scholarly journals The nursing workload assessed through the Nursing Activities Score as a predictor for the occurrence of ventilator-associated pneumonia in an adult intensive care unit

2019 ◽  
Vol 9 (9) ◽  
pp. 104
Author(s):  
Fabiola Alves Gomes ◽  
Denise Von Dolinger de Brito Röder ◽  
Thúlio Marquez Cunha ◽  
Rosângela De Oliveira Felice ◽  
Guilherme Silva Mendonça ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Costs ◽  
University Hospital ◽  
Nursing Workload ◽  
Ventilator Associated Pneumonia ◽  
Adult Intensive Care Unit ◽  
Icu Admission ◽  
Stay Time ◽  
The Impact

Objective: Evaluate the relation of nursing workload, evaluated by the Nursing Activities Score (NAS), with the occurrence of Ventilator-associated Pneumonia (VAP) in an Intensive Care Unit (ICU) and the impact of VAP on hospitalization costs.Methods: Retrospective cohort study in Adult ICU of a high complexity Brazilian university hospital. The profile, outcomes, costs, and daily NAS from patients were collected. We also proposed some workload indicators based on NAS daily evaluation.Results: The study included 195 patients, 27.17% diagnosed with VAP. VAP was more prevalent in patients diagnosed with trauma on admission. The total costs of care were higher for VAP patients. In all multivariate models tested were predictive for VAP: the patient's intubation that occurs in days prior of the ICU admission day (higher risk if occurs in days prior the ICU admission day) and ventilation time prior ICU (higher risk if higher time). We found others predictors, but these were dependent on the model tested. Additional risk predictors were tracheostomy, propofol use, neuromuscular blocker use and the higher NAS from admission. The protective factors found were the percentage of adequacy of the assignment based in NAS that measure if the workload measured by the NAS was offered and the increment in NAS during the ventilation time.Conclusions: The offering of an adequate nursing work scale (adequate number of professionals for the care), as a function of the nursing workload measured by the NAS, could be effective in the reduction of VAP, hospital stay time and hospital costs.

Team-Based Intervention to Reduce the Impact of Nonactionable Alarms in an Adult Intensive Care Unit

2020 ◽  
Vol 35 (2) ◽  
pp. 115-122
Author(s):  
Justin Yeh ◽  
Ruth Wilson ◽  
Lufei Young ◽  
Lisa Pahl ◽  
Steven Whitney ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Adult Intensive Care Unit ◽  
The Impact

scholarly journals Impact Of Wounds In The Assistance To Basic Human Needs In Intensive Care

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 ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Positive Impact ◽  
Soft Tissue Injuries ◽  
Quantitative Character ◽  
Adult Intensive Care Unit ◽  
Human Needs ◽  
Positive Effects ◽  
Basic Human Needs ◽  
The Impact

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.  

Incidence and costs of ventilator-associated pneumonia in the adult intensive care unit of a tertiary referral hospital in Mexico

2019 ◽  
Vol 47 (9) ◽  
pp. e21-e25 ◽  
Author(s):  
Oscar Sosa-Hernández ◽  
Bernadine Matías-Téllez ◽  
Abril Estrada-Hernández ◽  
Monica Alethia Cureño-Díaz ◽  
Juan Manuel Bello-López
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Referral Hospital ◽  
Ventilator Associated Pneumonia ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Adult Intensive Care Unit

scholarly journals Incidence and Risk Factors for Ventilator-Associated Pneumonia in Kathmandu University Hospital

2012 ◽  
Vol 9 (1) ◽  
pp. 28-31 ◽  
Author(s):  
S Ranjit ◽  
B Bhattarai
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Univariate Analysis ◽  
University Hospital ◽  
Ventilator Associated Pneumonia ◽  
Chi Square ◽  
H2 Blockers ◽  
Observational Cohort ◽  
Level Of Significance

Background Ventilator associated pneumonia is a major cause of morbidity in the intensive care unit. Difficulties in identification of the risk factors, in diagnosing and in prevention, have intensified the problem. Objectives To measure the incidence of ventilator associated pneumonia in intensive care unit and to identify the risk factors associated. Methods A prospective observational cohort study of 69 patients who were mechanically ventilated for more than 48 hours were evaluated to find out the development of nosocomial pneumonia and presence or absence of risk factors. Data were subjected to univariate analysis using chi-square and t-test. Level of significance was set at 0.05. Results Twenty two (31.88%) out of 69 patients developed ventilator associated pneumonia, majority of them between four days to 14 days. Reintubation, invasive lines, H2 blockers and low PaO2/FiO2 were identified as major risk factors in our study. Enteral feeding via nasogastric tube and use of steroids was not associated with development of ventilator associated pneumonia. The patients with ventilator associated pneumonia had significantly longer duration of mechanical ventilation (18.88±7.7 days vs 7.36±4.19 days) and stay (29±17.8 days vs 9.22±5.14 days). The morality was similar for both the groups with or without ventilator associated pneumonia. ConclusionThe incidence of ventilator pneumonia is high. Patients requiring prolonged ventilation, re-intubation, more invasive lines and H2 blockers, are at high risk and need special attention towards prevention.http://dx.doi.org/10.3126/kumj.v9i1.6258 Kathmandu Univ Med J 2011;9(1):28-31 

One-Week versus 2-Day Ventilator Circuit Change in Neonates with Prolonged Ventilation: Cost-Effectiveness and Impact on Ventilator-Associated Pneumonia

2014 ◽  
Vol 36 (3) ◽  
pp. 287-293 ◽  
Author(s):  
Shih-Ming Chu ◽  
Mei-Chin Yang ◽  
Hsiu-Feng Hsiao ◽  
Jen-Fu Hsu ◽  
Reyin Lien ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cost Effectiveness ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Ventilator Associated Pneumonia ◽  
Ventilator Circuit ◽  
Mechanical Ventilators ◽  
Prolonged Intubation ◽  
The Impact

ObjectiveTo investigate the impact of 1-week ventilator circuit change on ventilator-associated pneumonia and its cost-effectiveness compared with a 2-day change.DesignAn observational cohort study.SettingA tertiary level neonatal intensive care unit in a university-affiliated teaching hospital in Taiwan.PatientsAll neonates in the neonatal intensive care unit receiving invasive intubation for more than 1 week from July 1, 2011, through December 31, 2013.InterventionWe investigated the impact of 2 ventilator circuit change regimens, either every 2 days or 7 days, on ventilator-associated pneumonia of our cohort.Measurements and Main ResultsA total of 361 patients were maintained on mechanical ventilators for 13,981 days. The 2 groups did not differ significantly in any demographic characteristics. The rate of ventilator-associated pneumonia was comparable between the 2-day group and the 7-day group (8.2 vs 9.5 per 1,000 ventilator-days, P=.439). The durations of mechanical ventilation and hospital stay, and rates of bloodstream infection and mortality, were also comparable between the 2 groups. Switching from a 2-day to a 7-day change policy would save our neonatal intensive care unit a yearly sum of US $29,350 and 525 working hours.ConclusionDecreasing the frequency of ventilator circuit changes from every 2 days to once per week is safe and cost-effective in neonates requiring prolonged intubation for more than 1 week.Infect Control Hosp Epidemiol 2014;00(0): 1–7

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