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Nursing Workload in the ICU

Stefano Elli, Luigi Cannizzo, Giuseppe Foti, Roberto Fumagalli, Alberto Lucchini
BACKGROUND: Critically ill patients in ICU are exposed to high risk of hospital acquired infections. In recent years, the multi drug resistant microorganisms (MDR) represent the most worrying epidemiological problem. AIM: The aim of this study is to evaluate the relationship between isolation precautions and nursing workload. METHODS: We studied patients who had an infection by MDR, subject to isolation precautions, and measured their NAS score during stay in ICU...
October 2017: Professioni Infermieristiche
Priya N Bhat, John M Costello, Ranjit Aiyagari, Paul J Sharek, Claudia A Algaze, Mjaye L Mazwi, Stephen J Roth, Andrew Y Shin
Introduction Diagnostic errors cause significant patient harm and increase costs. Data characterising such errors in the paediatric cardiac intensive care population are limited. We sought to understand the perceived frequency and types of diagnostic errors in the paediatric cardiac ICU. METHODS: Paediatric cardiac ICU practitioners including attending and trainee physicians, nurse practitioners, physician assistants, and registered nurses at three North American tertiary cardiac centres were surveyed between October 2014 and January 2015...
February 7, 2018: Cardiology in the Young
Siv K Stafseth, Tor Inge Tønnessen, Lisbeth Fagerström
OBJECTIVES: Nurse staffing costs represent approximately 60% of total intensive care unit costs. In order to analyse resource allocation in intensive care, we examined the association between nurse staffing costs and two patient classification systems: the nursing activities score (NAS) and nine equivalents of nursing manpower use score (NEMS). RESEARCH METHODOLOGY/DESIGN: A retrospective descriptive correlational analysis of nurse staffing costs and data of 6390 patients extracted from a data warehouse...
February 2, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
Wei-Chen Chen, Kuo-Shu Hung, Szu-Han Chen, Shyh-Jou Shieh, Jing-Wei Lee, Jenn-Ren Hsiao, Yao-Chou Lee
BACKGROUND: Whether postoperative care in the intensive care unit (ICU) is a necessity for patients undergoing head and neck free flap reconstruction remains debatable. In August 2012, our institute initiated a policy to care for these patients in the ICU, opposed to the previous policy of care in the ward. Thus, we used this opportunity to compare outcomes between these 2 care approaches. PATIENTS AND METHODS: Patients with oral cancer who underwent cancer ablation and immediate anterolateral thigh flap reconstruction from August 2010 to July 2014 were included in this retrospective study...
February 2018: Annals of Plastic Surgery
Daniel Aragão Machado, Nébia Maria Almeida de Figueiredo, Luciane de Souza Velasques, Cleonice Alves de Melo Bento, Wiliam César Alves Machado, Lúcia Alves Marques Vianna
OBJECTIVE: To measure the levels of stress, anxiety, and depression of nurses working in ICUs, relating them to levels of attention before and after 24 hours. METHOD: An observational, quantitative, analytical study with 18 nurses undergoing an inventory of stress, anxiety, and depression, as well as assessment of attention levels and psychomotor functioning. RESULTS: Sixty-one percent showed positive for stress. Depression was observed in 33%; and anxiety in 99...
January 2018: Revista Brasileira de Enfermagem
Saajida Mahomed, Ozayr Mahomed, A Willem Sturm, Stephen Knight, Prashini Moodley
Background: The incidence of healthcare-associated infections (HAIs) in the public health sector in South Africa is not known due to the lack of a surveillance system. We report on the challenges experienced in the implementation of a surveillance system for HAIs in intensive care units (ICUs). Methods: A passive, paper-based surveillance system was piloted in eight ICUs to measure the incidence of ventilator-associated pneumonia, catheter-associated urinary tract infection, and central line-associated bloodstream infection...
2017: Critical Care Research and Practice
Biljana Eftimova, Dejan Mirakovski, Marija Sholjakova, Marija Hadzi-Nikolova
AIM: To determine average personal exposure to nitrous oxide for anaesthesiologists and nurses working in operating rooms (ORs) and intensive care units (ICU) in Clinical Hospital in Shtip, ENT University Clinic in Skopje and General Hospital in Kochani. METHODS: To determine TWA exposure nitrous oxide concentration was continuously measured over 8 hours shift within breathing zone of the subjects involved, using the handheld electrochemical instrument with data logging option...
October 15, 2017: Open Access Macedonian Journal of Medical Sciences
C S Hartog
BACKGROUND: Burnout is an emerging topic and has recently been the subject of a position paper of the US American Society of Critical Care Medicine. OBJECTIVES: To give an overview over prevalence, causes, and relevance of burnout in intensive care unit (ICU) clinicians and point to potential prevention strategies MATERIALS AND METHODS: Narrative review. RESULTS AND CONCLUSION: Burnout is a job-related state which results from long-lasting, permanent work overload when short spells of recreation, for instance during the weekend, are not effective to reduce exhaustion, vegetative symptoms, loss of efficiency, and depersonalization...
October 12, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Clarita Terra Rodrigues Serafim, Magda Cristina Queiroz Dell'Acqua, Meire Cristina Novelli E Castro, Wilza Carla Spiri, Hélio Rubens de Carvalho Nunes
Objective: To analyze whether an increase in patient severity and nursing workload are correlated to a greater incidence of adverse events (AEs) in critical patients. Method: A prospective single cohort study was performed on a sample of 138 patients hospitalized in an intensive care unit (ICU). Results: A total of 166 AEs, occurred, affecting 50.7% of the patients. Increased patient severity presented a direct relationship to the probability of AEs occurring...
September 2017: Revista Brasileira de Enfermagem
Limin Chen, Ruihong Liu, Biyu Shen, Lingling Wang, Zhiming Cui, Guanhua Xu
OBJECTIVE: To evaluate the effect of a new type of fixation tape for tracheal catheter in intensive care patients. METHODS: A purposive sampling study was conducted. Ninety patients experienced oral tracheal intubation for mechanical ventilation, and admitted to respiratory intensive care unit (ICU) of the Second Affiliated Hospital of Nantong University from November 2015 to February 2017 were enrolled. All the patients were randomly (random number) divided into the control group and the observation group with 45 patients in each group...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
R Jam, O Hernández, J Mesquida, C Turégano, E Carrillo, R Pedragosa, V Gómez, L Martí, J Vallés, P Delgado-Hito
OBJECTIVE: To analyse whether adherence to non-pharmacological measures in the prevention of ventilator-associated pneumonia (VAP) is associated with nursing workload. METHODS: A prospective observational study performed in a single medical-surgical ICU. Nurses in charge of patients under ventilator support were assessed. VARIABLES: knowledge questionnaire, application of non-pharmacological VAP prevention measures, and workload (Nine Equivalents of Nursing Manpower Use Score)...
October 2017: Enfermería Intensiva
Jie Xu, Carrie Reale, Jason M Slagle, Shilo Anders, Matthew S Shotwell, Timothy Dresselhaus, Matthew B Weinger
BACKGROUND: Medication safety presents an ongoing challenge for nurses working in complex, fast-paced, intensive care unit (ICU) environments. Studying ICU nurse's medication management-especially medication-related events (MREs)-provides an approach to analyze and improve medication safety and quality. OBJECTIVES: The goal of this study was to explore the utility of facilitated MRE reporting in identifying system deficiencies and the relationship between MREs and nurses' work in the ICUs...
September 2017: Nursing Research
Jean-Michel Arnal, Aude Garnero, Dominik Novotni, Gaëlle Corno, Stéphane-Yannis Donati, Didier Demory, Gabrielle Quintana, Laurent Ducros, Thomas Laubscher, Jacques Durand-Gasselin
BACKGROUND: There is an equipoise regarding closed-loop ventilation modes and the ability to reduce workload for providers. On one hand some settings are managed by the ventilator but on another hand the automatic mode introduces new settings for the user. METHODS: This randomized controlled trial compared the number of manual ventilator setting changes between a full closed loop ventilation and oxygenation mode (INTELLiVENT-ASV®) and conventional ventilation modes (volume assist control and pressure support) in Intensive Care Unit (ICU) patients...
January 2018: Minerva Anestesiologica
Marissa Monroe, Linda Wofford
AIMS AND OBJECTIVES: To explore the effect of open visitation on critical care nurse job satisfaction. BACKGROUND: Open visitation has many benefits for ICU patients and families. However, ICU open visitation also affects nurses' work environment. Because nurse satisfaction is crucial to overall patient satisfaction, nurses' perceptions, experiences and opinions about open visitation should be considered. DESIGN: A literature search was performed through CINAHL Complete, MEDLINE Complete, PubMed, ScienceDirect, Academic Search Premier and PsychINFO...
December 2017: Journal of Clinical Nursing
Stephan M Jakob, Lukas Bütikofer, David Berger, Michael Coslovsky, Jukka Takala
BACKGROUND: Diarrhea is frequent in patients in intensive care units (ICU) and is associated with discomfort and complications and may increase the length of stay and nursing workload. METHODS: This was a prospective, double-blind, randomized, controlled single-center pilot study to assess the incidence and frequency of diarrhea and the respective effects of a modified enteral diet (intervention: Peptamen® AF, rich in proteins, medium chain triglycerides and fish oil) compared to a standard diet (control: Isosource® Energy) in 90 randomized adult patients (intervention, n = 46; control, n = 44) with an ICU stay ≥5 days and tube feeding ≥3 days...
June 10, 2017: Critical Care: the Official Journal of the Critical Care Forum
Margo M C van Mol, Marjan D Nijkamp, Jan Bakker, Wilmar B Schaufeli, Erwin J O Kompanje
BACKGROUND AND OBJECTIVES: Working in an Intensive Care Unit (ICU) is increasingly complex and is also physically, cognitively and emotionally demanding. Although the negative emotions of work-related stress have been well studied, the opposite perspective of work engagement might also provide valuable insight into how these emotional demands may be countered. This study focused on the work engagement of ICU professionals and explored the complex relationship between work engagement, job demands and advantageous personal resources...
May 20, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Anna Lee, Yip Sing Leo Cheung, Gavin Matthew Joynt, Czarina Chi Hung Leung, Wai-Tat Wong, Charles David Gomersall
BACKGROUND: Despite the central role of nurses in intensive care, a relationship between intensive care nurse workload/staffing ratios and survival has not been clearly established. We determined whether there is a threshold workload/staffing ratio above which the probability of hospital survival is reduced and then modeled the relationship between exposure to inadequate staffing at any stage of a patient's ICU stay and risk-adjusted hospital survival. METHODS: Retrospective analysis of prospectively collected data from a cohort of adult patients admitted to two multi-disciplinary Intensive Care Units was performed...
December 2017: Annals of Intensive Care
J Herta, J Koren, F Fürbass, A Zöchmeister, M Hartmann, A Hosmann, C Baumgartner, A Gruber
OBJECTIVE: To assess whether ICU caregivers can correctly read and interpret continuous EEG (cEEG) data displayed with the computer algorithm NeuroTrend (NT) with the main attention on seizure detection and determination of sedation depth. METHODS: 120 screenshots of NT (480h of cEEG) were rated by 18 briefly trained nurses and biomedical analysts. Multirater agreements (MRA) as well as interrater agreements (IRA) compared to an expert opinion (EXO) were calculated for items such as pattern type, pattern location, interruption of recording, seizure suspicion, consistency of frequency, seizure tendency and level of sedation...
June 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Renata Eloah de Lucena Ferretti-Rebustini, Lilia de Souza Nogueira, Rita de Cassia Gengo E Silva, Vanessa de Brito Poveda, Selma Pinheiro Machado, Elaine Machado de Oliveira, Rafaela Andolhe, Katia Grillo Padilha
OBJECTIVE: Verify if aging is an independent predictor of NW in ICU, according to age groups, and its predictive value as a determinant of NW in ICU. METHODS: Study was conducted from 2012 to 2016. A convenience sample composed by patients (age ≥ 18) admitted to nine ICU belonging to a Brazilian hospital, was analyzed. Age was assumed as an independent variable and NW (measured by the Nursing Activities Score - NAS) as dependent. Linear regression model and ROC curve were used for the analysis...
April 3, 2017: Revista da Escola de Enfermagem da U S P
L Cao, X H Ye, J Li, L N Zhang, L Li, W Y Zhang, L L Deng
Objective: To explore the effect of bedside ultrasound in measuring gastric residual volume in neurosurgical critical patients with enteral nutrition support. Method: From March to August 2016, 70 critically neurological patients with continues enteral nutrition who admitted in Intensive Care Unit (ICU) were randomized into two groups. The observation group applied the bedside ultrasound monitoring gastric residual volume every day to guide the implementation of enteral nutrition. The control group used syringes withdrawing every 8 hours to measure the gastric residual volume...
March 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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