Incidence of hospital acquired pressure injury in critically ill patients with COVID-19 in prone position admitted to the intensive care unit.

Critical patients have conditions that may favor the occurrence of hospital-acquired pressure injury (HAPI). The objective of this study was to identify the incidence and factors associated with the occurrence of HAPI in patients with coronavirus disease 2019 admitted to the intensive care unit (ICU) who used the prone position. Retrospective cohort study carried out in an ICU of a tertiary university hospital. Two hundred four patients with positive real-time polymerase chain reactions were evaluated, of which 84 were placed in the prone position. All patients were sedated and submitted to invasive mechanical ventilation. Of the prone patients, 52 (62%) developed some type of HAPI during hospitalization. The main place of occurrence of HAPI was the sacral region, followed by the gluteus and thorax. Of the patients who developed HAPI, 26 (50%) had this event in places possibly associated with the prone position. The factors associated with the occurrence of HAPI in patients prone to coronavirus disease 2019 were the Braden Scale and the length of stay in the ICU. The incidence of HAPI in prone patients was extremely high (62%), which denotes the need to implement protocols in order to prevent the occurrence of these events.

Nursing and advocacy in health: An integrative review.

BACKGROUND: The practice of health advocacy in nursing has been defined as a process aimed at promoting the independence and autonomy of users of health services, in addition to providing information on healthcare decision-making and offering support for decisions taken. ETHICAL CONSIDERATIONS: Ethics approval was not required to conduct this review. AIM: This integrative review aims to synthesize evidence in the literature on health advocacy in professional nursing practice. METHODS: An integrative review methodology guided by Whittemore and Knalf was used. Studies were identified by conducting searches on PubMed, Scopus, Web of Science, CINAHL, and LILACS databases. Of 2179 records, 34 studies matched the inclusion criteria. RESULTS: The main aspects involved in the practice of health advocacy by professional nurses are related to the ethical principles of the nursing profession, such as protecting patients seeking autonomy and care. Furthermore, the practice of health advocacy by nurses requires an empathetic attitude, responsibility, and assertive communication. CONCLUSION: The diverse possibilities for the practice of advocacy synthesized in this study allow nurses to approach and become familiarized with the topic, being able to acquire and complement knowledge that will reflect on their professional practice in different work environments such as the educational field, in hospital practice, or basic health care.

Nursing and health advocacy: development process of an educational manual / Enfermería y defensa de la salud: proceso de elaboración de cartilla educativa / Enfermagem e a advocacia em saúde: processo de elaboração de cartilha educativa

ABSTRACT Objective: to describe the development and validation of an educational manual for nurses on the practice of health advocacy in their professional experience. Method the method used to develop the manual was composed of three stages carried out from 2018 to 2020: an integrative review of studies published from 2010 to 2018, development of the content, and validation of the educational manual by experts. Results: based on the integrative literature review, 91 final articles related to the theme of advocacy in health and nursing were selected, which subsidized the definition of four themes: The meaning and fundamental elements for the practice of advocacy in nursing; Advocacy in teaching and the involvement of other care actors; Advocacy as a professional, moral, and ethical obligation; Advocacy about specific population groups. The themes contributed to the development of the educational manual content. After submission and validation by specialists, it was possible to define the layout, size, number of pages, and final design of the educational manual, which will be printed and handed out to nursing professionals and students, and made available online. Conclusions: the elaboration and validation of the manual help to build knowledge related to the professional practice of the nursing team and the exercise of advocacy in health.

RESUMEN Objetivo describir la elaboración y validación de una cartilla educativa para enfermeros sobre el ejercicio de la abogacía en salud en su práctica profesional. Método para la elaboración de la cartilla se utilizó el método compuesto de tres etapas realizadas de 2018 a 2020: revisión integradora de estudios publicados en el período de 2010 a 2018, construcción del contenido y valoración de la cartilla educativa por parte de especialistas. Resultados: a partir de la revisión bibliográfica integradora, se seleccionaron 91 artículos finales relacionados con el tema de la abogacía en salud y enfermería, que subvencionaron la definición de cuatro temas: Del significado y elementos fundamentales para la práctica de la abogacía en enfermería; La abogacía en la enseñanza y la participación de otros actores del cuidado; La abogacía como obligación profesional, moral y ética; La abogacía en relación con grupos de población específicos. Los temas contribuyeron a la construcción de los contenidos del folleto educativo. Tras la presentación y validación por parte de los expertos, se pudo definir la maquetación, el tamaño, el número de páginas y el diseño final del folleto educativo, que se imprimirá y distribuirá a los profesionales y estudiantes de enfermería, y estará disponible en línea. Conclusiones la elaboración y validación del cuaderno contribuye a la construcción de conocimientos relacionados con la práctica profesional del equipo de enfermería y el ejercicio de la abogacía en salud.

RESUMO Objetivo: descrever a elaboração e validação de uma cartilha educativa para enfermeiros sobre o exercício da advocacia em saúde em sua prática profissional. Método para a elaboração da cartilha foi utilizado o método composto de três etapas realizadas de 2018 a 2020: revisão integrativa de estudos publicados no período de 2010 a 2018, construção do conteúdo e validação da cartilha educativa por especialistas. Resultados com base na revisão integrativa de literatura, foram selecionados 91 artigos finais relacionados ao tema de advocacia em saúde e enfermagem e que subsidiaram a definição de quatro temas: Do sentido e elementos fundamentais para a prática de advocacia em enfermagem; Advocacia no ensino e o envolvimento de outros atores do cuidado; Advocacia como obrigação profissional, moral e ética; Advocacia com relação a grupos específicos da população. Os temas contribuíram para a construção dos conteúdos da cartilha educativa. Depois de realizar o envio e a validação por especialistas, foi possível definir a diagramação, dimensão, quantidade de páginas e o design final da cartilha educativa, que será impressa e distribuída aos profissionais e estudantes de enfermagem e disponibilizada online. Conclusões: a elaboração e validação da cartilha contribui para a construção de conhecimentos relacionados à prática profissional da equipe de enfermagem e o exercício da advocacia em saúde.