Objetivo: Analisar a correlação entre a carga de trabalho da equipe de enfermagem, aferida pelo escore NAS (Nursing Activities Score) e a mortalidade predita pelo escore SAPS 3 dos pacientes internados em Unidade de Terapia Intensiva, verificando as correlações entre os profissionais de enfermagem atuantes na unidade segundo o preconizado pela RDC e o recomendado pelo escore NAS. Material e Métodos: Trata-se de um estudo de coorte realizado no período de setembro de 2014 a abril de 2015, com 270 pacientes. Utilizou-se o instrumento NAS e, posteriormente, foi submetido a análise estatística no BioEstat 5.3®. Resultados: A partir da análise dos resultados foi possível identificar que a sepse foi o principal diagnóstico. Houve correlação linear entre o NAS médio e o inicial dos pacientes internados com o índice prognóstico SAPS 3, com diferença estatisticamente significante entre o número de profissionais atuantes nas unidades e o número de profissionais de enfermagem dimensionados pelo NAS. Conclusão: Conclui-se que o NAS é uma ferramenta importante para dimensionar a carga de trabalho da equipe nas UTIs. Descritores: Administração Hospitalar. Unidade de Terapia Intensiva. Carga de trabalho.
Introduction: Sepsis is a major global health problem and is responsible for the deaths of thousands of people each year. It is the second leading cause of death in intensive care units, after coronary heart disease. Due to the high mortality rate, sepsis needs to be addressed through evidence-based practice, institutionalized protocols, well-developed clinical strategies, and continuing education. This study analyzed the clinical impact of adherence to an education tool for sepsis control measures at the Adventist Hospital of Belém in Brazil. Methodology:A prospective, quasi-experimental study was carried out from March to December 2015. The study included 152 patients diagnosed as having selection criteria with suspected sepsis. The patients diagnosed in the emergency department of the hospital were divided into a control group (n=30) and a case group (n=122) based on the period in which an educational tool was applied, for adherence to the hospital sepsis protocol. Results:The best adherence measure, after the tool application, was antimicrobial therapy. There was a reduction in the hospitalization time of the surviving patients from 19.7 days to 7.7 days and the mortality rate decreased from 63.3% to 30.6%. Conclusion:Although adherence to resuscitation packages was low, the education tool increased the insight of professionals in the identification of septic patients, resulting in a diagnosis and early treatment that corresponded with a reduction in hospitalization time and a decrease in mortality. The implementation of the educational tool and feedback letter was performed in August 2015. Patients admitted from March to July 2015, the period prior to the use of the tool, were eligible for participation in the control group, while patients admitted from August to December 2015 were eligible for participation in the case group. All adult patients greater than 18 years of age and diagnosed with sepsis, severe sepsis, and septic shock, admitted from the emergency department or transferred to the ICU within the first 24 hours of the diagnosis, were included in the study. The criteria for defining sepsis were based on the Sepsis Survival campaign (CSS) criteria. Obstetric patients, patients with sepsis referred from other institutions, and patients with organic dysfunctions not considered secondary to a chronic disease were excluded. KeywordsThe compilation of clinical and demographic data was conducted through the patients' clinical histories, using the form designed by the Institute Latin American Sepsis (ILAS) 9 and adapted by hospital quality management in conjunction with the Hospital Infection Control Committee (CCIH). From the time that the patient with suspected sepsis was admitted to the hospital, the CCIH team was activated and the data was collected using the pre-designed form. The evaluation was based on compliance with the updated CSS resuscitation package from 2012. The package also includes requirements that must be met within the first three and six hours, which are comprised of diagnosti...
Objective: To analyze the economic impact of implementing an early sepsis detection protocol in the emergency department of a private hospital in the city of Belém, Pará, Brazil. Methods: Experimental, cross-sectional, retrospective study, carried out from March 2015 to December 2019 from a highly complex referral Center. The implementation of the protocol took place in March 2015. Results: A total of 257 patients were studied, 128 from the group before the protocol (AP group) and 129 belonging to the group after the protocol (DP group), with similar proportions. in relation to sex. Regarding the mean age and standard deviation, in the AP group it was 73.5 ± 23.3 and in the DP group 76.0 ± 17.0. After the implantation of the protocol, there was a reduction in the time of organ dysfunction, mortality rate, ICU stay and hospital stay, both with statistical difference of p = 0.0015, p = 0.04, p = 0.012 and p = 0.0401, respectively. In the evaluation of hospital costs, a reduction in the average spent with each patient was identified both in the total cost of hospitalization and in the total cost referring only to the length of stay in the ICU. Conclusion: It is noticeable that sepsis costs are a public health problem both nationally and internationally. However, such expenses can be reduced with the implementation of protocols that aim to standardize the care provided to patients and thereby positively influence the reduction of hospital stay, hospitalization costs and mortality.
Objective: Characterize and evaluate the prevalence of SB in physicians residing in the specialty of Gynecology and Obstetrics at the University Hospital Materno Infantil, Federal University of Maranhão, in São Luís, linking the epidemiological characteristics in order to identify risk factors. Method: Epidemiological questionnaires were used to define the variables and the Maslach Burnout Inventory (MBI), the most used instrument to evaluate SB. Results: From this, it was observed that the prevalence of SB among the above-mentioned residents is 80.8%; individuals who have renumbered activity outside the home have a higher personal achievement than those who do not have it; 2nd and 3rd year has a higher personal achievement level than first year residents. Conclusion: No significant differences were found in any of the SB variables in relation to age, marital status, gender, whether or not to have a child, whether or not to have pain / discomfort in the last 6 months, in relation to CH of weekly work outside the residence and the time of medical performance before entering the PRM (Medical Residency Program).
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