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1.
Nurse Pract ; 45(4): 48-54, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32205675

RESUMO

Community-acquired acute kidney injury (CA-AKI) can be a devastating diagnosis for any patient and can increase mortality during hospitalization. There can be long-term consequences for those who survive the initial insult. This article discusses CA-AKI and its implications for APRNs.


Assuntos
Lesão Renal Aguda/enfermagem , Prática Avançada de Enfermagem , Infecções Comunitárias Adquiridas/enfermagem , Lesão Renal Aguda/etiologia , Mortalidade Hospitalar , Humanos , Diagnóstico de Enfermagem , Fatores de Risco , Resultado do Tratamento
2.
Rev Bras Enferm ; 72(2): 476-483, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31017213

RESUMO

OBJECTIVE: To identify and map nursing care to the adult patient with Healthcare-Associated Infections admitted to the Intensive Care Unit. METHOD: Scoping Review, conducted in January 2018, through the search of studies in national and international databases, journals, catalogs of theses and dissertations, and websites of Brazilian health institutions. We included full surveys published in the Portuguese, Spanish or English language; which had as object of study the researched subject, besides manuals and protocols. We analyzed the type of material, year, country, population, method, Level of Evidence, and nursing care. The final sample consisted of 33 publications. RESULTS: Among the nursing care to the patient, hand hygiene was identified, general care in nursing procedures, use of protocols, effective communication and periodic training. CONCLUSION: Identifying patient care with infection was important in order to list methods and reorient nursing activities.


Assuntos
Infecções Comunitárias Adquiridas/enfermagem , Controle de Infecções/normas , Cuidados de Enfermagem/métodos , Brasil , Hospitalização/tendências , Humanos , Controle de Infecções/métodos , Inquéritos e Questionários
3.
Rev. bras. enferm ; 72(2): 476-483, Mar.-Apr. 2019. tab, graf
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-1003465

RESUMO

ABSTRACT Objective: To identify and map nursing care to the adult patient with Healthcare-Associated Infections admitted to the Intensive Care Unit. Method: Scoping Review, conducted in January 2018, through the search of studies in national and international databases, journals, catalogs of theses and dissertations, and websites of Brazilian health institutions. We included full surveys published in the Portuguese, Spanish or English language; which had as object of study the researched subject, besides manuals and protocols. We analyzed the type of material, year, country, population, method, Level of Evidence, and nursing care. The final sample consisted of 33 publications. Results: Among the nursing care to the patient, hand hygiene was identified, general care in nursing procedures, use of protocols, effective communication and periodic training. Conclusion: Identifying patient care with infection was important in order to list methods and reorient nursing activities.


RESUMEN Objetivo: Identificar y asignar los cuidados de enfermería al paciente adulto con Infecciones Relacionadas a la Asistencia a la Salud internado en Unidad de Terapia Intensiva. Método: Scoping Review, realizado en enero de 2018, mediante la búsqueda de estudios en bases de datos, revistas, catálogos de tesis y disertaciones nacionales e internacionales, además de sitios de instituciones brasileñas de salud. Esto incluye la investigación publicada en su totalidad en portugués, español o Inglés; que tenían como objeto de estudio la temática investigada, además de manuales y protocolos. Se analizó el tipo de material, año, país, población, método, Nivel de evidencia, y cuidados de enfermería. La muestra final fue de 33 publicaciones. Resultados: Entre los cuidados de enfermería al paciente, se identificó la higienización de las manos, cuidados generales en los procedimientos de enfermería, utilización de protocolos, comunicación efectiva y entrenamientos periódicos. Conclusión: Identificar los cuidados al paciente con infección fue importante para elencar métodos y reorientar las actividades de la Enfermería.


RESUMO Objetivo: Identificar e mapear os cuidados de enfermagem ao paciente adulto com Infecções Relacionadas à Assistência à Saúde internado em Unidade de Terapia Intensiva. Método: Scoping Review, realizado em janeiro de 2018, mediante busca de estudos em bases de dados, revistas, catálogos de teses e dissertações nacionais e internacionais, além de sites de instituições brasileiras de saúde. Incluem-se pesquisas publicadas na íntegra na língua portuguesa, espanhola ou inglesa; que tinham como objeto de estudo a temática investigada, além de manuais e protocolos. Analisou-se o tipo de material, ano, país, população, método, Nível de Evidência, e cuidados de enfermagem. A amostra final foi de 33 publicações. Resultados: Dentre os cuidados de enfermagem ao paciente, identificou-se a higienização das mãos, cuidados gerais nos procedimentos de enfermagem, utilização de protocolos, comunicação efetiva e treinamentos periódicos. Conclusão: Identificar os cuidados ao paciente com infecção foi importante para elencar métodos e reorientar as atividades da Enfermagem.


Assuntos
Humanos , Controle de Infecções/normas , Infecções Comunitárias Adquiridas/enfermagem , Cuidados de Enfermagem/métodos , Brasil , Inquéritos e Questionários , Controle de Infecções/métodos , Hospitalização/tendências
5.
Intensive Crit Care Nurs ; 31(6): 375-9, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26364123

RESUMO

Programming infusion pumps has been recognised as a high-risk step and a source of adverse events (Nuckols et al., 2008; Hyman, 2010). Literature describing infusion pump loading dose errors and NORepinephrine complications is scarce (Girard et al., 2010). This case study presents the first ever report of an inadvertent overinfusion of NORepinephrine due to the loading dose option on the infusion pump, and resulting cardiac arrest of the patient. A patient was admitted to the emergency room and started on a NORepinephrine infusion inadvertently as a loading dose rather than a primary infusion. Historical values for the loading dose volume to be infused (VTBI) and primary rate were not adjusted during the setup. Eight hours and 58minutes later, the loading dose VTBI reached 0mL and the pump reverted to the historical primary rate of 999mL/hour. The event log showed that 37.1mL of NORepinephrine was infused resulting in an equivalent calculated bolus dose of 1.8mg administered in two minutes. The patient suffered a cardiac arrest and the infusion was stopped. No faults were found with the pump. Herein, we discuss our analysis of the pump event logs and propose further safety strategies and interventions.


Assuntos
Agonistas alfa-Adrenérgicos/administração & dosagem , Parada Cardíaca/induzido quimicamente , Erros de Medicação , Norepinefrina/administração & dosagem , Agonistas alfa-Adrenérgicos/efeitos adversos , Adulto , Infecções Comunitárias Adquiridas/enfermagem , Cuidados Críticos , Humanos , Bombas de Infusão , Masculino , Norepinefrina/efeitos adversos , Pneumonia/enfermagem , Insuficiência Respiratória/enfermagem
6.
Metas enferm ; 18(6): 70-74, jul.-ago. 2015. tab
Artigo em Espanhol | IBECS | ID: ibc-140249

RESUMO

OBJETIVO: identificar las necesidades educativas al alta en pacientes con neumonía adquirida en la comunidad (NAC). MÉTODO: revisión narrativa en la que se realiza una búsqueda bibliográfica de la literatura publicada, desde el año 2000 hasta la actualidad, en las bases de datos Pubmed, CINAHL, Cuiden y Cochrane Library Plus. La búsqueda se efectuó utilizando el lenguaje controlado MeSH, mediante las siguientes palabras clave en inglés: community-acquired pneumonia, patient discharge. Fueron aceptados los artículos que analizaban el consumo de recursos sanitarios posterior al alta hospitalaria (reingresos, consultas a urgencias o mortalidad) y los conocimientos de los pacientes ingresados con NAC. RESULTADOS: fueron analizados 22 estudios que examinaban el consumo de recursos sanitarios posterior al alta hospitalaria (reingresos, consultas a urgencias o mortalidad) y los conocimientos de los pacientes ingresados con NAC. Las principales necesidades educativas del paciente hospitalizado con NAC son las relativas a: hidratación, adherencia al tratamiento farmacológico y vacunas indicadas, conocimiento y control de la enfermedad, actividad física progresiva, abandono de hábitos tóxicos y manejo de las comorbilidades. CONCLUSIONES: las necesidades educativas detectadas deben incluirse en programas educativos previos al alta hospitalaria en pacientes con NAC para mejorar el manejo de la enfermedad y disminuir el consumo de recursos sanitarios posterior al alta


OBJECTIVE: to identify the educational needs at hospital discharge in patients with Community-Acquired Pneumonia (CAP). METHOD: a narrative review where a bibliographic search was conducted on published literature, from year 2000 to the present day, in the Pubmed, CINAHL, Cuiden and Cochrane Library Plus databases. The search was conducted using the MeSH controlled vocabulary, through the following key words in English: community-acquired pneumonia, patient discharge. Articles were accepted on Use of Healthcare Resources after Hospital Discharge (re-hospitalizations, visits to the Emergency Unit or mortality), and knowledge of patients hospitalized with CAP. RESULTS: 22 studies were analyzed, which examined the use of healthcare resources after hospital discharge (re-hospitalizations, visits to the Emergency Unit or Mortality), and the level of knowledge of patients hospitalized with CAP. The main educational needs of patients hospitalized with CAP were those associated with hydration, adherence to pharmacological treatment, and vaccine indications, awareness and monitoring of the disease, progressive physical activity, giving up toxic habits, and management of comorbidities. CONCLUSIONS: the educational needs detected must be included in educational programs previous to hospital discharge in patients with CAP, in order to improve the disease management, and reduce the use of healthcare resources after discharge


Assuntos
Humanos , Pneumonia/enfermagem , Sumários de Alta do Paciente Hospitalar/normas , Infecções Comunitárias Adquiridas/enfermagem , Educação de Pacientes como Assunto , Alta do Paciente/tendências
8.
Nurse Pract ; 38(12): 1-7, 2013 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-24253524

RESUMO

Lean methodology, an evidence-based practice approach adopted from Toyota, is grounded on the pillars of respect for people and continuous improvement. This article describes the use of Lean methodology to improve healthcare outcomes for patients with community-acquired pneumonia. Nurse practitioners and other clinicians should be knowledgeable about this methodology and become leaders in Lean transformation.


Assuntos
Assistência à Saúde/organização & administração , Eficiência Organizacional , Prática Clínica Baseada em Evidências , Gestão da Qualidade Total/métodos , Infecções Comunitárias Adquiridas/enfermagem , Humanos , Liderança , Profissionais de Enfermagem , Avaliação de Resultados em Cuidados de Saúde , Readmissão do Paciente
10.
Nurs Times ; 108(27): 15-7, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22860372

RESUMO

Nurses face several challenges in caring for patients with recurrent episodes of C difficile in the community. This article reports on the development of a clinical pathway to meet the needs of older patients and their families.


Assuntos
Controle de Doenças Transmissíveis/métodos , Infecções Comunitárias Adquiridas/enfermagem , Infecções Comunitárias Adquiridas/prevenção & controle , Enterocolite Pseudomembranosa/enfermagem , Enterocolite Pseudomembranosa/prevenção & controle , Algoritmos , Humanos , Prevenção Secundária
11.
Crit Care Nurs Clin North Am ; 24(3): 431-41, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22920467

RESUMO

Pneumonia affects millions of people every year in the United States. Hospital-acquired pneumonia is associated with a mortality rate as high as 50%. Pneumonia is classified according to where it was acquired or by the infecting organism. This article explores the similarities and differences in three types of pneumonia seen routinely in the intensive care unit: community-acquired pneumonia, ventilator-associated pneumonia, and health care-associated pneumonia.


Assuntos
Infecções Comunitárias Adquiridas/prevenção & controle , Infecção Hospitalar/prevenção & controle , Pneumonia Associada à Ventilação Mecânica/prevenção & controle , Pneumonia/prevenção & controle , Infecções Comunitárias Adquiridas/diagnóstico , Infecções Comunitárias Adquiridas/enfermagem , Infecções Comunitárias Adquiridas/terapia , Infecção Hospitalar/diagnóstico , Infecção Hospitalar/enfermagem , Infecção Hospitalar/terapia , Humanos , Avaliação em Enfermagem , Educação de Pacientes como Assunto , Pneumonia/diagnóstico , Pneumonia/enfermagem , Pneumonia/terapia , Pneumonia Associada à Ventilação Mecânica/diagnóstico , Pneumonia Associada à Ventilação Mecânica/enfermagem , Pneumonia Associada à Ventilação Mecânica/terapia , Fatores de Risco
12.
Br J Nurs ; 21(4): 245-9, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22398939

RESUMO

Streptococcus pneumoniae is a cause of significant morbidity and mortality worldwide. There are many different serotypes of the organism which may be carried by up to 50% of children under the age of 6 years, as well as many adults. The organism is associated with both pneumonia and invasive pneumococcal disease, which may result in septicemia or meningitis. It is also a principal cause of otits media and sinusitis, which are not life-threatening, but generate a lot of discomfort, loss of schooling or working days, and around 60 000 GP consultations per year in the UK. Vaccination is a safe and effective way to prevent this infection from causing significant ill health.


Assuntos
Infecções Comunitárias Adquiridas , Infecções Pneumocócicas , Vacinas Pneumocócicas/uso terapêutico , Streptococcus pneumoniae , Infecções Comunitárias Adquiridas/diagnóstico , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/enfermagem , Humanos , Morbidade , Infecções Pneumocócicas/diagnóstico , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/enfermagem , Reino Unido/epidemiologia
13.
Br J Nurs ; 21(2): 103-6, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22306639

RESUMO

Pneumonia is a significant cause of morbidity and mortality and can affect all age groups although it is the very young and the very old who are most at risk. Pneumonia can be caused by many different organisms and can present as a primary condition or as a complication of other diseases or acute health problems. This article will give an overview of the disease, its symptoms and treatment and will focus primarily on community-acquired pneumonia. Two further articles will look at specific causative organisms, i.e. Streptococcus Pneumoniae and influenza, as well as the preventive strategies for these.


Assuntos
Pulmão/patologia , Pneumonia Bacteriana/patologia , Pneumonia Bacteriana/prevenção & controle , Pneumonia Viral/patologia , Pneumonia Viral/prevenção & controle , Infecções Comunitárias Adquiridas/mortalidade , Infecções Comunitárias Adquiridas/enfermagem , Infecções Comunitárias Adquiridas/patologia , Infecções Comunitárias Adquiridas/prevenção & controle , Humanos , Pulmão/fisiologia , Pneumonia Bacteriana/mortalidade , Pneumonia Bacteriana/enfermagem , Pneumonia Viral/mortalidade , Pneumonia Viral/enfermagem , Fatores de Risco
14.
J Neurosci Nurs ; 43(4): 193-6; quiz 197-8, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21796040

RESUMO

BACKGROUND: Air embolism is a well-published complication arising from central venous catheter use. Literature and case studies provide information regarding clinical sequelae. Preventable mistakes still occur despite following what is considered appropriate protocol. This case report describes the neurological complications likely caused by a cerebral air embolism related to central venous catheter removal. CASE: An 84-year-old man was admitted to the neuroscience critical care unit with acute stroke symptoms and seizures after removal of a central venous catheter. CONCLUSION: There is an abundance of literature describing best practice, complications, and treatment of venous air embolism associated with central line catheter use. Utilization of central venous catheters is increasing. With increased utilization comes the responsibility to improve commonplace knowledge and ensure that practice guidelines and protocols are dependable and consistent.


Assuntos
Cateterismo Venoso Central/enfermagem , Cateteres de Demora/efeitos adversos , Infecções Comunitárias Adquiridas/enfermagem , Remoção de Dispositivo/enfermagem , Embolia Aérea/enfermagem , Embolia Intracraniana/enfermagem , Pneumonia Bacteriana/enfermagem , Sepse/enfermagem , Idoso de 80 Anos ou mais , Cateterismo Venoso Central/efeitos adversos , Cateterismo Venoso Central/instrumentação , Comorbidade , Remoção de Dispositivo/efeitos adversos , Remoção de Dispositivo/instrumentação , Fidelidade a Diretrizes , Humanos , Masculino , Ordens quanto à Conduta (Ética Médica)
16.
AAOHN J ; 59(3): 135-40; quiz 141-2, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21366203

RESUMO

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) skin infections have been common in prisons for more than a decade. However, CA-MRSA as a cause of pneumonia has been reported infrequently. This infection can present with flu-like symptoms and rapidly progress, possibly leading to death in a matter of days. Two cases of MRSA community-acquired pneumonia (CAP) associated with influenza-like illness in correctional officers employed in two separate prisons within the California prison system are presented. Both individuals were previously healthy, but one died of this disease. MRSA is an uncommon, but now recognized, cause of CAP. These cases are notable for their unique presentation and occurrence in non-health care, occupational settings. Prompt diagnosis and intervention by occupational health nurses and physicians are critical to improving outcomes, especially in high-risk settings such as prisons. These worksites need an effective occupational health program to manage MRSA, with adequate training for both employees and inmates.


Assuntos
Doenças Transmissíveis Emergentes , Staphylococcus aureus Resistente à Meticilina , Enfermagem do Trabalho , Prisões , Infecções Estafilocócicas , Doenças Transmissíveis Emergentes/diagnóstico , Doenças Transmissíveis Emergentes/enfermagem , Doenças Transmissíveis Emergentes/prevenção & controle , Infecções Comunitárias Adquiridas/diagnóstico , Infecções Comunitárias Adquiridas/enfermagem , Infecções Comunitárias Adquiridas/prevenção & controle , Educação Continuada em Enfermagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Necrose , Pneumonia Bacteriana/diagnóstico , Pneumonia Bacteriana/enfermagem , Pneumonia Bacteriana/prevenção & controle , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/enfermagem , Infecções Estafilocócicas/prevenção & controle
17.
Prim Health Care Res Dev ; 12(1): 42-51, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21426614

RESUMO

BACKGROUND: Maintaining the principles of asepsis when performing wound care and other invasive procedures is one of the fundamental approaches of preventing healthcare-acquired infection. Such an approach has been advocated for community practitioners. LITERATURE: The performance of an aseptic technique is an under-researched area. The few studies that have been conducted have identified how strict adherence to the technique is difficult and contamination of hands/gloves is common and that community nurses often have a fatalistic view about whether asepsis is possible in a community setting. AIM: The overall aim of this research project was to examine how experienced practitioners have adapted the aseptic technique within a community setting and to what extent the changed procedure still adhered to the principles of asepsis. METHODS: This study used a mixture of non-participant observation and individual semi-structured interviews to examine adherence to the principles of the aseptic technique among the district nurses. Data were collected from one Trust in England with a total of 10 district nurses taking part and 30 aseptic procedures been observed. RESULTS: The results show that almost all of the staff understood the principles of asepsis and had adapted the standard procedure for use in a patient's home. Common challenges included wound cleaning using a single nurse procedure, the contents of the pack and the home environment. The research also identified misconceptions about clean versus aseptic procedures and a lack of training for staff. CONCLUSIONS: This study highlights the challenges of maintaining the principles of asepsis in a home environment and the fact that district nurses are often relied upon to find creative solutions to such challenges. The study also highlights issues around the implementation of evidence-based practice and the need for clearer guidance about how evidence should be used alongside existing procedures.


Assuntos
Assepsia/métodos , Serviços de Saúde Comunitária/métodos , Infecções Comunitárias Adquiridas/prevenção & controle , Meio Ambiente , Profissionais de Enfermagem , Cicatrização , Adulto , Infecções Comunitárias Adquiridas/enfermagem , Inglaterra , Medicina Baseada em Evidências , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa
18.
J Am Acad Nurse Pract ; 23(1): 23-32, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21208331

RESUMO

PURPOSE: To analyze the state of the science of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in the United States to support the integration of current knowledge for primary care nurse practitioners' (PCNP) practice. DATA SOURCES: Published research limited to U.S. studies in MEDLINE, CINAHL, and Cochrane Review from 1950 to the week of September 4, 2008. Investigations were identified through electronic search engines and databases. Manual searches were done of hard copy references in journal articles. Citations and reference lists for English language research studies of CA-MRSA in the United States were reviewed to identify additional research that fit evaluation criteria for this analysis. CONCLUSIONS: Until the late 1990s, healthcare-associated MRSA (HA-MRSA) was the predominant cause of serious infections. Recently, CA-MRSA has caused infections in previously healthy nonhospitalized people. Major demographic and epidemiological differences exist between the two types of resistant bacteria; the emergence of CA-MRSA suggests new implications for primary care. IMPLICATIONS FOR PRACTICE: PCNPs will undoubtedly treat MRSA infections and need a comprehensive understanding of the pathogenicity, diagnosis, and management of CA-MRSA to ensure expedient and appropriate treatment. This will help to prevent invasive disease as a result of improperly treated infections.


Assuntos
Infecções Comunitárias Adquiridas/enfermagem , Staphylococcus aureus Resistente à Meticilina , Profissionais de Enfermagem/tendências , Atenção Primária à Saúde/métodos , Infecções Estafilocócicas/enfermagem , Antibacterianos/uso terapêutico , Competência Clínica , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/prevenção & controle , Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/prevenção & controle , Estados Unidos/epidemiologia
19.
J Wound Ostomy Continence Nurs ; 37(6): 633-8, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-21076263

RESUMO

Infection is a common complication of chronic wounds that delays healing. Community-acquired methicillin-resistant Staphylococcus aureus has emerged as a common pathogen and major impediment to healing affected chronic wounds. Community-acquired methicillin-resistant S aureus is virulent, highly communicable, and difficult to eradicate. Treatment options include incision and drainage, debridement, and systemic antimicrobials. Early aggressive wound management and appropriate antibiotic therapy are considered essential to successful treatment. Facility-specific protocols should be developed to minimize the spread of this organism to the general population, with particular attention focused on protecting patients burdened with chronic wounds. This article reviews current knowledge of community-acquired methicillin-resistant S aureus, focusing on its impact on persons with chronic wounds.


Assuntos
Infecções Comunitárias Adquiridas/enfermagem , Staphylococcus aureus Resistente à Meticilina , Infecções Estafilocócicas/enfermagem , Ferimentos e Lesões/microbiologia , Ferimentos e Lesões/enfermagem , Antibacterianos/uso terapêutico , Doença Crônica , Infecções Comunitárias Adquiridas/transmissão , Desbridamento , Drenagem , Humanos , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/patogenicidade , Infecções Estafilocócicas/transmissão
20.
Med Clin (Barc) ; 135(2): 47-51, 2010 Jun 12.
Artigo em Espanhol | MEDLINE | ID: mdl-20451224

RESUMO

BACKGROUND AND OBJECTIVE: Different scientific societies propose the use of scales of severity and additional criteria (AC) in order to determine the setting for the treatment of Community-Acquired Pneumonia (CAP).The objective of this study is to correlate the risk regarding three clinical prediction rules (PSI, CURB-65 and PSCRUXO-80) and AC with the effectiveness of hospital at home (HaH). PATIENTS AND METHOD: Evaluation of cases of CAP referred from the Emergency Unit to HaH between January 2000 and May 2008. They were classified regarding three risk scales and presence of AC and its association with the effectiveness of HaH during the treatment was analysed. RESULTS: 146 women and 181 men were admitted, (mean age, 60.3 years). The average stay in HaH was 8.6 days. Two patients died, 25 (7.7%) were admitted to hospital, 219 progressed favourably throughout and 81 after overcoming complications. Hospital at Home was effective in 92.3% of total patients. The rate was 85% for those in PSI=IV or V with or without additional criteria; 80% for CURB-65=2 and 77.5% for a PSCURXO-80 score of 10-19. The effectiveness of HaH is inversely related to severity. CONCLUSIONS: Hospital a Home (HaD) is an effective and safe care option for many cases of CAP in which hospital admission is normally recommended on the basis of prediction rule scores or additional admission criteria.


Assuntos
Infecções Comunitárias Adquiridas/terapia , Serviços Hospitalares de Assistência Domiciliar , Pneumonia/terapia , Adulto , Idoso , Antibacterianos/uso terapêutico , Infecções Comunitárias Adquiridas/tratamento farmacológico , Infecções Comunitárias Adquiridas/mortalidade , Infecções Comunitárias Adquiridas/enfermagem , Feminino , Serviços Hospitalares de Assistência Domiciliar/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente , Readmissão do Paciente/estatística & dados numéricos , Pneumonia/tratamento farmacológico , Pneumonia/mortalidade , Pneumonia/enfermagem , Avaliação de Programas e Projetos de Saúde , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Espanha
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