Contenuto dell'articolo principale

Abstract

Introduzione: I pazienti in condizioni critiche ricoverati nei reparti di terapia intensiva sono considerati ad alto rischio di infezioni. Il fenomeno più preoccupante oggi nell'epidemiologia delle infezioni ospedaliere è rappresentato dai microrganismi multiresistenti agli antibiotici (MDR). Obiettivo: Lo scopo di questo studio è stato quello di valutare se il carico di lavoro infermieristico sia influenzato dalle misure di isolamento del paziente.

Metodo: Sono stati messi in relazione il Punteggio NAS (Nursing Activities Score) e le misure di isolamento attuate per ogni paziente che ha sviluppato una positivití  per MDR: Acinetobacter Baumannii, Klebsiella KPC, MRSA, Pseudomonas, Escherichia coli, Serratia marcescens e Clostridium difficile. Le misure di isolamento prevedevano l'utilizzo di codici colore ad intensití  crescente (verde, giallo, rosso) in base alla situazione microbiologica del paziente.

Risultati: Durante il 2012, 44 pazienti hanno sviluppato i criteri per l'isolamento. Il punteggio NAS medio nel campione è risultato risultato pari a 81,54 ± 10. Il NAS medio dei pazienti con codice verde è stato pari a 81,25 ± 22,12, con codice giallo è stato 82,57 ± 11,25, con codice rosso è stato 79,06 ± 29.

Discussione: La presenza di positivití  per un microrganismo MRD e la conseguente adozione delle misure di isolamento del paziente non sembra di per sé comportare un maggiore carico di lavoro infermieristico, misurato attraverso il punteggio NAS. Unica eccezione è rappresentata dai pazienti positivi per Acinetobacter Baumannii. Il campione ridotto e la scarsití  di letteratura in materia rendono necessari ulteriori studi per meglio definire il problema.

Parole chiave:"ˆterapia intensiva, carico di lavoro infermieristico, infezioni, misure di isolamento. 


Isolation precautions in multi drug resistent infections and nursing workload in a general intensive care unit

Background: Critically ill patients in ICU are exposed to high risk of hospital acquired infections. In recent years, the multi drug resistant microorganisms (MDR) represent the most worrying epidemiological problem.

Aim: The aim of this study is to evaluate the relationship between isolation precautions and nursing workload.

Methods: We studied patients who had an infection by MDR, subject to isolation precautions, and measured their NAS score during stay in ICU. MDR infections of studied patients were: Acinetobacter Baumannii, Klebsiella KPC, MRSA, Pseudomonas, Escherichia coli, Serratia marcescens e Clostridium difficile. Isolation precutions wer identified by color code (green, yellow, red).

Results: We studied 44 patients during the year 2012. NAS average was 81.54 ± 10.25. NAS average for "green code" patients was 81.25 ± 22.12, for "yellow code" patients was 82.57 ± 11.25 and for "red code" patients was 79.06 ± 29.12.

Discussion: the presence of isolation precautions seems to have no influence on nursing workload measured by NAS score, except for Acinetobacter Baumannii infection. Further research will be needed for better evaluation of this topic.

Keywords: intensive care, nursing workload, infection, isolation.

Dettagli dell'articolo

Come citare
Elli, S., Canizzo, L., Foti, G., Fumagalli, R., & Lucchini, A. (2018). Misure di isolamento per infezioni da microorganismi multiresistenti e carico di lavoro infermieristico in una terapia intensiva polivalente. PROFESSIONI INFERMIERISTICHE, 70(4). Recuperato da https://www.profinf.net/pro3/index.php/IN/article/view/450

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