https://repositorio.ufms.br/handle/123456789/1977 2026-04-15T06:17:53Z https://repositorio.ufms.br/handle/123456789/12830 Título: PROPOSTA DE PADRONIZAÇÃO DOS PROCEDIMENTOS DE (RE)FIXAÇÃO DO CATETER NASOENTERAL COM FITA ADESIVA EM UNIDADE DE TERAPIA INTENSIVA ADULTO Abstract: Proper fixation of the nasoenteral catheter (NEC) in adult intensive care unit (ICU) patients is crucial to ensure the effectiveness of nutritional therapy and prevent complications such as nasal injuries, accidental displacement, and prolonged discomfort. Although adhesive tape is widely used in clinical practice, the absence of a specific Standard Operating Procedure (SOP) results in varied techniques and increases the risk of adverse events (AEs). This methodological study aimed to develop and validate an SOP for the safe and efficient (re)fixation of NEPs with adhesive tape in adult ICUs. Conducted between September and November 2024, it involved nurses with at least six months of experience in the ICU. Initially, a preliminary POP model was developed, followed by an analysis of the techniques used by professionals. Validation was based on Pasquali's criteria (objectivity, simplicity, clarity, precision, appearance, scientific writing, sequence, and content), using a Likert scale. Agreement among experts was achieved through the Delphi Technique, with a minimum Content Validity Index (CVI) of 0.80. In the first round, the diversity of fixation methods was evident. In the second round, after incorporating the suggestions, the SOP was validated, with an emphasis on improvements such as standardizing skin preparation, fixation techniques, and ensuring both aesthetic and functional adequacy. The implementation of this SOP aims to reduce AEs, increase patient safety, and standardize care practices, thus contributing to greater effectiveness in enteral nutrition therapy. Future research may evaluate the effectiveness of the updated protocol in different ICUs, analyze catheter fixation materials and techniques, the incidence of skin lesions, the durability of fixation, and the economic impact of implementation, with a focus on reducing hospital costs. Tipo: Dissertação 2025-01-01T00:00:00Z https://repositorio.ufms.br/handle/123456789/12758 Título: FATORES RELACIONADOS À (SUB) NOTIFICAÇÃO DE EVENTOS ADVERSOS POR PROFISSIONAIS DA TERAPIA INTENSIVA Abstract: Introduction: The global discussion on the magnitude and social impact of adverse health events has made it essential to analyze the factors related to their incidence to improve care. However, gaps in the identification and reporting persist among multidisciplinary teams in adult intensive care units. Objective: To compare incident triggers in patient records with adverse event reports in adult intensive care units. Method: Exploratory, documentary, multi-method research conducted in an adult intensive care unit of a hospital in southern Brazil from May to October 2024. The sample consisted of medical records selected by simple random sampling and spontaneous adverse event reports submitted to the Patient Safety Center during the study period. The records were analyzed using the Global Trigger Tool. Data were collected by trained nurses, and the listed triggers were reviewed by a team of nurses and a physician. Data were analyzed using descriptive statistics, chi-square test, and logistic regression using R 4.4.0 software. Results: A total of 87 medical records of patients with a mean age of 61.07 years and a median length of stay of three days were analyzed. Triggers and adverse events (AEs) were identified in 85 records (97.7%). A total of 352 triggers were identified, 190 of which were confirmed as AEs. Each additional trigger increased the likelihood of notifications by 30.6%. However, only 10% of the confirmed AEs were reported. A statistically significant association was observed between the occurrence of an adverse event and the following triggers: "cardiorespiratory arrest," "pressure injury," "procedural complications," and "healthcare-associated infections." Of the total number of notifications during this period, 224 reports of AEs involving 98 patients were recorded, with an average of two events per patient. The majority of patients were male (61.2%) and predominantly white or brown (both 46.9%). Spontaneous notifications were more frequent in May and June. The most common events were pressure- or device-related injuries (62.1%), unscheduled device removals (16.1%), and medication failures (6.7%). The root causes were related to method (48.7%) and labor (41.5%), emphasizing communication failures, noncompliance with protocols, and inadequate training. Conclusion: The high rate of underreporting of adverse events highlights the importance of using active surveillance methods, in addition to voluntary reporting, to strengthen the culture of patient safety. Descriptors: Patient Safety. Adverse Event. Intensive Care Unit. Incident Reporting. Nursing. Tipo: Dissertação 2025-01-01T00:00:00Z https://repositorio.ufms.br/handle/123456789/12738 Título: ATENÇÃO EM SAÚDE AO ADOLESCENTE COM O COMPORTAMENTO DE AUTOLESÃO, E SUA FAMÍLIA, NA REDE DE ATENÇÃO PSICOSSOCIAL: PERSPECTIVA DE ADOLESCENTES, FAMILIARES E PROFISSIONAIS Abstract: The mental health of adolescents is a national and international concern, since the changes that occur during this phase can cause psychological distress. In this context, non-suicidal self-injury (NSSI) can be an inadequate strategy for relieving distress in this population. This health condition impacts both the individual's life and that of their family, who face different feelings such as fear, shame, and uncertainty. Access to health services and comprehensive care for adolescents and their families are important, however, there are gaps identified both in these individuals' access to health services and in comprehensive care. Thus, this study aims to understand how health care is provided within the Psychosocial Care Network to adolescents with self-harming behavior and their families, from the perspective of adolescents, family members, and health professionals. To this end, a qualitative study was conducted, based on the theoretical framework of Kleinman's Explanatory Model of Illness. The participants were adolescents with ALNS behavior, their families, and professionals from services belonging to the RAPS in a capital city in the Midwest region of Brazil. Data collection took place between May and July 2025, through in-depth interviews with the interest groups, using an initial semi-structured script with guiding questions based on the theoretical framework. The average duration of the interviews ranged from ten to forty minutes, and they were audio-recorded. Data collection began with contact with the fields chosen to present the research proposal and, after acceptance, it was requested that it be disclosed to adolescents and their families through an invitation written in the form of an open letter with information about the research. Afterwards, an interview was scheduled with those participants who accepted and qualified for the research. For data analysis, thematic content analysis was used, following three established stages: pre-analysis, exploration of the material, and treatment of the results. The results were organized based on the thematic content analysis, giving rise to the central theme “Self-harm in adolescence: experiences, family relationships, and care within the Psychosocial Care Network (RAPS),” where the main findings showed that self-harm in adolescents affects not only the relationship between parents and children, but on the entire family dynamic, reinforcing the importance of including the family in therapeutic care. It also revealed that, although CAPSi is recognized as a welcoming space, assistance is still fragmented, marked by a shortage of professionals, insufficient training, and weaknesses in the coordination of RAPS. In addition, it highlighted the school as a strategic space for early detection and referral of cases. The results of this study provided a comprehensive understanding of the experience of adolescents who self-harm and their families, revealing profound emotional impacts that extend beyond the parent-child relationship to also affect marital and family dynamics. Tipo: Dissertação 2025-01-01T00:00:00Z https://repositorio.ufms.br/handle/123456789/12338 Título: ANÁLISE CLÍNICO EPIDEMIOLÓGICA DOS PACIENTES SUBMETIDOS À CIRURGIA DE REVASCULARIZAÇÃO DO MIOCÁRDIO NO ESTADO DE MATO GROSSO DO SUL ANTES E APÓS O INÍCIO DA PANDEMIA DA COVID-19 Abstract: Introduction: The onset of the coronavirus pandemic, officially declared by the World Health Organization in early 2020, increased morbidity and mortality associated with cardiovascular conditions, particularly among patients who underwent surgical myocardial revascularization (MR). Objective: To analyze the clinical and epidemiological profile of patients who underwent surgical myocardial revascularization before and after the onset of the COVID-19 pandemic. Method: This is a cross-sectional study based on medical record data from patients who underwent surgical myocardial revascularization (MR) between 2016 and 2023 in three large public hospitals in the state of Mato Grosso do Sul. The data were collected between April and December 2024. The study population included patients aged 18 or older who underwent surgical myocardial revascularization (MR) during the study period, based on information extracted from their medical records. Records that were incomplete, unavailable for review, or related to patients who underwent combined surgical procedures were excluded. The collected data underwent both descriptive and inferential statistical analyses, which included the chi-square or Fisher’s exact tests, along with the Mann-Whitney U test, using a significance level of 0.05. The study was approved by the Research Ethics Committees of the Universidade Federal de Mato Grosso do Sul (UFMS) under the Certificate of Presentation for Ethical Consideration (Portuguese Acronym: CAAE) number 75540223.7.0000.0021. Results: The sample consisted of 210 patients. It was characterized by a predominance of male patients (70.5%) and a mean age of 61.59 years (±9.67). Following the pandemic, there was an increase in the incidence of non–ST-segment elevation myocardial infarction (from 25% to 64%), use of extracorporeal circulation (ECC) (from 79.3% to 84.4%), ECC duration (from 1:09:55 (± 0:36:18) to 1:31:10 (± 1:01:02); p = 0.001), cardiopulmonary arrest (from 2.4% to 11.2%), overall acute myocardial infarction (from 19.2% to 21.6%), and atrial fibrillation (from 18% to 26.4%). Regarding post-surgical outcomes, most patients were discharged following clinical improvement. However, the mortality rate increased after the onset of the pandemic (from 8.5% to 15.6%). Conclusion: This study identified significant clinical changes following the onset of the pandemic, including a higher incidence of non–ST-segment elevation myocardial infarction, increased use and prolonged duration of extracorporeal circulation, and a greater occurrence of complications. These findings contribute to a deeper understanding of cardiovascular care and underscore the critical importance of comprehensive preoperative and postoperative management. Tipo: Dissertação 2025-01-01T00:00:00Z