COVID-19 infection in nursing staff: A cohort study.

AIM: This study aims to identify the working conditions of Brazilian nursing professionals and the risk factors for these professionals to become infected by coronavirus disease. BACKGROUND: Understanding the factors that affected nursing professionals during the pandemic can support better nursing management. DESIGN: This is a quantitative, cross-sectional survey study. METHODS: Data collection was carried out between February and March 2022 in Brazil. All nursing professionals registered in the national database received by e-mail the study instrument with the data collection variables: professionals' sociodemographic and comorbid, professional and institutional characteristics, and professionals' health conditions and disease-related aspects for COVID-19. RESULTS: Four thousand eight hundred sixty-two nursing professionals reported a lack of personal protective equipment for patient care, and 4424 were infected by coronavirus disease. The risk factors to become infected were having cardiovascular disease, being under 60 years of age, living in the northern region, using public transportation, working in a hospital, an emergency department or reference institution for COVID-19, living with an infected person and lack of respirators or waterproof aprons. CONCLUSION: Multiple risk factors for infection with SARS-CoV-2 were demonstrated for the nursing professionals during the pandemic, highlighting current and future pandemics factors that are modifiable in a worthwhile time frame to minimize nurses' infection risks, such as inadequate working conditions associated with lack of essential personal protective equipment.

Surgical Smoke and Biological Symptoms in Healthcare Professionals and Patients: A Systematic Review.

PURPOSE: This study aimed to identify the evidence in the scientific literature between exposure to surgical smoke and biological symptoms in healthcare professionals and patients. DESIGN: A systematic review. METHODS: Electronic databases were searched, including vivo observational and experimental studies published until August 2020 in Portuguese, English, Spanish and French. FINDINGS: We identified 13 studies, with a predominance of cross-sectional (6; 46.15%), experimental laboratory (4; 30.76%) and cohort (3; 23.07%) studies. The main manifestations identified were related to respiratory tract and headache. There was identification of histopathological changes in the nasal mucosa of healthcare professionals and the presence of toxic substances from smoke identified in the urine of patients and healthcare professionals. CONCLUSION: The scientific literature on the biological symptoms of surgical smoke is mainly composed of observational studies with a reduced sample size, thus constituting aspects which limit a broader and long-term understanding of the biological effects of surgical smoke exposure in healthcare professionals and patients.

Instruments to Identify Delirium in Patients Recovering From Anesthesia: A Scoping Review.

PURPOSE: To identify the validated instruments used for screening and detecting postoperative delirium (POD) during Post Anesthesia Recovery (PAR) period, and the incidence and associated risk factors with POD. DESIGN: A scoping review. METHODS: The study search occurred in May 2021 in the PubMed, Embase, Scopus, CINAHL, Web of Science and LILACS databases. Primary studies that used validated instruments for screening and detecting POD in the PAR period were included. FINDINGS: A total of 38 articles were included. The most used instruments were CAM-ICU, Nu-DESC, and RASS. The instruments that screened and detected delirium earliest were the Nu-DESC and CAM-ICU. POD incidence was up to 20% in more than half of the included studies. Cardiovascular comorbidities, chronic kidney disease, low functional reserve, chronic obstructive pulmonary disease and postoperative pain were among the primary risk factors. CONCLUSION: The instrumentsshowing the greatest accuracy for screening and detecting POD in the PAR period were the Nu-DESC and CAM-ICU.

Perioperative intensive glycemic control for liver transplant recipients to prevent surgical site infection: A systematic review and meta-analysis.

BACKGROUND: Surgical Site Infections (SSIs) are common among liver transplant recipients and result in adverse patient outcomes. Standard glycemic control is effective in reducing SSIs. Some studies suggest intensive glycemic control reduces the risk of SSI further. METHODS: For this systematic review, were searched for studies comparing perioperative intensive and standard glycemic control in liver transplant recipients. Clinical trials registries and reference lists of included studies were also searched. No date or language restrictions were applied. Randomized controlled trials (RCTs) were assessed using Cochrane risk of bias tool and GRADE method. Cohort studies were assessed using the Newcastle-Ottawa Scale. RESULTS: Two RCTs and three cohort studies met the inclusion criteria. Low-quality evidence from the two RCTs in a meta-analysis with 264 recipients found it was uncertain whether the risk of SSI was reduced by having intensive glycemic control (Risk Ratio [RR] 1.52, 95% CI 0.66-3.51). However, there was an increased risk of hypoglycemia among recipients having intensive glycemic control (RR 2.34, 95% CI 1.40-3.92) n = 264. Meta-analyses found it uncertain whether secondary outcomes, allograft rejection and death, were reduced among recipients having intensive glycemic control; (RR 0.85, 95% CI 0.48-1.50) and (RR 0.92, 95% CI 0.44-1.95), respectively. The two cohort studies were poor quality and presented conflicting outcomes on the effects of intensive blood glucose control on SSI. CONCLUSION: There is insufficient evidence to recommend the use of intensive glycemic control among liver transplant recipients to reduce SSIs.

Proposal of nursing diagnoses, outcomes and interventions for postoperative patients of orthognathic surgery. / Proposta de diagnósticos, resultados e intervenções de enfermagem para pacientes em pós-operatório de cirurgia ortognática.

OBJECTIVE: To propose nursing diagnoses, outcomes and interventions for patients in the postoperative period of orthognathic surgery. METHOD: Secondary analysis of an information bank of a focal group with five patients submitted to orthognathic surgery. The classifications of the North American Nursing Diagnosis Association International, Nursing Outcomes Classification and Nursing Interventions Classification were used for elaborating nursing diagnoses, outcomes and interventions. Nursing diagnoses were identified based on the transcription of the focus group and the expected outcomes and interventions were proposed. In the second stage, the material was submitted to an analysis by judges for validating the previous stage. RESULTS: After careful analysis of the retrieved information, nine nursing diagnoses that relate to both the difficulties already installed and to potential patient difficulties were identified. After this phase, the expected outcomes for nursing care and the appropriate interventions for the postoperative period at home were identified. CONCLUSION: Given the short hospital stay and the long postoperative period, the established actions have a strong educational focus.

Assessing gastric residual volume: a description of nurses' clinical practice. / Aferição do volume residual gástrico: retrato da prática clínica de enfermeiros.

OBJECTIVE: To analyze the differences in nurses' clinical practice for assessing residual gastric volume and identifying the theoretical framework which supports their practice. METHOD: A cross-sectional study carried out by sending an online questionnaire by e-mail to nurses registered at the Regional Nursing Council of the State of São Paulo. RESULTS: This study included 598 nursing professionals, with 484 only providing care to adults and 114 exclusively to children. The gastric residual volume test is performed by 83.4% of nursing professionals; in most cases the suspension and prescription of enteral nutritional therapy are performed by the physician. Suspension of enteral nutritional therapy among adults predominantly occurs when the gastric residual volume is equal to 200 ml, and in children when values are less than 100 ml. Procedure after diet suspension involves the return of aspirated gastric contents and maintaining the catheter closed until the next hour in 48.3% of the procedures among adults, and 68.4% among children. 42.9% of the participants in this study were not aware of the theoretical basis that supports the test performance. CONCLUSION: We can highlight the need for nurses' training and further studies focused on the practice for assessing gastric residual volume.

Perioperative fasting time among cancer patients submitted to gastrointestinal surgeries.

OBJECTIVE: To identify the length of perioperative fasting among patients submitted to gastrointestinal cancer surgeries. METHOD: Retrospective cohort study, developed by consulting the medical records of 128 patients submitted to gastrointestinal cancer surgeries. RESULTS: The mean of total length of fasting was 107.6 hours. The total length of fasting was significantly associated with the number of symptoms presented before (p=0.000) and after the surgery (p=0.007), the length of hospital stay (p=0.000), blood transfusion (p=0.013), nasogastric tube (p=0.001) and nasojejunal tube (p=0,003), postoperative admission at ICU (p=0.002), postoperative death (p=0.000) and length of preoperative fasting (p=0.000). CONCLUSION: The length of fasting is associated with complications that affect the quality of the patients' postoperative recovery and nurses' work. The nursing team should be alert to this aspect and being responsible for overseeing the patients' interest, should not permit the unnecessary extension of fasting. OBJETIVO: Identificar la duración del ayuno perioperatorio entre los pacientes sometidos a cirugías de cáncer gastrointestinal. MÉTODO: Estudio de cohorte retrospectivo, por consulta de los registros médicos de 128 pacientes sometidos a cirugías de cáncer gastrointestinal. RESULTADOS: La media de la duración total del ayuno fue de 107,6 horas. La duración total del ayuno se asoció significativamente con el número de síntomas presentados antes (p=0,000) y después de la cirugía (p=0,007), la duración de la estancia hospitalaria (p=0,000), transfusión de sangre (p=0,013),tubo nasogástrico (P=0,003), ingreso postoperatorio en la UCI (p=0,002), muerte postoperatoria (p=0,000) y duración del ayuno preoperatorio (p=0,000). CONCLUSIÓN: La duración del ayuno se asocia con complicaciones que afectan la calidad de la recuperación postoperatoria de los pacientes y el trabajo de enfermería. El equipo de enfermería debe estar alerta en relación a este aspecto y ser responsable de supervisar el interés de los pacientes, no permitiendo la extensión innecesaria del ayuno.

Aging as a predictor of nursing workload in Intensive Care Unit: results from a Brazilian Sample.

OBJECTIVE: Verify if aging is an independent predictor of NW in ICU, according to age groups, and its predictive value as a determinant of NW in ICU. METHODS: Study was conducted from 2012 to 2016. A convenience sample composed by patients (age ≥ 18) admitted to nine ICU belonging to a Brazilian hospital, was analyzed. Age was assumed as an independent variable and NW (measured by the Nursing Activities Score - NAS) as dependent. Linear regression model and ROC curve were used for the analysis. RESULTS: 890 participants (361 older people), mostly males (58.1%). The mean NAS score was higher among older participants in comparison to adults (p=0.004) but not within categories of aging (p=0.697). Age was responsible for 0.6% of NAS score. Each year of age increases NAS score in 0.081 points (p=0.015). However, age was not a good predictor of NAS score (AUC = 0.394; p=0.320). CONCLUSION: The care of older people in ICU is associated with an increase in NW, compared to adults. Aging can be considered an associated factor but not a good predictor of NW in ICU. OBJETIVO: Verificar si el envejecimiento es un predictor independiente de la Carga de Trabajo de Enfermería (CTE) en la Unidad de Cuidados Intensivos (UCI), según grupos etarios y su valor predictivo como determinante de la CTE en la UCI. MÉTODOS: Se analizó una muestra de conveniencia compuesta por pacientes (edad ≥ 18) ingresados en nueve UCI pertenecientes a un hospital brasileño. La edad se asumió como variable independiente y como variable dependiente la carga de trabajo de enfermería -medida por el sistema Nursing Activities Score (NAS) de puntuación de actividades de enfermería. Para el análisis, se utilizaron el modelo de regresión lineal y la curva ROC. RESULTADOS: 890 participantes (361 adultos mayores), en su mayoría varones (58,1%). La puntuación NAS promedio fue mayor entre los participantes adultos mayores en comparación con los adultos (p=0,004), pero no en las categorías de envejecimiento (p=0,697). La edad fue responsable del 0,6% de la puntuación NAS. Cada año de edad aumenta la puntuación NAS en 0,081 puntos (p=0,015). Sin embargo, la edad no resultó un buen predictor de la puntuación NAS (AbC=0,394; p=0,320). CONCLUSIÓN: El cuidado de los adultos mayores en UCI se asocia con un aumento de la CTE en comparación con los adultos. El envejecimiento puede considerarse un factor asociado, pero no un buen predictor de la CTE en UCI.

Intraoperative body temperature control: esophageal thermometer versus infrared tympanic thermometer.

OBJECTIVE: To verify the correlation between temperature measurements performed using an infrared tympanic thermometer and an esophageal thermometer during the intraoperative period. METHOD: A longitudinal study of repeated measures was performed including subjects aged 18 years or older undergoing elective oncologic surgery of the digestive system, with anesthesia duration of at least 1 hour. Temperature measurements were performed simultaneously by a calibrated esophageal thermometer and by a calibrated infrared tympanic thermometer, with laboratory reading precision of ±0.2ºC. The operating room temperature remained between 19 and 21ºC. RESULTS: The study included 51 patients, mostly men (51%), white (80.4%). All patients were kept warm by a forced-air heating system, for an average of 264.14 minutes (SD = 87.7). The two temperature measurements showed no different behavior over time (p = 0.2205), however, tympanic measurements were consistently 1.24°C lower (p<0.0001). CONCLUSION: The tympanic thermometer presented reliable results but reflected lower temperatures than the esophageal thermometer. OBJETIVO: Verificar a correlação entre as medidas de temperatura realizadas por meio de um termômetro timpânico por infravermelho e por um termômetro esofágico, durante o período intraoperatório. MÉTODO: Realizou-se um estudo longitudinal, de medidas repetidas, incluindo sujeitos com idade igual ou superior a 18 anos, submetidos à cirurgia oncológica eletiva do sistema digestório, com duração da anestesia de, no mínimo, 1 hora. As medidas de temperatura eram realizadas, ao mesmo tempo, por meio de um termômetro esofágico calibrado e por termômetro timpânico por infravermelho calibrado, com precisão de leitura em laboratório de ±0,2ºC. A temperatura da sala operatória permaneceu entre 19 e 21ºC. RESULTADOS: Foram incluídos 51 pacientes, em sua maioria homens (51%), brancos (80,4%). Todos os pacientes foram aquecidos com o sistema de ar forçado aquecido, em média por 264,14 minutos (DP = 87,7). As duas medidas de temperatura não tiveram comportamento diferente ao longo do tempo (p = 0,2205), mas a medida timpânica foi consistentemente menor em 1,24°C (p < 0,0001). CONCLUSÃO: O termômetro timpânico apresentou resultados confiáveis, mas refletiu temperaturas mais baixas do que o termômetro esofágico.

Glycemic control strategies and the occurrence of surgical site infection: a systematic review.

OBJECTIVE: To analyze the evidence available in the scientific literature regarding the relationship between the glycemic control strategies used and the occurrence of surgical site infection in adult patients undergoing surgery. METHOD: This is a systematic review performed through search on the databases of CINAHL, MEDLINE, LILACS, Cochrane Database of Systematic Reviews and EMBASE. RESULTS: Eight randomized controlled trials were selected. Despite the diversity of tested interventions, studies agree that glycemic control is essential to reduce rates of surgical site infection, and should be maintained between 80 and 120 mg/dL during the perioperative period. Compared to other strategies, insulin continuous infusion during surgery was the most tested and seems to get better results in reducing rates of surgical site infection and achieving success in glycemic control. CONCLUSION: Tight glycemic control during the perioperative period benefits the recovery of surgical patients, and the role of the nursing team is key for the successful implementation of the measure. OBJETIVO: Analisar as evidências disponíveis na literatura científica sobre a relação entre as estratégias de controle glicêmico efetuadas e a ocorrência de infecção do sítio cirúrgico em pacientes adultos submetidos à cirurgia. MÉTODO: Trata-se de revisão sistemática, por meio das bases de dados CINAHL, MEDLINE, LILACS, Cochrane Database of Systematic Reviews e EMBASE. RESULTADOS: Foram selecionados oito ensaios clínicos randomizados. Apesar da diversidade de intervenções testadas, os estudos concordam que o controle glicêmico é essencial para a redução das taxas de infecção do sítio cirúrgico e deve ser mantido entre 80 e 120 mg/dL durante o perioperatório. A infusão contínua de insulina no transoperatório foi a mais testada e parece obter melhores resultados na redução das taxas de infecção do sítio cirúrgico e sucesso no controle glicêmico comparada às demais estratégias. CONCLUSÃO: O controle glicêmico rigoroso durante o perioperatório beneficia a recuperação do paciente cirúrgico, destacando-se a atuação da equipe de enfermagem para a implantação bem-sucedida da medida.

[Antimicrobial activity of Eucalyptus globulus oil, xylitol and papain: a pilot study]. / Atividade antimicrobiana do óleo de Eucalyptus globulus, xilitol e papaína: estudo piloto.

OBJECTIVE: To evaluate the in vitro antimicrobial activity of the Eucalyptus globulus essential oil, and of the xylitol and papain substances against the following microorganisms: Pseudomonas aeruginosa; Samonella sp.; Staphylococus aureus; Proteus vulgaris; Escherichia coli and Candida albicans. METHOD: The in vitro antimicrobial evaluation was used by means of the agar diffusion test and evaluation of the inhibition zone diameter of the tested substances. Chlorhexidine 0.5% was used as control. RESULTS: The Eucalyptus globulus oil showed higher inhibition than chlorhexidine when applied to Staphylococcus aureus, and equal inhibition when applied to the following microorganisms: Escherichia coli, Proteus vulgaris and Candida albicans. Papain 10% showed lower antimicrobial effect than chlorhexidine in relation to Candida albicans. Xylitol showed no inhibition of the tested microorganisms. CONCLUSION: The Eucalyptus globulus oil has antimicrobial activity against different microorganisms and appears to be a viable alternative as germicidal agent hence, further investigation is recommended.

Nursing workload: is it a predictor of healthcare associated infection in intensive care unit? / Carga de trabalho de enfermagem: preditor de infecção relacionada à assistência à saúde na terapia intensiva?

Objective To analyze the influence of nursing workload on the occurrence of healthcare associated infection (HAI) in patients in the intensive care unit (ICU), according to type of treatment. Method Retrospective cohort study developed in nine ICUs in São Paulo, Brazil, from September to December 2012. Nursing workload was measured by the Nursing Activities Score (NAS). The Student's t and Fisher's exact tests and logistic regressions were used in the analyses. Results The sample was composed of 835 patients (54.3±17.3 years; 57.5% male), of which 12.5% acquired HAI in the ICU. The NAS of the patients admitted for clinical treatment was 71.3±10.9, and for surgery 71.6±9.2. Length of stay in ICU and severity were predictive factors for occurrence of HAI in patients admitted to the unit for clinical or surgical treatment, and male sex only for surgical patients. When considering the admissions independent of type of treatment, in addition to the variables mentioned above, index of comorbidities also remained in the regression model. The NAS was not a predictive factor of HAI. Conclusion Nursing workload did not influence occurrence of HAI in the patients included in this study.

Bathing with wipes impregnated with chlorhexidine gluconate to prevent central line-associated bloodstream infection in critically ill patients: A systematic review with meta-analysis.

BACKGROUND: Recommendations for different types of bathing to prevent central line-associated bloodstream infections (CLABSI) are still divergent. The objective of this study was to verify whether bed bathing with wipes impregnated with 2% chlorhexidine (CHG) compared to conventional bed bathing is more effective in preventing CLABSI. METHODS: Systematic review of the literature by consulting the electronic databases PubMed/Medline, Embase, CINAHL, Scopus, and Web of Science from the date of inception until July 1, 2023, with no language or time restrictions. RESULTS: A total of 84,462 studies were examined, of which 6 were included in the meta-analysis. Data from 20,188 critical care patients included in primary studies were analyzed. The meta-analysis found that bed bathing with wipes impregnated with 2% CHG reduced the risk of CLABSI by 48% compared to conventional bed bathing (risk ratio 0.52; 95% confidence interval, 0.37-0.73), and this is moderate-quality evidence. The reduction in length of stay in the intensive care unit and length of hospital stay as well as the risk of death were not significantly different between the study groups. Whether bed bathing with 2% CHG-impregnated wipes increases the occurrence of skin reactions is unclear. CONCLUSIONS: This meta-analysis provides moderate-quality evidence that daily bathing with 2% CHG-impregnated wipes is safe and helps prevent CLABSI among adult intensive care unit patients.

Oral hygiene in critically ill patients at a tertiary hospital in São Paulo, Brazil: a best practice implementation project.

OBJECTIVES: This project aimed to promote evidence-based practices relat. ed to the oral health of critically ill patients in an intensive care unit in Brazil. INTRODUCTION: The oral hygiene of patients on mechanical ventilation is an essential component of nursing care quality, and well-defined guidelines ensure appropriate care. Mechanical ventilation is associated with the risk of ventilator-associated pneumonia, which can increase mortality, length of stay, time on mechanical ventilation, and hospital costs. METHODS: This project was guided by the JBI Evidence Implementation Framework, which consists of seven stages: (1) identification of the area of practice to be changed, (2) involvement of change agents, (3) context assessment and readiness for change, (4) review of practices against evidence-based audit criteria, (5) implementation of practice changes, (6) reassessment of practices using a follow-up audit and (7) consideration of the sustainability of changes in practice. RESULTS: Four audit criteria were developed to evaluate compliance with best practices. In the follow-up audit, Criteria 1, 2, and 3 obtained compliance of ≥ 80%. Thus, for Criterion 1, all the patients on mechanical ventilation for more than 24 hours were evaluated by the oral medicine team, resulting in 100% compliance. For Criterion 2 on appropriate oral hygiene measures, a compliance rate of 80% was achieved. For Criterion 3, 39 professionals (90.7%) participated in educational activities related to the oral health protocol for critically ill patients, obtaining 90.7% compliance. For Criterion 4 regarding patients being evaluated before receiving any oral health care, improvement was low (only 50%), revealing the need for further improvement. CONCLUSION: This best practice project improved the professional practice of nursing staff and increased compliance with best practices for the oral health of critically ill patients. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A175.

Evaluation of different body temperature measurement methods for patients in the intraoperative period.

OBJECTIVES: this study aimed at estimating and comparing the reliability of temperature measurements obtained using a peripheral infrared temporal thermometer, a central cutaneous thermometer ("Zero-Heat-Flux Cutaneous thermometer") and an esophageal or nasopharyngeal thermometer among elective surgical patients in the intraoperative period. METHOD: a longitudinal study with repeated measures carried out by convenience sampling of 99 patients, aged at least 18 years old, undergoing elective abdominal cancer surgeries, with anesthesia lasting at least one hour, with each patient having their temperature measured by all three methods. RESULTS: the intraclass correlation coefficient showed a low correlation between the measurements using the peripheral temporal thermometer and the central cutaneous (0.0324) and esophageal/nasopharyngeal (-0.138) thermometers. There was a high correlation (0.744) between the central thermometers evaluated. CONCLUSION: the data from the current study do not recommend using infrared temporal thermometers as a strategy for measuring the body temperature of patients undergoing anesthetic-surgical procedures. Central cutaneous thermometers and esophageal/nasopharyngeal thermometers are equivalent for detecting intraoperative hypothermia.

Model proposal for calculating waste associated with processing consigned surgical instruments. / Propuesta de modelo para el cálculo de desperdicio asociado al procesamiento de instrumental quirúrgico consignado.

OBJECTIVE: to evaluate the waste generated from processing surgical instruments consigned in elective orthopedic surgeries and propose a model for calculating waste associated with processing consigned surgical instruments. METHOD: a quantitative, descriptive-exploratory case study carried out in a large university hospital in two phases: (1) retrospective by consulting administrative records of canceled elective orthopedic surgeries, with provision for the use of consigned materials for identification of the sub-specializations with the greatest demand; and (2) prospective through direct, non-participant observations of processing consigned surgical instruments prepared for the identified surgeries and proposition of a model for calculating waste associated with processing these materials. RESULTS: hip arthroplasty, spine arthrodesis and knee arthroplasty surgeries were identified as presenting the greatest demand, resulting in 854 boxes of consigned surgical instruments processed and unused. Processing waste was estimated at R$34,340.18 (US$6,359.30). CONCLUSION: the proposed equation made it possible to calculate the waste related to the production and non-use of boxes of surgical instruments consigned for orthopedic procedures and can equip nurses for planning based on institutional, care and financial data, aiming to make better use of resources through waste identification.

Patient participation in surgical site infection prevention: perceptions of nurses, physicians and patients.

OBJECTIVE: To analyze the perception of patients and health professionals regarding patients' participation in surgical site infection prevention. METHODS: Cross-sectional study conducted in two hospitals in the city of São Paulo, with a convenience sample of 123 patients in the postoperative period of elective surgeries and 92 health professionals (physicians and nurses) acting in direct care of surgical patients. RESULTS: Patients (78.9%) and professionals (79.4%) fully agreed with the importance of patient participation to prevent surgical site infection. The impact of patient participation on infection rates was significant for those undergoing previous surgery (p = 0.021). Patients and professionals disagreed about the best time to prepare the patient about the topic (p<0.001). The participation strategies considered most effective by patients and professionals were, respectively, oral presentation (47.2% and 75%), videos (40.7% and 58.7%) and leaflets (30.9% and 58.7%). CONCLUSION: Patients and health professionals believe that patient participation in surgical site infection prevention is important.

Role of perioperative nursing in anesthesia: a national overview.

OBJECTIVES: To assess the actions performed by the operating room nurse during anesthesia and their behavior for patient safety regarding the reporting on adverse events, and to analyze their knowledge about anesthetic practices. METHOD: This is a cross-sectional study carried out using an electronic questionnaire consisting of socio-demographic, professional practice, knowledge in anesthesia, patient safety, and professional practice questions, conducted from January to March 2019 with operating room nurses. RESULTS: One hundred nurses participated, 89 (89%) being women, with a mean age of 41.09 years (SD = 9.36), time of undergraduate completion of 14.33 years (SD = 8.34). The average attendance was 4.69 operating rooms (SD = 2.07) per nurse, with an emphasis on action before induction (49; 49%). Professionals reported performance of simultaneous activities (72; 72%) and insufficient number of employees (57; 57%) as difficulties of their daily practice. Among the participants, 77 (77%) correctly cited the periods of general anesthesia and 80.4% always reported the occurrence of an adverse event. CONCLUSION: Nurses identified their role in anesthesia, with limitations for assistance from multiple activities and lack of professionals.

Effect of implementing an anesthesia nurse checklist in a safety and teamwork climate: quasi-experimental study.

OBJECTIVE: To evaluate the effect of implementing a Patient safety checklist: nursing in anesthetic procedure on the perception of safety climate and team climate of nurses and anesthesiologists from an operating room. METHOD: Quasi-experimental study held in the operating room of a hospital in Brazil with a sample of nurses and anesthesiologists. The outcome was evaluated through the instruments "Safety Attitudes Questionnaire/Operating Room Version" and "Team Climate Inventory", applied before and after the implementation of a Patient safety checklist: nursing in anesthetic procedure by nurses. The mixed effects linear regression model was used to analyse the effect of the implementation. RESULTS: Altogether, 19 (30.2%) nurses and 44 (69.8%) anesthesiologists participated in the study, implementing the Patient safety checklist: nursing in anesthetic procedure in 282 anesthesias. The Safety Attitudes Questionnaire/Operating Room Version score changed from 62.5 to 69.2, with modification among anesthesiologists in the domain "Perception of management" (p = 0.02). Between both professionals, the Team Climate Inventory score increased after the intervention (p = 0.01). CONCLUSION: The implementation of the Patient safety checklist: nursing in anesthetic procedure changed the perception score of safety and teamwork climate, improving communication and collaborative work.

Perioperative nursing education in Brazil: reviewing the past to survive the future.

OBJECTIVES: to summarize historical aspects related to perioperative nursing education in Brazil and to outline future perspectives. METHODS: a descriptive-reflexive essay about the historical process of Brazilian perioperative teaching at undergraduate and graduate levels. RESULTS: the reflection addresses the historical axes of perioperative nursing, teaching perioperative nursing, curriculum changes, graduate studies and relationship with the perioperative period and trends in perioperative nursing education. Curriculum changes reduced time available for teaching and learning, with a focus on the perioperative period, and diluted contents of surgical nursing in other subjects, which could cause irreversible losses for generalist nurses' training. FINAL CONSIDERATIONS: when reviewing historical aspects of national nursing curricula, it was found that the nomenclature perioperative nursing was never used in the curriculum, however, the surgical area has always been contemplated in undergraduate and graduate studies. Future trends indicate the need to integrate themes and prepare professionals with perspectives focused on global health and technology.