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Texto & contexto enferm ; 29: e20200119, Jan.-Dec. 2020.
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-1115946


ABSTRACT Objective: to describe the actions performed by nurses from the mobile pre-hospital service before, during, and after consultations and transfers of suspected and/or confirmed patients of Covid-19, and the limitations found by these professionals on reducing exposure to the disease. Method: a descriptive-reflective study about the actions performed by nurses from the mobile pre-hospital service in a capital city in southern Brazil to increase safety during consultations or transfers of suspected and/or confirmed patients of Covid-19. Results: the study allowed us to reflect on the multidimensionality of actions necessary for the prevention and control of the pandemic. Attitudes were identified to ensure instrumental safety in mobile units, professional safety, and patient safety in mobile pre-hospital care. Conclusion: regarding the nurses, concern with the safety of the professionals and patients was identified, since they adopted conducts for the prevention and control of the pandemic through the use of equipment, materials, and preparation of the ambulance. Subjective aspects of the professionals involved must be considered, such as technical and psychological preparation, which is a fundamental aspect both for serving the population and for the safety of the patient and the professional in terms of exposure to the virus.

RESUMEN Objetivo: describir las acciones llevadas a cabo por enfermeros del servicio prehospitalario móvil antes, durante y después de consultas y transferencias de pacientes sospechosos y/o confirmados respecto del Covid-19 y las limitaciones encontradas por estos profesionales para reducir la exposición a la enfermedad. Método: estudio descriptivo-reflexivo sobre las acciones realizadas por enfermeros del servicio móvil prehospitalario en una ciudad capital del sur de Brasil para aumentar la seguridad durante las consultas o transferencias de pacientes sospechosos y / o confirmados de Covid-19. Resultados: el estudio nos permitió reflexionar sobre el carácter multidimensional de las acciones necesarias para la prevención y el control de la pandemia. Se identificaron conductas para garantizar la seguridad instrumental en las unidades móviles, la seguridad profesional y la seguridad del paciente en la atención prehospitalaria móvil. Conclusión: de parte de los enfermeros, se identificó una preocupación por la seguridad de los profesionales y pacientes, ya que adoptaron conductas para la prevención y el control de la pandemia mediante el uso de equipos, materiales y preparación de la ambulancia. Se deben considerar los aspectos subjetivos de los profesionales involucrados, como la preparación técnica y psicológica, que es un aspecto fundamental tanto para atender a la población como para la seguridad del paciente y del profesional en términos de exposición al virus.

RESUMO Objetivo: descrever as ações realizadas por enfermeiros do serviço pré-hospitalar móvel antes, durante e após atendimentos e transferências de pacientes suspeitos e/ou confirmados para Covid-19 e as limitações encontradas por esses profissionais para diminuir a exposição à doença. Método: estudo descritivo-reflexivo acerca das ações realizadas por enfermeiros do serviço pré-hospitalar móvel de uma capital no Sul do Brasil para aumentar a segurança durante os atendimentos ou transferências de pacientes suspeitos e/ou confirmados para Covid-19. Resultados: o estudo permitiu refletir sobre a multidimensionalidade de ações necessárias para prevenção e controle da pandemia. Foram identificadas condutas para garantir a segurança instrumental nas unidades móveis, a segurança profissional e a segurança do paciente em atendimento pré-hospitalar móvel. Conclusão: por parte dos enfermeiros, identificou-se preocupação com a segurança dos profissionais e pacientes, uma vez que adotaram condutas para a prevenção e controle da pandemia mediante a utilização de equipamentos, materiais e preparo da ambulância. Aspectos subjetivos dos profissionais envolvidos devem ser considerados, como o preparo técnico e psicológico, sendo este um aspecto fundamental tanto para o atendimento à população como para a segurança do paciente e do profissional na exposição ao vírus.

Humanos , Enfermagem em Emergência , Infecções por Coronavirus , Pandemias , Segurança do Paciente , Profissionais de Enfermagem , Cuidados de Enfermagem
Am J Emerg Med ; 38(9): 1875-1878, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32739859


INTRODUCTION: Previous studies have identified obesity as a risk factor for difficult IV access, but this has not been studied in the acute trauma setting. The primary objective was to determine if obesity is associated with increased difficulty placing peripheral IVs in trauma patients. Secondary analysis evaluated IV difficulty and associations with nursing self-competence ratings, trauma experience, and patient demographics. METHODS: Prospective, observational study at academic level I trauma center with 58,000 annual visits. Trauma activation patients between January and October of 2016 were included. Each nurse who attempted IV placement, completed anonymous 7 question survey, including trauma experience (years), self-competence and IV difficulty (Likert scales 1-5), and attempts. Demographic and clinical information was retrospectively collected from the EMR and nursing surveys. Descriptive statistics, chi-square tests, and spearman correlations were used. RESULTS: 200 patients included in the study with 185 BMI calculations. 110 overweight (BMI > 25) and 48 obese (BMI > 30). 70 (35%) female, 149 (75%) white, average age 48. Increased BMI and IV difficulty displayed spearman correlation (ρ) of 0.026 (P = 0.72) suggesting against significant association. Increased trauma experience and self-competence ratings significantly correlated with decreased IV difficulty, ρ = -0.173 and -0.162 (P = 0.010 and 0.014). There was no statistically significant association with IV difficulty in regards to patient race, age, sex, or location of IV placement. CONCLUSION: Obesity was not associated with increased difficulty in placing peripheral IVs in trauma activation patients. Nurses with greater trauma experience and higher self-competence ratings, had less difficulty inserting IVs.

Cateterismo Periférico , Obesidade/complicações , Ferimentos e Lesões/terapia , Cateterismo Periférico/efeitos adversos , Competência Clínica , Enfermagem em Emergência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Inquéritos e Questionários , Ferimentos e Lesões/complicações
J Nurs Adm ; 50(7-8): 407-413, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32675478


OBJECTIVE: The aim of this study was to examine current levels of self-reported professional emergency preparedness competence among nurses. In addition, relationships between nurse professional emergency preparedness competence, personal preparation for a disaster, and perceived likelihood of reporting to work after a disaster are examined. BACKGROUND: Evidence suggests wide gaps in nurses' familiarity with the dimensions of professional emergency preparedness competence and their likelihood to report, potentially impacting human life after a disaster. METHODS: An exploratory, cross-sectional survey design was used with a sample of 186 RNs and licensed practical nurses. RESULTS: Results indicate significant weaknesses in nurses' professional emergency preparedness competence. There are positive correlations between likelihood to report, personal preparedness, and professional emergency preparedness competence. CONCLUSIONS: Nurses across the United States lack sufficient competence in professional emergency preparedness. Results demonstrate the need to improve the education of nurses to meet the demands of populations in urgent situations. Action items nurse administrators can take are provided.

Defesa Civil/normas , Competência Clínica , Planejamento em Desastres , Enfermagem em Emergência , Enfermeiras Administradoras/organização & administração , Papel do Profissional de Enfermagem , Estudos Transversais , Feminino , Humanos , Masculino , Autorrelato , Inquéritos e Questionários , Estados Unidos , Recursos Humanos/estatística & dados numéricos
Brain Behav Immun ; 88: 60-65, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32512134


BACKGROUND: The emergency department is considered to be a high-risk area, as it is often the first stop for febrile patients who are subsequently diagnosed with coronavirus disease 2019. This study, which employed a cross-sectional design, aimed to assess the mental health of emergency department medical staff during the epidemic in China. METHODS: Demographic data and mental health measurements were collected by electronic questionnaires from February 28, 2020 to March 18, 2020. OUTCOMES: A total of 14,825 doctors and nurses in 31 provinces of mainland China completed the survey. The prevalence rates of depressive symptoms and post-traumatic stress disorder (PTSD) were 25.2% and 9.1%, respectively. Men were more likely to have depressive symptoms and PTSD than women. Those who were middle aged, worked for fewer years, had longer daily work time, and had lower levels of social support were at a higher risk of developing depressive symptoms and PTSD. Working in the Hubei province was associated with a higher risk of depressive symptoms, while those working in the Hubei province but residing in another province had a lower risk of depressive symptoms and PTSD. Being a nurse was associated with a higher risk of PTSD. INTERPRETATION: The findings suggest that targeted psychological interventions to promote the mental health of medical staff with psychological problems need to be immediately implemented. Special attention should be paid to local medical staff in Hubei.

Infecções por Coronavirus , Depressão/epidemiologia , Medicina de Emergência , Enfermagem em Emergência , Enfermeiras e Enfermeiros/psicologia , Pandemias , Médicos/psicologia , Pneumonia Viral , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adulto , Distribuição por Idade , Betacoronavirus , China/epidemiologia , Depressão/psicologia , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Saúde Mental , Admissão e Escalonamento de Pessoal , Prevalência , Distribuição por Sexo , Apoio Social , Transtornos de Estresse Pós-Traumáticos/psicologia
Epidemiol Health ; 42: e2020030, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32512668


OBJECTIVES: Medication errors (MEs) made by nurses are the most common errors in emergency departments (EDs). Identifying the factors responsible for MEs is crucial in designing optimal strategies for reducing such occurrences. The present study aimed to review the literature describing the prevalence and factors affecting MEs among emergency ward nurses in Iran. METHODS: We searched electronic databases, including the Scientific Information Database, PubMed, Cochrane Library, Web of Science, Scopus, and Google Scholar, for scientific studies conducted among emergency ward nurses in Iran. The studies were restricted to full-text, peer-reviewed studies published from inception to December 2019, in the Persian and English languages, that evaluated MEs among emergency ward nurses in Iran. RESULTS: Eight studies met the inclusion criteria. Most of the nurses (58.9%) had committed MEs only once. The overall mean rate of MEs was 46.2%, and errors made during drug administration accounted for 41.7% of MEs. The most common type of administration error was drug omission (17.8%), followed by administering drugs at the wrong time (17.5%) and at an incorrect dosage (10.6%). The lack of an adequate nursing workforce during shifts and improper nurse-patient ratios were the most critical factors affecting the occurrence of MEs by nurses. CONCLUSIONS: Despite the increased attention on patient safety in Iran, MEs by nurses remain a significant concern in EDs. Therefore, nurse managers and policy-makers must take adequate measures to reduce the incidence of MEs and their potential negative consequences.

Enfermagem em Emergência , Serviço Hospitalar de Emergência , Erros de Medicação/estatística & dados numéricos , Humanos , Irã (Geográfico)
Metas enferm ; 23(5): 61-70, jun. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-194590


OBJETIVO: explorar la importancia que los profesionales de Enfermería de urgencia pre-hospitalaria otorgan a las competencias del puesto, así como a la formación necesaria para adquirir dichas competencias. MÉTODO: estudio descriptivo transversal sobre profesionales de Enfermería de asistencia pre-hospitalaria de las gerencias de emergencias de toda España. Se diseñó, atendiendo a la literatura y al criterio de expertos, un cuestionario autoadministrado ad hoc online, compuesto por 60 competencias distribuidas en 10 dominios (cada competencia era valorada en una escala Likert de 1 a 5 [mejor valoración]). Variables independientes: edad, sexo, tipo de recurso en el que desarrolla su actividad asistencial, nivel formativo en urgencias, duración del título de postgrado y experiencia laboral. Análisis bivariante con pruebas no paramétricas (U de Mann-Whitney y el test de Kruskal-Wallis). RESULTADOS: se obtuvieron 91 respuestas. Las tres competencias mejor valoradas fueron "Ejecutar maniobras de soporte vital" (media: 4,85), "Poseer una actitud de cooperación para el trabajo en equipo" (media: 4,77) y "Exigencia de formación y actualización profesional permanente" (media: 4,74). La importancia atribuida mostró diferencias significativas según sexo en ocho competencias, según tipo de recurso asistencial en el que desempeña su actividad profesional en siete competencias, y según la duración de la formación de postgrado en cuatro competencias. El nivel formativo de postgrado se perfiló como imprescindible. CONCLUSIONES: la importancia atribuida combina, con mayor puntuación, la competencia técnica de ejecutar maniobras de soporte vital, la competencia no técnica de actitud cooperativa con el equipo y la exigencia de formación permanente. La eficacia en el desempeño exige formación de nivel superior al Grado

OBJECTIVE: to explore the importance assigned by pre-hospital emergency nursing professionals to competence in their position, as well as to the training needed to acquire said skills. METHOD: a descriptive cross-sectional study on pre-hospital care nursing professionals from the emergency managements throughout Spain. An ad-hoc self-administered online questionnaire was designed, considering literature and criteria by experts, and consisting of 60 skills distributed into 10 domains (each skill was valued through a Likert scale from 1 to 5 (best valued)). Independent variables: age, gender, type of setting where the activity of care is conducted, training level in emergencies, duration of the post-graduate degree, and work experience. Bivariate analysis was conducted with non-parametric tests (Mann-Whitney's U and Kruskal-Wallis test). RESULTS: in total, 91 answers were retrieved. The three best valued skills were: "Conducting life support manoeuvres" (mean: 4.85), "Having a cooperative attitude for team work"" (mean: 4.77) and "Demand for permanent professional training and update" (mean: 4.74). The importance assigned showed significant differences according to gender in eight skills, depending on type of care setting where they conducted their professional activity in seven skills, and according to the duration of postgraduate training in four skills. Postgraduate training level was considered essential. CONCLUSIONS: the importance assigned combines, with a higher score, the technical skill of conducting life support manoeuvres, the non-technical skill of a cooperative attitude with the team, and the demand for permanent training. Efficacy in performance demands training beyond Degree

Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Papel do Profissional de Enfermagem , Enfermagem em Emergência/métodos , Educação Baseada em Competências/métodos , Atenção Primária à Saúde , Enfermagem em Emergência/organização & administração , Espanha , Estudos Transversais , Estatísticas não Paramétricas , Inquéritos e Questionários
Rev. Rol enferm ; 43(6): 417-428, jun. 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-193667


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

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
Nursing ; 50(6): 58-61, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32453156


Continuous review of current research and practice has resulted in updates to the American Heart Association guidelines for CPR and emergency cardiovascular care. This article examines the recommendations and their implementation into current healthcare practice.

Reanimação Cardiopulmonar/enfermagem , Doenças Cardiovasculares/enfermagem , Enfermagem em Emergência/organização & administração , Primeiros Socorros/enfermagem , Adolescente , Adulto , American Heart Association , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Estados Unidos
Health Qual Life Outcomes ; 18(1): 116, 2020 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-32349759


BACKGROUND: Studies have shown that poor sleep could result in many unpleasant consequences and is prevalent in nurses. Considering the fact of high stress, overwhelming workload and many night shifts in the emergency department in China, this study aimed to evaluate the current status of emergency nurses' sleep quality in public hospitals in Shandong, China and explored its influencing factors. METHODS: A self-administered questionnaire incorporating the Job Content Questionnaire and Pittsburgh Sleep Quality Index (PSQI) was conducted among 4856 emergency nurses in five randomly selected city emergency command systems in Shandong, China. The association of potential influencing factors, including occupational, psychosocial and individual factors, with poor sleep (PSQI> 5) was quantified by multivariate logistic regression analysis. RESULTS: The average PSQI score of 4730 emergency nurses in public hospitals was 8.2 ± 3.9, including 3114 (65.8%) subjects with PSQI > 5 and 2905 (61.4%) > 8; these figures were found highest for 337 emergency nurses in 14 tertiary hospitals with 11.8 ± 4.3, 257 (76.3%) and 232 (68.8%), followed by 1044 emergency nurses in 43 secondary hospitals with 9.5 ± 3.9, 725 (69.4%) and 675 (64.7%) and 3349 emergency nurses in 167 primary hospitals with 7.4 ± 3.5, 2132 (63.7%) and 1998 (59.7%). The following factors were associated with poor sleep: hospital level (tertiary vs. primary, secondary vs. primary), female sex, less of exercise, long work hours per week, many patients in the charge of at night, high monthly night shift frequency (4-6 vs. never, ≥7 vs. never) and high occupational stress. CONCLUSIONS: The sleep quality of emergency nurses in public hospitals in China was poor, especially in tertiary hospitals. Many factors as listed above, especially occupational stress, night shift taking and workload at night, should be considered when improving emergency nurses' sleep quality.

Enfermagem em Emergência/estatística & dados numéricos , Serviço Hospitalar de Emergência/organização & administração , Recursos Humanos de Enfermagem no Hospital/psicologia , Sono/fisiologia , Tolerância ao Trabalho Programado/psicologia , Adulto , China , Estudos Transversais , Feminino , Hospitais Públicos/classificação , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Inquéritos e Questionários
Metas enferm ; 23(3): 16-23, abr. 2020. tab, mapas, graf
Artigo em Espanhol | IBECS | ID: ibc-194507


OBJETIVO: conocer la percepción de los egresados sobre su formación en servicios de urgencias y emergencias y las competencias adquiridas con ella; valorar su satisfacción con la formación recibida y estimar la intención de cursar una hipotética especialidad en Enfermería de Urgencias y Emergencias (EUE) en caso de que estuviese reglada. MÉTODO: estudio descriptivo transversal realizado entre 2017 y 2019 cuya población diana fueron los estudiantes de último curso de Enfermería de las universidades españolas. Se diseñó un cuestionario ad hoc autoadministrado que incluyó variables sociodemográficas, relacionadas con la formación teórica y práctica y con la intención de cursar la Especialidad de Urgencias y Emergencias si existiese. Se realizaron análisis uni y bivariantes. RESULTADOS: participaron 1.529 estudiantes. El 65,9% cursó alguna asignatura relacionada con urgencias y emergencias. La valoración global de la duración de las estancias clínicas, entre quienes las efectuaron, fue de 3,9 sobre 7 en el caso de la rotación hospitalaria y de 3,6 en la rotación extrahospitalaria. Un 28% de los estudiantes refirió no haber adquirido competencias suficientes para trabajar en el primer caso y un 35,9% en el segundo. Cuanto mayor es la duración de la estancia clínica, mayor es la valoración de los alumnos en cuanto a la adquisición de las competencias. Un 53% elegiría la "hipotética" especialidad de EUE vía Enfermera Interna Residente como primera opción sobre resto de opciones actuales. CONCLUSIONES: es necesario un análisis profundo de la aplicación de los planes de estudios del Grado en Enfermería. Los recién egresados tendrían entre sus expectativas la realización de una especialidad en EUE

OBJECTIVE: to understand the perception of graduated students about their education on Emergency Care and the skills acquired through it; to assess their satisfaction with the training received, and estimate their willingness to follow a hypothetical specialty on Emergency Care Nursing (ECN), in case this was regulated. METHOD: a cross-sectional descriptive study conducted between 2017 and 2019; its target population was the last-year students of the Nursing Degree in Spanish universities. A self-administered ad hoc questionnaire was designed, which included sociodemographical variables, as well as variables regarding theoretical and practical training, and about the willingness to follow the Emergency Care specialty if available. Univariate and bivariate analyses were conducted. RESULTS: the study included 1,529 patients; 65.9% of them studied some subject associated with Emergency Care. The overall assessment of the duration of clinical stays, between those involved, was 3.9 out of 7 in the case of hospital rotation, and 3.6 in case of extra-hospital rotation. In total, 28% of students reported that they had not acquired enough skills to work in the first case, and 35.9% in the second case. The longer the duration of the clinical stay, the higher the score assigned by students to the skills acquired. Of these students, 53% would choose the "hypothetical" ECN through Internal Nursing Resident as their first option over the rest of current options. CONCLUSIONS: deep analysis is required regarding the implementation of the education plans for the Nursing Degree. Recent graduates would have an ECN specialty among their education expectations

Humanos , Enfermagem em Emergência/educação , Enfermagem em Emergência/métodos , Educação em Enfermagem , Enfermagem em Emergência/organização & administração , Estudos Transversais , Inquéritos e Questionários
Metas enferm ; 23(3): 65-74, abr. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-194511


OBJETIVO: describir los métodos de identificación, detección y diagnóstico del maltrato a ancianos y valorar su aplicabilidad en el ámbito del servicio de urgencias. MÉTODO: revisión narrativa mediante búsqueda bibliográfica en las bases de datos: PubMed, Cochrane Library, Biblioteca Virtual de Salud y ScienDirect. Se seleccionaron artículos publicados entre 2009-2019, en español e inglés, disponibles a texto completo. Se incluyeron todos aquellos trabajos que tratasen aspectos relacionados con el objetivo principal de este estudio. RESULTADOS: se revisaron un total de 286 referencias bibliográficas. Se seleccionaron un total de 11 manuscritos, con distintos diseños. Se identificaron tres métodos para detectar el maltrato al anciano: reconocer los factores de riesgo, los signos clínicos e indicadores de sospecha más habituales, y la utilización de cuestionarios dirigidos a la víctima y al cuidador. De los instrumentos de detección revisados solo tres fueron validados específicamente para el ámbito de urgencias. CONCLUSIÓN: las herramientas identificadas en este estudio pueden ser de aplicación en el servicio de urgencias, atendiendo a sus características y limitaciones de uso y validez

OBJECTIVE: to describe the methods for screening, detecting and diagnosing elder abuse, and assess their potential implementation in the Emergency Unit setting. METHOD: a narrative review through bibliographic search in the databases: PubMed, Cochrane Library, Biblioteca Virtual de Salud and ScienDirect. Articles published between 2009 and 2019 were selected, in Spanish and English, with full text available. The review included all those articles dealing with aspects associated with the primary objective of the study. RESULTS: in total, 286 bibliographic references were reviewed. Eleven (11) manuscripts were selected in total, with different designs. Three methods to detect elder abuse were identified: detecting the risk factors, the most usual clinical signs and suspicion indicators, and the use of questionnaires targeted to the victim and the caregiver. Only three of the screening tools reviewed had been validated specifically for the Emergency setting. CONCLUSION: the tools identified in this study can be implemented at the Emergency Unit, addressing its characteristics and limitations for use and validity

Humanos , Maus-Tratos ao Idoso/diagnóstico , Serviços Médicos de Emergência , Enfermagem em Emergência/organização & administração , Populações Vulneráveis , Fatores de Risco
Australas Emerg Care ; 23(1): 1-5, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32113919


BACKGROUND: The creation of the safety culture coordinator role within an Australian Local Health District followed a critical incident in one of its emergency departments. As part of the role, it was important to have an understanding of how nurses viewed the term safety culture in order to support them in implementing any changes that would influence their everyday practice. METHODS: A descriptive qualitative design was chosen for the study. Focus groups allowed the perspectives of nurses to be heard and represented. RESULTS: Five themes emerged from the data: defining safety culture, influences of team culture, differences in environmental impact, the reality of reporting incidents and commitment to best practice and patient care. These highlighted the influencing factors that promoted and inhibited a safety culture. CONCLUSION: This study provides a greater understanding of what supports a positive safety culture and the challenges that nurses face. Across the three emergency departments, nurses had similar beliefs about safety culture, with a consensus that safety was everyone's responsibility. This has enabled the safety culture coordinator position to have greater consideration of what initiatives are valued and important in working with nurses to design strategies that influence their safety culture.

Formação de Conceito , Enfermeiras e Enfermeiros/psicologia , Gestão da Segurança , Enfermagem em Emergência/métodos , Enfermagem em Emergência/normas , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/estatística & dados numéricos , Grupos Focais/métodos , Humanos , New South Wales , Enfermeiras e Enfermeiros/estatística & dados numéricos
J Clin Nurs ; 29(13-14): 2352-2362, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32221999


AIM: The aim of this study was to examine the knowledge, perceptions and factors influencing pain assessment and management practices among Australian emergency nurses. BACKGROUND: Pain is the most commonly reported symptom in patients presenting to the emergency department, with over half rating their pain as moderate-to-severe. Patients unable to communicate, such as critically ill intubated patients, are at greater risk of inadequate pain management. DESIGN: This cross-sectional exploratory study used survey methodology to explore knowledge, perceptions and factors influencing pain management practices among Australian emergency nurses. METHODS: Australian emergency nurses were invited to complete an online survey comprising 91 items. The response rate was 450 of 1,488 (30.2%). STROBE guidelines were used in reporting this study. RESULTS: Variations in level of acute pain management knowledge, especially in older, cognitively impaired or mechanically ventilated patients were identified. Poor interprofessional communication, workload and staffing negatively impacted on nurses' intention to administer analgesia. For intubated patients, validated observation pain assessment instruments were rarely used, although respondents recognised the importance of pain management in critically ill patients. CONCLUSIONS: Emergency nurses recognise the importance of pain relief. The ability to nurse-initiate analgesia, education and training in pain management education is variable. Little education is provided on assessing and managing acute pain in elderly, cognitively impaired or mechanically ventilated patients. Use of validated pain assessment instruments to assess pain in critically ill patients is poor. RELEVANCE TO CLINICAL PRACTICE: While pain management is the responsibility of all healthcare professionals, in the emergency department, it is a core role of emergency nursing. This study highlights the variation in ability to nurse-initiate analgesia, level of acute pain knowledge, education and training, and use of validated pain assessment instruments to guide pain management in critically ill intubated patients.

Enfermagem em Emergência/métodos , Manejo da Dor/enfermagem , Medição da Dor/enfermagem , Adulto , Idoso , Austrália , Estado Terminal/enfermagem , Estudos Transversais , Serviço Hospitalar de Emergência/organização & administração , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Inquéritos e Questionários
Br J Nurs ; 29(4): 204-210, 2020 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-32105532


A child presenting with decreased level of conscious (dLOC) is of great concern due to the wide range of possible causes, and potential for death or serious long-term sequelae. It is therefore vital that health professionals can recognise a child with dLOC quickly, intervene appropriately and escalate for senior review as a matter of urgency. This article provides an explanation for the mechanisms of decreased consciousness, outlines the different causative pathologies, and provides a simple and logical approach to the first-line recognition and management that a health professional may apply when faced with such a patient. Illustrative case studies have been included, to demonstrate how children with dLOC may present in clinical practice.

Transtornos da Consciência/enfermagem , Diagnóstico de Enfermagem , Criança , Transtornos da Consciência/epidemiologia , Transtornos da Consciência/fisiopatologia , Diagnóstico Diferencial , Enfermagem em Emergência , Feminino , Humanos , Lactente , Masculino , Papel do Profissional de Enfermagem , Exame Físico/enfermagem
J Forensic Nurs ; 16(1): 22-28, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32068676


INTRODUCTION: The need for trauma care and forensic services is among the top five reasons for seeking healthcare in the United States. Critical aspects of caring for a forensic patient include early recognition of the need for implementing forensic approaches to care: assessment, evidence collection and preservation, and forensic documentation. The intent of this study was to examine fundamental forensic knowledge and perceived ability of graduate-level emergency nurse practitioner students. METHODS: The study was designed to assess fundamental forensic knowledge of graduate-level emergency nurse practitioners using a pretest-and-posttest prospective design utilizing simulation. RESULTS: Students showed an increase in their knowledge of forensic nursing concepts from pretest to posttest (t(39) = 9.63, p < 0.001). In addition, there was an increase in students' perceived ability (confidence) to recognize the forensic aspects of patient care. Two unexpected findings were revealed during debriefing. Although the students were interested in gaining forensic knowledge, they felt it was more important to know when to refer a patient rather than to gain the requisite knowledge to perform forensic functions on their own. Furthermore, students developed an awareness of how their previous clinical experiences influenced their care. CONCLUSION: Findings from this study will inform further development of graduate-level nursing education to include forensic and multidisciplinary simulation exercises.

Competência Clínica , Enfermagem em Emergência , Enfermagem Forense/educação , Profissionais de Enfermagem/educação , Treinamento por Simulação , Avaliação Educacional , Feminino , Humanos , Masculino , Estudos Prospectivos
Nurs Clin North Am ; 55(1): 81-95, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32005368


The Veterans Health Administration Home Based Primary Care (VHA-HBPC) program serves Veterans with complex, chronic conditions. Emergency management is a concern for VHA-HBPC programs. Geographic information system (GIS) mapping has been implemented for local program operations in 30 locations. An evaluation assessed GIS mapping as a tool in emergency management, including frontline nurses' and nurse leaders' experiences. Nurses' roles included making and using maps for preparedness and response. Maps provided valuable information, including locations of vulnerable patients (eg, ventilator dependent), community emergency resources, and environmental threats (eg, hurricane). Nurses' willingness to embrace this new technology and skill set was notable.

Serviços Médicos de Emergência/organização & administração , Enfermagem em Emergência/organização & administração , Sistemas de Informação Geográfica , Serviços de Assistência Domiciliar/organização & administração , Medicina Militar/organização & administração , Papel do Profissional de Enfermagem , Veteranos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atenção Primária à Saúde/organização & administração , Estados Unidos
REME rev. min. enferm ; 24: e1308, fev.2020.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1125485


RESUMO Objetivo: identificar e desenvolver estratégias para o aprimoramento da competência da comunicação em enfermeiros hospitalares. Métodos: estudo exploratório, de abordagem qualitativa do tipo pesquisa intervenção. O cenário foi constituído por uma instituição hospitalar pública de ensino, referência no atendimento em urgências e emergências, situada no interior paulista. A investigação ocorreu de novembro de 2016 a março de 2017, em que participaram 21 enfermeiros. Utilizou-se a técnica de grupo operativo para identificar e desenvolver a competência da comunicação, tendo como suporte para a intervenção um estudo de caso clínico; posteriormente foram realizadas entrevistas individuais para verificar a eficácia da intervenção aplicada. A análise dos dados ocorreu por meio de análise temática indutiva. Resultados: foram realizados sete grupos operativos de aprendizagem, em que os participantes, por meio da intervenção, identificaram estratégias coletivas para melhorar o processo de comunicação, tais como: documentos formalizados; canais de comunicação; reuniões; grupos de discussão multidisciplinar; e o uso das tecnologias de informação e comunicação: Whatsapp. Após a intervenção, os participantes aplicaram as estratégias levantadas no grupo. Conclusão: a implementação de estratégias que possam trazer melhorias para a comunicação no contexto do hospital deve contribuir para a unificação das informações e mais compreensão dos profissionais sobre o seu processo de trabalho, promovendo, assim, transformações na práxis profissional do enfermeiro, bem como nas suas atitudes, tornando-os encorajados e envolvidos com o compromisso ético e político da instituição.

RESUMEN Objetivo: identificar y desarrollar estrategias para mejorar las habilidades de comunicación entre los enfermeros del hospital. Métodos: estudio exploratorio, con enfoque cualitativo, tipo de investigación de intervención. El escenario consistió en un hospital público docente, referente en atención de urgencias y emergencias del interior del estado de São Paulo. La investigación se realizó entre noviembre de 2016 y marzo de 2017 con 21 enfermeros. Para identificar y desarrollar habilidades de comunicaciónse utilizó la técnica grupal operativa; la intervención se basó en un estudio de caso clínico; posteriormente, se realizaron entrevistas individuales para verificar la efectividad de dicha intervención; luego se efectuó el análisis de contenido temático de los datos. Resultados: se formaron siete grupos de aprendizaje operativo y, a través de la intervención, los participantes identificaron estrategias colectivas para mejorar el proceso de comunicación tales como: documentos formalizados, canales de comunicación, reuniones, grupos de discusión multidisciplinarios y tecnologías de información y comunicación: Whatsapp. Después de la intervención, los participantes aplicaron las estrategias planteadas en el grupo. Conclusión: la implementación de estrategias para mejorar la comunicación en el contexto hospitalario podrá llevar a la unificación de la información y mejor comprensión de los profesionales sobre su proceso de trabajo, promover transformaciones en las actitudes y en la práctica profesional de los enfermeros y fomentar su compromiso con la ética y la política de la institución.

ABSTRACT Objective: to identify and develop strategies for improving communication skills in hospital nurses. Methods: exploratory study, with a qualitative approach, type of intervention research. The scenario was constituted by a public teaching hospital, a reference in urgent and emergency care, located in the interior of São Paulo. The investigation took place from November 2016 to March 2017, in which 21 nurses participated. The operative group technique was used to identify and develop communication skills, with a clinical case study as support for the intervention; subsequently, individual interviews were conducted to verify the effectiveness of the applied intervention. Data analysis took place through inductive thematic analysis. Results: seven operational learning groups were carried out, in which the participants, through the intervention, identified collective strategies to improve the communication process, such as: formalized documents; communication channels; meetings; multidisciplinary discussion groups; and the use of information and communication technologies: Whatsapp. After the intervention, the participants applied the strategies raised in the group. Conclusion: the implementation of strategies that can bring improvements to communication in the hospital context should contribute to the unification of information and a better understanding of professionals about their work process, thus promoting transformations in the professional praxis of nurses, as well as in their attitudes, making them encouraged and involved with the institution's ethical and political commitment.

Humanos , Efetividade , Enfermagem em Emergência , Comunicação , Emergências , Serviços Médicos de Emergência/métodos , Assistência Ambulatorial , Compreensão , Informação/métodos
Neonatal Netw ; 39(1): 29-34, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31919291


PURPOSE: To assess the impact of a quality improvement (QI) project to increase nursing staff confidence in responding to neonatal emergencies. DESIGN: Mandatory neonatal emergency in situ scenarios done quarterly. SAMPLE: Bedside NICU nursing staff and the subset of NICU nurses that attend all high-risk deliveries and neonatal emergencies on the obstetrics unit. OUTCOME MEASURES: Confidence levels in responding to neonatal emergencies, demonstrating neonatal resuscitation skills, and communicating effectively during an emergency. RESULTS: Sixty-eight NICU nurses completed the pre- and postintervention surveys. Self-reported confidence levels increased in all areas measured. Overall, the percentage of nursing staff that reported confidence in being able to participate in a neonatal emergency increased from 48 percent to 77 percent.

Reanimação Cardiopulmonar/educação , Emergências/enfermagem , Enfermagem em Emergência/educação , Unidades de Terapia Intensiva Neonatal/organização & administração , Melhoria de Qualidade , Adulto , Competência Clínica , Feminino , Humanos , Recém-Nascido , Masculino , Medição de Risco , Inquéritos e Questionários