Enfermeria Intensiva最新文献_第5页

Evaluación de la Atrofia Muscular en la UCI: Aplicación de la Ecografía como Herramienta Diagnóstica y Pronóstica UCI中肌肉萎缩的评估：超声成像作为诊断和预防工具的应用

IF 1.1 Q3 NURSING

Enfermeria Intensiva

Pub Date : 2025-04-01 DOI: 10.1016/j.enfi.2025.500553

Bernat Planas-Pascual PT PhD , Stefania Spiliopoulou PT MSc , Gonzalo Ballesteros-Reviriego PT MSc

引用次数: 0

Asociación entre competencia del cuidador familiar y dependencia en pacientes que egresan de Unidad de Cuidado Intensivo 照顾者的责任与从重症监护病房出院的病人的依赖关系

IF 1.1 Q3 NURSING

Enfermeria Intensiva

Pub Date : 2025-03-26 DOI: 10.1016/j.enfi.2025.500540

Natalia Esquivel-Garzón RN, PhD, Dora Inés Parra RN, MSN

Objective

To determine the association between the competence (knowledge, skill and preparation) of the family caregiver and the degree of dependency of patients discharged from Intensive Care Unit.

Method

A descriptive, cross-sectional study was carried out to characterize family caregivers and patients discharged from the ICU with moderate, severe or total dependence according to Barthel score. Competence was measured with the application of the CUIDAR instrument and caregiver performance (execution of activities in a specific situation) with an instrument that evaluated the performance of actions aimed at supplying basic needs of feeding, elimination, body hygiene, skin care, oxygen therapy and medication administration in a sample of 140 caregivers.

Results

A positive association was found between patient functionality and caregiver performance (Spearman rho: 0.38; P<.001). In contrast, no significant correlation was observed between the self-perception of caregiver competence assessed with the CUIDAR instrument and the patient's functionality, measured by the Barthel scale (Spearman rho: 0.12; P=.16). The 69.3% of the participants had a medium or low competence, only (30.7%) were classified at a high level. The lowest scores were obtained in knowledge (62.9%), followed by uniqueness (32.9%).

Conclusion

There is a significant association between patient functionality and objectively assessed caregiver performance; thus, caregivers of more dependent patients have significant challenges to achieve adequate performance in their role.

目的探讨家庭护理人员的能力（知识、技能和准备）与重症监护出院患者依赖程度的关系。方法采用描述性横断面研究，根据Barthel评分对家庭照顾者和ICU出院患者进行中度、重度和完全依赖的特征分析。能力是通过应用CUIDAR仪器和护理人员表现（在特定情况下执行活动）来测量的，该仪器评估了140名护理人员在提供喂养、排泄、身体卫生、皮肤护理、氧气治疗和药物管理等基本需求方面的行动表现。结果患者功能与护理人员表现呈正相关(Spearman ρ: 0.38；术;措施)。相比之下，用CUIDAR工具评估的照顾者能力自我知觉与用Barthel量表测量的患者功能之间没有显著的相关性(Spearman ρ: 0.12；P = 16)。69.3%的被试具有中等或较低的能力，只有30.7%的被试具有较高的能力。知识得分最低（62.9%），唯一性得分次之（32.9%）。结论患者功能与客观评估的护理人员表现之间存在显著相关性；因此，更多的依赖患者的照顾者有显著的挑战，以实现充分的表现在他们的角色。

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引用次数: 0

Recovery and severity of acute kidney injury in critically ill clinical and surgical patients 临床及外科危重病人急性肾损伤的恢复及严重程度

IF 1.1 Q3 NURSING

Enfermeria Intensiva

Pub Date : 2025-03-25 DOI: 10.1016/j.enfi.2025.500545

Raquel Teles-Mesquita Graduated , Natália Vieira-Araújo-Cunha MSN , Marcia Cristina-da-Silva-Magro PhD , Kamilla Grasielle-Nunes-da-Silva MSN

Introduction

The identification of patients at risk has implications on the management of clinical and surgical patients. The severity of acute kidney injury (AKI) has a negative impact on the patient's prognosis and effects on kidney function recovery.

Objective

To determine the cases of renal recovery and level of severity of AKI in clinical and surgical patients admitted to the intensive care unit. (ICU).

Method

Prospective, observational, longitudinal, and quantitative analytical study. It was carried out in an ICU of a teaching hospital. The sample was non-probabilistic, consisting of 59 surgical and clinical patients. A structured questionnaire consisting of 38 questions subdivided into sections was used for data collection such as hospitalization data; surgery data; history of current hospitalization; hemodynamic and laboratory parameters; AKI severity. Variable analysis was based on non-parametric tests. Two-sided p values < 0.05 were considered statistically significant.

Results

The most severe AKI according to the classification KDIGO (Kidney Disease: Improving Global Outcomes) was 3 and mainly affected clinical patients (34.5%). Surgical patients predominantly developed AKI – KDIGO 2 and 3 (23.3%). The length of hospital stay (p = 0.04), and ICU stay (p = 0.001) was significant in patients who developed AKI. Renal recovery occurred predominantly in surgical patients (20.3%).

Conclusions

Clinical patients admitted to the ICU are more affected by more severe AKI (KDIGO 3). Renal recovery was observed in approximately two out of every five patients, being more significant in surgical patients.

高危患者的识别对临床和外科患者的管理具有重要意义。急性肾损伤（acute kidney injury， AKI）的严重程度对患者的预后和肾功能恢复有负面影响。目的了解重症监护病房临床及外科患者肾恢复情况及严重程度。(ICU)。方法前瞻性、观察性、纵向、定量分析研究。手术是在一所教学医院的重症监护室进行的。样本是非概率的，包括59例外科和临床患者。数据收集采用了包含38个细分问题的结构化问卷，如住院数据；手术数据;当前住院史；血流动力学和实验室参数；阿基严重性。变量分析基于非参数检验。双侧p值<；0.05认为有统计学意义。结果KDIGO （Kidney Disease: improved Global Outcomes）分类中最严重的AKI为3，主要影响临床患者（34.5%）。手术患者主要发展为AKI - KDIGO 2和3（23.3%）。在发生AKI的患者中，住院时间（p = 0.04）和ICU住院时间（p = 0.001）具有显著性。肾脏恢复主要发生在手术患者中（20.3%）。结论ICU住院患者受AKI的影响更严重（KDIGO 3）。大约每5例患者中有2例肾脏恢复，手术患者更明显。

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引用次数: 0

Percepción del paciente en relación con la valoración de la fragilidad en las unidades de cuidados intensivos: estudio fenomenológico 患者对重症监护病房脆弱性评估的看法：现象学研究

IF 1.1 Q3 NURSING

Enfermeria Intensiva

Pub Date : 2025-03-24 DOI: 10.1016/j.enfi.2025.500548

María Teresa González-Gil RN, MsC, PhD , Susana Arias-Rivera RN, MsC, PhDc

Frail patients admitted to the Intensive Care Unit (ICU) have a poorer outcome that may be related to Post ICU Syndrome, readmissions or death within a year of discharge. Assessing frailty can help guide decision-making and care planning.

Objective

To explore the perception of patients in relation to the assessment of frailty in the ICU.

Methodology

Qualitative phenomenological study through semi-structured interviews in the ICU of a public hospital of intermediate complexity. Thirteen patients with experience of admission to the ICU participated. A thematic analysis of the discourse was carried out following Braun and Clarke's proposal.

Results

Three themes and seven subthemes were identified as pivotal in describing the patients’ experience: perception of own frailty, coping styles and resources for dealing with frailty, and the value of monitoring the evolution of frailty. Participants understand frailty as opposed to strength, from a multidimensional perspective and linked to the idea of loss of capabilities. They try to deal with fragility by coping and struggling with it, drawing on intrapersonal and interpersonal resources. They place value on monitoring the evolution of frailty insofar as they feel considered and supported.

Conclusions

The patients’ narratives evidence the important repercussion that an ICU admission has on the physical and psycho-socio-emotional dimensions of patients and caregivers. The assessment of frailty and the monitoring of its evolution at discharge is valued as important to be able to adapt care and significant as a facilitator of emotional support. There is a clear need for support at discharge in the different spheres and for accompanying the patient throughout their recovery to enable an early return to their life prior to admission.

入住重症监护室（ICU）的体弱患者预后较差，可能与ICU后综合征、出院后一年内再入院或死亡有关。评估虚弱可以帮助指导决策和护理计划。目的探讨重症监护病房患者对虚弱评估的看法。方法：采用半结构化访谈法对某中等复杂性公立医院ICU进行定性现象学研究。13例有ICU住院经验的患者参与。根据Braun和Clarke的建议，对话语进行了主题分析。结果发现三个主题和七个子主题是描述患者体验的关键：对自身脆弱的感知，应对方式和处理脆弱的资源，以及监测脆弱演变的价值。参与者从多维角度理解脆弱，而不是力量，并将其与丧失能力的想法联系起来。他们试图通过应对和挣扎来处理脆弱，利用个人和人际资源。他们重视监控脆弱的演变，因为他们感到被考虑和支持。结论患者的叙述证明了ICU住院对患者和护理人员的身体和心理社会情感维度的重要影响。对衰弱的评估和出院时对其演变的监测对于能够适应护理和作为情感支持的推动者具有重要意义。出院时显然需要不同领域的支持，并在整个康复过程中陪伴患者，以便在入院前早日恢复生活。

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引用次数: 0

Satisfacción laboral e intención de abandono de la unidad de cuidados intensivos de las enfermeras 护士重症监护病房的工作满意度和离职意向

IF 1.1 Q3 NURSING

Enfermeria Intensiva

Pub Date : 2025-03-24 DOI: 10.1016/j.enfi.2025.500537

Marta Santana-Martín RN , José Manuel López-Álvarez MD, PhD , Yeray Gabriel Santana-Padilla RN, MSN, PhD , Luciano Santana-Cabrera MD, PhD , Borja Nicolás Santana-López RN, MSN, PhD

Introduction

Nurse turnover increases the shortfall in coverage of different health services. Research studies have found high quitting intention rates related to low levels of job satisfaction among nurses in different areas, including intensive care units (ICU). The aim of this study was to compare the level of job satisfaction of ICU nurses according to the population of critically ill patients they care for (paediatric vs. adult) and their intention to leave the ICU.

Method

A cross-sectional descriptive study in which nurses from public ICUs on the island of Gran Canaria, 2 adult units and one paediatric unit, participated. An electronic questionnaire was sent out, which included questions on socio-demographic and occupational variables, the validated Font Roja job satisfaction survey and a final question on the participant's own intention to leave. Comparative analysis was performed using Chi-square for qualitative variables and Mann-Whitney U for quantitative variables.

Results

A total of 152 nurses were recruited, 55.9% of whom expressed their intention to leave the ICU. Although both types of units had a higher number of nurses who wanted to leave the ICU, there was a higher proportion in the paediatric ICU who had this intention in the short period of time (30.4 vs. 7.0%) (χ² = 11.691; p = 0.003). Job satisfaction was generally good (3.37/5), being lower among those who did intend to leave (3.97 vs. 2.91; p < 0.001).

Conclusions

There is a high intention to leave among the professionals consulted. Paediatric ICU nurses had the highest intention to leave the ICU in the short term (< 6 months). An inverse relationship was found between intention to leave and job satisfaction.

护士的更替增加了不同保健服务覆盖面的不足。研究发现，在包括重症监护室（ICU）在内的不同领域，护士的高辞职意愿率与低工作满意度相关。本研究的目的是比较ICU护士的工作满意度水平，根据他们所照顾的危重病人（儿科与成人）和他们离开ICU的意愿。方法对大加那利岛2个成人病房和1个儿科病房的公立icu护士进行横断面描述性研究。发送了一份电子问卷，其中包括有关社会人口统计和职业变量的问题，经过验证的Font Roja工作满意度调查以及关于参与者自己离职意图的最后一个问题。定性变量采用卡方比较分析，定量变量采用Mann-Whitney U比较分析。结果共招募护士152人，其中55.9%的护士表示愿意离开ICU。虽然这两种类型的病房都有更多的护士想要离开ICU，但儿科ICU在短时间内有这一意向的比例更高（30.4% vs. 7.0%） (χ2 = 11.691；p = 0.003)。总体而言，工作满意度较好（3.37/5），打算离职的员工满意度较低(3.97对2.91；p & lt;0.001)。结论受访专业人员的离职意向较高。儿科ICU护士短期内离开ICU的意向最高(<；6个月)。离职意向与工作满意度呈负相关。

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引用次数: 0

Trabajo en equipo a través del programa de entrenamiento basado en TeamSTEPPS® mediante una experiencia de escape room: una investigación mixta 通过基于TeamSTEPPS®的逃生室体验培训计划进行协作：一项混合研究

IF 1.1 Q3 NURSING

Enfermeria Intensiva

Pub Date : 2025-03-24 DOI: 10.1016/j.enfi.2025.500536

Oscar Arrogante RN, Psy, MSc, PhD , Marta Raurell-Torredà RN, MSN, PhD , Elena Maestre-González RN, MsC , Francisco Javier Sánchez-Chillón RN, MSN , Martín Torralba-Melero RN, MSN , Anna Maria Aliberch-Raurell RN, MSN , Andrés Rojo-Rojo RN, PhD , Ignacio Zaragoza-García RN, PhD

Introduction

The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS®) program has been shown to improve teamwork among critical care professionals. The escape room as an educational strategy is effective for the learning process of professionals according to recent evidence.

Objectives

To analyze the degree of satisfaction and explore the perceptions of intensive care nurses after an escape room experience based on the TeamSTEPPS® program.

Methods

Cross-sectional descriptive and phenomenological study using a mixed methodology. A specific and adapted satisfaction survey was applied to the participants of the escape room, including at the end an open-ended question for them to make comments and thus analyze their perceptions of the experience. A thematic content analysis of the comments was carried out using the interpretative paradigm. Quantitative and qualitative data were analyzed using IBM® SPSS® Statistics 29.0 and ATLAS.ti 24™ respectively.

Results

Fifty-five nursing professionals from different intensive care units in Spain participated, with a median age of 34 years (RIC = 12) and 9 years of experience in intensive care (RIC = 11), most of them being women (89.1%). The participants expressed high overall satisfaction with the activity, with a median of 47 points out of 50 (RIC = 4). Three main categories with their respective subcategories emerged from their comments: learning through the escape room (learning new tools; fun way to learn); usefulness of TeamSTEPPS® strategies (communication skills, patient safety and teamwork); implementation in clinical practice (applicable strategies and ease of implementation).

Conclusions

The escape room can be a dynamic, interactive, engaging, and fun way to promote teamwork training and education in intensive care nurses through the TeamSTEPPS® training program.

提高绩效和患者安全的团队策略和工具（TeamSTEPPS®）计划已被证明可以改善重症监护专业人员之间的团队合作。根据最近的证据，密室逃生作为一种教育策略对专业人员的学习过程是有效的。目的分析重症监护护士在TeamSTEPPS®密室逃生体验后的满意度，并探讨其感知。方法采用混合方法进行横断面描述性和现象学研究。对密室逃生的参与者进行了一项具体的、适应性的满意度调查，包括在最后提出一个开放式问题，让他们发表评论，从而分析他们对这次经历的看法。运用解释性范式对评语进行了主题内容分析。采用IBM®SPSS®Statistics 29.0和ATLAS对定量和定性数据进行分析。Ti 24™。结果55名来自西班牙不同重症监护病房的专业护理人员参与调查，年龄中位数34岁（RIC = 12），有9年重症监护经验（RIC = 11），以女性居多（89.1%）。参与者对活动表达了很高的总体满意度，中位数为47分（总分为50分）（RIC = 4）。从他们的评论中出现了三个主要类别及其各自的子类别：通过密室学习(学习新工具；有趣的学习方式)；TeamSTEPPS®策略的有效性（沟通技巧、患者安全和团队合作）；临床实践中的实施（适用策略和实施的便利性）。通过TeamSTEPPS®培训项目，逃生室可以成为一种动态的、互动的、吸引人的、有趣的方式来促进重症监护护士的团队合作培训和教育。

{"title":"Trabajo en equipo a través del programa de entrenamiento basado en TeamSTEPPS® mediante una experiencia de escape room: una investigación mixta","authors":"Oscar Arrogante RN, Psy, MSc, PhD , Marta Raurell-Torredà RN, MSN, PhD , Elena Maestre-González RN, MsC , Francisco Javier Sánchez-Chillón RN, MSN , Martín Torralba-Melero RN, MSN , Anna Maria Aliberch-Raurell RN, MSN , Andrés Rojo-Rojo RN, PhD , Ignacio Zaragoza-García RN, PhD","doi":"10.1016/j.enfi.2025.500536","DOIUrl":"10.1016/j.enfi.2025.500536","url":null,"abstract":"<div><h3>Introduction</h3><div>The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS®) program has been shown to improve teamwork among critical care professionals. The <em>escape</em> room as an educational strategy is effective for the learning process of professionals according to recent evidence.</div></div><div><h3>Objectives</h3><div>To analyze the degree of satisfaction and explore the perceptions of intensive care nurses after an <em>escape</em> room experience based on the TeamSTEPPS® program.</div></div><div><h3>Methods</h3><div>Cross-sectional descriptive and phenomenological study using a mixed methodology. A specific and adapted satisfaction survey was applied to the participants of the <em>escape</em> room, including at the end an open-ended question for them to make comments and thus analyze their perceptions of the experience. A thematic content analysis of the comments was carried out using the interpretative paradigm. Quantitative and qualitative data were analyzed using IBM® SPSS® Statistics 29.0 and ATLAS.ti 24™ respectively.</div></div><div><h3>Results</h3><div>Fifty-five nursing professionals from different intensive care units in Spain participated, with a median age of 34 years (RIC = 12) and 9 years of experience in intensive care (RIC = 11), most of them being women (89.1%). The participants expressed high overall satisfaction with the activity, with a median of 47 points out of 50 (RIC = 4). Three main categories with their respective subcategories emerged from their comments: learning through the <em>escape</em> room (learning new tools; fun way to learn); usefulness of TeamSTEPPS® strategies (communication skills, patient safety and teamwork); implementation in clinical practice (applicable strategies and ease of implementation).</div></div><div><h3>Conclusions</h3><div>The <em>escape</em> room can be a dynamic, interactive, engaging, and fun way to promote teamwork training and education in intensive care nurses through the TeamSTEPPS® training program.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 2","pages":"Article 500536"},"PeriodicalIF":1.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680620","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}

引用次数: 0

Caracterización del perfil profesional y condiciones laborales de personal de enfermería en unidades de cuidado intensivo 对重症监护病房护士的专业情况和工作条件进行描述

IF 1.1 Q3 NURSING

Enfermeria Intensiva

Pub Date : 2025-03-24 DOI: 10.1016/j.enfi.2025.500525

Diana Marcela Achury-Saldaña (MSN) , Luisa Fernanda Achury-Beltrán (MSN) , Sandra M. Rodríguez-Colmenares (MSN) , Herly Ruth Alvarado-Romero (MSN) , Martha Consuelo Romero-Torres (RN) , Diana Lucero Pardo-Camacho (RN) , María Teresa Diaz-Muñoz (RN) , Marcela Moran-Vargas (RN) , Janeth Daza-Ramírez (RN) , David Andradre-Fonseca (MSN)

Introduction

The development of political and academic actions aimed at increasing the quality of care and the outcomes of health care requires knowledge of the conditions of the nursing workforce in intensive care units.

Aim

To characterize the professional profile and working conditions of Intensive Care Unit nurses in Colombia.

Methods

Multicenter, cross-sectional observational study. A total of 433 Intensive Care Unit nurses in Colombia participated, the information was collected through an online survey. The information was analyzed with RStudio statistical software. Descriptive statistics were used for the presentation of results.

Results

79.4% of the nursing professionals were women with a mean age of 35.6 (± 9,6) years. A total of 63.9% worked in private adult Intensive Care Units and only 22.4% had a degree in Critical Care. The competencies that are permanently applied are care management, problem solving and communication; however, those related to teamwork and personal development are not fully developed. Regarding working conditions, it was found that: 71.6% have a nurse-patient ratio of 1:6 or more; only 47.5% have an indefinite term contract; 62% work have a salary remuneration of 3.5 minimum wages and only 23,5% are satisfied with their work.

Conclusion

The profile of nurses shows the need to strengthen specialized training, while skills and working conditions must be improved to guarantee quality care and the well-being of staff.

旨在提高护理质量和保健效果的政治和学术行动的发展需要了解重症监护室护理人员的条件。目的了解哥伦比亚重症监护室护士的专业概况和工作条件。方法采用多中心、横断面观察研究。哥伦比亚共有433名重症监护室护士参与，信息通过在线调查收集。使用RStudio统计软件对信息进行分析。结果79.4%的护理专业人员为女性，平均年龄35.6（±9.6）岁。共有63.9%的人在私立成人重症监护病房工作，只有22.4%的人拥有重症监护学位。永久应用的能力是护理管理，解决问题和沟通；然而，那些与团队合作和个人发展相关的技能并没有得到充分的发展。关于工作条件，调查发现：71.6%的护士与病人的比例为1:6或更高；只有47.5%的人签订无限期合同；62%的人的工资报酬是最低工资的3.5倍，只有23.5%的人对自己的工作感到满意。结论护理人员的素质状况表明，需要加强专业培训，改善技能和工作条件，以保证护理质量和工作人员的福祉。

{"title":"Caracterización del perfil profesional y condiciones laborales de personal de enfermería en unidades de cuidado intensivo","authors":"Diana Marcela Achury-Saldaña (MSN) , Luisa Fernanda Achury-Beltrán (MSN) , Sandra M. Rodríguez-Colmenares (MSN) , Herly Ruth Alvarado-Romero (MSN) , Martha Consuelo Romero-Torres (RN) , Diana Lucero Pardo-Camacho (RN) , María Teresa Diaz-Muñoz (RN) , Marcela Moran-Vargas (RN) , Janeth Daza-Ramírez (RN) , David Andradre-Fonseca (MSN)","doi":"10.1016/j.enfi.2025.500525","DOIUrl":"10.1016/j.enfi.2025.500525","url":null,"abstract":"<div><h3>Introduction</h3><div>The development of political and academic actions aimed at increasing the quality of care and the outcomes of health care requires knowledge of the conditions of the nursing workforce in intensive care units.</div></div><div><h3>Aim</h3><div>To characterize the professional profile and working conditions of Intensive Care Unit nurses in Colombia.</div></div><div><h3>Methods</h3><div>Multicenter, cross-sectional observational study. A total of 433 Intensive Care Unit nurses in Colombia participated, the information was collected through an online survey. The information was analyzed with RStudio statistical software. Descriptive statistics were used for the presentation of results.</div></div><div><h3>Results</h3><div>79.4% of the nursing professionals were women with a mean age of 35.6 (±9,6) years. A total of 63.9% worked in private adult Intensive Care Units and only 22.4% had a degree in Critical Care. The competencies that are permanently applied are care management, problem solving and communication; however, those related to teamwork and personal development are not fully developed. Regarding working conditions, it was found that: 71.6% have a nurse-patient ratio of 1:6 or more; only 47.5% have an indefinite term contract; 62% work have a salary remuneration of 3.5 minimum wages and only 23,5% are satisfied with their work.</div></div><div><h3>Conclusion</h3><div>The profile of nurses shows the need to strengthen specialized training, while skills and working conditions must be improved to guarantee quality care and the well-being of staff.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 2","pages":"Article 500525"},"PeriodicalIF":1.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680617","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}

引用次数: 0

Nursing diagnoses for patients hospitalized with COVID-19 in critical care units in Brazil: A cross-sectional study 巴西重症监护病房COVID-19住院患者的护理诊断：一项横断面研究

IF 1.1 Q3 NURSING

Enfermeria Intensiva

Pub Date : 2025-03-24 DOI: 10.1016/j.enfi.2025.500541

Giovanna Maria de Lima-Medeiros RN , Caio Rodrigo Menezes-dos-Santos RN , Thiago de Jesus-Santos MSN , Edilza Fraga-Santos RN , Andreia Centenaro-Vaez PhD , Fernanda Gomes de Magalhães Soares-Pinheiro PhD , Damião da Conceição-Araújo PhD

Background

The COVID-19 pandemic had a significant global impact, particularly on patients hospitalized in critical care units. Studies addressing nursing diagnoses in the context of the pandemic are essential to strengthen the evidence and contribute to the development of clinical practice.

Objective

Analyze the prevalence of nursing diagnoses in hospitalizations of critically ill adult patients with COVID-19 in northeastern Brazil.

Method

This is a cross-sectional study conducted in a university hospital in northeastern Brazil. The sample included 117 hospitalizations between 2020 and 2021. Data were retrospectively collected from electronic medical records and analyzed using absolute frequencies, percentages, and bivariate and multivariate analyses.

Results

The results revealed a predominance of nursing diagnoses such as risk for falls in adults (95.7%), risk for infection (94%), and bathing self-care deficit (89.7%). Patients on mechanical ventilation had higher prevalence rates of imbalanced nutrition, diarrhea and impaired physical mobility.

Conclusions

The prevalence of nursing diagnoses in critically ill COVID-19 patients highlights the complexity of care required and the importance of evidence-based practice to improve clinical outcomes.

2019冠状病毒病大流行对全球产生了重大影响，特别是对重症监护病房住院患者。针对大流行背景下护理诊断的研究对于加强证据和促进临床实践的发展至关重要。目的分析巴西东北部地区成人COVID-19危重患者住院护理诊断情况。方法在巴西东北部一所大学医院进行横断面研究。样本包括2020年至2021年期间的117例住院治疗。回顾性地从电子病历中收集数据，并使用绝对频率、百分比、双变量和多变量分析进行分析。结果成人跌倒风险（95.7%）、感染风险（94%）、洗澡自理能力不足（89.7%）等护理诊断占主导地位。机械通气患者营养失衡、腹泻和身体活动能力受损的发生率较高。结论COVID-19危重症患者护理诊断的流行凸显了护理需求的复杂性以及循证实践对改善临床结果的重要性。

{"title":"Nursing diagnoses for patients hospitalized with COVID-19 in critical care units in Brazil: A cross-sectional study","authors":"Giovanna Maria de Lima-Medeiros RN , Caio Rodrigo Menezes-dos-Santos RN , Thiago de Jesus-Santos MSN , Edilza Fraga-Santos RN , Andreia Centenaro-Vaez PhD , Fernanda Gomes de Magalhães Soares-Pinheiro PhD , Damião da Conceição-Araújo PhD","doi":"10.1016/j.enfi.2025.500541","DOIUrl":"10.1016/j.enfi.2025.500541","url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 pandemic had a significant global impact, particularly on patients hospitalized in critical care units. Studies addressing nursing diagnoses in the context of the pandemic are essential to strengthen the evidence and contribute to the development of clinical practice.</div></div><div><h3>Objective</h3><div>Analyze the prevalence of nursing diagnoses in hospitalizations of critically ill adult patients with COVID-19 in northeastern Brazil.</div></div><div><h3>Method</h3><div>This is a cross-sectional study conducted in a university hospital in northeastern Brazil. The sample included 117 hospitalizations between 2020 and 2021. Data were retrospectively collected from electronic medical records and analyzed using absolute frequencies, percentages, and bivariate and multivariate analyses.</div></div><div><h3>Results</h3><div>The results revealed a predominance of nursing diagnoses such as risk for falls in adults (95.7%), risk for infection (94%), and bathing self-care deficit (89.7%). Patients on mechanical ventilation had higher prevalence rates of imbalanced nutrition, diarrhea and impaired physical mobility.</div></div><div><h3>Conclusions</h3><div>The prevalence of nursing diagnoses in critically ill COVID-19 patients highlights the complexity of care required and the importance of evidence-based practice to improve clinical outcomes.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 2","pages":"Article 500541"},"PeriodicalIF":1.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680618","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}

引用次数: 0

Moral distress in critical care nurses caring for patients undergoing ECMO: A cross-sectional study 重症监护护士在ECMO患者护理中的道德困扰：一项横断面研究

IF 1.1 Q3 NURSING

Enfermeria Intensiva

Pub Date : 2025-03-17 DOI: 10.1016/j.enfi.2025.500533

Elisangela da-Conceição-Jorge RN , João Paulo-Vitorino RN , Donna M-Wilson RN, PhD , Filipe Utuari-de-Andrade-Coelho RN, PhD

Background

Extracorporeal membrane oxygenation (ECMO) is commonly used now in cases of refractory cardiac and pulmonary failure. Moral distress among nurses is often present; nevertheless, the literature regarding this topic is scarce.

Objective

To identify the level of moral distress among nurses providing direct care to patients undergoing ECMO by applying the Moral Distress Scale Revised (MDSR).

Method

This is a cross-sectional study conducted in an Adult Intensive Care Unit (ICU) in Brazil, involving nurses providing direct care to patients undergoing ECMO. Data on nurse sociodemographic and professional characteristics were collected, along with MDSR data and Moral Distress Index (MDI).

Results

A total of 30 nurses were included, of whom 80.0% were female, with an age of 32 (27.7–38.2) years, professional experience time of 5 (3.0–11.2) years, duration of direct support care experience of 2.5 (1.4–4.0) years, and 83.3% had completed an institutional ECMO course. The questions in the MDRS with the highest mean scores which indicate moral distress were 3 (8.57 ± 4.83), 6 (7.20 ± 4.73), 16 (6.10 ± 6.13), 2 (5.87 ± 4.39) and 7 (5.77 ± 4.26), with these collectively resulting in a mean MDI of 70.7 ± 48.02, indicating a significant intensity and frequency of moral distress experienced by the research participants.

Conclusion

Moral distress for nursing professionals caring for ECMO patients appears to be linked to the need for ongoing questioning, discussions, and reflections among the working teams. The greatest intensity and frequency of moral distress were attributed to adhering to the family's wishes to sustain life even when it might not be in the best interest of the patient. The study highlights the importance of developing educational programs to identify and mitigate the presence of moral distress and its triggering factors in critical care teams, aiming to reduce its impact over time.

背景体外膜肺氧合（ECMO）目前常用于难治性心肺功能衰竭病例。方法这是一项横断面研究，在巴西的一家成人重症监护病房（ICU）进行，研究对象是为 ECMO 患者提供直接护理的护士。结果共纳入 30 名护士，其中 80.0% 为女性，年龄为 32（27.7-38.2）岁，专业经验时间为 5（3.0-11.2）年，直接支持护理经验时间为 2.5（1.4-4.0）年，83.3% 的护士完成了机构 ECMO 课程。在 MDRS 中，表示道德困扰的平均分最高的问题分别为 3（8.57 ± 4.83）、6（7.20 ± 4.73）、16（6.10 ± 6.13）、2（5.87 ± 4.39）和 7（5.77 ± 4.26），这些问题合计的平均 MDI 为 70.7 ± 48.02，表明道德困扰的强度和频率非常高。结论：护理 ECMO 患者的护理专业人员的精神压力似乎与工作团队中不断提问、讨论和反思的需要有关。最大程度和最频繁的道德困扰归因于遵从家属的意愿维持生命，即使这可能不符合患者的最佳利益。这项研究强调了制定教育计划的重要性，以识别和减轻危重症护理团队中存在的道德困扰及其诱发因素，从而随着时间的推移减少其影响。

{"title":"Moral distress in critical care nurses caring for patients undergoing ECMO: A cross-sectional study","authors":"Elisangela da-Conceição-Jorge RN , João Paulo-Vitorino RN , Donna M-Wilson RN, PhD , Filipe Utuari-de-Andrade-Coelho RN, PhD","doi":"10.1016/j.enfi.2025.500533","DOIUrl":"10.1016/j.enfi.2025.500533","url":null,"abstract":"<div><h3>Background</h3><div>Extracorporeal membrane oxygenation (ECMO) is commonly used now in cases of refractory cardiac and pulmonary failure. Moral distress among nurses is often present; nevertheless, the literature regarding this topic is scarce.</div></div><div><h3>Objective</h3><div>To identify the level of moral distress among nurses providing direct care to patients undergoing ECMO by applying the Moral Distress Scale Revised (MDSR).</div></div><div><h3>Method</h3><div>This is a cross-sectional study conducted in an Adult Intensive Care Unit (ICU) in Brazil, involving nurses providing direct care to patients undergoing ECMO. Data on nurse sociodemographic and professional characteristics were collected, along with MDSR data and Moral Distress Index (MDI).</div></div><div><h3>Results</h3><div>A total of 30 nurses were included, of whom 80.0% were female, with an age of 32 (27.7–38.2) years, professional experience time of 5 (3.0–11.2) years, duration of direct support care experience of 2.5 (1.4–4.0) years, and 83.3% had completed an institutional ECMO course. The questions in the MDRS with the highest mean scores which indicate moral distress were 3 (8.57±4.83), 6 (7.20±4.73), 16 (6.10±6.13), 2 (5.87±4.39) and 7 (5.77±4.26), with these collectively resulting in a mean MDI of 70.7±48.02, indicating a significant intensity and frequency of moral distress experienced by the research participants.</div></div><div><h3>Conclusion</h3><div>Moral distress for nursing professionals caring for ECMO patients appears to be linked to the need for ongoing questioning, discussions, and reflections among the working teams. The greatest intensity and frequency of moral distress were attributed to adhering to the family's wishes to sustain life even when it might not be in the best interest of the patient. The study highlights the importance of developing educational programs to identify and mitigate the presence of moral distress and its triggering factors in critical care teams, aiming to reduce its impact over time.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 2","pages":"Article 500533"},"PeriodicalIF":1.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143636510","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}

引用次数: 0

Enfermeras de unidades de cuidados intensivos y formación en donación y trasplantes a adolescentes. Revisión de alcance 来自重症监护室和青少年移植和捐赠培训单位的护士。范围审查

IF 1.1 Q3 NURSING

Enfermeria Intensiva

Pub Date : 2025-03-03 DOI: 10.1016/j.enfi.2025.500532

Meritxell Comas-Carrillo RN, MSN, PhDc , Ignacio Zaragoza-García RN, MSN, PhD , Concepción Campos-Asensio BPharm, MLS , Marta Raurell-Torredà RN, MSN, PhD

Background

The attitude and practice of intensive care unit nurses are crucial for organ donation and transplantation (OTD), for the time and communication they share with family members. Therefore, they can be excellent educators of adolescents, contributing to encourage the authorization of donation among those who represent the future of the community.

Objective

To describe teaching methodologies in DTO for adolescents and analyze their influence on attitudes, beliefs, knowledge and predisposition towards donation.

Methods

Scoping review using Medline, Cochrane Library, Embase, CINAHL, and ERIC, between January 2022 and June 2023. No time or language limits were applied. Two independent investigators reviewed titles, abstracts, and full text according to inclusion and exclusion criteria.

Results

We analyzed 829 abstracts from databases and 50 from citation searches, gray literature and the National Transplant Organization website. A total of 16 articles were selected. The pre-intervention educational knowledge questionnaires showed no significant differences between groups in terms of knowledge and opinions on OTD, but post-intervention, different authors agreed on an improvement in knowledge, linked to less rejection of OTD and promoting a favorable attitude towards donation. None of the experts who gave the training were ICU nurses; only one was a transplant coordinator, but she did not indicate a care unit. In the interventions that had used some technological support (video, presentation, web, etc.), the results seem more favorable compared to traditional educational programs (50 vs. 14%).

Conclusions

Fifteen teaching programmes have been found to have favourable results on attitudes, beliefs, knowledge and willingness to donate. However, no validated instrument was used to measure these changes. The use of technology is related to better outcomes. No ICU nurses have been identified as trainers.

重症监护病房护士的态度和做法对器官捐献和移植（OTD）至关重要，因为他们与家庭成员分享的时间和沟通。因此，他们可以成为优秀的青少年教育者，有助于鼓励那些代表社区未来的人授权捐赠。目的探讨青少年捐赠教育的教学方法，分析其对青少年捐赠态度、信念、知识和倾向的影响。方法在2022年1月至2023年6月期间，使用Medline、Cochrane Library、Embase、CINAHL和ERIC进行范围评价。没有时间和语言的限制。两名独立研究者根据纳入和排除标准审查了标题、摘要和全文。结果我们分析了来自数据库的829篇摘要，以及来自引文检索、灰色文献和国家移植组织网站的50篇摘要。共有16篇文章入选。在干预前的教育知识问卷调查中，各组之间对外行手术的知识和看法没有显著差异，但在干预后，不同的作者都认为知识有所提高，这与减少对外行手术的排斥和促进对捐赠的积极态度有关。进行培训的专家都不是ICU护士；只有一个人是移植协调员，但她没有指明是在护理病房。在使用了一些技术支持（视频、演示、网络等）的干预措施中，结果似乎比传统教育计划更有利（50%对14%）。结论15个教学项目在态度、信念、知识和捐赠意愿方面取得了良好的效果。然而，没有有效的仪器被用来测量这些变化。技术的使用与更好的结果有关。没有ICU护士被确定为培训师。

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