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ORIGINAL ARTICLE
Humanized care in the Intensive Care Unit: discourse of Angolan nursing professionals
Revista Brasileira de Enfermagem. 2023;76(2):e20220474
05-12-2023
Resumo
ORIGINAL ARTICLEHumanized care in the Intensive Care Unit: discourse of Angolan nursing professionals
Revista Brasileira de Enfermagem. 2023;76(2):e20220474
05-12-2023DOI 10.1590/0034-7167-2022-0474
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Objectives:
to analyze the perception of nursing professionals in an intensive care unit in Angola about humanized care and identify resources necessary for its implementation.
Methods:
a qualitative, descriptive study conducted with 15 professionals in June-October/2020 in intensive care unit in Angola. The data were collected through semi-structured interviews; analysis based on the collective subject discourse technique.
Results:
five central ideas emerged: three related to the perception of humanized care (“From integral vision and empathy to a set of actions in all phases of care”, “Humanizing is extending care to family members and companions”, “Humanized care requires the establishment of a bond of trust and guarantee of individualized care”); and two on the resources necessary for this care (“Need for infrastructure - human and material resources”, “Professional training and humanized care are interconnected”).
Final Considerations:
humanized care involves objectivity and subjectivity; it includes family members. An adequate infrastructure can provide it.
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ORIGINAL ARTICLE
Accuracy of the nursing diagnosis of ineffective airway clearance in intensive care unit patients
Revista Brasileira de Enfermagem. 2023;76(1):e20220174
01-30-2023
Resumo
ORIGINAL ARTICLEAccuracy of the nursing diagnosis of ineffective airway clearance in intensive care unit patients
Revista Brasileira de Enfermagem. 2023;76(1):e20220174
01-30-2023DOI 10.1590/0034-7167-2022-0174
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Objectives:
to analyze the accuracy of the clinical indicators of ineffective airway clearance in adult intensive care unit patients.
Methods:
diagnostic accuracy study, performed in the intensive care unit of a university hospital in northeastern Brazil. The sample consisted of 104 patients hospitalized between June and October 2019.
Results:
the prevalence of ineffective airway clearance was 36.54%. The indicators with high specificity included absence of cough (0.8326), orthopnea (0.6817), adventitious breath sounds (0.8175), and diminished breath sounds (0.8326). The clinical indicators with high sensitivity and specificity were alteration in respiratory rate (0.9999) and alteration in respiratory pattern (0.9999).
Conclusions:
six clinical indicators provided an accurate identification of ineffective airway clearance. The clinical indicators alteration in respiratory rate and alteration in respiratory pattern were the most accurate for critical adult patients. The findings of this study contribute to accurate diagnostic inferences and to prevention of respiratory complications in these patients.
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ORIGINAL ARTICLE
Educational material production and validity: educational instrument for home care for premature newborns
Revista Brasileira de Enfermagem. 2023;76(1):e20210648
01-30-2023
Resumo
ORIGINAL ARTICLEEducational material production and validity: educational instrument for home care for premature newborns
Revista Brasileira de Enfermagem. 2023;76(1):e20210648
01-30-2023DOI 10.1590/0034-7167-2021-0648
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Objective:
to produce and validate a booklet, based on Jean Watson’s Theory, on home care for premature newborns, based on caregivers’ experiences.
Method:
a methodological study, developed in the following stages: diagnosis of knowledge needs about home care; survey of scientific content; educational material production; and validity by judges/experts.
Results:
the literature review resulted in 19 articles. The main themes (breastfeeding, bath care, bond building, infection prevention and support network) were listed for producing the booklet “Booklet for Premature Newborns: Demystifying Home Care”. The booklet content and appearance received the overall Content Validity Index of 0.85, considered suitable within the scientific rigor of validity.
Final considerations:
the booklet produced and validated is an educational material whose main role is to provide knowledge and awaken caregivers’ autonomy in providing home care to newborns.
Palavras-chave: Educational and Promotional MaterialsHealth EducationInfantIntensive Care UnitsNeonatalPrematureValidation StudyVer mais -
ORIGINAL ARTICLE
Effects of multidisciplinary rounds and checklist in an Intensive Care Unit: a mixed methods study
Revista Brasileira de Enfermagem. 2022;75(3):e20210934
09-23-2022
Resumo
ORIGINAL ARTICLEEffects of multidisciplinary rounds and checklist in an Intensive Care Unit: a mixed methods study
Revista Brasileira de Enfermagem. 2022;75(3):e20210934
09-23-2022DOI 10.1590/0034-7167-2021-0934
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Objectives:
to analyze the implementation of multidisciplinary checklist-directed rounds before health indicators and multidisciplinary team perception of an Intensive Care Unit.
Methods:
a mixed methods study, with an explanatory sequential design, carried out at a hospital in southern Brazil, from September 2020 to August 2021. The integration of quantitative and qualitative data was combined by connection.
Results:
after the implementation of checklist-directed rounds, there was a significant reduction in hospital stay from ventilator-associated pneumonia, urinary tract infection and daily invasive device use. The investigated practice is essential for comprehensive care, harm reduction, effective work and critical patient safety.
Conclusions:
the multidisciplinary rounds with checklist use reduced data on health indicators of critically ill patients and was considered a vital practice in the intensive care setting.
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REVIEW
Medical adhesive-related skin injury in adult intensive care unit: scoping review
Revista Brasileira de Enfermagem. 2022;75(6):e20210926
09-09-2022
Resumo
REVIEWMedical adhesive-related skin injury in adult intensive care unit: scoping review
Revista Brasileira de Enfermagem. 2022;75(6):e20210926
09-09-2022DOI 10.1590/0034-7167-2021-0926
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Objectives:
to identify and synthesize scientific evidence on preventing medical adhesive-related skin injuries in adult intensive care patients.
Methods:
this is a scoping review based on PRISMA-ScR recommendations and the technique proposed by Joanna Briggs Institute. PubMed, CINAHL, Web of Science, Scopus, LILACS, and Embase databases were searched using “Injuries AND Adhesives AND Skin AND Medical” descriptors”.
Results:
1,329 studies were identified, and after analysis, the final sample consisted of nine articles. We obtained two experts’ consensus, three case studies, two cross-sectional studies, one prospective cohort study, and one literature review regarding the type of studies.
Final Considerations:
the synthesized evidence allowed us to list health care measures to prevent medical adhesive-related skin injuries. The professional must know how to identify the skin injuries associated with medical adhesives and the main strategies for their prevention.
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ORIGINAL ARTICLE
Factors associated with the incidence of pressure wounds in critical patients: a cohort study
Revista Brasileira de Enfermagem. 2022;75(6):e20210267
06-24-2022
Resumo
ORIGINAL ARTICLEFactors associated with the incidence of pressure wounds in critical patients: a cohort study
Revista Brasileira de Enfermagem. 2022;75(6):e20210267
06-24-2022DOI 10.1590/0034-7167-2021-0267
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Objectives:
to identify the incidence of pressure wound in critical patients and its associated factors.
Methods:
retrospective cohort study, based on the analysis of 369 critical patients’ records. Descriptive and inferential statistics were used, as well as logistic regression.
Results:
the incidence of pressure wounds was 11.4%. Patients who had been hospitalized for four days or more (OR 2.99; CI95% 1.15-7.78), used nasoenteric tubes (OR: 3.81; CI95%: 1.4010.38), vesical drainage catheters (OR: 4.78; CI95%: 1.31-17.38) and tracheostomy (OR: 3.64; CI95%: 1.48-8.97) had a higher chance of developing pressure wounds. The mean score of the Braden scale among participants who developed (14.2 points) pressure wounds was statistically different (p<0.001) than that of those who did not (12.3 points).
Conclusions:
the incidence of pressure wounds was associated with a higher time in the unit, the use of nasoenteric tubes, vesical drainage catheters, and tracheostomies were associated with a higher time of hospitalization in the unit.
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REVIEW
Alteration of skin condition in newborns admitted to neonatal intensive care: a concept analysis
Revista Brasileira de Enfermagem. 2022;75(4):e20210473
03-30-2022
Resumo
REVIEWAlteration of skin condition in newborns admitted to neonatal intensive care: a concept analysis
Revista Brasileira de Enfermagem. 2022;75(4):e20210473
03-30-2022DOI 10.1590/0034-7167-2021-0473
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Objectives:
to analyze the concept of alteration of skin condition in newborns admitted to the Neonatal Intensive Care Unit.
Methods:
this is a concept analysis operationalized by scoping review. The search was conducted in three parts: the first, in sources like Scopus and Web of Science; the second, in Google Scholar®; and the third, through a parallel list of references.
Results:
according to the types of skin, the most frequent alterations were erythema/redness and pressure injuries. The concept analysis was more evident in the attribute “skin lesions or alterations” than the others. The most frequent antecedents were gestational age, birth weight, and factors related to hospitalization. Among the consequences stood out infection/sepsis.
Conclusions:
this study allows improving the vision of health professionals regarding alterations in skin condition of neonates and, therefore, may contribute to a safe and systematized nursing practice.
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ORIGINAL ARTICLE
Critically ill COVID-19 patients: a sociodemographic and clinical profile and associations between variables and workload
Revista Brasileira de Enfermagem. 2022;75(Suppl 1):e20210119
03-07-2022
Resumo
ORIGINAL ARTICLECritically ill COVID-19 patients: a sociodemographic and clinical profile and associations between variables and workload
Revista Brasileira de Enfermagem. 2022;75(Suppl 1):e20210119
03-07-2022DOI 10.1590/0034-7167-2021-0119
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Objective:
To identify the sociodemographic and clinical profile of COVID-19 patients; measure workload and make associations between clinical variables.
Methods:
Cross-sectional study with 150 adult COVID-19 patients in an intensive care unit (from March to June 2020). Data from the electronic medical record in the first 24 hours of hospitalization: gender, age, education, origin, comorbidities, invasive mechanical ventilation, prone maneuver, renal replacement therapy, pressure injury, Braden, Nursing Activities Score, diagnoses, and nursing care. Descriptive statistical analysis, associations between clinical variables and age group.
Results:
Male (55.3%); mean age, 59 years; hypertensive (57.3%); obese (50.6%); diabetic (34%); invasive mechanical ventilation (66.7%); pronated (20.6%); hemodialysis (15.3%); Nursing Activities Score average, 86%. Twenty-eight nursing diagnoses and 73 cares were found.
Conclusion:
Patients required highly complex support. There was a significant association between pressure injury and workload with the prone maneuver. Nursing diagnoses and care reflect the needs of critical patients.