RESUMO
Background: The global COVID-19 pandemic has had a devastating effect on global health, resulting in a strain on healthcare services worldwide. The faster a patient with acute ischemic stroke (AIS) receives reperfusion treatment, the greater the odds of a good functional outcome. To maintain the time-dependent processes in acute stroke care, strategies to reorganize infrastructure and optimize human and medical resources were needed. Methods: Data from AIS patients who received thrombolytic therapy were prospectively assessed in the emergency department (ED) of Hospital de Clínicas de Porto Alegre from 2019 to 2021. Treatment times for each stage were measured, and the reasons for a delay in receiving thrombolytic therapy were evaluated. Results: A total of 256 patients received thrombolytic therapy during this period. Patients who arrived by the emergency medical service (EMS) had a lower median door-to-needle time (DNT). In the multivariable analysis, the independent predictors of DNT >60 min were previous atrial fibrillation (OR 7) and receiving thrombolysis in the ED (OR 9). The majority of patients had more than one reason for treatment delay. The main reasons were as follows: delay in starting the CT scan, delay in the decision-making process after the CT scan, and delay in reducing blood pressure. Several actions were implemented during the study period. The most important factor that contributed to a decrease in DNT was starting the bolus and continuous infusion of tPA on the CT scan table (decreased the median DNT from 74 to 52, DNT ≤ 60 min in 67% of patients treated at radiology service vs. 24% of patients treated in the ED). The DNT decreased from 78 min to 66 min in 2020 and 57 min in 2021 (p = 0.01). Conclusion: Acute stroke care continued to be a priority despite the COVID-19 pandemic. The implementation of a thrombolytic bolus and the start of continuous infusion on the CT scan table was the main factor that contributed to the reduction of DNT. Continuous monitoring of service times is essential for improving the quality of the stroke center and achieving better functional outcomes for patients.
RESUMO
Neste estudo, teve-se por objetivo caracterizar a produção do conhecimento das pesquisas publicadas na Revista Mineira de Enfermagem (REME) entre 1997 e 2005. Realizou-se uma pesquisa bibliográfica exploratório-descritiva com abordagem quantitativa. Oram analisados 213 resumos de artigos publicados em 18 exemplares, dos quais foram localizados 131 artigos oriundos de pesquisas, o que representa 61,5% do total. Constatou-se que há um crescimento na publicação de investigações por parte do periódico nos últimos três anos (2002-2005). Predominaram trabalhos que envolveram temáticas relacionadas à saúde da mulher (16,1%), com abordagem qualitativa (62,6%), e que utilizaram os pacientes/clientes/usuários dos serviços de saúde para a obtenção dos dados (25,2%). A entrevista configura-se como a principal técnica de coleta (42,2%) e o ambiente extra-hospitalar, como principal local para a coleta (56,5%), com 38,6% de autores com doutorado, em artigos com dupla parceria (42,8%) e oriundos da Região Sudeste brasileira (91,6%). Os resultados apontam as principais características das pesquisas publicadas na REME e contribuição delas para a construção do estado da arte do conhecimento em Enfermagem.
The objective of this study was to describe the production of knowledge in research published in Revista Mineira de Enfermagem (REME) from 1997 to 2005. An exploratory-descriptive and bibliographic survey was carried out using a quantitative approach. A total of 213 abstracts were examined from 18 issues, including 131 from research (61.5%). We found that there is a growth in the publication of research by the magazine in the last three years (2002-2005). The main themes found were: women's health (16.1%) using a qualitative approach (62.6%), and data obtained came from patients/clients of the health services (25.2%). Interviews were the main collection technique used (42.2%), and the non-hospital environment was the main collection data (56.5%); 38.6% of the authors had a doctoral degree; and co-authored articles (42.8%) from the southeast of Brazil (91.6%). The results show the main characteristics of the research published in REME and their contribution to build state of the art knowledge in Nursing.
Este estudio tiene por objeto caracterizar la producción del conocimiento de los estudios de investigación publicados en la Revista Mineira de Enfermagem (REME), entre los años 1997 y 2005. Se realizó investigación bibliográfica de tipo exploratorio-descriptivo con enfoquee cuantitativo. Se analizaron 213 resúmenes de artículos publicados en 18 ejemplares, de los cuales fueron ubicados 131 artículos oriundos de investigación, lo que representa 61,5% del total. Se constató que hay crecimiento en la publicación de artículos de investigación en los últimos tres años (2002-2005). Predominan trabajos con temáticas relacionadas a la salud de la mujer (16,1%), con abordaje cualitativo (62,6%) y utilizaron a los pacientes/clientes/usuarios de los servicios de salud para la obtención de datos (25,2%). La entrevista se configura como técnica principal de recogida de datos (42,2%), el ambiente extra-hospitalario como principal sitio de recogida (56,5%), 38,6% de autores tienen doctorado, artículos con doble aparcería (42,8%) y oriundos de la región sudeste brasileña (91,6%). Los resultados apuntan a las principales características de las investigaciones publicadas en la REME y sus aportes para la construcción del estado del arte del conocimiento en Enfermería.