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2.
Rev. enferm. UERJ ; 28: e48578, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS (Américas), BDENF | ID: biblio-1116102

RESUMO

Objetivo: conhecer a experiência dos pais como estratégia de avaliação da qualidade da assistência de enfermagem. Método: pesquisa descritiva com abordagem qualitativa, desenvolvida na Unidade Neonatal de um Hospital do sul do Brasil. A coleta de dados foi realizada através de entrevistas, utilizando a técnica do incidente crítico (TIC), com 18 pais que estavam com seus filhos internados por 20 dias ou mais e que tinham previsão e plano de alta hospitalar. Após, os dados foram submetidos à análise de conteúdo. Resultados: a análise revelou fragilidades no cuidado prestado pela equipe de enfermagem em relação à administração de medicamentos, ao uso de equipamentos, à monitorização e ao posicionamento dos bebês, aos cuidados com a pele e à higiene de mãos. Conclusão: a experiência dos pais revelou elementos que integram a avaliação da assistência em enfermagem, destacando-os como pilares para a segurança do paciente.


Objective: to learn the parents' experience as a strategy for assessing the quality of nursing care. Method: in this qualitative, descriptive study at the Neonatal Unit of a hospital in southern Brazil, data were collected by critical incident (CI) interviews of 18 parents whose children had been hospitalized for 20 days or more, and whose discharge was scheduled and planned for. The data subsequently underwent content analysis. Results: data analysis revealed weaknesses in the care provided by the nursing staff as regards administration of medication, use of equipment, monitoring and positioning of babies, skin care and hand hygiene. Conclusion: The parents' experience revealed elements that enter into evaluation of nursing care, revealing parents to be mainstays of patient safety.


Objetivo: conocer la experiencia de los padres como estrategia para evaluar la calidad de la atención de enfermería. Método: en este estudio cualitativo y descriptivo en la Unidad Neonatal de un hospital en el sur de Brasil, los datos fueron recolectados por entrevistas de incidentes críticos (IC) de 18 padres cuyos hijos habían estado hospitalizados durante 20 días o más, y cuyo alta fue programada y planificada para. Los datos posteriormente se sometieron a análisis de contenido. Resultados: el análisis de datos reveló debilidades en la atención brindada por el personal de enfermería en lo que respecta a la administración de medicamentos, uso de equipos, monitoreo y posicionamiento de bebés, cuidado de la piel e higiene de manos. Conclusión: la experiencia de los padres reveló elementos que entran en la evaluación de la atención de enfermería, revelando que los padres son pilares de la seguridad del paciente.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Adulto , Pais , Qualidade da Assistência à Saúde , Unidades de Terapia Intensiva Neonatal/normas , Segurança do Paciente , Equipe de Enfermagem/normas , Análise e Desempenho de Tarefas , Brasil , Terapia Intensiva Neonatal , Pesquisa Qualitativa , Dano ao Paciente/prevenção & controle
3.
Enferm. foco (Brasília) ; 11(1): 114-117, jun. 2020. ilus
Artigo em Português | LILACS (Américas), BDENF | ID: biblio-1102819

RESUMO

Introdução: Estudos mostram que o ambiente muito estimulante, com altos níveis sonoros, interfere negativamente no desenvolvimento e crescimento de recém-nascidos. Objetivo: verificar se o "horário do soninho" é capaz de reduzir os níveis de pressão sonora em uma unidade de cuidados neonatais. Método: Trata-se de uma pesquisa transversal. A medida do nível de pressão sonora foi realizada durante 15 dias não consecutivos, com tempo de avaliação de 30 minutos antes, 1 hora durante e 30 minutos após o "horário do soninho" Resultado: Observamos uma redução dos níveis de pressão sonora durante o "horário do soninho" (p = 0,00). Essa redução permaneceu no período dos 30 minutos subsequentes, com diferença estatisticamente significante quando comparada ao período antes do "horário do soninho" (p = 0,00). Conclusão: O "horário do soninho" é uma ferramenta capaz de reduzir o nível de pressão sonora em uma unidade de terapia intensiva neonatal. (AU)


Objective: Verify if the "quiet time" is able to reduce the sound pressure levels in a neonatal care unit. Method: It is a cross-sectional research. The measurement of the sound pressure level was performed during 15 non-consecutive days with an evaluation time of 30 minutes before, 1 hour during and 30 minutes after the "quiet time" Result: We observed a reduction of the sound pressure levels during the hours of quiet time (p = 0.00). This reduction remained in the period of the subsequent 30 minutes, with a statistically significant difference when compared to the period before sleep time (p = 0.00). Conclusion: The "quiet time is a tool capable of reducing sound pressure level in a neonatal intensive care unit. (AU)


Objectivo: Verificar si el "tiempo de silencio" puede reducir los niveles de presión acústica en una unidad de cuidados neonatales. Método: Investigación transversal. La medición del nivel de presión sonora se realizó durante 15 días no consecutivos con un tiempo de evaluación de 30 minutos antes, 1 hora durante y 30 minutos después del "tiempo de silencio". Resultado: Observamos una reducción de los niveles de presión sonora durante las horas de tiempo de silencio (p = 0.00). Esta reducción se mantuvo en el período de los siguientes 30 minutos, con una diferencia estadísticamente significativa en comparación con el período anterior al tiempo de sueño (p = 0,00). Conclusión: el "tiempo de silencio es una herramienta capaz de reducir el nivel de presión acústica en una unidad de cuidados intensivos neonatales. (AU)


Assuntos
Ruído , Sono , Recém-Nascido , Terapia Intensiva Neonatal
4.
REME rev. min. enferm ; 24: e-1280, fev.2020.
Artigo em Português | LILACS (Américas), BDENF | ID: biblio-1051326

RESUMO

Introdução: a participação dos homens, como pais, também é muito importante para desenvolvimento do recém-nascido, especialmente quando ele é hospitalizado. Para tanto, o pai também deve ter suas necessidades compreendidas e assistidas no contexto da assistência neonatal. Objetivo: descrever os sentimentos paternos acerca da hospitalização do filho em unidade de terapia intensiva neonatal. Método: trata-se de estudo exploratório e descritivo, com abordagem qualitativa, que foi desenvolvido em uma unidade neonatal de um hospital público de ensino. Os sujeitos foram pais de recém-nascidos hospitalizados. A coleta de dados ocorreu por meio de entrevista semiestruturada, realizada individualmente em local privativo. As entrevistas foram gravadas, transcritas e analisadas segundo análise de conteúdo proposta por Minayo. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Estadual de Campinas, sob o Parecer nº 1.387.229, CAAE: 50873215.9.0000.5404. Resultados: realizou-se entrevista com 21 pais, com idades que variaram de 18 a 49 anos. Dos discursos dos pais emergiram três categorias temáticas: a) sentimentos paternos; b) hospitalização como experiência árdua; c) enfrentamento da hospitalização por meio da fé. Os pais demandam suporte e apoio ao longo da experiência de hospitalização do filho tanto quanto as mães. Os resultados denotam que eles também vivenciam dificuldades e não sabem como lidar com elas, enquanto tentam dar suporte ao filho, mulher e família. Considerações finais: o cuidado intencional e direcionado aos pais poderá atenuar sentimentos negativos e favorecer os positivos que emergiram nos discursos dos pais do presente estudo, como amor, alegria e gratidão.(AU)


Introduction: the participation of men as parents is also very important for the development of the newborn, especially when he is hospitalized. Therefore, the father must also have his needs understood and assisted in the context of neonatal care. Objective: to describe the father's feelings about the child's hospitalization in a neonatal intensive care unit. Method: this is an exploratory and descriptive study with a qualitative approach, developed in a neonatal unit of a public teaching hospital. The participants were fathers of the hospitalized newborns. Data collection took place through semistructured interviews, carried out individually in a private location. The interviews were recorded, transcribed and analyzed according to content analysis proposed by Minayo. The Research Ethics Committee of the Universidade Estadual de CampinasUnicamp approved the study under Opinion No. 1,387,229, CAAE: 50873215.9.0000.5404. Results: we conducted an interview with 21 parents, aged between 18 and 49 years..(AU)


Introducción: la participación del hombre, como padre, es muy importante para el desarrollo del recién nacido, especialmente cuando el propio niño está hospitalizado. Por lo tanto, deben tenerse en cuenta sus sentimientos dentro del contexto de atención neonatal. Objetivo: describir los sentimientos del padre sobre la hospitalización del propio niño en la unidad de cuidados intensivos neonatales. Método: estudio exploratorio descriptivo de enfoque cualitativo, desarrollado en la unidad neonatal de un hospital escuela público. Los sujetos eran los padres de recién nacidos hospitalizados. La recogida de datos se llevó a cabo a través de una entrevista semiestructurada individual a cada padre realizada en un lugar privado. Las entrevistas fueron grabadas, transcritas y analizadas de acuerdo con el análisis de contenido propuesto por Minayo. El estudio fue aprobado por el Comité de Ética en Investigación de la Universidad Estatal de Campinas, bajo el dictamen No. 1,387,229, CAAE: 50873215.9.0000.5404. Resultados: se realizó una entrevista a cada uno de los 21 padres, con edades entre 18 y 49 años. De los discursos de los padres surgieron tres categorías temáticas: a) los sentimientos paternos; b) la hospitalización como una ardua experiencia; c) el hacer frente a la hospitalización a través de la fe. Los padres precisan apoyo y respaldo durante la experiencia de hospitalización de sus hijos, tanto como las madres. Los resultados muestran que también sienten dificultades y no saben cómo manejarlas, mientras tratan de brindar apoyo al hijo, a la mujer y a la familia. Consideraciones finales: la atención intencional dirigida a los padres podría mitigar los sentimientos negativos y favorecer los positivos que surgieron en sus discursos tales como amor, alegría y gratitud.(AU)


Assuntos
Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Terapia Intensiva Neonatal , Criança Hospitalizada , Emoções , Relações Pai-Filho , Pai
5.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-811105

RESUMO

PURPOSE: Necrotizing enterocolitis and intestinal perforation are the most common surgical emergency in the neonatal intensive care unit. The purpose of this study is to evaluate if peritoneal drainage (PD) is beneficial in extremely low birth weight infants with intestinal perforation.METHODS: Retrospective cohort study of extremely low birth weight infants with a diagnosis of intestinal perforation. They were received primary PD (n = 23, PD group) or laparotomy (n = 13, LAP group). Laboratory and physiologic data were collected and organ failure scores calculated and compared between preprocedure and postprocedures. Data were analyzed using appropriated statistical tests.RESULTS: Between January 2005 and December 2015, 13 infants (male:female = 9:4) received laparotomy. Of 23 infants (male:female = 16:7) received PD, 20 infants received subsequent laparotomy. There were no demographic differences between PD and LAP groups. And there were no differences in total organ score in either group (PD, P = 0.486; LAP, P = 0.115). However, in LAP group, respiratory score was statistically improved between pre- and postprocedure organ failure score (P = 0.02). In physiologic parameter, PD group had a statistically worsening inotropics requirement (P = 0.025). On the other hand, LAP group had a improvement of PaO₂/FiO₂ ratio (P = 0.01).CONCLUSION: PD does not improve clinical status in extremely low birth weight infants with intestinal perforation.


Assuntos
Estudos de Coortes , Diagnóstico , Drenagem , Emergências , Enterocolite Necrosante , Mãos , Humanos , Lactente , Recém-Nascido de Peso Extremamente Baixo ao Nascer , Recém-Nascido de Baixo Peso , Recém-Nascido , Terapia Intensiva Neonatal , Perfuração Intestinal , Laparotomia , Escores de Disfunção Orgânica , Estudos Retrospectivos
6.
Rev. latinoam. bioét ; 19(2): 63-74, jul.-dic. 2019. tab
Artigo em Espanhol | LILACS (Américas) | ID: biblio-1115725

RESUMO

Resumen: El objetivo del presente estudio fue determinar la relación entre la percepción del clima ético, el estrés moral y el relacionado con el trabajo. El diseño fue descriptivo correlacional y el muestreo fue tipo censo con un total de muestra de 106 participantes (80 profesionales de enfermería y 26 médicos). Los resultados mostraron que existe una relación negativa y significativa del clima ético con el estrés laboral (r s =-.326, p<.01). Además, se identificó como hallazgo adicional que el clima ético predice el estrés relacionado con el trabajo, tanto en médicos como en enfermeras (R2=7.9, p=.004). La evidencia científica del presente estudio confirma que la bioética como ciencia debe ser competencia de todos los profesionales de la salud y, en particular, de la enfermería, debido a los desafíos éticos y morales de su práctica profesional, especialmente en áreas críticas debido a las políticas, la normatividad y los recursos con los que cuentan el lugar de trabajo. Tanto el clima ético como el estrés moral y laboral deben ser considerados por las Instltuclones de salud, tenlendo en cuenta que pueden Influir negativamente en la salud de los médicos y enfermeras que brlndan los cuidados, lo cual limita la calldad de la atenclón.


Abstract: The objective of this study is to determine relationship between the perception of ethical climate, moral stress and work-related stress. The design was descriptive correlational, and the sampling was census-type with a total sample of 106 participants (80 nursing professionals and 26 doctors). Results showed that there is a negative and significant relationship between the ethical climate and work-related stress (r s =-.326, p<.01). An additional finding was that the ethical climate predicts work-related stress, both in doctors and in nurses (R2=7.9, p=.004). Scientific evidence found in this study confirms that bioethics as a science should be a competence required for all health professionals and ,in particular nurses due to the ethical and moral challenges faced in their professional practice, especially in critical areas due to the policies, regulations and resources they count on at the workplace. The ethical climate as well as the moral and work stress have to be considered by the health institutions, taking into account that they can have a negative effect on the doctors and nurses' health, which limits the quality of health care they provide.


Resumo: O objetlvo deste estudo foi determinar a relação entre a percepção do clima ético, do estresse moral e do estresse no âmbito do trabalho. O desenho foi correlacional descritivo e a amostra foi do tipo censo, com uma amostra total de 106 participantes (80 profissionais de enfermagem e 26 médicos). Os resultados mostraram que existe uma relação negativa e significativa entre o clima ético e o estresse no trabalho (rs =-.326, p<.01). Adicionalmente, chegamos à conclusão de que o clima ético prediz o estresse relacionado ao trabalho, tanto em médicos quanto em enfermeiras (R2=7.9, p=.004). As evidências científicas do presente estudo confirmam que a bioética, como ciência, deve ser competência de todos os profissionais de saúde e, em particular, dos enfermeiros, devido aos desafios éticos e morais de sua prática profissional, principalmente em áreas críticas, por causa das políticas, regulamentos e recursos disponíveis no local de trabalho. As instituições de saúde devem considerar tanto o clima ético quanto o estresse moral e ocupacional, já que eles podem influenciar negativamente a saúde dos médicos e enfermeiros que prestam assistência, o que limita a qualidade da atenção.


Assuntos
Humanos , Ética Profissional , Estresse Ocupacional , Bioética , Terapia Intensiva Neonatal , Corpo Clínico Hospitalar
7.
Rev. enferm. UERJ ; 27: e38515, jan.-dez. 2019. tab
Artigo em Português | LILACS (Américas), BDENF | ID: biblio-1010087

RESUMO

Objetivo: identificar a prevalência das técnicas de mensuração para inserção de cateter gástrico em recém-nascidos prematuros utilizadas pela equipe de enfermagem da unidade de terapia intensiva neonatal. Método: trata-se de uma pesquisa de corte transversal, realizada entre maio e agosto de 2018, em um hospital universitário da cidade do Rio de Janeiro, que contou com a participação de 52 profissionais, e a coleta de dados foi efetuada através do autopreenchimento de questionários pelos participantes do estudo. Foi utilizada estatística descritiva para a análise de dados. O estudo passou por aprovação de Comitê de Ética em Pesquisa. Resultados: foram encontradas seis técnicas distintas, que variaram de acordo com a via de inserção, oral e nasal. Metade delas não foi descrita na literatura. Conclusão: as técnicas mais prevalentes foram CEX (comissura labial-orelhaxifoide), NEX (nariz-orelha-xifoide) e ENX (orelha-nariz-xifoide), no entanto nenhuma delas foi validada para neonatologia, devido à escassez de pesquisas voltadas para os recém-nascidos


Objective: to identify the prevalence of measurement techniques used by the neonatal intensive care unit nursing team for gastric tube insertion in preterm newborns. Method: in this cross-sectional study, carried out between May and August 2018 at a university hospital in Rio de Janeiro City, the participants were 52 health professionals. Data were collected by selfcompleted questionnaire and analyzed using descriptive statistics. The study was approved by the research ethics committee. Results: six different techniques were found, which varied by route of insertion (oral or nasal). Half of these have not been described in the literature. Conclusion: the most prevalent techniques were CEX (labial commissure-earlobe-xiphoid), NEX (nose-earlobe-xiphoid) and ENX (earlobe-nose-xiphoid). However, none has been validated for neonatology due to the lack of research directed to newborns.


Objetivo: identificar la prevalencia de las técnicas de medición para inserción de catéter gástrico en neonatos prematuros utilizadas por el equipo de enfermería de la unidad de terapia intensiva neonatal. Método: se trata de una investigación de corte transversal, realizada entre mayo y agosto de 2018, en un hospital universitario de la ciudad de Río de Janeiro, que contó con la participación de 52 profesionales. La recolección de datos se efectuó a través del autollenado de cuestionarios por los participantes del estudio. Se utilizó estadística descriptiva para el análisis de datos. El estudio pasó por la aprobación del Comité de Ética en Investigación. Resultados: se encontraron seis técnicas distintas, que variaron de acuerdo con la vía de inserción, oral y nasal. La mitad de ellas no se encuentra en la literatura médica. Conclusión: las técnicas más prevalentes fueron CEX (comisura labial-oreja-xifoides), NEX (nariz-oreja-xifoides) y ENX (oreja-nariz-xifoides), sin embargo ninguna de ellas fue validada para neonatología, debido a la escasez de investigaciones volcadas hacia los neonatos.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Adulto , Recém-Nascido Prematuro , Cateterismo , Terapia Intensiva Neonatal , Nutrição Enteral , Intubação Gastrointestinal , Cuidados de Enfermagem , Brasil , Recém-Nascido , Estudos Transversais , Hospitais Universitários
9.
Rev. Paul. Pediatr. (Ed. Port., Online) ; 37(3): 275-282, July-Sept. 2019. tab
Artigo em Inglês | LILACS (Américas) | ID: biblio-1041346

RESUMO

ABSTRACT Objective: To characterize near miss neonatal morbidity in tertiary hospitals in a capital city of Northeast Brazil based on Health Information Systems, and to identify differences regarding indicators of near miss cases, allowing the surveillance of newborns with risk of death. Methods: A cross-sectional study carried out in hospitals with neonatal intensive care unit, whose neonatal near miss cases in 2012 were identified from a deterministic linkage between the Mortality Information System and the Live Birth Information System. The biological variables of children, variables related to maternal characteristics and indicators of near miss were calculated by type of service and hospital. Biological variables of children, variables related to maternal characteristics and near miss indicators were calculated by service type and hospital and then compared by ratio difference test, parametric and non-parametric tests for measures of central tendency. Results: Of 24,254 live births, 2,098 cases of neonatal morbidity near miss were identified, most of them concentrated in the public hospitals (89.9%). The combination of birth weight and gestational age had the largest number of cases in both segments, public (43.5%) and private (46%). Variations in neonatal near miss indicators were observed between hospitals, which suggests assistance problems. Conclusions: The concept of neonatal near miss, its applicability with data from Health Information Systems, and its indicators are a preliminary tool to monitor hospital care for newborns by signaling health services that require in-depth evaluation and investments for quality improvement.


RESUMO Objetivo: Caracterizar a morbidade neonatal near miss em hospitais terciários de uma capital do Nordeste do Brasil, por meio dos Sistemas de Informação em Saúde, e identificar diferenças quanto aos indicadores de near miss que possibilitem a vigilância dos recém-nascidos com risco de morte. Métodos: Estudo transversal realizado em hospitais com unidade de terapia intensiva neonatal cuja população foram os casos de near miss neonatal nascidos em 2012, identificados mediante o linkage determinístico entre os bancos de dados do Sistema de Informações sobre Mortalidade e do Sistema de Informações sobre Nascidos Vivos. As variáveis biológicas das crianças, as referentes às características maternas e os indicadores de near miss foram calculados por tipo de serviço e por hospital e comparados por meio de testes de diferença de proporção e testes paramétricos e não paramétricos para medidas de tendência central. Resultados: Do total de 24.254 nascidos vivos, foram identificados 2.098 casos de morbidade neonatal near miss, com a maioria no segmento público (89,9%). O peso ao nascer agregado à idade gestacional concentrou o maior número de casos em ambos os segmentos, público (43,5%) e privado (46%). Foram observadas variações nos indicadores de near miss neonatal entre os hospitais, sugerindo problemas assistenciais. Conclusões: O conceito de near miss neonatal, sua aplicabilidade com base nos dados dos Sistemas de Informação em Saúde e seus indicadores constituem uma ferramenta preliminar para monitorar a assistência hospitalar ao recém-nascido ao sinalizar serviços de saúde que necessitam de investigação aprofundada e investimentos para a melhoria da qualidade.


Assuntos
Humanos , Recém-Nascido , Terapia Intensiva Neonatal , Melhoria de Qualidade , Centros de Atenção Terciária , Near Miss/estatística & dados numéricos , Avaliação de Processos e Resultados em Cuidados de Saúde , Índice de Apgar , Brasil/epidemiologia , Recém-Nascido de Baixo Peso , Estudos Transversais , Idade Gestacional
10.
Notas enferm. (Córdoba) ; 19(33): 29-39, jun.2019.
Artigo em Espanhol | LILACS (Américas), BDENF, BINACIS, UNISALUD | ID: biblio-1008163

RESUMO

Introducción. Cuidado seguro se defne como causa o consecuencia de las intervenciones de enfermería. La seguridad en el paciente es un tema de interés en los últimos años, no obstante, hablar del recién nacido pretérmino (RNPT) con tubo endotraqueal (TET), es enfrentarse a una población vulnerable por sus características biofsiológicas. La Unidad de Cuidado Intensivo Neonatal (UCIN) representa un medio ambiente complejo, en estos escenarios es de importancia conocer los factores que pueden contribuir al "Cuidado Seguro" evitando un evento adverso(EA)y sus repercusiones para la vida. Objetivo: Describir y dar a conocer aspectos encontrados a nivel mundial sobre el cuidado seguro al RNPT con TET. Desarrollo: Se realizó una búsqueda en distintas bases de datos: Pubmed, Scielo, BVS, LILACS, Elsevier, utilizando (DeCs)/ (MeSH), rescatando artículos nacionales e internacionales, idioma español, inglés y portugués, de 5 años a la fecha, con títulos relacionados al cuidado del neonato. Tres rubros fueron los explorados: posición corporal en el RNPT, cuidado de enfermería omitido, eventos adversos (EAs) en la UCIN. Conclusiones: La función respiratoria del RNPT con TET se optimiza con el factor posición corporal. El cuidado omitido ha sido poco estudiado en el área neonatal. Los EAs que prevalecen son: los relacionados a la terapia de infusión, termorregulación, infecciones asociadas y extubación no programada (ENP). El cuidado seguro debe ser abordado a profundidad a fn de emitir recomendaciones específcas para este grupo vulnerable de la población(AU)


Introduction. Safe Care is the cause or consequence of nursing interventions. Patient safety is a topic of interest in recent years, however, to speak of the preterm newborn (RNPT) with endotracheal tube (ETT), is to confront a vulnerable population due to its biophysiological characteristics. Te Neonatal Intensive Care Unit (NICU) represents a complex environment, in these scenarios it is important to know the factors that can contribute to "Safe Care" avoiding an adverse event (AD) and its repercussions for life. Objective: Describe and publicize aspects found around the world on the Safe Care of RNPT with TET. Development: A search was made in different databases: Pubmed, Scielo, VHL, LILACS, Elsevier, using (DeCs) / (MeSH), rescuing national and international articles, Spanish, English and Portuguese, from 5 years to date , with titles related to the care of the newborn. Tree items were explored: body position in the RNPT, nursing care omitted, adverse events (AEs) in the NICU. Conclusions: Te respiratory function of RNPT with TET is optimized with the body position factor. Te omitted care has been little studied in the neonatal area. Te EAs that prevail are: those related to infusion therapy, thermoregulation, associated infections and unscheduled extubation (ENP). Safe Care must be approached in depth in order to issue specifc recommendations for this vulnerable group of the population(AU)


Introdução. Safe Care é a causa ou consequência das intervenções de enfermagem. A segurança do paciente é um tema de interesse nos últimos anos, no entanto, falar do recém-nascido pré-termo (RNPT) com tubo endotraqueal (TET) é confrontar uma população vulnerável devido às suas características biofsiológicas. A Unidade de Terapia Intensiva Neonatal (UTIN) representa um ambiente complexo, nesses cenários é importante conhecer os fatores que podem contribuir para o "Cuidado Seguro" evitando um evento adverso (DA) e suas repercussões para a vida. Objetivo: Descrever e divulgar aspectos encontrado em todo o mundo sobre o Cuidado Seguro do RNPT com o TET. Desenvolvimento: Pesquisa realizada em diferentes bases de dados: Pubmed, Scielo, BVS, LILACS, Elsevier, utilizando (DeCs) / (MeSH), resgatando artigos nacionais e internacionais, espanhol, inglês e português, a partir de 5 anos, com títulos relacionados ao cuidado do recém-nascido. Três itens foram explorados: posição corporal no RNPT, cuidados de enfermagem omitidos, eventos adversos (EAs) na UTIN. Conclusões: A função respiratória do RNPT com TET é otimizada com o fator de posição corporal. O cuidado omitido tem sido pouco estudado na área neonatal. Os EAs que prevalecem são: aqueles relacionados à terapia de infusão, termorregulação, infecções associadas e extubação não programada (ENP). Cuidados Seguros devem ser abordados em profundidade, a fm de emitir recomendações específcas para este grupo vulnerável da população(AU)


Assuntos
Humanos , Recém-Nascido , Qualidade da Assistência à Saúde , Recém-Nascido Prematuro , Terapia Intensiva Neonatal , Intubação Intratraqueal , Gestão da Segurança
11.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-758572

RESUMO

PURPOSE: This study aims to investigate the effects of waterbirth on the maternal delivery process and its safety on the newborn babies. METHODS: This study is a retrospective study, analyzing the medical records of pregnant women who gave birth at a natural birthing center in Seoul, Republic of Korea. The study compared and analyzed a total of 1,907 medical records of pregnant women, composed of 539 women who used a birthing pool and 1,160 women who did not use a birthing pool from 2015 to 2017. The collected data were analyzed by the chi-square test, Mann-Whitney U-test and Fisher exact test using SPSS ver. 22.0. The results are shown in the table below. RESULTS: The cesarean section rate was lower in the birthing pool use group, compared to the non-birthing pool use group (p=0.038), with the significantly lower cesarean section rate in birthing pool use group among primigravida women in particular (p=0.002). The birthing pool use group also used oxytocin less frequently than the non-birthing pool use group (p=0.001) And especially in primigravida women, the second stage of delivery in birthing pool use group was found to be shorter than that of the non-birthing pool use group (p=0.045). There were no significant differences in the neonatal Apgar score and the neonatal intensive care unit admission rate between the 2 groups. CONCLUSION: This study has its meaning as the first report in Korea that analyzes the effects of waterbirth on the maternal delivery process and its safety on the newborn babies.


Assuntos
Índice de Apgar , Centros de Assistência à Gravidez e ao Parto , Cesárea , Feminino , Humanos , Recém-Nascido , Terapia Intensiva Neonatal , Coreia (Geográfico) , Registros Médicos , Ocitocina , Parto , Gravidez , Gestantes , República da Coreia , Estudos Retrospectivos , Seul
12.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-763256

RESUMO

PURPOSE: This study aimed to examine engagement and satisfaction with a mobile web-based education program (HiChart) among pregnant women. METHODS: A cross-sectional descriptive study was conducted of 97 pregnant women hospitalized for obstetric care. Data were collected from October 1 to November 30, 2016, and were analyzed with descriptive statistics. RESULTS: Among participants, 16.5% engaged fully with HiChart, while 43.3% engaged partially. The overall satisfaction with HiChart was high. Some main reasons for not engaging with the education were participants' unawareness of the text messages, lack of time, and poor internet connection. The participants suggested that more educational content needed to be covered, such as coping with infant emergencies and information about the neonatal intensive care unit. CONCLUSION: To increase pregnant women's engagement with mobile web-based education, efforts are needed to strengthen the system of sending text messages as part of mobile web-based education to all patients, to inform pregnant women that an educational web link was sent, and to encourage them to engage with mobile web-based education. Furthermore, it is essential to improve the HiChart service by providing educational content corresponding to users' needs.


Assuntos
Educação , Emergências , Feminino , Humanos , Lactente , Recém-Nascido , Terapia Intensiva Neonatal , Internet , Satisfação Pessoal , Gestantes , Educação Pré-Natal , Smartphone , Envio de Mensagens de Texto
13.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-763240

RESUMO

PURPOSE: This study aimed to characterize the relationship between parental stress and nurses' communication as perceived by parents of high-risk newborns in a neonatal intensive care unit (NICU). METHODS: The participants were 54 parents of high-risk newborns in a NICU. Data were collected from January to March 2018. Parental stress and parents' perceptions of nurses' communication ability and styles were measured using a questionnaire. RESULTS: The average scores for parental stress and nurses' communication ability were 3.39 and 4.38 respectively, on a 5-point scale. Parents most commonly reported that nurses showed a friendly communication style, followed by informative and authoritative styles. Mothers and fathers reported significantly different levels of parental stress. Parental stress showed a negative correlation with nurses' perceived verbal communication ability. Higher scores for nurses' verbal communication ability and for friendly and informative communication styles were associated with lower parental stress induced by the environment, the baby's appearance and behaviors, and treatments in the NICU. CONCLUSION: The findings of this study suggest that nurses need to offer proper information for parents and to support parents by encouraging them to express their emotions of stress and by providing parents with therapeutic communication and opportunities to participate in care.


Assuntos
Comunicação , Pai , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Terapia Intensiva Neonatal , Mães , Pais , Estresse Psicológico
14.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-741366

RESUMO

PURPOSE: Myotonic dystrophy, also known as dystrophia myotonica (DM), is an autosomal dominant disorder with 2 genetically distinct forms. DM type 1 (DM1) is the more common form and is caused by abnormal expansion of cytosine/thymine/guanine (CTG) repeats in the DM protein kinase (DMPK) gene. Our study aimed to determine whether the age of onset is correlated with CTG repeat length in a population of pediatric patients with DM1. METHODS: We retrospectively identified 30 pediatric patients with DM1 that underwent DMPK testing, of which the clinical data of 17 was sufficient. The cohort was divided into 2 subgroups based on the clinical phenotype (congenital-onset vs. late-onset) and number of CTG repeats ( < 1,000 vs. ≥1,000). RESULTS: We found no significant difference between the age of onset and CTG repeat length in our pediatric patient population. Based on clinical subgrouping, we found that the congenital-onset subgroup was statistically different with respect to several variables, including prematurity, rate of admission to neonatal intensive care unit, need for respiratory support at birth, hypotonia, dysphagia, ventilator dependence, and functional status on last visit, compared to the late-onset subgroup. Based on genetic subgrouping, we found a single variable (poor feeding in neonate) that was significantly different in the large CTG subgroup than that in the small CTG subgroup. CONCLUSION: Clinical variables exhibiting statistically significant differences between the subgroups should be focused on prognosis and designing tailored management approaches for the patients; our findings will contribute to achieve this important goal for treating patients with DM1.


Assuntos
Idade de Início , Estudos de Coortes , Transtornos de Deglutição , Estudos de Associação Genética , Genótipo , Humanos , Recém-Nascido , Terapia Intensiva Neonatal , Hipotonia Muscular , Distrofia Miotônica , Miotonina Proteína Quinase , Parto , Fenótipo , Prognóstico , Estudos Retrospectivos , Ventiladores Mecânicos
15.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-786532

RESUMO

PURPOSE: This study aimed to investigate the molecular epidemiology of a methicillin-resistant Staphylococcus aureus (MRSA) outbreak at a newborn nursery and neonatal intensive care unit (NICU).METHODS: During the outbreak, from August to September 2017, MRSA isolates collected from neonates and medical staff underwent genotyping and screened for virulence factors. Antibiotic susceptibilities were tested.RESULTS: During the study period, 41 neonates were admitted at the nursery (n=27) and NICU (n=14). Of these, 7 had MRSA infections (skin infection [n=6] and sepsis [n=1]) and 4 were colonized with MRSA. Associated medical staff (n=32) were screened; three were nasal MRSA carriers. Staphylococcal chromosomal cassette mec (SCCmec) type II, sequence type (ST) 89, spa type t375 was found to be the skin infection outbreak causing strain, with multi-drug resistance including low-level mupirocin resistance. SCCmec type IVa, ST 72, and a novel spa type designated t17879, was the cause of MRSA sepsis. Many different types of MRSA were colonized on the neonates; however, SCCmec type IVa, ST 72, spa type t664 was colonized in both neonates and a NICU nurse. All MRSA isolates from colonized infants were positive for the Panton-Valentine leukocidin (PVL) toxin gene.CONCLUSIONS: The strain causing an outbreak of skin infections had multi-drug resistance. Also, MRSA colonized in the neonates were found to carry the PVL toxin gene. Because different strains are present during an outbreak, molecular epidemiologic studies are important to identify the outbreak strain and colonized strains which aid in effective control and prevention of future MRSA outbreaks.


Assuntos
Colo , Surtos de Doenças , Resistência a Múltiplos Medicamentos , Estudos Epidemiológicos , Humanos , Lactente , Recém-Nascido , Terapia Intensiva Neonatal , Leucocidinas , Corpo Clínico , Resistência a Meticilina , Staphylococcus aureus Resistente à Meticilina , Epidemiologia Molecular , Mupirocina , Berçários para Lactentes , Sepse , Pele , Fatores de Virulência
16.
Neonatal Medicine ; : 204-212, 2019.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-786440

RESUMO

PURPOSE: This study aimed to investigate the prevalence of delayed thyroid dysfunction based on iodine disinfectant use and to analyze associated risk factors.METHODS: A retrospective study was conducted on late preterm infants admitted to the neonatal intensive care unit between January 2010 and June 2018, who underwent neonatal thyroid screening (NTS) and ≥2 thyroid function tests (TFTs). NTS was performed 3 days after birth, with at least two TFTs 1 week and 2 to 4 weeks after birth. To distinguish between normal and dysfunctional thyroid levels, we reviewed TFT results at 2 to 4 weeks and examined possible risk factors for the development of thyroid dysfunction.RESULTS: Of 295 late preterm infants, 262 were enrolled with a mean gestational age and birth weight of 34.8±0.7 weeks and 2,170±454 g, respectively. A total of 7.6% developed hyperthyrotropinemia at the age of 24.3±14.6 days (range, 12 to 69). The incidence of hyperthyrotropinemia during iodine use was approximately 12.6%, while that during discontinuation was 2.4% (P=0.002). Multivariate analysis revealed that small for gestational age (SGA), iodine disinfectant use, and abnormal NTS results were significant risk factors for delayed hyperthyrotropinemia (adjusted odds ratio [AOR]: 4.27, P=0.008; AOR: 8.24, P=0.003; and AOR: 7.80, P=0.002, respectively).CONCLUSION: Delayed hyperthyrotropinemia was prevalent in late preterm infants exposed to topical iodine and those identified as being SGA. Secondary TFTs should be considered 2 to 4 weeks after birth for this population at risk.


Assuntos
Peso ao Nascer , Hipotireoidismo Congênito , Idade Gestacional , Humanos , Incidência , Recém-Nascido , Recém-Nascido Prematuro , Terapia Intensiva Neonatal , Iodo , Programas de Rastreamento , Análise Multivariada , Razão de Chances , Parto , Características da População , Prevalência , Estudos Retrospectivos , Fatores de Risco , Testes de Função Tireóidea , Glândula Tireoide , Tireotropina
17.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-785569

RESUMO

PURPOSE: The purpose of this study was to examine the correlation between a flexible parental visiting environment and parental stress in neonatal intensive care units (NICUs).METHODS: The study participants included 60 parents of premature infants in NICUs. Structured questionnaires and interviews, as well as observations by researchers using a caregiving behavior checklist, were used to measure the flexibility of the parental visiting environment and parents' stress levels. Quantitative and qualitative data were collected concurrently and were initially analyzed as separate data sets. Data collection extended from March 11, 2018 to June 30. 2018 and the data were analyzed using descriptive statistics, the independent t-test, one-way analysis of variance, and Pearson correlation coefficients.RESULTS: There was a negative correlation (r=−.30, p=.021) between parental stress and the total number of visits in 7 days. We also found that the average duration of each visit and the number of caregiving behaviors performed by parents were positively correlated (r=.73, p<.001).CONCLUSION: When designing a flexible visiting environment for parents, parents should be encouraged to visit their babies. By doing so, stress can be reduced both for babies and for parents. Therefore, it is suggested that the related polices and regulations in South Korea should be changed to provide more a flexible visiting environment to promote better parent-child attachment and family adjustment.


Assuntos
Lista de Checagem , Coleta de Dados , Conjunto de Dados , Enfermagem Familiar , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Unidades de Terapia Intensiva Neonatal , Terapia Intensiva Neonatal , Coreia (Geográfico) , Pais , Maleabilidade , Controle Social Formal , Estresse Psicológico , Visitas a Pacientes
18.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-785565

RESUMO

PURPOSE: The purpose of this study was to investigate partnerships with nurses, social support and readiness for discharge among mothers of premature infants in the neonatal intensive care unit (NICU) and to examine the factors associated with readiness for discharge.METHODS: A survey was conducted among 85 mothers of premature infants hospitalized in a NICU in Seoul, Korea. The collected data were analyzed with descriptive statistics, the t-test, one-way analysis of variance, Pearson' correlation coefficients, and multiple linear regression using SPSS version 25.0.RESULTS: The results of the regression analysis showed that partnerships with nurses (β=.32, p=.011) and parenting experience (β=.32, p=.001) were significantly associated with readiness for discharge.CONCLUSION: To improve the readiness for discharge among mothers of premature infants, developing strategies to strengthen their partnership with nurses and to provide family-centered care will be needed.


Assuntos
Humanos , Recém-Nascido , Recém-Nascido Prematuro , Unidades de Terapia Intensiva Neonatal , Terapia Intensiva Neonatal , Coreia (Geográfico) , Modelos Lineares , Mães , Poder Familiar , Pais , Alta do Paciente , Seul
19.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-785555

RESUMO

PURPOSE: The purpose of this study was to identify the effects of an educational intervention by evaluating neonatal emergency airway management knowledge, critical thinking disposition, problem- solving ability, and confidence in clinical performance after developing and operating a simulation-based neonatal emergency airway management education program for nurses in a neonatal intensive care unit.METHODS: The participants were 30 nurses in a neonatal intensive care unit. Data were collected from June 6 to 15, 2018 and analyzed using IBM SPSS version 22.0.RESULTS: The results of the pretest and posttest for each educational group showed statistically significant improvements in neonatal emergency airway management knowledge, critical thinking, problem- solving ability, and confidence in clinical performance.CONCLUSION: The simulation-based neonatal emergency airway management training program was an effective educational program that enhanced neonatal emergency airway management knowledge, critical thinking disposition, problem-solving ability, and confidence in clinical performance among nurses in a neonatal intensive care unit. Therefore, it is suggested that the program described in this study can contribute to improving nursing quality by enhancing the ability of nurses to cope with emergencies in practice. It can also be used for education for new nurses and contribute to the development of nurses' practices.


Assuntos
Manuseio das Vias Aéreas , Educação , Emergências , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Terapia Intensiva Neonatal , Enfermagem , Simulação de Paciente , Pensamento
20.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-760680

RESUMO

OBJECTIVE: After globally acceptance of planned vaginal birth after cesarean section (VBAC), the mode of induction is still a matter of debate and requires further discussion. We aimed to study obstetric outcomes in post-cesarean patients undergoing induction of labor with prostaglandin gel compared with patients who developed spontaneous labor pains. METHODS: All patients at 34 weeks or more of gestation with previous one cesarean section eligible for trial of labor after cesarean section admitted in a labor room within one year were divided in 2 groups. Group one consisted of patients who experienced the spontaneous onset of labor pains and group 2 consisted of patients who underwent induction of labor with prostaglandin gel. They were analyzed for maternofetal outcomes. Descriptive statistics, independent sample t-test, and chi-square test were applied using SPSS 20 software for statistical analysis. RESULTS: Both groups were comparable in maternal age, parity, and fetal weight, but different in bishop score, mode of delivery, and neonatal outcome. Admisson bishop score was 6.61±2.51 in group 1 and 3.15±1.27 in group 2 (P<0.005). In the patients who experienced spontaneous labor, 86.82% had successful VBAC. In the patients with induced labor, 64.34% had successful VBAC with an average dose of gel of 1.65±0.75. Both groups had one case each of uterine rupture. The neonatal intensive care unit admission rate was 4.1% in group one and 10.4% in group 2. CONCLUSION: This study reflects that supervised labor induction with prostaglandin gel in previous one cesarean section patients is a safe and effective option.


Assuntos
Cesárea , Feminino , Peso Fetal , Humanos , Recém-Nascido , Terapia Intensiva Neonatal , Dor do Parto , Trabalho de Parto Induzido , Idade Materna , Paridade , Gravidez , Prostaglandinas , Prova de Trabalho de Parto , Ruptura Uterina , Nascimento Vaginal Após Cesárea
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