A Assistência de Enfermagem Frente à Pacientes Oncológicos

Introduction: Cases of cancer in Brazil have been increasing and progressive. Given this, it demands improved technical and scientific knowledge regarding the provision of services by the Nursing team that work directly in the care of cancer patients. Objective: to analyze, through an integrative literature review, the identification of nursing care complexities required by cancer patients undergoing treatment and the importance of qualified nursing care for their prognosis. Material and methods: This is an integrative review article from the Virtual Health Library (VHL); Virtual Health Library (VHL); through queries in the DeCS: “Nursing Care”, “Oncology”, “Oncology Nursing”. A total of five (07) articles published between the year 2019 and the present year (2023) were selected. Results: Fragility was found in the nursing team's knowledge regarding nursing care for cancer patients in terms of patient safety and chemotherapy treatment. Conclusions: It is understood the need to reinforce the idea of ​​adherence to standardized systems in Nursing care in chemotherapy treatment and the importance of continuous and up-to-date education for professionals working in the area.    Introdução: Os casos de câncer no Brasil têm se mostrado crescente e progressivo. Visto isso, demanda um conhecimento técnico científico aprimorado no que tange à prestação de serviços da equipe de Enfermagem que atuam diretamente nos cuidados com pacientes oncológicos. Objetivo: analisar através de revisão integrativa na literatura, a identificação de complexidades da assistência de Enfermagem requisitadas pelos pacientes oncológicos em fase de tratamento e a importância de uma assistência de Enfermagem qualificada para o prognóstico do mesmo. Material e métodos: Trata-se de um artigo de revisão integrativa procedente da Biblioteca Virtual de Saúde (BVS); Biblioteca Virtual de Saúde (BVS); através de consultas no DeCS: “Assistência de Enfermagem”, ”Oncologia”, "Enfermagem oncológica". Foram selecionados no total de cinco (07) artigos publicados entre o ano de 2019 até o presente ano (2023).  Resultados: Foi constatado fragilidade no conhecimento da equipe de Enfermagem no que se refere à assistência de Enfermagem frente ao paciente oncológico nos aspectos de segurança do paciente e no tratamento quimioterápico.  Conclusões: Compreende-se a necessidade de reforçar a ideia de adesão de sistemas padronizados na assistência de Enfermagem no tratamento quimioterápico e a importância da educação contínua e atualizada para os profissionais que atuam na área.   &nbsp

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)