Parents who spent more hours in intensive care units with their low birthweight newborn infant did not achieve autonomous care faster.

AIM: We examined the correlation between how long it took the parents of very low birthweight infants, born weighing up to 1500 g, to provide different kinds of autonomous care in a neonatal intensive care unit (NICU). METHODS: This prospective observational was conducted in the NICU of a Spanish hospital from 10 January 2020 to 3 May 2022. The unit had 11 beds single-family rooms and provided eight beds in an open bay room. The study examined breastfeeding, patient safety, participation in rounds, pain prevention and cleanliness. RESULTS: We studied 96 patients and their parents and there was no correlation between any type of care and the time it took parents to provide it autonomously. Parents in the single-family room cohort spent a median of 9.5 h per day between them in the NICU, while the parents in the open bay room spent 7.0 h with their infants (p = 0.03). However, parents in the single-family room group were able to recognise pain faster (p = 0.02). CONCLUSION: Parents in single-family rooms spent more time in the NICU and recognised pain faster but did not achieve autonomous care faster than parents in the open bay group.

Análisis del registro de la atención inicial al paciente con trauma grave / Analysis of the registry of the initial care given to the patient with severe trauma

Objetivo: analizar el cumplimiento del registro de atención inicial al paciente con trauma grave en la Unidad de Cuidados Intensivos de trauma y emergencias del Hospital 12 de Octubre de Madrid. Material y método: estudio descriptivo sobre los registros de atención inicial al paciente con trauma grave (RAIT), basados en la metodología Advanced Trauma Life Support. Se diseñaron 10 variables principales (VP): para evaluar el cumplimiento: demográfica, clínica, constantes atención inicial, constantes traslado intrahospitalario, constantes pruebas diagnósticas extra-unidad,equilibrio hídrico, atención prehospitalaria, atención en la unidad, pruebas diagnósticas-analíticas, equipo de atención. El nivel de cumplimentación total se relacionó con el Injurity Severity Score (ISS), turno y cambio-turno. Se realizó un análisis descriptivo de las variables y se utilizó el test de Kruskall-Wallis par el análisis bivariante. Resultados: se analizaron los registros del 331 pacientes. La cumplimentación total media fue 49,5%. No se daban diferencias significativas entre la cumplimentación total, ISS, turno y cambio-turno. El registro de VP: demográfica82,18%, clínica 3,63%, constantes en la atención inicial 44,4%, constantesy pruebas diagnósticas extra-unidad 16,9%, equilibrio hídrico 0,9%,ningún registro de constantes durante el traslado intrahospitalario, atención prehospitalaria 68,9%, atención en la unidad 91,8%, pruebas diagnósticas-analíticas95%, equipo de atención 90,3%.Conclusión: es necesario mejorar la cumplimentación del RAIT. Se detectan áreas de mejora como el incremento del registro de constantes atención inicial (temperatura), constantes pruebas diagnósticas extra-unidad, equilibriohídrico (pérdidas hemáticas) y grupo sanguíneo, por la importancia en el manejo del paciente con trauma grave (AU)

Objective: to analyse compliance with the registry of the initial care given to the patient with severe trauma at the Trauma and Emergency Intensive Care Unit of the Hospital 12 de Octubre in Madrid.Material and method: descriptive study of the registry of the initial caregiven to the patient with severe trauma (RAIT), based on the Advanced Trauma Life Support. 10 primary variables (PV) were designed (VP) to assess compliance:demographic, symptoms, initial care vital signs, vital signs during intrahospital transfer, diagnostic test outside the unit vital signs, water balance, prehospital care, care at the unit, diagnostic tests-laboratory work,care team. The level of total compliance was related to the Injury Severity Score(ISS), shift and shift-change. A descriptive analysis of the variables was carried and the Kruskall-Wallis test was used for bivariate analysis.Results: the registries of 331 patients were reviewed. Mean total compliancerate was 49,5%. No significant differences were found between total compliance, ISS, shift and shift-change. The registry of PV: demographic 82,18%, symptoms 3,63%, vital signs on initial care 44,4%, vital signs and diagnostic tests outside the unit 16,9%, water balance 0,9%, no recording of vital signs during intrahospital transfer, prehospital care 68,9%, care given at the unit 91,8%, diagnostic tests-laboratory work 95%, care team 90,3%.Conclusion: it is necessary to improve compliance with the RAIT protocol.Areas in need of improvement are detected such as increased recordings in the registry of vital signs at initial care (temperature), increased recordings of vital signs during diagnostic tests/laboratory work and increased recording of water balance (blood loss) and blood type, given the importance that these data have in the management of patients with severe trauma (AU)