Use of tissue adhesive for neonatal intravenous access devices: A scoping review.

Neonates often require vascular access devices for medication or fluid therapy, but a third of devices fail before treatment completion or end with a complication. For adults and children, securing these devices with tissue adhesive (TA) increases the dwell and reduces complications. However, there is a lack of evidence for the neonatal population. This scoping review aimed to assess the evidence of TA for vascular access devices in neonates. The Arksey and O'Malley's (2005) framework was used. The inclusion criteria covered studies published from 2007 (when TA was first reported for use in vascular access devices) to June 2024, available in English, Portuguese, and Spanish, across six databases. Two independent reviewers assessed the studies using Covidence software, with a third reviewer resolving conflicts. Quality assessment was performed using the Mixed Methods Appraisal Tool. From 981 identified studies, 12 were included. Most studies (n = 5, 41.7%) enrolled between 100 and 500 neonates with vascular access devices. Publications originated from four regions and were observational studies (n = 6, 50%), quasi-experimental (n = 3, 25%), and case series (n = 2, 16.7%) with one randomized controlled trial (8.3%) focusing on umbilical venous catheters (UVC). The most common TA composition used was a combination of n-butyl- and 2-octyl- cyanoacrylate (n = 4, 33.3%). The amount of TA applied varied across studies, and often TA was part of a bundle (n = 7, 58.3%). Most studies applied TA to central venous access devices (n = 10, 83.3%) and 2 (16.7%) in peripheral devices. Although there was variation in device failure, the studies generally indicated a reduction in complications such as dislodgment (central catheter: 11.3% [peripherally inserted central catheter {PICC}] to 24.6% [UVC] in non-TA group vs 0.7% [PICC] to 7.7% [UVC] in TA group), device-associated bloodstream infections (central: 7.7% [UVC] and incidence of 2.76/1000 catheter days [PICC] in non-TA group vs 3.1% [UVC] and incidence of 0.99/1000 catheter day [PICC] in TA group), and phlebitis (13% in non-TA group vs 3% in TA-group), as well as increased dwell time in peripheral catheters. Most studies included both term and preterm neonates but did not differentiate between them in their analyses. Skin assessment, life of first dressing, and follow-up of catheters and patients were not reported in most studies. CONCLUSION: TA may reduce complications in vascular access devices, but the evidence in neonates is limited and varied. Many studies include TA as part of bundle, making it difficult to isolate its effects. Additionally, the current evidence lacks robustness due to the design limitations of the studies. Future research should focus on randomized controlled trials to evaluate TA's effectiveness and safety in preventing device failures and complications in neonates, considering different subgroups, to ensure the safety of TA in these nuanced populations. WHAT IS KNOWN: • Research in adults and pediatrics provides evidence supporting the use of tissue adhesive (TA) for vascular access devices, showing a positive impact in reducing failures and complications. • The use of TA in neonates needs to be carefully considered due to their unique characteristics. WHAT IS NEW: • There is a gap in the literature on the use of TA for securing vascular access devices in neonates, particularly regarding its safety and effectiveness in preventing failures and complications. • Further studies are needed to provide robust evidence verifying the effectiveness and safety of TA in this population.

Impact of the I-DECIDED Tool to Improve Peripheral Intravenous Catheter Care in Paediatrics: Interrupted Time-Series Study.

AIM: To determine whether the I-DECIDED assessment and decision tool enhances peripheral intravenous catheter assessment, care and decision-making in paediatrics. DESIGN: Quasi-experimental, interrupted time-series study. METHODS: An interrupted time-series study was conducted in a paediatric inpatient unit at a public teaching hospital in Brazil. The participants were patients aged less than 15 years old with a peripheral intravenous catheter, and their parents or guardians. Data were collected between January and July 2023, encompassing six time points, three pre-intervention and three post-intervention. Evaluation data were based on the I-DECIDED tool, including idle devices, dressings, complications, patient/family awareness, hand hygiene, disinfection and documentation. RESULTS: We conducted 585 peripheral intravenous catheter observations, with 289 in the pre-intervention phase and 296 in the post-intervention phase, inserted in 65 hospitalised children, 30 in the pre-intervention phase and 35 in the post-intervention phase. After the intervention, reductions were observed in the number of idle catheters, substandard dressings and complications. Patients and family members reported an increase in device assessment, hand hygiene and peripheral intravenous catheter disinfection. Additionally, there was an increase in documentation of decision-making performed by nurses and nursing technicians/assistants. CONCLUSION: Implementation of the I-DECIDED assessment and decision tool in a paediatric unit significantly improved the assessment, care and decision-making regarding peripheral intravenous catheters. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Opportunity to enhance practice standards, elevate the quality of care provided to paediatric patients, contribute to improved patient outcomes, advance evidence-based practice in vascular access management and enhance patient experience through increased involvement in care. IMPACT: To influence clinical practice and healthcare policies aimed at improving peripheral intravenous catheter care and patient safety in paediatric settings. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution to the design of this study.

PiccPed® app impact on nurses' knowledge to prevent adverse events for peripherally inserted central catheters (PICC) in pediatric and neonatal healthcare: A quasi-experimental study.

BACKGROUND: The PiccPed® health application was developed to support clinical decision-making in peripherally inserted central catheter (PICC) management. We aimed to evaluate its impact on nurses' knowledge regarding the prevention of PICC-associated adverse events in pediatrics and neonatology. METHODS: A quasi-experimental, pre-post intervention study, was conducted with a dependent/paired sample of pediatric and neonatal nurses from two tertiary hospitals in South Brazil. Data were collected from October 2022 to January 2023 across three phases: pre-, intervention (use of the PiccPed®) and post-test. Study outcomes were a knowledge test (15 questions) of evidence-based PICC maintenance procedures, and PiccPed® app time spent and screens used. RESULTS: A total of 56 nurses completed the study. The post-test mean score was significantly higher (12/15; standard deviation (SD) 1.9) in comparison with the pre-test (mean 9/15; SD 2.2). The change in scores was significantly higher for nurses without postgraduate qualifications, in comparison to those with (Mean Difference 1.26; p = 0.039). Each minute using the app resulted in a significant increase of 0.04 points (95% confidence interval 0.01-0.08; p = 0.014) on the mean post-test score (10.94 points). CONCLUSION: The research demonstrated that PiccPed® enhances nurses' learning regarding the prevention of adverse events associated with PICC maintenance in pediatrics and neonatology. APPLICATION TO PRACTICE: The app can be safely and effectively used for training and continuing education of nurses who care for children and neonates with PICCs.

Utilization of local pressure devices in pain management during injections: scoping review.

OBJECTIVE: to map scientific evidence regarding the use of local pressure devices in pain relief during injection procedures in patients. METHODS: scoping review, following the recommendations of the JBI Manual for Evidence Synthesis and PRISMA-ScR, with searches conducted in the PubMed, EMBASE, CINAHL, LILACS, and PsycINFO databases, without temporal restrictions and with a cutoff date of March 2023. RESULTS: a total of 1,514 studies were identified, with 20 articles included in the final sample. The ShotBlocker® device was utilized during subcutaneous and intramuscular injections in children and adults, proving beneficial in reducing pain, anxiety, and fear associated with the procedure. FINAL CONSIDERATIONS: the ShotBlocker® is a low-cost, easy-to-use device that can enhance nursing clinical practice during painful procedures. However, studies involving the Brazilian Pikluc® device are scarce. Further research involving both local pressure devices is recommended.

Adsorption and ion exchange of toxic metals by Brazilian clays: clay selection and studies of equilibrium, thermodynamics, and binary ion exchange modeling.

In this study, four Brazilian clays (Bofe, Verde-lodo, commercial Fluidgel, and expanded commercial vermiculite) were evaluated for their adsorptive capacity and removal percentage in relation to different toxic metals (Ni2+, Cd2+, Zn2+, and Cu2+). The best results were obtained by expanded vermiculite, with cadmium removal reaching values of 95%. The most promising clay was modified by the sodification process, and the metal cadmium was used to evaluate the ion exchange process. The clays expanded vermiculite (EV) and VNa-sodified vermiculite were evaluated by equilibrium study at 25, 35, and 45 °C. At 25 °C, EV obtained a maximum adsorption capacity of 0.368 mmol/g and sodified vermiculite 0.480 mmol/g, which represents an improvement of 30.4% in modified clay capacity. At 45 °C, the sodified vermiculite reached 0.970 mmol/g adsorption capacity. The Langmuir, Redlich-Peterson Freundlich, and Dubinin-Raduskevich models were adjusted to the results. Langmuir provided the best fit among the models. The thermodynamic quantities (ΔS, ΔH, and ΔG) demonstrated that the process is spontaneous and endothermic and the metal is captured by physisorption and chemisorption in the studied temperature range. For the ion exchange equilibrium, the binary Langmuir and binary Langmuir-Freundlich models were adjusted to the expanded vermiculite and sodified vermiculite isotherms, respectively. Both models were predictive. Thermal analysis indicated good heat resistance even after material modification. The apparent and real densities demonstrated that after each treatment or contamination, the clayey material undergoes contraction in its structure. An improved efficiency of the adsorbent was found after sodification.

Factors associated with the disinfection of devices attached to peripheral intravenous catheters performed by the nursing team in pediatric units.

Background: Peripheral intravenous catheterization, as well as drug administration through it, represents one of the most performed procedures by the Nursing team and, for that, precautions need to be adopted to offer harm-free care. Objective: To verify the association of Nursing professionals' work shift and training time with proper disinfection of intravenous catheter devices in pediatric units. Methods: A cross-sectional and analytical study conducted between June and August 2021 in three hospitalization units of a Pediatric Hospital. The inclusion criterion was drug administration via peripheral intravenous catheters performed by Nursing professionals. The data were analyzed according to inferential statistics, adopting p ≤ .05 as significance level. Results: There were a total of 385 observations of drug administration procedures. The device was not disinfected in 60.3% of the cases, there was no friction at the suitable time in 86.3%, and the disinfectant was not allowed to dry in 72.5%. The work shift exerted no influence on performance of the disinfection procedure (p = .376). However, longer training time was associated with a lower rate in performing such procedure (p < .001). Conclusion: Performing friction below the recommended time can cause a false sense of prevention of catheter-associated bloodstream infection; therefore, training sessions and strategies for adherence to the disinfection procedures should be considered, mainly for professionals with more training time.

Effects of the TIV-Disinfect educational intervention in pediatric units: a quasi-experimental study.

OBJECTIVE: To verify the effect of the educational intervention TIV-Disinfect (Intravenous Therapy-Disinfect) on the knowledge of nursing professionals in pediatric inpatient units. METHOD: Quasi-experimental study, with a dependent sample of 65 nursing professionals from pediatric inpatient units. A questionnaire with objective questions regarding the disinfection of venous devices was used, and pre- and post-tests were applied. Data collection was conducted in two public hospitals in southern Brazil, between April and July 2022. For data analysis, descriptive statistics and McNemar's test were used. RESULTS: There was a statistically significant difference between the pre- and post-tests regarding variables of passive disinfection, and recommended antiseptics and materials, rubbing and drying. A lower frequency of incorrect alternatives was noted after the intervention. CONCLUSION: The educational intervention had a positive effect. Better results were observed in the knowledge of nursing professionals regarding the disinfection of venous devices, as well as allowing the professionals to reinforce already consolidated knowledge. This intervention can be used as a tool for updating and/or continuing training of nursing professionals, aiming at the safety of pediatric patients and care practices.

Biosorption of europium and erbium from aqueous solutions using crosslinked sericin-alginate beads.

Critical metals such as rare earths are essential for important industrial applications and for producing high-tech materials. Currently, the development of alternative and non-conventional biomaterials has gained significant interest. This work investigated the use of crosslinked sericin-alginate-based natural polymeric particles for the removal of rare earths from water. Affinity tests showed that sericin-alginate/polyethylene glycol diglycidyl ether had the highest potential for capturing europium (0.258 mmol/g and 94.33%) and erbium (0.259 mmol/g and 94.55%). Next, erbium was selected based on the affinity with sericin-alginate/polyethylene glycol diglycidyl to investigate the effect of dose/pH, biosorption kinetics, isothermal equilibrium, desorption/reuse, and selectivity. The effect of dose and pH showed that 8.0 g/L (95.91%) and pH 5.0 (97.53%) were more efficient in capturing erbium. The biosorption kinetics showed that the equilibration time was reached within 210 min. The PSO and EMTR models effectively represented the kinetics data. The isothermal equilibrium revealed that the maximum uptake capacity for erbium was 0.641 mmol/g. The isothermal curves better fit the Dubinin-Radushkevich (55 °C) and Langmuir (25 and 40 °C) models. Thermodynamic quantitates indicated that erbium uptake was spontaneous, governed by entropic changes, and endothermic. The recovery of Er3+ was greater than 98% and the reuse of the eluent in the cycles enriched the Er3+ load 10-times (1.0 to 9.91 mmol/L). The beads also showed better performance for capturing Er3+ and Eu3+ with other coexisting ions. Characterization analyzes revealed the ion exchange mechanism between Ca2+/Er3+ prevailed in the Er3+ removal. Thus, the results pointed out that crosslinked sericin-alginate can be used as an alternative and promising biosorbent to remove and recover rare earths.

Ion exchange and adsorption of cadmium from aqueous media in sodium-modified expanded vermiculite.

The use of mineral clays as alternative adsorbent has received attention due to their physicochemical characteristics, superficial negative charge, abundance of vermiculite (especially in Brazil), low cost, and chemical composition, which allows the material modification to increase the adsorptive capacity. This manuscript evaluated the use of expanded vermiculite (EV) and sodium-modified vermiculite (VNa) in the adsorption and ion exchange of Cd2+ ions. The sodification was successfully carried out making the ion exchange capacity greater in the modified clay, confirmed by EDX, cation exchange capacity (CEC), DRX, and FTIR analysis. The CEC was 210 and 233 mEq/100 g for the EV and VNa, respectively, with 97.8% exchangeable ion (Na+) in the VNa. FTIR spectra showed small variations in the groups related to ion exchange and XRD analysis indicated changes in the distance of the layers with loss of crystallinity after clay modification, which was recovered after cadmium adsorption. The kinetics became faster with an equilibrium time of 10 min for VNa and 45 min for EV. Cd2+ removal by vermiculite above 99% was achieved. Pseudo-second order model best described the kinetics, in which the resistance to mass transfer in external film is the limiting step of the process and, once this resistance is overcome, the ion exchange happens quickly. Despite the decrease in surface area after sodification, the adsorptive capacity increased 158% in the sodified adsorbent, from 0.107 mmol/g for EV to 0.276 mmol/g for VNa, under the evaluated conditions.

I-decided®-brazil: cross-cultural adaptation of an assessment and decision-making tool for peripheral intravenous catheter / I-decided®-brasil: adaptación transcultural de una herramienta de evaluación y toma de decisiones para catéteres intravenosos periféricos / I-decided®-brasil: adaptação transcultural da ferramenta de avaliação e tomada de decisão para cateter intravenoso periférico

ABSTRACT Objective: to translate and adapt the I-DECIDED® Tool to Portuguese and Brazilian context. Method: this methodological research used Beaton's framework for the translation and cross-cultural adaptation process, which occurred in five stages: initial translation; synthesis of translations; back-translation; committee of experts; and pre-testing. It was carried out from July to December 2022. For data analysis, the Content Validity Index and Cronbach's alpha were used. Results: from a committee of experts, the adapted version of I-DECIDED® obtained satisfactory semantic, idiomatic, experiential and conceptual equivalence when compared to the original version, reaching a Content Validity Index of 0.94. In pre-testing, 60 nurses participated, and the reliability of the adapted tool was 0.83. Conclusion: the translation and cross-cultural adaptation process of I-DECIDED® was carried out and provides Brazilian professionals with an assessment and decision-making tool in relation to peripheral intravenous catheters aligned with patient safety.

RESUMEN Objetivo: traducir y adaptar la herramienta I-DECIDED® al idioma portugués y al contexto brasileño. Método: esta investigación metodológica utilizó el marco de Beaton para el proceso de traducción y adaptación transcultural, que ocurrió en cinco etapas: traducción inicial; síntesis de traducciones; traducción inversa; comité de expertos; y prueba previa. Se realizó de julio a diciembre de 2022. Para el análisis de los datos se utilizó el Índice de Validez de Contenido y el alfa de Cronbach. Resultados: con base en el comité de expertos, la versión adaptada de I-DECIDED® obtuvo equivalencia semántica, idiomática, experiencial y conceptual satisfactoria respecto al original, alcanzando un Índice de Validez de Contenido de 0,94. En el pretest participaron 60 enfermeros y la confiabilidad de la herramienta adaptada fue de 0,83. Conclusión: se realizó el proceso de traducción y adaptación transcultural de la I-DECIDED® que brinda a los profesionales brasileños una herramienta de evaluación y toma de decisiones en relación a los catéteres intravenosos periféricos alineados con la seguridad del paciente.

RESUMO Objetivo: traduzir e adaptar a Ferramenta I-DECIDED® para o idioma português e contexto brasileiro. Método: pesquisa metodológica que utilizou o referencial de Beaton para o processo de tradução e adaptação transcultural, que ocorreu em cinco etapas: tradução inicial, síntese das traduções, tradução reversa, comitê de especialistas e pré-teste. Realizado no período de julho a dezembro de 2022. Para análise de dados, foram utilizados o Índice de Validade de Conteúdo e Alpha de Cronbach. Resultados: a partir do Comitê de Especialistas, a versão adaptada da Ferramenta I-DECIDED® obteve satisfatória equivalência semântica, idiomática, experiencial e conceitual quando comparada à original, atingindo o Índice de Validade de Conteúdo de 0,94. No pré-teste, participaram 60 enfermeiros e a confiabilidade da Ferramenta adaptada foi de 0,83. Conclusão: o processo de tradução e adaptação transcultural da Ferramenta I-DECIDED® foi realizado e disponibiliza aos profissionais brasileiros uma ferramenta de avaliação e tomada de decisão em relação ao cateter intravenoso periférico alinhada à segurança do paciente.

Patient safety culture in intensive care units: perspective of health professionals. / Cultura de segurança em unidades de terapia intensiva: perspectiva dos profissionais de saúde.

OBJECTIVE: To identify the patient safety culture in intensive care units. METHOD: This qualitative, exploratory-descriptive study was conducted with five physicians, five nurses and 24 nursing technicians working in the intensive care units of two hospitals in the South of Brazil: one public and one philanthropic. Semi-structured interviews were held in September and October 2016 and analyzed using discursive textual analysis. RESULTS: Two categories emerged: Perception of error and Error management. CONCLUSION: The professionals acknowledge the existence of errors in health care and assign their occurrence to individual failures and failures accruing from the organizational system but support a non-punitive culture of safety and encourage collective learning.

Utilization of local pressure devices in pain management during injections: scoping review / Uso de dispositivos de presión local en el manejo del dolor durante las inyecciones: revisión de alcance / Utilização de dispositivos de pressão local no manejo da dor durante injeções: revisão de escopo

ABSTRACT Objective: to map scientific evidence regarding the use of local pressure devices in pain relief during injection procedures in patients. Methods: scoping review, following the recommendations of the JBI Manual for Evidence Synthesis and PRISMA-ScR, with searches conducted in the PubMed, EMBASE, CINAHL, LILACS, and PsycINFO databases, without temporal restrictions and with a cutoff date of March 2023. Results: a total of 1,514 studies were identified, with 20 articles included in the final sample. The ShotBlocker® device was utilized during subcutaneous and intramuscular injections in children and adults, proving beneficial in reducing pain, anxiety, and fear associated with the procedure. Final considerations: the ShotBlocker® is a low-cost, easy-to-use device that can enhance nursing clinical practice during painful procedures. However, studies involving the Brazilian Pikluc® device are scarce. Further research involving both local pressure devices is recommended.

RESUMEN Objetivo: mapear evidencia científica sobre el uso de dispositivos de presión local en el alivio del dolor durante la aplicación de inyecciones en pacientes. Métodos: revisión de alcance, siguiendo las recomendaciones del Manual JBI para Síntesis de Evidencia y PRISMA-ScR, con búsqueda en las bases de datos PubMed, EMBASE, CINAHL, LILACS y PsycINFO, sin restricciones temporales y con fecha límite hasta marzo de 2023. Resultados: se identificaron un total de 1,514 estudios, con 20 artículos incluidos en la muestra final. El dispositivo ShotBlocker® se utilizó durante las inyecciones subcutáneas e intramusculares en niños y adultos, demostrando ser beneficioso en la reducción del dolor, la ansiedad y el miedo asociados con el procedimiento. Consideraciones finales: el ShotBlocker® es un dispositivo de bajo costo y fácil manejo que puede mejorar la práctica clínica de enfermería durante procedimientos dolorosos. Sin embargo, los estudios sobre el dispositivo brasileño Pikluc® son escasos. Se recomienda realizar estudios con ambos dispositivos de presión local.

RESUMO Objetivo: mapear evidências científicas acerca da utilização de dispositivos de pressão local no alívio da dor durante a aplicação de injeções em pacientes. Métodos: revisão de escopo, conforme recomendações do JBI Manual for Evidence Synthesis e PRISMA-ScR, com busca nas bases PubMed, EMBASE, CINAHL, LILACS e PsycINFO, sem recorte temporal e data limite até março de 2023. Resultados: foram encontrados 1.514 estudos, sendo incluídos 20 artigos na amostra final. O dispositivo ShotBlocker® foi utilizado durante a aplicação de injeções subcutânea e intramuscular em crianças e adultos, sendo benéfico na redução da dor, da ansiedade e do medo associados ao procedimento. Considerações finais: o ShotBlocker® é um dispositivo de baixo custo e fácil manuseio a ser utilizado para aprimorar a prática clínica da Enfermagem durante a realização de procedimentos dolorosos. Contudo, estudos com o dispositivo brasileiro Pikluc® são escassos. Recomenda-se a realização de estudos com ambos os dispositivos de pressão local.

Aplicativos sobre terapia intravenosa e prevenção de infecção de corrente sanguínea associada ao cateter: prospecção tecnológica / Applications on intravenous therapy and catheter-associated bloodstream infection prevention: technology prospection / Aplicaciones en terapia intravenosa y prevención de infecciones del torrente sanguíneo asociadas a catéteres: prospección tecnológica

RESUMO Objetivo: identificar aplicativos móveis sobre terapia intravenosa e prevenção de infecção de corrente sanguínea associada ao cateter. Método: prospecção tecnológica, com busca dos dados nas Bases de Patentes e Lojas Virtuais, a coleta dos dados ocorreu de maio a agosto de 2021. Critérios de inclusão: aplicativos móveis voltados para a Terapia Intravenosa; aplicativos móveis voltados para a prevenção de infecção de corrente sanguínea, a análise foi realizada de forma qualitativa comparativa, reconhecendo as funções desenvolvidas pelos aplicativos e seus potenciais para utilização na prática clínica. Resultados: 19 aplicativos foram selecionados e organizados em temáticas: aplicativos para auxiliar no cateterismo; aplicativos para manutenção de cateter; aplicativos sobre prevenção de infecção de corrente sanguínea; e aplicativo sobre diagnóstico de infecção de corrente sanguínea associada ao cateter. Conclusão: a identificação de poucos aplicativos sobre a temática serve de fomento para construção de novos aplicativos.

ABSTRACT Objective: to identify mobile applications on intravenous therapy and prevention of catheter-associated bloodstream infection. Method: technological prospection, with data search in Patent Bases and Virtual Stores, data collection occurred from May to August 2021. Inclusion criteria: mobile applications focused on Intravenous Therapy; mobile applications focused on the prevention of bloodstream infection. The analysis was carried out in a qualitative comparative way, recognizing the functions developed by the applications and their potential for use in clinical practice. Results: 19 applications were selected and organized into themes: applications to assist in catheterization; applications for catheter maintenance; applications on bloodstream infection prevention; and applications on diagnosis of catheter-associated bloodstream infection. Conclusion: The identification of few apps on the theme serves to promote the construction of new apps.

RESUMEN Objetivo: identificar aplicaciones móviles sobre terapia intravenosa y prevención de la infección del torrente sanguíneo asociada a catéteres. Método: prospección tecnológica, con búsqueda de datos en Bases de Patentes y Almacenes Virtuales, la recolección de datos ocurrió de mayo a agosto de 2021. Criterios de inclusión: aplicaciones móviles centradas en la Terapia Intravenosa; aplicaciones móviles centradas en la prevención de la infección del torrente sanguíneo, el análisis se realizó de forma cualitativa comparativa, reconociendo las funciones desarrolladas por las aplicaciones y su potencial de uso en la práctica clínica. Resultados: Se seleccionaron 19 aplicaciones y se organizaron en temas: aplicaciones para ayudar en el cateterismo; aplicaciones para el mantenimiento del cateterismo; aplicaciones sobre la prevención de la infección de transmisión sanguínea; y aplicación sobre el diagnóstico de la infección de transmisión sanguínea asociada al cateterismo. Conclusión: la identificación de pocas aplicaciones sobre el tema sirve de estímulo para la construcción de nuevas aplicaciones.

Qualidade dos relatos de ensaios clínicos randomizados sobre realidade virtual durante punção/cateterismo intravenoso periférico / Quality of randomized clinical trial reports on virtual reality during peripheral intravenous catheterization/venipuncture / Calidad de los informes de ensayos clínicos aleatorizados sobre realidad virtual durante punción/cateterismo intravenoso periférico

Objetivo: avaliar a qualidade dos relatos de ensaios clínicos randômicos sobre realidade virtual durante a punção/cateterismo venoso periférico. Método: estudo avaliativo, realizado em duas etapas: revisão de escopo, no intuito de identificar ensaios clínicos randômicos sobre a temática, publicados nas bases de dados Cochrane, Cumulative Index to Nursing and Allied Health Literature, Embase, PubMed® e Literatura Latino-Americana e do Caribe em Ciências da Saúde; e avaliação da qualidade dos relatos dos ensaios clínicos randômicos, utilizandose do Consolidated Standards of Reporting Trials. Os dados foram analisados por meio de estatística descritiva e inferencial, sendo aplicado o Teste Kappa. Resultados: o total de estudos encontrados foram 291, sendo incluídos oito; destes, 75% apresentaram boa qualidade do relato, atendendo parcialmente os itens previamente definidos como necessários. Conclusão: os artigos apresentaram boa qualidade no relato, porém há necessidade de melhora na descrição dos itens.(AU)

Objective: to evaluate the quality of reports of randomized clinical trials on virtual reality during peripheral venous catheterization. Method: an evaluative study, conducted in two stages: scoping review, to identify randomized clinical trials on the subject, published in Cochrane, Cumulative Index to Nursing and Allied Health Literature, Embase, PubMed® and Latin American and Caribbean Health Sciences Literature databases; and quality assessment of the reports of randomized clinical trials, using the Consolidated Standards of Reporting Trials. Data were analyzed using descriptive and inferential statistics, and the Kappa Test was applied. Results: a total of 291 studies were found, eight of which were included. Of these, 75% showed good quality reporting, partially meeting the items previously defined as necessary. Conclusion: the articles presented good quality reports, but there is a need for improvement in the description of the items.(AU)

Objetivo: evaluar la calidad de los informes de ensayos clínicos aleatorizados sobre realidad virtual durante la punción/cateterismo venoso periférico. Método: estudio evaluativo, realizado en dos etapas: scoping review, con el fin de identificar ensayos clínicos aleatorizados sobre el tema, publicados en las bases de datos Cochrane, Cumulative Index to Nursing and Allied Health Literature, Embase, PubMed® y Literatura Latinoamericana y del Caribe en Ciencias de la Salud; y evaluación de la calidad de los informes de ensayos clínicos aleatorios, utilizando los Consolidated Standards of Reporting Trials. Los datos fueron analizados mediante estadística descriptiva e inferencial, utilizando la prueba de Kappa. Resultados: el total de estudios encontrados fue de 291, de los cuales se incluyeron ocho; de estos, el 75% presentó buena calidad del informe, cumpliendo parcialmente con los ítems previamente definidos como necesarios. Conclusión: los artículos presentaron buena calidad en el informe, pero hay necesidad de mejora en la descripción de los ítems.(AU)

Personal protective equipment in hospital nursing care: a scoping review / Equipo de protección personal en la atención hospitalaria de enfermería: revisión de alcance / Equipamentos de proteção individual na assistência hospitalar de enfermagem: revisão de escopo

ABSTRACT Objective: to analyze the scientific production on the use of Personal Protective Equipment by Nursing professionals during the care provided in the hospital environment. Method: this is a scoping review, based on the 2020 Joanna Briggs Institute Manual and guided by PRISMA-PCR. PUBMED, EMBASE, CINAHL, LILACS, BDENF, SCOPUS and WEB of SCIENCE were used as databases, choosing a search period corresponding to the last 20 years. Data collection took place from September to October 2021. The study protocol is available in the Open Science Framework: https://osf.io/7d8q9/files/. Studies on the use of Personal Protective Equipment in direct care provided by the Nursing team in hospitals were included; and those that addressed reviews, theses and dissertations in other settings were excluded, as well as studies not available in full. Results: the sample consisted of 26 documents. The items most cited and with the highest adherence in the studies were procedure gloves, while use of goggles was the least mentioned. The following stand out among the factors that facilitate PPE use by nurses: interpersonal relationships, knowledge, workload, standardization of guidelines, and participation of the care team in management decisions. Conclusion: the need to educate the professionals using behavioral knowledge as a strategy, as well as maintenance of communication in the sectors to avoid contamination, the influence of workload and the standardization of guidelines are necessary in the hospital health services to increase health professionals' engagement towards the biosafety practices.

RESUMEN Objetivo: analizar la producción científica sobre el uso del Equipo de Protección Personal en profesionales de Enfermería durante la atención provista en el ámbito hospitalario. Método: revisión de alcance basada en el Manual del Joanna Briggs Institute de 2020 y guiada por PRISMA-PCR. Se utilizaron las bases de datos PUBMED, EMBASE, CINAHL, LILACS, BDENF, SCOPUS y WEB of SCIENCE, eligiéndose los últimos 20 años como período de búsqueda. Los dados fueron recolectados de septiembre a octubre de 2021. El protocolo del estudio se encuentra disponible en Open Science Framework: https://osf.io/7d8q9/files/. Se incluyeron estudios sobre el uso del Equipo de Protección Personal en la atención directa provista por el equipo de Enfermería en hospitales y se excluyó a los que tenían como tema revisiones, tesis y disertaciones en otros ámbitos, al igual que estudios no disponibles en formato de texto completo. Resultados: la muestra estuvo compuesta por 26 documentos. Los elementos de protección más citados y con mayor adhesión en los estudios fueron los guantes de procedimiento, mientras que las gafas protectoras fueron las menos mencionadas. Entre los factores que facilitan el uso del PPE en los profesionales de Enfermería se destacan las relaciones interpersonales, el conocimiento, la carga de trabajo, la estandarización de las pautas y la participación del equipo asistencial en las decisiones gerenciales. Conclusión: la necesidad de educar a los profesionales empleando como estrategia el conocimiento conductual, mantener la comunicación entre los sectores para para evitar la contaminación, la influencia de la carga de trabajo, y la estandarización de las pautas son medidas necesarias en los servicios de salud hospitalaria para mejorar el nivel de compromiso de los profesionales de la salud con las prácticas de bioseguridad.

RESUMO Objetivo: analisar a produção científica sobre o uso de equipamento de proteção individual pelos profissionais da enfermagem durante a assistência no âmbito hospitalar. Método: trata-se de uma revisão de escopo, baseada no Manual Institute Joanna Briggs de 2020 e norteado pelo PRISMA-PCR. Utilizou-se como base de dados PUBMED, EMBASE, CINAHL, LILACS, BDENF, SCOPUS e WEB of SCIENCE, sendo o período de busca escolhido nos últimos 20 anos. A coleta de dados ocorreu de setembro a outubro de 2021. Protocolo de estudo disponível em Framework: https://osf.io/7d8q9/files/. Foram incluídos estudos sobre o uso dos Equipamentos de Proteção Individual na assistência direta da equipe de enfermagem nos hospitais e excluídos aqueles que abordassem em outros cenários, revisões, teses, dissertações e estudos não disponíveis na íntegra. Resultados: a amostra foi composta por 26 documentos. O equipamento mais citado e com maior adesão nos estudos foram as luvas de procedimento, enquanto que o uso dos óculos foi o menor. Dos fatores que facilitam o uso dos EPIs pelos enfermeiros destacam-se as relações interpessoais, conhecimento, carga de trabalho, padronização das diretrizes e participação da equipe assistencial nas decisões gerenciais. Conclusão: a necessidade de educação dos profissionais utilizando como estratégia o conhecimento comportamental, a manutenção da comunicação nos setores para evitar a contaminação, a influência da carga de trabalho, a padronização das diretrizes são necessárias nos serviços de saúde hospitalar para aumentar o engajamento dos profissionais de saúde às práticas de biossegurança.

Marcos de visibilidade da enfermagem na era contemporânea: uma reflexão à luz de Wanda / Hortamilestones of visibility of nursing in the contemporary era: a reflection in the light of Wanda / Hortahitos de visibilidad de la enfermería enla época contemporánea: una reflexión a la luz de Wanda horta

Objetivo: refletir acerca dos marcos da visibilidade da Enfermagem na era contemporânea à luz de Wanda Horta. Método: trata-se um estudo teórico-reflexivo, fundamentado na base teórica e dos pressupostos de Wanda Horta. Resultados: foram elencadas duas categorias centrais: Enfermagem na percepção de Wanda Horta e Enfermagem enquanto arte e ciência. Wanda Horta participou ativamente do processo de transformação da profissão Enfermagem no Brasil, corroborando para a uma assistência sistematizada através do desenvolvimento do Processo de Enfermagem, bem como na cientificidade da profissão por meio da elaboração de sua teoria voltada para as necessidades humanas básicas. Além disso, colaborou no processo de ensino-aprendizagem e de formação de novos enfermeiros, assim como na divulgação da Enfermagem enquanto arte e ciência. Considerações finais: Horta contribuiu para o avanço da Enfermagem na dimensão prática, científica e profissional, revolucionando a assistência de Enfermagem no Brasil.

Objective:to reflect on the milestones of nursing visibility in the contemporary era in the light of Wanda Horta. Method:this is a theoretical-reflexive study, based on the theoretical basis of Wanda Horta's assumptions. Results:two central categories were selected: Nursing in the perception of Wanda Horta and Nursing as art and science. Wanda Horta actively participated in the process of transformation of the nursing profession in Brazil, corroborating for systematized care through the development of the Nursing Process, as well as in the scientific of the profession through the elaboration of its theory focused on basic human needs. In addition, he collaborated in the teaching-learning process and training of new nurses, as well as in the dissemination of Nursing as art and science. Final considerations:Horta contributed to the advancement of Nursing in the practical, scientific and professional dimension, revolutionizing nursing care in Brazil.

Objetivo:reflexionar sobre los hitos de la visibilidad de la enfermería en la era contemporánea a la luz de Wanda Horta. Método: se trata de un estudio teórico-reflexivo, basado en la base teórica de los supuestos de Wanda Horta. Resultados: se seleccionaron dos categorías centrales: Enfermería en la percepción de Wanda Horta y Enfermería como arte y ciencia. Wanda Horta participó activamente en el proceso de transformación de la profesión de enfermería en Brasil, corroborando para la atención sistematizada a través del desarrollo del Proceso de Enfermería, así como en la cientificidad de la profesión a través de la elaboración de su teoría centrada en las necesidades humanas básicas. Además, colaboró en el proceso de enseñanza-aprendizaje y formación de nuevas enfermeras, así como en la difusión de la Enfermería como arte y ciencia. Consideraciones finales: Horta contribuyó al avance de la Enfermería en la dimensión práctica, científica y profesional, revolucionando el cuidado de enfermería en Brasil.

Compreensão de estudantes de enfermagem sobre as Redes de Atenção à Saúde / Nursing undergraduates' understanding of Health Care Networks / Comprensión de los estudiantes de enfermería sobre las Redes de Atención a la Salud

Objetivo: analisar a compreensão de estudantes de graduação em enfermagem sobre as Redes de Atenção à Saúde. Método: estudo descritivo e exploratório, qualitativo, realizado com 27 estudantes em Enfermagem de uma universidade federal do sul do Brasil, por meio de entrevistas semiestruturadas realizadas entre agosto e setembro de 2018. Resultados: foi evidenciado o conhecimento dos estudantes em relação ao conceito e objetivo das Redes de Atenção à Saúde, a identificação de fragilidades na comunicação e a falta de conhecimento do usuário como obstáculos na efetivação das mesmas, a dificuldade em ver a atuação do enfermeiro dentro dos variados serviços das redes e a percepção sobre a fragmentação do processo de formação. Conclusão: o estudo contribui para a discussão sobre a inclusão dos estudantes nas Redes de Atenção à Saúde, com intuito de superar as exigências educacionais que buscam favorecer a efetivação do Sistema Único de Saúde e das Redes de Atenção à Saúde.

Objective: to examine undergraduate nursing students' understanding of Health Care Networks (HCNs). Method: in this exploratory, qualitative descriptive study, semi-structured interviews were conducted with 27 Nursing students at a federal University in southern Brazil between August and September 2018. Results: the interviews revealed that the students' knowledge related to the HCNs' concept and purpose, beyond the communication weaknesses and users' lack knowledge as obstacles to effective HCNs, the difficulty in seeing nurses' roles in the various network services, and perceived fragmentation in the training process. Conclusion: the study contributed to discussion of inclusion of students in HCRs, with a view to meeting the educational requirements designed to favor implementation of the national health system (SUS) and the HCNs.

Objetivo: analizar la comprensión de los estudiantes de enfermería de pregrado sobre las redes de atención de la salud (HCN). Método: en este estudio exploratorio, cualitativo descriptivo, se realizaron entrevistas semiestructuradas a 27 estudiantes de Enfermería de una Universidad federal del sur de Brasil entre agosto y septiembre de 2018. Resultados: las entrevistas revelaron que los conocimientos de los estudiantes relacionados con el concepto y propósito, más allá de las debilidades de comunicación y la falta de conocimiento de los usuarios como obstáculos para una HCN eficaz, la dificultad para ver el rol de las enfermeras en los distintos servicios de la red y la fragmentación percibida en el proceso de formación. Conclusión: el estudio contribuyó a la discusión de la inclusión de los estudiantes en las HCR, con miras a cumplir con los requisitos educativos diseñados para favorecer la implementación del Sistema Nacional de Salud (SUS) y las HCN.

Tratamento de efluentes de lavanderia hospitalar por processo oxidativo avançado: UV/H2O2 / Wastewater treatment of hospital laundry by advanced oxidation process: UV/H 2 O 2

RESUMO O objetivo deste trabalho foi avaliar o tratamento de efluentes de lavanderia hospitalar por processo oxidativo avançado UV/H2O2. O planejamento fatorial 32 foi empregado de modo a avaliar a influência do pH e da dosagem de peróxido na eficiência do tratamento. Os experimentos de foto-oxidação foram realizados com efluentes coletados na lavanderia do Hospital Universitário Regional de Maringá (HUM). Resultados relativos à caracterização do efluente e às reduções de parâmetros físico-químicos: cor, turbidez, demanda biológica de oxigênio (DBO), surfactantes e a quantificação de coliformes totais e termotolerantes, também são apresentados neste trabalho. Foram testados três valores de pH - 5, 7 e 9 - e três dosagens de peróxido de hidrogênio nas razões de [DQO]:[H2O2] - 1:0,5, 1:2,5 e 1:5. Os melhores resultados foram alcançados com o tratamento realizado em pH 9 e razão [DQO]:[H2O2] de 1:2,5. As eficiências de remoção da demanda química de oxigênio (DQO) e de surfactantes foram, em média, de 60,3 e 98%, respectivamente, porém o tratamento não se mostrou eficiente na redução de cor e turbidez, demonstrando a necessidade de se acoplar tratamentos complementares para a redução de tais parâmetros.

ABSTRACT The objective of this work was to evaluate the treatment of hospital laundry effluents by advanced oxidation process UV/H2O2. Factorial design 32 was employed to investigate the influence of pH and peroxide dosage on treatment efficiency. The photo-oxidation experiments were performed with effluents collected in the laundry of the Regional University Hospital of Maringá (HUM). Physicochemical parameters of effluent color, turbidity, BOD, surfactants and quantification of total and thermotolerant coliforms are presented in this study. Three values ​​of pH - 5, 7 and 9 - and three dosages of hydrogen peroxide with [COD]:[H2O2] ratios of 1:0.5, 1:2.5 and 1:5 (w:w) were tested. The best results were achieved with the treatment performed at pH 9 and ratio [COD]:[H2O2] of 1:2.5. The average removal efficiencies of COD and surfactants were 60.3 and 98%, respectively. However, the treatment was not efficient in reducing color and turbidity, demonstrating the need to combine complementary treatments for the reduction of such parameters.

Estratégias para o fortalecimento da cultura de segurança em unidades de terapia intensiva / Strategies for strengthening safety culture in intensive care units / Estrategias para el fortalecimiento de la cultura de seguridad en unidades de cuidados intensivos

Objetivo: identificar estratégias de promoção que contribuam para o fortalecimento da cultura de segurança do paciente em unidades de terapia intensiva. Método: estudo qualitativo, descritivo, realizado com cinco médicos, cinco enfermeiros e 24 técnicos de enfermagem atuantes em unidades de terapia intensiva de duas instituições hospitalares do sul do Brasil em 2016. A coleta dos dados foi realizada por meio de entrevistas semiestruturadas e o tratamento, pela análise textual discursiva. A pesquisa foi aprovada por Comitê de Ética em Pesquisa. Resultados: emergiram três categorias: implementação de protocolos de segurança do paciente; envolvimento institucional e multiprofissional; e segurança do paciente na educação permanente. Conclusão: os profissionais de saúde consideram a implementação de protocolos na assistência à saúde, a inclusão da temática da segurança na educação permanente e o envolvimento da instituição, bem como da equipe multiprofissional, como as principais estratégias para promover e fortalecer a cultura de segurança do paciente.

Objective: identify promotion strategies that contribute to strengthening patient safety culture in intensive care units. Method: in this qualitative, descriptive study, data were collected in 2016 by semi-structured interviews of five physicians, five nurses and 24 nursing technicians working in intensive care units at two hospitals in southern Brazil, and analyzed using discursive textual analysis. The study was approved by the research ethics committee. Results: three categories emerged: implementation of patient safety protocols; institutional and multi-professional involvement and patient safety in continuing professional development. Conclusion: health personnel considered the implementation of health care protocols, the inclusion of safety as a topic in continued professional development and the involvement of both the institution and the multi-professional team to be the main strategies for promoting and strengthening patient safety culture.

Objetivo: identificar estrategias de promoción que contribuyan al fortalecimiento de la cultura de seguridad del paciente en unidades de cuidados intensivos. Método: estudio cualitativo, descriptivo, realizado junto a cinco médicos, cinco enfermeros y 24 técnicos de enfermería que trabajan en unidades de cuidados intensivos de dos instituciones hospitalarias del sur de Brasil, en 2016. La recolección de los datos se realizó por medio de entrevistas semiestructuradas y el tratamiento de los datos por el análisis textual discursivo. La investigación fue aprobada por Comité de Ética en Investigación. Resultados: surgieron tres categorías: implementación de protocolos de seguridad del paciente; participación institucional y multiprofesional y seguridad del paciente en la educación permanente. Conclusión: los profesionales de la salud consideran la implementación de protocolos en la asistencia a la salud, la inclusión de la temática de la seguridad en la educación permanente y la participación de la institución, así como del equipo multiprofesional, como las principales estrategias para promover y fortalecer la cultura de seguridad del paciente.

Cultura de segurança em unidades de terapia intensiva: perspectiva dos profissionais de saúde / Cultura de seguridad en unidades de terapia intensiva: perspectiva de los profesionales de salud / Patient safety culture in intensive care units: perspective of health professionals

Resumo OBJETIVO Conhecer a cultura de segurança do paciente em unidades de terapia intensiva. MÉTODO Estudo qualitativo, exploratório-descritivo, realizado com cinco médicos, cinco enfermeiros e 24 técnicos de enfermagem atuantes em unidades de terapia intensiva de duas instituições hospitalares do sul do Brasil, uma pública e uma filantrópica. Realizaram-se entrevistas semiestruturadas no período de setembro e outubro de 2016, analisadas por meio da análise textual discursiva. RESULTADOS Emergiram duas categorias: Percepção sobre o erro e Gestão do erro. CONCLUSÃO Evidenciou-se que os profissionais reconhecem a existência do erro na assistência à saúde e atribuem a sua ocorrência a falhas individuais e do sistema organizacional, além de estimularem uma cultura não punitiva e o aprendizado coletivo.

Resumen OBJETIVO Conocer la cultura de seguridad del paciente en unidades de terapia intensiva. MÉTODO Estudio cualitativo, exploratorio-descriptivo, realizado con cinco médicos, cinco enfermeros y 24 técnicos de enfermería actuantes en unidades de terapia intensiva de dos instituciones hospitalarias del sur de Brasil, una pública y una filantrópica. Se realizaron entrevistas semiestructuradas en el período de septiembre y octubre de 2016, analizadas por medio del análisis textual discursivo. RESULTADOS Surgieron dos categorías: Percepción sobre el error y Gestión del error. CONCLUSIÓN Se evidenció que los profesionales reconocen la existencia del error en la asistencia a la salud y atribuyen su ocurrencia a fallas individuales y del sistema organizacional, además de estimular una cultura no punitiva y el aprendizaje colectivo.

Abstract OBJECTIVE To identify the patient safety culture in intensive care units. METHOD This qualitative, exploratory-descriptive study was conducted with five physicians, five nurses and 24 nursing technicians working in the intensive care units of two hospitals in the South of Brazil: one public and one philanthropic. Semi-structured interviews were held in September and October 2016 and analyzed using discursive textual analysis. RESULTS Two categories emerged: Perception of error and Error management. CONCLUSION The professionals acknowledge the existence of errors in health care and assign their occurrence to individual failures and failures accruing from the organizational system but support a non-punitive culture of safety and encourage collective learning.