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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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REVIEW07-15-2024
Risk for imbalanced blood pressure pattern among incarcerated women: Middle-Range Theory
Revista Brasileira de Enfermagem. 2024;77:e20230288
Abstract
REVIEWRisk for imbalanced blood pressure pattern among incarcerated women: Middle-Range Theory
Revista Brasileira de Enfermagem. 2024;77:e20230288
DOI 10.1590/0034-7167-2023-0288
Views0See moreABSTRACT
Objectives:
to develop a Middle-Range Theory for the Risk for imbalanced blood pressure pattern among incarcerated women.
Methods:
theoretical development study to obtain the theoretical-causal validity of the Nursing Diagnosis Risk for unstable blood pressure. The Middle-Range Theory was developed according to six stages: establishment of the approach to developing the theory; definition of the conceptual models to be later analyzed; definition of the main conceptions; a pictorial diagram; propositions; causal relationships and evidence for practice.
Results:
two attributes and 20 antecedents related to imbalanced blood pressure were identified, a pictorial diagram was developed, and nine theoretical propositions were presented.
Conclusions:
the theory developed here favors the diagnostic reasoning of nurses and contributes to planning actions to promote the cardiovascular health of incarcerated women. A new proposition for the diagnosis of Risk for unstable blood pressure was also structured with a new title, definition, and etiological factors.
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ORIGINAL ARTICLE07-15-2024
Root cause analysis of safety incidents in antineoplastic use in children
Revista Brasileira de Enfermagem. 2024;77:e20230139
Abstract
ORIGINAL ARTICLERoot cause analysis of safety incidents in antineoplastic use in children
Revista Brasileira de Enfermagem. 2024;77:e20230139
DOI 10.1590/0034-7167-2021-0139
Views0See moreABSTRACT
Objectives:
to identify and analyze the factors that contribute to safety incident occurrence in the processes of prescribing, preparing and dispensing antineoplastic medications in pediatric oncology patients.
Methods:
a quality improvement study focused on oncopediatric pharmaceutical care processes that identified and analyzed incidents between 2019-2020. A multidisciplinary group performed root cause analysis (RCA), identifying main contributing factors.
Results:
in 2019, seven incidents were recorded, 57% of which were prescription-related. In 2020, through active search, 34 incidents were identified, 65% relating to prescription, 29% to preparation and 6% to dispensing. The main contributing factors were interruptions, lack of electronic alert, work overload, training and staff shortages.
Conclusions:
the results showed that adequate recording and application of RCA to identified incidents can provide improvements in the quality of pediatric oncology care, mapping contributing factors and enabling managers to develop an effective action plan to mitigate risks associated with the process.
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REVIEW07-15-2024
Leprosy and its impact on the quality of life of people with physical disabilities: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20230101
Abstract
REVIEWLeprosy and its impact on the quality of life of people with physical disabilities: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20230101
DOI 10.1590/0034-7167-2023-0101
Views0See moreABSTRACT
Objectives:
to identify and synthesize, from the literature, the impacts of physical disability caused by leprosy on the quality of life of individuals receiving care within the Health Care Network.
Methods:
this is a scoping review conducted following the JBI recommendations. The databases used in the search included the Medical Literature Analysis and Retrieval System Online, Cochrane Library, Web of Science, Lilacs, Cumulative Index to Nursing and Allied Health Literature, Scopus, Embase, Leprosy Information Services, and Google Scholar.
Results:
1690 documents were identified, of which 36 were included in the review. Physical disability caused by leprosy affects the quality of life in the areas of daily activities, socioeconomic aspects, psychological well-being, pain, and overall well-being.
Conclusions:
we identified the impairments caused by physical disability in the quality of life, highlighting the need for prevention, promotion, and rehabilitation actions, such as screening, case management, and health education.
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ORIGINAL ARTICLE07-15-2024
Depressive symptoms and associated factors among travestis and transsexuals: a cross-sectional study
Revista Brasileira de Enfermagem. 2024;77:e20230071
Abstract
ORIGINAL ARTICLEDepressive symptoms and associated factors among travestis and transsexuals: a cross-sectional study
Revista Brasileira de Enfermagem. 2024;77:e20230071
DOI 10.1590/0034-7167-2023-0071
Views0ABSTRACT
Objectives:
to estimate the prevalence of depressive levels and their associated factors among transvestite and transsexual individuals.
Methods:
this cross-sectional study involved 58 participants assisted by non-governmental organizations. The Beck Depression Inventory was utilized to assess levels of depression, complemented by a sociodemographic questionnaire and a questionnaire on experiences of violence. Data were analyzed using descriptive statistics and Poisson regression with robust variance.
Results:
a prevalence of 27.6% (95% CI = 11.50-39.10) for moderate to severe levels of depression was observed. This prevalence was associated with being unmarried (PR = 1.19; 95% CI = 1.10-1.28) and experiencing violence in healthcare services (PR = 2.30; 95% CI = 1.10-4.81).
Conclusions:
the absence of a partner and experiences of violence in healthcare settings negatively impacted mental health, leading to an increased prevalence of depressive symptoms among transvestite and transsexual individuals. Advocating for transgender rights and providing ongoing education in health care for professionals are critical strategies in promoting the mental health of this population.
Keywords:Cross-Sectional StudiesDepressionGender-Based ViolenceSexual and Gender MinoritiesTransgender PersonsSee more -
REVIEW07-15-2024
Factors associated with Burnout Syndrome in police officers: a scoping review
Revista Brasileira de Enfermagem. 2024;77(2):e20230444
Abstract
REVIEWFactors associated with Burnout Syndrome in police officers: a scoping review
Revista Brasileira de Enfermagem. 2024;77(2):e20230444
DOI 10.1590/0034-7167-2023-0444
Views0See moreABSTRACT
Objectives:
to synthesize research on factors associated with Burnout Syndrome (BS) in police officers.
Methods:
a scoping review was conducted without temporal or language restrictions. Data were exported to EndNote to remove duplicates and then imported into the Rayyan app for organization, article selection, and data extraction.
Results:
a total of 4559 publications were identified, with 50 studies included in the review. Research conducted in Brazil and the United States predominated. Certain occupational factors were found to be more closely linked to police officers compared to other professions, including law enforcement, frequency of interaction with suspects and criminals, rank, dissatisfaction with the organization, and civilian confrontations.
Conclusions:
certain aspects of the police profession contribute to BS, even in countries with better working conditions in public security. It is recommended to prioritize health promotion initiatives for these professionals.
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¿Puede la enfermería contribuir a reducir la mortalidad por accidentes de transporte terrestre?
Revista Brasileira de Enfermagem. 2024;77(4):e770401
Abstract
¿Puede la enfermería contribuir a reducir la mortalidad por accidentes de transporte terrestre?
Revista Brasileira de Enfermagem. 2024;77(4):e770401
DOI 10.1590/0034-7167.2024770401es
Views0La morbilidad y la mortalidad por causas externas, especialmente las resultantes de accidentes de transporte terrestre (ATT), persisten como un desafío global, dado que es responsable de alrededor de 2 millones de vidas perdidas anualmente, impactando a diversos segmentos de la sociedad, especialmente en los servicios y sistemas de salud().La evidencia indica que los ATT […]See more -
Can nursing contribute to reducing mortality from land transport accidents?
Revista Brasileira de Enfermagem. 2024;77(4):e770401
Abstract
Can nursing contribute to reducing mortality from land transport accidents?
Revista Brasileira de Enfermagem. 2024;77(4):e770401
DOI 10.1590/0034-7167.2024770401
Views0Morbidity and mortality from external causes, especially those resulting from land transport accidents (LTA), persist as a global challenge, given that they account for around 2 million lives lost annually, impacting various segments of society, especially in health services and systems().Evidence indicates that LTA are preventable, although historically they have been considered inevitable. However, isolated […]See more -
ORIGINAL ARTICLE06-28-2024
Quality of life at work for health professionals during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2024;77:e20230461
Abstract
ORIGINAL ARTICLEQuality of life at work for health professionals during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2024;77:e20230461
DOI 10.1590/0034-7167-2023-0461
Views0ABSTRACT
Objective:
to evaluate the quality of life at work of health professionals in direct and indirect care of COVID-19 cases.
Methods:
this was a cross-sectional study with 156 health professionals from a referral hospital. The relationship between sociodemographic and work-related variables and perceived stress and domains of the Quality of Life at Work Scale was investigated using inferential statistics and regression.
Results:
Satisfaction with Compassion was moderate (mean: 38.2), with low perception of stress, Burnout and Secondary Traumatic Stress (means: 18.8, 21.6 and 19.1). There were associations between: education, salary, multiple jobs and direct care with Compassion Satisfaction; low income, being a nurse and working overtime with Burnout; and working more than 12 hours, underlying disease and hospitalization for COVID-19 with Secondary Traumatic Stress.
Conclusion:
quality of life at work was satisfactory, despite the presence of Burnout and Secondary Traumatic Stress.
Keywords:Occupational HealthOccupational StressPsychological BurnoutQuality of LifeWorking ConditionsSee more
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Polysomnography assessment of sleep and wakefulness in premature newborns
Revista Brasileira de Enfermagem. 2015;68(6):1109-1115
Abstract
Polysomnography assessment of sleep and wakefulness in premature newborns
Revista Brasileira de Enfermagem. 2015;68(6):1109-1115
DOI 10.1590/0034-7167.2015680616i
Views0See moreABSTRACT
Objective:
to describe the total sleep time and its stages, total wake time, heart rate values and oxygen saturation shown by premature infants, and the influence of the periods of the day on sleep and physiological parameters.
Method:
a descriptive study was conducted of 13 hospitalized premature infants. Data collection was performed using polysomnography and unstructured observation for 24 uninterrupted hours.
Results:
the newborns remained asleep for 59.6% of the day, predominantly in quiet sleep, with a higher mean heart rate during wakefulness (p<0.001). No difference was found between the variables related to sleep, physiological parameters and periods of the day, but in the morning a predominance of quiet sleep was observed (p=0.002).
Conclusion:
the preterm newborn presented more total sleep time than wakefulness; quiet sleep was the predominant stage, and heart rate was higher during wakefulness.
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Learning Incubator: an instrument to foster entrepreneurship in Nursing
Revista Brasileira de Enfermagem. 2015;68(6):1103-1108
Abstract
Learning Incubator: an instrument to foster entrepreneurship in Nursing
Revista Brasileira de Enfermagem. 2015;68(6):1103-1108
DOI 10.1590/0034-7167.2015680615i
Views0See moreABSTRACT
Objective:
this study aimed to know the contributions of the Learning Incubator to the process of lifelong education in health.
Method:
this is a qualitative field research whose data was collected from August to December 2014 by the focus group technique. The research had 34 employees of a Teaching Hospital in the central region of the state of Rio Grande do Sul that participated previously in the incubation process.
Results:
from the data encoded by content analysis, three themes were selected: Learning Incubator – welcoming and integrating space; An instigating instrument that enhances possibilities; Continuous and lifelong education strategy.
Conclusion:
the Learning Incubator is an important instrument to foster entrepreneurship in nursing and other health areas due to its capacity of rethinking mechanized practices, to the possibility of instigating new ways of being and acting, and to the ability of creating and developing new ideas based on individual and institutional needs.
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RESEARCH01-01-2015
Estratégias não farmacológicas para diminuição da ansiedade no cateterismo cardíaco: revisão integrativa
Revista Brasileira de Enfermagem. 2015;68(6):1093-1102
Abstract
RESEARCHEstratégias não farmacológicas para diminuição da ansiedade no cateterismo cardíaco: revisão integrativa
Revista Brasileira de Enfermagem. 2015;68(6):1093-1102
DOI 10.1590/0034-7167.2015680614i
Views0See moreRESUMEN
Objetivo:
identificar y revisar los estudios de literatura que abordan las estrategias no farmacológicas utilizadas para reducir la ansiedad en los pacientes que reciben un cateterismo cardíaco.
Método:
revisión integradora. La investigación se llevó a cabo utilizando las bases de datos LILACS, SciELO, Medline (BVS y PubMed) y Scopus. Los estudios se analizaron de acuerdo con sus objetivos, la metodo, los instrumentos utilizados para la evaluación de la ansiedad de los pacientes, y los resultados obtenidos.
Resultados:
la estrategia dirigida más para reducir la ansiedad en los pacientes que recibieron cateterización cardíaca fue la musicoterapia. No se encontró estudio, sin embargo, identificando el momento más adecuado para esta intervención (antes, durante y / o después de este procedimiento). Otras estrategias identificados en esta revisión eran videos educativos, masajes y terapia de palma.
Conclusión:
los resultados sugieren que la ansiedad se puede reducir el uso de estrategias no farmacológicas.
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Non-pharmacological strategies to decrease anxiety in cardiac catheterization: integrative review
Revista Brasileira de Enfermagem. 2015;68(6):1093-1102
Abstract
Non-pharmacological strategies to decrease anxiety in cardiac catheterization: integrative review
Revista Brasileira de Enfermagem. 2015;68(6):1093-1102
DOI 10.1590/0034-7167.2015680614i
Views0See moreABSTRACT
Objective:
to identify and review the literature on non-pharmacological strategies used for reducing anxiety in patients receiving cardiac catheterization.
Method:
this study was an integrative literature review. The research was conducted using the databases LILACS, SciELO, Medline (through BVS and PubMed) and Scopus. Studies were analyzed according to their objective, method, instruments used for evaluating patients’ anxiety, and the results obtained.
Results:
the most used strategy for reducing anxiety in patients receiving cardiac catheterization was music therapy. However, no study identifying the most appropriate time for this intervention (before, during and/or after the procedure) was found. Other strategies identified in this review were educational videos, massage, and palm therapy.
Conclusion:
the results found suggest that anxiety can be reduced using non-pharmacological strategies.
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Convergence, divergence and diagnostic accuracy in the light of two nursing terminologies
Revista Brasileira de Enfermagem. 2015;68(6):1086-1092
Abstract
Convergence, divergence and diagnostic accuracy in the light of two nursing terminologies
Revista Brasileira de Enfermagem. 2015;68(6):1086-1092
DOI 10.1590/0034-7167.2015680613i
Views0See moreABSTRACT
Objective:
compare divergences and convergences between the nursing diagnoses established for a case study, in the light of two nursing terminologies.
Method:
a descriptive research was undertaken. The participants were 24 nurses from public teaching hospitals (N=12) and hospital care institutions (N=12) in the Northeast of Brazil.
Results:
in group A (6 faculty members and 6 clinical professionals), 51 diagnoses were established according to NANDA-I: 54.9% of high accuracy, 23.5% zero, 15.7% low and 5.9% moderate accuracy. In group B (6 faculty members and 6 clinical professionals), 43 declarations were established using the ICNP®: 44.2% of zero accuracy, 39.5% high, 16.3% low. Four out of fi ve diagnostic titles of high accuracy in group A and the seven titles in group B converged; divergences were attributed to the number of combinations among the focus, judgment and location axes of the ICNP®.
Conclusion:
a range of titles was observed with different diagnostic inferences and low diagnostic accuracy in both groups.
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Speeches of managers about the policy of the directly observed treatment for tuberculosis
Revista Brasileira de Enfermagem. 2015;68(6):1069-1077
Abstract
Speeches of managers about the policy of the directly observed treatment for tuberculosis
Revista Brasileira de Enfermagem. 2015;68(6):1069-1077
DOI 10.1590/0034-7167.2015680611i
Views0See moreABSTRACT
Objective:
to analyze the managers’ speeches about the policy transfer of the directly observed treatment (DOT) for tuberculosis control in the city of João Pessoa, Paraíba, Brazil.
Method:
this is a qualitative study developed in May and June, 2013 through semi-directed interviews with twenty health professionals in five health districts in João Pessoa/PB. The empirical material produced was analyzed according to the theoretical-analytical basis of the French Discourse Analysis by Pêcheux.
Results:
the study demonstrated weaknesses in the conduction and organization of actions in relation to the DOT. It revealed that the lack of knowledge of the managers about this policy has direct implications to the care of tuberculosis patients.
Conclusion:
the management should trace strategic plans to rethink the care practices and thus, reorganize the entire care network to users in order to effectively contribute to user adherence in the fight against tuberculosis.
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