Navegando por Palavras-chave "cuidados intensivos"
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- ItemSomente MetadadadosCompetências da enfermagem em terapia intensiva: construção e proposições para o desenvolvimento profissional(Universidade Federal de São Paulo (UNIFESP), 2013-02-27) Viana, Renata Andrea Pietro Pereira [UNIFESP]; Carmagnani, Maria Isabel Sampaio Carmagnani [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Nowadays with globalization, the demand for healthcare providers with knowledge, versatility and capable of facing the reality of cost-effectiveness, should estimulate them to develop attitudes towards continuous education and they must learn how to learn. In this scenario, the intensive care unit (ICU) nurse has been involved in his daily practice with questions of teaching, research, service, management and policy issues that require ongoing construction of multiple skills. Objective: The aim of this study was to construct a profile of the skills and strategies needed to develop professional nursing care in the ICU, focused on the needs, labor relations, the experiences and demands of a labor market in continous transformation, imposed conditions on nurses in differents hospitals at the intensive care unit. Methods: A qualitative approach was made as a strategy of action research methodology, whose techniques for data collection were developed in two phases. During the first phase, it was done the data collection through one questionnaire answered by nurses who had attended scientific events promoted by the Brazilian Association of Intensive Care. Through this instrument, the researchers were able to know the ICU’s nurses opinion from different regions of the country, about the different skills needed to work in this area and how the development has occurred. In the second phase of this research, the questionnaire answered in the first phase guided the data collection. This phase has occurred by conducting five focal groups meetings, where twelve nurses from public and private hospitals of the city of São Paulo were invited to attend these meetings. This technique was adopted to identify the profile of skills and strategies for its development in the training of nurses. Results: In the exploratory phase 400 questionnaires were distributed but only 295 were validated. It was observed that nurses believe that they should have a dynamic profile, encompassing a constant scientific update. In accord to the abilities, technical knowledge, scientific and leadership were the most prominent. At this phase, it was identified and mapped ten competencies required for intensive care nurses, besides the creation of a plan for the development of individual nurses in the ICU. Conclusion: It was evident that there is a specific profile both in training and in personal aspects to work in intensive care, due the specific characteristics that involve the sector. It was also shown that the development of expertise by these workers occur in routine situations, from which they build skills, which is not the result of a cumulative and mechanical processes. For this, it is necessary to consider the entire context in which the professional is inserted, for instance his life and his work. With the data obtained, it is expected to formulate a training program for nurses in intensive care units, departing from the desired professional profile and planned to occur in a permanet way. Such program must value the search for integral care of critical patient and, considerate previous education of the professionals, stimulating participative, critical and reflexive acitivities.
- ItemAcesso aberto (Open Access)Nurses' leadership styles in the icu: association with personal and professional profile and workload(Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo, 2009-02-01) Balsanelli, Alexandre Pazetto [UNIFESP]; Cunha, Isabel Cristina Kowal Olm [UNIFESP]; Whitaker, Iveth Yamaguchi [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)This study aims to explore the association between nurses' leadership styles and personal and professional nursing profile and workload. The sample consisted of seven nurses and seven nursing technicians who were grouped into pairs. At the end of three months, nurses were queried regarding what leadership style would be adopted when the nursing technician under their evaluation delivered care to patients admitted to the ICU. Relevant data was analyzed by applying descriptive statistics, Tukey's multiple comparison test and Student's t-test (p< 0.05). Nursing workload reached 80.1% on average. The personal and professional profile variables did not show any relation with the leadership styles chosen by nurses (p>0.05). The determine, persuade, and share leadership styles prevailed. However, whenever the nursing workload peaked, the determine and persuade styles were used (p<0.05).
- ItemAcesso aberto (Open Access)Potencial hidrogeniônico de soluções de cloridrato de dobutamina expostas a condições ambientais de unidades de cuidados intensivos neonatais(Sociedade Brasileira de Pediatria, 2009-12-01) Reis, Lidiane Lopes [UNIFESP]; Peterlini, Maria Angélica Sorgini [UNIFESP]; Pedreira, Mavilde da Luz Gonçalves [UNIFESP]; Hospital Israelita Albert Einstein Unidade de Cuidados Intensivos Neonatais; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To verify the hydrogen-ion potential (pH) of dobutamine hydrochloride solutions under environmental conditions similar to those of neonatal intensive care units. METHODS: We analyzed the pH of the drug diluted in 5% dextrose in water or 0.9% NaCl under different conditions of temperature (22 and 37 °C) and light (dark, fluorescent light bulbs, and phototherapy equipment), using colorless and amber intravenous sets at time intervals of 0, 1, 24, 48, 72, and 96 hours. RESULTS: The pH values of the marketed form of the drug and the diluted drug were similar. The pH means were 3.45±0.19 at 22 °C and 3.55±0.20 at 37 °C. The average of the pH according to light conditions were as follows: in the dark = 3.62±0.09, under room light = 3.63±0.07, and exposed to phototherapy = 3.31±0.16. Solutions stored in colorless intravenous sets had a lower mean (3.41±0.24) than those kept in amber intravenous sets (3.52±0.15). We found lower pH values in the solutions exposed to phototherapy using colorless intravenous sets (3.17±0.03) than in those using amber intravenous sets (3.55±0.03). CONCLUSION: There was higher variation in the pH of the solutions exposed to phototherapy, and the use of amber intravenous sets reduced such effect.
- ItemAcesso aberto (Open Access)Soluções hipertônicas em pediatria(Sociedade Brasileira de Pediatria, 2003-11-01) Carvalho, Werther Brunow de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Hospital Santa Catarina; Beneficência Portuguesa de São PauloOBJECTIVE: To describe the current knowledge and indications for use of hypertonic saline solutions in pediatrics patients. SOURCE OF DATA: Medline recent review articles and personal files. SUMMARY OF THE FINDINGS: Basic physiologic principles were reviewed concerning the distribution of fluid inside the intravascular, interstitial and intracellular compartments. We also reviewed the findings concerning the mechanisms responsible for the rapid onset of cardiocirculatory effects and the additional effect of the colloid component. Finally, we present the medical terms used in the context of small-volume resuscitation, the indications for clinical use, the evidence from clinical research (hemorrhagic shock, preclinical trauma care, septic shock, and head trauma), and the disadvantages and potential adverse effects of small-volume resuscitation. CONCLUSIONS: Resuscitation by means of hypertonic saline solutions associated or not with colloid solutions is one of the most innovative concepts for primary resuscitation from trauma and shock established in the past decade. Currently, the spectrum of potential indications involves not only prehospital trauma care, but also perioperative and intensive care therapy. However, additional randomized double-blind studies are required with both children and adult patients to confirm the advantages of the method in terms of survival.