Participatory planning and quality assessment: contributions of a nursing management technology

Objective: to analyze the outcomes of participatory planning and quality assessment of the nursing care provided in a hospital ward using a nursing management technology. Method: Convergent care research focuses on research and practice intervention, developed in a hospital in southern Brazil from April to August 2016. Participatory planning and quality evaluation was performed using the PRAXIS® technology. Results: In the participatory planning, a survey of needs/problems was carried out by 33 professionals followed by 5 workshops, where mission, guiding principles, 4 priority problems, expected results, objectives and plans of activities were defined. For quality evaluation, two indicators were used: satisfaction and notification of adverse events. The evaluation was carried out with 101 patients and /or relatives, predominating “great or good”. Adverse events, 28 records, predominating medication errors. Conclusion: Participatory planning and quality assessment are essential to improve nursing care management and the PRAXIS® technological innovation has been a useful resource.info:eu-repo/semantics/publishedVersio

Nursing Diagnosis Risk for falls: prevalence and clinical profile of hospitalized patients

Objectives: to identify the prevalence of the Nursing Diagnosis (ND) Risk for falls in the hospitalizations of adult patients in clinical and surgical units, to characterize the clinical profile and to identify the risk factors of the patients with this ND. Method: a cross-sectional study with 174 patients. The data was collected from the computerized nursing care prescriptions system and on-line hospital records, and analyzed statistically. Results: the prevalence of the ND Risk for falls was 4%. The patients’ profile indicated older adults, males (57%), those hospitalized in the clinical units (63.2%), with a median length of hospitalization of 20 (10-24) days, with neurological illnesses (26%), cardio-vascular illnesses (74.1%) and various co-morbidities (3±1.8). The prevalent risk factors were neurological alterations (43.1%), impaired mobility (35.6%) and extremes of age (10.3%). Conclusion: the findings contributed to evidencing the profile of the patients with a risk of falling hospitalized in clinical and surgical wards, which favors the planning of interventions for preventing this adverse event

Caracterização das quedas de pacientes segundo notificação em boletins de eventos adversos Caracterización de las caídas de pacientes de acuerdo a las notificaciones en boletines de eventos adversos Characterization of patient falls according to the notification in adverse event reports

Este estudo foi desenvolvido com o objetivo de caracterizar as quedas de pacientes internados ocorridas em hospital terciário. Foram analisados 826 Boletins de Notificação de Eventos Adversos, de um período de 30 meses, que registraram 0,30 quedas por 1000 pacientes/dia. Quedas do leito foram mais frequentes (55%), com maior prevalência na enfermaria de neurologia. Maior frequência de quedas foi verificada no período noturno (63,7%), nos primeiros cinco dias da admissão (61,7%), nos pacientes de sexo masculino (57,5%) e na faixa etária maior de 60 anos (50%). Nos casos de quedas do leito, os diagnósticos relacionaram-se a doenças infecciosas e parasitárias (18,2%), doenças do sistema nervoso (18,2%) e doenças do aparelho circulatório (13,7%). Nas quedas da própria altura, os diagnósticos relacionaram-se a neoplasias (19,4%) e doenças do aparelho geniturinário (16,1%). A caracterização desses eventos adversos auxilia no reconhecimento dos grupos de maior risco e na elaboração de propostas preventivas.<br>Esta investigación fue desarrollada con el objetivo de verificar las características de las caídas sufridas por pacientes internados en un hospital privado. Fueron analizados 826 Boletines de Notificación de Eventos Adversos, en un período de 30 meses. Fueron registradas 0,30 caídas por cada 1000 pacientes/día. Las caídas de la cama fueron las más frecuentes (55%), con mayor prevalencia en la Enfermería de Neurología. Se verificó una mayor frecuencia de caídas en el período nocturno (63,7%), durante los primeros cinco días de admisión (61,7%), en los pacientes de sexo masculino (57,5%) y en la faja etaria de mayores de 60 años (50%). En los casos de caídas de la cama, los diagnósticos se relacionaban con enfermedades infecciosas y parasitarias (18,2%), enfermedades del sistema nervioso (18,2%) y enfermedades del aparato circulatorio (13,7%). En las caídas directas del cuerpo, se encontró relación con las neoplasias (19,4%) y enfermedades del aparato genitourinario (16,1%). La caracterización de esos eventos adversos coadyuva en el reconocimiento de los grupos de mayor riesgo y en la elaboración de propuestas de carácter preventivo.<br>The objective of this study was to observe the characteristics of falls occurring in the inpatient population at a tertiary hospital. Eight hundred and twenty-six Adverse Events Notification Reports were analyzed over a 30 months period, and 0.30 falls per 1,000 patients/day were reported. Falls from beds were the most frequent (55%), showing the highest occurrence in the neurology ward. A higher frequency of falls was observed at night time (63.7%), during the first five hospitalization days (61.7%), in male patients (57.5%) over 60 years old (50%). In cases of falls from a bed, the diagnoses were related to infectious and parasitic diseases (18.2%), diseases affecting the nervous system (18.2%) and those affecting the circulatory system (13.7%). In cases of falls from one's own height, they were related to neoplasms (19.4%) and diseases affecting the genitourinary system (16.1%). It is concluded that high importance should be placed on studying the population to characterize those at high risk for falls to assist in the implementation of preventive measures

Coping strategies of ostomized individuals Estrategias de enfrentamiento (coping) en personas ostomizadas Estratégias de enfrentamento (coping) de pessoas ostomizadas

This study aimed at understanding the experience of individuals with intestinal diversions as regards coping with their new life conditions. The qualitative approach was used, involving 11 ostomized subjects. The data were collected by means of semi-structured interviews which were taped and later fully transcribed and analyzed according to Content Analysis as proposed by Bardin and the Coping theoretical framework . The findings in the study were evidenced by three core categories denominated: i did not choose it; i had to accept it and i have to live with the ostomy. The form to manage the condition of being ostomized was revealed by coping strategies which were based on both emotions and the problem itself. The study contributed for reflection and application of knowledge in assistance practice and teaching for care the ostomized.<br>El objetivo del estudio fue comprender la experiencia que personas con derivaciones intestinales presenta al enfrentar esta nueva condición de vida. Se utilizó un enfoque de naturaleza cualitativa, con 11 sujetos estomizados. Los datos fueron recolectados a través de entrevistas semiestructuradas, grabadas y posteriormente transcritas en su totalidad, siendo analizadas según el Análisis de Contenido de Bardin y el fundamento teórico de Coping. Los hallazgos del estudio fueron en tres categorías centrales, denominadas: no lo elegí; tuve que aceptarlo y con(vivo) con la estomía. La estrategia para controlar la condición, ser estomizado, se realizó a través de estrategias para enfrentar tanto aspectos emocionales como el problema en sí. El estudio contribuyó para reflexionar y utilizar el conocimiento en la práctica asistencial y para la educación en cuanto al cuidado del entomizado.<br>Este trabalho objetivou compreender a experiência de pessoas com derivações intestinais, quanto ao enfrentamento à nova condição de vida. Realizou-se estudo qualitativo, sendo entrevistados 11 sujeitos ostomizados. Os dados foram coletados por meio de entrevistas semi-estruturadas, gravadas e posteriormente transcritas na íntegra e foram analisadas segundo a proposta de análise de conteúdo de Bardin e do referencial teórico de Coping . Os achados do estudo evidenciaram-se por três categorias centrais: eu não escolhi; tive que aceitar e con(vivo) com a ostomia. A forma para manejar a condição de estar ostomizado revelou-se por estratégias de enfrentamento tanto baseadas na emoção, como no problema. O estudo contribuiu para a reflexão e a utilização do conhecimento na prática assistencial e de ensino para cuidar do ostomizado