Carga de trabalho de enfermagem na consulta à pessoa com diabetes mellitus: estudo preliminar / Workload in the nursing consultationto the person with diabetes mellitus: preliminary study

Introduction and objectives: Evaluating the activities developed in the consultation and determining the associated workload becomes relevant insofar as it influences safety and the quality of care. The purpose of this study was to identify the assistance and non-assistance activities carried out within the scope of the consultation; determine the execution time of the performed activities and set the average time of the consultation. Methodology: An exploratory descrip-tive study of quantitative nature was carried out. 16 primary health care nurses of 3 health units participated in the study. The instrument evaluates three dimensions: sociodemographic characterization of the clients, nursing and non-care nursing activity that integrates the previously defined categories and actions and socio-professional characterization of the nurse. The study was carried out between February and May 2018. Data was processed using SPSS25(R). Results and discussion: 103 nursing consultations were performed. It was identified that the most accompli-shed assistance activities belonged to the evaluation and health education categories. The documented non-care activities were the reception of the patient; infection control procedures and documentation of the provided care. The mean time of consultation was 24 minutes, the maximum time was 76,6 m and the minimum time was 7, 91 m. Conclusion: Identifying what activities were carried out and determining the associated workload allows us to know what work is being done and its implications in the provided care

No disponible

Knowledge, beliefs and practices on antibiotic use and resistance among a group of trainee nurses in Sri Lanka.

OBJECTIVES: Nurses are the main communication link for healthcare messages to hospitalized patients and also play a crucial role in preventing the emergence and spread antibiotic resistant bacteria through antibiotic stewardship and infection control programmes. This requires them to possess correct knowledge and attitudes towards antibiotic use and resistance. This study was carried out to identify the level of knowledge, attitude and practices on antibiotic use and antibiotic resistance among student nurses. RESULTS: A descriptive cross-sectional study was conducted using a pre-validated, self-administered questionnaire with closed and open ended questions, among 199 student nurses at a government nurses training school in Sri Lanka. Scores and proportions were analysed with non-parametric methods and thematic analysis was done for the qualitative data. The study cohort had a mean knowledge score of 71.9% (SD 14). However, close to 40% believed that taking antibiotics will help to prevent cold from worsening and make recovery faster. Infection control was identified as the main method that nurses can engage in preventing antibiotic resistance. While the knowledge among our study cohort appeared to be good, some misbeliefs were present. Our findings can be used in developing the nursing curricula on antibiotic use and resistance.

Association Between Room Location and Adverse Outcomes in Hospitalized Patients.

OBJECTIVE: To investigate whether a patient's proximity to the nurse's station or ward entrance at time of admission was associated with increased risk of adverse outcomes. METHOD: We conducted a retrospective cohort study of consecutive adult inpatients to 13 medical-surgical wards at an academic hospital from 2009 to 2013. Proximity of admission room to the nurse's station and to the ward entrance was measured using Euclidean distances. Outcomes of interest include development of critical illness (defined as cardiac arrests or transfer to an intensive care unit), inhospital mortality, and increase in length of stay (LOS). RESULTS: Of the 83,635 admissions, 4,129 developed critical illness and 1,316 died. The median LOS was 3 days. After adjusting for admission severity of illness, ward, shift, and year, we found no relationship between proximity at admission to nurse's station our outcomes. However, patients admitted to end of the ward had higher risk of developing critical illness (odds ratio [ OR] = 1.15, 95% confidence interval [CI] = [1.08, 1.23]), mortality ( OR = 1.16, 95% CI [1.03, 1.33]), and a higher LOS (13-hr increase, 95% CI [10, 15] hours) compared to patients admitted closer to the ward entrance. Similar results were observed in sensitivity analyses adjusting for isolation room patients and considering patients without room transfers in the first 48 hr. CONCLUSIONS: Our study suggests that being away from the nurse's station did not increase the risk of these adverse events in ward patients, but being farther from the ward entrance was associated with increase in risk of adverse outcomes. Patient safety can be improved by recognizing this additional risk factor.

The Role of the Built Environment: How Decentralized Nurse Stations Shape Communication, Patient Care Processes, and Patient Outcomes.

Increasingly, health communication scholars are attending to how hospital built environments shape communication, patient care processes, and patient outcomes. This multimethod study was conducted on two floors of a newly designed urban hospital. Nine focus groups interviews were conducted with 35 health care professionals from 10 provider groups. Seven of the groups were homogeneous by profession or level: nursing (three groups), nurse managers (two groups), and one group each of nurse care technicians ("techs") and physicians. Two mixed groups were comprised of staff from pharmacy, occupational therapy, patient care facilitators, physical therapy, social work, and pastoral care. Systematic qualitative analysis was conducted using a conceptual framework based on systems theory and prior health care design and communication research. Additionally, quantitative modeling was employed to assess walking distances in two different hospital designs. Results indicate nurses walked significantly more in the new hospital environment. Qualitative analysis revealed three insights developed in relationship to system structures, processes, and outcomes. First, decentralized nurse stations changed system interdependencies by reducing nurse-to-nurse interactions and teamwork while heightening nurse interdependencies and teamwork with other health care occupations. Second, many nursing-related processes remained centralized while nurse stations were decentralized, creating systems-based problems for nursing care. Third, nursing communities of practices were adversely affected by the new design. Implications of this study suggest that nurse station design shapes communication, patient care processes, and patient outcomes. Further, it is important to understand how the built environment, often treated as invisible in communication research, is crucial to understanding communication within complex health care systems.

How Patients and Nurses Experience an Open Versus an Enclosed Nursing Station on an Inpatient Psychiatric Unit.

The inpatient environment is a critical space for nurses and patients in psychiatric settings. In this article, we describe nurses' and patients' perceptions of the inpatient environment both before the removal of a Plexiglas enclosure around a nurses' station and after its removal. Nurses had mixed feelings about the enclosure, reporting that it provided for confidentiality and a concentrated work space but also acknowledged the challenge of the barrier for communication with their patients. Patients unanimously preferred the nurses' station without the barrier, reporting increased feelings of freedom, safety, and connection with the nurses after its removal. It is important to consider the implications of environmental decisions in inpatient settings in order to promote a healthy workplace and healing environment for all community members.

Noise Levels in Patient Rooms and at Nursing Stations at Three VA Medical Centers.

OBJECTIVES: To conduct an assessment of sound, dB(A) levels, in two areas of the hospital: patient rooms and nurse stations using sound meters (SMs). BACKGROUND: The World Health Organization (WHO) recommends sound levels of 35 dB(A) during the day and 30 dB(A) during the night; however, many hospitals exceed these recommended levels. Assessing post-occupancy sound levels enables hospital administrators and healthcare workers to identify whether interventions to improve sound levels are needed. METHODS: Sound assessments were conducted at three healthcare facilities in both patient rooms and nursing stations, and we include information on facility characteristics. An Amprobe SM-20A Sound Level Meter was placed for a 24-hr period and recorded decibel levels every 8 min. These sound levels were averaged for each hour for reporting purposes. Averages as well as highest and lowest readings are reported for both daytime (8 a.m.-10 p.m.) and nighttime (10 p.m.-8 a.m.) for each facility. RESULTS: All three sites are considered urban and are classified with the highest complexity level (1a). Average daytime measurements for patient rooms and their corresponding nurses stations were as follows: Site A-63 dB(A)/56 dB(A), Site B-52 dB(A)/55 dB(A), and Site C-42 dB(A)/59 dB(A). Average nighttime measurements for patient rooms and nurses stations were Site A-62 dB(A)/55 dB(A), Site B-48 dB(A)/55 dB(A), and Site C-42 dB(A)/60 dB(A). CONCLUSION: Our findings, considered independently and collectively, showed that facilities in this study exceeded the WHO-recommended sound levels for patient rooms of 35 dB(A) during daytime and 30 dB(A) during nighttime. Research has reported negative patient outcomes, for example, decreased satisfaction, sleep disturbance, and higher incidence of rehospitalization in patients staying in areas with higher noise levels.