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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
The nursing practice environment and hospital sociotechnical complexity: a mixed-methods study
Revista Brasileira de Enfermagem. 2024;77(6):e20230315
12-16-2024
Abstract
ORIGINAL ARTICLEThe nursing practice environment and hospital sociotechnical complexity: a mixed-methods study
Revista Brasileira de Enfermagem. 2024;77(6):e20230315
12-16-2024DOI 10.1590/0034-7167-2023-0315
Views1See moreABSTRACT
Objectives:
to analyze the relationship between the nursing practice environment and hospital sociotechnical complexity as perceived by nurses.
Methods:
a sequential explanatory mixed-methods study was conducted in a hospital in southern Brazil. The Brazilian version of the Practice Environment Scale-Nursing Work Index and the Complexity Characterization Questionnaire were administered to 132 nurses. Subsequently, semi-structured interviews were conducted with 18 participants, and the data were subjected to thematic analysis. Data integration was achieved through a connection approach.
Results:
the nursing practice environment was found to be favorable, except in the subscale concerning Staffing and Resource Adequacy, where complexity was present in the activities. The three emerging categories explained human and technical aspects related to complexity in the practice environment, quality of care, and patient safety. Unexpected variability was inversely correlated with the practice environment.
Conclusions:
the study results indicate a relationship between these constructs, with implications for the quality and the safety of care.
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REVIEW
Recommendations for guidelines for promoting mental health in the workplace: an umbrella review
Revista Brasileira de Enfermagem. 2024;77(6):e20240086
12-16-2024
Abstract
REVIEWRecommendations for guidelines for promoting mental health in the workplace: an umbrella review
Revista Brasileira de Enfermagem. 2024;77(6):e20240086
12-16-2024DOI 10.1590/0034-7167-2024-0086
Views1See moreABSTRACT
Objectives:
to summarize the recommendations of guidelines for promoting mental health in the workplace.
Methods:
an umbrella review, according to Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses methodological assumptions. Data collection was carried out in January 2021 and updated in July 2023 in the American Psychological Association, Cochrane Library, EMBASE, National Library of Medicine, and Scopus databases. Systematic reviews that assessed guidelines with recommendations for mental health care for workers were included. PROSPERO registration CRD42023461845.
Results:
four systematic reviews published between 2015 and 2018 were identified. The abstracts highlighted actions that facilitate and inhibit the recommendations as well as three categories of intervention: primary prevention – worker protection; secondary prevention – promoting workers’ mental health; and tertiary prevention – supporting, monitoring and rehabilitating workers upon returning to work.
Conclusions:
the interventions are based on prevention, promotion and early recognition, support and rehabilitation of mental health problems.
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ORIGINAL ARTICLE
Validation of a clinical simulation setting in the management of postpartum haemorrhage
Revista Brasileira de Enfermagem. 2019;72(3):624-631
06-27-2019
Abstract
ORIGINAL ARTICLEValidation of a clinical simulation setting in the management of postpartum haemorrhage
Revista Brasileira de Enfermagem. 2019;72(3):624-631
06-27-2019DOI 10.1590/0034-7167-2018-0065
Views0See moreABSTRACT
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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REVIEW
Access of the black population to health services: integrative review
Revista Brasileira de Enfermagem. 2020;73(4):e20180834
06-01-2020
Abstract
REVIEWAccess of the black population to health services: integrative review
Revista Brasileira de Enfermagem. 2020;73(4):e20180834
06-01-2020DOI 10.1590/0034-7167-2018-0834
Views0ABSTRACT
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
Keywords:African Continental Ancestry GroupHealth of Ethnic MinoritiesHealth PolicyHealth Services AccessibilityPrimary Health CareSee more -
ORIGINAL ARTICLE
Occupational stress and engagement in primary health care workers
Revista Brasileira de Enfermagem. 2019;72(6):1580-1587
10-21-2019
Abstract
ORIGINAL ARTICLEOccupational stress and engagement in primary health care workers
Revista Brasileira de Enfermagem. 2019;72(6):1580-1587
10-21-2019DOI 10.1590/0034-7167-2018-0681
Views0ABSTRACT
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.
Keywords:Family Health StrategyHealth PersonnelOccupational StressPrimary Health CareWork EngagementSee more -
ORIGINAL ARTICLE
Patient safety culture: perception of nursing professionals in high complexity institutions
Revista Brasileira de Enfermagem. 2020;73(5):e20190174
07-01-2020
Abstract
ORIGINAL ARTICLEPatient safety culture: perception of nursing professionals in high complexity institutions
Revista Brasileira de Enfermagem. 2020;73(5):e20190174
07-01-2020DOI 10.1590/0034-7167-2019-0174
Views0See 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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REVIEW
Transitional care to caregivers of dependent older people: an integrative literature review
Revista Brasileira de Enfermagem. 2020;73:e20200394
11-06-2020
Abstract
REVIEWTransitional care to caregivers of dependent older people: an integrative literature review
Revista Brasileira de Enfermagem. 2020;73:e20200394
11-06-2020DOI 10.1590/0034-7167-2020-0394
Views0See moreABSTRACT
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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ORIGINAL ARTICLE
Debriefing evaluation in nursing clinical simulation: a cross-sectional study
Revista Brasileira de Enfermagem. 2019;72(3):788-794
06-27-2019
Abstract
ORIGINAL ARTICLEDebriefing evaluation in nursing clinical simulation: a cross-sectional study
Revista Brasileira de Enfermagem. 2019;72(3):788-794
06-27-2019DOI 10.1590/0034-7167-2018-0103
Views0See moreABSTRACT
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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REVIEW
Validation methods of nursing protocols: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20200050
10-19-2020
Abstract
REVIEWValidation methods of nursing protocols: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20200050
10-19-2020DOI 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 REPORT
Implementation of an Artificial Intelligence Algorithm for sepsis detection
Revista Brasileira de Enfermagem. 2020;73(3):e20180421
04-09-2020
Abstract
EXPERIENCE REPORTImplementation of an Artificial Intelligence Algorithm for sepsis detection
Revista Brasileira de Enfermagem. 2020;73(3):e20180421
04-09-2020DOI 10.1590/0034-7167-2018-0421
Views0See moreABSTRACT
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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