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1.
Esc. Anna Nery Rev. Enferm ; 26: e20210109, 2022.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1346058

RESUMO

Resumo Objetivo Analisar as percepções de enfermeiros sobre gestão do cuidado e seus fatores intervenientes para o controle da tuberculose na Atenção Primária em Saúde. Método Estudo descritivo, qualitativo, realizado com 29 enfermeiros que atuavam no controle da tuberculose em 23 Unidades Básicas de Saúde de Belém, Pará. Os dados foram produzidos por entrevistas individuais, utilizando roteiro semiestruturado, e submetidos à análise de conteúdo temática, proposta por Bardin. Resultados Originaram-se duas categorias temáticas: "A gestão do cuidado de enfermeiros para o controle da tuberculose nas Unidades Básicas de Saúde" e "Fatores intervenientes na efetivação da gestão do cuidado no controle da tuberculose nas Unidades Básicas de Saúde". Conclusão e implicações para a prática O conhecimento dos enfermeiros sobre a política e a gestão do cuidado no controle da tuberculose precisa ser fortalecido, e embora eles tenham clareza sobre suas competências, não conseguem realizá-las em sua plenitude por questões referentes à pouca organização dos serviços, centralização das atividades nos enfermeiros, baixa cooperação multiprofissional, falta de insumos e de pessoal e questões socioeconômicas ligadas ao usuário com tuberculose.


Resumen Objetivo Analizar la percepción de enfermeros sobre la gestión de la atención y los factores intervinientes para el control de la tuberculosis en la Atención Primaria de la Salud. Método Estudio descriptivo cualitativo realizado con 29 enfermeros que pre en el control de la tuberculosis en 23 Unidades Básicas de Salud de Belém, Pará. Los datos fueron producidos por entrevistas individuales, utilizando un guion semiestructurado, y sometido al análisis de contenido temático propuesto por Bardin. Resultados Se originaron dos categorías temáticas: "La gestión de la atención de enfermeros para el control de la tuberculosis en las Unidades Básicas de Salud" y "Factores intervinientes en la efectividad de la gestión de la atención en el control de la tuberculosis en las Unidades Básicas de Salud". Conclusión e implicaciones para la práctica Es necesario fortalecer el conocimiento de las enfermeras sobre la política y la gestión de la atención en el control de la tuberculosis, y aunque tienen claras sus competencias, no pueden implementarlas en su totalidad debido a problemas relacionados con la mala organización de los servicios, la centralización de actividades en los enfermeros, baja cooperación multiprofesional, falta de insumos y personal y aspectos socioeconómicos relacionados con el usuario con tuberculosis.


Abstract Objective To analyze nurses' perceptions on care management and its intervening factors for tuberculosis control in Primary Health Care. Method A descriptive and qualitative study conducted with 29 nurses who worked on tuberculosis control in 23 Basic Health Units in Belém, Pará. The data were produced by individual interviews, using a semi-structured script, and submitted to thematic content analysis, as proposed by Bardin. Results Two thematic categories emerged, namely: "Care management by nurses for tuberculosis control in Basic Health Units" and "Intervening factors in the application of care management for tuberculosis control in Basic Health Units". Conclusion and implications for the practice The nurses' knowledge about the care policy and management for tuberculosis control needs to be strengthened and, although nurses are aware of their competences, they are unable to fully implement them due to issues related to poor organization services, centralization of activities on them, low multiprofessional cooperation, scarcity of supplies and personnel, and socioeconomic issues related to tuberculosis patients.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Atenção Primária à Saúde , Tuberculose/prevenção & controle , Gestão em Saúde , Enfermeiras e Enfermeiros/psicologia , Prática Profissional , Apoio Social , Fatores Socioeconômicos , Tuberculose/enfermagem , Tuberculose/terapia , Educação em Saúde , Pesquisa Qualitativa , Vulnerabilidade em Saúde , Capacitação Profissional , Estigma Social , Cooperação e Adesão ao Tratamento , Cuidados de Enfermagem
2.
Rev. enferm. UERJ ; 29: e51932, jan.-dez. 2021.
Artigo em Inglês, Português | LILACS | ID: biblio-1224598

RESUMO

Objetivo: analisar a produção do conhecimento sobre a experiência da família acerca dos cuidados paliativos da criança com câncer hospitalizada na unidade de terapia intensiva e discutir o papel da enfermagem no atendimento à família da criança com câncer frente aos cuidados paliativos. Método: revisão integrativa realizada na PUBMED, LILACS, SCOPUS, SCIELO e CINAHL entre janeiro e março de 2020. Resultados: a amostra foi composta por 13 artigos, originando duas categorias: O impacto do cuidado paliativo da criança com câncer na dinâmica familiar e o cuidado multiprofissional, em especial dos enfermeiros, à família da criança com câncer. Conclusão: os estudos revelaram o panorama nacional e internacional dos cuidados paliativos à criança com câncer e a desestruturação da dinâmica familiar nos aspectos físicos, sociais, psicológicos, e financeiros, caracterizando o período como estressante e doloroso. Os enfermeiros estabelecem condutas terapêuticas objetivando promover qualidade de vida para crianças em cuidados paliativos e seus familiares.


Objective: to examine production of knowledge on families' experience of palliative care for children with cancer hospitalized in an intensive care center and discuss the role of nursing in assisting the family of the child in palliative cancer care. Method: this integrative review was conducted on PubMed, LILACS, Scopus, SciELO and CINAHL between January and March 2020. Results: from the sample of 13 articles, two categories originated: The impact of palliative cancer care for children on family dynamics and multiprofessional care, especially by nurses, for the family of the child with cancer. Conclusion: the studies revealed the national and international panorama of palliative care for children with cancer and the breakdown of physical, social, psychological, and financial family dynamics, characterizing the period as stressful and painful. Nurses establish therapeutic approaches aimed at promoting quality of life for children in palliative care and their families.


Objetivo: analizar la producción de conocimiento sobre la experiencia familiar en los cuidados paliativos de niños con cáncer, hospitalizados en la unidad de cuidados intensivos, y discutir el papel de la enfermería en la asistencia a la familia del niño con cáncer frente a los cuidados paliativos. Método: Revisión integradora realizada en PUBMED, LILACS, SCOPUS, SCIELO y CINAHL entre enero y marzo de 2020. Resultados: La muestra estuvo conformada por 13 artículos, originando dos categorías: El impacto de los cuidados paliativos para niños con cáncer en la dinámica familiar y los cuidados multiprofesionales, especialmente de las enfermeras, a la familia del niño con cáncer. Conclusión: Los estudios revelaron el panorama nacional e internacional de los cuidados paliativos para niños con cáncer y la ruptura de la dinámica familiar en aspectos físicos, sociales, psicológicos y económicos, caracterizándolo como un período estresante y doloroso. Las enfermeras establecen enfoques terapéuticos dirigidos a promover la calidad de vida de los niños en cuidados paliativos y sus familias.


Assuntos
Humanos , Masculino , Feminino , Criança , Cuidados Paliativos , Família/psicologia , Criança Hospitalizada , Conhecimentos, Atitudes e Prática em Saúde , Unidades de Terapia Intensiva , Neoplasias/terapia , Papel do Profissional de Enfermagem , Neoplasias/enfermagem , Relações Enfermeiro-Paciente
3.
Br J Community Nurs ; 26(11): 544-552, 2021 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-34731035

RESUMO

Type 1 diabetes is a lifelong condition which affects all age ranges, for reasons unknown, and the UK has one of the highest incidences of this complex condition in the world. Type 1 diabetes is caused by autoimmune damage to the insulin-producing ß-cells found in the pancreatic islet cells, leading to severe insulin deficiency. People with diabetes need to achieve a target glyosylated haemoglobin level to avoid macro- and microvascular complications, but there is the associated risk of hypoglycaemic events. These can vary in severity and consequences but will likely always cause worry for the person living with diabetes. There are many risk factors and reasons to be explored when looking at hypoglycaemia. This case study explores the nursing interventions that can be safely worked through and prioritised, within the community setting, to allow people with diabetes to be safe from severe hypoglycaemia, thus improving their quality of life and safety, as well as reducing costs for the NHS.


Assuntos
Automonitorização da Glicemia/métodos , Diabetes Mellitus Tipo 1/enfermagem , Hemoglobina A Glicada/análise , Hipoglicemia/prevenção & controle , Hipoglicemiantes/administração & dosagem , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/tratamento farmacológico , Humanos , Hipoglicemia/etiologia , Hipoglicemia/enfermagem , Hipoglicemiantes/uso terapêutico , Qualidade de Vida
4.
Rev Gaucha Enferm ; 42(spe): e20200336, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34787233

RESUMO

OBJECTIVE: To analyze the most frequent words in interviews given by nurses during the coronavirus pandemic. METHOD: This is a qualitative, exploratory, descriptive study, carried out with 45 interviews granted by nurses to newspapers of great circulation in Brazil and Portugal. The data were processed using the ATLAS.ti® software and analyzed using the word cloud tool. RESULTS: The seven most frequent words were: "home" (respect for isolation), "nurses" (valuing of the profession and structural problems), "patients/diseased" and "care" (referring to the severity of the disease), "family" (missing her own family/emotional stress) and "fear" (fear of contamination of oneself and others). FINAL CONSIDERATIONS: The word cloud revealed how straining nurses' experiences have been and reinforced the urgent need to rethink nursing work and the risks faced. Reflections like this contribute to the construction of more valued nursing and public policies for the protection of nurses.


Assuntos
COVID-19/psicologia , Cuidados Críticos/psicologia , Emoções , Enfermeiras e Enfermeiros/psicologia , Pandemias , Brasil/epidemiologia , COVID-19/epidemiologia , COVID-19/enfermagem , Feminino , Humanos , Entrevistas como Assunto , Portugal/epidemiologia , Pesquisa Qualitativa , Estresse Fisiológico
5.
Am J Nurs ; 121(12): 18-28, 2021 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-34743129

RESUMO

ABSTRACT: For nurses, the challenges posed by demanding work environments and schedules often lead to fatigue, and this can be exacerbated during crises like the COVID-19 pandemic. In this article, the authors discuss causes and challenges of nurse fatigue and consider several evidence-based strategies and solutions for individual nurses and organizations. Barriers to implementation, including a negative workplace culture and inadequate staffing, are also described, and several resources are presented.


Assuntos
Fadiga/epidemiologia , Fadiga/prevenção & controle , Enfermeiras e Enfermeiros/psicologia , COVID-19/enfermagem , Humanos , Recursos Humanos/estatística & dados numéricos , Local de Trabalho/organização & administração , Local de Trabalho/psicologia
6.
Clin Nurse Spec ; 35(6): 314-317, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34606211

RESUMO

PURPOSE/OBJECTIVES: Blood culture collection is a common procedure performed in emergency departments. Rate of blood culture contamination is a metric that is tracked by organizations to ensure appropriate treatment for patients suspected of having bacteremia and ensure appropriate use of hospital resources. A team of nurses and technicians undertook a quality improvement project to decrease blood culture contamination rates in a suburban emergency department. DESCRIPTION OF THE PROJECT: The project included use of standardized blood culture collection kits, creation of a dedicated collection team, and implementation of a new blood culture collection device. OUTCOME: Through this work, blood culture contamination rates decreased from greater than 3.0% to less than 1.5% consistently for nearly 24 months. CONCLUSIONS: Providing feedback and continued monitoring has made this quality improvement initiative a success for the department and the organization and has resulted in cost savings of nearly 2 million dollars.


Assuntos
Hemocultura/métodos , Serviço Hospitalar de Emergência/organização & administração , Contaminação de Equipamentos/prevenção & controle , Enfermeiras Clínicas , Melhoria de Qualidade/organização & administração , Bacteriemia/enfermagem , Contaminação de Equipamentos/estatística & dados numéricos , Humanos , Pesquisa em Avaliação de Enfermagem
7.
Clin Nurse Spec ; 35(6): 318-326, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34606212

RESUMO

INTRODUCTION: Individuals with early-onset Alzheimer's disease face many challenges and barriers older adults with late-onset Alzheimer's do not. Unfortunately, information about early-onset Alzheimer's disease is in its infancy stage in comparison with late-onset Alzheimer's. PURPOSE/AIMS: The purpose of this study was to examine the lived experiences of a 54-year-old man with early-onset Alzheimer's disease and his family (wife, sister, and mother) to understand the effects on the family unit. DESIGN: Interpretive phenomenology was used to guide this study. METHODS: All participants completed 2 in-person one-on-one interviews, and a final interview was completed online. Field notes, member checks, and triangulation were used to enhance the study's credibility. RESULTS: This article focuses on the theme "'A big curve ball': Disruption of the life cycle." Participants indicated the major financial and social challenges experienced by Joe and his wife. Furthermore, participants emphasized the importance of acceptance and maintaining a positive attitude to help cope with Joe's diagnosis. CONCLUSIONS: The accounts of Joe and his family shed light on an area relatively void in the literature. In addition, Joe's experiences may provide comfort for other families facing early-onset Alzheimer's disease. The implications for community health nurses in assisting individuals with early-onset Alzheimer's disease and their families are discussed.


Assuntos
Adaptação Psicológica , Doença de Alzheimer/psicologia , Família/psicologia , Idade de Início , Doença de Alzheimer/enfermagem , Enfermagem em Saúde Comunitária , Humanos , Masculino , Pessoa de Meia-Idade
8.
Br J Community Nurs ; 26(10): 474-480, 2021 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-34632792

RESUMO

Despite its many devastating effects, the COVID-19 pandemic has had a positive impact in the ways in which society, scientific institutions, governing bodies, businesses, educational organisations, and communication have functioned unchallenged over the years. Rapid advancement in science enabled identification and characterisation of the virus and in developing vaccines to combat the disease. The mysterious ways in which the virus attacks the vital organs that lead on to multiorgan failure and thrombosis of the arterial and venous system have also been revealed. The ability to study the microcirculatory changes at the bedside and predict prognosis is a way forward. All the evidence suggests that the outcome of COVID-19 infection is related to the severity of the disease seen in the intensive care unit setting. This article discusses microcirculatory changes and immune coagulopathy caused by COVID-19.


Assuntos
COVID-19 , Microcirculação , Trombose , COVID-19/complicações , COVID-19/enfermagem , Humanos , Trombose/virologia
9.
Medicine (Baltimore) ; 100(37): e27156, 2021 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-34664841

RESUMO

BACKGROUND: The purpose of this meta-analysis was to assess the effects of Modified Robert Jones Bandage (MRJB) in primary total knee arthroplasty (TKA). METHODS: PubMed, EMBASE, the Cochrane Library, Web of Science, and Google Scholar were systematically searched for randomized controlled trials (RCTs). All RCTs were compared to receive either MRJB (study group) or conventional wound dressing (control group) in TKA. Statistical analysis was assessed using RevMan 5.3 software. RESULTS: A total of 5 RCTs involving 362 patients were included in the meta-analysis. No significant difference between the 2 groups was found in terms of total blood loss (Mean difference [MD], -25.41; 95% confidence interval [CI], -90.52 to 39.70; P = .44), intra-operative blood loss (MD, -13.77; 95% CI, -31.84 to 4.29; P = .14), drain blood loss (MD, 0.83; 95% CI, -30.07 to 31.72; P = .96), and transfusion rate (risk ratio, 0.95; 95% CI, 0.55-1.64; P = .86); There was also no significant difference in terms of range of motion (MD, -0.93; 95% CI, -3.64 to 1.79; P = .50), visual analog scale pain sores (MD, -0.02; 95% CI, -0.34 to 0.30; P = .90), and operative time (MD, -3.12; 95% CI, -13.42 to 7.18; P = .55), without increasing the risk of wound-related complications (risk ratio, 0.75; 95% CI, 0.27-2.08; P = .58) in both groups. No deep venous thrombosis occurred in all studies. CONCLUSIONS: The current meta-analysis of the available evidence indicates patients with MRJB had not required the additional advantage compared to the conventional wound dressing for TKA. However, more high-quality studies are needed to confirm the above conclusions. LEVEL OF EVIDENCE: Level I, therapeutic study.


Assuntos
Artroplastia do Joelho/efeitos adversos , Bandagens/normas , Perda Sanguínea Cirúrgica/prevenção & controle , Hemorragia/classificação , Artroplastia do Joelho/métodos , Perda Sanguínea Cirúrgica/enfermagem , Hemorragia/prevenção & controle , Humanos , Complicações Pós-Operatórias/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos
10.
Medicine (Baltimore) ; 100(37): e27256, 2021 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-34664874

RESUMO

ABSTRACT: International evidence-based guidelines recommend self-management support for stroke survivors to improve their health outcomes. We developed a 4-week nurse-led stroke self-management programme (SSMP) and conducted a randomised controlled trial to assess its effects. This paper reports the findings of a qualitative study nested within the randomised controlled trial to explore stroke survivors' experiences of SSMP participation. Semi-structured interviews were conducted with all adult participants who were clinically diagnosed with a first or recurrent ischaemic or haemorrhagic stroke, residing at home, communicable in Cantonese, had a Montreal Cognitive Assessment score below the second percentile, and participated in at least 1 SSMP session. All interviews were conducted in Cantonese, lasted approximately 45 minutes, and were audio-recorded. Interview data were transcribed verbatim and analysed thematically. Sixty-four stroke survivors (mean age 66.33 years, SD 12.34) were recruited, and 59 were interviewed via phone immediately after completion of SSMP. Three themes were derived. Overall, participants were satisfied with the SSMP. Their understanding of self-management was improved, and they recognised its importance in recovery. Their confidence in self-management was also enhanced through the use of multifaceted strategies. Suggestions were made to enhance their participation experiences, including increased home visits and group sessions, making group session attendance optional and arranging them more accessibly, meeting the survivors who shared their survival experiences in the videos, and access to the videos online. This study concurred that the SSMP enhanced stroke survivors' self-efficacy in self-management. Rearrangement of the programme format and enhancements in accessibility could be further examined to enable more effective stroke self-management.


Assuntos
Vida Independente/psicologia , Autogestão/psicologia , Acidente Vascular Cerebral/enfermagem , Sobreviventes/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Vida Independente/lesões , Entrevistas como Assunto/métodos , Masculino , Pessoa de Meia-Idade , Teoria de Enfermagem , Avaliação de Programas e Projetos de Saúde/métodos , Avaliação de Programas e Projetos de Saúde/estatística & dados numéricos , Pesquisa Qualitativa , Autogestão/métodos , Autogestão/estatística & dados numéricos , Acidente Vascular Cerebral/psicologia , Reabilitação do Acidente Vascular Cerebral/enfermagem , Reabilitação do Acidente Vascular Cerebral/psicologia , Reabilitação do Acidente Vascular Cerebral/normas , Sobreviventes/estatística & dados numéricos
11.
PLoS One ; 16(10): e0258757, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34648609

RESUMO

INTRODUCTION: Hepatitis B infection remains a public health threat associated with undesirable statistics of morbidity and mortality. Good knowledge, attitude and practice (KAP) of hepatitis B infection (HBI) prevention are essential for HBI control. However, there is limited evidence concerning the KAP of HBI prevention among nursing students, who are significantly exposed to HBI. We assessed the KAP of HBI prevention and the factors associated with the practice of HBI prevention among nursing students in the Upper West Region of Ghana. METHODS: We administered an online cross-sectional survey in November 2020 to a stratified random sample of 402 nursing students in two nursing training colleges in the Upper West Region. Using STATA version 13, we computed composite scores of KAP of HBI prevention with maximum scores of 18 for knowledge and 8 each for attitude and practice. A generalised ordered logistic regression model was run to assess the factors associated with the practice of HBI prevention. RESULTS: The students had moderate median scores for knowledge (12.00; IQR = 10-13) and attitude (6.00; IQR = 5.00-7.00) but a poor median score (5.00; IQR = 4.00-6.00) for the practice of HBI prevention. High knowledge (aOR = 2.05; p = 0.06), good attitude, being a male, second year student and having parents with tertiary education were significantly associated with higher likelihoods (aOR >1; p < 0.05) of demonstrating good practice of HBI prevention. Students who had never married were significantly (aOR = 0.34; p = 0.010) less likely to exhibit good practice of HBI prevention. CONCLUSION: The KAP scores of HBI prevention among the students were sub-optimal. We recommend institution-based policies and regular education on HBI prevention, free/subsidised HBI prevention services, and the enforcement of proper professional ethics on HBI prevention in nursing training colleges. Such interventions should predominantly target female, non-married and first year nursing students.


Assuntos
Hepatite B/prevenção & controle , Estudantes de Enfermagem/psicologia , Adulto , Competência Clínica , Estudos Transversais , Feminino , Gana , Conhecimentos, Atitudes e Prática em Saúde , Hepatite B/enfermagem , Humanos , Masculino , Adulto Jovem
12.
PLoS One ; 16(10): e0258787, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34662355

RESUMO

Despite concerted research and clinical efforts, sepsis remains a common, costly, and often fatal occurrence. Little evidence exists for the relationship between institutional nursing resources and the incidence and outcomes of sepsis after surgery. The objective of this study was to examine whether hospital nursing resource quality is associated with postsurgical sepsis incidence and survival. This cross-sectional, secondary data analysis used registered nurses' reports on hospital nursing resources-staffing, education, and work environment-and multivariate logistic regressions to model their association with risk-adjusted postsurgical sepsis and mortality in 568 hospitals across four states. Better work environment quality was associated with lower odds of sepsis. While the likelihood of death among septic patients was nearly seven times that of non-septic patients, better nursing resources were associated with reduced mortality for all patients. Whereas the preponderance of sepsis research has focused on clinical interventions to prevent and treat sepsis, this study describes organizational characteristics hospital administrators may modify through organizational change targeting nurse staffing, education, and work environments to improve patient outcomes.


Assuntos
Recursos Humanos de Enfermagem no Hospital/educação , Complicações Pós-Operatórias/enfermagem , Sepse/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Mortalidade Hospitalar , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Mortalidade , Admissão e Escalonamento de Pessoal , Complicações Pós-Operatórias/mortalidade , Sepse/etiologia , Sepse/enfermagem , Local de Trabalho , Adulto Jovem
13.
Am J Nurs ; 121(11): 44-49, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34673696

RESUMO

This article is the first in a new series, Supporting Family Caregivers in the 4Ms of an Age-Friendly Health System, published in collaboration with the AARP Public Policy Institute as part of the ongoing Supporting Family Caregivers: No Longer Home Alone series. The 4Ms of an Age-Friendly Health System (What Matters, Medication, Mentation, and Mobility) is an evidence-based framework for assessing and acting on critical issues in the care of older adults across settings and transitions of care. Engaging the health care team, including older adults and their family caregivers, with the 4Ms framework can help to ensure that every older adult gets the best care possible, is not harmed by health care, and is satisfied with the care they receive. The articles in this new series present considerations for implementing the 4Ms framework in the inpatient hospital setting and incorporating family caregivers in doing so. Resources for both nurses and family caregivers, including a series of accompanying videos developed by AARP and the Rush Center for Excellence in Aging and funded by the John A. Hartford Foundation, are also provided. Nurses should read the articles first, so they understand how best to help family caregivers. Then they can refer caregivers to the informational tear sheet-Guide to the 4Ms of an Age-Friendly Health System for Family Caregivers-and instructional videos, encouraging them to ask questions. For additional information, see Resources for Nurses.


Assuntos
Cuidadores/psicologia , Doença Crônica , Equipe de Assistência ao Paciente , Satisfação do Paciente , Qualidade da Assistência à Saúde , Idoso , Doença Crônica/enfermagem , Doença Crônica/terapia , Humanos
14.
J Emerg Nurs ; 47(6): 879-891, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34635345

RESUMO

INTRODUCTION: This study aimed to assess (1) the prevalence of burnout risk among nurses working in intensive care units and emergency department before and during the coronavirus disease 2019 pandemic and (2) the individual and work-related associated factors. METHODS: Data were collected as part of a cross-sectional study on intensive care unit and emergency nurses in Belgium using 2 self-administered online questionnaires distributed just before the pandemic (January 2020, N = 422) and during the first peak of the pandemic (April 2020, N = 1616). Burnout was assessed with the Maslach Burnout Inventory scale. RESULTS: The overall prevalence of burnout risk was higher among emergency nurses than intensive care unit nurses but was not significantly different after the coronavirus disease 2019 pandemic (from 69.8% to 70.7%, χ²â€¯= 0.15, P = .68), whereas it increased significantly among intensive care unit nurses (from 51.2% to 66.7%, χ²â€¯= 23.64, P < .003). During the pandemic, changes in workload and the lack of personal protective equipment were significantly associated with a higher likelihood of burnout risk, whereas social support from colleagues and from superiors and management were associated with a lower likelihood of burnout risk. Several determinants of burnout risk were different between intensive care unit and emergency nurses. CONCLUSION: Our findings indicate that nurses in intensive care unit and emergency department were at risk of burnout but their experience during the coronavirus disease 2019 pandemic was quite different. Therefore, it is important to implement specific measures for these 2 groups of nurses to prevent and manage their risk of burnout.


Assuntos
Esgotamento Profissional , COVID-19 , Recursos Humanos de Enfermagem no Hospital , Pandemias , Bélgica/epidemiologia , Esgotamento Profissional/epidemiologia , COVID-19/epidemiologia , COVID-19/enfermagem , Estudos Transversais , Serviço Hospitalar de Emergência , Humanos , Unidades de Terapia Intensiva , Recursos Humanos de Enfermagem no Hospital/psicologia , Prevalência , Fatores de Risco , Inquéritos e Questionários
15.
Br J Community Nurs ; 26(Sup9): S6-S11, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34473537

RESUMO

Wound bed preparation is the management of a wound in order to optimise healing and/or facilitate other therapeutic measures. It is the most pivotal step in healing wounds. Early referral to a specialist wound clinic can markedly improve the wound healing process. This overview will discuss the techniques involved in the preparation of the wound bed that will effectively accelerate the healing process. The process begins with a correct diagnosis of the wound and optimising the patient's medical condition. The TIMERS framework is discussed. Wound dressings, including the use of negative-pressure wound therapy, are discussed, along with debridement techniques and agents. The timing of wound intervention and evaluating progress will also be discussed, and wound bed preparation strategies will be included. There has been an added challenge of wound care in the community as a result of the COVID-19 pandemic. The present article provides an overview of how to prepare a wound bed in the community.


Assuntos
Enfermagem em Saúde Comunitária , Ferimentos e Lesões , Bandagens , COVID-19 , Desbridamento/métodos , Desbridamento/enfermagem , Humanos , Ferimentos e Lesões/enfermagem
16.
Br J Community Nurs ; 26(9): 438-443, 2021 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-34473556

RESUMO

This article offers a review of what is known so far about post-acute covid-19 and the underlying pathophysiology related to this condition. The main focus will be on the respiratory symptoms. It will then explore how community nurses can monitor and support patients with symptoms of breathlessness with a supporting discussion of the current recommendations for the management and treatment of patients presenting with symptoms of breathlessness. Palliation of symptoms will be highlighted but managing the supportive care needs for patients affected by COVID-19 and nearing the end of life is outside the scope of this article.


Assuntos
COVID-19/complicações , Enfermagem em Saúde Comunitária , Dispneia , COVID-19/enfermagem , COVID-19/fisiopatologia , Dispneia/etiologia , Dispneia/enfermagem , Humanos , Cuidados Paliativos
17.
Br J Community Nurs ; 26(Sup10): S30-S35, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34542312

RESUMO

During the second wave of the COVID-19 pandemic, district nursing teams were overwhelmed with their caseload due to the palliative care needs of their patients. This led to patients with wet legs and chronic wounds deteriorating due to staffing levels. Therefore, the Swansea Bay University Health Board and Lymphoedema Network Wales teams redeployed two working time equivalents (WTE) into the community to take over the management of these patients with chronic wounds for 4 months. The clinicians came from a variety of different backgrounds, including nursing, physiotherapy, emergency medicine and occupational therapy. Between the teams, 866 visits were carried out over the 4-month period, where patients' compression therapy was altered to promote healing and reduce oedema. At the end of the 4-month period, 21% of the patients were discharged off the district nursing caseload completely, while of the 60% who were still active caseload patients, 35% were in increased compression and 20% had reduced need for visits.


Assuntos
COVID-19 , Enfermagem em Saúde Comunitária , Linfedema , Pandemias , COVID-19/epidemiologia , Enfermagem em Saúde Comunitária/organização & administração , Humanos , Linfedema/enfermagem , Reino Unido/epidemiologia
18.
Br J Community Nurs ; 26(Sup10): S6-S15, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34542313

RESUMO

Management of secondary head and neck lymphoedema has undergone little research investigation. Its treatment is time and labour intensive and involves multiple therapeutic modalities without a clear understanding of which is most effective. This study aimed to determine the feasibility of a randomised controlled trial comparing two therapeutic modalities to manage head and neck lymphoedema. The secondary objective was to evaluate the clinical effects of these treatments. Participants were randomised to receive treatment with manual lymphatic drainage or compression over 6 weeks, with the primary outcome-percentage tissue water-measured 12 weeks after treatment. Six participants were recruited until the study was ceased due to restrictions imposed by the COVID-19 pandemic. Some 86% of required attendances were completed. Percentage tissue water increased in all participants at 12 weeks. No consistent trends were identified between internal and external lymphoedema. The small number of people recruited to this study informs its feasibility outcomes but limits any conclusions about clinical implications.


Assuntos
COVID-19 , Linfedema , Pesquisa em Enfermagem , Pandemias , COVID-19/epidemiologia , Bandagens Compressivas , Estudos de Viabilidade , Cabeça , Humanos , Linfedema/enfermagem , Drenagem Linfática Manual , Pescoço , Pesquisa em Enfermagem/organização & administração , Resultado do Tratamento , Reino Unido/epidemiologia
19.
Br J Community Nurs ; 26(Sup10): S16-S21, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34542314

RESUMO

Reticence to apply compression therapy has been widely observed in clinical practice, compounded by an absence of evidenced-based pathways for application of prompt compression prior to measuring ankle brachial pressure index (ABPI). Importantly, delaying compression therapy for patients with chronic oedema and lymphorrhoea causes many avoidable complications. In 2017, Lymphoedema Network Wales (LNW) developed an evidenced-based pathway to improve the management of chronic oedema and wet legs (lymphorrhoea) for community nurses. During the past 4 years, the Chronic Oedema Wet Leg Pathway has been presented, published and used internationally, as well as being translated into different languages. It is commonly used in community nursing Teams as an evidenced-based document. However, like all documents and guidelines, when more evidence becomes available, the pathway needs updating. Therefore, this clinical focus article will present the new and enhanced Chronic Oedema Wet Leg Pathway, introducing a new level four compression section, which increases the layers of compression bandaging for patients with venous insufficiency or who are morbidly obese.


Assuntos
Procedimentos Clínicos , Linfedema , Doença Crônica , Humanos , Perna (Membro) , Linfedema/enfermagem , País de Gales
20.
Br J Community Nurs ; 26(Sup10): S22-S28, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34542317

RESUMO

The use of compression therapy to treat chronic oedema of the lower limbs can be a challenge, especially when this is undertaken by clinicians who have limited experience and knowledge of the theoretical principles which underpin its use in clinical practice. This articles aims to discuss the reasoning which underpins the use of compression hosiery in the management of lymphoedema and how this understanding can improve treatment outcomes and reduce the burden of disease on patients and clinical resources.


Assuntos
Linfedema , Meias de Compressão , Doença Crônica , Humanos , Extremidade Inferior , Linfedema/enfermagem , Resultado do Tratamento
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