Delirium como foco de atenção para os enfermeiros de terapia intensiva

Pós-graduação em Enfermagem - FMB

Espécies ácidas gasosas e íons majoritários no material particulado atmosférico de uma região agriícola do Mato Grosso

Pós-graduação em Química - IQ

Gerenciamento dos resíduos de serviços de saúde da Unidade de Terapia Intensiva do Pronto Socorro do Hospital das Clínicas da Faculdade de Medicina de Botucatu – UNESP

Health care waste (HCW) is the type of waste that results from activities performed in health care services during care provision to humans or animals. Presently, according to RDC 306/04, issued in 2004 by Anvisa, and Resolution no. 358/05, by CONAMA, waste groups have the following classification: Group A (biological waste), Group B (chemical waste), Group C (waste containing radionucleotides), Group D (common waste) and Group E (piercing and cutting waste). In Brazil, 149 tons of wastes are collected every day, and HCW corresponds to approximately 1% to 3 % of that total. An efficient way to adequately manage HCW is through the Health Care Waste Management Plan (HCWMP), and it is possible to reduce the risk posed by certain materials in addition to ensuring disposal in an ecologically correct and economical fashion. According to the Pan-American Health Organization (PAHO), the management process enables health care establishments to adequately manage waste. Hence, there is greater control and reduction in the health risks caused by infectious or special waste, in addition to facilitated recycling, treatment, storage, transport and final disposal of solid hospital waste in an environmentally safe fashion. To evaluate the management of HCW of Groups A and D from the Intensive Care Unit of the University Emergency Hospital - FMB - UNESP in the city of Botucatu according to the guidelines presently in force. The waste flow was followed up, and during four random days in the month of September 2011, waste was quantified by estimating daily and monthly values, according to its classification. : In 2011, the University hospital has produced an average of 57,676.8 kg/month of biological and common waste. By adding Groups A and D, during the four days, approximately 209.8 Kg of waste (202.2 Kg of Group A and 7.6 Kg of Group D) were produced in the establishment under study, which... (Complete abstract click electronic access below)

Eventos adversos em terapia medicamentosa em Unidade de Terapia Intensiva - UTI

Due to the complexity and instability of clinical conditions of ICU patients, the drug therapy applied in this type of environment requires a combination of several prescribed drugs, which is a favorable condition for drug interaction, toxic synergism and possible iatrogenia. In the possible universe of ICU occurrences, this study aimed at identifying and evaluating the incidence of adverse events in drug therapy at the Intensive Care Therapy Service (SETI) in wards I and II. It is a cross-sectional, descriptive, prospective and quantitative study conducted from August to September, 2011 in the Intensive Care Service of the Botucatu School of Medicine University Hospital - UNESP. The population consisted of fifteen clinical nurses, including those in the Improvement and Volunteer Internship Programs, who contributed to the investigation after signing an informed consent form and according to approval by the Research Ethics Committee number 10711/CE - FMB. The data were entered on a form and analyzed. Results showed that, on average, 8.9% of events/day occurred, and the highest frequency was observed on August 04, 2011. 63% and 22% were respectively observed in the morning and afternoon shifts, and 15% in the night shift. 48% of these were due to administration time errors, followed by drug prescription and dispensation errors, with percentages of 22% and 18%, respectively. Antibiotics showed the highest frequency of adverse events - 18%, which was followed by 13% for anticoagulant, 11% for antiemetic and 10% for antiulcerative drugs. As regards the occurrence of adverse events related to hospitalization time, the highest frequency occurred in patients who were hospitalized for 10 days. Concerning the ratio between reported events and the number of items in the prescription, the highest frequency of events was related to prescriptions with 20 items... (Complete abstract click electronic access below)

Opinião de familiares sobre a internação de crianças em uma Unidade de Terapia Intensiva Pediátrica

A Pediatric Intensive care Unit (PICU) is an environment where care is provided to seriously ill children. Hospitalization is regarded as an unpleasant experience that requires adaptation and routine change. To assess the opinion of relatives of children hospitalized at a PICU concerning tie breakage and/or separation between children and their families. It is a descriptive, cross-sectional, quantitative study. A structured interview was conducted with the families of hospitalized children from July to September, 2010. The data were statistically analyzed. RESULTS: Twenty relatives were interviewed, 80% of whom believed that children’s behavior changes when they are present in the unit, and 85% considered the visitation time established to be sufficient. All the respondents reported to be satisfied about the care provided. The feelings prevailing in 50% of the relatives were fear and hope. Change in the family’s union after hospitalization occurred in 85% of the families. The most fearful aspect concerning the ICU is the equipment (25%), and the most worrisome, as regards personal life, is the separation from other children (65%). Health care professionals must pay more attention to relatives by including them in their health care plan so that the health care team and the family, who are essential in children’s recovery, can interact in a congenial fashion. It is also necessary to improve the knowledge related to that subject so that the health care team and families can work together towards children’s recovery

Diagnósticos de Enfermagem Prevalentes de Pacientes em Pós-Operatório de Cirurgia Bariátrica em uma Unidade de Terapia Intensiva

The goal of this study is to characterize the clinical outline of patients in postoperative of bariatric surgery attended in an Intensive Care Unit and identify the nursing diagnosis presented by these patients in accordance to Taxonomy II of North American Nursing Diagnosis Association (NANDA). This is a transversal, descriptive and prospective study that was desenvolved at the Intensive Care Unit of the Clinical Hospital of Botucatu Medical School – UNESP. The population was composed by all the patients who were submitted to the bariatric surgery and were attended at the Intensive Care Unit in the period between June and August of 2010, totalizing 13 patients. The data were collected based on the Nursing History that is composed by the Anamnesis, Physical Examination and Complementary Exams. The results were worked out: a) among the 13 patients studied, 10 are women (76,9%) and 3 men (23,1%); the majority is between 30 and 40 years old; 11 people of 13 are morbid obese, which means that they have Body Mass Index higher than 40 kg/m2; b) It was identified 22 nursing diagnosis and 14 of these were found in 100% of the patients. They belong to the dominions of Activity/Rest, Comfort, Elimination and Changing, Security and Protection, Functions and Relationships. Therefore, in relation to the factors, it was conclude that nursing diagnosis help nurses to understand the unsettled human answers or the risks to disturbance in an individual way, which contributes to plan specific interventions to these patients. It was possible to verify that the stage of the nursing diagnosis that is part of the nursing process should be executed by the nurses systematically, because it has been realized by the nurses’ clinical idea, but not in a systematical way

Morte e morrer: opinião dos profissionais de saúde de uma unidade de terapia intensiva pediátrica

Presently, the dying process and death most often occur in hospitals and, particularly, in Intensive Care Units (ICU), where patients’ lives are prolonged thanks to advanced technological devices and highly efficient medicines. To learn about the opinion of health care professionals working at a Pediatric Intensive Care Unit in relation to the dying process and dying. This is a descriptive quantitative study. A questionnaire was applied to the unit’s staff members from June to August, 2011. Data were statistically analyzed. Twenty-five professionals answered the questionnaire, and 72% faced death as a natural life process. 60% felt compassion, but that feeling did not interfere with how they cared for patients. Concerning their professional training, 52% reported not to have received any concerning patients’ caregivers in the dying process or death; therefore, they experienced such situation when they were already working, and 76% reported to be interested in updating courses on that theme. Further discussion about this topic during academic education is necessary. It is also necessary to provide health care professionals with specialization courses, debates and experience exchange so that they can better understand and deal with their feelings and limitations in face of death and thus give better care to patients and relate to patients’ families during the dying process of a loved one

Desenvolvimento regional e sustentabilidade: a indústria intensiva em recursos naturais na região administrativa de Ribeirão Preto

The natural resource intensive industries have moved from center to periphery in Brazil. This shift is related to the environmental impacts generated by this type of industry, as occur biggest benefits to these industries in small towns as tax exemptions and donations of land, and local institutional capacity is lower in pollution control. In the 1970s began, in the state of São Paulo, a process of industrial deconcentration of Metropolitan Region of São Paulo to the inside of state, which generated an intense industrialization of the region of Campinas, Ribeirão Preto, Sorocaba e São José dos Campos. This process of industrial deconcentration had support in state policies restricting new industries in the Metropolitan Region and the creation and financing of infrastructure and improvement of road. This research project aims to verify whether there has been a shift of natural resource intensive industries for the Administrative Region of Ribeirão Preto, as well as aspects of the sustainability of this process

Investigação de genes de resistência a carbapenêmicos e aminoglicosídeos e tipagem molecular de amostras de Acinetobacter baumannii isoladas de pacientes internados em unidades de terapia intensiva de um hospital terciário

Pós-graduação em Microbiologia - IBILCE

Eventos adversos relacionados à gravidade e carga de trabalho de enfermagem em Unidade de Terapia Intensiva

Pós-graduação em Enfermagem - FMB

Associação entre Síndrome de burnout, uso prejudicial de álcool e tabagismo em profissionais de enfermagem nas unidades de teripa intensiva do Hospital das Clínicas de Botucatu-UNESP

Pós-graduação em Saúde Coletiva - FMB

Carga e trabalho de enfermagem em unidade de terapia intensiva especializada em queimados

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Emprego de redes complexas para modelar e analisar a disseminação de microrganismos da familia enterobacteriaceae em pacientes mantidos em unidades de terapia intensiva

Nowadays the studies of different methodologies to interfere in the growing and spread of serious infections and systemic status in institutionalized patients those kept on intensive therapy units are relevant to understanding these complex systems and bring benefits to several health areas, particularly public health. In this study, it was analyzed the clinical and microbiological data from patients hospitalized in intensive therapy units. The interaction between patients and caregivers was modeled and analyzed using dynamic system model and complex network theory, identifying outbreaks values of microorganisms of Enterobacteriaceae Family.

Família Enterobacteriaceae, Acinetobacter baumannii e Pseudomonados na microbiota bucal de pacientes mantidos em unidades de terapia intensiva

Enteric organisms, pseudomonads and other opportunistic microorganisms in the oral microbiota have been linked to serious infections in patients hospitalized in intensive care units (ICU). The present study evaluated the presence of family Enterobacteriaceae, Pseudomonas aeruginosa, and Acinetobacter baumannii in the mouth of patients in ICU, correlating it with oral and systemic conditions. Data on health, socioeconomic status, medication use, drug addiction, medical and family histories of patients held for more than 72 hours in the ICU with a diagnosis of severe infection or that developed this condition after entry in said unit were obtained. Fifty patients provided clinical samples of supragingival and subgingival biofilms, saliva and oral mucous membranes were collected, as well as respiratory secretions from patients with pneumonia, blood and urine for sepsis. The presence of target microorganisms was carried out by polymerase chain reaction (PCR) and by culture using selective media. The Chi-square and Mann-Whitney tests were used for statistical analysis, and the significance level was 5%. The intraoral clinical conditions of the patients were poor. The family Enterobacteriaceae was the most prevalent, affecting 39.5% of the supragingival biofilm samples of patients attended in ICU and 18.6% of patients in the control group, besides the rods were the only group found in extraoral samples.

Enterococcus spp. em espécimes clínicos de pacientes atendidos em unidades de terapia intensiva

The relationship between the occurrence of enterococci in the oral microbiota and serious infections in patients hospitalized in intensive care units (ICU) has been established. This study evaluated the presence of Enterococcus faecalis and other species of this genus in the mouths of patients on ICU, correlating it with oral and systemic conditions. Data on health and socioeconomic, medication use, medical and family history of patients maintained for 72 hours in the ICU, diagnosed with severe infection or who have developed this condition after the entry to the unit were obtained. Fifty patients provided intraoral and extraoral clinical samples for analysis (above and subgingival biofilm, saliva and buccal mucosa, followed by obtaining samples of respiratory secretions for patients with pneumonia, and blood and urine for sepsis). The presence of target microorganisms was performed by polymerase chain reaction (PCR) and culture using selective media. The chi-square and Mann-Whitney tests were used for statistical analysis, and the significance level was 5%. The intraoral clinical conditions of the patients showed poor. E. faecalis was significantly more frequent microorganism, followed by E. faecium. The use of broadspectrum antimicrobial action was associated with the presence of these opportunistic microorganisms. These bacteria were more frequent in patients with periodontitis or gingivitis. The results showed that enterococci associated with serious infectious processes may originate from resident microbiota of patients and its prevalence is not elevated in healthy individuals.