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ORIGINAL ARTICLE12-13-2024

Nurses’ experience regarding patient safety in mobile pre-hospital care
Revista Brasileira de Enfermagem. 2024;77(5):e20230529

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Abstract
ORIGINAL ARTICLE
Nurses’ experience regarding patient safety in mobile pre-hospital care
Revista Brasileira de Enfermagem. 2024;77(5):e20230529
DOI 10.1590/0034-7167-2023-0529
Eduardo Dias Filipe ,
Roberto Chrispim Modesto ,
Hercules de Oliveira Carmo ,
Haviley Oliveira Martins ,
Maristela Santini Martins
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ABSTRACT

Objectives:

to understand nurses’ experience regarding patient safety in mobile pre-hospital care.

Method:

a qualitative, exploratory and descriptive study, conducted with nurses active in mobile pre-hospital care services. Semi-structured interviews were conducted, audio-graved and submitted to Bardin’s content analysis.

Results:

from four thematic categories established, nurses reported the care and management skills necessary to work in this service. They demonstrated a commitment to ensuring safe care for patients, staff and spectators. They highlighted the actions taken to prevent and mitigate incidents. However, they based their experiences on practice protocols and individual actions, expressing the need to improve knowledge about patient safety.

Final Considerations:

mobile pre-hospital care nurses’ experience in relation to patient safety was limited, suggesting the need for training on the subject, alignment of work processes and implementation of strategies, aiming to guarantee safe care.

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ORIGINAL ARTICLE12-13-2024

Stress in nursing workers caring for people with COVID-19
- Carla Barbosa de Menezes ,
- Maria Lúcia Silva Servo
Revista Brasileira de Enfermagem. 2024;77(5):e20230542

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
ORIGINAL ARTICLE
Stress in nursing workers caring for people with COVID-19
Revista Brasileira de Enfermagem. 2024;77(5):e20230542
DOI 10.1590/0034-7167-2023-0542
Carla Barbosa de Menezes ,
Maria Lúcia Silva Servo
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ABSTRACT

Objectives:

to analyze stress from the perspective of nursing workers caring for people with COVID-19 in a public hospital in the Recôncavo region of Bahia.

Methods:

this is an exploratory qualitative study, conducted through semi-structured interviews. The data were analyzed using word clouds, similarity trees, and content analysis.

Results:

nursing workers were exposed to stress while attending to patients with COVID-19. The reported stressors in the workplace included: work overload, lack of planning, speed in performing tasks, fatigue, lack of participation in decision-making, lack of support from management, technological changes, excessive responsibility without preparation, interpersonal conflicts, and professional undervaluation.

Conclusions:

exposure to these stressors leads to emotional exhaustion and demotivation, which were intensified during the COVID-19 pandemic.

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ORIGINAL ARTICLE12-13-2024

Knowledge and attitudes of nursing students regarding the sexuality of older adults: a quasi-experimental study
Revista Brasileira de Enfermagem. 2024;77(5):e20240011

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
ORIGINAL ARTICLE
Knowledge and attitudes of nursing students regarding the sexuality of older adults: a quasi-experimental study
Revista Brasileira de Enfermagem. 2024;77(5):e20240011
DOI 10.1590/0034-7167-2024-0011
Ana Carolina Macri Gaspar Vendramini ,
Rosemeiry Capriata de Souza Azevedo ,
Priscila Aguiar Mendes ,
Janderson Diego Pimenta da Silva ,
Annelita Almeida Oliveira Reiners ,
Amanda Cristina de Souza Andrade
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ABSTRACT

Objectives:

to compare the knowledge and attitudes of nursing students regarding sexual behavior and sexually transmitted infections (STIs) in older adults before and after an educational intervention.

Methods:

this quasi-experimental study involved a convenience sample of 45 nursing students from a public university, conducted in three stages: pre-intervention, intervention, and post-intervention. A questionnaire was used to assess sociodemographic characteristics, academic training, and knowledge and attitudes on the topic. The intervention was an educational web conference. Paired t-test and Wilcoxon test were used for data analysis.

Results:

there was a statistically significant difference in the knowledge and attitude scores of nursing students before and after the educational intervention (p < 0.001). A significant increase was observed in the knowledge score (from 9.3 to 12.2) and attitude score (from 108 to 117.2) in the post-intervention phase.

Conclusions:

the knowledge of nursing students regarding the sexuality of older adults increased after the educational intervention, and their attitudes on the subject became more positive.

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ORIGINAL ARTICLE12-13-2024

Educational booklet on labor and delivery: validity study
Revista Brasileira de Enfermagem. 2024;77(5):e20240138

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
ORIGINAL ARTICLE
Educational booklet on labor and delivery: validity study
Revista Brasileira de Enfermagem. 2024;77(5):e20240138
DOI 10.1590/0034-7167-2024-0138
Michelle Tatiane Carvalho Gonçalves ,
Ana Roberta Vilarouca da Silva ,
Mara Cristina Ribeiro Furlan ,
Bruna Moretti Luchesi ,
Tatiana Carvalho Reis Martins
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ABSTRACT

Objectives:

to develop and validate an educational booklet on labor and delivery for pregnant women.

Methods:

this methodological study involved constructing and validating a booklet based on Echer’s framework. We used the Content Validity Index and Cronbach’s alpha for content and face validation, selecting judges according to Fering’s criteria. We then conducted a clinical validation with the target population.

Results:

the booklet, developed based on evidence from an integrative review and validated by judges and the target audience, achieved global Content Validity Index of 0.919 and 0.913, respectively. After clinical validation with 22 pregnant women, it included 28 topics and 48 pages, with illustrations by a graphic designer.

Conclusions:

expert judges and the target audience considered this educational technology valid, deeming it a relevant tool for promoting the health of pregnant women.

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12-08-2024

Contexto ibero-americano da enfermagem: construindo e compartilhando conhecimento
- José Ramón Martínez-Riera
Revista Brasileira de Enfermagem. 2024;77(1):e770101

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Contexto ibero-americano da enfermagem: construindo e compartilhando conhecimento
Revista Brasileira de Enfermagem. 2024;77(1):e770101
DOI 10.1590/0034-7167.2024770101pt
José Ramón Martínez-Riera
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Na próxima semana, acontecerão dois grandes eventos científicos em Madri e Granada (Espanha). Serão atividades internacionais, específicas e de forma muito especial, embora não exclusivas do campo ibero-americano, organizadas e desenvolvidas por duas sociedades científicas de enfermagem muito importantes, como a Associação de Enfermagem Comunitária (AEC) e a Associação Latino-Americana de Escolas e Faculdades de […]
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ORIGINAL ARTICLE12-08-2024

Initial nipple damages in breastfeeding women: analysis of photographic images and clinical associations
Revista Brasileira de Enfermagem. 2024;77(1):e20220773

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
ORIGINAL ARTICLE
Initial nipple damages in breastfeeding women: analysis of photographic images and clinical associations
Revista Brasileira de Enfermagem. 2024;77(1):e20220773
DOI 10.1590/0034-7167-2022-0773
Bárbara Tideman Sartorio Camargo ,
Adriana Sañudo ,
Denise Miyuki Kusahara ,
Kelly Pereira Coca
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ABSTRACT

Objective:

to analyze the initial nipple damage degree by breastfeeding practice and to associate findings with clinical manifestations of breastfeeding women.

Methods:

a retrospective, cross-sectional study with primary data and photographic images database from two randomized clinical trials. Photographic images were analyzed by two independent evaluators using the Nipple Trauma Score. For analysis, the chi-square, Mann-Whitney tests and Kappa coefficient were applied.

Results:

115 breastfeeding women and their respective 186 photographic images were analyzed. The degree of agreement of evaluators using the Nipple Trauma Score was 93.6%. The nipple pain score during breastfeeding was moderate and compromised more than 25% of the nipple surface area.

Conclusions:

assistance to breastfeeding women should prioritize nipple pain intensity instead of the nipple damage size.

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REVIEW12-08-2024

Interventions for Strengthening General Self-Efficacy Beliefs in College Students: An Integrative Review
Revista Brasileira de Enfermagem. 2024;77(1):e20230192

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
REVIEW
Interventions for Strengthening General Self-Efficacy Beliefs in College Students: An Integrative Review
Revista Brasileira de Enfermagem. 2024;77(1):e20230192
DOI 10.1590/0034-7167-2023-0192
Lais Palotta Balderrama Gueroni ,
Daniele Alcalá Pompeo ,
Letícia Palota Eid ,
Marcos Antonio Ferreira Júnior ,
Carlos Alberto da Cruz Sequeira ,
Luciano Garcia Lourenção
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ABSTRACT

Objective:

To assess the evidence regarding the effectiveness of interventions aimed at strengthening self-efficacy beliefs in college students.

Methods:

Integrative Review conducted on the Lilacs, PubMed, CinahL, Cochrane Collaboration Databases, Scopus, and PsycInfo databases. The methodological quality of the studies was assessed using tools proposed by the Joanna Briggs Institute, and the results were analyzed descriptively.

Results:

Out of the 10 selected studies, six demonstrated that interventions aimed at strengthening self-efficacy were effective (Levels of Evidence II and III), and four revealed contrary results (Levels of Evidence I and II). Programs aimed at enhancing self-efficacy should include content on positive mental health, psychoeducation strategies, cover a period of eight to twelve weeks, and consider the completion of homework assignments.

Conclusion:

The synthesis of evidence pointed to pathways for building an effective self-efficacy strengthening program to be implemented in universities.

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REVIEW12-08-2024

Common mental disorders in hematopoietic stem cell transplant patients: a scoping review
Revista Brasileira de Enfermagem. 2024;77(1):e20220581

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
REVIEW
Common mental disorders in hematopoietic stem cell transplant patients: a scoping review
Revista Brasileira de Enfermagem. 2024;77(1):e20220581
DOI 10.1590/0034-7167-2022-0581
Ana Clara Paiva de Almeida ,
Valéria Dantas de Azevedo ,
Tássia Regine de Morais Alves ,
Viviane Euzébia Pereira Santos ,
Glauber Weder dos Santos Silva ,
Isabelle Campos de Azevedo
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ABSTRACT

Objective:

to map common recurrent mental disorders in patients undergoing hematopoietic stem cell transplantation.

Methods:

this is a scoping review carried out in January 2022 in electronic databases and repositories of dissertations and thesis. Studies that answered the research question, met the objective of the study and were available in full electronically, in any language, were included.

Results:

the sample consisted of 28 studies, 14 of which were published in the United States of America. The common mental disorders found were depressive, anxiety, post-traumatic stress and mood disorders. Twenty symptoms were mentioned, among the most prevalent are fatigue and sleep disorders/insomnia.

Conclusions:

the difficulty and importance of carrying out the differential diagnosis of these disorders were highlighted, since their symptoms can be confused with other health problems and have a strong potential to interfere with patients’ evolution.

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ORIGINAL ARTICLE03-24-2021

Costs of healthcare-associated infections in an Intensive Care Unit
- Michelle Araujo Leal ,
- Ana Amélia de Freitas-Vilela
Revista Brasileira de Enfermagem. 2021;74(1):e20200275

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
ORIGINAL ARTICLE
Costs of healthcare-associated infections in an Intensive Care Unit
Revista Brasileira de Enfermagem. 2021;74(1):e20200275
DOI 10.1590/0034-7167-2020-0275
Michelle Araujo Leal ,
Ana Amélia de Freitas-Vilela
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ABSTRACT

Objectives:

to evaluate hospitalization costs of patients with and without Healthcare-Associated Infections an Intensive Care Unit.

Methods:

a retrospective case-control study. Data collection was retrieved from the medical records of Intensive Care Unit of a medium-sized public hospital in Goiás-Brazil. For each case, two controls were selected. Data on socioeconomic, clinical, and hospital costs were collected. To verify associations between variables, Odds Ratio and linear regression were calculated.

Results:

a total of 21 patients diagnosed with Healthcare-Associated Infections and 42 controls were evaluated. The hospitalization cost for patients with infection was four times higher than for non-infection patients (p-value<0.001). There was an association between infection and higher mortality (p-value <0.001), longer hospital-stay (p-value =0.021), and higher hospital costs (p-value =0.007).

Conclusions:

hospitalization costs of diagnosed Healthcare-Associated Infections patients are high compared to those who do not have this diagnosis.

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
ORIGINAL ARTICLE03-24-2021

Feelings, experiences and expectations of kidney transplant individuals and challenges for the nurse
Revista Brasileira de Enfermagem. 2021;74(1):e20200392

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
ORIGINAL ARTICLE
Feelings, experiences and expectations of kidney transplant individuals and challenges for the nurse
Revista Brasileira de Enfermagem. 2021;74(1):e20200392
DOI 10.1590/0034-7167-2020-0392
Maria de Nazaré de Souza Ribeiro ,
Fátima Helena do Espírito Santo ,
Bruna da Silva Simões ,
Cleisiane Xavier Diniz ,
Helen Cristine Albuquerque Bezerra ,
Luiz dos Santos
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ABSTRACT

Objectives:

to identify feelings, experiences, and expectations of kidney transplant patients, generated from the diagnosis of chronic renal disease until the post-transplant period, highlighting the challenges for nurses to incorporate individualized care to cope throughout the disease process.

Methods:

qualitative, descriptive research, carried with seven kidney transplant patients, in the city of Manaus, State of Amazonas. The data analysis followed the methodological referential of Bardin’s content analysis.

Results:

the diagnosis of the disease was experienced negatively, and hemodialysis was described as an imprisonment and health decline. The transplant meant an improvement in quality of life. The main difficulties were lack of a specialized hospital and low immunity.

Conclusions:

the nurses’ approach of chronic renal patient and with the renal transplantation favored the discovery of solutions facing the demands of the disease and allowed greater capacity to implement individualized care, surrounding a relationship of trust and respect.

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ORIGINAL ARTICLE06-11-2021

Work at the surgical center: risks of the pathogenic suffering of the nursing team
- Rosane Lima de Araujo ,
- Cecília Helena Glanzner
Revista Brasileira de Enfermagem. 2021;74(2):e20190803

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
ORIGINAL ARTICLE
Work at the surgical center: risks of the pathogenic suffering of the nursing team
Revista Brasileira de Enfermagem. 2021;74(2):e20190803
DOI 10.1590/0034-7167-2019-0803
Rosane Lima de Araujo ,
Cecília Helena Glanzner
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ABSTRACT

Objectives:

to assess the risks of pathogenic suffering related to the experience of nursing workers in the operating room of a university hospital.

Methods:

cross-sectional, quantitative study, carried out from 11/2017 to 01/2018 in a university hospital in the South of Brazil. The sample was composed by 159 nursing workers of the units of a surgical center, that answered to the Scale of Evaluation of Pathogenic Suffering at Work. Data was submitted to statistical analysis.

Results:

the workers present low risk of pathogenic suffering related to the experiences at work, being the results of its factors: Uselessness (1.47±0.761) – low risk; Indignity (2.372±1.035) – medium risk; and Disqualification (1.74±0.903) – low risk.

Conclusions:

the evaluation of Pathogenic Suffering at Work Scale was positive, predominating low risk for pathogenic suffering of surgical center workers related to professional experiences, because they feel useful, valued and are not indignant about their work, feelings that reflect on the quality of care provided.

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ORIGINAL ARTICLE05-21-2021

Music in the relief of stress and distress in cancer patients
Revista Brasileira de Enfermagem. 2021;74(2):e20190838

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
ORIGINAL ARTICLE
Music in the relief of stress and distress in cancer patients
Revista Brasileira de Enfermagem. 2021;74(2):e20190838
DOI 10.1590/0034-7167-2019-0838
Mariana Scheidegger dos Santos ,
Filipe de Moraes Thomaz ,
Rafael Tavares Jomar ,
Angela Maria Mendes Abreu ,
Gunnar Glauco De Cunto Carelli Taets
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ABSTRACT

Objectives:

to evaluate the effects of music on the physiological stress and distress of cancer patients being treated in a hospital.

Methods:

quasi-experimental study carried out with cancer patients hospitalized in the nursing wards of a public hospital. There was a single 15-minute intervention using music. It was individual, and headphones were used for patients to listen to three songs chosen by each one. The levels of stress and distress were measured before and after the intervention, using music to analyze the cortisol in the saliva and the answers to the distress thermometer. The significance level of the statistical analysis was 5%, using the non-parametric Wilcoxon test.

Results:

the mean age of the 26 patients was 56 years old. Most were female, white, and had breast cancer. After intervention, there were statistically significant diminutions in both stress and distress — p < 0.001.

Conclusions:

the use of music diminishes the stress and the distress of cancer patients.

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ORIGINAL ARTICLE05-21-2021

Orthognathic surgery: doubts from patients with orofacial fissures regarding the immediate postoperative period
Revista Brasileira de Enfermagem. 2021;74(2):e20200089

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
ORIGINAL ARTICLE
Orthognathic surgery: doubts from patients with orofacial fissures regarding the immediate postoperative period
Revista Brasileira de Enfermagem. 2021;74(2):e20200089
DOI 10.1590/0034-7167-2020-0089
Tatiane Henrique ,
Fábio Luiz Banhara ,
Natiele Favarão da Silva ,
Francely Tineli Farinha ,
Maila Meryellen Ferreira Garcia Manso ,
Armando dos Santos Trettene
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ABSTRACT

Objectives:

to identify the main doubts regarding the immediate postoperative care of patients with orofacial clefts undergoing orthognathic surgery.

Methods:

cross-sectional, quantitative study, developed in a public and tertiary hospital, between November 2017 and May 2018. Data collection occurred through interviews during the preoperative nursing consultation. An instrument was used to describe doubts, which later were grouped according to the subject.

Results:

48 patients participated. The doubts referred to sun exposure (56%), food/mastication (48%), the relationship between intermaxillary block-breathing-vomiting (48%), oral hygiene (31%), physical activity restriction (27%), nasopharyngeal cannula, removal of surgical stitches, hospitalization time and speech/communication (23%), bleeding, cryotherapy, facial massage, aesthetic and functional results, healing, edema/ecchymosis, postoperative pain, and changes in facial sensitivity (21%).

Conclusions:

the doubts were related to food, the period of convalescence, care for the surgical wound, postoperative complications, and medications.

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ORIGINAL ARTICLE05-28-2021

The work of a Brazilian nursing team of collective health in the special indigenous health district
Revista Brasileira de Enfermagem. 2021;74(2):e20200116

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
ORIGINAL ARTICLE
The work of a Brazilian nursing team of collective health in the special indigenous health district
Revista Brasileira de Enfermagem. 2021;74(2):e20200116
DOI 10.1590/0034-7167-2020-0116
Jair da Silva Melo ,
Noélle de Oliveira Freitas ,
Maíra Rosa Apostolico
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ABSTRACT

Objective:

To identify the potential and the limits of the actions of the nursing team in the Primary Health Care for the Health of the Indigenous.

Methods:

This is a quantitative study guided by the Theory of Practical Intervention of Nursing and Collective Health. 230 nursing professionals participated, responding to an instrument about the frequency of the actions carried out in assistance, management, teaching, and research.

Results:

168 nursing technicians and 62 nurses participated. As strengths, 80% participated in the assistance most of the time. Stand out: 90.3% and 71% of nurses carried out nursing consultations and house visits, respectively. As a limitation, the involvement in education and research is small. Only 2% of the interviewees carried out scientific researches, reflecting the need to broaden and qualify care and improve the use of traditional practices, overcoming the biomedical model.

Final considerations:

Nursing assistance is essential in the modification and monitoring of the epidemiological profile of indigenous populations, and its results allow for the planning of quality actions.

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ORIGINAL ARTICLE05-28-2021

Managed clinical protocol: impact of implementation on sepsis treatment quality indicators
Revista Brasileira de Enfermagem. 2021;74(2):e20200282

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
ORIGINAL ARTICLE
Managed clinical protocol: impact of implementation on sepsis treatment quality indicators
Revista Brasileira de Enfermagem. 2021;74(2):e20200282
DOI 10.1590/0034-7167-2020-0282
Camila Brito Borguezam ,
Caroline Tolentino Sanches ,
Silvia Paulino Ribeiro Albaneser ,
Uiara Rodrigues de Oliveira Moraes ,
Cintia Magalhães Carvalho Grion ,
Gilselena Kerbauy
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ABSTRACT

Objectives:

to assess the impact of the implementation of a managed sepsis protocol on quality indicators of treatment for septic patients in an emergency department of a university hospital.

Methods:

an observational epidemiological study involving septic patients. The study was divided into two phases, pre-intervention and intervention, resulting from the implementation of the managed sepsis protocol. The study variables included sepsis treatment quality indicators. The results were statistically analyzed using the program Epi Info^TM.

Results:

the study sample included 631 patients, 95 from pre-intervention phase and 536 from intervention phases. Implementing the protocol increased patients’ chances of receiving the recommended treatment by 14 times. Implementing the protocol reduced the hospitalization period by 6 days (p <0.001) and decreased mortality (p <0.001).

Conclusions:

this study showed that implementing the managed protocol had an impact on the improvement of sepsis treatment quality indicators.

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ORIGINAL ARTICLE06-16-2021

The meaning of nursing 200 years after Nightingale – perceptions of professional practice in the intensivist context
- Emanuelle Caires Dias Araújo Nunes ,
- Regina Szylit
Revista Brasileira de Enfermagem. 2021;74(2):e20200364

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
ORIGINAL ARTICLE
The meaning of nursing 200 years after Nightingale – perceptions of professional practice in the intensivist context
Revista Brasileira de Enfermagem. 2021;74(2):e20200364
DOI 10.1590/0034-7167-2020-0364
Emanuelle Caires Dias Araújo Nunes ,
Regina Szylit
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ABSTRACT

Objectives:

to know the meaning of contemporary nursing from the experience of intensive care nurses.

Methods:

qualitative research based on the theoretical framework of Symbolic Interactionism and the methodological framework of Interpretive Interactionism. The setting was a general hospital in Bahia, being carried out with 12 nurses working in intensive care for at least one year, through semi-structured interviews and drawing-text-theme technique, whose data were organized according to Miles and Huberman and analyzed upon the referential.

Results:

the sense of being a nurse was evidenced; a being for care, resulting from the experience in intensive care, capable of promoting the development of professional self-image, by causing, in nurses, other skills – besides the scientific ones, such as empathy, creativity, spirituality and compassion.

Final Considerations:

the sense of being a nurse, currently, expresses developments inherited from the Nightingalean proposal, but transcends the technical-managerial emphasis of this to a humanistic care perspective converging with our contemporary professional identity: a being for care.

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