Clinical deterioration of hospitalized adults based on nursing records: a scoping review Edina Maria Araújo, Ismael Brioso Bastos, Tales Santiago de Lima Silva, Ticiana Linhares Coelho da Silva, Francisco Heron de Carvalho Junior, Cristiane Costa Araujo, Rhanna Emanuela Fontenele Lima de Carvalho Acta Paulista De Enfermagem, 2025 Objective To map in literature signs and symptoms present in nursing records that may signal clinical deterioration in hospitalized adult patients. Methods This is a scoping review, guided by JBI Reviewer’s Manual recommendations. Searches were conducted in databases such as MEDLINE, CINAHL, Web of Science, Scopus, Embase, CAPES Theses and Dissertations Portal and Google Scholar, without time or language restrictions. The results were managed in Rayyan software for selection by titles and abstracts, full text and removal of duplicates. Results The 18 studies analyzed identified 36 signs and symptoms associated with clinical deterioration in hospitalized adult patients. All articles highlighted the five vital signs as essential for detecting this deterioration, such as blood pressure, temperature, heart rate, respiratory rate, and oxygen saturation. The main symptoms observed include agitation, changes in blood pressure, changes in blood glucose, changes in breathing/abnormal respiratory signs, cyanosis, aggressive behavior, decreased urine output, abdominal distension, hyperglycemia, changes in heart rate, desaturation, shortness of breath, noisy breathing, dehydration, edema, wound exudation, bleeding, change in state of consciousness, anxiety, unwell appearance, chills, tension headache, seizure, pain, abdominal pain, chest pain, chest pain, lethargy, nausea, pallor, cold and clammy skin, rectal bleeding, signs of shock, sweating, dizziness, and productive cough. Conclusion Nursing records are essential tools for monitoring patients’ condition and guiding clinical decisions, as they reveal signs and symptoms that may indicate a state of clinical deterioration or other health conditions.
Patient safety culture in primary and home care services Letícia Martins Lousada, Francisco Clécio da Silva Dutra, Beatriz Viana da Silva, Natália Lúcia Lima de Oliveira, Ismael Brioso Bastos, Patrícia Freire de Vasconcelos, Rhanna Emanuela Fontenele Lima de Carvalho BMC Family Practice, 2020 Background Safety culture is still a poorly studied subject in primary care and home care, although these settings are considered gateways to access to healthcare. This study aims to evaluate safety culture in primary and home care settings. Methods An observational cross-sectional study was carried out with 147 professionals from nine districts covered by one home care program and six primary healthcare centres. The Safety Attitudes Questionnaire (SAQ) was used to evaluate the safety culture, in which scores ≥75 are indicative of a positive safety culture. Results A total of 56 (86,1%) questionnaires returned from the home care professionals and 91 (86,6%) from the primary care professionals. The Job satisfaction domain was the best evaluated, achieving a score of 88.8 in home care and 75.1 in primary care. The achievement of high scores on Safety Climate, Job Satisfaction, Teamwork Climate, and Total SAQ was related to male gender, and time of professional experience of three to 4 years. Perception of management and Working conditions had the lowest scores, and this result was related with long time of experience. Conclusions It is concluded that professionals working in home care gave higher scores for safety culture in their workplace than the primary care workers.
Construction and validation of educational booklet content for fall prevention in hospitals Maria Aline Moreira Ximenes, Natália Ângela Oliveira Fontenele, Ismael Brioso Bastos, Thamires Sales Macêdo, Nelson Miguel Galindo Neto, Joselany Áfio Caetano, Lívia Moreira Barros Acta Paulista De Enfermagem, 2019 Resumo Objetivo Construir e validar cartilha educativa para prevenção de quedas no hospital. Métodos Estudo metodológico desenvolvido a partir da construção, validação e avaliação da cartilha por 22 enfermeiros e 22 pacientes internados em clínica médica. Para a validação com juízes, avaliou-se objetivo, estrutura/apresentação e relevância do material e, na avaliação com pacientes, aplicou-se o instrumento Suitability Assesment of Materials (SAM). Utilizou-se o Índice de Validade de Conteúdo (IVC) para análise de cada etapa da validação, considerando válido os iguais ou superiores a 0,80. Resultados A cartilha intitulada “Cuidados para não cair nessa” é composta por 20 páginas. Na validação de conteúdo, os profissionais atribuíram o IVC global de 1,0 para objetivo, estrutura/apresentação e relevância do material. Na avaliação dos pacientes, o IVC global da cartilha foi de 0,98. Conclusão A cartilha educativa é considerada válida quanto ao conteúdo e compreensível pelos pacientes de forma que possui utilização viável na educação em saúde para prevenção de quedas no hospital.