Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 20
Filtrar
1.
Enferm. clín. (Ed. impr.) ; 30(2): 114-118, mar.-abr. 2020. tab
Artigo em Espanhol | IBECS-Express | ID: ibc-FGT-3074

RESUMO

Objetivo: Examinar la fiabilidad de la clasificación de lesiones relacionadas con la dependencia según su etiología mediante fotografías. Método: Se constituyó un panel de 5 expertas que evaluaron 24 fotografías de forma anónima, independiente y ciega, emitiendo un juicio para cada una de ellas. Las fotografías se enviaron por correo electrónico, junto con un cuestionario anónimo que se devolvió a un referente del grupo. Se propusieron 8 opciones de clasificación: úlceras por presión categorías I, II, III y IV, «sospecha de lesión de tejidos profundos», «lesión asociada a la humedad», etiología mixta presión-humedad y etiología multicausal. Se calculó el índice de acuerdo para cada fotografía y el coeficiente Kappa con técnica «jackknife» para cada imagen y cada categoría de clasificación, usando el paquete estadístico Epidat 4.2. Resultados: Los índices de acuerdo observado fueron variables, entre 0,4 y 1 dependiendo de la fotografía. En 6 ocasiones se obtuvo un 100% de acuerdo observado. El coeficiente Kappa global resultó moderado: 0,5202 (IC95%: 0,3850- 0,6542). El coeficiente de concordancia intraclase resultó moderado en 4 de las categorías y bajo en 3 de ellas, siendo alto solamente en úlceras por presión categoría II (Kappa 0,8924. IC 95%: 0,7388-1,0456). La concordancia entre observadoras resultó 0,6602 (IC 95%: 0,4969-0,8081). Conclusiones: La fiabilidad del uso de fotografías para la categorización de lesiones relacionadas con la dependencia resulta moderada, siendo mayor en úlceras por presión categoría II y baja en lesiones de mayor complejidad. Este método, debe ser usado con cautela en la categorización de lesiones crónicas, siendo necesario impulsar acciones formativas


Objective: To examine the reliability of the classification of dependence-related lesions using photography. Method: A panel of 5 experts carried out a blind, anonymous and independent assessment of 24 photographs. Images were sent by electronic mail, together with an anonymous questionnaire that was sent back to a referee of the research group. We suggested 8 options for classification: pressure ulcer (categories I, II, III, IV, or ‘suspect of deep-tissue damage’), moisture-associated damage, pressure-moisture combined aetiology and multifactorial lesion. Concordance index was calculated for every photography. Cohen‘s Kappa index with 'jackknife' technique were calculated for every photograph and category. We used the statistical programme Epidat 4.2. Results: Observed agreement was variable, between 4 and 1 depending on the photography. A consensus of 100% was observed in 6 images. Global Kappa resulted as moderate: 0.5202 (IC95%: 0.3850- 0.6542). Intra-group concordance resulted moderate in 4 categories, low in 3, and high only for pressure ulcer category II (Kappa 0.8924. IC 95%: 0.7388-1.0456). Inter-observer concordance was 0.6602 (IC 95%: 0.4969-0.8081). Conclusions: The reliability of the use of photographs for the categorization of dependence-related lesions is moderate, being higher for category II pressure ulcers and low for more complex wounds. This method must be used with care, and education on the subject is required

2.
Heart Lung ; 2020 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-32057426

RESUMO

Peripheral venous catheterization is a common technique in hospitals which is not always successful, resulting in multiple punctures and degradation of the vessels. This scenario, which we have termed 'difficult peripheral venous access', is associated to delays in care, obtention of samples or diagnosis, as well as a higher use of central catheters. This study intends to identify risk factors associated to the incidence of 'difficult peripheral venous access' in adults at hospital. We designed a systematic review of published studies (protocol PROSPERO 2018 CRD42018089160). We conducted structured electronic searches using key words and specific vocabulary, as well as directed searches in several databases. After validity analysis, we selected 7 studies with observational methodology. We found great variability in the definition of 'difficult peripheral venous access' and in the variables proposed as risk factors. Statistically significant factors through studies include demographic and anthropometric variables (gender, Body Mass Index), as well as medical and health conditions (diabetes, renal insufficiency, parenteral drug abuse, cancer chemotherapy), together with variables related to the vein or vascular access (vein visibility and palpability, vessel diameter, previous history of difficulty). Some studies have also considered variables related to the professional performing the technique. Meta-analyses were carried out for gender and obesity as potential risk factors. Only obesity appeared as a statistically significant risk factor with OR of 1.48; 95% CI (1.03 to 1.93; p = 0.016). Methodological heterogeneity prevented the development of further meta-analyses. It is essential to design future studies with diverse hospital populations, in which a wide selection of potential risk factors can be studied in a unique analysis. Our work identifies the most relevant variables that should be included in those studies.

3.
Artigo em Inglês | MEDLINE | ID: mdl-31367345

RESUMO

Background: Peripheral intravenous catheters (PIVCs) are the most widely used invasive devices among inpatients. Catheter-related bloodstream infections (CRBSI) are serious yet preventable events for patients. Although the contribution of PIVCs towards these infections is gradually being recognised, its role in the Spanish setting is yet to be determined. We aimed to estimate the rate and incidence of PIVC failure at Manacor hospital (Spain) as baseline within a wider quality improvement initiative. Methods: Tips from all PIVC removed during December 2017 and January 2018 in hospital wards were cultured semiquantitatively. The study population included all PIVCs inserted in adult patients admitted to any of three medical and one surgical wards, emergency department, critical care unit and operating rooms. Clinical, microbiological and ward information was collected by clinical researchers for each PIVC from insertion to removal on the study sites. CRBSI was defined per international guidelines (i.e., Centers for Disease Control and Prevention, USA). Data was analysed descriptively. Results: Seven hundred and eleven tips were cultured, with 41.8% (297/711) reported as PIVC failure. The PIVC failure rate density-adjusted incidence for hospital length of stay (HLOS) was 226.2 PIVC failure/1000 HLOS. 5.8% (41/711) tips yielded positive isolates, with most frequent microorganisms Staphylococcus spp (S. epidermidis 29/41, 70.7%, S. aureus 2/41, 4.9%, S. hominis 2/41, 4.9%), and Acinetobacter baumannii (1/41, 2.4%). One S. aureus isolate was methicillin-resistant. 53.6% (22/41) positive cultures were obtained from patients with local signs and symptoms compatible with catheter-related infection (CRI), 2.4% (1/41) were compatible with CRBSI type 2 and that clinical signs improve within 48 h of catheter removal (density-adjusted incidence for hospital stays of 16.7 PIVC-CRI/1000 hospital-stays and 0.76 PVC-BSI/1000 hospital-stays respectively) and no patients were diagnosed CRBSI type 3 with a bacterial growth concordant in tip and blood cultures. Most cases responded favourably to catheter removal and management. Conclusions: Our findings show that almost 42% PIVCs resulted in unplanned removal, amplifying the importance in terms of morbidity, mortality and patient safety. A high number of positive tip cultures without clinical signs and symptoms was observed. We underpin the importance to remove unnecessary PIVCs for the prevention of CRBSI.

4.
Enferm Clin ; 2019 Jun 13.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31204222

RESUMO

OBJECTIVE: To examine the reliability of the classification of dependence-related lesions using photography. METHOD: A panel of 5 experts carried out a blind, anonymous and independent assessment of 24 photographs. Images were sent by electronic mail, together with an anonymous questionnaire that was sent back to a referee of the research group. We suggested 8 options for classification: pressure ulcer (categories I, II, III, IV, or 'suspect of deep-tissue damage'), moisture-associated damage, pressure-moisture combined aetiology and multifactorial lesion. Concordance index was calculated for every photography. Cohen's Kappa index with 'jackknife' technique were calculated for every photograph and category. We used the statistical programme Epidat 4.2. RESULTS: Observed agreement was variable, between 4 and 1 depending on the photography. A consensus of 100% was observed in 6 images. Global Kappa resulted as moderate: 0.5202 (IC95%: 0.3850- 0.6542). Intra-group concordance resulted moderate in 4 categories, low in 3, and high only for pressure ulcer category II (Kappa 0.8924. IC 95%: 0.7388-1.0456). Inter-observer concordance was 0.6602 (IC 95%: 0.4969-0.8081). CONCLUSIONS: The reliability of the use of photographs for the categorization of dependence-related lesions is moderate, being higher for category II pressure ulcers and low for more complex wounds. This method must be used with care, and education on the subject is required.

5.
Enferm. clín. (Ed. impr.) ; 29(2): 119-124, mar.-abr. 2019.
Artigo em Espanhol | IBECS | ID: ibc-182601

RESUMO

En un contexto de envejecimiento de la población, aumento en la prevalencia de enfermedades crónicas y creciente complejidad, se hace necesario definir nuevos roles profesionales que consigan dar respuesta a las necesidades de salud de la población. A ello se une la certeza de que la variabilidad en la práctica clínica, así como en la gestión sanitaria, hace necesaria la adopción de las mejores evidencias como base de la toma de decisiones. Pero la aplicación de la práctica clínica basada en evidencia en un determinado contexto implica un amplio dominio de la evidencia disponible, su aplicabilidad y limitaciones, así como una profunda comprensión de las características particulares del ámbito en que se pretende aplicar, desde el nivel «macro» (políticas de salud, normativa marco, líneas estratégicas, valores sociales, etc.) hasta el «micro» (cultura local, preferencias de los usuarios, etc.). El Servei de Salut de les Illes Balears, en colaboración con la Facultad de Enfermería y Fisioterapia de la Universitat de les Illes Balears, propone el desarrollo de nuevos roles enfermeros de práctica avanzada que focalicen sus esfuerzos en la implementación planificada de evidencias en entornos clínicos. Las enfermeras de práctica avanzada han conseguido de manera natural, gracias a su desarrollo competencial, ejercer el papel de impulsoras de cambios organizacionales y actitudinales que facilitan la implementación de evidencia en organizaciones y entornos complejos


In a context of aging of the population, increased prevalence of chronic diseases and increasing complexity, it is necessary to define new professional roles that can meet the health needs of the population. Added to this is the certainty that variability in clinical practice, as well as in health management, makes it necessary to use best evidence as the basis for decision-making. But the application of clinical practice based on evidence in a specific context implies a broad mastery of the available evidence, its applicability and limitations, as well as a deep understanding of the particular characteristics of the area where it is to be applied, from the "macro" (health policies, framework regulations, strategic lines, social values, etc.) to the "micro" level (local culture, user preferences, etc.). The "Health Service of the Balearic Islands", in collaboration with the Faculty of Nursing and Physiotherapy from the University of the Balearic Islands, proposes the development of new advanced practice nursing roles that focus their efforts on the planned implementation of evidence in clinical settings. Advanced practice nurses have managed naturally, thanks to their competence development, to exercise the role of promoting organizational and attitudinal changes that facilitate the implementation of evidence in organizations and complex environments


Assuntos
Humanos , Prática Avançada de Enfermagem , Enfermagem Baseada em Evidências
6.
Enferm Clin ; 29(2): 119-124, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30819585

RESUMO

In a context of aging of the population, increased prevalence of chronic diseases and increasing complexity, it is necessary to define new professional roles that can meet the health needs of the population. Added to this is the certainty that variability in clinical practice, as well as in health management, makes it necessary to use best evidence as the basis for decision-making. But the application of clinical practice based on evidence in a specific context implies a broad mastery of the available evidence, its applicability and limitations, as well as a deep understanding of the particular characteristics of the area where it is to be applied, from the "macro" (health policies, framework regulations, strategic lines, social values, etc.) to the "micro" level (local culture, user preferences, etc.). The "Health Service of the Balearic Islands", in collaboration with the Faculty of Nursing and Physiotherapy from the University of the Balearic Islands, proposes the development of new advanced practice nursing roles that focus their efforts on the planned implementation of evidence in clinical settings. Advanced practice nurses have managed naturally, thanks to their competence development, to exercise the role of promoting organizational and attitudinal changes that facilitate the implementation of evidence in organizations and complex environments.


Assuntos
Prática Avançada de Enfermagem/normas , Enfermagem Baseada em Evidências , Humanos , Espanha
7.
BMJ Open ; 8(10): e021040, 2018 10 21.
Artigo em Inglês | MEDLINE | ID: mdl-30344166

RESUMO

OBJECTIVE: Catheter-related bloodstream infections are one of the most important adverse events for patients. Evidence-based practice embraces interventions to prevent and reduce catheter-related bloodstream infections in patients. At present, a growing number of guidelines exist worldwide. The purpose of the study was to assess clinical practice guidelines for peripheral and central venous access device care and prevention of related complications. DESIGN: Systematic review of clinical practice guidelines: We conducted a search of the literature published from 2005 to 2018 using Medline/PubMed, Embase, CINAHL, Ovid, ScienceDirect, Scopus and Web of Science. We also evaluated grey literature sources and websites of organisations that compiled or produced guidelines. Guideline quality was assessed with the Appraisal of Guidelines for Research and Evaluation, Second Edition tool by three independent reviewers. Cohen's kappa coefficient was used to evaluate the concordance between reviewers. RESULTS: We included seven guidelines in the evaluation. The concordance between observers was substantial, K=0.6364 (95% CI 0.0247 to 1.2259). We identified seven international guidelines, which scored poorly on crucial domains such as applicability (medium 39%), stakeholder involvement (medium 65%) and methodological rigour (medium 67%). Guidelines by Spanish Health Ministry and UK National Institute for Health and Care Excellence presented the highest quality. CONCLUSIONS: It is crucial to critically evaluate the validity and reliability of clinical practice guidelines so the best, most context-specific document is selected. Such choice is a necessary prior step to encourage and support health organisations to transfer research results to clinical practice. The gaps identified in our study may explain the suboptimal clinical impact of guidelines. Such low adoption may be mitigated with the use of implementation guides accompanying clinical documents.


Assuntos
Medicina Baseada em Evidências/normas , Guias de Prática Clínica como Assunto , Dispositivos de Acesso Vascular/normas , Humanos , Internacionalidade , Participação dos Interessados
8.
Enferm. nefrol ; 21(3): 240-248, jul.-sept. 2018. tab, mapas, graf
Artigo em Espanhol | IBECS | ID: ibc-174060

RESUMO

Introducción: La Variabilidad de la Práctica Asistencial se define como "aquella situación en la cual pacientes con una clínica similar no son cuidados ni tratados de la misma forma en diferentes niveles de atención, sin que exista una base sólida en conocimientos derivados del cumplimiento de guías de práctica clínica". Objetivo: Analizar la adherencia de las enfermeras a recomendaciones basadas en evidencias, comparar la adherencia respecto a las características sociodemográficas e identificar intervenciones con mayor variabilidad en el manejo del acceso vascular. Material y Método: Estudio observacional transversal. Los sujetos de estudio fueron enfermeras de hemodiálisis que contestaron un cuestionario online ad hoc formado por 33 preguntas a través de GoogleForm, difundido por correo electrónico a nivel nacional durante los meses de octubre y noviembre de 2017. El cuestionario se organizó para dar respuesta a las variables del perfil sociodemográfico y a la adherencia a recomendaciones basadas en las guías KDOQI, detectando 7 dominios fundamentales para la práctica enfermera en hemodiálisis. Resultados: Se obtuvieron 217 encuestas válidas procedentes de 17 comunidades autónomas, lo que supone una tasa de respuesta del 16,69%. La adherencia a las recomendaciones resultó moderada, un 53,24% de las respuestas coincidieron con la evidencia emitida en las guías de práctica clínica. Las intervenciones con mayor incertidumbre y variabilidad están relacionadas con el uso del antiséptico, tipo y tiempo de apósitos y técnica de punción. Conclusión: Se obtuvo una adherencia moderada sobre las áreas de conocimiento que están produciendo mayor incertidumbre en los entornos de hemodiálisis, siendo el mapeo de variabilidad un instrumento útil para su detección


Introduction: The Variability of the Care Practice is defined as "that situation in which patients with a similar clinical situation are not cared for or treated in the same way in different levels of care, without a solid base in knowledge derived from the compliance with clinical practice guidelines". Objective: To analyze the adherence of nurses to recommendations based on evidence, to compare adherence in relation to sociodemographic characteristics and to identify interventions with greater variability in the management of vascular access. Material and Method: Cross-sectional observational study. The study subjects were hemodialysis nurses who answered an ad hoc online questionnaire formed by 33 questions through GoogleForm, disseminated by email at national level, during October and November 2017. The questionnaire was organized to respond the variable of the sociodemographic profile and adherence to recommendations based on the KDOQI guidelines, detecting 7 fundamental domains for nursing practice in hemodialysis. Results: 217 valid surveys were obtained from 17 autonomous communities, which implies a response rate of 16.69%. Adherence to the recommendations was moderate, 53.24% of respondents agreed with the evidence issued in clinical practice guidelines. Interventions with greater uncertainty and variability are related to the use of the antiseptic, type and time of wound dressings, and puncture technique. Conclusion: A moderate adherence was obtained related to the areas of knowledge that are producing greater uncertainty in hemodialysis environments, being the mapping of variability a useful instrument for such detection


Assuntos
Humanos , Insuficiência Renal Crônica/terapia , Diálise Renal/enfermagem , Cuidados de Enfermagem/métodos , Dispositivos de Acesso Vascular , Estudos Transversais , Cateterismo Venoso Central/enfermagem , Pesquisas sobre Serviços de Saúde/estatística & dados numéricos , Qualidade da Assistência à Saúde/estatística & dados numéricos , Resultado do Tratamento
9.
Implement Sci ; 13(1): 100, 2018 07 25.
Artigo em Inglês | MEDLINE | ID: mdl-30045737

RESUMO

BACKGROUND: Peripheral venous catheters are the most commonly used invasive devices in hospitals worldwide. Patients can experience multiple adverse events during the insertion, maintenance, and management of these devices. Health professionals aim to resolve the challenges of care variability in the use of peripheral venous catheter through adherence to clinical practice guidelines. The aim of this cluster-randomized controlled trial is to determine the efficacy of a multimodal intervention on incidence of adverse events associated with the use of peripheral venous catheters in adult hospital patients. Additional aims are to analyze the fidelity of nurses and the relationship between contextual factors on the use of best available and the outcomes of the intervention. METHODS: Five public hospitals in the Spanish National Health System, with diverse profiles, including one university hospital and four second-level hospitals, will be included. In total, 20 hospitalization wards will be randomized for this study by ward to one of two groups. Those in the first group receive an intervention that lasts 12 months implementing evidence-based practice in healthcare related to peripheral catheters through a multimodal strategy, which will contain updated and poster protocols insertion, maintenance and removal of peripheral venous catheters, technologies applied to e-learning, feedback on the results, user and family information related to peripheral catheter, and facilitation of the best evidence by face-to-face training session. PRIMARY OUTCOME MEASURES: Incidence of adverse events associated with the use of peripheral venous catheters is measured by assessing hospital records. SECONDARY OUTCOME MEASURES: Nurses' adherence to clinical practice guidelines, clinical outcomes, and the cost of implementing the multimodal intervention. DISCUSSION: Clinical implementation is a complex, multifaceted phenomenon which requires a deep understanding of decision-making, knowledge mobilization, and sense making in routine clinical practice. Likewise, the inclusion of strategies that promote fidelity to recommendations through multicomponent and multimodal intervention must be encouraged. The use of a transfer model could counterbalance one of the greatest challenges for organizations, the evaluation of the impact of the implementation of evidence in the professional context through quality indicators associated with prevention and control of infections. TRIAL REGISTRATION: Current Controlled Trials ISRCTN10438530 . Registered 20 March 2018.


Assuntos
Infecções Relacionadas a Cateter/prevenção & controle , Cateterismo Periférico/métodos , Prática Clínica Baseada em Evidências , Fidelidade a Diretrizes , Hospitais Públicos/organização & administração , Pacotes de Assistência ao Paciente/métodos , Guias de Prática Clínica como Assunto , Adulto , Cateterismo Periférico/efeitos adversos , Hospitais Públicos/normas , Humanos , Aprendizagem , Enfermeiras e Enfermeiros , Pacotes de Assistência ao Paciente/normas
10.
BMJ Open ; 8(2): e020420, 2018 02 08.
Artigo em Inglês | MEDLINE | ID: mdl-29439080

RESUMO

INTRODUCTION: Patients with difficult venous access experience undesirable effects during healthcare, such as delayed diagnosis and initiation of treatment, stress and pain related to the technique and reduced satisfaction. This study aims to identify risk factors with which to model the appearance of difficulty in achieving peripheral venous puncture in hospital treatment. METHODS AND ANALYSIS: Case-control study. We will include adult patients requiring peripheral venous cannulation in eight public hospitals, excluding those in emergency situations and women in childbirth or during puerperium. The nurse who performs the technique will record in an anonymised register variables related to the intervention. Subsequently, a researcher will extract the health variables from the patient's medical history. Patients who present one of the following conditions will be assigned to the case group: two or more failed punctures, need for puncture support, need for central access after failure to achieve peripheral access, or decision to reject the technique. The control group will be obtained from records of patients who do not meet the above conditions. It has been stated a minimum sample size of 2070 patients, 207 cases and 1863 controls.A descriptive analysis will be made of the distribution of the phenomenon. The variables hypothesised to be risk factors for the appearance of difficult venous cannulation will be studied using a logistic regression model. ETHICS AND DISSEMINATION: The study was funded in January 2017 and obtained ethical approval from the Research Ethics Committee of the Balearic Islands. Informed consent will be obtained prior to data collection. Results will be published in a peer-reviewed scientific journal.


Assuntos
Cateterismo Periférico/métodos , Estudos de Casos e Controles , Cateteres Venosos Centrais , Hospitais Públicos , Humanos , Modelos Logísticos , Projetos de Pesquisa , Fatores de Risco , Espanha
11.
Enferm. nefrol ; 20(3): 215-220, jul.-sept. 2017. tab
Artigo em Espanhol | IBECS | ID: ibc-166838

RESUMO

Introducción: Los cuidados paliativos aportan una atención necesaria que promueve una respuesta integral y coordinada del sistema sanitario respetando la autonomía y valores de los pacientes en situación de final de vida. Objetivos: Determinar la prevalencia de necesidad de cuidados paliativos en la unidad de hemodiálisis de nuestro centro mediante el instrumento validado NECPAL CCOMSS-ICO e identificar la situación de complejidad en pacientes con necesidades paliativas usando la herramienta de IDC-Pal. Material y Método: Estudio observacional transversal. Tres enfermeras con formación en cuidados paliativos y en el uso de los cuestionarios NECPAL CCOMS-ICO y el IDC-Pal evaluaron de forma independiente a todos los pacientes de la unidad de crónicos de hemodiálisis. Las evaluaciones fueron realizadas entre los días 6 y 10 de marzo. Las discrepancias se resolvieron consensuando el resultado final entre las tres profesionales. Resultados: Se analizaron a 50 pacientes, con una edad media de 68.24. El perfil de paciente más frecuente fue aquel con un tiempo de permanencia en hemodiálisis de 48,8 meses de media. La enfermedad renal primaria y comorbilidad más prevalente fueron la nefropatía diabética (26%) y la hipertensión arterial (56%) respectivamente. Se identificaron 20 pacientes con necesidad de atención paliativa (40%). Respecto a la evaluación del IDC-Pal, se obtuvieron 19 pacientes en situación de complejidad y 1 en situación de no complejidad. Conclusiones: Las necesidades paliativas complejas sugieren la necesidad de realizar evaluaciones periódicas en las unidades de hemodiálisis, así como un enfoque asistencial multidisciplinar para dar respuesta a las necesidades identificadas (AU)


Introduction: The palliative care provides a necessary attention that promotes a comprehensive response and coordination of the health system respecting the autonomy and values of patients in the end-of-life situation. Aim: To determine the prevalence of the need for palliative care in the hemodialysis unit of our center using the validated instrument NECPAL CCOMSS-ICO and to identify the complexity situation in patients with palliative needs using IDC-Pal. Material and Method: Cross-sectional observational study. Three nurses trained in palliative care and in the use of the NECPAL CCOMS-ICO and IDC-Pal questionnaires independently assessed all patients in the chronic hemodialysis unit. The evaluations were carried out between the 6th and 10th of March. The discrepancies were resolved agreeing the final result among the three professionals. Results: 50 patients were analysed, with a mean age of 68.24. The most frequent patient profile was with a permanence time in hemodialysis of 48.8 months of means. The most prevalent renal disease and comorbidity were diabetic nephropathy (26%) and hypertension (56%), respectively. 20 patients with palliative care (40%) were identified. Regarding the evaluation of the IDC-Pal, 19 patients were obtained in a situation of complexity and 1 in situation of non-complexity. Conclusions: Complex palliative needs suggest the need for periodic evaluations in hemodialysis units, as well as a multidisciplinary care approach to respond to identified needs (AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Determinação de Necessidades de Cuidados de Saúde/organização & administração , Determinação de Necessidades de Cuidados de Saúde/normas , Enfermagem de Cuidados Paliativos na Terminalidade da Vida/organização & administração , Enfermagem em Nefrologia/organização & administração , Insuficiência Renal Crônica/enfermagem , Cuidados Paliativos , Estudos Transversais/métodos , Comorbidade
12.
Metas enferm ; 20(5): 4-9, jun. 2017. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-163755

RESUMO

Objetivo: averiguar los factores asociados con «vía venosa difícil» (VVD) en pacientes adultos atendidos en el servicio de urgencias, así como describir el uso que las enfermeras hacen de las técnicas de punción asistidas por ultrasonido (técnica eco-facilitada -EF- y técnica eco-guiada -EG-) y el grado de éxito de cada una frente a la técnica de canalización tradicional. Método: estudio descriptivo transversal realizado en pacientes adultos con «vía venosa difícil» atendidos en el servicio de urgencias del Hospital de Manacor (Mallorca). La enfermera que realizaba la canalización cumplimentaba un registro anónimo con variables relacionadas con su intervención, con la salud del paciente y con el éxito en cada una de las técnicas. Las pruebas de contraste de hipótesis utilizadas para determinar la asociación fueron la U de Mann-Whitney para variables cuantitativas y Chi cuadrado para categóricas. Resultados: se analizaron 51 casos. Las variables vinculadas a VVD fueron: no encontrar venas a la palpación (72,6%), no encontrar venas visibles (66,7%), historia previa de dificultad (66,7%) y más de dos intentos fallidos de canalización (49%). el factor agudo más común fue la hipotensión (29,4%), los factores crónicos más habituales fueron la obesidad (45,1%), tratamiento con quimioterapia (29,4%) y diabetes (23,5%). En 40 pacientes se utilizó la técnica «ciega» y en 39 casos se usaron técnicas asistidas por ecografía, que resultaron más eficaces que el abordaje habitual (p<0.05). Conclusiones: hay indicios de la existencia de factores asociados a la dificultad en la función periférica, las técnicas ecográficas permiten solucionar eficazmente estos casos provocando menor número de punciones (AU)


Objective: to find out the factors associated with «difficult venous access» (DVA) in adult patients managed at the Emergency Unit, as well as to describe the use by nurses of ultrasound-assisted puncture techniques (ultrasound-assisted (UA) technique and ultrasound-guided (UG) technique), and the degree of success of each one vs. the traditional catheterisation technique. Method: a descriptive transversal study conducted in adult patients with «difficult venous access» seen at the Emergency Unit of the Hospital de Manacor (Majorca). The nurse conducting the catheterization completed an anonymous record with variables associated with their intervention, the health of the patient, and success in each one of the techniques. the contrast hypothesis tests used to determine association were Mann-Whitney’s U for quantitative variables and Square Chi for categorical variables. Results: dirty-one (51) cases were studied. The DVA-associated variables were: not finding veins at palpation (72.6%), not finding visible veins (66.7%), previous history of difficulty (66.7%) and >2 failed catheterization attempts (49%). The most common acute factor was hypotension (29.4%), the most usual chronic factors were obesity (45.1%), chemotherapy treatment (29.4%) and diabetes (23.5%). The «blind» technique was used in 40 patients, and ultrasound-assisted techniques were used in 39 cases, which were more effective than the usual approach (p<0.05). Conclusions: there are signs of the presence of factors associated with difficulty in peripheral puncture; ultrasound techniques offer an effective solution for these cases, leading to a lower number of punctures (AU)


Assuntos
Humanos , Feminino , Masculino , Adulto , Cateterismo Periférico/métodos , Ultrassonografia , Dor/prevenção & controle , Cirurgia Assistida por Computador/métodos , Punções/métodos , Padrões de Prática em Enfermagem , Avaliação em Enfermagem/métodos
13.
Enferm. nefrol ; 20(2): 167-177, abr.-jun. 2017. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-164278

RESUMO

Introducción: La fístula arteriovenosa es el acceso vascular de elección para los tratamientos en hemodiálisis, puncionado periódicamente tres veces por semana. Existen tres tipos de técnicas de punción: en escalera, en área de punción y buttonhole. Las técnicas convencionales son causantes de gran morbilidad a medio y largo plazo, sin embargo, el Buttonhole está asociado a priori a la mejoraría de esos problemas. Objetivo: Comparar la técnica de punción de buttonhole con respecto a las técnicas convencionales para la canulación del acceso vascular en el tratamiento de Hemodiálisis, en función del grado de dolor asociado a la técnica, tasas de infección asociadas y la repercusión sobre la supervivencia del acceso vascular. Material y Método: Revisión bibliográfica narrativa. Se incluyeron estudios experimentales y observacionales en inglés y castellano publicados entre 2010 y 2015, que compararan la técnica de punción convencional respecto a la técnica de punción Buttonhole. Selección inicial por título y resumen. Se utilizaron las escalas CASPe y STROBE para la evaluación metodológica. Resultados: Se identificaron 1.827 estudios, de los que seleccionamos 13 tras el proceso de evaluación crítica. La heterogeneidad de resultados no permite afirmar que ninguna de las técnicas analizadas mejore los resultados en dolor en la punción o supervivencia del acceso, sin embargo, se asocia un aumento de eventos infecciosos con la técnica de Buttonhole. Conclusión: no se han hallado argumentos para asegurar que el Buttonhole pueda ser considerado una técnica de primera elección, debido a la heterogeneidad de las formas de medida de los estudios revisados (AU)


Introduction: The arteriovenous fistula is the standard vascular access for the treatments in hemodialysis, punctured periodically three times per week. There are three types of puncture techniques: ladder, puncture area and buttonhole. Conventional techniques cause great morbidity in the medium and long term, however, a priori, the buttonhole technique is associated to the improvement of those problems. Objective: To compare the buttonhole puncture technique with respect to conventional techniques for vascular access cannulation in the treatment of hemodialysis, depending on the degree of pain associated with the technique, associated infection rates and the repercussion on vascular access survival. Material and Method: Narrative bibliographic review. Experimental and observational studies in English and Spanish published between 2010 and 2015 were included, comparing the conventional puncture technique versus the Buttonhole puncture technique. Initial selection by title and summary. The CASPe and STROBE scales were used for the methodological evaluation. Results: 1.827 studies were identified, of which 13 were selected after the critical evaluation process. The heterogeneity of results does not allow to affirm improvements of any of the techniques analyzed in puncture pain or survival of the access, nevertheless, it is associated an increase of infectious events with the Buttonhole technique. Conclusion: Any arguments have been found to ensure that Buttonhole technique can be considered as first choice due to the heterogeneity of the measurement methods of the reviewed studie (AU)


Assuntos
Humanos , Fístula Arteriovenosa/complicações , Fístula Arteriovenosa/enfermagem , Diálise Renal/enfermagem , Sobrevivência , Infecção/complicações , Infecção/enfermagem , Cateterismo/enfermagem , Manejo da Dor/enfermagem , Enfermagem em Nefrologia/métodos
14.
Enferm. clín. (Ed. impr.) ; 26(4): 238-242, jul.-ago. 2016. tab
Artigo em Espanhol | IBECS | ID: ibc-154890

RESUMO

Objetivos: Como paso previo a estudios de prevalencia más extensos, se diseñó el presente trabajo con el objetivo de conocer la concordancia entre observadores y el tiempo invertido en la evaluación de pacientes usando una herramienta validada para la detección de necesidad de cuidados paliativos. También nos planteamos estimar la prevalencia de pacientes que requieren atención paliativa en una unidad de hospitalización de agudos. Método: Se realizó un estudio observacional transversal, en el que 4 investigadoras (2 médicas y 2 enfermeras) evaluaron de forma independiente todos los pacientes ingresados en una unidad de hospitalización de agudos del hospital de Manacor, Mallorca (España), usando el instrumento NECPAL CCOMS-ICO©, midiendo el tiempo en minutos dedicado a cada evaluación. Otro investigador analizó la historia clínica de los pacientes para el análisis del perfil muestral. Resultados: Cada investigadora evaluó 29 pacientes, 15 hombres y 14 mujeres con una edad media de 74,03±10.25 años. La concordancia entre las cuatro investigadoras fue moderada (Kappa 0,5043) encontrándose mayor concordancia entre enfermeras. El tiempo medio dedicado por paciente fue entre 1,9 y 7,72 minutos. La prevalencia de necesidad de atención paliativa resultó 23,28%. Conclusiones: La concordancia moderada nos orienta a la necesidad de realizar evaluaciones en equipo multidisciplinar. El tiempo invertido en la evaluación resultó de media inferior a 8 minutos, no se identificaron publicaciones que detallasen esta variable. Más del 20% de los pacientes atendidos en la unidad presentaban criterios de necesidad de cuidados paliativos (AU)


Objectives: Previous to wider prevalence studies, we designed the present pilot study to assess concordance and time invested in patient evaluations using a palliative care needs assessment tool. We also sought to estimate the prevalence of palliative care needs in an acute care hospital unit. Methods: A cross-sectional study was carried out, 4 researchers (2 doctors and 2 nurses) independently assessed all inpatients in an acute care hospital unit in Manacor Hospital, Mallorca (Spain), using the validated tool NECPAL CCOMS-ICO©, measuring time invested in every case. Another researcher revised clinical recordings to analise the sample profile. Results: Every researcher assessed 29 patients, 15 men and 14 women, mean age 74,03 ± 10.25 years. 4-observer concordance was moderate (Kappa 0,5043), tuning out to be higher between nurses. Mean time per patient evaluation was 1.9 to 7.72 minutes, depending on researcher. Prevalence of palliative care needs was 23,28%. Conclusions: Moderate concordance lean us towards multidisciplinary shared assessments as a method for future research. Avarage of time invested in evaluations was less than 8 minutes, no previous publications were identified regarding this variable. More than 20% of inpatients of the acute care unit were in need of palliative care (AU)


Assuntos
Humanos , Cuidados Paliativos/organização & administração , Doença Crônica/enfermagem , Enfermagem de Cuidados Paliativos na Terminalidade da Vida/tendências , Determinação de Necessidades de Cuidados de Saúde , Seleção de Pacientes
15.
Enferm Clin ; 26(4): 238-42, 2016.
Artigo em Espanhol | MEDLINE | ID: mdl-26872392

RESUMO

OBJECTIVES: Previous to wider prevalence studies, we designed the present pilot study to assess concordance and time invested in patient evaluations using a palliative care needs assessment tool. We also sought to estimate the prevalence of palliative care needs in an acute care hospital unit. METHODS: A cross-sectional study was carried out, 4 researchers (2 doctors and 2 nurses) independently assessed all inpatients in an acute care hospital unit in Manacor Hospital, Mallorca (Spain), using the validated tool NECPAL CCOMS-ICO©, measuring time invested in every case. Another researcher revised clinical recordings to analise the sample profile. RESULTS: Every researcher assessed 29 patients, 15 men and 14 women, mean age 74,03 ± 10.25 years. 4-observer concordance was moderate (Kappa 0,5043), tuning out to be higher between nurses. Mean time per patient evaluation was 1.9 to 7.72 minutes, depending on researcher. Prevalence of palliative care needs was 23,28%. CONCLUSIONS: Moderate concordance lean us towards multidisciplinary shared assessments as a method for future research. Avarage of time invested in evaluations was less than 8 minutes, no previous publications were identified regarding this variable. More than 20% of inpatients of the acute care unit were in need of palliative care.


Assuntos
Unidades Hospitalares , Cuidados Paliativos , Idoso , Idoso de 80 Anos ou mais , Pré-Escolar , Estudos Transversais , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Espanha
16.
Index enferm ; 24(4): 270-274, oct.-dic. 2015. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-150511

RESUMO

Objetivo: determinar el antiséptico más indicado para la prevención de la infección relacionada con catéteres vasculares durante su inserción y mantenimiento. Metodología: revisión sistemática. Se incluyeron ensayos clínicos aleatorizados en castellano, inglés, portugués y catalán publicados entre 2000-2013, sobre antisépticos en la inserción o mantenimiento de catéteres vasculares en pacientes adultos. Se excluyeron catéteres de diálisis, tunelizados, apósitos y catéteres impregnados, pacientes quemados e inmunodeprimidos. Selección inicial por título y resumen. Se utilizaron las escalas CASPEe y JADAD. 6 revisores seleccionaron y analizaron los estudios de forma independiente, ciega y pareada. Resultados: 77 artículos cumplieron los criterios de inclusión, 6 fueron seleccionados tras la revisión crítica. No se cumplieron criterios de homogeneidad para realizar metaanálisis. Conclusiones: Existen pocos ensayos de calidad que permitan actualizar las recomendaciones de las guías de práctica clínica. Los indicios apuntan a la clorhexidina como antiséptico de elección para el cuidado de catéteres vasculares


Objective: to establish which the most appropriate antiseptic solution is to prevent catheter-related infections when used previous to catheter insertion and continuous skin care. Methods: systematic review. Randomized controlled trials in Spanish, English, Portuguese and Catalonian languages published from 2000-2013, regarding antiseptic solutions for skin care previous to insertion or during catheter site care in adult hospitalized patients were included. Dialysis or tunelized catheters, antiseptic-coated catheters or dressings, burned and immunosuppressed populations were excluded. Initial selection included title and abstract. CASPe and JADAD scales were later used. 6 independent reviewers carried out a blind, peer review analysis. Results: 77 documents fit inclusion criteria, 6 trials were selected after critic review. Homogeneity criteria were insufficient to carry out a meta-analysis. Conclusions: few quality trials have been published during the last 10 years, not allowing guidelines recommendations update. Some evidence points to chlorhexidine alcohol-based solutions as the most suitable agents for catheter care


Assuntos
Humanos , Infecções Relacionadas a Cateter/prevenção & controle , Anti-Infecciosos Locais/uso terapêutico , Enfermagem Baseada em Evidências , Infecção Hospitalar/prevenção & controle , Dispositivos de Acesso Vascular/normas
17.
Metas enferm ; 12(2): 12-18, mar. 2009. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-59515

RESUMO

El dolor es un síntoma prevalente en hemodiálisis, pero pasa frecuentementeinadvertido. Los escasos estudios sobre el dolor en diálisis hacen referencia principalmente al dolor crónico. Objetivos: conocer las características del dolor durante la sesión de hemodiálisis y las del dolor crónico en pacientes que reciben esta terapia, las medidas analgésicas utilizadas y la posible interferencia del dolor en las actividades de la vida diaria (AVDs),así como las diferencias entre los dos tipos de dolor. Diseño: estudio descriptivo y transversal, en el que se incluyeron todos los pacientes mayores de edad que recibían hemodiálisisdurante más de un mes en la Unidad de Hemodiálisis del Hospital de Manacor, entre febrero de 2005 y febrerode 2006. Metodología: valoración del dolor en dos fases: dolor intradialisisy dolor crónico, mediante diversas escalas de medición: McGill Pain Questionnaire (MPQ) para las características cuantitativas y cualitativas del dolor; Escala VisualAnalógica (EVA) para la intensidad del dolor; Índice del Manejo del dolor (PMI) para evaluación de medidas farmacológicas y el Brief Pain Inventory (BPI) para la exploración del dolor en relación con las AVDs. Resultados y conclusiones: se analizaron 27 pacientes (edad media 66,7±13,6) con alta prevalencia de dolor intradiálisis, de intensidad moderada, siendo la causa más frecuente el dolor isquémico. La postura, la modificación de los parámetros de la diálisis, las medidas físicas y el tratamiento farmacológico mejoraban este dolor. La prevalencia de (...) (AU)


Pain is a prevalent symptom in haemodialysis, but frequentlygoes unnoticed. The limited amount of studies dealing with painin dialysis refer mainly to chronic pain.Objectives: to learn about the characteristics of pain duringhaemodialysis sessions and about the chronic pain experiencedby patients undergoing this treatment, analgesic measurestaken and the possible interference of pain with dailylife activities (DLA), as well as the differences between bothtypes of pain.Design: cross-sectional, descriptive study that included alloverage patients who had received haemodialysis for over amonth in the Haemodialysis Unit of the Manacor Hospital betweenfebruary 2005 and february 2006.Methodology: pain assessment in two phases: intradialysispain and chronic pain, using several measurement scales:McGill Pain Questionnaire (MPQ) for quantitative and qualitativecharacteristics of pain; Analog Visual Scale (AVS) forpain intensity; Pain Management Index (PMI) for assessmentof pharmacological measures and the Brief Pain Inventory(BPI) for exploration of pain in relation to DLAs.Results and conclusions: 27 patients (mean age 66,7±13,6)presenting a high prevalence of intradialysis pain, of moderateintensity, and most frequently caused by ischemic pain,were analyzed. Posture, modification of dialysis parameters,physical measures and pharmacological treatment lessenedthe pain. The prevalence of chronic pain was also high, thoughsignificantly less than intrasession pain, and most frequentlyderived from a musculoskeletal origin. Pain intensity wasmild or moderate and was significantly better treated. The durationof dialysis was significantly associated with pain intensityand pain intensity with hyperthyroidism levels. Generalactivity and movement/walking were the DLAs mostaffected by pain (AU)


Assuntos
Humanos , Dor/enfermagem , Diálise Renal/efeitos adversos , Hiperparatireoidismo/complicações , Analgesia/enfermagem , Analgésicos/uso terapêutico , Postura , Cuidados de Enfermagem/métodos
18.
Rev. Soc. Esp. Enferm. Nefrol ; 10(2): 65-71, abr.-jun. 2007. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-76533

RESUMO

El dolor es un síntoma frecuente en los pacientes sometidos a hemodiálisis, influyendo negativamente en su calidad de vida. La mayor accesibilidad a la terapia dialítica, el mayor tiempo de permanencia de los pacientes en los programas de hemodiálisis y el envejecimiento de la población han contribuido a la presencia habitual del dolor en la vida de estas personas. En el presente estudio se evalúa el dolor crónico en una población de hemodiálisis usando instrumentos de valoración validados procedentes de otras disciplinas, que han sido recientemente utilizados en pacientes de hemodiálisis. Un 82.1% de nuestros pacientes afirmaron tener dolor en casa, únicamente 7 pacientes lo negaron, y sólo en el 28.12% de los casos, la Escala Visual Analógica (EVA) usada para averiguar su intensidad, fue 0. Medidas no farmacológicas como el calor, masajes o cambios posturales mostraron una eficacia similar a la del tratamiento con fármacos. El tiempo de permanencia en hemodiálisis y el valor de PTHi se relacionaron estadísticamente con la intensidad del dolor y la descripción cualitativa del mismo, alterando frecuentemente las actividades de la vida diaria de los pacientes, principalmente el desplazamiento/caminar y la actividad general. Estas relaciones, descritas por primera vez en la literatura científica, podrían explicar, en parte, la alta prevalencia de este síntoma y el alto porcentaje de dolor músculo-esquelético referido por nuestros pacientes (AU)


Pain is a frequent symptom in patients undergoing dialysis, having a negative effect on their quality of life. Greater access to dialysis therapy, more time spent by patients on haemodialysis programmes and aging population have contributed to the habitual presence of pain in the life of these people. This study evaluates chronic pain in a population of patients on haemodialysis using validated valuation instruments used in other disciplines, which have been used recently in haemodialysispatients.82.1% of our patients indicated that they felt pain at home, only 7 patients denied having pain and only in 28.12% of cases the Visual Analogue Scale (VAS) used to determine the intensity of pain was zero. Non-pharmacological measures such as heat, massages or changes in posture showed similar efficiency to treatment with drugs. The time spent on haemodialysis and the value of PTHi were related statistically to the intensity of the pain and the qualitative description of it, frequently altering the activities of patients’ daily lives, mainly moving/walking and general activity. These connections, described for the first time in scientific literature, could explain in part the high prevalence of this symptom and the high percentage of muscular-skeletal pain referred by our patients (AU)


Assuntos
Humanos , Diálise Renal/efeitos adversos , Insuficiência Renal Crônica/complicações , Dor Intratável/epidemiologia , /métodos , Analgesia/métodos , Analgésicos/uso terapêutico
19.
Rev. Soc. Esp. Enferm. Nefrol ; 10(1): 14-21, ene.-mar. 2007. tab
Artigo em Espanhol | IBECS | ID: ibc-76525

RESUMO

Enfermería debe disponer de una herramienta que facilite la cumplimentación de los Registros Enfermeros. Se ha elaborado, entre diciembre de 2005 y marzo de 2006 un documento para el registro enfermero de las sesiones de hemodiálisis en una unidad acreditada según la norma ISO9001:2005, teniendo en cuenta el modelo de enfermería utilizado en la institución y usando las medidas externas de control de la calidad que establece dicha normativa. El proceso se dividió en tres fases: a) descriptiva: en las que se encuestó al equipo de enfermería sobre adecuación del registro anterior y aspectos a mejorar b) elaboración del documento y c) fase de control externo, en el que se realizaron, a propuesta del equipo, los cambios pertinentes, y se puso en marcha el documento, para ser sometido a control, a través de auditoria externa. Se sugirieron pequeños cambios para uso definitivo del documento que ha sido concebido como guía para la prestación de cuidados (AU)


Nursing should have a tool to facilitate the completionof Nursing Records. Between December2005 and March 2006, a document was drawn up for keeping nursing records of the haemodialysis sessions in a unit with ISO 9001:2005 recognition, taking into account the nursing model used in the institution and using the external quality control measures established by the above-mentioned standard. The process was divided into three phases: a) descriptive: in which a survey of the nursing team was carried out about the suitability of the previous record system and aspects to be improved b) preparation of the document and c) external control phase, in which the pertinent changes were made, at the team’s proposal, and the document was brought into use, to be subjected to control through external audit. Minor changes were suggested for the definitive use of the document which has been devised as a guide for the provision of care (AU)


Assuntos
Humanos , Registros de Enfermagem , Diálise Renal/normas , Cuidados de Enfermagem/normas , Normas Técnicas , Insuficiência Renal Crônica/terapia , Indicadores de Qualidade em Assistência à Saúde
20.
Rev. Soc. Esp. Enferm. Nefrol ; 9(2): 65-70, abr.-jun. 2006. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-047398

RESUMO

El dolor es un síntoma frecuente en los pacientes sometidos a hemodiálisis (HD), afectando directamente su calidad de vida. Sin embargo, sus características en este tipo de pacientes son poco conocidas y no existen publicaciones previas a este estudio en las que se valore de forma exclusiva el dolor durante una sesión de hemodiálisis. El presente estudio evalúa las características del dolor intradiálisis, incluyendo su prevalencia, intensidad, características cualitativas y medidas aplicadas para su control. Se utilizan para ello escalas de valoración validadas y ampliamente usadas en el control del dolor oncológico, que fueron ampliadas con una encuesta específica en la que se valoran aspectos del dolor relacionados con la propia diálisis, incluyendo temporalidad, frecuencia o influencia de los parámetros del tratamiento. Todo el proceso de recogida de información se realizó durante las sesiones de hemodiálisis. La prevalencia de dolor en HD fue de un 92,1%, sólo en 3 casos (7,89%) el nivel de dolor fue 0. Un 28,9% de los pacientes identificaron el propio procedimiento como causa del dolor, segunda causa más frecuente tras el dolor de origen isquémico. El Índice de Manejo del Dolor (PMI) indicó un claro infra-tratamiento, tanto más acentuado cuanto más intenso era el dolor descrito por el paciente. Sin embargo, las medidas llevadas a cabo durante la hemodiálisis para el control delos episodios de dolor detectados fueron eficaces en un porcentaje razonable, lo que indica que la mayor parte delos episodios de dolor pasan desapercibidos ante nuestros ojos


Pain is a frequent symptom in patients who under go haemodialysis (HD), directly affecting their quality of life. However, its characteristics in this type of patient are not well known and there are no publications prior to this study dedicated exclusively to assessing pain during a haemodialysis session. This study assesses the characteristics of intradialysis pain, including its prevalence, intensity, qualitative characteristics and measures applied to control it. For these purposes, validated valuation scales widely used in the control of oncological pain were used, which were extended with a specific survey that evaluated aspects of pain related to the dialysis itself, including timing, frequency or influence of the treatment parameters. The entire information compilation process took place during the haemodialysis sessions. The prevalence of pain in HD was 92.1%, only in 3 cases (7.89%) was the pain level zero. 28.9% of patients identified the procedure itself as the cause of the pain, the second most frequent cause after pain of ischemic origin. The Pain Management Index (PMI) showed clear under-treatment, which was most marked the more intense the pain described by the patient. However, the measures taken during haemodialysis for the control of the episodes of pain detected were efficient in a reasonable percentage of cases, which indicates that most of the pain episodes are not perceived by us


Assuntos
Humanos , Dor/epidemiologia , Diálise Renal/efeitos adversos , Medição da Dor , Qualidade de Vida , Epidemiologia Descritiva , Inquéritos e Questionários , Insuficiência Renal Crônica/terapia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA