scholarly journals Evaluating pharmaceutical waste disposal in pediatric units

2016 ◽  
Vol 50 (6) ◽  
pp. 922-928
Author(s):  
Maria Angélica Randoli de Almeida ◽  
◽  
Ana Maria Miranda Martins Wilson ◽  
Maria Angélica Sorgini Peterlini
Keyword(s):  
Intensive Care Unit ◽  
Team Performance ◽  
University Hospital ◽  
Convenience Sample ◽  
Healthcare Waste ◽  
Pharmaceutical Waste ◽  
Infectious Waste ◽  
Validated Instrument ◽  
Surgical Unit ◽  
Proper Disposal

Abstract OBJECTIVE To verify the disposal of pharmaceutical waste performed in pediatric units. METHOD A descriptive and observational study conducted in a university hospital. The convenience sample consisted of pharmaceuticals discarded during the study period. Handling and disposal during preparation and administration were observed. Data collection took place at pre-established times and was performed using a pre-validated instrument. RESULTS 356 drugs disposals were identified (35.1% in the clinic, 31.8% in the intensive care unit, 23.8% in the surgical unit and 9.3% in the infectious diseases unit). The most discarded pharmacological classes were: 22.7% antimicrobials, 14.8% electrolytes, 14.6% analgesics/pain killers, 9.5% diuretics and 6.7% antiulcer agents. The most used means for disposal were: sharps’ disposable box with a yellow bag (30.8%), sink drain (28.9%), sharps’ box with orange bag (14.3%), and infectious waste/bin with a white bag (10.1%). No disposal was identified after drug administration. CONCLUSION A discussion of measures that can contribute to reducing (healthcare) waste volume with the intention of engaging reflective team performance and proper disposal is necessary.

Profile of patients with pressure ulcers in the intensive care unit

2012 ◽  
Vol 6 (2) ◽  
pp. 378
Author(s):  
Joana Greicy Nascimento dos Santos ◽  
Priscila De Oliveira Carvalho ◽  
José Cristovam Martins Vieira
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Records ◽  
Pressure Ulcers ◽  
University Hospital ◽  
Cross Sectional ◽  
Ventilatory Assistance ◽  
Factores De Riesgo ◽  
Terapia Intensiva ◽  
Validated Instrument

ABSTRACTObjective: to identify the profile of patients with pressure ulcers (PUs) hospitalized in the intensive care unit (ICU) of a university hospital in Recife, Pernambuco, Brazil. Methodology: this is a retrospective study with a cross-sectional cohort and quantitative approach, carried out with the medical records of patients hospitalized in the ICU of Hospital das Clínicas within the period from January to June 2009. The data collection was held between September and November 2010, in Serviço de Arquivo Médico e Estatística (SAME), using the validated instrument in five medical records containing clinical, demographic and epidemiological aspects related to patients with pressure ulcers. This study was approved by the Research Ethics Committee of Universidade Federal de Pernembuco under the Protocol 229/10. Results: out of the 56 medical records of patients who met the inclusion criteria, 24 developed PUs (42.86%). Out of these ones, 62.5% were males and 58.4% were over 60 years. A prevalence of patients in Neurology and Medical Clinics was observed, both with 20.83%. Infectious disorders were the main reason for hospitalization (45.8%). Regarding risk factors, 87.5% underwent mechanical ventilatory assistance, 37.5% were sedated, and 70.8% were fed through nasogastric tube. Conclusion: the incidence of PU detected was high, showing the influence of multiple factors and conditions that increase the risk for its occurrence. Thus, one should emphasize a comprehensive approach from the multidisciplinary team, aiming to provide an adequate prevention of this injury. Descriptors: nursing; pressure ulcers; intensive care unit.RESUMOObjetivo: identificar o perfil de pacientes com úlceras por pressão (UPS) internados na unidade de terapia intensiva (UTI) de um hospital universitário de Recife-PE. Metodologia: Trata-se de estudo retrospectivo com de corte transversal e abordagem quantitativa, realizado com os prontuários de pacientes internados na UTI do Hospital das Clínicas, no período de janeiro a junho de 2009. A coleta de dados foi realizada entre setembro e novembro de 2010, no Serviço de Arquivo Médico e Estatística (SAME), utilizando o instrumento validado em cinco prontuários contendo aspectos clínicos, demográficos e epidemiológicos referentes a pacientes com úlceras por pressão. Este estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal de Pernambuco (UFPE), sob o Protocolo n. 229/10. Resultados: dos 56 prontuários de pacientes que preencheram os critérios de inclusão, 24 desenvolveram UPs (42,86%). Desses, 62,5% eram do sexo masculino e 58,4% tinham mais de 60 anos. Verificou-se uma prevalência dos pacientes da Neurologia e Clínica Médica, ambas com 20,83%. Predominaram as disfunções infecciosas como motivo de internação (45,8%). Em relação aos fatores de risco, 87,5% encontravam-se em assistência ventilatória mecânica, 37,5% sedados e 70,8% alimentavam-se por sonda nasoenteral. Conclusão: a incidência de UP detectada foi elevada, evidenciando-se a influência da multiplicidade de fatores e condições que aumentam o risco de sua ocorrência. Assim, deve-se enfatizar uma abordagem abrangente da equipe multidisciplinar, visando à prevenção adequada dessa lesão. Descritores: enfermagem; úlceras por pressão; unidade de terapia intensiva.RESUMENObjetivo: identificar el perfil de pacientes con úlceras por presión (UPs) en la unidad de terapia intensiva (UTI) de un hospital universitario en Recife, Pernambuco, Brasil. Metodología: esto es un estudio retrospectivo de corte transversal y abordaje cuantitativo, realizado con los prontuarios de pacientes internados en la UTI del Hospital das Clínicas en el periodo de enero a junio de 2009. La recogida de datos fue realizada entre septiembre y noviembre de 2010, en el Serviço de arquivo Médico e Estatística (SAME), utilizando validado en cinco prontuários conteniendo aspectos clínicos, demográficos y epidemiológicos referentes a pacientes com úlceras por presión. Este estúdio fue aprobado por el Comité de Ética en Investigación de la Universidade Federal de Pernambuco (UFPE), bajo el Protocolo 229/10. Resultados: de los 56 prontuarios de pacientes que cumplieron los criterios de inclusión, 24 desarrollaron UPs (42,86%). De estes 24 pacientes, 62,5% eran del sexo masculino y 58,4% tenían más de 60 años. Se verifico uma prevalencia de los pacientes de la Neurología y Clínica Médica, con 20,83% cada. Predominaron las disfunciones infecciosas (45,8%) como motivo de internación. Com relación a los factores de riesgo, 87,5% estaban en asistencia ventilatoria mecánica, 37,5% estaban sedados y 70,8% eran alimentados por sonda nasogástrica. Conclusión: la incidencia de UP detectada fue elevada, se evidenciando la influencia de la multiplicidad de factores y condiciones que aumentan el riesgo de su ocurrencia. Así, se debe enfatizar un abordaje abarcador del equipo multidisciplinario, intentando la prevención adecuada de esa lesión. Descriptores: enfermería; úlceras por presión; unidad de terapia intensiva.

scholarly journals Prevalence of multidrug-resistant Acinetobacter baumannii in a critical care setting: A tertiary teaching hospital experience

2021 ◽  
Vol 9 ◽  
pp. 205031212110011
Author(s):  
Thabit Alotaibi ◽  
Abdulrhman Abuhaimed ◽  
Mohammed Alshahrani ◽  
Ahmed Albdelhady ◽  
Yousef Almubarak ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Rate ◽  
Acinetobacter Baumannii ◽  
Care Setting ◽  
Multidrug Resistant ◽  
University Hospital ◽  
Published Data ◽  
Tertiary Teaching ◽  
The Mean

Background: The management of Acinetobacter baumannii infection is considered a challenge especially in an intensive care setting. The resistance rate makes it difficult to manage and is believed to lead to higher mortality. We aim to investigate the prevalence of Acinetobacter baumannii and explore how different antibiotic regimens could impact patient outcomes as there are no available published data to reflect our population in our region. Methods: We conducted a retrospective review of all infected adult patients admitted to the intensive care unit at King Fahad University Hospital with a confirmed laboratory diagnosis of Acinetobacter baumannii from 1 January 2013 until 31 December 2017. Positive cultures were obtained from the microbiology department and those meeting the inclusive criteria were selected. Variables were analyzed using descriptive analysis and cross-tabulation. Results were further reviewed and audited by blinded co-authors. Results: A comprehensive review of data identified 198 patients with Acinetobacter baumannii. The prevalence of Acinetobacter baumannii is 3.37%, and the overall mortality rate is 40.81%. Our sample consisted mainly of male patients, that is, 68.7%, with a mean age of 49 years, and the mean age of female patients was 56 years. The mean age of survivors was less than that of non-survivors, that is, 44.95 years of age. We observed that prior antibiotic use was higher in non-survivors compared to survivors. From the review of treatment provided for patients infected with Acinetobacter baumannii, 65 were treated with colistin alone, 18 were treated with carbapenems, and 22 were treated with a combination of both carbapenems and colistin. The mean length of stay of Acinetobacter baumannii–infected patients was 20.25 days. We found that the survival rates among patients who received carbapenems were higher compared to those who received colistin. Conclusion: We believe that multidrug-resistant Acinetobacter baumannii is prevalent and associated with a higher mortality rate and represents a challenging case for every intensive care unit physician. Further prospective studies are needed.

scholarly journals Evaluation of bedbath in critically ill patients: impact of water temperature on the pulse oximetry variation

2010 ◽  
Vol 44 (4) ◽  
pp. 1039-1045 ◽  
Author(s):  
Aretha Pereira de Oliveira ◽  
Dalmo Valério Machado de Lima
Keyword(s):  
Water Temperature ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Age Groups ◽  
University Hospital ◽  
Convenience Sample ◽  
Level Ii ◽  
Before And After ◽  
Quasi Experimental ◽  
Water Temperature Data

This is a participant study, quasi-experimental, of a before and after type. A quantitative approach of biophysiological measures was used, represented by the saturation of oxygen measured by pulse oximeter (SpO2), and recorded on three occasions: before, during and after the bedbath in critically ill patients hospitalized at the ICU of a University Hospital in Brazil. Objective: to compare the SpO2 in various stages of the bath, with and without control of water temperature. Data collection was performed between December 2007 and April 2008 on a convenience sample consisting of 30 patients aged over 18 who had classification in TISS-28 from level II. Results show that water temperature control means a lower variation of SpO2 (p<0.05). No marked differences in variation of saturation between men and women or between age groups were established. In conclusion, heated and constant water temperature during the bedbath is able to minimize the fall of SpO2 that occurs while handling patients during procedures.

scholarly journals Multidrug-resistant bacteria isolated from patients hospitalized in Intensive Care Unit in University Hospital of Constantine, Algeria (2011 - 2015)

2016 ◽  
Vol 10 (33) ◽  
pp. 1328-1336 ◽  
Author(s):  
Hecini-Hannachi Abla ◽  
Bentchouala Chafia ◽  
Lezzar Abdesselam ◽  
Laouar Houcine ◽  
Benlabed Kaddour ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Multidrug Resistant ◽  
University Hospital ◽  
Resistant Bacteria ◽  
Multidrug Resistant Bacteria

scholarly journals Development and evaluation of the focused assessment of sonographic pathologies in the intensive care unit (FASP-ICU) protocol

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Stefan Schmidt ◽  
Jana-Katharina Dieks ◽  
Michael Quintel ◽  
Onnen Moerer
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Conclusive Evidence ◽  
Rate Of Change ◽  
University Hospital ◽  
High Rate ◽  
Whole Body ◽  
Routine Surveillance ◽  
Organ Systems ◽  
Training Schemes

Abstract Background The use of ultrasonography in the intensive care unit (ICU) is steadily increasing but is usually restricted to examinations of single organs or organ systems. In this study, we combine the ultrasound approaches the most relevant to ICU to design a whole-body ultrasound (WBU) protocol. Recommendations and training schemes for WBU are sparse and lack conclusive evidence. Our aim was therefore to define the range and prevalence of abnormalities detectable by WBU to develop a simple and fast bedside examination protocol, and to evaluate the value of routine surveillance WBU in ICU patients. Methods A protocol for focused assessments of sonographic abnormalities of the ocular, vascular, pulmonary, cardiac and abdominal systems was developed to evaluate 99 predefined sonographic entities on the day of admission and on days 3, 6, 10 and 15 of the ICU admission. The study was a clinical prospective single-center trial in 111 consecutive patients admitted to the surgical ICUs of a tertiary university hospital. Results A total of 3003 abnormalities demonstrable by sonography were detected in 1275 individual scans of organ systems and 4395 individual single-organ examinations. The rate of previously undetected abnormalities ranged from 6.4 ± 4.2 on the day of admission to 2.9 ± 1.8 on day 15. Based on the sonographic findings, intensive care therapy was altered following 45.1% of examinations. Mean examination time was 18.7 ± 3.2 min, or 1.6 invested minutes per detected abnormality. Conclusions Performing the WBU protocol led to therapy changes in 45.1% of the time. Detected sonographic abnormalities showed a high rate of change in the course of the serial assessments, underlining the value of routine ultrasound examinations in the ICU. Trial registration The study was registered in the German Clinical Trials Register (DRKS, 7 April 2017; retrospectively registered) under the identifier DRKS00010428.

scholarly journals Prognostic Factors for Acute Heart Failure (AHF) in the Cardiology Intensive Care Unit (ICU) of the University Hospital Point G (UH Pt G)

2019 ◽  
Vol 09 (01) ◽  
pp. 42-50
Author(s):  
Camara Youssouf ◽  
Ba Hamidou Oumar ◽  
Sangare Ibrahima ◽  
Toure Karamba ◽  
Coulibaly Souleymane ◽  
...  
Keyword(s):  
Heart Failure ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Prognostic Factors ◽  
Acute Heart Failure ◽  
University Hospital ◽  
Point G ◽  
The University

scholarly journals Lower Cranial Nerve Palsies in the COVID-19 Pandemic: A 10-Case Series of Intensive Care Unit Patients

2021 ◽  
pp. 1-4
Author(s):  
Pierre Decavel ◽  
Olympe Nahmias ◽  
Carine Petit ◽  
Laurent Tatu
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Prone Position ◽  
Cranial Nerve ◽  
Nerve Palsy ◽  
Case Series ◽  
University Hospital ◽  
Cranial Neuropathy ◽  
Lower Cranial Nerve ◽  
Cranial Nerve Palsies

<b><i>Introduction:</i></b> A number of neurological complications of COVID-19 have been identified, including cranial nerve paralyses. We present a series of 10 patients with lower cranial nerve involvement after severe COVID-19 infection requiring hospitalization in an intensive care unit. <b><i>Methods:</i></b> We conducted a retrospective, observational study of patients admitted to the post-intensive care unit (p-ICU) of Besançon University Hospital (France) between March 16 and May 22, 2020. We included patients with confirmed COVID-19 and cranial neuropathy at admission to the p-ICU. All these patients were treated by orotracheal intubation, and all but one underwent prone-position ventilation therapy. <b><i>Results:</i></b> Of the 88 patients admitted to the p-ICU, 10 patients (11%) presented at least 1 cranial nerve palsy. Of these 10 patients, 9 had a hypoglossal nerve palsy and 8 of these also had a deficit in another cranial nerve. The most frequent association was between hypoglossal and vagal palsies (5 patients). None of the patients developed neurological signs related to a global neuropathy. We found no correlation between the intensity of the motor limb weakness and the occurrence of lower cranial nerve palsies. All but 2 of the patients recovered within less than a month. <b><i>Conclusion:</i></b> The mechanical compressive hypothesis, linked to the prone-position ventilation therapy, appears to be the major factor. The direct toxicity of SARS-CoV-2 and the context of immune dysfunction induced by the virus may be involved in a multifactorial etiology.

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