Concept analysis of Neonatal Near Miss.

OBJECTIVE: To analyze the concept of Neonatal Near Miss (NNM) using Walker and Avant's method. METHOD: This study employs conceptual analysis following Walker and Avant's model, involving concept selection, objective definition, identification of potential uses, determination of attributes, model case creation, additional case consideration, antecedent identification, consequent analysis, and empirical reference examination. To elucidate the concept, a scoping review was conducted across journals indexed in scientific databases such as Web of Science, EMBASE, SCOPUS, and MEDLINE/PubMed. RESULTS: The analysis encompassed 43 articles, revealing diverse definitions of neonatal near miss across different contexts. A comprehensive definition emerged from identified antecedents: risk of death, susceptibility to adverse outcomes, and potential adverse events. These antecedents were categorized into maternal conditions, neonatal conditions, and healthcare assistance. CONCLUSION: The analysis and definition of the NNM concept was successful, and its antecedents, attributes, and consequences were delineated. IMPLICATIONS: Identifying the risk factors associated with NNM cases may contribute to reducing infant morbidity and mortality and improving the quality of care, facilitating future research and improving the use of the NNM concept.

Effects of Educational Interventions on Maternal Self-efficacy and Childhood Diarrhea: A Randomized Clinical Trial.

OBJECTIVE: Diarrhea still causes high morbidity and mortality in children under five, requiring constant interventions. Thus, the study aims to evaluate the effects of educational technologies on maternal self-efficacy to prevent childhood diarrhea. METHODS: Randomized clinical trial carried out in Fortaleza, Ceará, Brazil, with four randomized groups of mothers of children under 5 years of age, as follows: control group (n = 61), group A (booklet, n = 60), group B (video, n = 60), and group AB (booklet and video, n = 60). From June to October 2015, data collection was carried out in three moments (the first in person and the others by telephone monitoring). RESULTS: All groups improved their self-efficacy after the intervention, with higher scores in the group AB (booklet and video). A statistically significant association was found between the occurrence of diarrhea and maternal self-efficacy in groups A (booklet) (p = 0.023) and AB (booklet and video) (p = 0.042) at the second moment of data collection. From the second moment to the third moment, the risk of diarrhea decreased in group A, from 12.8 to 1.3, and in group AB, from 8.5 to 1.1. CONCLUSION: The technologies used, isolated or combined, were effective in improving maternal self-efficacy and decreasing the occurrence of childhood diarrhea; therefore, they can be used by nurses as health education tools.

Patient safety in the administration of intramuscular medication in pediatrics: assessment of the nursing practice. / Segurança do paciente na administração de medicamento intramuscular em pediatria: avaliação da prática de enfermagem.

OBJECTIVE To evaluate the nursing care regarding the intramuscular medication administration procedure in pediatrics. METHODS It was an observational and quantitative study performed in a pediatric hospital located in the city of Fortaleza, in Ceará, Brazil. The data collection was carried out through the observation of 327 intramuscular medication administration procedures. An observational checklist composed by 25 steps was used to collect data. The performance of the 25 steps of the checklist was divided as follows: (1) five steps were applied before the procedure of intramuscular medication administration; (2) fourteen steps during the procedure; (3) six steps after the procedure. RESULTS It was found that none of the five steps carried out before the intramuscular medication administration procedure were satisfactory performed. Regarding the fourteen steps applied during the procedure, six of them were satisfactory performed (42.8%). With regards to the six steps applied after the procedure, three of them were satisfactory performed (50%). CONCLUSIONS Fragilities that negatively impact the intramuscular medication administration procedures in pediatric patients were identified in this study.

Residual volume in vials of antibiotics used in pediatrics.

OBJECTIVE: Quantifying residual volume contained in vials of antibiotics used in pediatrics. METHOD: This is an experiment involving samples from vials of antibiotics used in a pediatric hospital. Residual volume was identified by calculating the difference in weight measurement before and after the vials were washed. Evaluation of the residual volume difference in the vials was determined by the Wilcoxon non-parametric test for a sample and established at a significance level of 5%. RESULTS: 105 samples of antibiotics were selected. The correct use of the antibiotics oxacillin (88.57%) and ceftriaxone (94.28%) predominated with low residual values. The same did not occur for procaine benzylpenicillin + potassium benzylpenicillin, since a greater residual volume was discarded in 74.28% of the vials. CONCLUSION: We highlight the need for improvements in managing antibiotics in the institution under study, so that the excess volume of the antibiotics in the vials is used within the acceptable stable time. It is also necessary that the disposal of the residual volume be adequately disposed, since it presents a risk to public health and the environment. OBJETIVO: Quantificar o volume residual contido em frascos-ampola de antibióticos utilizados na pediatria. MÉTODO: Trata-se de um experimento com amostras de frascos-ampola de antibióticos utilizados em hospital pediátrico. O volume residual foi identificado calculando-se a diferença da aferição do peso antes e após a lavagem do frasco-ampola. A avaliação da diferença dos volumes residuais nos frascos-ampola foi determinada pelo teste não paramétrico de Wilcoxon para uma amostra e estabelecido o nível de significância de 5%. RESULTADOS: Foram selecionadas 105 amostras de antibióticos. Predominou o correto aproveitamento dos antibióticos oxacilina (88,57%) e ceftriaxona (94,28%), com baixos valores residuais. O mesmo não ocorreu com a benzilpenicilina procaína + potássica, pois em 74,28% dos frascos houve descarte de volume residual superior. CONCLUSÃO: Destaca-se a necessidade de melhorias na gestão dos antibióticos na instituição em estudo, para que o volume excedente do antibiótico em frasco-ampola seja aproveitado até o tempo de estabilidade permitido, assim como é necessário que haja a adequação da forma de descarte do volume residual, que apresenta risco à saúde pública e ao meio ambiente.

[Hygiene practices for patients with HIV/AIDS]. / Práticas de higiene para pacientes com HIV/AIDS.

The objective of this study was to analyze the scientific production on health interventions related to hygiene for adults with HIV/AIDS. An integrative literature review was performed using six databases in June 2013. The descriptors AIDS and Hygiene were used, in Portuguese, English or Spanish. A total of 682 articles were found and 16 were selected. Personal hygiene practices were identified, such as hand washing, showers, tooth brushing and quitting smoking. Food hygiene practices involved washing food and kitchen utensils, using treated water, conserving and cooking food. Environmental hygiene took into account raising domestic animals, control of disease vectors, household cleanliness, waste disposal and basic sanitation. In conclusion, these specific hygiene interventions can be applied to the general population and, especially, to people with HIV/AIDS, due to immunosuppression.

[Instruments of health literacy used in nursing studies with hypertensive elderly]. / Instrumentos de letramento em saúde utilizados nas pesquisas de enfermagem com idosos hipertensos.

This study aimed to analyze nursing research regarding the instruments used to evaluate health literacy in elderly hypertensive patients. This is an integrative literature review done in the databases LILACS, PubMed, CINAHL, Scopus, and Cochrane, in June 2013. The articles, electronically available, were selected for full-text review by nurses, who assessed health literacy of elderly with hypertension. Eight studies were selected for analysis and four different instruments were used in the research. The instruments were developed according to a methodology and they were all designed to evaluate the abilities of elderly regarding reading, numeracy, pronunciation and recognition of some health-related words. The nursing research analyzed in this study revealed the gaps in care related to measures aimed to increase patient's involvement in decision-making. Also, the instruments used for measuring health literacy showed limitations, and there is no gold standard test.

[Nursing: promoting the health of overweight children and adolescents in the school context]. / Enfermagem: promoção da saude de crianças e adolescentes com excesso de peso no contexto escolar.

The study aimed to analyze the nursing interventions related to the competencies of health promotion of overweight children and adolescents in the school context, in light of the Galway Consensus through an integrative review. Articles published between 1988 and June, 2013 were found in the databases CINAHL, SCOPUS, MEDLINE/PubMed, Cochrane, LILACS and SciELO. A total of 139 publications were obtained from indexed descriptors. Ten articles were selected after reading. The most evident competencies for health promotion were: catalyzing change, needs assessment and impact assessment. The highlights were activities of health education and partnerships with other health professionals and the families of students. It was found that the skills of health promotion developed by nurses can contribute to the adoption of healthy habits by overweight children and adolescents.

Social determinants and access to health services in patients with COVID-19: a cross-sectional study.

OBJECTIVE: To verify the association between social determinants of health and access to health services for COVID-19 patients. METHOD: Analytical, cross-sectional study, carried out in three states in the Northeast of Brazil (Ceará, Maranhão and Pernambuco), with 968 patients, using questionnaires with sociodemographic data, determinants and the Primary Care Assessment Tool, adapted to the reality of COVID-19, with 58 items, classified as high (score ≥ 6.6) and low (score < 6.6), whose high value reveals better standards of access to health services. The Chi-square test was used for comparative analysis. RESULTS: There was a significant difference (p < 0.05) between the domains of the instrument and the following determinants: age, skin color, body mass index, origin, schooling, employment, services close to home, first service, income and means of transport. CONCLUSION: Access to health services for people with COVID-19 was associated with various determinants, including individual, behavioural and social ones, correlated with the structural and organizational aspects of the health services offered by the three states of Northeastern Brazil.

Information booklet for promoting self-efficacy in childhood asthma: construction and validity.

OBJECTIVE: To construct and validate the content and appearance of an information booklet to promote self-efficacy of parents and/or caregivers in childhood asthma management and control. METHOD: This is a methodological study, developed from educational material elaboration, validity and assessment by 25 content judges and three technical judges. Language clarity, practical pertinence and theoretical relevance were used, calculating the Content Validity Coefficient (CVC) for validity, and the Suitability Assessment of Materials (SAM) instrument was applied for assessment. Judges were also able to make suggestions for modifications on each page of the booklet. Pages that reached a CVC ≥ 0.80 for content judges and CVC ≥ 0.70 for technical judges were considered validated. RESULTS: The total CVC of the booklet was 0.96 for content judges and 0.83 for technical judges. The educational material was considered superior according to the SAM, with a total score of 92.67% for content judges and 73.81% for technical judges. Changes were made to the booklet after the validity process, according to judges' suggestions, resulting in a second version. CONCLUSION: The information booklet is valid and has a high degree of recommendation for use with parents and/or caregivers in childhood asthma control and management.

Primary Health Care assessment in the COVID-19 pandemic from physicians' and nurses' perspective.

OBJECTIVES: to assess the operationalization of Primary Health Care in the COVID-19 pandemic, according to Primary Care Assessment Tool: PCATool-Brasil attributes, from physicians' and nurses' perspective. METHODS: a cross-sectional study, carried out with 99 physicians and nurses from Basic Health Units in a state in northeastern Brazil, with the aid of the adapted instrument PCATool-Brasil. RESULTS: Essential Score was classified as high performance (6.6) and General Score as low performance (6.5). First Contact Access, Care Integration, and Community Guidance scores were <6.6. The best performances were attributed to the Longitudinality, Comprehensiveness and Family Guidance services (scores>6.6). CONCLUSIONS: the attributes of Primary Health Care, in general, showed values above or close to the cut-off point in the assessment. These data can support strategies for local and national managers to strengthen Primary Health Care in the COVID-19 pandemic and future public health emergencies.

Analysis of the health advocacy concept from the perspective of the evolutionary method.

OBJECTIVE: To analyze the concept of Health Advocacy from the methodological framework of the Evolutionary Model. METHOD: The concept of interest was evaluated from the perspective of published studies identified in the databases: Web of Science, CINAHL, EMBASE, SCOPUS, MEDLINE and articles of interest. The attributes were determined from 19 scientific productions. Data were analyzed using thematic analysis, proposed by Bardin. RESULTS: The following operational definition was obtained: Health Advocacy is an intentional action, implemented jointly and in favor of individuals and communities, especially for those who suffer from health inequalities, with the aim of preserving and improving health, well-being and empowerment for health promotion. FINAL CONSIDERATIONS: Thus, a broader concept of Health Advocacy was abstracted, from the micro to the macro, which contemplates the development of the patient's autonomy; includes individuals and groups in care plans and involves them in political activities as possibilities to provide assistance and correct health inequalities.

Urinary incontinence in women: assessment with the aid of standardized nursing terminologies NANDA-I and NOC.

OBJECTIVES: to assess urinary impairment in incontinent women with the aid of standardized nursing terminologies NANDA-I and NOC. METHODS: a cross-sectional study, carried out with 97 women attending the gynecology outpatient clinic of a university hospital. Data collection took place using a form that contained information about NANDA-I diagnoses related to urinary incontinence and NOC Urinary Continence indicators. Statistical analysis was performed to assess the impairment of NOC indicators in the presence of NANDA-I nursing diagnoses. RESULTS: diagnosis Mixed Urinary Incontinence was the most prevalent (43.3%), and, in its presence, the most compromised indicators were voids in appropriate receptacle, gets to toilet between urge and passage of urine and empties bladder completely. CONCLUSIONS: urinary impairment was worse in women with elements of stress and urge urinary incontinence.

Skin injuries due to Personal Protective Equipment and preventive measures in the COVID-19 context: an integrative review. / Lesões de pele por Equipamentos de Proteção Individual e medidas preventivas no contexto da COVID-19: revisão integrativa.

OBJECTIVE: to identify the diverse scientific evidence on the types of skin lesions caused due to the use of Personal Protective Equipment in health professionals during the COVID-19 pandemic and to verify the recommended prevention measures. METHOD: this is an integrative review carried out in the MEDLINE, CINAHL, LILACS, SCOPUS, Science Direct, Web of Science and SciELO databases. The search was conducted in a paired manner, constituting a sample of 17 studies categorized according to the types of skin lesions and preventive measures. RESULTS: the main types of skin lesions related to mask use were stage 1 pressure ulcers, acne and cutaneous depression. Regarding the use of glasses and face shields, the most frequent were stage 1 and 2 pressure ulcers. Xerosis and irritant contact dermatitis occurred due to using gloves and protective clothing, respectively. The main preventive measures recommended were using hydrocolloid or foam dressing in the pressure regions, moisturizers and emollients. CONCLUSION: a considerable number of skin lesions associated with using the equipment were noticed, and the data obtained can guide the professionals in identifying risks and promoting preventive measures to avoid their occurrence.

Professional performance in the administration of medicines in pediatrics: a study cross-sectional observational.

OBJECTIVES: to evaluate Patient Safety actions carried out by nurses in the Administration of Medicines in Pediatrics. METHODS: observational, cross-sectional, quantitative study carried out in 2018, with 25 nurses from a Hospital in Peru. 183 observations were made; the instrument Safety of the patient was used in the administration of medicines in Pediatrics Spanish version. The performance of the professionals was evaluated by the Positivity Index. RESULTS: of 22 itens observed, five were adequate, five were safe, two were classified as borderline and ten as endurable among those who stand out; Bring to bed only medications prescribed for a single child and maintains an adequate record of prepared medications that will be stored. CONCLUSIONS: weaknesses were observed in the medication administration process, since only 10 itens were classified as safe or adequate, reinforcing the need for permanent education activities by the institution for nursing training.

[Nursing professionals' knowledge about erythropoietin]. / Conocimiento de los profesionales de enfermería sobre la eritropoyetina.

This study was performed with the objective to evaluate the knowledge that nursing professionals have about the process of preserving, preparing and administering erythropoietin (EPO). This exploratory, descriptive study used a quantitative approach. It was performed at a Dialysis Center, from January to March 2009, and consisted on applying a questionnaire to 40 nursing professionals. All ethical aspects were taken into consideration. About the interaction of EPO with the patients' blood pressure, 87.5% had inadequate knowledge; only 32% knew the ideal temperature to preserve the drug, and 52.5% believe that it should be removed from the refrigerator about 15 to 30 minutes before its administration; intravenous administration was the most reported. Among the care before the administration, the most frequent was checking the expiration date; 57.5% used exclusive syringe for the administration and 95% usually register having administered the drug.

[Nursing interventions for stroke patients: an integrative literature review]. / Intervenções de enfermagem aos pacientes com acidente vascular encefálico: uma revisão integrativa de literatura.

The objective of this study was to analyze the knowledge on nursing interventions for hospitalized stroke patients. An integrative literature review was performed by accessing five online databases, in September 2009. The descriptors used in the search were nursing care and stoke, in Portuguese, English and Spanish. A total 223 articles were found, and 12 were selected. It was found in the articles that there was a greater number of clinical nursing interventions, followed by educational, managerial and research interventions. Clinical interventions are more related to the biological aspects of patients. As to the educational interventions, the articles point at the fundamental role of nurses, as well as that of relatives and caregivers. The main managerial intervention was the coordination of health care. As for research interventions, only one was identified and described as the development and improvement of health care practice through clinical evidence.

Ineffective peripheral tissue perfusion in patients with diabetic foot: a mid-range theory.

OBJECTIVE: to develop a mid-range theory for nursing diagnosis ineffective peripheral tissue perfusion in patients with diabetic foot. METHOD: the theory construction was carried out in six stages: approach definition; theoretical-conceptual model definition; definition of the main concepts; pictogram development; construction of propositions and establishment of causal relationships evidence for practice. RESULTS: twelve etiological factors and 22 clinical indicators were included in the theory, some of which were not listed in NANDA International (Inc.) and others were adapted to better characterize patients with diabetic foot. A pictogram was constructed and eight propositions were established to verify causal relationships and evidence for practice. CONCLUSION: medium-range theory made it possible to broaden the concepts and demonstrate the causal relationships between the elements of ineffective peripheral tissue perfusion, providing subsidies to minimize gaps in knowledge and assist clinical nursing practice.

Training on intravenous medication administration in pediatric nursing: a before-after study.

OBJECTIVE: To evaluate the effect of training on intravenous medication administration in pediatric patients on nursing staff 's learning and response. METHOD: This is a quasi-experimental study (pre- and post-test), with 38 nursing professionals who participated in training on administration of intravenous (IV) medication in pediatric patients with heart disease. For data collection, a questionnaire with 19 items was applied to evaluate participants' learning before (pre-test) and after (post-test) training. Data were analyzed by descriptive and analytical statistics (binomial and Friedman tests). RESULTS: Nurses predominated (52.6%), mean age 41.2 years and 9.8 years of professional experience in pediatrics. For learning evaluation, there was an increase in the rate of hits from the pre-test to the post-test in 13 items, with a significant difference (p < 0.05) in the items: removing adornments to sanitize hands; wearing gloves when administering medication; administering medication with gloves, mask and goggles; and checking patient name by asking their companion. CONCLUSION: Training had positive effects on nursing professionals' learning and reaction.

Influence of social determinants of health on skin to skin contact between mother and newborn.

OBJECTIVE: to analyze the association of skin-to-skin contact and social determinants of health. METHODS: this is a cross-sectional study with 187 medical records of newborns from a reference rooming in in northeastern Brazil. An instrument with maternal and neonatal data was used. Analysis was descriptive and inferential statistics. For the associations, a chi-square test was used to measure strength, an Odds Ratio was calculated, with a 95% confidence interval. RESULTS: 62% of newborns who made skin-to-skin contact at birth were eutrophic, full-term, Apgar > 7, mothers with prenatal care and without abortion. The determinants associated with non-skin-to-skin contact were preterm (CR=3.2;95%CI: 2.72-18.98); 1st minute Apgar < 7 (CR:2.9;95%CI: 2.38-3.06), cesarean section (CR:8.4;95%CI: 4.29-16.57), and unhealthy NB (CR 12.7;95%CI: 4.9-32.67). We used STROBE guidelines. CONCLUSION: skin-to-skin contact was influenced by gestational age, Apgar, delivery, and newborn health.

Nursing training on the administration of medication in pediatrics: an assessment of observed and self-reported behavior.

OBJECTIVES: to evaluate the effect of a training program on the administration of intravenous drugs in pediatric patients on the observed and self-reported behavior of the nursing team. METHODS: evaluation study carried out with 38 professionals during three phases: Assessment of the behavior observed in the actions performed before training; Training implementation; and Assessment of observed and self-reported behaviors (immediately and six months after training). RESULTS: in the observed behavior, there was an improvement in six (6/12) hand hygiene actions; five (5/14) pertaining to environment Organization, selection, and preparation of materials; and in seven (7/10) referring to the Orientation of the procedure, administration and monitoring of the patient's reactions. In self-reported behavior, there was an improvement in two (2/8) actions. CONCLUSIONS: the training resulted in an improvement in the actions of nursing professionals related to the administration of intravenous medications, both in observed and in self-reported behavior.