ResumoEnquadramento: A confeção de um estoma constitui-se como um evento gerador de mudanças influenciado por diversos fatores, nomeadamente a presença de complicações do estoma e/ou pele periestomal. Estima-se que 80% das pessoas com ostomia experienciam, pelo menos, uma complicação relacionada com o estoma ao longo da sua vida. Objetivos: Identificar os fatores de risco associados ao desenvolvimento de complicações do estoma de eliminação e da pele periestomal. Metodologia: Revisão da literatura, com base na estratégia metodológica do Instituto Joanna Briggs para Scoping Reviews. Foram identificados 1492 artigos, sendo incluídos para análise 22. Resultados: A maioria dos fatores de risco para o desenvolvimento de complicações não é modificável. Dos sensí-veis à intervenção do enfermeiro evidenciam-se a educação pré e pós-operatória, a marcação do local do estoma e o acompanhamento após a alta hospitalar. Conclusão: O reconhecimento de fatores de risco associados ao desenvolvimento de complicações do estoma permite ao enfermeiro, por um lado, identificar precocemente indicadores de vulnerabilidade nos seus clientes e, por outro lado, intervir de forma mais efetiva. Palavras-chave: ostomia; fatores de risco; cuidados de enfermagem AbstractBackground: Stoma formation leads to changes that are influenced by several factors, namely the presence of stoma and/or peristomal skin complications. It is estimated that 80% of ostomy patients have at least one stoma-related complication throughout their life. Objectives: To identify the risk factors associated with the development of elimination stoma and peristomal skin complications. Methodology: Literature review, based on the methodological strategy of the Joanna Briggs Institute for scoping reviews. A total of 1,492 articles were identified, of which 22 were included for analysis. Results: Most of the risk factors for the development of complications are non-modifiable. Pre and postoperative education, stoma site marking, and follow-up after hospital discharge are some of the nursing-sensitive factors. Conclusion:The identification of risk factors associated with the development of stoma complications allows nurses to early identify patients' vulnerability indicators and intervene more effectively.

Research confirms that frailty, sarcopenia and falls are strongly correlated [1] and both are predictors of negative health outcomes such as falls, disability, hospitalisation and death [2]. Interventions are necessary to reverse frailty and treat sarcopenia [3] as it has been estimated that, by the year 2025, around 20% of the population in industrial countries will be aged 65 years and over. As the number of older people increases, their needs will become an increasingly important health issue. Reduction in physical function can lead to loss of independence, need for hospital and longterm nursing home care and premature death. The importance of physical, functional, psychological and social factors in realising a healthy old age is recognised by older people, health-care professionals, policy advisors and decision-makers. This chapter will review the concepts of frailty, sarcopenia and falls as well as the interventions for older people, carried out by nurses and other health-care professionals, that have the potential to positively affect health and functional status and may promote independent functioning of older people with frailty and sarcopenia. Learning OutcomesAt the end of the chapter, and following further study, the nurse will be able to:

Sarcopenia is age-related loss of muscle mass and strength with resulting decrease in function that affects balance, gait, and overall ability to perform tasks of daily living. Decline in skeletal muscle mass begins around age 30 with a significant acceleration after age 65, accompanied by a concomitant reduction in muscle strength (Curcio, et al., 2016). Muscle strength is a critical component of walking and its decrease in the older adult contributes to a high prevalence of falls (Dhillon & Hasni, 2017). Early recognition and intervention can modify some of these detrimental outcomes. Some major risk factors for sarcopenia include; lack of exercise, age-related decreases in hormone concentrations and a decrease in the body's ability to synthesize protein, combined with inadequate caloric and/or protein intake (Dhillon & Hasni, 2017). Acute and chronic illnesses raise the risk level. Screening for sarcopenia may not be routine in many clinical practices. However, screening for impairment in physical function and activities of daily living (ADL's) should be routine for all older adults. Individuals with impaired ADLs and those who describe a noticeable decline in function, strength, or overall health status should have more specific testing for sarcopenia (Brown & McCarthy, 2015). The European Working Group on Sarcopenia in Older people (EWGSOP), in their consensus document, outlined an algorithm to aid the screening and diagnosis of sarcopenia (Cruz-Jentoft, et al., 2010).

Aims (1) To identify and analyse diagnoses documented by nurses in Portugal within the scope of universal self‐care requisites; (2) to determine the main problems with nursing diagnoses syntaxes for semantic interoperability purposes; and (3) to suggest unified nursing diagnoses syntaxes within the scope of universal self‐care requisites. Background/Introduction Ageing societies and the increase in chronic diseases have led to significant concern regarding individuals' dependence to ensure self‐care. ICNP is widely used by Portuguese nurses in electronic health records for documentation of nursing diagnoses and interventions. Methods A qualitative study using inductive content analysis and focus group: 1. nursing e‐documentation content analysis and 2. focus group to explore implicit criteria or insights from content analysis results. Results From a corpus of analysis with 1793 nursing diagnoses, 432 nursing diagnoses centred on universal self‐care requisites emerged from the content analysis. One hundred ten nursing diagnoses resulted from the application of new encoding criteria that emerged after a focus group meeting. Conclusion Results reveal that nursing diagnoses related to universal self‐care requisites can emphasize the impairment or potentialities of the individuals performing self‐care. It also shows a lack of consensus on nominating the nursing diagnoses of people with a deficit in universal self‐care requisites, resulting in different diagnoses to express the same needs. Implications for nursing practice Representation of most relevant nursing diagnoses within the scope of universal self‐care requisites. Implications for health policy Incorporating standardized language into electronic health records is not enough for improving quality and continuity of care and semantic interoperability achievement. Electronic health records need to work with a nursing ontology in the backend to meet these requirements.

This review aims to continuously map the nursing knowledge on skin ulcer healing in any context of care.Introduction: Chronic wounds are an increasing concern for society and health care providers. Pressure ulcers and venous ulcers, among others, have devastating effects on morbidity and quality of life and require a systematic approach. The nursing process is an important method that allows a better organization and overall care quality for a systematic and continuous professional approach to nursing management of skin ulcers. The integration of this nursing knowledge in informatics systems creates an opportunity to embed decision-support models in clinical activity, promoting evidence-based practice.Inclusion criteria: This scoping review will consider articles on nursing data, diagnosis, interventions, and outcomes focused on people with skin ulcers in all contexts of care. This review will include quantitative, qualitative, and mixed methods study designs as well as systematic reviews and dissertations.Methods: JBI's scoping review guidance, as well as the Cochrane Collaboration's guidance on living reviews, will be followed to meet the review's objective. Screening of new literature will be performed regularly, with the review updated according to new findings. The search strategy will map published and unpublished studies. The databases to be searched include MEDLINE, CINAHL, Scopus, JBI Evidence Synthesis, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and PEDro. Searches for unpublished studies will include OpenGrey and Reposito ´rios Cientı ´ficos de Acesso Aberto de Portugal. Studies published in English and Portuguese since 2010 will be considered for inclusion.

EXECUTIVE SUMMARY Background Falls are a major problem today affecting adults of any age, but the elderly are a population that is more susceptible to falls. Falls are the leading cause of injury or death among older adults. Hospitalized older people are particularly vulnerable to falls. Falls cause direct injuries (minor injuries, severe wounds of the soft tissues and bone fractures) to patients and increased length of stay. The prevention of falls is commonly considered an indicator of the quality of care. Therefore, health institutions and professionals treat the identification and implementation of strategies to prevent or minimize their effects as a high priority. Fall prevention interventions involving physical restraints are still common and considered a primary preventative measure, despite controversy in their use. One of the most frequently used restraint interventions is bedrails. The question of the effectiveness of bedrails in preventing falls cuts across all societies and cultures and has with significant implications for the clinical practice of nurses. Objectives The objective of this review was to identify the effectiveness of the use of bedrails in preventing falls among hospitalized older adults when compared with no use of bedrails or any type of physical restraints. Inclusion criteria Types of participants The current review considered studies that included hospitalized adults (female and male), 65 years and over with any clinical condition in a non-intensive care unit (ICU). Types of intervention(s) The current review considered studies that evaluated the use of bedrails as a restraint to prevent falls among older adults in non-ICUs compared to no use of bedrails or any type of physical restraints, for example, bedrails versus no bedrails, and bedrails versus no wrist or ankle ties. Types of studies The current review considered any randomized controlled trials (RCTs). In the absence of RCTs, other research designs such as non-RCTs, before and after studies, cohort studies, case-control studies, descriptive studies, case series/reports and expert-opinion were considered. Outcomes The current review considered studies that included primary outcomes (number of patients who fell or the number of falls per patient) and secondary outcomes (number of head trauma, bone fractures or soft tissue injuries). Search strategy The search strategy aimed to find both published and unpublished articles. A three-step search strategy was utilized in 13 databases. Articles published in Portuguese, English and Spanish beginning from 1980 were considered for inclusion. Methodological quality Assessment of methodological quality was not conducted as no articles were identified that met the inclusion criteria. Data extraction and data synthesis Data extraction and synthesis was not performed, because no articles were included in this systematic review. Results The search identified a total of 875 potentially relevant articles. Sixteen articles were identified through the reference lists of all identified articles. One hundred and thirteen full-text papers were assessed by two independent reviewers to determine eligibility. However, 11 articles were not found (despite all the efforts), and 102 articles did not meet the inclusion criteria. Conclusion There is no scientific evidence comparing the use of bedrails in preventing falls among hospitalized older adults to no use of bedrails or any type of physical restraints.

Objective:This review aims to continuously map the nursing knowledge about people with paresis of voluntary muscles in any context of care.Introduction:Muscle paresis is a condition that significantly impacts quality of life. Nurses have a crucial role in managing this condition, particularly paresis of voluntary movement muscles. However, nursing knowledge about patients with paresis of voluntary muscles is dispersed, hampering the integration of evidence within the structure of information systems. Mapping how the nursing process components are identified is the first step in creating a Nursing Clinical Information Model for this condition, capable of integrating evidence into information systems.Inclusion criteria:This scoping review will consider studies focusing on the nursing process regarding people with paresis of voluntary muscles in all care contexts. The review will include quantitative, qualitative, and mixed-methods study designs, systematic reviews, clinical guidelines, dissertations, and theses.Methods:The review process will follow JBI's scoping review guidance, as well as the Cochrane Collaboration's guidance on living reviews. Screening of new literature will be performed regularly, with the review being updated according to new findings. The search strategy will map published and unpublished studies. The databases to be searched will include MEDLINE, CINAHL, Scopus, JBI Evidence Synthesis, and the Cochrane Central Register of Controlled Trials. Searches for unpublished studies will include OpenGrey and Repositorios Científicos de Acesso Aberto de Portugal. Studies published in English and Portuguese from 1975 will be considered for inclusion.Registration:Open Science Framework: https://osf.io/d7c9g/

AimsThis study aims to (1) analyse all self‐care–related interventions Portuguese nurses documented, (2) determine potential issues that may impair semantic interoperability and (3) propose a new set of interventions representing nursing actions regarding self‐care that may integrate any HER application.BackgroundAs populations age and chronic diseases increase, self‐care concerns rise. Individuals who seek healthcare, regardless of context, need prompt access to accurate health information. Healthcare professionals need to understand the information in all places where care is provided, creating the need for semantic interoperability within electronic health records.MethodsA qualitative descriptive and exploratory study was conducted in two phases: (1) a content analysis of nursing interventions e‐documentation and (2) a focus group with fifteen registered nurses exploring latent criteria or insights gleaned from the findings of content analysis. The COREQ statement was used to guide research reporting.ResultsWe extracted 1529 nursing intervention sentences from the electronic health records and created 209 intervention categories. We identified the main issues with semantic interoperability in nursing intervention identification.ConclusionAccording to the findings, nurses cooperate with clients, offering physical aid and encouraging them to overcome functional limitations to self‐care tasks hampered by their conditions.Implications for nursing policy and health policyThis article provides evidence to warn policy makers against decisions to use locally customised electronic health records, as well as evidence on the importance of policy promoting the adoption of a nursing ontology for electronic health records. And, as a result, the harmonisation and effective provision of high‐quality nursing care and the reduction of healthcare costs across nations.