Carga de trabalho de enfermagem e infecções relacionadas à assistência à saúde na unidade de terapia intensiva

In recent decades, the search for quality care has been widely discussed by the institutions and health professionals. In this context, it is the nurse coordinator of the process of providing nursing staff, reflecting the commitment to quality of care. In this process, it is the appearance of Infections Related to health care and its potential association with the workload in nursing as a valuable indicator of quality of care. Thus, this research contributes to studies to characterize the demand of nursing work to promote a safe healthcare practice. This study aimed to identify the association of nursing workload with the number of cases of Ventilator-Associated Pneumonia, urinary tract infection and central venous catheter infection in the intensive care unit. This is a quantitative research approach, descriptive, cross-sectional and prospective, held at Unimed Hospital in Natal-RN. The study population consisted of all patients treated in the Intensive Care Unit, Hospital for a period of 90 consecutive days in 2011. The convenience sample was compostapelos patients admitted to the ICU during the period of data collection, a total sample of 286 patients. To perform the data analysis software were used: Statistica 6.0, SPPS (Statistical Package for Social Sciences) version 17.0 (2004) and Excel 2007. In the descriptive analysis, we used Measures of Central Tendency and Measures of Dispersion or Variability and the use of nonparametric tests. Of the 286 patients, 88 were from the ICU and 198 ICU II II. Males predominated in the ICU I (51.1%) and female ICU II (57.6%) patients in the ICU I were aged 61-80 years (39.8%) followed by greater than 80 years (39.8%). In the ICU II, most of the patients were aged 61-80 years (38.9%) and then from 41 to 60 years (24.2%). In relation to the class of TISS inlet predominant class II in the two ICUs (59.1%), followed by Class III also in the two units (34.6%). Most patients (70.6%) out of the ICUs belonging to class II TISS. In the ICU I, the average number of forms of the TISS 28 was 6, has in ICU II this value drops to 3.2 forms. The overall mean was 19.9 TISS points in ICU patients I and ICU II.the 17 points in the average hours required to provide adequate nursing care to patients in the ICU I found that is 10 , 7 hours, and the ICU II 9.2 hours. It was found that the time provided by the nursing staff were higher in ICU II, with an average of 19 hours available for nurses in this sector. In the ICU I, which showed higher need of available hours, it was found that the mean value of 12.7 available hours. It was found that only 2.4% of patients had these units Ventilator-Associated Pneumonia, 1.0% were infected central venous catheter and 1.4% of patients had urinary tract infection. Infection associated with health care occurs, on average, on the tenth day of hospitalization. In the ICU II, this average value extends to the twelfth day with an excess of 2.7 hours of nursing care while in ICU I value decays to the ninth day of hospitalization with a deficiency of 12-hour assistance. It is concluded that patients generally showed a need for classification of semi-intensive care and has been assisted in their need to load. As for his association with the Related Infections Health will assist this analysis could not be performed due to the small number of notifications in this period. It is suggested further study how other factors related to infections me a longer period of analysis

Estudo de um compósito Nb-15%pCu obtidos por moagem de alta energia e sinterizados por fase líquida

There is great difficulty in forming a composite refractory metal niobium with copper. This is due to the fact that Nb-Cu system is almost mutually immiscible and may be neglected solubility between them. These properties hinder or prevent obtaining homogeneous and high-density structures, conventionally prepared. This study aims to analyze the use of high-energy milling process (MAE) to implement these natural difficulties, with regard to the densification of the sintered bodies. The MAE and the press were used in the preparation of powders, to obtain a fine and homogeneous distribution of the grain size. Four loads Nb and Cu powders containing 15% by weight of Cu were then milled for MAE in a planetary type ball mill under various milling times and speeds. The results obtained by MAE were analyzed by scanning electron microscopy (SEM), according to the parameters of time and grinding speed. The samples were compacted under pressure of 200 MPa, were then sintered in liquid phase in a vacuum furnace at temperatures of 1100 ° C / 60 min and 1200 ° C / 60 min. Then it was used to characterize diffraction of X-rays to identify the phases. The microstructures of the sintered samples were observed and evaluated using scanning electron microscopy (SEM). Vickers Microhardness tests were performed, obtaining higher values for the sintered bodies in the largest of the post milling times and the larger grinding speeds. It was found that the liquid phase sintering of the samples that were processed by MAE produced at the end of a homogeneous and densified structure in 77,4% relative to the value of the theoretical density of the composite

Secagem do resíduo de acerola (Malphigia emarginata D.C.): estudo do processo e avaliação do impacto sobre o produto final

Brazil, one of the largest agricultural producers in the world, has managed in recent years to significantly improve its production. However, in response to this advance in the agro-industrial sector, the generation of agro-industrial residues has also increased. New technological alternatives have to be implemented in order to bring economic and rational use of this material and drying is one of the possible choices. Considering the great importance that bioactive compounds present for food science and technology, this research aims to evaluate the air-drying process of acerola residue in a tray convective drier under controlled temperature (60, 70 e 80ºC), air velocity (4.0, 5.0 e 6.0 m/s) and material width (0.5, 0.62 e 0.75 cm) by applying an experimental planning 23 + 3. Based on that, the impact on physical-chemical characteristics, color, bioactive compounds concentration and antioxidant activity of dried acerola waste was evaluated, having the in natura and freeze dried waste as control groups. Dried acerola residue presented natural pigments, mainly carotenoids (143.68 - 68.29 mg/g) and anthocyanins (290.92 - 90.11 mg/100 g), which explain the red and yellow instrumental color parameters observed. The acerola residue powder is also rich in phenolic compounds (3261.11 -2692.60 mgGAEeq/100g), proanthocyanidins (61.33-58.46 eq/100g), ascorbic acid (389.44 739.29 mg/100 g) and DPPH antioxidant activity (20.91 24.72 μg Trolox eq/g). Results show decreased concentration of phenolic compounds, anthocyanins, carotenoids, proanthocyanidins and ascorbic acid caused by the air-drying process. However, even after the observed drying losses, the acerola residue powder can be considered a high value food ingredient, considering the high bioactive compounds concentration found in the final product, as well as the colorimetric characterization and microbiological stability of the dried powder

Hepatite C crônica em serviço de referência no nordeste do Brasil: um estudo retrospectivo de dezoito anos de acompanhamento

Chronic Hepatitis C is the leading cause of chronic liver disease in advanced final stage of hepatocellular carcinoma (HCC) and of death related to liver disease. Evolves progressively in time 20-30 years. Evolutionary rates vary depending on factors virus, host and behavior. This study evaluated the impact of hepatitis C on the lives of patients treated at a referral service in Hepatology of the University Hospital Onofre Lopes - Liver Study Group - from May 1995 to December 2013. A retrospective evaluation was performed on 10,304 records, in order to build a cohort of patients with hepatitis C, in which all individuals had their diagnosis confirmed by gold standard molecular biological test. Data were obtained directly from patient charts and recorded in an Excel spreadsheet, previously built, following an elaborate encoding with the study variables, which constitute individual data and prognostic factors defined in the literature in the progression of chronic hepatitis C. The Research Ethics Committee approved the project. The results were statistically analyzed with the Chi-square test and Fisher's exact used to verify the association between variable for the multivariate analysis, we used the Binomial Logistic regression method. For both tests, it was assumed significance p < 0.05 and 95%. The results showed that the prevalence of chronic hepatitis C in NEF was 4.96 %. The prevalence of cirrhosis due to hepatitis C was 13.7%. The prevalence of diabetes in patients with Hepatitis C was 8.78 % and diabetes in cirrhotic patients with hepatitis C 38.0 %. The prevalence of HCC was 5.45%. The clinical follow-up discontinuation rates were 67.5 %. The mortality in confirmed cases without cirrhosis was 4.10% and 32.1% in cirrhotic patients. The factors associated with the development of cirrhosis were genotype 1 (p = 0.0015) and bilirubin > 1.3 mg % (p = 0.0017). Factors associated with mortality were age over 35 years, abandon treatment, diabetes, insulin use, AST> 60 IU, ALT> 60 IU, high total bilirubin, extended TAP, INR high, low albumin, treatment withdrawal, cirrhosis and hepatocarcinoma. The occurrence of diabetes mellitus increased mortality of patients with hepatitis C in 6 times. Variables associated with the diagnosis of cirrhosis by us were blood donor (odds ratio 0.24, p = 0.044) and professional athlete (odds ratio 0.18, p = 0.35). It is reasonable to consider a revaluation in screening models for CHC currently proposed. The condition of cirrhosis and diabetes modifies the clinical course of patients with chronical hepatitis C, making it a disease more mortality. However, being a blood donor or professional athlete is a protective factor that reduces the risk of cirrhosis, independent of alcohol consumption. Public policies to better efficient access, hosting and resolution are needed for this population.