Karin Viegas

Assessment of the care process with orthotics, prosthetics and special materials

OBJECTIVE to assess potential failures in the care process with orthotics, prosthetics and special materials in a high-complexity hospital. METHOD an intervention study conducted from March to October 2013. This process was assessed with the Failure Mode and Effects Analysis (FMEA) service tool. The data were analysed according to the risk and the corrective measures were defined. RESULTS no failure was classified as high risk and the corrective measures indicated as low and moderate risk had the following improvement initiatives suggested: standardize the material records in the information system; create a specific form to require materials; hire specialized technical personnel and create a continuous education program. CONCLUSION all the suggested initiatives were implemented and helped to reduce the assistance risks for patients due to failures in this process. The actions increase safety levels and provide higher quality of service.

Políticas de Saúde de adolescentes e jovens no contexto luso-brasileiro: especificidades e aproximações

Resumo O objetivo deste artigo e caracterizar a producao cientifica sobre politicas e programas de saude de adolescentes no Brasil e em Portugal no periodo 2010-2017. Estudo de revisao da literatura, baseado no metodo de “Scoping Review”. A questao de investigacao: como se caracteriza a producao cientifica sobre politicas e programas de saude de adolescentes do Brasil e de Portugal? As buscas foram realizadas no mes de outubro de 2017, nas plataformas BVS, EBSCO e Google Academico. Foram selecionados 22 estudos, 17 brasileiros e 5 portugueses. Foram identificadas sete categorias tematicas transversais: avaliacao de politicas e programas; promocao e educacao para a saude; saude mental; saude sexual e reprodutiva; violencia; saude bucal e saude nutricional. Conclui-se que, embora em contextos sociais distintos, as tematicas refletem areas tradicionais de intervencao das politicas e programas, com excecao daquelas decorrentes do fenomeno da violencia estrutural, marcadamente presente na realidade brasileira. Ainda, ausencia de tematicas emergentes como identidades de genero, fluxos migratorios e morbimortalidade por causas externas, revelando possivel vazio assistencial das politicas e programas e um campo necessario a ser explorado.

PAPEL DO ENFERMEIRO NO PERÍODO PERIOPERATÓRIO PARA PREVENÇÃO DA TROMBOSE VENOSA PROFUNDA

Objectives: Determining how nurses implement deep vein thrombosis (DVT) prevention during the perioperative period in patients submitted to large surgeries and detecting the risk factors to the occurrences of DVT previously traced by nurses. Methodology: A case study with a qualitative approach. A sample of 12 nurses in the inpatient unit, operating room, and postanesthesia recovery room of a hospital specializing in trauma Porto Alegre (RS), Brazil. We used semi-structured interviews with 10 leading questions. For data interpretation, the Content Analysis Method introduced by Bardin was adopted. Results: Three final categories came up from the content analysis: risk factors to DVT, preventive measures to DVT, and adversities in implementing the systematization of nursing care in perioperative. Conclusion: Nurses perform prevention of DVT with massage, observation, physical examination/assessment, protective measures, and change of position but lack autonomy to apply some preventive measures. They showed several risk factors for the occurrence of DVT according to the literature, proving they have the knowledge about the disease.

BIOSSEGURANÇA NO CENTRO DE MATERIAIS E ESTERILIZAÇÃO: DÚVIDAS DOS PROFISSIONAIS

Objective: This work aims at knowing the doubts health professionals may have about biosecurity in Central Sterile Services Department (CSSD), and reflect upon the answers. Methods: This is a qualitative, descriptive exploratory study. The research was about a well known Brazilian website, which offers a discussion list by e-mail. 2,260 messages were sent to this list in 2014. The sample was composed by 109 messages containing topics about biosecurity in CSSD; interpreted using the Bardin’s Content Analysis. Results: Four theme categories emerged from the most frequent questions: chemical solutions, equipment and materials, Law, and process validation. Both in questions as in answers analyzed, there was a strong relation between the CSSD and Hospital Infection Control. Conclusions: Most professionals who referred questions were nurses. The most frequently asked questions on biosecurity related to the solutions used, equipment and materials. The answers were based on existing legislation and issued by professionals with experience.

Escore de alerta precoce modificado: avaliação de pacientes traumáticos

Objective: to identify the severity of patients admitted to an emergency trauma. Method: A cross-sectional and retrospective study with 115 trauma patients classified as orange (Manchester System), from June 2013 to July 2014. The data were presented as mean and standard deviation, in addition to the Pearson Chi-square test, One-Way ANOVA and Tukey tests. Results: from the sample, 81.7% were male with mean age of 39.46±19.71 years. Higher incidence of major trauma (48.7%) and traumatic brain injury (37.4%). At the end of the outcome and MEWS, most cases that had score 1 to 3 were referred to the operating room and the ICU. Conclusion: the start point of MEWS was 2 to 3 points, with significant increase in the severity of the situation of patients seen after 6 hours, and approximately half of the individuals underwent surgery, indicating that the scale is a good predictor of severity.Objetivo: identificar la gravedad de los pacientes ingresados en un trauma de emergencia. Metodo: estudio transversal y retrospectivo realizado en 115 pacientes con traumatismos clasificados como naranja (sistema de triage Manchester) a partir de junio de 2013 hasta julio de 2014. Los datos se presentaron como media y desviacion estandar, y prueba de chi-cuadrado Pearson, ANOVA de una via y Tukey. Resultados: 81,7% de hombres, edad media 39,46±19,71 anos. Mayor incidencia de traumatismos graves (48,7%) y lesion cerebral traumatica (37,4%). En el resultado final y MEWS (modified early warning score - puntuacion de alerta temprana modificada), la mayoria de los casos tenian una puntuacion de 1-3 y se remitieron a la sala de operaciones y UCI (unidad de cuidados intensivos). Conclusion: la puntuacion inicial MEWS fue de 2 a 3 puntos, con un aumento importante en la gravedad de la situacion de los pacientes atendidos despues de 6 horas, y aproximadamente la mitad de los individuos se sometieron a la cirugia, lo que indica que la escala es un buen predictor de la gravedad.Objective: to identify the severity of patients admitted to an emergency trauma. Method: A cross-sectional and retrospective study with 115 trauma patients classified as orange (Manchester System), from June 2013 to July 2014. The data were presented as mean and standard deviation, in addition to the Pearson Chi-square test, One-Way ANOVA and Tukey tests. Results: from the sample, 81.7% were male with mean age of 39.46±19.71 years. Higher incidence of major trauma (48.7%) and traumatic brain injury (37.4%). At the end of the outcome and MEWS, most cases that had score 1 to 3 were referred to the operating room and the ICU. Conclusion: the start point of MEWS was 2 to 3 points, with significant increase in the severity of the situation of patients seen after 6 hours, and approximately half of the individuals underwent surgery, indicating that the scale is a good predictor of severity.

Modified early warning score: evaluation of trauma patients

Objective: to identify the severity of patients admitted to an emergency trauma. Method: A cross-sectional and retrospective study with 115 trauma patients classified as orange (Manchester System), from June 2013 to July 2014. The data were presented as mean and standard deviation, in addition to the Pearson Chi-square test, One-Way ANOVA and Tukey tests. Results: from the sample, 81.7% were male with mean age of 39.46±19.71 years. Higher incidence of major trauma (48.7%) and traumatic brain injury (37.4%). At the end of the outcome and MEWS, most cases that had score 1 to 3 were referred to the operating room and the ICU. Conclusion: the start point of MEWS was 2 to 3 points, with significant increase in the severity of the situation of patients seen after 6 hours, and approximately half of the individuals underwent surgery, indicating that the scale is a good predictor of severity.Objetivo: identificar la gravedad de los pacientes ingresados en un trauma de emergencia. Metodo: estudio transversal y retrospectivo realizado en 115 pacientes con traumatismos clasificados como naranja (sistema de triage Manchester) a partir de junio de 2013 hasta julio de 2014. Los datos se presentaron como media y desviacion estandar, y prueba de chi-cuadrado Pearson, ANOVA de una via y Tukey. Resultados: 81,7% de hombres, edad media 39,46±19,71 anos. Mayor incidencia de traumatismos graves (48,7%) y lesion cerebral traumatica (37,4%). En el resultado final y MEWS (modified early warning score - puntuacion de alerta temprana modificada), la mayoria de los casos tenian una puntuacion de 1-3 y se remitieron a la sala de operaciones y UCI (unidad de cuidados intensivos). Conclusion: la puntuacion inicial MEWS fue de 2 a 3 puntos, con un aumento importante en la gravedad de la situacion de los pacientes atendidos despues de 6 horas, y aproximadamente la mitad de los individuos se sometieron a la cirugia, lo que indica que la escala es un buen predictor de la gravedad.Objective: to identify the severity of patients admitted to an emergency trauma. Method: A cross-sectional and retrospective study with 115 trauma patients classified as orange (Manchester System), from June 2013 to July 2014. The data were presented as mean and standard deviation, in addition to the Pearson Chi-square test, One-Way ANOVA and Tukey tests. Results: from the sample, 81.7% were male with mean age of 39.46±19.71 years. Higher incidence of major trauma (48.7%) and traumatic brain injury (37.4%). At the end of the outcome and MEWS, most cases that had score 1 to 3 were referred to the operating room and the ICU. Conclusion: the start point of MEWS was 2 to 3 points, with significant increase in the severity of the situation of patients seen after 6 hours, and approximately half of the individuals underwent surgery, indicating that the scale is a good predictor of severity.

Puntuación de alerta temprana modificada: evaluación de los pacientes traumáticos

Objective: to identify the severity of patients admitted to an emergency trauma. Method: A cross-sectional and retrospective study with 115 trauma patients classified as orange (Manchester System), from June 2013 to July 2014. The data were presented as mean and standard deviation, in addition to the Pearson Chi-square test, One-Way ANOVA and Tukey tests. Results: from the sample, 81.7% were male with mean age of 39.46±19.71 years. Higher incidence of major trauma (48.7%) and traumatic brain injury (37.4%). At the end of the outcome and MEWS, most cases that had score 1 to 3 were referred to the operating room and the ICU. Conclusion: the start point of MEWS was 2 to 3 points, with significant increase in the severity of the situation of patients seen after 6 hours, and approximately half of the individuals underwent surgery, indicating that the scale is a good predictor of severity.Objetivo: identificar la gravedad de los pacientes ingresados en un trauma de emergencia. Metodo: estudio transversal y retrospectivo realizado en 115 pacientes con traumatismos clasificados como naranja (sistema de triage Manchester) a partir de junio de 2013 hasta julio de 2014. Los datos se presentaron como media y desviacion estandar, y prueba de chi-cuadrado Pearson, ANOVA de una via y Tukey. Resultados: 81,7% de hombres, edad media 39,46±19,71 anos. Mayor incidencia de traumatismos graves (48,7%) y lesion cerebral traumatica (37,4%). En el resultado final y MEWS (modified early warning score - puntuacion de alerta temprana modificada), la mayoria de los casos tenian una puntuacion de 1-3 y se remitieron a la sala de operaciones y UCI (unidad de cuidados intensivos). Conclusion: la puntuacion inicial MEWS fue de 2 a 3 puntos, con un aumento importante en la gravedad de la situacion de los pacientes atendidos despues de 6 horas, y aproximadamente la mitad de los individuos se sometieron a la cirugia, lo que indica que la escala es un buen predictor de la gravedad.Objective: to identify the severity of patients admitted to an emergency trauma. Method: A cross-sectional and retrospective study with 115 trauma patients classified as orange (Manchester System), from June 2013 to July 2014. The data were presented as mean and standard deviation, in addition to the Pearson Chi-square test, One-Way ANOVA and Tukey tests. Results: from the sample, 81.7% were male with mean age of 39.46±19.71 years. Higher incidence of major trauma (48.7%) and traumatic brain injury (37.4%). At the end of the outcome and MEWS, most cases that had score 1 to 3 were referred to the operating room and the ICU. Conclusion: the start point of MEWS was 2 to 3 points, with significant increase in the severity of the situation of patients seen after 6 hours, and approximately half of the individuals underwent surgery, indicating that the scale is a good predictor of severity.

Surgical patients’ understanding of the free and informed consent form

Objective To know surgical patients’ understanding of the free and informed consent form (FICF). Methods Cross-sectional study conducted with patients in the immediate postoperative period of different surgical procedures. Intentional sample. Data were collected by means of a questionnaire with Likert type responses, and analyzed through descriptive and analytical statistics. Results Of the 374 patients evaluated, 36.4% underwent surgical procedures on the musculoskeletal system, and 35.3% received the FICF from a non-medical professional (secretary). The patients agreed that they understood the information written on the FICF (44.7%), that the information was clear (59.6%), that doubts were clarified (57%), and that they knew the function of the FICF (59.6%). Only 28.6% of patients confirmed that they had obtained a signed copy of the FICF. Conclusion Most participants understood the written information on the FICF, but it is necessary to expand this understanding to all patients, as well as provide a copy of the signed document.