Adesão às precauções padrão no acesso vascular periférico

This prospective and quantitative study was carried out in a small private general hospital, where the adherence to standard precaution in the peripheral vascular access was evaluated. The data were collected through a questionnaire aiming to characterize the nursing team's knowledge and opinion about standard precautions and the availability of materials. In addition, a systemized observation of the procedures of vein puncture and medicine administration was performed. It was identified that 84.4% of the punctures had been carried out without gloves or previous hand washing; in 29.7% of the procedures, needles were recapped and 93.2% of the professionals reported adequate material supply. Concluding, the professionals expose themselves and patients to unnecessary risks of infection. The nursing team must be the focus of continuous interventions and future actions in order to minimize the risk of infection in the procedure of peripheral vascular access.Estudio prospectivo, cuantitativo, realizado en un hospital general privado de poca complejidad, donde fue evaluado el seguimiento de las precauciones patrón para realizar inserción vascular periférica. Los datos fueron recolectados por medio de un cuestionario, con el objetivo de determinar las características del conocimiento y de opinión del equipo de enfermería sobre los temas de adhesión, precauciones patrón, disponibilidad de materiales; y por observación sistémica de los procedimientos de punción venosa y administración de medicamentos. Se identificó que 84,4% de las punciones fueron realizadas sin guantes y sin lavado previo de manos, 29,7% de las veces hubo reutilización de agujas y 93,2% de los profesionales afirmó tener una adecuada cantidad de materiales. Se concluyó que los profesionales exponen a sus pacientes y a sí mismos a riesgos de infección innecesaria. El equipo de enfermería debe enfocar su intervención y actividades futuras con el objetivo de minimizar el riesgo de infección durante el procedimiento vascular periférico.Estudo prospectivo, quantitativo, realizado num hospital geral privado de pequeno porte, onde foi avaliada a adesão às precauções padrão no acesso vascular periférico. Os dados foram coletados por meio de questionário, visando a caracterização do conhecimento e da opinião da equipe de enfermagem sobre os temas adesão às precauções padrão e a disponibilidade de materiais e por observação sistematizada dos procedimentos de punção venosa e administração de medicamentos. Identificou-se que 84,4% das punções foram realizadas sem luvas e sem lavagem prévia das mãos 29,7% das vezes houve reencape de agulhas e 93,2% dos profissionais afirmou ser adequada a oferta de material. Conclui-se que os profissionais expõem a si próprios e os pacientes a riscos de infecção desnecessários. A equipe de enfermagem deve ser foco de intervenção e ações futuras visando minimizar o risco de infecção no procedimento de acesso vascular periférico

Ansiedade, estresse e depressão de familiares de pacientes com insuficiência cardíaca

Objective: Identifying the level of anxiety, stress and depression symptoms in family members of patients with heart failureidentifying the relationship between these feelings with sociodemographic and clinical variables. Method: A cross-sectional study carried out with 100 family members. Depression, anxiety, and stress were evaluated by the Beck Depression and Anxiety Inventories and the Perceived Stress Scale - 10. The relationship between feelings and variables was performed through the t-test, Mann-Whitney or Kruskal-Wallis. Results: Mean depression was 8.24, anxiety was 77.95, and stress was 17.43. The correlation coefficient between depression and anxiety and depression and stress was 0.53, and it was 0.66 between anxiety and stress. Females (p=0.002, p=0.031), smoking (p=0.05, p=0.011) and sedentary lifestyle (p=0.023, p=0.001) were related to anxiety and stress, respectively. Family income lower than five minimum wages (p=0.012) was related to depression, and regular/poor self-perceived health status related to the three feelings. Conclusion: Family members did not present high levels of these feelings. The scales were directly correlated with each one another and some variables were related to stress, anxiety and depression.OBJETIVO: Identificar o nível de ansiedade, estresse e sintomas de depressão de familiares de pacientes com insuficiência cardíaca; identificar a relação entre esses sentimentos com as variáveis sociodemográficas e clínicas. MÉTODO: Estudo transversal composto por 100 familiares. A depressão, a ansiedade e o estresse foram avaliados pelos Inventários de Depressão e Ansiedade de Beck e pela Escala de Estresse Percebido ‒ 10. A relação dos sentimentos com as variáveis foi realizada pelo teste t, Mann-Whitney ou Kruskal-Wallis. RESULTADOS: A média de depressão foi de 8,24, ansiedade, 7,95 e estresse, 17,43. O coeficiente de correlação entre depressão e ansiedade e depressão e estresse foi de 0,53 e de 0,66 entre ansiedade e estresse. Sexo feminino (p=0,002; p=0,031), tabagismo (p=0,05; p=0,011) e sedentarismo (p=0,023; p=0,001) se relacionaram com a ansiedade e estresse respectivamente. Renda familiar menor que cinco salários mínimos (p=0,012) se relacionou com a depressão, e autoavaliação de saúde regular/ruim se relacionou com os três sentimentos. CONCLUSÃO: Os familiares não apresentaram níveis elevados desses sentimentos. As escalas foram diretamente correlacionadas entre si e algumas variáveis se relacionaram com estresse, ansiedade e depressão.Univ Fed Sao Paulo, Escola Paulista Enfermagem, Rua Napoleao de Barros 754,2 Andar, BR-04024002 Sao Paulo, SP, BrazilEscola Paulista de Enfermagem, Universidade Federal de São Paulo. Rua Napoleão de Barros 754, 2º andar CEP 04024-002 - São Paulo, SP, BrazilWeb of Scienc

Ansiedad, estrés y depresión de familiares de pacientes con insuficiencia cardiaca

OBJETIVO Identificar el nivel de ansiedad, estrés y síntomas de depresión de familiares de pacientes con insuficiencia cardiaca; identificar la relación entre dichos sentimientos con las variables sociodemográficas y clínicas. MÉTODO Estudio transversal compuesto de 100 familiares. La depresión, la ansiedad y el estrés fueron evaluados por los Inventarios de Depresión y Ansiedad de Beck y la Escala de Estrés Percibido ‒ 10. La relación de los sentimientos con las variables fue realizada por la prueba t, Mann-Whitney o Kruskal-Wallis. RESULTADOS El promedio de depresión fue de 8,24, ansiedad, 7,95 y estrés, 17,43. El coeficiente de correlación entre depresión y ansiedad y depresión y estrés fue de 0,53 y de 0,66 entre ansiedad y estrés. Sexo femenino (p=0,002; p=0,031), tabaquismo (p=0,05; p=0,011) y sedentarismo (p=0,023; p=0,001) se relacionaron con ansiedad y estrés respectivamente. Renta familiar menor que cinco salarios mínimos (p=0,012) se relacionó con depresión, y autoevaluación de salud regular/mal se relacionó con los tres sentimientos. CONCLUSIÓN Los familiares no presentaron niveles elevados de esos sentimientos. Las escalas estuvieron directamente correlacionadas entre sí y algunas variables se relacionaron con estrés, ansiedad y depresión.OBJETIVO Identificar o nível de ansiedade, estresse e sintomas de depressão de familiares de pacientes com insuficiência cardíaca; identificar a relação entre esses sentimentos com as variáveis sociodemográficas e clínicas. MÉTODO Estudo transversal composto por 100 familiares. A depressão, a ansiedade e o estresse foram avaliados pelos Inventários de Depressão e Ansiedade de Beck e pela Escala de Estresse Percebido ‒ 10. A relação dos sentimentos com as variáveis foi realizada pelo teste t, Mann-Whitney ou Kruskal-Wallis. RESULTADOS A média de depressão foi de 8,24, ansiedade, 7,95 e estresse, 17,43. O coeficiente de correlação entre depressão e ansiedade e depressão e estresse foi de 0,53 e de 0,66 entre ansiedade e estresse. Sexo feminino (p=0,002; p=0,031), tabagismo (p=0,05; p=0,011) e sedentarismo (p=0,023; p=0,001) se relacionaram com a ansiedade e estresse respectivamente. Renda familiar menor que cinco salários mínimos (p=0,012) se relacionou com a depressão, e autoavaliação de saúde regular/ruim se relacionou com os três sentimentos. CONCLUSÃO Os familiares não apresentaram níveis elevados desses sentimentos. As escalas foram diretamente correlacionadas entre si e algumas variáveis se relacionaram com estresse, ansiedade e depressão.OBJECTIVE Identifying the level of anxiety, stress and depression symptoms in family members of patients with heart failure; identifying the relationship between these feelings with sociodemographic and clinical variables. METHOD A cross-sectional study carried out with 100 family members. Depression, anxiety, and stress were evaluated by the Beck Depression and Anxiety Inventories and the Perceived Stress Scale - 10. The relationship between feelings and variables was performed through the t-test, Mann-Whitney or Kruskal-Wallis. RESULTS Mean depression was 8.24, anxiety was 77.95, and stress was 17.43. The correlation coefficient between depression and anxiety and depression and stress was 0.53, and it was 0.66 between anxiety and stress. Females (p=0.002, p=0.031), smoking (p=0.05, p=0.011) and sedentary lifestyle (p=0.023, p=0.001) were related to anxiety and stress, respectively. Family income lower than five minimum wages (p=0.012) was related to depression, and regular/poor self-perceived health status related to the three feelings. CONCLUSION Family members did not present high levels of these feelings. The scales were directly correlated with each one another and some variables were related to stress, anxiety and depression

Anxiety, stress and depression in family members of patients with heart failure

Abstract OBJECTIVE Identifying the level of anxiety, stress and depression symptoms in family members of patients with heart failure; identifying the relationship between these feelings with sociodemographic and clinical variables. METHOD A cross-sectional study carried out with 100 family members. Depression, anxiety, and stress were evaluated by the Beck Depression and Anxiety Inventories and the Perceived Stress Scale - 10. The relationship between feelings and variables was performed through the t-test, Mann-Whitney or Kruskal-Wallis. RESULTS Mean depression was 8.24, anxiety was 77.95, and stress was 17.43. The correlation coefficient between depression and anxiety and depression and stress was 0.53, and it was 0.66 between anxiety and stress. Females (p=0.002, p=0.031), smoking (p=0.05, p=0.011) and sedentary lifestyle (p=0.023, p=0.001) were related to anxiety and stress, respectively. Family income lower than five minimum wages (p=0.012) was related to depression, and regular/poor self-perceived health status related to the three feelings. CONCLUSION Family members did not present high levels of these feelings. The scales were directly correlated with each one another and some variables were related to stress, anxiety and depression

Correlations between stress, anxiety and depression and sociodemographic and clinical characteristics among outpatients with heart failure

Aim To describe and investigate correlations among anxiety, stress and depression and identify their relationship with sociodemographic and clinical characteristics of patients with heart failure. Methods: This is an analytical cross-sectional study. Sociodemographic and clinical characteristics were collected, along with levels of anxiety, stress and depression from 309 outpatients. Results: The mean levels of stress, anxiety and depression were correlated but low. Time since diagnosis, the disease's functional class, family income, and smoking influenced stress. Functional class and Chagas disease influenced anxiety and depression. Being unemployed and smoking influenced anxiety, while being a homeowner influenced depression. Conclusion: These findings should be considered when planning nursing interventions.Univ Fed Sao Paulo, Paulista Nursing Sch, 754 Napoleao de Barros St, BR-04024002 Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Paulista Nursing Sch, 754 Napoleao de Barros St, BR-04024002 Sao Paulo, SP, BrazilWeb of Scienc

Adherence to standard precaution in the peripheral vascular access Siguiendo las precauciones padrón para procedimiento de inserción vascular periférico Adesão às precauções padrão no acesso vascular periférico

This prospective and quantitative study was carried out in a small private general hospital, where the adherence to standard precaution in the peripheral vascular access was evaluated. The data were collected through a questionnaire aiming to characterize the nursing team's knowledge and opinion about standard precautions and the availability of materials. In addition, a systemized observation of the procedures of vein puncture and medicine administration was performed. It was identified that 84.4% of the punctures had been carried out without gloves or previous hand washing; in 29.7% of the procedures, needles were recapped and 93.2% of the professionals reported adequate material supply. Concluding, the professionals expose themselves and patients to unnecessary risks of infection. The nursing team must be the focus of continuous interventions and future actions in order to minimize the risk of infection in the procedure of peripheral vascular access.<br>Estudio prospectivo, cuantitativo, realizado en un hospital general privado de poca complejidad, donde fue evaluado el seguimiento de las precauciones patrón para realizar inserción vascular periférica. Los datos fueron recolectados por medio de un cuestionario, con el objetivo de determinar las características del conocimiento y de opinión del equipo de enfermería sobre los temas de adhesión, precauciones patrón, disponibilidad de materiales; y por observación sistémica de los procedimientos de punción venosa y administración de medicamentos. Se identificó que 84,4% de las punciones fueron realizadas sin guantes y sin lavado previo de manos, 29,7% de las veces hubo reutilización de agujas y 93,2% de los profesionales afirmó tener una adecuada cantidad de materiales. Se concluyó que los profesionales exponen a sus pacientes y a sí mismos a riesgos de infección innecesaria. El equipo de enfermería debe enfocar su intervención y actividades futuras con el objetivo de minimizar el riesgo de infección durante el procedimiento vascular periférico.<br>Estudo prospectivo, quantitativo, realizado num hospital geral privado de pequeno porte, onde foi avaliada a adesão às precauções padrão no acesso vascular periférico. Os dados foram coletados por meio de questionário, visando a caracterização do conhecimento e da opinião da equipe de enfermagem sobre os temas adesão às precauções padrão e a disponibilidade de materiais e por observação sistematizada dos procedimentos de punção venosa e administração de medicamentos. Identificou-se que 84,4% das punções foram realizadas sem luvas e sem lavagem prévia das mãos 29,7% das vezes houve reencape de agulhas e 93,2% dos profissionais afirmou ser adequada a oferta de material. Conclui-se que os profissionais expõem a si próprios e os pacientes a riscos de infecção desnecessários. A equipe de enfermagem deve ser foco de intervenção e ações futuras visando minimizar o risco de infecção no procedimento de acesso vascular periférico

Anxiety, stress and depression in family members of patients with heart failure

Abstract OBJECTIVE Identifying the level of anxiety, stress and depression symptoms in family members of patients with heart failure; identifying the relationship between these feelings with sociodemographic and clinical variables. METHOD A cross-sectional study carried out with 100 family members. Depression, anxiety, and stress were evaluated by the Beck Depression and Anxiety Inventories and the Perceived Stress Scale - 10. The relationship between feelings and variables was performed through the t-test, Mann-Whitney or Kruskal-Wallis. RESULTS Mean depression was 8.24, anxiety was 77.95, and stress was 17.43. The correlation coefficient between depression and anxiety and depression and stress was 0.53, and it was 0.66 between anxiety and stress. Females (p=0.002, p=0.031), smoking (p=0.05, p=0.011) and sedentary lifestyle (p=0.023, p=0.001) were related to anxiety and stress, respectively. Family income lower than five minimum wages (p=0.012) was related to depression, and regular/poor self-perceived health status related to the three feelings. CONCLUSION Family members did not present high levels of these feelings. The scales were directly correlated with each one another and some variables were related to stress, anxiety and depression

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research