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RESEARCH01-01-2018
Accuracy of the defining characteristics in nursing diagnoses of Hyperthermia in newborns
Revista Brasileira de Enfermagem. 2018;71(2):357-362
Abstract
RESEARCHAccuracy of the defining characteristics in nursing diagnoses of Hyperthermia in newborns
Revista Brasileira de Enfermagem. 2018;71(2):357-362
DOI 10.1590/0034-7167-2017-0037
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Objective:
to clinically validate the accuracy of the defining characteristics in nursing diagnoses of Hyperthermia in newborns.
Method:
a cross-sectional study conducted in units of medium and high risk in a maternity from the city of Fortaleza-CE. A total of 216 newborns were evaluated to identify the defining characteristics of diagnoses. A latent class model with random effects was used to measure sensitivity and specificity.
Results:
Hyperthermia was present in 5.6% of the sample. The characteristics lack of suction maintenance (31.3%); skin warm to touch (25.5%); lethargy (24.2%); and tachypnea (21.4%) were the most frequent. Stupor presented higher sensitivity (99.9%) and specificity (100%) while vasodilation characteristics, irritability and lethargy only showed significant values for specificity (92.7%, 91.6% and 74.3%, respectively).
Conclusion:
four characteristics of high specificity contribute to Hyperthemia. However, stupor is the only one with significant sensitivity to identify it at its early-stage.
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RESEARCH01-01-2018
Non-frail elderly people and their license to drive motor vehicles
Revista Brasileira de Enfermagem. 2018;71(2):350-356
Abstract
RESEARCHNon-frail elderly people and their license to drive motor vehicles
Revista Brasileira de Enfermagem. 2018;71(2):350-356
DOI 10.1590/0034-7167-2016-0675
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Objective:
to analyse the link between the non-frailty condition and the results of driving license for elderly people to drive motor vehicles.
Method:
cross-sectional study with data collection in the sample period from August 2015 to March 2016. Study performed with 347 elderlies (≥60 years).
Results:
180 (51.9%) of the participants were classified as non-frail. 48 (26.7%) of them were considered capable to drive, 121 (67.2%) capable to drive with restrictions and 11 (6.1%) temporarily uncapable. No significant relation was found between the non-frailty conditions and the results of the motor vehicles driving license study (p=0.557).
Conclusion:
The absence of physical frailty does not necessarily points out that the elderly are able to drive motor vehicles. Tracking the frailty subsidizes preventive interventions, which seek to interfere positively in the act of driving. This is an unprecedented study in nursing and it highlights an essential field for the performance of gerontological nursing.
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RESEARCH01-01-2018
Practice of use of diapers in hospitalized adults and elderly: cross-sectional study
Revista Brasileira de Enfermagem. 2018;71(2):343-349
Abstract
RESEARCHPractice of use of diapers in hospitalized adults and elderly: cross-sectional study
Revista Brasileira de Enfermagem. 2018;71(2):343-349
DOI 10.1590/0034-7167-2016-0341
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Objective:
analyze the practice of use of diapers in adults and elderly in hospital.
Method:
observational cross-sectional study, with a sample of 105 participants assigned according to the data collection period, from September 2013 to January 2014, in the surgical clinic wards in a University Hospital.
Results:
it was observed that 38% of the 105 participants of the study did not need the use of diapers. 18% used it because they were disabled and 16% had their cognitive system damaged. As they were hospitalized, it was identified that 51.4% of patients were there ranging from 02 to 10 days, and 60% used diapers for the same period. It is also identified that long term urinary catheter (24.8%), as technology associated to diapers in the urinary control and to pressure ulcers (12.4%), being the main complication.
Conclusion:
the use of diapers did not have specific criteria to be selected. For this, it was proposed an “Evaluation Scale of Diapers Use in Adults”, as for indication as for its monitoring to help the study transposal for the nursing practice.
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RESEARCH01-01-2018
Burnout and nursing work environment in public health institutions
Revista Brasileira de Enfermagem. 2018;71(2):336-342
Abstract
RESEARCHBurnout and nursing work environment in public health institutions
Revista Brasileira de Enfermagem. 2018;71(2):336-342
DOI 10.1590/0034-7167-2016-0524
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Objective:
to identify associations between the Burnout domains and the characteristics of the work environment.
Method:
cross-sectional study with 745 nurses from 40 public health institutions in São Paulo. Nursing Work Index-Revised (NWI-R) and Maslach Burnout Inventory were used. Similar institutions according to NWI-R were grouped by clustering and the Anova and Bonferroni tests were used in the comparative analyzes.
Results:
there was significant and moderate correlation between emotional exhaustion and autonomy, control over the environment and organizational support; between reduced personal accomplishment, autonomy and organizational support; and between depersonalization and autonomy. The group that presented the worst conditions in the work environment differed on emotional exhaustion from the group with most favorable traits.
Conclusion:
emotional exhaustion was the trait of Burnout that was more consistently related to the group of institutions with more unfavorable working conditions regarding autonomy, organizational support and control over the environment.
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RESEARCH01-01-2018
Patients’ knowledge about medication prescription in the emergency service
Revista Brasileira de Enfermagem. 2018;71(2):329-335
Abstract
RESEARCHPatients’ knowledge about medication prescription in the emergency service
Revista Brasileira de Enfermagem. 2018;71(2):329-335
DOI 10.1590/0034-7167-2017-0002
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Objective:
To identify which orientations were received by the patient about the medication prescription and which professional performed it; to evaluate the patients’ knowledge about prescription drugs and to correlate it to socioeconomic variables, comorbidities, and the frequency with which the patient seeks emergency service; and to evaluate the knowledge about the medication prescribed after the health care.
Method:
This was a cross-sectional study on 304 patients that received emergency service’s discharge along with medication prescription. Applied instruments: sociodemographic characterization and evaluation of the knowledge about the prescribed medication. We used a descriptive and inferential analysis.
Results:
Most subjects had no doubts about how or for how long to take the medication; and presented questions about adverse reactions and what to do in case of forgetting to take the medication doses. There was a significant association between age; educational level; comorbidity; the frequency of emergency service’s use; and knowledge about medications.
Conclusion:
a total of 48% of the patients declared to need information about adverse effects and what to do if they forget to take the medication.
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RESEARCH01-01-2018
Calf circumference: clinical validation for evaluation of muscle mass in the elderly
Revista Brasileira de Enfermagem. 2018;71(2):322-328
Abstract
RESEARCHCalf circumference: clinical validation for evaluation of muscle mass in the elderly
Revista Brasileira de Enfermagem. 2018;71(2):322-328
DOI 10.1590/0034-7167-2017-0121
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Objective:
To validate calf circumference as a technology for assessing muscle mass in the elderly.
Method:
Cross-sectional study with 132 elderly people from Goiânia, Goiás, Brazil. Decreased muscle mass was determined by the skeletal muscle mass index (IME) using Dual Energy X-Ray Absortometry (DEXA). The cutoff circumferences (CC) cutoff points to indicate muscle mass decrease were estimated by ROC curve, sensitivity, specificity and accuracy.
Results:
The most accurate cut-off points for detecting decreased muscle mass in the elderly were 34 cm for men (sensitivity: 71.5%, specificity: 77.4%) and 33 cm for women (sensitivity: 80.0%; specificity: 84.6%).
Conclusion:
CC can be used as a measure for early identification of muscle mass decrease in routine evaluations of the elderly in primary care.
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RESEARCH01-01-2018
Critical defining characteristics for nursing diagnosis about ineffective breastfeeding
Revista Brasileira de Enfermagem. 2018;71(2):314-321
Abstract
RESEARCHCritical defining characteristics for nursing diagnosis about ineffective breastfeeding
Revista Brasileira de Enfermagem. 2018;71(2):314-321
DOI 10.1590/0034-7167-2016-0549
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Objective:
To investigate the Nursing diagnostic accuracy measures and to propose a model to use defining characteristics in order to judge the nursing diagnosis of ineffective breastfeeding.
Method:
Cross-sectional study with a sample of 73 binomials mom-child hospitalized in a maternity ward of an University Hospital, from July to August of 2014.
Results:
The diagnostic predominance rate was 58.9%. The characteristics that best meet the needs of logistic regression model were: discontinuance of breast sucking; infant’s inability of seizing the areola-nipple region correctly; infant’s crying one hour after breastfeeding and inappropriate milk supply perceived.
Conclusion:
Breastfeeding process is dynamic; diagnostic judgement may suffer some changes according to the time data are collected; the defining characteristics are the best predictors if associated with models and rules of use.
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RESEARCH01-01-2018
Construction and validation of clinical contents for development of learning objects
Revista Brasileira de Enfermagem. 2018;71(2):306-313
Abstract
RESEARCHConstruction and validation of clinical contents for development of learning objects
Revista Brasileira de Enfermagem. 2018;71(2):306-313
DOI 10.1590/0034-7167-2016-0622
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Objective:
to describe the process of construction and validation of clinical contents for health learning objects, aimed at patients in the treatment of head and neck cancer.
Method:
descriptive, methodological study. The development of the script and the storyboard were based on scientific evidence and submitted to the appreciation of specialists for validation of content. The agreement index was checked quantitatively and the suggestions were qualitatively evaluated.
Results:
The items described in the roadmap were approved by 99% of expert experts. The suggestions for adjustments were inserted in their entirety in the final version. The free-marginal kappa statistical test, for multiple evaluators, presented value equal to 0.68%, granting a substantial agreement.
Conclusion:
The steps taken in the construction and validation of the content for the production of educational material for patients with head and neck cancer were adequate, relevant and suitable for use in other subjects.
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ORIGINAL ARTICLE06-27-2019
Validation of a clinical simulation setting in the management of postpartum haemorrhage
Revista Brasileira de Enfermagem. 2019;72(3):624-631
Abstract
ORIGINAL ARTICLEValidation of a clinical simulation setting in the management of postpartum haemorrhage
Revista Brasileira de Enfermagem. 2019;72(3):624-631
DOI 10.1590/0034-7167-2018-0065
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Objective:
To construct and validate a clinical simulation setting for postpartum haemorrhage.
Method:
Quantitative research of methodological development, carried out from May to July of 2016 with 22 expert judges and 30 students. Analysis was performed from descriptive statistics, Binomial Test and Content Validity Index (CVI), considering CVI ≥ 80%.
Results:
Setting construction was based on learning objectives, fidelity, evaluation tool, pre-setting activities and debriefing. Agreement, regarding its validity, was satisfactory in the 23 items analyzed. Items evaluated by judges had CVI> 0.90; in the evaluation by students, CVI was > 0.95.
Conclusion:
It was considered validated and suitable for training and use by nursing students. Other studies should be carried out in order to test its effectiveness in the construction of theoretical and practical knowledge of both nursing students and nurses during Permanent Education.
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REVIEW06-01-2020
Access of the black population to health services: integrative review
Revista Brasileira de Enfermagem. 2020;73(4):e20180834
Abstract
REVIEWAccess of the black population to health services: integrative review
Revista Brasileira de Enfermagem. 2020;73(4):e20180834
DOI 10.1590/0034-7167-2018-0834
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Objectives:
demonstrate and discuss how the black population’s access to health services occurs
Methods:
integrative literature review with the following question: How does the black population’s access to health services occur? The search was carried out in the Scholar, LILACS and SciELO databases and used the descriptor “access to health services” and the term “population,” resulting in a sample with twelve articles.
Results:
studies show that the difficulty of access is a fundamental factor for the quality of life of people, directly compromising preventive services, especially for women’s health and, in addition, it has significant impact on the illness process of the black population within its particularities.
Final Considerations:
several limiting factors compromise the black population’s access to health services, including institutional and structural factors
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ORIGINAL ARTICLE10-21-2019
Occupational stress and engagement in primary health care workers
Revista Brasileira de Enfermagem. 2019;72(6):1580-1587
Abstract
ORIGINAL ARTICLEOccupational stress and engagement in primary health care workers
Revista Brasileira de Enfermagem. 2019;72(6):1580-1587
DOI 10.1590/0034-7167-2018-0681
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Objective:
To evaluate levels of occupational stress and work engagement among primary health care workers.
Method:
A descriptive, correlational and transversal study was carried out in a small municipality in the countryside of São Paulo, with a non-probabilistic sample of convenience, with 85 workers. Three self-applied instruments were used: one developed by researchers, containing sociodemographic variables; Work Stress Scale (WSS) and Utrech Work Engagement Scale (UWES).
Results:
Prevalence of women (72.6%), 40 years old or more (45.9%), 4 years and 4 months of mean working time in primary care. Thirty-one workers (36.5%) presented significant stress (scores ≥2.5). Work engagement showed a mean of 4.1 (±1.2) to 4.4 (±1.4), classified as high in all dimensions. Occupational stress and work engagement correlated negatively.
Conclusion:
Workers presented high levels of work engagement; more than one-third had significant occupational stress. Workers with high levels of occupational stress tend to have lower work engagement.
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ORIGINAL ARTICLE07-01-2020
Patient safety culture: perception of nursing professionals in high complexity institutions
Revista Brasileira de Enfermagem. 2020;73(5):e20190174
Abstract
ORIGINAL ARTICLEPatient safety culture: perception of nursing professionals in high complexity institutions
Revista Brasileira de Enfermagem. 2020;73(5):e20190174
DOI 10.1590/0034-7167-2019-0174
Views1See moreABSTRACT
Objectives:
to analyze the perception of nursing professionals about patient safety culture in three highly complex hospital institutions.
Methods:
descriptive and quantitative study with professionals working in care. The Hospital Survey on Patient Safety Culture questionnaire was applied, classifying its dimensions according to the percentage of positive responses (strengthened: ≥75.0%; potential for improvement: <75.0% to> 50.0%; weakened: ≤50.0%).
Results:
four hundred sixty-seven professionals (79.6%), mostly women (88.4%), nursing technicians/assistants (57.2%), 20 to 39 years (60.8%), less than five years in the institution (57.8%) and exclusive bond (79.2%) participated in the study. Safety culture was considered fragile, seven dimensions assessed as such, highlighting “Openness to communication” and “Non-punitive responses to errors” with <30.0% positive responses.
Conclusions:
evidence of the need for discussion of the subject and strategies for change that promote quality and safety of care.
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ORIGINAL ARTICLE06-27-2019
Debriefing evaluation in nursing clinical simulation: a cross-sectional study
Revista Brasileira de Enfermagem. 2019;72(3):788-794
Abstract
ORIGINAL ARTICLEDebriefing evaluation in nursing clinical simulation: a cross-sectional study
Revista Brasileira de Enfermagem. 2019;72(3):788-794
DOI 10.1590/0034-7167-2018-0103
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Objective:
Evaluate the contribution of debriefing after clinical simulations for nursing students.
Method:
Quantitative study, conducted with 35 nursing students who participated in five clinical simulation scenarios with planned debriefings based on the model of the National League Nursing/Jeffries Simulation Theory. After the fifth scenario, students answered the Debriefing Evaluation Scale associated with the Simulation.
Results:
The items evaluated involved the psychosocial, cognitive, and affective values, and within a scale from one to five, the highest mean was found in cognitive value with 4.23 (±0.56) points, then in psychosocial value with 3.77 (±0.53), and finally in affective value with 3.71 (±0.63) points.
Conclusion:
The debriefing conducted after the clinical simulation scenarios was a reflective exercise that contributed to the student integrating multiple knowledges in affective, cognitive and psychosocial values, and thus develop the competencies required.
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REVIEW11-06-2020
Transitional care to caregivers of dependent older people: an integrative literature review
Revista Brasileira de Enfermagem. 2020;73:e20200394
Abstract
REVIEWTransitional care to caregivers of dependent older people: an integrative literature review
Revista Brasileira de Enfermagem. 2020;73:e20200394
DOI 10.1590/0034-7167-2020-0394
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Objective:
To identify the needs of caregivers of dependent older people related to self-care in the transition from hospital to home.
Methods:
Integrative literature review that followed a predefined protocol, carried out from March to May 2019 in the platforms EBSCO, B-On, Scopus, Web of Science, and Joanna Briggs Institute. Descriptors and eligibility criteria were defined for the bibliographic sample, which was ten articles. The search was limited to articles published between 2015 and 2019 to guarantee evidence topicality.
Results:
The needs of caregivers related to transitional care can be grouped into five categories: needs in the transition into the role of caregiver; needs related to self-care of caregivers themselves; health needs; economic needs; and social and collective needs.
Final considerations:
The work developed by nurses regarding transitional care of caregivers must have two focuses: managing care provided to dependent older people and managing the needs of caregivers and the care offered to them.
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REVIEW10-19-2020
Validation methods of nursing protocols: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20200050
Abstract
REVIEWValidation methods of nursing protocols: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20200050
DOI 10.1590/0034-7167-2020-0050
Views0See moreABSTRACT
Objective:
to identify scientific production about validation methods of nursing care protocols.
Method:
an integrative review with search at Scielo, Pubmed/MEDLINE, Virtual Health Library, Web of Science, Scopus, and EBSCOhost. The descriptors “validation studies”, “validation studies as topic”, “protocols”, “clinical protocols”, “practice guidelines as topic”, “nursing” and “nursing assessment” and the uncontrolled descriptor “validation” were used.
Results:
thirty-two articles were selected, most of them Brazilian. Content validation by experts was the most frequent method, with no consensus on the number of participants for the process. The collection instruments were mostly created by the authors. Data analysis was performed using descriptive statistics and Content Validity Index, with a variable consensus rate in the analyzed articles.
Conclusion:
protocols validated by experts are robust tools for use in clinical practice, with methodological rigor in development essential for its quality.
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EXPERIENCE REPORT04-09-2020
Implementation of an Artificial Intelligence Algorithm for sepsis detection
Revista Brasileira de Enfermagem. 2020;73(3):e20180421
Abstract
EXPERIENCE REPORTImplementation of an Artificial Intelligence Algorithm for sepsis detection
Revista Brasileira de Enfermagem. 2020;73(3):e20180421
DOI 10.1590/0034-7167-2018-0421
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Objectives:
to present the nurses’ experience with technological tools to support the early identification of sepsis.
Methods:
experience report before and after the implementation of artificial intelligence algorithms in the clinical practice of a philanthropic hospital, in the first half of 2018.
Results:
describe the motivation for the creation and use of the algorithm; the role of the nurse in the development and implementation of this technology and its effects on the nursing work process.
Final Considerations:
technological innovations need to contribute to the improvement of professional practices in health. Thus, nurses must recognize their role in all stages of this process, in order to guarantee safe, effective and patient-centered care. In the case presented, the participation of the nurses in the technology incorporation process enables a rapid decision-making in the early identification of sepsis.
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