scholarly journals The epidemiology of intensive care unit-acquired hyponatraemia and hypernatraemia in medical-surgical intensive care units

Critical Care ◽  
2008 ◽  
Vol 12 (6) ◽  
pp. R162 ◽  
Author(s):  
Henry Stelfox ◽  
Sofia B Ahmed ◽  
Farah Khandwala ◽  
David Zygun ◽  
Reza Shahpori ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Surgical Intensive Care

scholarly journals Perceived and sources of occupational stress in surgical intensive care nurses

2020 ◽  
pp. 201010582096329
Author(s):  
Semra Bulbuloglu ◽  
Gurkan Kapikiran ◽  
Serdar Saritas
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Stress Management ◽  
Intensive Care Units ◽  
Organ Transplant ◽  
University Hospital ◽  
Spiritual Support ◽  
Surgical Intensive Care ◽  
Computer Environment ◽  
Bonferroni Test

Aim: The study aimed to determine sources of stress and stress levels of nurses working in surgical intensive care units in addition to understanding the stress level in nurses, drawing attention and raising awareness. Material and methods: The study was conducted using a descriptive design with the participation of nurses ( n=132) working in surgical intensive care units of a university hospital. The data were collected through the source of stress identification form and perceived stress scale. The data obtained in the study were transferred to a computer environment, and for statistical analyses, the package for social sciences for Windows 25 software was used. In the analyses of the data, descriptive statistics, independent t-test, one-way analysis of variance and regression analysis, and the Bonferroni test were employed. Results: It was also determined that 28.8% of the surgical nurses were working in an organ transplant intensive care unit and 25% worked in an anaesthesia intensive care unit, that 49.3% had professional experience of between 6 and 11 years and that 92.4% worked on both day and night shifts. In the study, the rate of nurses who perceived a high level of stress was found to be 45.5%, and it was identified that 78.8% needed training in stress management. Conclusion: Imperative funding and human resources should be provided in order to give nurses problem-solving abilities and a stress management course. The financial support of the managers and spiritual support of health professionals and organising regular meetings with nurses can help nurses to experience less stress.

Using a Decision Wheel to Reduce Use of Restraints in a Medical-Surgical Intensive Care Unit

2016 ◽  
Vol 25 (6) ◽  
pp. 479-486 ◽  
Author(s):  
Stacy Hevener ◽  
Barbara Rickabaugh ◽  
Toby Marsh
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Decision Support ◽  
Intensive Care Units ◽  
Decision Support Tool ◽  
Educational Activity ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Support Tool ◽  
Unplanned Extubations

Background Little information is available on the use of tools in intensive care units to help nurses determine when to restrain a patient. Patients in medical-surgical intensive care units are often restrained for their safety to prevent them from removing therapeutic devices. Research indicates that restraints do not necessarily prevent injuries or removal of devices by patients. Objectives To decrease use of restraints in a medical-surgical intensive care unit and to determine if a decision support tool is useful in helping bedside nurses determine whether or not to restrain a patient. Methods A quasi-experimental study design was used for this pilot study. Data were collected for each patient each shift indicating if therapeutic devices were removed and if restraints were used. An online educational activity supplemented by 1-on-1 discussion about proper use of restraints, alternatives, and use of a restraint decision tool was provided. Frequency of restraint use was determined. Descriptive statistics and thematic analysis were used to examine nurses’ perceptions of the decision support tool. Results Use of restraints was reduced 32%. No unplanned extubations or disruption of life-threatening therapeutic devices by unrestrained patients occurred. Conclusions With implementation of the decision support tool, nurses decreased their use of restraints yet maintained patients’ safety. A decision support tool may help nurses who are undecided or who need reassurance on their decision to restrain or not restrain a patient.

scholarly journals Bundled Consent in US Intensive Care Units

2020 ◽  
Vol 29 (3) ◽  
pp. e44-e51
Author(s):  
Maria L. Espinosa ◽  
Aaron M. Tannenbaum ◽  
Megha Kilaru ◽  
Jennifer Stevens ◽  
Mark Siegler ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Units ◽  
The United States ◽  
Self Report ◽  
Medical Decision ◽  
Consent Rate ◽  
Surgical Intensive Care ◽  
American Hospital ◽  
American Hospital Association

Background Bundled consent, the practice of obtaining anticipatory consent for a predefined set of intensive care unit procedures, increases the rate of informed consent conversations and incorporation of patients’ wishes into medical decision-making without sacrificing patients’ or surrogates’ understanding. However, the adoption rate for this practice in academic and nonacademic centers in the United States is unknown. Objective To determine the national prevalence of use of bundled consent in adult intensive care units and opinions related to bundled consent. Methods A random sample of US hospitals with medical/surgical intensive care units was selected from the AHA [American Hospital Association] Guide. One intensive care unit provider (bedside nurse, nurse manager, or physician) from each hospital was asked to self-reportuse of per-procedure consent versus bundled consent, consent rate for intensive care unit procedures, and opinions about bundled consent. Results Of the 238 hospitals contacted, respondents from 100 (42%) completed the survey; 94% of respondents were nurses. The prevalence of bundled consent use was 15% (95% CI, 9%–24%). Respondents using per-procedure consent were more likely than those using bundled consent to self-report performing invasive procedures without consent. Users of bundled consent unanimously recommended the practice, and 49% of respondents using per-procedure consent reported interest in implementing bundled consent. Results Bundled consent use is uncommon in academic and nonacademic intensive care units, most likely because of conflicting evidence about the effect on patients and surrogate decision makers. Future work is needed to determine if patients, family members, and providers prefer bundled consent over per-procedure consent.

Elderly patients' reports of physical restraint experiences in intensive care units

2001 ◽  
Vol 10 (3) ◽  
pp. 168-171 ◽  
Author(s):  
A Minnick ◽  
RM Leipzig ◽  
ME Johnson
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Elderly Patients ◽  
Intensive Care Units ◽  
Physical Restraint ◽  
Surgical Intensive Care Unit ◽  
Physical Restraints ◽  
Surgical Intensive Care ◽  
Staff Members ◽  
Well Elderly

BACKGROUND: Use of physical restraints has undesirable sequelae. As they weigh the risks and benefits of protocols for reducing the use of restraints, staff members in intensive care units, where restraints are most used in hospitals, need to know how well elderly patients remember being restrained and how patients perceive the use of restraints. OBJECTIVES: To estimate the proportion of patients who remember being restrained, describe the experience from the patients' perspectives, and describe any distress caused by use of restraints within the overall experience of being in the intensive care unit. METHODS: Transcripts of semistructured, audiotaped interviews of patients who had been in the medical or surgical intensive care unit in any of 3 eastern and midwestern medical centers were analyzed by question and for overall themes. RESULTS: Six patients (40%) remembered some aspect of being restrained but did not report great distress. Patients accepted restraints as needed because of the lack of alternatives. Patients reported remembering that they should not perform certain behaviors but being unable to stop themselves. Patients cited hallucinations and intubation as major stressors in the intensive care unit. Patients' continuing health problems after discharge from the intensive care unit severely limited recruitment of subjects. CONCLUSIONS: Patients do not remember great distress specifically related to the use of restraints, but the overall situation leading to use of restraints is disturbing if remembered. The discovery of methods to reduce the distress of intubation and hallucinations could decrease use of restraints.

Feasibility of a Mindfulness-Based Intervention for Surgical Intensive Care Unit Personnel

2017 ◽  
Vol 26 (1) ◽  
pp. 10-18 ◽  
Author(s):  
Beth A. Steinberg ◽  
Maryanna Klatt ◽  
Anne-Marie Duchemin
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Work Engagement ◽  
Intervention Group ◽  
Surgical Intensive Care Unit ◽  
Control Group ◽  
Negative Effects ◽  
Surgical Intensive Care ◽  
Utrecht Work Engagement Scale

Background Surgical intensive care unit personnel are exposed to catastrophic situations as they care for seriously injured or ill patients. Few interventions have been developed to reduce the negative effects of work stress in this environment. Objective This pilot study evaluated the feasibility of a workplace intervention for increasing resilience to stress. The intervention was implemented within the unique constraints characteristic of surgical intensive care units. Methods Participants were randomly assigned to an intervention or control group. The mindfulness-based intervention included meditation, mild yoga movement, and music and was conducted in a group format 1 hour a week for 8 weeks in a surgical intensive care unit during work hours. Assessments were performed 1 week before and 1 week after the intervention. Results The intervention was well received, with a 97% overall retention rate and 100% retention in the intervention group. Work satisfaction, measured with the Utrecht Work Engagement Scale, increased significantly in the intervention group with no change in the control group. Negative correlations were found between the vigor subscale scores of the Utrecht Work Engagement Scale and scores for emotional exhaustion on the Maslach Burnout Inventory and scores for burnout on the Professional Quality of Life scale. Participants rated recognizing their stress response as a main benefit of the intervention. Conclusion Workplace group interventions aimed at decreasing the negative effects of stress can be applied within hospital intensive care units. Despite many constraints, attendance at weekly sessions was high. Institutional support was critical for implementation of this program.

scholarly journals Decreasing Delirium Through Music: A Randomized Pilot Trial

2020 ◽  
Vol 29 (2) ◽  
pp. e31-e38 ◽  
Author(s):  
Sikandar H. Khan ◽  
Chenjia Xu ◽  
Russell Purpura ◽  
Sana Durrani ◽  
Heidi Lindroth ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Controlled Trial ◽  
Pilot Trial ◽  
Median Number ◽  
Assessment Method ◽  
Recruitment Rate ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care

Background Management of delirium in intensive care units is challenging because effective therapies are lacking. Music is a promising nonpharmacological intervention. Objectives To determine the feasibility and acceptability of personalized music (PM), slow-tempo music (STM), and attention control (AC) in patients receiving mechanical ventilation in an intensive care unit, and to estimate the effect of music on delirium. Methods A randomized controlled trial was performed in an academic medical-surgical intensive care unit. After particular inclusion and exclusion criteria were applied, patients were randomized to groups listening to PM, relaxing STM, or an audiobook (AC group). Sessions lasted 1 hour and were given twice daily for up to 7 days. Patients wore noise-canceling headphones and used mp3 players to listen to their music/audiobook. Delirium and delirium severity were assessed twice daily by using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and the CAM-ICU-7, respectively. Results Of the 1589 patients screened, 117 (7.4%) were eligible. Of those, 52 (44.4%) were randomized, with a recruitment rate of 5 patients per month. Adherence was higher in the groups listening to music (80% in the PM and STM groups vs 30% in the AC group; P = .01), and 80% of patients surveyed rated the music as enjoyable. The median number (interquartile range) of delirium/coma-free days by day 7 was 2 (1-6) for PM, 3 (1-6) for STM, and 2 (0-3) for AC (P = .32). Median delirium severity was 5.5 (1-7) for PM, 3.5 (0-7) for STM, and 4 (1-6.5) for AC (P = .78). Conclusions Music delivery is acceptable to patients and is feasible in intensive care units. Further research testing use of this promising intervention to reduce delirium is warranted.

Opinions of nurses on the ethical problems encountered while working as a team in intensive care units

2018 ◽  
Vol 13 (3) ◽  
pp. 120-125
Author(s):  
Oya Ögenler ◽  
Ahmet Dağ ◽  
Havva Doğan ◽  
Talip Genç ◽  
Hürmüs Kuzgun ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Units ◽  
University Hospital ◽  
Surgical Intensive Care Unit ◽  
University Graduates ◽  
Surgical Intensive Care ◽  
Ethical Problems ◽  
Item Data ◽  
Intensive Care Unit Nurses

Background The intensive care unit entails working as a team in rescuing patients from life-threatening conditions. The care being given by the team could also be done by nurses and other health professionals through the coordinated use of all medical practices. Objective To determine the opinion of nurses on the ethical problems they experienced while working as a team in the intensive care units of a university hospital. Method The descriptive research was conducted on nurses working in intensive care units (n = 96). A 56-item data collection form consisting of two parts developed by the researchers was used. Frequency (percent) and median were evaluated, and statistical calculations were used for group comparisons. Results Out of the 82 (85.4%) nurses who participated in the study, 65 (82.3%) were university graduates. About 52 (66.7%) of the participants were female with a mean age of 28.12 ± 5.84; 26 (31.6%) had intensive care certification, and 54 (65.1%) had ethical training. The internal intensive care unit nurses were less satisfied with their jobs, able to use tools, said that they had the right to refuse the patient compared to the surgical intensive care unit nurses. Discussion and conclusions: It is a positive situation for the participants to score low with ethical problems based on suggestion as the probability of meeting with their teammates. However, it is important that the problems that affect the motivation of the nurses are different according to the intensive care unit and the employees.

Parameters of bed occupancy of intensive care units in Hungary

2011 ◽  
Vol 152 (24) ◽  
pp. 946-950 ◽  
Author(s):  
Miklós Gresz
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Health Insurance ◽  
Intensive Care Units ◽  
Emergency Care ◽  
Present Author ◽  
Bed Occupancy ◽  
National Network ◽  
Bed Capacity

According to the Semmelweis Plan for Saving Health Care, ”the capacity of the national network of intensive care units in Hungary is one but not the only bottleneck of emergency care at present”. Author shows on the basis of data reported to the health insurance that not on a single calendar day more than 75% of beds in intensive care units were occupied. There were about 15 to 20 thousand sick days which could be considered unnecessary because patients occupying these beds were discharged to their homes directly from the intensive care unit. The data indicate that on the whole bed capacity is not low, only in some institutions insufficient. Thus, in order to improve emergency care in Hungary, the rearrangement of existing beds, rather than an increase of bed capacity is needed. Orv. Hetil., 2011, 152, 946–950.

Sign in / Sign up

Export Citation Format

Share Document