Graciele Fernanda da Costa Linch

Advanced Nursing Process quality: Comparing the International Classification for Nursing Practice (ICNP) with the NANDA-International (NANDA-I) and Nursing Interventions Classification (NIC).

AIMS AND OBJECTIVESnTo assess the quality of the advanced nursing process in nursing documentation in two hospitals.nnnBACKGROUNDnVarious standardised terminologies are employed by nurses worldwide, whether for teaching, research or patient care. These systems can improve the quality of nursing records, enable care continuity, consistency in written communication and enhance safety for patients and providers alike.nnnDESIGNnCross-sectional study.nnnMETHODSnA total of 138 records from two facilities (69 records from each facility) were analysed, one using the NANDA-International and Nursing Interventions Classification terminology (Centre 1) and one the International Classification for Nursing Practice (Centre 2), by means of the Quality of Diagnoses, Interventions, and Outcomes instrument. Quality of Diagnoses, Interventions, and Outcomes scores range from 0-58 points. Nursing records were dated 2012-2013 for Centre 1 and 2010-2011 for Centre 2.nnnRESULTSnCentre 1 had a Quality of Diagnoses, Interventions, and Outcomes score of 35·46 (±6·45), whereas Centre 2 had a Quality of Diagnoses, Interventions, and Outcomes score of 31·72 (±4·62) (pxa0<xa00·001). Centre 2 had higher scores in the Nursing Diagnoses as Process dimension, whereas in the Nursing Diagnoses as Product, Nursing Interventions and Nursing Outcomes dimensions, Centre 1 exhibited superior performance; acceptable reliability values were obtained for both centres, except for the Nursing Interventions domain in Centre 1 and the Nursing Diagnoses as Process and Nursing Diagnoses as Product domains in Centre 2.nnnCONCLUSIONnThe quality of nursing documentation was superior at Centre 1, although both facilities demonstrated moderate scores considering the maximum potential score of 58 points. Reliability analyses showed satisfactory results for both standardised terminologies.nnnRELEVANCE TO CLINICAL PRACTICEnNursing leaders should use a validated instrument to investigate the quality of nursing records after implementation of standardised terminologies.

Discomfort Reported by Patients After Cardiac Catheterization Using the Femoral or Radial Approaches

ABSTRACT Background Complaints of patients undergoing invasive percutaneous procedures are a frequent finding. Our objective was to assess the discomfort of patients undergoing cardiac catheterization using femoral or radial approach. Methods Cross-sectional study with a non-probabilistic sample of adults undergoing catheterization. Data were collected through a questionnaire. Results We included 228 patients, of whom 205 underwent the procedure via the femoral approach and 23 by the radial approach. A 6xa0F arterial sheath was used in all patients. Mean age was 60.0xa0±xa011.5xa0years and most of them were male (50.4%). The main complaints were lumbar pain in 65.8% and malaise in 32.0% of the cases. In a scale of 0 to 10, the average value assigned for lumbar pain intensity was 5.0xa0±xa04.2 and 1.5xa0±xa02.7 for pain at the puncture site. Patients who used the radial approach reported having more pain at the puncture site than patients who used the femoral access (26.8% vs. 52.2%; pxa0=xa00.01). However, patients who used the femoral approach most often reported lumbar pain (69.8% vs. 30.4%; p Conclusions The predominant discomfort after femoral puncture was lumbar pain and in patients undergoing radial puncture it was pain at the access site. Our findings corroborate the recommendations for a clinical practice that promotes better patient care, including comfort measures, such as the use of cushions, changes in body position, supervised ambulation and the creation of a welcoming environment.

Desconfortos Relatados Pelos Pacientes Após Cateterismo Cardíaco Pelas Vias Femoral ou Radial

Background: Complaints of patients undergoing invasive per-cutaneous procedures are a frequent finding. Our objective was to assess the discomfort of patients undergoing cardiac catheterization using femoral or radial approach. Methods: Cross-sectional study with a non-probabilistic sample of adults undergoing catheterization. Data were collected through a questionnaire. Results: We included 228 patients, 205 who underwent the procedure via the femoral approach and 23 by the radial approach. A 6 F arterial sheath was used in all patients. Mean age was 60.0 ± 11.5 years and most of them were male (50.4%). The main complaints were lumbar pain in 65.8% and malaise in 32.0% of the cases. In a scale of 0 to 10, the average value assigned for lumbar pain intensity was 5.0 ± 4.2 and 1.5 ± 2.7 for pain at the puncture site. Patients who used the radial approach reported having more pain at the puncture site than patients who used the femoral access (26.8% vs. 52.2%; p = 0.01). However, patients who used the femoral approach most often reported lumbar pain (69.8% vs. 30.4%; p < 0.01) and malaise (34.6% vs. 8.7%; p = 0.01). Conclusions: The predominant discomfort after femoral puncture was lumbar pain and in patients undergoing radial puncture it was pain at the access site. Our findings corroborate the recommendations for a clinical practice that promotes better patient care, including comfort measures, such as the use of cushions, changes in body position, supervised ambulation and the creation of a welcoming environment.

ESTRATÉGIAS DIDÁTICAS NO PROCESSO DE ENSINO-APRENDIZAGEM DE GESTÃO EM ENFERMAGEM

Objective: to analyz the didactic strategies used in the teaching and learning process of nursing management. Method: an integrative review of the literature available in the Latin American and Caribbean Literature in Health Sciences and the Scientific Electronic Library Online databases using the following descriptors and keywords in Portuguese: teaching, nursing, management, administration, management, nursing education, organization and administration, distance education and health management. The sample consisted of 23 publications. Results: the didactic strategies used for teaching nursing management are especially related to the independent working method and team work method. Strategies that make the articulation between theory and practice possible are highlighted such as: situational strategic planning, the problematization methodology using Maguerez’ Arch, seminars, workshops, and dialogued and interactive lectures/classes. Conclusion: teaching nursing management is following the pedagogical changes of higher education in the health area. DESCRIPTORS: Higher education. Nursing faculty. Nursing faculty practice. Management. Nursing administration research. ESTRATÉGIAS DIDÁTICAS NO PROCESSO DE ENSINO-APRENDIZAGEM DE GESTÃO EM ENFERMAGEMObjective: to analyz the didactic strategies used in the teaching and learning process of nursing management. Method: an integrative review of the literature available in the Latin American and Caribbean Literature in Health Sciences and the Scientific Electronic Library Online databases using the following descriptors and keywords in Portuguese: teaching, nursing, management, administration, management, nursing education, organization and administration, distance education and health management. The sample consisted of 23 publications. Results: the didactic strategies used for teaching nursing management are especially related to the independent working method and team work method. Strategies that make the articulation between theory and practice possible are highlighted such as: situational strategic planning, the problematization methodology using Maguerez’ Arch, seminars, workshops, and dialogued and interactive lectures/classes. Conclusion: teaching nursing management is following the pedagogical changes of higher education in the health area

Situação da cobertura vacinal de imunobiológicos no período de 2009-2014

Aim: to check the status of vaccination coverage in the three political and administrative levels in the period from 2009-2014. Method: historical series study. The information used was available in the Computer Department of Health System related to biopharmaceuticals: Tuberculosis, Route Human Virus, Hepatitis B, Polio, MMR Fever Amarelae. Results: It was found that, in Brazil, the covers are stable, keeping immunobiologicals above the target during the period. In the State there was an increase of vaccination coverage of all biopharmaceuticals from 2013 on. The municipality from Rio Grande do Sul followed the design of the country and the state in coverage in the period from 2009-2011, declining in the last two years. Conclusion: the analyzed vaccination coverage were mostly similar among the three spheres. However, from 2012 to 2013, the municipality’s coverage dropped down. The heterogeneity of the covers points as necessary the definition of strategies able to direct the actions of nursing to the prevention of immunopreventable diseases.

Impacto de uma intervenção educativa na qualidade dos registros de enfermagem

ABSTRACT Objective: to evaluate the impact of an educational intervention on the quality of nursing records. Method: quasi-experimental study with before-and-after design conducted in a hospital. All the nurses in the cardiac intensive care unit of the hospital received the intervention, which consisted of weekly meetings during five months. To collect data, the instrument Quality of Diagnoses, Interventions and Outcomes was applied to the patients’ charts in two moments: baseline and after intervention. Results: the educational intervention had an impact on the quality of the records, since most of the items presented a significant increase in their mean values after the intervention, despite the low values in the two moments. Conclusion: the educational intervention proved to be effective at improving the quality of nursing records and a lack of quality was identified in the evaluated records, revealed by the low mean values and by the weakness of some questions presented in the items, which did not present a significant increase. Therefore, educational actions focused on real clinical cases may have positive implications for nursing practice.Objetivo: evaluar el impacto de una intervencion educativa en la calidad de las anotaciones de enfermeria. Metodo: se trata de un estudio cuasi-experimental del tipo antes y despues, realizado en una institucion hospitalaria. Todas las enfermeras de la unidad de cuidados intensivos de cardiologia del hospital en cuestion recibieron la intervencion compuesta por sesiones semanales, durante cinco meses. Para la recoleccion de datos de las historias clinicas de los pacientes, se utilizo el instrumento Quality of Diagnoses, Interventions and Outcomes (Calidad de Diagnosticos, Intervenciones y Resultados), aplicado en dos momentos, basal y pos-intervencion. Resultados: la intervencion educativa causo efecto en la calidad de las anotaciones, visto que la mayoria de los items aumento significativamente los valores medios posteriores a la intervencion, a pesar de los promedios bajos de los items en los dos momentos. Conclusion: se demostro la efectividad de la intervencion para mejorar la calidad de las anotaciones de enfermeria y se evidencio la falta de calidad de las anotaciones evaluadas, revelada por los valores bajos del promedio y la fragilidad de algunas preguntas presentadas en los items, las cuales no obtuvieron un aumento significativo. Por eso, acciones educativas, con enfoque en casos reales, pueden impactar positivamente en la practica de enfermeria.

Posoperatorio inmediato de trasplante pulmonar: mapeo de intervenciones de enfermería

OBJETIVOS: conocer las principales intervenciones/acciones de enfermeria prescritas para el posoperatorio inmediato de los receptores de trasplante pulmonar, registrados en las fichas medicas y mapear esas prescripciones con la taxonomia Nursing Interventions Classification (NIC). METODO: investigacion documental retrospectiva compuesta por 183 fichas medicas de pacientes sometidos a trasplante pulmonar (2007/2012). Los datos del perfil de los pacientes fueron agrupados de acuerdo con las variables investigadas y sometidos al analisis descriptivo. Las intervenciones de enfermeria prescritas fueron analizadas por el metodo del mapeo cruzado con las intervenciones relacionadas en la NIC. Se excluyeron las fichas medicas sin prescripciones de enfermeria. RESULTADOS: la mayoria de los pacientes era hombre, con diagnostico medico de fibrosis pulmonar, sometidos a trasplante pulmonar con donador fallecido. Se encontraron 26 intervenciones/acciones mas citadas. La mayoria (91,6%) pertenecia a los dominios fisiologicos complejo y basico de la NIC. No fue posible mapear dos acciones prescritas por los enfermeros. CONCLUSIONES: se identifico que las principales prescripciones contenian cuidados generales de posoperatorio de cirugias de gran porte, y no individualizadas para paciente en posoperatorio de trasplante pulmonar. Los cuidados relacionados al dolor fueron subestimados en las prescripciones. El mapeo con la taxonomia puede contribuir para la elaboracion del plan de cuidados y la utilizacion de sistemas computarizados en esta compleja modalidad terapeuticaOBJECTIVES: to investigate the principle nursing interventions/actions, prescribed in the immediate post-operative period for patients who receive lung transplantation, recorded in the medical records, and to map these using the Nursing Interventions Classification (NIC) taxonomy. METHOD: retrospective documental research using 183 medical records of patients who received lung transplantation (2007/2012). The data of the patients profile were grouped in accordance with the variables investigated, and submitted to descriptive analysis. The nursing interventions prescribed were analyzed using the method of cross-mapping with the related interventions in the NIC. Medical records which did not contain nursing prescriptions were excluded. RESULTS: the majority of the patients were male, with medical diagnoses of pulmonary fibrosis, and underwent lung transplantation from a deceased donor. A total of 26 most frequently-cited interventions/actions were found. The majority (91.6%) were in the complex and basic physiological domains of the NIC. It was not possible to map two actions prescribed by the nurses. CONCLUSIONS: it was identified that the main prescriptions contained general care for the postoperative period of major surgery, rather than prescriptions individualized to the patient in the postoperative period following lung transplantation. Care measures related to pain were underestimated in the prescriptions. The mapping with the taxonomy can contribute to the elaboration of the care plan and to the use of computerized systems in this complex mode of therapy.

Pós-operatório imediato de transplante pulmonar: mapeamento de intervenções de enfermagem

OBJETIVOS: conocer las principales intervenciones/acciones de enfermeria prescritas para el posoperatorio inmediato de los receptores de trasplante pulmonar, registrados en las fichas medicas y mapear esas prescripciones con la taxonomia Nursing Interventions Classification (NIC). METODO: investigacion documental retrospectiva compuesta por 183 fichas medicas de pacientes sometidos a trasplante pulmonar (2007/2012). Los datos del perfil de los pacientes fueron agrupados de acuerdo con las variables investigadas y sometidos al analisis descriptivo. Las intervenciones de enfermeria prescritas fueron analizadas por el metodo del mapeo cruzado con las intervenciones relacionadas en la NIC. Se excluyeron las fichas medicas sin prescripciones de enfermeria. RESULTADOS: la mayoria de los pacientes era hombre, con diagnostico medico de fibrosis pulmonar, sometidos a trasplante pulmonar con donador fallecido. Se encontraron 26 intervenciones/acciones mas citadas. La mayoria (91,6%) pertenecia a los dominios fisiologicos complejo y basico de la NIC. No fue posible mapear dos acciones prescritas por los enfermeros. CONCLUSIONES: se identifico que las principales prescripciones contenian cuidados generales de posoperatorio de cirugias de gran porte, y no individualizadas para paciente en posoperatorio de trasplante pulmonar. Los cuidados relacionados al dolor fueron subestimados en las prescripciones. El mapeo con la taxonomia puede contribuir para la elaboracion del plan de cuidados y la utilizacion de sistemas computarizados en esta compleja modalidad terapeuticaOBJECTIVES: to investigate the principle nursing interventions/actions, prescribed in the immediate post-operative period for patients who receive lung transplantation, recorded in the medical records, and to map these using the Nursing Interventions Classification (NIC) taxonomy. METHOD: retrospective documental research using 183 medical records of patients who received lung transplantation (2007/2012). The data of the patients profile were grouped in accordance with the variables investigated, and submitted to descriptive analysis. The nursing interventions prescribed were analyzed using the method of cross-mapping with the related interventions in the NIC. Medical records which did not contain nursing prescriptions were excluded. RESULTS: the majority of the patients were male, with medical diagnoses of pulmonary fibrosis, and underwent lung transplantation from a deceased donor. A total of 26 most frequently-cited interventions/actions were found. The majority (91.6%) were in the complex and basic physiological domains of the NIC. It was not possible to map two actions prescribed by the nurses. CONCLUSIONS: it was identified that the main prescriptions contained general care for the postoperative period of major surgery, rather than prescriptions individualized to the patient in the postoperative period following lung transplantation. Care measures related to pain were underestimated in the prescriptions. The mapping with the taxonomy can contribute to the elaboration of the care plan and to the use of computerized systems in this complex mode of therapy.

The immediate post-operative period following lung transplantation: mapping of nursing interventions

OBJETIVOS: conocer las principales intervenciones/acciones de enfermeria prescritas para el posoperatorio inmediato de los receptores de trasplante pulmonar, registrados en las fichas medicas y mapear esas prescripciones con la taxonomia Nursing Interventions Classification (NIC). METODO: investigacion documental retrospectiva compuesta por 183 fichas medicas de pacientes sometidos a trasplante pulmonar (2007/2012). Los datos del perfil de los pacientes fueron agrupados de acuerdo con las variables investigadas y sometidos al analisis descriptivo. Las intervenciones de enfermeria prescritas fueron analizadas por el metodo del mapeo cruzado con las intervenciones relacionadas en la NIC. Se excluyeron las fichas medicas sin prescripciones de enfermeria. RESULTADOS: la mayoria de los pacientes era hombre, con diagnostico medico de fibrosis pulmonar, sometidos a trasplante pulmonar con donador fallecido. Se encontraron 26 intervenciones/acciones mas citadas. La mayoria (91,6%) pertenecia a los dominios fisiologicos complejo y basico de la NIC. No fue posible mapear dos acciones prescritas por los enfermeros. CONCLUSIONES: se identifico que las principales prescripciones contenian cuidados generales de posoperatorio de cirugias de gran porte, y no individualizadas para paciente en posoperatorio de trasplante pulmonar. Los cuidados relacionados al dolor fueron subestimados en las prescripciones. El mapeo con la taxonomia puede contribuir para la elaboracion del plan de cuidados y la utilizacion de sistemas computarizados en esta compleja modalidad terapeuticaOBJECTIVES: to investigate the principle nursing interventions/actions, prescribed in the immediate post-operative period for patients who receive lung transplantation, recorded in the medical records, and to map these using the Nursing Interventions Classification (NIC) taxonomy. METHOD: retrospective documental research using 183 medical records of patients who received lung transplantation (2007/2012). The data of the patients profile were grouped in accordance with the variables investigated, and submitted to descriptive analysis. The nursing interventions prescribed were analyzed using the method of cross-mapping with the related interventions in the NIC. Medical records which did not contain nursing prescriptions were excluded. RESULTS: the majority of the patients were male, with medical diagnoses of pulmonary fibrosis, and underwent lung transplantation from a deceased donor. A total of 26 most frequently-cited interventions/actions were found. The majority (91.6%) were in the complex and basic physiological domains of the NIC. It was not possible to map two actions prescribed by the nurses. CONCLUSIONS: it was identified that the main prescriptions contained general care for the postoperative period of major surgery, rather than prescriptions individualized to the patient in the postoperative period following lung transplantation. Care measures related to pain were underestimated in the prescriptions. The mapping with the taxonomy can contribute to the elaboration of the care plan and to the use of computerized systems in this complex mode of therapy.