ABSTRACT
@#Ageing is associated with changes in the body composition, reduced insulin sensitivity and beta-cell function, which predispose the older adults to glucose intolerance and a higher risk of diabetes mellitus. The diabetes treatment for older adults is complicated by higher rates of coexisting illnesses, functional and physical disability, cognitive impairment, and more prone to injury. The treatment goal is less stringent, with a reasonable HbA1c between 7.0 to 8.0 percent, with the aim to minimise the risk of hypoglycaemia. Medical nutrition therapy and physical activity are the cornerstones in the management, failing so, pharmacotherapy with oral or injectable diabetes medication would be needed for diabetes control. The Appropriate Care Guidelines, Ministry of Health, on Oral Glucose-Lowering Agents, and Initiating Basal Insulin in type 2 diabetes mellitus, published in 2017, have provided the framework for the use of oral glucose-lowering agents and insulin therapy for diabetes management in the general population. The diabetes management plan includes a multidisciplinary team, a greater consideration of patient factors, aspiration and goals, and risk evaluation and mitigation strategy to prevent hypoglycaemia. Easy and early access to health care is critical as older adults are prone to rapid deterioration in the clinical condition.
ABSTRACT
New silver-containing dressings developed in recent years have brought new and powerful means for the prevention and treatment of wound infection, which promote development and progress of wound therapy. There are many kinds of silver-containing dressings, however, misunderstanding and even misapplication exist in how to choose and use these dressings. Based on literature evidence, we propose this national expert consensus on clinical application of silver-containing dressings, particularly in terms of kinds and mechanisms, indications, contraindications, rational selections in different wounds, and cautions in the clinical application of silver-containing dressings. This consensus would be helpful for medical and nursing personnels to use silver-containing dressings in wound repair field in clinic correctly and professionally.
Subject(s)
Humans , Administration, Topical , Bandages , Burns , Therapeutics , Consensus , Silver Compounds , Therapeutic Uses , Surgical Wound Infection , Wound Infection , TherapeuticsABSTRACT
New silver-containing dressings developed in recent years have brought new and powerful means for the prevention and treatment of wound infection, which promote development and progress of wound therapy. There are many kinds of silver-containing dressings, however, misunderstanding and even misapplication exist in how to choose and use these dressings. Based on literature evidence, we propose this national expert consensus on clinical application of silver-containing dressings, particularly in terms of kinds and mechanisms, indications, contraindications, rational selections in different wounds, and cautions in the clinical application of silver-containing dressings. This consensus would be helpful for medical and nursing personnel to use silver-containing dressings in wound repair field in clinic correctly and professionally.
Subject(s)
Humans , Administration, Topical , Bandages , Burns , Therapeutics , Consensus , Silver Compounds , Therapeutic Uses , Surgical Wound Infection , Wound Healing , Wound Infection , TherapeuticsABSTRACT
The nursing attendance in mental health has been changing your paradigm, such as psychiatric remodeling and the new role assumed by the nurses. This study aims to describe the activities developed for a group of nursing academics during the practical process of teaching-learning applied at patients with mental disease in therapeutic phase. It is an experience report developed at a Psychosocial Support Center located at the city of Fortaleza-Ceará in the period held from September to November of 2004. The activities implemented by the academics were the group of community therapy, the wait room group and the therapeutic relationship. The community therapy and the therapeutic relationship obtained larger success due to the deep interaction between patients and academics, in addiction to the confort and sence of valuable the activities caused them. The development of the experience revealed itself important once it provided the mutual learning, obtaining satisfactory results and certainty that these activities are susceptible of implementation in other services.
A assistência de enfermagem em saúde mental tem mudado seu paradigma e desde a reforma psiquiátrica o enfermeiro assume um novo papel. O estudo tem por objetivo descrever as atividades desenvolvidas por um grupo de acadêmicos de enfermagem durante o ensino-aprendizagem prático junto aos pacientes portadores de doença mental em fase terapêutica. É um relato de experiência desenvolvida em um Centro de Apoio Psicossocial localizado na cidade de Fortaleza-Ceará no período de setembro a novembro de 2004. As atividades implementadas pelos acadêmicos foram o grupo de terapia comunitária, o grupo sala de espera e o relacionamento terapêutico. A terapia comunitária e o relacionamento terapêutico foram as atividades implementadas que obtiveram maior êxito porque houve profunda interação entre os pacientes e os acadêmicos, além dos pacientes se sentirem confortados e valorizados com as atividades. O desenvolvimento da experiência revelou-se importante porque proporcionou a aprendizagem mútua, a obtenção de resultados satisfatórios e a certeza de que estas atividades são passíveis de serem implementadas em outros serviços.
Subject(s)
Humans , Male , Female , Nursing Care , Nursing , Psychiatric Nursing , Mental HealthABSTRACT
The attendance to the domiciliary health resurges as an alternative modality to the model of attention to the health of the country and the professional nurse who acts in this area as commitment and responsibility to improve its knowledge. Thus, this article, is a theoretical reflection on the interface of the standards of the knowledge of nursing identified by Barbara Carper (1978), Munhall (1993), White (1995) and brazilians studious where they point the possibility, importance and relevancy with respect to the area of nursing and in special in domiciliary attendance to the health while caring practice that confers an uneven and particular situation to the inserted client in its domicile. This interface is based on the reciprocity with the well-taken care of being, propitiating learning and growth conditions, in order to contribute for the consolidation of new experiences, enriching the capacity to take care of the nurse, patient and family member.
O atendimento domiciliar à saúde ressurge como uma modalidade alternativa ao modelo de atenção à saúde do país e o profissional enfermeiro que atua nesta área tem como compromisso e responsabilidade aprimorar seus conhecimentos. Assim, esse artigo é uma reflexão teórica sobre a interface dos padrões do conhecimento de enfermagem identificados por Bárbara Carper (1978), Munhall (1993), White (1995) e estudiosos brasileiros em que apontam a possibilidade, importância e pertinência para a área de enfermagem e em especial para o atendimento domiciliar à saúde enquanto prática cuidativa que confere uma atenção ímpar e particular ao cliente inserido em seu domicílio. Essa interface baseia-se na reciprocidade com o ser cuidado, propiciando condições de crescimento e de aprendizagem, a fim de contribuir para a consolidação de novas experiências, enriquecendo a capacidade de cuidar do enfermeiro, paciente e familiar.
La atención de la salud domiciliar resurge como una modalidad alternativa al modelo de atención de la salud del país, y el profesional enfermero que actúa en esta área tiene como compromiso y responsabilidad el perfeccionar sus conocimientos. Así, este artículo es una reflexión teórica sobre la interrelación entre el uso e importancia de las pautas de conocimiento de enfermería, identificados por Bárbara Carper en 1978, Munhall (1993), White (1995) y estudiosos brasileros quienes señalan la posibilidad, importancia y competencia del área de enfermería principalmente para la atención de la salud domiciliar como práctica de cuidados que atribuye una situación impar y particular al cliente dentro de su domicilio. Esta interrelación se basa en la reciprocidad con el ser cuidado, propiciando condiciones de crecimiento y de aprendizaje, a fin de contribuir a la consolidación de nuevas experiencias, enriqueciendo la capacidad del enfermero de cuidar del paciente y de su familia.
Subject(s)
Humans , Male , Female , Home Nursing , Primary Health Care , Nursing Care , NursingABSTRACT
En la actualidad, según datos de la Sociedad Internacional de Enfermedades Infecciosas (ISID), las infecciones nosocomiales en los países desarrollados es de 5 a 10% y en los países en desarrollo puede superar el 25%. Estas infecciones como es de entender, aumentan considerablemente la morbilidad, mortalidad y los costos. Las medidas de bioseguridad deben ser una práctica rutinaria en las unidades médicas, y ser cumplida); por todo el personal que labora en esos centros, independientemente del grado de riesgo según su actividad y de las diferentes áreas que componen el hospital. El Centro de Enfermedades (CDC), de Atlanta, Georgia, publicó en 1996 las nuevas técnicas de aislamiento, las cuales cubren todas las posibilidades de transmisión: las precauciones estándar y las precauciones por vía de transmisión. Precauciones estándar: Lavado de manos: es la medida más económica, sencilla y eficaz para prevenir infecciones intrahospitalarias. Uso de guantes: principalmente para reducir los riesgos de colonización transitoria de gérmenes del personal y transmisión de estos al paciente. Uso de bata: se recomienda cuando se realicen procedimientos que puedan producir salpicaduras. Uso de cubreboca o mascarilla y gogles: se recomienda durante procedimientos que puedan generar salpicaduras; Manejo de material punzocortante; la adecuada disposición de desechos de material punzocortante es fundamental para prevenir accidentes y por consecuencia, prevenir la transmisión de enfermedades infecciosas. Manejo de ropa sucia: debe colocarse en bolsas de plástico y transportarla en carros exclusivos. Para el control del microorganismo infeccioso en los hospitales, se utilizan además de las precauciones estándar los sistemas de aislamiento por contacto, por aire y por gotas de acuerdo con la ruta de transmisión
At the present time, according to data of the International Society of Infectious Illnesses (ISID), the infections nosocomiales in the developed countries is from 5 to 10% and in the countries in development can overcome 25%. These infections like it is of understanding, they increase the morbility, mortality and the costs considerably. The biosecurity measures should be a routine practice in the medical units, and to be completed independently by the whole personnel that works in those centers, of the degree of risk according to their activity and of the different areas that compose the hospital. The Center of Illnesses (CDC), of Atlanta, Georgia, published in 1996 the new isolation techniques, which cover all the transmission possibilities: the cautions standard and the cautions by way of transmission. Cautions standard: washing hands: it is the most economic, simple and effective measure to prevent infections intrahospital. Use of gloves: mainly to reduce the risks of transitory colonization of the personnel's germs and transmission from these to the patient. The use of robe: it is recommended when they are carried out procedures that can produce splashes. Use a mask and gogles: it is recommended during procedures that can generate splashes; Manage of material used; the appropriate disposition of waste of material is fundamental to prevent accidents and for consequence, to prevent the transmission of infectious illnesses. Dirty laundry handling: it should be placed in bags of plastic and to transport it in exclusive cars. For the control of the infectious microorganism in the hospitals, they are used besides the cautions standard the isolation systems for contact, for air and for agreement drops with the transmission route.