Frequency of Clinical Alarms in Intensive Care Units and Nurses’ Sensitivity to Them: An Observational Study

2021 ◽  
Vol 30 (3) ◽  
pp. 186-192
Author(s):  
Burcu Ceylan ◽  
Leyla Baran ◽  
Ülkü Yapucu Güneş
Keyword(s):  
Intensive Care ◽  
Observational Study ◽  
Intensive Care Units ◽  
University Hospital ◽  
False Alarms ◽  
Emergency Intervention ◽  
Clinical Alarms ◽  
The Mean ◽  
Care Practices ◽  
Observation Period

Background All clinical alarms require nurses to respond even if an intervention is not needed. Nurses are expected to respond appropriately to each alarm and establish priorities among their care practices accordingly. This study was conducted to examine the number and types of clinical device alarms used in intensive care units, the duration of their activation, and nurses’ degree of sensitivity to them. Methods This observational study was conducted in 4 intensive care units in a university hospital in Turkey. A total of 20 nurses (5 from each unit) were observed for a total of 80 hours. The alarms were categorized as valid, false, or technical. Results During the study observation period, the mean number of alarms sounding per hour per bed was 1.8. A total of 144 alarms were recorded, of which 70.8% were valid, 15.3% were false, and 13.9% were technical. The mean duration of alarm activation was 8 minutes for valid alarms, 14 minutes for false alarms, and 53 minutes for technical alarms. Conclusions Nurses’ responses to alarms differ depending on alarm type; for alarms that do not require an emergency intervention, nurses tend to respond late or not at all.

scholarly journals Automated versus manual urine output monitoring in the intensive care unit

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Joni Minor ◽  
Ali Smith ◽  
Frederic Deutsch ◽  
John A. Kellum
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Urine Output ◽  
Kidney Injury ◽  
University Hospital ◽  
Intensive Care Patients ◽  
The Mean ◽  
Output Monitoring ◽  
Observation Period

AbstractAcute kidney injury (AKI) is defined by changes in serum creatinine and urine output (UO). Significant limitations exist regarding accurate ascertainment of urine output even within the intensive care unit. We sought to evaluate an automated urine output collections system and compare it to nursing measurements. We prospectively collected urine output using an electronic urine monitoring system and compared it to charted hourly UO in 44 patients after cardiac surgery at a single university hospital ICU. We calculated UO and oliguria rates and compared them to data from the sensor and from nursing charting. A total of 187 hourly UO measurements were obtained and on average, UO was reported 47 min late, with a median of 18 min, and a maximum of almost 6 h. Patients had a mean hourly UO of 76.3 ml over the observation period. Compared to manual measurements by study personnel, nurses significantly overestimated hourly UO by 19.9 ml (95% CI: 10.3; 29.5; p =  < 0.001). By contrast, the mean difference between the UO measured with the sensor and by study personnel was 2.29 ml (95% CI: − 6.7; 11.3), p = 0.61. Electronic UO monitoring is significantly more accurate than nurse-performed manual measurements in actual intensive care patients. Furthermore, timely ascertainment of UO is difficult to achieve with manual technique, resulting in important delays in detecting oliguria perhaps leading to missed cases of AKI.

scholarly journals Cardiac arrest in adult intensive care units in the Medellin metropolitan area, Colombia: observational study

2020 ◽  
Vol 48 (3) ◽  
pp. 118-125
Author(s):  
Juan Carlos Villa-Velásquez ◽  
Natalia Andrea Hoyos-Vanegas ◽  
Juan Carlos Gómez-Echeverry ◽  
Airton Payares-Benítez ◽  
Fabián David Casas-Arroyave
Keyword(s):  
Cardiac Arrest ◽  
Intensive Care ◽  
Observational Study ◽  
Intensive Care Units ◽  
Metropolitan Area ◽  
Adult Patients ◽  
University Hospital ◽  
Neurological Prognosis ◽  
Hospital Cardiac Arrest ◽  
Infrequent Event

Introduction: In-hospital cardiac arrest (CA) is a rare but lifethreatening event. However, the epidemiology of this event in intensive care units (ICU) is not clear. Objective: To determine the clinical characteristics of CA in adult patients hospitalized in several ICU of the Metropolitan Area of the Aburrá Valley, Colombia, over a period of 1 year. Methods: Observational study for a limited period of 1 year for adult patients with CA in the ICU of the hospitals of the Metropolitan Area of the Aburrá Valley, Colombia: San Vicente Foundation University Hospital, IPS University, and Manuel Uribe Ángel Hospital. Results: Of 3710 eligible patientswhowere treated in 91 beds, 646 CA events occurred during this period, of which 151 were candidates for resuscitation maneuvers. The overall incidence of CA in the ICU was 17.1%, without differences between the 3 hospitals included and the incidence of resuscitable CA was 39.9 cases per 1000 admissions to the ICU. The most common CA rhythm was asystole (54.3%) and the overall survival at hospital discharge was 3.3%. Conclusion: In the analyzed ICU, CA was an infrequent event, but it presents a high mortality at discharge from the ICU and hospital. However, the few patients who survive have a good neurological prognosis.

scholarly journals Measuring family‐centred care practices in adult intensive care units: The EMPATHIC‐F questionnaire

2021 ◽  
Author(s):  
Emilio Rodríguez‐Ruiz ◽  
Maitane Campelo‐Izquierdo ◽  
Montserrat Mansilla Rodríguez ◽  
Ana Estany‐Gestal ◽  
Andrés Blanco Hortas ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Care Practices

scholarly journals Results of screening for emergent highly resistant bacteria in Tunisian intensive care units

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Ben Rejeb ◽  
A Ben Cheikh ◽  
S Bhiri ◽  
H Ghali ◽  
M Kahloul ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Early Identification ◽  
Infection Prevention ◽  
Screening Program ◽  
Control Measures ◽  
University Hospital ◽  
Infection Prevention And Control ◽  
Resistant Bacteria ◽  
Prevention Interventions

Abstract Background The infections caused by emergent highly resistant bacteria (eHBR) that develop in intensive care units (ICUs) may result in significant patient illnesses and deaths, extend the duration of hospital stays and generate added costs. Facing this problem, the screening that emphasizes early identification of colonized patients, reduces the prevalence and incidence of infection, improves patient outcomes and reduces healthcare costs. In this context, we have implemented a screening for eHBR in ICUs of Sahloul university hospital of Sousse (Tunisia), which we report in this study the first six-months outcomes. Methods Rectal swab cultures were collected to detect Vancomycin resistant enterococcus (VRE) and Carbapenemase producing Enterobacteriaceae (CPE) among patients admitted in six ICUs of Sahloul university hospital of Sousse (Tunisia) and more than three times, at least one week apart, between 1 June and 31 December 2018. Results During the study period 174 patients were screened. Of them, 69.5% were male and 73.6% were admitted in surgical ICU. In total, 161 and 152 samples were realized respectively for the detection of CPE and VRE. These samples were positive in 15% and 8.5% respectively for CPE and VRE. Klebsiella pneumoniae OXA 48 was the most isolated CPE (80%). Conclusions Our screening program helped us in infection control by early identification of patients, thereby facilitating an informed decision about infection prevention interventions. Moreover, these results encouraged us to improve and generalize this program throughout the hospital. Key messages eHRB screening becomes an important axis in the prevention of eHRB infections in our facilities. eHRB screening allows the reinforcement of the basic infection prevention and control measures.

scholarly journals Inappropriateness of Antibiotic Prescribing in Medical, Surgical and Intensive Care Units: Results of a Multicentre Observational Study

Life ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 475
Author(s):  
Margherita Macera ◽  
Federica Calò ◽  
Lorenzo Onorato ◽  
Giovanni Di Caprio ◽  
Caterina Monari ◽  
...  
Keyword(s):  
Intensive Care ◽  
Observational Study ◽  
Intensive Care Units ◽  
Case Report Form ◽  
Antibiotic Prescribing ◽  
Duration Of Treatment ◽  
Campania Region ◽  
Stewardship Program ◽  
Surgical Units ◽  
Set Up

The objectives of the present study were to provide a snapshot analysis of antibiotic appropriateness in two hospitals in Southern Italy in three specific areas, surgical, medical and intensive care, and to evaluate the risk factors associated with inappropriateness in antimicrobial prescriptions. We conducted a multicentre observational study in two hospitals in the Campania region. We collected data of all patients admitted on the day of evaluation to antibiotic therapy or prophylaxis through a case report form. The primary outcome was to assess the inappropriateness of antibiotic prescribing, related to the spectrum, dose, route of administration and duration of treatment—in particular, to assess whether there was a difference in the adequacy of the prescriptive practice in the medical, surgical and intensive sectors. Prescriptive inappropriateness was more frequently observed in surgical units (79.8% of the 104 antimicrobial prescriptions) than in medical units (53.8% of the 65 prescriptions, p = 0.0003) or in intensive care units (64.1% of the 39 prescriptions, p = 0.052). The reasons for the inappropriate antimicrobial prescriptions were similar in the three areas evaluated: antimicrobial unnecessary and antimicrobial not recommended were the most frequent reasons for inappropriateness. Not participating in an antimicrobial stewardship program (ASP) was identified as a factor associated with inappropriate antimicrobial prescriptions in medical and surgical units, but not in Intensive Care Units (ICUs). ASPs may enhance the appropriateness of antimicrobial prescriptions especially in medical and surgical units. In ICUs, specific programs able to limit empirical therapies and encourage the collection of microbiological samples may be useful to set up targeted therapies and to design antimicrobial protocols.

scholarly journals Effect of applying nurses driven electrolyte repletion protocol on electrolyte disturbances control among critically ill patients

2020 ◽  
Vol 10 (4) ◽  
pp. 72
Author(s):  
Mohamed E. Abdelgawad ◽  
Nadia T. Ahmed ◽  
Ahmed M. Elmenshawy
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Improve Patient Care ◽  
University Hospital ◽  
Treatment Modalities ◽  
Control Group ◽  
Electrolyte Disturbances ◽  
Electrolyte Loss

Background and objective: Electrolyte disturbances remain a common lifesaving issue in the intensive care units. They are associated with increased morbidity and mortality. They are mostly resulted secondary to critical illness itself or associated treatment modalities. Therefore, electrolytes repletion should be done effectively and timely. This could be ensured using nurse driven protocols rather than traditional methods of repletion. These protocols are nurse initiated and collaboratively developed. They have been shown to improve patient care outcomes through the provision of high quality care. They are increasingly being used in the critical care setting. Objective: Determine the effect of applying nurses driven electrolytes repletion protocol on electrolytes disturbance control among critically ill patients.Methods: Quasi experimental research design was used. Sixty two critically ill patients with electrolytes loss were enrolled in the study at Alexandria Main University Hospital intensive care units, Egypt. All episodes of electrolyte loss were evaluated. Repletion of electrolyte loss was done according to unit routine for the control group and nurses driven electrolytes repletion protocol for the study group. Episodes of electrolyte disturbances, adverse events and timing of repletion were evaluated.Results: Neurological disorders represent the most encountered diagnosis. The most common cause of electrolyte loss in was the use of diuretics. Furthermore, there was a highly statistical difference between the two groups as regard electrolytes levels, effectiveness and timing of replacement.Conclusions: Application of nurses driven electrolyte repletion protocol resulted in improvements in the effectiveness and timeliness of electrolyte replacement.

Sign in / Sign up

Export Citation Format

Share Document