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Bosch Alcaraz A, Corrionero Alegre J, Gil Domínguez S, Luna Castaño P, Piqueras Rodríguez P, Belda Hofheinz S, Ángeles Saz Roy M, Zuriguel Pérez E, Fernández Lorenzo R, Mata Ferro M, Martín Gómez A, Serradell Orea M, Martínez Oliva M, González Rivas S, Añaños Montoto N, José Espildora González M, Martín-Peñasco Osorio E, Carracedo Muñoz E, López Fernández E, Lozano Almendral G, Victoria Ureste Parra M, Gomez Merino A, García Martínez A, Morales Cervera D, Frade Pardo L, García Piñero JM. Intention to use physical restraint in paediatric intensive care units and correlated variables: A multicentre and cross-sectional study. Intensive Crit Care Nurs 2024; 83:103690. [PMID: 38598942 DOI: 10.1016/j.iccn.2024.103690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/31/2024] [Accepted: 03/17/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVES To determine the intention to use physical restraint (PR) and the relationship with sociodemographic and professional variables of the Paediatric Intensive Care Unit (PICU) nurses. RESEARCH METHODOLOGY/DESIGN AND SETTING A multicentre and correlational study was carried out from October 2021 to December 2023 in five paediatric intensive care units from five maternal and child hospitals in Spain. The Paediatric Physical Restraint-Theory of Planned Behaviour Questionnaire was provided. Moreover, sociodemographic and employment variables were registered. RESULTS A total of 230 paediatric nurses participated in the study. A total of 87.7 % were females with an average age of 35.5 ± 9.7 years and working experience of 10.5 ± 8.4 years. The mean scores obtained were 21.1 ± 3.8 for attitude, 13.1 ± 5.0 for subjective norms, 14.4 ± 4.3 for perceived behavioural control and 28.0 ± 6.0 for intention. The nurses apply more physical restraint to anxious patients, with scarce analgesics and sedation, those affected with pharmacological withdrawal symptoms and those with a high risk of accidental removal of vital support devices or fall from bed. The sex (p = 0.007) and type of employment contract (p = 0.01) are the variables that are significantly correlated with the intention to use of PR. CONCLUSION The paediatric nurses analysed had a moderate attitude, social pressure and perceived behavioural control towards the use of PR. IMPLICATIONS FOR CLINICAL PRACTICE It is important to know the factors that influence the intention to use physical restraint in order to standardise safe practice for critically ill paediatric and to ensure that patients' rights are respected by obtaining informed consent and assessing the prescription, continuation and removal of physical restraint.
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Affiliation(s)
- Alejandro Bosch Alcaraz
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Faculty of Nursing, University of Barcelona (UB), Barcelona, Spain; Mental Health, Psychosocial and Complex Nursing Care Research Group-NURSEARCH, University of Barcelona, Barcelona, Spain.
| | | | | | | | - Pedro Piqueras Rodríguez
- Pediatric Intensive Care Unit Nursing Supervisor, La Paz Hospital, Madrid, Spain; Research Member in Health Care, Health Research Institute, La Paz Hospital - IdiPAZ, Madrid, Spain
| | | | - M Ángeles Saz Roy
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Faculty of Nursing, University of Barcelona (UB), Barcelona, Spain; Mental Health, Psychosocial and Complex Nursing Care Research Group-NURSEARCH, University of Barcelona, Barcelona, Spain.
| | - Esperanza Zuriguel Pérez
- Nurse, Department of Knowledge Management and Evaluation, Vall d'Hebron Hospital, Barcelona, Spain; Multidisciplinary Nursing Research Group. Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | | | - María Mata Ferro
- Pediatric Intensive Care Unit, Sant Joan de Déu Hospital, Barcelona, Spain
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Alcaraz AB, Ángeles Saz Roy M. Adequate delirium management in the ICU starts with delirium assessment. Intensive Crit Care Nurs 2024; 83:103692. [PMID: 38555758 DOI: 10.1016/j.iccn.2024.103692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Affiliation(s)
- Alejandro Bosch Alcaraz
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Faculty of Nursing, University of Barcelona, Barcelona, Spain; Mental Health, Psychosocial and Complex Nursing Care Research Group-NURSEARCH, University of Barcelona, Barcelona, Spain.
| | - M Ángeles Saz Roy
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Faculty of Nursing, University of Barcelona, Barcelona, Spain; Mental Health, Psychosocial and Complex Nursing Care Research Group-NURSEARCH, University of Barcelona, Barcelona, Spain
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Bosch Alcaraz A, Piqueras Rodríguez P, Corrionero Alegre J, García Piñero JM, Belda Hofheinz S, Gil Domínguez S, Zuriguel Pérez E, Luna Castaño P, Saz Roy MÁ, Martínez Oliva M, González Rivas S, Añaños Montoto N, Espildora González MJ, Martín-Peñasco Osorio E, Carracedo Muñoz E, López Fernández E, Lozano Almendral G, Gomez Merino A, Morales Cervera D, Fernández Lorenzo R, Mata Ferro M, Martín Gómez A, Serradell Orea M, Esquinas López C, Via Clavero G. Adaptation and validation of the Physical Restraint-Theory of Planned Behaviour Questionnaire to the paediatric context. Nurs Crit Care 2024. [PMID: 38531666 DOI: 10.1111/nicc.13066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 03/07/2024] [Accepted: 03/11/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVE To create and test psychometrically a paediatric version of the Physical Restraint-Theory of Planned Behaviour Questionnaire to assess paediatric critical care nurses' intention to use physical restraint. DESIGN A psychometric study. SETTING Five medical-surgical Paeditric Intensive care Units from five hospitals in Spain. METHODS The study took place in three phases. In phase 1, the questionnaire was adapted. In phase 2, the content validity of each item was determined, and a pilot test was conducted. In phase 3, we administered the questionnaire and determined its psychometric properties. RESULTS The assessment of the intention to use physical restraint was extended to all critical paediatric patients, two items were eliminated from the initial questionnaire, four new items were included, and the clinical scenarios of the intention subscale were expanded from three to six. Overall content validity index for the full instrument of 0.96 out of 1. The Paediatric Physical Restraint-Theory of Planned Behaviour Questionnaire is made up of four subscales (attitude, subjective norms (SN), perceived behavioural control (PBC), and intention) subdivided into 7 factors and 51 items. The internal consistency for the attitude subscale obtained a Cronbach's Alpha of 0.80 to 0.73, for the SN it was 0.72 to 0.89, for the PBC it was from 0.80 to 0.73 and for the intention subscale it was 0.75. CONCLUSIONS The Paediatric Physical Restraint-Theory of Planned Behaviour Questionnaire is an instrument composed of seven factors and 51 items that validly and reliably assesses the intention of paediatric nurses to apply PR in PICUs. RELEVANCE FOR CLINICAL PRACTICE Having this instrument will help health centres move towards restraint-free care by allowing managers to assess professionals' attitudes, beliefs, and intentions around the use of PR in PICUs.
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Affiliation(s)
- Alejandro Bosch Alcaraz
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Faculty of Nursing, University of Barcelona (UB), Barcelona, Spain
- Mental Health, Psychosocial and Complex Nursing Care Research Group-NURSEARCH, University of Barcelona, Barcelona, Spain
| | - Pedro Piqueras Rodríguez
- Pediatric Intensive Care Unit, La Paz Hospital, Madrid, Spain
- Health Research Institute, La Paz Hospital - IdiPAZ, Madrid, Spain
| | | | | | | | | | - Esperanza Zuriguel Pérez
- Department of Knowledge Management and Evaluation, Vall d'Hebron Hospital, Barcelona, Spain
- Multidisciplinary Nursing Research Group, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Patricia Luna Castaño
- Alfonso X el Sabio University, Madrid, Spain
- Health Care and Services Research Unit (Investén-ISCIII), Madrid, Spain
| | - M Ángeles Saz Roy
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Faculty of Nursing, University of Barcelona (UB), Barcelona, Spain
- Mental Health, Psychosocial and Complex Nursing Care Research Group-NURSEARCH, University of Barcelona, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | | | | - María Mata Ferro
- Pediatric Intensive Care Unit, Sant Joan de Déu Hospital, Barcelona, Spain
| | | | | | - Cristina Esquinas López
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Faculty of Nursing, University of Barcelona (UB), Barcelona, Spain
| | - Gemma Via Clavero
- Hospital Universitari de Bellvitge, Barcelona, Spain
- Faculty of Nursing, University of Barcelona (UB), Barcelona, Spain
- Nursing Research Group (GRIN), Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
- International Research Project for the Humanization of Health Care, Proyecto HU-CI, Madrid, Spain
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Mata Ferro M, Falcó Pegueroles A, Fernández Lorenzo R, Saz Roy MÁ, Rodríguez Forner O, Estrada Jurado CM, Bonet Julià N, Geli Benito C, Hernández Hernández R, Bosch Alcaraz A. The effect of a live music therapy intervention on critically ill paediatric patients in the intensive care unit: A quasi-experimental pretest-posttest study. Aust Crit Care 2023; 36:967-973. [PMID: 36868934 DOI: 10.1016/j.aucc.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 12/29/2022] [Accepted: 01/07/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND Music therapy as a nonpharmacological means of managing patient pain, anxiety, and discomfort is a recognised technique, although it is not widely used in the paediatric intensive care unit (PICU). AIM The aim of this study was to assess the clinical effect of a live music therapy intervention on vital signs and levels of discomfort and pain for paediatric patients in the PICU. METHODS This was a quasi-experimental pretest-posttest study. The music therapy intervention was carried out by two music therapists who were specifically trained, each possessing a master's degree in the field of hospital music therapy. Ten minutes before the start of the music therapy session, the investigators recorded the vital signs of the patients and assessed their levels of discomfort and pain. The procedure was repeated at the start of the intervention; at 2, 5, and 10 min during the intervention; and at 10 min following the conclusion of the intervention. RESULTS Two hundred fifty-nine patients were included; 55.2% were male, with a median age of 1 year (0-21). A total of 96 (37.1%) patients suffered a chronic illness. The main reason for PICU admission was respiratory illness, at 50.2% (n = 130). Significantly lower values were observed for heart rate (p = 0.002), breathing rate (p < 0.001), and degree of discomfort (p < 0.001) during the music therapy session. CONCLUSIONS Live music therapy results in reduced heart rates, breathing rates, and paediatric patient discomfort levels. Although music therapy is not widely used in the PICU, our results suggest that using interventions such as that used in this study could help reduce patient discomfort.
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Affiliation(s)
- María Mata Ferro
- Pediatric Intensive Care Unit, Sant Joan de Déu Hospital, Barcelona, Spain
| | - Anna Falcó Pegueroles
- Department of Fundamental Care and Medical-Surgical Nursing, School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona (UB), Barcelona, Spain
| | | | - M Ángeles Saz Roy
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona (UB), Barcelona, Spain
| | | | | | | | | | | | - Alejandro Bosch Alcaraz
- Pediatric Intensive Care Unit, Sant Joan de Déu Hospital, Barcelona, Spain; Department of Public Health, Mental Health and Maternal and Child Health Nursing, School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona (UB), Barcelona, Spain.
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Rodríguez-Navarro MÁ, Díaz-Alejo C, Padilla-Del Rey ML, Alcaraz AB, González-Pérez P, Benítez M. Safe intrathecal fluorescein use for identification of cerebrospinal fluid leaks: Case-report and perioperative algorithm description. ACTA ACUST UNITED AC 2017; 64:533-536. [PMID: 28390712 DOI: 10.1016/j.redar.2017.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 03/06/2017] [Accepted: 03/06/2017] [Indexed: 11/24/2022]
Abstract
Intrathecal injection of fluorescein is a method for repairing cerebrospinal fluid fistulas. The most frequent surgical procedure is endonasal endoscopy and the purpose of injecting this dye is to locate the fistula. The anaesthesiologists usually perform the puncture, therefore it is necessary to review this method and to specify some anaesthetic considerations such as correct dosing, safe management protocols and medical-legal aspects. In this case-report we describe the pre, intra and postoperative protocol of action implemented in our department that basically consists of: obtaining a specific consent, prior neurological/ophthalmologic assessment to rule out hypertension and brain damage, use of corticosteroids and previous antihistamines, choosing the correct dose and concentration of intrathecal sodium fluorescein (maximum 1ml at a concentration of 5% diluted in 9ml of cerebrospinal fluid) and close intra and postoperative monitoring.
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Affiliation(s)
- M Á Rodríguez-Navarro
- Departamento de Anestesiología y Reanimación, Hospital General Universitario Morales Meseguer, Murcia, España.
| | - C Díaz-Alejo
- Departamento de Anestesiología y Reanimación, Hospital General Universitario Morales Meseguer, Murcia, España
| | - M L Padilla-Del Rey
- Departamento de Anestesiología y Reanimación, Hospital General Universitario Morales Meseguer, Murcia, España
| | - A B Alcaraz
- Departamento de Anestesiología y Reanimación, Hospital General Universitario Morales Meseguer, Murcia, España
| | - P González-Pérez
- Departamento de Anestesiología y Reanimación, Hospital General Universitario Morales Meseguer, Murcia, España
| | - M Benítez
- Departamento de Anestesiología y Reanimación, Hospital General Universitario Morales Meseguer, Murcia, España
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