Changes in quality of life associated with surgical risk in elderly patients undergoing cardiac surgery.

The study aims to verify quality of life of elderly patients submitted to cardiac surgery, and correlating surgical risk to health-related quality of life instrument domains. Prospective cohort study, performed at a cardiology hospital. It included elderly patients who had undergone elective cardiac surgery. Pre- and postoperative quality of life was evaluated by applying the World Health Organization Quality of Life-Old (WHOQOL-OLD) scale and the Short-Form Health Survey (SF-36) questionnaire. Surgical risk was stratified using the European System for Cardiac Operative Risk Evaluation (EuroSCORE). Fifty-four patients, mostly men (64.8%), were included, with a mean age of 69.3 ± 5.7 years. The eight domains of the SF-36 questionnaire, and the four facets presented for the WHOQOL-OLD scale showed improved quality of life 6 months after surgery (P < 0.001). No difference was found in the association of EuroSCORE with the domains of the health-related quality of life instruments. The data showed improved quality of life of elderly people submitted to cardiac surgery, unrelated to surgical risk.

Data Literacy and Data Science Literacy for Nurses: State of the Art Literature Review.

In the rapidly evolving landscape of modern healthcare, nurses must proficiently navigate data utilization and grasp the principles of data science. Despite this urgency, nursing stakeholders currently do not fully understand the extent of data literacy or data science literacy they need to acquire. This paper aims to elucidate the distinctions between data literacy and data science literacy, offering insights into strategies for nurturing these competencies within nursing education, research, and practice. Through a state-of-the-art review of 22 articles and six healthcare industry resources, we identified a notable absence of comprehensive frameworks and assessment tools, highlighting key areas for future development.

Effectiveness of nursing interventions in heart failure patients in home care using NANDA-I, NIC, and NOC.

OBJECTIVE: The objective of the study is to evaluate the effectiveness of nursing interventions (NIC) using nursing outcomes (NOC) and based on NANDA-I nursing diagnoses in patients with heart failure in home care. METHOD: In this longitudinal study, 23 patients with heart failure were followed for 6 months, in four home visits. During the visits, nursing diagnoses were established, outcomes assessed, and interventions implemented. RESULTS: Of the 11 NIC interventions implemented, eight proved effective, that is, showed significant improvement between the first and the fourth visit, according to scores obtained for six outcomes: knowledge: treatment regimen, knowledge: medication, compliance behavior, symptom control, activity tolerance, and energy conservation. CONCLUSION: NIC interventions health education, self-modification assistance, behavior modification, teaching: prescribed medication, teaching: disease process, nutritional counseling, telephone consultation, and energy conservation showed effective outcomes based on NOC scores, suggesting that the NANDA-I, NIC, and NOC linkage is useful in patients with heart failure in home care.

[Cross-cultural adaptation and validation of a questionnaire on what nurses know of heart failure]. / Adaptação transcultural e validação de um questionário de conhecimento sobre insuficiência cardíaca para enfermeiros.

This study aims to perform the cross-cultural adaptation and to verify the content validity and stability of Nurses' Knowledge of Heart Failure Education Principles to evaluate what Brazilian nurses know of heart failure. The process of cross-cultural adaptation involved translation, synthesis, back-translation, committee's proofreading and pre-test. The following psychometric properties were assessed content validity (face), reliability through internal consistency (Cronbach's Alpha) and stability (Kappa coefficient). After the cross-cultural adaptation, the instrument was applied to 54 nurses (27 from a cardiology hospital and 27 from a general hospital). The Cronbach's Alpha was 0.7. The questions 4, 5, and 11 presented a Kappa coefficient less than or equal to 0.4, and further questions presented a Kappa coefficient superior or equal to 0.7. This questionnaire was validated and proved to be adequate to assess the knowledge of this group of professionals.

[Consensus on nursing diagnoses, interventions and outcomes for home care of patients with heart failure]. / Consenso de diagnósticos, resultados e intervenções de enfermagem para pacientes com insuficiência cardíaca em domicílio.

This was a consensus study with six cardiology nurses with the objective of selecting nursing diagnoses, outcomes and interventions described by NANDA International (NANDA-I), Nursing Outcomes Classification (NOC), Nursing Intervention Classification (NIC), for home care of patients with heart failure (HF). Eight nursing diagnoses (NDs) were pre-selected and a consensus was achieved in three stages, during which interventions/activities and outcomes/indicators of each NDs were validated and those considered valid obtained 70% to 100% consensus. From the eight pre-selected NDs, two were excluded due to the lack of consensus on appropriate interventions for the clinical home care scenario. Eleven interventions were selected from a total of 96 pre-selected ones and seven outcomes were validated out of 71. The practice of consensus among expert nurses provides assistance to the qualifications of the care process and deepens the knowledge about the use of tazonomies in nursing clinical practice.

[Alzheimer's disease and care needs: what do nurses know?]. / Doença de Alzheimer e demandas de cuidados: o que os enfermeiros sabem?

The aim of this study is to show what nurses from hospitalization units know about Alzheimer's disease (AD) and the demands of care for patients and their families. This is a descriptive and exploratory study with a qualitative approach. The data were collected through semistructured interviews. Data saturation occurred after interviewing eleven nurses in two private hospitals. Six categories emerged from the content analysis: AD characterization, risk factors, ways to diagnose, complications, treatment medication, patient and family care. It was observed that nurses have partial knowledge regarding AD, focusing their care actions only on the clinical change that caused admission. They recognize signs and symptoms but only show themselves as supporting assistants, instead of acting more autonomously in dealing with care needs and family support.

Simulation in cardiorespiratory arrest: assessment of satisfaction with the learning of nursing students.

OBJECTIVE: To evaluate the satisfaction and self-confidence of undergraduate nursing students' learning in a scenario of realistic clinical simulation with the theme of advanced cardiopulmonary arrest maneuvers. METHOD: Exploratory-descriptive study, with a quantitative approach. In order to evaluate the simulation activity developed undergraduate nursing students responded to the Student Satisfaction and Self-Confidence with Learning Scale. RESULTS: 19 students participated in the study. Students' satisfaction and self-confidence with learning were identified, with an average of 4.17 ± 0.59 in the developed scenario. In the subscale of satisfaction with current learning and in the subscale of self-confidence with learning, 86.3% and 76.6% of students scored the items in a maximum way (4-5), respectively. CONCLUSION: Nursing students demonstrate satisfaction and self-confidence with learning from a realistic clinical simulation scenario on the theme of advanced cardiorespiratory arrest maneuvers.

Knowledge of patients with mechanical valve prostheses concerning chronic oral anticoagulant therapy.

Adherence to chronic Oral Anticoagulant Therapy (OAT) is directly related to patients' understanding of the therapy. This study verified the knowledge of patients with mechanical valve prostheses concerning OAT. This is a contemporary cross-sectional study, the sample is composed of patients with mechanical valve prostheses (MVP) in outpatient follow-up. A 10-question instrument was used; answers were 'know' (1 point), 'know partially' (half point), or 'do not know' (zero). Patients were grouped according to the result obtained: ≤ 4 points was considered insufficient knowledge; > 4 ≤ 8 equated to moderate knowledge; and > 8 was considered appropriate knowledge. Of the 110 patients, 61.8% presented moderate knowledge, 40.9% were not able to name at least one factor that may alter the INR (International Normalized Ratio) and 37.3% were not able to report their INR target range. The majority of patients presented moderate knowledge concerning the treatment. Strategies to improve knowledge on the topic should be implemented to minimize risks.

[Evaluation of nursing records on the physical examination]. / Avaliação dos registros de enfermagem quanto ao exame físico.

The nursing records are essential to generate benefits to individualized care planning, once data collection is the first step of the Nursing Process. The purpose of this study is to analyze the records made by nurses during each physical patient examination in critical care units (CCU) and hospitalization units (HU). This is a transverse and retrospective study, in which forms and records from both public and private hospitals were analyzed. From the 69 records considered, we observed a greater quality and frequency in records from CCUs, while records from HUs were mostly about intercurrences that happened during the shift. The research shows a deficit in physical examination records of patients, which complicates the individual assistance focused on the real needs of the patient, since many changes in patient's condition might not be recorded.

[Adherence to appointments and medication treatment of patients from randomized clinical trials of the industry]. / Adesão às consultas e ao tratamento medicamentoso de pacientes em ensaios clínicos randomizados da indústria.

Historical cohort study that assessed the adherence rate of patients of randomized clinical trials (RCT) of pharmaceutical industry in cardiology to appointments and follow-up medical treatment. This study was conducted at the cardiology research unit in a public university hospital in Porto Alegre, Rio Grande do Sul, Brazil. High adherence was regarded as > or = 80%. Seven RCT (120 medical records) were revised. We discovered that 117 (97%) of patients had adherence to follow-up visits to > or = 80%; 83.3% of patients had rates of > or = 80% adherence to medication in the study; the median number of tablets ingested, among patients with good adherence was 175 (72-500), and among patients with lower adherence was 500 (500-962). These results indicate that patients in studies with longer follow up and greater number of oral medication present loss in adherence

[Implementation of nursing diagnosis in intensive care units: a periodic review]. / Implantação do diagnóstico de enfermagem em unidade de terapia intensiva: uma análise periódica.

Knowledge about the prevalence of nursing diagnosis (ND) helps to provide the necessary care and to guide continuing education programs. This cross-sectional study aimed to identify the main nursing diagnosis (ND) prescribed in intensive care units (ICU) and to compare them with medical and surgical patients. Data analysis was performed according to the North American Nursing Diagnoses Association (NANDA) Taxonomy II. In the 150 medical records evaluated were found 195 nursing diagnoses, with an average of 1.3 per patient, mainly in the protection and security domain (39.5%). The most common ND were: impaired tissue integrity (22%), impaired gas exchange (22%), ineffective cerebral tissue perfusion (8.7%), impaired skin integrity (7.7%), decreased cardiac output (6.7%) and ineffective tissue perfusion cardiopulmonary (6.1%). The most prevalent nursing diagnoses revealed the physiological needs as the most common in our sample.

Cohort study to evaluate nursing team performance in a theoretical test after training in cardiopulmonary arrest.

OBJECTIVES: To evaluate nursing professionals' theoretical knowledge of cardiopulmonary arrest (CPA) treatment before specific training, immediately after, and six months later. METHODS: Cohort study, performed in a cardiology hospital in Porto Alegre, Rio Grande do Sul (November/2005 to May/2006), Brazil. Nurses, nursing technicians and assistants were included. A questionnaire was administered in the three periods, and 75% of correct answers was considered a satisfactory result. RESULTS: Thirty-five nurses participated in the pre-test, and 34 in the immediate and 6-month tests. Among technicians and assistants, 232, 227, and 104 participated in the pre-test, immediate, and 6-months tests, respectively. Among nurses, 62.9% achieved an adequate percentage of correct answers in the pre-test, 94.1% in the immediate, and 64.7% in the 6-months test; for nursing technicians and assistants, these values were 36.2%, 79.3%, and 62.5%, respectively. CONCLUSION: Training in CPA improved the nursing professionals' knowledge immediately after its administration, with a reduction in the rate of correct answers after 6 months.

[Nurse perception about the assistencial practice in mental health public services]. / Percepção do enfermeiro acerca da prática assistencial nos serviços públicos extra-hospitalares de saúde mental.

The goal of this study was to identify the nurses' perception of extra-hospitable services concerning the treatment practice in mental health and the influence of the Psychiatric Reform. Qualitative, descriptive-exploratory researches, carried out with all of the active nurses in public services of attention to the mental health of a town in the mountainous region of Rio Grande do Sul (Psychosocial Attention and Residential Therapeutic Centers). It was verified in the four interviewees' speeches, the transition of a hospital-centered and segregated care to an integral and human care, in which the interdisciplinary team inserted in those services disables that the treatment practice becomes isolated and disjointed, favoring the service to the user of the mental health net. The Psychiatric Reform process is felt and noticed by the professionals by their treatment practices in mental health that requires tolerance, acceptance and understanding of the needs of users to become humanized.

[Door-to-electrocardiogram (EKG) time: an indicator of efficacy in the treatment of acute myocardial infarction]. / Tempo porta-eletrocardiograma (ECG): um indicador de eficácia no tratamento do infarto agudo do miocárdio.

This investigation aimed to measure door-to-electrocardiogram (EKG) time in patients with acute myocardial infarction who were attended at the emergency room of a General Hospital. This is a cohort study which evaluated the time of arrival, EKG, nursing and thrombolytic care. Data were obtained from records from March to July of 2006. The sample was composed of 53 patients with an average age of 61.1 +/- 12.2 years, 64% male. The first attendance was performed by the nurse staff 50% of the patients were treated in eight minutes and the door-to-EKG time was within 20 minutes. There was no difference between the door-to-EKG time and the mean of transportation used to get to the hospital (P = 0.39). The shift and the medical specialty did not influence the EKG time (P = 0.23) and (P = 0.14). The study results show an increase in time for EKG performance. However it was not possible to identify the factors that delayed the EKG

[Knowledge on chronic oral anticoagulation of patients followed up in a specialized outpatient clinic]. / Conhecimento dos pacientes sobre anticoagulação oral crônica acompanhados em ambulatório especializado.

This study was carried out to assess patients' knowledge on anticoagulant therapy in an outpatient clinic. A questionnaire with ten questions with closed answers was applied. Correct answers to about 80% of the questions were considered satisfactory. Out of the 120 evaluated patients, 77 (64.1%) showed satisfactory knowledge, with an average of 7.8 +/- 1.7 correct answers. As to the International Normalized Ratio (INR), 69.4% of the sample was beyond therapeutic range, and 42.5% had hemorrhages in the last 6 months. Factors such as education level, income, hemorrhagic event, anticoagulation time, and gender did not show statistically significant difference. There is an obvious need for a systematic follow-up by health care professionals, using educational measures, to detect the difficulties faced by patients, maintaining an optimal INR.

[Non-verbal communication of patients submitted to heart surgery: from awaking after anesthesia to extubation]. / Comunicação não verbal do paciente submetido a cirurgia cardíaca: do acordar da anestesia a extubação.

Preoperative orientation is an essential tool for patient's communication after surgery. This study had the objective of evaluating non-verbal communication of patients submitted to cardiac surgery from the time of awaking from anesthesia until extubation, after having received preoperative orientation by nurses. A quantitative cross-sectional study was developed in a reference hospital of the state of Rio Grande do Sul, Brazil, from March to July 2006. Data were collected in the pre and post operative periods. A questionnaire to evaluate non-verbal communication on awaking from sedation was applied to a sample of 100 patients. Statistical analysis included Student, Wilcoxon, and Mann Whittney tests. Most of the patients responded satisfactorily to non-verbal communication strategies as instructed on the preoperative orientation. Thus, non-verbal communication based on preoperative orientation was helpful during the awaking period.

[Training in cardiopulmonary resuscitation: impact on the theoretical knowledge of nurses]. / Tempo decorrido do treinamento em parada cardiorrespiratória e o impacto no conhecimento teórico de enfermeiros.

This cross-sectional study aimed at evaluating the knowledge of nurses on cardiopulmonary resuscitation (CPR) as a function of the time elapsed since training was concluded. The study was performed in a general hospital in Porto Alegre, Rio Grande do Sul, during July and August, 2005. Nurses were assigned to groups 1 (33 nurses, in units equipped with a heart monitor and a cardiac defibrillator) and 2 (23 nurses, in units without this equipment). Nurses in group 1 showed better knowledge on the recognition of electrocardiographic recordings, and 91% of them recognized the ventricular fibrillation algorithm. Among nurses in group 2, 85% had knowledge on issues relative to basic care. The results showed that training in CPR generates positive results. Continued and systematic education strategies are essential to ensure better performance of the nursing team.

Simulation in cardiorespiratory arrest: assessment of satisfaction with the learning of nursing students / Simulación de parada cardiorrespiratoria: evaluación de la satisfacción con el aprendizaje de estudiantes de enfermería / Simulação em parada cardiorrespiratória: avaliação da satisfação com a aprendizagem de estudantes de enfermagem

ABSTRACT Objective: To evaluate the satisfaction and self-confidence of undergraduate nursing students' learning in a scenario of realistic clinical simulation with the theme of advanced cardiopulmonary arrest maneuvers. Method: Exploratory-descriptive study, with a quantitative approach. In order to evaluate the simulation activity developed undergraduate nursing students responded to the Student Satisfaction and Self-Confidence with Learning Scale. Results: 19 students participated in the study. Students' satisfaction and self-confidence with learning were identified, with an average of 4.17 ± 0.59 in the developed scenario. In the subscale of satisfaction with current learning and in the subscale of self-confidence with learning, 86.3% and 76.6% of students scored the items in a maximum way (4-5), respectively. Conclusion: Nursing students demonstrate satisfaction and self-confidence with learning from a realistic clinical simulation scenario on the theme of advanced cardiorespiratory arrest maneuvers.

RESUMEN Objetivo: Evaluar la satisfacción y la autoconfianza de estudiantes de enfermería con el aprendizaje en un escenario de simulación clínica realista y con la temática de maniobras avanzadas de parada cardiorrespiratoria. Método: Se trata de un estudio exploratorio y descriptivo, de enfoque cuantitativo. Para evaluar la actividad de simulación desarrollada, estudiantes del curso de graduación de enfermería respondieron a la Escala de Satisfacción de Estudiantes y Autoconfianza con el Aprendizaje. Resultados: Participaron diecinueve estudiantes. Se identificó la satisfacción y la autoconfianza de los estudiantes con el aprendizaje, con una media de 4,17 ± 0,59 en el escenario desarrollado. En la subescala de satisfacción con el aprendizaje actual y en la subescala de autoconfianza con el aprendizaje, el 86,3% y el 76,6% de los estudiantes, respectivamente, puntuaron los ítems al máximo (4-5). Conclusión: Los estudiantes de enfermería demostraron satisfacción y autoconfianza con el aprendizaje en el escenario de simulación clínica realista, en la temática de maniobras avanzadas de parada cardiorrespiratoria.

RESUMO Objetivo: Avaliar a satisfação e autoconfiança com a aprendizagem de estudantes de enfermagem em cenário de simulação clínica realística com a temática de manobras avançadas de parada cardiorrespiratória. Método: Estudo exploratório-descritivo, com abordagem quantitativa. Para avaliação da atividade de simulação desenvolvida, estudantes do curso de graduação em enfermagem responderam à Escala de Satisfação de Estudantes e Autoconfiança com a Aprendizagem. Resultados: Participaram 19 estudantes. Identificou-se satisfação e autoconfiança dos estudantes com a aprendizagem, com média de 4,17 ± 0,59 no cenário desenvolvido. Na subescala de satisfação com a aprendizagem atual e na subescala de autoconfiança com a aprendizagem, 86,3% e 76,6% dos estudantes pontuaram os itens de forma máxima (4-5), respectivamente. Conclusão: Estudantes de enfermagem demonstram satisfação e autoconfiança com a aprendizagem a partir de cenário de simulação clínica realística na temática de manobras avançadas de parada cardiorrespiratória.

Nursing Interventions and Outcomes for the Diagnosis of Impaired Tissue Integrity in Patients After Cardiac Catheterization: Survey.

PURPOSE: Determine the outcomes and interventions for patients undergoing cardiac catheterization with nursing diagnosis of impaired tissue integrity. METHODS: Survey with e-questionnaires sent for expert nurses in two rounds. FINDINGS: Only one nursing outcome was approved: tissue integrity-skin and mucosa and five related interventions, namely, pressure control, topical drug administration, care of incision site, care of injuries, and infection control. CONCLUSIONS: The expected outcomes and the most significant interventions for the implementation of nursing care during the immediate recovery of patients with impaired tissue integrity following invasive hemodynamic procedures were defined. IMPLICATIONS FOR NURSING PRACTICE: The study findings support selection of appropriate nursing outcomes and interventions for this patient profile.

A nurse-based strategy reduces heart failure morbidity in patients admitted for acute decompensated heart failure in Brazil: the HELEN-II clinical trial.

AIMS: Home-based interventions for heart failure (HF) patients might be particularly effective in middle-income countries, where social, cultural, and economic constraints limit the effectiveness of HF treatment outside the hospital environment. METHODS AND RESULTS: HELEN-II was a randomized clinical trial conducted in Brazil designed to evaluate the clinical efficacy of a nurse-based strategy, started after discharge following an acute decompensated HF (ADHF) admission. HELEN-II compares the efficacy of home visits and telephone reinforcement (n = 123) with that of the conventional strategy, which is based on medical follow-up (n = 129). The primary outcome was a composite endpoint of a first visit to the emergency department (≤ 24 h), a hospital readmission (> 24 h), or all-cause death, assessed during the first 6 months of follow-up. Most enrolled subjects were middle-aged (62 ± 13 years) males (63%) in NYHA functional class II-III (84%) with severe LV dysfunction (mean LVEF 29.6 ± 9%). The primary composite endpoint was decreased by 27% in the interventional group (relative risk 0.73; 95% confidence interval 0.54-0.99; P = 0.049). At the end of follow-up, the rate of use of the standard-of-care HF medications was similar in both groups, except for the higher use of furosemide in the interventional group. Also, HF knowledge and self-care were significantly increased in the interventional group. CONCLUSIONS: A post-discharge, nurse-led management strategy significantly decreases the morbidity of ADHF patients in the public health system of a developing middle-income country.