Maria Lígia Silva Nunes Cavalcante

Cross-cultural adaptation of the Caregiver Reaction Assessment for use in Brazil with informal caregivers of the elderly

This study aimed to carry out the cross-cultural adaptation of the Caregiver Reaction Assessment CRA for use in Brazil with informal caregivers of dependent elderly METHOD A methodological study, of five steps: initial translation, synthesis of translations, retro-translation, evaluation by a judge committee and a pre-test, with 30 informal caregivers of older persons in Fortaleza, Brazil. Content validity was assessed by five experts in gerontology and geriatrics. The cross-cultural adaptation was rigorously conducted, allowing for inferring credibility. RESULTS The Brazilian version of the CRA had a simple and fast application (ten minutes), easily understood by the target audience. It is semantically, idiomatically, experimentally and conceptually equivalent to the original version, with valid content to assess the burden of informal caregivers for the elderly (Content Validity Index = 0.883). CONCLUSION It is necessary that other psychometric properties of validity and reliability are tested before using in care practice and research.UNLABELLED This study aimed to carry out the cross-cultural adaptation of the Caregiver Reaction Assessment CRA for use in Brazil with informal caregivers of dependent elderly METHOD A methodological study, of five steps: initial translation, synthesis of translations, retro-translation, evaluation by a judge committee and a pre-test, with 30 informal caregivers of older persons in Fortaleza, Brazil. Content validity was assessed by five experts in gerontology and geriatrics. The cross-cultural adaptation was rigorously conducted, allowing for inferring credibility. RESULTS The Brazilian version of the CRA had a simple and fast application (ten minutes), easily understood by the target audience. It is semantically, idiomatically, experimentally and conceptually equivalent to the original version, with valid content to assess the burden of informal caregivers for the elderly (Content Validity Index = 0.883). CONCLUSION It is necessary that other psychometric properties of validity and reliability are tested before using in care practice and research.

Indicators of health and safety among institutionalized older adults

OBJECTIVE To identify the incidence of mortality, diarrheal diseases, scabies and falls; and the prevalence of pressure ulcers - all of which are related to the safety ofinstitutionalized older adults. METHOD This was a documentary retrospective study developed in a long-term residential careinstitution for older adults in the Northeast region of Brazil. The data were gathered from records of health assessment indicators filed between January 2008 and December 2015. Analysis included absolute case frequency; the sum of monthly prevalence and incidence rates; mean values of cases; and mean annual incidence and prevalence rates. RESULTS The incidence of mortality over these nine years ranged from 9% to 13%; of acute diarrheic disease from 13% to 45%; and scabies from 21% to 63%. The prevalence of pressure ulcers ranged from 8% to 23%. Between 2012 and 2015, the incidence rate of falls without injury varied from 38% to 83%, and with injury from12% to 20%. CONCLUSION Analysis of the health indicators revealeda high incidence of scabies and falls and a high prevalence of pressure ulcers. The identification of less than optimal rates for performance indicators canhelp improve the quality of nursing care. OBJETIVO Identificar a incidência de mortalidade, doenças diarreicas, escabiose e quedas, e a prevalência de lesões por pressão para a segurança do idoso institucionalizado. MÉTODO Estudo documental, retrospectivo desenvolvido em uma Instituição de Longa Permanência para Idosos, localizada no nordeste do Brasil. Os dados foram coletados por meio dos registros dos indicadores de avaliação de saúde, arquivados de janeiro de 2008 a dezembro de 2015. A análise incluiu a frequência absoluta dos casos; o somatório das taxas de prevalência e incidência mensais; a média de casos e das taxas de incidência e prevalência anuais. RESULTADOS Observa-se que a incidência de óbitos nos nove anos considerados variou de 9 a 13%; de doenças diarreicas agudas, de 13 a 45%; e de escabiose, de 21 a 63%. A prevalência de lesão por pressão oscilou de 8 a 23%. Entre os anos de 2012 a 2015, a taxa de incidência de quedas sem lesão variou em torno de 38 a 83%, e com lesão, de 12 a 20%. CONCLUSÃO A análise da amplitude dos indicadores de saúde permitiu identificar a alta incidência de escabiose e de quedas e a elevada prevalência de lesões por pressão. A identificação do comprometimento dos indicadores contribui para otimização da qualidade da assistência de enfermagem.OBJECTIVE To identify the incidence of mortality, diarrheal diseases, scabies and falls; and the prevalence of pressure ulcers - all of which are related to the safety ofinstitutionalized older adults. METHOD This was a documentary retrospective study developed in a long-term residential careinstitution for older adults in the Northeast region of Brazil. The data were gathered from records of health assessment indicators filed between January 2008 and December 2015. Analysis included absolute case frequency; the sum of monthly prevalence and incidence rates; mean values of cases; and mean annual incidence and prevalence rates. RESULTS The incidence of mortality over these nine years ranged from 9% to 13%; of acute diarrheic disease from 13% to 45%; and scabies from 21% to 63%. The prevalence of pressure ulcers ranged from 8% to 23%. Between 2012 and 2015, the incidence rate of falls without injury varied from 38% to 83%, and with injury from12% to 20%. CONCLUSION Analysis of the health indicators revealeda high incidence of scabies and falls and a high prevalence of pressure ulcers. The identification of less than optimal rates for performance indicators canhelp improve the quality of nursing care.ABSTRACT Objective: To identify the incidence of mortality, diarrheal diseases, scabies and falls; and the prevalence of pressure ulcers – all of which are related to the safety of institutionalized older adults. Method: This was a documentary retrospective study developed in a long-term residential care institution for older adults in the Northeast region of Brazil. The data were gathered from records of health assessment indicators filed between January 2008 and December 2015. Analysis included absolute case frequency; the sum of monthly prevalence and incidence rates; mean values of cases; and mean annual incidence and prevalence rates. Results: The incidence of mortality over these nine years ranged from 9% to 13%; of acute diarrheic disease from 13% to 45%; and scabies from 21% to 63%. The prevalence of pressure ulcers ranged from 8% to 23%. Between 2012 and 2015, the incidence rate of falls without injury varied from 38% to 83%, and with injury from 12% to 20%. Conclusion: Analysis of the health indicators revealed a high incidence of scabies and falls and a high prevalence of pressure ulcers. The identification of less than optimal rates for performance indicators can help improve the quality of nursing care.

Safety culture: perception of health professionals in a mental hospital

OBJECTIVE To evaluate the culture of patient safety in a mental health service. METHOD Cross-sectional study conducted with health professionals in a mental hospital, by applying the Safety Attitudes Questionnaire (SAQ). Descriptive and inferential analyses were performed. RESULTS One-hundred and three professionals participated in the study, with female predominance (64.1%) and time of performance equal to or greater than 21 years (32.4%). The nursing professionals of technical level and with statutory work regime were the most participative, 54.4% and 52% respectively. The total score was 69 points. The domain that reached the highest score was Job satisfaction (80 points) and the lowest was Working conditions (57 points). The statutory professionals and those with longer professional experience obtained better scores in the perception of safety culture. CONCLUSION The result of safety culture was below the recommended, indicating the need for strengthening this construct in mental health hospitals.

Evaluación de la cultura de seguridad en hospitales públicos en Brasil

Objetivo: evaluar la cultura de seguridad en tres hospitales publicos. Metodo: estudio transversal realizado en tres hospitales publicos brasilenos, desarrollado con profesionales de la salud aplicando el Safety Attitudes Questionnaire (SAQ). Fueron considerados positivos puntajes mayores o iguales a 75. Resultados: participaron del estudio 573 profesionales, incluyendo tecnicos y auxiliares de enfermeria 292 (51%), enfermeros 105 (18,3%), medicos 59 (10,3%), y otros profesionales 117 (20,4%). El promedio del SAQ vario entre 65 a 69 en los tres hospitales. Sin embargo, en los dominios, Satisfaccion en el Trabajo presento mayor puntaje y lo opuesto fue observado en el dominio Percepcion de la Administracion. Los profesionales tercerizados presentaron mejor percepcion de la cultura de seguridad que los profesionales estatutarios. Los profesionales de nivel superior presentaron mejor percepcion de los factores estresores que los profesionales de nivel medio. Conclusion: el nivel de cultura de seguridad encontrado se encuentra debajo de lo ideal. Las acciones administrativas son consideradas como el principal contribuyente para la fragilidad de la cultura, entretanto los profesionales se demostraron satisfechos con el trabajo.

Avaliação da cultura de segurança em hospitais públicos no Brasil

Objetivo: evaluar la cultura de seguridad en tres hospitales publicos. Metodo: estudio transversal realizado en tres hospitales publicos brasilenos, desarrollado con profesionales de la salud aplicando el Safety Attitudes Questionnaire (SAQ). Fueron considerados positivos puntajes mayores o iguales a 75. Resultados: participaron del estudio 573 profesionales, incluyendo tecnicos y auxiliares de enfermeria 292 (51%), enfermeros 105 (18,3%), medicos 59 (10,3%), y otros profesionales 117 (20,4%). El promedio del SAQ vario entre 65 a 69 en los tres hospitales. Sin embargo, en los dominios, Satisfaccion en el Trabajo presento mayor puntaje y lo opuesto fue observado en el dominio Percepcion de la Administracion. Los profesionales tercerizados presentaron mejor percepcion de la cultura de seguridad que los profesionales estatutarios. Los profesionales de nivel superior presentaron mejor percepcion de los factores estresores que los profesionales de nivel medio. Conclusion: el nivel de cultura de seguridad encontrado se encuentra debajo de lo ideal. Las acciones administrativas son consideradas como el principal contribuyente para la fragilidad de la cultura, entretanto los profesionales se demostraron satisfechos con el trabajo.

Assessment of the culture of safety in public hospitals in Brazil

Objetivo: evaluar la cultura de seguridad en tres hospitales publicos. Metodo: estudio transversal realizado en tres hospitales publicos brasilenos, desarrollado con profesionales de la salud aplicando el Safety Attitudes Questionnaire (SAQ). Fueron considerados positivos puntajes mayores o iguales a 75. Resultados: participaron del estudio 573 profesionales, incluyendo tecnicos y auxiliares de enfermeria 292 (51%), enfermeros 105 (18,3%), medicos 59 (10,3%), y otros profesionales 117 (20,4%). El promedio del SAQ vario entre 65 a 69 en los tres hospitales. Sin embargo, en los dominios, Satisfaccion en el Trabajo presento mayor puntaje y lo opuesto fue observado en el dominio Percepcion de la Administracion. Los profesionales tercerizados presentaron mejor percepcion de la cultura de seguridad que los profesionales estatutarios. Los profesionales de nivel superior presentaron mejor percepcion de los factores estresores que los profesionales de nivel medio. Conclusion: el nivel de cultura de seguridad encontrado se encuentra debajo de lo ideal. Las acciones administrativas son consideradas como el principal contribuyente para la fragilidad de la cultura, entretanto los profesionales se demostraron satisfechos con el trabajo.

Nursing Practices In Intravenous Therapy In Newborns: An Integrative Review

Objective: to identify the evidence on nursing practices in intravenous therapy in newborns. Method: integrative review in the PubMed, Scopus and SciELO databases. A total of 150 articles were selected, and after thorough reading, eight studies remained. Results: Most of the studies were descriptive and cross-sectional (50%), using peripheral venous catheter (62.5%). The years varied between 2006 and 2014. Brazilian studies corresponded to 37.5%. Conclusion: The main nursing practices were: use of saline solution for catheter clearing; use of larger caliber catheters; use of splints to support the limbs; adequate positioning of the upper limb during radiography for correct confirmation of the positioning of the tip of the peripherally inserted central catheter; management of pain with pharmacological and non-pharmacological actions. Descriptors: Nursing care; Newborn; Peripheral catheterization; Vascular access devices; Evidence-Based Clinical Practice.

Indicadores sanitarios y la seguridad del anciano institucionalizado

OBJECTIVE To identify the incidence of mortality, diarrheal diseases, scabies and falls; and the prevalence of pressure ulcers - all of which are related to the safety ofinstitutionalized older adults. METHOD This was a documentary retrospective study developed in a long-term residential careinstitution for older adults in the Northeast region of Brazil. The data were gathered from records of health assessment indicators filed between January 2008 and December 2015. Analysis included absolute case frequency; the sum of monthly prevalence and incidence rates; mean values of cases; and mean annual incidence and prevalence rates. RESULTS The incidence of mortality over these nine years ranged from 9% to 13%; of acute diarrheic disease from 13% to 45%; and scabies from 21% to 63%. The prevalence of pressure ulcers ranged from 8% to 23%. Between 2012 and 2015, the incidence rate of falls without injury varied from 38% to 83%, and with injury from12% to 20%. CONCLUSION Analysis of the health indicators revealeda high incidence of scabies and falls and a high prevalence of pressure ulcers. The identification of less than optimal rates for performance indicators canhelp improve the quality of nursing care. OBJETIVO Identificar a incidência de mortalidade, doenças diarreicas, escabiose e quedas, e a prevalência de lesões por pressão para a segurança do idoso institucionalizado. MÉTODO Estudo documental, retrospectivo desenvolvido em uma Instituição de Longa Permanência para Idosos, localizada no nordeste do Brasil. Os dados foram coletados por meio dos registros dos indicadores de avaliação de saúde, arquivados de janeiro de 2008 a dezembro de 2015. A análise incluiu a frequência absoluta dos casos; o somatório das taxas de prevalência e incidência mensais; a média de casos e das taxas de incidência e prevalência anuais. RESULTADOS Observa-se que a incidência de óbitos nos nove anos considerados variou de 9 a 13%; de doenças diarreicas agudas, de 13 a 45%; e de escabiose, de 21 a 63%. A prevalência de lesão por pressão oscilou de 8 a 23%. Entre os anos de 2012 a 2015, a taxa de incidência de quedas sem lesão variou em torno de 38 a 83%, e com lesão, de 12 a 20%. CONCLUSÃO A análise da amplitude dos indicadores de saúde permitiu identificar a alta incidência de escabiose e de quedas e a elevada prevalência de lesões por pressão. A identificação do comprometimento dos indicadores contribui para otimização da qualidade da assistência de enfermagem.OBJECTIVE To identify the incidence of mortality, diarrheal diseases, scabies and falls; and the prevalence of pressure ulcers - all of which are related to the safety ofinstitutionalized older adults. METHOD This was a documentary retrospective study developed in a long-term residential careinstitution for older adults in the Northeast region of Brazil. The data were gathered from records of health assessment indicators filed between January 2008 and December 2015. Analysis included absolute case frequency; the sum of monthly prevalence and incidence rates; mean values of cases; and mean annual incidence and prevalence rates. RESULTS The incidence of mortality over these nine years ranged from 9% to 13%; of acute diarrheic disease from 13% to 45%; and scabies from 21% to 63%. The prevalence of pressure ulcers ranged from 8% to 23%. Between 2012 and 2015, the incidence rate of falls without injury varied from 38% to 83%, and with injury from12% to 20%. CONCLUSION Analysis of the health indicators revealeda high incidence of scabies and falls and a high prevalence of pressure ulcers. The identification of less than optimal rates for performance indicators canhelp improve the quality of nursing care.ABSTRACT Objective: To identify the incidence of mortality, diarrheal diseases, scabies and falls; and the prevalence of pressure ulcers – all of which are related to the safety of institutionalized older adults. Method: This was a documentary retrospective study developed in a long-term residential care institution for older adults in the Northeast region of Brazil. The data were gathered from records of health assessment indicators filed between January 2008 and December 2015. Analysis included absolute case frequency; the sum of monthly prevalence and incidence rates; mean values of cases; and mean annual incidence and prevalence rates. Results: The incidence of mortality over these nine years ranged from 9% to 13%; of acute diarrheic disease from 13% to 45%; and scabies from 21% to 63%. The prevalence of pressure ulcers ranged from 8% to 23%. Between 2012 and 2015, the incidence rate of falls without injury varied from 38% to 83%, and with injury from 12% to 20%. Conclusion: Analysis of the health indicators revealed a high incidence of scabies and falls and a high prevalence of pressure ulcers. The identification of less than optimal rates for performance indicators can help improve the quality of nursing care.

Indicadores de saúde e a segurança do idoso institucionalizado

OBJECTIVE To identify the incidence of mortality, diarrheal diseases, scabies and falls; and the prevalence of pressure ulcers - all of which are related to the safety ofinstitutionalized older adults. METHOD This was a documentary retrospective study developed in a long-term residential careinstitution for older adults in the Northeast region of Brazil. The data were gathered from records of health assessment indicators filed between January 2008 and December 2015. Analysis included absolute case frequency; the sum of monthly prevalence and incidence rates; mean values of cases; and mean annual incidence and prevalence rates. RESULTS The incidence of mortality over these nine years ranged from 9% to 13%; of acute diarrheic disease from 13% to 45%; and scabies from 21% to 63%. The prevalence of pressure ulcers ranged from 8% to 23%. Between 2012 and 2015, the incidence rate of falls without injury varied from 38% to 83%, and with injury from12% to 20%. CONCLUSION Analysis of the health indicators revealeda high incidence of scabies and falls and a high prevalence of pressure ulcers. The identification of less than optimal rates for performance indicators canhelp improve the quality of nursing care. OBJETIVO Identificar a incidência de mortalidade, doenças diarreicas, escabiose e quedas, e a prevalência de lesões por pressão para a segurança do idoso institucionalizado. MÉTODO Estudo documental, retrospectivo desenvolvido em uma Instituição de Longa Permanência para Idosos, localizada no nordeste do Brasil. Os dados foram coletados por meio dos registros dos indicadores de avaliação de saúde, arquivados de janeiro de 2008 a dezembro de 2015. A análise incluiu a frequência absoluta dos casos; o somatório das taxas de prevalência e incidência mensais; a média de casos e das taxas de incidência e prevalência anuais. RESULTADOS Observa-se que a incidência de óbitos nos nove anos considerados variou de 9 a 13%; de doenças diarreicas agudas, de 13 a 45%; e de escabiose, de 21 a 63%. A prevalência de lesão por pressão oscilou de 8 a 23%. Entre os anos de 2012 a 2015, a taxa de incidência de quedas sem lesão variou em torno de 38 a 83%, e com lesão, de 12 a 20%. CONCLUSÃO A análise da amplitude dos indicadores de saúde permitiu identificar a alta incidência de escabiose e de quedas e a elevada prevalência de lesões por pressão. A identificação do comprometimento dos indicadores contribui para otimização da qualidade da assistência de enfermagem.OBJECTIVE To identify the incidence of mortality, diarrheal diseases, scabies and falls; and the prevalence of pressure ulcers - all of which are related to the safety ofinstitutionalized older adults. METHOD This was a documentary retrospective study developed in a long-term residential careinstitution for older adults in the Northeast region of Brazil. The data were gathered from records of health assessment indicators filed between January 2008 and December 2015. Analysis included absolute case frequency; the sum of monthly prevalence and incidence rates; mean values of cases; and mean annual incidence and prevalence rates. RESULTS The incidence of mortality over these nine years ranged from 9% to 13%; of acute diarrheic disease from 13% to 45%; and scabies from 21% to 63%. The prevalence of pressure ulcers ranged from 8% to 23%. Between 2012 and 2015, the incidence rate of falls without injury varied from 38% to 83%, and with injury from12% to 20%. CONCLUSION Analysis of the health indicators revealeda high incidence of scabies and falls and a high prevalence of pressure ulcers. The identification of less than optimal rates for performance indicators canhelp improve the quality of nursing care.ABSTRACT Objective: To identify the incidence of mortality, diarrheal diseases, scabies and falls; and the prevalence of pressure ulcers – all of which are related to the safety of institutionalized older adults. Method: This was a documentary retrospective study developed in a long-term residential care institution for older adults in the Northeast region of Brazil. The data were gathered from records of health assessment indicators filed between January 2008 and December 2015. Analysis included absolute case frequency; the sum of monthly prevalence and incidence rates; mean values of cases; and mean annual incidence and prevalence rates. Results: The incidence of mortality over these nine years ranged from 9% to 13%; of acute diarrheic disease from 13% to 45%; and scabies from 21% to 63%. The prevalence of pressure ulcers ranged from 8% to 23%. Between 2012 and 2015, the incidence rate of falls without injury varied from 38% to 83%, and with injury from 12% to 20%. Conclusion: Analysis of the health indicators revealed a high incidence of scabies and falls and a high prevalence of pressure ulcers. The identification of less than optimal rates for performance indicators can help improve the quality of nursing care.

Nursing Diagnoses Using the International Classification for Nursing Practice (ICNP®) for Institucionalized Elderly

Introduction: Nursing care for institutionalized elderly should be done through systematized actions and by using the nursing process, directing the care actions to the affected needs with theoretical support and use of classification systems. In this context, the objective was to develop nursing diagnoses of the International Classification for Nursing Practice for institutionalized elderly.Method: This is a descriptive study, developed in a Long-stay Institution for Elderly People in Northeast Brazil. The survey was conducted from April to May 2016, with 28 institutionalized elderly. Data collection was guided by a form based in Henderson’s theory and carried out through physical examination, clinical interview and records consultation. The nursing diagnoses were developed by using the International Classification for Nursing Practice version 2015. Data were analyzed using SPSS version 20.0.Results: Authors found 81 types of diagnoses, among which there was highlight to: impaired heart condition, productive cough, obesity, urinary incontinence, constipation, diarrhea, risk for falls, impaired sleep, impaired ability to perform hygiene, edema in the lower limbs and impaired vision, lack of recreational activity, positive socialization and positive religious belief. Most nursing diagnoses belonged to the needs of moving and maintaining desirable posture and communicating.Conclusion: There was an increased frequency of diagnoses related to biological needs.