Edi Toma

Localização inicial da ponta de cateter central de inserção periférica (PICC) em recém-nascidos

This is a cross-sectional study aiming to identify the initial tip position of peripherally inserted central catheters (PICC) and to verify the prevalence of success in inserting such catheters in neonates. The study was carried out in the neonatal care unit of Hospital das Clinicas, Universidade de Sao Paulo. Data were collected prospectively from March to September 2006. 37 neonates underwent PICC insertion were included in the study. The rate of success for this procedure was 72.3% (27 neonates). Of them, four (14.8%) had the catheter tips placed in the axilary or inominate veins. Three others (11.1%) had them placed in a jugular vein. When these catheters were removed, 13 (48.2%) catheter tip were placed in the right atrium, and they were relocated to the superior vena cava.This is a cross-sectional study aiming to identify the initial tip position of peripherally inserted central catheters (PICC) and to verify the prevalence of success in inserting such catheters in neonates. The study was carried out in the neonatal care unit of Hospital das Clinicas, Universidade de São Paulo. Data were collected prospectively from March to September 2006. 37 neonates underwent PICC insertion were included in the study. The rate of success for this procedure was 72.3% (27 neonates). Of them, four (14.8%) had the catheter tips placed in the axilary or inominate veins. Three others (11.1%) had them placed in a jugular vein. When these catheters were removed, 13 (48.2%) catheter tip were placed in the right atrium, and they were relocated to the superior vena cava.

Assessment of a neonatal unit nursing staff: application of the Nursing Activities Score

OBJETIVO: estudio propone analizar la carga de trabajo de enfermeria de los sectores de una unidad neonatal por medio del Nursing Activities Score - NAS, y calcular el cuantitativo ideal del equipo, comparandolo con la actual. METODO: el instrumento NAS fue aplicado en todos los recien nacidos internados por como minimo 24 horas; la suma de los puntos del NAS suministro la carga de trabajo de la unidad, la cual fue utilizada para el calculo del dimensionamiento del equipo por medio de la ecuacion matematica. RESULTADOS: El sector de Bajo Riesgo presento carga de trabajo de 267 medidas NAS, y desfase de 8,8 profesionales diariamente; el Mediano Riesgo, carga de 446,7, y desfase de 22,3; el Alto Riesgo, carga de 359, y deficit de 17,9; el sector Aislamiento, demanda de 609, y desfase de 18,2; y UTI, 568,6 de carga, con deficit de 16,1 empleados. CONCLUSION: el estudio revelo desfase importante de profesionales con relacion a la elevada demanda de trabajo a la cual estan sometidos diariamente. La aplicacion del Nursing Activities Score en unidades neonatales contribuyo a la evaluacion de la carga de trabajo y dimensionamiento del equipo de enfermeria.OBJECTIVE The study proposes to analyze the nursing staff workload of the sectors of a neonatal unit by means of the Nursing Activities Score - NAS and to calculate the quantitative ideal for the team, comparing it with the current workload. METHOD The NAS tool was applied for all newborns interned for at least 24 hours; the sum of the NAS points provided the unit workload which was used for calculating the team assessment by means of mathematical equation. RESULTS The sector of Low Risk presented a workload of 267 NAS points and an imbalance of 8.8 professionals daily; the Medium Risk sector a workload of 446.7 and an imbalance of 22.3; the High Risk sector a workload of 359 and a deficit of 17.9; the Isolation sector a demand of 609 and an imbalance of 18.2; and NICU a workload of 568.6 with a deficit of 16.1 professionals. CONCLUSION The study disclosed an important imbalance of professionals in relation to the exalted work demand they are subjected to daily. The application of the Nursing Activities Score in neonatal units contributes to the evaluation of the workload and assessment of the nursing team.

Initial placement of the peripherally inserted central catheter's tip in neonates

This is a cross-sectional study aiming to identify the initial tip position of peripherally inserted central catheters (PICC) and to verify the prevalence of success in inserting such catheters in neonates. The study was carried out in the neonatal care unit of Hospital das Clinicas, Universidade de Sao Paulo. Data were collected prospectively from March to September 2006. 37 neonates underwent PICC insertion were included in the study. The rate of success for this procedure was 72.3% (27 neonates). Of them, four (14.8%) had the catheter tips placed in the axilary or inominate veins. Three others (11.1%) had them placed in a jugular vein. When these catheters were removed, 13 (48.2%) catheter tip were placed in the right atrium, and they were relocated to the superior vena cava.This is a cross-sectional study aiming to identify the initial tip position of peripherally inserted central catheters (PICC) and to verify the prevalence of success in inserting such catheters in neonates. The study was carried out in the neonatal care unit of Hospital das Clinicas, Universidade de São Paulo. Data were collected prospectively from March to September 2006. 37 neonates underwent PICC insertion were included in the study. The rate of success for this procedure was 72.3% (27 neonates). Of them, four (14.8%) had the catheter tips placed in the axilary or inominate veins. Three others (11.1%) had them placed in a jugular vein. When these catheters were removed, 13 (48.2%) catheter tip were placed in the right atrium, and they were relocated to the superior vena cava.

Dimensionamento de pessoal de enfermagem de uma unidade neonatal: utilização do Nursing Activities Score

OBJETIVO: estudio propone analizar la carga de trabajo de enfermeria de los sectores de una unidad neonatal por medio del Nursing Activities Score - NAS, y calcular el cuantitativo ideal del equipo, comparandolo con la actual. METODO: el instrumento NAS fue aplicado en todos los recien nacidos internados por como minimo 24 horas; la suma de los puntos del NAS suministro la carga de trabajo de la unidad, la cual fue utilizada para el calculo del dimensionamiento del equipo por medio de la ecuacion matematica. RESULTADOS: El sector de Bajo Riesgo presento carga de trabajo de 267 medidas NAS, y desfase de 8,8 profesionales diariamente; el Mediano Riesgo, carga de 446,7, y desfase de 22,3; el Alto Riesgo, carga de 359, y deficit de 17,9; el sector Aislamiento, demanda de 609, y desfase de 18,2; y UTI, 568,6 de carga, con deficit de 16,1 empleados. CONCLUSION: el estudio revelo desfase importante de profesionales con relacion a la elevada demanda de trabajo a la cual estan sometidos diariamente. La aplicacion del Nursing Activities Score en unidades neonatales contribuyo a la evaluacion de la carga de trabajo y dimensionamiento del equipo de enfermeria.OBJECTIVE The study proposes to analyze the nursing staff workload of the sectors of a neonatal unit by means of the Nursing Activities Score - NAS and to calculate the quantitative ideal for the team, comparing it with the current workload. METHOD The NAS tool was applied for all newborns interned for at least 24 hours; the sum of the NAS points provided the unit workload which was used for calculating the team assessment by means of mathematical equation. RESULTS The sector of Low Risk presented a workload of 267 NAS points and an imbalance of 8.8 professionals daily; the Medium Risk sector a workload of 446.7 and an imbalance of 22.3; the High Risk sector a workload of 359 and a deficit of 17.9; the Isolation sector a demand of 609 and an imbalance of 18.2; and NICU a workload of 568.6 with a deficit of 16.1 professionals. CONCLUSION The study disclosed an important imbalance of professionals in relation to the exalted work demand they are subjected to daily. The application of the Nursing Activities Score in neonatal units contributes to the evaluation of the workload and assessment of the nursing team.

Complications related to the type of epicutaneous catheter in a cohort of neonates

Objetivos: analisar a relacao entre o tipo de cateter epicutâneo instalado e o tempo ate a ocorrencia de complicacoes que motivam a remocao precoce do dispositivo. Metodo: Coorte prospectiva, realizada em uma unidade de cuidados intensivos neonatais de um hospital privado na cidade de Sao Paulo, no periodo de 01 de julho de 2010 a 30 de junho de 2011. A coorte foi composta por neonatos submetidos a instalacao do cateter epicutâneo duplolumen de poliuretano ou monolumen de silicone. Resultados e discussao: Foram analisados 270 cateteres. Nao houve associacao entre o tipo de cateter epicutâneo e o tempo ate a ocorrencia de complicacoes (p=0,45). O cateter duplolumen de poliuretano apresentou maior tempo medio de permanencia do cateter (p≤0,01). Conclusao: Os dois tipos de cateteres epicutâneos permitiram a infusao intravenosa por mais de 10 dias e nao apresentaram complicacoes mais graves.

Dimensionamiento de personal de enfermería de una unidad neonatal: utilización del Nursing Activities Score

OBJETIVO: estudio propone analizar la carga de trabajo de enfermeria de los sectores de una unidad neonatal por medio del Nursing Activities Score - NAS, y calcular el cuantitativo ideal del equipo, comparandolo con la actual. METODO: el instrumento NAS fue aplicado en todos los recien nacidos internados por como minimo 24 horas; la suma de los puntos del NAS suministro la carga de trabajo de la unidad, la cual fue utilizada para el calculo del dimensionamiento del equipo por medio de la ecuacion matematica. RESULTADOS: El sector de Bajo Riesgo presento carga de trabajo de 267 medidas NAS, y desfase de 8,8 profesionales diariamente; el Mediano Riesgo, carga de 446,7, y desfase de 22,3; el Alto Riesgo, carga de 359, y deficit de 17,9; el sector Aislamiento, demanda de 609, y desfase de 18,2; y UTI, 568,6 de carga, con deficit de 16,1 empleados. CONCLUSION: el estudio revelo desfase importante de profesionales con relacion a la elevada demanda de trabajo a la cual estan sometidos diariamente. La aplicacion del Nursing Activities Score en unidades neonatales contribuyo a la evaluacion de la carga de trabajo y dimensionamiento del equipo de enfermeria.OBJECTIVE The study proposes to analyze the nursing staff workload of the sectors of a neonatal unit by means of the Nursing Activities Score - NAS and to calculate the quantitative ideal for the team, comparing it with the current workload. METHOD The NAS tool was applied for all newborns interned for at least 24 hours; the sum of the NAS points provided the unit workload which was used for calculating the team assessment by means of mathematical equation. RESULTS The sector of Low Risk presented a workload of 267 NAS points and an imbalance of 8.8 professionals daily; the Medium Risk sector a workload of 446.7 and an imbalance of 22.3; the High Risk sector a workload of 359 and a deficit of 17.9; the Isolation sector a demand of 609 and an imbalance of 18.2; and NICU a workload of 568.6 with a deficit of 16.1 professionals. CONCLUSION The study disclosed an important imbalance of professionals in relation to the exalted work demand they are subjected to daily. The application of the Nursing Activities Score in neonatal units contributes to the evaluation of the workload and assessment of the nursing team.

Reliability of an instrument to classify newborns according to care complexity

In most maternity units, the physician classifies, evaluates, and determines which unit will receive the newborn (NB) after birth. Evaluation occurs in the delivery room, taking into consideration the following factors: birth weight, gestational age, and behaviors that define the clinical picture and disease. This observational study evaluates the reliability of an NB classification instrument. The study was conducted at the nursery of a public hospital in São Paulo. Nine nurses applied the instrument to 63 NB, with two of the nurses working simultaneously in each of the nurserys five sectors. The Kappa level of agreement among the nurses was found to be excellent for most care areas (69.0%). It was concluded that there was a consensus and agreement among the nurses that the instrument was complete, easy to understand and applicable, but was very time consuming. The nurses recognize the instruments importance for the allocation of professionals, organization, and care planning.In most maternity units, the physician classifies, evaluates, and determines which unit will receive the newborn (NB) after birth. Evaluation occurs in the delivery room, taking into consideration the following factors: birth weight, gestational age, and behaviors that define the clinical picture and disease. This observational study evaluates the reliability of an NB classification instrument. The study was conducted at the nursery of a public hospital in Sao Paulo. Nine nurses applied the instrument to 63 NB, with two of the nurses working simultaneously in each of the nursery’s five sectors. The Kappa level of agreement among the nurses was found to be excellent for most care areas (69.0%). It was concluded that there was a consensus and agreement among the nurses that the instrument was complete, easy to understand and applicable, but was very time consuming. The nurses recognize the instrument’s importance for the allocation of professionals, organization, and care planning.

Confiabilidad de un instrumento para clasificar al recién nacido de acuerdo con la complejidad de la atención

In most maternity units, the physician classifies, evaluates, and determines which unit will receive the newborn (NB) after birth. Evaluation occurs in the delivery room, taking into consideration the following factors: birth weight, gestational age, and behaviors that define the clinical picture and disease. This observational study evaluates the reliability of an NB classification instrument. The study was conducted at the nursery of a public hospital in São Paulo. Nine nurses applied the instrument to 63 NB, with two of the nurses working simultaneously in each of the nurserys five sectors. The Kappa level of agreement among the nurses was found to be excellent for most care areas (69.0%). It was concluded that there was a consensus and agreement among the nurses that the instrument was complete, easy to understand and applicable, but was very time consuming. The nurses recognize the instruments importance for the allocation of professionals, organization, and care planning.In most maternity units, the physician classifies, evaluates, and determines which unit will receive the newborn (NB) after birth. Evaluation occurs in the delivery room, taking into consideration the following factors: birth weight, gestational age, and behaviors that define the clinical picture and disease. This observational study evaluates the reliability of an NB classification instrument. The study was conducted at the nursery of a public hospital in Sao Paulo. Nine nurses applied the instrument to 63 NB, with two of the nurses working simultaneously in each of the nursery’s five sectors. The Kappa level of agreement among the nurses was found to be excellent for most care areas (69.0%). It was concluded that there was a consensus and agreement among the nurses that the instrument was complete, easy to understand and applicable, but was very time consuming. The nurses recognize the instrument’s importance for the allocation of professionals, organization, and care planning.

Confiabilidade de um instrumento para classificar o recém-nascido segundo a complexidade assistencial

In most maternity units, the physician classifies, evaluates, and determines which unit will receive the newborn (NB) after birth. Evaluation occurs in the delivery room, taking into consideration the following factors: birth weight, gestational age, and behaviors that define the clinical picture and disease. This observational study evaluates the reliability of an NB classification instrument. The study was conducted at the nursery of a public hospital in São Paulo. Nine nurses applied the instrument to 63 NB, with two of the nurses working simultaneously in each of the nurserys five sectors. The Kappa level of agreement among the nurses was found to be excellent for most care areas (69.0%). It was concluded that there was a consensus and agreement among the nurses that the instrument was complete, easy to understand and applicable, but was very time consuming. The nurses recognize the instruments importance for the allocation of professionals, organization, and care planning.In most maternity units, the physician classifies, evaluates, and determines which unit will receive the newborn (NB) after birth. Evaluation occurs in the delivery room, taking into consideration the following factors: birth weight, gestational age, and behaviors that define the clinical picture and disease. This observational study evaluates the reliability of an NB classification instrument. The study was conducted at the nursery of a public hospital in Sao Paulo. Nine nurses applied the instrument to 63 NB, with two of the nurses working simultaneously in each of the nursery’s five sectors. The Kappa level of agreement among the nurses was found to be excellent for most care areas (69.0%). It was concluded that there was a consensus and agreement among the nurses that the instrument was complete, easy to understand and applicable, but was very time consuming. The nurses recognize the instrument’s importance for the allocation of professionals, organization, and care planning.

Localización inicial de la punta del catéter central de inserción periférica (PICC) en recién nacidos

This is a cross-sectional study aiming to identify the initial tip position of peripherally inserted central catheters (PICC) and to verify the prevalence of success in inserting such catheters in neonates. The study was carried out in the neonatal care unit of Hospital das Clinicas, Universidade de Sao Paulo. Data were collected prospectively from March to September 2006. 37 neonates underwent PICC insertion were included in the study. The rate of success for this procedure was 72.3% (27 neonates). Of them, four (14.8%) had the catheter tips placed in the axilary or inominate veins. Three others (11.1%) had them placed in a jugular vein. When these catheters were removed, 13 (48.2%) catheter tip were placed in the right atrium, and they were relocated to the superior vena cava.This is a cross-sectional study aiming to identify the initial tip position of peripherally inserted central catheters (PICC) and to verify the prevalence of success in inserting such catheters in neonates. The study was carried out in the neonatal care unit of Hospital das Clinicas, Universidade de São Paulo. Data were collected prospectively from March to September 2006. 37 neonates underwent PICC insertion were included in the study. The rate of success for this procedure was 72.3% (27 neonates). Of them, four (14.8%) had the catheter tips placed in the axilary or inominate veins. Three others (11.1%) had them placed in a jugular vein. When these catheters were removed, 13 (48.2%) catheter tip were placed in the right atrium, and they were relocated to the superior vena cava.