Polypharmacy and high-alert medications in patients with nasally placed feeding tube on admission and at hospital discharge: Multicenter cross-sectional study.

Background: Polypharmacy and the use of high-alert medications in patients with nasally placed feeding tube (NPFT) increase the risks of drug related problems. Objective: Characterize drugs prescribed to patients with NPFT and compare the rates of polypharmacy and high-alert medication use at admission and hospital discharge. Design and setting: Multicenter cross-sectional study with 327 participants. Methods: Data of patients with NPFT were obtained from the medical records and recorded in an electronic data collection tool. Mean number of drugs, polypharmacy and number of high-alert medications prescribed on admission and at discharge were compared using Wilcoxon or McNemar's tests. Generalized Estimating Equations analyzed the relationship between polypharmacy and high-alert medications according to age and time point. Primary reason for hospital admission, level of consciousness, severity of comorbid diseases and patient care complexity were also assessed. Results: Most patients were male, older people, hospitalized for circulatory system diseases and had at least one comorbidity. On admission, a significant number of patients were alert (59.9%), at high risk for death (43.1%) and high dependent on nursing care (35.4%). Additionally, 92% patients were on polypharmacy on admission, versus 84.7% at hospital discharge (p = 0,0011). The occurrence of polypharmacy was independent of age (p = 0.2377). >17% of all drugs prescribed were high-alert medications, with no statistically significant difference between admission and discharge (p = 0,3957). There was no statistical evidence that the use of high-alert medications increases with age (n = 0,5426). Conclusions: These results support the planning of multidisciplinary qualified actions for patients using NPFT.

Factors associated with mechanical device-related complications in tube fed patients: A multicenter prospective cohort study.

AIMS: To identify the types of nasogastric/nasoenteric tube (NGT/NET)-related adverse events and to analyze the degree of harm and the factors associated with mechanical device-related complications. MATERIALS AND METHODS: A prospective cohort study was conducted from October 2017 to April 2019 in seven Brazilian hospitals. Data from 447 adult patients with NGT/NET were collected through electronic forms. Three methods were used to assess the NGT/NET-related adverse events: (1) encouraging spontaneous reports; (2) regular visits to the wards; and (3) review of medical records. The events were classified as mechanical device-related complications and other events. The degree of harm was classified according to the World Health Organization's International Classification for Patient Safety. Data were analyzed using the R program, version 3.5.3. The following tests were applied to identify associations between the explanatory and response variables: Cochran-Armitage Chi-Square test, Fisher's exact test, and Linear-by-linear Chi-Square test. Logistic regression analysis was performed to verify the predictors of mechanical device-related complications. All analyses were performed considering a 5% significance level. RESULTS: 191 NGT/NET-related adverse events were identified in 116 patients; the majority were mechanical device-related complications and resulted in mild harm to the patient. At the moment of the event, patients had a mean of 3.27 comorbidities, were highly dependent on nursing care, with high risk of death and altered level of consciousness. There was no association between the degree of harm and the care complexity, disease severity or level of consciousness. Intensive care was the strongest predictor for mechanical device-related complications and critical patients had a four times greater likelihood of presenting this type of event when compared to patients receiving minimal care. CONCLUSION: Intensive care patients should receive special attention as the complexity of care is an important predictor for mechanical device-related complications in tube fed patients.

Validação de material educativo para homens em uso de cateter urinário de demora no domicílio / Validation of an educational material for men using indwelling urinary catheters at home / Validación de material educativo para hombres que usan cateter urinario de demora en el domicilio

Objetivo: elaborar e validar material educativo escrito e ilustrativo para homens em uso de cateter urinário de demora no ambiente domiciliar. Material e Método: letramento em saúde, educação em saúde, modelos de validação de conteúdo diagnóstico de Enfermagem e Suitability Assessment of Educational Materials (SAM) foram referenciais teóricos e metodológicos utilizados. Resultados e discussão: realizaram-se a validação de conteúdo e aparência do material com base na avaliação de 30 peritos. Quanto ao conteúdo, todas as orientações foram validadas com escore final igual ou superior a 0,80. A aparência foi avaliada positivamente em todos os itens por 89,7% dos peritos. As sugestões contribuíram sobremaneira para melhor qualidade do material. Conclusão: considera-se que a validação de conteúdo e aparência com base nos referenciais utilizados pode contribuir como método de validação de materiais educativos em saúde.(AU)

Objective: to elaborate and validate a written and illustrative educational material aimed at men using home indwelling urinary catheters. Material and Method: health literacy, health education, nursing content validation models, and the Suitability Assessment of Material (SAM) were the theoretical and methodological references used. Results and discussion: the content and appearance of the material were validated based on the evaluation of 30 experts. Regarding the content, all guidelines were validated with a final score equal to or greater than 0.80. The appearance of the material was evaluated positively in all items by 89.7% of the experts. The suggestions have contributed greatly to increase the quality of the material. Conclusion: it is considered that the validation of content and appearance based on the references used can contribute as a validation method of educational materials in health.(AU)

Objetivo: elaborar y validar material educativo escrito e ilustrativo para hombres que usan catéter urinario de demora en el domicilio. Material y método: alfabetismo en salud, educación en salud, modelos de validación de contenido diagnóstico en enfermería y Suitability Assessment of Educational Materials (SAM) sirvieron como referentes teóricos. Resultados y discusión: se validó el contenido y la apariencia del material en base a la evaluación de 30 especialistas. Todas las orientaciones referentes al contenido recibieron puntuación final igual o superior a 0,80. El 89,7% de los especialistas evaluó positivamente todos los puntos referentes a la apariencia. Las sugerencias fueron de gran utilidad para mejorar la calidad del material. Conclusión: se considera que la validación de contenido y apariencia en base a los referentes empleados puede ayudar como método de validación de material educativo en salud.(AU)

Fatores de risco e medidas de prevenção do câncer de próstata: subsídios para a enfermagem / Risk factors and prevention actions in prostate cancer: fundamentals for nursing / Factores de riesgo y medidas de prevención del cáncer de próstata: basis para la enfermería

Apresenta-se um artigo de reflexão sobre fatores de risco e medidas de prevenção do câncer de próstata, visando contribuir para a abordagem de homens, especialmente durante a consulta de enfermagem. Idade avançada, origem étnica e hereditariedade são fatores de risco potenciais. Dieta pobre em gorduras, rica em frutas, verduras, legumes, grãos e outros é citada como minimizadora. A finasterida, droga inibidora da 5 alpha-redutase tem sido estudada como redutor de risco. O rastreamento da doença pela dosagem do Antígeno Prostático Específico (PSA) e toque retal é também medida recomendada. Entretanto, maiores evidências científicas ainda estão sendo buscadas sobre esses fatores. A abordagem dos homens na consulta de enfermagem pode contribuir para a identificação de fatores de risco, sinais e sintomas de possíveis alterações.

A reflexive article about risk factors and prostate cancer prevention actions is presented to contribute to the approach of men, especially during nursing consultation. Increasing age, ethnical origin and heredity are potential risk factors. Low-fat diet and a diet rich in fruits, vegetables, legumes, grains and others, are related as capable of potentially minimize the risks. Finasteride, a drug that is inhibitor of 5 alpha-reductase has been studied as a risk reducer. Investigating the disease by measuring levels of Prostate-Specific Antigen (PSA) and digital rectal examination is also a recommended action. However, further scientific evidences about these factors are being sough. The approach of men in nursing consultation may contribute to the identification of risk factors, signs and symptoms of possible changes.

Presentase un artículo de reflexión sobre los factores de riesgo y medidas de prevención del cáncer de la próstata, para contribuir en el tratamiento de los hombres, especialmente durante la consulta de enfermería. La edad avanzada, origen étnico y la herencia son factores de riesgo potenciales. Dieta baja en grasas y rica en frutas, verduras, legumbres, granos, entre otros está relacionada como potencialmente capaz de reducir los riesgos. Finasteride, un fármaco inhibidor de la 5 alfa-reductasa, se ha estudiado como un reductor de riesgo. El seguimiento de la enfermedad mediante la medición de los niveles de Antígeno Prostático Específico (PSA), y el examen digital del recto, son también recomendados. Sin embargo, si buscan más evidencias científicas acerca de estos factores. El enfoque de los hombres en la consulta de enfermería puede contribuir a la identificación de factores de riesgo, signos y síntomas de los posibles problemas.