scholarly journals Optimization of Step-By-Step Care for Patients in Intensive Care Units Based on Grade 6 of the Rehabilitation Routing Scale

2021 ◽  
Vol 3 (1) ◽  
pp. 142-148
Author(s):  
Andrey A. Belkin ◽  
Evgenyi N. Rudnik ◽  
Vladimir A. Belkin ◽  
Elena A. Pinchuk ◽  
Nadezhda S. Lipovka
Keyword(s):  
Palliative Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Routing Algorithm ◽  
Point Of View ◽  
Cerebral Injury ◽  
Rehabilitation Center ◽  
Highly Qualified ◽  
Rehabilitation Potential ◽  
Step Care

Introduction. Evaluation of ICU patients on specialized scales, such as the modified Rankin scale (mRS) and the rehabilitation routing scale (RRS), allows you to determine the degree of dependence on outside help in connection with the development of PICS syndrome, to decide on the level of complexity of the upcoming rehabilitation, and to route the patient to the appropriate rehabilitation center or palliative care department. Aims: Analysis of the experience of application RRS in the system of routing patients in intensive care units for rehabilitation treatment. Methods. As a result of the application of the routing algorithm based on the application of both scales, 224 patients with the level of dependence of RRS 56 (mRS 5) were selected for the examination of the rehabilitation potential and the re-habilitation attempt during 2019. Results. At the end of the rehabilitation course, 60 patients showed a decrease in the level of dependence to 34 points for both mRS and RRS. In 164 patients, the rating on the Rankin scale did not change (mRS 5), while the score on the RRS score of dependence in 135 decreased to 5 points. By the time of discharge, 29 patients with CNS continued to meet the criteria of RRS 6. All of them were verticalized to the level of landing in the chair and included in the remote tele patronage. During the quarterly visits, 9 patients showed signs of realizing their positive prognosis, underwent repeated rehabilitation courses during 20202021, and reduced the level of dependence to RRS 45. In practical terms, a decrease in the grade of SRM to 5 indicated that the patient was ready to stay at home, while patients with SRM 6 remained in need of highly qualified care, requiring at least a referral to the palliative care unit. From the point of view of the mRS scale, both described patient categories corresponded to 5 points, i. e., based on the assessment of the patients condition according to mRS, it was not possible to draw conclusions about further patient management tactics. Conclusions. Thus, the experience of using the RRS scale demonstrated its effectiveness in routing patients with acute cerebral injury and showed greater sensitivity and specificity in comparison with mRS.

Barriers of Palliative Care in Neonatal Intensive Care Units

2016 ◽  
Vol 34 (3) ◽  
pp. 205-211 ◽  
Author(s):  
Mansooreh Azzizadeh Forouzi ◽  
Marjan Banazadeh ◽  
Jila Soltan Ahmadi ◽  
Farideh Razban
Keyword(s):  
Palliative Care ◽  
Organizational Culture ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Attitude Scale ◽  
Neonatal Intensive Care Units ◽  
Cross Sectional ◽  
Neonatal Nurses ◽  
Eol Care

Objective: Neonatal nurses face numerous barriers in providing end-of-life (EOL) care for neonates and their families. Addressing neonatal nurses’ attitudes could provide insight into barriers that impede neonatal palliative care (NPC). This study thus conducted to examine neonatal nurses’ attitude toward barriers in providing NPC in Southeast Iran. Method: In this cross-sectional study, a translated modified version of Neonatal Palliative Care Attitude Scale was used to examine attitudes of 70 nurses toward barriers of palliative care in 3 neonatal intensive care units in Southeast Iran. Results: Findings indicated that overall 42.63% of nurses were strongly agreed or agreed with the proposed barriers in NPC. Among all categories, the highest and the lowest scores belonged to the categories of “insufficient resources” (3.42 ± 0.65) and “inappropriate personal and social attitudes” (2.33 ± 0.48), respectively. Neonatal nurses who had less education and study regarding NPC reported the presence of more barriers to NPC in the categories of “inappropriate organizational culture” and/or “inadequate nursing proficiency.” Also, younger nurses had more positive attitudes toward the category of inappropriate organizational culture as being a barrier to provision of NPC (4.62). Conclusion: The findings suggest that developing a context-based instrument is required to represent the barrier more precisely. Neonatal palliative care can be improved by establishing a special environment to focus on infants’ EOL care. This establishment requires standard palliative care guidelines and adequate NPC-trained nurses.

scholarly journals Palliative care in advanced coronavirus disease in intensive care units

2020 ◽  
Vol 10 (3) ◽  
pp. 340-340 ◽  
Author(s):  
Ali Esmaeili Vardanjani ◽  
Hossein Rafiei ◽  
Mostafa Mohammdi
Keyword(s):  
Palliative Care ◽  
Intensive Care ◽  
Intensive Care Units

Living with Dying in the Pediatric Intensive Care Unit: A Nursing Perspective

2016 ◽  
Vol 25 (4) ◽  
pp. 350-356 ◽  
Author(s):  
Debbie Stayer ◽  
Joan Such Lockhart
Keyword(s):  
Intensive Care Unit ◽  
Palliative Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Emotional Impact ◽  
Pediatric Intensive Care Units ◽  
Personal Support ◽  
Life Threatening

Background Despite reported challenges encountered by nurses who provide palliative care to children, few researchers have examined this phenomenon from the perspective of nurses who care for children with life-threatening illnesses in pediatric intensive care units. Objectives To describe and interpret the essence of the experiences of nurses in pediatric intensive care units who provide palliative care to children with life-threatening illnesses and the children’s families. Methods A hermeneutic phenomenological study was conducted with 12 pediatric intensive care unit nurses in the northeastern United States. Face-to-face interviews and field notes were used to illuminate the experiences. Results Five major themes were detected: journey to death; a lifelong burden; and challenges delivering care, maintaining self, and crossing boundaries. These themes were illuminated by 12 subthemes: the emotional impact of the dying child, the emotional impact of the child’s death, concurrent grieving, creating a peaceful ending, parental burden of care, maintaining hope for the family, pain, unclear communication by physicians, need to hear the voice of the child, remaining respectful of parental wishes, collegial camaraderie and support, and personal support. Conclusion Providing palliative care to children with life-threatening illnesses was complex for the nurses. Findings revealed sometimes challenging intricacies involved in caring for dying children and the children’s families. However, the nurses voiced professional satisfaction in providing palliative care and in support from colleagues. Although the nurses reported collegial camaraderie, future research is needed to identify additional supportive resources that may help staff process and cope with death and dying.

scholarly journals Proactive Palliative Care in Intensive Care Units: A Retrospective Study (FR420C)

2016 ◽  
Vol 51 (2) ◽  
pp. 355-356
Author(s):  
David Lee ◽  
Jonathan Wu ◽  
Sarah Dobson ◽  
Mudit Dabral
Keyword(s):  
Palliative Care ◽  
Intensive Care ◽  
Retrospective Study ◽  
Intensive Care Units
Sign in / Sign up

Export Citation Format

Share Document