Experimental studies in the gestational period: an overview of scientific production. / Estudos experimentais no período gestacional: panorama da produção científica.

OBJECTIVE: Describing the current panorama on the production of experimental studies related to the gestational period. METHOD: A bibliometric descriptive study using a quantitative approach. The data collection was performed in the International Clinical Trials Registry Platform in the month of October 2016. A descriptive statistical analysis was conducted after reading the abstracts and summarizing the material. RESULTS: The sample consisted of 33 studies registered in the period from 2007 to 2016. The Southeast Region concentrated 48.5% of the studies. Regarding the subjects covered, 33.1% of the total refer to physical activities during pregnancy and to perineal exercises to strengthen the pelvic floor musculature. CONCLUSION: The study showed us the panorama of the experimental studies focused on the gestational period, serving as support and incentive for performing further studies with a high level of evidence, which can impact the care provided to this population.

Indicators of health and safety among institutionalized older adults.

OBJECTIVE: To identify the incidence of mortality, diarrheal diseases, scabies and falls; and the prevalence of pressure ulcers - all of which are related to the safety ofinstitutionalized older adults. METHOD: This was a documentary retrospective study developed in a long-term residential careinstitution for older adults in the Northeast region of Brazil. The data were gathered from records of health assessment indicators filed between January 2008 and December 2015. Analysis included absolute case frequency; the sum of monthly prevalence and incidence rates; mean values of cases; and mean annual incidence and prevalence rates. RESULTS: The incidence of mortality over these nine years ranged from 9% to 13%; of acute diarrheic disease from 13% to 45%; and scabies from 21% to 63%. The prevalence of pressure ulcers ranged from 8% to 23%. Between 2012 and 2015, the incidence rate of falls without injury varied from 38% to 83%, and with injury from12% to 20%. CONCLUSION: Analysis of the health indicators revealeda high incidence of scabies and falls and a high prevalence of pressure ulcers. The identification of less than optimal rates for performance indicators canhelp improve the quality of nursing care. OBJETIVO: Identificar a incidência de mortalidade, doenças diarreicas, escabiose e quedas, e a prevalência de lesões por pressão para a segurança do idoso institucionalizado. MÉTODO: Estudo documental, retrospectivo desenvolvido em uma Instituição de Longa Permanência para Idosos, localizada no nordeste do Brasil. Os dados foram coletados por meio dos registros dos indicadores de avaliação de saúde, arquivados de janeiro de 2008 a dezembro de 2015. A análise incluiu a frequência absoluta dos casos; o somatório das taxas de prevalência e incidência mensais; a média de casos e das taxas de incidência e prevalência anuais. RESULTADOS: Observa-se que a incidência de óbitos nos nove anos considerados variou de 9 a 13%; de doenças diarreicas agudas, de 13 a 45%; e de escabiose, de 21 a 63%. A prevalência de lesão por pressão oscilou de 8 a 23%. Entre os anos de 2012 a 2015, a taxa de incidência de quedas sem lesão variou em torno de 38 a 83%, e com lesão, de 12 a 20%. CONCLUSÃO: A análise da amplitude dos indicadores de saúde permitiu identificar a alta incidência de escabiose e de quedas e a elevada prevalência de lesões por pressão. A identificação do comprometimento dos indicadores contribui para otimização da qualidade da assistência de enfermagem.

Patient safety culture assessment before and after safety huddle implementation.

OBJECTIVE: To identify whether safety huddle implementation enabled a change in patient safety culture. METHOD: Quasi-experimental research that assessed patient safety culture before and after safety huddle implementation. RESULTS.: The study revealed that 53.98% completed the two safety culture assessments, with 60.1% adherence from the nursing team, with a statistically significant difference in the second assessment regarding perception of patient safety and adverse events notified (p < 0.00). Regarding good practice indicators, a statistically significant difference (p < 0.00) was observed in item 43 and improvement in almost all dimensions in the second safety culture assessment. The huddles totaled 105 days, with 100% adherence from the nursing team. Regarding checklist items, all presented satisfactory responses (above 50%). CONCLUSION: Safety huddles proved to be an effective tool for communication between healthcare professionals and managers, demonstrating positive impacts on good practice indicators and most safety culture dimensions.

360° Video Simulation Scenario for the WHO Global Patient Safety Challenge "Medication Without Harm".

BACKGROUND: High-quality video productions integrating 360° simulations of real-life nursing scenarios, though still emerging and relatively rare, have shown promise in enriching learning experiences and refining students' competencies, attitudes, and knowledge. PURPOSE: To develop a 360° video simulation scenario for teaching medication safety in nursing. METHODS: The methodological framework comprised 3 key stages: (1) crafting the script; (2) scrutinizing the script's validity through evaluation by expert judges in medication administration; and (3) developing the set, filming scenes, and refining the video using a 360° camera. RESULTS: All evaluated elements garnered substantial concurrence among the expert panel. After script validation, the video script underwent refinement and validation by expert judges. The 360° video was tailored for utilization with virtual reality glasses, rendering it accessible for integration into nursing education curricula. CONCLUSIONS: The final version consisted of a continuous scene that ended with a question that prompted the identification of errors.

Emotional intelligence of health personnel and safety climate in hospitals during the COVID-19 pandemic.

OBJECTIVE: To analyze the relationship between the emotional intelligence of healthcare workers in a hospital environment and their perception of the safety climate in the COVID-19 pandemic. METHOD: Cross-sectional, analytical study, carried out with 81 health workers who worked in hospitals during the pandemic, between September and November 2021. Data collection was carried out using an electronic form, which included a sociodemographic/occupational questionnaire and the Brazilian versions of the Safety Attitudes Questionnaire and the Schutte Self Test. Spearman's correlation test and simple and multiple linear regression analyses were applied. RESULTS: An increase of 1 point in emotional intelligence levels resulted in an increase of 0.487 points in the perception of the safety climate. The most significant predictor of this perception was the ability to manage other people's emotions (ß=0.334; p=0.003; R2=0.168). CONCLUSION: A higher level of emotional intelligence in hospital healthcare workers was related to a greater perception of the safety climate during the COVID-19 pandemic.

Knowledge of nursing staff before and after training on incontinence-associated dermatitis.

OBJECTIVE: To verify the knowledge of nursing staff before and after training on incontinence-associated dermatitis. METHOD: A study before and after an educational intervention carried out with nursing staff from the medical and surgical clinics and intensive care unit of the university hospital in June 2023. The training took place over three meetings. Data was collected using a questionnaire administered immediately before and after the training. McNemar's test for dependent samples was used to compare before and after training. RESULTS: 25 nurses and 14 nursing technicians took part. The items that showed statistical significance were related to the identification and correct differentiation of dermatitis associated with incontinence and pressure injury; and the correct way to sanitize the skin. CONCLUSION: The training of the nursing team made it possible to assess their knowledge of how to identify, prevent and treat incontinence-associated dermatitis.

Polypharmacy and high-alert medications in patients with nasally placed feeding tube on admission and at hospital discharge: Multicenter cross-sectional study.

Background: Polypharmacy and the use of high-alert medications in patients with nasally placed feeding tube (NPFT) increase the risks of drug related problems. Objective: Characterize drugs prescribed to patients with NPFT and compare the rates of polypharmacy and high-alert medication use at admission and hospital discharge. Design and setting: Multicenter cross-sectional study with 327 participants. Methods: Data of patients with NPFT were obtained from the medical records and recorded in an electronic data collection tool. Mean number of drugs, polypharmacy and number of high-alert medications prescribed on admission and at discharge were compared using Wilcoxon or McNemar's tests. Generalized Estimating Equations analyzed the relationship between polypharmacy and high-alert medications according to age and time point. Primary reason for hospital admission, level of consciousness, severity of comorbid diseases and patient care complexity were also assessed. Results: Most patients were male, older people, hospitalized for circulatory system diseases and had at least one comorbidity. On admission, a significant number of patients were alert (59.9%), at high risk for death (43.1%) and high dependent on nursing care (35.4%). Additionally, 92% patients were on polypharmacy on admission, versus 84.7% at hospital discharge (p = 0,0011). The occurrence of polypharmacy was independent of age (p = 0.2377). >17% of all drugs prescribed were high-alert medications, with no statistically significant difference between admission and discharge (p = 0,3957). There was no statistical evidence that the use of high-alert medications increases with age (n = 0,5426). Conclusions: These results support the planning of multidisciplinary qualified actions for patients using NPFT.

Factors determining safety culture in hospitals: a scoping review.

OBJECTIVE: To evaluate and synthesise the factors determining patient safety culture in hospitals. METHODS: The scoping review protocol was based on the criteria of the Joanna Briggs Institute. Eligibility criteria were as follows: (1) empirical study published in a peer-reviewed journal; (2) used methods or tools to assess, study or measure safety culture or climate; (3) data collected in the hospital setting and (4) studies published in English. Relevant literature was located using PubMed, CINAHL, Web of Science and PsycINFO databases. Quantitative and qualitative analyses were performed using RStudio and the R interface for multidimensional analysis of texts and questionnaires (IRaMuTeQ). RESULTS: A total of 248 primary studies were included. The most used instruments for assessing safety culture were the Hospital Survey on Patient Safety Culture (n=104) and the Safety Attitudes Questionnaire (n=63). The Maslach Burnout Inventory (n=13) and Culture Assessment Scales based on patient perception (n=9) were used in association with cultural instruments. Sixty-six articles were included in the qualitative analysis. In word cloud and similarity analyses, the words 'communication' and 'leadership' were most prominent. Regarding the descending hierarchical classification analysis, the content was categorised into two main classes, one of which was subdivided into five subclasses: class 1a: job satisfaction and leadership (15.56%), class 1b: error response (22.22%), class 1c: psychological and empowerment nurses (20.00%), class 1d: trust culture (22.22%) and class 2: innovation worker (20.00%). CONCLUSION: The instruments presented elements that remained indispensable for assessing the safety culture, such as leadership commitment, open communication and learning from mistakes. There was also a tendency for research to assess patient and family engagement, psychological safety, nurses' engagement in decision-making and innovation.

Reflections based on the Tidal Model about the concept of psychosis.

OBJECTIVE: To reflect on the concept of psychosis using the Tidal Model framework. METHOD: Reflective study developed from the bookEl modelo Tidal: salud mental, reivindicación y recuperación by Phil Barker and Poppy Buchanan-Barker and other texts. RESULTS: The reflection was organized into three axes of discussion: "The Tidal Model", "The metaphor, psychosis and the domain of the self" and "The Tidal Model, nonlinearity and psychosis: synergisms with the Brazilian mental health policy". FINAL CONSIDERATIONS: The Tidal Model encompasses the concept of psychosis, in addition to being synergistic with aspects of psychiatric reform and mental health policies in Brazil. The limitations of the study are the fact that it only presents initial and general approximations about the relationship between the concept of psychosis and the Tidal Model, and it is necessary to deepen this knowledge in the specific context of care practice.

Presenteeism and safety culture: evaluation of health workers in a teaching hospital.

OBJECTIVES: to verify associations between presenteeism and safety culture among health workers. METHODS: a descriptive, cross-sectional study with health workers from a teaching hospital in Rio Grande do Sul. Data collection took place through instruments of sample characterization, the Brazilian version of the Stanford Presenteeism Scale and the Safety Attitudes Questionnaire were analyzed using descriptive statistics and chi-square tests. RESULTS: a total of 758 (48%) professionals participated; 330 (43.5%) presenteeism were identified, who evaluated the safety culture more negatively compared to non- presenteeism. The safety culture had a mean less than 75; associations between presenteeism and general safety culture were observed, and with the domains of teamwork climate, safety climate, stress recognition and working conditions. CONCLUSIONS: presenteeism was associated with a safety culture, which requires investment by hospital management, with consideration to the health of workers.

Creation and validation of a serial album for the prevention of Pressure Ulcer: a methodological study.

OBJECTIVES: to create and validate a serial album for Pressure Ulcer prevention in the hospital environment. METHODS: a methodological study with the production of the serial album and validation by 22 judges and 22 patients. The content was based on the integrative review and the reports of the World Health Organization. It was considered a Content Validity Index equal to or greater than 80% in the items and the binomial test for the judges' agreement. RESULTS: the serial album entitled "Pressure Ulcer Prevention in the hospital environment" has 13 pages. In the content and layout validation, all items had an agreement above 80% among the participants. The overall Content Validity Index was 0.99 for the judges and 1.0 for the patients. CONCLUSIONS: the constructed and validated material presented itself as an adequate instrument to be used in health education activities.

Interprofessional work in health in the context of the COVID-19 pandemic: a scoping review.

OBJECTIVE: to map the scientific production on interprofessional relationships in health in the first year of the COVID-19 pandemic. METHOD: this is a scoping review performed in PubMed, Scopus, LILACS, CINAHL, Web of Science, Google Scholar and Science Direct databases, covering the period of publication in 2020, using the acronym PCC (Population = health professionals; Concept = interprofessional relationships; Context = health services) and respective search strategies. RESULTS: fourteen scientific articles were selected and the content discussed in the manuscripts was standardized, analyzed and organized into categories of affinities and similarities of their results: 1 - Interprofessional collaboration; 2 - Collaborative practice; 3 - Interprofessional work; 4 - Interactive and interprofessional learning. CONCLUSION: the pandemic demanded quick and effective responses that were only possible through collaboration and interprofessionalism dimensions. Interprofessional work in health during the first year of the COVID-19 pandemic confirms the importance of interprofessional work and its dimensions for the provision of more comprehensive, resolute and safer health services.

Patient safety culture in surgical centers: nursing perspectives. / Cultura de segurança do paciente em centros cirúrgicos: perspectivas da enfermagem.

OBJECTIVE: To analyze patient safety culture in the different spheres of management in the perspective of the nursing team providing services in surgical centers. METHOD: Cross-sectional study with 200 nursing professionals, in three surgical centers of Piauí state - one municipal, one federal, and one state - from January to August 2016 through the application of the instrument Hospital Survey on Patient Safety Culture. RESULTS: The first surgical center did not present a strengthened patient safety culture; the others presented the dimension "Organizational learning - continuous improvement" (80.6%/75.6%) and "Frequency of reported events" (76.2%) as strengthened areas. In the first, the safety score "average" was prevalent, whereas participants of the second and third judged patient safety as "very good". Most participants of the three surgical centers (80.0%) reported no adverse event in the previous 12 months. CONCLUSION: The state and federal surgical centers obtained the best patient safety scores when compared to the municipal surgical center. Therefore, for a more effective and safe care, the strengthened dimensions in each type of management should be enhanced and the weakened ones should be improved.

PEDCARE: validation of a mobile application on diabetic foot self-care.

OBJECTIVE: to describe the process of validating a multimedia application on a mobile platform to promote foot care for people with diabetes. METHOD: a technological production and methodological type study. Content and appearance were validated by 39 judges (29 nursing judges and ten information and communication technology judges and 15 people from the target audience). RESULTS: nursing judges made it possible to validate the material with a total Content Validity Index of 0.95, a non-significant binomial test for most items and Cronbach's alpha of 0.92, information and communication technology judges with Suitability Assessment of Materials of 99.2% and the target audience with an agreement index of 98%. CONCLUSION: the application proved to be valid and reliable for use in clinical practice as an educational technology to promote foot care for people with diabetes.

Patient safety culture from the perspective of all the workers of a general hospital.

OBJECTIVE: To assess the patient safety culture among the workers of a hospital institution in southern Brazil. METHOD: This is a cross-sectional study, which was performed with 630 hospital workers, at Santa Rosa, Rio Grande do Sul, Brazil, through the Safety Attitudes Questionnaire tool, in the month of April 2017. RESULTS: We found positive scores in all the safety culture domains, except for the perceived stress domain. CONCLUSION: Job satisfaction and teamwork spirit showed better scores for nursing and health professionals, when compared to the support team. Schooling, gender, operation time and the choice of workplace positively influenced the safe atmosphere.

Usability of a mobile application on diabetic foot self-care.

OBJECTIVES: to assess the usability of an app prototype for diabetic foot self-care by an end user. METHODS: a descriptive study that uses heuristic assessment of a hybrid app usability. Fifteen users of an outpatient diabetes care service in a capital of Northeastern Brazil participated in the study during April 2018. The usability measurement tool called Smartphone Usability questionnaiRE was applied. RESULTS: the lowest score was 77 and the highest was 112, with an average usability of 96.1 points. Usability was framed in the last two levels, 70 and 8o. Users now strongly agree (level 70) and fully (level 80) with the assessed items, which represents good usability of the apps prototype. CONCLUSIONS: the final product developed focuses on user needs and requirements, which can ensure usability based on effectiveness, efficiency and satisfaction triad.

Are patients with a nasally placed feeding tube at risk of potential drug-drug interactions? A multicentre cross-sectional study.

AIMS: The primary aims were to determine the rate of potential drug-drug interactions (pDDIs) in patients with nasally placed feeding tubes (NPFT) and the factors significantly associated with pDDIs. The secondary aim was to assess the change in pDDIs for patients between admission and discharge. MATERIAL AND METHODS: This multicentre study applied a cross-sectional design and was conducted in six Brazilian hospitals, from October 2016 to July 2018. Data from patients with NPFT were collected through electronic forms. All regular medications prescribed were recorded. Medications were classified according to the World Health Organization (WHO) Anatomical Therapeutic Chemical code. Drug-drug interaction screening software was used to screen patients' medications for pDDIs. Negative binomial regression was used to account for the over dispersed nature of the pDDI count. Since the number of pDDIs was closely related to the number of prescribed medications, we modelled the rate of pDDIs with the count of pDDIs as the numerator and the number of prescribed medications as the denominator; six variables were considered for inclusion: time (admission or discharge), patient age, patient gender, age-adjusted Charlson Comorbidity Index (CCI) score, type of prescription (electronic or handwritten) and patient care complexity. To account for correlation within the two time points (admission and discharge) for each patient a generalised estimating equations approach was used to adjust the standard error estimates. To test the change in pDDI rate between admission and discharge a full model of six variables was fitted to generate an adjusted estimate. RESULTS: In this study, 327 patients were included. At least one pDDI was found in more than 91% of patients on admission and discharge and most of these pDDIs were classified as major severity. Three factors were significantly associated with the rate of pDDIs per medication: patient age, patient care complexity and prescription type (handwritten vs electronic). There was no evidence of a difference in pDDI rate between admission and discharge. CONCLUSION: Patients with a NPFT are at high risk of pDDIs. Drug interaction screening tools and computerized clinical decision support systems could be effective risk mitigation strategies for this patient group.

Nasogastric/Nasoenteric tube-related incidents in hospitalised patients: a study protocol of a multicentre prospective cohort study.

INTRODUCTION: Hospitalised patients with nasogastric/nasoenteric tube (NGT/NET) are at constant risk of incidents; therefore, healthcare professionals need to routinely monitor risks and adopt strategies for patient safety and quality of care. AIM: This study aimed to evaluate the NGT/NET-related incidents in hospitalised patients and associated factors. METHODS: This is a multicentre study, with a prospective cohort design. Data will be collected at the general medical ward of seven Brazilian hospitals in the north, northeast, southeast and south. The sample will consist of 391 patients that require an NGT/NET during hospitalisation. Three different methods will be used to identify the incidents: (1) healthcare professionals and patients/caregivers will be required to report any NGT/NET-related incidents; (2) researchers will visit the wards to get information about the incidents with healthcare professionals and patients/caregivers; (3) the researchers will review the medical records looking for information on the occurrence of any NGT/NET-related incidents. Demographic, clinical and therapeutic details will be obtained from the medical records and will be registered in an electronic data collection tool developed for the purposes of this study. The complexity of patients will be assessed by the Patient Classification System, and the severity of comorbid diseases will be assessed through the Charlson Comorbidity Index. IMPLICATION FOR PRACTICE: The results may encourage the use of evidence effectively to influence the scientific foundation for clinical practice and the development of evidence-based policies that will prevent, manage and eliminate complications caused by NGT/NET-related incidents, and improve the quality and safety of care provided to hospitalised patients. ETHICS AND DISSEMINATION: The study has been approved by the Research Ethics Committee. Detailed information about the study can be provided by the principal investigator. The findings will be reported through academic journals, seminar and conference presentations, social media, print media, the internet and community/stakeholder engagement activities.

PLISSIT model: sexual counseling for breast cancer survivors.

OBJECTIVE: Reporting the experience of use of the PLISSIT model as tool for the nursing care of breast cancer survivors with sexual dysfunction. METHOD: case study developed from January to August 2017, in the outpatient mastology clinic and sexuality service of a maternity in Fortaleza, Ceará, Brazil, with 15 breast cancer survivors. RESULTS: sexual counseling sessions were conducted using the PLISSIT model to address sexual issues, highlighting the particularities of women who experience survival after the treatment of breast cancer. FINAL CONSIDERATIONS: the model used in the practice of nursing care is customary and allows identifying issues experienced by women, as it has easy availability and practicality for use by nursing professionals, helping to address sexual matters with greater tranquility.

Medication administration safety assessment tool: Construction and validation.

OBJECTIVE: To build and validate the Patient Safety Assessment in Medication Administration (ASPAM - Avaliação da Segurança do Paciente na Administração de Medicamentos) tool. METHOD: Methodological study in which the construction, Content Validation Index (CVI), construct validation (factorial analysis) and reliability were performed in terms of homogeneity (Cronbach's Alpha). RESULTS: The ASPAM reached CVI of 0.77 for simplicity, 0.76 for clarity and 0.93 for relevance. The exploratory factorial analysis was adequate for the tool (Kaiser-Meyer-Olkim of 0.66 and Bartlett's sphericity with p <0.001). The Cronbach's Alpha end of the scale with 28 items was 0.85. CONCLUSION: The ASPAM tool was valid and reliable for the identification of risk-generating conditions for the occurrence of Adverse Drug Events.