Screening complications in the postoperative period of orthopedic surgeries by video arthroscopy

To analyze the prevalence and characteristics of late postoperative complications of orthopedic surgeries by video arthroscopy.This was a descriptive cross-sectional study that evaluated, through its own instrument, local and systemic postoperative complications of patients undergoing orthopedic surgeries by video arthroscopy. The study included 270 patients, who were evaluated on days 30(without prosthesis) and 90(with prosthesis placement) of the postoperative period, by telephone service. The selection of participants occurred sequentially and population-based, within the data collection period, from February to July 2020, in a large hospital for medium and high complexity surgeries. Of the 270 procedures performed in the period, 4.4% (n = 12) presented late postoperative infection. The most frequent complications were erythema (83%), edema (75%) and secretion (67%) in the surgical wound. Most used antibiotic therapy (92%) and anti-inflammatory drugs (67%). Hospital readmission was not necessary concerning the complications. Only 50% required medical evaluation before the scheduled time.The need for practices that ensure the quality of perioperative care and improve the active search to assess surgical outcomes is reinforced.

Nursing Care of Patients With Cirrhosis: The LiverHope Nursing Project.

Cirrhosis is a complex disease that is associated with disturbances in different organs besides the liver, including kidneys, heart, arterial circulation, lungs, gut, and brain. As a consequence, patients develop a number of complications that result in frequent hospital admissions and high morbidity and mortality. Patients with cirrhosis require constant and rigorous monitoring both in and outside the hospital. In this context, the role of nurses in the care of patients with cirrhosis has not been sufficiently emphasized and there is very limited information about nursing care of patients with cirrhosis compared with other chronic diseases. The current article provides a review of nursing care for the different complications of patients with cirrhosis. Nurses with specific knowledge on liver diseases should be incorporated into multidisciplinary teams managing patients with cirrhosis, both inpatient and outpatient. Conclusion: Nurses play an important role in the management and prevention of complications of the disease and improvement in patients' quality of life and bridge the gap between clinicians and families, between primary care and hospital care, and provide medical education to patients and caregivers.

Pediatric Nurses' Perceptions of Their Role in Antimicrobial Stewardship: A Focus Group Study.

PURPOSE: To explore pediatric nurses' perceptions of their role in antimicrobial stewardship. DESIGN AND METHODS: Twelve focus group sessions were conducted at a freestanding children's hospital including 90 nurses across a range of settings, units, and years of experience. Transcripts of the focus group sessions were jointly coded, from which themes were developed. RESULTS: Specific nursing roles in antibiotic stewardship identified include: (1) advocating for the patient, (2) communicating with the team, (3) administering medications safely, (4) educating caregivers, and (5) educating themselves. Identified barriers hindering effective execution of these roles include inconsistent inclusion on rounds and lack of institutional protocols for antibiotic use. CONCLUSION: Nurses easily identified numerous daily nursing tasks that fit within the framework of antimicrobial stewardship and desired additional education and engagement in antibiotic stewardship. IMPLICATIONS: Engaging nurses could improve the structure of antibiotic stewardship programs and break down the barriers that keep nurses from fulfilling their role.

¿Son los calcetines para pacientes diabéticos aptos para cicatrizar heridas? / Are socks for diabetic patients suitable garments to heal wounds?

La diabetes mellitus afecta en España a más del 13 % de la población adulta mayor de 18 años. En estos pacientes, la aparición de úlceras en el pie representa un signo de alerta indicativo de la progresión desfavorable de su enfermedad. El desarrollo textil hacia prendas deportivas especializadas y ropa técnica ha conllevado la elaboración de productos para el sector sanitario, como el calcetín para pacientes diabéticos. La composición textil de los distintos modelos es variable. Algunos de ellos ofrecen propiedades antibacterianas y antifúngicas al incluir plata y quitosano/ chitosan en su composición. Estas combinaciones se vinculan a la probable prevención o tratamiento de la dermatitis, micosis y heridas de los pies. Las pequeñas lesiones en las extremidades inferiores de los pacientes diabéticos, en ocasiones, presentan dificultades para cerrarlas con productos de cura avanzada, sobre todo en las fases finales. Estas prendas terapéuticas combinadas, dada su composición, son capaces de epitelizar pequeñas heridas en los pies o tobillos. Describimos cinco casos en el siguiente estudio: lesiones en pies diabéticos, isquémicos y neuropáticos; en tobillo con lesión traumática compleja; una infección fúngica; y una lesión traumática compleja, en paciente diabética con reacciones alérgicas a los productos y apósitos habituales. Se ponen de relieve las dificultades terapéuticas que han implicado y las distintas fases de tratamiento hasta su resolución. La recomendación del uso de calcetines especiales para diabéticos como parte de la Educación para la Salud realizada por las enfermeras estaría indicada en usuarios con problemas neuropáticos periféricos, vasculares y micosis

Diabetes mellitus affects more than 13 % of Spain’s adult population (18 years old and above), with an increasing prevalence especially among children. In diabetic patients, the appearance of a diabetic foot ulcer means a warning sign that indicates the serious nature of the disease’s progression. The textile industry’s development towards the production of specialized sports and technic clothing has led to the manufacturing of specialized garments for the health sector, including therapeutic socks for diabetic patients. These socks’ textile composition varies considerably between models. Some offer antibacterial and antifungal properties by including silver and chitosan in their yarn. These combined compositions are intended to prevent and/or treat ailments that are likely to appear, such as dermatitis, mycoses and foot injuries. Small injuries in the lower extremities of diabetic patients sometimes present difficulties in the healing process despite the use of advanced healing products, especially in their final stages. Given the composition of diabetic socks, these garments epithelialize small wounds in the feet and ankles. The following study describes the use of therapeutic diabetic socks in five cases, highlighting the therapeutic difficulties involved and the different phases of treatment until their resolution. The cases included: three injuries in diabetic, ischemic and neuropathic feet; an ankle with complex traumatic injury; a fungal infection; and a traumatic complex injury in a diabetic patient with allergic reactions to products and dressings involved in usual treatments. Including the use of therapeutic socks for diabetic patients as part of the Education for Health activities performed by nurses is recommendable for patients with peripheral neuropathic and vascular problems and mycoses

Incidencia de la infección nosocomial en pacientes trasplantados hepáticos. Factores de riesgo y rol de las enfermeras / Incidence of cross infection in liver transplant patients. Risk factors and role of nursinge

Objetivo: Conocer la incidencia de infección en pacientes trasplantados hepáticos, en el postrasplante inmediato y los factores de riesgo de infección, durante el ingreso en una unidad de trasplante hepático. Metodología: Estudio descriptivo, prospectivo realizado en la Unidad de trasplante hepático del Hospital Clínic que incluyó a todos los pacientes que fueron trasplantados entre enero de 2012 y agosto de 2015(n=241). Se realizó el análisis de datos con el paquete estadístico R Comander. Las variables cualitativas se compararon con el chi2 y las cuantitativas con la t de Student, considerándose significativa una p≤ 0,05. Resultados: La incidencia de infección fue de 34,8% (n=241). Las bacterianas fueron las más frecuentes (75,3%) y dentro de estas las urinarias (34%) causadas por Escherichia coli y Klebsiella pneumoniae. Realizado el análisis multivariado en las infecciones bacterianas, se observó que el sexo, la edad y los días de estancia en hospital fueron los factores predictivos independientes. Conclusiones: La infección bacteriana en el postrasplante inmediato es común y repercute en la recuperación del paciente, implicando más días de estancia hospitalaria y más procesos invasivos. El personal de enfermería debe conocer los factores de riesgo relacionados con la infección para extremar medidas de prevención. La correcta aplicación de las recomendaciones publicadas en la bibliografía sobre la inserción, mantenimiento y retirada precoz de dispositivos médicos y el cumplimiento de la higiene de manos son fundamentales (AU)

Objective: To determine the incidence and risk factors of infection in liver transplant recipients immediately post-transplant, during admission to a liver transplant unit during the immediate post-transplant admission. Methodology: Descriptive, prospective study performed in the Liver Transplant Unit of Hospital Clínic, Barcelona. All liver transplant recipients between January 2012 and August 2015 (n=241) were included. Statistical analysis was performed with R Commander. Variables were compared with Chi-square and Student's t-test. A value of p≤.05 was considered significant. Results: The incidence of infection was 34.8%. The most frequent infections were bacterial (75.3%), particularly urinary infections (34.6%) caused by Escherichia coli and Klebsiella pneumoniae. Independent risk factors for the development of bacterial infections according to multivariate analysis were sex, age and length of hospital stay. Conclusions: Infections are a significant problem in the early post-transplant period, and are associated with longer hospitalisation periods. The role of nursing in preventing infections, by identifying risk factors, correctly applying nursing protocols in insertion, maintenance and early withdrawal of medical devices and fulfilling hand hygiene, is essential (AU)

Bacterial sepsis in the neonate.

Neonatal bacterial infections leading to sepsis occur frequently in the first few days or weeks of life. NPs must be able to recognize the early signs of sepsis and understand the need for rapid evaluation and treatment. This article discusses antibiotic treatments for various types and locations of bacterial infections and sepsis in the neonate.

The Human Microbiome and Understanding the 16S rRNA Gene in Translational Nursing Science.

BACKGROUND: As more is understood regarding the human microbiome, it is increasingly important for nurse scientists and healthcare practitioners to analyze these microbial communities and their role in health and disease. 16S rRNA sequencing is a key methodology in identifying these bacterial populations that has recently transitioned from use primarily in research to having increased utility in clinical settings. OBJECTIVES: The objectives of this review are to (a) describe 16S rRNA sequencing and its role in answering research questions important to nursing science; (b) provide an overview of the oral, lung, and gut microbiomes and relevant research; and (c) identify future implications for microbiome research and 16S sequencing in translational nursing science. DISCUSSION: Sequencing using the 16S rRNA gene has revolutionized research and allowed scientists to easily and reliably characterize complex bacterial communities. This type of research has recently entered the clinical setting, one of the best examples involving the use of 16S sequencing to identify resistant pathogens, thereby improving the accuracy of bacterial identification in infection control. Clinical microbiota research and related requisite methods are of particular relevance to nurse scientists-individuals uniquely positioned to utilize these techniques in future studies in clinical settings.

[Antibiotic prescription usage and assessment in geriatric patients]. / Usage et évaluation des prescriptions antibiotiques en gériatrie.

Due to the high risk of infection, the geriatric population is regularly subjected to antibiotics. Faced with bacterial resistance, particularly among elderly dependent patients, it is essential to promote proper use and correct prescription of antibiotics. A study evaluated antibiotic prescription in a geriatric hospital with 598 beds and highlighted the importance of collaboration between geriatricians and infectious disease specialists.