<p>Standardvårdplaner är vanligt förekommande inom hälso- och sjukvård och är under ständig utveckling. Standardvårdplaner är i olika grad evidensbaserade och framtagna med skiftande kvalitet. Standardvårdplaner används som ett hjälpmedel för effektivisering och kvalitetshöjning av vården för en specifik patientgrupp och är en på förhand formulerad vårdplan. Behov av ytterligare forskning efterfrågas om standardvårdplaner faktiskt minskar mängden dubbeldokumentation, leder till ökad tidsvinst och ökad vårdkvalitet. Syftet med föreliggande litteraturstudie var att göra en beskrivning av de effekter som användande av standardvårdplaner leder till. I litteraturstudien bearbetades 10 vetenskapliga artiklar som grund för resultatredovisningen. Resultatet visar att standardvårdplaner kan höja vårdkvaliteten, minska mängden dubbeldokumentation och leda till att tid frigörs till patientnära arbete. Det finns emellertid studier som visar på det motsatta. Standardvårdplanen kan ses som ett verktyg som underlättar en jämlik, högkvalitativ vård till alla patienter oavsett vem som vårdar. Utveckling av standardvårdplaner i vården bör ske på ett strukturerat och vetenskapligt sätt och tid till detta bör prioriteras. Litteraturstudien redovisar motstridiga resultat vilket indikerar behovet av fortsatt forskning av vilka effekter standardvårdplaner har för vården, både sett ur patientperspektiv, personalperspektiv samt ur ett organisatoriskt perspektiv.</p> / <p>Standardized care plans are commonly used in health care and are under constant development. Standardized care plans are to varying degrees evidence-based and designed with varying quality. Standardized care plans are used as a tool for improving the quality of care and are seen as a pre-formulated treatment plan. Research is needed into whether standardized care plans reduce the amount of redundant documentation, save time and increase quality of care. The aim of this literature study was to describe the situation regarding effects of using standardized care plans. In this study 10 scientific articles were analyzed. Results show that standardized care plans can improve quality of care, reduce redundant documentation and decrease time spent on documentation. However, there are studies that demonstrate the opposite.<strong> </strong>Standardized care plans can be seen as a tool for providing high-quality basic care for all patients. Scientific evidence should be used for development of standardized care plans and therefore priority should be given to making resources for this work available. There is a need for further research to validate the effects of standardized care plans as the results from this literature study are ambiguous. It would also be interesting to compare the views from patients, staff and management on the effects of using standardized care plans.</p>

Standardvårdplaner är vanligt förekommande inom hälso- och sjukvård och är under ständig utveckling. Standardvårdplaner är i olika grad evidensbaserade och framtagna med skiftande kvalitet. Standardvårdplaner används som ett hjälpmedel för effektivisering och kvalitetshöjning av vården för en specifik patientgrupp och är en på förhand formulerad vårdplan. Behov av ytterligare forskning efterfrågas om standardvårdplaner faktiskt minskar mängden dubbeldokumentation, leder till ökad tidsvinst och ökad vårdkvalitet. Syftet med föreliggande litteraturstudie var att göra en beskrivning av de effekter som användande av standardvårdplaner leder till. I litteraturstudien bearbetades 10 vetenskapliga artiklar som grund för resultatredovisningen. Resultatet visar att standardvårdplaner kan höja vårdkvaliteten, minska mängden dubbeldokumentation och leda till att tid frigörs till patientnära arbete. Det finns emellertid studier som visar på det motsatta. Standardvårdplanen kan ses som ett verktyg som underlättar en jämlik, högkvalitativ vård till alla patienter oavsett vem som vårdar. Utveckling av standardvårdplaner i vården bör ske på ett strukturerat och vetenskapligt sätt och tid till detta bör prioriteras. Litteraturstudien redovisar motstridiga resultat vilket indikerar behovet av fortsatt forskning av vilka effekter standardvårdplaner har för vården, både sett ur patientperspektiv, personalperspektiv samt ur ett organisatoriskt perspektiv. / Standardized care plans are commonly used in health care and are under constant development. Standardized care plans are to varying degrees evidence-based and designed with varying quality. Standardized care plans are used as a tool for improving the quality of care and are seen as a pre-formulated treatment plan. Research is needed into whether standardized care plans reduce the amount of redundant documentation, save time and increase quality of care. The aim of this literature study was to describe the situation regarding effects of using standardized care plans. In this study 10 scientific articles were analyzed. Results show that standardized care plans can improve quality of care, reduce redundant documentation and decrease time spent on documentation. However, there are studies that demonstrate the opposite. Standardized care plans can be seen as a tool for providing high-quality basic care for all patients. Scientific evidence should be used for development of standardized care plans and therefore priority should be given to making resources for this work available. There is a need for further research to validate the effects of standardized care plans as the results from this literature study are ambiguous. It would also be interesting to compare the views from patients, staff and management on the effects of using standardized care plans.

Project (B.S.)--James Madison University, 2009. / Includes bibliographical references.

Submitted by Fabiana Gonçalves Pinto (benf@ndc.uff.br) on 2017-02-23T17:18:30Z No. of bitstreams: 1 Magali Rezende de Carvalho.pdf: 3727493 bytes, checksum: cd7ca0e5fa89bc698cb1c0a9fe619926 (MD5) / Made available in DSpace on 2017-02-23T17:18:30Z (GMT). No. of bitstreams: 1 Magali Rezende de Carvalho.pdf: 3727493 bytes, checksum: cd7ca0e5fa89bc698cb1c0a9fe619926 (MD5) Previous issue date: 2016 / Mestrado Acadêmico em Ciências do Cuidado em Saúde / Contextualização: Os fatores de crescimento atuam no reparo tecidual emitindo sinais modulatórios estimulando ou inibindo os processos celulares. Objetivo: Analisar a eficácia dos fatores de crescimento no processo cicatricial de úlceras venosas através da busca de evidência na literatura científica. Método: Revisão sistemática segundo as recomendações da Colaboração Cochrane. Critérios de inclusão: Ensaios clínicos randomizados sobre o uso dos fatores de crescimento no tratamento de úlceras venosas; abordando o número total de úlceras cicatrizadas, redução da área e/ou tempo de cicatrização. Exclusão: estudos em andamento, protocolos de pesquisa; artigos que associam fatores de crescimento ao enxerto de pele e estudos que incluíram úlceras de múltiplas etiologias sem análise por subgrupo. Bases de dados consultadas: Ovid MEDLINE(R); Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations; Ovid MEDLINE(R) Epub Ahead of Print; EMBASE; CINAHL Plus with Full Text, Cochrane CENTRAL, LILACS e Web of Science. Também foram consultados a Biblioteca Digital Brasileira de Teses e Dissertações e Google Acadêmico, além da busca manual através da lista de referências dos estudos incluídos. Não houve restrição temporal ou de idioma. A análise estatística foi realizada através do programa Review Manager 5.3 (Colaboração Cochrane). Para variáveis dicotômicas, foram calculados o risco relativo considerando um intervalo de confiança de 95%. A metanálise foi realizada utilizado o modelo de efeito fixo de Mantel-Haenszel quando I2 < 50% e modelo randômico para I2 > 50%. Resultados: A aplicação de fatores de crescimento para tratamento de úlceras venosas não acelerou o reparo tecidual comparado como tratamento padrão/placebo (RR 1,01 [IC 95%: 0,88-1,16]). Resultados semelhantes foram encontrados ao analisar os subgrupos PRP (RR 1,01 [IC 95%: 0,80-1,28]); KGF (RR 0,93 [IC 95%:0,78-1,11]); PDGF (RR 1,17 [IC 95%: 0,78-1,74]); EGF (RR 2,87 [IC 95%: 0,65-12,73; p=0,17]); TGF (RR 1,14 [IC 95%: 0,41-3,15]). Conclusão: Os resultados dessa revisão foram baseados em estudos classificados como moderado a alto risco de viés, portanto, precisam ser interpretados com cautela. Portanto, não há evidências para afirmar que os fatores de crescimento influenciam positivamente na cicatrização de úlceras venosas. Estudos mais robustos, com maior poder e melhor qualidade metodológica são necessários para de determinar melhores recomendações sobre o uso dos fatores de crescimento no tratamento de úlceras venosas. (Registro PROSPERO: CRD42016038390). / Background: Growth factors act in tissue repair by sending modulated signals stimulating or inhibiting cellular processes. Aim: To analyze the efficacy of growth factors in the healing process of venous ulcers by seeking evidence in the scientific literature. Method: Systematic review according to Cochrane Collaboration. Inclusion criteria: Randomized controlled trials using growth factors in the treatment of venous leg ulcers; approaching the total number of healed ulcers, wound area reduction and healing time. Exclusion: ongoing studies, research protocols; articles linking growth factors to the skin graft and studies that included ulcers of multiple etiologies without subgroup analysis. Databases consulted: Ovid MEDLINE (R); Ovid MEDLINE (R) In-Process & Other Non-Indexed Citations; Ovid MEDLINE (R) Epub Ahead of Print; EMBASE; CINAHL Plus with Full Text, Cochrane CENTRAL, LILACS and Web of Science. Also, the Brazilian Digital Library of Theses and Dissertations and Google Scholar were consulted, as well as hand search through the list of references of included studies. There was no time or language restrictions. Statistical analysis was performed using Review Manager 5.3 software (Cochrane Collaboration). For dichotomous variables, the relative risk was calculated considering a 95% confidence interval. The meta-analysis was performed using the fixed-effect model of Mantel-Haenszel when I2 <50% and a random model for I2> 50%. Results: The application of growth factors for the treatment of venous ulcers did not accelerate the healing process compared to standard treatment/placebo (RR 1.01 [95% CI: 0.88 to 1.16]). Similar results were found when analyzing the following subgroups: PRP (RR 1.01 [95% CI: 0.80 to 1.28]); KGF (RR 0.93 [95% CI: 0.78 to 1.11]); PDGF (RR 1.17 [95% CI: 0.78 to 1.74]); EGF (RR 2.87 [95% CI: 0.65 to 12.73, p = 0.17]); TGF (RR 1.14 [95% CI: 0.41 to 3.15]). Conclusion: The results of this review were based on studies classified as moderate to high risk of bias, therefore need to be interpreted with caution. So there is no evidence that the growth factors positively influence the healing of venous leg ulcers. More robust studies, more power and better methodological quality are needed to determine the best recommendations on the use of growth factors in the treatment of venous leg ulcers. (PROSPERO Registration: CRD42016038390).

In today's hospital environment, good care has become synonymous with positive patient outcomes. Marring this landscape is the alarming rate of hospital acquired (nosocomial) infections. Urinary tract infection (UTI) is one of the most common hospital acquired infections. The major cause associated with these infections is the use of indwelling urinary catheters. Bacteria invade the lower urinary tract by ascending through or around the catheter. Morbidity associated with urinary catheter-associated UTI can be minimized by prudent decisions concerning catheter usage and good catheter care. The principle route of dispersal of nosocomial infections is likely from patient-to-patient via transiently contaminated hands of hospital personnel. The purpose of this evidence-based project was to determine if hospital-acquired catheter-associated urinary tract infection rates among patients admitted to an acute care facility could be decreased through staff education and consistent application of nursing care using selected perineal infection control interventions. The setting was a 43-bed medical/surgical floor in a 321 bed not for profit Magnet hospital in Northeast Florida. Twenty-four registered nurses and 18 patient care technicians completed targeted in-service education on general nosocomial infections, perineal care, and hand hygiene. A catheter dwell time notification system was also implemented. Chart review data was obtained from 383 admissions (197 pre-intervention, 133 after the educational intervention, and 53 after the dwell time notification). There was a significant difference in catheter-associated urinary tract infection rates after the interventions (11.17 pre-intervention, 10.53 after the educational intervention and 0.392 after the dwell time notification). A longer length of time in practice an on this hospital unit was associated with lower infection rates.

Bakgrund: Obesa utgör 10% av befolkningen i Sverige. De riskerar på grund av sin anatomi attdrabbas av lungkomplikationer efter generell anestesi. De har rätt till säker,evidensbaserad och individanpassad omvårdnad utifrån sina behov för att förebyggariskerna för onödigt lidande och samhällskostnad. Det är anestesisjuksköterskansansvar att leverera anestesiologisk omvårdnad av sådan kvalitet, och medkompetensutveckling utifrån evidens och ett patientsäkert förhållningssätt är detlångt ifrån omöjligt. Syfte: Kartlägga effekter av intraoperativa ventilationsmetoder och åtgärder somanestesisjuksköterskor kan tillämpa för förbättrad ventilation hos obesa patientersom genomgår generell anestesi. Metod: Systematisk litteraturstudie, 13 randomiserade kontrollerade studier som presenteratsgenom en narrativ syntes. Resultat: Analysen resulterade i tre kategorier av ventilationsmetoder eller åtgärder som kanförbättra obesa patienters ventilation. Ventilatorinställningar, Alveolär rekryteringoch Applikation av positivt tryck vid spontanandning. Slutsatser: Högt/individanpassat PEEP i kombination med lungrekrytering kan förbättra denintraoperativa ventilationen. Både VCV och PCV kan tillämpas för effektivventilation av obesa patienter, PCV, icke-invasiv ventilation med positivt tryck, ochinverterad respirationsratio kan ge bättre intraoperativ syresättning. Ingen kopplingmellan i resultatet förekommande ventilationsmetoder och minskade postoperativakomplikationer kunde påvisas. / Bakgrund: Överviktiga utgör 10% av sveriges befolkning. Av anatomiska skäl riskerar de att drabbas av lungkomplikationer efter generell anestesi. De har rätt till säker, evidensbaserad och individualiserad vård som härrör från deras behov för att förehålla risken för onödigt lidande och börda för den nationella ekonomin. Det är narkosläkarens ansvar att leverera anestesiologisk vård av sådan kvalitet, och med kompetensutveckling som härrör från såväl bevis som en patientsäkerhetsapproach är det långt ifrån omöjligt. Sikta: Att kartlägga effekterna av intraoperativa ventilationsmetoder och åtgärder som dåurs narkosläkare kan ansöka om förbättrad ventilation av överviktiga patienter som utsätts förgenetisk anestesi. Metod: En systematisk litteratur översyn, 13 randomiserade kontrollerade prövningar analyserades och presenterades i en berättande syntes. Resultat: Analysen gav tre kategorier av ventilationsmetoder och åtgärder som kan bidra till ett positivt resultat när det gäller den överviktiga patientens ventilation. Ventilatorsettings, alveolar rekrytering och tillämpning av positivt tryck underspontanig andning. Slutsatser: Hög/individualiserad PEEP i kombination med rekryteringsmanövrering kan förbättra intraoperativ ventilation. Både VCV och PCV kan tillämpas för effektivventilation av överviktiga patienter, PCV, icke-invasiv positivt tryck ventilation och inverterade andning förhållandet kan resultera i högre intraoperativa syrenivåer. Ingen anslutning hittades mellan ventilationsmetoderna som inträffade i resultatetoch minskning av postoperativa pulmonell komplikationer.

No description available.

The purpose of this study was to determine the nurse educators’ experiences in implementing the evidence-based practice (EBP) in teaching and learning, and to describe the importance and benefits of EBP teaching and learning to the nursing profession, especially for nurse educators and student nurses. A qualitative research design and methods were followed in conducting the study. A non-probability purposive sampling technique was used to access the sample of twelve nurse educators from two nursing campuses under KwaZulu-Natal College of Nursing within Umgungundlovu Health District. Data were collected using semi-structured interviews, the interview guide, and the digital voice recorder. Data were analysed manually, following a content thematic data analysis approach. Two themes emerged as follows:  Challenges experienced by nurse educators with the implementation of EBP in teaching and learning.  Benefits/value of EBP in teaching and learning. Findings revealed that, although most of the nurse educators are supportive and displayed a positive attitude towards implementing EBP in teaching and learning, the level of knowledge and skills was questionable. This was coupled with a lack of motivation and commitment towards research. Therefore, recommendations for nursing education, nursing practice, and future research were suggested, for successful implementation of EBP in teaching and learning. / Health Studies / M.A. (Health Studies)