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1.
Rev Infirm ; 70(270): 16-19, 2021 Apr.
Artículo en Francés | MEDLINE | ID: mdl-33832722

RESUMEN

Nearly 5% of the general population experiences a suicidal crisis every year in France. It is essential for any caregiver to learn to recognize it and intervene appropriately. This crisis most often occurs in a context of stress combined with individual vulnerability factors that causes the individual to lose their balance. The clinical presentation for suicidal crisis vary from one subject to another. It is usually fluctuating and temporary. The subject does not want to die; he wants to stop suffering. The suicidal act is the dreaded but not systematic outcome of the suicidal crisis. Here we will set out the general principles of the assessment of the suicidal crisis.


Asunto(s)
Suicidio , Instituciones de Atención Ambulatoria , Francia , Humanos , Evaluación en Enfermería , Factores de Riesgo , Suicidio/prevención & control , Suicidio/estadística & datos numéricos
2.
Rev Infirm ; 70(270): 24-28, 2021 Apr.
Artículo en Francés | MEDLINE | ID: mdl-33832725

RESUMEN

Knowing how to assess the suicidal risk of people in crisis, knowing how to orient them, welcome them, treat them and look after them are the keys to these multidisciplinary health care.


Asunto(s)
Intervención en la Crisis (Psiquiatría) , Ideación Suicida , Suicidio , Humanos , Evaluación en Enfermería , Medición de Riesgo , Suicidio/prevención & control
5.
Nursing ; 51(4): 34-40, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33759861

RESUMEN

ABSTRACT: Patients with diabetes mellitus may experience painful and nonpainful diabetic peripheral neuropathy (DPN). This article offers an overview of DPN and the clinical assessment and management of patients with DPN, as well as the nurse's role in supporting these patients.


Asunto(s)
Neuropatías Diabéticas/enfermería , Humanos , Rol de la Enfermera , Evaluación en Enfermería , Atención Dirigida al Paciente
6.
Nursing ; 51(4): 42-46, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33759863

RESUMEN

ABSTRACT: Local or regional anesthetics are becoming more common pain management options for patients, especially considering concerns regarding opioid use disorders. Though mostly safe, these interventions may carry serious risks such as local anesthetic systemic toxicity (LAST). This article discusses LAST and the importance of recognizing its signs and symptoms.


Asunto(s)
Anestésicos Locales/toxicidad , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/enfermería , Manejo del Dolor/enfermería , Humanos , Evaluación en Enfermería
7.
Nursing ; 51(4): 62-66, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33759868

RESUMEN

ABSTRACT: Incomplete spinal cord injury is challenging to diagnose and treat. This overview of Brown-Séquard syndrome outlines key assessment and nursing considerations important to enhancing recovery outcomes.


Asunto(s)
Síndrome de Brown-Séquard/enfermería , Síndrome de Brown-Séquard/fisiopatología , Síndrome de Brown-Séquard/rehabilitación , Humanos , Evaluación en Enfermería , Diagnóstico de Enfermería , Resultado del Tratamiento
8.
J Med Internet Res ; 23(2): e25518, 2021 02 10.
Artículo en Inglés | MEDLINE | ID: mdl-33529157

RESUMEN

BACKGROUND: COVID-19 has necessitated the implementation of innovative health care models in preparation for an influx of patients. A virtual ward model delivers clinical care remotely to patients in isolation. We report on an Australian cohort of patients with COVID-19 treated in a virtual ward. OBJECTIVE: The aim of this study was to describe and evaluate the safety and efficacy of a virtual ward model of care for an Australian cohort of patients with COVID-19. METHODS: Retrospective clinical assessment was performed for 223 patients with confirmed COVID-19 treated in a virtual ward in Brisbane, Australia, from March 25 to May 15, 2020. Statistical analysis was performed for variables associated with the length of stay and hospitalization. RESULTS: Of 223 patients, 205 (92%) recovered without the need for escalation to hospital care. The median length of stay in the virtual ward was 8 days (range 1-44 days). In total, 18 (8%) patients were referred to hospital, of which 6 (33.3%) were discharged after assessment at the emergency department. Furthermore, 12 (5.4%) patients were admitted to hospital, of which 4 (33.3%) required supplemental oxygen and 2 (16.7%) required mechanical ventilation. No deaths were recorded. Factors associated with escalation to hospital care were the following: hypertension (odds ratio [OR] 3.6, 95% CI 1.28-9.87; P=.01), sputum production (OR 5.2, 95% CI 1.74-15.49; P=.001), and arthralgia (OR 3.8, 95% CI 1.21-11.71; P=.02) at illness onset and a polymerase chain reaction cycle threshold of ≤20 on a diagnostic nasopharyngeal swab (OR 5.0, 95% CI 1.25-19.63; P=.02). CONCLUSIONS: Our results suggest that a virtual ward model of care to treat patients with COVID-19 is safe and efficacious, and only a small number of patients would potentially require escalation to hospital care. Further studies are required to validate this model of care.


Asunto(s)
Atención Ambulatoria/métodos , Hospitalización/estadística & datos numéricos , Aislamiento de Pacientes , Telemedicina/métodos , Adolescente , Adulto , Anciano , Australia , Estudios de Cohortes , Manejo de la Enfermedad , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Hospitales , Humanos , Tiempo de Internación/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Evaluación en Enfermería , Alta del Paciente , Respiración Artificial/estadística & datos numéricos , Estudios Retrospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad , Teléfono , Adulto Joven
9.
Int J Palliat Nurs ; 27(1): 58-63, 2021 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-33629908

RESUMEN

BACKGROUND: Homecare nurses play an important role in end-of-life care. A protocol is needed for the remote verification of expected deaths using information and communication technologies (ICT), that is consistent with Japanese guidelines. AIM: To clarify the processes that nurses use to verify deaths and to develop a tentative nursing protocol for verifying expected deaths, using home-based ICT. METHODS: Using literature and semi-structured interviews, a tentative nursing protocol was developed for verifying expected deaths using home-based ICT. FINDINGS: To protect the dignity of patients and their families, it is important that their understanding and consent is provided for the remote verification of expected deaths. Furthermore, the up-to-date legal and ethical responsibilities of nurses should be discussed regarding the verification of a patient's death to provide the best care for the patients and families when implementing the Death Certification Using Information and Communication Technology (DCUICT). CONCLUSION: This suggested protocol offers a framework for a new delivery of nursing care. It provides guidance for homecare nurses organising the care processes and nursing roles of DCUICT. Further revisions to this protocol must incorporate the specific requirement for the verification of nurses.


Asunto(s)
Muerte , Servicios de Atención de Salud a Domicilio , Evaluación en Enfermería , Teleenfermería , Certificado de Defunción , Humanos , Japón
10.
Int J Palliat Nurs ; 27(1): 10-19, 2021 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-33629914

RESUMEN

BACKGROUND: Children with life-limiting conditions have a high risk of colonisation with a multidrug-resistant organism (MDRO). To avoid the spread of hospital-aquired infections to other patients, children with a MDRO are moved to an isolated room or ward. However, such isolation prevents social participation, which may reduce the child's quality of life (QoL). To overcome this challenge of conflicting interests on a paediatric palliative care inpatient unit, a hygiene concept for patients colonised with MDRO, called PALLINI, was implemented. PALLINI advises that, instead of isolating the affected children, strict barrier nursing should be used. AIM: To identify the impact of a complex hygiene concept on children's and parents' QoL and social participation. METHODS: Cross-sectional mixed-methods research approach, comprising semi-structured interviews with parents and staff members, and a QoL-questionnaire focusing on the child which was completed by parents. FINDINGS: In paediatric patients with life-limiting conditions who have MDRO colonisation, using a complex hygiene protocol resulted in both benefits and barriers to social participation. However, the child's QoL did not appear to be affected. CONCLUSION: All staff members and families have to be familiar with the hygiene concept and the concept has to be self-explanatory and easy to apply.


Asunto(s)
Resistencia a Múltiples Medicamentos , Control de Infecciones/organización & administración , Calidad de Vida , Participación Social , Enfermo Terminal , Niño , Preescolar , Infección Hospitalaria/prevención & control , Estudios Transversales , Femenino , Unidades Hospitalarias , Humanos , Lactante , Capacitación en Servicio , Entrevistas como Asunto , Masculino , Evaluación en Enfermería , Cuidados Paliativos , Padres , Aislamiento de Pacientes , Seguridad del Paciente , Estereotipo , Encuestas y Cuestionarios
11.
Rech Soins Infirm ; (143): 118-126, 2021 Jan 13.
Artículo en Francés | MEDLINE | ID: mdl-33485280

RESUMEN

Introduction : The caritative impact of nursing care provided in forensic mental health settings is rarely questioned.Context : Caritative nursing care is indirectly regulated by the Review Board (RB), a para-judicial court which ensures public safety.Objective : This study presents a critical reflection on the political and social effects of the RB, forensic psychiatry hospitals and practices of forensic mental health nurses.Method : The reflection is centered on the concepts of biopower, degradation ceremonies, moral career and identity (re)construction.Results : ‘Therapeutic’ nursing practices are useful for disciplinary purposes in the forensic psychiatric hospital, insofar as they permit the identification and management of dangerous persons. However, the practices also fall within the biopolitical scope of the RB, since they assist the latter in ensuring public safety.Discussion : The forensic psychiatric environment can prove problematic for nurses, requiring a double allegiance, whereby their responsibilities to patients (consent and confidentiality) and to the institution (protection of the public) can lead to tension.Conclusion : The analytical framework of the study allows for a reassessment of other presumed processes in psychiatric environments, which nonetheless constitute just as many rituals of identity (re)construction.


Asunto(s)
Psiquiatría Forense , Trastornos Mentales , Enfermería Psiquiátrica , Conducta Peligrosa , Humanos , Trastornos Mentales/enfermería , Evaluación en Enfermería
12.
Medicine (Baltimore) ; 99(50): e23108, 2020 Dec 11.
Artículo en Inglés | MEDLINE | ID: mdl-33327232

RESUMEN

To explore the effect of Joanna Briggs Institute (JBI) physical restraint standards in improving physical restraint in critical and emergency department patients.Enrolled 300 critical patients admitted in our hospital's emergency department from January to December 2019: 150 patients admitted January to June 2019 as control group and 150 patients admitted July to December 2019 as observation group. Routine restraints were applied in control group. Emergency department nurses in the observation group received thematic and practical JBI standardized training. This included pre-restraint assessment, principles of physical restraint, informed consent, using a restraint decision-making wheel, and alternatives to physical restraint. The incidence of restraint-associated adverse events (e.g., skin bruising, swelling) and restraint utilization rate were examined between 2 groups.The incidence of adverse events and the restraint utilization rate were significantly lower in the observation group (P < .05).The application of JBI physical restraint standards for emergency department patients can effectively reduce the incidence of adverse events and the restraint utilization rate.


Asunto(s)
Cuidados Críticos/estadística & datos numéricos , Personal de Enfermería en Hospital/ética , Restricción Física/efectos adversos , Restricción Física/ética , Estudios de Casos y Controles , Cuidados Críticos/tendencias , Enfermería de Cuidados Críticos/normas , Toma de Decisiones , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Consentimiento Informado , Masculino , Persona de Mediana Edad , Evaluación en Enfermería/métodos , Personal de Enfermería en Hospital/educación , Estudios Prospectivos , Estándares de Referencia
14.
Med. intensiva (Madr., Ed. impr.) ; 44(9): 542-550, dic. 2020. tab, graf
Artículo en Español | IBECS | ID: ibc-198560

RESUMEN

OBJETIVOS: Determinar las propiedades métricas de la escala COMFORT Behavior Scale desarrollada por van Dijk et al. (2000) en el contexto del paciente crítico pediátrico. DISEÑO: Estudio observacional, psicométrico y prospectivo. LUGAR DE ESTUDIO: Unidad de Cuidados Intensivos de un hospital pediátrico y universitario de tercer nivel asistencial. PACIENTES: Un total de 311 niños con una mediana de edad de 5,07 años (0,9-11,7). INTERVENCIONES: Ninguna. PRINCIPALES VARIABLES Y RESULTADOS: La escala fue administrada de forma simultánea por 2enfermeros a 311 pacientes ingresados en una unidad de críticos de 18 camas de un hospital pediátrico de tercer nivel asistencial. La versión española de la COMFORT Behavior Scale obtuvo un alfa de Cronbach de 0,715 y está compuesta por 3factores, con 2ítems cada uno: 1) alerta y movimiento físico; 2) calma/agitación y respuesta respiratoria/llanto, y 3) tono muscular y tensión facial. CONCLUSIONES: La escala COMFORT B logró ser adaptada al idioma español y mostró ser válida para determinar y cuantificar el grado de confort en un grupo de niños ingresados en una unidad de cuidados pediátricos española


OBJECTIVES: To determine the measurement properties of the Spanish version of the COMFORT Behavior Scale developed by van Dijk et al. (2000) in pediatric critical care patients. DESIGN: Prospective observational and psychometric study. SETTING: Level III Intensive Care Area at a university's children hospital. PATIENTS: A total of 311 children with median age of 5.07 years (IQR = 0.9-11.7). INTERVENTIONS: None. PRINCIPAL VARIABLES AND RESULTS: To determine the measurement properties the Spanish version of the COMFORT Behavior Scale was simultaneous administered by 2nurses to 311 patients admitted to an eighteen-bed critical care unit of a third level pediatric hospital. The Spanish version of the COMFORT Behavior Scale obtained a Cronbach alpha coefficient of 0.715 and it is a tool made up of 3factors with 2items: 1) alertness and physical movement; 2) calmness/agitation and respiratory response/crying, and 3) muscle tone and facial tension. CONCLUSIONS: The COMFORT B was adapted to Spanish and it has shown to be a valid an reliable tool to assess comfort in a group of children admitted to an Spanish Intensive Care Unit


Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Comparación Transcultural , Cuidados Críticos/psicología , Psicometría , Evaluación en Enfermería , Estudios Prospectivos , Dimensión del Dolor/métodos
16.
Estima (Online) ; 18(1): e3220, jan.-dez. 2020.
Artículo en Portugués | BDENF - Enfermería | ID: biblio-1146349

RESUMEN

Objetivo: desenvolver e validar uma cartilha educativa para ajudar o profissional da saúde a prevenir e tratar da lesão por fricção. Método: estudo metodológico. Foi realizada revisão integrativa da literatura dos periódicos publicados entre 2009 e 2019 nas principais bases de dados de Ciências da Saúde. A avaliação da cartilha educativa foi conduzida com 32 enfermeiros, utilizando a técnica de Delphi. A análise estatística utilizada foi o Índice de Validade de Conteúdo. Resultados: os juízes consideraram o conteúdo da cartilha educativa entre os conceitos "inadequado" e "adequado", na primeira avaliação; após as correções solicitadas pelos juízes, a cartilha foi reenviada aos avaliadores e o conteúdo da cartilha educativa foi avaliado entre "adequado" e "totalmente adequado". O Índice de Validade de Conteúdo geral foi de 0,8118 na primeira avaliação e 1,0 na segunda avaliação. Conclusão: após a revisão integrativa da literatura, o material foi construído e validado por profissionais com experiência em avaliar e tratar de indivíduos com feridas, obtendo consenso entre os avaliadores na segunda avaliação.


Asunto(s)
Heridas y Traumatismos , Educación en Salud , Fricción , Evaluación en Enfermería
17.
Estima (Online) ; 18(1): e1720, jan.-dez. 2020.
Artículo en Portugués | BDENF - Enfermería | ID: biblio-1140705

RESUMEN

Objetivo: Verificar a concordância interobservador sobre avaliação de feridas utilizando a ferramenta TIME. Métodos: Estudo de caráter exploratório, não experimental com delineamento transversal e abordagem quantitativa. A população foi constituída por graduandos do oitavo, nono e décimo período do curso de bacharelado em enfermagem, matriculados no segundo semestre do ano de 2018. Aula expositiva-dialogada sobre a ferramenta TIME foi elaborada e posta aos participantes. Os graduandos foram direcionados ao hospital de ensino para socialização de casos clínicos e avaliação individual de dez lesões de pele com características clínicas diferentes, no paciente hospitalizado utilizando a ferramenta TIME. Para identificar a concordância entre os discentes na utilização da ferramenta TIME, foi utilizado o coeficiente de concordância Kappa. Resultados: Prevaleceu o número de graduandos que estavam cursando o nono período do curso (80%), sexo feminino (80%), idade média (23,2 anos). Obteve-se que, considerando a classificação Kappa, houve excelência (K= 1,0) na concordância interobservador em todas as etapas da ferramenta TIME. Conclusão: Infere-se que a ferramenta TIME assegura concordância na avaliação de feridas entre graduandos de enfermagem que estão cursando os últimos períodos de curso, podendo contribuir com a melhoria da qualidade do cuidado de enfermagem.


Asunto(s)
Heridas y Traumatismos , Enfermería , Benchmarking , Evaluación en Enfermería
18.
Metas enferm ; 23(9): 56-61, nov. 2020.
Artículo en Español | IBECS | ID: ibc-197938

RESUMEN

El consumo inadecuado de alcohol es un importante problema en la sociedad actual, y sus consecuencias pueden causar un daño irreparable en la salud del individuo, principalmente cuando está asociado a enfermedades como el VIH, puesto que la capacidad de autocuidado y de control de transmisión de la infección pueden verse afectadas. En este caso se presenta a un hombre de 36 años, inmigrante, con VIH y alcoholismo, que acude al Servicio de Urgencias por tener edemas en miembros inferiores y testículos, siendo diagnosticado de hepatitis alcohólica aguda/descompensación hidrópica. La valoración enfermera se realizó utilizando el Modelo de Necesidades Humanas de Virginia Henderson. Para la etapa diagnóstica se empleó la taxonomía NANDA y para el establecimiento de resultados e intervenciones, las taxonomías NOC y NIC respectivamente. Los diagnósticos enfermeros identificados fueron Gestión ineficaz de la salud y Riesgo de transición migratoria complicada; y Náuseas como problema de colaboración. Aunque solo se alcanzó la puntuación diana en uno de los indicadores relacionado con la ingesta de alimentos, se consiguió aumentar la puntuación final, suponiendo una mejora del estado de salud del paciente


The inadequate consumption of alcohol is a major problem in our current society, and its consequences can cause irreparable damage in the health of the person, particularly when associated with conditions such as HIV, given that the ability of self-care and control for infection transmission can be affected. This case presents a 36-year-old man, an immigrant with HIV and alcoholism, who attended the Emergency Unit due to oedemas in lower limbs and testicles; he was diagnosed with acute alcohol-related hepatitis / dropsical decompensation. Nursing assessment was conducted using the Human Needs Model by Virginia Henderson. NANDA taxonomy was used for the diagnostic stage, and NOC and NIC taxonomies, respectively, for determining results and interventions. The nursing diagnoses identified were: Ineffective Management of Health and Risk for Complicated Immigration Transition; and Nausea as collaborative problem. Although the target score was only achieved in one of the indicators associated with food intake, the final score could be increased, representing an improvement in the health status of the patient


Asunto(s)
Humanos , Masculino , Adulto , Intoxicación Alcohólica/complicaciones , Evaluación en Enfermería/métodos , Infecciones por VIH/diagnóstico , Emigrantes e Inmigrantes/estadística & datos numéricos , Diagnóstico de Enfermería , Estado de Salud , Alcoholismo/epidemiología , Disparidades en el Estado de Salud , Autonomía Personal
19.
Nursing ; 50(11): 24-31, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33009283

RESUMEN

Psoriatic arthritis (PsA) is associated with psoriasis, a chronic inflammatory skin disease. About 30% of patients with psoriasis develop PsA, and some of these patients are children and young adults. Because onset can be gradual, PsA signs and symptoms are easily attributed to other causes, especially in younger patients. This article discusses the assessment, pathophysiology, and diagnosis of PsA and informs nurses how best to support patients with PsA.


Asunto(s)
Artritis Psoriásica/enfermería , Relaciones Enfermero-Paciente , Apoyo Social , Artritis Psoriásica/fisiopatología , Humanos , Evaluación en Enfermería , Diagnóstico de Enfermería , Adulto Joven
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