Impact of the I-DECIDED Tool to Improve Peripheral Intravenous Catheter Care in Paediatrics: Interrupted Time-Series Study.

AIM: To determine whether the I-DECIDED assessment and decision tool enhances peripheral intravenous catheter assessment, care and decision-making in paediatrics. DESIGN: Quasi-experimental, interrupted time-series study. METHODS: An interrupted time-series study was conducted in a paediatric inpatient unit at a public teaching hospital in Brazil. The participants were patients aged less than 15 years old with a peripheral intravenous catheter, and their parents or guardians. Data were collected between January and July 2023, encompassing six time points, three pre-intervention and three post-intervention. Evaluation data were based on the I-DECIDED tool, including idle devices, dressings, complications, patient/family awareness, hand hygiene, disinfection and documentation. RESULTS: We conducted 585 peripheral intravenous catheter observations, with 289 in the pre-intervention phase and 296 in the post-intervention phase, inserted in 65 hospitalised children, 30 in the pre-intervention phase and 35 in the post-intervention phase. After the intervention, reductions were observed in the number of idle catheters, substandard dressings and complications. Patients and family members reported an increase in device assessment, hand hygiene and peripheral intravenous catheter disinfection. Additionally, there was an increase in documentation of decision-making performed by nurses and nursing technicians/assistants. CONCLUSION: Implementation of the I-DECIDED assessment and decision tool in a paediatric unit significantly improved the assessment, care and decision-making regarding peripheral intravenous catheters. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Opportunity to enhance practice standards, elevate the quality of care provided to paediatric patients, contribute to improved patient outcomes, advance evidence-based practice in vascular access management and enhance patient experience through increased involvement in care. IMPACT: To influence clinical practice and healthcare policies aimed at improving peripheral intravenous catheter care and patient safety in paediatric settings. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution to the design of this study.

PiccPed® app impact on nurses' knowledge to prevent adverse events for peripherally inserted central catheters (PICC) in pediatric and neonatal healthcare: A quasi-experimental study.

BACKGROUND: The PiccPed® health application was developed to support clinical decision-making in peripherally inserted central catheter (PICC) management. We aimed to evaluate its impact on nurses' knowledge regarding the prevention of PICC-associated adverse events in pediatrics and neonatology. METHODS: A quasi-experimental, pre-post intervention study, was conducted with a dependent/paired sample of pediatric and neonatal nurses from two tertiary hospitals in South Brazil. Data were collected from October 2022 to January 2023 across three phases: pre-, intervention (use of the PiccPed®) and post-test. Study outcomes were a knowledge test (15 questions) of evidence-based PICC maintenance procedures, and PiccPed® app time spent and screens used. RESULTS: A total of 56 nurses completed the study. The post-test mean score was significantly higher (12/15; standard deviation (SD) 1.9) in comparison with the pre-test (mean 9/15; SD 2.2). The change in scores was significantly higher for nurses without postgraduate qualifications, in comparison to those with (Mean Difference 1.26; p = 0.039). Each minute using the app resulted in a significant increase of 0.04 points (95% confidence interval 0.01-0.08; p = 0.014) on the mean post-test score (10.94 points). CONCLUSION: The research demonstrated that PiccPed® enhances nurses' learning regarding the prevention of adverse events associated with PICC maintenance in pediatrics and neonatology. APPLICATION TO PRACTICE: The app can be safely and effectively used for training and continuing education of nurses who care for children and neonates with PICCs.

Factors associated with the disinfection of devices attached to peripheral intravenous catheters performed by the nursing team in pediatric units.

Background: Peripheral intravenous catheterization, as well as drug administration through it, represents one of the most performed procedures by the Nursing team and, for that, precautions need to be adopted to offer harm-free care. Objective: To verify the association of Nursing professionals' work shift and training time with proper disinfection of intravenous catheter devices in pediatric units. Methods: A cross-sectional and analytical study conducted between June and August 2021 in three hospitalization units of a Pediatric Hospital. The inclusion criterion was drug administration via peripheral intravenous catheters performed by Nursing professionals. The data were analyzed according to inferential statistics, adopting p ≤ .05 as significance level. Results: There were a total of 385 observations of drug administration procedures. The device was not disinfected in 60.3% of the cases, there was no friction at the suitable time in 86.3%, and the disinfectant was not allowed to dry in 72.5%. The work shift exerted no influence on performance of the disinfection procedure (p = .376). However, longer training time was associated with a lower rate in performing such procedure (p < .001). Conclusion: Performing friction below the recommended time can cause a false sense of prevention of catheter-associated bloodstream infection; therefore, training sessions and strategies for adherence to the disinfection procedures should be considered, mainly for professionals with more training time.

Validation of a Guideline for Nurses Taking Care of Patients With Liver Cirrhosis in the Context of COVID-19 in the Emergency Department.

The objective of this study was to prepare and validate the content of a guideline for nursing care of adult patients with liver cirrhosis and COVID-19 treated in the emergency department. The study was conducted in two stages: first, the guideline was developed based on an integrative literature review and existing guidelines on the topic. The guideline was prepared with six domains and 64 care items. In the second stage, 15 specialists in urgency and emergency services performed content validation of the guideline. The data were analyzed using the Content Validity Index, with reliability assessed through Cronbach's α. The judges validated the guide regarding language clarity, objectivity, theoretical relevance, and practical pertinence. The value of the guideline's Content Validity Index was 0.96. Cronbach's α reliability reached a value of 0.93. The judges validated all domains and items of the guideline for theoretical relevance and practical pertinence, to be used by researchers and clinical practice professionals in the nursing area.

Behavior of Murrah buffaloes under influence of strangers in the milk parlor during milk control / Análisis comportamental de búfalas Murrah bajo la influencia de personas extrañas en el Control Lechero

Objective. The study was carried out in two farms, located in São Sebastião do Passé, Bahia, Brazil, during the three first months of lactation of 81 female buffaloes, to observe if stranger people at milk parlor could affect the milk production. Materials and methods. Four strangers were at the milking parlor during the milking time to observe the following parameters: Duration of Stay in the Milking Parlor; Milking Period; Rumination; Defecation; Urination Reactivity; Stress Level; Side Preference in the Milking Parlor; Milk Yield, and Post Control Milk Yield. The females were categorized as 1=primiparous, 2=pluriparous, and 3=when information about calving number was not available. The data were analyzed using SAS Statistical Package. Results. During the presence of four strangers at the milking parlor, it was observed that the mean value for Duration of Stay in the Milking Parlor was 23 minutes (varying from 12 to 38 minutes). Average Milking Period was 8 minutes (varying from 4 to 13 minutes). Average Milk Yield during observation days (MY) varied from 2.30 kg to 14.70 kg, with an average value of 7.70±2.60 kg, while Mean Milk Yield after the observation days was 8.600±2.70 kg. Conclusions. As far as Post Control Milk Yield, since the animals presented increased milk yield in both farms on the days following the observations, it is possible to assert that the presence of strangers in the milk parlor during milk control reduced milk yield only during the day of observation, with no adverse effects on subsequent milk production.

Objetivo. El estudio fue realizado en dos propiedades en el municipio de São Sebastião do Passé - Bahía, Brasil, durante los tres primeros meses de lactancia de 81 búfalas, para observar si las personas extrañas en sala de ordeño podrían afectar la producción de leche. Materiales y métodos. Cuatro personas extrañas estaban en la sala de ordeño durante el tiempo de ordeño para observar los siguientes parámetros: el Tiempo de Permanencia en la Sala de Ordeño; Tiempo de Ordeño; Rumiación; Defecación; Micción; Reactividad; Nivel de Estrés; Preferencia de Lado en la Sala de Ordeño; Producción de Leche y Producción de Leche Post - Control. Las búfalas fueron Categorizadas como 1, para las primíparas, 2 para las multíparas y 3 cuando la información del número de partos no fue obtenida en la hacienda. Los análisis fueron realizados a través del Statistical Analysis System. Resultados. Durante la presencia de cuatro extraños en la sala de ordeño, se observó que el Tiempo de Permanencia en la Sala de Ordeño medio fue de 23 minutos (variando de 12 a 38 minutos) y el Tiempo de Ordeño medio de 08 minutos (variando de 4 a 13 minutos). La producción de leche media en el día de Control Lechero varió de 2.30 kg a 14.70 kg, con media igual a 7.70±2.60 kg. La producción de leche en los días siguientes fue igual a 8.60±2.70 kg. Conclusiones. Como los animales presentaron aumento de producción lechera después del control en ambas haciendas, es posible que la presencia de personas extrañas en la sala de ordeño durante el Control Lechero mensual redujera el rendimiento apenas durante los días de observación, sin efectos adversos sobre la posterior producción de leche.

Patient safety culture at Neonatal Intensive Care Units: perspectives of the nursing and medical team.

OBJECTIVE: To verify the assessment of the patient safety culture according to the function and length of experience of the nursing and medical teams at Neonatal Intensive Care Units. METHOD: Quantitative survey undertaken at four Neonatal Intensive Care Units in Florianópolis, Brazil. The sample totaled 141 subjects. The data were collected between February and April 2013 through the application of the Hospital Survey on Patient Safety Culture. For analysis, the Kruskal-Wallis and Chi-Square tests and Cronbach's Alpha coefficient were used. Approval for the research project was obtained from the Ethics Committee, CAAE: 05274612.7.0000.0121. RESULTS: Differences in the number of positive answers to the Hospital Survey on Patient Safety Culture, the safety grade and the number of reported events were found according to the professional characteristics. A significant association was found between a shorter Length of work at the hospital and Length of work at the unit and a larger number of positive answers; longer length of experience in the profession represented higher grades and less reported events. The physicians and nursing technicians assessed the patient safety culture more positively. Cronbach's alpha demonstrated the reliability of the instrument. CONCLUSION: The differences found reveal a possible relation between the assessment of the safety culture and the subjects' professional characteristics at the Neonatal Intensive Care Units.

[The challenges coped by the novice in nursing practice]. / Os desafios enfrentados pelos iniciantes na prática de enfermagem.

The purpose of the study was to investigate the challenges faced by the nurses during the first years of their nursing work. A total of 31 novice nurses were included in the sample that answered a questionnaire with open and closed questions. The data analysis was conducted by using the qualitative software called Atlas Ti. The novice nurses deal with some challenges related to: a) leadership team; b) the competence and technique ability. The findings suggested that the nursing novice is not well prepared for assuming a leadership role as well as for caring in the settings of high-complexity. In order to cope those challenges new strategies of education and nursing practice has to be developed together with nurses educators and nurses practitioners.

[Living groups: contributions for an educational proposal for tuberculosis]. / Grupos de convivência: contribuições para uma proposta educativa em tuberculose.

This study is a report on care practice. Its objective was to develop a proposal for education in health care from a group of people with tuberculosis, seeking to increase the effectiveness of their treatment. The data was obtained through a proposal for education in health care, developed through a living group. Two interrelated themes resulted from the process of analyzing the data: the perception of tuberculosis and its care and treatment, and social isolation. These represent the elements that influence education in health care for people with tuberculosis, as well as the meaning that such a situation has to these people.

[People with diabetes mellitus: their care and treatment choices]. / Pessoas com Diabetes Mellitus: suas escolhas de cuidados e tratamentos.

Study based on qualitative research, from an interpretative perspective. Its objective was to understand the therapeutic itinerary of people with Diabetes Mellitus who search for different care and treatments within the different subsystems of health care. The data was collected through in-depth interviews and focus groups. As a result of the data analysis therapeutic modalities were identified, the evaluation of the care process and health treatment and the therapeutic journey in the three subsystems. The person with Diabetes Mellitus needs to reevaluate their process of living. Thus, the person circulates through various therapeutic modalities until they perceive that (or those) which are most convenient for them. This also applies to how said care or treatment becomes integrated into their day-to-day.

[Quality of life from the perspective of persons with chronic respiratory diseases: the contribution of a social group]. / Qualidade de vida na perspectiva de pessoas com problemas respiratórios crônicos: a contribuição de um grupo de convivência.

This convergent care research was carried out in a social group of persons with chronic respiratory diseases and aimed to identify the elements affecting the quality of life of persons with chronic respiratory problems, and to understand how the educative practice in a social group has contributed to the quality of life of persons with a chronic health condition. Data were collected at group meetings, during which the statements of eleven subjects and two family members were tape-recorded. Data analysis showed that controlling conflicting feelings, continuing to fight for a better life, overcoming one's limitations brought about by disease and treatment and getting family support are factors that affect the quality of life of persons with chronic respiratory problems. The study also made evident that health education acquired through social groups brings effective outcomes in promoting quality of life among the study participants.

[Quality of life of patients with chronic renal insufficiency in hemodialysis treatment]. / Qualidade de vida de pessoas com insuficiência renal crônica em tratamento hemodialítico.

This is a convergent-assistance research, which has as its objective the identification of the factors affecting the quality of life of people suffering from Chronic Kidney Failure and who are undergoing hemodialysis. Data were collected in a health education program, developed for a companionship group, across hemodialysis sessions. During the analysis, four categories were identified, representing the elements that are considered as causes for the life quality conditions of those people: health assistance; acceptance and coping with the health condition; support received, and hoping for a better future. In spite of living with an illness which has important consequences on the physical well-being and social roles, persons referred to a life where quality can be achieved, although sometimes it may be difficult to perceive or conquer such quality.