Articles - Revista Brasileira de Enfermagem

  • 01-01-2016

    Prevention and monitoring of delirium in older adults: an educational intervention

    Revista Brasileira de Enfermagem. 2016;69(4):725-732

    Abstract

    Prevention and monitoring of delirium in older adults: an educational intervention

    Revista Brasileira de Enfermagem. 2016;69(4):725-732

    DOI 10.1590/0034-7167.2016690416i

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    ABSTRACT

    Objective:

    to conduct an educational intervention with the nursing team members of an intensive care unit (ICU), aiming to increase knowledge and to introduce improvements in their practices regarding prevention and monitoring of delirium in older patients.

    Method:

    this is an action research, in which workshops were conducted with eleven nurses and a nursing technician from an ICU unit in Salvador, Bahia, Brazil.

    Results:

    ten problems regarding nursing practices for prevention and monitoring of delirium were identified. Educational, practical, technical, and managerial actions were planned, involving cross-sector connections for planning ways to solve these problems. The groups reported significant changes in the practices, with the implementation of drug-free measures for preventing and managing the situation.

    Conclusion:

    the educational intervention contributed to improve the nursing practices in the ICU unit studied, and it also favored the development of critical thinking about the problems mentioned, thus enabling permanent review of offered treatments.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  • 01-01-2016

    Technology-dependent children and the demand for pharmaceutical care

    Revista Brasileira de Enfermagem. 2016;69(4):718-724

    Abstract

    Technology-dependent children and the demand for pharmaceutical care

    Revista Brasileira de Enfermagem. 2016;69(4):718-724

    DOI 10.1590/0034-7167.2016690415i

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    ABSTRACT

    Objective:

    to understand the experience of mothers of technology-dependent children as regards pharmaceutical care.

    Method:

    this was a qualitative, descriptive-exploratory study developed based on open interviews using a structured characterization tool, and applied during home visits to 12 mothers caring for technology-dependent children. The data was submitted to inductive content analysis.

    Results:

    this study is split into two themes: (i) maternal overload during pharmaceutical care, demonstrating the need to administer drugs continuously and the repercussions of this exhaustive care on the caregivers; (ii) the ease or difficulty of access to the medicines required, showing informal strategies and support networks.

    Conclusion:

    pharmaceutical care is a daily challenge expressed in maternal overload and difficulty accessing the drugs, made worse by failures in the care network and coordinated care.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  • 01-01-2016

    Fasting of less than eight hours in urgent and emergency surgeries versus complication

    Revista Brasileira de Enfermagem. 2016;69(4):712-717

    Abstract

    Fasting of less than eight hours in urgent and emergency surgeries versus complication

    Revista Brasileira de Enfermagem. 2016;69(4):712-717

    DOI 10.1590/0034-7167.2016690414i

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    ABSTRACT

    Objective:

    to verify the occurrence of intraoperative and postoperative complications in patients undergoing urgent and emergency surgical procedures between January and December 2012, with fasting time of less than 8 hours.

    Method:

    a quantitative study was conducted, of the retrospective cohort type, through the analysis of medical records.

    Results:

    we included 181 records of patients undergoing surgical procedures with average duration of 59.4 minutes. Fractures correction surgeries stood out, totalling 32% of cases. We observed complications in 36 patients (19.9%), vomiting being the most prevalent (47.2%); followed by nausea (16.7%); need for blood transfusion (13.9%); surgical site infection (11.1%); and death (11.1%). The average fasting time was 133.5 minutes. The fasting time showed no statistically significant correlation with the complications investigated.

    Conclusion:

    intraoperative and postoperative complications were associated with the clinical conditions of the patients and not with the fasting time.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  • 01-01-2016

    Validation to Portuguese of the Debriefing Experience Scale

    Revista Brasileira de Enfermagem. 2016;69(4):705-711

    Abstract

    Validation to Portuguese of the Debriefing Experience Scale

    Revista Brasileira de Enfermagem. 2016;69(4):705-711

    DOI 10.1590/0034-7167.2016690413i

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    ABSTRACT

    Objective:

    to translate and validate to Portuguese the Debriefing Experience Scale jointly with individuals that used high-fidelity simulation in learning.

    Method:

    methodological and exploratory study for an instrument translation and validation. For the validation process, the event “III Workshop Brazil – Portugal: Care Delivery to Critical Patients” was created.

    Results:

    103 nurses attended. Validity and reliability of the scale, the correlation pattern among variables, the sampling adequacy test, and the sphericity test showed good results. Since there was no relationship among the groups established in the exploratory factor analysis, the option was to follow the division established by the original version.

    Conclusion:

    the version of the instrument was called Escala de Experiência com o Debriefing. The results showed good psychometric properties and a good potential for use. However, further studies will contribute to consolidate the validity of the scale and strengthen its potential use.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  • 01-01-2016

    Factor analysis of an instrument to measure the impact of disease on daily life

    Revista Brasileira de Enfermagem. 2016;69(4):697-704

    Abstract

    Factor analysis of an instrument to measure the impact of disease on daily life

    Revista Brasileira de Enfermagem. 2016;69(4):697-704

    DOI 10.1590/0034-7167.2016690412i

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    ABSTRACT

    Objective:

    to verify the structure of factors of an instrument to measure the Heart Valve Disease Impact on Daily Life (IDCV) when applied to coronary artery disease patients.

    Method:

    the study included 153 coronary artery disease patients undergoing outpatient follow-up care. The IDCV structure of factors was initially assessed by means of confirmatory factor analysis and, subsequently, by exploratory factor analysis. The Varimax rotation method was used to estimate the main components of analysis, eigenvalues greater than one for extraction of factors, and factor loading greater than 0.40 for selection of items. Internal consistency was estimated using Cronbach’s alpha coefficient. Results: confirmatory factor analysis did not confirm the original structure of factors of the IDCV. Exploratory factor analysis showed three dimensions, which together explained 78% of the measurement variance.

    Conclusion:

    future studies with expansion of case selection are necessary to confirm the IDCV new structure of factors.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
    Factor analysis of an instrument to measure the impact of disease on daily life
  • 01-01-2016

    Association of frailty in hospitalized and institutionalized elderly in the community-dwelling

    Revista Brasileira de Enfermagem. 2016;69(4):691-696

    Abstract

    Association of frailty in hospitalized and institutionalized elderly in the community-dwelling

    Revista Brasileira de Enfermagem. 2016;69(4):691-696

    DOI 10.1590/0034-7167.2016690411i

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    ABSTRACT

    Objective:

    to investigate the association between frailty with hospitalization and institutionalization in a follow-up study of elderly residents.

    Method:

    the follow-up study was performed in 2008 and 2013 with elderly of both genders, aged 65 years and older who were living in the community-dwelling. The sampling procedure performed was probabilistic, with dual-stage clustering. In 2008, 515 elderly people were interviewed and, in 2013, 262. We used the socioeconomic and demographic data, self-reported morbidity, specific data of hospitalization and institutionalization. Frailty was measured by the Edmonton Frail Scale (EFS), and functional capacity through the Functional Independence Measure.

    Results:

    we found the mean gross EFS score was higher among resident elderly who were hospitalized and institutionalized and was statistically significant in both investigated years.

    Conclusion:

    the confirmation of association between frailty and hospitalization and institutionalization reinforces the importance of the subject, and highlights frailty as an important tool for risk estimates for these adverse events.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  • 01-01-2016

    Associação da fragilidade em idosos internados e institucionalizados na comunidade

    Revista Brasileira de Enfermagem. 2016;69(4):691-696

    Abstract

    Associação da fragilidade em idosos internados e institucionalizados na comunidade

    Revista Brasileira de Enfermagem. 2016;69(4):691-696

    DOI 10.1590/0034-7167.2016690411i

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    RESUMEN

    Objetivo:

    investigar la asociación entre la fragilidad y la internación e institucionalización, en un estudio de acompañamiento de residentes ancianos.

    Método:

    el estudio de acompañamiento fue realizado en 2008 y 2013, con ancianos de ambos sexos, de 65 años o más, los cuales vivían en la comunidad. El procedimiento de muestreo realizado fue probabilístico, con agrupamiento en dos etapas. Fueron entrevistados 512 ancianos en 2008 y 262 en 2013. Datos socioeconómicos y demográficos, morbilidad relatada por los mismos y datos específicos de internación e institucionalización han sido utilizados. La fragilidad fue medida por la escala Edmond Frail Scale (EFS) y la capacidad funcional por la escala Functional Independence Measure (FIM).

    Resultados:

    El promedio de la puntuación EFS fue mayor entre los residentes ancianos que fueron internados y hospitalizados, siendo estadísticamente significativa en los dos años investigados.

    Conclusión:

    La confirmación de la asociación entre la fragilidad y la internación e institucionalización refuerza la importancia del tema y enfatiza la fragilidad como un instrumento importante en la evaluación de los riesgos para estos eventos adversos.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  • 01-01-2016

    Analysis of managerial and healthcare indicators after nursing personnel upsizing

    Revista Brasileira de Enfermagem. 2016;69(4):684-690

    Abstract

    Analysis of managerial and healthcare indicators after nursing personnel upsizing

    Revista Brasileira de Enfermagem. 2016;69(4):684-690

    DOI 10.1590/0034-7167.2016690410i

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    ABSTRACT

    Objective:

    analyze healthcare and managerial indicators after nursing personnel upsizing.

    Method:

    a retrospective, descriptive study was conducted using data from computer systems of a university hospital in southern Brazil. Healthcare and managerial indicators related to the first half of 2013 and 2014 were statistically analyzed.

    Results:

    increases of 40.0% in the number of nurses and 16.0% in the number of nursing technicians led to reductions of 12.0% in the number of sickness absences, 21.8% in positive balance for compensatory time off, 92.0% in paid overtime. Reductions of 75.0% in pressure ulcer rates, 10.5% in the number of falls and 50.0% in infections due to indwelling catheter use were also observed.

    Conclusion:

    nursing staff upsizing caused a positive impact on managerial and healthcare indicators and helped qualify care and improve work conditions for the nursing team.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
    Analysis of managerial and healthcare indicators after nursing personnel upsizing

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