Autori: Christel Westerlund
Ustanova zaposlenja: SWEDEN
Ključne riječi: Follow up clinic, facial mask, NIV
Kongres/Simpozij: ”5. Međunarodni kongres HDMSARIST-a” i ”8. Međunarodni kongres WFCCN-a”
Mjesto i vrijeme održavanja: Šibenik, 12.-15. travnja 2012. godine
It is well-known that ICU patients have few or fragmentary memories, from their stay at the ICU. They describe their memories as disillusioned, nightmares and sometimes even hallucinations. Some of the ICU patients even develop ICU-delirium and critical illness poly neuropathy, which later could cause PTSD, post traumatic stress disorder.
Following up discharged ICU patients with a stay at ICU > 96 hours is a quality indicator at SIR (Swedish Intensive Care registry). In Sweden many hospitals have established a ICU follow-up clinic during the last decade The follow-up clinic at Danderyds Hospital started 2004, and during this time nearly 300 discharged ICU patients have visit the Following up clinic.
During the follow up service they meet an anesthetist, a physiotherapist, and a critical care nurse, with whom they discuss their experience in ICU. They fill in three questionnaires, ICU-Memory Tool, SF 36 and questions who could render future changes and improvements in daily care.
Quality Improvement in treatment and nursing care are continuously going on at the ICU. Tendency in Sweden today is a decrease in sedation, a strategy to keep patients more awake. A combination of less sedated and spontaneously breathing patients with support from the ventilator makes the patient able to start an earlier mobilization. Significant factors reducing length of stay at the ICU. Increasing number of patients have NIV (noninvasive ventilation) support with different shapes of facemasks. During the last one and a half year we have interviewed the patients about their experience of wearing a facemask.
We found from the results from the questionnaires and from the interview that after changing sedation strategies patients more often have memories of their stay at the ICU. They also experienced discomfort when treated with NIV. The discomfort was related to the facemask. A conceptual and future challenge is to meet the benefits with the new treatments in relation to patient comfort.