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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
Views0ABSTRACT
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.
Keywords:COVID-19Health Care Evaluation MechanismsHealth PersonnelHealth Services ResearchPrimary Health CareSee more -
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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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
Views0RESUMEN
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.
Keywords:Administração em SaúdeFluxo de TrabalhoGestão da QualidadeMelhoria de QualidadeUnidades de Terapia IntensivaSee more -
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
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
Views0ABSTRACT
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.
Keywords:AgedCardiovascular DiseasesCosts and Cost AnalysisLearning Health SystemPrimary Health CareSee 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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ORIGINAL ARTICLE01-10-2024
Nursing students and the internet: a reflection of digital ethics
Revista Brasileira de Enfermagem. 2024;77:e20230459
Abstract
ORIGINAL ARTICLENursing students and the internet: a reflection of digital ethics
Revista Brasileira de Enfermagem. 2024;77:e20230459
DOI 10.1590/0034-7167-2023-0459
Views0See moreABSTRACT
Objectives:
to identify how first-year nursing students use cyberspace and propose an orientation guide with criteria guiding the use of cyberspace.
Methods:
qualitative and descriptive research, carried out with 24 nursing students from a federal public institution in Rio de Janeiro. Data collection was carried out through semi-structured interviews. Data analysis occurred using IRAMUTEQ®. The research was approved by the institution’s Research Ethics Committee.
Results:
students use cyberspace to communicate, study, find “cool things”, share photos and memories. Furthermore, they are concerned about hate speech, intolerance and fake news. The good and bad sides and the types of technologies most used were also portrayed.
Final considerations:
the moral and ethical values of physical coexistence, together with awareness of individual responsibility, are the pillars for using cyberspace. The guide comes as an awareness tool.
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ORIGINAL ARTICLE01-10-2024
Maternity behind and beyond bars: analysis from the perspective of protection bioethics
Revista Brasileira de Enfermagem. 2024;77:e20220576
Abstract
ORIGINAL ARTICLEMaternity behind and beyond bars: analysis from the perspective of protection bioethics
Revista Brasileira de Enfermagem. 2024;77:e20220576
DOI 10.1590/0034-7167-2022-0576
Views0See moreABSTRACT
Objective:
to analyze how motherhood is expressed in female prison units from the perspective of Bioethics of Protection.
Method:
qualitative research with an ethnographic approach, developed in two women’s prison units. Participantes were: six mothers deprived of liberty, 15 health professionals, and nine prison officers. For data collection, semi-structured interviews and descriptive observation were used. Data analysis was based on the Content Analysis technique, thematic category.
Results:
three categories emerged: women and children violated behind bars (inequities); mothers and children in prison exacerbating imbalances, tensions and conflicts; and limits and references for resocialization.
Final Considerations:
the Bioethics of Protection proposal appears as a valid tool for the analytical direction of the process of confronting issues in the scope of public health in prison units, considering vulnerable groups and aiming at equity and human dignity.
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ORIGINAL ARTICLE01-10-2024
Self-harm in the two years of greatest restrictions during the covid-19 pandemic: a cross-sectional study
Revista Brasileira de Enfermagem. 2024;77:e20240289
Abstract
ORIGINAL ARTICLESelf-harm in the two years of greatest restrictions during the covid-19 pandemic: a cross-sectional study
Revista Brasileira de Enfermagem. 2024;77:e20240289
DOI 10.1590/0034-7167-2024-0289
Views0See moreABSTRACT
Objective:
to analyze occurrence of self-harm, sociodemographic profile of victims and referrals in the first 24 months of the COVID-19 pandemic in São Paulo.
Method:
cross-sectional study carried out by the Notifiable Diseases Information System with data on self-harm in São Paulo. The period outlined was March 2020 to February 2022. R (4.0.2) software and chi-square test were used.
Results:
there were 15,946 incidents. Victims were young, white, single, heterosexual women. There was high incidence of people with previous mental disorders more than once and without clear motivation. The method used was poisoning/intoxication. There was a considerable number of referrals to the health network, although not totalitarian.
Conclusion:
the years of greater insecurity in relation to the pandemic have given rise to self-harm cases with peculiar characteristics. Agile health policies must be applied in atypical conditions, such as pandemics, especially for adolescents/young people with previous mental disorders.
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REVIEW01-10-2024
Health of quilombola children as a challenge for the Sustainable Development Goals: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20240106
Abstract
REVIEWHealth of quilombola children as a challenge for the Sustainable Development Goals: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20240106
DOI 10.1590/0034-7167-2024-0106
Views0See moreABSTRACT
Objective:
to map the literature on quilombola children’s health and its relationship with the Sustainable Development Goals.
Method:
a scoping review, which followed the JBI protocol and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Searches were conducted in the LILACS, BDENF, Web of Science, Scopus, MEDLINE databases and Google Scholar platform. The research protocol was registered in the Open Science Framework.
Results:
eighteen articles out of 2,055 studies were selected as relevant for this study. The articles were grouped into four axes: Access to healthcare services; Nutritional aspects of quilombola children; Health problems of quilombola children; and Care for quilombola children. The relationship between these articles and SDGs 1, 3, 4, 6 and 10 was observed.
Final considerations:
the study provided an extremely important mapping of the theme of quilombola children’s health and themes related to the Sustainable Development Goals.
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REVIEW01-10-2024
Prevalence and exposure variables of latent infection by mycobacterium tuberculosis in healthcare workers
Revista Brasileira de Enfermagem. 2024;77:e20240052
Abstract
REVIEWPrevalence and exposure variables of latent infection by mycobacterium tuberculosis in healthcare workers
Revista Brasileira de Enfermagem. 2024;77:e20240052
DOI 10.1590/0034-7167-2024-0052
Views0See moreABSTRACT
Objectives:
To identify in the scientific literature the prevalence, diagnostic methods, and exposure variables of latent infection by Mycobacterium tuberculosis in healthcare workers.
Methods:
An integrative review of the scientific literature based on the following review question: What are the available scientific evidence in the literature that address the prevalence of latent infection by Mycobacterium tuberculosis in healthcare workers and its association with possible risk factors among these workers?
Results:
Being a physician or nurse, being older, and being male were generally associated with higher prevalences. The study also showed that interferon-gamma release assays were more commonly used as a diagnostic method compared to skin tests.
Conclusions:
More studies are needed regarding the epidemiology of latent infection by Mycobacterium tuberculosis in the context of healthcare workers, aiming for higher impact actions that contribute to the reduction of tuberculosis worldwide.
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Nurses’ managerial knowledge in the hospital setting
Revista Brasileira de Enfermagem. 2016;69(4):676-683
Abstract
Nurses’ managerial knowledge in the hospital setting
Revista Brasileira de Enfermagem. 2016;69(4):676-683
DOI 10.1590/0034-7167.2016690409i
Views0See moreABSTRACT
Objective:
to analyze nurses’ managerial skills in the hospital setting, their perception of their own education and the relevance of training for their professional practice.
Method:
qualitative study based on the dialectical hermeneutics framework. Thirty-two nurses from three hospitals in the Brazilian state of Minas Gerais contributed to the study by taking part in six focus groups. Records were transcribed and three categories emerged from content analysis.
Results:
results evidenced the following managerial skills: supervision, leadership, decision making, planning and organization, as well as the relevance of education centers for their improvement and the continuing development of the nurses’ managerial skills.
Conclusion:
the authors believe this investigation will contribute for the improvement of nurses’ necessary managerial skills and also to identify gaps in this area of their education.
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Analysis of obstetric care provided by the Mobile Emergency Care Service
Revista Brasileira de Enfermagem. 2016;69(4):669-675
Abstract
Analysis of obstetric care provided by the Mobile Emergency Care Service
Revista Brasileira de Enfermagem. 2016;69(4):669-675
DOI 10.1590/0034-7167.2016690408i
Views1ABSTRACT
Objective:
analyze the pertinence of calls made by obstetric users of the Mobile Emergency Care Service (SAMU 192) of Botucatu-SP.
Method:
retrospective and analytical research. All records of prehospital obstetric care delivered by the SAMU 192 in 2012 were analyzed. To be considered responsive, calls should lead to referral to a reference obstetric hospital or be classified with the colors red, orange and yellow, according to risk criteria defined by the Ministry of Health.
Results:
considering the two outcomes evaluated: referral to a reference hospital and risk criteria defined by the Ministry of Health, 6.7% and 75.6% of the calls were not pertinent, respectively. There was no matching between outcomes, neither variation between primiparas and multiparas as regards the call pertinence.
Conclusion:
this study ratifies the need for implementing a risk classification protocol in obstetrics, and support managers in the organization, qualification and effective implementation of the Rede Cegonha.
Keywords:Emergence Medical ServicesEmergency NursingObstetric NursingPregnant WomenPrehospital ServicesSee more -
Experiences with severe maternal morbidity: a qualitative study on the perception of women
Revista Brasileira de Enfermagem. 2016;69(4):662-668
Abstract
Experiences with severe maternal morbidity: a qualitative study on the perception of women
Revista Brasileira de Enfermagem. 2016;69(4):662-668
DOI 10.1590/0034-7167.2016690407i
Views0See moreABSTRACT
Objective:
to know and analyze the experiences of women who developed an episode of Severe Maternal Morbidity.
Method:
this is a qualitative study, in which we interviewed 16 women admitted to a tertiary level hospital, as a result of this morbid state. We used content analysis in data processing.
Results:
two categories were identified: “Understanding maternal morbidity as a negative presence” and “Moving ahead: on constant alert”. The interviewees mentioned negative aspects, such as treatment difficulties and hospitalization, feelings of fear, concern for the fetus, frustration with the idealized pregnancy, trauma; and positive aspects, such as learning and the expression of the divine will in the experience of illness.
Conclusion:
effective care during the prenatal period, delivery and postpartum period should provide adequate support for the prevention and assistance in Severe Maternal Morbidity.
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Dialogue: network that intertwines the pedagogical relationship into the practical-reflective teaching
Revista Brasileira de Enfermagem. 2016;69(4):654-661
Abstract
Dialogue: network that intertwines the pedagogical relationship into the practical-reflective teaching
Revista Brasileira de Enfermagem. 2016;69(4):654-661
DOI 10.1590/0034-7167.2016690406i
Views0See moreABSTRACT
Objective:
to understand how dialogue occurs in the pedagogical relation in the practical reflective teaching in an undergraduate program in nursing.
Method:
qualitative research, case study. Data collection was conducted from May 2013 to September 2014 with eight professors of Nursing, by means of observation and interviews. Data analysis followed the operational proposal constituted by the exploratory stage and the interpretive stage.
Results:
point the dialogue established within the pedagogical relation as a challenge to be faced in practical-reflective teaching, so professor and student build a relationship that foster thought and action in the theoretical context and in the field of practice.
Conclusion:
in establishing a dialogic-reflective tone in the pedagogical relationship, the professor opens paths to new discoveries, enabling the creation of teaching-learning spaces that stimulate autonomy, abilities, and critical and reflective attitudes of students along their education.
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Nursing care through the perception of hospitalized children
Revista Brasileira de Enfermagem. 2016;69(4):646-653
Abstract
Nursing care through the perception of hospitalized children
Revista Brasileira de Enfermagem. 2016;69(4):646-653
DOI 10.1590/0034-7167.2016690405i
Views0See moreABSTRACT
Objective:
to describe the perception of hospitalized children of school age, on nursing care and understand what are, from their perspective, the best ways to address it to when performing such care.
Method:
qualitative, descriptive, exploratory research, with concepts of Vygotsky used as theoretical framework. The data collection occurred through interviews mediated by drawings and was performed with ten school children, with the interview later transcribed and submitted to a thematic analysis.
Results:
showed the importance of playing during hospitalization, of a friendly and caring approach and providing explanations regarding the performed procedures.
Conclusion:
nursing professionals need to consider how the children would like to receive the care being provided, so that their singularities are respected, characterizing nursing actions according to a perspective of the whole human being.
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Cost of dressings for prevention of sacral pressure ulcers
Revista Brasileira de Enfermagem. 2016;69(4):641-645
Abstract
Cost of dressings for prevention of sacral pressure ulcers
Revista Brasileira de Enfermagem. 2016;69(4):641-645
DOI 10.1590/0034-7167.2016690404i
Views0See moreABSTRACT
Objective:
to identify costs of dressings to prevent sacral pressure ulcers in an adult intensive care unit in Paraná, Brazil.
Methods:
secondary analysis study with 25 patients admitted between October 2013 and March 2014, using transparent polyurethane film (n=15) or hydrocolloid dressing (n=10) on the sacral region. The cost of each intervention was based on the unit amount used in each type of dressing, and its purchase price (transparent film = R$15.80, hydrocolloid dressing = R$68.00).
Results:
the mean cost/patient was R$23.17 for use of transparent film and R$190.40 for use of hydrocolloid dressing. The main reason for changing the dressing was detachment.
Conclusion:
the transparent film was the most economically advantageous alternative to prevent sacral pressure ulcers in critical care patients. However, additional studies should be carried out including assessment of the effectiveness of both dressings.
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Health practices: the view of the black elderly population in a terreiro community
Revista Brasileira de Enfermagem. 2016;69(4):633-640
Abstract
Health practices: the view of the black elderly population in a terreiro community
Revista Brasileira de Enfermagem. 2016;69(4):633-640
DOI 10.1590/0034-7167.2016690403i
Views1See moreABSTRACT
Objective:
to understand health practices of black, elderly people in a terreiro community (community of followers of traditional African-Brazilian religions).
Method:
qualitative descriptive study under the Black-African paradigm of civilization constituted by the Black-African cultural complex and the structuring elements of the African cosmovision. Semi-structured interviews were carried out from July to September 2013, with six black older people from a terreiro community in Porto Alegre, RS.
Results:
thematic content analysis resulted in the following categories: Ancestry; Belonging: the way to know and practice health; Health knowledge and practices in terreiro communities; and Complementarity: promoting health in the terreiro and traditional medicine and its respective subcategories.
Conclusion:
the study understood the importance of having a knowledge of the practices of African traditions in both the lifestyle and health of the older black population to help with nursing planning and interventions in response to their needs.
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