Adhesión al bundle de prevención de neumonía asociada a la ventilación mecánica

Esteban

Rincón-Romero

et al. 2021

Rev. esc. enferm. USP

Objective: To determine the effectiveness of a nursing intervention for delirium prevention in critically ill patients. Method: A quasi-experimental study was conducted with a non-equivalent control group and with evaluation before and after the intervention. 157 Patients were part of the intervention group and 134 of the control group. Patients were followed-up until they were discharged from the ICU or died. The incidence of delirium in both groups was compared. Additionally, the effect measures were adjusted for the propensity score. Results: The incidence and incidence rate of delirium in the control group were 20.1% and 33.1 per 1000 person-days (CI 95% 22.7 to 48.3) and in the intervention group was 0.6% and 0.64 per 1000 person-days (CI 95% 0.22 to 11.09), respectively. The crude Hazard Ratio was 0.06 (CI 95% 0,008 to 0,45) and adjusted 0.07 (CI 95% 0,009 to 0,60). The number needed to be treated was six. Conclusion: Low incidence of delirium in critically ill patients intervened demonstrated the effectiveness of interventions. The average intervention time was 4 days with a 15-minutes dedication for each patient.

Section: Discussionmentioning

confidence: 77%

Nursing intervention to prevent delirium in critically ill adults

Esteban

Rincón-Romero

et al. 2021

Rev. esc. enferm. USP

“…Finally, considering that a high workload has been described as a risk factor for attention-associated infections that impact the quality of care, such as the onset of phlebitis, pneumonia, and pressure ulcers (21,(27)(28)(29) , it is necessary to highlight the importance of establishing a nurse-patient that is in line with the workload. This is important as there are many modifying factors, such as direct and indirect care, type of patients, and schedules and shifts (30) .…”

Section: Discussionmentioning

confidence: 99%

Factors associated with nursing workload in three intensive care units

Rivera

Romero

2021

Rev. esc. enferm. USP

Objective: To determine the nursing workload in intensive care units (ICUs) and the factors associated with the Nursing Activities Score (NAS). Method: An analytical cross-sectional study was carried out in three ICUs in Bucaramanga, Colombia, between February 2018 and February 2020. The nursing workload was estimated based on the NAS. A descriptive and bivariate analysis stratified by ICU was performed using a robust multiple linear regression model, and the factors associated with the nursing workload (p < 0.05) were estimated. Results: In this study, 362 records were included. The median NAS was 68.1 points (Q1:47.2–Q3:116.7). APACHE II (β = 3.13, CI: 95% 2.28; 3.98), days of stay in ICU ≥3 (β = 16.78, CI: 95% 6.15; 27.41), surgery provenance service (β = 22.31, CI: 95% 9.76; 34.86), and traumatology and emergencies diagnostic category (β = 33.72, CI 95%: 9.90; 57.53) were associated with high NAS scores. Conclusion: The nursing staff spend approximately 70% of their time on a single patient, and administrative work takes up most of their time. Hospital stays of longer than 3 days, high APACHE II score, coming from the surgery department, and having a diagnosis of trauma and emergency were associated with a high workload.

“…It also shows that, when they participate, the families seem to perceive the nursing personnel as more respectful, supportive, and collaborative. Therefore, these and other multicomponent non-pharmacological nursing interventions carried out in the patients in intensive care units show the need to continue working in strategies that can promote the quality of care practices, making nursing work more visible (18)(19) .…”

Section: Discussionmentioning

confidence: 99%

Multicomponent nursing program to prevent delirium in critically ill patients: a randomized clinical trial

Esteban

Parra

et al. 2021

Rev. Gaúcha Enferm.

Objectives To determine the efficacy of a multicomponent nursing program to prevent delirium in critically ill patients. Methods Parallel controlled randomized clinical trial to prevent delirium in 81 critically ill patients: 41 in the control group and 40 in the intervention group (intervention: spatial and temporal guidance, visual stimulus, auditive stimulus, and family support). Participants were recruited from September 2017 to March 2018 in the university hospital Los Comuneros, Bucaramanga, Colombia. Clinical Trials record NCT03215745. Results The incidence of delirium was 5% in the intervention group and 24% in the control group. The relative risk was 0.20 (95% CI 0.05 to 0.88). The absolute risk reduction was 19.39% (95% CI 4.61 to 34.17) and the number needed to treat was 5 (95 CI % 3 to 26%). Conclusion The multicomponent nursing program is efficient to prevent delirium in critically ill patients.