Effectiveness of care transition strategies for colorectal cancer patients: a systematic review and meta-analysis.

INTRODUCTION: Implementing effective strategies to transition care for individuals with colorectal cancer is an important tool to qualify care for affected individuals, as well as contribute to the dispensation of continuous and quality care to patients. OBJECTIVE: To evaluate the effectiveness of strategies to transition from hospital care to the community compared to usual care for colorectal cancer patients to reduce hospital stay, readmissions at 30 days, and visit to the emergency department up to 30 days. METHOD: Systematic review and meta-analysis followed the recommendations of PRISMA statement, with protocol registered in PROSPERO (CRD 42,020,162,249). Searches were carried out in May 2020 in the following databases: PubMed/MEDLINE, LILACS, EMBASE, and Cochrane Central. Meta-analysis was performed using a random-effects model. The measure of effect used for dichotomous outcomes was relative risk, and for continuous outcomes, the difference of means was used, with their confidence intervals of 95%. Heterogeneity was evaluated using inconsistency statistics. RESULTS: Of 631 identified studies, seven studies were included. The meta-analysis of the studies showed a reduction in readmissions at 30 days of 32% and a significant reduction in hospital stay time of approximately one and a half days, both of which were analyzed in favor of the group of care transition interventions. CONCLUSION: The findings showed effective care transition strategies for the transition of colorectal cancer patients, such as post-discharge active surveillance program, standardized protocol of improved recovery, and telephone follow-up. TRIAL REGISTRATION: CRD42020162249.

Simulação realística no transporte intra-hospitalar do recém-nascido: estratégia educativa / Realistic simulation of in-hospital transport of newborns: educational strategy

O presente trabalho aborda o transporte intra-hospitalar de recém-nascidos com estado de gravidade do Centro Cirúrgico Obstétrico (CCO) para os cuidados na Unidade de Terapia Intensiva Neonatal (UTIN). O objetivo geral foi a elaboração de uma intervenção educativa voltada para a equipe de enfermagem do Centro Obstétrico (CO), na modalidade de simulação realística, baseada nas necessidades frente à transferência intra-hospitalar de recém-nascidos com estado de gravidade. Justificou-se o estudo mediante a incidência de intercorrências durante o transporte de recém-nascidos (RN) gravemente enfermos que gira em torno de 20%, sendo os mais frequentes a perda do acesso venoso, extubação acidental, obstrução da cânula endotraqueal, alteração da temperatura corporal e deterioração clínica com necessidade de maior aporte de oxigênio, que podem ser minimizados pela educação permanente. Intercorrências essas, presentes no cenário da pesquisa, apontando a relevância do estudo. Metodologicamente é uma pesquisa descritiva, exploratória, com abordagem qualitativa. O cenário da pesquisa foi uma Maternidade pública, de médio porte, localizado no Estado do Rio de Janeiro. Foi aplicada a técnica de observação não participante (checklist) e um diário de campo, com 18 oportunidades de transporte intra-hospitalar, no período de outubro e dezembro de 2017. Os participantes da pesquisa foram os profissionais de enfermagem que trabalham diretamente na assistência do RN no CCO e que atuam no setor há no mínimo 03 meses, nos plantões diurnos, e os profissionais que aceitaram participar do estudo. Não participaram da pesquisa aqueles que estavam de folga, férias ou afastamentos. A pesquisa foi aprovada pelo comitê de ética sob o parecer nº2.265.963. Foi utilizada a metodologia de análise administrativa de Cury (2012), para o diagnóstico do problema. Nesta fase aplicou-se a Matriz de SWOT e GUT aos resultados, a fim de priorizar as ações educativas, parte integrante do produto de intervenção, identificando as oportunidades, fragilidades e ameaças para a assistência segura. Nos resultados, foram identificados 3 maiores problemas, apresentados em um Ranking e foram considerando em nível 4 e nível 5, compatíveis aos danos graves e gravíssimos para o transporte intra-hospitalar do RN do CCO até a UTIN. Foi realizada a construção de uma estratégia educativa, em forma de simulação realística, mediante a identificação e análise de como ocorre o transporte intra-hospitalar do RN do CCO até a UTIN

The present study deals with the intra-hospital transport of newborns with severity status of the Obstetric Surgical Center (CCO) for care in the Neonatal Intensive Care Unit (NICU). The general objective was the elaboration of an educational intervention directed to the nursing team of the Obstetric Center (CO), in the simulation modality realistic, based on the needs in front of the intra-hospital transfer of newborns with a serious state. The study was justified by the incidence of complications during the transport of severely ill neonates (RN), which is around 20%, with the most frequent being loss of venous access, accidental extubation, obstruction of the endotracheal tube, body temperature and clinical deterioration with a need for greater oxygen supply, which can be minimized by permanent education. These intercurrences, present in the research scenario, pointing out the relevance of the study. Methodologically, it is a descriptive, exploratory research with a qualitative approach. The research scenario was a medium-sized maternity hospital, located in the State of Rio de Janeiro. The non-participant observation technique (checklist) and a field diary with 18 intrahospital transportation opportunities were applied in the period of October and December of 2017. The participants of the research were the nursing professionals who work directly in the care of the newborn in the CCO and that have worked in the sector for at least 03 months, in the daytime shifts, and the professionals who accepted to participate in the study. Those who were on leave, vacation or leave were not included in the survey. The research was approved by the ethics committee under opinion nº2,265,963. The methodology of administrative analysis of Cury (2012) was used to diagnose the problem. At this stage, the SWOT and GUT Matrix was applied to the results, in order to prioritize the educational actions, an integral part of the intervention product, identifying the opportunities, fragilities and threats for the safe attendance. In the results, 3 major problems were identified, presented in a Ranking and were considered in level 4 and level 5, compatible with the serious and serious damages for the inhospital transport of the NB from the CCO to the NICU. The construction of an educational strategy, in the form of a realistic simulation, was carried out through the identification and analysis of how intra-hospital transport of the newborn from the CCO to the NICU occurs

Prototipo de bioingenieria para el traslado y pesaje de pacientes hospitalizados con sobrepeso o movilidad limitada / Prototype of bioengineering for the transfer and weighing inpatient overweight or limited mobility

Objetivo: diseñar, fabricar y realizar pruebas de un prototipo de sistema electromecánico para mejorar la atención a pacientes hospitalizados, con sobrepeso o problemas de movilidad, en los servicios de enfermería. Material y métodos: estudio de investigación experimental, como base de prueba, realizado por los profesores de las facultades de Enfermería de la Universidad Peruana Cayetano Heredia y Ingeniería Mecánica de la Universidad Nacional de Ingeniería. Se partió de la realidad de los servicios de un hospital del Ministerio de Salud-Lima. Resultados: se presentó el prototipo integrando la camilla recta, la balanza electrónica y el sistema de comunicación vía bluetooth, cuyas funcionalidades (lectura de pesos, uso y manejo del sistema integrado) fueron explicadas al personal de la Facultad de Enfermería para su posterior validación con los pacientes. Conclusiones: el prototipo de sistema bioingenieril contribuye a mejorar la calidad de atención en el pesaje y en el traslado de manera segura y cómoda de pacientes hospitalizados y evitar lesiones físicas al personal de salud.

Objetive: Design, manufacture and testing of a prototype of electromechanical system to improve care to hospitalized patients, overweight or problems of mobility in nursing services. Material and Methods: Study of experimental research, as a basis for testing, conducted by professors from the faculties of Nursing of the Cayetano Heredia Peruvian University and Mechanical Engineering of the National University of Engineering. It departed from the reality of the services of a hospital of the Ministry of health-Lima. Results: Presented the prototype integrating the stretcher straight, the electronic scale and the communication system via bluetooth, whose capabilities (weights, use and management of the integrated reading) were explained to the staff of the school of nursing for further validation with patients.Conclusions. The prototype bioingenieril system contributes to improve the quality of care at the weigh-in and in the transfer of safe and comfortable way of hospitalized patients and prevent injury to health personnel.