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1.
Emergencias (Sant Vicenç dels Horts) ; 31(6): 385-390, dic. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-ET2-3123

RESUMO

Objetivos. El tiempo es un factor clave en el tratamiento y pronóstico del ictus. Nuestro centro ha implementado un protocolo de Actuación Rápida Puerta Aguja (ARPA) para optimizar los tiempos de reperfusión. Este protocolo intrahospitalario consiste en tratar a los pacientes derivados por código ictus (CI) directamente en el escáner o en la sala de angiografía movilizando al equipo de ictus. Los objetivos son evaluar el impacto del protocolo ARPA en los tiempos de reperfusión, y valorar la viabilidad y seguridad de incorporar un enfermero de la unidad de ictus (UI) al equipo de ictus para la asistencia a pacientes CI, así como la satisfacción de los profesionales. Método. Estudio descriptivo de pacientes atendidos en el circuito CI entre marzo 2015 y marzo 2018. Se compararon con el periodo previo entre febrero 2014 y febrero 2015. Resultados. Se atendieron 903 pacientes con el protocolo ARPA y recibieron tratamiento de reperfusión 502 pacientes (55,6%). La mediana de tiempo puerta-aguja para fibrinolisis fue de 24 (18-33) minutos y puerta-punción para trombectomía 39 (20-75) minutos, ambos inferiores (p < 0,001) al periodo anterior, que tuvo unos tiempos de 43 (31-66) y 93 (60-150) minutos, respectivamente. El enfermero atendió los CI durante 25 (20-32) minutos, y no se encontraron problemas graves de seguridad o viabilidad. Veinte profesionales (95%) refirieron que el protocolo ARPA aumentaba su carga de trabajo pero consideraron que se debía seguir aplicando. Conclusiones. El tratamiento de pacientes CI directamente en el escáner o en la sala de angiografía incorporando un enfermero de la UI reduce, de forma segura, los tiempos de reperfusión


Background and objectives. The timing of treatment is a key prognostic factor in stroke. Our hospital implemented a rapid-action time-to-intervention protocol to optimize reperfusion times. The protocol consisted of direct transfer of stroke-code patients to the scanner or angiosuite and mobilization of the stroke team. Our aim was to assess the impact of the protocol on times to reperfusion. We also sought to evaluate the feasibility and safety of including a stroke-team nurse and assess staff satisfaction with the protocol. Methods. Descriptive study of patients attended by the hospital stroke team between March 2015 and March 2018. Outcomes were compared to those for the previous period (February 2014 to February 2015). Results. Nine hundred three patients were attended under the rapid-action protocol; 502 of them (55.6%) underwent reperfusion. The median (interquartile range) door-to-needle or groin access times were 24 (18-33) minutes for fibrinolysis and 39 (20-75) minutes for thrombectomy. Both times were significantly shorter than in the earlier period (43 [31-66] and 93 [60-150] minutes, respectively; P<.001). Median duration of nurse attendance was 25 (20-32) minutes during the implementation period, and no problems of feasibility or safety appeared during nurse attendance. Twenty staff members (95%) reported that the rapid-action protocol increased their workload but they felt it warranted continued application. Conclusion. Direct transfer of stroke patients for scanning or to the angiography suite, with nurse attendance, safely reduced reperfusion times


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Fatores de Tempo , Acidente Vascular Cerebral/diagnóstico , Reperfusão/métodos , Protocolos Clínicos , Cuidados de Enfermagem , Estudos Transversais , Inquéritos e Questionários , Relações Enfermeiro-Paciente , Monitorização Hemodinâmica , Trombectomia , Fibrinólise , Acidente Vascular Cerebral/classificação , Recursos Humanos de Enfermagem/estatística & dados numéricos
2.
Nurs Res ; 68(6): 439-444, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31693549

RESUMO

BACKGROUND: Nursing presence has been developed as a distinct concept with identifiable behaviors but remains only partially defined as a quantifiable construct. OBJECTIVES: This study asked if the Presence of Nursing Scale (PONS) is a reliable and valid instrument to measure nursing presence from the patient's perspective. METHODS: A convenience sample of 75 adult acute care inpatients were verbally administered the 25-item PONS considering the registered nurse taking care of them on the day of data collection. Open-ended questions elicited the patients' explanations of their ratings. They also rated their overall satisfaction with the nursing care provided by the subject nurse using a 5-point scale. RESULTS: The mean PONS score was 104.5 (SD = 17.26) on the 25-125 scale. Instrument reliability reported as a Cronbach's alpha coefficient of .95 was .94 in this study. Instrument validity was tested correlating PONS scores to the satisfaction rating. The Spearman's rho correlation was large and statistically significant, r (73) = .708. The higher the PONS score, the more satisfied the patient was with care from that nurse. Nineteen narratives selected from the lower quartile PONS scores (PONS < 99) and 11 from the upper quartile (PONS > 116) were thematically analyzed. Lower PONS scores corresponded with themes of patients being objectified as the work of the nurse without a respectful and caring nurse-patient relationship. Higher PONS scores coincided with patients' perceptions of enhanced nurse-patient rapport, feelings of better coping, and decreased anxiety. DISCUSSION: These results demonstrate reliability and validity of the PONS and add to the body of evidence about nurse behaviors exhibited in the nurse-patient relationship, which influence patients' feelings of being cared for and satisfied with nursing care. These findings may be useful in the development of educational materials aimed at the advancement of nursing presence competency.


Assuntos
Relações Enfermeiro-Paciente , Satisfação do Paciente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Indicadores de Qualidade em Assistência à Saúde , Reprodutibilidade dos Testes , Inquéritos e Questionários
3.
Metas enferm ; 22(9): 64-74, nov. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-185042

RESUMO

Objetivo: analizar los cuidados enfermeros dirigidos a garantizar la seguridad del paciente neurocrítico portador de drenaje ventricular externo (DVE) tras haber sufrido un traumatismo craneoencefálico grave. Método: revisión narrativa mediante búsqueda bibliográfica en bases de datos de la Ciencias de la Salud: PubMed, CINAHL y la Biblioteca Cochrane, así como en los metabuscadores Dialnet Plus y Google Académico. Resultados: se seleccionaron 14 artículos por su idoneidad para abordar el objetivo principal del trabajo, analizando los cuidados generales de Enfermería que afectan a la presión intracraneal: cuidado bucal, aspiración de secreciones endotraqueales, elevación del cabecero de la cama, reposicionamiento y movilización temprana, administración de medicación sedativa y estimulación auditiva e interacción con el paciente. Conclusiones: la excelencia en el cuidado y la seguridad de los pacientes con traumatismo craneoencefálico radica en una indicación fundamentada para monitorizar la presión intracraneal y un equipo de enfermeras cuyas intervenciones se establezcan sobre la base de la evidencia científica. Para reducir la incidencia de complicaciones relacionadas con el drenaje intraventricular se han de protocolizar los cuidados. Como principales limitaciones de los estudios analizados están la heterogeneidad, el reducido tamaño muestral, la escasez de ensayos clínicos y estudios multicéntricos y la ausencia de protocolos y guías de práctica clínica para el manejo de estos pacientes


Objective: to analyze the nursing care required in order to ensure safety in neurocritical patients with an external ventricular drain after suffering a severe traumatic brain injury. Method: a narrative review through bibliographic search in Health Sciences databases: PubMed, CINAHL and the Cochrane Library, as well as the metasearch engines Dialnet Plus and Academic Google. Results: fourteen (14) articles were selected because they were adequate to address the primary objective of the study, analyzing the general Nursing care regarding intracranial pressure: mouth care, aspiration of endotracheal secretions, elevation of the head end of the bed, repositioning and early mobilization, administration of sedative medication, and auditory stimulation and interaction with the patient. Conclusions: excellence in care and safety of patients with traumatic brain injury lies in a well-founded indication to monitor intracranial pressure, and a team of nurses with specific interventions based on scientific evidence. In order to reduce the incidence of complications associated with intraventricular drain, there must be a protocol of care. The main limitations in the studies analyzed were: heterogeneity, reduced sample size, the limited number of clinical trials and multicenter studies, and the lack of protocols and clinical practice guidelines for the management of these patients


Assuntos
Humanos , Enfermagem de Cuidados Críticos , Segurança do Paciente , Lesões Encefálicas Traumáticas/enfermagem , Sucção/métodos , Hipertensão Intracraniana/complicações , Movimentação e Reposicionamento de Pacientes , Relações Enfermeiro-Paciente
4.
Rev Lat Am Enfermagem ; 27: e3193, 2019.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-31596422

RESUMO

OBJECTIVE: to analyze nonverbal communication between nurse and parturient during the active phase of labor in two Portuguese-speaking countries. METHOD: a quantitative and analytical study, whose sample consisted of 709 interactions that used the nonverbal communication of nurses and parturients. The analyzed variables were: distance; posture; axis; contact; emblematic gestures; illustrator gestures and regulatory gestures. For the analysis of the data, the Chi-Square and Likelihood Ratio tests were used. RESULTS: the intimate distance between nurse and parturient in both countries (p = 0.005) prevailed. In both, touch was the most commonly used form of contact (p <0.0001). In both countries, the parturient remained lying down (p <0.0001). In relation to the established contact (p <0.0001), the parturient did not use contact. The face-to-face axis predominated in the interactions in both countries between nurse-parturient (p <0.0001) and parturient-nurse (p <0.0001). CONCLUSION: similarities were observed in non-verbal communication between nurses and parturients in both countries. However, there are differences such as the established contact between Brazilian and Cape Verdean nurses to parturients.


Assuntos
Trabalho de Parto , Comunicação não Verbal , Relações Enfermeiro-Paciente , Saúde da Mulher , Brasil , Cabo Verde , Empatia , Feminino , Humanos , Cuidados de Enfermagem , Enfermagem Obstétrica , Gravidez
5.
Rev Infirm ; 68(254): 16-18, 2019 Oct.
Artigo em Francês | MEDLINE | ID: mdl-31587843

RESUMO

There is a new role for relational aspects in care. A sociological approach can identify different dimensions of care as a collective care production. We can link this production to that of autonomy as a process in which the narrative and reflective dimensions occupy a new role. They lead to making relational modes visible by formalising them. In doing so, they participate in their transformations.


Assuntos
Relações Enfermeiro-Paciente , Cuidados de Enfermagem/organização & administração , Humanos
8.
J Nurs Adm ; 49(11): 520-522, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31651609

RESUMO

The American Nurses Credentialing Center's Magnet Recognition Program 2019 Magnet Application Manual "continue(s) to raise the bar as the gold standard for nursing" (p. IX). In this column, the authors, who are Magnet commissioners, provide background and guidance on the standards for nurse satisfaction and patient satisfaction.


Assuntos
Satisfação no Emprego , Papel do Profissional de Enfermagem , Relações Enfermeiro-Paciente , Cuidados de Enfermagem/normas , Recursos Humanos de Enfermagem no Hospital/psicologia , Recursos Humanos de Enfermagem no Hospital/normas , Satisfação do Paciente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Estados Unidos
9.
Nursing (Säo Paulo) ; 22(257): 3234-3238, out.2019.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1026098

RESUMO

O estudo objetivou compreender a experiência da criança com Dermatite Atópica em relação ao enfrentamento da doença por meio do conteúdo expresso na brincadeira, à luz do Interacionismo Simbólico. Trata-se de pesquisa qualitativa, realizada em uma unidade ambulatorial filantrópica em São Paulo-SP, com crianças em fase pré-escolar. Este percebeu que o viver com dermatite atópica é marcado por uma série de restrições. Os resultados permitiram compreender a experiência vivenciada pela criança pré-escolar com dermatite atópica e entender como esta condição interfere em sua vida e na interação com o ambiente à sua volta. O brinquedo mostrou-se como um aliado da criança no enfrentamento da doença e importante ferramenta de coleta de dados, possibilitando à criança expressar-se com liberdade. Este avançou no conhecimento sobre o tema e pode auxiliar o enfermeiro na decisão por ações centradas na criança e em sua perspectiva, contribuindo para aprimorar a qualidade da assistência de enfermagem.(AU)


The research aimed to understand the experience of the child with Atopic Dermatitis in relation to the confrontation of the disease through the content expressed in the game, by the light of Symbolic Interactionism. This is a qualitative research, carried out in a philanthropic outpatient unit in São Paulo, Brazil, with pre-school children. The results allowed us to understand the experience of preschool children with atopic dermatitis and to understand how this condition interferes with their life and their interaction with the environment around them. The therapeutic play proved to be an ally of the child in overcoming his hardships and proved to be an important data collection tool that enables the child to express himself with freedom. It has advanced in the knowledge about the subject and can help nurses in the decision for actions centered on the child and their perspective, contributing to improve the quality of nursing care.(AU)


El estudio objetivó comprender la experiencia del niño con Dermatitis Atópica en relación al enfrentamiento de la enfermedad por medio del contenido expresado en la broma, a la luz del Interaccionismo Simbólico. Se trata de una investigación cualitativa, realizada en una unidad ambulatorial filantrópica en São Paulo-SP, con niños en fase preescolar. Este percibió que el vivir con dermatitis atópica está marcado por una serie de restricciones. Los resultados permitieron comprender la experiencia vivenciada por el niño preescolar con dermatitis atópica y entender cómo esta condición interfiere en su vida y en la interacción con el ambiente a su alrededor. El juguete se mostró como un aliado del niño en el enfrentamiento de la enfermedad e importante herramienta recolecta de datos, permitiendo al niño expresarse con libertad. Este avanzó en el conocimiento sobre el tema y puede auxiliar al enfermero en la decisión por acciones centradas en el niño y en su perspectiva, contribuyendo a mejorar la calidad de la asistencia de enfermería.(AU)


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Enfermagem Pediátrica , Jogos e Brinquedos , Dermatite Atópica , Relações Enfermeiro-Paciente , Serviços de Saúde da Criança , Saúde da Criança
12.
Pflege ; 32(5): 267-276, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31441714

RESUMO

Support self-management of symptoms in cancer therapies:The Symptom-Navi-Program Abstract. Background: Cancer patients experience a variety of symptoms associated with their disease and treatment. Many patients express uncertainty how to self-manage these symptoms. We developed the Symptom-Navi-Program (SNP) to support cancer patients' symptom self-management. The SNP comprises concise information leaflets, Symptom-Navi-Flyers (SNF), with content tailored to the needs of patients and nurse-led semi-structured consultations. AIM: The aim of the study was to to explore if patients experienced with the SNP with a focus on the perceived usefulness. METHOD: In a qualitative study, we conducted ten semi-structured interviews with cancer patients undergoing treatment. The interviews conduct and data analysis was based on thematic analysis as defined by 1-2Braun and Clarke (2006). RESULTS: Overall, patients described the SNP as a helpful facilitator for their self-management of symptoms. They highlighted its usefulness in an emotionally challenging situation. Nurse-led education and SNF tailored to the individual situation were experienced as self-management empowering elements. Consequently, patients experienced to know and have more choices in their symptom management strategies. Patients also described to use SNF to inform their relatives. CONCLUSIONS: Patients experience the SNP as a promising tool to facilitate their symptom self-management. Its implementation in clinical practice will now be further evaluated.


Assuntos
Neoplasias/terapia , Relações Enfermeiro-Paciente , Autocuidado/psicologia , Humanos , Pesquisa em Avaliação de Enfermagem , Educação de Pacientes como Assunto , Pesquisa Qualitativa
13.
J Nurs Adm ; 49(9): 423-429, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31436740

RESUMO

The development of a program to integrate an organization's values and culture, Watson's Caring Theory, and personal motivators resulted in transforming nursing theory into practice and a noted improvement in the patient experience. This article will teach the reader how this was accomplished.


Assuntos
Emoções , Relações Enfermeiro-Paciente , Cuidados de Enfermagem/organização & administração , Cuidados de Enfermagem/psicologia , Recursos Humanos de Enfermagem no Hospital/psicologia , Cultura Organizacional , Relações Profissional-Família , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Enfermagem
15.
Br J Nurs ; 28(14): 946, 2019 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-31348712

RESUMO

Aysha Mendes, Editor, British Journal of Cardiac Nursing, aysha.freelance@gmail.com, discusses support for patients living with heart disease.


Assuntos
Cardiopatias/enfermagem , Cardiopatias/psicologia , Relações Enfermeiro-Paciente , Qualidade de Vida , Cardiopatias/reabilitação , Humanos , Estilo de Vida , Participação do Paciente , Reabilitação/estatística & dados numéricos , Fatores de Risco , Apoio Social
16.
Rev Lat Am Enfermagem ; 27: e3151, 2019 Jul 18.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31340342

RESUMO

OBJECTIVE: to adapt the Consultation and Relational Empathy Measure (Brazilian version) for nurses; to evaluate the concurrence between empathy self-reported by nurses and that perceived by patients; To correlate self-compassion to the empathy self-reported by nurses and perceived by patients. METHOD: seven specialists validated the Consultation and Relational Empathy Measure Nurses (Brazilian version)' adaptation by original author's authorization. A sample with 15 triage nurses and 93 patients they admitted to the Emergency Department of a philanthropic private hospital were interviewed according to the following instruments: Consultation and Relational Empathy Measure - Nurses (Brazilian version) and the Self-Compassion Scale (Brazilian version). RESULTS: the psychometrics properties of Consultation and Relational Empathy Measure - Nurses (Brazilian version) showed appropriate internal consistency (Cronbach's alpha=0,799). The evaluation of empathy provided by the patients was better than that self-reported by the nurses (p<0,001). The nurses with higher level of self-compassion also showed higher empathy scores (p=0,002). CONCLUSION: our results confirmed the psychometrics properties' adequacy of Consultation and Relational Empathy Measure - Nurses (Brazilian version), allowing to compare empathy scores embased at same parameters. Self-compassion showed to influence self-reported empathy.


Assuntos
Empatia , Relações Enfermeiro-Paciente , Assistência Centrada no Paciente/normas , Autorrelato , Adolescente , Adulto , Idoso , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Triagem , Adulto Jovem
17.
Nursing ; 49(8): 46-49, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31343533

RESUMO

Pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS) describes a disorder that develops in children who abruptly develop neurologic abnormalities following a streptococcal infection. The authors discuss what is known about this poorly understood disorder and how nurses can educate and support patients and their families.


Assuntos
Doenças Autoimunes/enfermagem , Transtorno Obsessivo-Compulsivo/enfermagem , Infecções Estreptocócicas/enfermagem , Doenças Autoimunes/fisiopatologia , Criança , Humanos , Relações Enfermeiro-Paciente , Diagnóstico de Enfermagem , Transtorno Obsessivo-Compulsivo/fisiopatologia , Educação de Pacientes como Assunto , Relações Profissional-Família , Apoio Social , Infecções Estreptocócicas/fisiopatologia
18.
BMC Health Serv Res ; 19(1): 496, 2019 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-31311531

RESUMO

BACKGROUND: Although there is evidence with respect to the effectiveness of Chronic Care Model (CCM)-based programs in terms of improved patient outcomes, less attention has been given to the effect of high-quality care on productivity of patient-professional interactions, especially among frail older persons. The aim of our study was therefore to examine whether frail community-dwelling older persons' perspectives on quality of primary care according to the dimensions of the CCM are associated with the productivity of the patient-professional interactions. METHODS: Our study was part of a large-scale evaluation study with a matched quasi-experimental design to compare outcomes of frail community-dwelling older persons that participated in a proactive, integrated primary care approach based on (elements of) the CCM and those that received usual primary care. Frail older persons' perceptions of quality of care were assessed with the Patient Assessment of Chronic Illness Care Short version (PACIC-S). Productive interactions with general practitioners (GPs) and practice nurses were assessed using a relational coproduction instrument. Measurements were performed at baseline (T0) and 12 months thereafter (T1). In total, 232 frail older persons were participating in the intervention group at T0 and matched to 232 frail older persons in the control group. At T1, 182 persons were in the intervention group and 176 in the control group. RESULTS: Paired sample t-tests showed significant improvements in overall quality of care, the majority of underlying quality of care items, and productive interactions within the intervention group and control group over time. Multilevel analyses revealed that productive interaction with the GP and practice nurse at T1 was significantly related to perceived productive interaction with them at T0, the perceived quality of primary care at T0, and the change in perceived quality of primary care over time (between T0 and T1). CONCLUSIONS: Frail community-dwelling older persons' perspectives on quality of primary care were associated with perceived productivity of their interactions with the GP and practice nurse in both the intervention group and the control group. We found no significant differences in overall perceived quality of care and perceived patient-professional interaction between the intervention group and control group at baseline and follow-up. In times of population aging it is necessary to invest in high-quality care delivery for frail older persons and productive interactions with them.


Assuntos
Idoso Fragilizado/psicologia , Relações Enfermeiro-Paciente , Relações Médico-Paciente , Atenção Primária à Saúde , Qualidade da Assistência à Saúde , Idoso , Idoso de 80 Anos ou mais , Doença Crônica/terapia , Feminino , Idoso Fragilizado/estatística & dados numéricos , Clínicos Gerais/psicologia , Pesquisa sobre Serviços de Saúde , Humanos , Vida Independente , Masculino , Enfermeiras e Enfermeiros/psicologia
19.
Br J Nurs ; 28(13): 858-863, 2019 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-31303035

RESUMO

This is the first of a two-part article on the communication process in health care. The interactive process of effective communication is crucial to enabling healthcare organisations to deliver compassionate, high-quality nursing care to patients, in facilitating interactions between the organisation and its employees and between team members. Poor communication can generate negativity; for instance, misperception and misinterpretation of the messages relayed can result in poor understanding, patient dissatisfaction and lead to complaints. Reflection is a highly beneficial tool. In nursing, it enables nurses to examine their practice, identify problems or concerns, and take appropriate action to initiate improvements. This two-part article examines the role of a uro-oncology clinical nurse specialist (UCNS). Ongoing observations and reflections on the UCNS's practice had identified some pertinent issues in the communication process, specifically those relating to clinical practice and the management of practice-related issues and complaints. Part 1 examines the inherent problems in the communication process, with explanation of their pertinence to delivering optimal health care to patients, as demonstrated in four case studies related to breaking bad news to patients and one scenario related to communicating in teams. Part 2 will focus on the management of complaints.


Assuntos
Comunicação , Assistência à Saúde/organização & administração , Relações Enfermeiro-Paciente , Revelação da Verdade , Humanos
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