Fugulin scale for classifying pediatric patients in a respiratory inpatient unit: experience report

OBJECTIVE

To describe the use of the Fugulin scale to classify pediatric patients hospitalized in a respiratory unit as a subsidy for the allocation of human resources given the increase in cases of Severe Acute Respiratory Syndrome.

METHOD

Experience report conducted in a children's hospital in the Metropolitan Region of Curitiba with data collection from medical records and approved by the Institution and by the Research Ethics Committee.

RESULTS

Between February and May 2022, the percentage of patients categorized in minimal and intermediate care decreased by 53 and 11.4%, respectively, while those in high dependency and semi-intensive care expanded by 31.2 and 84.2%. In addition, in just four months, there was a considerable increase in the positivity of virologies compared to the twelve months of 2021. The susceptibility of children to the development of severe respiratory infection was proven through the decrease in virologies with undetectable results.

CONCLUSION

The results obtained allowed us to conclude there was a significant increase in the complexity of patients admitted to the respiratory unit, showing it is essential to provide a nursing team compatible with the care needs.

Implementation of modified Seldinger technology for percutaneous catheterization in critically ill newborns

OBJECTIVE

To describe the implementation of Modified Seldinger Technology for percutaneous catheterization in critically ill newborns.

METHOD

A quasi-experimental before- and-after study, carried out with neonatologist nurses in a Neonatal Intensive Care Unit.

RESULTS

Seven nurses participated in the research. Catheter pre-insertion, insertion and maintenance were assessed using the conventional and modified Seldinger technique. Reliability was satisfactory in pre-test, 5.40 (Md = 6.00), and post-test, 5.94 (Md = 7.00), and perfect in the items about device insertion and maintenance. There was low assertiveness in the items on indication, microintroduction procedure via ultrasound, limb repositioning and disinfection of connections/connectors.

CONCLUSION

Despite the Modified Seldinger Technique expanding some stages of execution over the traditional method of percutaneous catheterization, nurses were more assertive after theoretical-practical training. The technology was implemented and is in the process of being implemented in the health service.

Prevalence of central venous catheter salvage in newborn with staphylococcal bloodstream infection

OBJECTIVES

to establish the prevalence of salvage of central venous catheters in newborns with bloodstream infection caused by coagulase-negative staphylococci.

METHODS

retrospective cross-sectional study with 136 newborns admitted to the Neonatal Intensive Care Unit between 2011 and 2017. The total of 143 infection events undergoing antibiotic therapy were evaluated.

RESULTS

among the 143 infection events, 39 catheters in which antibiotic therapy was used were saved and in 69 cases, the device was removed. Positive central blood culture and single lumen catheter were factors associated with salvage failure. The probability of salvage decreased with infections diagnosed from 15 days of using the catheter. Negative blood culture raised the chance of salvage by fourfold.

CONCLUSIONS

the use of antibiotic therapy in the treatment of infections resulted in a low prevalence of salvage of the central venous catheter. The probability of salvage was associated with variables of the device.

Nursing care of a newborn with deep incisional surgical site infection: a case report

OBJECTIVE

To describe a case of deep incisional surgical site infection in a children's hospital in South Brazil, emphasizing the nursing care measures provided to the newborn.

METHOD

Case study with data collection from medical record, approved by the institution and the Human Research Ethics Committee.

RESULTS

From the diagnosis of surgical site infection, a plan was established for specific care of the lesion using occlusive dressings made with technologies aimed at accelerating the second-intention healing process.

CONCLUSION

Despite the severity of the lesions, the scientific knowledge and the skill of the nurses during treatment of the surgical site infection provided the newborn with full surgical wound healing and hospital discharge before the estimated moment.

DESFECHOS RELACIONADOS AO CATETER VENOSO CENTRAL DE INSERÇÃO PERIFÉRICA E À DISSECÇÃO CIRÚRGICA EM RECÉM-NASCIDOS

Objetivo: investigar os desfechos relacionados ao cateter central de inserção periférica e à dissecção cirúrgica em neonatos de uma unidade de terapia intensiva.Método: estudo quantitativo transversal retrospectivo, realizado em hospital infantil no Paraná. Coletaram-se os dados em setembro de 2017, por meio das fichas  referentes aos neonatos internados no período de janeiro a dezembro de 2016, que utilizaram cateter central de inserção periférica ou dissecção cirúrgica. Aplicou-se estatística descritiva e de associação.Resultados: analisaram-se 165 fichas, sendo 134 cateteres de inserção periférica (81,2%) e 31 dissecções cirúrgicas (18,8%). Os cateteres apresentaram menor quantitativo de infecção comparado às dissecções (6% e 16,1%, respectivamente). Associaram-se ao tipo de dispositivo as variáveis: local de inserção (p<0,001), fixação do curativo (p<0,001), medidas de protocolo operacional padrão (p<0,001), indicadores de eventos adversos (p<0,001), com destaque ao extravasamentoassociado à dissecção cirúrgica (p=0,006).Conclusão: sugerem-se maiores benefícios aos neonatos frente ao cateter de inserção periférica.