Effectiveness of Nursing Interventions to Prevent Dry Eye in Critically Ill Patients

2019 ◽  
Vol 28 (4) ◽  
pp. 299-306
Author(s):  
Diego Dias de Araujo ◽  
Daniel Vinicius Alves Silva ◽  
Carolina Amaral Oliveira Rodrigues ◽  
Patricia Oliveira Silva ◽  
Tamara Goncalves Rezende Macieira ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Dry Eye ◽  
Critically Ill Patients ◽  
Controlled Trial ◽  
Nursing Interventions ◽  
Blink Rate ◽  
Artificial Tears ◽  
Adult Intensive Care Unit

Background Critically ill patients are susceptible to the development of dry eye. Few studies have been conducted on how to best prevent and treat this condition. Objective To compare the effectiveness of 2 nursing interventions in preventing dry eye in adult intensive care unit patients: liquid artificial tears (Lacribell; Latinofarma) and artificial tears gel (Vidisic Gel; Bausch and Lomb). Methods In this randomized controlled trial, 140 participants were randomly assigned to 1 of 2 treatment groups: a liquid artificial tears group (n = 70) and an artificial tears gel group (n = 70). The study inclusion criteria were as follows: admission to the intensive care unit, age of 18 years or older, no diagnosis of dry eye at admission, receipt of mechanical ventilation, blink rate of less than 5 times per minute, and a score of 7 or less on the Glasgow Coma Scale. On 5 consecutive days, a single researcher who was unaware of the treatment assignment assessed the participants’ eyes using the fluorescein eye stain test and the Schirmer test for dry eye. Results Dry eye developed in 21% of participants who received liquid artificial tears versus 9% of participants who received artificial tears gel (P = .04). Conclusions In this study, artificial tears gel was superior to liquid artificial tears in preventing the development of dry eye. These results may help nurses deliver evidence-based eye care aimed at reducing the risk of dry eye in critically ill patients.

Faecal diversion system usage in an adult intensive care unit

2020 ◽  
Vol 22 (2) ◽  
pp. 152-157
Author(s):  
Nicholas Wilson ◽  
◽  
Rinaldo Bellomo ◽  
Tyler Hay ◽  
Timothy Fazio ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Adverse Events ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Rectal Tube ◽  
Adult Intensive Care Unit ◽  
Packed Red Blood Cells ◽  
Risk Of Death ◽  
Faecal Diversion

OBJECTIVE: To determine the frequency, indications and complications associated with the use of faecal diversion systems (rectal tubes) in critically ill patients. DESIGN: A single centre observational study over 15 months. SETTING: Intensive care unit (ICU). PARTICIPANTS: Patients admitted during this period. MAIN OUTCOME MEASURES: Frequency of rectal tubes utilisation in ICU, as well as associated adverse events, with major events defined as lower gastrointestinal bleeding associated with defined blood transfusion of two or more units of red cells or endoscopy or surgical intervention. RESULTS: Of 3418 admission episodes, there were 111 episodes of rectal tubes inserted in 99 patients. Rectal tubes remained indwelling for a median of 5 days (range, 1–23) for a total of 641 patient-days. The most frequent indication for insertion was excessive bowel motions. A major adverse event was observed in three patients (3%; 0.5 events per 100 device days). Two patients underwent laparotomy and one patient sigmoidoscopy. These patients received between two and 23 units of packed red blood cells. Patients who had a rectal tube inserted had a substantially greater duration of ICU admission (mean, 14 days [SD, 14] v 2.8 days [SD, 3.7]) and hospital mortality (15% v 7.7%; risk ratio, 2.0; 95% CI, 1.2–3.4) as well as an overall higher Australian and New Zealand Risk of Death (ANZROD) score (mean, 27 [SD, 22] v 12.6 [SD, 20]). CONCLUSION: Rectal tubes appear to be frequently inserted and can lead to major adverse events in critically ill patients.

scholarly journals Application of FASTHUG-MAIDENS mnemonic and evaluation of its impact in pharmaceutical intervention in an adult intensive care unit

2021 ◽  
Vol 12 (1) ◽  
pp. 566
Author(s):  
Íkaro M. LIMA ◽  
Samira B. VIDIGAL ◽  
Nathália M. LIMA ◽  
Daniel A. CARVALHO ◽  
Elton J. SANTOS ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Clinical Evaluation ◽  
Critically Ill Patients ◽  
Infusion Rate ◽  
Medical Prescription ◽  
Adult Intensive Care Unit ◽  
Clinical Pharmacists ◽  
Pharmaceutical Interventions

Objective: To evaluate the impact of the application of the FASTHUG-MAIDENS mnemonic by clinical pharmacists to optimize critically ill patients’ pharmacotherapy. Methods: Cross-sectional study performed on an adult intensive care unit of an University Hospital, between august and november 2019, where 155 patients were followed by three clinical pharmacists during hospital stay. Patients who stayed less than 24 hours in the hospital or whose stay was during weekends or holidays were excluded. The interventions were performed together with a multidisciplinary team using FASTHUG-MAIDENS, as well as technical analysis of medical prescription and patients’ clinical evaluation. The clinical evaluation included analysis of laboratory tests, nursing records and medical prescription, all registered in an institutional spreadsheet. The pharmaceutical interventions were registered in the pharmaceutical section of both physic and electronic medical records, and the data were later evaluated, classified, and submitted to descriptive analytical analysis. Results: 1.145 pharmaceutical interventions were performed, with an acceptance rate of 99,3%. The number of pharmaceutical interventions were increased by 104,4% with the application of the FASTHUG-MAIDENS mnemonic, compared to the period before the research. The main interventions performed were: inclusion of a drug (25,2%), exclusion of a drug (17,9%), dose adjustment (12,2%), change of the administration timetable to avoid intravenous incompatibility (11,4%), inclusion of infusion rate (7,3%), dilution adequacy (5,8%), inclusion of reconstitution (3,5%), microbiological culture request (3,4%), drug interaction monitoring (2,7%), adequacy of infusion rate (2,6%) and others (7,4%).Pharmaceutical interventions showed clinical (96,9%), preventive (99,3%) and economic (21,6%) impact. Conclusion: The application of the FASTHUG-MAIDENS mnemonic extended the pharmaceutical care to critically ill patients, enabling an accurate evaluation of the pharmacotherapy, clinically impacting critical patient care and reducing errors and adverse drug events.

Surface Electrostimulation of Acupuncture Points for Sedation of Critically Ill Patients in the Intensive Care Unit – a Pilot Study

2008 ◽  
Vol 26 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Sandeep Nayak ◽  
Richard Wenstone ◽  
Andy Jones ◽  
Jill Nolan ◽  
Ann Strong ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pilot Study ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Controlled Trial ◽  
Acupuncture Points ◽  
Current Frequency ◽  
Arterial Blood ◽  
Randomised Controlled

Background This is a pilot study to investigate the effects of electrostimulation of acupuncture points on sedation and the dose of sedatives in the Intensive Care Unit. Methods Electrostimulation of acupuncture points was performed on 12 critically ill patients requiring sedation for mechanical ventilation. Electrostimulation was applied by point surface electrodes at LI4, ST36, HT7 and LR3 points for 20 minutes every hour for 12 hours using dense dispersed mode with a current frequency of 10–100Hz and maximum intensity of 10mA. All patients were sedated with propofol and alfentanil as required. The dose of propofol was reduced by 10mg/hour provided the patient remained sedated according to our guidelines. Sedation and analgesia scores, dose of sedative and analgesics drugs, respiratory rate, heart rate, mean arterial blood pressure and compliance with the ventilator were recorded before electrostimulation of acupuncture points, and hourly thereafter for 12 hours. Results There was significant reduction in the median propofol consumption from 145mg/hour (range 30–250) to 15mg/hour (range 0–250) (P<0.05), without any significant change in sedation scores or analgesia scores. The haemodynamic and respiratory variables remained stable. All patients were compliant with the ventilator. Conclusion This pilot study showed significant reduction in the dose of propofol required for sedation in critically ill patients following surface electrostimulation of acupuncture points, without any adverse effects. A randomised controlled trial is warranted.

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