7 research outputs found

    A utilização do cateter central de inserção periférica (CCIP) no ambiente hospitalar

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    El estudio objetiv√≥ analizar el hist√≥rico de la utilizaci√≥n del cat√©ter central de inserci√≥n perif√©rica en pacientes adultos e internados en ambiente hospitalario de 2000 a 2007. Tuvo abordaje de cohorte hist√≥rico con recolecci√≥n de datos retrospectivo en fichas del Grupo de Cat√©teres de la Asociaci√≥n Hospitalaria Molinos de Viento en Porto Alegre, RS, totalizando 229 cat√©teres inseridos. La curva de crecimiento en la utilizaci√≥n del CCIP fue de 1 cat√©ter inserido en 2000 a 57 inseridos en 2007. La prevalencia inherente a la patolog√≠a fue oncol√≥gica (17,9%, n=41). En relaci√≥n a las indicaciones de uso prevaleci√≥ la terapia con antibi√≥ticos (54,1%, n=124). En la confirmaci√≥n radiol√≥gica la vena cava fue prevalente (68,1%, n=156). La utilizaci√≥n del CCIP en el ambiente hospitalario est√° en expansi√≥n y la enfermer√≠a tiene un papel fundamental en la inserci√≥n, manutenci√≥n y remoci√≥n.O estudo objetivou analisar o hist√≥rico da utiliza√ß√£o do cateter central de inser√ß√£o perif√©rica em pacientes adultos e internados, em ambiente hospitalar, de 2000 a 2007. Teve abordagem de coorte hist√≥rica, com coleta de dados retrospectiva em prontu√°rios do Grupo de Cateteres da Associa√ß√£o Hospitalar Moinhos de Vento, em Porto Alegre, RS, totalizando 229 cateteres inseridos. A curva de crescimento na utiliza√ß√£o do cateter central de inser√ß√£o perif√©rica (CCIP) foi de 1 cateter inserido em 2000 a 57 inseridos em 2007. A preval√™ncia inerente √† patologia foi a oncol√≥gica (17,9%, n=41). Em rela√ß√£o √†s indica√ß√Ķes ao uso, prevaleceu a antibioticoterapia (54,1%, n=124). Na confirma√ß√£o radiol√≥gica, a veia cava foi prevalente (68,1%, n=156). Pode-se concluir que a utiliza√ß√£o do CCIP no ambiente hospitalar est√° em expans√£o e a enfermagem tem papel fundamental na inser√ß√£o, manuten√ß√£o e sua remo√ß√£o.The study aimed to analyze the history of the use of the peripherally inserted central catheters in adult patients admitted to hospital from 2000 to 2007. The historical cohort approach was used with retrospective data collection from medical records of the Catheter Group of the Moinhos de Vento Hospital Association in Porto Alegre, RS, totaling 229 catheters inserted. The growth curve in the use of the PICC was from 1 catheter inserted in 2000 to 57 in 2007. The most prevalent pathology was oncology (17.9%, n=41). In relation to the indications of use, antibiotic use prevailed (54.1%, n=124). In the radiological confirmation the vena cava was prevalent (68.1%, n=156). The use of the PICC in the hospital environment is expanding and nursing has a fundamental role in its insertion, maintenance and removal

    Risco de queda relacionado a medicamentos em hospitais: abordagem de aprendizado de m√°quina

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    Objective: To compare the performance of machine-learning models with the Medication Fall Risk Score (MFRS) in predicting fall risk related to prescription medications. Methods: This is a retrospective case-control study of adult and older adult patients in a tertiary hospital in Porto Alegre, RS, Brazil. Prescription drugs and drug classes were investigated. Data were exported to the RStudio software for statistical analysis. The variables were analyzed using Logistic Regression, Naive Bayes, Random Forest, and Gradient Boosting algorithms. Algorithm validation was performed using 10-fold cross validation. The Youden index was the metric selected to evaluate the models. The project was approved by the Research Ethics Committee. Results: The machine-learning model showing the best performance was the one developed by the Naive Bayes algorithm. The model built from a data set of a specific hospital showed better results for the studied population than did MFRS, a generalizable tool. Conclusion: Risk-prediction tools that depend on proper application and registration by professionals require time and attention that could be allocated to patient care. Prediction models built through machine-learning algorithms can help identify risks to improve patient care

    Cuidados de enfermagem e perfil epidemiol√≥gico de pacientes com pneumonia associada √† ventila√ß√£o mec√Ęnica

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    Background and Objectives: to assess the epidemiological profile of patients diagnosed with ventilator-associated pneumonia (VAP) in an Intensive Care Unit (ICU) and to investigate nursing care adequacy. Methods: a quantitative retrospective cohort study, applied in the ICU of a hospital in the countryside of Rio Grande do Sul. It involved 100% of medical records of patients over 20 years of age, in the year 2019, who developed VAP. Results: a total of 3,215 patients were on invasive mechanical ventilation (IMV), and of these 13 developed VAP (2.47%). Most were men (76.92%), with a mean age of 60.3 years, whose main causes of hospitalization were heart problems (30.77%), multiple trauma (30.77%) and stroke (15.39%). The main pathogens found in tracheal aspirates were Acinetobacter sp. (15%) and Pseudomonas aeruginosa (15%). The mean ICU stay was 30.61 days, and 61.53% died. For nursing care assessment, the mean checklist of the VAP bundle applied was calculated, according to the number of days in VMI. The result was 2.62 checklists per day, with the institution recommending four. Conclusion: the study made it possible to know the epidemiological profile of patients with VAP, in addition to observing the need for improvement in nursing care, considering that the checklist completion was below the recommended. ¬†Justificaci√≥n y Objetivos: evaluar el perfil epidemiol√≥gico de pacientes con diagn√≥stico de neumon√≠a asociada a ventilaci√≥n mec√°nica (NAVM) en una Unidad de Cuidados Intensivos (UCI) e investigar la adecuaci√≥n de los cuidados de enfermer√≠a. M√©todos: estudio de cohorte cuantitativo, retrospectivo, aplicado en el UCI de un hospital del interior de Rio Grande do Sul. Involucr√≥ el 100% de las historias cl√≠nicas de pacientes mayores de 20 a√Īos, en el a√Īo 2019, que desarrollaron NAVM. Resultados: un total de 3.215 pacientes estaban en ventilaci√≥n mec√°nica invasiva (VMI), y, de estos, 13 desarrollaron NAVM (2,47%). La mayor√≠a eran hombres (76,92%), con una edad media de 60,3 a√Īos, cuyas principales causas de hospitalizaci√≥n fueron problemas card√≠acos (30,77%), politraumatismos (30,77%) y accidentes cerebrovasculares (15,39%). Los principales pat√≥genos encontrados en los aspirados traqueales fueron Acinetobacter sp (15%) y Pseudomonas aeruginosa (15%). La estancia media en UCI fue de 30,61 d√≠as, y falleci√≥ el 61,53%. Para la evaluaci√≥n de la atenci√≥n de enfermer√≠a, se calcul√≥ el checklist promedio del bundle VAP aplicado, de acuerdo con el n√ļmero de d√≠as en VMI. El resultado fue de 2,62 checklists por d√≠a, y la instituci√≥n recomend√≥ cuatro. Conclusi√≥n: el estudio posibilit√≥ conocer el perfil epidemiol√≥gico de los pacientes con NAVM, adem√°s de observar la necesidad de mejor√≠a en la atenci√≥n de enfermer√≠a, considerando que el llenado del checklist estuvo por debajo de lo recomendado.Justificativa e Objetivos: avaliar o perfil epidemiol√≥gico de pacientes diagnosticados com pneumonia associada √† ventila√ß√£o mec√Ęnica (PAVM) em Unidade de Terapia Intensiva (UTI) e investigar a adequa√ß√£o dos cuidados de enfermagem. M√©todos: estudo quantitativo de coorte, retrospectivo, aplicado na UTI de um hospital do interior do Rio Grande do Sul. Envolveu 100% dos prontu√°rios de pacientes com mais de 20 anos de idade, no ano de 2019, que desenvolveram PAVM. Resultados: estiveram em ventila√ß√£o mec√Ęnica invasiva (VMI) 3.215 pacientes e, desses, 13 desenvolveram PAVM (2,47%). A maioria era homens (76,92%), com m√©dia de idade de 60,3 anos, cujas principais causas de interna√ß√£o foram problemas card√≠acos (30,77%), politraumatismo (30,77%) e acidente vascular cerebral (15,39%). Os principais pat√≥genos encontrados nos aspirados traqueais foram Acinetobacter sp (15%) e Pseudomonas aeruginosa (15%). A m√©dia de perman√™ncia na UTI foi de 30,61 dias, e foram a √≥bito 61,53%. Para avalia√ß√£o dos cuidados de enfermagem, foi calculada a m√©dia de checklist do bundle de PAVM, aplicados, conforme a quantidade de dias em VMI. O resultado foi de 2,62 checklists por dia, sendo que a institui√ß√£o preconiza quatro. Conclus√£o: o estudo permitiu conhecer o perfil epidemiol√≥gico dos pacientes com PAVM, al√©m de observar a necessidade de melhora nos cuidados de enfermagem, considerando que a realiza√ß√£o do checklist ficou abaixo do recomendado

    Impact of implementing a vancomycin protocol to reduce kidney toxicity: A comparative study

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    Introduction: Vancomycin is a frequently used antibiotic for treating severe infections caused by multidrug-resistant, Gram-positive pathogens. To ensure its effectiveness and minimize the risk of nephrotoxicity, safe administration and dose monitoring are crucial. Understanding the impact of vancomycin serum levels on clinical outcomes is of paramount importance, necessitating improved knowledge on its use, dose monitoring, nephrotoxicity, and safe administration.Objective: This study aimed to evaluate the incidence of acute kidney injury (AKI) in patients receiving vancomycin before and after the implementation of an institutional protocol for vancomycin administration in a public tertiary hospital in southern Brazil.Materials and methods: A cross-sectional study design was employed, analyzing data from the electronic medical records of 422 patients who received vancomycin. The patient population was divided into two independent cohorts: those treated in 2016 (pre-protocol) and those treated in 2018 (post-protocol), following the implementation of the institutional vancomycin administration protocol.Results: The study included 211 patients in each year of assessment. Patients from both cohorts had a Charlson Comorbidity Index (CCI) score of 4. The post-protocol cohort consisted of older individuals, with a mean age of 62.8¬†years. In addition, patients in the post-protocol year had higher baseline creatinine levels, higher rates of intensive care unit (ICU) hospitalization, and increased use of vasopressors. In the pre-protocol year, patients received vancomycin therapy for a longer duration. When comparing the incidence of AKI between the two groups, an intervention study revealed rates of 38.4% in group 1 and 20.9% in group 2, indicating a significant reduction (p < 0.001) in the post-protocol group. A logistic regression model was developed to predict AKI, incorporating variables that demonstrated significance (p ‚ȧ 0.250) in bivariate analysis and those recognized in the literature as important factors for AKI, such as the duration of therapy, vancomycin serum level, and ICU hospitalization. The logistic regression classification performance was assessed using a receiver operating characteristic (ROC) curve, yielding an area under the curve of 0.764, signifying acceptable discrimination of the regression model.Conclusion: Implementation of the institutional protocol for vancomycin administration resulted in a significant and cost-effective impact, ensuring appropriate therapeutic dosing, reducing adverse events (e.g., nephrotoxicity), and improving clinical outcomes for patients in the study population

    Prevalence of hepatitis C in patients with renal disease undergoing hemodialysis treatment

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    Introduction and Objective: This study aimed at determining the prevalence of hepatitis C among 649 patients diagnosed with chronic or acute kidney disease − patients were undergoing hemodialysis treatment at a large hemodialysis center in Porto Alegre-RS, from January through December, 2012 –, as well as relating our data to that presented in the national census, reporting cases of coinfection by hepatitis C and human immunodeficiency virus (HIV), and defining the demographic profile of these patients. Method: An observational cross-sectional study was conducted and data was obtained from information in patients’ electronic medical records. Result and conclusion: The prevalence of hepatitis C in this study was 10.17% of the sampled population. However, further analysis of other liver centers would be required to estimate an accurate prevalence rate of infection caused by the hepatitis C virus in patients undergoing hemodialysis in Porto Alegre
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