Degree of implementation of preventive strategies for post-ICU syndrome: Multi-centre, observational study in Spain

Enferm Intensiva (Engl Ed). 2019 Apr-Jun;30(2):59-71. doi: 10.1016/j.enfi.2018.04.004. Epub 2018 Jun 28.
[Article in English, Spanish]

Abstract

Aim: To evaluate the degree of implementation of protocols associated with the prevention of intensive-care-unit (ICU) acquired muscle weakness, and the presence of the physiotherapist in various ICU in Spain.

Method: A descriptive, cross-sectional study performed in 86 adult ICU in Spain between March and June 2017. Neurosurgical and major burns ICU were excluded. A multiple-choice survey was used that included questions on protocols for glycaemia control, sedation, pain assessment, delirium prevention, delirium management and early mobilisation. The survey was completed using a user-protected application and password. The Student's t-test or Mann-Whitney U test and Pearson's correlation or Spearman's Rho test were used for the inferential analysis.

Results: Eighty-nine point five percent of the ICU had a glycaemia control protocol, with a predominating range of 110-140mg/dl. Seventy-four point four percent evaluated sedation levels, although only 36% had sedation protocols. Pain assessment was carried out on communicative patients in 73.7%, and on uncommunicative patients in only 47.5%. Only 37.2% performed daily screening to detect delirium and 31.4% of the ICU had delirium prevention protocols, 26.7% had delirium management protocols and 14% had protocols for early mobilisation. Thirty-four point nine percent requested cross consultation with the rehabilitation department.

Conclusions: The implementation of the different protocols associated with the prevention of ICU-acquired muscle weakness was high in relation to glycaemia control protocols, sedation level and pain assessment in communicative patients, and was low for early mobilisation and delirium screening and prevention. Similarly, the physiotherapist was seldom present in the ICU.

Keywords: Critical illness; Early mobility; Enfermedad crítica; Enfermería; Intensive Care Units; Movilización precoz; Nursing; Physical therapy; Rehabilitación; Rehabilitation; Terapia física; Unidades de Cuidados Intensivos.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adult
  • Clinical Protocols
  • Cross-Sectional Studies
  • Guideline Adherence
  • Humans
  • Intensive Care Units*
  • Muscle Weakness / prevention & control*
  • Spanien
  • Syndrome