Efficacy of aromatherapy with Lavandula angustifolia oil on postoperative pain after cardiac surgery: A randomized clinical trial.

OBJECTIVE: To evaluate the effect of aromatherapy through inhalation of Lavandula angustifolia essential oil in relieving pain during the immediate postoperative period of patients undergoing cardiac surgery. METHODS: A single-blind, randomized and controlled clinical trial, with 52 patients in the immediate postoperative period of cardiac surgery were randomly distributed into experimental (n = 26) and control (n = 26) groups. The primary outcome was whether or not pain was relieved and secondary outcomes included changes in vital signs, sleep and facial relaxation. The control group received industry standard care and application of an essential oil-free ceramic diffuser necklace. The experimental group received the inhalation intervention with pure Lavandula angustifolia essential oil, with a drop of the oil on a ceramic diffuser necklace at a distance of 15-20 cm from the patient's nose for 30 min. Pain was measured using the Numerical Visual Scale, and vital signs using the multiparametric monitor before the intervention, 10 minutes after its start and 30 minutes after the total end of inhalation. Face relaxation was assessed before and after the intervention and sleep was assessed at the end of inhalation. RESULTS: There was a decrease in pain levels (p < 0.001) 30 min after the end of inhalation in the Experimental Group, with a decrease in the measurements of Mean Blood Pressure (p= 0.008) and Respiratory Rate (p = 0.011). Furthermore, facial relaxation and sleep had a large effect size of 2.54 and 1.28, respectively. CONCLUSION: Lavandula angustifolia essential oil was effective in relieving pain, causing sleep and relaxation, proving to be a low-cost and easy-to-use tool that the nursing team can use in their care.

Recomendações para o preparo do paciente em pré-operatório de cirurgias cardíacas: revisão de escopo / Recommendations for patient preparation in the preoperative period of cardiac surgeries: a scoping review / Recomendaciones para la preparación del paciente en el preoperatorio de cirugías cardíacas: revisión del alcanc

OBJETIVO: Mapear a produção de conhecimento a respeito das recomendações para o preparo pré-operatório de qualquer tipo de cirurgia cardíaca, eletiva ou de urgência, de pacientes com idade superior a 18 anos em unidades de internação hospitalar. MÉTODO: Revisão de escopo realizada em dezembro de 2020, em 11 fontes de dados, seguindo as recomendações do Instituto Joanna Briggs, com análise de dados descritiva. RESULTADOS: Foram selecionados e caracterizados 27 estudos, identificando-se como principais recomendações pré-operatórias de cirurgia cardíaca: a educação pré-operatória, medicações, escalas para estratificação de risco pós-operatório, treinamento muscular inspiratório e realização de exames. CONCLUSÃO: As recomendações apresentaram eficácia na estabilidade hemodinâmica, atenuação do medo e ansiedade do paciente quanto à cirurgia, de arritmias, internação hospitalar, taxa de mortalidade e complicações pós-operatórias.

OBJECTIVE: To map the production of knowledge regarding the recommendations for the preoperative preparation of any type of cardiac surgery, whether elective or urgent, of patients over 18 years old in hospitalization units. METHOD: A scoping review carried out in December 2020 in 11 data sources, following the Joanna Briggs Institute recommendations, with descriptive data analysis. RESULTS: A total of 27 studies were selected and characterized, identifying the following as the main preoperative recommendations for cardiac surgeries: preoperative education, medications, scales for postoperative risk stratification, inspiratory muscle training and tests. CONCLUSION: The recommendations presented efficacy in hemodynamic stability, attenuation of the patient's fear and anxiety regarding the surgery, of the number of arrhythmias and hospitalizations, of the mortality rate and of postoperative complications.

OBJETIVO: Mapear la producción de conocimiento sobre las recomendaciones para la preparación preoperatoria de cualquier tipo de cirugía cardiaca, electiva o urgente, de pacientes mayores de 18 años en unidades de hospitalización. MÉTODO: Revisión de alcance realizada en diciembre de 2020, en 11 fuentes de datos, siguiendo las recomendaciones del Instituto Joanna Briggs, con análisis descriptivo de datos. RESULTADOS: Se seleccionaron y caracterizaron 27 estudios, las principales recomendaciones preoperatorias para cirugía cardiaca que se identificaron son: educación preoperatoria, medicamentos, escalas para estratificación de riesgo postoperatorio, entrenamiento de músculos inspiratorios y exámenes. CONCLUSIÓN: Las recomendaciones fueron efectivas para mejorar la estabilidad hemodinámica, disminuir el miedo y la ansiedad del paciente por la cirugía, las arritmias, el tiempo de estancia hospitalaria, la tasa de mortalidad y las complicaciones postoperatorias.

Root Cause Analysis, Failures and Effects in pediatric total quality management: a scoping review.

OBJECTIVES: to analyze the applicability of Root Cause Analysis and Failure Mode and Effect Analysis tools, aiming to improve care in pediatric units. METHODS: this is a scoping review carried out according to the Joanna Briggs Institute guidelines, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes extension for Scoping Reviews. Search took place in May 2018 on 15 data sources. RESULTS: search totaled 8,254 studies. After using the relevant inclusion and exclusion criteria, 15 articles were included in the review. Of these, nine were published between 2013 and 2018, 12 used Failure Mode and Effect Analysis and 11 carried out interventions to improve the quality of the processes addressed, showing good post-intervention results. FINAL CONSIDERATIONS: the application of the tools indicated significant changes and improvements in the services that implemented them, proving to be satisfactory for detecting opportunities for improvement, employing specific methodologies for harm reduction in pediatrics.

Root Cause Analysis, Failures and Effects in pediatric total quality management: a scoping review / Análisis de Causa Raiz, Fallas y Efectos en la gestión total de la calidad pediátrica: revisión del alcance / Análise de Causa Raiz, Falhas e Efeitos na gestão da qualidade total pediátrica: scoping review

ABSTRACT Objectives: to analyze the applicability of Root Cause Analysis and Failure Mode and Effect Analysis tools, aiming to improve care in pediatric units. Methods: this is a scoping review carried out according to the Joanna Briggs Institute guidelines, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes extension for Scoping Reviews. Search took place in May 2018 on 15 data sources. Results: search totaled 8,254 studies. After using the relevant inclusion and exclusion criteria, 15 articles were included in the review. Of these, nine were published between 2013 and 2018, 12 used Failure Mode and Effect Analysis and 11 carried out interventions to improve the quality of the processes addressed, showing good post-intervention results. Final Considerations: the application of the tools indicated significant changes and improvements in the services that implemented them, proving to be satisfactory for detecting opportunities for improvement, employing specific methodologies for harm reduction in pediatrics.

RESUMEN Objetivos: analizar la aplicabilidad de las herramientas Análisis de Causa Raiz y Análisis de Fallas Modales y Efectos, con el objetivo de mejorar la atención en las unidades pediátricas. Métodos: revisión de alcance, realizada de acuerdo con las directrices del Instituto Joanna Briggs, siguiendo la lista de verificación de los Ítems Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. La búsqueda se realizó en mayo de 2018 en 15 fuentes de datos. Resultados: la búsqueda totalizó 8.254 estudios. Después de utilizar los criterios de inclusión y exclusión relevantes, se incluyeron 15 artículos en la revisión. De estos, nueve fueron publicados entre 2013 y 2018, 12 utilizaron; Análisis de Fallas Modales y Efectos y 11 realizaron intervenciones para mejorar la calidad de los procesos abordados, mostrando buenos resultados post-intervención. Consideraciones Finales: la aplicación de las herramientas indicó cambios y mejoras significativas en los servicios que las implementaron, resultando satisfactorias para detectar oportunidades de mejora, empleando metodologías específicas para la reducción de daños en pediatría.

RESUMO Objetivos: analisar a aplicabilidade das ferramentas Análise de Causa Raiz e Análise Modal de Falhas e Efeitos, visando à melhoria da assistência em unidades pediátricas. Métodos: scoping review, realizada conforme orientações do Instituto Joanna Briggs, seguindo o checklist do Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. A busca ocorreu em maio de 2018 em 15 fontes de dados. Resultados: busca totalizou 8.254 estudos. Após a utilização dos critérios de inclusão e exclusão pertinentes, incluíram-se 15 artigos na revisão. Desses, nove foram publicados entre 2013 e 2018, 12 utilizaram Análise Modal de Falhas e Efeitos e 11 realizaram intervenções para melhoria da qualidade nos processos abordados, mostrando bons resultados pós-intervenções. Considerações Finais: a aplicação das ferramentas indicou mudanças e melhorias significativas nos serviços que as implementaram, mostrando-se satisfatórias para detectar oportunidades de melhorias, empregando metodologias específicas para a redução de danos em pediatria.

Aspectos epidemiológicos, clínicos e angiográficos de pacientes submetidos à Intervenção Coronária Percutânea primária / Epidemiological, clinical and angiographic aspects of patients submitted to primary Percutaneous Coronary Intervention

Introduction: Having the profile of patients undergoing angioplasty helps to improve their quality of life and assist the health team. Objective: to analyze the epidemiological, clinical, and angiographic aspects and their relationship with the gender of patients undergoing primary percutaneous coronary intervention. Method: this is a descriptive and cross-sectional study carried out at a University Hospital in Rio Grande do Norte. Data collection took place between April and October 2017 from data found in the computerized and printed medical records of 93 patients undergoing Primary Percutaneous Coronary Intervention. Tests such as Kolmogorov-Sminorv, Mann-Whitney (U), and Pearson's chi-square (X2) evaluated the information evidenced by the research. Results: 64.5% of the 93 patients included in the study were men, with a mean age of 62.3 years old. Regarding the door-to-balloon time, 18.2% of women and 8.3% of men had time less than 90 minutes. The comorbidities of systemic arterial hypertension, diabetes mellitus, and alcoholism stand out. Conclusion: the results on the epidemiological, clinical, and angiographic aspects evidenced in this study favor greater knowledge, contributing to the generation of strategies for the prevention of diseases of patients submitted to primary Percutaneous Coronary Intervention.

Introdução: Dispor do perfil de pacientes submetidos à angioplastia colabora para a melhoria da qualidade de vida dos mesmos e trabalho assistencial da equipe de saúde. Objetivo: analisar os aspectos epidemiológicos, clínicos e angiográficos e suas relações com o sexo dos pacientes submetidos à intervenção coronária percutânea primária. Método: estudo descritivo e transversal realizado em Hospital Universitário do Rio Grande do Norte. A coleta de dados ocorreu entre abril e outubro de 2017 a partir de dados encontrados no prontuário informatizado e impresso de 93 pacientes submetidos à Intervenção Coronária Percutânea Primária. Utilizaram-se testes como o Kolmogorov-Sminorv, Mann-Whitney (U) e Qui-quadrado de Pearson (X2) para a avaliação das informações evidenciadas pela pesquisa. Resultados: dos 93 pacientes inclusos no estudo, 64,5% eram homens, com média de idade de 62,3 anos. Sobre o tempo porta-balão,18,2% das mulheres e 8,3% dos homens conseguiram o tempo menor que 90 minutos. Quanto às comorbidades, destacam-se Hipertensão Arterial Sistêmica, diabetes mellitus, além do hábito de vida etilismo. Conclusão: os resultados sobre os aspectos epidemiológicos, clínicos e angiográficos evidenciados neste estudo favorecem um maior conhecimento, contribuindo para a geração de estratégias para a prevenção de agravos de pacientes submetidos à Intervenção Coronária Percutânea Primária.