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PURPOSE: This study evaluated the prevalence of complications in the postoperative period of esophagogastric oncological surgeries. METHODS: We conducted a retrospective cross-sectional study, adhering to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. The study size implied 163 patients who underwent surgical treatment for esophageal and gastric cancer and experienced postoperative complications between January 2018 and December 2022. These patients were treated at the Liga Norte Riograndense Contra o Câncer, a high-complexity oncology center and a reference for cancer treatment in Northeast Brazil. RESULTS: The prevalence found was 88.3%. The most prevalent complications were Clavien-Dindo I and II, and infection was the most common. According to our statistics analysis, hypoalbuminemia showed a positive correspondence with the occurrence of postoperative complications (odds ratio = 8.60; 95% confidence interval 1.35-54.64, p = 0.0358). CONCLUSIONS: Postoperative complications of gastroesophageal surgeries increase patient morbidity and mortality.
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Neoplasias Esofágicas , Complicações Pós-Operatórias , Neoplasias Gástricas , Humanos , Estudos Transversais , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Masculino , Feminino , Estudos Retrospectivos , Neoplasias Esofágicas/cirurgia , Pessoa de Meia-Idade , Prevalência , Neoplasias Gástricas/cirurgia , Brasil/epidemiologia , Idoso , Adulto , Fatores de RiscoRESUMO
Abstract Objective: This meta-analysis of randomized controlled trials (RCTs) aimed to update evidence on the effectiveness and safety of laser therapy for treating genitourinary syndrome of menopause (GSM). Data sources: Manuscripts published until May 2023 were systematically searched in PubMed; Embase; Scopus; Web of Science; CENTRAL; CINAHL; and clinical trial databases (www.trialscentral.org, www.controlled-trials.com, and clinicaltrials.gov), with no language and year of publication restriction. Studies selection: RCTs with women diagnosed with GSM, and the intervention was vaginal laser therapy (CO2-laser or Er: YAG-laser) comparing with placebo (sham therapy), no treatment or vaginal estrogen therapy. Data collection: Two authors evaluated the publications for inclusion based on the title and abstract, followed by reviewing the relevant full-text articles. Disagreements during the review process were addressed by consensus, with the involvement of a third author. Data synthesis: Twelve RCTs, representing a total of 5147 participants, were included in this review. Vaginal health index (VHI) significantly improved in the carbon dioxide laser (CO2-laser) therapy group (MD=2.21; 95% CI=1.25 to 3.16), while dyspareunia (MD=−0.85; 95% CI=−1.59 to −0.10), dryness (MD=−0.62; 95% CI=−1.12 to −0.12) and burning (MD= −0.64; 95% CI=−1.28 to −0.01) decreased. No serious adverse effects were reported. Conclusion: CO2-laser increases VHI score and decreases dyspareunia, dryness and burning, especially when compared to sham-laser. However, the certainty of the evidence is low, thus preventing the recommendation of laser therapy for GSM management.
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Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Menopausa , Pós-Menopausa , Doenças Urogenitais Femininas , Terapia a LaserRESUMO
Purpose: This study evaluated the prevalence of complications in the postoperative period of esophagogastric oncological surgeries. Methods: We conducted a retrospective cross-sectional study, adhering to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. The study size implied 163 patients who underwent surgical treatment for esophageal and gastric cancer and experienced postoperative complications between January 2018 and December 2022. These patients were treated at the Liga Norte Riograndense Contra o Câncer, a high-complexity oncology center and a reference for cancer treatment in Northeast Brazil. Results: The prevalence found was 88.3%. The most prevalent complications were Clavien-Dindo I and II, and infection was the most common. According to our statistics analysis, hypoalbuminemia showed a positive correspondence with the occurrence of postoperative complications (odds ratio = 8.60; 95% confidence interval 1.35-54.64, p = 0.0358). Conclusions: Postoperative complications of gastroesophageal surgeries increase patient morbidity and mortality.
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Complicações Pós-Operatórias , Neoplasias Gástricas , Esofagectomia , Oncologia Cirúrgica , GastrectomiaRESUMO
OBJECTIVE: evaluate the efficacy of Zingiber Officinale in the management of nausea and vomiting induced by treatment with cisplatin associated with radiotherapy in patients with uterine cervical neoplasms. METHODS: a triple-blind, randomized, placebo-controlled trial. Interventions: Comparing the effects of ginger with institutional antiemetic therapy (ondansetron with dexamethasone). Patients with cervical cancer who started treatment with cisplatin with an indication of 40 mg/m² associated with radiotherapy, aged over 18 years, and with the ability to tolerate swallowing a capsule were recruited and equally allocated (1:1:1) into 3 groups of 16 patients each (the ginger capsules 250 mg group, ginger capsules 500 mg group, and placebo group). Nausea and vomiting were measured on baseline, 7 days after the first dose of medication and every seven consecutive days during a treatment break. RESULTS: The 250 mg ginger group had an 8.0% greater chance of experiencing nausea within 24 h after the chemotherapy infusion than the placebo group, although there is no statistical significance (P = .92986). The 500 mg ginger group showed a 63.9% reduction in nausea under the same conditions (P = .40460). No change was detected in the occurrence of nausea episodes during the 6 weeks (P = .8664) or between the groups (P = .2817). No change was detected in acute or late vomiting during the 6 weeks (P = .3510) or between the groups (P = .8500 and P = .5389, respectively). CONCLUSION: Ginger supplementation does not reduce the intensity of acute and late nausea and vomiting. REBEC (RBR-47yx6p9).
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Neoplasias do Colo do Útero , Zingiber officinale , Feminino , Humanos , Adulto , Pessoa de Meia-Idade , Cisplatino/efeitos adversos , Método Duplo-Cego , Vômito/induzido quimicamente , Vômito/tratamento farmacológico , Náusea/induzido quimicamente , Náusea/tratamento farmacológicoRESUMO
Abstract Objective To assess the efficacy, safety, and acceptability of misoprostol in the treatment of incomplete miscarriage. Data sources The PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Clinical Trials databases (clinicaltrials.gov) were searched for the relevant articles, and search strategies were developed using a combination of thematic Medical Subject Headings terms and text words. The last search was conducted on July 4, 2022. No language restrictions were applied. Selection of studies Randomized clinical trials with patients of gestational age up to 6/7 weeks with a diagnosis of incomplete abortion and who were managed with at least 1 of the 3 types of treatment studied were included. A total of 8,087 studies were screened. Data collection Data were synthesized using the statistical package Review Manager V.5.1 (The Cochrane Collaboration, Oxford, United Kingdom). For dichotomous outcomes, the odds ratio (OR) and 95% confidence interval (CI) were derived for each study. Heterogeneity between the trial results was evaluated using the standard test, I2 statistic. Data synthesis When comparing misoprostol with medical vacuum aspiration (MVA), the rate of complete abortion was higher in the MVA group (OR = 0.16; 95%CI = 0.07-0.36). Hemorrhage or heavy bleeding was more common in the misoprostol group (OR = 3.00; 95%CI = 1.96-4.59), but pain after treatment was more common in patients treated with MVA (OR = 0.65; 95%CI = 0.52-0.80). No statistically significant differences were observed in the general acceptability of the treatments. Conclusion Misoprostol has been determined as a safe option with good acceptance by patients.
Resumo Objetivo Avaliar a eficácia, segurança e aceitabilidade do misoprostol no tratamento do aborto incompleto. Fontes de dados Os bancos de dados PubMed, Scopus, Embase, Web of Science, Cochrane Library e bancos de dados de Ensaios Clínicos (clinicaltrials.gov) foram pesquisados para os artigos relevantes, e estratégias de busca foram desenvolvidas usando uma combinação de termos temáticos de Medical Subject Headings e palavras de texto. A última pesquisa foi realizada em 4 de julho de 2022. Nenhuma restrição de idioma foi aplicada. Seleção dos estudos Foram incluídos ensaios clínicos randomizados com pacientes com idade gestacional até 6/7 semanas com diagnóstico de aborto incompleto e que foram manejadas com pelo menos um dos três tipos de tratamento estudados. Um total de 8.087 estudos foram selecionados. Coleta de dados Os dados foram sintetizados usando o pacote estatístico Review Manager V.5.1 (The Cochrane Collaboration, Oxford, United Kingdom). Para resultados dicotômicos, o odds ratio (OR, na sigla em inglês) e o intervalo de confiança (IC) de 95% foram derivados para cada estudo. A heterogeneidade entre os resultados do ensaio foi avaliada usando o teste padrão, estatística I2. Síntese dos dados Ao comparar misoprostol com aspiração a vácuo médico (MVA, na sigla em inglês), a taxa de aborto completo foi maior no grupo MVA (OR = 0,16; IC95% = 0,07-0,36). Hemorragia ou sangramento intenso foi mais comum no grupo do misoprostol (OR = 3,00; 95%CI = 1,96-4,59), mas a dor após o tratamento foi mais comum em pacientes tratados com MVA (OR = 0,65; 95%CI = 0,52-0,80). Não foram observadas diferenças estatisticamente significativas na aceitabilidade geral dos tratamentos. Conclusão O misoprostol tem se mostrado uma opção segura e com boa aceitação pelos pacientes.
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Humanos , Feminino , Gravidez , Misoprostol/uso terapêutico , Curetagem , AbortoRESUMO
OBJECTIVE: to trace the clinical and epidemiological profile of penile cancer in Rio Grande do Norte/Brazil and relate them to data published in the literature. METHODS: a cross-sectional study was conducted with 94 patients diagnosed with penile cancer in 2011-2018, treated at the Liga Norte Riograndense Contra o Cancer. RESULTS: all patients were diagnosed with squamous cell carcinoma, mainly aged over 50 years, from the states interior, brown, illiterate, or with incomplete primary education. At diagnosis, 68% of patients were classified as having tumors =T2, and 30% had lymph node involvement. Distant metastases were detected in 2.1% of patients at diagnosis. Most patients received the diagnosis in the initial phase of the disease, but 20.2% were diagnosed in stage IV. Partial penectomy was the most performed surgery, and 10% of patients relapsed, mainly in the lymph nodes (87.5%). The mean follow-up of the patients was 18 months, with an estimated overall survival at five years of 59.1%. However, 25% of patients were followed up for up to 3 months, losing follow-up. CONCLUSION: the State of Rio Grande do Norte has a high incidence of penile cancer with a high frequency of locally advanced tumors at diagnosis and in younger patients younger than 50. Furthermore, socioeconomic factors interfere with early diagnosis and hinder access to specialized services.
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Carcinoma de Células Escamosas , Neoplasias Penianas , Masculino , Humanos , Pessoa de Meia-Idade , Neoplasias Penianas/epidemiologia , Neoplasias Penianas/cirurgia , Neoplasias Penianas/patologia , Brasil/epidemiologia , Estudos Transversais , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/cirurgia , Estudos Retrospectivos , Estadiamento de NeoplasiasRESUMO
SUMMARY OBJECTIVE: The objective of this study was to determine adverse maternal and perinatal outcomes in pregnant women with hypertensive disorders of pregnancy. METHODS: An analytical cross-sectional study was conducted on women admitted with hypertensive disorders of pregnancies to a university maternity hospital from August 2020 to August 2022. Data were collected using a pretested structured questionnaire. Variables associated with adverse maternal and perinatal outcomes were compared using multivariable binomial regression. RESULTS: Of 501 women with pregnancies, 2, 35, 14, and 49% had eclampsia, preeclampsia, chronic hypertension, and gestational hypertension, respectively. Women with preeclampsia/eclampsia had significantly higher risks of cesarean section (79.4 vs. 65%; adjusted RR, 2,139; 95%CI, 1,386-3,302; p=0.001) and preterm delivery at <34 weeks' gestation (20.5 vs. 6%; adjusted RR, 2.5; 95%CI, 1.19-5.25; p=0.01) than those of women with chronic/gestational hypertension. Risks of prolonged maternal hospitalization (43.9 vs. 27.1%), neonatal intensive care unit admission (30.7 vs. 19.8%), and perinatal mortality (23.5 vs. 11.2%) were higher among women with preeclampsia/eclampsia. CONCLUSIONS: Women with preeclampsia/eclampsia had a higher risk of adverse maternal and neonatal outcomes than those with chronic or gestational hypertension. This major maternity care center requires strategies for preventing and managing preeclampsia/eclampsia to improve pregnancy outcomes.
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ABSTRACT Objective: to trace the clinical and epidemiological profile of penile cancer in Rio Grande do Norte/Brazil and relate them to data published in the literature. Methods: a cross-sectional study was conducted with 94 patients diagnosed with penile cancer in 2011-2018, treated at the Liga Norte Riograndense Contra o Cancer. Results: all patients were diagnosed with squamous cell carcinoma, mainly aged over 50 years, from the states interior, brown, illiterate, or with incomplete primary education. At diagnosis, 68% of patients were classified as having tumors =T2, and 30% had lymph node involvement. Distant metastases were detected in 2.1% of patients at diagnosis. Most patients received the diagnosis in the initial phase of the disease, but 20.2% were diagnosed in stage IV. Partial penectomy was the most performed surgery, and 10% of patients relapsed, mainly in the lymph nodes (87.5%). The mean follow-up of the patients was 18 months, with an estimated overall survival at five years of 59.1%. However, 25% of patients were followed up for up to 3 months, losing follow-up. Conclusion: the State of Rio Grande do Norte has a high incidence of penile cancer with a high frequency of locally advanced tumors at diagnosis and in younger patients younger than 50. Furthermore, socioeconomic factors interfere with early diagnosis and hinder access to specialized services.
RESUMO Objetivo: traçar o perfil clínico e epidemiológico do câncer de pênis no Rio Grande do Norte/Brazil e relacioná-los com dados publicados na literatura. Métodos: realizou-se estudo transversal de 94 pacientes diagnosticados com câncer de pênis no período de 2011-2018, tratados na Liga Norte Riograndense Contra o Câncer. Resultados: todos os pacientes foram diagnosticados com carcinoma espinocelular, principalmente com idade acima dos 50 anos, provenientes do interior do estado, pardos, analfabetos ou com ensino fundamental incompleto. Ao diagnóstico, 68% dos pacientes foram classificados com tumores =T2 e 30% possuiam envolvimento linfonodal. Metástases à distância foram detectadas em 2,1% dos pacientes ao diagnóstico. A maioria dos pacientes recebeu o diagnóstico na fase inicial da doença, mas 20,2% foram diagnosticados em estádio IV. Penectomia parcial foi a cirurgia mais realizada e 10% dos pacientes recidivaram, principalmente para linfonodos (87,5%). A média de seguimento dos pacientes foi de 18 meses, apresentando estimativa de sobrevida global em 5 anos de 59,1%. No entanto, 25% dos pacientes foram acompanhados por até 3 meses, perdendo o seguimento. Conclusão: o Estado do Rio Grande do Norte apresenta elevada incidência de câncer de pênis com alta frequência de tumores localmente avançados ao diagnóstico, assim como em pacientes mais jovens, menores que 50 anos de idade. Outrossim, o fator socioeconômico interfere no diagnóstico precoce e dificulta o acesso a serviços especializados. .
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Resumo O presente artigo aborda o tema da ética no contexto das organizações públicas, edificada em dois grandes pilares: a Constituição Federal Brasileira e o marco legal do Sistema de Gestão da Ética do Poder Executivo Federal. Para o exercício das funções, os servidores, além da qualificação técnica, necessitam de competências políticas e éticas. Este trabalho é resultante de pesquisa que teve como objetivos: compreender os sentidos da ética e da ética pública para servidores públicos e identificar a importância e as dificuldades para o exercício da ética no processo de trabalho desenvolvido. Trata-se de uma pesquisa exploratória com utilização de abordagem qualitativa. A coleta de dados foi realizada por meio de entrevista semiestruturada e os dados coletados foram analisados por meio da análise de conteúdo, na modalidade de análise temática. Os resultados da pesquisa subsidiaram reflexões para auxiliar futuras decisões relacionadas ao tema estudado, tendo em vista o intuito de disseminar a importância do cumprimento dos preceitos éticos que devem alicerçar a atuação dos servidores. Os argumentos conclusivos reforçam a necessidade de uma ampla discussão do tema "Ética" dentro da esfera pública e a urgência em fomentar posturas que visem à melhoria das relações, cimentando pensamentos críticos e reflexivos no processo de trabalho com base em imperativos éticos.
Abstract This article aims to discuss the subject of ethics in the context of public organizations, built on two main pillars: the Brazilian Federal Constitution and the legal framework of the Ethics Management System of the Federal Executive Power. To carry out their duties, public servants, in addition to technical qualifications, need political and ethical skills. This article is the result of a research that had the following objectives: to understand the meanings of ethics and public ethics for public servants and to identify the importance and difficulties for the exercise of ethics in the work process developed. This is an exploratory research using a qualitative approach. Information collection was carried out with semi-structured interviews, and the data collected analyzed by content analysis, in the thematic analysis mode. The research results supported reflections to help future decisions related to the studied topic, considering the objective of disseminating the importance of complying with the ethical precepts that should underpin the performance of public servants. The conclusive arguments support the need for a broad discussion of the topic of "Ethics" within the public reach and the urgency to promote postures aimed at improving relationships, reinforcing critical and reflective thoughts in the work process based on ethical imperatives.
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Gestão de Recursos Humanos , Ética InstitucionalRESUMO
SUMMARY OBJECTIVE: The aim of this study was to evaluate and compare Maternal Near Miss prevalence and outcomes before and during the coronavirus disease 2019 pandemic. METHODS: This retrospective study was carried out in a university maternity hospital of high complexity. The population was divided into two groups: G1, 1 year before the coronavirus disease 2019 pandemic period (August 2018-July 2019) and G2, 1 year during the pandemic period (August 2020-July 2021). All pregnant/postpartum women hospitalized up to 42 days after the end of pregnancy/childbirth were included, and pregnant women who were admitted with coronavirus disease 2019/flu symptoms were excluded. The association of variables with "Maternal Near Miss" was estimated using logistic regression. RESULTS: A total of 568 women from G1 and 349 women from G2 fulfilled the Maternal Near Miss criteria. The prevalence of Maternal Near Miss in pre-pandemic was 144.1/1,000 live births and during the pandemic was 78.5/1,000 live births. In the analysis adjusted for G1, the factors of days of hospitalization (PR: 1.02, CI: 1.0-1.0, p<0.05), pre-eclampsia (PR: 0.41, CI: 1.4-2.2, p<0.05), and sepsis/severe systemic infection (PR: 1.79, CI: 0.3-0.4, p<0.05) were crucial for women with the Maternal Near Miss condition to have a greater chance of being admitted to the intensive care unit. In G2, low education (PR: 0.45, CI: 0.2-0.9, p<0.05), eclampsia (PR: 5.28, CI: 3.6-7.6, p<0.05), and use of blood products (PR: 6.48, CI: 4.7-8.8, p<0.05) increased the risk of admission to the intensive care unit. CONCLUSION: During the pandemic, there was a lower prevalence of Maternal Near Miss in high-risk pregnancies, fewer hospitalizations, and more deaths compared to the non-pandemic period.
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Introduction: Axillary dissection is increasingly less indicated for axillary evaluation of patients with breast cancer and clinically negative axilla. This study evaluated the application of sentinel lymph node in patients with clinical axillary remission after neoadjuvant chemotherapy. Methods: Prospective study carried out from December 2017 to July 2018, at the Liga Norte Riograndense Contra o Cancer. We considered 24 patients who had a positive axilla and after neoadjuvant chemotherapy had clinical axillary remission (ypN0). Only patients with a strongly positive status during physical examination were included, and biopsy and ultrasound examinations were not required to confirm axillary disease. The dual-tracer technique of sentinel lymph node biopsy followed by axillary dissection was used. Results: The accuracy of the sentinel lymph node in patients with clinical axillary remission was 91.7%, with a false negative rate of 13.3% (2/24). It was observed that 66.6% of patients were stage I after chemotherapy and 13 patients with negative sentinel lymph node biopsy no longer had axillary disease. During the sentinel lymph node biopsy procedure, 16 patients (79.1%) had only 1 sentinel lymph node removed. Conclusions: For patients with clinical axillary remission after neoadjuvant chemotherapy, sentinel lymph node biopsy has been included in clinical practice, reducing the indications for axillary dissection and, consequently, its morbidity. The dual-agent mapping technique of sentinel lymph node biopsy and a sample of 3 lymph nodes at surgery decrease false-negative rates and make the procedure safer.
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SUMMARY BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections can affect the nervous system, triggering problems such as the Guillain-Barre Syndrome (GBS), an association that can bring complications to the patient. OBJECTIVE: This scoping review aimed to clarify the clinical features and analyze patients with GBS associated with SARS-CoV-2 infection, looking at morbidity, mortality, and neurological outcomes. SEARCH STRATEGY: The search was conducted through Medline, Web of Science, Embase, CINAHAL, Latin-American and Caribbean Literature in Health Sciences (LILACS), clinicaltrials.gov, SCOPUS, and the Cochrane Central Register of Controlled Trials. SELECTION CRITERIA: Observational studies, published after 2019, describe patients with GBS associated with SARS-CoV-2 infection. There were no language restrictions while selecting the studies. DATA COLLECTION AND ANALYSIS: Three authors, Kleyton Santos de Medeiros, Luíza Thomé de Araújo Macêdo, and Wederson Farias de Souza, independently screened the search results using titles and abstracts. Duplicate studies were excluded. The same authors then went through the entire text to determine whether the studies met the inclusion criteria. Discrepancies were resolved by other reviewers, Ana Paula Ferreira Costa, Ayane Cristine Sarmento, and Ana Katherine Gonçalves. Finally, the selection of the studies was summarized in a PRISMA flow diagram. MAIN RESULTS: Main manifestations were fever, coughing, dyspnea, sore throat, ageusia, anosmia, and respiratory failure, in addition to paresthesia of the upper and lower limbs, tetraparesis, facial diplegia, areflexia, asthenia, mastoid pain, acute ataxia, fatigue, numbness, swallowing disorder, and moderate low back pain. CONCLUSION: Coronavirus disease 2019 (COVID-19) can trigger the GBS, despite the few studies on this topic. Patients had clinical manifestations of COVID-19 infection and neurological manifestations characterizing GBS.
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Síndrome de Guillain-Barré/etiologia , COVID-19 , Dispneia , Febre , SARS-CoV-2RESUMO
RESUMO Objetivo: propor passos para a segurança do paciente a partir da análise dos riscos no atendimento pré-hospitalar móvel sob a ótica dos enfermeiros. Método: estudo quantitativo, e descritivo. Amostra intencional, composta por 23 enfermeiros. Utilizou-se o método de pesquisa fotográfica para identificar os riscos à segurança do paciente em um Serviço de Atendimento Móvel de Urgência de uma cidade do Rio Grande do Norte. A coleta foi realizada de março a junho de 2012 e organizada em cinco etapas: obtenção das fotos de situações de segurança e não segurança; seleção de fotos pela qualidade de imagem; seleção de fotos pelos experts da temática; seleção de dez imagens de modo aleatório; e aplicação do instrumento de análise das fotos pelos profissionais. Foi utilizada a análise de conteúdo e análise descritiva. Resultados: os riscos apontados no estudo foram: dificuldades no acondicionamento de equipamentos e materiais; especificidades do trabalho no atendimento pré-hospitalar móvel; risco de infecção; risco de traumas; e dificuldades na administração de medicamentos. A partir dessas informações e confrontos com a literatura, foram sugeridos dez passos para a segurança do paciente no atendimento pré-hospitalar, voltados às necessidades de redução dos riscos apresentados. Conclusão: a análise de riscos e proposta de intervenções para a segurança do paciente favorecem a qualidade do atendimento em saúde, com benefícios na esfera: paciente, equipe, profissional e ambiente. Sugere-se que sejam desenvolvidas de acordo com as necessidades de cada serviço.
RESUMEN Objetivo: proponer los pasos a seguir para la seguridad del paciente a partir del análisis de los riesgos en la atención pre-hospitalaria móvil y bajo la óptica de los enfermeros. Método: estudio cuantitativo, y descriptivo. Muestra intencional compuesta por 23 enfermeros. Se utilizó el método de investigación fotográfica para identificar los riesgos para la seguridad del paciente en un Servicio de Atención Móvil de Urgencia de una ciudad del estado de Rio Grande do Norte. La recolección se realizó de Marzo a Junio del 2012 y se organizó en cinco etapas: obtención de las fotos de situaciones de seguridad y sin seguridad, selección de fotos por la cualidad de imagen, selección de fotos por los peritos en la temática, selección de diez imágenes de forma aleatoria y aplicación del instrumento de análisis de las fotos por los profesionales. Se usó el análisis del contenido y el análisis descriptivo. Resultados: los riesgos mencionados en el estudio fueron las dificultades en el acondicionamiento de equipamientos y materiales, especificidades del trabajo en la atención pre-hospitalaria móvil, riesgo de infección, riesgo de traumas y dificultades en la administración de medicamentos. A partir de estas informaciones y cotejos con la literatura fueron sugeridos diez pasos a seguir para la seguridad del paciente en la atención pre-hospitalaria relacionados con las necesidades de reducción de los riesgos presentados. Conclusión: el análisis de riesgos y propuesta de intervenciones para la seguridad del paciente favorece la cualidad de la atención en la salud y con beneficios en las áreas paciente, equipo, profesional y ambiente. Se sugiere que sean desarrolladas de acuerdo con las necesidades de cada servicio.
ABSTRACT Objective: propose steps for patient safety based on the analysis of risks in mobile emergency care from nurses' perspective. Method: quantitative and descriptive study. Intentional sample consisting of 23 nurses. The photographic research method was used to identify the risks for patient safety in a Mobile Emergency Care Service in a city in Rio Grande do Norte (Brazil). The data were collected between March and June 2012 and organized in five phases: collection of pictures from safe and non-safe situations; selection of pictures based on the image quality; selection of pictures by experts on the theme; random selection of ten images; and application of picture analysis tool by the professionals. Content analysis and descriptive analysis were used. Results: the risks appointed in the study were: difficulties to store equipment and material; particularities of work in mobile emergency care; risk of infection; risk of traumas; and medication administration difficulties. Based on this information and confrontations with the literature, ten steps were suggested towards patient safety in emergency care, focused on the needs to reduce the risks presented. Conclusion: the risk analysis and the intervention proposal towards patient safety favor the quality of health care, with benefits in the following spheres: patient, team, equipment, professional and environment. These should be developed in accordance with the needs of each service.
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Humanos , Qualidade da Assistência à Saúde , Gestão de Riscos , Serviços Médicos de Emergência , Assistência Pré-Hospitalar , Fotografia , Segurança do PacienteRESUMO
OBJETIVO: Analisar os vídeos no sítio de compartilhamento YouTube, observando quais os pontos tratados nos vídeos relacionados à reanimação cardiopulmonar e ao Suporte Básico de Vida. MÉTODOS: A análise foi baseada no Guidelines de 2010 da American Heart Association.Trata-se de uma pesquisa do tipo exploratória, quantitativa e qualitativa, realizada no sítio de compartilhamento do YouTube, utilizando-se os Descritores em Ciências da Saúde "reanimação cardiopulmonar" e "suporte básico de vida" para vídeos que tinham como foco o suporte básico de vida. RESULTADOS: Durante a investigação inicial encontrou-se 260 vídeos, foram escolhidos para análise,61. Estes,em sua maioria, foram postados por pessoa física e pertencem à categoria Education. Grande parte dos vídeos, apesar de serem adicionados ao sítio depois da publicação do Guidelines de 2010 da AHA, estava de acordo com as antigas diretrizes de 2005. CONCLUSÃO: Embora o sítio de compartilhamento de vídeos YouTube seja amplamente usado atualmente, nele há uma carência de vídeos a respeito de reanimação cardiopulmonar e Suporte Básico de Vida adequados às diretrizes da American Heart Association, podendo influenciar negativamente a população que o utiliza.
OBJECTIVE: To analyze the videos on the YouTube video sharing site, noting which points addressed in the videos related to CPR and BLS, based on the 2010 Guidelines for the American Heart Association (AHA). METHODS: This was an exploratory, quantitative and qualitative research performed in the YouTube sharing site, using as keywords the expressions in Portuguese equivalent to the Medical Subject Headings (MeSH) "Cardiopulmonary Resuscitation" and "Basic Life Support" for videos that focused on the basic life support. RESULTS: The research totaled 260 videos over the two searches. Following the exclusion criteria, 61 videos remained. These mostly are posted by individuals and belong to the category Education. Moreover, most of the videos, despite being added to the site after the publication of the 2010 AHA Guidelines, were under the older 2005 guidelines. CONCLUSION: Although the video-sharing site YouTube is widely used today, it lacks videos about CPR and BLS that comply to the most recent AHA recommendations, which may negatively influence the population that uses it.