Melaleuca alternifolia essential oil soap: a potential alternative for hand hygiene.

This study aimed to compare the antimicrobial action of three soaps for hand hygiene (HH): 2.0% Tea Tree Oil (TTO); 0.5% triclosan; 2.0% chlorhexidine, and to explore the perception of healthcare professionals about TTO. Two-step study: a quantitative, to determine the logarithmic reduction of Escherichia coli K12 colony-forming units before and after HH of 15 volunteers and quali-quantitative, through interviews with 23 health professionals. All the three products demonstrated antimicrobial action (a log10 reduction factor of 4.18 for TTO, 4.31 for triclosan, 3.89 for chlorhexidine, and 3.17 for reference soap). Professionals remarked the pleasant aroma and non-dryness of skin when using soap containing TTO.

Proposal of nursing diagnoses, outcomes and interventions for postoperative patients of orthognathic surgery. / Proposta de diagnósticos, resultados e intervenções de enfermagem para pacientes em pós-operatório de cirurgia ortognática.

OBJECTIVE: To propose nursing diagnoses, outcomes and interventions for patients in the postoperative period of orthognathic surgery. METHOD: Secondary analysis of an information bank of a focal group with five patients submitted to orthognathic surgery. The classifications of the North American Nursing Diagnosis Association International, Nursing Outcomes Classification and Nursing Interventions Classification were used for elaborating nursing diagnoses, outcomes and interventions. Nursing diagnoses were identified based on the transcription of the focus group and the expected outcomes and interventions were proposed. In the second stage, the material was submitted to an analysis by judges for validating the previous stage. RESULTS: After careful analysis of the retrieved information, nine nursing diagnoses that relate to both the difficulties already installed and to potential patient difficulties were identified. After this phase, the expected outcomes for nursing care and the appropriate interventions for the postoperative period at home were identified. CONCLUSION: Given the short hospital stay and the long postoperative period, the established actions have a strong educational focus.

Patient readmission for orthopaedic surgical site infection: an hermeneutic phenomenological approach.

AIM AND OBJECTIVE: To explore the individual experience of being readmitted for surgical site infection resulting from orthopaedic surgery. BACKGROUND: Surgical site infection has been a cause of concern worldwide and contributes to the greatest number of hospital readmission occurrences. Health professionals must understand the meaning of these readmissions for the individual, as an understanding of these exclusive experiences improves the quality of surgical care. DESIGN: Qualitative research based on the existential phenomenology of Martin Heidegger. METHOD: Eleven individuals who were readmitted because of surgical site infection participated in the study. The testimonials were obtained over an 11-month period in 2014-2015 based on the following leading question: What has it been like for you to be readmitted because of orthopaedic surgical site infection? The phenomenological analysis identified the sentiment units of the testimonials and their interrelation, revealing the meanings. RESULTS: The revealed contents were fear and insecurity of the unknown, frustration, and the sense of time passing them by and being unable to live their lives. The individuals felt neglected, and they experienced their social relationality as impaired and sometimes approaching a breakdown. The patients connected with God as an attempt to avoid complications and death. CONCLUSION: We urge healthcare professionals to deepen their knowledge of the dimensions of care by developing competencies that consider the subjectivity of experiences of the health-disease process. When the only listening that takes place is qualified listening, the professional's attitudes compromise his or her ability to provide true care, which transcends the knowledge of doing and reaches the knowledge of doing with sensitivity. RELEVANCE TO CLINICAL PRACTICE: Nursing care requires an attitude that considers the patient as more than a carrier of illness and should not be limited to what is described and prescribed, although the latter cannot be excluded in an organisational point of view.

Perioperative fasting time among cancer patients submitted to gastrointestinal surgeries.

OBJECTIVE: To identify the length of perioperative fasting among patients submitted to gastrointestinal cancer surgeries. METHOD: Retrospective cohort study, developed by consulting the medical records of 128 patients submitted to gastrointestinal cancer surgeries. RESULTS: The mean of total length of fasting was 107.6 hours. The total length of fasting was significantly associated with the number of symptoms presented before (p=0.000) and after the surgery (p=0.007), the length of hospital stay (p=0.000), blood transfusion (p=0.013), nasogastric tube (p=0.001) and nasojejunal tube (p=0,003), postoperative admission at ICU (p=0.002), postoperative death (p=0.000) and length of preoperative fasting (p=0.000). CONCLUSION: The length of fasting is associated with complications that affect the quality of the patients' postoperative recovery and nurses' work. The nursing team should be alert to this aspect and being responsible for overseeing the patients' interest, should not permit the unnecessary extension of fasting. OBJETIVO: Identificar la duración del ayuno perioperatorio entre los pacientes sometidos a cirugías de cáncer gastrointestinal. MÉTODO: Estudio de cohorte retrospectivo, por consulta de los registros médicos de 128 pacientes sometidos a cirugías de cáncer gastrointestinal. RESULTADOS: La media de la duración total del ayuno fue de 107,6 horas. La duración total del ayuno se asoció significativamente con el número de síntomas presentados antes (p=0,000) y después de la cirugía (p=0,007), la duración de la estancia hospitalaria (p=0,000), transfusión de sangre (p=0,013),tubo nasogástrico (P=0,003), ingreso postoperatorio en la UCI (p=0,002), muerte postoperatoria (p=0,000) y duración del ayuno preoperatorio (p=0,000). CONCLUSIÓN: La duración del ayuno se asocia con complicaciones que afectan la calidad de la recuperación postoperatoria de los pacientes y el trabajo de enfermería. El equipo de enfermería debe estar alerta en relación a este aspecto y ser responsable de supervisar el interés de los pacientes, no permitiendo la extensión innecesaria del ayuno.

[Aromatherapy and nursing: historical and theoretical conception]. / Aromaterapia e enfermagem: concepção histórico-teórica.

Aromatherapy is a Practical or Complementary Health Therapy that uses volatile concentrates extracted from plants called essential oils, in order to improve physical, mental and emotional well-being. Aromatherapy has been practiced historically and worldwide by nurses and, as in Brazil is supported by the Federal Nursing Council, it is relevant to discuss this practice in the context of Nursing through Theories of Nursing. This study of theoretical reflection, exploratory and descriptive, aims to discuss the pharmacognosy of essential oils, the historical trajectory of Aromatherapy in Nursing and the conceptions to support Aromatherapy in light of eight Nursing Theorists (Florence Nightingale, Myra Levine, Hildegard Peplau, Martha Rogers, Callista Roy, Wanda Horta, Jean Watson and Katharine Kolcaba), contributing to its inclusion as a nursing care practice.

Chinese phytotherapy to reduce stress, anxiety and improve quality of life: randomized controlled trial.

OBJECTIVE: To evaluate the effect of Chinese phytotherapyto reduce stress levels, anxiety and improve quality of life. METHOD: double-blind randomized controlled trial with 89 volunteers divided into three groups: control (no intervention), Placebo and Phytotherapy. The study was conducted in 2015 with healthy adults treated at the Integrated and Eastern Therapy Institute,in Sao Paulo, Brazil. Participants were evaluated at baseline and after three weeks with the Stress Symptoms List (SSL), Anxiety Inventory-Trait and State and SF12v2 for quality of life. Intervention groups received a placebo or Gan May Zao formula (GMDZ)flaskwith 50 ml. RESULTS: According to ANOVA, there were significant differences (p = 0.025) after treatment of stress (SSL2). And the difference was between control and Phytotherapy groups, according to the Tukey post hoc (p = 0.022). There were no differences in the levels of state-anxiety and physical and mental domains in the SF12v2. CONCLUSION: The GMDZ formula reduced stress levels, but more studies are needed with greater sample, with reassessment of dosage and a longer period of treatment to confirm and extend the results. Brazilian Registry of Clinical Trials: RBR-28s4hz. OBJETIVO: Avaliar o efeito da fitoterapia chinesa na redução de níveis de estresse, ansiedade e melhoria de qualidade de vida. MÉTODO: Ensaio clínico randomizado duplo-cego, com 89 voluntários divididos em três grupos: Controle (sem intervenção), Placebo e Fitoterapia. Foi realizado em 2015, com adultos saudáveis atendidos no Instituto de Terapia Integrada e Oriental, São Paulo. Foram avaliados no baseline e, após 3 semanas,pela Lista de Sintomas de Stress (LSS), Inventário de Ansiedade-Traço e Estado e o SF12v2 de qualidade de vida. Os grupos de intervenção receberam um frasco de 50 ml de placebo ou da fórmula Gan Mai Da Zao (GMDZ). RESULTADOS: Segundo ANOVA, houve diferença (p=0,025) no pós-tratamento de estresse (LSS2). E a diferença foi entre os grupos Controle e Fitoterapia, de acordo com o post hocde Tukey (p=0,022). Não houve diferenças nos níveis de ansiedade-estado e domínio físico e mental do SF12v2. CONCLUSÃO: A fórmula GMDZ reduziu os níveis de estresse, mas são necessários mais estudos com amostra significativa, com reavaliação da posologia e um período maior de tratamento para confirmar e ampliar os resultados. Registro Brasileiro de Ensaios Clínicos: RBR-28s4hz.

Organizational culture and climate for patient safety in Intensive Care Units. / Cultura e clima organizacional para segurança do paciente em Unidades de Terapia Intensiva.

Objective To assess the perception of health professionals about patient safety climate and culture in different intensive care units (ICUs) and the relationship between scores obtained on the Hospital Survey on Patient Safety Culture (HSOPSC) and the Safety Attitudes Questionnaire (SAQ). Method A cross-sectional study conducted at a teaching hospital in the state of São Paulo, Brazil, in March and April 2014. As data gathering instruments, the HSOPSC, SAQ and a questionnaire with sociodemographic and professional information about the staff working in an adult, pediatric and neonatal ICU were used. Data analysis was conducted with descriptive statistics. Results The scales presented good reliability. Greater weaknesses in patient safety were observed in the Working conditions andPerceptions of management domains of the SAQ and in the Nonpunitive response to error domain of the HSOPSC. The strengths indicated by the SAQ wereTeamwork climate and Job satisfactionand by the HSOPC, Supervisor/manager expectations and actions promoting safety and Organizational learning-continuous improvement. Job satisfaction was higher among neonatal ICU workers when compared with the other ICUs. The adult ICU presented lower scores for most of the SAQ and HSOPSC domains. The scales presented moderate correlation between them (r=0.66). Conclusion There were differences in perception regarding patient safety among ICUs, which corroborates the existence of local microcultures. The study did not demonstrate equivalence between the SAQ and the HSOPSC.

[Antimicrobial activity of Eucalyptus globulus oil, xylitol and papain: a pilot study]. / Atividade antimicrobiana do óleo de Eucalyptus globulus, xilitol e papaína: estudo piloto.

OBJECTIVE: To evaluate the in vitro antimicrobial activity of the Eucalyptus globulus essential oil, and of the xylitol and papain substances against the following microorganisms: Pseudomonas aeruginosa; Samonella sp.; Staphylococus aureus; Proteus vulgaris; Escherichia coli and Candida albicans. METHOD: The in vitro antimicrobial evaluation was used by means of the agar diffusion test and evaluation of the inhibition zone diameter of the tested substances. Chlorhexidine 0.5% was used as control. RESULTS: The Eucalyptus globulus oil showed higher inhibition than chlorhexidine when applied to Staphylococcus aureus, and equal inhibition when applied to the following microorganisms: Escherichia coli, Proteus vulgaris and Candida albicans. Papain 10% showed lower antimicrobial effect than chlorhexidine in relation to Candida albicans. Xylitol showed no inhibition of the tested microorganisms. CONCLUSION: The Eucalyptus globulus oil has antimicrobial activity against different microorganisms and appears to be a viable alternative as germicidal agent hence, further investigation is recommended.

[Readmission from orthopedic surgical site infections: an integrative review]. / Readmissão por infecção do sítio cirúrgico ortopédico: uma revisão integrative.

OBJECTIVE: Characterizing readmissions from orthopedic surgical site infections. METHOD: An integrative review of literature in the LILACS, IBECS, MEDLINE, Cochrane, SciELO and PUBMED databases, using the descriptors Patient readmission, Wound infection, Cross infection, Orthopedic procedures, Orthopedics. RESULTS: 78 studies were identified and 10 publications were selected. Surgical site infections are the most common cause of unplanned orthopedic readmissions, representing long periods of hospitalization, new surgical procedures and high costs, and greater possibility of subsequent hospitalizations. Most significant predictors have indicated average length of hospitalization, need for intensive care, emergency status at admission, risk of death, age > 65 years, males and higher body mass index. CONCLUSION: Readmission rates have increasingly become measures of quality and concerns about costs. New studies could involve issues related to indirect costs, specifically social and psychological costs.

[Disinfection with sodium hypochlorite in hospital environmental surfaces in the reduction of contamination and infection prevention: a systematic review]. / Desinfecção com hipoclorito de sódio em superfícies ambientais hospitalares na redução de contaminação e prevenção de infecção: revisão sistemática.

OBJECTIVE: To search for evidence of the efficiency of sodium hypochlorite on environmental surfaces in reducing contamination and prevention of healthcare-associated infection HAIs. METHOD: Systematic review in accordance with the Cochrane Collaboration. RESULTS: We analyzed 14 studies, all controlled trials, published between 1989-2013. Most studies resulted in inhibition of microorganism growth. Some decreased infection, microorganism resistance and colonization, loss of efficiency in the presence of dirty and surface-dried viruses. CONCLUSION: The hypochlorite is an effective disinfectant, however, the issue of the direct relation with the reduction of HAIs remains. The absence of control for confounding variables in the analyzed studies made the meta-analysis performance inadequate. The evaluation of internal validity using CONSORT and TREND was not possible because its contents were not appropriate to laboratory and microbiological studies. As a result, there is an urgent need for developing specific protocol for evaluating such studies.

Cancer patients caregivers comfort.

Cross-sectional study, carried out at the outpatient clinic of an oncology hospital. Data were collected from 88 caregivers of cancer patients using the Caregiver General Comfort Questionnaire (GCQ) to assess the caregivers' comfort. The caregivers' GCQ score mean was 203.9; better comfort scores was associated with age, care time and current occupation; positive aspects of comfort were related to the fact that caregivers felt loved, to patients' physical and environmental comfort and to caregivers' spirituality. 203.9; better comfort scores were associated with age of the caregiver and current occupation; positive aspects of comfort were related to the fact that caregivers felt loved, to patients' physical and environmental comfort and to caregivers' spirituality. Caregivers, who didn't have a paid job or leisure's activities showed a worse GCQ. The GCQ scale can help to identify factors that interfere in caregivers' comfort, as well as needs that can be modified through health professionals' interventions.

Flower therapy and perceived stress in primary health care nursing professionals: randomized clinical trial.

OBJECTIVE: To analyze the effectiveness of Bach flower therapy compared to placebo in reducing perceived stress levels in primary health care nursing professionals. METHOD: Pragmatic, parallel randomized clinical trial conducted with 87 primary care nursing professionals with self-identified stress, from October 2021 to June 2022, in the cities of Osasco and São Paulo, Brazil. The intervention group (n=43) received the collective flower formula, and the placebo group (n=44) received only the diluent. Data analysis was performed using the linear mixed model, and effect size was measured by partial Eta squared, significance level 5%. RESULTS: Data analysis showed a significant reduction in perceived stress levels within groups (p=0.038). However, there was no significant difference between the study groups (p=0.750). Participants in the intervention group reported a greater perception of changes than participants in the placebo group, but without statistical significance (p=0,089). CONCLUSION: The floral formula was not more effective than the placebo formula in reducing perceived stress. There was a significant stress reduction among nursing professionals in both study groups, although with a small effect size.

[Problem-solving in the Indigenous Health Care Subsystem (SASI-SUS): analysis in a reference service in Amazonas, Brazil]. / Resolutividade no Subsistema de Atenção à Saúde Indígena (SASI-SUS): análise em um serviço de referência no Amazonas, Brasil.

Problem-solving is one of the principles of the Unified Health System (SUS) in Brazil, with its ability to solve the health problems of the population at different levels of complexity. The Indigenous Health Care Subsystem (SASI-SUS) is part of this service, respecting the specificities of indigenous populations. The scope of this article is to analyze the perception of professionals and managers of an Indigenous Health Center (CASAI) regarding its ability to cope with the circumstances of the pandemic. It involved qualitative and descriptive research under the National Health Care Policy for Indigenous Peoples (PNASPI) and Paul Ricoeur's hermeneutic theory. Interviews were conducted with participants in order to record the experiences in the work process of the actors who assist the indigenous people housed at CASAI. Four essential themes were identified in the interviews: cultural care; permanent education in health & health education; negotiation & improvisation; and reception & infrastructure. CASAI is an institution that is more than a support center or accommodation, being a crossover point between the different levels of care and knowledge production of the indigenous people, as well as a place for establishing a relationship, resulting in a problem-solving space.

A resolutividade é um dos princípios do Sistema Único de Saúde (SUS) no Brasil, com sua capacidade de resolver os problemas da população nos diferentes níveis de complexidade da saúde. O Subsistema de Atenção à Saúde Indígena (SASI-SUS) integra este sistema, respeitando as especificidades das populações indígenas. O objetivo deste artigo é analisar a percepção dos profissionais e gestores de uma Casa de Saúde Indígena (CASAI) a respeito da resolutividade no subsistema quanto às circunstâncias da pandemia. Pesquisa qualitativa, de caráter descritivo, à luz da Política Nacional de Atenção à Saúde dos Povos Indígenas (PNASPI) e da teoria hermenêutica de Paul Ricoeur. Foram realizadas entrevistas entre os participantes a fim de registrar as experiências no processo de trabalho dos atores que cuidam dos indígenas referenciados à Manaus, Amazonas. Foram identificadas, pelas entrevistas, quatro temáticas essenciais: cuidado cultural; educação permanente em saúde & educação em saúde; negociação & improviso e; acolhimento & infraestrutura. A CASAI é uma instituição que vai além de um centro de apoio ou alojamento, sendo ponto de articulação entre os diferentes níveis de atenção aos indígenas e local de produção de cuidados e de saberes, tal como da construção de suas relações, resultando em um espaço resolutivo.

Evaluation of acupuncture and auriculotherapy in the control of chemotherapy-induced nausea and vomiting: a Pilot Study.

OBJECTIVE: To evaluate the effectiveness of acupuncture and auriculotherapy protocol in relieving chemotherapy-induced nausea and vomiting in cancer patients compared to the antiemetic protocol. METHOD: Pilot study of a pragmatic two-arm clinical trial: an acupuncture group received systemic acupuncture, auriculotherapy, and antiemetic protocol; a control group used antiemetic protocol. The sample consisted of 42 patients with cancer of the gastrointestinal system or multiple myeloma. The outcome was assessed using the Chemotherapy-Induced Nausea and Vomiting Assessment Tool and the patient's diary. RESULTS: There was no statistically significant difference between groups according to the assessment of the patient's diary and the Assessment Tool of chemotherapy-induced nausea and vomiting. The patients were 60 years old on average and the groups were homogeneous, except for marital status. In the diary, there was no statistical difference between groups and sessions for days of nausea (p = 0.873) and vomiting episodes (p = 0.993). CONCLUSION: The protocol of acupuncture and auriculotherapy as a complementary treatment of chemotherapy-induced nausea and vomiting was ineffective, considering the limitations of the study.

Membranophone percussion instruments in music therapy with adult patients in the health context: a scope review.

OBJECTIVE: To map scientific knowledge about the use of percussion instruments in music therapy in individuals over 18 years of age in the health context. METHOD: Scope review with search strategy implemented in September 2021, in 13 databases, using indexed descriptors and keywords. Studies on the use of membranophones for care of people over 18 years of age were included. Studies with the participation of pregnant women, psychiatric patients (schizophrenia, psychosis, addiction), or people with hearing impairment, and journal editorials were excluded. The selection process was carried out by two independent researchers. RESULTS: Thirteen studies were included and the results showed that the membranophones have a positive impact on the physical, psychological, and social health of people in different care environments, and allow them to repeat rhythmic patterns and play music. Active music therapy was the strategy predominantly used in interventions, and the most used membranophone was the djembe. CONCLUSION: The results suggest that music therapy with membranophones proved to be a viable intervention with beneficial results in improving physical, psychological, and social health of people over 18 years of age.

[Perception of orthognathic surgery patients on postoperative care]. / Percepção dos pacientes submetidos à cirurgia ortognática sobre o cuidado pós-operatório.

Patient's anxiety and worry due to a lack of knowledge about the orthognathic surgery motivated the development of this study. The objective was to identify information needs of postoperative patient undergoing orthognathic surgery. It's an exploratory and qualitative research that used the focus group to collect the dada. Postoperative patients of orthognathic surgery from an oral and maxillofacial surgery and trauma ambulatory were invited to participate in the group. Through content analysis it was possible to identify the following problems related to the postoperative procedure: long recovery time, nutrition, oral hygiene, relief of postoperative signs and symptoms. Themes involving self-image and satisfaction levels related to the outcome of the surgery were also recognized pointing out the need of future studies to explore these issues.

[Microorganisms of the Coccidia subclass: resistance and implications for the aseptic processing of healthcare products]. / Micro-organismos da subclasse Coccidia: resistência e implicações para o processamento de materiais de assistência à saúde.

This theoretical study proposes a reflection on the intrinsic resistance of the subclass Coccidia, particularly the genus Cryptosporidium, considered to be potential pathogens for immunocompromised patients, and the implications for nursing practice. Currently, the international and national guidelines support the chemical disinfection of digestive system endoscopes after their cleansing as a safe and effective procedure. However, studies show that microorganisms of the subclass Coccidia, namely Cryptosporidium, responsible for enteric infection, are more resistant than mycobacteria and are not inactivated by high-level disinfectants, except for hydrogen peroxide 6% and 7.5%, which are not currently available in Brazil. We conclude that the legislation should include this agent among test microorganisms for approving high-level disinfectants. Health authorities should make efforts to ensure that healthcare institutions have access to effective disinfectants against Cryptosporidium.

[Attitudes of nursing staff related to the nursing process]. / Atitudes dos profissionais de enfermagem relacionadas ao Processo de Enfermagem.

The aims of the study were to describe nurses' positions on nursing process and their perception of power; and to analyse associations between positions on nursing process, power perception and selected variables. One thousand six hundred and five nurses (86.9% female, mean age=44.12 years, SD=9.55) participated in the study. Mean score on the Positions on Nursing Process (PNP) tool was 112.37 (SD=22.28); and on the Power as Knowing Participation in Change Tool - Brazilian Version (PKPCT) was 281.12 (SD=38.72). Baccalaureate nurses had statistically higher scores on PNP and PKPCT than auxiliary nurses. There was positive and moderate correlation between PNP and PKPCT scores. Auxiliary nurses' scores on PNP were associated with sex and post-graduation; auxiliary nurses' scores on PKPCT were associated with sex. For baccalaureate nurses there was association between PKPCT and administrative position. More studies should be developed in order to identify variables potentially associated with the use of nursing process in clinical practice.

[Education in operating room nursing: transformation of the discipline at University of São Paulo School of Nursing (Brazil)]. / Ensino de enfermagem em centro cirúrgico: transformações da disciplina na Escola de Enfermagem da USP (Brasil).

The objectives of this paper are to present a summary of the evolution of the content of perioperative nursing at the University of São Paulo School of Nursing (EEUSP) and reflect on the National Curriculum Directives (NCD) for the nursing course. The study was developed from a brief history of the practice of perioperative nursing and the inclusion of this topic in the nursing curriculum at EEUSP. The National Curriculum Directives are important because they permit undergraduate schools to determine the amount of teaching time for each course that will comprise their curriculum, but the competencies and skills proposed are nonspecific. We believe that the general nurse should have theoretical and practical learning opportunities to work in every area and level of healthcare.

Usability assessment of a mobile app for patients with peripherally inserted central catheters.

OBJECTIVE: to evaluate usability of the Meu PICC (My PICC) app for follow-up of outpatients using peripherally inserted central catheters through the validated System Usability Scale instrument. METHOD: a cross-sectional study that applied the System Usability Scale to 30 patients using peripherally inserted central catheters, ten nurses and eight Information and Communication Technology professionals to assess usability of the app. RESULTS: a statistical difference was observed between age and usability (p=0.006), as well as a negative correlation between app use time and usability (p=0.002). As per the System Usability Scale adjectival classification, 40.0% and 33.3% of the patients considered the app as the best possible to be imagined and as excellent, respectively. In relation to the nurses, 70.0% considered the app as the best possible to be imagined and 20.0% as excellent; of the Information and Communication Technology professionals, 50.0% considered the app as the best possible to be imagined and the other 50.0%, as excellent. CONCLUSION: the usability assessment showed that patients, nurses and ICT professionals considered the app useful for monitoring patients using PICCs and evaluated it as appropriate, evaluating it as the best possible to be imagined or as excellent. These results corroborate use of the Meu PICC app in the monitoring of outpatient use of PICCs.