Nivel de conocimiento y aplicabilidad de mecánica corporal de las enfermeras que laboran en emergencia - Hospital Regional Lambayeque, 2015

El personal de enfermería desarrolla múltiples tareas que requieren un gran esfuerzo físico; para evitar las lesiones durante la realización de estas actividades es necesario tener el conocimiento y práctica de la mecánica corporal. Por ello se realizó este estudio con el objetivo de: Determinar el nivel de conocimiento y aplicabilidad de mecánica corporal de las enfermeras que laboran en emergencia del Hospital Regional Lambayeque, 2015. La hipótesis a comprobar fue: existe relación entre la variable nivel de conocimiento y aplicabilidad de mecánica corporal. Esta investigación fue de tipo cuantitativa diseño metodológico correlacional, se consideró una muestra de 35 enfermeras. Se aplicaron dos cuestionarios referidos al nivel de conocimiento y aplicabilidad de la mecánica corporal, las mismas que fueron validadas por prueba piloto, con una confiabilidad según alfa de Conbrach de 0.64 y 0.69 respectivamente. Los resultados obtenidos revelaron que el 24.14% y el 72.41% de los profesionales de enfermería tienen un alto y medio nivel de conocimiento sobre mecánica corporal respectivamente. En relación a la aplicabilidad se obtuvo que el 89.66% siempre aplica la mecánica corporal y el 10.34% a veces. Se obtuvo una correlación entre las dos variables: nivel de conocimiento y aplicabilidad de mecánica corporal con un nivel de significancia de 0,041.En la investigación se aplicaron la validez, confiabilidad y objetividad como rigor científico; y los principios éticos de beneficencia, respeto a la dignidad humana y de justicia

Factores que determinan la extubación tardía y riesgos asociados a esta en pacientes post operados cardíacos en la Unidad de Terapia Intensiva del Hospital Edgardo Rebagliati Martins durante el período enero - junio 2010

El documento digital no refiere asesorPublicación a texto completo no autorizada por el autorDetermina las características y variables preoperatorias e intraoperatorias responsables de prolongar la insuficiencia respiratoria perioperatoria del paciente sometido a cirugía cardíaca y determinar el impacto de la extubación tardía en la estancia hospitalaria, específicamente unidad de terapia intensiva y la ocurrencia de complicaciones postoperatorias relacionadas. El estudio es retrospectivo de casos y controles, se revisaron historias clínicas de los pacientes postoperados cardiacos durante el período enero-junio 2010. La población estuvo formada por 137, se identificaron los casoso, pacientes extubados después de las 8 hrs, y se obtuvieron sus pares sometidos a extubación temprana, menor de 8 horas. Dentro de las variables asociadas a extubación tardía se encuentran, preoperatorias : FE baja (χ²=4.73 con un nivel de significancia del 95%) con un OR 3, IC 2,48-8,80, para un p 30 (χ²=5.14 con un nivel de significación de 95%) OR 3.33 , IC 1,14-9,71 , hipoxemia ,< 80 mmHg, (χ²=4.73 con un nivel de significancia del 95%) con OR 3 IC 1,18-7,4 para un p </= 0,05; variables intraopeatorias: CEC prolongada (χ²= 6,23 significancia 95%) OR 3,6 , con IC 1,18-9,86; cirugía de emergencia ( χ²= 8,35 con significancia de 95%) OR 4.0 IC de 1.57-10,20; revascularización de tres o más arterias ( χ²= 5,17 nivel de significancia de 95%) OR 3,84, con IC 1,32-11.02. En este grupo de pacientes, se aprecia el desarrollo de infecciones respiratorias intrahospitalarias, neumonía y traqueobronquitis ( χ²= 4.64 , p <= 0.05) OR 4.26 e IC de 1.26-13.7 y estancia mayor de 72 horas en la unidad de terapia intensiva( χ²= 5.29, p <= 0.05), un OR 3.37 con IC de 1,36- 8,54; además de niveles más bajos de hemoglobina, menores de 10 g/dl,( χ²= 5,93 , nivel de significancia de 95%) un OR 2,78 para un IC 1,13-6,86 con p <= 0.05. La extubación tardía se asocia a mayor estacia en UCI y a infecciones respiratorias. Las variables que determinan extubación tardía son IMC, presión arterial de oxígeno, fracción de eyección, CEC prolongada, cirugía de emergencia y ejecución de 3 o más injertos

Nivel de conocimiento y aplicabilidad de mecánica corporal de las enfermeras que laboran en emergencia - Hospital Regional Lambayeque, 2015

TesisEl personal de enfermería desarrolla múltiples tareas que requieren un gran esfuerzo físico; para evitar las lesiones durante la realización de estas actividades es necesario tener el conocimiento y práctica de la mecánica corporal. Por ello se realizó este estudio con el objetivo de: Determinar el nivel de conocimiento y aplicabilidad de mecánica corporal de las enfermeras que laboran en emergencia del Hospital Regional Lambayeque, 2015. La hipótesis a comprobar fue: existe relación entre la variable nivel de conocimiento y aplicabilidad de mecánica corporal. Esta investigación fue de tipo cuantitativa diseño metodológico correlacional, se consideró una muestra de 35 enfermeras. Se aplicaron dos cuestionarios referidos al nivel de conocimiento y aplicabilidad de la mecánica corporal, las mismas que fueron validadas por prueba piloto, con una confiabilidad según alfa de Conbrach de 0.64 y 0.69 respectivamente. Los resultados obtenidos revelaron que el 24.14% y el 72.41% de los profesionales de enfermería tienen un alto y medio nivel de conocimiento sobre mecánica corporal respectivamente. En relación a la aplicabilidad se obtuvo que el 89.66% siempre aplica la mecánica corporal y el 10.34% a veces. Se obtuvo una correlación entre las dos variables: nivel de conocimiento y aplicabilidad de mecánica corporal con un nivel de significancia de 0,041.En la investigación se aplicaron la validez, confiabilidad y objetividad como rigor científico; y los principios éticos de beneficencia, respeto a la dignidad humana y de justicia

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

International audienceBackground: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0-4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2-6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society