Aim and objective To identify the occurrence of skin and mucosal lesions and factors related to the use of medical devices in newborns admitted to a neonatal intensive care unit. Background The use of medical devices increases the risk of injury in newborns due to the immaturity and fragility of their skin and mucosa. Design Observational and longitudinal study. Methods The study included 85 newborns admitted to in a neonatal intensive care unit from a public teaching hospital. Data were collected from February–August 2018. For the evaluation, the Neonatal Skin Condition Score was used, as well as an instrument covering sociodemographic and clinical variables, medical devices in use and materials for skin protection. The study followed the recommendations STROBE. Simple frequency, measures of central tendency and variability, Pearson's correlation coefficient and multiple linear regression analysis were used for data analysis. Results Of the n = 85 newborns evaluated, n = 62 (72.9%) presented skin or mucosal lesions caused using medical devices, excoriations being the most observed n = 55 (64.7%), and n = 32 (37.6%) had 1–3 lesions. As the number of devices increased, so did the number of lesions. On the other hand, the age of the newborn and the number of lesions were inversely proportional. Conclusion Most participants, n = 62 (72.9%), had skin or mucosal lesions associated with medical devices. The number of medical devices used and the age of the newborn were predictors for this occurrence. Relevance to clinical practice The results show that it is fundamental that nurses know the factors that can interfere in the skin and mucosa conditions and, thus, promote the implementation of injury prevention measures in newborns, supporting safe and quality care.
ResumoObjetivos: identificar a opinião dos enfermeiros supervisores do estágio hospitalar sobre fatores que dificultam sua atuação durante a supervisão; identificar a importância do estágio supervisionado para os enfermeiros e verificar a percepção destes quanto à sua participação durante o estágio curricular supervisionado hospitalar. Método: estudo exploratório descritivo com abordagem qualitativa, realizado em um hospital de ensino de uma cidade do Triângulo Mineiro. Foram entrevistados 45 enfermeiros que já atuaram como supervisores de estágio por meio de entrevista semiestruturada seguido de Análise de Conteúdo. Resultados: surgiram sete categorias: preparo profissional; importância do estágio curricular supervisionado; dificuldades presentes do estágio curricular supervisionado; despreparo dos acadêmicos; atribuições do enfermeiro; sugestões de melhoria para o estágio curricular supervisionado e responsabilidade de supervisionar. Conclusão: o estágio supervisionado é fundamental para a formação acadêmica, porém o desconhecimento de alguns enfermeiros sobre o papel de supervisor, o despreparo dos acadêmicos e falta de tempo dificultam a supervisão. Palavras chave: Estágios, Programas de Graduação em Enfermagem, Pesquisa em Educação de Enfermagem. AbstractObjective: The main objective was to identify the opinion of supervisors of hospital internship about factors that may hamper their performance during supervision, identify what is the importance of the supervised intership for the nurses and verify their perception about their participation during the supervised hospital intership discipline.Method: a discriptive exploratory study with a qualitative approach, performed in a teaching hospital in a city located in Triângulo Mineiro, State of Minas Gerais, Brazil. 45 nurses that have worked as intership supervisors were interviewed through semi structured interviews followed by content analyses. Results: seven categories emerged: profesional preparation, the importance of the intership program, difficulties present in the intership program, unpreparedness of 1 Enfermeiro. Doutor em Ciências.
Background Preoperative anxiety and postoperative pain are frequent in cardiac surgeries and constitute important stressors for patients, which can cause several complications. One strategy that aims to alleviate these phenomena is listening to music as a non-pharmacological intervention. The aim of this study is to evaluate the effect of listening to music on preoperative state-anxiety, postoperative pain, at rest and when instructed to cough, and cardiorespiratory parameters in patients undergoing cardiac surgery. Methods A randomized, parallel, simple masking clinical trial will be conducted with patients 18 years of age or older who have undergone elective cardiac surgery by sternotomy, who agree to participate in the research and sign a free and informed consent form. Study participants will be randomly divided, in a 1:1 ratio, to one of the two groups: experimental (subjected to listening to music for 20 min in the pre- and postoperative period) or control (standard care in the pre- and postoperative period), using a randomization scheme generated by the Randomization.com website. The sample size calculation was obtained after conducting a pilot study. Discussion The results of the study may contribute to the implementation of non-pharmacological interventions in health services, highlighting the protocols for listening to music, to minimize anxiety and pain in cardiac surgery. Trial registration ReBEC RBR-8mdyhd. Posted on December 10, 2019
Introduction: Postoperative pain is common and occurs frequently in patients undergoing cardiac surgery, which can lead to adverse events. Therefore, it is critical that assessment and adequate analgesia are performed to avoid compromising the recovery process. It is recommended that multimodal therapy be used for this purpose, as it promotes better analgesia. Therefore, the aim of this study is to search for studies that address the efficacy of nonpharmacological methods for pain relief in these patients. Methods: This study used a PRISMA-compliant systematic literature review that selected primary randomized clinical trials on the efficacy of nonpharmacological pain relief therapies in patients undergoing cardiac surgery. Searches were conducted in PubMed, LILACS, CINAHL, the Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials, with no time or language restrictions. The Joanna Briggs Institute Critical Appraisal Checklist for Randomized Clinical Trials was used to assess methodological rigor. Results: After screening, 23 of the 140 studies found in the databases were selected. The studies examined the efficacy of thirteen different nonpharmacological therapies, as well as a combination of therapies, with massage therapy being the most commonly examined, followed by musical intervention and hypnosis. Conclusions: Some interventions, when combined with pharmacological therapy, were effective in relieving postoperative pain after cardiac surgeries, according to the studies analyzed. However, most studies had significant methodological flaws, and further studies with high methodological quality are needed. Systematic review registration: The present study is registered in the International Prospective Register of Systematic Reviews (PROSPERO) under number CRD42020168681.
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