scholarly journals Nursing intervention to prevent delirium in critically ill adults

Author(s):  
Claudia Consuelo Torres Contreras ◽  
Astrid Nathalia Páez-Esteban ◽  
Mayerli Katherine Rincon-Romero ◽  
Raquel Rivera Carvajal ◽  
Marisela Márquez Herrera ◽  
...  

ABSTRACT Objective: To determine the effectiveness of a nursing intervention for delirium prevention in critically ill patients. Method: A quasi-experimental study was conducted with a non-equivalent control group and with evaluation before and after the intervention. 157 Patients were part of the intervention group and 134 of the control group. Patients were followed-up until they were discharged from the ICU or died. The incidence of delirium in both groups was compared. Additionally, the effect measures were adjusted for the propensity score. Results: The incidence and incidence rate of delirium in the control group were 20.1% and 33.1 per 1000 person-days (CI 95% 22.7 to 48.3) and in the intervention group was 0.6% and 0.64 per 1000 person-days (CI 95% 0.22 to 11.09), respectively. The crude Hazard Ratio was 0.06 (CI 95% 0,008 to 0,45) and adjusted 0.07 (CI 95% 0,009 to 0,60). The number needed to be treated was six. Conclusion: Low incidence of delirium in critically ill patients intervened demonstrated the effectiveness of interventions. The average intervention time was 4 days with a 15-minutes dedication for each patient.

2016 ◽  
Vol 25 (3) ◽  
pp. e40-e47 ◽  
Author(s):  
Carmen S. Rodriguez ◽  
Meredeth Rowe ◽  
Loris Thomas ◽  
Jonathan Shuster ◽  
Brent Koeppel ◽  
...  

Background Sudden speechlessness is common in critically ill patients who are intubated or have had surgery for head and neck cancer. Sudden inability to speak poses challenges for hospitalized patients because strategies to facilitate communication are often limited and unreliable. Objective To determine the impact of a technology-based communication intervention on patients’ perception of communication difficulty, satisfaction with communication methods, and frustration with communication. Methods A quasi-experimental, 4-cohort (control and intervention) repeated-measures design was used. Data were collected daily for up to 10 days. Patients in adult critical care units were followed up as they were transferred to other units within the institutions selected for the study. The impact of a technology-based communication system (intervention) was compared with usual care (control). Patients’ communication outcomes pertinent to communication with nursing staff that were evaluated included perception of communication ease, satisfaction with methods used for communication, and frustration with communication. Results Compared with participants in the control group, participants in the intervention group reported lower mean frustration levels (−2.68; SE, 0.17; 95% CI, −3.02 to −2.34; P < .001) and higher mean satisfaction levels (0.59; SE, 0.16; 95% CI, 0.27 to 0.91; P < .001) with use of the communication intervention. Participants in the intervention group reported a consistent increase in perception of communication ease during the hospital stay. Conclusions The results facilitated evaluation of a bedside technology-based communication intervention tailored to the needs of suddenly speechless critically ill patients.


2019 ◽  
Vol 25 (2) ◽  
pp. 251-262
Author(s):  
Kwang Ok Park ◽  
Mi Yu

Purpose: This study aimed to identify the effect of a situational module learning course on critical thinking disposition and metacognition in sophomore nursing students. Methods: This study was a non-equivalent control-group pretest-posttest quasi-experimental design; the participants included 64 nursing students (32 in the experimental and 32 in the control group) from two Korean universities. Critical thinking disposition and metacognition between the control and intervention groups were measured before and after program participation. Data collection was conducted between September 1 and December 15, 2016. An independent t-test was used to determine differences in critical thinking disposition and metacognition between the groups and Pearson's correlations were measured for correlation with critical thinking disposition and metacognition. Results: The intervention group showed higher critical thinking disposition (t=3.16, p=.002); intellectual integrity (t=2.85, p=.006); and open-mindedness (t=3.30, p=.002) relative to those of the control group. However, there were no statistical differences in metacognition between the two groups (t=-0.14, p=.888). A significant positive correlation between metacognition and critical thinking disposition was found. (r=.62, p<.001). Conclusion: The situational module learning course developed in this study could be used to promote critical thinking disposition in nursing students.


2010 ◽  
Vol 44 (4) ◽  
pp. 1039-1045 ◽  
Author(s):  
Aretha Pereira de Oliveira ◽  
Dalmo Valério Machado de Lima

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.


F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 929
Author(s):  
Nouran Hesham El-Sherazy ◽  
Naglaa Samir Bazan ◽  
Sara Mahmoud Shaheen ◽  
Nagwa A. Sabri

Background Antioxidants show nephroprotective effect against vancomycin associated nephrotoxicity (VAN) in animals. This study aimed to assess the ascorbic acid nephro-protective role against VAN clinically. Methods Forty-one critically ill patients were randomly assigned to one of two groups: intervention group (vancomycin IV plus ascorbic acid, n=21) or control group (vancomycin IV only, n=20). Primary outcomes were the incidence of VAN and the absolute change in creatinine parameters, while mortality rate was the secondary outcome. Nephrotoxicity was defined as an increase in serum creatinine (S.cr) by at least 0.5 mg/dL or 50% of baseline for at least two successive measurements. This study is registered at Clinicaltrials.gov (NCT03921099), April 2019. Results Mean absolute S.cr increase was significant when compared between both groups, P-value = 0.036, where S.cr increased by 0.05(0.12) and 0.34(0.55) mg/dL in the intervention and control groups, respectively. Mean absolute Cr.cl decline was significant when compared between both groups, P-value = 0.04, where Cr.cl was decreased by 5.9(17.8) and 22.3(30.4) ml/min in the intervention and control groups, respectively. Incidence of VAN was 1/21(4.7%) versus 5/20(25%) in the intervention and control groups, respectively (RR: 0.19; CI: 0.024–1.49; P-value = 0.093). Mortality was higher in the control group; however, it was not statistically significant, P-value = 0.141. Conclusion Co-administration of ascorbic acid with vancomycin preserved renal function and reduced the absolute risk of VAN by 20.3%, however, the reduction in VAN incidence didn’t reach statistical significance level. Further large multicenter prospective trials are recommended.


2019 ◽  
Vol 1 (2) ◽  
Author(s):  
Dyah Restuning Prihati ◽  
Maulidta Karunianingtyas Wirawati

Diabetic ulcer is caused by damage to the skin nerves due to reduced blood flow. Pain and anxiety when wound care begins when dressing and cleaning the wound. Murottal therapy is a distraction technique in the form of al-quran records, decreases stress hormones and provides a feeling of relaxation. The purpose of this study was to reduce the level of pain and anxiety during wound care in patients with DM ulcers after being given murrotal therapy in RSUD K.M.T. Wongsonegoro Semarang. The research method with quasi experimental pre-posttest control group. a sample of 17 people in the intervention group and 15 in the control group. Sample selection with total sampling. The murrottal listening intervention group played for 3 times for 15 minutes. Respondents were conducted pre and posttest with NRS pain measuring instruments and DASS anxiety. The results of the Wilcoxon test in the intervention group obtained p = 0,000, there were differences in the level of pain between before and after murotal therapy and p = 0.002 there was a difference in the level of anxiety between before and after murotal therapy. In the control group obtained p = 0.02, there were differences in the level of pain between before and after murotal therapy and the value of p = 1.00, there was no difference in the level of anxiety between before and after given murotal therapy. Conclusion: Murrotal therapy can reduce the level of pain and anxiety during wound care for DM ulcer patients.


2020 ◽  
Vol 7 (1) ◽  
pp. 71-87
Author(s):  
Tasbihul Anwar ◽  
Anwar Wardi Warongan ◽  
Fitrian Rayasari

Laparotomy is one of the major surgeries. Laparotomy is an operative technique that can be performed on digestive and urinary sistem disorders that will cause pain. This study aims to determine thes effects of kinesio taping on the level of pains in post laparotomy patients. The methods of this study use a pre-post and control group quasi experimental design research. Consisting of the intervention group and the control group, the number of sample was 24 samples with 12 respondent in the kinesio taping installation intervention group and 12 respondent in the control group giving standar drug, using a simple random sampling technique. Dependent t-test obtained an average difference of 2.08 in the control group while ansaveragesdifferencesof 3.84 insthe intervention group. Independent T test results obtained P value (0.001)<(0.05). The conclusion there was assignificant difference in the level of pain in the kinesio taping intervention group and the control group that did not have kinesio taping. Variable confounding has been performed statistically. The results shows that here is no relationships between age, attitude and belief in the pain of Laparotomy, while age is related to post-Laparotomy pain, kinesio taping can be used as an independent nursing intervention to reduce the intensity of pain in post-Laparotomy patients.


2018 ◽  
Vol 5 (2) ◽  
pp. 106-112
Author(s):  
Anafrin Yugistyowati ◽  
Lia Endriyani

Newborn with low birth weight (LBW) in Indonesia is relatively high even up to 16,9 %. The role of the neonatal nurse is highly expected to provide care for newborn babies with LBW by giving supportive environment. Neonatal Developmental Care (NDC) is one of intervention that aims to implement modifications to the nursery environment and care practices to promote growth and development of newborn with LBW. Most of nurses still have no information related NDC and its implementation in neonatal room. This study aimed to explore the influence of NDC information exposure toward nurse’s attitude. A quasi-experimental with before-and-after design was applied. This study recruited 21 nurses to participate as intervention and control group. The Paired T-Test was performed to analyze the data. The results showed there is an influence of NDC information exposure toward nurse’s attitude in caring for newborn with low birth weight by P-value 0,00. This study recommend that NDC can be one of nursing intervention for caring newborn baby with LBW in order to optimize caring for infant along caring for growth and development during their treatment in hospital.


2016 ◽  
Vol 55 (6) ◽  
pp. 339 ◽  
Author(s):  
Hartono Gunadi ◽  
Rini Sekartini ◽  
Retno Asti Werdhani ◽  
Ardi Findyartini ◽  
Muhammad Arvianda Kevin Kurnia

Background Immunization is recognized as one of the strategiesto reduce vaccine preventable diseases. Competency related toimmunization are consequently important for medical students andthe medical school needs to assure the competence acquisition.Objective To assess competence related to immunization andits retention following lectures with simulations compared tolectures only.Methods A quasi-experimental study was conducted to the 5th yearstudents of University of Indonesia Medical School during the ChildAdolescent Health Module in 2012-2013. The intervention grouphad lectures with simulations and the control group had lecturesonly. Immunization knowledge was assessed with a 30 multiplechoice question (MCA) items performed before and after themodule. Competence retention was assessed by MCQ (knowledge)and OSCE (skills) 2-6 months afterwards.Results Sixty eight subjects for each group with similarcharacteristics were analyzed. There was significant differenceafter module MCQ score between two groups. Competenceretention in 2-6 months after module completion was betterin intervention group, both for the knowledge (median MCQscore of 70.00 (range 37-93) vs. mean score of 58.01 (SD 12.22),respectively; P<0.001) and skill (OSCE mean scores of 75.21 (SD10.74) vs. 62.62 (SD 11.89), respectively; P < 0.001). Proportionof subjects in the intervention group who passed both the MCQand OSCE were also significantly greater.Conclusion Lectures with simulations are proved to bemore effective in improving medical students’ immunizationcompetence as well as its retention compared to lectures onlyapproach.


2020 ◽  
Vol 8 (T2) ◽  
pp. 196-199
Author(s):  
Stang Stang ◽  
Debora Selin ◽  
Suriah Suriah ◽  
Sumarni Marwang ◽  
Hasanuddin Ishak

BACKGROUND: Each pregnancy and childbirth has complication risks. These complications are accompanying pathological incidences that might cause maternal mortality. AIM: This research aims to determine the effect of educational media development in increasing knowledge and attitudes about complications of pregnancy and childbirth in pregnant women. METHODS: This research method passed through several stages as follows: First stage consisted of the development of educational media (leaflets), and second stage consisted of development test with leaflet media using a quasi-experimental research design. The samples were Trimester I to Trimester III pregnant women who visited Sayang Rakyat Hospital Makassar, which consisted of 30 people as intervention group and 30 people as control group. The intervention group was provided leaflets while the control group was provided books on maternal and child health. Data analysis used Wilcoxon Signed Ranks Test and Mann–Whitney test. RESULTS: The results showed that there are differences in case of knowledge and attitudes of pregnant women regarding complications of pregnancy and childbirth before and after being provided with leaflet intervention with a value of p = 0.000. Likewise, there are differences in the case of knowledge and attitudes of pregnant women regarding pregnancy and childbirth complications between the intervention and control groups with p = 0.041 and 0.001, respectively. CONCLUSION: Educational media on knowledge and attitudes about complications of pregnancy and childbirth has a positive effect in pregnant women at Sayang Rakyat Hospital in Makassar.


2017 ◽  
Vol 5 (2) ◽  
pp. 29
Author(s):  
Muhammad Taukhid

Background : Fatigue is feeling tired physically, psychologically, cognitively perceived cancer patients while undergoing therapies for the disease, including chemotherapy. The purpose of this study was to determine differences in the level of fatigue in cancer patients between before and after aerobic exercise combined with relaxation techniques of yoga. Methods :  This study used Quasi-experimental design with pretest-posttest control group in patients with breast cancer in the course of chemotherapy. The sampling methods used purposive sampling. The fatigue level was collected by subjective instruments Pipper Fatigue Scale (PFS), and then analyzed by the Independent and Dependent T test, and multivariate analysis used linear regression with a significance value of α 0.05. Results :  There were differences in the level of fatigue post-test between the intervention group and the control group with a difference of 1.25 (p = 0.013). History of previous exercise may explain the 17.8% level of fatigue that occurs in patients with breast cancer in the course of chemotherapy, the rest was explained by other variables. Conclusion : There were a decrease in the level fatigue statistically, however clinically the level of fatigue remain the same catagories.


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