Background: Cultural competence is central to ensuring effective culturally congruent care to patients and fostering positive work environments, particularly in multicultural settings. Objective: This study aimed to analyse the relationship between cultural competence, the nursing work environment, and the delivery of culturally congruent care in multicultural units of a healthcare organisation in Portugal. Method: This was a quantitative, descriptive, and cross-sectional study, targeting nurses from multicultural units. Data were collected using both online and paper-based questionnaires, which included the Cultural Competence Questionnaire for Help Professionals, the Nursing Work Index—Revised Scale (NWI-R-PT), and a single question assessing nurses’ perceptions of the adequacy of the culturally congruent care they provide. Results: A moderate, positive correlation was identified between cultural competence and the Fundamentals for Nursing, while the nursing work environment was influenced by organisational support, professional category, and unit type. Discussion: The findings suggest that enhancing cultural knowledge and technical skills and reinforcing management support may positively impact culturally congruent care delivery in multicultural settings. Conclusion: This study contributes to nursing knowledge by highlighting the complex interactions between cultural competence and the work environment in Portuguese multicultural healthcare units. Future research should explore the impact of transcultural nursing leadership on multicultural work environments and in the delivery of culturally congruent care.

Objective: to map the instruments for risk assessment of pressure ulcers in adults in critical situation in intensive care units; identify performance indicators of the instrument, and the appreciation of users regarding the instruments’ use/limitations. Method: a scoping review. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews in the writing of the study. We carried out the searches in the EBSCOhost search tool for 8 databases, resulting in 1846 studies, of which 22 studies compose the sample. Results: we identified two big instrument groups: generalist [Braden, Braden (ALB), Emina, Norton-MI, RAPS, and Waterlow]; and specific (CALCULATE, Cubbin & Jackson, EVARUCI, RAPS-ICU, Song & Choi, Suriaidi and Sanada, and COMHON index). Regarding the predictive value, EVARUCI and CALCULATE presented better results for performance indicators. Concerning appreciation/limitations indicated by users, we highlight the CALCULATE scale, followed by EVARUCI and RAPS-ICU, although they still need future adjustments. Conclusion: the mapping of the literature showed that the evidence is sufficient to indicate one or more instruments for the risk assessment of pressure ulcers for adults in critical situation in intensive care units.

Objetivo: mapear los instrumentos para la evaluación del riesgo de lesiones por presión en adultos en situación crítica en una unidad de terapia intensiva; identificar los indicadores de desempeño de los instrumentos y la apreciación de los usuarios con respecto al uso/limitaciones de los instrumentos. Método: scoping review. Para redactar el estudio se utilizó la extensión Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. La investigación se realizó mediante la herramienta de búsqueda EBSCOhost en 8 bases de datos, resultando 1846 estudios, de los cuales 22 conforman la muestra. Resultados: se identificaron dos grandes grupos de instrumentos: los generalistas [Braden, Braden (ALB), Emina, Norton-MI, RAPS y Waterlow]; y los específicos (CALCULATE, Cubbin & Jackson, EVARUCI, RAPS-ICU, Song & Choi, Suriaidi y Sanada y el índice COMHON). En cuanto al valor predictivo, EVARUCI y CALCULATE mostraron los mejores resultados de indicadores de desempeño. En cuanto a las apreciaciones/limitaciones señaladas por los usuarios, destaca la escala CALCULATE, seguida de la EVARUCI y la RAPS-ICU, aunque aún necesitan ajustes futuros. Conclusión: el mapeo mostró que las evidencias son suficientes para indicar uno o más instrumentos para la evaluación del riesgo de lesiones por presión en adultos críticos en una unidad de cuidados intensivos.

Background: The prevention of pressure injuries depends on the early and correct assessment of at-risk patients. Since risk assessment involves more than using a risk factor instrument, we intend to map the existing recommendations and statements of good practice for pressure injury risk assessment in adults admitted to intensive care units, as well as identify the strengths of the evidence and recommendations in the literature. Methods: This study is a scoping review, guided by the Joanna Briggs Institute framework. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews was adopted as a guide for writing this study. Results: Searches were carried out in six databases, resulting in 794 studies, of which 15 were included. The recommendations and statements of good practice were grouped into five categories: risk assessment instruments, skin assessment, medical device surveillance, other alternatives to risk assessment, and implementing best practices in clinical settings. The strengths of the evidence and recommendations were identified when available in the literature. Conclusions: The mapping showed that the evidence is sufficient to indicate recommendations and statements of good practice for the risk assessment of pressure injuries in adults admitted to intensive care units. The protocol was retrospectively registered in the Open Science Framework on the 4th of August of 2023.

As Lesões Por Pressão (LPP) constituem uma problemática que acompanha os cuidados de saúde ao longo do tempo pelos danos que causam ao paciente e pelos custos do tratamento. É um dos principais desafios enfrentados pelos gestores organizacionais, devido à alta taxa de morbidade, ao risco de infeção hospitalar, ao aumento do tempo de recuperação e ao comprometimento da qualidade de vida do paciente. Também abarca um acréscimo na equipe de enfermagem para prestação de cuidados e elevados custos com produtos específicos para tratamentos das lesões⁽¹ 1. Galvão N, Serique M, Santos V, Nogueira P. Knowledge of the nursing team on pressure ulcer prevention. Rev Bras Enferm. 2017;70(2):294-300. https://doi.org/10.1590/0034-7167-2016-0063 https://doi.org/10.1590/0034-7167-2016-0... ⁾. A LPP é considerada um evento adverso, pois trata-se de uma lesão que pode ser evitada, constituindo-se em um indicador de qualidade da assistência de enfermagem. Isso reflete diretamente na qualidade dos cuidados de enfermagem e de outros profissionais relacionados ao cuidado⁽² 2. Santos C, Oliveira M, Pereira A, Suzuki L, Lucena, A. Pressure ulcer care quality indicator: analysis of medical records and incident report. Rev Gaucha Enferm. 2013;34(1):111-8. https://doi.org/10.1590/s1983-14472013000100014 https://doi.org/10.1590/s1983-1447201300... ⁾.

Background: the prevention of pressure injuries depends on early and correct assessment of at-risk patients. Since risk assessment is more than identifying it using a risk factor instrument, we intend to map the existing recommendations and statements of good practice for pressure injury risk assessment in adults admitted to intensive care units, as well as identifying the strengths of evidence and recommendations. Methods: scoping review, by Joanna Briggs Institute, adopting the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews as a guide for writing the study. Results: the search was carried out in six databases, resulting in 741 studies, of which 15 were included. The recommendations and statements of good practice were grouped into five categories: risk assessment instruments, skin assessment, medical device surveillance, other alternatives to risk assessment and implement the best practices in clinical settings. The strengths of evidence and recommendation were identified, when available in the literature. Conclusions: the mapping showed that the evidence is sufficient to indicate the recommendations and statements of good practice to risk assessment of pressure injuries in adults admitted to an intensive care unit. The protocol was retrospectively registered in the Open Science Framework on the 4th of august of 2023 (https://doi.org/10.17605/OSF.IO/5NF3U).