ISSN: 1981-8963 DOI: 10.5205/reuol.3934-31164-1-SM.

0703esp201332

Gonalves RCS, Santana RF. Risco para contaminao de artigos e materiais

NOTE PREVIEW
RISK OF CONTAMINATION OF EQUIPMENT AND MATERIALS: A PROPOSAL OF
NURSING DIAGNOSIS
RISCO PARA CONTAMINAO DE ARTIGOS E MATERIAIS: UMA PROPOSTA DE DIAGNSTICO
DE ENFERMAGEM
RIESGO DE CONTAMINACIN DE LOS ARTCULOS Y MATERIALES: UNA PROPUESTA PARA EL
DIAGNSTICO DE ENFERMERA
Raquel Calado da Silva Gonalves1, Rosimere Ferreira Santana2
ABSTRACT
Objective: to validate in form and content the proposed diagnostic Risk of contamination of equipment
and materials. Method: this is a study with quantitative nature, which is comprised of two phases: at the
first, we will identify, in the literature, the constituent elements for the formulation of the proposed
diagnostic, risk factors, relevance of titles, concepts and disposal in domains, according to the NANDA-I
classification. The second phase will be consisted of the analysis of the content prepared in phase I, by the
specialists. The sample will be comprised of nurses selected by predetermined criteria, adapted in
accordance with the recommendations of Fehring. Data collection will be conducted through a questionnaire.
The data will be subjected to the descriptive and inferential statistical analysis. This project was submitted to
the appreciation of the ERC from the Hospital Universitrio Antnio Pedro, under CAAE n
04960612.5.0000.5243. Expected results: it aims the validation of a nursing diagnosis relevant to the work
process of the nursing professional at the Sterilized Material Center. Descriptors: Nursing Process;
Sterilization; Nursing Diagnosis.
RESUMO
Objetivo: validar em forma e contedo a proposta diagnstica Risco para contaminao de artigos e
materiais. Mtodo: estudo de natureza quantitativa, composto de duas fases: na primeira, sero
identificados na literatura os elementos constituintes para formulao da proposta diagnstica, os fatores de
risco, a pertinncia de ttulos, conceitos e a disposio em domnios, conforme a classificao NANDA-I. A
segunda fase consistir na anlise do contedo elaborado na fase I, pelos especialistas. A amostra ser
composta por enfermeiros selecionados atravs de critrios preestabelecidos, adaptados segundo
recomendaes de Fehring. A coleta de dados ser realizada por meio de questionrio. Os dados sero
submetidos anlise estatstica descritiva e inferencial. Projeto submetido apreciao do CEP do Hospital
Universitrio Antnio Pedro, sob CAAE n 04960612.5.0000.5243. Resultados esperados: validao de um
diagnstico de enfermagem pertinente ao processo de trabalho do enfermeiro no Centro de Material e
Esterilizao. Descritores: Processos de Enfermagem; Esterilizao; Diagnstico de Enfermagem.
RESUMEN
Objetivo: validar la forma y el contenido de la propuesta de diagnstico de riesgos de contaminacin de los
materiales y objetos. Mtodo: Estudio cuantitativo, que consiste en dos fases: la primera se identifica en la
literatura los componentes de la formulacin de la propuesta de diagnstico, los factores de riesgo, la
relevancia de los ttulos y los conceptos de diseo en campos como la clasificacin NANDA-I. La segunda fase
comprende el anlisis, de este contenido preparado en la Fase I, por los expertos. La muestra constar de las
enfermeras seleccionadas por criterios predeterminados adaptados de recomendaciones de Fehring. La
recoleccin de datos se llevar a cabo a travs de un cuestionario. Los datos se analizarn a travs de
estadstica descriptiva e inferencial. Proyecto presentado a Antonio del CEP Hospital Pedro Universidad.
CAAE: 04960612.5.0000.5243. Resultados esperados: validacin de un diagnstico de enfermera pertinentes
para el proceso de trabajo de enfermera en el Centro de Material y Esterilizacin. Descriptores: Proceso de
Enfermera; Esterilizacin; Nursing Diagnosis.
1
Nurse, Specialist in Nursing in SC, PAR and SMC, Masters Student from the Professional Master Program in Assistential Nursing -
MPEA/EEAAC/UFF. Nurse at the Hospital Federal Cardoso Fontes HFCF/MS. Rio de Janeiro (RJ), Brazil. Email:
raquelcalado@yahoo.com.br; 2Nurse, PHD in Nursing, Adjunct Professor at the Escola de Enfermagem Aurora de Afonso Costa
(EEAAC/UFF). Niteri (RJ), Brazil. Email: rosifesa@enf.uff.br

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Gonalves RCS, Santana RF.
INTRODUCTION
One of the main steps of the Nursing Care
Systematization (NCS) is the nursing diagnosis
(ND), since this contributes to the
identification of phenomena concerning the
nurses' performance and leads to the
formulation of nursing interventions.1
In the classification of the NANDA -
International (NANDA-I), a ND refers to the
answers to health problems and life processes,
whether actual or potential, and would be the
basis for selection and favoring of
interventions and results achievement.2-3
One ND can be classified into four
categories: real, health promotion, welfare or
risk. The risk diagnosis relies on risk factors
that contribute to increased vulnerability and
describes answers that could be developed,
individually or collectively.2
It could be said that the idea of diagnosing
in nursing arose by means of the Florence
Nightingale herself, when she identified
factors that were related to health problems
presented by the sick people. So, when these
factors were taken off, positive results started
to emerge. This was one of the first ways of
systematizing the care: when diagnosing,
intervening and getting results.1
The absence of a common standardized
language in the practice of the nursing
professional at the Sterilized Material Center
(SMC) would be an obstacle to an indirect care
of systematized nursing and with quality.
By correlating the nursing work at the SMC
with the one developed by Florence
Nightingale, we can identify similarities, such
as the indirect care positively influencing over
the direct care.
The SMC nursing team works to offer
subsidies for that the direct care to the
patient can be conducted in the best way,
thus controlling the infection related to the
health procedures. Its care is not directly
connected to the patient, but it can be
configured in an indirect care, by directly
acting in preventing infections.
Florence Nightingale identified the
importance of the indirect care to the
patient, by means of acting on the
environment and, this factor influences over
the direct care, through the reduction of
mortality and infection rates.
Thus, the nurse must act in a systematized
way; in this regard, it becomes necessary to
identify the problems/phenomena of its area
of operation and, hence, safe interventions
will be formulated.
English/Portuguese
J Nurs UFPE on line., Recife, 7(spe):1059-63, Mar., 2013
DOI: 10.5205/reuol.3934-31164-1-SM.0703esp201332
Risco para contaminao de artigos e materiais
It should be highlighted the existing gap on
the proposed thematic, thus, the
development of a ND and its validation would
contribute for the application in the practical
scenario of the SMC, both for doing research
and conducting teaching in the area, in order
to allow the pupils to understand the nurses
role at the SMC, since it is considered that the
developed work in this sector would be
directly linked to the prevention of infections
related to the health care, and that its non-
compliance would generate sanitary
violations, thus justifying the relevance of
performing this study.4-5
By approaching the current public policy in
Brazil, the development of a ND that would
systematize the care provided by nurses at
the SMC emerges at a time in which the work
developed there has been gaining visibility on
the part of regulator and supervisory bodies,
including questionings on what would be the
ideal professional to be responsible for such
activity; as set out in the resolutions aimed at
regulating the duties and activities of
professionals at the SMC.5-6
In this context, the design of a specific ND
for the phenomenon with regard to work,
performance and professional practice of
nurse at the SMC would be relevant in
contributing to the visibility of the nursing
care systematization provided by these
professionals, which in turn, could offer the
patients of the health institution an indirect
quality care, since any ND requires a nursing
intervention.
The validation of a ND produces scientific
and technical knowledge, which is necessary
for understanding answers to specific
phenomena, by making possible its use, both
in the setting of the clinical practice, as also
to bring important implications for teaching
and research.3
OBJECTIVE
To validate in form and content the
proposed diagnostic Risk of contamination of
equipment and materials.
SPECIFIC OBJECTIVES
To identify the diagnostic proposal from
the integrative literature review;
To identify the risk factors, as well as the
relevance of titles, concepts and disposal in
domains, according to the NANDA-I
classification, through the analysis by experts.
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METHOD
This is a quantitative research, with
content validation of ND, to be held in two
phases:
Phase 1 - Concept analysis and integrative
review;
Phase 2 Content validation
specialists.7-8
At the first phase, there will be an
integrative literature review, which will serve
as a theoretical support to substantiate the
phenomenon related to the nurses action
within the SMC for safety and protection of
the patient, by providing scientific support for
the definition of diagnosis concept and its risk
factors. Thus, one could define titles,
concepts, and determine the risk factors of
the ND and its disposal in domains.
We will cover the six steps of the
integrative literature review: establishment of
the hypothesis/research question; literature
search; categorization of studies; assessment
of the studies included in the review;
interpretation of the results and presentation
of the review.9
For the sample identification that will
compose the analysis, we will conduct a
search in the following databases: Latin
American and Caribbean Health Sciences
(LILACS), Cumulative Index to Nursing and
Allied Health Literature (CINAHL), Scientific
Electronic Library Online (SciELO), Medical
Literature Analysis and Retrieval System
online (MEDLINE) and Dedalus, the
Bibliographic Database from the Universidade
de So Paulo/USP.
The inclusion criteria will be: articles
indexed in the aforementioned databases,
without defined period, in Portuguese, English
and Spanish, as well as articles that address
the work process at the SMC.
The summaries presented at scientific
meetings, notes to the editor, in addition to
unpublished theses and dissertations will be
excluded.
Expert Definition
Master in Nursing
Master in Nursing with dissertation with
relevant content for the diagnosis of
interest
Publication of research on diagnostic data
or relevant content
Publication of article on diagnostic in a
referential journal
Doctorate thesis on diagnosis
Current clinical practice of at least 1 year
of duration in relevant area for the
diagnosis of interest
Certification of clinical practice in relevant
area for the diagnosis of interest
Figure 1. Definition of the adapted expert from the Fehring model. Niteri / RJ, 2012.
English/Portuguese
J Nurs UFPE on line., Recife, 7(spe):1059-63, Mar., 2013
DOI: 10.5205/reuol.3934-31164-1-SM.0703esp201339
Fatores determinantes da automedicao por idosos
The terms to be used in the search will be:
nursing, sterilization and work, which were
previously researched in the Medical Subject
Headings, MeSH, from the Virtual Health
Library (VHL).
The second phase of this study will be
conducted through contact by e-mail with
by nurses.
We opted for the communication by means
of the World Wide Web, since it has become
an indispensable research source, due to its
huge collection, available for consultation and
because of its extreme ease of access.10
At this stage, the aim will be the
appreciation and evaluation of the construct
by specialists or experts, with basis on a tool
generated from the results of the previous
stage and constructed in accordance with the
NANDA-I structure, plus the operational
definition of each risk factor.11
The sample will be comprised of nurses
that meet the definition of expert adapted
from the Fehring model. This adaptation of
the Fehring model took place because of the
need to specify certain criteria, so that the
sample permits the inclusion of a greater
number of specialists with knowledge on the
proposed thematic.
The clinical experience and the theoretical
knowledge will be extremely important. Thus,
two groups of specialists will be used: one
group comprised of nurses with clinical
practice for at least five years and another
group of nurses who are specialized in
diagnosis.11
A specific score will be associated to each
criterion, so that the nurse who reaches a
minimum score of five points will selected as
a specialist.
Score Adaptation of the Fehring Model Score
4,0 Master in Nursing 4,0
1,0 Master in Nursing with dissertation 1,0
related to the SMC, HICS and/or
nursing diagnosis
2,0 Publication of research on 2,0
diagnosis, SMC, SC and/or HICS
2,0 Publication of article on diagnosis, 2,0
SMC, SC and/or HICS
2,0 PHD in Nursing 2,0
1,0 Clinical practice of at least 1 year 1,0
in SMC, SC, HICS or teaching
2,0 Specialization in SC, SMC, PAR or 2,0
Certification of specialist from the
SOBECC
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The sample will be comprised of at least 32
nurses, by considering an acceptable sampling
error of 10%, a confidence level of 99% and
the proportion of specialists of 95% for the
validation of the diagnosis.11
By considering the thematic and the
definition criteria for expert, we will establish
contact with nurses from the list of e-mail
addresses of the researcher itself and from
the e-mail addresses contained in the articles
selected for composing the integrative review,
through the advanced search by using the
Lattes Platform, as well as the snowball
sampling, which would be the selection of
subjects by means of indication or
recommendation of previous subjects.12
In possession of the proper completed
instrument, the data will be stored in a
spreadsheet that will be generated by
Microsoft Office Excel application (2010).
We will conduct a quantitative analysis
with regard to the relevance of the diagnosis
and its suitability of the definition of its
respective titles, by applying descriptive
statistics (distribution of frequencies).
The averages by weight will be obtained by
the sum of the weights assigned to each
answer, divided by the total of answers.7
Ethical considerations
This is a dissertation project, from the
Professional Master Program in Assistential
Nursing - Programa de Mestrado Profissional
em Enfermagem Assistencial (MPEA), from the
Universidade Federal Fluminense (UFF). In
accordance with the Resolution 196/96, from
the National Health Council - Conselho
Nacional de Sade (CNS), this project was
submitted to the appreciation of the Ethics
Research Committee - Comit de tica em
Pesquisa (CEP), from the Hospital
Universitrio Antnio Pedro, for approval
regarding the ethical implications of
researches involving human beings, under
CAAE n 04960612.5 .0000.5243.
ACNOWLEDGEMENTS
Financing Body of this Project: Regional
Nursing Council- RJ/Brazil
REFERENCES
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DOI: 10.5205/reuol.3934-31164-1-SM.0703esp201332
Risco para contaminao de artigos e materiais
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.2047-3095.2012.01213.x/abstract
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Santos TR, Alves FP, Coutinho BG et al. Fatores determinantes da automedicao por idosos

12. Polit DF, Beck CT. Fundamentos de

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Submission: 2012/12/01
Accepted: 2013/01/19
Published: 2013/03/15
Corresponding Address
Raquel Calado da Silva Gonalves
Rua Pedro Teles, 478, Bl 1/205
CEP: 21320-120 Praa Seca (RJ), Brazil

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