Health problems of nursing workers in a public educational institution

Objective: To identify the issues occurred with nursing workers through a Health Monitoring System for Nursing Workers (SIMOSTE) and to describe the consequences of those problems. Method: This is a quantitative, exploratory and descriptive study realized in a teaching hospital in the west region of the city of São Paulo. Results: From the SIMOSTE, 1.847 occurrences were registered in a six month period. Within the main occurrences, medical licenses, work related accidents with and without removals; psychiatric consultations and psychotherapy were highlighted. Conclusion: The data points out to the need for the development of new health vigilance actions to notify accidents and illness related to work, besides the prevention of issues. 


Antimicrobial activity of Eucalyptus globulus oil, xylitol and papain: a pilot study

OBJECTIVE To evaluate the in vitro antimicrobial activity of the Eucalyptus globulus essential oil, and of the xylitol and papain substances against the following microorganisms: Pseudomonas aeruginosa; Samonella sp.; Staphylococus aureus; Proteus vulgaris; Escherichia coli and Candida albicans. METHOD The in vitro antimicrobial evaluation was used by means of the agar diffusion test and evaluation of the inhibition zone diameter of the tested substances. Chlorhexidine 0.5% was used as control. RESULTS The Eucalyptus globulus oil showed higher inhibition than chlorhexidine when applied to Staphylococcus aureus, and equal inhibition when applied to the following microorganisms: Escherichia coli, Proteus vulgaris and Candida albicans. Papain 10% showed lower antimicrobial effect than chlorhexidine in relation to Candida albicans. Xylitol showed no inhibition of the tested microorganisms. CONCLUSION The Eucalyptus globulus oil has antimicrobial activity against different microorganisms and appears to be a viable alternative as germicidal agent hence, further investigation is recommended.

Nursing staff sizing in the emergency room of a university hospital

OBJECTIVE To verify the adequacy of the professional nursing staff in the emergency room of a university hospital and to evaluate the association between categories of risk classification triage with the Fugulin Patient Classification System. METHOD The classification of patients admitted into the emergency room was performed for 30 consecutive days through the methodology proposed by Gaidzinski for calculating nursing requirements. RESULTS The calculation determines the need for three registered nurses and four non-registered nursing for each six hour shift. However, only one registered nurse and four non-registered nurse were available per shift. There was no correlation between triage risk classification and classification of care by the Fugulin Patient Classification System. CONCLUSION A deficit in professional staff was identified in the emergency room. The specificity of this unit made it difficult to measure. To find the best strategy to do so, further studies should be performed.

Disinfection with sodium hypochlorite in hospital environmental surfaces in the reduction of contamination and infection prevention: a systematic review

OBJECTIVETo search for evidence of the efficiency of sodium hypochlorite on environmental surfaces in reducing contamination and prevention of healthcare-associated infection HAIs.METHODSystematic review in accordance with the Cochrane Collaboration.RESULTSWe analyzed 14 studies, all controlled trials, published between 1989-2013. Most studies resulted in inhibition of microorganism growth. Some decreased infection, microorganism resistance and colonization, loss of efficiency in the presence of dirty and surface-dried viruses.CONCLUSIONThe hypochlorite is an effective disinfectant, however, the issue of the direct relation with the reduction of HAIs remains. The absence of control for confounding variables in the analyzed studies made the meta-analysis performance inadequate. The evaluation of internal validity using CONSORT and TREND was not possible because its contents were not appropriate to laboratory and microbiological studies. As a result, there is an urgent need for developing specific protocol for evaluating such studies.

Map of homicides by firearms: profile of the victims and the assaults

AbstractOBJECTIVEDescribing the profile of victims and assaults by gunshot, where the outcome was death.METHODAn ecological study conducted in the city of Maceió/AL, in 2012. Data were collected from the death statements. The variables studied were: the death circumstances, gender, age, marital status, place, date, time, month and proportion according to the occurring neighborhood.RESULTSThe homicide mortality rate was 65.2 per 100,000 inhabitants, with 130.6 per 100,000 men and 7.8 per 100,000 women. Of the total number of homicides, 93.6% of the victims were men. The age group between 15 and 29 years of age was the most affected, with 68.8%. In 97.6% of cases the death occurred at the site of aggression, 74.1% in the streets. In relation to the date, 54.2% of cases occurred between Friday and Sunday. 59.7% of the homicides were concentrated in seven neighborhoods.CONCLUSIONThe map of violence presented shows heterogeneous areas for the occurrence of assaults with firearms, characterizing the existing urban inequality in violence distribution.

Advantages of a cohort study on cardiac arrest conducted by nurses

AbstractOBJECTIVEIdentifying factors associated to survival after cardiac arrest.METHODAn experience report of a cohort study conducted in a university hospital, with a consecutive sample comprised of 285 patients. Data were collected for a year by trained nurses. The training strategy was conducted through an expository dialogue lecture. Collection monitoring was carried out by nurses via telephone calls, visits to the emergency room and by medical record searches. The neurological status of survivors was evaluated at discharge, after six months and one year.RESULTSOf the 285 patients, 16 survived until hospital discharge, and 13 remained alive after one year, making possible to identify factors associated with survival. There were no losses in the process.CONCLUSIONCohort studies help identify risks and disease outcomes. Considering cardiac arrest, they can subsidize public policies, encourage future studies and training programs for CPR, thereby improving the prognosis of patients.

Triage at the Emergency Department: association between triage levels and patient outcome

AbstractOBJECTIVEIdentify association between sociodemographic, clinical and triage categories with protocol outcomes developed at Hospital São Paulo (HSP).METHODSRetrospective cohort study conducted with patients older than 18 years submitted to the triage protocol in August 2012. Logistic regression was used to associate the risk categories to outcomes (p-value ≤0,05).RESULTSMen with older age and those treated in clinical specialties had higher rates of hospitalization and death. Patients in the high-priority group had hospitalization and mortality rates five and 10.6 times, respectively (p < 0.0001).CONCLUSIONThe high-priority group experienced higher hospitalization and mortality rates. The protocol was able to detect patients with more urgent conditions and to identify risk factors for hospitalization and death.

Readmission from orthopedic surgical site infections: an integrative review

Abstract OBJECTIVE Characterizing readmissions from orthopedic surgical site infections. METHOD An integrative review of literature in the LILACS, IBECS, MEDLINE, Cochrane, SciELO and PUBMED databases, using the descriptors Patient readmission, Wound infection, Cross infection, Orthopedic procedures, Orthopedics. RESULTS 78 studies were identified and 10 publications were selected. Surgical site infections are the most common cause of unplanned orthopedic readmissions, representing long periods of hospitalization, new surgical procedures and high costs, and greater possibility of subsequent hospitalizations. Most significant predictors have indicated average length of hospitalization, need for intensive care, emergency status at admission, risk of death, age > 65 years, males and higher body mass index. CONCLUSION Readmission rates have increasingly become measures of quality and concerns about costs. New studies could involve issues related to indirect costs, specifically social and psychological costs.

Cultura e clima organizacional para segurança do paciente em Unidades de Terapia Intensiva

RESUMO Objetivo Avaliar a percepção dos profissionais de saúde sobre o clima e a cultura de segurança do paciente em Unidades de Terapia Intensiva (UTI) e a relação entre os instrumentos Hospital Survey on Patient Safety Culture (HSOPSC) e o Safety Attitudes Questionnaire (SAQ). Método Estudo transversal realizado em hospital de ensino no interior do estado de São Paulo, Brasil, em março/abril de 2014. Aplicaram-se o HSOPSC, o SAQ e um instrumento para levantamento das informações sociodemográficas e profissionais aos funcionários das UTI adulto, pediátrica e neonatal. A análise utilizou a estatística descritiva. Resultados As escalas apresentaram boa confiabilidade. Maiores fragilidades para a segurança do paciente foram observadas nos domínios “condições de trabalho” e “percepções da gerência” do SAQ e “resposta não punitiva aos erros” do HSOPSC. As fortalezas no SAQ foram o “clima de trabalho em equipe” e a “satisfação no trabalho” e para o HSOPSC “expectativas e ações de promoção de segurança supervisores/gerentes” e “aprendizado organizacional e melhoria mútua”. Na UTI Neonatal houve maior satisfação no trabalho do que nas demais UTI. A UTI Adulto apresentou menores pontuações para a maioria dos domínios do SAQ e HSOPSC. A correlação entre as escalas foi de força moderada (r=0,66). Conclusão Há diferenças de percepções quanto à segurança do paciente entre as UTI, o que corrobora com a existência de microculturas locais. O estudo não demonstra que o SAQ e o HSOPSC sejam equivalentes.

Aromatherapy and nursing: historical and theoretical conception

Abstract Aromatherapy is a Practical or Complementary Health Therapy that uses volatile concentrates extracted from plants called essential oils, in order to improve physical, mental and emotional well-being. Aromatherapy has been practiced historically and worldwide by nurses and, as in Brazil is supported by the Federal Nursing Council, it is relevant to discuss this practice in the context of Nursing through Theories of Nursing. This study of theoretical reflection, exploratory and descriptive, aims to discuss the pharmacognosy of essential oils, the historical trajectory of Aromatherapy in Nursing and the conceptions to support Aromatherapy in light of eight Nursing Theorists (Florence Nightingale, Myra Levine, Hildegard Peplau, Martha Rogers, Callista Roy, Wanda Horta, Jean Watson and Katharine Kolcaba), contributing to its inclusion as a nursing care practice.

Activities of tabanids (Diptera, Tabanidae) attacking domestic duck-Cairina moschata (Linnaeus) (Aves, Anatidae), introduced in a forest area in the Central Amazon, Manaus, Brazil

Presented here are the feeding habits, attack behavior, daily and annual activity of adult of Phorcotabanus cinereus (Wiedeman, 1821), Chrysops laetus (Fabricius, 1805) and Phaeotabanus cajennensis (Fabricius, 1787), while biting a domestic duck, Cairina moschata (Linnaeus, 1758). The last two species were recorded for the first time attacking birds. This study comprehended monthly observations of two consecutive days from April/97 to March/98 between 5:30 a.m. and 6:30 p.m. at the Army Instructional Base ((BI-2/CIGS) near Manaus. Annual occurrence of P. cinereus was from July to September, with a daily occurrence between 9:00 a.m. and 5:00 p.m. and highest activity at 12:00 a.m. and 2:00 p.m. C. laetus ocurred from June to October; with a daily occurrence between 8:00 a.m. and 3 p.m. and highest activity at 11:00 and 12:00 a.m. Occurrence of P. cajennensis with one specimen only, was in July between 10:00 and 11:00 a.m.

O acervo de mosquitos (Diptera, Culicidae) de Nelson L. Cerqueira na Coleção de Invertebrados do Instituto Nacional de Pesquisas da Amazônia, Manaus, Brasil

Registra-se a descoberta de espécimes de mosquitos que pertenciam a Nelson L. Cerqueira, e estão sendo depositados na coleção de Invertebrados do Instituto Nacional de Pesquisas da Amazônia. A coleção contém 2.046 espécimes adultos e 387 lâminas representando 261 espécies, 22 gêneros, incluindo 51 parátipos de 34 espécies. Mais de 90% dos espécimes foram coletados no Brasil dos quais metade são do Estado do Amazonas. As espécies representadas neste acervo são listadas indicando o número de espécimes para cada tipo de preparação e as localidades de coleta. O material tipo também é listado, incluindo os dados dos rótulos de identificação e de procedência, bem como outras informações pertinentes.

Sobrevivência de pupas de Lucilia eximia (Wiedemann) (Diptera, Calliphoridae) após submersão em laboratório

Entre Maio e Junho de 2008 foi observado a sobrevivência das pupas de Lucilia eximia (Diptera, Calliphoridae) após submersão em laboratório. Para este experimento foram utilizadas 480 pupas de mesma idade, sendo estas divididas em oito grupos: o controle não foi submerso e os demais grupos foram submersos de um a sete dias. O aumento do período de submersão diminui a sobrevivência, com um dia de submersão a sobrevivência é de 80%, com dois dias 40%, é de 30% a partir do terceiro dia, no quarto dia cai para 23,34% e no quinto dia fica em 10%. Após este período a mortalidade sobe para 100%. Este padrão pode ser explicado pela curva "U-shaped" que ocorre no consumo de O2 durante o período pupal, onde o consumo é maior no início e no final do período pupal. O tempo de submersão também afeta o tempo de desenvolvimento, aumentando o período pupal. Estes dados têm o potencial para serem utilizados em investigações envolvendo Entomologia Forense, para a estimativa do tempo de submersão de um cadáver.

Mosquitoes (Diptera, Culicidae) inhabiting foliar tanks of Guzmania brasiliensis Ule (Bromeliaceae) in central Amazonia, Brazil

Mosquitoes in the family Culicidae develop their immature forms in different environments depending on various circumstances. This study represents the first contribution to the ecological knowledge of culicids living in the bromeliad G. brasiliensis. The objectives of the study were to compare the Culicidae fauna of bromeliads in two seasonal periods, analyzing their abundance, richness and the influence of pH, conductivity and water volume, on the populations. Sampling was done at Reserva Adolpho Ducke, Manaus, Amazonas, Brazil between 2003 and 2005. Six samplings were done in the rainy season and six in the dry season. On each sampling day, six terrestrial and six epiphytic bromeliads, totaling 144 sampling units, were retrieved. A total of 444 immature mosquitoes were collected, distributed in the following species: Culex (Microculex) stonei Lane & Whitman, Culex (Microculex) chryselatus Dyar & Knab, Culex (Microculex) sp., Wyeomyia (Hystatomyia) autocratica Dyar & Knab and Wyeomyia (Hystatomyia) splendida Bonne-Wepster & Bonne. The relationship between abundance of Culicidae and sampling period was not significant, although abundance was higher in the dry period. There were significant correlations between water volume and the abundance (p = 0.003) and richness (p = 0.001) of culicids. The pH was positively related to the occurrence of the species Wy. autocratica (p= 0.010) and Wy. splendida (p= 0.006), demonstrating the influence of this factor in the structuring of bromeliad-inhabiting communities.

The previously unknown pupa and adult male of Neobezzia fittkaui Wirth & Ratanaworabhan (Diptera, Ceratopogonidae)

The previously unknown pupa and adult male of Neobezzia fittkaui Wirth & Ratanaworabhan (Diptera, Ceratopogonidae). The pupa of Neobezzia fittkaui Wirth & Ratanaworabhan, 1972, collected from a mat of floating fern (Salvinia auriculata Aubl., Salviniaceae) in Ilha da Marchantaria near Manaus, Brazil and the reared adult male are described, photographed and illustrated for the first time. This is the first detailed pupal description for the genus Neobezzia Wirth & Ratanaworabhan.