Marília Perrelli Valença

Use of the air mattress in the reduction of pressure ulcers: efficacy and perceptions of nursing

Objective: to evaluate the effectiveness of the air mattress in reducing pressure ulcers in the coronary unit of a referral hospital for cardiology. Method: Cross-sectional, retrospective, descriptive, exploratory study with a quantitative approach carried out at the Epidemiology and Infection Control (NEPI-CCIH) and in coronary care units I and II of the University Cardiac Emergency Room of Pernambuco Prof. Luiz Tavares/PROCAPE. The Ethics Committee in Research, CAAE No 12292213.2.0000.5194, approved the research project. Results: the mattresses were effective in reducing the incidence of pressure ulcers, showing a rate of 55.3% when comparing years 2011 and 2012. The opinion of the nursing staff about the effectiveness of the mattress showed positive results in the majority of the interviewed (98.6%), but 48.8% of professionals did not know the technology before the implementation. Conclusion: there is the need to update the teams working in intensive care for the use of air mattresses. Descriptors: Pressure Ulcer; Nursing Evaluation; Nursing; Intensive Care. RESUMO Objetivo: avaliar a eficácia do colchão pneumático na redução de úlceras por pressão nas unidades coronarianas de um hospital de referência em cardiologia. Método: estudo transversal, retrospectivo, descritivo-exploratório, com abordagem quantitativa, realizado no Núcleo de Epidemiologia e Controle de Infecção (NEPI-CCIH) e nas unidades coronarianas I e II do Pronto-Socorro Cardiológico Universitário de Pernambuco – Prof. Luiz Tavares/PROCAPE. O projeto de pesquisa foi aprovado pelo Comitê de Ética em Pesquisa, CAAE no 12292213.2.0000.5194. Resultados: os colchões apresentaram-se eficazes na redução da incidência das ulceras por pressão, apontando uma taxa de 55,3% quando comparados os anos de 2011 e 2012. A opinião da equipe de enfermagem quanto à eficácia do colchão mostrou resultado positivo na maioria dos entrevistados (98,6%), porém foi observado que 48,8% dos profissionais não conheciam a tecnologia antes de sua implantação. Conclusão: há necessidade de atualização das equipes que trabalham em terapia intensiva para o uso dos colchões pneumáticos. Descritores: Úlcera por Pressão; Avaliação em Enfermagem; Cuidados de Enfermagem; Terapia Intensiva. RESUMEN Objetivo: evaluar la eficacia del colchón de aire en la reducción de úlceras por presión en las unidades coronarias de un hospital de referencia en cardiología. Método: estudio transversal, retrospectivo, descriptivo-exploratorio, con enfoque cuantitativo, realizado en el Núcleo de Epidemiologia y Control de Infección (NEPI-CCIH) y en las unidades coronarias I y II de la Emergencia Cardiológica Universitaria de Pernambuco Prof. Luiz Tavares/PROCAPE. El proyecto de investigación fue aprobado por el Comité de Ética en Investigación, CAAE no 12292213.2.0000.5194. Resultados: los colchones se presentaron eficaces en la reducción de la incidencia de las ulceras por presión, mostrando una tasa de 55,3% cuando comparados a los años de 2011 y 2012. La opinión del equipo de enfermería sobre la eficacia del colchón mostró resultado positivo en la mayoría de los entrevistados (98,6%), sin embargo fue observado que 48,8% de los profesionales no conocían la tecnología antes de su implantación. Conclusión: hay necesidad de actualización de los equipos que trabajan en terapia intensiva para el uso de los colchones de aire. Descriptores: Úlcera por Presión; Evaluación en Enfermería; Cuidados de Enfermería; Terapia Intensiva. Nurse, Higher Education Foundation of Olinda/FUNESO. Olinda (PE), Brazil. E-mail: ruana.nobrega@hotmail.com; Nurse, Higher Education Foundation of Olinda /FUNESO. Olinda (PE), Brazil. E-mail: ruana.nobrega@hotmail.com; Nurse, Specialist in Life Advanced Support, Student in the Nursing Specialization Program in Cardiology Residency, Cardiac Emergency Room in Pernambuco/PROCAPE. Recife (PE), Brazil. Email: edutgs@hotmail.com; Nurse, Master degree in Health Science, CCIH of the Cardiac Emergency Room in Pernambuco/PROCAPE. Recife (PE), Brazil. Email: mariliaperreli@gmail.com; Nurse, Master degree in Health Science, ICU of the Clinic Hospital, Federal University of Pernambuco/UFPE. Recife (PE), Brazil. Email: aracelecavalcanti@hotmail.com ORIGINAL ARTICLE Pinho CM, Correia RN, Valença MP et al. Use of the air mattress in the reduction of... English/Portuguese J Nurs UFPE on line., Recife, 8(8):2729-35, Aug., 2014 2730 ISSN: 1981-8963 DOI: 10.5205/reuol.6081-52328-1-SM.0808201421 Risk factors predispose the individual to prolonged periods of ischemia induced by pressure reducing the ability of tissue recovery from the ischemic injury and may be associated with intrinsic or extrinsic factors. Injuries by pressure worry and discourage patients and are a gateway to infection, hindering recovery, increasing the time required for nursing care and therefore costs, increasing mortality in some patients. The loss of skin integrity produces significant consequences for the individual, the institution and the community. The prevalence of pressure ulcers has increased in recent years due to increased life expectancy of the population, associated with the advances of modern medicine, making possible the survival of patients with serious diseases and before lethal, transforming into chronic diseases and slowly wasting. Despite these advances in health care, pressure ulcer is still an important cause of morbidity and mortality and impact on quality of life of patients and their families, creating a social and economic problem. More than one million people develop pressure ulcers each year. Taking into account the pressure ulcers, the prevalence in a given sector is defined as the number of clients with at least one pressure ulcer that exists in a population of patients in a given time. Some risk factors are the most important for the development of pressure ulcers, condition imposing physical, emotional and social overload on the patients and their family. The patient feels unmotivated to continue the treatment becoming susceptible to the deterioration in quality of life, implying increased costs for health care, as special dressings and medications, when staying longer in the hospital and predisposing the patient to prolonged periods of ischemia induced by pressure, reducing the ability of ischemic tissue injury recovery and increasing morbidity and mortality by infections. Immobility, malnutrition, anemia, edema, drug vasoconstriction, altered level of consciousness, incontinence and vascular disorders increase the developing of pressure ulcers, causing additional problems such as pain, suffering and increased mortality and morbidity, longer the time and cost of hospitalization. The lack of mobility is one of the risk factors for pressure ulcers, enabling the presence of local pressure on bony prominences without alternations, having tissue malnutrition. Tissue injury by pressure is a wound that causes suffering and discomfort, being avoided and minimized using systematization of nursing care to define the changes in position, protocols for prevention of ulcers with technological covers reducing the risk of friction and shear and the bony prominences, aid risk scales already translated and validated and the use of alternating pressure mattresses helping in the continuous change of pressure in the bony prominences and alleviating blood flow, reducing the possibility of ischemia area. Reducing or relieving pressure is the most important prophylactic measure and it can be achieved by proper positioning of the patient in bed and reducing the use of pressure devices. The position changing is needed to relieving and redistributing pressure on the skin, allowing the flow of blood into the ischemic areas and helping in the recovery of tissue from the effects of pressure. Many times it is necessary the use of pressure relief devices, especially patients for bedridden and who have risk factors as a preventive way to relieve pressure on bony prominences, preventing the development of pressure ulcers. The system can reduce the working time of nurses’ professionals, giving mobility and changing the position of the bedridden often, to allow them to do other activities. Another advantage is the savings in materials and hospital equipment, because with the prevention of pressure ulcers, it is possible to avoid the many complications that would occur in their presence, reducing the consumption and use of resources in the health area. The use of mattresses with redistributed surface of pressure on hospital beds and operating tables decreases the possibility of new lesions. Although it requires more investment, it can be cost-effective decreasing the time of hospitalization. To prevent pressure ulcers, there are various mattresses available in the market using a fluid substance to ease and redistribute the pressure body on a surface. In addition to preventing the diseases, these mattresses also ensure support of the body more comfortably. Among the fluids used in these applications are water, air or special gels. There are also models that use alternating pressure between the body and the mattress by inflation and deflation of air in pneumatic pockets. Pressure control in these pockets is usually by some sort of electronic system. INTRODUCTION Pinho CM, Correia RN, Valença MP et al. Use of the air mattress in the reduction of... English/Portuguese J Nurs UFPE on line., Recife, 8(8):2729-35, Aug., 2014 2731 ISSN: 1981-8963 DOI: 10.5205/reuol.6081-52328-1-SM.0808201421 ● To evaluate the effectiveness of the use of air mattress in reducing pressure ulcers in coronary care units of a cardiology hospital referral. Descriptive, cross-sectional, retrospective study with a quantitative approach carried out at the Epidemiology and Infection Control (NEPI-CCIH) and in coronary care units I and II of the University Cardiac Emergency Room of Pernambuco Prof. Luiz Tavares (PROCAPE). The PROCAPE is a cardiology referral service in th

Religiosidade prejudicada e sofrimento espiritual em pessoas vivendo com HIV/aids.

Objetivo: Verificar a inferencia dos Diagnosticos de Enfermagem, Religiosidade prejudicada e Sofrimento espiritual em pessoas vivendo com HIV/AIDS. Metodos: Trata-se de um estudo transversal, com abordagem quantitativa, realizado em um Servico de Assistencia Especializada de Recife, Pernambuco, de junho a novembro de 2015. Os resultados relacionados as 52 pessoas vivendo com HIV/AIDS entrevistadas foram analisados por tres juizes enfermeiros. Resultados: Estimou-se em 73,1% (38) a incidencia de Sofrimento espiritual, 36,5% (19) de Religiosidade prejudicada, com numero medio de caracteristicas definidoras de 3,88±2,05 e 2,55±0,69. A principal caracteristica definidora para a Religiosidade prejudicada foi: “relata necessidade de reconectar-se com crencas anteriores” (92,3%); e para Sofrimento espiritual: “expressa falta de finalidade na vida/expressa falta de significado na vida” (86,5%). Conclusoes: Os resultados apontam para a necessidade de considerar a dimensao religiosa-espiritual nos protocolos assistenciais e de pesquisa em enfermagem. Palavras-chave: Espiritualidade. HIV. Diagnostico de enfermagem.

Estrategias de afrontamiento religioso y espiritual en personas que viven con VIH/SIDA

OBJECTIVE evaluate the religiosity and the religious/spiritual coping of people living with HIV/Aids. METHOD descriptive, cross-sectional study with quantitative approach, conducted in a reference HIV/Aids outpatient clinic in a university hospital of Recife-PE, Brazil, from June to November 2015. At total of 52 people living with HIV/Aids (PLWHA) participated in the research, which employed own questionnaire, the Duke University Religion Index (DUREL), and the Religious/Spiritual Coping Scale (RCOPE). RESULTS the sample presented high indices of organizational religiosity (4.23±1.66), non-organizational religiosity (4.63±1.50), and intrinsic religiosity (13.13±2.84). Positive RCOPE was used in high mean scores (3.66±0.88), and negative RCOPE had low use (2.12 ± 0.74). In total, use of RCOPE was high (3.77±0.74), having predominated the positive RCOPE (NegRCOPE/PosRCOPE ratio=0.65±0.46). CONCLUSION it is evident the importance of encouraging religious activity and RCOPE strategies, seen in the past as inappropriate interventions in clinical practice.

Coping religioso e espiritual em pessoas vivendo com HIV/Aids

OBJECTIVE evaluate the religiosity and the religious/spiritual coping of people living with HIV/Aids. METHOD descriptive, cross-sectional study with quantitative approach, conducted in a reference HIV/Aids outpatient clinic in a university hospital of Recife-PE, Brazil, from June to November 2015. At total of 52 people living with HIV/Aids (PLWHA) participated in the research, which employed own questionnaire, the Duke University Religion Index (DUREL), and the Religious/Spiritual Coping Scale (RCOPE). RESULTS the sample presented high indices of organizational religiosity (4.23±1.66), non-organizational religiosity (4.63±1.50), and intrinsic religiosity (13.13±2.84). Positive RCOPE was used in high mean scores (3.66±0.88), and negative RCOPE had low use (2.12 ± 0.74). In total, use of RCOPE was high (3.77±0.74), having predominated the positive RCOPE (NegRCOPE/PosRCOPE ratio=0.65±0.46). CONCLUSION it is evident the importance of encouraging religious activity and RCOPE strategies, seen in the past as inappropriate interventions in clinical practice.

Religious and spiritual coping in people living with HIV/Aids

OBJECTIVE evaluate the religiosity and the religious/spiritual coping of people living with HIV/Aids. METHOD descriptive, cross-sectional study with quantitative approach, conducted in a reference HIV/Aids outpatient clinic in a university hospital of Recife-PE, Brazil, from June to November 2015. At total of 52 people living with HIV/Aids (PLWHA) participated in the research, which employed own questionnaire, the Duke University Religion Index (DUREL), and the Religious/Spiritual Coping Scale (RCOPE). RESULTS the sample presented high indices of organizational religiosity (4.23±1.66), non-organizational religiosity (4.63±1.50), and intrinsic religiosity (13.13±2.84). Positive RCOPE was used in high mean scores (3.66±0.88), and negative RCOPE had low use (2.12 ± 0.74). In total, use of RCOPE was high (3.77±0.74), having predominated the positive RCOPE (NegRCOPE/PosRCOPE ratio=0.65±0.46). CONCLUSION it is evident the importance of encouraging religious activity and RCOPE strategies, seen in the past as inappropriate interventions in clinical practice.

Adesão às medidas de prevenção para pneumonia associada à ventilação mecânica

Aim: to assess adherence of health professionals from intensive care units concerning the preventive measures of ventilation associated to pneumonia implemented in the hospital. Method: descriptive, quantitative and observational study, developed with 130 patients on mechanical ventilation for more than 48 hours, resulting in 481 observations, conducted at a university hospital in Recife city from february to april 2014. Results: results revealed substandard care and patient exposure to hazards, since only 35.38% of the patients, completely joined the ventilation associated to pneumonia prevention protocol. Sedation interruption and oral hygiene are the interventions that showed the lowest line index, 70.06% and 48.86% respectively. Final Remarks: quality care reflects in the reduction of pneumonia cases associated to mechanical ventilation and patient safety, therefore it requires multidisciplinary education and periodic lectures

Burnout syndrome in nursing staff working in the intensive care units of an university hospital

ABSTRACT Objective : to investigate the occurrence of burnout syndrome in nurses who works in the intensive care units (ICU). Method : this is about a descriptive, exploratory and transverse sectional research. Data collection will be accomplished through self-administered questionnaire to the study population through the Maslach Burnout Inventory (MBI) which will investigate professional burnout. Expected Results : it will be used for data analysis the SPSS (Statistical Package for Social Sciences), considering the results statistically significant if p Descriptors : nursing; burnout professional; intensive care units. RESUMO Objetivo : investigar a ocorrencia da Sindrome de Burnout em enfermeiros que trabalham nas Unidades de Terapia Intensiva (UTI) de um Hospital Universitario da cidade do Recife. Metodo : estudo descritivo, de carater exploratorio, do tipo corte transversal. A populacao sera constituida pela totalidade dos enfermeiros que prestam assistencia em terapia intensiva no referido hospital, o que corresponde a uma amostra de 43 enfermeiros (as). A coleta de dados sera realizada por meio de questionario auto-aplicavel, o Maslach Burnout Inventory (MBI) onde sera investigado o desgaste do profissional. Resultados esperados : sera utilizado para analise dos dados o SPSS (Statistical Package for the Social Sciences), considerando os resultados estatisticamente significantes se p Descritores : enfermagem; esgotamento profissional; unidades de terapia intensiva. RESUMEM Objetivo : investigar la aparicion del sindrome de burnout en enfermeros que trabajan en unidades de cuidados intensivos (UCI). Metodo : estudio descriptivo, exploratorio de la seccion transversal. La recopilacion de datos se llevara a cabo a traves de cuestionario auto-administrado a la poblacion de estudio a traves del Maslach Burnout Inventory (MBI), que investigara el desgaste profesional. Resultados esperados : se utiliza para el analisis de datos lo SPSS (Statistical Package for Social Sciences), teniendo en cuenta los resultados estadisticamente significativos si p Descriptores : enfermeria; agotamiento profesional; unidades de terapia intensive.