Tamara Gonçalves Rezende Macieira

Risk of surgical site infection in patients undergoing orthopedic surgery

Estudio para identificar factores de riesgo asociados a infecciones de sitio quirurgico en pacientes quirurgicos ortopedicos de un hospital publico de Minas Gerais, Brasil, entre 2005 y 2007. Cohorte historica de 3.543 pacientes sometidos a cirugias ortopedicas. Un analisis descriptivo fue realizado y la tasa de incidencia de infeccion fue estimada. Para verificar la asociacion entre la infeccion y los factores de riesgo se uso el test chi-cuadrado. La fuerza de la asociacion del evento con las variables independientes fue estimada por el Riesgo Relativo, con un intervalo de confianza de 95% y p <0,05. La incidencia de infeccion de sitio quirurgico fue 1,8%. Fueron estadisticamente asociados a la infeccion el potencial de contaminacion de la herida quirurgica, las condiciones clinicas del paciente, el tiempo quirurgico y el tipo de procedimiento ortopedico. La identificacion de asociacion de infeccion de sitio quirurgico con los factores de riesgo mencionados es importante y contribuye para la practica clinica del enfermero.Descriptores: Infeccion de Herida Operatoria; Factores de Riesgo; Enfermeria; Ortopedia.

Risco para infecção de sítio cirúrgico em pacientes submetidos a cirurgias ortopédicas

Estudio para identificar factores de riesgo asociados a infecciones de sitio quirurgico en pacientes quirurgicos ortopedicos de un hospital publico de Minas Gerais, Brasil, entre 2005 y 2007. Cohorte historica de 3.543 pacientes sometidos a cirugias ortopedicas. Un analisis descriptivo fue realizado y la tasa de incidencia de infeccion fue estimada. Para verificar la asociacion entre la infeccion y los factores de riesgo se uso el test chi-cuadrado. La fuerza de la asociacion del evento con las variables independientes fue estimada por el Riesgo Relativo, con un intervalo de confianza de 95% y p <0,05. La incidencia de infeccion de sitio quirurgico fue 1,8%. Fueron estadisticamente asociados a la infeccion el potencial de contaminacion de la herida quirurgica, las condiciones clinicas del paciente, el tiempo quirurgico y el tipo de procedimiento ortopedico. La identificacion de asociacion de infeccion de sitio quirurgico con los factores de riesgo mencionados es importante y contribuye para la practica clinica del enfermero.Descriptores: Infeccion de Herida Operatoria; Factores de Riesgo; Enfermeria; Ortopedia.

PatientNarr: Towards generating patient-centric summaries of hospital stays

PatientNarr summarizes information taken from textual discharge notes written by physicians, and structured nursing documentation. It builds a graph that highlights the relationships between the two types of documentation; and extracts information from the graph for content planning. SimpleNLG is used for surface realization.

The Use of Simulation to Teach Nursing Students and Clinicians Palliative Care and End-of-Life Communication: A Systematic Review:

Objectives: To present the findings of a systematic review on the use of simulation-based learning experiences (SBLEs) to teach communication skills to nursing students and clinicians who provide palliative and end-of-life care to patients and their families. Background: Palliative care communication skills are fundamental to providing holistic patient care. Since nurses have the greatest amount of direct exposure to patients, building such communication competencies is essential. However, exposure to patients and families receiving palliative and end-of-life care is often limited, resulting in few opportunities to learn these skills in the clinical setting. Simulation-based learning experiences can be used to supplement didactic teaching and clinical experiences to build the requisite communication skills. Methods: Searches of CINAHL, MEDLINE, PsychINFO, ERIC, and Web of Science electronic databases and Grey Literature returned 442 unique records. Thirty articles met the established criteria, including the SBLE must contain a nursing role. Results: Simulation-based learning experience are being used to teach palliative and end-of-life communication skills to nursing students and clinicians. Lack of standardization, poor evaluation methods, and limited exposure to the entire interprofessional team makes it difficult to identify and disseminate validated best practices. Conclusion: While the need for further research is acknowledged, we recommend this evidence be augmented by training programs that utilize SBLEs through (1) applying standards, (2) clearly specifying goals and objectives, (3) integrating externally validated scenarios, and (4) employing rigorous evaluation methods and measures that link the SBLE to the training objectives and desired clinician practice behaviors and patient outcomes.

Cuidados de enfermagem a pacientes com temperatura corporal elevada: revisão integrativa

Revisao integrativa para identificar as evidencias disponiveis na literatura sobre os melhores cuidados de enfermagem para o paciente comtemperatura corporal elevada. A busca foi realizada nas bases de dados PubMed/MedLine, LILACS, CINAHL e Cochrane Reviews. A amostra foiconstituida de 16 estudos. Os estudos foram avaliados em relacao ao nivel de evidencia e grau de recomendacao. Os artigos da amostra sao derevisao sistematica, ensaio clinico randomizado, estudo de caso, descritivo, transversal, qualitativo, relato de experiencia e quase-experimental. Asmelhores evidencias referem-se aos cuidados com criancas e adultos com febre. Existe uma carencia de estudos com delineamento experimentalque testem os cuidados de enfermagem recomendados na literatura a pacientes com temperatura corporal elevada nas diferentes faixas etarias,principalmente com idosos. Sugere-se o desenvolvimento de pesquisas clinicas que analisem os cuidados de enfermagem a pacientes adultoscom o diagnostico de enfermagem de hipertermia, especialmente relacionados a utilizacao de metodos fisicos, como realizacao de banhomorno, aplicacao de compressas mornas, bolsas de gelo e ventilacao do ambiente. The aim of this integrative review is to identify available evidence in the literature concerning the best practices in nursing care for patients withhigh body temperature. The search was performed in the databases PubMed/MedLine, LILACS, CINAHL and Cochrane Reviews. The samplewas composed by 16 studies. The studies were analyzed according to their level of evidence and grade of recommendation. The articles of thesample are classified as systematic reviews, randomized clinical trials, case studies, descriptive, transversal, qualitative, experience report andquasi-experimental. The best evidence refers to care of children and adults with fever. There is a lack of studies with experimental design that testthe nursing practices recommended in the literature for patients with high body temperature in different ages, specially the elderly. We suggest thedevelopment of new clinical researches, which will investigate nursing care interventions to adult patients with the nursing diagnosis hyperthermia,especially the physical interventions such as warm/cold bathing, warm/ice compresses and also ventilation of the environment. Revision integradora para identificar la evidencia disponible en la literatura acerca de la mejor atencion de enfermeria para pacientes con temperaturacorporal elevada. La busqueda se realizo en las bases de datos PubMed/MEDLINE, LILACS, CINAHL y Cochrane Reviews. La muestra consistio en 16estudios que se evaluaron para el nivel de evidencia y grado de recomendacion. Los articulos que integran la muestra son revisiones sistematicas, ensayoscontrolados aleatorios, estudios de caso descriptivo, transversal, cualitativo, relatos de experiencia y cuasi-experimental. La mejor evidencia se refiere a laatencion de ninos y adultos con fiebre. Escasean los estudios de diseno experimental que ponen a prueba la atencion de enfermeria recomendada en laliteratura para pacientes con temperatura corporal elevada en diferentes grupos de edad, especialmente en los ancianos. Sugerimos mas investigacionclinica para analizar los cuidados de enfermeria de pacientes adultos con diagnostico de hipertermia...The aim of this integrative review is to identify available evidence in the literature concerning the best practices in nursing care for patients with high body temperature. The search was performed in the databases PubMed/MedLine, LILACS, CINAHL and Cochrane Reviews. The sample was composed by 16 studies. The studies were analyzed according to their level of evidence and grade of recommendation. The articles of the sample are classified as systematic reviews, randomized clinical trials, case studies, descriptive, transversal, qualitative, experience report and quasi-experimental. The best evidence refers to care of children and adults with fever. There is a lack of studies with experimental design that test the nursing practices recommended in the literature for patients with high body temperature in different ages, specially the elderly. We suggest the development of new clinical researches, which will investigate nursing care interventions to adult patients with the nursing diagnosis hyperthermia, especially the physical interventions such as warm/cold bathing, warm/ice compresses and also ventilation of the environment.

Riesgo para infección de sitio quirúrgico en pacientes sometidos a cirugías ortopédicas

Estudio para identificar factores de riesgo asociados a infecciones de sitio quirurgico en pacientes quirurgicos ortopedicos de un hospital publico de Minas Gerais, Brasil, entre 2005 y 2007. Cohorte historica de 3.543 pacientes sometidos a cirugias ortopedicas. Un analisis descriptivo fue realizado y la tasa de incidencia de infeccion fue estimada. Para verificar la asociacion entre la infeccion y los factores de riesgo se uso el test chi-cuadrado. La fuerza de la asociacion del evento con las variables independientes fue estimada por el Riesgo Relativo, con un intervalo de confianza de 95% y p <0,05. La incidencia de infeccion de sitio quirurgico fue 1,8%. Fueron estadisticamente asociados a la infeccion el potencial de contaminacion de la herida quirurgica, las condiciones clinicas del paciente, el tiempo quirurgico y el tipo de procedimiento ortopedico. La identificacion de asociacion de infeccion de sitio quirurgico con los factores de riesgo mencionados es importante y contribuye para la practica clinica del enfermero.Descriptores: Infeccion de Herida Operatoria; Factores de Riesgo; Enfermeria; Ortopedia.

A Shovel-Ready Solution to Fill the Nursing Data Gap in the Interdisciplinary Clinical Picture

PURPOSE To critically evaluate 2014 American Academy of Nursing (AAN) call-to-action plan for generating interoperable nursing data. DATA SOURCES Healthcare literature. DATA SYNTHESIS AANs plan will not generate the nursing data needed to participate in big data science initiatives in the short term because Logical Observation Identifiers Names and Codes and Systematized Nomenclature of Medicine - Clinical Terms are not yet ripe for generating interoperable data. Well-tested viable alternatives exist. CONCLUSIONS Authors present recommendations for revisions to AANs plan and an evidence-based alternative to generating interoperable nursing data in the near term. These revisions can ultimately lead to the proposed terminology goals of the AANs plan in the long term.