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.

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.

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.

Blood transfusion in Intensive Care Units: knowledge of the nursing team

Abstract Objective: To assess the knowledge of nursing team professionals in the Intensive Care Units of blood transfusion and related factors associated with it. Methodology: Cross-sectional, quantitative study, which was carried out in three hospitals. The non-systematic sample included 104 nursing professionals working in the Intensive Care Units of these health institutions. For data collection, a checklist instrument developed and validated by the authors was used. Results: The overall knowledge score registered an average of 50.4%. The factors associated with knowledge were as follows: Training and/or guidance and monitoring of the protocols/directions to carry out the transfusion process; Frequency of blood transfusion procedures carried out by professionals, and The self-confidence factor. For etapa pré-transfusão, etapa de transfusão and etapa póst-transfusão stages, the results were 48.3%, 52.2%, and 58.3%, respectively. Conclusions: This study identified that, on the one hand, nursing professionals possess increased knowledge of post-transfusion complications; and, on the other, that self-confidence, use of protocols, training programs, and having only one job are factors associated with increased knowledge and with vigilance during the procedure.

Resumen Objetivo: Evaluar el conocimiento de los profesionales del equipo de enfermería de Unidades de Cuidados Intensivos sobre transfusión de sangre y los factores asociados a ésta. Metodología: Se trata de un estudio transversal y cuantitativo, el cual se realizó en tres hospitales. La muestra, no sistemática, se constituyó por 104 profesionales de enfermería que laboran en las Unidades de Cuidados Intensivos de estas instituciones de salud. Para la recolección de los datos, se utilizó un instrumento de tipo check-list desarrollado y validado por las autoras. Resultados: La puntuación global de conocimiento presentó una media de 50,4%. Los factores asociados al conocimiento fueron Entrenamiento u orientación y seguimiento de protocolos/directrices para llevar a cabo el proceso de transfusión; Frecuencia de los procedimientos de transfusión de sangre realizados por el profesional; y El factor autoconfianza. Para las etapas: etapa pré-transfusão, etapa de transfusão y etapa póst-transfusão, los resultados fueron 48,3%, 52,2% y 58,3%, respectivamente. Conclusiones: El presente estudio evidenció no sólo que los profesionales de enfermería poseen un mejor conocimiento de las complicaciones postransfusionales, sino también que la auto-confianza, el uso de protocolos, los programas de entrenamiento y tener sólo un empleo son factores asociados a un mejor conocimiento y a la vigilancia durante la realización del procedimiento.

Resumo Objetivo: Avaliar o conhecimento dos profissionais da equipe de enfermagem de Unidades de Terapia Intensiva sobre hemotransfusão e fatores associados. Metodologia: Trata-se de um estudo transversal e quantitativo, realizado em três hospitais. A amostra, não sistemática, foi constituída por 104 profissionais de enfermagem que atuavam nas Unidades de Terapia Intensiva dessas instituições de saúde. Para a coleta de dados, utilizou-se um instrumento do tipo checklist desenvolvido e validado pelas autoras. Resultados: O escore geral médio de conhecimento foi de 50,4%. Os fatores associados ao conhecimento foram: Treinamento ou orientação e seguir protocolos/diretriz para a realização do processo transfusional; Frequência de procedimentos de hemotransfusão realizados pelo profissional; e O fator auto-confiança. Para as etapas: etapa pré-transfusão, etapa de transfusão e etapa póst-transfusão, os resultados foram 48,3%, 52,2% e 58,3%, respectivamente. Conclusões: O presente estudo evidenciou que os profissionais de enfermagem possuem melhor conhecimento das complicações pós-transfusionais e que a auto-confiança, o uso de protocolos direcionadores, os programas de treinamento e ter apenas um emprego são fatores associados com melhor conhecimento e vigilância durante a realização do procedimento.