Niveles de ruido ambiental en dos unidades de cuidados intensivos pediátricos con diferente infraestructura / Comparative analysis of environmental noise levels in two paediatric intensive care units

OBJETIVOS: 1) Determinar los niveles de ruido ambiental en dos unidades de cuidados intensivos pediátricos (UCIP) de un hospital pediátrico de tercer nivel asistencial y 2) analizar si dichos valores cumplen con la normativa actual. MÉTODO: Estudio observacional, descriptivo y transversal llevado a cabo en dos UCIP con infraestructura diferente: boxes separados por cortinas y habitaciones individuales. Se empleó un sonómetro PCE-999 tipo 2 para determinar el ruido ambiental y la unidad de medida registrada fue en decibelios (dB). A la vez, se diseñó un documento de recogida de datos ad hoc diferenciando entre unidad (abierta y cerrada), hora de registro. RESULTADOS: Se recogió un total de 330 determinaciones, 72 en la UCIP abierta y 258 en la de habitaciones individuales. El ruido ambiental que imperaba en la unidad de críticos abierta fue de 56,74 ± 3,6 decibelios versus 50,36 ± 4,7 en la de boxes individuales, observándose valores mayores en el turno diurno. DISCUSIÓN: Tal como sucede en otros estudios previos, se observa que el ruido que impera en la unidad excede los límites permitidos. Además, se coincide con el hecho de que las principales fuentes de ruido ambiental de la UCI provienen de las alarmas, la maquinaria, como monitores o respiradores y las conversaciones entre profesionales sanitarios. CONCLUSIONES: Tras la presente investigación, se ha podido constatar que los niveles de ruido ambiental que imperan en las dos Unidades de Cuidados Intensivos Pediátricos analizadas son elevados. Los datos obtenidos apuntan a que la organización arquitectónica de concepto cerrado puede tener un impacto a la hora de disminuir la generación de dicho input medioambiental

AIMS: 1) To determine noise levels in two paediatric intensive care units (PICU) of a tertiary hospital and 2) to analyse whether these values comply with the current standards. METHOD: Observational, descriptive and cross-sectional study carried out in two PICU with different infrastructure: bays separated by curtains and individual bedrooms. A PCE-999 sound level meter was used to determine noise levels, which were registered in decibels (dB). At the same time, an ad hoc data recording document was designed in which we differentiated between each unit (open concept or closed), time of recording. RESULTS: A total of 330 tests, 72 from open PICUs and 258 from closed PICUs were collected. The noise in the open PICU was 56.74 ± 3.61 decibels versus 50.36 ± 4.71 in the closed PICU, obtaining the highest levels during the morning. DISCUSSION: As it occurs in other studies, noise levels exceed the allowed limits. At the same time, the main sources of noise in the PICU came from alarms, medical equipment, such as monitors or respirators, and conversations between health professional. CONCLUSIONS: This investigation has shown high levels of environmental noise in the two PICUs analysed. The data obtained indicate that the architectural concept of individual bedrooms may have an impact in decreasing this environmental input

Comparative analysis of environmental noise levels in two paediatric intensive care units. / Niveles de ruido ambiental en dos unidades de cuidados intensivos pediátricos con diferente infraestructura.

AIMS: 1) To determine noise levels in two paediatric intensive care units (PICU) of a tertiary hospital and 2) to analyse whether these values comply with the current standards. METHOD: Observational, descriptive and cross-sectional study carried out in two PICU with different infrastructure: bays separated by curtains and individual bedrooms. A PCE-999 sound level meter was used to determine noise levels, which were registered in decibels (dB). At the same time, an ad hoc data recording document was designed in which we differentiated between each unit (open concept or closed), time of recording. RESULTS: A total of 330 tests, 72 from open PICUs and 258 from closed PICUs were collected. The noise in the open PICU was 56.74 ± 3.61 decibels versus 50.36 ± 4.71 in the closed PICU, obtaining the highest levels during the morning. DISCUSSION: As it occurs in other studies, noise levels exceed the allowed limits. At the same time, the main sources of noise in the PICU came from alarms, medical equipment, such as monitors or respirators, and conversations between health professional. CONCLUSIONS: This investigation has shown high levels of environmental noise in the two PICUs analysed. The data obtained indicate that the architectural concept of individual bedrooms may have an impact in decreasing this environmental input.

Validez de contenido de una escala de confort crítico pediátrico mediante una metodología mixta / Validity of contents of a paediatric critical comfort scale using mixed methodology

Introducción: La enfermedad crítica en el paciente pediátrico incluye desde una patología aguda en un niño sano a una agudización de una enfermedad crónica, hecho que ha conllevado centrar su atención clínica en las Unidades de Cuidados Intensivos Pediátricos. El rol del/la enfermero/a pediátrico/a se centra también en promover el confort en estos pacientes críticos. Por este motivo, es necesario disponer de instrumentos de medida que permitan un correcto sensado del grado de confort. Objetivo: Describir el proceso de validación de contenido de una escala de confort crítico pediátrico mediante el empleo de una metodología mixta. Material y métodos: Se realizó una adaptación transcultural del inglés al español mediante el método de traducción-retraducción de la Comfort Behavior Scale. Posteriormente, se validó el contenido de la misma mediante una metodología mixta. Esta segunda etapa se dividió en una fase cuantitativa empleando un cuestionario ad hoc donde se valoró la relevancia/pertinencia y el redactado de cada dominio/ítem de la escala y en una cualitativa donde se realizaron dos reuniones con profesionales sanitarios, pacientes y un familiar siguiendo las recomendaciones de la metodología Delphi. Resultados: Todos los ítems y dominios obtuvieron un índice de validez de contenido >0,80, exceptuando el movimiento físico, en su relevancia, que obtuvo un 0,76. El índice global de validez de contenido de la escala fue de 0,87 (elevado). Durante la fase cualitativa se reformularon y/o eliminaron ítems de cada uno de los dominios de la escala para hacerla más comprensible y aplicable. Conclusiones: El empleo de una metodología mixta de validación de contenido otorga riqueza y sensibilidad evaluatoria al instrumento a diseñar (AU)

Introduction: Critical illness in paediatric patients includes acute conditions in a healthy child as well as exacerbations of chronic disease, and therefore these situations must be clinically managed in Critical Care Units. The role of the paediatric nurse is to ensure the comfort of these critically ill patients. To that end, instruments are required that correctly assess critical comfort. Objective: To describe the process for validating the content of a paediatric critical comfort scale using mixed-method research. Material and Methods: Initially, a cross-cultural adaptation of the Comfort Behavior Scale from English to Spanish using the translation and back-translation method was made. After that, its content was evaluated using mixed method research. This second step was divided into a quantitative stage in which an ad hoc questionnaire was used in order to assess each scale's item relevance and wording and a qualitative stage with two meetings with health professionals, patients and a family member following the Delphi Method recommendations. Results: All scale items obtained a content validity index >0.80, except physical movement in its relevance, which obtained 0.76. Global content scale validity was 0.87 (high). During the qualitative stage, items from each of the scale domains were reformulated or eliminated in order to make the scale more comprehensible and applicable. Conclusions: The use of a mixed-method research methodology during the scale content validity phase allows the design of a richer and more assessment-sensitive instrument (AU)

Validity of contents of a paediatric critical comfort scale using mixed methodology. / Validez de contenido de una escala de confort crítico pediátrico mediante una metodología mixta.

INTRODUCTION: Critical illness in paediatric patients includes acute conditions in a healthy child as well as exacerbations of chronic disease, and therefore these situations must be clinically managed in Critical Care Units. The role of the paediatric nurse is to ensure the comfort of these critically ill patients. To that end, instruments are required that correctly assess critical comfort. OBJECTIVE: To describe the process for validating the content of a paediatric critical comfort scale using mixed-method research. MATERIAL AND METHODS: Initially, a cross-cultural adaptation of the Comfort Behavior Scale from English to Spanish using the translation and back-translation method was made. After that, its content was evaluated using mixed method research. This second step was divided into a quantitative stage in which an ad hoc questionnaire was used in order to assess each scale's item relevance and wording and a qualitative stage with two meetings with health professionals, patients and a family member following the Delphi Method recommendations. RESULTS: All scale items obtained a content validity index >0.80, except physical movement in its relevance, which obtained 0.76. Global content scale validity was 0.87 (high). During the qualitative stage, items from each of the scale domains were reformulated or eliminated in order to make the scale more comprehensible and applicable. CONCLUSIONS: The use of a mixed-method research methodology during the scale content validity phase allows the design of a richer and more assessment-sensitive instrument.