The influence of care interventions on the continuity of sleep of intensive care unit patients.

OBJECTIVE: to identify care interventions, performed by the health team, and their influence on the continuity of sleep of patients hospitalized in the Intensive Care Unit. METHOD: descriptive study with a sample of 12 patients. A filming technique was used for the data collection. The awakenings from sleep were measured using the actigraphy method. The analysis of the data was descriptive, processed using the Statistical Package for the Social Sciences software. RESULTS: 529 care interventions were identified, grouped into 28 different types, of which 12 (42.8%) caused awakening from sleep for the patients. A mean of 44.1 interventions/patient/day was observed, with 1.8 interventions/patient/hour. The administration of oral medicine and food were the interventions that caused higher frequencies of awakenings in the patients. CONCLUSION: it was identified that the health care interventions can harm the sleep of ICU patients. It is recommended that health professionals rethink the planning of interventions according to the individual demand of the patients, with the diversification of schedules and introduction of new practices to improve the quality of sleep of Intensive Care Unit patients.

Nurses' perception about risk classification in an emergency service.

OBJECTIVE: Get to know how nurses perceive the accomplishment of risk classification in an emergency service. METHODOLOGY: In this qualitative study, 11 nurses were included with at least two months of experience in the risk classification of patients who visited the emergency service. Semistructured interviews were used to collect the information. The data were collected between August and December 2011. For data analysis, Bardin's theoretical framework was used. RESULTS: The nurses in the study consider the risk classification as a work organization instruments that permits closer contact between nurses and patients. The nursing skills needed for risk classification were identified: knowledge about the scale used, clinical perspective, patience and agility. The availability of risk classification scales was the main facilitator of this work. The main difficulties were the disorganization of the care network and the health team's lack of knowledge of the protocol. CONCLUSION: Risk classification offers an opportunity for professional autonomy to the extent that it is the main responsible for regulating care at the entry door of the emergency services.

[Nursing diagnoses in patients classified as priority level I and II according to the Manchester protocol]. / Diagnósticos de enfermagem em pacientes classificados nos níveis I e II de prioridade do Protocolo Manchester.

The aim of this study was to identify possible nursing diagnoses in patients classified as priority level I and II according to the Manchester protocol. This descriptive retrospective study evaluated 40 medical charts classified as priority level I and II. To identify nursing diagnoses, two experts analyzed signs and symptoms registered in medical charts at the time of risk classification. For priority level I patients, the most frequent nursing diagnoses were acute pain (65.0%), respiratory insufficiency (45.0%), and impaired gas exchange (40.0%). For the priority level II patients, the most frequent nursing diagnoses were acute pain (80.0%), nausea (10.0%), and risk for electrolyte imbalance (10.0%). This study suggests that the use of the Manchester protocol enabled identification of defining characteristics and risk factors and supports the elaboration of nursing diagnoses in risk classification.

[Creating diagnoses and interventions under the auspices of different nursing classification systems]. / Elaboração de diagnósticos e intervenções à luz de diferentes sistemas de classificações de enfermagem.

This study analyzes the use of different nursing classification systems to meet the standards established by the norm ISO 18.104:2003, based on a fictitious clinical situation. Nursing diagnoses and interventions were created using NANDA-I, NIC and ICNP® and an analysis was performed of the terminology agreement of these classification systems with the model proposed by the norm ISO 18.104:2003. For the creation of nursing diagnoses, NANDA-I and ICNP® comply with norm ISO 18.104:2003. As for the creation of nursing interventions, ICNP® meets the terminology reference model proposed by ISO 18104:2003. NIC, on the other hand, does not propose a combinatory terminology reference model. The unification of nursing terminology depends on reviewing, standardizing and testing these classifications in order to establish a common and sound language for the profession.