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Neiman AE, Campanharo CRV, Lopes MCBT, Piacezzi LHV, Batista REA. COVID-19: Association of risk classification with the Modified Early Warning Score and hospital outcomes. Rev Lat Am Enfermagem 2023; 31:e3977. [PMID: 37729245 PMCID: PMC10508216 DOI: 10.1590/1518-8345.6666.3977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 06/06/2023] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVE to evaluate the association of the risk classification categories with the Modified Early Warning Score and the outcomes of COVID-19 patients in the emergency service. METHOD a crosssectional study carried out with 372 patients hospitalized with a COVID-19 diagnosis and treated at the Risk Classification Welcoming area from the Emergency Room. In this study, the patients' Modified Early Warning Score was categorized into without and with clinical deterioration, from 0 to 4 and from 5 to 9, respectively. Clinical deterioration was considered to be acute respiratory failure, shock and cardiopulmonary arrest. RESULTS the mean Modified Early Warning Score was 3.34. In relation to the patients' clinical deterioration, it was observed that, in 43%, the time for deterioration was less than 24 hours and that 65.9% occurred in the Emergency Room. The most frequent deterioration was acute respiratory failure (69.9%) and the outcome was hospital discharge (70.3%). CONCLUSION COVID-19 patients who had a Modified Early Warning Scores > 4 were associated with the urgent, very urgent and emergency risk classification categories, had more clinical deterioration, such as respiratory failure and shock, and evolved more to death, which shows that the Risk Classification Protocol correctly prioritized patients at risk of life.
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Affiliation(s)
| | - Cássia Regina Vancini Campanharo
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, Departamento de Enfermagem Clínica e Cirúrgica, São Paulo, SP, Brasil
| | | | - Luiz Humberto Vieri Piacezzi
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, Departamento de Enfermagem Clínica e Cirúrgica, São Paulo, SP, Brasil
| | - Ruth Ester Assayag Batista
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, Departamento de Enfermagem Clínica e Cirúrgica, São Paulo, SP, Brasil
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Lopes MCBT, Bustillo RA, Whitaker IY. In-hospital complications after trauma due to road traffic accidents. Eur J Trauma Emerg Surg 2023; 49:1855-1862. [PMID: 37017763 DOI: 10.1007/s00068-023-02264-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 03/28/2023] [Indexed: 04/06/2023]
Abstract
PURPOSE The study aimed to verify the association between in-hospital complications and characterization and clinical variables including hospital care and trauma severity. METHODS This analysis with the prospective cohort data was conducted at a municipal hospital in São Paulo, Brazil, and included participants aged 14 years or older, with traumatic injuries from traffic accidents. Data was collected from January 2015 to July 2016 and included demographics variables, type of traumatic event, clinical parameters, length of stay in the Emergency department and in the Intensive Care Unit, length of hospital stay, survival probability, trauma severity and mortality. RESULTS Of the 327 patients, 25.1% had in-hospital complications and their occurrence was statistically associated with higher mean age, run-overs and higher trauma severity. The length of stay in the emergency room, hospital stay, ICU stay, percentage of deaths, and hospital readmission were higher in patients with complications. The number of complications was correlated with trauma severity, ICU stay, and mortality. CONCLUSION Complications were associated with older age, run-overs, greater trauma severity, length of stay and readmission after hospital discharge.
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Affiliation(s)
| | | | - Iveth Yamaguchi Whitaker
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, Rua Napoleão de Barros, 754, Sao Paulo, SP, CEP: 04024-002, Brazil
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Souza LFD, Batista REA, Camapanharo CRV, Costa PCPD, Lopes MCBT, Okuno MFP. Factors associated with risk, perception and knowledge of falls in elderly people. Rev Gaucha Enferm 2022; 43:e20200335. [PMID: 35043875 DOI: 10.1590/1983-1447.2022.20200335] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 05/17/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To verify the factors associated with risk, perception, and knowledge of falls; and pain among older adults. METHOD A cross-sectional study carried out in the Emergency Service of a teaching hospital in the city of São Paulo between September 2019 and March 2020. We selected 197 older adults aged 65 and over, who were not disoriented or confused, of both genders. The instruments Awareness Questionnaire on the Risk of Falls, Morse Fall Scale and Numerical Pain Scales were applied. Mann-Whitney and Kruskal-Wallis tests were used. RESULTS Interviewees with a high risk of falls in older adults (p = 0.0041); those with a support network had a lower perception and knowledge about the risk of falls (p = 0.0025) and lower percentage of severe pain (p = 0.0033). CONCLUSION Factors associated with risk, perception and knowledge of falls and pain among older adults were age, family income, number of dependents, caregiver, support network, hypertension, impaired walking, antihypertensive medication, lipid-lowering medication, level of education, comorbidities and religion.
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Affiliation(s)
- Lidia Ferreira de Souza
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Enfermagem, Programa de Pós-Graduação em Enfermagem. São Paulo, São Paulo, Brasil
| | - Ruth Ester Assayag Batista
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Enfermagem, Departamento de Enfermagem Clínica Cirúrgica. São Paulo, São Paulo, Brasil
| | - Cássia Regina Vancini Camapanharo
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Enfermagem, Departamento de Enfermagem Clínica Cirúrgica. São Paulo, São Paulo, Brasil
| | - Paula Cristina Pereira da Costa
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Enfermagem, Departamento de Saúde Coletiva. São Paulo, São Paulo, Brasil
| | - Maria Carolina Barbosa Teixeira Lopes
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Enfermagem, Departamento de Enfermagem Clínica Cirúrgica. São Paulo, São Paulo, Brasil
| | - Meiry Fernanda Pinto Okuno
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Enfermagem, Departamento de Saúde Coletiva. São Paulo, São Paulo, Brasil
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Santana ER, Piacezzi LHV, Lopes MCBT, Batista REA, Vancini-Campanharo CR, Góis AFTD. Construction and validation of an in-hospital transport simulation scenario. Einstein (Sao Paulo) 2022; 19:eAO5868. [PMID: 35024757 PMCID: PMC8428806 DOI: 10.31744/einstein_journal/2021ao5868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 12/01/2020] [Indexed: 11/07/2022] Open
Abstract
Objective To build and validate the content of a clinical simulation scenario for teaching in-hospital transport of critically ill patients. Methods A descriptive study of construction and validation of a clinical simulation scenario for teaching in-hospital transport. A scenario based on the literature was built, followed by validation, using the Delphi technique, by five specialists, with an agreement of 80%. The experts were selected through snowball sampling. An instrument was developed containing 26 topics to be assessed for relevance, clarity, objectivity, feasibility, current content, vocabulary, and a field for observations. Results Two rounds were carried out by the specialists to reach a consensus of 80%. According to the experts´ recommendation, the initial scenario was written more clearly and objectively, and divided into two parts: patient preparation and patient transport. Conclusion In this study, the construction and validation of the scenario for teaching in-hospital transport were successfully performed. It may be applied in several services to evaluate the training of nursing undergraduate students, as well as for the professional improvement of those who work in the in-hospital transport service.
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Affiliation(s)
- Ellen Reis Santana
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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Jesus APSD, Okuno MFP, Campanharo CRV, Lopes MCBT, Batista REA. Association of the Charlson index with risk classification, clinical aspects, and emergency outcomes. Rev Esc Enferm USP 2022; 56:e20200162. [PMID: 35080236 PMCID: PMC10132840 DOI: 10.1590/1980-220x-reeusp-2020-0162] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 07/22/2021] [Indexed: 04/28/2023] Open
Abstract
Abstract Objective: To exam the association of the age-adjusted Charlson comorbidity index with the categories of risk classification, the clinical aspects, and the patient outcomes in the emergency department. Method: Cross-sectional, analytical study that analyzed the medical records of 3,624 patients seen in the emergency department. Charlson index scores greater than 2 showed a high rate of comorbidity (mortality risk). T-test and analysis of variance were applied in the analyses. Results: There was a significant difference between the Charlson comorbidity index and the risk classification, with higher scores found in patients classified in the white (2.57) and red (2.06) categories. Patients with vascular, endocrine, neurological, cardiologic, or device problems, and those who underwent a head tomography had a high rate of comorbidity. In addition, those admitted, transferred, or who died in the emergency room had significantly higher index scores compared to those who were discharged from the hospital. Conclusion: The high rate of comorbidity was associated with the categories of risk classification, main and nonspecific complaints, performance of a head tomography, and patient outcomes in the emergency room.
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Jesus APSD, Batista REA, Campanharo CRV, Lopes MCBT, Okuno MFP. Evaluation of the Manchester Triage System quality indicator: service time. Rev Gaucha Enferm 2021; 42:e20200371. [PMID: 34878015 DOI: 10.1590/1983-1447.2021.20200371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 06/24/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to verify the conformity of the time interval between the end of the risk classification and the beginning of medical care with that recommended by the Manchester protocol and to relate the times of care and the risk categories with the outcome. METHOD Cross-sectional, retrospective, and analytical study. The t test, the analysis of variance and the generalized linear model were used. RESULTS The average time for medical care in the red and orange categories was 3 and 39.5 minutes, respectively. Death outcome was associated with the red category, with an average time to start the classification of 5.5 minutes and an average length of stay of 2.3 hours. CONCLUSION The waiting time for medical care in the high priority categories was longer than recommended, which suggests the need to continuously monitor the system. Shorter waiting times for classification and permanence were related to the red category and the outcome of death.
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Affiliation(s)
- Ana Paula Santos de Jesus
- Universidade Federal do Recôncavo da Bahia (UFRB), Centro de Ciências da Saúde. Santo Antônio de Jesus, Bahia, Brasil
| | - Ruth Ester Assayag Batista
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Enfermagem. São Paulo, São Paulo, Brasil
| | | | | | - Meiry Fernanda Pinto Okuno
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Enfermagem. São Paulo, São Paulo, Brasil
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Jesus APSD, Okuno MFP, Campanharo CRV, Lopes MCBT, Batista REA. Manchester Triage System: assessment in an emergency hospital service. Rev Bras Enferm 2021; 74:e20201361. [PMID: 34287496 DOI: 10.1590/0034-7167-2020-1361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 03/03/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES to analyze demographic data, clinical profile and outcomes of patients in emergency services according to Manchester Triage System's priority level. METHODS a cross-sectional, analytical study, carried out with 3,624 medical records. For statistical analysis, the Chi-Square Test was used. RESULTS white individuals were more advanced in age. In the red and white categories, there was a higher percentage of men when compared to women (p=0.0018) and higher prevalence of personal history. Yellow priority patients had higher percentage of pain (p<0.0001). Those in red category had a higher frequency of altered vital signs, external causes, and death outcome. There was a higher percentage of exams performed and hospitalization in the orange category. Blue priority patients had a higher percentage of non-specific complaints and dismissal after risk stratification. CONCLUSIONS a higher percentage of altered vital signs, number of tests performed, hospitalization and death were evidenced in Manchester protocol's high priority categories.
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Antequera IG, Lopes MCBT, Batista REA, Campanharo CRV, Costa PCPD, Okuno MFP. Rastreamento de violência contra pessoas idosas: associação com estresse percebido e sintomas depressivos em idosos hospitalizados. Esc Anna Nery 2021. [DOI: 10.1590/2177-9465-ean-2020-0167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivo Avaliar a prevalência e fatores associados à violência em idosos hospitalizados. Método Estudo transversal realizado com 100 idosos internados. Aplicaram-se os instrumentos: H-S/EAST, Escala de Estresse Percebido e Escala de Depressão Geriátrica. Utilizou-se análise descritiva para a caracterização sociodemográfica e clínica. Para associar a idade ao H-S/EAST foi utilizado o teste de Mann-Whitney; estresse percebido com o H-S/EAST foi utilizado o teste T, e sintomas depressivos com o H-S/EAST foi utilizado o teste da Razão Verossimilhança. Resultados A média de idade dos idosos foi 70,39 e 56,0%, houve risco aumentado para violação de direitos pessoais, características de vulnerabilidade e situações potencialmente abusivas. Os fatores associados ao risco aumentado para violação de direitos pessoais ou abuso direto nos idosos foram maior idade, apresentar estresse percebido e ter sintomas de depressão leve a severa. Conclusão e implicação para a prática Esses resultados mostram, portanto, a importância da observação atenta do idoso por parte do enfermeiro para permitir a identificação do risco para violência ou violação de direitos. O que possibilita estabelecer ações preventivas, coordenadas com a participação dos demais profissionais bem como o encaminhamento correto de cada situação, cumprimento do dever legal da profissão e do papel cidadão.
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Costa AFD, Lopes MCBT, Campanharo CRV, Belasco AGS, Okuno MFP, Batista REA. Functional capacity and quality of life of elderly people admitted to emergency service. Rev Esc Enferm USP 2020; 54:e03651. [PMID: 33331502 DOI: 10.1590/s1980-220x2019021203651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 02/17/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To correlate the functional capacity and quality of life of elderly people admitted to emergency service. METHOD This is a cross-sectional and analytical study carried out with elderly patients admitted to a university hospital's emergency service in the city of São Paulo, between December 2015 and January 2017. Data were collected through interviews using a structured questionnaire, the Medical Outcome Study 36, the Katz of Independence in Activities of Daily Living, and the Functional Independence Measure. RESULTS Two hundred fifty elderly people with a mean age of 71.9 years, male (56.8%), white in color (67.2%), married (54.0%), with low education (32.0%), low income (58.0%), with comorbidities (81.2%) and home providers (53.6%) have participated. The most compromised Quality of Life dimensions were physical aspect (11.4%), emotional aspect (21.6%) and functional capacity (25.2%). Concerning functional capacity, independence was characterized for Basic Activities of Daily Living and moderate dependence for Instrumental Activities of Daily Living. The higher the scores of the Functional Independence Measure, the higher the quality of life scores. CONCLUSION The more independent the elderly the better their quality of life.
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Lopes MCBT, Bernardo LS, Camargo ESD, Moraes GMD, Piacezzi LHV, Batista REA, Vancini-Campanharo CR. Use of three-dimensional technology in tracheal intubation: an alternative to minimize the contamination risk by COVID-19. Einstein (São Paulo) 2020; 18:eCE6118. [PMID: 33206815 PMCID: PMC7647383 DOI: 10.31744/einstein_journal/2020ce6118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 09/02/2020] [Indexed: 12/05/2022] Open
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Miura CRM, Campanharo CRV, Batista REA, Lopes MCBT, Barros PF, Okuno MFP. QUALIDADE DE VIDA E EXPERIÊNCIAS RELIGIOSAS/ ESPIRITUAIS DE PACIENTES COM CÂNCER EM UM SERVIÇO DE EMERGÊNCIA. Cogit Enferm 2020. [DOI: 10.5380/ce.v25i0.67474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivo: avaliar qualidade de vida, experiências espirituais em pacientes com câncer e sua correlação.Método: estudo transversal, realizado na Emergência, de fevereiro a setembro de 2017. Utilizado o Medical Outcome Study 36 – Item Short-Form Health Survey para verificação da qualidade de vida, com oito dimensões, escore de 0 (pior estado) a 100 (melhor estado) e a Escala Diária de Experiência Espiritual, com 16 itens, pontuação entre 16 e 94 (menores pontuações refletem maior frequência de experiências). Utilizou-se o Coeficiente de Spearman para correlacionar qualidade de vida e espiritualidade.Resultados: 83 pacientes, média de idade 58 anos, predomínio masculino. A dimensão da qualidade de vida mais comprometida foi “aspecto físico”. A Escala de Experiência Espiritual apresentou média 51, com correlação negativa entre qualidade de vida e espiritualidade.Conclusão: a espiritualidade relaciona-se com qualidade de vida e deve ser considerada no atendimento a pacientes com câncer na emergência.
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Costa AFD, Lopes MCBT, Campanharo CRV, Batista REA, Okuno MFP. QUALITY OF LIFE AND BURDEN OF CAREGIVERS OF ELDERLY PEOPLE. Texto contexto - enferm 2020. [DOI: 10.1590/1980-265x-tce-2019-0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to assess caregivers’ quality of life and correlate it with elderly people’s quality of life, as well as assess the burden of caregivers of elderly people hospitalized in an Emergency Service and correlate it with their quality of life. Method: this is a cross-sectional and analytical study conducted with 250 caregivers of elderly patients admitted to the Emergency Service of Hospital São Paulo, Brazil, from December 2015 to January 2017. To assess caregivers’ quality of life, the generic Short-Form-36 questionnaire, item short-form health survey was used; burden was assessed using the Zarit Burden Interview. Results: the mean age was 48.36 years, with a predominance of females, most of whon were elderly people’s children. Caregivers showed mild to moderate burden, and in quality of life assessment, the most compromised domains were general health status, vitality, and social aspects. The Short-Form-36 dimensions that had a significant correlation with Zarit Burden Interview scores were physical aspect, general health status, vitality, social aspects, and emotional aspect. Conclusion: caregivers’ quality of live is associated with elderly people’s quality of life. Burden is related to the worsening quality of life of caregivers. It is necessary to identify the work demands and specific needs of caregivers of elderly people in order to develop care strategies involving this population.
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Guskuma EM, Lopes MCBT, Piacezzi LHV, Okuno MFP, Batista REA, Campanharo CRV. Conhecimento da equipe de enfermagem sobre ressuscitação cardiopulmonar em um hospital universitário. Rev Eletr Enf 2019. [DOI: 10.5216/ree.v21.52253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objetivou-se identificar o conhecimento teórico da equipe de enfermagem sobre as manobras de ressuscitação cardiopulmonar em suporte básico de vida, associando tal conhecimento às variáveis sociodemográficas, econômicas e de formação profissional. Trata-se de estudo transversal, descritivo e quantitativo, cujos dados foram obtidos de questionários aplicados a 351 funcionários de uma equipe de enfermagem de um serviço de emergência e de unidades de terapia intensiva. Houve declínio do conhecimento dos sujeitos sobre ressuscitação e parada cardiopulmonar com o passar do tempo. Fatores socioeconômicos e profissionais estiveram associados ao conhecimento dos profissionais de enfermagem. Sugere-se que treinamentos com menores intervalos aumentem o grau de retenção e o conhecimento da equipe de enfermagem.
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Billett MC, Campanharo CRV, Lopes MCBT, Batista REA, Belasco AGS, Okuno MFP. Functional capacity and quality of life of hospitalized octogenarians. Rev Bras Enferm 2019; 72:43-48. [PMID: 31826190 DOI: 10.1590/0034-7167-2017-0781] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 06/28/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the ability to perform activities of daily living (ADL) and to correlate functional capacity with quality of life (QoL) of hospitalized octogenarians. METHOD A cross-sectional study with 128 patients using the quality of life instruments WHOQOL-OLD and WHOQOL-BREF and the Katz Scale. RESULTS The majority of patients was fully dependent; patients with higher schooling had less independence; older adults with partial dependence and independence had higher scores in perceived QoL; in the domains of autonomy, past, present and future activities; and better overall QoL than those with full dependence. Partially dependent patients had higher scores in the death and dying domain than independent patients. CONCLUSION Older adults' QoL is associated with the maintenance of autonomy and functional capacity. Older adults experience a health decline during the hospitalization process, due to the limitation in performing their ADL and lack of encouragement by the health team.
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Oscalices MIL, Okuno MFP, Lopes MCBT, Campanharo CRV, Batista REA. Discharge guidance and telephone follow-up in the therapeutic adherence of heart failure: randomized clinical trial. Rev Lat Am Enfermagem 2019; 27:e3159. [PMID: 31432915 PMCID: PMC6703101 DOI: 10.1590/1518-8345.2484.3159] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 02/23/2019] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE to evaluate the effectiveness of the behavioral intervention of discharge guidance and telephone follow-up in the therapeutic adherence, re-hospitalization and mortality of patients with heart failure. METHOD randomized clinical trial without blinding, including 201 patients diagnosed with heart failure admitted to the emergency room, who were randomized in Control Group and Intervention Group. Intervention was carried out with specific discharge guidance in the Intervention Group, who were contacted for solving doubts via phone calls after 7 and 30 days, and the adherence to treatment was evaluated after 90 days with the Morisky test, the Brief Medical Questionnaire and the non-drug adherence test in both groups. The Generalized Estimating Equations Model was used (p<0.05%). RESULTS One-hundred and one patients were randomly sorted in the Control Group and in the Intervention Group, their average age being 62.6±15.2. The Intervention Group had higher drug and non-drug therapeutic adherence compared to the Control Group (p<0.001) and there were lower re-hospitalization and death rates in the Intervention Group after 90 days. CONCLUSION discharge guidance with telephone follow-up was effective and resulted in greater therapeutic adherence, as well as in decrease of re-hospitalization and death rates in patients with heart failure. Clinical Trial Registration (REBEC): RBR- 37n859.
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Affiliation(s)
- Monica Isabelle Lopes Oscalices
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem,
São Paulo, SP, Brasil
- Instituto Dante Pazzanese de Cardiologia, Pronto Socorro, São Paulo,
SP, Brasil
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Oscalices MIL, Okuno MFP, Lopes MCBT, Batista REA, Campanharo CRV. Health literacy and adherence to treatment of patients with heart failure. Rev Esc Enferm USP 2019; 53:e03447. [PMID: 31314864 DOI: 10.1590/s1980-220x2017039803447] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 12/04/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To relate the level of functional health literacy with adherence and barriers to non-adherence, rehospitalization, readmission and death in patients with heart failure. METHOD A cross-sectional, analytical study with patients admitted to the emergency room with a diagnosis of heart failure. Literacy was assessed by the Newest Vital Sign. Patient adherence to medication treatment and barriers to non-compliance were assessed 90 days after discharge by the Morisky-Green test and the Brief Medical Questionnaire, respectively. RESULTS 100 patients participated in the study. The mean age was 63.3 years (± 15.2), with a predominance of white women. Medication adherence was low in 41.1% of participants, of which 55.9% presented inadequate literacy. Re-hospitalization and death were present in patients with inadequate literacy (p<0.001). CONCLUSION The low level of literacy was directly related to lower adherence and the presence of barriers to medication adherence, as well as higher rehospitalization rates and death.
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Affiliation(s)
- Monica Isabelle Lopes Oscalices
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, São Paulo, SP, Brazil.,Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil
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Frota ML, Campanharo CRV, Lopes MCBT, Piacezzi LHV, Okuno MFP, Batista REA. Good practices for preventing ventilator-associated pneumonia in the emergency department. Rev Esc Enferm USP 2019; 53:e0460. [PMID: 31215615 DOI: 10.1590/s1980-220x2018010803460] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 09/25/2018] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To evaluate the conformity of the set of good practices for preventing ventilator-associated pneumonia (VAP) in the emergency department of a university hospital. METHOD A cross-sectional analytical study with a quantitative approach, conducted in a university hospital in the city of São Paulo. The study sample consisted of opportunities for care observations that comprise the set of good practices for preventing ventilator-associated pneumonia provided to intubated patients hospitalized in the emergency department. RESULTS A total of 209 observations were performed in 42 patients. Of the hospitalized patients, 23.8% developed VAP, and 52.4% died. Of the five recommended measures for preventing VAP, only two presented compliance above 50%. CONCLUSION The care provided to patients is not in line with what is recommended in the literature, which demonstrates the need for periodic renewal of the team's educational practices and the development of auditing projects to ensure improvements in the care process.
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Affiliation(s)
- Melissa Lopes Frota
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, São Paulo, SP, Brazil
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Okuno MFP, Rosa ADS, Lopes MCBT, Campanharo CRV, Batista REA, Belasco AGS. QUALITY OF LIFE OF HOSPITALIZED OCTOGENARIANS. Texto contexto - enferm 2019. [DOI: 10.1590/1980-265x-tce-2018-0207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to characterize socio-demographic and economic profiles, as well as to evaluate the quality of life of hospitalized octogenarians. Method: cross-sectional study with 128 hospitalized octogenarians. Instruments from the World Health Organization were used to evaluate the quality of life. Spearman correlation coefficient, student’s t-test and analysis of variance were used to correlate the studied variables with the quality of life of octogenarians. Results: the longer the hospitalization time, the higher the psychological score (p=0.0126), and the higher the scores in the past, present and future activity domain (p = 0.0485). The higher the age, the lower the score in the past, present, and future activity domain (p=0.0480). The higher the number of octogenarian morbidities, the lower the score in the social relation domain. Conclusion: it is highly important that care for the hospitalized elderly is planned and implemented, taking into account the factors that interfere in a positive and negative way in their quality of life.
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Souza BT, Lopes MCBT, Okuno MFP, Batista REA, Góis AFTD, Campanharo CRV. Identification of warning signs for prevention of in-hospital cardiorespiratory arrest. Rev Lat Am Enfermagem 2019. [PMCID: PMC6358140 DOI: 10.1590/1518-8345.2853.3072] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: to identify the occurrence of warning signs and changes in vital signs in individuals who experienced in-hospital cardiorespiratory arrest and correlate them with the occurrence of this event. Method: this is a retrospective, analytical and quantitative study that included 218 medical records of patients who suffered in-hospital cardiorespiratory arrest and identified warning signs and alterations in vital signs. Mean, standard deviation, median, minimum and maximum values were calculated for the continuous variables, and frequency and percentage for the categorical variables. We compared the age and occurrence of cardiorespiratory arrest with the occurrence of warning signs using the Chi-Square Test and the Mann Whitney non-parametric test (p-value < 0.05). Results: 62.1% of the patients presented signs and symptoms of shock, 44.9% of neurological alteration, 40.4% of malaise, 15.2% presented signs suggestive of acute coronary syndrome, and 25.9% presented mental confusion. In the last measurement of vital signs before cardiorespiratory arrest, the majority of patients had altered abnormal (32.6%) and severely abnormal (23.9%) heart rate, and abnormal (37.1%) and severely abnormal (27.0%) respiratory rate. Conclusion: the warning signs identified were: shock, neurological signs, malaise and acute coronary syndrome. The prevalent changes in vital signs were: heart rate, respiratory rate and O2 saturation. Patients with severely abnormal systolic blood pressure were not discharged and those with abnormal respiratory rate did not survive 6 months after cardiorespiratory arrest.
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Ohl ICB, Chavaglia SRR, Ohl RIB, Lopes MCBT, Campanharo CRV, Okuno MFP, Batista REA. Evaluation of delirium in aged patients assisted at emergency hospital service. Rev Bras Enferm 2019; 72:153-160. [DOI: 10.1590/0034-7167-2018-0386] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 02/26/2019] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: identify the occurrence of delirium in aged patients assisted in emergency services and verify its relationship with sociodemographic and clinical variables. Method: cross-sectional, prospective study with a quantitative approach. Two hundred aged hospitalized patients participated. The Confusion Assessment Method was used for data collection. For statistical analysis, chi-square tests, likelihood ratio and Fisher’s test were used, with a significance level of 5%. Results: male gender and mean age of 71.8 years were predominant. In the first 24 hours of hospitalization, 56 (28%) aged individuals presented delirium. An association of the disease with lack of physical activity, presence of a caregiver, hypertension, dyslipidemia and cerebrovascular diseases was identified. Conclusion: Delirium was associated with no physical activity, the need of a caregiver, and the presence of comorbidities. The importance of conducting other studies that may lead to early identification of the condition to prevent its complications is emphasized.
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Viveiros WL, Okuno MFP, Campanharo CRV, Lopes MCBT, Oliveira GN, Batista REA. Pain in emergency units: correlation with risk classification categories. Rev Lat Am Enfermagem 2018; 26:e3070. [PMID: 30462784 PMCID: PMC6248802 DOI: 10.1590/1518-8345.2415.3070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Accepted: 08/13/2018] [Indexed: 11/21/2022] Open
Abstract
Objectives: to correlate risk classification categories with the level of pain of
patients in an emergency service. Method: cross-sectional study carried out in the Risk Classification of 611 patients.
The variables studied were: age, gender, comorbidities, complaint duration,
medical specialty, signs and symptoms, outcome, color attributed in the risk
classification of and degree of pain. We used Analysis of Variance, a
Chi-Square test and a Likelihood Ratio test. Results: the average age was 42.1 years (17.8); 59.9% were women; the green (58.9%)
and yellow (22.7%) risk classification prevailed and hypertension (18.3%)
was the most common Comorbidity. The most frequent pain intensity was
moderate (25.9%). In the red category, patients presented a higher
percentage of absence of pain; in the blue, mild pain; and in the green,
yellow and orange categories, there was a greater percentage of intense pain
(p < 0.0001). Conclusion: among the patients who presented pain, the majority reported moderate
intensity. Regarding risk categories, most patients in the red category did
not report pain. Those who were classified as green, yellow and orange,
reported mostly intense pain. On the other hand, patients in the blue
category reported predominantly mild pain.
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Droguett TC, Okuno MFP, Campanharo CRV, Lopes MCBT, Batista REA. Percepção da enfermagem sobre a qualidade do Acolhimento com Classificação de Risco do serviço de emergência. Rev Enferm UFSM 2018. [DOI: 10.5902/2179769228748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Objetivo: avaliar a qualidade do Acolhimento com Avaliação e Classificação de Risco de um serviço de emergência segundo percepção dos profissionais de enfermagem. Método: estudo transversal realizado no Acolhimento com Avaliação e Classificação de Risco do serviço de emergência do Hospital São Paulo, entre março e julho de 2016. Participaram 133 profissionais que atuavam no setor no mínimo há três meses. Foi utilizado questionário com variáveis para caracterização sociodemográfica e instrumento para Avaliação do Acolhimento com Classificação de Risco. Resultados: idade média 36,2 anos, maioria do sexo feminino (77,4%) e formado há mais de 5 anos (59,1%). O Acolhimento com Avaliação e Classificação de Risco obteve as seguintes pontuações: estrutura (23,0), processo (22,0) e resultado (20,9). Conclusão: o Acolhimento com Avaliação e Classificação de Risco foi avaliado como precário na percepção dos profissionais de enfermagem.
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Carvalho TPD, Okuno MFP, Campanharo CRV, Lopes MCBT, Batista REA. Patients' knowledge about medication prescription in the emergency service. Rev Bras Enferm 2018; 71:329-335. [PMID: 29412290 DOI: 10.1590/0034-7167-2017-0002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 05/08/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To identify which orientations were received by the patient about the medication prescription and which professional performed it; to evaluate the patients' knowledge about prescription drugs and to correlate it to socioeconomic variables, comorbidities, and the frequency with which the patient seeks emergency service; and to evaluate the knowledge about the medication prescribed after the health care. METHOD This was a cross-sectional study on 304 patients that received emergency service's discharge along with medication prescription. Applied instruments: sociodemographic characterization and evaluation of the knowledge about the prescribed medication. We used a descriptive and inferential analysis. RESULTS Most subjects had no doubts about how or for how long to take the medication; and presented questions about adverse reactions and what to do in case of forgetting to take the medication doses. There was a significant association between age; educational level; comorbidity; the frequency of emergency service's use; and knowledge about medications. CONCLUSION a total of 48% of the patients declared to need information about adverse effects and what to do if they forget to take the medication.
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Affiliation(s)
- Thaynara Paola de Carvalho
- Universidade Federal de São Paulo, Multi-professional Residency in Urgency and Emergency. São Paulo, Brazil
| | | | | | | | - Ruth Ester Assayag Batista
- Universidade Federal de São Paulo, Multi-professional Residency in Urgency and Emergency. São Paulo, Brazil
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Mendes JR, Lopes MCBT, Vancini-Campanharo CR, Okuno MFP, Batista REA. Types and frequency of errors in the preparation and administration of drugs. ACTA ACUST UNITED AC 2018; 16:eAO4146. [PMID: 30231142 PMCID: PMC6178856 DOI: 10.1590/s1679-45082018ao4146] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 02/14/2018] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To identify compatibility, types and frequency of errors in preparation and administration of intravenous drugs. METHODS A cross-sectional and descriptive study performed at the emergency department of a university hospital in the city of São Paulo (SP). The sample consisted of 303 observations of the preparation and administration of intravenous drugs by nursing aides, nursing technicians and registered nurses, using a systematized script, similar to a checklist. The following variables were collected: errors related to dispensing, omission, schedule, unauthorized administration, dosage, formulation, incompatibility, preparation and administration. RESULTS In the preparation stage, the following errors were identified: no hand hygiene (70.29%), and no use of aseptic technique (80.85%). Upon administration, no hand hygiene (81.18%), and no use of aseptic technique (84.81%). In 31.35% of observations, there was more than one medication at the same time for the same patient, of which 17.89% were compatible, 56.84% were incompatible and 25.26% were not tested, according to the Micromedex database. CONCLUSION In both preparation and administration stages, the most frequent errors were no hand hygiene and no use of aseptic technique, indicating the need to develop and implement education programs focused on patient safety.
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Mauricio ECB, Lopes MCBT, Batista REA, Okuno MFP, Campanharo CRV. Results of the implementation of integrated care after cardiorespiratory arrest in a university hospital. Rev Lat Am Enfermagem 2018; 26:e2993. [PMID: 30020334 PMCID: PMC6053291 DOI: 10.1590/1518-8345.2308.2993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 11/26/2017] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES to identify the care measures performed after cardiorespiratory arrest (CRA) and to relate them to the neurological status and survival at four moments: within the first 24 hours, at the discharge, six months after discharge, and one year after discharge. METHOD retrospective, analytical and quantitative study performed at the Emergency Department of a university hospital in São Paulo. Eighty-eight medical records of CRA patients who had a return of spontaneous circulation sustained for more than 20 minutes were included and the post-CRA care measures performed in the first 24 hours were identified, as well as its relationship with survival and neurological status. RESULTS the most frequent post-CRA care measures were use of advanced airway access techniques and indwelling bladder catheterization. Patients who had maintained good breathing and circulation, temperature control and who were transferred to intensive care unit had a better survival in the first 24 hours, after six months and one year after discharge. Good neurological status at six months and one year after discharge was associated with non-use of vasoactive drugs and investigation of the causes of the CRA. CONCLUSION the identification of good practices in post-CRA care may help to reduce the mortality of these individuals and to improve their quality of life.
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Affiliation(s)
| | | | - Ruth Ester Assayag Batista
- PhD, Full Professor, Escola Paulista de Enfermagem, Universidade
Federal de São Paulo, São Paulo, SP, Brazil
| | - Meiry Fernanda Pinto Okuno
- PhD, Assistant Professor, Escola Paulista de Enfermagem,
Universidade Federal de São Paulo, São Paulo, SP, Brazil
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Vancini-Campanharo CR, Vancini RL, Machado Netto MC, Lopes MCBT, Okuno MFP, Batista REA, Góis AFTD. Do not attempt resuscitation orders at the emergency department of a teaching hospital. Einstein (Sao Paulo) 2018; 15:409-414. [PMID: 29364362 PMCID: PMC5875152 DOI: 10.1590/s1679-45082017ao3999] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 08/08/2017] [Indexed: 11/25/2022] Open
Abstract
Objective To identify factors associated with not attempting resuscitation. Methods A cross-sectional study conducted at the emergency department of a teaching hospital. The sample consisted of 285 patients; in that, 216 were submitted to cardiopulmonary resuscitation and 69 were not. The data were collected by means of the in-hospital Utstein Style. To compare resuscitation attempts with variables of interest we used the χ2 test, likelihood ratio, Fisher exact test, and analysis of variance (p<0.05). Results No cardiopulmonary resuscitation was considered unjustifiable in 56.5% of cases; in that, 37.7% did not want resuscitation and 5.8% were found dead. Of all patients, 22.4% had suffered a previous cardiac arrest, 49.1% were independent for Activities of Daily Living, 89.8% had positive past medical/surgical history; 63.8% were conscious, 69.8% were breathing and 74.4% had a pulse upon admission. Most events (76.4%) happened at the hospital, the presumed cause was respiratory failure in 28.7% and, in 48.4%, electric activity without pulse was the initial rhythm. The most frequent cause of death was infection. The factors that influenced non-resuscitation were advanced age, history of neoplasm and the initial arrest rhythm was asystole. Conclusion Advanced age, past history of neoplasia and asystole as initial rhythm were factors that significantly influenced the non-performance of resuscitation. Greater clarity when making the decision to resuscitate patients can positively affect the quality of life of survivors.
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Frango BCTM, Batista REA, Campanharo CRV, Okuno MFP, Lopes MCBT. Association of the frequent users profile with the characteristics of using an
emergency service. REME: Revista Mineira de Enfermagem 2018. [DOI: 10.5935/1415-2762.20180001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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da Silva JA, Emi AS, Leão ER, Lopes MCBT, Okuno MFP, Batista REA. Emergency Severity Index: accuracy in risk classification. Einstein (Sao Paulo) 2017; 15:421-427. [PMID: 29364364 PMCID: PMC5875154 DOI: 10.1590/s1679-45082017ao3964] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 05/10/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To verify agreement between estimative of predicted resources using the adapted Emergency Severity Index and the real amount of resources used by patients. To analyze the variables number of years since graduation, years of work experience and years of experience in emergency services especially with accurate anticipation of resources need. METHODS This retrospective analytical study with a quantitative approach included 538 medical records of patients assisted by 11 triage nurses. Data collected were related to assistances carried out from December 2012 to February 2013. RESULTS There was no significant association between the adequacy of the number of resources used, based on Emergency Severity Index score, number of years since graduation, year of work experience or years of experience in emergency services. Kappa agreement coefficient (0.34) showed that agreement was low between predicted and real used number of resources. CONCLUSION Nurses' accuracy index to predict resources for patients care from emergency room using the adapted Emergency Severity Index was lower than results reported in the studies in the literature that used the original scale. There was low agreement of diagnostic exams predicted by nurses and those really performed. There was no association among correct prediction of resources needed, number of years since graduation, years of experience in emergency services and years of work experience in the unit where the study was done.
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Vancini-Campanharo CR, Vancini RL, de Lira CAB, Andrade MDS, Lopes MCBT, Okuno MFP, Batista REA, Atallah ÁN, de Góis AFT. Characterization of cardiac arrest in the emergency department of a Brazilian University Reference Hospital: A prospective study. Indian J Med Res 2017; 144:552-559. [PMID: 28256463 PMCID: PMC5345301 DOI: 10.4103/0971-5916.200898] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background & objectives: Sudden cardiac arrest (CA) represents one of the greatest challenges for medicine due to the vast number of cases and its social and economic impact. Despite advances in cardiopulmonary resuscitation (CPR) techniques, mortality rates have not significantly decreased over decades. This study was undertaken to characterize patients that have suffered CA and to identify factors related to mortality. Methods: This prospective study was conducted at Emergency Department of São Paulo Hospital, Brazil. Two hundred and eighty five patients were followed for one year after treatment for CA. The mean age was 66.3±17.2 yr, and they were predominantly male (55.8%) and Caucasian (71.9%). Mortality rate and factors associated with mortality were the primary and secondary outcome measures. Data were collected using an in-hospital Utstein-style report. A logistic regression analysis was used to determine which variables were related to mortality. Results: Regarding the characteristics of CPR, 76.5 per cent occurred in hospital, respiratory failure was the most common presumed immediate cause of CA (30.8%) and pulseless electrical activity was the most frequent initial rhythm (58.7%). All attempts at CPR utilized chest compressions and ventilation and the most utilized interventions were epinephrine (97.2%) and intubation (68.5%). Of all patients treated, 95.4 per cent died. Patients with pulseless electrical activity had a higher risk of death than those patients with ventricular fibrillation. Interpretation & conclusions: The findings of the study highlighted that the mortality rate among CA patients was high. The variable that best explained mortality was the initial CA rhythm.
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Affiliation(s)
| | - Rodrigo Luiz Vancini
- Federal University of Espirito Santo, 173 Feliciano Bicudo Street, Sao Paulo, SP 02301-020, Brazil
| | | | | | | | - Meiry Fernanda Pinto Okuno
- Paulista School of Nursing/Federal University of Sao Paulo, 754 Napoleao de Barros Street, São Paulo, SP 04024-002, Brazil
| | - Ruth Ester Assayag Batista
- Paulista School of Nursing/Federal University of Sao Paulo, 754 Napoleao de Barros Street, São Paulo, SP 04024-002, Brazil
| | - Álvaro Nagib Atallah
- Paulista School of Medicine/ Federal University of Sao Paulo, 740 Botucatu Street, Sao Paulo, SP 04023-062, Brazil
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Santos WC, Vancini-Campanharo CR, Lopes MCBT, Okuno MFP, Batista REA. Assessment of nurse's knowledge about Glasgow coma scale at a university hospital. Einstein (Sao Paulo) 2017; 14:213-8. [PMID: 27462896 PMCID: PMC4943356 DOI: 10.1590/s1679-45082016ao3618] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 05/17/2016] [Indexed: 12/02/2022] Open
Abstract
Objective To assess knowledge of nurses of emergency services and intensive care units about Glasgow Coma Scale. Methods This cross-sectional analytical study included 127 nurses of critical units of an university hospital. We used structured interview with 12 questions to evaluate their knowledge about the scale. Association of Knowledge with professionals’ sociodemographic variables were verified by the Fisher-test, χ2 and likelihood ratio. Results Most of participants were women mean aged 31.1 years, they had graduated more than 5 years previously, and had 1 to 3 years of work experience. In the assessment of best score possible for Glasgow scale (question 3) nurses who had graduate more than 5 years ago presented a lower percentage success rate (p=0.0476). However, in the question 7, which evaluated what interval of the scale indicated moderate severity of brain trauma injury, those with more years of experience had higher percentage of correct answers (p=0.0251). In addition, nurses from emergency service had more correct answers than nurses from intensive care unit (p=0.0143) in the same question. Nurses graduated for more than 5 years ago had a lower percentage of correct answers in question 7 (p=0.0161). Nurses with more work experience had a better score (p=0.0119) to identify how assessment of motor response should be started. Conclusion Number of year since graduation, experience, and work at critical care units interfered in nurses’ knowledge about the scale, which indicates the need of training.
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Maurício LFS, Okuno MFP, Campanharo CRV, Lopes MCBT, Belasco AGS, Batista REA. Professional nursing practice in critical units: assessment of work environment characteristics. Rev Lat Am Enfermagem 2017; 25:e2854. [PMID: 28301034 PMCID: PMC5363330 DOI: 10.1590/1518-8345.1424.2854] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 11/14/2016] [Indexed: 11/22/2022] Open
Abstract
Objective assess the autonomy, control over environment, and organizational support of nurses' work process and the relationships between physicians and nurses in critical care units. Method cross-sectional study conducted with 162 nurses working in the intensive care units and emergency service of a university hospital. The workers' satisfaction with their work environment was assessed using Brazilian Nursing Work Index - Revised, translated and adapted for the Brazilian culture. Results average age was 31.6 ± 3.9 years; 80.2% were women; 68.5% Caucasians and 71.6% worked in intensive care units. The nurses considered autonomy (2.38 ± 0.64) and their relationship with physicians (2.24 ± 0.62) to be characteristics of the work environment that favored professional practice. Control over environment (2.78 ± 0.62) and organizational support (2.51 ± 0.54), however, were considered to be unfavorable. No statistically significant differences were found between the units based on the scores obtained by the professionals on the Brazilian Nursing Work Index - Revised. Conclusion autonomy, relationship between physicians and nurses, and organizational support were considered by the units to be characteristics that favored nurses' professional practices. On the other hand, control over environment and organizational support were considered unfavorable.
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Affiliation(s)
| | | | | | | | | | - Ruth Ester Assayag Batista
- PhD, Adjunct Professor, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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Vancini-Campanharo CR, Okuno MFP, Lopes MCBT, Batista REA, Gabrielloni MC, Campanharo FF, Lira CABD, Vancini RL. Ressuscitação cardiopulmonar na gestação: uma revisão integrativa. ABCS Health Sci 2016. [DOI: 10.7322/abcshs.v41i3.909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
O objetivo deste estudo foi identificar dados sobre atendimento à parada cardiorrespiratória na gestação. Foi realizada uma revisão integrativa de artigos publicados entre 2010 e 2015, em português, inglês e espanhol com a utilização dos seguintes descritores: “Parada Cardíaca”; “Ressuscitação Cardiopulmonar”; “Gestante” e “Gestação”, nas seguintes bases de dados: MEDLINE, LILACS, IBECS e CUMED. A idade gestacional variou de 10 a 41 semanas, as etiologias mais comuns da parada cardiorrespiratória foram embolia pulmonar e trauma, os ritmos foram fibrilação ventricular e atividade elétrica sem pulso e o tempo em parada cardiorrespiratória variou de 15 a 60 minutos. O tratamento foi ressuscitação cardiopulmonar, intubação, administração de epinefrina e cesárea de emergência. Os desfechos mais observados nas mães e recém-nascidos foram alta e bom estado neurológico. Conclui-se que protocolos de atendimento específicos podem respaldar e auxiliar a tomada de decisão da equipe durante a ressuscitação cardiopulmonar, aumentando a sobrevida e diminuindo o dano neurológico nestas pacientes.
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Oliveira GN, Vancini-Campanharo CR, Lopes MCBT, Barbosa DA, Okuno MFP, Batista REA. Correlation between classification in risk categories and clinical aspects and outcomes. Rev Lat Am Enfermagem 2016; 24:e2842. [PMID: 27982310 PMCID: PMC5171782 DOI: 10.1590/1518-8345.1284.2842] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 09/23/2016] [Indexed: 12/04/2022] Open
Abstract
Objective: to correlate classification in risk categories with the clinical profiles, outcomes and origins of patients. Method: analytical cross-sectional study conducted with 697 medical forms of adult patients. The variables included: age, sex, origin, signs and symptoms, exams, personal antecedents, classification in risk categories, medical specialties, and outcome. The Chi-square and likelihood ratio tests were used to associate classifications in risk categories with origin, signs and symptoms, exams, personal antecedents, medical specialty, and outcome. Results: most patients were women with an average age of 44.5 years. Pain and dyspnea were the symptoms most frequently reported while hypertension and diabetes mellitus were the most common comorbidities. Classifications in the green and yellow categories were the most frequent and hospital discharge the most common outcome. Patients classified in the red category presented the highest percentage of ambulance origin due to surgical reasons. Those classified in the orange and red categories also presented the highest percentage of hospitalization and death. Conclusion: correlation between clinical aspects and outcomes indicate there is a relationship between the complexity of components in the categories with greater severity, evidenced by the highest percentage of hospitalization and death.
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Affiliation(s)
- Gabriella Novelli Oliveira
- Master's student, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brazil, Enfermeira, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | | | - Dulce Aparecida Barbosa
- PhD, Associated Professor, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | | | - Ruth Ester Assayag Batista
- PhD, Adjunct Professor, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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Botelho RMDO, Campanharo CRV, Lopes MCBT, Okuno MFP, Góis AFTD, Batista REA. The use of a metronome during cardiopulmonary resuscitation in the emergency room of a university hospital. Rev Lat Am Enfermagem 2016; 24:e2829. [PMID: 27878221 PMCID: PMC5173302 DOI: 10.1590/1518-8345.1294.2829] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 08/14/2016] [Indexed: 11/21/2022] Open
Abstract
Objective: to compare the rate of return of spontaneous circulation (ROSC) and death after
cardiac arrest, with and without the use of a metronome during cardiopulmonary
resuscitation (CPR). Method: case-control study nested in a cohort study including 285 adults who experienced
cardiac arrest and received CPR in an emergency service. Data were collected using
In-hospital Utstein Style. The control group (n=60) was selected by matching
patients considering their neurological condition before cardiac arrest, the
immediate cause, initial arrest rhythm, whether epinephrine was used, and the
duration of CPR. The case group (n=51) received conventional CPR guided by a
metronome set at 110 beats/min. Chi-square and likelihood ratio were used to
compare ROSC rates considering p≤0.05. Results: ROSC occurred in 57.7% of the cases, though 92.8% of these patients died in the
following 24 hours. No statistically significant difference was found between
groups in regard to ROSC (p=0.2017) or the occurrence of death (p=0.8112). Conclusion: the outcomes of patients after cardiac arrest with and without the use of a
metronome during CPR were similar and no differences were found between groups in
regard to survival rates and ROSC.
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Affiliation(s)
- Renata Maria de Oliveira Botelho
- Urgency and emergency care services specialist, RN, Hospital Universitário, Univesidade Federal de São Paulo, São Paulo, SP, Brazil
| | | | | | | | | | - Ruth Ester Assayag Batista
- PhD, Adjunct Professor, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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Abstract
Trata-se de pesquisa quantitativa, com os objetivos de observar a adesão à higiene das mãos por profissionais de saúde de um Serviço de Emergência de Hospital Universitário, no estado de São Paulo, e verificar se houve modificação na adesão após a realização de intervenção educativa, entre julho de 2012 e dezembro de 2013. Foram observadas e registradas 5061 oportunidades de higiene das mãos em 120 horas de observação. O maior número de oportunidades foi de profissionais de enfermagem (70,05%), por ser a maior força de trabalho e tender predominantemente à assistência; seguiram-se a equipe médica (17,82%) e fisioterapeutas (12,13%). Observou-se adesão de 28,6% para 38,9% após as ações educativas. Na fase pós-intervenção, todos os profissionais apresentaram maior adesão à higiene das mãos quando comparado ao período pré-intervenção e a adesão foi significativamente maior após a realização de procedimentos assépticos. Conclui-se que a higienização das mãos esteve aquém do esperado e que estratégias educativas favoreceram a adesão.
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Santos FGD, Campanharo CRV, Lopes MCBT, Okuno MFP, Batista REA. Avaliação da qualidade do atendimento ao paciente com síndrome coronariana aguda no serviço de emergência. Rev Eletr Enf 2015. [DOI: 10.5216/ree.v17i4.32692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Estudo com objetivo de avaliar indicadores de qualidade no atendimento aos pacientes com suspeita de síndrome coronariana aguda (SCA) e associá-los a alta, óbito e tempo de internação hospitalar. Pesquisa transversal, analítica de 84 prontuários de pacientes com suspeita de SCA no Serviço de Emergência. Foi estudada a associação entre os fatores de risco e indicadores de qualidade no atendimento à SCA com: tempo de internação, óbito, recorrência de eventos isquêmicos e revascularização do miocárdio por meio da correlação de Spearman. O tempo de internação foi significativamente menor para pacientes com infarto sem supradesnivelamento de ST que tiveram menor intervalo entre admissão e tratamento. Para pacientes com infarto com supradesnivelamento de ST, o tempo de internação foi significativamente menor quando o intervalo entre classificação de risco e tratamento foi menor. Não houve associação dos indicadores de qualidade com recorrência de eventos isquêmicos, revascularização do miocárdio, tempo de internação e óbito.
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Vancini-Campanharo CR, Oliveira GN, Andrade TFL, Okuno MFP, Lopes MCBT, Batista REA. Systemic Arterial Hypertension in the Emergency Service: medication adherence and understanding of this disease. Rev Lat Am Enfermagem 2015; 23:1149-56. [PMID: 26626007 PMCID: PMC4664016 DOI: 10.1590/0104-1169.0513.2660] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 04/30/2015] [Indexed: 02/08/2023] Open
Abstract
Objective: to identify the epidemiological profile of hypertension patients, how much they
understand about the disease and the rate of adherence to treatment by these
patients who had been hospitalized in the Brazilian emergency service. Methods: this cross-sectional study was performed with 116 patients, both male and female
and aged over 18 years, who had been hospitalized in the Emergency Service of a
University Hospital between March and June, 2013. The studied variables were data
referring to socio-demographics, comorbidities, physical activity and knowledge
regarding the disease. Patient adherence to treatment and the identification of
the barriers were respectively evaluated using the Morisky test and the Brief
Medication Questionnaire. Results: most of the patients involved in this study were women (55%), with white skin
color (55%), married (51%), retirees or pensioners (64%) and with a low
educational level (58%). Adherence to treatment, in most cases (55%), was moderate
and the most prevalent adherence barrier was recall (67%). When medication was
acquired at no cost to the patient, there was greater adherence to treatment. Conclusion: this study's patients had a moderate understanding about the disease. The high
correlation between the number of drugs used and the recall barrier suggests that
monotherapy is an option that can facilitate treatment adherence and reduce how
often the patients forget to take their medication.
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Campanharo CRV, Vancini RL, Lopes MCBT, Okuno MFP, Batista REA, Atallah ÁN, Góis AFTD. [Advantages of a cohort study on cardiac arrest conducted by nurses]. Rev Esc Enferm USP 2015; 49:762-6. [PMID: 26516745 DOI: 10.1590/s0080-623420150000500008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 06/15/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Identifying factors associated to survival after cardiac arrest. METHOD An experience report of a cohort study conducted in a university hospital, with a consecutive sample comprised of 285 patients. Data were collected for a year by trained nurses. The training strategy was conducted through an expository dialogue lecture. Collection monitoring was carried out by nurses via telephone calls, visits to the emergency room and by medical record searches. The neurological status of survivors was evaluated at discharge, after six months and one year. RESULTS Of the 285 patients, 16 survived until hospital discharge, and 13 remained alive after one year, making possible to identify factors associated with survival. There were no losses in the process. CONCLUSION Cohort studies help identify risks and disease outcomes. Considering cardiac arrest, they can subsidize public policies, encourage future studies and training programs for CPR, thereby improving the prognosis of patients.
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Affiliation(s)
| | - Rodrigo Luiz Vancini
- Centro de Educação e Desportos, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
| | | | | | | | - Álvaro Nagib Atallah
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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Vancini-Campanharo CR, Vancini RL, de Lira CAB, Lopes MCBT, Okuno MFP, Batista REA, Atallah ÁN, Góis AFTD. One-year follow-up of neurological status of patients after cardiac arrest seen at the emergency room of a teaching hospital. Einstein (Sao Paulo) 2015; 13:183-8. [PMID: 26154538 PMCID: PMC4943807 DOI: 10.1590/s1679-45082015ao3286] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 04/04/2015] [Indexed: 11/22/2022] Open
Abstract
Objective: To describe neurological status and associated factors of survivors after cardiac arrest, upon discharge, and at 6 and 12 month follow-up. Methods: A cohort, prospective, descriptive study conducted in an emergency room. Patients who suffered cardiac arrest and survived were included. A one-year consecutive sample, comprising 285 patients and survivors (n=16) followed up for one year after discharge. Neurological status was assessed by the Cerebral Performance Category before the cardiac arrest, upon discharge, and at 6 and 12 months after discharge. The following factors were investigated: comorbidities, presence of consciousness upon admission, previous cardiac arrest, witnessed cardiac arrest, location, cause and initial rhythm of cardiac arrest, number of cardiac arrests, interval between collapse and start of cardiopulmonary resuscitation, and between collapse and end of cardiopulmonary resuscitation, and duration of cardiopulmonary resuscitation. Results: Of the patients treated, 4.5% (n=13) survived after 6 and 12 months follow-up. Upon discharge, 50% of patients remained with previous Cerebral Performance Category of the cardiac arrest and 50% had worsening of Cerebral Performance Category. After 6 months, 53.8% remained in the same Cerebral Performance Category and 46.2% improved as compared to discharge. After 12 months, all patients remained in the same Cerebral Performance Category of the previous 6 months. There was no statistically significant association between neurological outcome during follow-up and the variables assessed. Conclusion: There was neurological worsening at discharge but improvement or stabilization in the course of a year. There was no association between Cerebral Performance Category and the variables assessed.
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Affiliation(s)
| | - Rodrigo Luiz Vancini
- Centro de Educação Física e Desportos, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
| | - Claudio Andre Barbosa de Lira
- Human Physiology and Exercise Department, Faculdade de Educação Física e Dança, Universidade Federal de Goiás, Goiânia, GO, Brazil
| | | | | | | | - Álvaro Nagib Atallah
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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Lopes MCBT, Lage JSS, Vancini-Campanharo CR, Okuno MFP, Batista REA. Factors associated with functional impairment of elderly patients in the emergency departments. Einstein (Sao Paulo) 2015; 13:209-14. [PMID: 26154541 PMCID: PMC4943811 DOI: 10.1590/s1679-45082015ao3327] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 04/23/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To assess the functional capacity of elderly patients in the emergency department as to Basic and Instrumental Activities of Daily Living. METHODS A cross-sectional study of 200 elderly patients admitted to the emergency department of a teaching hospital in São Paulo (SP), Brazil. The functional capacity of the elderly was assessed by the Katz index and Lawton & Brody scale. Statistical analyses were performed using analysis of variance, Bonferroni correction, χ2 test, or the likelihood ratio test. RESULTS Most seniors were independent (65%), and the degree of dependence was related to age, female gender, being single and widowed, and presence of cerebrovascular disease and dementia. The more dependent elderly for Instrumental Activities of Daily Living had increased dependence for Basic Activities. CONCLUSION We emphasize the importance of assessing the functional capacity of the elderly in the emergency department as it provides data for the nursing care in order to minimize or to avoid their functional impairment.
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Becker JB, Lopes MCBT, Pinto MF, Campanharo CRV, Barbosa DA, Batista REA. Triage at the Emergency Department: association between triage levels and patient outcome. Rev Esc Enferm USP 2015; 49:783-9. [DOI: 10.1590/s0080-623420150000500011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 07/09/2015] [Indexed: 11/22/2022] Open
Abstract
AbstractOBJECTIVEIdentify association between sociodemographic, clinical and triage categories with protocol outcomes developed at Hospital São Paulo (HSP).METHODSRetrospective cohort study conducted with patients older than 18 years submitted to the triage protocol in August 2012. Logistic regression was used to associate the risk categories to outcomes (p-value ≤0,05).RESULTSMen with older age and those treated in clinical specialties had higher rates of hospitalization and death. Patients in the high-priority group had hospitalization and mortality rates five and 10.6 times, respectively (p < 0.0001).CONCLUSIONThe high-priority group experienced higher hospitalization and mortality rates. The protocol was able to detect patients with more urgent conditions and to identify risk factors for hospitalization and death.
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Antunes JDFS, Pinto Okuno MF, Barbosa Teixeira Lopes MC, Vancini Campanharo CR, Assayag Batista RE. AVALIAÇÃO DA FRAGILIDADE DE IDOSOS INTERNADOS EM SERVIÇO DE EMERGÊNCIA DE UM HOSPITAL UNIVERSITÁRIO. Cogitare Enferm 2015. [DOI: 10.5380/ce.v20i2.39928] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
O objetivo do estudo foi avaliar a fragilidade de idosos internados no Serviço de Emergência de umhospital universitário do estado de São Paulo. O período da coleta de dados foi de março a junho de 2014.Estudo transversal com 101 idosos, por período igual ou superior a 24 horas. Análise realizada pela aplicaçãoda Edmonton Frail Scale. A média de idade foi 75 anos, 50,5% sexo feminino, 58,4% não terminou o ensinofundamental, 89,1% aposentados ou pensionistas e 84,2% acompanhados de cuidador. Antecedentes frequentesforam: hipertensão arterial (65,3%), diabetes mellitus (65,3%) e tabagismo (44,6%). Em relação à fragilidade, amédia do escore total foi 9,85, indicando fragilidade moderada. Os idosos com doenças neurológicas, demência,idade mais avançada e que tinham cuidador apresentaram maior fragilidade. O rastreamento da fragilidade propiciaplanejamento com vistas à prevenção de incapacidade e o agravamento das condições de saúde dos idosos.
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Okuno MFP, Costa N, Lopes MCBT, Campanharo CRV, Batista REA. DIAGNÓSTICOS DE ENFERMAGEM MAIS UTILIZADOS EM SERVIÇO DE EMERGÊNCIA. Cogitare Enferm 2015. [DOI: 10.5380/ce.v20i2.38606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivou-se identificar os principais diagnósticos de enfermagem utilizados por expertsem área de emergência. Estudo descritivo realizado em Serviço de Emergência, período de junho a novembro de 2011. Utilizouse a Técnica Delphi para a obtenção do consenso entre sete profissionais de diferentes instituições brasileiras, sobre os diagnósticos de enfermagem prevalentes em Ser viços de Urgência e Emergência. Os diagnósticos de enfermagem que tiveram consenso foram: Troca de gases prejudicada, Padrão respiratório ineficaz, Ventilação espontânea prejudicada, Risco de infecção, Risco de integridade da pele prejudicada, Integridade tissular prejudicada e Risco de quedas. Conclui-se que a Técnica Delphi mostrou-se como grande facilitadora para a obtenção de consenso, sobre os diagnósticos de enfermagem prevalentes em Ser viços de Emergência, relacionados aos domínios da Nor th American Nursing Diagnosis Association de “segurança e proteção”, “atividade e repouso” e “eliminação e troca”.
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Paixão TCRD, Campanharo CRV, Lopes MCBT, Okuno MFP, Batista REA. Nursing staff sizing in the emergency room of a university hospital. Rev Esc Enferm USP 2015; 49:486-93. [DOI: 10.1590/s0080-623420150000300017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 03/19/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To verify the adequacy of the professional nursing staff in the emergency room of a university hospital and to evaluate the association between categories of risk classification triage with the Fugulin Patient Classification System. METHOD The classification of patients admitted into the emergency room was performed for 30 consecutive days through the methodology proposed by Gaidzinski for calculating nursing requirements. RESULTS The calculation determines the need for three registered nurses and four non-registered nursing for each six hour shift. However, only one registered nurse and four non-registered nurse were available per shift. There was no correlation between triage risk classification and classification of care by the Fugulin Patient Classification System. CONCLUSION A deficit in professional staff was identified in the emergency room. The specificity of this unit made it difficult to measure. To find the best strategy to do so, further studies should be performed.
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Caires BR, Lopes MCBT, Okuno MFP, Vancini-Campanharo CR, Batista REA. Knowledge of healthcare professionals about rights of patient's images. Einstein (Sao Paulo) 2015; 13:255-9. [PMID: 26267838 PMCID: PMC4943819 DOI: 10.1590/s1679-45082015ao3207] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 09/30/2014] [Indexed: 11/21/2022] Open
Abstract
Objective To assess knowledge of healthcare professionals about capture and reproduction of images of patients in a hospital setting. Methods A cross-sectional and observational study among 360 healthcare professionals (nursing staff, physical therapists, and physicians), working at a teaching hospital in the city of São Paulo (SP). A questionnaire with sociodemographic information was distributed and data were correlated to capture and reproduction of images at hospitals. Results Of the 360 respondents, 142 had captured images of patients in the last year, and 312 reported seeing other professionals taking photographs of patients. Of the participants who captured images, 61 said they used them for studies and presentation of clinical cases, and 168 professionals reported not knowing of any legislation in the Brazilian Penal Code regarding collection and use of images. Conclusion There is a gap in the training of healthcare professionals regarding the use of patient´s images. It is necessary to include subjects that address this theme in the syllabus of undergraduate courses, and the healthcare organizations should regulate this issue.
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Antunes JDFS, Okuno MFP, Lopes MCBT, Campanharo CRV, Batista REA. Drug interaction in elderly inpatients in the emergency department of a university hospital. REME: Revista Mineira de Enfermagem 2015. [DOI: 10.5935/1415-2762.20150070] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abstract
Objetivo: Comparar a gravidade das lesões e do trauma mensurada pelas versões da Abbreviated Injury Scale 1998 e 2005 e verificar a mortalidade nos escores Injury Severity Score e New Injury Severity Score nas duas versões.Método: Estudo transversal e retrospectivo analisou lesões de pacientes de trauma, de três hospitais universitários do município de São Paulo, Brasil. Cada lesão foi codificada com Abbreviated Injury Scale 1998 e 2005. Os testes estatísticos aplicados foram Wilcoxon, McNemar-Bowker, Kappa e teste Z.Resultados: A comparação das duas versões resultou em discordância significante de escores em algumas regiões corpóreas. Com a versão 2005 os níveis de gravidade da lesão e do trauma foram significantemente reduzidos e a mortalidade foi mais elevada em escores mais baixos. Conclusão: Houve redução da gravidade da lesão e do trauma e alteração no percentual de mortalidade com o uso da Abbreviated Injury Scale 2005.
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Lopes MCBT, Whitaker IY. [Measuring trauma severity using the 1998 and 2005 revisions of the abbreviated injury scale]. Rev Esc Enferm USP 2014; 48:640-647. [PMID: 25338244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 06/12/2014] [Indexed: 06/04/2023] Open
Abstract
OBJECTIVES This study aims to compare injury and trauma severity as measured by the 1998 and 2005 revisions of the Abbreviated Injury Sca le and to determine the mortality in the Injury Severity Score and the New Injury Severity Score in both versions. METHOD This cross-sectional retrospective study analyzed injuries of trauma patients from three university hospitals in Sao Paulo, Brazil. Each injury was coded using the Abbreviated Injury Scale 1998 and 2005. The statistical tests applied were the Wilcoxon, McNemar-Bowker, Kappa, and Z tests. RESULTS Comparing the two versions resulted in significant disagreement regard ing the scores of certain body regions. With the 2005 version, injury and trauma severity levels were significantly decreased, and the mortality was higher at lower scores. CONCLUSION Injury and trauma severity were decreased and the percentage mortality was changed when the 2005 revision of the Abbreviated Injury Scale was used.
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Lage JSS, Okuno MFP, Campanharo CRV, Lopes MCBT, Batista REA. FUNCTIONAL CAPACITY AND PROFILE OF ELDERLY PEOPLE AT EMERGENCY UNITS. REME: Revista Mineira de Enfermagem 2014. [DOI: 10.5935/1415-2762.20140063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abstract
OBJETIVO: Correlacionar a capacidade funcional do idoso com a gravidade do trauma e compará-la nos momentos antes e após a ocorrência do trauma. MÉTODOS: Estudo prospectivo e observacional realizado no Serviço de Emergência. Foram incluídos 55 idosos com idade a partir de 60 anos, ambos os sexos, vítimas de trauma. Foram avaliados a incapacidade de pacientes com restrições funcionais de origem variada. Os instrumentos de pesquisa aplicados em três momentos foram: a Medida de Independência Funcional e o Injury Severity Score para avaliar a gravidade do trauma. RESULTADOS: A capacidade funcional em até 48 horas foi significativamente maior que a capacidade funcional na alta e após um mês. Quanto menor a gravidade do trauma maior a capacidade funcional do idoso. CONCLUSÃO: Os idosos apresentaram piora da capacidade funcional durante o período de internação e após um mês de na alta hospitalar.
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