Asociación entre Glucemia inestable, tiempo de estancia y mortalidad de pacientes en estado críticos: Estudio de cohorte / Associação Entre Glicemia Instável, Tempo de Permanência e Mortalidade de Pacientes Críticos: Estudo de Coorte / Relationships between unstable Glycemia, Hospital Length Of Stay, and mortality In Critically Ill patients: A cohort study

Resumen Introducción: El control y la evaluación de los niveles glucémicos de pacientes en estado críticos es un desafío y una competencia del equipo de enfermería. Por lo que, determinar las consecuencias de esta durante la hospitalización es clave para evidenciar la importancia del oportuno manejo. Objetivo: Determinar la asociación entre la glucemia inestable (hiperglucemia e hipoglucemia), el resultado de la hospitalización y la duración de la estancia de los pacientes en una unidad de cuidados intensivos. Metodología: Estudio de cohorte prospectivo realizado con 62 pacientes a conveniencia en estado crítico entre marzo y julio de 2017. Se recogieron muestras diarias de sangre para medir la glucemia. Se evaluó la asociación de la glucemia inestable con la duración de la estancia y el resultado de la hospitalización mediante ji al cuadrado de Pearson. El valor de p<0.05 fue considerado significativo. Resultados: De las 62 personas participantes, 50 % eran hombres y 50 % mujeres. La edad media fue de 63.3 años (±21.4 años). La incidencia de glucemia inestable fue del 45.2 % y se asoció con una mayor duración de la estancia en la UCI (p<0.001) y una progresión a la muerte como resultado de la hospitalización (p=0.03). Conclusión: Entre quienes participaron, la glucemia inestable se asoció con una mayor duración de la estancia más prolongada y con progresión hacia la muerte, lo que refuerza la importancia de la actuación de enfermería para prevenir su aparición.

Resumo Introdução: O controle e avaliação dos níveis glicêmicos em pacientes críticos é um desafio e uma competência da equipe de enfermagem. Portanto, determinar as consequências da glicemia instável durante a hospitalização é chave para evidenciar a importância da gestão oportuna. Objetivo: Determinar a associação entre glicemia instável (hiperglicemia e hipoglicemia), os desfechos hospitalares e o tempo de permanência dos pacientes em uma unidade de terapia intensiva. Métodos: Um estudo de coorte prospectivo realizado com 62 pacientes a conveniência em estado crítico entre março e julho de 2017. Foram coletadas amostras diariamente de sangue para medir a glicemia. A associação entre a glicemia instável com o tempo de permanência e o desfecho da hospitalização foi avaliada pelo teste qui-quadrado de Pearson. O valor de p <0,05 foi considerado significativo. Resultados: Das 62 pessoas participantes, 50% eram homens e 50% mulheres. A idade média foi de 63,3 anos (±21,4 anos). A incidência de glicemia instável foi de 45,2% e se associou a um tempo de permanência mais prolongado na UTI (p <0,001) e uma progressão para óbito como desfecho da hospitalização (p = 0,03). Conclusão: Entre os participantes, a glicemia instável se associou a um tempo mais longo de permanência e com progressão para óbito, enfatizando a importância da actuação da equipe de enfermagem para prevenir sua ocorrência.

Abstract Introduction: The control and evaluation of glycemic levels in critically ill patients is a challenge and a responsibility of the nursing team; therefore, determining the consequences of this during hospitalization is key to demonstrate the importance of timely management. Objective: To determine the relationship between unstable glycemia (hyperglycemia and hypoglycemia), hospital length of stay, and the hospitalization outcome of patients in an Intensive Care Unit (ICU). Methods: A prospective cohort study conducted with 62 critically ill patients by convenience sampling between March and July 2017. Daily blood samples were collected to measure glycemia. The correlation of unstable glycemia with the hospital length of stay and the hospitalization outcome was assessed using Pearson's chi-square. A p-value <0.05 was considered significant. Results: Among the 62 patients, 50% were male and 50% were female. The mean age was 63.3 years (±21.4 years). The incidence of unstable glycemia was 45.2% and was associated with a longer ICU stay (p<0.001) and a progression to death as a hospitalization outcome (p=0.03). Conclusion: Among critically ill patients, unstable glycemia was associated with an extended hospital length of stay and a progression to death, emphasizing the importance of nursing intervention to prevent its occurrence.

Problematization methodology's impact on nursing and medical students' knowledge about hypodermoclysis: quasi-experimental study.

OBJECTIVE: to analyze the problematization methodology impact on the knowledge of nursing and medical students about hypodermoclysis. METHOD: quasi-experimental study conducted with 22 undergraduate nursing and medical students from a public Brazilian higher education institution. The students participated in the educational intervention using the problematization methodology based on the Arch of Maguerez. A previously validated questionnaire was used to determin' the students' knowledge level about hypodermoclysis. This instrument was applied before and after the educational intervention. The results were compared by McNemar's test and Student's t test for paired samples. RESULTS: when comparing the correct answers before and after the intervention, there was a significant increase in 75% of the questions (p<0.05), including theoretical and practical aspects of hypodermoclysis. The mean score on students' self-assessment of the ability to explain (0.9 versus 5.9 points) and perform hypodermoclysis (1.9 versus 5.0) was significantly higher after applying the problematization methodology (p<0.001). CONCLUSION: the problematization methodology had a positive impact on the students' knowledge about hypodermoclysis. The number of correct answers after the educational intervention was higher than the initial assessment. The problematization methodology can be incorporated into the teaching-learning process of nursing and medical students for teaching procedures such as hypodermoclysis. BACKGROUND: (1) The problematization methodology had a positive impact on students' knowledge. BACKGROUND: (2) The number of correct answers after the educational intervention increased. BACKGROUND: (3) Problematization can be incorporated into the teaching of nursing and medicine. BACKGROUND: (4) The teaching-learning process through active methodologies should be encouraged. BACKGROUND: (5) Problematization has the potential to develop cognitive and attitudinal skills.

Artificial intelligence to predict bed bath time in Intensive Care Units.

OBJECTIVES: to assess the predictive performance of different artificial intelligence algorithms to estimate bed bath execution time in critically ill patients. METHODS: a methodological study, which used artificial intelligence algorithms to predict bed bath time in critically ill patients. The results of multiple regression models, multilayer perceptron neural networks and radial basis function, decision tree and random forest were analyzed. RESULTS: among the models assessed, the neural network model with a radial basis function, containing 13 neurons in the hidden layer, presented the best predictive performance to estimate the bed bath execution time. In data validation, the squared correlation between the predicted values and the original values was 62.3%. CONCLUSIONS: the neural network model with radial basis function showed better predictive performance to estimate bed bath execution time in critically ill patients.

Artificial intelligence to predict bed bath time in Intensive Care Units / Inteligencia artificial para predecir la hora del baño en cama en Unidades de Cuidados Intensivos / Inteligência artificial para predição do tempo de banho no leito em Unidades de Terapia Intensiva

ABSTRACT Objectives: to assess the predictive performance of different artificial intelligence algorithms to estimate bed bath execution time in critically ill patients. Methods: a methodological study, which used artificial intelligence algorithms to predict bed bath time in critically ill patients. The results of multiple regression models, multilayer perceptron neural networks and radial basis function, decision tree and random forest were analyzed. Results: among the models assessed, the neural network model with a radial basis function, containing 13 neurons in the hidden layer, presented the best predictive performance to estimate the bed bath execution time. In data validation, the squared correlation between the predicted values and the original values was 62.3%. Conclusions: the neural network model with radial basis function showed better predictive performance to estimate bed bath execution time in critically ill patients.

RESUMEN Objetivos: evaluar el rendimiento predictivo de diferentes algoritmos de inteligencia artificial para estimar el tiempo de ejecución del baño en cama en pacientes críticos. Métodos: estudio metodológico, que utilizó algoritmos de inteligencia artificial para predecir el tiempo de baño en cama en pacientes críticos. Se analizaron los resultados de modelos de regresión múltiple, redes neuronales perceptrón multicapa y función de base radial, árbol de decisión y random forest. Resultados: entre los modelos evaluados, el modelo de red neuronal con función de base radial, que contiene 13 neuronas en la capa oculta, presentó el mejor desempeño predictivo para estimar el tiempo de ejecución del baño en cama. En la validación de datos, la correlación al cuadrado entre los valores predichos y los valores originales fue del 62,3%. Conclusiones: el modelo de red neuronal con función de base radial mostró mejor rendimiento predictivo para estimar el tiempo de ejecución del baño en cama en pacientes críticos.

RESUMO Objetivos: avaliar a performance preditiva de diferentes algoritmos de inteligência artificial para estimar o tempo de execução do banho no leito em pacientes críticos. Métodos: estudo metodológico, que utilizou algoritmos de inteligência artificial para predizer o tempo de banho no leito em pacientes críticos. Foram analisados os resultados dos modelos de regressão múltipla, redes neurais perceptron multicamadas e função de base radial, árvore de decisão e random forest. Resultados: entre os modelos avaliados, o modelo de rede neural com função de base radial, contendo 13 neurônios na camada oculta, apresentou melhor performance preditiva para estimar o tempo de execução do banho no leito. Na validação dos dados, o quadrado da correlação entre os valores preditos e os valores originais foi de 62,3%. Conclusões: o modelo de rede neural com função de base radial apresentou melhor performance preditiva para estimar o tempo de execução do banho no leito em pacientes críticos.

Problematization methodology's impact on nursing and medical students' knowledge about hypodermoclysis: quasi-experimental study / Impacto de la metodología de problematización en el conocimiento de estudiantes de enfermería y medicina sobre hipodermoclisis: estudio cuasiexperimental / Impacto da metodologia de problematização no conhecimento de estudantes de enfermagem e medicina sobre hipodermóclise: estudo quase experimental

Objective: to analyze the problematization methodology impact on the knowledge of nursing and medical students about hypodermoclysis. Method: quasi-experimental study conducted with 22 undergraduate nursing and medical students from a public Brazilian higher education institution. The students participated in the educational intervention using the problematization methodology based on the Arch of Maguerez. A previously validated questionnaire was used to determin' the students' knowledge level about hypodermoclysis. This instrument was applied before and after the educational intervention. The results were compared by McNemar's test and Student's t test for paired samples. Results: when comparing the correct answers before and after the intervention, there was a significant increase in 75% of the questions (p<0.05), including theoretical and practical aspects of hypodermoclysis. The mean score on students' self-assessment of the ability to explain (0.9 versus 5.9 points) and perform hypodermoclysis (1.9 versus 5.0) was significantly higher after applying the problematization methodology (p<0.001). Conclusion: the problematization methodology had a positive impact on the students' knowledge about hypodermoclysis. The number of correct answers after the educational intervention was higher than the initial assessment. The problematization methodology can be incorporated into the teaching-learning process of nursing and medical students for teaching procedures such as hypodermoclysis.

Objetivo: analizar el impacto de la metodología de problematización en el conocimiento de estudiantes de enfermería y medicina sobre hipodermoclisis. Método: estudio cuasiexperimental realizado con 22 estudiantes de enfermería y medicina de una institución pública de educación superior brasileña. Los estudiantes participaron de la intervención educativa utilizando la metodología de problematización basada en el Arco de Maguerez. Se utilizó un cuestionario previamente validado para determinar el nivel de conocimiento de los estudiantes sobre la hipodermoclisis. Este instrumento se aplicó antes y después de la intervención educativa. Los resultados se compararon mediante la prueba de McNemar y la prueba t de Student para muestras pareadas. Resultados: al comparar las respuestas correctas antes y después de la intervención, se observó un aumento significativo en el 75% de las preguntas (p<0,05), que incluye aspectos teóricos y prácticos de la hipodermoclisis. El puntaje promedio en la autoevaluación de los estudiantes con respecto a su capacidad para explicar (0,9 versus 5,9 puntos) y realizar hipodermoclisis (1,9 versus 5,0) fue significativamente mayor después de aplicar la metodología de problematización (p<0,001). Conclusión: la metodología de problematización tuvo impacto positivo en el conocimiento de los estudiantes sobre la hipodermoclisis. El número de respuestas correctas luego de la intervención educativa fue mayor que en la evaluación inicial. La metodología de problematización puede incorporarse al proceso de enseñanza-aprendizaje de estudiantes de enfermería y medicina para enseñar procedimientos como la hipodermoclisis.

Objetivo: analisar o impacto da metodologia de problematização no conhecimento de estudantes de enfermagem e medicina sobre hipodermóclise. Método: estudo quase-experimental realizado com 22 estudantes de graduação em enfermagem e medicina de uma instituição pública de ensino superior brasileira. Os alunos participaram da intervenção educacional usando a metodologia de problematização baseada no Arco de Maguerez. Um questionário previamente validado foi usado para determinar o nível de conhecimento dos alunos sobre hipodermóclise. Esse instrumento foi aplicado antes e depois da intervenção educacional. Os resultados foram comparados pelo teste de McNemar e pelo teste t de Student para amostras pareadas. Resultados: ao comparar as respostas corretas antes e depois da intervenção, houve um aumento significativo em 75% das questões (p<0,05), incluindo aspectos teóricos e práticos da hipodermóclise. A pontuação média na autoavaliação dos alunos quanto à capacidade de explicar (0,9 versus 5,9 pontos) e realizar a hipodermóclise (1,9 versus 5,0) foi significativamente maior após a aplicação da metodologia de problematização (p<0,001). Conclusão: a metodologia de problematização teve um impacto positivo no conhecimento dos alunos sobre hipodermóclise. O número de respostas corretas após a intervenção educacional foi maior do que na avaliação inicial. A metodologia de problematização pode ser incorporada ao processo de ensino-aprendizagem de estudantes de enfermagem e medicina para o ensino de procedimentos como a hipodermóclise.

Standard Operating Procedure validity on intramuscular vaccine administration in adults: a methodological study.

OBJECTIVE: to validate a Standard Operating Procedure on the intramuscular vaccine administration technique in adults using high frequency vibration associated with cryotherapy. METHODS: a literature review on intramuscular vaccination practice using a vibration device associated with cryotherapy. Then, a form was created to validate the instrument, detailing the items that were assessed by judges following recommendations in the literature. Judges' answers were assessed using the Content Validity Index, with items whose index was greater than or equal to 0.80 being validated. RESULTS: twenty-five nurses participated in validity, identifying judges' opinion regarding item relevance, clarity and accuracy. Judges validated the instrument, according to the values that remained between 0.88 and 1.0. CONCLUSIONS: the instrument developed and validated is a tool capable of guaranteeing safety and standardizing immunization practice in vaccine rooms.

Hypothermia among premature newborns on admission to a neonatal intensive care unit.

OBJECTIVE: To assess prevalence and factors associated with hypothermia in preterm infants admitted to a neonatal intensive care unit. METHODS: It is a cross-sectional retrospective study, with 154 premature newborns admitted between 2017 and 2019 in a neonatal intensive care unit. Logistic regression was used to evaluate the association to hypothermia. RESULTS: There was a predominance of males (55.8%), coming from the operating room (55.8%), gestational age > 32 weeks (71.4%), weight > 1500g (59.1%), Apgar in the 1st minute of life less than seven (51.9%) and in the 5th minute of life greater than or equal to seven (94.2%). The prevalence of hypothermia at admission was 68.2%. It was found that the lower the weight, the greater the chances of hypothermia, being three times higher in low weight (OR 3.480), five times higher in very low weight (OR5.845) and up to 47 times higher in extremely low weight (OR47.211). CONCLUSION: Hypothermia was 68.2% and it was associated with lower birth weight.

Quality of life and satisfaction of students with auriculotherapy in the covid-19 pandemic: a quasi-experimental study.

OBJECTIVES: to evaluate the quality of life before and after the application of auriculotherapy and the satisfaction of university students with the treatment during the covid-19 pandemic. METHODS: quasi-experimental study conducted with 44 students in a University Health Center. The intervention consisted of ten sessions of auriculotherapy focusing on emotional changes with quality of life assessment before and after treatment. The study also investigated the satisfaction concerning the intervention. RESULTS: predominated among the students: women, from health courses, in use of psychotropic drugs and complaining of emotional changes. There was a statistically significant increase in all domains of quality of life, and students were satisfied with the treatment. CONCLUSIONS: auriculotherapy improved the quality of life of university students during the covid-19 pandemic, and the level of satisfaction with the treatment was high.

Hospitalizations and deaths of children and adolescents with Severe Acute Respiratory Infection due to COVID-19 during the epidemiological year of 2020.

This study aimed to analyze the profile of hospitalizations and factors associated with the deaths of children and adolescents with severe acute respiratory infection (SARI) caused by SARS-CoV-2 nationwide. The study comprised 6,843 children and adolescents hospitalized in 2020 who tested positive for COVID-19, based on data from the Influenza Epidemiological Surveillance Information System. Sociodemographic and clinical profiles, hospitalization frequency, lethality and recovery rates were analyzed. The outcome was recovery or death. The 6,843 children and adolescents comprised 1.9% of SARI hospitalized cases (n = 563,051). Of these, 57.7% developed critical SARI and 90% survived. Comorbidities were present in 40.8%, especially asthma, immunodepression, and neurological and cardiovascular diseases. The main symptoms were fever, cough, dyspnea, respiratory distress, and low oxygen saturation. Among those with critical SARI, 91.4% died. There was a higher frequency of children, especially those under five years of age and of mixed ethnicity. The highest hospitalization frequency occurred in the Southeastern and Northeastern regions, the highest recovery rates in the Southeastern and Southern regions, and the highest lethality rates in the Northern and Northeastern regions. Deaths were associated with ages ranging from 12 to 19 and being under one year of age, living in the Northern and Northeastern regions, progression to critical SARI, and having immunosuppression and cardiovascular disease. In contrast, asthma was associated with lower death rates. The frequency of complications and mortality rates caused by SARS-Cov-2 in the pediatric population are relevant, as well as the severity of the epidemic in the social inequality context and the health services' frailty.

Efeitos da terapia assistida com animais no manejo da dor: protocolo de revisão sistemática / Effects of assisted therapy with animals for pain management: systematic review protocol

OBJETIVO: Avaliar os ensaios clínicos randomizados existentes na literatura sobre os efeitos da terapia assistida com animais no manejo da dor, em pessoas com quadros álgicos, comparando-a ao tratamento convencional ou a outras intervenções não farmacológicas. MÉTODO: Trata-se de um protocolo de revisão sistemática reportado segundo o Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). O protocolo foi registrado na International Prospective Register of Systematic Reviews (PROSPERO). A busca será realizada em bases de dados variadas, combinando os descritores 'Animal Assisted Therapy', 'Pain Management' e 'Controlled Clinical Trial' e suas variações. Serão incluídos apenas ensaios clínicos randomizados e o gerenciamento dos resultados se dará nos softwares EndNote e Rayyan. A ferramenta Cochrane Collaboration Risk of Bias 2 será utilizada para avaliação do risco de viés, e a ferramenta Grading of Recommendations, Assessment, Development and Evaluation (GRADE) será utilizada para avaliação da certeza de evidência. Se possível, a metanálise será realizada para determinar o efeito da terapia assistida com animais sobre a intensidade da dor.

OBJECTIVE: To evaluate the existing randomized clinical trials in the literature on the effects of Animal Assisted Therapy on pain management in people with pain when compared to conventional treatment or other non-pharmacological interventions. METHOD: Systematic Review, reported according to Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). The protocol was registered at the International Prospective Register of Systematic Reviews (PROSPERO). The search will be carried out in various sources of information, combining the descriptors 'Animal Assisted Therapy', 'Pain Management', and 'Controlled Clinical Trial' and their variations. Only randomized clinical trials will be included, and results will be managed in EndNote and Rayyan software. The assessment of bias risk will be carried out by the Cochrane Collaboration Risk of Bias 2 tool, and the assessment of the certainty of evidence by the Grading of Recommendations, Assessment, Development, and Evaluation. If possible, a meta-analysis will be performed to determine the effect of Assisted Therapy with Animals on pain intensity.

Análise dos indicadores de qualidade em uma unidade de terapia intensiva adulto: um estudo descritivo / Analysis of quality indicators in an adult intensive care unit: a descriptive study

OBJETIVO: Analisar os resultados obtidos pelos indicadores de qualidade em assistência à saúde monitorados em uma unidade de terapia intensiva adulto. MÉTODO: Estudo descritivo com análise retrospectiva dos relatórios de indicadores de uma unidade de terapia intensiva adulto. RESULTADOS: Dos 33 indicadores, nove referem-se ao funcionamento global do setor, destacando-se a baixa taxa de reinternação em 24 horas (0,8%); 14 referem-se aos dispositivos invasivos, com predomínio da utilização de cateteres vesicais de demora (63,2%), venosos periféricos (59,8%) e nasogástricos/nasoentéricos (50,0%); seis referem-se a incidentes não infecciosos, destacando-se a incidência de lesão por pressão (5,2%), obstrução (2,7%) e remoção de cateter nasogástrico/nasoentérico (2,3%); e quatro abordam os incidentes infecciosos, com destaque para a densidade de incidência de pneumonia associada à ventilação mecânica (37,8 por 1000 pacientes-dia). CONCLUSÃO: Foram observados aspectos positivos, como o predomínio de altas hospitalares e baixa taxa de reinternação, e aspectos negativos, como a ocorrência de incidentes.

OBJECTIVE: To analyze the results of quality indicators in healthcare assistance monitored in an adult intensive care unit. METHOD: A descriptive study with a retrospective analysis of the indicator reports from an adult intensive care unit. RESULTS: Of the 33 indicators, nine are related to the overall functioning of the unit, with a low readmission rate within 24 hours (0.8%). Fourteen indicators are related to invasive devices, with a predominance of use for indwelling urinary catheters (63.2%), peripheral venous catheters (59.8%), and nasogastric/nasoenteric tubes (50.0%). Six indicators pertain to non-infectious incidents, highlighting pressure ulcer incidence (5.2%), obstruction (2.7%), and removal of nasogastric/nasoenteric tubes (2.3%). Additionally, four indicators address infectious incidents, with a significant incidence density of ventilator-associated pneumonia (37.8 per 1000 patient days). CONCLUSION: Positive aspects were observed, such as a predominance of hospital discharges and low readmission rates, while negative aspects included incidents.

Análise dos indicadores de qualidade em uma unidade de terapia intensiva adulto: um estudo descritivo / Analysis of quality indicators in an adult intensive care unit: a descriptive study

OBJETIVO: Analisar os resultados obtidos pelos indicadores de qualidade em assistência à saúde monitorados em uma unidade de terapia intensiva adulto. MÉTODO: Estudo descritivo com análise retrospectiva dos relatórios de indicadores de uma unidade de terapia intensiva adulto. RESULTADOS: Dos 33 indicadores, nove referem-se ao funcionamento global do setor, destacando-se a baixa taxa de reinternação em 24 horas (0,8%); 14 referem-se aos dispositivos invasivos, com predomínio da utilização de cateteres vesicais de demora (63,2%), venosos periféricos (59,8%) e nasogástricos/nasoentéricos (50,0%); seis referem-se a incidentes não infecciosos, destacando-se a incidência de lesão por pressão (5,2%), obstrução (2,7%) e remoção de cateter nasogástrico/nasoentérico (2,3%); e quatro abordam os incidentes infecciosos, com destaque para a densidade de incidência de pneumonia associada à ventilação mecânica (37,8 por 1000 pacientes-dia). CONCLUSÃO: Foram observados aspectos positivos, como o predomínio de altas hospitalares e baixa taxa de reinternação, e aspectos negativos, como a ocorrência de incidentes.

OBJECTIVE: To analyze the results of quality indicators in healthcare assistance monitored in an adult intensive care unit. METHOD: A descriptive study with a retrospective analysis of the indicator reports from an adult intensive care unit. RESULTS: Of the 33 indicators, nine are related to the overall functioning of the unit, with a low readmission rate within 24 hours (0.8%). Fourteen indicators are related to invasive devices, with a predominance of use for indwelling urinary catheters (63.2%), peripheral venous catheters (59.8%), and nasogastric/nasoenteric tubes (50.0%). Six indicators pertain to non-infectious incidents, highlighting pressure ulcer incidence (5.2%), obstruction (2.7%), and removal of nasogastric/nasoenteric tubes (2.3%). Additionally, four indicators address infectious incidents, with a significant incidence density of ventilator-associated pneumonia (37.8 per 1000 patient days). CONCLUSION: Positive aspects were observed, such as a predominance of hospital discharges and low readmission rates, while negative aspects included incidents.

Standard Operating Procedure validity on intramuscular vaccine administration in adults: a methodological study / Validación del Procedimiento Operativo Estándar sobre administración intramuscular de vacunas en adultos: estudio metodológico / Validação de Procedimento Operacional Padrão sobre administração intramuscular de vacina em adultos: estudo metodológico

ABSTRACT Objective: to validate a Standard Operating Procedure on the intramuscular vaccine administration technique in adults using high frequency vibration associated with cryotherapy. Methods: a literature review on intramuscular vaccination practice using a vibration device associated with cryotherapy. Then, a form was created to validate the instrument, detailing the items that were assessed by judges following recommendations in the literature. Judges' answers were assessed using the Content Validity Index, with items whose index was greater than or equal to 0.80 being validated. Results: twenty-five nurses participated in validity, identifying judges' opinion regarding item relevance, clarity and accuracy. Judges validated the instrument, according to the values that remained between 0.88 and 1.0. Conclusions: the instrument developed and validated is a tool capable of guaranteeing safety and standardizing immunization practice in vaccine rooms.

RESUMEN Objetivo: validar un Procedimiento Operativo Estándar sobre la técnica de administración de vacunas intramusculares en adultos mediante vibración de alta frecuencia asociada a crioterapia. Métodos: revisión de la literatura sobre la práctica de la vacunación intramuscular mediante un dispositivo de vibración asociado a la crioterapia. Luego, se elaboró un formulario para validar el instrumento, detallando los ítems que fueron evaluados por los jueces siguiendo las recomendaciones de la literatura. Las respuestas de los jueces fueron evaluadas mediante el Índice de Validez de Contenido, siendo validados los ítems cuyo índice fuera mayor o igual a 0,80. Resultados: 25 enfermeros participaron de la validación, captando la opinión de los jueces sobre la pertinencia, claridad y precisión de los ítems. Los jueces validaron el instrumento según los valores, que se mantuvieron entre 0,88 y 1,0. Conclusiones: el instrumento desarrollado y validado es una herramienta capaz de garantizar la seguridad y estandarizar la práctica de inmunización en salas de vacunas.

RESUMO Objetivo: validar um Procedimento Operacional Padrão sobre a técnica de administração de vacinas pela via intramuscular em adultos utilizando vibração em alta frequência associada à crioterapia. Métodos: revisão de literatura sobre a prática de vacinação intramuscular utilizando dispositivo de vibração associado à crioterapia. Em seguida, elaborou-se um formulário para validação do instrumento, com detalhamento dos itens que foram avaliados por juízes seguindo recomendações da literatura. As respostas dos juízes foram avaliadas pelo Índice de Validade de Conteúdo, sendo validados os itens cujo índice foi maior ou igual a 0,80. Resultados: 25 enfermeiros participaram da validação, captando o parecer dos juízes quanto à relevância, clareza e precisão dos itens. Os juízes validaram o instrumento segundo os valores, que permaneceram entre 0,88 e 1,0. Conclusões: o instrumento desenvolvido e validado é uma ferramenta capaz de garantir a segurança e padronizar a prática de imunização nas salas de vacina.

Hypothermia among premature newborns on admission to a neonatal intensive care unit / Hipotermia entre los recién nacidos prematuros que ingresan en una unidad de cuidados intensivos neonatales / Hipotermia entre recém-nascidos prematuros na admissão em uma unidade de terapia intensiva neonatal

ABSTRACT Objective: To assess prevalence and factors associated with hypothermia in preterm infants admitted to a neonatal intensive care unit. Methods: It is a cross-sectional retrospective study, with 154 premature newborns admitted between 2017 and 2019 in a neonatal intensive care unit. Logistic regression was used to evaluate the association to hypothermia. Results: There was a predominance of males (55.8%), coming from the operating room (55.8%), gestational age > 32 weeks (71.4%), weight > 1500g (59.1%), Apgar in the 1st minute of life less than seven (51.9%) and in the 5th minute of life greater than or equal to seven (94.2%). The prevalence of hypothermia at admission was 68.2%. It was found that the lower the weight, the greater the chances of hypothermia, being three times higher in low weight (OR 3.480), five times higher in very low weight (OR5.845) and up to 47 times higher in extremely low weight (OR47.211). Conclusion: Hypothermia was 68.2% and it was associated with lower birth weight.

RESUMEN Objetivo: Evaluar prevalencia y factores asociados a la hipotermia entre los recién nacidos prematuros ingresados en una unidad de cuidados intensivos neonatales. Métodos: Estudio transversal retrospectivo, con 154 recién nacidos prematuros ingresados entre 2017 y 2019 en una unidad de cuidados intensivos neonatales. Se utilizó la regresión logística para evaluar la asociación a la hipotermia. Resultados: Hubo un predominio de varones (55,8%), procedentes del centro quirúrgico (55,8%), edad gestacional > 32 semanas (71,4%), peso > 1500g (59,1%), puntuación de Apgar en el primer minuto de vida inferior a siete (51,9%) y en el quinto minuto superior o igual a siete (94,2%). La prevalencia de hipotermia al ingreso fue del 68,2%. Se comprobó que cuanto menor es el peso, mayores son las posibilidades de hipotermia, tres veces más para el peso bajo (R.O. 3,480), cinco veces más para el peso muy bajo (R.O.5,845) y hasta 47 veces más para el peso extremadamente bajo (R.O.47,211). Conclusión: La hipotermia fue del 68,2% y se asoció a un menor peso al nacer.

RESUMO Objetivo: Avaliar prevalência de hipotermia e fatores associados entre recém-nascidos prematuros admitidos em uma unidade de terapia intensiva neonatal. Métodos: Estudo transversal retrospectivo, com 154 recém-nascidos prematuros admitidos entre 2017 e 2019 em uma unidade de terapia intensiva neonatal. Utilizou-se regressão logística para avaliar associação à hipotermia. Resultados: Houve predomínio do sexo masculino (55,8%), procedência de centro cirúrgico (55,8%), idade gestacional > 32 semanas (71,4%), peso > 1.500g (59,1%), Apgar no 1º minuto de vida menor que sete (51,9%) e no 5º maior ou igual a sete (94,2%). A prevalência de hipotermia à admissão foi de 68,2%. Verificou-se que quanto menor o peso, maiores as chances de hipotermia, sendo três vezes maior no baixo peso (O.R. 3,480), cinco vezes maior no muito baixo peso (O.R. 5,845) e 47 vezes maior no extremo baixo peso (O.R. 47,211). Conclusão: A hipotermia foi de 68,2% e esteve associada ao menor peso ao nascer.

Hospitalizations and deaths of children and adolescents with Severe Acute Respiratory Infection due to COVID-19 during the epidemiological year of 2020

ABSTRACT This study aimed to analyze the profile of hospitalizations and factors associated with the deaths of children and adolescents with severe acute respiratory infection (SARI) caused by SARS-CoV-2 nationwide. The study comprised 6,843 children and adolescents hospitalized in 2020 who tested positive for COVID-19, based on data from the Influenza Epidemiological Surveillance Information System. Sociodemographic and clinical profiles, hospitalization frequency, lethality and recovery rates were analyzed. The outcome was recovery or death. The 6,843 children and adolescents comprised 1.9% of SARI hospitalized cases (n = 563,051). Of these, 57.7% developed critical SARI and 90% survived. Comorbidities were present in 40.8%, especially asthma, immunodepression, and neurological and cardiovascular diseases. The main symptoms were fever, cough, dyspnea, respiratory distress, and low oxygen saturation. Among those with critical SARI, 91.4% died. There was a higher frequency of children, especially those under five years of age and of mixed ethnicity. The highest hospitalization frequency occurred in the Southeastern and Northeastern regions, the highest recovery rates in the Southeastern and Southern regions, and the highest lethality rates in the Northern and Northeastern regions. Deaths were associated with ages ranging from 12 to 19 and being under one year of age, living in the Northern and Northeastern regions, progression to critical SARI, and having immunosuppression and cardiovascular disease. In contrast, asthma was associated with lower death rates. The frequency of complications and mortality rates caused by SARS-Cov-2 in the pediatric population are relevant, as well as the severity of the epidemic in the social inequality context and the health services' frailty.

Quality of life and satisfaction of students with auriculotherapy in the covid-19 pandemic: a quasi-experimental study / Calidad de vida y satisfacción de estudiantes con auriculoterapia en la pandemia de covid-19: estudio cuasi experimental / Qualidade de vida e satisfação de estudantes com auriculoterapia na pandemia de covid-19: estudo quase experimental

ABSTRACT Objectives: to evaluate the quality of life before and after the application of auriculotherapy and the satisfaction of university students with the treatment during the covid-19 pandemic. Methods: quasi-experimental study conducted with 44 students in a University Health Center. The intervention consisted of ten sessions of auriculotherapy focusing on emotional changes with quality of life assessment before and after treatment. The study also investigated the satisfaction concerning the intervention. Results: predominated among the students: women, from health courses, in use of psychotropic drugs and complaining of emotional changes. There was a statistically significant increase in all domains of quality of life, and students were satisfied with the treatment. Conclusions: auriculotherapy improved the quality of life of university students during the covid-19 pandemic, and the level of satisfaction with the treatment was high.

RESUMEN Objetivos: evaluar la calidad de vida antes y después de la aplicación de auriculoterapia y satisfacción de estudiantes universitarios con el tratamiento durante la pandemia de covid-19. Métodos: estudio cuasi experimental, realizado con 44 estudiantes en centro de salud de una universidad. La intervención constituyó en diez sesiones de auriculoterapia, enfocado en las altercaciones emocionales, y la evaluación de la calidad de vida pasó antes y después del tratamiento. La satisfacción con la intervención también fue investigada. Resultados: predominaron entre los estudiantes: mujeres, de cursos del área de la salud, en uso de psicotrópicos y con queja de alteraciones emocionales. Hubo aumento estadísticamente significante en todos los dominios de la calidad de vida, y los estudiantes quedaron satisfechos con el tratamiento. Conclusiones: la auriculoterapia fue capaz de mejorar la calidad de vida de estudiantes universitarios durante la pandemia de covid-19, y el nivel de satisfacción con el tratamiento fue alto.

RESUMO Objetivos: avaliar a qualidade de vida antes e depois da aplicação da auriculoterapia e a satisfação de estudantes universitários com o tratamento durante a pandemia de covid-19. Métodos: estudo quase experimental, realizado com 44 estudantes em um centro de saúde de uma universidade. A intervenção consistiu em dez sessões de auriculoterapia, com foco nas alterações emocionais, e a avaliação da qualidade de vida ocorreu antes e depois do tratamento. A satisfação com a intervenção também foi investigada. Resultados: predominaram entre os estudantes: mulheres, de cursos da área da saúde, em uso de psicotrópicos e com queixa de alterações emocionais. Houve aumento estatisticamente significativo em todos os domínios da qualidade de vida, e os estudantes ficaram satisfeitos com o tratamento. Conclusões: a auriculoterapia foi capaz de melhorar a qualidade de vida de estudantes universitários durante a pandemia de covid-19, e o nível de satisfação com o tratamento foi alto.

Survival of patients with diabetes mellitus hospitalized for acute respiratory syndrome due to COVID-19.

Given the magnitude of COVID-19 and the increase in hospitalization cases for severe acute respiratory syndrome (SARS), especially among patients with diabetes mellitus, it is essential to understand the epidemiological aspects inherent to the disease and the worsening of cases. Thus, this study aimed to analyze the survival of patients with diabetes mellitus hospitalized for SARS due to COVID-19 in different regions of Brazil. This is a longitudinal study, carried out based on data reported in the Influenza Epidemiological Surveillance Information System during the year 2020. The number of patients with diabetes mellitus among the hospitalized cases of SARS due to COVID-19 in the different regions of Brazil and the lethality rate among them were identified. A comparison of patient profiles of those who survived or did not survive and the Cox regression analysis were performed to evaluate the factors associated with shorter survival of patients. It was found that 51.4% of patients hospitalized with SARS due to COVID-19 had diabetes, and the case lethality rate among them was 45.0%. The Northeastern and Northern regions presented a higher proportion of patients with diabetes mellitus (56.5% and 54.3%, respectively) and a higher lethality rate (53.8% and 59.9%, respectively). The mean survival time of cases with diabetes mellitus hospitalized for SARS due to COVID-19 was estimated to be 35.7 days (0.5 days). A lower survival rate was observed among residents of the Northeastern and Northern regions with skin color reported as non-white, who required admission to Intensive Care Units and invasive mechanical ventilation, and presented respiratory symptoms such as dyspnea, respiratory distress and an oxygen saturation lower than 95%. It is concluded that diabetes mellitus was responsible for the high occurrence and lethality, mainly in the Northeastern and Northern regions, among non-white patients and those with greater clinical severity, which reinforces the importance of taking measures aimed at supporting this population.

Análise dos óbitos entre pacientes críticos: comparação da mortalidade estimada pelo saps-3 e mortalidade observada / Análisis de las muertes entre pacientes críticos: comparación de la mortalidad estimada por el saps-3 y mortalidad observada / Analysis of deaths among critical patients: comparison of estimated mortality by saps-3 and observed mortality

Objetivo:comparar a mortalidade estimada pelo SAPS-3 com a mortalidade observada entre os pacientes críticos admitidos em uma Unidade de Terapia Intensiva e identificar os fatores associados ao óbito. Métodos: estudo longitudinal realizado com dados secundários de 400 pacientes críticos. Realizou-se a comparação damortalidade estimada e observada, e os fatores associados ao óbito. Resultados:houve predomínio de pacientes idosos (média de 65,5 anos)do sexo masculino (50,5%), com internação financiada peloSistema Único de Saúde (78,0%).Os pacientes que apresentaram maior pontuação no escore de gravidade e maior mortalidade estimada foram os que evoluíram a óbito (p<0,001). O óbito esteve associado às internações por doenças infecciosas e parasitárias (p<0,001), enquanto a maior parte dos pacientes internados por causas externas receberam alta (p<0,001). Conclusão:os pacientes com maior gravidade pelo SAPS-3 foram os que evoluíram a óbito, predominando o desfecho negativo entre os internados por doenças infecciosas e parasitárias.

Objective:to compare the mortality estimated by the SAPS-3 with the observed mortality among critically ill patients admitted to an Intensive Care Unit and to identify the factors associated with death. Methods:longitudinal study carried out with secondary data from 400 critically ill patients. Estimated and observed mortality and the factors associated with death were compared. Results:there was a predominance of elderly patients (mean age 65.5 years) male (50.5%), with hospitalization financed by the Unified Health System (78.0%). The patients with the highest severity score and the highest estimated mortality were those who died (p<0.001). Death was associated with hospitalizations for infectious and parasitic diseases (p<0.001), while most patients hospitalizedfor external causes were discharged (p<0.001). Conclusion:the patients with the highest severity by SAPS-3 were those who died, with a predominant negative outcome among those hospitalized for infectious and parasitic diseases

Objetivo:comparar la mortalidad estimada por el SAPS-3 con la mortalidad observada en pacientes críticos ingresados en una Unidad de Cuidados Intensivos e identificar los factores asociados a la muerte. Métodos:estudio longitudinal realizado con datos secundarios de 400 pacientes críticos. Se comparó la mortalidad estimada y observada y los factores asociados a la muerte. Resultados:hubo predominio de pacientes adultos mayores (edad media 65,5 años) del sexo masculino (50,5%), con hospitalización financiada porel Sistema Único de Salud (78,0%). Los pacientes con mayor puntuación de gravedad y mayor mortalidad estimada fueron los que fallecieron (p<0,001). La muerte se asoció con las hospitalizaciones por enfermedades infecciosas y parasitarias (p<0,001), mientras que la mayoría de los pacientes hospitalizados por causas externas fueron dados de alta (p<0,001). Conclusión:los pacientes con mayor gravedad por SAPS-3 fueron los que fallecieron, con desenlace negativo predominante entre los hospitalizados por enfermedades infecciosas y parasitarias.

Effect of vibration associated with cryotherapy on vaccine-related pain and anxiety levels in adults: study protocol for a randomized clinical trial.

BACKGROUND: Vaccination is one of the most effective strategies for prevention and eradication of immunopreventable diseases, but community acceptance of vaccination can be influenced by different factors, such as pain and anxiety. The use of high-frequency vibration associated with cryotherapy has been used to manage pain and anxiety during the vaccination process in children, but studies with adults are still scarce. This study aims to evaluate the effect of high-frequency vibration associated with cryotherapy on the levels of self-reported pain and anxiety related to administration of the Influenza vaccine intramuscularly in adults. METHODS: A two-arm, parallel, randomized clinical trial conducted in a Brazilian Primary Health Care Unit is proposed. A sample of 350 adults will be randomly assigned to participate in the control group, receiving the vaccine intramuscularly according to the standard protocol of the service, or in the intervention group, receiving the vaccine by the same route and using a portable device of high frequency vibration associated with cryotherapy for 30 s before and during administration. The primary endpoints will be self-reported levels of pain, assessed before and after vaccine administration. Secondary endpoints will be levels of anxiety, satisfaction with vaccine administration, and discomfort caused by high frequency vibration and temperature of the frozen bag in contact with the skin. Self-reported levels of pain and anxiety will be compared before and after vaccination as well as between the control and intervention groups. DISCUSSION: By evaluating the effect of high-frequency vibration associated with cryotherapy on pain and anxiety levels, we expect to find evidence that will support nursing practice, in order to promote greater comfort and safety in the vaccination process and, consequently, greater compliance by the population, by minimizing its undesirable effects. TRIAL REGISTRATION: Human Research Ethics Committee Opinion Number: 5.138.564. Approved on December 2, 2021. Brazilian Registry of Clinical Trials (REBEC): Registration number RBR-5zgy25w. Registered on December 09, 2021.

Factors associated with the incidence of pressure wounds in critical patients: a cohort study.

OBJECTIVES: to identify the incidence of pressure wound in critical patients and its associated factors. METHODS: retrospective cohort study, based on the analysis of 369 critical patients' records. Descriptive and inferential statistics were used, as well as logistic regression. RESULTS: the incidence of pressure wounds was 11.4%. Patients who had been hospitalized for four days or more (OR 2.99; CI95% 1.15-7.78), used nasoenteric tubes (OR: 3.81; CI95%: 1.4010.38), vesical drainage catheters (OR: 4.78; CI95%: 1.31-17.38) and tracheostomy (OR: 3.64; CI95%: 1.48-8.97) had a higher chance of developing pressure wounds. The mean score of the Braden scale among participants who developed (14.2 points) pressure wounds was statistically different (p<0.001) than that of those who did not (12.3 points). CONCLUSIONS: the incidence of pressure wounds was associated with a higher time in the unit, the use of nasoenteric tubes, vesical drainage catheters, and tracheostomies were associated with a higher time of hospitalization in the unit.