Bruna Kosar Nunes

Assessment of a neonatal unit nursing staff: application of the Nursing Activities Score

OBJETIVO: estudio propone analizar la carga de trabajo de enfermeria de los sectores de una unidad neonatal por medio del Nursing Activities Score - NAS, y calcular el cuantitativo ideal del equipo, comparandolo con la actual. METODO: el instrumento NAS fue aplicado en todos los recien nacidos internados por como minimo 24 horas; la suma de los puntos del NAS suministro la carga de trabajo de la unidad, la cual fue utilizada para el calculo del dimensionamiento del equipo por medio de la ecuacion matematica. RESULTADOS: El sector de Bajo Riesgo presento carga de trabajo de 267 medidas NAS, y desfase de 8,8 profesionales diariamente; el Mediano Riesgo, carga de 446,7, y desfase de 22,3; el Alto Riesgo, carga de 359, y deficit de 17,9; el sector Aislamiento, demanda de 609, y desfase de 18,2; y UTI, 568,6 de carga, con deficit de 16,1 empleados. CONCLUSION: el estudio revelo desfase importante de profesionales con relacion a la elevada demanda de trabajo a la cual estan sometidos diariamente. La aplicacion del Nursing Activities Score en unidades neonatales contribuyo a la evaluacion de la carga de trabajo y dimensionamiento del equipo de enfermeria.OBJECTIVE The study proposes to analyze the nursing staff workload of the sectors of a neonatal unit by means of the Nursing Activities Score - NAS and to calculate the quantitative ideal for the team, comparing it with the current workload. METHOD The NAS tool was applied for all newborns interned for at least 24 hours; the sum of the NAS points provided the unit workload which was used for calculating the team assessment by means of mathematical equation. RESULTS The sector of Low Risk presented a workload of 267 NAS points and an imbalance of 8.8 professionals daily; the Medium Risk sector a workload of 446.7 and an imbalance of 22.3; the High Risk sector a workload of 359 and a deficit of 17.9; the Isolation sector a demand of 609 and an imbalance of 18.2; and NICU a workload of 568.6 with a deficit of 16.1 professionals. CONCLUSION The study disclosed an important imbalance of professionals in relation to the exalted work demand they are subjected to daily. The application of the Nursing Activities Score in neonatal units contributes to the evaluation of the workload and assessment of the nursing team.

Evidence-based practices published in Brazil: identification and analysis of their types and methodological approches

Revisao integrativa de estudos brasileiros sobre praticas baseadas em evidencias (PBE) em saude, publicados em periodicos ISI/JCR, nos ultimos 10 anos. O objetivo foi identificar as especialidades que mais realizaram estes estudos, seus enfoques e abordagens metodologicas. A partir de criterios de inclusao, foram selecionados 144 trabalhos. Os resultados indicam que a maior quantidade de estudos feitos em PBE foram sobre infância e adolescencia, infectologia, psiquiatria/saude mental e cirurgia. Os enfoques predominantes foram prevencao, tratamento/reabilitacao, diagnostico e avaliacao. As metodologias mais empregadas foram revisao sistematica sem ou com metanalise, revisao de protocolos ou sintese de estudos de evidencias ja disponiveis, e revisao integrativa. Constata-se forte expansao multiprofissional da PBE no Brasil, contribuindo para a busca de praticas mais criteriosas pela reuniao, reconhecimento e analise critica dos conhecimentos produzidos. O estudo contribui tambem para a propria analise dos modos de fazer pesquisa e novas possibilidades de investigacao.This is an integrative review of Brazilian studies on evidence-based practices (EBP) in health, published in ISI/JCR journals in the last 10 years. The aim was to identify the specialty areas that most accomplished these studies, their foci and methodological approaches. Based on inclusion criteria, 144 studies were selected. The results indicate that most EBP studies addressed childhood and adolescence, infectious diseases, psychiatrics/mental health and surgery. The predominant foci were prevention, treatment/rehabilitation, diagnosis and assessment. The most used methods were systematic review with or without meta-analysis, protocol review or synthesis of available evidence studies, and integrative review. A strong multiprofessional expansion of EBP is found in Brazil, contributing to the search for more selective practices by collecting, recognizing and critically analyzing the produced knowledge. The study also contributes to the analysis itself of ways to do research and new research possibilities.

Práticas baseadas em evidências publicadas no Brasil: identificação e análise de suas vertentes e abordagens metodológicas

Revisao integrativa de estudos brasileiros sobre praticas baseadas em evidencias (PBE) em saude, publicados em periodicos ISI/JCR, nos ultimos 10 anos. O objetivo foi identificar as especialidades que mais realizaram estes estudos, seus enfoques e abordagens metodologicas. A partir de criterios de inclusao, foram selecionados 144 trabalhos. Os resultados indicam que a maior quantidade de estudos feitos em PBE foram sobre infância e adolescencia, infectologia, psiquiatria/saude mental e cirurgia. Os enfoques predominantes foram prevencao, tratamento/reabilitacao, diagnostico e avaliacao. As metodologias mais empregadas foram revisao sistematica sem ou com metanalise, revisao de protocolos ou sintese de estudos de evidencias ja disponiveis, e revisao integrativa. Constata-se forte expansao multiprofissional da PBE no Brasil, contribuindo para a busca de praticas mais criteriosas pela reuniao, reconhecimento e analise critica dos conhecimentos produzidos. O estudo contribui tambem para a propria analise dos modos de fazer pesquisa e novas possibilidades de investigacao.This is an integrative review of Brazilian studies on evidence-based practices (EBP) in health, published in ISI/JCR journals in the last 10 years. The aim was to identify the specialty areas that most accomplished these studies, their foci and methodological approaches. Based on inclusion criteria, 144 studies were selected. The results indicate that most EBP studies addressed childhood and adolescence, infectious diseases, psychiatrics/mental health and surgery. The predominant foci were prevention, treatment/rehabilitation, diagnosis and assessment. The most used methods were systematic review with or without meta-analysis, protocol review or synthesis of available evidence studies, and integrative review. A strong multiprofessional expansion of EBP is found in Brazil, contributing to the search for more selective practices by collecting, recognizing and critically analyzing the produced knowledge. The study also contributes to the analysis itself of ways to do research and new research possibilities.

[Systematic review and meta-analysis of the predictive value of C-reactive protein in postoperative infections].

This systematic review on C-reactive protein (CRP) was performed with the purpose to identify its predictive value in the prognosis/diagnosis of infection in surgical patients. The sources used in the search were: COCHRANE, EMBASE, LILACS, MEDLINE and OVID, and bibliographic references of the located studies. All studies found increased CRP levels after surgery in cases of postoperative infection (PO), in eight studies a CRP peak between the second and third PO was reported as normal aspect of the CRP curve, reducing in patients without postoperative complications and increasing in patients with complications. The meta-analysis revealed an average of 85% (sensitivity), 86% (specificity), the area under the SROC curve was 0.9060, and the Odds Ratio was 23.56. Along with other clinical interventions, CRP is considerably valuable in the prognosis/diagnosis of postoperative infections.This systematic review on C-reactive protein (CRP) was performed with the purpose to identify its predictive value in the prognosis/diagnosis of infection in surgical patients. The sources used in the search were: COCHRANE, EMBASE, LILACS, MEDLINE and OVID, and bibliographic references of the located studies. All studies found increased CRP levels after surgery in cases of postoperative infection (PO), in eight studies a CRP peak between the second and third PO was reported as normal aspect of the CRP curve, reducing in patients without postoperative complications and increasing in patients with complications. The meta-analysis revealed an average of 85% (sensitivity), 86% (specificity), the area under the SROC curve was 0.9060, and the Odds Ratio was 23.56. Along with other clinical interventions, CRP is considerably valuable in the prognosis/diagnosis of postoperative infections.

Dimensionamento de pessoal de enfermagem de uma unidade neonatal: utilização do Nursing Activities Score

OBJETIVO: estudio propone analizar la carga de trabajo de enfermeria de los sectores de una unidad neonatal por medio del Nursing Activities Score - NAS, y calcular el cuantitativo ideal del equipo, comparandolo con la actual. METODO: el instrumento NAS fue aplicado en todos los recien nacidos internados por como minimo 24 horas; la suma de los puntos del NAS suministro la carga de trabajo de la unidad, la cual fue utilizada para el calculo del dimensionamiento del equipo por medio de la ecuacion matematica. RESULTADOS: El sector de Bajo Riesgo presento carga de trabajo de 267 medidas NAS, y desfase de 8,8 profesionales diariamente; el Mediano Riesgo, carga de 446,7, y desfase de 22,3; el Alto Riesgo, carga de 359, y deficit de 17,9; el sector Aislamiento, demanda de 609, y desfase de 18,2; y UTI, 568,6 de carga, con deficit de 16,1 empleados. CONCLUSION: el estudio revelo desfase importante de profesionales con relacion a la elevada demanda de trabajo a la cual estan sometidos diariamente. La aplicacion del Nursing Activities Score en unidades neonatales contribuyo a la evaluacion de la carga de trabajo y dimensionamiento del equipo de enfermeria.OBJECTIVE The study proposes to analyze the nursing staff workload of the sectors of a neonatal unit by means of the Nursing Activities Score - NAS and to calculate the quantitative ideal for the team, comparing it with the current workload. METHOD The NAS tool was applied for all newborns interned for at least 24 hours; the sum of the NAS points provided the unit workload which was used for calculating the team assessment by means of mathematical equation. RESULTS The sector of Low Risk presented a workload of 267 NAS points and an imbalance of 8.8 professionals daily; the Medium Risk sector a workload of 446.7 and an imbalance of 22.3; the High Risk sector a workload of 359 and a deficit of 17.9; the Isolation sector a demand of 609 and an imbalance of 18.2; and NICU a workload of 568.6 with a deficit of 16.1 professionals. CONCLUSION The study disclosed an important imbalance of professionals in relation to the exalted work demand they are subjected to daily. The application of the Nursing Activities Score in neonatal units contributes to the evaluation of the workload and assessment of the nursing team.

Práticas baseadas em evidências publicadas no Brasil: identificação e reflexão na área da prevenção em saúde humana

Integrative review of Brazilian studies about evidence-based practices (EBP) about prevention in human health, published in Web of Science/JCR journals, between October 2010 and April 2011. The aim was to identify the specialties that most accomplished these studies, their foci and methodological approaches. Based on inclusion criteria, 84 studies were selected, mainly published in public health journals, focusing on primary care and also addressing clinical issues and different specialties. Prevention foci and methodological approaches also varied, with a predominance of systematic reviews without meta-analysis. The results indicate that there is no single way to conceptualize and practice EBP in the field of prevention, and that its application may not only serve to obtain indisputable evidence to equip intervention actions. This endless knowledge area is under construction, with a view to the analysis and further understanding of health phenomena.Integrative review of Brazilian studies about evidence-based practices (EBP) about prevention in human health, published in Web of Science/JCR journals, between October 2010 and April 2011. The aim was to identify the specialties that most accomplished these studies, their foci and methodological approaches. Based on inclusion criteria, 84 studies were selected, mainly published in public health journals, focusing on primary care and also addressing clinical issues and different specialties. Prevention foci and methodological approaches also varied, with a predominance of systematic reviews without meta-analysis. The results indicate that there is no single way to conceptualize and practice EBP in the field of prevention, and that its application may not only serve to obtain indisputable evidence to equip intervention actions. This endless knowledge area is under construction, with a view to the analysis and further understanding of health phenomena.

Evaluation of practices for the prevention and control of bloodstream infections in a government hospital

The aim of this study was to observe clinical procedures in order to evaluate the practices used for the control and prevention of bloodstream infections associated with short-term central venous catheters (BSI-ACVC). The study data came from 5877 assessments distributed among selected practices. The results revealed the following adherence rates among the practices selected: 91.6% for recording the indication and permanence time of the CVC, 51.5% for adhering to the care and maintenance of the dressing at the CVC insertion site and its devices, 10.7% for hand hygiene practices while performing procedures related to the CVC, and 0.0% for the practices related to the insertion of the central venous catheter (CVC). The results demonstrate the need for further elaboration of strategies that ensure sustainable compliance practices for prevention and control BSI-ACVC in the institution being assessed.O objetivo deste estudo foi avaliar as praticas de prevencao e controle de infeccao da corrente sanguinea associada ao cateter venoso central (ICS-ACVC) de curta permanencia, por meio da aplicacao de indicadores clinicos processuais. A amostra foi constituida por 5.877 avaliacoes distribuidas entre as praticas selecionadas. Obteve-se ampla variacao de conformidade: 91,6% - registro de indicacao e tempo de permanencia do CVC; 51,5% - cuidados e manutencao do curativo da insercao do CVC e seus dispositivos; 10,7% - higienizacao das maos na realizacao de procedimentos de cuidado e manutencao do CVC; 0,0% - insercao do cateter venoso central (CVC). Os resultados demonstram necessidade de elaboracao de novas estrategias que assegurem conformidade duradoura para a maioria das praticas de prevencao e controle de ICS-ACVC avaliadas. Conclui-se pela vantagem na aplicacao de avaliacao processual, pela possibilidade de nao somente identificar seus indices de conformidade em relacao a melhor pratica esperada, como tambem favorecer, sobremaneira, reconhecimento das situacoes especificas que contribuiram para os valores encontrados.

Avaliação das práticas de prevenção e controle de infecção da corrente sanguínea em um hospital governamental

The aim of this study was to observe clinical procedures in order to evaluate the practices used for the control and prevention of bloodstream infections associated with short-term central venous catheters (BSI-ACVC). The study data came from 5877 assessments distributed among selected practices. The results revealed the following adherence rates among the practices selected: 91.6% for recording the indication and permanence time of the CVC, 51.5% for adhering to the care and maintenance of the dressing at the CVC insertion site and its devices, 10.7% for hand hygiene practices while performing procedures related to the CVC, and 0.0% for the practices related to the insertion of the central venous catheter (CVC). The results demonstrate the need for further elaboration of strategies that ensure sustainable compliance practices for prevention and control BSI-ACVC in the institution being assessed.O objetivo deste estudo foi avaliar as praticas de prevencao e controle de infeccao da corrente sanguinea associada ao cateter venoso central (ICS-ACVC) de curta permanencia, por meio da aplicacao de indicadores clinicos processuais. A amostra foi constituida por 5.877 avaliacoes distribuidas entre as praticas selecionadas. Obteve-se ampla variacao de conformidade: 91,6% - registro de indicacao e tempo de permanencia do CVC; 51,5% - cuidados e manutencao do curativo da insercao do CVC e seus dispositivos; 10,7% - higienizacao das maos na realizacao de procedimentos de cuidado e manutencao do CVC; 0,0% - insercao do cateter venoso central (CVC). Os resultados demonstram necessidade de elaboracao de novas estrategias que assegurem conformidade duradoura para a maioria das praticas de prevencao e controle de ICS-ACVC avaliadas. Conclui-se pela vantagem na aplicacao de avaliacao processual, pela possibilidade de nao somente identificar seus indices de conformidade em relacao a melhor pratica esperada, como tambem favorecer, sobremaneira, reconhecimento das situacoes especificas que contribuiram para os valores encontrados.

Evidence-based practices published in brazil: identification and analysis studies about human health prevention

Integrative review of Brazilian studies about evidence-based practices (EBP) about prevention in human health, published in Web of Science/JCR journals, between October 2010 and April 2011. The aim was to identify the specialties that most accomplished these studies, their foci and methodological approaches. Based on inclusion criteria, 84 studies were selected, mainly published in public health journals, focusing on primary care and also addressing clinical issues and different specialties. Prevention foci and methodological approaches also varied, with a predominance of systematic reviews without meta-analysis. The results indicate that there is no single way to conceptualize and practice EBP in the field of prevention, and that its application may not only serve to obtain indisputable evidence to equip intervention actions. This endless knowledge area is under construction, with a view to the analysis and further understanding of health phenomena.Integrative review of Brazilian studies about evidence-based practices (EBP) about prevention in human health, published in Web of Science/JCR journals, between October 2010 and April 2011. The aim was to identify the specialties that most accomplished these studies, their foci and methodological approaches. Based on inclusion criteria, 84 studies were selected, mainly published in public health journals, focusing on primary care and also addressing clinical issues and different specialties. Prevention foci and methodological approaches also varied, with a predominance of systematic reviews without meta-analysis. The results indicate that there is no single way to conceptualize and practice EBP in the field of prevention, and that its application may not only serve to obtain indisputable evidence to equip intervention actions. This endless knowledge area is under construction, with a view to the analysis and further understanding of health phenomena.

Revisão sistemática e metanálise sobre o valor preditivo da proteína C-reativa em infecção pós-operatória

This systematic review on C-reactive protein (CRP) was performed with the purpose to identify its predictive value in the prognosis/diagnosis of infection in surgical patients. The sources used in the search were: COCHRANE, EMBASE, LILACS, MEDLINE and OVID, and bibliographic references of the located studies. All studies found increased CRP levels after surgery in cases of postoperative infection (PO), in eight studies a CRP peak between the second and third PO was reported as normal aspect of the CRP curve, reducing in patients without postoperative complications and increasing in patients with complications. The meta-analysis revealed an average of 85% (sensitivity), 86% (specificity), the area under the SROC curve was 0.9060, and the Odds Ratio was 23.56. Along with other clinical interventions, CRP is considerably valuable in the prognosis/diagnosis of postoperative infections.This systematic review on C-reactive protein (CRP) was performed with the purpose to identify its predictive value in the prognosis/diagnosis of infection in surgical patients. The sources used in the search were: COCHRANE, EMBASE, LILACS, MEDLINE and OVID, and bibliographic references of the located studies. All studies found increased CRP levels after surgery in cases of postoperative infection (PO), in eight studies a CRP peak between the second and third PO was reported as normal aspect of the CRP curve, reducing in patients without postoperative complications and increasing in patients with complications. The meta-analysis revealed an average of 85% (sensitivity), 86% (specificity), the area under the SROC curve was 0.9060, and the Odds Ratio was 23.56. Along with other clinical interventions, CRP is considerably valuable in the prognosis/diagnosis of postoperative infections.