Validation of parameters to fill in the Perroca's patient classification system. / Validação de parâmetros para preenchimento do sistema de classificação de pacientes de Perroca.

OBJECTIVE: To propose parameters to qualify the filling of the Patient Classification System proposed by Perroca. METHOD: Validation study by consensus held in 2014, in a university hospital. The sample included 10 specialist nurses, four teachers and a computer science professional, all knowledgeable in the Classification System. The information was collected and analyzed through meetings registration, where strategies were discussed to enable the systematic application of the instrument in the institution. For the construction, it was considered a consensus of 100% among the experts. RESULTS: The computerized parameter guide was elaborated with a description of what to evaluate in each item of the Perroca's instrument, standardizing the filling by the nurses. CONCLUSIONS: The parameter guide made it possible to minimize the subjectivity of the evaluators when applying the classification instrument, provided guiding elements to fill it in and qualified the nursing care benchmarking.

Factors associated with smoking initiation among school-aged adolescents. / Fatores associados à iniciação tabágica em adolescentes escolares.

OBJECTIVE: To identify factors associated with smoking initiation in adolescent secondary school students. METHOD: This is a cross-sectional study conducted in 2014 with 864 adolescents at a secondary school in southern Brazil. Data were collected using an instrument with sociodemographic questions, application of the Fagerström Nicotine Dependence Scale, and Beck Depression Inventory, and analysed using descriptive statistics, Fisher's Exact test, Chi-square test, Mann-Whitney's test, and the Poisson Regression test. RESULTS: Fifty-four of the adolescents started smoking, of which 35 continued smoking and exhibited high nicotine dependence. Smoking was associated with brown skin (p = 0.020), single-parent household (p = 0.006), a fair family relationship (p = 0.003), and drug users in the family (p = 0.04). A significantly higher prevalence ratio was detected for boys (p = 0.038), higher family income (p> 0.001), living with one family member (p> 0.001), and a fair family relationship (p> 0.001). CONCLUSIONS: We identified factors associated with smoking initiation, revealing the importance of supporting health education strategies to change this reality.

Clinical profile, nursing diagnoses and nursing care for postoperative bariatric surgery patients. / Perfil clínico, diagnósticos e cuidados de enfermagem para pacientes em pós-operatório de cirurgia bariátrica.

Objective To analyze the clinical profile, nursing diagnoses, and nursing care established for postoperative bariatric surgery patients. Method Cross-sectional study carried out in a hospital in southern Brazil with a sample of 143 patients. Data were collected retrospectively from electronic medical records between 2011 and 2012 and analyzed statistically. Results We found a predominance of adult female patients (84%) with class III obesity (59.4%) and hypertension (72%). Thirty-five nursing diagnoses were reported, among which the most frequent were: Acute Pain (99.3%), Risk for perioperative positioning injury (98.6%), and Impaired tissue integrity (93%). The most frequently prescribed nursing care were: to use protection mechanisms in the surgical patient positioning, to record pain as 5th vital sign, and to take vital signs. There was an association between age and comorbidities. Conclusion The nursing diagnoses supported the nursing care prescription, which enables the qualification of nursing assistance.

[Profile and motivation for smoking cessation in surgical inpatients]. / Perfil e motivação para a cessação do tabagismo em pacientes cirúrgicos hospitalizados.

The aim of this cross-sectional study was to describe the profile of smokers hospitalized for surgery, and investigate their motivation to quit. The sample consisted of 100 patients recruited from a university hospital in southern Brazil. Data were collected between February and May 2013, and analyzed using descriptive statistics. The sample was predominantly male (n=58; 58%) and had a mean age of 54.5±13.8 years. Seventy-nine (79%) of the participants were white, 38(38%) were married and 67(67%) had primary education only. Patients started smoking at a mean age of 17±6.6 years, smoked approximately 20(10 to 28.7) cigarettes/day and had been smoking for a mean of 37.4±14.4 years. Ninety-one (91%) patients wanted to stop smoking, 57(57%) were in the preparation phase, 36(36%) had low nicotine dependence and 35(35%) had been encouraged to quit. We concluded that, although hospitalization is a good moment to address smoking cessation, health care professionals do not enact effective and systematic interventions in this regard.

[The challenge of tobacco control at a university hospital]. / O dasafio de controlar o tabagismo em um hospital universitário.

OBJECTIVE: To identify the actions taken by the Commission of Tobacco Control (CTC) to control smoking in the hospital environment. METHODS: Descriptive and exploratory retrospective documentary research conducted at a university hospital in southern Brazil, in 2014. The content of the minutes of CTC meetings was used to create a database, and the rounds reports were descriptively analyzed. We sought to identify the most relevant actions from 2005 to 2014. RESULTS: The CTC implemented the Tobacco-Free Environment programme restricted cigarette smoking to designated areas and subsequently deactivated these areas. The only remaining outdoor smoking area in 2014 was deactivated. CONCLUSION: CTC actions have contributed to tobacco control in the hospital environment. This study will hopefully serve as a model to encourage other institutions to implement similar actions.

[Complications during the hospitalization of kidney transplant recipients]. / Complicações durante a internação de receptores de transplante renal.

The objective of the study was to identify the complications in patients that have received a renal transplant. A Historical cohort performed in a university hospital from January/2007 through January/2009 with a sample of 179 patients; data collected retrospectively from the medical history of patients and submitted to statistical analyses. Mean age of patients was 43 (SD=13.7) years, 114 (63.7%) men, 95 (65.1%) non smokers and 118(66.93%) received the graft from a deceased donor. The main complications were rejection 68 (32.1%) and infection 62 (29.2%). There was statistical significance between rejection and median days of hospital stay (p < 0.001); days of use of central venous catheter (p = 0.010) and smoking status (p = 0.008); infection and central venous catheter (p = 0.029); median days of hospital stay (p < 0.001) and time of use of urinary catheter (p = 0.009). It was concluded that it is important to reduce the days of hospital stay and permanence of catheters, which may be considered in the planning of nursing care.

Perceptions of academics and nursing staff about the extension project: "Walking through the hospital".

OBJECTIVE: To know the perception of academics and nursing staff about the extension project "Walking through the hospital". METHOD: Qualitative study conducted in a Brazilian university hospital from November/2019 to April/2022 with nursing students and professionals participating in a university extension project. Data were collected using instruments on the Google Forms® platform and submitted to Content Thematic Analysis. The project was approved by the Ethics Committee. RESULTS: Fifteen academics, four nurses and six nursing technicians participated in the study. Four categories emerged from the analysis: "Knowing the hospital environment/dynamics", "Articulation between theory and practice","Bond between academics and health care professionals" and "Work process in the unit". FINAL CONSIDERATIONS: The findings highlight the importance of university extension in providing knowledge and experienceof hospital clinical practice, which can contribute to strengthening teaching and academic training in nursing.

Effects of an educational intervention with nursing professionals on approaches to hospitalized smokers: a quasi-experimental study.

OBJECTIVE: to assess the effects of an educational intervention on smoking cessation aimed at the nursing team. METHOD: this is a quasi-experimental study with 37 nursing professionals from a Brazilian hospital from May/2019 to December/2020. The intervention consisted of training nursing professionals on approaches to hospitalized smokers divided into two steps, the first, online, a prerequisite for the face-to-face/videoconference. The effect of the intervention was assessed through pre- and post-tests completed by participants. Smokers' medical records were also analyzed. For analysis, McNemar's chi-square test was used. RESULTS: there was an increase in the frequency of actions aimed at smoking cessation after the intervention. Significant differences were found in guidelines related to disclosure to family members of their decision to quit smoking and the need for support, encouragement of abstinence after hospital discharge, and information on tobacco cessation and relapse strategies. CONCLUSION: the educational intervention proved to be innovative and with a great capacity for disseminating knowledge. The post-test showed a positive effect on the frequency of actions aimed at smoking cessation implemented by the nursing team.

Elaboration and validation of a protocol for the care of patients with COVID-19 in hemodialysis centers.

OBJECTIVE: To describe the elaboration and validation of a protocol for the care of suspected patients with Coronavirus Disease-19 (COVID-19) undergoing hemodialysis. METHOD: A methodological study conducted from March to August 2020 at a hospital in southern Brazil. The study involved situational diagnosis, literature review, protocol elaboration and content validation (scope, clarity and relevance). Ten professionals from the multidisciplinary team with experience in caring for patients with kidney disease and an official Nursing supervisory body participated in the validation. 100% consensus was reached among the experts. RESULTS: The following were elaborated: "Flow of patient care consisting of six stages" and "Management plan for dialysis centers". The validation allowed improving and refining the content, complying with the precepts of health standards, safety and clinical guidelines. FINAL CONSIDERATIONS: The elaboration and validation of the protocol can standardize and guide the clinical practice, promoting continuity and safety in care, and can be used in other centers.

Validation of manual to complement the transition of care at discharge from intensive care.

OBJECTIVE: To develop and validate an interprofessional manual for the transfer of care to critically ill adult patients. METHOD: Methodological study, conducted from January to September 2019. The content of the manual was listed by the multidisciplinary team of an adult Intensive Care Unit, in southern Brazil. In the validation by the professionals, the content validity index (CVI) of the evaluation questions was calculated. Subsequently, a sample of 30 patients/caregivers evaluated the product, and the arithmetic mean of the questions was calculated. RESULTS: The manual addresses important information and care transition guidance for patients and caregivers, from admission to the intensive care to discharge to the inpatient unit. The professionals' CVI ranged from 0.9 to 1. The arithmetic mean of 17 patients and 13 caregivers was 3.8. FINAL CONSIDERATIONS: The validated manual can be used as a complementary material for health education and qualify the transition of care.

Venous ulcer healing treated with conventional therapy and adjuvant laser: is there a difference?

OBJECTIVES: to evaluate the effects of venous ulcer healing in patients after six months of conventional treatment and adjuvant low-power laser therapy. METHODS: prospective cohort study nested in a randomized clinical trial with 38 patients, allocated into an intervention group (conventional treatment and adjuvant laser therapy) and a control group (conventional treatment). Patients were followed up as outpatients, sociodemographic and clinical variables were collected, and indicators of the outcomes Wound healing: secondary intention (1103) and Tissue integrity: skin and mucous membranes(1101) of the Nursing Outcomes Classification. Generalized estimating equations, Kaplan-Meier tests, and robust Poisson regression were used in the analysis. RESULTS: the clinical indicators Decreased wound size and Scar formation showed a statistically significant difference in the intervention group, higher number of healed wounds, lower rate, longer time to relapse. CONCLUSIONS: laser therapy adjuvant to conventional treatment returned better results in healing and lower recurrence rates after six months of intervention.

Routine workflow in a reference clinical research center in face of COVID-19.

OBJECTIVE: To develop and validate the content of workflows for trial participants care in a clinical research center during the Covid-19 pandemic. METHOD: development study by consensus of experts carried out from March to July 2020 in southern Brazil. The flowcharts were developed following literature and validated by specialists considering comprehensiveness, clarity and pertinence, obtaining a 100% agreement index on each item of the developed instruments. The study was approved by the Ethics Committee of the institution. RESULTS: two flowcharts of care were elaborated and validated: "Flow diagram to conduct protocols with research participant " and "Flow diagram in protocols with research participant with suspected or confirmed COVID-19 infection"; which describes activities to ensure continuity of care. FINAL CONSIDERATIONS: a routine workflow can promote the continuity and safety of clinical research protocols. It is expected that the adopted flowcharts in this study can guide other institutions with a similar research profile.

Blended learning in permanent education of nursing professionals on smoking cessation.

OBJECTIVE: To develop and validate the content of an educational intervention on smoking cessation for Nursing professionals using a Blended Learning approach. METHOD: A development and validation study by consensus of experts of the "Smoking Cessation" course for Nursing professionals on approaches to the smoking patient carried out in 2018. For refinement and validation of the final content, a convenience sample was made up of 12 professionals with expertise in the subject natter and an 80% consensus among the participants was considered. RESULTS: The construction of the course involved the choice of subjects, production, and content validation. As a teaching strategy, Blended Learning was used, which has an interactive online stage and a face-to-face meeting to discuss concepts and exchange experiences. CONCLUSION: The course using a Blended Learning method proved to be innovative, low-cost, and with great capacity for disseminating knowledge, being an important ally to permanent education in health.

Factors associated with smoking in pregnancy.

The aim of this cross-sectional study was to identify factors related to smoking during pregnancy. The sample included 267 puerperae hospitalized in the maternity unit of a university hospital in Porto Alegre/RS. The data were collected through a self-applied instrument and statistically analyzed. The majority of the puerperae (51.3%) were between 18 and 25 years old, 55.4% were nonsmokers, 25.5% were smokers, 19.1% had recently ceased smoking (in abstinence). The nonsmokers had more consultations than the smokers and the abstinent smokers (p=0.025). The number of women who had more than one child was higher among smokers than among nonsmokers and abstinent smokers (p=0.002). Women were more likely to stop smoking before pregnancy when they had a partner who was a nonsmoker (p=0.007). Several factors influence smoking and smoking cessation and these are important in prenatal interventions aimed at pregnant women and their partners.

Nursing interventions in the clinical practice of an intensive care unit.

This cross-sectional study was carried out at a university hospital to describe the nursing interventions most frequently performed in the clinical practice of an intensive care unit, based on nursing care prescriptions, and to investigate their similarity to the Nursing Interventions Classification (NIC). The sample consisted of 991 hospitalizations of patients. Data were retrospectively collected from the computer database and analyzed through descriptive statistics and cross-mapping. A total of 57 different NIC interventions frequently used in the unit were identified; most of them in the complex (42%) and basic physiological (37%) domains, in the classes 'respiratory management' and 'self-care facilitation'. Similarity between the nursing care prescribed and nursing interventions/NIC was found in 97.2% of the cases. The conclusion is that the interventions/NIC used in the clinical practice of this intensive care unit reflects the level of complexity of nursing care, which is mainly directed at the regulation of the body's physical and homeostatic functioning.

[Patients with gastric cancer submitted to gastrectomy: an integrative review]. / Pacientes com câncer gástrico submetidos à gastrectomia: uma revisão integrativa.

This study aims to analyze the scientific production about patients with gastric cancer submitted to gastrectomy and describe important aspects of nursing guidelines for these patients. An integrative review was carried out using Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) and Medical Literature Analysis and Retrieval System Online (MEDLINE) databases; twenty two articles were analyzed. Retrospective cross-sectional studies were the most frequent. The scientific production of nursing is numerically small in relation to the medical area. The results show that approaches related to pre and post-operative in gastrectomy for gastric cancer resection subsidize the knowledge of issues essential for nurses to promote efficient intervention for the recovery of such patients. There is still the need for further research on the practice of nursing in the guidelines of this kind of surgery.

Use of the Nursing Outcomes Classification - NOC to assess the knowledge of patients with venous ulcer.

OBJECTIVE: To evaluate the knowledge of patients with venous ulcers (VU) on their chronic disease, treatment, and prevention of complications, according to the Nursing Outcomes Classification-NOC. METHODS: This is a cross-sectional study conducted between 2017 and 2018 in a Brazilian hospital. The sample consisted of 38 patients with VU attended in outpatient nursing consultations. The study analyzed sociodemographic, clinical and nine indexes from the Knowledge: Chronic Disease Management (1847) of the NOC, assessed using a five-point Likert scale, analyzed using descriptive statistics. RESULTS: The mean of the result Knowledge: Chronic Disease Management (1847) was 3.56±1.42. The clinical index Procedures involved in treatment regimen had the highest mean 4.18±0.21, followed by Pain management strategies with 3.92±0.27. In the association between knowledge and healing, the best scores were in patients with at least one healed VU. CONCLUSION: The knowledge of the patients was moderate and it was necessary to promote educational actions according to individual demands.

[Central vascular catheter infection in adult patients from a center of intensive therapy]. / Infecção de cateter vascular central em pacientes adultos de um centro de terapia intensiva.

This is a Retrospective Descriptive study that describes the profile of adult patients, down in an intensive therapy center of a University hospital in Porto Alegre, Rio Grande do Sul, Brazil, that presented infections of central vascular catheter in the year of 2007. There were 43 infections related to catheter with 37 Patients. Of these, 54% male age 58, 6 years old average. Hypothermia was the infectious sign, met in 33 of 37 patients. Infection in another site happened in 86,5% of the cases. The infection rate associated to the catheter was 3,6 per 1.000 catheters a day. The average time between insertion of the catheter and infection 11,8 days. Five patients presented sepsis associated to the catheter 24 received treatment to the infection associated to the catheter 21 died during internment, 12 for septicemia. The high happening of infection in another site and the high death rate show the need of searching efficient strategies to prevent these events.

[Changing in process that involves rest scales of nursing assistant]. / Mudança no processo que envolve escalas de folgas de auxiliares de enfermagem.

Describe the implantation of a new process of management of the nursing assistant rest scale of a hospitalization unit of a universitarian hospital. It is presented the reality before the proposal, when the rests were distributed along the week; the reasons that took to the proposition of the new method and the working of the new scale, with rests in weekends and holidays. Among the benefits already seen include: bigger number of professionals working during the days of bigger work flow; more time of leisure of the workers with their families; bigger personal integration and professional of the group; scales organized for a year, which allows the employee plan his vacation, rests and studies; and bigger satisfaction with the work, with the new scale being considered a professional conquest.

Elaboration and validation of a drug administration checklist for patients in research protocols. / Elaboração e validação de checklist para administração de medicamentos para pacientes em protocolos de pesquisa.

OBJECTIVE: To describe the elaboration and validation of a checklist as a strategy for safe drug administration. METHOD: It is a Validation study by consensus of experts conducted from January to June 2018, in a Clinical Research Center of a university hospital. The checklist was validated by three nurses, two nursing technicians, a pharmacist, two nurse teachers and one medical teacher, all with extensive experience in drug administration and in clinical research. For the final version of the checklist, a consensus of 100% was considered. RESULTS: A guide was prepared consisting of six items to be checked by the care team before, during and after administration of Clinical Research drugs. CONCLUSION: The validation of the checklist provided guiding elements for the prevention of behaviors that could lead to the risk of adverse events and also allowed the care teams to seek safe strategies of care in drug administration.