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Objective:to estimate the incidence of surgical site infection in general surgeries at a large Brazilian hospital while identifying risk factors and prevalent microorganisms. Method:non-concurrent cohort study with 16,882 information of patients undergoing general surgery from 2008 to 2011. Data were analyzed by descriptive, bivariate and multivariate analysis. Results:the incidence of surgical site infection was 3.4%. The risk factors associated with surgical site infection were: length of preoperative hospital stay more than 24 hours; duration of surgery in hours; wound class clean-contaminated, contaminated and dirty/infected; and ASA index classified into ASA II, III and IV/V. Staphyloccocus aureus and Escherichia coli were identified. Conclusion:the incidence was lower than that found in the national studies on general surgeries. These risk factors corroborate those presented by the National Nosocomial Infection Surveillance System Risk Index, by the addition of the length of preoperative hospital stay. The identification of the actual incidence of surgical site infection in general surgeries and associated risk factors may support the actions of the health team in order to minimize the complications caused by surgical site infection.

Patients hospitalized in the Intensive Care Unit (ICU) may present risk for corneal injury due to sedation or coma. This study aimed to estimate the incidence of corneal injuries; to identify the risk factors and to propose a risk prediction model for the development of corneal injury, in adult patients, in an intensive care unit of a public hospital. This is a one year, prospective cohort study with 254 patients. The data were analyzed using descriptive statistics, univariate and logistic regression. Of the 254 patients, 59.4% had corneal injuries and the mean time to onset was 8.9days. The independent variables that predispose to risk for punctate type corneal injury were: duration of hospitalization, other ventilatory support device, presence of edema and blinking less than five times a minute. The Glasgow Coma Scale and exposure of the ocular globe were the variables related to corneal ulcer type corneal injury. The injury frequencies were punctate type (55.1%) and corneal ulcers (11.8%). Risk prediction models for the development of punctate and corneal ulcer type corneal injury were established. Lesões na córnea: incidência e fatores de risco em Unidade de Terapia IntensivaPacientes internados em unidade de terapia intensiva (UTI) podem apresentar risco para lesão na córnea devido à sedação ou coma. Este estudo teve por objetivo estimar a incidência das lesões na córnea, identificar os fatores de risco e propor modelo de predição de risco para o desenvolvimento de lesão na córnea, em pacientes adultos, em unidade de terapia intensiva, de um hospital público. É estudo de coorte prospectiva de um ano, com 254 pacientes. Os dados foram analisados por estatística descritiva, univariada e de regressão logística. Dos 254 pacientes, 59,4% tiveram lesão na córnea e o tempo médio para o seu aparecimento foi de 8,9 dias. As variáveis independentes que predispõem ao risco para lesão na córnea, tipo puntacta, foram: tempo de internação, outro dispositivo de assistência ventilatoria, presença de edema e piscar de olhos menor que cinco vezes por minuto. Escala de coma de Glasgow e exposição de globo ocular foram as variáveis relacionadas à lesão na córnea do tipo úlcera de córnea. As lesões foram do tipo puntacta (55,1%) e úlceras de córnea (11,8%). Modelos de predição de risco para lesões na córnea do tipo puntacta e úlcera foram estabelecidos.Descritores: Doenças da Córnea; Úlcera da Córnea; Fatores de Risco; Diagnóstico de Enfermagem; Unidades de Terapia Intensiva; Enfermagem. Lesiones en la córnea: incidencia y factores de riesgo en Unidad de Terapia IntensivaPacientes internados en Unidad de Terapia Intensiva (UTI) pueden presentar riesgo de lesión en la córnea debido a la sedación o al coma. Este estudio tuvo por objetivo estimar la incidencia de las lesiones en la córnea; identificar los factores de riesgo y proponer un modelo de predicción de riesgo para el desarrollo de lesión en la córnea, en pacientes adultos, en Unidad de Terapia Intensiva, de un hospital público. Estudio de cohorte prospectivo de un año co...

4This study aimed to identify risk factors associated with surgical site infections in orthopedic surgical patients at a public hospital in Minas Gerais, Brazil, between 2005 and2007. A historical cohort of 3,543 patients submitted to orthopedic surgical procedures. A descriptive analysis was conducted and surgical site infection incidence rates were estimated. To verify the association between infection and risk factors, the Chi-square Test was used. The strength of association of the event with the independent variables was estimated using Relative Risk, with a 95% confidence interval and p<0.05. Riesgo para infección de sitio quirúrgico en pacientes sometidos a cirugías ortopédicasEstudio para identificar factores de riesgo asociados a infecciones de sitio quirúrgico en Un análisis descriptivo fue realizado y la tasa de incidencia de infección fue estimada.Para verificar la asociación entre la infección y los factores de riesgo se usó el test chicuadrado. La fuerza de la asociación del evento con las variables independientes fue estimada por el Riesgo Relativo, con un intervalo de confianza de 95% y p <0,05. La incidencia de infección de sitio quirúrgico fue 1,8%. Fueron estadísticamente asociados a la infección el potencial de contaminación de la herida quirúrgica, las condiciones clínicas del paciente, el tiempo quirúrgico y el tipo de procedimiento ortopédico. La identificación de asociación de infección de sitio quirúrgico con los factores de riesgo mencionados es importante y contribuye para la práctica clínica del enfermero.

The applicability of the risk index for surgical site infection of the National Nosocomial Infection Surveillance (NNIS) has been evaluated for its performance in different surgeries.In some procedures, it is necessary to include other variables to predict. Objective: to evaluate the applicability of the NNIS index for prediction of surgical site infection in orthopedic surgeries and to propose an alternative index. The study involved a historical cohort of 8236 patients who had been submitted to orthopaedic surgery. Statistical analysis was performed using multivariate logistic regression to fit the model. The incidence of infection was 1.41%. Prediction models were evaluated and compared to the NNIS index.The proposed model was not considered a good predictor of infection, despite moderately stratified orthopedic surgical patients in at least three of the four scores. The alternative model scored higher than the NNIS models in the prediction of infection. Infección de sitio quirúrgico en pacientes sometidos a cirugías ortopédicas: el índice de riesgo NNIS y la predicción de riesgo La aplicabilidad del Índice de Riesgo de Infección Quirúrgica del National NosocomialInfection Surveillance-NNIS ha sido evaluada en cuanto a su desempeño en diferentes cirugías. En algunos procedimientos es necesaria la inclusión de otras variables de predicción. El objetivo de este estudio fue evaluar la aplicabilidad del Índice NNIS para la predicción de la Infección de Sitio Quirúrgico en cirugías ortopédicas y proponer un índice alternativo. Se realizó un estudio de cohorte histórica en 8.236 pacientes sometidos a cirugías ortopédicas. Se utilizó el modelo logístico multivariado para ajustar el modelo. La incidencia de infección fue 1,41%. Modelos de predicción fueron evaluados y comparados al Índice NNIS. El modelo propuesto fue aquel que presentó mayor precisión en clasificar pacientes con y sin infección. El Índice NNIS no fue considerado un buen factor de predicción de la infección, a pesar de haber estratificado moderadamente a los pacientes quirúrgicos ortopédicos en por el menos tres de los cuatro puntajes. El modelo alternativo fue superior al modelo NNIS en la predicción de infección.

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Fall is used as an indicator of quality in healthcare institutions specialized in elderly care and is also considered an important indicator of quality of life of seniors in all environments. This is a cross-sectional study with a convenience sample of 108 elderlies enrolled at a Health Center, in Belo Horizonte, Minas Gerais, in order to determine the occurrence of falls in elderly people and also look for its association with some variables. Data were collected from clinical records and interviews during home healthcare visits using a structured and specific instrument. It was found that 64 (59.3%) of the elderly patients have already suffered falls, and a significant statistical relationship (p=0.01) between the elderly cognitive ability and the occurrence of the falls. It is recommended that nursing care focuses in the early identification of the elderlies that are more likely to suffer falls, especially those who, in addition to the risk of falling are at increased risk of suffering serious injury originated from the falls.

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