Patient Destination after Discharge from Intensive Care Units: Wards or Intermediate Care Units?

Abstract

This study characterizes patients hospitalized in Intensive Care Units (ICUs) Destino del paciente después de recibir el alta médica de la unidad de cuidados intensivos: ¿unidad de internación o intermedia?Este estudio tuvo como objetivos caracterizar a los pacientes internados en unidades de terapia intensiva (UTI) de hospitales con unidades intermediarias -en lo que se refiere a los datos demográficos y clínicos -e identificar los factores relacionados con el alta médica para esa unidad. Es estudio prospectivo longitudinal, con 600 pacientes adultos, internados en UTIs generales de cuatro hospitales del municipio de Sao Paulo. En los resultados, las características demográficas y clínicas fueron similares a las descritas en otros estudios sobre pacientes en UTIs. Los factores asociados con el alta hospitalaria para la unidad intermediaria fueron: edad ≥60 años, antecedentes relacionados al sistema nervioso, circulatorio o respiratorio, procedencia de la unidad intermediaria y valores del Simplified Acute Physiologic Score II (SAPS II), Logistic Organ Dysfunction (LODS) y Nursing Activities Score (NAS) en la admisión y el alta de la UTI. En el análisis de regresión logística múltiple la edad y el riesgo de muerte en la admisión, por el SAPS II, se destacaron como indicadores del alta médica para la unidad intermediaria.

Nursing Workload in Intensive Care Unit Trauma Patients: Analysis of Associated Factors

“…The NAS average was 71.3%, a value that is higher than the value found in most studies that applied this instrument to patients admitted to general ICUs [5], [6], [23], [24], [25]. Two investigations, conducted in Brazil, addressed specific populations and found NAS means that were higher: 72.93% in the analysis of elderly patients [7] and 73.6% in a postoperative cardiac surgery unit [26].…”

Carga de trabajo en tres grupos de pacientes de UCI Española según el Nursing Activities Score

“…Other studies have previously shown the need for intermediate care units for patients who suffer from a critical disease as an additional step before sending such patients to a conventional ward. The workload results at discharge in this group of patients again reveal the usefulness of units for patients requiring high-intensity care but low-intensity medical treatment (16)(17) .…”

Nursing workload in an inpatient unit

“…These patients, however, may require a heavy workload (13) , which in turn overloads the professionals in these sectors as they meet the care demands of these patients. This is a fact that requires greater investigation because imbalance in the proportion between patients and nurses has important implications for the safety of patients, for hospital mortality and morbidity, professionals turnover, and for different aspects related to the health of workers such as the occurrence of burnout syndrome and professional dissatisfaction (14) .…”