Search

The study aimed to develop and validate, through machine learning, a fall risk prediction model related to prescribed medications specific to adults and older adults admitted to hospital. A case-control study was carried out in a tertiary hospital, involving 9,037 adults and older adults admitted to hospital in 2016. The variables were analyzed using the algorithms: logistic regression, naive bayes, random forest and gradient boosting. The best model presented an area under the curve = 0.628 in the older adult subgroup, compared to an area under the curve (AUC) = 0.776 in the adult subgroup. A specific model was developed for this sample. The gradient boosting model presented the best performance in the sample of older adults (AUC = 0.71). Models developed to predict the risk of falls based on medications specifically aimed at older adults presented better performance in relation to models developed in the total population studied., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Amanda Pestana da Silva reports financial support was provided by Coordination for the Improvement of Higher Education Personnel and by the National Council for Scientific and Technological Development (CNPq). If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: To examine the quality of life of children who depend on health technologies as expressed in their own words., Methods: A parallel and convergent mixed methods design was employed with 30 aged five to 12 year old children who depend on health technologies. Data collection was done through a characterization form, Pediatric Quality of Life Inventory 4.0 questionnaire with the total sample in quantitative phase; semi-structured interviews with a subset of nine participants in qualitative phase. Quantitative and qualitative data were analyzed using descriptive statistics and deductive thematic content analyses, respectively., Results: Findings from PedsQL 4.0 showed that quality of life for children who depend on health technologies is average. However, data integration through mixed methods showed that this average goes beyond quantitative data through hearing the children's own voices. The results from data integration pointed out that children recognize their limitations and adapt to them; what most affects their quality of life is the emotional domain; children reported suffering prejudice due to their physical limitations; and that the school positively impacts their quality of life., Conclusions: Data integration highlighted that children acknowledge their limitations and pain generated by these devices. Concerns about the future and the ability to do things that other children the same age can do was the most impactful aspect on their quality of life., Implications for Practice: Nursing care plans should consider that what affects most children who depend on health technologies' quality of life is anxiety for the future of being incapacitated or dependent., Competing Interests: Declaration of Competing Interest The authors of the manuscript “Quality of life in the voice of children who depend on health technologies: mixed methods study” Neves ET, Silva JH, Urbanetto JS, Buboltz FL, Kegler JJ, Ribeiro CF, Oliveira DC, Lorenzini, E. declare no conflicts of interest., (Copyright © 2023. Published by Elsevier Inc.)

Objectives: to analyze patient safety culture from nursing professionals' perception at a university hospital, by assessing the convergence between the Safety Attitudes Questionnaire and the Hospital Survey on Patient Safety Culture., Methods: a cross-sectional study, with 434 nursing professionals. Data collection took place through the application of both instruments. Descriptive and inferential statistics were used., Results: in the Hospital Survey on Patient Safety Culture, the "teamwork within the units" dimension was considered a strong area of patient safety. In the Safety Attitudes Questionnaire, the "job satisfaction" and "perception of stress" domains reached the score for a good safety culture. Patient safety culture perception is correlated, in both instruments, with high magnitude., Conclusions: the two instruments converge towards a similar assessment of patient safety culture.

Background: Pressure injuries (PIs), especially in the sacral region are frequent, costly, and increase morbidity and mortality of patients in an intensive care unit (ICU). These injuries can occur as a result of prolonged pressure and/or shear forces. Neuromuscular electrical stimulation (NMES) can increase muscle mass and improve local circulation, potentially reducing the incidence of PI., Methods: We performed a randomized controlled trial to assess the efficacy and safety of NMES in preventing PI in critically ill patients. We included patients with a period of less than 48 h in the ICU, aged ≥ 18 years. Participants were randomly selected (1:1 ratio) to receive NMES and usual care (NMES group) or only usual care (control group-CG) until discharge, death, or onset of a PI. To assess the effectiveness of NMES, we calculated the relative risk (RR) and number needed to treat (NNT). We assessed the muscle thickness of the gluteus maximus by ultrasonography. To assess safety, we analyzed the effects of NMES on vital signs and checked for the presence of skin burns in the stimulated areas. Clinical outcomes were assessed by time on mechanical ventilation, ICU mortality rate, and length of stay in the ICU., Results: We enrolled 149 participants, 76 in the NMES group. PIs were present in 26 (35.6%) patients in the CG and 4 (5.3%) in the NMES group (p ˂ 0.001). The NMES group had an RR = 0.15 (95% CI 0.05-0.40) to develop a PI, NNT = 3.3 (95% CI 2.3-5.9). Moreover, the NMES group presented a shorter length of stay in the ICU: Δ = - 1.8 ± 1.2 days, p = 0.04. There was no significant difference in gluteus maximus thickness between groups (CG: Δ = - 0.37 ± 1.2 cm vs. NMES group: Δ = 0 ± 0.98 cm, p = 0.33). NMES did not promote deleterious changes in vital signs and we did not detect skin burns., Conclusions: NMES is an effective and safe therapy for the prevention of PI in critically ill patients and may reduce length of stay in the ICU. Trial registration RBR-8nt9m4. Registered prospectively on July 20th, 2018, https://ensaiosclinicos.gov.br/rg/RBR-8nt9m4., (© 2022. The Author(s).)

Objective: to assess the correlations between the patient safety culture, the missed Nursing care, and the reasons for the omission in the obstetric area., Method: a cross-sectional study, conducted in 2019, with 62 Nursing professionals working in the obstetric area of a teaching hospital in southern Brazil. The MISSCARE-Brasil and Hospital Survey on Patient Safety Culture instruments were used. The data were analyzed using descriptive statistics, means comparison test and Spearman correlation., Results: the overall mean of positive answers for the safety culture was 34.9 (± 17.4). The care of assessing the vital signs and monitoring capillary blood glucose were the most prioritized, with airway aspiration and oral hygiene being the most overlooked. The main reasons for the omissions refer to labor resources and to inadequate staffing. A significant and inversely proportional correlation was found between the patient safety culture and overlooked nursing care (r=-0.393)., Conclusion: the safety culture of the obstetric area was assessed as fragile by the Nursing professionals. The more the safety culture is strengthened and the greater investment in labor and human resources, the less care is overlooked.

Objective: Cross-cultural adaptation of the National Early Warning Score 2 to Brazilian Portuguese., Methods: A methodological study of a cross-cultural adaptation of a scale, based on the Beaton et al. framework, authorized by the Royal College of Physicians. Judges from nine Brazilian states, nurses and physicians evaluated the semantic, idiomatic, cultural, and conceptual equivalence between the original instrument and the translated versions. The nurses, working in inpatient or emergency units, conducted the pilot test, applying the final version to three case studies. Psychometric tests were used for data analysis: Content Validity Index (CVI), Kappa Coefficient, and Cronbach's Alpha., Results: The adaptation showed a mean CVI of 0.98 and perfect/almost perfect inter-rater agreement, with scores above 0.80. The consistency of the scale was 0.712., Conclusion: The process of cross-cultural adaptation of the scale to Brazilian Portuguese was successful, providing Brazilian professionals with an instrument aligned with patient safety.

Objective: To evaluate the environment of the professional practice of the nursing staff from inpatient units and to compare it according to professional and work characteristics., Method: A cross-sectional analytical study conducted in southern Brazil. Data was collected through the Brazilian version of the Nursing Work Index-Revised with a sample of (n=142) professionals, them being nurses (n=56; 34.9%) and nursing technicians/assistants (n=86; 60.6%). The analysis was performed by means of descriptive and analytical statistics., Results: The professional practice environment was considered favorable in all the subscales. The subscale of relationships between physicians/nursing staff showed a significant difference among the professional categories, with better results for nurses. The afternoon shift stood out in the favorable assessment. Longer working time at the institution and unit tended to have worse assessments for autonomy and control, respectively., Conclusion: The assessment of the practice environment was favorable; however, the study signals opportunities for improvements for the nursing team.

Objective: analyze associations between demographic, academic, health, stress, overweight and obesity characteristics among nursing students., Method: this is a cross-sectional study with 95 students from a private university in Rio Grande do Sul, Brazil. A demographic, academic and health characterization questionnaire and the Assessment of Stress in Nursing Students (ASNS) scale were applied. Anthropometric measures were taken and descriptive and bivariate analyses were performed., Results: female students predominated in this study, mean age: 25.6±5.87 years. Weight gain was observed in 52.6% of the students, with the 'Professional training' session reporting high (29.5%) and very high (36.8%) levels of stress. None of the stress scale sessions was associated with overweight and obesity., Conclusion: overweight and obesity were associated with male participants, high blood pressure, weight gain since the beginning of the course, altered waist circumference, no physical activity, eating more in stressful situations, and consumption of unhealthy foods.

Objective: To identify the population's knowledge of the terms "sepsis" and "acute myocardial infarction" (AMI)., Method: Cross-sectional quantitative study. Data was collected through the application of a questionnaire to two groups of participants, as follows: individuals who visit parks in Porto Alegre, State of Rio Grande do Sul and companions of patients of a university hospital in Porto Alegre. Analysis of the results was performed by descriptive and inferential statistics. RESULTSThe sample consisted of 1,986 respondents: 1,455 parkgoers and 531 companions of patients admitted to the hospital. Regarding the knowledge of sepsis, only 19.1% of the respondents had already heard about the subject. However, compared to knowledge about AMI, it was found that 98.7% knew the term., Conclusions: The study found that the scarce knowledge of the population about the term "sepsis" is related to the social level of the respondents, demonstrating poor access to information about health care.

Objective: To describe the scientific evidence published in literature regarding the risk factors for the development of phlebitis., Method: Integrative literature review with the inclusion of 14 original articles found in the LILACS, Scielo and Pubmed bases from January 2004 to April 2015, analyzed by levels of evidence and frequency, associated factors, degree and treatment of phlebitis., Results: The frequency / incidence / minimum rate of phlebitis was 3% and the maximum was 59.1%. Most articles (57.14%) reported an association of phlebitis with risk factors, including the dwell time, puncture site and / or anatomical region, hospitalization period, number of accesses, reason for removal, sex, antibiotics, intermittent maintenance and emergency insertion., Conclusions: The need for standardizing the quantification of this event and a weak connection between the risk factors associated with phlebitis were identified. Further studies need to be developed in order to grant a real understanding of this disease in the daily routines of a hospital.

Objective: to determine the incidence of phlebitis during and after the use of peripheral intravenous catheter (PIC), and analyse the association of this complication with risk factors., Methods: cohort study with 165 adult patients admitted to a university hospital in Porto Alegre, totalling 447 accesses, from December 2014 to February 2015. Data were collected on a daily basis and analysed by means of descriptive and analytical statistics., Results: The incidence of phlebitis during PIC was 7.15% and the incidence of post-infusion phlebitis was 22.9%. Phlebitis during catheter use was associated with the use of Amoxicillin + Clavulanic Acid. The grade of post-infusion phlebitis was associated with age and use of Amoxicillin + Clavulanic Acid, Tramadol Hydrochloride, and Amphotericin., Conclusion: The incidence of post-infusion phlebitis proved to be an important indicator to analyse the quality of the healthcare setting.

Objectives: assess the risk of falls in adult hospitalized patients and verify the incidence of the event in this environment., Method: cohort study, with approval by the Research Ethics Committee, which monitored 831 patients hospitalized at a university hospital. The Morse Fall Scale (MFS) was used to assess the risk and patients with high risk (≥45 points) were considered exposed to falls., Results: the mean MFS score was 39.4 (±19.4) points. Between the first and the final assessment, the score increased by 4.6%. The first assessment score presented a strong and positive correlation with the final assessment score (r=0.810; p=0.000)., Conclusion: the higher the risk score for falls when the patient is admitted, the higher the score at the end of the hospitalization period and vice-versa. The incidence rate corresponded to 1.68% with a higher percentage of patients classified at high risk of falls.

Objective: To analyse the power to predict risk and verify the validity of the Morse Fall Scale - Brazilian version (MFS-B)., Method: This is a methodological, longitudinal study with 1487 adult patients of two university hospitals of Rio Grande do Sul, Brazil conducted from November 2013 to March 2014. The MFS-B was used to assess the risk of falls. Statistical analysis comprised multivariate methods (discriminant function analysis and ROC curve). The research was approved by the ethics committees of the institutions., Results: The best estimate to predict falls was at the cutoff point 44.78 of the average MFS-B score, with a sensitivity of 95.2% and a specificity of 64%. The occurrence of falls and the high-risk classification were significant (p<0.00001)., Conclusions: The results show that the MFS-B can appropriately predict the risk of falls at the cutoff point for the high-risk classification, according to the original classification. The MFS-B had adequate validation test results and maintained the six items of the original scale.

The study aimed to translate and adapt the Morse Fall Scale from English into the Portuguese language. This was performed in seven steps: authorization by the author of the scale; translation into Portuguese; evaluation and structuring of the translated scale; reverse translation into English; evaluation and validation of the scale by a committee of experts; evaluation of clarity of items and operational definitions with 45 professionals; evaluation of agreement between raters and the reliability of reproducibility, related to data from the evaluation of 90 patients, performed by four evaluators/judges. The clarity of the scale was considered very satisfactory, with a confidence interval of 73.0% to 100% in the option very clear. For the concordance of responses, the results showed Kappa coefficients of approximately 0.80 or higher. It was concluded that the adaptation of the scale was successful, indicating that its use is appropriate for the population of Brazilian patients.