Cristina Arreguy-Sena

Percepções de enfermeiros e clientes sobre cuidados de enfermagem no transplante de rim

Objective: To analyze the perceptions of nurses and transplanted patients about the pre-transplantation nursing consultation of kidney transplantation. Methods: Qualitative study with content analysis as the methodological approach. The participants were ten nurses and two categories were identified (contents and user demands in the immediate pre-transplantation phase; and conceptions, behaviors, expectations and emerging situations during and after the kidney transplantation and 20 transplanted patients with two categories (previous experiences with restrictions imposed by the dialysis; and unexpected or conflicting situations identified during and after the transplantation). The research instrument contained the variables related to the sample characteristics, guiding questions and situations of overcoming according to the perceptions of nurse specialists and posttransplanted patients. Results: Coincidence and complementariness was found between the subjects’ approaches and the forms of coping during and after the transplantation. Conclusion: The nursing consultation in the pre-transplantation phase is important to incorporate the orientations into the experiences and behaviors of transplanted patients in the course of the transplantation process and after the procedure. Descritores Cuidados de enfermagem; Transplante de rim; Enfermagem pratica; Processos de enfermagem; Pesquisa em enfermagem

Superficial peripheral vein type classification of adolescents, adults and elderly according to the Delphi technique

This descriptive research attempts to cooperate with the standardization of communication about vein types in Nursing. Authors utilized the “Delphi” technique and aimed at elaborating and validating a peripheral vein type classification of adolescents/adults/elderly according to their vein characteristics. Initially, authors identified different vein types in literature. This was a preliminary classification that contained the titles and definitions, which were complemented during the expert (nurses, angiologists, anesthetists and biochemists) validation process. Twelve criteria and 27 vein types were validated (agreement level ≥ 90%). In addition, authors organized a set of pictures representing the different vein types. From these, 144 were used; 35 experts chose one picture to exemplify each classification title. The pictures representing 21 vein types were identified. This classification contributes to the clinical assessment of blood vessels and can be used in teaching, research and patient care management.This descriptive research attempts to cooperate with the standardization of communication about vein types in Nursing. Authors utilized the “Delphi” technique and aimed at elaborating and validating a peripheral vein type classification of adolescents/adults/elderly according to their vein characteristics. Initially, authors identified different vein types in literature. This was a preliminary classification that contained the titles and definitions, which were complemented during the expert (nurses, angiologists, anesthetists and biochemists) validation process. Twelve criteria and 27 vein types were validated (agreement level ≥ 90%). In addition, authors organized a set of pictures representing the different vein types. From these, 144 were used; 35 experts chose one picture to exemplify each classification title. The pictures representing 21 vein types were identified. This classification contributes to the clinical assessment of blood vessels and can be used in teaching, research and patient care management.

Adaptação transcultural da Infiltration Scale para o português

Objective To translate, adapt and evaluate the psychometric properties of the Infiltration Scale for the Portuguese culture. Methods A methodological study of trans-cultural adaptation to evaluate the psychometric properties of the Infiltration Scale, conducted in a cohort study with 110 adults undergoing intravenous therapy. Results In the translation and cultural adaptation, language adjustments were discussed by researchers and a panel of experts, achieving an agreement of 85.71% for clinical criteria, except for “Possible numbness”. The scale identified infiltration in 48 patients (60% prevalence). Edema was the most evident sign in the insertion site and areas adjacent to the venous catheter. The internal consistency, determined by Cronbach’s alpha, was 0.85. Conclusion The scale adapted to the Portuguese culture presented linguistic equivalence to the original, proved valid and reliable, with good internal consistency for assessing infiltration. The systematic evaluation of infiltration using the scale can support decision-making and the implementation of preventive measures.

The nursing staff opinion about the continuous quality improvement program of a university hospital

ABSTRACT Objective To analyze the nursing staff opinion about the continuous quality improvement program at a University Hospital. Methods A descriptive study designed as a case study, analyzing the quality program at a University Hospital, with the opinion of a sample stratified by nursing team category through a self-administered questionnaire, from May to July 2012. The answers were submitted to factor analysis, having the dialectical and historical materialism as the theoretical-methodological reference. Results The factor analysis grouped the variables in six factors: working conditions, approval, belongingness, tranquility, interpersonal relations, and private life. With the exception of the factor interpersonal relations, the answers revealed that workers do not have opinion about the proposed questions. Four of the six factors had a predominance of positive answers. Conclusion A high percentage of respondents was not aware of the implications of a quality program. The majority believed that the program influenced positively in their working conditions and in the interpersonal relationships at work and agree with the program; however, they did not feel part of the program, and were not at ease to develop these activities. They did not acknowledge the program interfering in their personal life.

Características definidoras de trauma vascular periférico em urgência e emergência: ocorrência e tipos

Resumen Investigación de tipo convergente asistencial. El objetivo fue calcular la aparición y documentar la evidencia clínica del trauma vascular periférico en las punciones de adultos y ancianos en el departamento de urgencia y emergencia de Minas Gerais, Brasil. Se consideraron los siguientes criterios de inclusión: el primer lado perforado y la evaluación clínica a intervalos de menos de 24 horas. Las evidencias de trauma fueron registrados en fotografías. Muestra con selección completa. De los 200 sitios estudiados, había 110 casos de trauma vascular con 288 de los acontecimientos de: dolor, decoloración de la piel, disminución de la capacidad funcional local, edema, endurecimiento, cortes, postulación e hipo o hipertermia local. Las fotografías documentan todo tipo de eventos capaces de registro visual. Esta investigación nos ha permitido reafirmar las características definitorias de los diagnósticos de enfermería de “traumatismo vascular periférico” en el servicio de Urgencias/ Emergencias. Palabras clave: Enfermería. Los vasos sanguíneos. Diagnóstico de Enfermería. Vulnerabilidad. 1 Enfermeira Graduada pela Faculdade de Enfermagem da Universidade Federal de Juiz de Fora e integrante do Grupo de Pesquisa “Tecnologia, Cultura e comunicação em Saúde e em Enfermagem”. Juiz de Fora – MG. Brasil. E-mail: paula@krempser.com.br ; 2 Enfermeira, Doutora e Professora Associada da Faculdade de Enfermagem da Universidade Federal de Juiz de Fora. Juiz de Fora – MG. Brasil. E-mail: cristina.arreguy@ufjf.edu.br; 3 Estatística, Doutora e Professora Adjunta da Universidade Fluminense, Rio de Janeiro, Brasil. Saquarema – RJ. Brasil. E-mail: ana_sobral@vm.uff.br PESQUISA RESEARCH INVESTIGACIÓN Convergent assistance research. The objective was to estimate the occurrence and document the clinical evidence of peripheral vascular trauma in punctures of adults and elderly in an urgency and emergency department in Minas Gerais, Brazil. We considered the following inclusion criteria: the first side punctured and the clinical assessments at intervals of less than 24 hours. The evidences of trauma were recorded by photographs. Sample with a full selection. From the 200 sites evaluated, there were 110 cases of vascular trauma with 288 events of: 1) pain, skin discoloration, local functional capacity decreased, edema, induration, cuts, postulation and local hypo or hyperthermia. The photographs documented every type of event capable of visual record. This investigation led us to reaffirm the defining characteristics for nursing diagnosis of “pheripheral vascular trauma” in the Urgency/Emergency department. K e y w o r d s : N u r s i n g . B l o o d v e s s e l s . N u r s i n g Diagnosis. Vulnerability. Defining characteristics of Peripheral vascular trauma in Urgent and Emergency: occurrence and types Definición de las características del trauma vascular periférico en urgencia y emergencia: la aparición y los tipos i j Paula Krempser1 Cristina Arreguy-Sena2 Ana Paula Sobral Barbosa3

[Systematized care in cardiac preoperative: theory of human caring in the perspective of nurses and users].

Estudo de caso que objetivou desvelar, a partir da adocao da Teoria do Cuidado Transpessoal, os significados do relacionamento interpessoal terapeutico entre enfermeiro e usuario, sobre a visita pre-operatoria de enfermagem apos a vivencia do processo cirurgico. A amostra, de conveniencia, foi constituida por tres enfermeiros e tres usuarios de uma instituicao que possui cadastro atualizado para realizar cirurgia de alta complexidade cardiovascular, perfazendo nove combinacoes de interacoes terapeuticas. Foram utilizados impressos estruturados segundo a teoria de Jean Watson e as taxonomias North American Nursing Diagnosis Association, Nursing Intervention Classification e Nursing Outcome Classification. Os aspectos eticos e legais de pesquisa envolvendo seres humanos foram assegurados. Nos resultados, identificaram-se tres clusters para apreender a significacao da visita pre-operatoria pelos usuarios e cinco clusters para apreender a percepcao dos enfermeiros ao vivenciarem esta experiencia clinica.This is a case study research that aimed to know, with the adoption of the Theory of Human Caring, the meanings of therapeutic interpersonal relationship between nurse and user on the preoperative nursing visit after the experience of the surgical process. The convenience sample was composed of three nurses and three users of an institution that has updated records to perform highly complex cardiovascular surgery, comprising nine combinations of therapeutic interactions. It was used instruments, structured according to the theory of Jean Watson and North American Nursing Diagnosis Association, Nursing Intervention Classification and Nursing Outcomes Classification taxonomies. The legal and ethical aspects of research involving human subjects were assured. The results revealed three clusters to grasp the significance of preoperative visits by users and five clusters to capture the perception of nurses when they experience this clinical experience.

Survey of clinical manifestations of peripheral vascular trauma in children admitted to pediatric wards

Aim: To analyze the clinical evidence for a diagnosis of “peripheral vascular trauma” based on occurrence and type, in children between six months and twelve years old. Method: Survey of peripheral venous punctures performed in children having a first puncture on that site. Daily clinical evaluations were performed on the puncture site and adjacent areas at intervals, commencing within 24 hours following the puncture and continuing until the resolution of the trauma, or the patient’s discharge, excluding any subsequent punctures. Results: From the 338 punctures observed, 53.3% presented with at least one clinical manifestation of trauma, characterized by: pain (30.1%), change in the skin color (18.6%), skin integrity (47.7%), functional capacity (6.2%) or local temperature (14.2%). Discussion: The defining characteristics of peripheral vascular trauma generated a scientific theoretical structure for the nurses in their clinical practice, alerting them to the occurrence of this event in children. Conclusion: The characterization of vascular trauma in children permits a re-evaluation of this procedure.

Ser idoso e o processo do envelhecimento: saúde percebida

Pesquisa qualitativa tipo survey realizada em Rio Novo-Minas Gerais que objetivou analisar a concepcao dos idosos sobre envelhecimento e suas percepcoes de serem/estarem idosos. Amostra por tipicidade composta por 20 voluntarios com 60 ou mais anos, cadastrados no Programa de Vacinacao do Municipio. Excluiram-se pessoas com: alteracao de consciencia; dissociacoes moderadas do pensamento; dificuldade para verbalizacao; e moradores rurais. Identificaram-se 385 crencas, segundo Rokeach, que tenderam em 76,3% a centralidade. Duas concepcoes de envelhecimento foram identificadas (nova oportunidade na vida e deterioracao corporal, da autonomia e das relacoes). A propria idade e o nivel de insercao social foram os criterios para conceituar quem nao se sente idoso ou envelhecido e quem e ou nao envelhecido, respectivamente.

Classificação de veias superficiais periféricas de adolescentes, adultos e idosos pela técnica Delphi

This descriptive research attempts to cooperate with the standardization of communication about vein types in Nursing. Authors utilized the “Delphi” technique and aimed at elaborating and validating a peripheral vein type classification of adolescents/adults/elderly according to their vein characteristics. Initially, authors identified different vein types in literature. This was a preliminary classification that contained the titles and definitions, which were complemented during the expert (nurses, angiologists, anesthetists and biochemists) validation process. Twelve criteria and 27 vein types were validated (agreement level ≥ 90%). In addition, authors organized a set of pictures representing the different vein types. From these, 144 were used; 35 experts chose one picture to exemplify each classification title. The pictures representing 21 vein types were identified. This classification contributes to the clinical assessment of blood vessels and can be used in teaching, research and patient care management.This descriptive research attempts to cooperate with the standardization of communication about vein types in Nursing. Authors utilized the “Delphi” technique and aimed at elaborating and validating a peripheral vein type classification of adolescents/adults/elderly according to their vein characteristics. Initially, authors identified different vein types in literature. This was a preliminary classification that contained the titles and definitions, which were complemented during the expert (nurses, angiologists, anesthetists and biochemists) validation process. Twelve criteria and 27 vein types were validated (agreement level ≥ 90%). In addition, authors organized a set of pictures representing the different vein types. From these, 144 were used; 35 experts chose one picture to exemplify each classification title. The pictures representing 21 vein types were identified. This classification contributes to the clinical assessment of blood vessels and can be used in teaching, research and patient care management.

Flebite e infiltração: traumas vasculares associados ao cateter venoso periférico

Objetivos: determinar la tasa de incidencia y los factores de riesgo para los indicadores sensibles a los cuidados de Enfermeria, flebitis e infiltracion, en pacientes portadores de cateteres venosos perifericos (CVPs). Metodo: se trata de un estudio de cohorte entre 110 pacientes. Se utilizaron escalas para evaluar y documentar la flebitis y la infiltracion. Se recogieron variables sociodemograficas y clinicas, relativas al CVP, a la medicacion y a la internacion. Se realizo un analisis descriptivo e inferencial, y modelacion logistica multivariada. Resultados: la tasa de incidencia de flebitis e infiltracion fue de 43,2 y 59,7 por mil cateteres-dia, respectivamente. Se removio la mayoria de los CVPs en las primeras 24 horas debido a dichos traumas vasculares. Los factores de riesgo para la flebitis fueron: el tiempo de internacion (p=0,042) y el numero de cateteres insertados (p<0,001); para la infiltracion: la piperacilina/tazobactan (p=0,024) y el numero de cateteres insertados (p<0,001). Conclusion: la investigacion documento la incidencia de indicadores sensibles a los cuidados de Enfermeria (flebitis e infiltracion) y evidencio nuevos factores de riesgo relacionados con la infiltracion. Posibilito, tambien, una reflexion sobre los cuidados de Enfermeria para prevenir los traumas vasculares y sobre las indicaciones y contraindicaciones del CVP, con la implantacion del PICC auxiliando en las practicas de Enfermeria como alternativa del CVP.ABSTRACT Objective: to determine the incidence rate and risk factors for the nursing-sensitive indicators phlebitis and infiltration in patients with peripheral venous catheters (PVCs). Method: cohort study with 110 patients. Scales were used to assess and document phlebitis and infiltration. Socio-demographic variables, clinical variables related to the PVC, medication and hospitalization variables were collected. Descriptive and inferential analysis and multivariate logistic models were used. Results: the incidence rate of phlebitis and infiltration was respectively 43.2 and 59.7 per 1000 catheter-days. Most PVCs with these vascular traumas were removed in the first 24 hours. Risk factors for phlebitis were: length of hospital stay (p=0.042) and number of catheters inserted (p<0.001); risk factors for infiltration were: piperacillin/tazobactan (p=0.024) and the number of catheters inserted (p<0.001). Conclusion: the investigation documented the incidence of nursing-sensitive indicators (phlebitis and infiltration) and revealed new risk factors related to infiltration. It also allowed a reflection on the nursing care necessary to prevent these vascular traumas and on the indications and contraindications of the PVC, supporting the implementation of the PICC as an alternative to PVC.