Os Sistemas de Informação Hospitalar podem ser definidos como uma rede integrada de informações, projetada para gerenciar aspectos assistenciais, administrativos e jurídicos em organizações de saúde. No contexto da busca pela melhoria da qualidade na assistência à saúde, proporcionada pelos avanços significativos das tecnologias da informação e comunicação, insere-se a necessidade da abordagem da sepse enquanto importante tema de saúde pública mundial. A sepse pode ser definida como síndrome de anormalidades fisiológicas, patológicas e bioquímicas induzidas por um processo infeccioso. A equipe multiprofissional de saúde deve atuar no reconhecimento precoce dos pacientes com quadro sugestivo de infecção e suas potenciais complicações, que podem culminar em síndrome séptica, estabelecendo medidas que garantam seu controle, manuseio precoce, intervenção eficaz e segura, por meio de uma assistência integral e contínua. O objetivo neste estudo foi verificar a contribuição dos Sistemas de Informação Hospitalar para a identificação precoce e o manejo da sepse em pacientes cirúrgicos de um hospital universitário. Trata-se de pesquisa com delineamento quantitativo, retrospectivo, descritivo e correlacional. A coleta de dados foi realizada por meio dos Sistemas de Informação Hospitalar, mediante aprovação do Comitê de Ética em Pesquisa. A população foi composta de 28 pacientes que atenderam os critérios de inclusão da pesquisa. Na caracterização sociodemográfica desses pacientes, constatou-se predominância do sexo masculino (17; 60,7%), brancos (26; 92,9%), com 60 anos ou mais (21; 75,0%). Quanto à análise clínica do paciente, 11 apresentaram predominância do diagnóstico oncológico (39,3%) na admissão hospitalar, assim como 24 (85,7%) tiveram histórico de somente uma internação hospitalar no período. No final do período de internação (desfecho), predominantemente 20 pacientes (71,4%) evoluíram para óbito. Quanto ao tempo de internação, 13 pacientes (46,4%) permaneceram internados por tempo superior a 30 dias, com média de 30,5 (DP=25,0), a maioria dos pacientes (18; 64,8%) passou pelo procedimento cirúrgico até o quinto dia de internação, com média de 8,25 dias (DP=15,2). Da mesma forma, apresentaram predominância de desenvolvimento dos primeiros sinais de SIRS e de disfunção orgânica também até o quinto dia de internação 19 pacientes (67,8%), com média de 5,2 dias (DP=4,8), e 15 (53,6%), com média de 9,14 dias (DP=12,23), respectivamente. A confirmação ou hipótese do diagnóstico de sepse ocorreu até o décimo dia de internação com 15 pacientes (53,5%), com média de 11,6 (DP=13,4). Na análise da evolução dos pacientes para óbito, identificou-se significância estatística em relação à idade, à especialidade do diagnóstico na admissão e ao tempo de internação. O conteúdo dos registros realizados diariamente pela equipe multidisciplinar evidenciou que os primeiros sinais de SIRS foram identificados, predominantemente, no sistema de monitorização dos pacientes (26; 92,9%), enquanto os primeiros sinais de disfunção orgânica foram descritos nas evoluções da equipe de enfermagem (24; 85,7%). Os resultados evidenciam a importância da qualidade dos registros de enfermagem nos Sistemas de Informações Hospitalares, para identificação dos riscos, reconhecimento precoce e manejo adequado da sepse em pacientes submetidos a procedimentos cirúrgicos, enquanto integrantes da equipe multidisciplinar, visando o alcance de maior efetividade das ações de gerenciamento dos processos de assistência à saúde / Hospital information systems can be defined as an integrated network of information, designed to manage assistance, administrative and legal aspects in healthcare organizations. In the context of the quest for quality improvement in health care, provided by the significant advances of information and communication technologies, the need of sepsis as an important theme of global public health. Sepsis can be defined as abnormalities syndrome, pathological and physiological biochemical induced by an infectious process. The multidisciplinary team of health should act in the early recognition of patients with suggestive of infection and its potential complications, which can lead to septic syndrome, establishing measures to ensure the control, early intervention handling effective and safe, through a full and continuous assistance. The objective of this study was to verify the contribution of hospital information systems for early identification and management of sepsis in surgical patients in a university hospital. This is a quantitative, descriptive, retrospective and correlational research. The data collection was performed through hospital information systems, subject to the approval of the Research Ethics Committee. The population was composed of 28 patients who attended the inclusion criteria of the survey. In demographic characterization of these patients, there was a predominance of males (17; 60.7%), white (26; 92.9%), 60 years or older (21; 75.0%). For the clinical analysis of patient, 11 showed predominance of oncological diagnostics (39.3%) in hospital admission, as well as 24 (85.7%) had a history of only one hospitalization. At the end of the period of hospitalization (outcome), predominantly 20 patients (71.4%) evolved to death. Regarding length of stay 13 patients (46.4%) remained hospitalized for more than 30 days, with an average of 30.5 (SD = 25.0), most patients (18; 64.8%) passed the surgical procedure until the fifth day of hospitalization, averaging 8.25 days (SD = 15.2). Similarly, showed a predominance of development of the first signs of SIRS and organic dysfunction, too, until the fifth day of hospitalization 19 patients (67.8%), with an average of 5.2 days (DP = 4.8), and 15 (53.6%), with an average of 9.14 days (SD = 12.23), respectively. Confirmation or chance of diagnosis of sepsis occur until the tenth day of hospitalization with 15 patients (53.5%), with an average of 11.6 (SD = 13.4). In the analysis of the evolution of the patients to death, statistical significance was identified in relation to age, the speciality of the diagnosis on admission and length of stay. The contents of the records held daily by the multidisciplinary team showed that the first signs of SIRS were identified, predominantly, in the system of monitoring of the patients (92.9%), while 26; the first signs of organic dysfunction were described in the evolutions of the nursing staff (24; 85.7%). The results highlight the importance of the quality of nursing records in hospital information systems, to identify the risks, early recognition and appropriate management of sepsis in patients undergoing surgical procedures, while members of the multidisciplinary team, aiming at the achievement of greater effectiveness of the actions of management of care processes health

No description available.

The problem of this study was to ascertain (a) the teaching practices of medical-surgical nursing teachers in the clinical laboratory of baccalaureate nursing schools in the State of Texas, and (b) some variables possibly associated with these practices.

Millions of people in the United States are living with a serious mental illness or substance abuse disorder. These individuals suffer from a high rate of medical co-morbidities. Because of this, patients hospitalized on medical-surgical units for medical reasons often are living with psychiatric/substance abuse co-morbidities, which are not addressed during their medical hospital admission. These patients can be perceived as difficult and even dangerous by nurses who have not received training or education in mental health care. The purpose of this project is to measure medical-surgical nurse’s perceptions of their abilities to recognize psychiatric/substance abuse symptoms and their perception of self-competency to provide appropriate interventions. This project utilized the Behavioral Health Care Competency (BHCC) instrument to measure hospital nurse perceptions of behavioral healthcare competency to determine if additional education and training are needed. The BHCC tool was administered to 19 nurses working on two medical-surgical units in Southern Arizona. Findings support the need for educational intervention, especially in the areas of psychotropic medication recommendation and intervention for patients experiencing hallucinations.

Os Sistemas de Informação Hospitalar podem ser definidos como uma rede integrada de informações, projetada para gerenciar aspectos assistenciais, administrativos e jurídicos em organizações de saúde. No contexto da busca pela melhoria da qualidade na assistência à saúde, proporcionada pelos avanços significativos das tecnologias da informação e comunicação, insere-se a necessidade da abordagem da sepse enquanto importante tema de saúde pública mundial. A sepse pode ser definida como síndrome de anormalidades fisiológicas, patológicas e bioquímicas induzidas por um processo infeccioso. A equipe multiprofissional de saúde deve atuar no reconhecimento precoce dos pacientes com quadro sugestivo de infecção e suas potenciais complicações, que podem culminar em síndrome séptica, estabelecendo medidas que garantam seu controle, manuseio precoce, intervenção eficaz e segura, por meio de uma assistência integral e contínua. O objetivo neste estudo foi verificar a contribuição dos Sistemas de Informação Hospitalar para a identificação precoce e o manejo da sepse em pacientes cirúrgicos de um hospital universitário. Trata-se de pesquisa com delineamento quantitativo, retrospectivo, descritivo e correlacional. A coleta de dados foi realizada por meio dos Sistemas de Informação Hospitalar, mediante aprovação do Comitê de Ética em Pesquisa. A população foi composta de 28 pacientes que atenderam os critérios de inclusão da pesquisa. Na caracterização sociodemográfica desses pacientes, constatou-se predominância do sexo masculino (17; 60,7%), brancos (26; 92,9%), com 60 anos ou mais (21; 75,0%). Quanto à análise clínica do paciente, 11 apresentaram predominância do diagnóstico oncológico (39,3%) na admissão hospitalar, assim como 24 (85,7%) tiveram histórico de somente uma internação hospitalar no período. No final do período de internação (desfecho), predominantemente 20 pacientes (71,4%) evoluíram para óbito. Quanto ao tempo de internação, 13 pacientes (46,4%) permaneceram internados por tempo superior a 30 dias, com média de 30,5 (DP=25,0), a maioria dos pacientes (18; 64,8%) passou pelo procedimento cirúrgico até o quinto dia de internação, com média de 8,25 dias (DP=15,2). Da mesma forma, apresentaram predominância de desenvolvimento dos primeiros sinais de SIRS e de disfunção orgânica também até o quinto dia de internação 19 pacientes (67,8%), com média de 5,2 dias (DP=4,8), e 15 (53,6%), com média de 9,14 dias (DP=12,23), respectivamente. A confirmação ou hipótese do diagnóstico de sepse ocorreu até o décimo dia de internação com 15 pacientes (53,5%), com média de 11,6 (DP=13,4). Na análise da evolução dos pacientes para óbito, identificou-se significância estatística em relação à idade, à especialidade do diagnóstico na admissão e ao tempo de internação. O conteúdo dos registros realizados diariamente pela equipe multidisciplinar evidenciou que os primeiros sinais de SIRS foram identificados, predominantemente, no sistema de monitorização dos pacientes (26; 92,9%), enquanto os primeiros sinais de disfunção orgânica foram descritos nas evoluções da equipe de enfermagem (24; 85,7%). Os resultados evidenciam a importância da qualidade dos registros de enfermagem nos Sistemas de Informações Hospitalares, para identificação dos riscos, reconhecimento precoce e manejo adequado da sepse em pacientes submetidos a procedimentos cirúrgicos, enquanto integrantes da equipe multidisciplinar, visando o alcance de maior efetividade das ações de gerenciamento dos processos de assistência à saúde / Hospital information systems can be defined as an integrated network of information, designed to manage assistance, administrative and legal aspects in healthcare organizations. In the context of the quest for quality improvement in health care, provided by the significant advances of information and communication technologies, the need of sepsis as an important theme of global public health. Sepsis can be defined as abnormalities syndrome, pathological and physiological biochemical induced by an infectious process. The multidisciplinary team of health should act in the early recognition of patients with suggestive of infection and its potential complications, which can lead to septic syndrome, establishing measures to ensure the control, early intervention handling effective and safe, through a full and continuous assistance. The objective of this study was to verify the contribution of hospital information systems for early identification and management of sepsis in surgical patients in a university hospital. This is a quantitative, descriptive, retrospective and correlational research. The data collection was performed through hospital information systems, subject to the approval of the Research Ethics Committee. The population was composed of 28 patients who attended the inclusion criteria of the survey. In demographic characterization of these patients, there was a predominance of males (17; 60.7%), white (26; 92.9%), 60 years or older (21; 75.0%). For the clinical analysis of patient, 11 showed predominance of oncological diagnostics (39.3%) in hospital admission, as well as 24 (85.7%) had a history of only one hospitalization. At the end of the period of hospitalization (outcome), predominantly 20 patients (71.4%) evolved to death. Regarding length of stay 13 patients (46.4%) remained hospitalized for more than 30 days, with an average of 30.5 (SD = 25.0), most patients (18; 64.8%) passed the surgical procedure until the fifth day of hospitalization, averaging 8.25 days (SD = 15.2). Similarly, showed a predominance of development of the first signs of SIRS and organic dysfunction, too, until the fifth day of hospitalization 19 patients (67.8%), with an average of 5.2 days (DP = 4.8), and 15 (53.6%), with an average of 9.14 days (SD = 12.23), respectively. Confirmation or chance of diagnosis of sepsis occur until the tenth day of hospitalization with 15 patients (53.5%), with an average of 11.6 (SD = 13.4). In the analysis of the evolution of the patients to death, statistical significance was identified in relation to age, the speciality of the diagnosis on admission and length of stay. The contents of the records held daily by the multidisciplinary team showed that the first signs of SIRS were identified, predominantly, in the system of monitoring of the patients (92.9%), while 26; the first signs of organic dysfunction were described in the evolutions of the nursing staff (24; 85.7%). The results highlight the importance of the quality of nursing records in hospital information systems, to identify the risks, early recognition and appropriate management of sepsis in patients undergoing surgical procedures, while members of the multidisciplinary team, aiming at the achievement of greater effectiveness of the actions of management of care processes health

Problem: Interruption during medication administration is a significant patient safety concern within health care, especially during the administration of high risk medications in nursing. Patient-controlled analgesia (PCA) devices are frequently associated with adverse events and have a four-fold increased risk of patient injury compared to non-PCA related adverse events. While the nature and frequency of interruptions have been established for nurses* medication processes, the impact of interruption frequency on nurses* PCA interaction has not been fully measured or described. Purpose: The purposes of this study were to quantify the impact of interruption frequency on registered nurses* (RN) performance, satisfaction, and cognitive workload during PCA interaction, and to determine nurses* perceptions of the impact of interruption frequency. Methods: This study employed a mixed-method design. First, an experimental repeated measures design was used to quantify the impact of interruption frequency on a purposive sample of nine medical-surgical RNs. The RNs completed PCA programming tasks in a simulated laboratory nursing environment for each of four conditions where interruption frequency was pre-determined. Four established human factors usability measures were completed for each of the four test conditions. The research questions were answered using repeated measures analysis of variance with (RM-ANOVA), McNamar*s test, and Friedman*s test. After each experiment, semi-structured interviews were used to collect data that were analyzed using inductive qualitative content analysis to determine RNs* perceptions of the impact of interruption frequency. Results: Results of the RM-ANOVA were significant for the main effect of interruption frequency on efficiency F(3,24)=9.592, p = .000. McNemar*s test did not show significance for the impact of interruption frequency on effectiveness (accuracy). Friedman test showed participant satisfaction was significantly impacted by interruption frequency (x2=9.47, df=3, p=0.024). Friedman test showed no significance for the main effect of interruption frequency on cognitive workload scores by condition type (x2=1.88, df=3, p=0.599). Results of the qualitative content analysis revealed two main categories to describe nurses* perception of interruption frequency: the nature of interruptions and nurses* reaction to the interrupted work environment. Discussion/Implications: The results suggested that interruption frequency significantly affected task completion time and satisfaction for participants but not participant accuracy or cognitive workload. A high error rate during PCA programming tasks indicated the need to evaluate the conditions in which RNs complete PCA programming as each error presents potential risk of patient harm. RNs* described the impact of interruption frequency as having a negative impact on the work environment and subsequently implement compensating strategies to counterbalance interruptions. RNs* perceived that patient safety was negatively impacted by frequent interruption. RNs experienced negative intrapersonal consequences as a results of frequent interruption. Additional study is needed to better understand the impact of interruption frequency on RNs* performance accuracy and cognitive workload.

O processo de recuperação cirúrgica pode ser precoce, esperado ou prejudicado, conforme estado de saúde do individuo e do próprio ato cirúrgico, que determinam a perspectiva de bem-estar e qualidade de vida, tendo neste período como parâmetro o alcance de condições superiores ou equivalentes as que os pacientes apresentavam no período pré-operatório. O objetivo deste estudo foi caracterizar variáveis sociodemográficas, clínicas e psicológicas e identificar os fatores preditivos para o bem-estar e qualidade de vida nos diferentes períodos de observação (0, 30, 90, 180 e 360 dias). Trata-se de um estudo longitudinal, de 120 participantes submetidos à prostatectomia radical, por período de até 12 meses. Foram utilizados questionários para caracterização do participante e para avaliação clínica e os instrumentos: Escala Visual Analógica de Dor, Inventário de Estratégias de Coping, Escala Hospitalar de Ansiedade e Depressão, Escala de Satisfação com o Suporte Social, Escala de Satisfação Conjugal, Escala de Bem-Estar Subjetivo e o Expanded Prostate Cancer Index. Os dados foram descritos por períodos e analisados pelo modelo linear de efeitos mistos. Os principais resultados na descrição dos dados apontaram que as médias dos escores de dor variaram de 0,63 a 2,42. As médias de enfrentamento focado no problema variaram de 1,20 a 1,67, sendo mais evidente em T0, T1, T2 e T3 em relação ao enfrentamento focado na emoção, que teve variação de 1,20 a 1,48. As médias de ansiedade variaram de 4,42 a 6,01 e a depressão de 3,59 a 4,24, sendo as de ansiedade ligeiramente superiores às de depressão na maioria dos períodos, exceto em T4. A satisfação com o suporte social variou com médias de 3,81 a 3,97. A satisfação conjugal variou de 1,73 a 1,99, de modo que, a maioria dos participantes não estava satisfeita com o relacionamento conjugal. Já o bem-estar subjetivo apresentou médias de 2,59 a 2,77, sendo a satisfação com a vida e o afeto positivo os principais domínios. Notou-se que o bem-estar subjetivo se apresentou estável nos períodos quando comparado com T0. Já a qualidade de vida variou com médias de 68,69 a 81,80. No período T0, os participantes apresentaram menores médias quanto à função sexual e incômodo urinário. Entretanto, nos períodos T1, T2, T3 e T4, as menores médias foram em relação à função sexual e incontinência urinária. Quando comparado com T0, a qualidade de vida foi inferior em todos os períodos no pós-operatório. Na análise de métodos mistos, o tempo de cirurgia, enfrentamento focado no problema, ansiedade e satisfação conjugal foram preditores de bem-estar subjetivo, entretanto, as variáveis idade, raça/cor, tempo de anestesia, dor, depressão e satisfação com o suporte social não foram preditoras para o bem-estar subjetivo. Já os preditores de qualidade de vida foram as variáveis dor, depressão, enfrentamento focado na emoção, ansiedade e satisfação conjugal, entretanto, a idade, raça/cor, tempo de anestesia e satisfação com o suporte social não foram preditoras para a qualidade de vida. Os resultados apresentados contribuem para a compreensão do processo de recuperação cirúrgica de participantes submetidos à prostatectomia radical / The surgical recovery process can be early, expected or impaired, according to the individual\"s health condition and the surgery, which determine the perspectives of wellbeing and quality of life. In this period, the achievement of conditions higher or equivalent to what the patients presented in the preoperative period serves as the parameter. The objective in this study was to characterize sociodemographic, clinical and psychological variables and to identify the predictive factors of wellbeing and quality of life in the different observation periods (0, 30, 90, 180 and 360 days). A longitudinal study was undertaken of 120 participants submitted to radical prostatectomy over a 12-month period. Questionnaires were used to characterize and clinically assess the participants, as well as the following instruments: Visual Analogue Pain Scale, Ways of Coping, Hospital Anxiety and Depression Scale, Satisfaction with Social Support Scale, Scale of Marital Satisfaction, Subjective Wellbeing Scale and the Expanded Prostate Cancer Index. The data were described per period and analyzed using the linear mixed effects model. The main results in the description of the data appointed that the mean pain scores ranged between 0.63 and 2.42. The mean problemfocused coping scores varied between 1.20 and 1.67, being clearer in T0, T1, T2 and T3 than emotion-focused coping, which varied between 1.20 and 1.48. The mean anxiety scores ranged between 4.42 and 6.01 and depression between 3.59 and 4.24, the former slightly surpassing the latter in most periods, except in T4. The satisfaction with social support varied with averages between 3.81 and 3.97. Marital satisfaction ranged between 1.73 and 1.99, showing that most participants were not satisfied with the marital relationship. Subjective wellbeing presented mean scores between 2.59 and 2.77, the main domains being satisfaction with life and positive affect. As observed, subjective wellbeing was stable in the periods when compared to T0. Quality of life, then, varied with averages between 68.69 and 81.80. In period T0, the participants presented lower averaged for the sexual function and urinary discomfort. In periods T1, T2, T3 and T4, on the other hand, the lowest averages were related to the sexual function and urinary incontinence. When compared to T0, the quality of life was lower in all postoperative periods. In the mixed methods analysis, the length of surgery, problem-focused coping, anxiety and marital satisfaction were predictors of subjective wellbeing, while age, race/color, length of anesthesia, pain, depression and satisfaction with social support did not serve as predictors of subjective wellbeing. The predictors of quality of life were pain, depression, emotion-focused coping, anxiety and marital situation, while age, race/color, length of anesthesia and satisfaction with social support did not serve as predictors for quality of life. The results presented contribute to understand the surgical recovery process of participants submitted to radical prostatectomy