Débora Feijó Villas Boas Vieira

Risk factors for falls in hospitalized adult patients: an integrative review

Objetivo: Identificar os fatores de risco para a ocorrencia de quedas em pacientes adultos hospitalizados. Metodo: Revisao integrativa realizada nas bases de dados LILACS, SciELO, MEDLINE e Web of Science, abrangendo artigos publicados entre 1989 e 2012. Resultados: Setenta e um artigos compuseram a amostra final do estudo. Os fatores de risco para quedas apresentados nesta revisao foram relacionados ao paciente (intrinsecos), ao ambiente hospitalar e ao processo de trabalho dos profissionais da saude, em especial a enfermagem (extrinsecos). Conclusao: A triagem sistematica de fatores de risco para queda foi identificada como fator contribuinte para a reducao desse agravo, auxiliando a nao ocorrencia deste evento que, apesar de ser prevenivel, pode determinar consequencias graves incluindo o obito.OBJECTIVE Identifying risk factors for the occurrence of falls in hospitalized adult patients. METHOD Integrative review carried out in the databases of LILACS, SciELO, MEDLINE and Web of Science, including articles published between 1989 and 2012. RESULTS Seventy-one articles were included in the final sample. Risk factors for falls presented in this review were related to patients (intrinsic), the hospital setting and the working process of health professionals, especially in nursing (extrinsic). CONCLUSION The systematic screening of risk factors for falls was identified as a contributing factor to the reduction of this injury, helping the non-occurrence of this event that, despite being preventable, can have serious consequences including death.

Fatores de risco para quedas em pacientes adultos hospitalizados: revisão integrativa

Objetivo: Identificar os fatores de risco para a ocorrencia de quedas em pacientes adultos hospitalizados. Metodo: Revisao integrativa realizada nas bases de dados LILACS, SciELO, MEDLINE e Web of Science, abrangendo artigos publicados entre 1989 e 2012. Resultados: Setenta e um artigos compuseram a amostra final do estudo. Os fatores de risco para quedas apresentados nesta revisao foram relacionados ao paciente (intrinsecos), ao ambiente hospitalar e ao processo de trabalho dos profissionais da saude, em especial a enfermagem (extrinsecos). Conclusao: A triagem sistematica de fatores de risco para queda foi identificada como fator contribuinte para a reducao desse agravo, auxiliando a nao ocorrencia deste evento que, apesar de ser prevenivel, pode determinar consequencias graves incluindo o obito.OBJECTIVE Identifying risk factors for the occurrence of falls in hospitalized adult patients. METHOD Integrative review carried out in the databases of LILACS, SciELO, MEDLINE and Web of Science, including articles published between 1989 and 2012. RESULTS Seventy-one articles were included in the final sample. Risk factors for falls presented in this review were related to patients (intrinsic), the hospital setting and the working process of health professionals, especially in nursing (extrinsic). CONCLUSION The systematic screening of risk factors for falls was identified as a contributing factor to the reduction of this injury, helping the non-occurrence of this event that, despite being preventable, can have serious consequences including death.

Nursing workload in a coronary unit according to the Nursing Activities Score

OBJECTIVE this study aimed to using the Nursing Activities Score to assess nursing workload in a coronary care unit, to assess the distribution of workload between shifts, and to compare the current staff of the care unit with that recommended by the instrument. METHOD this was a longitudinal study, conducted in a teaching hospital in Southern Brazil, between April to June 2012. RESULTS A total of 604 NAS measures were obtained from the 61 patients included. The mean workload per shift was 47% (±12), with the greatest workload being reported in the afternoon shifts. CONCLUSION according to the NAS, a mean of two and a maximum of 2.4 nursing professionals would be required per shift to meet all patient demands, suggesting that the current staff size in the CCU is adequate. The NAS was successful in assessing nursing workload and changes in patient demands over time.

Prevalência de síndrome de burnout em médicos intensivistas de cinco capitais brasileiras

Objective: To estimate the prevalence of burnout in intensivist doctors working in adult, pediatric and neonatal intensive care units in five Brazilian capitals. Methods: Descriptive epidemiological study with a random sample stratified by conglomerate with 180 intensivist doctors from five capitals representing the Brazilian geographic regions: Porto Alegre (RS), Sao Paulo (SP), Salvador (BA), Goiania (GO) and Belem (PA). A self-administered questionnaire examining sociodemographic data and the level of burnout was evaluated through the Maslach Burnout Inventory. Results: A total of 180 doctors were evaluated, of which 54.4% were female. The average age was 39 ± 8.1 years, 63.4% had specialization as the highest degree, 55.7% had up to 10 years of work experience in an intensive care unit, and 46.1% had the title intensive care specialist. Most (50.3%) had weekly workloads between 49 and 72 hours, and the most frequent employee type was salaried. High levels of emotional exhaustion, depersonalization and inefficacy were found (50.6%, 26.1% and 15.0%, respectively). The prevalence of burnout was 61.7% when considering a high level in at least one dimension and 5% with a high level in three dimensions simultaneously. Conclusion: A high prevalence of burnout syndrome among intensivist doctors was observed. Strategies for the promotion and protection of health in these workers must be discussed and implemented in hospitals.Objective To estimate the prevalence of burnout in intensivist doctors working in adult, pediatric and neonatal intensive care units in five Brazilian capitals. Methods Descriptive epidemiological study with a random sample stratified by conglomerate with 180 intensivist doctors from five capitals representing the Brazilian geographic regions: Porto Alegre (RS), Sao Paulo (SP), Salvador (BA), Goiania (GO) and Belem (PA). A self-administered questionnaire examining sociodemographic data and the level of burnout was evaluated through the Maslach Burnout Inventory. Results A total of 180 doctors were evaluated, of which 54.4% were female. The average age was 39 ± 8.1 years, 63.4% had specialization as the highest degree, 55.7% had up to 10 years of work experience in an intensive care unit, and 46.1% had the title intensive care specialist. Most (50.3%) had weekly workloads between 49 and 72 hours, and the most frequent employee type was salaried. High levels of emotional exhaustion, depersonalization and inefficacy were found (50.6%, 26.1% and 15.0%, respectively). The prevalence of burnout was 61.7% when considering a high level in at least one dimension and 5% with a high level in three dimensions simultaneously. Conclusion A high prevalence of burnout syndrome among intensivist doctors was observed. Strategies for the promotion and protection of health in these workers must be discussed and implemented in hospitals.

Carga de trabalho em unidade coronariana segundo o Nursing Activities Score

OBJECTIVE this study aimed to using the Nursing Activities Score to assess nursing workload in a coronary care unit, to assess the distribution of workload between shifts, and to compare the current staff of the care unit with that recommended by the instrument. METHOD this was a longitudinal study, conducted in a teaching hospital in Southern Brazil, between April to June 2012. RESULTS A total of 604 NAS measures were obtained from the 61 patients included. The mean workload per shift was 47% (±12), with the greatest workload being reported in the afternoon shifts. CONCLUSION according to the NAS, a mean of two and a maximum of 2.4 nursing professionals would be required per shift to meet all patient demands, suggesting that the current staff size in the CCU is adequate. The NAS was successful in assessing nursing workload and changes in patient demands over time.

Risk factors for fall occurrence in hospitalized adult patients: a case-control study

ABSTRACT Objective: to identify risk factors for falls in hospitalized adult patients. Methods: a matched case-control study (one control for each case). A quantitative study conducted in clinical and surgical units of a teaching hospital in Southern Brazil. The sample comprised 358 patients. Data were collected over 18 months between 2013-2014. Data analysis was performed with descriptive statistics and conditional logistic regression using Microsoft Excel and SPSS version 18.0. Results: risk factors identified were: disorientation/confusion [OR 4.25 (1.99 to 9.08), p<0.001]; frequent urination [OR 4.50 (1.86 to 10.87), p=0.001]; walking limitation [OR 4.34 (2.05 to 9.14), p<0.001]; absence of caregiver [OR 0.37 (0.22 to 0.63), p<0.001]; postoperative period [OR 0.50 (0.26 to 0.94), p=0.03]; and number of medications administered within 72 hours prior the fall [OR 1.20 (1.04 to 1.39) p=0.01]. Conclusion: risk for falls is multifactorial. However, understanding these factors provides support to clinical decision-making and positively influences patient safety.

Carga de trabajo en unidad coronaria según la Nursing Activities Score

OBJECTIVE this study aimed to using the Nursing Activities Score to assess nursing workload in a coronary care unit, to assess the distribution of workload between shifts, and to compare the current staff of the care unit with that recommended by the instrument. METHOD this was a longitudinal study, conducted in a teaching hospital in Southern Brazil, between April to June 2012. RESULTS A total of 604 NAS measures were obtained from the 61 patients included. The mean workload per shift was 47% (±12), with the greatest workload being reported in the afternoon shifts. CONCLUSION according to the NAS, a mean of two and a maximum of 2.4 nursing professionals would be required per shift to meet all patient demands, suggesting that the current staff size in the CCU is adequate. The NAS was successful in assessing nursing workload and changes in patient demands over time.

Factores de riesgo de caídas en pacientes adultos hospitalizados: revisión integradora de la literatura

Objetivo: Identificar os fatores de risco para a ocorrencia de quedas em pacientes adultos hospitalizados. Metodo: Revisao integrativa realizada nas bases de dados LILACS, SciELO, MEDLINE e Web of Science, abrangendo artigos publicados entre 1989 e 2012. Resultados: Setenta e um artigos compuseram a amostra final do estudo. Os fatores de risco para quedas apresentados nesta revisao foram relacionados ao paciente (intrinsecos), ao ambiente hospitalar e ao processo de trabalho dos profissionais da saude, em especial a enfermagem (extrinsecos). Conclusao: A triagem sistematica de fatores de risco para queda foi identificada como fator contribuinte para a reducao desse agravo, auxiliando a nao ocorrencia deste evento que, apesar de ser prevenivel, pode determinar consequencias graves incluindo o obito.OBJECTIVE Identifying risk factors for the occurrence of falls in hospitalized adult patients. METHOD Integrative review carried out in the databases of LILACS, SciELO, MEDLINE and Web of Science, including articles published between 1989 and 2012. RESULTS Seventy-one articles were included in the final sample. Risk factors for falls presented in this review were related to patients (intrinsic), the hospital setting and the working process of health professionals, especially in nursing (extrinsic). CONCLUSION The systematic screening of risk factors for falls was identified as a contributing factor to the reduction of this injury, helping the non-occurrence of this event that, despite being preventable, can have serious consequences including death.