Introduction: The disposition and preparation of the nursing personnel is one of the main aspects in the PediatricIntensiveCare Units.Objective: To evaluate the degree of competence and performance of the nurses in PediatricIntensiveCare Units in relation to vascular and non- vascular approach techniques. Methods:An applied, descriptive, prospective and longitudinal research carried out during 2008 in the PediatricIntensiveCare Unit at "Pepe Portilla" Provincial Teaching Hospital, Pinar del Rio. Cuba. Survey and observation were the methods used compared in two moments and separate from a training course. The universe and the sample coincided in a total of 35 nurses. Results: An increase was obtained in the level of knowledge of the nurses in relation to vascular and non-vascular approaches after the training course considering the learning needs. Conclusions: It is necessary the continuing preparation and training of the nursing staff in the intensivecare services in all Pediatric Units.
RESULTS: Medical records of five hundred seventy-eight patients hospitalized in the PediatricIntensiveCare Unit of Misericordia Hospital Foundation in Bogota were reviewed in a period from January 1, 2009 until June 30, 2010. There were presented 6.22 events of ventilator-associated to pneumonia VAP per 1000 ventilator days (3.11%), central catheter-related sepsis 4.6 events per 1000 catheter days (1.38%) and infections associated with catheterization 4 events per 1000 catheter days (1.21%). Klebsiellapneumoniae was isolated in 18% and was the germ which was associated more frequently with ventilator-associated pneumonia (32.35%), catheter sepsis (17.14%) and urinary catheter-associated infection (21, 21%).
simple low-cost evidenced-based interventions in a pediatricintensivecare unit. Design: Prospective cohort study. Setting: PediatricIntensiveCare Unit, Instituto Nacional de Salud del Niño (INSN), Lima, Perú. Methods: We evaluated all patients under the age of 18 years with central venous catheter in the PICU were evaluated, from 2009 to 2012. A basal measure was performed from 2007 to 2010. During the project, from 2011 to 2012, simple, low-cost measures were implemented. Main outcome measures: Rate of catheter line associated bloodstream infection (CLABSI) per 1 000 catheter days. Results: During the pre-project period (2007-2010), 1 047 patients with CVC were followed during 9 303 catheter-days; 60 patients presented CLABSI, and the average annual CLABSI rate was 6.03 (10.01, 5.33, 3.28 y 5.49 per year, respectively). During the project, 267 patients were followed, with 2 303 catheter-days; 4 patients presented CLABSI, with an average annual rate of 1.7. In 2011, an estimation of nine CLABSI that could have been prevented gave an estimated cost of 338 364 soles per year. Conclusions: There was a constant decrease of CLABSI in the PICU during the months of implementation of the project. The simple, low-cost measures decreased the average annual rate of CLABSI to 1.7.
The use of prognostic models for patients admit- ted to the intensivecare unit (ICU) is of great im- portance, since they provide an objective evaluation for a group of patients with potentially high morta- lity rates and cost. The advanced stage of liver failu- re and the presence of cirrhotic complications contribute to the poor prognosis of cirrhotic pa- tients admitted to the ICU. Mortality rates are also affected by the severity of liver disease and concu- rrent dysfunction of other organ systems.
Methods: This is cohort study made at a general intensivecare unit. Patients who required at least 48 hours of mechanical ventilation were included. Data on the clinical and physiologic features were collected for every intubated patient on the third day. Uni- and multivariate statistical analyses were conducted to determine the variables associated with extubation. Results: 163 (62%) were male, and the median age was 59±17 years. Almost one-third (36%) of patients required mechanical ventilation longer than 7 days. The variables strongly associa- ted with prolonged mechanical ventilation were: age (HR 0.97 (95% CI 0.96-0.99); diagnosis of surgical emergency in a pa- tient with a medical condition (HR 3.68 (95% CI 1.62-8.35), diagnosis of surgical condition-non emergency (HR 8.17 (95% CI 2.12-31.3); diagnosis of non-surgical-medical condition (HR 5.26 (95% CI 1.85-14.9); APACHE II (HR 0.91 (95% CI 0.85-0.97) and SAPS II score (HR 1.04 (95% CI 1.00-1.09) The area under ROC curve used for prediction was 0.52. 16% of patients were extubated after day 8 of intubation.
Bioethics dilemmas and their possible solutions in pediatricintensive therapy units of Federal District (Mexico) Abstract: The process of decision making in pediatricintensive therapy units (PITU) is based on an ethical, legal and scientific framework, which generally is more complex that with adults and involves parents or tutors, thus, it must be solved carefully, with time and methodological precision. A survey was design for experts with anonymous and voluntary application, in a non institutional way, in which questions arise referring to bioethical dilemmas generated in PITU services and proceedings for their solution are proposed. Delphi method was used as instrument in two rounds. The most important results, among others, consisted in recognizing that all physician surveyed face in their unit ethical dilemmas, the most frequent being obstinacy in therapy in 32% cases, result linked to the difficulty to establish the diagnosis of terminal patient in 13% cases. To include bioethics topics and decision making with moral content in training professionals, as well as implementing assertive communication among health care team and families, and promoting adequate functioning of hospital bioethics committees with emergency consulting functions, are proposals which arise from the conclusions of this study.
6. Harless DW, Mark BA. Nurse staffing and quality of care with direct measurement of inpatient staffing. Med Care. 2010 Jul;48(7):659-63.
7. Canadian Nurses Association. Measuring nurses’ workload. Nursing Now: Issues and trends in Canadian Nurs. [Internet]. 2003; [acesso 13 jun 2013];15(1). Disponível em: http://www2.cna-aiic.ca/CNA/documents/ pdf/publications/NN_NursesWorkloadmarch2003_e.pdf 8. Rossetti AC, Gaidzinski RR, Fugulin FMT. Nursing workload in the emergency department: a methodological proposal. Rev. Latino-Am. Enfermagem. 2013;21(spe):225-32. 9. Ducci AJ, Padilha KG. Nursing activities score: estudo comparativo da aplicação retrospectiva e prospectiva em unidade de terapia intensiva. Acta Paul Enferm. [Internet]. 2008 [acesso 10 jan 2013];21(4):581-7. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext& pid=S0103-21002008000400008&lng=en. http://dx.doi. org/10.1590/S0103-21002008000400008
With regard to workload, working more than 60 h per week was associated with a high level of burnout in a re- cent study . Intention to leave is a known predictor of burnout [17, 18], as well. Because 60 h was the median weekly workload of our respondents and more than half of them reported their desire to leave the ICU before re- tirement, Latin American academic intensivists probably experience high-level burnout. Along the same line, a re- cent study of ICM training program directors showed that higher workload correlated with negative self-perception about the teaching role, patient care, and job stability . In addition, the number of night shifts has clearly been as- sociated with burnout among pediatric intensivists  and critical care nurses . In our survey, staff physicians reported a higher night shift load and higher intention to leave, an association described previously [20, 21]. These findings call for responsible authorities to be concerned about intensivists’ workload and mental health.
• Observation component: represent the set of data obtained from test, signs, background, etc. Some data are fixed but others vary depending on therapeutics a patient is receiving. In general, a patient must go into an intensivecare unit because some of these values risk its life. The main goal of an ICU is to monitor the evolution of these values until a stable and normal condition is reached. Predictive models are used to quantify risks when a patient arrives to an ICU.
SHD Italia manufactures specific modular cladding and prefabricated self-loading partition systems that guarantee optimal and flexible utilisation of spaces in critical hospital departments requiring controlled bacterial contamination conditions. SHD Italia offers its expertise and experience, col- laborating with top professionals in the health- care sector, studying and developing solutions suitable for Surgical Units, IntensiveCare Units, Dialysis Units and Central Sterile Services Depart- ments.
We defined the nosocomial infection as the one that appears at the patient's admission, which manifests at 72 h or more of the admission and that was not present at the time of admission. It is the most common complication in hospitalized patients. A quarter of these infections occur in IntensiveCare Units. In particular, intrahospital infections due to the use of venous catheters are the most frequent cause of nosocomial bacteremia. Therefore, preventive measures are essential to reduce the incidence of infections associated with catheters, where nursing care plays a very important role.
A study by van den Wijngaard et al.  did not aim to predict influenza epidemics, but instead explored whether excesses in influenza severity per season can be detected by combining GP, hospital, laboratory, and mortality data (7 years of data). Their finding was that combining these data sources is of added value, allowing for better understanding of increases in severe morbidity and mortality due to influenza infections. Also from our data we see that trends in ICU related SARI differ from the trends of ILI in the general population and may thus be of value in offering additional information on severity of influenza seasons which need Table 1. Number of participating IntensiveCare Units (ICUs), number and percentage of medical ICU admissions for respiratory infections and gender and age distribution.
From the Department of Medical Microbiology (A.L.A.B., A.C.F., W.M.T.J., and J.V.) and Department of Surgery (A.L.A.B., M.R.V., and I.H.M.B.R.), University Medical Center Utrecht, Utrecht, the Netherlands; Universite´ Lyon 1, Centre National de Re´fe´rence des Staphylocoques, Faculte´ Laennec (T.F.), and Service de Re´animation Me´dicale Poˆle d’Activite´ d’Urgences et de Re´animation Me´dicales Groupement Hospitalier Edouard Herriot Hospices Civils de Lyon (L.A. and A.C.R.), Lyon, France; Department of Microbiology, Hospital Geral de Santo Antonio, Porto, Portugal (J.M.A.); Department of Microbiology, Hospital Virgen Macarena, Seville, Spain (A.P. and L.L.-C.); Department of Microbiology (S.S.) and IntensiveCare Unit Ward, Vittorio Emanuele Hospital (G.C.), Catania, Italy; Athens University School of Nursing, IntensiveCare Unit (P.E.), and Microbiology and Immunology Department, KAT Hospital, Athens, Greece (S.T.).
Introduction: The Hospital Universitario del Valle (HUV) at the Pediatrics IntensiveCare Unit (PICU) admits intoxicated patients, erroneously medicated by «teguas» or family members with serious aggravation of basic diseases or generating severe intoxications. Absent reports of these practices in Colombia motivated the publication of this case series Objective: To report a series of pediatric intoxication cases secondary to oral or dermatological application of varied substances by healers («teguas») or family members, leading to admission at the PICU, and to describe complications and hospital costs of these events.