Protocolo de avaliação do cuidado de enfermagem e da segurança do paciente em unidades de terapia intensiva

The reports of adverse events date from 1990 up to the present day. Conceptually, these adverse events are unintentional injuries unrelated to the underlying disease, causing measurable lesions in patients, extending the period of hospitalization, or leading to death. These issues require discussions with regard to patient safety, improved quality of service, and preventing medical errors. In the Intensive Care Units, this concern is greater because these are sectors of intensive care to individuals with hemodynamic changes and imminent risk of death. Therefore, it is essential to conduct evaluation processes to investigate aspects of quality of nursing care and patient safety in these spaces. For that reason, we aimed to propose the Evaluation protocol of nursing care and patient safety in Intensive Care Units. For its achievement, we needed to: 1) analyze the evolution of the patient safety concept used in scientific productions, under Rodgers evolutionary concept; 2) identify the necessary items to build the evaluation protocol of nursing care and patient safety in the Intensive Care Unit, from the available evidence in literature; 3) construct an instrument for content validation of the evaluation protocol of nursing care and patient safety in the Intensive Care Unit; and 4) describe and evaluate the appropriateness of the content for an evaluation protocol of nursing care and patient safety in the Intensive Care Unit. This is a methodological study for the content validation of the abovementioned protocol. To meet the first three specific objectives, we used the integrative literature review in Theses Database of the Coordination for the Improvement of Higher Education Personnel and the portal of the Collaborating Centre for Quality of Care and Patient Safety. The fourth specific objective happened through the participation of judges, located from the Lattes curricula, in the content validation process developed in two stages: Delphi 1 and Delphi 2. As instrument, we used the electronic form of Google docs. We present in tables the answers from the evaluation instruments by Delphi consensus and Content Validity Index (CVI) of the entire protocol. We summarized the results in articles entitled Analysis of the patient safety concept: Rodgers evolutionary concept ; Scientific evidence regarding patient safety in the Intensive Care Unit ; Technological device for the content validation process: experience report ; and Evaluation protocol of nursing care and patient safety in Intensive Care Units. The Embodied Opinion of the Research Ethics Committee of the Universidade Federal do Rio Grande do Norte, No. 461,246, under CAAE 19586813.2.0000.5537, approved the study. Thus, we conclude the protocol valid in its content, constituting an important tool for evaluating the quality of nursing care and patient safety in Intensive Care Units

Population structure and effects of inbreeding on milk yield and quality of Murrah buffaloes

To provide data for conservation, selection, and expansion programs of buffalo herds, this study evaluated the history of a population of Murrah buffaloes based on population structure and the effect of inbreeding on accumulated 305-d milk yield (MY), fat yield (FY), protein yield (PY), mozzarella production (MProd), and somatic cell score (SCS). The usefulness of including the individual inbreeding coefficient (F) or individual increase in inbreeding coefficient (Delta F) in the model to describe inbreeding depression was evaluated. Pedigree information from 8,054 animals born between 1976 and 2008 and 4,497 lactation records obtained from 12 herds were used. The realized effective population size was 40.10 +/- 1.27, and the mean F of the entire population was 2.14%. The ratio between the number of founders and ancestors demonstrated the existence of a bottleneck in the pedigree of this population, which may contribute to a reduction of genetic diversity. The effect of F on MY, FY, PY, MProd, and SCS was -1.005 kg, -0.299 kg, -0.246 kg, -1.201 kg, and -0.002 units, and the effect of Delta F transformed to equivalent F (%) for a mean of 2.57 equivalent generations was -4.287 kg, -0.581 kg, -0.383 kg, -2.001 kg, and -0.007 units, respectively. The inbreeding depression observed may have important economic repercussions for production systems. The Delta F can be considered the better of the two indicators of inbreeding depression due to its properties that prevent underestimation of this effect. A designed mating system to avoid inbreeding may be applied to this population to maintain genetic diversity.

Effect of supplementation of diets for quails with vitamins A, D and E on performance of the birds and quality and enrichment of eggs

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Phosphorus rates on yield and quality of lettuce seeds

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Eventos adversos: análise de um instrumento de notificação utilizado no gerenciamento de enfermagem

A direção de enfermagem de um hospital universitário terciário da região Centro-Sul do Estado de São Paulo, visando a segurança do paciente e o estabelecimento de meio de comunicação entre equipe e direção, implementou em janeiro de 2004 o Boletim de Notificação de Eventos Adversos. O objetivo deste estudo foi analisar a utilização deste instrumento de comunicação e identificar: frequência, tipo, natureza e período dos incidentes/eventos adversos. Realizou-se análise descritiva dos dados de 826 boletins elaborados no período de janeiro/2004 a junho/2006. Verificou-se adesão à utilização do instrumento. Predominaram notificações de ocorrências assistenciais, embora notificações administrativas tenham apresentado número crescente de registros. Eventos adversos mais frequentes relacionaram-se à medicação, quedas, cateteres, sondas/drenos e integridade da pele. A praticidade do instrumento viabilizou sua utilização também por auxiliares e técnicos de enfermagem. A análise sistematizada e acompanhamento dos eventos adversos associados aos recursos de comunicação mostraram-se fundamentais para a segurança do paciente.

Health-related behavior and quality of life among the elderly: a population-based study

OBJETIVO: Analisar a associação de comportamentos saudáveis com a qualidade de vida relacionada à saúde em idosos. MÉTODOS: Estudo transversal de base populacional que envolveu 1.958 idosos residentes em quatro áreas do estado de São Paulo, em 2001/2002. A qualidade de vida foi aferida com o uso do instrumento Medical Outcomes Study SF-36-Item Short Form Health Survey. As oito escalas e os dois componentes do instrumento constituíram as variáveis dependentes e as independentes foram atividade física, freqüência semanal de ingestão de bebida alcoólica e hábito de fumar. Modelos de regressão linear múltipla foram usados para controlar o efeito de sexo, idade, escolaridade, trabalho, área de residência e número de doenças crônicas. RESULTADOS: Atividade física foi positivamente associada com as oito escalas do SF-36. As maiores associações foram encontradas em aspectos físicos (β = 11,9), capacidade funcional (β = 11,3) e no componente físico. Idosos que ingeriam bebida alcoólica pelo menos uma vez por semana apresentaram melhor qualidade de vida do que os que não ingeriam. Comparados com os que nunca fumaram, os fumantes tiveram pior qualidade de vida no componente mental (β = -2,4). CONCLUSÕES: Os resultados apresentam que praticar atividade física, consumir bebida alcoólica moderadamente e não fumar são fatores positivamente associados a uma melhor qualidade de vida em idosos.

Clinical and quality-of-life outcomes after autologous fascial sling and tension-free vaginal tape: a prospective randomized trial

Purpose: Evaluate the impact autologous fascial sling (AFS) and tension-free vaginal tape (TVT) procedures on quality-of-life in incontinent women. Materials and Methods: Forty-one women were randomly distributed into two groups. Group G1 (n = 21), underwent AFS and group G2 (n = 20) TVT implant. The clinical follow up was performed at 1, 6, 12 and 36 months. Results: TVT operative time was significantly shorter than AFS. Cure rates were 71% at 1 month, 57% at 6 and 12 months in G1. In G2, cure rates were 75% at 1 month, 70% at 6 months and 65% at 12 months; there was no significant difference between groups. As regards the satisfaction rate, there was no statistical difference between groups. Analysis of quality of life at 36 months revealed that there was no significant difference between groups. Conclusion: Similar results between AFS and TVT, except for operative time were shorter in TVT.

Alternative calcium source effects on commercial egg production and quality

This study aimed at verifying the possibility of replacing calcitic limestone by marine calcium in the diet of layers. A total number of 321 Hi-sex hens, with 40 weeks of age at the beginning of the experiment, was used. A completely randomized experimental design was applied, with 5 treatments (0, 15, 30, 45, and 60 % of calcitic limestone replacement by marine calcium source) and eight replicates of eight birds each. Treatments significantly affected specific gravity (p<0.05), with the inclusion of 60% marine calcium (T5) presenting the worst result as compared to T1, which included only calcitic limestone as calcium source. It was concluded that marine calcium can replace up to 45% of calcitic limestone with no effects on performance or egg quality.

Relationship between disease severity and quality of life in patients with chronic obstructive pulmonary disease

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Storage temperature and quality of red mombin fruits (Spondias purpurea L.)

The aim was to study the effect of different storage temperatures on quality of red mombin fruit. The red mombin fruits were obtained from the Company CEAGESP/São Paulo/Brazil and transported in cool boxes to the laboratory, where they were selected on the base of appearance, maturity lack of physical damage, sanitized in 50 ppm chlorine-free solution and packaged in polystyrene trays wrapped with film of polyvinyl chloride (PVC). The experiment was a completely randomized design with three temperatures (4, 8 and 25 degrees C) and 5 time intervals (0, 2, 4, 6 and 8 days after the experiment installation). In each survey firmness, titratable acidity, soluble solids, ascorbic acid content, the skin color and also the release of CO(2) by the fruit over time were evaluated. It was observed that low temperatures prolong the fruits shelf life and the storage temperature influences the characteristics, the temperature of 8 degrees C was most suitable for the storage of red mombin fruits. Besides, the fruit color was a good indicator of changes in the pulp during storage.

Sexual behaviour, sperm quantity and quality after short-term streptozotocin-induced hyperglycaemia in rats

Studies of diabetes mellitus in the streptozotocin rat model suggest that sexual dysfunctions may result from diabetes-induced alterations of the neuroendocrine-reproductive tract axis. Our investigation was performed to better define the effects of short-term hyperglycaemia on rat epididymal sperm quantity, quality and transit time, using both natural mating and artificial in utero insemination protocols. Male rats were made diabetic with streptozotocin (sc, 40 mg/kg), whereas controls received vehicle. Sexual behaviour was tested after 15 days and sperm fertilizing ability was checked 22 days after the injection through natural mating and artificial in utero insemination. Other parameters such as daily sperm production, testosterone levels, as well as sperm morphology and motility were also investigated. Fifty per cent of the diabetic animals showed no copulatory behaviour during tests and the number of animals reaching ejaculation was smaller in the diabetic group when compared with the control group (33% vs. 83%). Diabetes resulted in decreased body and reproductive organ weights, as well as diminished sperm counts in the testis and epididymis, that were associated with diminution of plasmatic testosterone levels. After natural mating, there was a decrease in the fertility in the diabetic adult male rats (25.5%) compared with control animals (81.5%). However, distal cauda epididymal sperm from diabetic rats displayed normal fertilization ability (91.5%) using in utero insemination. There were no effects of hyperglycaemia on sperm transit time in the epididymis and on spermatogenesis. Our results indicate that diabetes mellitus produces reproductive dysfunction, but does not compromise sperm fertilizing ability in the cauda epididymis in this experimental model.

Calcium in pre-laying and laying rations on the performance and quality of laying hens' eggshell

O ensaio experimental objetivou avaliação do efeito de diferentes níveis de cálcio (Ca) nas rações de pré-postura e postura sobre o desempenho e qualidade dos ovos de poedeiras comerciais. Foram alojadas 256 frangas da linhagem Hisex Brown com 16 semanas de idade em galpão convencional de postura. O delineamento experimental foi inteiramente casualizado em arranjo fatorial 4 x 2 (4 níveis de cálcio - 0,8; 1,3; 1,8 e 2,3% na pré-postura e 2 níveis de cálcio - 2,5 e 3,5% na postura), totalizando oito tratamentos com quatro repetições de oito aves por unidade experimental. Iniciou-se com a ração de pré-postura às 16 semanas de idade das aves, sendo que a mesma foi fornecida até as aves atingiram 18 semanas de idade, quando então, iniciou-se com a ração de postura. Foram avaliadas durante quatro ciclos de 28 dias as seguintes variáveis: produção e peso dos ovos, consumo de ração, conversão alimentar, massa de ovos e qualidade da casca dos ovos. Através dos resultados obtidos pode-se concluir que um bom desempenho foi obtido com 0,8% de cálcio na fase de pré-postura. Na fase de postura o nível de 3,5% de cálcio promoveu maior peso de ovo e melhor qualidade de casca.

Plant spacing and pollen quantity on yield and quality of squash seeds

O rendimento e a qualidade de sementes de abóbora podem ser aprimorados por uma densidade populacional de plantas adequada, além da quantidade de pólen, que influi na qualidade da polinização e fertilização. Para este estudo, aplicaram-se nove tratamentos, que resultaram da combinação fatorial de três espaçamentos entre plantas (0,8 x 0,3; 0,8 x 0,6 e 0,8 x 0,9 m) com duas quantidades de pólen (50% de uma antera e uma antera inteira) e a polinização natural por insetos. Foram avaliados parâmetros de produção de frutos e sementes, além da qualidade física e fisiológica das sementes. O delineamento experimental adotado foi em blocos ao acaso com cinco repetições e dez plantas úteis por amostragem. O aumento do espaçamento entre plantas elevou o número médio de frutos maduros e a produção de sementes por planta. A produtividade de sementes foi diretamente proporcional à quantidade de pólen usada durante a polinização. Já o fator espaçamento entre plantas não afetou a produção de sementes por área. A maior quantidade de pólen resultou em uma maior produção de sementes por planta e por área. A polinização manual, com a utilização de uma antera inteira, não diferiu da polinização natural com insetos, tanto para rendimento como para a qualidade de sementes.