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1.
Nurse Pract ; 44(10): 29-36, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31568028

RESUMO

Dizziness is a common patient complaint with multiple etiologies. Many causes are benign, but NPs should consider red flags for serious differential diagnoses. A systematic patient history and physical exam are crucial to accurately diagnosing conditions related to dizziness. This article reviews common etiologies of dizziness and vertigo, assessment techniques, and treatment options.


Assuntos
Tontura/enfermagem , Vertigem/enfermagem , Diagnóstico Diferencial , Tontura/classificação , Tontura/etiologia , Humanos , Profissionais de Enfermagem , Avaliação em Enfermagem/métodos , Vertigem/etiologia
3.
Rio de Janeiro; s.n; 20190000. 127 p. ilus.
Tese em Português | LILACS, BDENF - Enfermagem | ID: biblio-1025305

RESUMO

Tipologia/Estratificação do produto: A classificação de produção técnica no âmbito deste projeto para a área da enfermagem é T3. Objetivo: Construir um protocolo para o manejo de crianças ventiladas mecanicamente em prona e validar o conteúdo do protocolo com a utilização de juízes. Método: Estudo do tipo metodológico para a validação do conteúdo de um protocolo assistencial, contemplando três etapas: revisão integrativa de literatura, elaboração do protocolo e validação do mesmo com a utilização de sete voluntários como juízes especialistas. Para a seleção dos mesmos, foi utilizada a técnica de amostragem não probabilística chamada "amostragem em bola de neve". Os critérios para compor o time de especialistas foram adaptados com base no sistema de pontuação proposto por Fehring (1994). A concordância entre as respostas dos experts foi obtida por meio do Índice de Validade de Conteúdo (IVC), adotando como o ponto de corte de > ou = 0.80. Resultados: Foram selecionados 16 estudos, a partir da revisão integrativa, que serviram de base para a seleção dos temas que compuseram o protocolo. Cada juiz avaliou um total 49 de itens. A grande maioria deles exibiu IVC de 1 (100%) e nenhum item apresentou IVC < 0,8 (80%). O IVC médio geral do protocolo foi igual a: 0,98 (98%) para clareza de linguagem, 0,99 (99%) para pertinência prática e 0,99 (99%) para relevância teórica. Conclusão, aplicabilidade e impacto: Os resultados dos IVC sugerem a adequação do protocolo para ser utilizado como instrumento norteador da tomada de decisão no processo de cuidar de crianças ventiladas em prona, a ser empregado por todos os profissionais que exercem suas atividades em terapia intensiva pediátrica, em especial, a equipe de enfermagem


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Respiração Artificial/enfermagem , Unidades de Terapia Intensiva Pediátrica , Decúbito Ventral , Avaliação em Enfermagem/métodos
4.
Metas enferm ; 22(4): 72-77, mayo 2019. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-183563

RESUMO

Las repercusiones de las úlceras por presión (UPP) sobre los pacientes en términos de deterioro de salud y percepción de calidad de vida, y en términos económicos sobre los sistemas sanitarios de salud, son grandes. Según el Cuarto Estudio Nacional de Prevalencia realizado por la GNEAUPP los valores de prevalencia de UPP se han duplicado en centros sociosanitarios (CSS), y la localización del talón ha sido la segunda más frecuente en este tipo de centros. El agravamiento de la lesión implica que algunos pacientes requieran asistencia en el ámbito hospitalario. Por esa razón, el propósito del manuscrito es presentar el caso clínico de un varón de 84 años que reside en un CSS, que presenta una UPP de grado III en el talón, cuyo tratamiento se aborda de forma coordinada entre hospitalización a domicilio (HAD) y el CSS donde reside. La enfermera de HAD junto con la enfermera del CSS elaboró un plan de cuidados basado en las necesidades descritas por Henderson y con el lenguaje taxonómico de Enfermería NANDA-NOC-NIC


Pressure ulcers (PUs) have major impact on patients in terms of health deterioration and perception of quality of life, and in economic terms for the public health system. According to the 4th National Prevalence Study conducted by the GNEAUPP, the values of reference for PUs have doubled in socio-sanitary centers (SSCs), and the heel has been the second most frequent PU location in this type of centers. Lesion worsening leads to some patients requiring hospital care. For this reason, the objective of this manuscript is to present the case report of an 84-year-old male patient living in a SSC who presented a Grade III PU in his heel; treatment was addressed in coordination between home hospitalization (HH) and the SSC where he lived. The HH nurse prepared a plan of care together with the SSC nurse, based on the needs described by Henderson, and with the Nursing taxonomic language NANDA-NOC-NIC


Assuntos
Humanos , Masculino , Idoso de 80 Anos ou mais , Níveis de Atenção à Saúde , Lesão por Pressão/terapia , Cicatrização , Qualidade de Vida , Avaliação em Enfermagem/métodos , Terminologia Padronizada em Enfermagem , Diagnóstico de Enfermagem/métodos
5.
Am J Nurs ; 119(5): 34-41, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30985327

RESUMO

: Effective pain assessment is a necessary component of successful pain management and the pursuit of optimal health outcomes for patients of all ages. In the case of children, accurate pain assessment is particularly important, because children exposed to prolonged or repeated acute pain, including procedural pain, are at elevated risk for such adverse outcomes as subsequent medical traumatic stress, more intense response to subsequent pain, and development of chronic pain.As with adults, a child's self-report of pain is considered the most accurate and reliable measure of pain. But the assessment of pain in children is challenging, because presentation is influenced by developmental factors, and children's responses to certain features of pain assessment tools are unlike those commonly observed in adults.The authors describe the three types of assessment used to measure pain intensity in children and the tools developed to address the unique needs of children that employ each. Such tools take into account the child's age as well as special circumstances or conditions, such as ventilation requirements, cognitive impairment, and developmental delay. The authors also discuss the importance of proxy pain reporting by the parent or caregiver and how nurses can improve communication between the child, caregiver, and health care providers, thereby promoting favorable patient outcomes.


Assuntos
Bem-Estar da Criança/psicologia , Dor Crônica/terapia , Avaliação em Enfermagem/métodos , Manejo da Dor/enfermagem , Medição da Dor/enfermagem , Cuidadores/psicologia , Criança , Feminino , Humanos , Masculino , Pais/psicologia
6.
Enferm. glob ; 18(54): 374-385, abr. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-183488

RESUMO

Objetivos: Validar un protocolo de cuidados elaborado para clientes post-angioplastia transluminal coronaria.Métodos: Para validación del protocolo, se utilizó la técnica Delphi, contando con un panel de nueve jueces, todos enfermeros con experiencia en el área de cardiología. Además de la evaluación cualitativa, según preconiza la técnica Delphi, se utilizaron medidas cuantitativas como el índice de validez de contenido y la tasa de concordancia.Resultados: De acuerdo con las sugerencias hechas por los expertos en cada ronda, el documento fue ajustado hasta alcanzar la tasa de concordancia e índice de validez de contenido de por lo menos 0,9, siendo necesarias tres rondas de cuestionarios.Conclusión: El protocolo de validación se considera la herramienta para guiar la práctica de las personas que trabajan en esta área específica


Objetivo: Validar um protocolo de cuidados elaborado para clientes pós-angioplastia transluminal coronariana. Métodos: Para validação do protocolo, foi utilizada a técnica Delphi, contando com um painel de nove juízes, todos enfermeiros com expertise na área de cardiologia. Além da avaliação qualitativa, conforme preconiza a técnica Delphi, utilizou-se medidas quantitativas como o índice de validade de conteúdo e a taxa de concordância. Resultados: De acordo com as sugestões feitas pelos especialistas em cada rodada, o documento foi ajustado até atingir a taxa de concordância e índice de validade de conteúdo de no mínimo 0,9, sendo necessárias três rodadas de questionários. Conclusões: Considera-se o protocolo validado uma ferramenta para nortear a prática do enfermeiro que atua nesta área específica


Objectives: To validate an elaborate care protocol for clients after coronary transluminal angioplasty.Methods: For the validation of the protocol, the Delphi technique was used, counting on a panel of nine judges, all nurses with expertise in the area of cardiology. In addition to the qualitative evaluation, as recommended by the Delphi technique, we used quantitative measures such as the content validity index and the agreement rate.Results: According to the suggestions made by the experts in each round, the document was adjusted to reach the agreement rate and content validity index of at least 0,9, requiring three rounds of questionnaires.Conclusion: The validated protocol is considered a tool to guide the practice of nurses working in this specific area


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Cuidados Pós-Operatórios/enfermagem , Cuidados de Enfermagem/métodos , Angioplastia Coronária com Balão/enfermagem , Avaliação em Enfermagem/métodos , Complicações Pós-Operatórias/prevenção & controle , Planejamento de Assistência ao Paciente/organização & administração , Epidemiologia Descritiva
7.
Nihon Koshu Eisei Zasshi ; 66(3): 121-128, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-30918203

RESUMO

Objectives This report aims to present the community assessment model developed by the Committee on Public Health Nursing (6th term) of the Japanese Association of Public Health. This new model was designed such that it could be applied to a broad range of public health activities. It aims at theorizing public health nurses' practice-based knowledge and sharing it among other public health professionals.Methods The model was developed during seven committee meetings held from October 2014 to September 2017. In the first step, we brainstormed the definition and methods of community assessment and constructed a framework for a literature review. In the second step, information on theories, research, and practice relevant to community assessment was reviewed based on this framework. In the third step, the community assessment model was developed based on the results of the literature review and the practice experience of the committee members. In the last step, we examined the applicability of this model to the practice of occupational health and public health administration.Project activities We defined community assessment as the "skills and methods based on applied science that drive Plan-Do-Check-Action (PDCA) cycles in every activity that aims at achieving a better quality of life (QOL)." We further classified community assessment into two types; comprehensive assessment and targeted assessment. The model underlined that community assessment was a continuous and developmental process that occurs throughout every stage of the PDCA cycle, and that it was oriented toward improving the QOL of community residents. This model also purported that the empirical and scientific intuition, and ethical sensitivity of assessors were among the key determinants of assessment quality.Conclusion The model on community assessment developed in the present study based on the empirical knowledge of public health nurses could be applied to all types of public health activities in communities.


Assuntos
Modelos de Enfermagem , Avaliação em Enfermagem/métodos , Enfermagem em Saúde Pública/organização & administração , Prática de Saúde Pública , Saúde Pública , Sociedades de Enfermagem/organização & administração , Membro de Comitê , Humanos , Disseminação de Informação , Japão , Conhecimento , Qualidade de Vida
8.
J Wound Ostomy Continence Nurs ; 46(2): 150-153, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30844871

RESUMO

PURPOSE: The purpose of this study was to evaluate content validity and feasibility of the Chinese language perineal assessment tool (PAT-C), to assess its use in the clinical setting, and establish an optimal cut point for identifying patients at high risk for incontinence-associated dermatitis (IAD). DESIGN: Psychometric evaluation of existing instrument. SUBJECTS AND SETTING: The sample comprised 440 patients managed in intensive care units of 3 hospitals across the island of Taiwan and an affiliated home care service. One hundred three nurses practicing throughout Taiwan participated in the workshops in the third phase of the experiment. METHODS: The content validity of the PAT-C was evaluated by 3 experienced nurses using the content validity index statistic. We calculated a receiver operating characteristics (ROC) curve to determine a cut point of high-risk IAD. The curve was based on assessment of patients from receiving care from the intensive care unit and home care service of Cathay General Hospital (located in Taipei, New Paipei and Hsinchu). Nurse perceptions on the feasibility of PAT-C were assessed using an investigator-developed survey. RESULTS: Three experienced nurses rated the PAT-C and gave a robust overall content validity index score of 97.22%. The cut point for identifying patients at high risk for developing IAD via ROC curve analysis of 440 patients was 7.5 (sensitivity: 0.85; specificity: 0.79, area under curve: 0.82, P value < .001). One hundred three enrolled nurses attended the workshops and evaluated the feasibility using the PAT-C. Most of the participants considered the PAT-C as necessary (97.90%), 49.7% of participants suggested IAD risk assessment should be implemented by first-line (generalist) nurses, and 40% of participants recommended assessment on a daily basis. CONCLUSIONS: Study findings indicate robust content validity, and results of the investigator survey of nurse perceptions of the PAT-C indicate the potential for its widespread use in the clinical setting. We found that a cut point score 8 or more indicates a high risk for developing IAD.


Assuntos
Avaliação em Enfermagem/normas , Períneo/lesões , Dermatopatias/classificação , Tradução , Idoso , Idoso de 80 Anos ou mais , Área Sob a Curva , Dermatite/classificação , Dermatite/etiologia , Incontinência Fecal/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação em Enfermagem/métodos , Curva ROC , Medição de Risco/métodos , Medição de Risco/normas , Dermatopatias/diagnóstico , Inquéritos e Questionários , Taiwan , Incontinência Urinária/complicações
9.
J Clin Nurs ; 28(11-12): 2285-2295, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30791157

RESUMO

AIM: To elucidate the infrared thermal patterns and temperature readings of the surfaces of surgical wounds for detecting delayed wound healing within four days after surgery. BACKGROUND: The nursing assessment of surgical wounds within the first four days after surgery is commonly based on visual and physical examination. Surgical wounds with delayed healing may be not detected if they do not exhibit signs such as redness or exudate within four days after surgery. DESIGN: This study was conducted using prospective observational design with reference to the STROBE Statement (see Supporting Information Appendix S1) to examine the temperatures of surgical wounds in their natural settings. METHODS: Based on convenience sampling, 60 participants admitted to the colorectal surgical ward for enterostoma closure from January-November 2013 were recruited. RESULTS: Although both infected and noninfected surgical wounds exhibited a significant increase in wound temperature from Days 1-4, the infected wounds revealed a statistically significantly lower temperature than the noninfected ones. Within the infrared thermal images, the infected wounds presented with partial warming of the skin surrounding and along the incision, suggesting that delayed healing could be identified. CONCLUSION: This study demonstrates that delayed wound healing can be detected within the first four days after surgery for early intervention of prevention and treatment before discharge. RELEVANCE TO CLINICAL PRACTICE: This paper provides evidence-based information for healthcare professionals in assessing surgical wounds for delayed healing within the first four days after surgery. The findings herein enable the early detection of delayed wound healing, based on which early intervention of prevention and treatment may be instituted for affected patients before their discharge.


Assuntos
Infecção da Ferida Cirúrgica/diagnóstico , Ferida Cirúrgica/enfermagem , Temperatura Ambiente , Cicatrização , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Avaliação em Enfermagem/métodos , Período Pós-Operatório , Estudos Prospectivos , Infecção da Ferida Cirúrgica/prevenção & controle , Termografia/enfermagem , Adulto Jovem
10.
J Pediatr Nurs ; 44: 9-15, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30683286

RESUMO

The interrater reliability of the Braden Q skin risk assessment scale has never been reported. The purpose of the study was to assess the interrater reliability among pediatric Skin Champion (SC) nurses with the use of the Braden and Braden Q scales. The pilot study included 16 paired SC nurses. Each pair of nurses attempted to assess 8 patients using the Braden and Braden Q scales. However, patient care requirements at the time of the study assessments limited the number slightly. The actual number of assessments with the Braden scale was n = 52 and the Braden Q was n = 63. The Intra-class Correlation Coefficient (ICC) for the Braden scale was 0.894, 95% confidence interval (CI) (0.823, 0.938), which is excellent agreement. The ICC for the Braden Q was 0.726, 95% CI (0.585, 0.824), which is fair to good agreement. Among the six subcategories on the Braden scale, mobility and activity had higher agreement scores among the SC nurses. Among the seven subcategories on the Braden Q scale, mobility and sensory perception had higher agreement scores. Nutrition and friction/shear subcategories on both scales had the lowest agreement scores. Subcategories with the lowest agreement usually have the greatest measurement error. Possible sources of error include unclear definitions of scoring criteria, different clinical data pulled from different locations in the chart. Error can be reduced by clarifying the subcategory definitions and standardizing the data used for the assessment and the location of each data point in the EMR. A high interrater agreement is the goal because it provides confidence that the scale is used reliably to identify high risk patients who require additional care to prevent harmful events.


Assuntos
Avaliação em Enfermagem/métodos , Enfermagem Pediátrica/normas , Lesão por Pressão/enfermagem , Lesão por Pressão/prevenção & controle , Adulto , Criança , Estudos de Coortes , Feminino , Hospitais Pediátricos , Humanos , Masculino , Variações Dependentes do Observador , Enfermagem Pediátrica/tendências , Projetos Piloto , Prognóstico , Medição de Risco , Índice de Gravidade de Doença , Gestão da Qualidade Total , Resultado do Tratamento
11.
Emerg Med J ; 36(2): 66-71, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30327415

RESUMO

OBJECTIVE: To compare the Danish Emergency Process Triage (DEPT) with a quick clinical assessment (Eyeball triage) as predictors of short-term mortality in patients in the emergency department (ED). METHODS: The investigation was designed as a prospective cohort study conducted at North Zealand University Hospital. All patient visits to the ED from September 2013 to December 2013 except minor injuries were included. DEPT was performed by nurses. Eyeball triage was a quick non-systematic clinical assessment based on patient appearance performed by phlebotomists. Both triage methods categorised patients as green (not urgent), yellow, orange or red (most urgent). Primary analysis assessed the association between triage level and 30-day mortality for each triage method. Secondary analyses investigated the relation between triage level and 48-hour mortality as well as the agreement between DEPT and Eyeball triage. RESULTS: A total of 6383 patient visits were included. DEPT was performed for 6290 (98.5%) and Eyeball triage for 6382 (~100%) of the patient visits. Only patients with both triage assessments were included. The hazard ratio (HR) for 48-hour mortality for patients categorised as yellow was 0.9 (95% CI 0.4 to 1.9) for DEPT compared with 4.2 (95% CI 1.2 to 14.6) for Eyeball triage (green is reference). For orange the HR for DEPT was 2.2 (95% CI 1.1 to 4.4) and 17.1 (95% CI 5.1 to 57.1) for Eyeball triage. For red the HR was 30.9 (95% CI 12.3 to 77.4) for DEPT and 128.7 (95% CI 37.9 to 436.8) for Eyeball triage. For 30-day mortality the HR for patients categorised as yellow was 1.7 (95% CI 1.2 to 2.4) for DEPT and 2.4 (95% CI 1.6 to 3.5) for Eyeball triage. For orange the HR was 2.6 (95% CI 1.8 to 3.6) for DEPT and 7.6 (95% CI 5.1 to 11.2) for Eyeball triage, and for red the HR was 19.1 (95% CI 10.4 to 35.2) for DEPT and 27.1 (95% CI 16.9 to 43.5) for Eyeball triage. Agreement between the two systems was poor (kappa 0.05). CONCLUSION: Agreement between formalised triage and clinical assessment is poor. A simple clinical assessment by phlebotomists is superior to a formalised triage system to predict short-term mortality in ED patients.


Assuntos
Avaliação em Enfermagem/normas , Medição de Risco/métodos , Triagem/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Competência Clínica/normas , Estudos de Coortes , Dinamarca , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/tendências , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade/tendências , Avaliação em Enfermagem/métodos , Estudos Prospectivos , Sistema de Registros/estatística & dados numéricos , Medição de Risco/normas , Triagem/métodos
12.
Rev Assoc Med Bras (1992) ; 65(12): 1476-1481, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31994629

RESUMO

OBJECTIVE: Exploring the use of forecasting models and simulation tools to estimate demand and reduce the waiting time of patients in Emergency Departments (EDs). METHODS: The analysis was based on data collected in May 2013 in the ED of Recanto das Emas, Federal District, Brasil, which uses a Manchester Triage System. A total of 100 consecutive patients were included: 70 yellow (70%) and 30 green (30%). Flow patterns, observed waiting time, and inter-arrival times of patients were collected. Process maps, demand, and capacity data were used to build a simulation, which was calibrated against the observed flow times. What-if analysis was conducted to reduce waiting times. RESULTS: Green and yellow patient arrival-time patterns were similar, but inter-arrival times were 5 and 38 minutes, respectively. Wait-time was 14 minutes for yellow patients, and 4 hours for green patients. The physician staff comprised four doctors per shift. A simulation predicted that allocating one more doctor per shift would reduce wait-time to 2.5 hours for green patients, with a small impact in yellow patients' wait-time. Maintaining four doctors and allocating one doctor exclusively for green patients would reduce the waiting time to 1.5 hours for green patients and increase it in 15 minutes for yellow patients. The best simulation scenario employed five doctors per shift, with two doctors exclusively for green patients. CONCLUSION: Waiting times can be reduced by balancing the allocation of doctors to green and yellow patients and matching the availability of doctors to forecasted demand patterns. Simulations of EDs' can be used to generate and test solutions to decrease overcrowding.


Assuntos
Simulação por Computador , Aglomeração , Serviço Hospitalar de Emergência/estatística & dados numéricos , Modelos Teóricos , Listas de Espera , Algoritmos , Brasil , Previsões , Humanos , Avaliação em Enfermagem/métodos , Projetos Piloto , Reprodutibilidade dos Testes , Fatores de Tempo
13.
Neonatal Netw ; 37(5): 319-323, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30567814

RESUMO

There are numerous factors placing neonates at increased risk of developing pressure injuries while hospitalized. Prevention of hospital-acquired pressure injuries in this vulnerable patient population requires early risk identification. Unfortunately, identifying neonates who are at risk of developing pressure injuries is complicated because of the lack of pressure injury risk assessment tools validated for use in neonates. The Braden Q risk assessment scale was adopted by two NICUs within a health care system to aid in identifying neonates at risk of developing a pressure injury. Additionally, the electronic health record was adapted to assist nurses in implementation of appropriate interventions to prevent pressure injuries based on Braden Q subscores.


Assuntos
Enfermagem Neonatal/métodos , Avaliação em Enfermagem/métodos , Lesão por Pressão/diagnóstico , Lesão por Pressão/enfermagem , Medição de Risco/métodos , Feminino , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Masculino , Fatores de Risco , Índice de Gravidade de Doença
14.
Rev Bras Enferm ; 71(6): 3041-3047, 2018.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30517410

RESUMO

OBJECTIVE: To classify the level of risk for foot ulcers in people with diabetes mellitus and identify their main predictive risk factors. METHOD: Exploratory, descriptive study, in which patients were assessed in a municipal ambulatory of São Paulo through nursing consultation, following the guidelines of the International Consensus on the Diabetic Foot. Data were descriptively analyzed. RESULTS: The analyzed population was composed of 50 longevous and retired people, with household income of up to two minimum wages, with dermato-neurofunctional risk factors and unfavorable clinical indicators, and 66% had Risk 1; 16% Risk 2; 6% Risk 3 and 12% Risk 4. Of this analyzed total, 96% never had their feet examined with the Semmes-Weinstein monofilament. CONCLUSION: The data found indicate the importance of careful feet examination in people with diabetes by the nursing staff to identify future risks of ulcers and, thus, prevent them.


Assuntos
Pé Diabético/classificação , Neuropatias Diabéticas/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Instituições de Assistência Ambulatorial/organização & administração , Instituições de Assistência Ambulatorial/estatística & dados numéricos , Feminino , Humanos , Masculino , Programas de Rastreamento/métodos , Programas de Rastreamento/estatística & dados numéricos , Pessoa de Meia-Idade , Avaliação em Enfermagem/métodos , Fatores de Risco
15.
Rev Bras Enferm ; 71(suppl 6): 2837-2842, 2018.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30540064

RESUMO

OBJECTIVE: to report the use experience of convergent healthcare research for developing a nursing care protocol. METHOD: convergent care research developed in university hospital, from July to December 2016, with 27 participants. RESULTS: the stages of the research and its results are described in the steps: conception, instrumentation, screening and analysis. The end result was the nursing care protocol in day zero of hematopoietic stem cell transplantation. CONCLUSION: convergent care research was an appropriate method for developing the care protocol, and an important contribution to the approximation between theory and practice. The nursing care protocol was the result of this study and confirmed both the purpose of the research as a professional Master's in acquiring knowledge aimed at improving professional practice.


Assuntos
Avaliação em Enfermagem/métodos , Desenvolvimento de Programas/métodos , Hospitais Universitários/organização & administração , Humanos
16.
Clin J Oncol Nurs ; 22(6): 8-18, 2018 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-30452021

RESUMO

BACKGROUND: Frailty is defined as a disability in those of advanced age, often with comorbidities, poor nutritional status, cognitive decline, and reduced functional status. OBJECTIVES: The purpose of this article is to discuss the concept of frailty, assess the use of a comprehensive geriatric assessment (CGA), and understand the implications for treatment to maintain or enhance physical, functional, and cognitive health of older adult patients with cancer. METHODS: Literature about frailty in older adult patients diagnosed with cancer was reviewed to determine evidence-based assessment and treatment options. FINDINGS: About half of all older adult patients with cancer experience some degree of frailty. CGA is a useful way to evaluate frailty and the extent of limitations. Many frailty-specific tools have been developed. Evidence-based strategies are available to address limitations associated with frailty in older adult patients with cancer.


Assuntos
Atividades Cotidianas , Fragilidade/diagnóstico , Fragilidade/enfermagem , Avaliação Geriátrica/métodos , Neoplasias/terapia , Avaliação em Enfermagem/métodos , Idoso , Idoso de 80 Anos ou mais , Terapia Combinada , Tomada de Decisões , Medicina Baseada em Evidências , Feminino , Enfermagem Geriátrica/organização & administração , Humanos , Masculino , Determinação de Necessidades de Cuidados de Saúde , Neoplasias/diagnóstico , Índice de Gravidade de Doença
17.
J Pak Med Assoc ; 68(11): 1636-1643, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30410141

RESUMO

OBJECTIVE: To assess the efficacy of theoretical training related to medical errors and patient safety and practical simulation training on students' knowledge and skill levels.. METHODS: This experimental study was conducted from March 28 to May 18, 2016, at nursing department of a university and comprised of students attending the third grade of the nursing school. The subjects were divided into two equal experimental and control groups. The experimental group, among other things, received simulation training that involved a demonstration and subsequent one-to-one practice. Data was collected on a proforma that included demographic information, pretest and post-test scores, checklists for pre-assessments and final assessments related to nursing practices. RESULTS: There were 62 nurses divided into two groups of 31(50%) each. The difference between post-test scores of the concerning theoretical training about medical errors and patient safety was statistically significant (p<0.05). Pre-assessment of the groups concerning practical training on nursing skills and medical errors revealed no statistically significant difference (p>0.05), while there was a significant difference between their final assessments (p<0.05). CONCLUSIONS: Theoretical education increased students' levels of knowledge regarding medical errors and patient safety, and the the practical simulation training reduced malpractices by improving skills.


Assuntos
Bacharelado em Enfermagem/métodos , Erros Médicos/prevenção & controle , Modelos Educacionais , Avaliação em Enfermagem/métodos , Simulação de Paciente , Estudantes de Enfermagem , Feminino , Humanos , Masculino , Estudos Retrospectivos , Turquia , Universidades , Adulto Jovem
18.
J Nurs Adm ; 48(12): 622-628, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30407930

RESUMO

OBJECTIVE: The objective of this study was to determine if patient and family advisors' (PFAs) collaboration in an educational program could increase the empathy levels of intensive care unit (ICU) nurses. BACKGROUND: Data suggest that nurse empathy is on the decline. Ensuring that nurses consistently empathize with patients and families helps create positive patient experiences. METHODS: Thirty nurses participated in a PFA-designed educational intervention using simulation-based role playing. The Toronto Empathy Questionnaire (TEQ) was used to measure empathy before and after the intervention. RESULTS: The TEQ empathy scores increased significantly after nurses completed the PFA-designed educational program. Younger nurses (<30 years) improved on average 3.03 ± 3.6 points compared with older nurses (>30 years), who improved, on average, only 0.43 ± 2.06 points (t24.4 = 2.46, P = .021). For the changes in TEQ scores from preintervention to postintervention, age was significantly associated with improvements in TEQ scores. CONCLUSIONS: Patient and family advisors can positively impact empathy among ICU nurses.


Assuntos
Enfermagem de Cuidados Críticos/organização & administração , Empatia , Papel do Profissional de Enfermagem/psicologia , Avaliação em Enfermagem/métodos , Recursos Humanos de Enfermagem no Hospital/psicologia , Simulação de Paciente , Adulto , Comportamento Cooperativo , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Pesquisa Metodológica em Enfermagem , Recursos Humanos de Enfermagem no Hospital/organização & administração
20.
J Wound Ostomy Continence Nurs ; 45(6): 497-502, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30395123

RESUMO

The purpose of this quality improvement project was to develop an evidence-based protocol designed for pressure injury prevention for neonates and children in a pediatric cardiac care unit located in the Midwestern United States. The ultimate goal of the project was dissemination across all pediatric critical care and acute care inpatient arenas, but the focus of this initial iteration was neonates and children requiring cardiac surgery, extracorporeal support in the form of extracorporeal membranous oxygenation and ventricular assist devices in the cardiac care unit, or cardiac transplantation. A protocol based upon the National Pressure Ulcer Advisory Panel guidelines was developed and implemented in the pediatric cardiac care unit. Pediatric patients were monitored for pressure injury development for 6 months following protocol implementation. During the 40-month preintervention period, 60 hospital-acquired pressure injuries (HAPIs) were observed, 13 of which higher than stage 3. In the 6-month postintervention period, we observed zero HAPI greater than stage 2. We found that development and use of a standardized pressure injury prevention protocol reduced the incidence, prevalence, and severity of HAPIs among patients in our pediatric cardiac care unit.


Assuntos
Unidades de Cuidados Coronarianos/estatística & dados numéricos , Lesão por Pressão/prevenção & controle , Melhoria de Qualidade , Adolescente , Criança , Pré-Escolar , Unidades de Cuidados Coronarianos/organização & administração , Unidades de Cuidados Coronarianos/normas , Humanos , Incidência , Recém-Nascido , Meio-Oeste dos Estados Unidos/epidemiologia , Avaliação em Enfermagem/métodos , Avaliação em Enfermagem/normas , Pediatria/métodos , Pediatria/normas , Lesão por Pressão/epidemiologia
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