RESUMO
BACKGROUND: To date, there are no tools for the nursing staff to gain systematic insight on the experience lived by patients with chronic heart failure. The objective of this study was to develop a scale for this purpose. METHODS: The study was conducted between January 2018 and December 2020 in three Spanish hospitals. The process described by DeVellis was used for the development of the scale. The items were built based on a phenomenological study and a systematic review of the literature. Next, feedback from a panel of experts was obtained, the scale was administered to a sample of patients with chronic heart failure, and a cognitive interview and an observational study were conducted to create the final version of the scale. RESULTS: The first version of the scale had in seven domains and 76 items. After its evaluation by a panel of experts, it was reduced to a second version with six domains and 55 items. Following the administration of Version 2 to 17 patients (58.8% male, mean age 59.53, 70.6% classified as NYHA functional class II), five items were modified and two eliminated. Thus, the third version of the UNAV-CHF Experience Scale was composed of six domains and 53 items. CONCLUSIONS: This study presents the development of the UNAV-experience of living with chronic heart failure scale. It is an original and novel instrument that allows systematically explore this experience. A larger-scale study is necessary to confirm the validity of our scale.
Assuntos
Insuficiência Cardíaca , Qualidade de Vida , Humanos , Masculino , Feminino , Inquéritos e Questionários , Reprodutibilidade dos Testes , Doença Crônica , Estudos Observacionais como AssuntoRESUMO
UNLABELLED: Patients admitted to the ICU are at risk of immobility and an early and important physical deconditioning. OBJECTIVE: To develop and to implement an early and safe protocol for ICU patients' mobilization. METHODOLOGY: The Evidence Based Practice Model for Staff Nurses was used. It encompasses Assessment, Problem Identification, Planning, Implementation and Evaluation, Integration and Maintenance in Practice. RESULTS: The research team (Advanced Practice Nurse and expert clinical nurses), along with the medical team and rehabilitation service, identified the need to develop the protocol. For its elaboration, a literature search on the data bases PubMed, CINA-HL and Cochrane Library was performed; a questionnaire was administered and structured observations were conducted. For the implementation training sessions were offered to nurses, posters were placed in the unit and protocol was included in the computer program. Finally, an assessment of the knowledge, perceptions and practices of nurses in the unit and a recording of adverse events related to the mobilization will take place. CONCLUSIONS: The development and implementation of a protocol for early mobilization of ICU patients has facilitated the integration of this care in daily practice. This model of evidence-based practice allows nurses an active part in changing the culture in terms of the integration of research into practice.
Assuntos
Protocolos Clínicos , Deambulação Precoce/enfermagem , Enfermagem Baseada em Evidências , Unidades de Terapia Intensiva , Árvores de Decisões , Humanos , Segurança do PacienteRESUMO
El paciente ingresado en la UCI tiene riesgo de inmovilidad y de un deterioro temprano e importante de su función física. Objetivo. Desarrollar e implementar un protocolo para la movilización temprana y segura del paciente en UCI. Metodología. Se utilizó el Evidence Based Practice Model for Staff Nurses que engloba: Valoración, Identificación del problema, Planificación, Implementación y evaluación e Integración y mantenimiento en la práctica. Resultados. El equipo investigador (la enfermera de práctica avanzada y enfermeras asistenciales expertas), junto con el equipo médico y el servicio de rehabilitación, detectó la necesidad de elaborar este protocolo. Para ello, se realizó una búsqueda bibliográfica en las bases de datos PubMed, CINAHL y Cochrane Library, se administró un cuestionario y se llevaron a cabo observaciones estructuradas. Para la implementación se impartieron sesiones de formación al personal de enfermería, se colocaron pósteres en la unidad y se incluyó el protocolo en el programa informático. Por último, se realizará una evaluación de los conocimientos, percepciones y prácticas de las enfermeras de la unidad y un registro de los eventos adversos relacionados con la movilización. Conclusiones. El desarrollo e implementación de un protocolo para la movilización temprana del paciente en UCI ha facilitado la integración de este cuidado en la práctica diaria. Este modelo de práctica basada en la evidencia permite que el personal de enfermería forme parte activa en el cambio de cultura en cuanto a la integración de la investigación en la práctica (AU)
Patients admitted to the ICU are at risk of immobility and an early and important physical deconditioning. Objective. To develop and to implement an early and safe protocol for ICU patients mobilization. Methodology. The Evidence Based Practice Model for Staff Nurses was used. It encompasses Assessment, Problem Identification, Planning, Implementation and Evaluation, Integration and Maintenance in Practice. Results. The research team (Advanced Practice Nurse and expert clinical nurses), along with the medical team and rehabilitation service, identified the need to develop the protocol. For its elaboration, a literature search on the data bases PubMed, CINAHL and Cochrane Library was performed; a questionnaire was administered and structured observations were conducted. For the implementation training sessions were offered to nurses, posters were placed in the unit and protocol was included in the computer program. Finally, an assessment of the knowledge, perceptions and practices of nurses in the unit and a recording of adverse events related to the mobilization will take place. Conclusions. The development and implementation of a protocol for early mobilization of ICU patients has facilitated the integration of this care in daily practice. This model of evidence-based practice allows nurses an active part in changing the culture in terms of the integration of research into practice (AU)
