Effect of a Non-pharmacological Intervention on Vaccine-related Pain: Randomized Clinical Trial.

BACKGROUND: Acute pain during vaccine administration is an expected event; however, some strategies, such as the use of high frequency vibration devices associated with cryotherapy, may minimize it. AIM: Evaluate the effect of high frequency vibration associated with cryotherapy on the level of pain related to the administration of influenza vaccine by intramuscular route in adults. METHOD: A randomized clinical trial was conducted with 350 adults who received the influenza vaccine. Participants allocated to the intervention group used a high-frequency vibration device associated with cryotherapy during vaccination, and those in the control group administered the vaccine according to the service routine. RESULTS: Mean self-reported pain after vaccination of participants who used the device was lower (1.5 ±1.7) when compared to those who did not use it (1.9 ±1.9) (p = .041). There was an association of higher levels of pain after vaccination with participants in the control group (p = .011), females (p = .042), with higher level of pain expected with vaccination (p < .001) and higher level of anxiety before (p < .001) and after vaccination (p = .001). CONCLUSIONS: The use of high frequency vibration associated with cryotherapy has been shown to be a viable non-pharmacological intervention for the reduction of pain associated with influenza vaccination in adults.

Risk of deep venous thrombosis associated with peripherally inserted central catheter: A retrospective cohort study of 11.588 catheters in Brazil.

INTRODUCTION: Deep Venous Thrombosis (DVT) due to Peripherally Inserted Central Catheter (PICC) is one of the most threatening complications after device insertion. OBJECTIVE: To assess the rate of PICC-associated DVT and analyze the risk factors associated with this event in cancer and critically ill patients. METHODS: We conducted a descriptive, retrospective cohort study with 11,588 PICCs from December 2014 to December 2019. Patients ≥ 18 years receiving a PICC were included. Pre-and post-puncture variables were collected and a logistic regression was used to identify the independent factors associated with the risk of DVT. RESULTS: The DVT prevalence was 1.8% (n = 213). The median length of PICC use was 15.3 days. The median age was 75 years (18; 107) and 52% were men, 53.5% were critically ill and 29.1% oncological patients. The most common indications for PICC's were intravenous antibiotics (79.1%). Notably, 91.5% of PICC showed a catheter-to-vein ratio of no more than 33%. The tip location method with intracavitary electrocardiogram was used in 43%. Most catheters (67.9%) were electively removed at the end of intravenous therapy. After adjusting for cancer profile ou chemotherapy, regression anaysis revealed that age (OR 1.011; 95% CI 1.002-1.020), previous DVT (OR 1.96; 95% CI 1.12-3.44) and obstruction of the device (OR 1.60; 95% CI 1.05-2.42) were independent factors associated with PICC-associated DVT, whereas the use of an anticoagulant regimen was a protective variable (OR 0.73; 95% CI 0.54-0.99). CONCLUSION: PICC is a safe and suitable intravenous device for medium and long-term therapy, with low rates of DVT even in a cohort of critically ill and cancer patients.

Problematization methodology's impact on nursing and medical students' knowledge about hypodermoclysis: quasi-experimental study.

OBJECTIVE: to analyze the problematization methodology impact on the knowledge of nursing and medical students about hypodermoclysis. METHOD: quasi-experimental study conducted with 22 undergraduate nursing and medical students from a public Brazilian higher education institution. The students participated in the educational intervention using the problematization methodology based on the Arch of Maguerez. A previously validated questionnaire was used to determin' the students' knowledge level about hypodermoclysis. This instrument was applied before and after the educational intervention. The results were compared by McNemar's test and Student's t test for paired samples. RESULTS: when comparing the correct answers before and after the intervention, there was a significant increase in 75% of the questions (p<0.05), including theoretical and practical aspects of hypodermoclysis. The mean score on students' self-assessment of the ability to explain (0.9 versus 5.9 points) and perform hypodermoclysis (1.9 versus 5.0) was significantly higher after applying the problematization methodology (p<0.001). CONCLUSION: the problematization methodology had a positive impact on the students' knowledge about hypodermoclysis. The number of correct answers after the educational intervention was higher than the initial assessment. The problematization methodology can be incorporated into the teaching-learning process of nursing and medical students for teaching procedures such as hypodermoclysis. BACKGROUND: (1) The problematization methodology had a positive impact on students' knowledge. BACKGROUND: (2) The number of correct answers after the educational intervention increased. BACKGROUND: (3) Problematization can be incorporated into the teaching of nursing and medicine. BACKGROUND: (4) The teaching-learning process through active methodologies should be encouraged. BACKGROUND: (5) Problematization has the potential to develop cognitive and attitudinal skills.

Hypothermia among premature newborns on admission to a neonatal intensive care unit.

OBJECTIVE: To assess prevalence and factors associated with hypothermia in preterm infants admitted to a neonatal intensive care unit. METHODS: It is a cross-sectional retrospective study, with 154 premature newborns admitted between 2017 and 2019 in a neonatal intensive care unit. Logistic regression was used to evaluate the association to hypothermia. RESULTS: There was a predominance of males (55.8%), coming from the operating room (55.8%), gestational age > 32 weeks (71.4%), weight > 1500g (59.1%), Apgar in the 1st minute of life less than seven (51.9%) and in the 5th minute of life greater than or equal to seven (94.2%). The prevalence of hypothermia at admission was 68.2%. It was found that the lower the weight, the greater the chances of hypothermia, being three times higher in low weight (OR 3.480), five times higher in very low weight (OR5.845) and up to 47 times higher in extremely low weight (OR47.211). CONCLUSION: Hypothermia was 68.2% and it was associated with lower birth weight.

Nursing protocol in chronic kidney disease prevention in older adults in primary care.

OBJECTIVES: to develop a protocol for Nursing Process operationalization in approaching older adults with vulnerability to chronic kidney disease in Primary Health Care, based on Neuman's stressors. METHODS: a methodological study, carried out in two stages: 1) synthesis of evidence using an inductive strategy (mixed method study) and 2) protocol development to support the nursing process operationalization with older adults enrolled in a Basic Health Unit, using a deductive strategy (Neuman's stressor concepts, NANDA, NIC, and NOC taxonomies, Risner's line of reasoning, and cross-mapping), described according to A Step-by-Step Guide to Developing Protocols. RESULTS: 102 older adults participated, and 17 diagnoses, 34 interventions and 26 nursing outcomes were identified. CONCLUSIONS: the protocol developed is a technology that makes it possible to operationalize the Nursing Process, based on Neuman's stressors and on taxonomy, conceptual and care frameworks, guiding care and nursing records.

Effect of vibration associated with cryotherapy on vaccine-related pain and anxiety levels in adults: study protocol for a randomized clinical trial.

BACKGROUND: Vaccination is one of the most effective strategies for prevention and eradication of immunopreventable diseases, but community acceptance of vaccination can be influenced by different factors, such as pain and anxiety. The use of high-frequency vibration associated with cryotherapy has been used to manage pain and anxiety during the vaccination process in children, but studies with adults are still scarce. This study aims to evaluate the effect of high-frequency vibration associated with cryotherapy on the levels of self-reported pain and anxiety related to administration of the Influenza vaccine intramuscularly in adults. METHODS: A two-arm, parallel, randomized clinical trial conducted in a Brazilian Primary Health Care Unit is proposed. A sample of 350 adults will be randomly assigned to participate in the control group, receiving the vaccine intramuscularly according to the standard protocol of the service, or in the intervention group, receiving the vaccine by the same route and using a portable device of high frequency vibration associated with cryotherapy for 30 s before and during administration. The primary endpoints will be self-reported levels of pain, assessed before and after vaccine administration. Secondary endpoints will be levels of anxiety, satisfaction with vaccine administration, and discomfort caused by high frequency vibration and temperature of the frozen bag in contact with the skin. Self-reported levels of pain and anxiety will be compared before and after vaccination as well as between the control and intervention groups. DISCUSSION: By evaluating the effect of high-frequency vibration associated with cryotherapy on pain and anxiety levels, we expect to find evidence that will support nursing practice, in order to promote greater comfort and safety in the vaccination process and, consequently, greater compliance by the population, by minimizing its undesirable effects. TRIAL REGISTRATION: Human Research Ethics Committee Opinion Number: 5.138.564. Approved on December 2, 2021. Brazilian Registry of Clinical Trials (REBEC): Registration number RBR-5zgy25w. Registered on December 09, 2021.

COVID-19 and Brazilian Indigenous Populations.

The newly discovered SARS-CoV-2 is the cause of COVID-19, including severe respiratory symptoms with an important lethality rate and high dissemination capacity. Considering the indigenous people of Brazil, it is feared that COVID-19 will spread to these communities, causing another stage of decimation. Despite advances in indigenous health care in the country, there are still many challenges due to the social vulnerability of this population, whose lands continue to be illegally exploited. Based on these considerations, this article discusses challenges in caring for the indigenous population in the context of the COVID-19 pandemic in Brazil.

Practice challenges in patient safety.

OBJECTIVE: to understand the professional practice challenges in reaching the goals and objectives of the National Patient Safety Program (Programa Nacional de Segurança do Paciente). METHOD: qualitative case study, based on the Comprehensive Sociology, carried out with 31 professionals from the Patient Safety Center (Núcleo de Segurança do Paciente) and the nursing team, working in a teaching hospital. Data collection took place between May and December 2015 through interviews, observation and documentary analysis. The analysis proceeded according to the prerogatives of the Content Analysis. RESULTS: three categories emerged: the prescribed reality; material resources and their impact on care; and human resources related to the reality. FINAL CONSIDERATIONS: challenges to safe professional practice are caused by inadequate physical structure, insufficient physical and human resources, but mainly invade the transition from the prescriptive reality scope.

Health professionals' practices related with tourniquet use during peripheral venipuncture: a scoping review. / Práticas relacionadas ao uso do garrote durante a punção venosa periférica: uma revisão de escopo.

OBJECTIVES: during peripheral venipuncture, health professionals are recommended to use a tourniquet above the puncture site in order to potentiate venous distension. Given its characteristics and use in clinical settings, tourniquets may represent a source of microorganism dissemination. However, the results of scientific studies in this area are scattered in the literature. This scoping review aims to map the available evidence on health professionals' practices related with tourniquet use during peripheral venipuncture and associated microbiological contamination. METHODS: scoping review following the Joanna Briggs Institute methodology. Two independent reviewers analyzed the relevance of the studies, extracted and synthesized data. RESULTS: fifteen studies were included in the review. Overall, tourniquets were reused without being subject to recurring decontamination processes. It has been found that practitioners share these devices among themselves and use them successively for periods between two weeks and seven and half years. CONCLUSION: nursing practices related to tourniquet use during peripheral venipuncture are not standard. Reuse of tourniquets may jeopardize the patient's safety if reprocessing (cleaning and disinfection/sterilization) is not adequate, given the type of tourniquet material and microbiota found. New studies are needed to assess the impact of various types of reprocessing practices on tourniquet decontamination and patient safety.

Problematization methodology's impact on nursing and medical students' knowledge about hypodermoclysis: quasi-experimental study / Impacto de la metodología de problematización en el conocimiento de estudiantes de enfermería y medicina sobre hipodermoclisis: estudio cuasiexperimental / Impacto da metodologia de problematização no conhecimento de estudantes de enfermagem e medicina sobre hipodermóclise: estudo quase experimental

Objective: to analyze the problematization methodology impact on the knowledge of nursing and medical students about hypodermoclysis. Method: quasi-experimental study conducted with 22 undergraduate nursing and medical students from a public Brazilian higher education institution. The students participated in the educational intervention using the problematization methodology based on the Arch of Maguerez. A previously validated questionnaire was used to determin' the students' knowledge level about hypodermoclysis. This instrument was applied before and after the educational intervention. The results were compared by McNemar's test and Student's t test for paired samples. Results: when comparing the correct answers before and after the intervention, there was a significant increase in 75% of the questions (p<0.05), including theoretical and practical aspects of hypodermoclysis. The mean score on students' self-assessment of the ability to explain (0.9 versus 5.9 points) and perform hypodermoclysis (1.9 versus 5.0) was significantly higher after applying the problematization methodology (p<0.001). Conclusion: the problematization methodology had a positive impact on the students' knowledge about hypodermoclysis. The number of correct answers after the educational intervention was higher than the initial assessment. The problematization methodology can be incorporated into the teaching-learning process of nursing and medical students for teaching procedures such as hypodermoclysis.

Objetivo: analizar el impacto de la metodología de problematización en el conocimiento de estudiantes de enfermería y medicina sobre hipodermoclisis. Método: estudio cuasiexperimental realizado con 22 estudiantes de enfermería y medicina de una institución pública de educación superior brasileña. Los estudiantes participaron de la intervención educativa utilizando la metodología de problematización basada en el Arco de Maguerez. Se utilizó un cuestionario previamente validado para determinar el nivel de conocimiento de los estudiantes sobre la hipodermoclisis. Este instrumento se aplicó antes y después de la intervención educativa. Los resultados se compararon mediante la prueba de McNemar y la prueba t de Student para muestras pareadas. Resultados: al comparar las respuestas correctas antes y después de la intervención, se observó un aumento significativo en el 75% de las preguntas (p<0,05), que incluye aspectos teóricos y prácticos de la hipodermoclisis. El puntaje promedio en la autoevaluación de los estudiantes con respecto a su capacidad para explicar (0,9 versus 5,9 puntos) y realizar hipodermoclisis (1,9 versus 5,0) fue significativamente mayor después de aplicar la metodología de problematización (p<0,001). Conclusión: la metodología de problematización tuvo impacto positivo en el conocimiento de los estudiantes sobre la hipodermoclisis. El número de respuestas correctas luego de la intervención educativa fue mayor que en la evaluación inicial. La metodología de problematización puede incorporarse al proceso de enseñanza-aprendizaje de estudiantes de enfermería y medicina para enseñar procedimientos como la hipodermoclisis.

Objetivo: analisar o impacto da metodologia de problematização no conhecimento de estudantes de enfermagem e medicina sobre hipodermóclise. Método: estudo quase-experimental realizado com 22 estudantes de graduação em enfermagem e medicina de uma instituição pública de ensino superior brasileira. Os alunos participaram da intervenção educacional usando a metodologia de problematização baseada no Arco de Maguerez. Um questionário previamente validado foi usado para determinar o nível de conhecimento dos alunos sobre hipodermóclise. Esse instrumento foi aplicado antes e depois da intervenção educacional. Os resultados foram comparados pelo teste de McNemar e pelo teste t de Student para amostras pareadas. Resultados: ao comparar as respostas corretas antes e depois da intervenção, houve um aumento significativo em 75% das questões (p<0,05), incluindo aspectos teóricos e práticos da hipodermóclise. A pontuação média na autoavaliação dos alunos quanto à capacidade de explicar (0,9 versus 5,9 pontos) e realizar a hipodermóclise (1,9 versus 5,0) foi significativamente maior após a aplicação da metodologia de problematização (p<0,001). Conclusão: a metodologia de problematização teve um impacto positivo no conhecimento dos alunos sobre hipodermóclise. O número de respostas corretas após a intervenção educacional foi maior do que na avaliação inicial. A metodologia de problematização pode ser incorporada ao processo de ensino-aprendizagem de estudantes de enfermagem e medicina para o ensino de procedimentos como a hipodermóclise.

Effect of the association of two educational interventions on students' knowledge about hypodermoclysis: a quasi-experimental study / Efecto de la asociación de dos intervenciones educativas en el conocimiento de los estudiantes sobre la hipodermoclisis: estudio cuasiexperimental / Efeito da associação de duas intervenções educativas no conhecimento de estudantes sobre hipodermóclise: estudo quase-experimental

ABSTRACT Objective: to ass the effect of associating the problematization methodology with practical demonstration on nursing students' knowledge about hypodermoclysis. Method: this is a quasi-experimental study with 20 students in their final year of the undergraduate course in nursing at a public higher education institution, located in Viçosa, Minas Gerais, Brazil. Students participated in two educational interventions focused on teaching hypodermoclysis, one using problematization methodology and the other the practical demonstration of the puncture technique. The effect of the interventions on students' knowledge was assessed using a previously validated questionnaire applied before the first intervention and after the second intervention. The results were compared using the McNemar test. Results: students' mean age was 24.7 (±1.7) years, with a predominance of females (75.0%). It was found that, of the 12 questions assessed about theoretical and practical knowledge of hypodermoclysis, 10 (83.3%) showed an increase in correct answers after educational interventions (p<0.05). Students' mean score in self-assessment on their ability to explain the procedure (before: 0.9 points; after: 7.7 points) and perform the technique (before: 2.1 points; after: 8.1 points) was significantly higher after educational interventions (p<0.001). Conclusion: the number of correct answers by nursing students on theoretical and practical questions about hypodermoclysis and self-assessment was greater after participating in educational interventions, which demonstrates a positive effect of the association of problematization methodology and practical demonstration as a teaching strategy on this topic.

RESUMEN Objetivo: evaluar el efecto de asociar la metodología de problematización con la demostración práctica sobre el conocimiento de los estudiantes de enfermería sobre la hipodermoclisis. Método: estudio cuasiexperimental con 20 estudiantes del último año de la carrera de enfermería de una institución pública de educación superior, ubicada en Viçosa, Minas Gerais, Brasil. Los estudiantes participaron de dos intervenciones educativas enfocadas a la enseñanza de la hipodermoclisis, una utilizando la metodología de la problematización y la otra una demostración práctica de la técnica de punción. El efecto de las intervenciones sobre el conocimiento de los estudiantes se evaluó mediante un cuestionario previamente validado aplicado antes de la primera intervención y después de la segunda intervención. Los resultados se compararon mediante la prueba de McNemar. Resultados: la edad promedio de los estudiantes fue de 24,7 (±1,7) años, con predominio del sexo femenino (75,0%). Se encontró que, de las 12 preguntas evaluadas sobre conocimientos teóricos y prácticos de la hipodermoclisis, 10 (83,3%) mostraron aumento de aciertos después de las intervenciones educativas (p<0,05). La puntuación media de los estudiantes en la autoevaluación sobre su capacidad para explicar el procedimiento (antes: 0,9 puntos; después: 7,7 puntos) y realizar la técnica (antes: 2,1 puntos; después: 8,1 puntos) fue significativamente mayor después de las intervenciones educativas (p<0,001). Conclusión: el número de respuestas correctas de los estudiantes de enfermería a preguntas teóricas y prácticas sobre hipodermoclisis y autoevaluación fue mayor después de participar en intervenciones educativas, lo que demuestra un efecto positivo de la asociación de la metodología de problematización y la demostración práctica como estrategia de enseñanza en este tema.

RESUMO Objetivo: avaliar o efeito da associação da metodologia da problematização com a demonstração prática no conhecimento de estudantes de Enfermagem sobre hipodermóclise. Método: estudo quase-experimental com 20 estudantes do último ano do curso de graduação em Enfermagem de uma instituição pública de ensino superior, localizada em Viçosa, Minas Gerais, Brasil. Os estudantes participaram de duas intervenções educativas com foco no ensino da hipodermóclise, uma utilizando a metodologia da problematização e a outra a demonstração prática da técnica de punção. O efeito das intervenções sobre o conhecimento dos estudantes foi avaliado a partir de um questionário previamente validado aplicado antes da primeira intervenção e depois da segunda intervenção. Os resultados foram comparados pelo teste de McNemar. Resultados: a média de idade dos estudantes foi de 24,7 (±1,7) anos, com predomínio do sexo feminino (75,0%). Verificou-se que, das 12 questões avaliadas sobre o conhecimento teórico e prático da hipodermóclise, 10 (83,3%) apresentaram aumento de acertos após as intervenções educativas (p<0,05). A pontuação média dos estudantes na auto avaliação sobre a capacidade de explicar o procedimento (antes: 0,9 pontos; após: 7,7 pontos) e executar a técnica (antes: 2,1 pontos; após: 8,1 pontos) foi significativamente maior após as intervenções educativas (p<0,001). Conclusão: o número de acertos dos estudantes de Enfermagem nas questões teóricas e práticas sobre hipodermóclise e a auto avaliação foi maior após a participação nas intervenções educativas, o que demonstra efeito positivo da associação da metodologia da problematização e da demonstração prática como estratégia de ensino sobre essa temática.

Nursing protocol in chronic kidney disease prevention in older adults in primary care / Protocolo de enfermería en la prevención de la enfermedad renal crónica en ancianos en atención primaria / Protocolo de enfermagem na prevenção de doença renal crônica em pessoas idosas na atenção primária

ASBTRACT Objectives: to develop a protocol for Nursing Process operationalization in approaching older adults with vulnerability to chronic kidney disease in Primary Health Care, based on Neuman's stressors. Methods: a methodological study, carried out in two stages: 1) synthesis of evidence using an inductive strategy (mixed method study) and 2) protocol development to support the nursing process operationalization with older adults enrolled in a Basic Health Unit, using a deductive strategy (Neuman's stressor concepts, NANDA, NIC, and NOC taxonomies, Risner's line of reasoning, and cross-mapping), described according to A Step-by-Step Guide to Developing Protocols. Results: 102 older adults participated, and 17 diagnoses, 34 interventions and 26 nursing outcomes were identified. Conclusions: the protocol developed is a technology that makes it possible to operationalize the Nursing Process, based on Neuman's stressors and on taxonomy, conceptual and care frameworks, guiding care and nursing records.

RESUMEN Objetivos: desarrollar un protocolo para la operacionalización del Proceso de Enfermería en el abordaje de ancianos con vulnerabilidad a la enfermedad renal crónica en la Atención Primaria de Salud, a partir de los estresores de Neuman. Métodos: estudio metodológico, realizado en dos etapas: 1) síntesis de evidencias utilizando una estrategia inductiva (estudio de método mixto) y 2) desarrollo del protocolo para apoyar la operacionalización del proceso de enfermería con personas mayores inscritas en una Unidad Básica de Salud, utilizando una estrategia deductiva (conceptos de factores estresantes de Neuman, taxonomías NANDA, NIC y NOC, línea de razonamiento de Risner y mapeo cruzado), descritos de acuerdo con A Step-by-Step Guide to Developing Protocols. Resultados: Participaron 102 ancianos. Se capturaron 17 diagnósticos, 34 intervenciones y 26 resultados de enfermería. Conclusiones: el protocolo desarrollado es una tecnología que posibilita la operacionalización del Proceso de Enfermería, a partir de los estresores de Neuman y de referencias taxonómicas, conceptuales y asistenciales, de los cuidados orientadores y de los registros de enfermería.

RESUMO Objetivos: desenvolver um protocolo para a operacionalização do Processo de Enfermagem na abordagem de pessoas idosas com vulnerabilidade para doença renal crônica na Atenção Primária à Saúde, alicerçado nos estressores de Neuman. Métodos: estudo metodológico, realizado em duas etapas: síntese das evidências por estratégia indutiva (estudo de método misto) e desenvolvimento do protocolo para subsidiar a operacionalização do Processo de Enfermagem com pessoas idosas adstritas a uma Unidade Básica de Saúde, utilizando estratégia dedutiva (conceitos de estressores de Neuman, taxonomias NANDA, NIC e NOC, linha de raciocínio de Risner e mapeamento cruzado), descrito segundo A Step-by-Step Guide to Developing Protocols. Resultados: participaram 102 idosos. Foram captados 17 diagnósticos, 34 intervenções e 26 resultados de enfermagem. Conclusões: o protocolo elaborado constitui uma tecnologia que possibilita operacionalizar o processo de enfermagem alicerçado nos estressores de Neuman e em referenciais taxonômicos, conceituais e assistenciais, norteando o cuidado e os registros de enfermagem.

Hypothermia among premature newborns on admission to a neonatal intensive care unit / Hipotermia entre los recién nacidos prematuros que ingresan en una unidad de cuidados intensivos neonatales / Hipotermia entre recém-nascidos prematuros na admissão em uma unidade de terapia intensiva neonatal

ABSTRACT Objective: To assess prevalence and factors associated with hypothermia in preterm infants admitted to a neonatal intensive care unit. Methods: It is a cross-sectional retrospective study, with 154 premature newborns admitted between 2017 and 2019 in a neonatal intensive care unit. Logistic regression was used to evaluate the association to hypothermia. Results: There was a predominance of males (55.8%), coming from the operating room (55.8%), gestational age > 32 weeks (71.4%), weight > 1500g (59.1%), Apgar in the 1st minute of life less than seven (51.9%) and in the 5th minute of life greater than or equal to seven (94.2%). The prevalence of hypothermia at admission was 68.2%. It was found that the lower the weight, the greater the chances of hypothermia, being three times higher in low weight (OR 3.480), five times higher in very low weight (OR5.845) and up to 47 times higher in extremely low weight (OR47.211). Conclusion: Hypothermia was 68.2% and it was associated with lower birth weight.

RESUMEN Objetivo: Evaluar prevalencia y factores asociados a la hipotermia entre los recién nacidos prematuros ingresados en una unidad de cuidados intensivos neonatales. Métodos: Estudio transversal retrospectivo, con 154 recién nacidos prematuros ingresados entre 2017 y 2019 en una unidad de cuidados intensivos neonatales. Se utilizó la regresión logística para evaluar la asociación a la hipotermia. Resultados: Hubo un predominio de varones (55,8%), procedentes del centro quirúrgico (55,8%), edad gestacional > 32 semanas (71,4%), peso > 1500g (59,1%), puntuación de Apgar en el primer minuto de vida inferior a siete (51,9%) y en el quinto minuto superior o igual a siete (94,2%). La prevalencia de hipotermia al ingreso fue del 68,2%. Se comprobó que cuanto menor es el peso, mayores son las posibilidades de hipotermia, tres veces más para el peso bajo (R.O. 3,480), cinco veces más para el peso muy bajo (R.O.5,845) y hasta 47 veces más para el peso extremadamente bajo (R.O.47,211). Conclusión: La hipotermia fue del 68,2% y se asoció a un menor peso al nacer.

RESUMO Objetivo: Avaliar prevalência de hipotermia e fatores associados entre recém-nascidos prematuros admitidos em uma unidade de terapia intensiva neonatal. Métodos: Estudo transversal retrospectivo, com 154 recém-nascidos prematuros admitidos entre 2017 e 2019 em uma unidade de terapia intensiva neonatal. Utilizou-se regressão logística para avaliar associação à hipotermia. Resultados: Houve predomínio do sexo masculino (55,8%), procedência de centro cirúrgico (55,8%), idade gestacional > 32 semanas (71,4%), peso > 1.500g (59,1%), Apgar no 1º minuto de vida menor que sete (51,9%) e no 5º maior ou igual a sete (94,2%). A prevalência de hipotermia à admissão foi de 68,2%. Verificou-se que quanto menor o peso, maiores as chances de hipotermia, sendo três vezes maior no baixo peso (O.R. 3,480), cinco vezes maior no muito baixo peso (O.R. 5,845) e 47 vezes maior no extremo baixo peso (O.R. 47,211). Conclusão: A hipotermia foi de 68,2% e esteve associada ao menor peso ao nascer.

Construction and validation of forms: systematization of the care of people under hemodialysis.

OBJECTIVE: create and validate forms to subsidize the systematization of nursing care with people on hemodialysis. METHOD: institutional case study to support the systematization of assistance from the construction of forms for data collection, diagnoses, interventions and nursing results, using cross-mapping, Risner's reasoning, Neuman's theory, taxonomies of diagnoses, interventions and nursing results with application in clinical practice and validation by focal group with specialist nurses. RESULTS: 18 people on hemodialysis and 7 nurses participated. Consensus content of form matter with specialist nurses in the area (Crombach 0.86). The papers captured 43 diagnoses, 26 interventions and 78 nursing results depicting human responses in their singularities. FINAL CONSIDERATIONS: the validated forms fill a gap by enabling the capture of human responses from people on hemodialysis and by subsidizing the planning of nursing care on a scientific basis.

Phlebitis and infiltration: vascular trauma associated with the peripheral venous catheter.

OBJECTIVE: to determine the incidence rate and risk factors for the nursing-sensitive indicators phlebitis and infiltration in patients with peripheral venous catheters (PVCs). METHOD: cohort study with 110 patients. Scales were used to assess and document phlebitis and infiltration. Socio-demographic variables, clinical variables related to the PVC, medication and hospitalization variables were collected. Descriptive and inferential analysis and multivariate logistic models were used. RESULTS: the incidence rate of phlebitis and infiltration was respectively 43.2 and 59.7 per 1000 catheter-days. Most PVCs with these vascular traumas were removed in the first 24 hours. Risk factors for phlebitis were: length of hospital stay (p=0.042) and number of catheters inserted (p<0.001); risk factors for infiltration were: piperacillin/tazobactan (p=0.024) and the number of catheters inserted (p<0.001). CONCLUSION: the investigation documented the incidence of nursing-sensitive indicators (phlebitis and infiltration) and revealed new risk factors related to infiltration. It also allowed a reflection on the nursing care necessary to prevent these vascular traumas and on the indications and contraindications of the PVC, supporting the implementation of the PICC as an alternative to PVC.

Escala Portuguesa de Flebite: adaptação transcultural, validade e confiabilidade para uso no Brasil / Portuguese Phlebitis Scale: cross-cultural adaptation, validity and reliability for use in Brazil / Escala Portuguesa de Flebitis: adaptación transcultural, validez y confiabilidad para uso en Brasil

Objetivos: Adaptar a Escala Portuguesa de Flebite para a cultura brasileira e verificar as propriedades psicométricas da versão adaptada. Métodos: Estudo metodológico envolvendo análise da equivalência semântica, cultural e idiomática para adaptação transcultural, cognitive debriefing, verificação da consistência interna e validade de construto. Equivalência foi analisada utilizando percentual de acordos. Validade de construto foi testada utilizando análise fatorial exploratória.A confiabilidade foi avaliada pela consistência interna (α de Cronbach e Ω de McDonald). Resultados: No processo de adaptação transcultural, envolvendo dez especialistas, dois itens não alcançaram concordância ≥ 80% e sofreram ajustes conforme as sugestões recebidas. Doze participantes do cognitive debriefing aprovaram a versão adaptada. Participaram da análise de confiabilidade e de validação do construto 244 adultos em uso de cateter venoso periférico. Análise fatorial exploratória identificou um único fator incluindo todos os itens testados (dor, eritema, edema, rubor no trajeto da veia e cordão venoso palpável) e carga fatorial > 0,743. Consistência interna do conjunto de itens foi alta (α de Cronbach = 0,771 e Ω de McDonald = 0,853). Conclusão: A Escala Portuguesa de Flebite ­ Versão adaptada para o Brasil mostrou-se válida e confiável. Alcançou propriedades que permitem sua utilização na prática clínica, no ensino e pesquisas no país.

Objectives: To adapt the Portuguese Phlebitis Scale to the Brazilian culture and verify the adapted version's psychometric properties. Methods: Methodological study involving analysis of semantic, cultural, and idiomatic equivalence for cross-cultural adaptation, cognitive debriefing, verification of internal consistency, and construct validity. The equivalence was analyzed considering the percentage of agreement among experts. Exploratory factor analysis was used to test construct validity. Reliability was assessed by internal consistency (Cronbach's α and McDonald's Ω). Results: In the cross-cultural adaptation process involving ten experts, two items did not reach an agreement ≥ 80% and underwent adjustments according to the suggestions received. Twelve cognitive debriefing participants approved the adapted version. Adults (n = 244) using a peripheral venous catheter participated in the reliability and construct validation analysis. Exploratory factor analysis identified a single factor, including all tested items (pain, erythema, edema, streak formation along the course of the vein, and palpable venous cord) and factor loading > 0.743. Internal consistency of the set of items was high (Cronbach's α = 0.771 and McDonald's Ω = 0.853). Conclusion: The Portuguese Scale of Phlebitis - Version adapted for Brazil proved valid and reliable. It achieved properties that allow use in Brazil's clinical practice, teaching, and research.

Objetivos: Adaptar la Escala de Flebitis Portuguesa a la cultura brasileña y verificar las propiedades psicométricas de la versión adaptada. Métodos: Estudio metodológico que involucró análisis de equivalencia semántica, cultural e idiomática para adaptación transcultural, debriefing cognitivo, verificación de consistencia interna y validez de constructo. Para el análisis de la concordancia de la equivalencia se utilizó el porcentaje de concordancias. Para probar la validez de constructo, se utilizó el análisis factorial exploratorio. La fiabilidad se evaluó mediante la consistencia interna (α de Cronbach e Ω de McDonald). Resultados: En el proceso de adaptación transcultural, en el que participaron diez expertos, dos ítems no alcanzaron un acuerdo ≥ 80% y se ajustaron de acuerdo con las sugerencias recibidas. Doce participantes en el debriefing cognitivo aprobaron la versión adaptada. Usuarios de catéter venoso periférico (n = 244) participaron en el análisis de confiabilidad y la validación de constructo. El análisis factorial exploratorio identificó un solo factor que incluía todos los ítems probados (dolor, eritema, edema, enrojecimiento en la vena y el cordón venoso palpable) y una carga factorial > 0,743. La consistencia interna de los ítems fue alta (αde Cronbach = 0,771 y Ω de McDonald = 0,853). Conclusión: La Escala Portuguesa de Flebitis ­ Versión adaptada para Brasil demostró ser válida y confiable. Alcanzó propiedades que permiten su uso en la práctica clínica, la docencia e la investigación en Brasil.

Eficácia de uma intervenção educativa para prevenção de complicações no cateter venoso periférico / Effectiveness of an educational intervention for the prevention of peripheral venous catheter complications / Eficacia de una intervención educativa para la prevención de las complicaciones del catéter venoso periférico

RESUMO Objetivo avaliar a eficácia de uma intervenção educativa de prática baseada em evidências na prevenção de complicações no cateter venoso periférico. Método estudo observacional com intervenção educativa para profissionais de enfermagem de um hospital de Minas Gerais, Brasil, sobre as técnicas de flushing, push-pause e locking. Amostragem por conveniência: 181 cateteres no grupo pré-intervenção e 157 no pós-intervenção. Avaliaram-se a incidência de complicações e comparação pelos testes do Qui-quadrado e exato de Fisher. Resultados a incidência de complicações no grupo pós-intervenção foi: 4,5% para obstrução (p=0,000), 10,8% para remoção acidental (p=0,265) e 1,9% para flebite (p=0,847). A utilização das técnicas de flushing, push-pause e locking resultaram em significativa redução na incidência de obstrução. Conclusão a intervenção educativa possibilitou conhecimento atualizado e a implementação do flushing, push-pause e locking nas práticas de enfermagem. O estudo é uma contribuição para o planejamento de intervenção de enfermagem para reduzir a ocorrência de obstrução.

ABSTRACT Objective: To evaluate the effectiveness of an evidence-based practice educational intervention in preventing peripheral venous catheter complications. Method observational study with educational intervention for nursing professionals of a hospital in Minas Gerais, Brazil, about flushing, push-pause and locking techniques. Convenience sampling: 181 catheters in the pre-intervention group and 157 in the post-intervention group. The incidence of complications was evaluated and compared by the Chi-square and Fisher's exact tests. Results the incidence of complications in the post-intervention group was: 4.5% for obstruction (p=0.000), 10.8% for accidental removal (p=0.265) and 1.9% for phlebitis (p=0.847). The use of the flushing, push-pause and locking techniques resulted in a significant reduction in the incidence of obstruction. Conclusion the educational intervention enabled updated knowledge and the implementation of flushing, push-pause and locking in nursing practices. The study is a contribution to nursing intervention planning to reduce the occurrence of obstruction.

RESUMEN Objetivo: evaluar la eficacia de una intervención educativa basada en la evidencia para prevenir las complicaciones del catéter venoso periférico. Método estudio observacional con intervención educativa para los profesionales de enfermería de un hospital de Minas Gerais, Brasil, sobre las técnicas de lavado, empuje-pausa y bloqueo. Muestreo de conveniencia: 181 catéteres en el grupo pre-intervención y 157 en el grupo post-intervención. La incidencia de complicaciones y la comparación se evaluaron mediante los tests de Chi-cuadrado y exacto de Fisher. Resultados la incidencia de complicaciones en el grupo posterior a la intervención fue del 4,5% para la obstrucción (p=0,000), del 10,8% para la extracción accidental (p=0,265) y del 1,9% para la flebitis (p=0,847). El uso de las técnicas de enjuague, empuje-pausa y bloqueo dio lugar a una reducción significativa de la incidencia de la obstrucción. Conclusión la intervención educativa permitió la actualización de los conocimientos y la implementación del flushing, push-pause y locking en las prácticas de enfermería. El estudio es una contribución a la planificación de la intervención de enfermería para reducir la aparición de la obstrucción.

Peripheral venous puncture and contrast in radiological exams: social representations anchored in neuman's stressors / Punción venosa periférica y contraste en exámenes radiológicos: representaciones sociales ancladas en los estresores de neuman / Punção venosa periférica e contraste nos exames radiológicos: representações sociais ancoradas nos estressores de neuman

ABSTRACT Objective: to discuss the social representations about peripheral venipuncture and the use of contrast media of people submitted to radiological examinations, referring to stressor concept. Method: this is qualitative research, outlined in the procedural approach of the Social Representation Theory, carried out with 57 users undergoing computed tomography and magnetic resonance imaging at a university hospital in Juiz de Fora, Minas Gerais, Brazil. In-depth individual interviews triggered by guiding questions were conducted in January 2019. The contents of the interviews were fully transcribed and content analysis was carried out in three stages (pre-analysis, material exploration and treatment/interpretation of results). We established thematic analysis based on the dimensions and representational origins, which made it possible to discuss the findings anchored in the concepts of stressors, allowing the identification of three categories based on intrapersonal, interpersonal and transpersonal stressors. Results: puncture and examination were represented by individual, group, professional and therapeutic environment experiences, classified into the following categories: itinerary and conceptions on puncture and contrasted examinations based on intrapersonal stressors; shared relationships on puncture and examination, based on interpersonal stressors; and experiences in the therapeutic environment of a diagnostic imaging service, based on transpersonal stressors. Conclusion: the social representations were signified by examination, results and impacts on life, portraying stressors based on images/feelings of doubt and positive behaviors rationally justified, which explain human responses to reified content, enabling the restructuring of health care and nursing.

RESUMEN Objetivo: discutir las representaciones sociales sobre la venopunción periférica y el uso de medios de contraste en personas sometidas a exámenes radiológicos, refiriéndose al concepto de estresores. Método: investigación cualitativa, enmarcada en el enfoque procedimental de la Teoría de las Representaciones Sociales, realizada con 57 usuarios sometidos a tomografía computarizada y resonancia magnética en un hospital universitario de Juiz de Fora, Minas Gerais, Brasil. Se realizaron entrevistas individuales en profundidad desencadenadas por preguntas orientadoras en enero de 2019. Los contenidos de las entrevistas se transcribieron íntegramente y se realizó un análisis de contenido en tres etapas (preanálisis, exploración del material y tratamiento/interpretación de los resultados). El análisis de contenido temático-categoría establecido a partir de las dimensiones y orígenes representacionales permitió discutir los hallazgos anclados en los conceptos de estresores, permitiendo la identificación de tres categorías a partir de estresores intrapersonales, interpersonales y transpersonales. Resultados: la punción y el examen fueron representados por las experiencias individuales y grupales, con los profesionales y el ambiente terapéutico, clasificados en las categorías: itinerario y concepciones sobre punción y exámenes contrastados, a partir de estresores intrapersonales; relaciones compartidas sobre punción y examen, basadas en estresores interpersonales; y experiencias en el ambiente terapéutico de un servicio de diagnóstico por imagen, basado en estresores transpersonales. Conclusión: las representaciones sociales fueron significadas por el examen, los resultados y los impactos en la vida, retratando estresores a partir de imágenes/sentimientos de duda y comportamientos positivos justificados racionalmente, que explican las respuestas humanas a los contenidos cosificados, posibilitando la reestructuración de los cuidados de salud y enfermería.

RESUMO Objetivo: discutir as representações sociais sobre a punção venosa periférica e o uso de meios de contraste de pessoas submetidas a exames radiológicos, referenciando-se no conceito de estressores. Método: pesquisa qualitativa, delineada na abordagem processual da Teoria das Representações Sociais, realizada com 57 usuários submetidos a exames de Tomografia Computadorizada e Ressonância Magnética em um Hospital Universitário de Juiz de Fora, Minas Gerais, Brasil. Realizaram-se entrevistas individuais em profundidade desencadeadas por questões norteadoras em janeiro de 2019. Os conteúdos das entrevistas foram transcritos na íntegra e realizou-se análise de conteúdo em três etapas (pré-análise, exploração do material e tratamento/interpretação dos resultados). A análise temático-categorial estabelecida a partir das dimensões e origens representacionais possibilitou a discussão dos achados ancorada nos conceitos de estressores, permitindo a identificação de três categorias baseadas nos estressores intrapessoais, interpessoais e transpessoais. Resultados: a punção e o exame foram representados pelas vivências individuais, grupais, com profissionais e ambiente terapêutico, classificados nas categorias: itinerário e concepções sobre punção e exames contrastados, com base em estressores intrapessoais; relações compartilhadas sobre a punção e o exame, fundamentadas em estressores interpessoais e vivências no ambiente terapêutico de um serviço de diagnóstico por imagem, a partir dos estressores transpessoais. Conclusão: as representações sociais foram significadas por exame, resultado e impactos na vida, retratando estressores alicerçados em imagens/sentimentos de dúvida e comportamentos positivos justificados racionalmente, que explicitam respostas humanas a conteúdos reificados, possibilitando a reestruturação do cuidado em saúde e em enfermagem.

Práticas de enfermagem relacionadas ao flushing em cateter venoso periférico: estudo descritivo / Prácticas de enfermería relacionadas com el lavado en catéteres venosos periféricos: estudio descriptivo / Nursing practices related to flushing in peripheral venous catheters: a descriptive study

Objetivo: Analisar as práticas de enfermagem relacionadas ao flushing para prevenção da obstrução do cateter venoso periférico. Método: Estudo descritivo com aplicação de questionário aos 78 profissionais de enfermagem e checklist durante a observação das práticas de enfermagem numa clínica médica, durante 30 dias. Resultados: 89,7% dos profissionais de enfermagem realizavam o flushing na prática clínica. A técnica de pushpause era realizada por 12,86% dos participantes. A seringa mais utilizada foi de 10ml (85,72%), com 10ml de solução fisiológica 0,9% (52,86%). A técnica push-pause foi realizada em 10,7% das observações e a avaliação da permeabilidade do cateter em 3,6%. Conclusão: O flushing é utilizado para prevenção da obstrução do cateter nas práticas de enfermagem, entretanto, verificou-se diferenças na técnica, tamanho da seringa, volume de solução fisiológica utilizada e momentos para realização entre os profissionais e o recomendado pela literatura(AU)

Objective: To analyze nursing practices related to flushing to prevent peripheral venous catheter obstruction. Method: Descriptive study, with application of a semi-structured questionnaire to 78 members of the nursing team, and observation of the clinical practices of medical clinic professionals regarding prevention of obstruction, during 30 days, using a checklist. Results: 89.7% of nursing professionals performed flushing in clinical practice. The push-pause technique was performed by 12.86% of the participants. The most used syringe was the 10ml (85.72%) one with 10ml of 0.9% saline solution (52.86%). The push-pause technique was performed in 10.7% of the observations and catheter permeability evaluation in 3.6%. Conclusion: Flushing is used to prevent catheter obstruction in nursing practices, however, differences in technique, syringe size, volume of saline solution used, and times of performance were observed among professionals and those recommended by the literature(AU)

Objetivo: Analizar las prácticas de enfermería relacionadas con el flushing para prevenir la obstrucción del catéter venoso periférico. Método: Estudio descriptivo con aplicación de cuestionario a 78 profesionales de la enfermería y checklist durante la observación de las prácticas en una clínica médica, durante 30 días. Resultados: El 89,7% de los profesionales realizó el flushing en la práctica. El 12,86% de los participantes realizó la técnica de empuje-pausa. La jeringa más utilizada fue la de 10 ml (85,72%), con 10 ml de solución salina (52,86%). La técnica de empuje-pause se realizó en el 10,7% de las observaciones, y la evaluación de la permeabilidad del catéter en el 3,6%. Conclusión: El flushing se utiliza para prevenir la obstrucción del catéter en las prácticas de enfermería, sin embargo, se verificaron diferencias en la técnica, el tamaño de la jeringa, el volumen de solución salina y los momentos de realización entre los profesionales y lo recomendado por la literatura.(AU)