Objective: to perform an integrative review of strategies presented in care bundles to decrease central catheter-associated bloodstream infection among newborns. . Method a search was conducted of the Cochrane Library, IBECS, PubMed, Lilacs, Medline and Scielo catalogues, using the terms "bundle", "catheter-related infection", "infection control", "prevention", "evidence-based nursing"," evidence-based medicine" and" central venous catheter". Inclusion criteria were: papers published from 2009 to April 2014; written in Portuguese, English or Spanish; addressing both neonatal and pediatric populations or just neonatal populations; describing the use and/or assessing care bundles or protocols to control central catheter-associated infection. Results fifteen studies published between 2009 and 2013 were selected. The main information extracted from the studies was systematized as: 1) measures adopted to prevent central catheter-associated bloodstream infection according to level of scientific evidence, and 2) strategies used to implement evidence into health practice. Conclusion there was a variety of practices adopted, some of which are consistent with scientific evidence and some of which are not. Systematization conducted in this study is expected to contribute to practice, facilitating the use of the best evidence in each context, and research indicating gaps in knowledge to be explored in future studies
O objetivo foi avaliar o dimensionamento de pessoal de enfermagem de unidades neonatais de um hospital universitário em relação a sua formação e experiência profissional da equipe de enfermagem e a adequação à legislação profissional vigente. Estudo descritivo, quantitativo, realizado na Unidade de Tratamento Intensivo e de Cuidados Intermediários Neonatal. Utilizou-se dois instrumentos para coleta de dados com equipe de enfermagem e sobre a relação profissionais e ocupação de leitos. Os funcionários apresentaram média de experiência em unidades neonatais de 14 anos; a maioria tinha mais de uma formação profissional (59,3%). O número de enfermeiros estava abaixo do preconizado pela legislação profissional vigente (12,5%) e o de auxiliares de enfermagem acima (56,2%); em 51,9% havia funcionários de outros setores realizando horas extras. Concluiu-se que apesar de qualificada, o que pode determinar uma assistência diferenciada, a equipe não atende as normas para dimensionamento profissional preconizado para a assistência nessas unidades especializadas. ResumoThe aim was to evaluate the size of the nursing neonatal units of a university hospital regarding the education and professional experience of the nursing staff and the adequacy of existing legislation professional staff. Descriptive, quantitative study, conducted at the Intensive Care Unit and Neonatal Intermediate Care. We used two instruments to collect data with the nursing staff and the professional relationship and bed occupancy. Employees had an average experience in neonatal units of 14 years; most had more than one vocational training (59.3%). The number of nurses was below the recommended by current professional legislation (12.5%) and nursing assistants above (56.2%); 51.9% were employees in other sectors doing overtime. It was concluded that although qualified, which can determine a differentiated service, the team does not meet the recommended sizing standards for professional assistance in these specialized units.Palavras-chave: Dimensionamento de pessoal. UTI neonatal. Enfermagem.
Introduction: The use of central catheters in intensive care is essential, but exposes the patient to the risk of a bloodstream infection. Although there is evidence to improve the care for these patients, there is a gap between knowledge and healthcare practices. This study was designed to describe the bundle implementation for central catheters in light of the knowledge translation (KT) conceptual framework in a neonatal unit and assess its impact on care practices with catheters. Methodology: A time-series quasi-experimental study design was conducted in a Brazilian neonatal unit, through 289 non-participant observations of professional practices before and after the implementation of the bundles. Results: The deployment of two bundles was guided through the steps of a careful selection of adopting KT evidence and context-related and investment factors in the facilitation process. The implementation of the bundles was planned by a group manager, mediated by a facilitator, and guided by targets established by professionals. The biggest impact was on the maintenance of catheters; seven of eleven practices improved significantly (p < 0.01). The insertion of catheters showed lesser impact of change, with high adequacy ratios before implementation, but also presented satisfactory adherence to recommendations. Conclusions: This is the first Brazilian study using the KT conceptual framework to develop, implement, and evaluate the impact of central line bundles in a neonatal care environment, detailing the implementation process. It highlights the importance of accountability and staff involvement in all stages of the study.
Objetivo: sistematizar as produções disponíveis sobre aplicativos para smartphones voltados para promover a amamentação de bebês prematuros. Método: revisão de escopo realizada em setembro e outubro de 2019 nas bases: CINAHL, MEDLINE, Scopus e PubMed. Não houve delimitação de idioma ou temporal. Além da busca pela produção científica acerca dessa temática, foram investigadas as plataformas de download dos dois sistemas operacionais de smartphones hegemônicos – Google Play Store (Android) e Apple App Store (iOS). Em março de 2020 foram refeitas as buscas replicando a mesma estratégia para verificar se os protocolos incluídos haviam originado novas publicações, bem como identificar novos estudos ou protocolos. Resultados: a busca resultou em 764 documentos, dos quais dois artigos e três protocolos foram incluídos na revisão. O número de estudos encontrados confirma a escassez de produção científica sobre apps especificamente voltados para a população de prematuros, apesar de apontarem uma atual tendência em incorporar esse recurso para o apoio ao aleitamento materno. Não foram encontradas diferenças nas taxas de sucesso de aleitamento materno mediante utilização de tais recursos, quando comparadas com a assistência presencial. Destaca-se a necessidade de mais estudos avaliando diferentes propostas de aplicativos e em cenários diversos para avaliar a efetividade desse recurso tecnológico para complementar o cuidado convencional. Conclusão: as produções disponíveis sobre apps para o apoio ao aleitamento materno de bebês prematuros são muito escassas. Considera-se insuficiente o corpo de informações disponíveis para a avaliação do efeito desse tipo de recurso para promover o aleitamento materno junto a esta população.
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