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ORIGINAL ARTICLE
Sepsis and COVID-19: outcomes in young adults in intensive care
Revista Brasileira de Enfermagem. 2023;76(6):e20230037
12-04-2023
Abstract
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
Views0See moreABSTRACT
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.
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ORIGINAL ARTICLE
Changes in body composition of burn patients during the phases of response to trauma
Revista Brasileira de Enfermagem. 2023;76(6):e20230039
12-04-2023
Abstract
ORIGINAL ARTICLEChanges in body composition of burn patients during the phases of response to trauma
Revista Brasileira de Enfermagem. 2023;76(6):e20230039
12-04-2023DOI 10.1590/0034-7167-2023-0039
Views0See moreABSTRACT
Objective:
To assess the changes in body composition of burn patients through electrical bioimpedance in the phases of response to trauma.
Methods:
a longitudinal observational study, carried out from October 2019 to March 2020. Sociodemographic, clinical, epidemiological, anthropometric and body composition data were collected. Statistical analysis was performed with SPSS, considering a significance of 5%. The comparison between variables was performed using the paired Student’s t test.
Results:
the sample consisted of 58 adult burn patients, with a mean age of 38.2±12.5 years. The mean body surface area (BSA) with burns was 10.8±7.3%. Nutritional assessment demonstrated a depletion of body weight, Body Mass Index, fat-free mass and muscle mass in the phases of response to trauma (p<0.005).
Conclusion:
metabolic alterations in the different phases of the metabolic response to trauma led to a depletion of the nutritional status of burn patients of both sexes during hospitalization.
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ORIGINAL ARTICLE
Clinical simulation scenarios for the planning and management of infusion therapy by nurses
Revista Brasileira de Enfermagem. 2023;76(6):e20230019
12-04-2023
Abstract
ORIGINAL ARTICLEClinical simulation scenarios for the planning and management of infusion therapy by nurses
Revista Brasileira de Enfermagem. 2023;76(6):e20230019
12-04-2023DOI 10.1590/0034-7167-2023-0019
Views0ABSTRACT
Objective:
to build, evaluate and test two clinical simulation scenarios for the planning and management of infusion therapy by nurses.
Methods:
methodological study, with construction of scenarios based on the NLN Jeffries Simulation Theory and the theoretical model Vessel Health Preservation; evaluation of the scenario design by judges, with calculation of the Modified Kappa Coefficient (MKC); testing scenarios with the target audience. Results: scenarios built for: 1. Patient assessment and vascular device selection; and 2. Identification and management of deep vein thrombosis. In the evaluation by judges, testing of validated scenarios in relation to educational practices and simulation design, the items evaluated presented MKC values ≥ 0.74.
Conclusion:
two evidence-based scenarios related to infusion therapy were constructed, with high levels of agreement among judges regarding their design. In testing with nurses, good results were obtained regarding the design and structuring of educational practice.
Keywords:Educational MeasurementNursing EducationPatient Care PlanningSimulation TrainingVascular Access DevicesSee more -
ORIGINAL ARTICLE
Burnout, ethical climate and work organization in covid-19 intensive care units: mixed method study
Revista Brasileira de Enfermagem. 2023;76:e20220684
12-04-2023
Abstract
ORIGINAL ARTICLEBurnout, ethical climate and work organization in covid-19 intensive care units: mixed method study
Revista Brasileira de Enfermagem. 2023;76:e20220684
12-04-2023DOI 10.1590/0034-7167-2022-0684
Views0See moreABSTRACT
Objectives:
to analyze the association between burnout and the perception of the ethical climate in nursing professionals in the covid-19 Intensive Care Unit and the relationship with the organization of work from the perspective of managers of these units.
Methods:
mixed method study conducted in three university hospitals in southern Brazil from December 2021 to March 2022. A cross-sectional study was developed with 110 nursing professionals, followed by an exploratory-descriptive study through semi-structured interviews with six managers. Descriptive and analytical statistics and discursive textual analysis were used.
Results:
the prevalence of burnout was 10% and the perception of negative ethical climate was 24.5%. The association between burnout and ethical climate revealed overload and fatigue during working hours, related to tension, fear, and stress that emerged from the consequences of the organization and relations of work in the covid-19 Intensive Care Unit.
Conclusions:
there was an association between burnout and ethical climate and elements of the work organization.
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Ethical dilemmas at the end of life: a reflection from the Philosophical Perspective of Luigina Mortari
Revista Brasileira de Enfermagem. 2023;76:e20220759
12-04-2023
Abstract
Ethical dilemmas at the end of life: a reflection from the Philosophical Perspective of Luigina Mortari
Revista Brasileira de Enfermagem. 2023;76:e20220759
12-04-2023DOI 10.1590/0034-7167-2022-0759
Views0See moreABSTRACT
Objectives:
to reflect on the ethical dilemmas involved in the care of patients at the end of their lives.
Methods:
this is a theoretical-reflective study based on the ethics of care proposed by Luigina Mortari.
Results:
discussing care involves addressing the ways of being inherent to human existence and understanding the unique characteristics of this condition. Ethical care constitutes an action driven by interest in the other and by the perception of their need. Ethical dilemmas are a part of end-of-life care, making it essential to maintain respectful assistance that considers the patient’s autonomy, using strategies for expressing their wishes, and ensuring continuous clear and empathetic communication among all those involved in providing care.
Final Considerations:
issues related to being, stemming from one’s reality of dependency and vulnerability, contribute to the emergence of ethical dilemmas present in care actions.
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EDITORIAL
Chronicity and its impact on workers’ health: a call for concrete actions
Revista Brasileira de Enfermagem. 2023;76:e76suppl301
12-04-2023
Abstract
EDITORIALChronicity and its impact on workers’ health: a call for concrete actions
Revista Brasileira de Enfermagem. 2023;76:e76suppl301
12-04-2023DOI 10.1590/0034-7167.202376suppl301
Views0The relationship between chronicity and work has been a growing concern in contemporary society. As the number of chronic illnesses increases around the world, it is critical to understand how these conditions impact workers’ health(). In this editorial, we will explore the impacts of chronicity on workers’ health, highlighting data from the Global Burden of […]See more -
General Law on Personal Data Protection and applicability to Nursing
Revista Brasileira de Enfermagem. 2023;76:e20230126
12-04-2023
Abstract
General Law on Personal Data Protection and applicability to Nursing
Revista Brasileira de Enfermagem. 2023;76:e20230126
12-04-2023DOI 10.1590/0034-7167-2023-0126
Views0See moreABSTRACT
Objectives:
to reflect on the impacts of the General Personal Data Protection Law on Nursing practice.
Methods:
reflection article, through the intentional collection of materials relating to the topic.
Results:
legislation regulates confidentiality, processing and data sharing, requiring institutional protection measures. The nursing team is responsible for acting preventively, both in care and in the management role, in order to avoid the misuse of the patient’s personal data. The law allows academic research to be carried out as long as the purpose is clear, data collection occurs with an explicit purpose and data is anonymized.
Final Considerations:
although the General Personal Data Protection Law requires greater care in relation to data processing, it is established on precepts of good faith and respect for the rights of the individual, concepts aligned with the nursing code of ethics.
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ORIGINAL ARTICLE
Perceptions and expectations of pregnant women about the type of birth
Revista Brasileira de Enfermagem. 2019;72:41-49
12-13-2019
Abstract
ORIGINAL ARTICLEPerceptions and expectations of pregnant women about the type of birth
Revista Brasileira de Enfermagem. 2019;72:41-49
12-13-2019DOI 10.1590/0034-7167-2017-0731
Views0See moreABSTRACT
Objective:
to understand the perceptions and expectations of pregnant women about the type of birth.
Method:
this is a qualitative research, based on the assumptions of the Humanization of Obstetric Care. 15 pregnant women were interviewed twice at the beginning and the end of gestation between October 2015 and May 2016. Data were analyzed according to the method of the Discourse of the Collective Subject.
Results:
the discourses were associated with four themes: Advantages of vaginal birth over cesarean section; Fear and unpredictability of vaginal birth; Importance of the doctor in the definition of the type of birth; and Influence of family and friends in choosing the type of birth.
Final considerations:
according to pregnant women, vaginal birth has more benefit compared to cesarean section. However, during gestation and birth, fear of pain and the unexpected, and medical opinions of friends and family against vaginal birth strongly influence the choice of cesarean section.
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REVIEW
Nursing practice environment in Primary Health Care: a scoping review
Revista Brasileira de Enfermagem. 2020;73(6):e20190479
08-14-2020
Abstract
REVIEWNursing practice environment in Primary Health Care: a scoping review
Revista Brasileira de Enfermagem. 2020;73(6):e20190479
08-14-2020DOI 10.1590/0034-7167-2019-0479
Views0INTRODUCTIONKnowledge and scientific evidence about nursing practice environments (NPE) in the context of Primary Health Care (PHC) is scarce.Policy makers, health and professional organizations have proposed to redesign the health system in PHC with the aim of increasing citizens’ accessibility, improving customer outcomes and maximizing efficiency. […]See more -
REVIEW
Telenursing in care, education and management in Latin America and the Caribbean: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20190317
09-30-2020
Abstract
REVIEWTelenursing in care, education and management in Latin America and the Caribbean: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20190317
09-30-2020DOI 10.1590/0034-7167-2019-0317
Views0See moreABSTRACT
Objective:
Analyze the knowledge generated about telenursing related to the roles of nurses (care, education and management) in Latin America and the Caribbean, based on scientific evidence.
Methods:
Integrative review, for the years 2009 to 2019, in scientific databases from Latin America and the Caribbean. Twelve articles were selected.
Results:
Nine studies focused on care and three on education. The information and communication technology used in the studies was telephony directed toward non-communicable diseases. There were concerns about the remote communication process. With respect to education, two focused on educating health teams and one on educating patients.
Conclusion:
It is necessary to conduct studies on telenursing that generate changes in care practices, explore information and communication technology resources and provide communication training focused on this new care model.
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ORIGINAL ARTICLE
High-risk areas of leprosy in Brazil between 2001-2015
Revista Brasileira de Enfermagem. 2020;73(3):e20180583
04-09-2020
Abstract
ORIGINAL ARTICLEHigh-risk areas of leprosy in Brazil between 2001-2015
Revista Brasileira de Enfermagem. 2020;73(3):e20180583
04-09-2020DOI 10.1590/0034-7167-2018-0583
Views0See moreABSTRACT
Objectives:
to identify high-risk areas of leprosy in Brazil from 2001 to 2015.
Methods:
this is an ecological study of spatial analysis based on Brazilian municipalities. Spatial scan statistics were used to identify spatial clustering and measure the relative risk from the annual detection rate of new cases of leprosy. By criterion based on the Gini index, only secondary clusters were considered.
Results:
spatial scan statistics detected 26 clusters, in which the detection rate was 59.19 cases per 100 thousand inhabitants, while in the remainder of the country it was 11.76. Large part of the cluster area is located in the Legal Amazon. These groups included only 21.34% of the total population, but 60.40% of the new cases of the disease.
Conclusions:
Leprosy remains concentrated in some areas, showing the need for control programs to intensify actions in these municipalities.
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ORIGINAL ARTICLE
Personal Protective Equipment in the coronavirus pandemic: training with Rapid Cycle Deliberate Practice
Revista Brasileira de Enfermagem. 2020;73:e20200303
06-29-2020
Abstract
ORIGINAL ARTICLEPersonal Protective Equipment in the coronavirus pandemic: training with Rapid Cycle Deliberate Practice
Revista Brasileira de Enfermagem. 2020;73:e20200303
06-29-2020DOI 10.1590/0034-7167-2020-0303
Views0See moreABSTRACT
Objective:
to discuss the application of Rapid Cycle Deliberate Practice for attire and unattire training in the context of COVID-19 and structure a practical guide to the application at this juncture.
Methods:
this methodological study described theoretical and practical aspects of the application of a simulation strategy as a technological training tool. An application guide was constructed from the search for evidence from the main health authority bodies in Brazil.
Results:
maximizing time in Deliberate Practice, feedback with evidence and psychological security are the principles of this strategy. The dynamic involves repetition and feedback. The application guide presents the sequence of actions for attire and unattire.
Final considerations:
coping with this pandemic requires appropriate use of personal protective equipment. The authors suggest the Rapid Cycle Deliberate Practice as a technological educational tool for attire/unattire, since it encourages mastery performance.
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ORIGINAL ARTICLE
Interruptions and nursing workload during medication administration process
Revista Brasileira de Enfermagem. 2019;72(4):1001-1006
08-19-2019
Abstract
ORIGINAL ARTICLEInterruptions and nursing workload during medication administration process
Revista Brasileira de Enfermagem. 2019;72(4):1001-1006
08-19-2019DOI 10.1590/0034-7167-2018-0680
Views0See moreABSTRACT
Objective:
To investigate the sources and causes of interruptions during the medication administration process performed by a nursing team and measure its frequency, duration and impact on the team’s workload.
Métodos:
This is an observational study that timed 121 medication rounds (preparation, administration and documentation) performed by 15 nurses and nine nursing technicians in a Neonatal Intensive Care Unit in the countryside of the state of São Paulo.
Resultados:
63 (52.1%) interruptions were observed. In each round, the number of interruptions that happened ranged from 1-7, for 127 in total; these occurred mainly during the preparation phase, 97 (76.4%). The main interruption sources were: nursing staff – 48 (37.8%) − and self-interruptions – 29 (22.8%). The main causes were: information exchanges – 54 (42.5%) − and parallel conversations – 28 (22%). The increase in the mean time ranged from 53.7 to 64.3% (preparation) and from 18.3 to 19.2% (administration) – p≤0.05.
Conclusão:
Interruptions in the medication process are frequent, interfere in the workload of the nursing team and may reflect on the safety of care.
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ORIGINAL ARTICLE
Depression among nursing students and its association with academic life
Revista Brasileira de Enfermagem. 2020;73(1):e20180173
02-10-2020
Abstract
ORIGINAL ARTICLEDepression among nursing students and its association with academic life
Revista Brasileira de Enfermagem. 2020;73(1):e20180173
02-10-2020DOI 10.1590/0034-7167-2018-0173
Views0See moreABSTRACT
Objective:
To measure the levels of depression among Nursing students from a public institution of higher education and the association with aspects of academic life.
Method:
Analytical and quantitative study with 203 students from a higher education institution that uses active methodologies. We used Beck’s Depression Inventory and the Likert type scale of academic factors.
Results:
We verified that 19.2% had moderate or severe levels of depression. Higher levels of depression were associated with female gender (p=0.003), working more than 40 hours per week (p=0.047), spending more than 90 minutes to reach academic activities (p=0.043) and with 12 academic factors specific to routines of the studied institution.
Conclusion:
The results contribute to managers’ and professors’ reflection and analysis concerning nursing students’ mental health, in addition to indicating in which aspects there is a need to provide greater support to these students.
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