Enfermería intensiva
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Enfermería intensiva · Oct 2002
[Development of a quality guarantee system for mechanical ventilation (register in a multi-purpose CCU)].
1. Obtaining information about the demographic distribution of patients undergoing long-term mechanical ventilation. 2. Defining our reference standards for mechanical ventilation, length of UCC and complications related to mechanical ventilation (MV), comparable with the international standards. Detailed follow-up of pneumonias associated to mechanical ventilation and incidence of accidental extubation (AE). ⋯ During the period of study 1058 patients were hospitalized in the critical care unit (CCU), 287 (27%) of which needed mechanical ventilation (MV). 29% of the patients were women. The age and APACHE II were as median (percentile 25 and 75) 68 (57-76) and 26 (20-31) respectively. The reasons that made MV necessary were: acute respiratory failure 70%, intensified acute exacerbation of chronic respiratory failure 11%, coma 18% and neuromuscular illness 1%. The density of average incidence of accidental extubation (AE) was 15.7/1000 days of MV, the AE was associated to a longer duration of MV, longer stay in CCU and in the hospital and a greater incidence of pneumonia associated to MV, but it was not associated to an increment in mortality. The density of incidence of pneumonia associated to MV was 12.6/1000 days of MV, being the germ more frequently responsible the pseudomona aeruginosa.
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Enfermería intensiva · Oct 2002
[Prone position in adult respiratory distress syndrome: nursing care].
The use of prone position in patients with Adult Respiratory Distress Syndrome is becoming a more and more habitual therapeutic measure in the units of Intensive Care, for what to have appropriate Nursing protocols will improve our professional performances. This article seeks to modernize knowledge by means of the practical experience and the bibliographical revision about Adult Respiratory Distress Syndrome, of the prone position and its effects on the organism, as well as the prone technique and the Nursing cares of the patients in prone position. It is propounded a detailed technique in steps, to carry out the prone position in a sure way, an itemized revision on the posture of the patient's maintenance in prone position and a Nursing cares protocol for the patients located in this posture.
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Enfermería intensiva · Jul 2002
[Utilization of the nine equivalents of nursing manpower use score (NEMS) in a pediatric intensive care unit].
In 1994, sponsored by the European Communities Commission and the FRICE (Foundation for Research on Intensive Care in Europe), the EURICUS proyect was born, which, among other objectives, sets out to know objectively the work loads of the nursing staff in the intensive medicine services. As a consequence, the FRICE developed and validated a new therapeutic index, the nine equivalents of nursing manpower use score, NEMS. This scale (NEMS) can determine the therapeutic effort required by critically ill patients in a simple way and only using nine therapeutic variables. ⋯ In a pediatric ICU, the age of the patient who is hospitalized influences the requirements of the nursing staff. Depending on at what time the scale is measured, not all the nursing activity is reflected, due to the high number of daily admissions and discharges. The NEMS scale is simple to use and reflects the therapeutic effort of the patients admitted to a PICU; however it only measures those cares delegated from therapeutic intervention and does not reflect the basic nursing cares.
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Enfermería intensiva · Apr 2002
[Perception of night-time sleep by the surgical patients in an intensive care unit].
Night-time rest of the patients hospitalized in Intensive Care is a very important feature within the health/disease process since it has a direct repercussion on their adequate recovery. The objectives of this investigation are: 1) describe how the surgical patients perceive their night-time sleep in the Polyvalent Intensive Care Unit: 2) compare the subjective perception of the patients with the nursing record in the care plan and analyze the degree of agreement between both assessments. Night-time sleep has been studied in 104 patients; surgery patients from emergencies, patients who are intubated, with previous psychiatric treatment, sleep apnea, drinking habit or impossibility of adequate communication were not included. ⋯ The total mean score of the sleep on the first post-operative night was 51.42 mm. When the scores obtained in each one of the questionnaire items are analyzed, it is seen that the sleep profile of these patients has been characterized by being light sleep, with frequent wakenings and generally with little difficulty to go back to sleep when woke op or were awakened. The assessment of the night-time sleep performed by the nurse coincides with the perception of the patients on many occasions, and when there is discrepancy, the nurse has overestimated the patient's sleep.
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Because of easiness and accessibility, the oral route of administration is usually the route of choice for medication delivery, as long as the oral drug form is available and the patients' circumstances allow it. In patients admitted to the intensive care unit this route is frequently altered. This provokes difficulties in swallowing and consequently an enteral feeding catheter must be inserted to supply the patient's nutritional requirements. ⋯ The aim of this study was to establish guidelines for drug administration through enteral feeding catheters. We provide a thorough review of the literature, describe oral drug forms, present a protocol for correct drug administration and provide a guide to the most commonly used drugs in our unit. For each of these drugs we include recommendations on administration and possible alternatives.