scholarly journals EFFECTIVENESS OF SUCTION ABOVE CUFF ENDOTRACHEAL TUBE (SACETT) IN PREVENTING VENTILATOR ASSOCIATED PNEUMONIA IN CRITICAL PATIENTS IN INTENSIVE CARE UNIT

2018 ◽  
Vol 4 (4) ◽  
pp. 380-389
Author(s):  
Arfiyan Sukmadi ◽  
Rr Sri Endang Pujiastuti ◽  
Aris Santjaka ◽  
Supriyadi Supriyadi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Endotracheal Tube ◽  
Intervention Group ◽  
Control Group ◽  
Ventilator Associated Pneumonia ◽  
Mechanical Ventilator ◽  
Control Group Design ◽  
Bacterial Development ◽  
Critical Patients

Background: The mechanical ventilator is an indispensable breathing tool in the Intensive Care Unit (ICU). But the mechanical ventilator is associated with the risk of Ventilator Associated Penumonia (VAP). VAP occurs due to poor hygiene of the endotracheal tube (ETT). ETT hygiene should be maintained to inhibit bacterial development in the lungs using suction above cuff endotracheal tube (SACETT) to prevent VAP.Objective: To analyze the effectiveness of SACETT in preventing Ventilator Associated Pneumonia (VAP) in critical patients in the ICU.Methods: This was a quasy experimental study with posttest only with control group design with 15 samples in intervention group (SACETT and Chlorhexidine 0.2%) and 15 in control group (ETT, Open Suction, and Chlorhexidine 0.2%) with purposive technique sampling. The Simplified Clnical Pulmonary Infection Score (CPIS) was used to measure VAP.Results: This study illustrates that there was no VAP incidence in the intervention group, and as much as 13.3% VAP in the control group. SACETT was more effective in preventing VAP than in standard ETT on day 4 (p = 0.001).Conclusion: SACETT is more effective in preventing VAP than standard ETT in the fourth day in patients with neurological, cardiovascular, urinary, digestive, and immune system disorders.

scholarly journals THE EFFECT OF BODY REPOSITIONING ON HEMODYNAMIC STATUS IN PATIENTS WITH VASOPRESSOR THERAPY IN INTENSIVE CARE UNIT

2018 ◽  
Vol 4 (6) ◽  
pp. 572-580
Author(s):  
Vica Sari Oktorina ◽  
Aan Nuraeni
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intervention Group ◽  
Sampling Technique ◽  
T Test ◽  
Control Group ◽  
Vasopressor Therapy ◽  
Control Group Design ◽  
Hemodynamic Status ◽  
The Difference

Background: Repositioning the patients every 2 hours were often not implemented during patient care. One of the causes perceived by nurses as contraindications to repositioning in critical patients is the use of vasoactive agents. This condition increases the risk of decubitus, decreased orthostatic stability and muscle atrophy.Objective: The purpose of this study was to identify the effect of body reposition on hemodynamic patients receiving vasopressor therapy in Intensive Care Unit (ICU).Methods: The research method used Quasi Experiment with non-equivalent control group design. The subjects were ICU patients who received vasopressor therapy. The respondents recruited using consecutive sampling technique for a-four month period and obtained 34 respondents, which was divided into control and intervention group. Data analysis used paired t-test to analyze the difference in the same group and unpaired t-test to test the difference between two groups.Results: Pre-post hemodynamic differences in the intervention group when patients were repositioned from supine to the right lateral and  right lateral to left lateral showed p> 0.05. The hemodynamic difference between  the control and the intervention group also had p> 0.05. The results showed there were no significant difference.Conclusions: In general, there is no effect of body repositioning on hemodynamic status. Critical nurses can perform body repositioning activities every two hours including in patients with vasopressor therapy to prevent complications of immobilization, still considerating contraindication condition.

scholarly journals INVESTIGATING EFFECT OF NURSING INTERVENTIONS, BASED ON WELLS SCORE RESULTS, ON THE INCIDENCE OF DEEP VEIN THROMBOSIS IN PATIENTS ADMITTED TO THE INTENSIVE CARE UNIT

2018 ◽  
Vol 11 (5) ◽  
pp. 377
Author(s):  
Morteza Habibi Moghadam ◽  
Marzieh Asadizaker ◽  
Simin Jahani ◽  
Elham Maraghi ◽  
Hakimeh Saadatifar ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Deep Vein Thrombosis ◽  
Intervention Group ◽  
Control Group ◽  
Nursing Interventions ◽  
Vein Thrombosis ◽  
Wells Score ◽  
Deep Vein ◽  
Pitting Edema

 Objective: Venous thromboembolism, including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common complaint in critically ill patients. Therefore, the present study was conducted to determine the effect of nursing interventions, based on the Wells results, on the incidence of DVT in intensive care unit (ICU) patients.Methods: The present clinical trial was conducted on 72 ICU patients without DVT and PE who met the inclusion criteria according to Wells score in Dr. Ganjavian Hospital, Dezful in 2012. The participants were investigated and randomly divided into intervention (n=36) and control groups (n=36). The intervention group received preventive nursing measures based on the risk level determined by the Wells score, and routine therapeutic interventions were performed for the control group. Then, patients were evaluated using Wells score, D-dimer testing, and Doppler sonography on the 1st, 5th, and 10th days. Data were finally coded and entered into SPSS version 23. Data analysis was performed using Chi-square, Fisher’s exact, and Mann–Whitney U tests.Results: The incidence of DVT in both groups showed that 2 patients of the control group who were identified to be at risk using the Wells score were diagnosed with DVT while none of the patients of the intervention group experienced DVT. The present study showed that 22.2% of the patients of the control group suffered from non-pitting edema, which was significantly different from the intervention group (p=0.005).Conclusion: The results of the present study showed that using the Wells score for early identification of the at-risk patients and nursing interventions based on this score’s results is helpful in the prevention of DVT. Appropriate nursing interventions were also effective in reducing the incidence of non-pitting edema in the lower extremities.

Improving Family Communications at the End of Life: Implications for Length of Stay in the Intensive Care Unit and Resource Use

2003 ◽  
Vol 12 (4) ◽  
pp. 317-324 ◽  
Author(s):  
Tom Ahrens ◽  
Valerie Yancey ◽  
Marin Kollef
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
End Of Life ◽  
Resource Utilization ◽  
Intervention Group ◽  
Clinical Nurse Specialist ◽  
Control Group ◽  
Nurse Specialist ◽  
Clinical Nurse

• Background Inadequate communication persists between healthcare professionals and patients and patients’ families in intensive care units. Unwanted or ineffective treatments can occur when patients’ goals of care are unknown or not honored, increasing costs and care. Having the primary physician provide medical information and then having a physician and clinical nurse specialist team improve opportunities for patients and their families to process that information could improve the situation. This model has not been tested for its effect on patients’ outcomes and resource utilization.• Objectives To evaluate the effect of a communication team that included a physician and a clinical nurse specialist on length of stay and costs for patients near the end of life in the intensive care unit.• Methods During a 1-year period, patients judged to be at high risk for death (N = 151) were divided into 2 groups: 43 patients who were cared for by the medical director teamed with a clinical nurse specialist and 108 patients who received standard care, provided by an attending physician.• Results Compared with the control group, patients in the intervention group had significantly shorter stays in both the intensive care unit (6.1 vs 9.5 days) and the hospital (11.3 vs 16.4 days) and had lower fixed ($15 559 vs $24 080) and variable ($5087 vs $8035) costs.• Conclusions Use of a physician and a clinical nurse specialist focused on improving communication with patients and patients’ families reduced lengths of stay and resource utilization.

Effect of abdominal massage on prevention of aspiration in intubated and enterally fed patients: A randomized controlled trial

2020 ◽  
Vol 17 (3) ◽  
Author(s):  
Mahlagha Dehghan ◽  
Amanollah Fatehi Poor ◽  
Roghayeh Mehdipour-Rabori ◽  
Mehdi Ahmadinejad
Keyword(s):  
Intensive Care ◽  
Confidence Interval ◽  
Endotracheal Tube ◽  
Intervention Group ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Respiratory Secretion ◽  
Intensive Care Patients ◽  
Randomized Controlled ◽  
Abdominal Massage

AbstractBackgroundAspiration is a serious side effect of delayed gastric emptying and increased residual volume in intensive care patients. Aspiration can increase the risk of pneumonia and death. Currently, pharmaceutical methods are the most commonly used techniques for decreasing aspiration, but non-pharmaceutical methods may also be effective in reducing aspiration. One of these methods is an abdominal massage. The present study aimed to examine the effect of abdominal massage on aspiration incidence in intensive care patients with an endotracheal tube.MethodsThis study was a randomized controlled clinical trial. Seventy intensive care patients with an endotracheal tube were chosen by convenience sampling and allocated to an intervention or a control group by the minimization method. The intervention group was provided with a 15-min abdominal massage twice a day for 3 days, while the control group received only routine cares. The patients’ respiratory secretion was suctioned before and after the intervention, and immediately after suctioning, the incidence of the aspiration was assessed using special strips which are sensitive to respiratory secretion pH and glucose. SPSS 18 was used to analyze data. Descriptive statistics were used. T independent, Mann-Whitney U, χ2, and Fisher exact tests were used to compare two groups.ResultsThe incidence rates of the aspiration were 5.7% (confidence interval: 0.0–14.3%) and 20% (confidence interval: 8.6–34.3%) in the abdominal massage and the control groups, respectively. The incidence of aspiration differed between two groups, but it was not statistically significant (p=0.07).ConclusionAlthough the low rate of aspiration in the abdominal massage group did not differ significantly with that of the control group, it can be clinically important. It is suggested that further studies be conducted to confirm the effect of abdominal massage on the prevention of aspiration in intensive care patients with an endotracheal tube.

Cerebral Oximetry Monitoring to Maintain Normal Cerebral Oxygen Saturation during High-risk Cardiac Surgery

2016 ◽  
Vol 124 (4) ◽  
pp. 826-836 ◽  
Author(s):  
Alain Deschamps ◽  
Richard Hall ◽  
Hilary Grocott ◽  
C. David Mazer ◽  
Peter T. Choi ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Intervention Group ◽  
Perioperative Outcomes ◽  
Control Group ◽  
Cerebral Oxygen ◽  
Cerebral Desaturation ◽  
Cerebral Saturation

Abstract Background Cerebral oxygen desaturation during cardiac surgery has been associated with adverse perioperative outcomes. Before a large multicenter randomized controlled trial (RCT) on the impact of preventing desaturations on perioperative outcomes, the authors undertook a randomized prospective, parallel-arm, multicenter feasibility RCT to determine whether an intervention algorithm could prevent desaturations. Methods Eight Canadian sites randomized 201 patients between April 2012 and October 2013. The primary outcome was the success rate of reversing cerebral desaturations below 10% relative to baseline in the intervention group. Anesthesiologists were blinded to the cerebral saturation values in the control group. Intensive care unit personnel were blinded to cerebral saturation values for both groups. Secondary outcomes included the area under the curve of cerebral desaturation load, enrolment rates, and a 30-day follow-up for adverse events. Results Cerebral desaturations occurred in 71 (70%) of the 102 intervention group patients and 56 (57%) of the 99 control group patients (P = 0.04). Reversal was successful in 69 (97%) of the intervention group patients. The mean cerebral desaturation load (SD) in the operating room was smaller for intervention group patients compared with control group patients (104 [217] %.min vs. 398 [869] %.min, mean difference, −294; 95% CI, −562 to −26; P = 0.03). This was also true in the intensive care unit (P = 0.02). There were no differences in adverse events between the groups. Conclusions Study sites were successful in reversal of desaturation, patient recruitment, randomization, and follow-up in cardiac surgery, supporting the feasibility of conducting a large multicenter RCT.

scholarly journals Oral Care Effect on Intubated Patient with 0.2 per cent Chlorhexidine Gluconate and Tooth Brushing in Intensive Care Unit

2017 ◽  
Vol 8 (1-2) ◽  
pp. 26-33
Author(s):  
Mohammad Khan ◽  
Zeehaida Mohamed ◽  
Saedah Ali ◽  
Norkhafizah Saddki ◽  
Sam’an Malik Masudi ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Oral Care ◽  
Chlorhexidine Gluconate ◽  
Tooth Brushing ◽  
Control Group ◽  
Ventilator Associated Pneumonia ◽  
Statistical Software ◽  
Patient Screening ◽  
Experimental Group

Aims and Objectives: Ventilator-associated pneumonia is associated with increased morbidity and mortality. The aim of this pilot study was to determine the effectiveness of oral care with both tooth brushing and 0.2 per cent chlor-hexidine gluconate compared to 0.2 per cent chlorhexidine gluconate alone for the intubated patient in an intensive care unit (ICU). Materials and Methods: Patient screening was done over a period of two months. After taking informed consent, those ICU patients were divided into two groups. Only nine subjects were enrolled. During the study, the experimental group (N = 4) got oral care that consisted of both tooth brushing and 0.2 per cent chlorhexidine gluconate thrice a day. The control group got oral care with 0.2 per cent chlorhexidine gluconate alone thrice a day. The data were analysed by IBM statistical software SPPS, version 24. Results: Preliminary results suggest that the risk of ventilator-associated pneumonia in intubated patients can be reduced by maintaining thrice-daily oral care involving both tooth brushing and 0.2 per cent chlorhexidine gluconate. Conclusion: Thrice-daily oral care consisted of both tooth brushing and 0.2 per cent chlorhexidine gluconate might be a promise as a ventilator-associated pneumonia-reduction strategy in ICU. Furthermore, more studies are required for its application widely.

scholarly journals Pengaruh Musik Keroncong selama Pelaksanaan Kangaroo Mother Care terhadap Respons Fisiologis dan Lama Rawat Bayi dengan Berat Badan Lahir Rendah

2015 ◽  
Vol 10 (2) ◽  
pp. 93
Author(s):  
Anita Rahmawati ◽  
Endah Marianingsih Theresia ◽  
Yuliasti Eka Purnamaningrum
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Low Birthweight ◽  
T Test ◽  
Control Group ◽  
P Value ◽  
Control Group Design ◽  
Purposive Sampling

AbstrakKangaroo mother care (KMC) merupakan metode merawat bayi beratbadan lahir rendah (BBLR). Beberapa intervensi perawatan di neonatal intensive care unit seperti pijat bayi, KMC, dan mendengarkan musik bermanfaat untuk pertumbuhan bayi berupa respons fisiologis BBLR dan mengurangi lama rawat. Penelitian ini bertujuan untuk mengetahui manfaat musik keroncong terhadap respons BBLR selama KMC dan lama rawat. Rancangan penelitian adalah quasi eksperimental dengan pretest dan posttest dengan desain grup kontrol. Pada Juli - September 2014 populasi penelitian adalah ibu dan bayi BBLR yang melaksanakan KMC. Pengambilan sampel dengan purposive sampling sebanyak 60 bayi. Kriteria inklusi bayi BBLR yang ditetapkan adalah berat badan bayi 1.500 – 2.499 gram, tanpa memandang usia kehamilan, bayi mampu menghisap walaupun masih lemah, tidak mengalami kesulitan pernapasan. Kriteriaeksklusi adalah bayi dengan kelainan kongenital, gejala sepsis, dan bayi yang dilakukan foto terapi. Uji statistik menggunakan uji-t berpasangan, ujit independen dengan nilai p < 0,05 dan CI 95%. Setelah perlakuan hari ketiga, terjadi penurunan nadi pada bayi dengan BBLR 8,13 kali/menit (nilai p = 0,000), respirasi penurunannya 2,36 kali/menit (nilai p = 0,000). Rerata lama rawat bayi pada kelompok perlakuan adalah 8,57 hari, sedangkan kelompok kontrol adalah 11,87 hari (nilai p = 0,038). Suhu hasilnya tidak bermakna (nilai p > 0,05). Dapat disimpulkan bahwa musik keroncong berpengaruh terhadap penurunan nadi, respirasi selama KMC, dan lama rawat bayi.AbstractKangaroo Mother Care (KMC) is nursing care method for low birthweight(LBW) infants. Some care interventions in neonatal intensive care unit, such as infant massage, KMC and listening to music have advantage for infant growth in form of physiological responses and reduce LBW infant-nursing length. This study aimed to determine advantage of keroncong music toward LBW infant’s response during KMC and nursing length. The study design was quasi experimental using pretest and posttest using control group design. Population was mothers and LBW infants implementing KMC. Samples were 60 infants taken by purposive sampling. Inclusion criteria determined for LBW infants were having weight 1,500 – 2,499 gram, without considering pregnancy age, having ability to suckle though still weak, not suffering breathing distress. Meanwhile, exclusion criteria were infants with congenital disorder, sepsis symptoms and infants during therapy photo. Statistical test used paired t-test, independent t-test with p value < 0.05 and confidence interval (CI) 95%. After third day of treatment, LBW pulse decreased 8.13 times/minute (p value = 0.000), respiration decreased 2.36 times/minute (p value = 0.000). Nursing length mean on the treatment group was 8.57 days, while the control group was 11.87 days (p value = 0.038). Temperature result was insignificant (p value > 0.05). In conclusion, keroncong music influences on decrease of pulse, respiration during KMC and length of infant nursing.

scholarly journals The Effect of Abdominal Massage on Enteral Complications in Geriatric Patients

2020 ◽  
Vol 6 ◽  
pp. 237796082096377
Author(s):  
Onur Çetinkaya ◽  
Özlem Ovayolu ◽  
Nimet Ovayolu
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Geriatric Patients ◽  
Intervention Group ◽  
Control Group ◽  
Residual Volume ◽  
Gastric Residual Volume ◽  
Quasi Experimental ◽  
Abdominal Massage ◽  
Positive Effect

Introduction and Purpose Geriatric patients, who are fed by nasogastric tube (NG), may suffer from complications. Therefore, this study was conducted to evaluate the effect of abdominal massage on Gastric residual volume (GRV), distension, vomiting, and defecation in geriatric patients, who were hospitalized in intensive care unit and fed by NG. Methods The quasi-experimental study was conducted in intensive care units. The researcher applied abdominal massage to patients in the intervention group (n = 30) twice a day for 15–20 minutes before feeding. The data of the study were collected by using a questionnaire and a parameter questionnaire. Results GRV decreased significantly in the intervention group and increased significantly in the control group ( p < 0.05). The frequency of defecation significantly increased in intervention group ( p < 0.05). It was found that there was no positive effect of abdominal massage on vomiting ( p > 0.05). Conclusion It was observed that while abdominal massage reduced high GRV and distension incidence, it increased the incidence of defecation.

Effect of Nebulized Eucalyptus for Preventing Ventilator-Associated Pneumonia in Patients under Mechanical Ventilation: A Randomized Double Blind Clinical Trial

2018 ◽  
Author(s):  
HasanAli Karimpour ◽  
Behzad Hematpour ◽  
Saeed Mohammadi ◽  
Javad Aminisaman ◽  
Maryam Mirzaei ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Intervention Group ◽  
Control Group ◽  
Pulmonary Infections ◽  
Double Blind ◽  
Double Blind Clinical Trial ◽  
And Control ◽  
And Staphylococcus Aureus

Abstract Background: Pneumonia caused by the ventilator is the most common acquired infection in the intensive care unit, which increases the morbidity and mortality of the patients. Eucalyptus plant has antiseptic properties. Therefore, the present study investigates the effect of eucalyptus incense on prevention of pneumonia in patients with endotracheal tube in the intensive care unit. Methods: This clinical trial study was performed on 100 patients under ventilation in two intervention and control groups in Imam Reza Hospital, Kermanshah, Iran in 2018. The patients in the intervention group, Eucalyptus solution 2% and in the control group received 10 cc distilled water as an inhaler three times a day. The results of the two groups were compared to the incidence of pulmonary infections based on CPIS criteria and compared with SPSS version 19 software. Results: The incidence of late pneumonia was significantly lower in the intervention group (P=0.02). The onset of pneumonia significantly later in the intervention group than the control group (P=0.01). The prevalence of Klebsiella, Candida albicans, and Staphylococcus aureus was significantly decreased in the intervention group (P=0.02) (P=0.04) (P=0.01). Conclusion: The results of this study showed that eucalyptus inhalation is effective in reducing the incidence of pulmonary infection in patients under ventilation. It is recommended that these products be used to prevent pulmonary infections in these patients.

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