Browsing by Author "Padilla Fortunatti, Cristóbal Felipe"

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    Asociación entre carga laboral de enfermería, gravedad del paciente y mortalidad en pacientes críticos de un hospital público
    (2023) Padilla Fortunatti, Cristóbal Felipe; Escobar Lazcano, Cristina; Ruiz Balart, Carmen Carolina; Rojas Silva, Noelia Pilar
    OBJETIVO: Determinar la asociación entre la carga laboral de enfermería, gravedad del paciente, y mortalidad en una unidad de pacientes críticos (UPC) de un hospital público en Chile. METODOLOGÍA: Estudio retrospectivo, correlacional, que analizó fichas clínicas de pacientes de una UPC. Se recolectaron variables demográficas, clínicas, gravedad de paciente (APACHE II) y carga de trabajo de enfermería (TISS-28)al ingreso del paciente. Se realizaron análisis descriptivos y bivariados. Se utilizaron regresiones logísticas para identificar las variables asociadas a mortalidad en la UPC y hospitalaria. RESULTADOS: Se incluyeron 311 pacientes con una mediana de 7 días (RIQ=9,5) de estadía en la UPC. Un 48,9% ingreso desde el servicio de urgencia y un 25,7% tuvo un diagnostico neurológico. El puntaje TISS-28 se asoció positivamente con el del APACHE II (r=0,359, p<0,001) y los días de estadía en UPC (r=0,146, p<0,05). En los modelos de regresión, la mortalidad en UPC estuvo asociada con el puntaje APACHE II (OR=1,109, p<0,001) y el TISS-28 (OR=0,955, p<0,05). Los puntajes de APACHE II y TISS-28 no se asociaron significativamente con la mortalidad hospitalaria. CONCLUSIÓN: Una mayor gravedad del paciente critico se asoció con un aumento en la carga de trabajo de enfermería. La mortalidad en UPC se asoció negativamente con la carga de trabajo en enfermería, pero positivamente con la gravedad de paciente. La carga de trabajo de enfermería es una variable relevante en el desenlace del paciente crítico por lo que debe evaluarse regularmente y de este modo, asegurar dotaciones que respondan a las demandas asistenciales del paciente en la UPC.
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    Family Satisfaction in the Adult Intensive Care Unit : A Concept Analysis
    (LIPPINCOTT WILLIAMS & WILKINS, 2021) Padilla Fortunatti, Cristóbal Felipe; De Santis, Joseph P.; Munro, Cindy L.
    Admission of patients to an intensive care unit is often a stressful event for family members. In the context of patient- and family-centered care, family satisfaction is recognized as a quality indicator of intensive care unit care. However, family satisfaction has not been consistently used or conceptualized in the literature. A modified version of Walker and Avant's method for concept analysis was utilized to examine the concept of family satisfaction in the adult intensive care unit. Antecedents, attributes, consequences, and empirical referents of family satisfaction are presented and implications for practice, research, and policy.
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    Impact of two bundles on central catheter-related bloodstreaminfection in critically ill patients
    (2017) Padilla Fortunatti, Cristóbal Felipe
    Objective: To evaluate the impact of the implementation of insertion and maintenance bundles on the rates of catheter-related bloodstream infection in an intensive care unit. Method: This is a quasi-experimental, before-and-after study with a non-equivalent control group. During a six-month period, insertion and maintenance bundles for the central venous catheters were implemented. Supervision guidelines were developed to assess compliance with the bundle and catheter characteristics. Results: A total of 444 central catheters corresponding to 390 patients were observed, of which 68.7% were inserted in the unit. The maintenance and insertion bundles reached 62.9% and 94.7% compliance, respectively, and 50.7% of the insertions were supervised. It was possible to observe a 54.5% decrease in the rate of central catheter infection (3.48 vs 1.52 x 1000 days/catheter, p<0.05) when compared with the control group. Conclusion: The simultaneous implementation of insertion and maintenance bundles has a positive impact on the reduction of catheter-related bloodstream infection; therefore it is an efficient alternative to improve the quality and safety of care in high complexity units.
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    Needs of relatives of critically ill patients in an academic hospital in Chile
    (2018) Padilla Fortunatti, Cristóbal Felipe; Rojas Silva, Noelia Pilar; Amthauer Rojas, Macarena Paz; Molina Muñoz, Y.
    Objective: To identify the importance of the needs of family members of patients in an intensive care unit (ICU).||Method: Descriptive, comparative and cross-sectional study based on a secondary data analysis of 251 relatives of ICU patients at a university hospital in Santiago, Chile. Using non-random sampling, the 'Critical Care Family Needs Inventory' was used to establish the family needs, as well as a sociodemographic questionnaire that included: age, gender, educational level, patient relationship and previous ICU experience. A descriptive statistical analysis, Student's T test and ANOVA were performed.||Results: The most important family needs related to the dimensions of 'security' (mean = 3.90) and 'information' (mean = 3.76), while those of minor importance with 'support' (mean = 3.09). In the latter, differences were observed at an older age (P<.05), an educational level (P<.001) and relationship with the patient (P<.05).||Conclusions: The most relevant needs for family members in the ICU are related to safety and information. Less important needs are influenced by certain sociodemographic variables. Identifying the degree of importance of family needs will allow the health team to improve its relationship with families in ICUs. (C) 2017 Sociedad Espanola de Enfermeria Intensiva y Unidades Coronarias (SEEIUC). Published by Elsevier Espana, S.L.U. All rights reserved.