Objective:to construct and validate the contents of the Self-care Assessment instrument for patients with type 2 diabetes mellitus. Method:methodological study, based on Orem's General Theory of Nursing. The empirical categories and the items of the instrument were elucidated through a focus group. The content validation process was performed by seven specialists and the semantic analysis by 14 patients. The Content Validity Indices of the items, ≥0.78, and of the scale, ≥0.90, were considered excellent. Results:the instrument contains 131 items in six dimensions corresponding to the health deviation self-care requisites. Regarding the maintenance, a Content Validity Index of 0.98 was obtained for the full set of items, and, regarding the relevance, Content Validity Indices ≥0.80 were obtained for the majority of the assessed psychometric criteria. Conclusion:the instrument showed evidence of content validity.

Background According to the literature, 25% to 50% of antimicrobials prescribed in hospitals are unnecessary or inappropriate, directly impacting antimicrobial resistance. Thus, the present study aimed to evaluate the use of antimicrobials in a university hospital in Northeast Brazil, using days of therapy (DOT) and length of therapy (LOT) indicators in accordance with the latest national and international recommendations for monitoring the use of antimicrobials. Methods This is an observational, prospective analytical study conducted in a teaching hospital, with 94 active beds, distributed between the intensive care unit (ICU), the surgical clinic (SUR), the medical clinic (MED), the pneumology/infectology department (PNE/INF) and pediatrics (PED). The duration of the study was from the beginning of January to the end of December 2018. Results During the study period, a total of 11,634 patient-days were followed up and 50.4% of the patients were found to have received some antimicrobial, with a significant reduction in use of 1% per month throughout the year. Patients were receiving antimicrobial therapy for 376 days in every 1000 days of hospitalization (LOT = 376/1000pd). Overall, the 1st-generation cephalosporins and fluoroquinolones were the most used in respect of the number of prescriptions and the duration of therapy. The calculated global DOT/LOT ratio showed that each patient received an average of 1.5 antimicrobials during the hospital stay. The incidence of antimicrobial resistance, globally, for both methicillin-resistant Staphylococcus aureus (methicillin R), Carbapenem-resistant Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii (Carbapenem R), was 1 per 1000 patient-days. Conclusions The results obtained from the analyses revealed that half of the patients admitted to the hospital who took part in the study were exposed to the use of antimicrobials at some point during their stay. Although moderate, it is noteworthy that there was a decline in the use of antimicrobials throughout the year. The indicators used in this study were found to be very effective for gathering data on the use of antimicrobials, and assessing the results of the initiatives taken as part of the Stewardship program.

Objective: to manage the risk of bronchoaspiration in patients with oropharyngeal dysphagia through signalizing plates in the hospital bed. Methods: a descriptive, quantitative study, developed in the medical clinic I (diagnostic investigation), medical clinic II (infectology / pneumology), surgical clinics and intensive care unit of the University Hospital of the Federal University of Sergipe, from February to August 2017. It was composed of patients in the age group ≥ 18 years of age, of both sexes, diagnosed with oropharyngeal dysphagia, based on the application of the adapted protocol of clinical evaluation in the hospital bed and instrumental examination of swallowing, when pertinent. Following the clinical evaluation and identification of the risk of bronchoaspiration due to oropharyngeal dysphagia, the signs were inserted at the hospital bed by the speech therapist. Results: the study included 43 patients at risk of bronchoaspiration due to oropharyngeal dysphagia, average age of 53.7 ± 3.53 years old, with 51.1% (n = 22) females and 48.9% (n = 21) males. A predominance of neuropathies (53.4%) and severe neurogenic oropharyngeal dysphagia (37.2%) was observed. The intensive care unit stood out with 44.18% (n = 19) of the application of signs of risk of bronchoaspiration. Conclusion: the management of bronchoaspiration risk has been shown to be a promising measure to reduce adverse events, which affect the patient's safety and consequently the quality of care in the hospital environment, as well as a possible strategy for measuring respiratory complications triggered by aspiration of oropharyngeal contents.

Objetivo: Avaliar a cultura de segurança por meio das percepções e atitudes dos profissionais que atuam no centro cirúrgico de um hospital deensino. Método: Trata-se de um estudo exploratório, descritivo e transversal, com abordagem quantitativa, desenvolvido com 110 profissionais que atuamno centro cirúrgico, utilizando o Safety Attitudes Questionnaire. Resultados: A média geral dos escores evidenciou uma cultura de segurança incipiente.Ao avaliar a cultura por domínios, satisfação do trabalho e percepção do estresse foram avaliados como positivos, e clima de trabalho em equipe, climade segurança, percepção da gerência da unidade/hospital e condições de trabalho, como negativos. Conclusão: O nível de cultura de segurança encontradoestá abaixo do preconizado na literatura. As ações gerenciais e as condições de trabalho foram consideradas os principais fatores que contribuírampara a fragilidade dessa cultura, entretanto os profissionais demonstraram-se satisfeitos com a unidade de trabalho.

Purpose: to identify associated factors and preventive measures for aspiration pneumonia in hospitalized elderly patients. Methods: the PPOT (population, predictor, outcome, and type of study) was the strategy used to define the eligibility criteria: (1) Population: people over 60 years of age; (2) predictor: hospitalized patients (3) Outcomes: associated factors and measures to prevent aspiration pneumonia; (4) Type of study: Observational Studies (transversal and case-control). We performed the data collection in the PubMed, Lilacs, Scielo, Google Scholar, Science Direct, and Web of Science databases. Observational studies on factors associated with aspiration pneumonia and preventive measures in the elderly, without language restriction and available in full, were included. Data on authors/year/country, objective, methodology, sample, and results, were collected. The risk of bias was assessed, according to the JBI Critical Appraisal Checklist. Results: a case-control and two cross-sectional studies were analyzed. One paper presented a smaller sample with 86 patients, and another presented a larger sample comprising 443 patients. The median age was 77 years old. Conclusion: factors such as severe stroke, dysphagia, advanced age, male gender, coronary heart disease, lower Glasgow coma scale score, use of mechanical ventilation for more than 48 hours, and aspiration of colonized gastric juice were associated with aspiration pneumonia.