Background: Several risk factors, such as age, alcohol abuse, dementia, and severe illness, can contribute to the development of delirium. However, limited information is available in the literature regarding the risk of delirium among surgical, trauma, neurological, and medical intensive care patients.Aim: To describe the prevalence of risk factors associated with delirium in intensive care units.Design: This study used an observational design.Methods: We enrolled 165 patients hospitalized in two intensive care units in Italy.Patients were first evaluated using the Prediction of Delirium model and were subsequently evaluated using the Intensive Care Delirium Screening Checklist; evaluation lasted a maximum of 5 days for each admitted patient after sedation. A logistic regression model was used to identify the prevalence and risk factors of delirium. Results:The average age of the patients was 57.6 (SD = 18.3) years, and the patients were predominantly male (65.0%). The majority of patients had been subjected to trauma (38.8%); 37.6% had undergone general surgical interventions, and 23.6% had undergone medical interventions. Delirium occurred in 55.8% of the 165 patients.The risk of delirium was independently associated with coma (odds ratio = 10.6; 95% confidence interval, 3.08-39.9) and the Acute Physiology and Chronic Health Evaluation II score (odds ratio = 4.27; 95% confidence interval, 1.58-11.53). Conclusions: This study confirmed that coma and the Acute Physiology and ChronicHealth Evaluation II score were non-modifiable risk factors for delirium. Further studies could categorize the different types of coma. Proper delirium management could limit the impact on the recovery of these patients, their autonomy, and their reintegration into the social and professional world.Relevance to clinical practice: Delirium increases intensive care unit and hospital length of stay. Early identification and risk factor assessment by critical care nurses are considered the key factors in the treatment of delirium.
Background Hemodynamic monitoring, implemented by the placement of peripheral arterial catheters (PACs), is a characterizing aspect of the intensive care units. Peripheral arterial catheters can continually detect blood pressure and quickly conduct blood sampling. The use of PACs is generally considered safe, without serious complications. Currently, only 25% of the implanted catheters are actually subject to complications, including accidental removal, dislocation, occlusion, and infection. All of these complications arise from inadequate catheter stabilization at the level of the skin. This study aimed to summarize and describe the effectiveness and characteristics of dressings and securement devices for catheter stabilization. Methods A systematic review of literature from the following databases was conducted: MEDLINE, CINAHL, Cochrane, EMBASE, and OvidSP. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement to guide article selection and reporting. Results Herein 626 articles were referred, with 5 directly related to the topic under discussion. We found 3 studies that describe PAC failure and 4 about dislodgement. We described 6 types of dressings or securement devices and classified them into 3 categories for classifying PAC dressings or securement devices. These were detected and grouped as adhesive tissues, sutureless devices, and transparent polyurethane dressings. Conclusions Current research indicates that transparent polyurethane dressings offer the most effective catheter stabilization, but adhesive tissues may constitute a valid alternative. However, there are limited high-quality studies about effective dressings and securement devices for PACs.
Introduzione: La soddisfazione lavorativa o job satisfaction è intesa come l’atteggiamento positivo di una persona nei confronti del lavoro che svolge e che può influenzare le performance degli infermieri, sia la qualità delle cure. Un ambiente di lavoro che favorisca un buon reciproco supporto professionale, opportunità di sviluppo e crescita, può aumentare la soddisfazione lavorativa. Obiettivo: Descrivere il grado di job satisfaction degli infermieri di due Aziende Ospedaliere di Roma. Materiali e Metodi: È stato condotto uno studio trasversale in due ospedali metropolitani romani, in diverse aree cliniche, tra Ottobre e Novembre 2017. È stato usata la versione italiana dell’Index of Work Satisfaction di Stamps. L’ANOVA è stata utilizzata per valutare le differenze tra più di due gruppi. Risultati: Dei 504 questionari distribuiti solo 264 sono stati compilati interamente, con un tasso di risposta pari al 52%. Delle 7 aree indagate, l’autonomia ha ottenuto il punteggio medio più alto (Media = 42.4; DS = 7.7) seguita da status professionale (Media = 33.3; DS = 7.2), interazioni con i colleghi (Media = 25.4; DS = 5.6), politiche organizzative (Media = 20.5; DS = 5.7), mansioni richieste dal ruolo (Media = 19.6; DS = 5.9), interazioni con i medici (Media = 18.9; DS = 5.5) e la retribuzione (Media = 14.2; DS = 6.5). Risultano essere associate ad un aumento della soddisfazione lavorativa il turnover (P=0,002) e la tipologia di contratto (P=0.004). Conclusione: La ricerca mostra che l’autonomia, lo status professionale e la retribuzione sono le aree che impattano positivamente sulla soddisfazione lavorativa. Parole Chiave: infermieri, soddisfazione lavorativa, autonomia, status professionale, turnover
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