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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
Evaluation of the performance of the modified early warning score in a Brazilian public hospital
Revista Brasileira de Enfermagem. 2019;72(6):1428-1434
10-21-2019
Abstract
ORIGINAL ARTICLEEvaluation of the performance of the modified early warning score in a Brazilian public hospital
Revista Brasileira de Enfermagem. 2019;72(6):1428-1434
10-21-2019DOI 10.1590/0034-7167-2017-0537
Views0ABSTRACT
Objective:
To evaluate the performance of the modified early warning score (Mews) in a nursing ward for patients in clinical deterioration.
Method:
This is an analytical, quantitative and predictive study. Mews’ parameters (systolic blood pressure, heart rate, respiratory rate, temperature and level of consciousness) were evaluated every six hours. The following events were reported: death, cardiopulmonary arrest and transfer to intensive care. The evaluations were performed in a hospital of reference in the state of São Paulo, Brazil.
Results:
A total of 300 patients were included (57 ± 18 years old, males: 65%). There number of combined events was observed to be greater the higher the score’s value (00%; 00%; 01; 09%; 19%; 28%; 89%, respectively, for Mews 0; 1; 2; 3; 4; 5 and 6; p < 0.0001). Mews ≥ 4 was the most appropriate cut-off point for prediction of these events (sensitivity: 87%, specificity: 85% and accuracy: 0.86).
Conclusion:
Mews properly measured the occurrence of severe events in hospitalized patients of a Brazilian public hospital’s nursing ward. Mews ≥ 4 seems to be the most appropriate cut-off point for prediction of these events.
Keywords:Critical CareEmergency MedicineNursing CareOrgan Dysfunction ScoresRapid Response Teams in HospitalsSee more -
ORIGINAL ARTICLE
Nursing professionals’ biosafety in confronting COVID-19
Revista Brasileira de Enfermagem. 2022;75:e20201104
10-18-2022
Abstract
ORIGINAL ARTICLENursing professionals’ biosafety in confronting COVID-19
Revista Brasileira de Enfermagem. 2022;75:e20201104
10-18-2022DOI 10.1590/0034-7167-2020-1104
Views0See moreABSTRACT
Objective:
To investigate the nursing professionals’ biosecurity in confronting COVID-19.
Methods:
This is a Survey type study. Nursing professionals were invited via messaging apps, using self-applied data collection forms. The sample selection (n=693) was non-probabilistic. A descriptive data analysis was conducted.
Results:
considering the biosafety aspects in facing COVID-19, 79.0% of the participants had not received training or considered it insufficient, 69.3% reported the lack of personal protective equipment during work, and 81.8% did not feel safe with the internal flux adaptations for handling COVID-19 cases.
Conclusion:
Continuous and effective nursing team training and personal protective equipment availability are necessary, as well as internal flow adjustments for attending suspected or confirmed cases.
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ORIGINAL ARTICLE
The association between knowledge about HIV and risk factors in young Amazon people
Revista Brasileira de Enfermagem. 2020;73(5):e20190453
07-08-2020
Abstract
ORIGINAL ARTICLEThe association between knowledge about HIV and risk factors in young Amazon people
Revista Brasileira de Enfermagem. 2020;73(5):e20190453
07-08-2020DOI 10.1590/0034-7167-2019-0453
Views0See moreABSTRACT
Objectives:
analyze the association between the level of HIV knowledge among young people from Amazonas region, their sociodemographic profile and infection risk factors.
Methods:
cross-sectional analytical study, which used a structured questionnaire containing questions about sociodemographic, behavioral aspects and HIV knowledge. Data were grouped by sex and underwent ordinal and binary logistic regression analysis.
Results:
the students had an HIV knowledge deficit, associated with a low educational level of their parents and low family income. The most frequent risk factors were lack of knowledge on the part of female students regarding proper male condom use, their infrequent use in sexual relations and failure to do HIV testing. There was an association between level of knowledge and use of dating apps by female students.
Conclusions:
there was no association between level of knowledge and the preponderant risk factors, but the students’ knowledge deficit rendered them more vulnerable to infection.
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REVIEW
Gender violence perpetrated against trans women
Revista Brasileira de Enfermagem. 2022;75:e20210173
03-07-2022
Abstract
REVIEWGender violence perpetrated against trans women
Revista Brasileira de Enfermagem. 2022;75:e20210173
03-07-2022DOI 10.1590/0034-7167-2021-0173
Views0See moreABSTRACT
Objectives:
to identify scientific evidence on gender violence perpetrated against trans women.
Methods:
integrative review, carried out in June 2020, without time frame, in the Scopus, MEDLINE, Embase, CINAHL, WoS, PsycInfo and LILACS databases. The controlled descriptors of DeCS, MeSH and their entry terms were used: “Transgender People”, “Transgender”, “Gender Identity”, “Transsexuality”, “Gender Violence”, “Aggression”, “Sexual Offenses”, “Rape”, “Violence”, “Domestic Violence”. The presentation and synthesis of the results were presented in the PRISMA-2009 flowchart.
Results:
the final sample, consisting of 16 articles, identified different types of violence (sexual, physical, verbal, psychological and financial), perpetrated by family members, strangers, police officers, intimate partners, health professionals, acquaintances, or friends.
Conclusions:
trans women suffer violence and social exclusion that result from stigma and discrimination due to gender identity and result in unrestricted damage to physical health.
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ORIGINAL ARTICLE
Changes implemented in the work environment of nurses in the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2022;75:e20201381
11-29-2022
Abstract
ORIGINAL ARTICLEChanges implemented in the work environment of nurses in the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2022;75:e20201381
11-29-2022DOI 10.1590/0034-7167-2020-1381
Views0See moreABSTRACT
Objective:
to describe the changes implemented in the work environment of nurses in university hospitals considering the COVID-19 pandemic.
Methods:
this qualitative and descriptive research was developed from an online survey with 75 nurses from three Brazilian university hospitals. Data processing occurred through textual analysis with the aid of software IRAMUTEQ.
Results:
five semantic classes were obtained: Organization of units for exclusive care of patients with COVID-19; Adaptations in the use of personal protective equipment; Physical structure adaptation; Care flow institution; Increased number of beds and training courses. Final considerations: the results show the effort of healthcare and nursing professionals/managers in the development of structural adaptations and reorganizations of care processes, in the hospital context, to respond with quality and efficiency to the demands arising from the COVID-19 pandemic.
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ORIGINAL ARTICLE
Women’s perception of labor and birth care: obstacles to humanization
Revista Brasileira de Enfermagem. 2022;75:e20210215
03-07-2022
Abstract
ORIGINAL ARTICLEWomen’s perception of labor and birth care: obstacles to humanization
Revista Brasileira de Enfermagem. 2022;75:e20210215
03-07-2022DOI 10.1590/0034-7167-2021-0215
Views0See moreABSTRACT
Objectives:
to understand women’s perception regarding the care received during labor and birth.
Methods:
this is a descriptive-exploratory, qualitative study carried out with 54 postpartum women from hospitals in the Metropolitan Region II of the state of Rio de Janeiro, from January to December 2018, using semi-structured interviews submitted to content analysis.
Results:
puerperal women’s perceptions about the childbirth care they received indicated the use of interventions, such as pressure maneuvers on the uterine fundus during the expulsion period – Kristeller maneuver, episiotomy and repeated vaginal examination and without consent. The use of institutional routines, such as zero diet, horizontal birth and disrespect.
Final Considerations:
despite the encouragement of public humanization policies, the technocratic model is still present in obstetric care during childbirth. The humanization of obstetric care requires changes in attitudes and care paradigms, in order to guarantee respect and the right to quality care.
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ORIGINAL ARTICLE
Permanent education for good practices in the prevention of pressure injury: almost-experiment
Revista Brasileira de Enfermagem. 2019;72(6):1646-1652
10-21-2019
Abstract
ORIGINAL ARTICLEPermanent education for good practices in the prevention of pressure injury: almost-experiment
Revista Brasileira de Enfermagem. 2019;72(6):1646-1652
10-21-2019DOI 10.1590/0034-7167-2018-0778
Views0See moreABSTRACT
Objective:
To verify the effectiveness of the educational intervention through the evaluation of nurses’ knowledge about prevention of pressure injury.
Method:
A quasi-experimental study with a single group, carried out with 95 nurses from a teaching hospital in the interior of Minas Gerais, in August and September 2017. As a teaching strategy, the active methodology and hybrid teaching were used, based on the reference of the Method of the Arch of Charles Maguerez. Data were collected from a validated instrument, called the Pieper Knowledge Test, and analyzed by descriptive statistics and Student’s t-test with significance level of p <0.001.
Results:
The mean number of correct answers obtained by the nurses was 78.8% in the pre-test and 88.8% in the post-test, and the difference was statistically significant (p <0.001).
Conclusion:
The educational intervention developed was effective, since it contributed to the improvement of nurses’ knowledge.
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