Clinical Severity as a Predictor of Nursing Workload in Pediatric Intensive Care Units: A Cross-Sectional Study

2019 ◽  
Vol 13 (4) ◽  
pp. 175-184
Author(s):  
Alexandra-Stavroula Nieri ◽  
Eleni Spithouraki ◽  
Petros Galanis ◽  
Daphne Kaitelidou ◽  
Vasiliki Matziou ◽  
...  
Keyword(s):  
Intensive Care ◽  
Elective Surgery ◽  
Pediatric Intensive Care ◽  
Cross Sectional Study ◽  
Clinical Severity ◽  
Critically Ill Children ◽  
Nursing Workload ◽  
Sectional Study ◽  
Cross Sectional ◽  
Logistic Organ Dysfunction

BackgroundIncreased nursing workload (NW) is associated with increased incidence of adverse events. In adult ICUs, one of the factors that increase NW is the severity of illness; however, this has not been adequately investigated in pediatric intensive care unit (PICU).AimTo explore potential association between clinical severity of critically ill children and NW in PICU.MethodsA descriptive, correlational, cross-sectional study design was employed. Data were collected from three PICUs of Athens, Greece, during November 2015 to March 2016, using a sample of 58 pediatric patients. The Pediatric-Nursing Activities Score (P-NAS) and the Therapeutic Intervention Scoring System 28 (TISS-28) were used to measure NW and the Pediatric Logistic Organ Dysfunction (PELOD) to assess clinical severity. Demographic and clinical variables of the children were also investigated. Multiple linear regressions were used to identify NW predictive factors, at 5% significance level.ResultsParticipants' median age (interquartile range [IQR]) was 38.5 (7.0–127.0) months and 50% of them were male. PELOD score was significantly correlated with NW scores on the first day of hospitalization in PICU (P-NAS: ρ = .319, p = .020, TISS-28: ρ = .547, p < .0001) and with NW during total PICU stay (TISS-28: ρ = .483, p < .001). The PELOD (β = .694, p = .052) and the elective surgery (β = −13.12, p = .01) were predictors of the P-NAS on the first day of hospitalization, and the PELOD (β = .563, p = .029) and the emergency surgery (β = 16.09, p = .01) were predictors of the P-NAS during total PICU stay. The PELOD (β = .509, p = .001) was a predictor factor of the TISS-28 score on the first day of PICU hospitalization and the PELOD (β = .371, p = .003) and the age (β = .036, p = .005) were predictors of the TISS-28 score during total PICU stay.ConclusionsThe clinical severity is a predictive factor of NW required in PICUs.

Increase in Pediatric Intensive Care Unit Hospitalizations Due to Toxic Ingestions during the COVID-19 Pandemic

2021 ◽  
Author(s):  
Jennifer L. van Helmond ◽  
Brittany Fitts ◽  
Jigar C. Chauhan
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Home Environment ◽  
Clinical Characteristics ◽  
Pediatric Intensive Care ◽  
Cross Sectional Study ◽  
Mitigation Measures ◽  
Sectional Study ◽  
Cross Sectional

AbstractThe coronavirus disease 2019 (COVID-19) pandemic and related community mitigation measures had a significant psychosocial impact. We suspected that more patients were admitted to our pediatric intensive care unit (PICU) for toxic ingestions since the start of the pandemic. We therefore investigated if PICU admissions related to toxic ingestions were higher in 2020 as a result of COVID-19 compared with previous years. We completed a cross-sectional study at a tertiary children's hospital comparing admissions to our PICU between April 2020 and October 2020, during which COVID-19 and community mitigation measures were in place, to those during the same 7-month period in the previous 3 years. Total PICU admissions, admissions for all toxic ingestions (intentional ingestions and accidental ingestions), and demographic and clinical characteristics of patients were compared. Total PICU admissions in 2020 during COVID-19 pandemic months were lower compared with the same months in the preceding 3 years (−16%, p< 0.001), however, admissions for toxic ingestions were higher during COVID-19 (+64%, p< 0.001). When separated by type, intentional (+55%, p = 0.012) and accidental ingestions (+94%, p = 0.021) were higher during COVID-19. COVID-19 with community mitigation measures has led to an increase in PICU admissions for intentional and accidental ingestions, indicating an increase in severity of toxic ingestions in children associated with the pandemic. Mental health of adolescents, and safety of infants and toddlers in their home environment, should be targeted with specific interventions in the ongoing COVID-19 pandemic.

Nursing workload in neurological intensive care units: Cross-sectional study

2013 ◽  
Vol 29 (2) ◽  
pp. 112-116 ◽  
Author(s):  
Alda Ferreira Queijo ◽  
Renata Soares Martins ◽  
Rafaela Andolhe ◽  
Elaine Machado Oliveira ◽  
Ricardo Luis Barbosa ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Cross Sectional Study ◽  
Nursing Workload ◽  
Sectional Study ◽  
Cross Sectional ◽  
Neurological Intensive Care

scholarly journals Severity and workload of nursing with patients seeking admission to an intensive care unit

2017 ◽  
Vol 22 (1) ◽  
Author(s):  
Meire Cristina Novelli e Castro ◽  
Magda Cristina Queiroz Dell'Acqua ◽  
Igor Chagas Unger ◽  
Claudia Maria Silva Cyrino ◽  
Priscila Masquetto Vieira de Almeida
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Demographic Data ◽  
Simplified Acute Physiology Score ◽  
Cross Sectional Study ◽  
The State ◽  
Nursing Workload ◽  
Sectional Study ◽  
Cross Sectional ◽  
Seriously Ill

Abstract Objective: To identify the severity and workload of nursing with adult patients seeking admission to an Intensive Care Unit (ICU). Methods: A cross-sectional study with a quantitative, exploratory and prospective approach was performed, developed in a hospital in the state of São Paulo. Demographic data on patients were collected, the Simplified Acute Physiology Score III (SAPS III) was applied to assess the severity of patients and the Nursing Activities Score (NAS) was used to evaluate nursing workload, between July and August 2014. Results: The overall mean score of the SAPS III was 30.52 ± 18.39 and that of the NAS was 58.18 ± 22.29. The group of patients admitted to the ICU showed higher severity and higher workload of nursing compared to non-admitted patients. Non-admitted patients had an NAS of 53.85. Conclusion: The nursing workload in patients who were not admitted to the ICU was also high. The evaluation of workload in other contexts where patients are seriously ill is important. The workload assessment in other contexts where severely ill patients are found is evident.

scholarly journals Long-stay patients in pediatric intensive care units. Five-years, 2-points, cross-sectional study

2020 ◽  
Vol 41 (11) ◽  
pp. 1187-1196
Author(s):  
Mohamad-Hani Temsah ◽  
Ayman Al-Eyadhy ◽  
Fahad Al-Sohime ◽  
Marwah Hassounah ◽  
Mohammed Almazyad ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Pediatric Intensive Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Pediatric Intensive Care Units

scholarly journals Utilisation of medications among elderly patients in intensive care units: a cross-sectional study using a nationwide claims database

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e026605 ◽  
Author(s):  
Sun-Young Jung ◽  
Hyun Joo Lee
Keyword(s):  
Intensive Care ◽  
Elderly Patients ◽  
Intensive Care Units ◽  
Medication Use ◽  
Cross Sectional Study ◽  
Clinical Severity ◽  
Sectional Study ◽  
Cross Sectional ◽  
Claims Database ◽  
Severity Scores

ObjectivesClinical practice guidelines for the management of pain and sedation in critically ill patients have been developed and applied; however, there is limited data on medication use among elderly patients. This study identifies current practice patterns for analgo-sedative use in mechanically ventilated elderly patients in Korea using a national claims database.DesignCross-sectional study.Setting and participantsVentilated elderly patients aged 65 years or older in intensive care units (ICUs) from an aged patients’ national claims database in KoreaPrimary outcome measuresUse of sedatives including benzodiazepines, opioids and non-opioid analgesics, neuromuscular blocking agents (NMBAs) and antipsychotic drugs were analysed by the duration of mechanical ventilation (MV), age and time.ResultsFrom 2012 to 2016, 22 677 elderly patients underwent MV in 267 general or tertiary ICUs. Mean age was 77.2 (±6.9) years and the median duration of MV was 4.1 days; 77.2% of patients received sedatives, 65.0% analgesics, 29.1% NMBAs and 19.6% antipsychotics. Midazolam (62.0%) was the most commonly prescribed medication. The proportions of sedatives, analgesics and NMBAs increased, whereas the percentages of person-days decreased with longer MV duration (p<0.01). With advanced age, the prevalence and duration of sedative, analgesic and NMBA use decreased (adjusted OR (95% CI) 0.98 (0.97 to 0.98) in all three classes) while antipsychotic did not (adjusted OR 1.00 (1.00–1.01)). Annually, benzodiazepines showed reduced administration (76.2% in 2012 and 71.4% in 2016, p<0.01), while daily opioid dose increased (21.6 in 2012 vs 30.0 mg in 2016, p<0.01).ConclusionsThe prevalence of sedative, analgesic and NMBAs use and daily opioid doses were lower, whereas antipsychotic use was higher compared with those in previous studies in adult patients. The findings warrant further studies investigating appropriateness and safety of medication use that consider clinical severity scores with a focus on elderly patients in ICUs.

scholarly journals Two Serial Hematocrit Level Just After Admission to Predict Dengue Hemorrhagic Fever Severity

2018 ◽  
Vol 6 (3) ◽  
Author(s):  
Fauziyyah Ramadhani ◽  
Mohammad Ghozali ◽  
Leni Lismayanti
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Hemorrhagic Fever ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Plasma Leakage ◽  
The Difference

Dengue hemorrhagic fever (DHF) is still the leading cause of hospitalization and death among children in Indonesia because of plasma leakage leading to shock syndromes. This study aimed to associate the hematocrit difference (first and second) from serial hematocrit (Hct) examination just after admission with DHF severity. A analytical cross-sectional study was involving medical records of pediatric patients with DHF admitted at the pediatric ward and the Pediatric Intensive Care Unit (PICU) of Dr. Hasan Sadikin General Hospital, Bandung in January–December 2015. The subjects excluded if other conditions also cause plasma leakage. The difference in first and second Hct (∆Hct) from serial Hct examination just after admission and DHF grade of severity (DHF I–IV) confirmed by a positive result in serologic tests (anti-dengue IgM/IgG), or detection of dengue virus antigen (NS1Ag test) obtained. Spearman association analysis test used for analysis. A total of 16 subjects with DHF I, 21 subjects with DHF II, 31 subjects with DHF III and two subjects with DHF IV included in this study. There was no significant correlation between positive ∆Hct value (hemoconcentration) and DHF severity (r=0.247, p=0.394, CI=95%). In conclusion, the difference in first and second Hct from serial Hct examination just after admission has no significant association with the disease severity. DUA NILAI HEMATOKRIT SERIAL SESAAT SETELAH ADMISI SEBAGAI PREDIKTOR KEPARAHAN DEMAM BERDARAH DENGUEDemam berdarah dengue (DBD) merupakan penyebab utama hospitalisasi dan kematian anak di Indonesia disebabkan oleh kebocoran plasma yang berujung pada syok. Tujuan penelitian ini mengetahui hubungan perbedaan hematokrit pertama dan kedua pada pemeriksaan hematokrit serial sesaat setelah admisi dengan keparahan DBD. Penelitian merupakan analytical cross-sectional study menggunakan data sekunder berupa rekam medis pasien anak yang dirawat di ruang perawatan anak dan Pediatric Intensive Care Unit (PICU) RSUP Dr. Hasan Sadikin Bandung pada Januari–Desember 2015. Subjek penelitian dieksklusi apabila pada rekam medis terdapat diagnosis lain yang menyebabkan kebocoran plasma. Variabel penelitian ini adalah perbedaan hematokrit pertama dan kedua (∆Hct) pada pemeriksaan hematokrit serial serta diagnosis DBD (DBD I–IV) yang dikonfirmasi oleh hasil positif pada pemeriksaan serologis (IgM/IgG antidengue) atau deteksi antigen virus (NS1Ag). Terdapat 16 subjek DBD I, 21 subjek DBD II, 31 subjek DBD III, dan 2 subjek DBD IV. Dengan menggunakan Uji Analisis Spearman, tidak terdapat korelasi yang signifikan antara nilai positif ∆Hct (hemokonsentrasi) dan tingkat keparahan DBD (r=0,247; p=0,394; CI=95%). Simpulan, perbedaan hematokrit pertama dan kedua pada pemeriksaan hematokrit serial tidak berhubungan dengan keparahan DBD.

scholarly journals Utilization of mechanical ventilators in low resource Faculty: a cross sectional study

2020 ◽  
Author(s):  
Tigist Bacha ◽  
Netsanet Tsegaye ◽  
Wagari Tuli
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Mortality Rate ◽  
Severity Score ◽  
Pediatric Intensive Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Multi Organ Dysfunction Syndrome

Abstract Background Few studies are available from Africa on the use of mechanical ventilation (MV) in the pediatric intensive care unit (PICU). Knowledge of the outcome of patients on MV is critical for better use of resources and clinical decision making. We aimed to see the outcome and pattern of patients treated in a pediatric intensive care unit in a teresery hospital, which is the first study to evaluate an Ethiopian PICU. Methods A cross-sectional study with retrospective data collection was employed. Data were abstracted from the patients’ medical records by trained health professionals. SPSS version 21 software was used for data entry and analysis. The reports were depicted descriptively using measures of central tendency, dispersion, and displayed through tables and graphs. Results There were 536 patients admitted during the study period. 202 (41.2%) incidence of mechanical ventilation (MV) rate 63.6% of the participants were males and 130 (59.1%) died. The most common indication for the initiation of MV was respiratory problems 46 (20.9%). we identified 30.59/1000 ventilator days developed complications.Ventilator-associated pneumonia accounted for 18.6% of the complications with 20.9/1000 ventilator days. Survival of medical cases was better than the surgical cases (including trauma); [AOR = 0.13, 95% CI(0.04–0.413)] and those who have MV for more than 3 days are 79% more likely to die than those of less than 3 days ventilated; (p = 0.003). Those who have multi-organ dysfunction syndrome die more likely than the other group of patients; [AOR = 0.181, 95% CI (0.08, 0.412)] and the patient who had high PIM II severity score had higher mortality rate; [AOR = 35, 95% CI (1.7, 11)]. Conclusions In the current study, the mortality rate of mechanically ventilated pediatric patients was high. Severity score, multi-organ dysfunction syndrome, length of stay, and being a surgical patient increased the risk of mortality. Adequate education of PICU staff on the use of mechanical ventilator and prevention of complications as well as the use of severity score is necessary.

Role of Sildenafil in the Treatment of Persistent Pulmonary Hypertension of Newborn (PPHN) - Should it Be Withdrawn from Market of Bangladesh due to Threat of being Misuses

2020 ◽  
Vol 35 (2) ◽  
pp. 100-104
Author(s):  
Maksudur Rahman ◽  
Mohammad Abdullah Al Mamun ◽  
MAK Azad Chowdhury ◽  
Abu Sayeed Munsi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cardiac Intensive Care Unit ◽  
Cross Sectional ◽  
Cardiac Intensive Care ◽  
Hospital Protocol

Background: Recently it has been apprehended that sildenafil, a drug which has been successfully using in the treatment of PPHN and erectile dysfunction in adult, is going to be withdrawn from the market of Bangladesh due to threat of its misuses. Objective: The aim of this study was to see the extent of uses of sildenafil in the treatment of PPHN and importance of availability of this drugs in the market inspite of its probable misuses. Methods: This cross sectional study was conducted in neonatal intensive care unit (NICU), special baby care unit (SCABU) and cardiac intensive care unit (CICU) of Dhaka Shishu (Children) Hospital from June, 2017 to May 2018. Neonates with PPHN were enrolled in the study. All cases were treated with oral sildenefil for PPHN along with others management according to hospital protocol. Data along with other parameters were collected and analyzed. Results: Total 320 patients with suspected PPHN were admitted during the study period. Among them 92 (29%) cases had PPHN. Male were 49(53 %) cases and female were 43(47%) cases. Mean age at hospital admission was 29.7±13.4 hours. Based on echocardiography,13(14%) cases had mild, 38 (41%) cases moderate and 41(45%) cases severe PPHN. Mean duration of sildenafil therapy was 11.9±7.1 days. Improved from PPHN were 83 (90%) cases. Mortality was 10% (9). Conclusion: In this study it was found that the incidence of PPHN is 29% among the suspected newborns. Sildenafil is successfull in improving the oxygenation of PPHN and to decrease the mortality of neonates. DS (Child) H J 2019; 35(2) : 100-104

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