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Palliative care strategies in the management of people with serious cases of COVID-19
Revista Brasileira de Enfermagem. 2023;76:e20220308
Abstract
Palliative care strategies in the management of people with serious cases of COVID-19
Revista Brasileira de Enfermagem. 2023;76:e20220308
DOI 10.1590/0034-7167-2022-0308
Views0See moreABSTRACT
Objectives:
to analyze the assistance strategies in palliative care developed in the COVID-19 pandemic for critically ill patients and their families.
Methods:
an integrative review carried out in August 2021 and updated in April 2022 in the Base de Dados de Enfermagem (BDENF), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (MEDLINE), US National Library of Medicine (PubMed), Web of Science databases, and presented in the PRISMA flowchart.
Results:
thirteen works were selected for reading and content analysis, from which emerged the two main themes that reflect the reality evidenced in this context: The sudden advent of COVID-19 with impacts on palliative care; and The strategies used in palliative care to mitigate these impacts.
Final Considerations:
palliative care is the best strategy for providing health care, used as a comfort to bring relief and comfort to patients and families.
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ORIGINAL ARTICLE03-06-2023
The pandemic changes daily life and ways of living: technosociality and user/families experiences
Revista Brasileira de Enfermagem. 2023;76:e20220177
Abstract
ORIGINAL ARTICLEThe pandemic changes daily life and ways of living: technosociality and user/families experiences
Revista Brasileira de Enfermagem. 2023;76:e20220177
DOI 10.1590/0034-7167-2022-0177
Views0See moreABSTRACT
Objectives:
understand the changes imposed by the COVID-19 pandemic in the daily lives of users of Primary Health Care and their families and its impact on self-care and health promotion.
Methods:
this is a holistic-qualitative multiple case study, based on the Comprehensive Sociology of Everyday Life, in which 61 users participated.
Results:
experiencing a new daily life in COVID-19 pandemic times, users express their feelings, adaptation to new habits and ways of living. Health technologies and virtual social networks stand out in helping with everyday tasks, in communicating with loved ones and health professionals, and in validating dubious information. Faith and spirituality arise in the face of uncertainty and suffering.
Final Considerations:
it is imperative to pay close attention to the changes in daily life caused by the COVID-19 pandemic, in order to offer care directed to the singular and collective needs.
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ORIGINAL ARTICLE03-06-2023
Construct elaboration and validity of the Pregnancy Depression Risk Scale
Revista Brasileira de Enfermagem. 2023;76(2):e20220306
Abstract
ORIGINAL ARTICLEConstruct elaboration and validity of the Pregnancy Depression Risk Scale
Revista Brasileira de Enfermagem. 2023;76(2):e20220306
DOI 10.1590/0034-7167-2022-0306
Views0See moreABSTRACT
Objectives:
to elaborate and analyze the Pregnancy Depression Risk Scale psychometric properties.
Methods:
methodological research, in six steps: theoretical model empirical definition; elaboration of scale items with literature review; consultation with five professional health experts and 15 pregnant women; content validity with six experts; pre-test-semantic validity with 24 pregnant women; scale factor structure definition with 350 pregnant women; pilot study with 100 pregnant women, totaling 489 pregnant women and 11 experts. Data were analyzed by content analysis, exploratory factor analysis, multitrait-multimethod analysis and internal consistency.
Results:
sixty-eight risk factors were identified for item formulation. The final version of the scale consisted of 24 items in five domains. The scale demonstrated satisfactory construct content, semantic, validity and reliability.
Conclusions:
the scale proved to be valid in terms of content and semantics, with a factor structure defined according to the adopted theoretical model and satisfactory psychometric properties.
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REVIEW03-06-2023
Nursing protocols to reduce urinary tract infection caused by indwelling catheters: an integrative review
Revista Brasileira de Enfermagem. 2023;76(2):e20220067
Abstract
REVIEWNursing protocols to reduce urinary tract infection caused by indwelling catheters: an integrative review
Revista Brasileira de Enfermagem. 2023;76(2):e20220067
DOI 10.1590/0034-7167-2022-0067
Views0See moreABSTRACT
Objectives:
to analyze the production of knowledge in research articles about the effectiveness of nursing protocols for reducing indwelling urinary catheter dwell time and catheter-associated urinary tract infection rate in hospitalized adult and older patients.
Methods:
an integrative review of three full articles, available in the MEDLINE Complete – EBSCO, Scopus and Web of Science databases, from 01/01/2015 to 04/26/2021.
Results:
the three protocols reduced infection rates, and from the review/synthesis of their knowledge, a level IV body of evidence emerged to compose the nursing care process aimed at reducing indwelling urinary catheter dwell time and catheter-associated urinary tract infection.
Final Considerations:
this process gathers scientific evidence to support the elaboration of nursing protocols and, consequently, the conduction of clinical trials on its effectiveness in reducing urinary tract infection by indwelling urinary catheter.
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ORIGINAL ARTICLE03-06-2023
Medication reconciliation in pediatrics: a validation of instruments to prevent medication errors
Revista Brasileira de Enfermagem. 2023;76(2):e20210755
Abstract
ORIGINAL ARTICLEMedication reconciliation in pediatrics: a validation of instruments to prevent medication errors
Revista Brasileira de Enfermagem. 2023;76(2):e20210755
DOI 10.1590/0034-7167-2021-0755
Views0See moreABSTRACT
Objectives:
to develop and validate the content of two instruments for promoting medication reconciliation for the transition of care of hospitalized children.
Methods:
methodological study, conducted in five stages: scope review for conceptual structure; elaboration of the initial version; content validation with five specialists using the Delphi technique; reassessment; and construction of the final version of the instruments. A content validity index of at least 0.80 was adopted.
Results:
three rounds of evaluation were carried out to reach the validity index of the proposed contents, whereas a new analysis of 50% of the 20 items of the instrument aimed at families, and 28.5% of the 21 items aimed at professionals was necessary. The instrument aimed at families reached an index of 0.93, and the instrument for professionals, 0.90.
Conclusions:
the proposed instruments were validated. It is now possible to proceed with practical implementation studies to identify their influence on safety during medication reconciliation at transition of care.
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ORIGINAL ARTICLE03-06-2023
Organizational politics and professional struggles in nursing
Revista Brasileira de Enfermagem. 2023;76(1):e20220180
Abstract
ORIGINAL ARTICLEOrganizational politics and professional struggles in nursing
Revista Brasileira de Enfermagem. 2023;76(1):e20220180
DOI 10.1590/0034-7167-2022-0180
Views0See moreABSTRACT
Objective:
to analyze the professional struggles between nursing organizational entities, in Rio de Janeiro, during the Regional Nursing Council’s electoral process (1990-1993 administration).
Method:
historical study. We used journalistic articles, normative documents, legislation and semi-structured interviews with five nursing professionals who participated in this process. Interpretation of findings was supported by Bourdieu’s concepts of habitus, field, capital, and symbolic power.
Results:
Electoral Code changes of the aforementioned council, under the influence of administration (1987-1990), candidate for re-election, influenced the disclosure and eligibility criteria, making it difficult for broad participation, especially of Associação Brasileira de Enfermagem Rio de Janeiro Section.
Final considerations:
nursing, in this period, generated a field of disputes related to positions of power and gender, which was evidenced in the electoral process studied, which highlighted using limiting strategies by a group, making it difficult for the entire category to participate.
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Proyecto Termómetro Social COVID-19: articulaciones transnacionales para abordar poblaciones en situación de vulnerabilidad social
Revista Brasileira de Enfermagem. 2023;76:e76suppl201
Abstract
Proyecto Termómetro Social COVID-19: articulaciones transnacionales para abordar poblaciones en situación de vulnerabilidad social
Revista Brasileira de Enfermagem. 2023;76:e76suppl201
DOI 10.1590/0034-7167.202376suppl201es
Views0El COVID-19 es una enfermedad infecciosa que ha impactado significativamente diferentes contextos alrededor del mundo, directa y/o indirectamente, y en mayor escala en países pobres y/o en vías de desarrollo(). No sabemos con certeza los efectos acumulativos del COVID-19 en las poblaciones (trastornos mentales, insomnio, ansiedad, trombosis, déficit cognitivo, problemas de memoria, etc.) tras la […]See more -
COVID-19 Social Thermometer Project: transnational articulations to approach populations in situations of social vulnerability
Revista Brasileira de Enfermagem. 2023;76:e76suppl201
Abstract
COVID-19 Social Thermometer Project: transnational articulations to approach populations in situations of social vulnerability
Revista Brasileira de Enfermagem. 2023;76:e76suppl201
DOI 10.1590/0034-7167.202376suppl201
Views0COVID-19 is an infectious disease that has significantly impacted different contexts around the world, directly and/or indirectly, and on a larger scale in poor and/or developing countries(). We do not know for sure the cumulative effects of COVID-19 on populations (mental disorders, insomnia, anxiety, thrombosis, cognition deficit, memory problems, etc.) after exposure to infection by […]See more
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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
Views0See moreABSTRACT
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.
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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
Views1See 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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Pressure ulcer healing with Plenusdermax® Calendula officinalis L. extract
Revista Brasileira de Enfermagem. 2016;69(2):250-257
Abstract
Pressure ulcer healing with Plenusdermax® Calendula officinalis L. extract
Revista Brasileira de Enfermagem. 2016;69(2):250-257
DOI 10.1590/0034-7167.2016690207i
Views0See moreABSTRACT
Objective:
to evaluate the therapeutic benefits of the bioactive extracts of Plenusdermax®Calendula officinalis for pressure ulcer healing.
Method:
an observational cohort study, including 41 patients with a diagnosis of pressure ulcer that was stable in size for more than three months. Patients were evaluated every two weeks, over 30 weeks, for: reduction of the wound area, infection control, types of tissue and exudate, and ulcer microbiology.
Results:
the proportions of patients who were completely healed after 15 and 30 weeks of treatment were 63% and 88%, respectively, and the mean healing time was 12.5±7.8 weeks. No adverse events were observed during treatment.
Conclusion:
the results of the study indicate that bioactive C. officinalis Plenusdermax® is a safe treatment that promotes healing of pressure ulcers.
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Quality of life assessment for health promotion groups
Revista Brasileira de Enfermagem. 2016;69(2):242-249
Abstract
Quality of life assessment for health promotion groups
Revista Brasileira de Enfermagem. 2016;69(2):242-249
DOI 10.1590/0034-7167.2016690206i
Views0See moreABSTRACT
Objective:
to analyze the use of quality of life assessment (QOL) as a strategy to evaluate the work with health promotion groups in the community.
Method:
cross-sectional, descriptive and analytical study. Participants of two elderly groups (n=46) were individually interviewed to fill the sociodemographic instruments, WHOQOL-BREF and WHOQOL-OLD.
Results:
the participants were women with up to 79 years, who did not live with a partner, with up to four years of study, retired, with individual income of up to a minimum salary. The mean scores on the WHOQOL-BREF were higher on “Social Relations” and lower in the “Environment”. For the WHOQOL-OLD, the highest scores were achieved in facets “Social Participation” (G1) and “Past, Present and Future Activities” (G2), while “Death and Dying” facet obtained lower scores in both groups.
Conclusion:
the assessment of QOL appears to be useful in helping to identify the coordination aspects of life of elderly people that need to be better developed in groups.
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Transcultural adaptation and validation of the Brazilian version of Treatment Spirituality/Religiosity Scale
Revista Brasileira de Enfermagem. 2016;69(2):235-241
Abstract
Transcultural adaptation and validation of the Brazilian version of Treatment Spirituality/Religiosity Scale
Revista Brasileira de Enfermagem. 2016;69(2):235-241
DOI 10.1590/0034-7167.2016690205i
Views0See moreABSTRACT
Objective:
to perform the translation and transcultural adaptation to Brazilian Portuguese, and analyze the psychometric properties of the instrument Treatment Spirituality/Religiosity Scale (TSRS).
Method:
the sample consisted of 188 nursing students of technical and higher education. The reliability analysis by test-retest was performed one month after the first application of the instrument. To measure the construct validation, a factorial analysis was carried out.
Results:
the Brazilian version of the TSRS consisted of 10 items, with two factors. The reliability by test-retest showed a Kappa coefficient ranging from 0.22 to 0.47, and a global internal consistency Cronbach’s alpha of 0.85.
Conclusion:
the Brazilian version of the TSRS showed satisfactory values of validity and internal consistency, being suitable for use in the national context.
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Epidemiological characteristics and causes of deaths in hospitalized patients under intensive care
Revista Brasileira de Enfermagem. 2016;69(2):229-234
Abstract
Epidemiological characteristics and causes of deaths in hospitalized patients under intensive care
Revista Brasileira de Enfermagem. 2016;69(2):229-234
DOI 10.1590/0034-7167.2016690204i
Views0See moreABSTRACT
Objective:
to describe the epidemiological and sociodemographic characteristics of patients hospitalized in an ICU.
Method:
an epidemiological, descriptive and retrospective study. Population: 695 patients admitted from January to December 2011. The data collected were statistically analyzed with both absolute and relative frequency distribution.
Results:
61.6% of the patients are male, aged 40 to 69 years, and most of them came from the surgery rooms. The most frequent reason for admission was diseases of the circulatory system (23.3%). At discharge from the ICU, 72.4% of the patients were sent to other units of the same institution, 31.1% to the intermediate care unit, and 20.4% died, of which 24.6% from diseases of the circulatory system. The afternoon shift had 45.8% of the admissions and 53.3% of the discharges.
Conclusion:
the description of the sociodemographic and epidemiological features guides the planning of nursing actions, providing a better quality service.
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Hospital discharge of premature newborns: the father’s experience
Revista Brasileira de Enfermagem. 2016;69(2):221-228
Abstract
Hospital discharge of premature newborns: the father’s experience
Revista Brasileira de Enfermagem. 2016;69(2):221-228
DOI 10.1590/0034-7167.2016690203i
Views0See moreABSTRACT
Objective:
To describe the father’s experience with his premature child discharge of the Neonatal Intensive-Care Unit and to point out interventions to promote this experience.
Method:
Qualitative research with eight fathers, adopting the Symbolic Interactionism as theoretical reference and thematic narrative research as methodological frame.
Results:
The analysis of data has allowed us to describe the experience of the father from three thematic units: “fatherhood boundaries”, “high responsibility for the child” and “social network and support”.
Conclusion:
The father feels insecure with the idea of taking care of his child at home because of the lack of professional support and the initial contact with the child in the Neonatal Intensive-Care Unit.
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Nurses from the Mobile Emergency Service: profile and developed activities
Revista Brasileira de Enfermagem. 2016;69(2):213-220
Abstract
Nurses from the Mobile Emergency Service: profile and developed activities
Revista Brasileira de Enfermagem. 2016;69(2):213-220
DOI 10.1590/0034-7167.2016690202i
Views0See moreABSTRACT
Objective:
to characterize the profile and identify the activities developed by nurses from the Mobile Emergency Care Service of a state of southern Brazil.
Method:
an exploratory, descriptive study. Data were collected through a questionnaire with 63 nurses.
Results:
the profile showed a workforce predominantly female, young and having specialized training. The activities were organized in the dimensions of caring, managing and educating, verifying the predominance of the first one. Care actions involved multiple procedures, but the use of the Systematization of Nursing Care (SNC) was not mentioned in the development of care activities. Then, the managerial dimension with a predominance of bureaucratic activities was emphasized. Educational activities were less prominent.
Conclusion:
care actions are the focus of the activities of nurses, predominantly the prescribed institutional care without the use of instruments such as SNC that could contribute to the greater visibility of their professional work.
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Challenges and leadership imperatives in cooperation with the World Health Organization
Revista Brasileira de Enfermagem. 2016;69(2):207-208
Abstract
Challenges and leadership imperatives in cooperation with the World Health Organization
Revista Brasileira de Enfermagem. 2016;69(2):207-208
DOI 10.1590/0034-7167.2016690201i
Views0When an institution promotes strategic innovations, it starts the rupture with tradition, causing changes and, consequently, altering the expectations and prospects of both their internal clients, as their external clients.The engines of the adopted innovations are driven by a broader view of the organization’s purposes, expanding its borders in terms of breadth and depth, which […]See more -
Desafios e imperativos de liderança na cooperação com a Organização Mundial da Saúde
Revista Brasileira de Enfermagem. 2016;69(2):207-208
Abstract
Desafios e imperativos de liderança na cooperação com a Organização Mundial da Saúde
Revista Brasileira de Enfermagem. 2016;69(2):207-208
DOI 10.1590/0034-7167.2016690201i
Views0Quando uma instituição promove inovações estratégicas, é colocado em curso o rompimento com a tradição, provocando mudanças e, por consequência, alterando as expectativas e as perspectivas tanto dos seus clientes internos, quanto dos seus clientes externos.Os motores das inovações adotadas são acionados por uma visão ampliada dos fins da organização, alargando suas fronteiras em termos […]See more
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