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
ISSN: 11302399





Enfermeria Intensiva
Editorial
Elsevier, STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA, España
Tipo de documento: Article
Volumen: 31 Número: 1
Páginas: 3-18
WOS Id: 000513839500002
ID de PubMed: 31003871

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