Maria Cristina Soares Rodrigues

Thyroid hormone transport is disturbed in erythrocytes from patients with chronic renal failure on hemodialysis

Aims: To now, there are no studies reporting whether thyroid hormones (THs) transport play a role in thyroid hormone dysfunction observed in chronic renal failure (CRF). Therefore, the aim of this study was to investigate the transport of THs in erythrocytes from patients with CRF on hemodialysis (HD). Methods: [125I]‐L‐triiodothyronine ([125I]T3) and [125I]‐L‐thyroxine ([125I]T4) erythrocytes uptake was measured at 1 min and 5 min. To study L‐triiodothyronine (LT3) and L‐thyroxine (LT4) efflux from erythrocytes, we preloaded the cells during 180 min with [125I]T3 or [125I]T4 and measured their [125I]T3 or [125I]T4 efflux during 60 min. Results: [125I]T3 uptake in erythrocytes from uremic patients pre‐HD was higher than control subjects by 50% at 1 min and by 55% at 5 min. However, [125I]T4 uptake in erythrocytes from uremic patients was significantly lower at 1min (88%) and at 5 min (63%). LT3 efflux rate was lower and LT4 efflux was significantly higher than in control subjects. After 60‐min of efflux, LT3 remained in erythrocytes was 80% higher and LT4 was 57% lower than in normal individuals. Neither [125I]T3 and [125I]T4 uptake, nor efflux rates were changed by hemodialysis. Conclusion: Despite the fact that uremic patients on hemodialysis show low serum levels of LT3, changes in LT3 influx and efflux could act as a compensatory mechanism that neutralize thyroid hormone dysfunction in order to maintain the euthyroid state.

Vigilância de infecção de sítio cirúrgico pós-alta hospitalar em hospital de ensino do Distrito Federal, Brasil: estudo descritivo retrospectivo no período 2005-2010

Objective: this study investigated the occurrence of surgical site infection (SSI) and characteristics of cases among patients served under the program of post-discharge surveillance of the General Surgery Teaching Hospital of Brasilia, Federal District, Brazil. Methods: the retrospective descriptive study, from 2005-2010, used data obtained by consulting hospital information systems, patients records, and records of results of microbiological tests. Results: during the study period, 4,098 were treated and 82.2% of them attended by the follow-up program. From 4,375 surgeries evaluated, (3.4%) 147 cases of SSI were diagnosed; Staphylococcus aureus was predominant among the 19 species isolated in cultures of the surgical site; a higher incidence of SSI occurred between the 6th and the 10th postoperative day. Conclusion: this study showed the importance of ambulatory accompaniment in reducing underreporting and its consequent contribution to the validity of indicators and in improving the surveillance of SSI in the health services.

Drug-drug interactions and adverse drug reactions in polypharmacy among older adults: an integrative review

Objetivo: identificar y resumir los estudios que analizan tanto las interacciones medicamentosas (IM) como las reacciones adversas a medicamentos (RAM) en los adultos mayores polimedicados. Metodos: revision integradora de estudios publicados entre enero de 2008 a diciembre de 2013, siguiendo criterios de inclusion y exclusion, en las bases de datos electronicas MEDLINE y EMBASE. Resultados: cuarenta y siete estudios de texto completo incluidos fueron analizados incluyendo 14,624,492 adultos mayores (≥ 60 anos), de ellos 24 (51,1%) en relacion con RAM, 14 (29,9%) con IM y 9 estudios (19,1%) que investigaron tanto IM como RAM. Encontramos una gran variedad de disenos metodologicos. Los estudios revisados reforzaron el concepto que la polifarmacia es un proceso multifactorial, y los predictores y la prescripcion inadecuada se asocian con resultados negativos para la salud tales como el aumento de la frecuencia y tipos de RAM y IM implicando diferentes clases de farmacos, ademas que algunos estudios muestran cuales son las intervenciones mas exitosas para optimizar la prescripcion. Conclusiones: IM y RAM siguen siendo un problema importante en el mundo entero entre los adultos mayores. Los resultados de los estudios incluidos en esta revision integradora, sumado a las revisiones previas, pueden contribuir a la mejora de las practicas avanzadas de enfermeria geriatrica, para promover la seguridad de los pacientes de mayor edad en la polifarmacia. Sin embargo, se necesita mas investigacion para esclarecer los vacios de conocimiento.ABSTRACT Objective: to identify and summarize studies examining both drug-drug interactions (DDI) and adverse drug reactions (ADR) in older adults polymedicated. Methods: an integrative review of studies published from January 2008 to December 2013, according to inclusion and exclusion criteria, in MEDLINE and EMBASE electronic databases were performed. Results: forty-seven full-text studies including 14,624,492 older adults (≥ 60 years) were analyzed: 24 (51.1%) concerning ADR, 14 (29.8%) DDI, and 9 studies (19.1%) investigating both DDI and ADR. We found a variety of methodological designs. The reviewed studies reinforced that polypharmacy is a multifactorial process, and predictors and inappropriate prescribing are associated with negative health outcomes, as increasing the frequency and types of ADRs and DDIs involving different drug classes, moreover, some studies show the most successful interventions to optimize prescribing. Conclusions: DDI and ADR among older adults continue to be a significant issue in the worldwide. The findings from the studies included in this integrative review, added to the previous reviews, can contribute to the improvement of advanced practices in geriatric nursing, to promote the safety of older patients in polypharmacy. However, more research is needed to elucidate gaps.

Adaptação transcultural de instrumento de cultura de segurança para a Atenção Primária

Objetivo Traduzir, adaptar e validar o instrumento de pesquisa Medical Office Survey on Patient Safety Culture (MOSPSC). Metodos Estudo metodologico de adaptacao transcultural do instrumento MOSPSC elaborado pela Agency for Healthcare and Research in Quality. Seguiram-se as etapas de traducao, retrotraducao, analise de especialistas, grupo de populacao meta e pre-teste com amostra de 37 profissionais. Resultados Na analise dos especialistas, o instrumento atingiu indice de validade de conteudo geral de 0,85. A avaliacao pelo grupo de populacao meta foi realizada por seis profissionais, e as sugestoes de adaptacao foram analisadas e modificadas por consenso. O pre-teste foi realizado com 37 profissionais, que avaliaram o instrumento como de facil compreensao. O coeficiente alfa de Cronbach foi de 0,95. Conclusao O instrumento foi traduzido e adaptado para a lingua portuguesa do Brasil com nivel satisfatorio de validade de conteudo e alta confiabilidade.

Educação do paciente sobre regime terapêutico medicamentoso no processo de alta hospitalar: uma revisão integrativa

Adequate patient education about drug treatment regimen at discharge contributes to the continuity of home care. Integrative review aimed to analyze and synthesize the scientific literature about patient education on medication regimen in the hospital discharge process. We consulted the databases Medical Literature Analysis and Retrieval System on-line (MEDLINE) and Latin-American and Caribbean Center on Health Sciences Information (LILACS), and selected 24 articles published between 2005 and 2010. Inter-related aspects, such as structured discharge planning, medication reconciliation, drug education, adverse drug events and medication adherence, permeate the theme.

ADAPTAÇÃO E VALIDAÇÃO DE CHECKLIST DE SEGURANÇA CIRÚRGICA NA CESÁREA

Objective: adapt and validate a surgical safety instrument in the cesarean delivery, based on an integrative review of the literature, and on the World Health Organization protocol and surgical safety checklist. Method: methodological study, with triangulation of data, involving a total of 43 participants, being eight judges for the validation of content and apparent of the instrument, using the Delphi technique, and for the semantic validation, another 35 professionals from the surgical team of a public hospital in the Federal District, Brazil. The reliability coefficient was applied to the instrument. Results: the instrument achieved general content validity index of 0.9 and inter-rater agreement of 1. The total coefficient of Cronbach’s alpha was 0.86, and the mean score of the dimensions obtained high scores. Conclusion: the instrument presented validity in the three criteria studied and reliability to be applied in future studies evaluating the surgical safety in cesarean deliveries.

Ambiente da prática de enfermagem em unidades de terapia intensiva

Objective To analyze the nursing practice environment in intensive care units. Methods This is a descriptive study with a quantitative approach, carried out with 209 nursing professionals of three Brazilian teaching hospitals. The nursing work environment was evaluated using the Practice Environment Scale. Data were analyzed descriptively, assuming a significance level of 5% (p<0.05). Cronbach’s alpha coefficient was used to assess the internal consistency of the constructs. Results Nurse professionals considered unfavorable four of the five professional practice environment dimensions: nurse participation in hospital affairs, nursing foundation for quality of care, nurse manager ability, leadership and support of nurses and staffing and resources adequacy. Only the dimension of collegial nurse-physician relations presented a positive evaluation. Unfavorable characteristics of the working environment were recognized more strongly by nurses in comparison to nursing technicians. Conclusion The environment proved to be unfavorable for the practice of nursing professionals. Efforts are necessary to make the work environment more attractive to them, thus stimulating improvements in the quality and safety of care delivered to patients.

PERFIL CRIATIVO DOCENTE-DISCENTE: INFLUÊNCIA NO ENSINO, HABILIDADES E ATITUDES DA ENFERMAGEM

Objetivo: analisar o perfil criativo de docentes e discentes do ensino superior de Enfermagem e discutir sua influencia no cuidar. Metodologia: estudo exploratorio-descritivo desenvolvido em dois Cursos de Graduacao de Enfermagem, Distrito Federal, com 251 estudantes e 26 docentes, distribuidos em 4 grupos. Enquadramento conceitual oriundo de Teorias da Criatividade. Coletaram-se os dados, aplicando questionario validado contendo caracteristicas do perfil criativo. Realizaram-se estatisticas de frequencia absoluta e relativa. Resultados: curiosidade, espontaneidade, coragem e Persistencia foram caracteristicas do perfil criativo mais destacadas. Tais aspectos de pensamento e atitudes sao indispensaveis aos profissionais atuantes na cultura dos cuidados. Conclusao: o ensino promotor da expressao criativa docente-discente desenvolve potenciais, habilidades e atitudes cuidativas. Descritores: Enfermagem, Educacao Superior, Criatividade, Aprendizagem, Habilidade. TEACHER-STUDENT CREATIVE PROFILE: INFLUENCE IN NURSING TEACHING, SKILLS AND ATTITUDES Objective: to analyze the creative profile of higher education nursing teachers and students and discuss its influence in health care. Methodology: this is a descriptive-exploratory study developed in two Nursing Undergraduate Courses, Federal District, whose guiding question was: what are the creative characteristics declared by higher education nursing teachers and students? Its conceptual framework arises from Theories of Creativity. Data were collected by applying a validated questionnaire containing profile creative characteristics. Statistics of absolute and relative frequency were conducted. Results: Curiosity, Spontaneity, Courage and Persistence were the most highlighted characteristics of the creative profile. Such aspects of thought and attituds are indispensable to professionals working in the culture of care. Conclusion: the teaching that promotes the teacher-student creative expression develops strengths, skills and attitudes toward health care. Descriptors: Nursing, Higher Education, Creativity, Learning, Aptitude. PERFIL CREATIVO ENSENANTE-ESTUDIANTE: INFLUENCIA EN LA ENSENANZA, HABILIDADES Y ACTITUDES DE LA ENFERMERIA Objetivo: analizar el perfil creativo de los ensenantes y estudiantes de la ensenanza superior de enfermeria y discutir su influencia en la atencion. Metodologia: estudio exploratorio-descriptivo desarrollado en dos Cursos de Pregrado de Enfermeria, Distrito Federal, cuya pregunta orientadora fue: ?cuales son las caracteristicas creativas declaradas por los ensenantes y estudiantes del curso superior de enfermeria? Encuadre conceptual procedente de las Teorias de la Creatividad. Los datos fueron recogidos mediante la aplicacion de un cuestionario validado conteniendo las caracteristicas del perfil creativo. Se realizaron estadisticas de frecuencia absoluta y relativa. Resultados: Curiosidad, Espontaneidad, Coraje y Persistencia fueron las caracteristicas del perfil creativo mas destacadas. Estos aspectos del pensamiento y actitudes son indispensables para los profesionales que trabajan en el cuidado de la atencion. Conclusion: la ensenanza promotora de la expresion creativa ensenante-estudiante desarrolla los potenciales, habilidades y actitudes de atencion. Descriptores: Enfermeria, Educacion Superior, Creatividad, Aprendizaje, Aptitud.

Patient education on drug treatment regimen in the process of hospital discharge: an integrative review

Adequate patient education about drug treatment regimen at discharge contributes to the continuity of home care. Integrative review aimed to analyze and synthesize the scientific literature about patient education on medication regimen in the hospital discharge process. We consulted the databases Medical Literature Analysis and Retrieval System on-line (MEDLINE) and Latin-American and Caribbean Center on Health Sciences Information (LILACS), and selected 24 articles published between 2005 and 2010. Inter-related aspects, such as structured discharge planning, medication reconciliation, drug education, adverse drug events and medication adherence, permeate the theme.

Educación del paciente sobre el régimen terapéutico en el proceso del alta hospitalario: una revisión integradora

Adequate patient education about drug treatment regimen at discharge contributes to the continuity of home care. Integrative review aimed to analyze and synthesize the scientific literature about patient education on medication regimen in the hospital discharge process. We consulted the databases Medical Literature Analysis and Retrieval System on-line (MEDLINE) and Latin-American and Caribbean Center on Health Sciences Information (LILACS), and selected 24 articles published between 2005 and 2010. Inter-related aspects, such as structured discharge planning, medication reconciliation, drug education, adverse drug events and medication adherence, permeate the theme.