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PURPOSE: To assess the surgical wound (SW) healing in orthopedic patients with Impaired tissue integrity according to the Nursing Outcomes Classification (NOC). METHODS: A prospective longitudinal study performed with 24 patients. Data collection was performed through an instrument containing the NOC indicators. FINDINGS: The indicators skin approximation, drainage, surrounding skin erythema, periwound edema, increased skin temperature, and foul wound odor presented a statistically significant increase when compared the means between the first and the last day of evaluation. CONCLUSION: The NOC indicators allowed to monitor the SW healing indicating an improvement. IMPLICATIONS FOR NURSING PRACTICE: The NOC can favor an earlier identification of the degree of commitment for each patient and enables implementation of care to achieve target outcomes.

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AIM: To describe the facilitators and barriers for nurses to perform quality wound care in three surgical wards of a hospital in Port-au-Prince, Haiti. BACKGROUND: Up to a quarter of patients in low- and middle-income countries may acquire at least one infection while hospitalized. There is a paucity of research investigating nursing wound care practices in low- and middle-income countries regarding the prevention of hospital-acquired infections. METHODS: The design was qualitative descriptive. We observed nursing staff on the general surgery, orthopaedics and maternity units while they performed routine dressing changes (n = 15). We interviewed nursing (n = 13) and medical residents (n = 3) and inquired about their perceptions of facilitators and barriers for nurses to perform quality wound care. FINDINGS: A number of wound care practices appeared well integrated including using gloves to remove dressings, applying sterile dressings, properly disposing of soiled materials, inspecting wounds for signs of infection and employing comfort and privacy measures. Areas that may need improvement included aseptic technique, hand hygiene, pain assessments, patient education and documentation. We identified four themes related to barriers and facilitators to perform quality wound care: (i) materials and resources; (ii) nurse-to-patient ratios, workload and support; (iii) roles and responsibilities of nurses; and (iv) knowledge and training of nurses. CONCLUSION: Nursing wound care practices may be optimized by improving nurses' professional status and working conditions. IMPLICATIONS FOR NURSING PRACTICE AND HEALTH POLICY: Greater financial investment in health care and (continuing) education, self-regulation and development of the nursing role, including more autonomy, are needed to elevate the professional status of nurses in Haiti. Institutional policies should promote best practices, clarify nursing roles and responsibilities and foster interdisciplinary collaboration in patient care.

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Objective To analyze the clinical profile, nursing diagnoses, and nursing care established for postoperative bariatric surgery patients. Method Cross-sectional study carried out in a hospital in southern Brazil with a sample of 143 patients. Data were collected retrospectively from electronic medical records between 2011 and 2012 and analyzed statistically. Results We found a predominance of adult female patients (84%) with class III obesity (59.4%) and hypertension (72%). Thirty-five nursing diagnoses were reported, among which the most frequent were: Acute Pain (99.3%), Risk for perioperative positioning injury (98.6%), and Impaired tissue integrity (93%). The most frequently prescribed nursing care were: to use protection mechanisms in the surgical patient positioning, to record pain as 5th vital sign, and to take vital signs. There was an association between age and comorbidities. Conclusion The nursing diagnoses supported the nursing care prescription, which enables the qualification of nursing assistance.

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RESUMO Objetivo Analisar o perfil clínico, os diagnósticos e os cuidados de enfermagem estabelecidos para pacientes em pós-operatório de cirurgia bariátrica. Método Estudo transversal realizado em um hospital do Sul do Brasil, com amostra de 143 pacientes. Os dados foram coletados retrospectivamente entre 2011-2012 no prontuário eletrônico dos pacientes, os quais foram analisados estatisticamente. Resultados Identificaram-se pacientes femininas adultas (84%) com obesidade grau III (59,4%) e hipertensas (72%), com 35 diagnósticos de enfermagem, sendo os mais frequentes: Dor aguda (99,3%), Risco de lesão pelo posicionamento perioperatório (98,6%) e Integridade tissular prejudicada (93%). Dentre os cuidados de enfermagem prescritos, os mais utilizados foram: usar mecanismos de proteção no posicionamento cirúrgico do paciente, registrar a dor como 5° sinal vital e verificar sinais vitais. Foi observada associação entre a idade e as comorbidades. Conclusão Os diagnósticos de enfermagem subsidiaram a prescrição de cuidados, possibilitando qualificar a assistência de enfermagem.

RESUMEN Objetivo Analizar el perfil clínico, diagnósticos de enfermería y cuidados de enfermería establecidos para los pacientes en postoperatorio de cirugía bariátrica. Método Estudio transversal con la muestra de 143 pacientes. El estudio se realizó entre 2011-2012, en un hospital en el sur de Brasil. Los datos fueron recolectados retrospectivamente de los registros médicos electrónicos y analizados estadísticamente. Resultados Se identificaron pacientes femeninas adultas (84%), con obesidad clase III (59,4%), hipertensión (72%) y con 35 diagnósticos de enfermería, siendo los más frecuentes: el Dolor agudo (99,3%), Riesgo de lesión perioperatoria de posicionamiento (98,6%) y la Integridad del tejido deteriorado (93%). Entre los cuidados de enfermería prescritos los más utilizados fueron: utilizar los mecanismos de protección en el posicionamiento quirúrgico del paciente, registrar el dolor como quinto signo vital y verificar los signos vitales. Se observó una asociación entre la edad y las comorbilidades. Conclusión Los diagnósticos de enfermería apoyaron la prescripción de los cuidados de enfermería, lo que permite calificar la asistencia de enfermería.

ABSTRACT Objective To analyze the clinical profile, nursing diagnoses, and nursing care established for postoperative bariatric surgery patients. Method Cross-sectional study carried out in a hospital in southern Brazil with a sample of 143 patients. Data were collected retrospectively from electronic medical records between 2011 and 2012 and analyzed statistically. Results We found a predominance of adult female patients (84%) with class III obesity (59.4%) and hypertension (72%). Thirty-five nursing diagnoses were reported, among which the most frequent were: Acute Pain (99.3%), Risk for perioperative positioning injury (98.6%), and Impaired tissue integrity (93%). The most frequently prescribed nursing care were: to use protection mechanisms in the surgical patient positioning, to record pain as 5th vital sign, and to take vital signs. There was an association between age and comorbidities. Conclusion The nursing diagnoses supported the nursing care prescription, which enables the qualification of nursing assistance.

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