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Uso seguro de la sedación inhalada en pacientes críticos con ventilación mecánica invasiva 在接受有创机械通气的重症患者中安全使用吸入镇静剂
IF 1.1 Q3 NURSING Pub Date : 2025-01-01 DOI: 10.1016/j.enfi.2024.04.003
Diana Gil-Castillejos RN, MSN, PhD , María Luisa Palomanes-Espadalé RN, MSN , Sara Rosich-Andreu MD , Olga Vallés-Fructuoso RN, MSN , Oriol Plans-Galvan MD
Inhaled sedation uses halogenated drugs (isoflurane and sevoflurane) in a liquid state that, through a vaporizer, change to a gaseous state and reach the patient by the respiratory route. These drugs have a rapid onset of action, with minimal metabolism and elimination takes place almost exclusively through the airways. They don’t cause significant tolerance, tachyphylaxis or significant abstinence. Inhaled sedation enables a rapid and more predictable awakening and reduced the need for opioids and neuromuscular relaxants (than intravenous sedation). In addition, have bronchodilatory, anticonvulsing and potential antiinflammatory and cardioprotective effects.
To date, inhaled sedation has been practically exclusive to the areas of anesthesia and surgery. For its therapeutic application in the environment of the Intensive Care Units (ICU) there are two devices, Sedaconda ACD® and Mirus®. Its design, adaptable to different respirators and with a safe scavenging gas system, has facilitated its introduction in the ICUs. Scientific evidence supports the use of isoflurano and Sevoflurano (with limitations), especially in cases of moderate-deep sedation, and for people with acute respiratory distress syndrome, acute bronchospasm, status epilepticus, people who are difficult to sedate, prolonged sedation (only isoflurano) and patients post cardiac arrest or who need daily neurological assessment.
Halogenated sedation is safe and effective for the critical patient undergoing mechanical ventilation. However, it is not exempt from risks and requires learning by professionals who will prescribe and/or apply. Nurses must know the characteristics of the drug, its handling, and be an expert in the route of administration so that the therapy is safe for the patient and health professionals.
吸入镇静使用液态卤化药物(异氟醚和七氟醚),通过蒸发器变为气态并通过呼吸途径到达患者。这些药物起效迅速,代谢极少,几乎完全通过气道排出。它们不会引起明显的耐受性,快速反应或明显的戒断。吸入镇静可使患者快速且更可预测地苏醒,减少对阿片类药物和神经肌肉松弛剂的需求(比静脉镇静)。此外,具有支气管扩张,抗惊厥和潜在的抗炎和心脏保护作用。迄今为止,吸入镇静实际上是麻醉和外科领域的专有技术。对于其在重症监护病房(ICU)环境中的治疗应用,有两种设备,Sedaconda ACD®和Mirus®。它的设计适用于不同的呼吸器,并具有安全的清除气体系统,促进了它在icu中的应用。科学证据支持使用异氟拉诺和七氟拉诺(有局限性),特别是在中度深度镇静的情况下,以及患有急性呼吸窘迫综合征、急性支气管痉挛、癫痫持续状态、难以镇静的人、长时间镇静(仅异氟拉诺)和心脏骤停后或需要每日神经系统评估的患者。卤化镇静对危重患者进行机械通气安全有效。然而,它并不能免除风险,需要专业人士的学习,他们将开处方和/或应用。护士必须知道药物的特性,它的处理方法,并且是给药途径的专家,这样治疗对病人和卫生专业人员是安全的。
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引用次数: 0
Monitorización fisiológica del dolor en pacientes críticos no comunicativos 对无交流能力的重症患者进行生理疼痛监测
IF 1.1 Q3 NURSING Pub Date : 2025-01-01 DOI: 10.1016/j.enfi.2024.04.002
Candelas López-López RN, MSc, PhD , Gemma Robleda-Font RN, MSc, PhD , Gemma Via-Clavero RN, MSc, PhD , Aaron Castanera-Duro RN, MSc, PhD
Electrophysiological monitoring of pain provides objective measures that allow for pain control and adjustment of analgesia in non-communicative patients.
Among the available electrophysiological devices, automated infrared pupillometry, Analgesia Nociception Index (ANI), and Nociception Level Index (NOL®) stand out. These non-invasive measurement systems analyze the sympathetic or parasympathetic nervous system response to painful stimuli by observing pupillary dilatation and reactivity (pupillometry), heart rate during respiration (ANI), or a combination of multiple parameters from the nociceptive-autonomic medullary circuit (NOL®). These methods have mainly been used in the monitoring of nociception related to procedures in critically ill patients.
Furthermore, they have allowed for the prediction, adjustment, and customization of analgesia administration prior to painful procedures. To obtain accurate measurements and properly interpret the values provided by these devices, it is important to consider certain limitations in their use, such as the administration of specific medications or the presence of certain pathologies, due to their influence on the autonomic nervous system response. It is also important to note that the reported level of evidence is limited, as randomized clinical trials in the context of intensive care unit regarding these devices are currently lacking.
疼痛的电生理监测提供了客观的措施,允许疼痛控制和调整非交流患者的镇痛。在现有的电生理设备中,自动红外瞳孔测量仪、镇痛痛觉指数(ANI)和痛觉水平指数(NOL®)最为突出。这些非侵入性测量系统通过观察瞳孔扩张和反应性(瞳孔测量)、呼吸时心率(ANI)或来自伤害-自主髓神经回路(NOL®)的多个参数的组合来分析交感或副交感神经系统对疼痛刺激的反应。这些方法主要用于危重病人手术过程中伤害感觉的监测。此外,它们还允许在疼痛手术之前预测、调整和定制镇痛给药。为了获得准确的测量和正确解释这些装置提供的值,重要的是要考虑其使用中的某些限制,例如特定药物的施用或某些病理的存在,由于它们对自主神经系统反应的影响。同样值得注意的是,报告的证据水平有限,因为目前缺乏在重症监护病房中关于这些装置的随机临床试验。
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引用次数: 0
Colaboración interprofesional en las sesiones clínicas de una Unidad de Cuidados Intensivos: percepción de enfermeras y médicos. Una revisión sistemática de la literatura 重症监护室临床会议中的跨专业合作:护士和医生的看法。文献系统回顾
IF 1.1 Q3 NURSING Pub Date : 2025-01-01 DOI: 10.1016/j.enfi.2024.03.002
Marina Alzate-Moreno RN, Belén Calderón-Breñosa RN, Kenia Rodríguez-San Miguel RN, María del Mar Sarasa-Monreal RN, MSc
<div><h3>Introducción</h3><div>Las Unidades de Cuidados Intensivos son unidades dinámicas y complejas que requieren del trabajo conjunto de varios profesionales. Esto se consigue mediante la práctica colaborativa interprofesional, que es el proceso en el que interactúan diferentes profesionales con metas y objetivos comunes en la toma de decisiones, proporcionando una atención segura y de calidad. Las sesiones clínicas conjuntas brindan a los profesionales la posibilidad de interactuar, mejorando la comunicación y los resultados en la práctica clínica.</div></div><div><h3>Objetivos</h3><div>Explorar las percepciones de enfermeras y médicos sobre la práctica colaborativa en las sesiones clínicas conjuntas en una Unidad de Cuidados Intensivos.</div></div><div><h3>Metodología</h3><div>Se realizó una revisión sistemática de la literatura en las bases de datos Medline, Pubmed, Cinahl, Web of Science y Psycinfo, incluyendo artículos publicados en los últimos diez años.</div></div><div><h3>Resultados</h3><div>El análisis de las publicaciones detectó cinco categorías principales: 1) Concepto: definición de colaboración interprofesional según enfermeras y médicos; 2) Repercusión en la práctica clínica: valor otorgado a las sesiones clínicas por enfermeras y médicos; 3) Barreras: aspectos influyentes en las sesiones clínicas según la percepción de enfermeras y médicos; 4) Rol: papel percibido por cada profesional, y 5) Estrategias de mejora: propuestas planteadas por profesionales de enfermería y medicina.</div></div><div><h3>Conclusiones</h3><div>A pesar de que médicos y enfermeras son conscientes de la importancia y repercusión de la práctica colaborativa interprofesional en la atención al paciente crítico, no resulta una práctica habitual en la asistencia.</div></div><div><h3>Introduction</h3><div>Intensive Care Units are dynamic and complex units that require several professionals to work together. This is achieved through Interprofessional Collaborative Practice, which is the process in which different professionals interact with common goals and objectives in decision making, providing safe and quality care. Joint clinical sessions provide professionals with the opportunity to interact, improving communication and outcomes in clinical practice.</div></div><div><h3>Objectives</h3><div>To explore nurses’ and physicians’ perceptions of collaborative practice in joint clinical sessions in an Intensive Care Unit.</div></div><div><h3>Methodology</h3><div>A systematic literature review was conducted in the databases Medline, Pubmed, Cinahl, Web of Science and Psycinfo, including articles published in the last ten years.</div></div><div><h3>Results</h3><div>The analysis of the publications detected five main categories: 1) Concept: definition of interprofessional collaboration according to nurses and doctors, 2) Impact on clinical practice: value given to clinical sessions by nurses and doctors, 3) Barriers: relevant aspects in clinical sessions according to
重症监护单位是动态和复杂的单位,需要几个专业人员的合作。这是通过专业间的协作实践来实现的,在这个过程中,不同的专业人员在决策中具有共同的目标和目标,提供安全和高质量的护理。联合临床会议为专业人员提供了互动的机会,改善了临床实践中的沟通和结果。目标探索护士和医生在重症监护病房联合临床会议中对协作实践的看法。对Medline、Pubmed、Cinahl、Web of Science和Psycinfo数据库中的文献进行了系统的综述,包括过去十年发表的文章。对出版物的分析确定了五个主要类别:1)概念:护士和医生对专业间协作的定义;2)对临床实践的影响:护士和医生对临床会议的重视;3)障碍:根据护士和医生的看法影响临床治疗的因素;4)角色:每个专业人员感知到的角色;5)改进策略:由护理和医疗专业人员提出的建议。虽然医生和护士都意识到专业间合作实践在重症监护中的重要性和影响,但这并不是护理中的标准做法。介绍重症监护单位是动态和复杂的单位,需要几个专业人员一起工作。这是通过跨专业协作实践来实现的,在这个过程中,不同的专业人员在决策中与共同的目标和目标互动,提供安全和质量的护理。联合临床会议为专业人员提供了互动、改善沟通和临床实践成果的机会。目的:探索护士和医生对重症监护病房联合临床会议协作实践的看法。对数据库Medline、Pubmed、Cinahl、Web of Science和Psycinfo进行了系统的文献综述,包括过去十年发表的文章。ResultsThe analysis of the出版物detected五个主要类别:1)概念:definition of interprofessional collaboration根据护士和医生,2)Impact on value给予临床实践:护士和医生的临床会议、3)有关的障碍:aspects in to the perception of clinical会议的护士和医生,4)作用:作用薄弱,各专业和5)改进战略:建议put forward by护理和医疗专业人员。结论:虽然医生和护士意识到专业间协作实践在护理危重病人方面的重要性和影响,但这并不是护理中的常见做法。
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引用次数: 0
REFLEXIONES SOBRE LA PERSPECTIVA DE GÉNERO EN LA INVESTIGACIÓN 对调查中的性别观点的思考
IF 1.1 Q3 NURSING Pub Date : 2025-01-01 DOI: 10.1016/j.enfi.2025.500509
María Gema Cid-Expósito MA
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引用次数: 0
Factores de riesgo asociados a eventos adversos por medicación notificados por enfermería en un Hospital Pediátrico de México 墨西哥一家儿科医院护士报告的与药物不良事件有关的危险因素
IF 1.1 Q3 NURSING Pub Date : 2025-01-01 DOI: 10.1016/j.enfi.2024.03.003
Rosa María Hidalgo-Velasco RN , Graciela Martínez-Velasco RN , Martha Martínez-Salazar PhD , Karina Juárez-González MSc , Salvador Vázquez-Vega PhD

Introduction

During pediatric medication administration, patient safety-related incidents such as sentinel event, adverse event or quasi-failure still occur.

Objective

To identify risk factors associated with adverse events during the medication of pediatric patients reported by nurses.

Methods

Cross-sectional study, non-probabilistic sampling. From January to October 2021, 411 reports from the Vencer II System were reviewed, of which only 140 reported notifications of incidents during the medication of pediatric patients. Using root cause analysis 38 factors associated with adverse events were investigated. Descriptive and inferential statistics were used.

Results

Of the 411 reports reviewed, 140 (34.0%) correspond to incidents; 116 (83.0%) to adverse events and 24 (17.0%) to quasi-failure, no sentinel events were reported. In the human factor, 6 of the 7 proximal factors had a frequency ≥ 40%. Work overload was significantly associated with the occurrence of adverse events; OR = 3.24 (95% CI, 1.31-7.99) (P=.008). Contrary to what has been reported, LASA (Look-Alike, Sound-Alike) medications and double-check omission were identified as protective against the occurrence of incidents; OR = 0.323 (95% CI, 0.13-0.84) (p = 0.017); OR = 0.39 (95% CI, 0.15-0.99) (P=.047).

Conclusions

Work overload was identified as a risk factor associated with the occurrence of adverse events, so it is necessary to evaluate this factor from objective medication and from the nurses’ perception of it. Having a documented incident notification and response system in place will allow healthcare institutions to demonstrate diligence and transparency. Finally, the usefulness of root cause analysis and the Ishikawa diagram to identify factors that can cause incidents is again supported, so their integration into the VENCER II instrument would be useful.
在儿童给药过程中,仍会发生与患者安全相关的事件,如哨点事件、不良事件或准失败。目的了解护士报告的儿科患者用药不良事件的相关危险因素。方法横断面研究,非概率抽样。从2021年1月至10月,我们审查了来自Vencer II系统的411份报告,其中只有140份报告了儿科患者用药期间的事件通知。采用根本原因分析对38个与不良事件相关的因素进行了调查。采用描述性统计和推断性统计。结果411份报告中,140份(34.0%)对应事件;不良事件116例(83.0%),准失败24例(17.0%),未报告前哨事件。在人为因素中,7个近端因素中有6个频率≥40%。工作负荷与不良事件的发生显著相关;Or = 3.24 (95% ci, 1.31-7.99) (p = 0.008)。与所报道的情况相反,LASA(相似,相似声音)药物和双重检查遗漏被确定为防止事件发生的保护措施;OR = 0.323 (95% CI, 0.13-0.84) (p = 0.017);Or = 0.39 (95% ci, 0.15-0.99) (p = 0.047)。结论超负荷工作是不良事件发生的危险因素,有必要从客观用药和护士认知两方面对其进行评估。拥有一个记录在案的事件通知和响应系统将使医疗机构能够表现出勤勉和透明度。最后,再次支持根本原因分析和Ishikawa图用于识别可能导致事故的因素,因此将其集成到VENCER II仪器中将是有用的。
{"title":"Factores de riesgo asociados a eventos adversos por medicación notificados por enfermería en un Hospital Pediátrico de México","authors":"Rosa María Hidalgo-Velasco RN ,&nbsp;Graciela Martínez-Velasco RN ,&nbsp;Martha Martínez-Salazar PhD ,&nbsp;Karina Juárez-González MSc ,&nbsp;Salvador Vázquez-Vega PhD","doi":"10.1016/j.enfi.2024.03.003","DOIUrl":"10.1016/j.enfi.2024.03.003","url":null,"abstract":"<div><h3>Introduction</h3><div>During pediatric medication administration, patient safety-related incidents such as sentinel event, adverse event or quasi-failure still occur.</div></div><div><h3>Objective</h3><div>To identify risk factors associated with adverse events during the medication of pediatric patients reported by nurses.</div></div><div><h3>Methods</h3><div>Cross-sectional study, non-probabilistic sampling. From January to October 2021, 411 reports from the Vencer II System were reviewed, of which only 140 reported notifications of incidents during the medication of pediatric patients. Using root cause analysis 38 factors associated with adverse events were investigated. Descriptive and inferential statistics were used.</div></div><div><h3>Results</h3><div>Of the 411 reports reviewed, 140 (34.0%) correspond to incidents; 116 (83.0%) to adverse events and 24 (17.0%) to quasi-failure, no sentinel events were reported. In the human factor, 6<!--> <!-->of the 7<!--> <!-->proximal factors had a frequency ≥ 40%. Work overload was significantly associated with the occurrence of adverse events; OR<!--> <!-->=<!--> <!-->3.24 (95% CI, 1.31-7.99) <em>(P</em>=.008). Contrary to what has been reported, LASA (Look-Alike, Sound-Alike) medications and double-check omission were identified as protective against the occurrence of incidents; OR<!--> <!-->=<!--> <!-->0.323 (95% CI, 0.13-0.84) (p<!--> <!-->=<!--> <!-->0.017); OR<!--> <!-->=<!--> <!-->0.39 (95% CI, 0.15-0.99) <em>(P</em>=.047).</div></div><div><h3>Conclusions</h3><div>Work overload was identified as a risk factor associated with the occurrence of adverse events, so it is necessary to evaluate this factor from objective medication and from the nurses’ perception of it. Having a documented incident notification and response system in place will allow healthcare institutions to demonstrate diligence and transparency. Finally, the usefulness of root cause analysis and the Ishikawa diagram to identify factors that can cause incidents is again supported, so their integration into the VENCER II instrument would be useful.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 1","pages":"Article 100492"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143344130","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
Experiencia de padres de niños que han fallecido en una unidad de cuidados intensivos pediátricos sobre la conexión humana y los cuidados compasivos 在儿科重症监护病房死亡儿童的父母关于人际关系和关爱关怀的经验
IF 1.1 Q3 NURSING Pub Date : 2025-01-01 DOI: 10.1016/j.enfi.2024.06.002
Sara Alcón-Nájera RN, MsC, PhD , María Teresa González-Gil RN, MsC, PhD

Introduction

The death of a child in an Pediatric Intensive Care Unit (PICU) is a rare event, the main causes being failed resuscitation efforts, brain death or limitation of the therapeutic effort. The family interpretation of this experience has a significant impact on mourning. Knowledge of the elements that condition this interpretation, is fundamental to be able to accompany and care.

Aims

General: to explore the experience of families who have suffered the loss of a child in the PICU. Specific: to describe the experience of «human connection and family centred compassionate care».

Methodology

A qualitative phenomenological study was carried out in the PICU of a high complexity hospital. Thirteen interviews were conducted (11 mothers/9 fathers), with an average duration of 60 minutes until thematic saturation. Data were analysed following Van Manen's hermeneutic approach.

Results

Compassionate family-centred care is based on the human connection between care team and family system with the objectives of: recognising care as a family affair, promoting a collaborative approach to care and strengthening family bonds. Their achievement requires: informing/training parents about the disease process and care, involving them in decision-making, facilitating their participation in care, generating spaces for honest communication with the care team, facilitating care respire and sibling visits, making, promoting «family magic spaces», and generating family memories.

Conclusions

The experience of losing a child in the PICU is conditioned by the care team's approach to the management of the families’ suffering. The co-creation of a relationship space centred on their needs and mediated by sincere communication and real collaboration is valued as a valuable gift.
儿童在儿科重症监护病房(PICU)死亡是一件罕见的事件,主要原因是复苏失败、脑死亡或治疗努力有限。家属对这一经历的解释对哀悼有重大影响。对这些要素的了解,是能够陪伴和关怀的基础。目的:探讨在重症监护病房中失去孩子的家庭的经历。具体的:描述“人际关系和以家庭为中心的富有同情心的护理”的经验。方法对某高复杂性医院PICU进行定性现象学研究。共进行了13次访谈(11位母亲/9位父亲),平均时长为60分钟,直到主题饱和。数据分析遵循Van Manen的解释学方法。结果富有同情心的以家庭为中心的护理是建立在护理团队和家庭系统之间的人际关系的基础上的,其目标是:承认护理是一项家庭事务,促进合作的护理方法,加强家庭纽带。实现这些目标需要:向父母通报/培训疾病过程和护理,让他们参与决策,促进他们参与护理,创造与护理团队诚实沟通的空间,促进护理呼吸和兄弟姐妹访问,创造和促进“家庭魔法空间”,并产生家庭记忆。结论在PICU中失去孩子的经历取决于护理团队处理家庭痛苦的方法。以他们的需求为中心,以真诚的沟通和真正的合作为媒介,共同创造一个关系空间,这是一种宝贵的礼物。
{"title":"Experiencia de padres de niños que han fallecido en una unidad de cuidados intensivos pediátricos sobre la conexión humana y los cuidados compasivos","authors":"Sara Alcón-Nájera RN, MsC, PhD ,&nbsp;María Teresa González-Gil RN, MsC, PhD","doi":"10.1016/j.enfi.2024.06.002","DOIUrl":"10.1016/j.enfi.2024.06.002","url":null,"abstract":"<div><h3>Introduction</h3><div>The death of a child in an Pediatric Intensive Care Unit (PICU) is a rare event, the main causes being failed resuscitation efforts, brain death or limitation of the therapeutic effort. The family interpretation of this experience has a significant impact on mourning. Knowledge of the elements that condition this interpretation, is fundamental to be able to accompany and care.</div></div><div><h3>Aims</h3><div><em>General:</em> to explore the experience of families who have suffered the loss of a child in the PICU. <em>Specific:</em> to describe the experience of «human connection and family centred compassionate care».</div></div><div><h3>Methodology</h3><div>A qualitative phenomenological study was carried out in the PICU of a high complexity hospital. Thirteen interviews were conducted (11 mothers/9 fathers), with an average duration of 60<!--> <!-->minutes until thematic saturation. Data were analysed following Van Manen's hermeneutic approach.</div></div><div><h3>Results</h3><div>Compassionate family-centred care is based on the human connection between care team and family system with the objectives of: recognising care as a family affair, promoting a collaborative approach to care and strengthening family bonds. Their achievement requires: informing/training parents about the disease process and care, involving them in decision-making, facilitating their participation in care, generating spaces for honest communication with the care team, facilitating care respire and sibling visits, making, promoting «family magic spaces», and generating family memories.</div></div><div><h3>Conclusions</h3><div>The experience of losing a child in the PICU is conditioned by the care team's approach to the management of the families’ suffering. The co-creation of a relationship space centred on their needs and mediated by sincere communication and real collaboration is valued as a valuable gift.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 1","pages":"Article 100504"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143344603","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
Ritmo intestinal en el paciente trasplantado de pulmón 肺移植患者的肠道节律
IF 1.1 Q3 NURSING Pub Date : 2025-01-01 DOI: 10.1016/j.enfi.2024.06.001
Cristina González-Blasco RN , Blanca Isabel Fernández-Alonso RN , Beatriz Hernández-Iglesias RN , Ignacio Zaragoza-García RN, PhD , Marta María Torres-Romero RN , Patricia Sotillo-Nieto RN , Laura Alonso-Pérez RN

Introduction

Lung transplantation is the option for patients with end-stage respiratory pathology. Among the acute post-surgical complications, constipation is novel and relevant, as it has been little studied. Knowing the incidence of patients with constipation during post-implantation allows the creation of an adequate care plan. Several authors relate it to poor postoperative prognosis.

Methodology

Descriptive, longitudinal and retrospective study. Target population: lung trasplanted patients in a tertiary hospital with an ICU stay ≥3 days.

Main variable

Presence of constipation. Sociodemographic, clinical and pharmacological variables related to the patient's bowel rhythm were collected. Prior authorization was obtained from the hospital research committee.

Results

44 trasplanted patients were analyzed. The mean age was 52.75 ± 13.05 years, 59,1% were male. The 45,4% were overweight-obese. The main diagnosis is COPD. The majority were bipulmonary (88,6%). Constipation was between 97,7% and 67,9%. The median stool onset is 7,40 days. Prokinetics were introduced prophylactically in a median of 4 days and laxatives in 3 days. Enteral nutrition was introduced early in only 6,8% of patients.

Conclusions

A high percentage of lung trasplanted patients present constipation; Prophylaxis by means of prokinetics and laxatives is early, although enteral nutrition is not introduced early; It is necessary to review the nutritional protocol to avoid constipation.
肺移植是终末期呼吸系统病变患者的选择。在急性术后并发症中,便秘是一种新颖且相关的问题,因为它的研究很少。了解患者在植入后便秘的发生率有助于制定适当的护理计划。一些作者认为这与术后预后不良有关。方法:描述性、纵向和回顾性研究。目标人群:三级医院ICU住院≥3天的肺移植患者。主要变量有无便秘。收集与患者肠节律相关的社会人口学、临床和药理学变量。事先获得了医院研究委员会的授权。结果对44例移植患者进行了分析。平均年龄52.75±13.05岁,男性59.1%。45.4%的人超重肥胖。主要诊断为慢性阻塞性肺病。以双肺为主(88.6%)。便秘的比例在97.7%到67.9%之间。中位起便时间为7,40天。中位数为4天预防性使用促生药,3天使用泻药。只有6.8%的患者在早期引入肠内营养。结论肺移植患者出现便秘的比例较高;虽然肠内营养不是早期引入,但通过促动剂和泻药进行预防是早期的;有必要审查营养方案,以避免便秘。
{"title":"Ritmo intestinal en el paciente trasplantado de pulmón","authors":"Cristina González-Blasco RN ,&nbsp;Blanca Isabel Fernández-Alonso RN ,&nbsp;Beatriz Hernández-Iglesias RN ,&nbsp;Ignacio Zaragoza-García RN, PhD ,&nbsp;Marta María Torres-Romero RN ,&nbsp;Patricia Sotillo-Nieto RN ,&nbsp;Laura Alonso-Pérez RN","doi":"10.1016/j.enfi.2024.06.001","DOIUrl":"10.1016/j.enfi.2024.06.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Lung transplantation is the option for patients with end-stage respiratory pathology. Among the acute post-surgical complications, constipation is novel and relevant, as it has been little studied. Knowing the incidence of patients with constipation during post-implantation allows the creation of an adequate care plan. Several authors relate it to poor postoperative prognosis.</div></div><div><h3>Methodology</h3><div>Descriptive, longitudinal and retrospective study. Target population: lung trasplanted patients in a tertiary hospital with an ICU stay ≥3 days.</div></div><div><h3>Main variable</h3><div>Presence of constipation. Sociodemographic, clinical and pharmacological variables related to the patient's bowel rhythm were collected. Prior authorization was obtained from the hospital research committee.</div></div><div><h3>Results</h3><div>44 trasplanted patients were analyzed. The mean age was 52.75<!--> <!-->±<!--> <!-->13.05 years, 59,1% were male. The 45,4% were overweight-obese. The main diagnosis is COPD. The majority were bipulmonary (88,6%). Constipation was between 97,7% and 67,9%. The median stool onset is 7,40 days. Prokinetics were introduced prophylactically in a median of 4 days and laxatives in 3 days. Enteral nutrition was introduced early in only 6,8% of patients.</div></div><div><h3>Conclusions</h3><div>A high percentage of lung trasplanted patients present constipation; Prophylaxis by means of prokinetics and laxatives is early, although enteral nutrition is not introduced early; It is necessary to review the nutritional protocol to avoid constipation.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 1","pages":"Article 100503"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143344131","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
Modificación de una escala de riesgo de lesión ocular en niños críticamente enfermos 修改重症儿童眼外伤风险量表
IF 1.1 Q3 NURSING Pub Date : 2025-01-01 DOI: 10.1016/j.enfi.2024.04.007
Beatriz Vilchez-Rodriguez RN , Marta Marcos-López RN , Isabel Manzanal-Martín RN , Pablo González-Navarro MSc , Jesús López-Herce-Cid MD, PhD

Introduction

There is no validated tool that assesses the risk of eye injury in intensive care units. The aim of this study was to analyse the ability to detect keratopathies after modification of an eye injury risk assessment scale in critically ill children.

Methods

Observational, retrospective study. We modified a designed scale of risk of ocular damage tested in 194 children without previous ocular pathology admitted to paediatric intensive care for more than 48 hours. The original scale classified patients as high/medium/low risk according to a sum of 10 risk factors. The scale was simplified by eliminating the face mask and slow blinking. Intubation was replaced by mechanical ventilation. All patients were re-classified with the new scale and the early detection ability of the modified scale for eye damage was compared.

Results

There was no statistically significant difference between the two scales for the ability to detect patients at risk of eye injury (P=.4361). The new scale classified patients’ risk of eye injury with the same reliability, with the exception of one patient whose eye injury with the new scale would have been detected one day later.

Conclusions

The new scale had a similar ability to detect eye injury risk as the original scale in critically ill children.
目前还没有有效的工具来评估重症监护病房中眼睛损伤的风险。本研究的目的是分析危重儿童在修改眼损伤风险评估量表后检测角膜病变的能力。方法采用观察性、回顾性研究。我们修改了一项设计的眼损伤风险量表,对194名在儿科重症监护室住院超过48小时且既往无眼部病理的儿童进行了测试。原始量表根据10个危险因素的总和将患者分为高/中/低风险。通过去除面罩和慢速眨眼来简化量表。插管改为机械通气。所有患者均采用新量表重新分类,并比较修改后的量表对眼损伤的早期检测能力。结果两种量表对眼损伤危险的检测能力比较,差异无统计学意义(P=.4361)。新量表对患者眼损伤风险的分类具有相同的可靠性,但有一名患者的眼损伤在新量表下一天后会被检测到。结论新量表对危重儿童眼损伤风险的检测能力与原量表相近。
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引用次数: 0
Calidad de vida en el trabajo e intención de rotar en enfermeras de cuidado intensivo. Estudio transversal 重症监护护士的工作生活质量和轮岗意向。横断面研究
IF 1.1 Q3 NURSING Pub Date : 2025-01-01 DOI: 10.1016/j.enfi.2024.02.004
Laura del Pilar Quiñones-Rozo RN, MSN, PhD, Paola Andrea Largacha-Medina RN, Ingrid Yulieth Bravo-Bolaños RN, Gladys Eugenia Canaval-Erazo RN, MSc, PhD

Introduction

The high demands and current working conditions of nursing professionals who work in intensive care units’ impact both their quality of life and their intention to rotate, and these in turn impact the quality of care.

Objective

Identify the relationship between quality of Work Life (QWL) and the intention to rotate and/or leave the organization of nursing profession in intensive care units.

Method

Analytical cross-sectional observational study with 101 nursing professionals (NP) working in adult intensive care with more than one year of experience in the area. Simple random probabilistic sampling (51 NP) and non-probabilistic convenience sampling (50 NP). The Quality of Life at Work (CVT GOHISALO) instrument is applied plus 5 questions on turnover intention and other sociodemographic questions. The exploratory statistical analysis considered frequency tables and Chi square measures of association to develop the Logit model with the CVT variable as the exposure and the intention to rotate as the outcome.

Results

The dimensions of Quality of Life at Work that show the greatest dissatisfaction are integration with work (D3 [61%]), job satisfaction (D4 [72%]), personal development (D6 [67%]) and free time management (D7 [75%]). There is a high intention to change to another institution (57%) and to migrate to another country (63%). The intention to change to another institution can be explained by job satisfaction and institutional support (P<.001).

Conclusions

There is an inverse relationship between satisfaction with the dimensions of quality of life at work and the intention to change to another service, institution, or independent work, which would imply developing strategies that improve CVT to reduce the intention to rotate.
在重症监护病房工作的护理专业人员的高要求和当前的工作条件影响了他们的生活质量和轮换的意愿,而这些反过来又影响了护理质量。目的探讨重症监护室护理专业轮换和/或离职意向与工作生活质量的关系。方法对101名在成人重症监护工作1年以上的护理专业人员进行分析性横断面观察研究。简单随机概率抽样(51 NP)和非概率方便抽样(50 NP)。工作生活质量(CVT GOHISALO)仪器加上5个关于离职意向和其他社会人口学问题。探索性统计分析考虑频率表和关联的卡方测量来开发Logit模型,其中CVT变量为暴露,旋转意图为结果。结果对工作生活质量最不满意的维度是与工作的融合(D3[61%])、工作满意度(D4[72%])、个人发展(D6[67%])和空闲时间管理(D7[75%])。有很高的意愿换到另一个机构(57%)和移民到另一个国家(63%)。跳槽意向可以用工作满意度和机构支持来解释(P<.001)。结论:对工作生活质量维度的满意度与换到其他服务、机构或独立工作的意愿之间存在反比关系,这意味着制定提高CVT的策略以降低轮换意愿。
{"title":"Calidad de vida en el trabajo e intención de rotar en enfermeras de cuidado intensivo. Estudio transversal","authors":"Laura del Pilar Quiñones-Rozo RN, MSN, PhD,&nbsp;Paola Andrea Largacha-Medina RN,&nbsp;Ingrid Yulieth Bravo-Bolaños RN,&nbsp;Gladys Eugenia Canaval-Erazo RN, MSc, PhD","doi":"10.1016/j.enfi.2024.02.004","DOIUrl":"10.1016/j.enfi.2024.02.004","url":null,"abstract":"<div><h3>Introduction</h3><div>The high demands and current working conditions of nursing professionals who work in intensive care units’ impact both their quality of life and their intention to rotate, and these in turn impact the quality of care.</div></div><div><h3>Objective</h3><div>Identify the relationship between quality of Work Life (QWL) and the intention to rotate and/or leave the organization of nursing profession in intensive care units.</div></div><div><h3>Method</h3><div>Analytical cross-sectional observational study with 101 nursing professionals (NP) working in adult intensive care with more than one year of experience in the area. Simple random probabilistic sampling (51 NP) and non-probabilistic convenience sampling (50 NP). The Quality of Life at Work (CVT GOHISALO) instrument is applied plus 5<!--> <!-->questions on turnover intention and other sociodemographic questions. The exploratory statistical analysis considered frequency tables and Chi square measures of association to develop the Logit model with the CVT variable as the exposure and the intention to rotate as the outcome.</div></div><div><h3>Results</h3><div>The dimensions of Quality of Life at Work that show the greatest dissatisfaction are integration with work (D3 [61%]), job satisfaction (D4 [72%]), personal development (D6 [67%]) and free time management (D7 [75%]). There is a high intention to change to another institution (57%) and to migrate to another country (63%). The intention to change to another institution can be explained by job satisfaction and institutional support <em>(P</em>&lt;.001).</div></div><div><h3>Conclusions</h3><div>There is an inverse relationship between satisfaction with the dimensions of quality of life at work and the intention to change to another service, institution, or independent work, which would imply developing strategies that improve CVT to reduce the intention to rotate.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 1","pages":"Article 100484"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141844153","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}
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IF 1.1 Q3 NURSING Pub Date : 2025-01-01 DOI: 10.1016/S1130-2399(25)00015-X
{"title":"Nota de editor","authors":"","doi":"10.1016/S1130-2399(25)00015-X","DOIUrl":"10.1016/S1130-2399(25)00015-X","url":null,"abstract":"","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 1","pages":"Article 500520"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143344125","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}
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Enfermeria Intensiva
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