Mariana Fernandes de Souza

Avaliação da realização e do registro da Sistematização da Assistência de enfermagem (SAE) em um hospital universitário

Estudo descritivo que teve por objetivo identificar a realizacao e o registro das etapas da Sistematizacao da Assistencia de Enfermagem SAE- pelo processo de enfermagem e tambem os diagnosticos de enfermagem mais frequentes. Os dados foram obtidos pela analise retrospectiva do total de 135 prontuarios de pacientes internados no periodo de janeiro a julho de 2002 nas unidades de Cardiologia, Doencas Infecto-Parasitarias no Adulto e Neurocirurgia de um Hospital Universitario da cidade de Sao Paulo. As fases: historico, diagnostico, prescricao, evolucao e anotacoes de enfermagem foram realizadas e registradas nas tres unidades, porem, constatou-se falhas na sistematizacao relativas ao registro de diagnosticos de enfermagem sem constar o historico, e o registro de prescricoes sem evolucoes. O diagnostico de enfermagem mais frequente nas tres unidades foi risco de infeccao.This descriptive study was carried out in a teaching hospital at São Paulo city and had as objective to identify the phases performance and registration of nursing care systematization and the most frequent nursing diagnoses. Data were collected retrospectively from 135 patients records of three units: Cardiology, Adult Infectious Diseases and Neurosurgery, from January to July, 2002. The phases: history, nursing diagnoses, prescription, evolution and assessment were performed and registered in the three units, however, it was verified systematization gaps performance related to nursing diagnoses registered without the realization of nursing history and nursing prescriptions without evolution. The most frequent nursing diagnosis in the three units was risk for infection.Este estudio descriptivo tuvo como objetivo identificar la realizacion y registro de las etapas del processo de enfermeria mas frequentemente presentados por pacientes internados en tres enfermerias de um Hospital Universitario de la ciudad de Sao Paulo. Fueron analisados 135 prontuaros de pacientes internados de enero a julho de 2002 en las enfermarias de Cardiologia, Molestias Infecciosas y Parasitarias de Adulto y Neurocirugia. Las fases: historico, diagnostico, prescripcion, evolucion y anotacion de enfermeira fueron realizadas y registradas en las tres unidades. Entretanto, se constato que existen fallas del processo de enfermeria, representadas por el registro de diagnosticos de enfermeria sin constar el historico o el registro de prescripcion sin la evolucion. El diagnostico de enfermeria mas frequente en las tres unidades fue risco para infeccion.

Construção do conhecimento e do fazer enfermagem e os modelos assistenciais

Artigo de reflexao que enfoca as origens e as principais caracteris-ticas dos modelos clinico e epide-miologico, seus nexos com os mo-delos assistenciais vigentes no sis-]tema de saude brasileiro, e a cons-trucao do conhecimento da enfer-magem nesse contexto. Nessa perspectiva, as autoras propoem um repensar acerca do saber/fazer da enfermagem, apontando possibilidades de expansao do seu campo de atuacao, bem como dos limites e desafios a serem venci-dos pelos profissionais da area.This is a reflective paper focused on the origins and main characteristics of the epidemiological and clinical models, their connections with the health care models currently adopted in Brazil, and the construction of Nursing knowledge in this context. From this perspective, the authors propose a re-thinking of Nursing knowledge and practice, pointing out possibilities for expanding the Nursing field, as well as the boundaries and challenges to be overcome by the area professionals.

Difficulties and facilities pointed out by nurses of a university hospital when applying the nursing process

OBJETIVO: Identificar las dificultades y facilidades mencionadas por enfermeras del Hospital Sao Paulo en la ejecucion de las fases del proceso de enfermeria. METODOS: Fueron entrevistadas 83 enfermeras, que trabajaban en 20 unidades de internamiento que poseen el proceso de enfermeria implantado en el servicio, utilizandose cuestionarios estructurados. RESULTADOS: El diagnostico y evolucion de enfermeria fueron las fases que las enfermeras refirieron tener mayor dificultad para operacionalizar. El nucleo de las dificultades y facilidades esta relacionado con el nivel de conocimiento teorico y practico de las enfermeras para la ejecucion de las fases del proceso de enfermeria. CONCLUSION: La falta de conocimiento suficiente se vuelve una barrera para la adhesion de las enfermeras al metodo. Se sugiere la evaluacion de la ensenanza teorica y practica del proceso de enfermeria en el pregrado y la educacion permanente en los servicios hospitalarios.Objective: To identify the difficult and easy aspects of performing the different stages of the nursing process, according to the reports of nurses working at Hospital Sao Paulo. Methods: Eighty-three nurses from 20 different hospital units, where the nursing process was regularly implemented, answered structured research questionnaires. Results: Nursing diagnosis and evolution were the phases where nurses reported more difficulties. Most of the difficult and easy points reported are related to the nurses’ theoretical and practical knowledge to perform the phases of the process. Conclusion: Insufficient knowledge becomes an obstacle for the nurses’ compliance to the nursing process. An evaluation of theoretical and practical teaching of the nursing process during undergraduate courses is recommended, as well as continuous education in hospital settings.

Dificuldades e facilidades apontadas por enfermeiras de um hospital de ensino na execução do processo de enfermagem

OBJETIVO: Identificar las dificultades y facilidades mencionadas por enfermeras del Hospital Sao Paulo en la ejecucion de las fases del proceso de enfermeria. METODOS: Fueron entrevistadas 83 enfermeras, que trabajaban en 20 unidades de internamiento que poseen el proceso de enfermeria implantado en el servicio, utilizandose cuestionarios estructurados. RESULTADOS: El diagnostico y evolucion de enfermeria fueron las fases que las enfermeras refirieron tener mayor dificultad para operacionalizar. El nucleo de las dificultades y facilidades esta relacionado con el nivel de conocimiento teorico y practico de las enfermeras para la ejecucion de las fases del proceso de enfermeria. CONCLUSION: La falta de conocimiento suficiente se vuelve una barrera para la adhesion de las enfermeras al metodo. Se sugiere la evaluacion de la ensenanza teorica y practica del proceso de enfermeria en el pregrado y la educacion permanente en los servicios hospitalarios.Objective: To identify the difficult and easy aspects of performing the different stages of the nursing process, according to the reports of nurses working at Hospital Sao Paulo. Methods: Eighty-three nurses from 20 different hospital units, where the nursing process was regularly implemented, answered structured research questionnaires. Results: Nursing diagnosis and evolution were the phases where nurses reported more difficulties. Most of the difficult and easy points reported are related to the nurses’ theoretical and practical knowledge to perform the phases of the process. Conclusion: Insufficient knowledge becomes an obstacle for the nurses’ compliance to the nursing process. An evaluation of theoretical and practical teaching of the nursing process during undergraduate courses is recommended, as well as continuous education in hospital settings.

Anti-metastatic immunotherapy based on mucosal administration of flagellin and immunomodulatory P10

Current therapies against malignant melanoma generally fail to increase survival in most patients, and immunotherapy is a promising approach as it could reduce the dosage of toxic therapeutic drugs. In the present study, we show that an immunotherapeutic approach based on the use of the Toll‐like receptor (TLR)‐5 ligand flagellin (Salmonella Typhimurium FliCi) combined with the major histocompatibility complex class II‐restricted P10 peptide, derived from the Paracoccidioides brasiliensis gp43 major surface protein, reduced the number of lung metastasis in a murine melanoma model. Compounds were administered intranasally into C57Bl/6 mice intravenously challenged with syngeneic B16F10‐Nex2 melanoma cells, aiming at the local (pulmonary) immune response modulation. Along with a marked reduction in the number of lung nodules, a significant increase in survival was observed. The immunization regimen induced both local and systemic proinflammatory responses. Lung macrophages were polarized towards a M1 phenotype, lymph node cells, and splenocytes secreted higher interleukin‐12p40 and interferon (IFN)‐γ levels when re‐stimulated with tumor antigens. The protective effect of the FliCi+P10 formulation required TLR‐5, myeloid differentiation primary response gene 88 and IFN‐γ expression, but caspase‐1 knockout mice were only partially protected, suggesting that intracellular flagellin receptors are not involved with the anti‐tumor effect. The immune therapy resulted in the activation of tumor‐specific CD4+ T lymphocytes, which conferred protection to metastatic melanoma growth after adoptive transfer. Taken together, our results report a new immunotherapeutic approach based on TLR‐5 activation and IFN‐γ production capable to control the metastatic growth of B16F10‐Nex2 melanoma, being a promising alternative to be associated with chemotherapeutic drugs for an effective anti‐tumor responses.

Acompanhante de adulto na Unidade de Terapia Intensiva: uma visão do paciente

OBJECTIVE: to identify whether or not adult clients would benefit from a companion when admitted to an Intensive Care Unit (ICU). The study variables included gender, age, marital status, educational level, disease acuity, and the number of admission to the ICU. METHODS: this was a descriptive study. Data were collected using semi-structured interviews. Participants included 138 adult clients admitted to an ICU for at least 24 hours. RESULTS:the majority of the participants were male (55.1%). Approximately 59% of the participants reported a preference for the presence of a companion. There was a significant association between a preference for a companion and the number of ICU admission (p = 0.03). There was also a significant association between the female gender and the preference for a companion (p = 0.05). The remaining variables were non-significant. CONCLUSION:the studys findings suggest the need to ask adult clients if they desire a companion on admission to an ICU.Objective: to identify whether or not adult clients would benefit from a companion when admitted to an Intensive Care Unit (ICU). The study variables included gender, age, marital status, educational level, disease acuity, and the number of admission to the ICU. Methods: this was a descriptive study. Data were collected using semi-structured interviews. Participants included 138 adult clients admitted to an ICU for at least 24 hours. Results: the majority of the participants were male (55.1%). Approximately 59% of the participants reported a preference for the presence of a companion. There was a significant association between a preference for a companion and the number of ICU admission (p = 0.03). There was also a significant association between the female gender and the preference for a companion (p = 0.05). The remaining variables were non-significant. Conclusion: the study’s findings suggest the need to ask adult clients if they desire a companion on admission to an ICU.OBJECTIVE: to identify whether or not adult clients would benefit from a companion when admitted to an Intensive Care Unit (ICU). The study variables included gender, age, marital status, educational level, disease acuity, and the number of admission to the ICU. METHODS: this was a descriptive study. Data were collected using semi-structured interviews. Participants included 138 adult clients admitted to an ICU for at least 24 hours. RESULTS:the majority of the participants were male (55.1%). Approximately 59% of the participants reported a preference for the presence of a companion. There was a significant association between a preference for a companion and the number of ICU admission (p = 0.03). There was also a significant association between the female gender and the preference for a companion (p = 0.05). The remaining variables were non-significant. CONCLUSION:the studys findings suggest the need to ask adult clients if they desire a companion on admission to an ICU.

Evaluation of nursing care systematization through the phases of nursing process performance and registration in a teaching hospital

Estudo descritivo que teve por objetivo identificar a realizacao e o registro das etapas da Sistematizacao da Assistencia de Enfermagem SAE- pelo processo de enfermagem e tambem os diagnosticos de enfermagem mais frequentes. Os dados foram obtidos pela analise retrospectiva do total de 135 prontuarios de pacientes internados no periodo de janeiro a julho de 2002 nas unidades de Cardiologia, Doencas Infecto-Parasitarias no Adulto e Neurocirurgia de um Hospital Universitario da cidade de Sao Paulo. As fases: historico, diagnostico, prescricao, evolucao e anotacoes de enfermagem foram realizadas e registradas nas tres unidades, porem, constatou-se falhas na sistematizacao relativas ao registro de diagnosticos de enfermagem sem constar o historico, e o registro de prescricoes sem evolucoes. O diagnostico de enfermagem mais frequente nas tres unidades foi risco de infeccao.This descriptive study was carried out in a teaching hospital at São Paulo city and had as objective to identify the phases performance and registration of nursing care systematization and the most frequent nursing diagnoses. Data were collected retrospectively from 135 patients records of three units: Cardiology, Adult Infectious Diseases and Neurosurgery, from January to July, 2002. The phases: history, nursing diagnoses, prescription, evolution and assessment were performed and registered in the three units, however, it was verified systematization gaps performance related to nursing diagnoses registered without the realization of nursing history and nursing prescriptions without evolution. The most frequent nursing diagnosis in the three units was risk for infection.Este estudio descriptivo tuvo como objetivo identificar la realizacion y registro de las etapas del processo de enfermeria mas frequentemente presentados por pacientes internados en tres enfermerias de um Hospital Universitario de la ciudad de Sao Paulo. Fueron analisados 135 prontuaros de pacientes internados de enero a julho de 2002 en las enfermarias de Cardiologia, Molestias Infecciosas y Parasitarias de Adulto y Neurocirugia. Las fases: historico, diagnostico, prescripcion, evolucion y anotacion de enfermeira fueron realizadas y registradas en las tres unidades. Entretanto, se constato que existen fallas del processo de enfermeria, representadas por el registro de diagnosticos de enfermeria sin constar el historico o el registro de prescripcion sin la evolucion. El diagnostico de enfermeria mas frequente en las tres unidades fue risco para infeccion.

Auto cuidado no tratamento pelo método de Ilizarov: um estudo de caso

As autoras realizaram um estudo de caso com aplicacao do modelo de auto cuidado de Dorothea Orem, no tratamento pelo metodo de Ilizarov, utilizando cuidados e orientacoes especificas para a recuperacao e prevencao de complicacoes. A operacionalizacao do estudo constou de procedimentos relativos as demandasdecuida dos universais e terapeuticos, durante a hospitalizacao. As demandas foram detectadas no pre-operatorio e os cuidados desenvolvidos no pos-operatorio, facilitando ao paciente o aprendizado e a realizacao dos procedimentos necessarios a dar continuidade dos mesmos no seu domicilio.

As classificações e a construção do conhecimento na enfermagem

En este articulo, el conocimiento es enfocado como un proceso, un devenir. Son abordados los aspectos evolutivos dei saber en Enfermeria y son hechas consideraciones sobre el lenguaje y su importancia para la identidad profisional. Tambien es destacada la relevancia de crear conceptos y clasificaciones para guiar la accion profesional. Son resumidamente presentados los Sistemas de Clasificaciones en Enfermeria y es resaltada su contribucion para la construccion dei conocimiento dei area.In the course of this article, knowledge is focused on as a process, a series of continuous transformations. Evolutionary aspects of knowledge in nursing are presented. Considerations are taken into account concerning the human language and its significance as well as the conceptual development and classifications to be used in professional actions. Nursing Classification Systems are briefly described and their importance in the building of knowledge in the nursing area is emphasized.En este articulo, el conocimiento es enfocado como un proceso, un devenir. Son abordados los aspectos evolutivos dei saber en Enfermeria y son hechas consideraciones sobre el lenguaje y su importancia para la identidad profisional. Tambien es destacada la relevancia de crear conceptos y clasificaciones para guiar la accion profesional. Son resumidamente presentados los Sistemas de Clasificaciones en Enfermeria y es resaltada su contribucion para la construccion dei conocimiento dei area.

Health care models and the building of nursing knowledge and practice

Artigo de reflexao que enfoca as origens e as principais caracteris-ticas dos modelos clinico e epide-miologico, seus nexos com os mo-delos assistenciais vigentes no sis-]tema de saude brasileiro, e a cons-trucao do conhecimento da enfer-magem nesse contexto. Nessa perspectiva, as autoras propoem um repensar acerca do saber/fazer da enfermagem, apontando possibilidades de expansao do seu campo de atuacao, bem como dos limites e desafios a serem venci-dos pelos profissionais da area.This is a reflective paper focused on the origins and main characteristics of the epidemiological and clinical models, their connections with the health care models currently adopted in Brazil, and the construction of Nursing knowledge in this context. From this perspective, the authors propose a re-thinking of Nursing knowledge and practice, pointing out possibilities for expanding the Nursing field, as well as the boundaries and challenges to be overcome by the area professionals.