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1.
Int J Nurs Knowl ; 34(4): 247-253, 2023 Oct.
Article in English | MEDLINE | ID: mdl-36151784

ABSTRACT

PURPOSE: The aim was to apply the Advanced Nursing Process and demonstrating procedures of surgical positioning, as well as to show the participating the Nursing Outcomes Classification findings in order to translate the knowledge on specific preventive perioperative positioning into practice, the review of clinical protocols and nursing care plan. METHODS: The methods used include case report about knowledge translation by applying training modalities, review and adaptation of clinical protocols and examination of nursing care plans. FINDINGS: One hundred and nine healthcare providers attended the training, including nurses and nursing technicians working in the surgical center and the outpatient surgical center of the hospital chosen for this study. The surgical positioning protocols were revised based on the evidence described in the literature and the main surgical guidelines. The review of care registered in the institution's electronic system for the nursing prescription stage of the diagnosis Risk of perioperative positioning injury was based on the review on evidence on risk factors, the main guidelines in the area and the interventions suggested by Nursing Intervention Classification. The electronic system had registered 14 cares for this diagnosis, and after the review, one care was excluded and eight new cares were included, totaling 21 cares. CONCLUSION: Nursing teams play a prominent role in positioning patients for surgery, protecting them in a moment of extreme vulnerability, thus making knowledge about the fundamental elements of surgical positioning essential. This emphasizes the importance of training, and of reviewing protocols and records of procedures that promote safety to patients and care teams. IMPLICATION FOR NURSING PRACTICE: The translation of knowledge about the Advanced Nursing Process in the perioperative area contributes to the refinement of classifications and standardization of language in this scenario, subsidizing an evidence-based clinical practice.


OBJETIVO: O objetivo foi aplicar o Processo de Enfermagem Avançado e demonstrar procedimentos de posicionamento cirúrgico, bem como mostrar aos participantes os achados da Nursing Outcomes Classification para traduzir na prática o conhecimento específico sobre prevenção no posicionamento perioperatóriontivo, bem como a revisão de protocolos clínicos e do plano de cuidados de enfermagem. MÉTODOS: Relato de caso sobre tradução do conhecimento por meio da aplicação de modalidades de treinamento, revisão e adaptação de protocolos clínicos e análise de planos de cuidados de enfermagem. RESULTADOS: 109 profissionais de enfermagem participaram do treinamento, incluindo enfermeiros e técnicos de enfermagem que atuam no centro cirúrgico e no centro cirúrgico ambulatorial do hospital escolhido para este estudo. Os protocolos de posicionamento cirúrgico foram revisados com base nas evidências descritas na literatura e nas principais diretrizes cirúrgicas. A revisão dos cuidados registrados no sistema eletrônico da instituição para a etapa de prescrição de enfermagem do diagnóstico Risco de lesão por posicionamento perioperatório foi baseada na revisão das evidências sobre os fatores de risco, as principais diretrizes da área e as intervenções sugeridas pela Nursing Intervention Classification. O sistema eletrônico tinha 14 cuidados cadastrados para este diagnóstico, e após a revisão, um cuidado foi excluído e oito novos cuidados foram incluídos, totalizando 21 cuidados. CONCLUSÃO: A equipe de enfermagem tem papel de destaque no posicionamento do paciente para a cirurgia, protegendo-o em um momento de extrema vulnerabilidade, tornando imprescindível o conhecimento sobre os elementos fundamentais do posicionamento cirúrgico. Ressalta-se a importância do treinamento e da revisão de protocolos e registros de procedimentos que promovem a segurança do paciente e da equipe assistencial. IMPLICAÇÃO PARA A PRÁTICA DE ENFERMAGEM: A tradução do conhecimento sobre o Processo de Enfermagem Avançado na área perioperatória contribui para o refinamento das classificações e padronização da linguagem neste cenário, subsidiando uma prática clínica baseada em evidências.


Subject(s)
Nursing Care , Standardized Nursing Terminology , Humans , Translational Science, Biomedical , Vocabulary, Controlled , Risk Factors
2.
J Clin Nurs ; 28(23-24): 4367-4378, 2019 Dec.
Article in English | MEDLINE | ID: mdl-31410897

ABSTRACT

AIMS AND OBJECTIVES: To test the validity and reliability of Nursing Outcomes Classification outcomes and their clinical indicators for patients with the nursing diagnosis 'Risk for perioperative positioning injury'. BACKGROUND: Surgical positioning is an essential part of perioperative nursing practice. The use of a standardised language values the clinical evaluation of the perioperative nurse, reinforcing its contribution to surgical patient care. DESIGN: Longitudinal concept validation cohort study. METHODS: Patients were selected based on the operating room surgical schedule. The sample included adult patients who underwent elective surgical procedures requiring anaesthesia, classified as surgical class 2, 3 or 4. Outcomes were measured with an instrument, which included 33 clinical indicators for eight outcomes. The patients were assessed at five distinct time points in the perioperative phases. This study followed the STROBE guidelines. RESULTS: A total of 50 patients were included. Each underwent five clinical assessments, for a total of 250 documented assessments. Differences in evaluations were mostly related to reduced scores of clinical indicators in the immediate postsurgical time points, which recovered to the highest score at the end of the fifth (and last) evaluation. The results of factor analysis and Cronbach's alpha calculations suggested a new configuration for this nursing outcomes, consisting of five outcomes-Circulation Status, Tissue Perfusion: peripheral, Neurological Status: peripheral, Tissue Integrity: skin and mucous membranes and Thermoregulation-and 13 clinical indicators. CONCLUSIONS: Nursing Outcomes Classification outcomes and clinical indicators for the nursing diagnosis at 'Risk for perioperative positioning injury' are sensitive to patient states during the perioperative period. RELEVANCE TO CLINICAL PRACTICE: Use of nursing taxonomies during the perioperative period may contribute to the discussion on the role of perioperative nurses and their relevance in patient care.


Subject(s)
Nursing Diagnosis/standards , Patient Positioning/adverse effects , Perioperative Nursing/methods , Adult , Elective Surgical Procedures/standards , Female , Humans , Longitudinal Studies , Male , Middle Aged , Reproducibility of Results , Vocabulary, Controlled
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