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  1 / 1953 MEDLINE  
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[PMID]:28891880
[Au] Autor:Abela-Dimech F; Johnston K
[Ad] Endereço:Frances Abela-Dimech, MN, BScN, RN, is Director of Interprofessional Practice, Patient Safety and Risk at the Centre for Addiction and Mental Health, Toronto Ontario. Kim Johnston, MN, BScN, BA, RN, is Manager of Clinical Education and Informatics, Centre for Addiction and Mental Health, Toronto, Ontario.
[Ti] Título:Safe Searches: The Scale and Spread of a Quality Improvement Project.
[So] Source:J Nurses Prof Dev;33(5):247-254, 2017 Sep/Oct.
[Is] ISSN:2169-981X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:To ensure the safety of staff, patients, and visitors to psychiatric inpatient units, a standardized safe search protocol was developed and implemented across a psychiatric facility. This article provides an overview of the methods used in the planning, implementation, and spread of this quality improvement initiative, focusing on the concepts of change management, leadership, and team involvement. The professional development of point-of-care staff is enhanced by active engagement in quality improvement initiatives.
[Mh] Termos MeSH primário: Implementação de Plano de Saúde/métodos
Melhoria de Qualidade
Segurança/normas
Medidas de Segurança/normas
[Mh] Termos MeSH secundário: Seres Humanos
Liderança
Unidade Hospitalar de Psiquiatria/normas
Desenvolvimento de Pessoal
Visitas a Pacientes
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170912
[St] Status:MEDLINE
[do] DOI:10.1097/NND.0000000000000385


  2 / 1953 MEDLINE  
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[PMID]:28885136
[Au] Autor:Jiang L; Ng HL; Ho HJ; Leo YS; Prem K; Cook AR; Chen MI
[Ad] Endereço:Saw Swee Hock School of Public Health, National University of Singapore and National University Health System,Singapore,Singapore.
[Ti] Título:Contacts of healthcare workers, patients and visitors in general wards in Singapore.
[So] Source:Epidemiol Infect;145(14):3085-3095, 2017 10.
[Is] ISSN:1469-4409
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:To characterize contacts in general wards, a prospective survey of healthcare workers (HCWs), patients and visitors was conducted using self-reported diary, direct observation and telephone interviews. Nurses, doctors and assorted HCWs reported a median of 14, 18 and 15 contact persons over one work shift, respectively. Within 1 h, we observed 3·5 episodes with 25·6 min of cumulative contact time for nurses, 2·9 episodes and 22·1 min for doctors and 5·0 episodes with 44·3 min for assorted-HCWs. In interactions with patients, nurses had multiple brief episodes of contact; doctors had fewer episodes and less cumulative contact time; assorted-HCWs had fewer contact episodes of longer durations (than for nurses and doctors). Assortative mixing occurred amongst HCWs: those of the same HCW type were the next most frequent class of contact after patients. Over 24-h, patients contacted 14 persons with 23 episodes and 314·5 min of contact time. Patient-to-patient contact episodes were rare, but a maximum of five were documented from one patient participant. 22·9% of visitors reported contact with patients other than the one they visited. Our study revealed differences in the characteristics of contacts among different HCW types and potential transmission routes from patients to others within the ward environment.
[Mh] Termos MeSH primário: Quartos de Pacientes/estatística & dados numéricos
Pacientes/estatística & dados numéricos
Recursos Humanos em Hospital/estatística & dados numéricos
Centros de Atenção Terciária
Visitas a Pacientes/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Infecção Hospitalar/transmissão
Feminino
Seres Humanos
Masculino
Meia-Idade
Modelos Teóricos
Estudos Prospectivos
Singapura
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171125
[Lr] Data última revisão:
171125
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170909
[St] Status:MEDLINE
[do] DOI:10.1017/S0950268817002035


  3 / 1953 MEDLINE  
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[PMID]:28700838
[Au] Autor:David JG
[Ad] Endereço:From the Department of Psychology, Drexel University, Philadelphia.
[Ti] Título:The Chair Grant.
[So] Source:N Engl J Med;377(2):108-109, 2017 Jul 13.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Organização do Financiamento
Decoração de Interiores e Mobiliário
Visitas a Pacientes
[Mh] Termos MeSH secundário: Doença de Crohn/terapia
Feminino
Seres Humanos
Pacientes Ambulatoriais
Pacientes
Pesquisadores
[Pt] Tipo de publicação:JOURNAL ARTICLE; PERSONAL NARRATIVES
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170724
[Lr] Data última revisão:
170724
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170713
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMp1704381


  4 / 1953 MEDLINE  
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[PMID]:28671901
[Au] Autor:Rosa RG; Tonietto TF; da Silva DB; Gutierres FA; Ascoli AM; Madeira LC; Rutzen W; Falavigna M; Robinson CC; Salluh JI; Cavalcanti AB; Azevedo LC; Cremonese RV; Haack TR; Eugênio CS; Dornelles A; Bessel M; Teles JMM; Skrobik Y; Teixeira C; ICU Visits Study Group Investigators
[Ad] Endereço:1Department of Intensive Care, Hospital Moinhos de Vento, Porto Alegre, Brazil. 2Institute for Education and Research, Hospital Moinhos de Vento, Porto Alegre, Brazil. 3Department of Intensive Care, Instituto Nacional do Câncer, Rio de Janeiro, Brazil. 4Research Institute, Hospital do Coração (HCor), São Paulo, Brazil. 5Institute for Education and Research, Hospital Sírio Libanês, São Paulo, Brazil. 6Department of Intensive Care, Hospital de Urgência de Goiânia, Goiânia, Brazil. 7Department of Medicine, McGill University, Montréal, Canada.
[Ti] Título:Effectiveness and Safety of an Extended ICU Visitation Model for Delirium Prevention: A Before and After Study.
[So] Source:Crit Care Med;45(10):1660-1667, 2017 10.
[Is] ISSN:1530-0293
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To evaluate the effect of an extended visitation model compared with a restricted visitation model on the occurrence of delirium among ICU patients. DESIGN: Prospective single-center before and after study. SETTING: Thirty-one-bed medical-surgical ICU. PATIENTS: All patients greater than or equal to 18 years old with expected length of stay greater than or equal to 24 hours consecutively admitted to the ICU from May 2015 to November 2015. INTERVENTIONS: Change of visitation policy from a restricted visitation model (4.5 hr/d) to an extended visitation model (12 hr/d). MEASUREMENTS AND MAIN RESULTS: Two hundred eighty-six patients were enrolled (141 restricted visitation model, 145 extended visitation model). The primary outcome was the cumulative incidence of delirium, assessed bid using the confusion assessment method for the ICU. Predefined secondary outcomes included duration of delirium/coma; any ICU-acquired infection; ICU-acquired bloodstream infection, pneumonia, and urinary tract infection; all-cause ICU mortality; and length of ICU stay. The median duration of visits increased from 133 minutes (interquartile range, 97.7-162.0) in restricted visitation model to 245 minutes (interquartile range, 175.0-272.0) in extended visitation model (p < 0.001). Fourteen patients (9.6%) developed delirium in extended visitation model compared with 29 (20.5%) in restricted visitation model (adjusted relative risk, 0.50; 95% CI, 0.26-0.95). In comparison with restricted visitation model patients, extended visitation model patients had shorter length of delirium/coma (1.5 d [interquartile range, 1.0-3.0] vs 3.0 d [interquartile range, 2.5-5.0]; p = 0.03) and ICU stay (3.0 d [interquartile range, 2.0-4.0] vs 4.0 d [interquartile range, 2.0-6.0]; p = 0.04). The rate of ICU-acquired infections and all-cause ICU mortality did not differ significantly between the two study groups. CONCLUSIONS: In this medical-surgical ICU, an extended visitation model was associated with reduced occurrence of delirium and shorter length of delirium/coma and ICU stay.
[Mh] Termos MeSH primário: Delírio/prevenção & controle
Unidades de Terapia Intensiva
Visitas a Pacientes
[Mh] Termos MeSH secundário: Idoso
Brasil/epidemiologia
Coma/epidemiologia
Estudos Controlados Antes e Depois
Infecção Hospitalar/epidemiologia
Delírio/epidemiologia
Feminino
Mortalidade Hospitalar
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170704
[St] Status:MEDLINE
[do] DOI:10.1097/CCM.0000000000002588


  5 / 1953 MEDLINE  
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[PMID]:28240697
[Au] Autor:Kozub E; Scheler S; Necoechea G; OʼByrne N
[Ad] Endereço:Surgical Intensive Care Unit, Sharp Memorial Hospital, San Diego, California.
[Ti] Título:Improving Nurse Satisfaction With Open Visitation in an Adult Intensive Care Unit.
[So] Source:Crit Care Nurs Q;40(2):144-154, 2017 Apr/Jun.
[Is] ISSN:1550-5111
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The focus on patient- and family-centered care (PFCC) has become increasingly prevalent throughout health care. In the intensive care unit (ICU), family involvement becomes critical, as patients are often unable to fully engage in their care. After expanding family visitation to 24 hours, nurses in a surgical ICU perceived that they did not have the ability to tailor the visitation to meet the patient's condition and there was an opportunity to improve nurse satisfaction related to PFCC. The objective of this performance improvement project was to increase nurse satisfaction related to PFCC and create consistency across clinicians for visitation practices. The Unit Practice Council developed staff guidelines for family visitation that included scripting prompts the nurse could use when communicating with families. The adoption of staff guidelines for family visitation was helpful in creating a culture change toward PFCC. Nurses' overall mean stress level with PFCC decreased, and their perception of having difficulty in reducing patients' or families' anxieties also decreased. The development of guidelines for family visitation can be easily implemented across other critical care environments. Scripting prompts along with the visitation guidelines can serve as a useful strategy to build nurses' skills in communicating with families.
[Mh] Termos MeSH primário: Atitude do Pessoal de Saúde
Unidades de Terapia Intensiva
Satisfação no Emprego
Recursos Humanos de Enfermagem no Hospital/psicologia
Visitas a Pacientes
[Mh] Termos MeSH secundário: Enfermagem de Cuidados Críticos
Enfermagem Familiar
Seres Humanos
Política Organizacional
Visitas a Pacientes/psicologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170417
[Lr] Data última revisão:
170417
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170228
[St] Status:MEDLINE
[do] DOI:10.1097/CNQ.0000000000000151


  6 / 1953 MEDLINE  
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[PMID]:28209429
[Au] Autor:Knutsson S; Enskär K; Golsäter M
[Ad] Endereço:Department of Nursing, School of Health and Welfare, Jönköping University, Sweden; CHILD Research Group, Jönköping University, Sweden. Electronic address: susanne.knutsson@ju.se.
[Ti] Título:Nurses' experiences of what constitutes the encounter with children visiting a sick parent at an adult ICU.
[So] Source:Intensive Crit Care Nurs;39:9-17, 2017 Apr.
[Is] ISSN:1532-4036
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Despite a cultural change in visitation policies for children (0-17 years) at the intensive care unit (ICU) to a more open approach, children are still restricted from visiting for various reasons. To overcome these obstacles, it is vital to determine what is needed while encountering a child. AIM: To elucidate nurses' experiences of what constitutes the encounter with children visiting a sick parent at an adult ICU. METHOD: An explorative inductive qualitative design was used, entailing focus group interviews with 23 nurses working at a general ICU. The interviews were analysed according to inductive content analysis. RESULTS: The findings show components that constitute the encounter with children as relatives at the ICU, as experienced by ICU nurses: nurses need to be engaged and motivated; parents need to be motivated; the child needs individual guidance; and a structured follow-up is needed. This reflects a child-focused encounter. CONCLUSIONS: Nurses need to adopt a holistic view, learn to see and care for the child individually, and be able to engage parents in supporting their children. To accomplish this the nurses need engagement and motivation, and must have knowledge about what constitutes a caring encounter, in order to achieve a caring child-focused encounter.
[Mh] Termos MeSH primário: Relações Interpessoais
Enfermeiras e Enfermeiros/psicologia
Relações Profissional-Família
[Mh] Termos MeSH secundário: Adolescente
Atitude do Pessoal de Saúde
Criança
Pré-Escolar
Enfermagem de Cuidados Críticos/recursos humanos
Feminino
Grupos Focais
Seres Humanos
Unidades de Terapia Intensiva/organização & administração
Masculino
Pais/psicologia
Assistência Centrada no Paciente
Pesquisa Qualitativa
Visitas a Pacientes/psicologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170822
[Lr] Data última revisão:
170822
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170218
[St] Status:MEDLINE


  7 / 1953 MEDLINE  
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[PMID]:28121791
[Au] Autor:Goldsack JC; Mascioli CJ; Sonnad SS; Mascioli S
[Ad] Endereço:At Christiana Care Health System in Newark, Del., Jennifer C. Goldsack is a research associate, Christopher J. Mascioli is a research assistant, and Seema S. Sonnad is director of health services research, all at the Value Institute; and Susan Mascioli is the director of nursing quality and safety.
[Ti] Título:Data transparency at the point of care: Results of patient and visitor interviews.
[So] Source:Nursing;47(2):59-66, 2017 Feb.
[Is] ISSN:1538-8689
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Atitude Frente à Saúde
Disseminação de Informação
Pacientes/psicologia
Sistemas Automatizados de Assistência Junto ao Leito
Visitas a Pacientes/psicologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Estudos Transversais
Feminino
Seres Humanos
Masculino
Meia-Idade
Segurança do Paciente
Satisfação do Paciente
Pacientes/estatística & dados numéricos
Pesquisa Qualitativa
Visitas a Pacientes/estatística & dados numéricos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170126
[St] Status:MEDLINE
[do] DOI:10.1097/01.NURSE.0000511821.03527.29


  8 / 1953 MEDLINE  
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[PMID]:28070956
[Au] Autor:Biggar S
[Ad] Endereço:26 Brinsley Road, Melbourne, Victoria, 3124, Australia.
[Ti] Título:The view from the elevator.
[So] Source:J Paediatr Child Health;53(1):87-88, 2017 Jan.
[Is] ISSN:1440-1754
[Cp] País de publicação:Australia
[La] Idioma:eng
[Mh] Termos MeSH primário: Hospitais Pediátricos
Política Organizacional
Irmãos
Visitas a Pacientes
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Infecção Hospitalar/prevenção & controle
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; PERSONAL NARRATIVES
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170111
[St] Status:MEDLINE
[do] DOI:10.1111/jpc.13437


  9 / 1953 MEDLINE  
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[PMID]:27915124
[Au] Autor:Johnson C
[Ad] Endereço:Clinical Research Nurse, NET Research Team (Neuro, Emergencies and Trauma) St. Mary's Hospital, Imperial College Healthcare NHS Trust, United Kingdom. Electronic address: katjohnson@hotmail.co.uk.
[Ti] Título:A literature review examining the barriers to the implementation of family witnessed resuscitation in the Emergency Department.
[So] Source:Int Emerg Nurs;30:31-35, 2017 Jan.
[Is] ISSN:1878-013X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Caring for people near death in the Emergency Department (ED) is challenging for professionals, duty bound to respond to the needs of the dying. Family witnessed resuscitation (FWR) is practiced internationally, allowing relatives to be present at the time of a patient's death, offering comfort to the dying and aiding the bereaved along a healthy grief trajectory. AIM: The literature review elicits barriers to the implementation of FWR in the ED, examining why practice is sporadic despite numerous professional bodies calling for implementation. FWR is often met with opposition from staff, subsequently largely dependent upon who is on duty as opposed to adherence with best practice guidelines, risking inconsistent idiosyncratic practice. FINDINGS: Barriers include; a lack of organisational support; shortage of manpower for provision of a family support person; absence of champions for the concept; willful non-adherence due to personal beliefs; restriction on coping strategies reliant upon the ability to emotionally detach, enhancing staff resilience facing repeated exposure to emotionally labile events. CONCLUSION: All resuscitation efforts can be successful, whether the patient lives or dies, if practice supports healthy grieving. The challenge remains with such divided, entrenched and passionate views, how FWR can be adopted as accepted practice.
[Mh] Termos MeSH primário: Família/psicologia
Relações Profissional-Família
Ressuscitação/psicologia
Visitas a Pacientes/psicologia
[Mh] Termos MeSH secundário: Adaptação Psicológica
Adulto
Atitude do Pessoal de Saúde
Morte
Serviço Hospitalar de Emergência/organização & administração
Seres Humanos
Política Organizacional
Ressuscitação/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:161205
[St] Status:MEDLINE


  10 / 1953 MEDLINE  
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[PMID]:27906731
[Au] Autor:Suba S; Donesky D; Scruth EA; Carrieri-Kohlman V
[Ad] Endereço:Author Affiliations: Research Assistant (Mr Suba) and Associate Adjunct Professor (Dr Donesky), Department of Physiological Nursing, University of California, San Francisco School of Nursing; Critical Care/Sepsis Clinical Practice Consultant, Clinical Effectiveness Team, Regional Quality and Regulatory Services, Kaiser Permanente, Oakland, California (Dr Scruth); and Professor Emeritus, University of California, San Francisco School of Nursing (Dr Carrieri-Kohlman).
[Ti] Título:Association Between Clinical Nurse Specialist's Presence and Open Visitation in US Intensive Care Units.
[So] Source:Clin Nurse Spec;31(1):30-35, 2017 Jan/Feb.
[Is] ISSN:1538-9782
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Current evidence shows that an open visitation policy can benefit patients and families during intensive care unit (ICU) stays. Therefore, an unrestricted visitation policy in the ICU has been proposed as part of patient-centered care. PURPOSE: The purpose of this secondary analysis is to explore the likelihood of an ICU with a clinical nurse specialist (CNS) having an open visitation policy when compared with an ICU without a CNS. DESIGN: This is a secondary analysis of a survey conducted between 2008 and 2009, describing the ICU visitation practices in more than 600 hospitals across the United States. METHODS: χ Analysis was performed comparing the presence of CNS in the ICU with visitation policies, with P < 0.05 considered statistically significant. RESULTS: There were data from 347 hospitals used in the analysis, with 47 hospitals (13.5%) having open visitation policies. There were 108 hospitals (31%) that had a CNS present in the ICU; 14 of the hospitals (13%) had open visitation policies. No significant correlation was found between a CNS being present in the ICU and open visitation policy (odds ratio, 0.93; P = .83), regardless of hospital geographic regions. CONCLUSIONS: Although CNS presence was not associated with open visitation in this study, given the strong evidence to support the benefits to patients and the CNS role as a change agent in the hospital system, liberalization of visitation in the ICU is an area that could benefit from CNS advocacy.
[Mh] Termos MeSH primário: Unidades de Terapia Intensiva
Enfermeiras Clínicas
Visitas a Pacientes
[Mh] Termos MeSH secundário: Seres Humanos
Unidades de Terapia Intensiva/organização & administração
Funções Verossimilhança
Papel do Profissional de Enfermagem
Política Organizacional
Assistência Centrada no Paciente
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170501
[Lr] Data última revisão:
170501
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:161202
[St] Status:MEDLINE



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