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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
Views0See moreABSTRACT
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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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
Views0See moreABSTRACT
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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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
Views0See moreABSTRACT
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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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
Views1See moreABSTRACT
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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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
Views0See moreABSTRACT
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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RESEARCH01-01-2016
Associação da fragilidade em idosos internados e institucionalizados na comunidade
Revista Brasileira de Enfermagem. 2016;69(4):691-696
Abstract
RESEARCHAssociação da fragilidade em idosos internados e institucionalizados na comunidade
Revista Brasileira de Enfermagem. 2016;69(4):691-696
DOI 10.1590/0034-7167.2016690411i
Views0See moreRESUMEN
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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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
Views0See moreABSTRACT
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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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
Views0ABSTRACT
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.
Keywords:AbsenteeismHealth Care Quality IndicatorsHospital Nursing StaffHospital Personnel AdministrationPatient SafetySee more
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Analysis of the decision-making process of nurse managers: a collective refl ection
Revista Brasileira de Enfermagem. 2015;68(4):668-675
Abstract
Analysis of the decision-making process of nurse managers: a collective refl ection
Revista Brasileira de Enfermagem. 2015;68(4):668-675
DOI 10.1590/0034-7167.2015680414i
Views0ABSTRACT
Objective:
to analyze the decision-making model adopted by nurses from the perspective of some decision-making process theories.
Method:
qualitative approach, based on action research. Semi-structured questionnaires and seminars were conducted from April to June 2012 in order to understand the nature of decisions and the decision-making process of nine nurses in position of managers at a public hospital in Southern Brazil. Data were subjected to content analysis.
Results:
data were classified in two categories: the current situation of decision-making, which showed a lack of systematization; the construction and collective decision-making, which emphasizes the need to develop a decision-making model.
Conclusion:
the decision-making model used by nurses is limited because it does not consider two important factors: the limits of human rationality, and the external and internal organizational environments that infl uence and determine right decisions.
Keywords:Decision Support PracticesNursingNursing Administration ResearchPractice ManagementProfessional CompetenceSee more -
Social representations of sexuality for the elderly
Revista Brasileira de Enfermagem. 2015;68(4):662-667
Abstract
Social representations of sexuality for the elderly
Revista Brasileira de Enfermagem. 2015;68(4):662-667
DOI 10.1590/0034-7167.2015680413i
Views0See moreABSTRACT
Objective:
to know the social representations of sexuality for the elderly, based on the Social Representation Theory.
Method:
study performed in a Basic Family Health Unit in Maracanau-CE, Brazil, with 30 elderly adults. Data were collected from March through April of 2013, using the free word evocation technique. Data were organized and processed using the EVOC 2000.software
Results:
the subjects evoked 150 words associated with the evocator word “sexuality”. Out of these, 43 were different. At the possible core of the representation of sexuality for the elderly, the following words were found: love, affection and respect. Sex, companionship, understanding and coexistence composed the intermediate elements of representation.
Conclusion:
the performed analyses pointed to love, respect and affection as central elements that structured and organized the social representation of sexuality in the elder years for the group studied.
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Post-accident work behavior in caring for people with HIV/Aids
Revista Brasileira de Enfermagem. 2015;68(4):656-661
Abstract
Post-accident work behavior in caring for people with HIV/Aids
Revista Brasileira de Enfermagem. 2015;68(4):656-661
DOI 10.1590/0034-7167.2015680412i
Views0ABSTRACT
Objective:
To identify post-accident conduct in the workplace by health professionals in caring for people with HIV/Aids.
Method:
A qualitative and descriptive research study with a socio-historical perspective (1986-2006), performed in a reference hospital for infectious diseases in the State of Santa Catarina. To collect data, interviews were conducted with oral history among 23 health workers and, for the treatment of data, Bardin’s content analysis was used.
Results:
Post-accident behaviors emerged that included assessment, accident records, chemoprophylaxis when necessary, support, monitoring of the injured worker, and mainly psychological support.
Conclusion:
In situations in which the accident could not be avoided, post-exposure behaviors were important biosecurity strategies mentioned by health workers caring for patients with HIV/Aids, in the sense of minimizing the possible transmission of the HIV virus.
Keywords:Acquired Immunodeficiency SyndromeHealth ProfessionalsOccupational AccidentsOccupational HealthOccupational RisksSee more -
Nursing care management for children hospitalized with chronic conditions
Revista Brasileira de Enfermagem. 2015;68(4):641-648
Abstract
Nursing care management for children hospitalized with chronic conditions
Revista Brasileira de Enfermagem. 2015;68(4):641-648
DOI 10.1590/0034-7167.2015680410i
Views0See moreABSTRACT
Objective:
to understand the interactions of nurses managing nursing care for the hospitalized child with a chronic condition.
Method:
Theoretical and methodological references were used, Complex Thought and grounded theory, respectively. In the study 18 subjects have participated arranged in three groups: nurses, nursing technicians and family members. A semi-structured interview was used as technique for data collection. The data analysis followed three stages of coding: open, axial and selective.
Results:
the category “Needing to manage nursing care to the hospitalized child with chronic condition in Pediatric Inpatient Unit” and their subcategories show the complex inter subjective bindings established by nurses that support the practice of nursing care management.
Conclusion:
There are difficulties for nursing professionals to interact with the child’s family and the dialogical order/disorder/interaction/organization in the implementation of the management process of care is.
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Functional disability and socioeconomic and demographic factors in elderly
Revista Brasileira de Enfermagem. 2015;68(4):633-640
Abstract
Functional disability and socioeconomic and demographic factors in elderly
Revista Brasileira de Enfermagem. 2015;68(4):633-640
DOI 10.1590/0034-7167.2015680409i
Views0See moreABSTRACT
Objective:
to verify the prevalence of functional disability and associated socioeconomic and demographic factors in elderly patients of Campina Grande/PB.
Method:
cross-sectional study with elderly patients of both genders. The variables associated with functional disability were assessed using Poisson regression.
Results:
A total of 420 elderly patients were included (68.1% women). The highest prevalence of functional disability were found among females aged 80 or older, white, widowed, of economic classes D/E , who lived alone, with frequency of contacts of up to 224 people and diversity of contacts of up to 14 people. After multivariate analysis, statistically significant association was observed between functional disability, gender and age group.
Conclusion:
the association between functional disability gender and age group is shown to be an important guidance for health interventions since it will allow health services to plan actions aiming to improve, maintain or restore the functional capacity of the elderly population.
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Hypertension and Diabetes Mellitus Program evaluation on user’s view
Revista Brasileira de Enfermagem. 2015;68(4):626-632
Abstract
Hypertension and Diabetes Mellitus Program evaluation on user’s view
Revista Brasileira de Enfermagem. 2015;68(4):626-632
DOI 10.1590/0034-7167.2015680408i
Views0See moreABSTRACT
Objectives:
to evaluate the program proposed by the Reorganization Care Plan for Hypertension and Diabetes Mellitus on user’s view, and describe aspects of the trajectory of the participants correlating with the program’s evaluation.
Method:
evaluative study with a qualitative approach conducted in health units with the Family Health Strategy, in a city of the metropolitan region of Curitiba, in the period from September to March, 2012. A total of 30 adults with hypertension and/or Diabetes mellitus were interviewed. Data were analyzed through content analysis.
Results:
Four categories were identified: Disease diagnosis; Reasons for the program need; Knowledge of the program, and program evaluation.
Conclusion:
there was the recognition of the orientations, and the monitoring of activities developed, with emphasis in cost reduction for users.
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Violence in the eye of adolescents: education intervention with Culture Circles
Revista Brasileira de Enfermagem. 2015;68(4):617-625
Abstract
Violence in the eye of adolescents: education intervention with Culture Circles
Revista Brasileira de Enfermagem. 2015;68(4):617-625
DOI 10.1590/0034-7167.2015680407i
Views0See moreABSTRACT
Objective:
to apply the methodology of Culture Circles on adolescents as a strategy for health education of nurses in the construction of the collective knowledge of the thematic violence.
Method:
action research type and qualitative study. Participants were 11 adolescents from a public school in Recife, PE, Brazil. Data production in Culture Circles included the participant observation with field diary, photographic recording and filming, as well as the photovoice technique. The analysis was performed by triangulating data in dialogue with the literature.
Results:
it was shown that the problematizing action provided by the Culture Circle made possible to create situations in which adolescents felt invited to critically refl ect on the phenomenon of violence in all its complexity.
Conclusion:
the health education intervention, performed by Culture Circles, added learning and mutual growth subsidizing nursing care actions that excel at leadership and autonomy of adolescents.
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Nasal colonization with Staphylococcus aureus in nursing students: ground for monitoring
Revista Brasileira de Enfermagem. 2016;69(6):1046-1051
Abstract
Nasal colonization with Staphylococcus aureus in nursing students: ground for monitoring
Revista Brasileira de Enfermagem. 2016;69(6):1046-1051
DOI 10.1590/0034-7167-2016-0210
Views0See moreABSTRACT
Objective:
to monitor bacterial strains of Staphylococcus aureus that are resistant or not to oxacillin in nursing undergraduate students, with an emphasis on the process of colonization.
Method:
cross-sectional prevalence study carried out with 138 nursing students. The biological samples of the nasal cavity were collected in June 2015, by means of sterile swabs, which were subsequently submitted to confirmatory tests of catalase and coagulase. Isolated Staphylococcus aureus had their sensitivity profile determined by means of the Kirby Bauer method. Descriptive, univariate and bivariate analyses were performed.
Results:
the prevalence of Staphylococcus aureus was 21.7. Regarding the resistance profile, 24.1% of strains were resistant to oxacillin, with ampicillin being the antimicrobial with the greatest resistance (82.8%).
Conclusion:
the nasal cavity is an important bacterial flora of S. aureus in nursing students. The profile of isolated strains highlights the increase of Staphylococcus aureus resistance to antimicrobials such as oxacillin.
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Factors associated with the occurrence of adverse events in critical elderly patients
Revista Brasileira de Enfermagem. 2016;69(6):1039-1045
Abstract
Factors associated with the occurrence of adverse events in critical elderly patients
Revista Brasileira de Enfermagem. 2016;69(6):1039-1045
DOI 10.1590/0034-7167-2016-0199
Views0See moreABSTRACT
Objective:
to identify the factors associated with the occurrence of adverse events in critical elderly patients admitted to intensive care unit according to demographic and clinical characteristics.
Method:
a retrospective cohort study was conducted in nine units of a teaching hospital. Data were collected from medical records and from monitoring of nursing shift change. We used the t-test/Mann-Whitney, chi-square and logistic regression to test associations. Significance level of 5% was used.
Results:
out of the 315 elderly, 94 experienced events. Those who experienced events were men (60.6%) with mean age of 70.7 years, length of hospital stay of 10.6 days and survivors (61.7%). Most of the 183 events were clinical processes and procedures (37.1%). There was an association between adverse event and length of hospital stay in the unit (p=0.000; OR=1.10, 95% CI [1.06, 1.14]).
Conclusion:
the identification of associated events and factors in the elderly subsidize the prevention of these occurrences before the vulnerability of this age group.
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Challenges to implementation of advance directives of will in hospital practice
Revista Brasileira de Enfermagem. 2016;69(6):1031-1038
Abstract
Challenges to implementation of advance directives of will in hospital practice
Revista Brasileira de Enfermagem. 2016;69(6):1031-1038
DOI 10.1590/0034-7167-2016-0085
Views0See moreABSTRACT
Objective:
to understand the difficulties and limitations in the implementation of advance directives of will in the hospital context.
Method:
qualitative, exploratory and descriptive study conducted by means of semi-structured interviews with nurses, resident physicians and family caregivers. The data were analyzed by using discursive textual analysis based on the framework of bioethics principles.
Results:
the following categories emerged: Terminality as an expression of loss and cure as an option for care; concerns about legal implications; advance directives of will demand patient autonomy and proper communication.
Conclusion:
limitations and difficulties in practice of advance directives of will from the perspective of the participants show, apart from countless conflicts and dilemmas regarding end-of life matters, that impending death experiences obstruct patients’ wishes.
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Experience and coping strategies in relatives of addicts
Revista Brasileira de Enfermagem. 2016;69(6):1024-1030
Abstract
Experience and coping strategies in relatives of addicts
Revista Brasileira de Enfermagem. 2016;69(6):1024-1030
DOI 10.1590/0034-7167-2015-0044
Views0See moreABSTRACT
Objective:
to understand the experience and coping strategies in relatives of drug addicts.
Method:
a study was developed with 87 relatives of addicts, registered in two Basic Health Units. The focus group was used as the study method, and content analysis was applied.
Results:
four categories were chosen: perception of relatives about the drug addiction of their family members; feelings and attitudes related to being a relative of an addict; difficulties found in the process; and, coping strategies. The findings reflected the difficulty when mentioning the subject, and the need of being cared for. Relatives believed that the addict needs to have the will to get into treatment, and they faced challenges in dealing with sporadic disappearances. They pointed to feelings of pity, impotence, disgust, hate, shame, fear of aggressiveness, and humiliation.
Conclusion:
the biggest difficulties were dealing with relapses, and the lack of public resources. Religiosity and faith, isolation and advice were used as coping strategies; ambivalence in thoughts and attitudes was demonstrated.
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Leadership and cooperation: 25 years of mission as a WHO collaborating center
Revista Brasileira de Enfermagem. 2016;69(6):1017-1023
Abstract
Leadership and cooperation: 25 years of mission as a WHO collaborating center
Revista Brasileira de Enfermagem. 2016;69(6):1017-1023
DOI 10.1590/0034-7167-2016-0058
Views0See moreABSTRACT
Objective:
analyse the evolution in the mission and vision of a World Health Organization Collaborating Centre in Nursing in Brazil in the context of the implementation of its terms of reference.
Method:
Historical-social documentary research with a qualitative approach.
Results:
During the 25 years of its activities as a Collaborating Centre, its mission to “promote and stimulate the development of nursing research in the region, with a focus on Latin America” triggered activities in the context of its terms of reference in four areas: Human Resource Formation for Research, Knowledge Production, Knowledge Dissemination, Encouragement of Exchange and Stimulus of Partnerships.
Conclusion:
The activities developed were consolidated through the strengthening of Brazilian and international partnerships, further stimulated by the five redesignations of the Collaborating Centre in the period analysed. Thus, its vision of becoming leader and driving agent of innovations in the academic, care and political context of nursing could be put in practice.
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ABEn 90 years and the Brazilian Journal of Nursing
Revista Brasileira de Enfermagem. 2016;69(6):1011-1012
Abstract
ABEn 90 years and the Brazilian Journal of Nursing
Revista Brasileira de Enfermagem. 2016;69(6):1011-1012
Views0In this special edition, we celebrate 90 years of the Brazilian Nursing Association (ABEn), at the same time in which we celebrate the creation and maintenance of the first scientific nursing journal in Brazil. Emerging in 1932, it has shone a light on the production of knowledge and the constitution of nursing in Brazil today.As […]See more -
ABEn 90 anos e a Revista Brasileira de Enfermagem
Revista Brasileira de Enfermagem. 2016;69(6):1011-1012
Abstract
ABEn 90 anos e a Revista Brasileira de Enfermagem
Revista Brasileira de Enfermagem. 2016;69(6):1011-1012
Views0Neste número temático, celebramos os 90 anos da Associação Brasileira de Enfermagem (ABEn), ao mesmo tempo em que comemoramos a criação e manutenção da primeira revista científica de enfermagem do Brasil, que, desde 1932, despontou trazendo luz para a produção do conhecimento e a constituição do que é a enfermagem no Brasil atual.A ABEn, como […]See more -
ERRATUM
Revista Brasileira de Enfermagem. 2016;69(5):1003-1003
Abstract
ERRATUM
Revista Brasileira de Enfermagem. 2016;69(5):1003-1003
DOI 10.1590/0034-7167.20166905e02
Views1Article “Association between self-care and hospital readmissions of patients with heart failure”, with number of DOI: 10.1590/0034-7167.2016690312i, published in the journal Revista Brasileira de Enfermagem, v69(3):469-74, page 469 that read:“Amanda Chlalup LinnI, Karina AzollinII,III, Emiliane Nogueira de SouzaII,IV“.[…]See more
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