Daniele Fávaro Ribeiro

Caracterização e etiologia da insuficiência renal crônica em unidade de nefrologia do interior do Estado de São Paulo

OBJETIVOS: Caracterizar a los pacientes con insuficiencia renal cronica (IRC) que participan en un programa dialitico; verificar las causas de la IRC; identificar las enfermedades asociadas a la IRC; levantar el tipo de tratamiento y el acceso actual de esos pacientes. METODOS: Se trata de un estudio descriptivo epidemiologico, realizado en una Unidad de Nefrologia en el que fueron incluidos todos los pacientes registrados en el Programa Nefro Data. RESULTADOS: De los 217 pacientes registrados en la Unidad en estudio, observamos que el 68,2% tenian edad superior a 40 anos y el 59,4% eran del sexo masculino. En cuanto a la enfermedad de base, el 31,3% de los pacientes presentan Nefroesclerosis Hipertensiva y el 25,3% Diabetes Mellitus (DM), seguido de la Glomerulonefritis con el 24,5%. Respecto a las enfermedades asociadas, el 42,4% de los pacientes poseen Hipertension Arterial Sistemica (HAS), el 24,9% no poseen comorbidades, el 19,8% HAS y DM. En relacion al tipo de acceso vascular el 70,5% poseen fistula arteriovenosa, siendo la utilizacion del cateter de Tenckhoff exclusivo de la dialisis peritoneal en el 13,3%. CONCLUSION: los resultados permiten una mejor planificacion frente a las necesidades reales de los pacientes.Objectives: Characterize the pacients with chronic renal failure (CRF) in dialythical program; verify the causes of the CRF; identify the associated diseases to CRF; measure the type of treatment and the actual access of the pacients to them. Methods: This is a epidemiological descriptive research performed in a nephrology unit, and all pacients registered in the Nefro Data program were included. Results: Of the group of 217 patients registered in the studied unit, 68,2% have age of 40 or greater and 59,4% are male. Regarding the base disease, 31,3% of the pacients have Hipertensive Nephrosclerosis, 25,3% have Diabetes Mellitus (DM) and 24,5% have Glomerulonephritis. Regarding the associated diseases, 42,4% of the pacients have Systemic Arterial Hipertension (SAH) 24,9% don’t have comorbities, 19,8% have both SAH and DM. Regarding the type of vascular acess, 70,5% have arteriovenous fistula, being the utilization of the Tenckhoff catheter exclusive of peritoneal dialysis in 13,3% of the studied cases. Conclusion: The results allow a better planning with regard to the patients real needs.

Elaboração de um instrumento da assistência de enfermagem na unidade de hemodiálise

This study aimed at developing an instrument to record nursing assistance systematization in a hemodialysis unit. For this development, we used the instrument formulated from literature on nursing diagnosis in nephropathic patients. The record instrument has been analyzed according to: layout and process facilitation. The process relied on the Basic Human Needs Theory and the taxonomy of the North American Nursing Diagnosis Association. The instrument has been facilitating the implementation of the nursing process in the hemodialysis unit. It was possible to record the data in a organized and concise fashion and use key information to plan and evaluate the assistance offered.ABSTRACT This study aimed at developing an instrument to record nursing assistance systematization in a hemodialysis unit. For this deve lopment, weused the instrument formulated from literature on nursing diagnosis in nephropathic patients. The record instrument has been analyzedaccording to: layout and process facilitation. The process relied on the Basic Human Needs Theory and the taxonomy of the North AmericanNursing Diagnosis Association. The instrument has been facilitating the implementation of the nursing process in the hemodialysis unit. Itwas possible to record the data in a organized and concise fashion and use key information to plan and evaluate the assistance offered. Keywords : Hemodialysis units, hospital; Renal dialysis/nursing; Nursing care; Nursing diagnosis RESUMO O objetivo deste estudo O relatar a experiŒncia de construcao de um instrumento para registro da sistematizacao da assistŒncia de enfermagemem uma unidade de tratamento dialitico. Para esta construcao, utilizou-se o instrumento formulado com base na literatura sobre diagnosticosde enfermagem em pacientes nefropatas. O instrumento de registr o foi analisado conforme: diagramacao e facilitacao do processo. O processoteve como norteador a teoria das Necessidades Humanas BAEsicas e a taxonomia da North American Nursing Diagnosis Association. Oinstrumento tem facilitado a implantacao do processo de enfermagem na unidade de hemodiAElise. Com o seu uso, foi possivel o registroorganizado e conciso dos dados e uso de informacies importantes para o planejamento e avaliacao da assistŒncia prestada.

Processo de cuidar do idoso em Diálise Peritoneal Ambulatorial Contínua no domicílio

Objectives: To describe the elders with end stage renal disease (ESRD) undergoing continuous ambulatory peritoneal dialysis (CAPD), their caregivers, and the care the caregivers provide to the elders. Methods: This was a qualitative study with 9 caregivers. Data were collected through oral history. Data analysis consisted of thematic content analysis. Results: The sample consisted of 5 male and 4 female elders and all them were dependent on caregivers to change the dialysis collection bag. The mean age of the participants was 70 years. Among the caregivers, 8 of them were female with a mean age of 41.5 years and they provided 8 hours of care to the elders daily. The main theme emerging from the content analysis was “home care for the elderly undergoing continuous ambulatory peritoneal dialysis.” Conclusion: Caregivers need support for the development of knowledge and skills to deal with the elders’ demand of care, particularly in regard to the management of CAPD.

Avaliação do grau de satisfação de pacientes renais crônicos em hemodiálise

Objective: To identify the level of satisfaction in patients with chronic renal disease on hemodialysis regarding their care and the physical structure of the hemodialysis unit of the Hospital “de Base” of Sao Jose do Rio Preto, SP. Methods: This descriptive study used a Likettype scale to collect data from 81 patients from the nephrology department. Results: Almost all patients were very satisfied (53 %) or satisfied (47%) regarding their care and the physical structure of the hemodialysis unit. A few limitations of the service were also reported. Conclusion: Patients’ satisfaction with the service led to reflection among health care providers regarding their practice and served as an indicator for continuous improvement of the hemodialysis service.

Necessidades de aprendizagem de profissionais de enfermagem na assistência aos pacientes com fístula arteriovenosa

Objectives: To identify the learning needs of professional nurses to provide quality care for patients with arteriovenous fistula (AV Fistula) for hemodialysis. Methods: This cross-sectional descriptive study was conducted with 36 professional nurses from the hemodialysis unit of a hospital in the State of Sao Paulo. A semi-structured questionnaire was used to collect the data. Initially, questionnaires were distributed to 43 nurses, but only 36 (83.7%) responded and returned the questionnaires. Results: A great number of nurses (44.9 %) reported to have difficulties in providing quality care for patients with AV Fistula. Difficulties were related to the access of AV Fistula for hemodialysis (47.2%), hemostasis of the site when withdrawing the needle after hemodialysis (19.4%) and lack of competency for the management of hematoma (13.9%), and patient’s instructions and education (19.4%). Conclusions: Nurses had many learning needs to prepare them to care for patients with arteriovenous AV Fistula. This finding led to the development of a protocol to facilitated quality care nursing care.OBJECTIVES: To identify the learning needs of professional nurses to provide quality care for patients with arteriovenous fistula (AV Fistula) for hemodialysis. METHODS: This cross-sectional descriptive study was conducted with 36 professional nurses from the hemodialysis unit of a hospital in the State of Sao Paulo. A semi-structured questionnaire was used to collect the data. Initially, questionnaires were distributed to 43 nurses, but only 36 (83.7%) responded and returned the questionnaires. RESULTS: A great number of nurses (44.9 %) reported to have difficulties in providing quality care for patients with AV Fistula. Difficulties were related to the access of AV Fistula for hemodialysis (47.2%), hemostasis of the site when withdrawing the needle after hemodialysis (19.4%) and lack of competency for the management of hematoma (13.9%), and patients instructions and education (19.4%). CONCLUSIONS: Nurses had many learning needs to prepare them to care for patients with arteriovenous AV Fistula. This finding led to the development of a protocol to facilitated quality care nursing care.

Elaboration of a instrument for nursing care in the hemodialysis unit

This study aimed at developing an instrument to record nursing assistance systematization in a hemodialysis unit. For this development, we used the instrument formulated from literature on nursing diagnosis in nephropathic patients. The record instrument has been analyzed according to: layout and process facilitation. The process relied on the Basic Human Needs Theory and the taxonomy of the North American Nursing Diagnosis Association. The instrument has been facilitating the implementation of the nursing process in the hemodialysis unit. It was possible to record the data in a organized and concise fashion and use key information to plan and evaluate the assistance offered.ABSTRACT This study aimed at developing an instrument to record nursing assistance systematization in a hemodialysis unit. For this deve lopment, weused the instrument formulated from literature on nursing diagnosis in nephropathic patients. The record instrument has been analyzedaccording to: layout and process facilitation. The process relied on the Basic Human Needs Theory and the taxonomy of the North AmericanNursing Diagnosis Association. The instrument has been facilitating the implementation of the nursing process in the hemodialysis unit. Itwas possible to record the data in a organized and concise fashion and use key information to plan and evaluate the assistance offered. Keywords : Hemodialysis units, hospital; Renal dialysis/nursing; Nursing care; Nursing diagnosis RESUMO O objetivo deste estudo O relatar a experiŒncia de construcao de um instrumento para registro da sistematizacao da assistŒncia de enfermagemem uma unidade de tratamento dialitico. Para esta construcao, utilizou-se o instrumento formulado com base na literatura sobre diagnosticosde enfermagem em pacientes nefropatas. O instrumento de registr o foi analisado conforme: diagramacao e facilitacao do processo. O processoteve como norteador a teoria das Necessidades Humanas BAEsicas e a taxonomia da North American Nursing Diagnosis Association. Oinstrumento tem facilitado a implantacao do processo de enfermagem na unidade de hemodiAElise. Com o seu uso, foi possivel o registroorganizado e conciso dos dados e uso de informacies importantes para o planejamento e avaliacao da assistŒncia prestada.

Characterization and etiology of the chronic renal failure in a countryside nephrology unit of São Paulo State

OBJETIVOS: Caracterizar a los pacientes con insuficiencia renal cronica (IRC) que participan en un programa dialitico; verificar las causas de la IRC; identificar las enfermedades asociadas a la IRC; levantar el tipo de tratamiento y el acceso actual de esos pacientes. METODOS: Se trata de un estudio descriptivo epidemiologico, realizado en una Unidad de Nefrologia en el que fueron incluidos todos los pacientes registrados en el Programa Nefro Data. RESULTADOS: De los 217 pacientes registrados en la Unidad en estudio, observamos que el 68,2% tenian edad superior a 40 anos y el 59,4% eran del sexo masculino. En cuanto a la enfermedad de base, el 31,3% de los pacientes presentan Nefroesclerosis Hipertensiva y el 25,3% Diabetes Mellitus (DM), seguido de la Glomerulonefritis con el 24,5%. Respecto a las enfermedades asociadas, el 42,4% de los pacientes poseen Hipertension Arterial Sistemica (HAS), el 24,9% no poseen comorbidades, el 19,8% HAS y DM. En relacion al tipo de acceso vascular el 70,5% poseen fistula arteriovenosa, siendo la utilizacion del cateter de Tenckhoff exclusivo de la dialisis peritoneal en el 13,3%. CONCLUSION: los resultados permiten una mejor planificacion frente a las necesidades reales de los pacientes.Objectives: Characterize the pacients with chronic renal failure (CRF) in dialythical program; verify the causes of the CRF; identify the associated diseases to CRF; measure the type of treatment and the actual access of the pacients to them. Methods: This is a epidemiological descriptive research performed in a nephrology unit, and all pacients registered in the Nefro Data program were included. Results: Of the group of 217 patients registered in the studied unit, 68,2% have age of 40 or greater and 59,4% are male. Regarding the base disease, 31,3% of the pacients have Hipertensive Nephrosclerosis, 25,3% have Diabetes Mellitus (DM) and 24,5% have Glomerulonephritis. Regarding the associated diseases, 42,4% of the pacients have Systemic Arterial Hipertension (SAH) 24,9% don’t have comorbities, 19,8% have both SAH and DM. Regarding the type of vascular acess, 70,5% have arteriovenous fistula, being the utilization of the Tenckhoff catheter exclusive of peritoneal dialysis in 13,3% of the studied cases. Conclusion: The results allow a better planning with regard to the patients real needs.

Learning needs of professional nurses to care for patients with arteriovenous fistula

Objectives: To identify the learning needs of professional nurses to provide quality care for patients with arteriovenous fistula (AV Fistula) for hemodialysis. Methods: This cross-sectional descriptive study was conducted with 36 professional nurses from the hemodialysis unit of a hospital in the State of Sao Paulo. A semi-structured questionnaire was used to collect the data. Initially, questionnaires were distributed to 43 nurses, but only 36 (83.7%) responded and returned the questionnaires. Results: A great number of nurses (44.9 %) reported to have difficulties in providing quality care for patients with AV Fistula. Difficulties were related to the access of AV Fistula for hemodialysis (47.2%), hemostasis of the site when withdrawing the needle after hemodialysis (19.4%) and lack of competency for the management of hematoma (13.9%), and patient’s instructions and education (19.4%). Conclusions: Nurses had many learning needs to prepare them to care for patients with arteriovenous AV Fistula. This finding led to the development of a protocol to facilitated quality care nursing care.OBJECTIVES: To identify the learning needs of professional nurses to provide quality care for patients with arteriovenous fistula (AV Fistula) for hemodialysis. METHODS: This cross-sectional descriptive study was conducted with 36 professional nurses from the hemodialysis unit of a hospital in the State of Sao Paulo. A semi-structured questionnaire was used to collect the data. Initially, questionnaires were distributed to 43 nurses, but only 36 (83.7%) responded and returned the questionnaires. RESULTS: A great number of nurses (44.9 %) reported to have difficulties in providing quality care for patients with AV Fistula. Difficulties were related to the access of AV Fistula for hemodialysis (47.2%), hemostasis of the site when withdrawing the needle after hemodialysis (19.4%) and lack of competency for the management of hematoma (13.9%), and patients instructions and education (19.4%). CONCLUSIONS: Nurses had many learning needs to prepare them to care for patients with arteriovenous AV Fistula. This finding led to the development of a protocol to facilitated quality care nursing care.

Levantamento sobre a infecção na inserção do cateter de duplo lúmen

Objective: The purpose of this study was to identify the infection rate, etiologic agent, infectious complications and the double-lumen catheter permanence in one same period in alternating years. Methods: This retrospective study was carried out in the Center of Hemodialysis of the Hospital de Base de Sao Jose do Rio Preto-SP. All patients who presented infection in the double-lumen catheter insertion site within the period of the survey were included. Results: It was reported that of the 80 patients undergoing hemodialysis treatment in the first period, from January to June 2002, 21% of the patients were using catheter. Three years later, 186 patients were in the same conditions, and of these, 10.7% was being treated with catheter therapy. The bloodstream infections were reduced by 9.4% in the last period. Bacteremia was the main prevailing infectiou complication. The Staphylococcus aureus was the most prevalent etiologic agent and the average doublelumen catheter permanence time was of 43 days in both periods of the study. Conclusion: This study revealed that there was a significant improvement as for the infection indexes in that population.OBJECTIVE: The purpose of this study was to identify the infection rate, etiologic agent, infectious complications and the double-lumen catheter permanence in one same period in alternating years. METHODS: This retrospective study was carried out in the Center of Hemodialysis of the Hospital de Base de Sao Jose do Rio Preto-SP. All patients who presented infection in the double-lumen catheter insertion site within the period of the survey were included. RESULTS: It was reported that of the 80 patients undergoing hemodialysis treatment in the first period, from January to June 2002, 21% of the patients were using catheter. Three years later, 186 patients were in the same conditions, and of these, 10.7% was being treated with catheter therapy. The bloodstream infections were reduced by 9.4% in the last period. Bacteremia was the main prevailing infectiou complication. The Staphylococcus aureus was the most prevalent etiologic agent and the average double-lumen catheter permanence time was of 43 days in both periods of the study. CONCLUSION: This study revealed that there was a significant improvement as for the infection indexes in that population.

Necesidades de aprendizaje de profesionales de enfermería en la asistencia a pacientes con fístula arteriovenosa

Objectives: To identify the learning needs of professional nurses to provide quality care for patients with arteriovenous fistula (AV Fistula) for hemodialysis. Methods: This cross-sectional descriptive study was conducted with 36 professional nurses from the hemodialysis unit of a hospital in the State of Sao Paulo. A semi-structured questionnaire was used to collect the data. Initially, questionnaires were distributed to 43 nurses, but only 36 (83.7%) responded and returned the questionnaires. Results: A great number of nurses (44.9 %) reported to have difficulties in providing quality care for patients with AV Fistula. Difficulties were related to the access of AV Fistula for hemodialysis (47.2%), hemostasis of the site when withdrawing the needle after hemodialysis (19.4%) and lack of competency for the management of hematoma (13.9%), and patient’s instructions and education (19.4%). Conclusions: Nurses had many learning needs to prepare them to care for patients with arteriovenous AV Fistula. This finding led to the development of a protocol to facilitated quality care nursing care.OBJECTIVES: To identify the learning needs of professional nurses to provide quality care for patients with arteriovenous fistula (AV Fistula) for hemodialysis. METHODS: This cross-sectional descriptive study was conducted with 36 professional nurses from the hemodialysis unit of a hospital in the State of Sao Paulo. A semi-structured questionnaire was used to collect the data. Initially, questionnaires were distributed to 43 nurses, but only 36 (83.7%) responded and returned the questionnaires. RESULTS: A great number of nurses (44.9 %) reported to have difficulties in providing quality care for patients with AV Fistula. Difficulties were related to the access of AV Fistula for hemodialysis (47.2%), hemostasis of the site when withdrawing the needle after hemodialysis (19.4%) and lack of competency for the management of hematoma (13.9%), and patients instructions and education (19.4%). CONCLUSIONS: Nurses had many learning needs to prepare them to care for patients with arteriovenous AV Fistula. This finding led to the development of a protocol to facilitated quality care nursing care.