Nursing-Sensitive Outcomes among Patients Cared for in Paediatric Intensive Care Units: A Scoping Review
Abstract
:1. Introduction
2. Material and Methods
2.1. Study Aims
2.2. Study Design
2.3. Establishing the Research Question
2.4. Identifying Relevant Studies
2.5. Study Selection
2.6. Charting the Data
2.7. Collating, Summarising, and Reporting the Results
3. Results
3.1. The State of the Art of NSOs Research in PICU Settings
3.2. NSOs and Metrics Documented to Date in PICUs
4. Discussion
4.1. The State of the Art of NSO Research in the PICU Setting
4.2. NSOs and Metrics Documented to Date in PICUs
4.3. Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
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Search | Query |
---|---|
MEDLINE (PubMed) | |
1 | “Outcome Assessment, Health Care” [Mesh] AND “Intensive Care Units, Paediatric” [Mesh] AND “Paediatric Nursing” [Mesh] |
2 | “Critical Care Outcomes” [Mesh] AND “Intensive Care Units, Paediatric” [Mesh] AND “Paediatric Nursing” [Mesh] |
3 | “Outcomes Measures” AND “Intensive Care Units, Paediatric” [Mesh] AND “Paediatric Nursing” [Mesh] |
4 | “Quality of Health Care” [Mesh] AND “Critical Care Outcomes” [Mesh] AND “Paediatric Nursing” [Mesh] |
CINAHL | |
1 | Paediatric intensive care unit + outcomes + nursing |
2 | Intensive care unit, paediatric + quality of health care + paediatric nursing |
3 | Intensive care unit, paediatric + patient outcomes + nursing |
Limited to English language and paediatric population (<18 years) |
Item | Inclusion |
---|---|
Language | English language |
Publication time | Any |
Population | Paediatric population (<18 years of age) |
Setting | Paediatric intensive care unit |
Study design | All quantitative and qualitative study designs, as well as secondary studies based on all types of reviews |
Study focus | Concerning paediatric patients admitted and cared for in PICU settings |
Study Characteristic | Number of Studies (n = 58) n. (%) |
---|---|
Year of publication | |
January 1999 to December 2009 | 8 (13.8) |
January 2010 to April 2020 | 50 (86.2) |
Continent | |
US and Canada | 28 (48.3) |
Europe | 10 (17.2) |
Middle East | 7 (12.1) |
Australia and New Zealand | 6 (10.3) |
Asia | 4 (6.9) |
Central and South America | 3 (5.2) |
Setting (PICU type) | |
General | 53 (91.4) |
Specialised (e.g., cardiac intensive care) | 5 (8.6) |
Study design | |
Observational | 30 (51.7) |
Experimental and quasi-experimental | 20 (34.5) |
Literature review | 8 (13.8) |
Outcome Domain (n.) [9] | Outcome Sub-Domain (n.) [11] | Reported Outcome(s) and n. of Publications Including Each Specific Outcome (n.) | Metrics of NSOs and Brief Description |
---|---|---|---|
Safety (41) | Healthcare- associated infections (23) | VAP (8) | Prevalence/incidence rate (e.g., events per 1000 ventilator-days, VAP per 1000 intubated patients) |
Healthcare-associated infections (e.g., colonisation of the oropharynx) (5) | Prevalence/incidence rate (e.g., nosocomial infection rate per 1000 PICU-days) | ||
CRBSI (4) | Prevalence/incidence rate (e.g., events per 1000 catheter-days) | ||
CAUTI (3) | Prevalence/incidence rate (e.g., events per 1000 device-days) | ||
CLABSI (3) | Prevalence/incidence rate (e.g., events per 1000 line-days) | ||
Critical incidents (18) | Pressure ulcers (8) | Prevalence/incidence rate (e.g., events per 100 PICU-days) | |
Unplanned/accidental extubations (2) | Prevalence/incidence rate (e.g., events per 100 ventilator-days) | ||
Mobilisation-related adverse events (2) | Number of events (e.g., line removal) | ||
Aspiration events (1) | Number of events | ||
Postpyloric tube placement events (1) | Number of events (e.g., oropharyngeal bleeding) | ||
Radiation exposures (1) | Number of events | ||
Haematoma (1) | Prevalence/incidence rate | ||
PIVC failures (e.g., occlusion) (1) | Prevalence/incidence rate | ||
Blood volume overdrawn (1) | Millilitre/kilogram per PICU-days | ||
Clinical (83) | General health (59) | PICU LOS (18) | Number of PICU-days |
Mortality (16) | Mortality rate; 90-days mortality; paediatric risk of mortality (PRISM) score; paediatric index of mortality (PIM) 2 score; paediatric index of mortality (PIM) 3 score | ||
Duration of mechanical ventilation (10) | Number of intermittent mandatory ventilation days | ||
Hospital LOS (4) | Number of PICU-days | ||
Morbidity (4) | Diseased state (e.g., severity of organ dysfunction) | ||
Readmission rate to PICU in 48 h (2) | Prevalence/incidence rate | ||
Weaning duration (2) | Hours | ||
Reintubation (2) | Prevalence/incidence rate | ||
Weaning failure (1) | Prevalence/incidence rate | ||
Goal assessment and monitoring (24) | Pain and distress (3) | Critical Care Pain Observation Tool; Numeric Rating Scale | |
Sedation and agitation level (3) | State Behavioural Scale | ||
Vomiting (2) | Number of events | ||
Occurrence of iatrogenic withdrawal (2) | Number of events | ||
Ventilator-free days (2) | Days | ||
PIVC dwell time (2) | Catheterisation-days; PIVC-hours | ||
Vasoactive-free days (1) | Days | ||
PICU-free days (1) | Days | ||
Diarrhoea (1) | Prevalence/incidence rates | ||
Post-extubation stridor (1) | Prevalence/incidence rates | ||
Clinical deterioration (1) | Paediatric early warning systems scores | ||
Nasojejunal tube (1) | Number of successful placements | ||
Changes in intracranial pressure (1) | Measurement in mm/hg | ||
Changes in mean arterial pressure and cerebral perfusion pressure (1) | Measurement in mm/hg | ||
Change of PIVC dressing (1) | Prevalence/incidence rates | ||
Incidence of red-blood cells transfusion (1) | Prevalence/incidence rates | ||
Functional (18) | Physical dimension (12) | Nutritional status (6) | Prevalence/incidence rates; adequate feeding (90–110% of required kcal/die); underfeeding (<90% of required kcal/die); overfeeding (>110% of required kcal/die) |
Oral health (3) | Oral assessment scale; culturing oropharyngeal flora; amount of mucositis; presence of dental plaque accumulation | ||
Hypoglycaemia (2) | Prevalence/incidence rate | ||
Mobilisation (1) | Protocol adherence | ||
Psychosocial dimension (6) | Delirium (4) | Cornell Assessment of Paediatric Delirium Tool; Preschool Confusion Assessment Method for the ICU | |
Cognitive status (1) | Glasgow Coma Scale | ||
Noise pollution (1) | Hourly decibel readings | ||
Perceptual (-) | Experience of being in PICU (-) | (-) | (-) |
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Danielis, M.; Castellano, A.; Mattiussi, E.; Palese, A. Nursing-Sensitive Outcomes among Patients Cared for in Paediatric Intensive Care Units: A Scoping Review. Int. J. Environ. Res. Public Health 2021, 18, 9507. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18189507
Danielis M, Castellano A, Mattiussi E, Palese A. Nursing-Sensitive Outcomes among Patients Cared for in Paediatric Intensive Care Units: A Scoping Review. International Journal of Environmental Research and Public Health. 2021; 18(18):9507. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18189507
Chicago/Turabian StyleDanielis, Matteo, Adele Castellano, Elisa Mattiussi, and Alvisa Palese. 2021. "Nursing-Sensitive Outcomes among Patients Cared for in Paediatric Intensive Care Units: A Scoping Review" International Journal of Environmental Research and Public Health 18, no. 18: 9507. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18189507