scholarly journals Pengkajian Nyeri pada Pasien Kritis dengan Menggunakan Critical Pain Observation Tool(CPOT) di Intensive Care Unit(ICU)

1970 ◽  
Vol 4 (2) ◽  
Author(s):  
Ayu Prawesti Priambodo ◽  
Kusman Ibrahim ◽  
Nursiswati N
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pain Intensity ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Sampling Technique ◽  
Pain Scale ◽  
Kappa Index ◽  
Cross Sectional ◽  
Consecutive Sampling

Penggunaan alat ukur pengkajian nyeri yang sistematik dan terstandar pada pasien kritis yang tidak mampu untuk melaporkan rasa nyeri adalah suatu hal yang perlu diperhatikan. Behavioural pain scales(BPS) adalah alat ukur yang lebih dini dan banyak digunakan di area keperawatan kritis. Critical pain observation tools(CPOT) adalah alat yang dikembangkan menggunakan unsur-unsur rasa nyeri yang ada pada beberapa alat ukur pengkajian nyeri, termasuk BPS, namun CPOT belum banyak dikenal dan digunakan. Tujuan penelitian adalah melihat kesesuaian alat ukur CPOT dengan alat ukur BPS. Penelitian ini bersifat observasional analitik dengan rancangan Crosssectional dengan sampel pasien GICU (General Intensive Care Unit) dengan penurunan kesadaran dan menggunakan ventilasi mekanik sebanyak 48 pasien. Teknik pengambilan sampel dengan consecutive sampling. Pengkajian dilakukan dengan observasi skala nyeri menggunakan BPS dan CPOT pada saat pasien kondisi istirahat dan positioninguntuk melihat keandalan alat ukur nyeri. Hasil uji beda dan korelasi pada hasil pengukuran nyeri pada BPS dan CPOT adalah bermakna. Hal ini menunjukkan bahwa BPS dan CPOT dapat mengukur perbedaan intensitas nyeri saat istirahat dengan saat positioning. Hasil uji kesesuaian (kappa) pengukuran BPS dengan CPOT memiliki nilai kesesuaian yang bermakna, dengan nilai kesesuaian (kappa) BPS-CPOT pada kondisi istirahat sebesar 0,937, sedangkan nilai kesesuaian (Kappa)BPS-CPOT pada kondisi positioning sebesar 0,265. BPS dan CPOT adalah alat penilaian nyeri yang dapat digunakan dalam menilai rasa sakit dan meningkatkan manajemen nyeri pada pasien kritis. CPOT lebih mudah digunakan dan aplikatif karena memiliki definisi operasional yang jelas. Kata kunci : Behavioural pain scale, Critical pain observation tool, pasien kritis.Pain Assessment among Critically Ill Patients using the Critical Pain Observation Tool (CPOT) in the Intensive Care Unit AbstractA systematic and standardised tool to assess pain experienced by critically ill patients has been previously highlighted. The BPS is the common tool used in the intensive care setting which can be used. But, the Critical Pain Observation Tool (COPT) has not been used extensively in the hospital. Thus, the efficacy of this tool needs to be examined. This descriptive observational study aimed to find an agreement of CPOT with BPS using a cross-sectional method recruited 48 participants with consecutive sampling technique. Pain assessment was performed during a resting and positioning period to check the agreement of the tools. Data was analysed using Cohen’s Kappa index analysis. Findings demonstrated a significance difference of pain intensity measured by BPS and CPOT during the period of resting (κ = 0.937) and positioning (κ = 0.265). Thus, BPS and CPOT are reliable scales to measure pain intensity. It is expected that those tools can help nurses to improve pain management for critically ill patients. However, CPOT is considered more applicable and user-friendly compared to the BPS.Keywords: Behavioral Pain Scale, Critical Pain Observation Tool, critical nursing care

scholarly journals Knowledge, Attitude, and Practices towards Physical Assessment of Critically Ill Patients among Nurses Working in Intensive Care Unit: A Cross-Sectional Study in Lahore, Pakistan

2021 ◽  
Vol 3 (1) ◽  
pp. 44-61
Author(s):  
Muhammad Saghir ◽  
Muhammad Hussain ◽  
Kousar Perveen ◽  
Muhammad Afzal ◽  
Maliha Shoukat Shoukat
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Pearson Correlation ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Physical Assessment

Purpose: The purpose of the study to examine nurses' knowledge, attitudes, and practices towards physical assessment of critically ill patients in Tertiary Care Hospital, Lahore Pakistan. Methodology: The cross-sectional study was performed. A well-designed questionnaire was used to observe responses. Statistical Package for the Social Sciences (SPSS) version 25 was used to analyze the data. For the analysis, descriptive statistics of demographic data were used, meaning standard deviation and frequency. The Pearson correlation test was used to measure the correlation between knowledge, attitude, and practice towards physical assessment of critically ill patients. The study results display in tables and charts. Pearson correlation at p <0.05 consider as significant. Findings: The study was carried out to assess the knowledge, attitude, and practice among intensive care unit nurses towards physical assessment of critically sick patients in Tertiary Care Hospital Lahore, Pakistan. In this study, around 57.2% of nurses had good knowledge, 59.4% positive attitude, and 68.1% good practice towards critical ill patient’s physical assessment Unique contribution to theory, practice and policy: This study provide the opportunity to the nurses better to enhance their level of knowledge and skill of practice on physical assessment. Nurses, who had better knowledge and skill, should also teach their respective colleagues. Keywords: Knowledge, Attitude, Practice, Intensive Care Unit, Nurses, Physical Assessment.

scholarly journals TINGKAT PENGETAHUAN PENGUNJUNG DALAM HAND HYGIENE DI RUANG ICU RUMAH SAKIT BALI ROYAL

2019 ◽  
Vol 1 (2) ◽  
pp. 82
Author(s):  
Made Adi Sinta Meryanti ◽  
Anak Agung Ayu Yuliati Darmini ◽  
I Gusti Ayu Rai Rahayuni
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hand Hygiene ◽  
Sampling Technique ◽  
Good Knowledge ◽  
Cross Sectional ◽  
Royal Hospital ◽  
Descriptive Research ◽  
Consecutive Sampling ◽  
Level Of Knowledge

ABSTRAK Infeksi nosokomial dapat dicegah dengan cara hand hygiene efektif namun belum sepenuhnya individu memahami hal ini. Penelitian ini bertujuan untuk mengetahui gambaran tingkat pengetahuan pengunjung dalam melakukan Hand Hygiene .Penelitian deskriptif dengan pendekatan cross-sectional ini  menggunakan teknik Consecutive Sampling pada 55 pengunjung Rumah Sakit di ruang Ruang ICU Rumah Sakit Bali Royal. Hasil penelitian didapatkan sebagian besar responden berjenis kelamin laki-laki 31 (56,45%), berpendidikan sebagian besar sarjana 24 (43,6%), bekerja sebagai wiraswasta sebanyak 24 (43,6%). Sebagian besar pengunjung memiliki pengetahuan baik yaitu sebanyak 38 (69,1%), memiliki pengetahuan cukup sebanyak 13 (23,6%) dan pengetahuan kurang sebanyak 4 (7,3%) responden. Meskipun sebagian besar pengunjung memiliki pengetahuan baik tentang hand hygiene, masih ada sebagian yang perlu ditingkatkan pemahaman tentang hand hygiene pada saat membesuk pasien ke rumah sakit untuk mencegah terjadinya infeksi nosokomial. Kata Kunci : Hand Hygiene, Pengetahuan  ABSTRACTNosocomial infections can prevent by effective but not all individual know about this. Study aimed to describe the level of knowledge of visitors in conducting Hand Hygiene in ICU Bali Royal Hospital. Descriptive research design with cross-sectional approach was used consecutive Sampling technique with 55 hospital visitors in the Intensive Care Unit of Bali Royal Hospital. The result showed the majority respondents is male (31 respondents; 56.45%), most of them were scholars educated (24 respondents; 43.6%) and work as self-employed about (24 respondents; 43.6%). It could be seen most of the visitors had a good knowledge (38 repondents; 69.1%), had sufficient knowledge (13 respondents; 23.6%) and lack of knowledge (4 respondents; 7.3%). The study concluded that even though most of hospital’visitor have good knowledge about hand hygiene when visit the patient at the hospital, but still need to improve the knowledge about hand hygiene to prevent nosocomial infections.  Keywords: Hand Hygiene, Knowledge 

scholarly journals Practice and the Influencing Factors of Nurses Working in the Intensive Care Unit regarding Physical Restraint use: Multi-centered cross-sectional study

2020 ◽  
Author(s):  
Tilahun Kassew Gebeyehu ◽  
Ambaye Dejen Tilahun ◽  
Bikis Liyew Wudu
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Influencing Factors ◽  
Critically Ill Patients ◽  
Physical Restraint ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Restraint Use

Abstract Background: Nurses working in the intensive care unit commonly use physical restraint on critically ill patients. The main reason for the restraining of patients is to prevent the dislodgement of invasive procedures/ medical equipment, reduce agitation. Patients are exposed to different complications from physical restraint like worsening of agitation and delirium, fall injury, limb edema, restricted circulation, and skin laceration at restraint site, and death as a result of nurses’ improper practice regarding restraining. Despite this impact, there was no documented study in Ethiopia in this regard. Objective: To assess practice and its influencing factors of nurses working in the Intensive Care Unit regarding physical restraint Methods: An institution-based cross-sectional study was conducted from July to August 2019 at Amhara regional state referral hospitals, Northwest Ethiopia. All (260) nurses working in the intensive care unit were invited to participate through a convenience sampling technique. Structured questionnaires which consist of socio-demographic, professional characteristics and Level of Knowledge, Attitudes and Practices of Staff Regarding Physical Restraints Questionnaire were used. Simple and multiple linear regression and beta (β) coefficient at 95% confidence interval was employed with p-value<0.05 as statistical significance. Result: The mean score of nurses’ practice regarding physical restraint use among critically ill patients was 30.94±5.44. Nurses with short (≤2 years) experience of the intensive care unit, received educational training during graduate class regarding restraining, knowledge and attitude scores were the factors significantly associated with nurses’ practice score regarding physical restraining use. Conclusion: The practice regarding physical restraint use among critically ill patients among participant nurses’ was a satisfactory. The administrators’ should develop and provide educational and in-service training programs for nurses working in intensive care unit settings regarding physical restraint use and its alternatives, which is crucial for the nurses’ to improve their behavior of restraining. Keywords: Intensive care unit, Nurses’, Practice, Physical restraint

scholarly journals Implementation of Stress Ulcer Prophylaxis (SUP) in an Intensive Care Unit (ICU)

2019 ◽  
pp. 1-7
Author(s):  
Foroud Shahbazi ◽  
Hasanali Karimpur ◽  
Elham Hosseini
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Stress Ulcer ◽  
Tertiary Hospital ◽  
Stress Ulcer Prophylaxis ◽  
Ulcer Bleeding ◽  
Cross Sectional ◽  
Ulcer Prophylaxis

Background: Critically ill patients are at high risk for developing stress ulcer bleeding, which may increase the length of hospitalization and mortality rate. Stress ulcer prophylaxis could be done either with PPIs or with H2 receptor blockers, which were prescribed in critically ill patients. Aim: This cross-sectional study was accomplished in an intensive care unit to implement new stress ulcer prophylaxis.  Methods: This study was conducted in a tertiary hospital of Kermanshah province, west of Iran. Patients who were hospitalized for at least 72 hours and received SUP prophylaxis, were included in our study. Updated ASHP guideline was used for calculating SUP risk score. Patients received either PPIs or H2RA (intravenously or enteral). Efficacy and safety of early changes to enteral route were evaluated in one year and cost was calculated in three years’ period.  Results: This study was conducted on 150 patients with a mean age of 58 ± 18 years old. More than half of patients (53.3%) were male. Stress ulcer prophylaxis was prescribed for all critically ill patients, regardless of the risk of GI bleeding while only 76.6% of patients had an appropriate indication for receiving SUP protocol. Six patients in the PPIs group (4 in intravenous and 2 in enteral) experienced gastrointestinal bleeding. Changing the route of administration from intravenous to intravenous over a three-year period resulted in a decrease in the mean use of pentoprazole vials from 12 to 4 per patient. Conclusion: Early changing (within 72 hours) SUP from IV to enteral is safe and cost-saving approach.

scholarly journals Treatment of a Critically Ill COVID-19 Patient with the Seraph 100 Microbind Affinity Filter

TH Open ◽  
2021 ◽  
Vol 05 (02) ◽  
pp. e134-e138
Author(s):  
Anke Pape ◽  
Jan T. Kielstein ◽  
Tillman Krüger ◽  
Thomas Fühner ◽  
Reinhard Brunkhorst
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Randomized Trials ◽  
Clinical Course ◽  
Pharmacological Therapy ◽  
The European Union ◽  
Positive Effects ◽  
Special Patient

AbstractThe coronavirus disease 2019 (COVID-19) pandemic has a serious impact on health and economics worldwide. Even though the majority of patients present with moderate and mild symptoms, yet a considerable portion of patients need to be treated in the intensive care unit. Aside from dexamethasone, there is no established pharmacological therapy. Moreover, some of the currently tested drugs are contraindicated for special patient populations like remdesivir for patients with severely impaired renal function. On this background, several extracorporeal treatments are currently explored concerning their potential to improve the clinical course and outcome of critically ill patients with COVID-19. Here, we report the use of the Seraph 100 Microbind Affinity filter, which is licensed in the European Union for the removal of pathogens. Authorization for emergency use in patients with COVID-19 admitted to the intensive care unit with confirmed or imminent respiratory failure was granted by the U.S. Food and Drug Administration on April 17, 2020.A 53-year-old Caucasian male with a severe COVID-19 infection was treated with a Seraph Microbind Affinity filter hemoperfusion after clinical deterioration and commencement of mechanical ventilation. The 70-minute treatment at a blood flow of 200 mL/minute was well tolerated, and the patient was hemodynamically stable. The hemoperfusion reduced D-dimers dramatically.This case report suggests that the use of Seraph 100 Microbind Affinity filter hemoperfusion might have positive effects on the clinical course of critically ill patients with COVID-19. However, future prospective collection of data ideally in randomized trials will have to confirm whether the use of Seraph 100 Microbind Affinity filter hemoperfusion is an option of the treatment for COVID-19.

scholarly journals Bereavement interventions to support informal caregivers in the intensive care unit: a systematic review

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Stephana J. Moss ◽  
Krista Wollny ◽  
Therese G. Poulin ◽  
Deborah J. Cook ◽  
Henry T. Stelfox ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Traumatic Stress ◽  
Critically Ill Patients ◽  
Informal Caregivers ◽  
Post Traumatic Stress ◽  
Bereavement Support ◽  
Complex Needs ◽  
Post Traumatic

Abstract Background Informal caregivers of critically ill patients in intensive care unit (ICUs) experience negative psychological sequelae that worsen after death. We synthesized outcomes reported from ICU bereavement interventions intended to improve informal caregivers’ ability to cope with grief. Data sources MEDLINE, EMBASE, CINAHL and PsycINFO from inception to October 2020. Study selection Randomized controlled trials (RCTs) of bereavement interventions to support informal caregivers of adult patients who died in ICU. Data extraction Two reviewers independently extracted data in duplicate. Narrative synthesis was conducted. Data synthesis Bereavement interventions were categorized according to the UK National Institute for Health and Clinical Excellence three-tiered model of bereavement support according to the level of need: (1) Universal information provided to all those bereaved; (2) Selected or targeted non-specialist support provided to those who are at-risk of developing complex needs; and/or (3) Professional specialist interventions provided to those with a high level of complex needs. Outcome measures were synthesized according to core outcomes established for evaluating bereavement support for adults who have lost other adults to illness. Results Three studies of ICU bereavement interventions from 31 ICUs across 26 hospitals were included. One trial examining the effect of family presence at brain death assessment integrated all three categories of support but did not report significant improvement in emotional or psychological distress. Two other trials assessed a condolence letter intervention, which did not decrease grief symptoms and may have increased symptoms of depression and post-traumatic stress disorder, and a storytelling intervention that found no significant improvements in anxiety, depression, post-traumatic stress, or complicated grief. Four of nine core bereavement outcomes were not assessed anytime in follow-up. Conclusions Currently available trial evidence is sparse and does not support the use of bereavement interventions for informal caregivers of critically ill patients who die in the ICU.

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