Pub Date : 2025-01-01DOI: 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.
{"title":"Modificación de una escala de riesgo de lesión ocular en niños críticamente enfermos","authors":"Beatriz Vilchez-Rodriguez RN , Marta Marcos-López RN , Isabel Manzanal-Martín RN , Pablo González-Navarro MSc , Jesús López-Herce-Cid MD, PhD","doi":"10.1016/j.enfi.2024.04.007","DOIUrl":"10.1016/j.enfi.2024.04.007","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>There was no statistically significant difference between the two scales for the ability to detect patients at risk of eye injury (<em>P</em>=.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.</div></div><div><h3>Conclusions</h3><div>The new scale had a similar ability to detect eye injury risk as the original scale in critically ill children.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 1","pages":"Article 100495"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141840348","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 : 2025-01-01DOI: 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.
{"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 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><.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}
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.
{"title":"Capacidad de discriminación de la escala de valoración actual del riesgo de desarrollar úlcera por presión en pacientes críticos de Quito, Ecuador","authors":"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","doi":"10.1016/j.enfi.2024.06.003","DOIUrl":"10.1016/j.enfi.2024.06.003","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Objective</h3><div>To evaluate the discriminative ability of the current pressure ulcer risk assessment scale in critically ill patients in Quito, Ecuador.</div></div><div><h3>Method</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 2","pages":"Article 100505"},"PeriodicalIF":1.1,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143403174","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 : 2024-10-18DOI: 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.
{"title":"Incidencia de retirada no programada de dispositivos invasivos en enfermos con COVID-19 en cuidados intensivos","authors":"Susana Arias-Rivera PhDc, MsN, RN , Raquel Jareño-Collado RN , María del Mar Sánchez-Sánchez MsN, RN , Fernando Frutos-Vivar MD","doi":"10.1016/j.enfi.2024.07.003","DOIUrl":"10.1016/j.enfi.2024.07.003","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Methodology</h3><div>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.</div></div><div><h3>Results</h3><div>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 (<em>P</em><.001), ICU stay (<em>P</em><.001) and mortality (<em>P</em>=.016) and, between 2020 and all other periods, in rates of use per 100 days-stay (<em>P</em><.010) and per 100 admissions (<em>P</em><.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, <em>P</em><.010), decrease in ET self-removals (2020 rate: 0.00 per 1000 intubation/days; <em>P</em><.050) and enteral catheters (14.33 per 1000 catheter/days). Overall reintubation (all periods) after self-extubation: 12.5%.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 2","pages":"Article 100507"},"PeriodicalIF":1.1,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143444953","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}
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.
{"title":"Eficacia de las amidas infiltradas como anestésico local en la punción arterial para gasometría: una revisión sistemática","authors":"Itxaso Nieves-Cámara RN , Sendoa Ballesteros-Peña RN, MPH, PhD","doi":"10.1016/j.enfi.2024.06.004","DOIUrl":"10.1016/j.enfi.2024.06.004","url":null,"abstract":"<div><h3>Aim</h3><div>To assess the efficacy of infiltrated amides in reducing pain caused by arterial puncture for blood gas analysis.</div></div><div><h3>Method</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 2","pages":"Article 100506"},"PeriodicalIF":1.1,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143403044","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 : 2024-10-02DOI: 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.
{"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}
The calculation of body height in the intensive care unit is essential for obtaining the ideal body weight, which is used to program the tidal volume and establish objective and effective pulmonary ventilation. The objective of the study was to determine the interrater reliability of a tool for measuring body height in adult patients in an intensive care unit (ICU) in southwestern Colombia.
Methods
This cross-sectional observational study was conducted between January and May 2021, following the recommendations of the COSMIN protocol. Two physiotherapists in the roles of observer/evaluator measured the heights of 106 patients upon admission to the ICU with a previously designed. The sample size was calculated based on Pearson's correlation coefficient. For interrater reliability, the intraclass correlation coefficient (ICC) was used, and Bland–Altman analysis was used to assess concordance. The 95% confidence interval was established, and a P value <0.05 indicated statistical significance.
Results
A total of 106 individuals with a mean age of 59.3 years were included; the mean body height was 158.5 cm for women. The interrater reliability of the measurement of height was excellent (global ICC of 0.99, P = 0.000), and an almost perfect positive correlation was obtained between the raters for both women and men (R = 0.99).
Conclusions
Excellent interrater/interobserver reliability was obtained for the measurement of body height in the ICU. This research highlights the importance of protocolizing the measurement of height in critical patients with valid and reliable instruments.
{"title":"Interevaluator reliability of a tool for measuring body height in adult intensive care patients","authors":"H.A. Payán-Salcedo , J.L. Estela-Zape , L.P. Chanchi-Quintero , E.C. Wilches-Luna","doi":"10.1016/j.enfi.2024.01.002","DOIUrl":"10.1016/j.enfi.2024.01.002","url":null,"abstract":"<div><h3>Background</h3><div>The calculation of body height in the intensive care unit is essential for obtaining the ideal body weight, which is used to program the tidal volume and establish objective and effective pulmonary ventilation. The objective of the study was to determine the interrater reliability of a tool for measuring body height in adult patients in an intensive care unit (ICU) in southwestern Colombia.</div></div><div><h3>Methods</h3><div>This cross-sectional observational study was conducted between January and May 2021, following the recommendations of the COSMIN protocol. Two physiotherapists in the roles of observer/evaluator measured the heights of 106 patients upon admission to the ICU with a previously designed. The sample size was calculated based on Pearson's correlation coefficient. For interrater reliability, the intraclass correlation coefficient (ICC) was used, and Bland–Altman analysis was used to assess concordance. The 95% confidence interval was established, and a P value <0.05 indicated statistical significance.</div></div><div><h3>Results</h3><div>A total of 106 individuals with a mean age of 59.3 years were included; the mean body height was 158.5 cm for women. The interrater reliability of the measurement of height was excellent (global ICC of 0.99, <em>P</em> = 0.000), and an almost perfect positive correlation was obtained between the raters for both women and men (<em>R</em> = 0.99).</div></div><div><h3>Conclusions</h3><div>Excellent interrater/interobserver reliability was obtained for the measurement of body height in the ICU. This research highlights the importance of protocolizing the measurement of height in critical patients with valid and reliable instruments.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 4","pages":"Pages 299-307"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652066","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 : 2024-10-01DOI: 10.1016/j.enfi.2024.05.001
F. Jafari Pour MSc, RN , R. Watson PhD, RN , E. Jafaripour MSc , R. Jafarian BSc
Introduction
Since the intensive care units are one of the most sensitive hospital settings and critically ill patients undergo various stressful factors that put their lives in danger, a more advanced level of nursing practice is imperative to accommodate these issues and provide optimal care of patients.
Objectives
To review the literature describing the roles and activities performed by advanced practice nurses in intensive care units.
Review methods
We conducted a scoping review to search published articles using Scopus, PubMed, CINAHL (EBSCOhost), Science Direct, MEDLINE (EBSCOhost) and Cochrane Library during a 10-year period from 2013 to 2023.
Results
We identified 729 records, from which eleven articles were included in the review. We included six reviews and five original articles or research papers. With regard to the target area of our review, we used the information provided by these studies and categorized the contents related to the roles of advanced practice nurses in intensive care units into five sections, including direct practice, education and counseling, research, collaboration, and leadership.
Conclusion
Advanced practice nurses are essential members of critical care team by playing various roles in practice, education, research, collaboration, and leadership, and therefore, they can increase patients’ access to critical care and improve healthcare outcomes. The advancement of technology and complexity of care in intensive care units have led to the role expansion of these nurses which results in task-shifting between doctors and nurses. Therefore, it is considered essential for nursing and medical professionals to reach an agreement to establish standardized roles for advanced practice nurses.
{"title":"The roles and responsibilities of advanced practice nurses in intensive care units: A scoping review","authors":"F. Jafari Pour MSc, RN , R. Watson PhD, RN , E. Jafaripour MSc , R. Jafarian BSc","doi":"10.1016/j.enfi.2024.05.001","DOIUrl":"10.1016/j.enfi.2024.05.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Since the intensive care units are one of the most sensitive hospital settings and critically ill patients undergo various stressful factors that put their lives in danger, a more advanced level of nursing practice is imperative to accommodate these issues and provide optimal care of patients.</div></div><div><h3>Objectives</h3><div>To review the literature describing the roles and activities performed by advanced practice nurses in intensive care units.</div></div><div><h3>Review methods</h3><div>We conducted a scoping review to search published articles using Scopus, PubMed, CINAHL (EBSCOhost), Science Direct, MEDLINE (EBSCOhost) and Cochrane Library during a 10-year period from 2013 to 2023.</div></div><div><h3>Results</h3><div>We identified 729 records, from which eleven articles were included in the review. We included six reviews and five original articles or research papers. With regard to the target area of our review, we used the information provided by these studies and categorized the contents related to the roles of advanced practice nurses in intensive care units into five sections, including direct practice, education and counseling, research, collaboration, and leadership.</div></div><div><h3>Conclusion</h3><div>Advanced practice nurses are essential members of critical care team by playing various roles in practice, education, research, collaboration, and leadership, and therefore, they can increase patients’ access to critical care and improve healthcare outcomes. The advancement of technology and complexity of care in intensive care units have led to the role expansion of these nurses which results in task-shifting between doctors and nurses. Therefore, it is considered essential for nursing and medical professionals to reach an agreement to establish standardized roles for advanced practice nurses.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 4","pages":"Pages e31-e40"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652161","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 : 2024-10-01DOI: 10.1016/j.enfi.2023.10.003
P. Romo-Miguel RN , S. Ballesteros-Peña RN, MPH, PhD
Aim
To compare the efficacy of conventional puncture versus ultrasound-guided puncture for arterial blood gas sampling in adults.
Method
A search protocol was developed and applied to 3 databases (Medline, Cochrane, and Dialnet). Clinical trials published between January 2013 and January 2023, in Spanish or English, were considered. Outcomes in terms of first-attempt success, number of attempts until success, time taken, self-reported iatrogenic pain, and patient or professional experience were collected. The risk of bias for each included study was assessed.
Results
Five randomized clinical trials were selected, with sample sizes ranging from 50 to 238 adult patients treated in emergency settings. Three out of 4 studies showed higher first-attempt success rates when using ultrasound, and 2 out of 4 studies reported a decrease in iatrogenic pain. Discrepant findings were observed among the studies in terms of time taken and the number of attempts required for success.
Conclusions
Although current evidence is limited and the findings are heterogeneous, ultrasound-guided arterial puncture may have advantages over conventional puncture in terms of first-attempt success and in reducing iatrogenic pain.
{"title":"Punción ecoguiada versus técnica tradicional para la extracción de gasometrías arteriales en adultos: una revisión sistemática","authors":"P. Romo-Miguel RN , S. Ballesteros-Peña RN, MPH, PhD","doi":"10.1016/j.enfi.2023.10.003","DOIUrl":"10.1016/j.enfi.2023.10.003","url":null,"abstract":"<div><h3>Aim</h3><div>To compare the efficacy of conventional puncture versus ultrasound-guided puncture for arterial blood gas sampling in adults.</div></div><div><h3>Method</h3><div>A search protocol was developed and applied to 3<!--> <!-->databases (Medline, Cochrane, and Dialnet). Clinical trials published between January 2013 and January 2023, in Spanish or English, were considered. Outcomes in terms of first-attempt success, number of attempts until success, time taken, self-reported iatrogenic pain, and patient or professional experience were collected. The risk of bias for each included study was assessed.</div></div><div><h3>Results</h3><div>Five randomized clinical trials were selected, with sample sizes ranging from 50 to 238 adult patients treated in emergency settings. Three out of 4<!--> <!-->studies showed higher first-attempt success rates when using ultrasound, and 2 out of 4 studies reported a decrease in iatrogenic pain. Discrepant findings were observed among the studies in terms of time taken and the number of attempts required for success.</div></div><div><h3>Conclusions</h3><div>Although current evidence is limited and the findings are heterogeneous, ultrasound-guided arterial puncture may have advantages over conventional puncture in terms of first-attempt success and in reducing iatrogenic pain.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 4","pages":"Pages 368-375"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139456041","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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