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.

National practice of Nursing professionals in the insertion of peripheral vascular access devices.

OBJECTIVE: to identify and compare the practice of Nursing professionals regarding the insertion of peripheral vascular access devices, according to professional category. METHOD: descriptive sectional study carried out between July 2021 and May 2022 with 2,584 Nursing professionals, using a questionnaire validated by three judges with expertise in intravenous therapy, containing variables related to catheterization and the vascular access device. Descriptive and inferential analysis was carried out. RESULTS: most professionals do not prepare the patient or perform some essential care before attempting peripheral intravenous catheterization. Regarding the preferred catheterization site, hands, arm and forearm stand out. There is no control over the tourniquet time, and the patient is punctured more than three times. The most used device materials are polyurethane and Teflon ® , more than one criterion is adopted for device selection, and Micropore ® type adhesive tape was the covering most cited by Nursing professionals. The identification of catheterization was not adequate. CONCLUSION: Nursing technicians and assistants are the professionals who least comply with what is recommended in recognized guidelines. Nurses' practice also presents deviations from scientific evidence.

Association between COVID-19 and the incidence of type 1 diabetes in Portugal - a registry study.

BACKGROUND: Viral respiratory infections may precipitate type 1 diabetes (T1D). A possible association between the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for COVID-19, and the incidence of T1D is being determined. This study was carried out using Portuguese registries, aiming at examining temporal trends between COVID-19 and T1D. METHODS: Hospital data, comparing the incidence before and during the COVID-19 pandemic, from children and young adults diagnosed with new-onset T1D, was acquired beginning in 2017 and until the end of 2022. Data was obtained from nine different Portuguese hospital units. The impact of the COVID-19 pandemic, beginning in March 2020, was assessed comparing the annual numbers of new-onset T1D cases. The annual median levels of glucose, glycated hemoglobin (HbA1c) and fasting C-peptide at T1D diagnosis were compared. The annual number of diabetic ketoacidosis (DKA) episodes among new T1D cases was also assessed at two centers. RESULTS: In total, data from 574 newly diagnosed T1D patients was analyzed, including 530 (92.3%) children. The mean ages for child and adult patients were 9.1 (SD 4.4) and 32.8 (SD 13.6) years, respectively. 57.8% (331/573) were male, one patient had unknown sex. The overall median (25-75 percentiles) levels of glucose, HbA1c and fasting C-peptide at diagnosis were 454 mg/dL (356-568), 11.8% (10.1-13.4) and 0.50 µg/L (0.30-0.79), respectively. DKA at T1D diagnosis was present in 48.4% (76/157). For eight centers with complete 2018 to 2021 data (all calendar months), no overall significant increase in T1D cases was observed during the COVID-19 pandemic, i.e. 90 cases in 2018, 90 cases in 2019, 112 in 2020 and 100 in 2021 (P for trend = 0.36). Two of the centers, Faro (CHUA) and Dona Estefânia (CHULC) hospitals, did however see an increase in T1D from 2019 to 2020. No significant changes in glucose (P = 0.32), HbA1c (P = 0.68), fasting C-peptide (P = 0.20) or DKA frequency (P = 0.68) at the time of T1D diagnosis were observed over the entire study period. CONCLUSION: The T1D incidence did not increase significantly, when comparing the years before and during the COVID-19 pandemic, nor did key metabolic parameters or number of DKA episodes change.

Utilization of local pressure devices in pain management during injections: scoping review.

OBJECTIVE: to map scientific evidence regarding the use of local pressure devices in pain relief during injection procedures in patients. METHODS: scoping review, following the recommendations of the JBI Manual for Evidence Synthesis and PRISMA-ScR, with searches conducted in the PubMed, EMBASE, CINAHL, LILACS, and PsycINFO databases, without temporal restrictions and with a cutoff date of March 2023. RESULTS: a total of 1,514 studies were identified, with 20 articles included in the final sample. The ShotBlocker® device was utilized during subcutaneous and intramuscular injections in children and adults, proving beneficial in reducing pain, anxiety, and fear associated with the procedure. FINAL CONSIDERATIONS: the ShotBlocker® is a low-cost, easy-to-use device that can enhance nursing clinical practice during painful procedures. However, studies involving the Brazilian Pikluc® device are scarce. Further research involving both local pressure devices is recommended.

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.

Utilization of local pressure devices in pain management during injections: scoping review / Uso de dispositivos de presión local en el manejo del dolor durante las inyecciones: revisión de alcance / Utilização de dispositivos de pressão local no manejo da dor durante injeções: revisão de escopo

ABSTRACT Objective: to map scientific evidence regarding the use of local pressure devices in pain relief during injection procedures in patients. Methods: scoping review, following the recommendations of the JBI Manual for Evidence Synthesis and PRISMA-ScR, with searches conducted in the PubMed, EMBASE, CINAHL, LILACS, and PsycINFO databases, without temporal restrictions and with a cutoff date of March 2023. Results: a total of 1,514 studies were identified, with 20 articles included in the final sample. The ShotBlocker® device was utilized during subcutaneous and intramuscular injections in children and adults, proving beneficial in reducing pain, anxiety, and fear associated with the procedure. Final considerations: the ShotBlocker® is a low-cost, easy-to-use device that can enhance nursing clinical practice during painful procedures. However, studies involving the Brazilian Pikluc® device are scarce. Further research involving both local pressure devices is recommended.

RESUMEN Objetivo: mapear evidencia científica sobre el uso de dispositivos de presión local en el alivio del dolor durante la aplicación de inyecciones en pacientes. Métodos: revisión de alcance, siguiendo las recomendaciones del Manual JBI para Síntesis de Evidencia y PRISMA-ScR, con búsqueda en las bases de datos PubMed, EMBASE, CINAHL, LILACS y PsycINFO, sin restricciones temporales y con fecha límite hasta marzo de 2023. Resultados: se identificaron un total de 1,514 estudios, con 20 artículos incluidos en la muestra final. El dispositivo ShotBlocker® se utilizó durante las inyecciones subcutáneas e intramusculares en niños y adultos, demostrando ser beneficioso en la reducción del dolor, la ansiedad y el miedo asociados con el procedimiento. Consideraciones finales: el ShotBlocker® es un dispositivo de bajo costo y fácil manejo que puede mejorar la práctica clínica de enfermería durante procedimientos dolorosos. Sin embargo, los estudios sobre el dispositivo brasileño Pikluc® son escasos. Se recomienda realizar estudios con ambos dispositivos de presión local.

RESUMO Objetivo: mapear evidências científicas acerca da utilização de dispositivos de pressão local no alívio da dor durante a aplicação de injeções em pacientes. Métodos: revisão de escopo, conforme recomendações do JBI Manual for Evidence Synthesis e PRISMA-ScR, com busca nas bases PubMed, EMBASE, CINAHL, LILACS e PsycINFO, sem recorte temporal e data limite até março de 2023. Resultados: foram encontrados 1.514 estudos, sendo incluídos 20 artigos na amostra final. O dispositivo ShotBlocker® foi utilizado durante a aplicação de injeções subcutânea e intramuscular em crianças e adultos, sendo benéfico na redução da dor, da ansiedade e do medo associados ao procedimento. Considerações finais: o ShotBlocker® é um dispositivo de baixo custo e fácil manuseio a ser utilizado para aprimorar a prática clínica da Enfermagem durante a realização de procedimentos dolorosos. Contudo, estudos com o dispositivo brasileiro Pikluc® são escassos. Recomenda-se a realização de estudos com ambos os dispositivos de pressão local.

Influence of a booklet about neonates' safety on family members' behavior and knowledge / Influencia de un folleto sobre seguridad neonatal sobre el comportamiento y los conocimentos de los familiares / Influência de cartilha sobre segurança do neonato no comportamento e conhecimentos de familiares

ABSTRACT Objective: to analyze the influence of the booklet entitled "How can you contribute to the safety of a newborn in the hospital?", in relation to the companions' knowledge and behavior regarding the safety actions for neonates. Method: a quasi-experimental before-and-after study was developed with 60 companions of newborns in the neonatal intermediate care unit of a public hospital between December 2022 and February 2023. Collection was through two groups, Control and Experimental, with use of the booklet and in three phases: Pre- and post-test and intervention. To compare the pre- and post-test scores, the Kolmogorov-Smirnov and McNemar tests were used and the significance level adopted was α=0.05. Results: the Experimental group had a higher percentage of correct answers in the post-test after using the booklet, showing increased knowledge and positive behavior in safety actions. However, only the "check the bracelet" and "confirm its data before care" items showed statistical significance. Conclusion: the booklet proved to be an important tool in the education and health process, which may be favorable for the neonate's safety.

RESUMEN Objetivo: analizar la influencia del folleto "¿Cómo puede contribuir para la seguridad de un bebé en el hospital?", en relación con el conocimiento y el comportamiento de los acompañantes en términos de acciones de seguridad neonatal. Método: estudio cuasiexperimental del tipo antes y después, desarrollado con 60 acompañantes de neonatos en la unidad de cuidados neonatales intermedios de un hospital público, entre diciembre de 2022 y febrero de 2023. Los datos se recolectaron por medio de dos grupos, Control y Experimental, utilizando el folleto y a lo largo de tres fases: Antes de la prueba, Después de la prueba e Intervención. Para comparar las puntuaciones antes y después de la prueba se utilizaron las pruebas de Kolmogorov-Smirnov y de McNemar y se adoptó α=0,05 como nivel de significancia. Resultados: el Grupo Experimental presentó un porcentaje de respuestas correctas más elevado en la fase posterior a la prueba, después de utilizar el folleto, lo que evidencia una mejora en el conocimiento y comportamiento positivo en las acciones de seguridad. Sin embargo, solamente los ítems "revisar la pulsera" y "confirmar sus dados antes de la atención" presentaron significancia estadística. Conclusión: el folleto demostró ser una herramienta importante en el proceso de educación y salud, lo que puede ser favorable para la seguridad de los neonatos.

RESUMO Objetivo: analisar a influência da cartilha "Como você pode contribuir para a segurança do bebê no hospital?", em relação ao conhecimento e comportamento dos acompanhantes quanto às ações de segurança do neonato. Método: estudo quase experimental, do tipo antes e depois, foi desenvolvido com 60 acompanhantes de neonatos na unidade de cuidados intermediários neonatal de um hospital público, entre dezembro de 2022 e fevereiro de 2023. A coleta ocorreu por meio de dois grupos, controle e experimental, com o uso da cartilha e ocorreu em três fases: pré e pós-teste e intervenção. Para comparar os escores de pré e pós-teste foi utilizado o Teste de Kolmogorov-Smirnov e McNemar e o nível de significância adotado foi de α=0,05. Resultados: o grupo experimental apresentou um percentual maior de acertos no pós-teste após utilização da cartilha, evidenciando aumento do conhecimento e comportamento positivo nas ações de segurança. Entretanto, apenas os itens de conferência da pulseira e confirmação de seus dados antes do cuidado apresentaram significância estatística. Conclusão: a cartilha demonstrou ser uma ferramenta importante no processo de educação e saúde, o que pode ser favorável para a segurança do neonato.

I-decided®-brazil: cross-cultural adaptation of an assessment and decision-making tool for peripheral intravenous catheter / I-decided®-brasil: adaptación transcultural de una herramienta de evaluación y toma de decisiones para catéteres intravenosos periféricos / I-decided®-brasil: adaptação transcultural da ferramenta de avaliação e tomada de decisão para cateter intravenoso periférico

ABSTRACT Objective: to translate and adapt the I-DECIDED® Tool to Portuguese and Brazilian context. Method: this methodological research used Beaton's framework for the translation and cross-cultural adaptation process, which occurred in five stages: initial translation; synthesis of translations; back-translation; committee of experts; and pre-testing. It was carried out from July to December 2022. For data analysis, the Content Validity Index and Cronbach's alpha were used. Results: from a committee of experts, the adapted version of I-DECIDED® obtained satisfactory semantic, idiomatic, experiential and conceptual equivalence when compared to the original version, reaching a Content Validity Index of 0.94. In pre-testing, 60 nurses participated, and the reliability of the adapted tool was 0.83. Conclusion: the translation and cross-cultural adaptation process of I-DECIDED® was carried out and provides Brazilian professionals with an assessment and decision-making tool in relation to peripheral intravenous catheters aligned with patient safety.

RESUMEN Objetivo: traducir y adaptar la herramienta I-DECIDED® al idioma portugués y al contexto brasileño. Método: esta investigación metodológica utilizó el marco de Beaton para el proceso de traducción y adaptación transcultural, que ocurrió en cinco etapas: traducción inicial; síntesis de traducciones; traducción inversa; comité de expertos; y prueba previa. Se realizó de julio a diciembre de 2022. Para el análisis de los datos se utilizó el Índice de Validez de Contenido y el alfa de Cronbach. Resultados: con base en el comité de expertos, la versión adaptada de I-DECIDED® obtuvo equivalencia semántica, idiomática, experiencial y conceptual satisfactoria respecto al original, alcanzando un Índice de Validez de Contenido de 0,94. En el pretest participaron 60 enfermeros y la confiabilidad de la herramienta adaptada fue de 0,83. Conclusión: se realizó el proceso de traducción y adaptación transcultural de la I-DECIDED® que brinda a los profesionales brasileños una herramienta de evaluación y toma de decisiones en relación a los catéteres intravenosos periféricos alineados con la seguridad del paciente.

RESUMO Objetivo: traduzir e adaptar a Ferramenta I-DECIDED® para o idioma português e contexto brasileiro. Método: pesquisa metodológica que utilizou o referencial de Beaton para o processo de tradução e adaptação transcultural, que ocorreu em cinco etapas: tradução inicial, síntese das traduções, tradução reversa, comitê de especialistas e pré-teste. Realizado no período de julho a dezembro de 2022. Para análise de dados, foram utilizados o Índice de Validade de Conteúdo e Alpha de Cronbach. Resultados: a partir do Comitê de Especialistas, a versão adaptada da Ferramenta I-DECIDED® obteve satisfatória equivalência semântica, idiomática, experiencial e conceitual quando comparada à original, atingindo o Índice de Validade de Conteúdo de 0,94. No pré-teste, participaram 60 enfermeiros e a confiabilidade da Ferramenta adaptada foi de 0,83. Conclusão: o processo de tradução e adaptação transcultural da Ferramenta I-DECIDED® foi realizado e disponibiliza aos profissionais brasileiros uma ferramenta de avaliação e tomada de decisão em relação ao cateter intravenoso periférico alinhada à segurança do paciente.

Compliance with central venous catheter infection prevention practices after intervention with simulation.

OBJECTIVES: to assess the effect of an educational intervention based on clinical simulation on nursing professionals' compliance with practices to prevent peripherally inserted central venous catheter-associated primary bloodstream infections in a Neonatal Intensive Care Unit. METHODS: a quasi-experimental study, with preand post-intervention assessment with a single group. The population consisted of 41 nursing professionals, with 31 observations being made before and after the intervention. Analyzes were performed using descriptive statistics and the McNemar non-parametric test. A significance level of 5% was adopted. RESULTS: after the intervention, there was an increase in compliance with prevention practices of surgical antisepsis and professional hand hygiene, skin antisepsis with chlorhexidine, waiting for the time of the effect of alcoholic chlorhexidine and compliance with the sterile technique. CONCLUSIONS: the educational intervention showed an effect on increasing compliance with catheter-associated infection prevention practices.

Implementation of upfront DPYD genotyping with a low-cost and high-throughput assay to guide fluoropyrimidine treatment in cancer patients.

OBJECTIVES: Genetic variants in the dihydropyrimidine dehydrogenase (DPYD ) gene are associated with reduced dihydropyrimidine dehydrogenase enzyme activity and can cause severe fluoropyrimidine-related toxicity. We assessed the frequency of the four most common and well-established DPYD variants associated with fluoropyrimidine toxicity and implemented a relatively low-cost and high-throughput genotyping assay for their detection. METHODS: This study includes 457 patients that were genotyped for the DPYD c.1129-5923C>G, c.1679T>G, c.1905 + 1G>A and c.2846A>T variants, either by Sanger sequencing or kompetitive allele specific PCR (KASP) technology. Of these, 172 patients presented toxicity during treatment with fluoropyrimidines (post-treatment group), and 285 were tested before treatment (pretreatment group). RESULTS: Heterozygous DPYD variants were identified in 7.4% of the entire series of 457 patients, being the c.2846A>T the most frequent variant. In the post-treatment group, 15.7% of the patients presented DPYD variants, whereas only 2.5% of the patients in the pretreatment group presented a variant. The KASP assays designed in this study presented 100% genotype concordance with the results obtained by Sanger sequencing. CONCLUSIONS: The combined assessment of the four DPYD variants in our population increases the identification of patients at high risk for developing fluoropyrimidine toxicity, supporting the upfront routine implementation of DPYD variant genotyping. Furthermore, the KASP genotyping assay described in this study presents a rapid turnaround time and relatively low cost, making upfront DPYD screening feasible in clinical practice.

O uso de realidade virtual no cateterismo intravenoso periférico em crianças/adolescentes: relato de experiência / The use of virtual reality in peripheral intravenous catheterization in children/adolescents: experience report / El uso de la realidad virtual en el cateterismo intravenoso periférico en niños/adolescentes: reporte de experiencia

Conclusão: a realidade virtual é um recurso que pode ser utilizado como distração durante o cateterismo intravenoso periférico. Para os discentes, houve reflexão sobre o tratamento adequado de enfermagem em pediatria, além do desenvolvimento de habilidades de comunicação e senso crítico

Conclusion: virtual reality is a resource that can be used as a distraction during peripheral intravenous catheterization. For the learners, this experience prompted reflection on appropriate pediatric nursing care, in addition to fostering the development of communication skills and critical thinking

Conclusión: la realidad virtual es un recurso que se puede utilizar como distracción durante la cateterización intravenosa periférica. Para los aprendices, esta experiencia llevó a una reflexión sobre la atención de enfermería pediátrica adecuada, además de fomentar el desarrollo de habilidades de comunicación y pensamiento crítico

Opioids and constipation therapy in the last week of life: Their impact on patients, caregivers, and the location of death.

The use of opioids to control pain at the end of life may cause constipation, a symptom that can negatively influence the well-being of patients and caregivers. The main aim of this study was to evaluate the impact of constipation on symptomatic control and patients' overall quality of life at this stage. A particular focus was placed on opioids. We also intended to investigate whether constipation and caregiver fatigue is related to the place of death (hospital vs home). The approach of 121 patients followed in 2021 in their last week of life by a home team specialized in palliative care was analyzed in an observational, retrospective, non-interventional study. The patients were followed up for an average of 39.7 days. A total of 82.6% wished to die at home, which occurred in 74% of the cases. The constipation prevention protocol reduced constipation by 55.1%. It seems that morphine is more related with constipation and tapentadol seems to reduce constipation induced by opioids. Patients tended to die in hospitals when their caregivers were exhausted; however, it was not possible to determine a cutoff point using the Zarit scale, which was used to assess caregiver burden. Constipation in the last week of life does not seem to influence the well-being of patients or their caregivers significantly and the individualization of intensive treatment of constipation is needed. Different opioids have different probabilities of causing adverse effects such as constipation. Future special support mechanisms can be created and activated for the most tired caregivers to avoid exhaustion and promote death at home, if that is the patient's will.

Qualidade dos relatos de ensaios clínicos randomizados sobre realidade virtual durante punção/cateterismo intravenoso periférico / Quality of randomized clinical trial reports on virtual reality during peripheral intravenous catheterization/venipuncture / Calidad de los informes de ensayos clínicos aleatorizados sobre realidad virtual durante punción/cateterismo intravenoso periférico

Objetivo: avaliar a qualidade dos relatos de ensaios clínicos randômicos sobre realidade virtual durante a punção/cateterismo venoso periférico. Método: estudo avaliativo, realizado em duas etapas: revisão de escopo, no intuito de identificar ensaios clínicos randômicos sobre a temática, publicados nas bases de dados Cochrane, Cumulative Index to Nursing and Allied Health Literature, Embase, PubMed® e Literatura Latino-Americana e do Caribe em Ciências da Saúde; e avaliação da qualidade dos relatos dos ensaios clínicos randômicos, utilizandose do Consolidated Standards of Reporting Trials. Os dados foram analisados por meio de estatística descritiva e inferencial, sendo aplicado o Teste Kappa. Resultados: o total de estudos encontrados foram 291, sendo incluídos oito; destes, 75% apresentaram boa qualidade do relato, atendendo parcialmente os itens previamente definidos como necessários. Conclusão: os artigos apresentaram boa qualidade no relato, porém há necessidade de melhora na descrição dos itens.(AU)

Objective: to evaluate the quality of reports of randomized clinical trials on virtual reality during peripheral venous catheterization. Method: an evaluative study, conducted in two stages: scoping review, to identify randomized clinical trials on the subject, published in Cochrane, Cumulative Index to Nursing and Allied Health Literature, Embase, PubMed® and Latin American and Caribbean Health Sciences Literature databases; and quality assessment of the reports of randomized clinical trials, using the Consolidated Standards of Reporting Trials. Data were analyzed using descriptive and inferential statistics, and the Kappa Test was applied. Results: a total of 291 studies were found, eight of which were included. Of these, 75% showed good quality reporting, partially meeting the items previously defined as necessary. Conclusion: the articles presented good quality reports, but there is a need for improvement in the description of the items.(AU)

Objetivo: evaluar la calidad de los informes de ensayos clínicos aleatorizados sobre realidad virtual durante la punción/cateterismo venoso periférico. Método: estudio evaluativo, realizado en dos etapas: scoping review, con el fin de identificar ensayos clínicos aleatorizados sobre el tema, publicados en las bases de datos Cochrane, Cumulative Index to Nursing and Allied Health Literature, Embase, PubMed® y Literatura Latinoamericana y del Caribe en Ciencias de la Salud; y evaluación de la calidad de los informes de ensayos clínicos aleatorios, utilizando los Consolidated Standards of Reporting Trials. Los datos fueron analizados mediante estadística descriptiva e inferencial, utilizando la prueba de Kappa. Resultados: el total de estudios encontrados fue de 291, de los cuales se incluyeron ocho; de estos, el 75% presentó buena calidad del informe, cumpliendo parcialmente con los ítems previamente definidos como necesarios. Conclusión: los artículos presentaron buena calidad en el informe, pero hay necesidad de mejora en la descripción de los ítems.(AU)

Compliance with central venous catheter infection prevention practices after intervention with simulation / Cumplimiento de las prácticas de prevención de infecciones del catéter venoso central después de una intervención simulada / Adesão às práticas de prevenção de infecção de cateter venoso central após intervenção com simulação

ABSTRACT Objectives: to assess the effect of an educational intervention based on clinical simulation on nursing professionals' compliance with practices to prevent peripherally inserted central venous catheter-associated primary bloodstream infections in a Neonatal Intensive Care Unit. Methods: a quasi-experimental study, with preand post-intervention assessment with a single group. The population consisted of 41 nursing professionals, with 31 observations being made before and after the intervention. Analyzes were performed using descriptive statistics and the McNemar non-parametric test. A significance level of 5% was adopted. Results: after the intervention, there was an increase in compliance with prevention practices of surgical antisepsis and professional hand hygiene, skin antisepsis with chlorhexidine, waiting for the time of the effect of alcoholic chlorhexidine and compliance with the sterile technique. Conclusions: the educational intervention showed an effect on increasing compliance with catheter-associated infection prevention practices.

RESUMEN Objetivos: evaluar el efecto de una intervención educativa basada en simulación clínica sobre la adherencia de profesionales de enfermería a prácticas de prevención de infecciones primarias del torrente sanguíneo asociadas a catéteres venosos centrales de inserción periférica en una Unidad de Cuidados Intensivos Neonatales. Métodos: estudio cuasiexperimental, con evaluación pre y postintervención con un solo grupo. La población estuvo constituida por 41 profesionales de enfermería, realizándose 31 observaciones antes y después de la intervención. Los análisis se realizaron utilizando estadística descriptiva y la prueba no paramétrica de McNemar. Se adoptó un nivel de significancia del 5%. Resultados: después de la intervención, hubo aumento en la adherencia a las prácticas de prevención de antisepsia quirúrgica e higiene profesional de manos, antisepsia cutánea con clorhexidina, espera del tiempo del efecto de la clorhexidina alcohólica y cumplimiento de la técnica estéril. Conclusiones: la intervención educativa mostró un efecto en el aumento de la adherencia a las prácticas de prevención de infecciones asociadas al catéter.

RESUMO Objetivos: avaliar o efeito de uma intervenção educativa pautada em simulação clínica na adesão de profissionais de enfermagem às práticas de prevenção de infecções primárias de corrente sanguínea associadas ao cateter venoso central de inserção periférica em Unidade de Terapia Intensiva Neonatal. Métodos: estudo quase-experimental, com avaliação pré e pós-intervenção com um grupo único. A população foi de 41 profissionais de enfermagem, sendo realizadas 31 observações antes e após intervenção. As análises foram por meio de estatística descritiva e pelo Teste Não Paramétrico de McNemar. Adotou-se um nível de significância de 5%. Resultados: após a intervenção, houve aumento da adesão às práticas de prevenção de antissepsia cirúrgica e higiene das mãos do profissional, antissepsia da pele com clorexidina, espera do tempo do efeito da clorexidina alcoólica e cumprimento da técnica estéril. Conclusões: a intervenção educativa mostrou efeito no aumento da adesão às práticas de prevenção da infecção associadas ao cateter.

Aplicativos sobre terapia intravenosa e prevenção de infecção de corrente sanguínea associada ao cateter: prospecção tecnológica / Applications on intravenous therapy and catheter-associated bloodstream infection prevention: technology prospection / Aplicaciones en terapia intravenosa y prevención de infecciones del torrente sanguíneo asociadas a catéteres: prospección tecnológica

RESUMO Objetivo: identificar aplicativos móveis sobre terapia intravenosa e prevenção de infecção de corrente sanguínea associada ao cateter. Método: prospecção tecnológica, com busca dos dados nas Bases de Patentes e Lojas Virtuais, a coleta dos dados ocorreu de maio a agosto de 2021. Critérios de inclusão: aplicativos móveis voltados para a Terapia Intravenosa; aplicativos móveis voltados para a prevenção de infecção de corrente sanguínea, a análise foi realizada de forma qualitativa comparativa, reconhecendo as funções desenvolvidas pelos aplicativos e seus potenciais para utilização na prática clínica. Resultados: 19 aplicativos foram selecionados e organizados em temáticas: aplicativos para auxiliar no cateterismo; aplicativos para manutenção de cateter; aplicativos sobre prevenção de infecção de corrente sanguínea; e aplicativo sobre diagnóstico de infecção de corrente sanguínea associada ao cateter. Conclusão: a identificação de poucos aplicativos sobre a temática serve de fomento para construção de novos aplicativos.

ABSTRACT Objective: to identify mobile applications on intravenous therapy and prevention of catheter-associated bloodstream infection. Method: technological prospection, with data search in Patent Bases and Virtual Stores, data collection occurred from May to August 2021. Inclusion criteria: mobile applications focused on Intravenous Therapy; mobile applications focused on the prevention of bloodstream infection. The analysis was carried out in a qualitative comparative way, recognizing the functions developed by the applications and their potential for use in clinical practice. Results: 19 applications were selected and organized into themes: applications to assist in catheterization; applications for catheter maintenance; applications on bloodstream infection prevention; and applications on diagnosis of catheter-associated bloodstream infection. Conclusion: The identification of few apps on the theme serves to promote the construction of new apps.

RESUMEN Objetivo: identificar aplicaciones móviles sobre terapia intravenosa y prevención de la infección del torrente sanguíneo asociada a catéteres. Método: prospección tecnológica, con búsqueda de datos en Bases de Patentes y Almacenes Virtuales, la recolección de datos ocurrió de mayo a agosto de 2021. Criterios de inclusión: aplicaciones móviles centradas en la Terapia Intravenosa; aplicaciones móviles centradas en la prevención de la infección del torrente sanguíneo, el análisis se realizó de forma cualitativa comparativa, reconociendo las funciones desarrolladas por las aplicaciones y su potencial de uso en la práctica clínica. Resultados: Se seleccionaron 19 aplicaciones y se organizaron en temas: aplicaciones para ayudar en el cateterismo; aplicaciones para el mantenimiento del cateterismo; aplicaciones sobre la prevención de la infección de transmisión sanguínea; y aplicación sobre el diagnóstico de la infección de transmisión sanguínea asociada al cateterismo. Conclusión: la identificación de pocas aplicaciones sobre el tema sirve de estímulo para la construcción de nuevas aplicaciones.

Modelo teórico-metodológico de elaboração e validação de tecnologia educacional para a área da enfermagem / Modelo teórico-metodológico con el objetivo de crear y validar tecnología educativa para el área de enfermería / Theoretical-methodological model to develop and validate educational technology for the nursing area

Objetivo: apresentar um modelo teórico-metodológico para nortear a elaboração e validação de tecnologia educacional do tipo cartilhas educativas para a área da Enfermagem. Método: trata-se de um estudo teórico-reflexivo, baseado na Taxonomia de Bloom. Resultados: o estudo apresentou um modelo teórico-metodológico que descreve a elaboração do roteiro e conteúdo do material educativo seguindo as recomendações da Taxonomia de Bloom, na dimensão do processo cognitivo. Ainda, apresentou os passos para elaboração e validação de cartilhas educativas: diagnóstico situacional, revisão de literatura e documental, seleção e sumarização de conteúdo, elaboração do roteiro, criação e diagramação de imagens, validação com especialistas e com o público-alvo. Considerações finais: a proposição do modelo teórico-metodológico solidifica o conhecimento da literatura e auxilia enfermeiros e pesquisadores na elaboração de cartilhas educativas com maior rigor científico e passíveis de efetividade.

Objetivo: presentar un modelo teórico-metodológico para orientar la creación y validación de tecnología educativa del tipo folletos didácticos para el área de Enfermería. Método: estudio teórico-reflexivo basado en la Taxonomía de Bloom. Resultados: el estudio presentó un modelo teórico-metodológico que describe la elaboración del guión y contenido del material educativo siguiendo las recomendaciones de la Taxonomía de Bloom, en la dimensión del Proceso cognitivo. También presentó los pasos para crear y validar folletos educativos: Diagnóstico situacional, Revisión de documental y de la literatura, Selección e sumario del contenido, Elaboración del guión, Creación y diagramación de imágenes, y Validación con especialistas y con la población objetivo. Consideraciones finales: la propuesta del modelo teórico-metodológico consolida el conocimiento existente en la literatura y auxilia enfermeros e investigadores en la creación de folletos educativos con mayor rigor científico y buenas perspectivas de efectividad.

Objective: to present a theoretical-methodological framework guiding the development and validation of educational technology, specifically didactic booklets for the Nursing area. Method: this is a theoretical-reflexive study grounded on Bloom's Taxonomy. Results: the study presented a theoretical-methodological model outlining the educational material script and content development in accordance with Bloom's Taxonomy recommendations, in the Cognitive Process dimension. Additionally, it outlined the steps for creating and validating educational booklets: situational analysis, literature and documentary review, content selection and summarization, script development, creation and layout of the illustrations, validation with experts, and validation with the target audience. Final considerations: the theoretical-methodological model proposal consolidates the knowledge existing in the literature and assists nurses and researchers in creating educational booklets with greater scientific rigor, increasing their effectiveness potential.

Demographic profile, training and practical experience of professionals performing peripheral intravenous catheterization in brazil / Perfil demográfico, formación y experiencia práctica de los profesionales que realizan cateterismo intravenoso periférico en brasil / Perfil demográfico, formação e experiência prática de profissionais executantes da cateterização intravenosa periférica no brasil

ABSTRACT Objective: to describe the demographic profile, training and practical experience of professionals who perform peripheral intravenous catheterization in Brazil. Method: this is a descriptive cross-sectional study, carried out in the five macroregions of Brazil with 2,584 nursing professionals who worked in direct care of patients undergoing peripheral intravenous catheterization, using a questionnaire containing professional demographic characteristics, training and experience. Data collection took place between July 2021 and May 2022. Descriptive statistics, one-way ANOVA test, Pearson's chi-square test for k independent samples and Tukey's multiple comparison test and adjusted residuals were used. Results: most nursing professionals resided in the southeast macro-region and were women. The mean age of nurses was 39.52 (±8.74) years, technicians, 39.66 (±9.22), and nursing assistants, 40.61 (±10.57). The mean training time for nurses was 11.83 (±8.18) years, for nursing technicians, 10.81 (±7.62), and for nursing assistants, 11.19 (±8.33). During the training process, most professionals received lessons in pharmacology, vascular access devices and venous catheterization. The mean number of devices inserted by nurses, in a 12-hour shift, was lower than the mean inserted by technicians and nursing assistants. Conclusion: nurses are not recognized as professionals legally responsible for the peripheral intravenous catheterization procedure, and intravenous therapy implementation is predominantly carried out by technicians and nursing assistants. The training process is incipient.

RESUMEN Objetivo: describir el perfil demográfico, la formación y la experiencia práctica de los profesionales que realizan cateterismo intravenoso periférico en Brasil. Método: estudio transversal descriptivo, realizado en las cinco macrorregiones de Brasil con 2.584 profesionales de enfermería que actuaban en el cuidado directo de pacientes sometidos a cateterismo intravenoso periférico, mediante un cuestionario que contiene las características demográficas, formación y experiencia de los profesionales. La recolección de datos se realizó entre julio de 2021 y mayo de 2022. Se utilizó estadística descriptiva, prueba ANOVA de 1 vía, Chi-Cuadrado T de Pearson para k muestras independientes y prueba de comparación múltiple de Tukey y residuos ajustados. Resultados: la mayoría de los profesionales de enfermería residían en la macrorregión Sudeste y eran mujeres. La edad media de los enfermeros fue de 39,52 (±8,74) años, de los técnicos, de 39,66 (±9,22) años, y de los auxiliares de enfermería, de 40,61 (±10,57) años. El tiempo medio de formación de los enfermeros fue de 11,83 (±8,18) años, de los técnicos de enfermería, de 10,81 (±7,62) años, y de los auxiliares de enfermería, de 11,19 (±8,33) años. Durante el proceso de formación, la mayoría de los profesionales recibieron lecciones de farmacología, dispositivos de acceso vascular y cateterismo venoso. El promedio de dispositivos insertados por enfermeros, en un turno de 12 horas, fue inferior al promedio insertado por técnicos y auxiliares de enfermería. Conclusión: los enfermeros no son reconocidos como profesionales legalmente responsables del procedimiento de cateterismo intravenoso periférico y la implementación de la terapia intravenosa es realizada predominantemente por técnicos y auxiliares de enfermería. El proceso de formación es incipiente.

RESUMO Objetivo: descrever o perfil demográfico, formação e a experiência prática de profissionais que realizam a cateterização intravenosa periférica no Brasil. Método: estudo transversal descritivo, realizado nas cinco macrorregiões do Brasil com 2.584 profissionais de enfermagem que atuavam no cuidado direto de pacientes submetidos à cateterização intravenosa periférica, utilizado um questionário contendo características demográficas, formação e experiência dos profissionais. A coleta ocorreu entre julho de 2021 e maio de 2022. Empregou-se estatística descritiva, Teste de Anova 1 Fator, Teste do Qui Quadrado de Pearson para k amostras independentes e Teste de comparações múltiplas de Tukey e resíduos ajustados. Resultados: a maior parte dos profissionais de enfermagem residiam na macrorregião sudeste, eram mulheres. A média de idade dos enfermeiros foi de 39,52 (±8,74) anos, dos técnicos de 39,66 (±9,22) anos e dos auxiliares de enfermagem de 40,61 (±10,57) anos. O tempo médio de formação dos enfermeiros foi igual a 11,83 (±8,18) anos, dos técnicos de enfermagem 10,81 (±7,62) anos e auxiliares de enfermagem 11,19 (±8,33) anos. Durante o processo formativo a maioria dos profissionais recebeu aulas de farmacologia, dispositivos de acesso vascular e cateterização venosa. O número médio de dispositivos inseridos por enfermeiros, em turno de 12 horas, foi inferior à média inserida por técnicos e auxiliares de enfermagem. Conclusão: enfermeiros não se reconhecem como profissionais legalmente responsáveis pelo procedimento de cateterização intravenosa periférica e a implementação da terapia intravenosa é predominantemente realizada pelos técnicos e auxiliares de enfermagem. O processo formativo é incipiente.

Disinfection of needleless connectors to reduce Staphylococcus aureus bacterial load.

HIGHLIGHTS: Compare effectiveness of chemical disinfectants in reducing S. aureus. Five disinfectants reduced the bacterial load, especially chlorhexidine solutions. Focus on Brazilian clinical practice of needleless connector disinfection. PURPOSE: This study aimed to gain further knowledge about the comparative effectiveness of chemical disinfectants in reducing the bacterial load of NCs inoculated with S. aureus. METHODS: Disinfection of needleless connectors was undertaken in vitro against S. aureus comparing 70% isopropyl alcohol (IPA), 70% ethanol, 0.5% and 2% chlorhexidine in 70% IPA applied with gauze, and 70% IPA single-use cap (Site-Scrub®). RESULTS: All disinfectants reduced the bacterial load (P<0.001), especially the chlorhexidine solutions. Mechanical friction should follow guidelines. CONCLUSION: This study found that all tested disinfectants effectively reduced the bacterial load and more clinical studies must be developed with a focus on the Brazilian clinical practice of needleless connector disinfection.

Liver Transplantation for Treatment of Unresectable Spontaneous Ruptured Hepatocellular Adenoma: A Rare Indication.

Hepatocellular Adenomas (HA) are rare benign tumors of the liver which occur predominantly in young women. Although benign, HA may have complications such as hemorrhage and malignant transformation. So, sometimes conservative management is not enough. We report a case of a 26-year-old woman on oral contraceptives who presented with acute abdominal pain and signs of hemodynamic shock. She underwent transarterial embolization due to the presence of multiple HA with rupture and active hemorrhage. This minimally invasive treatment failed to control the disease. The patient presented a progressive increase in the size of the masses with signs of recent hemorrhage, and the HA became unresectable, so she underwent liver transplantation. Liver transplantation is rarely indicated for the treatment of HA; however, in unresectable masses, it should be considered to prevent potential rupture with hemorrhage or malignant transformation.