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1.
Medicine (Baltimore) ; 99(50): e23108, 2020 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-33327232

RESUMO

To explore the effect of Joanna Briggs Institute (JBI) physical restraint standards in improving physical restraint in critical and emergency department patients.Enrolled 300 critical patients admitted in our hospital's emergency department from January to December 2019: 150 patients admitted January to June 2019 as control group and 150 patients admitted July to December 2019 as observation group. Routine restraints were applied in control group. Emergency department nurses in the observation group received thematic and practical JBI standardized training. This included pre-restraint assessment, principles of physical restraint, informed consent, using a restraint decision-making wheel, and alternatives to physical restraint. The incidence of restraint-associated adverse events (e.g., skin bruising, swelling) and restraint utilization rate were examined between 2 groups.The incidence of adverse events and the restraint utilization rate were significantly lower in the observation group (P < .05).The application of JBI physical restraint standards for emergency department patients can effectively reduce the incidence of adverse events and the restraint utilization rate.


Assuntos
Cuidados Críticos/estatística & dados numéricos , Recursos Humanos de Enfermagem no Hospital/ética , Restrição Física/efeitos adversos , Restrição Física/ética , Estudos de Casos e Controles , Cuidados Críticos/tendências , Enfermagem de Cuidados Críticos/normas , Tomada de Decisões , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Consentimento Livre e Esclarecido , Masculino , Pessoa de Meia-Idade , Avaliação em Enfermagem/métodos , Recursos Humanos de Enfermagem no Hospital/educação , Estudos Prospectivos , Padrões de Referência
2.
Estima (Online) ; 18(1): e1720, jan.-dez. 2020.
Artigo em Português | BDENF - Enfermagem | ID: biblio-1140705

RESUMO

Objetivo: Verificar a concordância interobservador sobre avaliação de feridas utilizando a ferramenta TIME. Métodos: Estudo de caráter exploratório, não experimental com delineamento transversal e abordagem quantitativa. A população foi constituída por graduandos do oitavo, nono e décimo período do curso de bacharelado em enfermagem, matriculados no segundo semestre do ano de 2018. Aula expositiva-dialogada sobre a ferramenta TIME foi elaborada e posta aos participantes. Os graduandos foram direcionados ao hospital de ensino para socialização de casos clínicos e avaliação individual de dez lesões de pele com características clínicas diferentes, no paciente hospitalizado utilizando a ferramenta TIME. Para identificar a concordância entre os discentes na utilização da ferramenta TIME, foi utilizado o coeficiente de concordância Kappa. Resultados: Prevaleceu o número de graduandos que estavam cursando o nono período do curso (80%), sexo feminino (80%), idade média (23,2 anos). Obteve-se que, considerando a classificação Kappa, houve excelência (K= 1,0) na concordância interobservador em todas as etapas da ferramenta TIME. Conclusão: Infere-se que a ferramenta TIME assegura concordância na avaliação de feridas entre graduandos de enfermagem que estão cursando os últimos períodos de curso, podendo contribuir com a melhoria da qualidade do cuidado de enfermagem.


Assuntos
Ferimentos e Lesões , Enfermagem , Benchmarking , Avaliação em Enfermagem
4.
PLoS One ; 15(11): e0241585, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33206672

RESUMO

AIM: This study aimed to investigate the predictors of maternal parenting self-efficacy when the children concerned are in the early years of life. METHOD: A descriptive-analytical research study was carried out among 213 women who were in the early months of the postpartum period and attending healthcare facilities in Irbid, Jordan. The State Anxiety Inventory (SAI) and the Maternal Parenting Self-Efficacy (PMP S-E) tool were used to collect the data. RESULTS: A significant correlation was found between the scores in self-efficacy and the quality of marriage relations (B = 3.56, P = 001), family income (B = 1.97, P = .05), employment (B = 4.027, P = .027), education (B = 2.48, P = .004), and living with extended family (B = 5.28, P = .02). CONCLUSION: The findings of this study show that MPSE is significantly associated with various predictors. These predictors are the mother's education, income, whether she lives with extended family, her quality of marriage, and her employment. Maternal anxiety was found not to be a predictor for MPSE and this may explain other factors such as social support and living with extended family. IMPLICATION: It is essential for nurses to understand maternal parenting self-efficacy, therefore, including the concept of maternal parenting self-efficacy in nursing curricula can help raise awareness of this important concept. Understanding maternal parenting self-efficacy is necessary for nurses to evaluate the mothers' parenting self-efficacy.


Assuntos
Comportamento Materno/psicologia , Avaliação em Enfermagem/métodos , Poder Familiar/psicologia , Cuidado Pós-Natal/métodos , Autoeficácia , Adulto , Pré-Escolar , Escolaridade , Feminino , Humanos , Renda , Lactente , Jordânia , Casamento/psicologia , Mães/psicologia , Psicometria/métodos , Apoio Social , Adulto Jovem
5.
Am J Nurs ; 120(12): 63-66, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33214377

RESUMO

This column is designed to help new nurses in their first year at the bedside-a time of insecurity, growth, and constant challenges-and to offer advice as they learn what it means to be a nurse. This article provides strategies and tips new nurses can use to improve their time management skills.


Assuntos
Bacharelado em Enfermagem , Papel do Profissional de Enfermagem/psicologia , Avaliação em Enfermagem/normas , Registros de Enfermagem/normas , Gerenciamento do Tempo/psicologia , Humanos , Adesão à Medicação , Transferência da Responsabilidade pelo Paciente/normas
6.
Nursing ; 50(11): 24-31, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33009283

RESUMO

Psoriatic arthritis (PsA) is associated with psoriasis, a chronic inflammatory skin disease. About 30% of patients with psoriasis develop PsA, and some of these patients are children and young adults. Because onset can be gradual, PsA signs and symptoms are easily attributed to other causes, especially in younger patients. This article discusses the assessment, pathophysiology, and diagnosis of PsA and informs nurses how best to support patients with PsA.


Assuntos
Artrite Psoriásica/enfermagem , Relações Enfermeiro-Paciente , Apoio Social , Artrite Psoriásica/fisiopatologia , Humanos , Avaliação em Enfermagem , Diagnóstico de Enfermagem , Adulto Jovem
8.
Metas enferm ; 23(7): 61-68, sept. 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-ET2-7119

RESUMO

Se presenta el caso clínico de un varón de 17 años con un osteocondroma antero-lateral en fémur distal derecho de cuatro años de evolución tratado mediante exéresis quirúrgica. Utilizando las 14 necesidades de Virginia Henderson se valoró al sujeto tras la cirugía y se elaboró un plan de cuidados identificando los diagnósticos enfermeros según la taxonomía de la North American Nursing Diagnosis Association (NANDA), los resultados según la Nursing Outcomes Classification (NOC) y las intervenciones enfermeras oportunas, siguiendo la Nursing Intervention Classification (NIC). Tras el alta hospitalaria del paciente se realizó un seguimiento durante tres meses. Se observó una evolución favorable destacando la importancia de efectuar una valoración integral de la persona debido a que se vieron afectadas las dimensiones física, psicológica y social, así como la necesidad de emplear una correcta información referente a su patología, con vocabulario comprensible al tratarse de un adolescente


We present the case report of a male 17-year-old patient with anterolateral osteochondroma in right distal femur with 4-year evolution treated through surgical excision. Using the 14-need theory by Virginia Henderson, the patient was assessed after surgery, and a plan of care was prepared identifying nursing diagnoses according to the taxonomy by the North American Nursing Diagnosis Association (NANDA), outcomes according to the Nursing Outcomes Classification (NOC), and the relevant nursing interventions, following the Nursing Intervention Classification (NIC). After the patient was discharged from hospital, there was 3-month follow-up. A favourable evolution was observed, highlighting the importance of conducting a comprehensive assessment of the person, because there was impact on his physical, psychological and social dimensions, as well as the need for adequate information regarding his condition, with terminology easy to understand by an adolescent


Assuntos
Humanos , Masculino , Adolescente , Osteocondroma/enfermagem , Osteocondroma/cirurgia , Planejamento de Assistência ao Paciente/organização & administração , Joelho/patologia , Joelho/cirurgia , Cuidados de Enfermagem , Avaliação em Enfermagem , Diagnóstico de Enfermagem , Força Muscular/fisiologia
9.
Clin Interv Aging ; 15: 1505-1511, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32921996

RESUMO

Aim: Life expectancy and incidence of cancer among older adults are increasing. The aim of this study was to assess whether routinely used nursing screening tools can predict surgical outcomes in older adults with colorectal cancer. Methods: Data of patients who underwent elective colorectal cancer surgery at Rabin Medical Center during the years 2014-2016 were collected retrospectively. Patients were divided into study group (age 80-89 y), and control group (age 60-69 y) for comparing surgical outcomes and six-month mortality. In the study group, screening tool scores were evaluated as potential predictors of surgical outcomes. These included Malnutrition Universal Screening Tool (MUST), Admission Norton Scale Scores (ANSS), Morse Fall Scale (MFS), and Charlson Co-morbidity Index (CCI). Results: The study group consisted of 77 patients, and the control group consisted of 129 patients. Postoperative mortality and morbidity were similar in both groups. Nursing screening tools did not predict immediate postoperative outcomes in the study group. MUST and CCI were predictors for six-month mortality. CCI score was 9.43±2.44 in those who died within six months from surgery compared to 7.07 ±1.61 in those who were alive after six months (p<0.05). Post-operative complications were not associated with increased 30-day mortality. Advanced grade complications were associated with an increased six-month mortality (RR=1.37, 95% CI 0.95-1.98, p=0.013). Conclusion: Different screening tools for high-risk older adults who are candidates for surgery have been developed, with the caveat of necessitating skilled physicians and resources such as time. Routinely used nursing screening tools may be helpful in better patient selection and informed decision making. These tools, specifically MUST and CCI who were found to predict six-month survival, can be used to additionally identify high-risk patients by the nursing staff and promote further evaluation. This can be a valuable tool in multidisciplinary and patient-centered care.


Assuntos
Neoplasias Colorretais/cirurgia , Cirurgia Colorretal/estatística & dados numéricos , Avaliação em Enfermagem/métodos , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/enfermagem , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Procedimentos Cirúrgicos do Sistema Digestório/efeitos adversos , Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Feminino , Humanos , Incidência , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Estudos Retrospectivos
10.
Rev Bras Enferm ; 73(suppl 2): e20200260, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32965401

RESUMO

OBJECTIVE: to develop a protocol of recommendations for facing dissemination of COVID-19 in Brazilian Nursing Homes. METHOD: a study of experts' recommendations using a structured form applied through the Delphi Technique, obtaining 100% agreement among professionals after four rounds of analysis. The population comprised six nurses members of the Scientific Department of Gerontological Nursing of the Brazilian Association of Nursing (Associação Brasileira de Enfermagem). RESULTS: the protocol was structured in a nucleus of nursing interventions to face the spread of COVID-19 in Nursing Homes, consisting of 8 actions. FINAL CONSIDERATIONS: the protocol can help nurse managers to organize assistance to face the pandemic, which can be adaptable to each reality, making training nurses and health teams easier.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Instituição de Longa Permanência para Idosos , Avaliação em Enfermagem/métodos , Casas de Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Adulto , Idoso , Brasil/epidemiologia , Comunicação , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/enfermagem , Infecções por Coronavirus/transmissão , Técnica Delfos , Desinfecção/métodos , Desinfecção/normas , Família , Feminino , Enfermagem Geriátrica , Educação em Saúde , Humanos , Masculino , Eliminação de Resíduos de Serviços de Saúde/métodos , Pessoa de Meia-Idade , Práticas Mortuárias/métodos , Avaliação em Enfermagem/organização & administração , Avaliação em Enfermagem/normas , Saúde do Trabalhador , Isolamento de Pacientes , Pneumonia Viral/epidemiologia , Pneumonia Viral/enfermagem , Pneumonia Viral/transmissão
11.
Nursing ; 50(10): 48-53, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32956203

RESUMO

A dramatic shift in adolescent risks and behaviors in recent years threatens adolescents' mental well-being more than ever. This article explores vulnerable adolescent populations, describes the importance of nurses in all categories of assessment for adolescent mental health, and identifies assessment strategies and immediate interventions for successful outcomes.


Assuntos
Transtornos Mentais/enfermagem , Avaliação em Enfermagem , Populações Vulneráveis/psicologia , Adolescente , Humanos , Suicídio/prevenção & controle , Populações Vulneráveis/estatística & dados numéricos
12.
Scand J Trauma Resusc Emerg Med ; 28(1): 81, 2020 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-32807224

RESUMO

BACKGROUND: In Sweden, the rapid emergency triage and treatment system (RETTS-A) is used in the pre-hospital setting. With RETTS-A, patients triaged to the lowest level could safely be referred to a lower level of care. The national early warning score (NEWS) has also shown promising results internationally. However, a knowledge gap in optimal triage in the pre-hospital setting persists. This study aimed to evaluate RETTS-A performance, compare RETTS-A with NEWS and NEWS 2, and evaluate the emergency medical service (EMS) nurse's field assessment with the physician's final hospital diagnosis. METHODS: A prospective, observational study including patients (≥16 years old) transported to hospital by the Gothenburg EMS in 2016. Three comparisons were made: 1) Combined RETTS-A levels orange and red (high acuity) compared to a predefined reference emergency, 2) RETTS-A high acuity compared to NEWS and NEWS 2 score ≥ 5, and 3) Classification of pre-hospital nurse's field assessment compared to hospital physician's diagnosis. Outcomes of the time-sensitive conditions, mortality and hospitalisation were examined. The statistical tests included Mann-Whitney U test and Fisher's exact test, and several binary classification tests were determined. RESULTS: Overall, 4465 patients were included (median age 69 years; 52% women). High acuity RETTS-A triage showed a sensitivity of 81% in prediction of the reference patient with a specificity of 64%. Sensitivity in detecting a time-sensitive condition was highest with RETTS-A (73%), compared with NEWS (37%) and NEWS 2 (35%), and specificity was highest with NEWS 2 (83%) when compared with RETTS-A (54%). The negative predictive value was higher in RETTS-A (94%) compared to NEWS (91%) and NEWS 2 (92%). Eleven per cent of the final diagnoses were classified as time-sensitive while the nurse's field assessment was appropriate in 84% of these cases. CONCLUSIONS: In the pre-hospital triage of EMS patients, RETTS-A showed sensitivity that was twice as high as that of both NEWS and NEWS 2 in detecting time-sensitive conditions, at the expense of lower specificity. However, the proportion of correctly classified low risk triaged patients (green/yellow) was higher in RETTS-A. The nurse's field assessment of time-sensitive conditions was appropriate in the majority of cases.


Assuntos
Serviços Médicos de Emergência , Avaliação em Enfermagem , Gravidade do Paciente , Idoso , Feminino , Humanos , Masculino , Valor Preditivo dos Testes , Estudos Prospectivos , Amostragem , Sensibilidade e Especificidade , Suécia , Triagem
13.
Int J Nurs Pract ; 26(5): e12875, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32671969

RESUMO

AIM: To identify factors influencing readiness for hospital discharge among Chinese patients having undergone a laryngectomy and to provide evidence for developing future processes. BACKGROUND: Laryngectomy changes the functional and psychological state of laryngeal cancer patients considerably. However, influencing factors for discharge readiness among laryngectomy patients have hardly been investigated. METHODS: A descriptive, cross-sectional design was used with Meleis' transitions theory as a guiding framework. This survey-based study was performed with 212 laryngeal cancer patients undergoing laryngectomy at a regional tertiary medical centre between August 2012 and September 2013. RESULTS: Quality of discharge teaching and having a designated caregiver after discharge were found to influence patients' readiness for discharge. CONCLUSION: Clinical interventions such as nursing assessment on discharge readiness, assistance to coordinate postdischarge support and individualized follow-up planning should be integrated into future clinical processes in China. However, further investigations are needed to systematically align relevant results before clinical practices in Chinese settings are eventually changed.


Assuntos
Laringectomia , Alta do Paciente , Adulto , Assistência ao Convalescente , Idoso , China , Estudos Transversais , Feminino , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação em Enfermagem , Inquéritos e Questionários
15.
Rev. Rol enferm ; 43(6): 417-428, jun. 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-193667

RESUMO

OBJETIVO: Implementación informática del sistema de Valoración Enfermera de la Urgencia Pediátrica en Atención Primaria (VEUPAP). DISEÑO: El desarrollo de la aplicación informática de VEUPAP siguió las siguientes fases: 1. Diseño de salidas y entradas al sistema necesarias para asegurar esas salidas. 2. Programación de los algoritmos y vínculos de enlace a partir de las entradas de datos para obtener las salidas de información esperadas. 3. Obtención de versión tentativa del VEUPAP informatizado, puesta a punto y prueba piloto de su funcionamiento con las modificaciones y ajustes hasta lograr su versión definitiva. RESULTADOS: VEUPAP en versión informática para ordenador personal en entorno operativo Windows Microsoft NT Professional, con la visión general de los campos de valoración que lo conforman, especificidades de entradas de cada campo e informe clínico tipo de salida. CONCLUSIONES: VEUPAP computarizado con incorporación a la historia clínica informatizada de Atención Primaria hace transparentes y accesibles todos los datos del proceso de la actividad clínica enfermera en cuidados pediátricos urgentes, permitiendo que sean conocidos y puedan ser empleados por todos los profesionales de la atención primaria. La huella de información generada por VEUPAP permite seguir su evolución y valorar su impacto en el manejo enfermero de las urgencias pediátricas en atención primaria, con la consiguiente evaluación de la posibilidad de su extensión a nuevos campos. La implementación de VEUPAP automatizado en la práctica diaria permitiría protocolizar y desarrollar áreas de atención enfermera finalista e incorporar sistemas taxonómicos enfermeros que, en función de la prioridad asignada y considerando el diagnóstico concreto del paciente, posibiliten gradar las intervenciones específicas que permitan alcanzar los resultados óptimos en cuidados enfermeros esperados


OBJECTIVE: Design of the informatic version of the VEUPAP system (Nurse Pediatric Emergency Assessment of Primary Care). DESIGN: The development of computer application VEUPAP followed three stages: 1. Design outputs and inputs necessary to the system to ensure those outings. 2. Data entry procedures and their programming algorithms to obtain the expected outputs. 3 Getting initial computerized version for VEUPAP, its set-up and pilot proof with modifications and adjustments to achieve final version. RESULTS: Automatized VEUPAP on personal computer with Microsoft Windows NT Professional operating system, with a general overview of the fields that comprise valuation, specificities of entries in each field and clinical report type output. CONCLUSIONS: Computerized VEUPAP linked with clinical history of primary care allows that all data process of nurse clinical activity in urgent pediatric care be transparent and accessible, allowing be known and be used by all professionals in primary care. The footprint of information generated by VEUPAP allows monitor progress and assess their impact on the nursing management of pediatric emergencies in primary care, with subsequent evaluation of the possibility of its extension to new fields. The implementation of automated VEUPAP in daily practice allows to develop areas of care nurse finalist and incorporate nursing taxonomic systems, depending on the assigned priority and considering the specific diagnosis of the patient, enable to graduate specific interventions to achieve optimal results in nursing care


Assuntos
Humanos , Avaliação em Enfermagem/métodos , Enfermagem Pediátrica/métodos , Atenção Primária à Saúde , Enfermagem Primária , Informática em Enfermagem/métodos , Avaliação em Enfermagem/organização & administração , Informática em Enfermagem/instrumentação , Enfermagem em Emergência/organização & administração
16.
Nursing ; 50(7): 54-60, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32558792

RESUMO

The prognosis for a patient with multiple organ dysfunction syndrome (MODS)-also known as organ dysfunction or organ failure-is grave, and mortality can be high when three or more organ systems fail. This article reviews ongoing abnormalities of organ-specific parameters and a bedside clinical scoring assessment tool to identify the mortality of MODS, focusing on the management of MODS resulting from cardiogenic shock in ICU patients who require support of failing organs to survive.


Assuntos
Insuficiência de Múltiplos Órgãos/enfermagem , Choque Cardiogênico/enfermagem , Humanos , Unidades de Terapia Intensiva , Insuficiência de Múltiplos Órgãos/etiologia , Insuficiência de Múltiplos Órgãos/mortalidade , Insuficiência de Múltiplos Órgãos/fisiopatologia , Avaliação em Enfermagem , Diagnóstico de Enfermagem , Testes Imediatos , Choque Cardiogênico/complicações
17.
Hu Li Za Zhi ; 67(3): 14-22, 2020 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-32495325

RESUMO

Delirium is a common clinical problem among adult patients receiving care in intensive care units (ICU). In recent years, several guidelines for the diagnosis, treatments, and care of ICU adult patient's delirium have been published with the objective of assisting clinical care teams to address the issue of delirium more effectively. In order to improve the understanding of delirium among ICU nursing staffs, the prevalence and common types of delirium in adult ICU settings are introduced in this article. In addition, recently published articles are synthesized to demonstrate the pathophysiological mechanisms of delirium, introduce the predictive assessment model of risk factors and two commonly used behavioral screening assessment tools, and describe the approach to conducting physiological assessments in delirium patients with acute and critical illnesses.


Assuntos
Enfermagem de Cuidados Críticos , Delírio/enfermagem , Delírio/fisiopatologia , Avaliação em Enfermagem , Adulto , Estado Terminal , Humanos , Unidades de Terapia Intensiva , Fatores de Risco
18.
Crit Care Nurs Q ; 43(3): 312-336, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32433072

RESUMO

Delirium is a manifestation of brain injury or acute and generalized dysfunction of the upper cerebral cortical processes. In this way, it is important to analyze delirium more broadly as a symptom to understand and intervene taking into account that it is manifesting the presence of brain lesions whose consequences are deleterious to the neurological performance of patients. This article is intended to present a comprehensive approach of delirium analyzed from a symptom perspective and from theoretical and conceptual structure, such as the Dynamic Symptoms Model, specific to the nursing practice. A literature review related to delirium and components of Dynamic Symptoms Model was carried out. We searched the MEDLINE, ScienceDirect, SciELO, and Scopus databases using the terms Delirium, Intensive Care Units, Nursing, and Risk Factor. The existing literature provides evidence of the antecedents, experience, interventions, interactions, and consequences of delirium, which are components of the Model. Thus, the analysis from the Dynamic Symptoms Model perspective bears relevance and contributes to the understanding and approach of delirium.


Assuntos
Delírio/fisiopatologia , Avaliação em Enfermagem , Teoria de Enfermagem , Enfermagem de Cuidados Críticos , Delírio/diagnóstico , Humanos , Unidades de Terapia Intensiva , Fatores de Risco
19.
Artigo em Inglês | MEDLINE | ID: mdl-32392838

RESUMO

Nursing documentation is an important proxy of the quality of care, and quality indicators in nursing assessment can be used to assess and improve the quality of care in health care institutions. The study aims to evaluate the completeness and the accuracy of nursing assessment, analyzing the compilation of pain assessment and nutritional status (body mass index (BMI)) in computerized nursing records, and how it is influenced by four variables: nurse to patient ratio, diagnosis related group weight (DRG), seniority of charge nurse, and type of ward (medical, surgical or other). The observational ecological pilot study was conducted between September and October 2018 in an Italian Tertiary-Level Teaching Hospital. The nursing documentation analyzed for the 'Assessment' phase included 12,513 records, 50.4% concerning pain assessment, and 45% BMI. The nurse-patient ratio showed a significant direct association with the assessment of nutritional status (p = 0.032). The average weight DRG has a negative influence on pain and BMI assessment; the surgical units positively correlate with the compilation of nursing assessment (BMI and pain). The nursing process is an essential component for the continuous improvement in the quality of care. Nurses need to be accountable to improve their knowledge and skills in nursing documentation.


Assuntos
Avaliação em Enfermagem , Registros de Enfermagem , Qualidade da Assistência à Saúde , Hospitais , Humanos , Medição da Dor , Projetos Piloto
20.
J Clin Nurs ; 29(15-16): 2927-2944, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32380572

RESUMO

AIM: To identify how activity and mobility lead to pressure ulcer development, using two objective assessments, one for mobility and one for early pressure ulcer detection. METHODS: 150 older persons from long-term settings were followed up for 20 days, using an observational, quantitative, prospective study design. The study was conducted in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology statement. Visual skin assessment and sub-epidermal moisture assessments were undertaken daily. Activity was measured using the Braden subscale. Further, a mobility profile of the participants was identified using a piezoelectric motion sensor which provided a "movement score" (mean number of movements/hour). Movement scores from 22 healthy participants were also measured to better understand the mobility profile in a healthy population. RESULTS: Pressure ulcer incidence using visual skin assessment was 12.7% (low movers = 6.7%; high movers = 6%) and 78.7% using sub-epidermal moisture assessment (low movers = 40.0%; high movers = 38.7%). Sub-epidermal moisture assessment detected pressure ulcers on average 8.2 days before they appeared visually on the skin's surface. Pressure ulcer detection was 25 times greater using sub-epidermal moisture compared to visual skin assessment. Considering the results of the "movement level" assessment using the motion sensor technology, of all those who were determined to be immobile by Braden, 18.8% were assessed as high movers. DISCUSSION & CONCLUSION: Pressure ulcers occurred both in low and high movers, which was unexpected as a similar finding has not been previously reported in the literature. RELEVANCE TO CLINICAL PRACTICE: The traditional focus on low movers/immobile individuals may detract from the identification of those making an abnormally high frequency of unsafe movements. Pressure ulcer assessment can be enhanced through a combination of sub-epidermal moisture assessment and visual skin assessment, and through the identification of both individuals with impaired mobility and those abnormally high movements, such as among those who are agitated.


Assuntos
Limitação da Mobilidade , Avaliação em Enfermagem/métodos , Lesão por Pressão/prevenção & controle , Higiene da Pele/enfermagem , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Lesão por Pressão/diagnóstico , Estudos Prospectivos , Fatores de Risco
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