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      Nursing care management in substitutive renal therapy in patients with COVID-19: integrative review Translated title: Gestión de cuidados de enfermería en terapia renal sustitutiva en pacientes con COVID-19: revisión integradora

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          Abstract

          ABSTRACT Introducción: Among the systems most affected by COVID-19, the renal system stands out, which leads to challenges in the management of nursing care for these patients. Objetives: To describe the scientific evidence on nursing care management in patients diagnosed with COVID-19 undergoing Renal Replacement Therapy. Methodology: Articles were searched in PubMed, SCOPUS, Web of Science, LILACS, BDENF, EMBASE, IBECS, CINAHL, COCHRANE LIBRARY, and Scielo databases, using the following cross-references: “renal therapy” AND “nursing care” AND “covid-19”. To systematize the searches, the Boolean operator “AND” was used. Initially, 167 primary references were identified in the selected databases/virtual library, and as a final sample, 14 articles were included. Results: It was found that among the contributions to nursing care management in hemodialysis patient care in the context of the COVID-19 pandemic, the use of health technologies (examples: use of telehealth and the development of new protocols), development of new methods in nursing care management and continuing education are described in the literature. These tools were essential for the continuity of nursing care. Conclusion: Among the tools used for nursing care management in the context of the pandemic of COVID-19 in hemodialysis patients, health technologies and continuing education in health are included, enabling qualified care management.

          Translated abstract

          ABSTRACT Introducción: Entre los sistemas más afectados por la pandemia COVID-19, destaca el sistema renal, circunstancia que conlleva desafíos en la gestión de cuidados de enfermería en los pacientes. Objetivos: Describir la evidencia científica sobre la gestión de cuidados de enfermería en pacientes diagnosticados con COVID-19 sometidos a terapia renal sustitutiva. Metodología: Se buscaron artículos en las bases de datos PubMed, SCOPUS, Web Of Science, LILACS, BDENF, EMBASE, IBECS, CINAHL, COCHRANE LIBRARY y Scielo, utilizando las siguientes palabras clave cruzadas: “renal therapy” AND “nursing care” AND “covid-19”. Para sistematizar las búsquedas, se utilizó el operador booleano “AND”. Inicialmente, se identificaron 167 referencias primarias en las bases de datos seleccionadas, y como muestra final, se incluyeron 14 artículos. Resultados: Se encontró que entre las contribuciones a la gestión de cuidados de enfermería en la atención de pacientes en hemodiálisis en el contexto de la pandemia de COVID-19, se describen el uso de tecnologías de la salud (ejemplos: el uso de telemedicina y el desarrollo de nuevos protocolos), el desarrollo de nuevos métodos en la gestión de cuidados de enfermería y la educación continua. Estas herramientas fueron esenciales para la continuidad de los cuidados de enfermería. Conclusión: Entre las herramientas utilizadas para la gestión de cuidados de enfermería en el contexto de la pandemia de COVID-19 en pacientes en hemodiálisis, se incluyen las tecnologías de la salud y la educación continua en salud, lo que permite una gestión de cuidados calificada.

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          Most cited references49

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          Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

          Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p<0·0001), and d-dimer greater than 1 μg/mL (18·42, 2·64–128·55; p=0·0033) on admission. Median duration of viral shedding was 20·0 days (IQR 17·0–24·0) in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days. Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.
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            Mild or Moderate Covid-19

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              Telehealth Transformation: COVID-19 and the rise of Virtual Care

              Abstract The novel coronavirus disease-19 (COVID-19) pandemic has altered our economy, society and healthcare system. While this crisis has presented the US healthcare delivery system with unprecedented challenges, the pandemic has catalyzed rapid adoption of telehealth or the entire spectrum of activities used to deliver care at a distance. Using examples reported by US healthcare organizations including ours, we describe the role telehealth has played in transforming healthcare delivery during the three phases of the US COVID-19 pandemic: 1) Stay-at-Home Outpatient Care; 2) Initial COVID-19 Hospital Surge, and 3) Post-Pandemic Recovery. Within each of these three phases, we examine how people, process and technology work together to support a successful telehealth transformation. Whether healthcare enterprises are ready or not, the new reality is that virtual care has arrived.
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                Author and article information

                Journal
                enefro
                Enfermería Nefrológica
                Enferm Nefrol
                Sociedad Española de Enfermería Nefrológica (Madrid, Madrid, Spain )
                2254-2884
                2255-3517
                September 2023
                : 26
                : 3
                : 220-230
                Affiliations
                [1] Ceará orgnameUniversidade Regional do Cariri orgdiv1Department of Nursing Brazil
                [2] orgnameCariri Regional Hospital Brazil
                Article
                S2254-28842023000300003 S2254-2884(23)02600300003
                10.37551/s2254-28842023021
                6c1091b8-6943-4a02-970c-7629c04600c9

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 28 October 2022
                : 14 July 2023
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 49, Pages: 11
                Product

                SciELO Spain

                Categories
                Reviews

                nursing,terapia de renal sustitutiva,COVID-19,enfermería,renal replacement therapy

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