Development of “care for skin integrity in the neonatal period”: documentation tool for skin conditions / Desenvolvimento do “cuidado com a integridade da pele neonatal”: instrumento para documentação das condições da pele

Objective: To develop tool for documenting skin conditions and wound management in neonatal patients´s records. Method: Methodological study conducted in two stages: development of the tool based on literature; content validation by a committee of experts and testing by administration to 50 newborns with wounds. Kappa coefficient was used to evaluate qualitative items, and Intraclass Correlation Coefficient (ICC) for quantitative items. Findings: The content of Care for Skin Integrity in the Neonatal Period (CIPNeo) were validated by 9 experts. Conclusion: The content of CIPNeo was validated. It showed satisfactory reliability when administered by nurses to patients, and is adequate for promoting documentation about skin conditions and wound management. Daily records are essential for continuous evaluation of factors for wound prevention, assessment, monitoring and treatment, and for providing support to nurses’ clinical reasoning.Objetivo: Desarrollar una herramienta para documentar condiciones de la piel y el manejo de heridas en pacientes neonatales. Método: Estudio metodológico realizado en dos etapas: desarrollo de la herramienta con base en la literatura; validación de contenido por un comité de expertos y pruebas por administración a 50 recién nacidos con heridas. Se utilizó el coeficiente Kappa para evaluar los ítems cualitativos y el coeficiente de correlación intraclase (CCI) para los ítems cuantitativos. Hallazgos: El contenido de Cuidado para integridade da pele neonatal (CIPNeo) fue validado por 9 expertos. Conclusión: Se validó el contenido de CIPNeo. Mostró una confiabilidad satisfactoria cuando fue administrado por enfermeras a los pacientes y es adecuado para promover la documentación sobre las condiciones de la piel y el manejo de heridas. Los registros diarios son esenciales para la evaluación continua de los factores de prevención, evaluación, seguimiento y tratamiento de las heridas, y para brindar apoyo al razonamiento clínico de las enfermeras.Objetivo: Desenvolver instrumento para documentar as condições da pele e o manejo de feridas de pacientes neonatais. Método: Estudo metodológico realizado em etapas: desenvolvimento de instrumento para registro, com base na literatura; validação de conteúdo por comitê de especialistas e teste com 50 recém-nascidos com feridas. O coeficiente Kappa foi utilizado para avaliar itens qualitativos e o Coeficiente de Correlação Intraclasse (ICC) para quantitativos. Resultados: O conteúdo do Cuidado para a Integridade da Pele Neonatal (CIPNeo) foi validado por 9 especialistas. Conclusão: O conteúdo do CIPNeo foi validado. Apresentou confiabilidade satisfatória quando administrado por enfermeiras aos pacientes, sendo adequado para promover documentação sobre condições de pele e manejo de feridas. Os registros diários são essenciais para avaliação contínua quanto a prevenção, monitoramento e tratamento de feridas, assim como para fornecer suporte ao raciocínio clínico dos enfermeiros.

Feasibility of trial procedures for a randomised controlled trial of a community based group exercise intervention for falls prevention for visually impaired older people: the VIOLET study

Background Visually impaired older people (VIOP) have a higher risk of falling than their sighted peers, and are likely to avoid physical activity. The aim was to adapt the existing Falls Management Exercise (FaME) programme for VIOP, delivered in the community, and to investigate the feasibility of conducting a definitive randomised controlled trial (RCT) of this adapted intervention. Methods Two-centre randomised mixed methods pilot trial and economic evaluation of the adapted group-based FaME programme for VIOP versus usual care. A one hour exercise programme ran weekly over 12 weeks at the study sites (Newcastle and Glasgow), delivered by third sector (voluntary and community) organisations. Participants were advised to exercise at home for an additional two hours over the week. Those randomised to the usual activities group received no intervention. Outcome measures were completed at baseline, 12 and 24 weeks. The potential primary outcome was the Short Form Falls Efficacy Scale – International (SFES-I). Participants’ adherence was assessed by reviewing attendance records and self-reported compliance to the home exercises. Adherence with the course content (fidelity) by instructors was assessed by a researcher. Adverse events were collected in a weekly phone call. Results Eighteen participants, drawn from community-living VIOP were screened; 68 met the inclusion criteria; 64 participants were randomised with 33 allocated to the intervention and 31 to the usual activities arm. 94% of participants provided data at the 12 week visit and 92% at 24 weeks. Adherence was high. The intervention was found to be safe with 76% attending nine or more classes. Median time for home exercise was 50 min per week. There was little or no evidence that fear of falling, balance and falls risk, physical activity, emotional, attitudinal or quality of life outcomes differed between trial arms at follow-up. Conclusions The intervention, FaME, was implemented successfully for VIOP and all progression criteria for a main trial were met. The lack of difference between groups on fear of falling was unsurprising given it was a pilot study but there may have been other contributory factors including suboptimal exercise dose and apparent low risk of falls in participants. These issues need addressing for a future trial

UMA REVISÃO DA LITERATURA NEONATAL PARA IDENTIFICAR ATRIBUTOS CRÍTICOS PARA DIAGNÓSTICOS DE ENFERMAGEM DE HIPOTERMIA

El objetivo del estudio fue explorar indicadores diagnósticos en neonatos para diagnóstico de enfermería aprobado por NANDA International, Inc., hipotermia, y para uno diagnóstico propuesto, el riesgo de hipotermia. En esta revisión integradora, 23 artículos fueron revisados de CINAHL, PubMed y Lilacs, de enero a abril de 2013. Los datos fueron extraídos de los artículos y sintetizados para desarrollar una lista de potenciales factores relacionados y/o de riesgo y características definitorias. Se identificaron potenciales características definitorias y factores relacionados asociados a los recién nacidos durante las pruebas clínicas en hipotermia (23 y 17 respectivamente). Veintitrés factores de riesgo se identificaron para el riesgo de hipotermia. Indicadores diagnósticos para diagnósticos de enfermería que ponen a los recién nacidos en riesgo de morbilidad y mortalidad permitirán detección y evaluación de riesgos más apropiadas. Estos indicadores diagnósticos recientemente identificados requieren investigaciones para validar su utilidad clínica

Diagnosis Keperawatan: Defenisi dan klasifikasi 2012-2014 (NANDA International)

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Senam Hamil: Relaxation and Exercise for Childbirth

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