Educational interventions and identification of risk factors to prevent and reduce peritonitis in peritoneal dialysis: A scoping review.

BACKGROUND: Peritonitis is a common and serious complication of peritoneal dialysis and is one of the main causes of peritoneal dialysis technique failure and long-term hemodialysis conversion. OBJECTIVES: The aim of the review was to identify and clarify peritonitis risk factors and learn about strategies employed at international level to prevent and reduce the occurrence of peritoneal dialysis associated infections and their complications. DESIGN: A scoping review. PARTICIPANTS: Adults in pertitoneal dialysis. MEASUREMENTS: The methodology framework of Arksey and O'Malley and PRISMA for Scoping Reviews guidelines were applied. A search was conducted of PubMed, Scopus and CINAHL using terms to identify peritoneal dialysis -associated risk factors and interventions carried out for the prevention and reduction of peritonitis in adult persons living at home. RESULTS: The 17 studies selected were based on work carried out in nine different countries. Eleven articles analysed modifiable risk factors (low educational level, being a foreigner and low adherence to aseptic technique) and non-modifiable risk factors (age and comorbidities) that predispose to peritonitis in peritoneal dialysis. The other six studies applied an intervention to improve the prevalence of peritonitis considering educational practices adapted to patient characteristics and the application of retraining. CONCLUSIONS: Personalised patient training and the identification of risk factors for peritonitis are key to reducing complications and enhancing the survival of peritoneal dialysis patients and the effectiveness of the technique.

Plan de cuidados de enfermería para el abordaje del duelo perinatal según la teoría del duelo disfuncional. Caso clínico / Nursing care plan for dealing with perinatal bereavement according to the theory of dysfunctional bereavement. Clinical case

Se presenta el caso clínico de una mujer de 33 años que, tras una muerte perinatal, presenta un proceso de duelo complicado.El objetivo es aplicar un plan de cuidados individualizado que permita un restablecimiento del equilibrio de la mujer y su entorno tras una vivencia de muerte perinatal.La valoración se inició durante la primera visita a su matrona en la que se aplicaron las escalas de insomnio de Atenas, de continuidad de vínculos y de ansiedad y depresión de Goldberg. Se realizó una valoración focalizada mediante los patrones de Gordon y desde el enfoque descrito en la teoría del duelo disfuncional.Se identificaron 6 etiquetas diagnósticas NANDA Internacional (duelo inadaptado, insomnio, desesperanza, proceso de maternidad ineficaz, sufrimiento moral y ansiedad), y se procedió a la priorización utilizando razonamiento clínico en red mediante el modelo análisis de resultados del estado actual, observando las relaciones entre las etiquetas diagnósticas e identificando cómo incidían sobre el resto.Para cada una de las etiquetas diagnósticas NANDA Internacional se planificaron los resultados esperados junto con las intervenciones enfermeras planificadas. Los resultados esperados contaron con la descripción de los indicadores de evaluación utilizando las escalas de Likert. Tanto resultados como intervenciones fueron consensuados entre el profesional y la mujer.El plan de cuidado plantea la dificultad que para los profesionales de enfermería supone la asistencia de situaciones de duelo complicado, y concretamente, las asociadas a una muerte perinatal. Esta situación hace necesarias competencias clave en la formación, así como la necesidad de conocer nuevos enfoques enfermeros.(AU)

We present the clinical case report of a 33-year-old woman who, after a perinatal death, presents a complicated grieving process.The aim is to apply an individualized care plan that allows a reestablishment of the balance of the woman and her environment after an experience of perinatal death.During the first visit to her midwife, the Athens Insomnia, Continuituing Bonds and Goldberg Anxiety and Depression scales were applied. Focused assessment was made using the Gordon patterns and based on the nursing approach described in Dysfunctional Grief Theory.Six International NANDA diagnostic labels were identified (maladaptative grieving, insomnia, hopelessness, ineffective motherhood process, moral distress and anxiety), and they were prioritized using clinical network reasoning using the Outcome Present State (OPT) model, observing the relationships between the labels, diagnoses and identifying how they affected the rest.For each International NANDA diagnostic labels, the nursing outcomes were planned nursing interventions. The expected results included the description of the evaluation indicators using the Likert scales. Both results and interventions were agreed between the professional and the woman.The care plan raises the difficulty that nursing professionals pose in assisting in situations of complicated grief, and specifically, associated with perinatal death. This situation makes key competencies necessary in training as well as the need to know new nursing approaches.(AU)

Nursing care plan for dealing with perinatal bereavement according to the theory of dysfunctional bereavement. Clinical case.

We present the clinical case report on a 33-year-old woman who, after a perinatal death, presented a complicated grieving process. The aim was to apply an individualised care plan that enabled reestablishment of the woman's emotional balance and environment after an experience of perinatal death. During the first visit to her midwife, the Athens Insomnia, Continuity Bonds and Goldberg Anxiety and Depression scales were applied. Focussed assessment was made using the Gordon patterns and based on the nursing approach described in the Dysfunctional Bereavement Theory. Six International NANDA diagnostic labels were identified (maladaptative grieving, insomnia, hopelessness, ineffective mothering process, moral distress and anxiety), and these were prioritised using clinical network reasoning, using the Outcome Present State Test (OPT) model, observing the relationships between the labels, diagnoses and identifying how they affected the rest. For each International NANDA diagnostic labels, the nursing outcomes were planned, along with the planned nursing interventions. The expected results included the description of the evaluation indicators using the Likert scales. Both results and interventions were agreed between the professional and the mother. The care plan raises the difficulty that nursing professionals face when attending to situations of complicated grief, and specifically, those associated with perinatal death. This situation makes key competencies necessary in training, as well as the need to find out about new nursing approaches.

Construcción de la imagen profesional de enfermería durante la pandemia por Covid-19 a través de las noticias de prensa / Construction of nursing professional image during the Covid-19 pandemic through press news

Objetivo: Describir la imagen social de la enfermería durante la primera oleada de pandemia por Covid-19 a través de la prensa escrita generalista y especializada. Metodología: Estudio documental cualitativo descriptivo, análisis realizado bajo la teoría de Moscovici. Selección 95 noticias del 15 marzo a 15 de mayo. Se descartaron artículos con alusión puntual a las enfermeras o al personal sanitario general. Se incluyeron finalmente 37 noticias prensa general y 40 prensa especializada. Extracción de datos siguiendo 8 indicadores: lenguaje verbal, imágenes, grado trascendencia y difusión de la información, ámbito, personas implicadas, por qué trasciende la información, identificación de juicios por parte de los autores y elementos de construcción social. Resultados: Prensa general: 94,5% lenguaje periodístico frente 5,5% científico-divulgativo. Uso mayoritario del masculino, centradas en la actividad asistencial. Las principales categorías emergentes fueron: ámbito de trabajo/profesión (43,75%), contexto/entorno (34,71%), emociones (13,88%) y patrones de conocimiento (7,64%). Conclusiones: Las noticias publicadas en prensa generalista incorporan una visión reduccionista de la enfermera sobre su desempeño profesional, aunque le otorgan un gran valor social. Es necesario lograr el reconocimiento del rol autónomo, así como la visibilización de todos los campos de actuación. Se evidencia como un recurso necesario, a la vez que escaso, para la viabilidad del sistema de salud y los cuidados de la población.(AU)

Objective: Describe the image of nursing during the first wave of the Covid-19 pandemic through the generalist and specialized written press. Methods: Descriptive qualitative documentary study, analysis carried out under Moscovici's theory. 95 news items published from March 15 to May 15 were selected. Articles that made specific references to nurses or dealt with health personnel in general were discarded. In a second selection phase, 36 news from the general press and 40 from the specialized press were included for the analysis. Data were extracted taking into account 8 indicators: verbal language, images, degree of importance and dissemination of the information, scope, people involved, why the information transcends, identification of judgments by the authors and elements of social construction. Results: General press: 94.5% journalistic language compared to 5.5% scientific-informative. Majority use of masculine, focused on care activity. The main emerging categories were: field of work/profession (43.75%), context/environment (34.71%), emotions (13.88%) and knowledge patterns (7.64%). Conclusions: The news published in the general press incorporates a reductionist view of the nurse regarding their professional performance, although they give it great social value. It is necessary to achieve recognition of the autonomous role as well as the visibility of all fields of action. It is evidenced as a necessary resource, as well as scarce, for the viability of the health system and the care of the population.(AU)

La profesionalización de la enfermería en Lleida a partir de las Hijas de la Caridad / A profissionalizaçao da Lleida enfermagem da filhas da Caridade / The professionalization of Lleida nursing from the Daughters of Charity

El objetivo del estudio es describir el proceso de profesionalización de la enfermería en Lleida a partir de la llegada de las Hijas de la Caridad de San Vicente de Paúl en el Hospital de Santa María. MATERIAL Y MÉTODO: Estudio histórico mediante técnica de observación documental y análisis de documentos legislativos. Los documentos utilizados son: copia de la escritura del establecimiento de las Hijas de la Caridad en el Hospital de Santa María (1792). RESULTADOS: En la copia de la escritura se establece que las hermanas se encargarán del régimen y cuidados de los enfermos según las reglas de su instituto; y que tanto el gobierno y dirección interior y exterior de ellas dependerá de la Congregación. En las Constituciones del 1797 se acredita que han resultado beneficiosas tanto para la organización del hospital como para la atención sanitaria. Ponen énfasis en posibles divulgaciones negativas con respecto a ellas. CONCLUSIONES Y DISCUSIÓN: El establecimiento de las Hijas de la Caridad mejoró la atención sanitaria de los enfermos y la salubridad del centro. La contraprestación económica nos ayuda para que podamos hablar de profesionalización de enfermería (AU)

O objetivo deste estudo é descrever o processo de profissionalização da enfermagem em Lleida a partir da chegada das Filhas da Caridade de São Vicente de Paulo no Hospital de Santa Maria. MATERIAIS E MÉTODOS: Estudo histórico pela técnica de documentário de observação e análise de documentos legislativos. Os documentos utilizados são: cópia da escritura de constituição da Filhas da Caridade do Hospital de Santa Maria (1792) e as Constituições para o governo da Cidade Santa General Hospital, em Lleida (1797). RESULTADOS: Na cópia do ato que declara as irmãs responsáveis do regime e dos cuidados dos pacientes de acordo com as regras do instituto e do governo e direção tanto dentro quanto fora deles depende da congregação. Nas Constituições de 1797, os créditos que tenham sido benéficas para a organização do hospital para atendimento. Enfatizar as potenciais divulgações negativas sobre eles. CONCLUSOES E DISCUSSAO: O estabelecimento das Filhas da Caridade de saúde melhorou e pacientes do centro de saúde. A compensação monetária nos ajuda para que possamos falar de profissionalização da enfermagem (AU)

The aim of this study is to describe the process of professionalization of nursing in Lleida from the arrival of the Daughters of Charity of St. Vincent de Paul in St. Maria Hospital. MATERIALS AND METHODS: Historical study by documentary observation technique and analysis of legislative documents. The documents used are: copy of the deed of establishment of the Daughters of Charity of St Maria Hospital (1792) and the Constitutions for the government of the Holy City General Hospital in Lleida (1797). RESULTS: In the copy of the deed states that the sisters in charge of the regime and care of patients according to the rules of the institute and that both the government and direction inside and outside of them depends on the congregation. In the Constitutions of 1797, credits that have been beneficial to the organization of the hospital to care. Emphasize potential negative disclosures about them. CONCLUSIONS AND DISCUSSION: The establishment of the Daughters of Charity health care improved patients and health center. The monetary compensation helps us so we can talk of professionalization of nursing (AU)