Pub Date : 2024-08-29DOI: 10.1016/j.enfi.2024.05.002
M. Acevedo-Nuevo RN, MsC, PhD , T. Velasco-Sanz RN, MsC, PhD , B. Del Olmo-Somolinos RN, MsC , G. Via-Clavero RN, MsC, PhD
Physical restraint use is a common practice in Intensive Care Units. However, despite this high prevalence, it is a practice full of adverse effects, with uncertain effectiveness in preventing self-removal devices and that raises numerous ethical conflicts. Current recommendations suggest restraints should be a last resort measure, they should not be prolonged beyond what is strictly necessary and that they should only be used if, in the interprofessional assessment of benefits-risks for the patient, benefits greatly outweigh harms. This manuscript aims to serve as a guide for decision-making from an ethical perspective on the use or non-use of physical restraints in critically ill patients. Likewise, a review of the legal and deontological framework that governs restraint use in our country is proposed. Finally, recommendations for practice are offered, both for healthcare professionals and healthcare managers, upon the construction of restraints-free Intensive Care Units and good practices in the exceptional cases they are necessary.
{"title":"Consideraciones ético-legales y recomendaciones de actuación en el uso de contenciones mecánicas en pacientes críticos","authors":"M. Acevedo-Nuevo RN, MsC, PhD , T. Velasco-Sanz RN, MsC, PhD , B. Del Olmo-Somolinos RN, MsC , G. Via-Clavero RN, MsC, PhD","doi":"10.1016/j.enfi.2024.05.002","DOIUrl":"10.1016/j.enfi.2024.05.002","url":null,"abstract":"<div><div>Physical restraint use is a common practice in Intensive Care Units. However, despite this high prevalence, it is a practice full of adverse effects, with uncertain effectiveness in preventing self-removal devices and that raises numerous ethical conflicts. Current recommendations suggest restraints should be a last resort measure, they should not be prolonged beyond what is strictly necessary and that they should only be used if, in the interprofessional assessment of benefits-risks for the patient, benefits greatly outweigh harms. This manuscript aims to serve as a guide for decision-making from an ethical perspective on the use or non-use of physical restraints in critically ill patients. Likewise, a review of the legal and deontological framework that governs restraint use in our country is proposed. Finally, recommendations for practice are offered, both for healthcare professionals and healthcare managers, upon the construction of restraints-free Intensive Care Units and good practices in the exceptional cases they are necessary.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 2","pages":"Article 100497"},"PeriodicalIF":1.1,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143403046","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}
One in every three critically ill patients who receive prolonged analgosedation may experience difficult sedation, negatively influencing their evolution and prognosis. Difficult sedation includes situations of therapeutic failure, tolerance or deprivation of analgesic and sedative drugs. Its origin is multifactorial and depends on the patient's characteristics, history of drug consumption, critical condition and the administration of drugs that alter the pharmacokinetics of the sedatives used. This update aims to describe the definition of difficult sedation, identify the group of critically ill sedated patients who can develop it, its etiology, and how it should be treated and managed. The difficulty in achieving an adequate level of sedation, increasing the dose of sedatives or adding new agents represents a challenge in daily practice in critical care units since it can increase the risks of toxicity and related complications. Prevention and early identification of difficult sedation situations are essential strategies to minimize their impact; hence nurses’ autonomy in the management of analgosedation represents a primary intervention.
{"title":"Manejo del paciente crítico con sedación difícil: actualización y estrategias clínicas","authors":"Diana Gil-Castillejos RN, MSN, PhD , Aaron Castanera-Duro RN, MSN, PhD , Gemma Via-Clavero RN, MSN, PhD , Alberto Sandiumenge-Camps MD, PhD","doi":"10.1016/j.enfi.2024.05.005","DOIUrl":"10.1016/j.enfi.2024.05.005","url":null,"abstract":"<div><div>One in every three critically ill patients who receive prolonged analgosedation may experience difficult sedation, negatively influencing their evolution and prognosis. Difficult sedation includes situations of therapeutic failure, tolerance or deprivation of analgesic and sedative drugs. Its origin is multifactorial and depends on the patient's characteristics, history of drug consumption, critical condition and the administration of drugs that alter the pharmacokinetics of the sedatives used. This update aims to describe the definition of difficult sedation, identify the group of critically ill sedated patients who can develop it, its etiology, and how it should be treated and managed. The difficulty in achieving an adequate level of sedation, increasing the dose of sedatives or adding new agents represents a challenge in daily practice in critical care units since it can increase the risks of toxicity and related complications. Prevention and early identification of difficult sedation situations are essential strategies to minimize their impact; hence nurses’ autonomy in the management of analgosedation represents a primary intervention.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 2","pages":"Article 100500"},"PeriodicalIF":1.1,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143444954","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 : 2024-07-20DOI: 10.1016/j.enfi.2024.05.004
Olga Vallés-Fructuoso RN, MSc, PhD , Juan José Rodríguez-Mondéjar RN, MSc, PhD , David Alonso-Crespo RN, MSc , Gemma Robleda-Font RN, MSc, PhD , Candelas López-López RN, MSc, PhD , Diana Gil-Castillejos RN, MSc, PhD , María Acevedo-Nuevo RN, MSc, PhD
In intensive care units, due to critical illness nature and environment special characteristics, it is relatively common for admitted patients to develop acute confusional syndrome (ACS) or delirium. The nurse's duties are to carry out interventions that reduce the presentation of this process, which is still an important complication as it is related to longer periods of mechanical ventilation, longer ICU and hospital stays, higher mortality; both in-hospital and after discharge and grater long term cognitive dysfunction. Therefore, nurses participation is essential to prevent and treat delirium, and more specifically in the autonomous part with non-pharmacological measures such as pain control, avoid under or oversedation, promoting restful sleep and facilitating family support among other measures. The objective is to carry out an update that describes 10 key points focused on the tools for detecting/monitoring delirium and non-pharmacological measures for its prevention and treatment. Based on the review of the literature, the 10 most common interventions are described to serve as an action plan to be included in the care plans of patients affected with delirium, providing quality care to prevent and/or treat delirium in critical patients.
{"title":"Diez puntos clave para la prevención, monitorización y tratamiento no farmacológico del delirio en el paciente crítico","authors":"Olga Vallés-Fructuoso RN, MSc, PhD , Juan José Rodríguez-Mondéjar RN, MSc, PhD , David Alonso-Crespo RN, MSc , Gemma Robleda-Font RN, MSc, PhD , Candelas López-López RN, MSc, PhD , Diana Gil-Castillejos RN, MSc, PhD , María Acevedo-Nuevo RN, MSc, PhD","doi":"10.1016/j.enfi.2024.05.004","DOIUrl":"10.1016/j.enfi.2024.05.004","url":null,"abstract":"<div><div>In intensive care units, due to critical illness nature and environment special characteristics, it is relatively common for admitted patients to develop acute confusional syndrome (ACS) or delirium. The nurse's duties are to carry out interventions that reduce the presentation of this process, which is still an important complication as it is related to longer periods of mechanical ventilation, longer ICU and hospital stays, higher mortality; both in-hospital and after discharge and grater long term cognitive dysfunction. Therefore, nurses participation is essential to prevent and treat delirium, and more specifically in the autonomous part with non-pharmacological measures such as pain control, avoid under or oversedation, promoting restful sleep and facilitating family support among other measures. The objective is to carry out an update that describes 10 key points focused on the tools for detecting/monitoring delirium and non-pharmacological measures for its prevention and treatment. Based on the review of the literature, the 10 most common interventions are described to serve as an action plan to be included in the care plans of patients affected with delirium, providing quality care to prevent and/or treat delirium in critical patients.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 2","pages":"Article 100499"},"PeriodicalIF":1.1,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141842642","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 : 2024-07-01DOI: 10.1016/j.enfi.2023.06.001
Introduction
Adjusting human resources to intensive care units (ICU) workload is essential. The development of software for estimating nursing workload using mobile devices (smartphone, smartwatch and/or tablets) could be a useful tool and complement and/or improve the measurements made with the Nursing Activities Score (NAS), a validated scale.
Objectives
To analyze the validity of devices and mobile applications for estimating ICU nurses’ workloads and their comparison with NAS.
Methodology
Systematised literature review from 2009 to 2021 informed by flowchart PRISMA-2020 and its extension PRISMA-S. Critical reading (CASPe). Steps: elaboration of the research question, concept identification (English and Spanish natural language and descriptors MesH, Emtree and CINAHL Headings), search strategy and data collection in MEDlars online (MEDLINE), Ovid, Excerpta Medica dataBASE (EMBASE), Elsevier, Cumulative Index to Nursing & Allied Health Literature (CINAHL), EBSCO and Web of Science (WoS); data extraction and evaluation, analysis and synthesis of results. We included studies with abstracts published in English and Spanish conducted in ICU with workload measurement (preferably NAS) using mobile devices.
Results
223 studies of which 84 in MEDLINE, 50 in CINAHL, 48 in EMBASE, 33 in WoS and 8 in other sources. 117 were eligible for screening, of which 95 did not meet the inclusion criteria. 22 studies were screened for eligibility, of which 17 were excluded. Five articles were selected for final review. None of the studies provided results on costs, acceptance testing, validity, reliability, system problems, advantages, disadvantages or resource estimation.
Discussion and conclusions
The use of mobile devices and applications to measure ICU workloads is not yet validated and has not been shown to be more accurate than traditional NAS assessment.
导言：根据重症监护病房（ICU）的工作量调整人力资源至关重要。使用移动设备（智能手机、智能手表和/或平板电脑）开发估算护理工作量的软件可能是一种有用的工具，可补充和/或改进使用护理活动评分（NAS）这一经过验证的量表进行的测量。方法根据流程图 PRISMA-2020 及其扩展 PRISMA-S，对 2009 年至 2021 年的文献进行系统回顾。批判性阅读（CASPe）。步骤：阐述研究问题、概念识别（英语和西班牙语自然语言和描述符 MesH、Emtree 和 CINAHL Headings）、检索策略以及在 MEDlars online (MEDLINE)、Ovid、Excerpta Medica dataBASE (EMBASE)、Elsevier、Cumulative Index to Nursing & Allied Health Literature (CINAHL)、EBSCO 和 Web of Science (WoS)中收集数据；数据提取和评估、结果分析和综合。结果 223 项研究中，MEDLINE 收录 84 项，CINAHL 收录 50 项，EMBASE 收录 48 项，WoS 收录 33 项，其他来源 8 项。117 项符合筛选条件，其中 95 项不符合纳入标准。对 22 项研究进行了资格筛选，其中 17 项被排除。最后筛选出 5 篇文章进行最终审查。这些研究均未提供有关成本、验收测试、有效性、可靠性、系统问题、优缺点或资源估算的结果。讨论与结论使用移动设备和应用程序来测量重症监护室的工作量尚未得到验证，也未证明其比传统的 NAS 评估更准确。
{"title":"Cargas de trabajo de las enfermeras en cuidados intensivos. Validez de su estimación mediante aplicaciones para dispositivos móviles y comparación con nursing activities score. Revisión sistematizada de la literatura","authors":"","doi":"10.1016/j.enfi.2023.06.001","DOIUrl":"10.1016/j.enfi.2023.06.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Adjusting human resources to intensive care units (ICU) workload is essential. The development of software for estimating nursing workload using mobile devices (smartphone, smartwatch and/or tablets) could be a useful tool and complement and/or improve the measurements made with the Nursing Activities Score (NAS), a validated scale.</p></div><div><h3>Objectives</h3><p>To analyze the validity of devices and mobile applications for estimating ICU nurses’ workloads and their comparison with NAS.</p></div><div><h3>Methodology</h3><p>Systematised literature review from 2009 to 2021 informed by flowchart PRISMA-2020 and its extension PRISMA-S. Critical reading (CASPe). Steps: elaboration of the research question, concept identification (English and Spanish natural language and descriptors MesH, Emtree and CINAHL Headings), search strategy and data collection in <em>MEDlars online</em> (MEDLINE), Ovid, <em>Excerpta Medica dataBASE</em> (EMBASE), Elsevier, <em>Cumulative Index to Nursing & Allied Health Literature</em> (CINAHL), EBSCO and <em>Web of Science</em> (WoS); data extraction and evaluation, analysis and synthesis of results. We included studies with abstracts published in English and Spanish conducted in ICU with workload measurement (preferably NAS) using mobile devices.</p></div><div><h3>Results</h3><p>223 studies of which 84 in MEDLINE, 50 in CINAHL, 48 in EMBASE, 33 in WoS and 8 in other sources. 117 were eligible for screening, of which 95 did not meet the inclusion criteria. 22 studies were screened for eligibility, of which 17 were excluded. Five articles were selected for final review. None of the studies provided results on costs, acceptance testing, validity, reliability, system problems, advantages, disadvantages or resource estimation.</p></div><div><h3>Discussion and conclusions</h3><p>The use of mobile devices and applications to measure ICU workloads is not yet validated and has not been shown to be more accurate than traditional NAS assessment.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 3","pages":"Pages 229-241"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139631704","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 : 2024-07-01DOI: 10.1016/j.enfi.2023.07.002
Introduction
Pediatric patients with cognitive dysfunction are at greater risk of pain than typically developing children. Pain assessment in these patients is complex and could generate uncertainty in health professionals about what the key aspects are.
Aim
To determine the training needs perceived by nursing professionals regarding acute pain assessment in pediatric patients with cognitive dysfunction.
Methods
A descriptive, cross-sectional, and multicenter study was performed using a survey addressed to nursing professionals who work in pediatrics during the months of August and September 2022.
Results
163 responses were obtained. Most of the professionals who responded were female (92.6%, n = 151), with a mean age of 38.98 ± 10.40 years. The most frequent work unit was the pediatric intensive care unit (PICU), in 36% (n = 58). Most of the participants reported not having previously received training on pain assessment in pediatric patients with cognitive disabilities (85.9%, n = 139). However, 70.4% (n = 114) considered it “very necessary” for the development of their work to receive specific training on this topic. Knowing how to assess acute pain in this population (85.3%, n = 139) and knowing the clinical and behavioral manifestations of pain in this type of patient (84.7%, n = 138) were the aspects that obtained higher scores.
Conclusion
This research notes more than 90% of participants consider “quite necessary” and “strong necessary” to be training in pediatric cognitive dysfunction patients pain assessment. Furthermore, work experience, academic education and to be pediatric specialist obtain statistical significance data.
{"title":"Estudio multicéntrico. Percepción de los profesionales de enfermería sobre las necesidades formativas de valoración del dolor en pacientes pediátricos con disfunción cognitiva","authors":"","doi":"10.1016/j.enfi.2023.07.002","DOIUrl":"10.1016/j.enfi.2023.07.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Pediatric patients with cognitive dysfunction are at greater risk of pain than typically developing children. Pain assessment in these patients is complex and could generate uncertainty in health professionals about what the key aspects are.</p></div><div><h3>Aim</h3><p>To determine the training needs perceived by nursing professionals regarding acute pain assessment in pediatric patients with cognitive dysfunction.</p></div><div><h3>Methods</h3><p>A descriptive, cross-sectional, and multicenter study was performed using a survey addressed to nursing professionals who work in pediatrics during the months of August and September 2022.</p></div><div><h3>Results</h3><p>163 responses were obtained. Most of the professionals who responded were female (92.6%, n<!--> <!-->=<!--> <!-->151), with a mean age of 38.98<!--> <!-->±<!--> <!-->10.40 years. The most frequent work unit was the pediatric intensive care unit (PICU), in 36% (n<!--> <!-->=<!--> <!-->58). Most of the participants reported not having previously received training on pain assessment in pediatric patients with cognitive disabilities (85.9%, n<!--> <!-->=<!--> <!-->139). However, 70.4% (n<!--> <!-->=<!--> <!-->114) considered it “very necessary” for the development of their work to receive specific training on this topic. Knowing how to assess acute pain in this population (85.3%, n<!--> <!-->=<!--> <!-->139) and knowing the clinical and behavioral manifestations of pain in this type of patient (84.7%, n<!--> <!-->=<!--> <!-->138) were the aspects that obtained higher scores.</p></div><div><h3>Conclusion</h3><p>This research notes more than 90% of participants consider “quite necessary” and “strong necessary” to be training in pediatric cognitive dysfunction patients pain assessment. Furthermore, work experience, academic education and to be pediatric specialist obtain statistical significance data.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 3","pages":"Pages 161-170"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139295388","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 : 2024-07-01DOI: 10.1016/j.enfi.2023.05.005
Introduction
End-stage heart failure (HF) is a condition whose only successful long-term treatment, with a survival of more than 10 years, is heart transplantation. However, limited organ availability and the progressive increase in the number of patients with advanced HF have served as an impetus for the development of implantable mechanical assistive devices.
Aim
To provide an overview of postoperative management and nursing care after the implementation of a Total Artificial Heart (TAH).
Methods
A scoping review was carried out by consulting the Pubmed, CINAHL, and Cochrane databases. From all the documents located, information was extracted on the date of publication, country of publication, type of study, and results of interest to answer the research question. In addition, the degree of recommendation was identified.
Results
Twenty-three documents were included in the scoping review. Results were classified in relation to: 1) description of the CAT SynCardia®; 2) nursing care in the immediate postoperative period (management of the device and management of hematological, infectious, nephrological, nutritional complications, related to immobilization, sleep-rest disturbances, psychological disorders, and patient and family education); and 3) follow-up at home.
Conclusions
The complexity of implantation of the TAH, the multiple related complications that can arise during this process, both in the immediate post-operative and late, require a standardized and multidisciplinary management. The absence of standardized protocols raises the need for future studies to measure the effectiveness of care in patients with TAH. A multidisciplinary approach is crucial. Nurses must acquire autonomy and involvement in decision-making and develop competencies to address the patient's and family's physiological and psychosocial needs.
{"title":"Manejo postoperatorio y cuidados de enfermería tras la implantación de un corazón artificial total: scoping review","authors":"","doi":"10.1016/j.enfi.2023.05.005","DOIUrl":"10.1016/j.enfi.2023.05.005","url":null,"abstract":"<div><h3>Introduction</h3><p>End-stage heart failure (HF) is a condition whose only successful long-term treatment, with a survival of more than 10 years, is heart transplantation. However, limited organ availability and the progressive increase in the number of patients with advanced HF have served as an impetus for the development of implantable mechanical assistive devices.</p></div><div><h3>Aim</h3><p>To provide an overview of postoperative management and nursing care after the implementation of a Total Artificial Heart (TAH).</p></div><div><h3>Methods</h3><p>A scoping review was carried out by consulting the Pubmed, CINAHL, and Cochrane databases. From all the documents located, information was extracted on the date of publication, country of publication, type of study, and results of interest to answer the research question. In addition, the degree of recommendation was identified.</p></div><div><h3>Results</h3><p>Twenty-three documents were included in the scoping review. Results were classified in relation to: 1) description of the CAT SynCardia®; 2) nursing care in the immediate postoperative period (management of the device and management of hematological, infectious, nephrological, nutritional complications, related to immobilization, sleep-rest disturbances, psychological disorders, and patient and family education); and 3) follow-up at home.</p></div><div><h3>Conclusions</h3><p>The complexity of implantation of the TAH, the multiple related complications that can arise during this process, both in the immediate post-operative and late, require a standardized and multidisciplinary management. The absence of standardized protocols raises the need for future studies to measure the effectiveness of care in patients with TAH. A multidisciplinary approach is crucial. Nurses must acquire autonomy and involvement in decision-making and develop competencies to address the patient's and family's physiological and psychosocial needs.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 3","pages":"Pages 213-228"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1130239923000664/pdfft?md5=5a6ecd4cc8605eac615e03bffc73e2ee&pid=1-s2.0-S1130239923000664-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127687245","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}
Pub Date : 2024-07-01DOI: 10.1016/j.enfi.2023.08.001
Introduction
The mothers of newborns who are discharged from a neonatal intensive care unit (NICU) experience stress and anxiety due to the specialized care their child requires at home, affecting their perception of maternal self-efficacy.
Objective
to evaluate the effect of the nursing intervention called Hospital Discharge Plan (HDP) on the promotion of self-efficacy in mothers of newborns discharged from the NICU.
Method
Quantitative study, quasi-experimental design with pre-test/post-test in a single group, using the Parental Evaluation Scale applied to a convenience sample of 72 mothers of high-risk newborns from a NICU located in the city of Villavicencio (Colombia). The first measurement was taken between days 3 and 4 before discharge and at 15 days’ post-discharge. Data processing was carried out using the statistical program SPSS, version 21. The intervention was based on the four concepts of self-efficacy by Barbara Resnick.
Results
The perception of maternal self-efficacy before the intervention showed a median of 8.9 points (RI 7.6-9.5); after the intervention it showed a median of 9.6 points (RI of 10-8.7); a statistically significant p-value < 0.001 was obtained before and after the intervention with the Wilcoxon rank test.
Conclusions
Education and follow-up promoted the development of knowledge and skills in mothers for the care of high-risk newborns. This contributed to the experience of mastery and vicarious experience from the teaching-learning process and contact with the experience of other mothers, which contributes to the effective development of motherhood.
{"title":"Promoción de la autoeficacia en madres con hijos/as que egresan de unidades de cuidado intensivo neonatal","authors":"","doi":"10.1016/j.enfi.2023.08.001","DOIUrl":"10.1016/j.enfi.2023.08.001","url":null,"abstract":"<div><h3>Introduction</h3><p>The mothers of newborns who are discharged from a neonatal intensive care unit (NICU) experience stress and anxiety due to the specialized care their child requires at home, affecting their perception of maternal self-efficacy.</p></div><div><h3>Objective</h3><p>to evaluate the effect of the nursing intervention called Hospital Discharge Plan (HDP) on the promotion of self-efficacy in mothers of newborns discharged from the NICU.</p></div><div><h3>Method</h3><p>Quantitative study, quasi-experimental design with pre-test/post-test in a single group, using the Parental Evaluation Scale applied to a convenience sample of 72 mothers of high-risk newborns from a NICU located in the city of Villavicencio (Colombia). The first measurement was taken between days 3 and 4 before discharge and at 15 days’ post-discharge. Data processing was carried out using the statistical program SPSS, version 21. The intervention was based on the four concepts of self-efficacy by Barbara Resnick.</p></div><div><h3>Results</h3><p>The perception of maternal self-efficacy before the intervention showed a median of 8.9 points (RI 7.6-9.5); after the intervention it showed a median of 9.6 points (RI of 10-8.7); a statistically significant p-value < 0.001 was obtained before and after the intervention with the Wilcoxon rank test.</p></div><div><h3>Conclusions</h3><p>Education and follow-up promoted the development of knowledge and skills in mothers for the care of high-risk newborns. This contributed to the experience of mastery and vicarious experience from the teaching-learning process and contact with the experience of other mothers, which contributes to the effective development of motherhood.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 3","pages":"Pages 171-177"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139538412","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 : 2024-07-01DOI: 10.1016/j.enfi.2024.07.001
Miguel Ángel Giménez Lajara PhD (Presidente SEEIUC)
{"title":"XLIX Congreso Nacional de la Sociedad Española de Enfermería Intensiva y Unidades Coronarias","authors":"Miguel Ángel Giménez Lajara PhD (Presidente SEEIUC)","doi":"10.1016/j.enfi.2024.07.001","DOIUrl":"10.1016/j.enfi.2024.07.001","url":null,"abstract":"","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 3","pages":"Pages 159-160"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141729347","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 : 2024-07-01DOI: 10.1016/j.enfi.2023.12.001
Introduction
Fournier's gangrene, a relatively rare form of necrotizing fasciitis, is a rapidly progressive disease affecting the deep and superficial tissues of the perineal, anal, scrotal, and genital regions. Despite the significant evolution in medical knowledge, there is still scarce evidence regarding the nursing care plan in patients affected by this pathology, which hinders its correct management. For this reason, we present the following clinical case of a 53-year-old male patient with Fournier's gangrene who was admitted to the emergency department for 3 days of pain in the perineal area and fever.
Objective
The objective was to establish an individualized care plan for the patient detailing the diagnoses, expected outcomes and interventions through nursing taxonomies.
Case development
A systematic assessment was performed using Marjory Gordon's model of functional health patterns as a reference. After drawing inferences, three collaborative problems and two nursing diagnoses were established with their outcome criteria and interventions. Once the plan was executed, the results obtained highlighted that the interventions were consistent in achieving the objectives set out in the problems present in the case patient.
Conclusions
The development of an individualized plan made it possible to detect problems, establish realistic objectives and define interventions that optimized nursing care in this patient with Fournier's gangrene.
{"title":"Plan de cuidados para un paciente con gangrena de Fournier: caso clínico","authors":"","doi":"10.1016/j.enfi.2023.12.001","DOIUrl":"10.1016/j.enfi.2023.12.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Fournier's gangrene, a relatively rare form of necrotizing fasciitis, is a rapidly progressive disease affecting the deep and superficial tissues of the perineal, anal, scrotal, and genital regions. Despite the significant evolution in medical knowledge, there is still scarce evidence regarding the nursing care plan in patients affected by this pathology, which hinders its correct management. For this reason, we present the following clinical case of a 53-year-old male patient with Fournier's gangrene who was admitted to the emergency department for 3<!--> <!-->days of pain in the perineal area and fever.</p></div><div><h3>Objective</h3><p>The objective was to establish an individualized care plan for the patient detailing the diagnoses, expected outcomes and interventions through nursing taxonomies.</p></div><div><h3>Case development</h3><p>A systematic assessment was performed using Marjory Gordon's model of functional health patterns as a reference. After drawing inferences, three collaborative problems and two nursing diagnoses were established with their outcome criteria and interventions. Once the plan was executed, the results obtained highlighted that the interventions were consistent in achieving the objectives set out in the problems present in the case patient.</p></div><div><h3>Conclusions</h3><p>The development of an individualized plan made it possible to detect problems, establish realistic objectives and define interventions that optimized nursing care in this patient with Fournier's gangrene.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 3","pages":"Pages 242-249"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S113023992400018X/pdfft?md5=5c2ea157a931c649ce9b9fcc1f71a389&pid=1-s2.0-S113023992400018X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140785388","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}
Pub Date : 2024-07-01DOI: 10.1016/j.enfi.2023.10.002
Objective
To determine the Intensity of Collaboration between the intensive care professionals of a third level hospital.
Method
Descriptive cross-sectional study with an analytical approach. Setting: 6 intensive care units of a third level hospital. Sample: nurses and doctors. Consecutive type non-probabilistic sampling. Data collection: sociodemographic, economic, motivation and professional satisfaction variables, and the intensity of collaboration using the «Scale of Intensity of Interprofessional Collaboration in Health».
Results
A total of 102 health professionals (91 nurses and 11 doctors) were included. The mean overall Intensity of Collaboration (IoC) was moderate. Men showed higher scores in all factors (p < 0,05). The IoC global score was higher in the group of professionals with ≤ 10 years of experience (p = 0,043) and those who were highly satisfied with the profession (p = 0,037). Physicians presented higher scores in the global IdC (p = 0,037) and in the Collaboration mean (p = 0,020) independently in the multivariate models. A negative linear relationship (rho: -0,202, p = 0,042) was observed between age and the overall IoC score. Professionals aged ≤ 30 years reported a higher perception of Shared Activities (p = 0,031). Negative linear relationships were observed between years of experience and total IoC score (rho: -0,202, p = 0,042) and patients’ Perception score (rho: -0.241, p = 0.015). The research activity also showed to be a variable related to a greater degree of Collaboration at a global level and in some of the factors (p < 0,05). The scale of IoC obtained a Cronbach's α of 0,9.
Conclusions
The intensity of interprofessional collaboration in ICUs is moderate. Professionals with experience of ≤ 10 years, a higher level of satisfaction and participation in research activities show a greater intensity of collaboration. Doctors perceive collaboration more intensely than nurses. All factors contribute equally to the internal consistency of the questionnaire.
{"title":"Intensidad de colaboración interprofesional y factores relacionados en las Unidades de Cuidados Intensivos. Un estudio descriptivo de tipo transversal con enfoque analítico","authors":"","doi":"10.1016/j.enfi.2023.10.002","DOIUrl":"10.1016/j.enfi.2023.10.002","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the Intensity of Collaboration between the intensive care professionals of a third level hospital.</p></div><div><h3>Method</h3><p>Descriptive cross-sectional study with an analytical approach. Setting: 6 intensive care units of a third level hospital. Sample: nurses and doctors. Consecutive type non-probabilistic sampling. Data collection: sociodemographic, economic, motivation and professional satisfaction variables, and the intensity of collaboration using the «Scale of Intensity of Interprofessional Collaboration in Health».</p></div><div><h3>Results</h3><p>A total of 102 health professionals (91 nurses and 11 doctors) were included. The mean overall Intensity of Collaboration (IoC) was moderate. Men showed higher scores in all factors (p<!--> <!--><<!--> <!-->0,05). The IoC global score was higher in the group of professionals with ≤<!--> <!-->10 years of experience (p<!--> <!-->=<!--> <!-->0,043) and those who were highly satisfied with the profession (p<!--> <!-->=<!--> <!-->0,037). Physicians presented higher scores in the global IdC (p<!--> <!-->=<!--> <!-->0,037) and in the Collaboration mean (p<!--> <!-->=<!--> <!-->0,020) independently in the multivariate models. A negative linear relationship (rho: -0,202, p<!--> <!-->=<!--> <!-->0,042) was observed between age and the overall IoC score. Professionals aged ≤<!--> <!-->30 years reported a higher perception of Shared Activities (p<!--> <!-->=<!--> <!-->0,031). Negative linear relationships were observed between years of experience and total IoC score (rho: -0,202, p<!--> <!-->=<!--> <!-->0,042) and patients’ Perception score (rho: -0.241, p<!--> <!-->=<!--> <!-->0.015). The research activity also showed to be a variable related to a greater degree of Collaboration at a global level and in some of the factors (p<!--> <!--><<!--> <!-->0,05). The scale of IoC obtained a Cronbach's α of 0,9.</p></div><div><h3>Conclusions</h3><p>The intensity of interprofessional collaboration in ICUs is moderate. Professionals with experience of ≤<!--> <!-->10 years, a higher level of satisfaction and participation in research activities show a greater intensity of collaboration. Doctors perceive collaboration more intensely than nurses. All factors contribute equally to the internal consistency of the questionnaire.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 3","pages":"Pages 188-200"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139872514","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号