ABORDAGENS PARA MELHORAR A SEGURANÇA DO PACIENTE EM UNIDADE DE TERAPIA INTENSIVA

Objective: to reflect on the relationship between epidemiological data and previous patient safety assessments and consider how nurses in intensive care units can be advocates for taking appropriate measures to reduce adverse events. Methodology: This is a descriptive study of the reflective analysis type, organized in two parts: a narrative review that allowed the theoretical and theoretical development of the mentioned topic, and the subsequent analysis between close concepts. Results: Based on theoretical developments, it was established that to promote public policies focused on service quality it is necessary to increase understanding of the context in which injured people find themselves in the health care process. In further analysis, the poor practice study highlighted the importance of risk factors as they measured the gap between support provided and better care and the provision of critical information to build safer health systems. Final Considerations: Reviewing adverse events is an excellent strategy for effective risk management in hospital operations, especially in intensive care units. This is because it provides better accident control, reduces losses and costs from adverse events and facilitates decision-making. You will help create, plan and improve patient safety.Objetivo: refletir sobre a relação dos dados epidemiológicos com avaliações prévias de segurança do paciente e considerar como o enfermeiro em unidades de terapia intensiva pode ser um defensor da tomada de medidas adequadas para redução de eventos adversos. Metodologia: Trata-se de um estudo descritivo do tipo análise reflexiva, organizado em duas partes: uma revisão narrativa que permitiu o desenvolvimento teórico e teórico do tema mencionado, e a posterior análise entre conceitos próximos. Resultados: Com base nos desenvolvimentos teóricos, estabeleceu-se que para promover políticas públicas focadas na qualidade do serviço é necessário aumentar a compreensão do contexto em que as pessoas acidentadas se encontram no processo de cuidado em saúde. Numa análise mais aprofundada, o estudo sobre práticas deficientes destacou a importância dos fatores de risco, uma vez que mediram a lacuna entre o apoio prestado e melhores cuidados e o fornecimento de informações críticas para construir sistemas de saúde mais seguros. Considerações Finais: A revisão de eventos adversos é uma excelente estratégia para o gerenciamento eficaz de riscos nas operações hospitalares, especialmente em unidades de terapia intensiva. Isso porque proporciona melhor controle de acidentes, reduz perdas e custos com eventos adversos e facilita a tomada de decisões. Você ajudará a criar, planejar e melhorar a segurança do paciente

O ACOLHIMENTO DA FAMÍLIA EM UNIDADE DE TERAPIA INTENSIVA NEONATAL E PEDIÁTRICA

The neonatal intensive care unit (NICU) is an essential environment for the treatment of high-risk and stressful neonates for patients and their families. The implementation of family-centered care, such as the implementation of humanistic embracement, requires understanding the experiences of fear, anxiety and anguish experienced by family members and addressing care needs that transcend the technical scope and condition the patient's clinical experience. Qualitative review systematic review of the perception of welcoming by nursing professionals and their families during admission to the neonatal intensive care unit. This is a qualitative systematic review with a metasynthesis approach, developed according to the guidelines of the Joanna Briggs Institute. The guiding question is: What is the opinion of nurses and family members regarding hospitalized newborns at risk of admission to the neonatal intensive care unit? The inclusion criteria were: participants (nurses and family members), design (admission), location (neonatal intensive care unit) and type of study: original qualitative study. The searches were carried out in the Scientific Electronic Libraries Online (SciELO), SciVerse Scopus (SCOPUS), Medical Literature Analysis and Retrieval System Online (MEDLINE) and Cumulative Index to Nursing and Allied Health Literature (CINAHL), using the plural term: understanding of cure. . Or kiss and neonatal intensive care unit at home. Language (English, Portuguese, Spanish), publication period (last five years) and total availability were defined as search limitations. The search returned 698 works. Among them, 12 articles were selected as a review set. In terms of methodological quality, the majority of studies met all criteria listed in the JBI Qualitative Research Critical Appraisal Checklist, with 3 studies meeting 7 criteria, 1 study meeting 8 criteria, and 1 study meeting 8 criteria. . 9 out of 10 criteria. The meta-analysis allowed the construction of 4 thematic categories representing the meaning and definition of reception, the necessary conditions, the difficulties and needs necessary to implement reception, and the consequences and consequences associated with (non)receptive practices. The results showed that there are still many gaps in the reception process due to the lack of professionals with the qualifications and equipment necessary to provide more sensitive care, as well as families' understanding of the medical team's workflow Interact and find out more obstacle The complexity of environments such as the neonatal intensive care unit raises issues that need to be addressed, including family leadership, caregiving relationships, and collaboration. Understanding the main meanings of the welcome that caregivers and families receive during the newborn's stay in the NICU is crucial to clarify gaps between experiences and expectations, identify differences and converge meanings to achieve mutual understanding.  A unidade de terapia intensiva neonatal (UTIN) é um ambiente essencial para o tratamento de neonatos de alto risco e estressante para os pacientes e seus familiares. A implementação do cuidado centrado na família, como a implantação do acolhimento humanístico, requer a compreensão das experiências de medo, ansiedade e angústia vivenciadas pelos familiares e a abordagem de necessidades de cuidado que transcendem o âmbito técnico e condicionam a clínica do paciente.Revisão qualitativa sistemática sobre a percepção do acolhimento pelos profissionais de enfermagem e seus familiares durante a admissão na unidade de terapia intensiva neonatal. Trata-se de uma revisão sistemática qualitativa com abordagem de metassíntese, desenvolvida segundo as diretrizes do Instituto Joanna Briggs. A questão norteadora é: Qual a opinião dos enfermeiros e familiares em relação aos recém-nascidos hospitalizados com risco de internação na unidade de terapia intensiva neonatal? Os critérios de inclusão foram: participantes (enfermeiros e familiares), desenho (admissão), local (unidade de terapia intensiva neonatal) e tipo de estudo: estudo qualitativo original. As buscas foram realizadas nas bases Scientific Electronic Libraries Online (SciELO), SciVerse Scopus (SCOPUS), Medical Literature Analysis and Retrieval System Online (MEDLINE) e Cumulative Index to Nursing and Allied Health Literature (CINAHL), utilizando o termo plural: compreensão da cura. . Ou beijo e unidade de terapia intensiva neonatal em casa. Idioma (inglês, português, espanhol), período de publicação (últimos cinco anos) e disponibilidade total foram definidos como limitações da busca. A busca retornou 698 trabalhos. Dentre eles, 12 artigos foram selecionados como conjunto de revisão. Em termos de qualidade metodológica, a maioria dos estudosatendeu a todos os critérios listados na lista de verificação de avaliação crítica de pesquisa qualitativa do JBI, com 3 estudos atendendo a 7 critérios, 1 estudo que atendeu a 8 critérios e 1 estudo atendeu a 8 critérios. 9 de 10 critérios. A meta-análise permitiu a construção de 4 categorias temáticas representativas do significado e definição do acolhimento, das condições necessárias, das dificuldades e necessidades necessárias à implementação do acolhimento, e das consequências e consequências associadas às práticas (não)receptivas. Os resultados mostraram que ainda existem muitas lacunas no processo de acolhimento devido à falta de profissionais com qualificação e equipamentos necessários para prestar um cuidado mais sensível, bem como a compreensão das famílias sobre o fluxo de trabalho da equipe médica Interaja e saiba mais obstáculo A complexidade de ambientes como a unidade de cuidados intensivos neonatais levanta questões que precisam de ser abordadas, incluindo a liderança familiar, as relações de prestação de cuidados e a colaboração. Compreender os principais significados do acolhimento que cuidadores e famílias recebem durante a permanência do recém-nascido na UTIN é crucial para esclarecer lacunas entre experiências e expectativas, identificar diferenças e convergir significados para alcançar o entendimento mútuo

Chemical and mechanical characterization of ternary cement pastes containing metakaolin and nanosilica

This paper, for the first time, focuses on the characterization of the chemical and mechanical properties of ternary cement pastes with the addition of up to 18% of metakaolin and colloidal nanosilica. The paste containing 15% of metakaolin and 3% of nanosilica presented an increase of 44% on the compressive strength and a reduction of 66% on the average pore diameter at the age of 91 days, in comparison with the reference paste. Results obtained remark the high potential of ternary cement mixes produced with the combination of metakaolin and nanosilica for the production of high performance cementitious materials.The authors would like to thank the postgraduate program in Structural Engineering and Construction from University of Brasília, Furnas Centrais Elétricas, Addendum to the Framework Agreement for Collaboration between University of Brasilia (UnB-Brazil) and Spanish National Research Council (CSIC-Spain) (ref: 201504001653451013W-2017), Eduardo Torroja Institute for Construction Science, Geology Institute from University of Brasília, Geochronology Laboratory from University of Brasília, Chemistry Institute from Federal University of Goiás, State University of Goiás and Unievangélica Center of Anápolis.Peer reviewe

Investigation of C-S-H in ternary cement pastes containing nanosilica and highly-reactive supplementary cementitious materials (SCMs): Microstructure and strength

This pioneering study reports on the investigation of C-S-H in as-produced ternary cement pastes while highly reactive supplementary cementitious materials, such as silica fume (SF) and metakaolin (MK), and colloidal nanosilica (NS) are included into the mixtures. Several techniques are used to evaluate the microstructure of the pastes containing colloidal NS (3%), SF (10%) and MK (10%): Consistency, compressive strength, thermogravimetric analyses, Fourier transform infrared spectroscopy, scanning electron microscopy (with energy dispersive X-ray spectrometry), 29Si-nuclear magnetic resonance, and mercury intrusion porosimetry. Ternary mixtures containing SF or MK require the highest superplasticizer (SP) consumption of 1.55% and 1.92%, respectively. Impressively, in late stage of aging, i.e 28 and 91 days of hydration, ternary mixtures reach compressive strength respectively above 90 MPa and 100 MPa, meaning an increase of about 30% above of the compressive strength of the reference paste. Moreover, the ternary MK-based paste shows increase C-S-H production, decreasing Ca/Si ratio and superior increasing mean chain length (MCL) of about 11.1 while compared with the MCL of the reference paste (about 4.6). Likewise, the highest relative reduction in mean porous size (56%) and the lowest totalThe authors would like to thank the Furnas Centrais Elétricas, Chemistry Institute from Federal University of Goiás, State University of Goiás and Unievangélica Center of Anápolis, Postgraduate Program in Structural Engineering and Construction from University of Brasília, Brazil Geology Institute from University of Brasília, Geochronology Laboratory from University of Brasília, Addendum to the Framework Agreement for Collaboration between University of Brasilia (UnB-Brazil) and Spanish National Research Council, Spain (CSIC-Spain) (ref: 201504001653451013W-2017), Eduardo Torroja Institute for Construction Science.Peer reviewe

Properties of ternary cement pastes with nanosilica and rice husk ssh

The present study reports on the pioneering addition of rice husk ash (RHA) and silica fume (SF) into portland cement-based (PC-based) materials, combined with nanosilica (NS), aiming to assess the impact of the RHA on the mechanical and microstructure properties of ternary mixtures. Pastes were prepared to perform compressive strength tests, thermal analysis (DTA/TG), infrared spectroscopy, and mercury porosimetry. The highest reduction in the calcium hydroxide index (CH.I) and the highest calciumsilicate- hydrate (C-S-H) formation are found in the PC-based ternary mixture containing NS plus SF and NS plus RHA after 91 days of hydration. In line with the aforementioned trends, the ternary mixtures containing NS show the highest compressive strength values and reduction of mean diameter of porous. Indeed, we found strong evidence of synergistic effect in ternary mixtures incorporating NS plus RHA or SF, thus supporting their use in fabrication of cementitious materials.Peer reviewe

Effect of partial substitution of highly reactive mineral additions by nanosilica in cement pastes

The phenomena involved in portland cement hydration and interactions with nanosilica are very complex and not yet fully understood. In addition, few papers have currently proposed to investigate the microstructure and mechanical properties of ternary mixtures using portland cement, colloidal nanosilica, and highly reactive mineral additions. This article investigates, for the first time, the behavior of different highly reactive mineral additions (silica fume and metakaolin) when partially replaced by colloidal nanosilica in the microstructure and hydration of cementitious materials. For the study of the cementitious material microstructures, a Langavant calorimeter, compressive strength, X-ray diffraction, thermogravimetry, infrared spectroscopy, and mercury intrusion porosimetry were used. The pastes with a 1% substitution of highly reactive mineral additions by nanosilica showed higher compressive strength and more refined porosity than the pastes with only silica fume or metakaolin. The results show that nanosilica appears to have better synergism with metakaolin than with silica fume.The authors also acknowledge the support provided by the European Commission, by Marie Curie IRSES Project GREAT (FP7-PEOPLE-2013-IRSES-612665), Addendum to the Framework Agreement for Collaboration between University of Brasilia (UnB433 Brazil) and Spanish National Research Council (CSIC-Spain) (ref: 201504001653451013W-2017), and by the Laboratory of Ceramic Materials (LACER) of the Federal University of Rio Grande do Sul (UFRGS-Brasil) for the laser granulometry and specific surface BET tests.Peer reviewe

Analysis of the Microstructure and Porosity of Cement Pastes with Functionalized Nanosilica with Different Contents of Aminosilane

This research aims to analyze the effect of functionalized nanosilica (NSF) with different levels of amine groups in the formation of hydration products. Four cement pastes were investigated, one reference with Portland cement and three replacing 1% of Portland cement by nanosilica (NS), NSF with a low content of amine groups, and NSF with a high content of amine groups. The heat of hydration of the pastes was evaluated up to 7 days of hydration, the amount of calcium hydroxide (CH) and hydrated phases by means of the thermogravimetric analysis (TGA) test and compressive strength at 2, 7, and 28 days, and porosity through tests of mercury intrusion porosimetry and computed tomography at 28 days of hydration. It was possible to observe that the NSF directly influenced the hydration kinetics of the pastes, delaying the hydration of the Portland cement; however, it demonstrated a similar mechanical performance to the paste with NS at 2 days of hydration and an increase of 10% at 28 days of hydration due to the improvement in the hydration process. Thus, it is possible to conclude that the functionalization of NSF with a low 3-aminopropyltriethoxysilane (APTES) content is promising for use in cementitious materials and may improve hydration and mechanical performance at more advanced ages compared to NS

Energy Balance, CO2 Balance, and Meteorological Aspects of Desertification Hotspots in Northeast Brazil

The main objective of this study was to evaluate meteorological variables and the simulated components of energy and CO2 balances in desertification hotspots in Northeast Brazil. Meteorological data were obtained from the National Institute of Meteorology measurement network for the Cabrobó and Ibimirim sites. Initially, hourly linear trends were calculated for the meteorological variables using the non-parametric Mann–Kendall test. Then, the seasonal variability in the components of energy and CO2 balances was assessed through simulations of the simple tropical ecosystem (SITE) model. Results showed evidence of increasing air temperature trends in the Cabrobó site in the first months of the year, which was not observed in the Ibimirim site. Regarding relative humidity, increasing trends were observed in a few months over the Cabrobó site, while decreasing trends were observed in the Ibimirim site. Opposite behaviors were also identified for the trends in wind speed in both sites. Gross primary production (GPP) and net ecosystem exchange (NEE) simulated values were higher in the first half of the year in both sites. GPP varied from 0.8 to 1.2 g C m−² h−¹, and NEE fluctuated around approximately −5 g C m−² h−¹. These results indicate that rainfall seasonality is a crucial factor for the modulation of CO2 and energy balance fluxes in the Caatinga biome