Thaís Dresch Eberhardt

Measurement of the area of venous ulcers using two software programs

Objetivo: comparar a mensuracao de area de ulceras venosas por meio dos softwares AutoCAD(r) e Image Tool. Metodo: trata-se de um estudo de avaliacao de reprodutibilidade de testes, realizado em um ambulatorio de angiologia de um hospital universitario. Os dados foram coletados de 21 pacientes com ulceras venosas, no periodo de marco a julho de 2015, por meio de formulario de coleta e fotografia das feridas. Cinco enfermeiros (avaliadores) do Grupo de Estudos de Lesoes de Pele do hospital participaram da pesquisa. As feridas foram mensuradas em ambos os softwares. Os dados foram analisados por meio do Coeficiente de correlacao intraclasse, Coeficiente de correlacao de concordância e procedimento de Bland e Altman. A pesquisa respeitou os aspectos eticos de acordo com a legislacao vigente. Resultados: os tamanhos das ulceras apresentaram grande amplitude, porem, sem diferenca significativa entre as mensuracoes, existe excelente correlacao intraclasse e de concordância entre os softwares, os quais parecem ser mais precisos na mensuracao de feridas com area > 10 cm². Conclusao: o uso de ambos os softwares e indicado para a mensuracao de ulceras venosas, parecendo ser mais precisos quando utilizados para mensurar feridas com area > 10 cm².ABSTRACT Objective: to compare the measurement area of venous ulcers using AutoCAD(r) and Image Tool software. Method: this was an assessment of reproducibility tests conducted in a angiology clinic of a university hospital. Data were collected from 21 patients with venous ulcers, in the period from March to July of 2015, using a collection form and photograph of wounds. Five nurses (evaluators) of the hospital skin wound study group participated. The wounds were measured using both software programs. Data were analyzed using intraclass correlation coefficient, concordance correlation coefficient and Bland-Altman analysis. The study met the ethical aspects in accordance with current legislation. Results: the size of ulcers varied widely, however, without significant difference between the measurements; an excellent intraclass and concordance correlation was found between both software programs, which seem to be more accurate when measuring a wound area >10 cm². Conclusion: the use of both software programs is appropriate for measurement of venous ulcers, appearing to be more accurate when used to measure a wound area > 10 cm².

Gestão da qualidade na assistência de enfermagem em unidades de clínica cirúrgica

Aim: to identify the facilities and difficulties that nurses encounter in management of quality in nursing assistance at clinical surgery unit. Method: descriptive and qualitative research performed at a University Hospital in South Brazil, from July to September 2013. Semi-structured interviews were conducted and evaluated according to Minayo thematic analysis. Results: two thematic categories were emerged: facilities in quality management at clinical surgery unit, composed by the topics professional experience, interaction with teamwork and integration with the workplace; and difficulties in quality management at clinical surgery unit through themes that pointed to work overload, the insufficient number of nursing staff, physical structure and insufficiency of material resources. Conclusion: the study will contribute with the nurses, because identifies facilitating and hindering factors in management of quality in nursing assistance, enabling strategies in search for effective care and health excellence

Nível de complexidade assistencial e dimensionamento de enfermagem no Pronto-Socorro de um hospital público

Aim: to assess the level of care complexity and the dimensioning of the nursing staff attending in the emergency unit of a public hospital. Method: descriptive and documental study, performed with data extracted from patients’ records. Results: we assessed 998 records. There was a prevalence (73,3%) of patients requiring minimal care. Concerning the nursing staff, the situation according to work shifts corresponded to 32,6% for nurses and 91,5% for nursing auxiliary/technicians from the frame projected for the unit. Conclusions: the prevalence of patients needing minimal care may stem from an inadequate flow of care provided for the health services and, consequently, producing an unnecessary use of the tertiary health services and, so, increasing the number of attendances. This context is worsened by the reduced number of nursing workers available to provide a qualified and safe care

Incorporação do protocolo de lesão por pressão na gerência do cuidado: Teoria Fundamentada nos Dados

Comprender el significado de la incorporacion del protocolo de lesion por presion en la gestion del cuidado realizada por el enfermero. Metodo: Investigacion cualitativa que utilizo el referencial metodologico de la Teoria Fundamentada en los Datos. La recoleccion de los datos se realizo por medio de una entrevista semiestructurada, con 22 enfermeros de un hospital universitario, en el periodo de julio a septiembre de 2014. Resultados: El fenomeno central “Significando el protocolo de lesion por presion como instrumento de calificacion del enfermero para la gestion del cuidado”, compuesto por la categoria “Calificando a los profesionales para la gestion del cuidado” y sus cuatro sub-categorias: “Percibiendo la calificacion a partir del protocolo”, “Considerando el protocolo una herramienta de ensenanza”, “Percibiendo el protocolo como instrumento de educacion en servicio”, y “Evidenciando la importancia de los protocolos en la seguridad del paciente”. Conclusion: El estudio evidencio que el protocolo es una herramienta de cuidado, y un instrumento de educacion en servicio, que hace mas seguro la gestion del cuidado y promueve la calificacion profesional.

Using AutoCAD software to measure venous leg ulcers: a reproducibility assessment study

OBJECTIVE To assess the reproducibility of using AutoCAD software to measure the area of venous leg ulcers (VLUs). METHOD Data from patients with VLUs were collected between March and July 2015, using data collection forms and photographing the different ulcers. A researcher and five nurses collected the data. The wounds were measured using AutoCAD software. Data were analysed using intraclass correlation coefficient (ICC), concordance correlation coefficient (CCC) and Bland-Altman analysis. RESULTS A total of 21 patients with 36 VLUs were included in the study. A statistically significant difference (p<0.05) was observed between the areas of VLUs measured by the researcher and the evaluators. There was an excellent agreement when analysing the ICC [p=0.98; 95% CI (0.97-0.99); p <0.05] and the CCC [CCC=CI 0.97; 95% (0.95-0.98)]. There was no difference between the measurements of VLUs ≤10 cm2 (p=0.49) and those with an area >10cm2 (p=0.22). CONCLUSION The use of AutoCAD software is appropriate for measuring VLUs and appears to be more accurate when used to measure VLUs with an area >10cm2.

Uso de software gratuito como recurso para mensuração de área de úlceras venosas

Aim: to verify the reproducibility of the Image tool software use for measuring venous ulcers area. Method: reproducibility assessment study of tests conducted in an angiology outpatient clinic of a university hospital in southern Brazil. Patients with venous ulcers were selected, having their ulcers photographed and measured using the above mentioned software. Data were statistically analysed. Results: no difference (p = 0.51) was observed between measurements. Excellent values of Intraclass Correlation Coefficient and Concordance Correlation Coefficient were observed. The software seems to be more accurate when used to measure large wounds (area>10 cm). Conclusion: Image tool software is reproducible for measuring venous ulcers area, being more precise to measure venous ulcers with area> 10 cm².

Perfil sociodemográfico e clínico de pacientes com úlceras venosas acompanhados em ambulatório: estudo transversal descritivo

Aim: to identify the sociodemographic and clinical profile of patients, who were outpatients from a university hospital in southern Brazil and that had venous ulcers. Method: this is a descriptive and transversal survey conducted in a angiology clinic of a university hospital. Data were collected through form, from 21 patients with venous ulcers, from March to July 2015 and analyzed by means of simple descriptive statistics. Results: the participants were mostly aged between 64 and 72, male, caucasian and retired. Each one of them had a venous ulcer with less than one year of existence and no relapses. Conclusion: patients with venous ulcers are mostly elderly men with a recent venous ulcers without recurrence.

Teoria Fundamentada nos Dados: possibilidade para a pesquisa qualitativa em enfermagem

TEORÍA FUNDAMENTADA EN LOS DATOS: POSIBILIDAD PARA LA INVESTIGACIÓN CUALITATIVA EN ENFERMERÍA Josete Luzia Leite 1 Suzinara Beatriz Soares de Lima2 Rhea Silvia de Avila Soares3 Thaís Dresch Eberhardt Doi: 10.5902/2179769224089 A busca pelo entendimento dos fenômenos nas diversas áreas de investigação, assim como ocorre na enfermagem, tem despertado nos pesquisadores, a apropriação por referencias teóricos e metodológicos coerentes com o objeto de estudo a ser pesquisado. Na perspectiva da pesquisa qualitativa, a Teoria Fundamentada nos Dados (TFD) ou GrouNded Theory (GT), destaca-se como referencial metodológico interpretativista capaz de compreender o significado que certo contexto ou objeto tem para as pessoas. Foi criada pelos sociólogos Barney Glaser e Anselm Strauss na década de 60, com o objetivo de desenvolver um processo de análise sistemático, gerando teoria e deslocando as investigações qualitativas em direção a arranjos teóricos explanatórios, a fim de produzir compreensões abstratas e conceituais dos fenômenos estudados. Além do mais, a TFD se caracteriza por possibilitar a construção de teorias baseadas na coleta e análise sistemática de dados. Assim, possibilita que os dados passem por processos sistemáticos de análise e revisão, ou seja, o método é circular, permitindo ao pesquisador mudar o foco de atenção e buscar outras direções, reveladas pelos dados que vão sendo encontrados. A TFD apresenta algumas características: simultaneidade na coleta e análise dos dados; elaboração de códigos e categorias analíticas a partir de dados coletados; emprego do método comparativo em todas as etapas da pesquisa, permitindo o avanço gradual no desenvolvimento da teoria; construção de memorandos como forma de registros; emprego de uma amostragem dirigida à construção da teoria, na qual o pesquisador busca seus dados em locais ou por meio do depoimento de pessoas que indicam deter conhecimento acerca da realidade a ser estudada; elaboração da revisão de literatura após o desenvolvimento, independente da análise. Após a coleta de dados, inicia-se o processo de codificação, no qual as informações são categorizadas. Esta fase consiste em dividir, conceituar e relacionar os dados por meio de três etapas interdependentes: codificação aberta; codificação axial; codificação seletiva. As etapas da codificação buscam tornar o processo analítico

Longitudinality Assessment in Primary Health Care Services: a cross-sectional study

Aim: To evaluate the presence and extent of longitudinality in primary health care (PHC) of a Regional Health Care Core of Rio Grande do Sul state. Method: A cross-sectional study with 1065 adult users, 1061 caregivers of children and 247 professionals in the PHC area, using a sample defined by convenience sampling and sample calculation. Adult patients, caregivers of children and health care professionals working in this area for six months are included. First-access users at the health care unit and those who cannot answer the study are to be excluded. Data collection will be conducted using the Primary Care Assessment Tool, with answers on a Likert scale. Expected results: To know the PHC quality in the aspect of longitudinality using the assessment as a tool to reorganize and improve these services. Implications for health: To promote the improvement and efficiency of continued attention, care and interpersonal relationships between patients and health services.

Measurement of venous ulcers by means of software: assessment of test reproducibility

Aim: To compare the measurement of the area of venous ulcers through AutoCAD® and Image Tool software. Method: This is a survey to assess the reproducibility of tests which used a quantitative approach. In the (judgment) sample, all patients with venous ulcers met in the data collection period (March-July 2015) will be included; patients under the age of 18 years, those with diminished cognitive ability or impaired verbal communication who are unaccompanied and those with ulcers that extend across more than one side of the leg, will be excluded. Data collection will be accomplished through photography and the filling in of forms. Expected results: This study intends to propose, together with the Group of Hospital Skin Injury Studies, the deployment and implementation of the evaluation method and the measurement of wounds. Implications for Health: to deepen and disseminate the theme, so that professionals begin using objective methods for measurement.