Cristina Ide Fujinaga

O ruído gerado durante a manipulação das incubadoras: implicações para o cuidado de enfermagem

UNLABELLED Uncontrolled experimental study. AIM Quantify the impact noise of the 23 incubators functioning in the intensive and intermediate care units of a public university hospital in Ribeirão Preto-SP. METHODOLOGY Measuring occurred during incubator manipulation in a careful and in a rough way, considering the impact noise generated by the various situations in which the incubator was manipulated. RESULTS In practically all manipulation situations in both the careful and the rough way, group B presented higher NPS, followed by group A and D. Group C demonstrated the lowest NPS during the different manipulation situations. Even careful manipulation generated a strong noise level, and NPS almost always doubled or tripled when the same situation was realized roughly. Careful manipulation, together with lower incubator use time, revealed to be effective in reducing the noise produced during equipment manipulation.Uncontrolled experimental study. Aim: quantify the impact noise of the 23 incubators functioning in the intensive and intermediate care units of a public university hospital in Ribeirao Preto-SP. Methodology: measuring occurred during incubator manipulation in a careful and in a rough way, considering the impact noise generated by the various situations in which the incubator was manipulated. Results: In practically all manipulation situations in both the careful and the rough way, group B presented higher NPS, followed by group A and D. Group C demonstrated the lowest NPS during the different manipulation situations. Even careful manipulation generated a strong noise level, and NPS almost always doubled or tripled when the same situation was realized roughly. Careful manipulation, together with lower incubator use time, revealed to be effective in reducing the noise produced during equipment manipulation.Estudio del tipo experimento no controlado. Objetivo: cuantificar el ruido de impacto de las 23 incubadoras en operacion de las unidades de cuidado intensivo e intermedio de un hospital universitario publico de Ribeirao Preto-SP. Metodologia: mediciones ocurrieron durante el manejo de las incubadoras de modo cuidadoso y brusco, visando el ruido de impacto generado por las diversas situaciones de manejo con la incubadora. Resultados: En practicamente todas las situaciones de manejo, tanto de modo cuidadoso como de modo brusco, el grupo B presento NPS mas elevados, seguido por el grupo A y D. El grupo C fue el que demostro los menores NPS durante las diversas situaciones de manejo. Mismo el manejo cuidadoso genero fuerte nivel de ruido, y el NPS casi siempre se dobla o triplica cuando la misma situacion se realiza bruscamente. El manejo cuidadoso, en conjunto con menor tempo de uso de la incubadora, se mostro eficaz en la reduccion del ruido producido al manosear el equipo.

Transição alimentar por via oral em prematuros de um Hospital Amigo da Criança

OBJETIVO: Caracterizar la transicion de la alimentacion gastrica por via oral en lo que se refiere a: madurez y peso del prematuro, vias y tecnicas de administracion y, duracion de la transicion hasta la alimentacion oral exclusiva. METODOS: Es un estudio retrospectivo con datos levantados en fichas de 116 prematuros asistidos en las unidades de cuidados intensivos e intermedios neonatales de un hospital universitario del municipio de Ribeirao Preto- SP. RESULTADOS: La edad de gestacion corregida promedio fue de 36 semanas en el inicio de la alimentacion oral y de 37 semanas cuando la alimentacion ocurrio totalmente por la via oral. El peso promedio fue de 1.743 gramos en el inicio de la alimentacion oral y el peso promedio de 1.934 gramos cuando la alimentacion ocurrio totalmente por la via oral. Durante el periodo de transicion fueron utilizadas una o mas tecnicas de administracion de leche. El uso de alimentacion forzada en conjunto con otras tecnicas (89,5%) predomino, complementada por el seno materno y mamadera (56,9%); la duracion de la transicion alimentar vario de menos de 1 dia a 47 dias. CONCLUSION: La madurez y el peso al nascer, ademas de las condiciones clinicas provenientes de esas variables, pueden interferir en el proceso de transicion de la alimentacion lactea del prematuro. Considerando las ventajas del amamantamiento materno, su practica debe ser iniciada lo mas precozmente posible en este segmento poblacional de riesgo.OBJECTIVE: To characterize the transition from oral gastric feeding related to: maturity and weight of premature babies, methods and techniques of administration and, duration of the transition to only oral feeding. METHODS: This is a retrospective study of data gathered in records of 116 infants attended in intensive care units and neonatal intermediate in a university hospital in Ribeirao Preto-SP. RESULTS: The mean-corrected of gestational age was 36 weeks at the start of oral feeding and 37 weeks when the [...]Objective: To characterize the transition from oral gastric feeding related to: maturity and weight of premature babies, methods and techniques of administration and, duration of the transition to only oral feeding. Methods: This is a retrospective study of data gathered in records of 116 infants attended in intensive care units and neonatal intermediate in a university hospital in Ribeirao Preto-SP. Results: The mean-corrected of gestational age was 36 weeks at the start of oral feeding and 37 weeks when the supply came entirely by the oral route. The average weight was 1,743 grams at the start of oral feeding and 1,934 grams when the food came entirely by the oral route. During the transition period were used one or more means of milk administration. The use of forced feeding in conjunction with other techniques (89.5%) predominated, this was complemented by breast feeding and milk bottle (56.9%); the duration of feeding transition ranged from less than 1 day to 47 days. Conclusion: The maturity and birth weight, in addition to the clinical conditions from these variables, can interfere in the process of milk feeding transition in preterm babies. Considering the advantages of breastfeeding, the practice should be initiated as early as possible in this risk population segment.

INSTRUMENTO DE AVALIAÇÃO DA SUCÇÃO DO RECÉM-NASCIDO COM VISTAS A ALIMENTAÇÃO AO SEIO MATERNO

Purpose: to evaluate the accuracy of the “Assessment sucking scale to newborn in breastfeeding”. Methods: this is a diagnostic study. The “Assessment sucking scale to newborn in breastfeeding” was drawn from an existing instrument, has been validated. The study included 152 mothers / newborn hospitalized in rooming in care. The study was divided into two stages, the first stage adaptation of the instrument and the second validation of the “Assessment sucking scale to newborn in breastfeeding” itself. For comparison between the instruments, it was considered as the gold standard “Protocol assessment of breastfeeding” proposed by UNICEF. Statistical analysis was applied to test the association chi square (first stage) and building the “Receiver Operating Characteristics” curve (second stage). Results: in the first phase, the “Assessment sucking scale to newborn in breastfeeding” was drawn from the behavior of newborns who were associated with breastfeeding, consisting of items posture, movement and cupping tongue and jaw movement. However, in the second stage, it was found that “Assessment sucking scale to newborn in breastfeeding” has a poor accuracy and is not a predictor of the behavior of the newborn in the breastfeeding. Conclusion: the “Assessment sucking scale to newborn in breastfeeding” cannot be considered a predictor of behavior newborn in the breastfeeding.

Efeitos da estimulação da sucção não nutritiva com dedo enluvado na transição alimentar em recém-nascido prematuro de muito baixo peso

Purpose to analyze the influence of nonnutritive sucking stimulation with the gloved finger technique on readiness and the transition from gastric to oral feeding in very low birthweigth premature infants. Methods aleatory, prospective, longitudinal, experimental and controlled study in premature infants attended in intense care units in Hospital de Clinicas, with gestational age £ 32 weeks and birth weigths £ 1500g, stable clinical. Newborns were randomly distributed in two groups: the control group, without stimulation NNS and the experimental group with stimulation NNS with gloved finger, three time for day, three days in the week. There were measured criteria such as the score of oral feeding readiness evaluation, stress signs during oral feeding and time of transition from gastric to oral feeding. Results when compared the experimental group with the control group, it was observed a significantly higher score in the preterm infant oral feeding readiness evaluation, lower of signs of stress and a shorter time of transition from gastric to oral feeding. Conclusion the NNS stimulation with the gloved finger technique, improved preterm infant oral feeding readiness, reduced stress signals frequency while oral feeding and influenced the time of feeding transition in the experimental group when compared to the control group.

Impact of a participatory program to reduce noise in a Neonatal Unit

This study evaluated the impact of a participatory program to reduce noise in a neonatal intermediate care unit of a university hospital. A time-series quasi-experimental design was used, in which sound pressure levels were measured before and after the intervention was implemented using the Quest-400 dosimeter. Non-parametric statistical tests were used to compare noise with the level of significance fixed at 5%. Results showed significant reduction of sound pressure levels in the neonatal unit after the intervention program was implemented (p<0.0001). The average Leq before the intervention was 62.5dBA and was reduced to 58.8dBA after the intervention. A reduction of 7.1dBA in the average Lmax(from 104.8 to 87.7dBA) and of 30.6dBA in the average Lpeak(from 138.1 to 107.5dBA) was observed. The program was proven to be effective in significantly reducing noise levels in the neonatal unit, although levels were still more intense than recommended.O objetivo deste estudo foi avaliar o impacto de um programa participativo na reducao do ruido ambiente em uma unidade neonatal, de um hospital universitario. Utilizou-se delineamento quase-experimental do tipo tempo-serie, no qual os niveis de pressao sonora foram dimensionados antes e apos a implantacao do programa de intervencao, utilizando o dosimetro Quest-400. Para a analise comparativa do ruido, utilizaram-se os testes estatisticos nao-parametricos (α=0,05). Constatou-se reducao significativa dos niveis de pressao sonora da unidade neonatal, apos a implantacao do programa de intervencao (p<0,0001). O Leq medio foi de 62,5dBA antes da intervencao e reduziu para 58,8dBA apos a intervencao. Houve reducao de 7,1dBA no Lmax medio (de 104,8 para 87,7dBA) e de 30,6dBA no Lpeak medio (de 138,1 para 107,5dBA). Concluiu-se que o programa foi efetivo na reducao do nivel sonoro da unidade neonatal, embora ainda se mantenha mais intenso que o recomendavel.

Impacto de um programa participativo de redução do ruído em unidade neonatal

This study evaluated the impact of a participatory program to reduce noise in a neonatal intermediate care unit of a university hospital. A time-series quasi-experimental design was used, in which sound pressure levels were measured before and after the intervention was implemented using the Quest-400 dosimeter. Non-parametric statistical tests were used to compare noise with the level of significance fixed at 5%. Results showed significant reduction of sound pressure levels in the neonatal unit after the intervention program was implemented (p<0.0001). The average Leq before the intervention was 62.5dBA and was reduced to 58.8dBA after the intervention. A reduction of 7.1dBA in the average Lmax(from 104.8 to 87.7dBA) and of 30.6dBA in the average Lpeak(from 138.1 to 107.5dBA) was observed. The program was proven to be effective in significantly reducing noise levels in the neonatal unit, although levels were still more intense than recommended.O objetivo deste estudo foi avaliar o impacto de um programa participativo na reducao do ruido ambiente em uma unidade neonatal, de um hospital universitario. Utilizou-se delineamento quase-experimental do tipo tempo-serie, no qual os niveis de pressao sonora foram dimensionados antes e apos a implantacao do programa de intervencao, utilizando o dosimetro Quest-400. Para a analise comparativa do ruido, utilizaram-se os testes estatisticos nao-parametricos (α=0,05). Constatou-se reducao significativa dos niveis de pressao sonora da unidade neonatal, apos a implantacao do programa de intervencao (p<0,0001). O Leq medio foi de 62,5dBA antes da intervencao e reduziu para 58,8dBA apos a intervencao. Houve reducao de 7,1dBA no Lmax medio (de 104,8 para 87,7dBA) e de 30,6dBA no Lpeak medio (de 138,1 para 107,5dBA). Concluiu-se que o programa foi efetivo na reducao do nivel sonoro da unidade neonatal, embora ainda se mantenha mais intenso que o recomendavel.

Oral feeding transition in preterm infants in a Child-Friendly Hospital

OBJETIVO: Caracterizar la transicion de la alimentacion gastrica por via oral en lo que se refiere a: madurez y peso del prematuro, vias y tecnicas de administracion y, duracion de la transicion hasta la alimentacion oral exclusiva. METODOS: Es un estudio retrospectivo con datos levantados en fichas de 116 prematuros asistidos en las unidades de cuidados intensivos e intermedios neonatales de un hospital universitario del municipio de Ribeirao Preto- SP. RESULTADOS: La edad de gestacion corregida promedio fue de 36 semanas en el inicio de la alimentacion oral y de 37 semanas cuando la alimentacion ocurrio totalmente por la via oral. El peso promedio fue de 1.743 gramos en el inicio de la alimentacion oral y el peso promedio de 1.934 gramos cuando la alimentacion ocurrio totalmente por la via oral. Durante el periodo de transicion fueron utilizadas una o mas tecnicas de administracion de leche. El uso de alimentacion forzada en conjunto con otras tecnicas (89,5%) predomino, complementada por el seno materno y mamadera (56,9%); la duracion de la transicion alimentar vario de menos de 1 dia a 47 dias. CONCLUSION: La madurez y el peso al nascer, ademas de las condiciones clinicas provenientes de esas variables, pueden interferir en el proceso de transicion de la alimentacion lactea del prematuro. Considerando las ventajas del amamantamiento materno, su practica debe ser iniciada lo mas precozmente posible en este segmento poblacional de riesgo.OBJECTIVE: To characterize the transition from oral gastric feeding related to: maturity and weight of premature babies, methods and techniques of administration and, duration of the transition to only oral feeding. METHODS: This is a retrospective study of data gathered in records of 116 infants attended in intensive care units and neonatal intermediate in a university hospital in Ribeirao Preto-SP. RESULTS: The mean-corrected of gestational age was 36 weeks at the start of oral feeding and 37 weeks when the [...]Objective: To characterize the transition from oral gastric feeding related to: maturity and weight of premature babies, methods and techniques of administration and, duration of the transition to only oral feeding. Methods: This is a retrospective study of data gathered in records of 116 infants attended in intensive care units and neonatal intermediate in a university hospital in Ribeirao Preto-SP. Results: The mean-corrected of gestational age was 36 weeks at the start of oral feeding and 37 weeks when the supply came entirely by the oral route. The average weight was 1,743 grams at the start of oral feeding and 1,934 grams when the food came entirely by the oral route. During the transition period were used one or more means of milk administration. The use of forced feeding in conjunction with other techniques (89.5%) predominated, this was complemented by breast feeding and milk bottle (56.9%); the duration of feeding transition ranged from less than 1 day to 47 days. Conclusion: The maturity and birth weight, in addition to the clinical conditions from these variables, can interfere in the process of milk feeding transition in preterm babies. Considering the advantages of breastfeeding, the practice should be initiated as early as possible in this risk population segment.

Noise generated during incubator manipulation: implications for nursing care

UNLABELLED Uncontrolled experimental study. AIM Quantify the impact noise of the 23 incubators functioning in the intensive and intermediate care units of a public university hospital in Ribeirão Preto-SP. METHODOLOGY Measuring occurred during incubator manipulation in a careful and in a rough way, considering the impact noise generated by the various situations in which the incubator was manipulated. RESULTS In practically all manipulation situations in both the careful and the rough way, group B presented higher NPS, followed by group A and D. Group C demonstrated the lowest NPS during the different manipulation situations. Even careful manipulation generated a strong noise level, and NPS almost always doubled or tripled when the same situation was realized roughly. Careful manipulation, together with lower incubator use time, revealed to be effective in reducing the noise produced during equipment manipulation.Uncontrolled experimental study. Aim: quantify the impact noise of the 23 incubators functioning in the intensive and intermediate care units of a public university hospital in Ribeirao Preto-SP. Methodology: measuring occurred during incubator manipulation in a careful and in a rough way, considering the impact noise generated by the various situations in which the incubator was manipulated. Results: In practically all manipulation situations in both the careful and the rough way, group B presented higher NPS, followed by group A and D. Group C demonstrated the lowest NPS during the different manipulation situations. Even careful manipulation generated a strong noise level, and NPS almost always doubled or tripled when the same situation was realized roughly. Careful manipulation, together with lower incubator use time, revealed to be effective in reducing the noise produced during equipment manipulation.Estudio del tipo experimento no controlado. Objetivo: cuantificar el ruido de impacto de las 23 incubadoras en operacion de las unidades de cuidado intensivo e intermedio de un hospital universitario publico de Ribeirao Preto-SP. Metodologia: mediciones ocurrieron durante el manejo de las incubadoras de modo cuidadoso y brusco, visando el ruido de impacto generado por las diversas situaciones de manejo con la incubadora. Resultados: En practicamente todas las situaciones de manejo, tanto de modo cuidadoso como de modo brusco, el grupo B presento NPS mas elevados, seguido por el grupo A y D. El grupo C fue el que demostro los menores NPS durante las diversas situaciones de manejo. Mismo el manejo cuidadoso genero fuerte nivel de ruido, y el NPS casi siempre se dobla o triplica cuando la misma situacion se realiza bruscamente. El manejo cuidadoso, en conjunto con menor tempo de uso de la incubadora, se mostro eficaz en la reduccion del ruido producido al manosear el equipo.

Assistência integral ao recém-nascido prematuro: implicações das práticas e da política pública

Objetivo: compreender a forma como ocorre a assistencia ao recem-nascido prematuro, conforme preconiza a politica publica de saude Metodo Canguru, a partir da percepcao dos profissionais envolvidos na assistencia. Metodos: trata-se de um estudo descritivo de delineamento qualitativo. Foram realizadas entrevistas com profissionais da area da saude, sobre a assistencia a saude de bebes prematuros. Participaram da pesquisa dezoito profissionais da saude. Destes, tres eram assistentes sociais, quatro enfermeiras, dois fonoaudiologos, dois nutricionistas, dois psicologos, quatro tecnicos de enfermagem e um medico. Todos os entrevistados eram do sexo feminino. As entrevistas foram encerradas a partir da saturacao das respostas, pois nao houve mais elementos significativos. A realizacao das entrevistas ocorreu na Secretaria Municipal de Saude, no Consorcio Intermunicipal de Saude e no Hospital Santa Casa, todas as instituicoes de um municipio do estado do Parana. A tecnica utilizada para analise dos dados, mediante Analise do Conteudo, foi a Analise Tematica. Resultados: foram elencados dois nucleos tematicos para a discussao: A fragmentacao do cuidado ao prematuro e as familias; Contradicoes entre as praticas profissionais e a politica publica instituida. Considera-se nao haver acompanhamento efetivo para os prematuros e questiona-se a continuidade nos atendimentos, para uma assistencia integral. Observa-se que os profissionais desconhecem o que a politica publica preconiza, e valorizam a atencao e cuidado hospitalar. Conclusao: os desajustes sao claros em todos os servicos de saude, e entao, nao ha o cumprimento da politica.

Impacto de un programa participativo de reducción de ruido en una unidad neonatal

This study evaluated the impact of a participatory program to reduce noise in a neonatal intermediate care unit of a university hospital. A time-series quasi-experimental design was used, in which sound pressure levels were measured before and after the intervention was implemented using the Quest-400 dosimeter. Non-parametric statistical tests were used to compare noise with the level of significance fixed at 5%. Results showed significant reduction of sound pressure levels in the neonatal unit after the intervention program was implemented (p<0.0001). The average Leq before the intervention was 62.5dBA and was reduced to 58.8dBA after the intervention. A reduction of 7.1dBA in the average Lmax(from 104.8 to 87.7dBA) and of 30.6dBA in the average Lpeak(from 138.1 to 107.5dBA) was observed. The program was proven to be effective in significantly reducing noise levels in the neonatal unit, although levels were still more intense than recommended.O objetivo deste estudo foi avaliar o impacto de um programa participativo na reducao do ruido ambiente em uma unidade neonatal, de um hospital universitario. Utilizou-se delineamento quase-experimental do tipo tempo-serie, no qual os niveis de pressao sonora foram dimensionados antes e apos a implantacao do programa de intervencao, utilizando o dosimetro Quest-400. Para a analise comparativa do ruido, utilizaram-se os testes estatisticos nao-parametricos (α=0,05). Constatou-se reducao significativa dos niveis de pressao sonora da unidade neonatal, apos a implantacao do programa de intervencao (p<0,0001). O Leq medio foi de 62,5dBA antes da intervencao e reduziu para 58,8dBA apos a intervencao. Houve reducao de 7,1dBA no Lmax medio (de 104,8 para 87,7dBA) e de 30,6dBA no Lpeak medio (de 138,1 para 107,5dBA). Concluiu-se que o programa foi efetivo na reducao do nivel sonoro da unidade neonatal, embora ainda se mantenha mais intenso que o recomendavel.