Enfermeria Intensiva最新文献_第8页

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

Enfermeria Intensiva

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。

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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

Enfermeria Intensiva

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。

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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

Enfermeria Intensiva

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。

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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

Enfermeria Intensiva

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

Enfermeria Intensiva

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, Paola Andrea Largacha-Medina RN, Ingrid Yulieth Bravo-Bolaños RN, 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 5questions 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><.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}

引用次数: 0

Nota de editor 编辑说明

IF 1.1 Q3 NURSING

Enfermeria Intensiva

Pub Date : 2025-01-01 DOI: 10.1016/S1130-2399(25)00015-X

引用次数: 0

Capacidad de discriminación de la escala de valoración actual del riesgo de desarrollar úlcera por presión en pacientes críticos de Quito, Ecuador 厄瓜多尔基多危重病人患压疮风险评估量表的鉴别能力

IF 1.1 Q3 NURSING

Enfermeria Intensiva

Pub Date : 2024-12-23 DOI: 10.1016/j.enfi.2024.06.003

F.M. Guerrero-Toapanta MD, MSc, M.J. Sandoval-Cóndor RN, M.T. Usuay-Usuay RN, C.J. Paida-Cañar RN, MSc, E.E. Cuenca-Bermúdes RN

Introduction

Pressure ulcers are adverse events that increase morbidity, mortality and costs. Critically ill patients have several risk factors. There are scales that predict their occurrence; however, it is necessary to use specific scales in critically ill patients.

Objective

To evaluate the discriminative ability of the current pressure ulcer risk assessment scale in critically ill patients in Quito, Ecuador.

Method

Observational, longitudinal, prospective study. Patients hospitalized for more than 48 h without evidence of ulcers on admission were recruited. Demographic and clinical variables were recorded, as well as the current risk assessment scales, Norton, and the appearance of ulcers on a daily basis. Data were analyzed using the JAMOVI® statistical package version 2.4. The significance level was p < 0.05.

Results

A total of 306 patients were enrolled, and 5 developed ulcers (incidence of 1.63%). Grade II ulcers and sites on the face and head were most common. For the current risk assessment scale, the ROC curve defined the best cut-off point of 13, at 48 h, Youden index 0.678, sensitivity 100%, specificity 67.77%, positive predictive value 4.9%, negative predictive value 100%, with an AUC of 0.855, with a relative risk of 1.05, with 95% confidence intervals of 1.01-1.10. For Norton, the ROC curve defined the best cut-off point as 9, at 48 h, Youden index 0.646, sensitivity 64.65%, specificity 100%, positive predictive value 100%, negative predictive value 4.55%, AUC 0.874, with a relative risk of 1.04, with 95% confidence intervals of 1.01-1.08.

Conclusions

The current risk assessment scale, similar to the Norton scale, can be used to discriminate the occurrence of pressure ulcers in critically ill patients. The best assessment may be at 48 h after admission, with a cut-off point of 13.

压疮是增加发病率、死亡率和成本的不良事件。危重病人有几个危险因素。有一些尺度可以预测它们的发生；但是，危重患者有必要使用特定的量表。目的评价厄瓜多尔基多地区现行压疮风险评估量表对危重患者压疮风险的鉴别能力。方法观察性、纵向、前瞻性研究。患者住院超过48小时，入院时无溃疡的证据。记录了人口统计学和临床变量，以及当前的风险评估量表、诺顿评分和每日溃疡的出现情况。使用JAMOVI®统计软件包2.4版分析数据。显著性水平为p <；0.05.结果共纳入306例患者，其中5例发生溃疡，发生率为1.63%。II级溃疡和面部及头部部位最常见。对于现行的风险评估量表，ROC曲线定义的最佳截断点为13,48 h时，约登指数0.678，敏感性100%，特异性67.77%，阳性预测值4.9%，阴性预测值100%，AUC为0.855，相对风险为1.05,95%可信区间为1.01-1.10。对于Norton， ROC曲线定义的最佳截断点为9,48 h时，约登指数0.646，敏感性64.65%，特异性100%，阳性预测值100%，阴性预测值4.55%,AUC 0.874，相对风险为1.04,95%可信区间为1.01-1.08。结论现有的风险评估量表与诺顿量表类似，可用于区分危重患者压疮的发生。最佳评估可能是在入院后48小时，分界点为13。

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引用次数: 0

Incidencia de retirada no programada de dispositivos invasivos en enfermos con COVID-19 en cuidados intensivos 2019冠状病毒病重症监护病房中侵入性装置意外移除的发生率

IF 1.1 Q3 NURSING

Enfermeria Intensiva

Pub Date : 2024-10-18 DOI: 10.1016/j.enfi.2024.07.003

Susana Arias-Rivera PhDc, MsN, RN , Raquel Jareño-Collado RN , María del Mar Sánchez-Sánchez MsN, RN , Fernando Frutos-Vivar MD

Introduction

The rate of unscheduled removal of invasive devices (ID) is an indicator of quality programmes in the critically ill. Our research group performed prevalence analyses since 2010 and another during the pandemic. The aim was to analyse the rates of use and non-planed removal of endotracheal tubes, catheters (central venous and arterial) and enteral catheters in the first wave of the COVID-19 pandemic comparing them with previous rates.

Methodology

Prevalence study in a polyvalente ICU. After 4 prospective observational analyses (2010, 2011, 2018, 2019) a retrospective analysis was performed (8 March-8 May 2020). Variables: diagnosis, stay and reason for removal of ID (endotracheal tubes (ET), central venous catheters, arterial catheters and enteral catheters) and rate of reintubation after self-removal of ET. Variables analysed and described as accidental removal rates per 1000 device-days and rates of ID use.

Results

2026 patients were included (631 in 2010, 724 in 2011, 210 in 2018, 361 in 2019 and 100 in 2020). Significant differences, between all periods, in diagnoses (P<.001), ICU stay (P<.001) and mortality (P=.016) and, between 2020 and all other periods, in rates of use per 100 days-stay (P<.010) and per 100 admissions (P<.001) in all devices except arterial catheter. In 2020, there was an increase in ET obstruction (36.0%; rate 20.27 per 1000 intubation/days, P<.010), decrease in ET self-removals (2020 rate: 0.00 per 1000 intubation/days; P<.050) and enteral catheters (14.33 per 1000 catheter/days). Overall reintubation (all periods) after self-extubation: 12.5%.

Conclusions

The rate of devices self-removal in COVID-19 patients in the first wave of the pandemic was lower than that observed in the previous four periods. The high incidence rate of ET obstruction in these patients was significant and relevant.

非计划移除侵入性装置（ID）的比率是危重病人质量规划的一个指标。我们的研究小组自2010年以来进行了患病率分析，另一次是在大流行期间进行的。目的是分析2019冠状病毒病第一波大流行期间气管内管、导管（中心静脉和动脉）和肠内导管的使用率和非计划拔除率，并将其与之前的使用率进行比较。方法多价ICU的患病率研究。经过4次前瞻性观察分析（2010年、2011年、2018年和2019年），进行了回顾性分析（2020年3月8日至5月8日）。变量：诊断、拔除ID（气管内管（ET）、中心静脉导管、动脉导管和肠内导管）的停留时间和原因，以及自行拔除ET后的再插管率。变量分析和描述为每1000个设备日的意外拔除率和ID使用率。结果共纳入2026例患者（2010年631例，2011年724例，2018年210例，2019年361例，2020年100例）。所有时期的诊断率（P< 0.001）、ICU住院率（P< 0.001）和死亡率（P= 0.016）以及2020年与所有其他时期除动脉导管外所有装置的每100天住院率（P< 0.010）和每100次入院率（P< 0.001）均存在显著差异。2020年，ET梗阻发生率增加了36.0%；比率为20.27 / 1000插管/天，P< 0.010)， ET自清除减少(2020年比率：0.00 / 1000插管/天；P< 0.050)和肠内导管（14.33 / 1000导管/天）。自拔管后整体再插管（所有时期）：12.5%。结论第一波疫情中，COVID-19患者的器械自行取出率低于前四波疫情。这些患者ET梗阻的高发生率具有显著性和相关性。

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引用次数: 0

Eficacia de las amidas infiltradas como anestésico local en la punción arterial para gasometría: una revisión sistemática 阿米胺作为局部麻醉剂在动脉穿刺中用于气测的有效性：系统综述

IF 1.1 Q3 NURSING

Enfermeria Intensiva

Pub Date : 2024-10-18 DOI: 10.1016/j.enfi.2024.06.004

Itxaso Nieves-Cámara RN , Sendoa Ballesteros-Peña RN, MPH, PhD

Aim

To assess the efficacy of infiltrated amides in reducing pain caused by arterial puncture for blood gas analysis.

Method

A search protocol was developed and applied across four databases (Medline, SCOPUS, Embase, and TRIP Database). Clinical trials published between January 2000 and May 2024, in either Spanish or English, were considered. Clinical trials comparing the analgesic efficacy of infiltrated amides in adult patients undergoing arterial puncture were selected.

Results

Five randomized clinical trials were selected, with sample sizes ranging from 10 to 133 adult patients per randomization group. The studies showed mixed results regarding the efficacy of infiltrated amides in reducing pain associated with arterial puncture. Two studies highlighted mepivacaine for its pain reduction efficacy, while the other three demonstrated variable efficacy of lidocaine.

Conclusions

The efficacy of infiltrated amides as local anesthetics in arterial puncture for blood gas analysis varies. Mepivacaine appears promising; however, further studies are needed to establish clear recommendations. It is crucial to consider patient preferences and professional experience when deciding on the use of these anesthetics.

目的探讨浸润酰胺对动脉穿刺血气分析疼痛的缓解作用。方法开发检索协议，并在Medline、SCOPUS、Embase和TRIP数据库中应用。2000年1月至2024年5月期间以西班牙语或英语发表的临床试验被纳入考虑范围。选择临床试验，比较浸润酰胺在成人动脉穿刺患者中的镇痛效果。结果随机选择5项临床试验，每个随机组的样本量为10 ~ 133例成人患者。研究显示浸润性酰胺在减轻动脉穿刺疼痛方面的疗效好坏参半。两项研究强调了甲哌卡因的镇痛效果，而另外三项研究表明利多卡因的疗效不同。结论浸润酰胺作为局麻药在动脉穿刺血气分析中的应用效果不同。甲哌卡因看起来很有希望；然而，需要进一步的研究来确定明确的建议。在决定使用这些麻醉剂时，考虑患者的偏好和专业经验是至关重要的。

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引用次数: 0

Factores asociados a la readmisión temprana en Unidades de Cuidados Intensivos: una revisión sistemática 与早期重新进入重症监护病房相关的因素：系统审查

IF 1.1 Q3 NURSING

Enfermeria Intensiva

Pub Date : 2024-10-02 DOI: 10.1016/j.enfi.2024.05.003

V. Badilla-Morales RN, MSN , R.M.C. Sousa RN, PhD , V. Nasabun-Flores RN, MSc , C. González-Nahuelquin RN, MSN

Introduction

Readmission to the Intensive Care Unit (ICU) determines worse outcomes such as higher mortality, increased hospital and ICU stay, as well as higher economic costs. When deciding which patient is suitable for transfer from the ICU, factors associated with readmission must be considered to avoid it. Knowledge of these factors helps professionals identify those patients with a higher probability of readmission, prioritizing their care, establishing and preparing interventions that seek to reduce the risk of readmission.

Objective

Determine factors associated with early readmission in patients transferred from the ICU to general hospitalization wards of the same hospital.

Method

Studies were retrieved from databases: CINAHL, EMBASE, BVS, PubMed, SCOPUS and WOS identifying original studies on adult patients readmitted early to the ICU during the same hospitalization, in any language and without time limit. Studies of patient readmission after seven days, review articles, editorials, protocols, clinical guidelines, qualitative studies and opinion surveys were excluded.

Results

Of 755 files found, 28 articles made up the review. The most analyzed factors were age, sex, severity of the disease, comorbidity, length of stay in the ICU, mechanical ventilation and nocturnal discharge. Those most frequently associated with readmission were age, severity of illness, comorbidity, and length of ICU stay. NEWS, MEWS, and SWIFT scores were also factors associated with readmission.

Conclusion

More research is needed to identify those modifiable factors that can decrease readmission rates. Using readmission prediction instruments at the time of discharge could support the decision of which patient is most prepared for it.

再次入住重症监护室（ICU）决定了更糟糕的结果，如更高的死亡率，住院和ICU住院时间的增加，以及更高的经济成本。在决定哪些患者适合从ICU转出时，必须考虑与再入院相关的因素，以避免再入院。了解这些因素有助于专业人员识别那些再入院概率较高的患者，优先考虑他们的护理，建立和准备旨在降低再入院风险的干预措施。目的探讨从ICU转至同一医院普通住院病房患者早期再入院的相关因素。方法从CINAHL、EMBASE、BVS、PubMed、SCOPUS和WOS数据库中检索研究，确定同一住院期间早期再入院ICU的成人患者的原始研究，以任何语言和无时间限制。7天后患者再入院的研究、综述文章、社论、方案、临床指南、定性研究和意见调查被排除在外。结果在755份文献中，有28篇文章构成了综述。分析最多的因素是年龄、性别、疾病严重程度、合并症、ICU住院时间、机械通气和夜间出院。与再入院最相关的因素是年龄、病情严重程度、合并症和ICU住院时间。NEWS、MEWS和SWIFT评分也是与再入院相关的因素。结论需进一步研究降低再入院率的可调整因素。在出院时使用再入院预测仪器可以帮助决定哪位患者准备得最充分。

{"title":"Factores asociados a la readmisión temprana en Unidades de Cuidados Intensivos: una revisión sistemática","authors":"V. Badilla-Morales RN, MSN , R.M.C. Sousa RN, PhD , V. Nasabun-Flores RN, MSc , C. González-Nahuelquin RN, MSN","doi":"10.1016/j.enfi.2024.05.003","DOIUrl":"10.1016/j.enfi.2024.05.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Readmission to the Intensive Care Unit (ICU) determines worse outcomes such as higher mortality, increased hospital and ICU stay, as well as higher economic costs. When deciding which patient is suitable for transfer from the ICU, factors associated with readmission must be considered to avoid it. Knowledge of these factors helps professionals identify those patients with a higher probability of readmission, prioritizing their care, establishing and preparing interventions that seek to reduce the risk of readmission.</div></div><div><h3>Objective</h3><div>Determine factors associated with early readmission in patients transferred from the ICU to general hospitalization wards of the same hospital.</div></div><div><h3>Method</h3><div>Studies were retrieved from databases: CINAHL, EMBASE, BVS, PubMed, SCOPUS and WOS identifying original studies on adult patients readmitted early to the ICU during the same hospitalization, in any language and without time limit. Studies of patient readmission after seven days, review articles, editorials, protocols, clinical guidelines, qualitative studies and opinion surveys were excluded.</div></div><div><h3>Results</h3><div>Of 755 files found, 28 articles made up the review. The most analyzed factors were age, sex, severity of the disease, comorbidity, length of stay in the ICU, mechanical ventilation and nocturnal discharge. Those most frequently associated with readmission were age, severity of illness, comorbidity, and length of ICU stay. NEWS, MEWS, and SWIFT scores were also factors associated with readmission.</div></div><div><h3>Conclusion</h3><div>More research is needed to identify those modifiable factors that can decrease readmission rates. Using readmission prediction instruments at the time of discharge could support the decision of which patient is most prepared for it.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 2","pages":"Article 100498"},"PeriodicalIF":1.1,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143403045","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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