El equipo de enfermería frente al deterioro clínico del paciente en la sala de ingreso: una revisión integrativa
Resumen
Objetivo: Buscar, en las publicaciones científicas, la atención de enfermería que se brinda a los pacientes adultos críticos o potencialmente graves internados en las salas.
Método: Revisión integradora, realizada en noviembre de 2022, en las bases de datos Web of Science, PubMed, Biblioteca Virtual en Salud, Scopus y EMBASE, utilizando la string: “nursing AND critical care AND patients’ rooms OR ward OR infirmary AND adult OR middle aged OR aged OR aged, 80 and over”.
Resultados: De los 4.596 estudios encontrados, se incluyeron 19 artículos originales, publicados entre 2017 y 2022. Los contenidos se agruparon en dos categorías: “barreras para la atención de pacientes agudos en las salas de ingreso” y “oportunidades para mejorar la calidad de la atención”.
Conclusión: A partir de esta revisión, fue posible extraer posibles barreras y posibilidades para mejorar la atención al paciente crítico en las salas de ingreso, que pueden servir como punto de partida para que los equipos de salud replanteen la práctica y creen estrategias para eliminar las barreras e implementar mejoras en la asistencia.
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Bonfada D, Barbosa ICR, Lima KC, Garcia-Altés A. Gasto de internação de idosos em unidades de terapia intensiva nos hospitais privados de uma capital do nordeste brasileiro. Rev Bras Geriatr Gerontol (Online) [Internet]. 2020 [cited 2022 Nov 10];23(2):e200020. DOI: https://doi.org/10.1590/1981-22562020023.200020
Al-Dorzi HM, Aldawood AS, Almatrood A, Burrows V, Naidu B, Alchin JD, Alhumedi H, Tashkandi N, Al-Jahdali H, Hussain A, Al Harbi MK, Al Zaibag M, Bin Salih S, Al Shamrani MM, Alsaawi A, Arabi YM. Managing critical care during COVID-19 pandemic: the experience of an ICU of a tertiary care hospital. J Infect Public Health [Internet]. 2021 [cited 2022 Nov 11];14(11):1635-1641. DOI: https://doi.org/10.1016/j.jiph.2021.09.018
Spagnolli W, Rigoni M, Torri E, Cozzio S, Vettorato E, Nollo G. Application of the National Early Warning Score (NEWS) as a stratification tool on admission in an Italian acute medical ward: a perspective study. Int J Clin Pract [Internet]. 2017 [cited 2022 Nov 29];71(3-4):e12934. DOI: https://doi.org/10.1111/ijcp.12934
Allen E, Elliott D, Jackson D. Recognising and responding to in-hospital clinical deterioration: an integrative review of interprofessional practice issues. Journal of clinical nursing. J Clin Nurs [Internet]. 2017 [cited 2023 Feb 02];26(23-24):3990-4012. DOI: https://doi.org/10.1111/jocn.13839
Al-Moteri M, Plummer V, Cooper S, Symmons M. Clinical deterioration of ward patients in the presence of antecedents: a systematic review and narrative synthesis. Aust Crit Care [Internet]. 2019 [cited 2023 Feb 02];32(5):411-20. DOI: https://doi.org/10.1016/j.aucc.2018.06.004
Harris S, Singer M, Sanderson C, Grieve R, Harrison D, Rowan K. Impact on mortality of prompt admission to critical care for deteriorating ward patients: an instrumental variable analysis using critical care bed strain. Intensive care medicine. Intensive Care Med. [Internet]. 2018 [cited 2023 Feb 02];44(5):606-15. DOI: https://doi.org/10.1007/s00134-018-5148-2
Almeida RO, Ferreira MA, Silva RC. O cuidado intensivo em unidades não-críticas: representações e práticas de enfermeiros recém-formados. Texto & contexto enferm. (Online) [Internet]. 2020 [cited 2022 Nov 01];29: e20190089. DOI: https://doi.org/10.1590/1980-265X-TCE-2019-0089
Souza MT, Silva MD, Carvalho R. Revisão integrativa: o que é e como fazer. Einstein (São Paulo) [Internet]. 2010 [cited 2022 Dec 04];8(1):102-6. DOI: https://doi.org/10.1590/s1679-45082010rw1134
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ [Internet]. 2021 [cited 2022 Nov 11];372(71). DOI: https://doi.org/10.1136/bmj.n71
Clark R, Mclean C. The professional and personal debriefing needs of ward based nurses after involvement in a cardiac arrest: an explorative qualitative pilot study. Intensive Crit Care Nurs [Internet]. 2018 [cited 2022 Nov 20];47:78-84. DOI: https://doi.org/10.1016/j.iccn.2018.03.009
Saab R, Wu BP, Rivas E, Chiu A, Lozovoskiy S, Ma C, et al. Failure to detect ward hypoxaemia and hypotension: contributions of insufficient assessment frequency and patient arousal during nursing assessments. Br J Anaesth [Internet]. 2021 [cited 2022 Nov 20];127(5):760-8. DOI: https://doi.org/10.1016/j.bja.2021.06.014
Chua WL, Legido-Quigley H, Ng PY, McKenna L, Hassan NB, Liaw SY. Seeing the whole picture in enrolled and registered nurses’ experiences in recognizing clinical deterioration in general ward patients: a qualitative study. Int J Nurs Stud [Internet]. 2019 [cited 2022 Dec 21];95:56-64. DOI: https://doi.org/10.1016/j.ijnurstu.2019.04.012
Kalliokoski J, Kyngäs H, Ala-Kokko T, Meriläinen M. Insight into hospital ward nurses’ concerns about patient health and the corresponding Medical Emergency Team nurse response. Intensive Crit Care Nurs [Internet]. 2019 [cited 2022 Dec 21];53:100-8. DOI: https://doi.org/10.1016/j.iccn.2019.04.009
Montenegro SMSL, Miranda CH. Avaliação do desempenho do escore de alerta precoce modificado em hospital público brasileiro. Rev Bras Enferm. (Online) [Internet]. 2019 [cited 2022 Nov 22];72(6):1502-9. DOI: http://dx.doi.org/10.1590/0034-7167-2017-0537
Connell CJ, Plummer V, Crawford K, Endacott R, Foley P, Griffiths DL, et al. Practice priorities for acute care nursing: a Delphi study. J Clin Nurs [Internet]. 2020 [cited 2022 Nov 25];29(13-14):2615-25. DOI: https://doi.org/10.1111/jocn.15284
Peet J, Theobald K, Douglas C. Strengthening nursing surveillance in general wards: a practice development approach. J Clin Nurs [Internet]. 2019 [cited 2022 Nov 25];28(15-16):2924-33. DOI: https://doi.org/10.1111/jocn.14890
Breen SJ, Rees S. Barriers to implementing the Sepsis Six guidelines in an acute hospital setting. Br J Nurs [Internet]. 2018 [cited 2022 Nov 26];27(9). DOI: https://doi.org/10.12968/bjon.2018.27.9.473
Kauppi W, Proos M, Olausson S. Ward nurses’ experiences of the discharge process between intensive care unit and general ward. Nurs Crit Care [Internet]. 2018 [cited 2022 Nov 27];23(3):127-33. DOI: https://doi.org/10.1111/nicc.12336
Petersen JA, Rasmussen LS, Rydahl-Hansen S. Barriers and facilitating factors related to use of early warning score among acute care nurses: a qualitative study. BMC Emerg Med [Internet] 2017 [cited 2022 Nov 28];17(36):1-9. DOI: https://doi.org/10.1186/s12873-017-0147-0
Peet J, Theobald KA, Douglas C. Building safety cultures at the frontline: an emancipatory Practice Development approach for strengthening nursing surveillance on an acute care ward. J Clin Nurs [Internet]. 2022 [cited 2022 Dec 11];31(5-6):642-56. DOI: https://doi.org/10.1111/jocn.15923
Badr MN, Khalil NS, Mukhtar AM. Effect of national early warning scoring system implementation on cardiopulmonary arrest, unplanned ICU admission, emergency surgery, and acute kidney injury in an emergency hospital, Egypt. J Multidiscip Healthc [Internet]. 2021 [cited 2022 Nov 01];14:1431-42. DOI: https://doi.org/10.2147/JMDH.S312395
Ludikhuize J, Dijkgraaf MG, Dongelmans DA, So R, Korsten E, Schoonderbeek J, et al. Clinical practices in the escalation of care for the deteriorating patient: a multicentre study. Neth J Crit Care [Internet]. 2021 [cited 2022 Dec 02];29(3). Available from: https://njcc.nl/clinical-practices-in-the-escalation-of-care-for-the-deteriorating-patient-a-multicentre-study/
Chua WL, Legido-Quigley H, Jones D, Hassan NB, Tee A, Liaw SY. A call for better doctor-nurse collaboration: a qualitative study of the experiences of junior doctors and nurses in escalating care for deteriorating ward patients. Aust Crit Care [Internet]. 2020 [cited 2022 Nov 03];3391):54-61. DOI: https://doi.org/10.1016/j.aucc.2019.01.006
Kamio T, Kajiwara A, Iizuka Y, Shiotsuka J, Sanui M. Frequency of vital sign measurement among intubated patients in the general ward and nurses’ attitudes toward vital sign measurement. J Multidiscip Healthc [internet]. 2018 [cited 2022 Dec 04];11:575-81. DOI: http://dx.doi.org/10.2147/JMDH.S179033
Thude BR, Primdahl J, Jensen HI, Elkjær M, Hoffmann E, Boye LK, et al. How did nurses cope with the fast, comprehensive organisational changes at Danish hospital wards during the COVID-19 pandemic? An interview study based on nurses' experiences. BMJ Open [Internet]. 2021 [cited 2022 Nov 20];11:e049668. DOI: https://doi.org/10.1136/bmjopen-2021-049668
Burns J, Williams D, Mlinaritsch D, Koechlin M, Trena Canning, Neitzel A. Early detection and treatment of acute illness in medical patients with novel software: a prospective quality improvement initiative. BMJ Open Qual [Internet]. 2022 [cited 2022 Nov 15];11:e001845. DOI: https://doi.org/10.1136/bmjoq-2022-001845
Wong HJ, Bierbrier R, Ma P, Quan S, Sannie L, Wu RC. An analysis of messages sent between nurses and physicians in deteriorating internal medicine patients to help identify issues in failures to rescue. Int J Med Inform [Internet]. 2017 [cited 2022 Nov 21];100:9-15. DOI: https://doi.org/10.1016/j.ijmedinf.2017.01.008
Treacy M, Stayt LC. To identify the factors that influence the recognizing and responding to adult patient deterioration in acute hospitals. J Adv Nurs [Internet]. 2019 [cited 2023 Feb 05];75(12):3272-85. DOI: https://doi.org/10.1111/jan.14138
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