scholarly journals Nursing workload in a coronary unit according to the Nursing Activities Score

2015 ◽  
Vol 36 (3) ◽  
pp. 28-35 ◽  
Author(s):  
Rejane Reich ◽  
Débora Feijó Villas Bôas Vieira ◽  
Luciana Bjorklund de Lima ◽  
Eneida Rejane Rabelo-Silva
Keyword(s):  
Longitudinal Study ◽  
Teaching Hospital ◽  
Coronary Care Unit ◽  
Nursing Workload ◽  
Southern Brazil ◽  
The Mean ◽  
Coronary Care ◽  
Nursing Professionals ◽  
Over Time

Objective: this study aimed to using the Nursing Activities Score to assess nursing workload in a coronary care unit, to assess the distribution of workload between shifts, and to compare the current staff of the care unit with that recommended by the instrument.Method: this was a longitudinal study, conducted in a teaching hospital in Southern Brazil, between April to June 2012.Results: A total of 604 NAS measures were obtained from the 61 patients included. The mean workload per shift was 47% (±12), with the greatest workload being reported in the afternoon shifts.Conclusion: according to the NAS, a mean of two and a maximum of 2.4 nursing professionals would be required per shift to meet all patient demands, suggesting that the current staff size in the CCU is adequate. The NAS was successful in assessing nursing workload and changes in patient demands over time.

scholarly journals Characteristics and outcomes in acute patients receiving mechanical ventilation in a Coronary Care Unit (CCU)

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
M Rivadeneira Ruiz ◽  
DF Arroyo Monino ◽  
T Seoane Garcia ◽  
MP Ruiz Garcia ◽  
JC Garcia Rubira
Keyword(s):  
Mechanical Ventilation ◽  
Cardiac Arrest ◽  
Hospital Mortality ◽  
Coronary Care Unit ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Funding Sources ◽  
Copd Patients ◽  
The Mean ◽  
Coronary Care

Abstract Funding Acknowledgements Type of funding sources: None. Objectives Mechanical ventilation is the short-term technical support most widely used and cardiac arrest its main indication in a Coronary Care Unit (CCU). However, the knowledge about the specific moment and ventilator mode of onset to avoid the acute lung injury is still equivocal. Our objective is to determine the survival rate and the prognostic factors in patients supported by mechanical ventilation. Methods We conducted a retrospective cohort study of adult patients admitted to the CCU between January 2018 and November 2020 that received mechanical ventilation during the hospital stay. Results We collected 94 patients, 28% females with a median age of 68 ± 11,9. 43% were diabetics and almost one quarter of them had some degree of chronic obstructive pulmonary disease (COPD). Ischemic cardiopathy (33%) and heart failure (31%) were frequent pathologies as well as renal injury (29% patients a filtration rate below 45 mL/min/1,73m2). The reason for initiating mechanical ventilation was cardiac arrest in the half of the patients. Volume-controlled ventilation (73%) was the initial setting mode in most cases. The support with vasoactive drugs were highly necessary in these patients (Infection rate of 48%). In the subgroup analysis, we realized that the number of reintubations and the necessity of non-invasive ventilation were higher in the COPD group (p = 0,01), as well as tracheostomy (p = 0,03). COPD patients also needed higher maintaining PEEP, though this was not statistically significant. The mean length of stay in the intensive care unit of our cohort was 11 days (range: 1-78 days; median: 8 days) and the mean length of mechanical ventilation 6 days (range: 1-64 days; median: 3 days). The in-hospital mortality was 41,4%. Conclusions Cardiac arrest is the most common reason of mechanical ventilation support. Our study showed that COPD patients presented more complications during the weaning and the period after extubation. In-hospital mortality remains high in intubated patients.

scholarly journals Patterns of bruising in preschool children—a longitudinal study

2015 ◽  
Vol 100 (5) ◽  
pp. 426-431 ◽  
Author(s):  
Alison M Kemp ◽  
Frank Dunstan ◽  
Diane Nuttall ◽  
M Hamilton ◽  
Peter Collins ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Preschool Children ◽  
Social Deprivation ◽  
Multilevel Modelling ◽  
Bleeding Disorders ◽  
Prospective Longitudinal Study ◽  
The Mean ◽  
Data Collections ◽  
Prospective Longitudinal ◽  
Over Time

IntroductionThis study aims to identify the prevalence and pattern of bruises in preschool children over time, and explore influential variablesMethodsProspective longitudinal study of children (<6 years) where bruises were recorded on a body chart, weekly for up to 12 weeks. The number and location of bruises were analysed according to development. Longitudinal analysis was performed using multilevel modelling.Results3523 bruises recorded from 2570 data collections from 328 children (mean age 19 months); 6.7% of 1010 collections from premobile children had at least one bruise (2.2% of babies who could not roll over and 9.8% in those who could), compared with 45.6% of 478 early mobile and 78.8% of 1082 walking child collections. The most common site affected in all groups was below the knees, followed by ‘facial T’ and head in premobile and early mobile. The ears, neck, buttocks, genitalia and hands were rarely bruised (<1% of all collections). None of gender, season or the level of social deprivation significantly influenced bruising patterns, although having a sibling increased the mean number of bruises. There was considerable variation in the number of bruises recorded between different children which increased with developmental stage and was greater than the variation between numbers of bruises in collections from the same child over time.ConclusionsThese data should help clinicians understand the patterns of ‘everyday bruising’ and recognise children who have an unusual numbers or distribution of bruises who may need assessment for physical abuse or bleeding disorders.

scholarly journals Aplicação do Nursing Activities Score (NAS) em diferentes tipos de UTI´s: uma revisão integrative

2019 ◽  
Vol 18 (4) ◽  
pp. 485-528
Author(s):  
Raiane Antonia Santos Nobre ◽  
Hertaline Menezes do Nascimento Rocha ◽  
Fernanda de Jesus Santos ◽  
Allan Dantas Dos Santos ◽  
Rafaela Gois De Mendonça ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nursing Workload ◽  
Inclusion Criteria ◽  
General Icus ◽  
High Workload ◽  
Terapia Intensiva ◽  
The Mean ◽  
Nas Score ◽  
Nursing Professionals

Objective: To compare the nursing workload measured by the Nursing Activities Score (NAS), between intensive care unit general adult ICU, and specialized surgical, cardiologic and trauma type.Methods: A literature review of the integrative type was carried out, searching the databases BDENF, LILACS, MEDLINE, and SCIELO, using the descriptors nursing, Intensive Care Unit, workload and Nursing Activities Score. They met the inclusion criteria 20 articles published in the period 2007 to 2017.Results: They show a high workload in the ICU, both in general ICUs and in all of the cited specificities, the same with a NAS score> 50.00, especially the trauma ICU, which was characterized with higher scores 72.00 and 71.3.Conclusion: In much of the research, the average number of nursing professionals calculated by the NAS is higher than the average number of professionals required by the legislation. It was observed that even in ICUs with the same specificity it was possible to perceive large differences in the mean of the NAS score, in this way, we understand that despite having the same specificity, the profile of the patient as well as that of the institution has its peculiarities requiring time to different assistance and consequently divergences in sizing. Objetivo: Comparar la carga de trabajo de enfermería medida por la Nursing Activities Score (NAS), entre la unidad de cuidados intensivos general de adultosy especializadas de quirúrgico, cardiología y trauma.Métodos: Realización de una revisión de la literatura del tipo integrativa. Búsqueda en las bases de datos BDENF, LILACS, MEDLINE, SCIELO, utilizando los descriptores enfermería, Unidad de Cuidados Intensivos, Carga de trabajo y Nursing Activities Score. Atendieron a los criterios de inclusión 20 artículos publicados en el periodo de 2007 a 2017.Resultados: Evidencian elevada carga de trabajo en UCI, tanto en UCIs general como en todas las especificidades citadas, las mismas con puntuación NAS > 50,00, destacando la UCI de trauma lo que se caracterizó con mayores marcadores 72,00 y 71,3.Conclusión: En gran parte de las investigaciones, la media de profesionales de enfermería calculada por la NAS es superior a la media de profesionales requerida por la legislación. Se observó que incluso en UCIs con la misma especificidad se perciben grandes diferencias en la media de la puntuación NAS, de esta forma, entendemos que a pesar de tener la misma especificidad, el perfil del paciente así como el de la institución tienen sus particularidades demandando tiempo de asistencia diferente y consecuentemente divergencias en el dimensionamiento. Objetivo: Comparar a carga de trabalho de enfermagem medida pelo Nursing Activities Score (NAS), entre unidade de terapia intensiva UTI geral adulto, e especializadas do tipo cirúrgica, cardiológica e trauma.Métodos: Foi realizada uma revisão de literatura do tipo integrativa, com busca nas bases de dados BDENF, LILACS, MEDLINE, e SCIELO, utilizando-se os descritores enfermagem, Unidade de Terapia Intensiva, carga de trabalho e Nursing Activities Score. Atenderam aos critérios de inclusão 20 artigos publicados no período de 2007 a 2017.Resultados: Evidenciam elevada carga de trabalho em UTI, tanto em UTIs geral quanto em todas as especificidades citadas, as mesmas com pontuação NAS > 50,00, destacando-se a UTI de trauma o que caracterizou-se com maiores escores 72,00 e 71,3.Conclusão: Em grande parte das pesquisas, a média de profissionais de enfermagem calculada pelo NAS é superior à média de profissionais requerida pela legislação. Observou-se que mesmo em UTIs com a mesma especificidade pôde-se perceber grandes diferenças na média do escore NAS, dessa forma, entendemos que apesar de possuir a mesma especificidade, o perfil do paciente assim como o da instituição tem suas particularidades demandando tempo de assistência diferente e consequentemente divergências no dimensionamento.

scholarly journals Teamwork in a coronary care unit: facilitating and hindering aspects

2016 ◽  
Vol 50 (3) ◽  
pp. 482-489 ◽  
Author(s):  
Bethania Ferreira Goulart ◽  
Silvia Helena Henriques Camelo ◽  
Ana Lúcia de Assis Simões ◽  
Lucieli Dias Pedreschi Chaves
Keyword(s):  
Critical Incident ◽  
Coronary Care Unit ◽  
Physical Therapists ◽  
Critical Incident Technique ◽  
Structured Interviews ◽  
Positive Behaviors ◽  
Coronary Care ◽  
One Year ◽  
Interprofessional Relationship ◽  
Nursing Professionals

Abstract OBJECTIVE To identify, within a multidisciplinary team, the facilitating and hindering aspects for teamwork in a coronary care unit. METHOD A descriptive study, with qualitative and quantitative data, was carried out in the coronary care unit of a public hospital. The study population consisted of professionals working in the unit for at least one year. Those who were on leave or who were not located were excluded. The critical incident technique was used for data collection, by means of semi-structured interviews. For data analysis, content analysis and the critical incident technique were applied. RESULTS Participants were 45 professionals: 29 nursing professionals; 11 physicians; 4 physical therapists; and 1 psychologist. A total of 49 situations (77.6% with negative references); 385 behaviors (54.2% with positive references); and 182 consequences emerged (71.9% with negative references). Positive references facilitate teamwork, whereas negative references hinder it. A collaborative/communicative interprofessional relationship was evidenced as a facilitator; whereas poor collaboration among agents/inadequate management was a hindering aspect. CONCLUSION Despite the prevalence of negative situations and consequences, the emphasis on positive behaviors reveals the efforts the agents make in order to overcome obstacles and carry out teamwork.

Chronic pain in multiple sclerosis: A10-year longitudinal study

2017 ◽  
Vol 16 (1) ◽  
pp. 198-203 ◽  
Author(s):  
Jamie Young ◽  
Bhasker Amatya ◽  
Mary P. Galea ◽  
Fary Khan
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Chronic Pain ◽  
Longitudinal Study ◽  
The Mean ◽  
The Impact ◽  
Over Time

AbstractBackground and purposePain is a common symptom associated with multiple sclerosis (MS), and has lasting effects on an individual’s functional capacity and quality of life. A wide range of prevalence rates of pain (between 23% and 90%)have been reported in MS and this is mainly due to the methodological differences amongst the studies such as variability in patient sources, method of sampling and the definition of pain used. Chronic pain in MS, defined as pain lasting for greater than 3–6 months, can have a significant impact on their biopsychosocial health, including negative impact on activities of daily living, relationships and social participation. The long-term course of MS-related pain and its impact in an Australian cohort over a 7-year period has been investigated earlier. The aim of this longitudinal study was to describe the impact of chronic pain, pain-related disability and carer burden in persons with MS over a 10-year period. The aim of this longitudinal study was to describe the impact of chronic pain, pain-related disability and carer burden in persons with MS over a 10-year period.MethodsThis was a prospective longitudinal study conducted at the Rehabilitation Department of Royal Melbourne Hospital (RMH), a tertiary referral hospital in Victoria and Australia. The source of participants was from the RMH MS database and contains detailed MS patient information including demographic data, diagnosis details (using McDonald’s criteria), pain characteristics. Structured face-face interviews and validated measures were used, which include the visual analogue scale (VAS); chronic pain grade (CPG); the assessment of quality of life (AQoL) and the carer strain index (CSI). The mean age of the participants (n = 70) was 55.3 years and majority (70%) were female.ResultsThe mean age of the participants (n = 70) was 55.3 years and majority (70%) were female. The findings show that over time (10 years), participants report having greater bilateral bodily pain and greater description of pain as ‘worse as it could be’. Pain types were similar to 7-years follow-up but remained higher than baseline. There was a significant deterioration in quality of life in those with more severe CPG over time. Almost half of the participants 31 (44%) required care either from a private carer, institution or from a family member. Although fear of taking medications and side effects were common barriers to treatment for pain, there was an increase in the use of pharmacological treatment over time and an increase in the use of healthcare services, mainly neurologists and general practitioners.ConclusionsThe pain measures reported by the participants were similar to those at the 7-year follow-up except there was a greater representation of bilateral pain locations (limb, trunk and facial pain) compared to baseline and 7-year follow-up. At 10-year follow-up, more participants used medications compared tc 7-year follow-up and there was an increase in the use of health professionals at the 10-year follow-up At the 10-year follow up QoL of the participants deteriorated significantly and more participants had progressed to higher CPGIII and CPGIV. This study demonstrates that chronic pain is a significant issue over time in MS, with clinical and health implications, impact on quality of life, disability and healthcare utilization.ImplicationsGreater awareness of chronic pain in pwMS, cognitive classifications and an interdisciplinary approach is required to improve long-term patient outcomes and well-being.Crown Copyright © 2017 Published by Elsevier B.V. on behalf of Scandinavian Association for the Study of Pain. All rights reserved.

scholarly journals Constancy of the angle between the Frankfort horizontal plane and the sella-nasion line: A nine-year longitudinal study

2013 ◽  
Vol 84 (2) ◽  
pp. 286-291 ◽  
Author(s):  
Young Jae Huh ◽  
Kyung-Hoe Huh ◽  
Hong-Kyun Kim ◽  
Shin-Eun Nam ◽  
Hye Yoon Song ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Horizontal Plane ◽  
Annual Change ◽  
Mixed Effect ◽  
Effect Regression ◽  
The Mean ◽  
Frankfort Horizontal Plane ◽  
Mixed Effect Regression Model ◽  
Over Time ◽  
Observation Period

ABSTRACT Objective: To investigate the constancy of the angle between the Frankfort horizontal plane (FH) and the sella-nasion line (SN) using longitudinal data. Materials and Methods: Longitudinal lateral cephalometric data of 223 children (116 girls and 107 boys) from 6 to 14 years of age were used. The angle between FH and SN (SNFH), the distance from FH to the nasion (NFH), the distance from FH to the sella (SFH), and the differences between the NFH and SFH (Δ) were also measured. All data were analyzed statistically using independent t-tests and mixed-effect regression model analysis. Results: The mean SNFH values showed some minor fluctuations, ranging from 9.26° to 9.74° in girls and 8.45° to 8.95° in boys. The mean NFH and SFH values gradually increased according to age irrespective of sex. There were statistically significant differences by sex for all measurements at several ages. The annual change in SFH and Δ showed sexual dimorphism. Conclusions: There are variations among individuals in the angle between the FH and SN. However, within an individual, the angle does not vary significantly over time during the observation period.

scholarly journals Theoretical and practical knowledge of Nursing professionals on indirect blood pressure measurement at a coronary care unit

2014 ◽  
Vol 12 (3) ◽  
pp. 330-335 ◽  
Author(s):  
Juliana Pereira Machado ◽  
Eugenia Velludo Veiga ◽  
Paulo Alexandre Camargo Ferreira ◽  
José Carlos Amado Martins ◽  
Ana Carolina Queiroz Godoy Daniel ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pressure Measurement ◽  
Coronary Care Unit ◽  
Practical Knowledge ◽  
Blood Pressure Measurement ◽  
Theory And Practice ◽  
Coronary Care ◽  
Practice Assessment ◽  
Nursing Professionals ◽  
Indirect Blood Pressure

Objective To determine and to analyze the theoretical and practical knowledge of Nursing professionals on indirect blood pressure measurement. Methods This cross-sectional study included 31 professionals of a coronary care unit (86% of the Nursing staff in the unit). Of these, 38.7% of professionals were nurses and 61.3% nurse technicians. A validated questionnaire was used to theoretical evaluation and for practice assessment the auscultatory technique was applied in a simulation environment, under a non-participant observation. Results To the theoretical knowledge of the stages of preparation of patient and environment, 12.9% mentioned 5-minute of rest, 48.4% checked calibration, and 29.0% chose adequate cuff width. A total of 64.5% of professionals avoided rounding values, and 22.6% mentioned the 6-month deadline period for the equipment calibration. On average, in practice assessment, 65% of the steps were followed. Lacks in knowledge were primary concerning lack of checking the device calibration and stethoscope, measurement of arm circumference to choose the cuff size, and the record of arm used in blood pressure measurement. Conclusion Knowledge was poor and had disparities between theory and practice with evidence of steps taken without proper awareness and lack of consideration of important knowledge during implementation of blood pressure measurement. Educational and operational interventions should be applied systematically with institutional involvement to ensure safe care with reliable values.

scholarly journals HbA1c levels in patients of acute decompensated heart failure

2016 ◽  
Vol 7 (4) ◽  
pp. 55-58
Author(s):  
Ravi Shekhar ◽  
Biju Govind ◽  
NVS Chowdary ◽  
Sadhna Sharma ◽  
R John Satish ◽  
...  
Keyword(s):  
Heart Failure ◽  
Coronary Care Unit ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Medical Sciences ◽  
Increased Risk ◽  
Ethical Approval ◽  
The Mean ◽  
Coronary Care ◽  
Hba1c Levels

Background: Hospitalization for Heart Failure (HF) is increasing in India. Diabetes Mellitus (DM) is closely related to HF. Hb1Ac is an index of metabolic control of DM. Hb1Ac is associated with increased risk of Acute Decompensated Heart Failure (ADHF). The relation between Hb1Ac and ADHF is less well defined.Aims and Objectives: The aim of the study was to find out the prevalence of ADHF among patients admitted for cardiac complaints and to investigate Hb1Ac levels in confirmed patients.Materials and Methods: A hospital based study was conducted at NRI Heart Centre, NRI General Hospital, Guntur from May to July 2013 after institutional ethical approval. All patients of ADHF were included in the study. Patients were analysed for HbA1c.Results: Out of 1147 patients admitted in Coronary Care Unit, there were 101 cases of ADHF giving a prevalence of 8.8%. The mean age was found to be 54.69 years. 19.8% of the patients were of age less than 40. There were 74.3% males and 25.7% females. The mean HbA1c in non diabetic, pre-diabetic and diabetic was 5.32%, 6.0% and 8.45% respectively.Conclusion: Elevated HbA1c is associated with increased morbidity in the heart failure and efforts should be made to treat these patients with proven therapies to lower the blood glucose levels.Asian Journal of Medical Sciences Vol.7(4) 2016 55-58

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