Ambiente da prática profissional e exaustão emocional entre enfermeiros de terapia intensiva

OBJECTIVE: to evaluate the characteristics of the professional nursing practice environment and its relationship with burnout, perception of quality of care, job satisfaction and the intention to leave the job in the next 12 months. METHOD: cross-sectional study with a quantitative approach to data. The sample was composed of 129 nurses working in adult Intensive Care Units from a region in the interior of São Paulo, Brazil. RESULTS: The structural equation modeling, using path analysis, revealed that characteristics of the environment influence job satisfaction, perception of quality of care, and having an intention to leave their job, when mediated by emotional exhaustion. Nurses with limited autonomy, poor control over their practice, and poor relationships with physicians, experience a greater level of emotional exhaustion, which can negatively influence their perception of quality of care, job satisfaction and an intention to abandon their jobs. CONCLUSION: the mediating role of emotional exhaustion may negatively influence care delivery. Therefore, there is a need to adopt strategies to minimize this condition among nurses.OBJETIVO: evaluar las características del ambiente de la práctica profesional de los enfermeros y su relación con el burnout, percepción de la calidad del cuidado, satisfacción en el trabajo y la intención de dejar el empleo en los próximos doce meses. MÉTODO: estudio transversal de abordaje cuantitativo de los datos. La muestra fue compuesta por 129 enfermeros de Unidades de Terapia Intensiva de adulto de una región del interior del Estado de Sao Paulo, Brasil. RESULTADOS: el modelaje de ecuaciones estructurales, por medio del análisis de caminos, mostró que las características del ambiente de la práctica influyen en la satisfacción en el trabajo, percepción de la calidad del cuidado y en la intención de dejar el empleo, cuando mediadas por el sentimiento de agotamiento emocional. El enfermero con poca autonomía, menor control sobre el ambiente y con peores relaciones con el médico, presenta mayor nivel de agotamiento emocional, lo que puede influenciar negativamente su percepción de la calidad del cuidado, satisfacción con el trabajo y la intención de dejar el empleo. CONCLUSÍON: la posición mediadora del agotamiento emocional puede influenciar negativamente en los resultados de la asistencia, habiendo, así, necesidad de adoptar estrategias que minimicen ese sentimiento en el enfermero.OBJETIVO: avaliar as características do ambiente da prática profissional dos enfermeiros e sua relação com o Burnout, percepção da qualidade do cuidado, satisfação no trabalho e a intenção de deixar o emprego nos próximos doze meses. MÉTODO: estudo transversal de abordagem quantitativa dos dados. A amostra foi composta por 129 enfermeiros de unidades de terapia intensiva de adulto de uma região do interior do Estado de São Paulo, Brasil. RESULTADOS: a modelagem de equações estruturais, por meio da análise de caminhos, mostrou que as características do ambiente da prática influenciam na satisfação no trabalho, percepção da qualidade do cuidado e na intenção de deixar o emprego, quando mediadas pelo sentimento de exaustão emocional. O enfermeiro com pouca autonomia, menor controle sobre o ambiente e com piores relações com o médico, apresenta maior nível de exaustão emocional, o que pode influenciar negativamente na sua percepção da qualidade do cuidado, satisfação com o trabalho e na intenção de deixar o emprego. CONCLUSÃO: a posição mediadora da exaustão emocional pode influenciar negativamente nos resultados da assistência, havendo, portanto, a necessidade de adoção de estratégias que minimizem esse sentimento no enfermeiro

Carga de trabalho de enfermagem em uma unidade de gastroenterologia

Um dos maiores desafios enfrentados pelo enfermeiro refere-se à necessidade de justificar o quantitativo e qualitativo de pessoal para a prestação da assistência. Para isso, dispõe de ferramentas gerenciais que auxiliam na determinação do pessoal necessário na equipe de enfermagem. Trata-se, aqui, de estudo descritivo, que objetivou avaliar a carga de trabalho de enfermagem em uma unidade clínica e cirúrgica, especializada em gastroenterologia. Para a coleta de dados, utilizou-se o Nursing Activities Score (NAS) por 30 dias consecutivos, totalizando 1080 observações, obtidas do registro de 149 pacientes. A média da pontuação do NAS foi de 34,9% e, considerando que cada ponto do NAS corresponde a 0,24h, foram requeridas, em média, 8,4 horas de enfermagem na assistência nas 24h. Isso significa que o perfil desses pacientes corresponde ao daqueles que requerem cuidados intermediários e semi-intensivos, o que sugere que o NAS pode ser utilizado para avaliar a carga de trabalho de enfermagem na referida unidade.Uno de los mayores desafíos enfrentados por el enfermero se refiere a la necesidad de justificar la cantidad y calidad de personal que se necesita en una unidad para la prestación de asistencia. Para eso, dispone de herramientas administrativas que auxilian en la determinación del personal necesario en el equipo de enfermería. Se trata de un estudio descriptivo, que tuvo por objetivo evaluar la carga de trabajo de enfermería en una unidad clínica y quirúrgica, especializada en gastroenterología. Para la recolección de datos, se utilizó el Nursing Activities Score (NAS) por 30 días consecutivos, totalizando 1.080 observaciones, obtenidas de los registros de 149 pacientes. El promedio de la puntuación del NAS fue de 34,9% y, considerando que cada punto del NAS corresponde a 0,24h, fueron requeridas, en promedio, 8,4 horas de enfermería para la asistencia en las 24h. Eso significa que el perfil de esos pacientes corresponde al de aquellos que requieren cuidados intermediarios y semi-intensivos, lo que sugiere que el NAS puede ser utilizado para evaluar la carga de trabajo de enfermería en la referida unidad.One of the biggest challenges nurses face is the need to justify the quantity and quality of staff for care delivery. For this, management instruments are available which help them to determine the staff needed in the nursing team. This descriptive study aims to evaluate the nursing workload at a specialized clinical and surgical gastroenterology unit. To collect data, the Nursing Activities Score (NAS) was used during 30 consecutive days, with 1080 comments, obtained from the records of 149 patients. The mean NAS score was 34.9% and, considering that each point of NAS corresponds to 0.24 hour, on the average, 8.4 hours of nursing care were required within 24 hours. This means that this profile is of patients who demand intermediate and semi-intensive care, which suggests that the NAS study can be used to evaluate the workload of nurses at that unit

Professional Nursing Practice: Environment And Emotional Exhaustion Among Intensive Care Nurses.

to evaluate the characteristics of the professional nursing practice environment and its relationship with burnout, perception of quality of care, job satisfaction and the intention to leave the job in the next 12 months. cross-sectional study with a quantitative approach to data. The sample was composed of 129 nurses working in adult Intensive Care Units from a region in the interior of São Paulo, Brazil. The structural equation modeling, using path analysis, revealed that characteristics of the environment influence job satisfaction, perception of quality of care, and having an intention to leave their job, when mediated by emotional exhaustion. Nurses with limited autonomy, poor control over their practice, and poor relationships with physicians, experience a greater level of emotional exhaustion, which can negatively influence their perception of quality of care, job satisfaction and an intention to abandon their jobs. the mediating role of emotional exhaustion may negatively influence care delivery. Therefore, there is a need to adopt strategies to minimize this condition among nurses.21376577

Bis(2-amino-3-nitro­pyridinium) dichromate(VI)

The title compound, (C5H6N3O2)2[Cr2O7], consists of 2-amino-3-nitro­pyridinium cations and discrete dichromate anions linked together by N—H⋯O and C—H⋯O hydrogen bonds, forming thick layers parallel to (101). Layer cohesion is ensured by N—H⋯O hydrogen bonding in addition to electrostatic and van der Waals inter­actions, forming a three-dimensional framework. The dichromate anion is located on a twofold axis that passes through its bridging O atom

Incidence of tuberculous and non-tuberculous mycobacteria, differentiated by multiplex PCR, in clinical specimens of a large general hospital

OBJECTIVE: To determine the incidence of Mycobacterium tuberculosis complex and non-tuberculous mycobacterial isolates in the routine setting of a large general hospital using an "in-house" multiplex polymerase chain reaction method and to establish a paradigm for the definitive identification of mycobacteria isolated using semi-automated equipment. METHODS: Established tests, including polymerase chain reaction restriction enzyme analysis, PNB, and NAP inhibition tests as the gold standard, showed 100% agreement with an IS6110/hsp65 multiplex polymerase chain reaction when used to identify stock strains (n = 117). RESULTS: In a subsequent study, 8,790 clinical specimens producing 476 isolates were evaluated with multiplex PCR and also showed 100% agreement in identification using PRA-polymerase chain reaction as the gold standard. The application of this technique to routine analysis was demonstrated in this study. A method was established with the initial application of multiplex PCR for all positive liquid cultures and the subsequent identification of non-tuberculous mycobacteria by polymerase chain reaction restriction enzyme analysis. In total, 77% of isolates belonged to the Mycobacterium tuberculosis complex, and 23% were non-tuberculous mycobacteria. CONCLUSIONS: Several non-tuberculous mycobacterial species were identified, primarily M. avium, but other potentially pathogenic species were also frequently observed, including M. fortuitum, M. abscessus, and M. kansasii. The expeditious communication of these data to the clinical staff was fundamental for the diagnosis of clinical cases. Even in settings where tuberculosis is of major importance, the incidence of non-tuberculous mycobacteria infection is substantial

Radiation effects on p+n InP junctions grown by MOCVD

The superior radiation resistance of InP over other solar cell materials such as Si or GaAs has prompted the development of InP cells for space applications. The early research on radiation effects in InP was performed by Yamaguchi and co-workers who showed that, in diffused p-InP junctions, radiation-induced defects were readily annealed both thermally and by injection, which was accompanied by significant cell recovery. More recent research efforts have been made using p-InP grown by metalorganic chemical vapor deposition (MOCVD). While similar deep level transient spectroscopy (DLTS) results were found for radiation induced defects in these cells and in diffused junctions, significant differences existed in the annealing characteristics. After injection annealing at room temperature, Yamaguchi noticed an almost complete recovery of the photovoltaic parameters, while the MOCVD samples showed only minimal annealing. In searching for an explanation of the different annealing behavior of diffused junctions and those grown by MOCVD, several possibilities have been considered. One possibility is the difference in the emitter structure. The diffused junctions have S-doped graded emitters with widths of approximately 0.3 micrometers, while the MOCVD emitters are often doped with Si and have widths of approximately 300A (0.03 micrometers). The difference in the emitter thickness can have important effects, e.g. a larger fraction of the total photocurrent is generated in the n-type material for thicker emitters. Therefore the properties of the n-InP material may explain the difference in the observed overall annealing behavior of the cells

Nursing workload in an intensive care unit of a teaching hospital

OBJECTIVE: To evaluate nursing workload in an adult intensive care unit (ICU), and to describe the profile of patients admitted to that unit. METHODS: A descriptive study using the Nursing Activities Score (NAS) for 33 days in an ICU with a capacity of 18 beds. RESULTS: 574 observations were obtained from the registry of 107 patients, and the mean NAS score was 62.2%. CONCLUSION: The NAS is in an important tool for measuring nursing workload in ICUs, as it considers various nursing activities performed in daily care. We stress the importance of its application on the everyday life of the nurse.OBJETIVO: Avaliar a carga de trabalho de enfermagem em uma Unidade de Terapia Intensiva (UTI) - adulto e descrever o perfil dos pacientes, nela, internados. MÉTODOS: estudo descritivo com o uso do Nursing Activities Score - NAS durante 33 dias em uma UTI com capacidade para 18 leitos. RESULTADOS: Foram 574 observações, obtidas do registro de 107 pacientes e a média da pontuação do NAS foi de 62,2%. CONCLUSÃO: O NAS constitui-se em um importante instrumento para mensurar a carga de trabalho de enfermagem em UTI, uma vez que contempla diversas atividades de enfermagem realizadas no dia a dia da assistência. Ressalta-se a importância de tornar sua aplicação parte do cotidiano do enfermeiro.OBJETIVO: Evaluar la carga de trabajo de enfermería en una Unidad de Cuidados Intensivos (UCI) - adulto y describir el perfil de los pacientes, internados en ella. MÉTODOS: estudio descriptivo realizado con el uso del Nursing Activities Score - NAS durante 33 días en una UCI con capacidad para 18 camas. RESULTADOS: Se efectuaron 574 observaciones, obtenidas del registro de 107 pacientes y el promedio de la puntuación del NAS fue de 62,2%. CONCLUSIÓN: El NAS se constituye en un importante instrumento para mensurar la carga de trabajo de enfermería en la UCI, ya que contempla diversas actividades de enfermería realizadas en el dia a dia de la asistencia. Se resalta la importancia de que su aplicación sea parte del cotidiano del enfermero.9610

Bis(2,6-dimethyl­pyridinium) tetra­bromido­zincate(II)

In the crystal structure of the title compound, (C7H10N)2[ZnBr4], the coordination geometry of the anion is approximately tetra­hedral and a twofold rotation axis passes through the Zn atom. The Zn—Br bond lengths range from 2.400 (2) to 2.408 (3) Å and the Br—Zn—Br angles range from 108.14 (6) to 115.15 (15)°. In the crystal structure, the [ZnBr4]2− anion is connected to two cations through N—H⋯Br and H2C—H⋯Br hydrogen bonds, forming two-dimensional cation–anion–cation layers normal to the b axis. No significant Br⋯Br inter­actions [the shortest being 4.423 (4) Å] are observed in the structure

N-(n-Dec­yl)-4-nitro­aniline

N-(n-Dec­yl)-4-nitro­aniline, C16H26N2O2, crystallizes with two essentially planar mol­ecules in the asymmetric unit. The decyl chains are fully extended in an anti conformation. The mol­ecules pack in planar layers, within which mol­ecules are linked into chains by two approximately linear N—H⋯O hydrogen bonds between the amine N atom and one O atom of the nitro group of an adjacent mol­ecule. These mol­ecular chains propagate via inter­leaving of the decyl chains to form the two dimensional sheets. The sheets are associated exclusively via non-bonded contacts. The structure has features in common with those of other N-alkyl-4-nitro­anilines, but also subtle differences in packing

Evidence for glycosylation on a DNA-binding protein of Salmonella enterica

BACKGROUND: All organisms living under aerobic atmosphere have powerful mechanisms that confer their macromolecules protection against oxygen reactive species. Microorganisms have developed biomolecule-protecting systems in response to starvation and/or oxidative stress, such as DNA biocrystallization with Dps (DNA-binding protein from starved cells). Dps is a protein that is produced in large amounts when the bacterial cell faces harm, which results in DNA protection. In this work, we evaluated the glycosylation in the Dps extracted from Salmonella enterica serovar Typhimurium. This Dps was purified from the crude extract as an 18-kDa protein, by means of affinity chromatography on an immobilized jacalin column. RESULTS: The N-terminal sequencing of the jacalin-bound protein revealed 100% identity with the Dps of S. enterica serovar Typhimurium. Methyl-alpha-galactopyranoside inhibited the binding of Dps to jacalin in an enzyme-linked lectin assay, suggesting that the carbohydrate recognition domain (CRD) of jacalin is involved in the interaction with Dps. Furthermore, monosaccharide compositional analysis showed that Dps contained mannose, glucose, and an unknown sugar residue. Finally, jacalin-binding Dps was detected in larger amounts during the bacterial earlier growth periods, whereas high detection of total Dps was verified throughout the bacterial growth period. CONCLUSION: Taken together, these results indicate that Dps undergoes post-translational modifications in the pre- and early stationary phases of bacterial growth. There is also evidence that a small mannose-containing oligosaccharide is linked to this bacterial protein