Characterization of the adaptation of the therapeutic effort in the care units for seriously ill adults, “Manuel Ascunce Domenech” Hospital

Abstract

Background: there are no published national studies that contribute statistical data related to the adaptation of the therapeutic effort in the care units for seriously ill patients of the country.Objective: to characterize the adaptation of the therapeutic effort in the clinical framework of the daily practice in the care units for seriously ill adults of the "Manuel Ascunce Domenech" General Teaching Hospital of Camagüey, from January 1 to December 31, 2017.Methods: a descriptive, explanatory and correlational study was carried out at the aforementioned institution and during the period herein declared. The universe was made up of the 1233 patients of 19 years of age or older who were admitted to the intensive care unit. The sample included 502 patients with indication of adaptation of the therapeutic effort, and unanimous consensus among the healthcare team, the patient, the family or their guardian, for the adaptation of the therapeutic effort. Pregnant and postpartum women were excluded.Results: patients with terminal oncological and chronic diseases were the ones who received the most therapeutic adaptation. Not being admitted to intensive care was the main form of adaptation, followed by non-cardiopulmonary cerebral resuscitation, with the predominance of patients of advanced years, of both sexes. The terminality criterion prevailed. Most of the patients had more than one therapeutic adaptation. 23,9 % of the patients survived.Conclusions: the adaptation of the therapeutic effort in the hospital was characterized. In most of the cases more than one therapeutic adjustment was performed. Not all the patients died.

Keywords

• patient acuity
• adult
• intensive care units
• principle-based ethics
• decision making