RELATIONSHIP BETWEEN HIGH ALERT MEDICATIONS AND A SELECTED OUTCOME AMONG PATIENTS AT INTENSIVE CARE UNITS - CAIRO UNIVERSITY HOSPITALS
Hanaa Ali Ahmed El-Feky - Assistant Professor, Critical Care and Emergency Nursing, Faculty of Nursing, Cairo University, Egypt
El Saied Abd El-Kader - Critical Care Department, Cairo University, Egypt
ABSTRACT
Background: Critically ill patients receiving high alert medication are at increased risk for drug –related events; of these is peripheral ischemia. Therefore, they require meticulous assessment for prevention, early detection and management. This study aimed to examine the relationship between high alert medications and selected patients' outcome at intensive care units - Cairo University Hospitals. High alert medications in the present study are Vasopressors, and patients' outcome refers to development of peripheral ischemia. Two research questions were stated: What is the frequency of peripheral ischemia among critically ill patients receiving high alert medications?; and what is the relationship between severity of peripheral ischemia, medical and demographic characteristics of critically ill patients at a University Hospital – Cairo? A descriptive exploratory research design was followed in this study. A purposive sample consisting of 120 adult male and female critically ill patients receiving high alert medications (Vasopressors) was included. Setting: This study was carried out at two intensive care units affiliated to Cairo University hospitals. Two tools were developed by the researchers and utilized to collect data: Patients' demographic and medical data tool; and critically ill patients' assessment tool for development of peripheral ischemia. Results: severe peripheral ischemia affected 71.7%, of the studied patients. It was most frequently noticed among patients aged >40 years old, males, having septic and cardiogenic shock, having both diabetes and hypertension as comorbidity diseases, smokers and overweight, in percentages of 65.3%, 75%, 70.6%, 54.5%, 84.4%, 74.7% and 77% respectively. Significant statistical relationships were found between demographic, medical characteristics, and severity of ischemia. Conclusion: Severe upper and lower peripheral ischemia was a common associated vascular complication among critically ill patients receiving high alert medications (vasopressors) in the present study. Recommendations: Meticulous focused and comprehensive assessment is important nursing consideration for critically ill patient receiving vasopressors; Establishment of standardized assessment tools to predict and detect peripheral / limb ischemia among critically ill patients; and replication of the study on a larger probability sample selected from different geographic areas in Egypt.
