Franciele Soares Pott

Medidas de conforto e comunicação nas ações de cuidado de enfermagem ao paciente crítico

Descriptive, quantitative study carried out at a University Hospital in Curitiba-PR, Brazil. The objective was to analyze the caring actions performed at a semi-intensive care unit, from the perspective of the caring humanization, and also to evaluate the presence of comfort and communication measures in performing these actions. The data collection occurred under a systematic non-participant observation. The caring actions were grouped, according to its frequency, and presented in graphs. The comfort measures were present at 45% of the caring actions performed, and communication establishment was present at 40% of these actions. Even today, the comfort and communication measures, as reflected in the process of caring humanization, remain as an ideal speech. However, they are too far from reality of the health care systems users and workers.Estudio descriptivo con enfoque cuantitativo, realizado en un Hospital Universitario en Curitiba. Este estudio tuvo como objetivo analizar las acciones de atencion realizadas en un centro de terapia semi intensiva, segun la perspectiva de la humanizacion de la atencion, y evaluar la presencia de medidas de comodidad y de la comunicacion en la realizacion de estas acciones. La tecnica de recoleccion de datos fue la observacion sistematica sin participacion. Las acciones de atencion se agruparon, de acuerdo con su frecuencia, y son presentadas en graficos. Las medidas de comodidad estuvieron presentes en el 45% de las acciones de atencion desarrolladas, y la comunicacion estuve presente en el 40%. Incluso hoy en dia, las medidas de comodidad y la comunicacion, tal como se refleja en el proceso de humanizacion de la atencion, permanecen como un discurso ideal, pero lejos de la realidad para los usuarios y profesionales de la salud.

The effectiveness of hydrocolloid dressings versus other dressings in the healing of pressure ulcers in adults and older adults: a systematic review and meta-analysis

Objective to evaluate the effectiveness of hydrocolloids in the healing of pressure ulcers in adult and older adult patients. Method systematic review with meta-analysis, based on the recommendations of the Cochrane Handbook. The search was undertaken in the databases: Medical Literature Analysis and Retrieval System Online, Latin American and Caribbean Health Sciences Literature (LILACS), Cochrane Database, Cumulative Index to Nursing and Allied Health Literature, Web of Science and the Scientific Electronic Library Online. Results 646 primary studies were identified, 69 were evaluated and nine were selected, referring to the use of the hydrocolloid dressing in healing; of these, four studies allowed meta-analysis. There was no statistically significant difference between the hydrocolloid group and the foams group (p value=0.84; Odds Ratio 1.06, CI 95% 0.61-1.86). A slight superiority of the polyurethane dressings was observed in relation to the hydrocolloid dressings. Conclusion the evidence is not sufficient to affirm whether the efficacy of hydrocolloid dressings is superior to that of other dressings. It is suggested that clinical randomized trials be undertaken so as to ascertain the efficacy of this intervention in the healing of pressure ulcers, in relation to other treatments.OBJETIVO: evaluar la efectividad del hidrocoloide en la cicatrizacion de ulcera por presion en pacientes adultos y ancianos. METODO: revision sistematica con metanalisis, basada en las recomendaciones del Cochrane Handbook. La busqueda fue realizada en las bases de datos Medical Literature Analysis and Retrieval System Online, Literatura Latino-Americana y del Caribe en Ciencias de la Salud, Cochrane Database, Cumulative Index to Nursing and Allied Health Literature, Web of Science y Scientific Electronic Library Online y Scientific Electronic Library Online. RESULTADOS: fueron identificados 646 estudios primarios, evaluados 69 y seleccionados nueve, que se referian a la utilizacion del aposito en la cicatrizacion, de esos, cuatro estudios posibilitaran el metanalisis. No hubo diferencia estadisticamente significativa entre los grupos hidrocoloide y espumas (p valor=0.84; Odds Ratio 1.06, IC 95% 0.61-1.86). Fue observada una discreta superioridad del aposito de poliuretano en relacion al hidrocoloide. CONCLUSION: las evidencias no fueron suficientes para afirmar si la eficacia del hidrocoloide es superior a otros apositos. Se sugiere la realizacion de ensayos clinicos aleatorios para verificar la eficacia de esa intervencion en la cicatrizacion de ulceras por presion en relacion a otros tratamientos

Comfort and communication measures in nursing caring actions for critically ill patients

Descriptive, quantitative study carried out at a University Hospital in Curitiba-PR, Brazil. The objective was to analyze the caring actions performed at a semi-intensive care unit, from the perspective of the caring humanization, and also to evaluate the presence of comfort and communication measures in performing these actions. The data collection occurred under a systematic non-participant observation. The caring actions were grouped, according to its frequency, and presented in graphs. The comfort measures were present at 45% of the caring actions performed, and communication establishment was present at 40% of these actions. Even today, the comfort and communication measures, as reflected in the process of caring humanization, remain as an ideal speech. However, they are too far from reality of the health care systems users and workers.Estudio descriptivo con enfoque cuantitativo, realizado en un Hospital Universitario en Curitiba. Este estudio tuvo como objetivo analizar las acciones de atencion realizadas en un centro de terapia semi intensiva, segun la perspectiva de la humanizacion de la atencion, y evaluar la presencia de medidas de comodidad y de la comunicacion en la realizacion de estas acciones. La tecnica de recoleccion de datos fue la observacion sistematica sin participacion. Las acciones de atencion se agruparon, de acuerdo con su frecuencia, y son presentadas en graficos. Las medidas de comodidad estuvieron presentes en el 45% de las acciones de atencion desarrolladas, y la comunicacion estuve presente en el 40%. Incluso hoy en dia, las medidas de comodidad y la comunicacion, tal como se refleja en el proceso de humanizacion de la atencion, permanecen como un discurso ideal, pero lejos de la realidad para los usuarios y profesionales de la salud.

La efectividad del hidrocoloide versus otros apósitos en la cicatrización de úlceras por presión en adultos y ancianos: revisión sistemática y metanálisis

Objective to evaluate the effectiveness of hydrocolloids in the healing of pressure ulcers in adult and older adult patients. Method systematic review with meta-analysis, based on the recommendations of the Cochrane Handbook. The search was undertaken in the databases: Medical Literature Analysis and Retrieval System Online, Latin American and Caribbean Health Sciences Literature (LILACS), Cochrane Database, Cumulative Index to Nursing and Allied Health Literature, Web of Science and the Scientific Electronic Library Online. Results 646 primary studies were identified, 69 were evaluated and nine were selected, referring to the use of the hydrocolloid dressing in healing; of these, four studies allowed meta-analysis. There was no statistically significant difference between the hydrocolloid group and the foams group (p value=0.84; Odds Ratio 1.06, CI 95% 0.61-1.86). A slight superiority of the polyurethane dressings was observed in relation to the hydrocolloid dressings. Conclusion the evidence is not sufficient to affirm whether the efficacy of hydrocolloid dressings is superior to that of other dressings. It is suggested that clinical randomized trials be undertaken so as to ascertain the efficacy of this intervention in the healing of pressure ulcers, in relation to other treatments.OBJETIVO: evaluar la efectividad del hidrocoloide en la cicatrizacion de ulcera por presion en pacientes adultos y ancianos. METODO: revision sistematica con metanalisis, basada en las recomendaciones del Cochrane Handbook. La busqueda fue realizada en las bases de datos Medical Literature Analysis and Retrieval System Online, Literatura Latino-Americana y del Caribe en Ciencias de la Salud, Cochrane Database, Cumulative Index to Nursing and Allied Health Literature, Web of Science y Scientific Electronic Library Online y Scientific Electronic Library Online. RESULTADOS: fueron identificados 646 estudios primarios, evaluados 69 y seleccionados nueve, que se referian a la utilizacion del aposito en la cicatrizacion, de esos, cuatro estudios posibilitaran el metanalisis. No hubo diferencia estadisticamente significativa entre los grupos hidrocoloide y espumas (p valor=0.84; Odds Ratio 1.06, IC 95% 0.61-1.86). Fue observada una discreta superioridad del aposito de poliuretano en relacion al hidrocoloide. CONCLUSION: las evidencias no fueron suficientes para afirmar si la eficacia del hidrocoloide es superior a otros apositos. Se sugiere la realizacion de ensayos clinicos aleatorios para verificar la eficacia de esa intervencion en la cicatrizacion de ulceras por presion en relacion a otros tratamientos

Second-Generation central venous catheter in the prevention of bloodstream infection: a systematic review

Abstract Objective: to evaluate the effectiveness and safety in the use of second-generation central venous catheters impregnated in clorhexidine and silver sulfadiazine when compared with other catheters, being them impregnated or not, in order to prevent the bloodstream infection prevention. Method: systematic review with meta-analysis. Databases searched: MEDLINE, EMBASE, CINAHL, LILACS/SciELO, Cochrane CENTRAL; search in Congress Proceedings and records from Clinical Trials. Results: 1.235 studies were identified, 97 were pre-selected and 4 were included. In catheter-related bloodstream infection, there was no statistical significance between second-generation impregnated catheter compared with the non-impregnated ones, absolute relative risk 1,5% confidence interval 95% (3%-1%), relative risk 0,68 (confidence interval 95%, 0,40-1,15) and number needed to treat 66. In the sensitivity analysis, there was less bloodstream infection in impregnated catheters (relative risk 0,50, confidence interval 95%, 0,26-0,96). Lower colonization, absolute relative risk 9,6% (confidence interval 95%, 10% to 4%), relative risk 0,51 (confidence interval 95% from 0,38-0,85) and number needed to treat 5. Conclusion: the use of second-generation catheters was effective in reducing the catheter colonization and infection when a sensitivity analysis is performed. Future clinical trials are suggested to evaluate sepsis rates, mortality and adverse effects.Objetivo: avaliar a efetividade e seguranca do uso de cateteres venosos centrais de segunda geracao, impregnados em clorexidina e sulfadiazina de prata, comparados com outros cateteres impregnados ou nao, na prevencao de infeccao de corrente sanguinea. Metodo: revisao sistematica com metanalise. Busca realizada nas bases: MEDLINE, EMBASE, CINAHL, LILACS/SciELO, Cochrane CENTRAL; consulta em anais de congresso e registro de ensaios clinicos. Resultados: foram identificados 1.235 estudos, 97 pre-selecionados e quatro incluidos. Na infeccao de corrente sanguinea, relacionada ao cateter, nao houve significância estatistica entre cateter de segunda geracao impregnado em comparacao aos nao impregnados risco relativo absoluto 1,5%, intervalo de confianca 95% (3%-1%), risco relativo 0,68 (intervalo de confianca 95%, 0,40-1,15) e numero necessario para tratar 66. Na analise de sensibilidade, houve diminuicao da infeccao de corrente sanguinea nos cateteres impregnados (risco relativo 0,50, intervalo de confianca 95%, 0,26-0,96). Reducao da colonizacao, risco relativo absoluto de 9,6% (intervalo de confianca 95%, 10% a 4%), risco relativo 0,51 (intervalo de confianca 95% de 0,38-0,85) e numero necessario para tratar 5. Conclusao: o uso dos cateteres de segunda geracao foi efetivo na reducao de colonizacao do cateter e de infeccao quando realizada analise de sensibilidade. Sugerem-se ensaios clinicos futuros que avaliem taxas de sepse, mortalidade e efeitos adversos.

Hyaluronic acid covers in burn treatment: a systematic review

OBJECTIVE To evaluate the effectiveness of hyaluronic acid in the healing of partial thickness burns. METHOD Systematic review of randomized controlled trials on the use of hyaluronic acid for the topical treatment of skin burns, based on recommendations of the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS Two randomized controlled trials that analyzed 143 patients with partial thickness burns and/or deep partial thickness burns were selected. They compared the application of hyaluronic acid 0.2% associated to silver sulfadiazine 1% 5g/cm2 versus silver sulfadiazine 1% 5g/cm2 alone for the outcome of complete healing. CONCLUSION This review emphasizes the need for new well-designed randomized controlled trials to establish the therapeutic relevance of hyaluronic acid with respect to the healing of burns of partial thickness or deep partial thickness. OBJETIVO Avaliar a efetividade do ácido hialurônico na cicatrização de queimaduras de espessura parcial. MÉTODO Revisão sistemática de ensaios clínicos randomizados sobre a utilização de ácido hialurônico no tratamento tópico de queimaduras de pele, baseada nas recomendações do Cochrane Handbook for Systematic Reviews of Interventions. RESULTADOS Foram recuperados dois ensaios clínicos randomizados que analisaram 143 pacientes portadores de queimaduras de espessura parcial e/ou espessura parcial profunda, comparando a aplicação de Ácido Hialurônico 0,2% associado à Sulfadiazina de Prata 1% 5g/cm2, versus Sulfadiazina de Prata 1% 5g/cm2 isolada, para o desfecho cicatrização completa. CONCLUSÃO Esta revisão enfatiza a necessidade de novos ensaios clínicos randomizados bem delineados para estabelecimento da relevância terapêutica do ácido hialurônico no que tange à cicatrização de queimaduras de espessura parcial ou espessura parcial profunda.

A efetividade do hidrocoloide versus outras coberturas na cicatrização de úlceras por pressão em adultos e idosos: revisão sistemática e metanálise

Objective to evaluate the effectiveness of hydrocolloids in the healing of pressure ulcers in adult and older adult patients. Method systematic review with meta-analysis, based on the recommendations of the Cochrane Handbook. The search was undertaken in the databases: Medical Literature Analysis and Retrieval System Online, Latin American and Caribbean Health Sciences Literature (LILACS), Cochrane Database, Cumulative Index to Nursing and Allied Health Literature, Web of Science and the Scientific Electronic Library Online. Results 646 primary studies were identified, 69 were evaluated and nine were selected, referring to the use of the hydrocolloid dressing in healing; of these, four studies allowed meta-analysis. There was no statistically significant difference between the hydrocolloid group and the foams group (p value=0.84; Odds Ratio 1.06, CI 95% 0.61-1.86). A slight superiority of the polyurethane dressings was observed in relation to the hydrocolloid dressings. Conclusion the evidence is not sufficient to affirm whether the efficacy of hydrocolloid dressings is superior to that of other dressings. It is suggested that clinical randomized trials be undertaken so as to ascertain the efficacy of this intervention in the healing of pressure ulcers, in relation to other treatments.OBJETIVO: evaluar la efectividad del hidrocoloide en la cicatrizacion de ulcera por presion en pacientes adultos y ancianos. METODO: revision sistematica con metanalisis, basada en las recomendaciones del Cochrane Handbook. La busqueda fue realizada en las bases de datos Medical Literature Analysis and Retrieval System Online, Literatura Latino-Americana y del Caribe en Ciencias de la Salud, Cochrane Database, Cumulative Index to Nursing and Allied Health Literature, Web of Science y Scientific Electronic Library Online y Scientific Electronic Library Online. RESULTADOS: fueron identificados 646 estudios primarios, evaluados 69 y seleccionados nueve, que se referian a la utilizacion del aposito en la cicatrizacion, de esos, cuatro estudios posibilitaran el metanalisis. No hubo diferencia estadisticamente significativa entre los grupos hidrocoloide y espumas (p valor=0.84; Odds Ratio 1.06, IC 95% 0.61-1.86). Fue observada una discreta superioridad del aposito de poliuretano en relacion al hidrocoloide. CONCLUSION: las evidencias no fueron suficientes para afirmar si la eficacia del hidrocoloide es superior a otros apositos. Se sugiere la realizacion de ensayos clinicos aleatorios para verificar la eficacia de esa intervencion en la cicatrizacion de ulceras por presion en relacion a otros tratamientos

Medidas de comodidad y comunicación en las acciones de atención de enfermería a pacientes críticos

Descriptive, quantitative study carried out at a University Hospital in Curitiba-PR, Brazil. The objective was to analyze the caring actions performed at a semi-intensive care unit, from the perspective of the caring humanization, and also to evaluate the presence of comfort and communication measures in performing these actions. The data collection occurred under a systematic non-participant observation. The caring actions were grouped, according to its frequency, and presented in graphs. The comfort measures were present at 45% of the caring actions performed, and communication establishment was present at 40% of these actions. Even today, the comfort and communication measures, as reflected in the process of caring humanization, remain as an ideal speech. However, they are too far from reality of the health care systems users and workers.Estudio descriptivo con enfoque cuantitativo, realizado en un Hospital Universitario en Curitiba. Este estudio tuvo como objetivo analizar las acciones de atencion realizadas en un centro de terapia semi intensiva, segun la perspectiva de la humanizacion de la atencion, y evaluar la presencia de medidas de comodidad y de la comunicacion en la realizacion de estas acciones. La tecnica de recoleccion de datos fue la observacion sistematica sin participacion. Las acciones de atencion se agruparon, de acuerdo con su frecuencia, y son presentadas en graficos. Las medidas de comodidad estuvieron presentes en el 45% de las acciones de atencion desarrolladas, y la comunicacion estuve presente en el 40%. Incluso hoy en dia, las medidas de comodidad y la comunicacion, tal como se refleja en el proceso de humanizacion de la atencion, permanecen como un discurso ideal, pero lejos de la realidad para los usuarios y profesionales de la salud.