International recommendations for a vascular access minimum dataset: a Delphi consensus-building study.

Background: Data regarding vascular access device use and outcomes are limited. In part, this gap reflects the absence of guidance on what variables should be collected to assess patient outcomes. We sought to derive international consensus on a vascular access minimum dataset.

Surgical Safety in Pediatrics: practical application of the Pediatric Surgical Safety Checklist.

Objectives: To assess the practical application of the Pediatric Surgical Safety Checklist on the preoperative period and to verify family satisfaction regarding the use of the material.

Method: Exploratory study that aimed to analyze the use of the checklist by children who underwent surgical interventions. The sample was constituted by 60 children (from preschoolers to teens) and 60 family members.

Pediatric Critical Care Nursing Research Priorities-Initiating International Dialogue.

Objective: To identify and prioritize research questions of concern to the practice of pediatric critical care nursing practice.

Design: One-day consensus conference. By using a conceptual framework by Benner et al describing domains of practice in critical care nursing, nine international nurse researchers presented state-of-the-art lectures.

Randomized crossover trial of endotracheal tube suctioning systems use in newborns.

Background: Maintaining endotracheal tube patency is critical for neonates receiving mechanical ventilation. Endotracheal tube suctioning removes accumulated secretions preventing potential adverse events, however is also potentially hazardous to the patient.

Objective: To compare respiratory rate, arterial blood oxygen saturation, heart rate and pain in newborns undergoing endotracheal tube suctioning with closed (CS) and open (OS) systems.

Endothelial, renal and hepatic variables in Wistar rats treated with Vancomycin.

Vancomycin (VCM) is indicated in combat against Gram-positive infections, but it is not considered a first-choice drug because of its adverse effects. It is believed that oxidative stress is the primary mechanism of endothelial injury and the consequent VCM toxicity, which varies from phlebitis to nephrotoxicity. Moreover, dose recommendations, dilution, rates and types of infusion are still controversial.

[Assertiveness and peripheral intravenous catheters dwell time with ultrasonography-guided insertion in children and adolescents].

Randomized controlled trial which aimed to verify whether the use of vascular ultrasound (VUS) increases assertiveness in the use of peripheral venous catheter in children, and the catheter dwell time, when compared to traditional puncture. Data were collected after approval of theethical merit. Children and adolescents undergoing VUS-guided peripheral intravenous (GVUS) or puncture guided by clinical assessment of the venous conditions(CG) were included in the study.

Oral care and oropharyngeal and tracheal colonization by Gram-negative pathogens in children.

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.

Predisposing factors for infiltration in children submitted to peripheral venous catheterization.

Aims: The aims were to compare characteristics of children with peripheral intravenous catheters who developed infiltration and those who did not and to identify risk factors for developing this complication.

Method: A retrospective cohort study carried out at a university hospital, with 338 children with peripheral intravenous catheters. Variables related to the children and therapies were investigated.

Medication errors reported in a pediatric intensive care unit for oncologic patients.

Background: Considering all sources of errors that may occur during healthcare, medication errors are the most common and also the most frequent cause of adverse events.

Objective: The objective of the study was to describe the medication errors reported in a pediatric intensive care unit for oncologic patients.

Methods: This is a descriptive and exploratory study.

Hydrogen-ion potential of dobutamine hydrochloride solutions exposed to environmental conditions of neonatal intensive care units.

Objective: To verify the hydrogen-ion potential (pH) of dobutamine hydrochloride solutions under environmental conditions similar to those of neonatal intensive care units.

Methods: We analyzed the pH of the drug diluted in 5% dextrose in water or 0.9% NaCl under different conditions of temperature (22 and 37 degrees C) and light (dark, fluorescent light bulbs, and phototherapy equipment), using colorless and amber intravenous sets at time intervals of 0, 1, 24, 48, 72, and 96 hours.

Oral care interventions and oropharyngeal colonization in children receiving mechanical ventilation.

Background: Recent progress in identification of oral microorganisms has shown that the oropharynx can be a site of origin for dissemination of pathogenic organisms to distant body sites, such as the lungs.

Objective: To compare the oropharyngeal microbiological profile, duration of mechanical ventilation, and length of stay in the intensive care unit of children receiving mechanical ventilation who had pharmacological or nonpharmacological oral care.

Methods: A randomized and controlled study was performed in a pediatric intensive unit in São Paulo, Brazil.

Retrospective analysis of renal transplantation outcomes in children admitted to a paediatric intensive care unit in Brazil.

Renal transplantation has been described as the main treatment for children with end-stage renal disease. Traditionally, infants and small children represented a high-risk group with poor allograft survival. However, studies conducted mainly in developed countries have been demonstrated improvements in allograft survival rates.

[Redesigning nursing activities to reduce medication errors in pediatrics].

Quasi-experimental study which aimed to verify the influence of nursing activities redesign in the reduction of medication errors in three pediatrics wards of a university hospital. Types and frequencies of medication errors identified in a study carried through the wards guided the redesign and exerted the function of dependent variable in the assessment of the intervention. To errs identification 556 documents on 77 children's medical charts were analyzed.

Subjective assessment of backrest elevation: magnitude of error.

Background: Backrest elevation, defined as the angle of the backrest height above the horizontal position, is a common nursing intervention that is often used by subjective visual estimation in critically ill patients.

Objectives: The aim of the study was to describe the magnitude of error during the subjective assessment of backrest elevation.

Methods: This prospective study was conducted in a sample of 160 subjects: 97 registered nurses, 48 undergraduate nursing students, and 15 nursing assistants.

Variability in the establishment of an external reference point for central venous pressure measurement in children.

Objective: To investigate the variability in the establishment of the midaxillary line as external reference point (ERP), by different healthcare workers, for the measurement of central venous pressure in children.

Methods: Descriptive and correlational study carried out in a pediatric intensive care unit of a teaching hospital. During the establishment of the midaxillary line as ERP for central venous pressure measurement, five assessments of the same patient made by healthcare workers and one assessment made by a trained evaluator were compared.

Noise level in a pediatric intensive care unit.

Objective: The purpose of this study was to verify the noise level at a PICU.

Methods: This prospective observational study was performed in a 10 bed PICU at a teaching hospital located in a densely populated district within the city of São Paulo, Brazil. Sound pressure levels (dBA) were measured 24 hours during a 6-day period.

[Medication errors in pediatrics: analysis of nursing records on the patient chart].

Descriptive and correlational study which aimed to verify medication errors through the analyzes of medical charts of children admitted in three pediatric wards of a university hospital. The errors could represent record gaps verified on the care process documentation, that do not compromise the patient safety. In the 68 medical charts 1717 errors were verified, 21.

[Prospective, randomized and controlled trial on the dwell time of peripheral intravenous catheters in children, according to three dressing regimens].

This prospective, randomized and controlled study verified the influence of three dressing regimens on the dwell time of peripheral intravenous catheters (PIC) in children. The study groups were composed of dressings with sterile gauze (EG 1), with sterile transparent film (EG 2) and with hypoallergenic adhesive tape (CG). Variables were selected to control for variables related to children, professionals and intravenous therapy characteristics.

Information technology and patient safety in nursing practice: an international perspective.

When people become patients, they place their trust in their health care providers. As providers assume responsibility for their diagnosis and treatment, patients have a right to expect that this will include responsibility for their safety during all aspects of care. However, increasing epidemiological data make it clear that patient safety is a global problem.