scholarly journals Incidence of pressure injury and nursing care time in intensive care

2020 ◽  
Author(s):  
Yasmin Cardoso Metwaly Mohamed Ali ◽  
Taís Milena Milena Pantaleão Souza ◽  
Paulo Carlos Garcia ◽  
Paula Cristina Nogueira
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Retrospective Study ◽  
Data Analysis ◽  
Nursing Care ◽  
University Hospital ◽  
Central Tendency ◽  
Hospital Data ◽  
Nursing Team ◽  
Pressure Injury

Objectives: To correlate the incidence of pressure injury (PI) with the average time of nursing care in an intensive care unit (ICU). Method: Epidemiological, observational, retrospective study, carried out in the ICU of a university hospital. Data were collected by consulting the PI incidence and the average nursing care time from ICU databases between 2010 and 2014. Measures of central tendency and variability, and Pearson’s correlation coefficient were used for data analysis. Results: The average incidence of PI between 2010 and 2014 was 10.83% (SD = 2.87) and the average time spent in nursing care for patients admitted to the ICU was 15 hours (SD = 0.94). There was no statistically significant correlation between the incidence of PI and the nursing care time (r = -0.17; p = 0.199), however, the results suggested an overload on the nursing team. Conclusion: This study confirms the importance of implementing and reassessing the effectiveness of preventive care protocols for PI, in addition to warning about the work overload of nursing in assisting critically ill patients.

scholarly journals Patient safety: understanding human error in intensive nursing care

2018 ◽  
Vol 52 (0) ◽  
Author(s):  
Sabrina da Costa Machado Duarte ◽  
Marluci Andrade Conceição Stipp ◽  
Maria Manuela Vila Nova Cardoso ◽  
Andreas Büscher
Keyword(s):  
Intensive Care ◽  
Nursing Care ◽  
Human Error ◽  
Participant Observation ◽  
Quality Care ◽  
Hospital Data ◽  
Nursing Team ◽  
Proactive Measures ◽  
Intensive Care Nursing ◽  
Care Nursing

ABSTRACT Objective: To analyze the active failures and the latent conditions related to errors in intensive nursing care and to discuss the reactive and proactive measures mentioned by the nursing team. Method: Qualitative, descriptive, exploratory study conducted at the Intensive Care Unit of a general hospital. Data were collected through interviews, participant observation and submitted to lexical analysis in the ALCESTE® software and to ethnographic analysis. Results: 36 professionals of the nursing team participated in the study. The analysis originated three lexical classes: Error in intensive care nursing; Active failures and latent conditions related to errors in the intensive care nursing team; Reactive and proactive measures adopted by the nursing team regarding errors in intensive care. Conclusion: Reactive and proactive measures influenced the safety culture, in particular, the recognition of errors by professionals, contributing to their prevention, safety and quality care.

Ethical challenges when intensive care unit patients refuse nursing care

2014 ◽  
Vol 23 (2) ◽  
pp. 214-222 ◽  
Author(s):  
Eva Martine Bull ◽  
Venke Sørlie
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Registered Nurses ◽  
Nursing Care ◽  
University Hospital ◽  
Personal Hygiene ◽  
Human Beings ◽  
Ethical Challenges ◽  
Science Data ◽  
Holistic Nursing

Background: Less sedated and more awake patients in the intensive care unit may cause ethical challenges. Research objectives: The purpose of this study is to describe ethical challenges registered nurses experience when patients refuse care and treatment. Research design: Narrative individual open interviews were conducted, and data were analysed using a phenomenological hermeneutic method developed for researching life experiences. Participants and research context: Three intensive care registered nurses from an intensive care unit at a university hospital in Norway were included. Ethical considerations: Norwegian Social Science Data Services approved the study. Permission was obtained from the intensive care unit leader. The participants’ informed and voluntary consent was obtained in writing. Findings: Registered nurses experienced ethical challenges in the balance between situations of deciding on behalf of the patient, persuading the patient and letting the patient decide. Ethical challenges were related to patients being harmful to themselves, not keeping up personal hygiene and care or hindering critical treatment. Discussion: It is made apparent how professional ethics may be threatened by more pragmatic arguments. In recent years, registered nurses are faced with increasing ethical challenges to do no harm and maintain dignity. Conclusion: Ethically challenging situations are emerging, due to new targets including conscious and aware critical care patients, leaving an altered responsibility on the registered nurses. Reflection is required to adjust the course when personal and professional ideals no longer are in harmony with the reality in the clinical practice. RNs must maintain a strong integrity as authentic human beings to provide holistic nursing care.

scholarly journals Nursing Interventions in the Clinical Practice of an Intensive Care Unit

2010 ◽  
Vol 18 (5) ◽  
pp. 873-880 ◽  
Author(s):  
Amália de Fátima Lucena ◽  
Maria Gaby Rivero de Gutiérrez ◽  
Isabel Cristina Echer ◽  
Alba Lucia Bottura Leite de Barros
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Practice ◽  
Nursing Care ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Nursing Interventions ◽  
Sectional Study ◽  
Cross Sectional ◽  
Respiratory Management

This cross-sectional study was carried out at a university hospital to describe the nursing interventions most frequently performed in the clinical practice of an intensive care unit, based on nursing care prescriptions, and to investigate their similarity to the Nursing Interventions Classification (NIC). The sample consisted of 991 hospitalizations of patients. Data were retrospectively collected from the computer database and analyzed through descriptive statistics and cross-mapping. A total of 57 different NIC interventions frequently used in the unit were identified; most of them in the complex (42%) and basic physiological (37%) domains, in the classes ‘respiratory management’ and ‘self-care facilitation’. Similarity between the nursing care prescribed and nursing interventions/NIC was found in 97.2% of the cases. The conclusion is that the interventions/NIC used in the clinical practice of this intensive care unit reflects the level of complexity of nursing care, which is mainly directed at the regulation of the body’s physical and homeostatic functioning.

scholarly journals Predictive Modeling of Pressure Injury Risk in Patients Admitted to an Intensive Care Unit

2020 ◽  
Vol 29 (4) ◽  
pp. e70-e80
Author(s):  
Mireia Ladios-Martin ◽  
José Fernández-de-Maya ◽  
Francisco-Javier Ballesta-López ◽  
Adrián Belso-Garzas ◽  
Manuel Mas-Asencio ◽  
...  
Keyword(s):  
Machine Learning ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Injury Risk ◽  
Area Under The Curve ◽  
University Hospital ◽  
Machine Learning Techniques ◽  
Real Environment ◽  
Learning Techniques ◽  
Pressure Injury

Background Pressure injuries are an important problem in hospital care. Detecting the population at risk for pressure injuries is the first step in any preventive strategy. Available tools such as the Norton and Braden scales do not take into account all of the relevant risk factors. Data mining and machine learning techniques have the potential to overcome this limitation. Objectives To build a model to detect pressure injury risk in intensive care unit patients and to put the model into production in a real environment. Methods The sample comprised adult patients admitted to an intensive care unit (N = 6694) at University Hospital of Torrevieja and University Hospital of Vinalopó. A retrospective design was used to train (n = 2508) and test (n = 1769) the model and then a prospective design was used to test the model in a real environment (n = 2417). Data mining was used to extract variables from electronic medical records and a predictive model was built with machine learning techniques. The sensitivity, specificity, area under the curve, and accuracy of the model were evaluated. Results The final model used logistic regression and incorporated 23 variables. The model had sensitivity of 0.90, specificity of 0.74, and area under the curve of 0.89 during the initial test, and thus it outperformed the Norton scale. The model performed well 1 year later in a real environment. Conclusions The model effectively predicts risk of pressure injury. This allows nurses to focus on patients at high risk for pressure injury without increasing workload.

scholarly journals Limited Mobility to the Bed Reduces the Chances of Discharge and Increases the Chances of Death in the ICU

2021 ◽  
Vol 12 (1) ◽  
pp. 8-16
Author(s):  
Talita Leite dos Santos Moraes ◽  
Joana Monteiro Fraga de Farias ◽  
Brunielly Santana Rezende ◽  
Fernanda Oliveira de Carvalho ◽  
Michael Silveira Santiago ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Retrospective Study ◽  
Medical Records ◽  
High Mobility ◽  
University Hospital ◽  
Limited Mobility ◽  
The Mean ◽  
The University

Background: Progressive mobility in the ICU has been recommended; however, the definitions of low, moderate, and high mobility in the ICU still diverge between studies. Therefore, our objective was to classify the mobility of the sample from verticalization and active withdrawal from the bed, and from that, to analyze the chances of discharge, death, and readmission to the ICU. Materials and methods: This is an observational and retrospective study that consults the medical records of individuals admitted to the ICU of the University Hospital of Sergipe (HU/SE) between August 2017 and August 2018. Mobility level was classified based on the Intensive Care Unit Mobility Scale (IMS). Results: A total of 121 individuals were included. The mean age was 61.45 ± 16.45, being 53.7% female. Of these, 28 (23.1%) had low mobility, 33 (27.3%) had moderate mobility, and 60 (49.6%) had high mobility. Individuals with low mobility were 45 times more likely to die (OR = 45.3; 95% CI = 3.23–636.3) and 88 times less likely to be discharged from the ICU (OR = 0.22; 95% CI = 0.002–0.30). Conclusion: Those who evolved with low mobility had a higher chance of death and a lower chance of discharge from the ICU. Moderate and high mobility were not associated with the investigated outcomes.

scholarly journals Clima Organizacional em uma Unidade de Terapia Intensiva: percepções da equipe de enfermagem

2021 ◽  
Vol 20 (2) ◽  
pp. 390-425
Author(s):  
Flávia Barreto Tavares Chiavone ◽  
Claúdia Cristiane Filgueira Martins Rodrigues ◽  
Larissa De Lima Ferreira ◽  
Pétala Tuani Candido de Oliveira Salvador ◽  
Manaces Dos Santos Bezerril ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Organizational Climate ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Nursing Team ◽  
Terapia Intensiva ◽  
Nursing Professionals

Objetivo: Medir el clima organizacional del equipo de enfermería en la unidad de cuidados intensivos. Método: Este es un estudio transversal, con enfoque cuantitativo, desarrollado en una unidad de cuidados intensivos de un hospital universitario en el noreste de Brasil. La recolección de datos se realizó en 2016, con la participación de 30 profesionales de enfermería. Se realizó el análisis de datos a partir de estadística descriptiva y análisis de datos bivariados. Resultados: Se encontró que los profesionales de enfermería perciben un clima organizacional bajo en el sector en que trabajan y el desarrollo profesional y los beneficios fueron el factor considerado más bajo entre los trabajadores. El análisis bivariado infiere significativamente que los profesionales que tienen hijos tienen una baja percepción del clima organizacional. Conclusión: La percepción del clima organizacional del equipo de enfermería investigado es baja. Objective: To measure the organizational climate of the nursing team in the intensive care unit. Method: This is a cross-sectional study, with a quantitative approach, developed in the intensive care unit of a university hospital in the Northeast of Brazil. Data collection was carried out in 2016, with the participation of 30 nursing professionals. Data analysis was carried out using descriptive statistics and a bivariate analysis of data. Results: It was found that nursing professionals perceive a low organizational climate score in the sector they work. The professional Development and the benefits were considered the lowest factor by the workers. The bivariate analysis significantly infers that the professionals who have children have a low perception of the organizational climate. Conclusion: The nursing team investigated is perceives the score of the organizational climate to be low. Objetivo: Mensurar o clima organizacional da equipe enfermagem na unidade de terapia intensiva. Método: trata-se de um estudo transversal, de abordagem quantitativa, desenvolvida em uma unidade de terapia intensiva em um hospital universitário no nordeste do Brasil. A coleta de dados foi realizada em 2016, com a participação de 30 profissionais de enfermagem. A análise dos dados se deu por estatística descritiva e análise bivariada dos dados. Resultados: Verificou-se que os profissionais de enfermagem percebem um baixo clima organizacional no setor que atuam e o Desenvolvimento profissional e benefícios foi o fator considerado mais baixo entre os trabalhadores. A análise bivariada infere de maneira significativa que os profissionais que possuem filhos têm uma baixa percepção do clima organizacional. Conclusão: A percepção do clima organizacional da equipe de enfermagem investigada é baixa.

scholarly journals Handover communication in intensive therapy: nursing team meanings and practices

2020 ◽  
Vol 41 ◽  
Author(s):  
Grazielle Rezende da Silva dos Santos ◽  
Fabiana de Mello Barros ◽  
Rafael Celestino da Silva
Keyword(s):  
Intensive Care Unit ◽  
Content Analysis ◽  
Intensive Care ◽  
Nursing Care ◽  
Intensive Therapy ◽  
The Other ◽  
Communication Process ◽  
Thematic Content Analysis ◽  
Nursing Team ◽  
Handover Process

ABSTRACT Objective: To analyze the meanings built by the nursing team regarding communication at shift handover in intensive care units. Method: A qualitative study, grounded on the theoretical framework of Berlo, was developed in the intensive care unit of a hospital in Rio de Janeiro with the nursing team participating in the handover process or working with patient care. Observation and interviews were conducted, with a thorough description of the data and thematic content analysis. Results: There is acknowledgment of the meaning of handover in nursing care, which is expressed in behaviors aimed at avoiding inefficacy or the incorrect perception of communication; on the other hand, there is little participation of nursing technicians, with side talks, lack of attention and incomplete information, which compromises their effectiveness. Conclusion: Professionals should understand their role in the communication process by playing it with active participation to reduce handover noises.

scholarly journals Nursing Activities Score by assistance sites in Intensive Care Units

2017 ◽  
Vol 22 (1) ◽  
Author(s):  
Claudia Maria Silva Cyrino ◽  
Magda Cristina Queiroz Dell'Acqua ◽  
Meire Cristina Novelli e Castro ◽  
Elaine Machado de Oliveira ◽  
Sérgio Deodato ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Retrospective Study ◽  
Confidence Interval ◽  
Clinical Characteristics ◽  
Surgical Patients ◽  
Nursing Workload ◽  
Work Process ◽  
Nursing Team

Abstract Objective: To compare the Nursing Activities Score (NAS) between the Assistance Sites in an Intensive Care Unit. Method: Descriptive, retrospective study, carried out in the Intensive Care Unit of a teaching hospital. The patients were organized in Assistance Sites according to their clinical characteristics and the nursing team's composition was organized in accordance with the Nursing Activities Score (NAS). The confidence interval was set at p < 0.05. Results: the majority were male surgical patients with a mean age of 56.8 years. The postoperative care Site presented the greatest patient turnover. The overall average NAS was 71.7%. There was a difference in the nursing workload between the different Assistance Sites. The shorter length of stay and the nonsurvivors contributed to increasing the workload in the ICU. Conclusion: Comparing the NAS in the different Sites made it possible to organize the work process of the nursing team according to each group, contributing to patient safety.

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