Objetivo: analisar registros de enfermagem quanto à presença das etapas do processo de enfermagem em prontuários de pacientes com feridas. Método: estudo transversal, de análise documental, realizado em um Hospital Escola, em estado de Goiás, de março a junho de 2016. A amostra constituiu-se de 180 blocos de registros de atendimentos a pessoas com feridas. Os registros foram classificados em relação às etapas do processo de enfermagem. Características das feridas foram observadas mediante checklist e comparadas com o teor dos registros. Foi utilizada na análise descritiva frequências simples e percentuais. Resultados: 91,6% dos blocos de registros continham elementos da etapa da coleta de dados. As etapas de diagnóstico de enfermagem, planejamento, implementação e avaliação da assistência foram pouco contempladas. Conclusão: há fragilidades no registro das etapas do processo de enfermagem na assistência ao paciente com feridas, que podem comprometer sua segurança, a avaliação do atendimento e pesquisas futuras.
Objective: To identify the incidence, risk factors for delirium, and its association with death in the elderly hospitalized with fractures. Method: Prospective cohort, with a one-year follow-up of elderly people with clinical or radiological diagnosis of fracture, from an emergency and trauma hospital in the state of Goiás. The outcome delirium was defined by the medical description in the medical record. The predictor variables were demographic, health conditions, and hospitalization complications. A hierarchical multiple analysis was performed using robust Poisson regression, with Relative Risk as a measure of effect. Results: A total of 376 elderly patients were included. The incidence of delirium was 12.8% (n = 48). Risk factors were male gender, age ≥80 years, dementia, heart disease, osteoporosis, chronic obstructive pulmonary disease, high-energy traumas, pneumonia, urinary tract infection, and surgery. The risk of death in the sample was 1.97 times higher (HR: 1.97 95% CI 1.19–3.25) in elderly people with delirium. Conclusion: Delirium had an intermediate incidence (12.8%); the risk of death in this group was about 2 times higher in one year after hospital admission. Demographic factors, past history of diseases, surgery, and complications have increased the risk and require monitoring during hospitalization of elderly people with fractures.
DOI: http://dx.doi.org/10.31011/1519-339X.2018a18n84.4 Objetiva-se avaliar a adesão da equipe de enfermagem às precauções padrão durante a realização dos curativos deferidas abertas. Estudo transversal descritivo, realizado na clínica cirúrgica de um hospital universitário do Estadode Goiás, no período de dezembro de 2015 a março de 2016. Foram observados 147 procedimentos de curativos.Os dados foram coletados por meio da observação direta com registro em checklist e analisados pelo SoftwareStatistical Package for the Social Sciences, são apresentados as frequências, média e desvio padrão. Os curativos forammajoritariamente realizados pela equipe técnica de enfermagem. Somente 55.8% aderiu a higiene das mãos antesou após o procedimento. Nenhum profi ssional utilizou proteção ocular, e os demais equipamentos de proteçãoindividual foram utilizados pela maioria, entretanto, frequentemente de maneira incorreta. Conclui-se que a equipede enfermagem aderiu parcialmente às precauções padrão para a realização dos curativos, adotaram condutasde risco biológico que podem comprometer a qualidade do cuidado e a saúde do profi ssional. Investimentos naformação e na qualifi cação profi ssional devem ser reforçados para a garantia da segurança e da qualidade desteprocedimento.Palavras-chave: Enfermagem; Precauções Universais; Ferimentos e Lesões. ABSTRACTThe aim is to evaluate the compliance of the nursing team to the standard precautions during the care of openwounds. Descriptive cross-sectional study, performed at the surgical clinic of a university hospital in the Stateof Goiás, from December 2015 to March 2016. A total of 147 dressing procedures were observed. The data werecollected through the direct observation with checklist and analyzed by the Software Statistical Package for theSocial Sciences, the frequencies, mean and standard deviation are presented. Dressings were mostly performedby the technical of nursing. Only 55.8% adhered to the hygiene of the hands before or after the procedure. Noprofessional used goggles, and others personal protective equipment was used by the majority, however, oftenincorrectly. It concludes that the nursing team adhered partially to the standard precautions for wound careprocedure, adopted biological risk behaviors that may compromise the quality of care and the health of theprofessional. Investments in training and professional qualifi cation should be strengthened to ensure the safetyand quality of this procedure.Keywords: Nursing; Universal Precautions; Wounds and Injuries.
Objective: This study analyzes the causes of death, survival, and other related factors in hospitalized elderly people with fractures over the course of one year. Methods: We followed 376 fracture patients for one year in a prospective cohort study to a reference hospital in central Brazil. The Cox regression model was used to analyze factors associated with survival. Results: The results indicate that the one-year mortality rate was high (22.9%). The independent factors linked to lower overall survival were as follows: patients aged ≥80 years with previous intensive care unit (ICU) admission and presence of comorbidities (diabetes mellitus [DM] and dementia). Conclusion: Our study results may contribute to a better understanding of the impact of fractures on the elderly population and reinforce the need to oversee age-groups, diabetic patients, and patients with complications during hospitalization.
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