Oplanerad återinläggning av patienter till thoraxintensivvårdsavdelning från vårdavdelning
Sammanfattning: Background: Every year approximately 2.5 percent of unplanned readmissions of patients to intensive care are carried out. There are several risk factors that may affect the care process leading to readmissions. The thoracic intensive care unit (TIVA) is a highly specialized intensive care unit, monitoring of all vital parameters with a high staff density. After the patient arrives to the ward, patients may begin to fail in one or more vital parameters, resulting in readmissions to TIVA. Effects of these unplanned readmissions include increased suffering for patients and increased length of care. The specialist nurse has a responsibility to observe all vital parameters necessary to decide about optimal care and treatment leading to stabilization of health status and subsequently being discharged from the unit.Aim: To describe nurses observed symptoms and signs among patients readmitted to TIVA within 72 hours after undergoing heart surgery-/ lung surgery.Method: A retrospective journal review of readmissions at TIVA from the ward. A manual medical record review of 26 medical records was performed. The study followed patients preoperatively until readmission. The focus was on the nurse's observation and documentation of patient's symptoms and sign in vital parameters. A descriptive analysis using SPSS was performed to obtain a descriptive picture of factors that may arise when patients are readmitted.Results: Out of 1,097 patients, 26 (2.3%) were readmitted to TIVA within 72 hours. Factors Symptoms and signs in circulatory failure, respiratory failure and communication failure were most common when readmission to TIVA occurred.Conclusion: Readmission within 72 hours to TIVA from the ward after heart surgery is associated with several symptoms and signs such as low blood pressure, initially deteriorated respiration and disorientation. In order to obtain the best care intervention qualified assessments of symptoms/signs and sign analysis and measures are needed, both from the specialist nurse and the general nurse at the ward.
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