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ORIGINAL ARTICLE12-04-2023
Sepsis and COVID-19: outcomes in young adults in intensive care
Revista Brasileira de Enfermagem. 2023;76(6):e20230037
Abstract
ORIGINAL ARTICLESepsis and COVID-19: outcomes in young adults in intensive care
Revista Brasileira de Enfermagem. 2023;76(6):e20230037
DOI 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 ARTICLE12-04-2023
Changes in body composition of burn patients during the phases of response to trauma
Revista Brasileira de Enfermagem. 2023;76(6):e20230039
Abstract
ORIGINAL ARTICLEChanges in body composition of burn patients during the phases of response to trauma
Revista Brasileira de Enfermagem. 2023;76(6):e20230039
DOI 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 ARTICLE12-04-2023
Clinical simulation scenarios for the planning and management of infusion therapy by nurses
Revista Brasileira de Enfermagem. 2023;76(6):e20230019
Abstract
ORIGINAL ARTICLEClinical simulation scenarios for the planning and management of infusion therapy by nurses
Revista Brasileira de Enfermagem. 2023;76(6):e20230019
DOI 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 ARTICLE12-04-2023
Burnout, ethical climate and work organization in covid-19 intensive care units: mixed method study
Revista Brasileira de Enfermagem. 2023;76:e20220684
Abstract
ORIGINAL ARTICLEBurnout, ethical climate and work organization in covid-19 intensive care units: mixed method study
Revista Brasileira de Enfermagem. 2023;76:e20220684
DOI 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
Abstract
Ethical dilemmas at the end of life: a reflection from the Philosophical Perspective of Luigina Mortari
Revista Brasileira de Enfermagem. 2023;76:e20220759
DOI 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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EDITORIAL12-04-2023
Chronicity and its impact on workers’ health: a call for concrete actions
Revista Brasileira de Enfermagem. 2023;76:e76suppl301
Abstract
EDITORIALChronicity and its impact on workers’ health: a call for concrete actions
Revista Brasileira de Enfermagem. 2023;76:e76suppl301
DOI 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
Abstract
General Law on Personal Data Protection and applicability to Nursing
Revista Brasileira de Enfermagem. 2023;76:e20230126
DOI 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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REVIEW09-21-2020
Middle range theory for the nursing diagnosis Excess Fluid Volume in pregnant women
Revista Brasileira de Enfermagem. 2020;73:e20190334
Abstract
REVIEWMiddle range theory for the nursing diagnosis Excess Fluid Volume in pregnant women
Revista Brasileira de Enfermagem. 2020;73:e20190334
DOI 10.1590/0034-7167-2019-0334
Views1See moreABSTRACT
Objective:
To stablish a middle range theory for the understanding of the causal mechanisms and clinical consequentes of the nursing diagnosis Excess Fluid Volume (00026) among pregnant women.
Method:
The Middle Range Theory was constructed in five stages: defining of construction approach, establishing main concepts, elaborating propositions, developing a pictorial diagram, and establishing the causal relationships and evidence for practice of the Middle Range Theory.
Results:
We identified 14 clinical indicators and 6 causal factors of Excess Fluid Volume. A pictorial diagram was developed and relationships between Excess Fluid Volume elements were established with 6 propositions for them.
Conclusion:
The Middle Range Theory included both physiological and pathological conditions to explain Excess Fluid Volume. This Middle Range Theory might help in the better understanding of interactions between causal factors and clinical indicators of Excess Fluid Volume.
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ORIGINAL ARTICLE06-27-2019
Assessment of the attribute “Community Orientation” from the perspective of primary care adult users
Revista Brasileira de Enfermagem. 2019;72(3):632-639
Abstract
ORIGINAL ARTICLEAssessment of the attribute “Community Orientation” from the perspective of primary care adult users
Revista Brasileira de Enfermagem. 2019;72(3):632-639
DOI 10.1590/0034-7167-2018-0601
Views1See moreABSTRACT
Objective:
To assess the presence and extension of the attribute “Community Orientation” of Primary Health Care from the perspective of health services adult users from the Municipality of Juazeiro do Norte-CE.
Methods:
Quantitative, cross-sectional and evaluative study, carried out in 14 Basic Health Units, from October 2016 to June 2017, using the Primary Care Assessment Tool.
Results:
The attribute assessment was negative, reaching expressive negative responses in the seven districts, with a mean score of 3.8 (±3.8). The Raw Score (RS) reached a mean of 6.6 and the Derived Score (DS) was assigned a score of 6.4, below the cut-off point ≥ 6.60.
Conclusion:
The low value of the DS represents that units are not providers of PHC, suggesting fragility in the integration of services with the community and the need to promote greater discussion among agents, when designing measures of intervention and improvement of scores.
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REVIEW12-21-2020
Communication between pre-hospital and intra-hospital emergency medical services: literature review
Revista Brasileira de Enfermagem. 2020;73:e20190817
Abstract
REVIEWCommunication between pre-hospital and intra-hospital emergency medical services: literature review
Revista Brasileira de Enfermagem. 2020;73:e20190817
DOI 10.1590/0034-7167-2019-0817
Views1ABSTRACT
Objectives:
to analyze, according to the scientific literature, communication strategies in the transfer of cases between pre-hospital and in-hospital services and their contributions to patient safety.
Methods:
this is a literature review study, that is, one that aims to gather and synthesize research results on the subject in a systematic and orderly manner.
Results:
ten articles were published, published between 2010 and 2018, and two points of discussion emerged: use of mnemonics; and barriers to transferring a case.
Conclusions:
studies point to the need to standardize the case transfer process, as well as integrative training of professionals, regular assessment of the teams involved in emergency medical services and the need for research on the subject.
Keywords:AmbulanceCommunicationEmergency Medical ServicesReviewTransfer of Responsibility by the PatientSee more -
ORIGINAL ARTICLE03-24-2021
Health promotion actions in the School Health Program in Ceará: nursing contributions
Revista Brasileira de Enfermagem. 2021;74(1):e20190769
Abstract
ORIGINAL ARTICLEHealth promotion actions in the School Health Program in Ceará: nursing contributions
Revista Brasileira de Enfermagem. 2021;74(1):e20190769
DOI 10.1590/0034-7167-2019-0769
Views1See moreABSTRACT
Objectives:
to compare health promotion actions carried out by Family Health teams in Ceará, linked to the School Health Program.
Methods:
a cross-sectional study involving the first and second cycles of an external assessment of 910 and 1,626 teams from 184 municipalities, which joined the Brazilian National Program for Improvement of Access and Quality of Primary Care. Eight clinical assessment and seven health promotion indicators were assessed, together with health professionals working in schools.
Results:
the interviewees were nurses (95.6% and 98.3%). Between the cycles, there was an increase in clinical assessment (78.7% and 91.3%), health promotion and disease prevention (82.5% and 89.3%) and survey of students for follow-up (41.4% and 66.4%) in schools.
Conclusions:
health actions at school advanced between cycles, with nurses as protagonists in school health, which can reduce vulnerabilities in children and adolescents and qualify Primary Care.
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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
Views1See moreABSTRACT
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 ARTICLE05-28-2021
Prevalence and severity levels of post-radical prostatectomy incontinence: different assessment instruments
Revista Brasileira de Enfermagem. 2021;74(2):e20200692
Abstract
ORIGINAL ARTICLEPrevalence and severity levels of post-radical prostatectomy incontinence: different assessment instruments
Revista Brasileira de Enfermagem. 2021;74(2):e20200692
DOI 10.1590/0034-7167-2020-0692
Views1See moreABSTRACT
Objectives:
to analyze urinary incontinence prevalence and severity in prostatectomized men assessed by three different instruments.
Methods:
a cross-sectional study was conducted with 152 men. The pad test, pad used, and International Consultation on Incontinence Questionnaire – Short Form (self-report) were considered. Data were analyzed using Spearman’s correlation, Kappa index, considering a significance level of 0.05.
Results:
urinary incontinence prevalence was 41.4%, 46.7% and 80.3% according to pad used, pad test and self-report. Positive correlations and moderate to poor agreement were found between the instruments. As for severity, most participants had mild incontinence. The largest number of cases of mild and severe incontinence was identified by self-report.
Conclusions:
the self-report showed higher values for prevalence of mild and severe severity levels. Through the identified differences, we propose that the objective assessment (pad used and pad test) be associated with individuals’ perception (self-report) to better estimate prevalence and severity.
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ORIGINAL ARTICLE05-28-2021
Cultural adaptation and validation of an instrument about nursing critical thinking skills
Revista Brasileira de Enfermagem. 2021;74(2):e20200720
Abstract
ORIGINAL ARTICLECultural adaptation and validation of an instrument about nursing critical thinking skills
Revista Brasileira de Enfermagem. 2021;74(2):e20200720
DOI 10.1590/0034-7167-2020-0720
Views1See moreABSTRACT
Objectives:
to validate the Nursing Critical Thinking in Clinical Practice Questionnaire regarding cultural aspects and metric properties.
Methods:
a methodological research carried out through cross-cultural adaptation, face and content validity, dimensional construct and known groups validity, test-retest reliability and internal consistency. 511 nurses from four hospitals participated in the study, of which 54 participated in retest.
Results:
the instrument validation for Brazilian Portuguese maintained equivalences, according to the original version. The dimensional validity demonstrated adjustment to the tetrafactorial structure of the original version (GFI=0.69). There were statistically significant differences in critical thinking skills between nurses with graduate degrees and who undertook training, reading articles, developing research and working in an institution with a longer time implementation of the Nursing Process. The instrument showed temporal stability (ICC 073-0.84; p<0.001) and adequate internal consistency (α=0.97).
Conclusions:
the instrument proved to be valid and reliable for the studied population.
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REVIEW07-09-2021
Breast cancer screening in Primary Health Care in Brazil: a systematic review
Revista Brasileira de Enfermagem. 2021;74(3):e20200995
Abstract
REVIEWBreast cancer screening in Primary Health Care in Brazil: a systematic review
Revista Brasileira de Enfermagem. 2021;74(3):e20200995
DOI 10.1590/0034-7167-2020-0995
Views1See moreABSTRACT
Objectives:
to analyze care strategies for breast cancer screening in Primary Health Care in Brazil.
Methods:
this is a systematic review following the Cochrane Collaboration recommendations.
Results:
among 355 manuscripts, five were eligible. The patient navigation program by Community Health Agent stood out with the best result, among the strategies: flexibility of goals considering viability; community engagement; team training; active search of the target population by Community Health Agent; request for mammography by physicians; actions integrated to women’s health; monitoring of mammography results, absent users, and population coverage by physician and nurse; and assessment of criteria for requesting screening mammography by means of an information system. The population coverage rate in the program ranged from 23% to 88%.
Conclusions:
Primary Health Care in Brazil presents devices with potential to induce the production of care for breast cancer screening.
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