RLAE | Number V32

Evaluation of nasogastric tube fixation methods: adhesion, displacement and skin integrity

Avaliação dos métodos de fixação de sonda nasogástrica: adesão, deslocamento e integridade da pele

Lucia Ingridy Farias Thorpe, Jabiael Carneiro da Silva, Renato Barros Moraes, Nataly da Silva Gonça...

Objective: to evaluate three methods of nasogastric tube fixation in terms of adhesion, displacement and skin integrity. Method: ex vivo study, with a sample of 30 experimental noses (10 for each type of fixation), developed with porcine skin, based on the average measurements of the human nose, in which 14-gauge polyvinyl chloride probes were inserted and 2 methods of fixation with adhesive tape (Fixation A and B) and one with an industrial device (Fixation C) were used. Each group was exposed to traction of 50, 100 and 500g sequentially over 12 and 24 hours, testing: adhesion capacity, probe displacement and skin integrity. The Chi-square test of independence was calculated for nominal variables and Student’s t-tests and analysis of variance (p< 0.05) for rational variables. Results: fixation B showed lower adhesion capacity (p <0.001) when compared to the other two fixations. A mean displacement of 52.17 mm was observed in the probes fixed by methods A and B and a greater occurrence of lesions associated with fixations A and C (p = 0.001). Conclusion: the results show complications related to the fixations: lack of adhesion, displacement of the probe and skin lesions, drawing attention to the complexity of the procedure.

Young nurses’ perceptions about their employment, working and health conditions

Percepções de jovens enfermeiros sobre sua condição de emprego, de trabalho e de saúde

Mabel Rocío Hernández Díaz, Zuly Bibiana Suárez Morales, Angelica María Vargas Monroy, Andrey S...

Objective: to interpret young nursing professionals’ perceptions about the relationship between working, employment and health conditions. Method: a qualitative study with an interpretive approach regarding the work-related experiences of 15 young nurses, who took part in the research through voluntary snowball sampling. The data from the interviews and the focus group were analyzed to reach an approximation to the realities inherent to the nurses’ work life. Results: the relevant study findings pointed out that work precariousness is a characteristic feature in the population group, mainly related to hiring modalities and to wages. According to the participants, the psychosocial working conditions (which were intensified during the COVID-19 pandemic) were the ones that caused the most effects on their mental and physical health. Conclusion: from the young nurses’ perspective, this study reports how the macro- and micro-structural working conditions and their relationship with health are perceived, pointing out the key elements to devise interventions focused on life paths that foster decent and healthy work postulates in their work environments, as well as actions to prevent injuries or harms to nurses’ health.

Promoting mental health in the workplace: web software development and validation

Promoção da saúde mental no ambiente laboral: desenvolvimento e validação de um web software

Evelin Daiane Gabriel Pinhatti, Regina Celia Bueno Rezende Machado, Rosangela Aparecida Pimenta, And...

Objective: to develop and validate the content and technical aspects of a web software program for promoting mental health in the workplace. Method: applied methodological study and technological development, carried out in three stages: 1) Umbrella review development; 2) Web software development; 3) Content and technical validation carried out by 14 judges. The data was submitted to descriptive statistical analysis and calculation of the content validity index. Results: based on the guidelines’ recommendations, information was defined and extracted in order to develop the web software consisting of the following dimensions: mental health education, support among coworkers, promotion strategies and mental health self-assessment. For the technical development, the objectives, general functions and technological infrastructure were defined. After development and functional testing, the version was made available for content and technical validation by judges. The overall content validity index was 0.98 and for the technical aspects it was 0.97. Conclusion: the agreement between the judges in relation to the content and technical aspects, as well as the suggestions incorporated, demonstrated the potential for using web software to promote mental health in the workplace.

Complications in the use of peripherally inserted central catheter associated with peripheral intravenous therapy: retrospective cohort

Complicações no uso do cateter central inserido perifericamente associadas à terapia intravenosa periférica: coorte retrospectiva

Elizângela Santana dos Santos, Elaine Barros Ferreira, Fernanda Titareli Merizio Martins Braga, Ama...

Objective: to analyze the occurrence of difficulty in the peripheral insertion of the central catheter and the presence of complications in the use of this device in hospitalized adults who received peripheral intravenous therapy through a short peripheral intravenous catheter and to identify whether there is an association between peripheral intravenous therapy and the presence of complications in the use of the peripherally inserted central catheter. Method: retrospective cohort, with patients aged 18 years or over, in a tertiary teaching hospital, with a peripherally inserted central catheter, who had at least one previous short peripheral intravenous catheter. Data were analyzed using descriptive statistics and Poisson regression. Results: the sample consisted of 76 patients. There was an association between difficulty in the insertion procedure and number of punctures (p<0.01) and insertion in the external jugular vein compared to the upper limbs (p<0.01). The insertion site was also associated with the removal of the peripherally inserted central catheter due to complications in the robust analysis of variance (p=0.02). No associations were identified between: difficulty inserting the device and time on peripheral intravenous therapy (crude model p=0.23; adjusted model p=0.21); difficulty in insertion with administration of irritating and vesicant medication (crude model p=0.69; adjusted model p=0.53); complication in the use of peripherally inserted central catheter and time of peripheral intravenous therapy (crude and adjusted models p=0.08); and secondary migration of the catheter tip with the device insertion site (p=0.24). Conclusion: it was possible to identify secondary migration as one of the main complications, resulting in premature removal of the device. Furthermore, the greater the number of puncture attempts to insert the PICC, the greater the difficulty in inserting it. Insertion into the external jugular vein was recurrent, with a higher risk of removal due to complications in relation to the upper limbs.

Sociodemographic and training profile of nursing professionals in the state of São Paulo in relation to Integrative and Complementary Health Practices

Perfil sociodemográfico e de formação dos profissionais de Enfermagem do estado de São Paulo em relação às Práticas Integrativas e Complementares em Saúde

Juliana Rizzo Gnatta, Thiago da Silva Domingos, Edilaine Cristina da Silva Gherardi-Donato, Suzimar ...

Objective: to analyze the sociodemographic and training profile of nursing professionals in the state of São Paulo in relation to Integrative and Complementary Practices in Health. Method: cross-sectional study, developed with 3,794 nursing professionals in the state of São Paulo, from 645 municipalities. To collect data, an online questionnaire was used containing sociodemographic and professional training variables. A hierarchical multiple Poisson regression model was constructed, considering training in practices as the dependent variable, with a significance level of 5%. Results: of the 3,794 (100%) participants, 479 (12.62%) had training in Integrative and Complementary Health Practices. The most frequent practices were auriculotherapy, Traditional Chinese Medicine/acupuncture and Reiki. The predominant training modalities were free, face-to-face and theoretical-practical courses. The variables age, no formal religion, higher education and specialization level, working hours and knowledge and previous experience on integrative practices were significant. Conclusion: the results indicate the need to encourage and expand the training of Integrative and Complementary Health Practices for nursing professionals, in order to strengthen their performance in health services.

Enhancing early bonding between mothers and preterm infants: findings from a Multicentre Qualitative Study of Nurses

Experiências de enfermeiros na facilitação do vínculo precoce entre mães e bebês prematuros: um estudo qualitativo multicêntrico

Nopi Nur Khasanah, Yeni Rustina, Dessie Wanda, Iskim Luthfa.

Objective: this study aims to explore neonatal nurses’ experiences of facilitating early bonding between mothers and premature babies. Method: a descriptive qualitative approach was adopted, using focus group discussions with 13 participants from four referral hospitals in a major city in a developing country. This was followed by in-depth interviews with three participants. Results: three main themes emerged, highlighting the barriers and facilitators to early bonding between mothers and preterm infants. The study also explored care practices aimed at facilitating early bonding within the social environment of preterm infants, involving mothers, families, nurses and hospitals. Conclusion: the barriers and facilitators identified inform the development of intervention strategies for neonatal nurses to promote early bonding. Optimal early bonding requires enhanced nurse management skills, adequate hospital infrastructure and involvement of the patient’s family. These findings contribute to the advancement of health and nursing knowledge.

Validation of the Family Integration Experience Scale: Chronic Illness for the Portuguese language spoken in Brazil

Validação da Family Integration Experience Scale: Chronic Illness para a Língua Portuguesa falada no Brasil

Carolliny Rossi de Faria Ichikawa, Regina Szylit.

Objective: to conduct the cross-cultural adaptation and psychometric validation of the Family Integration Experience Scale: Chronic Illness in Brazilian Portuguese. Method: a methodological study divided into two stages. In the first stage, the Family Integration Experience Scale: Chronic Illness was cross-culturally adapted for Brazilian culture, when the scale was subjected to translations, back-translations, and a committee of judges - to verify the semantic, linguistic, and contextual equivalence between the original and translated items. The second step was to validate the scale in a sample of families of children and adolescents with chronic illnesses. The participants were 230 families of children with chronic illnesses attending the outpatient clinic of a tertiary public hospital with teaching and research characteristics. Results: internal consistency was tested using Cronbach’s alpha (0.81) and McDonald’s omega (0.81). Confirmatory factor analysis was also tested, and the model’s fit was acceptable for validation standards. Conclusion: the version of the Family Integration Experience Scale: Chronic Illness showed evidence of validation and can be considered a valid and reliable instrument in Brazilian culture. The Brazilian Portuguese version of the Family Integration Experience Scale: Chronic Illness can be used to measure the experience of family integration in chronic illness.

Epidemic curves and the profile of patients hospitalized by COVID-19 in a border region

Curvas epidêmicas e o perfil de pacientes hospitalizados pela COVID-19 em região de fronteira

Merielly Kunkel, Érica Alves Ferreira Gordillo, Laiz Mangini Cicchelero, Franz Porzsolt, Mara Crist...

Objective: to describe the epidemic curves and analyze the epidemiological profile of patients hospitalized with COVID-19 in a triple border city. Method: descriptive-quantitative. The population consisted of COVID-19 cases that required hospitalization, analyzing variables such as: age, gender, race/color, city where they lived, occupation, pregnant woman, institutionalized patient and evolution. Descriptive statistical analysis and analysis of variance and chi-square tests were used. Results: four epidemic curves were identified in the studied period. Among hospitalized cases, males predominated (55%). Cure was the most frequent outcome in curves 1, 2 and 4, but with no statistical difference (p = 0.2916). Curve 3 showed a higher frequency of deaths (41.70%) in relation to cures (38.77%). The mean ages were significantly different between the curves, with curve 4 having the lowest mean age. Conclusion: it was concluded that the epidemic curves were influenced by different situations; unvaccinated population, easing of restrictive measures, reopening of the Brazil-Paraguay border, interruption of control actions, crowding of people and circulation of new variants of the disease. Through the epidemiological profile of hospitalized patients, it was concluded that being male, of mixed race/color, aged between 61 and 85 years, and being deprived of freedom were associated with hospitalization and the occurrence of death.

National practice of Nursing professionals in the insertion of peripheral vascular access devices

Prática nacional dos profissionais de Enfermagem na inserção de dispositivos de acesso vascular periférico

Bianka Sousa Martins Silva, Luciano Marques dos Santos, Patrícia Kuerten Rocha, Aline Nair Biaggio ...

Objective: to identify and compare the practice of Nursing professionals regarding the insertion of peripheral vascular access devices, according to professional category. Method: descriptive sectional study carried out between July 2021 and May 2022 with 2,584 Nursing professionals, using a questionnaire validated by three judges with expertise in intravenous therapy, containing variables related to catheterization and the vascular access device. Descriptive and inferential analysis was carried out. Results: most professionals do not prepare the patient or perform some essential care before attempting peripheral intravenous catheterization. Regarding the preferred catheterization site, hands, arm and forearm stand out. There is no control over the tourniquet time, and the patient is punctured more than three times. The most used device materials are polyurethane and Teflon ® , more than one criterion is adopted for device selection, and Micropore ® type adhesive tape was the covering most cited by Nursing professionals. The identification of catheterization was not adequate. Conclusion: nursing technicians and assistants are the professionals who least comply with what is recommended in recognized guidelines. Nurses’ practice also presents deviations from scientific evidence.

IST Nurse®: development and validity evidence of a mobile application as a support for the clinical management of Sexually Transmitted Infections

IST Nurse®: elaboração e evidências de validade de aplicativo móvel como subsídio ao manejo clínico de Infecções Sexualmente Transmissíveis

Leilane Barbosa de Sousa, Ismael Moreira de Sousa, Edmara Chaves Costa, Ana Paula Fragoso de Freitas...

Objective: to develop and evaluate the validity evidence of a mobile application to support nurses in the clinical management of sexually transmitted infections. Method: methodological study conducted in four steps: analysis and definition of requirements; content definition; computational representation with system design; and coding with testing and refinement. In the first steps, nurses with expertise in the subject participated, and in the last, professionals with education in information and communication technology. Data analysis was performed by calculating the Content Validity Index (CVI), considering the minimum agreement value of 0.78. To confirm the viability of the CVI, the binomial test was used through the R software. Variables with p > 0.05 indicated agreement between the judges. Results: the CVI was 0.98 for content, 1.0 for usability and 0.85 for functional performance, showing that the developed application has high validity. Conclusion: it is believed that the IST Nurse® application represents an important technological tool in strengthening evidence-based nursing care. Intervention studies are therefore suggested.

Moral sensitivity as a personal and work attribute of emergency care nurses: a cross-sectional study

Sensibilidade moral como atributo pessoal e de trabalho das enfermeiras nas urgências: estudo transversal

Mariana Oliveira Antunes Ferraz, Carlise Rigon Dalla Nora, Maria Manuela Ferreira Pereira da Silva M...

Objective: to analyze the moral sensitivity of Brazilian emergency care nurses according to their personal and work characteristics. Method: this is a quantitative, descriptive, cross-sectional study with a convenience sample. A total of 422 nurses from emergency care services in the five regions of Brazil took part. Sociodemographic and work-related information was collected, as well as the Brazilian version of the Moral Sensitivity Questionnaire. After approval by the Research Ethics Committee, the data was collected using a self-administered form on the Google Forms Platform, organized using Excel software and analyzed using the R language. Results: nurses with longer experience in emergency care services showed higher levels in the interpersonal orientation, moral conflict and moral significance dimensions, while in the professional knowledge dimension, men showed higher levels, as evidenced by items that include confidence in nursing knowledge, intuition, experience and opinion. Conclusion: the differences in the nurses’ moral sensitivity were due to their professional experience. It should be emphasized that valuing the sharing of intergenerational experiences in service could be a possible strategy for fostering moral competencies in the field of practice.

Predisposing and precipitating factors for the development of postoperative delirium in critically ill patients in a university intensive care unit

Fatores predisponentes e precipitantes para o desenvolvimento de delirium pós-operatório em pacientes críticos de uma unidade intensiva universitária

Danielle Moreira Marques, Davi da Silveira Barroso Alves, Taís Veronica Cardoso Vernaglia.

Objective: to detect the incidence of postoperative delirium in critically ill patients admitted to a surgical intensive care unit and to evaluate the predisposing and precipitating factors associated with postoperative delirium in critically ill patients admitted to a surgical intensive care unit. Method: this is a prospective cohort study of 157 critically ill surgical patients. Fisher’s exact test and Chi-square test were used for the association between factors and the occurrence of delirium, the Wilcoxon test for numerical variables, and the logistic regression model for the analysis of predisposing and precipitating factors. Results: the incidence of delirium was 28% (n=44). Age was a significant predisposing factor (p=0.001), followed by the length of surgery (p<0.001), blood transfusion (p=0.043), administration of crystalloids (p=0.008), and anti-inflammatory drugs (p=0.037), which were the precipitating factors identified. The best-adjusted models were: age, length of surgery, non-administration of anti-emetics, use of sufentanil, and blood transfusion. Conclusion: delirium is a frequent condition in critically ill adults undergoing surgery and the existence of precipitating and predisposing factors is relevant to the outcome, with the anesthetic-surgical procedure as the catalyst event.

Number V32

Original Articles