RESUMEN
Introduction: This study assessed the knowledge and satisfaction of a nursing staff regarding peripherally inserted central catheter (PICC) care before and after a combined training strategy consisting of a video and hands-on practice.Methods: A cross-sectional and prospective study with data collection held at a public university hospital from March 2018 to May 2018 and in March 2019. Participants answered a pre-test about PICC lines, watched a video on PICC care and maintenance, attended hands-on sessions, and answered a post-test.Results: A total of 520 professionals participated in the study, of which 87.4% were from the nursing staff. The pre-test was answered by 211 individuals and the post-test questions were answered by 203 people. The satisfaction research showed 97% of satisfied respondents.Conclusions: Our results indicate that a change from the traditional training model to an active educational approach reached more participants, representing an innovative pedagogical tool in the training of critical and reflexive professionals.
Asunto(s)
Recursos Audiovisuales , Enseñanza/educación , Cateterismo Periférico/enfermería , Atención de Enfermería/métodos , Capacitación de Recursos Humanos en Salud , Dispositivos de Acceso VascularRESUMEN
OBJECTIVE: To construct and implement an instrument (checklist) to improve safety when performing the prone maneuver. METHODS: This was an applied, qualitative and descriptive study. The instrument was developed based on a broad review of the literature pertaining to the construction of a care protocol using the main electronic databases (MEDLINE, LILACS and Cochrane). RESULTS: We describe the construction of a patient safety tool with numerous modifications and adaptations based on the observations of the multidisciplinary team regarding its use in daily practice. CONCLUSION: The use of the checklist when performing the prone maneuver increased the safety and reliability of the procedure. The team's understanding of the tool's importance to patient safety and training in its use are necessary for its success.
OBJETIVO: Construir e implementar um instrumento (checklist) para melhoria do cuidado na manobra prona. MÉTODOS: Estudo aplicativo, qualitativo e descritivo. O instrumento foi desenvolvido a partir de ampla revisão da literatura, para construção de um protocolo de atendimento assistencial, utilizando as principais bases eletrônicas (MEDLINE, LILACS e Cochrane). RESULTADOS: Descrevemos a construção de uma ferramenta de segurança do paciente com suas inúmeras modificações e adaptações, a partir das observações da equipe multidisciplinar com seu uso na prática diária. CONCLUSÃO: A aplicação do checklist na manobra de prona acrescentou confiabilidade e segurança ao procedimento. O entendimento da importância da ferramenta na segurança do paciente, por parte da equipe, e sua capacitação são necessários para seu sucesso.
Asunto(s)
Lista de Verificación , Posicionamiento del Paciente/métodos , Posición Prona , Síndrome de Dificultad Respiratoria/terapia , Humanos , Grupo de Atención al Paciente/organización & administración , Posicionamiento del Paciente/efectos adversos , Reproducibilidad de los ResultadosRESUMEN
Last year, interest in prone positioning to treat acute respiratory distress syndrome (ARDS) resurfaced with the demonstration of a reduction in mortality by a large randomized clinical trial. Reports in the literature suggest that the incidence of adverse events is significantly reduced with a team trained and experienced in the process. The objective of this review is to revisit the current evidence in the literature, discuss and propose the construction of a protocol of care for these patients. A search was performed on the main electronic databases: Medline, Lilacs and Cochrane Library. Prone positioning is increasingly used in daily practice, with properly trained staff and a well established care protocol are essencial.
Asunto(s)
Posicionamiento del Paciente/métodos , Posición Prona , Síndrome de Dificultad Respiratoria/terapia , Adulto , Protocolos Clínicos/normas , Cuidados Críticos/métodos , Humanos , Grupo de Atención al Paciente , Posicionamiento del Paciente/efectos adversos , Reproducibilidad de los Resultados , Factores de Tiempo , Resultado del TratamientoRESUMEN
INTRODUCTION: This study evaluated the development of periapical lesions in a rat model of type 2 diabetes and assessed the potential actions of the antioxidant agent tempol in this model. METHODS: Male Wistar rats were used; they received tap water (N = 5) or a 20% glucose solution (N = 15) during a period of 9 weeks. At the sixth week, periapical lesions were induced on the first mandibular molars, and the animals were subdivided into 4 groups. The subgroup 1 was composed of nondiabetic rats orally receiving saline solution (10 mL/kg). Chronically glucose-fed rats were divided into the following subgroups: (2) saline-treated animals (10 mL/kg by oral route), and animals treated with tempol by gavage at doses of (3) 50 mg/kg or (4) 100 mg/kg. The body weight was monitored thoroughly. After 21 days of apical periodontitis induction, the animals were killed, and the mandibles were collected and submitted to radiographic and histologic analysis. The livers were collected to determine free radicals, and the blood plasma was used to measure insulin levels. RESULTS: Type 2 diabetic rats displayed a significant decrease of body weight gain and a slight increase of insulin levels, which were allied to reduced levels of the antioxidant components catalase and reduced glutathione; these alterations were reversed by tempol. Concerning the periapical lesions, neither radiographic nor histologic analysis revealed any significant difference between control and type 2 diabetic rats. In diabetic rats, the apical periodontitis was refractory to tempol treatment. CONCLUSIONS: The extent and cellularity of periapical lesions in glucose-fed type 2 diabetic rats were similar to those seen in control rats. Despite affecting other parameters related to diabetes, tempol failed to improve the outcome of endodontic lesions in type 2 diabetic animals.
Asunto(s)
Antioxidantes/uso terapéutico , Diabetes Mellitus Experimental/tratamiento farmacológico , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Periodontitis Periapical/fisiopatología , Animales , Antioxidantes/administración & dosificación , Peso Corporal , Catalasa/análisis , Catalasa/efectos de los fármacos , Óxidos N-Cíclicos/administración & dosificación , Óxidos N-Cíclicos/uso terapéutico , Modelos Animales de Enfermedad , Radicales Libres/análisis , Glutatión/análisis , Glutatión/efectos de los fármacos , Insulina/sangre , Resistencia a la Insulina/fisiología , Hígado/metabolismo , Masculino , Mandíbula/diagnóstico por imagen , Mandíbula/patología , Diente Molar/diagnóstico por imagen , Diente Molar/patología , Estrés Oxidativo/fisiología , Periodontitis Periapical/diagnóstico por imagen , Periodontitis Periapical/patología , Radiografía , Ratas , Ratas Wistar , Marcadores de Spin , Resultado del TratamientoRESUMEN
RESUMO Objetivo: Construir e implementar um instrumento (checklist) para melhoria do cuidado na manobra prona. Métodos: Estudo aplicativo, qualitativo e descritivo. O instrumento foi desenvolvido a partir de ampla revisão da literatura, para construção de um protocolo de atendimento assistencial, utilizando as principais bases eletrônicas (MEDLINE, LILACS e Cochrane). Resultados: Descrevemos a construção de uma ferramenta de segurança do paciente com suas inúmeras modificações e adaptações, a partir das observações da equipe multidisciplinar com seu uso na prática diária. Conclusão: A aplicação do checklist na manobra de prona acrescentou confiabilidade e segurança ao procedimento. O entendimento da importância da ferramenta na segurança do paciente, por parte da equipe, e sua capacitação são necessários para seu sucesso.
ABSTRACT Objective: To construct and implement an instrument (checklist) to improve safety when performing the prone maneuver. Methods: This was an applied, qualitative and descriptive study. The instrument was developed based on a broad review of the literature pertaining to the construction of a care protocol using the main electronic databases (MEDLINE, LILACS and Cochrane). Results: We describe the construction of a patient safety tool with numerous modifications and adaptations based on the observations of the multidisciplinary team regarding its use in daily practice. Conclusion: The use of the checklist when performing the prone maneuver increased the safety and reliability of the procedure. The team's understanding of the tool's importance to patient safety and training in its use are necessary for its success.
Asunto(s)
Humanos , Síndrome de Dificultad Respiratoria/terapia , Posición Prona , Posicionamiento del Paciente/métodos , Lista de Verificación , Grupo de Atención al Paciente/organización & administración , Reproducibilidad de los Resultados , Posicionamiento del Paciente/efectos adversosRESUMEN
SUMMARY Last year, interest in prone positioning to treat acute respiratory distress syndrome (ARDS) resurfaced with the demonstration of a reduction in mortality by a large randomized clinical trial. Reports in the literature suggest that the incidence of adverse events is significantly reduced with a team trained and experienced in the process. The objective of this review is to revisit the current evidence in the literature, discuss and propose the construction of a protocol of care for these patients. A search was performed on the main electronic databases: Medline, Lilacs and Cochrane Library. Prone positioning is increasingly used in daily practice, with properly trained staff and a well established care protocol are essencial.
RESUMO No último ano, o interesse pela posição prona no tratamento da síndrome da angústia respiratória aguda (Sara) ressurgiu com a demonstração da redução da mortalidade por um grande estudo clínico randomizado. Os relatos, na literatura, sugerem que a incidência de eventos adversos é significativamente reduzida com uma equipe treinada e experiente no processo. O objetivo desta revisão é revisitar as evidências atuais, discutir e propor a construção de um protocolo de cuidados para esses pacientes. Foi realizada busca nas principais bases eletrônicas: Medline, Lilacs e Cochrane Library. A posição prona é cada vez mais utilizada na prática diária, sendo imprescindível a presença de uma equipe adequadamente treinada e um protocolo de cuidados bem estabelecido.