https://doi.org/10.4081/scenario.2013.117
Utilizzo della scala RASS e dello strumento CAMICU per la valutazione del livello di sedazione e della presenza di delirium nelle persone ricoverate in una terapia intensiva polivalente
Submitted: 23 January 2018
Accepted: 23 January 2018
Published: 23 January 2018
Accepted: 23 January 2018
Abstract Views: 2900
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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Materiali e metodi: valutare l’applicazione della Richmond Agitation-Sedation Scale (RASS) e della Confusion Assessment Method for the ICU
(CAM-ICU) nei pazienti ricoverati in una terapia intensiva polivalente. Studio osservazionale retrospettivo nel periodo gennaio 2007- dicembre 2011. La somministrazione della RASS è stata fatta almeno una volta per turno e ad ogni variazione dello stato di coscienza, mentre la CAM-ICU è stata somministrata quando l’infermiere sospettava la presenza di segni di delirium.
Risultati: su una popolazione di 1523 pazienti sono state ottenute 25.813 misurazioni RASS con un punteggio medio di -1,05 (±1,22). Le rilevazioni totali di CAM-ICU sono state 678 e i pazienti che sono stati oggetto di valutazione di delirium (11,03%).
Le rilevazioni positive sono state in totale 78 (11,50%). Il numero di pazienti con CAM-ICU positiva è stato pari a 45 (26,79%) rispetto a tutte le misurazioni effettuate e pari al 2,95% della popolazione totale.
Conclusioni: al fine di migliorare l’assistenza infermieristica è importante valutare lo stato di coscienza e l’insorgenza di delirium e applicare tutte le strategie assistenziali atte a ridurne l’incidenza. La RASS e la CAM-ICU sono strumenti semplici, facilmente utilizzabili dagli infermieri di area critica.
PUN BT, DUNN J. The sedation of critically ill adults: Part 1: Assessment. The first in a two-part series focuses on assessing seda- ted patients in the ICU. Am J Nurs. 2007;107(7):40.
PUN BT, DUNN J. The sedation of critically ill adults: part 2: management. Am J Nurs.2007;107(8):40-9.
JACOBI J, FRASER GL, COURSIN DB, RIKER RR, FONTAINE D, et al. Clinical practice guide- lines for the sustained use of sedatives and analgesics in the critically ill adult. Crit Care Med. 2002;30(1):119-41.
CHANQUES G, JABER S, BARBOTTE E, VIOLET S, SEBBANE M, et al. Impact of systematic evaluation of pain and agitation in an intensive care unit. Crit Care Med.2006;34(6):1691-9.
PAYEN JF, CHANQUES G, MANTZ J, HERCULE C, AURIANT I, et al. Current practices in sedation and analgesia for mechanically ventilated critically ill patients: a prospec- tive multicenter patient-based study. Anesthesiology. 2007;106(4):687 – 95.
AITKEN LM, MARSHALL AP, ELLIOTT R, MCKINLEY S. Critical care nurses' decision making: sedation assessment and mana- gement in intensive care. J Clin Nurs. 2009;18(1):36-45.
OSTERMANN ME, KEENAN SP, SEIFERLING RA, SIBBALD WJ. Sedation in the intensive care unit: a systematic review. JAMA. 2000;283(11):1451-9.
SESSLER CN, PEDRAM S. Protocolized and target-based sedation and analgesia in the ICU. Anesthesiol Clin. 2011;29(4):625-50
SESSLER CN, GOSNELL MS, GRAP MJ, BROPHY GM, O'NEAL PV, et al. The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients. Am J Respir Crit Care Med. 2002;166(10):1338-44.
ELY EW, TRUMAN B, SHINTANI A, THOMASON JW, WHEELER AP, GORDON S et al. Monitoring sedation status over time in ICU patients: reliability and validity of the Richmond Agitation-Sedation Scale (RASS). JAMA. 2003;289(22):2983-91.
BRUNO JJ, WARREN ML. Intensive care unit delirium. Crit Care Nurs Clin North Am. 2010;22(2):161-78.
STEVENS RD, NEUFELD KJ, SHARSHAR T. Delirium in the ICU: time to probe the hard questions. Crit Care. 2011;15(1):118.
ZAAL IJ, SLOOTER AJ. Delirium in critically ill patients: epidemiology, pathophysio- logy, diagnosis and management. Drugs. 2012 Jul;72(11):1457-71.
ELY EW, MARGOLIN R, FRANCIS J, MAY L, TRUMAN B, et al. Evaluation of delirium in critically ill patients: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Crit Care Med. 2001;29(7):1370-9.
ELY EW, INOUYE SK, BERNARD GR, GORDON S, FRANCIS J, et al. Delirium in mechanically ventilated patients: validity and reliabi- lity of the confusion assessment method for the intensive care unit (CAM-ICU). JAMA. 2001;286(21):2703-10.
MIRANDA DR, NAP R, DE RIJK A, SCHAUFELI W, IAPICHINO G. Nursing activities score. Crit Care Med. 2003;31(2):374-82.
SPRUNG CL, ARTIGAS A, KESECIOGLU J, PEZZI A, WIIS J, PIRRACCHIO R, et al. The Eldicus prospective, observational study of triage decision making in European intensive care units. Part II: intensive care benefit for the elderly. Crit Care Med. 2012;40(1):132-8.
MIRSKI MA, LEWIN JJ 3RD, LEDROUX S, THOMPSON C, MURAKAMI P, et al. Cognitive improvement during continuous sedation in critically ill, awake and responsive patients: the Acute Neurological ICU Sedation Trial (ANIST). Care Med. 2010;36(9):1505-13.
CIGADA M, CORBELLA D, MISTRALETTI G, FORSTER CR, TOMMASINO C, et al. Conscious sedation in the critically ill ventilated patient. J Crit Care. 2008;23(3):349-53.
VASILEVSKIS EE, PANDHARIPANDE PP, GIRARD TD, ELY EW. A screening, prevention, and restoration model for saving the injured brain in intensive care unit survivors. Crit Care Med. 2010;38(10 Suppl):S683-91.
NELSON LS. Teaching staff nurses the CAM-ICU for delirium screening. Crit Care Nurs Q. 2009;32(2):137-43.
SPRONK PE, RIEKERK-GRUL B, HOFHUIS JG. Are intensive care nurses really superior to the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) in detecting delirium? Crit Care Resusc. 2012;14(1):89; author reply 91-2.
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How to Cite
Doni, V., Re, R., Tancredi, V., Cannizzo, L., Bondi, H., Coppolecchia, G., & Lucchini, A. (2018). Utilizzo della scala RASS e dello strumento CAMICU per la valutazione del livello di sedazione e della presenza di delirium nelle persone ricoverate in una terapia intensiva polivalente. Scenario® - Il Nursing Nella Sopravvivenza, 30(1), 24–28. https://doi.org/10.4081/scenario.2013.117
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