Degree of implementation of preventive strategies for post-ICU syndrome: Multi-centre, observational study in Spain

Raurell-Torredà, M.; Arias-Rivera, S.; Martí, Joan-Daniel; Frade-Mera, M.J.; Zaragoza-García, Ignacio; Gallart, Elisabet; Velasco-Sanz, T.R.; José‐Arribas, Alicia San; Blázquez-Martínez, Eva; Delgado, María Esther Rodríguez; Rodríguez, Antonia María Contreras; Cimiano, Ester Oreña; Guerrero, Álvaro Ortega; Aguilà, Maria; Monsalve, Virginia Rodríguez; Herrera, Carlos Leonardo Cano; Pérez, Juan Manuel Masegosa; Cuesta, Delia María González de la; Arter, María Inmaculada Pardo; Laseca, Marta Palacios; Casao, Ana Isabel Cabello; Bellostas, María Belén Vicente de Vera; Martínez, Carmen Pérez; González, Sheila Escuder; Cisneros, Amelia Lezcano; Romeo, Antonio Miguel; Alegre, Isabel López; Pío, Emilia Romero de San; Alonso, Helena; Villanueva, Lara María Rodríguez; Suárez, Roberto Riaño; Cerviñio, Begoña Sánchez; Santos, Sergio Carrasco; García, Miriam González; Tavio, Antonio Linares; García, Paz Álvarez; Hernández, Nuria Polo; Cosío, Lourdes Gómez; Loza, Isabel Pérez; Pérez, Ángela Suárez; Rebollo, Sonia Crespo; Camargo, J.C. Muñoz; García, Julián García; Aguado, César Rojo; López, José Gómez; Bartolomé, Laura Sonseca; Arribas, Alicia San José; Nuñez, Sonia del Olmo; Mazo, Patricia García; Torres, Eduardo Siguero; Díez, Isabel Muñoz; Hito, Pilar Delgado; Martín, Mercedes Olalla Garrido; Vivó, Gemma Marín; Rovira, María del Mar Eseverri; Dobon, Montserrat Guillen; Esteve, Montserrat Aran; Rodríguez, Maribel Mirabete; Méndez, Albert Mariné; Fernández, Silvia Rodríguez; Sancho, Joan Rosselló; Lamas, Valeria Zafra; Delgado, Inmaculada Carmona; Arilla, Àngels Navarro; Esteva, Gustau Zariquiey; Luna, Ángel Lucas Bueno; Brianso, Cristina Lerma; García, Rubén Gómez; Pascual, Bernat Planas; López, Marta Sabaté; Frutos, Ana Isabel Mayer; Escrihuela, Roser Roca; Albà, Gemma Torrents; Flores, Vanesa García; Galmés, Joan Melis; Moral, Sandra Belmonte; Pellicer, Montserrat Grau; Eizmendi, Aintzane Ruiz; Moll, Carme Garriga; Jaureguízar, Esteve Bosch de; Cordovilla‐Guardia, Sergio; Espuela, Fidel López; Hinojal, Lara Mateos; Cantos, María Isabel Redondo; Redondo, María del Rosario Villar; Rey, Jesús Vila; Méndez, Susana Sánchez; Fernández, Yolanda García; Canosa, María Cristina Bénitez; Álvarez, Mauricio Díaz; Isorna, José Ramón Cordo; Penín, Ángeles Estébez; Rial, Gloria Güeto; López, Esther Bouzas; Arias-Rivera, S.; Mera, M.J. Frade; Alarcia, María Jesús Luengo; Díaz, Noelia Regueiro; Rodríguez-Rey, L.F. Carrasco; García, María del Rosario Hernández; Gómez, Gema Sala; Rubio, Javier Vecino; González, Saúl García; Sánchez, María del Mar Sánchez; Franco, Carmen Cruzado; Rivera, Beatriz Martín; Blanco, Rocío González; Ventana, Ana Belén Sánchez de la; Arcas, María Luisa Bravo; Lavela, Josefa Escobar; Moreno, María del Pilar Domingo; Arias, Mercedes García; Saiz, Inmaculada Concepción Collado; Nuevo, María Acevedo; Suárez, Alejandro Barrios; Bejarano, Francisco Javier Zarza; Muñoz, María Catalina Pérez; Rubio, Virginia Toribio; Chicharro, Patricia Martínez; Martínez, Alexandra Pascual; Pozo, Sergio López; Infante, Laura Sánchez; García, Verónica Ocaña; Medina, Daniel Menes; Cortázar, Ana Vadillo; Burgos, Gema Lendínez; Juntanez, Jesús Díaz; Olivares, Maria Teresa; Mondéjar, Juan José Rodríguez; Rojo, Francisco José Martínez; Martínez, María Vanessa Ruiz; Celdrán, Daniel Linares; Molina, Antonio Ros; Sánchez, Javier Sáez; Oliva, José María Martínez; Gilar, Ana Bernal; García, María Belén Hernández; Cortés, Antonio Tomás Ríos; Méndez, Raquel Navarro; García, Sebastián Gil; Garre, Juan Sánchez; Linares, Miriam del Barrio; Viguria, R. Goñi; Santano, Raquel Aguirre; Díez, Maria Rosario García; Cilla, Laura Aparicio; Domingo, Mónica Delicado; Núñez, César Rodríguez; López, Ane Arrasate; Morán, Ángela Romero; Melgoso, Rosa Paños; Cerón, Mónica Yañez; Martínez, Amparo Mercado; Llopis, Beatriz Martínez; Albelda, María Josefa Vayá; Carbonell, Javier Inat; Senent, M. Rosario Alcayne; García, Fátima Giménez; Gonzaga, Eva Cristina Fernández; Puchol, Laura Febrer; Ortuño, Senén Berenguer; Martínez, María Pastor; Talavera, Dunia Valera; Rovira, María José Segrera; Revert, Yolanda Langa; Pozuelo, Maricruz Espí; Miravet, María Ángeles de Diego; Aspas, Beatriz Garijo; García, María del Rosario Asensio; Muñoz, José Ramón Sánchez; Sánchez, Quirico Martínez; Mateu, Ramón López

doi:10.1016/j.enfie.2019.04.002

Cited by 5 publications

(13 citation statements)

References 44 publications

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“…This late mobilization could be explained by a lack of protocols promoting EM practices. Only 12.5% of the ICUs in our study applied these protocols, 32 compared with 24 to 30% in the international study by Bakhru 16 and 45% in a study in Brazil 10 . Late mobilization could also be explained by the presence of two common barriers to EM, which are deep sedation 7,27,28 and concerns regarding haemodynamic and respiratory instability 6,12,28 …”

Section: Discussionmentioning

confidence: 67%

“…Delirium was diagnosed only subjectively, because the CAM-ICU scale is not frequently used in our setting. 32 When the diagnosis of delirium is based on the charge nurse's subjective assessment, only hyperactive delirium is likely to be detected. Therefore, delirium was clearly underdiagnosed.…”

Section: Limitationsmentioning

confidence: 99%

“…The small representation of trauma and neurology patients can be explained by the inclusion criteria. Delirium was diagnosed only subjectively, because the CAM‐ICU scale is not frequently used in our setting 32 . When the diagnosis of delirium is based on the charge nurse's subjective assessment, only hyperactive delirium is likely to be detected.…”

Section: Limitationsmentioning

confidence: 99%

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Variables associated with mobility levels in critically ill patients: A cohort study

Raurell-Torredà

Arias-Rivera

Martí³

et al. 2021

Nursing in Critical Care

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Background: Early mobilization in the intensive care unit (ICU) helps improve patients' functional status at discharge. However, many barriers hinder this practice.Aim and objectives: To identify mobility levels acquired by critically ill patients and their variables.Design: A multi-centre cohort study was conducted in adult patients receiving invasive mechanical ventilation for at least 48 hours. Methods:The primary outcome was level of mobility according to the ICU mobility scale. The secondary outcome was human resource availability and existence of ABCDEF bundle guidelines. A logistic regression was performed, based on days 3 to 5 of the ICU stay and significant association with active mobility.

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Section: Discussionmentioning

confidence: 67%

Section: Limitationsmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

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Variables associated with mobility levels in critically ill patients: A cohort study

Raurell-Torredà

Arias-Rivera

Martí³

et al. 2021

Nursing in Critical Care

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“…A recent study in our country found that 18.6% of ICU teams included no physiotherapists; 10.5% had a physiotherapist for less than 5 hours a week, 12.8% had one between 5 and 10 hours a week, 10.5% between 10 and 15 hours a week, 8.1% between 15 and 20 hours a week, and only 4.6% had one for more than 24 hours a week. In the remaining 34.9%, physiotherapists could be consulted through the rehabilitation service [19]. Our protocol was designed considering that physiotherapists would be present for 6 hours a day on weekdays that were not on non-working-days.…”

Section: Discussionmentioning

confidence: 99%

Factors Affecting Adherence to Early Mobilization in an Intensive Care Unit: An Analysis of Data Collected Prospectively Over a Three-Year Period by Clinical Information System

Perelló

Gómez

Mariné

et al. 2021

Preprint

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Background: Early mobilization benefits critically ill patients. Scant information is available about adherence to early mobilization protocols in intensive care units (ICU). With the aim of optimizing the application of our early mobilization protocol in mechanically ventilated patients in routine daily practice, this study analyzed adherence to the protocol, impediments to adherence, and adverse eventsin our ICU. Methods: This observational study analyzed data collected prospectively at a 24-bed polyvalent ICU over a three-year period (2017–2019). Data from adult patients on mechanical ventilation > 48 hours who met the inclusion criteria for the early mobilization protocol were included. We analyzed demographics, adherence to the protocol, total number of mobilizations, impediments to early mobilization, artificial airway/ventilatory support at each mobilization level, and adverse events during mobilization. All data was automatically obtained from the clinical information system by extract, transform, and load processes using Python 3.0. The unit of analysis was ICU stay-day. Results: We analyzed 3269 stay-days from 388 patients with median age of 63 (51–72) years, median APACHE II 23 (18–29) and median ICU stay of 10.1 (6.2–16.5) days. Adherence to the protocol was 56.6% (1850 stay-days), but patients were mobilized in only 32.2% (1472) of all stay-days. The most common reasons for not mobilizing patients were failure to meeting the criteria for clinical stability in 241 (42%) stay-days and unavailability of physiotherapists in 190 (33%) stay-days. Adverse events occurred in only 6 (0.4%) stay-days mobilizations. Conclusions: Although adherence to the protocol was high, patients were mobilized in only one-third of all stay-days. This study points to ways we can improve early mobilization in our ICU, including assessing the suitability of the criteria for clinical stability and increasing the presence of physiotherapists.

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“…La movilización precoz entre el segundo y quinto día permite disminuir la incidencia y las secuelas de la debilidad adquirida en las UCI (40,41,42,43,44,45,46). Por tanto, los programas de apoyo entre pares de la UCI implican una interacción regular y constante con otros sobrevivientes de la UCI y sus familias (32).…”

Section: Estrategias De Prevenciónunclassified

Características del síndrome post cuidado intensivo: revisión de alcance

Castaño

Buitrago

Ramírez

et al. 2021

Investg. Enferm. Imagen Desarollo.

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Objetivo: identificar la evidencia disponible de las características del síndrome post unidad de cuidado intensivo en el paciente que egresa de la unidad de cuidado intensivo. Método: revisión de alcance con la metodología del Joanna Briggs Institut, en cinco bases de datos con la estrategia de búsqueda ([PostIntensive AND Care AND Syndrome] [Nursing AND Care AND PICS]). Se incluyeron estudios primarios publicados entre los años 2010 y 2020, disponibles en texto completo. Resultados: después del análisis de los 48 estudios primarios se extrajeron seis categorías temáticas así: aspecto cognitivo en el síndrome post UCI, osteomusculares, psicoemocionales, estrategias de prevención con modelos de sobrevivientes de UCI, síndrome post unidad cuidado intensivo en la familia y herramientas de evaluación. Conclusiones: mejorar la calidad de atención de los pacientes que presentan este síndrome, prevenir la aparición y aumentar la calidad de vida prestada a los sobrevivientes de UCI y sus familias. La evidencia reporta que entre los cuidadores se pueden desencadenar distintos trastornos que disminuyen su calidad de vida. La enfermería juega un papel crucial en la prevención de la aparición del síndrome mediante estrategias en la UCI e interdisciplinares; los planes de egreso y seguimiento a los pacientes pueden lograr que estos se rehabiliten más rápido y eviten discapacidades o secuelas a largo plazo.

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Degree of implementation of preventive strategies for post-ICU syndrome: Multi-centre, observational study in Spain

Cited by 5 publications

References 44 publications

Variables associated with mobility levels in critically ill patients: A cohort study

Variables associated with mobility levels in critically ill patients: A cohort study

Factors Affecting Adherence to Early Mobilization in an Intensive Care Unit: An Analysis of Data Collected Prospectively Over a Three-Year Period by Clinical Information System

Características del síndrome post cuidado intensivo: revisión de alcance

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