Medidas de prevenção de queda em idosos hospitalizados / Fall prevention strategies in hospitalized older adults

Objetivo: Avaliar medidas de prevenção de quedas prescritas e realizadas em idosos hospitalizados. Método: Estudo quantitativo, transversal, realizado em hospital público terciário, entre 2015 e 2016. Resultados: A amostra foi composta por 153 idosos, 101 (66,0%) eram mulheres. O risco de queda foi de 60,9% (92), sendo as mulheres com maior chance de queda (p=0,0016). A medida de prevenção relacionada a sinalização do risco de queda no leito não foi prescrito para 75,0% (69) dos idosos com risco, entretanto, este cuidado foi realizado para 92,4% (85) dos idosos. O uso de grade elevada do leito foi prescrito para 78,3% (72) dos idosos com risco de queda (p=0,006) e este cuidado foi realizado para 70,7% (65) dos idosos com risco e 54,2% (32) sem risco de queda. Conclusão: As medidas para prevenção de queda foram realizadas com maior frequência do que prescritas para todos os idosos, independente do risco de queda. (AU)

Objective: To evaluate fall prevention strategies prescribed and performed for hospitalized older adults. Methods: This was a quantitative, cross-sectional study conducted in a tertiary public hospital between 2015 and 2016. Results: The sample consisted of 153 older adults, 101 (66.0%) of whom were women. Risk of falling was found in 60.9% (92), and women had a higher chance of falling (p=0.0016). Visual signaling of fall risk on the bed was not prescribed for 75.0% (69) of the elderly patients at risk, however, this precaution was taken for 92.4% (85) of those patients. Maintaining bed rails elevated was prescribed for 78.3% (72) of the elderly patients at risk of falling (p=0.006). This precaution was taken for 70.7% (65) of the patients at risk and 54.2% (32) of those not at risk of falling. Conclusion: Fall prevention strategies were performed more frequently than prescribed for every elderly inpatients, regardless of risk for falling. (AU)

Objetivo: Evaluar medidas de prevención de caídas, prescritas y realizadas en ancianos hospitalizados. Métodos: Estudio cuantitativo, transversal, realizado en un hospital público terciario, entre 2015 y 2016. Resultados: La muestra fue compuesta por 153 ancianos; 101 (66,0%) fueron mujeres. El riesgo de caída fue de 60,9% (92), predominando en las mujeres la mayor posibilidad de caídas (p=0,0016). La medida de prevención, relacionada a la señalización del riesgo de caída de la cama, no fue prescrito para 75,0% (69) de los ancianos con riesgo; sin embargo, este cuidado fue realizado para el 92,4% (85) de los ancianos. El uso de rejilla elevada en la cama fue prescrito para 78,3% (72) de los ancianos con riesgo de caída (p=0,006); este cuidado fue realizado para 70,7% (65) de los ancianos con riesgo y 54,2% (32) sin riesgo de caída. Conclusión: Las medidas para prevención de caídas, fueron realizadas con mayor frecuencia que las prescritas para todos los ancianos, independientemente de los riesgos de caídas. (AU)

Colonization by multidrug-resistant microorganisms of hospitalized newborns and their mothers in the neonatal unit context.

INTRODUCTION: The mother plays a fundamental role in the constitution and regulation of her child's healthy microbiota, however, preterm newborns are separated from their mothers soon after birth and transferred to Neonatal Intensive Care Units, being exposed the constant risk for the development of multidrug-resistant microorganisms' infections. The aim of this study was to explore the multidrug-resistant microorganism colonization of hospitalized babies and their mothers in the neonatal unit context. METHODOLOGY: A prospective case study conducted with hospitalized babies and their mothers in the Neonatal Unit at a university hospital. The sample was composed of 433 binomials (mother-child). Colonization culture samples were taken at the moment of the baby's discharge, via two swabs in the oral, nasal, axillary, inguinal, and rectal regions. RESULTS: The colonization incidence among the binomials, 30 (6.9%) were both colonized by multi-resistant microorganisms. Mothers of colonized babies (24.4%) demonstrated a higher chance of colonization in comparison to mothers of non-colonized babies (11.9%) (p = 0.002). Relationships were drawn between baby colonization and prematurity, extremely low birth weight, and non-exclusive maternal breastfeeding (p<0.05). ESBL-producing Gram-negative microorganisms were more frequent in the cultures of the binomials, with 35.9% of the babies colonized with Klebsiella spp. ESBL and 42.0% of the mothers with Escherichia coli ESBL. Furthermore, 50% of the binomials were colonized with E. coli ESBL. CONCLUSION: The prematurity, extremely low birth weight, and non-exclusive breastfeeding at hospital discharge were associated with baby colonization by multidrug-resistant microorganism. Furthermore, mothers of colonized children presented higher chances of colonization.

Infecção do trato urinário associada ao cateter: fatores associados e mortalidade / Catheter-related urinary tract infection: associated factors and mortality

Objetivo: Identificar os fatores associados ao desenvolvimento de Infecção do Trato Urinária Associada ao Cateter (ITU-AC) e mortalidade entre pacientes com cateter urinário. Metodologia: Estudo de coorte, prospectivo, com amostragem por conveniência envolvendo 790 pacientes com idade superior a 12 anos, em uso de cateter durante hospitalização. Os dados coletados do prontuário e fichas de notificação de infecção hospitalar foram analisados pelo programa SPSS. Resultados: Contribuíram para o desenvolvimento da ITU-AC a permanência com o cateter urinário por período >20 dias (OR 26,5; p<0,001), ser cateterizado mais de uma vez (OR 8,92; p<0,001) e hospitalização >30 dias (OR 26,8; p<0,001). Pacientes que desenvolveram ITU-AC apresentaram chance maior de mortalidade (OR 2,7; p<0,001). Conclusão:Frequência da inserção do dispositivo urinário, períodos prolongados de hospitalização e de permanência com o cateter contribuíram para o desenvolvimento de ITU-AC, e as chances de mortalidade foram aumentadas entre pacientes com essa infecção. (AU)

Objective: To identify factors associated with the development of Catheter-related Urinary Tract Infection (CR-UTI) and mortality among patients using urinary catheter. Methodology: Prospective cohort study in a convenience sample of 790 patients older than 12 years using catheter during hospitalization.[A1] The data collected from medical records and hospital infection notification were analyzed using the SPSS program. Results: Permanence with the urinary catheter >20 days (OR 26.5; p<0.001), being catheterized more than once (OR 8.92; p<0.001) and hospitalization >30 days (OR 26.8; p<0.001) contributed to the development of CR-UTI. Patients who developed CR-UTI presented a greater chance of mortality (OR 2.7; p<0.001). Conclusion: Frequency of urinary device insertion, prolonged periods of hospitalization and of permanence with the catheter contributed to the development of CR-UTI, and the chances of mortality were increased among patients with this infection. (AU)

Objetivo: Identificar los factores asociados con el desarrollo de Infección del Tracto Urinario Asociada con el Catéter (ITU-AC) y la mortalidad entre los pacientes que usan catéter urinario. Metodología: Estudio de cohorte, prospectivo con una muestra de conveniencia de 790 pacientes mayores de 12 años, que usan catéter durante su hospitalización. Los datos recopilados de los registros médicos y los formularios de notificación de infección nosocomial fueron analizados por el programa SPSS. Resultados: Contribuyendo al desarrollo de la (ITU-AC) la permanencia con el catéter urinario por un plazo >20 días (OR 26,5; p <0,001), tener recibido catéter más de una vez (OR 8,92; p<0,001) y hospitalización >30 días (OR 26,8; p<0,001). Los pacientes que desarrollaron (ITU-AC) presentaron una mayor posibilidad de mortalidad (OR 2,7; p<0,001). Conclusión: Frecuencia de inserción del dispositivo urinario, períodos prolongados de hospitalización y de permanencia con el catéter contribuyeron al desarrollo de (ITU-AC), y las posibilidades de mortalidad aumentaron entre los pacientes con esta infección. (AU)

Colonization profile and duration by multi-resistant organisms in a prospective cohort of newborns after hospital discharge.

The aim of this study was to determine the spontaneous decolonization period and characteristics in a prospective cohort of newborns colonized by multidrug-resistant organisms, after their discharge from the neonatal intensive care unit. Multidrug resistance is defined as bacterial non-susceptibility to ≥ 1 agent of ≥ 3 antimicrobial categories. In total, 618 newborns were included in the study, of which 173 (28.0%) presented a positive culture for multidrug-resistant microorganisms, and of these, 52 (30.1%) were followed up in this study. The most frequent intrinsic factors were be born by cesarean section (86.5%), prematurity (84.6%), and very low birth weight (76.9%). The extrinsic factors were having remained hospitalized for an average of 27 days, during which 67.3% were submitted to invasive procedures and 88.5% received antimicrobials. The intrinsic and extrinsic factors of newborns were not associated to a decolonization period longer or shorter than 3 months, which was the average period of decolonization found in the present study. From the totality of colonization cultures sampled at hospital discharge, the Gram-negative Extended Spectrum ß-lactamase producing bacteria were the most common, with 28.9% of babies colonized by Klebsiella spp. The median period of decolonization by multidrug-resistant microorganisms in the newborns population after hospital discharge was 3 months, but was highly dependent on the microbial species, and this period was not associated to any intrinsic and extrinsic factors of the newborn.

Risco de queda do leito de pacientes adultos e medidas de prevenção / Risk of bed falls in adult patients and prevention measures / Riesgo de caídas de la cama en pacientes adultos y medidas de prevención

Objetivo: analisar a adequação entre avaliação de risco de queda de pacientes adultos e as medidas deprevenção adotadas. Método: estudo descritivo, transversal, de abordagem quantitativa. A amostra foicomposta por 1.408 pacientes de um hospital universitário público. A coleta de dados ocorreu por meio daaplicação da Escala de Morse e avaliação das medidas de prevenção de queda do leito. Os dados foramtabulados no programa Microsoft Office Excel 2010 e para análise estatística utilizou-se o Programa SPSSversão 2.1. Foram realizadas análises descritivas e aplicação do teste Qui-Quadrado, considerando um pvalor<0,05.Resultados: pacientes com idade superior a 60 anos apresentaram maior risco de queda (33,9%).Os indivíduos classificados com alto risco foram os que estavam conectados a dispositivos venosos (90,1%), osque apresentaram histórico de queda anterior (59,9%) e com estado mental desorientado (34,0%). As medidasde prevenção estavam adequadas em 91,0%. Conclusão: conhecer os riscos de queda e os indicadores dequalidades, associado com a sensibilização e capacitação dos profissionais, são medidas imprescindíveis naprevenção de incidentes e eventos adversos.(AU)

Objective: to analyze the adequacy between the evaluation of the risk in adult patients´ fall and the prevention measures adopted. Method: this is a descriptive, cross-sectional study with a quantitative approach. The sample consisted of 1,408 patients from a public university hospital. Data were collected through the application of the Morse Scale and evaluation of bed fall prevention measures. The data were tabulated in the Microsoft Office Excel 2010 program and for statistical analysis the SPSS Program version 2.1 was used. Descriptive analyzes and chi-square test were performed, considering a p-value <0.05. Results: patients older than 60 years old had a higher risk of falls (33.9%). The individuals classified as having high risk were those who were connected to venous devices (90.1%), those with a previous history of falling (59.9%) and with a disoriented state of mind (34.0%). The prevention measures were adequate in 91.0%. Conclusion: knowing the risks of falling and the quality indicators, associated with the awareness and training of professionals are essential measures in the prevention of incidents and adverse events.(AU)

Objetivo: analizar la adecuación entre evaluación de riesgo de caída de pacientes adultos y las medidas de prevención adoptadas. Método: estudio descriptivo, transversal, de enfoque cuantitativo. La muestra fue compuesta por 1.408 pacientes de un hospital universitario público. La recolección de datos fue por medio de la aplicación de la Escala de Morse y evaluación de las medidas de prevención de caídas de la cama. Los datos fueron tabulados en el programa Microsoft Office Excel 2010 y para análisis estadística se utilizó el Programa SPSS versión 2.1. Fueron realizadas análisis descriptivas y aplicación del test Chi-Cuadrado, considerando un p-valor<0,05. Resultados: pacientes con edad superior a 60 años presentaron mayor riesgo de caída (33,9%). Los individuos clasificados con alto riesgo fueron los que estaban conectados a dispositivos venosos (90,1%), los que presentaron histórico de caídas anteriores (59,9%) y con estado mental desorientado (34,0%). las medidas de prevención estaban adecuadas en 91,0%. Conclusión: conocer los riesgos de caídas y los indicadores de calidades, asociado con la sensibilización y capacitación de los profesionales, son medidas imprescindibles en la prevención de incidentes y eventos adversos.(AU)

Sentimentos e perspectivas de trabalhadores de instituição universitária pública frente à aposentadoria / Feelings and perspectives of civil servants from a public university facing retirement / Sentimientos y perspectivas de trabajadores de una universidad pública ante la inminencia de la jubilación

Este estudo teve por objetivo identificar os sentimentos e perspectivas de trabalhadores de uma instituição universitária pública frente àaposentadoria. Trata-se de estudo quantitativo, desenvolvido com 82 trabalhadores em fase de pré-aposentadoria, participantes de umPrograma de Preparação para a Aposentadoria. Os resultados demonstraram que a aposentadoria é percebida como o descanso merecido eum processo natural da vida. Sentimentos como liberdade, satisfação, ansiedade, medo e infelicidade ficaram evidentes. As atividades que osservidores pretendem realizar na aposentadoria são: atividades de lazer, trabalhos manuais, exercício físico, desempenhar outro trabalho, darmais atenção à família, cuidar de si e fazer cursos profissionalizantes. O desejo de trabalhar após a aposentadoria foi manifestado em 48,8% dasrespostas; 57,3% relataram não terem se preparado para a aposentadoria. Os resultados reforçam a importância dos programas de preparaçãopara aposentadoria, a fim de auxiliar no enfrentamento das expectativas e anseios dessa fase da vida profissional e pessoal dos trabalhadores.

The present study aimed to identify the feelings and perspectives of public university employees facing retirement. This is a quantitative study carriedout with 82 workers in pre-retirement stage who participated in a retirement preparatory program. Results revealed that retirement is perceived as awell-deserved rest and as being part of life’s natural process. Feelings of freedom, satisfaction, anxiety, fear and unhappiness became evident, though.After retirement the employees intend to dedicate themselves to leisure activities, arts and crafts, exercising, spending more time with their families,doing technical courses, taking care of themselves or taking up a new job - other than their previous ones. Forty eight point eight of the responses showedthe wish to work after retirement; 57.3 % reported that they were not prepared yet for retirement. The results of this study emphasize the importanceof retirement programs in order to assist employees in coping with their expectations and needs during this stage of their professional and personal life.

Este estudio tuvo como objetivo identificar los sentimientos y perspectivas de empleados de una universidad pública ante la inminencia dela jubilación. Se trata de un estudio cuantitativo realizado con 82 empleados en etapa de pre jubilación que participaban en el Programa dePreparación para la Jubilación. Los resultados mostraron que los empleados encaraban la jubilación como un merecido descanso y un procesonatural de la vida. Quedaron evidentes los sentimientos de libertad, satisfacción, ansiedad, miedo y tristeza. Los trabajadores tenían la intenciónde dedicarse al ocio, a los trabajos manuales, a practicar ejercicios físicos, a trabajar en otra cosa, a dedicarse más a la familia, a cuidarse más y ahacer cursos de formación profesional. Un 48,8 % de las respuestas indicó deseos de trabajar después de la jubilación; el 57,3 % que no se habíanpreparado para la jubilación. Los resultados refuerzan la importancia de los programas de preparación para la jubilación con miras a ayudar ahacer frente a las expectativas y anhelos de esta etapa de la vida profesional y personal de los trabajadores.