scholarly journals Factors Associated with Perceived Stressors among Critical Care Units Adult Patients: An Exploratory Study

2021 ◽  
pp. 204-209
Author(s):  
Swapnil Rahane ◽  
Roma Patel ◽  
Devrajsingh Chouhan
Keyword(s):  
Critical Care ◽  
Health Care Professionals ◽  
Critical Care Unit ◽  
Sampling Technique ◽  
Adult Patients ◽  
Exploratory Research ◽  
Related Complication ◽  
Early Recovery ◽  
Financial Problems ◽  
Critical Care Units

The critical care unit environment has been observed as a leading stressor not only amongst the health care professionals but in patients also. Unfamiliar surroundings, dependency on others, financial problems, etc. are among factors that are responsible for the development of stress in the patients admitted to the critical care units. Stress and its factors are also responsible for the patient's deliberate recovery and depraved prognosis. In this study, we explored the association between selective factors and perceived stressors among adult patients admitted to critical care units. A quantitative, exploratory research design study was conducted, to identify the association between the perceived stressors and selected factors of adult patients admitted in Critical Care Units of the selected multispecialty hospitals at Vadodara. A total of sixty patients admitted to the critical care departments were selected through the convenience sampling technique. A demographic variables datasheet and hospitals stress rating interview scale was used after the expert’s content validation to collect the data. Analysis and interpretation of data were done by using descriptive and inferential statistics. Results: Study findings revealed that all the patients, who were interviewed through the hospital stress interview scale, expressed the perception of stressors as indicated by the total perceived stressors score of above (1%). The study also revealed that separation from family members or spouses and financial problems are the highly rated perceived stressors among the patients admitted to the critical care unit. Patients also reported the least perceived stressful area was the problem with medication. There was a significant association between the socioeconomic status and medical-surgical diagnosis of patients with perceived stressors. Conclusion: Therefore, the findings of the study concluded that the study, patients admitted in the critical care department also suffer from stress due to some stressors, and it affects their prognosis and early recovery. Nursing professionals need to focus on the subjective characteristics of patients so that perceived stressors and early detection of the related complication can be prevented.

scholarly journals Rabies in the Critical Care Unit: Diagnostic and Therapeutic Approaches

2011 ◽  
Vol 38 (5) ◽  
pp. 689-695 ◽  
Author(s):  
Alan C. Jackson
Keyword(s):  
Critical Care ◽  
Critical Care Unit ◽  
Virus Antigen ◽  
Rabies Vaccine ◽  
Human Rabies ◽  
Therapeutic Approaches ◽  
Rna Detection ◽  
Critical Care Units ◽  
Antiviral Therapies ◽  
History Of

ABSTRACT:Worldwide, human rabies is prevalent where there is endemic dog rabies, but the disease may present unexpectedly in critical care units when suggestive clinical features have passed. In North America transmission from bats is most common and there is often no history of a bat bite or even contact with bats. Laboratory diagnostic evaluation for rabies includes serology plus skin biopsy, cerebrospinal fluid, and saliva specimens for rabies virus antigen and/or RNA detection. Rare patients have survived rabies, and most received rabies vaccine prior to the onset of illness. Therapeutic coma (midazolam and phenobarbital), ketamine, and antiviral therapies (dubbed the "Milwaukee Protocol") were given to a rabies survivor, but this therapy was likely not directly responsible for the favorable outcome. There have been many subsequent failures of similar therapeutic approaches. There is no scientific rationale for the use of therapeutic coma in human rabies. New approaches to treating human rabies need to be developed.

scholarly journals Death Notification in Italian Critical Care Unites and Emergency Services. A Qualitative Study with Physicians, Nurses and Relatives

2021 ◽  
Vol 18 (24) ◽  
pp. 13338
Author(s):  
Ines Testoni ◽  
Erika Iacona ◽  
Lorenza Palazzo ◽  
Beatrice Barzizza ◽  
Beatrice Baldrati ◽  
...  
Keyword(s):  
Critical Care ◽  
Qualitative Study ◽  
Protective Factors ◽  
Health Care Professionals ◽  
Emergency Services ◽  
Continuing Bonds ◽  
Critical Care Units ◽  
Death Notification ◽  
The Impact ◽  
Relational Difficulties

This qualitative study was conducted in critical care units and emergency services and was aimed at considering the death notification (DN) phenomenology among physicians (notifiers), patient relatives (receivers) and those who work between them (nurses). Through the qualitative method, a systemic perspective was adopted to recognise three different categories of representation: 23 clinicians, 13 nurses and 11 family members of COVID-19 victims were interviewed, totalling 47 people from all over Italy (25 females, mean age: 46,36; SD: 10,26). With respect to notifiers, the following themes emerged: the changes in the relational dimension, protective factors and difficulties related to DN. With respect to receivers, the hospital was perceived as a prison, bereavement between DN, lost rituals and continuing bonds. Among nurses, changes in the relational dimension, protective factors and the impact of the death. Some common issues between physicians and nurses were relational difficulties in managing distancing and empathy and the support of relatives and colleagues. The perspective of receivers showed suffering related to loss and health care professionals’ inefficacy in communication. Specifically, everyone considered DNs mismanaged because of the COVID-19 emergency. Some considerations inherent in death education for DN management among health professionals were presented.

Hospital Readmission and Post-Acute Care Use After Intensive Care Unit Admissions: New ICU Quality Metrics?

2020 ◽  
pp. 088506662095663
Author(s):  
Christopher F. Chesley ◽  
Michael O. Harhay ◽  
Dylan S. Small ◽  
Asaf Hanish ◽  
Hallie C. Prescott ◽  
...  
Keyword(s):  
Critical Care ◽  
Critical Illness ◽  
Acute Care ◽  
Hospital Readmission ◽  
Critical Care Unit ◽  
Readmission Rates ◽  
Critical Care Units ◽  
Icu Admission ◽  
Over Time ◽  
Post Acute Care

Objective: Care coordination is a national priority. Post-acute care use and hospital readmission appear to be common after critical illness. It is unknown whether specialty critical care units have different readmission rates and what these trends have been over time. Methods: In this retrospective cohort study, a cohort of 53,539 medical/surgical patients who were treated in a critical care unit during their index admission were compared with 209,686 patients who were not treated in a critical care unit. The primary outcome was 30-day all cause hospital readmission. Secondary outcomes included post-acute care resource use and immediate readmission, defined as within 7 days of discharge. Results: Compared to patients discharged after an index hospitalization without critical illness, surviving patients following ICU admission were not more likely to be rehospitalized within 30 days (15.8 vs. 16.1%, p = 0.08). However, they were more likely to receive post-acute care services (45.3% vs. 70.9%, p < 0.001) as well as be rehospitalized within 7 days (5.2 vs. 6.0%, p < 0.001). Post-acute care use and 30-day readmission rates varied by ICU type, the latter ranging from 11.7% after admission in a cardiothoracic critical care unit to 23.1% after admission in a medical critical care unit. 30-day readmission after ICU admission did not decline between 2010 and 2015 (p = 0.38). Readmission rates declined over time for 2 of 4 targeted conditions (heart failure and chronic obstructive pulmonary disease), but only when the hospitalization did not include ICU admission. Conclusions: Rehospitalization for survivors following ICU admission is common across all specialty critical care units. Post-acute care use is also common for this population of patients. Overall trends for readmission rates after critical illness did not change over time, and readmission reductions for targeted conditions were limited to hospitalizations that did not include an ICU admission.

An analysis of medicine costs of adult patients on a critical care unit

2014 ◽  
Vol 29 (3) ◽  
pp. 472.e7-472.e12 ◽  
Author(s):  
Sumayah Abdul-Jabbar ◽  
Ian Bates ◽  
Graham Davies ◽  
Rob Shulman
Keyword(s):  
Critical Care ◽  
Critical Care Unit ◽  
Adult Patients

scholarly journals Effectiveness of Critical Care Discharge Information in Supporting Early Recovery From Critical Illness

2013 ◽  
Vol 33 (3) ◽  
pp. 41-52 ◽  
Author(s):  
Suzanne Bench ◽  
Tina Day ◽  
Peter Griffiths ◽  
BA (Hons)
Keyword(s):  
Critical Care ◽  
Evidence Base ◽  
Current Evidence ◽  
Service Users ◽  
Early Recovery ◽  
Critical Care Units ◽  
Current Evidence Base ◽  
Physical Effects ◽  
Reported Data ◽  
Critical Care Patients

Providing patients with information can alleviate or reduce relocation stress, but how best to provide information to patients being discharged from critical care units is unclear. This narrative critical review describes (1) the current evidence base on the use of discharge information for adult critical care patients and (2) the extent of involvement of service users in the design and evaluation of such information. Seven publications reported data from 121 patients, 252 relatives, and 33 nurses. Overall evidence was of low quality but use of individualized information was associated with beneficial physical effects for patients and increased knowledge and satisfaction for their relatives. Findings highlight the significant gaps in our knowledge and understanding. The consequences of such findings for the future development of information that meets service users’ needs are discussed. Results should inform the design of future studies on this topic.

scholarly journals Kebutuhan Keluarga Pasien Critical Care Unit (CCU)

2021 ◽  
Vol 4 (2) ◽  
pp. 24-37
Author(s):  
Repindra Oktari ◽  
Hellena Deli ◽  
Lita Lita
Keyword(s):  
Critical Care ◽  
Support System ◽  
Critical Care Unit ◽  
Univariate Analysis ◽  
Sampling Technique ◽  
Family Needs ◽  
Waiting Room ◽  
Health Treatment ◽  
Consecutive Sampling ◽  
The Family

Family Needs of Patients Admitted to Critical Care Unit (CCU) Abstract The growing threat of patients’ death will impact on their family’s worry and stress which will negatively affect the role of the family as a part of the support system for the patient. The purpose of this study is to determine family needs of patients admitted to CCU of Arifin Achmad General Hospital of Riau Province. This is a quantitative study using descriptive design with 21 respondents chosen using consecutive sampling technique. The data were collected using questionnaire and then analyzed using univariate analysis. The study found that, regarding the need for service guarantees, 85.7% respondents stated that it was very important to understand the purpose of the medication and health treatment given to the patient; regarding the need for information, 66.7% respondents stated that it was very important to know the real condition of the patient; regarding the need for mental support from the family, 71.4% respondents stated that it was very important to have support from the family; regarding the need for convenience, 42.9% respondents stated that it was important and very important that they were provided with washroom close to the waiting room as well as the waiting room close to the intensive room; and regarding the need for closeness, 38.1% respondents stated that it was very important to be able to visit the patient at CCU with one member of the family. It can be concluded that the need for understanding the purpose of the medication and health treatment given to the patient is the one that patients’ family need the most. It is suggested that the nurses prioritize providing nursing care for the most needed family needs. Key words: CCU, Family needs.   Kebutuhan Keluarga Pasien Critical Care Unit (CCU) Abstrak Besarnya ancaman kematian pasien akan memiliki dampak kecemasan dan stres keluarga dan berdampak pada peran keluarga sebagai support system menjadi tidak maksimal. Penelitian ini bertujuan untuk menggambarkan kebutuhan keluarga pasien CCU di RSUD Arifin Achmad Provinsi Riau. Jenis penelitian ini adalah kuantitatif dengan desain deskriptif,  pengambilan sampel menggunakan teknik consecutive sampling, jumlah sampel dalam penelitian ini sebanyak 21 responden. Alat pengumpulan data menggunakan kuesioner dan analisis data dilakukan secara univariat. Hasil penelitian didapatkan pada kebutuhan jaminan pelayanan 85.7% responden menyatakan sangat penting untuk mengetahui tujuan pengobatan dan tindakan perawatan yang diberikan, pada kebutuhan informasi 66.7% responden menyatakan sangat penting mengetahui kondisi pasien yang sebenarnya, pada kebutuhan dukungan mental keluarga 71.4% responden menyatakan sangat penting mendapatkan dukungan antar keluarga, pada kebutuhan kenyamanan 42.9% responden menyatakan penting dan sangat penting untuk tersedia kamar mandi dekat ruang tunggu dan tersedia ruang tunggu didekat ruang intensif, serta pada kebutuhan kedekatan 38.1% responden menyatakan sangat penting untuk mengunjungi pasien diruang intensif (CCU) bersama salah satu kerabat. Dapat disimpulkan bahwa kebutuhan mengetahui tujuan pengobatan dan tindakan perawatan yang diberikan merupakan kebutuhan yang paling dibutuhkan keluarga. Kepada perawat disarankan untuk memprioritaskan asuhan keperawatan terhadap kebutuhan keluarga yang paling dibutuhkan.   Kata kunci : CCU , Kebutuhan keluarga.

scholarly journals Doctors’ and nurses’ views and experience of transferring patients from critical care home to die: A qualitative exploratory study

2014 ◽  
Vol 29 (4) ◽  
pp. 354-362 ◽  
Author(s):  
Maureen Coombs ◽  
Tracy Long-Sutehall ◽  
Anne-Sophie Darlington ◽  
Alison Richardson
Keyword(s):  
Critical Care ◽  
United Kingdom ◽  
End Of Life ◽  
Health Care Professionals ◽  
Care Home ◽  
Rare Event ◽  
Community Services ◽  
Critical Care Units ◽  
The United Kingdom ◽  
Doctors And Nurses

Background: Dying patients would prefer to die at home, and therefore a goal of end-of-life care is to offer choice regarding where patients die. However, whether it is feasible to offer this option to patients within critical care units and whether teams are willing to consider this option has gained limited exploration internationally. Aim: To examine current experiences of, practices in and views towards transferring patients in critical care settings home to die. Design: Exploratory two-stage qualitative study Setting/participants: Six focus groups were held with doctors and nurses from four intensive care units across two large hospital sites in England, general practitioners and community nurses from one community service in the south of England and members of a Patient and Public Forum. A further 15 nurses and 6 consultants from critical care units across the United Kingdom participated in follow-on telephone interviews. Findings: The practice of transferring critically ill patients home to die is a rare event in the United Kingdom, despite the positive view of health care professionals. Challenges to service provision include patient care needs, uncertain time to death and the view that transfer to community services is a complex, highly time-dependent undertaking. Conclusion: There are evidenced individual and policy drivers promoting high-quality care for all adults approaching the end of life encompassing preferred place of death. While there is evidence of this choice being honoured and delivered for some of the critical care population, it remains debatable whether this will become a conventional practice in end of life in this setting.

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