Enfermeria Intensiva最新文献

{"title":"Exploring patients’ experiences in intensive care units (ICU): A cross-sectional study in Pakistan","authors":"Tawseef Ahmad MS, Pharm-D ,&nbsp;Sirima Sitaruno Pharm-D, BCPS ,&nbsp;Sutthiporn Pattharachayakul Pharm-D, BCPS ,&nbsp;Faiz Ullah Khan Pharm-D, PhD ,&nbsp;Muhammad Kiddeer Pharm-D, M.Phil. ,&nbsp;Shujaat Ali Khan Pharm-D, PhD","doi":"10.1016/j.enfi.2025.500578","DOIUrl":"10.1016/j.enfi.2025.500578","url":null,"abstract":"<div><h3>Background</h3><div>Intensive care unit (ICU) stays are often traumatic, impacting patients psychologically, physically, and emotionally. However, patient experiences in ICU settings remain underexplored, particularly in developing countries like Pakistan.</div></div><div><h3>Objective</h3><div>This study aimed to assess the experiences of ICU patients in a tertiary care hospital in Pakistan, with a focus on psychological distress, emotional responses, and perceived quality of care.</div></div><div><h3>Methods</h3><div>A descriptive cross-sectional study was conducted at Ayub Teaching Hospital, Abbottabad. A total of 102 post-ICU patients meeting the inclusion criteria were interviewed within 72 hours of transfer to medical wards. Data were collected using the validated Intensive Care Experience Questionnaire (ICEQ), and analyzed to evaluate patient perceptions and associated factors.</div></div><div><h3>Results</h3><div>Of the participants, 93.13% expressed relief upon discharge from the ICU, while 42.15% reported experiencing blurred memories during their stay. Despite this, 77.45% expressed satisfaction with the care received. Notably, only 23.52% of patients felt involved in decision-making processes regarding their care, indicating a communication gap. Statistical analysis revealed a significant negative correlation between patient age and satisfaction with care (<em>r</em> <!-->=<!--> <!-->−0.199, <em>p</em> <!-->&lt;<!--> <!-->0.05), suggesting older patients experienced reduced satisfaction. Gender also negatively correlated with memory of experience (<em>r</em> <!-->=<!--> <!-->−0.236, <em>p</em> <!-->&lt;<!--> <!-->0.05) and satisfaction with care (<em>r</em> <!-->=<!--> <!-->−0.208, <em>p</em> <!-->&lt;<!--> <!-->0.05), with women reporting more negative experiences. Length of ICU stay was significantly associated with reduced environmental awareness (<em>r</em> <!-->=<!--> <!-->−0.230, <em>p</em> <!-->&lt;<!--> <!-->0.001).</div></div><div><h3>Conclusion</h3><div>The findings highlight significant psychological and emotional challenges faced by ICU patients in Pakistan. Enhanced patient-centered communication, psychological support, and greater involvement in care decisions are critical to improving ICU experiences. Nursing staff play a pivotal role in creating a supportive and therapeutic ICU environment that fosters trust and improves patient outcomes.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 1","pages":"Article 500578"},"PeriodicalIF":1.0,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145796787","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}

{"title":"Lung collapse during postural repositioning in a mechanically ventilated patient, could it have been avoided? A case report","authors":"María Dolores Rodríguez-Huerta RN, MSc ,&nbsp;Ana Díez-Fernández RN, MSc, PhD ,&nbsp;María Jesús Rodríguez-Alonso RN ,&nbsp;María Martín-Rodríguez RN ,&nbsp;Mario Fernández-Izquierdo RN","doi":"10.1016/j.enfi.2025.500583","DOIUrl":"10.1016/j.enfi.2025.500583","url":null,"abstract":"<div><h3>Objective</h3><div>To analyse through a clinical case the need for comprehensive management of bronchial secretions by nurses, with a proactive and preventive character to improve mechanically ventilated patients’ safety.</div></div><div><h3>Clinical case presentation</h3><div>A 76-year-old man under invasive mechanical ventilation admitted to the ICU due to pulmonary infection, who presented subtotal left lung collapse during routine postural changes. Trying to recover the left lung ventilation, the patient was repositioned, an endotracheal suctioning and two recruitment manoeuvres were made without any ventilation improvement. The previous level of left ventilation was not achieved until secretions were completely eliminated after three more suctioning manoeuvres.</div></div><div><h3>Discussion and implications for practice</h3><div>Critically ill patient care is complex, requiring general basic attention and monitoring, including the assessment of the risks that certain interventions and nursing care may entail for each individual patient. Both, postural repositioning and endotracheal suctioning constitutes tow integral parts of routine care for all mechanically ventilated patients. This case shows how the presence of deep secretions during postural repositioning can greatly affect the respiratory function, with no significant immediate or short-term changes observed on routine monitoring, as electrical impedance monitoring is not standard practice, so the changes described in this case would not have been observed in short term.</div></div><div><h3>Conclusions</h3><div>The implementation of a nursing integral care protocol for the management of secretions in mechanically ventilated patients, could be very useful in preventing adverse events, ineffective multiple endotracheal suctioning, which are not free of potential complications, and in reducing the need for deep airway clearance by fibrobronchoscopy.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 1","pages":"Article 500583"},"PeriodicalIF":1.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145747396","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}

{"title":"Clinical judgment and self-efficacy of nurses in sepsis management: The use of clinical simulation","authors":"Lilian Regina-de-Carvalho RN, MSc, PhD ,&nbsp;Ursula Marcondes-Westin RN, MSc, PhD ,&nbsp;Renata Elizabete-Pagotti-da-Fonseca RN, MSc, PhD ,&nbsp;Rafael Bressani-Lino RN, MSc, PhD ,&nbsp;João Paulo Victorino RN ,&nbsp;Silvia Helena-Zem-Mascarenhas RN, PhD","doi":"10.1016/j.enfi.2025.500577","DOIUrl":"10.1016/j.enfi.2025.500577","url":null,"abstract":"<div><h3>Introduction</h3><div>Sepsis has high mortality and demands prompt intervention. Nurses are key in its management, but knowledge gaps persist. Enhancing clinical judgment and self-efficacy is crucial, and clinical simulation offers a safe, effective strategy for developing these skills, supporting education in healthcare.</div></div><div><h3>Objective</h3><div>To evaluate the responses related to self-efficacy and clinical judgment of nurses in the management of sepsis through high-fidelity clinical simulation.</div></div><div><h3>Methods</h3><div>A quasi-experimental, pre- and post-test study design was adopted. Self-efficacy, clinical judgment, and knowledge were considered dependent variables, while time and participant role (scenario participant/observer) were treated as covariates. The sample consisted of 28 nurses. Data were transcribed into Microsoft Excel® spreadsheets and analyzed using SAS version 9.4 software.</div></div><div><h3>Results</h3><div>After the debriefing session, the mean scores for knowledge, clinical judgment, and self-efficacy increased compared to baseline. Knowledge scores improved from a mean of 9.71 (SD<!--> <!-->=<!--> <!-->2.02) to 12.75 (SD<!--> <!-->=<!--> <!-->1.24). Clinical judgment scores increased from 31.75 (SD<!--> <!-->=<!--> <!-->4.88) to 36.5 (SD<!--> <!-->=<!--> <!-->5.5), and self-efficacy rose from 4.05 (SD<!--> <!-->=<!--> <!-->0.44) to 4.19 (SD<!--> <!-->=<!--> <!-->0.55). Statistically significant differences were found in clinical judgment (<em>p</em> <!-->&lt;<!--> <!-->0.0001) and knowledge (<em>p</em> <!-->&lt;<!--> <!-->0.0001) across time points. Participants who actively engaged in the simulation had significantly higher post-simulation clinical judgment (mean<!--> <!-->=<!--> <!-->39.5 vs. 34.83; <em>p</em> <!-->=<!--> <!-->0.0252) and self-efficacy scores (mean<!--> <!-->=<!--> <!-->4.51 vs. 4.01; <em>p</em> <!-->=<!--> <!-->0.0269) compared to observers. However, there was no significant difference in post-test knowledge scores between the groups (<em>p</em> <!-->=<!--> <!-->0.6012). A strong correlation was identified between self-efficacy and clinical judgment. These findings support the effectiveness of simulation-based education in enhancing both clinical judgment and self-efficacy among nurses.</div></div><div><h3>Conclusions</h3><div>High-fidelity clinical simulation contributed to the development of nurses’ clinical judgment, self-efficacy, and knowledge regarding sepsis management.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 1","pages":"Article 500577"},"PeriodicalIF":1.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145747395","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}

{"title":"Effect of mobility at ICU discharge on mortality and length of post-ICU stay: A retrospective analysis","authors":"Roberto Gonçalves-Mendes MSN ,&nbsp;André Pinto-Novo PhD ,&nbsp;Manuel Lourenço-Nunes PhD ,&nbsp;Miguel Castelo-Branco PhD","doi":"10.1016/j.enfi.2025.500572","DOIUrl":"10.1016/j.enfi.2025.500572","url":null,"abstract":"<div><h3>Background</h3><div>Admission to intensive care can be accompanied by significant adverse effects for patients, which last beyond their stay in the unit. Early mobilisation is part of a set of a bundle to minimise these effects and is now unanimously considered to be safe and beneficial. It is therefore important to understand how it is being implemented in practice and what its real benefits are.</div></div><div><h3>Aim/Objective</h3><div>To characterise mobility in the ICU and correlate the level of mobility at discharge from the ICU with the results of post-intensive care, namely: length of stay after intensive care and hospital mortality.</div></div><div><h3>Methods</h3><div>This was an observational, retrospective study carried out in the Intensive Care Department of a Local Health Unit located in the Portuguese countryside. A quantitative research methodology was used.</div></div><div><h3>Results</h3><div>Of the 244 patients included in the sample, 54.5% achieved orthostatism during the ICU stay and 36.5% achieved deambulation. The average length of stay between leaving the ICU and hospital discharge was 8.0<!--> <!-->±<!--> <!-->7.5 days. Patients who remained at bed rest at discharge had longer hospital stays than patients who were ambulating (<em>p</em> <!-->=<!--> <!-->0.014); and patients who performed activities in bed also had longer hospital stays than those who were orthostatic or ambulating (<em>p</em> <!-->=<!--> <!-->0.026 and 0.002 respectively). Post-ICU mortality was 5.7%, and there was a strong correlation with mobility on discharge from the ICU (<em>p</em> <!-->&lt;<!--> <!-->0.001), with less mobile patients having a higher mortality rate than expected (odds ratio<!--> <!-->=<!--> <!-->5.13).</div></div><div><h3>Conclusions</h3><div>The mobility levels founded in this study are in line with international reality. Patients who achieve higher levels of mobility during their stay in intensive care have shorter hospital stays and lower mortality.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 1","pages":"Article 500572"},"PeriodicalIF":1.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145747393","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}

{"title":"Experiencia de cuidado de cuidadores y niños entre 12 y 17 años brindado por personal de salud durante la hospitalización en cuidado intensivo pediátrico","authors":"Herly Ruth Alvarado-Romero RN, MSc ,&nbsp;Carlos Yecid Bernal-Cárdenas RN, PhD ,&nbsp;Diana Norella Córdoba-Rojas RN, MSc ,&nbsp;Alba Deyanira Quiñonez-López MD ,&nbsp;Camila Yesenia Ruiz-Matore RN ,&nbsp;Paola Torres-Giraldo RN, MSN","doi":"10.1016/j.enfi.2025.500582","DOIUrl":"10.1016/j.enfi.2025.500582","url":null,"abstract":"<div><h3>Introduction</h3><div>Caring for children hospitalized in Pediatric Intensive Care Units is a complex and multidimensional process. This process includes specialized care, as well as emotional and psychological support for both patients and their caregivers. These caregivers play an essential role in the hospitalization experience, facing a range of emotions due to the severity of the children's illness and the connotations of being hospitalized.</div></div><div><h3>Objective</h3><div>Describe the caregiving experience of caregivers and children between the ages of 12 and 17 provided by healthcare personnel during hospitalization in the unit at an institution in Bogotá in 2023.</div></div><div><h3>Methodology</h3><div>Qualitative study with a phenomenological design, using in-depth semi-structured interviews with caregivers and children hospitalized in an Intensive Care Unit in Bogotá in 2023.</div></div><div><h3>Results</h3><div>Twenty-seven interviews were conducted to achieve data saturation. Most of the caregivers were women. The predominant socioeconomic status was 3 and the educational level was high school. Four categories and thirteen subcategories were identified: Environment and dynamics, interaction with healthcare personnel, recognition of healthcare personnel, and feelings and experience upon admission to the unit.</div></div><div><h3>Conclusion</h3><div>Nurses working in Pediatric Intensive Care Units play a fundamental role, as they are in constant contact with children and their caregivers, who often experience high levels of anxiety and fear due to the seriousness of the environment. To provide comprehensive and humanized care, it is essential that these professionals have specific scientific knowledge about children's health, as well as disciplinary skills to guide their interventions. In this way, they contribute to the child's recovery and the creation of a more humane care environment, even in a highly technical context.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 1","pages":"Article 500582"},"PeriodicalIF":1.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145747397","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}

{"title":"Prevalence, characteristics, and associated factors of dyskalemia in Moroccan intensive care units over a 28-month period: A cross-sectional correlational study","authors":"Kamal Takhdat RAN, PhD ,&nbsp;Salma El Hamdou REN, BSN ,&nbsp;Houda El Bannaoui REN, BSN ,&nbsp;Ahmed Rhassane El Adib MD","doi":"10.1016/j.enfi.2025.500570","DOIUrl":"10.1016/j.enfi.2025.500570","url":null,"abstract":"<div><h3>Introduction</h3><div>Dyskalemia disturbs electrophysiological homeostasis and even cause several life-threatening conditions. Improved understanding of dyskalemia risk factors is clinically relevant for prompt and effective dyskalemia treatment. This study aims to analyze dyskalemia prevalence and risk factors in two adult medical and surgical intensive care units (ICUs) in a Moroccan university hospital.</div></div><div><h3>Methods</h3><div>A retrospective cross-sectional study was conducted from January 1st 2022 to April 30, 2024. A total of 1274 patients’ medical records were examined, yielding for 549 dyskalemic patients. Single-factor and multi-factor logistic regression analyses were conducted to investigate associations between dyskalemia and the risk factors related to patients’ characteristics, comorbidities, and therapeutic agents.</div></div><div><h3>Results</h3><div>The prevalence of dyskalemia was found at 43%, with a dyskalemic patients’ mean age of 48.3 (±18.6). Over 62% of them developed dyskalemia during ICU stay. Multivariable analyses showed that the risk of hypokalemia was associated to female gender, diabetic ketoacidosis, anticancer drugs, heparin (LMWH), and insulin. However, the risk of hyperkalemia was associated with male gender, chronic kidney failure, metabolic acidosis, burns, blood transfusion, and propofol as a sedative agent.</div></div><div><h3>Conclusion</h3><div>Several associated factors of the risk of dyskalemia were identified. Critical care nurses should pay particular attention to high-risk patients of dyskalemia and be proactive in identifying early signs of dyskalemia in order to achieve targeted risk assessment, improve early diagnosis, and management of the patients’ conditions.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 1","pages":"Article 500570"},"PeriodicalIF":1.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145747394","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}

{"title":"Associations between ICU nursing care and functional outcomes in survivors of critical COVID-19: Longitudinal study","authors":"Raví P. Pereira RN, MSN ,&nbsp;Vanessa F. Bonatto RN, MSN ,&nbsp;Luísa B. Santana RN ,&nbsp;Isis M. Severo RN, PhD ,&nbsp;Michele D. Santarem RN, PhD ,&nbsp;Augusto Savi PT, PhD ,&nbsp;Cassiano Teixeira MD, PhD ,&nbsp;Karina de O. Azzolin RN, PhD","doi":"10.1016/j.enfi.2025.500579","DOIUrl":"10.1016/j.enfi.2025.500579","url":null,"abstract":"<div><h3>Introduction</h3><div>The evaluation of long-term functional disabilities and factors associated with decline following COVID-19-related critical illness in low- and middle-income countries remains underexplored in current literature. Addressing this gap is essential for healthcare professionals, particularly nurses, to develop targeted interventions aimed at reducing the risk of functional decline after critical illness during pandemics.</div></div><div><h3>Objectives</h3><div>To analyze ICU nursing care factors associated with functional outcomes in survivors of critical illness due to COVID-19, six months after ICU discharge.</div></div><div><h3>Methods</h3><div>A prospective longitudinal study was conducted. Adults (≥18 years) discharged from the ICU after viral pneumonia, confirmed by RT-PCR for SARS-CoV-2, with a minimum ICU stay of 72<!--> <!-->h, were included. Follow-up was conducted via telephone interviews at one, three, and six months to collect sociodemographic data and assess functional status using the Barthel Index. Data were analyzed using Generalized Estimating Equations.</div></div><div><h3>Results</h3><div>The study included 400 participants (mean age: 52.41<!--> <!-->±<!--> <!-->13.680 years; median ICU stay: 15.0 days, IQR: 8.0–26.0). Functional decline was observed in 43% of patients at one month, 28.4% at three months, and 20.4% at six months. Delirium and skin ulcers during ICU stay were modifiable factors associated with post-critical care functional disability.</div></div><div><h3>Conclusions</h3><div>Exploring targeted nursing interventions, such as delirium and pressure ulcer prevention, is essential to promote recovery and prevent long-term disability after critical illness.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 1","pages":"Article 500579"},"PeriodicalIF":1.0,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145691377","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}

{"title":"Experiencias percibidas por las madres y padres sobre la lactancia materna de un recién nacido prematuro en una unidad de cuidados intensivos neonatales","authors":"Èlia Santiveri-Camacho RN, MSc ,&nbsp;Alejandro Bosch-Alcaraz RN, PNP, MSc, PhD ,&nbsp;Mariela Patricia Aguayo-González RN, MSc, PhD ,&nbsp;M. Ángeles Saz-Roy RN, PNP, MSc, PhD","doi":"10.1016/j.enfi.2025.500571","DOIUrl":"10.1016/j.enfi.2025.500571","url":null,"abstract":"<div><h3>Introduction</h3><div>A premature birth involves stress derived from the context of the NICU where the baby is cared for. In addition, the separation between mother and father/couple and child involves an interruption of the biological process of breastfeeding. The experiences lived in this process between mother and father/couple are unequal, which entails different care needs to be covered by the health professional through informative and educational activities.</div></div><div><h3>Objective</h3><div>To explore the experiences of mothers and fathers/couple breastfeeding PTNB during their stay in the NICU.</div></div><div><h3>Design and methods</h3><div>A qualitative phenomenological study was carried out. The population studied were mothers and fathers/couple of PTNB in a neonatal unit who were breastfeeding. Using purposive convenience sampling and the principle of information saturation, the participants were 5 mothers and 4 fathers. Semi-structured interviews were conducted and organized into the following thematic areas: knowledge, environment, feelings, coping strategies and challenges.</div></div><div><h3>Results</h3><div>The mothers’ and fathers’/couples’ experiences are grouped into four themes: previous lack of knowledge about the breastfeeding process, BF as a personal challenge, barriers and facilitators during the process of breastfeeding a PTNB, and the feelings of the families.</div></div><div><h3>Conclusions</h3><div>From the perceptions and feelings reported by breastfeeding mothers and fathers/couples of PTNB, changes can be made to improve nursing care in the NICU. Improving early expressing within the first hour, developing specific protocols for breastfeeding in PTNB and updated training for nursing staff are aspects that emerge from the study and could help to priorities and meet the expressed needs for breastfeeding support in the NICU.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 1","pages":"Article 500571"},"PeriodicalIF":1.0,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624830","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}

{"title":"Occurrence of adverse events with arterial catheters and their contributing factors: A cross-sectional study","authors":"Patriny Marcelle Mariano-Gomes ,&nbsp;Adriana Ouverney-Braz RN, PhD ,&nbsp;Graciele Oroski-Paes RN, PhD","doi":"10.1016/j.enfi.2025.500575","DOIUrl":"10.1016/j.enfi.2025.500575","url":null,"abstract":"<div><h3>Introduction</h3><div>The insertion of an arterial line is one of the most important invasive procedures in intensive care, but it may still pose risks to patients.</div></div><div><h3>Objectives</h3><div>To determine the prevalence and analyze the association of contributing factors with the occurrence of adverse events related to the use of arterial catheters.</div></div><div><h3>Method</h3><div>Cross-sectional, retrospective, analytical and quantitative study. The sample included all reports of adverse events involving arterial catheters over the past five years. The hospital's electronic and physical medical records were used to supplement the patients’ clinical data. Descriptive and inferential analysis was carried out using frequency calculations and association tests, including Chi-square and Fisher's exact test. A significance level of up to 10% (<em>p</em>-value<!--> <!-->&lt;<!--> <!-->0.1) was used for all analyses. The study adhered to the STROBE Checklist guidelines (a checklist of items recommended for reports of cross-sectional studies).</div></div><div><h3>Results</h3><div>Between 2019 and 2023, 3104 arterial catheters were inserted in the hospital's intensive care units. 39 reports of adverse events with these catheters were included, with an occurrence rate of 1.25% (95% confidence interval). The most prevalent incident was inadvertent loss (41%), followed by pseudoaneurysm and/or hematoma formation (25.6%), and obstruction (20.51%). Human resources (<em>p</em>-value 0.069), need for sedation (<em>p</em>-value 0.011) and insertion site (<em>p</em>-value 0.074) were factors that were associated with accidental device loss. Factors related to the patient (<em>p</em>-value 0.079) and the puncture method (<em>p</em>-value 0.079) were related to the formation of pseudoaneurysms and hematomas. Human resources (<em>p</em>-value 0.001), the use of vasoactive amines (<em>p</em>-value 0.032) and the insertion site (<em>p</em>-value 0.012) were associated with system obstruction.</div></div><div><h3>Conclusion</h3><div>The results elucidated potential weaknesses that could compromise the safety of critically ill patients using blood pressure monitoring, such as the method of puncture, circuit management and the clinical characteristics of the patients. In addition to the negative impact on patients and costs, litigation can also result from failures in healthcare safety.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 1","pages":"Article 500575"},"PeriodicalIF":1.0,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624815","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}

{"title":"Risk factors and preventive measures for corneal injury in the intensive care unit: Scoping review","authors":"Felicialle Pereira-da-Silva RN, PhD ,&nbsp;Joana Estefanny de França-Oliveira RN ,&nbsp;Raphael Alves da-Silva RN ,&nbsp;Emanuela Batista Ferreira-e-Pereira RN, PhD ,&nbsp;Maria Eduarda Ximenes-do-Rego RN ,&nbsp;Yure Rodrigues-Silva RN ,&nbsp;Beatriz Mendonça Morais-Alves RN ,&nbsp;Camilla Ribeiro Lima-de-Farias RN, PhD ,&nbsp;Isabel Cristina Ramos Vieira-Santos RN, PhD","doi":"10.1016/j.enfi.2025.500580","DOIUrl":"10.1016/j.enfi.2025.500580","url":null,"abstract":"<div><h3>Objective</h3><div>To identify the risk factors and the main preventive measures in scientific literature related to the development of corneal injury in critically ill patients.</div></div><div><h3>Methods</h3><div>This is a scoping review, with a protocol previously registered on the Open Science Framework platform. The study was guided by the methodological guidelines of the Joanna Briggs Institute and followed the PRISMA-ScR framework. The research question was developed based on the PCC strategy. The search was conducted in the LILACS, PubMed, and SciELO databases, and in the gray literature via the CAPES Periodicals portal, with no language or time restrictions. The following descriptors were used: Corneal Injuries, Patient Care, Nursing, and Intensive Care Units. Two independent reviewers, with a third reviewer involved in case of disagreements, performed Screening and selection of studies. The steps followed the methodological recommendations for scoping reviews, aiming to map evidence on risk factors and preventive measures for corneal injuries in patients hospitalized in intensive care units.</div></div><div><h3>Results</h3><div>The studies analyzed indicate that the main risk factors for the development of ophthalmological injuries are higher among critically ill patients on mechanical ventilation, those under sedation and those with a decreased level of consciousness. Simple, effective nursing interventions are essential to the prevention of corneal injuries, contributing to the maintenance of ocular integrity of the patient.</div></div><div><h3>Conclusion</h3><div>Increasing the knowledge and training of nurses concerning ophthalmological care can contribute to greater awareness of the relevance of corneal injuries in critically ill patients, which is a crucial aspect of nursing care.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 1","pages":"Article 500580"},"PeriodicalIF":1.0,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624829","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}