Compreensão de profissionais sobre o processo de alta hospitalar de crianças dependentes de tecnologias / Understanding of professionals about the process of hospital discharge of children dependent on technologies / Comprensión de los profesionales sobre el proceso de alta hospitalaria de niños dependientes de tecnologías

Objetivo: compreender o processo de alta hospitalar de crianças dependentes de tecnologias por profissionais de unidades pediátricas e neonatais. Método: estudo descritivo com os profissionais da assistência à criança dependente de tecnologias de um Hospital Universitário entre julho e setembro de 2020. Os dados foram obtidos foram exportados para o software Iramuteq e interpretados à luz da teoria de análise de conteúdo. O estudo possui aprovação pelo Comitê de Ética e Pesquisa. Resultados: a nuvem de palavras contextualizou e forneceu subsídios para a identificação de duas categorias: Compreensão da necessidade de trabalho em equipe para planejamento de alta hospitalar e percepção da necessidade de implementação de ferramentas como protocolos e fluxos para o direcionamento do preparo para alta e continuidade do cuidado. Conclusão: os profissionais referem que a alta hospitalar é realizada conforme a rotina assistencial e ainda segue um modelo medicalocêntrico.

Objective: to understand the process of hospital discharge of technology-dependent children by professionals from pediatric and neonatal units. Method: descriptive study with technology-dependent child care professionals at a University Hospital between July and September 2020. The data obtained was exported to the Iramuteq software and interpreted in light of content analysis theory. The study is approved by the Research Ethics Committee. Results: the word cloud contextualized and provided support for the identification of two categories: Understanding the need for teamwork to plan hospital discharge and perception of the need to implement tools such as protocols and flows to guide preparation for discharge and continuity of care. Conclusion: professionals report that hospital discharge is carried out according to the care routine and still follows a medical-centric model.

Objetivo: comprender el proceso de alta hospitalaria de niños dependientes de tecnología por parte de profesionales de unidades de pediatría y neonatología. Método: estudio descriptivo con los profesionales de cuidado al niño que depende de tecnologías en un Hospital Universitario, entre julio y septiembre de 2020. Los datos obtenidos se exportaron al software Iramuteq y se interpretaron a la luz de la teoría del análisis de contenido. El estudio es aprobado por el Comité de Ética en Investigación. Resultados: la nube de palabras contextualizó y trajo subsidios para la identificación de dos categorías: comprensión de la necesidad de trabajo en equipo para planificar el alta hospitalaria y percepción de la necesidad de implementar herramientas como protocolos y flujos para orientar la preparación para el alta y la continuidad de la atención. Conclusión: los profesionales refieren que el alta hospitalaria se realiza según la rutina asistencial y sigue un modelo médico centrado.

Uso de checklist para o cuidado seguro à criança hospitalizada / Use of checklist for safe care of hospitalized children / Utilización de lista de verificación para atención segura de niños hospitalizados

Objetivo: identificar as temáticas dos checklists de segurança do paciente utilizados na assistência à criança hospitalizada. Método: revisão integrativa de literatura, realizada em agosto de 2019 nas bases de dados LILACS, BDENF, MEDLINE/PubMed, Web of Science, CINAHL e SciELO. Resultados: foram identificados 396 artigos, sendo selecionados 24 estudos após a aplicação dos critérios de elegibilidade. As áreas temáticas dos checklists foram: cirurgia, medicação, comunicação efetiva, terapia intensiva, intubação traqueal, transfusão sanguínea e radiologia digital, sendo que a maioria dos estudos aborda a cirurgia segura (45,8%). Conclusão: o uso de checklist na assistência à criança hospitalizada contribui para a identificação de falhas em processos de segurança do paciente; padronização de técnicas e processos; redução de erros relacionados aos cuidados em saúde; melhoria do trabalho em equipe; comunicação precisa e consistente; adesão às medidas de processo; e, consequentemente, melhoria da qualidade da assistência prestada.

Objective: to identify the themes of patient safety checklists used in the care of hospitalized children. Method: integrative literature review, conducted in August 2019 in the LILACS, BDENF, MEDLINE/PubMed, Web of Science, CINAHL and SciELO databases. Results: a total of 396 articles were identified, and 24 studies were selected after applying the eligibility criteria. The thematic areas of the checklists were: surgery, medication, effective communication, intensive care, tracheal intubation, blood transfusion and digital radiology, with most studies addressing safe surgery (45.8%). Conclusion: the use of checklist in the care of hospitalized children contributes to the identification of failures in patient safety processes; standardization of techniques and processes; reduction of errors related to health care; improvement of teamwork; accurate and consistent communication; adherence to process measures; and, consequently, improvement in the quality of care provided.

Objetivo: identificar los temas de las listas de verificación de seguridad del paciente utilizadas en la atención de niños hospitalizados. Método: revisión bibliográfica integradora, conducida en agosto de 2019 en las bases de datos LILACS, BDENF, MEDLINE/PubMed, Web of Science, CINAHL y SciELO. Resultados: se identificaron un total de 396 artículos y se seleccionaron 24 estudios después de aplicar los criterios de elegibilidad. Las áreas temáticas de las listas de verificación fueron: cirugía, medicación, comunicación efectiva, cuidados intensivos, intubación traqueal, transfusión de sangre y radiología digital, siendo la mayoría de los estudios sobre cirugía segura (45,8%). Conclusión: la mayoría demostró que la utilización de listas de verificación contribuye a la identificación de fallas en los procesos de seguridad del paciente; estandarización de técnicas y procesos; reducción de errores relacionados con la atención médica; mejora del trabajo en equipo; comunicación precisa y coherente; adhesión a las medidas procesales; y, como consecuencia, mejora de la calidad de la atención ofrecida.

Control study of the intelligent calculation method and the traditional calculation method in risk assessments of hospitalization / 中华危重病急救医学

Objective:To explore the accuracy of intelligent calculation (IC) method for risk assessment of hospitalization for patients, aiming to build a more advantageous risk assessment system.Methods:The "Search Engine" program was developed based on hospital information system (HIS) of the Fifth Center Hospital in Tianjin, which automatically captured patient information and generated nutritional risk screening 2002 (NRS 2002) score, Caprini thrombosis risk assessment model and Padua thrombosis risk assessment model for venous thromboembolism (VTE), the CHA 2DS 2-VASc for predicting stroke risk stratification in atrial fibrillation and the HAS-BLED for predicting bleeding risk in anticoagulated patients with atrial fibrillation. A randomized controlled trial was conducted. According to the applicable conditions of each risk assessment, 100 risk scores from "Search Engine" program belonged to each risk assessment were randomly selected, defined as the IC group. Manual scoring with the data of the same case at the same time, defined as the traditional calculation (TC) group, compared the consistency of the scores and the difference in time-consuming between the two groups. Results:The Bland-Altman plots showed that the 95% limits of agreement (95% LoA) of NRS 2002 score, Caprini score, Padua score, CHA 2DS 2-VASc score and HAS-BLED score was -0.46 to 0.41, -0.49 to 0.52, -0.50 to 0.41, -0.67 to 0.60, -0.44 to 0.43, respectively, all P > 0.05. In this study, the Bland-Altman plot showed that 95%, 96%, 97%, 97%, 95% plots fell within the 95% LoA in NRS 2002 score, Caprini score, Padua score, wwCHA 2DS 2-VASc score and HAS-BLED score by the two methods, respectively. The all plots of 95% LoA were within the clinically acceptable range (-0.5 to 0.5 scores). The time-consuming of NRS 2002 score, Caprini score, Padua score, CHA 2DS 2-VASc score and HAS-BLED score in IC group were significantly shorter than those in TC group [0.72 (0.71, 0.73) seconds vs. 361.02 (322.41, 361.02) seconds, 0.72 (0.72, 0.73) seconds vs. 196.68 (179.99, 291.20) seconds, 0.72 (0.72, 0.73) seconds vs. 105.75 (92.32, 114.70) seconds, 0.72 (0.71, 0.72) seconds vs. 72.66 (56.24, 84.20) seconds, 0.72 (0.71, 0.72) seconds vs. 51.30 (38.88, 57.15) seconds, respectively, all P < 0.001]. Conclusion:For the above five risk assessments, the TC method and IC method has good consistency in scores, and the IC method is faster, which has good application prospect for clinical application.

Investigation on the current situation and analysis of related influencing factors of xerosis in elderly inpatients / 中国实用护理杂志

Objective:To investigate the prevalence and influencing factors of xerosis in elderly inpatients, to provide basis for effective prevention and management of xerosis.Methods:Using the cross-sectional survey method and the self-designed survey table of the current situation of xerosis and prevention of the elderly, the incidence of xerosis in 1 028 patients hospitalized in Suqian Hospital Affiliated to Xuzhou Medical University, Suqian City Hospital of Traditional Chinese Medicine and Siyang County Hospital of Traditional Chinese Medicine was investigated, and the related factors were analyzed.Results:The incidence of xerofosis was 20.23%(208/1028); the incidence of xerosis was 20.23% (208/1 028), which was mainly found in the lower limbs, with the incidence of 53.37% (111/208), among which the incidence of mild xerosis was the most, with the incidence of 51.44% (107/208). The incidence rate of the elderly patients with xerosis between different age, qualifications, nutritional status, comorbidity, Braden score, drug use, main caregivers, departments, and daily skin care were statistically significant ( χ2 values were 6.91-35.71, all P<0.05). Binary logistic regression analysis showed that age, nutritional status, comorbidity status, Braden score and daily skin care were the independent influencing factors of skin dryness in elderly inpatients. Conclusions:There is a common skin symptom of xerosis in the elderly. It is necessary to establish a standardized management process and take targeted preventive and nursing measures.

Cost-effectiveness of Morse Fall Scale assessment in fall prevention care in hospitalized patients / 中南大学学报(医学版)

OBJECTIVES@#To analyze the cost-effectiveness of the Morse Fall Scale by clinical big data for nurses in the prevention of falls in hospitalized patients.@*METHODS@#A total of 59 358 hospitalized patients, who came from the Third Xiangya Hospital of Central South University in 1 year before nurses were trained by the Morse Fall Scale, served as a control, including 26 862 males and 32 496 females. While the 66 203 hospitalized patients served as an observation group in 1 year after nurses were trained by the Morse Fall Scale, including 29 881 males and 36 322 females. The time spent by clinical nurses in the fall-risk assessment and the fall number were recorded in the 2 groups, and the relationship was analyzed between the Morse Fall Scale assessment and the clinical ending along with the labor cost of nursing. The cost-effectiveness was analyzed. In addition, the incidence of fall in the observation group was compared between the falling high-risk patients and the non-high-risk patients.@*RESULTS@#The Morse Fall Scale showed that the incidences of fall in the observation group and the control group were 3.39/100 000 and 3.82/100 000,respectively, there was no significant difference between the 2 groups (@*CONCLUSIONS@#The evaluation of the Morse Fall Scale has a certain effect, but it is limited in the prevention of falls in adult hospitalized patients, and the cost-effectiveness analysis is not good. It is recommended to implement the intervention measures for high-risk patients after the assessment, which may improve the management level and efficiency of fall prevention.

Evaluation of Potentially Inappropriate Medication in Elderly Hospitalized Patients in Our Hospital Based on 2019 Beers Criteria / 中国药学杂志

OBJECTIVE: To investigate and analyze the potential inappropriate medication(PIM) in elderly hospitalized patients in our hospital, explore the related risk factors, and analyze the use of PIM involved drugs in different departments, so as to provide reference for the formulation of medication manuals for the elderies in different departments and for further standardizing the use of drugs in elderly patients. METHODS: The medical advice for elder patients(≥65 years old)hospitalised from January to October 2017 in our hospital was collected. Beers criteria of American Geriatrics Association 2019 was used as the reference to investigate and analyze PIM. And the risk factors of PIM were analyzed by logistic regression. RESULTS: The average age of 12 756 elderly hospitalized patients was (74.13±6.88) years and the average number of diseases per patient was (3.22±2.09). For each patient, (4.79±3.76) kinds of medicines were used. According to the 2019 Beers criteria, the incidence of PIM was 20.00%. Among them, the central nervous system medications(6.41%, 818/12 756) (estazolam tablets, alprazolam tablets) were the most frequently used. Data of PIM occurrence in different departments showed that the PIM incidence was higher in rheumatology, geriatrics, rehabilitation, anesthesia surgery and oncology departments. In addition, logistic regression analysis showed that gender, age, the number of combined medications and diseases, and length of stay were all potential risk factors for PIM. CONCLUSION: The incidence of PIM in elderly hospitalized patients in our hospital is high. The rational drug use in elderly patients needs to be improved.

Estudo da adequação de refeições servidas a pacientes em hospital de referência na cidade de Salvador, BA / Study of the adequacy of meals served to patients in a reference hospital in the city of Salvador, BA

[{"text": "A hospitalização tem impacto no estado nutricional dos pacientes, assim\r\ncomo a aceitação da dieta tem influência na evolução do quadro clínico e nutricional.\r\nO objetivo deste estudo foi verificar a adequação do almoço servido\r\naos pacientes internados de acordo com a prescrição nutricional. O estudo\r\nfoi realizado em um hospital de referência na cidade Salvador, BA em cinco\r\ndias de coleta, com avaliação da adequação de dietas prescritas e ofertadas\r\nem enfermarias de clínica médica, emergência geral e pediátrica, maternidade,\r\npediatria e hemodiálise. As inadequações encontradas foram classificadas\r\nquanto ao tipo de dieta (consistência), características (composição química),\r\nobservações individuais dos pacientes (substituição, adição e/ou restrição de\r\nalgum item), e ausência de algum item do cardápio. Foi encontrado um total\r\nde 22,2% de inadequações em dietas servidas em todo o hospital, com maior\r\nnúmero encontrado nas enfermarias da clínica médica. Na pediatria foi observado\r\n100% de adequação das dietas servidas. Foram encontradas importantes\r\ninconformidades nas refeições servidas a pacientes hospitalizados que\r\npodem indicar a ocorrência de erros no momento da montagem e distribuição\r\ndas refeições.(AU)", "_i": "pt"}]

Usefulness of Kampo Medicine for Avoiding Polypharmacy Among Hospitalized Patients / 日本東洋医学雑誌

We investigated the number of drugs and pharmaceutical cost among 159 patients prescribed Western medicine and hospitalized from August 2006 to August 2015 in the Department of Oriental (Kampo) Medicine at Chiba University Hospital. The number of drugs used in Western medicine among improved patients significantly decreased from 5.6 ± 3.6 at hospitalization to 5.3 ± 3.5 at discharge, but the number of Kampo medicine drugs was not changed. The total number of drugs including both Western medicine and Kampo medicine significantly decreased from 7.0 ± 3.8 to 6.7 ± 3.6. The number of drugs used in Western medicine among nochanged patients decreased from 5.1 ± 3.4 at hospitalization to 5.0 ± 3.7 at discharge, but the number of Kampo medicine drugs significantly increased from 1.0 ± 0.0 at hospitalization to 1.3 ± 0.5. The total number of drugs including both Western medicine and Kampo medicine increased from 6.1 ± 3.4 to 6.3 ± 3.9. We thus conclude that a combination of Kampo medicine with Western medicine can be useful for reducing the number of drugs related to polypharmacy. To achieve these results, it is essential to use the concept of sho (a way of pattern recognition of a patient's symptoms in Kampo medicine).

Avaliação do impacto psicossocial do diagnóstico e tratamento do câncer na vida de familiares cuidadores de pacientes em regime de internação hospitalar / Psychosocial assessment of the impact of cancer diagnosis and treatment on the life of family caregivers of hospitalized patients / Evaluación psicosocial del impacto del diagnóstico y tratamiento del cáncer en la vida de los cuidadores familiares de pacientes hospitalizados

diagnóstico de câncer representa um desafio para pacientes, familiares, cuidadores e profissionais de saúde. Nesse contexto é importante voltar o olhar para o familiar cuidador e identificar como ele é afetado pelas suas responsabilidades com o paciente com câncer, para que sejam desenvolvidas alternativas e intervenções adequadas para favorecer sua qualidade de vida e seu bem estar emocional. Este artigo é resultado de uma pesquisa exploratória, utilizando método quantitativo, desenvolvida com a finalidade de avaliar o impacto do processo de cuidar de um parente com câncer durante o período de internação hospitalar. A coleta de dados ocorreu ao longo de quatro meses no Hospital Universitário de Brasília e foram utilizados os seguintes instrumentos: Escala de Ansiedade e Depressão Hospitalar ­ HAD; Caregiver Reaction Assessment (CRA); entrevista estruturada para coleta de dados sociodemográficos da díade e médicos clínicos do paciente. Segundo os dados coletados, foi possível identificar que o estado de humor do paciente ­ ansiedade, depressão e distress ­ mostrou correlação significativa positiva com estado de humor do cuidador, diferente das demais variáveis. Também, um maior nível de sobrecarga no cuidado estava relacionado significativamente com o nível de ansiedade nos pacientes. O estudo sugere que cuidar do estado emocional do paciente pode ter maior impacto na minimização da sobrecarga do cuidador e vice-versa, confirmando a necessidade de compor as equipes com profissionais treinados para o manejo de dificuldades emocionais e, em especial, psico-oncologistas.

The cancer diagnosis represents a challenge for patients, family, parents, family caregivers and health care professionals. In this context, it is important to keep a lookout for the family caregiver and identify how he or she is affected for his or her responsabilities with the patient with cancer disease. It is important to develop alternatives and proper interventions to favor a quality of life and emotional well-being for him or her. This article is the result of a exploratory research, quantitative method, developed with the purpose of evaluate the impact of the process of looking after a relative with cancer during the period of hospital internment. The data collection had been occurred in the course of four months in the University Hospital of Brasília and it had been used the following instruments: Hospital Anxiety and Depression Scale ­ HAD; Caregiver Reaction Assesment (CRA); structured interview to collect social demographic data of the patient and the caregiver and clinical data of the patient. According to the data collection, it has been possible to identify that the state of the mood of the patient - anxiety, depression and emotional distress ­ showed significant correlation with the state of mood of the family caregiver, the others variables had different results. Also, a high level of the family caregiver's overload was related significantly with the level of anxiety in patients. The study sugests that taking care of the emotional state of the patient can have a great impact in minimization of the family caregiver´s overload and vice versa, confirming the need to compose the team with trained professionals to handle emotional difficulties and, especially, psycho-oncologists.

El diagnóstico de cáncer representa un reto para pacientes, familiares, cuidadores y profesionales de la salud. En este contexto, es importante volver la mirada al cuidador familiar e identificar cómo él se ve afectado por sus responsabilidades con el paciente de cáncer, para que puedan ser adoptadas alternativas e intervenciones apropiadas que mejoren su calidad de vida y su bien estar emocional. Este artículo es el resultado de una investigación exploratoria, utilizando el método cuantitativo desarrollado con el propósito de evaluar el impacto del proceso de cuidar a un familiar con cáncer durante su estancia en el hospital. La recolección de datos se llevó a cabo durante cuatro meses en el Hospital de la Universidad de Brasilia y se utilizaron los siguientes instrumentos: Escala de Ansiedad y Depresión en el Hospital - HAD; Caregiver Reaction Assessment (CRA); entrevista estructurada para recopilar datos sociales y demográficos de la díada y médicos clínicos del paciente. De acuerdo con los datos recogidos, fue posible identificar que el estado de ánimo del paciente - la ansiedad, la depresión y la angustia - mostró una correlación positiva significativa con el estado de ánimo del cuidador, diferente de las otras variables. Asimismo, un mayor nivel de sobrecarga en la atención estaba relacionado significativamente con el nivel de ansiedad en los pacientes. El estudio sugiere que el cuidado con el estado emocional del paciente puede tener un impacto más grande en la reducción de la sobrecarga del cuidador y viceversa, lo que confirma la necesidad de componer los equipos con profesionales capacitados para el manejo de dificultades emocionales y, en particular, psico-oncólogos.

Implementation and establishment of rapid response system for non-hospitalized patients / 中华护理杂志

We established the rapid response system for non-hospitalized patients from 2012 in order to improve the effectiveness of emergent critical care for non-hospitalized patients when emergency happened.From January 2013 to December 2016,there were 122 cases with RRS activation for non-hospitalized patients.The time to arrive was 3.16±0.41 min,and 107 cases(86.89％)were sent to the emergency department.Fifteen patients(14.02％)were classified as level 1,26(24.03％)as level Ⅱ,48(16.82％)as level Ⅲ,and 18(16.82％) as level ⅣV,and 83％ were critical patients.Rapid response system is important to cope with emergency in non-hospitalized patients.

Application of nutritional risk screening and the outcome of nutrition support in hospitalized patients / 肠外与肠内营养

Objective:The present study was aimed to evaluate the nutritional risk using nutritional risk screening 2002 (NRS2002) score and to investigate the impact of nutrition support on clinical outcome in hospitalized patients.Methods:Six hundred and ninety four hospitalized patients were recruited.NRS 2002 was applied to evaluate the nutritional risk of patients.Meanwhile,the effect of nutrition support on complication rate was evaluated between different types of patients.Results:14.0％ of patients had malnutrition and the incidence of nutritional risk was 27.5％.Patients with nutritional risk had a higher complication rate (P ＜0.01).Totally,22.0％ (153/694) patients received nutrition support,including 81.7％ patients with nutritional risk and 18.3％ patients without nutritional risk.Patients with nutritional risk benefited from nutrition support,as shown by lower complication rate and shorter length of hospital stay.In patients with nutritional risk,complication rate was lower in enteral fed patients compared to parenteral fed patients.Conclusion:With nutritional risk screening,patients' nutritional status can be evaluated and appropriate nutrition support can be performed.Compared to those without nutritional risk,patients with nutritional risk will benefit more from nutrition support,as indicated by lower complication rate and reduced length of hospital stay.

Analgésicos en el paciente hospitalizado: Revisión de tema / Analgesics in hospitalized patients: Topic review

El dolor como experiencia subjetiva es de alta incidencia en el paciente adulto hospitalizado, por tal motivo el uso de analgésicos en estos pacientes tiene gran impacto en la evolución clínica y en la calidad de la estancia hospitalaria. Entre las opciones terapéuticas para el manejo del dolor se encuentran antiinflamatorios no esteroideos (AINEs), opioides, paracetamol, metamizol; los cuales se pueden administrar en diferentes formas farmacéuticas, que se adaptan a las condiciones de cada uno de los pacientes. Actualmente, el uso de opioides está siendo reevaluado, así como las técnicas de administración, entre las que se destacan la analgesia controlada por el paciente y la analgesia intervencionista (analgesia epidural, bloqueo de nervios periféricos y la infiltración local). El éxito de la terapia analgésica no solo consiste en el adecuado uso de los analgésicos, sino también en las estrategias usadas para objetivar el dolor; esto se consigue por medio de la aplicación de escalas para cuantificar el dolor, de las cuales se destacan la escala visual análoga, la escala verbal numérica y la de valoración verbal.

Pain as a subjective experience is high incidence in the adult hospitalized patient, so the use of analgesics in these patients has a high impact on their medical developments and their comfort during their hospital stay. Among the therapeutic options for pain management there are Non-Steroidal Anti- Inflammatory drugs (NSAIDs), Opioids, Paracetamol and Metamizol. Each has different pharmaceutical dosage forms to adjust to the condition of each patient. Currently the use of Opioids is being re-evaluated as well as the management techniques like patient-controlled analgesia and interventionist analgesia(epidural analgesia, peripheral nerve blocks and local infiltration). The success of analgesic therapy consists of the appropriate use of analgesics and in the strategies used to objectify the pain; this can be achieved with the implementation of scales to quantify the pain like the visual analogous scale, numeric verbal scale and the verbal assessment.

Analysis of the prevalent characteristics of hospitalized patients with gastric cancer in Shanxi Cancer Hospital from 2001 to 2010 / 肿瘤研究与临床

Objective To analyze the prevalent characteristics of hospitalized patients with gastric cancer in Shanxi Cancer Hospital from 2001 to 2010,and explore its incidence trends.Methods All related data of gastric cancer patients from 2001 to 2010 were collected,sorted and analyzed in view of gender,age,distribution of areas,et al.Results A total of 14 296 (11 355 males and 2 941 females) gastric cancer patients were overviewed.Male/female ratio was 3.86:1.The total number of patients was increasing with years on(F =95.06,P ＜ 0.000 1).Overall,prevalence increased dramatically in age group of 40-80 yr,reaching a peak of 51-70 yr.Whereas,prevalence in rural areas was higher than that in urban areas.According to distribution of areas,gastric caner prevalence in Taiyuan was higher than that in other areas,followed by Linfen,Lyuliang and Changzhi.Conclusions Gastric cancer patients of hospitalization are increasing year by year.All patients present with significant epidemiological features in age,gender and region.

Another way to teach family: family nursing game / Um modo de ensinar família: jogo para enfermagem de família

Current paper describes the application of an innovative strategy to teach family, within a hospital context, by sensitizing nurses on the family subject through the use of a game. Given the hospitalization of a relative, the family faces changes in its dynamics caused by the crisis it is exposed to. It is the relevance for including the family within the care process. Since nurses are expected to assume a key role for which they need specific competence to intervene in families when experiencing an eventual crisis. The in-service education becomes a strategy of generating new skills and enhances human capital to improve the quality of nursing care. Considering the importance of including family in the care context, a playful tool called Family Nursing Game has been invented for teaching the family, especially by passing a model of family intervention. The strategy is based on the belief of the existence of relationship between game and learning.

Artigo descreve aplicação de uma estratégia inovadora para ensinar família em contexto hospitalar, sensibilizando os enfermeiros sobre família através de um jogo. Perante a hospitalização de um de seus membros, a família é confrontada com alterações em sua dinâmica com o paciente, daí a relevância da inclusão da família no processo de atendimento e cuidados. O enfermeiro assume neste nível um papel preponderante de competência específica para intervir junto a família de pacientes por ocasião de vivência de possível crise acidental. A educação em serviço, torna-se estratégia geradora de inovadas competências e potencializa o capital humano para a melhoria da qualidade na assistência em enfermagem. Da importância de inclusão da família no contexto de cuidados, criou-se um instrumento lúdico denominado Family Nursing Game com o intuito de ensinar família, nomeadamente divulgando um modelo de avaliação e intervenção familiar. Tal estratégia fundamenta-se na convicção da existência de relação entre o jogo e a aprendizagem.

Triagem nutricional como instrumento preditor dedesfechos clínicos em pacientes cirúrgicos / Nutritional screening instrument as a predictor of clinical outcomes insurgical patients

Introdução: A Triagem de Risco Nutricional (NRS 2002) foi propostapara identificar pacientes em risco nutricional, que podem sebeneficiar de terapia nutricional precoce. Os pacientes cirúrgicosdesnutridos possuem maior chance de apresentar complicaçõesdurante a internação hospitalar e elevado índice de morbidade emortalidade, sendo, portanto fundamental o monitoramento adequadodo estado nutricional.Objetivo: Identificar, por meio de revisão de literatura, a eficáciado método de triagem NRS 2002 em predizer desfechos clínicos empacientes cirúrgicos.Métodos: Foi realizada busca de artigos publicados no período de2003 a 2013, utilizando-se palavras-chaves em conformidade aosDescritores em Ciências da Saúde, nos idiomas inglês, português eespanhol. A seleção foi baseada nos títulos, resumos e descritores.Resultados: A alta taxa de prevalência de desnutrição no ambientehospitalar associa-se a um pior prognóstico, como maior tempode internação, maiores taxas de complicações infecciosas e não infecciosas,além da mortalidade. Dessa forma, é imperativo que essacondição seja detectada precocemente, a fim de se evitar tais desfechosnegativos, principalmente em pacientes cirúrgicos.Considerações finais: A triagem nutricional NRS 2002 permite aidentificação precoce e o tratamento da desnutrição, atenuando osefeitos adversos associados à desnutrição e melhorando o prognósticoclínico durante a internação.

Introduction: Nutritional Risk Screening (NRS 2002) was proposedto identify patients at nutritional risk who may benefit fromearly nutritional therapy. Malnourished surgical patients are morelkely to have complications during hospital stay and higher morbidityand mortality hospitalization and are therefore fundamentalto proper monitoring of nutritional status.Objective: To identify, through literature review, the effectivenessof NRS 2002 screening method for predicting clinical outcomes insurgical patients.Methods: A search was conducted for articles published in the period2003-2013, using keywords in accordance to Health SciencesDescriptors in English, Portuguese and Spanish languages . The selectionwas based on the titles, abstracts and keywords.Results: A high prevalence of malnutrition in hospitals is associatedwith a worse prognosis, longer hospitalization, higher rates ofinfectious and non-infectious complications, and mortality. Thus,it is imperative that this condition is detected early in order to avoidsuch negative outcomes, particularly in surgical patients.Conclusion: The nutritional screening NRS 2002 allows for theearly identification and treatment of malnutrition, mitigating theadverse effects associated with malnutrition and improving clinicaloutcomes during hospitalization.

The application value of prehospital index in hospitalized patients with acute trauma / 中华急诊医学杂志

Objective To evaluate the application value of prehospital index (PHI) in hospitalized patients with acute trauma.Methods A study was done in 1802 hospitalized patients with acute trauma by random sampling.PHI and injury severity score (ISS) were made respectively.Receiver operating characteristic curve (ROC curve) was used for detecting optimal cut-off point by taking the date of discharge as the endpoint and the outcome as observed indicator.In order to compare the predicting prognosis value of PHI in hospitalized patients with acute trauma,the corresponding predicting indicators were calculated and ISS was used for reference.Results The area under the ROC curve was 0.871 (95％ CI:0.855-0.886) by the score of PHI and 0.792 (95％ CI:0.773-0.811) by the score of ISS,and there was statistically difference between the two scoring systems (Z =2.674,P =0.007),and the optimal cut-off point was used for judging the potential for critically ill patients when PHI was ≥ 4,ISS ≥ 22.The sensitivity predictors of critically ill patients death of PHI was superior to ISS (x2 =6.975,P =0.008),the specificity and the accuracy of PHI and ISS showed no significant difference (P ＞ 0.05).Conclusions PHI has high potential for assessing patient condition and predicting the death of hospitalized patients with acute trauma,and it is equivalent to ISS in prediction value.The advantages of PHI are simple in operation,easy to learn,reflecting the condition timely and reliably,suitable for dynamic evaluation and comparison,which is suitable for critical patients with trauma of preliminary screening.

Percepción del paciente hospitalizado sobre el trato digno proporcionado por una enfermera-un enfermero / Perception of hospitalized patients about the proper treatment given by nurses", "_i": "

Introducción: Durante muchos años las mujeres han predominadoen enfermería, acentuándose con la división sexual deltrabajo; en la actualidad los hombres han incursionado en laprofesión, por lo que el paciente puede percibir la atención enforma distinta dependiendo del sexo del cuidador; el objetivo delestudio fue conocer la percepción del paciente hospitalizado sobreel trato digno proporcionado por una enfermera o enfermeroen un hospital de tercer nivel. Metodología: Se realizó unestudio comparativo, transversal y prolectivo tomándose unamuestra no probabilística de 48 pacientes hospitalizados que recibieronatención del personal de enfermería de ambos sexos, seaplicaron dos instrumentos acorde al indicador de calidad tratodigno modificado a escala tipo Likert para determinar si la percepcióndel paciente es buena, regular o mala con una Alfa deCronbach de 0.86. Se utilizó una prueba de c2 para la comparaciónde variables cualitativas, percepción del paciente y el sexode enfermería. Resultados: La percepción del paciente sobre eltrato digno proporcionado por las enfermeras se reportó comobuena 47 (98%) y regular 1 (2%) y por los enfermeros buena 46(96%) y regular 2 (4%). No existe diferencia en la percepción delpaciente con el sexo del personal de enfermería. Conclusión:De acuerdo a los resultados, la percepción del paciente sobre eltrato digno que proporciona el personal de enfermería es buenasin influir el sexo de éste.

Introduction: During a number of years there has been femaleprevalence in nursing, with the stress of this fact because of sexualdivision of labor. Nowadays, men have entered this profession.So patients may receive distinctive attention depending onthe sex of the caretaker. Objective: The objective of this studywas to know the perception of hospitalized patients about dignifiedtreatment provided by female or male nurses at a thirdlevelhospital. Methodology: A comparative, transversal andprolective study was performed on forty-eight patients, obtaininga non-probabilistic sample of those hospitalized patients whoreceived attention from nursing staff from both sexes. Two elementswere applied according to the quality indicator. Humanetreatment modified into Linker-type scale in order to determineif patient’s perception is good, normal/medium, or bad with aCronbach’s a (alpha) of 0.86. A c2 test was used for the comparisonof qualitative variables: patient’s perception, and nurse sex.Results: Patient’s perception about humane treatment provided by female nurses was reported as good in 47 cases (98%) andnormal/medium in 1 case (2%), and by male nurse as good in46 cases (96%) and normal/medium in 2 cases (4%). There isno difference in patient’s perception with regard to both sexesof infirmary staff. Conclusion: According to the results, patient’sperception about humane treatment provided by infirmary(nursing) staff is good, stating no difference between nursesexes.

Survey of acute kidney injury in hospitalized patients / 中华检验医学杂志

Objective To investigate the incidence of AKI and its relationship to mortality of inpatients by analyzing the changes of serum creatinine(SCr). Methods We collected the data of SCr in Peking Union Medical College Hospital through Jun 2006 to May 2007 and then selected the patients who were subjected to SCr determination more than one time. The relationship between the frequency of SCr determination and gender, age was analyzed. The relationship of increased SCr to gender, age, frequency of determination was also analyzed. The risk stratification based on SCr was investigated. In our study, we investigated the incidence of AKI in different diagnostic groups. The relationship between AKI and mortality in ICU and MICU unit was analyzed. Results There were 36 855 patients in one year, 16 934 patients were subjected to SCr determination only one time, 15 233 patients were subjected to SCr determination at least two times. Elder men were subjected to SCr determination more frequently (P<0.01). Along with the increase of SCr concentration, the frequency of SCr determination were increased significantly (P<0.01). Using the increasing of SCr exceeding 50% as the criteria for diagnosis of AKI, the incidence of hospital-acquired AKI was 8.46%, and it was higher in patients with injury and poisoning (16.7%), infection (16.0%), hematological system diseases (16.1%), neoplasms (12.7%). The incidence of AKI was 27.7% and 55.2% in ICU and MICU, respectively. Mortality of patients in MICU was increased along with the increasing of SCr level Mortality of patients with AKI in ICU was 23.3%, that was significant higher than patients without AKI, the adjust OR was 2.7 (P<0.01). Conclusions The incidence of AKI evaluated by analyzing SCr changing is significantly higher than that using experienced clinical diagnosis. This method is convenient in clinic for early diagnosis of AKI.

Conocimiento del paciente sobre sus derechos / The hospitalized patient's rights and their knowledge

Introducción: la Asociación Americana de Hospitales aprobó desde 1973 la carta que contiene los derechos de los pacientes. Objetivo: por lo que el propósito de este estudio fue identificar el conocimiento que tienen los pacientes sobre sus derechos mediante la aplicación de una encuesta con 21 preguntas. El análisis estadístico fue descriptivo. Resultados: 32% de los pacientes conocen sus derechos como paciente hospitalizado, el resto no conoce sus derechos, pero manifestaron que siete de los doce derechos si son respetados por el personal. Conclusiones: aunque la mayoría de los pacientes desconocen sus derechos, mencionaron recibir atención médica oportuna, información respecto a su padecimiento y atención con consideración y respeto por parte del personal de salud.

Introduction: the American Association of Hospitals approved consequently from 1973 a letter that contains the rights of the patients. Objective: the objective of this investigation was to identify of knowledge that you/they have 100 hospitalized patients by means of application of a survey of 21 questions focused before to the rights mentioned whose statistical analysis was descriptive. Results: 32% patients know their rights as hospitalized patients, 68% doesn't know them, however, they manifested that seven of the 1 2 these are applied by the personnel. Conclusions: although most of the patients ignore their rights, they mentioned to receive opportune medical attention, the doctor maintains them informed regarding the illness that they suffer and they are assisted with consideration and respect on the part of the personnel of health.