Nelma Ellen Zamberlan

O ruído gerado durante a manipulação das incubadoras: implicações para o cuidado de enfermagem

UNLABELLED Uncontrolled experimental study. AIM Quantify the impact noise of the 23 incubators functioning in the intensive and intermediate care units of a public university hospital in Ribeirão Preto-SP. METHODOLOGY Measuring occurred during incubator manipulation in a careful and in a rough way, considering the impact noise generated by the various situations in which the incubator was manipulated. RESULTS In practically all manipulation situations in both the careful and the rough way, group B presented higher NPS, followed by group A and D. Group C demonstrated the lowest NPS during the different manipulation situations. Even careful manipulation generated a strong noise level, and NPS almost always doubled or tripled when the same situation was realized roughly. Careful manipulation, together with lower incubator use time, revealed to be effective in reducing the noise produced during equipment manipulation.Uncontrolled experimental study. Aim: quantify the impact noise of the 23 incubators functioning in the intensive and intermediate care units of a public university hospital in Ribeirao Preto-SP. Methodology: measuring occurred during incubator manipulation in a careful and in a rough way, considering the impact noise generated by the various situations in which the incubator was manipulated. Results: In practically all manipulation situations in both the careful and the rough way, group B presented higher NPS, followed by group A and D. Group C demonstrated the lowest NPS during the different manipulation situations. Even careful manipulation generated a strong noise level, and NPS almost always doubled or tripled when the same situation was realized roughly. Careful manipulation, together with lower incubator use time, revealed to be effective in reducing the noise produced during equipment manipulation.Estudio del tipo experimento no controlado. Objetivo: cuantificar el ruido de impacto de las 23 incubadoras en operacion de las unidades de cuidado intensivo e intermedio de un hospital universitario publico de Ribeirao Preto-SP. Metodologia: mediciones ocurrieron durante el manejo de las incubadoras de modo cuidadoso y brusco, visando el ruido de impacto generado por las diversas situaciones de manejo con la incubadora. Resultados: En practicamente todas las situaciones de manejo, tanto de modo cuidadoso como de modo brusco, el grupo B presento NPS mas elevados, seguido por el grupo A y D. El grupo C fue el que demostro los menores NPS durante las diversas situaciones de manejo. Mismo el manejo cuidadoso genero fuerte nivel de ruido, y el NPS casi siempre se dobla o triplica cuando la misma situacion se realiza bruscamente. El manejo cuidadoso, en conjunto con menor tempo de uso de la incubadora, se mostro eficaz en la reduccion del ruido producido al manosear el equipo.

Validação do conteúdo de um instrumento para avaliação da prontidão do prematuro para início da alimentação oral

OBJECTIVES: to produce and validate the content and appearance of a tool for evaluating the readiness of preterm infants to begin the transition from gastric to oral feeding. METHODS: for the validation of the tool and accompanying instructions, the authors established a minimum percentage agreement of 85% among the 15 peers who participated in the study, all of them speech therapists with broad experience in the area of neonatology. RESULTS: the validated tool and accompanying instructions contained the following items: corrected gestational age, state of behavioral organization (state of consciousness, overall posture and overall muscle tone), oral posture (lips and tongue), oral reflexes (rooting, sucking, biting and gagging) and non-nutritive sucking (tongue movements, cupped tongue configuration, jaw movements, sucking force, sucking pause, maintaining the rhythm sucking and pause, maintaining an alert state and signs of stress). CONCLUSIONS: the tool and accompanying instructions aim to systematize the evaluation of preterm infants, beginning with the transition from gastric to oral feeding. Clinical validation is necessary before they can be used in neonatal wards.

Confiabilidade do instrumento de avaliação da prontidão do prematuro para alimentação oral

BACKGROUND The transition from gastric to oral feeding of preterm infants is one of the greatest concerns of health professionals and therefore needs an objective criterion to support the beginning of this process. AIM To test the reliability of an instrument that assesses the readiness of preterm infants for the transition from gastric to oral feeding. METHOD The instrument is composed by the following items: corrected gestational age; behavioral state; global posture and tonus; lips and tongue posture; rooting, suck, bite and gag reflexes; tongue and jaw movements; tongue cupping; sucking strain; sucking and pause; maintenance sucking/pause; maintenance alert state and stress signs. The study was conducted at the Intermediate Care Unit of the Hospital de Clínicas da Faculdade de Medicina de Ribeirão Preto-University of São Paulo. The research sample consisted of 30 preterm infants who attended the following inclusion criteria: corrected gestational age<36 weeks and 6 days; clinically stable; absence of facial deformities; respiratory, cardiovascular, gastrointestinal and neurological disorders or syndromes that prevent or make oral feeding difficult; and not having received oral feeding of milk. The Kappa Test was used to verify interjudge reliability. RESULTS The items that presented high reliability levels were: behavioral state, global posture and tonus, lips and tongue posture, gag reflex and maintenance of alert state. The items that presented satisfactory reliability levels were: rooting reflex, sucking and biting and jaw movement, sucking strain and sucking and pause. Only the items of tongue cupping, maintenance of sucking/pause and stress signs presented unsatisfactory reliability levels. CONCLUSION In general, the items investigated by the assessment instrument presented adequate interjudge reliability.

Transição alimentar por via oral em prematuros de um Hospital Amigo da Criança

OBJETIVO: Caracterizar la transicion de la alimentacion gastrica por via oral en lo que se refiere a: madurez y peso del prematuro, vias y tecnicas de administracion y, duracion de la transicion hasta la alimentacion oral exclusiva. METODOS: Es un estudio retrospectivo con datos levantados en fichas de 116 prematuros asistidos en las unidades de cuidados intensivos e intermedios neonatales de un hospital universitario del municipio de Ribeirao Preto- SP. RESULTADOS: La edad de gestacion corregida promedio fue de 36 semanas en el inicio de la alimentacion oral y de 37 semanas cuando la alimentacion ocurrio totalmente por la via oral. El peso promedio fue de 1.743 gramos en el inicio de la alimentacion oral y el peso promedio de 1.934 gramos cuando la alimentacion ocurrio totalmente por la via oral. Durante el periodo de transicion fueron utilizadas una o mas tecnicas de administracion de leche. El uso de alimentacion forzada en conjunto con otras tecnicas (89,5%) predomino, complementada por el seno materno y mamadera (56,9%); la duracion de la transicion alimentar vario de menos de 1 dia a 47 dias. CONCLUSION: La madurez y el peso al nascer, ademas de las condiciones clinicas provenientes de esas variables, pueden interferir en el proceso de transicion de la alimentacion lactea del prematuro. Considerando las ventajas del amamantamiento materno, su practica debe ser iniciada lo mas precozmente posible en este segmento poblacional de riesgo.OBJECTIVE: To characterize the transition from oral gastric feeding related to: maturity and weight of premature babies, methods and techniques of administration and, duration of the transition to only oral feeding. METHODS: This is a retrospective study of data gathered in records of 116 infants attended in intensive care units and neonatal intermediate in a university hospital in Ribeirao Preto-SP. RESULTS: The mean-corrected of gestational age was 36 weeks at the start of oral feeding and 37 weeks when the [...]Objective: To characterize the transition from oral gastric feeding related to: maturity and weight of premature babies, methods and techniques of administration and, duration of the transition to only oral feeding. Methods: This is a retrospective study of data gathered in records of 116 infants attended in intensive care units and neonatal intermediate in a university hospital in Ribeirao Preto-SP. Results: The mean-corrected of gestational age was 36 weeks at the start of oral feeding and 37 weeks when the supply came entirely by the oral route. The average weight was 1,743 grams at the start of oral feeding and 1,934 grams when the food came entirely by the oral route. During the transition period were used one or more means of milk administration. The use of forced feeding in conjunction with other techniques (89.5%) predominated, this was complemented by breast feeding and milk bottle (56.9%); the duration of feeding transition ranged from less than 1 day to 47 days. Conclusion: The maturity and birth weight, in addition to the clinical conditions from these variables, can interfere in the process of milk feeding transition in preterm babies. Considering the advantages of breastfeeding, the practice should be initiated as early as possible in this risk population segment.

Oral feeding transition in preterm infants in a Child-Friendly Hospital

OBJETIVO: Caracterizar la transicion de la alimentacion gastrica por via oral en lo que se refiere a: madurez y peso del prematuro, vias y tecnicas de administracion y, duracion de la transicion hasta la alimentacion oral exclusiva. METODOS: Es un estudio retrospectivo con datos levantados en fichas de 116 prematuros asistidos en las unidades de cuidados intensivos e intermedios neonatales de un hospital universitario del municipio de Ribeirao Preto- SP. RESULTADOS: La edad de gestacion corregida promedio fue de 36 semanas en el inicio de la alimentacion oral y de 37 semanas cuando la alimentacion ocurrio totalmente por la via oral. El peso promedio fue de 1.743 gramos en el inicio de la alimentacion oral y el peso promedio de 1.934 gramos cuando la alimentacion ocurrio totalmente por la via oral. Durante el periodo de transicion fueron utilizadas una o mas tecnicas de administracion de leche. El uso de alimentacion forzada en conjunto con otras tecnicas (89,5%) predomino, complementada por el seno materno y mamadera (56,9%); la duracion de la transicion alimentar vario de menos de 1 dia a 47 dias. CONCLUSION: La madurez y el peso al nascer, ademas de las condiciones clinicas provenientes de esas variables, pueden interferir en el proceso de transicion de la alimentacion lactea del prematuro. Considerando las ventajas del amamantamiento materno, su practica debe ser iniciada lo mas precozmente posible en este segmento poblacional de riesgo.OBJECTIVE: To characterize the transition from oral gastric feeding related to: maturity and weight of premature babies, methods and techniques of administration and, duration of the transition to only oral feeding. METHODS: This is a retrospective study of data gathered in records of 116 infants attended in intensive care units and neonatal intermediate in a university hospital in Ribeirao Preto-SP. RESULTS: The mean-corrected of gestational age was 36 weeks at the start of oral feeding and 37 weeks when the [...]Objective: To characterize the transition from oral gastric feeding related to: maturity and weight of premature babies, methods and techniques of administration and, duration of the transition to only oral feeding. Methods: This is a retrospective study of data gathered in records of 116 infants attended in intensive care units and neonatal intermediate in a university hospital in Ribeirao Preto-SP. Results: The mean-corrected of gestational age was 36 weeks at the start of oral feeding and 37 weeks when the supply came entirely by the oral route. The average weight was 1,743 grams at the start of oral feeding and 1,934 grams when the food came entirely by the oral route. During the transition period were used one or more means of milk administration. The use of forced feeding in conjunction with other techniques (89.5%) predominated, this was complemented by breast feeding and milk bottle (56.9%); the duration of feeding transition ranged from less than 1 day to 47 days. Conclusion: The maturity and birth weight, in addition to the clinical conditions from these variables, can interfere in the process of milk feeding transition in preterm babies. Considering the advantages of breastfeeding, the practice should be initiated as early as possible in this risk population segment.

Noise generated during incubator manipulation: implications for nursing care

UNLABELLED Uncontrolled experimental study. AIM Quantify the impact noise of the 23 incubators functioning in the intensive and intermediate care units of a public university hospital in Ribeirão Preto-SP. METHODOLOGY Measuring occurred during incubator manipulation in a careful and in a rough way, considering the impact noise generated by the various situations in which the incubator was manipulated. RESULTS In practically all manipulation situations in both the careful and the rough way, group B presented higher NPS, followed by group A and D. Group C demonstrated the lowest NPS during the different manipulation situations. Even careful manipulation generated a strong noise level, and NPS almost always doubled or tripled when the same situation was realized roughly. Careful manipulation, together with lower incubator use time, revealed to be effective in reducing the noise produced during equipment manipulation.Uncontrolled experimental study. Aim: quantify the impact noise of the 23 incubators functioning in the intensive and intermediate care units of a public university hospital in Ribeirao Preto-SP. Methodology: measuring occurred during incubator manipulation in a careful and in a rough way, considering the impact noise generated by the various situations in which the incubator was manipulated. Results: In practically all manipulation situations in both the careful and the rough way, group B presented higher NPS, followed by group A and D. Group C demonstrated the lowest NPS during the different manipulation situations. Even careful manipulation generated a strong noise level, and NPS almost always doubled or tripled when the same situation was realized roughly. Careful manipulation, together with lower incubator use time, revealed to be effective in reducing the noise produced during equipment manipulation.Estudio del tipo experimento no controlado. Objetivo: cuantificar el ruido de impacto de las 23 incubadoras en operacion de las unidades de cuidado intensivo e intermedio de un hospital universitario publico de Ribeirao Preto-SP. Metodologia: mediciones ocurrieron durante el manejo de las incubadoras de modo cuidadoso y brusco, visando el ruido de impacto generado por las diversas situaciones de manejo con la incubadora. Resultados: En practicamente todas las situaciones de manejo, tanto de modo cuidadoso como de modo brusco, el grupo B presento NPS mas elevados, seguido por el grupo A y D. El grupo C fue el que demostro los menores NPS durante las diversas situaciones de manejo. Mismo el manejo cuidadoso genero fuerte nivel de ruido, y el NPS casi siempre se dobla o triplica cuando la misma situacion se realiza bruscamente. El manejo cuidadoso, en conjunto con menor tempo de uso de la incubadora, se mostro eficaz en la reduccion del ruido producido al manosear el equipo.

Transición de alimentación oral en bebés prematuros en un Hospital Amigo del Niño

OBJETIVO: Caracterizar la transicion de la alimentacion gastrica por via oral en lo que se refiere a: madurez y peso del prematuro, vias y tecnicas de administracion y, duracion de la transicion hasta la alimentacion oral exclusiva. METODOS: Es un estudio retrospectivo con datos levantados en fichas de 116 prematuros asistidos en las unidades de cuidados intensivos e intermedios neonatales de un hospital universitario del municipio de Ribeirao Preto- SP. RESULTADOS: La edad de gestacion corregida promedio fue de 36 semanas en el inicio de la alimentacion oral y de 37 semanas cuando la alimentacion ocurrio totalmente por la via oral. El peso promedio fue de 1.743 gramos en el inicio de la alimentacion oral y el peso promedio de 1.934 gramos cuando la alimentacion ocurrio totalmente por la via oral. Durante el periodo de transicion fueron utilizadas una o mas tecnicas de administracion de leche. El uso de alimentacion forzada en conjunto con otras tecnicas (89,5%) predomino, complementada por el seno materno y mamadera (56,9%); la duracion de la transicion alimentar vario de menos de 1 dia a 47 dias. CONCLUSION: La madurez y el peso al nascer, ademas de las condiciones clinicas provenientes de esas variables, pueden interferir en el proceso de transicion de la alimentacion lactea del prematuro. Considerando las ventajas del amamantamiento materno, su practica debe ser iniciada lo mas precozmente posible en este segmento poblacional de riesgo.OBJECTIVE: To characterize the transition from oral gastric feeding related to: maturity and weight of premature babies, methods and techniques of administration and, duration of the transition to only oral feeding. METHODS: This is a retrospective study of data gathered in records of 116 infants attended in intensive care units and neonatal intermediate in a university hospital in Ribeirao Preto-SP. RESULTS: The mean-corrected of gestational age was 36 weeks at the start of oral feeding and 37 weeks when the [...]Objective: To characterize the transition from oral gastric feeding related to: maturity and weight of premature babies, methods and techniques of administration and, duration of the transition to only oral feeding. Methods: This is a retrospective study of data gathered in records of 116 infants attended in intensive care units and neonatal intermediate in a university hospital in Ribeirao Preto-SP. Results: The mean-corrected of gestational age was 36 weeks at the start of oral feeding and 37 weeks when the supply came entirely by the oral route. The average weight was 1,743 grams at the start of oral feeding and 1,934 grams when the food came entirely by the oral route. During the transition period were used one or more means of milk administration. The use of forced feeding in conjunction with other techniques (89.5%) predominated, this was complemented by breast feeding and milk bottle (56.9%); the duration of feeding transition ranged from less than 1 day to 47 days. Conclusion: The maturity and birth weight, in addition to the clinical conditions from these variables, can interfere in the process of milk feeding transition in preterm babies. Considering the advantages of breastfeeding, the practice should be initiated as early as possible in this risk population segment.

El ruido generado durante el manejo de incubadoras: implicaciones para la atención de enfermería

UNLABELLED Uncontrolled experimental study. AIM Quantify the impact noise of the 23 incubators functioning in the intensive and intermediate care units of a public university hospital in Ribeirão Preto-SP. METHODOLOGY Measuring occurred during incubator manipulation in a careful and in a rough way, considering the impact noise generated by the various situations in which the incubator was manipulated. RESULTS In practically all manipulation situations in both the careful and the rough way, group B presented higher NPS, followed by group A and D. Group C demonstrated the lowest NPS during the different manipulation situations. Even careful manipulation generated a strong noise level, and NPS almost always doubled or tripled when the same situation was realized roughly. Careful manipulation, together with lower incubator use time, revealed to be effective in reducing the noise produced during equipment manipulation.Uncontrolled experimental study. Aim: quantify the impact noise of the 23 incubators functioning in the intensive and intermediate care units of a public university hospital in Ribeirao Preto-SP. Methodology: measuring occurred during incubator manipulation in a careful and in a rough way, considering the impact noise generated by the various situations in which the incubator was manipulated. Results: In practically all manipulation situations in both the careful and the rough way, group B presented higher NPS, followed by group A and D. Group C demonstrated the lowest NPS during the different manipulation situations. Even careful manipulation generated a strong noise level, and NPS almost always doubled or tripled when the same situation was realized roughly. Careful manipulation, together with lower incubator use time, revealed to be effective in reducing the noise produced during equipment manipulation.Estudio del tipo experimento no controlado. Objetivo: cuantificar el ruido de impacto de las 23 incubadoras en operacion de las unidades de cuidado intensivo e intermedio de un hospital universitario publico de Ribeirao Preto-SP. Metodologia: mediciones ocurrieron durante el manejo de las incubadoras de modo cuidadoso y brusco, visando el ruido de impacto generado por las diversas situaciones de manejo con la incubadora. Resultados: En practicamente todas las situaciones de manejo, tanto de modo cuidadoso como de modo brusco, el grupo B presento NPS mas elevados, seguido por el grupo A y D. El grupo C fue el que demostro los menores NPS durante las diversas situaciones de manejo. Mismo el manejo cuidadoso genero fuerte nivel de ruido, y el NPS casi siempre se dobla o triplica cuando la misma situacion se realiza bruscamente. El manejo cuidadoso, en conjunto con menor tempo de uso de la incubadora, se mostro eficaz en la reduccion del ruido producido al manosear el equipo.