Bakgrund: Över hela världen råder det brist på organ. 1 januari 2019 stod 807 personer på väntelistan för att få ett nytt organ i Sverige. Efterfrågan på organ är större än tillgången. Efterfrågan skulle kunna tillmötesgå bättre om DCD (eng. Donation after Circulatory Death) kan implementeras som ett komplement till DBD (eng. Donation after Brain Death). Det har pågått ett pilotprojekt på sex olika sjukhus i Sverige.Måletmed projektet var att utreda om DCD i framtiden kan vara ett komplement till den idag etablerade donationsprocessen DBD vilket leder till att sjukvården kan möta allmänhetens donationsvilja samt öka antalet organ för transplantation. Då DCD inte är nationellt implementerat och genom att intensivvårdssjuksköterskor har ansvaret för att vårda potentiella organdonatorer är det viktigt med forskning som belyser intensivvårdssjuksköterskorsresonemang och föreställningar kring DCD.Syfte:Syftet var att beskriva intensivvårdssjuksköterskors resonemang och föreställningar om donation vid kontrollerad DCD.Metod:Kvalitativ intervjustudie med ändamålsenligt urval genomfördes. Data analyserades med kvalitativ innehållsanalys.Resultat:Analysen resulterade i fyra kategorier; Att påbörja något nytt inom området donation, Att erhålla kunskap minskar farhågor och oro, Att införa donation efter cirkulationsstillestånd ger möjlighet att möta en hög donationsvilja och att informera och ge tröst till anhöriga.Slutsats: Denna studie visar att engagemanget är stort hos intensivvårdssjuksköterskor och att tilltron tillett införande av DCD är hög. Genom att införa DCD som ett komplement till DBD så skulle fler donationer kunna genomföras och på sikt kunna matcha efterfrågan på organ. Mer forskning samt utbildning behövs för att öka kunskapen utifrån de krav som kommer att ställas på intensivvårdssjuksköterskor vid en eventuell implementering av DCD.

Made available in DSpace on 2016-04-04T18:28:07Z (GMT). No. of bitstreams: 1 CLEBER JOSE ALO DE MORAES.pdf: 2634763 bytes, checksum: 00f21e97451a3045afdec187b0e4421e (MD5) Previous issue date: 2012-12-18 / A professional nurse who works in an Intensive Care Unit (ICU) is daily confronted with the truth of death. Such process is usually followed by ambivalent feelings which, once overlooked or denied by the team itself, results in damages regarding the comforting of the patient s suffering, bringing on to the professional a psychical suffering. This study aims to investigate the imaginative expressions of an ICU nursing team who looks after adult patients, in search of the fields of affective-emotional meaning that sustain their imaginative constructions in the face of impending death. We have adopted the psychoanalytic methodology, which permeate our journey from the moment of an interactive narrative elaboration, to be presented as a dialogic procedure that entails an imaginative creation of the participants of this research, pervading the interviews that followed the interactive narratives, until the analysis of the obtained material. The interactive narratives and the transferencial narratives, both considered record documents that compile this study, unveil, among other findings, the field we have called Death Inevitability, being this one compound by three subfields: impotence, indifference and the assimilated absence. All three subfields are inextricably interwoven, sometimes appearing simultaneously in several narratives. The subfield of impotence is characterized by feelings and beliefs of defeat or failure, whenever the nursing team faces death without being able to subdue it. The subfield of indifference expresses itself predominantly through intellectualized reactions, where the emotional detachment and the rationalization predominate as defenses against the impact of death. On the other hand, the subfield called assimilated absence reveals the possibility of integration between the relative or limited power to the available resources and the experience of pain of the separation, which results in the iv acceptance of death as part of living. The emotional range that is woven by the participants through narratives reveals a fertile field of research on professional suffering, aging processes, palliative care, as well as psicossocial studies about the contemporary way of dealing with death and dying. / O profissional de enfermagem que trabalha no ambiente de UTI ? diariamente confrontado com a realidade da morte. Tal processo ? usualmente acompanhado de sentimentos ambivalentes que, ao serem menosprezados ou negados pela pr?pria equipe, trazem preju?zos no que se refere ao acolhimento do sofrimento do paciente, ocasionando o sofrimento ps?quico do profissional. Este estudo tem por objetivo investigar as produ??es imaginativas de uma equipe de enfermagem de Unidade de Terapia Intensiva que cuida de pacientes adultos, em busca dos campos de sentido afetivo-emocional que sustentam suas constru??es imaginativas diante da imin?ncia da morte. Adotamos o m?todo psicanal?tico, que permeia nosso percurso desde a elabora??o de uma narrativa interativa, a ser apresentada como procedimento dial?gico que enseja a cria??o imaginativa dos participantes desta pesquisa, perpassando as entrevistas que se seguiram ?s narrativas interativas, at? a an?lise interpretativa do material obtido. As narrativas interativas e as narrativas transferenciais, como os dois documentos de registro que comp?em este estudo, desvelam, entre outros achados, o campo de sentido o qual denominamos Inevitabilidade da Morte, sendo este composto por tr?s subcampos: a impot?ncia, a indiferen?a e a aus?ncia assimilada. Os tr?s subcampos se encontram intimamente imbricados, por vezes surgindo ao mesmo tempo nas diversas narrativas. O subcampo da impot?ncia ? caracterizado por sentimentos e cren?as ligadas ao sentimento de derrota ou fracasso da equipe de enfermagem ao enfrentar a morte sem conseguir subjug?-la. O subcampo da indiferen?a se expressa por rea??es predominantemente intelectualizadas, onde o distanciamento emocional e a racionaliza??o predominam como defesa contra o impacto emocional da morte. No subcampo chamado de aus?ncia assimilada, encontramos a integra??o ii entre a pot?ncia relativa ou limitada aos recursos dispon?veis e a viv?ncia da dor da separa??o, o que vem resultar na aceita??o da morte como parte integrante do viver. A gama emocional tecida em narrativas pelos participantes revela um campo f?rtil para a pesquisa do sofrimento profissional, dos processos de envelhecimento, dos cuidados paliativos, al?m de estudos psicossociais sobre o modo contempor?neo de lidar com a morte.

Submitted by Angela Maria de Oliveira (amolivei@uepg.br) on 2019-02-13T17:33:05Z No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Maikel Ramthun.pdf: 1228392 bytes, checksum: f2766da3a0032aa0187defd3c0998a15 (MD5) / Made available in DSpace on 2019-02-13T17:33:05Z (GMT). No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Maikel Ramthun.pdf: 1228392 bytes, checksum: f2766da3a0032aa0187defd3c0998a15 (MD5) Previous issue date: 2018-07-31 / O objetivo deste estudo foi descrever as características clínicas, laboratoriais, sociais e intervenções terapêuticas em doentes que foram submetidos a hemodiálise em duas unidades de terapia intensiva de um hospital terciário da região dos Campos Gerais no período de 01 de janeiro de 2014 a 01 de janeiro de 2016, para tentar encontrar associações entre essas características e a mortalidade. Também teve como objetivo identificar fatores de risco que pudessem ser modificados através de uma abordagem interdisciplinar da equipe de saúde. Foram avaliadas cinquenta variáveis. As variáveis quantitativas foram analisadas em média e desvio padrão e foram comparadas através do teste t de Student. As variáveis qualitativas foram apresentadas em valores absolutos e porcentagem e foram comparadas através do teste de Fisher. Os seguintes achados tiveram uma associação positiva para mortalidade: presença de ventilação mecânica, níveis mais elevados de potássio sérico, níveis mais baixos de creatinina no momento do internamento, uso de ranitidina para profilaxia de úlcera péptica, ausência de diurese e a necessidade do uso de noradrenalina. Estudos prospectivos com uma abordagem interdisciplinar na tentativa de minimizar os possíveis fatores de risco associados à maior mortalidade nesses pacientes são necessários. / This article aims to describe the clinical, laboratorial and social characteristics as well as therapeutical interventions in patients under hemodialysis and it’s association with mortality. This study was performed at two Intensive Care Units of Campos Gerais Tertiary Hospital from January first 2014 to January first 2016. This study also sought to analyze modifiable risk factors through a health care interdisciplinary approach. Fifty variables were analyzed. Quantitative variables were calculated with median and standart deviation and compared through Student t test. Fisher test was performed with the qualitative variables as well as comparison in absolute numbers and percentage. Mortality had positive association with Mechanical ventilation system, high blood levels of potassium, lower levels of creatinine at the admission time, use of ranitidine, the absence of diuresis and use of noradrenalin. Prospective studies with an interdisciplinary outreach will be required to try to minimize feasible risk factors associated with mortality.

No description available.

Deconditioning occurs in critically ill patients as early as 4 days after entering the intensive care unit (ICU) resulting in a loss of up to 25% peripheral muscle tone and 18% body weight by the time the patient is discharged. Early mobility (EM) has been shown to reduce complications such as neuromuscular weakness, muscle wasting, pneumonia, and the effects of prolonged periods of time on the ventilator. No formal education on EM had been provided to nurses at the clinical site. The purpose of this project was to develop an educational program on EM to promote early ambulation of critically ill ICU patients. The theory of knowledge to action was used to guide the development of the educational program. The practice-focused question addressed whether an educational program would improve nurses' perceptions of their knowledge of EM and if they would promote the use of EM among ICU patients. After a literature review to identify evidence-based practices and a protocol on EM, an educational program was developed that included a 25-item Likert-style pretest and posttest to measure percent agreement with perceptions of knowledge gained and likelihood of behavior change related to the practice of EM. Participants included 60 ICU nurses. Results demonstrated improvement in perceptions of knowledge of EM (from 74% before education to 88% after) and in likelihood of behavior change related to EM (from 69% before education to 91% after). Findings may be used to integrate EM into the ICU setting to reduce complications such as neuromuscular weakness, muscle wasting, and pneumonia. Results may also include improved patient outcomes, reduced length of stay, and increased quality of life for patients and their families, and thereby promote positive social change.

Total quality management (TQM) approach is often used to carry out company-wide continuous quality improvement plans in manufacturing and service industries. Similarly, TQM can also play a critical role for quality management in health care. Aiming to improve health care quality, experiences showed that major problems of non-patient care, patient records and vital signs monitoring are encountered. In this study, we aim to introduce TQM for quality improvement for intensive care unit (ICU) operations, including some solutions and the prototype of quality management. And vital signs monitoring at ICU is taken as an example of process. For quality improvement of non-patient care, Health Care Quality Development Life Cycle, including (1) quality requirement analysis, (2) quality specification review, (3) quality design, (4) quality implementation, (5) quality testing, (6) quality maintaining, and (7) quality validation, is discussed. The prototype of the first three phases for quality improvement at ICU is explored. Through quality requirement analysis, non-patient care quality at ICU is defined in areas of administration, facility and environment. For quality improvement of patient records maintaining, firstly, scope of health care information systems is categorized as administrative operational system, decision support system, clinical information system, and medical information system. According to this categorization and experience, some interesting result is found. For instance, the current applications of information systems for teaching hospitals in southern Taiwan surveyed are that most applications are administrative and clinical. And the essential information of patient records used in each information system is not complete or not easily accessed. Model of the patient record maintaining is introduced and the prototype design of patient records is recommended for quality improvement of patient records maintaining at ICU. To improve quality of vital signs monitoring is one essential requirement and specification for ICU quality improvement. Effective outcome measures of vital signs monitoring and early detecting of abnormal vital signs is considered important. For quality improvement of vital signs monitoring at ICU, heart rate graphs are taken as examples in our study through the heart rate graphs monitoring. Health professionals can understand the interactions of human autonomic nervous system. By use of digitizer, the computable heart rate data is acquired from each graph and grouped into mortality and near-to-normal cases. Then spectrum form of heart rate data, describing more about heart function, is used for statistical analysis. Several control chart methods have been experimented to detect small heart rate shifts from target, cumulative sum control chart (Cusum) is adopted in our study. The observable variable is the patient¡¦s heart rate, the purpose is to check the alarms pointed out by Cusum that could be partially be ascribed to changes of heart rate trend over time, and to a shift in the monitoring process mean. From summaries of nonconformities in the Cusum charts, mortality cases obviously have more nonconformities. It is obvious that Cusum control charts of mortality cases provide diagnostic information for vital signs monitoring process. In addition, Cusum charts may also inform ICU professionals that there is a small shift of patient heart rate, a continuously increasing or decreasing heart rate, and the adjustment of sympathetic nerve and parasympathetic nerve. In those cases, some special care is needed.

Made available in DSpace on 2016-06-02T20:44:15Z (GMT). No. of bitstreams: 1 5849.pdf: 1061693 bytes, checksum: 88926ff22d4e1191409542e3b320cf8c (MD5) Previous issue date: 2014-02-25 / Financiadora de Estudos e Projetos / The Neonatal ICUs are designed for newborns at high risk, as in the case of premature infants.The environment in the NICU is a protective factor for life, but may prove to be inappropriate for the neurological development of preterm, specifically in relation to visual aspects. The aim of this study was to develop and propose a protocol for evaluating the context of the NICU, as a checklist to identify the risk and protective factors visual development of premature infants. Moreover , had the following specific objectives : Map and describe the national and international scientific literature on the Neonatal Intensive Care Units in respect of related visual development of premature variables ; Identify the risk factors and protection to the visual development of premature newborns present in neonatal intensive care units , expressed in the literature. The methodology was based on bibliometric analysis of papers retrieved on the basis of national and international data: VHL, ScienceDirect and Scopus. Bibliometric indicators analyzed under the classification into two categories were produced: Category 1 - Primary Issue (TP) and Category 2 - Issue Secondary (TS). Since the focus of this study lies in the studies classified into Primary Issue , were analyzed and categorized into the following themes : " Retinopathy of Prematurity Risk Factors , Incidence, Prevalence , Screening and Prevention " , " Retinopathy of Prematurity Treatment " , " Normal Development " , " Retinopathy of Prematurity Instrument " , " Environment and Retinopathy of Prematurity " Retinopathy of Prematurity Theory " . These studies the risk factors and protection to the visual development of preterm infants were identified. These factors allowed the construction of check list (initially with partial version and then the final version ). As most of the studies ( 97.7 % ) address on the Retinopathy of Prematurity (ROP) , the instrument will help identify risk and protective for the development of ROP in premature infants in the NICU context factors . It is intended in the future instruments available to professionals in neonatal ICUs, thereby preventing ROP in premature and thereby reduce the incidence and progression of disease. / As UTIs Neonatais são destinadas aos recém-nascidos de alto risco, como no caso dos prematuros. O ambiente na UTI Neonatal é um fator de proteção à vida, mas pode vir a ser inapropriado para o desenvolvimento neuropsicomotor do prematuro, especificamente em relação aos aspectos visuais. O objetivo geral deste trabalho foi elaborar e propor um protocolo de avaliação do contexto da UTI Neonatal, na forma de um check list, para identificação de fatores de risco e proteção ao desenvolvimento visual dos prematuros. Além disso, teve como objetivos específicos: Mapear e descrever a produção científica nacional e internacional sobre as Unidades de Terapia Intensivas Neonatais em relação às variáveis relacionadas ao desenvolvimento visual dos prematuros; Identificar os fatores de risco e proteção ao desenvolvimento visual de recém-nascidos prematuros presentes em unidades de terapia intensivas neonatais, expressos na literatura. A metodologia utilizada foi a análise bibliométrica dos trabalhos recuperados nas bases de dados nacionais e internacionais: BVS, ScienceDirect e Scopus. Foram produzidos indicadores bibliométricos analisados sob a classificação em duas categorias: Categoria 1- Temáticas Primárias (TP) e Categoria 2- Temáticas Secundárias (TS). Como o foco deste estudo recai nos estudos classificados em Temáticas Primárias, foram analisados e categorizados nos seguintes temas: Retinopatia da Prematuridade Fatores de Risco, Incidência, Prevalência, Triagem e Prevenção , Retinopatia da Prematuridade Tratamento , Desenvolvimento Normal , Retinopatia da Prematuridade Instrumento , Retinopatia da Prematuridade Ambiente e Retinopatia da Prematuridade Teoria . Foram identificados nestes estudos os fatores de risco e proteção ao desenvolvimento visual dos prematuros. Estes fatores permitiram a construção do check list (inicialmente com a versão parcial e depois a versão final). Como a maioria dos estudos (97,7%) abordam sobre a Retinopatia da Prematuridade (ROP), o instrumento irá auxiliar na identificação dos fatores de risco e proteção ao desenvolvimento da ROP nos prematuros no contexto da UTI Neonatal. Pretende-se no futuro disponibilizar o instrumento aos profissionais que atuam em UTIs Neonatais, para assim prevenir a ROP em prematuros e com isso diminuir a incidência e progressão da doença.

Made available in DSpace on 2014-12-17T14:46:38Z (GMT). No. of bitstreams: 1 MaisaAS.pdf: 2002111 bytes, checksum: 3639909687907c825b2fac2980223c4c (MD5) Previous issue date: 2008-12-23 / Prospective descriptive study with quantitative approach, which aimed to analyze the relationship of the knowledge of Nurses and conduct assistance during the process of transfusion, to patients in the ICU of a university hospital in Natal-RN. The sample consisted of 27 professionals from the nursing staff (5 nurses and 22 nursing technicians), climbing in the ICU during the period of data collection. Data collection was through a questionnaire and structured form of observation, in addition to consulting the diary. The results were organized in SPSS 15.0, tabulated, cathegorized and analyzed by descriptive and inferential statistics. The results show a young population, aged between 21 and 32 years (63.0%), female (85.2%). Among those surveyed were the main type of stock, mostly technical, nursing (ρ= 0006), which have little time to experience - up to 2 years (ρ= 0008), did not know the DRC in 153 (ρ= 0019), held greater number of pipelines care in blood (ρ= 0018), the non-participation in training and feel informed about the process of transfusion, showed no significant differences. As for officials, highlighted only the time to experience more than 2 years, carrying out fewer procedures and feel informed about the blood. As for the pipes during the transfusion process, I found that the majority of pipes observed in both the stock and the staff were inadequate, with predominance in the first, both in the pursuit of conduct regarding the shortfall. The averages of inappropriate conduct, predominantly developed by stock, were higher in all stages for appropriate conduct. Analyzing the knowledge about the disease process, the stock market were those who had lower scores of knowledge in three stages. As the relationship between the pipes care and knowledge, we see that at all stages of the process of transfusion inadequate knowledge of the averages were higher, taking a significant difference in the stages pre-transfusion (ρ= 0012). When analyzing the average of pipes behind, we see that in inappropriate conduct were significantly higher (ρ= 0031), who had searched in inadequate knowledge. As for the frequency of total procedures performed, we found a significant predominance (ρ= 0049) of inappropriate conduct (88.9%) of which 81.5% were developed by professionals who had inadequate knowledge, showing moderate correlation (r = 0,516) and odds ratio of 2,750 times the development of inappropriate conduct in trade with inadequate knowledge. We conclude that the professionals surveyed, especially the technicians of nursing stock, showed serious deficiencies with regard to the development of pipelines and knowledge of the transfusion process, showing the inadequacy to develop this therapy. Facing the foregoing, we accept the alternative hypothesis proposed in the study, because we show that the inadequacy of knowledge about the process of transfusion influence in inappropriate conduct implemented by the nursing staff in ICU. / Estudo descritivo prospectivo, com abordagem quantitativa, que objetivou analisar a rela??o entre o conhecimento dos profissionais de enfermagem e as condutas assistenciais prestadas, durante o processo transfusional, aos pacientes na UTI de um hospital universit?rio em Natal-RN. A amostra foi composta por 27 profissionais da equipe de enfermagem (5 enfermeiros e 22 t?cnicos de enfermagem), escalados para a UTI durante o per?odo da coleta de dados, coleta esta realizada por meio de question?rio e formul?rio de observa??o estruturados, al?m da consulta ao prontu?rio. Esses resultados foram organizados no programa SPSS 15.0, tabulados, categorizados e analisados por meio de estat?stica descritiva e inferencial. Os resultados mostram uma popula??o jovem, na faixa et?ria entre 21 e 32 anos (63,0%), do sexo feminino (85,2%). Dentre os pesquisados houve predomin?ncia de bolsistas, em sua maioria t?cnicos de enfermagem (ρ= 0,006), os quais possuem pouco tempo de experi?ncia, at? 2 anos (ρ= 0,008), n?o conhecem a RDC no 153 (ρ= 0,019), realizaram o maior n?mero de condutas assistenciais na hemotransfus?o (ρ= 0,018), a n?o participa??o de treinamentos e a falta de informa??o sobre o processo transfusional n?o resultaram em diferen?as significativas. Quanto aos funcion?rios, destacaram-se apenas o tempo de experi?ncia superior a 2 anos, a realiza??o de menor n?mero de procedimentos e se sentirem informados sobre a hemotransfus?o. Em rela??o ?s condutas durante o processo transfusional, constatamos que, na maioria, as condutas observadas, tanto dos bolsistas como dos funcion?rios foram inadequados, com predomin?ncia nos primeiros, tanto na realiza??o das condutas quanto na inadequa??o. As m?dias das condutas inadequadas, predominantemente desenvolvidas pelos bolsistas, foram maiores em todas as etapas em rela??o ?s condutas adequadas. Analisando o conhecimento sobre o processo transfusional, os bolsistas foram os que apresentaram os menores escores de conhecimento nas tr?s etapas. Quanto ? rela??o existente entre as condutas assistenciais e o conhecimento, verificamos que em todas as etapas do processo transfusional as m?dias de conhecimentos inadequados foram superiores, tendo diferen?a significativa nas etapas pr?-transfusional (ρ= 0,012). Ao analisarmos a m?dia de condutas desenvolvidas, verificamos que nas condutas inadequadas foram significativamente maiores (ρ= 0,031) nos pesquisados que apresentaram conhecimentos inadequados. Quanto ? frequ?ncia total de procedimentos realizados, verificamos uma predomin?ncia significativa (ρ= 0,049) de condutas inadequadas (88,9%), das quais 81,5% foram desenvolvidas por profissionais que tiveram conhecimento inadequado, apresentando moderada correla??o (r = 0,516) e raz?o de chance de 2,750 vezes de desenvolvimento de condutas inadequadas nos profissionais com conhecimentos inadequados. Conclu?mos que os profissionais pesquisados, principalmente os t?cnicos de enfermagem bolsistas, apresentaram defici?ncias graves no tocante ao desenvolvimento das condutas e conhecimento sobre o processo transfusional, denotando a inadequa??o para desenvolver essa terap?utica. Diante do exposto, aceitamos a hip?tese alternativa proposta no estudo, pois evidenciamos que a adequa??o do conhecimento sobre o processo transfusional influenciou nas condutas adequadas implementadas pela equipe de enfermagem na UTI.

Made available in DSpace on 2014-12-17T14:46:39Z (GMT). No. of bitstreams: 1 ParticiaCBF_DISSERT.pdf: 926078 bytes, checksum: 9ea88765b5e731681c2629ed4e7288ec (MD5) Previous issue date: 2009-09-29 / A descriptive, quantitative approach and non-participant observation study, which was aimed at analyzing the association between knowledge and practice of inclusion and maintenance of urinary catheter by nursing professionals in the occurrence of urinary tract infection, performed in the ICU of Onofre Lopes University Hospital in Natal / RN. The original sample was composed of 42 nursing staff professional, five (5) nurses and 37 nursing technicians, 27 of them were outsourced (FUNPEC and IEL fellows) and 10 servers UFRN. Data collection was performed using two instruments, the first observation procedures used in the insertion and manipulation of indwelling urinary catheter (IUC) and the second with a questionnaire that addressed the characterization data of respondents, knowledge and conduct the insertion and manipulation of the IUC. The results were tabulated in Microsoft Excel and analyzed using SPSS software, version 15.0. We found the prevalence of institutional staff members on outsourcing - IEL and FUNPEC - (64.3%) were female (69.0%), aged 21 to 35 years (59.5%) and with mid-level education (88.1%). As to knowledge, we found that the nurses had levels of good to excellent and the nursing technicians, to regulate the poor. The nurses made a mistake when choosing IUC (40.0%) and washing hands (30.0%) and technicians on hand washing (74.4%) and the contents of the tray (34.7%). In relation to the conduct of insertion of IUC, the nurses made a mistake when choosing SVD (66.7%) and washing hands (57.1%). Regarding the handling of IUC/drainage system, the technicians were wrong more about washing their hands (56.0%). Analyzing the misconduct to the categorization of knowledge, we saw that the nursing staff who had missed more had inadequate knowledge (ρ = 0.001). At the end we found the risk of a patient to acquire UTI is higher in two and a half times when there is a large number of mismatches, patient spends more time using the IUC and hospitalized in the ICU. As regards the study hypotheses, we accept the alternative hypothesis and reject the null hypothesis proposed at the start of this research, where the number of gaps in knowledge and behavior increases the incidence of urinary tract infection. / Estudo descritivo, de abordagem quantitativa e observacional n?o participante, que teve como objetivo geral analisar a associa??o do conhecimento e conduta de inser??o e manuten??o da sonda vesical de demora pelos profissionais de enfermagem na ocorr?ncia de infec??o do trato urin?rio, realizado na UTI do Hospital Universit?rio Onofre Lopes em Natal/RN. A amostra pesquisada foi composta por 42 profissionais da equipe de enfermagem, sendo cinco (5) enfermeiros e 37 t?cnicos de enfermagem, deles 27 eram terceirizados (FUNPEC e bolsistas do IEL) e 10 servidores da UFRN. A coleta de dados foi realizada atrav?s de dois instrumentos, o primeiro utilizado na observa??o procedimentos de inser??o e de manipula??o da Sonda Vesical de Demora (SVD) e o segundo, com a aplica??o de um question?rio que abordou dados de caracteriza??o dos pesquisados, conhecimentos e conduta na inser??o e manipula??o da SVD. Os resultados foram tabulados no Excel e analisados atrav?s do programa estat?stico SPSS, vers?o 15.0. Encontramos a predomin?ncia de funcion?rios com v?nculo institucional terceirizado IEL e FUNPEC - (64,3%), do sexo feminino (69,0%), na faixa et?ria de 21 a 35 anos (59,5%) e com n?vel m?dio de escolaridade (88,1%). Quanto aos conhecimentos, verificamos que os enfermeiros apresentaram n?vel de bom a ?timo e os t?cnicos de enfermagem, de regular a ruim. Os enfermeiros erraram mais na escolha da SVD (40,0%) e na lavagem das m?os (30,0%) e os t?cnicos, na lavagem das m?os (74,4%) e no conte?do da bandeja (34,7%). Em rela??o ?s condutas de inser??o da SVD, os enfermeiros erraram mais na escolha da SVD (66,7%) e na lavagem das m?os (57,1%). Em rela??o ? manipula??o da SVD/sistema de drenagem, os t?cnicos erraram mais ao lavar as m?os (56,0%). Ao analisarmos as condutas inadequadas com a categoriza??o do conhecimento, vimos que os t?cnicos de enfermagem que erraram mais apresentaram conhecimentos inadequados (ρ = 0,001). Ao final, vimos que o risco de um paciente adquirir ITU est? maior em duas vezes e meia quando ocorre um n?mero grande de inadequa??es, paciente passa mais tempo usando a SVD e internado na UTI. Quanto ?s hip?teses do estudo, aceitamos a Hip?tese alternativa e rejeitamos a hip?tese nula proposta no in?cio desta pesquisa, onde a quantidade de inadequa??es no conhecimento e conduta aumenta a ocorr?ncia de infec??o do trato urin?rio.

Recent advancements in Artificial Intelligence has prompted a shearexplosion of new research initiatives and applications, improving notonly existing technologies, but also opening up opportunities for newand exiting applications. This thesis explores the MIMIC-III intensive care unit database and conducts experiment on an interpretable feature space based on sever-ty scores, defining a patient health state, commonly used to predict mortality in an ICU setting. Patient health state trajectories are clustered and correlated with administered medication and performed procedures to get a better understanding of the potential usefulness in evaluating treatments on their effect on said health state, where commonalities and deviations in treatment can be understood. Furthermore, medication and procedure classification is carried out to explore their predictability using the severity subscore feature space.