Auditing of enteral nutrition nursing care in critical care patients

Background & Aim: Enteral nutrition standards noncompliance is one of the factors that threatens patient safety. Auditing is an important part in quality improvement processes. The aim of this study was to determine enteral nutrition nursing care conformity rate with standards in the critical care units. Methods & Materials: In this descriptive study, 400 enteral feeding nursing care were assessed via time and event sampling methods. The tool was a researcher made check list in three fields: pre-feeding, feeding, and post feeding nursing care. Content validity and inter-rater coefficient reliability were calculated for checklist. The obtained data were analyzed using descriptive statistics. Results: The most conformity rate with standards was in feeding (86%), pre-feeding (3/8 %) and post feeding (2/3%) field, respectively. Determination of PH (100%) and accurate gastric residual volume (99.8%) in pre-feeding field, disconnection of the syringe from catheter after feeding, in feeding filed and accurate documentation of the care (99.3%) in post feeding field, were not implemented in the most of cases. Conclusion: Enteral nutrition nursing care is far from standards in the pre and post feeding fields. Lack of the clear clinical guidelines, shortage of nursing staff and equipment and inadequate training are relating factors.

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Efficacy of Epidural Analgesia for Pain Management of Critically Ill Patients and the Implications for Nursing Care

AACN Advanced Critical Care ◽

10.4037/15597768-1991-4013 ◽

1991 ◽

Vol 2 (4) ◽

pp. 729-740 ◽

Cited By ~ 1

Author(s):

Jeanne F. Slack ◽

Margaret Faut-Callahan

Keyword(s):

Critical Care ◽

Pain Relief ◽

Epidural Analgesia ◽

Critically Ill ◽

Nursing Care ◽

Critically Ill Patients ◽

Continuous Epidural Analgesia ◽

Analgesic Agents ◽

Care Problems ◽

Critical Care Patients

Management of pain for critically ill patients has been shown to be inadequately controlled and can have serious deleterious effects on a patient’s recovery. Continuous epidural analgesia can be used to control pain in critical care patients. This mode of analgesia administration provides pain relief without the delays inherent in the as-needed administration of analgesics. Fifteen critical care unit patients were part of a multidisciplinary, prospective, randomized, double-blind study of various epidural analgesic agents in 43 thoracic and 66 abdominal surgery patients. The purpose of the study was to identify the benefits and problems associated with continuous epidural analgesia administration and the implications for the nursing care of critically ill patients. Evaluation of the effectiveness of the analgesia was based on the following measures: 1) pain measured at regular intervals in the 72-hour period with a visual analog; 2) pain as measured after 72 hours with the word descriptor section of the McGill pain questionnaire; 3) amount of supplemental systemic narcotic analgesic needed; 4) recovery of ambulatory and respiratory function, including ability to perform coughing and deep-breathing exercises; 5) occurrence of adverse effects, and 6) the type and distribution of nursing care problems associated with continuous epidural infusions. The results of this study showed that the level of pain relief and recovery of postoperative function was superior to that provided by the more widely used as-needed systemic administration of narcotics. Although some nursing care problems were identified, continuous epidural analgesia can be used for pain relief in critical care patients, if the analgesia is administered by accurate reliable infusion systems and carefully monitored by nursing staff who are knowledgeable about the pharmacologic considerations of epidural analgesic agents and the management of patient care

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Designing and Validity Evaluation of Quality of Nursing Care Scale in Intensive Care Units

Journal of Nursing Measurement ◽

10.1891/1061-3749.22.3.461 ◽

2014 ◽

Vol 22 (3) ◽

pp. 461-471

Author(s):

Mashaalah Zeraati ◽

Negin Masoudi Alavi

Keyword(s):

Critical Care ◽

Intensive Care ◽

Intensive Care Units ◽

Nursing Care ◽

Content Validity ◽

Scale Level ◽

Validity Index ◽

Critical Care Units ◽

Quality Of Nursing

Background and Purpose: Quality of nursing care measurement is essential in critical care units. The aim of this study was to develop a scale to measure the quality of nursing care in intensive care units (ICUs). Methods: The 68 items of nursing care standards in critical care settings were explored in a literature review. Then, 30 experts evaluated the items’ content validity index (CVI) and content validity ratio (CVR). Items with a low CVI score (<0.78) and low CVR score (<0.33) were removed from the scale. Results: The 50 items remained in the scale. The Scale level-CVI and Scale level-CVR were 0.898 and 0.725, respectively. Conclusion: The nursing care scale in ICU (Quality of Nursing Care Scale-ICU) that was developed in this research had acceptable CVI and CVR.

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Enhance quality care performance: Determination of the variables for establishing a common database in French paediatric critical care units

Journal of Evaluation in Clinical Practice ◽

10.1111/jep.12984 ◽

2018 ◽

Vol 24 (4) ◽

pp. 767-771

Author(s):

Morgan Recher ◽

Caroline Bertrac ◽

Camille Guillot ◽

Jean Benoit Baudelet ◽

Yasemin Karaca-Altintas ◽

...

Keyword(s):

Critical Care ◽

Quality Care ◽

Critical Care Units ◽

Paediatric Critical Care ◽

Care Performance

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Effectiveness of Critical Care Discharge Information in Supporting Early Recovery From Critical Illness

Critical Care Nurse ◽

10.4037/ccn2013134 ◽

2013 ◽

Vol 33 (3) ◽

pp. 41-52 ◽

Cited By ~ 10

Author(s):

Suzanne Bench ◽

Tina Day ◽

Peter Griffiths ◽

BA (Hons)

Keyword(s):

Critical Care ◽

Evidence Base ◽

Current Evidence ◽

Service Users ◽

Early Recovery ◽

Critical Care Units ◽

Current Evidence Base ◽

Physical Effects ◽

Reported Data ◽

Critical Care Patients

Providing patients with information can alleviate or reduce relocation stress, but how best to provide information to patients being discharged from critical care units is unclear. This narrative critical review describes (1) the current evidence base on the use of discharge information for adult critical care patients and (2) the extent of involvement of service users in the design and evaluation of such information. Seven publications reported data from 121 patients, 252 relatives, and 33 nurses. Overall evidence was of low quality but use of individualized information was associated with beneficial physical effects for patients and increased knowledge and satisfaction for their relatives. Findings highlight the significant gaps in our knowledge and understanding. The consequences of such findings for the future development of information that meets service users’ needs are discussed. Results should inform the design of future studies on this topic.

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Cerebrospinal Fluid Pleocytosis in Critical Care Patients With Seizures

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2016.442 ◽

2017 ◽

Vol 44 (4) ◽

pp. 343-349

Author(s):

Carly Scramstad ◽

Alan C. Jackson

Keyword(s):

Cerebrospinal Fluid ◽

Critical Care ◽

Care Center ◽

Tertiary Care ◽

Retrospective Chart Review ◽

Critical Care Units ◽

Generalized Seizures ◽

Csf Pleocytosis ◽

Magnetic Resonance Imaging Mri ◽

Critical Care Patients

AbstractObjectives: To assess the etiology of cerebrospinal fluid (CSF) pleocytosis in critical care patients with seizure(s) or status epilepticus (SE). Many previous studies, some performed decades ago, concluded that CSF pleocytosis may be entirely attributable to seizure activity. Methods: We undertook a retrospective chart review of adult patients with an admitting or acquired diagnosis of seizure(s) or SE in critical care units at the Winnipeg Health Sciences Centre between 2009 and 2012. Patients were identified through a critical care information database at a tertiary care center. We limited our study to patients who had lumbar punctures at our center within 5 days of seizure(s) or SE. Results: Of 426 patients with seizures in critical care units, 51 met the inclusion criteria. Seizure subtypes included focal seizures (5 or 10%), generalized seizures (14 or 27%), and SE (32 or 63%). Twelve (seven with SE) of the 51 (24%) were found to have CSF pleocytosis. A probable etiological cause for the CSF pleocytosis was identified in all 12 cases. Conclusions: We conclude that seizures do not directly induce a CSF pleocytosis. Instead, the CSF pleocytosis more likely reflects the underlying acute or chronic brain process responsible for the seizure(s). This was not readily apparent in early studies without magnetic resonance imaging (MRI) of the brain and currently available laboratory investigations. An etiological cause of CSF pleocytosis must always be sought when patients present with seizures and it should never be assumed that seizures are the cause.

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Nursing staff readiness toward advanced mobile devices utilization in nursing care in critical care units

Menoufia Nursing Journal ◽

10.21608/menj.2017.131511 ◽

2017 ◽

Vol 2 (1) ◽

pp. 9-21

Author(s):

Samah Rashed ◽

Abeer Seade ◽

Fawzia Kamel

Keyword(s):

Critical Care ◽

Mobile Devices ◽

Nursing Care ◽

Nursing Staff ◽

Critical Care Units

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Impact of Enteral Nutrition Formulations Containing Dietary Fiber on Diarrhea Outcomes in Hospitalized Critical Care Patients: A Systematic Review and Meta-Analysis

Current Developments in Nutrition ◽

10.1093/cdn/nzab047_005 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 842-842

Author(s):

Kelly Cara ◽

Andrew Beauchesne ◽

Taylor Wallace ◽

Mei Chung

Keyword(s):

Systematic Review ◽

Critical Care ◽

Enteral Nutrition ◽

Dietary Fiber ◽

Critically Ill ◽

Random Effects ◽

Critically Ill Patients ◽

Outcome Data ◽

Meta Analyses ◽

Critical Care Patients

Abstract Objectives The objective is to conduct a systematic review on the safety of using enteral nutrition formulations containing dietary fiber in hospitalized critical care patients. Methods This systematic review was conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions (Version 6.1,2020). Searches were implemented in four databases on 4/20/20. Results were limited to English language studies conducted in humans. Any clinical study design or case study measuring adverse events (e.g., diarrhea and mortality) or health outcomes (as defined in each study) associated with enteral nutrition interventions containing dietary fiber in adult critically ill patients was considered. Random effects meta-analyses were conducted on outcomes assessed by three or more included studies. Results Altogether, 18 articles were included, and 11 randomized controlled trials assessed diarrhea outcomes (i.e., diarrhea score and number or frequency of events). Six studies used the Hart and Dobb (1988) diarrhea score, and random effects meta-analyses showed the mean diarrhea scores were lower for fiber compared to non-fiber groups (n = 4, pooled mean difference: −2.78, 95% confidence interval: −4.10, −1.47). Five of seven reported group comparisons showed fewer diarrhea events for fiber compared with non-fiber groups, although the overall difference was not statistically significant (n = 7, pooled risk ratio: 0.68, 95% CI: 0.45, 1.02). For three studies using other or unspecified scoring methods, pooled results showed significantly fewer diarrhea events in the fiber groups compared to non-fiber groups (n = 3, pooled RR: 0.42, 95% CI: 0.20, 0.89). Studies reported no difference in incidence of mortality due to fiber interventions (n = 7, pooled RR: 0.99, 95% CI: 0.66, 1.48). Risk of bias for diarrhea outcomes was high due to missing outcome data, and there was some concern for bias due to randomization, measurement of the outcome, and selection of reported results. Conclusions Enteral nutrition formulas with fiber may help reduce incidence and severity of diarrhea in critically ill patients without increasing incidence of mortality. As these results are subject to bias, more high-quality studies are needed to verify this conclusion. Funding Sources This study was supported by funding from an unrestricted educational grant from Nestle Health Sciences.

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