Low-laser light therapy in venous ulcer healing: a randomized clinical trial

ABSTRACT Objectives: to compare the effect of adjuvant low-laser light therapy versus conventional treatment alone on venous ulcer healing. Methods: this is a randomized clinical trial with 40 patients randomized equally to a control group (topical and compressive treatment) and intervention group (adjuvant low-laser light therapy). Outcomes of interest were Wound Healing: Secondary Intention and Tissue Integrity: Skin & Mucous Membranes, as described in the Classification of Nursing Outcomes/NOC. Results: groups with similar sociodemographic and clinical characteristics. Eighty-two ulcers were assessed, with an average duration of 1 to 5 years, in 1,066 nursing consultations, with a statistically significant difference in the time and number of healed ulcers (intervention group). There was a significant improvement in the nursing outcomes under study and in eight clinical indicators. Conclusions: low-laser light therapy improves and reduces tissue regeneration time, contributing to advances in wound treatment.

Exploring hospital compliance with the primary nursing care model: validating an inventory using the Delphi method

Background The primary nursing care model is considered a personalized model of care delivery based on care continuity and on the relationship between the nurse and patient. Primary nursing checklists are not often mentioned in the literature; however, they represent a valid instrument to develop, implement, and evaluate primary nursing. The aim of this study was to create a structured checklist to explore hospital compliance in primary nursing. Methods The Delphi method was used to develop and validate a checklist. The preliminary version was created and sent to three experts for their opinions. Their comments were ultimately used in the first version, which included four components with 19 items regarding primary nursing characteristics. A two-round Delphi process was used to generate consensus items. The Delphi panel consisted of six experts working in primary nursing contexts and/or teaching or studying primary nursing. Data were collected using a structured questionnaire from July 2020 to January 2021. These experts were asked to rate each element for relevance using a 4-point Likert-type scale. Furthermore, the consensus among the panel of experts was set at ≥78%, with selected items being voted “quite relevant” and “highly relevant”. Content validity index (I-CVI) and modified kappa statistic were also calculated. Following expert evaluation, the first version of the checklist was modified, and the new version, constituting 17 items, was sent to the same experts. Results The first version of the checklist demonstrated a main relevance score of 3.34 (SD = 0.83; range = 1.3–4; mean I-CVI = 0.84; range: 0.83–1), but three items did not receive an adequate I-CVI score, that is, lower than 0.78. After the second round, the I-CVIs improved. The main score of relevance was 3.61 (SD: 0.35; range = 2.83–4; mean = I-CVI: 0.93). The S-CVI/UA was 0.58, and the S-CVI/Ave was 0.93. Conclusion Measuring primary nursing compliance should be implemented to provide continuous feedback to nurses. Moreover, utilizing valid checklists could permit comparing different results from others’ research. Future research should be conducted to compare the results from the checklist with nursing outcomes.

Effect of Bundle Management in the Reduction of EN Complications in Patients Receiving Enteral Nutrition (EN) in the ICU

To investigate the efficacy of bundle management in reducing EN complications in ICU enteral nutrition (EN) patients. Methods: In this study, 90 patients with enteral nutrition who were admitted to our hospital and ICU from January 2018 to January 2021 were randomly divided into two groups by random number method: control group (n = 45) treated with routine nursing management and study group (n = 45) treated with bundle management by random number method. The nursing outcomes of the two groups were compared. Results: The incidence rate of enteral nutrition complications in the study group was significantly lower than that in the control group (P<0.05). The nutritional indexes after intervention in the study group were significantly better than those in the control group (P<0.05). There was no significant difference in the relative ratio of nutritional indexes before intervention between the two groups (P>0.05). The satisfaction degree of the patients’ family members in the study group was significantly better than that of the patients’ family members in the control group (P<0.05). Conclusion: Bundle management measures for patients with enteral nutrition in ICU can effectively improve the nutritional index of patients and the satisfaction of their family members, and reduce the incidence of complications of enteral nutrition, which has obvious clinical value.

Effect of Bundle Management in the Reduction of EN Complications in Patients Receiving Enteral Nutrition (EN) in the ICU

To investigate the efficacy of bundle management in reducing EN complications in ICU enteral nutrition (EN) patients. Methods: In this study, 90 patients with enteral nutrition who were admitted to our hospital and ICU from January 2018 to January 2021 were randomly divided into two groups by random number method: control group (n = 45) treated with routine nursing management and study group (n = 45) treated with bundle management by random number method. The nursing outcomes of the two groups were compared. Results: The incidence rate of enteral nutrition complications in the study group was significantly lower than that in the control group (P<0.05). The nutritional indexes after intervention in the study group were significantly better than those in the control group (P<0.05). There was no significant difference in the relative ratio of nutritional indexes before intervention between the two groups (P>0.05). The satisfaction degree of the patients' family members in the study group was significantly better than that of the patients' family members in the control group (P<0.05). Conclusion: Bundle management measures for patients with enteral nutrition in ICU can effectively improve the nutritional index of patients and the satisfaction of their family members, and reduce the incidence of complications of enteral nutrition, which has obvious clinical value.

POSICIONAMENTO DE PACIENTES ORTOPÉDICOS SEGUNDO A NURSING OUTCOMES CLASSIFICATION

Objetivo: avaliar o posicionamento de pacientes ortopédicos segundo a Nursing Outcomes Classification. Método: trata-se de um estudo quantitativo, descritivo, longitudinal, realizado em um hospital brasileiro, com 20 pacientes ortopédicos, submetidos à artroplastia total de quadril, que foram acompanhados por até quatro dias de pós-operatório. Realizou-se a avaliação de quatro indicadores do resultado Nursing Outcomes Classification - Posicionamento do Corpo: autoiniciado (0203) por meio da escala Likert de cinco pontos e, para a análise, foram empregados os testes t de Student, Equações Estimativas Generalizadas e Post Hoc de Bonferroni. Resultados: realizaram-se 76 avaliações e a média do resultado Posicionamento do Corpo: autoiniciado (0203), na primeira avaliação, foi de 2.01±0.25 pontos (Muito comprometido). Alcançou-se, na última, por este resultado, média de 4.73±0.08(Levemente comprometido), p<0.001. Conclusão: demonstrou-se uma melhora progressiva no posicionamento de pacientes ortopédicos. Acredita-se que a NOC é uma ferramenta clinicamente útil para a avaliação dos resultados do paciente durante a implementação do Processo de Enfermagem na prática clínica.

PRÉ-NATAL DE ALTO RISCO DECORRENTE DE LESÃO MEDULAR: uma análise direcionada a saúde mental

Objetivo: de forma geral, objetivou-se realizar a consulta de pré-natal a paciente com transtornos mentais; e de forma específica realizar a evolução da paciente; elaborar um plano de cuidados respaldado em North American Nursing Diagnosis Association, NIC - Nursing Interventions Classification, e NOC - Nursing Outcomes Classification; e descrever as atividades realizadas. Métodos: trata-se de um relatório de estágio, realizado em uma UBS (unidade básica de saúde) do município de Caxias – MA. Para realização do trabalho foi necessário o período de 22 dias para coleta de dados da paciente, utilizando como fontes: consulta de enfermagem, prontuários, exames realizados e prescrições médicas. Resultados: foram realizadas diversas atividades, tanto assistências quanto administrativas, no qual as principais foram acolhimento humanizado e orientações quanto ao atendimento; consulta de enfermagem (saúde mental); consulta de pré-natal; consulta de puericultura e puerpério; realização de ações educativas para promoção da saúde da mulher e do adolescente, entre outras. Conclusão: o estudo possibilitou expandir os conhecimentos acerca do pré-natal e demais atividades realizadas nas unidades básicas de saúde, além de permitir montar planos de cuidados desenvolvidos com foco nas gestantes que apresentam lesões medulares e os problemas enfrentados por elas.