Risk factors and preventive measures for corneal injury in the intensive care unit: Scoping review

Epidemiological studies on pressure ulcers (PUs) in hospitalised infants are scarce. Spain lacks comprehensive research studies providing data on the prevalence or incidence in this population. This work was developed to determine the incidence of PUs in hospitalised infants admitted to intensive and intermediate care units, along with relevant risk factors and preventive measures. A prospective study appraising the incidence of PUs in infants was performed. The risk factors and preventive measures were evaluated using a multivariate logistic regression model. A sample of 268 infants was included. The cumulative incidence of PUs was 12.70% (95% confidence interval, CI95% = [8.95%-17.28%]). The cumulative incidence in the intermediate care units was 1.90% (CI95% = [0.39%-5.45%]), while it was 28.18% (CI95% = [20.02%-37.56%]) in the intensive care units. The PUs were categorised as stage I, 57.10%; stage II, 31.70%; and stage III, 11.10%. The multivariate analysis found the following to be risk factors: low scores in the Spanish version of the Neonatal Skin Risk Assessment Scale (e-NSRAS) (Relative Risk (RR) 0.80; CI95% = [0.66-0.97]), the use of non-invasive mechanical ventilation (RR 12.24; CI95% = [4.02-37.32]), and the length of stay (RR 1.08; CI95% = [1.02-1.15]), suggesting a direct impact of these factors on PU development in infants. Kangaroo care influenced the prevention of PUs (RR 0.26; CI95% = [0.09-0.71]). The infants admitted in intermediate care units suffered PUs. In the case of intensive care units, the incidence is even higher. The risk increases with the length of stay, while the presence of medical devices, particularly non-invasive mechanical ventilation, is the main causal relationship. Kangaroo care has been shown to be an important preventive measure.

Risk factors and preventive measures for corneal injury in the intensive care unit: Scoping review.

Background: Varicose vein has disturbed humans since ancient days as a chronic disorder. According to the current statistics given by the Express health care, approximately 2.7 million people worldwide suffer with varicose veins. If left untreated and undiagnosed, varicose veins can end up with pooling of blood in the venous system and further complications.
 Aim and Objectives: Aim of the study was to assess the knowledge of staff nurses regarding risk factors and preventive measures of varicose vein. The study objectives were to assess the knowledge of staff nurses working in intensive care units regarding risk factors and preventive measures of varicose vein, to develop an evidence-based information booklet for staff nurses regarding prevention of varicose veins and to find out the association between the knowledge scores of staff nurses regarding risk factors and preventive measures of varicose vein with selected demographic variables.
 Materials and methods: A quantitative research approach with a non-experimental descriptive survey research design was used to select 60 staff nurses working in the ICUs using convenience sampling method. The data was collected using a structured knowledge questionnaire developed by the researchers. Data was analysed using descriptive and inferential statistics using SPSS.
 Results: The study results showed that 53% of the staff nurses had adequate knowledge scores regarding the risk factors and preventive measures of varicose veins whereas 30% had moderate knowledge, and 17 % had inadequate knowledge scores. Significant association was found between demographic variables such as age, experience and education of staff nurses with their knowledge scores.
 Conclusion: Approximately only half of the study participants had adequate knowledge regarding risk factors and preventive measures of varicose vein. Hence it is recommended that extensive educational sessions to be conducted for further enhancement of awareness of staff nurses related to prevention and management of varicose veins.

Multicentre prospective study to establish a risk prediction model on pressure injury in the neonatal intensive and intermediate care units.

Psychiatric management of Patients in intensive care units.

AimsThis study was performed to identify and summarize systematic reviews focusing on the prevention of unplanned endotracheal extubation in the intensive care unit.DesignOverview of systematic reviews.MethodsThis overview was conducted according to the Preferred Reporting Items for Overviews of Systematic Reviews, including the harms checklist. A literature search of PubMed, the Cochrane Library, CINAH, Embase, Web of Science, SINOMED and PROSPERO was performed from January 1, 2005–June 1, 2021. A systematic review focusing on unplanned extubation was included, resulting in an evidence summary.ResultsThirteen systematic reviews were included. A summary of evidence on unplanned endotracheal extubation was developed, and the main contents were risk factors, preventive measures and prognosis. The most important nursing measures were restraint, fixation of the tracheal tube, continuous quality improvement, psychological care and use of a root cause analysis for the occurrence of unplanned endotracheal extubation.ConclusionsThis overview re‐evaluated risk factors and preventive measures for unplanned endotracheal extubation in the intensive care unit, resulting in a summary of evidence for preventing unplanned endotracheal extubation and providing direction for future research.Trial registration detailsThe study was registered on the PROSPERO website.

Long-stay patients with cancer on the intensive care unit: characteristics, risk factors, and clinical outcomes

Critical care and the global burden of critical illness in adults

Survival from critical illness has improved in recent years, leading to increased attention to the sequelae of such illness. Neuromuscular weakness in the intensive care unit (ICU) is common, persistent, and has significant public health implications. The differential diagnosis of weakness in the ICU is extensive and includes critical illness neuromyopathy. Prolonged immobility and bedrest lead to catabolism and muscle atrophy, and are associated with critical illness neuromyopathy and ICU-acquired weakness. Early mobilization therapy has been advocated as a mechanism to prevent ICU-acquired weakness. Early mobilization is safe and feasible in most ICU patients, and improves outcomes. Implementation of early mobilization therapy requires changes in ICU culture, including decreased sedation and bedrest. Various technologies exist to increase compliance with early mobilization programs. Drugs targeting muscle pathways to decrease atrophy and muscle-wasting are in development. Additional research on early mobilization in the ICU is needed.

Are Unselected Risk Scores in the Cardiac Intensive Care Unit Needed?

How do you deal with burnout in the clinical workplace?

BackgroundInflammatory myopathies (IM) are life-threatening but treatable diseases. The risk factors for admission in Intensive care unit (ICU), the management and the outcome of patients with IM admitted to ICU...

To examine which patient characteristics increase the risk for intensive care unit readmission and assess the association of readmission with case-mix adjusted mortality and resource use. : Retrospective cohort study. Ninety-seven intensive and cardiac care units at 35 hospitals in the United States. A total of 229,375 initial intensive care unit admissions during 2001 through 2009 who met inclusion criteria. None. For patients who were discharged alive and candidates for readmission, we compared the characteristics of those with and without a readmission. A multivariable logistic regression analysis was used to identify potential patient-level characteristics that increase the risk for subsequent readmission. We also evaluated case-mix adjusted outcomes by comparing observed and predicted values of mortality and length of stay for patients with and without intensive care unit readmission. Among 229,375 first admissions that met inclusion criteria, 13,980 (6.1%) were eventually readmitted. Risk factors associated with the highest multivariate odds ratio for unit readmission included location before intensive care unit admission, age, comorbid conditions, diagnosis, intensive care unit length of stay, physiologic abnormalities at intensive care discharge, and discharge to a step-down unit. After adjustment for risk factors, patients who were readmitted had a four-fold greater probability of hospital mortality and a 2.5-fold increase in hospital stay compared to patients without readmission. Intensive care readmission is associated with patient factors that reflect a greater severity and complexity of illness, resulting in a higher risk for hospital mortality and a longer hospital stay. To improve patient safety, physicians should consider these risk factors when making intensive care discharge decisions. Because intensive care unit readmission correlates with more complex and severe illness, readmission rates require case-mix adjustment before they can be properly interpreted as quality measures.

ObjectiveTo explore mortality risk factors for patients hospitalised with COVID-19 in a critical care unit (CCU) or a hospital care unit (HCU).DesignRetrospective cohort analysis using the French national (Programme de...

Controlling the spread of vancomycin-resistant enterococci. Is active screening worthwhile?