ABSTRACT
El sondaje intermitente limpio (SIL) es el procedimiento de elección en pacientes con un vaciado incompleto. No todos los pacientes derivados a nuestra consulta son candidatos al SIL ni lo mantienen a corto plazo, ya sea por decisión del paciente o por disminución de los residuos. Nos planteamos como objetivo describir la adherencia al SIL de los pacientes remitidos a la consulta enfermera. Para ello realizamos un estudio descriptivo longitudinal realizado en el Hospital Universitari de Bellvitge del 1 de septiembre de 2013 al 1 de septiembre de 2014, población pacientes remitidos para educación terapéutica (ET) del SIL. Concluimos que la educación terapéutica en la consulta enfermera de urología logra una alta tasa de adherencia del paciente al SIL. Una tercera parte de los pacientes que han iniciado el SIL no lo precisa a los 6 meses por disminución del residuo
The clean intermittent catheterization (CIC) is the procedure of choice in patients with incomplete emptying. Not all patients referred to our unit are candidates for CIC or maintain this condition in the short term. This could be produced because of the decision of the patient or voiding reduction. We set as our objective to describe CIC adherence of patients referred to the nursing services. We carry out a longitudinal descriptive study in the University Hospital of Bellvitge from September 1st 2013 to September 1st, 2014 with a sample composed by patients referred for therapeutic education (ET) of CIC. We conclude that therapeutic education in urology nurse unit achieved a high rate of patient adherence to CIC. A third of patients who have started the CIC do not need it after 6 months because of decreasing of the voiding
Subject(s)
Humans , Urinary Incontinence/therapy , Urinary Catheterization/statistics & numerical data , Nursing Care/methods , Patient Compliance/statistics & numerical data , Patient Education as Topic , Prospective StudiesABSTRACT
INTRODUCTION: Measurement of residual gastric volume is a frequent practice in chronic patients, but there is lack of consensus on the convenience of reintroducing or discarding aspirated gastric content (AGC). OBJECTIVE: Determine the grade of scientific evidence on the efficacy of two interventions -reintroduction/rejection- of AGC in chronic patients. MATERIAL AND METHODS: Systematic review of the evidence available on the convenience of reintroducing or discarding ACG. PROCEDURE: a) establishment of inclusion/exclusion criteria; b) determination of the search strategy (keywords and itineraries); c) dumping of databases: MEDLINE, CINAHL, CUIDEN, IME, SCIELO and COCHRANE. Search for indirect method and manual dumping of indexes; d) independent and contrasted critical reading, using the CASPe template; and e) contrast of critical analysis results. RESULTS: Search itineraries generate more than 800 references that once purged make it possible to select 54. After reading them, only 4 really focused on the questions related with the reintroduction/rejection of AGC: 2 revisions, 1 observational study and a random clinical trial with a small sample. Meta-analysis techniques could not be used due to the heterogeneity of these studies. Thus, the results of the study were analyzed separately. Using this procedure, a final result was obtained that showed a low grade of scientific evidence. CONCLUSIONS: There is limited scientific evidence on the convenience, safety and benefits of both interventions. It is difficult to establish a care protocol, so that we suggest performing an experimental study to establish the indications and contraindications of both interventions.
Subject(s)
Anthropometry , Bibliometrics , Gastrointestinal Contents , Gastroparesis/diagnosis , Stomach/anatomy & histology , Algorithms , Databases, Bibliographic , Evidence-Based Medicine , Gastric Emptying , Gastroparesis/pathology , Humans , MEDLINE , Organ SizeABSTRACT
Introducción. La determinación del volumen gástrico residual es una práctica frecuente en pacientes críticos, pero hay falta de consenso acerca de la conveniencia de reintroducir o desechar el contenido gástrico aspirado (CGA). Objetivo. Determinar el grado de evidencia científica acerca de la eficacia de 2 intervenciones reintroducción/rechazo del CGA en pacientes críticos. Material y métodos. Revisión sistemática de la evidencia disponible acerca de la conveniencia de reintroducir o desechar el CGA. Proceso: a) establecimiento de los criterios de inclusión/exclusión; b) determinación de la estrategia de búsqueda (palabras clave e itinerarios); c) vaciado de las bases de datos: MEDLINE, CINAHL, CUIDEN, IME, SCIELO y COCHRANE. Búsqueda por método indirecto y vaciado manual de índices; d) lectura crítica independiente y contrastada, utilizando la plantilla CASPe, y e) contraste de resultados del análisis crítico. Resultados. Los itinerarios de búsqueda generan más de 800 referencias que, una vez depuradas, permiten seleccionar 54. Después de su lectura, sólo 4 se centran realmente en cuestiones relacionadas con la reintroducción/rechazo del CGA: 2 revisiones, un estudio observacional y un ECA de muestra pequeña. La heterogeneidad de estos estudios no permite emplear técnicas de metaanálisis. Por ello se analizan por separado los resultados de cada estudio. Mediante este proceso se obtiene un resultado final que demuestra un bajo grado de evidencia científica. Conclusiones. Hay escasa evidencia científica acerca de la conveniencia, la seguridad y los beneficios de ambas intervenciones. Es difícil establecer un protocolo de cuidados, por lo que se planteó realizar un estudio experimental para establecer las indicaciones y contraindicaciones de ambas intervenciones
Introduction. Measurement of residual gastric volume is a frequent practice in chronic patients, but there is lack of consensus on the convenience of reintroducing or discarding aspirated gastric content (AGC). Objective. Determine the grade of scientific evidence on the efficacy of two interventions reintroduction/rejection of AGC in chronic patients. Material and methods. Systematic review of the evidence available on the convenience of reintroducing or discarding ACG. Procedure: a) establishment of inclusion/exclusion criteria; b) determination of the search strategy (keywords and itineraries); c) dumping of databases: MEDLINE, CINAHL, CUIDEN, IME, SCIELO and COCHRANE. Search for indirect method and manual dumping of indexes; d) independent and contrasted critical reading, using the CASPe template; and e) contrast of critical analysis results. Results. Search itineraries generate more than 800 references that once purged make it possible to select 54. After reading them, only 4 really focused on the questions related with the reintroduction/rejection of AGC: 2 revisions, 1 observational study and a random clinical trial with a small sample. Meta-analysis techniques could not be used due to the heterogeneity of these studies. Thus, the results of the study were analyzed separately. Using this procedure, a final result was obtained that showed a low grade of scientific evidence. Conclusions. There is limited scientific evidence on the convenience, safety and benefits of both interventions. It is difficult to establish a care protocol, so that we suggest performing an experimental study to establish the indications and contraindications of both interventions
Subject(s)
Humans , Gastrointestinal Contents , Critical Care/methods , Preservation of Water Samples , Intubation, Gastrointestinal , Nursing Care/methodsABSTRACT
La traqueostomía percutánea es una técnica de acceso traqueal que se realiza con frecuencia en las unidades de cuidados intensivos. Tiene la ventaja de realizarse en la cama del paciente y reporta menor riesgo de complicaciones que la traqueostomía convencional. El profesional de Enfermería tiene un papel importante en la preparación del paciente, ejecución de la técnica y control de las posibles complicaciones
Percutaneous tracheotomy is a frequently performed technique in ICU´s that permits access to the trachea. One of its advantages is that it can be performed with the patient in bed and it entitles fewer risks than conventional tracheotomy. The nursing professional plays a very important role in the preparation of the patient, execution of the technique and control of possible complications