Marisa Dias Rolan Loureiro

Quality of nursing care in intensive care unit at a university hospital

Este estudo transversal objetivou analisar a qualidade da assistencia de enfermagem numa unidade de terapia intensiva geral para adultos de um hospital escola. Os dados foram coletados de 23 clientes com permanencia na unidade ≥ 72 horas, de junho a novembro de 2012, por meio de um Roteiro de Auditoria Operacional e a qualidade dos cuidados foi classificada segundo o indice de positividade (IP) da seguinte forma: IP = 100%: cuidado desejavel; de 90-99%: adequado; de 80-89%: seguro; de 70-79%: limitrofe; e < 70%: cuidado sofrivel. Assim, a qualidade da assistencia prestada foi sofrivel, pois a media global foi 61,71%. Ademais, o melhor IP foi atribuido ao item “utilizacao de equipamentos” (100%) e o pior ao item “atividades fisicas” (17,39%). Este estudo estabeleceu o diagnostico situacional das praticas de enfermagem no cenario estudado, etapa fundamental para o planejamento de estrategias e acoes que visem a melhoria da qualidade da assistencia prestada.This cross-sectional study aimed to identify and analyze the quality of nursing care in an adult general intensive care unit (ICU) at a university hospital. Data were collected from 23 clients with ICU length of stay > or = 72 hours, from June to November 2012, through an Operational Audit Script and quality of care classified according to the index of positivity (IP) as follows: IP = 100%. desirable care; 90-99%: appropriate care; 80-89%: safe care; 70-79%: limitrophe care, and > 70%: tolerable care. Thus, the quality of care provided was rated as tolerable, as the global average was 61.71%. Furthermore, it was found that the best IP was assigned to the item equipment use (100%) and the worst to the item physical activities (17.39%). This study established the diagnosis of the status of nursing practices in the studied environment, which is a critical step in planning strategies and actions aimed at improving the quality of care provided.

Open system endotracheal suctioning: practices of intensive care nursing professionals

The purpose of this study was to investigate the practices of nursing professionals working in intensive care units regarding open system endotracheal suctioning (ETS). This quantitative study of 25 subjects was conducted in the State of Mato Grosso do Sul (MS), Brazil. Data was collected from April to September 2011 using a checklist monitoring tool composed of 23 items related to the technique. Data was subjected to descriptive statistical analysis. The mean global adherence rate was 51.33%. Poor adherence to 16 items was observed, these being risk factors for the occurrence of adverse effects, particularly occupational accidents, hypoxemia, infection, and hemodynamic instability. Dissatisfactory performance of ETS was found among the professionals investigated, warranting interventions capable of promoting behavioral changes through continuing education aimed at improving the quality of care.Objetivo: Investigar las practicas de los profesionales de enfermeria de cuidados intensivos cuanto a la aspiracion endotraqueal (AET) por sistema abierto. Metodos: Se trata de una investigacion con enfoque cuantitativo, realizada con 25 sujetos en un Hospital Universitario en el estado de Mato Grosso do Sul, Brasil. Los datos fueron recolectados entre abril y septiembre de 2011 con instrumento de monitoreo tipo checklist, con 23 items de la tecnica, analizados mediante estadistica descriptiva. Resultados: El promedio de adhesion global fue del 51,33%. Se ha verificado poca adhesion para 16 items, los cuales son factores de riesgo para la ocurrencia de efectos adversos, en particular los accidentes laborales, las hipoxemias, las infecciones y la inestabilidad hemodinamica. Conclusion: Los profesionales no cumplen satisfactoriamente con la AET, siendo necesario intervenciones para promover cambios de comportamiento a traves de educacion continua dirigida a la mejora de la calidad de la atencion.

Aspiração endotraqueal por sistema aberto: práticas de profissionais de enfermagem em terapia intensiva

The purpose of this study was to investigate the practices of nursing professionals working in intensive care units regarding open system endotracheal suctioning (ETS). This quantitative study of 25 subjects was conducted in the State of Mato Grosso do Sul (MS), Brazil. Data was collected from April to September 2011 using a checklist monitoring tool composed of 23 items related to the technique. Data was subjected to descriptive statistical analysis. The mean global adherence rate was 51.33%. Poor adherence to 16 items was observed, these being risk factors for the occurrence of adverse effects, particularly occupational accidents, hypoxemia, infection, and hemodynamic instability. Dissatisfactory performance of ETS was found among the professionals investigated, warranting interventions capable of promoting behavioral changes through continuing education aimed at improving the quality of care.Objetivo: Investigar las practicas de los profesionales de enfermeria de cuidados intensivos cuanto a la aspiracion endotraqueal (AET) por sistema abierto. Metodos: Se trata de una investigacion con enfoque cuantitativo, realizada con 25 sujetos en un Hospital Universitario en el estado de Mato Grosso do Sul, Brasil. Los datos fueron recolectados entre abril y septiembre de 2011 con instrumento de monitoreo tipo checklist, con 23 items de la tecnica, analizados mediante estadistica descriptiva. Resultados: El promedio de adhesion global fue del 51,33%. Se ha verificado poca adhesion para 16 items, los cuales son factores de riesgo para la ocurrencia de efectos adversos, en particular los accidentes laborales, las hipoxemias, las infecciones y la inestabilidad hemodinamica. Conclusion: Los profesionales no cumplen satisfactoriamente con la AET, siendo necesario intervenciones para promover cambios de comportamiento a traves de educacion continua dirigida a la mejora de la calidad de la atencion.

Knowledge about endotracheal suctioning on the part of intensive care nursing professionals: a descriptive study

Objetivo: Avaliar o conhecimento dos profissionais de enfermagem de Unidade de Terapia Intensiva (UTI) acerca da aspiracao endotraqueal (AET) por sistema aberto. Metodo: Estudo exploratorio, descritivo, de abordagem quantitativa, realizado em julho de 2011 em duas UTIs de um hospital universitario de grande porte de Mato Grosso do Sul. Os dados foram coletados por meio de um questionario. A amostra constituiu-se de 27 profissionais, dos quais 51,9% eram do sexo masculino. Resultados: De maneira global, o conhecimento dos profissionais foi qualificado como regular (73,2% de acertos); contudo, foi considerado como pobre em cinco itens, alem de apresentar-se de maneira distinta entre as categorias profissionais. Discussao: Considerando que conhecimento incorreto predispoe comportamentos inadequados, infere-se que a pratica desses sujeitos pode comprometer a seguranca dos pacientes. Conclusao: Os estudados apresentaram deficits de conhecimento em alguns aspectos da AET, fato que merece investimentos no âmbito do ensino e da assistencia de enfermagem.

Aplicação da metodologia da assistência a pacientes com Lúpus Eritematoso Sistêmico em pulsoterapia: uma experiência docente

Este trabalho e um relato de experiencia do ensino de Enfermagem Clinica para alunos de graduacao, no qual foi utilizada a metodologia de assistencia de enfermagem como estrategia de ensino. Aplicada a pessoas adultas, portadoras de Lupus Eritematoso Sistemico (LES), em sua maioria mulheres jovens, submetidas a pulsoterapia, uma modalidade terapeutica que, por meio da imunossupressao, reduz o processo inflamatorio causado pelos autoanticorpos. Desta forma, a assistencia e sistematizada, individualizada e integral e permite ao academico, oportunidades singulares para correlacao teorico-pratica, com a aplicacao de conhecimentos basicos da area de formacao, contextualizacao do processo saude-doenca e focalizacao ampliada para alem do biologico, abrangendo aspectos emocionais, sociais e espirituais e oportunidade para o aluno avaliar as diversas nuancas que interferem nas condicoes de assistencia oferecidas pelos servicos publicos de saude.This research is an experience report of clinical teaching for undergraduate nursing students, to whom it was used the assistance methodology as a teaching strategy It was applied in adults, suffering Systemic Erythematosus Lupus, young women, in majority, who were submitted to drug pulse therapy, a therapeutic modality which, through immunesuppression, reduces the inflammatory process caused by self antibody. This way, the assistance is systemized, individualized and integral and it allows single opportunities of theoric-pratic correlation for the students, with the application of basic knowledge of the formation area, context of the health-disease process and the focus going beyond the biologic, including emotional, social and spiritual aspects and opportunities for the student to evaluate several factors that interfere in the assistance conditions offered by public health services.

Nursing Diagnosis of Mothers and Roomed-In Newborns

Objetivo: To identify the more frequent nursing diagnoses (ND) among mothers and newborns (NB) in a rooming-in accommodation, according to the taxonomy of the North American Nursing Diagnosis Association (NANDA) 2015-2017. Method: This is a quantitative, cross-sectional, descriptive study in a Rooming-in Maternity of a University Hospital located in the Midwest region of Brazil, in the period from July to October 2013. Results: The sample consisted of 101 mothers and their 102 newborn babies. There were 20 NDs identified among the mothers and nine ND among the newborns. The most common ND among the mothers were the risk of infection (96%), impaired tissue integrity (96%), impaired comfort (84%) and willingness to improved breastfeeding (66%); among the newborns ND there were the risk of infection (100%) and the risk of imbalance of body temperature (100%). Conclusion: A The identification of ND is essential for the work of nurses in rooming-in hospitals. It is expected that the results obtained in this research can contribute to the effectiveness of the NP in similar situations.

Brain Performance Evaluation of Patients Survivors after a Cardiorespiratory Arrest

Introduction: Cardiopulmonary arrest (CPA) is the absence of cardiac mechanical activity, confirmed by the absence of detectable pulse, lack of responsiveness and apnea or gasping, and panting. Objective: To evaluate the brain performance of the adult patients surviving the CPA before it, at discharge and after six months, and to describe the survival of patients six months after hospital discharge. Methods: This is a descriptive, analytical, prospective study with a quantitative approach, developed in a general philanthropic hospital in the city of Campo Grande, in Mato Grosso do Sul, Midwestern Brazil, with 78 patients surviving for Cardiopulmonary Arrest (CPA). Results: Regarding CPA, there were 56.4% (n=44) of cases occurring in the intra-hospital and 30 patients had their hospital discharge. Among the previous diseases, there was hypertension highlighted with 44.9% (n=35). However, there was no statistically significant difference between the previous average of Cerebral Performance Category (CPC) and CPA and at discharge. Of the 30 patients who had hospital discharge, 21 were followed up after discharge, 14 had CPC 1 at discharge, and 15 had the same index six months later. The average CPC at discharge was 1.47 and six months after, it was 1.42. Conclusion: These results enable to understand the gaps in the knowledge of the topic. It is suggested to carry out further research monitoring such patients and recognize the results to facilitate comparisons and contributions to the quality of care in health and decision-making.

Clinical Epidemiological Profile And Warning Signs Of Dengue

Dengue is an arbovirus transmitted to human beings by the Aedes aegypti mosquito, characterized as a systemic viral infection of rapid geographical expansion and today, it a major global infectious problem with the potential risk of death for the individuals affected. Objective: To describe the clinical and epidemiological profile and the most frequent and relevant warning signs of confirmed dengue cases occurred in Campo Grande, the capital of Mato Grosso do Sul (MS), Midwestern Brazil, during 2013 epidemic. Method: This is a descriptive, analytical, cross-sectional and retrospective study conducted through analysis of patients´ records treated at two public hospitals of reference for treatment of infectious and parasitic diseases (IPD) in the city of Campo Grande/MS, Brazil, during an epidemic in 2013. Results: There were 91 confirmed cases of dengue analyzed; 86 of them met the criteria for the diagnosis of dengue with warning signs (DCWS) and five as severe dengue (SD). There was a predominance of females with 60% for cases of DCWA and 64% for SD. The age ranged from 42.65 (±2.22) for cases of DCWS and 60.40 (±6.98) years old for cases of SD. The Warning Signs associated with worsening of the disease were abrupt decreasing in platelets, dyspnea, hypothermia, confusion and psychomotor agitation. Three of the five cases of SD died (60%).Conclusion: The epidemiological situation of dengue in the city of Campo Grande/MS is configured as a public health problem. It is emphasized the importance of developing measures to control and combat of the disease, as well as entomological, sanitary and health surveillance become indispensable.

Aspiración endotraqueal por sistema abierto: prácticas de los profesionales de enfermería en cuidado intensivo

The purpose of this study was to investigate the practices of nursing professionals working in intensive care units regarding open system endotracheal suctioning (ETS). This quantitative study of 25 subjects was conducted in the State of Mato Grosso do Sul (MS), Brazil. Data was collected from April to September 2011 using a checklist monitoring tool composed of 23 items related to the technique. Data was subjected to descriptive statistical analysis. The mean global adherence rate was 51.33%. Poor adherence to 16 items was observed, these being risk factors for the occurrence of adverse effects, particularly occupational accidents, hypoxemia, infection, and hemodynamic instability. Dissatisfactory performance of ETS was found among the professionals investigated, warranting interventions capable of promoting behavioral changes through continuing education aimed at improving the quality of care.Objetivo: Investigar las practicas de los profesionales de enfermeria de cuidados intensivos cuanto a la aspiracion endotraqueal (AET) por sistema abierto. Metodos: Se trata de una investigacion con enfoque cuantitativo, realizada con 25 sujetos en un Hospital Universitario en el estado de Mato Grosso do Sul, Brasil. Los datos fueron recolectados entre abril y septiembre de 2011 con instrumento de monitoreo tipo checklist, con 23 items de la tecnica, analizados mediante estadistica descriptiva. Resultados: El promedio de adhesion global fue del 51,33%. Se ha verificado poca adhesion para 16 items, los cuales son factores de riesgo para la ocurrencia de efectos adversos, en particular los accidentes laborales, las hipoxemias, las infecciones y la inestabilidad hemodinamica. Conclusion: Los profesionales no cumplen satisfactoriamente con la AET, siendo necesario intervenciones para promover cambios de comportamiento a traves de educacion continua dirigida a la mejora de la calidad de la atencion.

Qualidade da assistência de enfermagem em unidade de terapia intensiva de um hospital escola

Este estudo transversal objetivou analisar a qualidade da assistencia de enfermagem numa unidade de terapia intensiva geral para adultos de um hospital escola. Os dados foram coletados de 23 clientes com permanencia na unidade ≥ 72 horas, de junho a novembro de 2012, por meio de um Roteiro de Auditoria Operacional e a qualidade dos cuidados foi classificada segundo o indice de positividade (IP) da seguinte forma: IP = 100%: cuidado desejavel; de 90-99%: adequado; de 80-89%: seguro; de 70-79%: limitrofe; e < 70%: cuidado sofrivel. Assim, a qualidade da assistencia prestada foi sofrivel, pois a media global foi 61,71%. Ademais, o melhor IP foi atribuido ao item “utilizacao de equipamentos” (100%) e o pior ao item “atividades fisicas” (17,39%). Este estudo estabeleceu o diagnostico situacional das praticas de enfermagem no cenario estudado, etapa fundamental para o planejamento de estrategias e acoes que visem a melhoria da qualidade da assistencia prestada.This cross-sectional study aimed to identify and analyze the quality of nursing care in an adult general intensive care unit (ICU) at a university hospital. Data were collected from 23 clients with ICU length of stay > or = 72 hours, from June to November 2012, through an Operational Audit Script and quality of care classified according to the index of positivity (IP) as follows: IP = 100%. desirable care; 90-99%: appropriate care; 80-89%: safe care; 70-79%: limitrophe care, and > 70%: tolerable care. Thus, the quality of care provided was rated as tolerable, as the global average was 61.71%. Furthermore, it was found that the best IP was assigned to the item equipment use (100%) and the worst to the item physical activities (17.39%). This study established the diagnosis of the status of nursing practices in the studied environment, which is a critical step in planning strategies and actions aimed at improving the quality of care provided.