Assessment of analgesia, sedation, physical restraint and delirium in patients admitted to Spanish intensive care units. Proyecto ASCyD
Por:
Arias-Rivera, S, Lopez-Lopez, C, Frade-Mera, M, Via-Clavero, G, Rodriguez-Mondejar, J, Sanchez-Sanchez, M, Acevedo-Nuevo, M, Gil-Castillejos, D, Robleda, G, Cachon-Perez, M, Latorre-Marco, I, Mera, M, Rivera, S, Vega, V, Lavela, J, Basurto, F, Monzo, V, Sanchez, M, Olivares, J, Mancera, A, Jaen, S, Diaz, N, Rodriguez-Rey, L, Garcia, M, Lopez, C, Sanz, T, de la Ventana, A, Martinez, M, Olivera, M, Sanchez, L, Gozalo, M, Pena, J, Dominguez, S, Cobo, M, Fernandez, O, Mora, M, Gonzalez, M, Lopez, J, Ayala, A, Blanco, R, Rodriguez-Palmero, L, Nuevo, M, Marco, I, Gonzalez, S, Fernandez, A, Santos, C, Garcia, S, Sevillano, M, Mondejar, J, Molina, A, Celdran, D, Lopez, N, Garcia, A, Sanz, L, Rojo, F, Hernandez, A, Gonzalez, S, Viguria, R, Oroz, A, Berardo, B, Roig, M, Ortiz, M, Orue, P, Gallano, J, Gomez, Y, Salazar, M, Nunez, C, Martinez, M, Aguado, G, Hervas, P, Marmaneu, M, Artola, M, Cisternas, E, Gimeno, Y, Calvo, A, Tato, J, Carbonell, J, Talavera, D, Jara, M, Martinez, J, Sanchez, B, Ceron, M, Pagan, M and Equipo ASCyD
Publicada:
1 ene 2020
Resumen:
Aims: Main aim: To determine the Spanish intensive care units (ICU) that assess and record pain levels, sedation/agitation, delirium and the use of physical restraint (PR) as standard practice. Secondary aims: To determine the use of validated assessment tools and to explore patients' levels of pain and sedation/agitation, the prevalence of delirium, and the use of PR.
Method: An observational, descriptive, cross-sectional, prospective and multicentre study using an ad hoc survey with online access that consisted of 2 blocks. Block I: with questions on the unit's characteristics and routine practice; Block II: aspects of direct care and direct assessments of patients admitted to participating units.
Results: One hundred and fifty-eight units and 1574 patients participated. The pain of communicative patients (CP) was assessed and recorded as standard in 109 units (69%), the pain of non-communicative patients (NCP) in 84 (53%), sedation/agitation in 111 (70%), and delirium in 39 units (25%). There was recorded use of PR in 39 units (25%). Validated scales were used to assess the pain of CP in 139 units (88%), of NCP in 102 (65%), sedation/agitation in 145 (92%), delirium in 53 units (34%). In 33 units (21%) pain, sedation/agitation and delirium of PC and NPC was assessed, and in 8 of these units there was a specific PR protocol and register. Among the patients who could be assessed, an absence of pain was reported in 57%, moderate pain in 27%; 48% were calm and collaborative, and 10% agitated; 21% had PR, and 12.6% of the patients had delirium.
Conclusions: The assessment of pain, sedation and delirium is demonstrated, and low percentages of agitation and delirium achieved. We observed a high percentage of patients with pain, and moderate use of PC. We should generalise the use of protocols to assess, prevent and treat pain and delirium by appropriately managing analgesia, sedation, and individual and well-considered use of PC. (C) 2019 Sociedad Espanola de Enfermeria Intensiva y Unidades Coronarias (SEEIUC). Published by Elsevier Espana, S.L.U. All rights reserved.
Filiaciones:
Arias-Rivera, S:
Hosp Univ Getafe, Madrid, Spain
Inst Salud Carlos III, GIBER Enfermedades Resp, Madrid, Spain
SEEIUC, GT ASCyD, Madrid, Spain
Lopez-Lopez, C:
SEEIUC, GT ASCyD, Madrid, Spain
Hosp Univ 12 Octubre, Madrid, Spain
Inst Invest Sanitaria Hosp 12 Octubre Imas12, Madrid, Spain
Univ Complutense, Fac Enfermeria Fisioterapia & Podol, Madrid, Spain
Frade-Mera, M:
SEEIUC, GT ASCyD, Madrid, Spain
Hosp Univ 12 Octubre, Madrid, Spain
Univ Complutense, Fac Enfermeria Fisioterapia & Podol, Madrid, Spain
Via-Clavero, G:
SEEIUC, GT ASCyD, Madrid, Spain
Hosp Univ Bellvitge GRIN IDIBELL, Barcelona, Spain
Rodriguez-Mondejar, J:
SEEIUC, GT ASCyD, Madrid, Spain
Serv Murciano Salud, Gerencia Urgencias & Emergencias 061, Murcia, Spain
Univ Murcia, Inst Murciano Invest Biomed, HCU Virgen de la Arrixaca IMIB Arrixaca, Murcia, Spain
Sanchez-Sanchez, M:
Hosp Univ Getafe, Madrid, Spain
SEEIUC, GT ASCyD, Madrid, Spain
Acevedo-Nuevo, M:
SEEIUC, GT ASCyD, Madrid, Spain
Hosp Univ Puerta de Hierro Majadahonda, Madrid, Spain
Inst Invest Sanitaria Puerta de Hierro Segovia de, Madrid, Spain
Univ Autonoma Madrid, Fac Ciencias Salud, Madrid, Spain
Gil-Castillejos, D:
SEEIUC, GT ASCyD, Madrid, Spain
Hosp Univ Juan XXIII, Tarragona, Spain
Robleda, G:
SEEIUC, GT ASCyD, Madrid, Spain
Univ Pompeu Fabra, Escuela Super Enfermeria Mar ESIMar, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Ctr Cochrane Iberoamer, Barcelona, Spain
Cachon-Perez, M:
SEEIUC, GT ASCyD, Madrid, Spain
Univ Europea Madrid, Fac Ciencias Biomed & Salud, Madrid, Spain
Latorre-Marco, I:
SEEIUC, GT ASCyD, Madrid, Spain
Hosp Univ Puerta de Hierro Majadahonda, Madrid, Spain
Inst Invest Sanitaria Puerta de Hierro Segovia de, Madrid, Spain
Mera, M:
Hosp Univ 12 Octubre, Madrid, Spain
Rivera, S:
Hosp Univ Getafe, Madrid, Spain
Vega, V:
Hosp Univ Principe Asturias, Alcala De Henares, Spain
Lavela, J:
Hosp Univ Sureste, Arganda Del Rey, Spain
Basurto, F:
Hosp Gen Villaba, Collado Villalba, Spain
Monzo, V:
Hosp Univ Henares, Coslada, Spain
Sanchez, M:
Hosp Univ Getafe, Madrid, Spain
Olivares, J:
Hosp Univ Getafe, Madrid, Spain
Mancera, A:
Hosp Univ Severo Ochoa, Leganes, Spain
Jaen, S:
Hosp Univ Severo Ochoa, Leganes, Spain
Diaz, N:
Hosp Univ 12 Octubre, Madrid, Spain
Rodriguez-Rey, L:
Hosp Univ 12 Octubre, Madrid, Spain
Garcia, M:
Hosp Univ 12 Octubre, Madrid, Spain
Lopez, C:
Hosp Univ 12 Octubre, Madrid, Spain
Sanz, T:
Hosp Univ Clin San Carlos, Madrid, Spain
de la Ventana, A:
Hosp Univ Clin San Carlos, Madrid, Spain
Martinez, M:
Hosp Cent Defensa Gomez Ulla, Madrid, Spain
Olivera, M:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Sanchez, L:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Gozalo, M:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Pena, J:
Hosp Univ Princesa, Madrid, Spain
Dominguez, S:
Hosp Univ Princesa, Madrid, Spain
Cobo, M:
Hosp Univ La Paz, Madrid, Spain
Fernandez, O:
Hosp Univ La Paz, Madrid, Spain
Mora, M:
Hosp Univ La Paz, Madrid, Spain
Gonzalez, M:
Hosp Univ La Paz, Madrid, Spain
Lopez, J:
Hosp Univ La Paz, Madrid, Spain
Ayala, A:
Hosp Univ Ramon Y Cajal, Madrid, Spain
Blanco, R:
Hosp Univ Ramon Y Cajal, Madrid, Spain
Rodriguez-Palmero, L:
Hosp Univ Ramon Y Cajal, Madrid, Spain
Nuevo, M:
Hosp Univ Puerta de Hierro Majadahonda, Majadahonda, Spain
Marco, I:
Hosp Univ Puerta de Hierro Majadahonda, Majadahonda, Spain
Gonzalez, S:
Hosp Univ Mostoles, Mostoles, Spain
Fernandez, A:
Hosp Univ Infanta Cristina, Parla, Spain
Santos, C:
Hosp Univ Torrejon, Torrejon De Ardoz, Spain
Garcia, S:
Hosp Univ Infanta Elena, Valdemoro, Spain
Sevillano, M:
Hosp Univ Infanta Leonor, Madrid, Spain
Mondejar, J:
IMIB Arrixaca, Serv Murciano Salud, Gerencia Urgencias & Emergencias, Murcia, Spain
Molina, A:
Hosp Univ Rafael Mendez, Lorca, Spain
Celdran, D:
Hosp Gen Univ Santa Lucia, Cartagena, Spain
Lopez, N:
Hosp Gen Univ Los Arcos del Mar Menor, San Javier, Spain
Garcia, A:
Hosp Clin Univ Virgen de la Arrixaca, Murcia, Spain
Sanz, L:
Hosp Gen Univ Reina Sofia, Murcia, Spain
Rojo, F:
Hosp Gen Univ Jose M Morale Meseguer, Murcia, Spain
Hernandez, A:
Complejo Hosp Navarra, Pamplona, Spain
Gonzalez, S:
Hosp Garcia Orcoyen, Estella Lizarra, Spain
Viguria, R:
Clin Univ Navarra, Pamplona, Spain
Oroz, A:
Complejo Hosp Navarra, Pamplona, Spain
Berardo, B:
Complejo Hosp Navarra, Pamplona, Spain
Roig, M:
Hosp Reina Sofia, Tudela, Spain
Ortiz, M:
Hosp Univ Basurto, Bilbao, Spain
Orue, P:
Hosp Univ Basurto, Bilbao, Spain
Gallano, J:
Hosp Univ Basurto, Bilbao, Spain
Gomez, Y:
Hosp Univ Cruces, Baracaldo, Spain
Salazar, M:
Hosp Univ Cruces, Baracaldo, Spain
Nunez, C:
Hosp Univ Araba Sedes Txagorritxu & Santiago, Vitoria, Spain
Martinez, M:
Hosp Univ Araba Sedes Txagorritxu & Santiago, Vitoria, Spain
Aguado, G:
Hosp Univ & Politecn La Fe, Valencia, Spain
:
Hosp Univ La Plana, Villareal, Spain
:
Hosp Gen Univ, Castellon de La Plana, Spain
:
Hosp Comarcal Vinaros, Vinaros, Spain
Cisternas, E:
Hosp Univ & Politecn La Fe, Valencia, Spain
Gimeno, Y:
Hosp Univ & Politecn La Fe, Valencia, Spain
:
Hosp Sagunto, Sagunt, Spain
:
Hosp Francesc de Borja, Gandia, Spain
Carbonell, J:
Hosp Clin Univ, Valencia, Spain
:
Hosp Univ Dr Peset Aleixandre, Valencia, Spain
:
Hosp Vega Baja, Orihuela, Spain
:
Hosp Gen Univ Elche, Elche, Spain
:
Hosp Gen Univ Elche, Elche, Spain
:
Hosp Gen Univ Elda, Elda, Spain
:
Hosp Univ Vinalopo, Elche, Spain
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