Intervenciones de cuidado aplicadas por el personal de enfermería en la prevención de la neumonía asociada a ventilación mecánica en pacientes de unidad de cuidado intensivo adulto

La neumonía asociada a ventilación mecánica (NAVM), es una de las infecciones nosocomiales de mayor prevalencia en las unidades de cuidado intensivo, lo que a su vez contribuye a un aumento en las tasas de morbimortalidad, estancia hospitalaria y por consiguiente incremento en los costos hospitalarios. Por ser un proceso patológico que se desarrolla intrahospitalariamente y se constituye una entidad prevenible la enfermera(o) desempeña un papel protagónico en liderar y desarrollar intervenciones oportunas que prevengan la aparición de NAVM.Especialista en Cuidado CríticoEspecializació

Effect of a discharge plan in patients with heart failure from january to november 2019 in Bogota

La falla cardiaca (FC) es una enfermedad con un alto impacto negativo en calidad de vida, siendo necesario el desarrollo de estrategias que promuevan el autocuidado desde la hospitalización y apoyen el proceso de transición. Objetivo: Determinar el efecto que tiene un plan de alta de enfermería en el nivel de autocuidado de los pacientes con FC que se encuentran hospitalizados de enero a noviembre de 2019. Metodología: Se realizará un ensayo clínico controlado con un a tamaño de muestra de 64 pacientes con diagnóstico de FC. Los pacientes se aleatorizaron al plan de alta o al seguimiento usual. Para la medición del nivel de autocuidado se utilizó la escala Europea de Autocuidado con una alfa de Cronbach de 0,7. Se realizó un análisis descriptivo con tablas de frecuencias y de distribución porcentual y la prueba no paramétrica U de Mann Whitney. Resultados: Antes de aplicar el plan de alta, se determinó que el 90,2 % de los pacientes del grupo control e intervención tenían un nivel bajo de autocuidado. Los ítems más relevantes y con mayor porcentaje que puntuaron en una escala tipo Likert de 5, es decir que nunca realizaban ese comportamiento fueron los relacionados con el contacto oportuno con el personal de salud ante la presencia de signos y síntomas de alarma y el de monitoreo diario de peso para los dos grupos. Posterior a la aplicación del plan de alta se observó una mejoría estadísticamente significativa (p: 0.000) en el nivel de autocuidado y en los ítems en el grupo intervención. Conclusiones: El plan de alta tuvo un efecto beneficioso en el nivel de autocuidado porque gracias a sus componentes educativos, motivacionales, de refuerzo de conductas y gestión de síntomas permitió que los pacientes asumieran un rol activo en la modificación de sus conductas para promover la salud. Palabras Clave: Plan de alta, falla cardiaca, enfermería, autocuidado.Pacientes con falla cardíacaHeart failure (HR) is a disease with a high negative impact on quality of life, being necessary to develop strategies that promote self-care from hospitalization and support the transition process. Objective: To determine the effect that a nursing discharge plan has on the level of self-care of patients with HR who are hospitalized from January to November 2019. Methodology: A controlled clinical trial will be conducted with a sample size of 64 patients diagnosed with CF. The patients were randomized to the discharge plan or to the usual follow-up. The European Self-care scale with a Cronbach alpha of 0.7 was used to measure the level of self-care. A descriptive analysis was carried out with frequency tables and percentage distribution and the non-parametric Mann Whitney U test. Results: Before applying the discharge plan, it was determined that 90.2% of the patients in the control and intervention group had a low level of self-care. The most relevant items with the highest percentage that scored on a Likert scale of 5, that is to say that they never performed this behavior were those related to the timely contact with health personnel in the presence of alarm signs and symptoms and monitoring Daily weight for both groups. After the application of the discharge plan, a statistically significant improvement (p: 0.000) was observed in the level of self-care and in the items in the intervention group. Conclusions: The discharge plan had a beneficial effect on the level of self-care because, thanks to its educational, motivational, behavioral reinforcement and symptom management components, it allowed patients to take an active role in modifying their behaviors to promote health. Keywords: Discharge plan, heart failure, nursing, self-care.Magíster en Enfermería en Cuidado CríticoMaestrí

Professional profile and work conditions of nurses working in intensive care units: A multicentre study

Aim: To determine the professional profile and the work conditions of nurses working in intensive care units (ICU) in Colombia, Argentina, Peru and Brazil. Background: ICUs require a differentiated professional profile to provide quality care, and appropriate working conditions, leading to a transformation of care and management practices. Design: Descriptive multicentre cross-sectional observational study. Methods: An online survey was applied to identify both the characteristics of the professional profile and the working conditions. 1,427 ICU nursing professionals were included. RStudio statistical software was used for the analysis of the information. Descriptive statistics were used for the presentation of the results. The STROBE checklist for cross-sectional studies was used in this study. Results: Only 33.6% of the professionals had a specialisation degree in intensive care. The skills that were most frequently put into practice were communication (68.5%) and care management (78.5%). The most predominant nurse-to-patient ratios were 1:2, and greater than 1:6. 59.1% of the nurses had an indefinite term contract, 38.8% worked 48 hours per week and 49.8% had rotating shifts. Only 50.4% of them received incentives. The average salary ranged between 348 and 1,500 USD. 64.5% of the participants were satisfied with their job. Conclusion: It is necessary to strengthen nurses’ professional profile by promoting both postgraduate education and the development of troubleshooting and teamwork skills. It is necessary to standardise the nurse-to-patient ratio, improve wages and increase incentives to achieve greater job satisfaction. Relevance to practice: The knowledge and the improvement of both the professional profile and the work conditions of nurses working in intensive care units will improve the quality of the care given to critical patients and, therefore, the quality of health outcomes.Fil: Achury Saldaña, Diana Marcela. Pontificia Universidad Javeriana. Faculty of Nursing; ColombiaFil: Achury Beltrán, Luisa Fernanda. Pontificia Universidad Javeriana. Faculty of Nursing; ColombiaFil: Rodríguez Colmenares, Sandra Mónica. Pontificia Universidad Javeriana. Faculty of Nursing; ColombiaFil: Alvarado Romero, Herly Ruth. Pontificia Universidad Javeriana. Faculty of Nursing; ColombiaFil: Cavallo, Edhit. Universidad Católica de Cordoba; ArgentinaFil: Ulloa, Ana Cristina. Universidad Católica de Cordoba; ArgentinaFil: Merino, Virginia. Hospital Edgardo Rebagliati Martins; PerúFil: da Silva Barreto, Mayckel. Universidade Federal do Mato Grosso do Sul; BrasilFil: Andrade Fonseca, David. B. Braun Avitum; ColombiaFil: Muñoz Acuña, Doraly. Universidad de los Llanos. Faculty of Nursing; ColombiaFil: Betancur Manrique, Yanier. Universidad Católica de Manizales. Faculty of Nursing; ColombiaFil: Rodríguez Marín, Jorge Eliecer. Universidad Católica de Manizales. Faculty of Nursing; ColombiaFil: González Gómez, Ana Angelica. Universidad de Cartagena. Faculty of Nursing; ColombiaFil: Herrera Corpas, Katerine. Universidad de Cartagena. Faculty of Nursing; ColombiaFil: Andrade Méndez, Brayant. Universidad Surcolombiana. Faculty of Nursing; ColombiaFil: Vargas Toloza, Ruby Elizabeth. Universidad Francisco de Paula Santander. Faculty of Nursing; ColombiaFil: Martínez Rojas, Sandra Milena. Universidad Francisco de Paula Santander. Faculty of Nursing; ColombiaFil: De las Salas Martínez, Roxana Patricia. Universidad del Norte. Faculty of Nursing; Colombi