Objectives: to analyze the diagnostic criteria for ventilator-associated pneumonia recommended by the Brazilian Health Regulatory Agency and the National Healthcare Safety Network/Centers for Disease Control and Prevention, as well as its risk factors. Methods: retrospective cohort study carried out in an intensive care unit throughout 12 months, in 2017. Analyses included chi-square, simple linear regression, and Kappa statistical tests and were conducted using Stata 12 software. Results: the sample was 543 patients who were in the intensive care unit and under mechanical ventilation, of whom 330 (60.9%) were men and 213 (39.1%) were women. Variables such as gender, age, time under mechanical ventilation, and oral hygiene proved to be significant risk factors for the development of ventilator-associated pneumonia. Conclusions: patients submitted to mechanical ventilation need to be constantly evaluated so the used diagnostic methods can be accurate and applied in an objective and standardized way in Brazilian hospitals.
Objective: To analyze the change in the clinical-epidemiological profile of patients attended at the specialized triage service for COVID-19 (COVID-19 tent) in the first three months of operation. Methods: Cross-sectional study, with users attended from March 2020 to May 2020 (n=379) at the COVID-19 tent in the city of Ponta Grossa, Paraná. Data collection was retrieved from an electronic form fed by tent professionals, which included sociodemographic characteristics, symptoms, risk factors of exposure, means of search and clinical conduct. Trend tests and chi-square tests were performed. Results: March showed a greater demand (n=197), motivated by mild symptoms and direct search (p<0.05). In the following months, there was a decrease in demand (n=93; n=89), however the search for referrals, ambulances and conditions that required medical attention, observation and hospitalization increased (p<0.05). The search resulting from exposure to risk factors has not changed (p>0.05). Conclusion: the profile has changed over time, reflecting, in the end, severe and critical symptoms, requiring intervention.
Exceto onde especificado diferentemente, a matéria publicada neste periódico é licenciada sob forma de uma licença Creative Commons -Atribuição 4. Justificativa e Objetivos:Ressaltando a relevância da adoção de medidas preventivas de infecção para a realização de uma assistência livre de danos emergiu a necessidade de observar como a equipe de saúde aplica o bundle. Objetivou-se verificar a adesão de medidas preventivas de pneumonia pelos profissionais de saúde, da Unidade de Terapia Intensiva geral adulta de um hospital público, Ponta Grossa-PR. Métodos: Pesquisa transversal, de abordagem quantitativa, prospectiva e observacional, realizada no período de abril a julho de 2013. A amostra constituiu-se de 33 pacientes que estavam em ventilação mecânica, totalizando o registro de 1522 momentos de aplicações das medidas preventivas de pneumonia associada à ventilação mecânica (PAVM).Resultados: Dos 33 pacientes, 13 desenvolveram pneumonia, a média de idade foi de 59,72 anos e a prevalência foi do gênero feminino (44,44%). Verificou-se que os profissionais de saúde atenderam a cabeceira elevada dos leitos em média 69,80%, assim como aderiram à interrupção da sedação em média 66,66%, realizaram a higiene oral com clorexidina 94,61%, mantiveram o cuff do tubo orotraqueal (entre 20 e 25 mmH20) 64,44%, adequaram o filtro de nebulizador para ficar dentro da validade 89,50% e em 93,4% das observações deixaram os circuitos livre de condensados. Analisou-se que o valor médio de dias passados em ventilação mecânica dos pacientes que adquiriram infecção foi de 15,85 (DP = 8,65) dias. Conclusão: Revela-se que quando a equipe aplica todas as medidas preventivas ao paciente sob ventilação mecânica há redução do risco de adquirir infecção no trato respiratório. Backgound and Objectives:Emphasizing the importance of adopting measures for infection prevention aiming at providing damage-free assistance, we verified the need to observe how the health team has been applying the bundle protocol. We aimed to assess adherence to preventive measures for pneumonia by health professionals at the Intensive Care Unit of a general adult public hospital, in Ponta Grossa -PR. Methods: Cross-sectional, quantitative, prospective and observational study, carried out from April to July 2013. The sample consisted of 33 patients on mechanical ventilation, totaling a record of 1,522 times application of preventive measures for ventilator-associated pneumonia (VAP). Results: Of 33 patients, 13 developed pneumonia, the mean age was 59.72 years and the prevalence was the female gender (44.44 %). It was found that health professionals maintained the head-of-the-bed (HOB) elevation in 69.89 % of cases, adhered to sedation interruption in 66.66% of cases, performed oral hygiene with chlorhexidine in 94.61%, kept the cuff of the endotracheal tube between 20 and 25mmH2O in 64.44%, maintained the nebulizer filters within the validity in 89.50% and maintained the circuits free of condensate formation in 93.4% of cases. It was verified that the mean amount of da...
O Diabetes Mellitus é um grupo de doenças metabólicas, sendo a terceira principal causa de morbimortalidade, envolvendo algumas complicações, deixando o paciente vulnerável. Os objetivos foram verificar a prevalência de amputações de membros inferiores decorrentes de úlceras diabéticas com infecção de pacientes de uma Unidade Saúde da Família e analisar as alterações fisiológicas detectadas durante a avaliação dos pacientes. Trata-se de uma pesquisa quantitativa de abordagem retrospectiva, realizada de maio a outubro de 2010, com uma amostra de 40 pessoas envolvida nas atividades. Como resultado encontrou-se que os pacientes apresentam alguma deformidade ou proeminência óssea (30,8%) e insensibilidade e ressecamento dos pés (46,2%) como complicações. Conclui-se que os profissionais da saúde, principalmente os enfermeiros devem realizar cuidados com esses pacientes, transmitindo assim conhecimento com foco no cuidado e prevenção, por meio de atividades educativas que visam o bem-estar pessoal e social do paciente.
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