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- Representação do conhecimento em enfermagem do trabalho: dados relevantes face à saúde individual do trabalhador sob influência do ambiente laboralPublication . Bastos, Fernanda; Morais, Ernesto; Joana Campos, Maria; Brito, Alice; Cardoso, Alexandrina; Sousa, P.Introduction: Occupational health presents itself as a whole area to ensure healthy work environments and a better quality of life for workers. In the information systems in use, it was found that this area was missing, and a representation of existing knowledge in occupational nursing is urgent, particularly concerning the data that allow the characterization of health needs in a work environment. Objectives: Formally represent the available knowledge related to data relating to the assessment of the client under the influence of the work environment, which represent the first element of the planning and description of the nursing care process, thus constituting a fundamental resource for the design of clinical decision support systems. Methodology: This work derives from a global project developed by the Center for Research and Development of Information Systems at the Porto School of Nursing, in collaboration with the Ordem dos Enfermeiros, which consolidated itself in the construction of a Nursing Ontology. A qualitative study of inferential nature was carried out for its conception, with content analysis to national parameterization and literature review. For content validation, a focus group was used. Results: Nineteen assessment data were identified, most of which could generate sensitive indicators for nursing care, organized into three domains: i) data related to the characterization of the work activity, its context and physical intensity; ii) data related to occupational exposure potentially leading to changes in bodily and psychological processes; and iii) data that characterize aspects related to health-seeking behaviours related to the adaptive process (transition) of the client in the work context, such as knowledge and awareness. Conclusions: The identification of data is decisive for the diagnostic process, with centrality in the characterization of the data centred on physical intensity and exposure to risk factors in the work activity and the adaptive process related to areas that will influence the choice of health-promoting behaviours.
- Validation of Nursing Diagnoses for people with chronic kidney conditions on conservative treatmentPublication . de Menezes, Harlon França; Camacho, Alessandra Conceição Leite Funchal; Sousa, P.; Primo, Cândida Caniçali; Ferreira, Lucas Batista; da Silva, Richardson Augusto RosendoABSTRACT Objective: To develop and validate Nursing Diagnoses statements of the International Classification for Nursing Practice (ICNP®) aimed at the care of people with chronic kidney conditions undergoing conservative treatment. Method: This is a methodological research structured in sequenced construction stages, cross-mapping, content validation by the Delphi Technique by specialist nurses, and categorization of Nursing Diagnoses. Results: Forty-two specialist nurses participated in the first round and 34 in the second. A total of 179 Nursing Diagnoses statements were prepared, categorized according to Roy’s adaptation model, of which 160 were validated for content, with Content Validity Index ≥ 0.80. Conclusion: The Diagnoses developed and validated show the modes of adaptation to health of people with chronic kidney conditions undergoing conservative treatment, influenced by biological, psychological, social, and cultural needs, with the Physiological Mode being the most prevalent.
- Termos da linguagem especializada de enfermagem no cuidado ao recém-nascido com cateter venoso centralPublication . Prado, Nanete Caroline da Costa; Menezes, Harlon França de; Sousa, P.; Lopes, Donatila Cristina Lima; Santos, Fernanda Rafaela dos; Santos, Rebecca Stefany da Costa; Almino, Romanniny Hévillyn Silva Costa; Silva, Richardson Augusto Rosendo daObjetivo: Construir e validar uma terminologia especializada de enfermagem para o cuidado a recém-nascidos com cateter venoso central de inserção periférica (PICC), com base no Modelo de Sistemas de Betty Neuman. Métodos: Estudo metodológico, realizado em uma maternidade pública, operacionalizado pelas etapas: extração dos termos de prontuários de neonatos em uso de PICC; normalização; mapeamento cruzado com a versão 2019/2020 da CIPE®; organização nos Sete Eixos; e validação de conteúdo com enfermeiros usando-se índice de validade de conteúdo e coeficiente kappa. Resultados: Extraíram-se 1.718 termos, sendo normalizados 372 termos pertinentes, estando 265 constantes e 107 não constantes. Foram validados 335 termos, sendo 246 constantes e 89 não constantes, os quais atingiram um índice de concordância e kappa ≥ 0,80. Conclusão: Identificaramse termos relevantes, que oportunizam a assistência aos recém-nascidos em uso de cateter venoso central; assim se contribuirá com um subconjunto terminológico para a informação na prática de enfermagem.
- Clinical Decision Support Systems for Pressure Ulcer Management: Systematic ReviewPublication . Sousa, P.; Araújo, Sabrina Magalhães; Dutra, InêsBackground: The clinical decision-making process in pressure ulcer management is complex, and its quality depends on both the nurse's experience and the availability of scientific knowledge. This process should follow evidence-based practices incorporating health information technologies to assist health care professionals, such as the use of clinical decision support systems. These systems, in addition to increasing the quality of care provided, can reduce errors and costs in health care. However, the widespread use of clinical decision support systems still has limited evidence, indicating the need to identify and evaluate its effects on nursing clinical practice. Objective: The goal of the review was to identify the effects of nurses using clinical decision support systems on clinical decision making for pressure ulcer management. Methods: The systematic review was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) recommendations. The search was conducted in April 2019 on 5 electronic databases: MEDLINE, SCOPUS, Web of Science, Cochrane, and CINAHL, without publication date or study design restrictions. Articles that addressed the use of computerized clinical decision support systems in pressure ulcer care applied in clinical practice were included. The reference lists of eligible articles were searched manually. The Mixed Methods Appraisal Tool was used to assess the methodological quality of the studies. Results: The search strategy resulted in 998 articles, 16 of which were included. The year of publication ranged from 1995 to 2017, with 45% of studies conducted in the United States. Most addressed the use of clinical decision support systems by nurses in pressure ulcers prevention in inpatient units. All studies described knowledge-based systems that assessed the effects on clinical decision making, clinical effects secondary to clinical decision support system use, or factors that influenced the use or intention to use clinical decision support systems by health professionals and the success of their implementation in nursing practice. Conclusions: The evidence in the available literature about the effects of clinical decision support systems (used by nurses) on decision making for pressure ulcer prevention and treatment is still insufficient. No significant effects were found on nurses' knowledge following the integration of clinical decision support systems into the workflow, with assessments made for a brief period of up to 6 months. Clinical effects, such as outcomes in the incidence and prevalence of pressure ulcers, remain limited in the studies, and most found clinically but nonstatistically significant results in decreasing pressure ulcers. It is necessary to carry out studies that prioritize better adoption and interaction of nurses with clinical decision support systems, as well as studies with a representative sample of health care professionals, randomized study designs, and application of assessment instruments appropriate to the professional and institutional profile. In addition, long-term follow-up is necessary to assess the effects of clinical decision support systems that can demonstrate a more real, measurable, and significant effect on clinical decision making.
- Terminological subset of the International Classification for Nursing Practice for patients hospitalized due to burnsPublication . Silva, Ilisdayne Thallita Soares da; Menezes, Harlon França de; Souza Neto, Vinicius Lino de; Sales, José Renato Paulino de; Sousa, P.; Silva, Richardson Augusto Rosendo daObjective: To develop a proposal of a terminological subset of the International Classification for Nursing Practice for burned patients. Method: This is a methodological study following the steps: identification of clinical findings; mapping of terms; construction of statements of diagnoses/results and nursing interventions; content validation of statements; and structuring of the subset with the theoretical model of Basic Human Needs. Content validation was performed by 26 specialist nurses, through the Content Validity Index, with statements ≥ 0.80 being considered validated. Results: A total of 36 diagnoses/results and 119 interventions were validated. Among these, the ones with the highest index were: Respiratory System Function, Impaired/Respiratory System Function, Effective; Volume of Fluids, Impaired/ Volume of Fluids, Effective; Burn Wound/Wound Healing, Effective; Pain, Acute/ Pain, Absent, and as interventions: To Monitor Vital Signs; to Monitor Fluid Balance; to Treat Skin Condition; to Assess Response to Pain Management (Control). Conclusion: The validated statements depict the burned people basic human needs, with the psychobiological ones being the most prevalent.
- Nursing diagnoses, results, and interventions in the care for Covid-19 patients in critical conditionPublication . Menezes, Harlon França de; Moura, Jéssica Lima; Oliveira, Sylvia Silva de; Fonseca, Michelle Carneiro; Sousa, P.; Silva, Richardson Augusto Rosendo daObjective: To develop and validate a terminological subset of the International Classification for Nursing Practice for COVID-19 patients in critical care. Method: This is a methodological study, which followed the guidelines of the Brazilian method, using the Basic Human Needs as a theoretical model. Content validation was performed by 25 specialist nurses using the Delphi technique. Results: A total of 73 diagnoses and their respective nursing results were prepared. Of these, 62 statements had a Content Validity Index ≥ 0.80, with the need for oxygenation having the highest number of statements. Of the 210 nursing interventions developed, and after suggestions from experts, 150 interventions reached an index ≥ 0.80 and comprised the terminological subset. Conclusion: The terminological subset developed showed statements that were validated by specialist nurses and, therefore, are relevant to the nurse’s clinic in the critical care scenario associated with Covid-19.
- Nursing knowledge on skin ulcer healing: a living scoping review protocolPublication . Gomes, João; Sousa, P.; Pereira, Filipe Miguel Soares; Queirós, Carmen; Neves, Hugo; Silva, Catarina; Silva, Abel; Parente, Paulo; Sousa, Paula Cristina; Brito, Alice; Silva, Maria Antónia; Morais, Ernesto; Cardoso, Alexandrina; Cruz, Inês; Machado, Natália; Oliveira, Manuel Fernando; Bastos, Fernanda; Prata, Ana Paula; Sequeira, CarlosObjective: This review aims to continuously map the nursing knowledge on skin ulcer healing in any context of care. Introduction: Chronic wounds are an increasing concern for society and health care providers. Pressure ulcers and venous ulcers, among others, have devastating effects on morbidity and quality of life and require a systematic approach. The nursing process is an important method that allows a better organization and overall care quality for a systematic and continuous professional approach to nursing management of skin ulcers. The integration of this nursing knowledge in informatics systems creates an opportunity to embed decision-support models in clinical activity, promoting evidence-based practice. Inclusion criteria: This scoping review will consider articles on nursing data, diagnosis, interventions, and outcomes focused on people with skin ulcers in all contexts of care. This review will include quantitative, qualitative, and mixed methods study designs as well as systematic reviews and dissertations. Methods: JBI’s scoping review guidance, as well as the Cochrane Collaboration’s guidance on living reviews, will be followed to meet the review’s objective. Screening of new literature will be performed regularly, with the review updated according to new findings. The search strategy will map published and unpublished studies. The databases to be searched include MEDLINE, CINAHL, Scopus, JBI Evidence Synthesis, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and PEDro. Searches for unpublished studies will include OpenGrey and Reposito´ rios Cientı´ficos de Acesso Aberto de Portugal. Studies published in English and Portuguese since 2010 will be considered for inclusion.
- Nursing knowledge of people with paresis of voluntary muscles: a living scoping review protocolPublication . Neves, Hugo; Parente, Paulo; Gomes, João; Queirós, Carmen; Sousa, Joana; Parola, Vítor; Sousa, Paula Cristina; Brito, Alice; Silva, Maria Antónia; Morais, Ernesto; Cardoso, Alexandrina; Cruz, Inês; Machado, Natália; Oliveira, Manuel Fernando; Bastos, Fernanda; Pereira, Filipe Miguel Soares; Prata, Ana Paula; Silva, Abel; Sequeira, Carlos; Sousa, P.Objective: This review aims to continuously map the nursing knowledge about people with paresis of voluntary muscles in any context of care. Introduction: Muscle paresis is a condition that significantly impacts quality of life. Nurses have a crucial role in managing this condition, particularly paresis of voluntary movement muscles. However, nursing knowledge about patients with paresis of voluntary muscles is dispersed, hampering the integration of evidence within the structure of information systems. Mapping how the nursing process components are identified is the first step in creating a Nursing Clinical Information Model for this condition, capable of integrating evidence into information systems. Inclusion criteria: This scoping review will consider studies focusing on the nursing process regarding people with paresis of voluntary muscles in all care contexts. The review will include quantitative, qualitative, and mixed-methods study designs, systematic reviews, clinical guidelines, dissertations, and theses. Methods: The review process will follow JBI's scoping review guidance, as well as the Cochrane Collaboration's guidance on living reviews. Screening of new literature will be performed regularly, with the review being updated according to new findings. The search strategy will map published and unpublished studies. The databases to be searched will include MEDLINE, CINAHL, Scopus, JBI Evidence Synthesis, and the Cochrane Central Register of Controlled Trials. Searches for unpublished studies will include OpenGrey and Repositorios Cientificos de Acesso Aberto de Portugal. Studies published in English and Portuguese from 1975 will be considered for inclusion.
- Qualidade dos cuidados de enfermagem: contribuições de enfermeiros especialistas em enfermagem médico-cirúrgicaPublication . Ribeiro, Olga; Martins, MM; Sousa, P.; Trindade, Letícia de Lima; Forte, Elaine Cristina Novatzki; Silva, João Miguel Almeida Ventura daObjective: to identify the performance of activities congruent with the quality standards of nursing care by expert nurses in medical-surgical nursing, in the hospital context. Methods: a descriptive study, carried out in 36 hospitals, in which 259 nurses specialized in medical-surgical nursing participated. For data collection, a questionnaire was used, later analyzed using descriptive statistics. Results: the participating nurses evaluated activities related to the dimensions of responsibility and rigor, customer satisfaction and prevention of complications with better scores; and with lower scores, activities integrated in the dimensions of health promotion, functional readaptation and well-being and self- -care. Conclusion: although the findings show the performance of expert nurses in the medical-surgical nursing area that tends to be consistent with quality standards, gaps in professional practice and potentialities that can support the qualification process of these professionals were signaled, alert managers and qualify nursing care
- Maintaining Effects of Pulmonary Rehabilitation at Home in Chronic Obstructive Pulmonary Disease: A Systematic Literature ReviewPublication . Pinto, Duarte; Spencer, Lissa; Pereira, Soraia; Puga Machado, Paulo Alexandre; Sousa, P.; Padilha, José Miguel Santos CastroTo systematize strategies that may support patients with Chronic Obstructive Pulmonary Disease to maintain the effects of pulmonary rehabilitation over time. This systematic literature review was conducted, and the evidence was electronically searched in the Web of Science, Scopus, and EBSCO databases. This review included randomized controlled clinical trials, published until September 2019, that addressed components of an unsupervised home-based pulmonary rehabilitation program, maintenance strategies following outpatient pulmonary rehabilitation programs, as well as data on outcomes for quality of life, exercise performance, and dyspnea. A final sample of 5 articles was obtained from a total of 1693 studies. Data for final synthesis were grouped into 2 categories: components of unsupervised home-based pulmonary rehabilitation programs and maintenance strategies. An unsupervised home-based pulmonary rehabilitation program should consist of an educational component, an endurance training component, and a strength training component. When patients are transferred to the home environment, it is important to include more functional exercises specifically adapted to the patient’s condition, goals, and needs.