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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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ORIGINAL ARTICLE07-10-2023
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
ORIGINAL ARTICLEMetodologia 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
Childbirth dynamics in the riverside region of the Brazilian Amazon from the perspective of geospatialization
Revista Brasileira de Enfermagem. 2024;77:e20240038
Abstract
ORIGINAL ARTICLEChildbirth dynamics in the riverside region of the Brazilian Amazon from the perspective of geospatialization
Revista Brasileira de Enfermagem. 2024;77:e20240038
DOI 10.1590/0034-7167-2024-0038
Views0See moreABSTRACT
Objective:
to analyze the spatial-temporal pattern of childbirths and flow of postpartum women assisted at a regional reference maternity hospital.
Methods:
ecological study of 4,081 childbirths, between September 2018 and December 2021, at a public maternity hospital in the Baixo Tocantins region, Pará, Brazil. With data collected from five sources, a geographic database was constructed, and spatial analysis was used with Kernel density interpolator. Maps were generated using QGis/3.5 and TerraView/4.3, calculating chi-square (p<0.05).
Results:
the highest concentrations of normal and cesarean childbirths were observed in Barcarena (n=2,558/62.68%), Abaetetuba (n=750/18.38%), Moju (n=363/8.89%) and Igarapé-Miri (n=219/5.37%). Among the municipalities in the region, ten had obstetric beds, totaling 210 beds. In this scenario, postpartum women traveled up to 288 km to reach the maternity hospital.
Conclusions:
long distances between certain municipalities of residence and maternity hospital, and low supply of obstetric beds, were identified as risk factors for unfavorable obstetric outcomes.
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REVIEW01-10-2024
Nurses’ practical contributions to improving healthy and sustainable public spaces: an integrative review
Revista Brasileira de Enfermagem. 2024;77:e20240023
Abstract
REVIEWNurses’ practical contributions to improving healthy and sustainable public spaces: an integrative review
Revista Brasileira de Enfermagem. 2024;77:e20240023
DOI 10.1590/0034-7167-2024-0023
Views0ABSTRACT
Objective:
to identify knowledge production about nurses’ contributions to improving healthy and sustainable public spaces.
Methods:
an integrative review carried out in February 2023 in electronic databases. Studies that answered the research question and that were available in full, in Portuguese, English and Spanish, were included.
Results:
a total of five articles were selected. The findings highlighted the importance of educational projects in the training of local managers and community autonomy; citizen participation and health promotion as ways to implement Sustainable Development Goal 11; nurses as facilitators of collective care; new health practices and modes of producing subjectivity; and use of public transportation, bicycles and/or walking in these spaces.
Final considerations:
there is a clear need for greater incentives from local governments to develop effective sustainability strategies that are led by nurses and the community.
Keywords:AttitudesCommunity HealthHealth KnowledgeHealthy Lifestyle, NursesNursesPracticeSustainable DevelopmentSee more -
ORIGINAL ARTICLE01-10-2024
Pain management in hospitalized infants: recommendations for achieving the Sustainable Development Goals
Revista Brasileira de Enfermagem. 2024;77:e20230421
Abstract
ORIGINAL ARTICLEPain management in hospitalized infants: recommendations for achieving the Sustainable Development Goals
Revista Brasileira de Enfermagem. 2024;77:e20230421
DOI 10.1590/0034-7167-2023-0421
Views0See moreABSTRACT
Objective:
to assess pain management in infants in a Neonatal Intensive Care Unit (NICU) and discuss its articulation with the Sustainable Development Goals, with a focus on promoting neonatal well-being.
Method:
a documentary study, retrospective in nature and quantitative approach, conducted in a NICU of a public hospital in Paraná, Brazil, between January and July 2022, with 386 medical records of infants, hospitalized for more than 24 hours, between 2019 and 2021. Data were subjected to descriptive and inferential analysis, considering p-value<0.05 as a statistical difference. National ethical guidelines were respected.
Results:
all infants underwent at least one painful procedure, but only 13.7% had documented pain. Pharmacological interventions, such as fentanyl (25.9%), and non-pharmacological interventions, such as breastfeeding encouragement (86%) were used. Only 2.8% were reassessed.
Conclusion:
there was a devaluation of neonatal pain management that may perpetuate neonatal well-being and sustainable development.
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LETTER TO THE EDITOR01-10-2024
Adherence to COVID-19 vaccination during the pandemic and fake news: Correspondence
Revista Brasileira de Enfermagem. 2024;77:e202477Suppl101c
Abstract
LETTER TO THE EDITORAdherence to COVID-19 vaccination during the pandemic and fake news: Correspondence
Revista Brasileira de Enfermagem. 2024;77:e202477Suppl101c
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LETTER TO THE EDITOR01-10-2024
Adherence to COVID-19 vaccination during the pandemic and fake news: Correspondence
Revista Brasileira de Enfermagem. 2024;77:e202477Suppl101c
Abstract
LETTER TO THE EDITORAdherence to COVID-19 vaccination during the pandemic and fake news: Correspondence
Revista Brasileira de Enfermagem. 2024;77:e202477Suppl101c
DOI 10.1590/0034-7167.202477Suppl101c
Views0Dear Dr Dulce Aparecida BarbosaEditor in Chief of the Revista Brasileira de Enfermagem[…]See more -
ORIGINAL ARTICLE01-10-2024
Clinical and epidemiological characteristics and outcomes of patients affected by COVID-19 in the Intensive Care Unit
Revista Brasileira de Enfermagem. 2024;77:e20230527
Abstract
ORIGINAL ARTICLEClinical and epidemiological characteristics and outcomes of patients affected by COVID-19 in the Intensive Care Unit
Revista Brasileira de Enfermagem. 2024;77:e20230527
DOI 10.1590/0034-7167-2023-0527
Views0See moreABSTRACT
Objective:
To understand the clinical and epidemiological characteristics, outcomes, and nursing care of adult patients affected by COVID-19 in the Intensive Care Unit.
Methods:
This is a quantitative, retrospective, and descriptive study. The study participants were clinical and epidemiological statistical reports. Variables analyzed included age, gender, race, comorbidities, signs and symptoms, length of hospital stay, use of mechanical ventilation, medications, infections, monitoring, invasive devices, positioning, diet, comfort, and clinical outcomes.
Results:
The majority of individuals were men, of white race, with a mean age of 63 years, hypertensive, diabetic, and obese. The average length of hospital stay was 16 days. Most required invasive mechanical ventilation, vasopressor drugs, sedoanalgesia, and neuromuscular blockers.
Conclusion:
Nursing care is related to monitoring, ventilation, medication administration, installation of devices, prone positioning, diet administration, and providing comfort.
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ORIGINAL ARTICLE01-10-2024
Morbidity and factors associated with frailty in post-COVID-19 elderly patients attended at a reference center
Revista Brasileira de Enfermagem. 2024;77:e20230454
Abstract
ORIGINAL ARTICLEMorbidity and factors associated with frailty in post-COVID-19 elderly patients attended at a reference center
Revista Brasileira de Enfermagem. 2024;77:e20230454
DOI 10.1590/0034-7167-2023-0454
Views0See moreABSTRACT
Objective:
To assess the morbidity profile and identify factors associated with frailty syndrome in post-COVID-19 elderly patients treated at the only Reference Center for Elderly Health Care in northern Minas Gerais.
Methods:
This is a case series study, utilizing the Clinical-Functional Vulnerability Index-20 (CFVI-20) and Comprehensive Geriatric Assessment (CGA) to characterize and evaluate the health condition of the group. To define the variables associated with frailty, a multivariate analysis was conducted.
Results:
The study included 204 elderly individuals, with a predominance of females (63.7%). The variables associated with frailty were cognitive impairment (OR: 2.95; 95% CI: 1.12-7.80; p=0.029), the presence of five or more comorbidities (OR: 11.55; 95% CI: 2.22-60.01; p=0.004), and impairment in instrumental activities of daily living (OR: 41.97; 95% CI: 5.47-321.93; p<0.001).
Conclusions:
The results of this study highlight the need for a well-established and prepared coordination of integrated care to meet the demands of the post-COVID-19 elderly population.
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ORIGINAL ARTICLE01-10-2024
Nursing care management strategies to address the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2024;77:e20230254
Abstract
ORIGINAL ARTICLENursing care management strategies to address the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2024;77:e20230254
DOI 10.1590/0034-7167-20230254
Views0See moreABSTRACT
Objective:
To characterize nursing care management strategies for addressing the COVID-19 pandemic.
Method:
A descriptive, qualitative study conducted with 22 nurse professionals at a University Hospital in Southern Brazil. Data collection through interviews in June and August 2021, analyzed according to Bardin’s Content Analysis and the theoretical framework of complex thinking.
Results:
The identified strategies were organized into four categories: Reorganization of health services; People management and emergency admission; Multiprofessional articulation; and Bedside nursing care.
Final Considerations:
Professional performance revealed a complex interplay between leadership and care management practices, even in the face of working condition restrictions, and were understood as crucial in the pandemic scenario.
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EDITORIAL12-04-2023
A cronicidade e o seu impacto na saúde do trabalhador: uma chamada para ações concretas
Revista Brasileira de Enfermagem. 2023;76:e76suppl301
Abstract
EDITORIALA cronicidade e o seu impacto na saúde do trabalhador: uma chamada para ações concretas
Revista Brasileira de Enfermagem. 2023;76:e76suppl301
DOI 10.1590/0034-7167.202376suppl301pt
Views0A relação entre cronicidade e trabalho tem sido uma preocupação crescente na sociedade contemporânea. À medida que o número de doenças crônicas aumenta em todo o mundo, é fundamental compreender como essas condições impactam a saúde dos trabalhadores(). Neste editorial, exploraremos os impactos da cronicidade na saúde do trabalhador, destacando dados da Carga Global de […]See more -
EDITORIAL12-04-2023
Chronicity and its impact on workers’ health: a call for concrete actions
Revista Brasileira de Enfermagem. 2023;76:e76suppl301
Abstract
EDITORIALChronicity and its impact on workers’ health: a call for concrete actions
Revista Brasileira de Enfermagem. 2023;76:e76suppl301
DOI 10.1590/0034-7167.202376suppl301
Views0The relationship between chronicity and work has been a growing concern in contemporary society. As the number of chronic illnesses increases around the world, it is critical to understand how these conditions impact workers’ health(). In this editorial, we will explore the impacts of chronicity on workers’ health, highlighting data from the Global Burden of […]See more -
General Law on Personal Data Protection and applicability to Nursing
Revista Brasileira de Enfermagem. 2023;76:e20230126
Abstract
General Law on Personal Data Protection and applicability to Nursing
Revista Brasileira de Enfermagem. 2023;76:e20230126
DOI 10.1590/0034-7167-2023-0126
Views0See moreABSTRACT
Objectives:
to reflect on the impacts of the General Personal Data Protection Law on Nursing practice.
Methods:
reflection article, through the intentional collection of materials relating to the topic.
Results:
legislation regulates confidentiality, processing and data sharing, requiring institutional protection measures. The nursing team is responsible for acting preventively, both in care and in the management role, in order to avoid the misuse of the patient’s personal data. The law allows academic research to be carried out as long as the purpose is clear, data collection occurs with an explicit purpose and data is anonymized.
Final Considerations:
although the General Personal Data Protection Law requires greater care in relation to data processing, it is established on precepts of good faith and respect for the rights of the individual, concepts aligned with the nursing code of ethics.
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REVIEW12-04-2023
Supervision of professional nursing practice in Brazil: a scoping review
Revista Brasileira de Enfermagem. 2023;76:e20230077
Abstract
REVIEWSupervision of professional nursing practice in Brazil: a scoping review
Revista Brasileira de Enfermagem. 2023;76:e20230077
DOI 10.1590/0034-7167-2023-0077
Views0See moreABSTRACT
Objectives:
to map studies that analyze the audit process of nursing councils.
Methods:
this is a scoping review, anchored in the JBI framework, with the guiding question: what is the evidence of the audit process of legal practice of nursing by class councils (COFEN/COREN system)? The searches were carried out in October and November 2022 without limitation of language and year.
Results:
of the 9 selected studies, all are Brazilian and published from 2014 onwards. Among the topics addressed are the role, challenges, costs and difficulties in nurse auditors’ daily work process, in addition to the contribution of the audit sector in Brazil.
Conclusions:
the studies gathered discuss aspects related to costs, challenges and difficulties, but there is no focus on corrective, disciplinary and educational activities as well as little is said about the audit process, its reporting, referral and outcomes.
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ORIGINAL ARTICLE12-04-2023
Overview of nursing ethics teaching in Brazilian public higher education institutions
Revista Brasileira de Enfermagem. 2023;76:e20220808
Abstract
ORIGINAL ARTICLEOverview of nursing ethics teaching in Brazilian public higher education institutions
Revista Brasileira de Enfermagem. 2023;76:e20220808
DOI 10.1590/0034-7167-2022-0808
Views0See moreABSTRACT
Objectives:
to outline the teaching of ethics in undergraduate Nursing programs in Brazilian public higher education institutions.
Methods:
descriptive and exploratory study, carried out through the documentary analysis of pedagogical projects of undergraduate Nursing programs in Brazil.
Results:
153 active undergraduate Nursing programs were found, of which 106 provide the pedagogical project. In addition to deontological teaching, the teaching of ethics was identified in a transversal way associated with themes such as Social Context, Hospital and Community Care, Pharmacology, Systematization of Nursing Care, Surgical Nursing, Epidemiology, Palliative Care, Management in Nursing, Diversity, Women’s, Children’s, Adolescent’s, Adult’s and Older People’s Health, and Mental Health.
Final Considerations:
the challenge in teaching nursing ethics is its integration with each action of caring, teaching and managing.
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Ethical dilemmas at the end of life: a reflection from the Philosophical Perspective of Luigina Mortari
Revista Brasileira de Enfermagem. 2023;76:e20220759
Abstract
Ethical dilemmas at the end of life: a reflection from the Philosophical Perspective of Luigina Mortari
Revista Brasileira de Enfermagem. 2023;76:e20220759
DOI 10.1590/0034-7167-2022-0759
Views0See moreABSTRACT
Objectives:
to reflect on the ethical dilemmas involved in the care of patients at the end of their lives.
Methods:
this is a theoretical-reflective study based on the ethics of care proposed by Luigina Mortari.
Results:
discussing care involves addressing the ways of being inherent to human existence and understanding the unique characteristics of this condition. Ethical care constitutes an action driven by interest in the other and by the perception of their need. Ethical dilemmas are a part of end-of-life care, making it essential to maintain respectful assistance that considers the patient’s autonomy, using strategies for expressing their wishes, and ensuring continuous clear and empathetic communication among all those involved in providing care.
Final Considerations:
issues related to being, stemming from one’s reality of dependency and vulnerability, contribute to the emergence of ethical dilemmas present in care actions.
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