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3.
Nursing ; 51(4): 24-31, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33759859

RESUMO

ABSTRACT: The pandemic caused by the novel coronavirus has challenged healthcare systems around the world. Learn how one medical facility incorporated key guiding principles to quickly adapt normal policies and protocols in order to safely care for patients with COVID-19.


Assuntos
/enfermagem , Enfermagem de Cuidados Críticos/organização & administração , /epidemiologia , Humanos
4.
Soins ; 66(852): 35-37, 2021.
Artigo em Francês | MEDLINE | ID: mdl-33750556

RESUMO

The COVD-19 wave of spring 2020 had a major impact on French intensive care departments. The intense activity, the support of reinforcements in the acquisition of the necessary skills and their capacity to adapt made intensive care nurses key players in this crisis. Grouped together within the French National Federation of Intensive Care Nurses, they are campaigning to have the specificity of their practice to be recognised and for the creation of certified training in order to meet public healthcare needs not currently fulfilled.


Assuntos
/enfermagem , Enfermagem de Cuidados Críticos , Unidades de Terapia Intensiva/estatística & dados numéricos , Enfermeiras e Enfermeiros/psicologia , /epidemiologia , Epidemias , França/epidemiologia , Humanos , Pandemias/prevenção & controle
5.
Medicine (Baltimore) ; 100(6): e24507, 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33578544

RESUMO

BACKGROUND: As nursing resources is directly related to patient outcomes in the intensive care unit setting, identifying factors related to nursing resources at various levels could contribute to improving those outcomes. This study aims to determine the association of nursing resources with outcomes of intensive care unit patients. METHOD: This study adheres to the Preferred Reporting Items for Systematic Reviews and Meta-analysis for Protocols. Chinese electronic Database (Chinese Biomedical Literature Database, Wanfang, and China National Knowledge Infrastructure) and international electronic databases (PubMed, Embase, Cochrane Library, and Web of Science) will be searched for all relevant published articles, with no restrictions on the year of publication or language. Study selection, data collection and assessment of study bias will be conducted independently by a pair of independent reviewers. The Newcastle-Ottawa Scale tool will be used for the risk of bias assessment. The Grading of Recommendations Assessment Development and Evaluation system will be used to assess the quality of evidence. The statistical analysis of this meta-analysis will be calculated by Review manager version 5.3. RESULTS: The results of this study will be published in a peer-reviewed journal. CONCLUSION: The findings of this systematic review will provide a high-quality synthesis of latest evidence and provide a basis for assessing the association of nursing resources on patients' outcomes in intensive care units. TRIAL REGISTRATION NUMBER: 10.17605/OSF.IO/9FNEX.


Assuntos
Enfermagem de Cuidados Críticos , Unidades de Terapia Intensiva , Enfermagem de Cuidados Críticos/métodos , Enfermagem de Cuidados Críticos/estatística & dados numéricos , Recursos em Saúde/provisão & distribução , Humanos , Unidades de Terapia Intensiva/estatística & dados numéricos , Resultado do Tratamento
6.
J Nurs Adm ; 51(3): E6-E12, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33570376

RESUMO

This article discusses the crucial role and dearth of critical care nurses in the United States highlighted during the COVID-19 pandemic. This challenge of sufficient critical care nursing resources existed before the pandemic, but now concern is heightened by the need for such crucial healthcare providers now and in the future. We present strategies to address the gap, as well as challenges inherent in the suggested approaches. The discussion is relevant as nurse leaders adapt to COVID-19 and other novel challenges in the future.


Assuntos
/enfermagem , Enfermagem de Cuidados Críticos/normas , Enfermagem de Cuidados Críticos/tendências , Recursos Humanos de Enfermagem no Hospital/provisão & distribução , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Pandemias/prevenção & controle , Guias de Prática Clínica como Assunto , Adulto , Enfermagem de Cuidados Críticos/estatística & dados numéricos , Feminino , Previsões , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos
9.
Rev. enferm. UFPE on line ; 15(1): [1-9], jan. 2021. ilus
Artigo em Português | BDENF - Enfermagem | ID: biblio-1145846

RESUMO

Objetivo: descrever a experiência de enfermeiros acerca de um treinamento em saúde realizado em um hospital de alta complexidade, na perspectiva da prática de higiene oral em pacientes críticos, utilizando, como ferramenta, o ciclo Plan, Do, Check, Act. Método: trata-se de estudo qualitativo, descritivo, tipo relato de experiência, cuja ação tornou possível capacitar os profissionais de Enfermagem visando à melhoria da qualidade da execução da higiene oral realizada, identificando os dificultadores da prática da higienização oral dos pacientes em ventilação mecânica. Resultados: realizou-se a capacitação dos profissionais de Enfermagem visando à melhoria da qualidade da execução da higiene oral realizada, ressaltando os aspectos inerentes à produção do conhecimento e identificando os dificultadores da prática da higienização oral dos pacientes em ventilação mecânica. Conclusão: observou-se a importância em se utilizar modernas metodologias administrativas para se alcançar novos padrões de qualidade, uma vez que, constantemente, são necessárias atualizações acerca das ações em serviços de saúde.(AU)


Objective: to describe the experience of nurses in a health training course in a high complexity hospital from the perspective of oral hygiene practice in critically ill patients by using the Plan, Do, Check, Act cycle as a tool. Method: it is a qualitative, descriptive, experience report type study, whose action made it possible to train Nursing professionals with the aim to improve the quality of oral hygiene practice performance and identify the difficulties in the practice of oral hygiene of patients under mechanical ventilation. Results: the training of Nursing professionals was carried out with a view to improving the quality of the oral hygiene performance, highlighting the aspects inherent to the production of knowledge and identifying the difficulties in the practice of oral hygiene of patients under mechanical ventilation. Conclusion: the importance of using modern administrative methodologies to achieve new quality standards was observed, since updates on health service actions are constantly needed.(AU)


Objetivo: describir la experiencia de los enfermeros sobre la formación en salud realizada en un hospital de alta complejidad, desde la perspectiva de la práctica de la higiene bucal en pacientes críticos, utilizando como herramienta el ciclo Planificar, Hacer, Controlar, Actuar. Método: se trata de un estudio cualitativo, descriptivo, tipo de relato de experiencia, cuya acción permitió formar profesionales de enfermería con el objetivo de mejorar la calidad de la higiene bucal realizada, identificando las dificultades en la práctica de la higiene bucal de los pacientes en ventilación mecánica. Resultados: se capacitó a profesionales de enfermería para mejorar la calidad de la higiene bucal realizada, enfatizando los aspectos inherentes a la producción de conocimiento e identificando las dificultades en la práctica de la higiene bucal de los pacientes en ventilación mecánica. Conclusión: se observó la importancia de utilizar metodologías administrativas modernas para lograr nuevos estándares de calidad, ya que constantemente se requieren actualizaciones sobre las acciones de los servicios de salud.(AU)


Assuntos
Humanos , Masculino , Feminino , Higiene Bucal , Respiração Artificial , Saúde Bucal , Cuidados Críticos , Enfermagem de Cuidados Críticos , Enfermagem de Cuidados Críticos/educação , Capacitação em Serviço , Unidades de Terapia Intensiva , Equipe de Enfermagem , Epidemiologia Descritiva , Pesquisa Qualitativa
10.
Rev. enferm. UFPE on line ; 15(1): [1-14], jan. 2021. ilus, tab, graf
Artigo em Português | BDENF - Enfermagem | ID: biblio-1147675

RESUMO

Objetivo: identificar os cuidados de Enfermagem na prevenção de pneumonia em pacientes sob o uso de ventilação mecânica invasiva. Método: trata-se de um estudo bibliográfico, descritivo, tipo revisão integrativa, de artigos publicados entre os anos de 2013 a 2018, nas bases de dados MEDLINE, LILACS e BDENF, publicados em português, inglês e espanhol. Realizou-se a leitura de títulos, resumos e texto completo que responderam ao objetivo e à pergunta condutora, e, seus resultados discutidos e apresentados em tabelas. Resultados evidenciou-se, após a análise dos artigos encontrados, que a equipe de Enfermagem tem insigne participação na prevenção e cuidados à Pneumonia Associada à Ventilação Mecânica, todavia, são encontradas barreiras no cotidiano do profissional, impedindo-os de aplicar boas práticas a essa abordagem, como domínio insuficiente à falta de recursos necessários. Conclusão: evidenciou-se escassez de estudos publicados em português com relação direta com a temática e de acordo com observações feitas e, por meio de estudo, foi elencada a necessidade de educação continuada aos profissionais, além de mais implementações para o apoio ao serviço de Enfermagem.(AU)


Objective: to identify nursing care in the prevention of pneumonia in patients under use of invasive mechanical ventilation. Method: this is a bibliographic, descriptive, integrative reviewtype study of articles published between 2013 and 2018 in the MEDLINE, LILACS and BDENF databases, published in Portuguese, English and Spanish. Titles, abstracts and full text were read, which answered the objective and the leading question, and their results discussed and presented in tables. Results: it was evident, after the analysis of the articles found, that the Nursing team has an outstanding participation in the prevention and care of Pneumonia Associated to Mechanical Ventilation, however, barriers are found in the daily life of the professional, preventing them from applying good practices to this approach, as insufficient domain to the lack of necessary resources. Conclusion: there was a scarcity of studies published in Portuguese with a direct relation to the subject and according to observations made and, by means of study, the need for continued education for professionals was listed, in addition to further implementations to support the Nursing service.(AU)


Objetivo: identificar la atención de Enfermería en la prevención de la neumonía en pacientes que utilizan ventilación mecánica invasiva. Método: se trata de un estudio tipo revisión bibliográfica, descriptiva, integradora de artículos publicados entre 2013 y 2018, en las bases de datos MEDLINE, LILACS y BDENF, publicados en portugués, inglés y español. Se leyeron títulos, resúmenes y texto completo, que respondieron al objetivo y a la pregunta principal, y sus resultados discutidos y presentados en tablas. Resultados: se evidenció, luego de analizar los artículos encontrados, que el equipo de Enfermería tiene una participación insignificante en la prevención y atención de la Neumonía Asociada a la Ventilación Mecánica, sin embargo, se encuentran barreras en la rutina diaria del profesional, impidiéndole aplicar buenas prácticas a este enfoque, como dominio insuficiente debido a la falta de recursos necesarios. Conclusión: hubo una escasez de estudios publicados en portugués en relación directa con el tema y de acuerdo con las observaciones realizadas y, mediante un estudio, se enumeró la necesidad de educación continua para los profesionales, además de más implementaciones para apoyar el servicio de Enfermería.(AU)


Assuntos
Humanos , Masculino , Feminino , Respiração Artificial , Educação Continuada em Enfermagem , Pneumonia Associada à Ventilação Mecânica , Pneumonia Associada à Ventilação Mecânica/prevenção & controle , Enfermagem de Cuidados Críticos , Unidades de Terapia Intensiva , Cuidados de Enfermagem , Epidemiologia Descritiva , MEDLINE , LILACS
11.
Rech Soins Infirm ; (143): 76-91, 2021 Jan 13.
Artigo em Francês | MEDLINE | ID: mdl-33485287

RESUMO

Nurses have a leading role in weaning patients from mechanical ventilation (WMV) given their constant presence and their continuous monitoring. To promote proper WMV, nurses must exercise autonomy and be involved in decision-making. However, in certain care contexts, there is little involvement of nurses. The purpose of this text is to establish the characteristics of the concept of autonomous decision-making applied to nursing during WMV. An analysis of this concept was carried out according to the evolutionary method of Rodgers. The identification of the attributes, antecedents, and consequences made it possible to note ambiguity in the definition of this concept. Nurses use autonomous decision-making for the execution of assigned tasks and when they make decisions according to a pre-prescribed decision-making algorithm. Significant foundations for the decision-making autonomy of critical care nurses during WMV emerged from this analysis : scope of practice, in-depth knowledge of the patient, and commitment to the success of WMV. Participation in interdependent decision-making allows nurses to bring the patient’s perspective into decisions. Avenues of reflection have also emerged, including decisions based on evidence to provide new avenues for autonomous decision-making.


Assuntos
Enfermagem de Cuidados Críticos , Tomada de Decisões , Autonomia Profissional , Desmame do Respirador , Humanos , Desmame do Respirador/enfermagem
12.
Am J Emerg Med ; 41: 120-124, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33421675

RESUMO

STUDY HYPOTHESIS: We hypothesized that establishing a program of specialized emergency critical care (ECC) nurses in the ED would improve mortality of ICU patients boarding in the ED. METHODS: This was a retrospective before-after cohort study using electronic health record data at an academic medical center. We compared in-hospital mortality between the pre- and post-intervention periods and between non-prolonged (≤6 h) boarding time and prolonged (>6 h) boarding time. In-hospital mortality was stratified by illness severity (eccSOFA category) and adjusted using logistic regression. RESULTS: Severity-adjusted in-hospital mortality decreased from 12.8% pre-intervention to 12.3% post-intervention (-0.5% (95% CI, -3.1% to 2.1%), which was not statistically significant. This was despite a concurrent increase in ED and hospital crowding. The proportion of ECC patients downgraded to a lower level of care while still in the ED increased from 6.4% in the pre-intervention period to 17.0% in the post-intervention period. (+10.6%, 8.2% to 13.0%, p < 0.001). Severity-adjusted mortality was 12.8% in the non-prolonged group vs. 11.3% in the prolonged group (p = 0.331). CONCLUSIONS: During the post-intervention period, there was a significant increase in illness severity, hospital congestion, ED boarding time, and downgrades in the ED, but no significant change in mortality. These findings suggest that ECC nurses may improve the safety of boarding ICU patients in the ED. Longer ED boarding times were not associated with higher mortality in either the pre- or post-intervention periods.


Assuntos
Enfermagem de Cuidados Críticos/organização & administração , Estado Terminal/mortalidade , Enfermagem em Emergência/organização & administração , Serviço Hospitalar de Emergência/organização & administração , Mortalidade Hospitalar , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo
13.
Med Care ; 59(5): 371-378, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33480661

RESUMO

BACKGROUND: Planning for extreme surges in demand for hospital care of patients requiring urgent life-saving treatment for coronavirus disease 2019 (COVID-19), while retaining capacity for other emergency conditions, is one of the most challenging tasks faced by health care providers and policymakers during the pandemic. Health systems must be well-prepared to cope with large and sudden changes in demand by implementing interventions to ensure adequate access to care. We developed the first planning tool for the COVID-19 pandemic to account for how hospital provision interventions (such as cancelling elective surgery, setting up field hospitals, or hiring retired staff) will affect the capacity of hospitals to provide life-saving care. METHODS: We conducted a review of interventions implemented or considered in 12 European countries in March to April 2020, an evaluation of their impact on capacity, and a review of key parameters in the care of COVID-19 patients. This information was used to develop a planner capable of estimating the impact of specific interventions on doctors, nurses, beds, and respiratory support equipment. We applied this to a scenario-based case study of 1 intervention, the set-up of field hospitals in England, under varying levels of COVID-19 patients. RESULTS: The Abdul Latif Jameel Institute for Disease and Emergency Analytics pandemic planner is a hospital planning tool that allows hospital administrators, policymakers, and other decision-makers to calculate the amount of capacity in terms of beds, staff, and crucial medical equipment obtained by implementing the interventions. Flexible assumptions on baseline capacity, the number of hospitalizations, staff-to-beds ratios, and staff absences due to COVID-19 make the planner adaptable to multiple settings. The results of the case study show that while field hospitals alleviate the burden on the number of beds available, this intervention is futile unless the deficit of critical care nurses is addressed first. DISCUSSION: The tool supports decision-makers in delivering a fast and effective response to the pandemic. The unique contribution of the planner is that it allows users to compare the impact of interventions that change some or all inputs.


Assuntos
Diretrizes para o Planejamento em Saúde , Necessidades e Demandas de Serviços de Saúde , Hospitais , Capacidade de Resposta ante Emergências , Recursos Humanos , Enfermagem de Cuidados Críticos , Inglaterra , Equipamentos e Provisões Hospitalares , Pessoal de Saúde , Número de Leitos em Hospital , Humanos
16.
Nurs Crit Care ; 26(2): 94-101, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33448567

RESUMO

BACKGROUND: Nurses are experiencing tremendous stress during the new coronavirus disease 2019 (COVID-19) pandemic, especially intensive care nurses. The pandemic of the disease is a tragedy, which may leave a catastrophic psychological imprint on nurses. Understanding nurses' mental distress can help when implementing interventions to mitigate psychological injuries to nurses. AIMS AND OBJECTIVES: To quantify the severity of nurses' post-traumatic stress disorder (PTSD) symptoms and stress and explore the influencing factors of their psychological health when caring for patients with COVID-19. DESIGN: A cross-sectional survey. METHODS: The PTSD Checklist-Civilian and the Perceived Stress Scale were administered from 11 to 18 March 2020, to 90 nurses selected from another city to go and help an intensive care unit (ICU) in Wuhan, China. These nurses were selected because of their high levels of clinical performance and resilience status. RESULTS: Nurses' average PTSD score was 24.62 ± 6.68, and five (5.6%) of the nurses reported a clinically significant level of PTSD symptoms (>38 points). Nurses' perceived stress averaged 19.33 ± 7, and 20 nurses (22.22%) scored positively >25 points. Nurses' stress and PTSD symptoms were positively correlated (P < .01). Major stress sources included working in an isolated environment, concerns about personal protective equipment shortage and usage, physical and emotional exhaustion, intensive workload, fear of being infected, and insufficient work experiences with COVID-19. CONCLUSIONS: This study showed that even relatively highly resilient nurses experienced some degree of mental distress, including PTSD symptoms and perceived stress. Our findings highlight the importance of helping nurses cultivate resilience and reduce stress. RELEVANCE TO CLINICAL PRACTICE: Recommendations for practice include providing adequate training and orientation before assigning nurses to ICU to help, offering disaster-emergency-preparedness training to keep nurses prepared, providing caring and authentic nursing leadership, offering ongoing psychological support to frontline nurses.


Assuntos
/enfermagem , Recursos Humanos de Enfermagem no Hospital/psicologia , Estresse Ocupacional/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adulto , China/epidemiologia , Enfermagem de Cuidados Críticos , Estudos Transversais , Feminino , Humanos , Masculino , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Fatores de Risco , Adulto Jovem
17.
Prof Case Manag ; 26(2): 62-69, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33507016

RESUMO

PURPOSE: Since the outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the disease known as COVID-19, case management has emerged as a critical intervention in the treatment of cases, particularly for patients with severe symptoms and medical complications. In addition, case managers have been on the front lines of the response across the health care spectrum to reduce risks of contagion, including among health care workers. The purpose of this article is to discuss the case management response, highlighting the importance of individual care plans to provide access to the right care and treatment at the right time to address both the consequences of the disease and patient comorbidities. PRIMARY PRACTICE SETTINGS: The COVID-19 response spans the full continuum of health and human services, including acute care, subacute care, workers' compensation (especially catastrophic case management), home health, primary care, and community-based care. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: From the earliest days of the pandemic, case managers have assumed an important role on the front lines of the medical response to COVID-19, ensuring that procedures are in place for managing a range of patients: those who were symptomatic but able to self-isolate and care for themselves at home; those who had serious symptoms and needed to be hospitalized; and those who were asymptomatic and needed to be educated about the importance of self-isolating. Across the care spectrum, individualized responses to the clinical and psychosocial needs of patients with COVID-19 in acute care, subacute care, home health, and other outpatient settings have been guided by the well-established case management process of screening, assessing, planning, implementing, following up, transitioning, and evaluating. In addition, professional case managers are guided by values such as advocacy, ensuring access to the right care and treatment at the right time; autonomy, respecting the right to self-determination; and justice, promoting fairness and equity in access to resources and treatment. The value of justice also addresses the sobering reality that people from racial and ethnic minority groups are at an increased risk of getting sick and dying from COVID-19. Going forward, case management will continue to play a major role in supporting patients with COVID-19, in both inpatient and outpatient settings, with telephonic follow-up and greater use of telehealth.


Assuntos
/enfermagem , Administração de Caso/normas , Enfermagem de Cuidados Críticos/educação , Pessoal de Saúde/educação , Pessoal de Saúde/psicologia , Planejamento de Assistência ao Paciente/normas , Assistência Centrada no Paciente/normas , Adulto , Administração de Caso/estatística & dados numéricos , Currículo , Educação Continuada em Enfermagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Planejamento de Assistência ao Paciente/estatística & dados numéricos , Assistência Centrada no Paciente/estatística & dados numéricos , Guias de Prática Clínica como Assunto
18.
Can J Nurs Res ; 53(1): 5-15, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33342299

RESUMO

BACKGROUND: The severity of the COVID-19 health crisis has placed acute care nurses in dire work environments in which they have had to deal with uncertainty, loss, and death on a constant basis. It is necessary to gain a better understanding of nurses' experiences to develop interventions supportive of their emotional well-being. PURPOSE: The purpose of this study is to explore how nurses are emotionally affected working in COVID-19 acute care hospital environments. The research question is: What is the emotional experience of nurses working in COVID-19 acute care hospital environments? METHODS: We employed a narrative methodology that focused on participants' stories. Twenty registered nurses, who worked in six hospitals in the Greater Toronto Area in Canada, participated in interviews. A narrative analysis was conducted with a focus on content and form of stories. RESULTS: We identified three themes about working in COVID-19 acute care hospital environments: the emotional experience, the agency of emotions, and how emotions shape nursing and practice. CONCLUSION: In moving forth with pandemic preparations, healthcare leaders and governments need to make sure that a nurse's sacrifice is not all-encompassing. Supporting nurses' emotional well-being and resilience is necessary to counterbalance the loss and trauma nurses go through.


Assuntos
/enfermagem , Enfermagem de Cuidados Críticos , Emoções , Recursos Humanos de Enfermagem no Hospital/psicologia , /epidemiologia , Canadá/epidemiologia , Hospitais , Humanos , Pesquisa Qualitativa
19.
Rev. baiana enferm ; 35: e38558, 2021. tab, graf
Artigo em Português | LILACS-Express | LILACS, BDENF - Enfermagem | ID: biblio-1149704

RESUMO

Objetivo avaliar a infusão da nutrição enteral em pacientes adultos internados em unidade de terapia intensiva. Método estudo descritivo, quantitativo e longitudinal, desenvolvido ao longo de quatro meses em hospital público de alta complexidade, com pacientes em uso da terapia nutricional enteral. Foram realizadas análises estatísticas descritivas com média, desvio-padrão e percentual. Resultados a administração da nutrição enteral ocorreu de forma precoce após a admissão na unidade de terapia intensiva na maioria dos casos (64%). Em 71% dos pacientes, o volume de infusão da nutrição enteral foi entre 80 e 100% do prescrito. Os fatores que mais limitaram a infusão foram complicações no uso da sonda de alimentação (14%), instabilidade hemodinâmica e clínica (12%), e estase gástrica (12%). Conclusão a infusão da nutrição enteral mostrou-se satisfatória, e dentre os fatores que limitaram a infusão muitos são passíveis de prevenção com o aprimoramento dos cuidados de enfermagem, requerendo a capacitação da equipe.


Objetivo evaluar la infusión da nutrición enteral en pacientes adultos internados en una unidad de cuidados intensiva. Método estudio descriptivo, cuantitativo y longitudinal, desarrollado en el transcurso de cuatro meses en un hospital público de alta complejidad, con pacientes sometidos a terapia nutricional enteral. Se realizaron análisis estadísticos descriptivos con media, desvío estándar y porcentaje. Resultados la administración de la nutrición enteral tuvo lugar en forma temprana después del ingreso a la unidad de cuidados intensivos en la mayoría de los casos (64%). En el 71% de los pacientes, el volumen de infusión de la nutrición enteral fue entre el 80% y el 100% de lo prescripto. Los factores que más limitaron la infusión fueron complicaciones en el uso de la sonda de alimentación (14%), inestabilidad hemodinámica y clínica (12%), y estasis gástrica (12%). Conclusión la infusión de la nutrición enteral evidenció ser satisfactoria y, entre los factores que limitaron la infusión, muchos son pasibles de prevenirse con una mejora de la atención de Enfermería, lo que requiere capacitación del equipo.


Objective to evaluate the infusion of enteral nutrition in adult patients admitted to an intensive care unit. Method a descriptive, quantitative and longitudinal study, carried out over four months in a high-complexity public hospital, with patients using enteral nutritional therapy. Descriptive statistical analyses were performed with mean, standard deviation and percentage. Results enteral nutrition was administered early after admission to the intensive care unit in most of the cases (64%). In 71% of the patients, the infusion volume of enteral nutrition was between 80% and 100% of that prescribed. The factors that most limited the infusion were complications in the use of the feeding tube (14%), hemodynamic and clinical instability (12%), and gastric stasis (12%). Conclusion the infusion of enteral nutrition proved to be satisfactory and, among the factors that limited the infusion, many are preventable with the improvement of Nursing care, requiring the training of the team.


Assuntos
Humanos , Nutrição Enteral , Enfermagem de Cuidados Críticos , Unidades de Terapia Intensiva , Cuidados Críticos
20.
Rev. cienc. cuidad ; 18(1): 30-41, 2021.
Artigo em Espanhol | LILACS, BDENF - Enfermagem, COLNAL | ID: biblio-1147584

RESUMO

La administración de medicamentos es uno de los pilares fundamen-tales en la gestión del cuidado de la enfermería, de ahí la impor-tancia y responsabilidad de su manejo con personas que estén re-cibiendo fármacos especializados por su condición aguda o crítica. Objetivo: Construir un instrumento de valoración con los principios homeodinámicos y el concepto de pandimensionalidad de la teoría de seres humanos unitarios, para la administración de medicamen-tos especializados, como inotrópicos y vasopresores en servicios de UCI y urgencias. Materiales y métodos: Es una investigación cua-litativa con enfoque descriptivo, para conocer la realidad del sujeto de cuidado desde la premisa sobre la relación de la administración de medicamentos y los principios de la teoría de Seres Humanos Unitarios. Resultados: Se construyó un instrumento de valoración desde la perspectiva de la teoría de Rogers. La misma permite al profesional de enfermería evaluar y generar propuestas de cuida-do guiadas al equilibrio armónico de los campos de energía, según propone esta teórica en relación con la administración de medica-mentos. También le facilita al estudiante el identificar las alteracio-nes de los principios de la teoría en relación a los efectos de los medicamentos. Conclusiones: El instrumento permite contemplar los principios homeodinámicos y la pandimensionalidad; además, facilita los procesos de cuidado en la administración de medicamen-tos, que en ocasiones por diferentes causas no se evalúa la respuesta del sujeto de cuidado ante un medicamento, retrasando su evolución ante la enfermedad.


The administration of medications is one of the fundamental pillars in the management of nursing care, hence the importance and responsibility of the management of medications to people who are receiving specialized medicine for their acute or critical condition, that is why this study was proposed The objective: is to build an assessment instrument with the homeodynamic principles and the concept of pandimensionality of the theory of unitary human beings for the administration of specialized drugs such as inotropics and vasopressors in ICU and emergency health services. Materials and methods: qualitative with a descriptive approach, to know the reality of the care subject from the premise of the relationship of the administration of medicines and principles of the theory of Unitary Human Beings, Results: an assessment instrument was built from the pers-pective of Rogers' theory that allows the nursing professional to evaluate and generate proposals for care guided to the harmonic balance of the energy fields proposed by this theory in relation to the administration of medications, also, it allows the student to identify alterations in the prin-ciples of the theory in relation to the effects of medications Conclusions: the instrument allows to contemplate homeodynamic principles and the concept of pandimensionality thus facilitate the process of care for the administration of drugs that sometimes for different reasons does not evaluate the response of the care subject to a drug, delaying the evolution of the subject before the disease.


A administração de medicamentos é um dos eixos fundamentais do cuidado de enfermagem, sendo importante a responsabilidade do seu manejo com pessoas que recebem fármacos espe-cializados pela sua condição aguda ou crítica. Objetivo: Construir um instrumento de avaliação dos princípios homeodinâmicos e o conceito de pandimensionalidade da teoria do ser humanos unitários, para a administração de medicamentos especializados como inotrópicos e vasopres-sores nas UTI e Unidades de Emergência. Materiais e métodos: Pesquisa qualitativa com foco descritivo para conhecer a realidade do sujeito de cuidado sobre a relação da administração de medicamentos e os princípios da teoria do Ser Humano Unitário. Resultados: Construiu-se um instrumento de valoração desde a perspectiva de Rogers, permitindo ao profissional de enferma-gem avaliar e gerar propostas de cuidado guiadas ao equilíbrio harmônico dos campos de energia, segundo a proposta da teoria em relação com a administração de medicamentos. Também lhe fa-cilita ao estudante identificar as alterações dos princípios da teoria em relação com os efeitos dos medicamentos. Conclusões: O instrumento permite contemplar os princípios homeodinâmicos e pandimensionalidade; além disso, facilita os processos de cuidado na administração de medica-mentos que ocasionalmente, por diferentes causas não se avalia a resposta do sujeito de cuidado ante um medicamento, retrasando a sua evolução perante a doença.


Assuntos
Enfermagem de Cuidados Críticos , Terapêutica , Medical Subject Headings
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