ABSTRACT
Central venous catheter-related infection is the most common complication in patients on hemodialysis. Nursing care is essential for its maintenance, minimizing risk factors, and avoiding complications, such as bacteremia. A systematic review was conducted to identify the influence of nursing care on the prevention of bacteremia due to hemodialysis catheter. The primary endpoint was the bacteremia rate measured as number of events per 1000 catheter days. The rate of bacteremia in the studies ranged from 0.2 to 5.47 events per 1000 catheter days after the application of nursing care. Several studies have shown a significant reduction in central venous catheter bacteremia with the application of management protocols, appropriate vigilance, and monitoring, as well as the inclusion of the Plan Do Check Act cycle and education.
Subject(s)
Bacteremia , Catheter-Related Infections , Catheterization, Central Venous , Central Venous Catheters , Humans , Catheterization, Central Venous/adverse effects , Catheters, Indwelling/adverse effects , Central Venous Catheters/adverse effects , Renal Dialysis/adverse effects , Bacteremia/etiology , Bacteremia/prevention & control , Catheter-Related Infections/etiologyABSTRACT
ABSTRACT Background: The consequences of SARSCoV- 2 infection on the mental health of kidney transplant recipients have not yet been investigated. Objectives: This study compares anxiety and quality of life in individuals with a kidney transplant who did or did not test positive for coronavirus. Design: Retrospective study of two prospective cohorts. Participants: Kidney transplant recipients under follow-up in a Spanish tertiary teaching hospital who tested positive for coronavirus (cases); and consecutive kidney recipients who had not suffered the infection (not-cases). Methods: Mortality and case fatality data were compared between the two cohorts for the two pandemic waves. For the second wave (July 1 to December 5, 2020), the data compared between cases (n=22) and not-cases (n=36) were state and trait anxiety (STAI), kidney transplant-related quality of life (KTQ), and mortality as the main outcome variables. Results: 601 transplanted persons of mean age 61.7 years (SD 12.8), 61.9% men. 12.1% (n=73) tested SARS-CoV-2-positive over the first two pandemic waves with a mortality of 2.9% and case fatality of 24.7%. Over the second wave, the mean quality of life score was 4.1 (SD 0.9) and the overall anxiety score was 49 (SD 24.3) for the two cohorts, which did not vary in terms of the impacts of these measures on the descriptive variables examined. Conclusions: Quality of life is invariably affected, and levels of anxiety are high regardless of whether or not they have had a SARS-CoV-2 infection. Over the period examined, mortality was low while coronavirus case fatality was high.
RESUMEN Introducción: Las personas con un trasplante renal forman una población vulnerable para la infección por SARS-CoV-2, lo que las puede llevar a sufrir consecuencias psicológicas que aún no han sido estudiadas. Objetivos: Comparar la incidencia de ansiedad y el nivel de calidad de vida, en personas con un trasplante renal, que se han contagiado de SARS-CoV-2 frente a los que no se han contagiado; así como describir la incidencia de contagios y la mortalidad en la población a estudio. Material y Métodos: Estudio retrospectivo de cohortes prospectivas. Durante la segunda ola de la pandemia (del 1 de julio al 5 de diciembre de 2020) se compararon los datos de la cohorte de casos (n=22) y la cohorte de no casos (n=36) en cuanto a ansiedad estado y ansiedad rasgo (medidas con el STAI), la calidad de vida (medida mediante el KTQ) y la mortalidad, como variables de interés principales. Resultados: La población a estudio fue de 601 personas trasplantadas, con una edad media de 61.7 años (DE: 12.8), 61.9% (372) fueron hombres. Se infectaron de SARS-CoV-2 el 12.1% (73) y fallecieron 6.2% (37), siendo el 52.9% (18) por SARSCoV- 2. Esto supone una tasa de mortalidad del 2.9% y una tasa de letalidad del 24.7%. Durante la segunda ola se infectaron un 6.2% (37). La calidad de vida media fue de 4.1 (DE: 0.9). En los infectados la media fue 4.2 (DE: 0.8), y en los no infectados 4 (DE: 1). Mientras que la media de ansiedad fue de 49 (DE:24.3); siendo 54.6 (DE: 25.7) en los infectados y 45.4 (DE: 23.1) en no infectados. No se encontraron diferencias estadísticamente significativas. Conclusiones: Las personas con un trasplante renal tienen afectada su calidad de vida y presentan altos niveles de ansiedad, independientemente de si han pasado o no la infección por SARS-CoV-2.La tasa de mortalidad durante el periodo analizado fue baja, mientras que la letalidad fue alta y ambas disminuyeron de la primera a la segunda ola de la infección.
ABSTRACT
UNLABELLED: Pressure ulcers represent an ongoing challenge, particularly in immobile patients, that must be met by all health professionals. Extrinsic influential factors involved in the development of pressure ulcers include local shear forces, skin friction, moisture, and temperature for a patient in bed. OBJECTIVES: Based on the relationship between pressure ulcers and skin temperature, we sought to study the influence of different bed support surface covers on skin temperature. The purpose of this study was to determine the influence of support surface materials and their effects on skin temperature at high risk areas of the body known to develop pressure ulcers. A quasi-experimental study with a non-probability sampling was used. A total of 31 subjects (14 males and 17 females) between 19 and 29 years old participated in this study. METHODS: The same standard foam bed cushion was used and three different types of surface protectors (also known as ticking) were chosen for comparison: no cover, cotton, or plastic. Skin temperature measurements were obtained from areas of high risk for developing pressure ulcers: sacrum, right and left scapula, right and left elbow, and right and left calcaneus. RESULTS: Upon analysis of the protective effect of different support surface coverings on the local skin temperature, we observed that temperatures were lower in all risk areas that had no support surface protector and were greater when the surfaces were in contact with protector material, with increases up to 2.13°C. CONCLUSIONS: The type of support surface protector material greatly influences skin temperature depending on the specific area of the body in contact with the surface. The protective plastic that is currently used in hospitals may increase the risk of skin lesions. Simple changes in practices could help minimize the negative impact that plastic protectors contribute to the skin. Regardless, the surface area should be covered with protective covers that do not produce an increase in local temperature and hygienically maintain their integrity.
