Psychological Consequences of Admission to the ICU

Rose, Louise; Muttalib, Fiona; Adhikari, Neill K. J.

doi:10.1001/jama.2019.9059

Cited by 20 publications

(20 citation statements)

References 17 publications

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“…22,34,39,44,51,71,82,88,98 Although underexplored, this medication harm has the potential to cause both unwanted physical and psychological ramifications for patients due to the distress associated with hospitalisation and intensive care stays. 115 Many studies also found a high proportion of preventable medication harm events to be caused by CV medications. 5,62,70,77,88,98 The resultant financial impact and consumption of healthcare resources due to potentially avoidable hospital presentations and prolonged length of hospital stays should also be considered when measuring the magnitude of the harm.…”

Section: Discussionmentioning

confidence: 99%

Patient harm from cardiovascular medications

Paradissis

Cottrell

Coombes

et al. 2021

Therapeutic Advances in Drug Safety

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Background Medication harm can lead to hospital admission, prolonged hospital stay and poor patient outcomes. Reducing medication harm is a priority for healthcare organisations worldwide. Recent Australian studies demonstrate cardiovascular (CV) medications are a leading cause of harm. However, they appear to receive less recognition as ‘high risk’ medications compared with those classified by the medication safety acronym, ‘APINCH’ (antimicrobials, potassium, insulin, narcotics, chemotherapeutics, heparin). Our aim was to determine the scale and type of medication harm caused by CV medications in healthcare. Methods A narrative review of adult (>16 years) medication harm literature identified from PubMed and CINAHL databases was undertaken. Studies with the primary outcome of measuring the incidence of medication harm were included. Harm caused by CV medications was described and ranked against other medication classes at four key stages of a patient’s healthcare journey. Where specified, the implicated medications and type of harm were investigated. Results A total of 75 studies were identified, including seven systematic reviews and three meta-analyses, with most focussing on harm causing hospital admission. CV medications were responsible for approximately 20% of medication harm; however, this proportion increased to 50% in older populations. CV medications were consistently ranked in the top five medication categories causing harm and were often listed as the leading cause. Conclusion CV medications are a leading cause of medication harm, particularly in older adults, and should be the focus of harm mitigation strategies. A practical approach to generate awareness among health professionals is to incorporate ‘C’ (for CV medications) into the ‘APINCH’ acronym. Plain language summary Patient harm from cardiovascular medications Background • Harm from medications can cause poor patient outcomes. • Certain medications have been identified as ‘high risk’ and are known to cause high rates of harm. • ‘High risk’ medications are included in medication guidelines used by health professionals. • Cardiovascular medications (e.g. blood pressure and cholesterol medications) are important and have many benefits. • Recent studies have found cardiovascular medications to cause high rates of harm. • Cardiovascular medication harm is often under-recognised in clinical practice. • Some guidelines do not consider cardiovascular medications to be ‘high risk’. Method • This review investigated the extent of harm caused by cardiovascular medications in adults across four healthcare settings: (1) at the time of hospital admission; (2) during hospital admission; (3) after hospital; and (4) readmission to hospital. • Harm caused by cardiovascular medications was ranked against other medication classes. • We investigated the type of cardiovascular medications to cause harm and the type of harm caused. Results • Seventy-five studies were reviewed across 41 countries. • Cardiovascular medications were ranked within the top five medications to cause harm. • Cardiovascular medications were a leading cause of harm in each healthcare setting investigated. • Harm caused by cardiovascular medications was common in older adults (>65 years). • Cardiovascular medications often caused preventable harm. • Medications to treat high blood pressure and abnormal heart rhythms were the most common causes of harm. • We reported kidney injury, electrolyte changes and low blood pressure as common types of harm. Conclusion • Increased focus on cardiovascular medications in clinical practice is needed. • Health professionals need to carefully prescribe and frequently review cardiovascular medications, especially in older adults. • Patient and health professional discussions should be based on both the benefits and harms of cardiovascular medications. • Cardiovascular medications should be included in all ‘high risk’ medication guidelines.

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Section: Discussionmentioning

confidence: 99%

Patient harm from cardiovascular medications

Paradissis

Cottrell

Coombes

et al. 2021

Therapeutic Advances in Drug Safety

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“…The first time in the ICU can be very scary: being critically ill, not being able to breathe, having severe pain etc. These memories are recalled when waking up and can become nightmares, even delirium (Rose et al, 2019;Boehm et al, 2021). These feelings are hard to communicate vocally during the ICU stay due to the patient's need for ventilation assistance.…”

Section: Intensive Cared Patientsmentioning

confidence: 99%

“…Delirium appears with different degrees of irritability, anger, fear, anxiety, and perplexity and can be characterised as anxiety, depression, acute and post-traumatic stress (Rose et al, 2019). The delirium experience has emotional, cognitive, physical, relational, spiritual, and situational dimensions, and there are feelings and memories that often stay in the memory for a long time (Boehm et al, 2021).…”

Section: Intensive Cared Patientsmentioning

confidence: 99%

Being cared for in an Intensive Care Unit – family functioning and support

Ahlberg

2022

Linköping University Medical Dissertations

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“…A internação em UTI é uma experiência geradora de angústia e sofrimento para os pacientes e familiares devido à representação desse ambiente, que envolve cuidados intensivos, alta complexidade de ações e procedimentos, impessoalidade e prognóstico incerto, causando um impacto emocional (Monteiro et al, 2017;Nunes & Gabarra, 2017). Naturalmente, esse cenário é desencadeador de situações estressoras e ansiogênicas para a família (Rose et al, 2019).…”

Section: Introductionunclassified

Percepção dos familiares de pacientes com COVID-19 sobre a internação em terapia intensiva adulto

Barilli

Silva²,

Santos³

et al. 2023

RSD

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Objetivo: Conhecer a percepção de familiares de pacientes internados por COVID-19 em Unidade de Terapia Intensiva Adulto sobre o período de internação. Metodologia: Estudo descritivo, qualitativo, realizado com familiares adultos de pacientes com COVID-19 internados em uma Unidade de Terapia Intensiva Adulto de um hospital público, terciário, em Porto Alegre (RS), Brasil. Utilizou-se ficha com dados sociodemográficos e um questionário semiestruturado. As entrevistas foram realizadas entre novembro e dezembro/2020 por chamada telefônica e a amostra foi determinada por saturação dos dados. Foi utilizada análise de conteúdo de Bardin. Resultados: Participaram nove familiares com idade entre 23 e 56 anos. Predominaram mulheres, a maioria filhas. O número de dias em isolamento variou de 8 a 31. Emergiram cinco categorias: A Unidade de Terapia Intensiva como sentença de morte; O impacto de uma doença nova; Distância e exclusão da família; Redes de apoio; A iminência da morte. Conclusão: As internações em Unidade de Terapia Intensiva por COVID-19 foram permeadas por medo e angústia dos familiares, incrementados por tratar-se de uma doença nova e sem cura. A necessidade de isolamento impossibilitou o contato físico, impactando na compreensão do quadro e na elaboração do luto. O apoio da equipe, de outros familiares e amigos, fé e religiosidade apareceram como mecanismos protetivos. Luto antecipatório, medo da morte sem despedida e perdas múltiplas figuram como centrais no tocante ao luto. Considera-se imprescindível o apoio emocional para os familiares, de forma a favorecer o bem-estar psíquico e prevenir agravos psicológicos e luto complicado.

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Psychological Consequences of Admission to the ICU

Cited by 20 publications

References 17 publications

Patient harm from cardiovascular medications

Patient harm from cardiovascular medications

Being cared for in an Intensive Care Unit – family functioning and support

Percepção dos familiares de pacientes com COVID-19 sobre a internação em terapia intensiva adulto

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