WorldWideScience

Sample records for unit icu nurses

  1. Communication skills in ICU and adult hospitalisation unit nursing staff.

    Science.gov (United States)

    Ayuso-Murillo, D; Colomer-Sánchez, A; Herrera-Peco, I

    In this study researchers are trying to analyse the personality factors related to social skills in nurses who work in: Intensive Care Units, ICU, and Hospitalisation units. Both groups are from the Madrid Health Service (SERMAS). The present investigation has been developed as a descriptive transversal study, where personality factors in ICU nurses (n=29) and those from Hospitalisation units (n=40) were compared. The 16PF-5 questionnaire was employed to measure the personality factors associated with communication skills. The comparison of the personality factors associated to social skills, communication, in both groups, show us that nurses from ICU obtain in social receptivity: 5,6 (A+), 5,2 (C-), 6,2 (O+), 5,1 (H-), 5,3 (Q1-), and emotional control: 6,1 (B+), 5,9 (N+). Meanwhile the data doesn't adjust to the expected to emotional and social expressiveness, emotional receptivity and social control, there are not evidence. The personality factors associated to communication skills in ICU nurses are below those of hospitalisation unit nurses. The present results suggest the necessity to develop training actions, focusing on nurses from intensive care units to improve their communication social skills. Copyright © 2016 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  2. A qualitative study of resilience and posttraumatic stress disorder in United States ICU nurses.

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    Mealer, Meredith; Jones, Jacqueline; Moss, Marc

    2012-09-01

    Intensive care unit (ICU) nurses are at increased risk of developing psychological problems including posttraumatic stress disorder (PTSD). However, there are resilient individuals who thrive and remain employed as ICU nurses for many years. The purpose of this study was to identify mechanisms employed by highly resilient ICU nurses to develop preventative therapies to obviate the development of PTSD in ICU nurses. Qualitative study using semi-structured telephone interviews with randomly selected ICU nurses in the USA. Purposive sampling was used to identify ICU nurses who were highly resilient, based on the Connor-Davidson Resilience Scale and those with a diagnosis of PTSD, based on the posttraumatic diagnostic scale. New interviews were conducted until we reached thematic saturation. Thirteen highly resilient nurses and fourteen nurses with PTSD were interviewed (n = 27). A constructivist epistemological framework was used for data analysis. Differences were identified in four major domains: worldview, social network, cognitive flexibility, and self-care/balance. Highly resilient nurses identified spirituality, a supportive social network, optimism, and having a resilient role model as characteristics used to cope with stress in their work environment. ICU nurses with a diagnosis of PTSD possessed several unhealthy characteristics including a poor social network, lack of identification with a role model, disruptive thoughts, regret, and lost optimism. Highly resilient ICU nurses utilize positive coping skills and psychological characteristics that allow them to continue working in the stressful ICU environment. These characteristics and skills may be used to develop target therapies to prevent PTSD in ICU nurses.

  3. A profile of European ICU nursing.

    Science.gov (United States)

    Depasse, B; Pauwels, D; Somers, Y; Vincent, J L

    1998-09-01

    To evaluate major similarities and major differences between Western European countries in intensive care unit (ICU) nurse staffing, education, training, responsibilities, and initiative. A questionnaire was sent to Western European doctor members of the European Society of Intensive Care Medicine, to be passed on to the nurse-in-charge of their ICU. 156 completed questionnaires were analyzed: 49% were from university hospitals, 26% from university-affiliated hospitals, and 25% from community hospitals; 42% of the hospitals had more than 700 beds, 67% of the ICUs had between 6 and 12 beds, and 54% were mixed medical-surgical units. Among British units, 79% had more than three full-time nursing equivalents (FTE) per ICU bed, while in Sweden 75% of units had less than two FTE/ICU bed. University hospitals had more nursing staff per bed than community hospitals. As regards training, 33% of nurses followed a training course before starting work on the ICU and 64% after starting on the unit, and 85% had easy access to continuing education, particularly in the university hospitals. In an emergency, more than 70% of nurses regularly initiated oxygen administration, mask ventilation, or cardiac massage. In Sweden 100% of nurses and in Switzerland 91% of nurses regularly inserted peripheral intravenous catheters, but only 7% of German nurses did. No German nurses and only 12% of British nurses regularly performed arterial puncture, but in Sweden 75% of nurses regularly did. Even though the number of participants were limited, our questionnaire revealed variations in nurse staffing patterns among European countries and in their systems of training and education. Nurse autonomy also varies widely between countries.

  4. Nurses knowledge, attitude and practice in prevention of ICU syndrome

    OpenAIRE

    Ali Dadgari; Farede Yaghmaie; Jasman Shahnazarian; Leyla Dadvar

    2007-01-01

    Introduction: Intensive care unit ICU syndrome is a disorder, in which patients in an ICU or a similar setting experience anxiety, hallucination and become paranoid, severely disoriented in time and place, very agitated, or even violent, etc. The aim of this study was to assess knowledge, attitude and practice (KAP) of nurses with regards to prevention of ICU syndrome (Delirium). Methods: Subjects of this research were 56 nurses with including criteria of registration in nursing, university d...

  5. [Nursing care systematization at the intensive care unit (ICU) based on Wanda Horta's theory].

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    Amante, Lúcia Nazareth; Rossetto, Annelise Paula; Schneider, Dulcinéia Ghizoni

    2009-03-01

    The purpose of this study was to implement the Nursing Care Systematization--Sistematização da Assistência de Enfermagem (SAE)--with Wanda Aguiar Horta's Theory of Basic Human Necessities and the North American Nursing Diagnosis Association's (NANDA) Nursing Diagnosis as its references. The starting point was the evaluation of the knowledge of the nursing team about the SAE, including their participation in this process. This is a qualitative study, performed in the Intensive Care Unit in a hospital in the city of Brusque, Santa Catarina, from October, 2006 to March, 2007. It was observed that the nursing professionals know little about SAE, but they are greatly interested in learning and developing it in their daily practice. In conclusion, it was possible to execute the healthcare systematization in an easy way, with the use of simple brochures that provided all the necessary information for the qualified development of nursing care.

  6. Occupational Health Hazards in ICU Nursing Staff

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    Helena Eri Shimizu

    2010-01-01

    Full Text Available This study analyzed occupational health hazards for Intensive Care Unit (ICU nurses and nursing technicians, comparing differences in the number and types of hazards which occur at the beginning and end of their careers. A descriptive cross-sectional study was carried out with 26 nurses and 96 nursing technicians from a public hospital in the Federal District, Brazil. A Likert-type work-related symptom scale (WRSS was used to evaluate the presence of physical, psychological, and social risks. Data were analyzed with the use of the SPSS, version 12.0, and the Kruskal-Wallis test for statistical significance and differences in occupational health hazards at the beginning and at the end of the workers' careers. As a workplace, ICUs can cause work health hazards, mostly physical, to nurses and nursing technicians due to the frequent use of physical energy and strength to provide care, while psychological and social hazards occur to a lesser degree.

  7. The changing nature of ICU charge nurses' decision making: from supervision of care delivery to unit resource management.

    Science.gov (United States)

    Miller, Anne; Buerhaus, Peter I

    2013-01-01

    Recent findings that variations in nursing workload may affect inpatient outcomes now highlight nurse workload management and the need for an updated analysis of the role of the charge nurse (CN). Observational data for eight CNs, each at one of eight ICUs in a not-for-profit Level 1 Trauma Center, coded to capture interprofessional interactions, decision making, team coordination phases, and support tools. A researcher shadowed each participant for 12 hours. Each shift began and ended with a face-to-face handoff that included summaries of each patient's condition; the current bed census; anticipated admissions, discharges, and transfers; and the number of nurses available to work the current and coming two shifts. The researcher, using a notebook, recorded the substantive content of all work conversations initiated by or directed to the CN from physicians, staff nurses, allied health workers, other employees, and patients/families. The tools used to support conversations were collected as blank forms or computer screen prints and annotated to describe how they were used, when, and for what purpose. Statistically significant three-way interactions suggest that CNs' conversations with colleagues depend on the team coordination phase and the decision-making level, and that the support tools that CNs use when talking to colleagues depend on the decision-making level and the team coordination phase. The role of ICU CNs appears to be continuing to evolve, now encompassing unit resource management in addition to supervising care delivery. Effective support tools, together with education that would enhance communication and resource management skills, will be essential to CNs' ability to support unit resilience and adaptability in an increasingly complex environment.

  8. The presence of resilience is associated with a healthier psychological profile in intensive care unit (ICU) nurses: results of a national survey.

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    Mealer, Meredith; Jones, Jacqueline; Newman, Julia; McFann, Kim K; Rothbaum, Barbara; Moss, Marc

    2012-03-01

    ICU nurses are repeatedly exposed to work related stresses resulting in the development of psychological disorders including posttraumatic stress disorder and burnout syndrome. Resilience is a learnable multidimensional characteristic enabling one to thrive in the face of adversity. In a national survey, we sought to determine whether resilience was associated with healthier psychological profiles in intensive care unit nurses. Surveys were mailed to 3500 randomly selected ICU nurses across the United States and included: demographic questions, the Posttraumatic Diagnostic Scale, Hospital Anxiety and Depression Scale, Maslach Burnout Inventory and the Connor-Davidson Resilience Scale. Overall, 1239 of the mailed surveys were returned for a response rate of 35%, and complete data was available on a total of 744 nurses. Twenty-two percent of the intensive care unit nurses were categorized as being highly resilient. The presence of high resilience in these nurses was significantly associated with a lower prevalence of posttraumatic stress disorder, symptoms of anxiety or depression, and burnout syndrome (resilience was independently associated with a lower prevalence of posttraumatic stress disorder (presilience was independently associated with a lower prevalence of posttraumatic stress disorder and burnout syndrome in intensive care unit nurses. Future research is needed to better understand coping mechanisms employed by highly resilient nurses and how they maintain a healthier psychological profile. Copyright © 2011 Elsevier Ltd. All rights reserved.

  9. Nurses knowledge, attitude and practice in prevention of ICU syndrome

    Directory of Open Access Journals (Sweden)

    Ali Dadgari

    2007-01-01

    Full Text Available Introduction: Intensive care unit ICU syndrome is a disorder, in which patients in an ICU or a similar setting experience anxiety, hallucination and become paranoid, severely disoriented in time and place, very agitated, or even violent, etc. The aim of this study was to assess knowledge, attitude and practice (KAP of nurses with regards to prevention of ICU syndrome (Delirium. Methods: Subjects of this research were 56 nurses with including criteria of registration in nursing, university degree and at least one month experience of working in open heart surgery ICUs. The data was gathered from 3 clusters in university hospitals equipped with open heart surgery ICUs in Tehran. All subjects were asked to fill in a questionnaire. Moreover all subjects were observed in all shifts. During observation, two researchers observed each subject simultaneously to achieve higher accuracy of observations. Descriptive and analytic statistics were applied to analysis the data. Results: The finding of the study showed that more than 53% of the subjects had passed a continuing education course, but less than 46% of them never passed a training course on ICU. According to this research, subjects, work experience in ICUs had significant relation on their knowledge with regard to prevention of ICU psychosis. However, it has not significant relation to their attitude and skill. Conclusion: According to the results of the study, subjects have little chance to be familiar with the concepts and elements of ICU syndrome in their university program. The finding also indicated that many subjects in this study were not familiar with the important concepts such as sleep deprivation, sensory overload and sensory deprivation, etc. Ongoing progression in high-tech ICUs brings about continuing nursing education programs for all nurses. The results also showed that stress factor in ICU, such as high mortality, isolation, high workload etc. Gradually influences nurses,attitude in

  10. Measuring the nursing workload per shift in the ICU

    NARCIS (Netherlands)

    Debergh, Dieter P.; Myny, Dries; Van Herzeele, Isabelle; Van Maele, Georges; Miranda, Dinis Reis; Colardyn, Francis

    In the intensive care unit (ICU) different strategies and workload measurement tools exist to indicate the number of nurses needed. The gathered information is always focused on manpower needed per 24 h. However, a day consists of several shifts, which may be unequal in nursing workload. The aim of

  11. It takes teamwork... the role of nurses in ICU design.

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    Redden, Pamela H; Evans, Jennie

    2014-01-01

    The changing economic environment in health care is pushing the health care construction industry to produce facilities which support improvements in patient care, patient experience, patient safety, staff satisfaction, and financial outcomes. The successful design, construction, and operation of a new or renovated intensive care unit (ICU) requires the participation of intensive care nurses to achieve success. A partnership between the architect and nurse, definition of the desired operational processes, and knowledge of evidence-based design are the foundations of good design. Hospital executives who support the participation of nurses in ICU facility projects will gain an efficient and safe intensive care facility.

  12. Integrating forensic science into nursing processes in the ICU.

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    Hoyt, Constance A

    2006-01-01

    The critical care nurse is in an ideal position to assume responsibilities related to the identification of forensic cases and the preservation of associated evidence. Victims of child and elder abuse and neglect, individuals involved in vehicular or industrial accidents, substance abusers, and incarcerated populations are among the several types of patients that are likely to managed in the intensive care unit (ICU). Hospitals and their personnel assume considerable liability in such cases for detecting, collecting, and preserving evidence, as well as for reporting and referring the cases to appropriate law enforcement or judicial authorities. The Joint Commission for the Accreditation of Healthcare Organizations has published specific regulatory guidance to ensure that all healthcare personnel are properly educated to assume certain forensic responsibilities. The orientation and in-service programs of the ICU nurse should include specific guidance regarding forensic principles, practices, and procedures.

  13. Evaluation of Mental Workload among ICU Ward's Nurses.

    Science.gov (United States)

    Mohammadi, Mohsen; Mazloumi, Adel; Kazemi, Zeinab; Zeraati, Hojat

    2015-01-01

    High level of workload has been identified among stressors of nurses in intensive care units (ICUs). The present study investigated nursing workload and identified its influencing perfor-mance obstacles in ICUs. This cross-sectional study was conducted, in 2013, on 81 nurses working in ICUs in Imam Khomeini Hospital in Tehran, Iran. NASA-TLX was applied for assessment of workload. Moreover, ICUs Performance Obstacles Questionnaire was used to identify performance obstacles associated with ICU nursing. Physical demand (mean=84.17) was perceived as the most important dimensions of workload by nurses. The most critical performance obstacles affecting workload included: difficulty in finding a place to sit down, hectic workplace, disorganized workplace, poor-conditioned equipment, waiting for using a piece of equipment, spending much time seeking for supplies in the central stock, poor quality of medical materials, delay in getting medications, unpredicted problems, disorganized central stock, outpatient surgery, spending much time dealing with family needs, late, inadequate, and useless help from nurse assistants, and ineffective morning rounds (P-value<0.05). Various performance obstacles are correlated with nurses' workload, affirms the significance of nursing work system characteristics. Interventions are recommended based on the results of this study in the work settings of nurses in ICUs.

  14. Crucial information needs of ICU charge nurses in Finland and Greece.

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    Lundgrén-Laine, Heljä; Kalafati, Maria; Kontio, Elina; Kauko, Tommi; Salanterä, Sanna

    2013-05-01

    To describe crucial information needs of ICU charge nurses, and to compare these needs in two countries in Europe. ICU charge nurses are on the front line for ensuring that the activities of their units are running smoothly. They are accountable for making sure that the right tasks are performed under the right circumstances, with the right people, at the right time. An online survey based on a previous observation study regarding the ad hoc decision-making of ICU shift leaders. A total of 257 Finnish and 50 Greek ICU charge nurses participated in this study, from 17 Finnish and 16 Greece ICUs for adults. Our survey incorporated 122 statements divided into six dimensions (patient admission, organization and management of work, allocation of staff, allocation of material, special treatments and patient discharge) with a rating scale from 0 to 10. Analysis involved descriptive statistics. Mann-Whitney U and Kruskal-Wallis tests were used to compare the answers of the two countries. Validity was verified with confirmatory factor analysis and the reliability was tested with Cronbach's α values. The most crucial information needs of ICU charge nurses concerned the overall organization and management of work. Both staff-related and individual patient-related information was needed. Information needs of Finnish and Greek charge nurses concerned similar kinds of situations in ICUs. However, there were some differences that might depend on the cultural differences between the countries. Accurate and real-time information is a prerequisite for ICU charge nurses' ad hoc decision-making during daily care management. Identification of the most crucial information is needed when tools for information management are developed. The results of this study indicated that a major portion of immediate information needs of ICU charge nurses are internationally common in similar settings. © 2013 The Authors. Nursing in Critical Care © 2013 British Association of Critical Care Nurses.

  15. Ten Australian ICU nurses' perceptions of organisational restructuring.

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    Wynne, Rochelle

    2004-02-01

    The Australian healthcare system underwent radical reform in the 1990s as economic rationalist policies were embraced. As a result, there was significant organisational restructuring within hospitals. Traditional indicators, such as nursing absenteeism and attrition, increase during times of organisational change. Despite this, nurses' views of healthcare reform are under-represented in the literature and little is known about the impact of organisational restructuring on perceived performance. This study investigated the perceived impact of organisational restructuring on a group of intensive care unit (ICU) nurses' workplace performance. It employed a qualitative approach to collect data from a purposive sample of clinical nurses. The primary method of data collection was semi-structured interviews. Content analysis generated three categories of data. Participants identified constant pressure, inadequate communication and organisational components of restructuring within the hospital as issues that had a significant impact on their workplace performance. They perceived organisational restructuring was poorly communicated, and this resulted in an environment of constant pressure. Organisational components of restructuring included the subcategories of specialised service provision and an alternative administrative structure that had both positive and negative ramifications for performance. To date, there has been little investigation of nurses' perceptions of organisational restructure or the impact this type of change has in the clinical domain. Participants in this study believed reorganisation was detrimental to quality care delivery in intensive care, as a result of fiscal constraint, inadequate communication and pressure that influenced their workplace performance.

  16. Qualitative research on ICU acquired weakness recognition of ICU nurses%ICU 护士对 ICU 获得性衰弱认知的质性研究

    Institute of Scientific and Technical Information of China (English)

    吴利; 王建宁

    2016-01-01

    目的:了解 ICU 护士对 ICU 获得性衰弱(ICU - AW)的认知现状,为寻找相应的改进措施提供参考性依据。方法:采用质性研究中现象学研究方法,对江西省某三级甲等综合性医院10名 ICU 专科护士进行一对一的半结构式深入访谈。结果:采用现象学分析程序升华出5个关于 ICU 护士对 ICU 获得性衰弱认知和理解的主题:ICU 护士 ICU - AW 相关知识水平有待提高,对 ICU - AW 评估的重视程度不高,迫切需求 ICU- AW 预防相关知识,缺乏 ICU - AW 相关知识信息的来源,存在一定的因素影响 ICU 护士学习 ICU - AW 相关知识。结论:护理管理者应关注ICU 护士对 ICU - AW 的认知情况,为其提供规范资源和相应的培训,促进 ICU 护理人员专业水平的提升。%l Objective:To learn about the current recognition condition of ICU nurses towards ICU acquired weakness(ICU - AW)and provide referential basis for corresponding improvement measures. Method:Adopted phenomenon research method of qualitative research,and conducted one - to - one semi- structure in - depth interview on 10 ICU specialty nurses from a third - grade class - A general hospital of Jiangxi province. Results:Sublimated 5 themes about the recognition and comprehension of ICU nurses towards ICU acquired weakness with phenomenon analysis program:improvement of ICU nurses’ relevant ICU - AW knowledge,insufficient attention of ICU - AW assessment,urgent need of relevant ICU - AW prevention knowledge,source lack of rele-vant ICU - AW knowledge information and certain factors affecting ICU nurses to learn relevant ICU - AW knowledge. Conclusion:Nursing administrators should focus on ICU nurses’recognition condition towards ICU - AW,provide them with normative resource and corresponding training to propel the im-provement of ICU nurses’level of expertise.

  17. Quality of Care of Nursing from Brain Death Patient in ICU Wards

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    Seyedeh Toktam Masoumian Hoseini

    2015-04-01

    Full Text Available Introduction: Nowadays, Intensive Care Unit (ICU nurses play a significant and key role in the care of brain dead patients and their families, therefore their Practice extremely important to the success of organ donation. To assess ICU nurse's practice in relation to nurse's role in the organ donation process from brain dead patients in Iran. Materials and Methods:In a cross-sectional analytical study 90 ICU nurses in Ghaem and Imam Reza Hospitals in Mashhad through stratified random sampling allocation method were selected. Data collection tools included a questionnaire on demographic information, factors influencing nurse's practice during the organ donation process and surveying "nurse's practice in relation to their roles in the organ donation process." Results: 90 nurses participated in this study. (70.0% of the research subjects had spoken with their own families about organ donation, and (20.0% had organ donation cards. Practice scores were calculated on a scale of 100. The mean score of nurses' practice was (6.04± 3.66. 96.7% of nurses’ weak practice in terms of their roles in the organ donation process. Conclusion: As a result, they do not have adequate practice regard nurse's role in organ donation process and in relation to brain death patient and their families. Therefore it is suggested to include nursing courses in the organ donation process and organ transplantation as well as educational programs to acquaint nurses with their roles in the process to improve their practice by different training methods.

  18. Blood glucose control using an artificial pancreas reduces the workload of ICU nurses.

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    Mibu, Kiyo; Yatabe, Tomoaki; Hanazaki, Kazuhiro

    2012-03-01

    Blood glucose management is one of the important therapies in the intensive care unit (ICU). However, blood glucose management using the sliding-scale method increases the workload of ICU nurses. An artificial pancreas, STG-22, has been developed to continuously monitor blood glucose levels and to maintain them at appropriate levels. In this study, we examined the hypothesis that compared to conventional methods, blood glucose management using the STG-22 reduces the workload of ICU nurses and has a positive impact on awareness regarding the management of blood glucose. This study included 45 patients who underwent elective surgery and were treated at the ICU postoperatively. The patients were separated into the following two groups: (1) blood glucose was maintained using the STG-22 (AP group) and (2) blood glucose was maintained using the sliding-scale method (SS group). In addition, a questionnaire was developed for an awareness survey of ICU nurses (N = 20). The frequency of blood sampling and number of double checks were significantly lower in the AP group (1.3 ± 1.4 vs. 8.9 ± 8.1 times/admission, P blood glucose.

  19. Relationship between ICU nurses' moral distress with burnout and anticipated turnover.

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    Shoorideh, Foroozan Atashzadeh; Ashktorab, Tahereh; Yaghmaei, Farideh; Alavi Majd, Hamid

    2015-02-01

    Moral distress is one of intensive care unit nurses' major problems, which may happen due to various reasons, and has several consequences. Due to various moral distress outcomes in intensive care unit nurses, and their impact on nurses' personal and professional practice, recognizing moral distress is very important. The aim of this study was to determine correlation between moral distress with burnout and anticipated turnover in intensive care unit nurses. This study is a descriptive-correlation research. A total of 159 intensive care unit nurses were selected from medical sciences universities in Iran. Data collection instruments included "demographic questionnaire," "ICU Nurses' Moral Distress Scale," "Copenhagen Burnout Inventory" and "Hinshaw and Atwood Turnover Scale." Data analysis was done by using SPSS19. Informed consent from samples and research approval was obtained from Shahid Beheshti Medical Sciences University Research Ethics Board in Tehran. The findings showed intensive care unit nurses' moral distress and anticipated turnover was high, but burnout was moderate. The results revealed that there was a positive statistical correlation between intensive care unit nurses' age, their work experience and the fraction of nurses' number to number of intensive care unit beds with their moral distress and burnout. However, there were no correlation between gender, marriage status, educational degree and work shift and moral distress. Some of the findings of this research are consistent with other studies and some of them are inconsistent. Similarly, moral distress with burnout and anticipated turnover did not have statistical correlation. However, a positive correlation was found between burnout and anticipated turnover. The results showed that increase in the recruitment of young nurses, and nursing personnel, and diminishing intensive care unit nurses' moral distress, burnout and their turnover intention are essential. © The Author(s) 2014.

  20. The Effect of Liaison Nurse Service on Patient Outcomes after Discharging From ICU: a Randomized Controlled Trial

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    Zeinab Tabanejad

    2016-09-01

    Full Text Available Introduction: Recent studies suggest that liaison nurse intervention might be effective to solve the gap between intensive care unit and wards, but little studies are known about the effect of this intervention. The aim of this study was to investigate the effect of liaison nurse service on patient outcomes after discharging from intensive care unit. Methods: In this single blinded randomized controlled trial, a total of 80 patients were selected by convenience sampling method from two teaching hospitals located in Tehran, Iran. Patients were randomly allocated to either the experimental or the control groups. Patients in the experimental group received post-ICU care from a liaison nurse and patients in the control group received the routine care. After the intervention, patients’ vital signs, level of consciousness, length of hospital stay, need for re-hospitalization in ICU, and satisfaction with care were measure. Data were analyzed by SPSS Ver.13 software. Results: None of the participants experienced ICU re-hospitalization. According to the result and there were no significant differences between the study groups regarding heart rate, respiratory rate, systolic blood pressure, post-ICU level of consciousness, satisfaction with care, and length of hospitalization in medical-surgical wards. However, the study groups differed significantly in terms of body temperature. Conclusion: Care services provided by an ICU liaison nurse has limited effects on patient outcomes. However, considering the contradictions among the studies, further studies are needed for providing clear evidence about the effectiveness of the liaison nurse strategy.

  1. The Effect of Liaison Nurse Service on Patient Outcomes after Discharging From ICU: a Randomized Controlled Trial

    Science.gov (United States)

    Tabanejad, Zeinab; Pazokian, Marzieh; Ebadi, Abbas

    2016-01-01

    Introduction: Recent studies suggest that liaison nurse intervention might be effective to solve the gap between intensive care unit and wards, but little studies are known about the effect of this intervention. The aim of this study was to investigate the effect of liaison nurse service on patient outcomes after discharging from intensive care unit. Methods: In this single blinded randomized controlled trial, a total of 80 patients were selected by convenience sampling method from two teaching hospitals located in Tehran, Iran. Patients were randomly allocated to either the experimental or the control groups. Patients in the experimental group received post-ICU care from a liaison nurse and patients in the control group received the routine care. After the intervention, patients’ vital signs, level of consciousness, length of hospital stay, need for re-hospitalization in ICU, and satisfaction with care were measure. Data were analyzed by SPSS Ver.13 software. Results: None of the participants experienced ICU re-hospitalization. According to the result and there were no significant differences between the study groups regarding heart rate, respiratory rate, systolic blood pressure, post-ICU level of consciousness, satisfaction with care, and length of hospitalization in medical-surgical wards. However, the study groups differed significantly in terms of body temperature. Conclusion: Care services provided by an ICU liaison nurse has limited effects on patient outcomes. However, considering the contradictions among the studies, further studies are needed for providing clear evidence about the effectiveness of the liaison nurse strategy. PMID:27752487

  2. [APACHE II and ATN-ISS in acute renal failure (ARF) in intensive care unit (ICU) and non-ICU].

    Science.gov (United States)

    Fernandes, Natáia Maria da Silva; Pinto, Patrícia dos Santos; Lacet, Thiago Bento de Paiva; Rodrigues, Dominique Fonseca; Bastos, Marcus Gomes; Stella, Sérgio Reinaldo; Cendoroglo Neto, Miguel

    2009-01-01

    Acute renal failure (ARF) remains highly prevalent with a high rate of morbidity and mortality. of this study was to compare use of the APACHE II scoring prognosis with that of the ATN-ISS to determine whether the APACHE II could be used for patients with ARF outside the ICU. For this purpose, 205 patients with ARF were accompanied in a prospective cohort. Demographic data, preexisting conditions, organ failure and characteristics of ARF were analyzed. The prognostic scores were performed with the assessment of a nephrologist. The mean age was 52 +/- 18 years, 50% were male, 69% were white, 45% were treated in ICU and 55% in other units. Mortality in the ICU group was 85% and in the non-ICU group 18%. Factors that correlated with higher mortality were more prevalent in the ICU group: age, male, hospitalization with ARF, organ failure, sepsis, septic IRA, oliguria and need of dialysis. Overall, the prognostic markers were the same for both the ICU and non-ICU groups. The discrimination with the APACHE II was similar in both, ICU and non-ICU groups and calibration was better in the non-ICU group. The ATN-ISS achieved good discrimination in both the ICU and non-ICU groups, but, regarding calibration, there was a discreet over estimating of mortality in the non-ICU group. The ATN-ISS showed a greater capacity for discrimination than the APACHE II in both the ICU and non-ICU groups. It was concluded that the APACHE II and ATN-ISS scores could be used for stratification of risk in patients with ARF treated outside of the ICU in Brazil.

  3. Nursing handover from ICU to cardiac ward: Standardised tools to reduce safety risks.

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    Graan, Sher Michael; Botti, Mari; Wood, Beverley; Redley, Bernice

    2016-08-01

    Standardising handover processes and content, and using context-specific checklists are proposed as solutions to mitigate risks for preventable errors and patient harm associated with clinical handovers. Adapt existing tools to standardise nursing handover from the intensive care unit (ICU) to the cardiac ward and assess patient safety risks before and after pilot implementation. A three-stage, pre-post interrupted time-series design was used. Data were collected using naturalistic observations and audio-recording of 40 handovers and focus groups with 11 nurses. In Stage 1, examination of existing practice using observation of 20 handovers and a focus group interview provided baseline data. In Stage 2, existing tools for high-risk handovers were adapted to create tools specific to ICU-to-ward handovers. The adapted tools were introduced to staff using principles from evidence-based frameworks for practice change. In Stage 3, observation of 20 handovers and a focus group with five nurses were used to verify the design of tools to standardise handover by ICU nurses transferring care of cardiac surgical patients to ward nurses. Stage 1 data revealed variable and unsafe ICU-to-ward handover practices: incomplete ward preparation; failure to check patient identity; handover located away from patients; and information gaps. Analyses informed adaptation of process, content and checklist tools to standardise handover in Stage 2. Compared with baseline data, Stage 3 observations revealed nurses used the tools consistently, ward readiness to receive patients (10% vs 95%), checking patient identity (0% vs 100%), delivery of handover at the bedside (25% vs 100%) and communication of complete information (40% vs 100%) improved. Clinician adoption of tools to standardise ICU-to-ward handover of cardiac surgical patients reduced handover variability and patient safety risks. The study outcomes provide context-specific tools to guide handover processes and delivery of verbal

  4. [Systematization of nursing assistance in critical care unit].

    Science.gov (United States)

    Truppel, Thiago Christel; Meier, Marineli Joaquim; Calixto, Riciana do Carmo; Peruzzo, Simone Aparecida; Crozeta, Karla

    2009-01-01

    This is a methodological research, which aimed at organizing the systematization of nursing assistance in a critical care unit. The following steps were carried out: description of the nursing practice; transcription of nursing diagnoses; elaboration of a protocol for nursing diagnosis based in International Classification for Nursing Practice (ICNP); determination of nursing prescriptions and the elaboration of guidelines for care and procedures. The nursing practice and care complexity in ICU were characterized. Thus, systematization of nursing assistance is understood as a valuable tool for nursing practice.

  5. [Prevalence and risk factors of occupational low back pain in ICU nurses].

    Science.gov (United States)

    Sun, Jing; He, Zhong; Wang, Sheng

    2007-08-01

    To explore the prevalence of occupational low back pain (OLBP) and assess work-related risk factors in ICU nurses. Forty hundred seventy-seven ICU nurses of study group and nurses working in other wards (control group) of the same comprehensive hospital were investigated using OLBP Investigation Questionnaire for nurses. Working postures and related work activities were evaluated by using the Win OWAS software and the compressive force (Fc) of the disc between L5 and S1 was calculated by using the Bless Pro software and sampling was taken by digital camera in ICU ward of one hospital. The prevalence of OLBP (87%), frequency of OLBP (48%=1 per month) and OLBP related work-absence (7%) of the ICU nurses were significantly higher than the control group (64%, 32% and 2%, respectively). The frequency of harmful postures occurred during working tasks of observing drainage, lifting and transferring patients in bed, injection, suctioning and adjusting drip were 99%, 90%, 75%, 75% and 6%, respectively. The ratios of Fc of adjusting drip rate (taken as 100), suctioning, injection, observing drainage and lifting and transferring patients in bed were 100:155:199:301:418. Prevalence of OLBP in ICU nurses is high. High frequency of bending and twisting, transferring patients in bed are the main causes of OLBP in ICU nurses.

  6. Phenomenological study of ICU nurses' experiences caring for dying patients.

    Science.gov (United States)

    King, Phyllis Ann; Thomas, Sandra P

    2013-11-01

    This existential phenomenological study explored caring for the dying based on the philosophical works of Merleau-Ponty. Fourteen critical care nurses were asked to describe lived experiences of caring for dying patients. An encompassing theme of Promises to Keep emerged, with five subthemes, including the following: (a) promise to be truthful: "Nurses are in the game of reality," (b) promise to provide comfort: "I'll make him comfortable," (c) promise to be an advocate: "Just one more day," (d) "Promise that couldn't be kept," and (e) "Promise to remain connected." The essence of intensive care nurses' lived experience of caring for dying patients is captured in the theme Promises to Keep. Nurses accept the reality of death and express strong commitment to making it as comfortable, peaceful, and dignified as possible, despite critical care unit environments that foster a "paradigm of curing" rather than a "paradigm of caring.".

  7. Teaching and practice for Position requirements-oriented training system of ICU training nurses in secondary hospital

    OpenAIRE

    Huang, Hai-yan; Luo, Jian

    2014-01-01

    Objective: Establish position requirements-oriented training system of ICU training nurses in secondary hospital .To standardize the teaching management and improve the training effect for the training nurses in our ICU. Methods: Form the ICU training nurse teaching staff; Formulate training manual according to survey results of nurse training demand;Implement clinical teaching in stages according to the content of the training manual; Proceed comprehensive skills assessment in the different ...

  8. ICU Occupancy and mechanical ventilator use in the United States

    Science.gov (United States)

    Wunsch, Hannah; Wagner, Jason; Herlim, Maximilian; Chong, David; Kramer, Andrew; Halpern, Scott D.

    2013-01-01

    Objectives Detailed data on occupancy and use of mechanical ventilators in United States intensive care units (ICU) over time and across unit types, are lacking. We sought to describe the hourly bed occupancy and use of ventilators in US ICUs to improve future planning of both the routine and disaster provision of intensive care. Design Retrospective cohort study. We calculated mean hourly bed occupancy in each ICU and hourly bed occupancy for patients on mechanical ventilators. We assessed trends in overall occupancy over the three years. We also assessed occupancy and mechanical ventilation rates across different types and sizes of ICUs. Setting 97 US ICUs participating in Project IMPACT from 2005–07. Patients 226,942 consecutive admissions to ICUs. Interventions None. Measurements and Main Results Over the three years studied, total ICU occupancy ranged from 57.4% to 82.1% and the number of beds filled with mechanically ventilated patients ranged from 20.7% to 38.9%. There was no change in occupancy across years and no increase in occupancy during influenza seasons. Mean hourly occupancy across ICUs was 68.2% SD ± 21.3, and was substantially higher in ICUs with fewer beds (mean 75.8% (± 16.5) for 5–14 beds versus 60.9% (± 22.1) for 20+ beds, P = 0.001), and in academic hospitals (78.7% (± 15.9) versus 65.3% (± 21.3) for community not-for profit hospitals, P beds available more than half the time. The mean percentage of ICU patients receiving mechanical ventilation in any given hour was 39.5% (± 15.2), and a mean of 29.0% (± 15.9) of ICU beds were filled with a patient on a ventilator. Conclusions Occupancy of US ICUs was stable over time, but there is uneven distribution across different types and sizes of units. Only three out of ten beds were filled at any time with mechanically ventilated patients, suggesting substantial surge capacity throughout the system to care for acutely critically ill patients. PMID:23963122

  9. 重症监护室患者并发ICU综合征的危险因素及护理防治措施分析%Analysis of risk factors and nursing control measures of ICU syndrome of patients in intensive care unit

    Institute of Scientific and Technical Information of China (English)

    凌莉萍; 冯瑞霞

    2016-01-01

    目的 研究重症监护室患者并发ICU综合征的危险因素及护理防治措施.方法 回顾性分析2013年10月至2015年9月在本院重症监护室就诊的90例患者临床病历资料,分析ICU综合征发病的危险因素,并据此探讨护理防治措施.结果 90例患者共发生ICU综合征36例,发生率40.00%,ICU综合征好发于高龄、入院时间长、有既往病史、患者文化程度偏低及自费医疗患者.ICU综合征发生组ICU环境压力源量表(ICUESS)、急性生理及慢性健康状况(APACHEⅡ)及匹兹堡睡眠质量指数量表(PSQ I)评分均显著高于未发生组,差异具有统计学意义(P<0.05).结论 重症监护室患者并发ICU综合征发生率与患者年龄、入院时间、既往病史、文化程度及医疗费用支付方式具有显著相关性,临床护理当以心理护理为重点,改善医疗环境,同时做好基础和专科常规护理,降低发病率.%Objective To study risk factors and nursing control measures of ICU syndrome of patients in intensive care unit.Methods Clinical data of 90 patients in ICU of our hospital from October 2013 to September 2015 was retrospectively analyzed.Analyzed risk factors of ICU syndrome and investigated nursing control measures.Results There were 36 cases of ICU syndrome in 90 patients,with the incidence rate of 40%.ICU syndrome was found mainly in patients with advanced age,long time of hospitalization,past medical history of ICU syndrome,low education level and medical cost at their own expense.The scores of ICUESS,acute physiology and chronic health status (APACHE Ⅱ) and Pittsburgh sleep quality index (PSQ Ⅰ) in ICU syndrome group were significantly higher than those in non-ICU syndrome group (P<0.05).Conclusions The incidence rate of ICU syndrome in patients in intensive care unit is significantly correlated with age,admission time,past medical history,education level and payment mode of medical expenses.In order to reduce the incidence

  10. The effects of teaching stress management skills on the quality of life in ICU nurses

    Directory of Open Access Journals (Sweden)

    FARIBA GHODSBIN

    2013-07-01

    Full Text Available Introduction: Job stress is one of the main factors in decreasing productivity in organizations and the leading cause of psychosomatic disorders in personnel. Since job stress of nurses working in Intensive Care Units (ICUs is considered as an important segment in health and medical systems, it significantly affects the quality of care and the nurse’s quality of life. To this end, the purpose of this research is to examine the effects of teaching stress management skills on the quality of life of the nurses working at ICU of the hospitals affiliated to Shiraz University of Medical Sciences. Methods: The subjects of the study consisted of 60 ICU nurses with the average stress score in Osipow job stress exam working at the hospitals affiliated to Shiraz University of Medical Sciences. The subjects were randomly assigned to two groups (30 in the case and 30 in the control group. The intervention was performed as a teaching stress management workshop for eight hours throughout two-days (four hours per day, and the nurses were followed up for two months. The data were collected through a two part questionnaire including demographic characteristics and WHO Quality of life BREF and were analyzed in SPSS software using paired t test, and t-test. Results: The findings showed that the nurses of both the case and control groups were homogeneous considering the demographic data such as age, sex, marital status, number of children, shift position, job satisfaction, number of working hours per week, work experience and the amount of income. Moreover, there was no significant difference between the mean score of the life quality before the intervention in both groups. But after the intervention, a significant increase was revealed in the mean score of the life quality of the case group as compared to that of the control group (P<0.0001. Conclusion: The findings revealed the efficacy of the stress management workshop in improving the life quality of ICU

  11. Development of a scale for "difficulties felt by ICU nurses providing end-of-life care" (DFINE): a survey study.

    Science.gov (United States)

    Kinoshita, Satomi; Miyashita, Mitsunori

    2011-08-01

    To develop a scale for assessing "difficulties felt by intensive care unit (ICU) nurses providing end-of-life care" (DFINE). A questionnaire survey of nurses in ICUs at general hospitals in the Kanto region, Japan. The scale was evaluated by exploratory factor analysis, calculation of Cronbach's α and test-retest reliability. The Frommelt Attitudes Toward Care of the Dying Scale (FATCOD-B-J) and the Nursing Job Stressor Scale (NJSS) were used to investigate concurrent validity. Respondents were 224 ICU nurses (response rate, 78%) at 18 hospitals. Five factors comprising 28 items were identified, involving difficulties related to: "the purpose of the ICU is recovery and survival"; "nursing system and model nurse for end-of-life care"; "building confidence in end-of-life care"; "caring for patients and families at end-of-life"; and "converting from curative care to end-of-life care". Cronbach's α for each factor ranged from 0.61 to 0.8. In terms of test-retest reliability, intraclass correlations for each factor ranged from 0.62 to 0.72. "Building confidence in end-of-life care" in DFINE showed a negative correlation with "positive attitudes towards caring for dying patient" in the FATCOD-B-J (r=-0.4). "Nursing system and model nurse for end-of-life care" in DFINE showed a positive correlation with "conflict with other nursing staffs" (r=0.32) and "conflict with physicians/autonomy" (r=0.31) in the NJSS. DFINE demonstrated acceptable reliability and validity. However, additional surveys need to be conducted with a larger sample to further characterise the scale. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Examining perception of job satisfaction and intention to leave among ICU nurses in China

    Directory of Open Access Journals (Sweden)

    Hong Tao

    2015-06-01

    Conclusions: For ICU nurses in China, sources of job dissatisfaction are potentially remedied with simple interventions. Adequate staffing is necessary but not sufficient for a positive work environment. Administrators should address the factors that directly affect their nurses' levels of job satisfaction, as it will ultimately result in less staff turnover and greater patient care.

  13. Research progress of ICU nurses' pressure%ICU护士压力研究进展

    Institute of Scientific and Technical Information of China (English)

    刘玉琳

    2011-01-01

    The concept of stress, stress research tools, the main source of stress about ICU nurses, the factors that ICU nurses feel stress out and the ways of reducing the pressure were summarized. To make targeted measures for raising the coping ability of ICU nurses, stabilizing the nursing team and serving patients better.%本文对压力的概念、压力研究工具、ICU护士主要压力源、影响ICU护士压力源感受的因素及如何减轻ICU护士压力的方式进行综述,旨在了解ICU护士所面临的压力问题,制定有针对性的心理应对措施,提高ICU护士的应对能力,从而稳定护理队伍,更好地为患者服务.

  14. Teamwork as a nursing competence at Intensive Care Units

    Directory of Open Access Journals (Sweden)

    Silvia Helena Henriques Camelo

    2013-03-01

    Full Text Available Objective. The aim in this study was to identify how Intensive Care Unit nurses perceive professional competences in thecare team. Methodology. Qualitative multiple case study with an exploratory focus. The sample consisted of 24 nurses from Intensive Care Units (ICU at two large hospitals. To collect the information, direct observation and - structured, non-structuredand participant - interviews were used. Results. Ninety-six percent of the participants were women, 79% were less than 40 years old, and 63% possessed less than five years of professional experience in ICU. Data analysis revealed three study categories: teamwork as a nursing management tool, improving teamwork, and interpersonal communication for teamwork. Conclusion. At the ICU where the nurses work, a teamwork strategy is observed, which demands cooperation and participation by other disciplines.

  15. Unplanned extubation in the ICU: Impact on outcome and nursing workload

    Directory of Open Access Journals (Sweden)

    Krayem Ayman

    2006-01-01

    Full Text Available PURPOSE: To determine the incidence and factors associated with unplanned extubation (UE in the intensive care unit (ICU and its relationship with nursing workload. MATERIALS AND METHODS: A retrospective case-control study was carried out within a cohort of ventilated patients in two teaching hospital medical-surgical ICUs. A total of 50 adult patients with UE were studied. Controls were subjects without UE who were matched to the cases on the following Five factors: age, gender, admission diagnostic category, admission date (within 3 months and duration of mechanical ventilation. Other data including patient demographics, comorbid conditions, APACHE III score, ventilation parameters, use of sedation, re-intubation, mortality rate and ICU/hospital length of stay were collected. Nine equivalents of nursing manpower use score (NEMS and multiple organ dysfunction score (MODS were calculated in both, cases and controls, 24 h before and after the event. RESULTS: Sixty-eight episodes of UE occurred in 66 patients during the 24-month study period (1.1%. Patients with UE were more agitated ( P P =0.023 than their controls. UE was associated with a higher rate of re-intubation compared to the control group ( P P >0.05. The mean NEMS were not significantly different between the two groups 24 h before ( P =0.69 and after ( P =0.99 the extubation event. Also, the mean MODS were similar between both groups 24 h before ( P =0.69 and after ( P =0.74 extubation. CONCLUSION: In this study, agitation and greater use of benzodiazepines were frequently associated with UE and potentially can be used as risk factors for UE. We have found no significant impact of UE on increasing mortality and, in a manner not shown before, nursing workload.

  16. 广东省ICU专科护士对ICU综合征认知情况的调查%A survey on the cognition of ICU syndrome by ICU nurses in Guangdong province

    Institute of Scientific and Technical Information of China (English)

    张丽丽; 闫俊辉; 黄兰

    2009-01-01

    Objective To understand the cognition of ICU syndrome by ICU nurses in Guangdong province. Methods Through questionnaire filling in, this investigation was made on the first hatch of ICU nurses dispatched to Hung Kong for ICU specialized training by Guangdong province. Information collected included the nurses' personal information and their knowledge about ICU syndrome. Results The sub-jects' knowledge about ICU syndrome was scanty, and was not related to their years of work, professional ti-tles, academic degrees or administrative duties. The overwhelming majority of the subjects had not paid at-tention to the disease in clinical work. Most departments had not formulated guidelines whatsoever on nurs-ing for ICU syndrome. In assessing the ICU syndrome, the vast majority of nurses relied on their clinical experience, with none of them relying on the confusion assessment method for the intensive care unit (CAM-ICU). Only very few of the subjects acquired some knowledge about the syndrome during their study at colleges. Conclusions The ICU nurses in Guangdong province should attach importance to ICU syn-drome and strengthen the study of related knowledge in their work and study. And it is essential to popular-ize CAM- ICU and to build a standard assessment system and work out the intervention measures for ICU syndrome.%目的 了解广东省ICU护士对ICU综合征的认知情况.方法 采用调查问卷的方式对广东省选派的首批赴香港ICU专科护士培训班学员进行调查.收集的信息包括个人的相关信息及对ICU综合征的相关知识.结果 调查对象对ICU综合征的知识匮乏,且与个人的工作年限、职称、学历、职务均无相关性;绝大部分被调查者在临床工作中未曾关注此病;大部分科室没有制订针对ICU综合征的护理指南;绝大多数被调查者在评估ICU综合征时依据临床经验,而没有一个是通过"用于ICU的精神混乱评估方法 (CAM-ICU)";只有很少部分人是

  17. Evaluation of Mental Workload among ICU Ward's Nurses

    Directory of Open Access Journals (Sweden)

    Mohsen Mohammadi

    2015-12-01

    Conclusion: Various performance obstacles are correlated with nurses' workload, affirms the signifi­cance of nursing work system characteristics. Interventions are recommended based on the results of this study in the work settings of nurses in ICUs.

  18. Hope of patient recovery in the ICU from the viewpoint of Iranian nurses: concept analysis.

    Science.gov (United States)

    Jahantigh, Mojgan; Rezaee, Nasrin; Rezaei, Nahid

    2014-07-15

    Nurses' care quality for patients in the ICU depends on their degree/ level of hope to improving patient, but there is no consensus on the concept "hoping to improve patient." The purpose of the present study is to analyze the concept nurses hoping to improving patient in the ICU. To analyze this concept, hybrid model is used which consists of theoretical phase, field work phase, and final analytical phase. In field phase work, semi-structured, face to face and individual interviews were done for nurses working in the ICU, and the data gathered from the interviews were analyzed using inductive content analysis. In theoretical phase, the concept hoping to improve patient was characterized by being available, being professional, expecting positively, and being future- oriented. The scientific definition of this concept was explained through properties which are necessary for qualified nursing care. In field work phase, the categories include nursing care, inner feeling, belief and consequences. In final analytical phase, final definition of the concept was explained through properties such as dynamic expectation, being realistic, and being goal- oriented which is a better function and attitude in effective nursing care accompanying peace of mind for nurses. Concept analysis showed that nurse's awareness of hoping to improve patient helps the nurse do his job in the best way and with peace of mind.

  19. The technology acceptance model: predicting nurses' intention to use telemedicine technology (eICU).

    Science.gov (United States)

    Kowitlawakul, Yanika

    2011-07-01

    The purposes of this study were to determine factors and predictors that influence nurses' intention to use the eICU technology, to examine the applicability of the Technology Acceptance Model in explaining nurses' intention to use the eICU technology in healthcare settings, and to provide psychometric evidence of the measurement scales used in the study. The study involved 117 participants from two healthcare systems. The Telemedicine Technology Acceptance Model was developed based on the original Technology Acceptance Model that was initially developed by Fred Davis in 1986. The eICU Acceptance Survey was used as an instrument for the study. Content validity was examined, and the reliability of the instrument was tested. The results show that perceived usefulness is the most influential factor that influences nurses' intention to use the eICU technology. The principal factors that influence perceived usefulness are perceived ease of use, support from physicians, and years working in the hospital. The model fit was reasonably adequate and able to explain 58% of the variance (R = 0.58) in intention to use the eICU technology with the nursing sample.

  20. [Job satisfaction, job burnout and their relationships with work'and patients' characteristics: a comparison between intensive care units (ICU) and not-intensive care units (not-ICU)].

    Science.gov (United States)

    Viotti, Sara; Converso, Daniela; Loera, Barbara

    2012-01-01

    Health worker's population is espoused to high level of stress, and several studies highlight differences between intensive care units (ICU) and non-intensive care unit (non-ICU). Particular features of the job in ICU concern responsibilities for critically patients, highly advanced technology and need for quick decision. Aims of this study are: (1) to examine differences between ICU's and not-ICU's workers on several dimensions describing work environment and workers' health; (2) investigate which specific work conditions have a role in determining psychological work reactions in ICU's and not-ICU's workers. 144 ICUs' and not-ICU's 114 workers employed in an Italian Hospital filled out a questionnaire concerning decision authority, autonomy, colleagues' and supervisors' support, physical and cognitive demands as antecedents; job satisfaction and job burnout (EE, DP) as consequences. 1) MANOVA highlighted how ICU workers reported significantly higher scores on depersonalization, job satisfaction, aggressive customers, while physical demands and proportionate customer expectations were significantly higher for not-ICU workers; (2) Six Multiple Linear Regressions were carried out. Those indicated decision authority, autonomy and supervisors' support as predictors of emotional exhaustions in ICU. In not-ICU only cognitive demands and colleagues' support are significant predictors. Depersonalization is predicted in ICU by colleagues' support. Predictors of job satisfaction both in ICU and not-ICU are: decision authority and colleagues support. Current study highlighted several differences among ICU and non-ICU workers' referred to work environment and psychological reactions.

  1. Cultivation and usage of the ICU nurse specialists%ICU专科护士培养与使用

    Institute of Scientific and Technical Information of China (English)

    成守珍; 高明榕; 白利平; 王越秀; 龚凤球

    2013-01-01

    目的:探讨重症监护病房(ICU)专科护士培养和使用的模式.方法:根据调查所得的ICU护士的核心能力水平,将ICU护士的核心能力分为四个层级,制定ICU专科护士的成长阶梯和使用计划.结果:ICU专科护士带动了ICU病区护理质量的提升.结论:建立持续性的、逐级递进的阶梯式教育培训系统是有效的ICU专科护士培养模式.%Objective: To explore the cultivating and using mode of the ICU nurse specialists. Methods: Based on the investigation of ICU nurses' competence, we divided the core competencies of the ICU nurses into four levels and draw up ICU nurses' growth ladder and usage plan. Results: The ICU nurse specialists played their corresponding role according to their different core competence levels and improved the nursing quality of ICU wards. Conclusion: Establishing a continuous and progressive staged education and training system is an effective mode to cultivate the ICU nurse specialists.

  2. Nurses' leadership styles in the ICU: association with personal and professional profile and workload.

    Science.gov (United States)

    Balsanelli, Alexandre Pazetto; Cunha, Isabel Cristina Kowal Olm; Whitaker, Iveth Yamaguchi

    2009-01-01

    This study aims to explore the association between nurses' leadership styles and personal and professional nursing profile and workload. The sample consisted of seven nurses and seven nursing technicians who were grouped into pairs. At the end of three months, nurses were queried regarding what leadership style would be adopted when the nursing technician under their evaluation delivered care to patients admitted to the ICU. Relevant data was analyzed by applying descriptive statistics, Tukey's multiple comparison test and Student's t-test (pleadership styles chosen by nurses (p>0.05). The determine, persuade, and share leadership styles prevailed. However, whenever the nursing workload peaked, the determine and persuade styles were used (p<0.05).

  3. Information technologies and nursing process records: case study at a neonatal ICU

    OpenAIRE

    Raphael Brandão Pereira; Maria Alice Coelho; Maria Márcia Bachion

    2016-01-01

    The objective of this study was to analyze the recording of the nursing process, supported by information and communication technologies in both printed and electronic media in the neonatal intensive care scenario. This case study was exclusive, integrated, and conducted between January and April 2014. The study counted on the participation of seven nurses who worked at a neonatal ICU before and after the deployment of new information and communication technologies, which combined electronic ...

  4. Indian ICU nurses' perceptions of and attitudes towards organ donation.

    Science.gov (United States)

    Vijayalakshmi, Poreddi; Nagarajaiah; Ramachandra; Math, Suresh Bada

    Nurses play a significant role in identifying and securing potential organ donors in the clinical environment. Research among Indian nurses related to organ donation is sparse. The present study aimed to investigate nurses' attitudes towards organ donation. A cross-sectional descriptive survey was carried out among nurses (n=184) at a tertiary care centre. Data were collected through self-report questionnaire. A majority (81%) of the respondents were 'willing to sign the card' for organ donation; however, only 3.8% (n=7) of them actually 'signed the organ donation card'. There were significant associations found between intentions to sign the organ donation card and gender (x2=5.852; pdonation. Furthermore, nurse administrators must take the initiative to develop guidelines clarifying the role of nurses in the organ donation and transplantation process to promote organ donation and improve rates.

  5. 改良早期预警评分指导 ICU 早期开展护理风险评估的效果评价%The value of Modified Early Warning Score in early nursing risk assessment of patients in intensive care unit

    Institute of Scientific and Technical Information of China (English)

    吴文娟; 张银英

    2016-01-01

    目的:探讨改良早期预警评分( MEWS)对ICU 收治危重患者早期(24 h内)病情变化的预测价值,为临床重症护理工作提供科学、客观的依据。方法:将826例患者随机分为M组( MEWS组)和C组(对照组),M组根据MEWS评分分级,C组根据三级监测评估系统分级。根据评分制定护理计划及分配护理资源。结果:M组的24 h非计划拔管率、24 h ICU内病死率、24 h ICU内心肺复苏率、ICU住院时间均低于C组,差异有统计学意义( P﹤0.05),M组24 h心肺复苏成功率高于C组,差异有统计学意义( P﹤0.05)。结论:改良早期预警评分有助于指导早期开展护理风险评估,减少意外事件及并发症的发生。%Objective To investigate the predictive effect of Modified Early Warning Score to the nursing evaluation of critical ill patients after intensive care unit( ICU)admission. Method 826 patients who were included were randomly divided into M group(Modified Early Warning Score group,MEWS group)and C group(Control group),M group graded according MEWS score,C group graded according to three levels of Monitoring and evaluation system. Nursing care plans were made,nursing re-sources were allocated,according rating. Results 24 hours unplanned extubation,24 hours fatality rate,24 hours cardiopulmonary resuscitation,ICU length of stay were significantly reduced in Modified Early Warning Score group,the difference was statistically significant(P﹤0. 05). Success rate of cardiopulmonary resuscitation in Modified Early Warning Score group were significantly higher than Control group,the difference was statistically significant( P﹤0. 05 ). Conclusion These data show the effectiveness of Modified Early Warning Score in identifying critically ill patients in an early phase making early nursing interventions possible and hopefully reduces mortality.

  6. Nursing staff's experiences of working in an evidence-based designed ICU patient room-An interview study.

    Science.gov (United States)

    Sundberg, Fredrika; Olausson, Sepideh; Fridh, Isabell; Lindahl, Berit

    2017-06-05

    It has been known for centuries that environment in healthcare has an impact, but despite this, environment has been overshadowed by technological and medical progress, especially in intensive care. Evidence-based design is a concept concerning integrating knowledge from various research disciplines and its application to healing environments. The aim was to explore the experiences of nursing staff of working in an evidence-based designed ICU patient room. Interviews were carried out with eight critical care nurses and five assistant nurses and then subjected to qualitative content analysis. The experience of working in an evidence-based designed intensive care unit patient room was that the room stimulates alertness and promotes wellbeing in the nursing staff, fostering their caring activities but also that the interior design of the medical and technical equipment challenges nursing actions. The room explored in this study had been rebuilt in order to create and evaluate a healing environment. This study showed that the new environment had a great impact on the caring staffs' wellbeing and their caring behaviour. At a time when turnover in nurses is high and sick leave is increasing, these findings show the importance of interior design ofintensive care units. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Teaching and practice for Position requirements-oriented training system of ICU training nurses in secondary hospital

    Directory of Open Access Journals (Sweden)

    Hai-yan HUANG

    2014-09-01

    Full Text Available Objective: Establish position requirements-oriented training system of ICU training nurses in secondary hospital .To standardize the teaching management and improve the training effect for the training nurses in our ICU. Methods: Form the ICU training nurse teaching staff; Formulate training manual according to survey results of nurse training demand;Implement clinical teaching in stages according to the content of the training manual; Proceed comprehensive skills assessment in the different stages of training. Results: The pass rate of the 84 training nurses in 2013was 100%, the excellent rate was 25.72%,the good rate was 36.37%. 84 training nurses completed the training task perfectly according to the training manual, and during the training there was no nursing security incidents. Conclusion: To establish position requirements-oriented training system of ICU training nurses is the main method to solve the shortage of nursing professionals  in secondary hospital. This kind of training system is appropriate to the needs of the development of intensive care ,training requirement and clinical requirement. It should be extended in nurse training work in ICU.

  8. THE IMPLEMENTATION OF THE SYSTEMATIZATION OF NURSING ICU - NEONATAL HOSPITAL REGIONAL DE CÁCERES-MT

    Directory of Open Access Journals (Sweden)

    Eliene de Souza Porto

    2013-01-01

    Full Text Available The study aimed to analyze the implementation of the Nursing Care System (NCS in the ICU - Neonatal Hospital Regional de Cáceres Dr. Anthony Fontes - HRCAF. This is an exploratory qualitative approach with descriptive profile of the case study. Data were collected through interviews with five nurses from ICU - Neonatal, using as research instrument, a questionnaire containing open and closed questions and analyzing a chart. The results showed that nurses know and realize the importance of NCS as a methodological tool that guides the practice of care and as professional recognition, although not held by all. The analysis of the records showed that there Systematization of Nursing Care at this clinic. Of the 707 days analyzed records there were only 30 (4.25% Nursing Research, none (0.0% record Diagnosis and Planning, 57 (8.26% days with record Deployment, Assessment and 23 record (3.24% in which its registered nursing care, assistance totaling 15.55% recorded in medical records. With the completion of this study, it was noted that the SAE often becomes impossible in practice of nursing because of various difficulties such as lack of time, lack of human resources, work overload, and the generic form organizational structure.

  9. 护理程序在ICU的应用和体会%Application and Understanding of ICU Nursing Procedure

    Institute of Scientific and Technical Information of China (English)

    罗晓清

    2002-01-01

    Objective To ensure entirity and continuance of nursing and meet the comprehesive requirement of physics,psychology and society. Methods ICU nurses apply the theory of modern nursing to the practice in view of nursing procedure,by collecting data of patients, assessing illness condition, diagnosing and taking plan in short time. Result Raising quality ofnursing and nurses forging close relationship between nurses and patients and increasing the economic and social benefit.Conclusion Scientific application of nursing procedure is the key to raise quality of nurses and nursing.

  10. The application of quality control circle in neurosurgery ICU nurses in raising compliance of the head of a bed

    Directory of Open Access Journals (Sweden)

    Na LI

    2014-11-01

    Full Text Available Objective: To explore the application of quality control circle in raising compliance of the head of a bed in neurosurgery ICU nurses. Methods: The quality control circle was made up of 4 ICU nurses, determine the subject in order to improve the neurosurgery ICU nurses in raising compliance of the head of a bed, according to the QCC activity steps to formulate plans, including grasp the current situation, goal setting, through analysis, circle members develop strategy and plan implementation and review, finally compared the situation before and after neurosurgery ICU nurses raised bed activities compliance. Results: After implementation of QCC, neurosurgery ICU nurses raised bed to 30 ~ 45 degrees. After activities, circle members in the team cooperation ability, cohesion, to accept new things ability, and innovative thinking ability and to raise the understanding of the relevant knowledge of the head of a bed has improved significantly. Conclusion: The application of quality management circle activity improves the neurosurgery ICU nurses effectively raise the compliance of the head of a bed, improve the comprehensive quality of the clinical nurses.

  11. ICU nurses' evaluations of integrated information displays on user satisfaction and perceived mental workload.

    Science.gov (United States)

    Koch, Sven H; Westenskow, Dwayne; Weir, Charlene; Agutter, Jim; Haar, Maral; Görges, Matthias; Liu, David; Staggers, Nancy

    2012-01-01

    Consolidated information from multiple sources (patient monitors, electronic medical records, infusion pumps, ventilators, medication references) may improve nurses' work and patient safety. Objective. Two hypotheses were tested, that integrated information displays (a) improve nurses' satisfaction and (b) lower perceived mental workload. Methods. In a counter-balanced, repeated measures design (integrated vs. traditional display) 12 ICU nurses performed realistic tasks using both display types. Results. Nurses' user interaction satisfaction was higher with the integrated display and it received more positive comments. Nurses' mean perceived mental workload scores were also lower, having significant differences in effort and frustration dimensions. A lower mental workload may reduce errors and improve treatment times. Integrated information displays have great promise, but technological factors such as bidirectional device communication must be addressed if these displays are to achieve their potential for improving patient safety.

  12. Occurrence of delirium is severely underestimated in the ICU during daily care

    NARCIS (Netherlands)

    Spronk, P.E.; Riekerk, B.; Hofhuis, J.; Rommes, J.H.

    2009-01-01

    Delirium is associated with prolonged intensive care unit (ICU) stay and higher mortality. Therefore, the recognition of delirium is important. We investigated whether intensivists and ICU nurses could clinically identify the presence of delirium in ICU patients during daily care. All ICU patients i

  13. Recent Advances in Pulmonary Rehabilitation for Patients in the Intensive Care Unit (ICU)

    OpenAIRE

    SATO, Ryuhei; Ebihara, Satoru; Kohzuki, Masahiro

    2017-01-01

    Pulmonary rehabilitation is important to prevent complications in critically ill patients in the intensive care unit (ICU) who are on mechanical ventilation. However, the effectiveness and adverse events related to pulmonary rehabilitation for patients in the ICU are largely unclear because of the diversity of diseases and various levels of severity in this situation. This review aims to clarify the evidence currently available for pulmonary rehabilitation in critically ill adult patients req...

  14. Satisfaction in the Intensive Care Unit (ICU). Patient opinion as a cornerstone.

    Science.gov (United States)

    Holanda Peña, M S; Talledo, N Marina; Ots Ruiz, E; Lanza Gómez, J M; Ruiz Ruiz, A; García Miguelez, A; Gómez Marcos, V; Domínguez Artiga, M J; Hernández Hernández, M Á; Wallmann, R; Llorca Díaz, J

    2017-03-01

    To study the agreement between the level of satisfaction of patients and their families referred to the care and attention received during admission to the ICU. A prospective, 5-month observational and descriptive study was carried out. ICU of Marqués de Valdecilla University Hospital, Santander (Spain). Adult patients with an ICU stay longer than 24h, who were discharged to the ward during the period of the study, and their relatives. Instrument: FS-ICU 34 for assessing family satisfaction, and an adaptation of the FS-ICU 34 for patients. The Cohen kappa index was calculated to assess agreement between answers. An analysis was made of the questionnaires from one same family unit, obtaining 148 pairs of surveys (296 questionnaires). The kappa index ranged between 0.278-0.558, which is indicative of mild to moderate agreement. The families of patients admitted to the ICU cannot be regarded as good proxies, at least for competent patients. In such cases, we must refer to these patients in order to obtain first hand information on their feelings, perceptions and experiences during admission to the ICU. Only when patients are unable to actively participate in the care process should their relatives be consulted. Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  15. ICU 护士评判性思维能力的培养%Training of critical thinking of ICU nurses

    Institute of Scientific and Technical Information of China (English)

    邓庆萍; 邬敏志; 王晓萍; 黄海英; 梁羚

    2014-01-01

    Objective To explore the methods for training the abitity of critical thinking of ICU nurses.Methods ICU nurses were trained in terms of knowledge training, case study, care rounds, self-reflection, case discussion, simulation training and seminars. The Chinese version of the critical thinking disposition inventory(CTDI-CV)was used before and one year after the training.Result The scores on CTDI-CV as well as the items after training were all significantly higher than that before training(P<0.05).Conclusion The knowledge and ability in critical thinking can be improved by knowledge and skills training.%探讨 ICU 护士评判性思维能力的培养方法及其效果。方法采用知识培训、个案病例分析、护理查房、自我反思、病例讨论、模拟训练、典型病例研讨等培训方式对 ICU 护士进行培训,培训前和培训1年后,采用中文版评判性思维测量表(the chinese version of critical mind meter,CTDI-CV)对护士进行测评。结果培训后,ICU 护士 CTDI-CV 总分及各维度得分均高于培训前,差异均有统计学意义(P<0.01)。结论通过知识和技能培训提高了 ICU 护士评判性思维的知识和能力。

  16. Nurses' and physicians' perceptions of Confusion Assessment Method for the intensive care unit for delirium detection

    DEFF Research Database (Denmark)

    Oxenbøll-Collet, Marie; Egerod, Ingrid; Christensen, Vibeke;

    2017-01-01

    of this study was to identify nurses' and physicians' perceived professional barriers to using the CAM-ICU in Danish ICUs. METHODS: This study uses a qualitative explorative multicentre design using focus groups and a semi-structured interview guide. Five focus groups with nurses (n = 20) and four...... with physicians (n = 14) were conducted. Strategic sampling was used to include participants with varying CAM-ICU experience at units, with variable implementation of the tool. RESULTS: Using a hermeneutical approach, three main themes and nine sub-themes emerged. The main themes were (1) Professional role issues......: CAM-ICU screening affected nursing care, clinical judgment and professional integrity; (2) Instrument reliability: nurses and physicians expressed concerns about CAM-ICU assessment in non-sedated patients, patients with multi-organ failure or patients influenced by residual sedatives/opioids; and (3...

  17. Critical care nurses' experiences of nursing mothers in an ICU after complicated childbirth.

    Science.gov (United States)

    Engström, Asa; Lindberg, Inger

    2013-09-01

    Providing nursing care for a critically ill obstetric patient or a patient who has just become a mother after a complicated birth can be a challenging experience for critical care nurses (CCNs). These patients have special needs because of the significant alterations in their physiology and anatomy together with the need to consider such specifics as breastfeeding and mother-child bonding. The aim with this study was to describe CCNs' experience of nursing the new mother and her family after a complicated childbirth. The design of the study was qualitative. Data collection was carried out through focus group discussions with 13 CCNs in three focus groups during spring 2012. The data were subjected to qualitative content analysis. The analysis resulted in the formulation of four categories: the mother and her vital functions are prioritized; not being responsible for the child and the father; an environment unsuited to the new family and collaboration with staff in neonatal and maternity delivery wards. When nursing a mother after a complicated birth the CCNs give her and her vital signs high priority. The fathers of the children or partners of the mothers are expected to take on the responsibility of caring for the newborn child and of being the link with the neonatal ward. It is suggested that education about the needs of new families for nursing care would improve the situation and have clinical implications. Whether the intensive care unit is always the best place in which to provide care for mothers and new families is debatable. © 2013 British Association of Critical Care Nurses.

  18. Validity and reliability of the Thai version of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU

    Directory of Open Access Journals (Sweden)

    Pipanmekaporn T

    2014-05-01

    Full Text Available Tanyong Pipanmekaporn,1 Nahathai Wongpakaran,2 Sirirat Mueankwan,3 Piyawat Dendumrongkul,2 Kaweesak Chittawatanarat,3 Nantiya Khongpheng,3 Nongnut Duangsoy31Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 2Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 3Division of Surgical Critical Care and Trauma, Department of Surgery, Chiang Mai University Hospital, Chiang Mai, ThailandPurpose: The purpose of this study was to determine the validity and reliability of the Thai version of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU, when compared to the diagnoses made by delirium experts.Patients and methods: This was a cross-sectional study conducted in both surgical intensive care and subintensive care units in Thailand between February–June 2011. Seventy patients aged 60 years or older who had been admitted to the units were enrolled into the study within the first 48 hours of admission. Each patient was randomly assessed as to whether they had delirium by a nurse using the Thai version of the CAM-ICU algorithm (Thai CAM-ICU or by a delirium expert using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision.Results: The prevalence of delirium was found to be 18.6% (n=13 by the delirium experts. The sensitivity of the Thai CAM-ICU’s algorithms was found to be 92.3% (95% confidence interval [CI] =64.0%-99.8%, while the specificity was 94.7% (95% CI =85.4%-98.9%. The instrument displayed good interrater reliability (Cohen’s κ=0.81; 95% CI =0.64-0.99. The time taken to complete the Thai CAM-ICU was 1 minute (interquatile range, 1-2 minutes.Conclusion: The Thai CAM-ICU demonstrated good validity, reliability, and ease of use when diagnosing delirium in a surgical intensive care unit setting. The use of this diagnostic tool should be encouraged for daily, routine use, so as to promote the early detection

  19. Relationship of nursing workload with the severity and outcome of the patients in the ICU

    Directory of Open Access Journals (Sweden)

    Nikolaos Stoufis

    2011-07-01

    Full Text Available The development of monitoring and measurement of nursing workload is constant and necessary not only to document the quality of health services but also to increase job satisfaction of nurses in order to reduce stress and burnout. PURPOSE: The purpose of? This review is to illustrate the complex role that nurses play in today's environment of care through the promotion of associations of nursing workload on the severity and outcome of patients in the ICU. MATERIAL AND METHOD: It became an international literature review through an internationally recognized search engine (pubmed, scopus, Mdconsult to highlight science-based views. RESULTS: The literature review highlights the efforts being made internationally in developing methods for assessing the quality of nursing care that is commonly accepted by both the nurse and the rest of the scientific community. CONCLUSION: Modern theories approaching nursing job considering all levels identify a health care system that both matters of organization and management structure of a service and issues related to clinical severity of hospitalized patients and the needs arising from it.

  20. Extent and application of ICU diaries in Germany in 2014

    DEFF Research Database (Denmark)

    Nydahl, Peter; Knueck, Dirk; Egerod, Ingrid

    2015-01-01

    -structured key-informant telephone-interviews on the application of ICU diaries. RESULTS: According to the survey, 8 out of 152 ICUs in the two federal states of Baden-Württemberg and Schleswig-Holstein had implemented ICU diaries and another six were planning implementation. Another 35 ICUs in other areas...... of Germany had implemented diaries and three units were planning to do so. Interviews were conducted with nurses at 14 selected ICUs. Informants reported successful adaption of the diary concept to their culture, but variability in application. No units were identified where all nursing staff participated...... in keeping ICU diaries. CONCLUSION: Six years after the introduction of ICU diaries, ICU nurses in Germany are becoming familiar with the concept. Nursing shortage and bureaucratic challenges have impeded the process of implementation, but the adaption of ICU diaries to German conditions appears...

  1. Sensitivity and specificity of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC) for detecting post-cardiac surgery delirium: A single-center study in Japan.

    Science.gov (United States)

    Nishimura, Katsuji; Yokoyama, Kanako; Yamauchi, Noriko; Koizumi, Masako; Harasawa, Nozomi; Yasuda, Taeko; Mimura, Chizuru; Igita, Hazuki; Suzuki, Eriko; Uchiide, Yoko; Seino, Yusuke; Nomura, Minoru; Yamazaki, Kenji; Ishigooka, Jun

    2016-01-01

    To compare the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC) for detecting post-cardiac surgery delirium. These tools have not been tested in a specialized cardio-surgical ICU. Sensitivities and specificities of each tool were assessed in a cardio-surgical ICU in Japan by two trained nurses independently. Results were compared with delirium diagnosed by psychiatrists using the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision. There were 110 daily, paired assessments in 31 patients. The CAM-ICU showed 38% sensitivity and 100% specificity for both nurses. All 20 false-negative cases resulted from high scores in the auditory attention screening in CAM-ICU. The ICDSC showed 97% and 94% sensitivity, and 97% and 91% specificity for the two nurses (cutoff ≥4). In a Japanese cardio-surgical ICU, the ICDSC had a higher sensitivity than the CAM-ICU. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Using Gamification Combined with Indoor Location to Improve Nurses' Hand Hygiene Compliance in an ICU Ward.

    Science.gov (United States)

    Lapão, Luís Velez; Marques, Rita; Gregório, João; Pinheiro, Fernando; Póvoa, Pedro; Mira da Silva, Miguel

    2016-01-01

    Healthcare acquired infections are among the biggest unsolved problems in healthcare, implying an increasing number of deaths, extra-days of hospital stay and hospital costs. Performing hand hygiene is a simple and inexpensive prevention measure, but healthcare workers compliance with it is still far from optimal. Recognized hurdles are lack of time, forgetfulness, wrong technique and lack of motivation. This study aims at exploring gamification to promote nurses' HH compliance self-awareness and action. Real-time data collected from an indoor location system will provide feedback information to a group of nurses working in an ICU ward. In this paper both the research's motivation and methods is presented, along with the first round of results and its discussion.

  3. ICU综合征的护理%Nursing of ICU syndrome

    Institute of Scientific and Technical Information of China (English)

    李丽萍

    2014-01-01

    It sums up the nursing experience of 11 cases of patients who associated ICU syndrome. Including health education and communication, environmental care, emotional care, basic nursing care and medication care, and to observe effectiveness. This study suggests that comprehensive care measures with sedation can effectively treat ICU syndrome and effectively prevent the occurrence of various adverse events and complications.%总结了对11例发生ICU综合征的患者进行镇静治疗和综合护理的体会。主要包括宣教与沟通、环境护理、情绪护理、基础护理和用药护理,并观察有效性。认为综合护理措施配合镇静治疗能有效治疗ICU综合征,有效防止各种不良事件和并发症的发生。

  4. Nurses empathy and family needs in the intensive care units.

    Science.gov (United States)

    Moghaddasian, Sima; Lak Dizaji, Sima; Mahmoudi, Mokhtar

    2013-09-01

    The patients' families in intensive care units (ICUs) experience excessive stress which may disrupt their performance in daily life. Empathy is basic to the nursing role and has been found to be associated with improved patient outcomes and greater satisfaction with care in patient and his/her family. However, few studies have investigated the nursing empathy with ICU patients. This study aimed to assess nursing empathy and its relationship with the needs, from the perspective of families of patients in ICU. In this cross-sectional study, 418 subjects were selected among families of patients admitted to ICUs in Tabriz, Iran, by convenience sampling, from May to August 2012. Data were collected through Barrett-Lennard Relationship inventory (BLRI) empathy scale and Critical Care Family Needs Intervention (CCFNI) inventories and were analyzed using descriptive and inferential statistical tests. Findings showed that most of the nurses had high level of empathy to the patients (38.8%). There was also statistically significant relationship between nurses' empathy and needs of patients' families (p < 0.001). In this study we found that by increasing the nurse's empathy skills, we would be able to improve providing family needs. Through empathic communication, nurses can encourage family members to participate in planning for the care of their patients. However, further studies are necessary to confirm the results.

  5. ICU护士对ICU谵妄认知的调查分析%Nurses' perceptions towards delirium in ICU

    Institute of Scientific and Technical Information of China (English)

    胥利; 赵庆华; 刘丽萍; 肖明朝; 谢微波

    2012-01-01

    目的 了解重庆市主城区5所三级甲等综合医院ICU护士ICU谵妄认知、知识需求及知识来源.方法 采用自行设计的问卷对186名ICU护士进行调查.结果对 ICU谵妄综合知识“十分清楚”的护士占6.5%,53.2%的护士认为“在校学习”是其获得ICU谵妄知识的主要来源,26.9%的护士接受过入职后相关岗位能力需求培训,7.3%的护士经常主动学习ICU谵妄知识.100%的调查对象认为曾在校学习的知识远远不能满足临床需要.结论 重庆市主城区5所三级甲等综合医院ICU护士ICU谵妄知识水平较低,不能满足临床需要.可能与护理人员的ICU谵妄知识主要来源于学校教育有关,建议在学校课程设置和后续培训中增加ICU谵妄知识的内容,提高工作能力、专业水平,以提高ICU患者的安全管理质量.%Objective To investigate nurses' perceptions towards delirium in ICU. Methods Totally 186 ICU nurses in Chongqing were investigated with a self-designed questionnaire. Results Only 6.5 percent of the nurses knew ICU delirium very clear. College education was considered to be their main source of knowledge about ICU delirium in 53.2 percent of the nurses. Only 26.9 percent of the respondents received further training about ICU delirium and 7.3 percent of them learn the related knowledge by themselves. All nurses thought that college education was far enough for clinical practice. Conclusion ICU nurses in Chongqing have less knowledge on ICU delirium. The main source of knowledge about it was college education. It is recommended that more ICU delirium knowledge should be added in the school education and continuing education in order to improve nurses' professional competency and the quality of safety management.

  6. Information technologies and nursing process records: case study at a neonatal ICU

    Directory of Open Access Journals (Sweden)

    Raphael Brandão Pereira

    2016-03-01

    Full Text Available The objective of this study was to analyze the recording of the nursing process, supported by information and communication technologies in both printed and electronic media in the neonatal intensive care scenario. This case study was exclusive, integrated, and conducted between January and April 2014. The study counted on the participation of seven nurses who worked at a neonatal ICU before and after the deployment of new information and communication technologies, which combined electronic and physical (paper support. Data were collected from medical records and a questionnaire answered by the nurses. Simple and percentage frequency in the levels of the nursing process application were used for analysis, as well as the set of intervening factors related to the work organization structure and process. Positive and negative results were seen, as well as intervening factors. The study concluded that the new information and communication technologies delivered in physical materials accounted for the registration of the higher number of records in the data collection and that the registration of the other stages did not show any substantial improvement.

  7. The Development and Evaluation of Delirium Assessment and Nursing Care Decision-Making Assistant Mobile Application for Intensive Care Unit.

    Science.gov (United States)

    Yang, Fangyu; Ji, Meihua; Ding, Shu; Wu, Ying; Chang, Polun; Lin, Chiawei; Yang, Xin

    2016-01-01

    Delirium is a common complication among patients in ICU settings. Although it has been repeatedly confirmed that Confusion Assessment Model for Intensive Care Unit (CAM-ICU), one of the most commonly used ICU delirium assessment tool, is highly accurate in validation studies, it's sensitivity and specificity is relatively low during routine practice among bedside nurses. The aim of this study is to develop a mobile application (app) to detect delirium and to test its reliability and validity both by research nurses and among ICU bedside nurses. The app was programmed with Java and installed on a mobile device with Android system. After completion of reliability and validity testing, the app will be integrated into the existing Hospital Information System in order to automatically retrieve essential information for risk factor identification and formulation of care plan accordingly to prevent or manage ICU delirium.

  8. The clinical utility of the functional status score for the intensive care unit (FSS-ICU) at a long-term acute care hospital: a prospective cohort study.

    Science.gov (United States)

    Thrush, Aaron; Rozek, Melanie; Dekerlegand, Jennifer L

    2012-12-01

    Long-term acute care hospitals (LTACHs) have emerged for patients requiring medical care beyond a short stay. Minimal data have been reported on functional outcomes in this setting. The purposes of this study were: (1) to measure the clinical utility of the Functional Status Score for the Intensive Care Unit (FSS-ICU) in an LTACH setting and (2) to explore the association between FSS-ICU score and discharge setting. Data were obtained from 101 patients (median age=70 years, interquartile range [IQR]=61-78; 39% female, 61% male) who were admitted to an LTACH. Participants were categorized into 1 of 5 groups by discharge setting: (1) home (n=14), (2) inpatient rehabilitation facility (n=26), (3) skilled nursing facility (n=23), (4) long-term care/hospice/expired (n=13), or (5) transferred to a short-stay hospital (n=25). Data were prospectively collected from a 38-bed LTACH in the United States over 8 months beginning in September 2010. Functional status was scored using the FSS-ICU within 4 days of admission and every 2 weeks until discharge. The FSS-ICU consists of 5 categories: rolling, supine-to-sit transfers, unsupported sitting, sit-to-stand transfers, and ambulation. Each category was rated from 0 to 7, with a maximum cumulative FSS-ICU score of 35. Cumulative FSS-ICU scores significantly improved from a median (IQR) of 9 (3-17) to 14 (5-24) at discharge. Median (IQR) cumulative discharge FSS-ICU scores were significantly different among the discharge categories: home=28 (22-32), inpatient rehabilitation facility=21 (15-24), skilled nursing facility=14 (8-21), long-term care/hospice/expired=5 (0-11), and transfer to a short-stay hospital=4 (0-7). Patients receiving therapy at an LTACH demonstrate significant improvements from admission to discharge using the FSS-ICU. This outcome tool discriminates among discharge settings and successfully documents functional improvements of patients in an LTACH setting.

  9. Constructing the story: How nurses work with families regarding withdrawal of aggressive treatment in ICU – A narrative study.

    Science.gov (United States)

    Peden-McAlpine, Cynthia; Liaschenko, Joan; Traudt, Terri; Gilmore-Szott, Eleanor

    2015-07-01

    Specific communication practices used by experienced intensive care nurses who are comfortable working with dying patients and their families in ICU to reach consensus on withdrawal of aggressive treatment and shift to palliative care are lacking in the literature. However, there are seven international qualitative studies relevant to this research. Important themes related to communication were composed of four elements: general communication and relationship building, recognizing the need to transition to palliative care, facilitating palliative care, and providing dignified care through to death. To describe the specific communication practices experienced intensive care nurses' comfortable working with dying patients' use with families to negotiate consensus on withdrawal of aggressive treatment and/or shift to palliative are at end of life. A qualitative narrative study. Purposeful sampling was used to recruit nineteen experienced intensive care nurses. A narrative approach was used for data collection and analysis. Consistent with narrative inquiry the results describe an overall plot: "constructing the story" and five subplots that identify and describe communicative actions relevant to the plot. The five subplots are: (A) organizing and interpreting knowledge of different kinds from different sources; (B) learning who the patient is as a person and putting the medical diagnosis into the biographical life of the patient; (C) helping families see the deteriorating status of the patient; (D) imagining and acting on moral possibilities for end of life care; and (E) facilitating saying goodbye – the end of the story. Findings from this study enrich the understanding of how experienced nurses who are comfortable with dying patients communicate with families as they navigate the difficult path of transitioning from aggressive care to palliative care for their significant other in the intensive care unit. This research provides a beginning language that can

  10. The benefits and challenges of providing nursing student clinical rotations in the intensive care unit.

    Science.gov (United States)

    Swinny, Betsy; Brady, Melanie

    2010-01-01

    The goal of providing a clinical rotation in a basic nursing program is to integrate skills and knowledge from the classroom setting into the clinical practice setting. In the intensive care unit (ICU), nursing students have the ability to learn about the complex health issues of critically ill patients, practice selected technical skills, and develop communication skills. There are both benefits and challenges to having nursing students in the intensive care setting. With preparation, the student is able to immerse in the ICU environment, acquire new knowledge and skills, and participate alongside the nurse caring for critically ill patients. The staff nurse must balance patient care with the added responsibilities of helping the student meet the clinical goals. It is optimal to have faculty that are also intensive care clinically competent and can facilitate the clinical experience. The school, the hospital, and the ICU need to collaborate to provide a positive clinical experience that is safe for the patient. In return, the hospital can recruit student nurses and clinical faculty. Planned with thought and intention, rotations in the ICU can be an ideal clinical setting for upper-level student nurses to learn the role of the registered nurse.

  11. Nurses Empathy and Family Needs in the Intensive Care Units

    Directory of Open Access Journals (Sweden)

    Sima Moghaddasian

    2013-08-01

    Full Text Available Introduction: The patients’ families in intensive care units (ICUs experience excessive stress which may disrupt their performance in daily life. Empathy is basic to the nursing role and has been found to be associated with improved patient outcomes and greater satisfaction with care in patient and his/her family. However, few studies have investigated the nursing empathy with ICU patients. This study aimed to assess nursing empathy and its relationship with the needs, from the perspective of families of patients in ICU.Methods: In this cross-sectional study, 418 subjects were selected among families of patients admitted to ICUs in Tabriz, Iran, by convenience sampling, from May to August 2012. Data were collected through Barrett-Lennard Relationship inventory (BLRI empathy scale and Critical Care Family Needs Intervention (CCFNI inventories and were analyzed using descriptive and inferential statistical tests. Results: Findings showed that most of the nurses had high level of empathy to the patients (38.8%. There was also statistically significant relationship between nurses’ empathy and needs of patients’ families (p < 0.001. Conclusion: In this study we found that by increasing the nurse’s empathy skills, we would be able to improve providing family needs. Through empathic communication, nurses can encourage family members to participate in planning for the care of their patients. However, further studies are necessary to confirm the results.

  12. Transforming a conservative clinical setting: ICU nurses' strategies to improve care for patients' relatives through a participatory action research.

    Science.gov (United States)

    Zaforteza, Concha; Gastaldo, Denise; Moreno, Cristina; Bover, Andreu; Miró, Rosa; Miró, Margalida

    2015-12-01

    This study focuses on change strategies generated through a dialogical-reflexive-participatory process designed to improve the care of families of critically ill patients in an intensive care unit (ICU) using a participatory action research in a tertiary hospital in the Balearic Islands (Spain). Eleven professionals (representatives) participated in 11 discussion groups and five in-depth interviews. They represented the opinions of 49 colleagues (participants). Four main change strategies were created: (i) Institutionally supported practices were confronted to make a shift from professional-centered work to a more inclusive, patient-centered approach; (ii) traditional power relations were challenged to decrease the hierarchical power differences between physicians and nurses; (iii) consensus was built about the need to move from an individual to a collective position in relation to change; and (iv) consensus was built about the need to develop a critical attitude toward the conservative nature of the unit. The strategies proposed were both transgressive and conservative; however, when compared with the initial situation, they enhanced the care offered to patients' relatives and patient safety. Transforming conservative settings requires capacity to negotiate positions and potential outcomes. However, when individual critical capacities are articulated with a new approach to micropolitics, transformative proposals can be implemented and sustained.

  13. Nurses' perceptions of standardised assessment and prevention of complications in an ICU.

    Science.gov (United States)

    Soh, Kim Lam; Davidson, Patricia M; Leslie, Gavin; DiGiacomo, Michelle; Soh, Kim Geok

    2013-03-01

    To describe nurses' perceptions of evidence-based recommendations to prevent complications in a Malaysian intensive care unit. Ventilator-associated pneumonia, catheter-related blood stream infection and pressure ulcer are three frequent adverse events in the intensive care unit. Implementing evidenced-based practice is critical in prevention of these complications. A qualitative focus group study. Focus groups were conducted with nurses in the intensive care unit of a regional hospital in Malaysia following evidence-based interventions. Focus group transcripts were analysed using the method of thematic analyses. Thirty-four nurses participated in eight focus groups. The main themes derived from the interviews: (1) nurses' knowledge impacts on the change process; (2) initial resistance, ambivalence and movement to acceptance; and (3) hierarchical organisational structure can hinder the change process. Enhancing nurses' knowledge and attitudes of evidence-based practice, providing them with tools to monitor their clinical practice, and empowering them to change practice are likely to be important in influencing clinical outcomes. Increasing the emphasis on evidence-based practice in nursing curricula and engaging in cultural change processes in the workplace are necessary to improve clinical outcomes. These findings provide valuable information for implementing clinical practice improvement interventions. © 2012 Blackwell Publishing Ltd.

  14. Clinical Alarms in Intensive Care Units: Perceived Obstacles of Alarm Management and Alarm Fatigue in Nurses.

    Science.gov (United States)

    Cho, Ok Min; Kim, Hwasoon; Lee, Young Whee; Cho, Insook

    2016-01-01

    The purpose of this descriptive study was to investigate the current situation of clinical alarms in intensive care unit (ICU), nurses' recognition of and fatigue in relation to clinical alarms, and obstacles in alarm management. Subjects were ICU nurses and devices from 48 critically ill patient cases. Data were collected through direct observation of alarm occurrence and questionnaires that were completed by the ICU nurses. The observation time unit was one hour block. One bed out of 56 ICU beds was randomly assigned to each observation time unit. Overall 2,184 clinical alarms were counted for 48 hours of observation, and 45.5 clinical alarms occurred per hour per subject. Of these, 1,394 alarms (63.8%) were categorized as false alarms. The alarm fatigue score was 24.3 ± 4.0 out of 35. The highest scoring item was "always get bothered due to clinical alarms". The highest scoring item in obstacles was "frequent false alarms, which lead to reduced attention or response to alarms". Nurses reported that they felt some fatigue due to clinical alarms, and false alarms were also obstacles to proper management. An appropriate hospital policy should be developed to reduce false alarms and nurses' alarm fatigue.

  15. Scarcity in the intensive care unit: principles of justice for rationing ICU beds.

    Science.gov (United States)

    Swenson, M D

    1992-05-01

    Difficult dilemmas arise when resources become scarce in intensive care units (ICUs). When there are fewer beds available than patients who need them, how are those beds to be distributed? In this report, I discuss such rationing dilemmas from the context of John Rawls' theory of justice. Principles of justice can be chosen by clinicians and used to set priorities in the distribution of scarce ICU beds. These principles consist of a ranking of patients based on available prognostic data. Such a ranking would be the most fair way of distributing scarce ICU beds within a Rawlsian conception of justice. It is a ranking that would be chosen by the patients themselves, were they able to consider the matter from a rational and impartial perspective.

  16. Influence of emotional intelligence level of ICU nurses on innovative behavior%ICU 护士情绪智力水平对创新行为的影响

    Institute of Scientific and Technical Information of China (English)

    魏柏玲

    2016-01-01

    [目的]了解 ICU 护士情绪智力水平对创新行为的影响情况。[方法]随机抽取哈尔滨市4所三级甲等医院的300名 ICU 护士为研究对象,采用一般资料、情绪智力量表和创新行为量表对 ICU 护士进行调查。[结果]ICU 护士的情绪智力评分为(3.94±0.53)分,创新行为评分为(3.99±0.48)分,均处于中等水平;ICU 护士的学历、职称及情绪智力的两个维度(自我情绪运用、自我情绪调整)为创新行为的主要影响因素(P <0.05)。[结论]ICU 护士的情绪智力水平越高,其创新能力也越强,有利于提高护理服务质量。%Objective:To know about the influence situation of the emotional intelligence level of ICU nurses on innovative behaviors.Methods:A total of 300 ICU nurses in 4 third grade A hospitals in Harbin city were ran-domly selected as the research objects,then they received the investigation by using the general information,e-motional intelligence scale and innovative behavior scale.Results:The Emotional Intelligence Score of ICU nur-ses was 3.94±0.53,innovative behavior score was 3.99±0.48,which were all in the medium level,and the ICU nurses’education background,professional titles and two dimensions of emotional intelligence(self emotional use,self emotional adjustment)were the main influencing factors on innovative behaviors.Conclusion:The higher the emotional intelligence level of ICU nurses was,the stronger their innovation ability was,which was beneficial to improve the quality of nursing service.

  17. Feasibility and acceptability of a resilience training program for intensive care unit nurses.

    Science.gov (United States)

    Mealer, Meredith; Conrad, David; Evans, John; Jooste, Karen; Solyntjes, Janet; Rothbaum, Barbara; Moss, Marc

    2014-11-01

    The critical nursing shortage is particularly apparent in specialty areas such as intensive care units (ICUs). Some nurses develop resilient coping strategies and adapt to stressful work experiences, mitigating the development of common maladaptive psychological symptoms. To determine if a multimodal resilience training program for ICU nurses was feasible to perform and acceptable to the study participants. In a randomized and controlled 12-week intervention study, treatment and control groups completed demographic questions and measures of resilience, anxiety, depression, posttraumatic stress disorder (PTSD), and burnout syndrome before and after the intervention. The intervention included a 2-day educational workshop, written exposure sessions, event-triggered counseling sessions, mindfulness-based stress reduction exercises, and a protocolized aerobic exercise regimen. Nurses in the intervention arm also completed satisfaction surveys for each component of the intervention. This mulitmodal resilience training program was feasible to conduct and acceptable to ICU nurses. Both nurses randomized to the treatment group and nurses randomized to the control group showed a significant decrease in PTSD symptom score after the intervention. A multifaceted resilience training program for ICU nurses was both feasible and acceptable. A sufficiently powered, randomized clinical trial is needed to assess the effect of the intervention on improving individuals' level of resilience and improving psychological outcomes such as symptoms of anxiety, depression, burnout syndrome, and PTSD. ©2014 American Association of Critical-Care Nurses.

  18. Nursing workload as a risk factor for healthcare associated infections in ICU: a prospective study.

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    Renata M Daud-Gallotti

    Full Text Available INTRODUCTION: Nurse understaffing is frequently hypothesized as a potential risk factor for healthcare-associated infections (HAI. This study aimed to evaluate the role of nursing workload in the occurrence of HAI, using Nursing Activities Score (NAS. METHODS: This prospective cohort study enrolled all patients admitted to 3 Medical ICUs and one step-down unit during 3 months (2009. Patients were followed-up until HAI, discharge or death. Information was obtained from direct daily observation of medical and nursing rounds, chart review and monitoring of laboratory system. Nursing workload was determined using NAS. Non-compliance to the nurses' patient care plans (NPC was identified. Demographic data, clinical severity, invasive procedures, hospital interventions, and the occurrence of other adverse events were also recorded. Patients who developed HAI were compared with those who did not. RESULTS: 195 patients were included and 43 (22% developed HAI: 16 pneumonia, 12 urinary-tract, 8 bloodstream, 2 surgical site, 2 other respiratory infections and 3 other. Average NAS and average proportion of non compliance with NPC were significantly higher in HAI patients. They were also more likely to suffer other adverse events. Only excessive nursing workload (OR: 11.41; p: 0.019 and severity of patient's clinical condition (OR: 1.13; p: 0.015 remained as risk factors to HAI. CONCLUSIONS: Excessive nursing workload was the main risk factor for HAI, when evaluated together with other invasive devices except mechanical ventilation. To our knowledge, this study is the first to evaluate prospectively the nursing workload as a potential risk factor for HAI, using NAS.

  19. The Occupational Therapy in adult Intensive Care Unit (ICU and team perceptions

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    Tatiana Barbieri Bombarda

    2016-10-01

    Full Text Available Introduction: The National Health Surveillance Agency (ANVISA, on 24 February 2010, adopted resolution number 7, which makes mandatory the presence of an occupational therapist as an active member of the Intensive Care Unit professional team. It is believed that the ICU scope is a small professional practice in Occupational Therapy due to the small number of publications in the literature. Objective: To describe the experience and actions developed by occupational therapy in an adult ICU and report the staff awareness reagrding this practice at a state hospital, located in the state of São Paulo. Method: This is an experience report in which we conducted document analysis to obtain data regarding actions taken by occupational therapy, as well as the application of a questionnaire with the team to understand the professionals perceptions regarding the care provided. The data obtained was processed through thematic content analysis. Results: We identified that the occupational therapy intervention transited by functional aspects and support for coping, with the recognition of these actions by the team. Conclusion: The described action consists of practices derived from the occupational therapy insertion process in an adult ICU and meets the desire to encourage the research development in this area for the promotion of debates to promote technical improvement of the profession in the care of critically ill patients.

  20. ICU护士常规谵妄评估的感受与困惑%Qualitative Research on Routine Delirium Assessment of ICU Nurses

    Institute of Scientific and Technical Information of China (English)

    裴娜; 宋瑰琦

    2016-01-01

    目的:探讨ICU护士应用ICU意识模糊评估法进行常规谵妄评估应用后的真实体验与感受,评价其效果和可行性,为临床常规谵妄评估应用做指导。方法选择安徽省某三级甲等医院ICU护士12名,应用ICU意识模糊评估法进行了3个月的常规谵妄评估后,采取面对面、半结构式深度访谈,用Colaizzi法对采集的资料进行分析。结果受访者应用ICU意识模糊评估法常规评估谵妄3个月后,在ICU谵妄评估的认知、态度、行为3方面均有所改善,对ICU谵妄常规评估的可行性予以肯定,但是在应用过程中存在着一定的问题和困难,主要是医、护、患三者间的合作困难,评估工具存在一定的缺陷,护士评估依从性不高。结论 ICU意识模糊评估法在ICU常规评估谵妄应用中起到一定的优势作用,但是在常规应用过程中存在着问题,有待解决。%Objective To explore the experience and feelings of ICU nurses routinely assessing delirium by CAM-ICU (Confusion Assessment Method for the Intensive Care Unit), to evaluate its effectiveness and feasibility, and provide guidance for clinical routine delirium assessment. Methods Twelve ICU nurses who worked in a third-level first-class hospital of Anhui were invited to participated in face-to-face, semi-structured, in-depth interviews after three months of routine assessment of delirium by CAM-ICU. The dates were analyzed by Colaizzi method. Results After three-month routine assessment of delirium by CAM-ICU, responders had improvement in knowledge, attitude and practice of assessment of delirium. They affirmed the feasibility of ICU routine delirium assessment. However, poor cooperation among doctors, nurses and patients, defects in assessment tool and poor assessment compliance of patients were the obstacles for smooth assessment of delirium. Conclusion Routine delirium assessment in ICU by CAM-ICU has some advantages, but there are

  1. Profile of Intravenous Admixture Compatibility in the Intensive Care Unit (ICU Patients

    Directory of Open Access Journals (Sweden)

    Sharly Dwijayanti

    2016-06-01

    Full Text Available which may directly impact to the outcome of treatment to the Intensive Care Unit (ICU patients. The objective of this study was to identify the profile of compatibility and incompatibility among IV admixtures given to the ICU patients. This observational research was conducted prospectively to the patients admitted in the ICU at a private hospital in Surabaya from October–December 2014. In this research, compatibility data of IV drug and its solution was compared with drug brochure and Handbook on Injectable Drugs 17th ed (2013 as references to analyze the compatibility of IV admixtures. The admixture between IV drug and its solvent was classified as compatible, incompatible, no information (NI, not applicable (NA, and not clear (NC, using a specific criteria. There were 1.186 IV drug‑solvent admixtures observed in 39 ICU patients. There were no IV drug-solvent admixtures classified as incompatible in both adult and child patients. Most of IV drugs were admixed with compatible solvents (adults: 72.31%; children: 69.84%. However, according to two of IV drugs compatibility references used in this research, there were some IV drug-solvent admixtures with unknown information about its compatibility that were classified as NI (adults: 19.68%; children: 30.16%. There were a few of IV drug-solvent admixtures classified as NA and NC, of 7.48% and 0.53%, respectively. The lack of information related to compatibility and stability of the IV admixtures emphasize the importance to continually monitor patients’ condition and drug concentration.

  2. Basic Competence of Intensive Care Unit Nurses: Cross-Sectional Survey Study

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    Riitta-Liisa Lakanmaa

    2015-01-01

    Full Text Available Critical care patients benefit from the attention of nursing personnel with a high competence level. The aim of the study was to describe and evaluate the self-assessed basic competence of intensive care unit nurses and related factors. A cross-sectional survey design was used. A basic competence scale (Intensive and Critical Care Nursing Competence Scale version 1, Likert scale 1–5, 1 = poor and 5 = excellent was employed among Finnish intensive care unit nurses (n=431. Intensive care unit nurses’ self-assessed basic competence was good (mean 4.19, SD 0.40. The attitude and value base of basic competence was excellent whereas experience base was the poorest compared to the knowledge base and skill base of intensive and critical care nursing. The strongest factor explaining nurses’ basic competence was their experience of autonomy in nursing care (F value 60.85, β 0.11, SE 0.01, and P≤0.0001. Clinical competence was self-rated as good. Nurses gave their highest competence self-ratings for ICU patient care according to the principles of nursing care. The ICU nurses also self-rated their professional competence as good. Collaboration was self-rated as the best competence. In basic and continuing education and professional self-development discussions it is meaningful to consider and find solutions for how to improve nurses’ experienced autonomy in nursing.

  3. ICU专科护士护理带教模式的探讨%Nursing Teaching Mode of ICU Professional Nurse

    Institute of Scientific and Technical Information of China (English)

    程晓红

    2011-01-01

    ICU是现代化医院中收治急重症及多脏器衰竭病人的特殊专科,对专业护理人员的素质和经验要求更加严格.文章结合实际工作对ICU专科护士的培训带教模式进行简单探讨和分析.%ICU is the special specialist accepting the patients with critically ill and organ failure, so it has more stringent requirements for the quality and experience of professional nursing. In combination with the actual work, the paper discusses the nursing teaching mode of ICU professional nurse.

  4. Managing ICU throughput and understanding ICU census.

    Science.gov (United States)

    Howell, Michael D

    2011-12-01

    Traditionally, hospitals have coped with chronically high ICU census by building more ICU beds, but this strategy is unlikely to be tenable under future financial models. Therefore, ICUs need additional tools to manage census, inflow, and throughput. Higher ICU census, without compensatory surges in nursing capacity, is associated with several adverse effects on patients and providers, but its relationship to mortality is uncertain. Providers also discharge patients more aggressively during times of high census. Little's Law (L = λ W), a cornerstone of queuing theory, provides an eminently practical basis for managing ICU census and throughput. One target for improving throughput is minimizing process steps that are without value to the patient, e.g., waiting for a bed at ICU discharge. Larger gains in ICU throughput can be found in ICU quality improvement. For example, spontaneous breathing trials, daily wake-ups, and early physical/occupational therapy programmes are all likely to improve throughput by reducing ICU length of stay. The magnitude of these interventions' effects on ICU census can be startling. ICUs should actively manage throughput and census. Operations management tools such as Little's Law can provide practical guidance about the relationship between census, throughput, and patient demand. Standard ICU quality improvement techniques can meaningfully affect both ICU census and throughput.

  5. Professional competences of nurse to work in Intensive Care Units: an integrative review.

    Science.gov (United States)

    Camelo, Silvia Helena Henriques

    2012-01-01

    This study aimed to identify and analyze nurses' competences to work at Intensive Care Units-ICU. An integrative review method was used, and data were collected in LILACS, SciELO and BDENF, from August to October 2010. Ten articles were identified, published in the last 12 years. Data grouping permitted the construction of thematic units related to nurses' competences: nursing care management, high-complexity nursing care delivery, decision making, leadership, communication, continuing/permanent education, human resource management, material resource management. The professional competences identified can support the outline of guidelines to constitute the profile of nursing working in intensive care units and drive/mobilize the improvement of nursing care practices.

  6. Profit and loss analysis for an intensive care unit (ICU in Japan: a tool for strategic management

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    Abe Toshikazu

    2006-01-01

    Full Text Available Abstract Background Accurate cost estimate and a profit and loss analysis are necessary for health care practice. We performed an actual financial analysis for an intensive care unit (ICU of a university hospital in Japan, and tried to discuss the health care policy and resource allocation decisions that have an impact on critical intensive care. Methods The costs were estimated by a department level activity based costing method, and the profit and loss analysis was based on a break-even point analysis. The data used included the monthly number of patients, the revenue, and the direct and indirect costs of the ICU in 2003. Results The results of this analysis showed that the total costs of US$ 2,678,052 of the ICU were mainly incurred due to direct costs of 88.8%. On the other hand, the actual annual total patient days in the ICU were 1,549 which resulted in revenues of US$ 2,295,044. However, it was determined that the ICU required at least 1,986 patient days within one fiscal year based on a break-even point analysis. As a result, an annual deficit of US$ 383,008 has occurred in the ICU. Conclusion These methods are useful for determining the profits or losses for the ICU practice, and how to evaluate and to improve it. In this study, the results indicate that most ICUs in Japanese hospitals may not be profitable at the present time. As a result, in order to increase the income to make up for this deficit, an increase of 437 patient days in the ICU in one fiscal year is needed, and the number of patients admitted to the ICU should thus be increased without increasing the number of beds or staff members. Increasing the number of patients referred from cooperating hospitals and clinics therefore appears to be the best strategy for achieving these goals.

  7. Analysis of death anxiety levels in nursing staff of critical care units

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    Mª Cristina Pascual Fernández

    2011-01-01

    Full Text Available When the patients are in the end-of-life, the cares would focus to favor a good death, for that reason the nursing staff must know how to integrate the death like a part of the life, being avoided that produces anxiety to them before the possibility of taking part its own fears to the death. The core of nursing staff in intensive care units is to maintain life of their patients, reason why the end-of life in them is not easy or natural.Objective: Evaluate the death anxiety levels in intensive care nursing staff.Material and method: An observational study was conducted descriptive cross hospital adult and Paediatric ICU General University Gregorio Marañón Hospital, through survey to nurses and auxiliary nurses of those units.The anxiety inventory was used to Death (Death Anxiety Inventory [DAI] for the assessment of anxiety before death. Outcomes: Paediatric ICU nurses have higher levels of anxiety that the adult ICU as well as the less experienced professionals and those declared not feel trained in the subject.Conclusions: Experience and the training are key elements that help professionals face to death, from management we must ensure that patients in stage terminal are served by professionals with this profile.

  8. The Inter-Rater Reliability of Simplified Acute Physiology Score 3 (SAPS3 among Intensive Care Unit Nurses

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    Jun Hyun Kim

    Full Text Available Background: Simplified acute physiology score 3 (SAPS3 was developed in 2005 to evaluate intensive care unit (ICU performance and to predict patient mortality or disease severity. The score is usually calculated by doctors, but it requires substantial human resources. And many nurse-lead studies use this scoring system. In the present study, we examined the inter-rater reliability of SAPS3 among nurses in an ICU. Methods: Five ICU nurses who worked in an ICU for a mean length of 7.8 years were educated for 2 hours about SAPS3 score and its components. Each nurse scored 26 patients, and the intraclass correlation coefficient (ICC of the total scores and each subset were evaluated. Results: The ICC (95% confidence interval of SAPS3 score was 0.89 (0.82-0.95, that of subset I was 0.90 (0.82-0.95, subset II was 0.54 (0.35-0.73, and subset III was 0.95 (0.91-0.97. The ICC of predicted mortality was 0.91 (0.85-0.96. Conclusions: The ICC of SAPS3 score and predicted mortality among ICU nurses were reliable. According to these ICC values, SAPS3 score is a reliable scale to be used by nurses. The ICC of subset II was lower than those of the other subsets, suggesting that education of SAPS3 should focus on the definition of each subset II component.

  9. Delirium and Sedation in the Intensive Care Unit (ICU): survey of behaviors and attitudes of 1,384 healthcare professionals

    Science.gov (United States)

    Patel, RP; Gambrell, M; Speroff, T; Scott, TA; Pun, BT; Okahashi, J; Strength, C; Pandharipande, P; Girard, TD; Burgess, H; Dittus, RS; Bernard, GR; Ely, EW

    2013-01-01

    Objective A 2001 survey found that most healthcare professionals considered ICU delirium as a serious problem, but only 16% used a validated delirium screening tool. Our objective was to assess beliefs and practices regarding ICU delirium and sedation management. Design and Setting Between October 2006 and May 2007, a survey was distributed to ICU practitioners in 41 North American hospitals, 7 international critical care meetings and courses, and the American Thoracic Society email database Study Participants A convenience sample of 1,384 health care professionals including 970 physicians, 322 nurses, 23 respiratory care practitioners, 26 pharmacists, 18 nurse practitioners and physicians’ assistants, and 25 others. Results A majority [59% (766/1300)] estimated that over 1 in 4 adult mechanically ventilated patients experience delirium. Over half [59% (774/1302)] screen for delirium, with 33% of those respondents (258/774) using a specific screening tool. A majority of respondents use a sedation protocol, but 29% (396/1355) still do not. A majority (76%, 990/1309) has a written policy on spontaneous awakening trials (SATs), but the minority of respondents (44%, 446/1019) practice SATs on more than half of ICU days. Conclusions Delirium is considered a serious problem by a majority of healthcare professionals, and the percent of practitioners using a specific screening tool has increased since the last published survey data. While most respondents have adopted specific sedation protocols and have an approved approach to stopping sedation daily, few report even modest compliance with daily cessation of sedation. PMID:19237884

  10. Intensive Care Unit Acquired Weakness (ICU-AW: a brief and practical review

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    Daniel Agustin Godoy

    2015-01-01

    Full Text Available Intensive care unit-acquired weakness (ICU-AW is an increasingly complication of survivors of critical illness. It should be suspected in the presence of  a patient with a flaccid  tetraparesis or tetraplegia with hyporeflexia or absent deep tendon reflexes and difficult to weaning from mechanical ventilation in the absence of different diagnoses. Important risk factors are age, sepsis, illness duration and severity, some drugs (neuromuscular blockers, steroids. Electrophysiological studies have shown an axonal damage of involved peripheral nerves (critical illness polyneuropathy. However, muscle can also be primitively affected (critical illness myopathy leading to ICUAW with inconstant myopathic damage patterns in electromyographic studies. Mixed forms can are present (critical illness polyneuromyopathy. Although the pathophysiology remains obscure, the hypothesis of an acquired channelopathy is substantial.Electroneuromyography is crucial for diagnosis. Muscular and nerve biopsy are necessary for diagnosis confirmation. Aggressive treatment of baseline disease, prevention, through avoiding or minimizing precipitating factors, strict glycemic control, and early rehabilitation combining mobilization with physiotherapy and muscle electrical muscle stimulation, are the keys to improving recovery of the affected individuals. This narrative review highlights the current literature regarding the etiology and diagnosis of ICU-AW.http://dx.doi.org/10.7175/rhc.v6i1.1037

  11. Informational support to family members of intensive care unit patients: the perspectives of families and nurses.

    Science.gov (United States)

    Gaeeni, Mina; Farahani, Mansoureh A; Seyedfatemi, Naima; Mohammadi, Nooredin

    2014-09-25

    The receiving information about the patients hospitalized in the intensive care unit is classified among the most important needs of the family members of such patients. Meeting the informational needs of families is a major goal for intensive care workers. Delivering honest, intelligible and effective information raises specific challenges in the stressful setting of the intensive care unit (ICU). The aim of this qualitative study was to explain perspectives of families of Intensive Care Unit patients and nurses about informational support. Using a conventional content analysis approach, semi-structured interviews were conducted with participants to explore their perspectives of providing informational support to families of ICU patients. A purposeful sampling method was used to recruit nineteen family members of thirteen patients hospitalized in the ICU and twelve nurses from three teaching hospitals. In general, 31 persons participated in this study. Data collection continued to achieve data saturation. A conventional content analysis of the data produced three categories and seven sub-categories. The three main categories were as followed, a) providing information, b) handling information and c) using information. Providing information had three sub-categories consisting of "receiving admission news", "receiving truthful and complete information" and receiving general information. Handling information had two sub-categories consisting "keeping information" and "gradual revelation". Lastly, using information has two sub-categories consisting of "support of patient" and "support of family members". The results of this study revealed perspectives of families of Intensive Care Unit patients and nurses about informational support. It also determines the nurses' need to know more about the influence of their supportive role on family's ICU patients informing. In addition, the results of present study can be used as a basis for further studies and for offering

  12. Rifampin use in acute community-acquired meningitis in intensive care units: the French retrospective cohort ACAM-ICU study.

    Science.gov (United States)

    Bretonnière, Cédric; Jozwiak, Mathieu; Girault, Christophe; Beuret, Pascal; Trouillet, Jean-Louis; Anguel, Nadia; Caillon, Jocelyne; Potel, Gilles; Villers, Daniel; Boutoille, David; Guitton, Christophe

    2015-08-26

    Bacterial meningitis among critically ill adult patients remains associated with both high mortality and frequent, persistent disability. Vancomycin was added to treatment with a third-generation cephalosporin as recommended by French national guidelines. Because animal model studies had suggested interest in the use of rifampin for treatment of bacterial meningitis, and after the introduction of early corticosteroid therapy (in 2002), there was a trend toward increasing rifampin use for intensive care unit (ICU) patients. The aim of this article is to report on this practice. Five ICUs participated in the study. Baseline characteristics and treatment data were retrospectively collected from charts of patients admitted with a diagnosis of acute bacterial meningitis during a 5-year period (2004-2008). The ICU mortality was the main outcome measure; Glasgow Outcome Scale and 3-month mortality were also assessed. One hundred fifty-seven patients were included. Streptococcus pneumoniae and Neisseria meningitidis were the most prevalent causative microorganisms. The ICU mortality rate was 15%. High doses of a cephalosporin were the most prevalent initial antimicrobial treatment. The delay between admission and administration of the first antibiotic dose was correlated with ICU mortality. Rifampin was used with a cephalosporin for 32 patients (ranging from 8% of the cohort for 2004 to 30% in 2008). Administration of rifampin within the first 24 h of hospitalization could be associated with a lower ICU survival. Statistical association between such an early rifampin treatment and ICU mortality reached significance only for patients with pneumococcal meningitis (p=0.031) in univariate analysis, but not in the logistic model. We report on the role of rifampin use for patients with community-acquired meningitis, and the results of this study suggest that this practice may be associated with lower mortality in the ICU. Nevertheless, the only independent predictors of ICU

  13. Application of nursing risk management in ICU nursing supervision%护理风险管理在ICU护理管理中的应用

    Institute of Scientific and Technical Information of China (English)

    武淑敏

    2012-01-01

    Objective To investigate the application effect of the nursing risk management in ICU nursing supervision. Methods The nursing risk management was used in the nursing supervision, including 3 level control of nursing quality, identification of risk factors in the nursing links, establishment of non-punishable nursing flaws reporting system, enhancement of nursing records management and training of theoretical knowledge and operative techniques. The nursing quality and the satisfaction level were compared between pre- and post-enforcement of nursing risk management. Results After the enforcement of nursing venture management, the proficiency of nursing operation, the standard of the nursing document writing, service attitude, communication ability, responsibility, and emergency handling ability were significantly better than those before the enforcement (P < 0.05). Conclusion The nursing risk management in the ICU nursing supervision may improve the quality of care and the patients' degree of satisfaction and decrease the incidences of medical risks and accidents.%目的 探讨护理风险管理在ICU护理管理中的应用效果,以提高护理质量和病人满意度.方法 将风险管理方法应用于护理管理中,内容包括落实3级护理质量控制,识别护理流程潜在危险因素,建立非惩罚性护理不良事件报告制度和分享制度,加强护理记录的管理和加强理论知识和操作技能培训.比较实施护理风险管理前后病房护理质量和病人满意度的差异.结果 实施护理风险管理后,护士操作熟练程度、护理文书书写规范、服务态度、沟通能力、责任心、应急能力6个方面和病人满意度均明显优于实施前,实施管理前后比较,均P< 0.05,差异具有统计学意义.结论 在ICU护理管理中应用风险管理可提高护理质量,提高病人对护理工作的满意度,有效地降低医疗风险和事故的发生.

  14. Hospital-Level Changes in Adult ICU Bed Supply in the United States.

    Science.gov (United States)

    Wallace, David J; Seymour, Christopher W; Kahn, Jeremy M

    2017-01-01

    Although the number of intensive care beds in the United States is increasing, little is known about the hospitals responsible for this growth. We sought to better characterize national growth in intensive care beds by identifying hospital-level factors associated with increasing numbers of intensive care beds over time. We performed a repeated-measures time series analysis of hospital-level intensive care bed supply using data from Centers for Medicare and Medicaid Services. All United States acute care hospitals with adult intensive care beds over the years 1996-2011. None. None. We described the number of beds, teaching status, ownership, intensive care occupancy, and urbanicity for each hospital in each year of the study. We then examined the relationship between increasing intensive care beds and these characteristics, controlling for other factors. The study included 4,457 hospitals and 55,865 hospital-years. Overall, the majority of intensive care bed growth occurred in teaching hospitals (net, +13,471 beds; 72.1% of total growth), hospitals with 250 or more beds (net, +18,327 beds; 91.8% of total growth), and hospitals in the highest quartile of occupancy (net, +10,157 beds; 54.0% of total growth). In a longitudinal multivariable model, larger hospital size, teaching status, and high intensive care occupancy were associated with subsequent-year growth. Furthermore, the effects of hospital size and teaching status were modified by occupancy: the greatest odds of increasing ICU beds were in hospitals with 500 or more beds in the highest quartile of occupancy (adjusted odds ratio, 18.9; 95% CI, 14.0-25.5; p hospitals in the highest quartile of occupancy (adjusted odds ratio, 7.3; 95% CI, 5.3-9.9; p bed expansion in the United States is occurring in larger hospitals and teaching centers, particularly following a year with high ICU occupancy.

  15. [End of life care difficulties in intensive care units. The nurses' perspective].

    Science.gov (United States)

    Velarde-García, Juan Francisco; Luengo-González, Raquel; González-Hervías, Raquel; González-Cervantes, Sergio; Álvarez-Embarba, Beatriz; Palacios-Ceña, Domingo

    To describe the difficulties perceived by nursing staff in the delivery of end-of-life care to critically ill patients within intensive care units (ICU). A descriptive phenomenological qualitative study was performed. A purposeful and snowball sampling of nursing staff with at least 1 year's previous experience working in an ICU was conducted. Twenty-two participants were enrolled. Data collection strategies included in-depth unstructured and semi-structured interviews and researcher's field notes. Data were analysed using the Giorgi proposal. Three themes were identified: academic-cultural barriers, related to the care orientation of the ICU and lack of training in end of life care; architectural-structural barriers, related to the lack of space and privacy for the patient and family in the last moments of life; and psycho-emotional barriers, related to the use of emotional detachment as a strategy applied by nursing staff. Nursing staff need proper training on end-of-life care through the use of guidelines or protocols and the development of coping strategies, in addition to a change in the organisation of the ICU dedicated to the terminal care of critically ill patients and family support. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Strengthen ICU Nursing Management to Control the ICU Hospital Infection Effectively%加强ICU护理管理有效预防控制ICU医院感染

    Institute of Scientific and Technical Information of China (English)

    蔡楠

    2015-01-01

    该文以该院ICU病房为例,深入了解医院感染的状况,对护理管理在预防及控制ICU医院感染管理方面发挥的积极作用做出了详细的阐述,从而得出切实落实护理管理在预防ICU医院感染中占据着关键地位的结论,与此同时提出提升护理管理水平,有效地预防ICU医院感染的具体措施。%In this paper, we takes our hospital ICU wards as example, to study the status of hospital infection, and clarify how the nursing management effects the infection preventing and controlling in the ICU wards. Inthe conclusion, we explain the importance of nursing management for the infection prevention in the ICU wards. For preventing the infection in ICU wards effectively, we also put forward the measures to improve the nursing management.

  17. Nursing workload measurement scales in Intensive Care Units. Correlation between NAS and NEMS

    Directory of Open Access Journals (Sweden)

    Montserrat Martínez Lareo

    2011-11-01

    Full Text Available The high costs of intensive care and the importance of patient safety and quality of care highlight the need to develop instrument to measure, as precisely as possible, nursing workload and staffing levels in intensive care. To assess the ideal staff number, we need instruments to measure the real nursing workload. The aim of this research is to compare two nursing workload measurement scales in Intensive Care Units, the Nursing Activities Score (NAS and Nine Equivalents of Nurse Manpower Use Score (NEMS. We also want to assess the staffing needs of our ICU. A descriptive correlational study will be performed in a mixed medical ICU. The sample will be composed of of a minimum of 70 patients. Data regarding individual patients and unit global workload will be recorded, measured both with the NEMS and NAS scales. The required nursing staff will be calculated according to the measured workload. Nursing staffing needs using both scales will be calculated and compared to the actual staff. A descriptive analysis of the variables will be performed, and the existing correlation between both scales will be assessed using the Pearson correlation coefficient. A Student-t test will be performed to determine the differences between the calculated staffing requirements and the actual nursing staff. All data analyses will be done using a statistical software.

  18. ICU患者心理问题及护理%Psychological Problems and Nursing Care of Patients with ICU

    Institute of Scientific and Technical Information of China (English)

    苏婕

    2014-01-01

    目的:通过对ICU患者的临床心理状态和具体情况分析,研究护理对策。方法用交谈法、观察法调查ICU 150例患者,了解常见不良心理状态。结果焦虑、恐惧心理47例(31.3%),烦躁心理62例(41.3%),孤独心理35例(23.3%)。结论良好有效的心理护理,不仅提高危重患者的抢救成功率,减少并发症的发生,同时可提高患者的生命质量,有助于取得令人满意的治疗效果。%Objective ICU patients through clinical psychology and the specific situation analysis, research nursing. Methods Conversation, observation survey ICU 150 patients understand common adverse mental state. Results Anxiety, fear 47 cases (31.3%), 62 cases of psychological ir itability (41.3%), 35 cases of psychological loneliness (23.3%). Conclusion Good and ef ective psychological care, not only to improve the survival rate of critical y il patients, reduce complications, and improve the patient's quality of life, help to achieve satisfactory therapeutic ef ect.

  19. Insulin resistance in early vs late nutrition and complications of sirs in neurosurgical intensive care unit (ICU).

    Science.gov (United States)

    Pilika, Kliti; Roshi, Enver

    2015-02-01

    Systemic Inflammatory Response Syndrome (SIRS) is a common complication in neurosurgical diseases in Intensive Care Unit (ICU). Because of associated insulin resistance (IR) the ICU is in dilemma in which stage to start the nutrition to patients and what is the amount of Insulin Unit to control the hyperglycemia. to define the IR and to compare IR and amount of insulin among ICU patients in "Mother Theresa" University Hospital Center (MTUHC) in Tirana Albania. 154 patients with neurosurgical disease and SIRS complications were randomized in two groups: early nutrition 73 patients (47%) and late nutrition 81 (53%) and compared for a number of variables. There was no statistical age and gender difference between the two groups (P>0.05). The amount of insulin units to control the level of glycemia (80-110 mg/dc) was 12.8±7 unit per day in early nutrition and 23.8 ±12.9 units in late nutrition group (p<0.01). No patient in early nutrition group but six (7.4%) patients in late nutrition group developed insulin resistance (p=0.03). the IR due to the infection complications is higher among late than early nutrition group. Therefore, we suggest that in neurosurgical ICU it would be better to start the nutrition within 72 hours.

  20. The application of return visit nursing in the comprehensive ICU after discharge from hospital%出科后回访护理在综合ICU的应用

    Institute of Scientific and Technical Information of China (English)

    杨宝义; 马士崟; 方敏; 汪蓉; 郭学珍

    2014-01-01

    Objective To understand the existing nursing problems in ICU through return visit,in order to improve the ICU inpatients satisfaction.Methods According to ICU admission odd or even date,300 patients were divided into two groups,130 patients in control group had not been implemented return visit,170 patients in interview group were treated with return visit nursing.Two groups were compared with ICU nursing work satisfaction,complaint rate and praise rate.Results Compared with control group,in the interview group ICU nursing job satisfaction and praise rate were 90.59% and 48.24% respectively,the complaint rate was only 5.88%,the differences were significant (P < 0.01 for all).Conclusions Return visit nursing for ICU discharged patients may promote the ICU nursing service quality continuous improvement,improve the patients and their families to ICU nursing job satisfaction,enhance the brand image of ICU.%目的 通过回访以了解ICU护理工作中存在的问题,提高ICU住院患者满意度.方法 按入住ICU时间的单双号将300例患者分为两组,单日130例患者为对照组,未实施回访;双日170例患者为访视组,实施访视护理,比较两组患者对ICU护理工作的满意度、投诉率及表扬率.结果 访视组患者对ICU护理工作满意度和表扬率分别高达90.59%和48.24%,显著高于对照组,投诉率仅为5.88%,显著低于对照组,差异具有显著性(均P<0.01).结论 开展ICU出科患者回访护理,可促进ICU护理服务质量的持续改进,提高患者及家属对ICU护理工作满意度,提升ICU的品牌形象.

  1. Survey and analysis on mental health of ICU nurses%ICU护士的心理健康状况调查与分析

    Institute of Scientific and Technical Information of China (English)

    程萌芽; 庄一瑜; 周丽萍; 丁扬

    2012-01-01

    Objective To explore the mental health condition of ICU nurses. Method Assess 92 ICU nurses on mental health condition by depression, anxiety, self-esteem and life satisfaction scale. Result Most ICU nurses suffer from depression and anxiety. Their self-esteem is in medium level. They have poor life satisfaction. Nurses who work for 3~5 years and more than 10 years have the highest anxiety level, while nurses in 2 years have the lowest. Conclusion ICU nurses have a low mental health level. Countcrmcasurcs should be taken to improve it.%目的 了解ICU护士的心理健康状况.方法 采用抑郁、焦虑、自尊及生活满意度量表对 92名ICU护士进行心理健康状况评价.结果 ICU大部分护士存在焦虑、抑郁,自尊水平中等,生活满意度低,尤为工作3~5年的护士和工作10年以上的护士焦虑水平最高,工作2年以内的护士焦虑水平最低.结论 ICU护士的心理健康水平相对较低,应采取措施提高护士的心理健康水平.

  2. Application of diversified nursing in ICU-prone syndrome%多元化护理在老年 ICU 综合征患者中的应用进展

    Institute of Scientific and Technical Information of China (English)

    余海洋; 肖莎

    2014-01-01

    Due to the special group of the elderly patients , they are easily to happen the ICU-prone syndrome.ICU syndrome can actually aggravate the patients'primary diseases and increase the incidence of postoperative complications and mortality , so as to delay the effects of rehabilitation .To prevent the occurrence of the ICU syndrome and give patients early nursing interventions , diversified nursing gradually applied to the ICU nursing intervention , however , specialized nursing intervention for the elderly patients was insufficient .This article retrieved the related literature to study the incidence and cause of ICU syndrome , the application of diversified nursing .Thus, we can achieve better application of diversified nursing on ICU syndrome , reduce and decrease the incidence and promote patients'recovery.%由于老年患者是特殊的群体,入住ICU后容易发生ICU综合征。 ICU综合征的发生可加重患者的原发疾病,增加术后并发症和疾病病死率,并可导致患者康复延迟或死亡。为防止该综合征的发生和早期、及时的护理干预,多元化护理逐步应用到该综合征的护理中,但专门针对老年患者ICU综合征的多元化护理应用较少,所以现通过对近几年多元化护理在ICU综合征中的应用的相关文献进行检索、整理,从老年ICU综合征患者发病情况、发病原因、多元化护理在ICU综合征中的应用情况及如何做好多元化护理在老年ICU综合征患者中的应用进行综述,希望能够更好地将多元化护理应用到老年ICU综合征患者的护理中,预防或减少ICU综合征的发生,促进患者早日康复。

  3. Mechanical ventilation in the ICU- is there a gap between the time available and time used for nurse-led weaning?

    Directory of Open Access Journals (Sweden)

    Nilsen Odd

    2008-12-01

    Full Text Available Abstract Background Mechanical ventilation (MV is a key component in the care of critically ill and injured patients. Weaning from MV constitutes a major challenge in intensive care units (ICUs. Any delay in weaning may increase the number of complications and leads to greater expense. Nurse-led, protocol-directed weaning has become popular, but it remains underused. The aim of this study was to identify and quantify discrepancies between the time available for weaning and time actually used for weaning. Further, we also wished to analyse patient and systemic factors associated with weaning activity. Methods This retrospective study was performed in a 12-bed general ICU at a university hospital. Weaning data were collected from 68 adult patients on MV and recorded in terms of ventilator-shifts. One ventilator-shift was defined as an 8-hour nursing shift for one MV patient. Results Of the 2000 ventilator-shifts analysed, 572 ventilator-shifts were available for weaning. We found that only 46% of the ventilator shifts available for weaning were actually used for weaning. While physician prescription of weaning was associated with increased weaning activity (p Conclusion Our study identified a significant gap between the time available and time actually used for weaning. While various patient and systemic factors were linked to weaning activity, the most important factor in our study was whether the intensive care nurses made use of the time available for weaning.

  4. Enteral nutrition practices in the intensive care unit: Understanding of nursing practices and perspectives

    Directory of Open Access Journals (Sweden)

    Babita Gupta

    2012-01-01

    Full Text Available Background: Adequate nutritional support is important for the comprehensive management of patients in intensive care units (ICUs. Aim: The study was aimed to survey prevalent enteral nutrition practices in the trauma intensive care unit, nurses′ perception, and their knowledge of enteral feeding. Study Design: The study was conducted in the ICU of a level 1 trauma center, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India. The study design used an audit. Materials and Methods: Sixty questionnaires were distributed and the results analyzed. A database was prepared and the audit was done. Results: Forty-two (70% questionnaires were filled and returned. A majority (38 of staff nurses expressed awareness of nutrition guidelines. A large number (32 of staff nurses knew about nutrition protocols of the ICU. Almost all (40 opined enteral nutrition to be the preferred route of nutrition unless contraindicated. All staff nurses were of opinion that enteral nutrition is to be started at the earliest (within 24-48 h of the ICU stay. Everyone opined that the absence of bowel sounds is an absolute contraindication to initiate enteral feeding. Passage of flatus was considered mandatory before starting enteral nutrition by 86% of the respondents. Everyone knew that the method of Ryle′s tube feeding in their ICU is intermittent boluses. Only 4 staff nurses were unaware of any method to confirm Ryle′s tube position. The backrest elevation rate was 100%. Gastric residual volumes were always checked, but the amount of the gastric residual volume for the next feed to be withheld varied. The majority said that the unused Ryle′s tube feed is to be discarded after 6 h. The most preferred (48% method to upgrade their knowledge of enteral nutrition was from the ICU protocol manual. Conclusion: Information generated from this study can be helpful in identifying nutrition practices that are lacking and may be used to review and revise enteral feeding

  5. Attitudes towards euthanasia among Greek intensive care unit physicians and nurses.

    Science.gov (United States)

    Kranidiotis, Georgios; Ropa, Julia; Mprianas, John; Kyprianou, Theodoros; Nanas, Serafim

    2015-01-01

    To investigate the attitudes of Greek intensive care unit (ICU) medical and nursing staff towards euthanasia. ICU physicians and nurses deal with end-of-life dilemmas on a daily basis. Therefore, the exploration of their stances on euthanasia is worthwhile. This was a descriptive quantitative study conducted in three ICUs in Athens. The convenience sample included 39 physicians and 107 nurses. Of respondents, 52% defined euthanasia inaccurately, as withholding or withdrawal of treatment, while 15% ranked limitation of life-support among the several forms of euthanasia, together with active shortening of the dying process and physician - assisted suicide. Only one third of participants defined euthanasia correctly. While 59% of doctors and 64% of nurses support the legalization of active euthanasia, just 28% and 26% of them, respectively, agree with it ethically. Confusion prevails among Greek ICU physicians and nurses regarding the definition of euthanasia. The majority of staff disagrees with active euthanasia, but upholds its legalization. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Nurses practices regarding the prevention of nosocomial infections in the neurosurgical intensive care unit

    Directory of Open Access Journals (Sweden)

    Hülya Bulut

    2010-12-01

    Full Text Available Objectives: This study was conducted for determining nurses’ interventions to preventive nosocomial infections seen in a neurosurgery intensive care unit (ICU.Materials and methods: The study population was comprised of with 10 nurses who worked in the neurosurgery ICU of a university hospital in Ankara. The data were collected using a questionnaire and an interventions form. In the analysis of data number of the account was used.Results: Mean knowledge level of the study population was 10.4 on 28 points in the questionnaire. While it is noted that the nurses take measures to prevent some of the nosocomial infections, which are included intervention form, there were no measures against surgical wound infections, meningitis, shunt infections that are seen infrequently in the neurosurgical units.Conclusion: Nurses’ knowledge on nosocomial infections and their interventions to prevent nosocomial infections were found to be inadequate and outdated.

  7. [Interventional Patient Hygiene Model. A critical reflection on basic nursing care in intensive care units].

    Science.gov (United States)

    Bambi, Stefano; Lucchini, Alberto; Solaro, Massimo; Lumini, Enrico; Rasero, Laura

    2014-01-01

    Interventional Patient Hygiene Model. A critical reflection on basic nursing care in intensive care units. Over the past 15 years, the model of medical and nursing care changed from being exclusively oriented to the diagnosis and treatment of acute illness, to the achievement of outcomes by preventing iatrogenic complications (Hospital Acquired Conditions). Nursing Sensitive Outcomes show as nursing is directly involved in the development and prevention of these complications. Many of these complications, including falls from the bed, use of restraints, urinary catheter associated urinary infections and intravascular catheter related sepsis, are related to basic nursing care. Ten years ago in critical care, a school of thought called get back to the basics, was started for the prevention of errors and risks associated with nursing. Most of these nursing practices involve hygiene and mobilization. On the basis of these reflections, Kathleen Vollman developed a model of nursing care in critical care area, defined Interventional Patient Hygiene (IPH). The IPH model provides a proactive plan of nursing interventions to strengthen the patients' through the Evidence-Based Nursing Care. The components of the model include interventions of oral hygiene, mobilization, dressing changes, urinary catheter care, management of incontinence and bed bath, hand hygiene and skin antisepsis. The implementation of IPH model follows the steps of Deming cycle, and requires a deep reflection on the priorities of nursing care in ICU, as well as the effective teaching of the importance of the basic nursing to new generations of nurses.

  8. Lived experiences of Rwandan ICU nurses caring for patients with a ...

    African Journals Online (AJOL)

    Do not resuscitate (DNR) is the policy and practice of deliberately not attempting to resuscitate ... DNR orders are a fairly new concept in Rwanda and the practice of DNR orders in ICU is very demanding for the staff, especially .... Data analysis.

  9. Analysis of the causes and nursing of delirium in ICU%ICU谵妄发生原因及护理分析

    Institute of Scientific and Technical Information of China (English)

    陆雪华

    2014-01-01

    Objective:To explore the causes of patients with delirium in ICU,and puts forward the countermeasure of nursing. Methods:Retrospective analysis of 28 ICU patients with delirium incidence,causes and nursing countermeasures.Results:The main causes of delirium occurred mainly in patients with individual factors,environmental factors and other factors.Nursing measures included close observation of disease,prevention of complications,improve the ICU therapeutic environment,improve patient comfort,ease pain,improve sleep,strengthen communication between nurses and patients,relieve tension.Conclusion:The active nursing intervention should be taken for the related causes of delirium in ICU patients,in order to reduce the occurrence of delirium.%目的:探讨 ICU 患者发生谵妄的原因,并提出护理对策。方法:回顾性分析28例 ICU 谵妄患者发生情况、原因及护理对策。结果:谵妄主要发生原因有患者个体因素、环境因素及其他因素,护理对策包括严密观察病情、预防并发症、改善ICU治疗环境、提高患者舒适度、缓解疼痛、改善睡眠、加强护患沟通、缓解紧张情绪。结论:需针对ICU患者发生谵妄的原因进行相应的积极护理干预,以减少谵妄的发生。

  10. 背景音乐对ICU医护人员焦虑的影响%Influence of Background Music on Anxiety Status of ICU Nurses

    Institute of Scientific and Technical Information of China (English)

    许珍连

    2015-01-01

    目的:探讨背景音乐在减轻 ICU 医护人员焦虑状况中的作用。方法采用方便抽样方法选取厦门市某三级甲等医院中心 ICU 和急诊ICU 的医护人员105例,分为给予背景音乐的实验组56例和无背景音乐的对照组49例,实验组每日听背景音乐2次,连续30 d,干预前后采用焦虑自评量表 SAS 分别对两组医护人员进行评分,比较两组医护人员在干预前后的焦虑状况。结果干预前两组 ICU 医护人员的焦虑状况差异无统计学意义,P >0.05。干预后实验组焦虑状况下降,两组医护人员的焦虑状况比较差异有统计学意义,P <0.05。结论背景音乐能减轻 ICU 医护人员的焦虑,提高心理健康水平,使医护人员能更加集中精力投入到治疗和护理工作中。%Objective To explore the background music in reducing the anxiety of ICU nurses. Methods Using convenient sampling methods to select 105 cases of medical staff from center ICU and emergency ICU in top three hospitals,divided them into experimental group with 56 cases giving background music and control group with 49 cases without background music. Experimental group listening to background music 2 times a day,30 days in a row,before and after the intervention by the self-assessment lists of anxiety SAS respectively to score of two groups of health care workers. Results Before intervention,the two groups of anxiety in the ICU nurses had no significant difference(P > 0.05). After intervention,the anxiety of experimental group decreased significantly,the anxiety between the two groups was statistically significant, P < 0.05. Conclusion The background music can alleviate anxiety status of ICU nurses,improve the level of mental health,make medical workers more focus on the treatment and nursing.

  11. Application of Nursing Labels in Nursing Safety Management of ICU Patients%护理标识在ICU患者护理安全管理中的应用

    Institute of Scientific and Technical Information of China (English)

    邱孝兰

    2014-01-01

    Objective To reduce the incidence of ICU nursing adverse events and increase the degree of nursing safety management of ICU patients. Method We established a nursing safety management team of ICU patients and developed the nursing labels system. Results After implementation of the nursing labels system,the incidence of ICU nursing adverse events was reduced,and the satisfaction of patients with the application of nursing labels and the degree of nursing safety management of ICU patients was increased. Conclusion The applica-tion of nursing labels can standardize nursing behavior,enhance risk awareness of nurses,strengthen the ability of patients to protect them-selves and reduce the occurrence of key nursing errors and accidents. There is a positive value for clinical care.%目的:应用护理标识,降低ICU护理差错事故的发生率,方便ICU患者护理安全管理。方法:建立ICU患者的护理安全管理团队和开发了护理标识系统。结果:护理人员的风险意识增强,实现了患者的安全管理,降低了护理差错的发生,同时也提高了患者满意度。结论:护理标识的应用有效地规范了护理行为,提高了护理人员的警惕性,增强了护理人员的风险意识,加强了患者自我保护能力,减少了关键环节护理差错及意外事故的发生,对临床护理工作有积极的应用价值。

  12. Application of Total Quality Management in ICU Nursing Management%全面质量管理在ICU护理管理中的运用

    Institute of Scientific and Technical Information of China (English)

    朱玉培

    2015-01-01

    The condition of patients in ICU ward the patient's condition is very complicated, and thus hospital must provide a high quality of care. Therefore, in order to improve the quality of nursing management of ICU, hospitals need to take ef-forts to manage ICU nursing work. And total quality management is commonly used in ICU nursing management measures in recent hospital. In this paper, we talk about the application of total quality management methods in ICU.%ICU病房病人的病情复杂且会在短期产生较大的变化,因而需要具备相当高的护理质量. 因此,为了更好地提高ICU的护理管理,医院需要从根本上规范管理ICU的护理工作. 而全面质量管理是ICU护理管理中的常用管理办法. 该研究对全面质量管理方法的应用展开简要的概述.

  13. Exploring family experiences of nursing aspects of end-of-life care in the ICU: A qualitative study

    NARCIS (Netherlands)

    Noome, M; Dijkstra, B.M.; Leeuwen, E. van; Vloet, L.C.M.

    2016-01-01

    Objectives: The aim of this study was to examine the experience(s) of family with the nursing aspects of End-of-life care in the intensive care unit after a decision to end life-sustaining treatment, and to describe what nursing care was most appreciated and what was lacking. Method: A phenomenologi

  14. Exploring family experiences of nursing aspects of end-of-life care in the ICU: A qualitative study

    NARCIS (Netherlands)

    Noome, M.; Dijkstra, B.M.; Leeuwen, E. van; Vloet, L.C.M.

    2016-01-01

    OBJECTIVES: The aim of this study was to examine the experience(s) of family with the nursing aspects of End-of-life care in the intensive care unit after a decision to end life-sustaining treatment, and to describe what nursing care was most appreciated and what was lacking. METHOD: A phenomenologi

  15. Quality of care in the intensive care unit from the perspective of patient's relatives: development and psychometric evaluation of the consumer quality index 'R-ICU'.

    Science.gov (United States)

    Rensen, Ans; van Mol, Margo M; Menheere, Ilse; Nijkamp, Marjan D; Verhoogt, Ellen; Maris, Bea; Manders, Willeke; Vloet, Lilian; Verharen, Lisbeth

    2017-01-24

    The quality standards of the Dutch Society of Intensive Care require monitoring of the satisfaction of patient's relatives with respect to care. Currently, no suitable instrument is available in the Netherlands to measure this. This study describes the development and psychometric evaluation of the questionnaire-based Consumer Quality Index 'Relatives in Intensive Care Unit' (CQI 'R-ICU'). The CQI 'R-ICU' measures the perceived quality of care from the perspective of patients' relatives, and identifies aspects of care that need improvement. The CQI 'R-ICU' was developed using a mixed method design. Items were based on quality of care aspects from earlier studies and from focus group interviews with patients' relatives. The time period for the data collection of the psychometric evaluation was from October 2011 until July 2012. Relatives of adult intensive care patients in one university hospital and five general hospitals in the Netherlands were approached to participate. Psychometric evaluation included item analysis, inter-item analysis, and factor analysis. Twelve aspects were noted as being indicators of quality of care, and were subsequently selected for the questionnaire's vocabulary. The response rate of patients' relatives was 81% (n = 455). Quality of care was represented by two clusters, each showing a high reliability: 'Communication' (α = .80) and 'Participation' (α = .84). Relatives ranked the following aspects for quality of care as most important: no conflicting information, information from doctors and nurses is comprehensive, and health professionals take patients' relatives seriously. The least important care aspects were: need for contact with peers, nuisance, and contact with a spiritual counsellor. Aspects that needed the most urgent improvement (highest quality improvement scores) were: information about how relatives can contribute to the care of the patient, information about the use of meal-facilities in the hospital, and

  16. Type A behaviour as a predictor of burnout and job satisfaction in intensive care units nurses

    Directory of Open Access Journals (Sweden)

    Dorota Włodarczyk

    2015-06-01

    Full Text Available Background: Working at intensive care unit (ICU is one of the most difficult and taxing nursing specialties. It demands not only extensive knowledge and professional skills but also specific personality-temperamental dispositions. The aim of the study was to verify if type A behavior (TAB is a predictor of burnout and job satisfaction in ICU nurses and if this effect still exists after controlling for selected demographic and job characteristics. Material and Methods: The study group consisted of 99 nurses (77 women, aged 24–58 (mean (M = 32.33; standard deviation (SD = 8.81 working at ICU. The following tools were used: to measure TAB – Type A Behavior Survey BWZ by Wrzesniewski; job burnout – the Oldenburg Burnout Inventory OLBI by Demerouti et al.; and job satisfaction – the Job Satisfaction Scale by Zalewska. Results: The results of hierarchical regression analyses showed that after controlling for selected demographic and job characteristics, tendency for aggression was a predictor of higher exhaustion, disengagement and lower job satisfaction. Achievement striving and tendency to dominate were related to higher job satisfaction and lower exhaustion, respectively. Significant predictors of professional functioning were also: duty work system, place of living and gender. Conclusions: The results of the study confirmed that all 3 content features of TAB were significant predictors of job functioning of ICU nurses. They also indicate that considering TAB in the context of individual adjustment to the environment of the job at ICU would be a valuable direction for future research. Med. Pr. 2015;66(2:213–224

  17. Ethical Issues Recognized by Critical Care Nurses in the Intensive Care Units of a Tertiary Hospital during Two Separate Periods

    OpenAIRE

    Park, Dong Won; Moon, Jae Young; Ku, Eun Yong; Kim, Sun Jong; Koo, Young-Mo; Kim, Ock-Joo; Lee, Soon Haeng; Jo, Min-Woo; Lim, Chae-Man; Armstrong, John David; Koh, Younsuck

    2015-01-01

    This research aimed to investigate the changes in ethical issues in everyday clinical practice recognized by critical care nurses during two observation periods. We conducted a retrospective analysis of data obtained by prospective questionnaire surveys of nurses in the intensive care units (ICU) of a tertiary university-affiliated hospital in Seoul, Korea. Data were collected prospectively during two different periods, February 2002-January 2003 (Period 1) and August 2011-July 2012 (Period 2...

  18. Family Perceptions of Intensive Care Unit Nurses' Roles: A Greek Perspective.

    Science.gov (United States)

    Malliarou, Maria; Gerogianni, Georgia; Babatsikou, Fotoula; Kotrotsiou, Evaggelia; Zyga, Sofia

    2014-01-13

    This study was done in order to examine the role of the nurse in families with critically ill patients as perceived by family members. A descriptive design was conducted with 93 family members aged 18-53 years from a 6-bed intensive care unit in a Greek Hospital. An anonymous self-completed questionnaire recording demographic data and the questionnaire Family members perception of nurses behavioral role expectation/enactment scale of Hickey and Lewandowski was used. Parametric statistic tests were used to examine the research questions. Intensive care unit (ICU) patients' family members expect nurses to make them feel they can ask whatever they want whenever they want, placing great emphasis on communicating with one another and on participating in decision making to the progress of patient care. The age seems to correlate with the expectation from nurse to meet the role of training on how to handle the patient. Nurses did well with regard to meeting family members' expectations. Most family members assessed positively the role of ICU nurse confirming the need for communication, and clear support of families.

  19. Job burnout in ICU nurses and its relationship with turnover intention%ICU护士职业倦怠及其与离职意愿的相关性调查

    Institute of Scientific and Technical Information of China (English)

    谭朝霞; 邹颢宇; 刘怡素; 胡霞红

    2014-01-01

    目的:探讨ICU护士职业倦怠及其与离职意愿之间的关系。方法采用Maslach职业倦怠量表、离职意愿量表对长沙市四所省级综合性三甲医院207名ICU护士进行问卷调查。结果 ICU护士职业倦怠中情绪衰竭维度得分为(23.20±9.71)分、去人格化维度得分为(6.43±5.81)分,均属于中度倦怠;个人成绩感得分为(32.34±9.40)分,属于高度倦怠。76.3%(158名)的ICU护士存在离职意愿,其中17.4%(36名)的ICU护士离职意愿强烈。情绪衰竭和去人格化与离职意愿呈正相关(r=0.531,r=0.384,P<0.05),而个人成就感与离职意愿呈负相关(r=-0.310,P<0.05)。结论 ICU护士职业倦怠较严重,离职意愿率较高。应注意降低ICU护士的职业倦怠感,从而减弱离职意愿,以便有效预防ICU护士离职行为的发生。%Objective To investigate the job burnout and its relationship with turnover intention in nurses in Intensive Care Unit. Methods The Chinese Maslach Burnout Inventory and Turnover intention questionnaire were used to conduct a survey in 207 ICU nurses from four provincial third-level comprehensive hospitals in Changsha. Results"Emotional exhaustion"(23.20±9.71) and"Depersonalization"(6.43±5.81) were moderate burnout and“Per-sonal accomplishment”(32.34 ± 9.40) was in a high degree of burnout among ICU nurses. 76.3 percentages of the ICU nurses (158) have turnover intention, of which 17.4 percentages (36) hold serious turnover intention. Turnover intention was significantly positive correlation with emotional exhaustion and depersonalization (r=0.531,r=0.384, P<0.05) and significantly negative correlation with personal accomplishment (r=-0.310,P<0.05) in ICU nurses. Conclusion The problem of job burnout is serious and the turnover intention is common in ICU nurses. Attention should be paid to reduce the job burnout in ICU nurses and weaken the turnover intention in order to effectively pre-vent the occurrence of

  20. The effect of comprehensive nursing intervention on the prognosis of patients with delirium in ICU%综合护理干预对 ICU 谵妄患者预后的效果观察

    Institute of Scientific and Technical Information of China (English)

    赵丽娜

    2016-01-01

    Objective: To explorer the effect of comprehensive nursing intervention on the prognosis of patients with delirium in ICU. Methods: 186 patients with delirium in our hospital were divided into the control group and the observation group randomly, with each group 93 cases. The control group was treated with the traditional nursing care, and patients in the observation group were given the comprehensive nursing on the basis of that. The prognosis of delirium was compared observed and compared between them. Results: After the good nursing, The effective rate of the observation group was 93.54% and the observation group 88.17% respectively, and the differences had statistical significance(P<0.05). Conclusion: Comprehensive nursing intervention in patients with delirium in ICU could improve the effective rate, shorten the hospital stay, and improve the prognosis of patients.%目的:探讨综合护理干预对 ICU 谵妄患者预后的效果。方法选取2014年8月-2015年8月我院 ICU 病房收治的186例谵妄患者作为研究对象。采用随机数字表法将其分为观察组和对照组,每组93例。对照组患者采用常规护理,观察组患者给予综合护理干预,比较两组患者预后的情况。结果经过精心治疗和护理后,观察组患者的好转率为93.54%,明显高于对照组的88.17%,组间比较,差异有统计学意义(P<0.05)。结论对 ICU 谵妄患者实施综合护理干预可有效提高好转率,缩短患者的住院时间,改善患者的预后。

  1. The expectation about ICU advanced practice nurse's competency among ICU medical staff%ICU高级实践护士能力期望的调查与分析

    Institute of Scientific and Technical Information of China (English)

    钟亚萍; 卢惠娟; 夏海鸥; 蒋红

    2012-01-01

    目的 探讨ICU医护人员对ICU高级实践护士能力的期望,为确立其培养目标提供依据.方法 对ICU406名护士和58名医生进行问卷调查,并对结果进行多维尺度分析.结果 对ICU高级实践护士能力的期望主要体现在临床作用和发展期望两个维度上,可被分成临床实践、团队工作、教育、控制改进等4类能力.其中对临床作用最大的是临床实践、团队工作能力;发展期望最高的是团队工作、控制改进能力.结论 ICU高级实践护士培养应重点发展团队工作能力、部分临床实践能力、控制改进能力.%Objective To investigate the expectation about the competency of ICU advanced practice nurses(APN) among ICU medical staff, so as to provide reference for determining objective of ICU APN training. Methods Totally 406 ICU nurses and 58 doctors were investigated by questionnaires. Data were analyzed by multidimensional scaling. Results Medical staffs' expectation about the competency of ICU APN focused on two dimensions:clinical role and expectation of development. The competencies could be classified into four following categories:clinical practice, teamwork, education, control and improvement Capacity of clinical practice and capacity of teamwork had the most important clinical role. Capacity of teamwork and capacity of control and improvement had the highest expectation degree of development. Conclusions It is suggested that education of ICU APN should focus on the competencies of teamwork,partial clinical practice,control and improvement.

  2. Nursing workload at a gastroenterology unit.

    Science.gov (United States)

    Panunto, Marcia Raquel; Guirardello, Edinêis de Brito

    2009-01-01

    One of the biggest challenges nurses face is the need to justify the quantity and quality of staff for care delivery. For this, management instruments are available which help them to determine the staff needed in the nursing team. This descriptive study aims to evaluate the nursing workload at a specialized clinical and surgical gastroenterology unit. To collect data, the Nursing Activities Score (NAS) was used during 30 consecutive days, with 1080 comments, obtained from the records of 149 patients. The mean NAS score was 34.9% and, considering that each point of NAS corresponds to 0.24 hour, on the average, 8.4 hours of nursing care were required within 24 hours. This means that this profile is of patients who demand intermediate and semi-intensive care, which suggests that the NAS study can be used to evaluate the workload of nurses at that unit.

  3. The Relationship between Social Support and Burnout among ICU Nurses in Shanghai:A Cross-Sectional Study

    Institute of Scientific and Technical Information of China (English)

    Li Li; Hong Ruan; Wei-Jun Yuan

    2015-01-01

    Objective: The associations between social support and burnout were explored in ICU nurses of Shanghai. Methods: We performed a cross-sectional study of 356 ICU nurses by applying random cluster sampling. Data were collected using self-reported questionnaires under the instruction of trained investigators. Data on emotional exhaustion, depersonalisation and feelings of low personal ac-complishment etc. were collected, calculated and analyzed. Results: The participants had a mean age of 26. 96 years ( SD 4. 07) . The mean value ( M) and stand-ard deviation ( SD) of emotional exhaustion was M=31. 85, SD=8. 38, those of depersonalisation was M=11. 69, SD=5. 54 and those of feelings of low personal accomplishment was M=19. 79, SD=7. 02. The high degree of emotional exhaustion ( EE) , depersonalisation ( DP) , and lack of personal accom-plishment ( PA) were revealed to be 76. 4%, 39. 6%, and 94. 9%, respectively. The major influencing factors of emotional exhaustion included support from co-workers( b=0. 343, t=1. 98, P=0. 049) , tak-ing leave( b=-1. 182, t=-3. 747, P=0. 001) , requisition of work( b=-1. 41, t=-2. 369, P=0. 018) , and supervisor support( b=-0. 524, t=-3. 926, P=0. 001) . The major influencing factors of depersonalisa-tion were support from the supervisor( b=-0. 333, t=-4. 146, P=0. 001) , age( b=-0. 89, t=-2. 272, P=0. 024) and requisition of work( b=-0. 148, t=-2. 124, P=0. 034) . There was a positive co-relationship between personal accomplishment and supervisor support. Conclusions: Supervisor support, age, and requisition of work were the major influencing fac-tors of depersonalisation. In addition, supervisor support plays an important role in low personal accomplishment. Further research should focus on supervisor support, co-worker support, time on leave, and requisition of work associated with emotional exhaustion.

  4. Partnership for a healthy work environment: tele-ICU/ICU collaborative.

    Science.gov (United States)

    Goran, Susan F; Mullen-Fortino, Margaret

    2012-01-01

    The tele-intensive care unit (ICU) provides a remote monitoring system that adds an additional layer of support for critically ill patients. However, to optimize contributions, the bedside team must incorporate this resource into the patient's plan of care. Using the American Association of Critical-Care Nurses' Healthy Work Environment Standards as a platform, we can create and nurture a new partnership model. Strategies that embrace the standards of skilled communication, true collaboration, and effective decision making become mutual goals for improving patient safety and outcomes. Joint communication guidelines facilitate timely and meaningful communication. Trust and the desire to cooperate encourage provider engagement to strengthen collaboration. The use of tele-ICU technology can assist in the interpretation and transformation of data to affect decision making at all levels to influence patient care. Through the lens of the healthy work environment, the tele-ICU/ICU partnership provides enhanced opportunities for improved patient care and team satisfaction.

  5. Influence of occupational stress on serum antioxidant enzymes of ICU male nurses%职业紧张对 ICU 男护士血清抗氧化物酶的影响

    Institute of Scientific and Technical Information of China (English)

    孙岚岚

    2014-01-01

    Objective:To probe into the influence of occupational stress on serum antioxidant enzymes of ICU male nurses.Methods:A total of 126 ICU male nurses in 1 6 three grade A hospitals were extracted by u-sing cluster sampling method,and they were investigated by using occu-pational stress scale on male nurses’occupational stress,and by monito-ring the serum antioxidant enzyme levels to study the influence of occu-pational stress on it.Results:Occupation task(ORQ)score and the indi-vidual stress response(PSQ)score in this group of ICU male nurse occu-pation stress inventory(ORQ)were higher than the national norm(P <0.05);personal coping resources(PRQ)score was lower than the national norm (P <0.05).Statistical analysis showed that there was statistically signif-icant differences between groups with different score levels(P <0.05).Conclu-sion:Through the investigation of ICU male nurse’s occupational stress, and to study its influence on serum antioxidant enzymes,it prompt thus hos-pital managers should pay attention to this special group of male nurses,and to take targeted intervention measures,thus to improve the quality of nursing,and comply with implementation of high quality care.%[目的]探讨职业紧张对 ICU 男护士血清抗氧化酶的影响。[方法]采用整群抽样法抽取某省16所三级甲等综合医院的126名 ICU 男护士,采用职业紧张量表调查男护士的职业紧张感,并监测其血清抗氧化物酶的水平,分析职业紧张对其产生的影响。[结果]ICU 男护士职业紧张量表中的职业任务(ORQ)与个体紧张反应(PSQ)评分均高于国内常模(P<0.05);个人应对资源(PRQ)评分低于国内常模(P <0.05)。不同得分水平组间比较差异有统计学意义(P <0.05)。[结论]通过对 ICU 男护士职业紧张感进行调查,并研究其对血清抗氧化酶的影响,提示医院管理者应关注男护士这一特殊的群体,并采取有针对性的干预措施,从而提高护理质

  6. 新生儿ICU移动护理信息系统的开发与应用%Development and application of neonatal ICU mobile nursing information system

    Institute of Scientific and Technical Information of China (English)

    陈海花; 朱玲玲; 毕越英; 董建英; 张岚

    2012-01-01

    目的 优化和完善新生儿ICU数据传输,加强护理工作的信息化管理,提高护理工作效率和质量.方法 研发适应大型新生儿ICU临床护理工作需要的移动护理信息系统,包括六项功能模块和两项管理模块,并应用于临床.结果 移动护理信息系统提供了全部护理过程信息收集、传递、分析功能,实现了新生儿ICU护理移动信息技术的突破.结论 新生儿ICU移动护理信息系统促进了护理管理科学化、信息化的进程,值得推广应用.%Objective To optimize the data transmission of neonatal ICU.and to strengthen nursing information management, and improve job efficiency and quality of nursing . Method A mobile nursing information system was developed and applied in order to meet the needs of clinical care in large neonatal ICU. The system consists of six modules and two management modules. Result Mobile nursing information system could collect, transmit and analyze all nursing information.lt improve the efficiency of nursing staff,ensure nursing safety and improve quality of nursing. Conclusion The mobile nursing information system in neonatal ICU can promote nursing management to scientific and information technology. The system should be used widely in

  7. ICU Nurses' Knowledge, Attitude, and Practice Towards their Role in the Organ Donation Process from Brain-Dead Patients and Factors Influencing it in Iran.

    Science.gov (United States)

    Masoumian Hoseini, S T; Manzari, Z; Khaleghi, I

    2015-01-01

    Nowadays, ICU nurses play a significant role in the care of brain-dead patients and their families. Therefore, their knowledge, attitude and practice towards this issue are extremely important to the success of organ donation. To assess ICU nurses' knowledge, attitude and practice towards their role in the organ donation process from brain-dead patients and factors influencing it in Iran. In a cross-sectional analytical study, 90 ICU nurses working in Ghaem and Emam Reza Hospitals affiliated to Mashhad University of Medical Sciences were selected through a stratified random sampling. Data were collected from the participants by a questionnaire included demographic information, and factors influencing the nurses knowledge, attitude, and practice towards their roles in the organ donation process. 90 nurses participated in this study. 70% of the research subjects had spoken with their own families about organ donation; 20% had organ donation cards. The mean±SD score of nurses' knowledge was 49.13±9.6, attitude 21.49±14.32, and practice was 3.66±6.04. 80% of nurses had a mean knowledge about their roles in the organ donation process; 82% agreed with their roles in this process, and 97% showed weak practice in this regard. Nurses did not have adequate knowledge, attitude, and practice towards their role in organ donation process. It is suggested to include nursing courses on the organ donation process and organ transplantation as well as educational programs to acquaint nurses with their roles in the organ donation process.

  8. Malnutrition in the ICU patient population.

    Science.gov (United States)

    Powers, Jan; Samaan, Karen

    2014-06-01

    Malnutrition has been identified as a cause for disease as well as a condition resulting from inflammation associated with acute or chronic disease. Malnutrition is common in acute-care settings, occurring in 30% to 50% of hospitalized patients. Inflammation has been associated with malnutrition and malnutrition has been associated with compromised immune status, infection, and increased intensive care unit (ICU) and hospital length of stay. The ICU nurse is in the best position to advocate for appropriate nutritional therapies and facilitate the safe delivery of nutrition.

  9. Intensive care unit nurses' opinions about euthanasia.

    Science.gov (United States)

    Kumaş, Gülşah; Oztunç, Gürsel; Nazan Alparslan, Z

    2007-09-01

    This study was conducted to gain opinions about euthanasia from nurses who work in intensive care units. The research was planned as a descriptive study and conducted with 186 nurses who worked in intensive care units in a university hospital, a public hospital, and a private not-for-profit hospital in Adana, Turkey, and who agreed to complete a questionnaire. Euthanasia is not legal in Turkey. One third (33.9%) of the nurses supported the legalization of euthanasia, whereas 39.8% did not. In some specific circumstances, 44.1% of the nurses thought that euthanasia was being practiced in our country. The most significant finding was that these Turkish intensive care unit nurses did not overwhelmingly support the legalization of euthanasia. Those who did support it were inclined to agree with passive rather than active euthanasia (P = 0.011).

  10. Ocorrência e significado do toque entre profissionais de enfermagem e pacientes de uma UTI e Unidade Semi-intensiva cirúrgica Ocurrencia y significado del toque entre profesionales de enfermería y pacientes de una uci y unidad semiintensiva quirúrgica Occurence and meaning of the touch between nursing professionals and patients of an icu and semi intensive surgical unit

    Directory of Open Access Journals (Sweden)

    Marília Fogaça Gala

    2003-03-01

    Full Text Available Este trabalho tem como objetivos identificar a utilização, pelos profissionais de Enfermagem, do toque instrumental e/ou afetivo e suas características, na comunicação não-verbal com os pacientes da UTI e unidade semi-intensiva cirúrgica do HU-USP; e os sentimentos e percepções dos profissionais de Enfermagem e dos pacientes em relação aos toques experimentados. O estudo foi desenvolvido com 19 profissionais e 19 pacientes, no período de outubro a novembro de 2000, através de observação direta das interações e entrevista individual. Os sentimentos e percepções relatados foram categorizados e percebemos que a maioria dos toques é instrumental-afetivo.Este trabajo tiene como objectivo identificar la utilización, por los profesionales de Enfermería del toque instrumental y / o afectivo y sus características, en la comunicación no verbal con los pacientes de la UCI y unidad semiintensiva quirúrgica del HU-USP, y los sentimientos y percepciones de los profesionales de Enfermería y los pacientes en relación de los toques experimentados. Lo estudio fue desenvuelto con 19 profesionales y 19 pacientes, en el período de octubre a noviembre de 2000, por medio de observaciones directas de las interacciones y encuestas individuales. Los sentimientos y percepciones relatados fueram categorizados y percibimos que la mayor parte de los toques fueran instrumental - afectivo.This study aims to identify the use of the instrumental and/or emotional touch and its characteristics by nursing professionals in the nonverbal communication with the ICU and Semi Intensive Surgical Unit patients of a school hospital - University of São Paulo; and to identify the professionals and patients feelings and perceptions in relation to the touches experienced. The study was developed with 19 nursing professionals and 19 patients, from October to November 2000, through direct observation of the interaction and individual interview. The feelings and

  11. Ethical issues recognized by critical care nurses in the intensive care units of a tertiary hospital during two separate periods.

    Science.gov (United States)

    Park, Dong Won; Moon, Jae Young; Ku, Eun Yong; Kim, Sun Jong; Koo, Young-Mo; Kim, Ock-Joo; Lee, Soon Haeng; Jo, Min-Woo; Lim, Chae-Man; Armstrong, John David; Koh, Younsuck

    2015-04-01

    This research aimed to investigate the changes in ethical issues in everyday clinical practice recognized by critical care nurses during two observation periods. We conducted a retrospective analysis of data obtained by prospective questionnaire surveys of nurses in the intensive care units (ICU) of a tertiary university-affiliated hospital in Seoul, Korea. Data were collected prospectively during two different periods, February 2002-January 2003 (Period 1) and August 2011-July 2012 (Period 2). Significantly fewer cases with ethical issues were reported in Period 2 than in Period 1 (89 cases [2.1%] of 4,291 ICU admissions vs. 51 [0.5%] of 9,302 ICU admissions, respectively; P ethical issues in both Periods occurred in MICU. The major source of ethical issues in Periods 1 and 2 was behavior-related. Among behaviorrelated issues, inappropriate healthcare professional behavior was predominant in both periods and mainly involved resident physicians. Ethical issue numbers regarding end-oflife (EOL) care significantly decreased in the proportion with respect to ethical issues during Period 2 (P = 0.044). In conclusion, the decreased incidence of cases with identified ethical issues in Period 2 might be associated with ethical enhancement related with EOL and improvements in the ICU care environment of the studied hospital. However, behaviorrelated issues involving resident physicians represent a considerable proportion of ethical issues encountered by critical care nurses. A systemic approach to solve behavior-related issues of resident physicians seems to be required to enhance an ethical environment in the studied ICU.

  12. ICU service in Taiwan.

    Science.gov (United States)

    Cheng, Kuo-Chen; Lu, Chin-Li; Chung, Yueh-Chih; Huang, Mei-Chen; Shen, Hsiu-Nien; Chen, Hsing-Min; Zhang, Haibo

    2014-01-01

    The aim of the study was to understand the current status of intensive care unit (ICU) in order to optimize the resources achieving the best possible care. The study analyzed the status of ICU settings based on the Taiwan National Health Insurance database between March 2004 and February 2009. A total of 1,028,364 ICU patients were identified. The age was 65 ± 18 years, and 61% of the patients were male. The total ICU bed occupancy rate was 83.8% which went up to 87.3% during winter. The ICU bed occupancy was 94.4% in major medical centers. The ICU stay was 6.5 ± 0.5 days, and the overall ICU mortality rate was 20.2%. The hospital stay was 16.4 ± 16.8 days, and the average cost of total hospital stay was approximately US$5,186 per patient. The rate of ICU bed occupancy was dependent on seasonal changes, and it reached near full capacity in major medical centers in Taiwan. The ICU beds were distributed based on the categories of hospitals in order to achieve a reasonable cost efficiency. ICU faces many challenges to maintain and improve quality care because of the increasing cost of state-of-the-art technologies and dealing with aging population.

  13. Aspergillosis in Intensive Care Unit (ICU patients: epidemiology and economic outcomes

    Directory of Open Access Journals (Sweden)

    Baddley John W

    2013-01-01

    Full Text Available Abstract Background Few data are available regarding the epidemiology of invasive aspergillosis (IA in ICU patients. The aim of this study was to examine epidemiology and economic outcomes (length of stay, hospital costs among ICU patients with IA who lack traditional risk factors for IA, such as cancer, transplants, neutropenia or HIV infection. Methods Retrospective cohort study using Premier Inc. Perspective™ US administrative hospital database (2005–2008. Adults with ICU stays and aspergillosis (ICD-9 117.3 plus 484.6 who received initial antifungal therapy (AF in the ICU were included. Patients with traditional risk factors (cancer, transplant, neutropenia, HIV/AIDS were excluded. The relationship of antifungal therapy and co-morbidities to economic outcomes were examined using Generalized linear models. Results From 6,424 aspergillosis patients in the database, 412 (6.4% ICU patients with IA were identified. Mean age was 63.9 years and 53% were male. Frequent co-morbidities included steroid use (77%, acute respiratory failure (76% and acute renal failure (41%. In-hospital mortality was 46%. The most frequently used AF was voriconazole (71% received at least once. Mean length of stay (LOS was 26.9 days and mean total hospital cost was $76,235. Each 1 day lag before initiating AF therapy was associated with 1.28 days longer hospital stay and 3.5% increase in costs (p  Conclusions Invasive aspergillosis in ICU patients is associated with high mortality and hospital costs. Antifungal timing impacts economic outcomes. These findings underscore the importance of timely diagnosis, appropriate treatment, and consideration of Aspergillus as a potential etiology in ICU patients.

  14. An on-the-job mindfulness-based intervention for pediatric ICU nurses: a pilot.

    Science.gov (United States)

    Gauthier, Tina; Meyer, Rika M L; Grefe, Dagmar; Gold, Jeffrey I

    2015-01-01

    The feasibility of a 5-minute mindfulness meditation for PICU nurses before each work-shift to investigate change in nursing stress, burnout, self-compassion, mindfulness, and job satisfaction was explored. Thirty-eight nurses completed measures (Nursing Stress Scale, Maslach Burnout Inventory, Mindfulness Attention Awareness Scale and Self-Compassion Scale) at baseline, post-intervention and 1 month after. The intervention was found to be feasible for nurses on the PICU. A repeated measures ANOVA revealed significant decreases in stress from baseline to post intervention and maintained 1 month following the intervention. Findings may inform future interventions that support on-the-job self-care and stress-reduction within a critical care setting.

  15. ICU Nursing Ethics Continuing Education Requirements and Countermeasures%ICU护理伦理要求与继续教育对策

    Institute of Scientific and Technical Information of China (English)

    尼春萍; 李璐; 刘喜文; 马金凤; 李璇

    2011-01-01

    This paper directs at the characteristics of ICU to probe continuing education requirements and the ethical response of the ICU nursing from the highly responsible attitude, training of self - restraint and care, style of calm and quick, and the spirit of determined and enterprising, aim at, according to the characteristics of ICU nursing work, in a targeted manner to strengthen the ethical and moral education of ICU nurses, to improve their ability for clinical ethical decision - making so as to, effective enhance the quality of care, for acute and critically ill patients.%探讨ICU护理工作的伦理要求与继续教育对策,旨在结合ICU护理岗位特点,有针对性地加强ICU护士伦理道德教育,提高临床伦理决策能力,有效提升急危重症患者护理服务的质量.

  16. Nursing research progress of ventilator associated pneumonia in ICU%ICU内呼吸机相关性肺炎的护理研究进展

    Institute of Scientific and Technical Information of China (English)

    苏文文

    2016-01-01

    ICU is the important place of ventilator associated pneumonia, the occurrence of fatality rate in patients with ventilator associated pneumonia is higher. In this paper, the cause of the ventilator associated pneumonia in ICU and nursing research progress are summarized, that enhance their awareness of the importance of nursing care and the use of normative evidence-based nursing in clinical practice thinking and nursing process, explore the nursing methods of more appropriate, to reduce the incidence of ventilator associated pneumonia in ICU is of great help.%ICU内是发生呼吸机相关性肺炎的重要场所,发生呼吸机相关性肺炎的患者病死率较高。本文对ICU发生呼吸机相关性肺炎的原因及护理研究进展进行了综述,认为增强护理人员的护理观念,在临床实践中运用规范性的循证护理思路以及护理程序,探索更恰当的护理方法,对减少ICU的呼吸机相关性肺炎发病率有着重要的帮助。

  17. 综合ICU病人烦躁的原因分析及护理%Analysis and nursing measures of irritable patient in comprehensive ICU

    Institute of Scientific and Technical Information of China (English)

    李云玲; 陈罕; 谢水群; 梁冬梅; 肖彩连; 林结萍

    2008-01-01

    分析综合ICU病人烦躁的原因,对其采取有针对性的护理和改善环境等措施,病人烦躁均得到不同程度的缓解,防止了各类意外事件的发生,促进了病人的康复.%To analyze the causes of the 122 irritable patients in comprehensive ICU,by adopting psychological nursing,the measures of protective restraint,application of analgesic and sedation,reinforced canal nursing and basic nursing,ICU surroundings improvement,all patients'irritability were relieved with varying degrees,preventing all kinds of accident and promoting the rehabilitation of the human body.

  18. Investigation on burnout of nurses working in ICU of beijing city%北京市ICU护士工作倦怠感的调查

    Institute of Scientific and Technical Information of China (English)

    曹炜; 路潜

    2008-01-01

    目的 了解北京市ICU护士的工作倦怠感的情况.方法 采用Maslach工作疲溃感量表,对北京市23家三级综合医院的792名ICU护士进行评测.结果 ICU护士的工作倦怠感中情绪倦怠感得分为(20.04±10.37),工作冷漠感得分为(6.94±5.98),均属于中度倦怠感,个人成就感得分为(28.32±8.84),属于高度倦怠感.不同年龄、不同学历、不同工作年限及职称的ICU护士的工作倦怠感存在差异,有统计学意义(P<0.05).结论 应重视ICU护士的工作倦怠感,护理管理者应寻求缓解护士工作倦怠感的有效措施,以保障ICU护士的心身健康.%Objective To know the burnout condition of nurses working in ICU of beijing city.Methods 792 nurses in ICU from 23 3A general hospitals were evaluated by Maslach burnout inventory.Results,The score of emotional burnout in work burnout of nurses in ICU was(20.04±10.37).and the score of work indifierent sensation was(6.94±5.98).The two were the middle degrees of burnout.The score of personal accomplishment was(28.32±8.84),belonging to the hish degree of burnout.There were differences in work burnout of ICU nurses with different age,educational background,work period and professional title,with statistical meanings(P<0.05).Conclusions The burnout of nurses working in ICU should be emphasized.The nursing managers should seek for the effective measures to alleviate the burnout of nunses working.ensuring the psychosomatic health of nurses in ICU.

  19. Analysis and Countermeasure of ICU Nursing Ethics Problem%ICU护理伦理道德问题分析及对策

    Institute of Scientific and Technical Information of China (English)

    刘家珲; 郭翠婷; 嵇委; 高媚; 姜新

    2016-01-01

    The ICU is centralized in critically ill patients with a special unit of the rescue, it has closed, 24 hours by nurs-es solely responsible for care, only a day to 1.5 hours allows family members to visit, so in the nursing process exist the ethical and moral problems such as ignoring patients and the families of the informed consent right, low quality of care and moral accomplishment, resource utilization unreasonable and humanistic care deletion etc.. Timely find and solve the prob-lem, is an important way to improve the nursing work, is the key to promote the health of patients with recovery measures.%ICU是集中抢救危重患者的特殊病房,它具有全封闭的特点,24 h时由护士全权负责护理,每天只有1~1.5 h的时间允许家属探视,因此在护理过程中存在相关的伦理道德问题,如:忽视患者与家属的知情同意权、护理质量与道德素养低、资源利用不合理、人文关怀的缺失等。及时发现问题并解决,是完善护理工作的重要途径,是促进患者恢复健康的关键措施。

  20. A study of the lived experiences of registered nurses who have provided end-of-life care within an intensive care unit.

    Science.gov (United States)

    Holms, Natalie; Milligan, Stuart; Kydd, Angela

    2014-11-01

    End-of-life care (EOLC) in the intensive care unit (ICU) has received little attention in the literature in comparison to the considerable amount of existing literature available on EOLC in other areas of nursing. The ethos of the ICU is to preserve life, but as many patients die in this environment, EOLC should be an integral part of the ICU nurse's role. This qualitative study explored the experiences of ICU nurses who had provided EOLC to patients and their families. Participants were purposively recruited within one local ICU (n=5). A semi-structured interview format was used to guide in-depth interviews. The themes identified from the interview analysis were; use of integrated care systems, communication, the environment, education and training, staff distress. The findings suggest that ICU nurses do not feel adequately prepared to give proficient EOLC. Those who felt more confident in EOLC had learned what to do over time. Appropriate training, support and improved communication between staff, patients and families is necessary for good EOLC in ICUs.

  1. Sistematização da Assistência de Enfermagem em Unidade de Terapia Intensiva sustentada pela Teoria de Wanda Horta Sistematización de la asistencia de enfermería en una unidad de terapia intensiva basada en la Teoría de Wanda Horta Nursing care systematization at the intensive care unit (ICU based on Wanda Horta's theory

    Directory of Open Access Journals (Sweden)

    Lúcia Nazareth Amante

    2009-03-01

    desarrollo calificado del cuidado de enfermería.The purpose of this study was to implement the Nursing Care Systematization - Sistematização da Assistência de Enfermagem (SAE - with Wanda Aguiar Horta's Theory of Basic Human Necessities and the North American Nursing Diagnosis Association's (NANDA Nursing Diagnosis as its references. The starting point was the evaluation of the knowledge of the nursing team about the SAE, including their participation in this process. This is a qualitative study, performed in the Intensive Care Unit in a hospital in the city of Brusque, Santa Catarina, from October, 2006 to March, 2007. It was observed that the nursing professionals know little about SAE, but they are greatly interested in learning and developing it in their daily practice. In conclusion, it was possible to execute the healthcare systematization in an easy way, with the use of simple brochures that provided all the necessary information for the qualified development of nursing care.

  2. Type D personality and post-traumatic stress disorder symptoms among intensive care unit nurses: The mediating effect of resilience.

    Science.gov (United States)

    Cho, Geum-Jin; Kang, Jiyeon

    2017-01-01

    The purpose of this study was to investigate the relationship between Type D personality and post-traumatic stress disorder (PTSD) symptoms of intensive care unit (ICU) nurses and to determine the mediating effect of resilience on this relationship. A cross-sectional survey was performed with 179 ICU nurses from 7 hospitals in Gyeong-Nam province, South Korea. The Type D personality, resilience, and PTSD symptoms of subjects were measured using a self-report questionnaire. The mediating effect was analyzed by a series of hierarchical multiple regressions. A total of 38.6% of the study participants turned out to have Type D personality. The Type D personality was positively correlated with PTSD symptoms, and negatively correlated with resilience. There was a negative correlation between resilience and PTSD symptoms. The indirect effect of Type D personality on PTSD symptoms via resilience (β = .51, p personality and PTSD symptoms of ICU nurses. Further studies need to be done to develop interventions for enhancing resilience in ICU nurses.

  3. ICU nurse professional skills training needs and influencing factors%ICU护士专业技能培训需求及影响因素研究

    Institute of Scientific and Technical Information of China (English)

    韦秀爱

    2015-01-01

    目的 分析ICU护士专业技能培训的需求,研究其影响因素.方法 采用问卷调查的方法,选取大化县人民医院ICU部门的23名护士作为研究对象,该医院为二乙医院,医疗水平以及医护人员综合素质均较高,具有一定的代表性. 设计情况调查表和ICU护士专业技能培训需求调查表,对参与调研的护士进行问卷调查分析,研究ICU护士专业技能培训需求及影响因素. 结果 大化县人民医院ICU护士多数对专业技能有着较高的需求, 平均得分为4.36分. 而对护士的个人资料以及经历分析得知,学历、工作自评以及ICU的工作年限都是影响ICU护士专业技能培训需求的重要因素.采用统计学软件处理,不同的工作年限、学历、工作自评对ICU护士专业技能培训需求影响明显,差异具有统计学意义,P<0.05. 结论 大化县人民医院ICU护士多数对专业技能培训需求较高,其中学历相对较低的护士需求越高,工作年限较长、工作自评越高的护士对自我要求也越高,因此对培训需求也较高. 因此,医院护理管理者、ICU部门在安排护士培训时,必须要结合ICU护士的层次、学历差异以及个体的差异性,按照逐级递增的原则系统的培训.%Objective To analyze the needs of ICU nursing skills training, study the influencing factors. Methods A ques-tionnaire, select Dahua County People's Hospital ICU department 23 nurses as research subjects, the hospital diethyl hos-pital, medical standards and the overall quality of health care are high, with a certain representation. Questionnaire design and ICU nurse professional skills training needs survey of nurses involved in research survey analysis, research ICU nurse professional skills training needs and influencing factors. Results Dahua County People's Hospital ICU nurse most of the professional skills have a higher demand, with an average score of 4.36 points. While the nurse's profile and

  4. 影响ICU护士落实“知情同意原则”原因及对策%The Causes and Countermeasures of ICU Nurses Implementing the “Informed Consent”

    Institute of Scientific and Technical Information of China (English)

    滕月玲

    2011-01-01

    Intensive care doctors pay attention to the informed consent in diagnosis and treatment process increasingly. They talk each important practice over with patients and family members and solicit consent orally or in writing. In contrast, it cannot be carried out effectively in the nursing performance because part of nurses didn't take this matter seriously. Therefore it can cause dispute between nurses and patients. Ensuring patients obtain the right of informed consent is the duty of nurses must carry out. Informing by nurses is the effective measure to defend the right of informed consent and prevent dispute between nurses and patients.%重症监护(intensive care unit,ICU)医生越来越重视在诊疗活动过程中的知情同意权,各种重要诊疗活动都与患者和家属沟通,并取得口头或文字上的同意,但部分护理人员对知情同意原则不重视,在环节中落实不力,从而易引发护患纠纷.而保证患者获得知情同意权是护理人员必须落实的义务,护士的告知是维护患者知情同意权和防范护患纠纷的有效手段.

  5. Relationship between glycated hemoglobin, Intensive Care Unit admission blood sugar and glucose control with ICU mortality in critically ill patients

    Science.gov (United States)

    Mahmoodpoor, Ata; Hamishehkar, Hadi; Shadvar, Kamran; Beigmohammadi, Mohammadtaghi; Iranpour, Afshin; Sanaie, Sarvin

    2016-01-01

    Background and Aims: The association between hyperglycemia and mortality is believed to be influenced by the presence of diabetes mellitus (DM). In this study, we evaluated the effect of preexisting hyperglycemia on the association between acute blood glucose management and mortality in critically ill patients. The primary objective of the study was the relationship between HbA1c and mortality in critically ill patients. Secondary objectives of the study were relationship between Intensive Care Unit (ICU) admission blood glucose and glucose control during ICU stay with mortality in critically ill patients. Materials and Methods: Five hundred patients admitted to two ICUs were enrolled. Blood sugar and hemoglobin A1c (HbA1c) concentrations on ICU admission were measured. Age, sex, history of DM, comorbidities, Acute Physiology and Chronic Health Evaluation II score, sequential organ failure assessment score, hypoglycemic episodes, drug history, mortality, and development of acute kidney injury and liver failure were noted for all patients. Results: Without considering the history of diabetes, nonsurvivors had significantly higher HbA1c values compared to survivors (7.25 ± 1.87 vs. 6.05 ± 1.22, respectively, P < 0.001). Blood glucose levels in ICU admission showed a significant correlation with risk of death (P < 0.006, confidence interval [CI]: 1.004–1.02, relative risk [RR]: 1.01). Logistic regression analysis revealed that HbA1c increased the risk of death; with each increase in HbA1c level, the risk of death doubled. However, this relationship was not statistically significant (P: 0.161, CI: 0.933–1.58, RR: 1.2). Conclusions: Acute hyperglycemia significantly affects mortality in the critically ill patients; this relation is also influenced by chronic hyperglycemia. PMID:27076705

  6. Relationship between glycated hemoglobin, Intensive Care Unit admission blood sugar and glucose control with ICU mortality in critically ill patients

    Directory of Open Access Journals (Sweden)

    Ata Mahmoodpoor

    2016-01-01

    Full Text Available Background and Aims: The association between hyperglycemia and mortality is believed to be influenced by the presence of diabetes mellitus (DM. In this study, we evaluated the effect of preexisting hyperglycemia on the association between acute blood glucose management and mortality in critically ill patients. The primary objective of the study was the relationship between HbA1c and mortality in critically ill patients. Secondary objectives of the study were relationship between Intensive Care Unit (ICU admission blood glucose and glucose control during ICU stay with mortality in critically ill patients. Materials and Methods: Five hundred patients admitted to two ICUs were enrolled. Blood sugar and hemoglobin A1c (HbA1c concentrations on ICU admission were measured. Age, sex, history of DM, comorbidities, Acute Physiology and Chronic Health Evaluation II score, sequential organ failure assessment score, hypoglycemic episodes, drug history, mortality, and development of acute kidney injury and liver failure were noted for all patients. Results: Without considering the history of diabetes, nonsurvivors had significantly higher HbA1c values compared to survivors (7.25 ± 1.87 vs. 6.05 ± 1.22, respectively, P < 0.001. Blood glucose levels in ICU admission showed a significant correlation with risk of death (P < 0.006, confidence interval [CI]: 1.004–1.02, relative risk [RR]: 1.01. Logistic regression analysis revealed that HbA1c increased the risk of death; with each increase in HbA1c level, the risk of death doubled. However, this relationship was not statistically significant (P: 0.161, CI: 0.933–1.58, RR: 1.2. Conclusions: Acute hyperglycemia significantly affects mortality in the critically ill patients; this relation is also influenced by chronic hyperglycemia.

  7. ICU护士与病人亲属对病人家庭需要重要性认识的调查分析%Comparative Study on the Family Needs for Nurses and Patients' Relatives in ICU Wards

    Institute of Scientific and Technical Information of China (English)

    王文茹; 李小妹; 高睿

    2001-01-01

    In order to investigate the family needs for the ICU nurses and patients' relatives in ICU wards, Molter family need scale for emergent and severe patients was applied to comparatively analyze 50 relatives of ICU patients and 50 ICU nurses. The results showed that the relatives of the ICU patients and ICU nurses all considered that the needs closely related with the life and benefit of the patients was the most important, but there was a significant difference in the scores between the relatives of the ICU patients and ICU nurses (P<0.05). It was suggested that ICU nurses should pay attention to the needs of the ICU patients, immediately provide information and fully understand the need of the relatives of the patients to help the patients' family act on the emergent status of the patients and maintain the physical and mental health of the patients and their relatives.%为了解病人在ICU接受监护时,其亲属及ICU护士对病人家庭需要重要性的认识,应用Molter“急危重病人家庭需要量表”对50名ICU病人亲属及50名ICU护士进行调查。结果ICU病人亲属及ICU护士均认为与病人生命及利益密切相关的需要最重要,但其得分比较,差异有显著性意义(P<0.05)。提示ICU护士必须充分认识ICU病人需要的重要性,及时提供各种信息,并充分认识其亲属的需要,以帮助病人家庭应对其危机状态,维护病人及亲属的身心健康。

  8. Nursing activities score (NAS): a proposal for practical application in intensive care units.

    Science.gov (United States)

    Gonçalves, Leilane Andrade; Padilha, Katia Grillo; Cardoso Sousa, Regina M

    2007-12-01

    For over 30 years in an attempt to demonstrate the cost-benefit ratio of the intensive care unit (ICU) a variety of tools have been developed to measure not only the severity of illness of the patient but also to capture the true cost of nursing workload. In this context, the nursing activities score (NAS) was developed as a result of modifications to the therapeutic interventions scoring system-28 (TISS-28). The NAS is a tool to measure nursing workload ICU and it has been shown to be twice as effective in measuring how nurses spend their time caring for critically ill patients than the TISS-28. This paper discuss the introduction of the NAS into everyday use in an intensive care unit in Brazil and highlights the challenges of standardisation of operational definitions, training requirements and accurate completion of the documentation when using such a tool. The rationale and steps undertaken to achieve this are outlined and the benefits of such a process are highlighted.

  9. Knowledge and attitudes of Saudi intensive care unit nurses regarding oral care delivery to mechanically ventilated patients with the effect of healthcare quality accreditation

    Directory of Open Access Journals (Sweden)

    A K Alotaibi

    2016-01-01

    Full Text Available Introduction: Ventilator-associated pneumonia is a major morbid outcome among intensive care unit (ICU patients. Providing oral care for intubated patients is an important task by the ICU nursing staff in reducing the mortality and morbidity. The objectives of this study were to evaluate the attitudes and knowledge of ICU nurses regarding oral care delivery to critically ill patients in Saudi Arabian ICUs. The findings were further correlated to the presence of healthcare quality accreditation of the institution. Materials and Methods: The nurses′ knowledge, attitudes, and healthcare quality accreditation status of the hospital were recorded. Two hundred fifteen nurses conveniently selected from 10 random hospitals were included in this study from Riyadh city, Saudi Arabia. This is a cross-sectional study in the form of a questionnaire. Results: When comparing the knowledge of the participants to their level of education, there was no statistically significant difference between the two groups of nurses. The majority of the nurses agreed that the oral cavity is difficult to clean and that oral care delivery is a high priority for mechanically ventilated patients. Furthermore, there was no statistically significant difference in the attitudes between nurses working in accredited and nonaccredited hospitals. Conclusion: The presence of healthcare quality accreditation did not reflect any significance in attitudes or knowledge of the ICU nurses in regard to mechanically ventilated patients. Factors affecting oral care delivery should be evaluated on the personal and institutional level to achieve better understanding of them.

  10. The Holistic Leadership Model and the Nurse Unit Manager ...

    African Journals Online (AJOL)

    1Neonatal intensive care unit at Rwanda Military Hospital. 2University of ... Keywords: Nurse; nursing practice; leadership; management; caring; competencies; holistic nursing ... indicators of a profession's advancement or lack thereof.

  11. ICU护士长-护士预约访谈制度的应用效果%Application effects of appointment interview policy between head nurse and nurses in ICU

    Institute of Scientific and Technical Information of China (English)

    俞萍; 任国琴; 杨正宇; 何平

    2016-01-01

    Objective To establish and implement an appointment interview policy between head nurse and nurses in ICU,in order to reduce their job burnout and to improve the job satisfaction and nursing quality. Methods A total of 68 appointment interviews were performed between head nurse and 28 nurses in ICU from February 2014 to September 2015.The job burnout level,job satisfaction,and the nursing quality were compared before and after the intervention.Results After the intervention,the score of emotional exhaustion reduced from (29.17 ±7.90)to (23.08 ±6.58);the personal achievement increased from (31.63 ±5.20)to (36.13 ±5.90);the job satisfaction significantly improved from (58.96 ±7.17)to (64.38 ±4.92);the nursing quality also improved from (80.13 ±1.65)to (88.88 ±1.89).The differences of the above scores had statistical significance (P <0.05 ).Conclusions The establishment of the appointment interview policy can effectively improve the relationship between the head nurse and nurses and provide supports to reduce their job burnout and improve the job satisfaction and nursing quality.%目的:建立并落实 ICU 护士长—护士预约访谈制度,降低 ICU 护士职业倦怠,提高工作满意度和工作质量。方法2014年2月—2015年9月,由 ICU 护士长对病区28名护士共进行68次预约访谈,对访谈制度实施前后 ICU 护士的工作倦怠水平、工作满意度和 ICU 护理工作质量进行比较。结果实施预约访谈制度后,ICU 护士工作倦怠评分情绪衰竭维度得分由(29.17±7.90)分下降到(23.08±6.58)分(P <0.05),个人成就感维度得分由(31.63±5.20)分提高到(36.13±5.90)(P <0.05),工作满意度评分由(58.96±7.17)分提高到(64.38±4.92)分(P <0.05),ICU 护理工作质量得分由(80.13±1.65)分提高到(88.88±1.89)分(P <0.05)。结论建立与实施护士长—护士预约访谈制度

  12. [Nurses' perception, experience and knowledge of palliative care in intensive care units].

    Science.gov (United States)

    Piedrafita-Susín, A B; Yoldi-Arzoz, E; Sánchez-Fernández, M; Zuazua-Ros, E; Vázquez-Calatayud, M

    2015-01-01

    Adequate provision of palliative care by nursing in intensive care units is essential to facilitate a "good death" to critically ill patients. To determine the perceptions, experiences and knowledge of intensive care nurses in caring for terminal patients. A literature review was conducted on the bases of Pubmed, Cinahl and PsicINFO data using as search terms: cuidados paliativos, UCI, percepciones, experiencias, conocimientos y enfermería and their alternatives in English (palliative care, ICU, perceptions, experiences, knowledge and nursing), and combined with AND and OR Boolean. Also, 3 journals in intensive care were reviewed. Twenty seven articles for review were selected, most of them qualitative studies (n=16). After analysis of the literature it has been identified that even though nurses perceive the need to respect the dignity of the patient, to provide care aimed to comfort and to encourage the inclusion of the family in patient care, there is a lack of knowledge of the end of life care in intensive care units' nurses. This review reveals that to achieve quality care at the end of life, is necessary to encourage the training of nurses in palliative care and foster their emotional support, to conduct an effective multidisciplinary work and the inclusion of nurses in decision making. Copyright © 2014 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

  13. The professional endanger factors of ICU nurses and its prevention%ICU 护士的职业危害因素及防护策略

    Institute of Scientific and Technical Information of China (English)

    吴惠贞; 董力

    2014-01-01

    Through the analysis of tutelar ward nurses facing al sorts of occupational hazards in the clinical work,puts forward corresponding protective measures,to improve clinical nurses conscious-ness of self protection,reduce the incidence of occupational hazards on nurses.%通过分析监护病房护士在临床工作中面临的各种职业危害,提出相应的防护对策,提高临床护士的自我防护意识,降低职业危害在护士身上的发生率。

  14. Team cohesion in intensive care nursing: at the interface of nurse self-concept and unit structure

    DEFF Research Database (Denmark)

    Paunova, Minna; Li-Ying, Jason

    2017-01-01

    Team cohesion is a critical factor in the provision of high-quality care, yet its antecedents remain understudied, particularly in the context of some healthcare professional groups where structural and individual constraints coexist, and demand for high quality performance is prevailing....... In this study, we focus on the nursing group in intensive care units (ICU). Not researched, yet important for employee attitudes towards their workplaces and workgroups, is the interface between the characteristics of individual care providers and those of the teams and organizations in which they are employed...... their teams as cohesive. A multi-source and multi-level study of approximately 140 nurses employed in 20 ICUs across Denmark demonstrates the critical role of self-concept in easing and enhancing the constraints workplaces impose on team cohesion. Furthermore, the study confirms the positive relationship...

  15. ICU visitation policies.

    Science.gov (United States)

    Cleveland, A M

    1994-09-01

    Critically ill patients need their families more than ever, but rigid policies often restrict family visitation in ICU. Family visitation is not a "privilege" granted by hospitals, it is a necessary adjunct to the therapeutic regimen. Though changing outdated visitation policies can be difficult, it must be done. The clinical nurse specialist can play an important role in planning and implementing needed change.

  16. Effectiveness of nursing interventions based on family needs on family satisfaction in the neurosurgery intensive care unit

    OpenAIRE

    Yousefi, Hojatollah; Afsaneh KARAMI; Moeini, Mahin; Ganji, Hamid

    2012-01-01

    Background: Since the family is a social system, the impairment in each of its component members may disrupt the entire family system. One of the stress sources for families is accidents leading to hospitalization particularly in the intensive care unit (ICU). In many cases, the families’ needs in patient care are not met that cause dissatisfaction. Since the nurses spend a lot of time with patients and their families, they are in a good position to assess their needs and perform appropriate ...

  17. Dysfunctional psychological responses among Intensive Care Unit nurses: a systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Maria Karanikola

    2015-10-01

    Full Text Available AbstractOBJECTIVETo systematically review evidence on dysfunctional psychological responses of Intensive Care Units nurses (ICUNs, with focus on anxiety and depressive symptoms and related factors.METHODA literature search was performed in CINAHL, PubMed and Scopus databases, from 1999 to present, along with a critical appraisal and synthesis of all relevant data. The following key words, separately and in combination, were used: "mental status" "depressive symptoms" "anxiety" "ICU nurses" "PTSD" "burnout" "compassion fatigue" "psychological distress".RESULTSThirteen quantitative studies in English and Greek were included. The results suggested increased psychological burden in ICUNs compared to other nursing specialties, as well as to the general population.CONCLUSIONSStudies investigating psychological responses of ICUNs are limited, internationally. Future longitudinal and intervention studies will contribute to a better understanding of the phenomenon.

  18. Effect of Hierarchical Management of ICU Nursing Staff on Improving the Quality of Nursing Care%ICU护理人员层级管理对提高护理质量的作用

    Institute of Scientific and Technical Information of China (English)

    杨洁

    2016-01-01

    目的探讨ICU护理人员层级管理对提高重症监护室护理质量的作用。方法组成质量护理管理小组,确定质量护理管理小组的人员及工作内容。确定护理质量内容及指标,对每月抽样检查的最终结果要进行小组讨论,每个人提出自己的见解,并要做出相应的评价。检查方法:护士长每月定期召开整个科室的护理分析会,对每周ICU护理质量检查发现的缺陷进行分析总结,提出改进方案,持续改善护理质量;护理组长每日定时对本组人员的护理工作进行分析总结,出现不好的现象要及时提出并选择合适的方式加以改进。结果2011-2014年的病区管理、特级护理、基础护理、ICU专科护理、急救物品的合格率逐年提高,四组比较差异具有统计学意义(P<0.05);对ICU护理质量、患者满意度进行调查,2011年150人参与调查,2014年164人参与调查,满意率都有所提高,两组比较差异具有统计学意义(P<0.05)。结论 ICU护理人员实行层级管理使ICU重症监护室护理质量有明显提高,患者满意度不断提高,证实该管理模式是成功的。%Objective To investigate the effect of hierarchical management of ICU nursing staff on improving the quality of nursing care in the intensive care unit.Methods Anursing quality management groupwas set up. The group member, main work content and indicators of nursing quality management group were determined.The final results of monthly sampling inspection would be discussed in the management group. Each member of the group should put forward their own opinions and evaluated the results. Inspection methods: Monthly Nursing Analysis Meeting would be held regularly by lead nurse in order to analyze the defects found in inspection, put forward improvement plan and improve the nursing quality continuously; lead nurse would analyze and sum up the daily nursing work of each member at regular

  19. Nursing continuing education in the united states

    OpenAIRE

    Robert, B.

    1981-01-01

    THE discussion of nursing continuing education in the United States is approached by a consideration of the following aspects: Definition and Background Evolution of the Concept Administration of the Process Teaching Techniques Range of Subjects Evaluation of the Program Issues and Problems: Mandatory vs. Voluntary Participation Control of the Accreditation Process Responsibility for Participation Program Cost/Availability

  20. Nursing continuing education in the united states

    Directory of Open Access Journals (Sweden)

    B Robert

    1981-09-01

    Full Text Available THE discussion of nursing continuing education in the United States is approached by a consideration of the following aspects: Definition and Background Evolution of the Concept Administration of the Process Teaching Techniques Range of Subjects Evaluation of the Program Issues and Problems: Mandatory vs. Voluntary Participation Control of the Accreditation Process Responsibility for Participation Program Cost/Availability

  1. [Nursing practice in maternity intensive care units. Severe pre-eclampsia in a primigravida].

    Science.gov (United States)

    Carmona-Guirado, A J; Escaño-Cardona, V; García-Cañedo, F J

    2015-01-01

    39 year old woman, pregnant for 31+5 weeks, who came to our intensive care unit (ICU) referred from the emergency department of the hospital, having swollen ankles, headache and fatigue at moderate effort. We proceeded to take blood pressure (158/96 mmHg) and assess lower limb edema. The fetal heart rate monitoring was normal. Knowledgeable and user of healthy guidelines during her pregnancy, she did not follow any treatment. Single mother, she worried about her fetus (achieved through in vitro fertilization), her mother offered to help for any mishap. We developed an Individualized Care Plan. For data collection we used: Rating 14 Virginia Henderson Needs and diagnostic taxonomy NANDA, NOC, NIC. Nursing diagnoses of "fluid volume excess" and "risk of impaired maternal-fetal dyad" were detected, as well as potential complications such as eclampsia and fetal prematurity. Our overall objectives (NOC) were to integrate the woman in the process she faced and that she knew how to recognize the risk factors inherent in her illness. Nursing interventions (NIC) contemplated the awareness and treatment of her illness and the creation of new healthy habits. The work of nursing Maternal ICU allowed women to help maintain maximum maternal and fetal well-being by satisfying any of her needs. Mishandling of the situation leads into a framework of high morbidity and mortality in our units.

  2. A Case Study on Improving Intensive Care Unit (ICU) Services Reliability: By Using Process Failure Mode and Effects Analysis (PFMEA)

    Science.gov (United States)

    Yousefinezhadi, Taraneh; Jannesar Nobari, Farnaz Attar; Goodari, Faranak Behzadi; Arab, Mohammad

    2016-01-01

    Introduction: In any complex human system, human error is inevitable and shows that can’t be eliminated by blaming wrong doers. So with the aim of improving Intensive Care Units (ICU) reliability in hospitals, this research tries to identify and analyze ICU’s process failure modes at the point of systematic approach to errors. Methods: In this descriptive research, data was gathered qualitatively by observations, document reviews, and Focus Group Discussions (FGDs) with the process owners in two selected ICUs in Tehran in 2014. But, data analysis was quantitative, based on failures’ Risk Priority Number (RPN) at the base of Failure Modes and Effects Analysis (FMEA) method used. Besides, some causes of failures were analyzed by qualitative Eindhoven Classification Model (ECM). Results: Through FMEA methodology, 378 potential failure modes from 180 ICU activities in hospital A and 184 potential failures from 99 ICU activities in hospital B were identified and evaluated. Then with 90% reliability (RPN≥100), totally 18 failures in hospital A and 42 ones in hospital B were identified as non-acceptable risks and then their causes were analyzed by ECM. Conclusions: Applying of modified PFMEA for improving two selected ICUs’ processes reliability in two different kinds of hospitals shows that this method empowers staff to identify, evaluate, prioritize and analyze all potential failure modes and also make them eager to identify their causes, recommend corrective actions and even participate in improving process without feeling blamed by top management. Moreover, by combining FMEA and ECM, team members can easily identify failure causes at the point of health care perspectives. PMID:27157162

  3. How to develop a tele-ICU model?

    Science.gov (United States)

    Rogove, Herb

    2012-01-01

    The concept of the tele-ICU (intensive care unit) is about 30 years old and more hospitals are utilizing it to cover multiple hospitals in their system or for hospitals that lack on-site critical care coverage such as in the rural setting. Doing a needs analysis, picking the appropriate committee to oversee development of the correct model, choosing quality metrics to measure, and designing an implementation plan that has a timeline is how the process should begin. Research including visitation to established programs and connecting with professional societies are helpful. Developing both a business and financial plan will optimize the value of a tele-ICU program. The innovative ICU nursing director will help to integrate a telemedicine program seamlessly with the on-site program to insure a successful program that benefits patients, their families, the ICU staff, and the hospital.

  4. How do doctors and nurses manage delirium in intensive care units? A qualitative study using focus groups

    Science.gov (United States)

    Palacios-Ceña, Domingo; Cachón-Pérez, José Miguel; Martínez-Piedrola, Rosa; Gueita-Rodriguez, Javier; Perez-de-Heredia, Marta; Fernández-de-las-Peñas, Cesar

    2016-01-01

    Objectives The aim of this study was to explore the experiences of doctors and nurses caring for patients with delirium in the intensive care unit (ICU) and to describe the process of delirium management. Setting This study was performed in 5 ICUs located within 4 hospitals in Madrid (Spain). Participants Purposeful sampling was performed which included (1) doctors and nurses working in ICUs, (2) with >1 year experience in the ICU and (3) clinical experience with delirium. 38 professionals participated (19 doctors, 19 nurses), including 22 women and 16 men. The total mean age was 39 years. Design A qualitative study using focus groups. Methods 7 focus groups were held to collect data: 3 nurse focus groups, 3 doctor focus groups and 1 mixed focus group. Each group comprised 6–10 participants. A semistructured questions guide was used. Thematic analysis methods were used to analyse the data. Results 3 themes were identified: (1) the professional perspective on delirium; (2) implementing pharmacological and non-pharmacological treatment for delirium and (3) work organisation in the ICU. The professionals regarded patients with delirium with uncertainty, and felt they were often underdiagnosed and poorly managed. Doctors displayed discrepancies regarding pharmacological prescriptions and decision-making. The choice of medication was determined by experience. Nurses felt that, for many doctors, delirium was not considered a matter of urgency in the ICU. Nurses encountered difficulties when applying verbal restraint, managing sleep disorders and providing early mobilisation. The lack of a delirium protocol generates conflicts regarding what type of care management to apply, especially during the night shift. A degree of group pressure exists which, in turn, influences the decision-making process and patient care. Conclusions Patients with delirium represent complex cases, requiring the implementation of specific protocols. These results serve to improve the process

  5. How do doctors and nurses manage delirium in intensive care units? A qualitative study using focus groups.

    Science.gov (United States)

    Palacios-Ceña, Domingo; Cachón-Pérez, José Miguel; Martínez-Piedrola, Rosa; Gueita-Rodriguez, Javier; Perez-de-Heredia, Marta; Fernández-de-las-Peñas, Cesar

    2016-01-29

    The aim of this study was to explore the experiences of doctors and nurses caring for patients with delirium in the intensive care unit (ICU) and to describe the process of delirium management. This study was performed in 5 ICUs located within 4 hospitals in Madrid (Spain). Purposeful sampling was performed which included (1) doctors and nurses working in ICUs, (2) with >1 year experience in the ICU and (3) clinical experience with delirium. 38 professionals participated (19 doctors, 19 nurses), including 22 women and 16 men. The total mean age was 39 years. A qualitative study using focus groups. 7 focus groups were held to collect data: 3 nurse focus groups, 3 doctor focus groups and 1 mixed focus group. Each group comprised 6-10 participants. A semistructured questions guide was used. Thematic analysis methods were used to analyse the data. 3 themes were identified: (1) the professional perspective on delirium; (2) implementing pharmacological and non-pharmacological treatment for delirium and (3) work organisation in the ICU. The professionals regarded patients with delirium with uncertainty, and felt they were often underdiagnosed and poorly managed. Doctors displayed discrepancies regarding pharmacological prescriptions and decision-making. The choice of medication was determined by experience. Nurses felt that, for many doctors, delirium was not considered a matter of urgency in the ICU. Nurses encountered difficulties when applying verbal restraint, managing sleep disorders and providing early mobilisation. The lack of a delirium protocol generates conflicts regarding what type of care management to apply, especially during the night shift. A degree of group pressure exists which, in turn, influences the decision-making process and patient care. Patients with delirium represent complex cases, requiring the implementation of specific protocols. These results serve to improve the process of care in patients with delirium. Published by the BMJ Publishing Group

  6. Bibliometrical analysis of research hot points of nursing works in ICU%有关ICU护理工作研究热点的文献计量学分析

    Institute of Scientific and Technical Information of China (English)

    张晓春; 李卓

    2011-01-01

    Objective : By adopting bibliometrics method,it analyzed the hot points and regulations of international research related to ICU nursing care. Methods : Literatures related to ICU nursing care published in nursing journals in English from 2000 to 2009 in PubMed database had been collected. Keywords quoted by literatures were downloaded and the frequencies of keywords appearing were counted. High - frequency keywords were selected according to the setting threshold value. And research hot points related to ICU nursing care were determined by cluster analysis of high -frequency keywords. Results: Totally 2 419 pieces of nursing literature about ICU nursing had been searched and 32 high -frequency keywords had been selected. Cluster analysis showed common research hot points mainly concentrated on the management of ICU,related professional skills of ICU nursing, psychological study and nurse - patient communication research.Conclusions:Research hot points in ICU nursing work in abroad mainly concentrated on the management of ICU, related professional skills of ICU nursing , psychological study and nurse - patient communication research.%[目的]采用文献计量学方法,分析国际有关ICU护理相关的研究热点和规律.[方法]收集PubMed数据库中2000年-2009年在护理学杂志上以英文发表的有关ICU护理工作的文献,下载这些文献所标引的419篇,截取32个高频主题词,共词聚类分析结果显示研究热点主要集中于ICU的管理、ICU护理相关的专业技能、心理学研究和护患沟通研究.[结论]国外ICU护理工作研究热点主要集中在ICU的管理、ICU护理相关的专业技能、心理学研究和护患沟通研究.

  7. Scope of Nursing Care in Polish Intensive Care Units

    Directory of Open Access Journals (Sweden)

    Mariusz Wysokiński

    2013-01-01

    Full Text Available Introduction. The TISS-28 scale, which may be used for nursing staff scheduling in ICU, does not reflect the complete scope of nursing resulting from varied cultural and organizational conditions of individual systems of health care. Aim. The objective of the study was an attempt to provide an answer to the question what scope of nursing care provided by Polish nurses in ICU does the TISS-28 scale reflect? Material and Methods. The methods of working time measurement were used in the study. For the needs of the study, 252 hours of continuous observation (day-long observation and 3.697 time-schedule measurements were carried out. Results. The total nursing time was 4125.79 min. (68.76 hours, that is, 60.15% of the total working time of Polish nurses during the period analyzed. Based on the median test, the difference was observed on the level of χ2=16945.8, P<0.001 between the nurses’ workload resulting from performance of activities qualified into the TISS-28 scale and load resulting from performance of interventions within the scopes of care not considered in this scale in Polish ICUs. Conclusions. The original version of the TISS-28 scale does not fully reflect the workload among Polish nurses employed in ICUs.

  8. Evaluation on implement ef ect of the quantitative performance appraisal in ICU nursing%量化绩效考核在ICU护理中的应用效果

    Institute of Scientific and Technical Information of China (English)

    苏中林

    2014-01-01

    Objective:To investigate the ef ect of the quantitative performance appraisal in ICU nursing.Methods:To compare the overal score of 24 nurses in ICU,scores of profession-al knowledge,scores of nursing quality,nursing errors and patients satisfaction for nursing after and before the quantitative performance appraisal .Results:After the quantitative performance ap-praisal ,The indices,like the overal score,scores of professional knowledge,scores of nursing quality,nursing errors and patients satisfaction for nursing,was bet er than that before the quanti-tative performance appraisal in ICU nursing (P<0.05).The number of nursing errors was less than that (P<0.05).Conclusion:The application of the quantitative performance appraisal in ICU nursing can improve the quality of nursing in ICU.%目的:探讨量化绩效考核在ICU护理中的应用效果。方法对比观察实施量化绩效考核制度前后ICU科室内24位护理人员整体评分、专业知识评分、工作质量评分、护理差错发生例数、护理满意度的情况。结果实施量化绩效考核后,护理人员整体评分、专业知识评分、工作质量评分、护理满意度明显高于实施前(P<0.05),护理差错发生比例明显降低(P<0.05)。结论量化绩效考核制度的实施有效的提高了ICU科室的护理服务质量。

  9. Data envelopment analysis model for the appraisal and relative performance evaluation of nurses at an intensive care unit.

    Science.gov (United States)

    Osman, Ibrahim H; Berbary, Lynn N; Sidani, Yusuf; Al-Ayoubi, Baydaa; Emrouznejad, Ali

    2011-10-01

    The appraisal and relative performance evaluation of nurses are very important and beneficial for both nurses and employers in an era of clinical governance, increased accountability and high standards of health care services. They enhance and consolidate the knowledge and practical skills of nurses by identification of training and career development plans as well as improvement in health care quality services, increase in job satisfaction and use of cost-effective resources. In this paper, a data envelopment analysis (DEA) model is proposed for the appraisal and relative performance evaluation of nurses. The model is validated on thirty-two nurses working at an Intensive Care Unit (ICU) at one of the most recognized hospitals in Lebanon. The DEA was able to classify nurses into efficient and inefficient ones. The set of efficient nurses was used to establish an internal best practice benchmark to project career development plans for improving the performance of other inefficient nurses. The DEA result confirmed the ranking of some nurses and highlighted injustice in other cases that were produced by the currently practiced appraisal system. Further, the DEA model is shown to be an effective talent management and motivational tool as it can provide clear managerial plans related to promoting, training and development activities from the perspective of nurses, hence increasing their satisfaction, motivation and acceptance of appraisal results. Due to such features, the model is currently being considered for implementation at ICU. Finally, the ratio of the number DEA units to the number of input/output measures is revisited with new suggested values on its upper and lower limits depending on the type of DEA models and the desired number of efficient units from a managerial perspective.

  10. 基于系统论的ICU护士核心能力培养模式构建%Development of the core competence training model based on system theory for ICU nurses

    Institute of Scientific and Technical Information of China (English)

    梁娟; 陆皓

    2016-01-01

    Objective To systematically analyze the current situation of the core competence training for ICU nurses in China and overseas,in order to create new perspectives on system theory training. Methods According to the literature review,this paper focused on the current situations and barriers to the core competence training for ICU nurses.Results The core competency training and assessment system for ICU nurses was neither consistent nor normative in China.Conclusions The systematic training method can effectively improve the potential of the core competence for ICU nurses,and can be considered as a scientific theoretical basis for the establishment of the related training and assessment system.%目的:通过系统分析国内外 ICU 护士核心能力培养现状,提出用系统方法培养 ICU 护士核心能力的思路。方法基于文献资料深入研究,对 ICU 护士核心能力内涵、培训现状及存在问题进行系统分析。结果 ICU 护士的核心能力培训及评价指标尚未形成全国性统一的、系统的、规范的体系。结论采用系统方法论培训护士,能够有效增强护士核心能力提升潜力,系统论是未来有效构建 ICU 护士培训模式及评价指标体系的科学理论基础。

  11. ICU综合征的影响因素分析及护理对策%Analysis of Related Factors and Nursing Countermeasure With ICU Syndrome

    Institute of Scientific and Technical Information of China (English)

    戴乌例; 周锦华

    2016-01-01

    目的:分析ICU综合征的影响因素,以制定相应的护理对策。方法选取本院2010年1月~2015年1月ICU内出现的50例ICU综合征患者为观察组,按照1:1比例选取未合并ICU综合征的患者50例为对照组。运用Logistic回归分析方法探讨ICU综合征发生的影响因素。结果2010年1月~2015年1月ICU住院总例数为196例,出现ICU综合征50例,发生率为25.5%。经Logistic回归单因素分析结果显示,年龄、性别、学历、家庭收入、病程、医患沟通、付费方式、治疗方式、健康状况影响ICU综合征的发生,差异均有统计学意义(均P<0.05);进一步采用Logistic回归多因素分析结果显示,高年龄、疾病认知能力不足、医患沟通不良、自费医疗费用是影响ICU综合征产生的独立危险因素。结论 ICU综合征发生的危险因素为高年龄、疾病认知能力不足,医患沟通不良以及自费医疗,应针对上述危险因素采取相应的护理对策,以降低ICU综合征的发生率。%Objective Analyzed the influence factors of ICU syndrome to formulate the corresponding nursing strategy.MethodsSelected the occurred 50 cases of patients with ICU syndrome in our hospital from January 2010 to January 2015 as Observation Group,selected 50 cases of patients with unincorporated ICU syndrome according to the proportion of 1:1 as Control Group. Applied logistic regression analysis method to discuss the influence factors of ICU syndrome occurrence. ResultsTotal case number of ICU hospitalization from January 2010 to January 2015 was 196,occurred 50 cases of ICU syndrome,and the occurrence rate was 25.5%. The result of logistic regression single factor analysis showed that age,sex,educational background, family income,symptoms duration,doctor-patient communication,payment method,treatment method and health condition influenced the occurrence of ICU syndrome,the difference had statistical significance(averageP<0

  12. Simulation training for hyperacute stroke unit nurses.

    Science.gov (United States)

    Roots, Angela; Thomas, Libby; Jaye, Peter; Birns, Jonathan

    National clinical guidelines have emphasized the need to identify acute stroke as a clinical priority for early assessment and treatment of patients on hyperacute stroke units. Nurses working on hyperacute stroke units require stroke specialist training and development of competencies in dealing with neurological emergencies and working in multidisciplinary teams. Educational theory suggests that experiential learning with colleagues in real-life settings may provide transferable results to the workplace with improved performance. Simulation training has been shown to deliver situational training without compromising patient safety and has been shown to improve both technical and non-technical skills (McGaghie et al, 2010). This article describes the role that simulation training may play for nurses working on hyperacute stroke units explaining the modalities available and the educational potential. The article also outlines the development of a pilot course involving directly relevant clinical scenarios for hyperacute stroke unit patient care and assesses the benefits of simulation training for hyperacute stroke unit nurses, in terms of clinical performance and non-clinical abilities including leadership and communication.

  13. ICU护士轮班模式的质性研究%Qualitative research in work shift pattern of ICU nurses

    Institute of Scientific and Technical Information of China (English)

    朱艳萍; 任璐璐; 潘红; 何静; 俞云; 张丽; 桑薇薇; 陈妍; 张笑辰

    2010-01-01

    Objective To explore the psychological experience of ICU nurses who had worked follow different work patterns, and find the most appropriate staffing model. Methods A phenomenological approach of qualitative research was conducted in 5 ICU nurses by intensive interview,then the data collected were read, analyzed, reflected,finally the theme was got. Results In the work pattern of shifted every 12 hours, with low work frequency and strong feeling of fatigue. In the work pattern of shifted every 8 hours, with high work frequency and the disadvantage of nurse- patient relationship. In the short-time continuous APN work pattern, with continuous management of patients' condition, promotion of nurse-patient relationship, improvement of doctor-nurse relationship, comparatively stable biological clock. Conclusions The short-time continuous APN work pattern can concentrate nurses' work and rest time, relieve the press that caused by the shifted work, at the same time, promote the patients',patients' family and doctors' satisfaction degree with nursing work, increase nurses' effect in the ICU team, guarantee the quality of care, eventually ensure the patients' safety.%目的 了解ICU护士对不同轮班模式的体验,探讨适合ICU护士的轮班模式.方法 选择5名有多种轮班模式经验的护士,采用质性研究中的现象学研究方法,以深入访谈的方式了解ICU护士对不同轮班模式的体验,并对资料进行阅读、分析、反思,最终提炼主题.结果 12 h轮班制,上班频率低,但疲劳感强烈.传统8 h轮班制,倒班频繁,不利于护息沟通.短期连续APN轮班制,病情管理连续,医护合作改善,生活短期稳定.结论 短期连续APN排班,可以使护士工作和休息的时间相对集中,缓解倒班对护士所致的压力,同时提高患者、家属、医生对护理工作的满意度,提高护士在ICU团队中的作用,保证护理质量,最终保障患者的安全,并受到ICU护士的好评.

  14. The application of the concept of sustainable humanistic care in ICU nursing%持续性人文关怀理念在ICU护理中的应用

    Institute of Scientific and Technical Information of China (English)

    王妍; 唐海霞; 陈小倩

    2015-01-01

    目的:探究在ICU护理中采用持续性人文关怀理念的护理效果。方法:选择在2013年10月至2015年10月期间我院收治的ICU患者90例,采用随机数字法将其分为常规组和实验组,每45例为1组,常规组给予常规护理方法,实验组在常规护理的基础上给予持续性人文关怀理念护理,将常规组和实验组的护理效果进行对比。结果:与常规组相比,实验组患者的焦虑评分明显较低,同时护理满意度明显较高,对比均P<0.05,存在统计学意义。结论:在ICU护理中采用持续性人文关怀理念护理效果较好,值得在临床护理中应用推广。%objective: to explore the ideas of adopting sustainable humanistic care in the ICU nursing effect. Methods: in October 2013 to October 2015, 90 cases of our hospital during the period of ICU patients, by using random Numbers will be divided into the normal group and experimental group, each for 1 group 45 cases, normal group was given routine nursing methods, the experimental group on the basis of conventional nursing support for humanistic care concept of nursing, the nursing effect compared to conventional group and experimental group. Results: compared with normal group, the experimental group score of anxiety in the patients with significantly lower, nursing satisfaction significantly higher at the same time, contrast all P < 0.05, there is statistical significance. Conclusion: adopting sustainable humanistic care in ICU nursing concept care effect is good, is worth application promotion in clinical nursing.

  15. "Where Withstanding is Difficult, and Deserting Even More": Head Nurses’ Phenomenological Description of Intensive Care Units

    Directory of Open Access Journals (Sweden)

    Roghieh Nazari

    2016-01-01

    Full Text Available Introduction: The intensive care unit is one of the specialized units in hospitals where head nurses are responsible for both motivating the personnel and providing high quality care. Understanding of the lived experiences of head nurses could help develop new assumptions of the ICU. The present study was therefore conducted to describe the lived experiences of head nurses working in ICU. Methods: In this phenomenological study, data were collected through unstructured in-depth interviews with 5 ICU head nurses in Northern Iran and then analyzed using 7 steps Colaizzi’s method. Results: Despite the "distressing atmosphere of the ICU", the "difficulty of managing the ICU" and the "difficulty of communication in the ICU", which encourages the "desire to leave the unit" among ICU head nurses, the "desire to stay in the unit" is stronger and head nurses are highly motivated to stay in the unit because the unit "develops a feeling of being extraordinary", "creates an interest in providing complicated care to special patients", "facilitates the spiritual bond", "develops a professional dynamism" and "creates an awareness about the nature of intensive care" among them. Conclusion: According to the result, ICU head nurses are still inclined to work in the unit and achieve success in spite of the problems that persist in working in the ICU. As the individuals’ motivation can be the backbone of organizations, and given that individuals with a high enthusiasm for success are productive, hospital managers can take advantage of this strength in choosing their head nurses.

  16. The effect of preceptor behavior on the critical thinking skills of new graduate nurses in the intensive care unit.

    Science.gov (United States)

    Kaddoura, Mahmoud A

    2013-11-01

    Little research has been conducted to examine the effect of preceptor behaviors on the critical thinking of new graduate nurses in the intensive care unit (ICU). This study explored the perceptions of new graduates on the effect of preceptor behaviors and strategies on the development of their critical thinking skills, using a qualitative exploratory descriptive design. Data were collected with demographic surveys and semistructured interviews. Data were analyzed with a qualitative content analysis approach. The study showed that relationships between new graduates and their preceptors played a key role in the development of critical thinking skills in new graduate nurses, and specific practical implications were suggested. The study data are useful for critical care nurses, preceptors, nurse educators, and clinical nurse specialists. The findings contribute to efforts to enhance the preceptor-preceptee relationship and develop critical thinking skills in new graduates.

  17. Continuous EEG monitoring in adults in the intensive care unit (ICU).

    Science.gov (United States)

    André-Obadia, N; Parain, D; Szurhaj, W

    2015-03-01

    Continuous EEG monitoring in the ICU is different from planned EEG due to the rather urgent nature of the indications, explaining the fact that recording is started in certain cases by the clinical team in charge of the patient's care. Close collaboration between neurophysiology teams and intensive care teams is essential. Continuous EEG monitoring can be facilitated by quantified analysis systems. This kind of analysis is based on certain signal characteristics, such as amplitude or frequency content, but raw EEG data should always be interpreted if possible, since artefacts can sometimes impair quantified EEG analysis. It is preferable to work within a tele-EEG network, so that the neurophysiologist has the possibility to give an interpretation on call. Continuous EEG monitoring is thus useful in the diagnosis of non-convulsive epileptic seizures or purely electrical discharges and in the monitoring of status epilepticus when consciousness disorders persist after initial treatment. A number of other indications are currently under evaluation.

  18. [Analysis of the workload and the use of the nursing resources in an intensive care unit].

    Science.gov (United States)

    Valls-Matarín, J; Salamero-Amorós, M; Roldán-Gil, C

    2015-01-01

    To evaluate and assess the nursing workload (NW) scales by means of three scales and to determine the theoretical and real nurse/patient relationship in a polyvalent ICU. Cross-sectional descriptive study between July 2012 and June 2013 in patients over 18 years old, for which 3 nurses quantified, in randomized days, the NW by the Nursing Activities Score (NAS), Nine Equivalents Manpower Score (NEMS) and Valoración de Cargas de Trabajo y Tiempos de Enfermería (VACTE). Efficiency parameters of nursing resources were calculated: "work utilization ratio" (WUR), "level of care" operative (LOCop) and planned (LOCp). Data on demographics, length of stay and number of nurses were collected. 720 records were collected. The mean age was 64 (13.6) years. 73% were male and the median of length of stay was 3 (1-12) days. 60% were admitted for medical causes. The average total score was: NAS: 696.8 (111.6), NEMS: 311.8 (55.3) and VACTE: 4,978 (897.7). The required number of nurses according to NAS was 7 and 6,7 according to NEMS and VACTE. The actual average was 5.5. On all 3 scales the WUR was >1 and LOCop was 1.6 pacients/nurse. The LOCp was 2 patients/nurse. Assessing NW allows to know the reality of each unit. According to the scales and efficiency parameters of the nursing resources used, there is a shortage of nurses in relation to the work generated. NAS reflects more parameters of NW. Copyright © 2014 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

  19. 浅谈ICU护理人员的心理压力与缓解策略%Discussion on the ICU nursing staff of the psychological pressure and mitigation strategies

    Institute of Scientific and Technical Information of China (English)

    李芳芳; 李绪温

    2015-01-01

    针对ICU护理人员工作的特殊性,探讨其心理压力产生的原因,并且提出相应的心理压力缓解策略,以实现ICU护理质量大幅度提高的目的。选择某医院2014年1月—2014年12月30名ICU护理人员为调查对象,通过问卷调查的形式对ICU护理人员的心理压力产生原因进行统计分析,从原因中探讨其缓解策略,从而正确使用心理减压方法,促进ICU护理人员心理健康水平的提高。%Aiming at the particularity of ICU nursing staff, to analyze the cause of psychological stress produces, and proposed the corresponding psychological stress mitigation strategies, in order to achieve ICU nursing quality greatly improved purpose. Choose a hospital in 2014 January -2014 year in December 30 ICU nursing personnel as the research object. Through the form of questionnaire on ICU nursing staff of the psychological pressure causes for statistical analysis. And explore its relief strategy from the reasons, so the correct use of psychological decompression method, promote the level of ICU nursing staff’s mental health.

  20. Educational Needs of Nurses in Intensive Care Unit for Poisoned Patients

    Directory of Open Access Journals (Sweden)

    Dadpour B

    2013-10-01

    Full Text Available Objectives: Poisoned patients are at risk of impaired ventilation in many situations. The purpose of this descriptive study was to investigate the impact of educational workshops on nurses' knowledge, confidence, and attitude in taking care of poisoned patients. Materials and Methods: This descriptive study was performed on 60 nursing staff in the intensive care unit (ICU for poisoned patients in Imam Reza (p hospital, Mashhad, Iran. Data was gathered by a researcher-designed questionnaire. Studied scales included perceived importance and novelty of educational meeting, matching with professional and educational needs, illustration of practical and knowledge weaknesses and strength and finally satisfaction in holding regular workshops annually. Two, half day workshops were held and various items were taught with various methods. The knowledge of participants was assessed by pretests and post-tests consisting of 12 items related to workshop topics. The impact of these educational meetings was evaluated and the results were analyzed by the SPSS software. Results: According to the results, workshops improved awareness of nurses about their weakness and strength points, professional knowledge and their interest and attention; likewise all participants had the same opinion about a strong need to hold similar workshops more than once and preferably 2 to 3 times annually. Conclusion: It seems that short educational courses in small groups for reviewing the old data and recent findings in the context of critical care are useful in order to promote the knowledge and skills of ICU staff in taking care of poisoned patients

  1. 层级护理管理模式在ICU护理管理中的应用研究%Application Research of Level Nursing Management Mode in ICU Nursing Management

    Institute of Scientific and Technical Information of China (English)

    张莉燕

    2015-01-01

    Nurses in ICU nursing work is often accompanied by a lot of pressure, because of ICU patients with the disease is severe, the nurse to 24 hours to continuous monitoring of patients, for patients with sudden serious illness, the nurse to take measures in the first time, save the life of the patients, nurses should not only work for a long period of time, but also to monitor the vital signs in patients with moment, to prevent the occurrence of accidents, so the nurse because of work pressure big, often can produce low moods, lead to the nurse's work efficiency is affected. Level of nursing management mode application can effectively improve the enthusiasm of nurses, improve the quality of nursing work, guarantee the effi-ciency of patient care.%护士在ICU护理工作中往往伴随着很大的压力,因为ICU的患者病情严重,护士要24 h对患者进行不间断监护,对于突发严重病情的患者,护士要在第一时间采取处理措施,挽救患者的生命,所以护士由于工作压力大,经常会产生低落的情绪,导致护士的工作效率受到影响。层级护理管理模式的应用能够有效提高护士的积极性,提高护士工作质量,保障了患者的治疗效率。

  2. CVC置管在ICU患者中的应用及护理%Application of CVC Catheter and Nursing in ICU Patients

    Institute of Scientific and Technical Information of China (English)

    马婷

    2014-01-01

    对中心静脉导管(CVC)置管在ICU患者中的应用及护理方法进行综述,积极预防置管后各种并发症,合理使用抗生素,以延长CVC置管的拔管时间,发挥置管的最大效用。%On central venous catheter (CVC) tube application and nursing methods in patients with ICU were reviewed, active prevention of complications after placing tube, the rational use of antibiotics, in order to extend the CVC catheter extubation time, maximize the ef ectiveness of catheter.

  3. Influence of job stress on psychological state,sleep and serum cortisol of nurses in neurological ICU%神经科 ICU 护士工作应激对心理、睡眠及血清皮质醇的影响

    Institute of Scientific and Technical Information of China (English)

    陈偶英; 杨玉佩; 钟捷; 伍永慧

    2015-01-01

    [目的]探讨神经科 ICU 护士工作应激对心理、睡眠及血清总皮质醇的影响。[方法]以湖南省某三级甲等医院31例神经科ICU 护士和30例康复科护士为研究对象,采用护士工作应激源量表、Zung 焦虑自评量表(SAS)及抑郁自评量表(SDS)、匹兹堡睡眠质量指数问卷(PSQI)进行调查,同时测定血清总皮质醇含量。[结果]神经科 ICU 护士的工作应激源量表粗分及其维度与对护士期望有关的应激源、与护理工作中人际关系有关的应激源、与工作负荷有关的应激源得分均高于康复科护士(P <0.01);神经科 ICU护士 SDS 评分、SAS 评分、PSQI 评分、血清总皮质醇检测值均高于康复科护士(P <0.05或 P <0.01)。[结论]工作应激是神经科ICU 护士心理、睡眠、血清总皮质醇异常的危险因素,管理者应针对性制订有效的防范措施,以避免神经科 ICU 护士因工作应激引发身心异常的发生。%Objective:To probe into the influence of job stress on psychological state,sleep and serum cortisol of nurses in neurological ICU.Methods:A total of 31 cases of nurses in neurological ICU and 30 cases of nurses in rehabilitation department were taken as study subjects from a third grade class A hospital in Changsha.The nurse job stressors scale,self rating scale of Zung anxiety (SAS)and depression (SDS),questionnaire of Pitts-burgh sleep quality index (PSQI)were used to investigate and measure their total serum cortisol.Results:The saw scores and dimension scores of the nurse job stressors scale in neurological ICU nurses,the stressors scores related to nurses’expectation,interpersonal relationship in nursing job or work load were all higher than that in nurses in rehabilitation department(P <0.01 ).The scores of SDS、SAS、PSQI、serum cortisol in neurological ICU nurses were higher than nurses in rehabilitation department(P <0.05 or P <0.01).Conclusion:Job stress was a risk factor for

  4. [Role of the nurse and midwife in educating parents of neonates treated at intensive care units].

    Science.gov (United States)

    Fryc, Dorota; Rudnicki, Jacek; Cwiek, Dorota

    2010-01-01

    Health education is an important element in the therapeutic process of every patient. If the patient is a neonate at an intensive care unit (ICU), the parents or legal guardians become the object of education. Knowledge and skills learned by parents at neonatal ICUs are later reflected in the quality of their childcare. The nursing and midwifery staff at ICUs plays an important role in the process of parental education. The aim of this study was to define educational needs of parents of neonates in intensive care and the impact of education on future parental childcare skills. We used the diagnostic poll method and the research tool was a questionnaire, which was addressed to parents of neonates treated at the neonatal intensive care unit of the Second University Hospital and the SPSZOZ Zdroje Hospital in Szczecin. The study was carried out in December-January of 2004/2005 and the group comprised 53 persons. The results were subjected to mathematical analysis. The following conclusions were drawn: (1) As all the parents wished to stay with their children at the neonatal ICU, special facilities for this purpose should be created at hospitals possessing such units. (2) Parents of neonates weighing more than 1000 g reported that their need to help their children was satisfied through participation in diagnostic, therapeutic, and nursing activities, which also gave them a sense of proximity with their offspring. extremely low birthweight to participate in the therapeutic process. (3) Parents expected to be taught by nurses and midwives and were interested in the activities of support groups. (4) Participation by parents in nursing activities is of importance for their unassisted childcare exercised later at home.

  5. [Application of cognitive techniques in the nursing care of mothers of premature newborns in the neonatal ICU].

    Science.gov (United States)

    Serret Serret, María

    2012-09-01

    In neonatal units, situations that cause pain and suffering to parents are common. One such situation occurs when a parent develops negative thoughts about the child. These thoughts, in turn, negatively affect the parent-child relationship. Normally, the expert nurse cares for these parents intuitively, based on her professional experience, but without a theoretical foundation such as cognitive theory. Cognitive theory postulates that an individual's emotional response to an event is determined not by the event itself, but by the conscious meaning that the individual gives it. Motivational interviewing and cognitive restructuring are two psychological techniques that allow us to identify, analyse and modify the interpretations and erroneous thoughts that people experience in certain situations. To show how application of these techniques can be useful in caring for these parents and helping them to create a strong, safe bond to their children. We selected the mother of a premature newborn. The nurse had observed that this woman had many negative thoughts that interfered notably in the bonding process with her son. After establishing an empathic relationship with the mother, the nurse performed a motivational interview followed by a cognitive restructuring. Both cognitive techniques are very useful in helping mothers of premature babies to change their feelings and attitudes towards their newborns, thus promoting a strong and happy bond.

  6. Isolation, molecular characteristics and disinfection of methicillin-resistant Staphylococcus aureus from ICU units in Brazil.

    Science.gov (United States)

    Campos, Guilherme B; Souza, Simone G; Lob O, Tassia N; Da Silva, Danilo C C; Sousa, Daniel S; Oliveira, Pollianna S; Santos, Verena M; Amorim, Aline T; Farias, S Vio T; Cruz, Mariluze P; Yatsuda, Regiane; Marques, Lucas M

    2012-04-01

    The aim of the present study was to isolate S. aureus strains resistant to antibiotics, characterize the genotype profiles of resistance staphylococci, and evaluate the efficacy of antiseptic agents and disinfectants used in two public hospitals of Vitoria da Conquista, Bahia, Brazil. Clinical samples were obtained from ICU environments and equipment surfaces in two public hospitals in Vitoria da Conquista. Broth cultures were plated onto mannitol salt agar, and antimicrobial susceptibility testing was performed by the broth microdilution method according to CLSI. MRSA strains were submitted to PCR for detecting the mecA gene. PCR products were purified and sequenced for SCCmec type identification. Moreover, the strains were tested for efficacy of different disinfectant solutions. S. aureus were isolated from 31 and 67 sites in each hospital, respectively. Among the isolates from hospital 1, 07 (22.6%) were resistant to oxacillin while 28 (41.8%) were resistant in hospital 2. Thirty-one were positive for the mecA gene. All isolates showed SCCmec type III genotype characteristics of the Brazilian epidemic clone. In disinfectant tests, sodium hypochlorite (0.5, 1.0 and 2.0%), 2% chlorhexidine gluconate, quaternary ammonium, peracetic acid and formaldehyde were effective against the isolates tested. The strains showed higher resistance to vinegar (4% acetic acid), alcohol and glutaraldehyde. The findings of this study should assist in reducing the occurrence of nosocomial infections and therefore the morbidity, mortality and socio-economic burden caused by prolonged hospitalization.

  7. Facilitated Nurse Medication-Related Event Reporting to Improve Medication Management Quality and Safety in Intensive Care Units.

    Science.gov (United States)

    Xu, Jie; Reale, Carrie; Slagle, Jason M; Anders, Shilo; Shotwell, Matthew S; Dresselhaus, Timothy; Weinger, Matthew B

    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. 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. We conducted 124 structured 4-hour observations of nurses in three different ICUs. Each observation included measurement of nurse's moment-to-moment activity and self-reports of workload and negative mood. The observer then obtained MRE reports from the nurse using a structured tool. The MREs were analyzed by three experts. MREs were reported in 35% of observations. The 60 total MREs included four medication errors and seven adverse drug events. Of the 49 remaining MREs, 65% were associated with negative patient impact. Task/process deficiencies were the most common contributory factor for MREs. MRE occurrence was correlated with increased total task volume. MREs also correlated with increased workload, especially during night shifts. Most of these MREs would not be captured by traditional event reporting systems. Facilitated MRE reporting provides a robust information source about potential breakdowns in medication management safety and opportunities for system improvement.

  8. Integrating palliative care in the surgical and trauma intensive care unit: a report from the Improving Palliative Care in the Intensive Care Unit (IPAL-ICU) Project Advisory Board and the Center to Advance Palliative Care.

    Science.gov (United States)

    Mosenthal, Anne C; Weissman, David E; Curtis, J Randall; Hays, Ross M; Lustbader, Dana R; Mulkerin, Colleen; Puntillo, Kathleen A; Ray, Daniel E; Bassett, Rick; Boss, Renee D; Brasel, Karen J; Campbell, Margaret; Nelson, Judith E

    2012-04-01

    Although successful models for palliative care delivery and quality improvement in the intensive care unit have been described, their applicability in surgical intensive care unit settings has not been fully addressed. We undertook to define specific challenges, strategies, and solutions for integration of palliative care in the surgical intensive care unit. We searched the MEDLINE database from inception to May 2011 for all English language articles using the term "surgical palliative care" or the terms "surgical critical care," "surgical ICU," "surgeon," "trauma" or "transplant," and "palliative care" or "end-of- life care" and hand-searched our personal files for additional articles. Based on review of these articles and the experiences of our interdisciplinary expert Advisory Board, we prepared this report. We critically reviewed the existing literature on delivery of palliative care in the surgical intensive care unit setting focusing on challenges, strategies, models, and interventions to promote effective integration of palliative care for patients receiving surgical critical care and their families. Characteristics of patients with surgical disease and practices, attitudes, and interactions of different disciplines on the surgical critical care team present distinctive issues for intensive care unit palliative care integration and improvement. Physicians, nurses, and other team members in surgery, critical care and palliative care (if available) should be engaged collaboratively to identify challenges and develop strategies. "Consultative," "integrative," and combined models can be used to improve intensive care unit palliative care, although optimal use of trigger criteria for palliative care consultation has not yet been demonstrated. Important components of an improvement effort include attention to efficient work systems and practical tools and to attitudinal factors and "culture" in the unit and institution. Approaches that emphasize delivery of

  9. 综合护理干预对ICU失眠症护士睡眠质量的影响%Effects of Comprehensive Nursing Interventions on Sleep Quality among ICU Nurses with Insomnia

    Institute of Scientific and Technical Information of China (English)

    杨亚娟; 张鹭鹭

    2013-01-01

    Objective To verify the effect of comprehensive nursing interventions in improving sleep quality among ICU nurses with insomnia. Methods From February 2011 to May 2012, 76 ICU (general ICU, brain surgery and cardiothoracic surgery ICU) nurses with insomnia were randomly divided into observational group and control group with 38 nurses in each group. Both groups received the sleep hygiene education and drug treatment (Zolpidem,10mg per night). In the observational group, we implemented a 3-month nursing interventions addressing sleep cognition-behavior, work and sleep environments and social support. Results Irregular bedtime routine(55. 26%)and emotionally upsetting before trying to go to sleep (59. 21%)were the most common factors of insomnia nurses. Significant differences were detected on the irreguley bedtime routine, sleep process parameters after the intervention between the two groups(P< 0. 01). After the intervention, the sleep quality (arousal time, arousal frequency, sleep efficiency and sleep maintenance) of the observational group was significantly improved. Conclusion Comprehensive nursing interventions can effectively improve the sleep quality and quality of life for ICU nurses with insomnia by changing the poor sleep hygiene habits, improving the working and resting environment and enhancing the nurses' ability to deal with work pressure.%目的 探讨综合护理干预对改善ICU失眠症护士睡眠质量的有效性.方法 2011年2月至2012年5月方便性抽样选取第二军医大学长征医院ICU(包括综合ICU、脑外科及胸心外科ICU)失眠症护士共76名,按照随机数字表法随机分为干预组和对照组各38例.两组护士均按常规给予睡眠健康宣教,遵医嘱每晚服用酒石酸唑吡坦片(商品名:思诺思)10 mg;干预组在此基础上进行睡眠认知及行为、工作及休息环境、社会支持等护理干预3个月.结果 睡眠时间无规律(55.26%)、准备睡觉前担心睡眠的能力(59.21%)

  10. Feedforward Control in the ICU Nursing Quality Control Applications%前馈控制在ICU护理质量监控中的应用观察

    Institute of Scientific and Technical Information of China (English)

    夏建萍

    2015-01-01

    目的:观察前馈控制在ICU护理质量监控中的应用及效果。方法以该院ICU病区为研究点,建立质量控制架构(三级质控网),实施前馈控制法,观察其在ICU护理质量监控中的作用。结果在ICU护理质量控制中实施前馈控制后,病房的护理文书质量、消毒隔离质量、护理管理质量等各项评分均显著高于实施前馈控制前(P<0.05),且不良事件的发生率(0.2豫)显著低于实施前馈控制前(2.1豫)(P<0.05)。结论在ICU护理质量监控中应用前馈控制,可以大大提高ICU风险管理能力、护理质量和患者护理满意度。%Objective To Observe before feedforward control the quality of care in the ICU monitoring application and effect. Methods In my hospital ICU ward for the study points to the establishment of quality control architecture (three quality control network), before the implementation of feedforward control method to observe its role in monitoring the quality of care in the ICU. Results After the implementation of feedforward control in ICU nursing quality control, quality of care ward instruments, steriliza-tion soundproof quality, care management and other quality scores were significantly higher than before the implementation of feedforward control before (P<0.05), and the bad event rate (0.2%) was significantly lower than before the implementation of feed-forward control(2.1%) (P<0.05). Conclusions Monitoring the quality of care in the ICU feedforward control, can greatly improve the ICU risk management capabilities, quality of care and patient satisfaction with care.

  11. Depression Common After Time Spent in ICU

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_160482.html Depression Common After Time Spent in ICU About one- ... of former intensive care unit (ICU) patients have depression, a new review finds. Each year, more than ...

  12. ICU谵妄患者的临床护理研究%Study on Clinical Nursing of Delirium in ICU Patients

    Institute of Scientific and Technical Information of China (English)

    李谢妹

    2016-01-01

    Objective To analyze the ICU of delirium patients with clinical nursing measures and effect. MethodsFrom May 2013 to January 2016,treatment of patients with delirium in 77 cases in ICU of our hospital, and were randomly assigned to reference group(38 cases)and experimental group(39 cases),respectively using the conventional nursing and nursing intervention,the nursing intervention effect were observed and compared.Results Experimental group patients admitted to the hospital after 48 h, prior to rol out 3 hours of the APACHE II score were significantly lower than the reference group,duration of delirium and mechanical ventilation time were significantly shorter than the reference group,difference between the two groups by t test, had statistical significance(P<0.05).Conclusion In ICU delirium patients with nursing intervention,the effect is very satisfactory,to shorten the process of patients with delirium duration, improve the prognosis of patients.%目的:对ICU谵妄患者的临床护理措施和效果进行分析研究。方法选取于2013年5月~2016年1月在我院ICU接受治疗的谵妄患者77例,并随机分为对照组(38例)和实验组(39例),对常规护理和护理干预的效果进行观察并比较。结果实验组患者入院后48 h、转出前3 h的APACHEⅡ评分均低于对照组,谵妄持续时间以及机械通气时间均短于对照组,组间差异经t检验,差异具有统计学意义(P<0.05)。结论 ICU谵妄患者应用护理干预的效果满意,能够使患者的谵妄持续时程缩短,改善患者的预后。

  13. Impact of young ICU nurses' role conflict,role ambiguity and job burnout on their turnover intention in ICU department%ICU年轻护士角色冲突和角色模糊、工作疲溃感对离职意愿的影响

    Institute of Scientific and Technical Information of China (English)

    刘晔; 杨敏; 陈菲菲

    2013-01-01

    目的 探讨ICU年轻护士角色冲突和角色模糊、工作疫渍感对离职意愿的影响.方法 采用角色冲突和角色模糊、工作疲溃感和离职意愿量表,对济南市6家综合性医院的144名ICU年轻护士进行调查.结果 ICU年轻护士的角色冲突和角色模糊、工作疲溃感与离职意愿均呈显著正相关,情绪疲溃感、工作冷漠感和角色模糊对其离职意愿有显著影响.结论 管理者应针对ICU年轻护士离职意愿的影响因素,采取相应的干预措施以降低离职率,稳定护理队伍.%Objective To investigate the impact of young ICU nurses' role conflict,role ambiguity and job burnout on their turnover intention.Methods Totally 144 young nurses who working in the ICU from 6 comprehensive hospitals were recruited in this study.Results Young ICU nurses' role conflict,role ambiguity and job burnout were positively correlated with turnover intention.Regression analysis indicated that young ICU nurses' emotional exhaustion,depersonalization and role ambiguity had significant effects on their turnover intention.Conclusions Hospital managers should adopt effective measures to relieve young ICU nurses' job burnout,role conflict and role ambiguity to maintain a stable nursing team.

  14. ICU护理小组对危重患者护理质量的影响%Effect of ICU nursing group on nursing quality in critically ill patients

    Institute of Scientific and Technical Information of China (English)

    欧阳凤珍

    2013-01-01

    目的 探讨ICU护理小组对危重患者护理质量的影响.方法 将本院ICU自2010年9月至2012年12月收治的700例患者按照护理方法的不同分为观察组和对照组,对照组采用常规护理,观察组采用ICU护理小组进行护理,比较两组患者的护理质量.结果 观察组的平均监护时间、护理不良事件的发生率、住院时间显著少于对照组,护理到位率高于对照组(P<0.05).观察组家属在宣教、环境、态度等护理项目方面的满意度均显著高于对照组(P<0.05).结论 ICU护理小组能够显著提高危重患者的护理质量,促进患者康复.%Objective To explore the effect of ICU nursing group on nursing quality in critically ill patients.Methods Seven hundred ICU patients treated in our hospital from 2010 September to 2012 December were divided into the observation group and the control group,the control group was given the conventional nursing,the observation group was given ICU group nursing care,nursing quality were compared between the two groups.Results The average nursing care time,incidence of adverse events and hospitalization days of the observation group were significantly were less than those of the control group,The satisfaction of education environment,attitude,operation and treatment in the observation group were significantly higher than those in the control group (P < 0.05).Conclusions ICU nursing group can significantly improve the quality of care for critically ill patients,promote the rehabilitation of patients.

  15. Implementation and evaluation of a nurse-centered computerized potassium regulation protocol in the intensive care unit - a before and after analysis

    Directory of Open Access Journals (Sweden)

    van der Horst Iwan CC

    2010-01-01

    Full Text Available Abstract Background Potassium disorders can cause major complications and must be avoided in critically ill patients. Regulation of potassium in the intensive care unit (ICU requires potassium administration with frequent blood potassium measurements and subsequent adjustments of the amount of potassium administrated. The use of a potassium replacement protocol can improve potassium regulation. For safety and efficiency, computerized protocols appear to be superior over paper protocols. The aim of this study was to evaluate if a computerized potassium regulation protocol in the ICU improved potassium regulation. Methods In our surgical ICU (12 beds and cardiothoracic ICU (14 beds at a tertiary academic center, we implemented a nurse-centered computerized potassium protocol integrated with the pre-existent glucose control program called GRIP (Glucose Regulation in Intensive Care patients. Before implementation of the computerized protocol, potassium replacement was physician-driven. Potassium was delivered continuously either by central venous catheter or by gastric, duodenal or jejunal tube. After every potassium measurement, nurses received a recommendation for the potassium administration rate and the time to the next measurement. In this before-after study we evaluated potassium regulation with GRIP. The attitude of the nursing staff towards potassium regulation with computer support was measured with questionnaires. Results The patient cohort consisted of 775 patients before and 1435 after the implementation of computerized potassium control. The number of patients with hypokalemia (5.0 mmol/L were recorded, as well as the time course of potassium levels after ICU admission. The incidence of hypokalemia and hyperkalemia was calculated. Median potassium-levels were similar in both study periods, but the level of potassium control improved: the incidence of hypokalemia decreased from 2.4% to 1.7% (P Conclusions Computerized potassium control

  16. Role-based support for intensive care nursing: A designer's perspective

    NARCIS (Netherlands)

    Melles, M.

    2011-01-01

    Design goals and design directions are formulated for the (digital) support of non-technical nursing tasks and skills in the intensive care unit (ICU), such as organizing work, evaluating care, coping with stress and dealing with poor team dynamics. A conceptual framework for ICU nursing was develop

  17. Factors Associated With the Increasing Rates of Discharges Directly Home From Intensive Care Units-A Direct From ICU Sent Home Study.

    Science.gov (United States)

    Lau, Vincent I; Priestap, Fran A; Lam, Joyce N H; Ball, Ian M

    2016-09-20

    To evaluate the relationship between rates of discharge directly to home (DDH) from the intensive care unit (ICU) and bed availability (ward and ICU). Also to identify patient characteristics that make them candidates for safe DDH and describe transfer delay impact on length of stay (LOS). Retrospective cohort study of all adult patients who survived their stay in our medical-surgical-trauma ICU between April 2003 and March 2015. Median age was 49 years (interquartile range [IQR]: 33.5-60.4), and the majority of the patients were males (54.8%). Median number of preexisting comorbidities was 5 (IQR: 2-7) diagnoses. Discharge directly to home increased from 28 (3.1% of all survivors) patients in 2003 to 120 (12.5%) patients in 2014. The mean annual rate of DDH was between 11% and 12% over the last 6 years. Approximately 62% (n = 397) of patients waited longer than 4 hours for a ward bed, with a median delay of 2.0 days (IQR: 0.5-4.7) before being DDH. There was an inverse correlation between ICU occupancy and DDH rates (r P = -.55, P occupancy and DDH rates (r s = -.055, P = .64, 95% CI = -0.25 to 0.21). The DDH rates have been increasing over time at our institution and were inversely correlated with ICU bed occupancy but were not associated with ward occupancy. The DDH patients are young, have few comorbidities on admission, and few discharge diagnoses, which are usually reversible single system problems with low disease burden. Transfers to the ward are delayed in a majority of cases, leading to increased ICU LOS and likely increased overall hospital LOS as well. © The Author(s) 2016.

  18. Nurse Competence on Physiologic Monitors Use: Toward Eliminating Alarm Fatigue in Intensive Care Units.

    Science.gov (United States)

    Sowan, Azizeh K; Vera, Ana G; Fonseca, Elma I; Reed, Charles C; Tarriela, Albert F; Berndt, Andrea E

    2017-01-01

    Studies on nurse competence on alarm management are a few and tend to be focused on limited skills. In response to Phase II of implementing the National Patient Safety Goal on clinical alarm systems safety, this study assessed nurses' perceived competence on physiologic monitors use in intensive care units (ICUs) and developed and validated a tool for this purpose. This descriptive study took place in a Magnet hospital in a Southwestern state of the U.S. A Nurse Competence on Philips Physiologic Monitors Use Survey was created and went through validation by 13 expert ICU nurses. The survey included 5 subscales with 59 rated items and two open-ended questions. Items on the first 4 subscales reflect most common tasks nurses perform using physiologic monitors. Items on the fifth subscale (advanced functions) reflect rarely used skills and were included to understand the scope of utilizing advanced physiologic monitors' features. Thirty nurses from 4 adult ICUs were invited to respond to the survey. Thirty nurses (100%) responded to the survey. The majority of nurses were from Neuro (47%) and Surgical Trauma (37%) ICUs. The data supported the high reliability and construct validity of the survey. At least one (3%) to 8 nurses (27%) reported lack of confidence on each item on the survey. On the first four subscales, 3% - 40% of the nurses reported they had never heard of or used 27 features/functions on the monitors. No relationships were found between subscales' scores and demographic characteristics (p > .05). Nurses asked for training on navigating the central-station monitor and troubleshooting alarms, and the use of unit-specific super users to tailor training to users' needs. This is the first study to create and test a list of competencies for physiologic monitors use. Rigorous, periodic and individualized training is essential for safe and appropriate use of physiologic monitors and to decrease alarm fatigue. Training should be comprehensive to include all

  19. Nursing administration graduate programs in the United States.

    Science.gov (United States)

    Scott, Elaine S

    2007-11-01

    Providing nursing administrators with excellent educational programming is imperative for the profession. The author analyzes trends in nursing administration education in the United States and how they compare with standards and future recommendations for graduate curricula. The degrees conferred, curricula, hours of study, and educational modalities are examined in 57 master's degrees in nursing programs with concentrations in administration.

  20. The effect of the TIM program (Transfer ICU Medication reconciliation) on medication transfer errors in two Dutch intensive care units : Design of a prospective 8-month observational study with a before and after period

    NARCIS (Netherlands)

    B.E. Bosma; E. Meuwese; Tan, S.S. (Siok Swan); J. van Bommel (Jasper); Melief, P.H.G.J. (Piet Herman Gerard Jan); N.G. Hunfeld; P.M.L.A. van den Bemt (Patricia)

    2017-01-01

    textabstractBackground: The transfer of patients to and from the Intensive Care Unit (ICU) is prone to medication errors. The aim of the present study is to determine whether the number of medication errors at ICU admission and discharge and the associated potential harm and costs are reduced by usi

  1. ICU离职护士状况调查及相关因素分析%The Cross-sectional Study and Analysis of Related Factor of Turnover for Nurses in ICU

    Institute of Scientific and Technical Information of China (English)

    薛燕萍; 王斌全

    2013-01-01

    Objective:To analyze the reasons of turnover for nurses in ICU,to offer basis on improving human resources management for managements of nursing in ICU.Method:To collect the basic information and the reasons of turnvver by site visits,phone calls or E-mail for the nurses who turnvver,to provide the strategies for reducing the turnover rate of nurses in ICU.Result:The reason of turnover were related with age,educational background and position of nurses,et al.The nurses task was heavy and the high pressure.The high nursing risk so easy to happen mistake.The low salary and welfare was disproportionate with the work.The work environment was airtight and the atmosphere was depressing.Conclusion:The strategies of reducing turnover rate of ICU nurses are suggested as follows:to rationally arrange the nurses and reduce the nurse workload;to increase the position of nurses and eliminate errors accident;to improve the salary and welfare according to performance appraisal;to strengthen the spare life of nurses in ICU and pay attention to the psychological quality of nurses.%  目的:分析ICU护士离职原因,为ICU护理管理提供改善人力资源管理的依据。方法:通过实地走访、电话或电子邮件等形式收集离职护士的基本资料及离职原因,经过分析提出降低ICU护士离职率的对策。结果:ICU护士离职与年龄、学历、任职方式等因素有关;ICU护理工作任务重、压力大;ICU护理风险大、极易发生差错事故;ICU护士薪酬待遇低,与工作付出不成比例;ICU护理工作环境封闭、气氛压抑。结论:合理配置人员,减轻护士工作量;增加岗位人员配置,杜绝差错事故;按绩效考核,提高ICU护士待遇;加强ICU护士的业余生活,重视护士的心理素质等是减少ICU护士离职的重要措施。

  2. Family members' experiences of being cared for by nurses and physicians in Norwegian intensive care units: a phenomenological hermeneutical study.

    Science.gov (United States)

    Frivold, Gro; Dale, Bjørg; Slettebø, Åshild

    2015-08-01

    When patients are admitted to intensive care units, families are affected. This study aimed to illuminate the meaning of being taken care of by nurses and physicians for relatives in Norwegian intensive care units. Thirteen relatives of critically ill patients treated in intensive care units in southern Norway were interviewed in autumn 2013. Interview data were analysed using a phenomenological hermeneutical method inspired by the philosopher Paul Ricoeur. Two main themes emerged: being in a receiving role and being in a participating role. The receiving role implies experiences of informational and supportive care from nurses and physicians. The participating role implies relatives' experiences of feeling included and being able to participate in caring activities and decision-making processes. The meaning of being a relative in ICU is experienced as being in a receiving role, and at the same time as being in a participating role. Quality in relations is described as crucial when relatives share their experiences of care by nurses and physicians in the ICU. Those who experienced informational and supportive care, and who had the ability to participate, expressed feelings of gratitude and confidence in the healthcare system. In contrast, those who did not experience such care, especially in terms of informational care expressed feelings of frustration, confusion and loss of confidence. However, patient treatment and care outweighed relatives' own feelings. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. The paediatric Confusion Assessment Method for the Intensive Care Unit (pCAM-ICU: Translation and cognitive debriefing for the German-speaking area

    Directory of Open Access Journals (Sweden)

    Clemens de Grahl

    2012-04-01

    Full Text Available Purpose: To date there are only a few studies published, dealing with delirium in critically ill patients. The problem with these studies is that prevalence rates of delirium could only be estimated because of the lack of validated delirium assessment tools for the paediatric intensive care unit (PICU. The paediatric Confusion Assessment Method for the Intensive Care Unit (pCAM-ICU was specifically developed and validated for the detection of delirium in PICU patients. The purpose of this study was the translation of the English pCAM-ICU into German according to international validated guidelines. Methods: The translation process was performed according to the principles of good practice for the translation and cultural adaptation process for patient reported outcomes measures: From three independently created German forward-translation versions one preliminary German version was developed, which was then retranslated to English by a certified, state-approved translator. The back-translated version was submitted to the original author for evaluation. The German translation was evaluated by clinicians and specialists anonymously (German grades in regards to language and content of the translation. Results: The results of the cognitive debriefing revealed good to very good results. After that the translation process was successfully completed and the final version of the German pCAM-ICU was adopted by the expert committee. Conclusion: The German version of the pCAM-ICU is a result of a translation process in accordance with internationally acknowledged guidelines. Particularly, with respect to the excellent results of the cognitive debriefing, we could finalise the translation and cultural adaptation process for the German pCAM-ICU.

  4. Monitoring costs in the ICU: a search for a pertinent methodology.

    Science.gov (United States)

    Reis Miranda, D; Jegers, M

    2012-10-01

    Attempts to determine costs in the intensive care unit (ICU) were not successful until now, as they failed to detect differences of costs between patients. The methodology and/or the instruments used might be at the origin of this failure. Based on the results of the European ICUs studies and on the descriptions of the activities of care in the ICU, we gathered and analysed the relevant literature concerning the monitoring of costs in the ICU. The aim was to formulate a methodology, from an economic perspective, in which future research may be framed. A bottom-up microcosting methodology will enable to distinguish costs between patients. The resulting information will at the same time support the decision-making of top management and be ready to include in the financial system of the hospital. Nursing staff explains about 30% of the total costs. This relation remains constant irrespective of the annual nurse/patient ratio. In contrast with other scoring instruments, the nursing activities score (NAS) covers all nursing activities. (1) NAS is to be chosen for quantifying nursing activities; (2) an instrument for measuring the physician's activities is not yet available; (3) because the nursing activities have a large impact on total costs, the standardisation of the processes of care (following the system approach) will contribute to manage costs, making also reproducible the issue of quality of care; (4) the quantification of the nursing activities may be the required (proxy) input for the automated bottom-up monitoring of costs in the ICU.

  5. Giving information to family members of patients in the intensive care unit: Iranian nurses' ethical approaches.

    Science.gov (United States)

    Farahani, Mansoureh A; Gaeeni, Mina; Mohammadi, Nooreddin; Seyedfatemi, Naima

    2014-01-01

    Receiving information related to patients hospitalized in the intensive care unit is among the most important needs of the family members of such patients. When health care professionals should decide whether to be honest or to give hope, giving information becomes an ethical challenge We conducted a research to study the ethical approaches of Iranian nurses to giving information to the family members of patients in the intensive care units. This research was conducted in the intensive care units of three teaching hospitals in Iran. It employed a qualitative approach involving semi-structured and in-depth interviews with a purposive sample of 12 nurses to identify the ethical approaches to giving information to family members of the intensive care unit patients. A conventional content analysis of the data produced two categories and five subcategories. The two categories were as follows: a) informational support, and b) emotional support. Informational support had 2 subcategories consisting of being honest in giving information, and providing complete and understandable information. Emotional support in giving information had 3 sub-categories consisting of gradual revelation, empathy and assurance. Findings of the study indicated that ethical approaches to giving information can be in the form of either informational support or emotional support, based on patients' conditions and prognoses, their families' emotional state, the necessity of providing a calm atmosphere in the ICU and the hospital, and other patients and their families' peace. Findings of the present study can be used as a basis for further studies and for offering ethical guidelines in giving information to the families of patients hospitalized in the ICU.

  6. Nursing and Patients with Delirium: a Literature Review

    Directory of Open Access Journals (Sweden)

    Ángela María Henao-Castaño

    2014-04-01

    Full Text Available Objective. This work sought to analyze the scientific production regarding delirium in patients in Intensive Care Units (ICU. Synthesis. Delirium (cognitive alteration occurs in acute and fluctuating manner in patients in ICU. It is a risk factor for mortality and prolonged stay in ICU. Its diagnosis is derived from an objective assessment with widely disseminated validated instruments, available in Spanish and other languages. Strategies to prevent delirium in ICU are documented. Conclusion. Implementation of these strategies to prevent, monitor, and control delirium in patients hospitalized in ICU must be a priority of nursing research in our setting.

  7. Role of Psychosocial Care on ICU Trauma

    OpenAIRE

    Usha Chivukula; Meena Hariharan; Suvashisa Rana; Marlyn Thomas; Sunayana Swain

    2014-01-01

    Context: Patients treated in intensive care units (ICU) though receive the best medical attention are found to suffer from trauma typically attributed to the ICU environment. Biopsychosocial approach in ICUs is found to minimize ICU trauma. Aims: This study investigates the role of psychosocial care on patients in ICU after coronary artery bypass graft (CABG). Settings and Design: The study included 250 post-operative CABG patients from five corporate hospitals. The combination of between sub...

  8. Stress Levels of Nurses in Oncology Outpatient Units.

    Science.gov (United States)

    Ko, Woonhwa; Kiser-Larson, Norma

    2016-04-01

    Oncology nursing is often a source of substantial stress for nurses. Many nurses, particularly novice nurses, have inadequate preparation to care for patients at the end of life and their families. Unless nurses prevent or manage work-related stress by using effective coping strategies, oncology nursing staff will continue to suffer from burnout and compassion fatigue. The purpose of this article is to identify stress levels and stressful factors of nurses working in oncology outpatient units and to explore coping behaviors for work-related stress of oncology staff nurses in outpatient units. A descriptive, cross-sectional design was used to identify stress levels and stressful factors for outpatient oncology nurses, investigate differences in stress levels among nurses' demographic characteristics, and explore coping behaviors of the nurses. Study participants (N = 40) included RNs and licensed practical nurses who completed the Nursing Stress Scale, three open-ended questions, and a demographic questionnaire. The highest sources of stress were workload and patient death and dying. Demographic variables of age and work experience in nursing showed a significant positive relationship to work-related stress scores. The three most frequently used coping behaviors were verbalizing, exercising or relaxing, and taking time for self. Continuing education programs on stress management are highly recommended. Outpatient oncology nurses should be nurtured and supported through tailored interventions at multiple levels to help them find effective coping strategies and develop self-care competencies. Although younger and less experienced nurses had lower mean stress scores than older and more experienced nurses, the continuing education programs and tailored interventions would be helpful for all oncology nursing staff.

  9. Effect of Family Participated Three Stages Nursing Model in the Prevention of Delirium for Patients in ICU%家属协作的三阶段护理模式预防 ICU 患者发生谵妄的效果

    Institute of Scientific and Technical Information of China (English)

    马红; 李晓静; 张其霞; 郑晓燕

    2015-01-01

    目的:探讨家属协作的三阶段护理模式预防 ICU 患者发生谵妄的效果。方法便利选取2012年4月至2014年4月入住温州医学院附属第二医院 ICU 的患者164例,采用随机数字表法分为对照组80例及干预组84例。对照组采用 ICU常规护理,干预组在此基础上实施家属协作的三阶段护理模式,比较两组患者入住 ICU 期间谵妄的发生率。结果对照组有51例患者的重症监护谵妄筛查量表(the intensive care delirium screening checklist,ICDSC)评分≥4分,即出现了谵妄症状,发生率为63.75%;而干预组谵妄发生率为30.95%,两组差异有统计学意义(P <0.05)。结论以患者为中心、护士指导、家属积极参与的三阶段护理模式能有效预防 ICU 患者谵妄的发生。%Objective To discuss the effect of family participated three stages nursing model in the prevention of delirium for patients in ICU.Methods By convenience sampling,164 patients were selected and randomly divided into control group (n =80)and intervention group(n =84).The control group received routine ICU nursing,while the intervention group received family participated three stages nursing model on the basis of routine care.The incidence of delirium in ICU were compared between two groups.Results The ICDSC score of 51 patients was ≥ 4 in control group,which means the delirium happened and the ratio was 63.75%,while the incidence of delirium in intervention group was 30.95% (P < 0.05).Conclusion The patient centered,nurses guiding with family participated three stages nursing model could effectively prevent the occurrence of delirium.

  10. [Nurses' role in the therapeutic team of stroke units].

    Science.gov (United States)

    Köpke, Sascha; Dehning, Kathrin; Molsen, Nadine; Möhler, Ralph; Kasper, Jürgen; Meyer, Gabriele

    2009-02-01

    Over the last decade, stroke units have been increasingly established in Germany. Within these units, nurses have been identified as having a crucial role in the coordination of multi-professional team activities. However, currently very little data exists to support this fact; therefore, a questionnaire was developed to assess various aspects of the nurses' role within the multi-professional team, including cooperation with other team members (e.g., communication behaviour and acceptance within the multi-professional team), contribution to team and unit organisation, and impact on patient recovery. A total of 55 multi-disciplinary staff members from three separate stroke units completed the questionnaire. Results showed that staff have comparable estimates concerning the nurses' level of interdisciplinary cooperation. As well, nurses and other non-medical staff rate nurses' contribution to unit organisation comparably high while physicians' ratings of nurses' contribution are lower. The professional groups' ratings of the nurses' contribution to patient recovery vary. The results indicate that German stroke unit nurses contribute significantly to stroke unit care by acting as coordinators of the unit organisation for various multi professional team members.

  11. Entrainment of the Human Circadian Clock to the Light-Dark Cycle and its Impact on Patients in the ICU and Nursing Home Settings.

    Science.gov (United States)

    Ritchie, Hannah K; Stothard, Ellen R; Wright, Kenneth P

    2015-01-01

    A robust circadian timekeeping system is important for human health and well-being. Inappropriately timed light exposure can cause circadian and sleep disruption, which has been shown to have negative health consequences. Lighting in medical care facilities, such as the NICU, ICU, and nursing homes, is not typically controlled and may be associated with circadian disruption observed in such settings. Cycled lighting and increased exposure to sunlight in medical care facilities have been shown to have positive effects on patient recovery and well-being, and expedite hospital discharge. Additional clinical research is needed to determine the optimal light exposure timing, duration, intensity, and spectrum to best promote recovery, health and well-being in the context of medical care.

  12. Influence of Emotion Management on ICU Nurses' Experience of Practice Environment%情绪管理对ICU护士执业环境感受的影响研究

    Institute of Scientific and Technical Information of China (English)

    林周; 郑超

    2016-01-01

    目的将情绪管理手段运用到现有的ICU管理中,通过测量ICU护士执业环境感受的变化,探讨情绪管理对ICU护士执业环境感受的影响,从而为临床护理管理实践提供参考。方法2014年10月至2015年4月,对本院106名ICU护士实施情绪管理,并采用护理人员执业环境感受问卷在实施情绪管理前后进行测评。结果实施情绪管理后,ICU护士执业环境感受较之前有所提高(116.01±10.294),差异具有统计学意义(P0.05)。结论实施情绪管理对ICU护士执业环境的评价具有积极、正向的作用,可以帮助ICU护士正确面对周围环境,并采取有效的应对措施进行情感抒发,增进上下级的沟通和信任,提升个人学习水平和业务能力。%Objective Through applying emotional management methods to ICU management and measuring ICU nurses' experience of practice environment, discussed the effect of emotional management on ICU nurses' experience of practice environment so as to provide a practical reference for clinical nursing management.Methods From April 2014 to October 2015, 106 ICU nurses in the 2nd Affiliated Hospital of Wenzhou Medical University were implemented with emotional management. The nurses took practice environment perception questionnaire before and after the implementation of emotion management.Results After the implementation of emotion management, ICU nurses' experience of practice environment increased compared with that before (116.01±10.294) with statistical difference (P 0.05).Conclusion Implementation of emotional management has positive role for evaluation of ICU nurses' comments on practice environment, which is conductive for them to facing the surroundings and taking effective measures to deal with their emotion problems. It could enhance on the communication and trust between nurses and their leaders and improved their professional proficiency and learning ability.

  13. ICU护士职业满意度的现状调查及相关因素分析%The status survey of the ICU nurses' job satisfaction and analysis of its influencing factors

    Institute of Scientific and Technical Information of China (English)

    柏兴华; 张晓春; 苏兰若

    2012-01-01

    Objective To describe the states of the nurses' job satisfaction in ICU and to analyze its influencing factors. Methods A survey about the job satisfaction was done in ICU nurse from three 3-A-grade general hospitals in Shenyang. Results The relationship of co-workers was the highest score of the ICU nurses' job satisfaction [(3.55±0.63) scores]; the extrinsic rewards [(2.23±0.73) scores] and the career development [(2.34±0.88) scores] were the lowest ones of the satisfac tion. The age, education background and service year were related to the nurses' job satisfaction in ICU (P < 0.05). The age of 20-25 and high education degree had higher level of the job satisfaction, but the nurses with long service year had lower level of the job satisfaction. Conclusion Improving the welfare of ICU nurses, understanding, supporting and defining the development direction of the job, managing nurses with their ability are the key of improving job satisfaction of ICU nurses.%目的 了解ICU护士职业满意度的现状,明确影响ICU护士职业满意度的相关因素.方法 采用问卷调查法对沈阳市3所三级甲等医院ICU护士进行职业满意度调查.结果 ICU护士职业满意度以同事的支持得分最高,为(3.55±0.63)分,ICU护士的薪酬满意度[(2.23±0.73)分]及职业发展的满意度[(2.34±0.88)分]得分较低.护士的年龄、学历、工作年限与职业满意度相关(P < 0.05),其中20~25岁、高学历的护士职业满意度较高,较高工作年限护士满意度较低.结论 提高ICU护士的薪酬,加强对ICU护理工作的支持与理解,确定职业发展方向及护士分层使用是提高ICU护士职业满意度的关键.

  14. Structure determines medication errors in nursing units: a mechanistic approach.

    Science.gov (United States)

    Hung, Chang-Chiao; Lee, Bih-O; Tsai, Shu-Ling; Tseng, Yun Shan; Chang, Chia-Hao

    2015-03-01

    Medication errors have long been considered critical in global health care systems. However, few studies have been conducted to explore the effects of nursing unit structure on medication errors. The purpose of this study, therefore, was to determine the effects of structural factors on medication errors in nursing units. A total of 977 staff nurses and 62 head nurses participated in this cross-sectional design study. The findings show that professional autonomy (β = .53, t = 6.03, p nursing experts (β = .52, t = 5.99, p medication error rates. This study shows that the structural factors influence medication administration and the mechanistic approach is specifically in relation of low medication error rates. The author suggests that head nurses should consider strategies that require adjustments to unit control mechanisms.

  15. 云南省10家三级医院综合性ICU护士健康现状的调查%Investigation on health status of nurses in comprehensive ICU of 10 tertiary hospitals

    Institute of Scientific and Technical Information of China (English)

    马雪芩; 周梅; 吴林雄; 杨名芳; 李存莉

    2013-01-01

    [Objective] To investigate the physical and mental health status and its affecting factors among ICU nurses in Yunnan Province so as to attract the attention of supervisors, and provide evidence for developing policies by related department. [ Methods] A total of 298 nurses from 10 tertiary hospitals were selected as study subjects. Health survey brief scale SF-8 and self-designed questionnaire were adopted for survey of health status and influencing factors. [Results]The physical and mental health score of ICU nurses from 10 tertiary hospitals were 46.15 ±6.49 and 40.67 ±9.67. The main factors influencing health were service length in ICU and night shift frequency. [ Conclusion] The physical and mental health status of ICU nurses from 10 tertiary hospitals is not optimistic. The related supervisors are suggested to pay more attention to the health of nurses, to adopted coping strategy to ensure the physical and mental health of ICU nurses.%目的 探讨目前云南省重症监护病房(ICU)专科护士的身心健康现状、影响因素,从而引起相关管理者的重视,并为相关部门制定政策提供参考依据.方法 选取云南省10家三级医院综合性ICU 298名护士为研究样本,采用健康调查简短量表SF-8以及自行设计的调查问卷对其健康现状及影响因素进行调查.结果 10家三级医院综合性ICU护士生理健康状况得分46.15±6.49,心理健康状况得分40.67±9.67.影响健康的因素主要为在ICU的工作年限和值夜班频率等.结论 云南省10家三级医院ICU护士的身心健康不容乐观,建议相关管理者应高度重视到护士人群的健康,积极采取应对策略,以保障ICU护士身心的健康.

  16. Influence of stress and nursing leadership on job satisfaction of pediatric intensive care unit nurses.

    Science.gov (United States)

    Bratt, M M; Broome, M; Kelber, S; Lostocco, L

    2000-09-01

    High levels of stress and the challenges of meeting the complex needs of critically ill children and their families can threaten job satisfaction and cause turnover in nurses. To explore the influences of nurses' attributes, unit characteristics, and elements of the work environment on the job satisfaction of nurses in pediatric critical care units and to determine stressors that are unique to nurses working in pediatric critical care. A cross-sectional survey design was used. The sample consisted of 1973 staff nurses in pediatric critical care units in 65 institutions in the United States and Canada. The following variables were measured: nurses' perceptions of group cohesion, job stress, nurse-physician collaboration, nursing leadership, professional job satisfaction, and organizational work satisfaction. Significant associations (r = -0.37 to r = -0.56) were found between job stress and group cohesion, professional job satisfaction, nurse-physician collaboration, nursing leadership behaviors, and organizational work satisfaction. Organizational work satisfaction was positively correlated (r = 0.35 to r = 0.56) with group cohesion, professional job satisfaction, nurse-physician collaboration, and nursing leadership behaviors. Job stress, group cohesion, job satisfaction, nurse-physician collaboration, and nursing leadership behaviors explained 52% of the variance in organizational work satisfaction. Dealing with patients' families was the most frequently cited job stressor. Job stress and nursing leadership are the most influential variables in the explanation of job satisfaction. Retention efforts targeted toward management strategies that empower staff to provide quality care along with focal interventions related to the diminishment of stress caused by nurse-family interactions are warranted.

  17. CONSUMPTION TRENDS OF RESCUE ANTI-PSYCHOTICS FOR DELIRIUM IN INTENSIVE CARE UNITS (ICU DELIRIUM) SHOW INFLUENCE OF CORRESPONDING LUNAR PHASE CYCLES: A RETROSPECTIVE AUDIT STUDY FROM ACADEMIC UNIVERSITY HOSPITAL IN THE UNITED STATES.

    Science.gov (United States)

    Gupta, Deepak; Pallekonda, Vinay; Thomas, Ronald; Mckelvey, George; Ghoddoussi, Farhad

    2015-02-01

    The etiology of delirium in intensive care units (ICU) is usually multi-factorial. There is common "myth" that lunar phases affect human body especially human brains (and minds). In the absence of any pre-existing studies in ICU patients, the current retrospective study was planned to investigate whether lunar phases play any role in ICU delirium by assessing if lunar phases correlate with prevalence of ICU delirium as judged by the corresponding consumptions of rescue anti-psychotics used for delirium in ICU. After institutional review board approval with waived consent, the daily census of ICU patients from the administrative records was accessed at an academic university's Non-Cancer Hospital in a Metropolitan City of United States. Thereafter, the ICU pharmacy's electronic database was accessed to obtain data on the use of haloperidol and quetiapine over the two time periods for patients aged 18 years or above. Subsequently the data was analyzed for whether the consumption of haloperidol or quetiapine followed any trends corresponding to the lunar phase cycles. A total of 5382 pharmacy records of haloperidol equivalent administrations were analyzed for this study. The cumulative prevalence of incidents of haloperidol equivalent administrations peaked around the full moon period and troughed around the new moon period. As compared to male patients, female patients followed much more uniform trends of haloperidol equivalent administrations' incidents which peaked around the full moon period and troughed around the new moon period. Further sub-analysis of 70-lunar cycles across the various solar months of the total 68-month study period revealed that haloperidol equivalent administrations' incidents peaked around the full moon periods during the months of November-December and around the new moon periods during the month of July which all are interestingly the major holiday months (a potential confounding factor) in the United States. Consumption trends of rescue

  18. Nursing unit managers, staff retention and the work environment.

    Science.gov (United States)

    Duffield, Christine M; Roche, Michael A; Blay, Nicole; Stasa, Helen

    2011-01-01

    This paper examined the impact of leadership characteristics of nursing unit managers, as perceived by staff nurses, on staff satisfaction and retention. A positive work environment will increase levels of job satisfaction and staff retention. Nurse leaders play a critical role in creating a positive work environment. Important leadership characteristics of the front-line nurse manager include visibility, accessibility, consultation, recognition and support. Secondary analysis of data collected on 94 randomly selected wards in 21 public hospitals across two Australian states between 2004-2006. All nurses (n = 2488, 80·3% response rate) on the selected wards were asked to complete a survey that included the 49-item Nursing Work Index-Revised [NWI-R] together with measures of job satisfaction, satisfaction with nursing and intention to leave. Subscales of the NWI-R were calculated. Leadership, the domain of interest, consisted of 12 items. Wards were divided into those reporting either positive or negative leadership. Data were analysed at the nurse level using spss version 16. A nursing manager who was perceived to be a good leader, was visible, consulted with staff, provided praise and recognition and where flexible work schedules were available was found to distinguish the positive and negative wards. However, for a ward to be rated as positive overall, nurse leaders need to perform well on all the leadership items. An effective nursing unit manager who consults with staff and provides positive feedback and who is rated highly on a broad range of leadership items is instrumental in increasing job satisfaction and satisfaction with nursing. Good nurse managers play an important role in staff retention and satisfaction. Improved retention will lead to savings for the organisation, which may be allocated to activities such as training and mentorship to assist nurse leaders in developing these critical leadership skills. Strategies also need to be put in place to

  19. ORAL HEALTH CARE IN ICU PATIENTS

    Directory of Open Access Journals (Sweden)

    Vânia Rosimeri Frantz Schlesener

    2012-11-01

    Full Text Available This article consists of a literature review on the importance of oral health of Intensive Care Unit patients. The research aimed to relate the tools and techniques for performing oral hygiene, in particular the use of chlorhexidine 0.12%, and co-relate the importance of a dentist in the multidisciplinary team of ICU to monitor and intervene the patient’s oral health. As the technique of oral hygiene is performed by nursing professionals, studies reports failures in its appliance, which can cause infectious complications in patient clinical evolution, interfering in the quality of the care provided. The oral hygiene is a significant factor and when properly applied can decrease infections rates, particularly nosocomial pneumonia, in patients on mechanical ventilation. It was concluded that as oral health is closely related to general health, same oral care should be instituted for ICU patients, preferably performed by a dentist, avoiding harmful comorbidities in this situation. Keywords: Intensive Care Units, Oral Hygiene, Nursing.

  20. ICU护士岗位核心胜任力现状调查及影响因素分析%Survey on status quo of ICU nurse post core competency and its influencing factors analysis

    Institute of Scientific and Technical Information of China (English)

    彭爱霞; 郦珍芳; 周田田

    2016-01-01

    目的:调查重症监护病房(ICU)护士岗位核心胜任力,了解其影响因素,为提升ICU护士核心胜任力制定相应干预策略,为更好地提升护理服务质量提供科学依据。方法2015年1月采用发放问卷调查的方式,对三级甲等医院96名ICU护士进行问卷调查。结果 ICU护士核心胜任力总评分为(3.75±0.59)分,与学历、ICU工作年限、婚姻状况、常上班次有关,差异均有统计学意义(P<0.05)。结论 ICU护士核心胜任力处于中上水平,受学历、ICU工作年限、婚姻状况、常上班次的影响。因此,根据主要影响因素采取有效措施可提高ICU护士核心胜任力,也有助于提高危重症患者的护理质量和抢救成功率。%Objective To investigate the status quo of post core competency among ICU nurses and to understand its in-fluencing factors to formulate the corresponding interventional strategy and provide the scientific basis for better elevating the nursing service quality. Methods Totally 96 ICU nurses in the class 3A hospitals were investigated by questionnaire in January 2015. Results The total score of ICU nurses core competency was (3.75±0.59)points,which were related with the educational background,ICU working years,marital status and common work shift,and the differences were statistically significant(P<0.05). Conclusion The core competency of ICU nurses is in the upper level,which is affected by the educational background,ICU working years,marital status and common work shift. Therefore taking effective measures according to the main influencing factors not only can improve the nurse core competency ,but also increases the nursing quality and treatment success rate of critically ill patients.

  1. Reducing Hospital ICU Noise: A Behavior-Based Approach

    Directory of Open Access Journals (Sweden)

    Avinash Konkani

    2014-01-01

    Full Text Available Noise in Intensive Care Units (ICUs is gaining increasing attention as a significant source of stress and fatigue for nursing staff. Extensive research indicates that hospital noise also has negative impact on patients. The objective of this study was to analyze noise variations as experienced by both nursing staff and patients, to gain a better understanding of noise levels and frequencies observed in ICU settings over extended (week-long durations, and to implement a low cost behavior modification program to reduce noise. The results of our study indicate that behavioral modification alone is not adequate to control excessive noise. There is a need for further research involving the supportive involvement by clinicians, ICU staff, along with effective medical device alarm management, and continuous process improvement methods.

  2. 集束化护理在ICU预防呼吸机相关性肺炎的应用%Application of Cluster Nursing on Prevention of Ventilator-associated Pneumonia in ICU

    Institute of Scientific and Technical Information of China (English)

    邵明珠

    2016-01-01

    Objective To explore the application value of nursing prevention of ventilator-associated pneumonia in ICU. Methods 62 cases of ICU patients with mechanical ventilation in parallel were receivedin our hospital from May 2013 to January 2016, divided into two groups, the control group received routine nursing care, the experimental group underwent nursing, analysis the nursing effect of two groups. Results The experimental group of nursing after the onset of ICU ventilator-associated pneumonia rate compared with the control group (P<0.05). Conclusion The application effect of cluster nursing in the prevention of ventilator associated pneumonia in ICU is remarkable.%目的:探讨集束化护理在ICU预防呼吸机相关性肺炎中的应用价值。方法选取我院2013年5月~2016年1月接收并行ICU机械通气患者62例,分为两组,对照组行常规护理,实验组行集束化护理,分析两组护理效果。结果实验组护理后ICU呼吸机相关性肺炎的发病率与对照组比较,差异有统计学意义(P<0.05)。结论集束化护理在ICU预防呼吸机相关性肺炎的应用效果显著。

  3. Erlang loss bounds for OT-ICU systems

    NARCIS (Netherlands)

    N.M. van Dijk; N. Kortbeek

    2009-01-01

    In hospitals, patients can be rejected at both the operating theater (OT) and the intensive care unit (ICU) due to limited ICU capacity. The corresponding ICU rejection probability is an important service factor for hospitals. Rejection of an ICU request may lead to health deterioration for patients

  4. Improving Staffing and Nurse Engagement in a Neuroscience Intermediate Unit.

    Science.gov (United States)

    Nadolski, Charles; Britt, Pheraby; Ramos, Leah C

    2017-06-01

    The neuroscience intermediate unit is a 23-bed unit that was initially staffed with a nurse-to-patient ratio of 1:4 to 1:5. In time, the unit's capacity to care for the exceeding number of progressively acute patients fell short of the desired goals in the staff affecting the nurse satisfaction. The clinical nurses desired a lower nurse-patient ratio. The purpose of this project was to justify a staffing increase through a return on investment and increased quality metrics. This initiative used mixed methodology to determine the ideal staffing for a neuroscience intermediate unit. The quantitative section focused on a review of the acuity of the patients. The qualitative section was based on descriptive interviews with University Healthcare Consortium nurse managers from similar units. The study reviewed the acuity of 9,832 patient days to determine the accurate acuity of neuroscience intermediate unit patients. Nurse managers at 12 University Healthcare Consortium hospitals and 8 units at the Medical University of South Carolina were contacted to compare staffing levels. The increase in nurse staffing contributed to an increase in many quality metrics. There were an 80% decrease in controllable nurse turnover and a 75% reduction in falls with injury after the lowered nurse-patient ratio. These 2 metrics established a return on investment for the staffing increase. In addition, the staffing satisfaction question on the Press Ganey employee engagement survey increased from 2.44 in 2013 to 3.72 in 2015 in response to the advocacy of the bedside nurses.

  5. Stress, coping and burnout among Intensive Care Unit nursing staff: associated factors.

    Science.gov (United States)

    Andolhe, Rafaela; Barbosa, Ricardo Luis; Oliveira, Elaine Machado de; Costa, Ana Lúcia Siqueira; Padilha, Katia Grillo

    2015-02-01

    Objective To investigate emotional stress, coping and burnout among nursing staff and their association with biosocial factors and characteristics of work in Intensive Care Units (ICU). Method This was a cross-sectional study, conducted in eight ICUs at a teaching hospital in the city of São Paulo, Brazil, in October 2012. Biosocial data and information about the professionals' work was gathered, and they were given the Scale of Occupational Stress, Scale of Occupational Coping, List of Signs and Symptoms of Stress and the Maslach Burnout Inventory. Results The study sample consisted of 287 subjects, predominately women, with partners and children. Most professionals presented moderate stress levels and control as a coping strategy (74.47% and 79.93%, respectively), and burnout was present among 12.54%. Factors associated with stress were related to working conditions. The most prevalent protective factors were having a partner, working in the clinical ICU and liking work, while adequate amount of sleep was a protective factor for burnout. Conclusion Control of the working environment and adequate sleep are decisive and protective factors in dealing with situations of occupational stress.

  6. [patient Profile And Nursing Workload At The Nephrology Unit].

    OpenAIRE

    Trepichio,Priscilla Branco; Guirardello,Edinêis de Brito; Duran,Erika Christiane Marocco; de Brito, Ana Paula

    2015-01-01

    Chronic kidney failure (CKF), which is frequently silent, can lead to considerable changes in the lives of patients. Depending on the stage, hospitalization and hours of nursing care are required to ensure medical and surgical treatment. The aim of this descriptive and quantitative study is to measure nursing workload at a nephrology unit based on daily application of the Nursing Activities Score (NAS) for 47 consecutive days. Patients were mostly young male adults in the chronic stage of the...

  7. ICU护士离职率较高的原因调查与研究%Investigation and Research on the Causes of High Turnover Rate of Nurses in ICU

    Institute of Scientific and Technical Information of China (English)

    王怀兰; 朱晶

    2015-01-01

    目的:分析评价ICU护士离职的原因并提出相应的改善对策。方法选择ICU病房的30名护士和以前在ICU病房工作过的护士30名为一组,普通病房的护士64名为另一组,采用不记名问卷调查的方法进行工作满意度调查,为确保护士对工作的真实反映,未采取当场填写方式,于第二天由护理部收集,对调查的满意度状况进行评价。结果两组满意度最低的是工作环境和工作强度,其次是管理决策、职业地位、福利待遇和职称晋级。ICU护士比普通病房护士的满意度更低。结论调查我院护士对工作的满意度,分析可能的影响因素,并提出应对措施,以提高护士的工作积极性和满意度,防止护理人才流失,改善护理人员短缺的局面。%Objective To evaluate the reason of ICU nurses leaving the hospital and put forward the corresponding improvement countermeasures. Methods Selected 30 nurses who work in the ICU now and 30 nurses who work in ICU before as a group,selected 64 nurses in other wards as a group,used anonymous questionnaire survey about job satisfaction. In order to ensure the real reflection of nurses,col ected the questionnaire on the next day, evaluated the satisfaction condition. Results The lowest satisfaction in two groups were the work environment and working intensity,fol owed by management decisions,occupational status,welfare benefits,and job title promotion. The satisfaction in ICU nurses were lower than nurses in common ward. Conclusion By analyzing the nurse job satisfaction and possible influencing factors,and puts forward the countermeasures,we can improve the nurses' working enthusiasm and satisfaction,prevent loss of nursing talents,improve nursing staff shortages.

  8. The roles of unit leadership and nurse-physician collaboration on nursing turnover intention.

    Science.gov (United States)

    Galletta, Maura; Portoghese, Igor; Battistelli, Adalgisa; Leiter, Michael P

    2013-08-01

    To report a study of the relationship between variables at the group and individual level with nurses' intention to leave their unit. Workplaces are collective environments where workers constantly interact with each other. The quality of working relationship employees develop at the unit-level influences both employee outcomes and unit performance by shaping employee attitudes. The study was a cross-sectional design with self-administered questionnaires. A questionnaire including measures of leader-member exchange and nurse-physician collaboration analysed at group-level and affective commitment and turnover intention analysed at individual level, was administered individually to 1018 nurses in five Italian hospitals. Data were collected in 2009. A total of 832 nurses (81·7% response rate) completed questionnaires. The results showed that affective commitment at individual level completely mediated the relationship between leader-member exchange at group-level and nursing turnover intention. Furthermore, the cross-level interaction was significant: at individual level, the nurses with high levels of individual affective commitment towards their unit showed low levels of turnover intention and this relationship was stronger when the nurse-physician collaboration at group-level was high. This study showed the importance for organizations to implement management practices that promote both high-quality nurse-supervisor and nurse-physician relationships, because they increase nurses' identification with their units. Individual affective commitment is an important quality for retaining a workforce and good nurses' relationship at group-level relationships with both supervisors and physicians are instrumental in developing identification with the work unit. Thus, the quality of relationship among staff members is an important factor in nurses' decision to leave. © 2012 Blackwell Publishing Ltd.

  9. ICU intensive care unit application effect analysis of air-cushion pressure ulcers prevention%ICU重症监护病房应用防压疮气垫的效果分析

    Institute of Scientific and Technical Information of China (English)

    赵雪梅

    2013-01-01

    目的:探讨ICU重症监护病房应用防压疮气垫的护理效果。方法:将我院重症监护室发生压疮的高危患者40例随机分为观察组和对照组各20例,观察组给予防压疮气垫护理,对照组未采用防压疮气垫防护措施,比较两组的压疮发生率。结果:对照组患者的压疮发生率显著高于观察组,两组比较,差异具有统计学意义(P<0.05)。结论:防压疮气垫能显著降低患者的压疮发生率,是ICU防治高危压疮的有效措施之一。%Objective:To discuss the ICU intensive care unit using the nursing effect of preventing pressure ulcers mattress. Methods:to the intensive care unit 40 patients with higher risk of pressure ulcers were randomly divided into observation group and control group 20 cases, observation group was given care in the air-cushion pressure ulcers, adopt protective measures preventing pressure ulcers air cushion, the control group to compare two groups the incidence of pressure ulcers. Results:the observation group is significantly higher than the control group, the incidence of pressure ulcers in patients with two groups of comparison, the difference statistically significant(P<0.05). Conclusion:for patients with pressure ulcers prevention air cushion bed can significantly reduce the incidence of pressure ulcers, ICU is one of the effective measures of prevention and treatment of pressure ulcers in high-risk patients.

  10. 综合护理干预对重症监护病房患者情绪及睡眠的影响%Effect of comprehensive nursing intervention on the mood and sleep of patients in ICU

    Institute of Scientific and Technical Information of China (English)

    朱淑敏

    2012-01-01

    To explore the effect of comprehensive nursing intervention on the mood and sleep of patients in ICU. Methods; 110 patients in ICU were randomly divided into an intervention group and a control group (55 cases in each group). The patients in the control group received routine nursing care and the patients in the intervention group were given comprehensive nursing intervention based on the routine nursing care. SAS and SMH were used to evaluate anxiety and sleep quality of the patients in the two groups after intervention and the results were compared. Results;SAS and SMH scores was significantly higher in the intervention group than those in the control group ( P < 0. 05 ) . Conclusion: The comprehensive nursing intervention can effectively relieve the anxiety of patients in ICU, improve their sleep quality and quality of life as well.%目的:探讨综合护理干预对重症监护病房(ICU)患者情绪及睡眠的影响.方法:将110例ICU患者随机分为对照组和干预组各55例.对照组给予常规护理,干预组在此基础上给予综合护理干预.应用情绪自测表(SAS)和睡眠质量自测表(SMH)测评两组患者干预后焦虑情绪和睡眠质量,并进行比较.结果:干预组干预后SAS及SMH评分明显高于对照组(P<0.05).结论:综合护理干预能有效改善ICU患者的焦虑情绪和睡眠质量,提高其生活质量.

  11. Nurse Staffing in Neonatal Intensive Care Units in the United States

    OpenAIRE

    Rogowski, Jeannette A.; Staiger, Douglas O.; Patrick, Thelma E; Jeffrey D Horbar; Kenny, Michael J.; Lake, Eileen T.

    2015-01-01

    The neonatal intensive care unit (NICU) is a setting with high nurse-to-patient ratios. Little is known about the factors that determine nurse workload and assignment. The goals of this study were to (1) develop a measure of NICU infant acuity; (2) describe the acuity distribution of NICU infants; (3) describe the nurse/infant ratio at each acuity level, and examine the factors other than acuity, including nurse qualifications and the availability of physicians and other providers, that deter...

  12. A physical function test for use in the intensive care unit: validity, responsiveness, and predictive utility of the physical function ICU test (scored).

    Science.gov (United States)

    Denehy, Linda; de Morton, Natalie A; Skinner, Elizabeth H; Edbrooke, Lara; Haines, Kimberley; Warrillow, Stephen; Berney, Sue

    2013-12-01

    Several tests have recently been developed to measure changes in patient strength and functional outcomes in the intensive care unit (ICU). The original Physical Function ICU Test (PFIT) demonstrates reliability and sensitivity. The aims of this study were to further develop the original PFIT, to derive an interval score (the PFIT-s), and to test the clinimetric properties of the PFIT-s. A nested cohort study was conducted. One hundred forty-four and 116 participants performed the PFIT at ICU admission and discharge, respectively. Original test components were modified using principal component analysis. Rasch analysis examined the unidimensionality of the PFIT, and an interval score was derived. Correlations tested validity, and multiple regression analyses investigated predictive ability. Responsiveness was assessed using the effect size index (ESI), and the minimal clinically important difference (MCID) was calculated. The shoulder lift component was removed. Unidimensionality of combined admission and discharge PFIT-s scores was confirmed. The PFIT-s displayed moderate convergent validity with the Timed "Up & Go" Test (r=-.60), the Six-Minute Walk Test (r=.41), and the Medical Research Council (MRC) sum score (rho=.49). The ESI of the PFIT-s was 0.82, and the MCID was 1.5 points (interval scale range=0-10). A higher admission PFIT-s score was predictive of: an MRC score of ≥48, increased likelihood of discharge home, reduced likelihood of discharge to inpatient rehabilitation, and reduced acute care hospital length of stay. Scoring of sit-to-stand assistance required is subjective, and cadence cutpoints used may not be generalizable. The PFIT-s is a safe and inexpensive test of physical function with high clinical utility. It is valid, responsive to change, and predictive of key outcomes. It is recommended that the PFIT-s be adopted to test physical function in the ICU.

  13. ICU中心静脉导管感染患者的护理%Nursing of infections in patients with central venous catheter in ICU

    Institute of Scientific and Technical Information of China (English)

    梁月圆

    2015-01-01

    Objective:To explore the central venous catheter related infections nursing in ICU .Methods:40 infection patients with central renous catheter from December 2012-December 2013 as the research object,according to the central venous catheter patients,clinical characteristics r related infection fac-tors to explore the nursing care.Results:All of 40 patients with infection were control effectively.Conclusion:Shortening the time of catheter,center care, strict aseptic concept,strengthen the medical staff to avoid reinfection between doctor-patient and doctor-nurse,improve the level of hospital care is effec-tively reduce the central venous catheter related infections such as one of the important measures.%目的:探讨ICU中心静脉导管感染患者的的护理措施。方法:选取2012年12月~2013年12月我院收治的40例中心静脉置管感染患者作为研究对象,根据中心静脉置管技术的临床特点及相关因素实施护理。结果:40例患者感染均得到有效控制。结论:缩短置管时间,严格中心静脉置管的护理,加强医护人员的无菌观念,避免医患、医护之间的再感染,提高医院的护理水平等是有效降低中心静脉置管感染的重要措施。

  14. ICU护士职业压力与职业倦怠的相关性分析%The correlation analysis between occupational stress and burnout among ICU nurses

    Institute of Scientific and Technical Information of China (English)

    田晓华; 陈长香

    2014-01-01

    Objective:To understand the correlation between occupational stress,coping styles and burnout, and provide a scientific basis for ICU nurses to alleviate the burnout. Methods:Investigations were carried out for 204 ICU nurses from 13 ICU in October 2013,used the Nurse working pressure Scale,Sim-ple Coping Scale,and Burnout Inventory. Results:The total score of ICU nurses occupational stress was (2. 36 ± 0. 42) points,and workload and time alloca-tion was the most important pressure source (2. 95 ± 0. 67) points. ICU nurse positive coping (1. 78 ± 0. 46) points,with no difference between the national norm,negative coping (1. 16 ± 0. 54) points was lower than the national norm,ICU nurse emotional exhaustion got (26. 60 ± 10. 23) points,personal ac-complishment (26. 20 ± 9. 78) points,depersonalization dimensions (6. 99 ± 5. 31) points. Correlation analysis showed that ICU nurse occupational stress, negative coping with emotional exhaustion,depersonalization were positively correlated,and actively respond positively correlated with personal accomplish-ment (P<0. 05). Conclusion:ICU nurses have greater occupational stress,emotional exhaustion and extent personified are heavier,positive coping nurses can improve personal accomplishment,negative copings are easy to make emotional exhaustion heavy and increase extent personified.%目的::了解ICU护士职业压力、应对方式及职业倦怠现状,明确职业压力、应对方式与职业倦怠的相关性,为减轻ICU护士职业倦怠提供科学依据。方法:2013年10月1~30日对我院13个重症监护室的204名护士,采用护士工作压力源、简易应对方式、职业倦怠量表进行问卷调查。结果:护士工作压力总分为(2.36±0.42)分,其中工作量及时间分配是其护士最主要工作压力源(2.95±0.67)分。 ICU护士积极应对方式(1.78±0.46)分,与全国常模无差异,消极应对方式(1.16±0.54)分,低于全国常模,ICU护士情感枯竭(26.60±10.23)

  15. Biological risk in nursing care provided in family health units

    National Research Council Canada - National Science Library

    Cardoso, Ana Carla Moreira; Figueiredo, Rosely Moralez de

    2010-01-01

    .... This exploratory and descriptive study characterizes the potential risk of biological exposure in procedures performed by nursing professionals in ten Family Health units in São Carlos-SP, Brazil...

  16. Care management in nursing within emergency care units

    Directory of Open Access Journals (Sweden)

    Roberta Juliane Tono de Oliveira

    2015-12-01

    Full Text Available Objective.Understand the conditions involved in the management of nursing care in emergency care units. Methodology. Qualitative research using the methodological framework of the Grounded Theory. Data collection occurred from September 2011 to June 2012 through semi-structured interviews with 20 participants of the two emergency care units in the city of Florianopolis, Brazil. Results. Hindering factors to care management are: lack of experience and knowledge of professionals in emergency services; inadequate number of professionals; work overload of emergency care units in the urgent care network; difficulty in implementing nursing care systematization, and need for team meetings. Facilitating factors are: teamwork; importance of professionals; and confidence of the nursing technicians in the presence of the nurse. Conclusion. Whereas the hindering factors in care management are related to the organizational aspects of the emergency care units in the urgency care network, the facilitating ones include specific aspects of teamwork.

  17. Implementing a Nurse Manager Profile to Improve Unit Performance.

    Science.gov (United States)

    Krugman, Mary E; Sanders, Carolyn L

    2016-06-01

    Nurse managers face significant pressures in the rapidly changing healthcare environment. Staying current with multiple sources of data, including reports that detail institutional and unit performance outcomes, is particularly challenging. A Nurse Manager Customized Profile was developed at a western academic hospital to provide a 1-page visual of pertinent data to help managers and director supervisors focus coaching to improve unit performance. Use of the Decisional Involvement Scale provided new insights into measuring manager performance.

  18. Research on the nursing dynamic management according to TISS-28 in the elderly ICU%TISS-28在老年ICU护理人员动态管理中的应用

    Institute of Scientific and Technical Information of China (English)

    蒋承慧; 魏薇; 周玉洁; 李霞; 柏健

    2014-01-01

    Objective To measure the daily nursing workload by simplified therapeutic intervention scoring system and provide information for reasonable dynamic management of nursing manpower and improving nursing service satisfaction of patients in elderly ICU.Methods 113 patients in elderly ICU were selected from July 2012 to June 2013.The Therapeutic Intervention Scoring System 28(TISS-28) was used to measure the nursing workload,reasonably arranged the nursing staff according to the daily total nursing workload.The average daily working time and service satisfaction were compared before and after the application of dynamic management of nursing manpower.Results After the application of dynamic management of nursing manpower,the average daily working time of nurses decreased,satisfactory degree of patients with nursing service increased,and satisfactory degree of medical workers with nursing manpower management also increased.Conclusions Measurement of nursing workload by TISS-28 can provide the basis for the dynamic management of nursing manpower in elderly ICU and improve satisfaction degree of medical workers.%目的 应用治疗干预评分系统TISS-28科学测量老年ICU每日护理工作量,为合理动态管理护理人力,提高患者护理服务满意度提供依据.方法 选择2012年7月至2013年6月收治的老年ICU患者113例,应用TISS-28测量护理工作量,根据每日工作总量合理安排护理人力,比较应用量表动态管理护理人力前后护理人员日平均工作时间和患者满意度.结果 应用TISS-28测量护理工作量动态管理护理人力后,护理人员日平均工作时间较实施前减少;患者护理服务满意度明显提高;医护人员对护理人力管理的满意度明显提高.结论 应用TISS-28测量护理工作量,可以为动态管理ICU护理人力及合理分配工作量提供依据,并能提高患者和医护人员满意度.

  19. Nursing unit teams matter: Impact of unit-level nurse practice environment, nurse work characteristics, and burnout on nurse reported job outcomes, and quality of care, and patient adverse events--a cross-sectional survey.

    Science.gov (United States)

    Van Bogaert, Peter; Timmermans, Olaf; Weeks, Susan Mace; van Heusden, Danny; Wouters, Kristien; Franck, Erik

    2014-08-01

    To investigate the impact of nurse practice environment factors, nurse work characteristics, and burnout on nurse reported job outcomes, quality of care, and patient adverse events variables at the nursing unit level. Nurse practice environment studies show growing insights and knowledge about determining factors for nurse workforce stability, quality of care, and patient safety. Until now, international studies have primarily focused on variability at the hospital level; however, insights at the nursing unit level can reveal key factors in the nurse practice environment. A cross-sectional design with a survey. In a cross-sectional survey, a sample of 1108 nurses assigned to 96 nursing units completed a structured questionnaire composed of various validated instruments measuring nurse practice environment factors, nurse work characteristics, burnout, nurse reported job outcomes, quality of care, and patient adverse events. Associations between the variables were examined using multilevel modelling techniques. Various unit-level associations (simple models) were identified between nurse practice environment factors, nurse work characteristics, burnout dimensions, and nurse reported outcome variables. Multiple multilevel models showed various independent variables such as nursing management at the unit level, social capital, emotional exhaustion, and depersonalization as important predictors of nurse reported outcome variables such job satisfaction, turnover intentions, quality of care (at the unit, the last shift, and in the hospital within the last year), patient and family complaints, patient and family verbal abuse, patient falls, nosocomial infections, and medications errors. Results suggested a stable nurse work force, with the capability to achieve superior quality and patient safety outcomes, is associated with unit-level favourable perceptions of nurse work environment factors, workload, decision latitude, and social capital, as well low levels of burnout

  20. Use of an electronic clinical experience portal for the education of nurses in a critical care unit.

    Science.gov (United States)

    Farrell, Maureen; Baldwin, Ian; Fealy, Nigel

    2011-01-01

    This paper examines a clinical experience portal (CEP) that was developed for critical care nurses to access on a personal digital assistant (PDA) while undertaking a 12-month postgraduate program. The increasing complexity of care provided to patients in intensive care units (ICU) in Australia and overseas requires that health care practitioners working in this area are competent and highly skilled, to prevent errors and adverse events. The CEP - unlike the traditional approach which is often lacking, antiquated or encompassed in paper records - provides opportunity for collaborative activities to occur between the learner and the teacher in an auditable environment to enhance the quality of the education provided. The CEP provided a method for the nurses to record their competencies and access educational material within the framework of a postgraduate program. The benefits of using the CEP for the education of all healthcare professionals' are also discussed.

  1. Negotiated reorienting: a grounded theory of nurses' end-of-life decision-making in the intensive care unit.

    Science.gov (United States)

    Gallagher, Ann; Bousso, Regina Szylit; McCarthy, Joan; Kohlen, Helen; Andrews, Tom; Paganini, Maria Cristina; Abu-El-Noor, Nasser Ibrahim; Cox, Anna; Haas, Margit; Arber, Anne; Abu-El-Noor, Mysoon Khalil; Baliza, Michelle Freire; Padilha, Katia Grillo

    2015-04-01

    Intensive care units (ICUs) focus on treatment for those who are critically ill and interventions to prolong life. Ethical issues arise when decisions have to be made regarding the withdrawal and withholding of life-sustaining treatment and the shift to comfort and palliative care. These issues are particularly challenging for nurses when there are varying degrees of uncertainty regarding prognosis. Little is known about nurses' end-of-life (EoL) decision-making practice across cultures. To understand nurses' EoL decision-making practices in ICUs in different cultural contexts. We collected and analysed qualitative data using Grounded Theory. Interviews were conducted with experienced ICU nurses in university or hospital premises in five countries: Brazil, England, Germany, Ireland and Palestine. Semi-structured interviews were conducted with 51 nurses (10 in Brazil, 9 in England, 10 in Germany, 10 in Ireland and 12 nurses in Palestine). They were purposefully and theoretically selected to include nurses having a variety of characteristics and experiences concerning end-of-life (EoL) decision-making. The study used grounded theory to inform data collection and analysis. Interviews were facilitated by using key questions. The comparative analysis of the data within and across data generated by the different research teams enabled researchers to develop a deeper understanding of EoL decision-making practices in the ICU. Ethical approval was granted in each of the participating countries and voluntary informed consent obtained from each participant. The core category that emerged was 'negotiated reorienting'. Whilst nurses do not make the 'ultimate' EoL decisions, they engage in two core practices: consensus seeking (involving coaxing, information cuing and voice enabling); and emotional holding (creating time-space and comfort giving). There was consensus regarding the core concept and core practices employed by nurses in the ICUs in the five countries. However

  2. Unit-Based Acute Confusion Resource Nurse: An Educational Program To Train Staff Nurses.

    Science.gov (United States)

    Rapp, Carla Gene; Onega, Lisa L.; Tripp-Reimer, Toni; Mobily, Paula; Wakefield, Bonnie; Kundrat, Mary; Akins, Jackie; Wadle, Karen; Mentes, Jan; Culp, Ken; Meyer, Jean; Waterman, James

    1998-01-01

    Describes the development and evaluation of an eight-hour educational program designed to prepare staff nurses to perform in a new role, the unit-based acute confusion Resource Nurse (ACRN). Tests showed that knowledge and confidence significantly increased for participants as a result of their participation in the educational program. (Author/GCP)

  3. The effect of the TIM program (Transfer ICU Medication reconciliation) on medication transfer errors in two Dutch intensive care units: design of a prospective 8-month observational study with a before and after period.

    Science.gov (United States)

    Bosma, Bertha Elizabeth; Meuwese, Edmé; Tan, Siok Swan; van Bommel, Jasper; Melief, Piet Herman Gerard Jan; Hunfeld, Nicole Geertruida Maria; van den Bemt, Patricia Maria Lucia Adriana

    2017-02-10

    The transfer of patients to and from the Intensive Care Unit (ICU) is prone to medication errors. The aim of the present study is to determine whether the number of medication errors at ICU admission and discharge and the associated potential harm and costs are reduced by using the Transfer ICU and Medication reconciliation (TIM) program. This prospective 8-month observational study with a pre- and post-design will assess the effects of the TIM program compared with usual care in two Dutch hospitals. Patients will be included if they are using at least one drug before hospital admission and will stay in the ICU for at least 24 h. They are excluded if they are transferred to another hospital, admitted and discharged in the same weekend or unable to communicate in Dutch or English. In the TIM program, a clinical pharmacist reconciles patient's medication history within 24 h after ICU admission, resulting in a "best possible" medication history and presents it to the ICU doctor. At ICU discharge the clinical pharmacist reconciles the prescribed ICU medication and the medication history with the ICU doctor, resulting in an ICU discharge medication list with medication prescription recommendations for the general ward doctor. Primary outcome measures are the proportions of patients with one or more medication transfer errors 24 h after ICU admission and 24 h after ICU discharge. Secondary outcome measures are the proportion of patients with potential adverse drug events, the severity of potential adverse drug events and the associated costs. For the primary outcome relative risks and 95% confidence intervals will be calculated. Strengths of this study are the tailor-made design of the TIM program and two participating hospitals. This study also has some limitations: A potential selection bias since this program is not performed during the weekends, collecting of potential rather than actual adverse drug events and finally a relatively short study period. Nevertheless

  4. Experience of Carrying out High Quality Nursing Service in ICU%浅谈ICU开展优质护理服务体会

    Institute of Scientific and Technical Information of China (English)

    章敏

    2015-01-01

    目的探讨优质护理服务在重症监护病房应用中的体会和具体实施措施。方法让护士转变观念,主动服务,实行大包干责任制及实施床边工作制,制定切实可行的基础护理工作时间表,规范护理服务行为,明确各岗位职责。结果自开展优质护理服务以来,护理质量及患者满意度明显提高。结论开展优质护理服务可以提高护理工作质量及患者满意度。%Objective To investigate the experience of high quality nursing service in the application in the intensive care unit and the specific implementation measures.Methods The implementation of al-round responsibility system and the implementation of bedside work system,formulate feasible basic nursing work schedule,standardized nursing behaviors,clear job responsibilities.Results Since car ying out high quality nursing service,nursing quality and patient satisfaction improved significantly.Conclusion to car y out high-quality care can improve the nursing quality and patients satisfaction.

  5. Temperature variability during delirium in ICU patients: an observational study.

    Directory of Open Access Journals (Sweden)

    Arendina W van der Kooi

    Full Text Available INTRODUCTION: Delirium is an acute disturbance of consciousness and cognition. It is a common disorder in the intensive care unit (ICU and associated with impaired long-term outcome. Despite its frequency and impact, delirium is poorly recognized by ICU-physicians and -nurses using delirium screening tools. A completely new approach to detect delirium is to use monitoring of physiological alterations. Temperature variability, a measure for temperature regulation, could be an interesting component to monitor delirium, but whether temperature regulation is different during ICU delirium has not yet been investigated. The aim of this study was to investigate whether ICU delirium is related to temperature variability. Furthermore, we investigated whether ICU delirium is related to absolute body temperature. METHODS: We included patients who experienced both delirium and delirium free days during ICU stay, based on the Confusion Assessment method for the ICU conducted by a research- physician or -nurse, in combination with inspection of medical records. We excluded patients with conditions affecting thermal regulation or therapies affecting body temperature. Daily temperature variability was determined by computing the mean absolute second derivative of the temperature signal. Temperature variability (primary outcome and absolute body temperature (secondary outcome were compared between delirium- and non-delirium days with a linear mixed model and adjusted for daily mean Richmond Agitation and Sedation Scale scores and daily maximum Sequential Organ Failure Assessment scores. RESULTS: Temperature variability was increased during delirium-days compared to days without delirium (β(unadjusted=0.007, 95% confidence interval (CI=0.004 to 0.011, p<0.001. Adjustment for confounders did not alter this result (β(adjusted=0.005, 95% CI=0.002 to 0.008, p<0.001. Delirium was not associated with absolute body temperature (β(unadjusted=-0.03, 95% CI=-0.17 to 0

  6. Survey of Quality of Work Life in ICU Nurses in ClassⅢ Grade Ⅰ Hospital%三级甲等医院ICU护士工作生活质量调查

    Institute of Scientific and Technical Information of China (English)

    陈碧群; 王宝春

    2014-01-01

    Objective To investigate the quality of work life in ICU nurses in class Ⅲ grade Ⅰ hospitals. Methods By using general questionnaire and the quality of work life questionnaire to investigate 1 1 0 ICU nurses in classⅢ gradeⅠ hospital in Xiamen.Results Different gender and different level ICU nurses had no statistic significance in scores for each dimension of quality of work life(P>0.05).There was statistic significance of score of work life quality between nurses with different marital status,different age,educa-tion level,years of working experience and different night shift frequency(P<0.05).Conclusion Hospital nursing managers should take targeted measures to improve ICU nurses quality of work life.%目的:了解三级甲等医院 ICU护士工作生活质量。方法采用护士一般基本资料调查表和员工工作生活质量调查表,便利抽样选择厦门市某三级甲等医院 ICU 110名护士进行问卷调查。结果不同性别 ICU护士及不同编制 ICU护士在工作生活质量各个维度上的得分差异无统计学意义(P>0.05)。不同婚姻状况、年龄、受教育程度、ICU工作年限及夜班频率的 ICU护士其工作生活质量得分差异均有统计学意义(均P<0.05)。结论医院护理管理者应有针对性地采取相关措施,以提高 ICU护士的工作生活质量。

  7. Nurse-Patient Communication Interactions in the Intensive Care Unit

    Science.gov (United States)

    Happ, Mary Beth; Garrett, Kathryn; Thomas, Dana DiVirgilio; Tate, Judith; George, Elisabeth; Houze, Martin; Radtke, Jill; Sereika, Susan

    2011-01-01

    Background The inability to speak during critical illness is a source of distress for patients, yet nurse-patient communication in the intensive care unit has not been systematically studied or measured. Objectives To describe communication interactions, methods, and assistive techniques between nurses and nonspeaking critically ill patients in the intensive care unit. Methods Descriptive observational study of the nonintervention/usual care cohort from a larger clinical trial of nurse-patient communication in a medical and a cardiothoracic surgical intensive care unit. Videorecorded interactions between 10 randomly selected nurses (5 per unit) and a convenience sample of 30 critically ill adults (15 per unit) who were awake, responsive, and unable to speak because of respiratory tract intubation were rated for frequency, success, quality, communication methods, and assistive communication techniques. Patients self-rated ease of communication. Results Nurses initiated most (86.2%) of the communication exchanges. Mean rate of completed communication exchange was 2.62 exchanges per minute. The most common positive nurse act was making eye contact with the patient. Although communication exchanges were generally (>70%) successful, more than one-third (37.7%) of communications about pain were unsuccessful. Patients rated 40% of the communication sessions with nurses as somewhat difficult to extremely difficult. Assistive communication strategies were uncommon, with little to no use of assistive communication materials (eg, writing supplies, alphabet or word boards). Conclusions Study results highlight specific areas for improvement in communication between nurses and nonspeaking patients in the intensive care unit, particularly in communication about pain and in the use of assistive communication strategies and communication materials. PMID:21362711

  8. Intra-hospital transfers to a higher level of care: contribution to total hospital and intensive care unit (ICU) mortality and length of stay (LOS).

    Science.gov (United States)

    Escobar, Gabriel J; Greene, John D; Gardner, Marla N; Marelich, Gregory P; Quick, Bryon; Kipnis, Patricia

    2011-02-01

    Patients who experience intra-hospital transfers to a higher level of care (eg, ward to intensive care unit [ICU]) are known to have high mortality. However, these findings have been based on single-center studies or studies that employ ICU admissions as the denominator. To employ automated bed history data to examine outcomes of intra-hospital transfers using all hospital admissions as the denominator. Retrospective cohort study. A total of 19 acute care hospitals. A total of 150,495 patients, who experienced 210,470 hospitalizations, admitted to these hospitals between November 1st, 2006 and January 31st, 2008. Predictors were age, sex, admission type, admission diagnosis, physiologic derangement on admission, and pre-existing illness burden; outcomes were: 1) occurrence of intra-hospital transfer, 2) death following admission to the hospital, 3) death following transfer, and 4) total hospital length of stay (LOS). A total of 7,868 hospitalizations that began with admission to either a general medical surgical ward or to a transitional care unit (TCU) had at least one transfer to a higher level of care. These hospitalizations constituted only 3.7% of all admissions, but accounted for 24.2% of all ICU admissions, 21.7% of all hospital deaths, and 13.2% of all hospital days. Models based on age, sex, preadmission laboratory test results, and comorbidities did not predict the occurrence of these transfers. Patients transferred to higher level of care following admission to the hospital have excess mortality and LOS. Copyright © 2010 Society of Hospital Medicine.

  9. Knowledge, attitude and practice of intensive care unit nurses about physical restraint.

    Science.gov (United States)

    Suliman, Mohammad; Aloush, Sami; Al-Awamreh, Khitam

    2017-09-01

    Physical restraint is mainly used in intensive care units (ICUs) to prevent delirious or agitated patients from removing tubes and lines connected to them. However, inappropriate use of physical restraint could have many detrimental physical effects on the patient, such as nerve damage, asphyxiation or even death. The aim of the study is to investigate nurses' knowledge, attitude and practice of physical restraint in ICUs in Jordanian hospitals, about which little is known. A descriptive and cross-sectional design was used. A convenience sample of 400 nurses working in three public hospitals and one university-affiliated hospital from different geographical regions in Jordan was selected. An Arabic version of the Physical Restraint Questionnaire (PRQ) was used to collect the data. A total of 300 completed questionnaires were returned, with a response rate of 75%. Of the total sample, 51% were males, 65.7% were from public hospitals and 80.3% held a bachelor's degree. The mean score in the knowledge section was 9.7 (SD =1.7) out of 15; in the attitude section, it was 24.7 (SD = 4.8) out of 33; and in the practice section, it was 30.9 (SD = 3.5) out of 42. Nurses who reported previous related education scored higher on the knowledge section (mean = 10.7; SD = 1.4) than nurses who reported no previous related education (mean = 9.1; SD = 1.6; p < .001). However, no significant differences between these categories were found in relation to attitude and practice. The study demonstrated some lack of knowledge and unsafe practices regarding physical restraint in ICUs in Jordan. It suggests improving nurses' knowledge, attitude and practices through in-service education on best practice for physical restraint, developing policies/guidelines and providing adequate staff and equipment to maintain patient safety and prevent complications. Conducting education programmes on physical restraint for ICU nurses and providing other preventive strategies

  10. ICU护士对心脏手术患者实施术前访视的效果分析%Effects of preoperative visits of nurses in ICU applied in heart surgery clients

    Institute of Scientific and Technical Information of China (English)

    马凤霞; 陈海花; 张岚; 周颖萍; 王媛媛

    2011-01-01

    目的 探讨ICU护士对心脏手术患者实施术前访视的作用.方法 选取2009年10月至2010年10月心脏外科ICU的140例手术患者为实验组,由ICU护士做术前访视,与2008年9月至2009年9月140例手术患者为对照组进行比较.结果 实验组患者对护理效果和护理工作满意度高于对照组,实验组患者住ICU天数少于对照组,差异均具有统计学意义(P<0.01或P<0.05).结论 ICU护士术前访视可提高护士对专科知识的掌握,提高患者对护理工作的满意度,缩短住院天数.%Objective To explore the effects of preoperative visits of nurses in ICU applied in heart surgery clients. Methods A total of 140 clients who had heart surgery from October 2009 to October 2010 were recruited as the experimental group and received preoperative visits from nurses in ICU. And 140 clients who had heart surgery from September 2008 to September 2009 were enrolled as the control group. The patients'satisfaction with nursing services and nursing effects of the two groups were compared. Results The patients satisfaction with nursing services and nursing effects of the experimental group were higher than the control group, the patients'days of experimental group in ICU was less than the control group, the difference was statistically significant (P <0. 01 or P <0.05). Conclusion Preoperative visits can enhance the specialist knowledge of ICU nurses and improve patients satisfaction with nursing services, and shorten the days of hospitalization.

  11. Relationships between registered nurse staffing, processes of nursing care, and nurse-reported patient outcomes in chronic hemodialysis units.

    Science.gov (United States)

    Thomas-Hawkins, Charlotte; Flynn, Linda; Clarke, Sean P

    2008-01-01

    Little attention has been given to the effects of registered nurse (RN) staffing and processes of nursing care on patient outcomes in hemodialysis units. This research examined the effects of patient-to-RN ratios and necessary tasks left undone by RNs on the likelihood of nurse-reported frequent occurrences of adverse patient events in chronic hemodialysis units. Study findings revealed that high patient-to-RN ratios and increased numbers of tasks left undone by RNs were associated with an increased likelihood of frequent occurrences of dialysis hypotension, skipped dialysis treatments, shortened dialysis treatments, and patient complaints in hemodialysis units. These findings indicate that federal, state, and dialysis organization policies must foster staffing structures and processes of care in dialysis units that effectively utilize the invaluable skills and services of professional, registered nurses.

  12. Effects of nursing care and staff skill mix on patient outcomes within acute care nursing units.

    Science.gov (United States)

    Hart, Patricia; Davis, Nancy

    2011-01-01

    This article presents the findings from a study that evaluates the relationships between staffing indicators and patient outcomes at the hospital unit level. Nursing administrators should not only evaluate the impact staffing decisions have on patient outcomes at the hospital level but also examine these relationships at the unit level. The findings from this study have implications for nursing practice in the areas of staff orientation, education, and patient outcome monitoring.

  13. Nurses' perceptions of open visiting hours in neuroscience intensive care unit.

    Science.gov (United States)

    Livesay, Sarah; Gilliam, Alicia; Mokracek, Marilyn; Sebastian, Sherly; Hickey, Joanne V

    2005-01-01

    A quality improvement project was undertaken by Neuro-ICU nurses to determine possible effects from open visitation. From a quality improvement perspective, nurses' concerns were investigated along with their perceptions about open visitation to determine a need for visitation policy revision. Vast variability in nurses' interpretation and implementation of individualized open visitation policy suggested a need for the following: staff education about the policy and its implementation, a review of the literature to determine the validity of concerns about deleterious physiologic effects on neuroscience patients from visitation, and improved communication among nurses about visitation.

  14. Recovery post ICU.

    Science.gov (United States)

    Jones, Christina

    2014-10-01

    Many ICU patients struggle to recovery following critical illness and may be left with physical, cognitive and psychological problems, which have a negative impact on their quality of life. Gross muscle mass loss and weakness can take some months to recover after the patients' Intensive Care Unit (ICU) discharge, in addition critical illness polyneuropathies can further complicate physical recovery. Psychological problems such as anxiety, depression and post traumatic stress disorder (PTSD) are common and have an negative impact on the patients' ability to engage in rehabilitation after ICU discharge. Finally cognitive deficit affecting memory can be a significant problem. The first step in helping patients to recover from such a devastating illness is to recognise those who have the greatest need and target interventions. Research now suggests that there are interventions that can accelerate physical recovery and reduce the incidence of psychological problems such as anxiety, depression and PTSD. Cognitive rehabilitation, however, is still in its infancy. This review will look at the research into patients' recovery and what can be done to improve this where needed.

  15. [Development of performance measure indicators in hospital nursing units].

    Science.gov (United States)

    Kang, Kyeong-Hwa; Kim, In-Sook

    2005-06-01

    The purpose of this study was to develop performance measure indicators for hospital nursing units based on a Balanced Scorecard (BSC). This study was a methodological study. The development process consisted of 3 stages. The first stage was setting up strategies for nursing units from a nursing department's mission and vision. The second stage was developing performance measure indicators after a validity check. The third stage was modifying developed performance measure indicators and classifying them. 7 strategies were set up according to 4 perspectives of a BSC. 15 performance measure indicators for hospital nursing units were developed, and the indicators were divided into 8 independent indicators and 7 shared indicators according to the degree of performance responsibility. In addition, they were classified into two groups, 7 leading indicators and lagging indicators. The result of this study suggests that performance measure indicators for hospital nursing units provide a framework and method for nursing organizations' performance management. Also, the developed indicators are expected to provide valuable information for successful organization management.

  16. The truth about nutrition in the ICU.

    OpenAIRE

    2014-01-01

    For the critically ill patient who is expected to remain more than 48 h in the intensive care unit (ICU), the need for nutrition is an accepted standard of care. The traditional screening tools used to identify malnutrition on the hospital ward are not adequate for use in the ICU because critically ill patients cannot communicate verbally to provide diet histories. Due to their high catabolic state, all ICU patients are at risk of developing malnutrition if not fed adequately. Since criticall...

  17. Depression prevalence in Intensive Care Unit nursing workers: a study at hospitals in a northwestern city of São Paulo State.

    Science.gov (United States)

    de Vargas, Divane; Dias, Ana Paula Vieira

    2011-01-01

    This study aimed to estimate the prevalence of depression in nursing staff working in Intensive Care Units of hospitals from a city in Northwestern São Paulo State - Brazil, examining its association with participants' socio-demographic characteristics. The Beck Depression Inventory was applied to a sample of 67 nursing workers from three general hospitals, showing an 28.4% prevalence of depression. The analysis based on the multiple model showed a significant association between depression and marital status (OR=1.52), night work (OR=1.46) and double shifts (OR=2.11). Also, there were significant percentages of workers who reported discouragement, sadness and hopelessness. In conclusion, the prevalence of depression is significant and more attention should be paid to this problem workers at these units face. Further studies are needed in the attempt to broaden knowledge on the subject, which can support strategies to guarantee attention to ICU nursing workers' physical and mental health needs.

  18. [Nursing duties in the basic health unit: perceptions and expectations of nursing assistants].

    Science.gov (United States)

    Soares, Cândida Elizabete Dos Santos; Biagolini, Rosângela Elaine Minéo; Bertolozzi, Maria Rita

    2013-08-01

    The present study aimed to analyze the perceptions and expectations regarding nursing duties of nursing assistants (NA) working in basic health units (BHUs) in a region of the municipality of São Paulo. This qualitative study used the collective subject discourse (CSD) technique. It took place in three BHUs with 20 NAs. Data were collected from interviews conducted in 2007. The NAs interviewed associated nursing duties with personal attitudes in daily work, seeing the nurse as a direct care provider who has the role of advisor and coordinator and who performs an excessive number of duties. The expectations of the interviewees were the participation of nurses in providing direct care to the user and the power to coordinate the team and assess the users' needs. Understanding nursing duties is important to respond appropriately to the needs of the community.

  19. Sizing personnel: evaluation of nursing in obstetric and mixed pediatric intensive care units

    OpenAIRE

    Mendes,Rodrigo Nonato Coelho; Carmo, Amanda de Figueirôa Silva; Salum, Rosana Dourado Loula; Gusmão-filho,Fernando Antônio Ribeiro de; Vidal, Suely Arruda; Santos, Viviane Euzébia Perreira

    2013-01-01

    Objectives: To assess the adequacy of nursing staff and understand how these professionals perceive this issue. Methods: evaluative, exploratory, descriptive, quantitative and qualitative study, developed in Obstetric and Mixed Pediatric ICUs for the Hospital Don Malan / IMIP in Petrolina-PE. Was calculated the scaling nursing and 13 semistructured interviews were conducted, analyzed according to Bardin. Results: Mixed Pediatric ICU has correct number of staff and Obstetric decrea...

  20. Job Satisfaction and Burnout among Intensive Care Unit Nurses and Physicians.

    Science.gov (United States)

    Myhren, Hilde; Ekeberg, Oivind; Stokland, Olav

    2013-01-01

    Introduction. Nurses and physicians working in the intensive care unit (ICU) may be exposed to considerable job stress. The study aim was to assess the level of and the relationship between (1) job satisfaction, (2) job stress, and (3) burnout symptoms. Methods. A cross-sectional study was performed at ICUs at Oslo University Hospital. 145 of 196 (74%) staff members (16 physicians and 129 nurses) answered the questionnaire. The following tools were used: job satisfaction scale (scores 10-70), modified Cooper's job stress questionnaire (scores 1-5), and Maslach burnout inventory (scores 1-5); high score in the dimension emotional exhaustion (EE) indicates burnout. Personality was measured with the basic character inventory. Dimensions were neuroticism (vulnerability), extroversion (intensity), and control/compulsiveness with the range 0-9. Results. Mean job satisfaction among nurses was 43.9 (42.4-45.4) versus 51.1 (45.3-56.9) among physicians, P burnout value (EE) was 2.3 (95% CI 2.2-2.4), and mean job stress was 2.6 (2.5-2.7), not significantly different between nurses and physicians. Females scored higher than males on vulnerability, 3.3 (2.9-3.7) versus 2.0 (1.1-2.9) (P Burnout (EE) correlated with job satisfaction (r = -0.4, P job stress (r = 0.6, P jobs compared to the physicians. Burnout mean scores are relatively low, but high burnout scores are correlated with vulnerable personality, low job satisfaction, and high degree of job stress.

  1. Sources of distress for physicians and nurses working in Swiss neonatal intensive care units.

    Science.gov (United States)

    Klein, Sabine D; Bucher, Hans Ulrich; Hendriks, Manya J; Baumann-Hölzle, Ruth; Streuli, Jürg C; Berger, Thomas M; Fauchère, Jean-Claude; On Behalf Of The Swiss Neonatal End-Of-Life Study Group

    2017-08-14

    Medical personnel working in intensive care often face difficult ethical dilemmas. These may represent important sources of distress and may lead to a diminished self-perceived quality of care and eventually to burnout. The aim of this study was to identify work-related sources of distress and to assess symptoms of burnout among physicians and nurses working in Swiss neonatal intensive care units (NICUs). In summer 2015, we conducted an anonymous online survey comprising 140 questions about difficult ethical decisions concerning extremely preterm infants. Of these 140 questions, 12 questions related to sources of distress and 10 to burnout. All physicians and nurses (n = 552) working in the nine NICUs in Switzerland were invited to participate. The response rate was 72% (398). The aspects of work most commonly identified as sources of distress were: lack of regular staff meetings, lack of time for routine discussion of difficult cases, lack of psychological support for the NICU staff and families, and missing transmission of important information within the caregiver team. Differences between physicians' and nurses' perceptions became apparent: for example, nurses were more dissatisfied with the quality of the decision-making process. Different perceptions were also noted between staff in the German- and French- speaking parts of Switzerland: for example, respondents from the French part rated lack of regular staff meetings as being more problematic. On the other hand, personnel in the French part were more satisfied with their accomplishments in the job. On average, low levels of burnout symptoms were revealed, and only 6% of respondents answered that the work-related burden often affected their private life. Perceived sources of distress in Swiss NICUs were similar to those in ICU studies. Despite rare symptoms of burnout, communication measures such as regular staff meetings and psychological support to prevent distress were clearly requested.

  2. Relation between Safety Organizing and Job Self-efficacy for ICU Nurses%安全组织与ICU护士工作效能感的关系探讨

    Institute of Scientific and Technical Information of China (English)

    杨旭英; 俞勤; 王志娟

    2016-01-01

    目的调查ICU护士的安全组织、工作效能感现状,分析两者之间的关系。方法采用中文版安全组织量表和工作效能感量表对15所三级医院948名ICU护士进行问卷调查。结果安全组织、工作效能感得分分别为(44.34±9.67)分、(29.56±5.87)分;ICU护士的安全组织与工作效能感呈正相关(r=0.822, P=0.002);职称、月收入、安全组织为工作效能感的影响因素(P<0.05)。结论 ICU护士的安全组织和工作效能感均处于中等水平,安全组织为ICU护士工作效能感的影响因素。%Objective To investigate current status of safety organizing and job self-efficacy of ICU nurses and analyze their relation.Methods Conducted questionnaire survey on 948 ICU nurses from 15 tertiary hospitals with safety organizing scale and job self-efficacy scale in Chinese version.Results The scores of safety organizing and job self-efficacy were (44.34±9.67) and (29.56±5.87) respectively. Safety organizing of ICU nurses was positively correlated with job self-efficacy (r=0.822, P=0.002). Title, monthly income and safety organizing were influencing factors for job self-efficacy (P<0.05). Conclusion The safety organizing and job self-efficacy of ICU nurses are at the middle level. Safety organizing is an influencing factors for job self-efficacy of ICU nurses.

  3. Preventive measures and nursing care of patients with ventilator associated pneumonia in ICU ward%ICU病房呼吸机相关性肺炎的预防措施与护理

    Institute of Scientific and Technical Information of China (English)

    吴兰花

    2016-01-01

    Objective:To investigate the preventive measures and nursing care of patients with ventilator associated pneumonia in ICU ward.Methods:40 patients with mechanical ventilation in ICU ward were selected.They were randomly divided into the two groups on average.All patients were given routine artificial airway care.On this basis,the observation group was strictly enforced sterilization management,oral care,respiratory tract care,airway humidification of nursing,nutrition nursing.The effect of two interventions on ventilator associated pneumonia were compared.Results:In the observation group after the application of prevention and nursing measures,the incidence of ventilator associated pneumonia was significantly less than that of the control group,which had statistical difference(P<0.05).Conclusion:The prevention and nursing measures of ventilator associated pneumonia in ICU ward can effectively reduce the ventilator associated pneumonia.%目的:探讨 ICU 病房呼吸机相关性肺炎的预防措施与护理。方法:收治 ICU 病房接受机械通气患者40例,随机平分为两组,均予以常规人工气道护理,观察组则在此基础上,应用严格执行灭菌消毒管理、口腔护理、呼吸道护理、气道湿化护理、营养护理,对比两种干预措施对呼吸机相关性肺炎的影响。结果:观察组在应用预防与护理措施后,其发生呼吸机相关性肺炎患者明显少于对照组,差异有统计学意义(P<0.05)。结论:ICU病房积极实施呼吸机相关性肺炎预防及护理措施,可有效减少呼吸机相关性肺炎发生。

  4. Development and evaluation of an interprofessional communication intervention to improve family outcomes in the ICU.

    Science.gov (United States)

    Curtis, J Randall; Ciechanowski, Paul S; Downey, Lois; Gold, Julia; Nielsen, Elizabeth L; Shannon, Sarah E; Treece, Patsy D; Young, Jessica P; Engelberg, Ruth A

    2012-11-01

    The intensive care unit (ICU), where death is common and even survivors of an ICU stay face the risk of long-term morbidity and re-admissions to the ICU, represents an important setting for improving communication about palliative and end-of-life care. Communication about the goals of care in this setting should be a high priority since studies suggest that the current quality of ICU communication is often poor and is associated with psychological distress among family members of critically ill patients. This paper describes the development and evaluation of an intervention designed to improve the quality of care in the ICU by improving communication among the ICU team and with family members of critically ill patients. We developed a multi-faceted, interprofessional intervention based on self-efficacy theory. The intervention involves a "communication facilitator" - a nurse or social worker - trained to facilitate communication among the interprofessional ICU team and with the critically ill patient's family. The facilitators are trained using three specific content areas: a) evidence-based approaches to improving clinician-family communication in the ICU, b) attachment theory allowing clinicians to adapt communication to meet individual family member's communication needs, and c) mediation to facilitate identification and resolution of conflict including clinician-family, clinician-clinician, and intra-family conflict. The outcomes assessed in this randomized trial focus on psychological distress among family members including anxiety, depression, and post-traumatic stress disorder at 3 and 6 months after the ICU stay. This manuscript also reports some of the lessons that we have learned early in this study.

  5. 护理干预对ICU清醒患者不良情绪的影响%Effect of nursing intervention on the bad mood of patients with consciousness in ICU

    Institute of Scientific and Technical Information of China (English)

    周红

    2012-01-01

    Objective: To explore the effect of nursing intervention on the bad mood of patients with consciousness in ICU and work out corresponding countermeasure in order to provide a basis for clinical nursing care. Methods: 124 patients with consciousness in ICU were randomly divided into an intervention group ( re = 61 ) and a control group ( re = 63 ). The patients in the control group were given routine nursing care and the patients in the intervention group were given such nursing intervention as nursing care with information retention, social support care, sleep care, comfort nursing care and non language communication. The Self - rating Anxiety Scale and Self - rating Depression Scale were used to make an investigation on the patients in the two groups. Results: There were statistically significant differences in the comparison of anxiety and depression status of the patients between the two groups ( P <0. 05 ). Conclusion:The nursing intervention can alleviate the negative emotions of patients with consciousness in ICU; the nursing staff should flexibly implement nursing intervention according to patients'conditions so as to improve the quality of nursing care.%目的:探讨护理干预对ICU清醒患者不良情绪的影响,并制定有利于患者健康的相应对策,为ICU临床护理提供依据.方法:将124例ICU清醒患者随机分为干预组61例和对照组63例,对照组给予常规护理,干预组在对照组基础上给予信息告知护理、社会支持护理、睡眠护理、舒适护理和非语言沟通等干预措施.应用焦虑自评量表和抑郁自评量表进行调查.结果:干预组与对照组比较,焦虑和抑郁程度差异有统计学意义(P<0.05).结论:护理干预可缓解ICU清醒患者不良情绪,护理人员应在实施护理的过程中灵活应用信息告知护理、社会支持护理、睡眠护理、舒适护理和非语言沟通等干预措施提高护理服务质量.

  6. Study on the influence of junior ICU nurses' Adversity Quotient on work engagement%低年资ICU护士逆商对其工作投入的影响研究

    Institute of Scientific and Technical Information of China (English)

    梁燕金; 王明娜; 付霞

    2016-01-01

    Objective: To investigate the inlfuence of junior ICU nurses' Adversity Quotient on work engagement. Methods: A total of 223 junior ICU nurses from Guangdong were investigated. A structured, self-administrated questionnaire revealing nurses' demographics, adversity quotient and work engagement was used. Results: The mean score of adversity quotient was (137.96±19.77). The mean score of work engagement was (56.95±5.06). Employment status of junior ICU nurses' was significantly associated with work engagement. Significance was also seen for control and patience among nurses with work engagement. Conclusion: Work engagement of junior ICU nurses was in moderate level. Frustration education should be provided to enhance nurses' adversity quotient in order to improve their work engagement.%目的:调查低年资ICU护士的逆商及工作投入的现状,分析逆商对其工作投入的影响。方法:使用一般资料调查问卷、逆商量表、工作投入量表,对223名低年资ICU护士进行调查。结果:低年资ICU护士的逆商得分为(137.96±19.77)分,工作投入总得分为(56.95±5.06)分。低年资ICU护士的用工性质、控制与忍耐对其工作投入水平具有正向预测作用。结论:目前低年资ICU护士工作投入处于中等水平,医院管理者可通过开展挫折环境模拟实训、心理素养教育等手段,增强低年资护士的逆商,以提升其工作投入水平。

  7. Effects Evaluation of Short-period Training of Delirium Related Knowledge on the ICU Nurses%对ICU护士开展谵妄知识短期培训的效果评价

    Institute of Scientific and Technical Information of China (English)

    张伟英; 顾君君; 胡文琳; 邱文娟; 叶文琴

    2014-01-01

    目的:探讨对心外科 ICU护士开展谵妄知识短期培训的效果,为完善谵妄护理干预方案提供依据.方法对心外科55名 ICU护士进行为期1周的短期培训,在培训前和培训后进行问卷调查,调查护士对谵妄知识的掌握程度;以培训时间为界将心外科冠状动脉旁路移植术(coronary artery bypass graft,CABG)患者分为培训前的 A组和培训后的 B组,比较两组患者谵妄发生率.结果培训后护士对谵妄知识的认知程度和掌握程度均有提高,B组患者术后谵妄发生率显著低于 A 组(P<0.05).结论对护士进行谵妄知识短期培训能够提高 ICU护士对谵妄知识的认知和掌握程度,降低患者谵妄发生率.%Objective To explore the effects of short-period delirium related knowledge training to the ICU nurses,and to provide evidences to improve the interventions on delirium nursing and management.Methods Totally 5 5 nurses of Cardiothoracic ICU were trained on delirium related knowledge for one week.The investigation questionnaires were conducted before and after the training to evaluate the knowledge of ICU nurses about delirium.The CABG patients were divided into before training group A and after training group B.The delirium incidence of two groups of patients were compared.Results After training,the train-ing nurses know more about delirium related knowledge,and the delirium incidence of group B was signifi-cantly decreased compared with that of group A (P<0.05).Conclusion Short-period training to the ICU nurses on delirium can help to improve the knowledge of nurses and decrease the delirium incidence of pa-tients.

  8. 前瞻性护理对 ICU 清醒患者不良情绪及睡眠质量的影响%The effect of prospective nursing on the negative emotion and sleep quality of ICU a-wake patients

    Institute of Scientific and Technical Information of China (English)

    李雪梅; 侯颖; 王丽; 聂成惠; 林芸

    2014-01-01

    Objective To investigate the effect of prospective nursing in awake patients of ICU.Methods Sixty cases of ICU a-wake patients in our hospital from November 2012 to February 2013 were randomly divided into the observation group and the control group , 30 cases in each group , the control group was received routine nursing , the observation group was given prospective nursing based on the control group , the nursing effect of two groups were compared.Results The effective communication of the observation group was significant-ly higher than that in the control group , treatment compliance was significantly higher than that in the control group , the sleep index was sig-nificantly lower than that in the control group , the pain score was significantly lower than those in the control group (P<0.05) .Anxiety, depression score in the observation group were significantly lower than those in the control group ( P<0.05 ) .Conclusions Prospective nursing can foresight to avoid affecting factors ICU sober life quality of awake patients of ICU , reduce the patient's bad mood , improve sleep quality.%目的:探讨前瞻性护理在ICU清醒患者护理中的应用效果。方法将我院2012年11月至2013年2月收治的60例ICU清醒患者随机分为观察组和对照组各30例,对照组采用常规护理,观察组在对照组的基础上采用前瞻性护理,比较两组患者的护理效果。结果观察组的有效沟通率显著高于对照组,治疗配合度显著高于对照组,睡眠指数显著低于对照组,疼痛评分显著低于对照组,观察组的焦虑、抑郁评分显著低于对照组,差异均有统计学意义( P<0.05)。结论前瞻性护理能预见性避免影响ICU清醒生命质量的因素,减少患者的不良情绪,提高睡眠质量。

  9. Perme Intensive Care Unit Mobility Score and ICU Mobility Scale: translation into Portuguese and cross-cultural adaptation for use in Brazil

    Directory of Open Access Journals (Sweden)

    Yurika Maria Fogaça Kawaguchi

    Full Text Available ABSTRACT Objective: To translate the Perme Intensive Care Unit Mobility Score and the ICU Mobility Scale (IMS into Portuguese, creating versions that are cross-culturally adapted for use in Brazil, and to determine the interobserver agreement and reliability for both versions. Methods: The processes of translation and cross-cultural validation consisted in the following: preparation, translation, reconciliation, synthesis, back-translation, review, approval, and pre-test. The Portuguese-language versions of both instruments were then used by two researchers to evaluate critically ill ICU patients. Weighted kappa statistics and Bland-Altman plots were used in order to verify interobserver agreement for the two instruments. In each of the domains of the instruments, interobserver reliability was evaluated with Cronbach's alpha coefficient. The correlation between the instruments was assessed by Spearman's correlation test. Results: The study sample comprised 103 patients-56 (54% of whom were male-with a mean age of 52 ± 18 years. The main reason for ICU admission (in 44% was respiratory failure. Both instruments showed excellent interobserver agreement ( > 0.90 and reliability ( > 0.90 in all domains. Interobserver bias was low for the IMS and the Perme Score (−0.048 ± 0.350 and −0.06 ± 0.73, respectively. The 95% CIs for the same instruments ranged from −0.73 to 0.64 and −1.50 to 1.36, respectively. There was also a strong positive correlation between the two instruments (r = 0.941; p < 0.001. Conclusions: In their versions adapted for use in Brazil, both instruments showed high interobserver agreement and reliability.

  10. Perme Intensive Care Unit Mobility Score and ICU Mobility Scale: translation into Portuguese and cross-cultural adaptation for use in Brazil

    Science.gov (United States)

    Kawaguchi, Yurika Maria Fogaça; Nawa, Ricardo Kenji; Figueiredo, Thais Borgheti; Martins, Lourdes; Pires-Neto, Ruy Camargo

    2016-01-01

    ABSTRACT Objective: To translate the Perme Intensive Care Unit Mobility Score and the ICU Mobility Scale (IMS) into Portuguese, creating versions that are cross-culturally adapted for use in Brazil, and to determine the interobserver agreement and reliability for both versions. Methods: The processes of translation and cross-cultural validation consisted in the following: preparation, translation, reconciliation, synthesis, back-translation, review, approval, and pre-test. The Portuguese-language versions of both instruments were then used by two researchers to evaluate critically ill ICU patients. Weighted kappa statistics and Bland-Altman plots were used in order to verify interobserver agreement for the two instruments. In each of the domains of the instruments, interobserver reliability was evaluated with Cronbach's alpha coefficient. The correlation between the instruments was assessed by Spearman's correlation test. Results: The study sample comprised 103 patients-56 (54%) of whom were male-with a mean age of 52 ± 18 years. The main reason for ICU admission (in 44%) was respiratory failure. Both instruments showed excellent interobserver agreement (κ > 0.90) and reliability (α > 0.90) in all domains. Interobserver bias was low for the IMS and the Perme Score (−0.048 ± 0.350 and −0.06 ± 0.73, respectively). The 95% CIs for the same instruments ranged from −0.73 to 0.64 and −1.50 to 1.36, respectively. There was also a strong positive correlation between the two instruments (r = 0.941; p < 0.001). Conclusions: In their versions adapted for use in Brazil, both instruments showed high interobserver agreement and reliability. PMID:28117473

  11. Nursing Activities Score: an updated guideline for its application in the Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Katia Grillo Padilha

    2015-12-01

    Full Text Available ABSTRACT Objective To describe nursing workload in Intensive Care Units (ICU in different countries according to the scores obtained with Nursing Activities Score (NAS and to verify the agreement among countries on the NAS guideline interpretation. Method This cross-sectional study considered 1-day measure of NAS (November 2012 obtained from 758 patients in 19 ICUs of seven countries (Norway, the Netherlands, Spain, Poland, Egypt, Greece and Brazil. The Delphi technique was used in expertise meetings and consensus. Results The NAS score was 72.8% in average, ranging from 44.5% (Spain to 101.8% (Norway. The mean NAS score from Poland, Greece and Egypt was 83.0%, 64.6% and 57.1%, respectively. The NAS score was similar in Brazil (54.0% and in the Netherlands (51.0%. There were doubts in the understanding of five out 23 items of the NAS (21.7% which were discussed until researchers’ consensus. Conclusion NAS score were different in the seven countries. Future studies must verify if the fine standardization of the guideline can have a impact on differences in the NAS results.

  12. Role of psychosocial care on ICU trauma

    Directory of Open Access Journals (Sweden)

    Usha Chivukula

    2014-01-01

    Full Text Available Context: Patients treated in intensive care units (ICU though receive the best medical attention are found to suffer from trauma typically attributed to the ICU environment. Biopsychosocial approach in ICUs is found to minimize ICU trauma. Aims: This study investigates the role of psychosocial care on patients in ICU after coronary artery bypass graft (CABG. Settings and Design: The study included 250 post-operative CABG patients from five corporate hospitals. The combination of between subject and correlation design was used. Materials and Methods: The ICU psychosocial care scale (ICUPCS and ICU trauma scale (ICUTS were used to measure the psychosocial care and trauma. Statistical Analysis: ANOVA and simple and multiple regression were applied. Results: Hospitals significantly differed in psychosocial care provided in ICUs. Higher the psychosocial care in ICU, lower was the ICU trauma experienced and vice versa. Psychosocial care was a significant major predictor of ICU trauma. Conclusions: The study suggests emphasis on psychosocial aspects in ICU care for optimizing prognosis.

  13. Moral distress, autonomy and nurse-physician collaboration among intensive care unit nurses in Italy.

    Science.gov (United States)

    Karanikola, Maria N K; Albarran, John W; Drigo, Elio; Giannakopoulou, Margarita; Kalafati, Maria; Mpouzika, Meropi; Tsiaousis, George Z; Papathanassoglou, Elizabeth D E

    2014-05-01

    To explore the level of moral distress and potential associations between moral distress indices and (1) nurse-physician collaboration, (2) autonomy, (3) professional satisfaction, (4) intention to resign, and (5) workload among Italian intensive care unit nurses. Poor nurse-physician collaboration and low autonomy may limit intensive care unit nurses' ability to act on their moral decisions. A cross-sectional correlational design with a sample of 566 Italian intensive care unit nurses. The intensity of moral distress was 57.9 ± 15.6 (mean, standard deviation) (scale range: 0-84) and the frequency of occurrence was 28.4 ± 12.3 (scale range: 0-84). The mean score of the severity of moral distress was 88.0 ± 44 (scale range: 0-336). The severity of moral distress was associated with (1) nurse-physician collaboration and dissatisfaction on care decisions (r = -0.215, P managerial task that could lead to the alleviation of nurses' moral distress and their retention in the profession. © 2013 John Wiley & Sons Ltd.

  14. Descriptive Analysis on ICU Medical Risk Management in United Kingdom, United States, Australia, Canada and Taiwan%英美澳加和中国台湾地区ICU医疗风险管理分析

    Institute of Scientific and Technical Information of China (English)

    孙纽云; 崔小花; 梁铭会; 王莉; 李幼平; 成岚; 李筱; 袁强

    2011-01-01

    Objective To analyze the policy and guideline, the institutional management and the operation mechanism of ICU medical risk management in the United Kingdom, the United States, Australia, Canada and Taiwan, so as to provide evidence and recommendations for health care risk management policy in China.Methods Such databases as PubMed, EMBASE, The Cochrane Library were searched to include the literatures such as the guideline documents and the research reports on ICU medical risk management in the United Kingdom, the United States, Australia, Canada and Taiwan; the institutional management and the operation mechanism of the risk management in the above four countries and one area were comprehensively analyzed, and especially the UK model was highly emphasized.Results A total of 31 literatures were included, including 1 guideline, 5 reviews, 2 investigative reports and 23 research documents.The United Kingdom guided the ICU risk management in forms of the standard and the guideline, formulated a clear tool of event classification and corresponding response mechanism.The United States learned from Australia's experience and established the ICU safety reporting system; both of them regarded ICU as one part of the medical risk management and set up a special management column.Conclusion The ICU risk management with the independent report system in the United Kingdom is brought into the scope of national patient safety management, and is regarded as the relative complete system at present.In Australia and the USA, the national institutions are in charge of setting up the research projects of ICU risk management; the industry associations and the non-governmental organizations lead the risk research; and the experimental units popularize gradually after self-application.%目的 通过分析四国一区ICU风险管理政策指南、机构管理和运行机制等,为我国ICU风险管理提供决策依据和政策建议.方法 计算机检索PubMed,、Embase,Cochrane Library

  15. ICU护士对开放性探视制度的信念和态度现状调查%Beliefs and attitudes toward unrestricted visiting policy among ICU nurses

    Institute of Scientific and Technical Information of China (English)

    周玉意; 邵菊琴; 张海燕

    2016-01-01

    Objective: To investigate the beliefs and attitudes toward unrestricted visiting policy among ICU nurses, and to explore its inlfuencing factors. Methods: Totally 245 ICU nurses from three Tertiary Grade A general hospitals in Hangzhou were recruited by convinience sampling method and investigated using the Beliefs and Attitudes toward Unrestricted Visiting Policy Questionnaire. Results: The average score of beliefs and attitudes toward unrestricted visiting policy among ICU nurses was (2.57±0.61), and (1.95±0.39), respectively. There wasn't correlation between beliefs and attitudes (r=0.135,P=0.064). The education background, working years and visiting experience were the influencing factors of the beliefs and attitudes toward unrestricted visiting policy among ICU nurses (R2=0.316,F=13.007,P<0.001). Conclusion: The beliefs and attitudes toward unrestricted visiting policy among ICU nurses needs to be improved.The education background, working years and visiting experience are the inlfuencing factors of the beliefs and attitudes toward unrestricted visiting policy among ICU nurses.%目的:调查分析重症监护室(ICU)护士对待实行开放性探视制度的信念和态度及其影响因素。方法:采用修订的护士对开放性探视制度信念和态度调查问卷对方便抽样的杭州市3所三级甲等综合医院的245名ICU护士进行调查。结果:ICU护士对开放性探视制度的信念条目均分为(2.57±0.61)分,态度条目均分为(1.95±0.39)分,信念与态度之间无相关性(r=0.135,P=0.064),学历、工作年限和是否有探视经历进入多元回归模型,共解释ICU护士对开放性探视制度信念和态度总变异的31.6%(P<0.001)。结论:ICU护士对开放性探视制度的认知情况还有待于提高,学历、工作年限和是否有探视经历是ICU护士对开放性探视制度信念和态度的影响因素。

  16. Nurse Staffing in Neonatal Intensive Care Units in the United States.

    Science.gov (United States)

    Rogowski, Jeannette A; Staiger, Douglas O; Patrick, Thelma E; Horbar, Jeffrey D; Kenny, Michael J; Lake, Eileen T

    2015-10-01

    The neonatal intensive care unit (NICU) is a setting with high nurse-to-patient ratios. Little is known about the factors that determine nurse workload and assignment. The goals of this study were to (1) develop a measure of NICU infant acuity; (2) describe the acuity distribution of NICU infants; (3) describe the nurse/infant ratio at each acuity level, and examine the factors other than acuity, including nurse qualifications and the availability of physicians and other providers, that determined staffing ratios; and (4) explore whether nurse qualifications were related to the acuity of assigned infants. In a two-stage cohort study, data were collected in 104 NICUs in 2008 by nurse survey (6,038 nurses and 15,191 infants assigned to them) and administrators reported on unit-level staffing of non-nurse providers; in a subset of 70 NICUs in 2009-2010, census data were collected on four selected shifts (3,871 nurses and 9,276 infants assigned to them). Most NICU infants (62%) were low-acuity (Levels 1 and 2); 12% of infants were high-acuity (Levels 4 and 5). The nurse-to-infant ratio ranged from 0.33 for the lowest-acuity infants to 0.95 for the highest-acuity infants. The staffing ratio was significantly related to the acuity of assigned infants but not to nurse education, experience, certification, or availability of other providers. There was a significant but small difference in the percentage of high-acuity (Levels 4 and 5) infants assigned to nurses with specialty certification (15% vs. 12% for nurses without certification). These staffing patterns may not optimize patient outcomes in this highly intensive pediatric care setting. © 2015 Wiley Periodicals, Inc.

  17. The effect of chronotype on sleepiness, fatigue, and psychomotor vigilance of ICU nurses during the night shift

    NARCIS (Netherlands)

    Reinke, Laurens; Ozbay, Yusuf; Dieperink, Willem; Tulleken, Jaap E.

    In general, sleeping and activity patterns vary between individuals. This attribute, known as chronotype, may affect night shift performance. In the intensive care unit (ICR), night shift performance may impact patient safety. We have investigated the effect of chronotype and social demographics on

  18. Nurses' Perceptions and Practices Toward Clinical Alarms in a Transplant Cardiac Intensive Care Unit: Exploring Key Issues Leading to Alarm Fatigue.

    Science.gov (United States)

    Sowan, Azizeh Khaled; Tarriela, Albert Fajardo; Gomez, Tiffany Michelle; Reed, Charles Calhoun; Rapp, Kami Marie

    2015-03-16

    Intensive care units (ICUs) are complex work environments where false alarms occur more frequently than on non-critical care units. The Joint Commission National Patient Safety Goal .06.01.01 targeted improving the safety of clinical alarm systems and required health care facilities to establish alarm systems safety as a hospital priority by July 2014. An important initial step toward this requirement is identifying ICU nurses' perceptions and common clinical practices toward clinical alarms, where little information is available. Our aim was to determine perceptions and practices of transplant/cardiac ICU (TCICU) nurses toward clinical alarms and benchmark the results against the 2011 Healthcare Technology Foundation's (HTF) Clinical Alarms Committee Survey. A quality improvement project was conducted on a 20-bed TCICU with 39 full- and part-time nurses. Nurses were surveyed about their perceptions and attitudes toward and practices on clinical alarms using an adapted HTF clinical alarms survey. Results were compared to the 2011 HTF data. Correlations among variables were examined. All TCICU nurses provided usable responses (N=39, 100%). Almost all nurses (95%-98%) believed that false alarms are frequent, disrupt care, and reduce trust in alarm systems, causing nurses to inappropriately disable them. Unlike the 2011 HTF clinical alarms survey results, a significantly higher percentage of our TCICU nurses believed that existing devices are complex, questioned the ability and adequacy of the new monitoring systems to solve alarm management issues, pointed to the lack of prompt response to alarms, and indicated the lack of clinical policy on alarm management (Palarms and poor usability of the cardiac monitors. A lack of standardized approaches exists in changing patients' electrodes and individualizing parameters. Around 60% of nurses indicated they received insufficient training on bedside and central cardiac monitors. A correlation also showed the need for training

  19. The implementation of an Intensive Care Information System allows shortening the ICU length of stay.

    Science.gov (United States)

    Levesque, Eric; Hoti, Emir; Azoulay, Daniel; Ichai, Philippe; Samuel, Didier; Saliba, Faouzi

    2015-04-01

    Intensive care information systems (ICIS) implemented in intensive care unit (ICU) were shown to improve patient safety, reduce medical errors and increase the time devolved by medical/nursing staff to patients care. Data on the real impact of ICIS on patient outcome are scarce. This study aimed to evaluate the effects of ICIS on the outcome of critically-ill patients. From January 2004 to August 2006, 1,397 patients admitted to our ICU were enrolled in this observational study. This period was divided in two phases: before the implementation of ICIS (BEFORE) and after implementation of ICIS (AFTER). We compared standard ICU patient's outcomes: mortality, length of stay in ICU, hospital stay, and the re-admission rate depending upon BEFORE and AFTER. Although patients admitted AFTER were more severely ill than those of BEFORE (SAPS II: 32.1±17.5 vs. 30.5±18.5, p=0.014, respectively), their ICU length of stay was significantly shorter (8.4±15.2 vs. 6.8±12.9 days; p=0.048) while the re-admission rate and mortality rate were similar (4.4 vs. 4.2%; p=0.86, and 9.6 vs 11.2% p=0.35, respectively) in patients admitted AFTER. We observed that the implementation of ICIS allowed shortening of ICU length of stay without altering other patient outcomes.

  20. 某部队医院ICU护理人员应急救援能力的调查分析%Investigation on emergency rescue capability of ICU nurses in a military hospital/

    Institute of Scientific and Technical Information of China (English)

    侯亚红; 邸红军

    2012-01-01

    目的 调查某部队医院ICU护理人员应急救援能力,为进一步的培训提供参考依据.方法 采取自行设计量表对某部队医院199名ICU护理人员进行调查.结果 护理人员职业素质(18.21±1.23)分,心理素质(17.55 ±2.01)分,专业技能(31.54±2.52)分,军事能力(14.73±1.98)分.结论 部队医院ICU护理人员除具有较高的职业素质外,在其他3个方面均存在一定的差距,管理者应关注护理人员应急救援能力的培训,提高为部队服务的能力.%Objective To investigate the emergency rescue capability of ICU nurses in a military hospital, so as to provide references for the further training. Method A total of 199 ICU nurses in the military hospital were investigated with a self - designed questionnaire. Results The scores of occupation quality, psychological quality,professional skills and military ability were (18.21 ± 1. 23 ) , ( 17. 55 ±2. 01) , (31. 54 ± 2. 52) and (14.73 ± 1.98) ,respectively. Conclusion ICU nurses in military hospitals have high occupation quality, however, there are certain gap in 3 other areas. Managers should pay attention to the education and training of emergency rescue capability of nurses, in order to improve the service capabilities for the army.

  1. Representation of nurse's managerial practice in inpatient units: nursing staff perspective.

    Science.gov (United States)

    Lima, Rogério Silva; Lourenço, Eliana Bernardes; Rosado, Sara Rodrigues; Fava, Silvana Maria Coelho Leite; Sanches, Roberta Seron; Dázio, Eliza Maria Rezende

    2016-03-01

    Objective To understand the meanings that nursing staff gives to nurse's managerial practice in the inpatient unit. Methods This is an exploratory and descriptive research with qualitative approach, conducted in a general hospital in a Southern city of Minas Gerais State. We used the Theory of Social Representations as theoretical framework. The study sample were composed by 23 nursing technicians and five nursing assistants. Data collection was conducted through semi-structured interviews, from December 2011 to January 2012. For data analysis we used the discourse analysis, according to social psychology framework. Results The meanings attributed to management occurred from the closeness/distance to staff and to patients` care actions. Conclusions The managerial nurse, perceived as a process apart from care, is classified as non familiar practice, of hard understanding and valuation.

  2. The Effect of Teaching Emotional Intelligence (EI Items on Job Related Stress in Physicians and Nurses Working in ICU Wards in Hospitals, Yerevan, Armenia

    Directory of Open Access Journals (Sweden)

    Sharif F

    2011-10-01

    Full Text Available Background: Intensive care units (ICUs are known as stressful environments. However, the conditions in which stressors may affect health professionals’ performance and well-being and the conditions that potentially lead to impaired performance and staff’s psychological distress are not well understood. Emotional intelligence, an essential factor responsible for determining success in life and psychological well-being, seems to play an important role in shaping the interaction between individuals and their work environment. The emotional dimension (personal is the concept of multi-dimensional intelligence, it is also necessary for physicians and nurses to learn how to view and understand people’s behavior, attitudes, interpersonal skills and potential. Individuals who have these characteristics are said to be “emotionally intelligent.”Objectives: The objective of the study is to determine the effects of emotional intelligence education items on job related stress in physicians and nurses working in intensive care units in hospitals in Yerevan, Armenia.Method: A cross interventional, pre-post, case and control group design was used and inferential study design was implemented, with 150 registered hospitals physicians and nurses, who were widely distributed.Results: A sample of 106 participants (18.7% of men and 31.3% of women in case and control group, representing various human service professions (physicians, nurses was eligible for the study. The mean age of the participants was 33.19 years in case group (SD = 6.44, and 31.6 in control group (SD = 6.04, and the employment period was 8.2 years (SD = 7.34 in case group and 5.57 years (SD = 4.02 in control group. The results confirmed an essential, very strong, role of emotional intelligence in perceiving occupational stress and preventing physicians and nurses from negative health outcomes. Conclusion: Results showed that physicians and nurses experienced high level of stress. The level

  3. The experience of registered nurses nursing in the general audit intensive care unit

    Directory of Open Access Journals (Sweden)

    E. Pope

    1998-09-01

    Full Text Available In this article a phenomenological qualitative research study is discussed. More attention will be given to the methodology of the research. The objectives of the study are two-fold: firstly to explore and describe the experience of registered nurses nursing in the adult intensive care unit (this is the first phase of the research and to describe guidelines based on the information obtained in the first phase to support the nurses in the form of a support programme in the second phase. The units of research are the registered nurses in the intensive care unit. The characteristics of the unit of research led to the emergence of a qualitative phenomenological research design of an explorative, descriptive and contextual nature. In the discussion of research methodology attention will be given to phase one: data gathering (ethical considerations and informed consent; purposive selection, phenomenological interviews and field notes; data analysis (Tesch’s method of data analysis, methods to ensure trustworthiness, organisation of raw data and integration of findings supported by literature. Five themes were identified through the data analysis: impaired communication with management; discrimination: white on black racism; lack of fair, competitive remuneration and disregard for professional worth; non-conducive physical environment, and stressful working environment. Phase two: Guidelines were described to support the registered nurses in the intensive care unit based on the information obtained in phase one of the research.

  4. Nursing Actions in practicing inpatient advocacy in a Burn Unit

    Directory of Open Access Journals (Sweden)

    Aline Carniato Dalle Nogario

    2015-08-01

    Full Text Available OBJECTIVEUnderstanding nursing actions in the practice of inpatient advocacy in a burn unit.METHODA single and descriptive case study, carried out with nurses working in a referral burn center in southern Brazil. Data were collected through focus group technique, between February and March 2014, in three meetings. Data was analysed through discursive textual analysis.RESULTSThree emerging categories were identified, namely: (1 instructing the patient; (2 protecting the patient; and (3 ensuring the quality of care.CONCLUSIONSThis study identified that the nurses investigated exercised patient advocacy and that the recognition of their actions is an advance for the profession, contributing to the autonomy of nurses and the effectiveness of patients' rights and social justice.

  5. [Job satisfaction of nurses in the clinical management units].

    Science.gov (United States)

    Martínez Lara, Concepción; Praena Fernández, Juan Manuel; Gil García, Eugenia

    2013-01-01

    Clinical Management Unit (CMU) is currently set in the Andalusian health institutions as the model reference management. This management model aims to make all healthcare professionals a powerful idea: the best performance of health resources is performed to drive clinical practice using the least number of diagnostic and therapeutic resources. The CMU not only aims at saving money, in the Clinical Management Agreement [1] are measured all the dimensions that make up the UGC: research, training, clinical process, the portfolio of services, objectives, financial management and indicators to control and security. The CMU is to transfer more responsibilities to Health Care Professionals, involving them in the management of the Unit. The CMU sets new approaches that directly affect health professionals and presents advantages and disadvantages for the Doctors and the Nurses, involved in achieving excellence in care work. Nurse Practitioners shows expectant before the changes are generated in health institutions and appears a discussion of skills derived from the CMU. Some Nurses believe that the bur, den of care to which they are subjected in public institutions has increased since the onset of the CMU and yet others believe that they are motivated and rewarded for the results obtained with this model of management. In health institutions, some professionals are more motivated than others and this is found in the outcome of health care activity [2]. Given the positive and negative perceptions that arise in the CMU Professional Nurses, it is considered appropriate to focus the objective of this work in the search for factors that influence job satisfaction of nurses in the CMU. There are few studies about the CMU [3] but are absent when linked with nursing, so the pursuit of scientific knowledge related to nursing management model based on Clinical and Quality Care can lead to establish new concepts around the nursing profession, a profession in which major changes are

  6. Prevalence of nursing diagnoses in an intensive care unit

    Directory of Open Access Journals (Sweden)

    Vinicia de Holanda Cabral

    2017-01-01

    Full Text Available To identify the main nursing diagnostic titles used in the care of critically ill patients hospitalized in an Intensive Care Unit, verifying the presence thereof in the diagnoses of NANDA International’s Taxonomy II. Methods: descriptive and documental study, in which 69 medical records of patients aged over 18 years were consulted. Results: 22 nursing diagnostic titles were found; the most frequent was risk for infection (99.0%, risk for skin integrity (75.0% and risk for aspiration (61.0%. Most diagnoses were in the domains safety/ protection (43.0% and activity/rest (26.5%. Conclusions: authors identified the main nursing diagnostic titles used in the care of critically ill patients admitted to the Intensive Care Unit and the presence thereof in the diagnoses of NANDA International’s Taxonomy II.

  7. [The nurse within emergency medical-psychological units].

    Science.gov (United States)

    Darbon, Rémy; Dalphin, Catherine; Prieto, Nathalie; Cheucle, Éric

    2017-04-01

    The growing recognition of post-traumatic stress disorders and the need to intervene early justifies the creation of emergency medical-psychological units. The nurse has a major role to play within these teams. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  8. Nurses' Knowledge and Responsibility toward Nutritional Assessment for Patients in Intensive Care Units

    Directory of Open Access Journals (Sweden)

    Mahmoud Al Kalaldeh

    2014-09-01

    Full Text Available Introduction: Nutritional assessment is a prerequisite for nutritional delivery. Patients in intensive care suffer from under-nutrition and nutritional failure due to poor assessment. Nursing ability to early detect nutritional failure is the key for minimizing imparities in practice and attaining nutritional goals. Aim of this article is to examine the ability of Jordanian ICU nurses to assess the nutritional status of critically ill patients, considering biophysical and biochemical measures.Methods: This cross sectional study recruited nurses from different health sectors in Jordan. ICU nurses from the governmental sector (two hospitals and private sectors (two hospitals were surveyed using a self-administered questionnaire. Nurses' knowledge and responsibility towards nutritional assessment were examined.Results: A total of 220 nurses from both sectors have completed the questionnaire. Nurses were consistent in regard to knowledge, responsibility, and documentation of nutritional assessment. Nurses in the governmental hospitals inappropriately perceived the application of aspiration reduction measures. However, they scored higher in applying physical examination and anthropometric assessment.  Although both nurses claimed higher use of biochemical measurements, biophysical measurements were less frequently used. Older nurses with longer clinical experience exhibited better adherence to biophysical measurement than younger nurses.Conclusion: Nursing nutritional assessment is still suboptimal to attain nutritional goals. Assessment of body weight, history of nutrition intake, severity of illness, and function of gastrointestinal tract should be considered over measuring albumin and pre-albumin levels.  A well-defined evidence-based protocol as well as a multidisciplinary nutritional team for nutritional assessment is the best to minimize episodes of under-nutrition.

  9. 预见性护理干预在预防ICU呼吸机相关性肺炎中的应用价值%Application Value of Predictive Nursing Intervention in Prevention of ICU Ventilator Associated Pneumonia

    Institute of Scientific and Technical Information of China (English)

    马翠云

    2016-01-01

    Objective To explore the clinical effect of predictive nursing intervention in the prevention of ICU ventilator associated pneumonia. Methods From November 2013 to November 2015, 92 cases of ICU patients were treated, randomly divided into two groups, each of 46 cases. The control group was treated with routine nursing care, observation group were treated with predictive nursing intervention, and the clinical nursing effect of the two groups was compared. Results Observation group nursing satisfaction was higher than the control group, the difference was signiifcant (P<0.05), the incidence of ventilator associated pneumonia in observation group was lower than that of control group (P<0.05). Conclusion Predictive nursing intervention in ICU patients can signiifcantly reduce the incidence of ventilator associated pneumonia, improve nursing satisfaction.%目的:探讨预见性护理干预应用于预防ICU呼吸机相关性肺炎的临床效果。方法选取2013年11月~2015年11月收治的ICU患者92例,随机分为两组,各46例。对照组行常规护理,观察组行预见性护理干预,对比两组临床护理效果。结果观察组护理满意度高于对照组,差异有统计学意义(P<0.05);观察组呼吸机相关性肺炎发生率低于对照组,差异有统计学意义(P<0.05)。结论预见性护理干预应用于ICU患者可降低呼吸机相关性肺炎发生率,提高护理满意度。

  10. [Patient profile and nursing workload at the nephrology unit].

    Science.gov (United States)

    Trepichio, Priscilla Branco; Guirardello, Edinêis de Brito; Duran, Erika Christiane Marocco; de Brito, Ana Paula

    2013-06-01

    Chronic kidney failure (CKF), which is frequently silent, can lead to considerable changes in the lives of patients. Depending on the stage, hospitalization and hours of nursing care are required to ensure medical and surgical treatment. The aim of this descriptive and quantitative study is to measure nursing workload at a nephrology unit based on daily application of the Nursing Activities Score (NAS) for 47 consecutive days. Patients were mostly young male adults in the chronic stage of the disease or admitted for kidney transplant. A total of 833 observations were obtained from 62 patients. The resulting NAS workload upon admission was 52%, corresponding to 12.5 hours of care per patient for 24 hours, which is similar to the workload found in intensive care units. This profile allows calculation of nursing work hours required for each patient and is a valuable tool for nursing managers when determining the number of staff members required to ensure assistance. Other studies should be conducted for clinical validation.

  11. ICU机械通气患者镇静效果观察与护理%Sedative effect of patients with mechanical ventilation in ICU and nursing care

    Institute of Scientific and Technical Information of China (English)

    叶玲; 赵金花

    2014-01-01

    Objective To explore the sedative effect of propofol, midazolam for ICU patients with mechanical ventilation and the nursing experience.Methods Totals of 120 patients of ICU from June 2012 to December 2012 were randomly selected and divided into experiment group ( n =60 ) and control group ( n=60), experiment group were given propofol injection sedation, control group were given midazolam sedation, using Ramsay sedation score, compared two groups of patients the onset time of drug, recovery time after stopping drug, medicine adverse reaction and vital signs changes.Results In experiment group, the onset time was (23 ±8)s, the recovery time is (22 ±6)min, patients in control group were (48 ±9)s, (58 ±12)mins, and the differences between two groups were statistically significant (t =3.12,5.67,respectively;P<0.05).After sedation, heart rate (74 ±11) times/min, and breath (15 ±3) times/min of experiment group were slower than that of control group, and the difference was statistically significant (P<0.05).Conclusions Propofol sedation effect is good, and can fast acting, while it has a great influencing on the heart rate.%目的:探讨丙泊酚、咪达唑仑应用于机械通气患者镇静的疗效及护理体会。方法随机选择ICU机械通气患者120例,采用随机数字表法分为试验组与对照组,每组60例,试验组给予丙泊酚注射液镇静,对照组给予咪达唑仑镇静,采用Ramsay镇静评分比较两组患者用药后起效时间及停药后苏醒时间,比较两组用药后不良反应及生命体征变化。结果试验组患者起效时间、苏醒时间分别为(23±8)s,(22±6)min,对照组患者分别为(48±9)s,(58±12)min,两组比较差异有统计学意义(t值分别为3.12,5.67;P<0.05)。试验组患者镇静后心率(74±11)次/min,呼吸(15±3)次/min,较对照组出现减慢现象,差异有统计学意义(t值分别为-5.28,-4.17;P<0

  12. Knowledge and fulfillment of biosecurity standards in nurse personal. Almanzor Aguinaga National Hospital. Chiclayo 2002

    OpenAIRE

    SOTO, VÍCTOR; Oficina Epidemiología y Programas Hospital Nacional Almanzor Aguinaga; OLANO, ENRIQUE; Centro de Prevención de Riesgos del Trabajo

    2013-01-01

    Objectives: To determine knowledge and fulfilment of biosecurity standards in nurses and nurse technicians who work in high risk areas. Material and Methods: Transversal, prospective and descriptive study. Population included nurses and nurse technicians who work at Emergency, Intensive Care Unit (ICU), Intermediate Care Unit (UCEMIN), General Surgery, Surgical Center, Neonatology and Hemodialysis services at Chiclayo Almanzor Aguinaga National Hospital, EsSalud. The sample included 117 worke...

  13. Contingency nursing care management for ICU wards in case of power failure%我院ICU病房停电应急护理管理的实践

    Institute of Scientific and Technical Information of China (English)

    陈巧玲; 柳芳登; 王建红; 杜肖红; 林秀霞

    2012-01-01

    介绍了我院应对重症加强护理病房(ICU)停电应急护理管理的实践.我院的SICU病房制定了《SICU标准化停电应急预案》,预案中将停电事件突发时当班护理人员,根据其当前的岗位及资质分为A、B、C3种角色,分别赋予负责患者安全、负责协调指挥、负责医疗辅助的应急职责,并建立相应职能的应急行为流程.通过培训和考核,使医护人员熟练掌握应急预案的流程,明确自己的职责.经过4次实践,应急预案的实施降低了风险事件的发生率,提高了满意度.预案管理使ICU护理人员在停电事件中能快速有效地应对危机事件,规避ICU护理风险.%The paper described the practice of contingency nursing management for ICU wards in case of power breakdown in the hospital The SICU wards have developed their power failure contingency plan in which the nurses on duty are divided into Group A,B and C according to their positions and qualifications.Respectively,they take charge of patient safety,coordination and command,and medical aid.We also established the procedure of emergency response for these duties.Training and examination familiarize the medical personnel with the procedure and their duties.Four practices proved that the implementation of the plan reduces risks exposure and improves the satisfaction.With the contingency plan,the nurses in ICU can now take care of critical incidents and avoid nursing risks in ICU efficiently.

  14. Qualitative research on student's expectation about curriculum design of ICU clinical nurse specialist training program%ICU临床护理专家培训项目课程设置的质性研究

    Institute of Scientific and Technical Information of China (English)

    钟亚萍; 卢惠娟; 夏海鸥; 蒋红

    2011-01-01

    目的 了解拟参加ICU临床护理专家培养项目的学员对该项目课程设置的期望,为合理地设置课程提供依据.方法 根据课程设置的理论和原则、相关文献及ICU护理实践状况,形成课程设置访谈框架,对拟参加ICU临床护理专家培训项目的12名ICU护士进行焦点团体访谈.结果 培养ICU临床护理专家有必要性和可行性;培养内容应包括临床护理、教育、科研、管理领导和咨询等多方面内容,并体现护理最新理念;教学方法应根据成人学习的特点采用案例讲授法、研讨法、情景模拟教学和自学等多种方法;评价方式以综合评价为主.结论 ICU临床护理专家培养应全面加强基础理论,强调发展学员的综合能力,培养高层次的护理人才.%Objective To identify the training needs of students who will attend the ICU CNS training program, and to provide scientific basis for course design. Methods An outline of interview was carefully worked out based on theories and principles of curriculum development, literature, and current practices of ICU nursing. Twelve students participated in this qualitative study. Focus group interview was used to develop insights into students' perceptions. Results Students believed that the training of ICU CNS is essential and feasible. Training contents should include direct nursing care, education, research, management and consultation, and should reflect the recent development of nursing. According to the characteristic of adult learning, several teaching methods could be used, such as lecture, seminar, situational simulation and self-study. Comprehensive evaluation should be used. Conclusion ICU CNS training program should target itself to help students strengthen basic theoretical knowledge and enhance comprehensive ability, in an effort to cultivate high-level nursing talents.

  15. Interprofessional collaboration in the ICU: how to define?

    Science.gov (United States)

    Rose, Louise

    2011-01-01

    The intensive care unit (ICU) is a dynamic, complex and, at times, highly stressful work environment that involves ongoing exposure to the complexities of interprofessional team functioning. Failures of communication, considered examples of poor collaboration among health care professionals, are the leading cause of inadvertent harm across all health care settings. Evidence suggests effective interprofessional collaboration results in improved outcomes for critically ill patients. One recent study demonstrated a link between low standardized mortality ratios and self-identified levels of collaboration. The aim of this paper is to discuss determinants and complexities of interprofessional collaboration, the evidence supporting its impact on outcomes in the ICU, and interventions designed to foster better interprofessional team functioning. Elements of effective interprofessional collaboration include shared goals and partnerships including explicit, complementary and interdependent roles; mutual respect; and power sharing. In the ICU setting, teams continually alter due to large staff numbers, shift work and staff rotations through the institution. Therefore, the ideal 'unified' team working together to provide better care and improve patient outcomes may be difficult to sustain. Power sharing is one of the most complex aspects of interprofessional collaboration. Ownership of specialized knowledge, technical skills, clinical territory, or even the patient, may produce interprofessional conflict when ownership is not acknowledged. Collaboration by definition implies interdependency as opposed to autonomy. Yet, much nursing literature focuses on achievement of autonomy in clinical decision-making, cited to improve job satisfaction, retention and patient outcomes. Autonomy of health care professionals may be an inappropriate goal when striving to foster interprofessional collaboration. Tools such as checklists, guidelines and protocols are advocated, by some, as ways

  16. Human Bite of a Staff Nurse on a Psychiatric Unit.

    Science.gov (United States)

    Suguna, Anbazhagan; Joseph, Bobby

    2016-04-01

    Occupational violence among health care professionals is a cause for concern, although often neglected especially in developing countries like India. Violence undermines the healing mission of the health care organization and interferes with the ability of the health care team to optimally contribute to positive patient outcomes. The authors discuss a case of a human bite of a staff nurse on a psychiatric unit in a tertiary care Indian hospital. The reported violence against this staff nurse lead to her admission for emergency care followed by emotional stress. Issues related to prevention of occupational violence are also discussed. © 2015 The Author(s).

  17. Nursing management and organizational ethics in the intensive care unit.

    Science.gov (United States)

    Wlody, Ginger Schafer

    2007-02-01

    This article describes organizational ethics issues involved in nursing management of an intensive care unit. The intensive care team and medical center management have the dual responsibility to create an ethical environment in which to provide optimum patient care. Addressing organizational ethics is key to creating that ethical environment in the intensive care unit. During the past 15-20 yrs, increasing costs in health care, competitive markets, the effect of high technology, and global business changes have set the stage for business and healthcare organizational conflicts that affect the ethical environment. Studies show that critical care nurses experience moral distress and are affected by the ethical climate of both the intensive care unit and the larger organization. Thus, nursing moral distress may result in problems related to recruitment and retention of staff. Other issues with organizational ethics ramifications that may occur in the intensive care unit include patient safety issues (including those related to disruptive behavior), intensive care unit leadership style, research ethics, allocation of resources, triage, and other economic issues. Current organizational ethics conflicts are discussed, a professional practice model is described, and multidisciplinary recommendations are put forth.

  18. Job Satisfaction and Burnout among Intensive Care Unit Nurses and Physicians

    Directory of Open Access Journals (Sweden)

    Hilde Myhren

    2013-01-01

    Full Text Available Introduction. Nurses and physicians working in the intensive care unit (ICU may be exposed to considerable job stress. The study aim was to assess the level of and the relationship between (1 job satisfaction, (2 job stress, and (3 burnout symptoms. Methods. A cross-sectional study was performed at ICUs at Oslo University Hospital. 145 of 196 (74% staff members (16 physicians and 129 nurses answered the questionnaire. The following tools were used: job satisfaction scale (scores 10–70, modified Cooper's job stress questionnaire (scores 1–5, and Maslach burnout inventory (scores 1–5; high score in the dimension emotional exhaustion (EE indicates burnout. Personality was measured with the basic character inventory. Dimensions were neuroticism (vulnerability, extroversion (intensity, and control/compulsiveness with the range 0–9. Results. Mean job satisfaction among nurses was 43.9 (42.4–45.4 versus 51.1 (45.3–56.9 among physicians, P<0.05. The mean burnout value (EE was 2.3 (95% CI 2.2–2.4, and mean job stress was 2.6 (2.5–2.7, not significantly different between nurses and physicians. Females scored higher than males on vulnerability, 3.3 (2.9–3.7 versus 2.0 (1.1–2.9 (P<0.05, and experienced staff were less vulnerable, 2.7 (2.2–3.2, than inexperienced staff, 3.6 (3.0–4.2 (P<0.05. Burnout (EE correlated with job satisfaction (r=-0.4, P<0.001, job stress (r=0.6, P<0.001, and vulnerability (r=0.3, P=0.003. Conclusions. The nurses were significantly less satisfied with their jobs compared to the physicians. Burnout mean scores are relatively low, but high burnout scores are correlated with vulnerable personality, low job satisfaction, and high degree of job stress.

  19. Influence of setting carnations service post on nurse patient relationship in ICU%重症监护病房设置康乃馨服务岗对护患关系的影响

    Institute of Scientific and Technical Information of China (English)

    刘晓霞; 朱英; 王晓玲

    2014-01-01

    [目的]设立康乃馨服务岗,改善重症监护病房护患关系,提高护理质量。[方法]于2012年11月开始设立康乃馨服务岗,成立康乃馨小组,对重症监护室病人根据访谈提纲进行回访,针对影响护患关系的主要因素进行护理,比较设岗前后4个月的病人满意度及护患纠纷发生情况。[结果]设立康乃馨服务岗后病人满意度为98.33%,护患纠纷发生率0.83%,明显优于设立前(P<0.05)。[结论]重症监护病房设立康乃馨服务岗,可有效改善护患关系。%Obj ective:To establish the carnations service post,improve ICU nurse patient relationship and improve quality of care.Methods:Carna-tions service post was began to set up in November 2012 and carnation group was founded;ICU patients were visited based on interviews outline;nursing care was conducted aiming at main factors influencing nurse pa-tient relationship;patients’satisfaction and the occurrence of nursing dis-putes were compared in four months before and after setting post.Results:After the establishment of carnations service post,patients'satisfaction was 98.33%,and incidence of nursing disputes was 0.83%,which was signifi-cantly better than that before the establishment(P<0.05).Conclusion:Setting up carnations service post in ICU can effectively improve the nurse patient relationship.

  20. The effect of prospective nursing on the bad mood and sleep quality of ICU patients%前瞻性护理对ICU清醒患者不良情绪及睡眠质量的影响

    Institute of Scientific and Technical Information of China (English)

    杭永青

    2015-01-01

    Objective to analyze the effect of prospective nursing care on the bad mood and sleep quality of patients with ICU. Methods from January 2014 to May 2015, 80 patients with ICU were randomly divided into control group and observation group. The control group was treated with routine nursing. The observation group was treated with routine nursing care. The effect of clinical nursing was compared between two groups. Results in the observation group, the patients with bad mood and sleep quality score were lower than those in the control group, the nursing satisfaction in the observation group was significantly higher than that in the control group, and the difference between the two groups was significant (P<0.05). Conclusion the application of ICU in awake patients can significantly reduce the patients' bad mood, improve the sleep quality of patients, improve nursing satisfaction, it is worthy of popularization and application.%目的:分析前瞻性护理对ICU清醒患者不良情绪及睡眠质量的影响。方法选择2014年1月至2015年5月我院收治的80例ICU清醒患者作为研究对象,随机把80例患者分成对照组与观察组,对照组实施常规护理,观察组在常规护理基础上应用前瞻性护理,比较两组患者临床护理效果。结果观察组患者不良情绪及睡眠质量评分均比对照组低,观察组护理满意度明显高于对照组,两组对比差异显著(P<0.05)。结论 ICU清醒患者应用前瞻性护理可以明显减轻患者不良情绪,改善患者睡眠质量,提高护理满意度,值得推广应用。

  1. Comparison of traditional hand wash with alcoholic hand rub in ICU setup

    Directory of Open Access Journals (Sweden)

    Maliekal Mona

    2005-01-01

    Full Text Available Background: Nosocomial infection rate are often higher for intensive care unit (ICU than other units of hospitals, and hands of health-care workers (HCWs play a major role in the transmission of the infections. Aim: To compare the efficacy of conventional hand wash with the hand rub in reducing the transient bacterial flora on the hands of nurses in ICU. Subject and Methods: The 34 nurses posted in our ICU during January-March 2003 were included. A total of 204 samples were collected for the residual bacterial flora on fingers using impression method on MacConkey agar plates. The subjects then used alcoholic hand rub or conventional hand wash and the residual bacterial flora rechecked by testing impression of fingers on MacConkey agar. Results: Escherichia coli, Klebsiella spp., nonlactose fermenting Gram-negative bacilli, staphylococci, and streptococci formed the transient bacterial flora on the hands. Moderate to heavy bacterial density was seen in more than 92.2% of the hands before washing or hand rub application. Conventional hand wash resulted in drastic reduction in the transient bacterial flora on hands in 50% cases whereas alcoholic hand rub achieved the effect in 95% of the samples. Conclusion: Compared with conventional hand wash, alcoholic hand rub is far more efficient in reducing transient bacterial flora on the hands of HCWs and it is more convenient and time saving. It is recommended as a hand hygiene practice in critical areas such as ICU.

  2. Developing a Mobility Protocol for Early Mobilization of Patients in a Surgical/Trauma ICU

    Directory of Open Access Journals (Sweden)

    Meg Zomorodi

    2012-01-01

    Full Text Available As technology and medications have improved and increased, survival rates are also increasing in intensive care units (ICUs, so it is now important to focus on improving the patient outcomes and recovery. To do this, ICU patients need to be assessed and started on an early mobility program, if stable. While the early mobilization of the ICU patients is not without risk, the current literature has demonstrated that patients can be safely and feasibly mobilized, even while requiring mechanical ventilation. These patients are at a high risk for muscle deconditioning due to limited mobility from numerous monitoring equipment and multiple medical conditions. Frequently, a critically ill patient only receives movement from nurses; such as, being turned side to side, pulled up in bed, or transferred from bed to a stretcher for a test. The implementation of an early mobility protocol that can be used by critical care nurses is important for positive patient outcomes minimizing the functional decline due to an ICU stay. This paper describes a pilot study to evaluate an early mobilization protocol to test the safety and feasibility for mechanically ventilated patients in a surgical trauma ICU in conjunction with the current unit standards.

  3. Effect of ICU nurses'preoperative visit on treatment compliance of patients after radical surgery of esophageal carcinoma%ICU 护士术前访视对食管癌根治术后患者遵医行为的影响

    Institute of Scientific and Technical Information of China (English)

    窦露群; 王君; 李梦群

    2015-01-01

    目的:探讨 ICU 护士术前访视对食管癌根治术患者术后遵医行为的影响。方法:选取2014年4月至2014年12月42例拟行食管癌根治术患者入对照组,2015年1月至2015年6月42例拟行食管癌根治术患者入观察组。对照组给予常规的病房和手术室术前宣教,观察组在对照组基础上给予 Icu 术前访视,比较两组患者术后遵医行为。结果:两组患者要求提前经口进食,要求家属陪同,不能有效咳嗽,躁动,吐管和非计划性拔管发生率的差异性具统计学意义(P <0.05),观察组术后遵医行为优于对照组。结论:ICU 护士实施术前访视能有效提高食管癌根治术患者术后遵医行为。%Objective:To evaluate the effect of ICU nurses'preoperative visit on treatment compliance of patients after radical surgery of esophageal carcino-ma.Methods:A total of 42 patients before Radical surgery of esophageal carcinoma from April 201 4 to December 201 4 were recruited as the contrasting group.And 42 patients before Radical surgery of esophageal carcinoma from January 201 5 to June 201 5 were recruited as the observation group.The contrasting group were given the preoperative care by general ward and preoperative visit by operating -room ,On the basis of the contrasting group,ICU nurses visited the obser-vation group before surgery.To compare the compliance between the two group patients after radical surgery of esophageal carcinoma.Results:The incidences of early oral feeding request,request accompanied by family members,ineffective cough,restlessness,behavior of spite endotracheal tube,unplanned extubation in the observation group were significantly lower than those of the contrasting group (P <0.05).Patients in the observation group had better compliance than the contrasting group after radical surgery of esophageal carcinoma.Conclusion:ICU nurses'preoperative visit can Effectively improve the compliance of patients after Radical

  4. Nurse managers' strategies for the integration of newly graduated nurses into clinical units in Japan: a qualitative exploratory study.

    Science.gov (United States)

    Gregg, Misuzu F; Wakisaka, Toyomi; Hayashi, Chifuyu

    2013-01-01

    The purpose of this study was to explore the strategies used by nurse managers in Japan to facilitate the integration of newly graduate nurses (NGNs) into their clinical units. The integration of NGNs into clinical units is an important issue for both NGNs and nurse managers because the first year of practice plays a vital role in a NGN's career. Data were generated through semi-structured interviews with 9 nurse managers in 9 acute care hospitals. Data analysis was conducted using a qualitative content analysis method. Nurse managers used a total of 6 strategies: understanding the circumstances of NGNs, providing opportunities for experience and learning, supporting nurses who teach NGNs, facilitating self-learning, promoting awareness of being a nurse in the clinical unit, and strengthening the sense of comradeship in clinical units. Three of these strategies were particularly important for NGNs' integration into clinical units: facilitating self-learning, promoting awareness of being a nurse in the clinical unit, and strengthening the sense of comradeship in clinical units. These strategies were described in this study. The strategies adopted by nurse managers should be aimed at all nurses, not just NGNs, in order to strengthen the sense of comradeship in clinical units. This approach would create a supportive environment for the integration of NGNs into clinical units. The strategies presented in this study can be utilized not just by nurse managers but all senior nurses in the unit. NGNs can use these strategies to help them understand what they need to do to become a full member of their unit.

  5. Factors influencing nursing care in a surgical intensive care unit

    Directory of Open Access Journals (Sweden)

    Raj John

    2006-01-01

    Full Text Available Context: The total time spent in nursing care depends on the type of patient and the patient′s condition. We analysed factors that influenced the time spent in nursing a patient. Aims : To analyse the factors in a patient′s condition that influenced time spent in nursing a patient. Materials and Methods: This study was performed in the Surgical Intensive Care Unit of a tertiary referral centre, over a period of one month. The total time spent on a patient in nursing care for the first 24 hours of admission, was recorded. This time was divided into time for routine nursing care, time for interventions, time for monitoring and time for administering medications. Statistical analysis used: A backward stepwise linear regression analysis using the age, sex, diagnosis, type of admission and ventilatory status as variables, was done. Results: Patients admitted after elective surgery required less time (852.4 ± 234.1 minutes, than those admitted after either emergency surgery (1069.5 ± 187.3 minutes, or directly from the ward or the emergency room (1253.7 ± 42.1 minutes. Patients who were ventilated required more time (1111.5 ± 132.5 minutes, than those brought on a T-piece (732.2 ± 134.8 minutes or extubated (639.5 ± 155.6 minutes. The regression analysis showed that only the type of admission and the ventilatory status significantly affected the time. Conclusions : This study showed that the type of admission and ventilatory status significantly influenced the time spent in nursing care. This will help optimal utilization of nursing resources.

  6. Correlation between Structure Empowerment and Patient Safety Culture in ICU Nurses%ICU护士结构性授权与病人安全文化的相关性分析

    Institute of Scientific and Technical Information of China (English)

    刘文婷; 尹安春; 张秀杰; 张婷婷; 原曼

    2016-01-01

    目的:了解ICU护士结构性授权和病人安全文化的现状,并分析两者之间的相关性。方法采用工作授能条件量表和病人安全文化调查问卷,对大连市5家三级甲等综合医院360名 ICU护士进行调查。采用 Pearson相关性检验进行数据分析。结果 ICU护士结构性授权总分(18.33±3.04)分,得分最高维度是非正式授权(3.37±0.66)分,得分最低维度是信息授权(2.71±0.83)分。ICU护士对病人安全文化的同意率为68.9%,得分为(45.66±7.69)分。 ICU护士结构性授权总分与病人安全文化总分呈正相关(r=0.526,P=0.000)。结论 ICU护士结构性授权和病人安全文化水平处中等,尚待改进,护理管理者应予以重视,并采取针对性措施提高ICU护士的结构性授权,提升其病人安全文化水平,从而改善危重症病人护理服务质量。%Objective To understand the status and the correlation between structure empowerment and patient safety culture in ICU nurses. Methods Hospital Survey on Patient Safety Culture instrument (HSOPSC) and Condition of Work Effectiveness Questionnaire (CWEQ-II) were used to survey 360 ICU nurses in five third-level first-class hospitals in Dalian. Results The total score of structure empowerment was 18.33±3.04, and the highest score was from the dimension of informal empowerment of 3.37±0.66, and lowest score from information empowerment of 2.71±0.83. The mean rate of positive response on patient safety culture dimensions in ICU nurses was 68.9%, with the total score of 45.66±7.69. There was a positive correlation between structure empowerment and patient safety culture(r=0.526, P=0.000). Conclusion Structure empowerment and patient safety culture of ICU nurses still need to be improved. Nursing managers should take effective measures to promote ICU nurses ’ level of structure empowerment and patient safety culture, then improve the quality of intensive care.

  7. Leadership development: an essential ingredient in supporting nursing unit managers

    Directory of Open Access Journals (Sweden)

    Wilson V

    2013-12-01

    Full Text Available Valerie Wilson,1,2 Sheree Paterson,3 Kelly Kornman1 1Nursing Research and Practice Development Unit, The Children’s Hospital at Westmead, Westmead, NSW, Australia; 2Faculty of Nursing Midwifery Health, The University of Technology, Sydney, Broadway, NSW, Australia; 3Formerly of the Nursing Research and Practice Development Unit, The Children’s Hospital at Westmead, Westmead, NSW, Australia Purpose: The aim of the leadership development program was to enhance participants’ understanding of person-centered leadership in the context of their nursing unit manager (NUM roles. Materials and methods: This article details the results of the NUM leadership development program (LDP. Twenty-one NUMs from an Australian pediatric hospital participated in the 8-month program. The evaluation encompassed a group claims/concerns/issues session, one-on-one interviews, and written feedback. Data were themed using a four-step sequential process. Results: The NUM LDP had a positive impact on the leadership practices of the participants. Six key themes were identified from the evaluation: “forming the group”; “being in the group”; “translating into practice”; “how we see ourselves; how do we want to be seen?”; “positive outcomes for me”; and “positive outcomes for others”. Conclusion: This study showed improvements in the leadership understanding and practice of NUMs who participated in the program. Further research, particularly into the transferability of skills and active participatory aspects of these types of evaluation studies, is required. Keywords: nurse, evaluation, person-centered care, experiential learning

  8. S. aureus colonization at ICU admission as a risk factor for developing S. aureus ICU pneumonia

    NARCIS (Netherlands)

    Paling, Fleur P; Wolkewitz, Martin; Bode, Lonneke G M; Klein Klouwenberg, Peter M C; Ong, David S Y; Depuydt, Pieter; de Bus, Liesbet; Sifakis, Frangiscos; Bonten, Marc J M; Kluijtmans, Jan

    OBJECTIVE: To quantify the incidence of intensive care unit (ICU) acquired pneumonia caused by Staphylococcus aureus (S. aureus) and its association with S. aureus colonization at ICU admission. METHODS: This was a post-hoc analysis of two cohort studies in critically ill patients. The primary

  9. 泉州市12所医院ICU护士工作倦怠现状调查及影响因素分析%Job Burnout and Its Influencing Factors among ICU Nurses in 12 Hospitals of Quanzhou

    Institute of Scientific and Technical Information of China (English)

    陈丽羚; 赵惠芬; 蔡珊红; 庄丽玲; 陈丽娜; 蔡丽吟; 李春燕

    2012-01-01

    目的 探讨ICU护士工作倦怠的现状及其影响因素.方法 使用Maslach工作倦怠量表对泉州市12所医院168名ICU护士进行调查.结果 ICU护士工作倦怠得分为(54.31±15.28)分,情绪衰竭维度(18.70±10.91)分,低个人成就感(29.07±10.41)分,去人格化(6.55±5.45)分;ICU护士的一般资料均未进入情绪衰竭影响因素的回归方程(P>0.05),月夜班次数是低个人成就感的影响因素,聘用方式、年龄、月夜班次数是去人格化的影响因素(P<0.05).结论 本组ICU护士情绪衰竭维度倦怠程度较低,低个人成就感维度倦怠程度最高,月夜班次数多的年轻护士、在编护士是工作倦怠的主体,应重视对这部分人群的干预,提高工作满意度.%Objective To explore the level of job burnout and its influencing factors among ICU nurses. Methods Totally 168 ICU nurses in 12 hospitals of Quanzhou were surveyed with Maslach Burnout Inventory (MBI). Results The scores of ICU nurses' job burnout, emotion exhaustion, low personal achievement and depersonalization were (54.31 ±15.28), (18.70±10.91), (29.07±10.41), and (6.55±5.45) respectively. The number of night shifts was the influencing factor of low personal achievement while employment style, age, the number of night shifts were the influencing factors of depersonalization. Conclusion Young nurses with more night shifts and enrolled nurses were the major part of job burnout. Intervention should be taken to improve their job satisfaction.

  10. 品管圈用于ICU提升基础护理合格率的效果观察%The application of quality control cycle to enhance the qualiifcation rate for basic nursing in ICU

    Institute of Scientific and Technical Information of China (English)

    彭宇

    2016-01-01

    Objective: To explorer the effect of quality control cycle to enhance the qualiifcation rate for basic nursing in ICU. Methods: 12 nurses in our hospital, who were selected from May 2014 to May 2016, were selected as the object. Scores of theoretical knowledge and professional skills of nurses and the qualiifcation rate for basic nursing were observed and compared before and after the implement of QCC. Results: After the implement of QCC, scores of theoretical knowledge and professional skills of nurses were higher than before, and the qualiifcation rate for basic nursing was also better .There were statistical signiifcant differences (P<0.05). Conclusion: The implement of QCC in ICU could effectively enhance the level of theoretical knowledge and professional skills of nurses, improve the basic nursing quality of our hospital, which would be worthy of promotion in other clinical departments.%目的:探讨品管圈在ICU基础护理中的应用效果。方法:选择2014年5月~2016年5月我院12名ICU护士作为研究对象,对比实施品管圈活动前后护士理论知识和技能得分情况及基础合格率情况。结果:实施品管圈活动后,观察组护士的理论知识与技能评分明显高于对照组,而基础合格率也明显高于对照组,两组比较,差异均具有统计学意义(P<0.05)。结论:品管圈活动的实施有利于提高护士的实际操作技能和理论知识水平,提升基础护理服务质量,值得临床科室借鉴使用。

  11. Perception of nurses regarding risk classification in emergency care units

    Directory of Open Access Journals (Sweden)

    Carmen Lúcia Mottin Duro

    2014-09-01

    Full Text Available This study aimed to assess nurses’ perception regarding the risk classification in emergency care units. It is a descriptive study that used a qualitative approach and that was conducted with 55 nurses from emergency care units in the south of Brazil. Data were collected between July and October, 2011, through open questions, answered in writing. The data collected were submitted to the thematic analysis technique. Results indicate that the risk classification contributes to the organization of the service flow provided to patients, intervening in severe cases and preventing sequelae. Difficulties were described, such as: inadequate physical installations, overcrowding, disagreement in the definition of priorities among doctors and nurses and lack of articulation between the emergency care network and basic health care. It is highlighted the need to improve the physical structure, the quantity of human resources and the implementation of public policies to overcome these challenges.

  12. Thinking inside the box: the tele-intensive care unit as a new clinical site.

    Science.gov (United States)

    Sepples, Susan B; Goran, Susan F; Zimmer-Rankin, Melinda

    2013-07-01

    The tele-intensive care unit (ICU) offers students an opportunity to observe the decision-making process of nurses working in consultative teams in a high-acuity environment, providing a unique opportunity for novices to "see" into the thinking and the communication of expert nurses. Students are often overwhelmed by the physical environment of an ICU--specifically, its noise, technology, and pace--and often are relegated to the sidelines when a patient becomes unstable. Clinical education in the tele-ICU allows students to participate safely in the care of complex, unstable patients. Nurse educators, as experienced tele-ICU nurses, can help students to process complex information and can model intradisciplinary and interdisciplinary communication about patient concerns. The experience moves the students from engagement in tasks and a linear process of thinking to engagement in decision making and a more complex understanding of the nurse's role in patient care. Copyright 2013, SLACK Incorporated.

  13. Influence of ICU-bed availability on ICU admission decisions.

    Science.gov (United States)

    Robert, René; Coudroy, Rémi; Ragot, Stéphanie; Lesieur, Olivier; Runge, Isabelle; Souday, Vincent; Desachy, Arnaud; Gouello, Jean-Paul; Hira, Michel; Hamrouni, Mouldi; Reignier, Jean

    2015-12-01

    The potential influence of bed availability on triage to intensive care unit (ICU) admission is among the factors that may influence the ideal ratio of ICU beds to population: thus, high bed availability (HBA) may result in the admission of patients too well or too sick to benefit, whereas bed scarcity may result in refusal of patients likely to benefit from ICU admission. Characteristics and outcomes of patient admitted in four ICUs with usual HBA, defined by admission refusal rate less than 11 % because of bed unavailability, were compared to patients admitted in six ICUs with usual low bed availability (LBA), i.e., an admission refusal rate higher than 10 % during a 90-day period. Over the 90 days, the mean number of days with no bed available was 30 ± 16 in HBA units versus 48 ± 21 in LBA units (p Bed availability affected triage decisions. Units with HBA trend to admit patients too sick or too well to benefit.

  14. 抽吸式牙刷在ICU经口气管插管患者口腔护理中的应用%Application of suction type toothbrush for oral nursing in the ICU breath tube intubation patients

    Institute of Scientific and Technical Information of China (English)

    罗玉珍; 汪海芹; 冼晓兰; 高明珠

    2013-01-01

    目的:探讨抽吸式牙刷结合牙膏在ICU经口气管插管患者口腔护理中效果,以提高ICU经口气管插管患者口腔护理质量.方法:对入住我科120例经口气管插管患者随机分为试验组60例和对照组60例.试验组采用抽吸式牙刷结合牙膏进行口腔护理,对照组采用传统的口腔护理方法.结果:试验组患者口腔护理后口腔炎症、口腔溃疡的发生率低于对照组.结论:使用抽吸式牙刷结合牙膏进行口腔护理能预防口腔感染.%Objective:To investigate suction type toothbrush with toothpaste in ICU patients with the breath tube inserted oral care,in order to improve the effect of ICU patients with a tube inserted oral nursing quality.Methods:120 patients in our department by the breath tube inserted were randomly divided into experimental group and control group with 60 cases in each group,while the study group with suction type toothbrush with toothpaste for oral nursing,control group adopted the traditional (cotton swab) oral nursing methods.Results:The experimental group patients after oral nursing and oral inflammation,oral ulcer incidence rate were lower than the control group.Conclusion:The use of suction toothbrush and toothpaste oral care can prevent oral infection.

  15. Competence of nurses in the intensive cardiac care unit

    OpenAIRE

    Nobahar, Monir

    2016-01-01

    Introduction Competence of nurses is a complex combination of knowledge, function, skills, attitudes, and values. Delivering care for patients in the Intensive Cardiac Care Unit (ICCU) requires nurses’ competences. This study aimed to explain nurses’ competence in the ICCU. Methods This was a qualitative study in which purposive sampling with maximum variation was used. Data were collected through semi-structured interviews with 23 participants during 2012–2013. Interviews were recorded, tran...

  16. Correlation between workplace and occupational burnout syndrome in nurses.

    Science.gov (United States)

    Ahmadi, Omid; Azizkhani, Reza; Basravi, Monem

    2014-01-01

    This study was conducted to determine the effect of nurses' workplace on burnout syndrome among nurses working in Isfahan's Alzahra Hospital as a reference and typical university affiliated hospital, in 2010. In this cross-sectional study, 100 nurses were randomly selected among those working in emergency, orthopedic, dialysis wards and intensive care unit (ICU). Required data on determination of occupational burnout rate among the nurses of these wards were collected using Maslach Burnout Inventory (MBI) standard and validated questionnaire. Nurses were selected using simple random sampling. The multivariate ANOVA analysis showed that occupational burnout mean values of nurses working in orthopedic and dialysis wards were significantly less than those of nurses working in emergency ward and ICU (P = 0.01). There was also no significant difference between occupational burnout mean values of nurses working in emergency ward and ICU (P > 0.05). t-test showed that there was a difference between occupational burnout values of men and women, as these values for women were higher than those of men (P = 0.001). Results showed that occupational burnout mean values of nurses working in emergency ward and ICU were significantly more than those of nurses working in orthopedic and dialysis wards.

  17. Rural nursing unit managers: education and support for the role.

    Science.gov (United States)

    Paliadelis, Penny S

    2005-01-01

    Nursing unit managers (NUMs) occupy the often unenviable position of first-line management in many health services in Australia. As such, their role is complex and multifaceted requiring an intertwining of their clinical and managerial responsibilities. While there is an abundance of studies that explore and describe the various management roles in many professions and industries, little is known about the experiences of nurses as managers, particularly in rural settings. This article focuses on the education and support needs of rural nursing unit managers. A qualitative study design was used to explore the stories of a number of nursing unit managers in rural New South Wales, Australia. Data was collected using semi-structured individual interviews. Data was analysed using a voice-relational method as a framework for more clearly hearing the voices of participants. This method of data analysis is particularly useful for hearing from those who do not usually have a 'strong' voice, for gaining an understanding of the context of the interviews, and for acknowledging the role of the researcher in the research process. All NUMs employed in a single regional health authority in rural Australia were invited to participate. Out of 42 NUMs in the region, 20 agreed to be interviewed. Nursing unit managers were asked to reflect on their experiences prior to and during the early days within the position. In summary, all the NUMs: believed they were promoted because of their clinical expertise; felt unprepared for the managerial and administrative aspects of their role; continued to identify as nurses rather than as managers; found the role isolated them from their former peer group. Those employed in small facilities had limited opportunities for education and peer support. Based on the NUMs' experiences and suggestions, the following information would have helped them to cope with the demands of their new role: information and discussions about the role expectations of

  18. [The process of death in the intensive care unit (ICU). From a medical, thanatological and legislative point of view].

    Science.gov (United States)

    Kaneko-Wada, Francisco de J Takao; Domínguez-Cherit, Guillermo; Colmenares-Vásquez, Ariadna Marcela; Santana-Martínez, Paola; Gutiérrez-Mejía, Juan; Arroliga, Alejandro C

    2015-01-01

    Traditional goals in the intensive care unit are to reduce morbidity and mortality. Despite medical and technological advances, death in the intensive care unit remains commonplace and the modern critical care team should be familiar with palliative care and legislation in Mexico. Preserving the dignity of patients, avoiding harm, and maintaining communication with the relatives is fundamental. There is no unique, universally accepted technical approach in the management of the terminal critical care patient, so it is important to individualize each case and define objectives together under the legal framework in Mexico.

  19. Triage of Patients Consulted for ICU Admission During Times of ICU-Bed Shortage

    Science.gov (United States)

    Orsini, Jose; Blaak, Christa; Yeh, Angela; Fonseca, Xavier; Helm, Tanya; Butala, Ashvin; Morante, Joaquin

    2014-01-01

    Background The demand for specialized medical services such as critical care often exceeds availability, thus rationing of intensive care unit (ICU) beds commonly leads to difficult triage decisions. Many factors can play a role in the decision to admit a patient to the ICU, including severity of illness and the need for specific treatments limited to these units. Although triage decisions would be based solely on patient and institutional level factors, it is likely that intensivists make different decisions when there are fewer ICU beds available. The objective of this study is to evaluate the characteristics of patients referred for ICU admission during times of limited beds availability. Methods A single center, prospective, observational study was conducted among consecutive patients in whom an evaluation for ICU admission was requested during times of ICU overcrowding, which comprised the months of April and May 2014. Results A total of 95 patients were evaluated for possible ICU admission during the study period. Their mean APACHE-II score was 16.8 (median 16, range 3 - 36). Sixty-four patients (67.4%) were accepted to ICU, 18 patients (18.9%) were triaged to SDU, and 13 patients (13.7%) were admitted to hospital wards. ICU had no beds available 24 times (39.3%) during the study period, and in 39 opportunities (63.9%) only one bed was available. Twenty-four patients (25.3%) were evaluated when there were no available beds, and eight of those patients (33%) were admitted to ICU. A total of 17 patients (17.9%) died in the hospital, and 15 (23.4%) expired in ICU. Conclusion ICU beds are a scarce resource for which demand periodically exceeds supply, raising concerns about mechanisms for resource allocation during times of limited beds availability. At our institution, triage decisions were not related to the number of available beds in ICU, age, or gender. A linear correlation was observed between severity of illness, expressed by APACHE-II scores, and the

  20. Investigation on scientific research ability of ICU specialist nurses and its related factors%ICU专科护士科研能力及相关因素调查研究

    Institute of Scientific and Technical Information of China (English)

    高素芳; 贾美君

    2015-01-01

    [目的]描述ICU专科护士科研能力的现状,探讨影响ICU专科护士科研能力的因素。[方法]采用护理人员一般资料问卷、护理人员科研能力自评量表、中国护士工作压力源量表、工作倦怠量表对2013年参加中华护理学会第十一届危重症护士培训班的学员进行调查。[结果]工作压力源与科研能力总分、文献查阅能力、科研设计能力、科研实践能力、资料处理能力呈负相关,工作倦怠、工作无成就感与科研能力呈负相关。[结论]ICU专科护士的科研能力总体处于中、低水平,且影响因素较多。%Objective:To describe the status quo of scientific research ability of ICU specialist nurses,so as to probe into the influencing factors of scientific research ability of them.Methods:Nurse students who participated in the critically ill training class of Chinese Nursing Association eleventh session in 2013 were investigated by u-sing nursing staff general information questionnaire,nursing research capacity of self rating scale,Chinese nurse job stressors work scale and job burnout scale.Results:Sources of work stress were negatively correlated with total score of scientific research ability,literature searching ability,scientific research and design ability,scientif-ic research practice ability and data processing ability.Job burnout and working without a sense of achievement were negatively correlated with scientific research ability.Conclusion:Scientific research ability of ICU specialist nurses is generally in medium and low level and has many influencing factors.

  1. Electronic nursing care reminders: implications for nursing leaders.

    Science.gov (United States)

    Piscotty, Ronald J; Kalisch, Beatrice; Gracey-Thomas, Angel; Yarandi, Hossein

    2015-05-01

    The aim of this study is to report the results of a replication study of the relationship between self-reported nursing care reminder (NCR) use and missed nursing care. A descriptive cross-sectional correlational design was used. The sample (N = 124) was composed of medical/surgical and ICU RNs working on acute care hospital units in a large Midwestern teaching hospital. The MISSCARE Survey, Nursing Care Reminders Usage Survey, and the Impact of Health Care Information Technology Survey were used to collect data. Adjusted hierarchical multiple regression was used to determine study outcomes. Nurses who use NCRs more frequently have decreased reports of missed nursing care. Nurses who perceive the impact of healthcare technology as positive on their practice also have decreased missed nursing care. The results of this study suggest that NCRs are an effective intervention to decrease missed nursing care in acute care hospitals.

  2. ICU病人镇静治疗的护理对策%Nursing strategy of sedative therapy to intensive care units patients

    Institute of Scientific and Technical Information of China (English)

    罗杨; 洪蝶玫; 黄嘉佳

    2009-01-01

    To explore the nursing strategy of sedative therapy to intensive care units (ICU) patients. The clinical nursing of 197 ICU patients treated with midazolam or propofol were retrospectively summarized and analyzed, whose Sedation Scale scores were 1. After the treatment all indexes of 197 patients in respiration and circulation systerm were obviously improved. 197 patients had more compliance to the treatment and without unexpected extubation, endotracheal tube falling off and the comphcations such as bad memory and dyssemnia. The synthesis measures such as closely observing pafient's condition, enhancing clinical monitoring, promptly modulating the doses of sedatives and dealing with drug adverse reaction, carefully completing the whole mental nursing were the key points of ensuring safe sedative treating and less complications to ICU patients.%探讨ICU病人应用镇静治疗的护理对策.对2006年9月至2007年9月197例Ramsay评分标准1分的ICU病人应用咪唑安定或丙泊酚镇静治疗的临床护理行回顾性总结和分析.197例病人应用镇静治疗后呼吸和循环系统各项指标明显改善,病人能更好地配合治疗,无意外拔管和导管脱落,无不良记忆及睡眠障碍等并发症发生.严密观察病情、加强临床监护、及时调整镇静药物的剂量和处理药物不良反应、细致做好全程心理护理等综合措施,是保证ICU病人镇静治疗安全、减少并发症发生的关键.

  3. Orthognathic Surgery Patients (Maxillary Impaction and Setback plus Mandibular Advancement plus Genioplasty) Need More Intensive Care Unit (ICU) Admission after Surgery

    Science.gov (United States)

    Eftekharian, Hamidreza; Zamiri, Barbad; Ahzan, Shamseddin; Talebi, Mohamad; Zarei, Kamal

    2015-01-01

    Statement of the Problem: Due to shortage of ICU beds in hospitals, knowing what kind of orthognathic surgery patients more need ICU care after surgery would be important for surgeons and hospitals to prevent unnecessary ICU bed reservation. Purpose: The aim of the present study was to determine what kinds of orthognathic surgery patients would benefit more from ICU care after surgery. Materials and Method: 210 patients who were admitted to Chamran Hospital, Shiraz, for bimaxillary orthognathic surgery (2008-2013) were reviewed based on whether they had been admitted to ICU or maxillofacial surgery ward. Operation time, sex, intraoperative Estimated Blood Loss (EBL), postoperative complications, ICU admission, and unwanted complications resulting from staying in ICU were assessed. Results: Of 210 patients undergoing bimaxillary orthognathic surgery, 59 patients (28.1%) were postoperatively admitted to the ICU and 151 in the maxillofacial ward (71.9%). There was not statistically significant difference in age and sex between the two groups (p> 0.05). The groups were significantly different in terms of operation time (p< 0.001). Blood loss For ICU admitted patients was 600.00±293.621mL and for those who were hospitalized in the ward was 350.00±298.397 mL. Statistically significant differences were found between the two groups (p< 0.001). Moreover, there was a direct linear correlation between operation time and intraoperative estimated blood loss and this relationship was statistically significant (r=0.42, p< 0.001). Patients with maxillary impaction and setback plus mandibular advancement plus genioplasty were among the most ICU admitted patients (44%), while these patients were only 20% of all patients who were admitted to the ward. As a final point, the result illustrated that patients who were admitted to the ICU experienced more complication such as bleeding, postoperative nausea, and pain (p< 0.001). Conclusion: Orthognathic surgery patients (maxillary

  4. Orthognathic Surgery Patients (Maxillary Impaction and Setback Plus Mandibular Advancement Plus Genioplasty Need More Intensive Care Unit (ICU Admission after Surgery

    Directory of Open Access Journals (Sweden)

    Hamidreza Eftekharian

    2015-03-01

    Full Text Available Statement of the Problem: Due to shortage of ICU beds in hospitals, knowing what kind of orthognathic surgery patients more need ICU care after surgery would be important for surgeons and hospitals to prevent unnecessary ICU bed reservation. Purpose: The aim of the present study was to determine what kinds of orthognathic surgery patients would benefit more from ICU care after surgery. Materials and Method: 210 patients who were admitted to Chamran Hospital, Shiraz, for bimaxillary orthognathic surgery (2008-2013 were reviewed based on whether they had been admitted to ICU or maxillofacial surgery ward. Operation time, sex, intraoperative Estimated Blood Loss (EBL, postoperative complications, ICU admission, and unwanted complications resulting from staying in ICU were assessed. Results: Of 210 patients undergoing bimaxillary orthognathic surgery, 59 patients (28.1% were postoperatively admitted to the ICU and 151 in the maxillofacial ward (71.9%. There was not statistically significant difference in age and sex between the two groups (p> 0.05. The groups were significantly different in terms of operation time (p< 0.001. Blood loss For ICU admitted patients was 600.00±293.621mL and for those who were hospitalized in the ward was 350.00±298.397 mL. Statistically significant differences were found between the two groups (p< 0.001. Moreover, there was a direct linear correlation between operation time and intraoperative estimated blood loss and this relationship was statistically significant (r=0.42, p< 0.001. Patients with maxillary impaction and setback plus mandibular advancement plus genioplasty were among the most ICU admitted patients (44%, while these patients were only 20% of all patients who were admitted to the ward. As a final point, the result illustrated that patients who were admitted to the ICU experienced more complication such as bleeding, postoperative nausea, and pain (p< 0.001. Conclusion: Orthognathic surgery patients

  5. The views of intensive care nurses regarding short-term deployment

    Directory of Open Access Journals (Sweden)

    Mokgadi C. Matlakala

    2015-02-01

    Full Text Available Background: Short-term deployment of nurses is usually used within the hospital units in order to ‘balance the numbers’ or to cover the shortage of staff in the different units. Often nurses in the intensive care unit (ICU are sent to go and assist in other units, where there is not enough nursing staff or when their own unit is not busy.Objectives: The objective of this study was to explore the views of the ICU nurses regarding short-term deployment to other units.Method: A qualitative design was used, following interpretivism. The study was conducted in the ICUs of two hospitals in Gauteng Province, South Africa. Data were collected through focus group interviews with a purposive sample of registered nurses working in the selected ICUs, transcribed verbatim and analysed using open coding.Results: The participants shared a similar view that deployment to other units should be based on a formal agreement, with policies and procedures. Consultation and negotiation are recommended prior to deployment of staff. Management should recognise and acknowledge expertise of ICU nurses in their own speciality area.Conclusion: The findings call for redesign of a deployment policy that will suit nurses from the speciality areas such as ICU.

  6. A recovery program to improve quality of life, sense of coherence and psychological health in ICU survivors: a multicenter randomized controlled trial, the RAPIT study

    DEFF Research Database (Denmark)

    Jensen, Janet F.; Egerod, Ingrid; Bestle, Morten H.

    2016-01-01

    Purpose: The aim of this randomized controlled trial (RCT) was to test the effectiveness of a post-ICU recovery program compared to standard care during the first year after ICU discharge. Methods: A pragmatic, non-blinded, multicenter, parallel-group RCT was conducted between December 2012...... and December 2015, at ten intensive care units (ICUs) in Denmark. We randomly assigned 386 adult patients (≥18 years) after receiving mechanical ventilation (≥48 h) to standard care (SC) plus a nurse-led intensive care recovery program or standard care alone after ICU discharge (190 intervention, 196 SC......). Primary outcome was health-related quality of life (HRQOL) at 12 months. Secondary outcomes were sense of coherence (SOC), anxiety, depression, and posttraumatic stress disorder (PTSD) assessed at 3 and 12 months after ICU discharge including utilization of healthcare services at 12 months. Results: At 12...

  7. A recovery program to improve quality of life, sense of coherence and psychological health in ICU survivors: a multicenter randomized controlled trial, the RAPIT study

    DEFF Research Database (Denmark)

    Jensen, Janet F.; Egerod, Ingrid; Bestle, Morten H.

    2016-01-01

    Purpose: The aim of this randomized controlled trial (RCT) was to test the effectiveness of a post-ICU recovery program compared to standard care during the first year after ICU discharge. Methods: A pragmatic, non-blinded, multicenter, parallel-group RCT was conducted between December 2012...... and December 2015, at ten intensive care units (ICUs) in Denmark. We randomly assigned 386 adult patients (≥18 years) after receiving mechanical ventilation (≥48 h) to standard care (SC) plus a nurse-led intensive care recovery program or standard care alone after ICU discharge (190 intervention, 196 SC......). Primary outcome was health-related quality of life (HRQOL) at 12 months. Secondary outcomes were sense of coherence (SOC), anxiety, depression, and posttraumatic stress disorder (PTSD) assessed at 3 and 12 months after ICU discharge including utilization of healthcare services at 12 months. Results: At 12...

  8. Knowledge Sharing, Control of Care Quality, and Innovation in Intensive Care Nursing

    DEFF Research Database (Denmark)

    Paunova, Minna; Li-Ying, Jason; Egerod, Ingrid Eugenie

    2016-01-01

    This study investigates the influence of nurse knowledge sharing behavior on nurse innovation, given different conditions of control of care quality within the intensive care unit (ICU). After conducting a number of interviews and a pilot study, we carried out a multi-source survey study of more...... than 200 nurses employed in 22 ICUs at 17 Danish hospitals. Overall, we find that knowledge sharing among individual ICU nurses has a positive impact on their innovation. Meanwhile, strong control of care quality makes this positive impact less effective. However, different aspects of knowledge sharing...

  9. Intensive Care Nurses' Belief Systems Regarding the Health Economics: A Focused Ethnography.

    Science.gov (United States)

    Heydari, Abbas; Vafaee-Najar, Ali; Bakhshi, Mahmoud

    2016-09-01

    Health care beliefs can have an effect on the efficiency and effectiveness of nursing practices. Nevertheless, how belief systems impact on the economic performance of intensive care unit (ICU) nurses is not known. This study aimed to explore the ICU nurses' beliefs and their effect on nurse's practices and behavior patterns regarding the health economics. In this study, a focused ethnography method was used. Twenty-four informants from ICU nurses and other professional individuals were purposively selected and interviewed. As well, 400 hours of ethnographic observations were used for data collection. Data analysis was performed using the methods described by Miles and Huberman (1994). Eight beliefs were found that gave meaning to ICU nurse's practices regarding the health economics. 1. The registration of medications and supplies disrupt the nursing care; 2.Monitoring and auditing improve consumption; 3.There is a fear of possible shortage in the future; 4.Supply and replacement of equipment is difficult; 5.Higher prices lead to more accurate consumption; 6.The quality of care precedes the costs; 7. Clinical Guidelines are abundant but useful; and 8.Patient economy has priority over hospital economy. Maintaining the quality of patient care with least attention to hospital costs was the main focus of the beliefs formed up in the ICU regarding the health economics. ICU nurses' belief systems have significantly shaped in relation to providing a high-quality care. Although high quality of care can lead to a rise in the effectiveness of nursing care, cost control perspective should also be considered in planning for improve the quality of care. Therefore, it is necessary to involve the ICU nurses in decision-making about unit cost management. They must become familiar with the principles of heath care economics and productivity by applying an effective cost management program. It may be optimal to implement the reforms in various aspects, such as the hospital

  10. Warning! fire in the ICU.

    Science.gov (United States)

    Rispoli, Fabio; Iannuzzi, Michele; De Robertis, Edoardo; Piazza, Ornella; Servillo, Giuseppe; Tufano, Rosalba

    2014-06-01

    At 5:30 pm on December 17, 2010, shortly after a power failure, smoke filled the Intensive Care Unit (ICU) of Federico II University Hospital in Naples, Italy, triggering the hospital emergency alarm system. Immediately, staff began emergency procedures and alerted rescue teams. All patients were transferred without harm. The smoke caused pharyngeal and conjunctival irritation in some staff members. After a brief investigation, firefighters discovered the cause of the fire was a failure of the Uninterruptible Power Supply (UPS).

  11. Neonatal Intensive Care Unit Nurses Working in an Open Ward: Stress and Work Satisfaction.

    Science.gov (United States)

    Lavoie-Tremblay, Mélanie; Feeley, Nancy; Lavigne, Geneviève L; Genest, Christine; Robins, Stéphanie; Fréchette, Julie

    2016-01-01

    There is some research on the impact of open-ward unit design on the health of babies and the stress experienced by parents and nurses in neonatal intensive care units. However, few studies have explored the factors associated with nurse stress and work satisfaction among nurses practicing in open-ward neonatal intensive care units. The purpose of this study was to examine what factors are associated with nurse stress and work satisfaction among nurses practicing in an open-ward neonatal intensive care unit. A cross-sectional correlational design was used in this study. Participants were nurses employed in a 34-bed open-ward neonatal intensive care unit in a major university-affiliated hospital in Montréal, Quebec, Canada. A total of 94 nurses were eligible, and 86 completed questionnaires (91% response rate). Descriptive statistics were computed to describe the participants' characteristics. To identify factors associated with nurse stress and work satisfaction, correlational analysis and multiple regression analyses were performed with the Nurse Stress Scale and the Global Work Satisfaction scores as the dependent variables. Different factors predict neonatal intensive care unit nurses' stress and job satisfaction, including support, family-centered care, performance obstacles, work schedule, education, and employment status. In order to provide neonatal intensive care units nurses with a supportive environment, managers can provide direct social support to nurses and influence the culture around teamwork.

  12. Risk evaluation and nursing intervention of deep venous thrombosis in ICU patients%ICU患者发生深静脉血栓的风险评估及护理干预

    Institute of Scientific and Technical Information of China (English)

    王彬; 唐晟

    2011-01-01

    目的 对ICU患者实行深静脉血栓形成(DVT)风险评估,探讨预防护理干预的效果.方法 将383例ICU住院患者随机分为两组,对照组147例采用ICU病房常规护理,实验组236例进行DVT风险评估,并给予相应的护理干预措施.观察两组患者发生DVT的情况.结果 对照组DVT发生21例(14.29%),实验组DVT发生9例(3.81%),两组比较差异有统计学意义(x2=13.75,P<0.01).结论 对ICU患者采取DVT风险评估后给予预防护理措施可以显著降低其发生率.%Objective To investigate the effect of risk evaluation of deep venous thrombosis (DVT)and nursing interventions on ICU patients.Methods 383 cases ICU patients were divided into two groups.The control group (147 cases) was treated with conventional measures.The experimental group (236 cases) was treated with risk evaluation of DVT and nursing interventions.Incidence rates of DVT of the two groups were observed.Results There were 9 cases (incidence rate of DVT was 3.81% ) of DVT in the experimental group and 21 cases ( incidence rate of DVT was 14.29% ) of DVT in the control group.The difference was statistically significant (x2 =13.75,P < 0.01 ).Conclusions Risk evaluation of DVT and nursing interventions could effectively decrease the incidence rate of DVT.

  13. Patient safety culture: the nursing unit leader's role.

    Science.gov (United States)

    Sammer, Christine Elizabeth; James, Barbara R

    2011-09-30

    Discussions about a culture of patient safety abound, yet nurse leaders continue to struggle to achieve such a culture in today's complex and fast-paced healthcare environment. In this article the authors discuss the concept of a patient safety culture, present a fictional scenario describing what happened in a hospital that lacked a culture of patient safety, and explain what should have happened in the above scenario. This discussion is offered within a framework consisting of seven driving factors of patient safety. These factors include leadership, evidence-based practice, teamwork, communication, and a learning, just, and patient-centered culture. Throughout, an emphasis is placed on leadership at the unit level. Nurse managers will find practical examples illustrating how leaders can help their teams establish a culture that offers the patient quality care in a safe environment.

  14. Correlation between workplace and occupational burnout syndrome in nurses

    Directory of Open Access Journals (Sweden)

    Omid Ahmadi

    2014-01-01

    Full Text Available Background: This study was conducted to determine the effect of nurses′ workplace on burnout syndrome among nurses working in Isfahan′s Alzahra Hospital as a reference and typical university affiliated hospital, in 2010. Materials and Methods: In this cross-sectional study, 100 nurses were randomly selected among those working in emergency, orthopedic, dialysis wards and intensive care unit (ICU. Required data on determination of occupational burnout rate among the nurses of these wards were collected using Maslach Burnout Inventory (MBI standard and validated questionnaire. Nurses were selected using simple random sampling. Results: The multivariate ANOVA analysis showed that occupational burnout mean values of nurses working in orthopedic and dialysis wards were significantly less than those of nurses working in emergency ward and ICU (P0 = 0.01. There was also no significant difference between occupational burnout mean values of nurses working in emergency ward and ICU ( P > 0.05. t-test showed that there was a difference between occupational burnout values of men and women, as these values for women were higher than those of men (P = 0.001. Conclusion: Results showed that occupational burnout mean values of nurses working in emergency ward and ICU were significantly more than those of nurses working in orthopedic and dialysis wards.

  15. The effect of critical thinking in nursing teaching effect of ICU%评判性思维在ICU护生带教中的应用效果观察

    Institute of Scientific and Technical Information of China (English)

    张宗雪; 冯珊珊; 林晓君; 陈文婷; 龙莎妮

    2014-01-01

    目的:观察评判性思维在ICU护理带教中的效果。方法将80名护生随机分为对照组和观察组各40名,对照组按传统的带教方法进行教学;观察组通过以小组形式进行教学查房,反思性教学法,提出问题,深入讨论等措施,逐渐培养和提高护生的评判性思维能力。结果2组护生出科时的理论考核、操作考核均差异有统计学意义(P<0.05)。结论评判性思维可以提高护生的综合能力,提高临床实习效果。%Objective To observe the effect of critical thinking in nursing teaching effect of ICU. Methods 80 Nursing students with Machine is divided into control group and observation group 40, control group with traditional teaching method to teaching, the obser-vation group by group form of teaching, reflective teaching, put forward the question, discussed in depth and other measures, gradually cultivate and improve nursing students' critical thinking ability. Results The two groups of nursing students of the theory test, opera-tion check, all P<0.05, the difference was statistically significant. Conclusion Nursing students critical thinking can improve the com-prehensive ability of nursing students, improve clinical practice effect.

  16. Effect Analysis of Pressure Ulcer Assessment Scale in the Nursing Medical Records of ICU%压疮评估表在ICU护理记录中应用的效果分析

    Institute of Scientific and Technical Information of China (English)

    左冬晶; 王烁

    2016-01-01

    Objectives To ensure the risk factors of pressure ulcer of patients in ICU through the pressure ulcer assessment scale, so as to improve the nursing treatment and decrease the incidence of pressure ulcer. Methods To conduct a retrospective analysis on the medical records materials of ICU patients since the pressure ulcer assessment scale was involved in the nursing medical record from January 1st, 2008 to December 31th,2015 of a hospital. Then took the patients in the former 5 years in ICU as control group, made statistical analysis on the risk factors of pressure ulcer and compared the incidence before and after the application of the scale. Results The incidence of pressure ulcer decreased from 9.3%to 6.7%(X2=11.240, P=0.001) after using the pressure ulcer assessment scale in the nursing medical record. Age, duration in hospital, hypoalbuminemia, stroke and high Braden scale were detected to be the risk factors of pressure ulcer by logistic regression. The albumin decreased lower than 2.315mg/dl was the cutoff value of pressure ulcer. Conclusions To enroll the pressure ulcer assessment scale into the convention items of nursing medical record was benefit to decrease the incidence of pressure ulcer and increase the nursing quality.%目的:通过压疮护理评估表,确定 ICU 患者压疮易发的危险因素,以改进护理措施,降低压疮发生率。方法回顾性分析2008年1月1日某院将压疮护理评估表纳入护理记录以来,至2015年12月31日收入ICU病房的所有患者的病案资料。同时以之前5年的ICU患者为对照,统计压疮易发的危险因素,对比评估表应用前后的压疮发生率。结果在护理记录中使用压疮护理评估表后,ICU患者的压疮发生率由之前的9.3%降至6.7%(X2=11.240, P=0.001)。通过logistic回归分析发现,年龄、住院时间、低蛋白血症、脑卒中和 Braden评分为压疮易发的危险因素。血清白蛋白水平低于2.315mg/dl为压疮易

  17. On ICU Patients Psychological Status Investigation and the Analysis of the Effect of Nursing Intervention%关于ICU患者心理状况及护理干预的效果分析

    Institute of Scientific and Technical Information of China (English)

    齐敏

    2016-01-01

    Objective about ICU patients psychological status investigation and the analysis of the effect of nursing inter-vention. Method to extract during April 2015 - January 2016 our hospital 98 cases of patients, on the basis of digital lot-tery is divided into control group (n = 49, routine nursing) and experimental group (n = 49, psychological intervention) and observation group patients' psychological intervention, first take the initiative to adopt proper ways to communicate with pa-tients, make them feel the concern of medical staff and warm, and gradually formed a sense of security and belonging. After waiting for the mood calm, patience to explain the treatment and operation, thus to improve their awareness and adherence to treatment, finally according to different personality patients given targeted nursing, for example, for patients with depres-sion, anxiety tendency, nursing staff main guide patients treated with a positive mental attitude to face, be optimistic. Ob-serve two groups of depression, anxiety, and so on and so forth. Results Out of the ICU, significant difference was found in two groups of depression score comparison, depressed mood improved significantly in the experimental group patients; Out of the ICU, two groups have significant anxiety score comparison, the experimental group with a significant reduction in the anxiety score. Conclusion Psychological intervention in the ICU, possesses the advantages of improving patients with de-pression and anxiety score, it can be as reliable nursing measures.%目的:关于ICU患者心理状况调查及护理干预的效果分析。方法抽取2015年4月-2016年1月期间该院患者98例,依据数字抽签方式划分为参照组(n=49,常规护理)以及实验组(n=49,心理干预),给予观察组患者心理干预,首先采用恰当的方式主动与患者沟通,使其感受医护人员的关怀以及温暖,进而逐渐形成安全感以及归属感;待其心情平复后,耐心向患者解释相关

  18. The Comparison of Ramsay and Richmond Scales for Intensive Care Unit Sedation, the Consistency Between Doctors and Nurses

    Directory of Open Access Journals (Sweden)

    Aslı Hepkarşı

    2015-12-01

    Full Text Available Objective: Daily interruption and monitoring of sedation in intensive care unit (ICU patients, especially in patients on mechanical ventilation, with the help of sedation scales is recommended for titration of sedative drugs. For this purpose, scales such as Richmond agitation-sedation scale (RASS and the Ramsay sedation scale (RSS are commonly used. Although these scales definitively describe sedation levels, perceptions and scores can differ among practitioners. The aim of this prospective observational study was to evaluate these subjective assessments and the consistency between nurses, residents and specialists, and to evaluate the degree of ease of these scales. Material and Method: After ethic committee approval, a single-center prospective observational study was planned; 128 adult patients, who were conscious, and had no motor and sensory defects, were included in the study. Each patient was evaluated with the RASS and RSS scales by nurses, residents and specialists simultaneously and the scores and ease of scale were recorded in such a way which did not allow the participants to see each other. Data was analyzed by the medical informatics and statistics department of the university and the Weighted Kappa values between practitioners were measured. Results: A total of 482 observations were made from the 128 patients included in the study. Practitioners evaluated both sedation scales simultaneously. Upon comparison of the practitioners’ scale values, the consistency between the matching observation numbers showed a Weighted Kappa value between 0.71-0.77, which was found to be statistically significant and the consistency between participants was classified as “good”. The degree of ease of application for both scales was found to be “very easy”. Conclusion: This study reveals a correlation between RASS and RSS scores between practitioners with different educational levels. The implementation of both scales was found

  19. Elaboration of leadership and culture in high-performing nursing units of hospitals as perceived by staff nurses.

    Science.gov (United States)

    Casida, Jesus M; Crane, Patrick C; Walker, Tara L; Wargo, Lisa M

    2012-01-01

    The leadership-culture phenomenon, a known explanatory construct for organizational performance, is understudied in nursing. Building on our previous work, we further addressed this knowledge gap through explorations of demographics and hospital variables which may have a significant influence on staff nurses' (SNs) perceptions of their nurse managers' (NMs) leadership and nursing unit culture. Furthermore, we explored the extent to which the NMs' leadership predicted specific cultures which typify nursing unit effectiveness. Using dissertation data provided by278 SNs, we found that SNs educated at the baccalaureate level or higher had favorable perceptions of their nursing unit performance and viewed their NMs' leadership differently than the SNs with diploma or associate degrees. The frequent portrayals of transformational (TFL) leadership behaviors (e.g., visionary) by the NMs were paramount in shaping culture traits which exemplify high performance outcomes. TFL leaders were more likely to shape unit cultures which are flexible and adaptive to the environmental challenges within and outside the nursing unit. Thus, the type of NMs' leadership and unit culture may provide an added value in explaining the performance level in patient care units which consequently affects the overall hospital/organizational outcomes. Implications for research and leadership practices are presented.

  20. Acoustic assessment of speech privacy curtains in two nursing units.

    Science.gov (United States)

    Pope, Diana S; Miller-Klein, Erik T

    2016-01-01

    Hospitals have complex soundscapes that create challenges to patient care. Extraneous noise and high reverberation rates impair speech intelligibility, which leads to raised voices. In an unintended spiral, the increasing noise may result in diminished speech privacy, as people speak loudly to be heard over the din. The products available to improve hospital soundscapes include construction materials that absorb sound (acoustic ceiling tiles, carpet, wall insulation) and reduce reverberation rates. Enhanced privacy curtains are now available and offer potential for a relatively simple way to improve speech privacy and speech intelligibility by absorbing sound at the hospital patient's bedside. Acoustic assessments were performed over 2 days on two nursing units with a similar design in the same hospital. One unit was built with the 1970s' standard hospital construction and the other was newly refurbished (2013) with sound-absorbing features. In addition, we determined the effect of an enhanced privacy curtain versus standard privacy curtains using acoustic measures of speech privacy and speech intelligibility indexes. Privacy curtains provided auditory protection for the patients. In general, that protection was increased by the use of enhanced privacy curtains. On an average, the enhanced curtain improved sound absorption from 20% to 30%; however, there was considerable variability, depending on the configuration of the rooms tested. Enhanced privacy curtains provide measureable improvement to the acoustics of patient rooms but cannot overcome larger acoustic design issues. To shorten reverberation time, additional absorption, and compact and more fragmented nursing unit floor plate shapes should be considered.

  1. Acoustic assessment of speech privacy curtains in two nursing units

    Directory of Open Access Journals (Sweden)

    Diana S Pope

    2016-01-01

    Full Text Available Hospitals have complex soundscapes that create challenges to patient care. Extraneous noise and high reverberation rates impair speech intelligibility, which leads to raised voices. In an unintended spiral, the increasing noise may result in diminished speech privacy, as people speak loudly to be heard over the din. The products available to improve hospital soundscapes include construction materials that absorb sound (acoustic ceiling tiles, carpet, wall insulation and reduce reverberation rates. Enhanced privacy curtains are now available and offer potential for a relatively simple way to improve speech privacy and speech intelligibility by absorbing sound at the hospital patient′s bedside. Acoustic assessments were performed over 2 days on two nursing units with a similar design in the same hospital. One unit was built with the 1970s′ standard hospital construction and the other was newly refurbished (2013 with sound-absorbing features. In addition, we determined the effect of an enhanced privacy curtain versus standard privacy curtains using acoustic measures of speech privacy and speech intelligibility indexes. Privacy curtains provided auditory protection for the patients. In general, that protection was increased by the use of enhanced privacy curtains. On an average, the enhanced curtain improved sound absorption from 20% to 30%; however, there was considerable variability, depending on the configuration of the rooms tested. Enhanced privacy curtains provide measureable improvement to the acoustics of patient rooms but cannot overcome larger acoustic design issues. To shorten reverberation time, additional absorption, and compact and more fragmented nursing unit floor plate shapes should be considered.

  2. Burnout syndrome indices in Greek intensive care nursing personnel.

    Science.gov (United States)

    Karanikola, Maria N K; Papathanassoglou, Elizabeth D E; Mpouzika, Meropi; Lemonidou, Chrysoula

    2012-01-01

    Burnout symptoms in Greek intensive care unit (ICU) nurses have not been explored adequately. The aim of this descriptive, correlational study was to investigate the prevalence and intensity of burnout symptoms in Greek ICU nursing personnel and any potential associations with professional satisfaction, as well as with demographic, educational, and vocational characteristics. Findings showed that the overall burnout level reported by Greek ICU nursing personnel was at a moderate to high degree. The most pronounced symptom of burnout was depersonalization, whereas emotional exhaustion was found to be a strong predictor of job satisfaction. This is a factor connected with the nurses' intention to quit the job. It appears that work factors have a more powerful influence over the development of burnout in comparison to personality traits.

  3. [Nursing in a pediatric unit. Proposal for systematization].

    Science.gov (United States)

    Santos, E R; de Barros, J R; Baraldi, M M; Minto, C A; Dupas, G

    1997-04-01

    The present work reports an initial process of nursing assistance systematization developed in a Pediatric Unit of a medium size hospital in São Carlos-SP, considering the actual human resources and the type of approach adopted by the institution on the assistance given to the hospitalized child. A Routine Manual was elaborated based on the literature and with the staff participation, and after that, a training was realized with these employees, starting from routines previously sketched, using groupal dynamics that looked forward to rescue the knowledge that they already had about the themes. The work considered the employees opinion about their participation in the systematization process.

  4. Measuring professional satisfaction and nursing workload among nursing staff at a Greek Coronary Care Unit

    Directory of Open Access Journals (Sweden)

    Maria Gouzou

    2015-12-01

    Full Text Available ABSTRACT Objective To explore potential associations between nursing workload and professional satisfaction among nursing personnel (NP in Greek Coronary Care Units (CCUs. Method A cross-sectional study was performed involving 66 members of the NP employed in 6 randomly selected Greek CCUs. Job satisfaction was assessed by the IWS and nursing workload by NAS, CNIS and TISS-28. Results The response rate was 77.6%. The reliability of the IWS was α=0.78 and the mean score 10.7 (±2.1, scale range: 0.5-39.7. The most highly valued component of satisfaction was “Pay”, followed by “Task requirements”, “Interaction”, “Professional status”, “Organizational policies” and “Autonomy”. NAS, CNIS and TISS-28 were negatively correlated (p≤0.04 with the following work components: “Autonomy”, “Professional status”, “Interaction” and “Task requirements”. Night shift work independently predicted the score of IWS. Conclusion The findings show low levels of job satisfaction, which are related with nursing workload and influenced by rotating shifts.

  5. Ethical problems in intensive care unit admission and discharge decisions: a qualitative study among physicians and nurses in the Netherlands

    NARCIS (Netherlands)

    Oerlemans, A.J.; Sluisveld, N. van; Leeuwen, E.S. van; Wollersheim, H.C.; Dekkers, W.J.M.; Zegers, M.

    2015-01-01

    BACKGROUND: There have been few empirical studies into what non-medical factors influence physicians and nurses when deciding about admission and discharge of ICU patients. Information about the attitudes of healthcare professionals about this process can be used to improve decision-making about res

  6. One-Year Outcome of Geriatric Hip-Fracture Patients following Prolonged ICU Treatment

    Directory of Open Access Journals (Sweden)

    Daphne Eschbach

    2016-01-01

    Full Text Available Purpose. Incidence of geriatric fractures is increasing. Knowledge of outcome data for hip-fracture patients undergoing intensive-care unit (ICU treatment, including invasive ventilatory management (IVM and hemodiafiltration (CVVHDF, is sparse. Methods. Single-center prospective observational study including 402 geriatric hip-fracture patients. Age, gender, the American Society of Anesthesiologists (ASA classification, and the Barthel index (BI were documented. Underlying reasons for prolonged ICU stay were registered, as well as assessed procedures like IVM and CVVHDF. Outcome parameters were in-hospital, 6-month, and 1-year mortality and need for nursing care. Results. 15% were treated > 3 days and 68% 3d cohort were significantly increased (p=0.001. Most frequent indications were cardiocirculatory pathology followed by respiratory failure, renal impairment, and infection. 18% of patients needed CVVHDF and 41% IVM. In these cohorts, 6-month mortality ranged > 80% and 12-month mortality > 90%. 100% needed nursing care after 6 and 12 months. Conclusions. ICU treatment > 3 days showed considerable difference in mortality and nursing care needed after 6 and 12 months. Particularly, patients requiring CVVHDF or IVM had disastrous long-term results. Our study may add one further element in complex decision making serving this vulnerable patient cohort.

  7. OSCE考核在急诊科、ICU护士临床实践技能培训中的应用%Application of OSCE Examination in the Clinical Practice Skill Training in the Department of Emergency and ICU Nurses

    Institute of Scientific and Technical Information of China (English)

    张青华

    2016-01-01

    Objective To explore the clinical application of OSCE examination in the clinical practice skill training of in the department of emergency and ICU nurses. Methods 60 cases of on-the-job nursing staff in our hospital were selected and randomly and dynamically divided into two groups with 30 cases in each, and the training time was from April 2015 to April 2016, the control group adopted the traditional teaching method, and the observation group adopted the OSCE exami-nation method. Results There were differences in the nursing evaluation score, case analysis score, specific nursing skill op-eration score, monitoring skill operation score, team rescue cooperation ability score and health education score between the two groups, P<0.05. Conclusion The effect of OSCE examination in the clinical practice skill training of in the department of emergency and ICU nurses is obvious.%目的:探索OSCE考核在急诊科、ICU护士临床实践技能培训中的临床应用。方法选取该院60名在岗护理人员,培训时间均集中在2015年4月-2016年4月期间,并将此次研究对象动态随机分为两组,每组30名护理人员,对照组采用传统教学方式,观察组采用OSCE考核方式。结果观察组和对照组两组护理人员,对比护理评估评分、病例分析评分、专科护理技能操作评分、监护技能操作评分、团队抢救协作能力评分、健康教育评分均存在差异性(P<0.05)。结论 OSCE考核在急诊科、ICU护士临床实践技能培训中效果显著。

  8. 综合护理干预对ICU谵妄患者预后的效果观察%The effect of comprehensive nursing intervention on the prognosis of patients with delirium in ICU

    Institute of Scientific and Technical Information of China (English)

    赵丽娜

    2016-01-01

    Objective: To explorer the effect of comprehensive nursing intervention on the prognosis of patients with delirium in ICU. Methods: 186 patients with delirium in our hospital were divided into the control group and the observation group randomly, with each group 93 cases. The control group was treated with the traditional nursing care, and patients in the observation group were given the comprehensive nursing on the basis of that. The prognosis of delirium was compared observed and compared between them. Results: After the good nursing, The effective rate of the observation group was 93.54%and the observation group 88.17%respectively, and the differences had statistical significance(P<0.05). Conclusion: Comprehensive nursing intervention in patients with delirium in ICU could improve the effective rate, shorten the hospital stay, and improve the prognosis of patients.%目的:探讨综合护理干预对ICU谵妄患者预后的效果。方法选取2014年8月-2015年8月我院ICU病房收治的186例谵妄患者作为研究对象。采用随机数字表法将其分为观察组和对照组,每组93例。对照组患者采用常规护理,观察组患者给予综合护理干预,比较两组患者预后的情况。结果经过精心治疗和护理后,观察组患者的好转率为93.54%,明显高于对照组的88.17%,组间比较,差异有统计学意义(P<0.05)。结论对ICU谵妄患者实施综合护理干预可有效提高好转率,缩短患者的住院时间,改善患者的预后。

  9. Exhaled Breath Metabolomics for the Diagnosis of Pneumonia in Intubated and Mechanically-Ventilated Intensive Care Unit (ICU-Patients

    Directory of Open Access Journals (Sweden)

    Pouline M. P. van Oort

    2017-02-01

    Full Text Available The diagnosis of hospital-acquired pneumonia remains challenging. We hypothesized that analysis of volatile organic compounds (VOCs in exhaled breath could be used to diagnose pneumonia or the presence of pathogens in the respiratory tract in intubated and mechanically-ventilated intensive care unit patients. In this prospective, single-centre, cross-sectional cohort study breath from mechanically ventilated patients was analysed using gas chromatography-mass spectrometry. Potentially relevant VOCs were selected with a p-value < 0.05 and an area under the receiver operating characteristics curve (AUROC above 0.7. These VOCs were used for principal component analysis and partial least square discriminant analysis (PLS-DA. AUROC was used as a measure of accuracy. Ninety-three patients were included in the study. Twelve of 145 identified VOCs were significantly altered in patients with pneumonia compared to controls. In colonized patients, 52 VOCs were significantly different. Partial least square discriminant analysis classified patients with modest accuracy (AUROC: 0.73 (95% confidence interval (CI: 0.57–0.88 after leave-one-out cross-validation. For determining the colonization status of patients, the model had an AUROC of 0.69 (95% CI: 0.57–0.82 after leave-one-out cross-validation. To conclude, exhaled breath analysis can be used to discriminate pneumonia from controls with a modest to good accuracy. Furthermore breath profiling could be used to predict the presence and absence of pathogens in the respiratory tract. These findings need to be validated externally.

  10. Turnover of professional nurses at Mokopane Hospital in the Limpopo Province, South Africa: Experiences of nursing unit managers

    Directory of Open Access Journals (Sweden)

    Mogale L. Mmamma

    2015-07-01

    Full Text Available Background: Staff turnover of professional nurses remains a concern for public and private hospitals management because it has an impact on the morale of nurses and it may also lead to poor patient care.Objectives: The objectives of this study were to explore and describe the experiences of nursing unit managers with regard to the turnover of professional nurses who were under their supervision.Method: A qualitative, explorative, descriptive research design was used to determine the experiences of nursing unit managers related to the turnover of professional nurses. Data collection was done by using semi-structured one-to-one interviews with professional nurses .Two groups of participants were interviewed: Those working day duty (n = 9 and those working night duty (n = 3 who were at work on the anticipated days for data collection.Results: The findings revealed that every unit was experiencing a shortage of professional nurses, which caused other nurses to work overtime with an inevitable increase in workload. That led to tiredness, conflict amongst professional nurses, job dissatisfaction, and absenteeism which compromised nursing care. This resulted in patient dissatisfaction and sometimes led to deaths that could have been prevented.Conclusion: It is recommended that staff turnover should be addressed by the hospital top management implementing several strategies. For example, top management could ensure that staff members work in a healthy environment with resources that they need during the provision of care, address the effects of the staff turnover, support the staff members and refrain from putting pressure on nursing unit managers whilst they are attending to problems.

  11. Measuring and accounting for the Hawthorne effect during a direct overt observational study of intensive care unit nurses.

    Science.gov (United States)

    Kurtz, Sharon Lea

    2017-09-01

    Because suspecting nurses could alter hand hygiene (HH) behavior when observed, the goal of this article was to describe how the Hawthorne effect (HE) was measured and accounted for in a direct observational prospective study. Observations were made 8 h/d for 3-5 days in 5 intensive care units (ICUs) (4 hospitals) on a convenience sample of 64 ICU nurses in Texas. The HE was measured so if hand hygiene adherence rates of the first 2 hours were 20% higher than the last 6 hours, the first 2 hours would be dropped and an additional 2 hours would be added at the end of the observation period. Hourly rates were recorded during the observation period, using room entry and room exit. The difference between aggregated rates of the first 2 hours and last 6 hours was 0.56% (range, 0.02%-15.74%) and not significant. On 12 observation days, higher rates were observed during the first 2 hours. On 6 days, higher rates were observed in the last 6 hours, with difference in rates of 1.43% (day 1), 2.97% (day 2), and 1.42% (day 3). The attempt at measuring and accounting for the HE showed little difference in HH rates throughout the observation period. Based on these results, necessity of the observer moving locations during HH surveillance after 10-20 minutes, because of a feared HE, might not be necessary. Copyright © 2017. Published by Elsevier Inc.

  12. The Effects of Anxiety and Depression of ICU Critical Patients with Systematic Nursing%系统护理对ICU危重患者焦虑和抑郁情绪的影响

    Institute of Scientific and Technical Information of China (English)

    饶捍卫

    2009-01-01

    目的 探讨系统护理干预对ICU危重患者焦虑和抑郁情绪的影响.方法 对296例ICU清醒患者随机分为对照组和系统护理干预组,每组148例,通过焦虑自评量表(SAS)和抑郁自评量表(SDS)对各组患者进行焦虑和抑郁评分.结果 两组患者焦虑和抑郁评分均高于临界6t(50分和41分).对照组护理前后焦虑和抑郁评分差异无统计学意义(P>0.05):系统护理干预组护理前后差异有统计学意义(P0.05). The scores of nursing intervention group after nursing intervention were significant statistical difference between before(P<0.01 ), and they were more than the control group (P<0.01 or P<0.05). CONCLUSION Systematic nursing could improve psychological status of ICU critical patients, promote recovering of the patients.

  13. The incidence of nosocomial infection in the Intensive Care Unit, Hospital Universiti Kebangsaan Malaysia: ICU-acquired nosocomial infection surveillance program 1998-1999.

    Science.gov (United States)

    Rozaidi, S W; Sukro, J; Dan, A

    2001-06-01

    CU-acquired nosocomial infection (NI) remains one of the major causes of ICU mortality. This study presents the incidence of ICU-acquired nosocomial infection in ICU HUKM for the years 1998 and 1999, as part of the ongoing ICU-acquired nosocomial infection surveillance program. The overall incidence was 23%. The main types of NI was lower respiratory tract infection (15.3%), primary bacteraemia (8.1%), ventilator associated pneumonia (5.4%), urinary tract infection (2.0%), skin infection (1.6%) central venous catheter sepsis (1.2%) and surgical skin infection (0.8%). The overall culture positive nosocomial infection rate was only 12.1%, majority from the lungs (12.6%), blood (7.3%), skin swabs (2.0%), and urine (1.6%). The main gram-negative organism cultured was Acinetobacter sp. (19%) and Staph. aureus (8.5%) was the gram-positive organism. The overall ICU mortality rate was 27.5% of which 60.9% of patients who died were attributed directly to sepsis.

  14. Live music therapy in waiting area of intensive care units: a novel concept for betterment of close relatives of ICU patients

    Directory of Open Access Journals (Sweden)

    Sundar Sumathy

    2016-03-01

    Full Text Available Family members of ICU patients experience high levels of stress and anxiety. We explored a novel concept of live music therapy for relatives of ICU patients. Weekly 1-hour sessions of live music therapy consisting of devotional songs and prayers were performed in waiting area of ICU in a tertiary care hospital. Responses of 100 first degree relatives of ICU patients were documented using an 8-item questionnaire. 69% of the subjects rated live music therapy sessions as and ldquo;excellent and rdquo;; 50% of the subjects reported that they felt and ldquo;excellent and rdquo; after a single session. Such sessions were reported as a felt need by 77% of the subjects; 92% of the subjects reported that there were high chances that they would recommend such sessions in the hospital in future. In our study, we found our concept to be feasible, acceptable and highly appreciated as well as encouraged by first degree relatives of ICU patients. [Int J Res Med Sci 2016; 4(3.000: 947-949

  15. Analysis of the status and influencing factors of job burnout of ICU nurses in provincial 3A-level comprehensive hospitals in Changsha%长沙市省级综合三级甲等医院ICU护士职业倦怠现状及其影响因素分析

    Institute of Scientific and Technical Information of China (English)

    张红辉; 刘怡素; 何国平; 秦月兰; 邹灏宇

    2013-01-01

    Objective To investigate the status of ICU nurse's job burnout in provincial 3 A -level comprehensive hospitals in Changsha, and to explore its influencing factors. Method The Chinese version of Maslach Burnout Inventory ( MBI) was used to conduct a survey among 215 ICU nurses in Changsha. Results The rates of low,moderate and severe level burnout among ICU nurses in Changsha were 30. 70% ,22. 79% ,5. 58% respectively. Gender,frequency of night shift, self - assessment of family communication quality and administrative duties were the main influencing factors of job burnout. Conclusion The problem of job burnout is significant among ICU nurses in Changsha, and the female ICU nurses with poor quality of family communication, with more night shifts are the priority groups for the intervention.%目的 调查长沙市省级综合三级甲等医院ICU护士职业倦怠现状,并探讨其影响因素.方法 采用工作倦怠量表对215名ICU护士进行问卷调查.结果 护士的轻、中、重度职业倦怠的检出率分别为30.70%、22.79%、5.58%;性别、班次轮换、自评家庭交流质量和职务是ICU护士职业倦怠的影响因素.结论 长沙市省级综合三级甲等医院ICU护士的职业倦怠问题比较严重,家庭交流质量差、夜班多的女性ICU护士应为职业倦怠干预的重点对象.

  16. Financial impact of nursing professionals staff required in an Intensive Care Unit.

    Science.gov (United States)

    Araújo, Thamiris Ricci de; Menegueti, Mayra Gonçalves; Auxiliadora-Martins, Maria; Castilho, Valéria; Chaves, Lucieli Dias Pedreschi; Laus, Ana Maria

    2016-11-21

    to calculate the cost of the average time of nursing care spent and required by patients in the Intensive Care Unit (ICU) and the financial expense for the right dimension of staff of nursing professionals. a descriptive, quantitative research, using the case study method, developed in adult ICU patients. We used the workload index - Nursing Activities Score; the average care time spent and required and the amount of professionals required were calculated using equations and from these data, and from the salary composition of professionals and contractual monthly time values, calculated the cost of direct labor of nursing. the monthly cost of the average quantity of available professionals was US$ 35,763.12, corresponding to 29.6 professionals, and the required staff for 24 hours of care is 42.2 nurses, with a monthly cost of US$ 50,995.44. the numerical gap of nursing professionals was 30% and the monthly financial expense for adaptation of the structure is US$ 15,232.32, which corresponds to an increase of 42.59% in the amounts currently paid by the institution. calcular o custo do tempo médio de assistência de enfermagem despendido e requerido pelos pacientes internados em Unidade de Terapia Intensiva (UTI) e o dispêndio financeiro para adequação do quadro de profissionais de enfermagem. pesquisa descritiva, quantitativa, na modalidade de estudo de caso, desenvolvida na UTI de pacientes adultos. Utilizou-se o índice de carga de trabalho - Nursing Activities Score; o tempo médio de assistência despendido, requerido e o quantitativo de profissionais requerido foram calculados por meio de equações e, a partir desses dados, e de valores da composição salarial dos profissionais e tempo mensal contratual, calculou-se o custo da mão de obra direta de enfermagem. o custo mensal do quantitativo médio de profissionais disponível foi de US$ 35.763,12, correspondendo a 29,6 profissionais, e o requerido para 24 horas de cuidado é de 42,2 profissionais de

  17. 产科儿科合作护理对ICU早产儿母乳喂养效果的影响%Effects of pediatric nursing cooperated with obstetrical nursing on breast-feeding effect of ICU preterm children

    Institute of Scientific and Technical Information of China (English)

    赵迎娟; 卢淑亚; 白利颖

    2016-01-01

    目的:探讨产科儿科合作护理在 NICU 早产儿母乳喂养临床管理中的应用及效果。方法选择2015年1—12月在NICU住院的早产儿126例,2015年1—6月早产儿设为对照组65例,2015年7—12月早产儿设为干预组61例,对照组产科和儿科分别进行常规产后护理,干预组采用产科儿科合作护理。结果干预组1周纯母乳喂养率高于对照组,混合喂养、人工喂养率均低于对照组,两组喂养方式差异有统计学意义(χ2=7.025,P=0.006);干预组首次母乳喂养日龄较对照组明显提前(χ2=2.365,P=0.020),1周内母乳喂养程度高于对照组(χ2=5.628,P=0.021;t=5.158,P<0.001)、2周内母乳喂养程度高于对照组(χ2=6.852,P=0.009;t=6.542,P<0.001)、住院期间达完全母乳喂养比例高于对照组(χ2=7.852,P<0.001)。干预组体质量增长速率明显高于对照组(t=4.526,P=0.003),住院时间较对照组缩短(t=3.524,P=0.009),败血症发生率明显低于对照组(χ2=4.159,P=0.042)。结论产科儿科合作护理可有效提高NICU早产儿母乳喂养程度及纯母乳喂养率,有利于促进新生儿体质量增长,缩短住院时间,降低败血症发生率。%Objective To investigate the application and effect of pediatric nursing cooperated with obstetrical nursing on breast-feeding effect of ICU preterm children. Methods Totally 126 cases of premature children hospitalized in our hospital NICU form January 2015 to December 2015 as the research object. Cases from January to June were selected as the control group ( n=65) , cases from July to December were selected as the intervention group ( n=61) . In the control group, routine post-natal nursing was performed respectively in obstetric and pediatrics. In the intervention group, pediatric nursing cooperated with obstetrical nursing was performed.Results Exclusive breast-feeding rate of 1 week in the intervention group was higher than the control group

  18. Leadership skills for nursing unit managers to decrease intention to leave

    Directory of Open Access Journals (Sweden)

    Roche MA

    2015-05-01

    Full Text Available Michael A Roche,1 Christine Duffield,1,2 Sofia Dimitrelis,1 Belinda Frew1 1Centre for Health Services Management, Faculty of Health, University of Technology, Sydney, NSW, 2Clinical Nursing and Midwifery Research Centre, School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA, Australia Aim: To examine specific elements of nursing leadership linked to intention to leave, in public acute care hospitals. Background: Nurse turnover is a global issue receiving widespread attention due to prolonged and projected workforce shortages. Nurse management and leadership qualities have been associated with intention to leave and turnover of nurses. The role of the nurse unit managers in the retention of nurses is becoming increasingly important, particularly because of their strong influence on the quality and stability of the work environment. Methods: Data were collected from 62 medical, surgical, and mixed units across eleven public acute care hospitals in three Australian states (September 2008 to August 2010. A total of 1,673 nurses completed a nurse survey that included measures of intention to leave and leadership aspects of the practice environment. Analyses explored specific leadership characteristics that were associated with turnover intent. Results: The role of nursing unit managers was confirmed to be a major factor in nurses’ intention to remain or leave their current workplace. Nurses valued “human” skills more highly than other leadership characteristics, including their manager’s connection with nurses’ concerns, clarity, participation in decisions, and encouragement. Conclusion: Strong leadership qualities in the nursing unit manager have been associated with greater job satisfaction, reduced turnover intention among nursing staff, and improved patient outcomes. Nurse leaders need to be supported in an effort to retain nurses given ongoing workforce issues and to ensure high-quality patient care. Keywords: nurse

  19. The United Kingdom National Healthy School Standard: A Framework for Strengthening the School Nurse Role

    Science.gov (United States)

    Wicklander, Molly K.

    2005-01-01

    The purpose of this review is to analyze the school nursing role within the National Healthy School Standard (NHSS) in the United Kingdom with a view toward clarifying and strengthening the role of school nurses globally. Within the National Healthy School Standard framework, school nurses serve an integral role in linking health and education…

  20. Association of nursing overtime, nurse staffing and unit occupancy with medical incidents and outcomes of very preterm infants.

    Science.gov (United States)

    Beltempo, M; Lacroix, G; Cabot, M; Blais, R; Piedboeuf, B

    2017-09-21

    To examine the association of nursing overtime, nursing provision and unit occupancy rate with medical incident rates in the neonatal intensive care unit (NICU) and the risk of mortality or major morbidity among very preterm infants. Single center retrospective cohort study of infants born within 23 to 29 weeks of gestational age or birth weight bed, level III NICU. Nursing overtime ratios (nursing overtime hours/total nursing hours), nursing provision ratios (nursing hours/recommended nursing hours based on patient dependency categories) and unit occupancy rates were pooled for all shifts during NICU hospitalization of each infant. Log-binomial models assessed their association with the composite outcome (mortality or major morbidity). Of the 257 infants that met the inclusion criteria, 131 (51%) developed the composite outcome. In the adjusted multivariable analyses, high (>3.4%) relative to low nursing overtime ratios (⩽3.4%) were not associated with the composite outcome (relative risk (RR): 0.93; 95% confidence interval (CI): 0.86 to 1.02). High nursing provision ratios (>1) were associated with a lower risk of the composite outcome relative to low ones (⩽1) (RR: 0.81; 95% CI: 0.74 to 0.90). NICU occupancy rates were not associated with the composite outcome (RR: 0.98; 95% CI: 0.89 to 1.07, high (>100%) vs low (⩽100%)). Days with high nursing provision ratios (>1) were also associated with lower risk of having medical incidents (RR: 0.91; 95% CI: 0.82 to 0.99). High nursing provision ratio during NICU hospitalization is associated with a lower risk of a composite adverse outcome in very preterm infants.Journal of Perinatology advance online publication, 21 September 2017; doi:10.1038/jp.2017.146.

  1. Outcome of mechanically ventilated patients initially denied admission to an intensive care unit and subsequently admitted.

    Science.gov (United States)

    Naser, Wasim; Schwartz, Naama; Finkelstein, Richard; Bisharat, Naiel

    2016-11-01

    The outcome of mechanically ventilated patients initially denied admission to an intensive care unit (ICU) and subsequently admitted is unclear. We compared outcomes of patients denied ICU admission and subsequently admitted, to those of patients admitted to the ICU and to patients refused ICU admission. The medical records of all the patients who were subjected to mechanical ventilation for at least 24h over a 4year period (2010-2014) were reviewed. Of 707 patients (757 admissions), 124 (18%) were initially denied ICU admission and subsequently admitted. Multivariate stepwise logistic regression analysis showed significant association with death of: age, length of stay, nursing home residency, duration of mechanical ventilation, previous admission with mechanical ventilation, cause for mechanical ventilation, rate of failed extubations, associated morbidity (previous cerebrovascular accident, dementia, chronic renal failure), and occurrence of nosocomial bacteremia. The odds for death among patients denied ICU admission and subsequently transferred to the ICU compared to patients admitted directly to the ICU was 3.6 (95% CI: 1.9-6.7) (Padmission compared to those who were initially denied and subsequently admitted were not statistically significant (OR=1.7, 95% CI: 0.8-3.8). In conclusion, patients denied ICU admission and subsequently admitted face a considerable risk of morbidity and mortality. Their odds of death are nearly three times those admitted directly to the ICU. Late admission to the ICU does not appear to provide benefit compared to patients who remain in general medicine wards.

  2. Impact of two different training modes on the critical thinking of ICU junior nurses%两种不同培训模式对ICU低年资护士评判性思维的影响

    Institute of Scientific and Technical Information of China (English)

    武爱勤

    2012-01-01

    To explore the impact of two different training modes on the critical thinking of ICU junior nurses in order to find training strategies to improve the critical thinking ability of ICU junior nurses. Methods:48 ICU junior nurses were arranged to attend the training course in turn according to their educational background. 24 junior nurses in each training course were randomly divided into an experimental group and a control group ( 12 nurses in each group }. The training mode of alternating theory teaching and practice combined with case analysis and self ?examination was adopted in the experimental group and the traditional training mode of teaching theory first and then doing practice was used in the control group. The critical thinking disposition inventory{ CTDI ?CV } was used to assess the nurses'ability in the early period of training and at the end of training. Results:There were statistically significant differences in the comparison of the total scores and the scores of seven dimensions in the experimental group in the early period of training and at the end of training ( P <0. 05, P <0. 01 };the comparison of opening thinking,curiosity and the total scores was significant different in the control group in the early period of training and at the end of training ( P < 0. 05, P < 0. 01 }; the differences in the comparison of the scores of seven dimensions and the total scores were statistically significant between the experimental and control groups after training ( P <0. 05,P <0. 01 }. Conclusion:The two different training modes have different effects on the critical thinking of ICU junior nurses,and the training mode of alternating theory teaching and practice combined with case analysis and self ?examination can effectively improve the ability of critical thinking of ICU junior nurses.%目的:探讨两种不同培训模式对ICU低年资护士评判性思维的影响,为提高低年资护士评判性思维能力寻找培训策略.方法:将48名ICU低

  3. Evaluating quality of care using modular nursing on a multispecialty unit.

    Science.gov (United States)

    Bechtel, G A; Printz, V

    1994-03-01

    The purpose of this study was to examine performance outcome measures of nurses who work on a general medical unit and those who work on specialized or modular units. A sample of 82 nurses were reassigned to patients in either specialty modules or a general medical unit. Findings suggest that large nursing units staffed according to modular groups based on common diagnosis may improve nursing care quality. Modular nurses assigned to patients on a general medical unit made more medication errors, charted nursing interventions less frequently, and were less likely to provide prompt PRN medication administration. Of concern is the care provided to chronically ill; elderly clients not admitted to a predetermined specialty module received the poorest nursing care. We support development of specialty nursing modules to replace large, general medical units, it does not measure the impact of retention, cost, or other key variables on nurse staffing. We suggest that large medical units be divided into specialty modules and that staff rotation to general medical units be minimized.

  4. [Tasks performed by nurses at inpatient units in a training hospital].

    Science.gov (United States)

    Costa, Rita de Almeida; Shimizu, Helena Eri

    2005-01-01

    The purpose of this study was to identify and analyze tasks performed by nurses at inpatient units in a large general hospital in Brasilia, Federal District, which also functions as a training hospital. A quantitative, exploratory, descriptive study was carried out and involved a total of 612 hours of direct observation of the activities performed by 18 nurses at the General Medicine, Surgical, Pediatric and Maternity units. The tasks observed were classified as: administration, nursing care delivery, education and related to information system. Nurses dedicate a large part of their time to administrative tasks, followed by tasks related to nursing care delivery and information system, performing almost no educative tasks.

  5. Nursing students’ experiences of professional patient care encounters in a hospital unit

    DEFF Research Database (Denmark)

    Kaldal, Maiken Holm; Kristiansen, Jette; Uhrenfeldt, Lisbeth

    2015-01-01

    REVIEW QUESTION / OBJECTIVE The objective of this systematic review is to identify, appraise and synthesize the best available evidence on nursing students’ experiences of professional patient care encounters in a hospital unit. More specifically the research questions are: How do nursing students...... describe their experiences of professional patient care in a hospital unit? What kinds of experiences do nursing students have in professional patient care encounters? INCLUSION CRITERIA Types of participants This review will consider studies that include undergraduate and postgraduate nursing students...... experiences of professional patient care encounters where students engage with patients and provide nursing care within the basic principles of nursing care relating to the patients’ physiological and psychological needs. Studies that reflect nursing students’ comprehension of or attitudes towards nursing...

  6. Train-the-trainer intervention to increase nursing teamwork and decrease missed nursing care in acute care patient units.

    Science.gov (United States)

    Kalisch, Beatrice J; Xie, Boqin; Ronis, David L

    2013-01-01

    Teamwork is essential for patient safety and results in less missed nursing care. The aim of this study was to test the impact of a train-the-trainer intervention on the level of satisfaction with nursing teamwork and the amount of missed nursing care. This study used a quasiexperimental design with repeated measures taken at pretest, posttest, and 2 months after completion of the intervention. The sample for this study was the nursing staff on three medical-surgical units in three separate acute care hospitals (one unit in each hospital). Three nurses from each unit underwent a training program and then taught the skills and knowledge they acquired to the staff members on their units in three-hour-long sessions. The training involved staff role-playing scenarios based on teamwork problems that occur regularly on inpatient units in acute care hospitals followed by debriefing, which focused on teamwork behaviors (e.g., leadership, team orientation, backup, performance monitoring) and missed nursing care. Four measures were used to test the efficacy of this intervention: The Nursing Teamwork Survey, the MISSCARE Survey, and questions about the knowledge of and satisfaction with teamwork. Return rates for the surveys ranged from 73% to 84%. Follow-up tests individually comparing pretest, posttest, and delayed posttest were conducted within the mixed model and used the Bonferroni correction for multiple comparisons. Teamwork increased (F = 6.91, df = 259.01, p = .001) and missed care decreased (F = 3.59, df = 251.29, p = .03) over time. Nursing staff also reported a higher level of satisfaction with teamwork and an increase of teamwork knowledge after the intervention. The intervention tested in this study shows promise of being an effective and efficient approach to increase nursing teamwork and decrease missed nursing care.

  7. Perceptions, attitudes, and current practices regards delirium in China: A survey of 917 critical care nurses and physicians in China.

    Science.gov (United States)

    Xing, Jinyan; Sun, Yunbo; Jie, Yaqi; Yuan, Zhiyong; Liu, Wenjuan

    2017-09-01

    The purpose of this study is to assess the knowledge, attitudes, and managements regarding delirium of intensive care nurses and physicans, and to assess the perceived barriers related to intensive care unit (ICU) delirium monitoring in China. A descriptive survey was distributed to 1156 critical care nurses and physicians from 74 tertiary and secondary hospitals across Shandong province, China. The overall response rate was 86.18% (n = 917). The majority of respondents (88%) believed that deirium was associated with prolonged mechanical ventilation, and 79.72% thought delirium was associated with prolonged length of hospitalization. Only 14.17% of respondents believed that delirium was common in the ICU setting. Only 25.62% of the respondents reported routine screening of ICU delirium, and only 15.81% utilized Confusion Assessment Method for Intensive Care Unit screening tools. "Lack of appropriate screening tools" and "time restraints" were the most common perceived barriers. 45.4% of the participants had never received any education on ICU delirium. In conclusion, most nurses and physicians consider ICU delirium to be a serious problem, but lack knowledge on delirium and monitor this condition poorly. The survey infers a disconnection between the perceived significance and current monitoring of ICU delirium. There is a critical unmet need for in-service education on ICU delirium for physicians and nurses in China.

  8. Consensus on the use of neurophysiological tests in the intensive care unit (ICU): electroencephalogram (EEG), evoked potentials (EP), and electroneuromyography (ENMG)

    DEFF Research Database (Denmark)

    Guérit, J-M; Amantini, A; Amodio, P

    2009-01-01

    contribution to all other experts. A complete consensus has been reached when submitting the manuscript. RESULTS: What the group considered as the best classification systems for EEG and EP abnormalities in the ICU is first presented. CN tests are useful for diagnosis (epilepsy, brain death, and neuromuscular...... disorders), prognosis (anoxic ischemic encephalopathy, head trauma, and neurologic disturbances of metabolic and toxic origin), and follow-up, in the adult, paediatric, and neonatal ICU. Regarding prognosis, a clear distinction is made between these tests whose abnormalities are indicative of an ominous...

  9. Leadership-organizational culture relationship in nursing units of acute care hospitals.

    Science.gov (United States)

    Casida, Jesus; Pinto-Zipp, Genevieve

    2008-01-01

    The phenomena of leadership and organizational culture (OC) has been defined as the driving forces in the success or failure of an organization. Today, nurse managers must demonstrate leadership behaviors or styles that are appropriate for the constantly changing, complex, and turbulent health care delivery system. In this study, researchers explored the relationship between nurse managers' leadership styles and OC of nursing units within an acute care hospital that had achieved excellent organizational performance as demonstrated by a consistent increase in patient satisfaction ratings. The data from this study support that transformational and transactional contingent reward leaderships as nurse manager leadership styles that are associated with nursing unit OC that have the ability to balance the dynamics of flexibility and stability within their nursing units and are essential for maintaining organizational effectiveness. It is essential for first-line nursing leaders to acquire knowledge and skills on organizational cultural competence.

  10. Nurse Activism in the newborn intensive care unit: actions in response to an ethical dilemma.

    Science.gov (United States)

    Settle, Peggy Doyle

    2014-03-01

    Nurses working in a newborn intensive care unit report that treatment decision disagreements for infants in their care may lead to ethical dilemmas involving all health-care providers. Applying Rest's Four-Component Model of Moral Action as the theoretical framework, this study examined the responses of 224 newborn intensive care unit nurses to the Nurses Ethical Involvement Survey. The three most frequent actions selected were as follows: talking with other nurses, talking with doctors, and requesting a team meeting. The multiple regression analysis indicates that newborn intensive care unit nurses with greater concern for the ethical aspects of clinical practice (p = .001) and an increased perception of their ability to influence ethical decision making (p = .018) were more likely to display Nurse Activism. Future research is necessary to identify other factors leading to and inhibiting Nurse Activism as these findings explained just 8.5% of the variance.

  11. Motivations of nursing students regarding their educational preparation for mental health nursing in Australia and the United Kingdom: a survey evaluation

    OpenAIRE

    Edward, Karen-leigh; Warelow, Philip; Hemingway, Steve; Hercelinskyj, Gylo; Welch, Anthony; McAndrew, Sue; Stephenson, John

    2015-01-01

    Background There has been much debate by both academics and clinical agencies about the motivations and abilities of nurse graduates to work in mental health nursing. The aim of this study was to recruit student nurses from a dedicated mental health nursing program in the United Kingdom (UK) and a comprehensive nursing program in Australia and illuminate their motivations towards considering mental health nursing as a career choice. Methods This study comprised of two UK and four Australian S...

  12. Relationships among NANDA-I diagnoses, nursing outcomes classification, and nursing interventions classification by nursing students for patients in medical-surgical units in Korea.

    Science.gov (United States)

    Noh, Hyun Kyung; Lee, Eunjoo

    2015-01-01

    The purpose of this study was to identify NANDA-I, Nursing Outcomes Classification (NOC), and Nursing Interventions Classification (NIC; NNN) linkages used by Korean nursing students during their clinical practice in medical-surgical units. A comparative descriptive research design was used to measure the effects of nursing interventions from 153 nursing students in South Korea. Nursing students selected NNN using a Web-based nursing process documentation system. Data were analyzed by paired t-test. Eighty-two NANDA-I diagnoses, 116 NOC outcomes, and 163 NIC interventions were identified. Statistically significant differences in patients' preintervention and postintervention outcome scores were observed. By determining patient outcomes linked to interventions and how the degree of outcomes change after interventions, the effectiveness of the interventions can be evaluated. © 2014 NANDA International, Inc.

  13. The effect of nursing management development program on clinical competency in coronary care unit

    Directory of Open Access Journals (Sweden)

    Ali Akbar Vaezi

    2011-03-01

    Full Text Available Background: Nurses are the main members in nursing cares and nursing managers can improve their clinical competency by applying better leadership skills. This study carried out to determine the effect of nursing management program on clinical competency of nurses in a coronary care unit (CCU.Methods: A quasi-experimental study was carried out in two educational hospitals in Yazd- Iran. These hospitals were allocated randomly in case and control hospitals. 25 matched nurses were selected by convenience sampling from both case and control hospitals. The clinical competency of nurses was measured by related questioners consisted of two dimensions caring and care management behaviors by self-evaluation and head nurse evaluation in case and control groups. Then, the intervention was implemented in four stages including nurse's development, managers' development, adaptation and supervision period during four months in the case group. After intervention, clinical competency of nurses was measured in both groups.Results: The results showed that before intervention more than 80% of nurses in two groups was in the moderate clinical competency level and they were proficient based on Benner's skill acquisition model. After intervention, nurses' clinical competency improved to higher level in case group but it didn't change in control group (P<0.05. Conclusion: Creating necessary modifications in nursing environments through the management development program by head nurses may improve nurses' clinical competency.

  14. Economic analysis of the cost of Intensive Care Units

    Directory of Open Access Journals (Sweden)

    Mazetas D.

    2014-04-01

    Full Text Available The cost of Intensive Care Units has the greatest impact on overall medical costs and the overall cost for the health of a country and an increasing number of studies from around the world presenting the quantification of these costs. Aim: Review of the Economic Analysis of the Cost of Intensive Care Units. Method: Search was made in the SCOPUS, MEDLINE and CINAHL databases using the key-words “Intensive Care Units (ICU”, “Cost”, “Cost Analysis”, “Health Care Costs”, “Health Resources”, “ICU resources”. The study was based on articles published in English from 2000 to 2011 investigating the Economic Analysis of the Cost of Intensive Care Units. Results: The cost of ICU is a significant percentage of gross domestic product in developed countries. Most cost analysis studies that relate to plans that include the study of staff costs, duration of stay in the ICU, the clinical situations of hospitalized patients, engineering support, medications and diagnostic tests costing scales and in relation to the diagnostic criteria. Conclusions: most studies conclude that the remuneration of staff, particularly nurses, in the ICU is the largest cost of ICU, while for the duration of stay in the ICU results are conflicting. The analysis on the cost-effectiveness of ICU can help to better apply these findings to the therapeutic context of ICU.

  15. 危急重症科护士情绪智力与心理韧性的相关性研究%Relationship between emotional intelligence and resilience among emergency and ICU nurses

    Institute of Scientific and Technical Information of China (English)

    胡紫宜; 冯先琼; 张雨晨

    2016-01-01

    Objective To investigate the status quo and the relationship between emotional intelligence and resilience of emergency and ICU nurses in tertiary general hospitals in Chengdu. Methods A total of 660 emergency and ICU nurses were surveyed by a pack of questionnaires including the General Information Questionnaire, the Resilience Scale and the Wong and Law Emotional Intelligence Scale. Results The average total score of the resilience scale was 123.07 ±23.76 and the average item score of the resilience scale was 4.92±0.95. The average total score of the emotional intelligence scale was 58.69±8.74 and the average item score of the emotional intelligence scale was 3.67±0.55. The correlation coefficient between the emotional intelligence and the resilience was 0.62 (P<0.01). Three subdimensions of the emotional intelligence including the usage of emotion, the appraisal of self-emotion, the regulation of emotion and the positions of nurses accounted for 43.3%of the variances of the resilience. Conclusions Emotional intelligence played an important role in affecting the psychological resilience of emergency and ICU nurses in tertiary general hospitals in Chengdu, it could positively predict the resilience of nurses.%目的:了解成都市三级甲等综合医院危急重症科护士的情绪智力与心理韧性的现状,探讨二者之间的关系。方法以成都市三级甲等综合医院660名急危重症科护士作为研究对象,运用一般资料调查表、情绪智力量表和心理韧性量表进行问卷调查。结果护士心理韧性总均分为(123.07±23.76)分,条目总均分为(4.92±0.95)分;情绪智力总均分为(58.69±8.74)分,条目总均分为(3.67±0.55)分;情绪智力总分与心理韧性总分的相关系数为0.62,P<0.01。情绪运用、自我情绪监测、情绪调节和护士工作岗位四者共同可解释心理韧性变异量的43.3%。结论情绪智力是影响成都市三级甲等综合医

  16. Study on the relationship among job stress, job burnout and organizational commitment in ICU nurses%ICU护士工作压力源、疲溃感与组织承诺的相关性研究

    Institute of Scientific and Technical Information of China (English)

    刘晔; 陈菲菲; 杨敏

    2016-01-01

    Objective To investigate the current working status and explore the relationship among job stress, job burnout and organizational commitment in ICU nurses. Methods By using cluster random sampling method, 233 nurses from 5 general hospitals were selected to accept investigation by Commitment Questionnaire and Nurses' general situation questionnaire. Results The job stress and job burnout were both significant negatively correlated with organizational commitment (r=-0.33, P<0.01;r=-0.22, P < 0.01).The management issues and interpersonal relationships and decreased personal accomplishment both had significant impact on affective commitment and continuance commitment of ICU nurses (r=0.539, P < 0.01; r=0.387, P < 0.01). The management issues and interpersonal relationships, professional and career issues and emotional exhaustion had significant predictive power on normative commitment(r=0.458,P < 0.01). Conclusion It generally was in a higher level of job stress in ICU nurses, which indicates that hospital mangers should try to eliminate the causes ,assist them to reduce job stress and relieve the job burnout.%目的:了解ICU护士的工作状况,探讨ICU护士工作压力源、疲溃感与组织承诺之间的关系。方法采用整群随机抽样方法,对山东省济南市5所综合性医院的233名在职ICU护士,通过护士工作压力源量表、工作疲溃感量表、组织承诺量表及护士一般情况调查表进行问卷调查。结果 ICU护士工作压力源与组织承诺呈显著负相关(r=-0.33,P<0.01);工作疲溃感与组织承诺呈显著负相关(r=-0.22,P<0.01)。管理及人际关系方面的问题和个人工作无成就感与护士的情感承诺呈显著正相关(r=0.539,P<0.01);管理及人际关系方面的问题、情绪衰竭感和个人工作无成就感护士的继续承诺呈显著正相关(r=0.387,P<0.01);管理及人际关系方面的问题、护理专业及工作方面问题和

  17. Nursing education and international health in the United States, Latin America, and the Caribbean.

    Science.gov (United States)

    da Gloria Miotto Wright, M; Godue, C; Manfredi, M; Korniewicz, D M

    1998-01-01

    To identify international health activities in United States, Latin American, and Caribbean schools of nursing. In the international community, nurses face challenges similar to those in related professions, but without the benefit of a long tradition. There is little research about how nursing education and associated activities prepare nurses to deal with international health, and little information about the extent of international health activities in U.S. schools of nursing. Descriptive. Using a questionnaire with 16 items, a survey was conducted in 1995 on a random sample of representatives from 100 university schools of nursing in the United States plus 15 schools with known international activities (10 from the United States and 5 from Latin America and the Caribbean). International health as a program topic was found in one-third of U.S. schools of nursing. However, nursing curriculums do not integrate international health with other subjects. Also, partnerships with foreign institutions are incipient and international health activities are usually individual initiatives with little institutional support. For nurses to become major contributors to international health, nursing curriculum content must shift from "international nursing" to "international health." Programs of nursing education should include study of social, economic, and political factors that affect health care systems. Schools should develop partnership agreements.

  18. Factors that guide nurse managers regarding the staffing of agency nurses in intensive care units at private hospitals in Pretoria

    Directory of Open Access Journals (Sweden)

    Karien Jooste

    2013-01-01

    Full Text Available Staffing needs affect the nursing department’s budget, staff productivity, the quality of care provided to patients and even the retention of nurses. It is unclear how the role players (the nursing agency manager, the nurse manager and the agency nurse perceive the staffing of agency nurses in intensive care units (ICUs. The purpose of this study was to explore and describe the factors that guide nurse managers regarding the staffing of agency nurses in ICUs at private hospitals in Pretoria. A quantitative exploratory and descriptive design was used. A survey by means of a structured questionnaire was carried out. Probability sampling was implemented to obtain a study sample (n = 124. One similar self-administered 5-point scale instrument was completed by the participants. Data was analysed by means of descriptive and inferential statistics. The principles of validity and reliability were adhered to and ethical considerations were also taken into account. The results indicated limitations in the determining of posts, recruitment and advertising, as well as the selection and appointment of agency nurses in ICUs at private hospitals in Pretoria. Recommendations on staffing are made to nurse managers in ICUs.

  19. Specific measures and analysis of requirements of emergency patients in need of psy-chological nursing in ICU%ICU急诊患者对心理护理的需求分析及具体措施

    Institute of Scientific and Technical Information of China (English)

    张华丽; 王媛; 卢晓娥

    2015-01-01

    Objective To evaluate the demand of emergency patients in need of psychological nursing in ICU and explore the measures of psychological nursing.Methods 445 cases of emergency patients, treated in the hospital from September 2012 to September 2013, were selected as the research object.The psychological care need was self-made.The analysis scale of the demand of psychological nursing was made by ourselves and at the same time questionnaire survey was carried out.The demand of psychological nursing before the be-ginning of psychological nursing was measured by using the MSSNS.The plan of targeted psychological nursing was made according to the content of the questionnaire and the effect of nursing was recorded.Results The results of the analysis scale of psychological nursing care showed that the patients needed the nurses'kind attitude and friendly greetings and the nurses could understand the patients.MSSNS scale showed that the negative psychological score of patients was (85.13±10.92)%, including the sub item score inside, which was at a rela-tively high level.The effect of nursing showed that the average of the total time of psychological nursing that the patients received was (81.4±7.1) min and the times of psychological nursing was (1.97±0.32) times.After the effective psychological nursing, the MSSNS scores of patients decreased to (62.32±8.51)%, including the sub item score, which was significantly lower than before (P<0.05) and there was statistical significance.Conclusions Patients in ICU have high demand for psychological nursing, and nursing staff needs to make a effective plan of psychological nursing to deal with the treatment.%目的:评价 ICU急诊患者对心理护理的需求,并探讨具体的心理护理措施。方法以2012年9月至2013年9月间入住我院ICU的445例急诊患者为研究对象,自制心理护理需求分析量表,同时利用MSSNS(非精神科住院患者心理状态评定量表)进行问卷调查,统计

  20. ICU护士岗位轮换认知、角色压力与工作满意度的相关性分析%Relationships among job rotation, role stress and job satisfaction in ICU nurses

    Institute of Scientific and Technical Information of China (English)

    胡少华; 李伦兰; 徐凤玲; 张庆娜

    2015-01-01

    目的:探讨ICU护士岗位轮换认知、角色压力与工作满意度的相关性。方法采用问卷调查的方法,应用一般资料问卷、台湾学者Wen-Hsien修订的护士岗位轮换认知量表、角色压力量表、工作满意度量表对某三级甲等医院156名ICU护士进行问卷调查,以分析不同人口学特征、岗位轮换认知、角色压力与工作满意度的关系。结果共发放问卷159份,收回有效问卷155份,有效回收率为97%。 ICU护士工作满意度平均得分为(65.80±10.03)分,各维度得分院内在满意度为(18.68±3.69)分,价值承诺为(15.78±2.70)分,努力承诺为(16.75±2.44)分,留职承诺为(14.59±2.94)分;护士的学历不同,工作满意度不同(P<0.01);不同婚姻状况、不同科室的护士工作满意度不同(P<0.05);岗位轮换认知与工作满意度呈显著正相关(P<0.01),角色负荷与工作满意度呈负相关(P<0.01)。结论护理管理者应重视对ICU护士岗位轮换认知及角色压力的评价;合理规划ICU护士的岗位轮换,提高护士对于岗位轮换的正向认知,促进岗位轮换益处的发挥;调节和疏散护士角色压力,提高护士工作满意度。%Objective To investigate the relationship among job rotation cognition, role stress and job satisfaction in ICU nurses. Methods 156 ICU nurses were investigated with general information questionnaire, job rotation scale, role stress scale and job satisfaction scale revised by Wen-Hsien. The relationships among different demographics of nurses, job rotation, role stress and job satisfaction were analyzed. Results There were 159 questionnaires, 155 valid question-naires taken back, the effective recovery rate was 97%. The average score of job satisfaction was (65.80±10.03) points, each dimension scores:internal satisfaction was (18.68±3.69) points, value commitment was (15.78±2.70) points, hard promises was (16.75±2.44) points, retention commitment

  1. Determining the economic cost of ICU treatment: a prospective "micro-costing" study.

    LENUS (Irish Health Repository)

    McLaughlin, Anne Marie

    2009-12-01

    To prospectively assess the cost of patients in an adult intensive care unit (ICU) using bottom-up costing methodology and evaluate the usefulness of "severity of illness" scores in estimating ICU cost.

  2. Alarm setting for the critically ill patient: a descriptive pilot survey of nurses' perceptions of current practice in an Australian Regional Critical Care Unit.

    Science.gov (United States)

    Christensen, Martin; Dodds, Andrew; Sauer, Josh; Watts, Nigel

    2014-08-01

    The aim of this survey was to assess registered nurse's perceptions of alarm setting and management in an Australian Regional Critical Care Unit. The setting and management of alarms within the critical care environment is one of the key responsibilities of the nurse in this area. However, with up to 99% of alarms potentially being false-positives it is easy for the nurse to become desensitised or fatigued by incessant alarms; in some cases up to 400 per patient per day. Inadvertently ignoring, silencing or disabling alarms can have deleterious implications for the patient and nurse. A total population sample of 48 nursing staff from a 13 bedded ICU/HDU/CCU within regional Australia were asked to participate. A 10 item open-ended and multiple choice questionnaire was distributed to determine their perceptions and attitudes of alarm setting and management within this clinical area. Two key themes were identified from the open-ended questions: attitudes towards inappropriate alarm settings and annoyance at delayed responses to alarms. A significant number of respondents (93%) agreed that alarm fatigue can result in alarm desensitisation and the disabling of alarms, whilst 81% suggested the key factors are those associated with false-positive alarms and inappropriately set alarms. This study contributes to what is known about alarm fatigue, setting and management within a critical care environment. In addition it gives an insight as to what nurses' within a regional context consider the key factors which contribute to alarm fatigue. Clearly nursing burnout and potential patient harm are important considerations for practice especially when confronted with alarm fatigue and desensitisation. Therefore, promoting and maintaining an environment of ongoing intra-professional communication and alarm surveillance are crucial in alleviating these potential problems. Copyright © 2014. Published by Elsevier Ltd.

  3. Health Occupations Curriculum. Skills and Theory for Practical Nurse. Units 18, 19, and 20.

    Science.gov (United States)

    Arizona State Dept. of Education, Phoenix.

    Part of a health occupations program, these instructional units consist of materials for use by those who are studying to become practical nurses. Covered in the units are the following: the nursing care of mothers and newborns (obstetrics, prenatal care and complications, patient needs, care of the newborn, prematurity, medications, and cultural…

  4. Perceptions of a Primary Nursing Care Model in a Pediatric Hematology/Oncology Unit.

    Science.gov (United States)

    Nadeau, Katie; Pinner, Kerri; Murphy, Katie; Belderson, Kristin M

    2016-02-22

    The primary nursing care model optimizes relationship-based care. Despite using a primary nursing model on a pediatric hematology/oncology inpatient unit, it was hypothesized patients and nurses were dissatisfied with the structure of primary care teams and inconsistency of primary assignments. The purpose of this study was to evaluate patient/family and nurse perceptions of our current care model through assessing gaps in its operationalization and satisfaction. This study used a descriptive cross-sectional design featuring patient/family and nurse surveys. Of the 59 patient/family respondents, 93.2% prefer to have a primary nurse care for them and 85% are satisfied with how often they are assigned a primary care team member. Similarly, 63% of the 57 nurse respondents are satisfied with the current implementation of our primary nursing model and 61% state the model reflects good continuity of care. Yet 80.7% of nurses believe safety would improve for a patient whose nurse works shifts consecutively even if not a primary nurse. Overall, patients, families, and nurses value care continuity and meaningful nurse-patient relationships, which is fundamental to primary nursing.

  5. Linking nursing unit's culture to organizational effectiveness: a measurement tool.

    Science.gov (United States)

    Casida, Jesus

    2008-01-01

    Organizational culture consists of the deep underlying assumptions, beliefs, and values that are shared by members of the organization and typically operate unconsciously. The four organizational culture traits of the Denison Organizational Culture Model (DOCM) are characteristics of organizational effectiveness, which include adaptability, involvement, consistency, and mission. Effective organizations demonstrate high levels of the four cultural traits which reflect their ability to balance the dynamic tension between the need for stability and the need for flexibility within the organization. The Denison Organizational Culture Survey (DOCS) is a measurement tool that was founded on the theoretical framework of the DOCM, and in the field of business, is one of the most commonly used tools for measuring organizational culture. The DOCS offers a promising approach to operationalizing and measuring the link between organizational culture and organizational effectiveness in the context of nursing units.

  6. Fluctuations in sedation levels may contribute to delirium in ICU patients

    DEFF Research Database (Denmark)

    Svenningsen, H; Egerod, Ingrid Eugenie; Videbech, P;

    2013-01-01

    Delirium in patients admitted to the intensive care unit (ICU) is a serious complication potentially increasing morbidity and mortality. The aim of this study was to investigate the impact of fluctuating sedation levels on the incidence of delirium in ICU.......Delirium in patients admitted to the intensive care unit (ICU) is a serious complication potentially increasing morbidity and mortality. The aim of this study was to investigate the impact of fluctuating sedation levels on the incidence of delirium in ICU....

  7. Cluster the comprehensive prevention ICU nursing the patients' negative mood disorder in clinicalresearch%集束化综合护理预防ICU老年患者术后负面情绪障碍的临床研究

    Institute of Scientific and Technical Information of China (English)

    逯文巧; 刘茜; 侯杰; 万莹; 冯冉

    2015-01-01

    目的 研究分析集束化综合护理在预防ICU老年患者术后负面情绪障碍上的应用.方法 回顾性分析2014年1月1日~2015年1月31日经心外科手术后收治ICU的120例老年患者纳入研究范围,均把患者分成实验组(60例)与对照组(60例).以常规护理结合集束化综合护理对实验组进行预后管理,对照组则只进行常规护理,记录护理前后数据,比较两组的焦虑评分、抑郁评分以及舒张压、收缩压及心律的变化情况.结果 两组患者经术后护理,负面情绪障碍及生理指标均比护理前有所提高,而实验组的焦虑评分及抑郁评分小于对照组(P<0.05),实验组的心率、收缩压及舒张压均优于对照组(P<0.05).结论 集束化综合护理可有效预防ICU老年患者术后负面情绪障碍,改善各项生理指标,值得在临床应用中进一步推广.%Objective To analysis of cluster the comprehensive care in elderly patients with postoperative prevention ICU in the application of negative mood disorders.Methods Select on January 1,2014 to January 31,2015,after cardiac surgery in 120 cases of elderly patients of ICU in research scope,the patients randomly divided into experimental group (60 c.ases) and control group (60 cases).With routine nursing in combination with cluster comprehensive care to prognosis of the experimental group management,the control group only routine nursing,nursing record data before and after comparison of two groups of anxiety score,depression score,and the change of diastolic and systolic blood pressure and heart rate.Results Two groups of patients with postoperative nursing,negative mood disorders and physiological indexes than before treatment,the scores of anxiety in the experimental group and depression score is less than the control group (P< 0.05),the experimental group of heart rate and systolic blood pressure and diastolic blood pressure are better than that of control group (P< 0.05).Conclusion

  8. Early rehabilitation using a passive cycle ergometer on muscle morphology in mechanically ventilated critically ill patients in the Intensive Care Unit (MoVe-ICU study): study protocol for a randomized controlled trial.

    Science.gov (United States)

    dos Santos, Laura Jurema; de Aguiar Lemos, Fernando; Bianchi, Tanara; Sachetti, Amanda; Dall' Acqua, Ana Maria; da Silva Naue, Wagner; Dias, Alexandre Simões; Vieira, Silvia Regina Rios

    2015-08-28

    Patients in Intensive Care Units (ICU) are often exposed to prolonged immobilization which, in turn, plays an important role in neuromuscular complications. Exercise with a cycle ergometer is a treatment option that can be used to improve the rehabilitation of patients on mechanical ventilation (MV) in order to minimize the harmful effects of immobility. A single-blind randomized controlled trial (the MoVe ICU study) will be conducted to evaluate and compare the effects of early rehabilitation using a bedside cycle ergometer with conventional physical therapy on the muscle morphology of the knee extensors and diaphragm in critical ill patients receiving MV. A total of 28 adult patients will be recruited for this study from among those admitted to the intensive care department at the Hospital de Clínicas de Porto Alegre. Eligible patients will be treated with MV from a period of 24 to 48 h, will have spent maximum of 1 week in hospital and will not exhibit any characteristics restricting lower extremity mobility. These subjects will be randomized to receive either conventional physiotherapy or conventional physiotherapy with an additional cycle ergometer intervention. The intervention will be administered passively for 20 min, at 20 revolutions per minute (rpm), once per day, 7 days a week, throughout the time the patients remain on MV. Outcomes will be cross-sectional quadriceps thickness, length of fascicle, pennation angle of fascicles, thickness of vastus lateralis muscle, diaphragm thickness and excursion of critical ICU patients on MV measured with ultrasound. The MoVe-ICU study will be the first randomized controlled trial to test the hypothesis that early rehabilitation with a passive cycle ergometer can preserve the morphology of knee extensors and diaphragm in critical patients on MV in ICUs. NCT02300662 (25 November 2014).

  9. Educação continuada da equipe de enfermagem nas UTIs do município de São Paulo Educación continua del equipo de enfermería en Unidades de Tratamiento Intensivo del municipio de São Paulo Continuing education of ICU nursing staff in São Paulo city

    Directory of Open Access Journals (Sweden)

    Maria Sumie Koizumi

    1998-07-01

    écnicas y rutinas y la atualizacción de patologias. Las actividades de educación continua son desarrolladas, predominantemente, por los enfermeros de las UTIs. 50,2% de los enfermeros respondieran haber frecuentado cursos de especialización o aprimoramiento en Enfermería Médico-Quirúrgica o en otras áreas. Frente a lo detectado y considerando el desarrollo del enfermero de UTI como el de un especialista, se presentan algunas sugestiones para el mejoramiento de las actividades de la educación continua en estas Unidades.This study is part of a project about ICU's characteristics in São Paulo city. This article describes the continuing education programs for nursing staff. 43 ICUs were analysed and the questionnaire answered by the ICU nurse cordinator was used to collect data. Results showed that 34 (79,1% of the ICUs have initial program for training each nursing staff category and 18 (41,9% had regular continuing education program focusing primarily on nursing procedures and routines and the update in pathologies. Continuing education programs are developed primarily by ICU's nurses. 50,2% of the nurses answered that they attended specialisation/ extension courses too, in Medical Surgical Nursing or in other areas or in both areas. Due to this result and the development of the ICU's nurses as specialists, some suggestions are presented to improve the continuing education program in these Units.

  10. Integrating quality and safety education into clinical nursing education through a dedicated education unit.

    Science.gov (United States)

    Masters, Kelli

    2016-03-01

    The Institute of Medicine and American Association of Colleges of Nursing are calling for curriculum redesign that prepares nursing students with the requisite knowledge and skills to provide safe, high quality care. The purpose of this project was to improve nursing students' knowledge of quality and safety by integrating Quality and Safety Education for Nurses into clinical nursing education through development of a dedicated education unit. This model, which pairs nursing students with front-line nursing staff for clinical experiences, was implemented on a medical floor in an acute care hospital. Prior to implementation, nurses and students were educated about the dedicated education unit and quality and safety competencies. During each clinical rotation, students collaborated with their nurses on projects related to these competencies. Students' knowledge was assessed using questions related to quality and safety. Students who participated in the dedicated education unit had higher scores than those with traditional clinical rotations. Focus groups were held mid-semester to assess nurses' perceptions of the experience. Five themes emerged from the qualitative data including thirsting for knowledge, building teamwork and collaboration, establishing trust and decreasing anxiety, mirroring organization and time management skills, and evolving confidence in the nursing role. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. As representações sociais dos trabalhadores de enfermagem não enfermeiros (técnicos e auxiliares de enfermagem sobre o trabalho em Unidade de Terapia Intensiva em um hospital-escola Las representaciones sociales del personal no enfermero (técnicos y auxiliares de enfermería sobre el trabajo en un Centro de Terapia Intensiva en un hospital ecuela Social representations of ICU auxiliary nursing personnel from a teaching hospital about their practice

    Directory of Open Access Journals (Sweden)

    Helena Eri Shimizu

    2002-06-01

    Full Text Available Este estudo tem como objetivos conhecer as representações sociais dos trabalhadores de enfermagem não enfermeiros acerca do trabalho na UTI, os modos de expressão do sofrimento e prazer e as formas de enfrentamento do sofrimento ligados a esse trabalho. Adota como referencial teórico-metodológico a Teoria das Representações Sociais. Os dados são obtidos por meio de entrevistas semi-estruturadas e analisados com a técnica de análise de conteúdo, especificamente, a análise de enunciação. As representações evidenciam que, para suportarem a dor, o sofrimento e a morte do paciente, utilizam-se de diversos mecanismos individuais de defesa, classicamente descritos pela Psicopatologia e pela Psicanálise.El objetivo de este estudio es conocer las representaciones sociales del personal no enfermero sobre el trabajo en el Centro de Terapia Intensiva, los modos de expresión del sufrimiento y el placer y las formas de el sufrimiento relacionados a esse trabajo. Adopta como referencia teórica-meodológica la Teoria de las Representaciones Sociales. Los datos fueron obtenidos mediante entrevistas semiestructuradas y analizados com la técnica del análisis de contenido, más exactamente, el análisis de enunciación. Las representaciones demuestran que, para soportar el dolor, el sufrimiento y la muerte del paciente, los técnicos y auxiliares de enfermeria se valen de diversos mecanismos individuales de defensa, clásicamente descritos por la psicopatología y psicoanálisis.The study identifies and analyses social representations of Intensive Care Unit (ICU nursing staff about their work and how they express feelings of sorrow and pleasure associated to their job. The theoretical and methodological reference used by this study was the Theory of Social Representations. Interviews were carried out with auxiliary nursing personnel (licensed practical nurse and nurse technician. The data were analyzed by analysis-of-content technique, in

  12. ICU早期预警评分对护理工作的指导作用%STUDY ON THE ICU EARLY WARNING SCORE IN NURSING

    Institute of Scientific and Technical Information of China (English)

    刘海霞

    2011-01-01

    早期对患者心事、收缩压、呼吸频率、体温和意识进行评分(早期预警评分),一旦分值达到一定标准,即可进行积极的医疗处置.适合广大医护人员客观及时地对患者的病情进行评估,及时采取干预措施,防范延误病情.%Early evaluating on the patient's heart rate, systolic blood pressure respiratory rate, body temperature and consciousness could provide information for active medical treatment. The ICU early warning score could paly a role in evaluating the disease. So we can evaluate the patient's condition in time and objectively, so that to prevent the occurrence of disease.

  13. The investigation of anxiety level in ICU nurse%重症监护室护士的焦虑抑郁情绪调查及对策

    Institute of Scientific and Technical Information of China (English)

    金莉红; 金玉莲; 邱寿珠; 金茹

    2004-01-01

    目的了解重症监护室(ICU)护士情绪状态.方法采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、艾森克个性调查表(EPQ)对ICU护士其他科护士作问卷调查.结果ICU护士焦虑抑郁高于其他科护士.结论ICU护士存在较明显的负性情绪,须引起护理管理者的高度重视,以保护ICU护士的心身健康.

  14. ICU-Acquired Weakness.

    Science.gov (United States)

    Jolley, Sarah E; Bunnell, Aaron E; Hough, Catherine L

    2016-11-01

    Survivorship after critical illness is an increasingly important health-care concern as ICU use continues to increase while ICU mortality is decreasing. Survivors of critical illness experience marked disability and impairments in physical and cognitive function that persist for years after their initial ICU stay. Newfound impairment is associated with increased health-care costs and use, reductions in health-related quality of life, and prolonged unemployment. Weakness, critical illness neuropathy and/or myopathy, and muscle atrophy are common in patients who are critically ill, with up to 80% of patients admitted to the ICU developing some form of neuromuscular dysfunction. ICU-acquired weakness (ICUAW) is associated with longer durations of mechanical ventilation and hospitalization, along with greater functional impairment for survivors. Although there is increasing recognition of ICUAW as a clinical entity, significant knowledge gaps exist concerning identifying patients at high risk for its development and understanding its role in long-term outcomes after critical illness. This review addresses the epidemiologic and pathophysiologic aspects of ICUAW; highlights the diagnostic challenges associated with its diagnosis in patients who are critically ill; and proposes, to our knowledge, a novel strategy for identifying ICUAW. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  15. The impact of ICU nurses' preoperative visit on treatment compliance of patients after lung transplantation%ICU护士术前访视对肺移植患者术后遵医行为的影响

    Institute of Scientific and Technical Information of China (English)

    王芳; 黄云娟; 许正红; 朱亭立; 黄琴红; 陈静瑜; 王俏英; 王玲秀

    2014-01-01

    Objective:To investigate the effects of preoperative visit on treatment compliance of patients after lung transplantation. Methods:Forty-two cases of lung transplant patients were enrolled and randomly divided into observation group and control group. And the observation group were interviewed before operation in ICU, the control group underwent routine preoperative preparation and education. Compliance was measured after operation. Results:Treatment compliance of observation group in the ifrst day and third day were 94.1%and 88.2%, and that in the control group was 88.0%and 84.0%, which showed a signiifcant difference between the two groups (P<0.05). Conclusion:ICU nurses' preoperative visits can effectively enhance the compliance of patients.%目的:探讨术前访视对肺移植患者术后遵医行为的影响。方法:将42例肺移植患者随机分为观察组和对照组,观察组接受ICU护士术前访视,对照组行常规术前准备及宣教,测评并比较患者术后遵医行为。结果:观察组术后第1天及第3天遵医率分别为94.1%、88.2%,对照组术后第1天及第3天遵医率分别为88.0%、84.0%,观察组遵医率高于对照组,差异有统计学意义(P<0.05)。结论:ICU护士术前访视能有效改善肺移植患者术后遵医行为。

  16. Effects of nursing unit spatial layout on nursing team communication patterns, quality of care, and patient safety.

    Science.gov (United States)

    Hua, Ying; Becker, Franklin; Wurmser, Teri; Bliss-Holtz, Jane; Hedges, Christine

    2012-01-01

    Studies investigating factors contributing to improved quality of care have found that effective team member communication is among the most critical and influential aspects in the delivery of quality care. Relatively little research has examined the role of the physical design of nursing units on communication patterns among care providers. Although the concept of decentralized unit design is intended to increase patient safety, reduce nurse fatigue, and control the noisy, chaotic, and crowded space associated with centralized nursing stations, until recently little attention has been paid to how such nursing unit designs affected communication patterns or other medical and organizational outcomes. Using a pre/post research design comparing more centralized or decentralized unit designs with a new multi-hub design, the aim of this study was to describe the relationship between the clinical spatial environment and its effect on communication patterns, nurse satisfaction, distance walked, organizational outcomes, patient safety, and patient satisfaction. Hospital institutional data indicated that patient satisfaction increased substantially. Few significant changes were found in communication patterns; no significant changes were found in nurse job satisfaction, patient falls, pressure ulcers, or organizational outcomes such as average length of stay or patient census.

  17. Real-time feedback for improving compliance to hand sanitization among healthcare workers in an open layout ICU using radiofrequency identification.

    Science.gov (United States)

    Radhakrishna, Kedar; Waghmare, Abijeet; Ekstrand, Maria; Raj, Tony; Selvam, Sumithra; Sreerama, Sai Madhukar; Sampath, Sriram

    2015-06-01

    The aim of this study is to increase hand sanitizer usage among healthcare workers by developing and implementing a low-cost intervention using RFID and wireless mesh networks to provide real-time alarms for increasing hand hygiene compliance during opportune moments in an open layout Intensive Care Unit (ICU). A wireless, RFID based system was developed and implemented in the ICU. The ICU beds were divded into an intervention arm (n = 10) and a control arm (n = 14). Passive RFID tags were issued to the doctors, nurses and support staff of the ICU. Long range RFID readers were positioned strategically. Sensors were placed beneath the hand sanitizers to record sanitizer usage. The system would alert the HCWs by flashing a light if an opportune moment for hand sanitization was detected. A significant increase in hand sanitizer use was noted in the intervention arm. Usage was highest during the early part of the workday and decreased as the day progressed. Hand wash events per person hour was highest among the ancilliary staff followed by the doctors and nurses. Real-time feedback has potential to increase hand hygiene compliance among HCWs. The system demonstrates the possibility of automating compliance monitoring in an ICU with an open layout.

  18. Hospital mortality is associated with ICU admission time

    NARCIS (Netherlands)

    Kuijsten, H.A.J.M.; Brinkman, S.; Meynaar, I.A.; Spronk, P.E.; van der Spoel, J.I.; Bosman, R.J.; de Keizer, N.F.; Abu-Hanna, A.; de Lange, D.W.

    2010-01-01

    Previous studies have shown that patients admitted to the intensive care unit (ICU) after "office hours" are more likely to die. However these results have been challenged by numerous other studies. We therefore analysed this possible relationship between ICU admission time and in-hospital mortality

  19. Sleep disturbances in critically ill patients in ICU

    DEFF Research Database (Denmark)

    Boyko, Yuliya; Ording, H; Jennum, P

    2012-01-01

    Sleep disturbances in the intensive care unit (ICU) seem to lead to development of delirium, prolonged ICU stay, and increased mortality. That is why sufficient sleep is important for good outcome and recovery in critically ill patients. A variety of small studies reveal pathological sleep patterns...

  20. ICU 患者 MRSA 定植与感染的危险因素研究%Risk factors for colonization/infection of methicillin-resistant Staphylo-coccus aureus in intensive care unit patients

    Institute of Scientific and Technical Information of China (English)

    范珊红; 李颖; 戈伟; 许文; 慕彩妮; 李谨革

    2015-01-01

    Objective To compare the colonization/infection of methicillin-resistant Staphylococcus aureus (MR-SA)in patients in intensive care unit (ICU),respiratory ICU (RICU)and neurosurgical ICU(NSICU),so as to find out the risk factors for MRSA colonization/infection in patients.Methods A prospective method was used for this study,data of all patients admitted to three ICUs between May 1 and July 31,2013 were collected,specimens of nasal swabs of patients and health care workers (HCWs),as well as specimens of patients’surroundings were taken and per-formed MRSA detection.Results The average colonization rate of MRSA in 197 patients at three ICUs was 11.17%,22 MRSA strains were isolated,the colonization rate in ICU,RICU and NSICU patients was 4.00%,11.90% and 15.87%respectively,no significant difference was found among different ICU groups (χ2 =4.04,P =0.133).The detection rate of MRSA from patients was 2.03% (4/197),colonization rate of MRSA in HCWs’nasal vestibule was 1.72%(2/116).De-tection rate of MRSA from surroundings of patients with MRSA colonization was higher than that without MRSA coloniza-tion (22.73%[5/22]vs 4.00%[7/175],χ2 =8.93,P =0.003).Multivariate logistic regression analysis indicated that pa-tients aged ≥60 years,invasive procedures,long length of ICU stay,and recent antimicrobial use were independent risk factors for MRSA colonization/infection.Conclusion Patients in ICU should be screened for MRSA colonization,ef-fective measures should be taken to avoid MRSA transmission between hospital and patients;invasive procedures should be minimized,length of ICU stay should be shortened,antimicrobial agents should be used rationally,so as to reduce MRSA colonization and infection in ICU patients.%目的:比较重症监护室(ICU)、呼吸内科监护室(RICU)和神经外科监护室(NSICU)耐甲氧西林金黄色葡萄球菌(MRSA)定植与感染状况,探讨患者 MRSA 定植/感染的危险因素。方法采用前瞻

  1. STRESS AND SELF EFFICACY AMONG NURSES IN NEONATAL INTENSIVE CARE UNITS

    OpenAIRE

    Rehab Hani Elkazaz; Abeer Elsayed Berma

    2017-01-01

    Stress is one of the main factors affecting one's efficiency as well as staff health and quality of nursing services. Neonatal   units   can be stressful environments for nurses, infants and families as well. Since there is no evidence in this regard in Egypt. Aim of the study: to determine the relationship between stress and self-efficacy among staff nurses in neonatal intensive care units (NICU) in Port Said. Method: This was a descriptive correlation study including thirty three nurses wor...

  2. An interactive web-based learning unit to facilitate and improve intrapartum nursing care of nursing students.

    Science.gov (United States)

    Gerdprasert, Sailom; Pruksacheva, Tassanee; Panijpan, Bhinyo; Ruenwongsa, Pintip

    2011-07-01

    First clinical exposures are stressful situations for nursing students, especially, when practicing on the labour ward. The purpose of this study was to develop intrapartum nursing care web-based learning to facilitate students' acquisition of conceptual knowledge and performance skills. This web-based learning unit integrated the 5E-model and information technology with the lecture content. Eighty four nursing students were recruited in the study. The control group received traditional teaching, while the experimental group was supplemented with the web-based learning unit on intrapartum nursing care. The results showed that the students in the experimental group had significant higher scores in conceptual knowledge and performance skill. The students also had significant lower scores in ignorance - related stress when compared to those of the control group. The students supplemented with the web-based course showed a strong positive attitude toward the new learning method.

  3. End-of-life attitudes in the Intensive Care Unit (ICU) amongst final year medical students at International Medical University, Malaysia

    OpenAIRE

    Sangeetha Poovaneswaran; Anuradha Poovaneswaran; hiruselvi Subramaniam

    2014-01-01

    With recent medical advances and the availability of newer sophisticated technologies, critically ill patients tend to survive longer.1 Thus, decisions to forgo life-sustaining medical treatment generate challenging issues that all doctors must face. The aim of this pilot study was to assess attitudes towards end-of-life care in ICU which included futile therapy (withholding and withdrawing therapy) among final year medical students who had received the same degr...

  4. Retrospective analysis of monitoring of death patients and the time of death and nursing countermeasures in ICU%ICU死亡患者监护、死亡时间的回顾性分析及护理对策

    Institute of Scientific and Technical Information of China (English)

    许春娟; 王敏

    2013-01-01

    目的 分析ICU死亡患者的监护时间,探索监护时间的影响因素,并提出护理对策.分析患者的死亡时间分布,预见性地做好救护防范措施.方法 对2011年7月至2012年7月ICU病房52例死亡患者的病史资料进行回顾性分析.结果 特护时间≤1d、特护时间2~7d以及特护时间>7d的3组患者院内感染发生率及病死率比较差异有统计学意义(x2 =6.741,P<0.05).特护时间越长,院感发生率越高.白班与夜班病死人数差异无统计学意义(P>0.05),但死亡时间集中于各班交班后的2h内.结论 管理者应积极主动采取有效措施,预防院内感染的发生.规范ICU准入与准出标准,控制ICU患者停留时间,从而降低感染率与死亡率.本研究中患者死亡时间在交接班时间段呈集中趋势,应采取相应的治疗护理对策,加大护理力度,及时发现病情变化,减少患者死亡.%Objective To analyze the ICU death patient monitoring time,to explore the impact factors of time monitoring and put forward nursing countermeasures ; To analyze the distribution of death time of the patients and make preventive measures.Methods The medical history and the data of 52 death patients from July 2011 to July 2012 were retrospectively analyzed.Results The incidence and mortality of nosocomial infection in the three groups patients including intensive care time ≤ 1 day,from 2 to 7 days and ≥7 days were different,and the difference was statistically significant (x2 =6.741,P < 0.05).The longer intensive care time,the higher incidence and mortality of nosocomial infection.The death cases were similar in the day shift and night shift,and the difference was not statistically significant (P > 0.05).The time of death focus on each class after hand-over 2 hours.Conclusions Managers should take effective measures to prevent the occurrence of nosocomial infection.To standardize access and exit in ICU and to control the residence time of ICU patients

  5. Frequency of nosocomial pneumonia in ICU Qazvin Razi hospital (2013

    Directory of Open Access Journals (Sweden)

    S. Makhlogi

    2016-12-01

    Full Text Available Background: Nosocomial pneumonia is the most prevalent cause of hospital-acquired infection in intensive care units (ICU. The aim of this research was to detect the frequency and predisposing factors of nosocomial Ventilator Associated Pneumonia, by cross sectional study on 188 patients that were hospitalized in ICU Qazvin Razi Hospital. Using questionnaire based on the national nosocomial infection surveillance system (NNIS data collected and analyzed. The average age of patients was 51±24 years old, 37 hospitalized patients (19/6% in the fourth day of admission were affected Ventilator Associated Pneumonia. The most common pathogenesis of causing nosocomial pneumonia were klebsiella in 13 patients (35/1%, staph in 8 patients (21/6%, sodomona in 8 patients (21/6%, ecoli in 3 patients (8/1%, cetrobacter in 2 patients (5/4%, antrococus and Proteus each of them in 1 patient (each 2/7%. Considering (19/6% frequency of nosocomial pneumonia in this study, it’s necessary to act standard protocols in nursing care and medication process.

  6. Viewing eCare through Nurses' Eyes: A Phenomenological Study

    Science.gov (United States)

    Willey, Jeffrey Allan

    2013-01-01

    Published research suggests that the future of health care will be dependent on new technologies that serve to decrease the need for increased numbers of critical-care nurses while also increasing the quality of patient care delivery. The eCare technology is one technology that provides this service in the intensive care unit (ICU) setting. The…

  7. Viewing eCare through Nurses' Eyes: A Phenomenological Study

    Science.gov (United States)

    Willey, Jeffrey Allan

    2013-01-01

    Published research suggests that the future of health care will be dependent on new technologies that serve to decrease the need for increased numbers of critical-care nurses while also increasing the quality of patient care delivery. The eCare technology is one technology that provides this service in the intensive care unit (ICU) setting. The…

  8. Media images of physicians and nurses in the United States.

    Science.gov (United States)

    Krantzler, N J

    1986-01-01

    This paper analyzes images of physicians and nurses presented in advertisements in the medical and nursing journals JAMA (Journal of the American Medical Association) and AJN (American Journal of Nursing). Advertisements are viewed as hyper-ritualized displays of symbols and rituals associated with medical and nursing practice, both reflecting and reaffirming stereotypes and beliefs that are widely held in the society at large. Trends over the past few decades show that medical advertisements are dropping some traditional symbols (such as the white coat and stethoscope) in favor of depicting science-in-action and high technology. Nursing advertisements, however, are more frequently utilizing the symbols formerly reserved for physicians. Both physicians and nurses are depicted in their respective journals as existing largely independent of one another. While these advertisements clearly do not depict social reality, they present a fictionalized version which reflects and reproduces some of the expressed ideals in medical and nursing practice.

  9. The Burnout on Nurses in ICU, Emergency and Surgery at Teaching Hospital Mazandaran University of Medical Sciences and Relationship with Perceived Stress

    Directory of Open Access Journals (Sweden)

    MK Fakhri

    2015-05-01

    Conclusion: assessment practices a key role in moderating the effects of stress in the workplace has been the experience, Therefore, identifying individuals who are perceived negative job stress In order to change their negative assessment of the situation causing stress in the workplace can reduce burnout and improve the quality of nursing care.

  10. Association of Nursing Overtime, Nurse Staffing, and Unit Occupancy with Health Care-Associated Infections in the NICU.

    Science.gov (United States)

    Beltempo, Marc; Blais, Régis; Lacroix, Guy; Cabot, Michèle; Piedboeuf, Bruno

    2017-08-01

    Objective This study aims to assess the association of nursing overtime, nurse staffing, and unit occupancy with health care-associated infections (HCAIs) in the neonatal intensive care unit (NICU). Study Design A 2-year retrospective cohort study was conducted for 2,236 infants admitted in a Canadian tertiary care, 51-bed NICU. Daily administrative data were obtained from the database "Logibec" and combined to the patient outcomes database. Median values for the nursing overtime hours/total hours worked ratio, the available to recommended nurse staffing ratio, and the unit occupancy rate over 3-day periods before HCAI were compared with days that did not precede infections. Adjusted odds ratios (aOR) that control for the latter factors and unit risk factors were also computed. Results A total of 122 (5%) infants developed a HCAI. The odds of having HCAI were higher on days that were preceded by a high nursing overtime ratio (aOR, 1.70; 95% confidence interval [95% CI], 1.05-2.75, quartile [Q]4 vs. Q1). High unit occupancy rates were not associated with increased odds of infection (aOR, 0.85; 95% CI, 0.47-1.51, Q4 vs. Q1) nor were higher available/recommended nurse ratios (aOR, 1.16; 95% CI, 0.67-1.99, Q4 vs. Q1). Conclusion Nursing overtime is associated with higher odds of HCAI in the NICU. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  11. [Management of technology and its influence on nursing care].

    Science.gov (United States)

    Palacios-Ceña, Domingo

    2007-01-01

    Currently, much nursing care adheres to a specific biomedical paradigm within the positivist framework. However, sometimes nursing care cannot be adapted to numerous human or vital conditions affecting our patients, their families or the environment in which nurses work. An specific example of these nursing interventions are those applied in intensive care units (ICU) where there is a large amount of technology and nursing care is specialized. Several questions that arise are whether the above-mentioned specialization is inherent to nurse care, whether technology management forms part of nursing care, whether this care has a non-nursing origin, and what is the source of nursing knowledge. The present article aims to provide basic knowledge to distinguish the nursing care performed in the ICU within the 2 predominant paradigms in current nursing: the biomedical and the holistic paradigms. The characteristics of nursing care in both paradigms are described and an integrated vision of these 2 paradigms and of nursing care with and without the use of technology is provided.

  12. Professional nursing practice in critical units: assessment of work environment characteristics

    Science.gov (United States)

    Maurício, Luiz Felipe Sales; Okuno, Meiry Fernanda Pinto; Campanharo, Cássia Regina Vancini; Lopes, Maria Carolina Barbosa Teixeira; Belasco, Angélica Gonçalves Silva; Batista, Ruth Ester Assayag

    2017-01-01

    ABSTRACT Objective: assess the autonomy, control over environment, and organizational support of nurses' work process and the relationships between physicians and nurses in critical care units. Method: cross-sectional study conducted with 162 nurses working in the intensive care units and emergency service of a university hospital. The workers' satisfaction with their work environment was assessed using Brazilian Nursing Work Index - Revised, translated and adapted for the Brazilian culture. Results: average age was 31.6 ± 3.9 years; 80.2% were women; 68.5% Caucasians and 71.6% worked in intensive care units. The nurses considered autonomy (2.38 ± 0.64) and their relationship with physicians (2.24 ± 0.62) to be characteristics of the work environment that favored professional practice. Control over environment (2.78 ± 0.62) and organizational support (2.51 ± 0.54), however, were considered to be unfavorable. No statistically significant differences were found between the units based on the scores obtained by the professionals on the Brazilian Nursing Work Index - Revised. Conclusion: autonomy, relationship between physicians and nurses, and organizational support were considered by the units to be characteristics that favored nurses' professional practices. On the other hand, control over environment and organizational support were considered unfavorable. PMID:28301034

  13. Nurse manager perspective of staff participation in unit level shared governance.

    Science.gov (United States)

    Cox Sullivan, Sheila; Norris, Mitzi R; Brown, Lana M; Scott, Karen J

    2017-08-30

    To examine the nurse manager perspective surrounding implementation of unit level shared governance in one Veterans Health Administration facility. Nursing shared governance is a formal model allowing nursing staff decision-making input into clinical practice, quality improvement, evidence-based practice and staff professional development. Unit level shared governance is a management process where decision authority is delegated to nursing staff at the unit level. Convenience sampling was used to recruit ten nurse managers who participated in face-to-face semi-structured interviews. Data were analysed using content analysis and constant comparison techniques. Demographic data were described using descriptive statistics. The participants included seven female and three male nurse managers with seven Caucasian and three African American. Participant quotes were clustered to identify sub-themes that were then grouped into four global themes to describe unit level shared governance. The global themes were: (1) motivation, (2) demotivation, (3) recommendations for success, and (4) outcomes. These research findings resonate with previous studies that shared governance may be associated with increased nurse empowerment, self-management, engagement, and satisfaction. These findings reflect the need for nurse managers to promote and recognize staff participation in unit level shared governance. © 2017 John Wiley & Sons Ltd.

  14. Modeling Serum Creatinine in Septic ICU Patients

    DEFF Research Database (Denmark)

    De Gaetano, Andrea; Cortese, Giuliana; Pedersen, Morten Gram

    2004-01-01

    Serum creatinine is a metabolite assumed to be constantly produced by the normally functioning muscle mass and is a good measure for monitoring daily renal function in the intensive care unit (ICU). High serum creatinine levels or an abnormal departure from normal pre-disease basal levels....... The present work details the structure of a model describing observed creatinine serum concentration (CSC) variations, depending on the time-varying septic insult to renal function in ICU patients, as well as the estimation of its parameters. CSC determinations were routinely obtained from 12 patients...

  15. [Analysis of the web pages of the intensive care units of Spain].

    Science.gov (United States)

    Navarro-Arnedo, J M

    2009-01-01

    In order to determine the Intensive Care Units (ICU) of Spanish hospitals that had a web site, to analyze the information they offered and to know what information they needed to offer according to a sample of ICU nurses, a cross-sectional observational, descriptive study was carried out between January and September 2008. For each ICU website, an analysis was made on the information available on the unit, its care, teaching and research activity on nursing. Simultaneously, based on a sample of intensive care nurses, the information that should be contained on an ICU website was determined. The results, expressed in absolute numbers and percentage, showed that 66 of the 292 hospitals with ICU (22.6%) had a web site; 50.7% of the sites showed the number of beds, 19.7% the activity report, 11.3% the published articles/studies and followed research lines and 9.9% the organized formation courses. 14 webs (19.7%) displayed images of nurses. However, only 1 (1.4%) offered guides on the actions followed. No web site offered a navigation section for nursing, the E-mail of the chief nursing, the nursing documentation used or if any nursing model of their own was used. It is concluded that only one-fourth of the Spanish hospitals with ICU have a web site; number of beds was the data offered by the most sites, whereas information on care, educational and investigating activities was very reduced and that on nursing was practically omitted on the web pages of intensive care units.

  16. 对行瓣膜置换术的重症心脏瓣膜病患者进行综合护理的效果观察%Observation of ICU nursing of severe valvular heart disease patients after valve replacement

    Institute of Scientific and Technical Information of China (English)

    李谢妹

    2016-01-01

    目的:探讨分析对行瓣膜置换术的重症心脏瓣膜病患者进行综合护理的临床效果。方法:选取近期我院收治的进行瓣膜置换术的重症心脏瓣膜病患者58例作为研究对象,将其随机分为对比组(24例)和实验组(34例),对对比组患者进行常规护理,对实验组患者进行综合护理,然后统计比较两组患者对护理工作的满意率。结果:实验组患者对护理工作的满意率明显高于对比组患者,差异具有统计学意义(P <0.05)。结论:对行瓣膜置换术的重症心脏瓣膜病患者进行综合护理的临床效果十分显著。%Objective: To explore the ICU nursing measures for the patients with severe valvular heart disease should be taken in after valve replacement and effect. Methods: a total of October 2014 to 2015 November treated 58 cases of severe cardiac valve disease patients after valve replacement given ICU nursing intervention, were randomly divided into two groups, the experimental group 34 patients were treated with comprehensive ICU nursing, control group (24 patients) were taken routine nursing intervention, compared two groups of patients with nursing effect. Results: the patients in the control group, nursing satisfaction was 79.17%, patients in the experimental group of nursing satisfaction was 94.12%, nursing satisfaction of the experimental group were higher, significant difference was statistically significant (P < 0.05). Conclusion: the patients with severe valvular heart disease underwent ICU nursing in patients after valve replacement, can improve the prognosis, reduce complications, reduce the mortality rate, helps the body back to health, it is recommended.

  17. Nurses' responses to do-not-resuscitate orders in the neonatal intensive care unit.

    Science.gov (United States)

    Savage, T A; Cullen, D L; Kirchhoff, K T; Pugh, E J; Foreman, M D

    1987-01-01

    A statewide survey of nurses in perinatal centers was conducted to assess the prevalence of do-not-resuscitate (DNR) policies in neonatal intensive care units (NICUs) and to examine factors influencing nurses in those centers in their compliance with DNR orders. Three nurses in each of 10 perinatal centers were asked to complete a questionnaire on DNR policies and nurses' compliance and to respond to four hypothetical clinical situations. Eighteen of the 27 responding nurses reported the existence of a DNR policy. Factors affecting compliance with DNR orders were agreement that the infant should not be resuscitated (n = 24) or respect for the parents' wishes (n = 19). Nurses' intention to resuscitate despite a DNR order varied, depending on the description of the infant. Multiple regression analyses showed that subjective norms (beta = .41 to .82) rather than attitudes (beta = .17 to .39) exerted a more powerful influence on nurses' decisions not to resuscitate.

  18. 前瞻性护理对 ICU 清醒患者不良情绪及睡眠质量的影响%The ef ect of prospective nursing on the negative emotion and sleep quality of conscious patient in ICU

    Institute of Scientific and Technical Information of China (English)

    吴清华

    2014-01-01

    Objective:To discuss the prospective nursing on the negative emotion and sleep quality of conscious patient in ICU.Methods:200 conscious patients,who were from our hospital during Oct 2013 to Jan 2014,were divided randomly into two groups,100 cases in each group.The control group was received routine nursing,and the observation group was carried out by prospective nursing on this basis.And then some indices were compared between two groups.Results:The indices of observation group,as the satisfaction of patients and the treatment com-pliance were significantly higher than that in the control group (P<0.05).The sleep index and the score of negative motion about anxiety were significantly lower than that in the control group (P<0.05).Conclusion:The application of prospective nursing on conscious patients after received routine nursing,can improve patients’satisfaction on nursing care,the treatment compli-ance,the sleep quality,and reduce the patient’s bad mood.%目的:探讨前瞻性护理对ICU清醒患者的不良情绪和睡眠的影响及临床意义。方法选取2013年10月~2014年1月我院ICU收治的200例患者为研究对象,采用随机抽签分组方法将其分成观察组和对照组,每组100例,对照组采用ICU常规护理,观察组在对照组基础上融入前瞻性护理,观察对比两组患者的满意度、治疗配合度、睡眠质量、焦虑情绪,评判两组患者的护理效果。结果经过统计分析得出,观察组患者满意度和治疗配合度明显高于对照组(χ2=23.8595,P=0.0000;χ2=20.9067,P=0.0000),观察组患者睡眠质量、焦虑情绪明显好于对照组(t=2.0585,P=0.0409;t=2.1731,P=0.0310)。结论在ICU清醒患者常规护理基础上采用前瞻性护理,能有效提高患者的满意度、治疗配合度、睡眠质量,能明显降低患者的焦虑情绪。

  19. ICU连续性肾替代疗法专业护理小组的建立与实践效果评价%Professional nursing team establishment and implementation effects evaluation of continuous renal replacement therapy in ICU

    Institute of Scientific and Technical Information of China (English)

    葛红梅

    2016-01-01

    目的:观察连续性肾代替疗法对危重病患者的临床治疗效果,探讨ICU连续性肾替代疗法专业护理小组的建立与实践效果评价。方法选取菏泽市立医院2013年10月—2014年10月ICU科内危重患者70例,组建连续性肾替代疗法专业护理小组,发挥专科护理小组的作用,给予危重患者行连续性肾替代疗法以及护理,并与护理小组建立前2012年10月—2013年10月的70例患者的疗效进行比较,观察危重患者治疗前后血钾、血钠、血尿素氮、血尿酸和肌酐含量的变化,测定治疗前后C反应蛋白的含量。结果连续性肾替代疗法可提高ICU抢救危重患者的成功率,140例危重患者死亡38例,5例放弃治疗,病死率为27.14%;与常规护理比较,经连续性肾代替疗法治疗及专业护理小组的综合护理后,危重患者血钾、血钠恢复正常,血尿素氮、血尿酸和肌酐的水平显著下降(P<0.01)。 C反应蛋白含量在治疗后显著下降(P<0.01);专业护理小组的实施,降低了患者并发症的发生,同时提高了ICU连续性肾替代疗法的护理质量。结论连续性肾替代疗法治疗危重患者取得较为理想的效果,且ICU连续性肾替代疗法专业护理小组的成立及良好的运作,可保证连续性肾代替疗法的顺利进行,提高危重患者的抢救成功率。%Objective To observe the clinical effects of continuous renal replacement treatment ( CRRT) in patients with critical illness and to explore the establishment and implementation effects evaluation of CRRT professional care team in ICU. Methods A total of 70 patients with critical illness in ICU were selected from October 2013 to October 2014 in Heze Municipal Hospital. CRRT professional nursing team was established to play an important role in CRRT by providing critical ill patients with CRRT and special nursing. Clinical effects were compared with those in another 70 patients from October 2012 to October 2013

  20. Occupational Risk Factors and Health Problems Faced by Nurses that Working Dialysis Unit and Nephrology Service

    Directory of Open Access Journals (Sweden)

    Mehtap Curcani

    2009-08-01

    Full Text Available AIM: This study is carried out descriptively with the aim of determining occupational risks the nurses working in dialysis units and nephrology services. METHOD: 47 nurses working in dialysis and nephrology units of the hospitals in Erzurum were included in the study content. In the collection of the data, questionnaire form prepared in the light of literature and including the preventions taken by nurses themselves or their organizations against the professional risks they faced, or personal problems the nurses experienced, professional risk or professional-personal features was used. RESULTS: In the result of the study, it was detected that 48.9% of the nurses was at 28-32 age group, and that 38.3% of the nurses graduated from nursing higher school, and that 72.3% of the nurses worked in dialysis unit. It was found out that while practicing their professions, the nurses expressed that infection risk (97.9%, stress (83%, verbal abuse (80.9%, psychiatric trauma (66%, allergic substance (63.8%, the noise (36.2%, and physical abuse (23.4% were the risk factors they raced in working medium .In the health problem seen in the nurses, in the first row is lumbago. CONCLUSION: In the result of the study, it was found out that while practicing their professions, the nurses expressed that infection risk was the highest rate among the risk factors they raced in working medium and, in the health problem seen in the nurses, in the first row is lumbago and that the nurses and organizations’ attempts which will reduce the risks were not sufficient. [TAF Prev Med Bull 2009; 8(4.000: 339-344

  1. [Work process of the nurse who works in child care in family health units].

    Science.gov (United States)

    de Assis, Wesley Dantas; Collet, Neusa; Reichert, Altamira Pereira da Silva; de Sá, Lenilde Duarte

    2011-01-01

    This is a qualitative research, which purpose was to analyse the working process of nurse in child care actions in family health units. Nurses are the subjects and empirical data was achieved by the means of participant observation, and interviews. Data analysis followed thematic analysis fundaments. Results reveal that working process organization of nurses still remains centered in proceedings with an offert of assistance based in client illness, showing obstacles to puericulture practice in health basic attention.

  2. Life Change Units (LCU) rating as stressors in Iranian hospitals' nurses.

    Science.gov (United States)

    Dargahi, Hossein; Shaham, Golsa

    2012-01-01

    Healthcare workers suffer from work-related or occupational stress. This can lead to severe distress, burnout or physical illness, and finally to decrease quality of work life and services provision. Nurses must be aware of retential stressors, because they add to the cumulative effect of other stressful events. Holmes and Rahe both found a relationship between life change unit as stressors and health changes. This research reported here aims to measure the life change units as stressors among Iranian Hospitals Nurses by LCU rating. A cross - sectional, descriptive and analytical study was conducted among 389 nurses working in 15 teaching hospitals in Tehran, Iran. The respondents were asked to select each of 54 events that cause stress ranked in order of their life change units developed by Holmes and Rahe as stress scale. Before beginning the main study, the reliability and coincidental validity was performed. All data were analyzed using SPSS for windows version 18, t-test, Anova statistical methods. Approximately, half of the nurses associated major mortgage, foreclosure of mortgage or loan. More than 50% of the Iranian nurses had 150-300 and more than 300 LCU rating which had the chance to expose to extremely serious risk to health.Iranian hospitals nurses suffer from stress that caused by Life Change Units organizational factors such as change in the financial state, change in the work environment and major mortgage. We recommend to Iranian nursing policy-makers to choose strategies to help nurses' cope effectively with workplace stressors. Nursing managers and / or nursing management should develop strategies to address and improve the quality of working conditions for nurses in the hospitals. Providing educational and career prospects can contribute to decrease nurses' occupational stress level, the maintaining their work ability.

  3. Life Change Units (LCU Rating as Stressors in Iranian Hospitals’ Nurses

    Directory of Open Access Journals (Sweden)

    Hossein Dargahi

    2012-02-01

    Full Text Available Healthcare workers suffer from work-related or occupational stress. This can lead to severe distress, burnout or physical illness, and finally to decrease quality of work life and services provision. Nurses must be aware of retential stressors, because they add to the cumulative effect of other stressful events. Holmes and Rahe both found a relationship between life change unit as stressors and health changes. This research reported here aims to measure the life change units as stressors among Iranian Hospitals Nurses by LCU rating. A cross - sectional, descriptive and analytical study was conducted among 389 nurses working in 15 teaching hospitals in Tehran, Iran. The respondents were asked to select each of 54 events that cause stress ranked in order of their life change units developed by Holmes and Rahe as stress scale. Before beginning the main study, the reliability and coincidental validity was performed. All data were analyzed using SPSS for windows version 18, t-test, Anova statistical methods. Approximately, half of the nurses associated major mortgage, foreclosure of mortgage or loan. More than 50% of the Iranian nurses had 150-300 and more than 300 LCU rating which had the chance to expose to extremely serious risk to health.Iranian hospitals nurses suffer from stress that caused by Life Change Units organizational factors such as change in the financial state, change in the work environment and major mortgage. We recommend to Iranian nursing policy-makers to choose strategies to help nurses cope effectively with workplace stressors. Nursing managers and / or nursing management should develop strategies to address and improve the quality of working conditions for nurses in the hospitals. Providing educational and career prospects can contribute to decrease nurses occupational stress level, the maintaining their work ability.

  4. The Effect Observation of Nursing Intervention in Improving the Anxiety of ICU Patients’Family Members%护理干预改善ICU患者家属焦虑的效果观察

    Institute of Scientific and Technical Information of China (English)

    郭艳; 朱银珍; 王丽玉; 叶金巧

    2014-01-01

    目的:探讨护理干预在改善ICU患者家属焦虑情绪中的应用效果。方法:将2012-2013年笔者所在医院80例ICU病房住院患者家属按施行不同干预措施分为干预组和对照组,各40名,对照组实施传统“探视-解答”模式的干预措施,对干预组家属实施综合干预措施,对两组家属干预前后的焦虑SAS评分进行综合比较。结果:两组家属干预前的SAS分值均明显高于中国常模分值(P<0.01),提示ICU患者家属普遍存在不同程度的焦虑情绪;两组家属施行干预措施后的SAS评分较干预前均有降低(P<0.01),但干预组评分较对照组下降更明显(P<0.01)。结论:在ICU患者家属中施行针对性的综合干预措施有利于改善家属焦虑情绪,积极配合医护工作,值得临床推广应用。%Objective:To explore the application effect of nursing intervention in improving the anxiety of ICU patients’family members.Method:80 cases of ICU hospitalized patients’family members in author’s hospital from 2012 to 2013 were divided into intervention group and control group according to the implementation of different interventions,40 cases in the control group implemented the traditional mode of“visiting-answer”intervention measures,40 cases in the intervention group implemented comprehensive intervention measures,the anxiety SAS scores of families of the two groups before and after intervention were comprehensive compared.Result:The SAS scores of two groups before intervention were significantly higher than Chinese norm(P<0.01),prompted that ICU patients’ family members generally exist different degrees of anxiety.The SAS scores of the two groups after implementation were lower compared with before(P<0.01),but the intervention group score down more obvious compared with control group(P<0.01).Conclusion:Targeted comprehensive intervention measures can improve anxiety of ICU patients’ family members,can make family

  5. Seizure detection in adult ICU patients based on changes in EEG synchronization likelihood

    NARCIS (Netherlands)

    Slooter, A. J. C.; Vriens, E. M.; Spijkstra, J. J.; Girbes, A. R. J.; van Huffelen, A. C.; Stam, C. J.

    2006-01-01

    Introduction: Seizures are common in Intensive Care Unit (ICU) patients, and may increase neuronal injury. Purpose: To explore the possible value of synchronization likelihood (SL) for the automatic detection of seizures in adult ICU patients. Methods: We included EEGs from ICU patients with a varie

  6. Planning for a smooth transition: evaluation of a succession planning program for prospective nurse unit managers.

    Science.gov (United States)

    Manning, Vicki; Jones, Alan; Jones, Pamela; Fernandez, Ritin S

    2015-01-01

    The current and projected nurse workforce shortage has created significant pressure on health care organizations to examine their approach to managing talent. This includes the need for strategic development of new formal leaders. This article reports on a succession planning program for prospective nursing unit managers. Eight prospective management candidates participated in a Future Nursing Unit Managers program. The effectiveness of the program was measured through a comparison of pre- and postprogram surveys relating to participants' perception of personal managerial and leadership skills. Significant differences in scores from baseline to 6-month follow-up surveys were observed in the participants' confidence in undertaking the nursing unit manager role and in their management skills. Investment in structured programs to prepare nurses for leadership roles is strongly recommended as a management workforce strategy.

  7. [Nurse's concept in the managerial conception of a basic health unit].

    Science.gov (United States)

    Passos, Joanir Pereira; Ciosak, Suely Itsuko

    2006-12-01

    This study is part of a larger survey called "Use of indicators in nurses' managerial practice in Basic Health Care Units in the city of Rio de Janeiro", which was carried out in the Basic Health Care Units of the Planning Area 5.3 and whose objectives were to identify nurses' conception regarding the tools required for management in those units and to discuss the role of management in organizing health services. The study is descriptive and data were collected in interviews with seven nurse managers. The results show that health services actions are organized and directed to the purpose of the working process through the relationship established between the object, the instruments and the final product, and that for those nurses the end result to be achieved is client's satisfaction and the quality of medical and nursing care.

  8. Clinical teaching of student nurses by unit managers of selected hospitals in Limpopo Province

    Directory of Open Access Journals (Sweden)

    LA Murathi

    2005-09-01

    Full Text Available The comprehensive nature of nurse training needs the involvement of almost all health team personnel, including unit managers to gain practical experience and learn to correlate theory and practice. The overall aim of the study was to explore and describe the experiences of unit managers regarding teaching of student nurses in the clinical area and to develop recommendations that will enhance clinical teaching, for the production of competent future nurse practitioners who will render quality care to patients. A qualitative design, which is explorative, descriptive and contextual in nature, was employed, utilizing a phenomenological approach to capture the experiences of unit managers regarding teaching of student nurses at selected hospitals, where students are allocated for their clinical exposure. Ethical measures as well as measures to ensure trustworthiness were adhered to. In-depth phenomenological interviews were conducted with unit managers who shared their experiences regarding clinical teaching of student nurses. Data analysis was done according to Tesch’s (1990 open coding method. One major theme emerged, namely that unit managers experienced problems when doing clinical teaching of student nurses. Based on the findings the following recommendations were made: Colleges should open a two-way communication with unit managers, involvement of unit managers in the activities that take place at the college like courses, seminars and workshops on clinical teaching, learning contracts should be developed for the students and issues of clinical learning should be addressed and unit managers should be included in both summative and formative evaluations.

  9. Leadership styles and personal and professional profile of intensive care unit nurses Estilos de liderazgo y perfil profesional de enfermeros de una Unidad de Cuidados Intensivos Estilos de liderança e perfil profissional de enfermeiros em Unidade de Terapia Intensiva

    OpenAIRE

    Alexandre Pazetto Balsanelli; Isabel Cristina Kowal Olm Cunha; Iveth Yamaguchi Whitaker

    2008-01-01

    OBJECTIVE: To verify the relation between leadership styles and personal and professional profile of a nurse facing another team member when performing ICU patient care. METHODS: Samples were collected on seven nurses and seven practical nurses working as partners. Throughout three months, the nurses were inquired about the leadership style applied when the practical nurse, under their assessment, performed ICU patient care. RESULTS: Persuasion style prevailed among other styles, followed by ...

  10. Investigation on nursing soft skills among intensive care unit in Harbin%哈尔滨市ICU护士护理软技能现状的调查

    Institute of Scientific and Technical Information of China (English)

    赵伟娣

    2012-01-01

    Objective To investigate the status and influencing factors of nursing soft skills among Intensive Care Unit in Harbin.Methods The nursing soft skills scale was used to investigate 245 ICU nurses from grade A hospitals between April and July 2011.Results The total of nursing soft skills of ICU nurses was (145.40 ± 15.43),lower than that of national norms,with the item of highest score was self-management skills (43.76±4.32),the item of lowest score was professional sentiment (26.17 ±2.54).Univariate analysis showed that nurses with different age,gender,education degree,marital status,hire form,and professional tide had different nursing soft skills scores,and the difference was statistically significant (F/t =13.28,6.14,4.22,6.85,2.34,5.24;P < 0.05).Multiple linear regression analysis indicated that education degree,age,marital status had significant effect on nurses' nursing soft skills (R2 =0.202).Conclusions The level of nursing soft skills of ICU Nurses should to be improved.The nurse managers should focus on nursing soft skills intervention and training of low education degree,married nurses and older nurses so as to improve nurse - patient relationship and quality of care.%目的 调查哈尔滨市重症监护室(ICU)护士护理软技能现状及其影响因素.方法 2011年4-7月采用整群随机抽样方法,在哈尔滨市抽取3家三甲医院ICU的护士为调查对象,采用护理软技能测评量表对300名ICU护士进行调查,评价其护理软技能情况并分析影响因素.结果 共发放问卷300份,回收275份,有效问卷245份,有效回收率为89.09%.哈尔滨市ICU护士护理软技能的总均分为(145.40 ±15.43)分,低于全国常模.得分最高的项目为自我管理技能(43.76±4.32)分,最低得分为职业情操(26.17±2.54)分.对影响ICU护士护理软技能得分的因素进行单因素分析,发现不同年龄、性别、学历、婚姻状态、聘用形式及职称的护士软技能得分不同,差异具有

  11. 综合性护理对ICU患儿应激程度及家长满意度的影响%Effect of comprehensive nursing care on the stress of chiIdren in ICU and satisfaction of their parents

    Institute of Scientific and Technical Information of China (English)

    薛焕芹

    2014-01-01

    目的:探讨综合性护理对ICU患儿应激程度及家长满意度的影响。方法:将ICU 60例患儿随机分为观察组和对照组各30例,对照组采用常规护理,观察组采用综合性护理;比较两组患儿的护理效果。结果:观察组应激性高血糖的发生率低于对照组,血糖恢复正常的时间、危重病情好转时间、ICU停留时间均短于对照组,病死率显著低于对照组,昏迷的疗效高于对照组( P%Objective:To investigate the effect of comprehensive nursing care on the stress of children in ICU and satisfaction of their parents. Methods:60 children in ICU were randomly divided into the observation group and the control group(30 cases in each group). The routine nursing care was taken in the control group and the comprehensive nursing care was adopted in the observation group. The nursing effects were compared between the two groups. Results:The incidence of stress hyperglycemia was less,the time of blood glucose returned to normal and the length of stay in ICU was shorter,the improvement of critical conditions of the children and the curative effect of coma was better and the fatality rate was significantly lower in the observation group than the control group(P﹤0. 05);the satisfaction rate of the parents with nursing care was higher in the observation group than the control group(P﹤0. 05). Conclusion:The comprehen-sive nursing care can reduce the stress level of children in ICU,promote the improvement of conditions of the children,decrease the fatality rate and improve the satisfaction of their parents.

  12. Bispectral index as a predictor of sedation depth during isoflurane or midazolam sedation in ICU patients.

    Science.gov (United States)

    Sackey, P V; Radell, P J; Granath, F; Martling, C R

    2007-06-01

    Bispectral index (BIS) is used for monitoring anaesthetic depth with inhaled anaesthetic agents in the operating room but has not been evaluated as a monitor of sedation depth in the intensive care unit (ICU) setting with these agents. If BIS could predict sedation depth in ICU patients, patient disturbances could be reduced and oversedation avoided. Twenty ventilator-dependent ICU patients aged 27 to 80 years were randomised to sedation with isoflurane via the AnaConDa or intravenous midazolam. BIS (A-2000 XP, version 3.12), electromyogram activity (EMG) and Signal Quality Index were measured continuously. Hourly clinical evaluation of sedation depth according to Bloomsbury Sedation Score (Bloomsbury) was performed. The median BIS value during a 10-minute interval prior to the clinical evaluation at the bedside was compared with Bloomsbury. Nurses performing the clinical sedation scoring were blinded to the BIS values. End-tidal isoflurane concentration was measured and compared with Bloomsbury. Correlation was poor between BIS and Bloomsbury in both groups (Spearman's rho 0.012 in the isoflurane group and -0.057 in the midazolam group). Strong correlation was found between BIS and EMG (Spearman's rho 0.74). Significant correlation was found between end-tidal isoflurane concentration and Bloomsbury (Spearman's rho 0.47). In conclusion, BIS XP does not reliably predict sedation depth as measured by clinical evaluation in non-paralysed ICU patients sedated with isoflurane or midazolam. EMG contributes significantly to BIS values in isoflurane or midazolam sedated, non-paralysed ICU patients. End-tidal isoflurane concentration appeared to be a better indicator of clinical sedation depth than BIS.

  13. CE: Inside an Ebola Treatment Unit: A Nurse's Report.

    Science.gov (United States)

    Wilson, Deborah

    2015-12-01

    In December 2013, the first cases of the most recent outbreak of Ebola virus disease (formerly known as Ebola hemorrhagic fever) emerged in the West African nation of Guinea. Within months the disease had spread to the neighboring countries of Liberia and Sierra Leone. The international humanitarian aid organization Médecins Sans Frontières (MSF; known in English as Doctors Without Borders) soon responded by sending staff to set up treatment centers and outreach triage teams in all three countries. In August 2014, the World Health Organization declared the outbreak an international public health emergency.In September 2014, the author was sent by MSF to work as a nurse in an Ebola treatment unit in Liberia for five weeks. This article describes her experiences there. It provides some background, outlines the practices and teams involved, and aims to convey a sense of what it's like to work during an Ebola outbreak and to put a human face on this devastating epidemic.

  14. The Relationships between a Dedicated Education Unit and Quality of Nursing Care

    Science.gov (United States)

    Tochterman, Lori A.

    2016-01-01

    The Dedicated Education Unit (DEU) is a model of clinical teaching which has gained widespread acceptance and national recognition as an innovative method of clinical education for undergraduate nursing students (Robert Wood Johnson Foundation, 2010; Warner & Burton, 2009). The primary goals and benefits of the DEU for schools of nursing are…

  15. The perception of partnership between parents of premature infants and nurses in neonatal intensive care units

    DEFF Research Database (Denmark)

    Brødsgaard, Anne; Larsen, Palle; Weis, Janne

    2016-01-01

    REVIEW QUESTION/OBJECTIVE: The objective of this review is to identify how parents of premature infants in neonatal intensive care units (NICUs) and nurses perceive their partnership.The review questions are: how do parents of premature infants and nurses perceive their partnership during hospita...

  16. Windows to the Future: Can the United Nations Sustainable Development Goals Provide Opportunities for Nursing?

    Science.gov (United States)

    Benton, David C; Ferguson, Stephanie L

    2016-01-01

    Windows of opportunity are wide open for the nursing profession to actively participate and engage in the policy implementation, evaluation, and achievement of the United Nations Sustainable Development Goals. Nurses bring valuable perspectives as members of diverse governance structures and offer a range of solutions that can help governments pursue and achieve the Sustainable Development Goals and targets by 2030.

  17. Assessing and developing critical-thinking skills in the intensive care unit.

    Science.gov (United States)

    Swinny, Betsy

    2010-01-01

    A lot of resources are spent on the development of new staff in the intensive care unit (ICU). These resources are necessary because the environment in the ICU is complex and the patients are critically ill. Nurses need an advanced knowledge base, the ability to accurately define and change priorities rapidly, good communication and teamwork skills, and the ability to work in a stressful environment in order to succeed and give their patients quality care. Critical thinking helps the nurse to navigate the complex and stressful environment of the ICU. Critical thinking includes more than just nursing knowledge. It includes the ability to think through complex, multifaceted problems to anticipate needs, recognize potential and actual complications, and to expertly communicate with the team. A nurse who is able to think critically will give better patient care. Various strategies can be used to develop critical thinking in ICU nurses. Nurse leaders are encouraged to support the development of critical-thinking skills in less experienced staff with the goal of improving the nurse's ability to work in the ICU and improving patient outcomes.

  18. A family nursing educational intervention supports nurses and families in an adult intensive care unit.

    Science.gov (United States)

    Eggenberger, Sandra K; Sanders, Marita

    2016-11-01

    The family experience of critical illness is filled with distress that may have a lasting impact on family coping and family health. A nurse can become a source of comfort that helps the family endure. Yet, nurses often report a lack of confidence in communicating with families and families report troubling relationships with nurses. In spite of strong evidence supporting nursing practice focused on the family, family nursing interventions often not implemented in the critical care setting. This pilot study examined the influence of an educational intervention on nurses' attitudes towards and confidence in providing family care, as well as families' perceptions of support from nurses in an adult critical care setting. An academic-clinical practice partnership used digital storytelling as an educational strategy. A Knowledge to Action Process Framework guided this study. Results of pre-intervention data collection from families and nurses were used to inform the educational intervention. A convenience sample of family members completed the Iceland Family Perceived Support Questionnaire (ICE-FPSQ) to measure perception of support provided by nurses. Video, voice, and narrative stories of nurses describing their experiences caring for family members during a critical illness and family members' experiences with a critically ill family member also guided education plans. When comparing the pre and post results of the Family Nurse Practice Scale (FNPS), nurses reported increased confidence, knowledge, and skill following the educational intervention. Qualitative data from nurses reported satisfaction with the educational intervention. Findings suggest that engaging nurses in educational opportunities focused on families while using storytelling methods encourages empathic understandings. Academic-clinician teams that drive directions show promise in supporting families and nurses in critical care settings. Plans are moving forward to use this study design and methods in

  19. Early Physical Rehabilitation in the ICU: A Review for the Neurohospitalist

    OpenAIRE

    Mendez-Tellez, Pedro A.; Nusr, Rasha; Feldman, Dorianne; Needham, Dale M.

    2012-01-01

    Advances in critical care have resulted in improved intensive care unit (ICU) mortality. However, improved ICU survival has resulted in a growing number of ICU survivors living with long-term sequelae of critical illness, such as impaired physical function and quality of life (QOL). In addition to critical illness, prolonged bed rest and immobility may lead to severe physical deconditioning and loss of muscle mass and muscle weakness. ICU-acquired weakness is associated with increased duratio...