ABSTRACT
It is not uncommon for patients in intensive care units (ICUs) to suddenly and unexpectedly present what is known as acute ICU syndrome. This syndrome appears independently of the patient's situation and diagnosis. The aim of the present study was to determine the incidence of this nursing diagnosis in our department, to identify the possible environmental factors that could contribute to its appearance and to evaluate nursing interventions to resolve this syndrome in the ICU.Data were collected from a register of 62 items containing information on the health status of the patient on presenting the syndrome (vital signs, laboratory investigations, etc.), data on the environment, drugs used and other factors that could, a priori, play a role. The statistical analysis was performed using the SPSS program. This prospective study was carried out in a general ICU with ten beds: six beds in an open ward and four individual rooms. Two hundred forty-three patients were admitted during the 6-month study period. The incidence of ICU syndrome was 8.1 % (20 cases). Factors influencing its appearance were the timing of the shifts, the temperature, and whether patients were in individual rooms or open wards. The frequency of the syndrome was much higher in open wards and in the afternoon (from 15:00 to 22:00). In conclusion, the attitude of the nursing staff should be alert to identify the syndrome early and initiate appropriate measures, such as orienting the patient in time and space, achieving an appropriate temperature, using relaxation techniques, facilitating access to the family, etc., since in 35 % of cases these measures are sufficient to stabilize and/or resolve the problem, without the need of drugs.
Subject(s)
Confusion/epidemiology , Intensive Care Units/statistics & numerical data , Acute Disease , Confusion/nursing , Female , Humans , Incidence , Male , Middle Aged , Nursing Diagnosis , Prospective Studies , Syndrome , Time FactorsABSTRACT
En la UCI se observa con cierta frecuencia que los enfermos, independientemente de su situación y enfermedad, presentan de forma brusca e inesperada lo que denominamos síndrome confusional agudo (SCA) como diagnóstico de enfermería. Los objetivos del estudio son: determinar la incidencia de este diagnóstico enfermero en nuestro servicio, conocer las posibles causas del entorno que pueden incidir de forma más importante sobre su aparición, y evaluar la intervención de enfermería para resolver el cuadro confusional agudo del paciente en UCI. Para la recogida de datos, se utilizó un registro con 62 ítems en el que quedan reflejadas las variables sobre el estado del paciente cuando se presentaba el cuadro (constantes vitales, parámetros analíticos, etc.), datos del entorno, fármacos utilizados, y otros factores que a priori podían incidir. Se realizó procesamiento estadístico con el programa estadístico SPSS. El estudio se desarrolló de forma prospectiva, en una UCI polivalente de 10 camas, con 6 camas abiertas y 4 en boxes cerrados. Durante el período de estudio (6 meses), ingresaron 243 enfermos. La incidencia del SCA fue del 8,1 por ciento (20 casos). Como factores que inciden en su aparición se detectaron: el turno horario, el ambiente, y la situación de boxes individuales o camas abiertas, siendo destacable la aparición del cuadro con mucha mayor frecuencia en estas últimas, y en horario de tardes (15 a 22 h). Como conclusión, es importante destacar "la actitud de enfermería" que debe estar alerta para identificar el cuadro precozmente e iniciar las medidas oportunas, como orientar en tiempo y espacio, procurar un ambiente adecuado, emplear técnicas de relajación, facilitar el acceso a la familia, etc., ya que en el 35 por ciento de los casos ha resultado "eficaz" para estabilizar y/o resolver este problema, sin necesidad de fármacos (AU)
Subject(s)
Middle Aged , Male , Female , Humans , Time Factors , Syndrome , Incidence , Nursing Diagnosis , Prospective Studies , Confusion , Acute Disease , Intensive Care UnitsABSTRACT
Withdrawal from drugs currently is and interesting topic because of the repercussions it has on different aspects of life, particularly: health, work, family and social relationships, etc. In this article we report a new system for minimizing the adverse effects of withdrawal from opiates (which usually are prolonged), and for carrying out withdrawal as quickly and effectively as possible. A protocol is described in detail, as well as special nursing care. This protocol is called ultrashort withdrawal (24 hours) and it has been developed and used in the intensive care department of the General University Hospital of Murcia (Spain), in collaboration with the center's hospital detoxification unit.
Subject(s)
Critical Care/methods , Narcotics/adverse effects , Patient Care Planning , Substance Withdrawal Syndrome/nursing , Clinical Protocols , Humans , Nursing Records , Patient Admission , Time FactorsABSTRACT
The importance of the prevention of infections related to venous catheters comes from the frequent morbility which derives from these devices in ICU and the foresecable increase of infections which are secondary to them with the consequent increase in the load of Nursing work and costs in Spain, bacteriemias related to central catheters are 8%, under 5% for Swan-Ganz and almost inexistent for peripherals. Germs responsible for infectious incidences caused by catheters are basically Staphylococcus coagulase-negative and Staphylococcus aureus. The most affected veins are the jugular, followed by femoral, antecubital, subclavian and peripheral. The colonization of the patient's skin and the connections of catheters are the most frequent origin of infections and, since certain germs create defensive structures which make them more resistant to treatment, it is very important to carry out protocols of prevention and care which should encompass hand washing efficiency, daily care of the wound, use of suitable disinfectants and, very especially, the protection of catheter connections.
