scholarly journals Lived Experiences of Iranian ICU Nurses In The Care of Patients With Covid-19: A Phenomenological Study

2020 ◽  
Author(s):  
Mehraban shahmari ◽  
Alireza Nikbakht Nasrabadi ◽  
Akram ghobadi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Work Experience ◽  
Lived Experiences ◽  
Phenomenological Study ◽  
Health Care Systems ◽  
Professional Challenges ◽  
Care Systems ◽  
The Mean ◽  
Depth Interviews

Abstract Background: Covid-19 pandemic with its sudden and widespread global outbreak has stunned health care systems. Nurses are at the forefront of fight against this pandemic, and Intensive care unit (ICU) nurses are more at risk of infection as they have a greater interaction with infected patients. Therefore, the present study was conducted to explore the lived experiences of Iranian ICU nurses in the care of patients with covid-19.Methods: This is an interpretive phenomenological study in which, 15 ICU nurses were purposefully selected. Semi-structured in-depth interviews were used to collect data. The transcripts of the interviews were recorded and then analyzed by Diekelmann (1989) method with hermeneutic approach.Results: Ten of the samples were female and five were male. The mean age of participants was 32 years and their average work experience in the intensive care unit was 6 years. Three main themes were obtained from data analysis, including beyond usual care, the emergence of a new image of nursing and the Realization of professional challenges. Conclusion: Working in difficult and unknown conditions with many challenges caused mental and physical depreciation of nurses in the intensive care unit. However, the nurses showed a spirit of self-sacrifice and did not give up their relentless efforts to fight this unknown enemy, and fulfilled their professional responsibilities to provide the best care to patients. By doing so, the nurses showed a new image of nursing to the society. Therefore, full support should be provided to healthcare workers, especially nurses by the authorities in order to prepare them to respond to unwanted crises.

scholarly journals The Lived Experiences of Family Members of Covid-19 Patients Admitted to Intensive Care Unit: A Phenomenological Study

Heart & Lung ◽  
2021 ◽  
Author(s):  
Davide Bartoli ◽  
Francesca Trotta ◽  
Silvio Simeone ◽  
Gianluca Pucciarelli ◽  
Giovanni Battista Orsi ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Lived Experiences ◽  
Phenomenological Study ◽  
Family Members

scholarly journals Predictability of COVID-19 Hospitalizations, Intensive Care Unit Admissions, and Respiratory Assistance in Portugal: Longitudinal Cohort Study (Preprint)

2020 ◽  
Author(s):  
André Patrício ◽  
Rafael S Costa ◽  
Rui Henriques
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
State Of The Art ◽  
Health Care Systems ◽  
Clinical Decision ◽  
Learning Approaches ◽  
Medical Needs ◽  
The Face ◽  
Care Systems ◽  
Respiratory Assistance

BACKGROUND In the face of the current COVID-19 pandemic, the timely prediction of upcoming medical needs for infected individuals enables better and quicker care provision when necessary and management decisions within health care systems. OBJECTIVE This work aims to predict the medical needs (hospitalizations, intensive care unit admissions, and respiratory assistance) and survivability of individuals testing positive for SARS-CoV-2 infection in Portugal. METHODS A retrospective cohort of 38,545 infected individuals during 2020 was used. Predictions of medical needs were performed using state-of-the-art machine learning approaches at various stages of a patient’s cycle, namely, at testing (prehospitalization), at posthospitalization, and during postintensive care. A thorough optimization of state-of-the-art predictors was undertaken to assess the ability to anticipate medical needs and infection outcomes using demographic and comorbidity variables, as well as dates associated with symptom onset, testing, and hospitalization. RESULTS For the target cohort, 75% of hospitalization needs could be identified at the time of testing for SARS-CoV-2 infection. Over 60% of respiratory needs could be identified at the time of hospitalization. Both predictions had >50% precision. CONCLUSIONS The conducted study pinpoints the relevance of the proposed predictive models as good candidates to support medical decisions in the Portuguese population, including both monitoring and in-hospital care decisions. A clinical decision support system is further provided to this end. CLINICALTRIAL

scholarly journals Lived Experiences of Critically Ill Patients with Covid-19 After Discharge from Intensive Care Unit: A Phenomenological Study

2021 ◽  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Lived Experiences ◽  
Phenomenological Study ◽  
Social Stigma ◽  
Phenomenological Approach ◽  
Hermeneutic Phenomenological ◽  
Supportive Role

Objectives: The present study aimed to explore lived experiences of critically ill patients with COVID-19 after discharge from intensive care units of hospitals in Iran. Methods: The present study was qualitative research with a hermeneutic phenomenological approach. Participants were purposefully selected from critically ill patients with COVID-19 who were discharged from the intensive care unit (ICU) and transferred to the general ward. Data were mostly collected through in-depth, semi-structured, face-to-face interviews and, in some cases, telephone calls. Data were analyzed using the method of Dickelman et al. (1985). Guba and Lincoln's (1989) criteria were used to achieve data authenticity. Results: Data were obtained from 16 COVID-19 recovered patients with a history of ICU admission. Twelve participants were female and four were male with a mean age of 35 years. The four main themes were identified along with their subthemes: perception of death before dying (worry, helplessness, and expecting a different death), social stigma (social isolation and stigma), a nurse as a symbol of rebirth (a compassionate and supportive nurse and the supportive role of others), and meaningful life (a change in outlook on life and the manifestation of spirituality). Conclusion: The results of the present study indicated that personal thoughts such as thinking about death and social treatments such as stigma can lead to threatening physical and psychological problems in COVID-19 patients. Nurses and family members can prevent many of these problems by providing holistic care and psychological support. Apart from the challenges posed by the disease, post-recovery changes in patients' attitudes toward life can be considered as a positive point.

Nurses' lived experiences of intensive care unit bed spaces as a place of care: a phenomenological study

2014 ◽  
Vol 19 (3) ◽  
pp. 126-134 ◽  
Author(s):  
Sepideh Olausson ◽  
Margaretha Ekebergh ◽  
Sofia Almerud Österberg
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Lived Experiences ◽  
Phenomenological Study

scholarly journals Professional Challenges of Bedside Rationing in Intensive Care

2008 ◽  
Vol 15 (6) ◽  
pp. 715-728 ◽  
Author(s):  
Kristin Halvorsen ◽  
Reidun Førde ◽  
Per Nortvedt
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Treatment ◽  
Nursing Care ◽  
Participant Observation ◽  
Limited Resources ◽  
Professional Challenges ◽  
National Priority ◽  
Scarcity Of Resources ◽  
Depth Interviews

As the pressure on available health care resources grows, an increasing moral challenge in intensive care is to secure a fair distribution of nursing care and medical treatment. The aim of this article is to explore how limited resources influence nursing care and medical treatment in intensive care, and to explore whether intensive care unit clinicians use national prioritization criteria in clinical deliberations. The study used a qualitative approach including participant observation and in-depth interviews with intensive care unit physicians and nurses working at the bedside. Scarcity of resources regularly led to suboptimal professional standards of medical treatment and nursing care. The clinicians experienced a rising dilemma in that very ill patients with a low likelihood of survival were given advanced and expensive treatment. The clinicians rarely referred to national priority criteria as a rationale for bedside priorities. Because prioritization was carried out implicitly, and most likely partly without the clinician's conscious awareness, central patient rights such as justice and equality could be at risk.

Healing experience for family caregivers after an intensive care unit death

2019 ◽  
pp. bmjspcare-2018-001561 ◽  
Author(s):  
Susan DeSanto-Madeya ◽  
Dan Willis ◽  
Julie McLaughlin ◽  
Aristotle Boslet
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Family Caregivers ◽  
Phenomenological Study ◽  
Healthcare Providers ◽  
Loved One ◽  
Hermeneutic Phenomenological ◽  
Telephone Interviews ◽  
Hermeneutic Phenomenological Study ◽  
Purposive Sample

ObjectivesFamily caregivers suffer a high burden of emotional and psychological distress following the death of a loved one in the intensive care unit and often struggle to heal in the weeks following their loss. The purpose of this hermeneutic phenomenological study was to describe and interpret the experience of healing for family caregivers six weeks following the death of a loved one in the ICU.MethodsSemi-structured telephone interviews were conducted with a purposive sample of twenty-four family caregivers six weeks following the death of their loved ones in the ICU. Qualitative analysis techniques were used to identify common themes central to the experience of healing across all interviews.ResultsSeven themes were interpreted from the data: searching for clarity from a time of uncertainty; riding an emotional rollercoaster; seeking peace in one’s decisions; moving forward with each new day; taking comfort in the memories; valuing layers of support; and discovering life on one’s own.ConclusionBy identifying and gaining an understanding of healing following the death of a loved one in the ICU, nursing and other healthcare providers have an opportunity to promote healing and positively impact family caregiver’s bereavement.

scholarly journals 1412. The utility of respiratory viral panel testing for nosocomial fever in the neonatal intensive care unit

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S713-S713
Author(s):  
Carlo Fopiano Palacios ◽  
Eric Lemmon ◽  
James Campbell
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Linear Regression ◽  
Length Of Stay ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
P Value ◽  
Fisher Exact Test ◽  
The Mean ◽  
Pcr Test

Abstract Background Patients in the neonatal intensive care unit (NICU) often develop fevers during their inpatient stay. Many neonates are empirically started on antibiotics due to their fragile clinical status. We sought to evaluate whether the respiratory viral panel (RVP) PCR test is associated with use of antibiotics in patients who develop a fever in the NICU. Methods We conducted a retrospective chart review on patients admitted to the Level 4 NICU of the University of Maryland Medical Center from November 2015 to June 2018. We included all neonates who developed a fever 48 hours into their admission. We collected demographic information and data on length of stay, fever work-up and diagnostics (including labs, cultures, RVP), and antibiotic use. Descriptive statistics, Fisher exact test, linear regression, and Welch’s ANOVA were performed. Results Among 347 fever episodes, the mean age of neonates was 72.8 ± 21.6 days, and 45.2% were female. Out of 30 total RVP samples analyzed, 2 were positive (6.7%). The most common causes of fever were post-procedural (5.7%), pneumonia (4.8%), urinary tract infection (3.5%), meningitis (2.6%), bacteremia (2.3%), or due to a viral infection (2.0%). Antibiotics were started in 208 patients (60%), while 61 neonates (17.6%) were already on antibiotics. The mean length of antibiotics was 7.5 ± 0.5 days. Neonates were more likely to get started on antibiotics if they had a negative RVP compared to those without a negative RVP (89% vs. 11%, p-value < 0.0001). Patients with a positive RVP had a decreased length of stay compared to those without a positive RVP (30.3 ± 8.7 vs. 96.8 ± 71.3, p-value 0.01). On multivariate linear regression, a positive RVP was not associated with length of stay. Conclusion Neonates with a negative respiratory viral PCR test were more likely to be started on antibiotics for fevers. Respiratory viral PCR testing can be used as a tool to promote antibiotic stewardship in the NICU. Disclosures All Authors: No reported disclosures

scholarly journals SARS-CoV-2 and Cytomegalovirus Co-Infections—A Case Series of Critically Ill Patients

2021 ◽  
Vol 10 (13) ◽  
pp. 2792
Author(s):  
Patrícia Moniz ◽  
Sérgio Brito ◽  
Pedro Póvoa
Keyword(s):  
Intensive Care Unit ◽  
Critically Ill ◽  
Immune Suppression ◽  
Clinical Course ◽  
Health Care Systems ◽  
Case Series ◽  
Confounding Factors ◽  
Care Systems ◽  
The Impact ◽  
Cmv Reactivation

The SARS-CoV-2 pandemic has placed great strain on the most developed of health care systems, especially in the context of critical care. Although co-infections with cytomegalovirus (CMV) are frequent in the critically ill due to underlying immune suppression of multiple causes, the impact on COVID-19 patients remains unclear. Furthermore, severe COVID-19 has recently been associated with significant immune suppression, and this may in turn impact CMV reactivation, possibly contributing to clinical course. Nevertheless, multiple confounding factors in these patients will certainly challenge upcoming research. The authors present a case series of five patients admitted to the intensive care unit (ICU) in the context of respiratory failure due to severe COVID-19. All patients evolved with CMV reactivation during ICU stay.

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