Evaluation of Acute Pain in Patients Undergoing Total Hip Arthroplasty: A Cohort Study.

PURPOSE: To evaluate pain levels in patients who underwent total hip arthroplasty (THA) using the Nursing Outcomes Classification (NOC). METHODS: Prospective cohort study conducted in the surgical hospitalization units of a university hospital in southern Brazil. Twenty-four patients were evaluated and followed-up for four consecutive days after THA. FINDINGS: A significant difference was found between the first and last evaluations for the outcome pain level (2102). Two indicators also showed statistically significant differences overtime. CONCLUSIONS: The NOC outcome and indicators demonstrated the different pain levels of patients who underwent THA. IMPLICATIONS FOR NURSING PRACTICE: The NOC system is applicable to clinical practice, because it facilitated the follow-up of patient progression.

Clinical indicators to monitor patients with risk for ineffective cerebral tissue perfusion.

OBJECTIVE: Select and validate the clinical indicators to monitor patients on risk for ineffective cerebral tissue perfusion, according to the Nursing Outcomes Classification (NOC). METHODOLOGY: Validation study carried out between November 2012 and August 2013, in a Brazilian hospital. Seventeen judges nurses evaluated the clinical indicators of Nursing Outcomes, according to NOC for patients on risk for ineffective cerebral tissue perfusion. In the first stage, were selected the nursing results for the assessment of the studied diagnosis and, in the second nurses assessment the importance of the indicators of the validated results in the previous step through a five points Likert scale (1 = not important to 5 = extremely important). Were used the content validity index (CVI) that corresponds to the calculation of weighted averages of them marks awarded for each indicator, as it considered the following weights: 1=0.00, 2=0.25, 3=0.50; 4=0.75; 5=1.00. For categorization, the CVI considered as critical = ≥0.80; supplementary =≥0.50 to 0.79 and were disposed results <0.50. RESULTS: Of the 9 nursing results, only the cerebral tissue perfusion obtained a 100% consensus. The CVI of the 18 indicators of this result showed that five were validated as critical (impaired neurological reflexes, systolic blood pressure, diastolic blood pressure, reduced level of consciousness and mean arterial pressure), 12 were validated as supplementary (Agitation, Impaired cognition, Intracranial pressure, Syncope, Vomiting, Findings of cerebral angiography, Headache, Restlessness, Fever, Unexplained anxiety, listlessness and Hiccughs) and one was disposed (carotid bruit). CONCLUSIONS: The validation of information about the conditions of risk may allow early intervention to minimize the consequences of ineffective cerebral tissue perfusion.