Patrícia de Oliveira Salgado

Predictive validity of the Manchester Triage System: evaluation of outcomes of patients admitted to an emergency department

OBJECTIVE to assess the predictive validity of the Manchester Triage System implemented in a municipal hospital in Belo Horizonte, MG, Brazil. METHOD cohort prospective and analytical study. The sample of 300 patients was stratified by color groups. The outcome measured was the scores, obtained by patients in each classification group in the Therapeutic Intervention Scoring System--28, 24 hours after admission to the emergency department. RESULTS A total of 172 (57%) patients were men and the average age of all patients was 57.3 years old. The median score concerning the severity of their conditions was 6.5 points in the yellow group, 11.5 in the orange group, and 22 points in the red group. Statistically significant differences were found among the three groups (p<0.001). CONCLUSION the data confirm that the conditions of patients within the color groups progressed at different levels of severity.OBJETIVO: avaliar a validade preditiva do protocolo de classificacao de risco de Manchester, implantado em um hospital municipal de Belo Horizonte, Minas Gerais. METODO: trata-se de estudo de coorte prospectivo e analitico A amostra estratificada por cores da classificacao foi de 300 pacientes. O desfecho avaliado foi a pontuacao pelo Therapeutic Intervention Scoring System - 28, obtida pelos pacientes em cada grupo de classificacao, apos 24 horas da admissao no servico de urgencia. RESULTADOS: entre os pacientes, 172 eram homens (57%) e a media de idade dos pacientes avaliados foi de 57,3 anos. A mediana de pontuacao do indice de gravidade no grupo amarelo foi de 6,5 pontos; no grupo laranja, 11,5 pontos e, no grupo vermelho, 22 pontos, havendo diferenca estatistica significante entre os tres grupos (p<0,001). CONCLUSAO: os dados reforcam que os pacientes evoluem com niveis de gravidade diferentes entre os grupos de cores de classificacao.

Identification and mapping of the nursing diagnoses and actions in an Intensive Care Unit

This is a descriptive study with the aim of examining the nursing diagnoses labels and actions prescribed by nurses in the clinical records of patients hospitalized in an Adult Intensive Care Unit. A sample of 44 clinical records was obtained and a total of 1087 nursing diagnoses and 2260 nursing actions were identified. After exclusion of repetitions 28 different nursing diagnoses labels and 124 different nursing actions were found. Twenty-five nursing diagnoses labels were related to human psychobiological needs and three to psychosocial needs. All the nursing actions were mapped to the physiological needs and also to interventions of the Nursing Interventions Classification-NIC. Concordance of 100% was obtained between the experts in the validation process of the mapping performed, both for the nursing diagnoses labels and actions. Similar studies should be conducted for the identification and development of nursing diagnoses and actions.Se trata de un estudio descriptivo con el objetivo de analizar los registros de los titulos de diagnostico y las acciones de enfermeria prescritas por enfermeros en las fichas de pacientes internados en una Unidad de Terapia Intensiva de Adultos. Se obtuvo una muestra de 44 fichas. Se identificaron 1.087 diagnosticos y 2.260 acciones de enfermeria. Despues de la exclusion de repeticiones se encontro 28 diferentes titulos de diagnostico y 124 diferentes acciones de enfermeria. Veinte y cinco titulos de diagnostico estan relacionados a las necesidades humanas psicobiologicas y tres a las necesidades psicosociales. Todas las acciones de enfermeria fueron mapeadas a las necesidades psicobiologicas y tambien a las intervenciones de la Clasificacion de las Intervenciones de Enfermeria-NIC. Se obtuvo 100% de concordancia entre los expertos en el proceso de validacion del mapeo realizado, tanto de los titulos de diagnostico como de las acciones de enfermeria. Estudios semejantes deben ser conducidos para la identificacion y evolucion de diagnosticos y acciones de enfermeria.

Mapping nursing goals of an Intensive Care Unit to the Nursing Outcomes Classification

AIM: to analyze whether nursing goals formulated for nursing diagnoses can be mapped to nursing outcomes classification and to identify the scales most appropriate to the outcomes mapped. METHOD: a descriptive study was developed in an intensive care unit. Data collection involved extraction of goals in 44 medical records, content standardization, cross-mapping to the outcomes, identification of appropriated scales and validation. Descriptive analysis and agreement with the cross-mapping process were performed. RESULTS: nursing goals (59) were mapped to (28) different outcomes, with agreement of 83% in the mapping process. All goals were mapped to outcomes, which allows to affirm that these outcomes contemplates the goals elaborated to patient care. CONCLUSION: these results favor the inclusion of outcomes and scales validated in the planning and evaluation phases of the nursing process of a software in construction.AIM to analyze whether nursing goals formulated for nursing diagnoses can be mapped to nursing outcomes classification and to identify the scales most appropriate to the outcomes mapped. METHOD a descriptive study was developed in an intensive care unit. Data collection involved extraction of goals in 44 medical records, content standardization, cross-mapping to the outcomes, identification of appropriated scales and validation. Descriptive analysis and agreement with the cross-mapping process were performed. RESULTS nursing goals (59) were mapped to (28) different outcomes, with agreement of 83% in the mapping process. All goals were mapped to outcomes, which allows to affirm that these outcomes contemplates the goals elaborated to patient care. CONCLUSION these results favor the inclusion of outcomes and scales validated in the planning and evaluation phases of the nursing process of a software in construction.

Diagnósticos de enfermagem identificados em pacientes internados em Unidade de Terapia Intensiva Adulto

This descriptive study was performed to identify the nursing diagnoses in the records of the inpatients of an adult intensive care unit, and map the most frequent diagnosis according to the Fundamental Human Needs. The sample consisted of 44 patient records. A total of 1,087 nursing diagnoses were identified. After excluding the repetitions, 28 different diagnoses were identified. Twenty-five diagnoses were related to psychobiological needs, and three to psychosocial needs. Further studies should identify, among the formulated nursing diagnoses and the affected human needs, which problems were solved and for what needs the care is predominantly developed. The present study results are important for the organization of teaching content for students and nurses, preparing them to consider human beings as a whole when providing care, considering their biological, emotional, and spiritual aspects.Estudo descritivo para identificar nos registros de prontuarios de pacientes internados em uma Unidade de Terapia Intensiva de Adultos os diagnosticos de enfermagem e mapear os diagnosticos mais frequentes as Necessidades Humanas Basicas. Obteve-se uma amostra de 44 prontuarios. Identificaram-se 1.087 diagnosticos de enfermagem. Apos exclusao de repeticoes, encontraram-se 28 diferentes titulos de diagnosticos. Vinte e cinco diagnosticos estavam relacionados as necessidades psicobiologicas, e tres, as necessidades psicossociais. Sugere-se a realizacao de estudos que identifiquem, entre os diagnosticos de enfermagem formulados e as necessidades humanas afetadas, quais foram solucionados e para quais necessidades sao predominantemente elaborados os cuidados. Os resultados deste estudo sao importantes para a organizacao de conteudos de ensino para alunos e enfermeiros, preparando-os para que, ao prestar o cuidado, considerem o ser humano, tanto nos aspectos biologicos, como emocionais e espirituais.

Nursing diagnoses identified in inpatients of an adult intensive care unit

This descriptive study was performed to identify the nursing diagnoses in the records of the inpatients of an adult intensive care unit, and map the most frequent diagnosis according to the Fundamental Human Needs. The sample consisted of 44 patient records. A total of 1,087 nursing diagnoses were identified. After excluding the repetitions, 28 different diagnoses were identified. Twenty-five diagnoses were related to psychobiological needs, and three to psychosocial needs. Further studies should identify, among the formulated nursing diagnoses and the affected human needs, which problems were solved and for what needs the care is predominantly developed. The present study results are important for the organization of teaching content for students and nurses, preparing them to consider human beings as a whole when providing care, considering their biological, emotional, and spiritual aspects.Estudo descritivo para identificar nos registros de prontuarios de pacientes internados em uma Unidade de Terapia Intensiva de Adultos os diagnosticos de enfermagem e mapear os diagnosticos mais frequentes as Necessidades Humanas Basicas. Obteve-se uma amostra de 44 prontuarios. Identificaram-se 1.087 diagnosticos de enfermagem. Apos exclusao de repeticoes, encontraram-se 28 diferentes titulos de diagnosticos. Vinte e cinco diagnosticos estavam relacionados as necessidades psicobiologicas, e tres, as necessidades psicossociais. Sugere-se a realizacao de estudos que identifiquem, entre os diagnosticos de enfermagem formulados e as necessidades humanas afetadas, quais foram solucionados e para quais necessidades sao predominantemente elaborados os cuidados. Os resultados deste estudo sao importantes para a organizacao de conteudos de ensino para alunos e enfermeiros, preparando-os para que, ao prestar o cuidado, considerem o ser humano, tanto nos aspectos biologicos, como emocionais e espirituais.

Validade preditiva do Protocolo de Classificação de Risco de Manchester:avaliação da evolução dos pacientes admitidos em um pronto atendimento

OBJECTIVE to assess the predictive validity of the Manchester Triage System implemented in a municipal hospital in Belo Horizonte, MG, Brazil. METHOD cohort prospective and analytical study. The sample of 300 patients was stratified by color groups. The outcome measured was the scores, obtained by patients in each classification group in the Therapeutic Intervention Scoring System--28, 24 hours after admission to the emergency department. RESULTS A total of 172 (57%) patients were men and the average age of all patients was 57.3 years old. The median score concerning the severity of their conditions was 6.5 points in the yellow group, 11.5 in the orange group, and 22 points in the red group. Statistically significant differences were found among the three groups (p<0.001). CONCLUSION the data confirm that the conditions of patients within the color groups progressed at different levels of severity.OBJETIVO: avaliar a validade preditiva do protocolo de classificacao de risco de Manchester, implantado em um hospital municipal de Belo Horizonte, Minas Gerais. METODO: trata-se de estudo de coorte prospectivo e analitico A amostra estratificada por cores da classificacao foi de 300 pacientes. O desfecho avaliado foi a pontuacao pelo Therapeutic Intervention Scoring System - 28, obtida pelos pacientes em cada grupo de classificacao, apos 24 horas da admissao no servico de urgencia. RESULTADOS: entre os pacientes, 172 eram homens (57%) e a media de idade dos pacientes avaliados foi de 57,3 anos. A mediana de pontuacao do indice de gravidade no grupo amarelo foi de 6,5 pontos; no grupo laranja, 11,5 pontos e, no grupo vermelho, 22 pontos, havendo diferenca estatistica significante entre os tres grupos (p<0,001). CONCLUSAO: os dados reforcam que os pacientes evoluem com niveis de gravidade diferentes entre os grupos de cores de classificacao.

Identificação e mapeamento dos diagnósticos e ações de enfermagem em Unidade de Terapia Intensiva

This is a descriptive study with the aim of examining the nursing diagnoses labels and actions prescribed by nurses in the clinical records of patients hospitalized in an Adult Intensive Care Unit. A sample of 44 clinical records was obtained and a total of 1087 nursing diagnoses and 2260 nursing actions were identified. After exclusion of repetitions 28 different nursing diagnoses labels and 124 different nursing actions were found. Twenty-five nursing diagnoses labels were related to human psychobiological needs and three to psychosocial needs. All the nursing actions were mapped to the physiological needs and also to interventions of the Nursing Interventions Classification-NIC. Concordance of 100% was obtained between the experts in the validation process of the mapping performed, both for the nursing diagnoses labels and actions. Similar studies should be conducted for the identification and development of nursing diagnoses and actions.Se trata de un estudio descriptivo con el objetivo de analizar los registros de los titulos de diagnostico y las acciones de enfermeria prescritas por enfermeros en las fichas de pacientes internados en una Unidad de Terapia Intensiva de Adultos. Se obtuvo una muestra de 44 fichas. Se identificaron 1.087 diagnosticos y 2.260 acciones de enfermeria. Despues de la exclusion de repeticiones se encontro 28 diferentes titulos de diagnostico y 124 diferentes acciones de enfermeria. Veinte y cinco titulos de diagnostico estan relacionados a las necesidades humanas psicobiologicas y tres a las necesidades psicosociales. Todas las acciones de enfermeria fueron mapeadas a las necesidades psicobiologicas y tambien a las intervenciones de la Clasificacion de las Intervenciones de Enfermeria-NIC. Se obtuvo 100% de concordancia entre los expertos en el proceso de validacion del mapeo realizado, tanto de los titulos de diagnostico como de las acciones de enfermeria. Estudios semejantes deben ser conducidos para la identificacion y evolucion de diagnosticos y acciones de enfermeria.

Mapeamento cruzado: títulos diagnósticos formulados segundo a CIPE® versus diagnósticos da NANDA Internacional

Estudio descriptivo cuyos objetivos fueron la elaboracion de etiquetas de diagnosticos de enfermeria segun la CIPE®, para llevar a cabo lo mapeo cruzado entre el diagnostico formulado y las etiquetas de los diagnosticos NANDA-I, para identificar entre los titulos de diagnosticos formulados los que eran constantes y no constantes en NANDA-I y asignarlos a las necesidades humanas basicas. Fueron conducidas tecnica de oficina con 32 enfermeros de las unidades de cuidados intensivos, mapeo cruzado y validacion de acuerdo con los expertos. Se elaboro 1665 titulos diagnosticos en la oficina sometidos a un proceso de refinamiento. El resultado fue de 120 titulos que se presentaron a un proceso de mapeo con los titulos de diagnosticos de la NANDA-I y con las necesidades humanas basicas. Validacion de contenido se realizo con los productos de lo mapeo por dos enfermeras expertas y las tasas de concordancia del 92% y 100% fueron obtenidas. Se encontro que 63 titulos estaban contenidos en la NANDA-I y 47 no lo hicieron.This descriptive study aimed at elaborating nursing diagnostic labels according to ICNP®; conducting a cross-mapping between the diagnostic formulations and the diagnostic labels of NANDA-I; identifying the diagnostic labels thus obtained that were also listed in the NANDA-I; and mapping them according to Basic Human Needs. The workshop technique was applied to 32 intensive care nurses, the cross-mapping and validation based on agreement with experts. The workshop produced 1665 diagnostic labels which were further refined into 120 labels. They were then submitted to a cross-mapping process with both NANDA-I diagnostic labels and the Basic Human Needs. The mapping results underwent content validation by two expert nurses leading to concordance rates of 92% and 100%. It was found that 63 labels were listed in NANDA-I and 47 were not.Estudio descriptivo cuyos objetivos fueron la elaboracion de etiquetas de diagnosticos de enfermeria segun la CIPE®, para llevar a cabo lo mapeo cruzado entre el diagnostico formulado y las etiquetas de los diagnosticos NANDA-I, para identificar entre los titulos de diagnosticos formulados los que eran constantes y no constantes en NANDA-I y asignarlos a las necesidades humanas basicas. Fueron conducidas tecnica de oficina con 32 enfermeros de las unidades de cuidados intensivos, mapeo cruzado y validacion de acuerdo con los expertos. Se elaboro 1665 titulos diagnosticos en la oficina sometidos a un proceso de refinamiento. El resultado fue de 120 titulos que se presentaron a un proceso de mapeo con los titulos de diagnosticos de la NANDA-I y con las necesidades humanas basicas. Validacion de contenido se realizo con los productos de lo mapeo por dos enfermeras expertas y las tasas de concordancia del 92% y 100% fueron obtenidas. Se encontro que 63 titulos estaban contenidos en la NANDA-I y 47 no lo hicieron.

Experiência em cuidados paliativos à criança portadora de leucemia: a visão dos profissionais

Palliative care is developed through multi-professional assistance with actions to provide support and comfort for the children and their families. The support involves the alleviation of suffering by controlling the pain and its symptoms, as well as ensuring psychosocial and spiritual support. This is a qualitative case study which sought to understand the multidisciplinary view of the team vis-a-vis a child with leukemia in palliative care, in a hospital in Belo Horizonte. The subjects of research were 17 health professionals of the direct assistance team to the child receiving such care and the data were analyzed using the content analysis technique. The professional experience in palliative care is intrinsic to the success and continuity of the patients care. It was found that the professionals have little experience in this area and have difficulty dealing with their emotions, and sometimes become unable to act when faced with the anguish of those involved and with death. However, despite the fact that the area of activity causes suffering and anguish to the professional, the multi-professional team still identifies with and likes the area, which is important for the children and their families to feel safe, respected and well cared for by the professionals.

Identificação e mapeamento das ações de enfermagem prescritas para pacientes internados em uma UTI de adultos

Descriptive study that aimed to identify nursing actions prescribed by nurses in the medical records of patients admitted to an Intensive Care Unit (ICU) for adults, in Belo Horizonte (MG), the terms used, their frequency and map the actions to the Theory of Basic Human Needs and NIC interventions. It was obtained a sample of 44 patient records. It was identified 2,260 nursing actions. After exclusion of repetitions, it was found 124 different actions. All nursing actions have been mapped to physiological needs and also to NIC interventions. It was obtained 100% of agreement among experts in the validation of the mapping process. It is suggested that similar studies in ICUs from other locations and different contexts / specialties should be driven to identify nursing actions developed and its evolution.Estudio descriptivo que tuvo como objetivo identificar las acciones de enfermeria prescritas por las enfermeras en las historias clinicas de pacientes ingresados en una Unidad de Cuidados Intensivos (UCI) de adultos de Belo Horizonte (MG), los terminos utilizados, la frecuencia y el mapeo de las acciones con la Teoria de las Necesidades Humanas basica y las intervenciones NIC. Se obtuvo una muestra de 44 historias clinicas de pacientes. Se identificaron 2.260 acciones de enfermeria. Tras la exclusion de las repeticiones, fueran encontradas 124 acciones diferentes. Todas las acciones de enfermeria se han asignado a las necesidades fisiologicas y tambien a las intervenciones de la NIC. Se obtuvo 100% de acuerdo entre los expertos en el proceso de validacion de la asignacion. Se sugiere que estudios similares sean desenvueltos en las UCI de otros lugares y diferentes contextos / especialidades, para identificar las acciones de enfermeria desarrollados y su evolucion.