Camila Cláudia Campos

Mapping nursing goals of an Intensive Care Unit to the Nursing Outcomes Classification

AIM: to analyze whether nursing goals formulated for nursing diagnoses can be mapped to nursing outcomes classification and to identify the scales most appropriate to the outcomes mapped. METHOD: a descriptive study was developed in an intensive care unit. Data collection involved extraction of goals in 44 medical records, content standardization, cross-mapping to the outcomes, identification of appropriated scales and validation. Descriptive analysis and agreement with the cross-mapping process were performed. RESULTS: nursing goals (59) were mapped to (28) different outcomes, with agreement of 83% in the mapping process. All goals were mapped to outcomes, which allows to affirm that these outcomes contemplates the goals elaborated to patient care. CONCLUSION: these results favor the inclusion of outcomes and scales validated in the planning and evaluation phases of the nursing process of a software in construction.AIM to analyze whether nursing goals formulated for nursing diagnoses can be mapped to nursing outcomes classification and to identify the scales most appropriate to the outcomes mapped. METHOD a descriptive study was developed in an intensive care unit. Data collection involved extraction of goals in 44 medical records, content standardization, cross-mapping to the outcomes, identification of appropriated scales and validation. Descriptive analysis and agreement with the cross-mapping process were performed. RESULTS nursing goals (59) were mapped to (28) different outcomes, with agreement of 83% in the mapping process. All goals were mapped to outcomes, which allows to affirm that these outcomes contemplates the goals elaborated to patient care. CONCLUSION these results favor the inclusion of outcomes and scales validated in the planning and evaluation phases of the nursing process of a software in construction.

Effect of salivary stimulation therapies on salivary flow and chemotherapy-induced mucositis: a preliminary study

OBJECTIVE The objective of this study was to evaluate the effect of salivary stimulation therapies on the salivary flow, oral mucositis, and salivary cytokine levels in patients receiving allogeneic hematopoietic stem cell transplantation. STUDY DESIGN Thirty-five eligible patients were randomized into 4 groups: control, mechanical sialogogue, transcutaneous electrical nerve stimulation (TENS) sialogogue, and combined mechanical/electrical sialogogue. Saliva was collected from patients before transplantation and at days 3, 7, and 14 after transplantation. The volume was measured and salivary cytokines were assessed using enzyme-linked immunosorbent assay. RESULTS By day 14, resting and stimulated salivary flow levels were diminished. Resting salivary flow rates decreased the most in the control and mechanical groups. In contrast, TENS alone or in combination with mechanical stimulatory therapy benefited the patients. TENS-treated patients showed increase in resting salivary flow. Also, the groups treated with TENS had fewer patients affected by grades 3 and 4 mucositis, and less mucositis was associated with better patient survival (P = .027). CONCLUSIONS TENS-associated salivary stimulation therapies minimized the reduction of salivary flow and prevented severe chemotherapy-induced oral mucositis.

Integrative review: evidences on the practice of intermittent/indwelling urinary catheterization

OBJETIVO: buscar las mejores evidencias disponibles en la literatura sobre el conocimiento producido y relacionado a la tecnica de cateterismo urinario intermitente y de demora para apoyar cientificamente el cuidado de enfermeria prestado al paciente sometido al cateterismo urinario y precaver infeccion del trato urinario. METODO: La busca fue realizada en las bases de datos PubMed y Cochrane para el desarrollo de la revision integrativa. La muestra fue de 34 articulos. Estos fueron analizados por dos investigadores independientes usando instrumento adaptado para verificar el nivel de evidencia y grado de recomendacion, ademas de la utilizacion de la escala de Jadad. RESULTADOS: las evidencias disponibles relacionadas a la atencion de enfermeria a los pacientes sometidos al cateterismo urinario son: la tasa de infeccion en el trato urinario no altera con la higienizacion del perineo con agua esteril o no, con el uso de solucion de iodo-povidona o clorhexidina; o aplicando tecnica aseada o esteril. El uso del cateter intermitente con tecnica aseada implica en menores tasas de complicaciones e infecciones en comparacion con la de demora. La remocion del cateter en hasta 24 horas pos cirugia y el uso del cateter impregnado con antimicrobiano y de revestimiento hidrofilico reduce incidencia de infeccion del trato urinario. CONCLUSIONES: existen controversias con relacion a la tecnica de higienizacion periuretral, tipo de material del cateter y algunos procedimientos para el mantenimiento y remocion del cateter. Los resultados de esta revision representan actualizacion de las conductas y tomada de decision del enfermero para la prevencion de infeccion del trato urinario en el cateterismo urinarioOBJECTIVE to seek the best evidence available in the literature concerning the knowledge produced and related to the techniques of intermittent and indwelling urinary catheterization, so as to place the nursing care given to patients submitted to urinary catheterization on a scientific foundation and to prevent urinary tract infections. METHOD the literature search was undertaken in the Pubmed and Cochrane databases for the development of the integrative review. The sample was of 34 articles. These were analyzed by two independent researchers using an instrument adapted for ascertaining the level of evidence and the grade of recommendation, in addition to the use of the Jadad scale. RESULTS the evidence available related to the nursing care for patients submitted to urinary catheterization is: the infection rate in the urinary tract does not alter whether the perineum is cleaned with sterile water or not, or with the use of povidone-iodine solution or chlorhexidine; or using clean or sterile technique. The use of an intermittent catheter with clean technique results in low rates of complications or infections compared to the use of an indwelling catheter. The removal of the catheter in up to 24 hours after surgery and the use of an antimicrobial-impregnated or hydrophilic-coated catheter reduce urinary tract infection . CONCLUSIONS there are controversies in relation to periurethral cleansing technique, the type of material the catheter is made of, and some procedures for the maintenance and removal of the catheter. This reviews results represent an updating of the nurses conducts and decision-making for the prevention of urinary tract infections in urinary catheterization.

Ações de enfermagem na prevenção de infecções relacionadas ao cateter venoso central: uma revisão integrativa

Objective: To identify nursing actions for the prevention of primary bloodstream infections. Method: It is an integrative literature review. We surveyed articles in online databases that addressed the prevention of central venous catheter-related infections. The studies were independently evaluated by two researchers, using an already validated collection instrument. Results: The sample was composed of 12 articles, where nine of them showed association of interventions through the care bundle, exhibiting great effectiveness in reducing infections. Three articles compared the use of sterile gauze and plastic film for the dressing. Conclusion: Evidences on nursing care to patients using central venous catheter serve as a basis to conduct an effective, safe, of good quality and low cost assistance.

Incidence and risk factors for surgical site infection in general surgeries

ABSTRACT Objective: to estimate the incidence of surgical site infection in general surgeries at a large Brazilian hospital while identifying risk factors and prevalent microorganisms. Method: non-concurrent cohort study with 16,882 information of patients undergoing general surgery from 2008 to 2011. Data were analyzed by descriptive, bivariate and multivariate analysis. Results: the incidence of surgical site infection was 3.4%. The risk factors associated with surgical site infection were: length of preoperative hospital stay more than 24 hours; duration of surgery in hours; wound class clean-contaminated, contaminated and dirty/infected; and ASA index classified into ASA II, III and IV/V. Staphyloccocus aureus and Escherichia coli were identified. Conclusion: the incidence was lower than that found in the national studies on general surgeries. These risk factors corroborate those presented by the National Nosocomial Infection Surveillance System Risk Index, by the addition of the length of preoperative hospital stay. The identification of the actual incidence of surgical site infection in general surgeries and associated risk factors may support the actions of the health team in order to minimize the complications caused by surgical site infection.

Revisão integrativa: evidências na prática do cateterismo urinário intermitente/demora

OBJETIVO: buscar las mejores evidencias disponibles en la literatura sobre el conocimiento producido y relacionado a la tecnica de cateterismo urinario intermitente y de demora para apoyar cientificamente el cuidado de enfermeria prestado al paciente sometido al cateterismo urinario y precaver infeccion del trato urinario. METODO: La busca fue realizada en las bases de datos PubMed y Cochrane para el desarrollo de la revision integrativa. La muestra fue de 34 articulos. Estos fueron analizados por dos investigadores independientes usando instrumento adaptado para verificar el nivel de evidencia y grado de recomendacion, ademas de la utilizacion de la escala de Jadad. RESULTADOS: las evidencias disponibles relacionadas a la atencion de enfermeria a los pacientes sometidos al cateterismo urinario son: la tasa de infeccion en el trato urinario no altera con la higienizacion del perineo con agua esteril o no, con el uso de solucion de iodo-povidona o clorhexidina; o aplicando tecnica aseada o esteril. El uso del cateter intermitente con tecnica aseada implica en menores tasas de complicaciones e infecciones en comparacion con la de demora. La remocion del cateter en hasta 24 horas pos cirugia y el uso del cateter impregnado con antimicrobiano y de revestimiento hidrofilico reduce incidencia de infeccion del trato urinario. CONCLUSIONES: existen controversias con relacion a la tecnica de higienizacion periuretral, tipo de material del cateter y algunos procedimientos para el mantenimiento y remocion del cateter. Los resultados de esta revision representan actualizacion de las conductas y tomada de decision del enfermero para la prevencion de infeccion del trato urinario en el cateterismo urinarioOBJECTIVE to seek the best evidence available in the literature concerning the knowledge produced and related to the techniques of intermittent and indwelling urinary catheterization, so as to place the nursing care given to patients submitted to urinary catheterization on a scientific foundation and to prevent urinary tract infections. METHOD the literature search was undertaken in the Pubmed and Cochrane databases for the development of the integrative review. The sample was of 34 articles. These were analyzed by two independent researchers using an instrument adapted for ascertaining the level of evidence and the grade of recommendation, in addition to the use of the Jadad scale. RESULTS the evidence available related to the nursing care for patients submitted to urinary catheterization is: the infection rate in the urinary tract does not alter whether the perineum is cleaned with sterile water or not, or with the use of povidone-iodine solution or chlorhexidine; or using clean or sterile technique. The use of an intermittent catheter with clean technique results in low rates of complications or infections compared to the use of an indwelling catheter. The removal of the catheter in up to 24 hours after surgery and the use of an antimicrobial-impregnated or hydrophilic-coated catheter reduce urinary tract infection . CONCLUSIONS there are controversies in relation to periurethral cleansing technique, the type of material the catheter is made of, and some procedures for the maintenance and removal of the catheter. This reviews results represent an updating of the nurses conducts and decision-making for the prevention of urinary tract infections in urinary catheterization.

Mapeamento de metas de enfermagem de uma Unidade de Terapia Intensiva por meio da Classificação de Resultados de Enfermagem

AIM: to analyze whether nursing goals formulated for nursing diagnoses can be mapped to nursing outcomes classification and to identify the scales most appropriate to the outcomes mapped. METHOD: a descriptive study was developed in an intensive care unit. Data collection involved extraction of goals in 44 medical records, content standardization, cross-mapping to the outcomes, identification of appropriated scales and validation. Descriptive analysis and agreement with the cross-mapping process were performed. RESULTS: nursing goals (59) were mapped to (28) different outcomes, with agreement of 83% in the mapping process. All goals were mapped to outcomes, which allows to affirm that these outcomes contemplates the goals elaborated to patient care. CONCLUSION: these results favor the inclusion of outcomes and scales validated in the planning and evaluation phases of the nursing process of a software in construction.AIM to analyze whether nursing goals formulated for nursing diagnoses can be mapped to nursing outcomes classification and to identify the scales most appropriate to the outcomes mapped. METHOD a descriptive study was developed in an intensive care unit. Data collection involved extraction of goals in 44 medical records, content standardization, cross-mapping to the outcomes, identification of appropriated scales and validation. Descriptive analysis and agreement with the cross-mapping process were performed. RESULTS nursing goals (59) were mapped to (28) different outcomes, with agreement of 83% in the mapping process. All goals were mapped to outcomes, which allows to affirm that these outcomes contemplates the goals elaborated to patient care. CONCLUSION these results favor the inclusion of outcomes and scales validated in the planning and evaluation phases of the nursing process of a software in construction.

Evaluation of falls in hospitalized elderly

800x600 ABSTRACT Objective: to evaluate the occurrence of falls in hospitalized elderly patients who presented high risk for the event. Method: a quantitative, concurrent cohort study, with 96 elderly individuals at risk of falling, using the Fall Risk Score scale. The data was released in the EpiInfo, program version 3.5.1, and performed double typing. Results: 53.13% were female; age between 60 and 95 years; of 24 days, and the incidence of falls during the hospitalization of the 96 elderly was 13.54%. After the final adjustment of the model, the factors associated with the occurrence of falls in the studied sample were: to present cognitive deficits, to have a diagnosis of depression and to use some type of orthosis. Conclusion: the falls are directly linked to the patients safety indicators, requiring a multidisciplinary and interdisciplinary approach, assessing the risk factors to which the hospitalized elderly are exposed in order to adopt preventive strategies for health maintenance. Descriptors : Patient Safety; Accidental Falls; Aged; Nursing. RESUMO Objetivo : avaliar a ocorrencia de queda nos pacientes idosos internados que apresentavam alto risco para o evento. Metodo : estudo quantitativo, tipo coorte concorrente, com 96 idosos em risco de queda, utilizando a escala Fall Risk Score . Os dados foram lancados no programa EpiInfo, versao 3.5.1, e realizada dupla digitacao. Resultados : 53,13% eram do sexo feminino; idade entre 60 e 95 anos; media de internacao de 24 dias, e a incidencia de queda durante a internacao dos 96 idosos foi de 13,54%. Apos o ajuste final do modelo, o s fatores associados a ocorrencia de quedas na amostra estudada foram: apresentar deficit cognitivo, ter diagnostico de depressao e utilizar algum tipo de ortese. Conclusao : as quedas estao ligadas diretamente aos indicadores de seguranca do paciente, sendo necessaria uma abordagem multiprofissional e interdisciplinar, avaliando os fatores de risco a que os idosos hospitalizados estao expostos para que sejam adotadas estrategias preventivas para a manutencao da saude. Descritores : Seguranca do Paciente; Acidentes por Quedas; Idoso; Enfermagem . RESUMEN Objetivo: evaluar la ocurrencia de caida en los pacientes ancianos internados que presentaban alto riesgo para el evento. Metodo: estudio cuantitativo, tipo cohorte concurrente, con 96 ancianos en riesgo de caida, utilizando la escala Fall Risk Score. Los datos fueron lanzados en el programa EpiInfo, version 3.5.1, y realizada doble digitacion. Resultados: 53,13% eran del sexo femenino; edad entre 60 y 95 anos; promedio de internacion de 24 dias, y la incidencia de caida durante la internacion de los 96 ancianos fue del 13,54%. Despues del ajuste final del modelo, los factores asociados a la ocurrencia de caidas en la muestra estudiada fueron: presentar deficit cognitivo, tener diagnostico de depresion y utilizar algun tipo de ortesis. Conclusion: las caidas estan ligadas directamente a los indicadores de seguridad del paciente, siendo necesaria un abordaje multiprofesional e interdisciplinario, evaluando los factores de riesgo a los que los ancianos hospitalizados estan expuestos para que se adopten estrategias preventivas para el mantenimiento de la salud. Descriptores : Seguralidad del Pacient; Accidentes por Caidas; Anciano; Enfermeria. Normal 0 21 false false false PT-BR X-NONE X-NONEA busca pela seguranca do paciente internado em instituicoes de saude tem sido estabelecida pelo Programa Nacional de Seguranca do Paciente objetivando a melhoria da assistencia a saude e consequentemente minimizando a ocorrencia de eventos adversos. Foi realizada uma coorte concorrente com 96 idosos em risco de queda que estavam internados em um hospital particular e de grande porte de Belo Horizonte - MG, no periodo de marco a setembro de 2014. O objetivo geral foi avaliar a ocorrencia de queda nos pacientes idosos internados que apresentavam alto risco para o evento. Os objetivos especificos foram: estimar a incidencia do risco de queda e a incidencia de queda dos pacientes acompanhados; identificar fatores de risco possivelmente associados ao evento queda. A incidencia de queda durante a internacao dos 96 idosos foi de 13,54%. A associacao entre os fatores de risco estudados e a ocorrencia de queda foi realizada utilizando a analise bivariada atraves do modelo de regressao logistica. Foram encontrados como fatores de risco associados a ocorrencia de quedas: paciente encontrar-se em posoperatorio, apresentar dificuldade de marcha, utilizar algum tipo de ortese, apresentar deficit cognitivo e ter diagnostico de depressao. Apos o ajuste final do modelo, os fatores associados a ocorrencia de quedas na amostra estudada foram: apresentar deficit cognitivo, ter diagnostico de depressao e utilizar algum tipo de ortese. As quedas estao ligadas diretamente aos indicadores de seguranca do paciente. Assim, faz-se necessario uma abordagem multiprofissional e interdisciplinar, avaliando os fatores de risco a que os idosos hospitalizados estao expostos para que sejam adotadas estrategias preventivas para manutencao da saude.

Incidência de infecção do trato urinário relacionada ao cateterismo vesical de demora: um estudo de coorte

Estudo de coorte nao concorrente com informacoes de 301 de pacientes internados em centros de terapia intensiva de dois hospitais publicos de Belo Horizonte. O objetivo foi analisar os aspectos epidemiologicos das infeccoes do trato urinario em pacientes submetidos ao cateterismo vesical de demora, estimar a taxa de incidencia nos dois hospitais, identificar possiveis fatores de risco relacionados a infeccao e aos microrganismos causadores. A amostra constituiu-se de todos os pacientes internados nas duas unidades e que foram submetidos ao cateterismo vesical de demora no periodo de seis meses. Dos 301 pacientes, 23 desenvolveram infeccao, sendo 56,52% do sexo masculino e com idade superior a 60 anos. A incidencia global de infeccao do trato urinario foi de 6,70 infeccoes/1.000 cateteres-dia. O hospital que utilizou agua e sabao para a higiene periuretral apresentou maior incidencia do que o hospital que utilizou antisseptico (14,01 e 3,05 infeccoes/1.000 cateteres-dia, respectivamente). O fator de risco identificado foi a higienizacao periuretral com agua e sabao. Os microrganismos mais prevalentes nas uroculturas foram Pseudomonas aeruginosa (17,39%) Candida sp. (13,04%), Escherichia coli (13,04%), e Proteus mirabilis (8,70%). O resultado encontrado neste estudo contradiz os achados da literatura e reforca a necessidade de estudos primarios que identifiquem a solucao mais eficaz para a realizacao da limpeza periuretral com vistas a reducao da infeccao do trato urinario relacionada ao cateterismo vesical de demora.(AU)

Recomendações de prevenção e controle para o cuidado de pacientes com Ebola em instituições de saúde

A review studyof national and international databases was conducted to identify the best prevention and control recommendations for direct care of patients with Ebola. For the research articles from national and international databaseswere used. The study sample consisted of 14 articles. Ebola hemorrhagic fever has epidemic characteristics and therefore the implementation of prevention and control strategies directly influence the risk of infection and disease transmission. The use of standard precaution measures, contact prevention and droplets, as well as proper care of medical equipment and materials are essential and should be adopted. Training of health professionals, as well as providing resources for the work by the health institutions are ethical ways to ensure that healthcare staff have a safe work environment with minimal risk of contamination and are able to provide the best care to patients.