Ana Argibay Lago, Diego Fernández Rodríguez, Nuria Ferrer Sala, Cristina Prieto Robles, Alexandre Hernanz del Río, Pedro Castro Rebollo
Objetivo La hipotermia terapéutica (HT) se recomienda para minimizar el daño neurológico de pacientes que sobreviven a una parada cardiorrespiratoria (PCR). Existen pocos datos que evalúen la carga de trabajo de Enfermería en estos pacientes. El objetivo del estudio es evaluar la carga de trabajo del personal de Enfermería en pacientes sometidos a HT tras una PCR.
Método Se diseñó un estudio prospectivo-retrospectivo comparativo de cohortes durante 43 meses donde se incluyeron todos los pacientes ingresados en unidades de cuidados intensivos con PCR recuperada. Se compararon características basales, manejo médico, mortalidad intrahospitalaria, y carga de trabajo de Enfermería en las primeras 96 horas mediante las escalas validadas Therapeutic Intervention Scoring System-28 (TISS-28); Nursing Activities Score (NAS); y Nine Equivalents of Nursing Manpower Use Score (NEMS) entre aquellos pacientes tratados y no tratados mediante HT.
Resultados Se incluyeron 46 pacientes: 26 en el grupo HT y 20 en el grupo no HT. El grupo HT presentó mayor prevalencia de tabaquismo (69 vs. 25%, p = 0,012), PCR extrahospitalaria (96 vs. 55%, p < 0,001) y realización de coronariografías (96 vs. 65%, p = 0,014). No hubo diferencias en la carga de trabajo evaluada por las escalas TISS 28, NAS o NEMS ni tampoco en el pronóstico intrahospitalario.
Conclusiones En este estudio la realización de HT en pacientes que sobreviven a una PCR no se asocia con un aumento de la carga de trabajo de Enfermería. La instauración de programas de HT no requeriría la implementación de más recursos en Enfermería en términos de carga de trabajo.
Objective Therapeutic hypothermia (TH) is recommended to minimize neurological damage in patients surviving sudden cardiac arrest (SCA). There is scarcity of data evaluating the nursing workload in these patients. The objective of the study is to assess the workload of nurses whilst treating patients undergoing TH after SCA.
Method A 43-month prospective-retrospective comparative cohort study was designed. Patients admitted to intensive care unit, for recovered SCA and persistent coma, were included. A comparison was made using the baseline characteristics, medical management, in-hospital mortality, and nursing workload during the first 96 hours using the Therapeutic Intervention Scoring System-28 (TISS-28); Nursing Activities Score (NAS); and Nine Equivalents of Nursing Manpower Use Score (NEMS) scales among patients who received TH and those who did not.
Results A total 46 patients were included: 26 in the TH group and 20 in the Non-TH group. Regarding baseline characteristics and management, the TH group presented higher prevalence of smoking habit (69 vs. 25%, p = 0 .012), out-of-hospital SCA (96 vs. 55%, p < 0 .001), and the performance of coronary angiography (96 vs. 65%, p = 0 .014) compared with the non-TH group. No differences were observed in the nursing workload, assessed by TISS 28, NAS or NEMS scales, or in-hospital mortality.
Conclusions In this study performance of TH in SCA survivors is not associated with an increase in nursing workload. The installation of a TH program does not require the use of more nursing resources in terms of workload.