Objective:To narrate the nurses' training experience in the implementation of a systematic delirium screening tool using the Confusion Assessment Method for Intensive Care Unit. Method: Experience report covering the steps of situation diagnosis, planning, staff training and evaluation of the tool's implementation between January and March 2013 with nurses in the ICU of a tertiary hospital in São Paulo. Results: The implementation of the assessment, using the Confusion Assessment Method for Intensive Care Unit, obtained signifi cant nurse adhesion and became a service indicator. Final considerations:The experience has shown that this assessment allows the results of the work process to be analyzed and the consequent transformation of daily initiatives.
Introducción: La hidrocefalia es una complicación frecuente entre los pacientes neurológicos y su tratamiento en casos agudos se hace a través de un catéter de derivación ventricular externa que permite monitorear y controlar la hipertensión intracraneal. El objetivo de este estudio fue describir la retención del conocimiento de los enfermeros después de la intervención educativa sobre cuidados relativos a la derivación ventricular externa. Materiales y Métodos: Estudio cuasi experimental con enfermeros de una unidad de terapia intensiva de adultos, en el que se evaluó la retención del conocimiento sobre el tema en tres momentos: antes, una semana y tres meses después del entrenamiento. Resultados: Después de una semana se observó una retención significativa, sin embargo no a los tres meses, dado que después de tres meses el índice de aciertos en las preguntas fue significativamente bajo con respecto a las fases anteriores. El desempeño de los participantes fue mejor en las preguntas relacionadas con el manejo del sistema. Discusión: El tiempo es un factor que interfiere en el aprendizaje y los estudios muestran que el conocimiento a los tres meses disminuye significativamente, y después de seis meses y un año casi por completo. Las conductas prácticas basadas en directrices de asistencia tienen mejor retención entre los profesionales, resaltando que resulta más fácil aprender habilidades técnicas que están asociadas con la vivencia profesional. Conclusiones: Se observó una retención de conocimiento significativa entre los profesionales en la primera semana posterior al entrenamiento, pero no a los tres meses después del entrenamiento.
Background: Several nonpharmacological strategies for the prevention and treatment of delirium have been increasingly used because the aetiology of delirium is multifactorial.Aims: To verify the association between nonpharmacological strategies (presence of companion, mobilization, absence of physical restraint and natural light) and the occurrence of delirium, and to identify risk factors for delirium in intensive care unit (ICU) patients.Study Design: The study was conducted in a Brazilian medical and surgical ICU. The sample included patients older than 18 years with length of ICU stay greater than 24 h and without delirium on admission. Delirium was identified by applying the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). The association between the variables and delirium was analysed using Mann-Whitney and chisquare tests, and multivariate logistic regression to identify the predictive factors.Results: Of the 356 patients, 64 (18%) had delirium. The presence of a companion, mobilization, and physical restraint were associated with delirium, and the first two were identified as protective factors. That is, the odds of delirium decreased by 88% when a companion was present and by 95% when the patient was mobilized. The risk factors of delirium were length of ICU stay and age. Conclusions:The presence of a companion and patient mobilization were identified as protective factors against delirium, highlighting their importance as preventive actions, especially in patients with a higher risk of developing this disorder. The findings regarding physical restraint can also be considered evidence indicating the need for careful use of this measure in clinical practice until evidence of its relationship with delirium is confirmed.Relevance to Clinical Practice: The implementation of strategies such as early mobilization, presence of a companion and careful assessment for the use of physical restraint by the multidisciplinary team can help control the occurrence of delirium in the ICU.
Background Mentoring programmes in health research are beneficial for both mentors and mentees and are essential for the development of the next generation of research leaders. This study describes the self-assessment of research skills in health professionals participating in a research mentoring programme and determines the correlation between the participants’ self-assessment of research skills and professional characteristics. Method This was a quasi-experimental, time-series study conducted in a Brazilian tertiary hospital. Thirty-five health professionals holding a master’s or PhD degree were included. The participants answered a survey in which they self-assessed their research skills distributed into eight domains, with one group responding before training and another group responding after training. The level of significance was set at 5% (p < 0.05). Results Those who received training scored better in research skills related to two domains: critical analysis of the literature and identification of appropriate research methods (p = 0.0245). Conclusion Trained professionals performed better in the domains of critical thinking and knowledge and management of steps in the research process.
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