Amália de Fátima Lucena

Mapeamento cruzado: uma alternativa para a análise de dados em enfermagem

The technological evolution of the information field has been steady along the present days thus making the nursing science to pursue its development in the same area. As such, there is the need to develop the classifications for nursing practice, with standard languages which allow for the communication of its body of knowledge and practice. Reality in Brazil shows that there are very few attempts to use those Classifications, either diagnoses, interventions or outcomes, although there are many nursing records with non-standard language. This article aims at introducing and describing the Cross-mapping method, which provides a mapping of nursing records with non-standardized language into standardized classification systems. The article is also a very brief approach to some existing classifications and it encompasses an example of how to use the Cross-mapping method, its processes and rules, as a helping tool for research development in the field, thus playing its role in the nursing body of knowledge.

Effectiveness of nursing interventions in heart failure patients in home care using NANDA-I, NIC, and NOC

OBJECTIVE The objective of the study is to evaluate the effectiveness of nursing interventions (NIC) using nursing outcomes (NOC) and based on NANDA-I nursing diagnoses in patients with heart failure in home care. METHOD In this longitudinal study, 23 patients with heart failure were followed for 6 months, in four home visits. During the visits, nursing diagnoses were established, outcomes assessed, and interventions implemented. RESULTS Of the 11 NIC interventions implemented, eight proved effective, that is, showed significant improvement between the first and the fourth visit, according to scores obtained for six outcomes: knowledge: treatment regimen, knowledge: medication, compliance behavior, symptom control, activity tolerance, and energy conservation. CONCLUSION NIC interventions health education, self-modification assistance, behavior modification, teaching: prescribed medication, teaching: disease process, nutritional counseling, telephone consultation, and energy conservation showed effective outcomes based on NOC scores, suggesting that the NANDA-I, NIC, and NOC linkage is useful in patients with heart failure in home care.

Construção do conhecimento e do fazer enfermagem e os modelos assistenciais

Artigo de reflexao que enfoca as origens e as principais caracteris-ticas dos modelos clinico e epide-miologico, seus nexos com os mo-delos assistenciais vigentes no sis-]tema de saude brasileiro, e a cons-trucao do conhecimento da enfer-magem nesse contexto. Nessa perspectiva, as autoras propoem um repensar acerca do saber/fazer da enfermagem, apontando possibilidades de expansao do seu campo de atuacao, bem como dos limites e desafios a serem venci-dos pelos profissionais da area.This is a reflective paper focused on the origins and main characteristics of the epidemiological and clinical models, their connections with the health care models currently adopted in Brazil, and the construction of Nursing knowledge in this context. From this perspective, the authors propose a re-thinking of Nursing knowledge and practice, pointing out possibilities for expanding the Nursing field, as well as the boundaries and challenges to be overcome by the area professionals.

Nursing Interventions in the Clinical Practice of an Intensive Care Unit

Este e estudo descritivo, transversal, realizado em um hospital universitario com os objetivos de descrever as intervencoes de enfermagem mais utilizadas na pratica clinica de uma unidade de terapia intensiva, com base nas prescricoes de enfermagem, e analisar a sua similaridade com a Nursing Interventions Classification (NIC). A amostra constou de 991 internacoes de pacientes. Os dados foram coletados, retrospectivamente, em base informatizada, e analisados pela estatistica descritiva e mapeamento cruzado. Identificaram-se 57 diferentes intervencoes/NIC, frequentemente utilizadas na unidade, sendo a maioria no dominio fisiologico complexo (42%) e fisiologico basico (37%), nas classes de controle respiratorio e facilitacao do autocuidado. Em 97,2% dos casos houve similaridade entre as prescricoes de enfermagem da unidade e as intervencoes/NIC. Conclui-se que as intervencoes/NIC, utilizadas na pratica clinica da unidade de terapia intensiva, refletem o nivel de complexidade do cuidado de enfermagem nessa unidade, destinando-se, principalmente, a regulacao do funcionamento fisico e homeostatico do organismo.

Clinical profile and nursing diagnosis of patients at risk of pressure ulcers

Estudo transversal, cujos objetivos foram caracterizar os pacientes em risco para ulcera por pressao (UP) e identificar os seus diagnosticos de enfermagem (DEs). A amostra consistiu de 219 hospitalizacoes de pacientes adultos em risco para UP, determinado pela escala de Braden. Os dados foram coletados, retrospectivamente, em registros da escala de Braden e em prontuario eletronico e, apos, analisados estatisticamente. A maioria dos pacientes era de mulheres, idosos, com tempo de internacao mediano de nove dias e portadores de doencas cerebrovasculares, pulmonares, cardiovasculares, metabolicas e neoplasicas. Os DEs mais frequentes foram risco para infeccao, sindrome do deficit no autocuidado, deficit no autocuidado: banho/higiene, mobilidade fisica prejudicada, nutricao desequilibrada: menos do que as necessidades corporais, padrao respiratorio ineficaz, integridade tissular prejudicada, dor aguda, alteracao na eliminacao urinaria, integridade da pele prejudicada, risco para prejuizo da integridade da pele. Conclui-se que esses DEs, na maioria, sao comuns a pratica clinica de enfermagem.This cross-sectional study characterizes patients at risk of Pressure Ulcers (PUs) and identifies their corresponding Nursing Diagnoses (NDs). The sample consisted of 219 hospitalizations of adult patients at risk for developing a PU established through the Braden Scale. Data concerning the results of the application of the Braden Scale were retrospectively collected from the patients’ medical files and statistically analyzed. Most patients were elderly women hospitalized for an average of nine days, affected by cancer, cerebrovascular, lung, cardiovascular and metabolic diseases. The most frequent NDs were Risk for infection, Self-care deficit syndrome, Bathing/hygiene self-care deficit, Impaired physical mobility, Imbalanced nutrition: less than body requirements, Ineffective breathing pattern, Impaired tissue integrity, Acute pain, Impaired urinary elimination, Impaired skin integrity, and Risk for impaired skin integrity. We conclude that most NDs are common in clinical nursing practice.

Diagnósticos de enfermagem e proposta de intervenções para pacientes com lesão medular

Introduction: Spinal cord lesions constitute very serious events that occur mostly among young people. Providing care to these patients is a complex task because they are greatly dependent on nursing staff and require a very carefully designed plan of care. The purpose of this study was to contribute ways to design a quality plan of care to attend these patients. Objectives: To identify nursing diagnoses according to the NANDA for patients with spinal cord lesions from an Orthopedic and Trauma Unit, and to propose appropriate nursing interventions according to the NIC. Methods: This study used a descriptive and prospective research design. The sample consisted of 10 patients with spinal cord lesions. Data were colleted from January, 2000 to July, 2002 using a specific assessment tool. Data analysis led the researchers to propose nursing diagnoses which were validated by two clinical nursing specialists. Results: Fifteen prevalent nursing diagnoses were identified and 26 nursing interventions were proposed. Conclusion: The results can be used to assist nurse to provide quality care for patients with spinal cord lesions, so as to improve the patients independence.INTRODUCAO: As lesoes medulares constituem evento grave que acomete principalmente jovens, requerendo um planejamento cuidadoso da assistencia de enfermagem Este estudo tem a finalidade de contribuir nesse planejamento, oferecendo subsidios para melhorar a qualidade do cuidado desses pacientes. OBJETIVOS: Identificar os diagnosticos de enfermagem, segundo a NANDA, em portadores de lesao medular internados numa Unidade de Ortopedia e Traumatologia; e propor as intervencoes de enfermagem, conforme a NIC. METODOS: Estudo descritivo prospectivo, com 10 casos analisados no periodo de janeiro/2000 a julho/2002. Os dados foram coletados por meio de um instrumento criado para uso na unidade de estudo, identificando-se os diagnosticos de enfermagem. As intervencoes foram propostas pelas autoras e submetidas a avaliacao de duas especialistas. RESULTADOS: Foram identificados 15 diagnosticos de enfermagem prevalentes, para os quais foram propostas 26 intervencoes de enfermagem. CONCLUSAO: Os resultados poderao subsidiar as enfermeiras ao cuidado do paciente com lesao medular, auxiliando-o e contribuindo a sua autonomia, atraves das intervencoes propostas.

Factors associated with smoking in pregnancy.

The aim of this cross-sectional study was to identify factors related to smoking during pregnancy. The sample included 267 puerperae hospitalized in the maternity unit of a university hospital in Porto Alegre/RS. The data were collected through a self-applied instrument and statistically analyzed. The majority of the puerperae (51.3%) were between 18 and 25 years old, 55.4% were nonsmokers, 25.5% were smokers, 19.1% had recently ceased smoking (in abstinence). The nonsmokers had more consultations than the smokers and the abstinent smokers (p=0.025). The number of women who had more than one child was higher among smokers than among nonsmokers and abstinent smokers (p=0.002). Women were more likely to stop smoking before pregnancy when they had a partner who was a nonsmoker (p=0.007). Several factors influence smoking and smoking cessation and these are important in prenatal interventions aimed at pregnant women and their partners.E um estudo descritivo transversal que teve por objetivo identificar os fatores relacionados ao tabagismo na gestacao. A amostra incluiu 267 puerperas, atendidas em uma unidade de internacao obstetrica de um hospital universitario de Porto Alegre, RS. Os dados foram coletados por instrumentos autoaplicados e analisados estatisticamente. A maioria das puerperas (51,3%) tinha entre 18 e 25 anos, sendo 55,4% nao fumantes, 25,5% fumantes em abstinencia e 19,1% fumantes. As nao fumantes consultaram mais do que as fumantes e fumantes em abstinencia (p=0,025). O numero de mulheres com mais de um filho foi maior entre as fumantes (p=0,002), e aquelas que se mostraram mais propensas a parar de fumar, antes da gestacao, foram as que tinham um companheiro nao fumante (p=0,007). Os fatores que influenciam o tabagismo e a sua cessacao sao diversos, o que determina intervencoes no pre-natal, direcionadas as necessidades das gestantes e seus companheiros.

Implantação da Escala de Braden em uma unidade de terapia intensiva de um hospital universitário

This is a prospective and longitudinal study which aimed to introduce the Braden Scale (BS) as an instrument to predict the risk of pressure ulcer (PU), and to analyze the results of its use in an intensive care unit. The sample was of 74 patients and the data were obtained by an instrument containing BS. Such data were analyzed by a simple descriptive statistic. 58 patients (78.37%) had a score ≤ 13 and PU incidence of 25.67%. In 45 patients (60.80%), BS was daily filled in. From these patients, 5 (11.10%) developed PU. In 29 patients (39.10%), BS was not daily filled in. From these patients, 14 (48.20%) showed PU. Results showed the efficiency of BS, which allowed identifying patients with PU risk. The difficulties of using BS refer to the periodic filling, which shows the need to educate and prepare nurses to use BS in the care of patients.This is a prospective and longitudinal study which aimed to introduce the Braden Scale (BS) as an instrument to predict the risk of pressure ulcer (PU), and to analyze the results of its use in an intensive care unit. The sample was of 74 patients and the data were obtained by an instrument containing BS. Such data were analyzed by a simple descriptive statistic. 58 patients (78.37%) had a score < or = 13 and PU incidence of 25.67%. In 45 patients (60.80%), BS was daily filled in. From these patients, 5 (11.10%) developed PU. In 29 patients (39.10%), BS was not daily filled in. From these patients, 14 (48.20%) showed PU Results showed the efficiency of BS, which allowed identifying patients with PU risk. The difficulties of using BS refer to the periodic filling, which shows the need to educate and prepare nurses to use BS in the care of patients.

Prevalence of smoking among employees of a university hospital

Este e um estudo transversal, e teve como objetivo identificar a prevalencia do tabagismo em funcionarios de um hospital universitario do Sul do Brasil. A coleta de dados ocorreu no ano 2008, durante exame periodico de saude dos funcionarios, por meio de questionario, de acordo com a condicao tabagica dos mesmos. A amostra ficou constituida por 1.475 sujeitos, desses, 979 (66,4%) eram nao fumantes, 295 (20%) ex-fumantes e 201 (13,6%) fumantes. O predominio de fumantes esta entre funcionarios com menor nivel de instrucao e entre aqueles que exerciam atividades em cargos administrativos. Identificou-se, entre os fumantes, dependencia leve, desejo e grau de motivacao elevados para cessar o tabagismo, sendo o principal motivo a preocupacao com a saude. Assim, considerando-se a motivacao dos funcionarios para parar de fumar, recomenda-se aproveitar esse momento para realizar trabalho de educacao em saude e apoio profissional especifico, para que o processo de cessacao do tabagismo ocorra.This cross-sectional study aimed to identify the prevalence of smoking among employees of a university hospital in Southern Brazil. Data collection happened in 2008, during the periodic health exam, using a questionnaire, according to the smoking status of the employees. The sample consisted of 1,475 subjects, in which 979 (66.4%) were non-smokers, 295 (20%) former smokers and 201 (13.6%) smokers. Smoking was more prevalent among employees with lower education levels and among professionals in administrative positions. Among smokers, low dependence was identified, as well as desire and high degree of motivation to stop smoking, with health concerns as the main reason. Thus, taking into account the motivation of smokers to stop smoking, this is an appropriate time for health education and specific support to employees in the process of smoking cessation.

Diagnósticos de enfermagem identificados em pacientes hospitalizados durante sessões de hemodiálise

OBJETIVO: Establecer los diagnosticos de enfermeria (DEs) de acuerdo con la NANDA International en pacientes hospitalizados con insuficiencia renal cronica (IRC), sometidos a hemodialisis, a partir de factores de riesgo y senales y sintomas descritos en evoluciones de enfermeria. METODOS: se trata de un estudio de cohorte retrospectivo, realizado con una muestra de 98 pacientes adultos hospitalizados con IRC y en sesiones de hemodialisis. Los datos fueron recolectados retrospectivamente en historias clinicas y analizados estadisticamente. RESULTADOS: Se identificaron tres DEs reales y cuatro de riesgo: Volumen excesivo de liquidos; Nauseas; Dolor agudo; Riesgo de infeccion; Riesgo de glicemia inestable; Riesgo de desequilibrio electrolitico y Riesgo de desequilibrio del volumen de liquidos. CONCLUSION: Estos DEs permitieron conocer mejor a los pacientes durante la sesion hemodialitica pudiendo subsidiar el cuidado de enfermeria.Objective: To establish NANDA International nursing diagnoses (NDs) in hospitalized patients with chronic renal failure (CRF), undergoing hemodialysis, using risk factors and signs and symptoms described in nursing developments. Methods: This was a retrospective cohort study, with a sample of 98 hospitalized adult patients with CRF who were having hemodialysis. Data were collected retrospectively from medical records, and analyzed statistically. Results: We identified three actual and four risk NDs: excess fluid volume, nausea, acute pain, risk for infection, risk for unstable blood glucose, risk for electrolyte imbalance, and risk for imbalanced fluid volume. Conclusion: These NDs enabled improved knowledge of the patients during the hemodialysis session, and therefore may be useful for nursing care.