Comparison of quality of life between patients on the waiting list and heart transplant recipients. / Comparação da qualidade de vida entre pacientes em lista de espera e pacientes submetidos a transplante cardíaco.

OBJECTIVES: To compare the quality of life (QOL) between wait-listed patients and heart transplant recipients. METHODS: Cross-sectional study of 56 adult patients at two institutions in Southern Brazil, 9(16%) wait-listed patients and 47(84%) transplant recipients. Data were collected from August to December 2012. QOL was assessed using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), with scores ranging from zero to 100. RESULTS: There was statistically significant difference between the two groups in the overall QOL score (p=0.010) and in four dimensions. The mean rank was 16.9 in wait-listed patients and 30.7 in transplant recipients. Wait-listed patients presented the lowest for general health (9.1) and the highest scores for role-emotional (24.8). Transplant recipients obtained the highest scores for general health (32.2) and the lowest scores for bodily pain (29.1). CONCLUSIONS: Undergoing a transplant has a positive impact on the QOL of recipients compared to that of patients awaiting transplantation.

[The challenge of tobacco control at a university hospital]. / O dasafio de controlar o tabagismo em um hospital universitário.

OBJECTIVE: To identify the actions taken by the Commission of Tobacco Control (CTC) to control smoking in the hospital environment. METHODS: Descriptive and exploratory retrospective documentary research conducted at a university hospital in southern Brazil, in 2014. The content of the minutes of CTC meetings was used to create a database, and the rounds reports were descriptively analyzed. We sought to identify the most relevant actions from 2005 to 2014. RESULTS: The CTC implemented the Tobacco-Free Environment programme restricted cigarette smoking to designated areas and subsequently deactivated these areas. The only remaining outdoor smoking area in 2014 was deactivated. CONCLUSION: CTC actions have contributed to tobacco control in the hospital environment. This study will hopefully serve as a model to encourage other institutions to implement similar actions.

Hemostasis control after femoral percutaneous approach: A systematic review and meta-analysis.

BACKGROUND: Hemostasis control after percutaneous endovascular procedures through the femoral approach remains challenging for catheterization laboratory nurses, given method variability. OBJECTIVE: To summarize the available evidence on vascular devices efficacy dedicated to hemostasis control compared to the extrinsic compression after percutaneous procedures in the femoral vein or artery. METHODS: A systematic review with meta-analysis of randomized clinical trials was conducted. We compared different hemostasis methods in adult patients who underwent diagnostic and/or therapeutic procedures through femoral access. The databases searched were PubMed, Embase, CINAHL and Cochrane CENTRAL, and updated on 03/2022. The outcomes included hematoma, pseudoaneurysm, bleeding, minor and major vascular complication, time to hemostasis, device failure, and manual compression repetition. The risk of bias was assessed using the Cochrane Risk of Bias Tool 1.0. Pooled effect sizes on continuous, categorical and proportion variables were estimated with the random effects model. The continuous variables were summarized as the difference between means weighted by the inverse of variance (WMD), and the categorical ones by the summary of relative risks (RR), estimated by the DerSimonian and Laird method. The Freeman-Tukey method was used to estimate the summary effect of proportions. RESULTS: Fifty articles were included in the systematic review. When compared to extrinsic compression, vascular closure devices resulted in a relative risk reduction (RRR) for hematoma: RR 0.82 [95%CI 0.72 to 0.94] and in shorter time to hemostasis WMD -15.06 min [95%CI -17.56 to -12.56]; no association was observed between interventions with vascular closure devices and extrinsic compression for pseudoaneurysm, bleeding, minor and major vascular complications. Compared to extrinsic compression, sealant or gel type devices were compatible with a RRR for hematoma: RR 0.73 [95%CI 0.59 to 0.90]; and metal clip or staple type devices for pseudoaneurysm: RR 0.48 [95%CI 0.25 to 0.90]; and major vascular complication: RR 0.33 [95%CI 0.17 to 0.64]. For each 100 observations, the device failure rate for metal clip or staple was 3.28% [95%CI 1.69 to 6.27]; for suture 6.84% [95%CI 4.93 to 9.41]; for collagen 3.15% [95%CI 2.24 to 4.41]; and for sealant or gel 7.22% [95% CI 5.49 to 9.45]. CONCLUSIONS: Vascular closure devices performed better in hemostasis control. The certainty of the evidence was rated as very low to moderate. REGISTRATION: PROSPERO CRD42019140794.

Use of the ADHERE Risk Model as a Predictor of Risk of in-Hospital Worsening Heart Failure in a Cohort. / Uso do Modelo de Risco ADHERE como Preditor de Piora Intra-Hospitalar de Insuficiência Cardíaca em uma Coorte.

BACKGROUND: Patients admitted with acute decompensated heart failure (HF) are subject to developing worsening episodes that require more complex interventions. The Acute Decompensated Heart Failure National Registry (ADHERE) risk model was developed in the United States to predict the risk of in-hospital worsening HF. OBJECTIVE: To use the ADHERE risk model in the assessment of risk of in-hospital worsening HF and to determine its sensitivity and specificity in hospitalized patients. METHODS: This cohort study was conducted at a Brazilian public university hospital, and data from 2013 to 2020 were retrospectively collected. P values < 0.05 were considered statistically significant. RESULTS: A total of 890 patients with a mean age of 74 ± 8 years were included. The model showed that, in the group of 490 patients at risk, 254 (51.8%) developed in-hospital worsening HF. In the group of 400 patients not at risk, only 109 (27.2%) experienced worsening HF. The results demonstrated a statistically significant curve (area under the curve = 0.665; standard error = 0.018; P < 0.01; confidence interval = 0.609 to 0.701), indicating good accuracy. The model had a sensitivity of 69.9% and a specificity of 55.2%, with a positive predictive value of 52% and a negative predictive value of 72.7%. CONCLUSIONS: In this cohort, we showed that the ADHERE risk model was able to discriminate patients who in fact developed worsening HF during the admission period, from those who did not.

FUNDAMENTO: Pacientes hospitalizados com insuficiência cardíaca (IC) aguda descompensada estão sujeitos a desenvolver episódios de piora que requerem intervenções mais complexas. O modelo de predição de risco "Acute Decompensated Heart Failure National Registry" (ADHERE) foi desenvolvido nos Estados Unidos para prever o risco de piora intra-hospitalar da IC. OBJETIVO: Utilizar o modelo de predição de risco ADHERE para avaliar o risco de piora intra-hospitalar da IC e determinar a sua sensibilidade e especificidade em pacientes hospitalizados. MÉTODOS: O presente estudo de coorte foi realizado em um hospital universitário público brasileiro e os dados de 2013 a 2020 foram coletados retrospectivamente. Foram considerados estatisticamente significativos valores de p < 0,05. RESULTADOS: Foram incluídos 890 pacientes com idade média de 74 ± 8 anos. O modelo mostrou que no grupo de 490 pacientes de risco, 254 (51,8%) desenvolveram piora intra-hospitalar da IC. No grupo de 400 pacientes sem risco, apenas 109 (27,2%) apresentaram piora da IC. Os resultados demonstraram uma curva estatisticamente significativa (área sob a curva = 0,665; erro padrão = 0,018; p < 0,01; intervalo de confiança = 0,609 a 0,701), indicando boa precisão. O modelo apresentou sensibilidade de 69,9% e especificidade de 55,2%, com valor preditivo positivo de 52% e valor preditivo negativo de 72,7%. CONCLUSÕES: Na presente coorte, demonstramos que o modelo de predição de risco ADHERE foi capaz de discriminar pacientes que, de fato, desenvolveram piora da IC durante o período de internação daqueles que não desenvolveram.

Specific causal validation of nursing diagnosis Risk for thrombosis: A case-control study.

PURPOSE: This study aims to perform specific causal validation of nursing diagnosis Risk for thrombosis (00291) of the NANDA International (NANDA-I) classification. METHODS: This is a case-control study conducted in a university hospital from January to October 2020. A total of 516 adult patients were included-344 in the Case Group (with venous or arterial thrombosis evidenced by imaging) and 172 in the Control Group (without thrombosis). Statistical analysis was performed by univariate and multivariate logistic regression test, and odds ratios were calculated to measure the effect of exposure between groups. The study was approved by the Research Ethics Committee. FINDINGS: The patients were predominantly female and aged 59 ± 16 years. In the univariate logistic analysis, five risk factors were significantly associated with thrombosis, two at-risk populations and 12 associated conditions. In the multivariate regression model, the following risk factors remained independently associated (p < 0.05): inadequate knowledge of modifiable factors (OR: 3.03; 95% CI: 1.25-8.56) and ineffective medication self-management (OR: 3.2; 95% CI:1.77-6.26); at-risk populations with history (OR: 2.16; 95% CI: 1.29-3.66) and family history of thrombosis (OR:2.60; 95% CI: 1.03-7.49); and the conditions associated with vascular diseases (OR:6.12; 95% CI:1.69-39.42), blood coagulation disorders (OR: 5.14; 95% CI:1.85-18.37), atherosclerosis (OR:2.07; 95% CI: 1.32-3.27), critical illness (OR: 2.28; 95% CI: 1.42-3.70), and immobility (OR: 2.09; 95% CI: 1.10-4.12). CONCLUSIONS: The clinical validation allowed to establish strong evidence for the refinement of the diagnosis Risk for thrombosis and, consequently, to raise its level of evidence in the classification of NANDA-I. IMPLICATIONS FOR NURSING PRACTICE: The evidence pointed out by this study favors the establishment of thrombosis diagnosis in an accurate way by nurses in clinical practice, directing preventive interventions to patients in this risk condition.

OBJETIVO: Realizar a validação causal específica do diagnóstico de enfermagem Risco de trombose (00291) da classificação diagnóstica da NANDA International, Inc. MÉTODOS: Estudo de caso-controle, realizado em hospital universitário entre janeiro e outubro de 2020. Foram incluídos 516 pacientes adultos - 344 no Grupo Caso (com trombose venosa ou arterial evidenciada em exame de imagem) e 172 no Grupo Controle (sem trombose). A análise estatística ocorreu por teste de regressão logística univariada e multivariada, e Odds ratios calculados para medir o efeito da exposição entre os grupos. O estudo foi aprovado em Comitê de Ética. RESULTADOS: Os pacientes foram predominantemente do sexo feminino e idade de 59±16 anos. Na análise logística univariada foi associado significativamente á trombose: cinco fatores de risco, duas populações em risco e 12 condições associadas. No modelo de regressão multivariada permaneceram independentemente associados (P<0,05) os fatores de risco conhecimento inadequado sobre os fatores modificáveis (OR:3,03; IC95%:1,25-8,56) e autogestão ineficaz de medicamentos (OR:3,24; IC95%:1,77-6,26); as populações em risco com história prévia (OR:2,16; IC95%:1,29-3,66) e história familiar de trombose (OR:2,60; IC95%:1,03-7,49); e as condições associadas a doenças vasculares (OR:6,12; IC95%:1,69-39,42), distúrbios de coagulaçõo (OR:5,14; IC95%:1,85-18,37),aterosclerose (OR:2,07; IC95%:1,32-3,27), doença crítica (OR:2,28; IC95%:1,42-3,70) e imobilidade (OR:2,09; IC95%:1,10-4,12). CONCLUSÕES: A validação clínica permitiu estabelecer fortes evidências para o refinamento do diagnóstico Risco de trombose e, consequentemente, elevar seu nível de evidência na classificação da NANDA-I. IMPLICAÇÕES PARA A PRÁTICA: As evidências apontadas pelo estudo favorecem o estabelecimento deste diagnóstico de forma acurada pelos enfermeiros na prática clínica, direcionando intervenções preventivas aos pacientes nesta condiçõo de risco.

[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.

NANDA-I, NOC, and NIC linkages to SARS-CoV-2 (COVID-19): Part 3. Family response.

PURPOSE: To provide guidance to nurses caring for families with COVID-19, we developed linkages using interoperable standardized nursing terminologies: NANDA International (NANDA-I) nursing diagnoses, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC). In addition, we wanted to identify gaps in the terminologies and potential new nursing diagnoses, outcomes, and interventions for future development related to nurse roles in family care during a pandemic. METHODS: Using a consensus process, seven nurse experts created the linkages focused on families during the COVID-19 pandemic using the following steps: (1) creating an initial list of potential nursing diagnoses, (2) selecting and categorizing outcomes that aligned with all components of each nursing diagnosis selected, and (3) identifying relevant nursing interventions. FINDINGS: We identified a total of seven NANDA-I nursing diagnoses as the basis for the linkage work. These are distributed in three NANDA-I Domains and based in the psychosocial dimension of the Nursing Care in Response to Pandemics model. Eighty-nine different NOC outcomes were identified to guide care based on the nursing diagnoses, and 54 different NIC interventions were suggested as possible interventions. Fifteen new proposed concepts were identified for future development across the three classifications. CONCLUSIONS: The linkages of nursing diagnoses, outcomes, and interventions provide a guide to enhance nursing practice and care documentation that could quantify the impact of nursing care to patient outcomes for families at risk for or infected by COVID-19. IMPLICATIONS FOR NURSING PRACTICE: NANDA-I, NOC, and NIC linkages identified in this paper provide resources to support clinical decisions and guide critical thinking for nurses encountering care needs of families with COVID-19. Documentation of these linkages provides data that can create new knowledge to enhance the care of families impacted by COVID-19.

NANDA-I, NOC, and NIC Linkages to SARS-Cov-2 (Covid-19): Part 1. Community Response.

PURPOSE: We developed linkages using interoperable standardized nursing terminologies, NANDA International (NANDA-I) nursing diagnoses, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC), to present initial guidance for the development of care plans focused on COVID-19 for nurses practicing in community or public health roles. METHODS: Seven nurse experts identified the linkages of NANDA-I, NOC and NIC for our work related to the COVID-19 pandemic. A model was developed to guide the project. The first step in creating linkages focused on the identification of nursing diagnoses. Then, for each nursing diagnosis, outcomes aligned with all components of the diagnosis were categorized and a list of nursing interventions was selected. The experts used their clinical judgment to make final decisions on the linkages selected in this study. FINDINGS: Two community level nursing diagnoses were identified as key problems appropriate for a pandemic related to COVID-19: Deficient Community Health and Ineffective Community Coping. For the nursing diagnosis Deficient Community Health, eight nursing outcomes and 12 nursing interventions were selected. In comparison for the nursing diagnosis, Ineffective Community Coping, nine nursing outcomes and 18 nursing interventions were identified. A total of40 concepts were identified for future development across the three classifications. CONCLUSIONS: The nursing diagnoses, outcomes and interventions selected during this linkage process provide knowledge to support the community challenged with responding to the COVID-19 pandemic, provide the opportunity to quantify the impact of nursing care, and enhance nursing practice by promoting the use of three standardized terminologies. IMPLICATIONS FOR NURSING PRACTICE: NANDA-I, NOC and NIC linkages identified in this manuscript provide resources to support clinical decisions and care plan development for nurses practicing in the community.

NANDA-I, NOC, and NIC linkages to SARS-CoV-2 (COVID-19): Part 2. Individual response.

PURPOSE: To provide guidance to nurses caring for individuals with COVID-19, we developed linkages using interoperable standardized nursing terminologies: NANDA International (NANDA-I) nursing diagnoses, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC). We also identified potential new NANDA-I nursing diagnoses, NOC outcomes, and NIC interventions for future development related to nurses' role during a pandemic. METHODS: Using a consensus process, seven nurse experts created the linkages for individuals during the COVID 19 pandemic using the following steps: (a) creating an initial list of potential nursing diagnoses, (b) selecting and categorizing outcomes that aligned with all components of each nursing diagnosis selected, and (c) identifying relevant nursing interventions. FINDINGS: A total of 16 NANDA-I nursing diagnoses were identified as the foundation for the linkage work, organized in two dimensions, physiological and psychosocial. A total of 171 different NOC outcomes were identified to guide care based on the nursing diagnoses and 96 NIC interventions were identified as suggested interventions. A total of 13 proposed concepts were identified for potential future development across the three classifications. CONCLUSIONS: The linkages of nursing diagnoses, outcomes, and interventions developed in this article provide a guide to enhance nursing practice and determine the effectiveness of nurses' contribution to patient outcomes for individuals at risk for or infected by COVID-19. IMPLICATIONS FOR NURSING PRACTICE: NANDA-I, NOC, and NIC linkages identified in this paper are an important example of the value of using standardized nursing terminologies to guide and document nursing care. When included in electronic health record databases and used widely, the data generated from the care plans can be used to create new knowledge about how to better improve outcomes for patients with COVID-19.

Hemostasis after percutaneous transfemoral access: A protocol for systematic review.

BACKGROUND: Access site hemostasis after percutaneous procedures done in the catheterization laboratory still needs to be better studied in relation to such aspects as the different results achieved with different hemostasis strategies, the impact of different introducer sheath sizes, and arterial versus venous access. The objective of this review is to synthesize the available scientific evidence regarding different techniques for hemostasis of femoral access sites after percutaneous diagnostic and therapeutic procedures. METHODS: This review is being reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). The primary outcomes will include the following vascular complications: hematoma, pseudoaneurysm, bleeding, minor, and major vascular complications. The secondary outcomes will include the following: time to hemostasis, repetition of manual compression, and device failure. A structured strategy will be used to search the PubMed/ MEDLINE, Embase, CINAHL, and CENTRAL databases. In addition, a handsearch of the reference lists of selected studies will be conducted. The ERIC research database will be queried for the gray literature and ClinicalTrials.gov, for potential results not yet published in indexed journals. Two reviewers will independently screen citations and abstracts, identify full-text articles for inclusion, extract data, and appraise the quality and risk of bias of included studies. If possible, a meta-analysis will be carried out. All estimations will be made using Review Manager 5.3. Statistical heterogeneity will be assessed by considering the I2 proxy, accompanied with qualitative indicators such as differences in procedures, interventions, and outcomes among the studies. If synthesis proves inappropriate, a narrative review will be undertaken. RESULTS: This protocol adheres to the PRISMA-P guideline to ensure clarity and completeness of reporting at all phases of the systematic review. CONCLUSION: This study will provide synthesized information on different methods used to achieve hemostasis after femoral access. ETHICS AND DISSEMINATION: Ethical approval number CAAE 19713219700005327. The results of the systematic review will be disseminated via publication in a peer-reviewed journal and through conference presentations. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019140794.

Prediction of risk and diagnostic accuracy in patients hospitalized for decompensated heart failure: cohort study. / Predição de risco e acurácia diagnóstica em pacientes internados com insuficiência cardíaca descompensada: estudo de coorte.

OBJECTIVES: To analyze the diagnostic accuracy in nursing in patients with predicted risk of clinical worsening during hospitalization for acutely decompensated heart failure. METHODS: Cohort study with data collection in medical records according to the Acute Decompensated Heart Failure National Registry risk model. After defining the patients at risk, the Nursing Diagnosis Accuracy Scale version 2 was applied. The scale classifies the accuracy as null, low, moderate or high. RESULTS: Of the 43 patients at risk of worsening, 22 (51%) did not worsen and 21 (49%) worsened; in both, the diagnostic accuracy was in the Moderate / High category in 22 (89%) and 16 (88%), respectively. Only Decreased cardiac output and Excessive fluid volume were scored with 100% in the High category. CONCLUSIONS: Patients with acute decompensated heart failure and risk of clinical worsening during hospitalization were identified with moderate or high diagnostic accuracy by nurses.

Uso do Modelo de Risco ADHERE como Preditor de Piora Intra-Hospitalar de Insuficiência Cardíaca em uma Coorte / Use of the ADHERE Risk Model as a Predictor of Risk of in-Hospital Worsening Heart Failure in a Cohort

Resumo Fundamento Pacientes hospitalizados com insuficiência cardíaca (IC) aguda descompensada estão sujeitos a desenvolver episódios de piora que requerem intervenções mais complexas. O modelo de predição de risco "Acute Decompensated Heart Failure National Registry" (ADHERE) foi desenvolvido nos Estados Unidos para prever o risco de piora intra-hospitalar da IC. Objetivo Utilizar o modelo de predição de risco ADHERE para avaliar o risco de piora intra-hospitalar da IC e determinar a sua sensibilidade e especificidade em pacientes hospitalizados. Métodos O presente estudo de coorte foi realizado em um hospital universitário público brasileiro e os dados de 2013 a 2020 foram coletados retrospectivamente. Foram considerados estatisticamente significativos valores de p < 0,05. Resultados Foram incluídos 890 pacientes com idade média de 74 ± 8 anos. O modelo mostrou que no grupo de 490 pacientes de risco, 254 (51,8%) desenvolveram piora intra-hospitalar da IC. No grupo de 400 pacientes sem risco, apenas 109 (27,2%) apresentaram piora da IC. Os resultados demonstraram uma curva estatisticamente significativa (área sob a curva = 0,665; erro padrão = 0,018; p < 0,01; intervalo de confiança = 0,609 a 0,701), indicando boa precisão. O modelo apresentou sensibilidade de 69,9% e especificidade de 55,2%, com valor preditivo positivo de 52% e valor preditivo negativo de 72,7%. Conclusões Na presente coorte, demonstramos que o modelo de predição de risco ADHERE foi capaz de discriminar pacientes que, de fato, desenvolveram piora da IC durante o período de internação daqueles que não desenvolveram.

Abstract Background Patients admitted with acute decompensated heart failure (HF) are subject to developing worsening episodes that require more complex interventions. The Acute Decompensated Heart Failure National Registry (ADHERE) risk model was developed in the United States to predict the risk of in-hospital worsening HF. Objective To use the ADHERE risk model in the assessment of risk of in-hospital worsening HF and to determine its sensitivity and specificity in hospitalized patients. Methods This cohort study was conducted at a Brazilian public university hospital, and data from 2013 to 2020 were retrospectively collected. P values < 0.05 were considered statistically significant. Results A total of 890 patients with a mean age of 74 ± 8 years were included. The model showed that, in the group of 490 patients at risk, 254 (51.8%) developed in-hospital worsening HF. In the group of 400 patients not at risk, only 109 (27.2%) experienced worsening HF. The results demonstrated a statistically significant curve (area under the curve = 0.665; standard error = 0.018; P < 0.01; confidence interval = 0.609 to 0.701), indicating good accuracy. The model had a sensitivity of 69.9% and a specificity of 55.2%, with a positive predictive value of 52% and a negative predictive value of 72.7%. Conclusions In this cohort, we showed that the ADHERE risk model was able to discriminate patients who in fact developed worsening HF during the admission period, from those who did not.

Trombose: análise de conceito como subsídio teórico para qualificar a prática clínica de enfermeiros / Thrombosis: concept analysis as a theoretical contribution to qualify the clinical practice of nurses

OBJETIVO: analisar o conceito de trombose e identificar aplicações, atributos definidores, antecedentes, consequentes e referenciais empíricos. MÉTODO: análise de conceito, segundo Walker e Avant. RESULTADOS: os atributos definidores mais citados foram trombo (s), tríade de Virchow e comprometimento total/ parcial do fluxo sanguíneo. Os antecedentes mais frequentes foram câncer/uso de quimioterápicos, trombofilias e diabetes. Várias manifestações compuseram os consequentes, conforme o leito vascular comprometido. Os mais citados foram: acidente vascular cerebral ou acidente isquêmico transitório, infarto agudo do miocárdio e tromboembolismo pulmonar. Os referenciais empíricos se relacionaram a exames clínicos, testes de coagulação e escores de risco. A tomografia computadorizada foi o exame de imagem mais citado. CONCLUSÃO: a análise de conceito de trombose evidenciou o uso deste termo na literatura atual, bem como os atributos definidores, antecedentes, consequentes e referenciais empíricos. Este estudo agrega conhecimento à prática clínica de enfermeiros e pode contribuir com o refinamento dos sistemas de linguagens padronizadas.

OBJECTIVE: to analyze the concept of thrombosis and identify its applications, defining attributes, antecedents, consequences, and empirical references. METHOD: a concept analysis was carried out using Walker and Avant's framework. RESULTS: the most cited defining attributes were thrombus, Virchow's triad, and total/partial impairment of blood flow. The most frequent antecedents were cancer/chemotherapy, thrombophilia, and diabetes. Several manifestations composed the consequences, according to the compromised vascular bed. The most cited were stroke or transient ischemic attack, acute myocardial infarction, and pulmonary thromboembolism. The empirical references were related to clinical examinations, coagulation tests, and risk scores. Computed tomography was the most cited imaging test. CONCLUSION: The analysis of the thrombosis concept showed the use of this term in the current literature, its defining attributes, antecedents, consequences, and empirical references. This study adds knowledge to nurses' clinical practice and can contribute to the refinement of standardized language systems.

Cross Mapping Between the Priority Nursing Care for Stroke Patients Treated With Thrombolytic Therapy and the Nursing Interventions Classification (NIC).

OBJECTIVE: To verify the correspondence between the priority nursing care for stroke patients treated with thrombolytic therapy and the Nursing Interventions Classification (NIC). METHODS: A cross-mapping study with a semi-structured interview was conducted with 11 expert nurses who described priority nursing care in clinical practice, and mapped it to the NIC. RESULTS: Eleven nursing care priorities cited by the nurses were mapped to eight NICs, including Thrombolytic Therapy Management (4270). CONCLUSIONS: There was correspondence between all priority nursing care interventions for stroke patients treated with thrombolytic therapy and the NIC. IMPLICATIONS FOR NURSING PRACTICE: The nursing care cited by the nurses was corroborated by the NIC, providing evidence for the clinical practice. OBJETIVO: Verificar a correspondência entre os cuidados de enfermagem prioritários a pacientes com acidente vascular encefálico tratados com terapia trombolítica e a Classificação das Intervenções de Enfermagem (NIC). MÉTODOS: Estudo de mapeamento cruzado com uma entrevista semi-estruturada aplicada a 11 enfermeiros especialistas que descreveram os cuidados de enfermagem prioritários na prática clínica, e mapeados para a NIC. RESULTADOS: Onze cuidados de enfermagem prioritários foram citados pelos enfermeiros e mapeados em oito intervenções de enfermagem NIC, incluindo a Thrombolytic Therapy Management (4270). CONCLUSÕES: Houve correspondência entre todos os cuidados de enfermagem prioritários para pacientes com acidente vascular encefálico tratados com a terapia trombolítica e as intervençães de enfermagem NIC. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: Os cuidados de enfermagem citados pelos enfermeiros foram corroborados pela NIC, produzindo evidências para a prática clínica.

A enfermagem frente ao paciente tabagista hospitalizado: diagnósticos e intervenções estabelecidos na prática clínica / Nursing in front of the hospitalized smoking patient: diagnosis and interventions established in clinical practice / Enfermería frente al paciente fumador hospitalizado: diagnóstico e intervenciones establecidas en la práctica clínica

Objetivo: Identificar diagnósticos e intervenções de enfermagem estabelecidos para pacientes tabagistas hospitalizados. Métodos: estudo transversal realizado em hospital universitário brasileiro entre agosto e setembro/2017 com entrevistas à beira do leito, consultas ao prontuário e query extraída do sistema informatizado da instituição. Resultados: participaram69 pacientes tabagistas, para os quais identificaram-se 41 diagnósticos de enfermagem distintos, com mediana de quatro (intervalo interquartil: 3;6) por paciente. As intervenções prescritas totalizaram 237, com mediana de 18,5 (intervalo interquartil: 10,5;28,25) por prescrição. Quatro pacientes possuíam diagnóstico com etiologia relacionada ao abuso de substância e para esses foram prescritas 17 intervenções de enfermagem. Em 33(48%) anamneses constava que o paciente era tabagista e, destes, nove(27%) havia o tempo de fumo e número de cigarros consumidos diariamente. Conclusão: a prevalência de tabagistas hospitalizados é expressiva, entretanto, as anamneses, os diagnósticos e intervenções de enfermagem não retratam esta realidade, havendo necessidade de sensibilizar e capacitar a equipe

Objetivo: Identificar diagnósticos e intervenciones de enfermería establecidos para los pacientes que fuman hospitalizados. Métodos: estudio transversal realizado em hospital universitario brasileño entre agosto y septiembre/2017 con entrevistas de cabecera e consultas em registros médicos del sistema computarizado de institución. Resultados: participaron 69 pacientes fumadores, para quienes se identificaron 41 diagnósticos de enfermería diferentes, con mediana de cuatro(rango intercuartil: 3;6) por paciente. Las intervenciones prescritas totalizaron 237, con mediana de 18.5(rango intercuartil: 10.5;28.25) por receta. Cuatro pacientes tuvieron diagnóstico con etiología relacionada con abuso de sustancias y se prescribieron 17 intervenciones de enfermería para estos. En 33(48%) anamnesas se informó que el paciente era fumador, de estos, nueve(13%) tenían el tiempo de fumar y cantidad de cigarrillos consumidos diariamente. Conclusión: la prevalencia de fumadores hospitalizados es significativa, sin embargo, las anamnesias, diagnósticos y intervenciones de enfermería no reflejan esta realidad, con la necesidad de crear conciencia y capacitar al equipo

Objective:To identify nursing diagnoses and interventions established for hospitalized smoking patients. Methods: cross-sectional study carried out in a Brazilian university hospital between August and September/2017 bybedside interviews, consultations on medical records and queries extracted from the institution's computerized system. Results: 69 smoking patients participated and 41 different nursing diagnoses were identified, with a median of four (interquartile range: 3;6) per patient. The prescribed interventions totaled 237, with a median of 18.5 (interquartile range: 10.5;28.25) per prescription. Four patients' diagnosis had etiology related to substance abuse and 17 nursing interventions were prescribed for these. In 33(48%) anamneses it was reported that the patient was a smoker and, of these, nine(13%) had the smoking time and number of cigarettes consumed daily. Conclusion: the prevalence of hospitalized smokers is significant, however, anamneses, diagnoses and nursing interventions don't portray this reality, with the need to raise awareness and train the team

Analysis of managerial and healthcare indicators after nursing personnel upsizing. / Análise de indicadores gerenciais e assistenciais após adequação de pessoal de enfermagem.

OBJECTIVE: analyze healthcare and managerial indicators after nursing personnel upsizing. METHOD: a retrospective, descriptive study was conducted using data from computer systems of a university hospital in southern Brazil. Healthcare and managerial indicators related to the first half of 2013 and 2014 were statistically analyzed. RESULTS: increases of 40.0% in the number of nurses and 16.0% in the number of nursing technicians led to reductions of 12.0% in the number of sickness absences, 21.8% in positive balance for compensatory time off, 92.0% in paid overtime. Reductions of 75.0% in pressure ulcer rates, 10.5% in the number of falls and 50.0% in infections due to indwelling catheter use were also observed. CONCLUSION: nursing staff upsizing caused a positive impact on managerial and healthcare indicators and helped qualify care and improve work conditions for the nursing team.

Passagem de plantão da enfermagem: desenvolvimento e validação de instrumentos para qualificar a continuidade do cuidado / Cambio de turno de enfermería: desarrollo y validación de instrumentos para calificar la continuidad de la atención / Nursing handoffs: development and validation of instruments to qualify care continuity

RESUMO Objetivo: desenvolver e validar o conteúdo de instrumentos para padronizar a passagem de plantão da enfermagem. Método: estudo de desenvolvimento e validação por consenso de especialistas, conduzido de janeiro a julho de 2019 em hospital do sul do Brasil. Participaram do estudo 24 profissionais de diferentes áreas, incluindo enfermeiros, técnicos e professores de enfermagem, com experiência na passagem de plantão hospitalar. Avaliou-se abrangência, clareza e pertinência dos itens dos instrumentos, sendo validados pelos especialistas sobre cada item dos instrumentos desenvolvidos, obtendo-se índice de concordância de 93%. Resultados: foram elaborados o "Formulário de Passagem de Plantão", contemplando identificação dos pacientes, informações clínicas e intercorrências de cada turno, e o "Procedimento Operacional Padrão para Passagem de Plantão", descrevendo atividades a serem realizadas para garantir a transmissão de informações precisas. Considerações finais os instrumentos elaborados podem nortear a passagem de plantão da enfermagem na prática clínica, promovendo a continuidade e segurança do cuidado.

RESUMEN Objetivo: desarrollar y validar el contenido de instrumentos para estandarizar el cambio de turno de Enfermería. Método: estudio para el desarrollo y la validación por consenso de especialistas realizado entre enero y julio de 2019 en un hospital del sur de Brasil. En el estudio participaron 24 profesionales de diferentes áreas, incluidos enfermeros, técnicos y profesores de Enfermería, con experiencia en el cambio de turno en hospitales. Se evaluó el alcance, la claridad y la pertinencia de los ítems de los instrumentos y los especialistas lo validaron en cada ítem de los instrumentos desarrollados, obteniéndose un índice de concordancia del 93%. Resultados: se elaboraron dos documentos, a saber: "Formulario de Cambio de Turno", que contempla la identificación de los pacientes, información clínica y complicaciones de cada turno, y el "Procedimiento Operativo Estándar para Cambio de Turno", que describe actividades que deben realizarse para garantizar la transmisión de información precisa. Consideraciones finales: los instrumentos elaborados pueden dirigir el cambio de turno de Enfermería en la práctica clínica, promoviendo así la continuidad y seguridad de la atención.

ABSTRACT Objective: to develop and validate the content of instruments to standardize Nursing handoffs. Method: a study for the development and validation through expert consensus conducted between January and July 2019 in a hospital of southern Brazil. The study participants were 24 professionals from different areas, including nurses, nursing technicians and professors, with experience in hospital handoffs. The experts evaluated and validated the scope, clarity and pertinence of the items of the instruments developed, obtaining an agreement index of 93%. Results: two documents were prepared, namely: the "Handoff Form", considering the patients' identification, clinical information, and complications during each shift, and the "Handoff Standard Operating Procedure", describing activities to be performed to ensure the transmission of precise information. Final considerations: the instruments elaborated can guide Nursing handoffs in the clinical practice, promoting care continuity and safety.

Prevalence and factors associated with smoking among tobacco growers in southern Brazil.

OBJECTIVE: identify the prevalence and factors associated with smoking in tobacco growers. METHOD: descriptive, cross-sectional research. Data collection occurred in 2012 through household survey and interviews, including application of a structured instrument and scale Fargeström. RESULTS: there were 100 growers included, average age of 46,9 ± 10,8 years; 90(90%) married; 72(72%) white, average family composition 3,7±1,1 people; median number of children 3(1-3), and the average study time 6±2,5. The prevalence of smoking among tobacco growers was 17%, which had less education (p=0.010) and fewer people in the household (p=0.049). CONCLUSION: the prevalence of smoking among tobacco growers was higher than the national average, but the nicotine dependence was low, which can facilitate the smoking cessation process. Highlights the need to implement a program to control smoking among tobacco growers.

Predição de risco e acurácia diagnóstica em pacientes internados com insuficiência cardíaca descompensada: estudo de coorte / Predicción de riesgo y precisión diagnóstica en pacientes internados con insuficiencia cardiaca descompensada: estudio de cohorte / Prediction of risk and diagnostic accuracy in patients hospitalized for decompensated heart failure: cohort study

Resumo OBJETIVOS Analisar a acurácia diagnóstica de enfermagem em pacientes com predição de risco de piora clínica durante internação por insuficiência cardíaca agudamente descompensada. MÉTODO Estudo de coorte com coleta de dados em prontuário de acordo com o Acute Decompensated Heart Failure National Registry risk model. Após a definição dos pacientes em risco, aplicou-se a Escala de Acurácia de Diagnósticos de Enfermagem versão 2. A escala classifica a acurácia em nula, baixa, moderada ou alta. RESULTADOS Dos 43 pacientes com risco de piora, 22(51%) não pioraram e 21(49%) pioraram; em ambos, a acurácia diagnóstica apresentou-se na categoria Moderada/Alta em 22(89%) e 16(88%), respectivamente. Apenas Débito cardíaco diminuído e Volume de líquidos excessivo foram pontuados com 100% na categoria Alta. CONCLUSÕES Pacientes agudamente descompensados e com risco de piora clínica durante a internação foram identificados com acurácia diagnóstica Moderada ou Alta pelos enfermeiros.

Resumen OBJETIVOS Analizar la precisión diagnóstica enfermera em pacientes con predicción de riesgo de empeoramiento clínico durante su internación por insuficiencia cardiaca agudamente descompensada. MÉTODO Estudio de cohorte con colecta de datos em las historias médicas de pacientes con riesgo de empeoramiento clínico de acuerdo con la Acute Decompensated Heart Failure National Registry risk model. Después de la definición de los pacientes en riesgo, se aplicó la Escala de Precisión de Diagnósticos de Enfermería versión 2. La escala clasifica la precisión en nula, baja, modera o alta. RESULTADOS De los 43 pacientes con riesgo de empeoramiento, 22(51%) no empeoraron y 21(49%) empeoraron; en ambos, la precisión diagnóstica se presentó en categoría Moderada/Alta en 22(89%) y 16(88%), respectivamente. Apenas Disminuición del Gasto cardíaco y Volumen de líquidos excesivo fueron puntuados con 100% en la categoría Alta. CONCLUSIONESPacientes con insuficiencia cardiaca agudamente descompensada y riesgo de peora clínica durante su internación fueron identificados con precisión diagnóstica Moderada o Alta por los enfermeros.

Abstract OBJECTIVES To analyze the diagnostic accuracy in nursing in patients with predicted risk of clinical worsening during hospitalization for acutely decompensated heart failure. METHODS Cohort study with data collection in medical records according to the Acute Decompensated Heart Failure National Registry risk model. After defining the patients at risk, the Nursing Diagnosis Accuracy Scale version 2 was applied. The scale classifies the accuracy as null, low, moderate or high. RESULTS Of the 43 patients at risk of worsening, 22 (51%) did not worsen and 21 (49%) worsened; in both, the diagnostic accuracy was in the Moderate / High category in 22 (89%) and 16 (88%), respectively. Only Decreased cardiac output and Excessive fluid volume were scored with 100% in the High category. CONCLUSIONS Patients with acute decompensated heart failure and risk of clinical worsening during hospitalization were identified with moderate or high diagnostic accuracy by nurses.