Physiological changes associated with routine nursing procedures in critically ill are common: an observational pilot...

Area of Science:

• Critical Care Medicine
• Nursing Science
• Physiology

Background:

• Routine nursing procedures in intensive care units (ICUs) are often presumed to have minimal adverse effects.
• However, these interventions can induce significant physiological alterations in vulnerable patients.
• This study investigated the frequency and nature of such changes.

Purpose of the Study:

• To determine the prevalence and severity of physiological changes associated with routine nursing procedures in critically ill patients.
• To identify specific nursing interventions that commonly lead to adverse physiological events.
• To provide data for optimizing patient care protocols in the ICU.

Main Methods:

• A prospective observational study was conducted involving 16 critically ill patients in a mixed university hospital ICU.
• All nursing procedures were meticulously observed, and continuous physiological data were collected.
• Physiological changes were categorized as minor (minimal respiratory/circulatory variations) or major (e.g., hypotension, desaturation, ventilatory distress).

Main Results:

• A total of 668 nursing procedures were observed over 187 hours, resulting in 158 major and 692 minor physiological changes.
• Patient repositioning was the most frequent procedure and the leading cause of physiological alterations.
• Common major changes included oxygen desaturation, ventilatory distress, and hypotension; minor changes involved blood pressure fluctuations and increased respiratory rate.

Conclusions:

• Routine nursing procedures in the ICU are frequently associated with common and sometimes severe physiological changes.
• These findings underscore the importance of vigilant monitoring and potential modification of nursing practices to mitigate patient risk.
• Further research is warranted to explore interventions aimed at minimizing these adverse events.