Dysphagia management by nurses in Spanish intensive care units.

INTRODUCTION/PURPOSE: Dysphagia is a disorder that presents with specific signs and symptoms in critically ill patients. Intensive care unit (ICU) nurses are responsible for monitoring and detecting abnormalities in critically ill patients, so they must be trained to assess swallowing and the complications that may arise. The aim of this research is to analyse the dynamics of the detection and assessment of dysphagia by ICU nurses. METHOD: Cross-sectional descriptive study using an electronic questionnaire to nurses from different Spanish ICUs. The survey was adapted from previous research and consisted of 6 sections with 30 items of qualitative questions. The collection period was between December 2022 and March 2023. Statistical analysis was performed using frequencies and percentages, and the Chi-Square test was used for bivariate analysis. OUTCOMES: 43 nurses were recruited. Dysphagia is considered an important problem (90,7%) but in 50,3% of the units there is no standard or care protocol for this disorder. The most common technique is the swallowing test (32,6%). There is a consensus in our sample that aspiration pneumonia is the main problem; however, nurses in the busiest care units consider sepsis to be a frequent complication (p = ,029). The most common treatment is modification of food consistency (86,0%). CONCLUSION: The findings of this research show a low systematisation of dysphagia screening in the units included. There is a need for greater implementation of interventions and clinical protocols for monitoring complications as well as for compensatory and rehabilitative management.

Necesidades de formación detectadas por enfermeras de una unidad de cuidados intensivos: un estudio fenomenológico / Training needs detected by nurses in an intensive care unit: a phenomenological study

Introducción: Las competencias que abordan en su entorno laboral las enfermeras de cuidados intensivos (UCI), han aumentado con la adquisición de nuevas responsabilidades asociadas a cuidados y dispositivos a realizar al paciente crítico. Múltiples estudios avalan la necesidad de la especialización de las enfermeras que trabajan en este tipo de unidades. Apoyado en estas evidencias, la European Federation of Critical Care Nurse, recomienda unificar la formación de las enfermeras de cuidados intensivos. Por tanto, nos planteamos el siguiente objetivo: valorar las necesidades formativas que detectan las enfermeras de UCI a través de sus vivencias y experiencias profesionales. Método: Estudio cualitativo descriptivo, con enfoque fenomenológico, a través de una entrevista semiestructurada donde se estudiaron los 4 ámbitos que la European Federation of Critical Care Nurse recoge (clínico, profesional, gestión y educativo). Se entrevistaron a 15 enfermeras de una UCI polivalente. Resultados: Los entrevistados reconocen que la formación previa era deficiente para los cuidados y medidas de soporte que tuvieron que afrontar. Consideran que la formación posterior y la experiencia fueron determinantes para poder desarrollar efectivamente su labor profesional. Además afirman que las medidas de soporte y los cuidados son temas a desarrollar continuamente mediante una formación dirigida. Conclusión: Las enfermeras reconocen que debe existir una formación destinada a cumplir las competencias que las UCI requieren, y que estas se ven afectadas por el tipo de unidad y el tipo de pacientes atendidos

Introduction: The competences of intensive care (ICU) nurses in their healthcare environment, have increased with the acquisition of new responsibilities associated with new care and devices for critical patients. Many studies suggest the need for specific training of nurses that work in these units. Based on this evidence, the European Federation of Critical Care Nurses Associations, recommends unifying the training of intensive care nurses. Therefore we set ourselves the following objective: to assess the training needs detected by ICU nurses through their experience and practical knowledge. Method: Descriptive qualitative study, with a phenomenological approach, through semi-structured interview where the four areas (clinical practice, professional, management and educational) covered by the European Federation of Critical Care Nurses Associations were studied. Fifteen nurses from an adult polyvalent ICU were interviewed. Results: The interviewees acknowledged that the previous training was deficient for the care and support measures that they had to face. They considered that subsequent training and experience were decisive in order to carry out their work effectively. They also stated that support measures and care are topics to be developed continuously through targeted training. Conclusion: The nurses in this research study acknowledged that training is needed to achieve the competences required in ICU, and these are affected by the type of unit and patients

Training needs detected by nurses in an intensive care unit: a phenomenological study. / Necesidades de formación detectadas por enfermeras de una unidad de cuidados intensivos: un estudio fenomenológico.

INTRODUCTION: The competences of intensive care (ICU) nurses in their healthcare environment, have increased with the acquisition of new responsibilities associated with new care and devices for critical patients. Many studies suggest the need for specific training of nurses that work in these units. Based on this evidence, the European Federation of Critical Care Nurses Associations, recommends unifying the training of intensive care nurses. Therefore we set ourselves the following objective: to assess the training needs detected by ICU nurses through their experience and practical knowledge. METHOD: Descriptive qualitative study, with a phenomenological approach, through semi-structured interview where the four areas (clinical practice, professional, management and educational) covered by the European Federation of Critical Care Nurses Associations were studied. Fifteen nurses from an adult polyvalent ICU were interviewed. RESULTS: The interviewees acknowledged that the previous training was deficient for the care and support measures that they had to face. They considered that subsequent training and experience were decisive in order to carry out their work effectively. They also stated that support measures and care are topics to be developed continuously through targeted training. CONCLUSION: The nurses in this research study acknowledged that training is needed to achieve the competences required in ICU, and these are affected by the type of unit and patients.