Discussion on Technical Safety Measures of Nursing for Critical Patients in Emergency Intensive Care Unit

2021 ◽  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Safety Measures ◽  
Critical Patients ◽  
Technical Safety

scholarly journals MOBILISASI PROGRESIF TERHADAP PERUBAHAN TEKANAN DARAH PASIEN DI INTENSIVE CARE UNIT (ICU)

2016 ◽  
Vol 12 (1) ◽  
Author(s):  
Ainnur Rahmanti ◽  
Dyah Kartika Putri
Keyword(s):  
Blood Pressure ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Rate ◽  
Respiratory Function ◽  
Lateral Position ◽  
High Morbidity ◽  
Left Lateral Position ◽  
Critical Patients

Patient with critical condition had high morbidity and mortality rate. This condition is worsened by long term immobilization. Instability vital sign made nurses stationed delayed mobilization activities in ICU. Progressive mobilization must be started for ICU patient to decrease respiratory function, level of awareness and cardiovascular function. The objective of this study was to identify progressive mobilization activities on blood pressure parameters among critical patients in ICU. The design of this study was quai experiment design. Thirty respondents were included to the study using concequtive sampling. Progressive mobilization was given with head of bed 300 (HOB 300), head of bed450 (HOB 450) with  passive range of motion, continued with right and left lateral position. Anova repeated measurement was used to identify mean difference each of blood pressure. The result of this study show there is two moment sistolic change between HOB 300 to HOB 450 and HOB 450 to right lateral position (3,3%). There is nine moment diastolic change between HOB 450 to right lateral position (16,7%).   Keywords: blood pressure, ICU, Progressive mobilization

scholarly journals Dermatological Manifestations in the Intensive Care Unit: A Practical Approach

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Mariona Badia ◽  
José Manuel Casanova ◽  
Lluís Serviá ◽  
Neus Montserrat ◽  
Jordi Codina ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cutaneous Lesion ◽  
Skin Lesions ◽  
Intensive Treatment ◽  
Main Diagnosis ◽  
Systemic Diseases ◽  
Cutaneous Manifestations ◽  
Critical Patients ◽  
The Moment

Dermatological problems are not usually related to intensive medicine because they are considered to have a low impact on the evolution of critical patients. Despite this, dermatological manifestations (DMs) are relatively frequent in critically ill patients. In rare cases, DMs will be the main diagnosis and will require intensive treatment due to acute skin failure. In contrast, DMs can be a reflection of underlying systemic diseases, and their identification may be key to their diagnosis. On other occasions, DMs are lesions that appear in the evolution of critical patients and are due to factors derived from the stay or intensive treatment. Lastly, DMs can accompany patients and must be taken into account in the comprehensive pathology management. Several factors must be considered when addressing DMs: on the one hand, the moment of appearance, morphology, location, and associated treatment and, on the other hand, aetiopathogenesis and classification of the cutaneous lesion. DMs can be classified into 4 groups: life-threatening DMs (uncommon but compromise the patient's life); DMs associated with systemic diseases where skin lesions accompany the pathology that requires admission to the intensive care unit (ICU); DMs secondary to the management of the critical patient that considers the cutaneous manifestations that appear in the evolution mainly of infectious or allergic origin; and DMs previously present in the patient and unrelated to the critical process. This review provides a characterization of DMs in ICU patients to establish a better identification and classification and to understand their interrelation with critical illnesses.

scholarly journals Training of intensive care nurses to handle continuous hemodialysis: a latent condition for safety

2019 ◽  
Vol 72 (suppl 1) ◽  
pp. 105-113 ◽  
Author(s):  
Bianca Ribeiro Porto de Andrade ◽  
Fabiana de Mello Barros ◽  
Honorina Fátima Ângela de Lúcio ◽  
Juliana Faria Campos ◽  
Rafael Celestino da Silva
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Private Hospital ◽  
Structured Interview ◽  
Thematic Content Analysis ◽  
Intensive Care Nurses ◽  
Analysis Technique ◽  
Critical Patients ◽  
Continuous Hemodialysis ◽  
Latent Failure

ABSTRACT Objective: To analyze the repercussions of the training of nurses working in the Intensive Care Unit for the management of continuous hemodialysis regarding the safety of critical patients with acute renal failure. Method: Qualitative research developed considering James Reason's reference in the Intensive Care Unit of a private hospital. The data was collected with 23 nurses who worked for more than three months in the management of continuous hemodialysis through a semi-structured interview, and analyzed with the thematic content analysis technique. Results: There are weaknesses in the training of intensive care nurses for the management of continuous hemodialysis that become a latent failure. Such a failure results in difficulties in handling hemodialysis, with risks for these professionals to commit active failures. Final considerations: The training program in service for the management of continuous hemodialysis must be perfected, to develop skills and competencies in nurses and improve their performance.

Pharmacy Personnel’s Involvement in Transitions of Care of Intensive Care Unit Patients: A Systematic Review

2020 ◽  
pp. 089719002091152
Author(s):  
Mikhaila Rice ◽  
Alyssa Lear ◽  
Sandra Kane-Gill ◽  
Amy L. Seybert ◽  
Pamela L. Smithburger
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Medication Safety ◽  
English Language ◽  
Health Care Team ◽  
Error Rates ◽  
Transitions Of Care ◽  
Patient Centered ◽  
Safety Measures ◽  
Team Members

Objective: Do pharmacy personnel- (ie, pharmacist or pharmacy technician) driven interventions at transitions of care into or out of the intensive care unit (ICU) improve medication safety measures compared to interventions made by other health-care team members or no intervention? Data Sources: A literature search of MEDLINE and Embase limited to English language and humans was performed (from 1969 until January 2019). Bibliographies of included investigations were reviewed for additional citations. Methods: Investigations were selected if they described a pharmacy-driven intervention at any point of transfer into or out of an ICU setting. Ten investigations were included. Five described interventions relevant to the entire ICU population, and 5 described interventions targeted to specific medications or disease. Results: A variety of interventions were utilized in the 10 included investigations. A significant improvement was demonstrated with pharmacy-driven intervention in all 4 studies that evaluated the entire ICU patient population. Interventions specific to certain medication and disease improved medication safety measures but were not always statistically significant. Medication error rates are high in patients transferred into and out of the ICU, and limited data exist to address this concern. This review compares and evaluates the current literature to guide future interventions and research in this area. Conclusions: Although pharmacy-driven interventions demonstrated some benefit in various medication safety measures in the majority of studies, additional randomized and prospective trials with patient-centered outcomes that assess morbidity and mortality are needed.

scholarly journals The iOSC3 System: Using Ontologies and SWRL Rules for Intelligent Supervision and Care of Patients with Acute Cardiac Disorders

2013 ◽  
Vol 2013 ◽  
pp. 1-13 ◽  
Author(s):  
Marcos Martínez-Romero ◽  
José M. Vázquez-Naya ◽  
Javier Pereira ◽  
Miguel Pereira ◽  
Alejandro Pazos ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cognitive Skills ◽  
Design Development ◽  
Cardiac Intensive Care Unit ◽  
Cardiac Disorders ◽  
Cardiac Intensive Care ◽  
Critical Patients ◽  
Northwest Region ◽  
Development And Validation

Physicians in the Intensive Care Unit (ICU) are specially trained to deal constantly with very large and complex quantities of clinical data and make quick decisions as they face complications. However, the amount of information generated and the way the data are presented may overload the cognitive skills of even experienced professionals and lead to inaccurate or erroneous actions that put patients’ lives at risk. In this paper, we present the design, development, and validation of iOSC3, an ontology-based system for intelligent supervision and treatment of critical patients with acute cardiac disorders. The system analyzes the patient’s condition and provides a recommendation about the treatment that should be administered to achieve the fastest possible recovery. If the recommendation is accepted by the doctor, the system automatically modifies the quantity of drugs that are being delivered to the patient. The knowledge base is constituted by an OWL ontology and a set of SWRL rules that represent the expert’s knowledge. iOSC3 has been developed in collaboration with experts from the Cardiac Intensive Care Unit (CICU) of the Meixoeiro Hospital, one of the most significant hospitals in the northwest region of Spain.

scholarly journals Using machine learning tools to predict outcomes for emergency department intensive care unit patients

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Qiangrong Zhai ◽  
Zi Lin ◽  
Hongxia Ge ◽  
Yang Liang ◽  
Nan Li ◽  
...  
Keyword(s):  
Machine Learning ◽  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Predictive Accuracy ◽  
Medical Center ◽  
Learning Tools ◽  
Critical Patients

AbstractThe number of critically ill patients has increased globally along with the rise in emergency visits. Mortality prediction for critical patients is vital for emergency care, which affects the distribution of emergency resources. Traditional scoring systems are designed for all emergency patients using a classic mathematical method, but risk factors in critically ill patients have complex interactions, so traditional scoring cannot as readily apply to them. As an accurate model for predicting the mortality of emergency department critically ill patients is lacking, this study’s objective was to develop a scoring system using machine learning optimized for the unique case of critical patients in emergency departments. We conducted a retrospective cohort study in a tertiary medical center in Beijing, China. Patients over 16 years old were included if they were alive when they entered the emergency department intensive care unit system from February 2015 and December 2015. Mortality up to 7 days after admission into the emergency department was considered as the primary outcome, and 1624 cases were included to derive the models. Prospective factors included previous diseases, physiologic parameters, and laboratory results. Several machine learning tools were built for 7-day mortality using these factors, for which their predictive accuracy (sensitivity and specificity) was evaluated by area under the curve (AUC). The AUCs were 0.794, 0.840, 0.849 and 0.822 respectively, for the SVM, GBDT, XGBoost and logistic regression model. In comparison with the SAPS 3 model (AUC = 0.826), the discriminatory capability of the newer machine learning methods, XGBoost in particular, is demonstrated to be more reliable for predicting outcomes for emergency department intensive care unit patients.

scholarly journals Severity and workload related to adverse events in the ICU

2017 ◽  
Vol 70 (5) ◽  
pp. 942-948 ◽  
Author(s):  
Clarita Terra Rodrigues Serafim ◽  
Magda Cristina Queiroz Dell’Acqua ◽  
Meire Cristina Novelli e Castro ◽  
Wilza Carla Spiri ◽  
Hélio Rubens de Carvalho Nunes
Keyword(s):  
Intensive Care Unit ◽  
Patient Safety ◽  
Cohort Study ◽  
Intensive Care ◽  
Adverse Events ◽  
Direct Relationship ◽  
Daily Activities ◽  
Nursing Workload ◽  
Critical Patients ◽  
Single Cohort

ABSTRACT Objective: To analyze whether an increase in patient severity and nursing workload are correlated to a greater incidence of adverse events (AEs) in critical patients. Method: A prospective single cohort study was performed on a sample of 138 patients hospitalized in an intensive care unit (ICU). Results: A total of 166 AEs, occurred, affecting 50.7% of the patients. Increased patient severity presented a direct relationship to the probability of AEs occurring. However, nursing workload did not present a statistically significant relationship with the occurrence of AEs. Conclusion: The results cast light on the importance of using evaluation tools by the nursing personnel in order to optimize their daily activities and focus on patient safety.

scholarly journals PENGALAMAN PERAWAT TENTANG CARING BERBASIS TEKNOLOGI PADA PASIEN KRITIS DI INTENSIVE CARE UNIT

2018 ◽  
Vol 2 (2) ◽  
pp. 70
Author(s):  
Lina Anggraeni ◽  
Suhartini Ismail
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Sampling Technique ◽  
Phenomenological Approach ◽  
Caring Behaviors ◽  
Central Java ◽  
Technological Competence ◽  
Critical Patients ◽  
High Competence

AbstrakICU merupakan suatu unit dengan pasien yang menerima perawatan intensif dan monitoring yang ketat. Untuk itu, diperlukan perawat yang terlatih secara khusus dengan menggunakan teknik yang canggih dan dapat memenuhi kebutuhan dasar dari pasien. Dengan membangun keseimbangan antara aspek perawatan pasien dan teknologi, perawat akan dapat memberikan perawatan yang lebih efisien dengan kualitas yang lebih tinggi. Penelitian ini bertujuan untuk mendeskripsikan pengalaman perawat tentang caring berbasis teknologi pada pasien kritis di intensive care unit. Penelitian ini merupakan penelitian kualitatif dengan pendekatan deskriptif fenomenologi. Penelitian dilakukan di Himpunan Perawat Critical Care Jawa Tengah. Partisipan penelitian sebanyak 10 perawat yang ditentukan dengan metode purpose sampling. Pengumpulan data dilakukan melalui wawancara mendalam kepada partisipan selama 40-60 menit sesuai dengan pedoman wawancara yang telah disusun sebelum penelitian. Data yang terkumpul dianalisa menggunakan metode Colaizzi. Hasil penelitian menghasilkan tiga tema yaitu kompetensi penggunaan teknologi menjadi bagian dari caring yang harus dimiliki perawat, keseimbangan perilaku caring dan kompetensi teknologi perawat di ruang pelayanan kritis, serta maleficient dan beneficient. Perawat ICU harus berperilaku caring yang ditunjukkan dengan memiliki kompetensi yang tinggi pada penggunaan teknologi agar terciptanya perawatan yang lebih baik untuk pasien kritis. Kata kunci: Caring berbasis teknologi, perawat ICU, pasien kritis, intensive care unit AbstractThe nurses’ experiences of technology-based caring in critical patients in the intensive care unit. Intensive Care Unit (ICU) is a unit in which patients receive intensive care and strict monitoring. For this reason, nurses who are specifically trained to use sophisticated techniques and able to meet the basic needs of patients are needed. By developing a balance between the aspects of patient care and technology, nurses will be able to provide more efficient care with higher quality. This study aimed to describe the nurses’ experiences of technology-based caring in critical patients in the intensive care unit. This study was qualitative research with a descriptive phenomenological approach conducted at the Critical Care Nurse Association of Central Java. The participants were ten nurses selected by using purposive sampling technique. The data were collected through in-depth interviews with the participants for 40-60 minutes based on the prepared interview guidelines. The collected data were analyzed using the Colaizzi method.  The results showed three themes that technological competence to be part of the caring that nurses must have, the balance between nurses’ caring behaviors and technological competence in the critical area, then, maleficient and beneficient. Nurses should behave caring which is shown by having high competence using of technology to provide better care for critical patients. Keywords: Caring based on technology, critical nurse, critical patient, intensive care unit

scholarly journals ABSENTEÍSMO NA EQUIPE MULTIPROFISSIONAL DE UMA UNIDADE DE TERAPIA INTENSIVA ADULTO

2019 ◽  
Vol 4 (1) ◽  
pp. 6
Author(s):  
Andressa Fernanda Silva ◽  
Maria Lúcia Carmo Cruz Robazzi ◽  
Rita de Cássia Marchi Barcellos Dalri ◽  
Cristiane Aparecida Silveira Monteiro
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Health Professionals ◽  
Scientific Instruments ◽  
Complex Environment ◽  
Multiprofessional Team ◽  
Adult Intensive Care Unit ◽  
Terapia Intensiva ◽  
Recursos Humanos ◽  
Critical Patients

Introdução: Os profissionais da saúde que trabalham nas Unidade de Terapia Intensiva, vivenciam em suas jornadas laborais um ambiente complexo, devido as relações entre os profissionais, pelo estado de saúde dos pacientes ali hospitalizados sendo eles, pacientes semi-críticos a críticos. Nessas unidades os profissionais precisam lidar com repleto aparato técnico e científico, com o objetivo de ofertar uma assistência integral e de qualidade aos usuários. Esta complexidade vivenciada por estes trabalhadores, pode resultar em adoecimento físico e mental. Objetivo: avaliar a ocorrência de absenteísmo na equipe multiprofissional de uma Unidade de Terapia Intensiva Adulta. Método: estudo retrospectivo, analítico, transversal e quantitativo, que utilizou para a coleta de dados informações do banco de dado do setor de Recursos Humanos do hospital onde foi realizado o estudo no período de 12 meses. Resultados: foram encontrados entre 15,30% a 24,06 % de absenteísmo total e de 14,15% a 23,24% de absenteísmo por tratamento de saúde e em todos os meses avaliados esses percentuais foram além dos 8,50 % estimados pela Instituição. Conclusões: os resultados são preocupantes referentes ao absenteísmo devido as altas taxas identificadas, demonstrando a gravidade que este fenômeno pode representar para a instituição, gestores, trabalhadores e, inclusive, podendo prejudicar a assistência ofertada aos pacientes nessa Unidade de Terapia Intensiva Adulta. ABSENTEEISM IN THE MULTIPROFESSIONAL TEAM OF AN ADULT INTENSIVE CARE UNIT ABSTRACT Introduction: Health professionals who work in the Intensive Care Units experience, in their working days, a complex environment due to the relations between the professionals, to the state of health of the patients hospitalized there, being them, semi-critical patients to critics. In these units the professionals need to deal with technical and scientific instruments, with the aim to offer integral and quality assistance to the users. Such complexity experienced by these professionals can result in physical and mental illness. Goal: evaluate the occurrence of absenteeism in the multiprofessional team of an Adult Intensive Care Unit. Method: the retrospective, analytical, transversal and quantitative study gathered information to data collection in the Human Resources sector database of the hospital where the study was carried out in the period of 12 months. Results: we found between 15.30% to 24.06% of total absenteeism and 14.15% to 23.24% of absenteeism due to health treatment and in all the evaluated months these percentages were beyond the 8.50% estimated by the Institution. Conclusion: the results regarding absenteeism are worrisome due to the high rates identified, demonstrating the gravity that this phenomenon can represent to the institution, managers, workers, and, besides, may affect the assistance offered to the patients in this Adult Intensive Care Unit.

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