Incidência de lesões por pressão relacionadas a dispositivos médicos em unidade de terapia intensiva adulto* / Incidencia de lesiones por presión relacionadas con dispositivos médicos en unidades de cuidados intensivos para adultos / Incidence of medical device-related pressure injuries in an adult intensive care unit

Objetivo: determinar a incidência de lesões por pressão relacionadas a dispositivos médicos e os fatores associados em unidade de terapia intensiva adulta. Método: quantitativo, observacional, prospectivo. Os dados foram coletados entre setembro e novembro de 2020, em um hospital público. Utilizou-se instrumento para avaliações diárias da pele sob e peri os dispositivos. Resultados: foram analisados 1.579 dispositivos em 292 avaliações, em 47 pacientes. Identificando-se 233 lesões (14,9%). A incidência de lesões foi de 6,1%. Em 20,9% (n= 61) dos dispositivos utilizados, as lesões foram relacionadas ao tubo orotraqueal. Com relação às regiões acometidas por lesões, 10,4% (n= 24) ocorreram nas orelhas; 7,8% (n= 18), na face. As lesões estágio 1 foram as mais frequentes (n=147; 63,3%) nas avaliações realizadas. Conclusão: observou-se incidência de 6,1%. Ressalta-se a necessidade de manter a vigilância, em especial em pacientes com tubo endotraqueal. Medidas de prevenção devem ser adotadas para diminuir a ocorrência destas lesões.

Objective: to determine the incidence of medical device-related pressure injuries and associated factors in adult intensive care unit. Method: quantitative, observational, prospective. Data were collected between September and November 2020, in a public hospital. An instrument was used for daily evaluations of the skin under and peri the devices. Results: 1,579 devices were analyzed in 292 evaluations in 47 patients, identifying 233 injuries (14.9%). The incidence of injuries was 6.1%. In 20.9% (n = 61) of the devices used, the injuries were related to the orotracheal tube. Regarding the regions affected by injuries, 10.4% (n = 24) occurred in the ears; 7.8% (n = 18) in the face. Stage 1 injuries were the most frequent (n=147; 63.3%) in the evaluations performed. Conclusion: incidence was 6.1%. The need to maintain surveillance is emphasized, especially in patients with endotracheal tube. Prevention measures should be adopted to reduce the occurrence of these injuries.

Objetivo: determinar la incidencia de lesiones por presión relacionadas con dispositivos médicos y los factores asociados en la unidad de cuidados intensivos para adultos. Método: cuantitativo, observacional, prospectivo. Los datos fueron recogidos entre septiembre y noviembre de 2020, en un hospital público. Se utilizó instrumento para evaluaciones diarias de la piel bajo y peri los dispositivos. Resultados: se analizaron 1.579 dispositivos en 292 evaluaciones, en 47 pacientes. Identificándose 233 lesiones (14,9%). La incidencia de lesiones fue del 6,1%. En el 20,9% (n= 61) de los dispositivos utilizados, las lesiones fueron relacionadas al tubo orotraqueal. Con relación a las regiones afectadas por lesiones, 10,4% (n= 24) ocurrieron en las orejas; 7,8% (n= 18), en la cara. Las lesiones etapa 1 fueron las más frecuentes (n=147; 63,3%) en las evaluaciones realizadas. Conclusión: se observó incidencia de 6,1%. Se subraya la necesidad de mantener la vigilancia, en especial en pacientes con tubo endotraqueal. Se deben adoptar medidas preventivas para reducir la aparición de estas lesiones.

Morbimortalidad en pacientes egresados de una unidad de cuidados intensivos en Boyacá, Colombia / Morbidity and mortality in patients discharged from an Intensive Care Unit in Boyacá, Colombia

Objetivo: determinar la morbimortalidad de pacientes luego del alta en una UCI en Boyacá durante un periodo de 20 meses. Materiales y métodos: estudio descriptivo trasversal con análisis de información de registros, historias clínicas y datos derivados de la aplicación de una encuesta; la población fue de 592 pacientes egresados vivos entre los meses de enero de 2015 a agosto de 2016 de la UCI con base en los promedios mensuales de atención. Resultados: de los 592 pacientes atendidos se encuentra una sobrevida del 63,9% dentro del primer mes del alta y una mortalidad del 36.1%, la cual fue mayor dentro de los primeros diez días pos egreso. Del total de la población atendida, el 55,2% corresponde a pacientes de sexo masculino y el restante 44,8% pacientes femeninas. La edad promedio fue de 58,9 años. La morbilidad reportada obedece principalmente a enfermedades metabólicas entre el 24,5% y 26,5%, alteraciones cardiovasculares, 14,7% y 19,7%, infecciosas con un 14,3% y 11,1% y politraumatismos el 8,7%. Conclusiones: el porcentaje de personas que sobreviven tras recibir atención en UCI corresponde a un indicador de eficiencia en la atención del paciente en condición crítica de salud. Las patologías prevalentes en los individuos fueron de etiología metabólica como diabetes mellitus, insuficiencia renal crónica, infarto agudo de miocardio, septicemias, politraumatismos e infecciones. Los datos constituyen un elemento determinante para formular políticas y planes de atención e intervenir efectivamente a los pacientes en condición crítica de salud tanto a nivel regional como nacional..Au

Objective: to determine the morbidity and mortality of patients after discharge from an ICU in Boyacá over a period of 20 months. Materials and methods: cross-sectional descriptive study with analysis of information records, medical records, and data derived from the application of a survey; The population consisted of 592 patients discharged from the ICU from January 2015 to August 2016 based on monthly care averages. Results: of the 592 patients attended, there is a survival of 63,9% within the first month of discharge and a mortality of 36,1%, which was the highest within the first ten days after discharge. Of the total population served, 55,2% correspond to male patients and the remaining 44,8% female patients. The average age was 58,9 years. The reported morbidity is mainly due to metabolic diseases between 24,5% and 26,5%, cardiovascular disorders between 14,7% and 19,7%, infectious 14,3% and 11,1% and multiple injuries 8,7%. Conclusions: the percentage of people who survive after receiving ICU care corresponds to an indicator of efficiency in patient care in a critical health condition. The prevalent pathologies in the individuals were of metabolic etiology such as diabetes mellitus, chronic renal failure, acute myocardial infarction, sepsis, multiple injuries and infections. The data affected is a determining element in the formulation of policies and care plans, to effectively intervene in patients in critical health conditions at both the regional and national levels..Au

Fragilidades e potencialidades vivenciadas pela equipe de saúde no processo de transplante de órgãos: revisão integrativa / Weaknesses and capabilities experienced by a healthcare team in the organ transplant process: integrative review

Avaliar as fragilidades e potencialidades vivenciadas pelos profissionais das unidades de pacientes críticos frente às etapas do processo de doação de órgãos. Revisão integrativa, desenvolvida em seis bases de dados, entre 2015 e 2020, nos idiomas inglês, português e espanhol. Foram selecionados 15 artigos. As informações foram agrupadas em duas categorias temáticas: conhecimento da equipe no processo de doação; complexidade do processo de doação de órgãos: aspectos emocionais nesse processo. As evidências apontam como principais fragilidades a pouca capacitação da equipe e estrutura das organizações de saúde. Quanto às potencialidades, destacam-se o reconhecimento das etapas e dos critérios para o diagnóstico de morte encefálica e a certificação do direito da família em receber informações sobre todas as etapas do processo de doação. Frente aos achados, a promoção de ações de educação permanente surge como estratégia efetiva para aprimorar a prática clínica neste processo.

The aim of this study is to evaluate the weaknesses and capabilities experienced by professionals working in critical care units during the stages of the organ donation process. This is an integrative review, developed using six databases, between 2015 and 2020, in English, Portuguese, and Spanish. A total of 15 articles were selected. The information was grouped into two thematic categories: team knowledge on the organ donation process; complexity of the organ donation process: emotional aspects of the process. The evidence indicates lack of training of the team and lack of structure of the healthcare organizations as the main weaknesses. Regarding the capabilities, recognition of the stages of and criteria for the diagnosis of brain death and guaranteeing the right of the family to receive information on all the stages of the transplant process stand out. Given the findings, promoting actions of continuing education emerges as an effective strategy to improve clinical practice in this process

Study on the incidence of adverse events during intrahospital transfer of critical care patients from emergency department

@#Introduction: Emergency department (ED) plays a main role in the initial management of patients who are critically ill. These patients require intra-hospital transfer for continuation of care. Adverse events can occur during this short duration and the distance of intra -hospital transfer. The aims of this study were to determine the incidence of adverse events during intrahospital transfer from ED and to determine the factors associated. Methodology: This was a cross-sectional observational study done from November 2017 until December 2017 at ED Hospital Sultan Abdul Halim (HSAH), a 650-bedded tertiary hospital in the state of Kedah. All patients that were triaged to red zone, age 18 years and above, and involved in intra-hospital transfer to critical coronary unit, intensive care unit and wards were included. All cases were documented in proforma by the accompanying staff. Results: Among the 170 critically ill patients, only 29 patients (17.1%) experienced adverse events during intra-hospital transfer. The adverse events seen were hypotension (12.4%), desaturation (3.5%) and dislodged peripheral line (2.4%). Cardiorespiratory related diagnosis was the commonest presentation. Intra-hospital transfer during morning shift and evening shift has 79.5% (b=-1.59, OR=0.21, 95% CI: 0.06, 0.69, p=0.011) and 75.6% ((b=-1.41, OR=0.24, 95% CI: 0.08, 0.73, p=0.012) lesser odds of experiencing adverse events compare to night shift. Patients with vasopressor/inotropes had 9 times higher odds of experiencing adverse events during transportation, compared to patients with no vasopressor/inotropes (b=2.27, OR=9.70, 95% CI: 3.39, 27.72, p<0.001). Conclusions: Critical care patients who are involved in intrahospital transfer were at risk of adverse events such as hypotension, desaturation and dislodge peripheral line. Risk identification and maintaining level of care is important to minimize the adverse events during transfer. Patients had higher rates of adverse events if they were transferred during night shifts and on inotropic/vasopressor support

Early Mobilization for Intensive Care Unit Acquired Weakness (review) / 中国康复理论与实践

Early mobilization is beneficial in the prevention of intensive care unit acquired weakness. This paper summarized the meth-ods, opportunity, evaluation of early mobilization intervention, and some notes.

Factorial Validation and Psychometric Properties Establishment of Malay Version Critical Care Family Need Inventory

Introduction: Despite general acknowledgement of the importance in assessing family needs in critical care patients, there is no psychometric instrument to measure the family needs within Malaysian settings. This study aimed to perform factorial validation and establish psychometric properties of Malay translated Critical Care Family Need Inventory (CCFNI-M) for Malaysians. Methods: This study consisted of four protocols: Forward-Backward translation, validity, internal reliability and inter domain correlations phases. The factorial validation of the CCFNI-M was based on its administration to 109 family members of critical care patients admitted to the Intensive Care Unit of Hospital Universiti Sains Malaysia, Kelantan, Malaysia. At validity phase, factorial validation was performed using Exploratory Factor Analysis using Principal Component Analysis with Varimax rotation. The internal consistency and inter domain correlations were calculated using Cronbach’s alpha and Pearson correlation coefficient respectively. Results: Preliminary analyses reported the suitability of data for factorial validation. With reference to the original CCFNI, five factors were extracted which explained 49.4% of the total variance. After removal of several items for different reasons, the final items in CCFNI-M were 42. The internal consistency values for five dimensions ranged from 0.72 to 0.87 with inter domain correlation values (r) among the dimensions ranged between 0.36 and 0.61. Conclusion: The high measures of factorial validity, internal consistency and inter domain correlations values of the CCFNI-M make it suitable measure for assessing the family needs of critical care patients.