Oncology Nursing Care

This chapter explores the recommendations in developing oncology nursing care for a comprehensive medical center. Nursing orientation, continuing education, and competencies are required for the oncology nurse to remain successful in care delivery. Nurse–patient ratios should be benchmarked with other competitive centers, acuity taken into consideration, and various workflows depending on the clinical settings. Nurses play an instrumental role in delivering oncology care, from preventative screening, throughout the continuum, and into end-of-life care.

A Atuação da Enfermagem Frente à Prevenção da Depressão Pós-Parto

Buscou-se reconhecer a predominância e as causas filiadas à depressão pós-parto - DPP entre puérperas. Este estudo relata a DPP e mostra os aspectos de riscos que podem colaborar para esta síndrome, sua primazia e as escalas mais utilizadas pelos profissionais da saúde. O método adotado foi a busca nas bases de dados com estudos propondo uma revisão bibliográfica do tipo narrativa. Foi realizado um levantamento bibliográfico em bases de dados virtuais indexadas em saúde como SciELO (Scientific Electronic Library Online), OMS (Organização Mundial da Saúde), Google acadêmico e Fiocruz (Fundação Oswaldo Cruz), usando os descritores “Depressão pós-parto em Puerperais”. Foram selecionados 25 artigos, publicados entre 2003 e 2018. Constatamos que a DPP se caracteriza como consequência de problemas sócio econômicos, alterações hormonais, complicações conjugais, insegurança em relação ao sentimento das pessoas, medo de não ser uma boa mãe, ansiedade diante da sua nova vida e grupos familiares. Diante dos estudos aqui efetuados, percebemos que o apoio da equipe de enfermagem deve ocorrer focado não somente no pré-natal, mas também no planejamento da gestação, no qual o enfermeiro orienta a futura mãe quantos aos sintomas e situações que ela irá apresentar (antes da gestação, durante a gestação e após a gestação), explicando a gestante todos os sentimentos e sensações que ela poderá vivenciar. Desta forma, esta orientação irá prevenir e tratar a ocorrência da DPP, assegurando assim sua vida e a do recém-nascido, evitando o suicídio, a rejeição ou até ao assassinato do recém-nascido. Palavras-chave: Baby-Blues. Depressão. Depressão Pós-Parto. Saúde Pública. AbstractThis work aimed to recognize the prevalence and the causes related to postpartum depression (PPD) among postpartum women. This study shows the risk aspects that may contribute to this syndrome, its predominance and the scales most used by health professionals. The method adopted was a database search including studies to come up with a narrative literature review. A bibliographic survey was carried out in indexed health databases as SciELO (Scientific Electronic Library Online), WHO (World Health Organization), Google academic and FIOCRUZ (Oswaldo Cruz Foundation), using the descriptor "Postpartum Depression in Puerperal". We selected 25 articles, published between 2003 and 2018, in which PPD is characterized by socioeconomic problem, hormonal changes, marital complications, insecurity in relation to people's feelings, fear of not being a good mother, anxiety about a new life and family group. Based on the studies selected, we noticed that nursing support should be focused not only on prenatal care, but also during pregnancy planning, in which the nurse should guide the future mother about symptoms and situations that she will experience before, during and after pregnancy, explaining all feelings and sensations that it might occur. In this way, nursing orientation will prevent and treat postpartum occurrence, ensuring the mother and newborn’s life, avoiding suicide, rejection or even a newborn murder.Keywords: Baby-Blues. Depression. Postpartum depression. Public Health.

Quality Improvement Project to Improve Screening for Tobacco Use in Adolescent Inpatients at a Children’s Hospital

Tobacco use begins in adolescence for the majority of smokers. The purpose of this study was to increase screening and reporting of tobacco use in hospitalized adolescents at a tertiary care children’s hospital. We completed a nursing focus group to understand challenges and completed four iterative Plan-Do-Study-Act cycles, which included: (1) in-person nursing education regarding tobacco use screening, (2) addition of an e-cigarette-specific screening question, (3) the creation and dissemination of an educational video for nursing, and (4) adding the video as a mandatory component of nursing orientation. Run charts of the percentage of patients screened who reported tobacco use were created. Absolute counts of tobacco products used were also captured. From January 2016 to September 2018, 12,999 patients ≥13 years of age were admitted to the hospital. At baseline, 90.1% of patients were screened and 4.8% reported tobacco use. While the absolute number of adolescents reporting e-cigarette use increased from zero patients per month at baseline to five, the percentage of patients screened and reporting tobacco use was unchanged; the majority of e-cigarette users reported use of other tobacco products. This study demonstrates that adding e-cigarettes to screening increases reporting and suggests systems level changes are needed to improve tobacco use reporting.

Effectiveness of video resources in nursing orientation before cardiac heart surgery

Summary Objective: To evaluate the effectiveness of video resources in increasing patient knowledge during preoperative orientation for cardiac surgery compared to standard orientation. Method: Randomized clinical trial. Patients in the intervention group (IG) received bedside orientation with the aid of a short video and a slide presentation on the day prior to surgery. Patients in the control group (CG) received standard orientation. Allocation and analysis of knowledge were blinded. Analysis was performed according to the intention to treat principle. Results: We included 90 patients, 45 in each group; 27.8% had incomplete primary education. There were no differences between groups in the baseline. After orientation, IG scored 7.20 (±1.56) and scored CG 2.71 (±1.96, p<0,001). The topic "surgical room" had the lowest proportion of correct answers in CG (6.7%), compared to IG (68.9%). The question about "postoperative unit" was the one with the highest proportion of correct answers in IG (93.3%), while in CG the proportion was 22.2%. "Ventilatory support" had a low proportion of correct answers in IG (60%), but still much higher than the correct answers in CG (17.8%). Conclusion: Orientation performed with the aid of video resources is more effective for knowledge retention in preoperative patients, compared to verbal orientation alone.