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Item Intervenções de enfermagem para o padrão respiratório ineficaz em idosos(Universidade Federal de Goiás, 2009-06-19) CAVALCANTE, Agueda Maria Ruiz Zimmer; NAKATANI, Adélia Yaeko Kyosen; http://lattes.cnpq.br/0202706625866781Upon the multiple ilnesses that aflict the elderly, respiratory problems stand out as cause of hospital admitance and re-admitance, and consequent worsening of funtional capacity. The nursing interventions directed to the human responses in evidence allow clinical improvement, visibility, and quality of nursing assistance to elderly patients with respiratory problems. The goal was to analyse the nursing interventions performed by the nursing staff to the nursing diagnosis ineffective breathing pattern in elderly patients. It is a descriptive study, developed in the internal medicine section of a scholl hospital in Goiânia, done in three stages, from July to December of 2008. The first stage consisted in the search of activities performed by the nursing staff to the ineffective breathing pattern in the elderly. The second consisted in the crossed mapping between the quoted activities and the interventions and activities priorized by the NIC to the ineffective breathing pattern diagnosis. And the third stage consisted in the new collection of data analyse the priorized NIC activities to ineffective breathing pattern in the elderly. If was adapted the descriptive statistic with distribution of the activities in simple frequence. 43 nursing workers took part in the study, after having read andsigned the form of free consent and understanding. Of the participants, 83,7% were women and 16,3% were men; 23,8% were between 36 and 40 years-old; 46,6% refered having completed high school, 11,6% had college education and 18,6% were in college, but not yet graduated; 18,6% had some complementary study after college and 2,3% had master degree; 60,5% were 1 to 5 years in the institution and 74,4% were 1 to 5 years in the same hospital section. From the 62 activities referred and mapped as NIC s interventions and activities, the ones witch presented a frequency higher than 50% were: Positioning (99,9%), Oxygen Therapy (99,8%) e Medication Administrantion (65,8%). Lower than 50%: Airway Manegement (45,0%), Anxiety Reduction (42,9%), Ventilation Assistance (40,8%), Respiratory Monitoring (36,8%), Vital Signs Monitoring (36,2%), Energy Management (31,6%), Emotional Support (27,2%), Pain Management (24,9%) e Surveillance (20,4%). Lower than 20%: Chest Physiotherapy (13,6%), Neurologic Monitoring (9,09%), Intravenous Therapy (6,8%), Airway Suctioning (6,8%), Intravenous Insertion (4,5%), Smoking Cessation Assistance (2,2%), Medication Management (2,2%), Fluid Monitoring (2,2%), Emergency Care (2,2%), Aspiration Precautions (2,2%) e Tube Care: Chest (2,2%).The drug administration activity present accordance as of the necessity of medical prescription; there was no accordance of the activities that are exclusive of the nurse. The activities concerning positioning, drug, administration, oxygen administration, aerosol administration and vital signs monitoring were referred as being frequently perfomed. The concerning monitoring of values of pulmonary function, fisioterapy and the ones that demanded, a physical exam evaluation were referred as not performed, and the main reason was being performed by another professional . The study made it possible to identify: the need to consider the interdisciplinarity in the interventions, the gaps in the assistance provided by the nursing staff, the abilities and skills required from the nurse to the assistance of the elderly patients that present ineffective breathing pattern , with focus a the prevention of disorders and on the integrality of the assistance,Item Diagnósticos de Enfermagem identificados na admissão hospitalar de idosos, para tratamento de doenças crônicas não transmissíveis.(Universidade Federal de Goiás, 2007-12-20) GUEDES, Helisamara Mota; NAKATANI, Adélia Yaeko Kyosen; http://lattes.cnpq.br/0202706625866781In accordance with the necessity of rethinking the nurse performance towards to the health program of elderly people, it appears the necessity of knowing these people human answers at the moment of the hospital admission. The nursing diagnostic knowledge will allow the assistance planning to these aged ones, and also, to prepare the nursing team to attend these answers. Objectives: to analyze these population characteristics such as: age, sex, occupation, education, civil state, religion, monthly income, number of children, origin, number of chronic illnesses, ways of admissions to the hospital and previous internments, according to their gender; to identify in accordance to the Taxonomy of NANDA (2006) Nursing Diagnostic among the interned ones for clinical treatment; to describe the related factors of risk and defining characteristics of the identified diagnostic of nursing in this population. Methodology: it is related to a descriptive study, quantitative boarding, in 28 aged ones admitted during the first 24 hours in the medical clinic, situated in a center-west region Hospital School. The data collection occurred between August to October, 2007, by means of an instrument usage, half-structuralized for the elderly people evaluation. For the identification of the nursing diagnostic, the process of clinical reasoning in accordance with Risner (1995) was used. Results: People admitted into the medical clinic had presented as characteristic to be predominantly men, aged group in between 60 to 69, Catholics, low education, monthly income of one to three minimum wages, carrying two or more illnesses, 85.7% with previous internments and 57.1% admitted by the Ready Aid. Among these numbers, 58 different nursing diagnosis had been identified, variation of 8 to 18 diagnostic, average of 12.36, shunting line standard of 2.94 and medium of 12. The domain Activity/Rest, Elimination and Exchange and Perception/Cognition, had presented greater prevalence of nursing diagnosis. The domain Life Principles and Growth/Development had not presented nursing diagnosis. The domain Security/Protection and Confrontation/Toleration to the Stress had presented a low prevalence if compared to the other domains. The diagnostics which have had bigger frequency of 50% were: harmed dentition (100%), risk for infection (100%), deficit knowledge (82.1%), disposal for improved self-concept (82.1%), disposal for improved familiar processes (72.5%), disposal for increased individual confrontation (60.6%) and risk for falls (57.1%). The diagnostics which have had less frequency of 3.5% were: fluid volume excess, altered nutrition: less than body requirements, constipation, risk for constipation, feeding self care deficit, rambling, disposal increased for knowledge concerning the illness, impaired memory, impaired verbal communication, risk of impotence feeling, situational low self esteem, body image disturbance, hyperthermia and social isolation. The most prevalent related factors to these nursing diagnostic prospects were weakness/fatigue, metabolic alterations, chronic illness, harmed cognition, disequilibrium between offer and demand of oxygen, the risk factors were the medicine usage, energy decrease/fatigue, presence of circulatory/respiratory problems. Conclusion: The present study had provided the knowledge of which are the elderly care necessities and also to supply subsidies so that the related hospital nursing team can base the assistance, planning an holistic and resolutive care, as well as making possible the adequacy of the human resources and material to attend the demandItem Adesão dos enfermeiros às precauções padrão à luz do modelo de crenças em saúde(Universidade Federal de Goiás, 2005-03-31) MELO, Dulcelene de Sousa; TIPPLE, Anaclara Ferreira Veiga; http://lattes.cnpq.br/4288704233343920; SOUZA, Adenicia Custodia Silva e; http://lattes.cnpq.br/5966034868102264This was a qualitative study done in a big-sized general public hospital in the city of Goiânia Goiás The aims was to analyze nurses´ adherence to standard precautions according to Rosenstock´s health belief model (HBM) (1974) Data were collected using a semi-structured interview guide based on principles of Critical Incidence Technique (CIT) The instrument was validated by judges and was then pre-tested The ethical-legal research principles were observed Among 90 nurses selected to participate in the study 82 agreed to take part in this study Inclusion criteria were nurses who were either in direct contact with patients or in supervisory positions in the hospital cleaning, laundry or sterilization services Data were analyzed in accordance with CIT The analysis categories were constructed using the dimensions of the HBM A total of 139 critical incidents were identified of which 66 were considered positive and 73 negative HBM dimensions were identified within 131 situations: 74 (56,5%) related to perceived susceptibility; 17 (13,0%) to perceived benefits and 40 (30,5%) to perceived barriers The majority of the reported critical incidents related to situations of occupational exposure to biological materials Among the Standard Precautions (SP) use of protective barriers was most frequently utilized Denial of susceptibility was indicated by the lack of use of protective barriers improper management of sharp objects and non-adherence to SP related to patients with multi-resistant pathogens Moderate perceived susceptibility was associated with partial adherence to SP in cases of patients requiring more complex levels of care; in situations following occupational exposure; and when patients needs took priority over personal protection High perceived susceptibility was observed in situations of caring for patients suspected or diagnosed with infections due to pathogens of epidemiological importance and those related to nurses responsibility Perceived seriousness was evident in behaviors and consequences related to critical incidences after occupational exposure in moments when nurses expressed feelings experienced psychosomatic symptoms and were diagnosed with an infection. Perceived benefits emerged above all from positive critical incidente with focus on protective barriers understood as protection strategies which lead to safety while procedures are executed Perceived barriers were: lack of personnel preparation lack of material resources insufficient personnel improper physical structure patient emergencies psychosocial factors lack of personnel policies for cases of exposure to biological material These barriers contribute to lower adherence of SP but they could be addressed by the Health Care Facilities since nurses have demonstrated adequate perception of susceptibility and benefits HBM dimensions were associated with nurses adherence to SP suggesting that plans should be developed to improve the nurses actions and decision-making in day-to-day nursing cars prioritizing the safety of those individuals involved in this processItem Análise clínica e microbiológica de úlceras venosas de pacientes atendidos em Unidades Básicas de Saúde de Goiânia(Universidade Federal de Goiás, 2012-03-30) SANTOS, Silvana de Lima Vieira dos; BACHION, Maria Marcia; http://lattes.cnpq.br/8503907944360635This cross-sectional study was performed in the dressing rooms of the primary healthcare network of Goiânia, Goiás, Brasil, with the following objectives: to identify the prevalence of Gram-negative bacteria (GNB) in venous ulcers (VU) with clinical signs of infection; analyze the susceptibility profile of the isolates; detect the production of AmpC β-lactamases and metallo-beta-lactamases, and extended spectrum beta-lactamase (ESBL); describe the clinical signs and symptoms of infection in VU; evaluate the wounds clinical stage of infection and its relationship with the presence of GNB. The data were analyzed by means of descriptive statistics procedures, proportion and Chi-square tests (p<0.05). All ethical aspects were followed. The participants were 69 patients with venous ulcers, with or without arterial complication, totaling 98 wounds. It was verified that 74.5% of the wounds showed GNB growth, particularly enterobacteria (53.8%) and non-fermenting gram-negative bacteria (46.2%). The prevalent species among the enterobacteria was Escherichia coli (24.5%), followed by Enterobacter aerogenes, Pantoea agglomerans and Proteus mirabilis (12.2% each). Regarding the non-fermenting gram-negative bacteria, the prevalent genre was Pseudomonas (66.6%), particularly the species P. aeruginosa (59.5%), present in 25.5% of the analyzed wounds. Regarding the susceptibility profile of the enterobacteria, the highest resistance rates were to tetracycline (38.8%) and amoxicillin-clavulanic acid (26.5%). Among P. aeruginosa, the highest resistance was observed for cefoxitin (100%). Regarding the production of the AmpC enzyme, 30% of the microorganisms in the CESP (Citrobacter spp., Enterobacter spp., Serratia spp. and Providencia spp.) group, and 100% of the P. aeruginosa were resistant to cefoxitin. The remaining microorganisms of the CESP group (70%) that were sensitive to cefoxitin were subjected to a confirmatory test, and 37.5% were found to be positive for the production of the AmpC enzyme. Regarding metallo-beta-lactamase, 23.8% of the non-fermenting gram-negative bacteria showed reduced sensitivity to imipenem, meropenem or ceftazidime. When subjected to the confirmatory test, 8% of the P. aeruginosa were positive for the MBL enzyme. Regarding the clinical signs and symptoms of infection, the highlighted results with >70% frequency are: opaque and/or reddish brown discoloration; increase in exudate volume and pain. Stage-three infection was the most prevalent (71.4%). An association was found between cellulitis and friable granulation tissue that bleeds easily and the culture for GNB. In conclusion, the presence of gram-negative pathogens with resistance profiles in primary healthcare patients suggests the need to implement microbiological surveillance for patients with VU experiencing a prolonged or difficult healing process, and that the identification VU infection should be guided by knowledge regarding the etiology, classic characteristic and clinical stages of infection.Item Forças impulsoras e restritivas para o trabalho em equipe de enfermagem em unidade de urgência e emergência(Universidade Federal de Goiás, 2009-05-25) SILVA, Ana Paula; MUNARI, Denize Bouttelet; http://lattes.cnpq.br/8409035360598716Teamwork is considered an essential tool in the process of improving health care, particularly emphasized in the Unique Health System guidelines as one of the axes that make it feasible the implementation of national health policy. It is a great challenge to both practitioners and managers, given its complexity. This is a descriptive exploratory study aimed at analyzing propelling and restrictive forces for nursing teamwork in an Adult Emergency and Urgency Unit of a public hospital through Kurt Lewin s approach. Mapping such forces enables managers to better deal with daily challenges, since they make it possible to categorize them into three related aspects: the SELF dimension- which includes personal factors, the OTHERincluding factors concerning interpersonal and ENVIRONMENTAL relations- which are part of elements not belonging to individuals, but to the environment. This is an investigation carried out in a school hospital located in the Midwestern Brazil, with 44 professionals taking part constituting the nursing team. Data was collected through questionnaire, submitted to content analysis process, categorized into dimensions previously defined. The outcomes showed balance in the teamwork forces domain, except concerning the ENVIRONMENTAL dimension, which result points to strong trends towards restrictive forces. The balance identified in the other dimensions signals that teamwork stagnation exists in the study group, which shows the need for interventions in order to stimulate and potentialize propelling forces and try to immobilize and transform restrictive forces. In the SELF dimension individual attributes, good relationship, friendship/love are seen as propelling forces, whereas individual limitations, absenteeism, health compromised, and technical competence limited are seen as restrictive ones. In the OTHER dimension, teamwork potential and force, active management posture and commitment/competence of both team and supportive areas are seen as propelling forces. As propelling forces in the same proportion relational limitation for teamwork and management posture which harm their work, as well as the harmed interpersonal relationship. Regarding the ENVIRONMENT, the propelling aspects are: proper setting and physical structure, efficient nursing records and integration between the clinical and supportive areas. Among restrictive aspects, dynamics and inadequate functioning of the unit, limited physical structure, shortage of material/equipment, and limited pharmacy service are highlighted. Identification of such factors shows that in the EUU there is a force field which needs to be developed towards teamwork, which may result in the betterment of quality of assistance and working conditions. For this reason, they need to be part of the institutional planning. Mapping such forces has enabled a concrete and objective view of the limitations and potential of the team studied, showing ways to orient changing processes. As a tool to be incorporated in the human resources management models for healthcare, this referential helps developing strategies to mobilize individual synergy and working teams, as well as with the elements favoring its effectiveness.Item Diagnósticos de enfermagem identificados em puérperas no período imediato e tardio no contexto da comunidade(Universidade Federal de Goiás, 2008-07-16) VIEIRA, Flaviana; SALGE, Ana Karina Marques; http://lattes.cnpq.br/7766918925030041; BACHION, Maria Marcia; http://lattes.cnpq.br/8503907944360635The puerperium occurs concomitant to the efetive exercise of maternity, in which a woman experiences profounds changes, within biological and in psychological and socio-cultural. The planned assistance, with the lifting of data, identification of human responses to problems or events from the life cycle in individual aspects, considering the context in which this woman is embedded is crucial during the post-partum phase. Studies with focus on nursing diagnosis (ND) identified in the puerperium have been made eminently at the hospital's context. This survey aimed to analyze the occurrence of 26 diagnosis of nursing care in the interest of immediate and late puerperium in the context of the community. This is a descriptive study of quantitative approach, carried out between February and May 2008. For the data gathering has been prepared an instrument from the defining characteristics and related factors / risk factors of diagnosis of interest, the NANDA Taxonomy II, version 2007-2008. The data gathering has included procedures for interview, physical examination and observation. A researcher conducted the fieldwork, completed the roadmap for collection and noted the diagnosis inference. Two experts reviewed the material for analysis of evidence about the presence of diagnosis reported. In the analysis was adopted procedures of descriptive statistics and inferential (Mann-Whitney, chi-square and its variants, P ≤ 0.05). It was even used Segment analysis, considering the typology of diagnosis made. Participated in the sample 40 puerperium during immediate and late periods, belonging to the team's area of coverage of family health team in the east region, after having been read and signed the term of free and informed consent. The socio-demographic characteristics of the participants were: predominant age group between 21 to 25 years (37.5%); brown color that self (65%), marital status or married with stable partner (82.5%); incomplete primary education (47.5%), 60% with housing itself; family income was, predominantly, from 1 to 2 (32.5%) or 3 to 4 (42.5%) minimum wage; family income over the male figure, since 55% of puerperium reported as occupying housewives. In this sample 65% had caesarian childbirth, the majority (70%) had up to two children, 80% began prenatal care in the first trimester of pregnancy, 80% performed at least 6 consultations, 90% had to full-term child; 32.5% claimed to have had urinary tract infection during pregnancy. Has been identified in this sample the occurrence of 24 of the 26 ND studied. Besides evidence of two new ND. The number of ND ranged from 08 to 16 in each puerperal woman, with an average of 13, totaling 521 ND, with 266 real diagnosis, 168-risk and 87 welfare or health promotion. In examining the relationship between the diagnosis of nursing and socio-demographic variables and obstetric (chi-square and its variants) was found a significant association for the diagnosis of breastfeeding interrupted and type of housing (p = 0.028); risk of breastfeeding interrupted and type of housing (p = 0.028); impaired tissue integrity and type of delivery (p = 0.011); risk for impaired integrity skin and number queries from prenatal (p = 0.020); impaired integrity skin and household income (p = 0.043)/number queries from prenatal (p = 0.032); altered nutrition: less than body requirements and housing (p = 0.001)/self that color (p = 0.021)/parity (p = 0.020); provision for improved nutrition and that self color (p = 0.044); altered nutrition: more than body requirements and type of housing (p = 0.001); acute pain and family income (p = 0.032)/self that color (p = 0.032 )/days of postpartum (p = 0.013)/type of delivery (p = 0.002); risk of constipation and type of delivery (p = 0.017); situational low self-esteem and family income (p=0,022). In examining the relationship between the number of diagnosis identified and the variables of interest, were not significantly different (Mann-Whitney). In the analysis of segments were found two cluster, which prevailed in the first segment more ND real and potential, than those related to psychological and social aspects. The characteristics of the two subgroups are presented descriptively. It was concluded that the diagnoses initially predicted were found in postpartum period at early and late period's, representing more human responses than those that have traditionally been exploited in monitoring the puerperal period, and is necessary to review the approach of nursing in this area under the education, assistance, research and public policies.