Emergency Response: A Cross-sectional Study of Core Competencies for Nurses Regarding Major Infectious Disease Outbreaks.

INTRODUCTION: The core competencies of nursing personnel have been identified as a main factor affecting nursing effectiveness. This study examined core emergency response competencies of Chinese nursing personnel related to the outbreak of major infectious diseases. METHODS: A survey was conducted among 960 nurses working in a tertiary hospital in Shanghai, China. Data were collected on core emergency response competencies of nursing personnel caring for patients with major infectious diseases, measuring overall competency as well as by dimensions of prevention ability, rescue ability, and preparation ability. A t-test and one-way analysis of variance were first analyzed for differences between groups, followed by multiple linear regression to analyze main influencing factors for core emergency response competencies. RESULTS: The average score for core emergency response competencies of nursing personnel delivering care to patients with major infectious diseases was 128.05 (SD 22.23) (range 36-180 points); or 71%, which is equivalent to moderate performance. Multiple linear regression analysis demonstrated that the main influencing factors for these nursing personnel were before participation in emergency drills for infectious diseases, current educational background, and working experience in the realm of infectious disease nursing. The final model explained 8.4% of the variance in core emergency response competencies. DISCUSSION: These findings indicate that it is necessary to strengthen the training of nursing staff with educational background deficits or no prior work or drill experience related to infectious diseases to effectively improve the core emergency response competencies of nursing personnel relative to infectious diseases.

Florence Now: el triple impacto del poder Nightingale / No disponible

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Manejo Clínico da COVID-19 na APS

O Conass realiza nessa sexta-feira (03/07), às 17 horas, o Debate Virtual: Manejo Clínico da Covid-19 na APS. O debate irá apresentar como manejar adequadamente os casos iniciais da Covid-19, tendo em vista a interiorização da pandemia. Cerca de 80% dos casos podem ser resolvidos na APS. A iniciativa faz parte da implantação do Guia Orientador do Enfrentamento da Covid-19 na Rede de Atenção à Saúde, elaborado em parceria com o Conselho Nacional de Secretarias Municipais de Saúde (Conasems), a partir da preocupação da Atenção a saúde das pessoas nas Unidades Básicas de Saúde. Três eixos descrevem a organização e integração das redes: atenção ao evento agudo de casos de SG (Síndrome Gripal) ou SRAG (Síndrome Respiratória Aguda Grave), suspeitos ou confirmados para Covid-19, coordenada para garantir a resposta das RAS de Urgência e Emergência; o monitoramento dos casos. Participarão do debate os apresentadores Priscila Rabelo Lopes, facilitadora da PAS/Conass; e Fabiano Gonçalves Guimarães, Médico de Família e Comunidade e gerente de Atenção Primária à Saúde da SMS de Belo Horizonte; e como debatedores, Eliane Regina Chomatas, facilitadora da PAS/Conass; e Leonardo Moura Vilela, assessor técnico e ex-presidente do Conass. A mediação do debate será feita pela assessora técnica, responsável pela Planificação da Atenção à Saúde (PAS) do Conass, Maria José Evangelista. Perguntas poderão ser enviadas pelo www.conass.org.br/participe O debate será transmitido pelo Portal do Conass: www.conass.org.br e pelos canais do Conselho no YouTube: www.youtube.com/conassoficial; e no FaceBook: www.facebook.com/conassoficial. Participe!

Caring for the Youngest Students: The ABCs of Preschool Nursing.

Caring for the preschool population presents unique challenges for the school nurse. These challenges are multiplied when the population includes those with special needs. Challenges include multiple risks to safety related to developmental stage, increased prevalence of infectious diseases due to the development of the child's immune system, management of chronic disease because of the student's ability to comprehend and follow directions, and many social and emotional issues. Using evidence-based strategies, the preschool nurse can gain the confidence to care for the youngest students.

Emerging Infectious Diseases.

Emerging infectious diseases (EID) and reemerging infectious diseases are increasing globally. Zoonotic diseases are transmitted from animals to humans through direct contact or through food, water, and the environment. Vector-borne diseases are major sources of mortality and morbidity globally. Three mosquito-borne viruses are yellow fever, chikungunya virus, and dengue virus. Recent EIDs include Candida auris, Elizabethkingia anopheles, The Lone Star tick, and avian influenza H7N2. In addition, mcr-1 may contribute to the dissemination of drug resistance to gram-negative bacteria. Nurses play a major role in the identification and prevention of EID within health care settings.

Nursing actions for liberty deprived people: a scoping review / Acciones de enfermería para las personas privadas de libertad: una scoping review / Ações de enfermagem para as pessoas privadas de liberdade: uma scoping review

Abstract Objective: To identify and map the care practices carried out by the nursing team for the Liberty Deprived People. Method: Scoping review according to the JBI Institute Reviewer's Manual. In the initial search we used MESH: Nursing, Delivery of Health Care and Prisoners, to delimit the final search strategy, made up by a combination of twelve keywords, performed in scientific and gray databases, with no temporal limit. Information about publication year, country of origin, objective, aspects of the method, results and conclusions related to the scoping review, were extracted. Results: 59.310 texts were found, after reading the title and abstract, 55 were read in full and 15 articles composed the final selection. Among nursing actions there is preponderance of clinical practices, screening and qualified listening, which contribute to improving the health conditions of liberty deprived people and their families. Conclusions and implications for practice: The nursing actions carried out in prisons contribute to health for liberty deprived people. This paper elucidates the role of nursing in the penitentiaries, informing on the actions that this professional class performs, in order to highlight the gaps that are still perceived and contributing to the training of nurses for acting in the prison system health teams.

Resumen Objetivo: Identificar y mapear las prácticas asistenciales ejercidas por un equipo de enfermería para las Personas Privadas de Libertad. Método: Scoping review según el JBI Institute Reviewer's Manual. En la búsqueda inicial se utilizaron los MESH: Nursing, Delivery of Health Care y Prisoners, para delimitar la estrategia final de búsqueda, compuesta por una combinación de doce palabras claves, realizada en bases de datos científicas y grises, sin límite temporal. Se extrajeron informaciones sobre el año de publicación, el país de origen, el objetivo, los aspectos del método, los resultados y las conclusiones relacionados con la scoping review. Resultados: Se encontraron 59.310 textos, después de la lectura de títulos y resúmenes, de los cuales se leyeron 55 en su totalidad y 15 artículos compusieron la selección final. Entre las acciones de enfermería hay preponderancia de las prácticas clínicas, la selección y la escucha cualificada, que contribuyen a una mejora de las condiciones de la salud de las PPL y sus familias. Conclusiones e implicaciones para la práctica: Las acciones de enfermería realizadas en las cárceles han sido resolutivas y equiparadas a aquella suministrada extramuros. Este trabajo aclara el papel de la enfermería en las cárceles, informa sobre las acciones llevadas a cabo, y contribuye a la formación de enfermeros para su desempeño en el sistema penitenciario.

Resumo Objetivo: Identificar e mapear as práticas assistenciais exercidas pela equipe de enfermagem para as Pessoas Privadas de Liberdade. Método: Scoping review segundo o JBI Institute Reviewer's Manual. Na busca inicial foram utilizados os MESH: Nursing, Delivery of Health Care e Prisoners, para delimitar a estratégia final de busca, composta por uma combinação de doze palavas-chaves, realizada em bases de dados científicas e cinzentas, sem limite temporal. Foram extraídas informações sobre o ano, país de origem, objetivo da publicação, aspectos do método, resultados e conclusões relacionados a scoping review. Resultados: Foram encontrados 59.310 textos, após a leitura de título e resumo, 55 foram lidos na íntegra e 15 artigos compuseram a seleção final. Entre as ações de enfermagem há preponderância de práticas direcionadas para doenças infectocontagiosas e saúde mental, com ações clínicas, triagem e escuta qualificada, que melhoram as condições de saúde nos presídios. Conclusões e implicações para a prática: As ações de enfermagem nos presídios contribuem para o acesso à saúde entre privados de liberdade. Este trabalho elucida o papel da enfermagem nas penitenciárias, informa sobre as ações desempenhadas e contribui para a formação de enfermeiros para a atuação no sistema prisional.

Validação de um histórico de enfermagem para indivíduos hospitalizados com doenças infectocontagiosas / Validation of a nursing assessment for hospitalized individuals with infectious diseases

Analisar a validade dos indicadores empíricos das necessidades humanas básicas contidos em um histórico de enfermagem para indivíduos hospitalizados com doenças infectocontagiosas. Pesquisa metodológica, desenvolvida em duas etapas: análise de conteúdo e validação clínica. Na primeira etapa participaram 37 enfermeiros especialistas e, da segunda, 65 indivíduos internados nas clínicas de doenças infectocontagiosas de dois hospitais universitários. Na validação clínica, foram avaliadas a presença e a ausência dos indicadores empíricos. Na análise de conteúdo, foram eliminados 14 indicadores empíricos, considerando o critério de relevância. Quanto aos critérios de clareza e precisão, 33 indicadores empíricos tiveram suas definições operacionais reformuladas, com alfa de Cronbach de 0,967 a 0,986. Na validação clínica, foram realizados ajustes para a estruturação final do histórico de enfermagem. Concluiu-se que os indicadores empíricos do histórico de enfermagem representaram adequadamente o foco de interesse e apresentaram excelente consistência interna.

To analyze the validity of empirical indicators of basic human needs contained in a nursing assessment for individuals hospitalized with infectious diseases. Methodological study developed in two stages: content analysis and clinical validation. A total of 37 specialist nurses participated in the first stage, and in the second stage there were 65 individuals admitted to the infectious disease clinics of two university hospitals. In the clinical validation, the presence and absence of empirical indicators were evaluated. In the content analysis, 14 empirical indicators were eliminated, considering the relevance criterion. Regarding the criteria of clarity and precision, 33 empirical indicators had their operational definitions reformulated, with Cronbach's alpha from 0.967 to 0.986. In clinical validation, adjustments were made to the final structure of the nursing assessment. It was concluded that the empirical indicators of the nursing assessment adequately represented the focus of interest and showed excellent internal consistency.

Itinerários terapêuticos em busca do diagnóstico e tratamento da hanseníase / Itinerarios terapéuticos en busca del iagnóstico y tratamiento del hanseníasis / Therapeutic itineraries in search of diagnosis and treatment of leprosy

Objetivo analisar o itinerário terapêutico de usuários em busca do diagnóstico e tratamento da hanseníase, suas dificuldades e percepções acerca da doença. Método estudo qualitativo e descritivo. Participaram da pesquisa 20 usuários com hanseníase em registro ativo até março de 2016 em um Centro de Saúde Escola no município de Belém, Pará. Foi realizada entrevista semiestruturada e aplicada a técnica de análise de conteúdo temática. Resultado emergiram duas categorias temáticas “Percepção sobre a doença” e “Percalços da suspeição ao diagnóstico e tratamento”. Ainda existem percepções negativas sobre a patologia e muitos percalços a percorrer até o diagnóstico da hanseníase. Conclusão a busca pelo diagnóstico da hanseníase apontou uma sucessão de erros diagnósticos, da rede privada à rede básica de saúde, delineando um percurso tortuoso. As percepções dos usuários atrelam-se ao preconceito, seja de outras pessoas, seja o autopreconceito.

Objetivo analizar el itinerario terapéutico de usuarios en busca del diagnóstico y tratamiento de la hanseniasis, sus dificultades y percepciones acerca de la enfermedad. Método estudio cualitativo y descriptivo. Participaron de la investigación 20 usuarios con hanseniasis en registro activo hasta marzo de 2016 en un Centro de Salud Escuela en el municipio de Belém, Pará. Fue realizada una entrevista semi-estructurada y aplicada la técnica de análisis de contenido temático. Resultado surgieron dos categorías temáticas “Percepción sobre la enfermedad” y “Percances de la sospecha al diagnóstico y tratamiento”. Aún existen percepciones negativas sobre la patología y muchos percances a andar hasta el diagnóstico de la hanseniasis. Conclusión la búsqueda por el diagnóstico de la hanseniasis mostró una sucesión de errores diagnósticos, de la red privada a la red básica de salud, delineando un curso de tortura. Las percepciones de los usuarios están unidas al perjuicio, sea de otras personas o del auto-perjuicio.

Objective to analyze the therapeutic itinerary of patients in search of the diagnosis and treatment of leprosy, its difficulties, and perceptions about the disease. Method this is a qualitative and descriptive study. Twenty patients with leprosy in the active registry until March 2016 participated in the study in a Health Center School in the city of Belém, Pará. A semi-structured interview was applied, and the technique of thematic content analysis was applied. Results two thematic categories emerged: "Perception of the disease" and "Mishaps of the suspicion to the diagnosis and treatment". There are still negative perceptions about the pathology and many steps to go through to the diagnosis of leprosy. Conclusion the search for the leprosy diagnosis showed a succession of diagnostic errors, from the private network to the basic health network, delineating a tortuous path. The perceptions of patients are linked to prejudice, whether of other people or self-prejudice.

An Integrated Intervention for Increasing Clinical Nurses' Knowledge of HIV/AIDS-Related Occupational Safety.

Background: Approximately 35 new HIV (Human Immunodeficiency Virus, HIV) cases and at least 1000 serious infections are transmitted annually to health care workers. In China, HIV prevalence is increasing and nursing personnel are encountering these individuals more than in the past. Contaminated needle-stick injuries represent a significant occupational burden for nurses. Evidence suggests that nurses in China may not fully understand HIV/AIDS (Acquired immunodeficiency syndrome, AIDS) and HIV-related occupational safety. At this time, universal protection precautions are not strictly implemented in Chinese hospitals. Lack of training may place nurses at risk for occupational exposure to blood-borne pathogens. Objectives: To assess the effectiveness of integrated interventions on nurses' knowledge improvement about reducing the risk of occupationally acquired HIV infection. Methods: We audited integrated interventions using 300 questionnaires collected from nurses at the Affiliated Hospital of Xiangnan University, a public polyclinic in Hunan Province. The intervention studied was multifaceted and included appropriate and targeted training content for hospital, department and individual levels. After three months of occupational safety integrated interventions, 234 participants who completed the program were assessed. Results: Of the subjects studied, 94.3% (283/300) were injured one or more times by medical sharp instruments or splashed by body fluids in the last year and 95.3% considered their risk of occupational exposure high or very high. After the intervention, awareness of HIV/AIDS-related knowledge improved significantly (χ² = 86.34, p = 0.00), and correct answers increased from 67.9% to 82.34%. Correct answers regarding risk perception were significantly different between pre-test (54.4%) and post-test (66.6%) (χ² = 73.2, p = 0.00). When coming into contact with patient body fluids and blood only 24.0% of subjects used gloves regularly. The pre-test knowledge scores on universal precautions were relatively high. Correct answers about universal precautions improved significantly from pre-test (83.71%) to post-test (89.58%; χ² = 25.00, p = 0.00). After the intervention, nurses' attitude scores improved significantly from pre-test (3.80 ± 0.79) to post-test (4.06 ± 0.75; t = 3.74, p = 0.00). Conclusions: Integrated educational interventions enhance nurses' knowledge of risk reduction for occupationally acquired HIV infections and improve the observance of universal precautionary procedures. This enhancement allows nurses to assume a teaching role for prevention and management of HIV/AIDS.

[Uniform and ornaments of hands of Healthcare workers: a point prevalence survey in Ausl of Rimini]. / La divisa e gli ornamenti delle mani del personale:un'indagine nell'Ausl di Rimini.

INTRODUCTION: The debate about uniform and hand ornament of nurses, technical and supporting staff is focused on two main topics: the risk of infections and the effect on the professional image perceived by patient. PRIMARY OBJECTIVE: to describe how nurses, technical and supporting staff dress their uniform. SECONDARY OBJECTIVE: to verify the use of ornaments of the hands during routine care. METHODS: The survey was conducted in a sample of 503 operators on 67 working contexts in hospital during 14 days. Study questionnaire was composed by 5 items that described behaviors regarding uniform (item 1-2) and the presence of hand ornaments (item 3-4-5). RESULTS: The 17.3% of observed subjects did not wear the uniform and identification badge appropriately; 16.1% had hand ornaments. DISCUSSION: Despite patient delegates, through advisory committee, pointed out the need to identify the workers through the uniform and badge, our results showed inadequate behaviours. The presence of ornaments that interfere with hands hygiene and increase infection risk is a critical issue that has to be periodically monitored. Future interventions are needed to improve behaviours of healthcare personnel.

Using nursing history to inform decision-making: Infectious diseases at the turn of the 20th century.

BACKGROUND: This historical paper examines the impact of infectious diseases on the urban poor of Chicago and New York a century ago, before most vaccines were developed. PURPOSE: Working on the front lines of health promotion and health care, nurses and other providers are charged with informing the public about offered vaccines. The intent of this paper is to supplement providers' knowledge about vaccination with an appreciation of the devastation these diseases once caused. METHOD: Historical methodology guided this study in which archival and oral sources were used. DISCUSSION: The continued outbreaks of smallpox at the turn of the twentieth century, when a vaccine was available, may be compared with the re-emergence of measles today. Additionally, this paper shows the devastation caused by other, non-preventable, infections of the period. CONCLUSIONS: Awareness of the history related to the impact of infectious diseases, especially the role nurses played in decision-making related to care, is critical for today's health care providers.

La enfermería penitenciaria y su formación / Prison nursing and its training

La función primordial de los enfermeros es cuidar a las personas sanas o enfermas y evaluar las respuestas de su estado de salud llevando a cabo aquellas actividades que contribuyan a su restablecimiento o a una muerte digna y, si es posible, ayudarles a recuperar su autonomía e independencia. Dentro de la profesión enfermera existen diferentes áreas donde se desarrollan sus cuidados como son: la atención primaria, la salud mental, las urgencias y emergencias, los cuidados intensivos y coronarios, atención quirúrgica, la pediatría, la geriatría, la salud pública, la salud laboral, la docencia, etc. En el caso que nos ocupa, la enfermería penitenciaria, una de las áreas más desconocidas de esta profesión, hemos querido ahondar en el trabajo que desempeña un enfermero en el contexto penitenciario, qué cuidados desarrollan y a qué tipo de población van destinados, así como la formación necesaria para poder trabajar en un medio tan singular. Como conclusión, hemos detectado que la titulación del enfermero generalista no incluye conocimientos en esta área, y que autores de diferentes países defienden la especificidad de la enfermería penitenciaria, así como la necesidad de estar formados en unos contenidos de acuerdo a los condicionantes de salud de la población reclusa y las características del contexto penitenciario (AU)

The main task of nurses is to take care of sick and healthy people and evaluate changes in their health conditions. The goal is to take the appropriate measures to help their recovery or guarantee a dignified death, and if possible, help them regain autonomy and independence. Nursing is present in different areas: primary health, mental health, accident and emergencies, intensive and coronary care, surgical care, paediatrics, geriatrics, public health, occupational health, teaching, etc. In our case, prison nursing, one of the least known branches of the profession, we wanted to investigate more deeply the work of nurses in prisons, which aspect of health care they are responsible for and to what type of population they are geared towards, as well as the necessary training to be able to work in such a particular environment. To conclude, we have seen that university degrees in general nursing do not include knowledge in this area, and that authors from different countries support the specialization of prison nursing and the need for nurses to be trained according to the health conditions of inmates and the characteristics of prisons (AU)