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ORIGINAL ARTICLE
Adherence to sepsis protocol in a high-risk maternity reference center
- Marianny Medeiros de Moraes
, - Amuzza Aylla Pereira dos Santos ,
- Juliana Duque da Silva de Sá Leitão ,
- Kassiara Ferreira Felix de Lima Farias ,
- Nathalya Anastácio dos Santos Silva , [ ... ],
- Isabel Comassetto
09-06-2024
Resumo
ORIGINAL ARTICLEAdherence to sepsis protocol in a high-risk maternity reference center
Revista Brasileira de Enfermagem. 2024;77(4):e20230453
09-06-2024DOI 10.1590/0034-7167-2023-0453
- Marianny Medeiros de Moraes ,
- Amuzza Aylla Pereira dos Santos ,
- Juliana Duque da Silva de Sá Leitão ,
- Kassiara Ferreira Felix de Lima Farias ,
- Nathalya Anastácio dos Santos Silva ,
- Núbia Vanessa da Silva Tavares ,
- Kariane Omena Ramos Cavalcante de Melo ,
- Isabel Comassetto
Visualizações0Ver maisABSTRACT
Objective:
To describe the adherence to the sepsis protocol by obstetric nurses in the obstetric triage of a high-risk maternity reference center.
Methods:
This was a quantitative, documental, and retrospective study involving 105 pregnant women treated in obstetric triage under sepsis criteria. Data were collected through electronic medical records using structured forms and were organized into tables employing descriptive statistics. This research adhered to ethical principles concerning human studies.
Results:
Of the checklists for initiating the SEPSIS protocol by obstetric nurses, 105 were identified. Regarding the protocol steps performed, lactate was collected in 97.1% of cases and blood cultures in 98.1%, antibiotic therapy was administered in 94.3%, and hydration was carried out in 51.4% of the cases.
Conclusion:
The initiation of the sepsis protocol for all women meeting the criteria was confirmed. However, the steps were not fully implemented as recommended by the institutional protocol, and the recommended broad-spectrum antibiotic was not administered.
Visualizações0
Resumo
ORIGINAL ARTICLEAdherence to sepsis protocol in a high-risk maternity reference center
Revista Brasileira de Enfermagem. 2024;77(4):e20230453
09-06-2024DOI 10.1590/0034-7167-2023-0453
- Marianny Medeiros de Moraes ,
- Amuzza Aylla Pereira dos Santos ,
- Juliana Duque da Silva de Sá Leitão ,
- Kassiara Ferreira Felix de Lima Farias ,
- Nathalya Anastácio dos Santos Silva ,
- Núbia Vanessa da Silva Tavares ,
- Kariane Omena Ramos Cavalcante de Melo ,
- Isabel Comassetto
Visualizações0Ver maisABSTRACT
Objective:
To describe the adherence to the sepsis protocol by obstetric nurses in the obstetric triage of a high-risk maternity reference center.
Methods:
This was a quantitative, documental, and retrospective study involving 105 pregnant women treated in obstetric triage under sepsis criteria. Data were collected through electronic medical records using structured forms and were organized into tables employing descriptive statistics. This research adhered to ethical principles concerning human studies.
Results:
Of the checklists for initiating the SEPSIS protocol by obstetric nurses, 105 were identified. Regarding the protocol steps performed, lactate was collected in 97.1% of cases and blood cultures in 98.1%, antibiotic therapy was administered in 94.3%, and hydration was carried out in 51.4% of the cases.
Conclusion:
The initiation of the sepsis protocol for all women meeting the criteria was confirmed. However, the steps were not fully implemented as recommended by the institutional protocol, and the recommended broad-spectrum antibiotic was not administered.
- Marianny Medeiros de Moraes
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ORIGINAL ARTICLE
Sepsis and COVID-19: outcomes in young adults in intensive care
- Talita Andrade Santos ,
- José Edilson de Oliveira ,
- Cassiane Dezoti da Fonseca ,
- Dulce Aparecida Barbosa ,
- Angélica Gonçalves da Silva Belasco , [ ... ],
- Carla Roberta Monteiro Miura
12-04-2023
Resumo
ORIGINAL ARTICLESepsis and COVID-19: outcomes in young adults in intensive care
Revista Brasileira de Enfermagem. 2023;76(6):e20230037
12-04-2023DOI 10.1590/0034-7167-2023-0037
- Talita Andrade Santos ,
- José Edilson de Oliveira ,
- Cassiane Dezoti da Fonseca ,
- Dulce Aparecida Barbosa ,
- Angélica Gonçalves da Silva Belasco ,
- Carla Roberta Monteiro Miura
Visualizações0Ver maisABSTRACT
Objective:
to verify sepsis incidence among young adults admitted to intensive care due to COVID-19 and to analyze its association with demographic, clinical and outcome variables.
Methods:
a quantitative, longitudinal, retrospective and analytical study, consisting of 58 adults aged 20 to 40 years in intensive care for SARS-CoV-2. It was carried out in a university hospital, from March 2020 to December 2021, with data collected from electronic medical records.
Results:
sepsis incidence was 65%. Sepsis was associated with acute kidney injury, use of vasoactive drugs and mechanical ventilation, being admitted to the emergency room, severity according to the Simplified Acute Physiology Score III and bacterial pulmonary co-infection, the latter being the most frequent etiology for sepsis.
Conclusions:
there was a high sepsis incidence, with 42% of deaths, which points to the importance of investing in preventive measures, especially in relation to bacterial pulmonary coinfections.
Visualizações0Resumo
ORIGINAL ARTICLESepsis and COVID-19: outcomes in young adults in intensive care
Revista Brasileira de Enfermagem. 2023;76(6):e20230037
12-04-2023DOI 10.1590/0034-7167-2023-0037
- Talita Andrade Santos ,
- José Edilson de Oliveira ,
- Cassiane Dezoti da Fonseca ,
- Dulce Aparecida Barbosa ,
- Angélica Gonçalves da Silva Belasco ,
- Carla Roberta Monteiro Miura
Visualizações0Ver maisABSTRACT
Objective:
to verify sepsis incidence among young adults admitted to intensive care due to COVID-19 and to analyze its association with demographic, clinical and outcome variables.
Methods:
a quantitative, longitudinal, retrospective and analytical study, consisting of 58 adults aged 20 to 40 years in intensive care for SARS-CoV-2. It was carried out in a university hospital, from March 2020 to December 2021, with data collected from electronic medical records.
Results:
sepsis incidence was 65%. Sepsis was associated with acute kidney injury, use of vasoactive drugs and mechanical ventilation, being admitted to the emergency room, severity according to the Simplified Acute Physiology Score III and bacterial pulmonary co-infection, the latter being the most frequent etiology for sepsis.
Conclusions:
there was a high sepsis incidence, with 42% of deaths, which points to the importance of investing in preventive measures, especially in relation to bacterial pulmonary coinfections.
- Talita Andrade Santos
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ORIGINAL ARTICLE
Construction and validation of a scenario for recognizing sepsis by nursing students: a methodological study
Revista Brasileira de Enfermagem. 2023;76(4):e20220537
10-09-2023
Resumo
ORIGINAL ARTICLEConstruction and validation of a scenario for recognizing sepsis by nursing students: a methodological study
Revista Brasileira de Enfermagem. 2023;76(4):e20220537
10-09-2023DOI 10.1590/0034-7167-2022-0537
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Objective:
To build and validate a clinical simulation scenario for teaching Nursing students about early recognition of signs and symptoms of sepsis in the context of the emergency unit.
Methods:
Methodological study developed in two phases: construction of a simulated scenario and content validation by expert judges. For data analysis, the Content Validity Index (CVI) was calculated considering agreement equal to or greater than 80%. The minimum acceptable CVI value for scenario validation was 1.0.
Results:
The simulation scenario proved to be appropriate, with a global Content Validity Index equal to 1. Some adjustments related to the clarity of the wording were necessary, as suggested by the judges. Conclusions: A medium-complexity, high-fidelity scenario was successfully constructed and validated for teaching early recognition of sepsis signs and symptoms.
Visualizações0Resumo
ORIGINAL ARTICLEConstruction and validation of a scenario for recognizing sepsis by nursing students: a methodological study
Revista Brasileira de Enfermagem. 2023;76(4):e20220537
10-09-2023DOI 10.1590/0034-7167-2022-0537
Visualizações0Ver maisABSTRACT
Objective:
To build and validate a clinical simulation scenario for teaching Nursing students about early recognition of signs and symptoms of sepsis in the context of the emergency unit.
Methods:
Methodological study developed in two phases: construction of a simulated scenario and content validation by expert judges. For data analysis, the Content Validity Index (CVI) was calculated considering agreement equal to or greater than 80%. The minimum acceptable CVI value for scenario validation was 1.0.
Results:
The simulation scenario proved to be appropriate, with a global Content Validity Index equal to 1. Some adjustments related to the clarity of the wording were necessary, as suggested by the judges. Conclusions: A medium-complexity, high-fidelity scenario was successfully constructed and validated for teaching early recognition of sepsis signs and symptoms.
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ORIGINAL ARTICLE
Beyond technology: Can artificial intelligence support clinical decisions in the prediction of sepsis?
- Juliane de Souza Scherer ,
- Jéssica Silveira Pereira ,
- Mariana Severo Debastiani ,
- Claudia Giuliano Bica
05-09-2022
Resumo
ORIGINAL ARTICLEBeyond technology: Can artificial intelligence support clinical decisions in the prediction of sepsis?
Revista Brasileira de Enfermagem. 2022;75(5):e20210586
05-09-2022DOI 10.1590/0034-7167-2021-0586
- Juliane de Souza Scherer ,
- Jéssica Silveira Pereira ,
- Mariana Severo Debastiani ,
- Claudia Giuliano Bica
Visualizações0Ver maisABSTRACT
Objective:
To analyze the critical alarms predictors of clinical deterioration/sepsis for clinical decision making in patients admitted to a reference hospital complex.
Methods:
An observational retrospective cohort study. The Machine Learning (ML) tool, Robot Laura®, scores changes in vital parameters and lab tests, classifying them by severity. Inpatients and patients over 18 years of age were included.
Results:
A total of 122,703 alarms were extracted from the platform, classified as 2 to 9. The pre-selection of critical alarms (6 to 9) indicated 263 urgent alerts (0.2%), from which, after filtering exclusion criteria, 254 alerts were delimited for 61 inpatients. Patient mortality from sepsis was 75%, of which 52% was due to sepsis related to the new coronavirus. After the alarms were answered, 82% of the patients remained in the sectors.
Conclusions:
Far beyond technology, ML models can speed up assertive clinical decisions by nurses, optimizing time and specialized human resources.
Visualizações0Resumo
ORIGINAL ARTICLEBeyond technology: Can artificial intelligence support clinical decisions in the prediction of sepsis?
Revista Brasileira de Enfermagem. 2022;75(5):e20210586
05-09-2022DOI 10.1590/0034-7167-2021-0586
- Juliane de Souza Scherer ,
- Jéssica Silveira Pereira ,
- Mariana Severo Debastiani ,
- Claudia Giuliano Bica
Visualizações0Ver maisABSTRACT
Objective:
To analyze the critical alarms predictors of clinical deterioration/sepsis for clinical decision making in patients admitted to a reference hospital complex.
Methods:
An observational retrospective cohort study. The Machine Learning (ML) tool, Robot Laura®, scores changes in vital parameters and lab tests, classifying them by severity. Inpatients and patients over 18 years of age were included.
Results:
A total of 122,703 alarms were extracted from the platform, classified as 2 to 9. The pre-selection of critical alarms (6 to 9) indicated 263 urgent alerts (0.2%), from which, after filtering exclusion criteria, 254 alerts were delimited for 61 inpatients. Patient mortality from sepsis was 75%, of which 52% was due to sepsis related to the new coronavirus. After the alarms were answered, 82% of the patients remained in the sectors.
Conclusions:
Far beyond technology, ML models can speed up assertive clinical decisions by nurses, optimizing time and specialized human resources.
- Juliane de Souza Scherer
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ORIGINAL ARTICLE
Managed clinical protocol: impact of implementation on sepsis treatment quality indicators
- Camila Brito Borguezam ,
- Caroline Tolentino Sanches ,
- Silvia Paulino Ribeiro Albaneser ,
- Uiara Rodrigues de Oliveira Moraes ,
- Cintia Magalhães Carvalho Grion , [ ... ],
- Gilselena Kerbauy
05-28-2021
Resumo
ORIGINAL ARTICLEManaged clinical protocol: impact of implementation on sepsis treatment quality indicators
Revista Brasileira de Enfermagem. 2021;74(2):e20200282
05-28-2021DOI 10.1590/0034-7167-2020-0282
- Camila Brito Borguezam ,
- Caroline Tolentino Sanches ,
- Silvia Paulino Ribeiro Albaneser ,
- Uiara Rodrigues de Oliveira Moraes ,
- Cintia Magalhães Carvalho Grion ,
- Gilselena Kerbauy
Visualizações0Ver maisABSTRACT
Objectives:
to assess the impact of the implementation of a managed sepsis protocol on quality indicators of treatment for septic patients in an emergency department of a university hospital.
Methods:
an observational epidemiological study involving septic patients. The study was divided into two phases, pre-intervention and intervention, resulting from the implementation of the managed sepsis protocol. The study variables included sepsis treatment quality indicators. The results were statistically analyzed using the program Epi InfoTM.
Results:
the study sample included 631 patients, 95 from pre-intervention phase and 536 from intervention phases. Implementing the protocol increased patients’ chances of receiving the recommended treatment by 14 times. Implementing the protocol reduced the hospitalization period by 6 days (p <0.001) and decreased mortality (p <0.001).
Conclusions:
this study showed that implementing the managed protocol had an impact on the improvement of sepsis treatment quality indicators.
Visualizações0Resumo
ORIGINAL ARTICLEManaged clinical protocol: impact of implementation on sepsis treatment quality indicators
Revista Brasileira de Enfermagem. 2021;74(2):e20200282
05-28-2021DOI 10.1590/0034-7167-2020-0282
- Camila Brito Borguezam ,
- Caroline Tolentino Sanches ,
- Silvia Paulino Ribeiro Albaneser ,
- Uiara Rodrigues de Oliveira Moraes ,
- Cintia Magalhães Carvalho Grion ,
- Gilselena Kerbauy
Visualizações0Ver maisABSTRACT
Objectives:
to assess the impact of the implementation of a managed sepsis protocol on quality indicators of treatment for septic patients in an emergency department of a university hospital.
Methods:
an observational epidemiological study involving septic patients. The study was divided into two phases, pre-intervention and intervention, resulting from the implementation of the managed sepsis protocol. The study variables included sepsis treatment quality indicators. The results were statistically analyzed using the program Epi InfoTM.
Results:
the study sample included 631 patients, 95 from pre-intervention phase and 536 from intervention phases. Implementing the protocol increased patients’ chances of receiving the recommended treatment by 14 times. Implementing the protocol reduced the hospitalization period by 6 days (p <0.001) and decreased mortality (p <0.001).
Conclusions:
this study showed that implementing the managed protocol had an impact on the improvement of sepsis treatment quality indicators.
- Camila Brito Borguezam
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REVIEW
The role of the nurse in caring for the critical patient with sepsis
- Maria João Chambel Branco ,
- Ana Paula Mirco Lucas ,
- Rita Margarida Dourado Marques ,
- Patrícia Pontífice Sousa
06-17-2020
Resumo
REVIEWThe role of the nurse in caring for the critical patient with sepsis
Revista Brasileira de Enfermagem. 2020;73(4):e20190031
06-17-2020DOI 10.1590/0034-7167-2019-0031
- Maria João Chambel Branco ,
- Ana Paula Mirco Lucas ,
- Rita Margarida Dourado Marques ,
- Patrícia Pontífice Sousa
Visualizações0Ver maisABSTRACT
Objectives:
to know the nursing interventions in the identification, prevention and control of sepsis in critical patients.
Methods:
integrative review of the literature, with two parallel researches using different MesH terms, using the EBSCO database and Google Scholar. Nine studies were included in the sample.
Results:
nursing interventions are centered on the creation/implementation of protocols for the early recognition of sepsis, the training of teams to ensure a safe and effective approach and the adoption of measures for infection prevention and control as a way to prevent sepsis.
Final Considerations:
the evidence shows that nurses are fundamental in the early identification, control and prevention of sepsis, preventing disease progression and contributing to decreased morbidity and mortality.
Visualizações0Resumo
REVIEWThe role of the nurse in caring for the critical patient with sepsis
Revista Brasileira de Enfermagem. 2020;73(4):e20190031
06-17-2020DOI 10.1590/0034-7167-2019-0031
- Maria João Chambel Branco ,
- Ana Paula Mirco Lucas ,
- Rita Margarida Dourado Marques ,
- Patrícia Pontífice Sousa
Visualizações0Ver maisABSTRACT
Objectives:
to know the nursing interventions in the identification, prevention and control of sepsis in critical patients.
Methods:
integrative review of the literature, with two parallel researches using different MesH terms, using the EBSCO database and Google Scholar. Nine studies were included in the sample.
Results:
nursing interventions are centered on the creation/implementation of protocols for the early recognition of sepsis, the training of teams to ensure a safe and effective approach and the adoption of measures for infection prevention and control as a way to prevent sepsis.
Final Considerations:
the evidence shows that nurses are fundamental in the early identification, control and prevention of sepsis, preventing disease progression and contributing to decreased morbidity and mortality.
- Maria João Chambel Branco
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EXPERIENCE REPORT
Implementation of an Artificial Intelligence Algorithm for sepsis detection
- Luciana Schleder Gonçalves ,
- Maria Luiza de Medeiros Amaro ,
- Andressa de Lima Miranda Romero ,
- Fernanda Karoline Schamne ,
- Jacson Luiz Fressatto , [ ... ],
- Carolina Wrobel Bezerra
04-09-2020
Resumo
EXPERIENCE REPORTImplementation of an Artificial Intelligence Algorithm for sepsis detection
Revista Brasileira de Enfermagem. 2020;73(3):e20180421
04-09-2020DOI 10.1590/0034-7167-2018-0421
- Luciana Schleder Gonçalves ,
- Maria Luiza de Medeiros Amaro ,
- Andressa de Lima Miranda Romero ,
- Fernanda Karoline Schamne ,
- Jacson Luiz Fressatto ,
- Carolina Wrobel Bezerra
Visualizações0Ver maisABSTRACT
Objectives:
to present the nurses’ experience with technological tools to support the early identification of sepsis.
Methods:
experience report before and after the implementation of artificial intelligence algorithms in the clinical practice of a philanthropic hospital, in the first half of 2018.
Results:
describe the motivation for the creation and use of the algorithm; the role of the nurse in the development and implementation of this technology and its effects on the nursing work process.
Final Considerations:
technological innovations need to contribute to the improvement of professional practices in health. Thus, nurses must recognize their role in all stages of this process, in order to guarantee safe, effective and patient-centered care. In the case presented, the participation of the nurses in the technology incorporation process enables a rapid decision-making in the early identification of sepsis.
Visualizações0Resumo
EXPERIENCE REPORTImplementation of an Artificial Intelligence Algorithm for sepsis detection
Revista Brasileira de Enfermagem. 2020;73(3):e20180421
04-09-2020DOI 10.1590/0034-7167-2018-0421
- Luciana Schleder Gonçalves ,
- Maria Luiza de Medeiros Amaro ,
- Andressa de Lima Miranda Romero ,
- Fernanda Karoline Schamne ,
- Jacson Luiz Fressatto ,
- Carolina Wrobel Bezerra
Visualizações0Ver maisABSTRACT
Objectives:
to present the nurses’ experience with technological tools to support the early identification of sepsis.
Methods:
experience report before and after the implementation of artificial intelligence algorithms in the clinical practice of a philanthropic hospital, in the first half of 2018.
Results:
describe the motivation for the creation and use of the algorithm; the role of the nurse in the development and implementation of this technology and its effects on the nursing work process.
Final Considerations:
technological innovations need to contribute to the improvement of professional practices in health. Thus, nurses must recognize their role in all stages of this process, in order to guarantee safe, effective and patient-centered care. In the case presented, the participation of the nurses in the technology incorporation process enables a rapid decision-making in the early identification of sepsis.
- Luciana Schleder Gonçalves
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RESEARCH
Validation of a care protocol for the septic patient in the Intensive Care Unit
Revista Brasileira de Enfermagem. 2018;71(3):1106-1114
01-01-2018
Resumo
RESEARCHValidation of a care protocol for the septic patient in the Intensive Care Unit
Revista Brasileira de Enfermagem. 2018;71(3):1106-1114
01-01-2018DOI 10.1590/0034-7167-2017-0312
Visualizações0Ver maisABSTRACT
Objective:
to elaborate and validate a protocol for the care of the nurse to the septic patient in Intensive Care Units (ICUs).
Method:
instrument validation study. Two steps were followed: instrument development and content validation according to the Delphi technique.
Results:
the validation of contents related to the nurse’s assistance to the septic patient in intensive care was initially composed of eighteen items analyzed by the evaluators/judges. From this, through the Content Validity Index (CVI), thirteen items with strong evidence of validation were identified, CVI = 0.79. Then the instrument was refined, being then composed of fifteen items, which in the second phase Delphi had a percentage of agreement above 84% for the variables pertinent to the protocol.
Conclusion:
the method was effective to validate the contents of a protocol for the nurse’s assistance to the septic patient in the ICU.
Visualizações0Resumo
RESEARCHValidation of a care protocol for the septic patient in the Intensive Care Unit
Revista Brasileira de Enfermagem. 2018;71(3):1106-1114
01-01-2018DOI 10.1590/0034-7167-2017-0312
Visualizações0Ver maisABSTRACT
Objective:
to elaborate and validate a protocol for the care of the nurse to the septic patient in Intensive Care Units (ICUs).
Method:
instrument validation study. Two steps were followed: instrument development and content validation according to the Delphi technique.
Results:
the validation of contents related to the nurse’s assistance to the septic patient in intensive care was initially composed of eighteen items analyzed by the evaluators/judges. From this, through the Content Validity Index (CVI), thirteen items with strong evidence of validation were identified, CVI = 0.79. Then the instrument was refined, being then composed of fifteen items, which in the second phase Delphi had a percentage of agreement above 84% for the variables pertinent to the protocol.
Conclusion:
the method was effective to validate the contents of a protocol for the nurse’s assistance to the septic patient in the ICU.
Sepsis Archives - Revista Brasileira de Enfermagem
