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- Supervision and mentoring in higher education: Dynamics of successPublication . Cunha, Madalena; Silva, Daniel; Reis Santos, Margarida; Albuquerque, CarlosINTRODUCTION. Based on the inherent benchmark of mentoring and perceptoring, and conscious of the challenge of reducing the estimated school dropout rate of 12% for the Polytechnic Institute of Viseu (IPV), the main aim of the project Supervision and Mentoring in Higher Education: Dynamics of Success (SuperES) is to promote the development of pedagogical supervision skills with focus on teacher – student dyads, and thus enhance the quality of teaching in the IPV. The direct bene*ciaries are the IPV assistants, and subsequently the students, who will bene*t from a pedagogical didactic literacy program (Cunha et al., 2017). OBJECTIVE. To promote the pedagogical supervision skills of the IPV assistants, which can reduce failure and school dropouts. METHODS. The sample will consist of approximately 210 assistants and 900 students. The methodology is based on an experimental research with two groups: the experimental group, which will receive training, and the control group. To monitor the e+ectiveness of the program, a battery of questionnaires will be applied before and after its implementation. RESULTS AND DISCUSSION. Of the 17 activities executed, the evaluation of the pedagogical supervision skills is highlighted. They are: (i) the construction/implementation/ evaluation of the SuperES Program; (ii) the construction of a computer platform/ website – Didactics & School Supervision: Caixa Geral de Ajudas; (iii) the creation of a tool, “Supervision +”, used for the self-monitoring of pedagogical skills. CONCLUSIONS. The SuperES program integrates a research action that aims to implement/ test training and research tools on the process of pedagogical supervision
- Eficácia da intervenção da enfermagem pré-hospitalar na estabilização das vítimas de traumaPublication . Mota, Mauro; Cunha, Madalena; Santos, Eduardo; Figueiredo, Ândrea; Silva, Márcio; Campos, Rui; Reis Santos, MargaridaAbstract Background: Trauma is a public health issue with a significant social and economic impact. However, national data on its characterization and the role of nursing in its management is still scarce. Objective: To assess the effectiveness of prehospital nursing interventions in stabilizing trauma victims provided by nurses of Immediate Life Support Ambulances in Portugal. Methodology: Observational, prospective, and descriptive-correlational study. Data were collected by nurses of the Immediate Life Support Ambulances in mainland Portugal, from 01/03/2019 to 30/04/2020, and the Azores, from 01/10/2019 to 30/04/2020. Trauma severity indices were assessed before and after the nursing interventions. Results: This study included 606 cases (79.4% blunt trauma; 40.8% road accidents) reported by 171 nurses. Nurses performed mostly interventions for hemodynamic support (88.9%) and non-pharmacological pain control (90.6%) of trauma victims. The nursing interventions improved the Revised Trauma Score and the Shock Index (p<0.001). Conclusion: Prehospital nursing interventions improve trauma victims’ clinical status.
- O enfermeiro no pré-hospitalar: cuidar para a curaPublication . Mota, Mauro; Cunha, Madalena; Reis Santos, MargaridaIntrodução: A presença de enfermeiros no contexto pré-hospitalar português remonta ao ano de 1981. Em 2007, constituíram-se as Ambulâncias Suporte Imediato de Vida do Instituto Nacional de Emergência Médica, onde os enfermeiros assumem a função de team leaders. Esta reflexão tem como objetivo analisar o papel dos enfermeiros no socorro pré-hospitalar. Desenvolvimento: O contexto pré-hospitalar imprime fortes desafios à Enfermagem e à sua identidade profissional. Os enfermeiros conduzem as suas intervenções e tomam as suas decisões de acordo com a melhor evidência científica, seguindo protocolos terapêuticos predefinidos. Enquanto lideres da equipa de socorro, são responsáveis pela gestão dos diferentes intervenientes que prestam assistência no pré-hospitalar, garantindo a segurança dos cuidados de saúde. As pessoas socorridas no pré-hospitalar depositam no enfermeiro as esperanças não só de garantir a sua sobrevivência, como também, de que no decorrer do socorro, o cuidar, intimamente ligado à génese da Enfermagem, seja também salvaguardado. A produção e disseminação de conhecimento científico contribuirá para a otimização de todas as práticas autónomas e interdependentes. Conclusões: O papel do enfermeiro do pré-hospitalar assenta em três pontos fundamentais: administração de cuidados de Enfermagem no processo de cura/saúde; implementação de metodologias de gestão do risco e desenvolvimento de estratégias de gestão para a segurança do socorro; promoção de investigação no âmbito da prestação de cuidados de emergência que contribuam para a melhoria dos cuidados de Enfermagem prestados. A disseminação do conhecimento que corrobora as práticas vigentes no contexto pré-hospitalar contribuirá para que se perceba a importância da participação de enfermeiros no quadro da emergência e para a afirmação da imprescindibilidade e insubstituibilidade da sua intervenção no pré-hospitalar.
- Food consumption, body mass index and risk for oral health in adolescentsPublication . Reis Santos, Margarida; Bica, Isabel; Cunha, Madalena; Costa, José; Costa, Patrícia; Bica, AlexandraObjective: The food intake has great in uence on the oral health of adolescents, being relevant to analyze the type of food consumed by adolescents and their relationship with the DMFT index (decayed, missing and lled), the plaque index (PI) and the body mass index (BMI). Design: Epidemiological study conducted in public schools of the 3rd cycle of basic education, central Portugal. Instruments: The sociodemographic and dietary habits and frequency characterization was obtained through a self-administered questionnaire completed by adolescents and validated for the population under study. The DMFT index was evaluated according to WHO criteria, oral hygiene was evaluated based on the plaque index and BMI through weight and height in adolescents. Participants: Random sample by clusters (schools) with 661 adolescents, 84.1% female and 15.9% male. Results: Adolescents with mean age 13.22 years (± 1.139). The mean DMFT was 2.23 (± 2.484), the prevalence of PI was 96.4%, and ≥ 5 BMI <85. Adolescents with a higher DMFT index consume more cariogenic foods (r = 0.160; P = .000). Adolescents with a higher BMI consume less cariogenic foods (r = –0.1343; P = .001). The value of t reveals that the consumption of cariogenic foods explains 1.8% of the variance of the BMI and 2.6% DMFT. Conclusion: The cariogenic foods are presented as a risk factor for dental caries. The results suggest that it is important to develop up actions for health education.
- Indicadores de saúde oral em adolecentesPublication . Bica, Isabel; Cunha, Madalena; Marinho, Catarina; Cordinhã, Patrícia; Rodrigues, Vitor; Reis Santos, MargaridaOs indicadores da saúde oral permitem mensurar o estado de saúde e higiene da boca. O presente, estudo de natureza descritiva e cariz transversal, foi realizado numa amostra constituída por 189 adolescentes com idades compreendidas entre os 11 e 17 anos, com uma média de idades de 13 anos (Dp=1.17), do concelho de Sátão, distrito de Viseu. A pesquisa teve como finalidade avaliar o Índice de Dentes Cariados, Perdidos e Obturados (CPOD), o Índice de Placa Bacteriana Simplificado e caracterizar as práticas de higiene oral dos adolescentes. Para o efeito, a avaliação dos indicadores de saúde oral foi efetuada por observação clínica. Em face dos resultados inferiu-se que os adolescentes apresentam saúde oral precária, com 34,9% de dentes cariados, a maioria apresenta placa bacteriana reveladora de deficientes práticas de higiene oral. Os resultados reforçam que o planeamento das intervenções de educação para a saúde em adolescentes devem considerar os valores dos indicadores de saúde oral.
- Consensus must be found on intravenous fluid therapy management in trauma patientsPublication . Mota, Mauro; Reis Santos, Margarida; Cunha, Madalena; Melo, Filipe; Neves, Hugo; Abrantes, TitoIntroduction: Trauma is an important cause of death among young people and 30-40% of this mortality rate is due to hypovolemic shock, intensified by trauma’s lethal triad: Hypothermia, Acidosis, and Coagulopathy. Nurses are responsible for managing fluid therapy administration in trauma victims. The purpose of this study is to analyse the reasons why intravenous fluid therapy is recommended for trauma patients’ hemodynamic stabilization. Methods: This narrative literature review included published and unpublished studies in English, Spanish or Portuguese between 1994 and January 2019. The search results were analyzed by two independent reviewers. Inclusion criteria encompasses quantitative studies involving trauma victims aged over 18 who underwent fluid therapy in a prehospital assessment context. Results& Discussion: 11 quantitative studies were included. 9 involved the use of fluid therapy for hypotension treatment and 2 of the studies analyzed involved the use of warmed fluid therapy for hypothermia treatment. The analysis performed reveals that the administration of aggressive fluid therapy seems to be responsible for the worsening of the lethal triad. In the presence of traumatic brain injury, permissive hypotension is not allowed due to the negative impact on cerebral perfusion pressure. Used as warming measure, warmed fluid therapy does not seem to have a significant impact on body temperature. Conclusions: There is no consensus regarding the administration of fluid therapy to trauma patients. This conclusion clearly supports the need to develop more randomized controlled trials in order to understand the effectiveness of such measure when it comes to control hypovolemia and hypothermia.
- More+ oral health with ProSorriso ProgramPublication . Bica, Isabel; Cunha, Madalena; Reis Santos, Margarida; Costa, José; Costa, PatríciaINTRODUCTION AND OBJECTIVE. The proactive involvement of health and education professionals with a focus on development transition groups is an important pillar for achieving the oral health goals for 2020 established by the World Health Organization and require reinforcement of actions for health promotion and prevention of oral diseases. Thus, it is justi+ed to develop a program of oral health promotion in schools, such as ProSorriso (Costa, 2014), in order to evaluate the e9ectiveness of the Program. METHODS. Quasi-experimental study, with measures’ application before and after the implementation of the ProSorriso Program, in 200 adolescents, aged between 11-16 years (mean of 13.21±1.014 years). This Program is developed in three phases: diagnosis, intervention and evaluation of the oral health of adolescents. The application of the Questionnaires of Eating Habits, Oral Hygiene and Oral Health Knowledge, as well as mouth observation according to WHO criteria (1997), occurred before and after participation in the program. RESULTS. Adolescents improved their oral health after active participation in ProSorriso, presenting fewer decayed teeth and more +lled teeth. Their dental plaque bio+lm also improved with signi+cant bene+ts for adolescents who bene+ted from the Program interventions (t = 7.389; p = .000). Adolescents’ knowledge about oral health and nutrition enhanced signi+cantly after participation in the ProSorriso Program (t = -6.510; p = .000); (t = 2.523; p = .012). CONCLUSIONS. Adolescents improved their health status, eating habits, hygiene and oral health knowledge, recognizing the e9ectiveness of the implementation of the ProSorriso Program as a determinant of adolescents present and future health.
- Non-pharmacological interventions for pain management in adult victims of traumaPublication . Mota, Mauro; Cunha, Madalena; Reis Santos, Margarida; Silva, Dulce; Santos, EduardoThis scoping review aims to map non-pharmacological interventions for reducing acute pain for adult victims of trauma. Introduction: Acute pain, as a consequence of either a pathological or traumatic event or even due to invasive and non-invasive healthcare procedures, is highly prevalent in critically ill patients. However, specific acute pain as a direct consequence of trauma is one of the least studied areas of acute pain. Inclusion criteria: This scoping review will consider studies on adult victims of trauma, aged 18 years or over, in prehospital emergency care, emergency departments and trauma centers. All studies that focus on non-pharmacological interventions designed to reduce acute pain, implemented and evaluated by health professionals in any form, duration, frequency and intensity, will be considered. Methods: An initial search of PubMed and CINAHL will be undertaken, followed by a second search for published and unpublished studies from 2000 to the present in major healthcare related electronic databases. Studies in English, French, Spanish and Portuguese will be included. Data extraction will be performed independently by two reviewers in tabular form and include details about the interventions, populations, study methods and outcomes of interest. A narrative synthesis will accompany the results and will describe how they relate to the review objectives
- Intervenções de enfermagem pré-hospitalar : revisão narrativaPublication . Mota, Mauro; Cunha, Madalena; Reis Santos, Margarida; Cunha, Isabel Cristina; Alves, Mónica; Marques, NunoConstruir algoritmos de intervenção de enfermagem pré-hospitalar para vítimas de trauma. Metodologia: Revisão Narrativa da Literatura, entre 2008 e 2019, nas principais bases de dados. Dois revisores independentes realizaram a avaliação crítica, extração e síntese dos dados. A construção dos algoritmos resultou do processo interpretativo da revisão narrativa por três peritos na área. Utilizou-se o modelo teórico de Virgínia Henderson. Resultados: Obtiveram-se 17 documentos, seis foram incluídos no desenvolvimento dos metaparadigmas Saúde, Pessoa e Ambiente e 16 na elaboração e construção de Algoritmos de avaliação, diagnóstico e intervenções de enfermagem às vítimas de trauma. Conclusões: A revisão possibilitou a operacionalização do modelo teórico de Henderson para a assistência pré-hospitalar permitindo a criação de algoritmos orientadores da prática de enfermagem.
- 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.