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Metas de Enfermería

Metas de Enfermería

MARZO 2021 N° 2 Volumen 24

Accidental removal of feeding tubes in critical patients

Section: Originals

How to quote

Sánchez-Sánchez MM, Arias-Rivera S, Jareño-Collado R, Sánchez-Izquierdo R, Barba-Aragón S, Casado-Osa E, et al. Retirada accidental de sondas enterales en el paciente crítico. Metas Enferm mar 2021; 24(2):7-15. Doi: https://doi.org/10.35667/MetasEnf.2021.24. 1003081716

Authors

María del Mar Sánchez-Sánchez1, Susana Arias-Rivera2, Raquel Jareño-Collado1, Raquel Sánchez-Izquierdo3, Susana Barba-Aragón1, Elena Casado-Osa1, Jesús Cidoncha-Moreno1, Patricia Castejón-Barruso1, Teresa Alcalá-Ponce de León3, Virginia López-López1

Position

1Enfermero/a. Unidad de Cuidados Intensivos y Grandes Quemados. Hospital Universitario de Getafe. Madrid2 Enfermera. Máster Universitario en Género y Salud. Unidad de Investigación. Hospital Universitario de Getafe. Madrid3Enfermera. Licenciada en Psicología. Unidad de Cuidados Intensivos y Grandes Quemados. Hospital Universitario de Getafe. Madrid

Contact address

María del Mar Sánchez Sánchez. Unidad de Cuidados Intensivos. Hospital Universitario de Getafe. Crtra. Madrid-Toledo, km. 12,500. 28905 Getafe (Madrid

Contact email: marwestpot@yahoo.es

Abstract

Objective: to assess the impact of a training session on accidental removal (AR) rates of the feeding tube (FT) [self-removal and removal due to a cause external to the patient (CEP] and on the levels of analgesia & sedation and delirium detection, in patients from an Intensive Care and Major Burns Unit (ICU-MBU).
Method: an observational, before-and-after, prospective study, conducted in a 24-bed ICU-MBU- First period: October, 15th, 2018 to January, 15th, 2019: second period: July, 15th, 2019 to January, 15th, 2020. Results were reported between periods, and a training session was conducted (FT attachment, pain assessment, sedation, and delirium). All patients with FT were included. Variables: demographics, severity, reason for removal, adverse event as a consequence of removal or reinsertion, pain, sedation/agitation, and delirium. Analysis: descriptive, and incidence rates per 1,000 device days. Approved by the Drug Research Ethics Committee (CEIm).
Results: hospitalizations in 2018 vs. 2019: 232 vs. 408 (1,586 vs. 3,149 hospitalization days); women: 34% vs. 42%. SAPS III, Median (IQR): 57 (45-67) vs. 45 (33-54). FTs inserted: 156 vs. 295. AR rates per 1,000 device days: overall 56.68 vs. 45.87 (p= 0.42); self-removal: 48.13 vs. 37.72 (p= 0.36), CEP 8.56 vs. 8.15 (p= 0.90). No adverse events were reported. At the time of self-removal, 26.6% vs. 19% patients presented pain (VAS/ESCID> 0); 66.6% vs. 40.6% patients presented agitation (RASS> 0, and 33.3% vs. 20.3% patients presented delirium (positive CAM-ICU).
Conclusions: after the training session, a non-significant reduction in AR rates was observed. In cases of self-removal, a significant reduction in agitation was observed, as well as a clinically relevant reduction in pain and presence of delirium.

Keywords:

Feeding tube; training; nursing care; device removal; analgesia; psychomotor agitation; Delirium; safety management

Versión en Español

Título:

Retirada accidental de sondas enterales en el paciente crítico

Artículo completo no disponible en este idioma / Full article is not available in this language

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