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1.
Nurs Crit Care ; 29(2): 397-406, 2024 03.
Artigo em Inglês | MEDLINE | ID: mdl-37690783

RESUMO

BACKGROUND: Intensive care environments already required complex work, and, furthermore, the recent COVID-19 pandemic increased health care demands, disorganized work teams and limited resources. Nonetheless, the real workload of nursing workers in the care for critical patients during this period was seldom investigated. AIM: To compare the workload of nursing workers, estimated using the Nursing Activities Score (NAS), in patients with and without COVID-19 who had been hospitalized in an adult intensive care unit (ICU). STUDY DESIGN: This study was developed in the ICU of a public university hospital in the south of Brazil. The workload of nursing workers was estimated using the NAS, which was developed through a retrospective cohort using reports of the assistance registered in electronic records, including the first 10 days of hospitalization of all patients admitted into the ICU in 2020 and 2021, who had at least one NAS evaluation; then, the workload was compared between patients with and without COVID-19. Generalized estimating equations models were used. The project was approved by the research ethics committee of the institution where the study took place. RESULTS: The follow-up of 3485 patients resulted in 20 506 days of observation during the first 10 days of ICU hospitalization. The mean NAS score for the entire patient/day sample was 85.6 ± 18.1%, with 87.8 ± 17.8% in the COVID-19 group and 82.6 ± 18.2% in the non-COVID-19 group (p < .001). The use of mechanical ventilation, noradrenaline, sedation and neuromuscular blocking drugs, extracorporeal membrane oxygenation and haemodialysis increased the value of NAS for patients with or without COVID-19. CONCLUSIONS: The workload of nursing professionals was higher for COVID-19 patients than for patients who did not present the disease in the first 10 days of ICU hospitalization. RELEVANCE TO CLINICAL PRACTICE: This study presents the impact of COVID-19 on the ICU nursing workload in Brazil. The high workload found can support management decisions regarding quantity and quality of workforce composition.


Assuntos
COVID-19 , Recursos Humanos de Enfermagem Hospitalar , Adulto , Humanos , Carga de Trabalho , Estudos Retrospectivos , COVID-19/terapia , Estado Terminal , Pandemias , Unidades de Terapia Intensiva
2.
Rev Gaucha Enferm ; 37(4): e64753, 2017 Feb 23.
Artigo em Português, Inglês | MEDLINE | ID: mdl-28273254

RESUMO

OBJECTIVE: To assess the time before and time spent on risk classification, priority of care, and destination of patients within 24 hours after their admission to an emergency medical service. METHODS: Retrospective cohort study that included adults classified by the Manchester Triage System at the largest emergency medical service in the south of the country in 2012. The data were made available in the form of an electronic sheet and analyzed according to their characteristics and distribution. RESULTS: Of the 139,556 admissions, half of the patients arrived at classification within the time recommended (7; IQR: 2-20 minutes), and were classified within two (IQR: 1-3) minutes. Lower priority classifications and hospital discharges (88.4%) were more frequent than hospitalizations (11.4%) and deaths (0.2%). CONCLUSION: The time involved in activities that precede the first medical care remained within the recommendation. The proportion of lower priority classifications and hospital discharges within 24 hours after classification was high.


Assuntos
Serviços Médicos de Emergência , Medição de Risco/métodos , Triagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo , Adulto Jovem
3.
Rev Gaucha Enferm ; 36(4): 98-103, 2015 Dec.
Artigo em Português | MEDLINE | ID: mdl-26735765

RESUMO

OBJECTIVE: to evaluate the correlation between the auscultation test and X-ray when detecting the position of an enteral feeding tube. METHODS: cross-sectional study in an intensive care unit in southern Brazil, in 2011. Clinical nurse and nurse researcher performed auscultation test recording the impressions regarding the placement of an enteral feeding tube in 80 patients. A doctor evaluated the X-ray. Kappa coefficient and PABAK reviewed the agreements. RESULTS: The X-ray showed that 70% of the enteral tubes were in the stomach, 27.4% in the duodenum, 1.3% in the esophagus, and 1.3% in the right lung. There was a weak correlation between clinical nurses and nurse researchers (PABAK=0.054; P=0.103), clinical nurses and X-rays (PABAK=0.188; P=0.111) and nurse researchers and X-rays (PABAK=0.128; P=0.107) . The auscultation test did not detect two risk conditions, enteral feeding tube in the esophagus and the bronchus. CONCLUSION: the auscultation test showed little agreement with the X-ray on the enteral feeding tube location.


Assuntos
Nutrição Enteral , Intubação Gastrointestinal/métodos , Auscultação , Estudos Transversais , Feminino , Trato Gastrointestinal/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia
4.
Rev Gaucha Enferm ; 34(4): 21-7, 2013 Dec.
Artigo em Português | MEDLINE | ID: mdl-25080696

RESUMO

The aim of this retrospective cohort study was to investigate clinical outcomes of the first year of life of premature infants discharged from the Neonatal Intensive Care Unit (NICU) based on mortality and readmission data, and the motor development of the children. The sample consisted of 170 children with gestational age under 37 weeks and who survived hospitalization in neonatal intensive care unit (NICU). Data were collected from medical records, the hospital IT system and telephone interview with the caregiver. The authors found 100% survival during the study period and that 39.4% of the infants were often readmitted (26.5%) due to respiratory conditions. Their development was considered as expected, when using the corrected age. In conclusion, the premature infants from this study showed good clinical evolution of the proposed observation.


Assuntos
Doenças do Prematuro , Recém-Nascido Prematuro , Estudos de Coortes , Feminino , Humanos , Lactente , Recém-Nascido , Doenças do Prematuro/epidemiologia , Masculino , Estudos Retrospectivos
5.
Rev Gaucha Enferm ; 34(3): 22-30, 2013 Sep.
Artigo em Português | MEDLINE | ID: mdl-24344581

RESUMO

The study aimed to evaluate the adequacy of low-risk prenatal care, as recommended by the Ministry of Health, concerning the minimum number of consultations, and identify possible associated factors. Prenatal care was evaluated in a historical cohort study of 95 pregnant women. Over 50% of the women underwent six or more prenatal consultations. The beginning of the prenatal care began in the first trimester of the gestation for 52% of the women, 84.2% of the women did all their prenatal medical tests, and only 16.8% had postpartum consultations. Prenatal assistance was considered adequate for 2.1% of the sample. A higher number of prenatal consultation was observed among women who had a partner and who had other children. The records reveal a low adequacy level with all minimum criteria established and few factors seem to explain this scenario.


Assuntos
Saúde da Família , Pacientes Desistentes do Tratamento , Cuidado Pré-Natal , Adolescente , Adulto , Agendamento de Consultas , Brasil , Estudos de Coortes , Testes Diagnósticos de Rotina/estatística & dados numéricos , Cuidado Periódico , Feminino , Humanos , Estado Civil , Ocupações , Visita a Consultório Médico/estatística & dados numéricos , Pacientes Desistentes do Tratamento/estatística & dados numéricos , Cuidado Pós-Natal/organização & administração , Cuidado Pós-Natal/estatística & dados numéricos , Gravidez , Cuidado Pré-Natal/organização & administração , Cuidado Pré-Natal/estatística & dados numéricos , Fatores Socioeconômicos , Adulto Jovem
6.
Rev Gaucha Enferm ; 34(2): 21-8, 2013 Jun.
Artigo em Português | MEDLINE | ID: mdl-24015458

RESUMO

Pressure ulcers (PU) may increase the incidence of hospital complications, and one should prevent this damage. The Braden Scale stands out as a tool to assess the risk of PU. The study aimed to identify changes in the score of the Braden subscales are associated with the risk of developing PCU. Logistic regression was used in a retrospective cohort study conducted in Hospital de Clínicas de Porto Alegre in adults hospitalized in surgical clinical units from October 2005 to June 2006. We evaluated the records database of 1503 patients with a mean aged 55.5 +/- 16 years, 52.7% female. The incidence of PU was 1.8% and was associated with diabetes and heart failure. There was a higher PU in patients worst in sensory perception, mobility, and activity and the presence of moisture. No association was found between nutrition and PU. Except nutrition, the other Braden sub-scales shown to be predictive of PU.


Assuntos
Úlcera por Pressão/epidemiologia , Índice de Gravidade de Doença , Idoso , Comorbidade , Demência/epidemiologia , Complicações do Diabetes/epidemiologia , Suscetibilidade a Doenças , Feminino , Insuficiência Cardíaca/epidemiologia , Humanos , Umidade , Falência Renal Crônica/epidemiologia , Masculino , Pessoa de Meia-Idade , Limitação da Mobilidade , Atividade Motora , Neoplasias/epidemiologia , Estado Nutricional , Valor Preditivo dos Testes , Úlcera por Pressão/etiologia , Úlcera por Pressão/enfermagem , Fatores de Risco , Transtornos de Sensação/epidemiologia
7.
Rev Gaucha Enferm ; 44: e20210343, 2023.
Artigo em Inglês, Português | MEDLINE | ID: mdl-37222386

RESUMO

OBJECTIVE: To determine incidence and time until first traction or obstruction of nasoenteral tube in hospitalized adults. METHODS: Prospective double cohort study that included 494 adults who were users of nasoenteral tubes as inpatients in two clinical units and two surgical units in a teaching hospital. The occurrence of tube tractions and obstructions was monitored daily between 2017 and 2019. The Kaplan-Meier method was used to estimate time until the first event. RESULTS: Tube traction occurred in 33% of the sample, and the incidence of the event was higher on the first five days of tube use. Tube obstruction incidence was 3.4% and grew as tube use time increased. CONCLUSION: Traction incidence was higher at the beginning of the period of use, whereas obstruction incidence grew as tube use time increased.


Assuntos
Hospitais de Ensino , Tração , Humanos , Adulto , Estudos de Coortes , Incidência , Estudos Prospectivos
8.
Rev Gaucha Enferm ; 43(spe): e20220211, 2022.
Artigo em Inglês, Português | MEDLINE | ID: mdl-36449840

RESUMO

OBJECTIVE: To evaluate the agreement between nurse and physician in verifying the positioning of the nasogastric tube by ultrasonography and describe the difficulties faced by nurse in performing the technique. METHOD: Cross-sectional study conducted in 2021, including critical patients after nasogastric tube insertion who were independently evaluated by a nurse and physician, using bedside ultrasonography. The tube was considered adequately positioned when viewed in infradiaphragmatic location in the topography of the stomach. RESULTS: In the 30 peer evaluations there was almost perfect agreement (k = 0.93; 95%CI: 0.65 - 0.99). In only one case the nurse was uncertain about the positioning. Some difficulties were reported: abdominal distention (n=2), gas interposition (n=3) and patient movement during the exam (n=2). CONCLUSION: A trained nurse obtained very similar results to those found by a physician in identifying the nasogastric tube placement by means of ultrasonography, suggesting a reproducible and safe technique.


Assuntos
Médicos , Humanos , Estudos Transversais , Ultrassonografia , Incerteza
9.
Rev Gaucha Enferm ; 42: e20200014, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33886922

RESUMO

OBJECTIVE: To describe the frequency of urinary complaints, bladder globe, and need for bladder relief catheterization according to ultrasound; to investigate the relationship between the urinary volume estimated by ultrasound and the one drained in catheterization; and to describe the relationship of patient's complaints and detection of bladder globe with the diagnosis of urinary retention. METHOD: A cross-sectional study with clinical patients with suspected urinary retention in a tertiary hospital, conducted from February to September 2018. Urinary volume ≥500 mL in ultrasound was considered urinary retention. RESULTS: Two hundred and five evaluations were performed in 44 patients. Urinary retention was detected by ultrasound in 33.2% of the evaluations. There was a strong correlation between ultrasound and bladder catheterization. There was a higher frequency of identification of bladder globe in urinary volumes ≥300 mL. CONCLUSION: The incidence of urinary retention was higher when ultrasound was used for the diagnosis, when compared to patient's complaint and physical examination. Ultrasound showed to be accurate in establishing urinary volume.


Assuntos
Retenção Urinária , Estudos Transversais , Humanos , Incidência , Exame Físico , Complicações Pós-Operatórias , Bexiga Urinária/diagnóstico por imagem , Cateterismo Urinário , Retenção Urinária/diagnóstico por imagem , Retenção Urinária/epidemiologia , Retenção Urinária/etiologia
10.
Rev Gaucha Enferm ; 42: e20200001, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34287594

RESUMO

AIM: To assess the incidence and factors associated with pressure wounds in patients of a Brazilian clinical and surgical Intensive Care Center (composed of three Intensive Care Units). METHOD: Cohort monitored for clinical and therapeutic variables in an Intensive Care Center. Cox's Multiple Regression was employed, establishing the number of days until the first pressure injury as a time variable; the omnibus test was also performed. RESULTS: 178 patients, 64 (36%) developed at least one pressure wound. The independent variables for the risk of pressure wounds were: Braden <13 (HR: 10.6; 95% CI: 2.5-43.7), history of previous stroke (HR: 2.6; 95% CI: 1.3-5.0), age> 60 years (HR: 2.0; 95% CI: 1.2-3.5), nothing by mouth time (HR: 1.06; 95% CI 1.02 -1.10) and physical therapy days (HR: 0.81; 95% CI: 0.73-0.91). CONCLUSION: Pressure wounds were incident. Braden <13 points, history of previous strokes, being elderly, and time in nothing by mouth were shown to be independent risk factors for pressure wounds. The days of exposure to physical therapy were protective. These findings corroborate recommendations to monitor the frequency of pressure wounds and to establish protective measures based on local indicators.


Assuntos
Cuidados Críticos , Unidades de Terapia Intensiva , Idoso , Estudos de Coortes , Humanos , Incidência , Pessoa de Meia-Idade , Fatores de Risco
11.
Rev Bras Enferm ; 73(5): e20190209, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32638932

RESUMO

OBJECTIVES: to identify the patient safety challenges described by health professionals in Primary Health Care. METHODS: a scoping review was conducted on the LILACS, MEDLINE, IBECS, BDENF, and CINAHL databases, and on the Cochrane, SciELO, Pubmed, and Web of Science libraries in January 2019. Original articles on patient safety in the context of Primary Health Care by health professionals were included. RESULTS: the review included 26 studies published between 2002 and 2019. Four categories resulted from the analysis: challenges of health professionals, administration challenges of health services, challenges with the patient and family, and the potential enhancing resources for patient safety. CONCLUSIONS: patient safety challenges for Primary Care professionals are multiple and complex. This study provides insight into resources to improve patient safety for health care professionals, patients, administrators, policy makers, educators, and researchers.


Assuntos
Segurança do Paciente/normas , Atenção Primária à Saúde/normas , Humanos , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/tendências , Gestão da Segurança
12.
Rev Gaucha Enferm ; 41(spe): e20190167, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32401856

RESUMO

OBJECTIVE: To describe the incidence and to report the cases of falls in a cohort of critical adults. METHOD: A prospective cohort study, conducted in 2018 at an adult Intensive Care Unit (ICU) in the south of Brazil. The patients were followed up from admission to discharge; observations were made in the morning and afternoon. The clinical and care variables were evaluated. The descriptive analysis was performed followed by the reporting of the cases. RESULTS: 551 patients were monitored during 6 [3-12.7] days of hospitalization, generating 7,839 observations. There were four cases of falls, with an incidence rate of 5.1/10.000 observations/day - confidence interval of 99% [0.9 to 16] and density of incidence of 7/10.000 observations/day - confidence interval of 99% [1.2 to 22]. No serious harms were observed. CONCLUSION: Falls occur less in the ICU, which can be explained by the use of safe care practices.


Assuntos
Acidentes por Quedas/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Estado Terminal , Feminino , Humanos , Incidência , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
13.
Rev Gaucha Enferm ; 41(spe): e20190159, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31778386

RESUMO

OBJECTIVE: Knowing the perceptions of nursing technicians about the risks to the patient in the use of enteral nutritional therapy, in a scenario of clinical simulation. METHOD: A qualitative study, performed through a clinical simulation with nursing technicians from a university hospital in the South of Brazil, in August 2017. The simulation sessions were recorded in audio and later transcribed. Content analysis was used for data analysis. RESULTS: Four thematic categories resulted from the analysis: Risks related to the tube; Risks related to diet; Risks related to contamination and Risks related to routine. CONCLUSION: The clinical simulation allowed nursing technicians to identify risks in the practice of enteral nutritional therapy and ways to minimize them. Promoting spaces for continuing education in the service, using clinical simulation methodology, gives an opportunity for critical reflection, which can contribute to safer, effective and quality nursing care.


Assuntos
Nutrição Enteral/efeitos adversos , Atitude do Pessoal de Saúde , Feminino , Humanos , Masculino , Enfermagem , Pesquisa Qualitativa , Medição de Risco , Treinamento por Simulação
14.
Online braz. j. nurs. (Online) ; 23: e20246696, 02 jan 2024. tab, ilus
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1554025

RESUMO

OBJETIVO: avaliar a contribuição da pandemia por COVID-19 sobre os tempos de atendimento e desfechos clínicos de admissões relacionadas à Síndrome Coronariana Aguda. MÉTODO: Coorte retrospectiva. Os dados foram analisados pelo SPSS, versão 20.0, empregados em testes paramétricos e não paramétricos para comparar os grupos. Aplicado o Modelo linear generalizado para análise multivariada. RESULTADOS: Incluídos 434 pacientes no período pré-pandemia e 430 durante a pandemia. Delta-t foi maior no período durante a pandemia (p=0,003). Não encontramos diferença nos tempos de atendimento e mortalidade. Admissão no período da pandemia (RR1,56; IC95%:1,30-1,87) e ter diagnóstico de cardiopatia isquêmica prévio (RR1,82; IC95%:1,50-2,20) foram associados ao aumento do Delta-t. CONCLUSÃO: Não houve diferença no número de pacientes que acessou a emergência por Síndrome Coronariana Aguda nos períodos analisados. Apesar do Delta-t ter sido maior durante a pandemia, não foram observados piores desfechos clínicos.


OBJECTIVE: To assess the impact of the COVID-19 pandemic on response times and clinical outcomes of acute coronary syndrome admissions. METHOD: Retrospective cohort study. Data were analyzed using SPSS version 20.0 with parametric and non-parametric tests for group comparisons. Generalized linear modeling was used for multivariate analysis. RESULTS: 434 patients were included in the pre-pandemic period and 430 during the pandemic. Delta-t was higher during the pandemic period (p=0.003). There were no differences in response times and mortality. Admission during the pandemic period (RR 1.56; 95% CI: 1.30-1.87) and a previous diagnosis of ischemic heart disease (RR 1.82; 95% CI: 1.50-2.20) were associated with increased delta-t. CONCLUSIONS: There was no difference in the number of patients presenting to the emergency department with acute coronary syndrome during the periods analyzed. Despite longer Delta-t during the pandemic, no worse clinical outcomes were observed.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Serviço Hospitalar de Emergência , Síndrome Coronariana Aguda , COVID-19 , Admissão do Paciente , Estudos Retrospectivos , Estudos de Coortes , Hospitais Universitários
15.
Rev Esc Enferm USP ; 53: e03438, 2019 06 13.
Artigo em Inglês | MEDLINE | ID: mdl-31215613

RESUMO

OBJECTIVE: Evaluate the performance of the Vascular Complications Risk Score in two public referral centers for interventional cardiology. METHOD: Subsample analysis of the Vascular Complications Risk Score, which was developed and validated in the catheterization laboratories of three cardiology referral centers (two public, one private) with a cutoff of <3 for no risk of developing vascular complications and ≥3 for risk. In this new analysis, we excluded data from the private facility, and only included participants from the original (validation) cohort of the two public hospitals. RESULTS: Among the 629 patients studied, 11.8% had vascular complications; of these, 1.8% were major and 10% minor. Among the patients with a score <3, 310 (94.5%) presented no vascular complications; of those with a score ≥3, 50 (17%) developed complications. Of those who developed vascular complications, 18 scored <3; two of these had major complications. CONCLUSION: This subanalysis confirms the ability of the Vascular Complications Risk core to predict low risk of vascular complications in patients with a score < 3.


Assuntos
Cateterismo Cardíaco/efeitos adversos , Intervenção Coronária Percutânea/efeitos adversos , Medição de Risco/métodos , Doenças Vasculares/epidemiologia , Idoso , Cardiologia , Estudos de Coortes , Estudos Transversais , Feminino , Hospitais Públicos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Doenças Vasculares/etiologia
16.
Nutrition ; 24(6): 528-35, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18417321

RESUMO

OBJECTIVE: This study examined the risk of diarrhea as a result of providing enteral nutrition in the hospital setting, adjusting for other clinical and therapeutic factors. METHODS: Adults admitted to a general tertiary care university hospital, in clinical or surgical units, were enrolled in the study between June 2004 and May 2005 and prospectively followed during their hospital stay. For each patient treated with enteral nutrition (n = 302), a comparable non-treated patient from the same ward (who also received antibiotics previously) and was similarly cared for by the same hospital staff was included in the study (n = 302), constituting a double-cohort study. All patients were seen three times per week, on alternating days, until the occurrence of diarrhea or hospital discharge. Cox's regression analyses were applied for adjustments. RESULTS: The incidence of diarrhea was 18% for patients receiving enteral nutrition and 6% for non-treated patients (P < 0.01). In multivariate analyses, enteral nutrition was independently associated with diarrhea (hazard ratio 2.7, 95% confidence interval 1.6-4.7), even adjusting for age (hazard ratio 1.02, 95% confidence interval 1.00-1.03) and hospitalization during the summer months (hazard ratio 2.4, 95% confidence interval 1.5-3.9). Patients for whom strict adherence to delivery-set washing-and-changing procedures was observed (on >75% of days) presented a lower incidence of diarrhea (6.5% versus 20.3%, P = 0.02; and 5.9% versus 19.8%, P = 0.05, respectively). CONCLUSION: Providing enteral nutrition to the hospitalized elderly during the summer months is associated with a higher risk of diarrhea. Strategies aimed toward improvement in the quality of enteral nutrition practices should be evaluated to minimize this deleterious clinical outcome.


Assuntos
Diarreia/epidemiologia , Nutrição Enteral/efeitos adversos , Fatores Etários , Idoso , Estudos de Coortes , Diarreia/etiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Estações do Ano
17.
Nutr Hosp ; 35(2): 259-264, 2018 02 27.
Artigo em Inglês | MEDLINE | ID: mdl-29756956

RESUMO

INTRODUCTION: few studies clearly describe incidents or adverse events that occur during the enteral nutrition process, which hinders the identification of critical points. OBJECTIVE: to describe breaches of protocol, incidents and adverse events, during the period beginning with indications until the use of enteral feeding tube in an Emergency Department. METHODS: trained nurses prospectively monitored a cohort of adults in a Brazilian Emergency Department where use of enteral feeding tube was indicated and up to their use. The study sought to identify breaches of protocol, such as verbal orders to insert feeding tubes, or authorization of their use without X-rays to confirm the position of the feeding tubes. Incidents were characterized as events that could have caused harm to patients, while adverse events were those that did actually cause harm. The study was approved by the institution's Research Ethics Committee. RESULTS: in 150 feeding tube insertions, there were 169 breaches of protocol: verbal orders for feeding tube insertion (n = 59); no X-rays taken (n = 11); and no examination of the X-rays by physicians (n = 12). There were 30 incidents: unintentional removal of the feeding tube (n = 23); and administration of enteral nutrition after breach of preventive barriers. There was one adverse event: aspiration of enteral nutrition. CONCLUSION: there was a high frequency of breaches of safety protocols; many developed into incidents, and one resulted in an adverse event.


Assuntos
Nutrição Enteral/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Estudos de Coortes , Feminino , Fidelidade a Diretrizes , Humanos , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros , Segurança do Paciente , Estudos Prospectivos
18.
Rev. gaúch. enferm ; 44: e20210343, 2023. tab, graf
Artigo em Inglês | LILACS-Express | LILACS, BDENF - Enfermagem | ID: biblio-1441892

RESUMO

ABSTRACT Objective: To determine incidence and time until first traction or obstruction of nasoenteral tube in hospitalized adults. Methods: Prospective double cohort study that included 494 adults who were users of nasoenteral tubes as inpatients in two clinical units and two surgical units in a teaching hospital. The occurrence of tube tractions and obstructions was monitored daily between 2017 and 2019. The Kaplan-Meier method was used to estimate time until the first event. Results: Tube traction occurred in 33% of the sample, and the incidence of the event was higher on the first five days of tube use. Tube obstruction incidence was 3.4% and grew as tube use time increased. Conclusion: Traction incidence was higher at the beginning of the period of use, whereas obstruction incidence grew as tube use time increased.


RESUMEN Objetivo: Determinar la incidencia y el tiempo hasta la primera tracción u obstrucción de la sonda nasoenteral en adultos hospitalizados. Método: Doble cohorte prospectiva incluyendo a 494 adultos usuarios de sonda nasoenteral, internados en dos servicios clínicos y dos servicios quirúrgicos de hospital universitario. Los pacientes fueron seguidos diariamente respecto de ocurrencia de tracciones u obstrucciones de sonda, entre 2017 y 2019. Se utilizó el método de Kaplan-Meier para estimar el tiempo hasta la ocurrencia del primer evento. Resultados: El 33% de la muestra sufrió tracción de la sonda, la incidencia fue mayor en los cinco primeros días de uso de la misma. La incidencia de obstrucción fue del 3,4% y aumentó con el tiempo de uso de la sonda. Conclusión: La incidencia de tracción es mayor hacia el inicio de su uso, mientras que la incidencia de la obstrucción aumenta con el tiempo de uso de la sonda nasoenteral.


RESUMO Objetivo: Determinar a incidência e o tempo até a primeira tração ou obstrução da sonda nasoenteral em adultos hospitalizados. Método: Dupla coorte prospectiva que incluiu 494 adultos usuários de sonda nasoenteral, internados em duas unidades clínicas e duas cirúrgicas de um hospital universitário. Os pacientes foram acompanhados diariamente quanto à ocorrência de trações ou obstruções da sonda, entre 2017 e 2019. O método de Kaplan-Meier foi utilizado para a estimação do tempo até a ocorrência do primeiro evento. Resultados: A tração de sonda ocorreu em 33% da amostra, e a incidência foi maior nos cinco primeiros dias de uso da sonda. A incidência de obstrução foi de 3,4%, e aumentou com otempo de uso da sonda Conclusão: A incidência de tração é maior no início do uso, enquanto a incidência de obstrução aumenta com o tempo de usoda sondanasoenteral.

19.
REVISA (Online) ; 12(2): 409-418, 2023.
Artigo em Português | LILACS | ID: biblio-1442343

RESUMO

Objetivo: avaliar a associação entre as complicações relacionadas à sonda nasoenteral e diagnósticos de enfermagem. Método: dupla coorte prospectiva de pacientes adultos, usuários de sonda nasoenteral em um hospital universitário. Os dados foram coletados diariamente do prontuário dos pacientes por meio de formulário eletrônico. As complicações relacionadas à sonda nasoenteral foram clínicas (diarreia e constipação) e mecânicas (tração e obstrução). Os diagnósticos de enfermagem avaliados foram aqueles relacionados à nutrição dos pacientes, identificados pela equipe assistente e coletado em prontuário. Resultados: Acompanhou-se 494 pacientes, a maioria idosos (69,4%). Do total de pacientes, 38,1% tiveram alguma complicação clínica e, 36,4% apresentaram complicações mecânicas relacionadas à sonda nasoenteral. Pacientes com complicações apresentaram maior número de diagnósticos de enfermagem implementados e tempo de uso de sonda (p<0,001). Deglutição prejudicada (31%) e Nutrição desequilibrada: menos que as necessidades corporais (30%) foram os diagnósticos de enfermagem mais frequentes. Conclusão: As complicações relacionadas à sonda nasoenteral ocorreram em percentual elevado. Os pacientes com tais complicações apresentaram maior número de diagnósticos de enfermagem implementados e tempo de uso de sonda.


Objective: to evaluate the association between complications related to the nasoenteral tube and nursing diagnoses. Method: double prospective cohort of adult patients using nasoenteral tube in a university hospital. Data were collected daily from the patients' charts using an electronic form. nasoenteral tube-related complications were clinical (diarrhea and constipation) and mechanical (traction and obstruction). The nursing diagnoses evaluated were those related to the patients' nutrition, identified by the assistant team and collected from the medical records. Results: 494 patients were followed up, most of them elderly (69.4%). Of the total number of patients, 38.1% had some clinical complication, and 36.4% had mechanical complications related to the nasoenteral tube. Patients with complications had a great number of nursing diagnoses implemented and time using nasoenteral tube (p<0.001). Impaired swallowing (31%) and Unbalanced nutrition: less than body needs (30%) were the most frequent nursing diagnoses. Conclusion: Complications related to the nasoenteral tube occurred in a high percentage. Patients with such complications had a greater number of nursing diagnoses implemented and time using nasoenteral tube.


Objetivo: evaluar la asociación entre las complicaciones relacionadas con la sonda nasoenteral y los diagnósticos de enfermería. Metodo: doble cohorte prospectiva de pacientes adultos usuários de sonda nasoenteral en um hospital universitário. Los datos se recogieron diariamente de las historias clínicas de los pacientes mediante un formulário electrónico. Las complicaciones relacionadas con la sonda nasoenteral fueron clínicas (diarrea y estreñimiento) y mecânicas (tracción y obstrucción). Los diagnósticos de enfermería evaluados fueron aquellos relacionados con la nutrición de los pacientes, identificados por el equipo asistencial y recolectados de las historias clínicas. Resultados: Se siguieron 494 pacientes, la mayoría ancianos (69,4%). Del total de pacientes, el 38,1% presentó alguna complicación clínica y el 36,4% presentó complicaciones mecánicas relacionadas con el sonda nasoenteral. Los pacientes con complicaciones tuvieron mayor número de diagnósticos de enfermería implementados y tiempo de uso de sonda (p<0,001). Deglución alterada (31%) y Nutrición desequilibrada: inferior a las necessidades corporales (30%) fueron los diagnósticos de enfermería más frecuentes. Conclusión: Las complicaciones relacionadas com el sonda nasoenteral ocurrieron em un alto porcentaje. Los pacientes con tales complicaciones tuvieron mayor número de diagnósticos de enfermería implementados y tiempo de uso de sonda.


Assuntos
Nutrição Enteral , Diagnóstico de Enfermagem , Segurança do Paciente , Intubação Gastrointestinal , Avaliação em Enfermagem
20.
Rev. baiana enferm ; 37: e51942, 2023. tab, graf
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1529666

RESUMO

Objetivo: analisar a relação entre a escala de distribuição de pacientes/profissional de enfermagem elaborada empiricamente pelos enfermeiros, embasada exclusivamente na sua experiência, e a recomendada pelo Nursing Activities Score. Método: coorte prospectiva, conduzida em julho e agosto de 2021 em duas Unidades de Terapia Intensiva adulto. Foram avaliadas características dos pacientes, Nursing Activities Score, escala de trabalho e distribuição de pessoal da enfermagem. Resultados: foram acompanhados 57 pacientes, gerando um total de 400 observações, num total de 60 dias de pesquisa. A média do Nursing Activities Score aumentou gradualmente nos primeiros 10 dias de internação. A escala diária de pessoal feita pelos enfermeiros e o Nursing Activities Score não apresentaram correlação nem quanto a distribuição de enfermeiros (r=0,0785), nem na distribuição de técnicos de enfermagem (r=0,2526). Conclusão: não houve correlação significativa entre a escala de distribuição de enfermeiros e técnicos e o Nursing Activities Score.


Objetivo: analizar la relación entre el plan de distribución de pacientes/profesionales de Enfermería elaborado empíricamente por los enfermeros basado exclusivamente en su experiencia y lo recomendado por el Nursing Activities Score. Método: estudio de cohorte prospectivo, realizado durante julio y agosto de 2021 en dos Unidades de Cuidados Intensivos para adultos. Se evaluaron características de los pacientes, el Nursing Activities Score, el plan de trabajo y la distribución del personal de Enfermería. Resultados: se realizó un seguimiento a 57 pacientes, generando un total de 400 observaciones, en un total de 60 días de investigación. El valor medio del Nursing Activities Score aumentó gradualmente durante los primeros 10 días de internación. El plan diario de personal elaborado por los enfermeros y el Nursing Activities Score no presentaron ninguna correlación con respecto a la distribución de enfermeros (r=0,0785) ni a la de técnicos de Enfermería (r=0,2526). Consideraciones finales: no se registró ninguna correlación significativa entre el plan de distribución de enfermeros/técnicos y el Nursing Activities Score.


Objective: to analyze the relationship between the patient/nursing professional distribution schedule empirically prepared by nurses, based exclusively on their experience, and the one recommended by the Nursing Activities Score. Method: a prospective cohort study conducted in July and August 2021 at two Intensive Care Units for adults. Characteristics of the patients, the Nursing Activities Score, the work schedule and the Nursing staff distribution were evaluated. Results: a total of 57 patients were monitored, generating a total of 400 observations, in a total of 60 research days. The mean Nursing Activities Score gradually increased during the first 10 hospitalization days. The daily staffing schedule made by nurses and the Nursing Activities Score did not show any correlation regarding the distribution of nurses (r=0.0785) or of nursing technicians (r=0.2526). Final considerations: there was no significant correlation between the distribution schedule of nurses and technicians and the Nursing Activities Score.


Assuntos
Humanos , Carga de Trabalho , Redução de Pessoal , Cuidados Críticos , Unidades de Terapia Intensiva , Equipe de Enfermagem , Estudos Transversais , Planejamento
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