Servir (Lisbon, Portugal)最新文献

Management is an activity that crosses every area of a hospital. Bioethics gives health care management the basic criteria to promote the common good, to respect everyone and to overcome the economistic paradigm. This article is based on an ongoing study in hospitals in the northern zone, within the PhD in Bioethics. It aims to disseminate the results obtained in the socio-professional group of nurses who perform management functions, regardless of the implemented management model or level of performance. We aim to understand if the system of human values and the ethics of hospital managers influence the decision on health care, while contributing to the identification of a "Profile of ethical skills to manage health units". Methodologically, this research is identified as an exploratory-descriptive and transversal study with a quantitative approach. When collecting data, we used the Ethicality Questionnaire of Hospital Management, developed and validated, with a good level of internal consistency (Cronbach's alpha = .74). It's a self-report instrument consisting of six dimensions (costs and ethics; weighting ethics; ethical decision, responsibility and quality; economic constraint and ethics, and ways to limit costs) and a total of 37 items, with a 5-point Likert-type scale response. We focused solely on the results of the group of professional nurses, given its predominance in the study (191 elements corresponding to 45,4%). The results that reveal the nurses' opinion suggest that there is an integration of values such as responsibility, respect for human dignity and equity, among others, highlighting the consideration of ethical issues in management practices in nursing. The ethical intentionality to manage with binding to values will have as a final and visible result the expression of a holistic care to the person.

Introduction: The incidence of pressure ulcers (PU) is still a current problem in our society and a constant challenge for all professionals and health institutions. Health professionals worry increasingly about the safety of their patients in the hospital environment. However, pressure ulcers continue to be one of the most common types of injuries acquired during hospitalization.

Objective: The objective of this study is to compare the incidence and prevalence of pressure ulcers in community settings and care differentiated and interpret these values as indicators of quality of care.

Methods: A review of literture reporting incidence and prevalence of pressure ulcer as an outcome measure and is relation with quality indicators. Electronic databases (CINAHL, MEDLINE and EBSCO) were searched from 1 January 1999 to 31 Dezembro 2012 in the English, Spanish and Portuguese language. The MESH descriptors data were Pressure ulcer, epidemiology, Quality indicator, incidence and prevalence.

Results: The 17 papers reported studiest conducted in nine countries. Diderent measurement instruments were utilised to measure theincidence and prevalence of pressure ulcers. Four themes emerged from the thematic analysis, the importance of prevention and treatment, diferential diagnosis and summary minimum data set for epidemiological studies. Prevalence varies in Europe between 3 and 28%, and the locations with the highest incidences services and intensive care medicine.

Conclusion: A system of classification of pressure ulcers in their different categories and the differential diagnosis with injuries humidity reduces the misclassification of UP. Different instruments of data collection does not allow us to compare results between different countries but identifies different contexts.

Background: As the population gets older, the rehabilitation nurse's importance gets higher. The rehabilitation nurse improves the patient's quality of life, well being, and contributes to upgrade health care worldwide. It has a fundamental role in multidisciplinary healthcare teams. In our institution's orthopedics ward, there was no rehabilitation care during the weekend and holidays, due to the absence of rehabilitation nurses during that period.

Aim: Ensure rehabilitation nursing care on weekends and holidays, continuing care and helping to decrease the length of stay in inpatient surgical services.

Methods: We did a retrospective analysis of the length of stay in the orthopedics ward at our hospital, after the implementation of rehabilitation care during weekends and holidays.

Results: In the last three years, since rehabilitation care is maintained during the weekend and holidays, the length of stay at the ward decreased.

Conclusions: The results sustain the importance of rehabilitation nurses in multidisciplinary teams, and emphasize its role in reducing the length of stay at the ward with health care gains.

Introduction: Although aging is not synonymous with illness and dependency, the process enhances the progressive limitation of the capabilities of the individual to meet daily living activities with autonomy, leading to greater need for informal and / or formal support.

Objectives: To identify the functional independence of the participants and their relation to the socio demographic, clinical, housing and social support variables;to assess the difficulties of informal caregivers in care when returning home.

Method: We opted for a triangulated methodology (quantitative and qualitative) following a descriptive-correlational path, using for this purpose a non-probabilistic sample of convenience consisting of 50 patients admitted in the Centro Hospitalar Tondela - Viseu, EPE, and their informal caregivers. The measuring instruments used were the Barthel Index and a semi-structured interview.

Results: The participants are mostly male, with an average age of 73.7 years, married, residing in rural areas. Their qualifications are the 1st cycle of basic education (four years of Primary School) and have a predominance of cerebrovascular diseases. They show moderate dependence at discharge, preferably returning to their own home. Functional independence is significantly influenced by age, educational attainment, place of residence after admission, housing adaptation and formal support. The informal caregiveris mainly the female spouse and daughters, presenting as main difficulties, employment, lack of support andtechnical assistance, the existence of architectural barriers and caregiver overload.

Conclusions: The inexistent of the caregiver's profile, their absence or inability to care was predictive of institutionalization.

Introduction: Pressure ulcers [PrUs], recognized as a complex problem of multifactorial cause, with high costs at individual, family and socioeconomic level, are also taken as an indicator of quality in nursing care. Knowing that the Person Victim of Trauma involves high risk of developing PrUs, it is imperative to investigate the factors that lead to it

Objectives: To determine the prevalence of PrUs in Person Victim of Trauma; to identify predisposing factors for the development of PrUs.

Materials and methods: Observational study conducted in a non-probabilistic sample of convenience, with 500 trauma victims as participants, admitted to the Hospital Infante D. Pedro, in Aveiro, in 2010. Data were collected based on the Clinic Grid (Cunha & Costa, 2011) RESULTS: The prevalence of Pressure Ulcer [PrU] was 4% and the statistically significant factors of its development were : advanced age, greater length of stay, lower diastolic blood pressure, higher pain intensity; dependence in self-care: eating and drinking; presence of diabetes, presence of urinary catheter on admission and during hospitalization, use of diaper; dependence on hygiene and protection of integuments; presence of dry skin; need for physical restraint; taking antibiotics and anti-inflammatory medicine; longer time from admission to the first application of the Braden Scale; higher risk of PrU in the first assessment

Conclusions: This confirms the multifactorial development of PrUs, which makes it relevant for the nurses to consider factors such as length of stay, age, blood pressure, pain, reliance on self-care, physical restraint; antibiotics, assessment and risk level in their planning / implementation of preventive measures against that development and the consequent improvement of the quality of their care.