Os impactos da pandemia de Coronavírus na Saúde mental de enfermeiros

Introduction: This work is based on concerns related to the increase in mental health impact rates that have been affecting nursing professionals, and which are mainly highlighted during the COVID-19 pandemic. Objective: To produce a theoretical reflection on emotional exhaustion in the hospital environment of nurses in the face of the pandemic. Methodology: This is an Integrative Literature Review (RIL) or was developed through a search for publications obtained in the databases: LILACS and VHL. The descriptors of mental health, nursing and coronavirus infections were used. Finally, 06 publications were chosen to compose the study. Results: During the research, it became clear how, in times of COVID-19, nurses have been developing considerable problems in their mental health, such as stress, fatigue, anxiety and even depression. This can be caused by work overload, as well as fatigue, both physical and mental, the feeling of incapacity and professional uncertainty. Final considerations: Therefore, it is important to ensure attention to the psycho-emotional health of nurses, supported by interventions aimed at better space and working conditions.Introdução: Este trabalho parte da inquietação relacionada aos acréscimos das taxas de impactos na saúde mental que vem afetando os profissionais da enfermagem, e que durante a pandemia da COVID-19 estão principalmente acentuadas. Objetivo: Produzir uma reflexão teórica sobre o esgotamento emocional no ambiente hospitalar dos enfermeiros frente à pandemia. Metodologia: Trata-se de uma Revisão Integrativa da Literatura (RIL) o qual foi desenvolvido mediante a busca de publicações obtidas nas bases de dados: LILACS e BVS. Foram utilizados os descritores de saúde mental, enfermagem e infecções por coronavírus. Por fim, optou-se por 06 publicações para compor o estudo. Resultados: No decorrer da pesquisa, foi tornando-se notório como, em tempos de COVID-19, os enfermeiros vêm desenvolvendo inúmeros problemas em sua saúde mental, tais como estresse, fadiga, ansiedade e até mesmo depressão. Isso pode ser ocasionado pela sobrecarga de trabalho, bem como pelo cansaço, tanto físico como mental, pela sensação de incapacidade e incerteza profissional. Considerações finais: Constata-se, portanto, a importância em   garantir uma atenção para a saúde psicoemocional do enfermeiro(a), apoiado em intervenções que visem um melhor espaço e condições de trabalho

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)