Nonpharmacologic Therapies for Postoperative Pain in Cardiac Surgery: A Systematic Review.

OBJECTIVES: To search for studies that address the efficacy of nonpharmacologic methods for pain relief in adults undergoing cardiac surgeries. DESIGN: A systematic review registered in the International Prospective Register of Systematic Reviews (PROSPERO) under number CRD42020168681. DATA SOURCE: PubMed, LILACS, CINAHL, the Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials. REVIEW/ANALYSIS METHODS: The review used a PRISMA guideline that selected primary randomized controlled trials on the efficacy of nonpharmacologic pain relief therapies in patients undergoing cardiac surgery, with no time or language restrictions. The Joanna Briggs Institute Critical Appraisal Checklist for Randomized Clinical Trials was used to assess methodological rigor. RESULTS: After screening, 23 of the 140 studies found in the databases were selected. The studies examined the efficacy of 13 different nonpharmacologic therapies, as well as a combination of therapies, with massage therapy being the most commonly examined, followed by musical intervention and hypnosis. CONCLUSIONS: Some interventions, when combined with pharmacologic therapy, were effective in relieving postoperative pain after cardiac surgeries, according to the studies analyzed. However, most studies had significant methodological flaws, and further studies with high methodological quality are needed.

Safe practices for bed bathing in the intensive care unit: validation of a checklist / Prácticas seguras para baño en el lecho en la unidad de cuidados intensivos: validación de un checklist / Práticas seguras para banho no leito na unidade de terapia intensiva: validação de um checklist

ABSTRACT Objective: To validate a checklist for safe bathing in critically ill patients. Methods: This is a methodological and quantitative study. Researchers developed a checklist for safe bathing in critically ill patients consisting of 41 items, which were submitted to the apparent and content validation process, evaluated by eleven judges, and interobserver reliability. For reliability analysis, the instrument was applied in 54 bed bath procedures in the ICU; Kappa and CHF tests were used. Results: In the apparent and content validation, adjustments were made according to the judges' suggestions. Kappa values ranged from moderate to almost perfect (0.462 to 0.962), and, in some items, there was 100% agreement; the reliability of the instrument was excellent (ICC = 0.962). Conclusion: The instrument proved to be dependable and easy to apply. Its use will contribute to safe bed bathing and subsidize interventions aimed at increasing the quality of care.

RESUMEN Objetivo: Validar lista de verificación para el baño seguro en pacientes críticos. Métodos: Estudio metodológico y cuantitativo. Se elaboró una lista de verificación para baño seguro en paciente crítico compuesta por 41 ítems, que fue sometida al proceso de validación aparente y de contenido, evaluada por 11 jueces, y confiabilidad interobservadores. Para el análisis de confiabilidad, el instrumento fue aplicado en 54 procedimientos de baño en el lecho en UTI; utilizados las pruebas de Kappa e ICC. Resultados: En la validación aparente y de contenido, fueron realizados ayustes conforme sugestiones de los jueces. Los valores de Kappa variaron de moderado a casi perfecto (0,462 a 0,962); y, en algunos ítems, hubo 100% de concordancia; la confiabilidad del instrumento fue excelente (ICC = 0,962). Conclusión: El instrumento se demostró confiable y de fácil aplicación. Su utilización contribuirá para el baño en el lecho seguro y subsidiará intervenciones que objetiven aumentar la calidad asistencial.

RESUMO Objetivo: Validar uma lista de verificação para o banho seguro em pacientes críticos. Métodos: Estudo metodológico e quantitativo. Elaborou-se uma lista de verificação para banho seguro no paciente crítico composta por 41 itens, que foi submetida ao processo de validação aparente e de conteúdo, avaliada por 11 juízes, e confiabilidade interobservadores. Para a análise de confiabilidade, o instrumento foi aplicado em 54 procedimentos de banho no leito em UTI; utilizaram-se os testes de Kappa e ICC. Resultados: Na validação aparente e de conteúdo, foram realizados ajustes conforme sugestões dos juízes. Os valores de Kappa variaram de moderado a quase perfeito (0,462 a 0,962); e, em alguns itens, houve 100% de concordância; a confiabilidade do instrumento foi excelente (ICC = 0,962). Conclusão: O instrumento demonstrou-se confiável e de fácil aplicação. Sua utilização contribuirá para o banho no leito seguro e subsidiará intervenções que visem aumentar a qualidade assistencial.

Safe practices for bed bathing in the intensive care unit: validation of a checklist.

OBJECTIVE: To validate a checklist for safe bathing in critically ill patients. METHODS: This is a methodological and quantitative study. Researchers developed a checklist for safe bathing in critically ill patients consisting of 41 items, which were submitted to the apparent and content validation process, evaluated by eleven judges, and interobserver reliability. For reliability analysis, the instrument was applied in 54 bed bath procedures in the ICU; Kappa and CHF tests were used. RESULTS: In the apparent and content validation, adjustments were made according to the judges' suggestions. Kappa values ranged from moderate to almost perfect (0.462 to 0.962), and, in some items, there was 100% agreement; the reliability of the instrument was excellent (ICC = 0.962). CONCLUSION: The instrument proved to be dependable and easy to apply. Its use will contribute to safe bed bathing and subsidize interventions aimed at increasing the quality of care.

Métodos para vigilância de infecção do sítio cirúrgico pós-alta: revisão integrativa / Post-discharge surveillance methods for infection of the surgical site: integrative review / Post-discharge surveillance methods for infection of the surgical site: integrative review / Métodos para control de infecciones del sitio quirúrgico posterior al alta: revisión integradora

Resumo Objetivo Identificar os métodos utilizados na vigilância de infecção do sítio cirúrgico pós-alta hospitalar. Métodos Revisão integrativa, realizada nas bases de dados PubMed, Cinahl, Lilacs, Embase e Web of Science, com estudos publicados até julho de 2022, utilizando os descritores controlados: Infecção da Ferida Cirúrgica, Vigilância, Alta do Paciente, Controle de Infecções e Profissionais Controladores de Infecções. Foram identificados 2.054 títulos relevantes e destes 17 foram selecionados. Utilizou-se análise descritiva e síntese do conhecimento produzido em cada estudo. Resultados Dos 17 estudos selecionados, dez foram encontrados na base de dados Pubmed, três na Cinahl e Embase e um na Lilacs. Todos foram publicados na língua inglesa e em periódicos internacionais de localidades diversas. Quanto aos métodos de vigilância utilizados para identificar a infecção do sítio cirúrgico após a alta hospitalar nove estudos usaram chamadas telefônicas, seis utilizaram revisão de prontuários, quatro usaram vigilância prospectiva e acompanhamento ambulatorial, e, outros realizaram avaliação clínica, consulta ao banco de dados do seguro de saúde, comunicação virtual, programa de vigilância ativa e tecnologia de smartphone. A maioria (64,7%) dos estudos selecionados utilizaram mais de um método de vigilância. Conclusão Os principais métodos identificados para a vigilância da infecção do sítio cirúrgico pós-alta foram chamadas telefônicas, revisão de prontuários, vigilância prospectiva e acompanhamento ambulatorial, sendo a combinação dos métodos uma estratégia comumente utilizada.

Resumen Objetivo Identificar los métodos utilizados en el control de infecciones del sitio quirúrgico posterior al alta hospitalaria. Métodos Revisión integradora, realizada en las bases de datos PubMed, Cinahl, Lilacs, Embase y Web of Science, con estudios publicados hasta julio de 2022, utilizando los descriptores controlados: Infección de la Herida Quirúrgica, Control, Alta del Paciente, Control de Infecciones y Profesionales Controladores de Infecciones. Se identificaron 2.054 títulos relevantes, de los cuales se seleccionaron 17. Se utilizó un análisis descriptivo y síntesis del conocimiento producido en cada estudio. Resultados De los 17 estudios seleccionados, diez fueron encontrados en la base de datos Pubmed, tres en Cinahl y Embase y uno en Lilacs. Todos fueron publicados en idioma inglés y en periódicos internacionales de distintos lugares. Con relación a los métodos de control utilizados para identificar infecciones del sitio quirúrgico después del alta hospitalaria, nueve estudios usaron llamadas telefónicas, seis utilizaron revisión de historias clínicas, cuatro usaron control prospectivo y seguimiento ambulatorio y otros realizaron evaluación clínica, consulta al banco de datos del seguro médico, comunicación virtual, programa de control activo y tecnología de smartphone. La mayoría (64,7 %) de los estudios seleccionados utilizó más de un método de control. Conclusión Los principales métodos identificados para el control de infecciones del sitio quirúrgico posterior al alta fueron llamadas telefónicas, revisión de historias clínicas, control prospectivo y seguimiento ambulatorio, y la combinación de los métodos fue una estrategia comúnmente utilizada.

Abstract Objective To identify post hospital discharge surveillance methods used in infection of the surgical wound. Methods Integrative review carried out in the PubMed, Cinahl, Lilacs, Embase, and Web of Science databases with studies published until July 2022, using controlled descriptors: Surgical Wound Infection, Surveillance, Patient Discharge, Infections Control, and Infection Control Practitioners. We identified 2,054 relevant records, and from that, we selected 17 studies. We used descriptive analysis and knowledge synthesis in each study. Results From the 17 selected studies, we found ten in the Pubmed database, three from Cinahl and Embase, and one from Lilacs. All of them published in English and international journals from different locations. Regarding the surveillance methods used to identify infection in the surgical wound post-hospital discharge, nine studies used telephone calls, six used medical records, four used prospective surveillance and outpatient follow-up, and others carried out a clinical evaluation, consultation of the health insurance database, virtual communication, active surveillance program, and smartphone technology. The majority (64.7%) of the selected studies used more than one surveillance method. Conclusion The main methods identified for infection surveillance of the surgical wound post-discharge were telephone calls, review of medical records, prospective surveillance, and outpatient follow-up, being the combination of methods a commonly used strategy.

Complications after percutaneous transluminal coronary angioplasty and associated factors

This study aimed to analyze the incidence of vascular complications and associated factors in patients undergoing elective percutaneous transluminal coronary angioplasty. This study is observational, quantitative, and longitudinal, and followed 50 patients undergoing elective percutaneous transluminal coronary angioplasty. An instrument for the sociodemographic, clinical, procedure, and vascular complications characterization was used for data collection. And descriptive statistics, bivariate analysis, and multiple binomial logistic regression were used for data analysis. The level of statistical significance considered was 95%. It was detected the prevalence of male patients (70%), elderly (54%), and diagnosed with systemic arterial hypertension (72%). As for the percutaneous access route prevailed the radial approach (64%). Age and body mass index were identified as possible risk factors for vascular complications. In the 50 procedures performed, there was a prevalence of hematomas (20%) and bleeding (10%). Among the complications prevailed radial Early Discharge After Transradial Stenting of Coronary (60%), large femoral hematoma (20%), small femoral hematoma (20%), and bleeding (Bleeding Academic Research Consortium 2) (100%). The results concluded an elevated incidence of vascular complications in the first 24 hours after elective percutaneous transluminal coronary angioplasty. This study contributes to research, assistance, and training in health and nursing by identifying post-PTCA vascular complications, minimizing their progression, handling their management, and developing health care safety protocols.

Efficacy of educational strategies in patient involvement for safety in care: a systematic review.

OBJECTIVE: To evaluate the effectiveness of educational strategies in the involvement of hospitalized adult patient for safety in care. METHOD: Systematic review carried out by searching for experimental and quasi-experimental studies, published from January/2010 to December/2021, in PubMed®, Cochrane Library CENTRAL, Scopus, Web of Science, LILACS, CINAHL and EMBASE. RESULTS: Twelve studies were included to involve the patient in safe care practices, five (41.7%) experimental and seven (58.3%) quasi-experimental. Different educational strategies were adopted in the articles included: verbal guidance, books, leaflets and folders (n=4; 33.3%); videos, e-books and electronic applications (n=5; 41.7%); poster, leaflets and video (n=3; 25%). Four experimental studies had a high risk of bias (80%) and all quasi-experimental studies had a low risk of bias (100%). CONCLUSION: The use of educational strategies proved to be effective in involving the patient in safe care practices. Considering the heterogeneity between studies, it is recommended carrying out future research.

Validation of a patient safety checklist for radiological procedures in hemodynamics.

OBJECTIVES: to carry out cultural adaptation and validation of WHO Surgical Safety Checklist: for Radiological Interventions ONLY to Brazilian Portuguese. METHODS: a methodological research with the following stages of the cultural adaptation process: translation of the instrument, achievement of a consensus in Portuguese, evaluation by a committee of judges, back-translation, achievement of a consensus in English, comparison with the original version, and a pre-test. The psychometric properties of the adapted version were evaluated through interobserver reliability. RESULTS: the values of the kappa coefficient ranged from moderate to almost perfect in most instrument items, demonstrating that the instrument items were understandable and reliable when applied to the observed context. CONCLUSIONS: the cultural adaptation and validation of face and content of the instrument met the criteria of equivalence between the original and the translated instrument. The tool proved to be understandable and feasible and can be applied in invasive radiological procedures in Brazil.

Effect of listening to music on anxiety, pain, and cardiorespiratory parameters in cardiac surgery: study protocol for a randomized clinical trial.

BACKGROUND: Preoperative anxiety and postoperative pain are frequent in cardiac surgeries and constitute important stressors for patients, which can cause several complications. One strategy that aims to alleviate these phenomena is listening to music as a non-pharmacological intervention. The aim of this study is to evaluate the effect of listening to music on preoperative state-anxiety, postoperative pain, at rest and when instructed to cough, and cardiorespiratory parameters in patients undergoing cardiac surgery. METHODS: A randomized, parallel, simple masking clinical trial will be conducted with patients 18 years of age or older who have undergone elective cardiac surgery by sternotomy, who agree to participate in the research and sign a free and informed consent form. Study participants will be randomly divided, in a 1:1 ratio, to one of the two groups: experimental (subjected to listening to music for 20 min in the pre- and postoperative period) or control (standard care in the pre- and postoperative period), using a randomization scheme generated by the Randomization.com website. The sample size calculation was obtained after conducting a pilot study. DISCUSSION: The results of the study may contribute to the implementation of non-pharmacological interventions in health services, highlighting the protocols for listening to music, to minimize anxiety and pain in cardiac surgery. TRIAL REGISTRATION: ReBEC RBR-8mdyhd . Posted on December 10, 2019.

Validation of a patient safety checklist for radiological procedures in hemodynamics / Validación de una lista de verificación de seguridad del paciente para procedimientos radiológicos en hemodinámica / Validação de um checklist de segurança do paciente para procedimentos radiológicos em hemodinâmica

ABSTRACT Objectives: to carry out cultural adaptation and validation of WHO Surgical Safety Checklist: for Radiological Interventions ONLY to Brazilian Portuguese. Methods: a methodological research with the following stages of the cultural adaptation process: translation of the instrument, achievement of a consensus in Portuguese, evaluation by a committee of judges, back-translation, achievement of a consensus in English, comparison with the original version, and a pre-test. The psychometric properties of the adapted version were evaluated through interobserver reliability. Results: the values of the kappa coefficient ranged from moderate to almost perfect in most instrument items, demonstrating that the instrument items were understandable and reliable when applied to the observed context. Conclusions: the cultural adaptation and validation of face and content of the instrument met the criteria of equivalence between the original and the translated instrument. The tool proved to be understandable and feasible and can be applied in invasive radiological procedures in Brazil.

RESUMEN Objetivos: realizar adaptación cultural y validación del WHO Surgical Safety Checklist: for Radiological Interventions ONLY al portugués brasileño. Métodos: investigación metodológica cuyo proceso de adaptación cultural recorrió las siguientes etapas: traducción del instrumento, obtención del consenso en portugués, evaluación por comité de jueces, retrotraducción, obtención del consenso en inglés, comparación con la versión original y pretest. Las propriedades psicométricas de la versión adaptada fueron evaluadas por medio de confiabilidad interobservadores. Resultados: los valores del coeficiente Kappa variaron de moderado a casi perfecto en la mayoría de los ítems del instrumento, demostrando que los ítems del instrumento fueron comprensibles y confiables cuando aplicados al contexto observado. Conclusiones: la adaptación cultural y la validación de Face y contenido del instrumento satisficieron los criterios de equivalencia entre el instrumento original y el traducido. El instrumento se mostró comprensible y viable, pudiendo ser aplicado en procedimientos radiológicos invasivos en Brasil.

RESUMO Objetivos: realizar adaptação cultural e validação do WHO Surgical Safety Checklist: for Radiological Interventions ONLY para o português brasileiro. Métodos: pesquisa metodológica cujo processo de adaptação cultural percorreu as seguintes etapas: tradução do instrumento, obtenção do consenso em português, avaliação por comitê de juízes, retrotradução, obtenção do consenso em inglês, comparação com a versão original e pré-teste. As propriedades psicométricas da versão adaptada foram avaliadas por meio de confiabilidade interobservadores. Resultados: os valores do coeficiente Kappa variaram de moderado a quase perfeito na maioria dos itens do instrumento, demonstrando que os itens do instrumento foram compreensíveis e confiáveis quando aplicados ao contexto observado. Conclusões: a adaptação cultural e a validação de face e conteúdo do instrumento satisfizeram os critérios de equivalência entre o instrumento original e o traduzido. O instrumento mostrou-se compreensível e viável, podendo ser aplicado em procedimentos radiológicos invasivos no Brasil.

Efficacy of educational strategies in patient involvement for safety in care: a systematic review / Eficacia de las estrategias educativas en la participación del paciente para la seguridad em la atención: una revisión sistemática / Eficácia de estratégias educativas no envolvimento do paciente para a segurança no cuidado: revisão sistemática

ABSTRACT Objective To evaluate the effectiveness of educational strategies in the involvement of hospitalized adult patient for safety in care. Method Systematic review carried out by searching for experimental and quasi-experimental studies, published from January/2010 to December/2021, in PubMed®, Cochrane Library CENTRAL, Scopus, Web of Science, LILACS, CINAHL and EMBASE. Results Twelve studies were included to involve the patient in safe care practices, five (41.7%) experimental and seven (58.3%) quasi-experimental. Different educational strategies were adopted in the articles included: verbal guidance, books, leaflets and folders (n=4; 33.3%); videos, e-books and electronic applications (n=5; 41.7%); poster, leaflets and video (n=3; 25%). Four experimental studies had a high risk of bias (80%) and all quasi-experimental studies had a low risk of bias (100%). Conclusion The use of educational strategies proved to be effective in involving the patient in safe care practices. Considering the heterogeneity between studies, it is recommended carrying out future research.

RESUMEN Objetivo Evaluar la efectividad de estrategias educativas en la participación de paciente adulto hospitalizado para la seguridad en el cuidado. Método Revisión sistemática realizada mediante la búsqueda de estudios experimentales y cuasiexperimentales publicados entre enero/2010 y diciembre/2021, en PubMed®, Cochrane Library CENTRAL, Scopus, Web of Science, LILACS, CINAHL y EMBASE. Resultados Se incluyeron doce estudios para involucrar al paciente en prácticas de cuidado seguras, cinco (41,7%) experimentales y siete (58,3%) cuasi experimentales. Se adoptaron diferentes estrategias educativas en los artículos incluidas: guías verbales, cuadernillos, trípticos y carpetas (n=4; 33,3%); vídeos, e-books y aplicaciones electrónicas (n=5; 41,7%); cartel, folletos y video (n=3; 25%). Cuatro estudios experimentales tenían un alto riesgo de sesgo (80 %) y todos los estudios cuasiexperimentales tenían un bajo riesgo de sesgo (100 %). Conclusión: El uso de estrategias educativas demostró ser efectivo para involucrar al paciente en prácticas de cuidado seguras. Se recomienda investigación adicional al considerar la heterogeneidad entre los estudios.

RESUMO Objetivo Avaliar a eficácia de estratégias educativas no envolvimento do paciente adulto hospitalizado para a segurança no cuidado. Método Revisão sistemática realizada por meio da busca de estudos experimentais e quase-experimentais, publicados de janeiro/2010 a dezembro/2021, no PubMed®, Cochrane Library CENTRAL, Scopus, Web of Science, LILACS, CINAHL e EMBASE. Resultados Foram incluídos doze estudos para envolver o paciente nas práticas seguras do cuidado, cinco (41,7%) experimentais e sete (58,3%) quase experimentais. Diferentes estratégias educativas foram adotadas nos artigos incluídos: orientações verbais, livretos, folhetos e folders (n=4; 33,3%); vídeos, e-book e aplicativos eletrônicos (n=5; 41,7%); pôster, folhetos e vídeo (n=3; 25%). Quatro estudos experimentais apresentaram alto risco de viés (80%) e todos quase-experimentais baixo risco de viés (100%). Conclusão O uso de estratégias educativas se demonstrou eficaz no envolvimento do paciente em práticas seguras do cuidado. Recomenda-se a condução de futuras pesquisas ao se considerar a heterogeneidade entre os estudos.

Prevention of medical adhesive-related skin injury during patient care: A scoping review.

Background: : Medical adhesive-related skin injury can occur during health care. Professionals must adopt preventive measures to maintain the integrity of the skin and patient comfort and safety. Objective: : To map the existing scientific evidence on preventing medical adhesive-related skin injury in adults. Design: : Scoping Review. Methods: : Searches were conducted in PubMed/Medline, Cochrane Library, Embase®, Latin American and Caribbean Literature in Health Sciences, Cumulative Index for Nursing and Allied Health Literature, and Google Scholar, without period delimitation. Duplicate studies and those that didn´t answer the research question were excluded. Results: : Of the 209 studies identified in the search process, 30 made up the final sample. The prevention of injury by adhesives mainly involves identifying risk factors, proper adhesive selection, and correct application and removal. Health education and medical records about injuries related to medical adhesives are essential. Conclusions: : The prevention of medical adhesive-related skin injury should be done by adopting multifactorial measures, which range from identifying risk factors and correct handling of adhesives to the process of educating professionals, patients and communities about these injuries. Registration: : The research was registered on the Open Science Framework DOI 10.17605/OSF.IO/NSWP8.

Barriers to research utilization influencing patient safety climate: A cross-sectional study.

AIMS: This study aimed to investigate the influence of barriers to the use of research results in the practice of nurses on patient safety perception. BACKGROUND: The use of research results in clinical practice promotes safe care, increases quality and reduces the possibility of adverse events. DESIGN: This is a cross-sectional study. METHODS: The sample consisted of 207 nurses from three public university hospitals in the state of Minas Gerais, Brazil from March 2017 to November 2018. They answered a questionnaire with professional characteristics, The Barriers Scale and Safety Attitudes Questionnaire. Descriptive analysis, Student's t test, Pearson correlation and multiple linear regression were used for data analysis. RESULTS: The findings showed most nurses had unfavourable competencies for implementing research results in practice. As barrier scores for the use of research results in practice increase, safety climate scores decrease. Taking a training course on the use of research results in clinical practice and organization characteristics, limitations of the setting were statistically significant, constituting factors that influence the perception of the safety climate. CONCLUSION: Investments in education are needed for health professionals to be aware of evidence-based practice and how to use evidence to impact decision-making outcomes, strengthening safety outcomes in health services.

Effectiveness of the serious game for learning in nursing: systematic review.

OBJECTIVE: To identify the effectiveness of the serious game in improving learning outcomes compared to the different teaching strategies used in the education of nursing students. METHOD: Systematic review, conducted from July 2019 to May 2020, at PubMed®, Scopus, CINAHL, Web of Science and LILACS. Studies of experimental and quasi-experimental design were included, with no delimitation of time frame, aimed at nursing students, who approached the use of the serious game as the main teaching strategy compared with other pedagogical methods. RESULTS: Six articles were included, which compared the serious game with traditional and active teaching and learning strategies (expository class, text reading and simulation). The studies were considered of moderate quality, with an average score of 12.83. Nursing students submitted to the serious game showed better learning results. CONCLUSION: The serious game proved to be more effective for learning in nursing when compared to other teaching strategies.

Assessment of patient safety in vaccination rooms / Evaluación de la seguridad del paciente en la sala de vacunación / Avaliação da segurança do paciente na sala de vacinação

ABSTRACT Objective: identify adherence to patient safety recommendations in the vaccination room. Method: this is a cross-sectional study that analyzed 463 vaccination procedures in six vaccination rooms in Minas Gerais from June to July 2018. Data were obtained with the application of the Patient Safety Checklist for Vaccination Rooms through systematic observation of the vaccination procedure. Descriptive statistics were used for data analysis. Results: 463 vaccination procedures were observed, and the mean overall adherence score was 58.5%, min. 43.3% and max. 74.1%. The items of higher adherence were related to the records of vaccine data (name, date, and batch) on the vaccination card; vaccine application with dose, route of administration, location and correct materials; and records in an information system. The items of lower adherence were related to health guidance; investigation of adverse events following immunization and the health status of the vaccinated person; records of vaccine laboratory and vaccination center on the vaccination card; vaccine workforce handwashing; and proper vaccine preparation. Conclusion: the mean overall score found in this study was 58.5% for the adherence to recommendations for vaccination procedures. This result highlights the need for educational interventions that promote patient safety in the vaccination room and studies analyzing the factors that prevent such adherence.

RESUMEN Objetivo: identificar la adhesión a las recomendaciones de seguridad del paciente en sala de vacunación. Método: estudio seccional realizado sobre 463 procedimientos de vacunación en seis salas de vacunación de Minas Gerais entre junio y julio de 2018. Datos obtenidos por aplicación de Lista de Verificación de Seguridad del Paciente en Sala de Vacunación, mediante observación sistemática del procedimiento de vacunación. Se utilizó estadística descriptiva para analizar los datos. Resultados: fueron observados 463 procedimientos de vacunación. El puntaje general promedio de adhesión fue del 58,5%, mínimo de 43,3% y máximo de 74,1%. Los ítems con mayor adhesión fueron los referentes al registro en la libreta de vacunación, con datos de la vacuna (nombre, fecha y lote); aplicación de vacuna con dosaje, vía de administración, lugar y materiales adecuados y registro en sistema de información. Los ítems de menor adhesión estuvieron relacionados con la orientación en salud: investigación de eventos adversos posteriores a la vacunación y estado de salud del vacunado; registro en libreta de vacunación del laboratorio productor de la vacuna y de la unidad de vacunación; higiene de las manos de los profesionales y correcta preparación de la vacuna. Conclusión: se evidenció puntaje promedio de 58.5% de adhesión a las recomendaciones de procedimientos de vacunación, resultando necesarias intervenciones educativas promotoras de la seguridad del paciente en la sala de vacunación respecto de los factores que dificultan la adhesión.

RESUMO Objetivo: identificar a adesão às recomendações de segurança do paciente, em sala de vacinação. Método: estudo seccional realizado com 463 procedimentos de vacinação, em seis salas de vacinação de Minas Gerais, no período de junho e julho de 2018. Os dados foram obtidos pela aplicação da Lista de Verificação de Segurança do Paciente em Sala de Vacina, por meio de observação sistemática do procedimento de vacinação. Estatística descritiva foi utilizada para análise de dados. Resultados: foram observados 463 procedimentos de vacinação, e o escore geral médio de adesão foi de 58,5%, mínimo de 43,3% e máximo de 74,1%. Os itens de maior adesão foram referentes ao registro no cartão de vacinas com dados da vacina (nome, data e lote); aplicação da vacina com dosagem, via de administração, local e materiais corretos e registro em sistema de informação. Os itens de menor adesão estavam relacionados à orientação em saúde; à investigação de eventos adversos pós-vacinais e do estado de saúde da pessoa vacinada; ao registro no cartão de vacinas quanto ao laboratório da vacina e da unidade vacinadora; à higienização das mãos dos profissionais e ao preparo da vacina de maneira correta. Conclusão: evidenciou-se escore médio de 58,5% de adesão às recomendações dos procedimentos de vacinação, assim, tornam-se necessárias intervenções educativas que promovam a segurança do paciente, na sala de vacinas, e investigações quanto aos fatores que dificultam a adesão.

Lesão por pressão decorrente do posicionamento cirúrgico e fatores associados / Úlcera por presión resultante de posicionamiento quirúrgico y factores asociados / Pressure injury related to surgical positioning and associated factors

Resumo Objetivo: Analisar a ocorrência de lesão por pressão decorrente do posicionamento cirúrgico e os fatores associados. Método: Estudo observacional, longitudinal, realizado com 239 pacientes submetidos à cirurgia eletiva. Para coleta de dados, utilizou-se instrumento de caracterização sociodemográfica e clínica e Escala de Avaliação de Risco para o Desenvolvimento de Lesões Decorrentes do Posicionamento Cirúrgico. Para a análise dos dados empregou-se estatística descritiva e regressão logística binominal múltipla e o nível de significância considerado foi α = 0,05. Resultados: A maioria dos pacientes era do sexo masculino, branco e adultos. A ocorrência de lesão por pressão decorrente do posicionamento cirúrgico foi de 37,7%, sendo que 81 (90,0%) pacientes apresentaram lesão por pressão estágio 1 e os locais mais frequentes de ocorrência deste tipo de lesão foram a região sacral (19; 13,9%) e calcâneos direito (16; 11,7%) e esquerdo (13; 9,5%). A idade (adulto) e o risco maior conforme escore da Escala de Avaliação de Risco para o Desenvolvimento de Lesões Decorrentes do Posicionamento Cirúrgico foram preditores para a ocorrência de lesão por pressão. Conclusão: A elevada ocorrência e os fatores associados (idade e risco maior na escala aplicada) para lesão por pressão decorrente do posicionamento cirúrgico foram resultados evidenciados que podem auxiliar na compreensão da problemática no cenário nacional, e para a implementação de intervenções com o propósito de reduzir o risco do paciente de ser acometido por este tipo de lesão no perioperatório.

Resumen Objetivo: Analizar la incidencia de úlcera por presión resultante del posicionamiento quirúrgico y los factores asociados. Métodos: Estudio observacional, longitudinal, realizado con 239 pacientes sometidos a cirugía electiva. Para la recolección de datos, se utilizó un instrumento de caracterización sociodemográfica y clínica y la Escala de Evaluación de Riesgo para la Aparición de Úlceras Resultantes del Posicionamiento Quirúrgico. Para el análisis de datos se usó estadística descriptiva y regresión logística binominal múltiple y el nivel de significación considerado fue α = 0,05. Resultados: La mayoría de los pacientes era de sexo masculino, blanco y adulto. La incidencia de úlcera por presión resultante del posicionamiento quirúrgico fue del 37,7 %, en el que 81 (90,0 %) pacientes presentaron úlcera por presión de estado 1 y los lugares más frecuentes de incidencia de este tipo de lesión fueron la región sacra (19; 13,9 %) y calcáneo derecho (16; 11,7 %) e izquierdo (13; 9,5 %). La edad (adulto) y el riesgo mayor, según la puntuación de la Escala de Evaluación de Riesgo para la Aparición de Úlceras Resultantes del Posicionamiento Quirúrgico, fueron predictores de los casos de úlcera por presión. Conclusión: La elevada incidencia y los factores asociados (edad y riesgo mayor en la escala aplicada) de úlceras por presión resultantes del posicionamiento quirúrgico fueron resultados evidenciados que pueden ayudar a comprender la problemática en el escenario nacional y a implementar intervenciones con el objetivo de reducir el riesgo de que el paciente presente este tipo de úlcera en el perioperatorio.

Abstract Objective: To analyze the occurrence of pressure injury resulting from surgical positioning and the associated factors. Method: An observational and longitudinal study, involving 239 patients undergoing elective surgery. Data collection was performed using an instrument for sociodemographic and clinical characteristics, and a risk assessment scale for the development of injuries due to surgical positioning. Descriptive statistics and multiple binominal logistic regression were used for data analysis, and the level of significance considered was α = 0.05. Results: Most of the patients were adult male Caucasians. The occurrence of pressure injury resulting from surgical positioning was 37.7%, and 81 (90.0%) patients developed stage 1 pressure injury, and the most frequent sites were sacral (19; 13.9%), and right (16; 11.7%) and left (13; 9.5%) calcaneus regions. Age (adult) and those identified at higher risk according to the Risk Assessment Scale for the Development of Injuries due to Surgical Positioning (ELPO) were predictors for occurrence of pressure injury. Conclusion: The high incidence and associated factors (age and higher risk on the administered scale) for pressure injuries resulting from surgical positioning provide results to help understand the problem within the national scenario, and to implement interventions to reduce the patient's risk of being affected by this type of injury in the perioperative period.

Efeitos da música na ansiedade de doadores de sangue: ensaio clínico randomizado / Efectos de la música en la ansiedad de donantes de sangre: ensayo clínico aleatorizado / Effects of music on the anxiety of blood donors: randomized clinical trial

Resumo Objetivo: Avaliar os efeitos da música sobre a ansiedade-estado, parâmetros fisiológicos e laboratoriais, em doadores de sangue. Métodos: Ensaio clínico randomizado, duplo-cego, realizado em um Hemocentro Regional, localizado no interior de Minas Gerais. Participaram do estudo 126 doadores de sangue, divididos aleatoriamente em dois grupos, sendo grupo experimental (intervenção musical antes da doação de sangue) e grupo controle (rotina padrão). Utilizou-se para a avaliação dos escores de ansiedade-estado, o Inventário de Ansiedade Traço-Estado (IDATE). A intervenção musical constitui-se de um repertório de músicas eruditas aplicadas através de fones de ouvidos, por aproximadamente 26 minutos. Para as variáveis quantitativas empregou-se análises descritivas, para análise das diferenças entre os escores de ansiedade-estado, frequência cardíaca e respiratória, utilizou-se Teste t Student e, Teste não paramétrico de Mann-Whitney para avaliar a diferença entre os valores de pressão arterial, saturação de oxigênio e níveis de cortisol. Resultados: O grupo submetido à intervenção musical não apresentou redução estatisticamente significativa dos escores de ansiedade-estado (p=0,31). Entretanto, observou-se reduções significativas na frequência cardíaca (p=0,006), frequência respiratória (p=0,007) e níveis de cortisol sanguíneo (p<0,001). Conclusão: A música não reduziu os níveis de ansiedade-estado. Contudo, foi possível demonstrar a eficácia da intervenção na redução de parâmetros fisiológicos e laboratoriais, os quais apresentam-se alterados frente a situações ansiogênicas.

Resumen Objetivo: Analizar los efectos de la música sobre la ansiedad-estado, parámetros fisiológicos y de laboratorio en donantes de sangre. Métodos: Ensayo clínico aleatorizado, doble ciego, realizado en un centro de donación de sangre regional, ubicado en el interior del estado de Minas Gerais. Participaron en el estudio 126 donantes de sangre, divididos aleatoriamente en dos grupos: un grupo experimental (intervención musical antes de la donación de sangre) y un grupo de control (rutina normal). Para analizar la puntuación de la ansiedad-estado, se utilizó el Cuestionario de Ansiedad Estado Rasgo (IDATE). La intervención musical estaba compuesta por un repertorio de música erudita aplicada con auriculares, durante 26 minutos aproximadamente. Para las variables cuantitativas, se emplearon análisis descriptivos. Se utilizó el test-T Student para analizar las diferencias entre la puntuación de la ansiedad-estado, la frecuencia cardíaca y respiratoria y la prueba no paramétrica de Mann-Whitney para analizar la diferencia entre los valores de presión arterial, saturación de oxígeno y niveles de cortisol. Resultados: El grupo sometido a la intervención musical no presentó reducción estadísticamente significativa en la puntuación de la ansiedad-estado (p=0,31). Sin embargo, se observaron reducciones significativas en la frecuencia cardíaca (p=0,006), frecuencia respiratoria (p=0,007) y niveles de cortisol sanguíneo (p<0,001). Conclusión: La música no redujo los niveles de ansiedad-estado. No obstante, fue posible demostrar la eficacia de la intervención para la reducción de parámetros fisiológicos y de laboratorio, que se presentan alterados ante situaciones ansiógenas.

Abstract Objective: To evaluate the effects of music on state-anxiety, physiological and laboratory parameters in blood donors. Methods: Randomized, double-blinded clinical trial, conducted in a regional blood bank, located in the interior of the state of Minas Gerais, Brazil. In total, 126 blood donors participated in the study, randomly divided into two groups, being one experimental group (musical intervention before blood donation) and one control group (standard routine). To assess the state-anxiety scores, the State-Trait Anxiety Inventory (STAI) was used. The musical intervention consists of a repertoire of classical songs played through headphones, lasting approximately 26 minutes. For the quantitative variables, descriptive analyses were used to analyze the differences between state-anxiety, heart rate and respiratory rate, Student's t- test and Mann-Whitney's nonparametric test to evaluate the difference between blood pressure, oxygen saturation and cortisol levels. Results: The group submitted to musical intervention did not present a statistically significant reduction in state-anxiety scores (p = 0.31). Nevertheless, significant reductions in heart rate (p=0.006), respiratory rate (p=0.007) and blood cortisol levels (p<0.001) were observed. Conclusion: Music did not reduce the state-anxiety levels. We were able to demonstrate the effectiveness of the intervention in reducing physiological and laboratory parameters though, which are altered in the face of anxiogenic situations.

Factors associated with skin and mucosal lesions caused by medical devices in newborns: Observational study.

AIM AND OBJECTIVE: To identify the occurrence of skin and mucosal lesions and factors related to the use of medical devices in newborns admitted to a neonatal intensive care unit. BACKGROUND: The use of medical devices increases the risk of injury in newborns due to the immaturity and fragility of their skin and mucosa. DESIGN: Observational and longitudinal study. METHODS: The study included 85 newborns admitted to in a neonatal intensive care unit from a public teaching hospital. Data were collected from February-August 2018. For the evaluation, the Neonatal Skin Condition Score was used, as well as an instrument covering sociodemographic and clinical variables, medical devices in use and materials for skin protection. The study followed the recommendations STROBE. Simple frequency, measures of central tendency and variability, Pearson's correlation coefficient and multiple linear regression analysis were used for data analysis. RESULTS: Of the n = 85 newborns evaluated, n = 62 (72.9%) presented skin or mucosal lesions caused using medical devices, excoriations being the most observed n = 55 (64.7%), and n = 32 (37.6%) had 1-3 lesions. As the number of devices increased, so did the number of lesions. On the other hand, the age of the newborn and the number of lesions were inversely proportional. CONCLUSION: Most participants, n = 62 (72.9%), had skin or mucosal lesions associated with medical devices. The number of medical devices used and the age of the newborn were predictors for this occurrence. RELEVANCE TO CLINICAL PRACTICE: The results show that it is fundamental that nurses know the factors that can interfere in the skin and mucosa conditions and, thus, promote the implementation of injury prevention measures in newborns, supporting safe and quality care.

Risk assessment for perioperative pressure injuries.

OBJECTIVES: to evaluate and classify patients according to the Risk Assessment Scale for Perioperative Pressure Injuries; verify the association between sociodemographic and clinical variables and the risk score; and identify the occurrence of pressure injuries due to surgical positioning. METHOD: observational, longitudinal, prospective and quantitative study carried out in a teaching hospital with 278 patients submitted to elective surgeries. A sociodemographic and clinical characterization questionnaire and the Risk Assessment Scale for Perioperative Pressure Injuries were used. Descriptive, bivariate and logistic regression analyses were applied. RESULTS: the majority of patients (56.5%) presented a high risk for perioperative pressure injury. Female sex, elderly group, and altered body mass index values were statistically significant (p < 0.05) for a higher risk of pressure injuries. In 77% of the patients, there were perioperative pressure injuries. CONCLUSION: most of the participants presented a high risk for development of perioperative decubitus ulcers. The female sex, elderly group, and altered body mass index were significant factors for increased risk. The Risk Assessment Scale for Perioperative Pressure Injuries allows the early identification of risk of injury, subsidizing the adoption of preventive strategies to ensure the quality of perioperative care.

Caracterização dos casos de óbito acidental de crianças por aspiração de corpos estranhos em Minas Gerais / Characterization of children accidental death cases by aspiration of foreign bodies in Minas Gerais / Caracterización de los casos de muerte accidental infantil por aspiración de cuerpos extraños en Minas Gerais

OBJETIVO: caracterizar os casos de óbitos decorrentes de asfixia acidental por sufocação em crianças. MÉTODO: estudo descritivo e retrospectivo de dados secundários no qual procedeu-se à análise dos dados dos óbitos de crianças menores de um ano e de um a quatro anos ocorridos no estado de Minas Gerais e notificados no banco de dados do Sistema Único de Saúde, no período de 2005 a 2015. Foram identificados 233 casos de óbitos por asfixia. Entre as vítimas prevaleceram o sexo masculino (131, 56,2%), a raça/cor branca (118, 50,6%), sendo em maior proporção nas crianças menores de um ano (175, 75,1%). Os diagnósticos mais frequentes foram inalação e ingestão de alimentos, causando obstrução do trato respiratório (155, 66,5%), em menores de um ano e de um a quatro anos. RESULTADOS: foram notificados, em média, 14,6 casos por ano com grande oscilação no período estudado, sendo que no ano de 2002 houve maior número de óbitos (21, 9,0%) e em 2006 apresentou-se o menor número de casos (7, 3%). CONCLUSÃO: destaca-se a importância da implementação de medidas preventivas e educativas, com vistas a reduzir o evento, as lesões e as sequelas decorrentes.(AU)

Objective: to characterize the cases of deaths due to accidental asphyxia by suffocation in children. Method: a descriptive and retrospective study of secondary data of death certificates of children, from 2005 to 2015, including those under one year old and those from one to four years old, in the state of Minas Gerais, that were reported in the Unified Health System database. The study identified 233 cases of death from asphyxia. Among the victims, the male sex (131, 56.2%), white race/skin color (118, 50.6%), and children under one year (175, 75.1%) were the most common. The most frequent diagnoses were inhalation and food intake, causing respiratory obstruction (155, 66.5%) in children under one year and from one to four years old. Results: an average of 14.6 cases per year were reported, with great variation, during the study period. The year 2002 had the highest number of deaths (21, 9.0%) and 2006, the lowest (7, 3%). Conclusion: the importance of the implementation of preventive and educational measures to reduce this occurrences, its injuries and sequelae, is highlighted. (AU)

Objetivo: caracterizar los casos de muerte por asfixia accidental en niños. Método: estudio descriptivo y retrospectivo de datos secundarios en el que se analizaron datos de la muerte de niños menores de un año y de uno a cuatro años en el estado de Minas Gerais informados en la base de datos del Sistema Únicode Salud de 2005 a 2015. Se identificaron 233 casos de muerte por asfixia. Entre las víctimas había más varones (131; 56,2%), de tez blanca (118; 50,6%), y en una proporción mayor entre los niños menores de un año (175; 75,1%). Los diagnósticos más frecuentes fueron inhalación e ingesta de alimentos, causando obstrucción del tracto respiratorio (155; 66.5%) en niños menores de un año y de uno a cuatro años. Resultados: en promedio, se informaron 14,6 casos por año con gran oscilación durante el período de estudio; en 2002 hubo más cantidad de muertes (21; 9,0%) y en 2006 menos muertes (7; 3%). Conclusión: se realza la importancia de la implementación de medidas preventivas y educativas para reducir los eventos, lesiones y secuelas. (AU)

Relaxation Therapy with Guided Imagery for Postoperative Pain Management: An Integrative Review.

OBJECTIVE: To identify the evidence in the literature about relaxation therapy with guided imagery for postoperative pain management. METHOD: Integrative review. DATA SOURCE: PubMed, Lilacs, Cochrane, Embase, Web of Science, Scopus and Cinahl, between August 2006 and December 2016. Descriptors: Postoperative Pain, Imagery (Psychotherapy) and Guided Imagery. STUDY SELECTION: original studies published in English, Spanish and Portuguese. 291 studies were identified and eight were selected. Descriptive data analysis, presented in detail, with a summary of the knowledge produced in each study. RESULTS: In the primary studies included, the use of guided imagery associated with other complementary therapies was highlighted: hand and foot "M" technique, education on postoperative pain management with analgesic drugs, relaxation exercises, respiration exercises, meditation, soothing biorhythmic music combined with positive and encouraging assertions and music with nature sounds. CONCLUSIONS: The knowledge synthesis resulting from this study indicates that evidence could be identified on the use of guided imagery associated with relaxation therapy as a complementary approach to drug analgesia in postoperative pain control strengthens its indication for nursing practice. This evidence, however, demonstrates that the quality of the use of this therapy is limited, and it is necessary to carry out new randomized clinical studies to fill the existing gaps in this topic.