Care bundle for family interview for pediatric organ donation.

PURPOSE: to develop a care bundle for best practices in conducting the family interview for organ and tissue donation with the families of children and adolescents. DESIGN AND METHODS: methodological study, with a qualitative approach, developed in Brazil, in three stages: literature review, qualitative study with professionals and family members, and development of the care bundle. RESULTS: Nine studies were selected and 17 health professionals and nine family members were interviewed. With this data, the care bundle was developed in three categories: communication of death, emotional support and information about organ and tissue donation. The recommendations were evaluated by five external professionals and all of them assessed the bundle as having the highest possible quality. CONCLUSIONS: the care bundle was built following the stages of integrative literature review and interviews with professionals working in this scenario and family members who have already gone through a family interview for organ and tissue donation of children and adolescents. PRACTICE IMPLICATIONS: the use of this material is seen as an important resource to support the professional during the conduction of the family interview in a scenario as sensitive and challenging as the care to family members facing death and the decision of organ and tissue donation of children and adolescents. Furthermore, the care bundle can increase the quality of family interviews and impact the reduction of family refusals. DESCRIPTORS: Practice Guideline as Topic. Tissue and Organ Procurement. Patient Care Team. Nursing. Pediatrics. Communication.

Using the Chat Generative Pre-trained Transformer in academic writing in health: a scoping review.

OBJECTIVE: to map the scientific literature regarding the use of the Chat Generative Pre-trained Transformer, ChatGPT, in academic writing in health. METHOD: this was a scoping review, following the JBI methodology. Conventional databases and gray literature were included. The selection of studies was applied after removing duplicates and individual and paired evaluation. Data were extracted based on an elaborate script, and presented in a descriptive, tabular and graphical format. RESULTS: the analysis of the 49 selected articles revealed that ChatGPT is a versatile tool, contributing to scientific production, description of medical procedures and preparation of summaries aligned with the standards of scientific journals. Its application has been shown to improve the clarity of writing and benefits areas such as innovation and automation. Risks were also observed, such as the possibility of lack of originality and ethical issues. Future perspectives highlight the need for adequate regulation, agile adaptation and the search for an ethical balance in incorporating ChatGPT into academic writing. CONCLUSION: ChatGPT presents transformative potential in academic writing in health. However, its adoption requires rigorous human supervision, solid regulation, and transparent guidelines to ensure its responsible and beneficial use by the scientific community.

Donation and Equitable Access to Organ, Tissue, and Cell Transplants: A Brazilian Perspective on the Strategy and Plan of Action 2019-2030.

OBJECTIVE: To position the Brazilian Transplant System within the context of the 4 Strategic Lines of Action proposed by the Pan-American Health Organization. METHOD: A specialist analysis was conducted through comparative analyses of the 4 Strategic Lines of Action, objectives, and indicators outlined in the Action Plan, along with the donation and transplantation system in accordance with Brazilian transplantation law. Subsequent to an in-depth review of the document issued by the health authority, a series of meetings involving 8 specialists in organ donation and transplantation were conducted. During these meetings, discussions were carried out with the objective of numerically interpreting each strategy presented in the document, and recommendations constructed. RESULTS: Four strategies were evaluated and only 2 of them the third (81,3%) and the fourth (90%) do not achieve the indicators to complete the objective related to equitable access to organ, tissue, and cell transplants in Brazil. CONCLUSION: The recommendations developed carry importance, as they are innovative and contribute to the establishment of priorities when shaping public policies. The report not only highlights indicators that were not satisfactorily met but also provides insights into the recommendations formulated to improve those indicators that have already been achieved and to work toward achieving those that have not yet been realized. Additionally, these recommendations can justify actions and establish priorities for research efforts in the field.

Time Elapsed Between Cells, Tissues, and Organs Donation and Transplantation and Adverse Events Detection.

BACKGROUND: This study was designed to discuss the time elapsed between cell, tissue, and organ donation and transplantation and detection of adverse events notified in São Paulo, Brazil. METHODS: This is a descriptive study with a quantitative approach. Data were provided by the Transplant Center of the state of São Paulo from the "Individual notification form of adverse reactions in Biovigilance" between 2016 and 2019. Analysis was performed using descriptive statistics. RESULTS: Fifty-two notifications were analyzed, and 3 categories were formed: (1) adverse events detected on the same day of the transplant, 8; (2) adverse events detected between 1 week and 1.5 years after transplant, 40; and (3) adverse events detected 2 years after transplant, 4. CONCLUSION: The discussion on the topic is beginning; however, it is important. Clinical management of transplant recipients and comprehending what is considered an adverse event and the natural course of a patient's life can impact clinical decision-making, public policies, and patient safety research. This study highlights the need to investigate related factors to adverse events, especially the time between the transplant procedure and adverse event detection, to establish clinical guidelines.

Patient Undergoing Liver Transplantation: Challenges and Strategies in the Face of the COVID-19 Pandemic.

BACKGROUND: We aimed to identify the challenges and strategies experienced by patients undergoing liver transplantation during the COVID-19 pandemic. METHODS: This was a descriptive study with a qualitative approach conducted in a large liver transplant hospital in southern Brazil. RESULTS: The participants included liver transplant patients between the years 2011 and 2022. Data collection was performed using a semi-structured interview. Data analysis comprised approximation of information and calculation of percentages. RESULTS: A total of 23 patients participated. Challenges identified included an increased dependence on others for daily activities, fear and stress due to the possibility of contamination, and the need for isolation from family and friends. Strategies included adaptation to the daily routine, reorganization of tasks inside and outside the home, formation of a support network, and reduced attendance to consultations and exams. CONCLUSIONS: Evidence of anguish and suffering of patients facing isolation and separation from family members was observed. Still, the study revealed the strength and determination of the patients to create strategies for preventing the SARS-CoV-2 virus and caring for themselves and their families. The study demonstrates the need for support from the health team in the face of such a scenario.

Factors related to musculoskeletal pain of nurses in the hospital setting: cross-sectional study.

OBJECTIVE: To analyze the relationship between musculoskeletal pain and sociodemographic and labor variables of nurses in the hospital setting. METHOD: Cross-sectional, descriptive research, carried out from December/2019 to March/2020, with 83 nurses from a philanthropic hospital. Sociodemographic, labor, pain-related characteristics were assessed and analyzed with descriptive and inferential statistics. RESULTS: 75.9% had pain, tingling and numbness in the last year. Most affected regions: neck, upper back, and shoulders; 36% rated their pain as moderate and 14.6% severe; Nurses who work 8 hours a day, 40/44 hours a week and work at night, assessed their pain with greater intensity; there was a correlation between pain intensity and daily working hours (p = 0.046) and work shift (p = 0.029). CONCLUSION: Nurses feel musculoskeletal pain in several anatomical regions and its intensity is related to the training time and acting in nursing, shift and weekly workload.

Resilience and the reduction of occupational stress in Nursing.

OBJECTIVE: to analyze the association between resilience and occupational stress of Nursing professionals from a general hospital. METHOD: an observational, cross-sectional study involving 321 Nursing professionals. The data collected were: socio-demographic and labour variables, stress and resilience, analyzed with descriptive and inferential statistics. RESULTS: 54.5% of the participants presented moderate resilience and 36.4%, high; 73.5% were at risk of exposure to occupational stress; the relationship between psychological demands and professional category (p=0.009), between control over work and age (p=0.04), professional category (p<0.001), having a management position (p=0.009), being a specialist (p=0.006) and between social support and professional category (p<0.001), having a management position (p=0.03), daily working hours (p=0.03), being a specialist (p<0.001) were verified. There was an association between resilience Factor I - resolutions of actions and values and control over work (p=0.04) and social support (p=0.002). CONCLUSION: the Nursing professionals of a general hospital have moderate to high resilience which, associated with high control over their work and high social support, may contribute to the reduction of exposure to occupational stress.

Nursing Team Workload and the Apache Index of Gravity of Patients Post Liver Transplantation: A Cohort Study.

BACKGROUND: Liver transplantation is a complex treatment that demands a high workload from the nursing team. This study evaluated the nursing workload and its relationship with the severity of patients after liver transplantation. MATERIAL AND METHODS: A retrospective cohort study, with a review of 286 medical records of liver transplant patients from January 2014 to June 2018 in a hospital in southern Brazil was performed. Demographic and clinical characteristics were analyzed, as well as the outcome and the scores Model for End-Stage Liver Disease (MELD), Nursing Activity Score (NAS), and Acute Physiology and Chronic Health Evaluation IV (APACHE IV). RESULTS: Men represented 68.9% of the sample, the mean age was 57.6 years (±10), and the MELD and APACHE IV scores respectively showed means of 24.3 (±5.6) and 58.9 (±23.7). The length of stay in the intensive care unit was 5 days (range, 3-7) and mortality was 9.1%. There was a gradual reduction in the mean NAS in 24 hours (94.9 ± 18.5), 48 hours (87.2 ± 17.0), 72 hours (83.3 ± 19.6) and at discharge (82.3 ± 18.0). Associations of NAS with MELD (P ˂ .05), APACHE IV (P ˂ .001), length of stay in the intensive care unit (P ˂ .001), and death outcome (P ˂ .001) were observed. The greatest workload was in checking vital signs, water balance, and administrative tasks (P ˂ .001). CONCLUSIONS: The nursing workload in the postoperative period of liver transplantation exceeds what is recommended and is related to the severity of the patients.

Family Interview Evaluation for Organ Donation: Communication of Death and Information About Organ Donation.

BACKGROUND: The aim of this study was to identify variables related to organ donation that can contribute to the development of best practices in planning and conducting family interviews by health professionals. METHODS: This descriptive and prospective study of quantitative approach was conducted at 2 southern Brazil health institutions referenced in organ donation. Data collection occurred between 2018 and 2019 by health professionals who conduct family interviews using validated instruments that assessed the stages of the interview. Analysis was performed by means of the proportions of the studied variables associated with the donation authorization categories per the χ2 test. The significance level adopted was 0.05. RESULTS: The variables that presented the highest level of significance in the correlation with the prevalence of family authorization for organ donation included the following: communication with the family about the results of each test in the brain death diagnostic protocol; identification of whether the family understood the information about the death; presence of a member of the transplantation commission who had training to communicate information about organ donation; presence of a family member who had power to authorize the donation; and the interval between the communication of death and information about organ donation. CONCLUSIONS: The study presents important gaps that can be filled by health teams and hospitals in order to improve the welcoming and respect for families, as well as the organ donation rates. It is important to understand that each family is unique when facing mourning, and to distance the communication of death from the discussion about organ donation is an act of respect and empathy.

Nurses' stress and resilience before and after evaluation for hospital accreditation.

OBJECTIVES: to analyze and compare levels of stress and resilience in nurses before and after the assessment for maintenance of the Hospital Accreditation Certification. METHODS: quantitative, observational, and longitudinal research, with 53 nurses from a philanthropic hospital, in the Rio Grande do Sul. Data collected in two stages, March, and July 2019, before the assessment visit and 60 days after, using the Bianchi Stress Scale and Resilience Scale. Descriptive and analytical statistics were employed. RESULTS: the majority of participants showed an average stress level before and after the evaluation. The highest stress scores were related to Domains E (coordination of unit activities) and C (activities related to personnel administration). In both moments of the study, the participants had medium and high resilience. CONCLUSIONS: managing people, processes, and assistance are stressful activities in the Accreditation process and increase the nurses' stress levels.

Implementação de diário em terapia intensiva: percepção de familiares e da equipe de enfermagem / Implementación del diario en cuidados intensivos: percepción de la familia y del equipo de enfermería / Implementation of intensive care diary: perception of the family and the nursing team

Resumo Objetivo identificar a percepção de familiares e da equipe de enfermagem sobre a implementação de um diário de Unidade de Terapia Intensiva à rotina de cuidados do paciente crítico. Método estudo descritivo, qualitativo, realizado em uma Unidade de Terapia Intensiva (UTI) adulto, entre julho e outubro de 2022. Implementou-se um diário, com registros de familiares e da equipe de enfermagem. A percepção dos familiares foi identificada através de entrevistas, e a da equipe, por meio de roda de conversa. Utilizou-se análise temática de Minayo. O estudo foi aprovado por Comitê de Ética em Pesquisa. Resultados participaram nove familiares; emergiram as seguintes categorias: Benefícios da utilização do diário de UTI e Fatores que podem influenciar no uso do diário de UTI". A partir da roda de conversa, com cinco profissionais de enfermagem, evidenciaram-se as categorias: Melhora da conexão com paciente e família; O diário como fonte de informações e Aspectos éticos relacionados aos registros. Considerações finais e implicações para a prática os familiares e os profissionais de enfermagem consideraram o instrumento benéfico, tanto para familiares quanto para pacientes. Para sua implementação, fluxos bem estabelecidos sobre o uso e a aproximação da família são essenciais para subsidiar o processo e obter a adesão das partes envolvidas.

Resumen Objetivo identificar la percepción de los familiares y del equipo de enfermería sobre la implementación del diario de Unidad de Cuidados Intensivos en el cuidado rutinario del paciente crítico. Método estudio descriptivo y cualitativo, realizado en una Unidad de Cuidados Intensivos (UCI) de adultos, entre julio y octubre de 2022. Se implementó un diario, con registros de los familiares y del equipo de enfermería. La percepción de los familiares fue identificada a través de entrevistas y la percepción del equipo a través de una rueda de conversación. Se utilizó el análisis temático de Minayo. El estudio fue aprobado por el Comité de Ética en Investigación. Resultados participaron nueve familiares; surgieron las siguientes categorías: Beneficios del uso del diario de UCI y Factores que pueden influir en el uso del diario de UCI. De la rueda de conversación, con cinco profesionales del equipo de enfermería, se destacaron las categorías: Mejora de la conexión con el paciente y la familia; El diario como fuente de información y Aspectos éticos relacionados con los registros. Consideraciones finales e implicaciones para la práctica los familiares y profesionales de enfermería consideraron beneficioso el instrumento, tanto para los familiares como para los pacientes. Para su implementación, son esenciales flujos bien establecidos sobre el uso y el alcance familiar para respaldar el proceso y obtener la aceptación de las partes involucradas.

Abstract Objective to identify the perception of family members and the nursing team regarding the implementation of an Intensive Care Unit diary into the routine care of critically ill patients. Method descriptive and qualitative study, carried out in an adult Intensive Care Unit (ICU), between July and October/2022. A diary was implemented, with records from family members and the nursing team. The family members' perception was identified through interviews, and the team's perception was identified through a conversation circle. Minayo thematic analysis was used. The study was approved by the Research Ethics Committee. Results nine family members participated; the following categories emerged: Benefits of using the ICU diary and Factors that may influence the use of the ICU diary. From the conversation circle, with five professionals from the nursing team, the categories were highlighted: Improved connection with patient and family; The diary as a source of information and ethical aspects related to records. Final considerations and implications for practice family members and nursing professionals considered the instrument beneficial, both for family members and patients. To support its implementation, well-established flows on use and family outreach are essential to support the process and obtain buy-in from the parties involved.

Using the Chat Generative Pre-trained Transformer in academic writing in health: a scoping review / Uso del Chat Generative Pre-trained Transformer en la escritura académica en salud: una revisión de alcance / Uso do Chat Generative Pre-trained Transformer na escrita acadêmica em saúde: uma revisão do escopo

Objective: to map the scientific literature regarding the use of the Chat Generative Pre-trained Transformer, ChatGPT, in academic writing in health. Method: this was a scoping review, following the JBI methodology. Conventional databases and gray literature were included. The selection of studies was applied after removing duplicates and individual and paired evaluation. Data were extracted based on an elaborate script, and presented in a descriptive, tabular and graphical format. Results: the analysis of the 49 selected articles revealed that ChatGPT is a versatile tool, contributing to scientific production, description of medical procedures and preparation of summaries aligned with the standards of scientific journals. Its application has been shown to improve the clarity of writing and benefits areas such as innovation and automation. Risks were also observed, such as the possibility of lack of originality and ethical issues. Future perspectives highlight the need for adequate regulation, agile adaptation and the search for an ethical balance in incorporating ChatGPT into academic writing. Conclusion: ChatGPT presents transformative potential in academic writing in health. However, its adoption requires rigorous human supervision, solid regulation, and transparent guidelines to ensure its responsible and beneficial use by the scientific community.

Objetivo: mapear la literatura científica sobre el uso del Chat Generative Pre-trained Transformer , ChatGPT, en la escritura académica en salud. Método: se trató de una revisión de alcance, siguiendo la metodología del JBI. Se incluyeron bases de datos convencionales y literatura gris. La selección de los estudios se realizó previa eliminación de duplicados y evaluación individual y en pares. Los datos se extrajeron basándose en un guión elaborado y se presentaron en un formato descriptivo, tabular y gráfico. Resultados: el análisis de los 49 artículos seleccionados reveló que ChatGPT es una herramienta versátil, que contribuye a la producción científica, descripción de procedimientos médicos y elaboración de resúmenes alineados con los estándares de las revistas científicas. Se ha demostrado que su aplicación mejora la claridad de la redacción y beneficia áreas como la innovación y la automatización. También se observaron riesgos, como la posibilidad de falta de originalidad y cuestiones éticas. Las perspectivas futuras resaltan la necesidad de una regulación adecuada, adaptación ágil y búsqueda de un equilibrio ético en la incorporación del ChatGPT a la escritura académica. Conclusión: ChatGPT presenta un potencial transformador en la escritura académica en el área de la salud. Sin embargo, su adopción requiere una supervisión humana rigurosa, una regulación sólida y directrices transparentes para garantizar su uso responsable y beneficioso por parte de la comunidad científica.

Objetivo: mapear a literatura científica referente ao uso do Chat Generative Pre-trained Transformer , ChatGPT, na escrita acadêmica em saúde. Método: tratou-se de uma revisão de escopo, seguindo o método do JBI. Foram incluídas bases de dados convencionais e literatura cinzenta. A seleção dos estudos foi realizada após a remoção de duplicatas e avaliação individual e em pares. Os dados foram extraídos com base em um roteiro elaborado, e apresentados de forma descritiva, tabular e gráfica. Resultados: a análise dos 49 artigos selecionados mostrou que o ChatGPT é uma ferramenta versátil, que contribui para a produção científica, descrição de procedimentos médicos e elaboração de resumos alinhados aos padrões das revistas científicas. Sua aplicação melhorou a clareza da redação e beneficia áreas como inovação e automação. Também foram observados riscos, como a possibilidade de falta de originalidade e questões éticas. Perspectivas futuras destacam a necessidade de regulamentação adequada, adaptação ágil e busca por um equilíbrio ético na incorporação do ChatGPT na escrita acadêmica. Conclusão: o ChatGPT apresenta um potencial transformador na escrita acadêmica na área da saúde. Contudo, sua adoção requer supervisão humana rigorosa, regulamentação sólida e diretrizes transparentes para garantir seu uso responsável e benéfico pela comunidade científica.

Mobile game: educational technology for home care of patients undergoing liver transplantation / Juego móvil: tecnología educativa para la atención domiciliaria de patients sometidos a trasplante de hígado / Mobile game: tecnologia educacional para cuidados domiciliares do paciente submetido ao transplante hepático

ABSTRACT Objective: to develop and validate an educational game capable of supporting health education actions for patients undergoing liver transplantation. Method: this is a study of a technological product, based on the User-Centered Design framework, carried out in a reference hospital for liver transplantation. Participants were patients undergoing liver transplantation, nurses and information technology professionals. Data collection took place through semi-structured interviews and a questionnaire, using Brazilian standards for usability assessment. Data analysis occurred through content analysis, based on the calculation model for the System Usability Scale. Results: seventeen patients participated, including seven nurses and four information technology professionals. The game is made up of five paths with the main care to be carried out at home. Each path presents steps to be followed with its rules. As for validation, the overall mean was 1.38. Usability assessment by patients had a mean of 80 points, while by professionals it was above 75%. Conclusion: it is considered that the aforementioned tool is capable of being used in practice by users. Furthermore, this was adjusted to meet the needs of patients undergoing liver transplantation to support and manage home care.

RESUMEN Objetivo: desarrollar y validar un juego educativo capaz de apoyar acciones de educación en salud para pacientes sometidos a trasplante de hígado. Método: estudio de un producto tecnológico, basado en el marco del Diseño Centrado en el Usuario, realizado en un hospital de referencia para trasplante hepático. Los participantes fueron pacientes sometidos a trasplante de hígado, enfermeras y profesionales de tecnologías de la información. La recolección de datos se realizó a través de entrevistas semiestructuradas y cuestionario, utilizando estándares brasileños para la evaluación de la usabilidad. El análisis de los datos ocurrió a través del análisis de contenido, basado en el modelo de cálculo de la System Usability Scale. Resultados: participaron 17 pacientes, entre ellos siete enfermeras y cuatro profesionales de tecnologías de la información. El juego se compone de cinco recorridos cuyo cuidado principal se realizará en casa. Cada camino presenta pasos a seguir con sus reglas. En cuanto a la validación, la media general fue de 1,38. La valoración de la usabilidad por parte de los pacientes tuvo una media de 80 puntos, mientras que la de los profesionales superó el 75%. Conclusión: se considera que la herramienta antes mencionada es susceptible de ser utilizada en la práctica por los usuarios. Además, esto se ajustó para satisfacer las necesidades de los pacientes sometidos a trasplante de hígado para apoyar y gestionar la atención domiciliaria.

RESUMO Objetivo: desenvolver e validar jogo educativo capaz de subsidiar ações de educação em saúde ao paciente submetido ao transplante hepático. Método: estudo de produto tecnológico, sustentado no referencial doDesign Centrado no Usuário, realizado em hospital de referência em transplante hepático. Participantes foram pacientes submetidos ao transplante hepático, enfermeiros e profissionais da tecnologia da informação. A coleta de dados ocorreu por meio de entrevista semiestruturada e questionário, utilizando as normas brasileiras para avaliação da usabilidade. A análise dos dados ocorreu por meio de análise de conteúdo, com base no modelo de cálculo para a escala de System Usability Scale. Resultados: participaram 17 pacientes, dos quais, sete enfermeiros e quatro profissionais da tecnologia da informação. O jogo é formado por cinco caminhos com os principais cuidados a serem desenvolvidos em domicílio. Cada caminho apresenta etapas a serem seguidas com suas regras. Quanto à validação, a média geral foi de 1,38. A avaliação da usabilidade pelos pacientes teve média de 80 pontos, já pelos profissionais foi acima de 75%. Conclusão: considera-se que a referida ferramenta está apta para ser usada na prática pelos usuários. Ainda, essa foi ajustada para atender às necessidades dos pacientes submetidos ao transplante hepático para apoiar e gerenciar os cuidados em domicílio.

Nursing interventions for preventing pressure ulcers in the perioperative period / Intervenciones de enfermería para prevenir lesiones por presión en el periodo perioperatorio / Intervenções de enfermagem para prevenção de lesão por pressão no perioperatório

Objective: To identify risk factors and nursing interventions for preventing pressure ulcers in perioperative patients. Method: This is an integrative literature review, for which data were collected in the following databases: Web of Science, Latin American and Caribbean Health Sciences Literature (LILACS), and National Library of Medicine (Medline). Data collection took place between July and August 2022. Original articles, without language restrictions and related to the research topic, were included. Thematic analysis was used for data processing. Results: Based on the analysis of the 16 publications that composed the corpus of this study, two categories were listed: a) risk factors for developing pressure ulcers in patients in the perioperative period; b) nursing interventions to prevent pressure ulcers. Conclusion: Risk factors for developing pressure ulcers are: being an older adult, malnourished or overweight, and comorbidities such as diabetes mellitus, vasculopathy, neuropathy, among others. Nursing interventions include: asses-sing risks using scales, such as ELPO and Munro, performing appropriate surgical positioning, protecting bone spurs, and planning unique patient care. (AU)

Objetivo: identificar factores de riesgo e intervenciones de enfermería para prevenir lesiones por presión en pacientes perioperatorios. Método: se trata de una revisión integradora, para la cual se recolectaron datos en las siguientes bases de datos: Web of Science, Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS), Biblioteca Nacional de Medicina (MEDLINE). Recopilación realizada entre julio y agosto de 2022. Se incluyeron artículos originales, sin restricción de idioma, relacionados con el tema de investigación. Se utilizó el análisis temático para procesar los datos. Resultados: A partir del análisis de las 16 publicaciones que constituyeron el corpus de este estudio, se enumeraron dos categorías: a) factores de riesgo para el desar-rollo de lesiones por presión en pacientes en el período perioperatorio; b) intervenciones de enfermería para prevenir las lesiones por presión. Conclusión: se consideran factores de riesgo para el desarrollo de lesiones por presión: ser anciano, estar desnutrido o con sobrepeso, comorbilidades como diabetes mellitus, vasculopatía, neuropatía, entre otras. Las intervenciones de enfermería incluyen: evaluación de riesgos mediante escalas como ELPO y Munro, realización de un posicionamiento quirúrgico adecuado, protección de protuberancias óseas y planificación de cuidados únicos al paciente. (AU)

Objetivo: Identificar fatores de risco e as intervenções de enfermagem para a prevenção de lesão por pressão em pacientes no perioperatório. Método: Trata-se de revisão integrativa, para a qual os dados foram coletados nas bases: Web of Science, Literatura Latino-americana e do Caribe em Ciências da Saúde (LILACS) e National Library of Medicine (Medline). Coleta realizada entre julho e agosto de 2022. Incluídos artigos originais, sem res-trição de idioma, relacionados à temática de investigação. Utilizou-se análise temática para tratamento dos dados. Resultados: Com base na análise das 16 publicações que compuseram o corpus deste estudo, foram elencadas duas categorias: a) fatores de risco para o desenvolvimento de lesão por pressão em pacientes no período perioperatório; b) intervenções de enfermagem para prevenir lesões por pressão. Conclusão: São considerados fatores de risco para o desenvolvimento de lesão por pressão: ser idoso, apresentar desnutrição ou sobrepeso, comorbidades como diabetes mellitus, vasculopatia, neu-ropatia, entre outros. As intervenções de enfermagem compreendem: avaliar os riscos por meio de escalas como a Elpo e a Munro, realizar o posiciona-mento cirúrgico adequado, proteger saliências ósseas e planejar o cuidado singular ao paciente. (AU)

Atuação de técnicos de enfermagem na prevenção de pneumonia associada à ventilação mecânica: estudo qualitativo / Actuación de técnicos de enfermería en prevención de neumonía asociada a la ventilación mecánica: estudio cualitativo / Role of nursing technicians in the prevention of pneumonia associated with mechanical ventilation: qualitative study

Objetivo: descrever a percepção do técnico de enfermagem e a sua atuação no bundle de prevenção de pneumonia, associada à ventilação mecânica em Unidade de Terapia Intensiva. Método: estudo descritivo e qualitativo, realizado com técnicos de enfermagem de uma Unidade de Terapia Intensiva Adulto de Porto Alegre. Coleta dos dados realizada por meio de entrevistas gravadas, seguindo roteiro semiestruturado. Dados analisados sob a ótica da análise temática de Minayo. Resultados: participaram 40 técnicos de enfermagem, em queemergiram quatro categorias: a) atuação do Técnico de Enfermagem no bundle de prevenção de Pneumonia Associada à Ventilação Mecânica (PAVM); b) itens que compõem o bundle de prevenção de PAVM; c) fragilidades na implantação do bundle de prevenção de PAVM; d) educação continuada sobre PAVM. Considerações finais: participantes conhecem as medidas de prevenção, reconhecem sua importância e as executam direta e indiretamente. A equipe utiliza um mnemônico próprio para memorização dos itens do bundle.

Objetivo: describir la percepción del técnico de enfermería en cuanto a su actuación en el Bundle de prevención de neumonía asociada a la ventilación mecánica en Unidad de Terapia Intensiva. Método: estudio descriptivo, cualitativo, realizado con técnicos de enfermería de una Unidad de Terapia Intensiva Adulto de Porto Alegre. Recolección de datos realizada por medio de entrevistas grabadas, siguiendo guion semiestructurado. Datos analizados bajo la óptica del análisis temático de Minayo. Resultados: participaron 40 técnicos de enfermería. Surgieron cuatro categorías: a) actuación del Técnico de Enfermería en el bundle de prevención de neumonía asociada a la ventilación mecánica (NAVM); b) ítems que componen el bundle de prevención de NAVM; c) fragilidades en la implantación del bundle de prevención de NAVM; y d) educación continuada sobre NAVM. Consideraciones finales los participantes conocen las medidas de prevención, reconocen su importancia y las ejecutan directa e indirectamente. El equipo utiliza un mnemotécnico propio para memorizar los elementos de bundle.

Objective: to describe the perception of the nursing technician regarding their performance in the bundle of prevention of pneumonia associated with mechanical ventilation in an Intensive Care Unit. Method: a descriptive, qualitative study conducted with nursing technicians from an Adult Intensive Care Unit in Porto Alegre. Data collection performed through recorded interviews, following a semi-structured script. Data analyzed from the perspective of thematic analysis of Minayo. Results: the participants were 40 nursing technicians. Four categories emerged: a) the role of the Nursing Technician in the bundle for the prevention of ventilator-associated pneumonia (VAP); b) items that make up the bundle for the prevention of VAP; c) weaknesses in the implementation of the bundle for the prevention of VAP; and d) continuing education on VAP. Final considerations: participants know the prevention measures, recognize their importance and execute them directly and indirectly. The team uses its own mnemonic to memorize the bundle items.

Síndrome autoimune induzida por adjuvantes (ASIA) sinais e sintomas experienciados por mulheres / Implementation of an intravenous therapy team based on convergent-assistance research / Síndrome autoinmune inducido por adyuvante (ASIA) signos y síntomas experimentados por mujeres

Objetivo: Identificar sinais e sintomas experienciados por mulheres com síndrome autoimune induzida por adjuvantes (ASIA) devido ao uso de prótese mamária e os tratamentos realizados. Método: Estudo de campo de abordagem qualitativa realizado por meio de entrevistas online utilizan-do-se a técnica bola de neve. Incluíram-se 13 participantes. Resultados: A partir da análise dos dados, foram elencadas quatro categorias: conhecimento acerca da síndrome; sinais e sintomas; tratamento; e cuidados e implicações de Enfermagem. Identificaram-se mais de 120 sinais e sintomas, e o explante foi mencionado como tratamento definitivo por todas as entrevistadas. Os sinais e sintomas apresentados pelas participantes vão ao encontro do que é descrito pela literatura. Conclusão: Antes da descoberta da doença, as participantes realizaram tratamento com foco no alívio dos sintomas. Após o diag-nóstico, todas as mulheres procederam com o explante

Objective: To identify signs and symptoms experienced by women with autoimmune/inflammatory syndrome induced by adjuvants (ASIA) due to the use of breast implants and the treatments performed. Method: Field study with a qualitative approach carried out through online interviews using the snowball technique. 13 participants were included. Results: Based on data analysis, four categories were listed: knowledge about the syndrome; signs and symptoms; treatment; and nursing care and implications. Over 120 signs and symptoms were identified, and the explant was mentioned as a defi-nitive treatment by all interviewees. The signs and symptoms presented by the participants are in line with what is described in the literature. Conclusion:Before discovering the disease, the participants underwent treatment focused on symptom relief. After diagnosis, all women proceeded with the explant.Keywords: Autoimmune diseases. Prothesis implantation. Breast implantation. Silicones. Perioperative nursing

Objetivo: Identificar los signos y síntomas experimentados por mujeres con síndrome autoinmune inducido por adyuvantes (ASIA) debido al uso de implantes mamarios y los tratamientos realizados. Método: Estudio de campo con enfoque cualitativo realizado a través de entrevistas en línea utilizando la técnica de bola de nieve. Se incluyeron 13 participantes. Resultados: Con base en el análisis de los datos, se enumeraron cuatro categorías: conocimiento sobre el síndrome; signos y síntomas; tratamiento; y cuidados e implicaciones de enfermería. Se identificaron más de 120 signos y sínto-mas, y todos los entrevistados mencionaron el explante como tratamiento definitivo. Los signos y síntomas presentados por los participantes están en línea con lo descrito en la literatura. Conclusión: Antes de descubrir la enfermedad, los participantes realizaban un tratamiento enfocado en el alivio de los síntomas. Después del diagnóstico, todas las mujeres procedieron al explante

Implantação de time de terapia intravenosa a partir de pesquisa convergente-assistencia / Implementation of an intravenous therapy team based on convergent-assistance research / Implementación de un equipo de terapia intravenosa basado en investigación convergente-asistencial

Objetivo: Implantar um time de terapia intravenosa em um hospital de grande porte. Método: Estudo de abordagem qualitativa realizado a partir de encontros de grupo de convergência, utilizando o referencial metodológico da pesquisa convergente-assistencial. Foram realizadas entrevis-tas semiestruturadas, a apuração dos dados obtidos por meio da análise de conteúdo e a formação de três categorias, que originaram os assuntos para a capacitação dos profissionais. Resultados: Participaram nove enfermeiros e, após a realização de quatro encontros de capacitação, foi implantado um time de terapia intravenosa e desenvolvido documento norteador para a execução do trabalho. Conclusão: O estudo resultou na implantação do time de terapia intravenosa em um hospital de grande porte a partir da pesquisa desenvolvida e da experiência de trabalho dos enfermeiros que atuam na prá-tica assistencial. O referencial metodológico possibilitou aos enfermeiros serem ouvidos enquanto promotores da ação e implementadores da inovação.Palavras-chave: Infecção hospitalar. Cateteres de demora. Infecções relacionadas a cateteres. Segurança do paciente.

Objective: To implement an intravenous therapy team in a large hospital. Method: Qualitative study carried out based on convergence group meetings, using the methodological framework of convergent-assistance research. Semi-structured interviews were carried out, data were collected through content analysis and three categories were formed, which originated the subjects for the training of professionals. Results: Nine nurses par-ticipated in the research and, after four training meetings, an intravenous therapy team was implemented and a guiding document was developed for carrying out the work. Conclusion: The study resulted in the implementation of an intravenous therapy team in a large hospital based on the research developed and the work experience of nurses who work in care practice. The methodological framework allowed nurses to be heard as promoters of action and implementers of innovation.

Objetivo: Implementar un equipo de terapia intravenosa en un gran hospital. Método: Estudio cualitativo realizado a partir de reuniones de grupos de convergencia, utilizando el marco metodológico de investigación convergente-asistencial. Fueron realizadas entrevistas semiestructuradas, reco-gida de datos a través del análisis de contenido y la formación de tres categorías, que originaron los temas para la formación de profesionales. Resultados:Participaron nueve enfermeros y, después de cuatro reuniones de capacitación, se implementó un equipo de terapia intravenosa y se elaboró un docu-mento guía para la realización del trabajo. Conclusión: El estudio resultó en la implementación de un equipo de terapia intravenosa en un hospital de gran porte a partir de la investigación desarrollada y la experiencia laboral de los enfermeros que actúan en la práctica asistencial. El marco metodológico permitió que los enfermeros sean escuchados como promotores de la acción e implementadores de la innovación.

Biovigilância e notificação de eventos adversos na doação e transplante de órgãos: revisão sistemática / Biovigilancia y notificación de eventos adversos en la donación y trasplante de órganos: revisión sistemática / Biosurveillance and reporting of adverse events in organ donation and transplantation: a systematic review

Resumo Objetivo Sintetizar e avaliar criticamente as evidências científicas oriundas de estudos observacionais sobre sistemas de biovigilância e notificação de eventos adversos na doação e transplante de órgãos. Métodos Revisão sistemática de estudos observacionais seguindo as recomendações das Diretrizes Metodológicas (REBRATS) e Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Foram incluídos estudos primários e relatos de caso conduzidos sobre biovigilância e/ou eventos adversos na doação e/ou transplante de órgãos, sem restrição de data de publicação ou idioma. Foram utilizadas seis bases de dados eletrônicas para a realização das buscas na literatura científica: - Medical Literature Analysis and Retrieval System Online (MEDLINE) (via PubMed), Excerpta Medica Database (Embase), Web of Science, LILACS, Scopus e a biblioteca eletrônica Scielo. Realizou-se também busca de dados nas seguintes bases secundárias: Notify - World Health Organization (WHO), Organização Pan-Americana de Saúde (OPAS) e Google Scholar. Para a avaliação da qualidade dos estudos foi utilizada a ferramenta MINORS. Resultados Foram identificados 551 estudos, após as etapas de avaliação, foram incluídos oito deles para a revisão sistemática. Estes foram divididos entre resultados, processos e estratégias de prevenção de eventos adversos. Quanto a classificação da qualidade dos estudos, dois obtiveram classificação boa. Conclusão Os resultados apontam a ocorrência de eventos adversos ocorridos em alguma etapa do processo de doação e transplante de órgãos e tecidos, como: reações adversas relacionadas a medicamentos; neurotoxicidade; aumento do tempo de hospitalização; reintervenções cirúrgicas; queda; coma; óbito; falha ou perda do enxerto. Destaca-se que os eventos adversos possivelmente ainda são subnotificados.

Resumen Objetivo Sintetizar y evaluar críticamente las evidencias científicas provenientes de estudios observacionales sobre sistemas de biovigilancia y notificación de eventos adversos en la donación y trasplante de órganos. Métodos Revisión sistemática de estudios observacionales guiada por las recomendaciones de las Directrices Metodológicas (REBRATS) y Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Se incluyeron estudios primarios y relatos de caso realizados sobre biovigilancia o eventos adversos en la donación o trasplante de órganos, sin restricción de fecha de publicación o idioma. Se utilizaron seis bases de datos electrónicas para realizar las búsquedas en la literatura científica: Medical Literature Analysis and Retrieval System Online (MEDLINE) (via PubMed), Excerpta Medica Database (Embase), Web of Science, LILACS, Scopus y la biblioteca electrónica Scielo. También se realizó la búsqueda de datos en las siguientes bases secundarias: Notify - World Health Organization (WHO), Organización Panamericana de la Salud (OPS) y Google Scholar. Para evaluar la calidad de los estudios se utilizó la herramienta MINORS. Resultados Se identificaron 551 estudios y, luego de las etapas de evaluación, se incluyeron ocho en la revisión sistemática, que fueron divididos entre resultados, procesos y estrategias de prevención de eventos adversos. Respecto a la clasificación de la calidad de los estudios, dos obtuvieron una clasificación buena. Conclusión Los resultados indican casos de eventos adversos ocurridos en alguna etapa del proceso de donación y trasplante de órganos y tejidos, como: reacciones adversas relacionadas con medicamentos, neurotoxicidad, aumento del tiempo de hospitalización, reintervenciones quirúrgicas, caída, coma, fallecimiento, falla o pérdida del injerto. Se destaca que los eventos adversos probablemente aún son subnotificados.

Abstract Objective To synthesize and critically evaluate the scientific evidence from observational studies on biosurveillance systems and adverse event reporting in organ donation and transplantation. Methods Systematic review of observational studies following the recommendations of the Methodological Guidelines (REBRATS) and Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Primary studies and case reports on biosurveillance and/or adverse events in organ donation and/or transplantation, without restriction of publication date or language were included. Six electronic databases were used in the scientific literature search: Medical Literature Analysis and Retrieval System Online (MEDLINE) (via PubMed), Excerpta Medica Database (Embase), Web of Science, LILACS, Scopus and the electronic library Scielo. A data search was also performed in the following secondary databases: Notify - World Health Organization (WHO), Pan American Health Organization (PAHO) and Google Scholar. The MINORS tool was used to assess the quality of studies. Results 551 studies were identified, and after the evaluation steps, eight of them were included in the systematic review. These were divided into results, processes and strategies for preventing adverse events. Regarding the classification of the quality of studies, two obtained a good classification. Conclusion The results indicate the occurrence of adverse events at some stage of the organ and tissue donation and transplantation process, such as: adverse drug-related reactions; neurotoxicity; longer length of hospital stay; surgical reinterventions; falls; coma; death; graft failure or loss. The fact that adverse events are possibly still underreported is noteworthy.

Controle de materiais e instrumental cirúrgico no intraoperatório: percepção e estratégias utilizadas por instrumentadores / Control of materials and surgical instruments in the intraoperative period: perception and strategies used by surgical technologists

Objetivo: Conhecer as estratégias utilizadas por instrumentadores para o controle de materiais e instrumental cirúrgico no intraope-ratório. Método: Estudo descritivo e qualitativo, realizado em hospital privado. Participaram 13 instrumentadores cirúrgicos. Os dados foram coletados entre agosto e setembro de 2022 por meio de entrevistas gravadas em áudio. Como instrumento para coleta dos dados, utilizou-se um roteiro estruturado, contendo sete perguntas, e questões referentes ao perfil da amostra. Foram incluídos técnicos de enfermagem forma-dos, atuantes como instrumentadores cirúrgicos. Foram excluídos instrumentadores ausentes no período da coleta de dados. Os dados foram analisados por meio da análise de conteúdo. Resultados: Com base na análise dos dados, emergiram quatro categorias: protocolo de cirurgia segura; controle de materiais e instrumentais; desafios no seguimento do protocolo de cirurgia segura; facilitadores do seguimento do proto-colo de cirurgia segura. Conclusão: Pôde-se conhecer as estratégias utilizadas por instrumentadores cirúrgicos para o controle dos materiais dispostos na mesa de instrumentação durante o intraoperatório. Pressa de profissionais, falta de adesão e o não seguimento de rotinas insti-tucionais caracterizam-se como desafios para o seguimento das etapas do protocolo de cirurgia segura

Objective: To know the strategies used by surgical technologists to control materials and surgical instruments in the intraopera-tive period. Method: This qualitative descriptive study was carried out in a private hospital. A total of 13 surgical technologists participated in the research. Data were collected during audio-recorded interviews between August and September 2022. The data collection instrument was a structured questionnaire consisting of seven questions, as well as items related to the sample profile. We included trained nursing technicians, working as surgical technologists. Those who were absent during data collection were excluded. Data were analyzed by con-tent analysis. Results: The data analysis produced four categories: surgical safety checklist; control of materials and instruments; challenges in following the surgical safety checklist; facilitators to following the surgical safety checklist. Conclusions: The study allowed us to know the strategies used by surgical technologists to control the materials arranged on the instrument table during the intraoperative period. The haste of professionals, lack of adherence, and non-compliance with institutional routines are regarded as challenges in following the steps of the surgical safety checklis

Objetivo: Conocer las estrategias utilizadas por instrumentistas para el control de materiales e instrumental quirúrgico en el intraope-ratorio. Método: Estudio descriptivo y cualitativo, realizado en hospital privado. Participaron 13 instrumentistas quirúrgicos. Los datos fueron colectados entre agosto y septiembre de 2022 por medio de entrevistas grabadas en audio. Como instrumento para colecta de los datos, se utilizó um guion estructurado, conteniendo siete preguntas, y cuestiones referentes al perfil de la muestra. Fueon incluidos técnicos de enfermería egre-sados, actuantes como instrumentistas quirúrgicos. Fueron excluidos instrumentistas ausentes en el período de la colecta de datos. Los datos fue-ron analizados por medio del análisis de contenido. Resultados: Con base en el análisis de los datos, emergieron cuatro categorías: protocolo de cirugía segura; control de materiales e instrumentales; desafíos en el seguimiento del protocolo de cirugía segura; facilitadores del seguimiento del protocolo de cirugía segura. Conclusión: Se pueden conocer las estrategias utilizadas por instrumentistas quirúrgicos para el control de los materiales dispuestos en la mesa de instrumentación durante el intraoperatorio. Prisa de profesionales, falta de adhesión y el no seguimiento de rutinas institucionales se caracterizan como desafíos para el seguimiento de las etapas del protocolo de cirugía segura

Resiliência associada ao enfrentamento da dor musculoesquelética em profissionais da enfermagem / Resilience is associated with coping with musculoskeletal pain in nursing professionals

A dor musculoesquelética é um problema frequente nos profissionais da enfermagem e várias medidas vêm sendo pesquisadas a fim de diminui-la, entretanto, poucos estudos abordam a influência do aumento da resiliência desses profissionais no controle da sua dor. Desta maneira, o objetivo deste trabalho foi identificar associação entre resiliência e dor musculoesquelética, em diferentes regiões anatômicas, referida por profissionais de enfermagem. Trata-se de estudo observacional transversal com 321 profissionais de enfermagem. Foram utilizados questionário sociodemográfico e laboral, questionário nórdico de sintomas osteomusculares, escala analógica da dor e escala de resiliência. Para análise foi utilizado estatística descritiva e analítica, através dos testes Mann-Whitney U e Kruskal Wallis. Foi verificada relação da dor com características sociodemográficas, laborais e resiliência, analisadas. 261 (81,3%) afirmaram ter apresentado dor musculoesquelética no último ano e as regiões mais acometidas foram partes superior e inferior das costas s e ombros. Identificou-se associação entre intensidade da dor e dor musculoesquelética em todas as regiões corporais investigadas (p < 0,05), idade (p = 0,015), categoria profissional (p = 0,032), tempo de atuação na enfermagem (p = 0,003) e turno de trabalho (p = 0,012), e correlação entre resiliência e dor musculoesquelética no pescoço (p = 0,010) e quadril e coxas (p = 0,009). Sendo assim, a elevada resiliência está associada ao melhor controle da dor musculoesquelética, em especial, na região do pescoço, de enfermeiros.

Musculoskeletal pain is a frequent problem in nursing professionals, and several treatments have been researched to reduce it; however, few studies address the influence of increased resilience of these professionals in controlling their pain. Thus, this study aimed to identify an association between resilience and musculoskeletal pain reported by nursing professionals in different anatomical regions. This is a cross-sectional observational study with 321 nursing professionals. A sociodemographic and work questionnaire, a Nordic musculoskeletal symptoms questionnaire, an analog pain scale, and a resilience scale were used. Descriptive and analytical statistics were used for analysis, using the Mann-Whitney U and Kruskal Wallis tests. The relationships between pain and sociodemographic, work, and resilience characteristics were analyzed. 261 (81.3%) reported having had musculoskeletal pain in the last year, and the most affected regions were the upper and lower backs and shoulders. An association was identified between pain intensity and musculoskeletal pain in all investigated body regions (p < 0.05), age (p = 0.015), professional category (p = 0.032), length of experience in nursing (p = 0.003), and work shift (p = 0.012). A correlation was also observed between resilience and musculoskeletal pain in the neck (p = 0.010) and hip and thighs (p = 0.009). Thus, high resilience is associated with better control of musculoskeletal pain among nurses, especially in the neck region.