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- Geriatric care: ways and means of providing comfortPublication . Ribeiro, Patrícia Cruz Pontífice Sousa Valente; Marques, Rita Margarida Dourado; Ribeiro, Marta PontificeObjective: To know the ways and means of comfort perceived by the older adults hospitalized in a medical service. Method:: Ethnographic study with a qualitative approach. We conducted semi-structured interviews with 22 older adults and participant observation of care situations. Results: The ways and means of providing comfort are centered on strategies for promoting care mobilized by nurses and recognized by patients(clarifying/informing, positive interaction/communication, music therapy, touch, smile, unconditional presence, empathy/proximity relationship, integrating the older adult or the family as partner in the care, relief of discomfort through massage/mobilization/therapy) and on particular moments of comfort (the first contact, the moment of personal hygiene, and the visit of the family), which constitute the foundation of care/comfort. Final considerations: Geriatric care is built on the relationship that is established and complete with meaning, and is based on the meeting/interaction between the actors under the influence of the context in which they are inserted. The different ways and means of providing comfort aim to facilitate/increase care, relieve discomfort and/or invest in potential comfort.
- The role of the nurse in caring for the critical patient with sepsisPublication . Branco, Maria João Chambel; Lucas, Ana Paula Mirco; Marques, Rita Margarida Dourado; Sousa, Patrícia PontíficeOBJECTIVES: to know the nursing interventions in the identification, prevention and control of sepsis in critical patients. METHODS: integrative review of the literature, with two parallel researches using different MesH terms, using the EBSCO database and Google Scholar. Nine studies were included in the sample. RESULTS: nursing interventions are centered on the creation/implementation of protocols for the early recognition of sepsis, the training of teams to ensure a safe and effective approach and the adoption of measures for infection prevention and control as a way to prevent sepsis. FINAL CONSIDERATIONS: the evidence shows that nurses are fundamental in the early identification, control and prevention of sepsis, preventing disease progression and contributing to decreased morbidity and mortality.
- Stabilization of the spine in the trauma victim - integrative reviewPublication . Bento, Ana Filipa Gaudêncio; Sousa, Patrícia PontíficeGoal: To identify harmful effects caused by the stabilization of the vertebral column in a trauma victim and in trauma situations without indication for stabilization of the spine in the prehospital. Method: It was perform an integrative literature review guided by research questions: is there a scientific evidence of harmful effects on trauma victims caused by spinal stabilization in prehospital care? and are there situations of trauma with no indication for stabilization of the spine? Results: We have performed a Boolean search in the electronic bases Cochrane Library and Pubmed and through the EBSCOhost engine in the databases CINAHL Plus, MEDLINE, MedicLatina, SPORTDiscus, PsycARTICLES, PsycBOOKS, Psychology and Behavioral Sciences Collection, Academic Search Complete. Twelve articles were obtained and after applying the inclusion and exclusion criteria, the sample was five articles. Conclusions: Harmful effects of spinal stabilization on the victim of trauma related to airway management, pain, discomfort and pressure injuries are described. Situations of penetrating trauma with unstable circulation and victims with gunshot injuries to the head do not require stabilization of the spine. Recommendations to support the prehospital decision regarding stabilization of the spine were collected. It is crucial for the improvement of prehospital care to integrate an individualized approach of the victim that refers to its clinical state and mechanism of injury.
- Delirium: nursing interventions directed to the hospitalized adult patient – a bibliographic reviewPublication . Bento, Marta Sofia Pão Mole; Marques, Rita Margarida Dourado; Sousa, Patrícia PontíficeDelirium is a neuropsychiatric syndrome, characterized by an acute attention and cognition deficit disorder, of multifactorial etiology. It has a high prevalence in the elderly population and it’s an indicator of a poor prognosis. It leads to a negative impact, provoking deterioration in the person’s quality of life. Objectives: This study aimed to identify the nursing interventions directed to the hospitalized adult / elderly, for the control of delirium. Methodology: Using a PICO question as a reference, a review of articles published between 2012 and 2017 was carried out. That identified, which nursing interventions aimed at the adult / elderly person hospitalized with delirium. Results: In this bibliographic review 5 studies were selected, in common, they present tendentially, non-pharmacological dynamic strategies of preventive character towards the delirium. This evidences the role of nursing in carrying out preventive actions (preferentially directed to risk factors, which may trigger this neurological alteration), such as the maintenance of the sensorial balance, assessing the local environment, monitoring pain, sleep and the stimulation of the early mobility. Conclusion: The interventions for delirium should include the identification of predisposing and precipitating factors with adequate actions, for its resolution. Research is imperative, to recognize and validate witch interventions may control delirium (prevent/ treat) and thus reduce its consequences.
- Nursing strategies to reduce the risk of therapeutic obstinacy in artificial nutritionPublication . Afonso, Tânia dos Santos; Veludo, Filipa; Sousa, Patrícia PontíficeBackground: Nurses have an important role in maintaining a patient's nutrition near the end of life. Aims: To define nursing nutrition strategies with the person near the end of life and their families; systematise the elements to be considered in artificial nutrition decision-making and evaluate the nursing interventions' influence on therapeutic obstinacy risk. Methods: A sample of 11 articles were selected and the results considered strategies to promote oral feeding before artificial nutrition; the follow-up of the health-disease process by nurses and described the nurse's role as a privileged patient advocate in the defence of the ethical principles of decision-making. These principles consider symptomatology, prognosis, psychology and the emotional significance of nutrition. Conclusion: Nurses are qualified professionals with a critical role in the patient's care due to the proximity they have with the patient; the evidence seems to show a relationship between nursing interventions and the reduction of the risk of therapeutic obstinacy; however, there are no studies in this specific area.
- Nursing approach to the person in critical situation submitted to extracorporeal membrane oxygenation: scoping reviewPublication . Chaiça, Verónica; Pontífice-Sousa, Patrícia; Marques, RitaExtracorporeal Membrane Oxygenation (ECMO) corresponds to a form of mechanical cardiopulmonary support used to treat severe respiratory failure, since it allows extracorporeal gas exchange. Additionally, in patients with severe heart failure, or experiencing cardiorespiratory arrest, this technique also provides systemic circulation. Nevertheless, ECMO carries some risks, such as clot formation. It is in this context that the nurse has a key role. Objective: To map the available scientific evidence about the nurses' approach to the critically ill person subjected to ECMO. Method: We conducted a scoping review, using databases accessed through the EBSCOhost platform and following the methodology proposed by the Joanna Briggs Institute. Through the combination of appropriate MesH descriptors, we selected articles published between 2009 and 2019, written in Portuguese or English. Results: Five studies were included in the review. Their analysis allowed us to verify that the nurse's approach focuses on the monitoring, surveillance, management and coordination of the care provided to critically ill patients subjected to ECMO. It was also found that the adoption of adequate protocols, the training of the multidisciplinary teams and an efficient communication between team members contributed to an effective, safe and high-quality performance when facing patients subjected to ECMO. Conclusion: An appropriate nursing approach is essential to ensure the provision of care with quality, and safety, to the patient subjected to ECMO.
- O conforto da pessoa idosa: projeto de vivência e cuidado co-criadoPublication . Sousa, Patrícia PontíficeA autora faz o retrato científico do contributo da enfermagem na promoção do conforto no período em que a idade nos torna mais vulneráveis às agressões do mundo. Texto indispensável para os cuidadores de quem tem as defesas diminuídas. Alexandre Castro Caldas, Médico, Professor Catedrático e Diretor do Instituto de Ciências da Saúde da UCP. Confortar carrega no seu significado a preocupação com a dignidade humana e a intenção de preservar a qualidade de vida, qualquer que seja a condição ou a doença da pessoa cuidada. Esta obra é uma referência imprescindível em qualquer estudo sobre a assistência a pessoas idosas. Margarida Vieira, Coordenadora da área de Enfermagem na UCP Vivemos a promoção cada vez maior do consumo pessoal. Poder aceder a uma obra onde se escreve e fala do conforto das pessoas maiores, constitui-se uma oportunidade excelente para saber e aprender mais enfermagem.
- Checklist for a safe intra-hospital transport of critically ill patients: a scoping reviewPublication . Canellas, Madalena; Palma, Isabel; Pontífice-Sousa, Patrícia; Rabiais, IsabelTransporting critically ill patients is has a set of risks that may jeopardize their safety. Knowing the risks associated with intrahospitalar transport of critically ill patients is essential to improving patient safety. For the sake of improving patient safety, was chosen to approach it as an intrahospitalar transport checklist, as the literature describes it as a practical and simple way to increase safety. Objective: Map available scientific evidence regarding aspects of a checklist that ensure the safety of critically ill patients in intrahospitalar transport. Material and Method: A scoping review was performed following the methodology proposed by The Joanna Briggs Institute in databases using the EBSCOhost and B-on search engines. Conducted research in Portuguese, English, and Spanish. Selected free full text articles, with no time limit. Inclusion criteria: adult/elderly critically ill patient, intrahospital transport, a checklist and patient safety. Results: Included 7 articles for analysis. Most verification requests that ensure the safety of critical patients on intrahospitalar transport concern the transport preparation phase, in which patient is monitored was the most mentioned aspect. From the post-transportation phase, checklist aspects are only available in 3 of 7 articles Conclusion: All studies address aspects that improve the safety of critically ill patients in intrahospitalar transport and are likely to be included in the checklist. There is no unanimity as to which aspects to include in the checklist.
- Burnout assessment in nurses from a general emergency servicePublication . Nobre, Daniela Filipa Rocha; Rabiais, Isabel Cristina Mascarenhas; Ribeiro, Patrícia Cruz Pontífice Sousa Valente; Seabra, Paulo Rosário CarvalhoOBJECTIVE: To assess the level of Burnout among nurses in a general emergency department. METHOD: Quantitative, descriptive, correlational and cross-sectional study. 32 nurses from a general adult emergency department answered a questionnaire to evaluate Burnout. (Copenhagen Burnout Inventory). RESULT: It was verified that 59.4% of the nurses presented total Burnout. Work-related burnout was the subscale with the highest average score. It was found that the lower the age and the longer the time working in the institution, the higher the level of Burnout. Longer professional experience was related to lower levels of Burnout. There were also higher scores of Burnout among participants who thought about changing their profession, their institution or their service. CONCLUSION: The prevalence of Burnout is high. Professional Burnout was the most critical subscale. Age and the current work are the subscales that most influence perceived Burnout.
- O conforto do doente idoso crónico em contexto hospitalar: contributos para uma revisão sistemática da literaturaPublication . Ribeiro, Patrícia Cruz Pontífice Sousa Valente; Costa, Arminda Arminda MendesEste artigo constitui o relatório de um estudo com contributos para uma revisão sistemática da literatura (RS), centrado na temática do conforto na prática de cuidados de enfermagem ao doente idoso crónico hospitalizado. Diretamente relacionado com o fenómeno de conforto do doente idoso crónico hospitalizado, não se encontrou qualquer trabalho em contexto nacional, verificando-se a existência de poucos trabalhos de investigação em contexto internacional, em amostras de doentes ou prestadores de cuidados/enfermeiros que procuram perceber as perspetivas/vivências dos diferentes atores. O objetivo é determinar a melhor evidência disponível relativamente ao processo de conforto – estrutura, construção e resposta do conforto - do doente idoso crónico hospitalizado – incluindo como participantes doentes idosos e enfermeiros/prestadores de cuidados, divulgando assim aspetos fundamentais da literatura. Na condução desta RS foi utilizada a metodologia PI[C]OD e a técnica de análise e integração de dados por metasumário. Foram identificados apenas quatro estudos, cujos achados foram analisados e sintetizados. Embora os achados revelem algumas pistas, não são suficientemente conclusivos e específicos para dar resposta à questão central do estudo. Recomenda-se o desenvolvimento de investigação que possibilite a compreensão da natureza do processo de conforto do doente idoso com vivência de uma situação crónica num contexto situacional de hospitalização.