RESUMO
OBJECTIVE: To examine the characteristics of patients admitted to the Medical Intensive Care Unit (MICU) after intentional drug overdose. DESIGN: Retrospective chart review, descriptive. SETTING: Midwestern teaching hospital. SUBJECTS: Convenience sample of 43 patients admitted to the MICU after intentional drug overdose. OUTCOME MEASURES: Survival and disposition of those patients who survived and were discharged from the MICU. RESULTS: Ninety-five percent of the patients survived and were discharged from the MICU; Acute Physiology and Chronic Health Evaluation II scores ranged from 1 to 29 (mean, 8); Glascow Coma Scale scores ranged from 3 to 15 (mean 12.5); five patients were intubated and two patients had serious electrocardiograph changes requiring pharmacologic intervention for dysrhythmia. CONCLUSIONS: Neurologic findings were the best indicators of serious complications after drug overdose. THerefore, patients with a Glascow Coma Scale score of more than six, and who are not intubated, may not need admission to an intensive care unit.
Assuntos
Cuidados Críticos , Overdose de Drogas/terapia , APACHE , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Overdose de Drogas/classificação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Tentativa de Suicídio , Resultado do TratamentoRESUMO
A program was implemented by clinical nurse specialists to manage the costs of the confused, agitated, or suicidal hospitalized patient. Key strategies used to implement and maintain the program are presented along with clinical and cost outcomes.
Assuntos
Confusão/enfermagem , Enfermeiros Clínicos , Recursos Humanos de Enfermagem Hospitalar/economia , Enfermagem Psiquiátrica , Agitação Psicomotora/enfermagem , Tentativa de Suicídio/prevenção & controle , Controle de Custos , Humanos , Enfermeiros Clínicos/economia , Recursos Humanos de Enfermagem Hospitalar/provisão & distribuição , Avaliação de Resultados em Cuidados de Saúde , Admissão e Escalonamento de Pessoal/economia , Enfermagem Psiquiátrica/economia , Recursos HumanosAssuntos
Diretivas Antecipadas/legislação & jurisprudência , Recursos Humanos de Enfermagem Hospitalar , Participação do Paciente/legislação & jurisprudência , Regulamentação Governamental , Hospitais Universitários/organização & administração , Humanos , Capacitação em Serviço , Relações Enfermeiro-Paciente , Recursos Humanos de Enfermagem Hospitalar/educação , Ohio , Projetos Piloto , Estados UnidosRESUMO
Hospital nurses led weekly group sessions to provide dermatologic inpatients a supportive climate in which to share common concerns about skin disease and a forum for dissemination of dermatologic information. Session leaders kept a journal, noting themes and group dynamic patterns for each meeting. Participants also responded to a session evaluation questionnaire. Data from the journal and questionnaires were collected for one year to describe the issues and concerns raised in a support group for dermatologic patients and to assess the effectiveness of this approach in overall patient management. Three themes were consistently discussed: problems with stress, self-esteem, and social interaction; concerns with medical treatment; and coping with loss. Participants indicated that support and encouragement had been given and received. Need for a dermatologic patient support group was demonstrated. Location of such a group in an outpatient day-care setting was recommended.
