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- Relevance of indicators of clinical supervision strategies in nursingPublication . Pinto, Duarte José Esteves; Reis Santos, Margarida; Pires, ReginaObjective: to identifying the indicators of strategies of clinical supervision in nursing that nurses consider more relevant. Methods: it is a descriptive and exploratory research with a quantitative approach. A questionnaire was constructed to collect data, applied to a sample of 316 nurses who performed functions in a hospital context and primary health care. Results: the relevance attributed by the nurses to the indicators of clinical supervision strategies, especially the reflexive processes, as well as to methods directed to action and demonstration, are highlighted. Conclusion: the indicators identified in the study constitute an important step in the structuring and evaluation of supervision processes, contributing to the improvement of quality and safety of care.
- Management of bleeding in trauma victims by Portuguese nurses in prehospital settingPublication . Mota, Mauro; Reis Santos, Margarida; Santos, Eduardo JF; Figueiredo, Andrea; Melo, Filipe; Albuquerque, Sara; Cunha, MadalenaIntroduction: External bleeding is the leading preventable cause of death from traumatic injuries. Implementation of guidelines for its control have been associated with a significant reduction in mortality. The objectives of this study were to provide a characterisation of trauma patients with external bleeding and to compare the outcomes from specific autonomous interventions applied by nurses in prehospital care.Methods: A non-randomised prospective study was conducted in the Immediate Life Support Ambulances in Portugal, from 1 March 2019 to 30 April 2020. Patients were divided into two groups according to whether external bleeding was controlled or not on their arrival at the emergency room.Results: A total of 189 patients were included in this study (73.0% men; mean age of 53.6 years). Among these patients, 140 (74.1%) had their external bleeding controlled by prehospital nurse’s intervention. The average time of assistance at the incident site was 31.5 min. Patients with uncontrolled bleeding had a higher average rescue time (30.8 ±15.2 vs 33.7 ±13.0). Cryotherapy was administered to 15.9% of all patients and 93.3% of these patients arrived at the emergency room with controlled bleeding (p=0.01).Discussion: Despite the substantial reduction in the number of patients who keep bleeding after prehospital care, it was observed that one fifth of patients have external bleeding on arrival at the emergency room. Cryotherapy has been shown to be effective in controlling external bleeding. Failure to use haemostatic agents may explain the ineffective control of more complex external bleeding.Contribution to Emergency Nursing Practice: The current literature on management of bleeding in trauma patients is scarce and contradictory, especially in terms of interventions provided by AUTHORSMAURO AL MOTA PhD, RN1,2,3,4,5MARGARIDA REIS SANTOS PhD, RN6,7EDUARDO JF SANTOS PhD, RN2,3ANDREA FIGUEIREDO MSN, RN5FILIPE MELO MSN, RN5,8,9SARA ALBUQUERQUE MSc, MD10MADALENA CUNHA PhD, RN2,31. Abel Salazar Institute of Biomedical Sciences, University of Porto, Porto, Portugal2. Health School of the Polytechnic Institute of Viseu, Portugal3. Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Portugal4. Hospital Nossa Senhora da Assunção, Local Health Unit of Guarda, Seia, Portugal5. INEM – National Institute of Medical Emergency. Portugal6. Nursing School of Porto, Porto, Portugal7. CINTESIS – Center for Health Technology and Services Research, University of Porto, Porto, Portugal8. Hospital de Faro. University Hospital Center of Algarve. Faro, Portugal9. ABC – Algarve Biomedical Centre. Faro, Portugal10. Group of Health Centers – Greater Porto VII – Gaia, USF Nova Salus, Gaia, PortugalRESEARCH ARTICLESManagement of bleeding in trauma victims by Portuguese nurses in prehospital setting rehospital teams led by a registered nurse. In addition, interventions vary from country to country.This article increases awareness of autonomous interventions implemented by prehospital nurses to manage external bleeding.Key implications for emergency nursing practice identified in this study suggest greater fluid therapy appears harmful while cryotherapy achieved the best results (control of the bleeding on emergency room arrival). This may contribute to the review of institutional algorithms and training in this area.
- Preparação para o parto: olhar das muheresPublication . Prata, Ana Paula; Reis Santos, Margarida; Santos, Célia; Koch, Maria Cândida
- Famílias de idosos com mobilidade reduzida : implicações na dependênciaPublication . Pimenta, Susana; Martins, MM; Monteiro, Clara; Reis Santos, Margarida; Martinho, Júlia
- Ansiedade perioperatória em adolescentes: manifestações e necessidades de controlo. Revisão integrativaPublication . Pestana-Santos, Márcia; Reis Santos, Margarida; Pestana-Santos, Adriana; Pinto, Cláudia; Lomba, LurdesBackground: In a phase of development as complex as adolescence, the surgical experience is a great challenge. While there is some knowledge about manifestations of anxiety in children, less is known about manifestations of anxiety in adolescents. Likewise, the knowledge about adolescents needs for control of anxiety in the perioperative period is missing. Aims: To synthesize the existing research on the manifestations of anxiety in adolescents in the perioperative period and to identify the adolescents needs for control of anxiety in the perioperative period. Methods: An integrative review was conducted using a literature search in five different health databases. Only original studies related to the study topic were included. A six-step method was used to develop the revision and to analyze the results. Results: Of the 251 articles initially selected, only five met the inclusion criteria. A total of 114 adolescents from five different countries were represented. The manifestations of anxiety were grouped in psychological, social and physical. These manifestations were mostly related with fear of surgery, how would they deal with pain, body image change, anxiety itself and the separation from their friends. The needs were ‘to be informed’ and ‘to be involved in the decisions about their own care process’. Conclusions: The adolescents have manifestations of anxiety and specific needs to deal with perioperative anxiety, which need to be taken into account in the planning of perioperative care. Further research is needed to promote the development of an evidence-based program tailored to answer to the adolescent’s needs and to minimize their manifestations of anxiety in the perioperative period.
- Estratégias de supervisão clínica: análise crítico-reflexiva das práticasPublication . Pires, Regina; Reis Santos, Margarida; Pereira, Filipe Miguel Soares; Pires, MargaridaIntrodução: A supervisão clínica em enfermagem é um processo formal de acompanhamento da prática clínica, que visa promover o desenvolvimento profissional, a proteção dos clientes e a segurança dos cuidados, através de processos de reflexão e análise das práticas. Objetivo: Identificar estratégias de supervisão clínica em uso. Métodos: Estudo qualitativo, exploratório. Os participantes foram 42 Enfermeiros de três Centros de Saúde da região norte de Portugal. Recolha dos dados através de entrevista semiestruturada e análise efetuada segundo os princípios do método da grounded theory. Resultados: Da análise emergiu a categoria “Análise crítico-reflexiva das práticas” e respetivas dimensões e subcategorias. As dimensões identificadas foram: “Dimensão intrapessoal”, da qual emergiram duas subcategorias; e a “Dimensão interpessoal”, da qual emergiram dez subcategorias. Conclusão: Concluiu-se que existia um conjunto de estratégias de supervisão em uso, promotoras do desenvolvimento profissional, nomeadamente, a análise crítico-reflexiva das práticas. Contudo, constatou-se que havia um conjunto de constrangimentos de natureza individual e contextual que podiam interferir com a operacionalização desta estratégia, que exige serem refletidos.
- Preparar o regresso a casa da criança com cancroPublication . Pires, Rita; Reis Santos, Margarida; Pinto, Cândida
- Pre-hospital treatment of acute trauma pain: an observational studyPublication . Mota, Mauro; Reis Santos, Margarida; Santos, Eduardo; Henriques, Carla; Matos, Ana; Cunha, MadalenaObjective: To describe and analyze the effectiveness of nurses’ interventions in pain reduction among patients with traumatic injury. Methods: Prospective cohort study conducted in the Immediate Life Support Ambulances in Portugal from March 1, 2019 to April 30, 2020. We have collected data on the kind of interventions implemented and the time elapsed during rescue procedures. To investigate the course of acute trauma pain, a 11-point Numeric Rating Scale was used. Changes in the level of pain registered throughout the three assessment moments were studied using linear mixed-effects models with random intercepts to account for the repeated measurements conducted on the same patient. These changes were assessed before and after the administration of the pain relief interventions. Results: 596 patients were included in this study. Most of them were male (65.9%) and had a mean age of 53.05±19.72 years. There was a reduction in the average pain intensity of 2.44 points (p<0.005), between the beginning and end of the assessment, and a reduction of 39.62% among the patients who were experiencing a level of pain equal to or greater than 7 (46.7% vs 7.08%, p<0.05). Measures involving the use of morphine, cryotherapy and relationship-based measures have proven to be effective. Comfort measures as a whole do not seem to have a significant impact on pain relief. Conclusion: Pre-hospital pharmacological and non-pharmacological nurses’ interventions have proven to be effective in reducing pain. Comfort measures have not been proved to be effective, so their potential must be rethought and enhanced.
- Parceria nos cuidados à criança nos serviços de pediatria: Perspetiva dos enfermeirosPublication . Lopes, Natália Quina; Reis Santos, Margarida; Sousa, Paula CristinaA prestação de cuidados em âmbito pediátrico implica que o enfermeiro detenha um complexo domínio de capacidades comunicacionais, relacionais e cognitivas, que lhe permitam interagir, de forma profissional, com a presença e participação do acompanhante no cuidado à criança hospitalizada. Inúmeras evidências científicas revelam as dificuldades que os acompanhantes sentem no processo de adaptação e trabalho em parceria com o enfermeiro. No entanto, são poucas ou, quase inexistentes, aquelas que se referem à perspetiva dos enfermeiros e às suas dificuldades neste processo. É com base nesta constatação que emerge o presente trabalho, cujo cerne se vincula à temática da presença e participação do acompanhante nos cuidados à criança hospitalizada, numa abordagem centralizada na opinião dos enfermeiros. Concluiu-se que os enfermeiros reconhecem a importância de envolver os acompanhantes no cuidado à criança hospitalizada, revelando que efetivamente o promovem nos cuidados básicos, contudo não o fazem nos de maior complexidade. Face ao Modelo de Parceria de Cuidados, baseado num processo de negociação, este estudo revelou que os enfermeiros ainda têm alguma dificuldade em incluir os acompanhantes como verdadeiros parceiros
- Avaliação dos conhecimentos sobre alimentação em crianças pré-escolaresPublication . Claro, Joana Filipa; Reis Santos, Margarida; Rêgo, Carla