Strategies in coping with the COVID-19 pandemic by nursing professionals: doing and learning

Objective: To describe strategies in coping with the COVID-19 pandemic adopted by nursing professionals. Method: Qualitative research conducted in a public teaching hospital in Salvador  –  Bahia, Brazil, between September and October 2020. A total of 17 nursing professionals who work in a reference unit for symptomatic respiratory patients were interviewed. Data were collected through semi-structured interviews and analyzed in the IRAMUTEQ software. The project was approved by a Research Ethics Committee. Results: nursing professionals developed strategies to cope with the pandemic to care for patients with COVID-19, their own family members, the team and themselves. For patients, the strategies adopted include greater concern for comfort, safety and improvements in the communication process. The distancing of family members has given rise to the need for the use of technological resources to favor approximation. A greater concern was identified with the protection of team members and with themselves, as they emphasized the correct use of personal protective equipment as a way to feel more protected and safe, including emotionally. Conclusion: The strategies developed by the professionals emerged from the practice to the extent that they were experiencing care to patients with COVID-19. These strategies aimed to adopt measures for self-protection, protection of their family members and team colleagues; and humanized patient care

Notificação de incidentes relacionados à assistência à saúde em crianças hospitalizadas

Objective: Analyzing the occurrence of incidents related to health care in hospitalized children.Material and method: An exploratory, descriptive and quantitative research conducted from a database of reports of incidents and adverse events involving children conducted between 2016 and 2018 from a teaching hospital belonging to the Unified Health System (SUS), located in Salvador - Bahia. The data were analyzed in the STATA version 12 program.Results: During the study period, 126 incidents were reported. Most of the children who suffered incidents were between 0 and 3 years old (57.14%); were male (58.73%); and belonged to the black race (87.92%). The incidents occurred mostly in the morning shift (29.37%), and the notifications were identified in 71.46% of the cases and were performed by nurses (88.10%). The most reported incidents were falls (29.37%); surgical (23.02%); phlebitis (9.52%); and skin lesions (8.73%). There was damage to patients in 39.68% of the cases, which was mild (80%).Conclusions: The findings indicate the need to create methods for assessing risk factors that favor the occurrence of incidents such as falls and other situations that compromise the safety of hospitalized children, since these patients have peculiarities that need to be considered in health care.Objetivo: Analizar la ocurrencia de incidentes relacionados con la atención de la salud en niños hospitalizados.Material y método: Investigación exploratoria, descriptiva y cuantitativa realizada a partir de una base de datos de reportes de incidentes y eventos adversos que involucran a niños realizada entre 2016 y 2018, desde un hospital docente, perteneciente al Sistema Único de Salud (SUS), ubicado en Salvador - Bahía. Los datos fueron analizados en el programa STATA versión 12.Resultados: Durante el período de estudio se reportaron 126 incidentes. La mayoría de los niños que sufrieron incidentes tenían entre 0 y 3 años (57,14%); eran hombres (58,73%); y pertenecía a la raza negra (87,92%). Los incidentes ocurrieron principalmente en el turno de mañana (29,37%), y las notificaciones se identificaron en el 71,46% de los casos y fueron realizadas principalmente por enfermeras (88,10%). Los incidentes más reportados fueron caídas (29,37%); quirúrgico (23,02%); flebitis (9,52%); y lesiones cutáneas (8,73%). Hubo daños en los pacientes en el 39,68% de los casos, que fueron predominantemente leves (80%).Conclusiones: Los hallazgos indican la necesidad de crear métodos para evaluar los factores de riesgo que favorezcan la ocurrencia de incidentes como caídas y otras situaciones que comprometan la seguridad de los niños hospitalizados, ya que estos pacientes tienen peculiaridades que deben ser consideradas en la atención de la salud.Objetivo: Analisar a ocorrência de incidentes relacionados à assistência à saúde em crianças hospitalizadas. Material e método: Pesquisa exploratória, descritiva e quantitativa realizada a partir de um banco de dados de notificações de incidentes e eventos adversos envolvendo crianças realizadas entre 2016 e 2018, de um hospital de ensino pertencente ao Sistema Único de Saúde (SUS), localizado em Salvador – Bahia. Os dados foram analisados no programa STATA versão 12. Resultados: No período do estudo foram notificados 126 incidentes. A maioria das crianças que sofreram incidentes se encontrava na faixa etária dos 0 aos 3 anos (57,14%); eram do sexo masculino (58,73%); e pertenciam à raça negra (87,92%). Os incidentes ocorreram majoritariamente no turno da manhã, (29,37%), sendo as notificações identificadas em 71,46% dos casos e foram realizadas principalmente por enfermeiros, (88,10%). Os incidentes mais notificados foram as quedas (29,37%); os cirúrgicos (23,02%); as flebites (9,52%); e as lesões de pele (8,73%). Houve dano aos pacientes em 39,68% dos casos, sendo este predominantemente de grau leve (80%). Conclusões: Os achados indicam a necessidade de criar métodos de avaliação dos fatores de risco que favorecem a ocorrência de incidentes como as quedas e demais situações que comprometem a segurança de crianças hospitalizadas, uma vez que esses pacientes apresentam peculiaridades que precisam ser consideradas no cuidado à saúde.

Notification of incidents related to health care in hospitalized children

Objetivo: Analizar la ocurrencia de incidentes relacionados con la atención de la salud en niños hospitalizados.Material y método: Investigación exploratoria, descriptiva y cuantitativa realizada a partir de una base de datos de reportes de incidentes y eventos adversos que involucran a niños realizada entre 2016 y 2018, desde un hospital docente, perteneciente al Sistema Único de Salud (SUS), ubicado en Salvador - Bahía. Los datos fueron analizados en el programa STATA versión 12.Resultados: Durante el período de estudio se reportaron 126 incidentes. La mayoría de los niños que sufrieron incidentes tenían entre 0 y 3 años (57,14%); eran hombres (58,73%); y pertenecía a la raza negra (87,92%). Los incidentes ocurrieron principalmente en el turno de mañana (29,37%), y las notificaciones se identificaron en el 71,46% de los casos y fueron realizadas principalmente por enfermeras (88,10%).Los incidentes más reportados fueron caídas (29,37%); quirúrgico (23,02%); flebitis (9,52%); y lesiones cutáneas (8,73%). Hubo daños en los pacientes en el 39,68% de los casos, que fueron predominantemente leves (80%). Conclusiones: Los hallazgos indican la necesidad de crear métodos para evaluar los factores de riesgo que favorezcan la ocurrencia de incidentes como caídas y otras situaciones que comprometan la seguridad de los niños hospitalizados, ya que estos pacientes tienen peculiaridades que deben ser consideradas en la atención de la salud.Objetivo: Analisar a ocorrência de incidentes relacionados à assistência à saúde em crianças hospitalizadas. Material e método: Pesquisa exploratória, descritiva e quantitativa realizada a partir de um banco de dados de notificações de incidentes e eventos adversos envolvendo crianças realizadas entre 2016 e 2018, de um hospital de ensino pertencente ao Sistema Único de Saúde (SUS), localizado em Salvador – Bahia. Os dados foram analisados no programa STATA versão 12. Resultados: No período do estudo foram notificados 126 incidentes. A maioria das crianças que sofreram incidentes se encontrava na faixa etária dos 0 aos 3 anos (57,14%); eram do sexo masculino (58,73%); e pertenciam à raça negra (87,92%). Os incidentes ocorreram majoritariamente no turno da manhã, (29,37%), sendo as notificações identificadas em 71,46% dos casos e foram realizadas principalmente por enfermeiros, (88,10%). Os incidentes mais notificados foram as quedas (29,37%); os cirúrgicos (23,02%); as flebites (9,52%); e as lesões de pele (8,73%). Houve dano aos pacientes em 39,68% dos casos, sendo este predominantemente de grau leve (80%). Conclusões: Os achados indicam a necessidade de criar métodos de avaliação dos fatores de risco que favorecem a ocorrência de incidentes como as quedas e demais situações que comprometem a segurança de crianças hospitalizadas, uma vez que esses pacientes apresentam peculiaridades que precisam ser consideradas no cuidado à saúde.Objective: Analyzing the occurrence of incidents related to health care in hospitalized children.Material and method: Anexploratory, descriptive and quantitative research conducted from a database of reports of incidents and adverse events involving children conducted between 2016 and 2018 from a teaching hospital belonging to the Unified Health System (SUS), located in Salvador - Bahia. The data were analyzed in the STATA version 12 program.Results: During the study period, 126 incidents were reported. Most of the children who suffered incidents were between 0 and 3 years old (57.14%); were male (58.73%); and belonged to the black race (87.92%). The incidents occurred mostly in the morning shift (29.37%), and the notifications were identified in 71.46% of the cases and were performed by nurses (88.10%).The most reported incidents were falls (29.37%); surgical (23.02%); phlebitis (9.52%); and skin lesions (8.73%). There was damage to patients in 39.68% of the cases, which was mild (80%). Conclusions: The findings indicate the need to create methods for assessing risk factors that favor the occurrence of incidents such as falls and other situations that compromise the safety of hospitalized children, since these patients have peculiarities that need to be considered in health care

NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics

Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the 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)