Purpose: Half of the patients experience pain during their ICU stay which is known to influence their outcomes. Nurses and physicians encounter organizational barriers towards pain assessment and treatment. We aimed to evaluate the association between adequate pain management and nurse to patient ratio, bed occupancy rate, and fulltime presence of an intensivist.
Materials And Methods: We performed unadjusted and case-mix adjusted mixed-effect logistic regression modeling on data from thirteen Dutch ICUs to investigate the association between ICU organizational characteristics and adequate pain management, i.e. patient-shift observations in which patients' pain was measured and acceptable, or unacceptable and normalized within 1 h. All ICU patients admitted between December 2017 and June 2018 were included, excluding patients who were delirious, comatose or had a Glasgow coma score < 8 at the first day of ICU admission.
Results: Case-mix adjusted nurse to patient ratios of 0.70 to 0.80 and over 0.80 were significantly associated with adequate pain management (OR [95% confidence interval] of respectively 1.14 [1.07-1.21] and 1.16 [1.08-1.24]). Bed occupancy rate and intensivist presence showed no association.
Conclusion: Higher nurse to patient ratios increase the percentage of patients with adequate pain management especially in medical and mechanically ventilated patients.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1016/j.jcrc.2019.11.010 | DOI Listing |
Cureus
November 2024
Department of Hepatobiliary and Pancreatic Surgery, Pontificia Universidad Católica de Chile, Santiago, CHL.
The surgical management of hepatic metastases from colorectal cancer may range from segmental resections to major or extended hepatectomies. The aim is to achieve complete removal of metastatic lesions while preserving adequate liver function. We present the case of a 42-year-old male patient with a history of glucose intolerance who presented with altered bowel movements and abdominal pain.
View Article and Find Full Text PDFCureus
November 2024
Orthopaedics and Trauma, Russells Hall Hospital, Dudley, GBR.
Background/objective: Adequate postoperative analgesics are an essential element in the recovery and rehabilitation of large joint lower-limb arthroplasty patients in their acute postoperative phase. In this study, we will establish that strong opioids like morphine should be included as postoperative analgesics to improve patient satisfaction. Material: This retrospective cross-sectional study was conducted in the Arthroplasty Ward, Trauma, and Orthopaedics Department in a district general hospital of the United Kingdom.
View Article and Find Full Text PDFClin Microbiol Infect
December 2024
Pharmacologie cellulaire et moléculaire, Louvain Drug Research Institute, Université catholique de Louvain, Brussels, Belgium. Electronic address:
Objectives: Temocillin is a β-lactam antibiotic used for preventing or treating bacterial infections in liver-transplanted children. We characterized its pharmacokinetics in plasma and ascitic fluid and proposed dosing regimens that maximize achievement of effective drug exposures in this patient group.
Methods: Patients aged 6-36 months received 25 mg/kg/12h (n=14) or 25 mg/kg/8h (n=23).
Clin Med (Lond)
December 2024
St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust.
Atopic eczema (eczema; also known as atopic dermatitis) is a chronic inflammatory skin condition. The burden of eczema can be very substantial with significant itch, skin pain, secondary infection, sleep disturbance and psychological distress. Eczema is common in pregnancy.
View Article and Find Full Text PDFSci Rep
December 2024
School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China.
Microtextured microneedles are tiny needle-like structures with micron-scale microtextures, and the drugs stored in the microtextures can be released after entering the skin to achieve the effect of precise drug delivery. In this study, the skin substitution model of Ogden's hyperelastic model and the microneedle array and microtexture models with different geometrical parameters were selected to simulate and analyse the flow of the microtexture microneedle arrays penetrating the skin by the finite-element method, and the length of the microneedles was determined to be 200 μm, the width 160 μm, and the value of the gaps was determined to be 420 μm. A four-pronged cone was chosen as the shape of microneedles, and a rectangle was chosen as the shape of the drug-carrying microneedle.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!