Patients' exposure to physical damage in the intesive care unit

Cilj: Cilj istraživanja je ispitati postojanje i razinu nepovoljnih fizikalnih čimbenika u jedinici intenzivnog liječenja okoline kao izvora stresa kod bolesnika te ispitati doprinos čimbenika kao stresora na kvalitetu življenja hospitaliziranih bolesnika. Ispitanici i metode: Uzorak ispitanika sačinjava 39 bolesnika hospitaliziranih u Klinici za anesteziologiju, reanimatologiju i intenzivno liječenje u Splitu. Istraživanje je provedeno pomoću anketnog upitnika kojeg su ispitanici popunili od ožujka do travnja do lipnja 2017. Rezultati: Bolesnici obuhvaćeni istraživanjem razlikuju se bitno po spolnoj i dobnoj strukturi, te je duljina trajanja hospitalizacije u širokom rasponu. Segment koji se ističe u smislu zadovoljstva pacijenata s različitim aspektima pružanja zdravstvenih usluga je zadovoljstvo pruženom zdravstvenom njegom i odnosom medicinske sestre. Isto tako ispitanici su nisko ocijenili informiranost o bolesti i planu liječenja. Nadalje, ispitivanjem prediktora stresa kod hospitaliziranih bolesnika naviše se ističe kategorija zabrinutosti za zdravlje. Analizom rezultata kojima su ispitanici procjenjivali fizikalne čimbenike čije prisustvo ili djelovanje može imati biti povezano s uzročnosti stresa, najviše se ističu čimbenici rasvjete i strujanja zraka, nakon čega slijedi buka u prostoriji. Među skupinom ispitanika nad kojima je provedeno istraživanje nije potvrđena stresogena okolnost fizikalnih agensa okoline kao statistički značajna. Dominantnu prediktivnu karakteristiku stresa za vrijeme hospitalizacije ispitanici su iskazali u varijabli brige za buduće zdravlje.Objective: The objective of this research is to examine the existence and level of unfavourable physical factors of the environment as a source of stress for patients in the intensive care unit and claim the contribution factors as stressors on the quality of life of hospitalized patients. Subjects and methods: The sample of respondents made up of 39 patients hospitalized at the clinic for Anesthesiology, reanimatology and intensive care in KBC Split. The survey was conducted using a questionnaire which the respondents fill in from March to April to June 2017. Results: Patients included in the survey were differ significantly by gender and age structure, and the length of the duration of hospitalization in a wide range. The segment that stands out in terms of patients' satisfaction with various aspects of the provision of health care services is the satisfaction with the health care and the conducts of nurses relationship. The subjects were also lowly rated information given about the disease and treatment plan. In addition, by examining the predictors of multidrug-resistant stress for hospitalized patients up notable category of concern for health. The analysis of the results which the respondents assessed the environmental factors like physical agents whose presence or action may have to be coupled with causality stress, the most notable factors were related to lighting and air circulation, followed by a noise in the room. Among a group of subjects over which the research was conducted, circumstance of physical agents environment were not cnofirmed as statistically significant. The dominant feature of a predictive stress during hospitalization, respondents expressed in variables of concern for future health

Patients' exposure to physical damage in the intesive care unit

Cilj: Cilj istraživanja je ispitati postojanje i razinu nepovoljnih fizikalnih čimbenika u jedinici intenzivnog liječenja okoline kao izvora stresa kod bolesnika te ispitati doprinos čimbenika kao stresora na kvalitetu življenja hospitaliziranih bolesnika. Ispitanici i metode: Uzorak ispitanika sačinjava 39 bolesnika hospitaliziranih u Klinici za anesteziologiju, reanimatologiju i intenzivno liječenje u Splitu. Istraživanje je provedeno pomoću anketnog upitnika kojeg su ispitanici popunili od ožujka do travnja do lipnja 2017. Rezultati: Bolesnici obuhvaćeni istraživanjem razlikuju se bitno po spolnoj i dobnoj strukturi, te je duljina trajanja hospitalizacije u širokom rasponu. Segment koji se ističe u smislu zadovoljstva pacijenata s različitim aspektima pružanja zdravstvenih usluga je zadovoljstvo pruženom zdravstvenom njegom i odnosom medicinske sestre. Isto tako ispitanici su nisko ocijenili informiranost o bolesti i planu liječenja. Nadalje, ispitivanjem prediktora stresa kod hospitaliziranih bolesnika naviše se ističe kategorija zabrinutosti za zdravlje. Analizom rezultata kojima su ispitanici procjenjivali fizikalne čimbenike čije prisustvo ili djelovanje može imati biti povezano s uzročnosti stresa, najviše se ističu čimbenici rasvjete i strujanja zraka, nakon čega slijedi buka u prostoriji. Među skupinom ispitanika nad kojima je provedeno istraživanje nije potvrđena stresogena okolnost fizikalnih agensa okoline kao statistički značajna. Dominantnu prediktivnu karakteristiku stresa za vrijeme hospitalizacije ispitanici su iskazali u varijabli brige za buduće zdravlje.Objective: The objective of this research is to examine the existence and level of unfavourable physical factors of the environment as a source of stress for patients in the intensive care unit and claim the contribution factors as stressors on the quality of life of hospitalized patients. Subjects and methods: The sample of respondents made up of 39 patients hospitalized at the clinic for Anesthesiology, reanimatology and intensive care in KBC Split. The survey was conducted using a questionnaire which the respondents fill in from March to April to June 2017. Results: Patients included in the survey were differ significantly by gender and age structure, and the length of the duration of hospitalization in a wide range. The segment that stands out in terms of patients' satisfaction with various aspects of the provision of health care services is the satisfaction with the health care and the conducts of nurses relationship. The subjects were also lowly rated information given about the disease and treatment plan. In addition, by examining the predictors of multidrug-resistant stress for hospitalized patients up notable category of concern for health. The analysis of the results which the respondents assessed the environmental factors like physical agents whose presence or action may have to be coupled with causality stress, the most notable factors were related to lighting and air circulation, followed by a noise in the room. Among a group of subjects over which the research was conducted, circumstance of physical agents environment were not cnofirmed as statistically significant. The dominant feature of a predictive stress during hospitalization, respondents expressed in variables of concern for future health

The impact of interventions to improve adherence to preventive measures on the incidence of nosocomial infections in ICUs

Half of all life-threating nosocomial infections occur in intensive care units (ICUs) and, despite the advances in intensive care, the incidence of nosocomial infections is still high. About one third of nosocomial infections are considered preventable. Awareness of risk factors, adherence to preventive measures and collaboration of all members participating in preventive programmes can lead to reduction of the incidence of nosocomial infections and thus can produce a positive impact on reducing morbidity, mortality and healthcare costs. A retrospective surveillance study was performed in a 14-bed medical ICU to identify device-related infections before and after the preventive interventions. Ventilator-associated pneumonia (VAP), central line-associated bloodstream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI) were obtained and compared before and after the interventions. In the year before the interventions, device-related nosocomial infections were diagnosed in 7.9% out of 737 hospitalised patients in the ICU, and in the year after the interventions they were diagnosed in 5.1% out of 684 hospitalised patients. Before the interventions, the infection rates were distributed as follows: 7.5 CLABSI/1000 catheter days, 28.4 VAP/1000 ventilator days, 6.5 CAUTI/1000 catheterisation days. After the interventions, the rates were distributed as follows: 2.5 CLABSI/1000 catheter days, 26.5 VAP/1000 ventilator days and 4.1 CAUTI/1000 catheterisation days. The implementation of effective preventive measures and maintaining strict surveillance is the basis of limiting the risk of nosocomial infections. Since hospital nosocomial infection rate is considered an indicator of quality and safety of care, all infection control activities are focused to decrease rate of nosocomial infections

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat