Made available in DSpace on 2015-05-08T14:47:47Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 684345 bytes, checksum: c453fd7508e1c3b08cde6fc0aa95a99d (MD5) Previous issue date: 2009-12-21 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Introduction: The CHF is considered public health problem in the whole world. In the last three decades, the incidence and prevalence of the CHF has increased. The work of the nurse has been highlighted in the last decades, once that, the pharmacologic treatment of the HF has improved day by day, although the non pharmacologic treatment has shown to be more and more important, justifying the development of clinics and programs of HF, most of them, managed by nurses, who master the handling of the non pharmacologic interventions. The use of the process of nursing triggered the development of systems of classification for some of the phases of this process, for the elements of the practice of nursing: diagnostics, results and interventions of nursing. The International classification for the Practice of Nursing (CIPE®) is a combinatory terminology for the practice of nursing, to facilitate the crossed mapping of local terms, classifications and existing vocabulary. The (CIPE®) version 1.0 presents a structure of classification comprehend by seven axis, denominated of Models of Seven Axis, which must facilitate the access to the user of the definitions and concepts of the (CIPE®), through them being able to build, the affirmatives of diagnostics, results and interventions of nursing. Objectives: Building based on the terms of the (CIPE®) Version 1.0, affirmatives of diagnostics/Results and interventions of nursing for patients with Congestive Heart Failure, using the phases determined by the National Council of Nursing. Methodological Procedures: It is study with exploratory-descriptive nature, which was developed in phases, being the first identification of the terms constant in the (CIPE®) Version 1.1, guided by the pathophysiological model of the CHF and its main signs and symptoms: Dyspnoea, tachycardia, edema and congestion. From these axis affirmative of diagnoses / results were built and nursing interventions using the guidelines set up by the NCN. Following completion of the construction of the statements of nursing diagnoses was made the cross-mapping of these statements of nursing diagnoses contained in the Books of Concepts of Nursing Diagnoses (CIPE®) Version 1.1 Results: 92 Thematic axis were identified of the axis focus related to the CHF, from which 68 diagnostic/results of nursing were constructed and afterwards standardized by functional class (Taquicardy, Dyspnoea, edema and congestion) generating 234 nursing interventions developed from the guidelines presented by the CIE for the construction of the (CIPE®) catalogue for CHF, which were elaborated according to the main signs symptoms of congestive heart failure(tachycardia, dyspnoea, edema and congestion) diagnoses resulting in 15 diagnoses for tachycardia, 26 for dyspnoea, 11 of edema and congestion resulting in 68 nursing diagnoses and 234 nursing interventions. Final Considerations: We hope that the proposal of the Catalog CIPE® for patients with ICC applicable to the functional class III of the NYHA, can favor the evaluation in the individuals with this disease, and consequently, the improvement of the quality of the assistance of nursing. / Introdução: A ICC é considerada problema de saúde pública no mundo inteiro. Nas últimas três décadas, tanto a incidência quanto a prevalência da ICC têm aumentado. O trabalho do enfermeiro tem ganhado destaque nas últimas décadas, uma vez que, o tratamento farmacológico da IC tem melhorado a cada dia, porém o tratamento não farmacológico tem demonstrado ser cada vez mais importante, justificando o desenvolvimento de clínicas e programas de IC, a maioria, administrados por enfermeiros, que detêm o manejo das intervenções não farmacológicas. O uso do processo de enfermagem desencadeou o desenvolvimento de sistemas de classificação para algumas das fases desse processo, ou seja, para os elementos da prática de enfermagem: diagnósticos, resultados e intervenções de enfermagem. A Classificação Internacional para a Prática de Enfermagem (CIPE®) é uma terminologia combinatória para a prática de enfermagem, para facilitar o mapeamento cruzado de termos locais, classificações e vocabulários existentes. A CIPE® Versão 1.0 apresenta uma estrutura de classificação compreendida por sete eixos, denominada de Modelo de Sete Eixos, que deve facilitar ao usuário o acesso às definições e conceitos da CIPE®, por meio dos quais se poderão construir, as afirmativas de diagnósticos, resultados e intervenções de enfermagem. Objetivos: Construir com base nos termos da CIPE® Versão 1.0, afirmativas de diagnósticos/resultados e intervenções de enfermagem para pacientes portadores de Insuficiência Cardíaca Congestiva na classe funcional III da escala da NYHA e apresentar uma proposta de Catálogo CIPEÒ para Insuficiência Cardíaca Congestiva, utilizando as etapas determinadas pelo Conselho Internacional de Enfermagem. Procedimentos Metodológicos: Trata-se de um estudo de natureza exploratório-descritivo, que foi desenvolvido em etapas, sendo a primeira identificação dos termos constantes na CIPE® Versão 1.1, norteados pelo modelo fisiopatológico da ICC e seus principais sinais e sintomas: Dispneia, Taquicardia, Edema e Congestão. A partir destes eixos foram construídas afirmativas de diagnósticos/resultados e intervenções de enfermagem utilizando as diretrizes orientadas pela CIE. Depois de realizada a construção das afirmativas de diagnósticos de enfermagem foi feito o mapeamento cruzado dessas afirmativas com os diagnósticos de enfermagem contidos no Catálogo de Conceitos de Diagnóstico de Enfermagem da CIPE® Versão 1.1. Resultados: Foram identificados 92 termos do eixo foco relacionados á ICC, a partir dos quais foram construídos 68 diagnósticos/resultados de enfermagem e posteriormente normatizados e separados por classe funcional (Taquicardia, Dispneia, Edema e Congestão) gerando 234 Intervenções de enfermagem, desenvolvidas a partir das diretrizes apresentadas pelo CIE, para a construção do Catálogo CIPE® para ICC, as quais foram elaboradas seguindo os principais sinais e sintomas da ICC (taquicardia, dispneia, edema e congestão) os diagnósticos resultando em 15 diagnósticos para taquicardia, 26 para Dispneia, 11 para edema e para Congestão resultando em 68 diagnósticos de enfermagem e 234 Intervenções de enfermagem. Considerações Finais: Espera-se que a proposta de Catálogo CIPE® para pacientes com ICC aplicáveis a classe funcional III da NYHA, possa favorecer a avaliação nos indivíduos portadores desta doença e, consequentemente, a melhoria da qualidade da assistência de enfermagem.

Traumatic brain injury (TBI) is a leading cause of morbidity and mortality among young children and adults. This primary injury initiates an inflammatory response that may lead to a secondary brain injury. Nursing care in the critical care setting supports prevention or reduction of secondary injury through control of intracranial pressure (ICP), mean arterial pressure (MAP), and the subsequent cerebral perfusion pressure (CPP). While secondary injury may be preventable, some nursing interventions may contribute to increased ICP and decreased CPP. Patients with increased ICP or decreased CPP are at risk for poor clinical outcomes. This literature review examined the effort of routine nursing care interventions on outcomes of TBI patients in the critical care setting. Eleven research articles studying head of bed elevation, head and neck positioning, turning, and spacing of patient care activities were the focus of the analysis. Results typically showed positive outcomes by elevating the head of the bed to thirty degrees. CPP was also maintained at thirty degrees, but showed varied results. ICP and CPP are best controlled with the head and neck in a neutral position. Turning patients is a routine nursing intervention that contributes to increased ICP in some positions in some patients. Most studies suggest ICP is lowest in the supine position and highest in the left lateral position, but differences in findings were noted. Providing basic nursing care interventions in close succession also may contribute to increases in ICP in some patients. Results from this review provide evidence to support the importance of assessing and planning care for each TBI patient individually. It is hoped that findings from this review will provide guidance for bedside nurses to improve clinical practice and drive future research to support best practices for care of patients who suffer TBI.

My dissertation is aimed at the following questions: System of children care, organization of health-care policy in the Czech Republic, competencies and abilities to children care, document Health for Everybody in 21st Century, community nursing, nurse interventions in particular age categories, and my own research proceedings. The research section of the work contains both quantitative and qualitative research procedures. The data were collected of a questionnaire and semi-structured interview. The examined set of a qualitative research consisted of 9 respondents {--} 5 nurses and 4 medical practitioners for children and youth. The quantitative data were collected with an interview method. The questionnaires were designed for the unprofessional public {--} parents of children who are up to 18. The examined set of the questionnaire research consisted of 73 respondents (100%). The research proceeded from mid June 2008 to the end of July 2008 and its results have been processed into category tables and graphs in the program of Microsoft Office Excel 2007. I especially try to find the opinion of children nurses and children medical practitioners on introduction of a community children nurse in the Czech Republic and specify the functions that a community children nurse can perform in the Czech Republic when working with children community. I also try to find locations at which the community children nurse could work, and obstacles hampering to establish this new working position within the Czech Republic. Last but not least, I am interested in the public interest in the nurse{\crq}s affect to health protection and care for children. So far, there has not been a community nurse position established as an independent community professional in health protection and care for children within the Czech Republic. However, in other countries, community nurses work in the state interest and they form a part of the public health-care system. They are rewarded for their work, which is highly appreciated, from the public budget. Development of the community health-care is a WHO priority, and it has already established its firm position in the Czech health-care conception. As the main advantage of introduction of a community nurse I consider the fact, that both children and parents would have a better chance to use a wider variety of health-care services at school, in their household or at the doctor{\crq}s consulting room. Community nurse{\crq}s activities could help to inform families and to improve the health-care edification level. They could also assist the families that need highly intensive health and social care. Because of independent work of community nurses, nurse{\crq}s profession would become more attractive and nurse{\crq}s social position would improve.