1
|
Gallart E, Delicado M, Nuvials X. [Update of the recommendations of the Bacteraemia Zero Project]. Enferm Intensiva 2022; 33:S31-S39. [PMID: 35911623 PMCID: PMC9315357 DOI: 10.1016/j.enfi.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
El proyecto Bacteriemia Zero (BZ) fue el primero de los Proyectos Zero que se implementó en las Unidades de Cuidados Intensivos (UCI), consiguiendo una disminución de las tasas de infección relacionadas con catéter por debajo de las recomendadas por los estándares de calidad de las sociedades científicas. A raíz de la pandemia causada por el SARS-CoV-2 en las UCI, se ha observado un incremento importante de estas tasas de infección. El incremento de las tasas de infección y la necesidad de incorporar en la práctica clínica la mejor evidencia disponible, justifica la necesidad de actualizar las recomendaciones del proyecto BZ. Se constituyó un grupo de trabajo formado por miembros de las diferentes sociedades científicas que consideró que el paquete de medidas obligatorias del proyecto no debía modificarse debido a su eficacia demostrada y decidió incorporar, después de su revisión, las siguientes medidas opcionales: uso de catéteres impregnados con antimicrobianos, uso de apósitos impregnados con clorhexidina, uso de tapones con solución antiséptica en los conectores e higiene corporal diaria con clorhexidina.
Collapse
Affiliation(s)
- E Gallart
- Unidad de Cuidados Intensivos, Hospital Universitari Vall d'Hebron, Grupo de Investigación Multidisciplinar de Enfermería, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, España
| | - M Delicado
- Organización Sanitaria Integrada Bilbao-Basurto Basurto, España
| | - X Nuvials
- Servicio de Medicina Intensiva, Hospital Universitari Vall d'Hebron, Grupo de Investigación SODIR, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, España
| | | |
Collapse
|
2
|
Raurell-Torredà M, Arias-Rivera S, Martí JD, Frade-Mera MJ, Zaragoza-García I, Gallart E, Velasco-Sanz TR, San José-Arribas A, Blazquez-Martínez E. Care and treatments related to intensive care unit-acquired muscle weakness: A cohort study. Aust Crit Care 2021; 34:435-445. [PMID: 33663950 DOI: 10.1016/j.aucc.2020.12.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/28/2020] [Accepted: 12/13/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Intensive care unit-acquired muscle weakness (ICUAW) has an incidence of 40-46%. Early mobilisation is known to be a protective factor. OBJECTIVE The aim of the study was to identify the incidence of ICUAW in Spain and to evaluate variables likely to contribute to the development of ICUAW. METHODS A 4-month, prospective observational multicentre cohort study was conducted on patients receiving invasive mechanical ventilation for at least 48 h. Data were collected from ICU day 3 until ICU discharge. The primary outcome was presence of ICUAW (diagnosed using the Medical Research Council [MRC] scale). The secondary outcome was nurse-patient ratio, physiotherapist availability, analgesia, sedation and delirium management, glycaemic control, and daily level of mobility during the ICU stay as per the ICU Mobility Scale. A logistic regression model was constructed based exclusively on days 3-5 of the ICU stay. RESULTS The data of 642 patients were analysed from 80 ICUs, accounting for 35% of all ICUs in Spain. The incidence of ICUAW was 58% (275 of 474 patients; 95% confidence interval [CI] [53-62]). The predictors for ICUAW were older age (odds ratio [OR] = 1.01; 95% CI [1.00-1.03]) and more days with renal replacement therapy (OR = 1.01; 95% CI [1.00-1.02]). The protective factors for ICUAW were male gender (OR = 0.58; 95% CI [0.38-0.89]), higher Barthel Index (showing prehospital functional independence) (OR = 0.97; 95% CI [0.95-0.99]), more days of being awake and cooperative (defined by a feasible MRC assessment) (OR = 0.98; 95% CI [0.97-0.99]), presence of delirium (OR = 0.98; 95% CI [0.97-0.99]), and more days with active mobilisation (ICU Mobility Scale ≥ 4) (OR = 0.98; 95% CI [0.97-0.99]). CONCLUSIONS The risk factors for ICUAW were functional dependence before admission, female gender, older age, and more days on renal replacement therapy. The protective factors for ICUAW were feasibility of MRC assessment, the presence of delirium, and being actively mobilised during the first 5 days in the ICU.
Collapse
Affiliation(s)
- M Raurell-Torredà
- Department of Fundamental and Medical Surgical Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Spain
| | - S Arias-Rivera
- University Hospital of Getafe, CIBER Respiratory Diseases, Carlos III Institute of Health, Madrid, Spain
| | - J D Martí
- Clinic University Hospital, Barcelona, Spain
| | - M J Frade-Mera
- 12 Octubre University Hospital, Madrid, Spain; Department of Nursing, Faculty of Nursing, Physiotherapy and Podology, Complutense University of Madrid, Spain
| | - I Zaragoza-García
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podology, Complutense University of Madrid, Spain; Care Research Group (Invecuid), 12 de Octubre Hospital Institute of Health Research (imas12), Madrid, Spain.
| | - E Gallart
- Vall Hebron University Hospital, Barcelona, Spain
| | - T R Velasco-Sanz
- San Carlos University Hospital, Madrid, Spain; Department of Nursing, Faculty of Nursing, Physiotherapy and Podology, Complutense University of Madrid, Spain
| | - A San José-Arribas
- Sant Pau University School of Nursing (Santa Creu i Sant Pau Hospital), Barcelona, Spain
| | | | | |
Collapse
|
3
|
Raurell-Torredà M, Arias-Rivera S, Martí J, Frade-Mera M, Zaragoza-García I, Gallart E, Velasco-Sanz T, San José-Arribas A, Blázquez-Martínez E, Rodríguez Delgado ME, Contreras Rodríguez AM, Oreña Cimiano E, Ortega Guerrero Á, Martínez del Aguila MDC, Rodríguez Monsalve V, Cano Herrera CL, Masegosa Pérez JM, González de la Cuesta DM, Pardo Artero MI, Palacios Laseca M, Cabello Casao AI, Vera Bellostas MBVD, Pérez Martínez C, Escuder González S, Lezcano Cisneros A, Miguel Romeo A, López Alegre I, San Pío ERD, Fernández Alonso H, Rodríguez Villanueva LM, Riaño Suárez R, Sánchez Cerviñio B, Carrasco Santos S, José Arribas AS, González García M, Linares Tavio A, Álvarez García P, Polo Hernández N, Gómez Cosío L, Pérez Loza I, Suárez Pérez Á, Crespo Rebollo S, Muñoz Camargo JC, García García J, Rojo Aguado C, Gómez López J, Sonseca Bartolomé L, José Arribas AS, Olmo Nuñez SD, García Mazo P, Siguero Torres E, Muñoz Díez I, Delgado Hito P, Garrido Martín MO, Marín Vivó G, Eseverri Rovira MDM, Guillen Dobon M, Aran Esteve M, Mirabete Rodríguez M, Mariné Méndez A, Rodríguez Fernández S, Rosselló Sancho J, Zafra Lamas V, Carmona Delgado I, Navarro Arilla À, Zariquiey Esteva G, Bueno Luna ÁL, Lerma Brianso C, Gómez García R, Planas Pascual B, Sabaté López M, Mayer Frutos AI, Roca Escrihuela R, Torrents Albà G, García Flores V, Melis Galmés J, Belmonte Moral S, Grau Pellicer M, Ruiz Eizmendi A, Garriga Moll C, de Jaureguízar EB, Cordovilla Guardia S, López Espuela F, Mateos Hinojal L, Redondo Cantos MI, Villar Redondo MDR, Vila Rey J, Sánchez Méndez S, García Fernández Y, Benítez Canosa MC, Díaz Álvarez M, Cordo Isorna JR, Estébez Penín Á, Güeto Rial G, Bouzas López E, Arias Rivera S, Frade Mera MJ, Luengo Alarcia MJ, Regueiro Díaz N, Carrasco Rodríguez-Rey LF, Hernández García MDR, Sala Gómez G, Vecino Rubio J, García González S, Sánchez Sánchez MDM, Cruzado Franco C, Martín Rivera B, González Blanco R, Sánchez de la Ventana AB, Bravo Arcas ML, Escobar Lavela J, Domingo Moreno MDP, García Arias M, Collado Saiz IC, Acevedo Nuevo M, Barrios Suárez A, Zarza Bejarano FJ, Pérez Muñoz MC, Toribio Rubio V, Martínez Chicharro P, Pascual Martínez A, López Pozo S, Sánchez Infante L, Ocaña García V, Menes Medina D, Vadillo Cortázar A, Lendínez Burgos G, Díaz Juntanez J, Godino Olivares MT, Rodríguez Mondéjar JJ, Martínez Rojo FJ, Ruiz Martínez MV, Linares Celdrán D, Ros Molina A, Sáez Sánchez J, Martínez Oliva JM, Bernal Gilar A, Hernández García MB, Ríos Cortés AT, Navarro Méndez R, Gil García S, Sánchez Garre J, Barrio Linares MD, Goñi Viguria R, Aguirre Santano R, García Díez MR, Aparicio Cilla L, Delicado Domingo M, Rodríguez Núñez C, Arrasate López A, Romero Morán Á, Paños Melgoso R, Yañez Cerón M, Mercado Martínez A, Martínez Llopis B, Vayá Albelda MJ, Inat Carbonell J, Alcayne Senent MR, Giménez García F, Fernández Gonzaga EC, Febrer Puchol L, Berenguer Ortuño S, Pastor Martínez M, Valera Talavera D, Segrera Rovira MJ, Langa Revert Y, Espí Pozuelo M, Diego Miravet MÁD, Garijo Aspas B, Asensio García MDR, Sánchez Muñoz JR, Martínez Sánchez Q, López Mateu R. Grado de implementación de las estrategias preventivas del síndrome post-UCI: estudio observacional multicéntrico en España. Enfermería Intensiva 2019; 30:59-71. [DOI: 10.1016/j.enfi.2018.04.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 04/05/2018] [Accepted: 04/12/2018] [Indexed: 01/28/2023]
|
4
|
García CB, Binks R, De Luca E, Dierkes C, Franci A, Gallart E, Niederalt G, Wyncoll D, Vaes P, Soderquist B, Gibot S. Expert Recommendations for Managing Acute Faecal Incontinence with Diarrhoea in the Intensive Care Unit. J Intensive Care Soc 2013. [DOI: 10.1177/17511437130144s201] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Acute faecal incontinence with diarrhoea (AFId) has been reported to affect up to 40% of patients in the intensive care unit (ICU). The clinical challenges of AFId include the risk of perineal skin breakdown and cross-contamination with nosocomial infections, such as Clostridium difficile. In addition, the management of AFId is a burden on nursing time and hospital resources. Despite these challenges, there is currently no standard way of managing AFId. To address this problem, an international panel of intensive care specialists was convened to discuss AFId management recommendations. The collective knowledge of the specialists combined with literature searches from online medical databases were used to create a set of guidelines together with an accompanying management algorithm to aid healthcare providers in deciding the most appropriate care for patients with AFId in the ICU. These guidelines have been specifically designed to take into account patient severity of illness and comorbidities, which coupled with common AFId-associated clinical complications, can influence management choices. A comprehensive review of current AFId management strategies, taking into account the spectrum of patients and hospital economic limitations, has been included as a reference guide. It is hoped that the wider adoption of these recommendations will be a step forward in improving the current management of AFId in the ICU.
Collapse
Affiliation(s)
| | - R Binks
- Airedale NHS Foundation Trust, West Yorkshire, UK
| | - E De Luca
- Policlinico Tor Vergata, Rome, Italy
| | - C Dierkes
- Hospital Barmherzige Brüder, Regensburg, Germany
| | - A Franci
- Azienda Ospedaliera Careggi, Florence, Italy
| | - E Gallart
- Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | | | - D Wyncoll
- Guy's and Thomas' Hospital NHS Foundation, London, UK
| | - P Vaes
- St Elisabeth Hospital, Tilburg, The Netherlands
| | | | - S Gibot
- Hopital Central, Nancy, France
| |
Collapse
|