Telephone follow-up reduced the occurrence of delayed surgical recovery.

Background: Patient undergoing surgery may be afraid and concerned about the diagnosis, the treatment, the procedure, the postoperative care, and the surgical recovery. Good communication between staff and patients can minimize or prevent this situation. This study aimed to evaluate the effectiveness of a Telecare nursing intervention, "Telephone consultation", in reducing the "Delayed surgical recovery" nursing diagnosis in patients undergoing laparoscopic cholecystectomy and hernia repair. Methods: This study was performed in two different institutions located in Rio de Janeiro, Brazil. A total of 43 patients were enrolled. The experimental group consisted of 22 patients who had access to the telephone followup intervention, and the control group consisted of 21 patients who received conventional treatment without telephone follow-up. This was a randomized controlled study with patients who were 60 years or older and awaiting operative procedures of hernia repair and laparoscopic cholecystectomy who had a mobile or landline phone and were available for telephone contact. Results: There was a reduction in "loss of appetite with nausea" (p = 0.013); "need help to complete self-care" (p = 0.041); "pain" (p = 0.041); and "postoperative sensation" (p = 0.023). The experimental group showed a significantly larger decrease in factors related to the "Delayed surgical recovery" diagnosis, suggesting a positive effect of the intervention compared to the effect in control group.\. Conclusion: Telephone consultation identified factors that increased the risk of complications after surgery, recognized potential patients for delayed surgical recovery and helped perioperative nurses provide accurate interventions to prevent or mitigate delayed recovery. This study was registered in the platform Brazilian Registry of Clinical Trials (ReBEC)-link: http://www. ensaiosclinicos.gov.br under registration number RBR-4C249M, retrospectively registered on April 13, 2020.

BackgroundSkin changes caused by aging increase the risk of skin damages, such as pressure ulcers, during hospitalization of elderly patients. There is few information about the cost of wound treatment in Brazil. Conversely, skin and wound problems are highly reported among hospitalized elderly patients and caregivers. The purpose is to analyze the socio-demographic and clinical profile associated with skin and wound care in hospitalized elderly.MethodsThis is a prospective observational study. The sample consisted of 75 patients, aged 60 years or more, randomly selected in three hospitals in Rio de Janeiro, Brazil. Data extraction from nursing records of the sample, using cross mapping with Nursing Interventions Classification. Data Synthesis supported by SAS 6.11 (SAS Institute, Inc. Cary North Carolina) in association with SPSS version 14.0 and statistics analysis.ResultsThe findings were: age standard deviation 7.8, with minimum as 60, and maximum as 91 years old. Prevalence of women and married seniors. High prevalence of long-term hospitalization. There were 21 Nursing Interventions in the nursing records and seventeen of them related to skin and wound care. They were described in 57 nursing activities, present during 376 evaluations and repeated 1756 times. A significant difference was obtained between age and the presence of the nursing interventions “Positioning” (p-0.004), Eye Care/Hygiene (p- < 0.0001) and Oral Health Maintenance (p-0.0003).ConclusionThe skin care to prevention and treatment of skin damages represented the major demand of nursing interventions in different clinical conditions of hospitalized elderly.

Purpose The purpose of this study was to analyze the prognostic capacity of the clinical indicators of a delayed surgical recovery nursing diagnosis throughout the hospital stay of patients having cardiac surgery. Design A prospective cohort design was adopted. A sample of inpatients undergoing elective cardiac surgery was followed during the immediate preoperative period and hospitalization. This research was conducted in the southeast region of Brazil at a national reference institution that treats highly complex diseases and performs cardiac surgeries. Data were collected from July 2017 to July 2018. Methods At the end of 1 year of data collection, 181 patients were followed in this study. The Kaplan‐Meier method was used to calculate the survival time related to delayed surgical recovery. In addition, an extended Cox model of time‐dependent covariates was adjusted to identify the clinical signs that influenced the change in the nursing diagnosis status. Results A delayed surgical recovery nursing diagnosis was present in 23.2% of the sample studied. With an expected length of stay of 8 to 10 days, most new cases of delayed surgical recovery were observed on the 10th postoperative day, and the survival rate after this day was decreased until the 29th postoperative day, when the nursing diagnosis no longer appeared. Interrupted healing of the surgical area, loss of appetite, and atrial flutter were indicators related to an increased risk for delayed surgical recovery. Conclusions Timely recognition of selected clinical indicators demonstrates a promising prognostic capacity for delayed surgical recovery. Clinical Relevance Accurate identification of prognostic factors allows nurses to identify early signs of postoperative complications. Consequently, the professional can develop an individualized plan of care, aiming at the satisfactory clinical recovery of the patient.

O presente estudo trata-se de uma revisão integrativa realizada nas bases do Lilacs, Bdenf e Medline, cujo objetivo foi identificar os riscos ocupacionais associados aos trabalhadores da UTI, assim como seus fatores de risco; e propor medidas educativas aos riscos encontrados. Após critérios de inclusão e exclusão foram selecionados seis artigos. Os resultados indicaram riscos biológicos, riscos químicos, riscos ergonômicos, riscos físicos e riscos mecânicos, como riscos ocupacionais presentes e os fatores de riscos ocupacionais que influenciam na rotina e no desenvolvimento de trabalho da equipe de enfermagem. Os estudos apresentam poucas medidas educativas a fim de amenizar estes tipos de riscos aos trabalhadores. Conclui-se que todos os riscos ocupacionais estão presentes na UTI, mas risco ergonômico é o responsável pelos altos índices nas pesquisas evidenciando o estresse como seu maior consequência. A educação permanente permeia as propostas educativas para minimizar os riscos ocupacionais.Descritores: Enfermagem; Saúde ocupacional; Saúde do trabalhador;  Unidade        de terapia intensiva.