Study of Obstetric Admissions to the Intensive Care Unit at PNS Shifa

Objectives: To investigate the indications, interventions and clinical outcomes of pregnant and newly delivered women admitted to the multidisciplinary intensive care unit. Study Design: Retrospective review / observational study. Setting and Duration: Critical care unit of Pakistan Navy Ship Shifa hospital Karachi from 1st August 2017 to 31st July 2018. Materials and Methods: This study was carried out in 13 bedded Intensive care units of PNS Shifa hospital Karachi, over a period of one year. All obstetrics admissions to ICU up to 42 days postpartum were included in the study, while those patients admitted after 42 days of delivery were excluded. Results: During the study period, 2688 women delivered and 66 obstetric patients were admitted to ICU, which was 7.5% of all ICU admission and it accounted for 2.4% of all deliveries. The most common indication for admission to ICU was hypertension disorders of pregnancy 45.4% followed by obstetric haemorrhage in 42.4% cases. 75% of the cases belonged to the age group of 21-35 years. The parity of 60% of patients was in the range of P2-P4. During the stay in ICU, 9% of patients were put on ventilator support, 40.9% had blood product transfusion, while 45% received antihypertensive and anticonvulsant therapy. Maternal mortality was 4.5%. Conclusion: Hypertensive disorder of pregnancy and obstetric hemorrhage were the main indications for admission to ICU. A multidisciplinary team approach and timely recognition of complications development can lead to a better maternal outcome. Universal availability of antenatal care can help in reducing serious complications and admissions to ICU. Keywords: Intensive care unit, maternal mortality, obstetric haemorrhage.

Evaluation of Knowledge of the Oral Hygiene Protocol by the Nursing Team of the Intensive Care Unit of Two Hospitals In Londrina/PR

Oral hygiene in the Intensive Care Unit - ICU is considered a basic and indispensable procedure whose goal is to maintain the patients’ healthy oral conditions, reducing complications and contributing to their recovery. The objective of this study was to evaluate the knowledge on the oral hygiene protocol by the ICU nursing team of two hospitals in Londrina/PR. The sample of this study was composed by the nursing and nursing technicians team of the Intensive Care Unit of the Hospital A and Hospital B, regardless of gender or age, and considering who had worked at the ICU for at least three months. A self-administered, unidentified questionnaire was used to collect data. The analyzed variables were: profession, age, sex, working time and oral hygiene. More than 80% of the professionals were Nursing Technicians, with average age above 30, female and working in the ICU of the hospital for over 3.5 years. The results of this study demonstrate the lack of knowledge of the oral hygiene protocol by more than 30% of the Nursing staff in both hospitals. Based on the methodology and the results analysis, it can be concluded that the oral hygiene protocol is unknown by more than a third of the ICU Nursing team of both surveyed hospitals. Keywords: Intensive Care Units. Disease Prevention. Oral Hygiene.ResumoA higiene bucal em Unidade de Terapia Intensiva - UTI é considerada um procedimento básico e indispensável cujo objetivo é manter saudáveis as condições bucais dos pacientes, reduzindo agravos e contribuindo para sua recuperação. O objetivo deste estudo foi avaliar o conhecimento do protocolo de higiene bucal pela equipe de enfermagem da UTI de dois hospitais em Londrina/PR. A amostra deste estudo foi composta pela equipe de Enfermagem (Enfermeiros e Técnicos em Enfermagem) da Unidade de Terapia Intensiva do Hospital A e do Hospital B, independente do sexo e idade, e que trabalhavam na UTI, no mínimo, há três meses. Para a coleta de dados foi utilizado um questionário autoaplicável, não identificado. As variáveis analisadas foram: profissão, idade, sexo, tempo de trabalho e higiene bucal. Mais de 80% dos profissionais eram Técnicos em Enfermagem, com idade média acima dos 30 anos de idade, do sexo feminino e atuando na UTI do hospital, em média, acima de 3,5 anos. Os resultados deste estudo demonstram a falta de conhecimento do protocolo de higiene bucal, por mais de 30% da equipe de Enfermagem, em ambos os hospitais. Com base na metodologia e análise dos resultados, pode-se concluir que o protocolo de higiene bucal é desconhecido por mais de um terço da equipe de Enfermagem da UTI de ambos os hospitais pesquisados.Palavras-chave: Unidades de Terapia Intensiva. Prevenção de doenças. Higiene Bucal.

A IMPORTÂNCIA DA PRESENÇA DO CIRURGIÃO-DENTISTA NA EQUIPE MULTIDISCIPLINAR DAS UNIDADES DE TRATAMENTO INTENSIVO

RESUMO O objetivo do presente estudo foi analisar a importância da presença do cirurgião-dentista em equipe multidisciplinar nas Unidades de Tratamento Intensivo (UTIs). Para tanto, foram selecionadas 11 unidades hospitalares do Estado do Rio de Janeiro. Como instrumento de pesquisa utilizou-se um questionário semiestruturado entregue aos profissionais responsáveis pelos cuidados da saúde bucal dos pacientes com variáveis relacionadas a procedimentos de higiene bucal e presença de doenças orais nos pacientes internados nestas unidades. Os resultados demonstraram que em 100% dos hospitais não foi encontrado um cirurgião-dentista na equipe multidisciplinar das UTIs. Em 72,70% das unidades era o enfermeiro, o profissional da saúde, responsável pelos procedimentos de higiene bucal dos pacientes internados. Este procedimento era realizado em 45,50% das unidades, duas vezes ao dia, sobre orientação de um profissional não especializado em 81,82% dos casos. Grande parte dos pacientes apresentava desordens bucais, como mau-hálito, cárie, gengivite e tártaro, e apesar disso não existia um profissional qualificado responsável pelo tratamento dessas enfermidades, sendo assim em 100% das unidades as doenças bucais não eram tratadas. Conclui-se que apesar da real e grande necessidade de um cirurgião-dentista nessas unidades, reconhecida inclusive pela maioria dos profissionais responsáveis pela higiene bucal, esta presença ainda não é efetiva, o que dificulta assim o correto tratamento de desordens bucais podendo contribuir para o surgimento e/ou agravamento de doenças sistêmicas. Palavras-Chaves: Unidades de Terapia Intensiva. Odontologia. Higiene Bucal. Equipe de Assistência ao Paciente ABSTRACT The aim of this study was to analyze the importance of the presence of dentists in a multidisciplinary team in the Intensive Care Units (ICUs). To this end, we selected 11 hospitals in the state of Rio de Janeiro. As a research tool used a semi-structured questionnaire given to the professionals responsible for the care of the oral health of patients with variables related to oral hygiene procedures and presence of oral disease in hospitalized patients in these units. The results showed that 100% of the hospitals was not found a dental surgeon in the multidisciplinary team in ICUs. In 72.70% of the units was the nurse, the health professional responsible for oral hygiene procedures for inpatients. This procedure was performed in 45.50% of the units, twice a day, on guidance of a professional not specialized in 81.82% of cases. Most patients had oral disorders such as bad breath, tooth decay, gum disease and tartar, and there wasn’t qualified professional responsible for the treatment of these diseases, therefore 100% of the units were untreated oral diseases yet. It concludes that despite the real and great need for a dentist in these units, including recognized by most professionals responsible for oral hygiene, this presence is not yet effective, which make it difficult the correct treatment of oral disorders may contribute to the emergence and / or worsening of systemic diseases. Keywords: Intensive Care Units. Dentistry. Oral hygiene. Patient Care Team