intervenção especializada de enfermagem

O presente Relatório de Estágio, inserido no Curso de Mestrado em Enfermagem na Área de Especialização à Pessoa em Situação Crítica pretende descrever o percurso de aquisição e de desenvolvimento de competências na prestação de cuidados à Pessoa em Situação Crítica e respetiva família, em contexto de estágio em Unidade de Cuidados Intensivos e Serviço de Urgência. O percurso de desenvolvimento de competências tem por base as estipuladas para este curso de mestrado, as metas enunciadas nos Descritores de Dublin para o 2.º ciclo de estudos e as competências comuns e específicas do enfermeiro especialista na área da PSC, preconizadas pela Ordem dos Enfermeiros. A condição de coma, independentemente da sua etiologia, é inerente a um considerável número de doentes internados nas Unidades de Cuidados Intensivos e Serviços de Urgência contemporâneos. O enfoque da gestão de cuidados à PSC em coma, incide na minimização da lesão cerebral secundária, cascata de eventos fisiopatológicos subsequentes a uma lesão inicial e que, quando não identificados e tratados atempadamente, perturbam a sua homeostasia e incorrem num desfecho potencialmente fatal. A melhoria da qualidade dos cuidados à PSC em coma elabora-se em torno da relevância da segurança e da vigilância do doente, como eixos estruturantes da intervenção especializada do enfermeiro, orientada para a promoção da perfusão cerebral, minimização da lesão cerebral secundária e consequente impacto no outcome final

Saúde ambiental : caderno de notas soltas III

Junho de 2023 © AutoresNa sua 3.ª edição, o Caderno de Notas Soltas pretende reunir diferentes perspetivas e metodologias, celebrando a sua razão de ser e a nobreza da sua génese intimamente ligada à realidade dos estudantes. Na verdade, passados três anos retomamos uma colaboração firmada desde a primeira hora com a Associação de Estudantes da Faculdade de Medicina de Lisboa (AEFML), num registo de proximidade da comunidade estudantil e dos interesses das gerações futuras.info:eu-repo/semantics/publishedVersio

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans—anteaters, sloths, and armadillos—have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths. Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the southern United States, Mexico, and Caribbean countries at the northern portion of the Neotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n = 5,941), and Cyclopes sp. have the fewest (n = 240). The armadillo species with the most data is Dasypus novemcinctus (n = 11,588), and the fewest data are recorded for Calyptophractus retusus (n = 33). With regard to sloth species, Bradypus variegatus has the most records (n = 962), and Bradypus pygmaeus has the fewest (n = 12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans data set. Please cite this data paper when using its data in publications. We also request that researchers and teachers inform us of how they are using these data

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)