Hipotermia terapéutica: estudio descriptivo de una cohorte de 10 años en un hospital público de alta complejidad / Therapeutic hypothermia: A descriptive, cohort study conducted over 10 years at a tertiary care public hospital

Introducción. La hipotermia terapéutica (HT) reduce el riesgo de muerte o discapacidad en niños con encefalopatía hipóxico-isquémica (EHI) moderada-grave. Objetivo. Describir una población de pacientes con EHI que requirió HT y su evolución hasta el alta hospitalaria. Población y métodos. Estudio descriptivo de cohorte retrospectivo. Se analizaron todos los pacientes que ingresaron a HT entre 2013 y 2022. Se evaluaron datos epidemiológicos, clínicos, de monitoreo, tratamiento, estudios complementarios y condición al alta. Se compararon los factores de riesgo entre pacientes fallecidos y sobrevivientes, y de estos, los que requirieron necesidades especiales al alta (NEAS). Resultados. Se incluyeron 247 pacientes. Mortalidad: 11 %. Evento centinela más frecuente: período expulsivo prolongado (39 %). Inicio del tratamiento: mediana 5 horas de vida. Convulsiones: 57 %. Eritropoyetina intravenosa: 66,7 %. Patrón anormal de monitoreo de función cerebral: 52 %. Normalización del monitoreo: mediana 24 horas. Resonancia magnética patológica: 42 %. Variables predictoras de mortalidad: Sarnat y Sarnat grave, y ecografía patológica al ingreso. Conclusión. La mortalidad global fue del 11 %. Las derivaciones aumentaron en forma más evidente a partir del año 2018. El horario de inicio de HT fue más tardío que en reportes anteriores. Los signos neurológicos de gravedad según la escala de Sarnat y Sarnat y la ecografía cerebral basal patológica fueron predictores independientes de mortalidad al alta. Los pacientes con NEAS presentaron normalización del trazado del electroencefalograma de amplitud integrada más tardío. El hallazgo más frecuente en la resonancia fue la afectación de los ganglios basales. No se encontraron diferencias clínicas ni de complicaciones estadísticamente significativas entre los pacientes que recibieron eritropoyetina.

Introduction. Therapeutic hypothermia (TH) reduces the risk of death or disability in children with moderate to severe hypoxic ischemic encephalopathy (HIE). Objective. To describe a population of patients with HIE that required TH and their course until discharge. Population and methods. Retrospective, descriptive, cohort study. All patients admitted to TH between 2013 and 2022 were studied. Epidemiological, clinical, monitoring, and treatment data were assessed, together with supplementary tests and condition at discharge. Risk factors were compared between deceased patients and survivors; and, among the latter, those requiring special healthcare needs (SHCN) at discharge. Results. A total of 247 patients were included. Mortality: 11%. Most common sentinel event: prolonged second stage of labor (39%). Treatment initiation: median of 5 hours of life. Seizures: 57%. Intravenous erythropoietin: 66.7%. Abnormal pattern in brain function monitoring: 52%. Normalization of monitoring: median of 24 hours. Pathological magnetic resonance imaging: 42%. Predictor variables of mortality: severe Sarnat and Sarnat staging and pathological ultrasound upon admission. Conclusion. The overall mortality rate was 11%. Referrals increased more markedly since 2018. The time of TH initiation was later than in previous reports. Severe neurological signs as per the Sarnat and Sarnat staging and a pathological baseline cranial ultrasound were independent predictors of mortality at discharge. Patients with SHCN at discharge showed a normalized tracing in the amplitude-integrated electroencephalography performed later. The most common finding in the magnetic resonance imaging was basal ganglia involvement. No statistically significant differences were observed in terms of clinical characteristics or complications among patients who received erythropoietin.

Rol de la figura de enlace en el modelo e transición en endocrinología. Experiencia en el ámbito público / Role of the liaison person in the transition model in Endocrinology. Experience in the public setting

Un proceso de transición planificado entre los sistemas de salud pediátricos y de adultos es necesario para poder garantizar una continuidad en la atención de los adolescentes. El objetivo del trabajo fue evaluar la población de pacientes del Servicio de Endocrinología del Hospital Garrahan en fase de transición y sus familias, desarrollar un protocolo para la transición de los adolescentes con patología endocrinológica crónica al Hospital de Clínicas José de San Martin y evaluar el rol de la "figura de enlace" en este proceso. Materiales y Métodos: Estudio observacional, transversal/prospectivo. Se obtuvieron datos sobre la consulta ambulatoria de 72 adolescentes mayores a 15 años con patología endocrinológica a los cuales se los acompañó en el proceso de transición. Se realizaron entrevistas y encuestas a los adolescentes, sus familias y a 16 endocrinólogos intervinientes en el seguimiento (9 pediátricos- 7 adultos). Resultados: La mayoría de los adolescentes evidenciaron falta de autonomía general, con mayor afectación en el área de "seguimiento de los problemas de salud". Esto, junto al paternalismo del pediatra y la sobreprotección familiar representaron inconvenientes para la transición. La mitad de los adultos entrevistados consideraron falta de autonomía o preparación en sus hijos considerando la edad ideal para la transición entre los 18-21 años. Las sensaciones referidas por los pacientes como sus acompañantes incluyen principalmente el miedo y ansiedad, y llamativamente en los pacientes la vergüenza. La creación de un consultorio de transición en el centro de adultos y el acompañamiento de la "figura de enlace", permitieron una mejor articulación y continuidad en el cuidado de la salud (AU)

TA planned transition process between pediatric and adult health systems is necessary to ensure continuity of care for adolescents. The aim of this study was to evaluate the patient population of the Endocrinology Service at Garrahan Hospital during the transition phase, along with their families, to develop a protocol for transitioning adolescents with chronic endocrinological disorders to Hospital de Clínicas José de San Martín, and to evaluate the role of the "liaison person" in this process. Materials and Methods: This observational, cross-sectional/ prospective study obtained data from outpatient consultations of 72 adolescents over 15 years of age with endocrinological disorders who were accompanied during the transition process. Interviews and surveys were conducted with the adolescents, their families, and 16 endocrinologists involved in the follow-up (9 pediatricians and 7 adult physicians). Results: Most of the adolescents showed a general lack of autonomy, with greater challenges in the area of "follow-up of health problems." This, combined with the paternalism of the pediatrician and the overprotection of the family, represented obstacles to the transition. Half of the parents interviewed perceived a lack of autonomy or preparation in their children, considering the ideal age for transition to be between 18-21 years old. The primary feelings reported by the patients and those who accompanied them included fear and anxiety, with patients also feeling embarrassment. The creation of a transition clinic in the adult center and the support of a "liaison person" allowed for better coordination and continuity in health care (AU)

Caracterización de enfermedad trofoblástica gestacional en el Hospital de Talca, 2013-2022 / Characterization of gestational trophoblastic disease at Hospital de Talca, 2013-2022

Introducción: La enfermedad trofoblástica gestacional (ETG) corresponde al espectro de lesiones proliferativas del tejido trofoblástico placentario. Presenta una incidencia mundial variable; en Chile no existen estudios nacionales, por lo que las cifras se deben extrapolar de estudios extranjeros. Objetivo: Caracterizar clínica y epidemiológicamente a las pacientes diagnosticadas con embarazo molar en el periodo 2013-2022 en el Hospital Regional de Talca (HRT). Método: Estudio observacional transversal, se consideró el recuento total de pacientes de la base de datos del Servicio de Onco-Ginecología (n = 100) y la cantidad de embarazos ocurridos entre 2013-2022 en el HRT. Resultados: La edad promedio de presentación fue de 32 años, obteniéndose una incidencia de ETG de 2,1 casos por cada 1.000 embarazos. El 54% de los casos corresponde a mola parcial. Los principales síntomas fueron metrorragia (67%) y dolor abdominal (40%). El principal tratamiento efectuado fue aspiración uterina (92%). En el 48% de los casos se sospechó la ETG con la clínica previo al diagnóstico por biopsia y solo en un 13% únicamente con estudio ecográfico. Conclusiones: Es necesario realizar más investigaciones nacionales que permitan recopilar información actualizada sobre ETG, sobre todo por la variabilidad clínica de la enfermedad, que hace difícil su sospecha diagnóstica.

Introduction: Gestational trophoblastic disease (GTO) corresponds to the spectrum of proliferative lesions of placental trophoblastic tissue. It has a variable global incidence; in Chile there are no national studies so it must be extrapolated from foreign studies. Objective: To clinically and epidemiologically characterize patients diagnosed with molar pregnancy in the period 2013-2022, at the Talca Regional Hospital (HRT). Method: Cross-sectional observational study, the total count of patients from the Onco-Gynecology Service database (n = 100) and the number of pregnancies that occurred between 2013-2022 in the HRT were considered. Results: The average age of presentation was 32 years, obtaining an incidence of GTO of 2.1 cases per 1000 pregnancies; 54% of cases correspond to partial mole. The main symptoms were metrorrhagia (67%) and abdominal pain (40%). The main treatment performed was uterine aspiration (92%). In 48% of the cases, GTO was suspected with clinical symptoms prior to diagnosis by biopsy, and only 13% with an ultrasound study alone. Conclusions: It is necessary to carry out more national research to collect updated information on GTO, especially due to the clinical variability of the disease that makes its diagnostic suspicion difficult.

Partos y cesáreas en edad de riesgo en hospitales del Maule desde 2017 a 2021 / Births and cesarean sections at risk age in Maule hospitals from 2017 to 2021

Pregnancy, despite being a physiological process, can lead to morbidity and mortality, which is increased at risk ages, defined as younger or equal to15 years and older or equal to 35 years. For an adequate approach it is necessary to know the local reality of the population, therefore, the objective of this study is to describe and analyze the discharges of births and cesarean sections at risk age in the Maule Region from 2017 to 2021 using the database collected from the Biostatistics Unit of the Maule Health Service, which includes the hospitals of the region. Within the observed period, a total of 30,599 deliveries and cesarean sections were studied, being these a total of 5,581 at risk age, of which 0.65% corresponds to women younger or equal to 15 years and 17.57% to women older or equal to 35 years. There is a downward tendency in births in general, mostly evidenced in less or equal to 15 years, and on the contrary, a rise in births and cesarean sections of more or equal to 35 years, differing with the statistics at the country level. The tendency of increasing maternal age of pregnancies in the Maule region and its consequences are a fundamental factor when planning new public policies, so we consider it of vital importance to promote research and update the evidence, with a focus on the local population.

El embarazo a pesar de ser un proceso fisiológico puede conllevar morbimortalidad, la cual se acrecienta en edades de riesgo, definida como menor o igual a 15 años y mayor o igual a 35 años. Para el adecuado enfrentamiento se necesita conocer la realidad local, por ello, el objetivo de este estudio es describir y analizar los egresos de partos y cesáreas en edad de riesgo en la Región del Maule desde el año 2017 a 2021 utilizando la base de datos recogida desde la Unidad de Bioestadística del Servicio de Salud Maule, la cual incluye los hospitales de la región. Dentro del periodo observado se estudió un total de 30.599 partos y cesáreas, siendo estos un total de 5.581 en edad de riesgo, de los cuales 0.65% corresponde a mujeres menores o igual a 15 años y 17.57% a mujeres mayores o igual a 35 años. Existe una tendencia a la baja de los nacimientos en general, mayormente evidenciado en menores o igual a 15 años, y por el contrario, un alza en los partos y cesáreas de mayores o igual a 35 años, difiriendo con las estadísticas a nivel país. El aumento de la edad materna de los embarazos en la región del Maule y sus consecuencias son un factor fundamental a la hora de planificar nuevas políticas públicas, por lo que consideramos de vital importancia promover la realización de investigaciones y actualización de la evidencia sobre el tema, con un enfoque en la población local.

Impacto de la pandemia de COVID-19 en pacientes sometidas a fertilización in vitro en el Hospital Gustavo Fricke / Impact of the COVID-19 pandemic on patients undergoing in vitro fertilization at the Gustavo Fricke Hospital

Introducción: La infertilidad es una enfermedad presente en el 17.5% de la población adulta. La COVID-19 provocó sobrecargas en atención de salud, generando un impacto incierto en unidades de salud reproductiva que realizan terapias de reproducción asistida. Objetivos: Comparar características clínicas y tiempos de atención de pacientes sometidas a fertilización in vitro de la Unidad de Medicina Reproductiva del Hospital Gustavo Fricke entre los periodos 2017-2019 y 2020-2022. Método: Estudio observacional descriptivo, utilizando base de datos anonimizada de la Unidad de Medicina Reproductiva del Hospital Gustavo Fricke con 82 pacientes sometidas a fertilización in vitro. Resultados: La media de edad fue de 34.2 ± 4.2 años. El tiempo de infertilidad fue de 5.1 ± 4.3 años. Los factores de infertilidad más frecuentes son el tuboperitoneal (59,8%) y masculino (46,3%). Durante los primeros 20 meses en prepandemia hubo mayor tendencia a derivación precoz al Centro de Reproducción Humana de la Universidad de Valparaíso (odds ratio: 3.84). Conclusiones: En pandemia se evidenció un aumento en el tiempo de infertilidad, mediana de gestaciones, abortos previos y frecuencia de factor masculino. No hubo cambios significativos en tiempos de derivación a fertilización in vitro, no obstante, durante la pandemia disminuyeron las derivaciones precoces.

Introduction: Infertility is a disease present in the 17.5% of the adult population. COVID-19 caused overload in health centers, producing an unclear impact in the reproductive health units that perform assisted reproduction therapies. Objectives: To compare clinical characteristics and the attention times of patients subjected to in vitro fertilization in the Reproductive Medicine Unit of the Gustavo Fricke Hospital between the 2017-2019 and 2020-2022 periods. Method: Descriptive observational study in which an anonymized database of 82 patients subjected to in vitro fertilization in the Reproductive Medicine Unit of the Gustavo Fricke Hospital was used. Results: The average age was 34.2 ± 4.2 years old. The infertility time was 5.1 ± 4.3 years. The most frequent infertility factors were tuboperitoneal (59.8%) and male factors (46.3%). During the first pre-pandemic 20 months, there was a higher tendency towards early referral to the Center for Human Reproduction of the Valparaiso University (odds ratio: 3.84). Conclusions: In the course of the pandemic, there was an increase of the infertility time, the pregnancies median, prior abortions, and male factor frequency. On the other hand, there were not considerable changes when it comes to referral times to in vitro fertilization, however, early referrals decreased during the pandemic.

Experiencia de parto instrumental con vacuum en Hospital Público de Santiago de Chile / Experience of vacuum-assisted instrumental delivery in a Public Hospital in Santiago, Chile

Introducción: El vacuum es el instrumento de elección para asistir el parto instrumental en países desarrollados. Objetivo: El objetivo del estudio es exponer los resultados maternos y fetales del uso del vacuum en población chilena y promover su disponibilidad y uso en nuestro país y Latinoamérica. Método: El estudio se realizó entre octubre de 2017 y diciembre de 2021, incluyendo a pacientes que tuvieron parto instrumental con vacuum en el Hospital San Juan de Dios de Chile. Se compararon los partos exitosos con vacuum y los partos en los que se requirió el uso de otro instrumento o una cesárea posterior al uso del instrumento. Resultados: Se realizaron 153 vacuum, correspondientes al 28,59% del total de partos instrumentales. El 79,74% tuvo éxito. El 5,88% no recibió anestesia o se aplicó anestesia local. Solo el 3,27% presentó desgarro perineal con compromiso del esfínter anal. El 91,5% de los recién nacidos no tuvieron complicaciones fetales. Un 20,3% requirió reanimación neonatal. Conclusiones: El estudio muestra que el vacuum es una opción segura y efectiva de parto instrumental en nuestra población. La correcta capacitación y protocolos adecuados son necesarios para garantizar resultados exitosos.

Introduction: Vacuum extraction is the instrument of choice for assisting instrumental delivery in developed countries. Objective: The aim of the study is to present the maternal and fetal outcomes of vacuum use in the Chilean population and promote its availability and usage in our country and Latin America. Method: The study was performed between October 2017 and December 2021, including patients who underwent instrumental delivery with a vacuum extraction at the Hospital San Juan de Dios in Chile. Successful vacuum deliveries were compared with deliveries where another instrument was required, or a cesarean section was performed after instrument use. Results: A total of 153 vacuum deliveries were carried out, accounting for 28.59% of all instrumental deliveries. 79.74% were successful. 5.88% did not receive anesthesia or received local anesthesia. Only 3.27% experienced perineal tear with involvement of the anal sphincter. 91.5% of newborns had no fetal complications. 20.3% required neonatal resuscitation. Conclusions: The study demonstrates that the vacuum is a safe and effective option for instrumental delivery in our population. Proper training and appropriate protocols are necessary to ensure successful outcomes.

Operational nursing managers' experiences of clinical supervision at a Johannesburg Hospital

Background: Clinical supervision is pivotal in supporting nurses in rendering quality, safe patient care. Therefore, it is essential to understand clinical supervision from operational nursing managers' context to define existing challenges and propose suitable recommendations. Objectives: This study aimed to explore and describe operational nursing managers' experiences of clinical supervision within the context of an academic hospital in Gauteng province and propose evidence-based practice recommendations to improve patient safety and the quality of clinical supervision. Method: An exploratory, sequential, mixed-method design was used and implemented over two phases to take advantage of the strengths of both the qualitative and quantitative research designs. Unstructured individual interviews were conducted to collect data in phase one, and an adapted Manchester Clinical Supervision Scale (MCSS) questionnaire was used to collect data in phase two. Results: Operational nursing managers work in stressful conditions and environments with a gross shortage of staff and tools of the trade while being expected to deliver high-quality and safe nursing care. Of the sampled respondents, 36% (n = 17) were dissatisfied with the supervision they received, while 64% (n = 30) were indifferent in the sense that they did not think it was adequate or inadequate. Conclusion: Clinical supervisors should be trained and supported in clinical supervision, with regular workshops on interpersonal relations. Contribution: A clearer understanding of clinical supervision within the hospital context and evidence-based practice recommendations to improve patient safety and the quality of clinical supervision.

Retrospective study of patients submitted to appendectomy in a tertiary hospital: is there a difference between the public and supplementary health system?

Introduction: Appendicitis is the surgical disease with the highest prevalence in emergency rooms. Its clinical and/or surgical complications are associated with the time course of symptoms, age, comorbidities, and stages of the disease. Objectives: To analyze the demographic and clinical data of patients who underwent appendectomy for acute appendicitis in a tertiary referral hospital in the city of São Paulo and compare these data between services provided by the Public and Supplementary Health System. Methodology: Retrospective analysis of data from electronic medical records of patients over 14 years old who underwent appendectomy for acute appendicitis at Hospital Santa Marcelina, both in the Public and Supplementary Health Systems from January 2015 to December 2017. Results: A total of 536 patients were analyzed, 354 (66%) of whom were male with a general mean age of 29.85 years (14-81 years). The mean time from symptoms to seeking medical care was 53.84 hours. Regarding the phases of acute appendicitis, a greater number of cases of complicated disease was observed in patients operated on in the Public Health System (p < 0.0001), as well as the time course of symptoms (p = 0.0005) and Conclusion: There was a predominance of male patients undergoing appendectomy for acute appendicitis, with longer time course of symptoms in those operated on in the Public Health System and a predominance of appendicitis in advanced stages (3 and 4) in this group. However, in this group there was no significant increase in the rate of postoperative infection, and the length of stay was shorter than that of patients operated on in the Supplementary Health System. (AU)

Sobrevida post instalación de gastrostomía: experiencia de un centro terciario / Survival post installation of gastrostomy: experience of a tertiary cente

Introduction: Percutaneous Endoscopic Gastrostomy (PEG) is one of the preferred methods for providing enteral feeding to patients whose oral intake nutrition is not feasible. There is limited evidence regarding post- PEG survival. Our primary objective is to evaluate long-term survival and identify main variables in a cohort of patients with PEG. Methodology: A retrospective study of patients who underwent PEG at Sótero del Río Hos- pital between 2013 and 2020 was conducted. Demographic data, indications for PEG, and time from placement to death, in applicable cases, were evaluated. Specific indications were classified into four groups: Neoplasia, Dementia, Stroke (CVA), and Other neurological causes. Kaplan-Meier curves were plotted to represent survival, and log-rank tests were used. Results: 635 patients were included, 53.5% male, with a median age of 69 years (IQR 55-79). Indications included Neoplasia (11.8%), Dementia (9.8%), Stroke (58.4%), and Other neurological causes (20.0%). The overall survival rate was 36%, with rates of 50.23% at one year and 3.94% at five years, and a median survival of 12 months (IQR 4-28). According to the previous diagnosis, the Other neurological causes group had a higher survival rate (p < 0.001), with a median survival of 16 months (IQR 4-35). Conclusions: PEG is an invasive technique where placement is influenced by multiple variables such as previous diagnosis and patient type. Our study demonstrated a survival rate consistent with the literature, where factors such as age and the type of disease that prompted indication are relevant to consider.

Introducción: La gastrostomía endoscópica percutánea (GEP) es uno de los métodos de elección para brindar alimentación enteral a pacientes que ven afectada su capacidad de nutrición por vía oral. Existe escasa evidencia respecto a la sobrevida post GEP, estudios describen un 40% al año, en relación a la gravedad inherente de la enfermedad de base de los pacientes. Nuestro objetivo principal es evaluar la sobrevida a largo plazo y cuáles serían las principales variables que podrían influir, en una cohorte de pacientes con GEP. Metodología: Estudio retrospectivo de pacientes a quienes se les instaló una GEP en el Hospital Sótero del Río, entre los años 2013- 2020. Se evaluaron datos demográficos, indicación de la GEP y tiempo transcurrido desde la instalación hasta el fallecimiento, en los casos correspondientes. Las indicaciones específicas fueron clasificadas en cuatro grandes grupos: Neoplasia, Demencia, Accidente Cerebrovascular (ACV) y Otras causas neurológicas. Se trazaron curvas de Kaplan-Meier para representar la supervivencia y se utilizaron pruebas de log-rank test. En el análisis estadísti- co se utilizó SPSS versión 25. Resultados: Se incluyeron 635 pacientes, 53,5% sexo masculino, con una mediana de edad 69 años (RIQ 55-79). Dentro las indicaciones: Neoplasia (11,8%), Demencia (9,8%), ACV (58,4%) y Otras causas neurológicas (20,0%). La tasa de sobrevida global fue del 36%, siendo al año 50,23 % y a los 5 años 3,94%; con una mediana de sobrevida de 12 meses (RIQ 4-28). Según diagnóstico previo, el grupo Otras causas neurológicos tuvo una mayor sobrevida (p < 0,001), con una mediana de 16 meses (RIQ 4-35). Conclusiones: La GEP es una técnica invasiva donde su instalación responde a múltiples variables como diagnóstico previo y tipo de paciente. Nuestro trabajo demostró una tasa de supervivencia acorde con la literatura, donde los factores como la edad y el tipo de enfermedad que originó indicación son relevantes a considerar.

Avaliação da cultura de segurança do paciente: percepção de trabalhadores de enfermagem e fatores associados / Evaluación de la cultura de seguridad del paciente: percepción de los trabajadores de enfermería y factores asociados / Evaluation of patient safety culture: perception of nursing workers and associated factors

Objetivos: avaliar a cultura de segurança do paciente na percepção de trabalhadores de enfermagem e identificar a associação dessa cultura com variáveis sociodemográficas e profissionais dos trabalhadores. Método: estudo transversal, com abordagem quantitativa, desenvolvido em hospital público geral de Salvador, Bahia, Brasil, com 180 trabalhadores de enfermagem. Foi empregado o questionário Hospital Survey on Patient Safety Culture e utilizou-se estatística descritiva, testes de associação e de correlação para análise dos dados. Resultados: nenhuma dimensão da cultura foi considerada fortalecida, a nota de segurança foi classificada como regular por 58,0% dos trabalhadores e 63,9% revelaram não efetuar notificação no último ano. A cultura esteve associada ao sexo, à categoria profissional, ao tipo e à quantidade de vínculo trabalhista, ao local de trabalho, à idade e à experiência profissional e no serviço. Conclusão: a cultura revelou-se fragilizada apontando para necessidade de intervenções, especialmente no que tange aos fatores associados.

Objetivos: evaluar la cultura de seguridad del paciente en la percepción de trabajadores de enfermería e identificar la asociación de esa cultura con variables sociodemográficas y profesionales de los trabajadores. Método: estudio transversal, con abordaje cuantitativo, desarrollado en hospital público general de Salvador, Bahía, Brasil, con 180 trabajadores de enfermería. Se empleó el cuestionario Hospital Survey on Patient Safety Culture y se utilizó estadística descriptiva, pruebas de asociación y de correlación para el análisis de los datos. Resultados: ninguna dimensión de la cultura fue considerada fortalecida, la nota de seguridad fue clasificada como regular por 58,0% de los trabajadores y 63,9% revelaron no efectuar notificación en el último año. La cultura estuvo asociada al sexo, a la categoría profesional, al tipo y a la cantidad de vínculo laboral, al lugar de trabajo, a la edad y a la experiencia profesional y en el servicio. En conclusión: la cultura se ha mostrado debilitada señalando la necesidad de intervenciones, especialmente en lo que respecta a los factores asociados.

Objectives: to evaluate the patient safety culture in the perception of nursing workers and to identify the association of this culture with sociodemographic and professional variables of workers. Method: cross-sectional study with a quantitative approach, developed in a general public hospital in Salvador, Bahia, Brazil, with 180 nursing workers. The Hospital Survey on Patient Safety Culture questionnaire was used and descriptive statistics, association and correlation tests were used to analyze the data. Results: no dimension of the culture was considered strengthened, the safety grade was classified as acceptable by 58.0% of the workers and 63.9% revealed no notification in the last year. Culture was associated with gender, professional category, type and amount of employment, workplace, age and professional and service experience. Conclusion: the culture proved to be fragile pointing to the need for interventions, especially regarding the associated factors.

Implementation of the Fast-track Protocol for Total Hip Arthroplasty in a Public Hospital in the State of São Paulo - Brazil / Implantação do protocolo de recuperação rápida para artroplastia total do quadril em hospital público do estado de São Paulo - Brasil

Abstract Objective Evaluate the results of the implementation of the Fast Track Protocol (FTP), a medical practice based on scientific evidence, for elective total hip arthroplasty surgery, mainly comparing the National Average Hospital Admission Rate of 7.1 days. Methods 98 patients who underwent elective total hip arthroplasty surgery via the direct anterior approach, anterolateral approach and posterior approach were included in the FTP from December 2018 to March 2020, being followed up preoperatively, intraoperatively and immediately postoperatively. Results The average length of hospital stay was 2.8 days, being 2.1 days for the direct anterior approach, 3.0 days for the anterolateral access approach and 4.1 days for the posterior access approach. The average surgery time was 90 minutes, 19 (19.39%) of the patients were referred to the ICU in the postoperative period, however, none of them underwent surgery using the direct anterior approach. We had no cases of deep vein thrombosis (DVT), pulmonary embolism (PTE) or neurological injury, 19 (19.39%) patients had postoperative bleeding requiring dressing change, 4 (4.08%) needed blood transfusion, 2 (2.04%) patients had implant instability, 1 (1.02%) patient had a fracture during surgery and 1 (1.02%) patient died of cardiac complications. Conclusion FTP may be a viable alternative to reduce the length of stay and immediate postoperative complications for elective total hip arthroplasty surgery decreasing the length of stay of patients by 2 to 3 times when compared to the national average of 7.1 days.

Resumo Objetivo Avaliar os resultados da implantação do Protocolo de Recuperação Rápida (PRR), prática médica baseada em evidências científicas, para cirurgia eletiva de artroplastia total do quadril principalmente comparando à Taxa Média de Internação Hospitalar nacional de 7.1 dias. Métodos 98 pacientes submetidos a cirurgia eletiva de artroplastia total do quadril pela via direta anterior, via anterolateral e via posterior foram incluídos no PRR no período de dezembro de 2018 a março de 2020 sendo acompanhados no pré-operatório, intraoperatório e pós-operatório imediato. Resultados a Taxa Média de Permanência Hospitalar foi de 2,8 dias, sendo 2,1 dias para a Via de Acesso Anterior, 3,0 dias para via de acesso anterolateral e 4,1 dias para via de acesso posterior. O tempo médio de cirurgia foi de 90 minutos, 19 (19,39%) dos pacientes foram encaminhados à UTI no pós-operatório, no entanto nenhum deles operado pela via direta anterior. Não tivemos casos de trombose venosa profunda (TVP), embolia pulmonar (TEP) ou lesão neurológica, 19 (19,39%) pacientes tiveram sangramento pós-operatório com necessidade de troca de curativo, 4 (4,08%) necessidade de transfusão sanguínea, 2 (2,04%) pacientes apresentaram instabilidade do implante, 1(1,02%) paciente teve fratura durante a cirurgia e 1(1,02%) paciente faleceu por complicações cardíacas. Conclusão O PRR pode ser uma alternativa viável para diminuir o tempo de internação e as complicações pós-operatórias imediatas para a cirurgia eletiva de artroplastia total do quadril diminuindo 2 a 3 vezes o tempo de internação dos pacientes quando comparado com a média nacional de 7,1 dias.

COVID-19 impact on bladder cancer treatment / Impacto de COVID-19 en el tratamiento del cáncer de vejiga

Objective: The proposed study aims to present the experience with radical cystectomy from a urology service in a public teaching, non-profit hospital with a medical residency service, during the COVID-19 pandemic period in 2020. Materials and methods: We led a prospective study from February 2020 to October 2020, in which three 2nd-year urology residents, guided by one particular attending physician, performed 20 radical cystectomies in an acute public hospital. Results: Most patients were male, with Muscle-invasive bladder cancer being the major indication in our sample. There was a meaningful and direct correlation between surgical time and length of stay in the Intensive Care Unit. Conclusion: Despite the complexity of the surgery, the execution of radical cystectomies during a pandemic period is feasible, with positive surgical results and complication rates compatible with the current literature

Objetivo: El estudio propuesto tiene como objetivo presentar la experiencia con cistectomía radical desde un servicio de urología en un hospital público docente, sin fines de lucro con el servicio de residencia médica, durante el período de pandemia de COVID-19 en 2020. Materiales y métodos: Realizamos un estudio prospectivo estudio de febrero de 2020 a octubre de 2020, en el que tres residentes de urología de segundo año, guiados por un médico tratante en particular, realizaron 20 cistectomías radicales en un hospital público de agudos. Resultados: La mayoría de los pacientes eran varones, siendo MIBC la principal indicación en nuestra muestra. Hubo una correlación significativa y directa entre el tiempo quirúrgico y la estancia en la Unidad de Cuidados Intensivos. Conclusión: A pesar de la complejidad de la cirugía, la realización de cistectomías radicales en período de pandemia es factible, con resultados quirúrgicos positivos y tasas de complicaciones compatibles con la literatura actua

Edad materna avanzada: complicaciones más frecuentes en el Hospital Regional de Talca / Advanced maternal age: most frequent complications in Talca's Regional Hospital

Professional development, the search for economic stability and personal fulfillment have been some of the reasons why an increasing number of women have decided to delay pregnancy beyond the third decade of life. By definition, a pregnancy of advanced maternal age is considered to be those over 35 years of age, and it is known that this age group faces a higher risk of complications during pregnancy, intrapartum and postpartum, in addition to perinatal morbidity and mortality that is usually associated with chromosomal abnormalities. In Chile, pregnancies over 35 years of age or late pregnant women have increased significantly in recent decades, however there are no statistical data at a local level. The objective of this study is to evaluate the prevalence of pregnancies of advanced maternal age and their most frequent complications in the Maule Region with data obtained between 2017 - 2022 at the Regional Hospital of Talca (RHT).

Aportes del Hospital de Día para la atención de niños/as y adolescentes con patologías mentales graves, en la formación de residentes de Psiquiatría Pediátrica / Contributions from the Day Hospital for the care of children and adolescents with serious mental pathologies, in the training of Pediatric Psychiatry residents

Cerca del 20 % de niños en todo el mundo experimentan trastornos mentales, independientemente de su procedencia o cultura. La manifestación de un trastorno mental durante la infancia puede ocasionar alteraciones en el desarrollo, impactando negativamente en la calidad de vida, la dinámica familiar, y en el progreso académico y social. En nuestro país los problemas de salud mental en la infancia y adolescencia están entre los principales problemas de salud en este grupo de edades, y las consultas y hospitalizaciones de niños, niñas y adolescentes se encuentran con una oferta de servicios limitada. En 2017, se aprueba la Ley de Salud Mental, que promueve la atención de los problemas en el ámbito comunitario, y la implementación de distintos dispositivos de atención alternativos a la hospitalización a tiempo completo. Uno de los dispositivos intermedios es el hospital de día, para la atención de trastornos mentales en forma ambulatoria diurna, como alternativa a la hospitalización. En el 2021 se abre el primer Hospital de Día para niños, niñas y adolescentes con trastornos psiquiátricos severos en el Centro Hospitalario Pereira Rossell. Con un equipo interdisciplinario con recursos de la Administración de los Servicios de Salud del Estado y la Facultad de Medicina, brinda la oportunidad de pasantías para estudiantes de distintas disciplinas. El Hospital de Día enriquece la formación de residentes de Psiquiatría Pediátrica para enfrentar desafíos clínicos y desarrollar estrategias de tratamiento interdisciplinarias, complementarias al abordaje tradicional, una atención de mayor calidad y una oportunidad de aprendizaje en trabajo en equipo.

About 20% children experience mental disorders worldwide, regardless of background or culture. Mental disorders appearing during childhood can cause developmental changes, with negative impact on quality of life, family dynamics, as well as on academic and social progress. In our country, Mental Health problems in childhood and adolescence are among the main health problems in this age group, increasing consultations and hospitalizations of children and adolescents, stressing a limited supply of services. In 2017, the Mental Health Law was passed, which promotes mental health care at the community level, and the implementation of different care strategies as alternatives to fulltime hospitalization. One of the intermediate strategies is the day hospital, for the care of mental disorders on a daytime outpatient basis, as an alternative to conventional hospitalization. In 2021, the first day hospital for children and adolescents with severe psychiatric disorders was opened in Uruguay at the Pereira Rossell Hospital Center. With an interdisciplinary team with resources from ASSE and the Faculty of Medicine, it provides opportunity for internships for students from different disciplines. The Day Hospital enriches the training of Pediatric Psychiatry residents. They learn how to cope with clinical challenges, have a teamwork learning opportunity, and develop interdisciplinary treatment strategies, complementary to the traditional approach, providing higher quality care in the management of serious childhood mental disorders.

Adherence to heart rate training zones in an exercise training program in adults with coronary artery disease

Objectives: To investigate the effect of exercise intensity on functional capacity in individuals with coronary artery disease, assess adherence to the heart rate training zone (HRTZ), and relationship between trained intensity and functional capacity. Methods: Retrospective study led with medical records of 54 outpatients with coronary artery disease in a public hospital. The prescribed intensity started at 50 ­60% of heart rate reserve, increasing monthly to 70 ­80% by the third month. Spearman's test was used to assess the correlation between improvement in distance in the incremental shuttle walk test (ISWT), exercise intensity, and rating of perceived exertion (Borg­RPE). Adherence was classified as 'below' when HRTZ was not achieved in any phase of the program, 'intermediate' when HR was within the HRTZ for one or two months, and 'above' when HR was at or higher than HRTZ two months. Improvement was tested with t-test and one-way ANOVA. Results: 51.9% of participants had an increase in ISWT of ≥70 m (p < 0.0001). In at least one month, 50.9% trained below HRTZ. Trained intensity did not go below 8.6% of the prescribed minimal threshold of HRTZ. Changes in ISWT were not significantly correlated with exercise intensity (p = 0.87) or Borg­RPE (p = 0.16). Conclusion: While a significant increase in functional capacity was found, considerable heterogeneity in changes were observed. This may, in part, be related to adherence to HRTZ with progressive exercise intensity and to the variability in exercise volume incardiovascular rehabilitation programs.

Atuação do enfermeiro hospitalar no gerenciamento da crise COVID-19 / Performance of hospital nurses in the management of the COVID-19 crisis / Papel de las enfermeras hospitalarias en la gestión de la crisis del COVID-19

Objetivo: compreender as perspectivas de enfermeiros hospitalares sobre a sua atuação no gerenciamento de crise face à pandemia COVID-19. Método: estudo qualitativo, descritivo, exploratório, realizado entre dezembro de 2021 a março de 2022 em hospital público. Participaram 22 enfermeiros, por meio de entrevista audiogravada guiada com seis perguntas abertas. Foi aplicado análise de conteúdo de Creswell auxiliado pelo software Iramuteq®. Resultados: das análises, emergiram quatro classes: Atuação dos enfermeiros refletida nos indicadores assistenciais e gerenciais; Dificuldades enfrentadas pelos enfermeiros para atuar durante a pandemia; Experiências anteriores dos enfermeiros como norte para a atuação na pandemia; Atuação dos enfermeiros em estratégias para o gerenciamento da crise COVID-19. Conclusão: a atuação do enfermeiro refletiu nos indicadores em detrimento às dificuldades no trabalho, principalmente, relacionados ao déficit de recursos humanos. Para gerenciar a crise, usaram de experiências anteriores tais como o H1N1 e estratégias indissociáveis à gestão/assistência para mitigar os impactos e atender a demanda(AU)

Objective: to understand the perspectives of hospital nurses on their role in crisis management in the face of the COVID-19 pandemic. Method: qualitative, descriptive, exploratory study carried out between December 2021 and March 2022 in a public hospital. 22 nurses participated in a guided audio-recorded interview with six open questions. Creswell content analysis aided by Iramuteq® software was applied. Results: from data analysis, four classes emerged: Nurses' performance reflected in care and management indicators; Difficulties faced by nurses to act during the pandemic; Previous experiences of nurses as a guide for acting in the pandemic; Nurses' performance in strategies for managing the COVID-19 crisis. Conclusion: The performance of the nurse was reflected in the indicators to the detriment of the difficulties at work, mainly related to the deficit of human resources. To manage the crisis, they used previous experiences such as H1N1 and strategies inseparable from management/assistance to mitigate impacts and meet demand(AU)

Objetivo: comprender las perspectivas de los enfermeros hospitalarios sobre su papel en la gestión de crisis frente a la pandemia de COVID-19. Método: estudio cualitativo, descriptivo, exploratorio, realizado entre diciembre de 2021 y marzo de 2022 en un hospital público. 22 enfermeros han participado de una entrevista guiada grabada en audio conteniendo seis preguntas abiertas. Se aplicó el análisis de contenido Creswell con ayuda del software Iramuteq®. Resultados: de los análisis, surgieron cuatro clases: actuación de los enfermeros reflejada en indicadores de atención y gestión; dificultades que enfrentan los enfermeros que trabajan durante la pandemia; experiencias previas de enfermeros como guía para trabajar en la pandemia; actuación de los enfermeros en las estrategias de gestión de la crisis de la COVID-19. Conclusión: la actuación del enfermero se reflejó en los indicadores en detrimento de las dificultades en el trabajo, principalmente relacionadas con el déficit de recursos humanos. Para gestionar la crisis, utilizaron experiencias previas como durante la incidencia de H1N1 y estrategias inseparables de la gestión/asistencia para mitigar impactos y atender la demanda(AU)

Desenhar, escrever e contar: qualidade de vida da criança e adolescente com condição crônica / Draw, write and tell interview: Quality of life of children and adolescents with chronic condition / Dibujar, escribir y contar: calidad de vida de niños y adolescentes con enfermedades crónicas

Objetivo: compreender por meio da técnica Desenhar, escrever e contar como a condição crônica influencia na qualidade de vida infantojuvenil; e analisar o uso da técnica nessa população. Método: estudo qualitativo, descritivo e exploratório. Participaram onze crianças e adolescentes com condição crônica entre sete e dezessete anos. A coleta de dados ocorreu mediante entrevista semiestruturada, com auxílio da técnica Desenhar, escrever e contar, em um Hospital público. Para análise dos dados utilizou-se a análise de conteúdo temática de Bardin. Resultados: emergiram três categorias que evidenciam diversas alterações na qualidade de vida dessa clientela, com destaque para o comprometimento físico, emocional e social que impacta nas de experiências que compõem a infância e a adolescência. A técnica Desenhar, escrever e contar foi um facilitador e enriqueceu a coleta de dados. Considerações finais: a técnica escolhida possibilitou identificar a qualidade de vida prejudicada da criança e adolescente com condição crônica(AU)

Objective: to understand, through the Draw, Write and Tell interview technique how chronic condition influences pediatric quality of life; To analyze the use of the technique in this population. Method: qualitative, descriptive, exploratory study. Eleven children and adolescents with chronic conditions between seven and seventeen years old participated. Data collection took place through semi-structured interviews, with the aid of the Draw, Write and Tell interview technique, in State University Hospital. For data analysis, thematic content analysis according to Bardin was used. Results: three categories emerged that show several changes in the quality of life of this clientele, with emphasis on the physical, emotional and social impairment that impact on the experiences that make up childhood and adolescence. The Draw, Write and Tell interview technique facilitated and enriched data collection. Final considerations: The chosen technique made it possible to identify the impaired quality of life of children and adolescents with chronic conditions(AU)

Objetivo: comprender, a través de la técnica de entrevista Dibujar, Escribir y Contar, cómo la condición crónica influye en la calidad de vida infantojuvenil; y analizar el uso de la técnica en esta población. Método: estudio cualitativo, descriptivo y exploratorio. Participaron once niños y adolescentes, con condiciones crónicas, de siete a diecisiete años. La recolección de datos ocurrió por medio de entrevistas semiestructuradas, con el auxilio de la técnica de entrevista Dibujar, Escribir y Contar, en un hospital público. En cuanto al análisis de datos, se utilizó el análisis de contenido temático de Bardin. Resultados: surgieron tres categorías que muestran varios cambios en la calidad de vida de esta clientela, con énfasis en el deterioro físico, emocional y social que tiene un gran impacto en las experiencias que componen la infancia y la adolescencia. La técnica Dibujar, Escribir y Contar facilitó y enriqueció la recolección de datos. Consideraciones finales: la técnica elegida permitió identificar la calidad de vida deteriorada de niños y adolescentes con condiciones crónicas(AU)

Burnout em lideranças de enfermagem durante a pandemia da COVID-19 / Burnout in nursing leaderships during the COVID-19 pandemic / Burnout en líderes de enfermería durante la pandemia de COVID-19

Objetivo: analisar a relação entre o contexto de trabalho das lideranças de enfermagem na pandemia da COVID-19 e o Burnout. Método: estudo de método misto, com uma amostra quantitativa de 64 líderes de enfermagem, de todos os setores de quatro hospitais gaúchos. A coleta de dados ocorreu de agosto a outubro de 2020, após aprovação do Comitê Nacional de Ética em Pesquisa. Foi realizada a análise inferencial dos dados quantitativos (n=64), aplicados os testes de Mann-Whitney e correlações bivariadas de Spearman, considerando diferenças estatisticamente significativas "p" bicaudal menor que 0,05. Realizaram-se entrevistas qualitativas (n=12) acerca dos impactos da pandemia. Resultados: identificou-se 6,3% de prevalência de Síndrome de Burnout. Houve associação entre os domínios Desgaste Emocional e Despersonalização e as variáveis medo, aumento do consumo de álcool e impacto na saúde (p<0,05). Evidenciaram-se mudanças no contexto laboral, aumento do nível de exigência e da carga de trabalho e impactos na saúde. Conclusão: conclui-se que há associação entre o contexto de trabalho na pandemia e o Burnout. O aumento da sobrecarga de trabalho repercutiu em prejuízos na saúde mental(AU)

Objective: to analyze the relationship between the work context of nursing leaders in the COVID-19 pandemic and Burnout. Method: mixed method study, with a quantitative sample of 64 nursing leaders, from all sectors of four hospitals in Rio Grande do Sul. Data collection carried out from August to October 2020, after approval by the National Research Ethics Committee. Inferential analysis of quantitative data (n=64) was performed, applying Mann-Whitney tests and bivariate Spearman correlations, considering statistically significant two-tailed "p" differences less than 0.05. Qualitative interviews (n=12) were carried out about the impacts of the pandemic. Results: a 6.3% prevalence of Burnout Syndrome was identified. There was an association between the Emotional Exhaustion and Depersonalization domains and the variables fear, increased alcohol consumption and impact on health (p<0.05). There were changes in the work context, an increase in the level of demand and workload, and impacts on health. Conclusion: it is concluded that there is an association between the work context in the pandemic and Burnout. The increase in work overload had negative effects on mental health(AU)

Objetivo: analizar la relación entre el contexto de trabajo de los líderes de enfermería en la pandemia de COVID-19 y el Burnout. Método: estudio de método mixto, con muestra cuantitativa de 64 líderes de enfermería, de todos los sectores de cuatro hospitales de Rio Grande do Sul. La recolección de datos tuvo lugar de agosto a octubre de 2020, previa aprobación del Comité Nacional de Ética en Investigación. Se realizó el análisis inferencial de datos cuantitativos (n=64), se aplicaron pruebas de Mann-Whitney y correlaciones bivariadas de Spearman, considerando diferencias estadísticamente significativas "p" de dos colas menor a 0,05. Se realizaron entrevistas cualitativas (n=12) sobre los impactos de la pandemia. Resultados: se identificó una prevalencia del Síndrome de Burnout del 6,3%. Hubo asociación entre los dominios Cansancio Emocional y Despersonalización y las variables miedo, aumento del consumo de alcohol e impacto en la salud (p<0,05). Se han producido cambios en el contexto laboral, aumento en el nivel de exigencia y en la carga de trabajo e impactos en la salud. Conclusión: se concluye que existe asociación entre el contexto laboral en la pandemia y el Burnout. El aumento de la sobrecarga de trabajo tuvo efectos negativos sobre la salud mental(AU)

Administração de anti-infecciosos em pacientes críticos: gestão proativa de riscos / Administration of anti-infectives in critically ill patients: proactive risk management / Administración de antiinfecciosos en pacientes críticos: gestión proactiva del riesgo

Objetivo: analisar a gestão de riscos proativa do processo de administração de anti-infecciosos em Unidade de Terapia Intensiva. Método: estudo qualitativo, em pesquisa-ação, com observação participante e grupo focal, realizado de 2019 a 2021. Foi mapeado o processo, analisados os riscos, planejadas ações de melhorias e redesenhado o processo. Resultados: a prescrição ocorria em sistema eletrônico e os registros da administração em impressos. O processo de administração de anti-infecciosos possuía 19 atividades, dois subprocessos, 16 modos de falhas e 23 causas potenciais. Os modos de falhas foram relacionados à assepsia e erro de dose no preparo de anti-infecciosos e as causas apontadas foram a falha humana na violação das técnicas e o lapso de memória. Cinco especialistas redesenharam o processo resultando em alterações de atividades e no sistema. Conclusão: a gestão de riscos proativa aplicada ao processo de administração de anti-infecciosos propiciou identificar riscos, suas causas e priorizar ações de melhorias, o que pode viabilizar tomadas de decisões apropriadas(AU)

Objective: to analyze the proactive risk management of the anti-infective administration process in an Intensive Care Unit. Method: qualitative study, in action research, with participant observation and focus group, from 2019 to 2021. The process was mapped, risks analyzed, improvement actions planned and the process redesigned. Results: the prescription occurred in an electronic system and the administration records in printed form. The anti-infective administration process had 19 activities, two sub-processes, 16 failure modes and 23 potential causes. The failure modes were related to asepsis and dose error in the preparation of anti-infectives and the identified causes were human error in violating techniques and memory lapse. Five specialists redesigned the process resulting in changes in activities and in the system. Conclusion: proactive risk management applied to the anti-infective administration process was effective in identifying risks, their causes and prioritizing improvement actions(AU)

Objetivo: analizar la gestión proactiva de riesgos del proceso de administración de antiinfecciosos en una Unidad de Cuidados Intensivos. Método: estudio cualitativo, en investigación-acción, con observación participante y grupo focal, que tuvo lugar del 2019 al 2021. Se mapeó el proceso, se analizaron los riesgos, se planificaron acciones de mejora y se rediseñó el proceso. Resultados: la prescripción ocurrió en sistema electrónico y los registros de administración en forma impresa. El proceso de administración de antiinfecciosos tuvo 19 actividades, dos subprocesos, 16 modos de falla y 23 causas potenciales. Los modos de falla estuvieron relacionados con la asepsia y error de dosis en la preparación de antiinfecciosos y las causas identificadas fueron error humano por violación de técnicas y lapsus de memoria. Cinco especialistas rediseñaron el proceso generando cambios en las actividades y en el sistema. Conclusión: la gestión proactiva de riesgos aplicada al proceso de administración de antiinfecciosos fue efectiva para identificar riesgos, sus causas y priorizar acciones de mejora, lo que puede factibilizar la toma de decisiones adecuadasa(AU)

Fatores associados à punção venosa periférica difícil em adultos submetidos à quimioterapia antineoplásica / Factors associated with difficult peripheral venipuncture in adults undergoing antineoplastic chemotherapy / Factores asociados a la venopunción periférica difícil en adultos sometidos a quimioterapia antineoplásica

Objetivo: identificar os fatores associados à punção venosa periférica difícil em adultos submetidos à quimioterapia antineoplásica. Método: estudo transversal, observacional, analítico e quantitativo realizado em uma Unidade de Alta Complexidade em Oncologia (UNACON) da região amazônica brasileira. Os dados foram analisados por meio de estatística descritiva e inferencial, onde a razão de possibilidades foi calculada. Resultados: a maioria dos participantes foi do sexo feminino (64,6%), autodeclarados como pardos (51,2%). Em relação à localização do câncer, a maioria possuía a doença no aparelho digestório (46,4%) ou reprodutor (45,2%). Pacientes que tinham histórico de punção venosa difícil, veias não visíveis ou não palpáveis apresentaram mais chance de apresentar a punção venosa difícil (OR 1,6, 1,5 e 1,3, respetivamente). Conclusão: os preditores encontrados relacionados à punção venosa periférica difícil em pacientes adultos submetidos à quimioterapia antineoplásica foram: histórico de punção difícil e veias não visíveis ou não palpáveis(AU)

Objective: to identify factors associated with difficult peripheral venipuncture in adults undergoing antineoplastic chemotherapy. Method: cross-sectional, observational, analytical, and quantitative study carried out in a High Complexity Oncology Unit (UNACON) in the Brazilian Amazon region. Data were analyzed using descriptive and inferential statistics, where the odds ratio was calculated. Results: majority of participants were female (64.6%), self-declared as brown (51.2%). Regarding the location of the cancer, the majority had the disease in the digestive (46.4%) or reproductive (45.2%) systems. Patients who had a history of difficult venipuncture, non-visible or non-palpable veins were more likely to have difficult venipuncture (OR 1.6, 1.5 and 1.3, respectively). Conclusion: found predictors related to difficult peripheral venipuncture in adult patients undergoing antineoplastic chemotherapy were: history of difficult puncture and non-visible or non-palpable veins(AU)

Objetivo: identificar los factores asociados a la dificultad de la venopunción periférica en adultos sometidos a la quimioterapia antineoplásica. Método: estudio transversal, observacional, analítico y cuantitativo realizado en una Unidad de Oncología de Alta Complejidad (UNACON) en la Amazonía brasileña. Se analizaron los datos mediante estadística descriptiva e inferencial, donde se calculó el odds ratio. Resultados: la mayoría de los participantes era del sexo femenino (64,6%), se auto declaró morena (51,2%). En cuanto a la ubicación del cáncer, la mayoría tenía la enfermedad en el sistema digestivo (46,4%) o reproductivo (45,2%). Los pacientes que tenían antecedentes de venopunción difícil, venas no visibles o no palpables tenían más probabilidades de tener venopunción difícil (OR 1,6, 1,5 y 1,3, respectivamente). Conclusión: Los predictores encontrados relacionados con la punción venosa periférica difícil en pacientes adultos sometidos a quimioterapia antineoplásica fueron antecedente de punción difícil y venas no visibles o no palpables(AU)