Food intake reported versus nursing records: is there agreement in surgical patients?

OBJECTIVES: To evaluate the agreement between oral feeding by patients and chart records of this acceptance. METHOD: Besides the food intake surveys of surgical patients, the nursing records of nutrition were evaluated. Is was considered good oral feeding: intake ≥ 75% of total calories prescribed at the day; medium acceptance: 50 to 74.9%; low acceptance: < 50% and NPO (nothing per oral). The Kappa coefficient was adopted to assess agreement. RESULTS: There were similar answers between patient and nursing records in 91.3% of NPO situations, 87.1% for good oral feeding, 17.8% for medium acceptance and 16.5% for low acceptance (Kappa = 0.45). CONCLUSION: Agreement between patient's reports and nursing records was moderate to low. A higher proportion of similar answers were observed when the patients related good oral feeding or NPO.

Objetivo: evaluar la concordancia entre la aceptacion de la dieta oral reportada por los pacientes y los registros en prontuario de esta aceptacion. Método: fueron evaluados el consumo de alimentos y los registros de la ingestion en prontuario por las enfermeras. Se considero "buena aceptacion": la ingesta de ≥ 75% de las calorias totales prescritas por dia, "regular aceptacion": de 50 a 74,9%; "baja aceptacion": < 50% y NPO (nada por la boca). Para la evaluacion de la concordancia fue utilizado el coeficiente Kappa. Resultados: la proporcion de respuestas coincidentes entre el relato del paciente y el registro de las enfermeras fue 91,3% en casos de NPO, 87,1% para "buena aceptacion", 17,8% para "regular aceptacion" y 16.5% para "baja aceptacion" (Kappa = 0,45). Conclusión: la concordancia entre los relatos de los pacientes y los registros de las enfermeras fue de moderada a debil. Hubo una mayor proporcion de respuestas coincidentes cuando los pacientes informaron "buena aceptacion" o cuando habia NPO prescrito.

Food intake reported versus nursing records: is there agreement in surgical patients? / ¿Aceptación de la dieta oral reportada por pacientes y los registros de enfermeras: existe acuerdo en pacientes quirúrgicos?

Objectives: to evaluate the agreement between oral feeding by patients and chart records of this acceptance. Method: Besides the food intake surveys of surgical patients, the nursing records of nutrition were evaluated. Is was considered good oral feeding: intake greater than or equal to 75% of total calories prescribed at the day; medium acceptance: 50 to 74.9%; low acceptance: < 50% and NPO (nothing per oral). The Kappa coefficient was adopted to assess agreement. Results: there were similar answers between patient and nursing records in 91.3% of NPO situations, 87.1% for good oral feeding, 17.8% for medium acceptance and 16.5% for low acceptance (Kappa = 0.45). Conclusion: agreement between patient’s reports and nursing records was moderate to low. A higher proportion of similar answers were observed when the patients related good oral feeding or NPO (AU)

Objetivo: evaluar la concordancia entre la aceptación de la dieta oral reportada por los pacientes y los registros en prontuario de esta aceptación. Método: fueron evaluados el consumo de alimentos y los registros de la ingestión en prontuario por las enfermeras. Se consideró'“buena aceptación': la ingesta de más que o igual a 75% de las calorías totales prescritas por día, 'regular aceptación': de 50 a 74,9%; 'baja aceptación': < 50% y NPO (nada por la boca). Para la evaluación de la concordancia fue utilizado el coeficiente Kappa. Resultados: la proporción de respuestas coincidentes entre el relato del paciente y el registro de las enfermeras fue 91,3% en casos de NPO, 87,1% para 'buena aceptación', 17,8% para 'regular aceptación' y 16.5% para 'baja aceptación' (Kappa = 0,45). Conclusión: la concordancia entre los relatos de los pacientes y los registros de las enfermeras fue de moderada a débil. Hubo una mayor proporción de respuestas coincidentes cuando los pacientes informaron 'buena aceptación' o cuando había NPO prescrito (AU)

[Mapping the nursing care with the NIC for patients in risk for pressure ulcer]. / Mapeamento de cuidados de enfermagem com a NIC para pacientes em risco de úlcera por pressão.

OBJECTIVE: To identify the nursing care prescribed for patients in risk for pressure ulcer (PU) and to compare those with the Nursing Interventions Classification (NIC) interventions. METHOD: Cross mapping study conducted in a university hospital. The sample was composed of 219 adult patients hospitalized in clinical and surgical units. The inclusion criteria were: score ≤ 13 in the Braden Scale and one of the nursing diagnoses, Self-Care deficit syndrome, Impaired physical mobility, Impaired tissue integrity, Impaired skin integrity, Risk for impaired skin integrity. The data were collected retrospectively in a nursing prescription system and statistically analyzed by crossed mapping. RESULT: It was identified 32 different nursing cares to prevent PU, mapped in 17 different NIC interventions, within them: Skin surveillance, Pressure ulcer prevention and Positioning. CONCLUSION: The cross mapping showed similarities between the prescribed nursing care and the NIC interventions.

Mapping the nursing care with the NIC for patients in risk for pressure ulcer / Mapeamento de cuidados de enfermagem com a NIC para pacientes em risco de úlcera por pressão / Mapeo de cuidados de enfermería con las nic para pacientes con riesgo de úlceras de presión

Objective:To identify the nursing care prescribed for patients in risk for pressure ulcer (PU) and to compare those with the Nursing Interventions Classification (NIC) interventions. Method: Cross mapping study conducted in a university hospital. The sample was composed of 219 adult patients hospitalized in clinical and surgical units. The inclusion criteria were: score ≤ 13 in the Braden Scale and one of the nursing diagnoses, Self-Care deficit syndrome, Impaired physical mobility, Impaired tissue integrity, Impaired skin integrity, Risk for impaired skin integrity. The data were collected retrospectively in a nursing prescription system and statistically analyzed by crossed mapping. Result: It was identified 32 different nursing cares to prevent PU, mapped in 17 different NIC interventions, within them: Skin surveillance, Pressure ulcer prevention and Positioning. Conclusion: The cross mapping showed similarities between the prescribed nursing care and the NIC interventions.

Objetivo: Identificar los cuidados de enfermería prescritos para pacientes con riesgo de úlceras por presión (UPP) y compararlos con las intervenciones de la Clasificación de Intervenciones de Enfermería(NIC). Método: Estudio con mapeo cruzado en el hospital universitario. La muestra estuvo compuesta por 219 pacientes adultos internados en unidades médico-quirúrgicas. Los criterios de inclusión fueron: puntuación ≤ 13 en la escala de Braden y uno de los siguientes diagnósticos de enfermería: Síndrome de déficit de autocuidado, Deterioro de la movilidad física, deterioro de la integridad tisular, deterioro de la integridad cutánea, riesgo de deterioro de la integridad cutánea. Los datos fueron recolectados retrospectivamente en el sistema de prescripción de enfermería y analizados estadísticamente y con mapeo cruzado. Resultados: Se identificaron 32 cuidados de enfermería distintos para la prevención de las UPP, mapeados en 17 intervenciones NIC diferentes, entre ellas: Supervisión de la piel, Prevención de úlceras por presión y Posiciones corporales. Conclusión: El mapeo cruzado mostró similitud entre los cuidados de enfermería y las intervenciones NIC.

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Objetivo: Identificar os cuidados de enfermagem prescritos para pacientes em risco de úlcera por pressão (UP) e compará-los com as intervenções da Nursing Interventions Classification (NIC). Método: Estudo com mapeamento cruzado realizado em hospital universitário. A amostra constou de 219 pacientes adultos internados em unidades clínicas e cirúrgicas. Os critérios de inclusão foram: escore ≤ 13 na Escala de Braden e um dos diagnósticos de enfermagem, Síndrome do déficit do autocuidado, Mobilidade física prejudicada, Integridade tissular prejudicada, Integridade da pele prejudicada, Risco de integridade da pele prejudicada. Os dados foram coletados retrospectivamente em sistema de prescrição de enfermagem e analisados estatisticamente e por mapeamento cruzado. Resultados: Identificou-se 32 diferentes cuidados de enfermagem para prevenção de UP, mapeados em 17 diferentes intervenções NIC, dentre elas: Supervisão da pele, Prevenção de úlcera por pressão e Posicionamento. Conclusão: O mapeamento cruzado apontou semelhança entre os cuidados de enfermagem prescritos e as intervenções NIC.


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Complicações pulmonares e neurológicas da varicela em adulto jovem previamente hígido / Pulmonary and neurological complications of varicella in a previously healthy young adult

Objetivos: realizar uma breve revisão sobre as complicações da varicela, descrevendo o caso de uma paciente adulta jovem que desenvolveu varicela primária com graves complicações.Descrição do caso: paciente do sexo feminino, 24 anos, com queixas de mialgia, tosse, dispnéia, hipertermia e lesões de pele, interna na emergência de um hospital público após diagnóstico médico de varicela. A paciente desenvolveu pneumonite e, mais tardiamente, encefalomielite disseminada aguda, com necessidade de ventilação mecânica invasiva por tempo prolongado e sintomas temporários do sistema nervoso central.Conclusões: a varicela no adulto é uma doença que merece sempre muita atenção, pela possibilidade de complicações graves associadas.

Aims: To review the literature about the complications of varicella, describing the case of a young adult patient who developed primary varicella and severe complications. Case description: A female patient, 24 years-old, complaining of myalgia, cough, dyspnea, hyperthermia and skin injuries, is admitted at the emergency room of a public hospital after the diagnosis of varicella. The patient developed pneumonitis, and later, acute disseminated encefalomielitis, with invasive mechanical ventilation for a long period, with temporary central nervous system abnormalities. Conclusions: Varicella in the adult is a disease that requires thorough attention, because of the potential associated complications.