Pakistan Journal of Intensive Care Medicine

IMPACT OF TRAINING IN CLINICAL PRACTICE STANDARDS ON EYE CARE FOR SEDATED PATIENTS: A PRE-POST INTERVENTIONAL STUDY AMONG INTENSIVE CARE UNIT NURSES

2024-03-26T07:31:30+00:00

Background: Vision is one of the most critical senses for humans, particularly in the intensive care unit (ICU) setting. Inadequate eye care for sedated patients can lead to significant ocular problems, including blindness. Nursing knowledge, attitudes, and abilities are essential for delivering effective eye care in the critical care unit. Objectives: To determine the impact of training ICU nurses on clinical practice standards for eye care in sedated patients on their knowledge, attitudes, and practices regarding eye care. Study Design: A pre-post interventional study was conducted on 40 ICU nurses. Setting: The study was conducted in the intensive care units of Bahria International Hospital, Lahore, Pakistan. Duration of Study This study was conducted from July 2022 to February 2023. Material and Methods: The experimental group received clinical guideline training for eye care for sedated patients over three sessions. Data collection utilized an eye care questionnaire assessing nurses' clinical competence, with domains including knowledge, attitude, and practice. Nurses self-assessed their competence before and three months after training. Data analysis was performed using SPSS 21. Results: Following the intervention, a significant difference was observed in the mean score of overall eye care clinical competence (ECCC) between the experimental and control groups (P ≤ 0.05). The experimental group's mean scores for knowledge, attitude, and practice significantly improved before and after the intervention (P ≤ 0.05). Conclusion: Training ICU nurses on clinical principles for eye care in sedated patients leads to improvements in their knowledge, attitudes, and practices. Ongoing training and supervision based on clinical guidelines are crucial for implementing evidence-based eye care practices in the ICU.

ASSESSMENT OF OUTCOMES OF MALIGNANCY PATIENTS ADMITTED IN INTENSIVE CARE UNITS

2024-03-23T10:46:08+00:00

Background: The decision to admit advanced cancer patients to the intensive care unit (ICU) is multifaceted, considering factors such as prognosis and quality of life. Objectives: The objective of this study was to identify mortality risk factors in critically ill advanced cancer patients admitted to the ICU. Study Design: This was an observational study. Setting: The study was conducted at Bahria International Hospital, Lahore. Duration of Study: The study was conducted between March 2022 and March 2023.Material and Methods: A total of 65 adult cancer patients admitted non-electively to the ICU were enrolled in the study. Data on demographics, clinical conditions, and outcomes were collected. Independent medical decisions were collected by ICU staff. Results: The ICU mortality rate was 34.6%, increased to 59.4% within thirty days post-discharge. Patients spent an average of 15.2 days in the ICU. Common admission reasons included respiratory failure (36.2%) and sepsis/septic shock (59.2%). Cox regression analysis revealed six significant indicators of poor outcomes: acute kidney injury (AKI), sepsis with multiple organ failure (MOF), acute respiratory distress syndrome (ARDS), uncontrolled malignancy, mechanical ventilation, and vasopressor use. Conclusion: Our findings highlight AKI, sepsis, MOF, ARDS, and uncontrolled malignancy as prognostic predictors of early death in critically ill cancer patients admitted to the ICU. Additionally, mechanical ventilation and vasopressor use are associated with increased mortality risk. These insights can aid clinicians in optimizing care strategies for cancer patients

THE PREVALENCE, RISK FACTORS, AND OUTCOMES OF DELIRIUM AMONGST ICU PATIENTS. A STUDY FROM THE LOCAL POPULATION OF PAKISTAN

2024-03-23T12:06:18+00:00

Background: Patients admitted to intensive care units (ICUs) often experience delirium, which is associated with adverse outcomes including prolonged ICU stays, increased mortality rates, and elevated healthcare costs. Despite its significance, delirium in Pakistan remains understudied. Objectives: To assess the delirium prevalence, identify predisposing factors and precipitating events, determine predictors of delirium, and explore its impact on ICU length of stay and mortality. Study Design: The study utilized a prospective observational design. Setting: The study was conducted at Bahria International Hospital ICU in Lahore, Pakistan. Duration of Study: This study was conducted from September 2022 to March 2023. Material and Methods: Utilizing the Intensive Care Delirium Screening Checklist (ICDSC), bedside nursing staff evaluated 140 patients twice daily. Data on predisposing factors, precipitating events, and clinical parameters were collected. Regression analysis was performed to identify predictors of delirium. Results: The study found a delirium prevalence of 29.2%, significantly affecting ICU length of stay. Regression analysis identified sepsis, metabolic acidosis, nasogastric tube use, and APACHE II score as independent predictors of delirium among ICU patients. Conclusion: Given the detrimental effects of delirium, implementing multidisciplinary preventive strategies targeting modifiable risk factors are recommended to improve patient outcomes.