scholarly journals The Healthcare Staffs’ Perception of Parents’ Participation in Critical Incidents at the PICU, a Qualitative Study

2021 ◽  
Vol 11 (3) ◽  
pp. 680-689
Author(s):  
Julia Hansson ◽  
Amanda Hörnfeldt ◽  
Gunilla Björling ◽  
Janet Mattsson

Background: Internationally, there are very few guidelines regarding how near relations can be taken care of on a children’s intensive care unit. Despite knowledge about the positive effects of parental presence, staff frequently reject parents out of insecurity. This study aimed to investigate health professionals’ understanding of letting parents be present throughout critical situations. A qualitative method with semi-structured interviews was used to answer the aim of his study. Nine persons participated in the study, both physicians and nurses. The result showed that health professionals’ main view is that parents’ presence is positive. However, their presence often has lower priority than the medical focus of the child and the health professionals’ concern of failure. Conclusion: Health professionals have the power to decide if parents can be present in critical situations. Only when a parent demands to be present does that demand beat the decisions made by health professionals. Lack of resources within the team and fear of parents becoming a disturbance or a distraction are cited as the primary reasons not to let parents be present.

2019 ◽  
Vol 15 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Bradley Lonergan ◽  
Alexandra Wright ◽  
Rachel Markham ◽  
Laura Machin

Background Withholding and withdrawing treatment are deemed ethically equivalent by most Bioethicists, but intensivists often find withdrawing more difficult in practice. This can lead to futile treatment being prolonged. Time-limited trials have been proposed as a way of promoting timely treatment withdrawal whilst giving the patient the greatest chance of recovery. Despite being in UK guidelines, time-limited trials have been infrequently implemented on Intensive Care Units. We will explore the role of time in Intensive Care Unit decision-making and provide a UK perspective on debates surrounding time-limited trials. Methods This qualitative study recruited 18 participants (nine doctors, nine nurses) from two Intensive Care Units in North West England for in-depth, one-to-one semi-structured interviews. A thematic analysis was performed of the data. Results Our findings show time is utilised by Intensive Care Unit staff in a variety of ways including managing uncertainty when making decisions about a patient’s prognosis or the reversibility of a disease, constructing relationships with patients’ relatives, communicating difficult messages to patients’ relatives, justifying resource allocation decisions to colleagues, and demonstrating compassion towards patients and their families. Conclusions Time shifts the balance towards greater certainty in Intensive Care Unit decision-making, by demonstrating futility, and can ease the difficult transition for staff and families from active treatment to palliation. However, this requires clear and open communication, both within the Intensive Care Unit team and with the family, being prioritised when time is used in decision-making.


TH Open ◽  
2021 ◽  
Vol 05 (02) ◽  
pp. e134-e138
Author(s):  
Anke Pape ◽  
Jan T. Kielstein ◽  
Tillman Krüger ◽  
Thomas Fühner ◽  
Reinhard Brunkhorst

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.


Author(s):  
Paloma Conde ◽  
Marta Gutiérrez ◽  
María Sandín ◽  
Julia Díez ◽  
Luisa Borrell ◽  
...  

Cities, and therefore neighborhoods, are under constant change. Neighborhood changes may affect residents’ health in multiple ways. The Heart Healthy Hoods (HHH) project studies the association between neighborhood and residents’ health. Focusing on a middle–low-socioeconomic neighborhood in Madrid (Spain), our aim was to describe qualitatively its residents’ perceptions on the urban changes and their impacts on health. We designed a qualitative study using 16 semi-structured interviews including adult residents and professionals living or working in the area. Firstly, we described the perceived main social and neighborhood changes. Secondly, we studied how these neighborhood changes connected to residents’ health perceptions. Perceived major social changes were new demographic composition, new socio–cultural values and economic changes. Residents’ negative health perceptions were the reduction of social relationships, increase of stress and labor precariousness. Positive health perceptions were the creation of supportive links, assimilation of self-care activities and the change in traditional roles. Neighborhood changes yielded both negative and positive effects on residents’ health. These effects would be the result of the interrelation of different elements such as the existence or absence of social ties, family responsibilities, time availability, economic resources and access and awareness to health-promoting programs. These qualitative research results provide important insight into crafting urban health policies that may ultimately improve health outcomes in communities undergoing change.


2016 ◽  
Vol 15 (2) ◽  
pp. 288 ◽  
Author(s):  
Farah Pitanga Porto Gois dos Santos ◽  
Isabel Comassetto ◽  
Anne Isadora Cavalcante Porciúncula ◽  
Regina Maria dos Santos ◽  
Fabiana Andrea Soares Ferreira ◽  
...  

Pesquisa que envolve o processo de morte, abordando a distanásia, a qual se constitui na obstinação terapêutica a fim de adiar a morte, e a Ortotanásia, que se constitui na morte em seu processo natural, sem prolongar o tratamento. Teve como objetivo reconhecer a percepção dos profissionais da equipe de saúde que atuam em unidade de terapia intensiva, acerca das situações de Ortotanásia e Distanásia. Realizado em um hospital universitário. Os dados foram coletados por meio de entrevistas semiestruturadas com 25 profissionais de saúde e submetidos à análise de conteúdo temática. Emergiram três categorias relacionadas: Apreendendo a Ortotanásia e a Distanásia; Percebendo o contexto da tomada de decisão; Ponderando a Ortotanásia e a Distanásia na finitude da vida. A percepção dos profissionais de saúde referente à Ortotanásia e à Distanásia exige discussões referentes aos conceitos éticos que envolvem as intervenções no processo de morte, possibilitando um embasamento da equipe multiprofissional, familiares e pacientes na tomada de decisão no final da vida.


2012 ◽  
Vol 6 (2) ◽  
pp. 252
Author(s):  
Hérvora Santuzza Pereira Araújo ◽  
Ildone Forte de Morais ◽  
Cecília Nogueira Valença ◽  
Marquiony Marques dos Santos ◽  
Raimunda Medeiros Germano

ABSTRACTObjective: to discuss the nursing staff's project in the context of the Intensive Care Unit (ICU) of Hospital Regional do Seridó, Caicó-RN. Method: qualitative descriptive-exploratory research. 19 semi-structured interviews were performed with professional nursing staff working in the ICU. The data were analyzed according to thematic content analysis, which consists of: pre-analysis, material exploration and processing of results. The study was approved by the Ethics Committee in Research of Universidade do Estado do Rio Grande do Norte as Protocol 027/10 and CAAE 0026.0.428.000-10, according to Resolution 196/96. Results: it was showed that the quantity of graduated professionals in nursing staff is unsatisfactory for the development of the necessary assistance to the ICU. Conclusion: this study reflects that the dimensioning of the nursing staff should involve the participation of hospital managers for researching and raising the critical points of functioning of the service, through promoting teamwork. Descriptors: personnel downsizing; intensive care unit; nursing team.RESUMOObjective: discutir o dimensionamento da equipe de enfermagem no contexto da Unidade de Terapia Intensiva do Hospital Regional do Seridó (HRS) em Caicó- RN. Método: pesquisa descritivo-exploratória qualitativa. Foram realizadas 19 entrevistas semiestruturadas com profissionais da equipe de enfermagem que trabalham na UTI. As informações foram analisadas de acordo com a análise de conteúdo temática, que consiste em: pré-análise, exploração do material e tratamento dos resultados obtidos. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa da Universidade do Estado do Rio Grande do Norte conforme protocolo nº 027/10 e CAAE 0026.0.428.000-10, de acordo com a Resolução 196/96. Resultados: apontaram que o quantitativo dos profissionais de nível superior em enfermagem é insatisfatório para o desenvolvimento da assistência necessária para a UTI. Conclusão: o estudo reflete que o dimensionamento da equipe de enfermagem deve envolver a participação dos gestores do hospital, para pesquisar e levantar os pontos críticos do funcionamento do serviço, através da promoção do trabalho em equipe. Descritores: downsizing organizacional; unidades de terapia intensiva; equipe de enfermagem.RESUMENObjetivo: discutir la dimensión del equipo de enfermería en el contexto de la Unidad de Cuidados Intensivos (UCI) del Hospital Regional de Seridó en Caico-RN. Método: investigación cualitativa descriptivo-exploratoria. Fueron realizadas 19 entrevistas semi-estructuradas con los profesionales del equipo de enfermería que trabajan en la UCI. Los datos fueron analizados según el análisis de contenido temático, que consiste en: pre-análisis, exploración de materiales y tratamiento de los resultados. El estudio fue aprobado por el Comité de Ética en Investigación de la Universidad del Estado de Rio Grande do Norte como Protocolo 027/10 y CAAE 0026.0.428.000-10, de acuerdo con la Resolución 196/96. Resultados: mostraron que el cuantitativo de profesionales de nivel superior en enfermería no es satisfactorio para el desarrollo de la asistencia necesaria a la UCI. Conclusión: este estudio refleja que la escala del equipo de enfermería debe incluir la participación de los administradores del hospital para investigar y levantar los puntos críticos de la funcionamiento del servicio, promoviendo el trabajo en equipo. Descriptores: reducción de personal; unidades de terapia intensiva; grupo de enfermería.


2021 ◽  
Vol 57 (3) ◽  
Author(s):  
Phumudzo Raphulu ◽  
Modjadji Linda Shirindi ◽  
Mankwane Daisy Makofane

Caring for children with cerebral palsy presents numerous circumstances which may contribute to mothers’ inability to cope with the demands of meeting their children’s needs. A qualitative study supported by explorative, descriptive and contextual designs was undertaken. Purposive and snowball sampling facilitated the identification of twelve participants who were interviewed through semi-structured interviews. The enquiry was based on the ecosystems approach. Thematic data analysis was followed through Tesch’s eight steps and Guba’s model was used for data verification. The findings highlighted the necessity to enhance the psycho-social functioning of mothers through collaboration of social workers, health professionals and various organisations.


10.3823/2385 ◽  
2017 ◽  
Vol 10 ◽  
Author(s):  
Jocelly De Araújo Ferreira ◽  
Nayda Babel Alves de Lima ◽  
Glenda Agra ◽  
Priscilla Tereza Lopes de Souza ◽  
Cecilia Jéssica Azevedo da Silva ◽  
...  

Objective: to understand the impact of soft tissue injuries in the provision of assistance to Basic Human Needs of customers by the nursing staff in the Adult Intensive Care Unit of a hospital in Pernambuco, Brazil. Methodology: this is a descriptive study with quantitative character, performed with 104 nurses in December 2015. A questionnaire drawn from Wanda Horta's theory was used for data collection. Results: the most judicious care provided by the multidisciplinary team (81.7%) and the establishment of bond between professionals and clients (57.7%) were found to be the main positive effects. However, negative effects were outstanding, indicated by increased hospital stay (86.5%) and feeling of anxiety (72.1%). Despite the interference of lesions, body care (86%), communication (63.3%), and religiosity/spirituality (43.3%) needs were referred to as met. Conclusion: the presence of wounds represents a difficulty to meet needs, although they bring some positive impact on the client. However, while recognizing the importance of valuing the customer subjectivity, this aspect is not yet addressed with proper attention. Keywords: Intensive Care Unit; Injuries; Nursing Care; Basic needs.  


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