Pub Date : 2024-10-01Epub Date: 2024-01-08DOI: 10.1016/j.enfi.2023.10.003
P. Romo-Miguel RN , S. Ballesteros-Peña RN, MPH, PhD
Aim
To compare the efficacy of conventional puncture versus ultrasound-guided puncture for arterial blood gas sampling in adults.
Method
A search protocol was developed and applied to 3 databases (Medline, Cochrane, and Dialnet). Clinical trials published between January 2013 and January 2023, in Spanish or English, were considered. Outcomes in terms of first-attempt success, number of attempts until success, time taken, self-reported iatrogenic pain, and patient or professional experience were collected. The risk of bias for each included study was assessed.
Results
Five randomized clinical trials were selected, with sample sizes ranging from 50 to 238 adult patients treated in emergency settings. Three out of 4 studies showed higher first-attempt success rates when using ultrasound, and 2 out of 4 studies reported a decrease in iatrogenic pain. Discrepant findings were observed among the studies in terms of time taken and the number of attempts required for success.
Conclusions
Although current evidence is limited and the findings are heterogeneous, ultrasound-guided arterial puncture may have advantages over conventional puncture in terms of first-attempt success and in reducing iatrogenic pain.
{"title":"Punción ecoguiada versus técnica tradicional para la extracción de gasometrías arteriales en adultos: una revisión sistemática","authors":"P. Romo-Miguel RN , S. Ballesteros-Peña RN, MPH, PhD","doi":"10.1016/j.enfi.2023.10.003","DOIUrl":"10.1016/j.enfi.2023.10.003","url":null,"abstract":"<div><h3>Aim</h3><div>To compare the efficacy of conventional puncture versus ultrasound-guided puncture for arterial blood gas sampling in adults.</div></div><div><h3>Method</h3><div>A search protocol was developed and applied to 3<!--> <!-->databases (Medline, Cochrane, and Dialnet). Clinical trials published between January 2013 and January 2023, in Spanish or English, were considered. Outcomes in terms of first-attempt success, number of attempts until success, time taken, self-reported iatrogenic pain, and patient or professional experience were collected. The risk of bias for each included study was assessed.</div></div><div><h3>Results</h3><div>Five randomized clinical trials were selected, with sample sizes ranging from 50 to 238 adult patients treated in emergency settings. Three out of 4<!--> <!-->studies showed higher first-attempt success rates when using ultrasound, and 2 out of 4 studies reported a decrease in iatrogenic pain. Discrepant findings were observed among the studies in terms of time taken and the number of attempts required for success.</div></div><div><h3>Conclusions</h3><div>Although current evidence is limited and the findings are heterogeneous, ultrasound-guided arterial puncture may have advantages over conventional puncture in terms of first-attempt success and in reducing iatrogenic pain.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 4","pages":"Pages 368-375"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139456041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2024-02-29DOI: 10.1016/j.enfi.2023.12.003
D. Kohanová PhD, RN , D. Bartoníčková MSc, RN
Introduction
Nurses represent the largest group of healthcare professionals and are responsible for improving patient safety, including reporting adverse events. However, adverse events are underreported due to the many barriers that compromise patient safety in the hospital setting.
Aim
The study aimed to investigate the barriers to reporting adverse events as perceived by nurses working in intensive care units (ICUs).
Methods
The exploratory sequential mixed-method study design was used. Data were collected between January 2022 and March 2023 in intensive care units of one selected university hospital in the Slovak Republic. The quantitative phase was carried out using a specific instrument to explore barriers to reporting adverse events and included 111 nurses from the ICU. The qualitative phase was conducted using semi-structured face-to-face interviews and consisted of 10 nurses from the ICU.
Results
In terms of quantitative aspect, fear of liability, lawsuits, or sanctions was the most significant barrier to reporting adverse events among ICU nurses. As a result of qualitative thematic analysis, four significant barriers to reporting adverse events were identified: negative attitude toward reporting adverse events; lack of knowledge and experience in reporting adverse events; time scarcity; fear.
Conclusion
Based on the results of the study, it is evident that only effective and regular reporting of adverse events leads to the minimization of adverse events. To improve patient safety in hospitals, education and management practices must be implemented to overcome barriers to reporting adverse events. The most important approach to overcoming barriers to reporting adverse events is to implement a culture of no blame and a positive culture of patient safety.
{"title":"Barriers to reporting adverse events from the perspective of ICU nurses: A mixed-method study","authors":"D. Kohanová PhD, RN , D. Bartoníčková MSc, RN","doi":"10.1016/j.enfi.2023.12.003","DOIUrl":"10.1016/j.enfi.2023.12.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Nurses represent the largest group of healthcare professionals and are responsible for improving patient safety, including reporting adverse events. However, adverse events are underreported due to the many barriers that compromise patient safety in the hospital setting.</div></div><div><h3>Aim</h3><div>The study aimed to investigate the barriers to reporting adverse events as perceived by nurses working in intensive care units (ICUs).</div></div><div><h3>Methods</h3><div>The exploratory sequential mixed-method study design was used. Data were collected between January 2022 and March 2023 in intensive care units of one selected university hospital in the Slovak Republic. The quantitative phase was carried out using a specific instrument to explore barriers to reporting adverse events and included 111 nurses from the ICU. The qualitative phase was conducted using semi-structured face-to-face interviews and consisted of 10 nurses from the ICU.</div></div><div><h3>Results</h3><div>In terms of quantitative aspect, fear of liability, lawsuits, or sanctions was the most significant barrier to reporting adverse events among ICU nurses. As a result of qualitative thematic analysis, four significant barriers to reporting adverse events were identified: negative attitude toward reporting adverse events; lack of knowledge and experience in reporting adverse events; time scarcity; fear.</div></div><div><h3>Conclusion</h3><div>Based on the results of the study, it is evident that only effective and regular reporting of adverse events leads to the minimization of adverse events. To improve patient safety in hospitals, education and management practices must be implemented to overcome barriers to reporting adverse events. The most important approach to overcoming barriers to reporting adverse events is to implement a culture of no blame and a positive culture of patient safety.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 4","pages":"Pages 287-298"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140468174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2024-11-08DOI: 10.1016/j.enfi.2024.10.001
Angel Cobos-Vargas , Aurora Bueno-Cavanillas
{"title":"Notificación de Incidentes. El eslabón más débil de los Sistemas de Seguridad del Paciente","authors":"Angel Cobos-Vargas , Aurora Bueno-Cavanillas","doi":"10.1016/j.enfi.2024.10.001","DOIUrl":"10.1016/j.enfi.2024.10.001","url":null,"abstract":"","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 4","pages":"Pages 251-254"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2024-05-27DOI: 10.1016/j.enfi.2024.02.006
Y.G. Santana-Padilla RN, MSc, PhD , T. Linares-Pérez RN , B.N. Santana-López RN, MSc, PhDc , L. Santana-Cabrera MD, PhD
Introduction/purpose
Dysphagia is a disorder that presents with specific signs and symptoms in critically ill patients. Intensive care unit (ICU) nurses are responsible for monitoring and detecting abnormalities in critically ill patients, so they must be trained to assess swallowing and the complications that may arise. The aim of this research is to analyse the dynamics of the detection and assessment of dysphagia by ICU nurses.
Method
Cross-sectional descriptive study using an electronic questionnaire to nurses from different Spanish ICUs. The survey was adapted from previous research and consisted of 6 sections with 30 items of qualitative questions. The collection period was between December 2022 and March 2023. Statistical analysis was performed using frequencies and percentages, and the Chi-Square test was used for bivariate analysis.
Outcomes
43 nurses were recruited. Dysphagia is considered an important problem (90.7%) but in 50.3% of the units there is no standard or care protocol for this disorder. The most common technique is the swallowing test (32.6%). There is a consensus in our sample that aspiration pneumonia is the main problem; however, nurses in the busiest care units consider sepsis to be a frequent complication (p = 0.029). The most common treatment is modification of food consistency (86.0%).
Conclusion
The findings of this research show a low systematisation of dysphagia screening in the units included. There is a need for greater implementation of interventions and clinical protocols for monitoring complications as well as for compensatory and rehabilitative management.
{"title":"Manejo de la disfagia por las enfermeras de las unidades de cuidados intensivos españolas","authors":"Y.G. Santana-Padilla RN, MSc, PhD , T. Linares-Pérez RN , B.N. Santana-López RN, MSc, PhDc , L. Santana-Cabrera MD, PhD","doi":"10.1016/j.enfi.2024.02.006","DOIUrl":"10.1016/j.enfi.2024.02.006","url":null,"abstract":"<div><h3>Introduction/purpose</h3><div>Dysphagia is a disorder that presents with specific signs and symptoms in critically ill patients. Intensive care unit (ICU) nurses are responsible for monitoring and detecting abnormalities in critically ill patients, so they must be trained to assess swallowing and the complications that may arise. The aim of this research is to analyse the dynamics of the detection and assessment of dysphagia by ICU nurses.</div></div><div><h3>Method</h3><div>Cross-sectional descriptive study using an electronic questionnaire to nurses from different Spanish ICUs. The survey was adapted from previous research and consisted of 6 sections with 30 items of qualitative questions. The collection period was between December 2022 and March 2023. Statistical analysis was performed using frequencies and percentages, and the Chi-Square test was used for bivariate analysis.</div></div><div><h3>Outcomes</h3><div>43 nurses were recruited. Dysphagia is considered an important problem (90.7%) but in 50.3% of the units there is no standard or care protocol for this disorder. The most common technique is the swallowing test (32.6%). There is a consensus in our sample that aspiration pneumonia is the main problem; however, nurses in the busiest care units consider sepsis to be a frequent complication (p<!--> <!-->=<!--> <!-->0.029). The most common treatment is modification of food consistency (86.0%).</div></div><div><h3>Conclusion</h3><div>The findings of this research show a low systematisation of dysphagia screening in the units included. There is a need for greater implementation of interventions and clinical protocols for monitoring complications as well as for compensatory and rehabilitative management.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 4","pages":"Pages 329-339"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2024-03-07DOI: 10.1016/j.enfi.2023.12.002
S. Pérez-Ortega RN, MSc, PhD student , M. Parellada-Vendrell RN, MSc, PhD student , E. Querol RN, MSc , J. Prats RN, MSc , M. Venturas RN, PhD , A. Zabalegui RN, PhD, FEANS
Introduction
Hygiene in critical patients is an essential daily care, provided under safe conditions, to promote comfort and maintain the integrity of skin and mucous membranes, however, it can generate feelings of dependence and vulnerability in patients.
The aim of this post hoc study is to know the differences in satisfaction and lived experience regarding bed hygiene in an intensive care unit according to biological sex and gender perspective.
Methods
Observational, descriptive and prospective study in which an ad hoc questionnaire was administered to 148 conscious and oriented patients of legal age. The questionnaire was completed 24-48 hours after admission to the unit, once the initial bed hygiene had been performed.
Results
Males experienced conformism (51%), embarrassment (31%) and relief (9%); Women felt conformism (35.4%), embarrassment (18.8%) and relief (29.2%) (P < .05). Women experienced a feeling of cleanliness in 89.1% compared to 56.1% of men (P < .05). Men were offered to wash their genitals in 72.9% compared to 35.7% of women (P < .05).
34.3% of men would prefer a family member to assist them during hygiene (62.9% by their wives), compared to 27.1% of women who would prefer a family member (84.6% by their daughters).
Conclusion
Women tolerate bed hygiene better than men and appreciate more the feeling of cleanliness.
Women are identified as caregivers, both professionally and in the family, and patients prefer them to collaborate in the performance of hygiene, being wives preferred by men and daughters preferred by women.
{"title":"Perspectiva de género en la realización de la higiene en cuidados intensivos cardiológicos","authors":"S. Pérez-Ortega RN, MSc, PhD student , M. Parellada-Vendrell RN, MSc, PhD student , E. Querol RN, MSc , J. Prats RN, MSc , M. Venturas RN, PhD , A. Zabalegui RN, PhD, FEANS","doi":"10.1016/j.enfi.2023.12.002","DOIUrl":"10.1016/j.enfi.2023.12.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Hygiene in critical patients is an essential daily care, provided under safe conditions, to promote comfort and maintain the integrity of skin and mucous membranes, however, it can generate feelings of dependence and vulnerability in patients.</div><div>The aim of this post hoc study is to know the differences in satisfaction and lived experience regarding bed hygiene in an intensive care unit according to biological sex and gender perspective.</div></div><div><h3>Methods</h3><div>Observational, descriptive and prospective study in which an ad hoc questionnaire was administered to 148 conscious and oriented patients of legal age. The questionnaire was completed 24-48<!--> <!-->hours after admission to the unit, once the initial bed hygiene had been performed.</div></div><div><h3>Results</h3><div>Males experienced conformism (51%), embarrassment (31%) and relief (9%); Women felt conformism (35.4%), embarrassment (18.8%) and relief (29.2%) (<em>P</em> <!--><<!--> <!-->.05). Women experienced a feeling of cleanliness in 89.1% compared to 56.1% of men (<em>P</em> <!--><<!--> <!-->.05). Men were offered to wash their genitals in 72.9% compared to 35.7% of women (<em>P</em> <!--><<!--> <!-->.05).</div><div>34.3% of men would prefer a family member to assist them during hygiene (62.9% by their wives), compared to 27.1% of women who would prefer a family member (84.6% by their daughters).</div></div><div><h3>Conclusion</h3><div>Women tolerate bed hygiene better than men and appreciate more the feeling of cleanliness.</div><div>Women are identified as caregivers, both professionally and in the family, and patients prefer them to collaborate in the performance of hygiene, being wives preferred by men and daughters preferred by women.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 4","pages":"Pages 278-286"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140087358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2024-04-04DOI: 10.1016/j.enfi.2023.11.001
M.D. Gonzalez-Baz RN, MSN, PhD , E. Pacheco-del Cerro RN, MSN, PhD , M.I. Durango-Limárquez RN, MSN , A. Alcantarilla-Martín RN , R. Romero-Arribas RN , J. Ledesma-Fajardo RN , M.N. Moro-Tejedor RN, MSN, PhD
Background
The stay in a critical care unit (CCU) has a serious impact on physical condition causing numerous discomfort factors such as pain or difficulty in communicating. All of these are associated with possible sequelae following discharge from the Intensive Care Unit (ICU) named post-ICU syndrome. The Kolcaba Comfort Theory allows, from a holistic approach, to identify care needs from the patient's perspective using instruments such as the General Comfort Questionnaire (GCQ).
Objectives
To determine the comfort level of patients admitted to the CCU using the GCQ of Kolcaba and to identify the discomfort factors.
Methods
Cross-sectional descriptive observational prospective study. Population: 580 patients admitted to adult CCU of two high complexity hospitals from June 2015 to March 2020 with stay ≥24 h were interviewed. Descriptive analysis, Student's t-test and ANOVA and multivariate analysis were performed using SPSS v26 and STATA v16.
Results
The mean age was 52.62 (16.21), 357 (61.6%) were male and 434 (74.8%) were believers. The type of admission was planned in 322 (55.5%) and the most prevalent reason for admission was surgical 486 (83.8%). The median pain score (NRS) was 3.00 [0-4] and severity score (APACHE II) was 13.26 (5.89), the median length of stay was 4.00 [2-7] days. The mean comfort level was 3.02 (0.31) showing the highest value for the Reanimation Unit 3.02 (0.30) and the lowest fort the Emergency and Trauma Unit 2.95 (0.38). Statistically significant differences were found between the units in the comfort level of patients >65 years of age (P=.029). The Relief comfort type obtained the lowest mean 2.81 (0.33) and the physical context 2.75 (0.41) in the three units. In the multivariate analysis, statistically significant differences were found between the comfort level and the pain level: no pain (P=.000) OR: 4.361; IC: 2.184-8.707, mild pain (P=.000) OR: 4.007; IC: 2.068-7.763, moderate pain (P=.007) OR: 2.803; IC: 1.328-5.913, and the APACHE II score equal to or greater than 10 (P=.000) OR: 0.472; IC: 0.316-0.705.
Conclusions
The comfort level showed high scores in all three units. The physical and environmental contexts and the relief comfort type negatively affected the perception of comfort. The variables that explained comfort were pain and severity of illness. The evaluation of comfort from the patient's perspective through the GCQ could be considered an indicator of quality of nursing interventions.
背景重症监护病房（CCU）的住院对患者的身体状况有严重影响，会引起许多不适，如疼痛或交流困难。所有这些都与重症监护室（ICU）出院后可能出现的后遗症（重症监护室出院后综合症）有关。科尔卡巴舒适理论（Kolcaba Comfort Theory）允许使用一般舒适度问卷（GCQ）等工具，从整体角度确定患者的护理需求。 Objectives To determine the comfort level of patients admitted to the CCU using the GCQ of Kolcaba and to identify the discomfort factors.MethodsCross-sectional descriptive observational prospective study.研究对象访谈2015年6月至2020年3月期间入住两家高复杂性医院成人CCU、住院时间≥24小时的580名患者。使用 SPSS v26 和 STATA v16 进行描述性分析、学生 t 检验、方差分析和多变量分析。结果平均年龄为 52.62（16.21）岁，357（61.6%）人为男性，434（74.8%）人为信徒。322人（55.5%）的入院类型为计划入院，486人（83.8%）的入院原因为手术。疼痛评分（NRS）中位数为 3.00 [0-4]，严重程度评分（APACHE II）为 13.26 (5.89)，住院时间中位数为 4.00 [2-7] 天。平均舒适度为 3.02 (0.31)，其中复苏室最高，为 3.02 (0.30)，急诊和创伤室最低，为 2.95 (0.38)。在 65 岁患者的舒适度方面，各病房之间存在明显的统计学差异（P=0.029）。在三个科室中，救济舒适度的平均值最低，为 2.81（0.33），物理舒适度的平均值为 2.75（0.41）。在多变量分析中，舒适度与疼痛程度之间存在显著的统计学差异：无痛（P=.000）OR：4.361；IC：2.184-8.707，轻度疼痛（P=.000）OR：4.007；IC：2.068-7.763；中度疼痛（P=.007）OR：2.803；IC：1.328-5.913；APACHE II 评分等于或大于 10（P=.000）OR：0.472；IC：0.316-0.705。物理和环境背景以及缓解舒适类型对舒适感有负面影响。解释舒适度的变量是疼痛和疾病的严重程度。通过 GCQ 从患者角度对舒适度进行评估，可被视为护理干预质量的一项指标。
{"title":"Percepción del confort en el paciente crítico desde el modelo teórico de Kolcaba","authors":"M.D. Gonzalez-Baz RN, MSN, PhD , E. Pacheco-del Cerro RN, MSN, PhD , M.I. Durango-Limárquez RN, MSN , A. Alcantarilla-Martín RN , R. Romero-Arribas RN , J. Ledesma-Fajardo RN , M.N. Moro-Tejedor RN, MSN, PhD","doi":"10.1016/j.enfi.2023.11.001","DOIUrl":"10.1016/j.enfi.2023.11.001","url":null,"abstract":"<div><h3>Background</h3><div>The stay in a critical care unit (CCU) has a serious impact on physical condition causing numerous discomfort factors such as pain or difficulty in communicating. All of these are associated with possible sequelae following discharge from the Intensive Care Unit (ICU) named post-ICU syndrome. The Kolcaba Comfort Theory allows, from a holistic approach, to identify care needs from the patient's perspective using instruments such as the General Comfort Questionnaire (GCQ).</div></div><div><h3>Objectives</h3><div>To determine the comfort level of patients admitted to the CCU using the GCQ of Kolcaba and to identify the discomfort factors.</div></div><div><h3>Methods</h3><div>Cross-sectional descriptive observational prospective study. <em>Population:</em> 580 patients admitted to adult CCU of two high complexity hospitals from June 2015 to March 2020 with stay ≥24<!--> <!-->h were interviewed. Descriptive analysis, Student's t-test and ANOVA and multivariate analysis were performed using SPSS v26 and STATA v16.</div></div><div><h3>Results</h3><div>The mean age was 52.62 (16.21), 357 (61.6%) were male and 434 (74.8%) were believers. The type of admission was planned in 322 (55.5%) and the most prevalent reason for admission was surgical 486 (83.8%). The median pain score (NRS) was 3.00 [0-4] and severity score (APACHE II) was 13.26 (5.89), the median length of stay was 4.00 [2-7] days. The mean comfort level was 3.02 (0.31) showing the highest value for the Reanimation Unit 3.02 (0.30) and the lowest fort the Emergency and Trauma Unit 2.95 (0.38). Statistically significant differences were found between the units in the comfort level of patients >65 years of age (<em>P</em>=.029). The Relief comfort type obtained the lowest mean 2.81 (0.33) and the physical context 2.75 (0.41) in the three units. In the multivariate analysis, statistically significant differences were found between the comfort level and the pain level: no pain (<em>P</em>=.000) OR: 4.361; IC: 2.184-8.707, mild pain (<em>P</em>=.000) OR: 4.007; IC: 2.068-7.763, moderate pain (<em>P</em>=.007) OR: 2.803; IC: 1.328-5.913, and the APACHE II score equal to or greater than 10 (<em>P</em>=.000) OR: 0.472; IC: 0.316-0.705.</div></div><div><h3>Conclusions</h3><div>The comfort level showed high scores in all three units. The physical and environmental contexts and the relief comfort type negatively affected the perception of comfort. The variables that explained comfort were pain and severity of illness. The evaluation of comfort from the patient's perspective through the GCQ could be considered an indicator of quality of nursing interventions.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 4","pages":"Pages 264-277"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140787083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2024-06-04DOI: 10.1016/j.enfi.2024.02.003
A. Monterde-Estrada RN, MSN , L. Ventura-Garcia PhD , F. Valls-Fonayet PhD
Introduction
Nurses play an essential role in the care of emergency hospital patients, being the ones who have the most contact with the patient and the first to be able to detect their imminent deterioration. However, the literature shows the impact that this can have in terms of stress and insecurity among new nurses, with the consequent risk of resignation in the institution and in their learning process.
Objectives
To explore the process of incorporation of new nurses in the emergency room, as well as to identify and understand their emotions, difficulties, needs and proposals for improvement.
Method
Qualitative research aimed at emergency room nurses in a tertiary level university hospital in Catalonia, between April 2022 and March 2023. Twelve semi-structured interviews were conducted with content analysis.
Results
Four categories emerged: identification of deficiencies, emotional dimension, competencies of the expert nursing professional, and needs and proposals for improvement, as main themes.
Conclusions
Insufficient training and deficit of interdisciplinary communication skills appear as main stressors. The analysis of the results suggests the need to create an intervention program that protects the mental and emotional health of new nurses and ensures the integrity of their patients. Innovative and multimodal training adapted to generational change is called for, with virtual, immersive, and contextualized simulation scenarios, together with the implementation of tools such as debriefing and nursing clin
{"title":"Percepción de las enfermeras principiantes en un box de emergencias: una aproximación cualitativa a sus experiencias y necesidades","authors":"A. Monterde-Estrada RN, MSN , L. Ventura-Garcia PhD , F. Valls-Fonayet PhD","doi":"10.1016/j.enfi.2024.02.003","DOIUrl":"10.1016/j.enfi.2024.02.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Nurses play an essential role in the care of emergency hospital patients, being the ones who have the most contact with the patient and the first to be able to detect their imminent deterioration. However, the literature shows the impact that this can have in terms of stress and insecurity among new nurses, with the consequent risk of resignation in the institution and in their learning process.</div></div><div><h3>Objectives</h3><div>To explore the process of incorporation of new nurses in the emergency room, as well as to identify and understand their emotions, difficulties, needs and proposals for improvement.</div></div><div><h3>Method</h3><div>Qualitative research aimed at emergency room nurses in a tertiary level university hospital in Catalonia, between April 2022 and March 2023. Twelve semi-structured interviews were conducted with content analysis.</div></div><div><h3>Results</h3><div>Four categories emerged: identification of deficiencies, emotional dimension, competencies of the expert nursing professional, and needs and proposals for improvement, as main themes.</div></div><div><h3>Conclusions</h3><div>Insufficient training and deficit of interdisciplinary communication skills appear as main stressors. The analysis of the results suggests the need to create an intervention program that protects the mental and emotional health of new nurses and ensures the integrity of their patients. Innovative and multimodal training adapted to generational change is called for, with virtual, immersive, and contextualized simulation scenarios, together with the implementation of tools such as debriefing and nursing clin</div><div>ical sessions.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 4","pages":"Pages 319-328"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141279481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The changes in health dynamics, caused by the SARS-CoV-2 pandemic and its consequences, generated a greater need to integrate palliative care in the ICU to promote a dignified death.
Objective
Identify interprofessional interventions and factors that improve the care of patients at the end of life.
Methodology
Integrative review, including experimental, quasi-experimental, observational, analytical, and descriptive studies with correlation of variables, published from 2010 to 2021, identified in Cochrane, CINAHL, CUIDEN, LILACS, SciELO, Dialnet, PsychInfo, PubMed, ProQuest Psychology Journals and ScienceDirect, with the MeSH terms: “Critical Care”, “Intensive Care”, “Life support care”, “Palliative care”, “Life Quality”, “Right to die”. A total of 36,271 were identified; after excluding duplicates and because of title, abstract, year of publication, design, theme, methodological quality, objectives, and content, 31 studies were found.
Results
It included 31 articles, 16.7% experimental, 3.3% quasi-experimental, 80% observational, analytical, and descriptive with correlation of variables, 38% published in the United States, and 19% in Brazil. The pooled sample was 24,779 participants. A percentage of 32.2 of the studies had level of evidence 1 recommendation (c), and 25.8% level of evidence 2 recommendation (c). This paper synthesizes evidence to promote interprofessional collaborative practice in the ICU, improve end-of-life care, and interventions to achieve established therapeutic goals, implement effective care policies, plans, and programs for critically ill patients and their families; factors that affect palliative care and improve with training and continuing education for health personnel.
Conclusion
There are interventions to manage physical and emotional symptoms, training strategies and emotional support aimed at health personnel and family members to improve the quality of death and reduce stays in the ICU. The interdisciplinary team requires training on palliative and end-of-life care to improve care.
{"title":"Intervenciones interprofesionales y factores que mejoran los cuidados al final de la vida en unidades de cuidados intensivos: revisión integradora","authors":"S.M. Hernández-Zambrano PhD , A.J. Carrillo-Algarra MSN , O.E. Manotas-Solano RN , S.E. Ibáñez-Gamboa RN , L.M. Mejia-Mendez RN , O.H. Martínez-Montoya RN , M. Fernández-Alcántara PhD , C. Hueso-Montoro PhD","doi":"10.1016/j.enfi.2023.08.003","DOIUrl":"10.1016/j.enfi.2023.08.003","url":null,"abstract":"<div><h3>Introduction</h3><div>The changes in health dynamics, caused by the SARS-CoV-2 pandemic and its consequences, generated a greater need to integrate palliative care in the ICU to promote a dignified death.</div></div><div><h3>Objective</h3><div>Identify interprofessional interventions and factors that improve the care of patients at the end of life.</div></div><div><h3>Methodology</h3><div>Integrative review, including experimental, quasi-experimental, observational, analytical, and descriptive studies with correlation of variables, published from 2010 to 2021, identified in Cochrane, CINAHL, CUIDEN, LILACS, SciELO, Dialnet, PsychInfo, PubMed, ProQuest Psychology Journals and ScienceDirect, with the MeSH terms: “Critical Care”, “Intensive Care”, “Life support care”, “Palliative care”, “Life Quality”, “Right to die”. A total of 36,271 were identified; after excluding duplicates and because of title, abstract, year of publication, design, theme, methodological quality, objectives, and content, 31 studies were found.</div></div><div><h3>Results</h3><div>It included 31 articles, 16.7% experimental, 3.3% quasi-experimental, 80% observational, analytical, and descriptive with correlation of variables, 38% published in the United States, and 19% in Brazil. The pooled sample was 24,779 participants. A percentage of 32.2 of the studies had level of evidence 1 recommendation (c), and 25.8% level of evidence 2 recommendation (c). This paper synthesizes evidence to promote interprofessional collaborative practice in the ICU, improve end-of-life care, and interventions to achieve established therapeutic goals, implement effective care policies, plans, and programs for critically ill patients and their families; factors that affect palliative care and improve with training and continuing education for health personnel.</div></div><div><h3>Conclusion</h3><div>There are interventions to manage physical and emotional symptoms, training strategies and emotional support aimed at health personnel and family members to improve the quality of death and reduce stays in the ICU. The interdisciplinary team requires training on palliative and end-of-life care to improve care.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 4","pages":"Pages 352-367"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141279171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2024-11-08DOI: 10.1016/j.enfi.2024.07.002
M. Raurell-Torredà , R.-J. Fernández-Castillo , M.-E. Rodríguez-Delgado , Á. Cobos-Vargas , D.-M. Achury-Saldaña , E. Cavallo , A. Muriel-García , S. Arias-Rivera
Introduction
Anaemia is a common condition in patients admitted to intensive care units (ICUs). It is also well known that a significant amount of the carbon dioxide produced by health services is likely attributable to blood donation, testing, and the manufacture, storage, and distribution of blood components. To mitigate this, prevention strategies such as blood-sparing techniques are available. There is a lack of knowledge regarding the use of such techniques in ICUs in Spain and Latin America, healthcare systems with very different health expenditures per capita. The aim is to assess the degree of implementation of blood-sparing techniques in these regions.
Methods
Cross-sectional online multicentre survey. 251 ICUs in Spain and 53 in Latin America (20 in Argentina, 20 in Colombia, 13 in Ecuador) participated. A 20-item survey on the use of point-of-care, small-volume tubes (SVT), and closed-blood sampling devices (CBSD) was validated. Effect sizes were calculated using Phi (φ) or Cramer’s V (V).
Results
A response rate of 77% was obtained for Spain and 96% for Latin America. In Spain, the majority of ICUs were affiliated with public hospitals (88.1%, 171/194) while in Latin America, most were associated with private hospitals (56.9%, 29/51). Regarding the use of point-of-care testing, 67.5% of Spanish ICUs, compared to 35.3% of Latin Americans, reported frequent use (V = 0.343). In 91.7% of Spanish ICUs and 58.9% of Latin Americans, SVTs were rarely or never used (V = 0.380). The use of CBSD was significantly lower in Spain for both arterial and central venous catheters (V = 0.336). Private hospitals used more CBSD in arterial catheter than public ones (27% vs 8.3%, V = 0.278).
Conclusion
Point-of-care testing can be improved in Latin America, while the use of CBSD and small-volume tubes can be enhanced in Spain. Private hospitals tend to implement blood-sparing techniques more effectively than public hospitals.
{"title":"Blood-sparing techniques prevalence in adult intensive care units: A multicentre survey study","authors":"M. Raurell-Torredà , R.-J. Fernández-Castillo , M.-E. Rodríguez-Delgado , Á. Cobos-Vargas , D.-M. Achury-Saldaña , E. Cavallo , A. Muriel-García , S. Arias-Rivera","doi":"10.1016/j.enfi.2024.07.002","DOIUrl":"10.1016/j.enfi.2024.07.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Anaemia is a common condition in patients admitted to intensive care units (ICUs). It is also well known that a significant amount of the carbon dioxide produced by health services is likely attributable to blood donation, testing, and the manufacture, storage, and distribution of blood components. To mitigate this, prevention strategies such as blood-sparing techniques are available. There is a lack of knowledge regarding the use of such techniques in ICUs in Spain and Latin America, healthcare systems with very different health expenditures per capita. The aim is to assess the degree of implementation of blood-sparing techniques in these regions.</div></div><div><h3>Methods</h3><div>Cross-sectional online multicentre survey. 251 ICUs in Spain and 53 in Latin America (20 in Argentina, 20 in Colombia, 13 in Ecuador) participated. A 20-item survey on the use of point-of-care, small-volume tubes (SVT), and closed-blood sampling devices (CBSD) was validated. Effect sizes were calculated using Phi (φ) or Cramer’s V (V).</div></div><div><h3>Results</h3><div>A response rate of 77% was obtained for Spain and 96% for Latin America. In Spain, the majority of ICUs were affiliated with public hospitals (88.1%, 171/194) while in Latin America, most were associated with private hospitals (56.9%, 29/51). Regarding the use of point-of-care testing, 67.5% of Spanish ICUs, compared to 35.3% of Latin Americans, reported frequent use (<em>V</em> <!-->=<!--> <!-->0.343). In 91.7% of Spanish ICUs and 58.9% of Latin Americans, SVTs were rarely or never used (<em>V</em> <!-->=<!--> <!-->0.380). The use of CBSD was significantly lower in Spain for both arterial and central venous catheters (<em>V</em> <!-->=<!--> <!-->0.336). Private hospitals used more CBSD in arterial catheter than public ones (27% vs 8.3%, <em>V</em> <!-->=<!--> <!-->0.278).</div></div><div><h3>Conclusion</h3><div>Point-of-care testing can be improved in Latin America, while the use of CBSD and small-volume tubes can be enhanced in Spain. Private hospitals tend to implement blood-sparing techniques more effectively than public hospitals.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 4","pages":"Pages 340-351"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2024-05-27DOI: 10.1016/j.enfi.2024.03.001
N. Canga-Armayor RN PhD
The nursing profession, without losing its essence, is in continuous evolution in order to face and respond to the ever-changing health challenges of the population. Advanced Practice Nursing is a clear example of this development. The performance of advanced practice roles entails greater responsibility, expansion and depth of nursing practice, which is only possible with additional education beyond the bachelor's degree - a master's or doctoral degree in nursing - and greater expertise in clinical practice in a particular area of specialization.
Advanced practice nursing is intrinsically linked to the level of education since, further academic development of nursing promotes the advancement of autonomous practice. This article addresses the education of Advanced Practice Nurses, and focuses on its core aspects; providing detailed information on competencies, curricular structure, curriculum and key components of training programs. Finally, special mention is made of advanced role training in the critical care setting.
{"title":"La formación académica de las enfermeras que desarrollan roles de práctica avanzada","authors":"N. Canga-Armayor RN PhD","doi":"10.1016/j.enfi.2024.03.001","DOIUrl":"10.1016/j.enfi.2024.03.001","url":null,"abstract":"<div><div>The nursing profession, without losing its essence, is in continuous evolution in order to face and respond to the ever-changing health challenges of the population. Advanced Practice Nursing is a clear example of this development. The performance of advanced practice roles entails greater responsibility, expansion and depth of nursing practice, which is only possible with additional education beyond the bachelor's degree - a master's or doctoral degree in nursing - and greater expertise in clinical practice in a particular area of specialization.</div><div>Advanced practice nursing is intrinsically linked to the level of education since, further academic development of nursing promotes the advancement of autonomous practice. This article addresses the education of Advanced Practice Nurses, and focuses on its core aspects; providing detailed information on competencies, curricular structure, curriculum and key components of training programs. Finally, special mention is made of advanced role training in the critical care setting.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 4","pages":"Pages e41-e48"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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