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1.
Invest. educ. enferm ; 39(2): [e11], 15 junio 2021. table 1, table 2, table 3, table 4, table 5, table 6
Article in English | LILACS, BDENF, COLNAL | ID: biblio-1254668

ABSTRACT

Objective. To evaluate the effects of application of a manual on the improvement of alarms management in Intensive Care Units (ICU). Methods. This quasi-experimental study evaluated the effectiveness of the introduction into of a manual for alarm management and control in the ICU of a hospital in southeastern Iran. The intervention was a 4-hour workshop was on topics related to the adverse effects of alarms, standardization of ECG, oxygen saturation and blood pressure monitoring systems, and the use of ventilators and infusion pumps. Data were collected thorough 200 hours of observation of 60 ICU nurses (100 hours' pre-intervention and 100 hours' post-intervention). Response time, type of response, customization of alarm settings for each patient, the person responding to an alarm, and the cause of the alarm were analyzed. Alarms were classified into three types: false, true and technical. Results. The results showed a statistically significant difference between the pre- and post-intervention frequency of alarm types, frequency of monitoring parameters, customized monitoring settings for patients, and individuals who responded to alarms. The percentage of effective interventions was significantly higher for all parameters after the intervention (46.9%) than before the intervention (38.9%). Conclusion. The employment of a manual for management of alarms from electronic equipment in ICUs can increase the frequency of appropriate responses to alarms in these units.


Objetivo. Evaluar los efectos de la aplicación de un manual en el mejoramiento de la gestión de las alarmas en enfermeros las Unidades de Cuidados Intensivos -UCI-. Métodos. Estudio cuasi- experimental en el que se evaluó la efectividad de la introducción de un manual en la práctica para la prevención y el control de alarmas en una UCI de un hospital del sudeste de Irán. Se realizó un taller de 4 horas de duración que incluía temas relacionados con los efectos adversos de las alarmas, la estandarización en los sistemas de monitoreo de ECG, saturación de oxígeno y presión arterial, y del uso de ventiladores y de bombas de infusión. Se realizaron 200 horas de observación a 60 enfermeras de la UCI (100 horas antes y 100 horas después de la intervención). Se analizó el tiempo de respuesta, el tipo de respuesta, la personalización de los ajustes de la alarma para cada paciente, la persona que responde a una alarma y la causa de la alarma. Las alarmas se clasificaron en tres tipos: falsas, verdaderas y técnicas. Resultados. Los hallazgos mostraron diferencias estadísticamente significativas entre la frecuencia de los tipos de alarma antes y después de la intervención, la frecuencia de los parámetros de monitorización, los ajustes de monitorización personalizados para los pacientes y las personas que responden a las alarmas. El porcentaje de intervenciones efectivas para el total de parámetros fue significativamente mayor después de la intervención (46.9%) que antes de la misma (38.9%). Conclusión. Los resultados del estudio muestran que el empleo del manual para la gestión de las alarmas de los equipos electrónicos en una UCI puede aumentar la frecuencia de respuestas adecuadas de los enfermeros de estos servicios.


Objetivo. Avaliar os efeitos da aplicação de um manual na melhoria do gerenciamento de alarmes em enfermeiros de Unidades de Terapia Intensiva -UTI-. Métodos. Estudo quase-experimental no qual foi avaliada a eficácia da introdução na prática de um manual para prevenção e controle de alarmes em uma UTI de hospital no sudeste do Irã. Foi realizado um workshop de 4 horas que incluiu tópicos relacionados aos efeitos adversos dos alarmes, padronização dos sistemas de monitoração de ECG, saturação de oxigênio e pressão arterial e uso de ventiladores e bombas de infusão. Foram realizadas 200 horas de observação em 60 enfermeiras de UTI (100 horas antes e 100 horas após a intervenção). O tempo de resposta, o tipo de resposta, a personalização das configurações de alarme para cada paciente, a pessoa que responde a um alarme e a causa do alarme foram analisados. Os alarmes foram classificados em três tipos: falso, verdadeiro e técnico. Resultados. Os resultados mostraram diferenças estatisticamente significativas entre a frequência dos tipos de alarme antes e depois da intervenção, a frequência dos parâmetros de monitoração, configurações de monitoração personalizadas para pacientes e pessoas que respondem aos alarmes. O percentual de intervenções eficazes para todos os parâmetros foi significativamente maior após a intervenção (46,9%) do que antes (38,9%). Conclusão. Os resultados do estudo mostram que a utilização do manual para gerenciamento de alarmes de equipamentos eletrônicos em UTIs pode aumentar a frequência de respostas adequadas aos alarmes nos enfermeiros desses serviços.


Subject(s)
Humans , Observation , Monitoring , Clinical Alarms , Intensive Care Units , Nurses
2.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 13: 1428-1435, jan.-dez. 2021. ilus
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1342109

ABSTRACT

Objetivo: identificar as causas da fadiga de alarmes em estudos de usabilidade de bomba de infusão em terapia intensiva pediátrica. Métodos: Realizou-se uma revisão integrativa nas bases de dados LILACS, SciELO, IBECS, SCOPUS e MEDLINE. Resultados: Foram identificadas 1.164 publicações e selecionados seis estudos primários que emergiram em duas temáticas: compreender as causas dos alarmes da bomba de infusão que constou: biblioteca de fármacos incompleta, limites absolutos e relativos rígidos, falta de protocolo de preparo e administração de medicação, período de férias dos funcionários; e as medidas que podem evitar a fadiga de seus alarmes.Conclusão:falhas na usabilidade de bombas de infusão aumentam os alarmes desnecessários que podem promovem sua fadiga. A utilização segura de bombas de infusão demanda uma equipe que monitore suas práticas e atue promovendo mudanças no contexto de trabalho


Objective: to identify the causes of alarm fatigue in studies of infusion pump usability in pediatric intensive care. Methods: an integrative review was carried out in the LILACS, SciELO, IBECS, SCOPUS and MEDLINE databases. Results: 1,164 publications were identified and six primary studies were selected that emerged in two themes: understanding the causes of the infusion pump alarms that consisted of: incomplete drug library, absolute and strict relative limits, lack of preparation protocol and medication administration, employee vacation period; and measures that can prevent fatigue from your alarms. Conclusion: the causes of alarm fatigue involve low user interaction with the equipment, inadequate work processes and low investment in preventive measures for its occurrence The safe use of infusion pumps requires a team to monitor their practices and act by promoting changes in the work context


Objetivo: identificar las causas de la fatiga de alarma en estudios de usabilidad de bombas de infusión en cuidados intensivos pediátricos. Métodos: se realizó una revisión integradora en las bases de datos LILACS, SciELO, IBECS, SCOPUS y MEDLINE. Resultados: se identificaron 1.164 publicaciones y se seleccionaron seis estudios primarios que surgieron en dos temas: comprender las causas de las alarmas de la bomba de infusión que consistían en: biblioteca de medicamentos incompleta, límites relativos absolutos y estrictos, falta de protocolo de preparación y administración de medicamentos, período de vacaciones de los empleados; y medidas que pueden prevenir la fatiga de sus alarmas. Conclusión: las causas de la fatiga de las alarmas involucran baja interacción del usuario con el equipo, procesos de trabajo inadecuados y baja inversión en medidas preventivas para su ocurrencia. El uso seguro de las bombas de infusión requiere que un equipo monitoree sus prácticas y actúe promoviendo cambios en el contexto de trabajo


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Infusion Pumps/standards , Intensive Care Units, Pediatric , Alert Fatigue, Health Personnel/prevention & control , Occupational Stress/prevention & control
3.
Rev. colomb. nefrol. (En línea) ; 7(2): 44-54, jul.-dic. 2020. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-1251564

ABSTRACT

Abstract Objectives: to identify valid blood biomarkers to detect heart failure and kidney failure associated with kidney disease and hemodialysis Methods: systematic literature review conducted in August 2018 in the following: Web Of Science, PubMed, Scopus, Cinahal, Cochrane, Science Direct and Lilacs. The guiding question was: "What are the blood biomarkers used to detect heart failure and kidney failure?" A total of537 publications were found, 94 of these appeared more than once, 383 were excluded after reading titles and abstracts, 32 were excluded after reading the full texts, and 10 were excluded in the quantitative and qualitative synthesis. Results: 18 papers compose the final sample and report laboratory and imaging tests, instruments to assess the risk of kidney and heart failure, and also clinical management of the progression of kidney and heart failure. All the studies correlated risk of mortality and death outcome. Conclusion: laboratory tests are important to identifying kidney and heart failure and need to be used to improve clinical management of the hemodialysis treatment of people with chronic kidney disease in order to improve quality of life and life expectancy.


Subject(s)
Humans , Male , Female , Renal Dialysis , Kidney Diseases , Blood , Brazil , Biomarkers , Diagnostic Techniques and Procedures , Renal Insufficiency , Clinical Alarms , Heart Failure
4.
Rev. bras. enferm ; 73(4): e20180963, 2020. tab, graf
Article in English | LILACS-Express | LILACS, BDENF | ID: biblio-1101529

ABSTRACT

ABSTRACT Objectives: to estimate the magnitude of the Nursing Activities Score effect on multiparametric monitor alarm response and staff response time. Methods: an observational, cross-sectional study outlined as an open cohort, performed in an Adult General Intensive Care Unit. The time taken for alarms triggered by the multi-parameter monitors was timed and characterized as attended or not. Results: the study obtained a total of 254 alarms triggered from the multiparameter monitors of 63 patients. The mean number of alarms triggered was 4.5 alarms per period/observation and 1.5 alarms/hour. The study showed that the Nursing Activities Score is associated with an additional probability of 4% (p < 0.05) of an alarm being met, for each additional point in the scale, and reduction in team response time. Conclusion: it has been verified that Nursing Activities Score has a direct relationship with the attendance and with the response time to the alarms triggered.


RESUMEN Objetivos: estimar la magnitud del efecto del Nursing Activities Score en la atención a las alarmas de los monitores multiparamétricos y en el tiempo de respuesta del equipo. Métodos: estudio observacional, seccional delineado como una cohorte abierta, realizado en una Unidad de Terapia Intensiva General de Adultos. El tiempo hasta la atención de las alarmas disparadas de los monitores multiparamétricos fue cronometrado y caracterizados como atendidos o no. Resultados: el estudio obtuvo un total de 254 alarmas disparadas de los monitores multiparamétricos de 63 pacientes. El promedio de alarmas disparadas fue de 4,5 alarmas por período/observación y 1,5 alarmas/hora. El estudio demostró que el Nursing Activities Score está asociado a una probabilidad adicional de 4% (p < 0,05) de una alarma ser atendida, para cada punto adicional en la escala, y reducción en el tiempo de respuesta del equipo. Conclusiones: se verificó que Nursing Activities Score tiene relación directa con la atención y con el tiempo de respuesta a las alarmas disparadas.


RESUMO Objetivos: estimar a magnitude do efeito do Nursing Activities Score no atendimento aos alarmes dos monitores multiparamétricos e no tempo de resposta da equipe. Métodos: estudo observacional, seccional delineado como coorte aberta, realizado em uma Unidade de Terapia Intensiva geral de adultos. O tempo até o atendimento dos alarmes disparados dos monitores multiparamétricos foi cronometrado e caracterizado como atendido ou não. Resultados: o estudo obteve um total de 254 alarmes disparados dos monitores multiparamétricos de 63 pacientes. A média de alarmes disparados foi de 4,5 alarmes por período/observação e 1,5 alarmes/hora. O estudo demonstrou que o Nursing Activities Score está associado a uma probabilidade adicional de 4% (p < 0,05) de um alarme ser atendido, para cada ponto adicional na escala, e redução no tempo de resposta da equipe. Conclusões: verificou-se que Nursing Activities Score possui relação direta com o atendimento e com o tempo de resposta aos alarmes disparados.

5.
Rev. bras. enferm ; 72(3): 609-616, May.-Jun. 2019. tab, graf
Article in English | LILACS, BDENF | ID: biblio-1013566

ABSTRACT

ABSTRACT Objective: To measure the magnitude of the effect of an individualized parameterization protocol for hemodynamic alarms in patients with acute myocardial infarction. Method: Pragmatic clinical trial, open label and single arm, whose intervention was performed through a protocol validated and tested in 32 patients using multiparametric monitors. The heart rate, blood pressure, respiratory rate, oxygen saturation and ST segment-monitoring were measured and classified for clinical consistency one hour before and after the intervention, for 64 hours. Results: The protocol obtained Content Validity Index of 0.92. Of the 460 registered alarms, 261 were considered inconsistent before the intervention and 47 after it. The Relative Risk of inconsistent alarms after the protocol was 0.32 (95% CI 0.23-0.43, p <0.0001). Conclusion: The protocol proved to be a protective factor to the appearance of inconsistent clinical alarms of multiparametric monitors.


RESUMEN Objetivo: Medir la magnitud del efecto de un protocolo de parametrización individualizada de alarmas hemodinámicas en pacientes con infarto agudo de miocardio. Método: Ensayo clínico pragmático, open label y single arm cuya intervención ocurrió por medio de un protocolo validado y testado en 32 pacientes, utilizándose monitores multiparamétricos. Las alarmas de frecuencia cardíaca, presión arterial, frecuencia respiratoria, saturación de oxígeno y segmento ST fueron valorados y clasificados según su consistencia clínica, una hora antes y después de la intervención, durante 64 horas. Resultados: El protocolo obtuvo un índice de Validez de Contenido de 0,92. De las 460 alarmas registradas, 261 fueron consideradas inconsistentes antes de la intervención y 47 después. El Riesgo Relativo de las alarmas incoherentes después del protocolo fue de 0,32 (IC 95% 0.23-0.43, p <0,0001). Conclusión: El protocolo se mostró un factor protector al surgimiento de alarmas clínicas inconsistentes de monitores multiparamétricos.


RESUMO Objetivo: Medir a magnitude do efeito de um protocolo de parametrização individualizada de alarmes hemodinâmicos em pacientes com infarto agudo do miocárdio. Método: Ensaio clínico pragmático, open label e single arm, cuja intervenção ocorreu por meio de um protocolo validado e testado em 32 pacientes usando monitores multiparamétricos. Os alarmes de frequência cardíaca, pressão arterial, frequência respiratória, saturação de oxigênio e segmento ST foram mensurados e classificados quanto à consistência clínica uma hora antes e após a intervenção, durante 64 horas. Resultados: O protocolo obteve Índice de Validade de Conteúdo de 0,92. Dos 460 alarmes registrados, 261 foram considerados inconsistentes antes da intervenção e 47 após. O Risco Relativo de alarmes inconsistentes após o protocolo foi de 0,32 (IC 95% 0.23-0.43, p<0,0001). Conclusão: O protocolo mostrou-se um fator protetor ao surgimento de alarmes clínicos inconsistentes de monitores multiparamétricos.


Subject(s)
Humans , Male , Female , Aged , Monitoring, Physiologic/nursing , Myocardial Infarction/nursing , Blood Pressure/physiology , Electrocardiography/nursing , Electrocardiography/standards , Clinical Alarms , Heart Rate/physiology , Intensive Care Units/organization & administration , Intensive Care Units/statistics & numerical data , Middle Aged , Monitoring, Physiologic/standards
6.
Chinese Journal of Burns ; (6): 626-628, 2019.
Article in Chinese | WPRIM | ID: wpr-810828

ABSTRACT

At present, there are many monitoring devices for vital signs parameters for clinical selection, but urine monitoring has not received enough attention. The traditional manual visual measurement, intermittent measurement of urine pH value, and other methods are still in use, so the authors designed a multifunctional urine bag. The urine bag can set up an alarm system per unit time according to patient′s age and condition as well as set up urine pH value detection area in hard plastic measuring bottle. This device can not only accurately monitor urine volume per unit time, but also hopefully realize the alarm automation of abnormal urine volume per unit time, as well as real-time dynamic monitoring of urine pH value. It is helpful for medical staff to make accurate judgment on patients′ condition changes, to guide the formulation and modification of clinical treatment plans, and to reduce the workload of clinical nursing staff to a certain extent.

7.
Rev. bras. enferm ; 71(6): 3035-3040, Nov.-Dec. 2018. tab
Article in English | LILACS, BDENF | ID: biblio-977617

ABSTRACT

ABSTRACT Objective: To measure the response time of health professionals before sound alarm activation and the implications for patient safety. Method: This is a quantitative and observational research conducted in an Adult Intensive Care Unit of a teaching hospital. Three researchers conducted non-participant observations for seven hours. Data collection occurred simultaneously in 20 beds during the morning shift. When listening the alarm activation, the researchers turned on the stopwatches and recorded the motive, the response time and the professional conduct. During collection, the unit had 90% of beds occupied and teams were complete. Result: We verified that from the 103 equipment activated, 66.03% of alarms fatigued. Nursing was the professional category that most provided care (31.06%) and the multi-parameter monitor was the device that alarmed the most (66.09%). Conclusion: Results corroborate the absence or delay of the response of teams, suggesting that relevant alarms might have been underestimated, compromising patient safety.


RESUMEN Objetivo: Mensurar el tiempo-respuesta de los profesionales de salud delante del disparo de las alarmas sonoras, y las implicaciones para la seguridad del paciente. Método: Investigación cuantitativa, observacional, en una Unidad de Terapia Intensiva - Adulto de un hospital de enseñanza. Los tres investigadores han realizado observaciones no participativas durante 7 horas. La recogida de los datos ha ocurrido simultáneamente en 20 camillas en el período diurno. Al oír el disparo, los investigadores accionaban los cronómetros y registraban el motivo, el tiempo-respuesta y la conducta profesional. Durante la recogida, la unidad estaba con el 90% de las camillas ocupadas y los equipos estaban completados. Resultados: Certificamos que, de los 103 equipamientos que han sido disparados, el 66,03% de las alarmas han fatigado. La enfermería ha sido la categoría profesional que más ha atendido (el 31,06%), y el monitor multiparámetros ha alarmado (el 66,09%). Conclusión: Los resultados han corroborado la ausencia o el retardo de la respuesta del equipo, sugiriendo que las alarmas relevantes hayan sido menospreciadas, comprometiendo la seguridad de los pacientes.


RESUMO Objetivo: Mensurar o tempo-resposta dos profissionais de saúde diante ao disparo dos alarmes sonoros e as implicações para a segurança do paciente. Método: Pesquisa quantitativa, observacional, em uma Unidade de Terapia Intensiva Adulto de um Hospital de Ensino. Os três pesquisadores realizaram observações não participativas durante 7 horas. A coleta de dados ocorreu simultaneamente em 20 leitos no período diurno. Ao ouvir o disparo, os pesquisadores acionavam os cronômetros e registravam o motivo, o tempo-resposta e a conduta profissional. Durante a coleta a unidade estava com 90% dos leitos ocupados e as equipes estavam completas. Resultados: Verificamos que, dos 103 equipamentos disparados, 66,03% dos alarmes fatigaram. A enfermagem foi a categoria profissional que mais atendeu (31.06%), e o monitor multiparâmetros alarmou (66,09%). Conclusão: Os resultados corroboram a ausência ou retardo de resposta da equipe, sugerindo que alarmes relevantes tenham sido menosprezados, comprometendo a segurança dos pacientes.


Subject(s)
Humans , Auditory Fatigue , Time Factors , Clinical Alarms/adverse effects , Brazil , Clinical Alarms/trends , Patient Safety/standards , Patient Safety/statistics & numerical data , Intensive Care Units/organization & administration , Intensive Care Units/statistics & numerical data , Length of Stay/statistics & numerical data , Monitoring, Physiologic/instrumentation , Monitoring, Physiologic/methods
8.
Article in Portuguese | LILACS, BDENF | ID: biblio-973250

ABSTRACT

OBJETIVOS: caracterizar quais alarmes sonoros disparados por ventiladores mecânicos foram mais frequentes, descrever o tempo estímulo-resposta aos alarmes do ventilador mecânico e analisar as condutas dos profissionais de enfermagem diante dos alarmes ventilatórios. MÉTODO: pesquisa descritiva, quantitativa, realizada em uma unidade de terapia intensiva de um hospital universitário do Rio de Janeiro. Os dados foram tratados com estatística descritiva. RESULTADOS: realizadas 60 horas de observação, nesse período, soaram 25 alarmes de ventiladores mecânicos, 20 alarmes foram atendidos e 5 pararam sem nenhuma intervenção. Os alarmes mais prevalentes foram volume minuto expirado baixo, e pressão de vias aéreas alta. O tempo mínimo para atendimento dos alarmes foi 10 segundos, o tempo máximo 3 minutos, e o tempo médio 38 segundos. As condutas mais realizadas pelos profissionais de enfermagem foram aspiração traqueal, reposicionamento do circuito e ausculta pulmonar. CONCLUSÃO: os achados da pesquisa apontaram que, nos alarmes mais prevalentes, as condutas dos profissionais de enfermagem, de acordo com a literatura, não foram suficientes para a resolutividade dos problemas apresentados.


OBJECTIVES: to characterize which alarms were activated by mechanical ventilators were more frequent, to describe the stimulusresponse time to the mechanical ventilator alarms and to analyze the nursing professionals conducts before ventilatory alarms. METHOD: descriptive, quantitative research performed in an intensive care unit of a university hospital in Rio de Janeiro. The data were treated with descriptive statistics. RESULTS: 60 hours of observation were performed. During this period, 25 mechanical ventilator alarms sounded, 20 alarms were answered and 5 stopped without any intervention. The most prevalent alarms were low expired minute volume, and high airway pressure. The minimum time to answer the alarms was 10 seconds, the maximum time 3 minutes, and the average time 38 seconds. The most accomplished conducts by the nursing professionals were tracheal aspiration, circuit repositioning and pulmonary auscultation. CONCLUSION: the research findings pointed out that, in the most prevalent alarms, nursing professionals' conduct, according to the literature, was not enough to solve the problems presented.


OBJETIVOS: caracterizar que alarmas sonoras disparadas por ventiladores mecánicos fueron más frecuentes, describir el tiempo estímulo-respuesta a las alarmas del ventilador mecánico y analizar las conductas de los profesionales de enfermería ante las alarmas ventilatorios. MÉTODO: investigación descriptiva, cuantitativa realizada en una unidad de terapia intensiva de un hospital universitario de Río de Janeiro. Los datos fueron tratados con estadística descriptiva. RESULTADOS: realizadas 60 horas de observación, en ese período sonaron 25 alarmas de ventiladores mecánicos, 20 alarmas fueron atendidas y 5 pararon sin ninguna intervención. Las alarmas más prevalentes fueron el volumen minuto expirado bajo, y la presión de las vías aéreas alta. El tiempo mínimo para la atención de las alarmas fue 10 segundos, el tiempo máximo 3 minutos, y el tiempo promedio 38 segundos. Las conductas más realizadas por los profesionales de enfermería fueron aspiración traqueal, reposicionamiento del circuito y auscultación pulmonar. CONCLUSIÓN: los hallazgos de la investigación apuntaron que, en las alarmas más prevalentes, las conductas de los profesionales de enfermería, de acuerdo con la literatura, no fueron suficientes para la resolución de los problemas presentados.


Subject(s)
Humans , Clinical Alarms , Intensive Care Units , Nursing , Respiration, Artificial
9.
Medisur ; 15(6): 884-887, nov.-dic. 2017.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-894793

ABSTRACT

Fundamento: las enfermedades por inmunodeficiencias son un grupo heterogéneo de trastornos que reflejan un déficit cuantitativo y/o cualitativo en uno o más componentes del sistema inmune. La rápida remisión de estos casos a la consulta de inmunología disminuye la morbilidad y mortalidad.Objetivo: establecer los signos de alarma para el diagnóstico de una inmunodeficiencia primaria, que servirán de criterio de remisión en la provincia de Cienfuegos.Métodos: se revisaron 11 artículos sobre los signos de alarma para el diagnóstico de las inmunodeficiencias primarias, publicados por asociaciones y organizaciones internacionales dedicadas a la inmunología. Se determinó del valor diagnóstico del signo como criterio para su inclusión en la relación de signos de alarma de esta enfermedad. Resultados: se establecieron 15 signos de alarma basados en su frecuencia de reporte y/o valor diagnóstico atribuido.Conclusiones: los signos de alarma establecidos por el grupo provincial de inmunología de Cienfuegos se tomarán como criterios de remisión a consulta de inmunología por sospecha de inmunodeficiencia primaria, lo que podrá contribuir a disminuir su morbilidad.


Foundation: immunodeficiency diseases are a heterogeneous group of disorders that reflect one or more components of the immune system quantitative and / or qualitative deficit. The fast reference of these cases to the immunology consultation decreases morbidity and mortality. Objective: to establish the alarm signs for a primary immunodeficiency diagnosis, that will be a referral criterion in the province of Cienfuegos. Methods: eleven articles on alarm signs for primary immunodeficiencies diagnosis, published by associations and international organizations dedicated to immunology were reviewed. The sign diagnostic value was determined as a criterion for inclusion in the disease warning signs list. Results: Fifteen alarm signs were established based on their reporting frequency and / or assigned diagnostic value. Conclusion: alarm signs established by the Cienfuegos provincial immunology group will be taken as referral criteria for immunology consultation due to primary immunodeficiency suspicion, which may contribute to decrease its morbidity.

10.
Rev. bras. enferm ; 70(6): 1206-1211, Nov.-Dec. 2017. graf
Article in English | LILACS, BDENF | ID: biblio-898305

ABSTRACT

ABSTRACT Objective: To characterize the sound alarms of the Intra-Aortic Balloon Pump (IABP) during aortic counterpulsation therapy; to measure the stimulus-response time of the team to these; and to discuss the implications of increasing this time for patient safety from the alarm fatigue perspective. Method: This is an observational and descriptive study with quantitative and qualitative approach, case study type, carried out in a Cardiac Surgical Intensive Care Unit. Results: The most audible IABP alarm was the one of high priority increased-reduced diastolic blood pressure. The stimulus-response time was 33.9 seconds on average. Conclusion: Managing the alarms of these equipment is essential to minimize the occurrence of the alarm fatigue phenomenon and to offer a safer assistance to patients who rely on this technology.


RESUMEN Objetivo: Caracterizar las alarmas sonoras disparadas por el balón de contrapulsación intraaórtico (BCIA) durante la terapia de contrapulsaciónaórtica; calcular el tiempo estímulo-respuesta del dispositivo y discutir las implicaciones al extenderse el tiempo para la seguridad del paciente cuando presente fatiga por las alarmas. Método: Estudio descriptivo observacional, con enfoques cuantitativo y cualitativo, de tipo estudio de caso, llevado a cabo en una Unidad de Cuidado Cardiontensivo Quirúrgico. Resultados: La alarma sonora más disparada por el BCIA fue la de la diástole aumentada y disminuida, de alta necesidad. El promedio del tiempo estímulo-respuesta fue de 33,9 segundos. Conclusión: La gestión de las alarmas de este dispositivo se hace imprescindible para minimizar su fatiga a los pacientes que lo utilizan y para ofrecerles un cuidado más seguro.


RESUMO Objetivo: Caracterizar os alarmes sonoros disparados pelo balão intra-aórtico (BIA) durante a terapia de contrapulsação aórtica; medir o tempo estímulo-resposta da equipe a esses e discutir as implicações do alargamento desse tempo para a segurança do paciente na perspectiva da fadiga de alarmes. Método: Trata-se de um estudo descritivo observacional, com abordagem quanti-qualitativa, do tipo estudo de caso, realizado em uma Unidade de Terapia Cardiointensiva Cirúrgica. Resultados: O alarme sonoro mais disparado pelo BIA foi o de pressão diastólica aumentada-diminuída, de alta prioridade. O tempo estímulo-resposta foi em média de 33,9 segundos. Conclusão: O gerenciamento dos alarmes desses equipamentos torna-se imprescindível para minimizar a ocorrência do fenômeno fadiga de alarmes e na oferta de uma assistência mais segura ao paciente dependente dessa tecnologia.


Subject(s)
Humans , Reaction Time , Time Factors , Clinical Alarms/standards , Patient Safety/standards , Intra-Aortic Balloon Pumping/instrumentation , Qualitative Research , Equipment Safety , Intensive Care Units/organization & administration , Intensive Care Units/statistics & numerical data
11.
Rev. bras. enferm ; 70(1): 172-179, jan.-fev. 2017. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-843623

ABSTRACT

RESUMO O presente estudo tem como propósito refletir sobre a prática de enfermagem no que concerne à temática da monitorização dos alarmes clínicos. Objetivo: Pretendemos identificar e sintetizar, a melhor, a evidência empírica produzida sobre os fatores que influenciam a resposta dos enfermeiros perante os alarmes clínicos. Método: Perspetivou-se um estudo de revisão integrativa da literatura. Selecionámos um conjunto de dez bases de dados eletrónicas, delimitou-se a pesquisa ao período temporal de 2005 a 2016. Resultados: Por meio de uma estratégia de cruzamento dos descritores selecionados, foram incluídos oito artigos. Conclusão: Na análise dos estudos, reconhecemos como possíveis fatores que interferem na resposta dos enfermeiros na monitorização dos alarmes clínicos: o grande número de falsos alarmes, a inaudibilidade dos alarmes por causa da competição de sons, a dificuldade de distinguir a urgência dos alarmes e o aumento do ruído provocado pelo aumento do número de alarmes.


RESUMEN El presente estudio tiene como propósito reflexionar sobre la práctica de enfermería en lo que concierne a la temática del monitoreo de las alarmas clínicas. Objetivo: Pretendemos identificar y sintetizar, la mejor, la evidencia empírica producida sobre los factores que influyen la respuesta de los enfermeros frente a las alarmas clínicas. Método: Se tuvo una perspectiva de un estudio de revisión integradora de la literatura. Seleccionamos un conjunto de diez bases de datos electrónicos, se delimitó la pesquisa al periodo temporal de 2005 a 2016. Resultados: Por medio de una estrategia de cruzamiento de los descriptores seleccionados, fueron incluidos ocho artículos. Conclusión: En el análisis de los estudios, reconocemos como posibles factores que interfieren en la respuesta de los enfermeros en el monitoreo de las alarmas clínicos: el gran número de falsas alarmas, lo inaudible de las alarmas por causa de la competición de sonidos, la dificultad de distinguir la urgencia de las alarmas y el aumento de ruido provocado por el aumento del número de alarmas.


ABSTRACT The aim of the present study was to reflect on nursing practice regarding the monitoring of clinical alarms. Objective: The objective of the present study was to identify and synthesize the best empirical evidence found on factors that influence the response of nurses regarding clinical alarms. Method: An integrative literature review was conducted with searches undertaken in ten electronic databases restricted to the period from 2005 to 2016. Results: Eight articles were included by cross-checking the descriptors selected. Conclusion: In the analysis of the studies, the following possible factors that might interfere with the response of nurses in the monitoring of clinical alarms were found: high number of false alarms, inaudibility of alarms due to the competition of sounds, difficulty in distinguishing the urgency of alarms, and increase in noise caused by the raise in the number of alarms.


Subject(s)
Humans , Clinical Alarms/adverse effects , Monitoring, Physiologic/methods , Auditory Fatigue , Attitude of Health Personnel , Clinical Alarms/standards , Monitoring, Physiologic/instrumentation
12.
Article in English | WPRIM | ID: wpr-99770

ABSTRACT

PURPOSE: Insulin pumps are widely used in diabetes. They are equipped with safety alarms to alert users. Pump manuals contain alarm codes and how to troubleshoot them. However, these manuals are lengthy and difficult to use, particularly in emergencies. We aim to assess the impact of targeted education on warnings and errors in improving competency to troubleshoot the alarms. METHODS: Twenty-one patients, with a median age of 13, were recruited over a 5-month period. Each patient had 2 study visits. The frequencies and types of alarms were recorded, and patients were given a summary sheet that outlined common alarms encountered and troubleshooting tips. In visit 2, the frequencies and types of alarms were compared to those of visit 1. The patients were asked to fill a questionnaire and to rate the education session given in visit 1, their level of competency in decrypting alarm codes, and their promptness in responding to alarms. RESULTS: Low cartridge (W1), low battery (W2), and bolus cancelled (W8) were the commonest warnings. The most noted errors were occlusion (E4), power interruption (E8), empty battery (E2), set not primed (E11), and cartridge empty (E1). The numbers of warning and error signals markedly decreased after targeted education (P < 0.05). The ability in decrypting warning signals significantly improved (P=0.02), and the frequency of response to pump alarms significantly increased (P=0.001). CONCLUSION: Certain warnings and errors are more common than others in insulin pumps. Targeted education is useful in improving competency and response of patients in managing pump alarms.


Subject(s)
Adolescent , Child , Clinical Alarms , Diabetes Mellitus, Type 1 , Education , Emergencies , Humans , Insulin Infusion Systems , Insulin , Medical Errors
13.
Article in English | WPRIM | ID: wpr-770997

ABSTRACT

BACKGROUND: An automatic alarm system was developed was developed for unexpected vital sign instability in admitted patients to reduce staffing needs and costs related to rapid response teams. This was a pilot study of the automatic alarm system, the medical emergency system (MES), and the aim of this study was to determine the effectiveness of the MES before expanding this system to all departments. METHODS: This retrospective, observational study compared the performance of patients admitted to the pulmonary department at a single center using patient data from three 3-month periods (before implementation of the MES, December 2013–February 2014; after implementation of the MES, December 2014–February 2015 and December 2015–February 2016). RESULTS: A total of 571 patients were admitted to the pulmonary department during the three observation periods. During this pilot study, the MES automatically issued 568 alarms for 415 admitted patients. There was no significant difference in the rate of cardiopulmonary resuscitation (CPR) before and after application of the MES. The mortality rate also did not change. However, it appeared that CPR was prevented in four patients admitted from the general ward to the intensive care unit (ICU) during MES implementation. The median length of hospital stay and median length of ICU stay were not significantly different before and after MES implementation. CONCLUSIONS: Although we did not find a significant improvement in outcomes upon MES implementation, the CPR rate and mortality rate did not increase despite increased comorbidities. This was a small pilot study and, based on these results, we believe that the MES may have significant effects in longer-term and larger-scale studies.


Subject(s)
Cardiopulmonary Resuscitation , Clinical Alarms , Comorbidity , Critical Care , Emergencies , Humans , Intensive Care Units , Internal Medicine , Korea , Length of Stay , Monitoring, Physiologic , Mortality , Observational Study , Patients' Rooms , Pilot Projects , Retrospective Studies , Vital Signs
14.
Article in English | WPRIM | ID: wpr-200984

ABSTRACT

BACKGROUND: An automatic alarm system was developed was developed for unexpected vital sign instability in admitted patients to reduce staffing needs and costs related to rapid response teams. This was a pilot study of the automatic alarm system, the medical emergency system (MES), and the aim of this study was to determine the effectiveness of the MES before expanding this system to all departments. METHODS: This retrospective, observational study compared the performance of patients admitted to the pulmonary department at a single center using patient data from three 3-month periods (before implementation of the MES, December 2013–February 2014; after implementation of the MES, December 2014–February 2015 and December 2015–February 2016). RESULTS: A total of 571 patients were admitted to the pulmonary department during the three observation periods. During this pilot study, the MES automatically issued 568 alarms for 415 admitted patients. There was no significant difference in the rate of cardiopulmonary resuscitation (CPR) before and after application of the MES. The mortality rate also did not change. However, it appeared that CPR was prevented in four patients admitted from the general ward to the intensive care unit (ICU) during MES implementation. The median length of hospital stay and median length of ICU stay were not significantly different before and after MES implementation. CONCLUSIONS: Although we did not find a significant improvement in outcomes upon MES implementation, the CPR rate and mortality rate did not increase despite increased comorbidities. This was a small pilot study and, based on these results, we believe that the MES may have significant effects in longer-term and larger-scale studies.


Subject(s)
Cardiopulmonary Resuscitation , Clinical Alarms , Comorbidity , Critical Care , Emergencies , Humans , Intensive Care Units , Internal Medicine , Korea , Length of Stay , Monitoring, Physiologic , Mortality , Observational Study , Patients' Rooms , Pilot Projects , Retrospective Studies , Vital Signs
15.
Ciênc. cuid. saúde ; 15(2): 220-226, Abr.-Jun. 2016. graf
Article in Portuguese | LILACS, BDENF | ID: biblio-974847

ABSTRACT

RESUMO Problemas inerentes a usabilidade de Equipamento Médico-Assistencial (EMA) e segurança do paciente em Unidades de Cuidados Intensivos (UCI) vão além daqueles descritos entre as seis metas internacionais de segurança do paciente do National Institutes of Health (NIH). Os Ventiladores Mecânicos (VM) geram muitos alarmes sonoros, alguns com dados pouco consistentes. Objetivou-se analisar a usabilidade de alarmes sonoros disparados por VM em UCI. Pesquisa observacional descritiva, do tipo estudo de caso, com abordagem quantitativa, desenvolvida na UCI de um hospital universitário localizado no Rio de Janeiro. Os dados foram analisados com estatística descritiva. Durante 30 horas de observação, foram registrados 129 alarmes disparados pelo VM, dos quais, somente cinco tiveram resposta e 124 fatigaram. Frequência respiratória alta (n=31), seguida do alarme de volume corrente baixo (n=26), pressão de via aérea alta (n=24), pressão de via aérea baixa (n=23), desconexão de circuito (n=18) e alarme de FiO2 (n=7) foram os mais prevalentes. Apenas 36 foram classificados como consistentes. Conclui-se que os alarmes passaram a ser cada vez mais banalizados pela equipe nas UCI. É necessário mudar a postura diante deles e melhorar sua efetividade.


RESUMEN Los problemas inherentes a la usabilidad de Equipo Médico-Asistencial (EMA) y seguridad del paciente en Unidades de Cuidados Intensivos (UCI) van más allá de los descritos entre los seis objetivos internacionales de seguridad del paciente del National Institutes of Health (NIH). Los Ventiladores Mecánicos (VM) generan muchas alarmas sonoras, algunas con datos inconsistentes. El objetivo fue analizar la usabilidad de alarmas sonoras provocadas por VM de las UCI. Estudio descriptivo observacional, del tipo estudio de caso, con abordaje cuantitativo, desarrollado en la UCI de un hospital universitario ubicado en Rio de Janeiro. Los datos fueron analizados con estadística descriptiva. Durante 30 horas de observación, se registraron 129 alarmas activadas por VM, de las cuales solo cinco tuvieron respuesta y 124 fatigaron. Los más prevalentes fueron: Frecuencia respiratoria alta (n = 31), alarma de volumen de corriente bajo (n = 26), presión de la vía aérea alta (n = 24), presión de la vía aérea baja (n = 23), desconexión de circuito (n = 18), y alarma FiO2 (n = 7). Solo 36 fueron clasificados como consistentes. Se concluye que las alarmas se han vuelto cada vez más trivializadas por el equipo en las UCI. Es necesario cambiar esta actitud y mejorar su efectividad.


ABSTRACT Problems inherent in the usability of medical and healthcare equipment (MHE) and patient safety in intensive care units (ICU) go beyond those described among the six international goals patient safety from the National Institutes of Health (NIH). The mechanical ventilators (MV) generate many audible alarms, some with inconsistent data. The objective was to analyze the usability of audible alarms triggered by VM in ICU. Descriptive observational research, study case type with a quantitative approach, developed in the ICU of a university hospital located in Rio de Janeiro. Data were analyzed with descriptive statistics. During 30 hours of observation, 129 alarms triggered by MV were recorded, of which only 05 had a response and 124 fatigued. Respiratory high frequency (n=31), followed by low volume alarm (n=26), high airway pressure (n=24), low airway pressure (n=23), circuit disconnection (n=18), and alarm FiO2 (n=7) were the most prevalent. Only 36 were classified as consistent. The alarms have become increasingly trivialized by the team in the ICU. It is necessary to change the attitude towards them, improving their effectiveness.


Subject(s)
History, 21st Century , Equipment Safety , Clinical Alarms , Patient Safety , Critical Care
16.
Article in English | WPRIM | ID: wpr-219433

ABSTRACT

OBJECTIVES: The purpose of this descriptive study was to investigate the current situation of clinical alarms in intensive care unit (ICU), nurses' recognition of and fatigue in relation to clinical alarms, and obstacles in alarm management. METHODS: Subjects were ICU nurses and devices from 48 critically ill patient cases. Data were collected through direct observation of alarm occurrence and questionnaires that were completed by the ICU nurses. The observation time unit was one hour block. One bed out of 56 ICU beds was randomly assigned to each observation time unit. RESULTS: Overall 2,184 clinical alarms were counted for 48 hours of observation, and 45.5 clinical alarms occurred per hour per subject. Of these, 1,394 alarms (63.8%) were categorized as false alarms. The alarm fatigue score was 24.3 +/- 4.0 out of 35. The highest scoring item was "always get bothered due to clinical alarms". The highest scoring item in obstacles was "frequent false alarms, which lead to reduced attention or response to alarms". CONCLUSIONS: Nurses reported that they felt some fatigue due to clinical alarms, and false alarms were also obstacles to proper management. An appropriate hospital policy should be developed to reduce false alarms and nurses' alarm fatigue.


Subject(s)
Clinical Alarms , Critical Care , Critical Illness , Fatigue , Humans , Intensive Care Units
17.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 7(4): 3418-3429, out.-dez. 2015. tab, graf
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1029880

ABSTRACT

Objective: To identify the cause of the invasive blood pressure alarms (PAI) have sounded and the staff response time; to describe the conduct set out to address them. Method: Descriptive study of quantitative/qualitative approach. The observation occurred in an adult ICU of a military hospital in Rio de Janeiro. The Research Ethics Committee of the Federal University of Rio de Janeiro (CAAE03284612.4.3001.5250) approved it. We considered as fatigued the alarms that had not been attended in 10minutes or stopped ringing before they are attended. Results: Were corded 76-PAI alarms; 21 (28%) were seen on average at 2.45 min. 55 (72%) were considered alarms fatigued. Conclusion: The high number o foutworn alarms that represent risk. It is a challenge to respond to all alarms considering the relation between the nurse/patient imposed by ANVISA.


Objetivo: Identificar porque soam os alarmes de pressão arterial invasiva (PAI) e o tempo de resposta da equipe; descrever as condutas estabelecidas para saná-los. Método: Pesquisa descritiva de abordagem quanti/qualitativa. A observação ocorreu em uma UTI adulto de um hospital militar no Rio de Janeiro. Foi aprovada pelo Comitê de Ética em Pesquisa da Universidade Federal do Estado do Rio de Janeiro (CAAE03284612.4.3001.5250). Considerou-se fatigados, alarmes não atendidos em 10 minutos, ou que paravam de soar antes de terem sidos atendidos. Resultados: Registraram-se 76 alarmes de PAI; 21 (28%) foram atendidos, em média em 2,45 min. 55 (72%) alarmes foram considerados fatigados. Conclusão: O elevado número de alarmes fatigados representam risco. É um desafio responder a todos os alarmes considerando a relação enfermeiro/ paciente imposta pela ANVISA.


Objetivo: Identificar por qué suenan las alarmas de la presión arterial invasiva(PAI) y el tiempo de respuesta del equipo; describir la conducta establecida para abordarlos. Método Estudio descriptivo de enfoque cuantitativo/cualitativo. La observación se produjo en una UCI de adultos de un hospital militar de Río deJaneiro. Fue aprobado por el Comité Ético de Investigación de la Universidad Federal del Estado de Río deJaneiro (CAAE 03284612.4.3001.5250). Se consideró alarmas fatigados no cubiertas en 10 minutos o se dejó de sonar antes de ser atendidos. Resultados: Se registraron 76 - PAI alarmas; 21 (28%) fueron mayores en promedio a 2,45 min. 55 (72%) se consideraron alarmas fatigados. Conclusión: El alto número de alarmas fatigados representan riesgo. Es uno desafío de responder a todas las alarmas se considerando la relación enfermera/paciente impuesta por la ANVISA.


Subject(s)
Humans , Clinical Alarms , Critical Care Nursing , Fatigue , Blood Pressure Monitors , Patient Safety , Intensive Care Units , Brazil
18.
Rev. latinoam. enferm ; 22(6): 1034-1040, 16/12/2014. tab, graf
Article in English | LILACS, BDENF | ID: lil-732956

ABSTRACT

OBJECTIVES: to identify the number of electro-medical pieces of equipment in a coronary care unit, characterize their types, and analyze implications for the safety of patients from the perspective of alarm fatigue. METHOD: this quantitative, observational, descriptive, non-participatory study was conducted in a coronary care unit of a cardiology hospital with 170 beds. RESULTS: a total of 426 alarms were recorded in 40 hours of observation: 227 were triggered by multi-parametric monitors and 199 were triggered by other equipment (infusion pumps, dialysis pumps, mechanical ventilators, and intra-aortic balloons); that is an average of 10.6 alarms per hour. CONCLUSION: the results reinforce the importance of properly configuring physiological variables, the volume and parameters of alarms of multi-parametric monitors within the routine of intensive care units. The alarms of equipment intended to protect patients have increased noise within the unit, the level of distraction and interruptions in the workflow, leading to a false sense of security. .


OBJETIVOS: identificar o número de alarmes dos equipamentos eletromédicos numa unidade coronariana, caracterizar o tipo e analisar as implicações para a segurança do paciente na perspectiva da fadiga de alarmes. MÉTODO: trata-se de estudo quantitativo observacional descritivo, não participante, desenvolvido numa unidade coronariana de um hospital de cardiologia, com capacidade para 170 leitos. RESULTADOS: registrou-se o total de 426 sinais de alarmes, sendo 227 disparados por monitores multiparamétricos e 199 alarmes disparados por outros equipamentos (bombas infusoras, hemodiálise, ventiladores mecânicos e balão intra-aórtico), nas 40h, numa média total de 10,6 alarmes/hora. CONCLUSÃO: os resultados encontrados reforçam a importância da configuração de variáveis fisiológicas, do volume e dos parâmetros de alarmes dos monitores multiparamétricos à rotina das unidades de terapia intensiva. Os alarmes dos equipamentos destinados a proteger os pacientes têm conduzido ao aumento do ruído na unidade, à fadiga de alarmes, a distrações e interrupções no fluxo de trabalho e à falsa sensação de segurança. .


OBJETIVOS: identificar el número de alarmas de los equipamientos electromédicos en una unidad coronariana, caracterizar el tipo y analizar las implicaciones para la seguridad del paciente en la perspectiva de fatiga de alarmas. MÉTODO: se trata de un estudio cuantitativo, observacional, descriptivo, no participante, desarrollado en una unidad coronariana de un hospital de cardiología, con capacidad de 170 camas. RESULTADOS: se registró un total de 426 señales de alarmas, siendo 227 disparadas por monitores multiparamétricos y 199 disparadas por otros equipamientos (bombas de infusión, hemodiálisis, ventiladores mecánicos y balón intraaórtico), durante 40h, con un promedio total de 10,6 alarmas/hora. CONCLUSIÓN: los resultados encontrados refuerzan la importancia de la configuración de las variables fisiológicas, del volumen y de los parámetros de alarma de los monitores multiparamétricos, a la rutina de las unidades de terapia intensiva. Las alarmas de los equipamientos destinados a proteger a los pacientes, han llevado al aumento del ruido en la unidad, a la fatiga de alarmas, a las distracciones e interrupciones en el flujo de trabajo y a una falsa sensación de seguridad. .


Subject(s)
Humans , DNA-Directed RNA Polymerases/metabolism , Oncogene Proteins, Viral/genetics , RNA Polymerase III/metabolism , Sarcosine/analogs & derivatives , Transcription Factors, TFIII , Transcription, Genetic , Transcription Factors/metabolism , Adenovirus Early Proteins , Detergents , DNA-Binding Proteins/genetics , HeLa Cells , Kinetics , Sarcosine/pharmacology , Transcription Factor TFIIIB , Transcription Factors/genetics , Transcription, Genetic/drug effects
19.
Med. UIS ; 27(2): 67-83, mayo-ago. 2014. ilus, tab
Article in Spanish | LILACS | ID: lil-729466

ABSTRACT

Introducción: el cólera es una enfermedad de origen bacteriano que ha causado epidemias, muerte y desolación desde los albores de la humanidad. Aún hoy, con todos los adelantos de las ciencias, sigue siendo una amenaza mortal para los seres humanos, en particular para quienes viven bajo condiciones de pobreza, con poco acceso al agua potable y a un adecuado manejo de excretas; de ahí su interés para la salud pública internacional. Metodología: se realizó una búsqueda virtual de boletines epidemiológicos, reseñas de prensa o comunicados públicos relacionados con el cólera, sobretodo en Colombia, además de una búsqueda de literatura actualizada sobre las características histolopatológicas, clínicas y microbiológicas relevantes para el área de la salud pública. Objetivo: hacer una revisión de la literatura sobre el cólera, con énfasis en la epidemiología y los conceptos básicos de diagnóstico y manejo del evento, con el fin de preparar a la comunidad científica para hacer frente a lo que pudiera ser la nueva pandemia. Desarrollo: se considera que en los últimos 200 años han ocurrido en el mundo entre siete y ocho pandemias de cólera, la última hace alrededor de 20 años. Sin embargo, desde el año 2010, estalló un brote después del terremoto en Haití al parecer con casos provenientes de Nepal que ha expandido una onda epidémica por República Dominicana, Cuba y recientemente México. La propagación de esta epidemia se ha convertido en una preocupación para las Américas, en particular para Colombia cuyo personal de salud, joven y sin la experiencia en las epidemias anteriores, puede no estar preparado para afrontarla. Conclusiones: los avances de la ciencia han sido útiles para monitorear las epidemias, elaborar y probar vacunas, disminuir las tasas de letalidad del 70% a menos del 1%, si recibe manejo adecuado y oportuno. Pero el temor a nuevos brotes y epidemias sigue estando latente, particularmente por epidemias como las ocurridas ...


Background. Cholera is a bacterial disease that has caused epidemics, death and desolation since the dawn of humanity. Nowadays, even with the advances of science, it remains as a deadly threat to humans, particularly for those living under conditions of poverty, with little access to clean water and sanitation, and hence its interest to international public health. It is considered that seven or eight cholera pandemics have already occurred during the last 200 years, the last of them around 20 years ago. However, an outbreak of cholera was reported in 2010, after the earthquake in Haiti since some cases from Nepal, and it has been expanding as an epidemic wave through Dominican Republic, Cuba and recently Mexico. The spread of this epidemic has become a concern for every American country, particularly for Colombia whose health staff, young and inexperienced, might not be prepared to face it. Methods. We did an online research for literary newsletters, press reviews or public statements related to cholera, especially in Colombia, along with a scientific search update on pathological, clinical and microbiological Cholera characteristics relevant to the area of public health. Objective. To review the literature about Cholera, with emphasis on epidemiology and basic concepts of diagnosis and management of the event, in order to prepare the scientific community to deal with what seems to be a new pandemic. Conclusions. Advances in science have been useful for monitoring epidemics, develop and test vaccines, reduce fatality rates of 70% to less than 1% if appropriate and opportune medical management is recieved. But the fear of further outbreaks and epidemics remains latent, particularly epidemics such as those in Haiti, Dominican Republic, Guinea Bissau and South Sudan. It is necessary to raise the performance of preventive measures in communities and assess the readiness of health systems to deal with the eventual arrival of the ...


Subject(s)
Humans , Cholera , Vibrio cholerae , Diarrhea , Pandemics
20.
Rev. gaúch. enferm ; 35(2): 135-141, 06/2014. graf
Article in English | LILACS, BDENF | ID: lil-716375

ABSTRACT

Observational, descriptive, exploratory, case study with the objective of measuring the stimulus-response time of the team to alarms monitoring invasive blood pressure (IBP) and analyzing the implications of this time for the safety of the patient. From January to March 2013, 60 hours of structured observation were conducted with registration of the alarms activated by IBP monitors in an adult ICU at a military hospital in the city of Rio de Janeiro. 76 IBP alarms were recorded (1.26 alarms/hour), 21 of which (28%) were attended to and 55 (72%) considered as fatigued. The average response time to the alarms was 2 min. 45 sec. The deficit in human resource and physical layout were factors determining the delay in response to the alarms. The increase in response times to these alarms may compromise the safety of patients with hemodynamic instability, especially in situations such as shock and the use of vasoactive drugs.


Estudio de caso observacional, descriptivo y exploratorio. Dirigido para medir el tiempo del equipo de estímulo y respuesta a las alarmas de monitoreo de la presión arterial invasiva (PAI) y analizar las implicaciones de este periodo la seguridad del paciente. Desde enero hasta marzo de 2013, hemos llevado a cabo 60 horas de observación estructurada y registro de alarmas disparadas por los monitores de MAP en una UCI de adultos de un hospital militar en la ciudad de Río de Janeiro. Se registraron 76 alarmas PAI (1,26 alarmas / hora), de los cuales 21 alarmas (28 %) fueron ingresados y 55 (72 %) considera fatigado. El tiempo promedio de respuesta fue 2 minutos y 45 segundos. La falta de recursos humanos y la planta física fueron los factores de respuesta tardía a las alarmas. La prórroga del plazo para responder a estas alarmas puede comprometer la seguridad de los pacientes con inestabilidad hemodinámica, especialmente en situaciones de shock y fármacos vasoactivos.


Estudo observacional, descritivo, exploratório, do tipo estudo de caso. Teve como objetivos medir o tempo estímulo-resposta da equipe aos alarmes de monitorização da pressão arterial invasiva (PAI) e analisar as implicações desse tempo para a segurança do paciente. De janeiro a março de 2013, foram realizadas 60 horas de observação estruturada e registro de alarmes disparados por monitores de PAI em uma UTI para adultos de um hospital militar da cidade do Rio de Janeiro. Foram registrados 76 alarmes de PAI (1,26 alarmes/hora), dos quais 21 alarmes (28%) foram atendidos e 55 (72%) considerados fatigados. O tempo médio de resposta aos alarmes foi 2 minutos e 45 seg.undos O déficit de recursos humanos e a planta física foram fatores determinantes no retardo da resposta aos alarmes. O alargamento do tempo de resposta a esses alarmes pode comprometer a segurança do paciente com instabilidade hemodinâmica, especialmente em situações de choque e uso de drogas vasoativas.


Subject(s)
Humans , Blood Pressure Determination , Clinical Alarms , Critical Care/standards , Patient Safety , Equipment Failure , Time Factors
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