Browsing by Author "Padilla Fortunatti, Cristóbal Felipe"
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- ItemAsociación entre carga laboral de enfermería, gravedad del paciente y mortalidad en pacientes críticos de un hospital público(2023) Padilla Fortunatti, Cristóbal Felipe; Escobar Lazcano, Cristina; Ruiz Balart, Carmen Carolina; Rojas Silva, Noelia PilarOBJETIVO: Determinar la asociación entre la carga laboral de enfermería, gravedad del paciente, y mortalidad en una unidad de pacientes críticos (UPC) de un hospital público en Chile. METODOLOGÍA: Estudio retrospectivo, correlacional, que analizó fichas clínicas de pacientes de una UPC. Se recolectaron variables demográficas, clínicas, gravedad de paciente (APACHE II) y carga de trabajo de enfermería (TISS-28)al ingreso del paciente. Se realizaron análisis descriptivos y bivariados. Se utilizaron regresiones logísticas para identificar las variables asociadas a mortalidad en la UPC y hospitalaria. RESULTADOS: Se incluyeron 311 pacientes con una mediana de 7 días (RIQ=9,5) de estadía en la UPC. Un 48,9% ingreso desde el servicio de urgencia y un 25,7% tuvo un diagnostico neurológico. El puntaje TISS-28 se asoció positivamente con el del APACHE II (r=0,359, p<0,001) y los días de estadía en UPC (r=0,146, p<0,05). En los modelos de regresión, la mortalidad en UPC estuvo asociada con el puntaje APACHE II (OR=1,109, p<0,001) y el TISS-28 (OR=0,955, p<0,05). Los puntajes de APACHE II y TISS-28 no se asociaron significativamente con la mortalidad hospitalaria. CONCLUSIÓN: Una mayor gravedad del paciente critico se asoció con un aumento en la carga de trabajo de enfermería. La mortalidad en UPC se asoció negativamente con la carga de trabajo en enfermería, pero positivamente con la gravedad de paciente. La carga de trabajo de enfermería es una variable relevante en el desenlace del paciente crítico por lo que debe evaluarse regularmente y de este modo, asegurar dotaciones que respondan a las demandas asistenciales del paciente en la UPC.
- ItemFamily Satisfaction in the Adult Intensive Care Unit : A Concept Analysis(LIPPINCOTT WILLIAMS & WILKINS, 2021) Padilla Fortunatti, Cristóbal Felipe; De Santis, Joseph P.; Munro, Cindy L.Admission of patients to an intensive care unit is often a stressful event for family members. In the context of patient- and family-centered care, family satisfaction is recognized as a quality indicator of intensive care unit care. However, family satisfaction has not been consistently used or conceptualized in the literature. A modified version of Walker and Avant's method for concept analysis was utilized to examine the concept of family satisfaction in the adult intensive care unit. Antecedents, attributes, consequences, and empirical referents of family satisfaction are presented and implications for practice, research, and policy.
- ItemImpact of two bundles on central catheter-related bloodstreaminfection in critically ill patients(2017) Padilla Fortunatti, Cristóbal FelipeObjective: To evaluate the impact of the implementation of insertion and maintenance bundles on the rates of catheter-related bloodstream infection in an intensive care unit. Method: This is a quasi-experimental, before-and-after study with a non-equivalent control group. During a six-month period, insertion and maintenance bundles for the central venous catheters were implemented. Supervision guidelines were developed to assess compliance with the bundle and catheter characteristics. Results: A total of 444 central catheters corresponding to 390 patients were observed, of which 68.7% were inserted in the unit. The maintenance and insertion bundles reached 62.9% and 94.7% compliance, respectively, and 50.7% of the insertions were supervised. It was possible to observe a 54.5% decrease in the rate of central catheter infection (3.48 vs 1.52 x 1000 days/catheter, p<0.05) when compared with the control group. Conclusion: The simultaneous implementation of insertion and maintenance bundles has a positive impact on the reduction of catheter-related bloodstream infection; therefore it is an efficient alternative to improve the quality and safety of care in high complexity units.
- ItemIncidence and factors associated with post-intensive care syndrome among caregivers of intensive care unit survivors: Protocol for a cohort study(2025) Padilla Fortunatti, Cristóbal Felipe; Rojas Silva, Noelia Pilar; Cortés Maripangue, Sergio; Palmeiro Silva, Yasna; Rojas Jara, Verónica; Nilo González, Valentina Maribel; Cifuentes Avendaño, Belén Fernanda; Morales Morales, Daniel; Garcés Brito, NicolasBackground: During the last decades, intensive care unit (ICU) mortality rates have significantly decreased but this progress has come with unintended consequences for patients and their caregivers. The adverse health-related effects observed in caregivers during the post-ICU period are referred to as Post-Intensive Care Syndrome-Family (PICS-F). Despite growing awareness of PICS-F, the long-term challenges faced by caregivers of ICU patients are not well characterized with several gaps in knowledge remaining unaddressed. The proposed study aims to determine the incidence of PICS-F impairments and identify associated factors among caregivers of ICU survivors. Methods: We plan to conduct a longitudinal prospective cohort study involving 175 caregivers of ICU patients admitted to a public hospital in Chile. Data will be collected during ICU admission, after ICU discharge, 3 months and 6 months after hospital discharge. Questionnaires will evaluate caregivers’ psychological, physical and cognitive outcomes and perceived social support, resilience, family satisfaction and caregiver burden. Factors associated with PICS-F impairments will be explored using generalised linear mixed models. Discussion: The current understanding of PICS-F is limited, particularly regarding the risk and protective factors associated with the syndrome among caregivers of ICU survivors. This study will contribute to addressing this gap by providing novel data about PICS-F and exploring previously unexamined factors linked to PICS-F such as family satisfaction, psychological buffers and caregiver burden.
- ItemNeeds of relatives of critically ill patients in an academic hospital in Chile(2018) Padilla Fortunatti, Cristóbal Felipe; Rojas Silva, Noelia Pilar; Amthauer Rojas, Macarena Paz; Molina Muñoz, Y.Objective: To identify the importance of the needs of family members of patients in an intensive care unit (ICU).||Method: Descriptive, comparative and cross-sectional study based on a secondary data analysis of 251 relatives of ICU patients at a university hospital in Santiago, Chile. Using non-random sampling, the 'Critical Care Family Needs Inventory' was used to establish the family needs, as well as a sociodemographic questionnaire that included: age, gender, educational level, patient relationship and previous ICU experience. A descriptive statistical analysis, Student's T test and ANOVA were performed.||Results: The most important family needs related to the dimensions of 'security' (mean = 3.90) and 'information' (mean = 3.76), while those of minor importance with 'support' (mean = 3.09). In the latter, differences were observed at an older age (P<.05), an educational level (P<.001) and relationship with the patient (P<.05).||Conclusions: The most relevant needs for family members in the ICU are related to safety and information. Less important needs are influenced by certain sociodemographic variables. Identifying the degree of importance of family needs will allow the health team to improve its relationship with families in ICUs. (C) 2017 Sociedad Espanola de Enfermeria Intensiva y Unidades Coronarias (SEEIUC). Published by Elsevier Espana, S.L.U. All rights reserved.
- ItemRelationship between perceived stress and health literacy on family satisfaction among family members of critically ill patients: A multicenter exploratory study(Elsevier Ltda., 2025) Padilla Fortunatti, Cristóbal Felipe; Palmeiro Silva, Yasna; Ovalle Meneses, Victor; Abaitua Pizarro, María; Espinoza Acuña, Jessica; Bustamante Troncoso, Claudia Raquel; Rojas Silva, Noelia PilarBackground: Intensive care unit (ICU) admission is often a stressful experience that can negatively influence family satisfaction (FS) with patient care, communication, and decision-making. Health literacy (HL) is associated with the patient's ability to obtain, process, and understand health-related information. Few studies have explored the influence of perceived stress and HL on FS simultaneously. Objective: To examine the association of perceived stress and HL with FS among family members of ICU patients. Design: A multicenter exploratory cross-sectional study. Methods: An exploratory, cross-sectional, multicenter study was conducted in three ICUs from different hospitals in Chile. Family members of ICU patients with >= 48 h of stay and respiratory support were eligible. The Family Satisfaction in the Intensive Care Unit-24 questionnaire and the Perceived Stress Scale were used. HL was evaluated using three screening questions. Multiple beta regressions were fit to explore the association between perceived stress, HL, and FS. Results: A total of 101 family members with 63.4% identified as at risk of low HL were included. Multiple beta regression revealed that low HL was not associated with FS. Conversely, FS was negatively associated with perceived stress, being admitted to the ICU of the central or southern region, and having a close personal relationship with a healthcare provider but positively associated with the number of communications with ICU staff. Conclusions: While perceived stress can be detrimental to FS, HL seems not to impact FS levels among family members of ICU patients. Further studies are required to explore the influence of HL on FS. Implications of the clinical practice: This study advances the knowledge regarding variables affecting FS in the ICU. Evaluating the family members' emotional status may help ICU healthcare providers in the allocation of resources to support family members and to properly assess their satisfaction. Patient or public contribution: Family members of ICU patients participated in this study.