Vilanice Alves de Araújo Püschel

Introduction: Pain is a frequent complaint in emergency departments (ED), particularly among polytrauma patients, who often experience high levels of pain. The Advanced Trauma Life Support protocol is widely used to assess such patients, prioritizing life-threatening conditions through the ABCDE approach. However, pain documentation is often insufficient, and analgesia administration is frequently delayed, even in conscious patients able to report their pain. Objectives: This project aimed to promote evidence-based practices for pain assessment and management in an emergency trauma room. Methods: The project followed the seven-phase JBI Evidence Implementation Framework. A baseline audit assessed 211 patient records against seven audit criteria and barriers to best practices were identified. After the implementation of improvement strategies, a follow-up audit measured changes in compliance with best practices. Results: Key barriers included lack of pain documentation, absence of a reliable assessment scale, no reassessment after analgesia or before ED discharge, and delays in analgesic administration. To address these, a protocol for systematic pain evaluation was implemented, ensuring analgesia aligned with recorded scores, alongside training for medical and nursing teams. The follow-up audit demonstrated marked improvement across all criteria. Compliance exceeded 70% for pain documentation upon arrival in the ED using a validated tool and for analgesia administration based on recorded scores. Reassessment after analgesia and prior to discharge remained below 60%, likely reflecting structural challenges within the ED. Time to first analgesic dose was reduced, indicating progress in timely administration. Conclusion: The implementation strategies proved effective, improving the systematic care provided in the emergency trauma room of the ED, in alignment with best practices for the assessment and management of pain in polytrauma patients. Spanish https://links.lww.com/IJEBH/A674

Objective: To map the elements for the planning, implementation/engagement, and monitoring of nutrition education aimed at people with diabetes mellitus in Primary Health Care. Method: A scoping review was conducted according to JBI guidelines. Searches were performed in databases (LILACS, BDENF, MEDLINE, Cochrane, Scopus, Web of Science, EMBASE) and grey literature sources (Google Scholar, BDTD/CAPES, Canadian-Theses-Portal, DiVA, RCAAP, OATD, WHO), with final tracking on May 4, 2025. Study selection was performed by reviewer pairs, independently and blindly, and data analysis by inductive thematic categorization. Results: Twenty-one studies were included, predominantly in English, from middle/high-income countries, and with experimental designs. The analysis defined three categories (planning, implementation/engagement, monitoring) and eight dimensions, highlighting community involvement, cultural adaptation, active methodologies, and continuous follow-up. Gaps persist in type 1 diabetes, long-term monitoring, and research in low-income countries. Conclusion: The findings reinforce the centrality of culturally sensitive, interactive, and interdisciplinary educational approaches that consider the cultural, social, and emotional specificities of the population served, promoting the protagonism of individuals in the self-care process.

RESUMO Objetivo: Mapear os elementos para o planejamento, a execução/engajamento e o monitoramento da educação nutricional voltada a pessoas com diabetes mellitus na Atenção Primária à Saúde. Método: Revisão de escopo, conforme as diretrizes do JBI. As buscas foram realizadas em bases de dados (LILACS, BDENF, MEDLINE, Cochrane, Scopus, Web of Science, EMBASE) e em fontes de literatura cinzenta (Google Acadêmico, BDTD/CAPES, Canadian-Theses-Portal, DiVA, RCAAP, OATD, WHO), com o rastreamento final em 04 de maio de 2025. A seleção dos estudos foi realizada por duplas de revisores de forma independente e cega, e a análise dos dados por categorização temática indutiva. Resultados: Incluíram-se 21 estudos, predominantemente em inglês, de países de médio/alto nível socioeconômico e com delineamentos experimentais. A análise definiu três categorias (planejamento, execução/engajamento, monitoramento) e oito dimensões, salientando envolvimento comunitário, adaptação cultural, metodologias ativas e acompanhamento. Lacunas persistem sobre diabetes tipo 1, monitoramento de longo prazo e pesquisas em países de baixo desenvolvimento econômico. Conclusão: os resultados reforçam a centralidade das abordagens educativas culturalmente sensíveis, interativas e interdisciplinares que considerem as especificidades culturais, sociais e emocionais da população atendida, promovendo o protagonismo dos indivíduos no processo de autocuidado.

RESUMEN Objetivo: Mejorar las prácticas de triaje y evaluación de la salud física de personas con trastornos mentales graves y persistentes asistidas en un centro de atención psicosocial de Brasil. Método: Se trata de un proyecto para establecer prácticas mejoradas según la Estructura de Implementación de Evidencias de la JBI, que se realizó en el municipio de Itatiba, estado de São Paulo, con usuarios del Centro de Atención Psicosocial II. La auditoría inicial (n = 278) y la auditoría de seguimiento (n = 134) evaluaron el cumplimiento de siete criterios basados en la evidencia. El proceso de recopilación de datos se llevó a cabo en diferentes fases, a saber, la identificación del área de la práctica a ser alterada, la participación de agentes de cambio, la evaluación del contexto y de la disposición al cambio, la auditoría de las prácticas usuales del servicio, la implementación de cambios en la práctica, la evaluación de las estrategias implementadas y el monitoreo de los cambios en la práctica. Resultados: La consecución inicial fue baja, con varios indicadores que no alcanzaban el 10%. Tras la implementación de herramientas de documentación estandarizadas, la integración de las evaluaciones de enfermería en el ingreso y la planificación de la coordinación entre servicios, se observaron mejoras significativas. La documentación del examen físico aumentó del 9,0% al 47,1% (+38,1 pp), el registro del Índice de Masa Corporal, del 0% al 22,4% (+22,4 pp) y la programación de consultas de seguimiento, del 1,1% al 21,6% (+20,5 pp). Sin embargo, se observó un progreso mínimo o nulo en los exámenes de laboratorio, en las solicitudes de electrocardiogramas y en la monitorización de los efectos secundarios de los antipsicóticos. Conclusión: El proyecto fortaleció las rutinas internas y demostró la viabilidad de implementar prácticas basadas en la evidencia. No obstante, el progreso limitado en criterios dependientes de factores externos y la necesidad de una integración profesional más sólida resaltan la importancia de una inversión mayor para abordar las brechas persistentes en la atención médica.

Objective: To improve physical health screening and assessment practices for individuals with severe and persistent mental disorders treated at a Psychosocial Care Center in Brazil. Method: A best practice implementation project following the JBI Evidence Implementation Framework conducted in the municipality of Itatiba in the state of São Paulo, with users of the Psychosocial Care Center II. The baseline audit (n = 278) and follow-up audit (n = 134) assessed compliance with seven evidence-based criteria. The data collection process occurred in different phases, which included identifying the area of practice to be changed, engaging change agents, assessing the context and readiness for change, auditing current service practices, implementing practice changes, evaluating the implemented strategies, and monitoring changes in practice. Results: Baseline compliance was low, with several indicators below 10%. After implementing standardized documentation tools, integrating nursing assessments at intake, and planning inter-service coordination, key improvements were observed. Documentation of physical examination increased from 9.0% to 47.1% (+38.1 pp), Body Mass Index recording from 0% to 22.4% (+22.4 pp), and scheduling of follow-up appointments from 1.1% to 21.6% (+20.5 pp). However, minimal or no progress occurred in laboratory testing, electrocardiogram requests, and monitoring of antipsychotic side effects. Conclusion: The project strengthened internal routines and demonstrated the feasibility of implementing evidence-based practices. Nevertheless, limited progress in criteria dependent on external factors and the need for stronger professional integration highlight the importance of greater investment to address persistent care gaps.

Introduction: The COVID-19 pandemic has primarily affected the older people, prompting isolation and social restriction. In addition, there was an overwhelming volume of information about the pandemic across various media, particularly the infodemic phenomenon, which has led to changes in their daily lives, negatively affecting their mental health. The objective of this study was to understand the repercussions of the infodemic on older people’s routine during the COVID-19 pandemic. Methods: This is an exploratory, descriptive study with a qualitative approach conducted with 43 community-dwelling older people aged 60 years and older, were capable of responding to questions autonomously, and had access to the Internet, carried out between 2021 and 2022, in the city of São Paulo. The data were collected via semi-structured interviews, entered into a database, and analyzed using the Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (IRAMUTEQ) software, employing thematic content analysis and the Reinert method. Results: Four thematic categories were identified, as follows: Search for information on COVID-19; Hesitation concerning the information disclosed during the pandemic; Changes to older people’s daily routine during the pandemic; and Feelings experienced by older people during the pandemic. Conclusion: The findings showed that even in the face of a pandemic crisis scenario and receiving excessive information, it was possible for them to readapt, although emotional burdens may have been generated, such as stress and anxiety.

RESUMO Objetivos: mapear as evidências sobre as práticas realizadas pela equipe de enfermagem na terapia antineoplásica ambulatorial com o uso de cateter intravenoso periférico e identificar as complicações associadas ao uso desse dispositivo. Métodos: trata-se de uma revisão de escopo seguindo a metodologia do JBI. O processo de seleção foi conduzido de forma cegada por dois revisores independentes. Resultados: foram recuperadas 1.287 publicações e, ao final, incluídos 16 estudos. As práticas foram relacionadas à responsabilidade pelo procedimento; prevenção de infecção e biossegurança; seleção do sítio de punção; escolha do dispositivo de punção; preparo da pele; punção venosa; manutenção do acesso; cobertura e estabilização; e retirada e descarte do dispositivo. Entre as complicações, destacaram-se flebite, edema, dor, ardência, extravasamento e infecção da corrente sanguínea. Conclusões: foi realizado o mapeamento das práticas de cateterismo intravenoso periférico ambulatorial em nove categorias, sendo as complicações mais frequentes flebite, edema, dor, ardência, extravasamento e infecção da corrente sanguínea.