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AIM: To compare the domains of the Multidimensional Model of Successful Aging (MMSA) with the nursing terminologies, such as, NANDA International (NANDA-I), Nursing Interventions Classification (NIC) and Nursing Outcomes Classification (NOC), in order to find similarities among them. METHOD: Cross-mapping between MMSA and nursing terminologies in two stages: individual analysis and comparison between the MMSA and the nursing terminologies, based on the mapping process rules; consensus among researchers to validate the results. RESULTS: All NOC and NIC domains were mapped with similarity in the MMSA domains, and 12 of the 13 NANDA-I domains showed similarity to the MMSA domains. In addition, similarity was identified between MMSA and most classes of the three classifications. CONCLUSIONS: The similarity between MMSA, NANDA-I, NIC and NOC supported the idea that the MMSA framework can be used in the nursing process to qualify the nursing practice in the elderly care.

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ABSTRACT Aim: To compare the domains of the Multidimensional Model of Successful Aging (MMSA) with the nursing terminologies, such as, NANDA International (NANDA-I), Nursing Interventions Classification (NIC) and Nursing Outcomes Classification (NOC), in order to find similarities among them. Method: Cross-mapping between MMSA and nursing terminologies in two stages: individual analysis and comparison between the MMSA and the nursing terminologies, based on the mapping process rules; consensus among researchers to validate the results. Results: All NOC and NIC domains were mapped with similarity in the MMSA domains, and 12 of the 13 NANDA-I domains showed similarity to the MMSA domains. In addition, similarity was identified between MMSA and most classes of the three classifications. Conclusions: The similarity between MMSA, NANDA-I, NIC and NOC supported the idea that the MMSA framework can be used in the nursing process to qualify the nursing practice in the elderly care.

RESUMEN Objetivo: Comparar dominios del Modelo Multidimensional del Envejecimiento Exitoso (MMES) con las terminologías de enfermería, NANDA International (NANDA-I), Nursing Interventions Classification (NIC) y Nursing Outcomes Classification (NOC) en busca de similitudes. Métodos: Mapeo cruzado entre MMES y las terminologías de enfermería realizado en dos etapas: análisis individual y comparación de MMES con las terminologías de enfermería, basado en las reglas del proceso de mapeo; consenso entre los investigadores para validar resultados. Resultados: Todos los dominios NOC y NIC se asignaron con similitud en los campos MMES, y 12 de los 13 dominios NANDA-I mostraron similitud con los campos MMES. Además, se identificó similitud entre el MMES y la mayoría de las clases de las clasificaciones. Conclusiones: La similitud entre MMES y NANDA-I, NIC, NOC fortaleció la idea de que el referencial del MMES puede entrelazarse con el proceso de enfermería para calificar la práctica de enfermería en el cuidado al anciano.

RESUMO Objetivo: Comparar domínios do Modelo Multidimensional do Envelhecimento Bem Sucedido (MMES) com as terminologias de enfermagem, NANDA International (NANDA-I), Nursing Interventions Classification (NIC) e Nursing Outcomes Classification (NOC) em busca de semelhanças entre eles. Métodos: Mapeamento cruzado entre MMES e terminologias de enfermagem realizado em duas etapas: análise individual e comparação do MMES e terminologias de enfermagem, com base nas regras do processo de mapeamento; consenso entre os pesquisadores para validar os resultados. Resultados: Todos os domínios NOC e NIC foram mapeados com similaridade nos domínios MMES, e 12 dos 13 domínios NANDA-I mostraram semelhança com os domínios MMES. Além disso, identificou-se semelhança entre o MMES e a maioria das classes das três classificações. Conclusões: A similaridade entre MMES e NANDA-I, NIC, NOC fortaleceu a ideia de que o referencial do MMES pode ser entrelaçado com o processo de enfermagem para qualificar a prática de enfermagem no cuidado ao idoso.

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OBJECTIVE: Describe the characteristics of falls in patients with damage, their risk factors and injuries. METHOD: Retrospective and longitudinal study of 260 records of falls with damage of adult patients in clinical and surgical units of a general hospital, from September 2012 to June 2017. Data were collected in May 2018 from the electronic fall and electronic record research instrument, and the statistical analysis was described. RESULTS: There were 260 falls with damage, mostly in the elderly (78%), female (55%), in clinical treatment (68%) and unaccompanied (59.4%). The falls occurred at the same height (63.4%) and in the patient's room (67.3%). The severity of the damage was mild in 80.8% of cases, severe in 11.9% and moderate in 7.3%. CONCLUSION: Improving understanding of falls and their consequences can assist professionals in identifying and assessing risks and in establishing preventive measures.

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Resumo OBJETIVO Descrever as características das quedas com dano de pacientes, seus fatores de risco e lesões decorrentes. MÉTODOS Estudo longitudinal e retrospectivo de 260 registros de quedas com dano de pacientes adultos em unidades clínicas e cirúrgicas de um hospital geral, de setembro de 2012 a junho de 2017. Os dados foram coletados em maio de 2018 a partir do instrumento de investigação de quedas e prontuário eletrônico, sendo a análise estatística descritiva. RESULTADOS A maioria dos pacientes que sofreram queda com dano eram idosos (78%), do sexo feminino (55%), em tratamento clínico (68%) e desacompanhados (59,4%). As quedas ocorreram da própria altura (63,4%) e no quarto do paciente (67,3%). A gravidade dos danos foi leve em 80,8% dos casos, grave em 11,9% e moderado, 7,3%. CONCLUSÕES Melhorar a compreensão sobre as quedas e suas consequências pode subsidiar os profissionais na avaliação dos riscos e no estabelecimento de medidas preventivas.

Resumen OBJETIVO Describir las características de las caídas de pacientes con daño, sus factores de riesgo y las lesiones derivadas. MÉTODO Estudio longitudinal y retrospectivo de 260 registros de caídas con daño de pacientes adultos en unidades clínicas y quirúrgicas de un hospital general, de septiembre de 2012 a junio de 2017. Se recolectaron los datos en mayo de 2018 a partir del instrumento de investigación de caídas e informes electrónicos, siendo el análisis estadístico descrito. RESULTADOS Se registraron 260 caídas con daño, en su mayoría en ancianos (78%), del sexo femenino (55%), en tratamiento clínico (68%,) y desatendidos (59,4%). Las caídas ocurrieron por la propia altura (63,4%) y en la habitación del paciente (67,3%). La gravedad de los daños fue leve en el 80,8% de los casos, grave en 11,9%, y moderado en 7,3%. CONCLUSIÓN Mejorar la comprensión sobre las caídas y sus consecuencias puede subsidiar a los profesionales para identificar y evaluar los riesgos y establecer medidas preventivas.

Abstract OBJECTIVE Describe the characteristics of falls in patients with damage, their risk factors and injuries. METHOD Retrospective and longitudinal study of 260 records of falls with damage of adult patients in clinical and surgical units of a general hospital, from September 2012 to June 2017. Data were collected in May 2018 from the electronic fall and electronic record research instrument, and the statistical analysis was described. RESULTS There were 260 falls with damage, mostly in the elderly (78%), female (55%), in clinical treatment (68%) and unaccompanied (59.4%). The falls occurred at the same height (63.4%) and in the patient's room (67.3%). The severity of the damage was mild in 80.8% of cases, severe in 11.9% and moderate in 7.3%. CONCLUSION Improving understanding of falls and their consequences can assist professionals in identifying and assessing risks and in establishing preventive measures.

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Introdução: As quedas representam um dos principais incidentes de segurança no ambiente hospitalar. O papel da enfermagem é fundamental na prevenção desses eventos, desde a avaliação de risco, até as intervenções preventivas e avaliação do cuidado. Nesse contexto, os resultados de enfermagem (RE) da Nursing Outcomes Classification (NOC) estabelecem medidas e definições padronizadas para avaliação dos pacientes, demonstram se estão respondendo adequadamente às intervenções preventivas e auxiliam a determinar se são necessárias mudanças no cuidado. Objetivo: Avaliar os REs de pacientes hospitalizados com alto risco de quedas e de seus familiares por meio da NOC. Método: Estudo longitudinal, prospectivo realizado em um hospital universitário brasileiro no período de setembro de 2017 a agosto de 2018. A amostra se constituiu de 68 pacientes adultos, internados há (no máximo) 24 horas e com alto risco de quedas (MFS-B ≥45) e 68 familiares. Os pacientes receberam três avaliações com mensuração de cinco REs: Conhecimento: Prevenção de Quedas (1828), Comportamento de Prevenção de Quedas (1909), Ambiente de Cuidado à Saúde Seguro (1934), Sinais Vitais (0802) e Resposta ao Medicamento (2301). Os familiares receberam uma única avaliação referente a dois REs: Conhecimento: Prevenção de Quedas (1828) e Comportamento de Prevenção de Quedas (1909). A análise descritiva e analítica considerou a escala Likert de 5 pontos da NOC, em que 1 corresponde ao pior escore e 5 ao mais desejável. O estudo foi aprovado pelo CEP da instituição (170279). Resultados: Os pacientes eram, na sua maioria, do sexo feminino (58,8%), com média de idade de 60,8 (±17,7) anos e 9,6 (±4,1) anos de estudo. Os familiares eram do sexo feminino (77,9%), com idade média de 50,3 (±10,5) anos e com média de 10,5 (±3,3) anos de estudo. A avaliação dos REs dos pacientes apontou para um nível de conhecimento entre limitado e moderado (2,55±0,06) e um comportamento preventivo raramente a algumas vezes demonstrado (2,62±0,05). Melhora significativa no nível da escala Likert foi observada em cinco indicadores de conhecimento: Uso correto de barras de apoio, Mudanças na pressão arterial que aumentam o risco de quedas, Medicamentos que aumentam o risco de quedas, Uso de procedimentos seguros de transferência e Uso correto de dispositivos de assistência e em dois indicadores de comportamento: Utiliza no banheiro barras de segurança, para apoio das mãos e Utiliza adequadamente a cama. Os REs Ambiente de Cuidado a Saúde Seguro (1934), Sinais Vitais (0802) e Resposta ao Medicamento (2301) não apresentaram melhora significativa entre os dias, indicando um ambiente moderadamente a totalmente adequado (4,44±0,04), sinais vitais sem nenhum a leve desvio da variação normal (4,6±0,03) e resposta ao medicamento entre leve a não comprometida (4,63±0,08). Na avaliação dos REs dos familiares verificou-se um nível de conhecimento entre limitado e moderado (2,45±0,39) e um comportamento preventivo raramente a algumas vezes demonstrado (2,14±0,61). Os pacientes que concordaram com a avaliação de risco apresentaram melhor nível de comportamento preventivo (p=0,01). Conclusão: A avaliação dos REs da NOC representa uma ferramenta útil no contexto da prevenção de quedas, uma vez que permite a avaliação do paciente e da sua evolução clínica, o planejamento da intervenção e a identificação de práticas efetivas. A equipe de enfermagem deve ser capacitada e sensibilizada para a implementação de intervenções educativas ao paciente e seu familiar que promovam, além de conhecimento e comportamento preventivo, a consciência do risco e envolvimento nas ações de cuidado.

Introduction: Falls represent one of the main incidents of safety in the hospital environment. The role of nursing is essential in the prevention of these events, from risk assessment, to preventive interventions and evaluation of care. In this context, the nursing outcomes (NO) of Nursing Outcomes Classification (NOC) establish standardized measures and definitions for assessing patients, demonstrating whether they are adequately responding to preventive interventions and assisting to determine whether changes in care are necessary. Objective: To evaluate the NOs of hospitalized patients with high risk of falls and their relatives through the NOC. Method: A longitudinal, prospective study conducted in a Brazilian University Hospital in the period from September 2017 to August 2018. The sample consisted of 68 adult patients hospitalized (at most) 24 hours and with high risk of falls (MFS-B ≥ 45) and 68 relatives. The patients received three assessments with measurement of five NOs: Knowledge: Fall Prevention (1828), Fall Prevention Behaviour (1909), Environment of Safe Health Care (1934), Vital Signs (0802) and Response to Medication (2301). The relatives received a single evaluation of two NOs: Knowledge: Fall Prevention (1828) and Fall Prevention Behaviour (1909). The descriptive and analytical analysis considered the Likert scale of 5 points, in which 1 corresponds to the worst score and 5 to the most desirable. The study was approved by the institution's CEP (170279). Results: The majority of the patients were females (58.8%), with a mean age of 60.8 (± 17.7) years and 9.6 (± 4.1) years of schooling. The relatives were female (77.9%), with a mean age of 50.3 (± 10.5) years and with an average of 10.5 (± 3.3) years of schooling. The evaluation of the patients ' NOs pointed to a level of knowledge, between limited and moderate (2.55 ± 0.06) and a preventive behaviour rarely sometimes demonstrated (2,62 ± 0.05). Significant improvement in the Likert scale level was observed in five knowledge indicators: Correct use of grab bars, Blood pressure changes that increase risk for falls, Prescribed medications that increase risk for falls, Use of safe transfer procedure and Correct use of assistive devices and in two behavioural indicators: Uses, in the bathroom, safety bars to support hands and Adequately uses the bed. The NOs of the Safe Health Care Environment (1934), Vital Signs (0802) and Response to Medication (2301) showed no significant improvement between days, indicating a moderate to fully adequate environment (4.44 ± 0.04), vital signs without any slight deviation of normal variation (4.6 ± 0.03) and response to the drug between lightly and uncompromised (4,63 ± 0.08). In the assessment of family members, there was a level of knowledge between limited and moderate (2.45 ± 0.39) and a preventive behaviour rarely sometimes demonstrated (2.14 ± 0.61). Patients who agreed to the risk assessment presented a better level of preventive behaviour (P = 0.01). Conclusion: The evaluation of NOC outcomes represents a useful tool in the context of the prevention of falls, since it allows the evaluation of the patient and its clinical evolution, the planning of the intervention and the identification of effective practices. The nursing team should be trained and sensitively to the implementation of educational interventions for patients and their relatives who promote, in addition to knowledge and preventive behaviour, awareness of risk and involvement in care actions.

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Objective Describing the incidence of falls and its relation with preventive actions developed in a Brazilian university hospital. Method A retrospective longitudinal study. Hospitalized adult patients in the clinical, surgical, psychiatric and emergency units who suffered a fall in the institution, and who had the event notified in the period from January 2011 to December 2015 were included in the study. The data were collected from the institution's management information system and analyzed in the SPSS statistical program. Results There were 2,296 falls, with a mean incidence of 1.70 falls/1,000 patients per day. An increase in the incidence of falls was observed in the period from 2011 (1.61) to 2012 (2.03). In the following years, the incidence of falls decreased from 1.83 falls/1,000 patients per day in 2013 to 1.42 falls/1,000 patients per day in 2015. The incidence of falls accompanied an implementation of preventive actions, suggesting the impact of such interventions in reducing the event occurrence. Conclusion The findings demonstrate the importance of implementing preventive interventions in reducing the incidence of falls in hospitalized patients.

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ABSTRACT Objective: to construct conceptual definitions for indicators of nursing outcome Knowledge: Fall Prevention, selected for evaluation of hospitalized patients with the nursing diagnosis Risk for falls. Method: integrative literature review performed in the LILACS, MEDLINE and Web of Science databases, comprising articles published in English, Spanish and Portuguese languages from 2005 to 2015. Results: the final sample of the study was composed of 17 articles. The conceptualizations were constructed for 14 indicators of nursing outcome Knowledge: Fall Prevention focused on hospitalized patients. Conclusion: the theoretical support of the Nursing Outcomes Classification (NOC), through the process of constructing the conceptual definitions of the indicators of its results, allows nurses to accurately implement this classification in clinical practice and to evaluate the effectiveness of their interventions through the change of the patients' status over time.

RESUMEN Objetivo: construir definiciones conceptuales de indicadores del Resultado de Enfermería (RE) Conocimiento: Prevención de Caídas, seleccionadas para evaluación de pacientes hospitalizados con el Diagnóstico de Enfermería Riesgo de Caídas. Método: revisión integrativa de la literatura realizada en las bases de datos LILACS, MEDLINE y Web of Science incluyendo artículos publicados en los idiomas inglés, español y portugués en el período de 2005 a 2015. Resultados: diecisiete artículos compusieron la muestra final del estudio. Se construyeron las conceptualizaciones para 14 indicadores del RE Conocimiento: Prevención de Caídas con foco en pacientes hospitalizados. Conclusión: la sustentación teórica de la NOC a través del proceso de construcción de las definiciones conceptuales de los indicadores de sus resultados posibilita que los enfermeros implementen esa clasificación en la práctica clínica de forma precisa, y puedan evaluar la efectividad de sus intervenciones a través del cambio del estado de los pacientes a lo largo del tiempo.

RESUMO Objetivo: construir definições conceituais de indicadores do Resultado de Enfermagem (RE) Conhecimento: Prevenção de Quedas, selecionadas para avaliação de pacientes hospitalizados com o Diagnóstico de Enfermagem Risco de Quedas. Método: revisão integrativa da literatura realizada nas bases de dados LILACS, MEDLINE e Web of Science, compreendendo artigos publicados nos idiomas inglês, espanhol e português, no período de 2005 a 2015. Resultados: dezessete artigos compuseram a amostra final do estudo. Foram construídas as conceituações para 14 indicadores do RE Conhecimento: Prevenção de Quedas com foco em pacientes hospitalizados. Conclusão: a sustentação teórica da NOC, por meio do processo de construção das definições conceituais dos indicadores de seus resultados, possibilita que o enfermeiro implemente essa classificação na prática clínica de forma precisa, e possa avaliar a efetividade das suas intervenções através da mudança do estado dos pacientes ao longo do tempo.

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OBJECTIVE: to construct conceptual definitions for indicators of nursing outcome Knowledge: Fall Prevention, selected for evaluation of hospitalized patients with the nursing diagnosis Risk for falls. METHOD: integrative literature review performed in the LILACS, MEDLINE and Web of Science databases, comprising articles published in English, Spanish and Portuguese languages from 2005 to 2015. RESULTS: the final sample of the study was composed of 17 articles. The conceptualizations were constructed for 14 indicators of nursing outcome Knowledge: Fall Prevention focused on hospitalized patients. CONCLUSION: the theoretical support of the Nursing Outcomes Classification (NOC), through the process of constructing the conceptual definitions of the indicators of its results, allows nurses to accurately implement this classification in clinical practice and to evaluate the effectiveness of their interventions through the change of the patients' status over time.

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RESUMO Objetivo Descrever a incidência das quedas e a sua relação com as ações preventivas desenvolvidas em um hospital universitário brasileiro. Método Estudo longitudinal retrospectivo. Foram incluídos pacientes adultos, internados em unidades clínicas, cirúrgicas, psiquiátrica e de emergência, que sofreram queda na instituição, e tiveram o evento notificado no período de janeiro de 2011 a dezembro de 2015. Os dados foram coletados no sistema de informação gerenciais da instituição e analisados no programa estatístico SPSS. Resultados Ocorreram 2.296 quedas, com uma média de incidência de 1,70 quedas/1.000 pacientes-dia. Houve aumento na incidência de quedas no período de 2011 (1,61) a 2012 (2,03). Nos anos seguintes, a incidência de quedas apresentou redução de 1,83 quedas/1.000 pacientes-dia em 2013 para 1,42 quedas/1.000 pacientes-dia em 2015. A incidência de quedas acompanhou a implementação de ações preventivas, sugerindo impacto destas intervenções na redução da ocorrência do evento. Conclusão Os achados demonstram a importância da implementação de intervenções preventivas na redução da incidência de quedas em pacientes hospitalizados.

RESUMEN Objetivo Describir la incidencia de las caídas y su relación con las acciones preventivas desarrolladas en un hospital universitario brasileño. Método Estudio longitudinal retrospectivo. Fueron incluidos pacientes adultos, ingresados en unidades clínicas, quirúrgicas, psiquiátricas y de emergencia, que sufrieron caída en el centro y tuvieron el evento notificado en el período de enero de 2011 a diciembre de 2015. Los datos fueron recolectados en el sistema de información de gestión del centro y analizados en el programa estadístico SPSS. Resultados Ocurrieron 2.296 caídas, con un promedio de incidencia de 1,70 caídas/1.000 pacientes-día. Hubo incremento en la incidencia de caídas en el período de 2011 (1,61) a 2012 (2,03). En los años siguientes, la incidencia de caídas presentó reducción de 1,83 caídas/1.000 pacientesdía en 2013 para 1,42 caídas/1.000 pacientes-día en 2015. La incidencia de caídas acompañó la implantación de acciones preventivas, sugiriendo el impacto de dichas intervenciones en la reducción de la ocurrencia del evento. Conclusión Los hallazgos demuestran la importancia de la implantación de intervenciones preventivas en la reducción de la incidencia de caídas en pacientes hospitalizados.

ABSTRACT Objective Describing the incidence of falls and its relation with preventive actions developed in a Brazilian university hospital. Method A retrospective longitudinal study. Hospitalized adult patients in the clinical, surgical, psychiatric and emergency units who suffered a fall in the institution, and who had the event notified in the period from January 2011 to December 2015 were included in the study. The data were collected from the institution's management information system and analyzed in the SPSS statistical program. Results There were 2,296 falls, with a mean incidence of 1.70 falls/1,000 patients per day. An increase in the incidence of falls was observed in the period from 2011 (1.61) to 2012 (2.03). In the following years, the incidence of falls decreased from 1.83 falls/1,000 patients per day in 2013 to 1.42 falls/1,000 patients per day in 2015. The incidence of falls accompanied an implementation of preventive actions, suggesting the impact of such interventions in reducing the event occurrence. Conclusion The findings demonstrate the importance of implementing preventive interventions in reducing the incidence of falls in hospitalized patients.

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OBJECTIVE: Identifying the prescribed nursing care for hospitalized patients at risk of falls and comparing them with the interventions of the Nursing Interventions Classifications (NIC). METHOD: A cross-sectional study carried out in a university hospital in southern Brazil. It was a retrospective data collection in the nursing records system. The sample consisted of 174 adult patients admitted to medical and surgical units with the Nursing Diagnosis of Risk for falls. The prescribed care were compared with the NIC interventions by the cross-mapping method. RESULTS: The most prevalent care were the following: keeping the bed rails, guiding patients/family regarding the risks and prevention of falls, keeping the bell within reach of patients, and maintaining patients' belongings nearby, mapped in the interventions Environmental Management: safety and Fall Prevention. CONCLUSION: The treatment prescribed in clinical practice was corroborated by the NIC reference.

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