Navegando por Palavras-chave "Paediatric nursing"

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    O brinquedo terapêutico na assistência à criança hospitalizada: significado da experiência para o aluno de graduação em enfermagem
    (Universidade de São Paulo, Escola de Enfermagem, 1998-04-01) Ribeiro, Circéa Amalia [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    This study describes a phenomenological analysis of a nursing under graduated student's discourse, who used the therapeutic play for caring a hospitalized child. The goal of the study was to understand the meaning of the experience for this student.
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    Oral care and oropharyngeal and tracheal colonization by Gram-negative pathogens in children
    (Wiley-Blackwell, 2012-05-01) Kusahara, Denise Miyuki [UNIFESP]; Friedlander, Lais Tambelli [UNIFESP]; Peterlini, Maria Angélica Sorgini [UNIFESP]; Pedreira, Mavilde da Luz Gonçalves [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Background: Critical care nursing interventions to oral care can reduce microorganisms in the oropharynx available for translocation.Objectives: To analyse the effect of 0.12% chlorhexidine digluconate on the colonization of oropharyngeal and tracheal secretions by Gram-negative pathogens in mechanically ventilated children.Methods: A randomized, controlled and double-blinded study was performed in the paediatric intensive care unit (PICU) of a Brazilian university hospital. Exclusion criteria included child age under 28 days, pneumonia diagnosis at admission, use of tracheostomy, PICU length of stay (LOS) less than 48 h and refusal to participate. Children were randomly allocated to the interventional group (IG), in which oral care with chlorhexidine was administered, or to the placebo group (PG), which received oral care without antiseptic use. the data were analysed through Pearson's chi(2) test, Fisher's exact and ANOVA tests with significance levels set at 0.05.Results: the demographic characteristics of the 74 children were not statistically different between groups. No between-group differences in oropharyx colonization by Gram-negative pathogens were identified (p = 0.316). Pathogens were isolated in the tracheal secretions of two (10.0%) children in the PG and four (19.0%) children in the IG (p = 0.355).Conclusion: the use of chlorhexidine did not significantly influence the colonization of oropharyngeal and tracheal secretions by Gram-negative pathogens of the studied sample.Relevance to clinical practice: This study demonstrated no influence of a specific antiseptic agent on colonization profile of mechanically ventilated children in PICU. Further research in this field is necessary to promote evidence-based nursing practice on oral care of critically ill children.
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    Oral care with 0.12% chlorhexidine for the prevention of ventilator-associated pneumonia in critically ill children: Randomised, controlled and double blind trial
    (Elsevier B.V., 2012-11-01) Kusahara, Denise Miyuki [UNIFESP]; Peterlini, Maria Angélica Sorgini [UNIFESP]; Pedreira, Mavilde da Luz Gonçalves [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Purpose: To test the effectiveness of oral care with 0.12% chlorhexidine in decreasing ventilator-associated pneumonia in critically ill children.Methods: Prospective, randomised, controlled, double-blind clinical trial performed in a paediatric critical care unit at a university hospital. the sample was composed of 96 mechanically ventilated children randomly allocated to the chlorhexidine group (oral care with a toothbrush and an antiseptic gel twice a day) and the placebo group (oral care with a toothbrush and a non-antiseptic gel twice a day). Microbiological analyses of oropharyngeal and tracheal secretions were performed 24, 48 and 96 h after intubation. Chi-square, Fischer's exact and Mann-Whitney tests were applied (p <= 0.05).Results: the chlorhexidine group was composed of 46 children, and the placebo group consisted of 50 children. Within these samples, 15 (32.6%) children in the chlorhexidine group and 16 (32.0%) children in the placebo group developed ventilator-associated pneumonia (p = 0.949). Children in the chlorhexidine group without potentially pathogenic microflora in their oropharynx 24 h after mechanical ventilation presented with fewer episodes of ventilator-associated pneumonia (p = 0.019). the pathogen colonization profile of children with ventilator-associated pneumonia in the chlorhexidine group included Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa. in the placebo group, Pseudomonas aeruginosa and Escherichia coli were the predominant potentially pathogenic microorganisms. the intervention did not influence paediatric intensive care unit mortality (p = 0.425), hospital length of stay (p = 0.143), or paediatric intensive care unit length of stay (p = 0.177).Conclusions: the use of 0.12% chlorhexidine did not significantly modify the VAP incidence in a sample of mechanically ventilated children. (C) 2012 Elsevier B.V. All rights reserved.