Priscilla Roberta Silva Rocha

Background/Objectives: Point-of-care ultrasound (PoCUS) has been increasingly incorporated into nursing practice across diverse clinical settings. However, the absence of a clear, nursing-specific conceptualization of the clinical competencies required for its use continues to limit its safe and effective integration. This scoping review aimed to map and synthesize the clinical competencies required for nurses to use PoCUS and to examine how these competencies have been described and assessed in the literature. Methods: A scoping review was conducted in accordance with the JBI Collaboration methodology and reported according to the PRISMA-ScR guideline. The protocol was registered in the Open Science Framework. Searches were conducted on 9 April 2025 in PubMed/MEDLINE, Embase, CINAHL, Web of Science, and the Cochrane Library, and were complemented by gray literature searches in Google Scholar and ProQuest Dissertations & Theses Global. Data synthesis was guided by Miller’s Pyramid of clinical competence. Results: A total of 2481 records were identified. After removal of 540 duplicates, 1941 records were screened. Of these, 128 full-text articles were assessed for eligibility and 28 studies were included in the final synthesis. Technical and procedural competencies predominated, particularly those related to image acquisition and ultrasound-guided interventions. By contrast, competencies associated with clinical reasoning, interpretive judgment, and autonomous decision-making were described inconsistently. Conclusions: Although PoCUS use by nurses is expanding, clinical competence development remains uneven and predominantly focused on technical proficiency. Nursing-specific frameworks, competency-based education, and validated assessment tools are essential to ensure the safe, ethical, and effective integration of PoCUS into clinical practice.

As lesões por pressão são eventos adversos de notificação obrigatória e constituem importantes indicadores da qualidade da assistência em saúde. Seu manejo representa um desafio clínico e organizacional significativo devido à complexidade do tratamento e às demandas associadas sobre os recursos do sistema de saúde. Este estudo descreve o processo de cicatrização de uma lesão por pressão sacral em estágio IV tratada com uma solução a 1% do extrato hexânico do óleo fixo de Pterodon pubescens (LDT-PPH), diluída no produto comercial Dersani®, composto por ácidos graxos essenciais, triglicerídeos de cadeia média e vitaminas A e E. Trata-se de um paciente do sexo masculino, de 81 anos, com comorbidades como hipertensão arterial sistêmica, diabetes mellitus e hipercolesterolemia, além de histórico prévio de infarto agudo do miocárdio. O paciente foi admitido em um hospital terciário após um acidente vascular cerebral isquêmico agudo e, posteriormente, desenvolveu uma lesão por pressão sacral. O tratamento tópico com a solução LDT-PPH promoveu evolução favorável do processo de cicatrização, caracterizada por aumento da vascularização, estímulo à angiogênese e redução da inflamação local. O leito da ferida evoluiu para a formação de tecido de granulação saudável, seguido de epitelização satisfatória e contração progressiva das bordas da ferida. Esses achados sugerem que o LDT-PPH pode representar uma estratégia terapêutica promissora para o manejo de lesões cutâneas complexas, especialmente durante as fases inflamatória e proliferativa da cicatrização, devido aos seus potenciais efeitos anti-inflamatórios e angiogênicos.

Background: Pulmonary aspiration of gastric contents is a serious clinical complication, particularly in patients receiving enteral nutrition or undergoing anesthesia. Gastric residual volume (GRV) is a commonly used surrogate marker that can identify delayed gastric emptying and enteral nutrition intolerance, both of which may increase the risk of aspiration. Traditional methods for measuring GRV are invasive and lack standardization. Point-of-care ultrasound (PoCUS) has emerged as a promising, noninvasive bedside alternative. Despite its growing clinical use, there is still no consolidated guidance on PoCUS procedures for GRV assessment in adult patients. Objective: This scoping review aims to map and synthesize the available evidence on procedural techniques, interpretation criteria, and decision-making applications related to PoCUS for GRV assessment. Methods: This scoping review will follow the JBI Collaboration methodology and will be reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols extension for Scoping Reviews) guidelines. The PCC (population, concept, and context) mnemonic guided the formulation of the research question. Systematic searches will be conducted in MEDLINE, CINAHL, Embase, Scopus, Cochrane Library, and LILACS, as well as in gray literature sources. Eligible sources will include primary studies, reviews, and clinical guidelines focused on PoCUS for GRV assessment in adults (aged ≥18 years). Two independent reviewers will perform study screening and data extraction. The synthesis will be structured using the I-AIM (indication, acquisition, interpretation, and medical decision-making) framework. Results will be summarized narratively, in tables, and through visual representations such as flowcharts and conceptual diagrams. Results: This protocol was registered on the Open Science Framework registry on August 21, 2025. The literature search began on April 3, 2026, with study selection and data extraction planned for May 2026. The final results are expected to be submitted for publication in July 2026. As this is a protocol study, no results are available yet. Conclusions: This review will identify and categorize the procedures, technical parameters, and clinical applications of PoCUS for GRV assessment in adult patients. By mapping the existing evidence, the findings may inform future research, educational curricula, and the development of clinical guidelines for nurses. In addition, the review will highlight methodological gaps and variations in practice that may affect the safe and effective use of PoCUS across diverse health care settings.

Objectives: This scoping review synthesized the available evidence on bedside ultrasonography used to confirm short-term nasogastric tube (NGT) placement in adults. Methods: The review followed JBI Collaboration methodology. Searches were conducted in CINAHL, Embase, LILACS, PubMed, and Scopus, as well as in gray literature sources (Google Scholar and ProQuest Dissertation & Thesis Global). Primary studies and clinical guidelines addressing bedside ultrasonography for short-term NGT placement in adults (≥18 years) were eligible, with no limits on language or publication year. Data were extracted and narratively summarized with the I-AIM framework (Indication, Acquisition, Interpretation, and Decision-Making). Results: Twenty-nine studies met the inclusion criteria. Most were single-center observational studies performed in intensive care units or emergency departments. Ultrasound was primarily used for confirmation prior to enteral nutrition initiation, while gastric decompression was less frequently reported. Acquisition protocols varied, although supine positioning, convex abdominal probes, and linear cervical probes were most commonly described. The gastric antrum and esophagus were the principal anatomical landmarks, with interpretation based on direct tube visualization and dynamic fogging; color Doppler was occasionally used. Radiography remained the reference standard in most studies, and only a minority initiated feeding based solely on ultrasound findings. Reported facilitators included bedside feasibility, absence of radiation exposure, and timeliness. Barriers included operator dependency, limited visualization in patients with obesity or gas interposition, protocol heterogeneity, and the limited methodological robustness of available studies. Conclusions: Current evidence suggests that ultrasonography may represent a feasible, radiation-free bedside approach for confirmation of NGT placement. Evidence from selected studies suggests that, with structured training, healthcare professionals may achieve diagnostic accuracy in specific clinical settings, although further robust multicenter investigations are needed to confirm these findings.

Objectives: This narrative review aimed to synthesize available evidence on procedures used for bedside ultrasonography-guided verification of nasogastric tube (NGT) placement. Methods: A comprehensive search was conducted in five databases, supplemented by gray literature and clinical guidelines, without restrictions on language or publication year. Eligible studies focused on ultrasound-guided NGT insertion or verification in adults. Data were extracted and synthesized descriptively using the I-AIM framework (Indication, Acquisition, Interpretation, and decision-Making). Results: 29 studies were included, most of them observational and conducted in intensive care or emergency settings. Ultrasound was primarily indicated for enteral nutrition, with gastric decompression less frequently reported. Acquisition protocols varied, though supine positioning, convex abdominal probes, and linear cervical probes were most common. The gastric antrum and esophagus were the main landmarks, with interpretation based on direct tube visualization and dynamic fogging; color Doppler was occasionally employed. Radiography remained the reference standard in over 90% of studies, though a few initiated feeding based on ultrasound alone. Facilitators included bedside feasibility, absence of radiation, and timeliness, whereas barriers encompassed operator dependency, limited visualization in patients with obesity or gas interposition, and heterogeneity of protocols. Conclusions: Ultrasonography is a promising, safe, and innovative method for NGT verification that can reduce delays, avoid radiation exposure, and improve patient safety. With structured training, nurses can achieve accuracy comparable to physicians, supporting greater autonomy in clinical decision-making. Standardized protocols and integration into nursing education are essential to ensure reliable and widespread adoption.

Objetivo: mapear a literatura relacionada às condições de letramento em saúde (LS) de cuidadores de crianças com transtorno do espectro autista (TEA). Método: revisão de escopo, realizada entre janeiro e fevereiro de 2024 e atualizada em agosto de 2025, em seis fontes de dados e literatura cinzenta. Os dados foram extraídos por meio de formulário adaptado da JBI e, em seguida, procedeu-se à análise descritiva das informações obtidas. O protocolo foi registrado no Open Science Framework. Resultados: das 741 publicações identificadas, quatro atenderam aos critérios de inclusão e compuseram a revisão. Cuidadores de crianças com TEA enfrentam fragilidades no acesso e na compreensão de informações de saúde, o que prejudica a tomada de decisões. Conclusão: o LS desses cuidadores permanece pouco explorado e investigá-los é fundamental para orientar intervenções que qualifiquem o cuidado infantil.

BACKGROUND Pulmonary aspiration of gastric contents is a serious clinical complication, especially in patients receiving enteral nutrition or undergoing anesthesia. Gastric residual volume (GRV) is a commonly used surrogate marker to identify delayed gastric emptying and enteral nutrition intolerance, which may increase aspiration risk. Traditional GRV measurement methods are invasive and lack standardization. Point-of-care ultrasound (PoCUS) has emerged as a promising, non-invasive, and bedside alternative. Despite its growing clinical use, there is no consolidated guidance on PoCUS procedures for GRV assessment in adult patients. OBJECTIVE This scoping review aims to map and synthesize the available evidence on procedural techniques, interpretation criteria, and decision-making applications related to PoCUS for GRV assessment. METHODS This scoping review will follow the JBI Collaboration methodology and will be reported in accordance with PRISMA-ScR guidelines. The PCC mnemonic (Population, Concept, Context) guided the formulation of the research question. Systematic searches will be performed in MEDLINE, CINAHL, Embase, Scopus, Cochrane, and LILACS, along with grey literature sources. Eligible studies will include primary studies, reviews, and clinical guidelines focused on PoCUS for GRV assessment in adults (≥18 years). Two independent reviewers will conduct screening and data extraction. The synthesis will be structured using the I-AIM framework (Indication, Acquisition, Interpretation, Medical decision-making). Results will be summarized narratively, in tables, and through visual representations such as flowcharts and conceptual diagrams. RESULTS A descriptive synthesis will be structured using the I-AIM framework (Indication, Acquisition, Interpretation, and decision-making). Quantitative data will be presented in tables, while qualitative findings will be analyzed thematically. Narrative, tabular, and visual formats—including diagrams, flowcharts, and summary figures—will be used to highlight variations, patterns, and gaps in practice. CONCLUSIONS This review will identify and categorize the procedures, technical parameters, and clinical applications of PoCUS for GRV assessment in adult patients. By mapping existing evidence, the findings will contribute to future research, educational curricula, and the development of clinical guidelines for nurses. Additionally, the review will highlight methodological gaps and practice variations that may impact the safe and effective use of PoCUS in diverse healthcare settings. CLINICALTRIAL This protocol has been registered in the Open Science Framework (OSF): https://osf.io/cq8s3

Objetivo: descrever a construção de um checklist para autoavaliação de úlceras diabéticas. Método: estudo metodológico construído de acordo com as etapas: I) estabelecimento da estrutura conceitual; II) definição dos objetivos do checklist e população envolvida; III) construção dos itens e escalas de resposta; IV) seleção e organização dos itens; e V) estruturação do checklist. Resultados: o checklist conta com um trecho de autoavaliação, que possui quatro itens: tamanho e profundidade da ferida; cor da ferida; secreções da ferida; e pele ao redor da ferida. A escala de resposta utiliza pictogramas faciais distintos, que predizem a condição da ferida e as condutas a serem adotadas. Além disso, o checklist contém um protocolo de aplicação e uma seção de orientações importantes. Conclusão: o checklist está atrelado aos aspectos clínicos das úlceras diabéticas, apoiando o processo de autocuidado e instruindo o paciente para o retorno aos serviços de saúde, conforme a pontuação alcançada.

Objective: To identify the frequency of acute kidney injury (AKI) in patients hospitalized with COVID-19, associated characteristics, mortality and lethality. Methods: Integrative review carried out in the databases CINAHL, Embase, LILACS, Livivo, PubMed, SCOPUS, Web of Science and in the grey literature (Google Scholar) on January 12, 2022. Articles were included in English, Spanish and Portuguese, published from November 2019 to January 2022, in hospitalized patients over 18 years old with COVID-19 and AKI according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria. The selected studies were read in full for extraction, interpretation, synthesis and categorization according to the level of evidence. Results: A total of 699 articles were found and 45 included. Older age, male gender, hypertension, chronic kidney disease, mechanical ventilation, increased C-reactive protein, use of vasoactive drugs and certain classes of antihypertensives were associated with AKI. AKI is related to a higher frequency of mortality. AKI occurred in 30% of patients hospitalized with COVID-19. The mortality rate from AKI was 5% and the case fatality rate was 18%. Conclusion: These results highlight the relevance of AKI as a significant complication of COVID-19 and suggest that more careful and early control of associated factors could potentially reduce mortality and lethality. It is crucial to intensify research in this field to better clarify the mechanisms involved in kidney injury in COVID-19 patients, as well as to identify more effective therapeutic strategies for its prevention and treatment in this context.

Resumo Objetivo Identificar a frequência de lesão renal aguda (LRA) em pacientes hospitalizados com COVID-19, as características associadas, a mortalidade e a letalidade. Métodos Revisão realizada nas bases de dados CINAHL, Embase, LILACS, Livivo, PubMed, SCOPUS, Web of Science e, na literatura cinzenta (Google Acadêmico) em 12 de janeiro de 2022. Foram incluídos artigos em inglês, espanhol e português, publicados a partir de novembro 2019 até janeiro de 2022, em pacientes maiores de 18 anos com COVID-19 hospitalizados e LRA