Revista de enfermería (Barcelona, Spain)
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To control the physical symptoms in end-of-life pharmacological management involves major intervention. The aim of this article is to review the relevant issues in the management of clinical nursing situation and drugs commonly used in palliative sedation in agony. ⋯ The goal of palliative sedation (PS) is to reduce the level of consciousness as the only way to relieve intense suffering in terminally ill patients, such as refractory delirium or dyspnea, massive bleeding, convulsive status, crackles premortem or refractory psychological suffering. The route of choice in PS is subcutaneous injection (sc). First line drugs in sedation are midazolam and levomepromazina. Opioids should be kept at equi-analgesic doses, morphine chloride being the most widely used. The fundamental role of nursing in SP is monitoring the level of sedation based on the Ramsay scale (or similar) and recognition of the indicative signs of discomfort for administration rescue sedative or analgesic medication and/or screening treatable intercurrent process (distended bladder, constipation, obstruction way, final dose effect, etc.).
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A key element to promote the compliance of hand hygiene (HH) among health care workers (HCWs) is to analyze their perceptions of it. Our objective was to evaluate the beliefs and perceptions that nursing students have on HH. ⋯ HH was rated as an important NI control measure. Educational programs should be carried out at universities to students do HH, whether they observe poor compliance among HCWs in their practices.
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Patients admitted to the ICU are at risk of immobility and an early and important physical deconditioning. ⋯ The development and implementation of a protocol for early mobilization of ICU patients has facilitated the integration of this care in daily practice. This model of evidence-based practice allows nurses an active part in changing the culture in terms of the integration of research into practice.
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Therapeutic hypothermia (TH) is recommended to improve survival and neurologic prognosis in sudden cardiac arrest (SCA) survivors. There are few data aboutglycemic levels in these patients. The aim of this study is to evaluate the glycemic control using a specific protocol in this group ofpeople. ⋯ The implementation of a specific insulin protocol in patients receiving TH contributes to improve the blood glucose levels. Further studies are needed to evaluate the clinical impact of these protocols in this group ofpatients.
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Sedation is monitored to avoid both under- and oversedation. ⋯ Deep sedation was clearly prevalent in patients with mechanical ventilation under continuous sedation, with few changes in ventilation mode, because it is prevalent control ventilation mode and no changes in sedonalagesic perfusion in that range.