Technology for nursing care in a Maternal Intensive Care Unit: a methodological study.

OBJECTIVES: to develop and validate a nursing care plan in a Maternal Intensive Care Unit. METHODS: a methodological study, developed in stages: integrative review; Nursing History construction; care plan restructuring; appearance and content validity by judges. RESULTS: the history was organized into sections: Identification; Basic Human Needs; Physical Examination; and Assessment of Basic Human Needs. A care plan was restructured with 34 diagnoses, organized according to basic human needs. A satisfactory level of appearance validity of the history and care plan was obtained (Concordance Index varying between 86.3 and 100 for both instruments), and content validity with average indexes of 90.8 and 92.8, respectively. Thirty-four diagnoses, their interventions and nursing actions were consolidated. CONCLUSIONS: the instruments were considered relevant and pertinent in terms of appearance and content, and their use in the institution under study as well as in other similar services may be recommended.

Nursing care protocol for critical users with tracheostomy under mechanical ventilation.

OBJECTIVES: to develop and assess a nursing care protocol for critically ill users with tracheostomy under mechanical ventilation. METHODS: a methodological study, developed through two phases, guided by the 5W2H management tool: I) target audience characterization and II) technology development. RESULTS: thirty-four nursing professionals participated in this study, who presented educational demands in relation to care for critical users with tracheostomy, with an emphasis on standardizing care through a protocol and carrying out continuing education. FINAL CONSIDERATIONS: the creation and validity of new technologies aimed at this purpose enhanced the participation of nursing professionals and their empowerment in the health institution's microsectoral actions and in macrosectoral actions, highlighting the need for public policies that guarantee the conduct of a line of care for users with tracheostomy.

Using interoperable nursing care data to improve outcomes for multiple traumas patients with Impaired Physical Mobility.

AIM(S): To demonstrate how interoperable nursing care data can be used by nurses to create a more holistic understanding of the healthcare needs of multiple traumas patients with Impaired Physical Mobility. By proposing and validating linkages for the nursing diagnosis of Impaired Physical Mobility in multiple trauma patients by mapping to the Nursing Outcomes Classification (NOC) and Nursing Interventions Classification (NIC) equivalent terms using free-text nursing documentation. DESIGN: A descriptive cross-sectional design, combining quantitative analysis of interoperable data sets and the Kappa's coefficient score with qualitative insights from cross-mapping methodology and nursing professionals' consensus. METHODS: Cross-mapping methodology was conducted in a Brazilian Level 1 Trauma Center using de-identified records of adult patients with a confirmed medical diagnosis of multiple traumas and Impaired Physical Mobility (a nursing diagnosis). The hospital nursing free-text records were mapped to NANDA-I, NIC, NOC and NNN linkages were identified. The data records were retrieved for admissions from September to October 2020 and involved medical and nursing records. Three expert nurses evaluated the cross-mapping and linkage results using a 4-point Likert-type scale and Kappa's coefficient. RESULTS: The de-identified records of 44 patients were evaluated and then were mapped to three NOCs related to nurses care planning: (0001) Endurance; (0204) Immobility Consequences: Physiological, and (0208) Mobility and 13 interventions and 32 interrelated activities: (6486) Environmental Management: Safety; (0840) Positioning; (3200) Aspiration Precautions; (1400) Pain Management; (0940) Traction/Immobilization Care; (3540) Pressure Ulcer Prevention; (3584) Skincare: Topical Treatment; (1100) Nutrition Management; (3660) Wound Care; (1804) Self-Care Assistance: Toileting; (1801) Self-Care Assistance: Bathing/Hygiene; (4130) Fluid Monitoring; and (4200) Intravenous Therapy. The final version of the constructed NNN Linkages identified 37 NOCs and 41 NICs. CONCLUSION: These valid NNN linkages for patients with multiple traumas can serve as a valuable resource that enables nurses, who face multiple time constraints, to make informed decisions efficiently. This approach of using evidence-based linkages like the one developed in this research holds high potential for improving patient's safety and outcomes. NO PATIENT OR PUBLIC CONTRIBUTION: In this study, there was no direct involvement of patients, service users, caregivers or public members in the design, conduct, analysis and interpretation of data or preparation of the manuscript. The study focused solely on analysing existing de-identified medical and nursing records to propose and validate linkages for nursing diagnoses.

Association of quality of nursing care with violence load, burnout, and listening climate.

BACKGROUND: Violence against nurses is common. Previous research has recommended further development of the measurement of violence against nurses and integration of the individual and ward-related factors that contribute to violence against hospital nurses. This study was designed to address these issues by investigating the associations between violence, the listening climate of hospital wards, professional burnout, and perceived quality of care. For this purpose, we used a new operationalization of the violence concept. METHODS: We sought nurses to participate in the study through social media which yielded 765 nurses working in various healthcare systems across Israel who volunteered to complete a self-administered online questionnaire. 80% of the sample were hospital nurses, and 84.7% were female. The questionnaire included validated measures of burnout, listening climate, and quality of care. Instead of using the traditional binary measure of exposure to violence to capture the occurrence and comprehensive impact of violence, this study measured the incremental load of violence to which nurses are subjected. RESULTS: There were significant correlations between violence load and perceived quality of care and between constructive and destructive listening climates and quality of care. Violence load contributed 14% to the variance of burnout and 13% to the variance of perceived quality of care. The ward listening climate moderated the relationship between burnout and quality of care. CONCLUSIONS: The results of this study highlight the impact of violence load among nurses and the ward listening climate on the development of burnout and on providing quality care. The findings call upon policymakers to monitor violence load and allocate resources to foster supportive work environments to enhance nurse well-being and improve patient care outcomes.

Rationing of nursing care and assessment of work safety and a healthy work environment in intensive care units: A cross-sectional, correlational study.

INTRODUCTION: Rationing of nursing care, whichrefers to the aspects of care not delivered by nurses in an intensive care unit (ICU), has implicationsfor patient outcomes and experiences. OBJECTIVES: This study aimed to identify the extent to which nursing care is rationed in intensive care units, as well as asses quality of nursing care, and the level of job satisfaction and its correlation with an assessment of the climate of work safety, teamwork, and a healthy work environment. METHODOLOGY: A cross-sectional, correlational study was conducted. The study included 226 ICU nurses. It was conducted with the use of three instruments: the Perceived Implicit Rationing of Nursing Care (PRINCA) questionnaire on the rationing of nursing care, assessment of patient care quality and job satisfaction, American Association of Critical-Care Nurses Healthy Work Environment Assessment Tool (HWEAT) and the Safe Attitudes and Behaviours Questionnaire questionnaire in the version: Teamwork and Safety Climate (BePoZa). SETTINGS: Intensive Care Units in Warmia and Mazury Region in Poland. MAIN OUTCOME MEASURES: Level of Nursing Care Rationing in Intensive Care Units. RESULTS: The majority of participants were women (89.82 %) with a mean age of 42.47 years. The average score for nursing care rationing across all groups was 0.58. The mean score for the HWEAT was 2.7 and BePoZa was 3.72. The scores from the questionnaires were negatively correlated with the nursing care rationing scores, being -0.36 for the HWEAT and -0.45 for BePoZa. All correlation coefficients were statistically significant at a p-value of less than 0.05. CONCLUSIONS: It is important to monitor work safety, teamwork climate, and standards of a healthy work environment in ICUs to minimise the risk of rationing nursing care. IMPLICATIONS FOR CLINICAL PRACTICE: Interventions that enhance work organisation and teamwork can elevate nursing quality and job satisfaction in ICUs, while underestimating patient care tasks; thus, highlighting the need for further research on the factors influencing nursing performance.

Manejo de PICC en el Servicio de Urgencias de un hospital universitario / Use of PICC at the University Hospital Emergency Unit

Para gestionar el capital venoso del paciente con seguridad y responsabilidad es necesario aumentar la calidad de los cuidados proporcionados, unificando y estandarizando los criterios de actuación, basándose siempre en la mejor evidencia científica. Las enfermeras de los Servicios de Urgencias deben aplicar la evidencia en el manejo del catéter venoso central de inserción periférica (PICC), conocer el protocolo aprobado por la Dirección Asistencial de su hospital y, sobre todo, evitar la variabilidad en la actuación, que podría aumentar los riesgos relacionados con la atención sanitaria, así como la desconfianza del paciente. Mantener actualizados los conocimientos y promover la adquisición de habilidades en la práctica clínica es de suma importancia para garantizar cuidados de calidad en el manejo de este tipo de catéteres, debiéndose comprobar periódicamente el grado de cumplimiento de la evidencia recogida en los protocolos existentes en el hospital. Las enfermeras tienen el reto de estar al día en el manejo de los accesos vasculares, y deben responder con seriedad y evidencia a los cuidados que necesitan los pacientes a los que se atienden. En este manuscrito se objetiva la necesidad de formar y capacitar de forma continua a los profesionales para el manejo adecuado del PICC. (AU)

In order to manage the venous resource of the patient safely and with responsibility, it is necessary to increase the quality of care provided, unifying and standardizing performance criteria, always based on the best scientific evidence. Emergency Unit nurses must apply evidence in their use of the peripherally inserted central venous catheter (PICC), they must know the protocol approved by the Patient Care Management in their hospital and, most of all, must avoid variability of action, which could increase the risks associated with healthcare as well as mistrust by patients. It is extremely important to keep an updated knowledge and to promote the acquisition of clinical practice skills, in order to guarantee quality care in the use of this type of catheters; the level of compliance of the evidence collected in the hospital protocols must be confirmed periodically. Nurses face the challenge of being updated in the management of vascular accesses, and must give response with seriousness and evidence to the care needed by their patients. This manuscript sets out objectively the need for continuous training and qualification for professionals regarding the adequate use of PICC. (AU)

Anticuerpos monoclonales biespecíficos: Cuidados de enfermería a propósito de un caso / [Bispecific monoclonal antibodies: Nursing care regarding a case]

El cáncer sigue siendo una enfermedad de primera magnitud a nivel mundial y uno de los pilares para su supervivencia son los tratamientos antineoplásicos. En los últimos años se ha producido un gran avance habiendo descrito múltiples estrategias de desarrollo, para conseguir mayor actividad antitumoral y menor toxicidad. En este contexto cabe destacar el uso de los anticuerpos monoclonales, en concreto, en los anticuerpos monoclonales biespecíficos. Dada la complejidad de estos tipos de tratamientos y sus efectos secundarios, es necesaria la formación en cuidados de enfermería específicos, con profesionales que tengan los conocimientos necesarios para garantizar una vigilancia adecuada a estos pacientes. Es por ello que el objetivo principal de este estudio es generar un Plan de Cuidados de Enfermería a una paciente con diagnóstico de Linfoma B del alto grado, que ha recibido tratamiento con Epcoritamab en el Hospital Universitario de Canarias. Así, en este artículo se realizó una valoración de enfermería según los patrones funcionales de Marjory Gordon y se desarrolló un Plan de Cuidados Individualizado (PCI) centrado en los siguientes diagnósticos: náuseas, patrón respiratorio ineficaz, riesgo de shock y riesgo de confusión aguda. (AU)

Cuidado cultural em região de fronteira: perspectiva de enfermeiros da atenção primária à saúde / Cultural care in a border region: perspective of primary health care nurses / Cuidado cultural en una región fronteriza: perspectiva de enfermeros de la atención primaria de salud

Objetivo: conhecer a perspectiva de enfermeiros sobre cultura e cuidado cultural em município de fronteira e sua formação para realizar o cuidado culturalmente congruente. Método: estudo exploratório-descritivo, conduzido à luz da Teoria Transcultural do Cuidado. Realizadas entrevistas com 18 enfermeiros da atenção primária de Foz do Iguaçu-PR, entre janeiro de 2020 e janeiro de 2021, submetidas à análise de conteúdo. Resultados: as categorias de análise mostraram que, para os enfermeiros, o indivíduo traz consigo sua cultura, apreendida em seu meio, ao nascimento e passa de geração em geração. Considerações finais: ser profissional em região de fronteira interfere na perspectiva das diferenças culturais, as quais se relacionam num processo de interculturalidade, tornando-se relevante conhecer a população, seus hábitos e crenças para preservá-los nas ações de cuidado. Enfermeiros migrantes na região do estudo buscam conhecer a população, seus hábitos e crenças para preservá-los nas ações de cuidado(AU)

Objective: to know the perspective of nurses on culture and cultural care in a border town and their training to provide culturally congruent care. Method: exploratory-descriptive study, conducted in the light of the Transcultural Theory of Care. Interviews were conducted with 18 primary care nurses in Foz do Iguaçu-PR, between January 2020 and January 2021, submitted to content analysis. Results: the analysis categories showed that, for nurses, the individual brings with him his culture, apprehended in his environment, at birth and passed from generation to generation. Final considerations: being a professional in a border region interferes with the perspective of cultural differences, which are related in an intercultural process, making it relevant to know the population, their habits and beliefs to preserve them in care actions. Migrant nurses in the study region seek to know the population, their habits and beliefs to preserve them in care actions(AU)

Objetivo: conocer la perspectiva de los enfermeros sobre la cultura y el cuidado cultural en una localidad fronteriza y su formación para brindar un cuidado culturalmente congruente. Método: estudio exploratorio-descriptivo, realizado a la luz de la Teoría del Cuidado Transcultural. Se realizaron entrevistas junto a 18 enfermeros de atención primaria en Foz do Iguazú-Paraná, entre enero de 2020 y enero de 2021, y se sometieron al análisis de contenido. Resultados: las categorías de análisis mostraron que, según los enfermeros, el individuo lleva consigo su cultura, aprehendida en su entorno al nacer y transmitida de generación en generación. Consideraciones finales: ser profesional en una región fronteriza interfiere con la perspectiva de las diferencias culturales, que se relacionan en un proceso intercultural y se vuelve relevante conocer a la población, sus hábitos y creencias para preservarlos en las acciones de cuidado. Los enfermeros migrantes en la región de estudio tratan de conocer a la población, sus hábitos y creencias para preservarlos en las acciones de cuidado(AU)

Nursing, history, and orthopedics in manuals (1875-1928).

OBJECTIVES: to discuss the content of manuals, with emphasis on orthopedics, in support of the development of nursing care culture. METHODS: cultural-historical method articulated with document analysis technique. The sources were nursing manuals - Portuguese, French, English, and Spanish - from 1875 to 1928. RESULTS: this study pointed to 12 works - 6 authored by physicians, 2 by nurses, 3 institutional, and 1 by a Sister of Charity - that presented, in a transversal way, the professionalization process initiated in Europe. The manuals addressed first aid care and immobilization methods, from the simplest, such as improvised splints, to the application of plaster casts. CONCLUSIONS: the nurses' work, even in a limited capacity, showed that they were able to observe warning signs so that doctors could act, with some exceptions.

Focus group in the development of concepts for a Nursing model: experience report.

OBJECTIVE: To communicate the experience of developing concepts for the construction of a care model through focus groups. METHODS: An experience report on the development of concepts through remote focus groups with members of a research group from a public university in southern Brazil. RESULTS: Focus groups were developed in which homogeneity and heterogeneity criteria were observed among participants. In addition to the concepts of the nursing metaparadigm, the concepts of care and family-centered care were developed, relevant to the nursing care model in question. FINAL CONSIDERATIONS: Despite the challenges of conducting remote focus groups, they were suitable for the collective construction of concepts for a nursing care model, allowing the interaction of participants from different locations.

Missed nursing care: A cross-sectional and multi-centric study from Turkey.

AIM: The aim of this study is to explore the extent of missed nursing care in Turkey and identify its predictors. DESIGN: This was a descriptive, cross-sectional, multicentre study. METHODS: A total of 477 nurses working in seven public hospitals participated in this study from March to July 2019. The survey included two components: a personal and professional characteristics data form and the MISSCARE survey. RESULTS: The study revealed that emotional support, patient bathing and ambulation were the most frequently missed nursing care activities. An inadequate number of assistive personnel and staff, along with an unexpected increase in patient volume, were identified as the primary reasons for missed nursing care. Of the 21 missed nursing care activities, nine predictive models showed statistical significance (p < 0.05). Factors such as the type of unit, years of work experience, working hours, number of patients cared for in a shift and intention to leave the unit were found to be significant predictors of seven missed nursing care activities (p < 0.05). CONCLUSION: This study found that numerous variables influence each care activity, which suggests the need to devise more targeted and specific strategies to minimize missed nursing care. Thorough investigation into the impact of these strategies on each care activity is essential.

Percepción de calidad de vida de pacientes hospitalizados con diagnóstico primario de cáncer y herida tumoral / Perception of quality of life of hospitalized patients with primary diagnosis of cancer and tumor wound

Introducción: las enfermedades oncológicas son la causa de 9.5 millones de muertes en el mundo y la tercera causa de muerte en México. La aparición de heridas tumorales es una complicación de la progresión de la enfermedad oncológica con síntomas que repercuten en la calidad de vida de los pacientes. Objetivo: evaluar la percepción de calidad de vida de pacientes hospitalizados con diagnóstico primario de cáncer y herida tumoral en un hospital de tercer nivel de la Ciudad de México. Metodología: estudio descriptivo que incluyó a 57 pacientes hospitalizados con diagnóstico de cáncer primario y herida tumoral. La percepción de calidad de vida se evaluó con el cuestionario McGill Quality of Life Questionnaire (MQOL) con 4 dimensiones: de bienestar físico, psicológico, existencial y de apoyo social. La herida tumoral se estadificó con la escala Malignant Cutaneous Wound Stating System. La severidad de la enfermedad se midió con la escala APACHE II. El análisis se hizo con estadística descriptiva. Resultados: de 57 pacientes con edad entre 24 y 81 años de edad, predominó el cáncer de mama en 31.5% de mujeres y cáncer de testículo en 10.5% de hombres. La herida tumoral grado IV se presentó en 72% de los pacientes. La percepción de calidad de vida en general, que se midió con el Single ítem scale, fue buena y regular en 38.6 y 26.3%, respectivamente. Conclusiones: para la práctica de enfermería la evaluación de la calidad de vida en las personas con cáncer significa una diversidad de posibilidades para intervenir y promover el bienestar en la persona y la familia.

Introduction: Oncological diseases are the cause of 9.5 million deaths in the world and the third cause of death in Mexico. The appearance of tumor wounds is a complication of the oncological disease progression with symptoms that affect the quality of life of patients. Objective: To evaluate the perception of quality of life of hospitalized patients with a primary diagnosis of cancer and tumor wound in a tertiary care hospital in Mexico City. Methodology: Descriptive study that included 57 hospitalized patients diagnosed with primary cancer and tumor wound. The perception of quality of life was evaluated with the McGill Quality of Life Questionnaire with 4 dimensions: of physical, psychological, and existential well-being, as well as social support. The tumor wound was staged using the Malignant Cutaneous Wound Stating System scale. The severity of the disease was calculated with the APACHE II scale. The analysis was made with descriptive statistics. Results: Out of 57 patients aged 24 to 81 years, breast cancer predominated in 31.5% of women and testicular cancer in 10.5% of men. Grade IV tumor wound occurred in 72% of patients. The perception of quality of life in general, measured with the Single Item Scale, was good and regular in 38.6 and 26.3%, respectively. Conclusions: For nursing practice, the evaluation of the quality of life in people with cancer means a diversity of possibilities to intervene and promote the well-being of the person and the family.

Experiencias del personal de enfermería acerca de los factores del entorno que intervienen durante el enlace de turno / Experiences of the nursing staff about the environmental factors that intervene during the shift change

Introduction: The shift change in the nursing care process, primarily located in hospital settings, is carried out through the transfer of verbal, written and gestural information from the interaction between nursing staff. The theoretical reference is from Elton Mayo's human relations. Objective: To understand and interpret the meaning of the nursing staff's experiences regarding the environmental factors involved during the shift change. Methodology: Qualitative study carried out with the phenomenological method. The information was obtained through non-participant observation and a semi-structured interview with operational nursing staff. Data saturation was reached with 32 interviews. Results: 7 categories were constructed: Verbal/language communication, Patient reception, Patient safety, Continuous care, Administrative documents, Shift change hours, and Work supplies. Conclusions: The findings show the various factors that interact and intervene between nursing staff during the shift change, which is an essential activity to provide continuity of care and guarantee safety in patient care.

Introducción: el enlace de turno en el proceso de atención de enfermería, primordialmente situado en escenarios hospitalarios, se lleva a cabo mediante la transferencia de información verbal, escrita y gestual a partir de la interacción entre personal de enfermería. El referente teórico es el de relaciones humanas de Elton Mayo. Objetivo: comprender e interpretar el significado de las experiencias del personal de enfermería acerca de los factores del entorno que intervienen durante el enlace de turno. Metodología: estudio cualitativo realizado con el método fenomenológico. La información se obtuvo mediante observación no participante y entrevista semiestructurada en personal de enfermería operativo. La saturación de datos se alcanzó con 32 entrevistas. Resultados: se construyeron 7 categorías: Comunicación verbal/lenguaje, Recepción del paciente, Seguridad del paciente, Cuidado continuo, Documentos administrativos, Horarios de enlace de turno e Insumos de trabajo. Conclusiones: los hallazgos permiten mostrar los diversos factores que interactúan e intervienen entre el personal de enfermería durante el enlace de turno, que es una actividad esencial para dar continuidad al cuidado y garantizar la seguridad en la atención de los pacientes.

Cuidados ao portador de púrpura trombocitopênica idiopática - revisão de literatura / Care for patients with idiopathic thrombocytopenic purpura - literature review

Introdução: Conhecida como púrpura trombocitopênica imunonológica, autoimune ou isoimune, a Púrpura Trombocitopênica Idiopática é uma doença hematológica frequente que pode ser aguda, mais frequente em crianças, ou crônica, quando persiste por mais de um ano, típica em adultos. Objetivo: Identificar na literatura científica dados sobre a doença púrpura trombocitopênica, quanto às manifestações clínicas, diagnóstico, tratamento e cuidados de enfermagem. Material e Método: Estudo embasado em revisão integrativa de literatura com busca realizada na base de dados da Biblioteca Virtual da Saúde, Scientific Electronic Library Online e Google Acadêmico, pelos descritores: "Púrpura Trombocitopênica Idiopática", "Cuidados de Enfermagem", e suas respectivas traduções em inglês: "IdiopaticThrombocytopenic Purpura" e "Nursing Care" em associação com operadores booleanos "OR" e "AND", para ampliar a busca dos artigos, dos últimos cinco anos. Resultados: Foram identificados 121 artigos com potencial de relevância, sendo excluídos 4 por duplicidade, totalizando em 117 artigos. Após leitura do título e resumo foram selecionados 17 artigos e excluídos 100. Em seguida, excluídos 12, por não responderem a questão norteadora do estudo, totalizando em 5 artigos para realizar a síntese qualitativa na íntegra. Há destaque quanto a importância da sistematização da assistência de enfermagem para o paciente acometido pela doença, e sobre os desafios da equipe de enfermagem no procedimento de transfusão sanguínea. Também um relato de experiência descreve como é viver com a doença e o tratamento, uma revisão integrativa sobre as manifestações clínicas da doença e a dificuldade de diagnosticar a PúrpuraTrombocitopênica Idiopática. Conclusão: Púrpura Trombocitopênica Idiopática é considerada uma doença grave e de difícil diagnóstico, pois pode ser confundida com outras doenças. O tratamento é específico, realizado com procedimentos de plasmaférese e transfusões sanguíneas em unidades especializadas e de alta complexidade assistencial. Assim, a equipe de enfermagem precisa estar preparada para os cuidados próprios e o enfermeiro, estimulado a desenvolver maneiras de cuidar e pesquisas com abordagens na doença

Introduction: Known as immunological, autoimmune or isoimmune thrombocytopenic purpura, Idiopathic Thrombocytopenic Purpura is a frequent hematological disease that can be acute, more frequent in children, or chronic, when it persists for more than a year, typical in adults. Objective: To identify in the scientific literature data on thrombocytopenic purpura, regarding clinical manifestations, diagnosis, treatment and nursing care. Material and Method: Study based on an integrative literature review with a search carried out in the database of the Virtual Health Library, Scientific Electronic Library Online and Google Scholar, by the descriptors: "Idiopathic Thrombocytopenic Purpura", "Nursing Care", and their respective English translations: "IdiopaticThrombocytopenic Purpura" and "Nursing Care" in association with Boolean operators "OR" and "AND", to expand the search for articles from the last five years. Results: 121 potentially relevant articles were identified, 4 of which were excluded due to duplicity, totaling 117 articles. After reading the title and abstract, 17 articles were selected and 100 were excluded. Then, 12 were excluded for not answering the guiding question of the study, totaling 5 articles to carry out the qualitative synthesis in full. There is emphasis on the importance of systematizing nursing care for the patient affected by the disease, and on the challenges of the nursing team in the blood transfusion procedure. Also an experience report of what it is like to live with the disease and the treatment, an integrative review on the clinical manifestations of the disease and the difficulty of diagnosing Idiopathic Thrombocytopenic Purpura. Conclusion: Idiopathic Thrombocytopenic Purpura is considered a serious disease and difficult to diagnose, as it can be confused with other diseases. The treatment is specific, carried out with plasmapheresis procedures and blood transfusions in specialized and highly complex care units. Thus, the nursing team needs to be prepared for self-care and the nurse encouraged to develop ways of caring and research with approaches to the disease

Introducción: Conocida como púrpura trombocitopénica inmunológica, autoinmune o isoinmune, púrpura trombocitopénica idiopática es una enfermedad hematológica frecuente que puede ser aguda, más frecuente en niños, o crónica, cuando persiste por más de un año, típica en adultos. Objetivo: Identificar datos sobre la púrpura trombocitopénica en la literatura científica, en cuanto a manifestaciones clínicas, diagnóstico, tratamiento y cuidados de enfermería. Material y Método: Estudio basado en una revisión integrativa de la literatura con búsqueda realizada en la base de datos de la Biblioteca Virtual en Salud, Scientific Electronic Library Online y Google Scholar, por los descriptores: "Idiopathic Thrombocytopenic Purpura", "Nursing Care", y sus respectivas traducciones al inglés: "IdiopaticThrombocytopenic Purpura" y "Nursing Care" en asociación con los operadores booleanos "OR" y "AND", para ampliar la búsqueda de artículos de los últimos cinco años. Resultados: Se identificaron 121 artículos potencialmente relevantes, de los cuales 4 fueron excluidos por duplicidad, totalizando 117 artículos. Después de la lectura del título y el resumen, se seleccionaron 17 artículos y se excluyeron 100. Luego, 12 fueron excluidos por no responder a la pregunta guía del estudio, totalizando 5 artículos para realizar la síntesis cualitativa en su totalidad. Se destaca la importancia de sistematizar los cuidados de enfermería al paciente afectado por la enfermedad y los desafíos del equipo de enfermería en el procedimiento de transfusión sanguínea. Además, un relato de experiencia describe cómo es vivir con la enfermedad y el tratamiento, una revisión integradora sobre las manifestaciones clínicas de la enfermedad y la dificultad de diagnosticar la Púrpura Trombocitopénica Idiopática. Conclusión: La púrpura trombocitopénica idiopática es considerada una enfermedad grave, de difícil diagnóstico, ya que puede confundirse con otras enfermedades. El tratamiento es específico, realizado con procedimientos de plasmaféresis y transfusiones de sangre en unidades especializadas de alta complejidad asistencial. Así, el equipo de enfermería necesita estar preparado para el autocuidado y el enfermero incentivado a desarrollar formas de cuidar e investigar con abordajes de la enfermedad

Modelo de aprendizaje de cuidados paliativos basado en la teoría de aprendizaje transformacional de cuidados paliativos de los estudiantes de enfermería en Indonesia / Palliative care learning model based on transformational learning theory in palliative care of nursing students in Indonesia

Introducción: La competencia sobre cuidados paliativos es una de las aptitudes que deben poseer los enfermeros generales. Por este motivo, deben llevarse a cabo estrategias para desarrollar modelos de aprendizaje de cuidados paliativos a fin de garantizar que los estudiantes de enfermería posean competencias en dicha materia. Por tanto, este estudio fue estructurado para desarrollar un modelo de aprendizaje de cuidados paliativos basado en la teoría de la transformación, que priorice la participación activa de los estudiantes, de cara a tratar los cuidados paliativos en la práctica futura. Métodos: Estudio transversal que incluyó a 189 estudiantes de enfermería como participantes. El modelo propuesto incluye 6 variables: características de los estudiantes, características del educador, medios de aprendizaje, competencias sobre cuidados paliativos, formación en paliativos basada en la teoría de aprendizaje transformativo (TLT) y logro de competencias. Los datos fueron recopilados utilizando un cuestionario probado mediante la técnica SEM (Structural Equation Modeling [Modelo de ecuaciones estructurales]). Resultados: El análisis SEM mostró que el valor R2 del aprendizaje de cuidados paliativos basado en TLT fue de 0,707, o 70,7%. Dichos resultados indican que la diversidad de las variables del aprendizaje de cuidados paliativos basado en TLT pueden explicarse mediante las variables de estudiantes, educadores, competencias sobre paliativos, y medios de aprendizaje en un 70,7%. Cada constructo tuvo un valor de Q2>0, lo cual significa que el modelo es satisfactorio. El valor del coeficiente por pasos de 0,627 indica que las características de los educadores tienen la contribución más significativa al modelo de aprendizaje de cuidados paliativos basado en TLT. Conclusión: Puede concluirse que el proceso de aprendizaje-formación basado en TLT es una estrategia prometedora para respaldar...(AU)

Introduction: Palliative care competence is one of the competencies that must be possessed by generalist nurses. For this reason, strategies for developing palliative care learning models need to be carried out to ensure nursing students have palliative care competencies. Therefore, this study was structured to develop a transformation theory-based palliative care learning model that prioritizes the active participation of students to deal with palliative care in future practice. Methods: This study was a cross-sectional study involving 189 nursing students as participants. The proposed model involves six variables, namely student characteristics, educator characteristics, learning media, palliative care competencies, transformative learning theory (TLT)-based palliative learning, and competency achievement. Data were collected using a questionnaire that was tested using the Structural Equation Modeling (SEM) technique. Results: SEM analysis showed that the R2 value of TLT-based palliative care learning was 0.707 or 70.7%. These results indicate that the diversity of TLT-based palliative care learning variables can be explained by the variables of students, educators, palliative competencies, and learning media by 70.7%. Each construct has a value of Q2>0, which means the model is satisfactory. The path coefficient value of 0.627 indicates that the characteristics of educators have the most significant contribution to the TLT-based palliative care learning model. Conclusion: It can be concluded that the teaching-learning process based on TLT is a promising strategy to support nursing students to achieve palliative care competence.(AU)

Cuide, movimente, evite lesão por pressão no seu paciente: um relato de experiência / Care, move, avoid pressure injury in your patient: an experience report / Cuidar, mover, evitar lesiones por presión en su paciente: informe de una experiencia

Introdução: As lesões por pressão (LPP) correspondem a danos na pele ou em tecidos moles encobertos, geralmente em áreas de proeminências ósseas, ou associado ao uso de dispositivo médico ou outro tipo de artefato. Diante disso, a enfermeira deve desenvolver sua prática, baseada em evidências científicas e priorizar a prevenção da formação das lesões na pele. Objetivo: Relatar a experiência de estudantes de Enfermagem sobre o desenvolvimento de ações de promoção do cuidado seguro relacionado à prevenção de LPP em pacientes internados em um hospital público pediátrico na Bahia. Metodologia: Trata-se de um estudo de caráter descritivo, do tipo relato de experiência, realizado por seis estudantes de Enfermagem em um hospital estadual pediátrico localizado no estado da Bahia, no período de novembro 2022. Principais resultados: Percebeu-se que existem profissionais de enfermagem que possuem interesse em obter mais conhecimento sobre o assunto, porém ainda há lacunas de conhecimento por parte da equipe sobre alguns assuntos abordados, tais como a escala de Braden e a utilização do colchão caixa de ovo para todas as faixas etárias. Foi possível perceber que os passos para prevenir a lesão por pressão não são cumpridos por parte da equipe e isso pode dificultar a prevenção das lesões de forma efetiva. Conclusão: Recomenda-se, portanto, que as unidades assistenciais, juntamente com suas respectivas coordenadoras, realizem ações contínuas de educação permanente, a fim de contribuir para uma melhor qualificação profissional, promovendo, acima de tudo, a segurança do paciente.

Introduction: Pressure lesions (PPL) correspond to damage to the skin or covert soft tissue, usually in areas of bony prominence, or associated with the use of a medical device or other type of artifact. Therefore, nurses should develop their practice, based on scientific evidence and prioritize the prevention of skin lesion formation. Objective: To report the experience of nursing students on the development of actions to promote safe care related to the prevention of PPL in patients admitted to a pediatric public hospital in Bahia. Methodology: This is a descriptive study, of the type of experience report, conducted by six nursing students in a pediatric state hospital located in the state of Bahia, in the period of November 2022. Main results: It was noticed that there are nursing professionals who have an interest in obtaining more knowledge about the subject, but there are still gaps in knowledge on the part of the team on some subjects addressed, such as the Braden scale and the use of the egg box mattress for all age groups. It was possible to notice that the steps to prevent pressure injury are not met by the team and this can hinder the prevention of injuries effectively. Conclusion: It is recommended, therefore, that the care units, together with their respective coordinators, carry out continuous actions of continuing education, in order to contribute to a better professional qualification, promoting, above all, patient safety.

Introducción: Las lesiones por presión (LPP) corresponden a lesiones en la piel o tejidos blandos encubiertos, generalmente en zonas de prominencia ósea, o asociadas al uso de un dispositivo médico u otro tipo de artefacto. Por ello, el personal de enfermería debe desarrollar su práctica, basándose en la evidencia científica y priorizando la prevención de la formación de lesiones cutáneas. Objetivo: Relatar la experiencia de estudiantes de enfermería sobre el desarrollo de acciones para promover cuidados seguros relacionados a la prevención de PPL en pacientes internados en un hospital público pediátrico de Bahía. Metodología: Se trata de un estudio descriptivo, del tipo relato de experiencia, realizado por seis estudiantes de enfermería en un hospital público pediátrico localizado en el estado de Bahía, en el período de noviembre de 2022. Principales resultados: Se observó que hay profesionales de enfermería que tienen interés en obtener más conocimientos sobre el tema, pero todavía hay lagunas de conocimiento por parte del equipo en algunos temas abordados, como la escala de Braden y el uso del colchón caja de huevos para todos los grupos de edad. Se pudo notar que los pasos para prevenir lesiones por presión no son cumplidos por el equipo y esto puede dificultar la prevención de lesiones de forma efectiva. Conclusiones: Se recomienda, por lo tanto, que las unidades asistenciales, junto con sus respectivos coordinadores, realicen acciones continuas de formación continuada, con el fin de contribuir a una mejor cualificación profesional, promoviendo, sobre todo, la seguridad del paciente.

A qualitative study of nurse-perceived barriers to body temperature management in postoperative patients.

Although evidence-based practices exist for preventing hypothermia in patients during surgery, few studies have focused on this concern in postoperative patients. The aim of this qualitative study was to explore the most challenging issues experienced by surgical ward nurses while managing the body temperature of adult surgical patients. To address this research gap, this study used a qualitative descriptive design to document barriers to body temperature management as reported by a sample of 16 perioperative nurses. The semi-structured, face-to-face interviews were digitally recorded, transcribed verbatim and analysed using inductive content analysis. The main barriers fell into three categories: professional nursing ability limitations, unfavourable working conditions and management of human resources. The eight subcategories were disadvantageous professional views, professional knowledge limitations, low motivation to provide nursing care, non-standard treatment environment, inadequate equipment and care protocols, heavy nursing care loads, inadequate staff training and ineffective staff supervision. These findings highlighted the importance of adequate resources, proper education and evidence-based care protocols in the effective delivery of body temperature management to postoperative patients.

Can fundamental care be advanced using the science of care framework?

AIMS: This manuscript aims to provide a description of an evidence-informed Science of Care practice-based research and innovation framework that may serve as a guiding framework to generate new discoveries and knowledge around fundamental care in a more integrated manner. BACKGROUND: New ways of thinking about models of care and implementation strategies in transdisciplinary teams are required to accelerate inquiry and embed new knowledge and innovation into practice settings. A new way of thinking starts with an explicit articulation and commitment to the core business of the healthcare industry which is to provide quality fundamental care. DESIGN: This discursive paper delineates an iteratively derived Science of Care research and innovation framework (Science of Care Framework) that draws from a targeted literature review. METHOD: The Science of Care Framework integrates caring science with safety and symptom sciences with implementation, improvement, innovation and team sciences. Each science dimension is described in terms of seminal and evolving evidence and theoretical explanations, focusing on how these disciplines can support fundamental care. CONCLUSIONS: The Science of Care Framework can serve as a catalyst to guide future efforts to propel new knowledge and discoveries around fundamental care and how best to implement it into clinical practice through a transdisciplinary lens. IMPACT ON NURSING SCIENCE, PRACTICE, OR DISCIPLINARY KNOWLEDGE: The Science of Care Framework can accelerate nursing discipline-specific knowledge generation alongside inter and transdisciplinary insights. The novel articulation of the Science of Care Framework can be used to guide further inquiries that are co-designed, and led, by nurses into integrated models of care and innovations in clinical practice.

Propiedades psicométricas de la escala CICAA (Conectar, Identificar, Comprender, Acordar y Ayudar) utilizada en simulación clínica de alta fidelidad de estudiantes de Enfermería / Psychometric properties of the CICAA (Connect, Identify, Understand, Agree, Agree and Assist) scale used in high fidelity clinical simulation of nursing students

Objetivo principal: Evaluar las propiedades psicométricas de la escala CICAA (Conectar, Identificar, Comprender, Acordar y Ayudar) al utilizarla en simulación clínica de alta fidelidad en estudiantes de enfermería. Metodología: Estudio analítico observacional de corte transversal en una muestra con 154 estudiantes de enfermería, a los cuales se les aplicó la escala CICAA durante el desarrollo de simulaciones clínicas de alta fidelidad. Los resultados de la escala fueron sometidos a pruebas psicométricas. Resultados principales: La escala CICAA presentó 29 componentes con sus respectivos autovalores y cuatro componentes principales que suman un 67,782% de la varianza total explicada. La consistencia interna global de la escala presentó un coeficiente α-Cronbach de 0,956. Conclusión principal: La escala CICAA ha mostrado ser un instrumento fiable y válido para evaluar habilidades comunicacionales de estudiantes de enfermería en simulaciones clínica de alta fidelidad.(AU)

Objective: To evaluate the psychometric properties of the CICAA (Connect, Identify, Understand, Agree, Agree and Assist) scale when used in high-fidelity clinical simulation in nursing students. Methodology: Observational cross-sectional analytical study in a sample of 154 nursing students, to whom the CICAA scale was applied during the development of high-fidelity clinical simulations. The results of the scale were subjected to psychometric tests. Results: The CICAA scale presented 29 components with their respective eigenvalues and four principal components accounting for 67.782% of the total variance explained. The overall internal consistency of the scale showed an α-Cronbach's coefficient of 0.956. Conclusion: The CICAA scale has been shown to be a reliable and valid instrument to assess communication skills of nursing students in high fidelity clinical simulations.(AU)