Validation of a care protocol for the septic patient in the Intensive Care Unit.

OBJECTIVE: to elaborate and validate a protocol for the care of the nurse to the septic patient in Intensive Care Units (ICUs). METHOD: instrument validation study. Two steps were followed: instrument development and content validation according to the Delphi technique. RESULTS: the validation of contents related to the nurse's assistance to the septic patient in intensive care was initially composed of eighteen items analyzed by the evaluators/judges. From this, through the Content Validity Index (CVI), thirteen items with strong evidence of validation were identified, CVI = 0.79. Then the instrument was refined, being then composed of fifteen items, which in the second phase Delphi had a percentage of agreement above 84% for the variables pertinent to the protocol. CONCLUSION: the method was effective to validate the contents of a protocol for the nurse's assistance to the septic patient in the ICU.

Validation of a care protocol for the septic patient in the Intensive Care Unit / Validación de protocolo asistencial al paciente séptico en la Unidad de Terapia Intensiva / Validação de protocolo assistencial ao paciente séptico na Unidade de Terapia Intensiva

ABSTRACT Objective: to elaborate and validate a protocol for the care of the nurse to the septic patient in Intensive Care Units (ICUs). Method: instrument validation study. Two steps were followed: instrument development and content validation according to the Delphi technique. Results: the validation of contents related to the nurse's assistance to the septic patient in intensive care was initially composed of eighteen items analyzed by the evaluators/judges. From this, through the Content Validity Index (CVI), thirteen items with strong evidence of validation were identified, CVI = 0.79. Then the instrument was refined, being then composed of fifteen items, which in the second phase Delphi had a percentage of agreement above 84% for the variables pertinent to the protocol. Conclusion: the method was effective to validate the contents of a protocol for the nurse's assistance to the septic patient in the ICU.

RESUMEN Objetivo: elaborar y validar un protocolo para asistencia del enfermero al paciente séptico en Unidades de Terapia Intensiva (UTI). Método: estudio de la validación metodológica de instrumento. Dos etapas fueron seguidas: la elaboración del instrumento y la validación del contenido de acuerdo con la técnica Delphi. Resultados: la validación del contenido referente a la asistencia del enfermero al paciente séptico en terapia intensiva fue inicialmente compuesta por dieciocho elementos analizados por los evaluadores/jueces. De este, a través del Índice de Validez de Contenido (IVC), se identificaron trece elementos con fuerte evidencia de validación, IVC=0,79. A continuación, el instrumento fue refinado, siendo pues compuesto por quince elementos, que en la segunda fase Delphi presentó porcentual de concordancia superior al 84% para las variables pertinentes al protocolo. Conclusión: el método fue eficaz para validar el contenido de un protocolo para la asistencia del enfermero al paciente séptico en la UTI.

RESUMO Objetivo: elaborar e validar um protocolo para assistência do enfermeiro ao paciente séptico em Unidades de Terapia Intensiva (UTI). Método: estudo de validação metodológica de instrumento. Foram seguidas duas etapas: elaboração do instrumento e validação de conteúdo segundo a técnica Delphi. Resultados: a validação de conteúdo referente à assistência do enfermeiro ao paciente séptico em terapia intensiva inicialmente foi composto por dezoito itens analisados pelos avaliadores/juízes. Deste, por meio do Índice de Validade de Conteúdo (IVC), identificou-se treze itens com forte evidência de validação, IVC=0,79. A seguir o instrumento foi refinado, sendo então composto por quinze itens, que na 2ª fase Delphi possuiu percentual de concordância acima de 84% para as variáveis pertinentes ao protocolo. Conclusão: o método foi eficaz para validar o conteúdo de um protocolo para assistência do enfermeiro ao paciente séptico na UTI.

Validação de conteúdo de um instrumento para avaliação da capacitação em ressuscitação cardiopulmonar / Validation of content of an instrument for the evaluation of training in cardiopulmonary resuscitation / Validación de contenido de un instrumento para evaluación de la capacitación en resucitación cardiopulmonar

O objetivo deste estudo foi realizar a validação de conteúdo de um instrumento para avaliação da capacitação em ressuscitação cardiopulmonar para profissionais da saúde.Trata-se de uma validação de conteúdo e aparência de um instrumento de coleta de dados, constituído pelas etapas de ajuizamento e elaboração da versão final do instrumento. Participaram cinco avaliadores/juízes e a representatividade dos itens em relação ao conteúdo abordado foi mensurada por meio do índice de validade de conteúdo (IVC), calculado pelo número de avaliadores concordante com o item pelo número total de avaliadores. Foram realizadas as readequações do instrumento de coleta de dados em concordância com as contribuições advindas dos avaliadores e análise da literatura científica. O instrumento elaborado com base nas diretrizes internacionais de ressuscitação cardiopulmonar, em sua versão final, após o processo de validação de conteúdo e aparência, apresenta 18 itens voltados para a avaliação do impacto e da qualidade das capacitações de profissionais da saúde no atendimento à vítima em parada cardiorrespiratória.(AU)

The aim of this study was to validate the content of an instrument for the evaluation of training in cardiopulmonary resuscitation for health professionals. This is a validation of the content and appearance of a data collection instrument, consisting of the steps of assessment and preparation of the final version of the instrument. Five evaluators / judges participated and the representativeness of the items in relation to the content was measured using the Content Validity Index (CVI), calculated by the number of evaluators according to the item by the total number of evaluators. The adjustments of the instrument of data collection were carried out in agreement with the contributions coming from the evaluators and analysis of the scientific literature. The instrument, based on international guidelines for cardiopulmonary resuscitation, in its final version, after the content and appearance validation process, presents eighteen items aimed at assessing the impact and quality of training of health professionals in the care of the victims at standstill Cardiopulmonary resuscitation.

Ethanol intake-induced apoptosis in glial cells and axonal disorders in the cerebellar white matter of UChA rats (voluntary ethanol consumers).

Ethanol intake may cause alterations in cellular metabolism altering motricity, learning and cognition. The cerebellum is one of the most susceptible organs to ethanol-related disorders during development, and is associated with oxidative stress-induced apoptosis being crucial for pathogenic consequences. The UChA variety is a special strain of Wistar rat genetically selected and represents a rare model for the studies related to genetic, biochemical, physiological, nutritional, and pharmacological effects of ethanol. We evaluated the structure and apoptosis in the cerebellar white matter of UChA rats. There were two groups of 09 rats: a control group that did not consume ethanol, and an experimental group of UChA rats that consumed ethanol at 10% (v/v) (<2 g ethanol/kg body weight/day). At 120 days old, rats were anaesthetized followed by decapitation, and their cerebella were collected and fixed. Cerebellar sections were subjected to immunohistochemistry for Caspase-3 and XIAP and transmission electron microscopy (TEM). The UChA group showed more glial cells immunoreactive for caspase-3 and less for XIAP than control group. Alcohol consumption affected myelin integrity. Severe ultrastructural damages in UChA group were observed such as disruption of the myelin sheath, disorganization and deformation of its components, and an increase in the interaxonal spaces. In conclusion, our data demonstrated that ethanol induced apoptosis in the glial cells and promoted an intense change in the myelin sheath of UChA rats, which may cause functional disorders.