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RESEARCH01-01-2018
Standard Operational Protocols in professional nursing practice: use, weaknesses and potentialities
Revista Brasileira de Enfermagem. 2018;71(1):126-134
Abstract
RESEARCHStandard Operational Protocols in professional nursing practice: use, weaknesses and potentialities
Revista Brasileira de Enfermagem. 2018;71(1):126-134
DOI 10.1590/0034-7167-2016-0621
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Objective:
to evaluate the use of Standard Operational Protocols (SOPs) in the professional practice of the nursing team based on the theoretical framework of Donabedian, as well as to identify the weaknesses and potentialities from its implementation.
Method:
Evaluative research, with quantitative approach performed with nursing professionals working in the Health Units of a city of São Paulo, composed of two stages: document analysis and subsequent application of a questionnaire to nursing professionals.
Results:
A total of 247 nursing professionals participated and reported changes in the way the interventions were performed. The main weaknesses were the small number of professionals, inadequate physical structure and lack of materials. Among the potentialities were: the standardization of materials and concern of the manager and professional related to patient safety.
Conclusion:
The reassessment of SOPs is necessary, as well as the adoption of a strategy of permanent education of professionals aiming at improving the quality of care provided.
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RESEARCH01-01-2018
Evaluation of the risk of misidentification of women in a public maternity hospital
Revista Brasileira de Enfermagem. 2018;71(1):120-125
Abstract
RESEARCHEvaluation of the risk of misidentification of women in a public maternity hospital
Revista Brasileira de Enfermagem. 2018;71(1):120-125
DOI 10.1590/0034-7167-2017-0134
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Objective:
To determine the frequency of similar names and hospital records of women in a public teaching maternity hospital and the risk of misidentification resulting from the similarity in spelling and pronunciation of the names and in records.
Method:
Quantitative, documental and case study of 5,975 admissions that occurred between 2011 and 2014. The data name, admission and discharge date, date of birth, hospital record and bed number were collected from an electronic information system. Analysis encompassed descriptive statistics and design of an algorithm for comparison of text and sound.
Results:
Examination of the names revealed that 86% of the misidentification cases resulted from identical surnames and 96.5% from a sound similarity in the first names. There were patients with identical first and last names at least one day a week.
Conclusion:
The risk of misidentification of patients is a reality, which stresses the importance of checking and pronouncing the complete names correctly.
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RESEARCH01-01-2018
Analysis of incidents notified in a general hospital
Revista Brasileira de Enfermagem. 2018;71(1):111-119
Abstract
RESEARCHAnalysis of incidents notified in a general hospital
Revista Brasileira de Enfermagem. 2018;71(1):111-119
DOI 10.1590/0034-7167-2016-0574
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Objective:
To evaluate the incidents spontaneously notified in a general hospital in Minas Gerais.
Method:
Retrospective, descriptive, quantitative study performed at a general hospital in Montes Claros – Minas Gerais State. The sample comprised 1,316 incidents reported from 2011 to 2014. The data were submitted to descriptive statistical analysis using Statistical Package for the Social Sciences version 18.0.
Results:
The prevalence of incidents was 33.8 per 1,000 hospitalizations, with an increase during the investigation period and higher frequency in hospitalization units, emergency room and surgical center. These occurred mostly with adult clients and relative to the medication supply chain. The main causes were noncompliance with routines/protocols, necessitating changes in routines and training.
Conclusion:
There was a considerable prevalence of incidents and increase in notifications during the period investigated, which requires the attention of managers and hospital staff. Nevertheless, we observed development of the patient safety culture.
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RESEARCH01-01-2018
Signs and symptoms in Gaucher Disease: priority nursing diagnoses
Revista Brasileira de Enfermagem. 2018;71(1):104-110
Abstract
RESEARCHSigns and symptoms in Gaucher Disease: priority nursing diagnoses
Revista Brasileira de Enfermagem. 2018;71(1):104-110
DOI 10.1590/0034-7167-2016-0434
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Objective:
Identify the signs and symptoms of patients with Gaucher Disease, inferring possible priority nursing diagnoses.
Method:
Cross-sectional study, developed in a specialized laboratory, between 2013 and 2015. The sample (n = 91) comprised the records of patients with genetic diagnosis for Gaucher Disease. The study respected research norms.
Results:
Prevalence of female sex (57.1%), age at diagnosis between 0 and 10 years, and origin from the Southeast Region of Brazil were prevalent. Hematologic changes, bone pain, hepatomegaly, splenomegaly, and fatigue were the most recurrent signs and symptoms. The inferred diagnoses for the studied population were: Risk for bleeding; Fatigue; Chronic pain and Acute pain; Impaired physical mobility; Imbalanced nutrition: less than body requirements; and Risk for Developmental Delay.
Conclusion:
The establishment of Priority Nursing Diagnoses based on signs and symptoms makes it possible to achieve expected outcomes for each individual in the care context.
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RESEARCH01-01-2018
Social determinants of health related to adhesion to mammography screening
Revista Brasileira de Enfermagem. 2018;71(1):97-103
Abstract
RESEARCHSocial determinants of health related to adhesion to mammography screening
Revista Brasileira de Enfermagem. 2018;71(1):97-103
DOI 10.1590/0034-7167-2016-0623
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Objective:
To identify proximal, intermediary and individual social determinants related to mammography adherence, according to the Social Determinants of Health model proposed by Dahlgren and Whitehead. Method: Correlational cross-sectional study, carried out with a sociodemographic and clinical data questionnaire and the Champion’s Health Belief Model Scale, translated and adapted for use in Brazil. Data analyzed by multiple linear regression, from the domains scale, and sociodemographic and clinical variables were used as predictors.
Results:
The age group of 60-64 years (55.0%) was highlighted, 22 (55.0%) women had a stable partner; and 14 (65.0%) completed higher education. The domain with the greatest influence on adhesion to mammography was perceived barriers.
Conclusion:
The social determinants of health are directly related to the levels of adherence to the exam among women, as well as the perceived benefits, susceptibilities and barriers.
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RESEARCH01-01-2018
Training of adolescent multipliers from the perspective of health promotion core competencies
Revista Brasileira de Enfermagem. 2018;71(1):89-96
Abstract
RESEARCHTraining of adolescent multipliers from the perspective of health promotion core competencies
Revista Brasileira de Enfermagem. 2018;71(1):89-96
DOI 10.1590/0034-7167-2016-0532
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Objective:
Recognize the domains of health promotion core competencies in the training process of adolescents carried out by nursing students.
Method:
Qualitative and descriptive study, which used the theoretical methodological contribution Developing Competencies and Professional Standards for Health Promotion Capacity Building in Europe (CompHP), carried out with 14 nursing students.
Results:
There were four domains: Enable Change; Mediate through Partnership; Communication; and Leadership. These domains came from the interest and commitment of adolescents in intersectoral partnership, the use of communication techniques, and the role of facilitator to catalyze learning and empowerment.
Conclusion:
There were some domains of core competency in the training of adolescents, suggesting that nursing students act as health promoters. Challenges for Nursing are the implementation of a theoretical contribution of CompHP in undergraduate and ongoing training to carry out health promotion action.
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RESEARCH01-01-2018
Validation of nursing diagnoses, interventions and outcomes in a pediatric clinic
Revista Brasileira de Enfermagem. 2018;71(1):80-88
Abstract
RESEARCHValidation of nursing diagnoses, interventions and outcomes in a pediatric clinic
Revista Brasileira de Enfermagem. 2018;71(1):80-88
DOI 10.1590/0034-7167-2016-0647
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Objectives:
To elaborate operational definitions for the Nomenclature nursing diagnoses, interventionsand outcomes of the Pediatric Clinic at a University Hospital and carry out a validation of the content and clinical aspects of this Nomenclature.
Method:
Methodological research, developed in two stages: documentary study, for the validation of content of the operational definitions of nursing diagnoses; and secondly applied research, via clinical cases, performed with children from 0 to 5 years.
Results:
The 126 diagnoses were submitted to consensus validation and 55.6% were validated. Six clinical case studies were carried out, using the phases of the nursing process, based on the theory of Basic Human Needs, identifying 24.3% of the validated diagnoses and 54.5% of the nursing interventions listed in the Nomenclature.
Conclusion:
The study showed the effectiveness of using the Nomenclature in the Pediatric Clinic, in order to optimize the care andquality of health services.
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RESEARCH01-01-2018
Cognitive changes in nurses working in intensive care units
Revista Brasileira de Enfermagem. 2018;71(1):73-79
Abstract
RESEARCHCognitive changes in nurses working in intensive care units
Revista Brasileira de Enfermagem. 2018;71(1):73-79
DOI 10.1590/0034-7167-2016-0513
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Objective:
To measure the levels of stress, anxiety, and depression of nurses working in ICUs, relating them to levels of attention before and after 24 hours.
Method:
An observational, quantitative, analytical study with 18 nurses undergoing an inventory of stress, anxiety, and depression, as well as assessment of attention levels and psychomotor functioning.
Results:
Sixty-one percent showed positive for stress. Depression was observed in 33%; and anxiety in 99.9%. A strong correlation between stress and depression (ρ = 0.564 with p <0.05) and anxiety (ρ = 1 with p <0.05) was observed. There was a weak correlation between stress and task execution time in M2 (ρ = 0.055) for TMT A, a fact that did not occur in M0 (ρ = -0.249).
Conclusion:
The study shows that the workload of the nurses working in 24-hour shifts in the ICU is correlated with high levels of stress, decreases in the attention process, and psychomotor decline.
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ORIGINAL ARTICLE03-24-2021
Costs of healthcare-associated infections in an Intensive Care Unit
Revista Brasileira de Enfermagem. 2021;74(1):e20200275
Abstract
ORIGINAL ARTICLECosts of healthcare-associated infections in an Intensive Care Unit
Revista Brasileira de Enfermagem. 2021;74(1):e20200275
DOI 10.1590/0034-7167-2020-0275
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Objectives:
to evaluate hospitalization costs of patients with and without Healthcare-Associated Infections an Intensive Care Unit.
Methods:
a retrospective case-control study. Data collection was retrieved from the medical records of Intensive Care Unit of a medium-sized public hospital in Goiás-Brazil. For each case, two controls were selected. Data on socioeconomic, clinical, and hospital costs were collected. To verify associations between variables, Odds Ratio and linear regression were calculated.
Results:
a total of 21 patients diagnosed with Healthcare-Associated Infections and 42 controls were evaluated. The hospitalization cost for patients with infection was four times higher than for non-infection patients (p-value<0.001). There was an association between infection and higher mortality (p-value <0.001), longer hospital-stay (p-value =0.021), and higher hospital costs (p-value =0.007).
Conclusions:
hospitalization costs of diagnosed Healthcare-Associated Infections patients are high compared to those who do not have this diagnosis.
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ORIGINAL ARTICLE03-24-2021
Feelings, experiences and expectations of kidney transplant individuals and challenges for the nurse
Revista Brasileira de Enfermagem. 2021;74(1):e20200392
Abstract
ORIGINAL ARTICLEFeelings, experiences and expectations of kidney transplant individuals and challenges for the nurse
Revista Brasileira de Enfermagem. 2021;74(1):e20200392
DOI 10.1590/0034-7167-2020-0392
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Objectives:
to identify feelings, experiences, and expectations of kidney transplant patients, generated from the diagnosis of chronic renal disease until the post-transplant period, highlighting the challenges for nurses to incorporate individualized care to cope throughout the disease process.
Methods:
qualitative, descriptive research, carried with seven kidney transplant patients, in the city of Manaus, State of Amazonas. The data analysis followed the methodological referential of Bardin’s content analysis.
Results:
the diagnosis of the disease was experienced negatively, and hemodialysis was described as an imprisonment and health decline. The transplant meant an improvement in quality of life. The main difficulties were lack of a specialized hospital and low immunity.
Conclusions:
the nurses’ approach of chronic renal patient and with the renal transplantation favored the discovery of solutions facing the demands of the disease and allowed greater capacity to implement individualized care, surrounding a relationship of trust and respect.
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ORIGINAL ARTICLE06-11-2021
Work at the surgical center: risks of the pathogenic suffering of the nursing team
Revista Brasileira de Enfermagem. 2021;74(2):e20190803
Abstract
ORIGINAL ARTICLEWork at the surgical center: risks of the pathogenic suffering of the nursing team
Revista Brasileira de Enfermagem. 2021;74(2):e20190803
DOI 10.1590/0034-7167-2019-0803
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Objectives:
to assess the risks of pathogenic suffering related to the experience of nursing workers in the operating room of a university hospital.
Methods:
cross-sectional, quantitative study, carried out from 11/2017 to 01/2018 in a university hospital in the South of Brazil. The sample was composed by 159 nursing workers of the units of a surgical center, that answered to the Scale of Evaluation of Pathogenic Suffering at Work. Data was submitted to statistical analysis.
Results:
the workers present low risk of pathogenic suffering related to the experiences at work, being the results of its factors: Uselessness (1.47±0.761) – low risk; Indignity (2.372±1.035) – medium risk; and Disqualification (1.74±0.903) – low risk.
Conclusions:
the evaluation of Pathogenic Suffering at Work Scale was positive, predominating low risk for pathogenic suffering of surgical center workers related to professional experiences, because they feel useful, valued and are not indignant about their work, feelings that reflect on the quality of care provided.
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ORIGINAL ARTICLE05-21-2021
Music in the relief of stress and distress in cancer patients
Revista Brasileira de Enfermagem. 2021;74(2):e20190838
Abstract
ORIGINAL ARTICLEMusic in the relief of stress and distress in cancer patients
Revista Brasileira de Enfermagem. 2021;74(2):e20190838
DOI 10.1590/0034-7167-2019-0838
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Objectives:
to evaluate the effects of music on the physiological stress and distress of cancer patients being treated in a hospital.
Methods:
quasi-experimental study carried out with cancer patients hospitalized in the nursing wards of a public hospital. There was a single 15-minute intervention using music. It was individual, and headphones were used for patients to listen to three songs chosen by each one. The levels of stress and distress were measured before and after the intervention, using music to analyze the cortisol in the saliva and the answers to the distress thermometer. The significance level of the statistical analysis was 5%, using the non-parametric Wilcoxon test.
Results:
the mean age of the 26 patients was 56 years old. Most were female, white, and had breast cancer. After intervention, there were statistically significant diminutions in both stress and distress — p < 0.001.
Conclusions:
the use of music diminishes the stress and the distress of cancer patients.
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ORIGINAL ARTICLE05-21-2021
Orthognathic surgery: doubts from patients with orofacial fissures regarding the immediate postoperative period
Revista Brasileira de Enfermagem. 2021;74(2):e20200089
Abstract
ORIGINAL ARTICLEOrthognathic surgery: doubts from patients with orofacial fissures regarding the immediate postoperative period
Revista Brasileira de Enfermagem. 2021;74(2):e20200089
DOI 10.1590/0034-7167-2020-0089
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Objectives:
to identify the main doubts regarding the immediate postoperative care of patients with orofacial clefts undergoing orthognathic surgery.
Methods:
cross-sectional, quantitative study, developed in a public and tertiary hospital, between November 2017 and May 2018. Data collection occurred through interviews during the preoperative nursing consultation. An instrument was used to describe doubts, which later were grouped according to the subject.
Results:
48 patients participated. The doubts referred to sun exposure (56%), food/mastication (48%), the relationship between intermaxillary block-breathing-vomiting (48%), oral hygiene (31%), physical activity restriction (27%), nasopharyngeal cannula, removal of surgical stitches, hospitalization time and speech/communication (23%), bleeding, cryotherapy, facial massage, aesthetic and functional results, healing, edema/ecchymosis, postoperative pain, and changes in facial sensitivity (21%).
Conclusions:
the doubts were related to food, the period of convalescence, care for the surgical wound, postoperative complications, and medications.
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ORIGINAL ARTICLE05-28-2021
The work of a Brazilian nursing team of collective health in the special indigenous health district
Revista Brasileira de Enfermagem. 2021;74(2):e20200116
Abstract
ORIGINAL ARTICLEThe work of a Brazilian nursing team of collective health in the special indigenous health district
Revista Brasileira de Enfermagem. 2021;74(2):e20200116
DOI 10.1590/0034-7167-2020-0116
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Objective:
To identify the potential and the limits of the actions of the nursing team in the Primary Health Care for the Health of the Indigenous.
Methods:
This is a quantitative study guided by the Theory of Practical Intervention of Nursing and Collective Health. 230 nursing professionals participated, responding to an instrument about the frequency of the actions carried out in assistance, management, teaching, and research.
Results:
168 nursing technicians and 62 nurses participated. As strengths, 80% participated in the assistance most of the time. Stand out: 90.3% and 71% of nurses carried out nursing consultations and house visits, respectively. As a limitation, the involvement in education and research is small. Only 2% of the interviewees carried out scientific researches, reflecting the need to broaden and qualify care and improve the use of traditional practices, overcoming the biomedical model.
Final considerations:
Nursing assistance is essential in the modification and monitoring of the epidemiological profile of indigenous populations, and its results allow for the planning of quality actions.
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ORIGINAL ARTICLE05-28-2021
Managed clinical protocol: impact of implementation on sepsis treatment quality indicators
Revista Brasileira de Enfermagem. 2021;74(2):e20200282
Abstract
ORIGINAL ARTICLEManaged clinical protocol: impact of implementation on sepsis treatment quality indicators
Revista Brasileira de Enfermagem. 2021;74(2):e20200282
DOI 10.1590/0034-7167-2020-0282
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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.
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ORIGINAL ARTICLE06-16-2021
The meaning of nursing 200 years after Nightingale – perceptions of professional practice in the intensivist context
Revista Brasileira de Enfermagem. 2021;74(2):e20200364
Abstract
ORIGINAL ARTICLEThe meaning of nursing 200 years after Nightingale – perceptions of professional practice in the intensivist context
Revista Brasileira de Enfermagem. 2021;74(2):e20200364
DOI 10.1590/0034-7167-2020-0364
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Objectives:
to know the meaning of contemporary nursing from the experience of intensive care nurses.
Methods:
qualitative research based on the theoretical framework of Symbolic Interactionism and the methodological framework of Interpretive Interactionism. The setting was a general hospital in Bahia, being carried out with 12 nurses working in intensive care for at least one year, through semi-structured interviews and drawing-text-theme technique, whose data were organized according to Miles and Huberman and analyzed upon the referential.
Results:
the sense of being a nurse was evidenced; a being for care, resulting from the experience in intensive care, capable of promoting the development of professional self-image, by causing, in nurses, other skills – besides the scientific ones, such as empathy, creativity, spirituality and compassion.
Final Considerations:
the sense of being a nurse, currently, expresses developments inherited from the Nightingalean proposal, but transcends the technical-managerial emphasis of this to a humanistic care perspective converging with our contemporary professional identity: a being for care.
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