35 research outputs found

    Screening Tools Designed to Assess and Evaluate Oropharyngeal Dysphagia in Adult Patients: A Scoping Review

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    Oropharyngeal Dysphagia (OD) significantly decreases a patient’s quality of life and poses a high economic burden to institutions. In this sense, evaluation and assessment are important interventions for health professionals, although current tools and instruments are multiple and are dispersed in the literature. The aim of this review was to map existing screening tools to assess and evaluate OD in adult patients, identify their relevant clinical parameters and respective contexts of use and provide a systematic approach and summary to better inform practice. A scoping review was developed guided by the JBI methodology and using PRISMA-ScR to report results published between 2014 and 2021, in English, Spanish and Portuguese. Databases included Medline, Academic Search Complete, CINAHL Complete, Scielo, Google Scholar, ScienceDirect, OpenGrey and B-On. Mendeley was used to store and screen data. A total of 33 studies were included in the study, of which 19 tools were identified, some being intervention-based tools and others an algorithm for decision. The most common context used was in the general population and older adults. Regarding clinical parameters, the most common were food consistency, presence of the cough reflex, swallowing effort, voice changes and weight. As oropharyngeal dysphagia concerns important risks for the patient, a rigorous assessment must be performed. In this sense, the review identified specific disease-related tools and more general instruments, and it is an important contribution to more efficient dysphagia screening and prevention.info:eu-repo/semantics/publishedVersio

    Reingreso por infección del sitio quirúrgico ortopédico: una revisión integradora

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    OBJETIVO Caracterizar los reingresos por infección del sitio quirúrgico ortopédico. MÉTODO Revisión integradora de la literatura, en las bases de datos LILACS, IBECS, MEDLINE, Cochrane, SciELO y PUBMED, por medio de los descriptores Reingreso del paciente, Infección de la herida operatoria, Infección hospitalaria, Procedimientos ortopédicos, Ortopedia. RESULTADOS Fueron identificados 78 estudios y seleccionadas 10 publicaciones. La infección del sitio quirúrgico es la causa más frecuente entre los reingresos ortopédicos no planificados, que representan largas estancias hospitalarias, nuevas intervenciones quirúrgicas y costos elevados, además de mayor posibilidad de ingresos subsiguientes. Los factores predictivos más significativos señalaron tiempo de estancia media, necesidad de cuidados intensivos, status de urgencia en el ingreso, riesgo de muerte, edad >; 65 años, sexo masculino y mayor índice de masa corpórea. CONCLUSIÓN Las tasas de reingreso se hacen cada vez más medidas de cualidad y preocupación con relación a los costos. Nuevos estudios podrían involucrar cuestiones relacionadas con costos indirectos, especialmente los sociales y psicológicos.OBJECTIVE Characterizing readmissions from orthopedic surgical site infections. METHOD An integrative review of literature in the LILACS, IBECS, MEDLINE, Cochrane, SciELO and PUBMED databases, using the descriptors Patient readmission, Wound infection, Cross infection, Orthopedic procedures, Orthopedics. RESULTS 78 studies were identified and 10 publications were selected. Surgical site infections are the most common cause of unplanned orthopedic readmissions, representing long periods of hospitalization, new surgical procedures and high costs, and greater possibility of subsequent hospitalizations. Most significant predictors have indicated average length of hospitalization, need for intensive care, emergency status at admission, risk of death, age >; 65 years, males and higher body mass index. CONCLUSION Readmission rates have increasingly become measures of quality and concerns about costs. New studies could involve issues related to indirect costs, specifically social and psychological costs.OBJETIVO Caracterizar as readmissões por infecção do sítio cirúrgico ortopédico. MÉTODO Revisão integrativa da literatura, nas bases de dados LILACS, IBECS, MEDLINE, Cochrane, SciELO e PUBMED, por meio dos descritores Readmissão do paciente, Infecção da ferida operatória, Infecção hospitalar, Procedimentos ortopédicos, Ortopedia. RESULTADOS Identificados 78 estudos e selecionadas 10 publicações. A infecção do sítio cirúrgico é a causa mais frequente entre as readmissões ortopédicas não planejadas, que representam longos períodos de internação, novas intervenções cirúrgicas e custos elevados, além de maior possibilidade de internações subsequentes. Fatores preditivos mais significantes apontaram tempo médio de internação, necessidade de cuidados intensivos,status de urgência na admissão, risco de morte, idade >; 65 anos, sexo masculino e maior índice de massa corporal. CONCLUSÃO Taxas de readmissão tornam-se cada vez mais medidas de qualidade e preocupação em relação a custos. Novos estudos poderiam envolver questões relacionadas a custos indiretos, especificamente os sociais e psicológicos

    Brief report on double-chamber syringes patents and implications for infusion therapy safety and efficiency

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    This review aimed to map the existing patents of double-chamber syringes that can be used for intravenous drug administration and catheter flush. A search was conducted in the Google patents database for records published prior to 28 October 2020, using several search terms related to double-chamber syringes (DCS). Study eligibility and data extraction were performed by two independent reviewers. Of the initial 26,110 patents found, 24 were included in this review. The 24 DCS that were found display two or more independent chambers that allow for the administration of multiple solutions. While some of the DCS have designated one of the chambers as the flushing chamber, most patents only allow for the sequential use of the flushing chamber after intravenous drug administration. Most DCS were developed for drug reconstitution, usually with a freeze-dried drug in one chamber. Some patents were designed for safety purposes, with a parallel post-injection safety sheath chamber for enclosing a sharpened needle tip. None of the DCS found allow for a preand post-intravenous drug administration flush. Given the current standards of care in infusion therapy, future devices must allow for the sequential use of the flushing chamber to promote a pre-administration patency assessment and a post-administration device flush.info:eu-repo/semantics/publishedVersio

    Cross-cultural validation of the Portuguese version of the Educational Needs Assessment Tool (PortENAT)

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    OBJECTIVESTo undertake a cross-cultural adaptation and validation of the educational needs assessment tool (ENAT) into Portuguese.METHODSThe first phase of this research (cross-cultural adaptation) utilised a well-established translation method comprising five sequential steps: forward-translation, synthesis of translations, back-translation, expert committee and field-testing of the adapted version. The second phase involved collecting data from 123 patients and subjecting them to Rasch analysis for validity testing including cross-cultural invariance.RESULTSThe translation and field-testing phase went smoothly giving rise to minor adjustments in the phrasing of some items. The preliminary analysis of the 39 items, revealed some deviations from the model with the overall item-person interaction fit statistics 2(df) = 56.025 (39), p = 0.038. Significant item-item correlations caused artificial inflation of the internal consistency, therefore violating the model assumption of local independence of items. To correct this, all locally dependent items were then grouped into their respective domains, creating a 7 testlet-scale which demonstrated a good fit to the Rasch model, 2(df) = 2.625 (7), p = 0.917 and internal consistency PSI = 0.975. Analysis of the pooled (Portuguese and the English) data revealed cross-cultural DIF, requiring adjustments in two testlets: 'treatments' and 'support' which ensured cross-cultural equivalence.CONCLUSIONSThis study confirms the Portuguese ENAT is a robust unidimensional tool with which to assess the educational needs of Portuguese people with RA. Cross-cultural adjustments are required only if the data from Portugal and the UK are pooled or compared. The tool is now available for use in clinical practice and research

    O Rei – Um Teste para Avaliação da Fluência e Precisão da Leitura no 1º e 2º ciclos do Ensino Básico

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    In this article is presented an instrument that evaluates two essential reading components: the fluency (number of words read per minute) and the accuracy (percentage of words correctly read). The test has two forms (A and B), which reproduce two Portuguese traditional tales (one in prose and another in verse). It is individually applied and it includes a record of the time spent reading the text, the number of words read and the mistakes given. The sample was constituted by 1st to 6th grade school children (N=387) and it was stratified according to the gender, school year and urban area typology variables. The study of the test’s psychometric features is presented, namely those referring to its reliability and validity, concluding that they are both strong. The effect of the gender, the residence’s geographical area and the intelligence in the test results, were analyzed.On présente dans cet article un outil qui évalue deux compétences essentielles de la lecture, notamment la précision (nombre de mots lus en une minute) et la vitesse (pourcentage de mots correctement lus). Le Test utilise deux contes traditionnels, l’un en prose et l’autre en vers, Forme A et B de ce Test. L’application du test «O Rei» est individuelle et elle prévoit le registre du temps de lecture du texte, du nombre de mots lus et des erreurs commises pendant la lecture. L´échantillon a été constitué par élèves du 1er et du 2e cycle (N=387) et a été stratifié par sexe, année de scolarité et typologie d’aire urbaine. Les études des caractéristiques psychométriques de ce Test, notamment celles qui se rapportent à la fiabilité et validité, ont permis de confirmer leur consistance. On a aussi étudié l’effet du genre, de la zone géographique de résidence et de l’intelligence dans les résultats du Test «O Rei».Neste artigo é apresentado um instrumento que avalia dois componentes essenciais da leitura: a fluência (número de palavras lidas por minuto) e a precisão (percentagem de palavras correctamente lidas). O teste tem duas formas (A e B), que reproduzem dois contos tradicionais portugueses (um em prosa e outro em verso). A sua aplicação é individual e inclui o registo do tempo de leitura do texto, do número de palavras lidas e dos erros cometidos A amostra foi constituída por crianças do 1º ao 6º ano de escolaridade (N=387) e foi estratificada nas variáveis sexo, ano de escolaridade e tipologia de área urbana. Os estudos das características psicométricas do Teste, nomeadamente os que se referem à fiabilidade e validade, permitiram concluir acerca da robustez das mesmas. Foram ainda analisados o efeito do género, da área geográfica de residência e da inteligência nos resultados do teste

    Helmet-Noninvasive Ventilation for Hospitalized Critically Ill COVID-19 Patients: Has Vaccination and the New Variants Changed Evidence?

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    Noninvasive ventilation (NIV) is a technique for breathing support that significantly improves gas exchange and vital signs, reducing intubation and mortality rates. Helmets, unlike facemasks, allow for longer-term treatment and better ventilation, also being more cost-effective. As of today, we have found no reviews addressing this topic. This review aims to identify, map, and describe the characteristics of the use of noninvasive ventilation through helmet interface in critically ill COVID-19 adult patients hospitalized in acute care settings throughout the multiple moments that defined the COVID-19 pandemic. This scoping review will follow the methodology for scoping reviews proposed by JBI. A set of relevant electronic databases will be searched using terms such as COVID-19, helmet, and noninvasive ventilation. Two reviewers will independently perform the study selection regarding their eligibility. Data extraction will be accomplished using a researcher’s developed tool considering the review questions. Findings will be presented in tables and a narrative description that aligns with the review’s objective. This scoping review will consider any quantitative, qualitative, mixed-methods studies and systematic review designs for inclusion, focusing on the use of helmet on critically ill adult patients with COVID-19 hospitalized in acute care settings.info:eu-repo/semantics/publishedVersio

    Estratégias de Reabilitação e Recomendações de Calçado para Enfermeiros em Ortostatismo Prolongado: Uma Revisão Narrativa

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    Introduction: Prolonged standing can lead to tendon and ligament damage, particularly in the feet and ankles, if preventive measures are not taken. Ill-fitting shoes are associated with increased foot pain and disorders, especially among nurses. This narrative review aims to comprehensively synthesize existing literature on footwear recommendations for nurses in prolonged standing positions, emphasizing healthcare strategies and rehabilitation benefits. It seeks to provide a comprehensive overview while identifying gaps for future research. Methodology: A narrative literature review was conducted using databases such as MEDLINE, CINAHL, Web of Science, and ScienceDirect. Studies were included if they described footwear characteristics and therapeutic indications for workers in prolonged standing contexts, following the PRISMA guideline. Results: Twenty-three studies published between 1998 and 2021 were reviewed, revealing recommendations to reduce gastrocnemius fatigue levels with viscoelastic insoles and arch support. Personalized footwear with cushioning is recommended to decrease peak pressure and alleviate issues like calluses and blisters. Soft shoes help reduce edema formation, while optimizing shoe climate is crucial. The combination of antifatigue mats and sports shoes enhances comfort. Discussion: Current research primarily focuses on insole impact, leaving areas like psychological comfort and footwear design acceptance largely unexplored. Future research should investigate the influence of standing environments and footwear, considering variations in foot health among worker cohorts. Conclusion: Few studies address nurses' footwear needs. Future research should provide detailed information on footwear characteristics and their podiatric benefits for nurses.Introducción: La bipedestación prolongada puede causar lesiones en tendones y ligamentos, sobre todo en pies y tobillos, si no se toman medidas preventivas. El calzado inadecuado se asocia a un aumento del dolor y los trastornos del pie, especialmente entre las enfermeras. Esta revisión narrativa pretende sintetizar de forma exhaustiva la bibliografía existente sobre recomendaciones de calzado para enfermeras en posiciones prolongadas de pie, haciendo hincapié en las estrategias de atención sanitaria y los beneficios de la rehabilitación. Pretende proporcionar una visión general exhaustiva, al tiempo que identifica lagunas para futuras investigaciones. Metodología: Se realizó una revisión narrativa de la literatura utilizando bases de datos como MEDLINE, CINAHL, Web of Science y ScienceDirect. Se incluyeron los estudios que describían las características del calzado y las indicaciones terapéuticas para los trabajadores en contextos de bipedestación prolongada, siguiendo la directriz PRISMA. Resultados: Se analizaron 23 estudios publicados entre 1998 y 2021 , que revelaron recomendaciones para reducir los niveles de fatiga del gastrocnemio con plantillas viscoelásticas y soporte para el arco del pie. Se recomienda un calzado personalizado con amortiguación para reducir la presión máxima y aliviar problemas como callosidades y ampollas. El calzado blando ayuda a reducir la formación de edemas, y es crucial optimizar la climatización del zapato. La combinación de alfombrillas antifatiga y calzado deportivo aumenta el confort. Discusión: La investigación actual se centra principalmente en el impacto de la plantilla, dejando áreas como el confort psicológico y la aceptación del diseño del calzado en gran medida inexploradas. Las investigaciones futuras deberían investigar la influencia del entorno del pie y del calzado, teniendo en cuenta las variaciones en la salud del pie entre grupos de trabajadores. Conclusión: Pocos estudios abordan las necesidades de calzado de las enfermeras. Las investigaciones futuras deberían proporcionar información detallada sobre las características del calzado y sus beneficios podológicos para las enfermeras.Introdução: A permanência prolongada em pé pode causar lesões nos tendões e ligamentos, especialmente nos pés e tornozelos, se não forem implementadas medidas preventivas. O calçado inadequado está associado a um aumento das dores e lesões no pé, especialmente entre os enfermeiros. Esta revisão narrativa tem como objetivo sintetizar de forma compreensiva a literatura existente sobre recomendações de calçado para enfermeiros em posições de ortostatismo prolongado, com ênfase em estratégias de cuidados de saúde e benefícios de reabilitação. O seu objetivo é fornecer uma visão geral abrangente, identificando simultaneamente lacunas para investigação futura. Metodologia: Foi efetuada uma revisão narrativa da literatura utilizando bases de dados como MEDLINE, CINAHL, Web of Science e ScienceDirect. Foram incluídos estudos que descreviam as características do calçado e as indicações terapêuticas para trabalhadores em situações de permanência prolongada, seguindo a diretriz PRISMA. Resultados: Foram analisados 23 estudos publicados entre 1998 e 2021, que revelaram recomendações para reduzir os níveis de fadiga do gastrocnémio, com palmilhas viscoelásticas e apoio do arco. O calçado almofadado personalizado é recomendado para reduzir a pressão máxima e aliviar problemas como calosidades e flictenas. O calçado suave ajuda a reduzir a formação de edemas e é crucial otimizar a climatização. A combinação de tapetes anti-fadiga e calçado desportivo aumenta o conforto. Discussão: A investigação atual centra-se principalmente no impacto da palmilha, deixando áreas como o conforto psicológico e a aceitação da conceção do calçado em grande parte inexploradas. A investigação futura deve investigar a influência do ambiente do pé e do calçado, tendo em conta as variações na saúde do pé entre grupos de trabalhadores. Conclusão: Poucos estudos abordam as necessidades de calçado dos enfermeiros. A investigação futura deve fornecer informações pormenorizadas sobre as características do calçado e os seus benefícios podológicos para os enfermeiros

    Foot and ankle disorders in nurses exposed to prolonged standing environments: a scoping review

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    Background: Prolonged standing environments constitute an occupational risk factor for nurses, particularly for developing foot and ankle disorders. The definitions and potential relationship to hours spent walking or standing are poorly understood. This scoping review aimed to synthesize the main disorders found on nurses’ ankles and feet, their prevalence, the influence of hours spent walking or standing, and gender differences. Methods: This review followed a previously published protocol. Primary and secondary studies were retrieved from relevant databases from December 2020 to March 2021. Potential articles were collated to Mendeley, and two independent reviewers assessed the title and abstracts. Studies meeting inclusion criteria were included. Two researchers retrieved and reviewed the full text of these studies independently. A predetermined extraction tool was used to retrieve relevant data, summarized in a tabular and narrative format. Findings: The most common disorder was pain, followed by numbness, burning feet, bunions, structural deformities, and calluses. Prevalence differed among studies, depending on settings and specific local policies. Discussion: Various foot and ankle disorders and related variables have been found, with clear gaps that may be addressed in the future. Conclusion/Applications to Practice:: Few studies have focused on nurses’ foot and ankle disorders. Mapping signs and symptoms may contribute to the future development of preventive interventions for nurses’ workplaces.info:eu-repo/semantics/publishedVersio
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