions with history of MRSA colonization or infection admitted to non-ICU settings were randomly selected from electronic health records. We observed patient care activities and cultured the gloves and gowns of 10 HCP interactions per patient prior to doffing. Cultures from patients’ anterior nares, chest, antecubital fossa and perianal area were collected to quantify bacterial bioburden. Bacterial counts were log transformed. Results: We observed 55 patients (Fig. 1), and 517 HCP–patient interactions. Of the HCP–patient interactions, 16 (3.1%) led to MRSA contamination of HCP gloves, 18 (3.5%) led to contamination of HCP gown, and 28 (5.4%) led to contamination of either gloves or gown. In addition, 5 (12.8%) patients had a positive clinical or surveillance culture for MRSA in the prior 7 days. Nurses, physicians and technicians were grouped in “direct patient care”, and rest of the HCPs were included in “no direct care group.” Of 404 interactions, 26 (6.4%) of providers in the “direct patient care” group showed transmission of MRSA to gloves or gown in comparison to 2 of 113 (1.8%) interactions involving providers in the “no direct patient care” group (P = .05) (Fig. 2). The median MRSA bioburden was 0 log 10CFU/mL in the nares (range, 0–3.6), perianal region (range, 0–3.5), the arm skin (range, 0-0.3), and the chest skin (range, 0–6.2). Detectable bioburden on patients was negatively correlated with the time since placed on contact precautions (rs= −0.06; P < .001). Of 97 observations with detectable bacterial bioburden at any site, 9 (9.3%) resulted in transmission of MRSA to HCP in comparison to 11 (3.6%) of 310 observations with no detectable bioburden at all sites (P = .03). Conclusions: Transmission of MRSA to gloves or gowns of HCP caring for patients on contact precautions for MRSA in non-ICU settings was lower than in the ICU setting. More evidence is needed to help guide the optimal use of contact precautions for the right patient, in the right setting, for the right type of encounter.Funding: NoneDisclosures: None

Atmung – Standardisierte Checkliste macht Intubation von Neugeborenen sicherer

2017 ◽  
Vol 22 (03) ◽  
pp. 124-125
Author(s):  
Maria Weiß
Keyword(s):  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Improve Patient Safety ◽  
Improve Patient

Hatch LD. et al. Intervention To Improve Patient Safety During Intubation in the Neonatal Intensive Care Unit. Pediatrics 2016; 138: e20160069 Kinder auf der Neugeborenen-Intensivstation sind besonders durch Komplikationen während des Krankenhausaufenthaltes gefährdet. Dies gilt auch für die Intubation, die relativ häufig mit unerwünschten Ereignissen einhergeht. US-amerikanische Neonatologen haben jetzt untersucht, durch welche Maßnahmen sich die Komplikationsrate bei Intubationen in ihrem Perinatal- Zentrum senken lässt.

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