Incidentes relacionados à limpeza de artigos para a saúde que comprometem a segurança do paciente

The aim was to identify evidence in the literature of the main incidents/adverse events reported due to inadequate processing of health articles. This is an integrative literature review, which used the PRISMA guidelines, and was carried out in the databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL) and International Literature in Health Sciences (MEDLINE/PubMed). From the PubMed database, 42 articles were identified, CINAHL 48 articles were identified, totaling 90 articles. Twenty-six articles from PubMed and 42 from CINAHL were selected for reading, resulting in a total of 68 articles. Among these, 18 PubMed and 35 CINAHL were excluded. Being elected 17 articles, which are part of this review. This study presents data that the Material and Sterilization Center (CME) acts through the implementation of good practices and evidence for recommendations or contraindications for the use of materials used in health services, a function that helps in the process of guaranteeing the quality of care and which is also related to the development of new tools. It is noticed that the MSC plays an important role when it comes to patient safety, a factor that is directly related to the improvement or not of their health status.Objetivou-se identificar na literatura evidências dos principais incidentes/eventos adversos notificados devido ao processamento inadequado dos artigos para a saúde. Trata-se de uma revisão integrativa de literatura, que utilizou as diretrizes PRISMA, e foi realizada nas bases de dados: Cumulative Index to Nursing and Allied Health Literature (CINAHL) e Literatura Internacional em Ciências da Saúde (MEDLINE/PubMed). Da base de dados PubMed foram identificados 42 artigos, CINAHL foram identificados 48 artigos, totalizando 90 artigos. Foram selecionados para leitura 26 artigos da PubMed e 42 da CINAHL sendo selecionados um total de 68 artigos. Dentre estes foram excluídos 18 PubMed e 35 da CINAHL. Sendo eleitos 17 artigos, os quais fazem parte desta revisão. Este estudo apresenta dados de que a Central de Material e Esterilização (CME) atua através da implementação de boas práticas e evidências para recomendações ou contraindicação de uso dos materiais utilizados em serviços de saúde, função que auxilia no processo de garantia da qualidade da atenção e que também tem relação com o desenvolvimento de novas ferramentas. Percebe-se que a CME desempenha uma importância de destaque quando se trata de segurança do paciente, fator que está diretamente relacionado com a melhoria ou não do estado de saúde deles

Incidentes relacionados à limpeza de artigos para a saúde que comprometem a segurança do paciente

The aim was to identify evidence in the literature of the main incidents/adverse events reported due to inadequate processing of health articles. This is an integrative literature review, which used the PRISMA guidelines, and was carried out in the databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL) and International Literature in Health Sciences (MEDLINE/PubMed). From the PubMed database, 42 articles were identified, CINAHL 48 articles were identified, totaling 90 articles. Twenty-six articles from PubMed and 42 from CINAHL were selected for reading, resulting in a total of 68 articles. Among these, 18 PubMed and 35 CINAHL were excluded. Being elected 17 articles, which are part of this review. This study presents data that the Material and Sterilization Center (CME) acts through the implementation of good practices and evidence for recommendations or contraindications for the use of materials used in health services, a function that helps in the process of guaranteeing the quality of care and which is also related to the development of new tools. It is noticed that the MSC plays an important role when it comes to patient safety, a factor that is directly related to the improvement or not of their health status.Objetivou-se identificar na literatura evidências dos principais incidentes/eventos adversos notificados devido ao processamento inadequado dos artigos para a saúde. Trata-se de uma revisão integrativa de literatura, que utilizou as diretrizes PRISMA, e foi realizada nas bases de dados: Cumulative Index to Nursing and Allied Health Literature (CINAHL) e Literatura Internacional em Ciências da Saúde (MEDLINE/PubMed). Da base de dados PubMed foram identificados 42 artigos, CINAHL foram identificados 48 artigos, totalizando 90 artigos. Foram selecionados para leitura 26 artigos da PubMed e 42 da CINAHL sendo selecionados um total de 68 artigos. Dentre estes foram excluídos 18 PubMed e 35 da CINAHL. Sendo eleitos 17 artigos, os quais fazem parte desta revisão. Este estudo apresenta dados de que a Central de Material e Esterilização (CME) atua através da implementação de boas práticas e evidências para recomendações ou contraindicação de uso dos materiais utilizados em serviços de saúde, função que auxilia no processo de garantia da qualidade da atenção e que também tem relação com o desenvolvimento de novas ferramentas. Percebe-se que a CME desempenha uma importância de destaque quando se trata de segurança do paciente, fator que está diretamente relacionado com a melhoria ou não do estado de saúde deles

Obstrução de cateter vesical de demora em pacientes com COVID-19

The aim was to describe the nursing interventions that should be implemented to minimize the time to change the Indwelling Bladder Catheter (CVD). Observational, descriptive study with a qualitative approach, of the experience report type, in which it was observed, in the Intensive Care Center for patients diagnosed with COVID-19, that critically ill patients presented CVD obstruction very often. The nurses' actions were related to CVD clearance due to hematuria, often without success, with the need to change the catheter more often than usual. Evidence shows that most acute kidney injuries (AKI) in individuals affected by SARS-CoV-2 are due to the acute tubular injury that they present in 80% of patients. This may be due to prolonged fluid volume reduction and hemodynamic states that decrease renal perfusion. The main nursing interventions aim to reduce the frequency of CVD exchanges and minimize the risk of infection. In care practice, it was possible to present the interventions to be implemented through the development of the nursing process in order to contribute to the reduction of risks of Health Care-Related Infections (HAI).Objetivou-se descrever as intervenções de enfermagem que devem ser implementadas, para minimizar o tempo de troca do Cateter Vesical de Demora (CVD). Estudo observacional, descritivo, com abordagem qualitativa, do tipo relato de experiência, no qual foi observado, no Centro de Terapia Intensiva destinado aos pacientes diagnosticados com COVID-19, que os pacientes graves apresentavam obstrução do CVD com muita frequência. As ações dos enfermeiros estavam relacionadas à desobstrução do CVD devido à hematúria, muitas vezes sem êxito, havendo a necessidade de troca do cateter mais vezes que o usual. As evidências mostram que a maioria das lesões renais agudas (LRA) em indivíduos acometidos pelo SARS-CoV-2 é decorrente da lesão tubular aguda que apresentam em 80% dos pacientes. Esta pode decorrer devido à redução do volume de líquidos prolongada e estados hemodinâmicos que diminuem a perfusão renal. As principais intervenções de enfermagem objetivam reduzir a frequência das trocas do CVD e minimizar os riscos de infecção. Na prática assistencial foi possível apresentar as intervenções a serem implementadas mediante o desenvolvimento do processo de enfermagem de forma a contribuir para redução de riscos de Infecções Relacionadas à Assistência de Saúde (IRAS)

Obstrução de cateter vesical de demora em pacientes com COVID-19

The aim was to describe the nursing interventions that should be implemented to minimize the time to change the Indwelling Bladder Catheter (CVD). Observational, descriptive study with a qualitative approach, of the experience report type, in which it was observed, in the Intensive Care Center for patients diagnosed with COVID-19, that critically ill patients presented CVD obstruction very often. The nurses' actions were related to CVD clearance due to hematuria, often without success, with the need to change the catheter more often than usual. Evidence shows that most acute kidney injuries (AKI) in individuals affected by SARS-CoV-2 are due to the acute tubular injury that they present in 80% of patients. This may be due to prolonged fluid volume reduction and hemodynamic states that decrease renal perfusion. The main nursing interventions aim to reduce the frequency of CVD exchanges and minimize the risk of infection. In care practice, it was possible to present the interventions to be implemented through the development of the nursing process in order to contribute to the reduction of risks of Health Care-Related Infections (HAI).Objetivou-se descrever as intervenções de enfermagem que devem ser implementadas, para minimizar o tempo de troca do Cateter Vesical de Demora (CVD). Estudo observacional, descritivo, com abordagem qualitativa, do tipo relato de experiência, no qual foi observado, no Centro de Terapia Intensiva destinado aos pacientes diagnosticados com COVID-19, que os pacientes graves apresentavam obstrução do CVD com muita frequência. As ações dos enfermeiros estavam relacionadas à desobstrução do CVD devido à hematúria, muitas vezes sem êxito, havendo a necessidade de troca do cateter mais vezes que o usual. As evidências mostram que a maioria das lesões renais agudas (LRA) em indivíduos acometidos pelo SARS-CoV-2 é decorrente da lesão tubular aguda que apresentam em 80% dos pacientes. Esta pode decorrer devido à redução do volume de líquidos prolongada e estados hemodinâmicos que diminuem a perfusão renal. As principais intervenções de enfermagem objetivam reduzir a frequência das trocas do CVD e minimizar os riscos de infecção. Na prática assistencial foi possível apresentar as intervenções a serem implementadas mediante o desenvolvimento do processo de enfermagem de forma a contribuir para redução de riscos de Infecções Relacionadas à Assistência de Saúde (IRAS)

Principais complicações apresentadas por pacientes diagnosticados com COVID-19: revisão integrativa

It was aimed to highlight and identify the main complications after infection by COVID-19 reported in the scientific literature. It is an integrative review of the literature. To achieve scientific production on the chosen theme, the Virtual Health Library (BVS) and the Databases: Medical Literature Analysis and Retrieval System Online (Medline), Latin American and Caribbean in the Caribbean in the search was used as a search. Health Sciences (Lilacs) and Pubmed. A total of 30 articles was obtained. After application of the inclusion and exclusion, reading and analysis criteria of the studies, 10 articles were reached for the construction of this review. Studies showed cardiovascular, renal, neurological, respiratory, liver, hematological, metabolic, functional and psychological complications. These include: ischemic injury of myocardial, pericarditis, renal failure, hematuria, proteinuria, stroke, yearsia, bronchopneumonia, bronchial mucosal edema, alterations in liver enzymes, venous thromboembolism, metabolic disorders, functional and psychological impairment. It is concluded that COVID-19 has high relevance during the appearance and development of its complications. We do not yet know how long these complications can reach patients if sequelae are temporary or definitive. Thus, the Unified Health System is prepared to continue watching these individuals.Objetivou-se evidenciar e identificar as principais complicações pós infecção pela COVID-19 relatadas na literatura científica. Trata-se de uma revisão Integrativa da literatura. Para alcançar a produção científica sobre a temática escolhida, utilizou-se como fonte de busca a Biblioteca Virtual em Saúde (BVS) e as bases de dados: Medical Literature Analysis and Retrieval System Online (MEDLINE), Literatura Latino-americana e do Caribe em Ciências da Saúde (LILACS) e PubMed. Obteve-se uma totalidade de 30 artigos. Após aplicação dos critérios de inclusão e exclusão, leitura e análise dos estudos, chegou-se ao número de 10 artigos para a construção da presente revisão. Os estudos evidenciaram complicações  cardiovasculares, renais, neurológicas, respiratórias, hepáticas, hematológica, metabólicas, funcionais e psicológicas. Dentre elas, destacam-se: lesão isquêmica do miocárdio, pericardite, insuficiência renal, hematúria, proteinúria, acidente vascular cerebral, anosmia, broncopneumonia, edema de mucosa brônquica, alterações na enzimas hepáticas, tromboembolismo venoso, disfunções metabólicas, comprometimento funcional e psicológico. Conclui-se que a COVID-19 possui alta relevância durante o aparecimento e desenvolvimento de suas complicações. Ainda  não sabemos após quanto tempo  essas complicações podem atingir os pacientes, se as sequelas são temporárias ou definitivas. Assim, o  Sistema Único de Saúde precisa está preparado para continuar assistindo estes indivíduos

Vivência de enfermeiros em unidade de terapia intensiva destinada a pacientes com COVID-19: relato de experiência

The aim was to report the performance of nurses in Adult Intensive Care Units at this time of pandemic. This is an experience report, of a descriptive type, with a qualitative approach, based on the experience of nurses, in the current moment of pandemic, in relation to time, the research is delimited from the practices and assistance of these professionals in a Health Unit. Exclusive Intensive Care for patients diagnosed with COVID-19, from February to July 2021. Continuing and continuing education in health is essential for the quality of care provided in the care of patients with SARS-CoV-2. Maintaining a communication relationship between the multidisciplinary teams is very important in view of the experienced scenario. The pandemic scenario has a framework of great challenges for the entire population, referring to nursing professionals, care actions, care practices, training, remodeling of work management. However, the preparation of professionals with knowledge about: the new disease COVID-19, critically ill patients and the use of new technologies is notorious, as well as providing a suitable workplace.Objetivou-se relatar a atuação de enfermeiros de Unidades de Terapia Intensiva Adulto neste momento de pandemia. Trata-se de um relato de experiência, do tipo descritivo, com abordagem qualitativa, baseado na experiência de enfermeiros, no atual momento de pandemia, em relação ao tempo, a pesquisa delimita-se a partir das práticas e assistência destes profissionais em Unidade de Terapia Intensiva exclusiva para pacientes diagnosticados com COVID-19, período de fevereiro a julho do ano de 2021. A educação continuada e permanente em saúde é imprescindível para qualidade da assistência prestada no atendimento ao paciente com SARS-CoV-2. Manter entre as equipes multiprofissionais uma relação de comunicação é muito importante diante do cenário experienciado. O cenário pandêmico tem um marco de grandes desafios para toda população, referente aos profissionais de enfermagem, as ações de cuidado, das práticas assistenciais, treinamentos, remodelação da gestão de trabalho. Contudo é notório a preparação dos profissionais com conhecimentos sobre:  a nova doença COVID-19, pacientes críticos e o uso das novas tecnologias como também proporcionar um local de trabalho adequado

Vivência de enfermeiros em unidade de terapia intensiva destinada a pacientes com COVID-19: relato de experiência

The aim was to report the performance of nurses in Adult Intensive Care Units at this time of pandemic. This is an experience report, of a descriptive type, with a qualitative approach, based on the experience of nurses, in the current moment of pandemic, in relation to time, the research is delimited from the practices and assistance of these professionals in a Health Unit. Exclusive Intensive Care for patients diagnosed with COVID-19, from February to July 2021. Continuing and continuing education in health is essential for the quality of care provided in the care of patients with SARS-CoV-2. Maintaining a communication relationship between the multidisciplinary teams is very important in view of the experienced scenario. The pandemic scenario has a framework of great challenges for the entire population, referring to nursing professionals, care actions, care practices, training, remodeling of work management. However, the preparation of professionals with knowledge about: the new disease COVID-19, critically ill patients and the use of new technologies is notorious, as well as providing a suitable workplace.Objetivou-se relatar a atuação de enfermeiros de Unidades de Terapia Intensiva Adulto neste momento de pandemia. Trata-se de um relato de experiência, do tipo descritivo, com abordagem qualitativa, baseado na experiência de enfermeiros, no atual momento de pandemia, em relação ao tempo, a pesquisa delimita-se a partir das práticas e assistência destes profissionais em Unidade de Terapia Intensiva exclusiva para pacientes diagnosticados com COVID-19, período de fevereiro a julho do ano de 2021. A educação continuada e permanente em saúde é imprescindível para qualidade da assistência prestada no atendimento ao paciente com SARS-CoV-2. Manter entre as equipes multiprofissionais uma relação de comunicação é muito importante diante do cenário experienciado. O cenário pandêmico tem um marco de grandes desafios para toda população, referente aos profissionais de enfermagem, as ações de cuidado, das práticas assistenciais, treinamentos, remodelação da gestão de trabalho. Contudo é notório a preparação dos profissionais com conhecimentos sobre:  a nova doença COVID-19, pacientes críticos e o uso das novas tecnologias como também proporcionar um local de trabalho adequado

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK

Background A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. Methods This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. Findings Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0–75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4–97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8–80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3–4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. Interpretation ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK.

BACKGROUND: A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. METHODS: This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. FINDINGS: Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0-75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4-97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8-80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3-4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. INTERPRETATION: ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials. FUNDING: UK Research and Innovation, National Institutes for Health Research (NIHR), Coalition for Epidemic Preparedness Innovations, Bill & Melinda Gates Foundation, Lemann Foundation, Rede D'Or, Brava and Telles Foundation, NIHR Oxford Biomedical Research Centre, Thames Valley and South Midland's NIHR Clinical Research Network, and AstraZeneca