Effectiveness of auricular acupuncture and pelvic floor muscle training in the management of urinary incontinence following surgical treatment for prostate cancer: A randomized clinical trial.

PURPOSE: To evaluate the effectiveness of auricular acupuncture combined with pelvic floor muscle training to manage urinary incontinence following radical prostatectomy. METHODS: This is a randomized clinical trial that was conducted between April 2019 and April 2020 with 60 participants allocated into two groups, namely: control (pelvic muscle training) and intervention (auricular acupuncture + pelvic muscle training). Interventions were carried out during eight weekly sessions. Generalized estimating equations and proportion difference tests were applied in the statistical analysis with a significance level of 0.05. RESULTS: Urinary incontinence severity decreased between pre-test and post-test in both groups. There was a statistically significant difference of the impact of urinary incontinence on quality of life between the groups at post-test in the domain "severity measures" (p = 0.013), and only in the intervention group between pre-test and post-test in the domains "emotions" (p < 0.001) and "sleep and mood" (p = 0.008). The intervention group was 20.8% (p = 0.007) and 25.3% (p = 0.002) less likely to present nocturia and urinary urgency, respectively. CONCLUSIONS: Auricular acupuncture combined with pelvic floor muscle training was more effective, compared to pelvic floor muscle training alone, in reducing the impact of urinary incontinence on quality of life and reducing the odds of nocturia and urinary urgency.

The effects of auricular acupuncture on vascular parameters on the risk factors for diabetic foot: A randomized clinical trial.

AIMS AND OBJECTIVES: To evaluate the effects of auricular acupuncture on vascular parameters on the risk factors for Diabetic Foot. METHODS: Randomized and masked clinical trial. The sample was composed of 44 individuals with type 2 Diabetes Mellitus and they were randomly assigned to two groups: intervention (n = 22), which received five sessions of auricular acupuncture, and control (n = 22), which did not receive the therapy. Three evaluations were performed: before the intervention; one day after the last acupuncture session and 15 days after the second evaluation. For this, the subject's characterization instrument, the Ankle-Brachial Index measurement, and thermography were used. For data analysis, Mann-Whitney, Wilcoxon, Wilcoxon signed-rank, Fisher's Exact and Chi-Square tests were used. RESULTS: Auriculotherapy provided results in the Ankle-Brachial Index Test, as well as in thermography, which showed significant temperature improvement. CONCLUSIONS: The technique proved to be efficient in improving circulatory conditions and plantar temperature.

Outcome assessment of patients classified through the Manchester Triage System in emergency units in Brazil and Portugal.

OBJECTIVES: The aim was to evaluate the outcomes of patients' treatment classified according to the Manchester Triage System (MTS) in two large hospitals. METHODS: Historical cohort study performed in two hospitals in different countries: one emergency unit of a hospital in Portugal, and another in Brazil. The studied population was composed of all patients attended and triaged by nurses in emergency services using the MTS, based on data obtained through the ALERT® software. The sample in this study was composed of 158 959 triages in Portugal and 155 121 in Brazil. RESULTS: The higher the priority attributed to the patient according to the MTS, the longer the hospital stay and risk of death. For both groups, the higher the risk classification of the patient, the greater the risk of death when compared to the group classified as "green". In Portugal, patients classified in the "red" category according to the MTS had 1 516-fold higher risk of death compared to those classified in the green category, and in Brazil, this risk was 1 177-fold higher. CONCLUSIONS: In both countries, the MTS proved to be a good predictor of length of hospital stay and death.

Relationship between risk stratification, mortality and length of stay in a Emergency Hospital / Relación entre la estratificación del riesgo, la mortalidad y el tiempo de permanencia en un servicio de Urgencias / Relação entre estratificação de risco, mortalidade e tempo de permanência em um hospital de urgência

Objective:To evaluate the relationship between risk stratification, mortality and hospital length of stay in emergency medical services. Methodology. A prospective cohort study that used the information in the ALERTÒ database of the HOSPUB to know the evolution of patients classified by nurses using the Manchester Risk Classification Triage System in the emergency medical services, of the Belo Horizonte Municipal Hospital - MG, Brazil. Results. 147,167 patients were analyzed, 5.9% were female. The most common risk classification was yellow (47.4%), followed by green (36.5%), orange (14.2%), blue (1.3%) and red (0.6%). The mean length of stay was less than one day in 95.4% of patients who were discharged from the hospital. Thirty percent of the patients classified as red, 2% of those classified as orange, and 0.3% of those classified as yellow died. There was direct a relationship between the severity of patient classification and the length of hospital stay. Conclusion. The risk classification system used by nurses in the hospital was a good predictor of death and hospital length of stay for patients admitted to the emergency medical services.

Objetivo:Evaluar la relación entre la estratificación del riesgo en el servicio de Urgencias, la mortalidad y el tiempo de permanencia hospitalaria. Metodología. Estudio descriptivo retrospectivo en el cual se utilizó la información de la base de datos ALERTÒ el HOSPUB para conocer la evolución de los pacientes clasificados por los enfermeros con el Sistema de Triage de Manchester de Clasificación del Riesgo del Servicio de Urgencias del Hospital Municipal de Belo Horizonte - MG, Brasil. Resultados. Se analizaron 147 167 pacientes, el (55.9%) de sexo femenino. La clasificación del riesgo más frecuente fue la amarilla (47.4%), seguida por la verde" (36.5%), la naranja (14.2%), la azul (1.3%) y la roja (0.6%). La media de permanencia en el servicio fue menor a un día, el 95.4% de los pacientes fue dado de alta del hospital. El (30%) de los pacientes clasificados en rojo, el (2%) de los naranja y el (0.3%) de los amarillo, fallecieron. Se verificó la relación directa entre la gravedad del paciente en la clasificación y el tiempo de permanencia hospitalaria. Conclusión. El sistema de clasificación del riesgo empleado por las enfermeras en este hospital fue un buen predictor de muerte y permanencia en el hospital de los pacientes que ingresaron al servicio de urgencias.

Objetivo:avaliar a relação entre a estratificação pela classificação de risco, mortalidade e permanência hospitalar em um Hospital de Urgência. Metodologia: Estudo de coorte prospectivo o qual foi utilizado o banco de dados ALERT® e HOSPUB para conhecer a evolução dos pacientes classificados pelos enfermeiros através do Sistema de Triagem de Manchester de Classificação de Risco de um Hospital Municipal de Belo Horizonte -MG, Brasil. Resultados: Foram atendidos 147 167 pacientes, destes (55.9%) foram do sexo feminino. A classificação de risco mais frequente foi a amarela (47.4%), seguida da verde (36.5%), da laranja (14.2%), azul (1.3%) e a vermelha (0.6%). A média de permanência no serviço foi menor que um dia e 95.4% dos pacientes receberam alta hospitalar. Os (30%) dos pacientes classificados como vermelho, (2%) dos laranjas e (0.3%) dos amarelos morreram. Verificou-se relação direta entre a gravidade da classificação dos pacientes e o tempo de permanência hospitalar. Conclusão: O sistema de classificação de risco utilizado pelos enfermeiros deste hospital, foi um bom indicador para o risco de óbito e permanência hospitalar dos pacientes que foram admitidos nos serviço de urgência.

Relationship between risk stratification, mortality and length of stay in a Emergency Hospital.

OBJECTIVE: To evaluate the relationship between risk stratification, mortality and hospital length of stay in emergency medical services. METHODOLOGY: A prospective cohort study that used the information in the ALERTÒ database of the HOSPUB to know the evolution of patients classified by nurses using the Manchester Risk Classification Triage System in the emergency medical services, of the Belo Horizonte Municipal Hospital - MG, Brazil. RESULTS: 147,167 patients were analyzed, 5.9% were female. The most common risk classification was yellow (47.4%), followed by green (36.5%), orange (14.2%), blue (1.3%) and red (0.6%). The mean length of stay was less than one day in 95.4% of patients who were discharged from the hospital. Thirty percent of the patients classified as red, 2% of those classified as orange, and 0.3% of those classified as yellow died. There was direct a relationship between the severity of patient classification and the length of hospital stay. CONCLUSION: The risk classification system used by nurses in the hospital was a good predictor of death and hospital length of stay for patients admitted to the emergency medical services.

Nursing diagnoses identified in records of hospitalized elderly.

OBJECTIVE: To identify nursing diagnoses (ND) formulated for elderly patients in a quaternary healthcare institution. METHODOLOGY: This was a descriptive cross-sectional study, conducted based on information contained in the records of 112 elderly patients, admitted from January to July 2011, in a public teaching hospital of Belo Horizonte, Minas Gerais (Brazil). RESULTS: 53% of patients were female and were 70 years or older. The most common diseases that led to hospitalization were cardiac (31%), neoplasms (22%), lung (10%) and vascular diseases (10%). Only 44% of the patients had a ND identified. After exclusion of repetitions, 36 different diagnosis labels were identified. The primary ND were: risk for infection (78%), impaired physical mobility (69%), risk for impaired skin integrity (59%), risk for falls (57%), imbalanced nutrition: less than body requirements (57%), risk for unstable blood glucose (51%) and self-care deficit (51%). CONCLUSION: In this study, the ND were linked to human responses related to the causes of hospitalization. These diagnoses are the basis for planning nursing interventions and provide improved quality of life, independence and preservation of functionality for these people.

Nurses' perception about risk classification in an emergency service / Percepción del enfermero sobre la realización de la clasificación del riesgo en el servicio de urgencias / Percepção do enfermeiro sobre a realização da classificação do risco no serviço de urgências

Objective. Get to know how nurses perceive the accomplishment of risk classification in an emergency service. Methodology. In this qualitative study, 11 nurses were included with at least two months of experience in the risk classification of patients who visited the emergency service. Semistructured interviews were used to collect the information. The data were collected between August and December 2011. For data analysis, Bardin's theoretical framework was used. Results. The nurses in the study consider the risk classification as a work organization instruments that permits closer contact between nurses and patients. The nursing skills needed for risk classification were identified: knowledge about the scale used, clinical perspective, patience and agility. The availability of risk classification scales was the main facilitator of this work. The main difficulties were the disorganization of the care network and the health team's lack of knowledge of the protocol. Conclusion. Risk classification offers an opportunity for professional autonomy to the extent that it is the main responsible for regulating care at the entry door of the emergency services.

Objetivo. Conocer la percepción de los enfermeros sobre la realización de la clasificación del riesgo en el servicio de urgencias. Metodología. Estudio cualitativo, con inclusión de 11 enfermeros quienes habían tenido experiencia durante, al menos, dos meses en la clasificación del riesgo de los pacientes que ingresaban al servicio de urgencias. Para la toma de la información se utilizó la entrevista semiestructurada. Los datos fueron recolectados entre agosto y diciembre de 2011. Para el análisis se utilizó el referente teórico propuesto por Bardin. Resultados. Para estos enfermeros, la clasificación de riesgo es vista como un instrumento de organización del trabajo que permite una mayor aproximación enfermero-paciente. Fueron identificadas las habilidades del enfermero necesarias en la clasificación del riesgo: conocimiento de la escala utilizada, ojo clínico, paciencia y agilidad. El trabajo se facilitó, principalmente, por la disposición de escalas de clasificación del riesgo. Las mayores dificultades fueron la desorganización de la red asistencial y la falta de conocimiento del protocolo por el equipo de salud. Conclusión. La clasificación del riesgo ofrece una oportunidad de autonomía profesional en la medida en que este es el principal responsable de la regulación de la atención en las puertas de entrada de los servicios de urgencias.

Objetivo. Conhecer a percepção dos enfermeiros sobre a realização da classificação do risco no serviço de urgências. Metodologia. Estudo qualitativo no que foram incluídos 11 enfermeiros que tinham tido experiência de ao menos dois meses na classificação do risco dos pacientes que ingressavam ao serviço de urgências. Para a tomada da informação se utilizou a entrevista semiestruturada. Os dados foram coletados entre agosto e dezembro de 2011. Para a análise se utilizou o referente teórico proposto por Bardin. Resultados. Para os enfermeiros do estudo a classificação de risco é vista como um instrumento de organização do trabalho que permite uma maior aproximação enfermeiro-paciente. Foram identificadas as habilidades necessárias do enfermeiro na classificação do risco: conhecimento da escala utilizada, olho clínico, paciência e agilidade. O dispor de escalas de classificação do risco foi o principal facilitador do trabalho. As maiores dificuldades foram a desorganização da rede assistencial e a falta de conhecimento do protocolo pela equipe de saúde. Conclusão. A classificação do risco oferece uma oportunidade de autonomia profissional na medida em que este se é o principal responsável da regulação do atendimento nas portas primeiramente dos serviços de urgências.