RESUMO

Fall is used as an indicator of quality in healthcare institutions specialized in elderly care and is also considered an important indicator of quality of life of seniors in all environments. This is a cross-sectional study with a convenience sample of 108 elderlies enrolled at a Health Center, in Belo Horizonte, Minas Gerais, in order to determine the occurrence of falls in elderly people and also look for its association with some variables. Data were collected from clinical records and interviews during home healthcare visits using a structured and specific instrument. It was found that 64 (59.3%) of the elderly patients have already suffered falls, and a significant statistical relationship (p=0.01) between the elderly cognitive ability and the occurrence of the falls. It is recommended that nursing care focuses in the early identification of the elderlies that are more likely to suffer falls, especially those who, in addition to the risk of falling are at increased risk of suffering serious injury originated from the falls.

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RESUMO

OBJECTIVE: to seek the best evidence available in the literature concerning the knowledge produced and related to the techniques of intermittent and indwelling urinary catheterization, so as to place the nursing care given to patients submitted to urinary catheterization on a scientific foundation and to prevent urinary tract infections. METHOD: the literature search was undertaken in the Pubmed and Cochrane databases for the development of the integrative review. The sample was of 34 articles. These were analyzed by two independent researchers using an instrument adapted for ascertaining the level of evidence and the grade of recommendation, in addition to the use of the Jadad scale. RESULTS: the evidence available related to the nursing care for patients submitted to urinary catheterization is: the infection rate in the urinary tract does not alter whether the perineum is cleaned with sterile water or not, or with the use of povidone-iodine solution or chlorhexidine; or using clean or sterile technique. The use of an intermittent catheter with clean technique results in low rates of complications or infections compared to the use of an indwelling catheter. The removal of the catheter in up to 24 hours after surgery and the use of an antimicrobial-impregnated or hydrophilic-coated catheter reduce urinary tract infection . CONCLUSIONS: there are controversies in relation to periurethral cleansing technique, the type of material the catheter is made of, and some procedures for the maintenance and removal of the catheter. This review's results represent an updating of the nurse's conducts and decision-making for the prevention of urinary tract infections in urinary catheterization.

Assuntos

RESUMO

A queda é utilizada como indicador de qualidade em serviços especializados no cuidado de idosos, sendo também considerado importante indicador de qualidade de vida de idosos em todos os ambientes. Realizou-se um estudo de corte transversal de 108 idosos cadastrados no Programa de Saúde da Família, em um Centro de Saúde de Belo Horizonte, Minas Gerais, com o objetivo de determinar a ocorrência de quedas nessa clientela, associando-as a algumas variáveis. Os dados foram coletados em prontuários e em visitas domiciliares por meio de entrevista estruturada, com instrumento específico. Observou-se que 64 (59,3%) dos pacientes idosos já haviam sofrido quedas, havendo relação estatisticamente significativa (p=0,01) entre capacidade cognitiva dos idosos e ocorrência das quedas. Recomenda-se o cuidado de enfermagem na identificação precoce dos idosos com maior chance de sofrerem quedas, especialmente daqueles que, além do risco de queda, apresentam risco aumentado de sofrer lesões graves decorrentes da mesma.

Fall is used as an indicator of quality in healthcare institutions specialized in elderly care and is also considered an important indicator of quality of life of seniors in all environments. This is a cross-sectional study with a convenience sample of 108 elderlies enrolled at a Health Center, in Belo Horizonte, Minas Gerais, in order to determine the occurrence of falls in elderly people and also look for its association with some variables. Data were collected from clinical records and interviews during home healthcare visits using a structured and specific instrument. It was found that 64 (59.3%) of the elderly patients have already suffered falls, and a significant statistical relationship (p=0.01) between the elderly cognitive ability and the occurrence of the falls. It is recommended that nursing care focuses in the early identification of the elderlies that are more likely to suffer falls, especially those who, in addition to the risk of falling are at increased risk of suffering serious injury originated from the falls.

La caída se utiliza como indicador de la calidad de los servicios especializados en el cuidado de los ancianos, y también se considera un indicador importante de la calidad de vida de las personas mayores en todos los ambientes. Se realizó un estudio transversal con 108 ancianos inscritos en el Programa Salud de la Familia de un Centro de Salud, en Belo Horizonte, Minas Gerais, con el fin de determinar la incidencia de caídas en esta clientela, vinculándolas a algunas variables. Los datos se obtuvieron de los registros médicos y visitas a domicilio mediante entrevista estructurada, con uso de un instrumento específico. Se observó que 64 (59,3%) de los ancianos ya había sufrido caídas, y una relación estadísticamente significativa (p = 0,01) entre la capacidad cognitiva de los ancianos y las caídas. Se recomienda la identificación temprana de las personas mayores más propensas a sufrir caídas, especialmente aquellas que, además del riesgo de caídas, tienen un mayor riesgo de sufrir lesiones graves derivados de las mismas.

Assuntos

RESUMO

OBJECTIVE: to seek the best evidence available in the literature concerning the knowledge produced and related to the techniques of intermittent and indwelling urinary catheterization, so as to place the nursing care given to patients submitted to urinary catheterization on a scientific foundation and to prevent urinary tract infections. METHOD: the literature search was undertaken in the Pubmed and Cochrane databases for the development of the integrative review. The sample was of 34 articles. These were analyzed by two independent researchers using an instrument adapted for ascertaining the level of evidence and the grade of recommendation, in addition to the use of the Jadad scale. RESULTS: the evidence available related to the nursing care for patients submitted to urinary catheterization is: the infection rate in the urinary tract does not alter whether the perineum is cleaned with sterile water or not, or with the use of povidone-iodine solution or chlorhexidine; or using clean or sterile technique. The use of an intermittent catheter with clean technique results in low rates of complications or infections compared to the use of an indwelling catheter. The removal of the catheter in up to 24 hours after surgery and the use of an antimicrobial-impregnated or hydrophilic-coated catheter reduce urinary tract infection . CONCLUSIONS: there are controversies in relation to periurethral cleansing technique, the type of material the catheter is made of, and some procedures for the maintenance and removal of the catheter. This review's results represent an updating of the nurse's conducts and decision-making for the prevention of urinary tract infections in urinary catheterization.

OBJETIVO: buscar as melhores evidências disponíveis na literatura sobre o conhecimento produzido e relacionado à técnica de cateterismo urinário intermitente e de demora, para embasar cientificamente o cuidado de enfermagem prestado ao paciente, submetido ao cateterismo urinário, e prevenir infecção do trato urinário. MÉTODO: a busca foi realizada nas bases de dados PubMed e Cochrane para o desenvolvimento da revisão integrativa. A amostra foi composta por 34 artigos. Esses foram analisados por dois pesquisadores independentes, usando-se instrumento adaptado para verificar o nível de evidência e grau de recomendação, além da utilização da escala de Jadad. RESULTADOS: as evidências disponíveis, relacionadas aos cuidados de enfermagem aos pacientes submetidos ao cateterismo urinário, são: a taxa de infecção no trato urinário não altera com a higienização do períneo com água estéril ou não, com o uso de solução de iodo-povidine ou clorexidine, ou aplicando técnica limpa ou estéril. O uso do cateter intermitente com técnica limpa implica em menores taxas de complicações e infecções em comparação com a de demora. A remoção do cateter em até 24 horas após cirurgia e o uso do cateter impregnado com antimicrobiano e de revestimento hidrofílico reduz a incidência de infecção do trato urinário. CONCLUSÕES: existem controvérsias em relação à técnica de higienização periuretral, tipo de material do cateter e alguns procedimentos para a manutenção e remoção do cateter. Os resultados desta revisão representam atualização das condutas e tomada de decisão do enfermeiro para a prevenção de infecção do trato urinário no cateterismo urinário.

OBJETIVO: buscar las mejores evidencias disponibles en la literatura sobre el conocimiento producido y relacionado a la técnica de cateterismo urinario intermitente y de demora para apoyar científicamente el cuidado de enfermería prestado al paciente sometido al cateterismo urinario y precaver infección del trato urinario. MÉTODO: La busca fue realizada en las bases de datos PubMed y Cochrane para el desarrollo de la revisión integrativa. La muestra fue de 34 artículos. Éstos fueron analizados por dos investigadores independientes usando instrumento adaptado para verificar el nivel de evidencia y grado de recomendación, además de la utilización de la escala de Jadad. RESULTADOS: las evidencias disponibles relacionadas a la atención de enfermería a los pacientes sometidos al cateterismo urinario son: la tasa de infección en el trato urinario no altera con la higienización del perineo con agua estéril o no, con el uso de solución de iodo-povidona o clorhexidina; o aplicando técnica aseada o estéril. El uso del catéter intermitente con técnica aseada implica en menores tasas de complicaciones e infecciones en comparación con la de demora. La remoción del catéter en hasta 24 horas pos cirugía y el uso del catéter impregnado con antimicrobiano y de revestimiento hidrofílico reduce incidencia de infección del trato urinario. CONCLUSIONES: existen controversias con relación a la técnica de higienización periuretral, tipo de material del catéter y algunos procedimientos para el mantenimiento y remoción del catéter. Los resultados de esta revisión representan actualización de las conductas y tomada de decisión del enfermero para la prevención de infección del trato urinario en el cateterismo urinario.

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RESUMO

This study aimed to identify risk factors associated with surgical site infections in orthopedic surgical patients at a public hospital in Minas Gerais, Brazil, between 2005 and 2007. A historical cohort of 3,543 patients submitted to orthopedic surgical procedures. A descriptive analysis was conducted and surgical site infection incidence rates were estimated. To verify the association between infection and risk factors, the Chi-square Test was used. The strength of association of the event with the independent variables was estimated using Relative Risk, with a 95 percent confidence interval and p<0.05. The incidence of surgical site infection was 1.8 percent. Potential surgical wound contamination, clinical conditions, time and type of surgical procedure were statistically associated with infection. Identifying the association between surgical site infection and these risk factors is important and contributes to nurses’ clinical practice.

Objetivou-se, neste estudo, identificar fatores de risco associados às infecções de sítio cirúrgico, em pacientes cirúrgicos ortopédicos, de um hospital público de Minas Gerais, Brasil, entre 2005 e 2007. Como método usou-se coorte histórica em 3.543 pacientes submetidos a cirurgias ortopédicas. Análise descritiva e taxa de incidência de infecção foram estimadas. Para verificar a associação entre a infecção e os fatores de risco usou-se o teste qui-quadrado. A força da associação do evento com as variáveis independentes foi estimada pelo risco relativo, intervalo de confiança de 95 por cento e p<0,05. A incidência de infecção de sítio cirúrgico foi de 1,8 por cento. Potencial de contaminação da ferida cirúrgica, condições clínicas do paciente, tempo cirúrgico e tipo de procedimento ortopédico foram estatisticamente associados à infecção. A identificação de associação de infecção de sítio cirúrgico aos fatores de risco mencionados é importante e contribui para a prática clínica do enfermeiro.

Estudio para identificar factores de riesgo asociados a infecciones de sitio quirúrgico en pacientes quirúrgicos ortopédicos de un hospital público de Minas Gerais, Brasil, entre 2005 y 2007. Cohorte histórica de 3.543 pacientes sometidos a cirugías ortopédicas. Un análisis descriptivo fue realizado y la tasa de incidencia de infección fue estimada. Para verificar la asociación entre la infección y los factores de riesgo se usó el test chi-cuadrado. La fuerza de la asociación del evento con las variables independientes fue estimada por el Riesgo Relativo, con un intervalo de confianza de 95 por ciento y p <0,05. La incidencia de infección de sitio quirúrgico fue 1,8 por ciento. Fueron estadísticamente asociados a la infección el potencial de contaminación de la herida quirúrgica, las condiciones clínicas del paciente, el tiempo quirúrgico y el tipo de procedimiento ortopédico. La identificación de asociación de infección de sitio quirúrgico con los factores de riesgo mencionados es importante y contribuye para la práctica clínica del enfermero.

Assuntos

RESUMO

This study aimed to identify risk factors associated with surgical site infections in orthopedic surgical patients at a public hospital in Minas Gerais, Brazil, between 2005 and 2007. A historical cohort of 3,543 patients submitted to orthopedic surgical procedures. A descriptive analysis was conducted and surgical site infection incidence rates were estimated. To verify the association between infection and risk factors, the Chi-square Test was used. The strength of association of the event with the independent variables was estimated using Relative Risk, with a 95% confidence interval and p<0.05. The incidence of surgical site infection was 1.8%. Potential surgical wound contamination, clinical conditions, time and type of surgical procedure were statistically associated with infection. Identifying the association between surgical site infection and these risk factors is important and contributes to nurses' clinical practice.

Assuntos