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ORIGINAL ARTICLE07-31-2023
Parenting of mothers of children in early childhood during the COVID-19 pandemic: qualitative research
Revista Brasileira de Enfermagem. 2023;76:e20220478
Abstract
ORIGINAL ARTICLEParenting of mothers of children in early childhood during the COVID-19 pandemic: qualitative research
Revista Brasileira de Enfermagem. 2023;76:e20220478
DOI 10.1590/0034-7167-2022-0478
Views0See moreABSTRACT
Objectives:
to understand practices of mothers of children in early childhood who live in contexts of poverty in the face of the COVID-19 pandemic.
Methods:
an exploratory, descriptive and qualitative study. Participants were selected in the community context, composing an intentional sample to be collected through semi-structured online interviews. Data were analyzed inductively and anchored in the Bioecological Model of Human Development.
Results:
eight mothers participated in the research. Mothers highlighted pleasure in taking care of their children, although they were overloaded with activities and comprehensive care at the time of the pandemic. Children, in mothers’ perception, showed a higher frequency of challenging behaviors, which may be related to negative parenting practices, such as punishment and physical violence.
Final Considerations:
interventions to support parenting become urgent in the face of changes brought about by the COVID-19 pandemic in families living in a context of poverty.
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ORIGINAL ARTICLE07-31-2023
Primary Health Care assessment in the COVID-19 pandemic from physicians’ and nurses’ perspective
Revista Brasileira de Enfermagem. 2023;76:e20220475
Abstract
ORIGINAL ARTICLEPrimary Health Care assessment in the COVID-19 pandemic from physicians’ and nurses’ perspective
Revista Brasileira de Enfermagem. 2023;76:e20220475
DOI 10.1590/0034-7167-2022-0475
Views0See moreABSTRACT
Objectives:
to assess the operationalization of Primary Health Care in the COVID-19 pandemic, according to Primary Care Assessment Tool: PCATool-Brasil attributes, from physicians’ and nurses’ perspective.
Methods:
a cross-sectional study, carried out with 99 physicians and nurses from Basic Health Units in a state in northeastern Brazil, with the aid of the adapted instrument PCATool-Brasil.
Results:
Essential Score was classified as high performance (6.6) and General Score as low performance (6.5). First Contact Access, Care Integration, and Community Guidance scores were <6.6. The best performances were attributed to the Longitudinality, Comprehensiveness and Family Guidance services (scores>6.6).
Conclusions:
the attributes of Primary Health Care, in general, showed values above or close to the cut-off point in the assessment. These data can support strategies for local and national managers to strengthen Primary Health Care in the COVID-19 pandemic and future public health emergencies.
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07-31-2023
Breastfeeding prevalence in newborns of mothers with COVID-19: a systematic review
Revista Brasileira de Enfermagem. 2023;76:e20220173
Abstract
Breastfeeding prevalence in newborns of mothers with COVID-19: a systematic review
Revista Brasileira de Enfermagem. 2023;76:e20220173
DOI 10.1590/0034-7167-2022-0173
Views0See moreABSTRACT
Objectives:
to compare exclusive breastfeeding prevalence versus artificial feeding in newborns of mothers with COVID-19.
Methods:
a systematic review of prevalence, according to JBI. Searches in PubMed®, Embase, CINAHL, LILACS and Web of Science™ databases in August 2021. Cross-sectional, longitudinal or cohort studies were selected, without language and time limitations that showed breastfeeding prevalence or that allowed calculation.
Results:
fifteen articles published in 2020 and 2021, cohort (60%) or cross-sectional (40%) were analyzed. The average of exclusive breastfeeding in mothers with COVID-19 was 56.76% (CI=39.90–72.88), and artificial breastfeeding, 43.23% (CI = 30.99 – 55.88), without statistically significant differences.
Conclusions:
despite the recommendations for maintaining breastfeeding, there was a reduction worldwide, when compared to periods prior to the pandemic. With advances in science, these rates have improved, showing the impact of evidence on practices. As limitations, study sources are cited. It is recommended to carry out new studies. PROSPERO registration CRD42021234486.
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REVIEW07-10-2023
Lean Six Sigma methodology to improve the discharge process in a Brazilian intensive care unit
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
Abstract
REVIEWLean Six Sigma methodology to improve the discharge process in a Brazilian intensive care unit
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
DOI 10.1590/0034-7167-2022-0538
Views0ABSTRACT
Objectives:
to describe the Lean Six Sigma implementation process to improve the discharge process in a Brazilian health institution’s ICU.
Methods:
prospective study following the Define-Measure-Analyse-Improve-Control project development method. This method consists of five phases, namely: project definition, measurement of the starting point and data collection, analysis of results, improvement in processes, and statistical control.
Results:
applying Lean Six Sigma methodology following the Define-Measure-Analyse-Improve-Control in the discharge process from the intensive care unit to the inpatient unit was effective in improving processes. This improvement represented a reduction in the mean patient transfer time to the inpatient unit from 189 minutes to 75 minutes, representing a 61% improvement in discharge time.
Conclusions:
this article demonstrates the effectiveness of applying Lean Six Sigma methodology to improve the discharge flow in a critical unit, resulting in time and waste reduction.
Keywords:Health Services AdministrationIntensive Care UnitsPatient DischargeTotal Quality ManagementWorkflowSee more -
ORIGINAL ARTICLE07-10-2023
Occurrence and preventability of adverse events in hospitals: a retrospective study
Revista Brasileira de Enfermagem. 2023;76(3):e20220025
Abstract
ORIGINAL ARTICLEOccurrence and preventability of adverse events in hospitals: a retrospective study
Revista Brasileira de Enfermagem. 2023;76(3):e20220025
DOI 10.1590/0034-7167-2022-0025
Views0See moreABSTRACT
Objectives:
to analyze the incidence of preventable adverse events related to health care in adult patients admitted to public hospitals in Brazil.
Methods:
observational, analytical, retrospective study based on medical records review.
Results:
medical records from 370 patients were evaluated, 58 of whom had at least one adverse event. The incidence of adverse events corresponded to 15.7%. Adverse events were predominantly related to healthcare-related infection (47.1%) and procedures (24.5%). Regarding the adverse event severity, 13.7% were considered mild, 51.0% moderate, and 35.3% severe. 99% of adverse events were classified as preventable. Patients admitted to the emergency room had a 3.73 times higher risk for adverse events.
Conclusions:
this study’s results indicate a high incidence of avoidable adverse events and highlight the need for interventions in care practice.
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07-10-2023
Metodologia Lean Seis Sigma para melhoria do processo de alta em uma unidade de terapia intensiva
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
Abstract
Metodologia Lean Seis Sigma para melhoria do processo de alta em uma unidade de terapia intensiva
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
DOI 10.1590/0034-7167-2022-0538
Views0See moreRESUMEN
Objetivos:
describir el proceso de implementación de Lean Six Sigma para mejorar el proceso de alta en una unidad de cuidados intensivos brasileña.
Métodos:
estudio prospectivo siguiendo el método de desarrollo de proyectos denominado DMAIC (Define-Measure-Analyze-Improve-Control). Este método consta de cinco fases, a saber: definición del proyecto, medición del punto de partida y recolección de datos, análisis de resultados, mejora en los procesos y control estadístico.
Resultados:
la aplicación de la metodología Lean Six Sigma fue efectiva para mejorar el proceso de alta de la unidad de cuidados intensivos a la unidad de hospitalización. Esta mejora representó una reducción en el tiempo promedio de alta de 189 a 75 minutos, totalizando una mejora del 61%.
Conclusiones:
este artículo demuestra la efectividad de la aplicación de la metodología Lean Six Sigma para mejorar el flujo de descarga en una unidad crítica, lo que resulta en la reducción de tiempo y desperdicio.
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ORIGINAL ARTICLE07-10-2023
Correlation between symptoms of depression, attitude, and self-care in elderly with type 2 diabetes
Revista Brasileira de Enfermagem. 2023;76(3):e20220741
Abstract
ORIGINAL ARTICLECorrelation between symptoms of depression, attitude, and self-care in elderly with type 2 diabetes
Revista Brasileira de Enfermagem. 2023;76(3):e20220741
DOI 10.1590/0034-7167-2022-0741
Views0See moreABSTRACT
Objectives:
to correlate depressive symptoms, attitude, and self-care of elderly people with type 2 diabetes.
Methods:
study developed with 144 elderly people with diabetes; carried out in Family Health Units. A semi-structured instrument was used to obtain data on the sociodemographic profile; the Geriatric Depression Scale (15 items), the Questionário de Atitudes Psicológicas do Diabetes [Psychological Attitudes of Diabetes Questionnaire], and the Diabetes Self-Care Activities Questionnaire (DSCA) were also used.
Results:
it was identified that 24.3% of the participants presented depressive symptoms, and 93.8% presented negative attitudes of coping. A greater adherence to self-care activities related to the practice of medication was observed. In the correlation between the scales, a negative and inversely proportional correspondence was noted between depressive symptomatology and physical activity (p=0.010) and foot care (p=0.006), likewise between attitude and foot care (p=0.009).
Conclusions:
self-care in elderly people with diabetes mellitus is influenced by depressive symptoms and negative coping attitudes.
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ORIGINAL ARTICLE07-10-2023
Primary care in supplementary health: assessment of costs in the care of older adult patients with heart diseases
Revista Brasileira de Enfermagem. 2023;76(3):e20220486
Abstract
ORIGINAL ARTICLEPrimary care in supplementary health: assessment of costs in the care of older adult patients with heart diseases
Revista Brasileira de Enfermagem. 2023;76(3):e20220486
DOI 10.1590/0034-7167-2022-0486
Views0See moreABSTRACT
Objectives:
to identify whether implementing a supplementary Primary Health Care (PHC) system makes it possible to reduce care costs for older adults with heart diseases.
Methods:
a retrospective cohort of 223 patients with heart disease aged ≥ 60 years. Data were obtained from medical records and cost databases, assessed for a period of one year before and after PHC implementation. The results were expressed as mean absolute frequencies for number of hospitalizations and as average annual expenses expressed in dollars (US$) in relation to cost data.
Results:
there was a reduction in hospitalization expenses after implementing supplementary PHC (p=0.01) and a decrease in the frequency of hospitalizations for the entire sample (p=0.006). There was a reduction in the frequency of consultations at the Emergency Room among frail older adults (p=0.011).
Conclusions:
there was a reduction in hospitalization costs and frequency of visits to the Emergency Room after supplementary PHC.
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ORIGINAL ARTICLE04-22-2020
Care coordination and longitudinality in primary health care in the Brazilian Amazon
Revista Brasileira de Enfermagem. 2020;73(3):e20180841
Abstract
ORIGINAL ARTICLECare coordination and longitudinality in primary health care in the Brazilian Amazon
Revista Brasileira de Enfermagem. 2020;73(3):e20180841
DOI 10.1590/0034-7167-2018-0841
Views0See moreABSTRACT
Objectives:
to evaluate the attributes of primary health care, care coordination and longitudinality, from the perception of the professional and patients in the state of Amazonas, Brazil.
Methods:
quantitative evaluative study, in which was used an external evaluation instrument with 469 professionals and 1,888 patients from 367 primary health care facilities that adhered to the Program for Improving Access and Quality of primary health care (Portuguese acronym: PMAQ) standardized by the Ministry of Health. Data were grouped by multivariate cluster analysis in order to find a classification of primary health care from the perspective of professionals and patients.
Results:
the attributes of coordination and longitudinality are still expressed in a weak and undeveloped way in the Brazilian Amazon scenario.
Conclusions:
it is necessary to recognize the organizational barriers and what could promote conditions for the performance of health care teams in the perspective of a continuous, integral and coordinated care.
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ORIGINAL ARTICLE07-31-2020
Social and obstetric inequalities and vaccination in pregnant women
Revista Brasileira de Enfermagem. 2020;73:e20190099
Abstract
ORIGINAL ARTICLESocial and obstetric inequalities and vaccination in pregnant women
Revista Brasileira de Enfermagem. 2020;73:e20190099
DOI 10.1590/0034-7167-2019-0099
Views0See moreABSTRACT
Objectives:
to analyze the association of socioeconomic level and obstetric characteristics with vaccine registration of pregnant women.
Methods:
cross-sectional study, performed with 480 women in puerperal. Vaccination of pregnant women was considered a dependent variable and as independent variables were age, skin color, education, steady union, paid work, and number of prenatal consultations. Association between variables was verified by the Poisson’s regression model.
Results:
from 480 pregnant women’s health cards, 10.63% had information on hepatitis B vaccination; 31.46% for tetanus; and 90% of the health cards had not register for influenza. There was an association of paid work and number of prenatal consultations with hepatitis B vaccination.
Conclusions:
lower percentages in absence of vaccination occurred in women who were in the job market and had a higher number of prenatal consultations. This suggests that socioeconomic inequalities may interfere with the vaccination of pregnant women in health services.
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ORIGINAL ARTICLE09-01-2021
Clinical Decision-Making in Nursing Scale (CDMNS-PT©) in nursing students: translation and validation
Revista Brasileira de Enfermagem. 2021;74:e20210032
Abstract
ORIGINAL ARTICLEClinical Decision-Making in Nursing Scale (CDMNS-PT©) in nursing students: translation and validation
Revista Brasileira de Enfermagem. 2021;74:e20210032
DOI 10.1590/0034-7167-2021-0032
Views0See moreABSTRACT
Objectives:
to validate, for the Portuguese population, the Clinical Decision-Making Nursing Scale© (CDMNS©).
Methods:
this methodological study involved 496 nursing students who filled in a questionnaire created using sociodemographic and academic data, and the scale to evaluate the making of decisions in nursing.
Results:
the confirmatory factorial analysis showed that the adjustment of the factorial structure has good quality, being made up by three factors (X2/gl = 2.056; GFI = 0.927; CFI = 0.917; RMSEA = 0.046; RMR = 0.039; SRMR = 0.050). For the scale to be reliable, it had to include only the reliability of the scale required it to be constituted by 23 items, with correlation values that varied from 0.184 and 0.610, and a global Cronbach’s Alpha of 0.851, which showed its good reliability.
Conclusions:
the CDMNS-PT© is valid and reliable, showing a high potential to be used in clinical practice and investigation.
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EXPERIENCE REPORT02-25-2022
Production and use of educational technologies in nursing post-graduation
Revista Brasileira de Enfermagem. 2022;75(5):e20210510
Abstract
EXPERIENCE REPORTProduction and use of educational technologies in nursing post-graduation
Revista Brasileira de Enfermagem. 2022;75(5):e20210510
DOI 10.1590/0034-7167-2021-0510
Views0See moreABSTRACT
Objective:
To report, under the light of Gardner’s Theory of Multiple Intelligences, the experience of students with advanced educational practices, involving the production and use of technologies in the postgraduation nursing course of the Universidade Federal de Pernambuco.
Methods:
Experience report of students from the post-graduation nursing program from the Universidade Federal de Pernambuco, about the production of knowledge using educational technology and the application of active methodologies in the teaching-learning process for face-to-face and distance teaching.
Results:
The post-graduate students participated in the educational process in a creative way, both during in-person and distance teaching. They created: domino games, educational videos, parodies, conceptual maps, virtual role-playing, an interactive quiz, among others.
Final considerations:
The experience of the students with the advanced educational practices, including the production and use of technologies in nursing post-graduation showed that the teaching-learning process can be innovative and planned to go beyond traditional methods.
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REVIEW12-13-2019
Critical path of women in situation of violence: an integrative literature review
Revista Brasileira de Enfermagem. 2019;72:321-332
Abstract
REVIEWCritical path of women in situation of violence: an integrative literature review
Revista Brasileira de Enfermagem. 2019;72:321-332
DOI 10.1590/0034-7167-2018-0265
Views1See moreABSTRACT
Objective:
To identify Brazilian and international scientific evidence on the critical path of women in situations of violence.
Method:
Integrative literature review developed in four databases and two electronic portals, in January 2017. Twenty-one full articles in English, Portuguese or Spanish from original researches were included in the time cut from 1994 to 2016, and which presented critical path elements, even without using this concept.
Results:
The critical path of women in situations of violence is constituted of elements related to their perceptions, actions and previous experiences regarding availability and quality of services, social representations of public servers and community and the results obtained in the search for help.
Conclusion:
Critical path elements are decisive for the women, and can promote, inhibit or delay the beginning of the route and consequently the end of situations of violence experienced by these women.
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ORIGINAL ARTICLE07-01-2020
Obstetric analgesia in labor and its association with neonatal outcomes
Revista Brasileira de Enfermagem. 2020;73(5):e20180757
Abstract
ORIGINAL ARTICLEObstetric analgesia in labor and its association with neonatal outcomes
Revista Brasileira de Enfermagem. 2020;73(5):e20180757
DOI 10.1590/0034-7167-2018-0757
Views0See moreABSTRACT
Objetive:
To investigate the association between analgesia during labor and occurrence of neonatal outcomes.
Method:
Retrospective cohort study with medical records of 850 parturient. The exposure variable of interest was receiving pharmacological analgesia during labor and neonatal outcomes were: one- and five-minute Apgar, resuscitation maneuvers and referral of the newborn to Neonatal ICU. A logistic regression was carried out to obtain Odds Ratios and 95% confidence interval, with adjustment for confounding factors.
Results:
Among the women studied, 35% received analgesia and this use was associated with a greater chance of neonatal outcomes such as one-minute Apgar < 7 (p <0.0001), resuscitation maneuvers (p <0.001) and referral to the Neonatal ICU (p = 0.004), mostly were among low-risk pregnant women, even after adjustments.
Conclusion:
The use of pharmacological analgesia during labor is associated with one-minute Apgar < 7, resuscitation maneuvers and referral to the Neonatal ICU.
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ORIGINAL ARTICLE12-13-2019
Nurses’ experiences in the care of high-risk newborns: a phenomenological study
Revista Brasileira de Enfermagem. 2019;72:111-117
Abstract
ORIGINAL ARTICLENurses’ experiences in the care of high-risk newborns: a phenomenological study
Revista Brasileira de Enfermagem. 2019;72:111-117
DOI 10.1590/0034-7167-2018-0221
Views0See moreABSTRACT
Objective:
To describe nurses’ experience in the care of high-risk newborns.
Method:
This is a descriptive study with a qualitative approach, based on Merleau-Ponty’s phenomenology and performed at the Fernando Magalhães Maternity Hospital in the state of Rio de Janeiro, through interviews with 30 nurses who work in neonatal care, according to the phenomenological thinking of Maurice Merleau- Ponty.
Results:
Three categories emerged: “experienced body of the nurse practitioner on the high-risk newborn”; “experienced world of the nurse practitioner on the high-risk newborn”; and “time spent by the nurse practitioner with the high-risk newborn”.
Final considerations:
The study allowed us to describe, through the participants’ speeches, that the care of the high-risk newborn is broad, that is, objective, subjective and carried out with advanced technologies, their experiences and scientific improvement are composed of shared practice and theory with the family, professionals and beginners in the neonatal universe, favoring a differentiated and humanized care.
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ORIGINAL ARTICLE11-29-2022
Ethics in nursing: categorization of legal processes
Revista Brasileira de Enfermagem. 2022;75(3):e20210099
Abstract
ORIGINAL ARTICLEEthics in nursing: categorization of legal processes
Revista Brasileira de Enfermagem. 2022;75(3):e20210099
DOI 10.1590/0034-7167-2021-0099
Views0See moreABSTRACT
Objectives:
to categorize factual elements of ethical-disciplinary nursing lawsuits in the state of Goiás.
Methods:
cross-sectional, retrospective study, based on secondary data obtained from ethical-disciplinary lawsuits filed at the Regional Nursing Council of Goiás (Coren-Goiás) between the years 2010 and 2019.
Results:
the highest number of lawsuits filed was in 2013 and 2014, with a greater frequency in the state capital. The majority came from the Nursing Ethics Committees and ex-officio complaints. The professional with most complaints was the nursing technician, aged between 31 and 40 years old, at the beginning of their career. The most common type of complaints referred to performing attributions that were not within the nursing competences.
Conclusions:
as a highlight are the contributions of this study to professional ethics in nursing and the clear need to consolidate these skills in nurses who are in training and in the continuous education for those already in the profession.
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