ABSTRACT
Justificación: La flebitis es una de las complicaciones mas frecuentes de los Catéteres Centrales de Inserción Periférica. La evidencia científica sobre la utilidad de las escalas de medición para el diagnostico de flebitis es escasa. Objetivos: Comparar la incidencia de flebitis antes y después de la implementación de un protocolo. Material y métodos: Estudio de cohortes retrospectivo en 159 pacientes ingresados en UCI, a los que se les ha colocado un PICC, en dos periodos equivalentes de dos años consecutivos, Periodo 1 (n=59); frente a un grupo del Periodo 2 (n=100) en el que se aplicó un nuevo protocolo para el diagnóstico y manejo de flebitis (definición de flebitis, aplicación de la Visual Infusion Phlebitis Score y valoración continua). Resultados: El riesgo de ser diagnosticado de flebitis fue significativamente menor en el P2 (OR: 0.09, I.C.95% 0.01-0.52) Conclusiones: La incorporación del protocolo redujo un 90% los diagnósticos de flebitis (AU)
Phlebitis incidence related to peripherally inserted central catheters (PICCs): New nursing protocol application. Phlebitis is one of the most common complications of peripherally inserted central catheters (PICCs). The scientific evidence about the utility of measuring scales to phlebitis diagnosis is very limited. Objectives: To compare phlebitis incidence rate before and after the introduction of a new protocol. Materials and Methods: Retrospective cohort study in 159 patients admitted to the intensive care unit (ICU) for two years. First we assess phlebitis in 59 patients (group 1). After that we apply a new protocol to identify phlebitis with visual score and continuous evaluation to 100 patients (group 2) Results: The probability of being diagnosed of phlebitis is significantly smaller in intervention group (OR: 0.09; 95% C.I.: 0.02-0.57). Conclusions: Protocol application reduced the diagnosis of phlebitis in 90% (AU)
Subject(s)
Humans , Male , Female , Adult , Nursing Assessment/organization & administration , Nursing Assessment/standards , Nursing Assessment , Phlebitis/complications , Phlebitis/epidemiology , Catheters , Catheterization, Central Venous/nursing , Nursing Assessment/methods , Nursing Assessment/trends , Phlebitis/nursing , Retrospective StudiesABSTRACT
UNLABELLED: The need for information to the families of critically ill patients is still not covered by the professionals involved. OBJECTIVE: Develop and implement a new process of informing relatives of critically ill patients. DESIGN: Participatory Action Research guided by the PEPPA Model (A Participatory, Evidence-Based, Patient-Focused Process for Advanced Practice Nursing Role Development, Implementation, and Evaluation). Field of study: general ICU of a tertiary university hospital (December 2011-May 2012). SAMPLING: convenience. SAMPLE: 11 relatives, 10 nurses and 8 doctors with more than one year of experience in ICU. DATA COLLECTION: semi-structured interviews and 10 participant observations. DATA ANALYSIS: content analysis of the interviews, observations and field notes. RESULTS: The EPA identified the need to systematize and structure the information process to families. Having received approval and commitment from the major stakeholders (doctors and nurses), we designed an algorithm and protocol performance, based on the results and on the best available evidence, to improve the process information to families of critically ill patients. To do this, EPA developed the following skills: direct clinical practice, coaching and guidance, consultation, collaboration, leadership, research and ethical decision making. CONCLUSIONS: A plan to improve the relatives of critically ill patients'process of information has been developed and implemented by the EPA. By the evaluation, it will be able to see the benefits of incorporating the advanced role and encourage its implementation in Spain.
Subject(s)
Critical Illness , Family , Health Services Research , Information Dissemination , Algorithms , HumansABSTRACT
La necesidad de información a los familiares de los pacientes críticos continúa sin cubrirse por parte de los profesionales. Objetivo. Desarrollar e implementar un nuevo proceso de información a los familiares del paciente crítico. Metodología. Diseño: Investigación-Acción Participativa (IAP) guiada por el modelo PEPPA (Proceso Participativo para la Enfermería de Práctica Avanzada -EPA-, centrado en el Paciente y basado en la Evidencia). Ámbito de estudio: UCI polivalente de un hospital universitario terciario. Muestreo: conveniencia. Muestra: 11 familiares, 10 enfermeras y 8 médicos de más de un año de experiencia en UCI. Recogida de datos: 10 observaciones participantes y 29 entrevistas semiestructuradas. Análisis de datos: análisis de contenido de entrevistas, observaciones y notas de campo. Resultados. La EPA detectó la necesidad de sistematizar y estructurar el proceso de información a las familias. Una vez recibida la aprobación y el compromiso por parte de los principales stakeholders (médicos y enfermeras), se diseñó un algoritmo de actuación y un protocolo, basado en los resultados y en la evidencia disponible, para mejorar el proceso de información a las familias de los pacientes críticos. Para ello, la EPA desarrolló las siguientes competencias: práctica clínica directa, coaching, consulta, colaboración, liderazgo, investigación y toma de decisiones éticas. Conclusiones. A través de este estudio, la EPA ha desarrollado e implementado un plan de mejora del proceso de información de los familiares del paciente crítico que se prevé evaluar próximamente. De este modo, se podrán percibir los beneficios de la incorporación de la práctica avanzada y favorecer su implantación en España (AU)
The need for information to the families of critically ill patients is still not covered by the professionals involved. Objective. Develop and implement a new process of informing relatives of critically ill patients. Methodology. Design: Participatory Action Research guided by the PEPPA Model (A Participatory, Evidence-Based, Patient-Focused Process for Advanced Practice Nursing Role Development, Implementation, and Evaluation). Field of study: general ICU of a tertiary university hospital (December 2011-May 2012). Sampling: convenience. Sample: 11 relatives, 10 nurses and 8 doctors with more than one year of experience in ICU. Data collection: semi-structured interviews and 10 participant observations. Data analysis: content analysis of the interviews, observations and field notes. Results. The EPA identified the need to systematize and structure the information process to families. Having received approval and commitment from the major stakeholders (doctors and nurses), we designed an algorithm and protocol performance, based on the results and on the best available evidence, to improve the process information to families of critically ill patients. To do this, EPA developed the following skills: direct clinical practice, coaching and guidance, consultation, collaboration, leadership, research and ethical decision making. Conclusions. A plan to improve the relatives of critically ill patients process of information has been developed and implemented by the EPA. By the evaluation, it will be able to see the benefits of incorporating the advanced role and encourage its implementation in Spain (AU)
