SISTEMATIZAÇÃO DA ASSISTÊNCIA DE ENFERMAGEM EM UNIDADE DE TERAPIA INTENSIVA: IMPLEMENTAÇÃO DE PROTOCOLO DE BANHO NO LEITO PARA PACIENTES ADULTOS CRÍTICOS

Objetivo: implementar e validar um protocolo de banho em pacientes internados em uma Unidade de Terapia Intensiva Adulta. Metodologia: pesquisa de implementação, realizada em 2018, utilizando a ferramenta do PDSA (Planejar, Fazer - Do, Estudar - Study e Agir - Act), possibilitando que o processo fosse reavaliado em cada etapa. Validação pelo AGREE II por domínios. A adaptação do protocolo seguiu o instrumento ADAPTE. Resultados: Planejamento: visita técnica ao local; composição do grupo de trabalho (enfermeiros, médico, fisioterapeuta e técnicos de enfermagem). Fazer: análise e avaliação do protocolo (AGREE II). Estudar: Inconformidades entre o protocolo e a realidade local reavaliadas e corrigidas, baseadas na melhor evidência cientifica. Agir: teste piloto; após adaptação, implantado no turno da manhã. Considerações Finais: Apesar do benefício da implementação do protocolo de banho, o mesmo deve ser objeto frequente de discussão, pois compreende parte central do cuidado de enfermagem, devendo ser praticado de forma segura, buscando-se minimizar riscos para pacientes.Descritores: Banho de leito; Paciente crítico; Unidade de Terapia Intensiva; Protocolo; Enfermagem; Higiene.NURSING CARE SYSTEMATIZATION IN AN INTENSIVE THERAPY UNIT: IMPLEMENTATION OF BEDROOM BATH PROTOCOL FOR ADULT CRITICAL PATIENTSObjective: To implement and validate a bath protocol in patients admitted to an Adult Intensive Care Unit. Methodology: Implementation research, conducted in 2018, using the PDSA tool (Plan,Do, Study and Act ), enabling the process to be re - evaluated at each stage. Validation by AGREE II by domains. The protocol adaptation followed the ADAPTE instrument. Results: Planning: technical visit to the site; composition of the working group (nurses, physician, physiotherapist and nursing technicians). Do: protocol analysis and evaluation (AGREE II). Study: Nonconformities between protocol and local reality reevaluated and corrected, based on the best scientific evidence. Act: pilot test; after adaptation, implanted in the morning shift. Final Considerations: Despite the benefit of the implementation of the bath protocol, it should be a frequent subject of discussion, as it comprises a central part of nursing care and should be practiced safely, seeking to minimize risks to patients.Descriptors: Bed bath; Critical patient; Intensive care unit; Protocol; Nursing; Hygiene.SISTEMATIZACIÓN DE CUIDADOS DE ENFERMERÍA EN UNA UNIDAD DE TERAPIA INTENSIVA: IMPLEMENTACIÓN DEL PROTOCOLO DE BAÑO DE DORMITORIO PARA PACIENTES CRÍTICOS ADULTOSObjetivo: Implementar y validar un protocolo de baño en pacientes ingresados en una Unidad de Cuidados Intensivos para Adultos. Metodología: Investigación de implementación, realizada en 2018, utilizando la herramienta PDSA (Plan, Do, Study and Act ), permitiendo que el proceso sea reevaluado en cada etapa. Validación por AGREE II por dominios. La adaptación del protocolo siguió el instrumento ADAPTE. Resultados: Planificación: visita técnica al sitio; composición del grupo de trabajo (enfermeras, médico, fisioterapeuta y técnicos de enfermería). Hacer: análisis y evaluación de protocolos (ACUERDO II). Estudio: Las no conformidades entre el protocolo y la realidad local reevaluados y corregidos, con base en la mejor evidencia científica. Acto: prueba piloto; después de la adaptación, implantado en el turno de la mañana. Consideraciones finales: a pesar del beneficio de la implementación del protocolo de baño, debe ser un tema de discusión frecuente, ya que comprende una parte central de la atención de enfermería y debe practicarse de manera segura, buscando minimizar los riesgos para los pacientes.Descriptores: Baño de cama; Paciente crítico; Unidad de terapia intensiva; Protocolo; Enfermería; Higiene.

Reliability of the Three-minute All-out Test for Non-motorized Treadmill Tethered Running

The 3-min all-out test was developed and validated on a cycle ergometer using a modification of a linear mathematical equation (1/time vs. power) obtained from the original critical power model. The purpose of this development was to obtain, in a single test, the aerobic and anaerobic capacity parameters and identify the exercise transition moment from heavy to severe intensity. The aim of this study was to propose an adaptation of the all-out 3-min cycle ergometer to a non-motorized treadmill with tethered running. In addition, we tested the reproducibility of this adapted protocol, highlighting the need for mechanical power evaluation using a specific ergometer. Consequently, 10 physically active individuals visited the laboratory 4 times for testing and data collection. The results suggested that the protocol adaptation for the 3-min all-out test for non-motorized treadmill with tethered running was reproducible and feasible. It was also possible to show that the AO3 application in this ergometer ensures the specificity of the sports that involve the running exercise, from assessment of both aerobic and anaerobic parameters, accomplished in a single day of application.

Architecture Support for Flexible Business Chain Integration Using Protocol Adaptors

Business chains increasingly rely on the dynamic integration of business processes of different partners. The interaction constraints that result from the business processes are captured in business protocols. Since the business protocols of each partner support its own way of working, the business protocols can easily mismatch, which hinders organizations from forming a business chain. Such mismatches can be resolved by protocol adaptors. In this paper, we show how protocol adaptors can be used to enable the flexible formation of business chains. For different types of business chains, we present formation cases that describe which partners are responsible for the construction and operation of protocol adaptors. Next, we present for each formation case an accompanying concrete software architecture that realizes the case. The presented software architectures support the flexible formation of business chains and use protocol adaptation as a key component. We show the feasibility of the approach by discussing a prototype implementation, which we apply to a case study from the healthcare domain.