scholarly journals CONOCIMIENTOS, PERCEPCIONES Y PRÁCTICAS EN PROFESIONALES DE LA SALUD SOBRE MOVILIZACION TEMPRANA EN LOS PACIENTES DE LAS UNIDADES DE CUIDADOS INTENSIVOS

2021 ◽  
Vol 6 (2) ◽  
pp. 5
Author(s):  
Ángela Yaleska Arévalo Tabares ◽  
Freiser Eceomo Cruz Mosquera ◽  
Yuly Viviana Valencia Salazar ◽  
Diego Alonzo Peláez Domínguez ◽  
Juan David Rosero Portocarrero
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Health Professionals ◽  
Early Mobilization ◽  
Post Discharge ◽  
Cross Sectional ◽  
Usual Practice ◽  
Calidad De Vida ◽  
Critical Patients

Introducción: Los pacientes críticos son sometidos a intervenciones que traen consigo complicaciones que pueden aparecer incluso de manera precoz, entre ellas se encuentra la debilidad muscular adquirida en unidad de cuidados intensivos, en este contexto tiene una importancia fundamental la movilización temprana del paciente crítico, que facilita el destete de la ventilación mecánica e influye en la calidad de vida posterior al alta. Objetivo: determinar los conocimientos, percepciones y prácticas en profesionales de la salud sobre movilizacion temprana en los pacientes de las unidades de cuidados intensivos de dos centros de salud de Cali.  Método: estudio observacional descriptivo de corte transversal en el que se incluyeron 24 profesionales de la salud que laboran en unidades de cuidados intensivos de dos Clínicas de la Ciudad de Cali, a los cuales se les aplicó un cuestionario autoadministrado sobre movilización temprana. El análisis de los datos se realizó en el programa SPSS versión 24. Resultados: La mayoría de los profesionales de la salud encuestados eran de sexo femenino, con una edad promedio de 31±5; se encontró que el 67% tenía un conocimiento medio, el 25% bajo y el 8% conocimiento alto. Por otro lado, el 88% manifestó ejecutar esta estrategia en su práctica habitual, y reportaron como barreras percibidas ausencia de protocolos y personal insuficiente. Conclusiones: gran parte de los profesionales de salud encuestados mostraron un conocimiento medio sobre movilización temprana y una alta incorporación de esta estrategia a la práctica clínica habitual. Palabras claves: movilización precoz de paciente crítico, cuidados intensivos, paciente crítico, ventilación mecánica. ABSTRACT Introduction: Critical patients are subjected to interventions that bring complications that can appear even early, among them is muscle weakness acquired in the intensive care unit, in this context, early mobilization of the critical patient is of fundamental importance, which facilitates weaning from mechanical ventilation and influences post-discharge quality of life. Objective: to determine the knowledge, perceptions and practices in health professionals about early mobilization in patients in the intensive care units of two health centers in Cali. Method: a descriptive, cross-sectional observational study that included 24 health professionals working in intensive care units of two Clinics in the City of Cali, to which a self-administered questionnaire on early mobilization was applied. Data analysis was performed using SPSS version 24. Results: Most of the health professionals surveyed were female, with a mean age of 31 ± 5; It was found that 67% had medium knowledge, 25% low and 8% high knowledge. On the other hand, 88% stated that they executed this strategy in their usual practice, and reported the absence of protocols and insufficient personnel as perceived barriers. Conclusions: a large part of the health professionals surveyed showed a medium knowledge about early mobilization and a high incorporation of this strategy into routine clinical practice. Keywords: early mobilization of critical patients, intensive care, critical patients, mechanical ventilation

Informational Needs of the Families of Patients Discharged From Intensive Care Units: A Case of Iran

2020 ◽  
pp. 0272684X2097264
Author(s):  
Asma Hajalizadeh ◽  
Mehdi Ahmadinejad ◽  
Mahlagha Dehghan ◽  
Mansoor Arab
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Health Care Providers ◽  
Self Care ◽  
Stressful Event ◽  
Informational Needs ◽  
Care Providers ◽  
Post Discharge ◽  
Cross Sectional ◽  
High Level

Background thousands of patients are admitted to intensive care units annually, which is a stressful event. Many of these patients still require particular care after discharge. In many countries, families play an essential role in taking care of these patients after discharge. This study aimed to determine the informational needs of families of patients discharged from Intensive Care Units (ICU), Kerman, southeast Iran. Methods this study had a cross-sectional design. Families were selected using the information extracted from patients’ medical records. One hundred forty family members of the ICU discharged patients participated in the survey using convenience sampling. Data collection tools were a validated researcher-made questionnaire about informational needs and a demographic characteristics form. Results the mean score of family informational needs was 31.18 ± 3.97 out of 40. Most families required a high level of information in all dimensions. However, the maximum need was associated with self-care subscale (4.89 out of 5), and the minimum need was associated with defecation (3.13 out of 5). Conclusion the families of patients discharged from intensive care units required much information about different areas of care particularly self-care. Health care providers, especially nurses, should be aware of the informational needs of the ICU patients’ families post-discharge to provide better care.

scholarly journals Management of early mobilization in intensive care units: a multicenter cross-sectional study

2018 ◽  
Vol 5 (4) ◽  
pp. 291-299
Author(s):  
Yan-Ping Zhu ◽  
Li-Xia Xia ◽  
Guo-Hong Li
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Physical Therapist ◽  
Early Mobilization ◽  
Cross Sectional Study ◽  
Activity Level ◽  
Unplanned Extubation ◽  
Cross Sectional ◽  
Educational Backgrounds ◽  
Nursing Experience

AbstractObjectiveThe aim of this study was to assess the management of early mobilization (EM) in Chinese intensive care units (ICUs).MethodsThis survey used a cross-sectional, observational design. A total of 65 tertiary and secondary hospitals were enrolled by convenience sampling and investigated using self-designed questionnaires.ResultsWe identified 69 ICUs in Jiangsu, China (response rate: 94.2%). 74.2% (1,004/1,353) of the nurses and nursing managers from 65 ICUs reported mobility practice. For the mobility level, 98.1% (1,327) reported use of in-bed exercise, 5.7% (77) sitting on a side of bed, 21.7% (294) transfer to chair, and 2.4% (33) walking. The most frequently reported barriers to early mobility were unplanned extubation, nursing resource, and absence of physical therapist. Nurses’ educational backgrounds, nursing experience, the lack of nursing resources, absence of physician, and the weakness of patient were the factors that influenced ICU early rehabilitation (P<0.01).ConclusionsAlthough implementation rates for EM in critically ill patients are high, the activity level is generally poor in most of the involved ICUs.

scholarly journals What matters most and for whom? A cross-sectional study exploring goals of health professionals in German neonatal intensive care units

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e044031
Author(s):  
Anne Mensen ◽  
Bernhard Roth ◽  
Ludwig Kuntz ◽  
Michael Wittland ◽  
Verena Glöckner ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Health Professionals ◽  
Neonatal Intensive Care ◽  
Cross Sectional Study ◽  
Hierarchical Level ◽  
Neonatal Intensive Care Units ◽  
Cross Sectional ◽  
Employee Survey ◽  
Patient Goals

ObjectivesQuality of care largely depends on successful teamwork, which in turn needs effective communication between health professionals. To communicate successfully in a team, health professionals need to strive for the same goals. However, it has been left largely unaddressed which goals professionals consider to be important. In this study, we aim to identify these goals and analyse whether differences between (1) personal and organisational goals, (2) different professions and (3) hierarchical levels exist in neonatal intensive care units (NICUs).DesignGoals were identified based on a literature review and a workshop with health professionals and tested in a pilot study. Subsequently, in the main study, a cross-sectional employee survey was undertaken.Setting and participants1489 nurses and 537 physicians from 66 German NICUs completed the questionnaire regarding personal and organisational goal importance between May and July 2013. Answers were given based on a 7-point Likert scale varying between none and exceptionally high importance.ResultsResults show that the goals can be subdivided into three main goal dimensions: patients, parents and staff. Furthermore, our results reveal significant differences between different professions and different hierarchical level: physicians rated patient goals with a mean (95% CI) importance of 6.37 (3.32 to 6.43), which is significantly higher than nurses with a mean (95% CI) importance of 6.15 (6.12 to 6.19) (p<0.01). Otherwise, nurses classified parental goals as more important (p<0.01). Furthermore, professionals in leading positions rate patient goals significantly higher than professionals that are not in leading positions (6.36 (3.28 to 6.44) vs 6.19 (6.15 to 6.22), p<0.01).ConclusionsDifferent employee goals need to be considered in decision-making processes to enhance employee motivation and the effectiveness of teamwork.Trial registration numberDRKS00004589.

scholarly journals Olfactory Dysfunction in Frontline Health Care Professionals During COVID-19 Pandemic in Brazil

2021 ◽  
Vol 12 ◽  
Author(s):  
Mariana Ferreira Sbrana ◽  
Marco Aurélio Fornazieri ◽  
Alexandre Bruni-Cardoso ◽  
Vivian I. Avelino-Silva ◽  
Deborah Schechtman ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Online Survey ◽  
Olfactory Dysfunction ◽  
Outpatient Clinics ◽  
Emergency Rooms ◽  
Cross Sectional

Upper respiratory viral infections can decrease the sense of smell either by inflammatory restriction of nasal airflow that carries the odorant molecules or through interference in olfactory sensory neuron function. During the coronavirus disease 2019 (COVID-19) pandemic, triggered by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), worldwide reports of severe smell loss (anosmia/hyposmia) revealed a different type of olfactory dysfunction associated with respiratory virus infection. Since self-reported perception of smell is subjective and SARS-CoV-2 exposure is variable in the general population, we aimed to study a population that would be more homogeneously exposed to the virus. Here, we investigated the prevalence of olfactory loss in frontline health professionals diagnosed with COVID-19 in Brazil, one of the major epicenters of the disease. We also analyzed the rate of olfactory function recovery and the particular characteristics of olfactory deficit in this population. A widely disclosed cross-sectional online survey directed to health care workers was developed by a group of researchers to collect data concerning demographic information, general symptoms, otolaryngological symptoms, comorbidities, and COVID-19 test results. Of the 1,376 health professionals who completed the questionnaire, 795 (57.8%) were working directly with COVID-19 patients, either in intensive care units, emergency rooms, wards, outpatient clinics, or other areas. Five-hundred forty-one (39.3%) participants tested positive for SARS-CoV-2, and 509 (37%) were not tested. Prevalence of olfactory dysfunction in COVID-19-positive subjects was 83.9% (454 of 541) compared to 12.9% (42 of 326) of those who tested negative and to 14.9% (76 of 509) of those not tested. Olfactory dysfunction incidence was higher in those working in wards, emergency rooms, and intensive care units compared to professionals in outpatient clinics. In general, remission from olfactory symptoms was frequent by the time of responses. Taste disturbances were present in 74.1% of infected participants and were significantly associated with hyposmia. In conclusion, olfactory dysfunction is highly correlated with exposure to SARS-CoV-2 in health care professionals, and remission rates up to 2 weeks are high.

Exercise in intensive care units, safety and hemodynamic monitoring

2020 ◽  
Vol 19 (1) ◽  
pp. 3
Author(s):  
Giulliano Gardenghi
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Hemodynamic Monitoring ◽  
Artificial Respiration ◽  
Exercise Physiology ◽  
Ventilatory Support ◽  
Early Mobilization ◽  
Cycle Ergometer ◽  
Search Terms

Introduction: Patients in the intensive care unit (ICU) have several deleterious effects of immobilization, including weakness acquired in the ICU. Exercise appears as an alternative for early mobilization in these patients. Objective: This work aims to highlight the hemodynamic repercussions and the applicability of exercise in the ICU. Methods: An integrative literature review was carried out, with articles published between 2010 and 2018, in the Lilacs, PubMed and Scielo databases, using the following search terms: exercise, cycle ergometer, intensive care units, early mobilization, mechanical ventilation, artificial respiration. Results: 13 articles were included, addressing hemodynamic monitoring and the role of exercise as early mobilization, with or without ventilatory support. The exercise sessions were feasible and safe within the ICU environment. Conclusion: Physical exercise can be performed safely in an ICU environment, if respecting a series of criteria such as those presented here. It is important that the assistant professional seeks to prescribe interventions based on Exercise Physiology that can positively intervene in the functional prognosis in critically ill patients.Keywords: exercise, intensive care units, patient safety.

scholarly journals Managing admission and discharge processes in intensive care units

2021 ◽  
Author(s):  
Jie Bai ◽  
Andreas Fügener ◽  
Jochen Gönsch ◽  
Jens O. Brunner ◽  
Manfred Blobner
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Numerical Study ◽  
Early Discharge ◽  
Fixed Costs ◽  
Real World Data ◽  
Trade Off ◽  
Markov Decision ◽  
Critical Patients ◽  
Expected Mortality

AbstractThe intensive care unit (ICU) is one of the most crucial and expensive resources in a health care system. While high fixed costs usually lead to tight capacities, shortages have severe consequences. Thus, various challenging issues exist: When should an ICU admit or reject arriving patients in general? Should ICUs always be able to admit critical patients or rather focus on high utilization? On an operational level, both admission control of arriving patients and demand-driven early discharge of currently residing patients are decision variables and should be considered simultaneously. This paper discusses the trade-off between medical and monetary goals when managing intensive care units by modeling the problem as a Markov decision process. Intuitive, myopic rule mimicking decision-making in practice is applied as a benchmark. In a numerical study based on real-world data, we demonstrate that the medical results deteriorate dramatically when focusing on monetary goals only, and vice versa. Using our model, we illustrate the trade-off along an efficiency frontier that accounts for all combinations of medical and monetary goals. Coming from a solution that optimizes monetary costs, a significant reduction of expected mortality can be achieved at little additional monetary cost.

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