Nursing audit is a management tool capable of assisting in the improvement of care quality and efficiency of hospital charges and may be performed concurrently, in other words, while the patient receives care. This study aims to describe nurses' experience about the implementation of concurrent nursing audit in a hospital environment. This is a report on an experience in the period from 2009 to 2014 at a hospital in the state of Rio Grande do Sul, Brazil. The following steps of this process are discussed: Instrument elaboration, Sensitization of the nursing team and Operation of concurrent audit. The results show the feasibility and benefits of adopting this model, especially regarding the reduction of time to send the bill to the health insurances, greater interaction between auditors and care teams, creation of indicators, and contributions to the improvement of healthcare quality and nursing records.
Background and purpose
Synchronous bilateral breast cancer (SBBC) accounts for 1–3.5% of breast cancer patients. The aim of this study was to evaluate dosimetric issues, clinical outcomes, and acute toxicities for SBBC patients receiving synchronous bilateral hypofractionated radiotherapy (SBHRT) and to compare them with patients treated with synchronous bilateral normofractionated RT schedule (SBNRT).
Materials and methods
From April 2016 to March 2020, 39 SBBC patients were referred to our institution. Patients were divided according to their prescription dose: Group A: 50 Gy/25fx (fractions), B: 60–64 Gy/25fx, C: 40.05 Gy/15fx; D: 48 Gy/15fx. Toxicity was evaluated using Common Terminology Criteria for Adverse Events (CTCAE)v.5.0.
Results
34 patients were finally evaluated. Median follow-up was 24 months for NF schedule and 9 months for HF schedule. In the HF schedule, no acute side-effects > G2 were observed and no dermatitis was reported in 6
th
month´s assessments. 95% of patients have no evidence of disease and only 1 patient presented local relapse in the first mammography after RT. No distant failures or deaths were observed. Regarding dosimetric issues, the inter-patient average D
mean
for the heart was: Group A: 5.0 Gy (4.6–5.5), Group B: 4.4 Gy (4.1–5.4), Group C: 4.8 Gy (4.5–5.1) and Group D: 5.3 Gy (4.4–5.6). For the lungs, the inter-patient average D
mean
was: Group A: 10.8 Gy (9.8–12.2), Group B: 11.5 Gy (11.3–12), Group C: 9.8 Gy (9.3–10.5) and Group D: 10.5 Gy (10–11.3).
Conclusions
This is the first study reporting the safety, feasibility, and tolerability of 40.05 Gy/15fx over 3 weeks for the treatment of SBBC patients. Further study with larger accrual is mandatory.
The purpose was to evaluate MR colonography (MRC) with barium fecal tagging in detecting colorectal pathology and to determine how air-based and water-based colonic distension influences MRC. We studied 83 patients with high risk of colonic neoplasms. All received oral barium sulfate for colonic preparation before unenhanced and enhanced T1-weighted gradient-echo MRC using either water (n=54) or air (n=29) for colonic distension. Fecal tagging, distension, and artifacts were recorded. All patients underwent conventional colonoscopy within 2 weeks of MRC; the techniques were compared for detection of malignant neoplasms and polyps >or=1 cm, 6-9 mm, and or=1 cm, but more air-distended MRC were excluded for poor quality. MRC with fecal tagging is useful for detecting lesions >or=1 cm. Air distension was inferior to water distension in most aspects. Water-based colonic distension should be used for barium-tagging MRC.
Objective: to know the coping strategies developed by intensive care unit nurse practioners to maintain mental health.
Method: qualitative descriptive study, with nursing workers from three Intensive Care Centers in a southern state of Brazil. Data collected between June 2019 and July 2021 through semi-structured interviews and submitted to thematic content analysis.
Results: individual coping strategies based on situations that generate suffering were unveiled. The loneliness of work was evidenced because of the mismatches between the therapeutic spaces offered by the institution and the demands of the workers. Finally, the possibility of re-signifying loneliness in cooperation through collective strategies was identified as a path to face suffering at work and as a protective factor of greater effectiveness.
Conclusion: collective coping actions and activities that strengthen the union and cooperation of intensive care nursing teams can be promoted.
Objetivo: conhecer as estratégias de enfrentamento desenvolvidas pelos trabalhadores de enfermagem de Unidades de Terapia Intensiva para a manutenção da saúde mental.
Método: estudo qualitativo descritivo, com trabalhadores de enfermagem de três Centros de Cuidados Intensivos de um estado do sul do Brasil. Dados coletados entre junho de 2019 e julho de 2021 por meio de entrevista semiestruturadas e submetidos à análise temática de conteúdo.
Resultados: desvelaram-se estratégias de enfrentamento individuais baseadas em situações geradoras de sofrimento. Evidenciou-se a solidão do trabalho, resultado dos descompassos entre os espaços terapêuticos oferecidos pela instituição e as demandas dos trabalhadores. Por fim, identificou-se a possibilidade de ressignificação da solidão em cooperação por meio das estratégias coletivas como caminho para enfrentamento do sofrimento no trabalho e como fator protetor de maior eficácia.
Conclusão: podem-se promover ações coletivas de enfrentamento e atividades que fortaleçam a união e cooperação das equipes de enfermagem em terapia intensiva.
Objetivo: conocer las estrategias de afrontamiento desarrolladas por los trabajadores de enfermería de las Unidades de Cuidados Intensivos para el mantenimiento de la salud mental.
Método: estudio cualitativo descriptivo, con trabajadores de enfermería de tres Centros de Cuidados Intensivos de un estado del sur de Brasil. Datos recogidos entre junio de 2019 y julio de 2021 mediante entrevistas semiestructuradas y sometidos a análisis de contenido temático.
Resultados: se desarrollaron estrategias de afrontamiento individuales basadas en situaciones de riesgo de soborno. Se evidenció la solidez del trabajo, resultado de los desajustes entre los espacios terapéuticos ofrecidos por la institución y las demandas de los trabajadores. Por último, se identificó la posibilidad de resignificar la solidaridad en la cooperación mediante las estrategias colectivas como camino para enfrentar el sufrimiento en el trabajo y como factor protector de mayor eficacia.
Conclusión: se pueden promover acciones colectivas de afrontamiento y actividades que fortalezcan la unión y cooperación de los equipos de enfermería en cuidados intensivos.
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