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ORIGINAL ARTICLE07-29-2024
Evidence of validity of the Risk Self-Medication Questionnaire focused on Health Literacy
Revista Brasileira de Enfermagem. 2024;77(3):e20230386
Abstract
ORIGINAL ARTICLEEvidence of validity of the Risk Self-Medication Questionnaire focused on Health Literacy
Revista Brasileira de Enfermagem. 2024;77(3):e20230386
DOI 10.1590/0034-7167-2023-0386
Views0See moreABSTRACT
Objectives:
to analyze the validity evidence of the internal structure of the Risk Self-Medication Questionnaire Focused on Health Literacy.
Methods:
a psychometric study with 499 adults. The internal structure was assessed with exploratory and confirmatory factor analysis to prove the adjustment. Internal consistency was measured by composite reliability and McDonald’s omega coefficient (ω).
Results:
the parameters revealed a model of 35 items distributed across four factors, explaining 56% of the total variance, with factor loadings ranging from 0.31 to 0.85 and adequate communalities. Accuracy (0.79
Conclusions:
an instrument was obtained with good evidence of structural validity for measuring self-medication.
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ORIGINAL ARTICLE07-29-2024
Nurses’ perspectives on nurses’ work methods
Revista Brasileira de Enfermagem. 2024;77(3):e20230374
Abstract
ORIGINAL ARTICLENurses’ perspectives on nurses’ work methods
Revista Brasileira de Enfermagem. 2024;77(3):e20230374
DOI 10.1590/0034-7167-2023-0374
Views0See moreABSTRACT
Objectives:
To analyze nurses’ perspectives on nurses’ work methods in the hospital context.
Methods:
A descriptive study with a qualitative approach was conducted in a hospital in northern Portugal, involving 17 nurses. Semi-structured interviews were used for data collection. Data collected between May and June 2023 underwent content analysis, supported by Atlas.ti software.
Results:
Three thematic areas emerged: “Nurses’ work methods in a hospital context,” highlighting the conception and components of work methods and the methods in use; “Implementation of nurses’ work methods,” emphasizing influencing factors and challenges to implementation; and “Impact of nurses’ work methods on patients, nurses, and institutions.”
Final Considerations:
Nurses’ work methods constitute the structure of nursing care. Some factors influence and some challenges arise in the implementation of these methods, producing impacts on patients, nurses, and institutions.
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ORIGINAL ARTICLE07-29-2024
Nursing Process for institutionalized older adults: contributions from knowledge awareness workshop
Revista Brasileira de Enfermagem. 2024;77(3):e20230349
Abstract
ORIGINAL ARTICLENursing Process for institutionalized older adults: contributions from knowledge awareness workshop
Revista Brasileira de Enfermagem. 2024;77(3):e20230349
DOI 10.1590/0034-7167-2023-0349
Views0See moreABSTRACT
Objective:
To analyze the knowledge of professionals working in a Nursing Home about the Nursing Process before and after the awareness workshop.
Methods:
This is strategic action research, developed with nursing professionals and managers of a Nursing Home in Rio Grande do Sul, Brazil. Data were collected between January and June 2023, through semi-structured interviews before and after an awareness workshop. Discursive textual analysis of the data was carried out.
Results:
The central category “Understanding about the Nursing Process in Nursing Homes” emerged, which was unitized into two units of meaning and three categories of analysis.
Conclusion:
Data revealed non-use and lack of knowledge of the Nursing Process before awareness raising. Afterwards, a deeper understanding of the topic and its importance was identified. Awareness-raising workshops contribute to transformation of knowledge.
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ORIGINAL ARTICLE07-29-2024
Excessive daytime sleepiness in nursing technicians: association with sleep quality and memory
Revista Brasileira de Enfermagem. 2024;77(3):e20230332
Abstract
ORIGINAL ARTICLEExcessive daytime sleepiness in nursing technicians: association with sleep quality and memory
Revista Brasileira de Enfermagem. 2024;77(3):e20230332
DOI 10.1590/0034-7167-2023-0332
Views0See moreABSTRACT
Objective:
to investigate excessive daytime sleepiness prevalence among nursing technicians and the association with sleep quality and memory.
Methods:
a cross-sectional, inferential study, carried out in a hospital unit in the state of Goiás between December 2020 and January 2021. Assessments were carried out using the Epworth Sleepiness Scale, the Pittsburgh Sleep Quality Index and the Prospective and Retrospective Memory Questionnaire, instruments validated for the Brazilian context. Bivariate and multivariate logistic regression analyzes were performed.
Results:
the sample consisted of 189 nursing technicians with a 40.9% excessive daytime sleepiness prevalence. In multivariate models, excessive daytime sleepiness was not associated with sleep quality, however there was a significant association with overall memory failures.
Conclusions:
study results demonstrate a high excessive daytime sleepiness occurrence, an association with overall memory failures and the need for psychosocial interventions for nursing technicians.
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ORIGINAL ARTICLE07-29-2024
Educational technology for multidisciplinary training for managing waiting lists for elective patients
Revista Brasileira de Enfermagem. 2024;77(3):e20230299
Abstract
ORIGINAL ARTICLEEducational technology for multidisciplinary training for managing waiting lists for elective patients
Revista Brasileira de Enfermagem. 2024;77(3):e20230299
DOI 10.1590/0034-7167-2023-0299
Views1See moreABSTRACT
Objectives:
to construct and assess an educational technology for managing patient waiting lists for multidisciplinary training.
Methods:
study supported by Instructional Design – ADDIE model, whose stages of construction of educational technology were developed in the form of a multi-professional training course. Its respective content assessment was carried out by a committee of experts from 2021 to 2022. The analysis occurred based on the proportion of content adequacy with 95% Confidence Interval.
Results:
seventeen products were created as educational technology learning objects: five storyboards; four videos; three comic books; two pedagogical action plans; a mind map; and a YouTube® playlist. Nine experts assessed content adequacy, which reached 0.89.
Conclusions:
this educational technology contributes to the performance of professionals who manage waiting lists by reducing inequalities, alleviating differences, in addition to promoting equity in care and good health for patients in the Brazilian Health System.
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ORIGINAL ARTICLE07-29-2024
Fuzzy Logic: vulnerability of women who have sex with women to sexually transmitted infections
Revista Brasileira de Enfermagem. 2024;77(3):e20230271
Abstract
ORIGINAL ARTICLEFuzzy Logic: vulnerability of women who have sex with women to sexually transmitted infections
Revista Brasileira de Enfermagem. 2024;77(3):e20230271
DOI 10.1590/0034-7167-2023-0271
Views0ABSTRACT
Objective:
To describe the possibility of applying Fuzzy Logic in analyzing the vulnerability of Women Who Have Sex with Women to Sexually Transmitted Infections/HIV/AIDS.
Methods:
We developed a Fuzzy Logic system with 17 input variables and one output variable, using data related to vulnerability in a municipality located in the Midwest region of the State of São Paulo, Brazil.
Results:
The factor with the greatest positive impact was the confirmation that a low understanding of Sexually Transmitted Infections/HIV/AIDS is associated with higher vulnerability. Conversely, the statement “Not disclosing sexual activity to healthcare professionals,” where individuals do not admit to having sex with women, had the least impact.
Conclusions:
Fuzzy Logic facilitates the identification of vulnerability, expressed through the analysis of interaction between variables in each dimension. This makes it a promising method to assist in analyzing the vulnerability of specific populations.
Keywords:Fuzzy LogicHealth VulnerabilityReproductive HealthSexually Transmitted DiseasesWomen Who Have Sex With WomenSee more -
ORIGINAL ARTICLE07-29-2024
University Student Depression Inventory, Brazilian Version, Construct Assessment
Revista Brasileira de Enfermagem. 2024;77(3):e20230232
Abstract
ORIGINAL ARTICLEUniversity Student Depression Inventory, Brazilian Version, Construct Assessment
Revista Brasileira de Enfermagem. 2024;77(3):e20230232
DOI 10.1590/0034-7167-2023-0232
Views0See moreABSTRACT
Objectives:
to assess the University Student Depression Inventory, Brazilian version (USDI-BR), construct.
Methods:
a methodological study carried out with a snowball probabilistic sample, consisting of 334 undergraduate and graduate students. Confirmatory factor analysis, reliability using McDonald’s omega coefficient and Cronbach’s alpha were performed. Principal component analysis was performed using the varimax rotation and oblimin rotation, using the Kaiser-Meyer-Olkin criteria, Bartlett’s test of sphericity and scree plot.
Results:
the USDI-BR presented an internal consistency of items of ω = 0.95 and remained with 30 items, with the addition of 1 factor (Death wish and social withdrawal), totaling 4 factors.
Conclusions:
the USDI-BR has evidence that points to its validity and also its internal consistency, deserving that new studies be carried out to expand the evidence of its psychometric properties.
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ORIGINAL ARTICLE07-29-2024
Family refusal of skin donation for transplantation: trends and associated factors
Revista Brasileira de Enfermagem. 2024;77(3):e20230209
Abstract
ORIGINAL ARTICLEFamily refusal of skin donation for transplantation: trends and associated factors
Revista Brasileira de Enfermagem. 2024;77(3):e20230209
DOI 10.1590/0034-7167-2023-0209
Views0See moreABSTRACT
Objectives:
to analyze the trends and factors associated with family refusal of skin donation for transplantation.
Methods:
this cross-sectional study was conducted in the State of São Paulo, with family authorization terms collected from 2001 to 2020. The variables analyzed included year, age, gender, cause of death, and type of institution. Data were analyzed using linear and multiple logistic regression, with the Odds Ratio estimated at p<0.05 for statistical significance.
Results:
1,355 individuals refused skin donation. The trend of refusals decreased between 2001 and 2009 in the age groups of 0-11 years and 12-19 years, but increased in the group aged ≥60 years. This trend continued to decrease in the 0-11 years group from 2010 to 2020, and increased in the 20-40 years group. Males and the age groups of 20-40 years, 41-59 years, and ≥60 years exhibited 27%, 34%, 47%, and 53% lower chances of refusal, respectively.
Conclusions:
there is an urgent need for measures to mitigate the high number of refusals associated with skin donation.
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REVIEW05-03-2024
Elements of fatherhood involved in the gestational period: a scoping review
Revista Brasileira de Enfermagem. 2024;77(1):e20230029
Abstract
REVIEWElements of fatherhood involved in the gestational period: a scoping review
Revista Brasileira de Enfermagem. 2024;77(1):e20230029
DOI 10.1590/0034-7167-2023-0029
Views0See moreABSTRACT
Objective:
To identify in the literature and summarize the elements and characteristics of fatherhood involved during pregnancy.
Method:
Scoping review that used PRISMA-ScR guide to report this review. Searches were carried out in PubMed, CINAHL, PsycInfo, LILACS and Scopus. Google search engines and public health agency websites assisted in searches of gray literature and Rayyan in screening studies.
Results:
A total of 406 articles were identified, of which 16 made up the final sample. Five elements make up an involved fatherhood: feeling like a father, being a provider and protector, being a partner and participant in pregnancy, participating in prenatal appointments and feeling prepared to take care of a baby.
Conclusion:
Fathers want to be involved in prenatal care, but feel excluded from this process. Public policies that encourage paternal involvement and healthcare professional training to better welcome and promote paternal involvement are of paramount importance.
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Preditores de volume excessivo de líquidos em pacientes em hemodiálise: estudo observacional
Revista Brasileira de Enfermagem. 2024;77(1):e20220816
Abstract
Preditores de volume excessivo de líquidos em pacientes em hemodiálise: estudo observacional
Revista Brasileira de Enfermagem. 2024;77(1):e20220816
DOI 10.1590/0034-7167-2022-0816
Views0See moreRESUMEN
Objetivos:
evaluar los factores de riesgo del exceso de volumen de líquido en pacientes en hemodiálisis.
Métodos:
estudio retrospectivo de casos y controles. Se incluyeron 392 pacientes (196 casos y 196 controles) de dos centros de hemodiálisis. Se evaluaron datos sociodemográficos y 23 factores de riesgo de exceso de volumen de líquido mediante un formulario de recolección de datos. Los datos se analizaron mediante un modelo de regresión logística multivariado.
Resultados:
factores de riesgo conocimiento insuficiente (OR=2,06), ingesta excesiva de líquidos (OR=2,33), retirada inadecuada de líquidos durante la hemodiálisis (OR=2,62) e ingesta excesiva de sodio (OR=1,91) pueden aumentar aproximadamente dos veces la posibilidad de que se produzca un exceso de volumen de líquido en pacientes en hemodiálisis. La educación (OR=0,95) y la edad (OR=0,97) son factores protectores del volumen excesivo de líquido.
Conclusiones:
conocer estos factores de riesgo puede ayudar a las enfermeras a realizar una inferencia diagnóstica precisa y rápida del riesgo de volumen excesivo de líquidos.
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ORIGINAL ARTICLE05-03-2024
Predictors of excess fluid volume in hemodialysis patients: an observational study
Revista Brasileira de Enfermagem. 2024;77(1):e20220816
Abstract
ORIGINAL ARTICLEPredictors of excess fluid volume in hemodialysis patients: an observational study
Revista Brasileira de Enfermagem. 2024;77(1):e20220816
DOI 10.1590/0034-7167-2022-0816
Views0See moreABSTRACT
Objectives:
to assess risk factors for excess fluid volume in hemodialysis patients.
Methods:
a retrospective case-control study was conducted. A total of 392 patients (196 cases and 196 controls) from two hemodialysis centers were included. Sociodemographic data and 23 risk factors for excess fluid volume were assessed using a data collection form. Data were analyzed using a multivariate logistic regression model.
Results:
the insufficient knowledge (OR=2.06), excessive fluid intake (OR=2.33), inadequate fluid removal during hemodialysis (OR=2.62) and excessive sodium intake (OR=1.91) risk factors may increase the chance of occurrence of excess fluid volume in hemodialysis patients by approximately two times. Education level (OR=0.95) and age (OR=0.97) are protective factors for excessive fluid volume.
Conclusions:
knowing these risk factors may help nurses with accurate and rapid diagnostic inference of the risk of excessive fluid volume.
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ORIGINAL ARTICLE05-03-2024
What is the burden of multimorbidity and the factors associated with its occurrence in elderly Brazilians?
Revista Brasileira de Enfermagem. 2024;77(1):e20220809
Abstract
ORIGINAL ARTICLEWhat is the burden of multimorbidity and the factors associated with its occurrence in elderly Brazilians?
Revista Brasileira de Enfermagem. 2024;77(1):e20220809
DOI 10.1590/0034-7167-2022-0809
Views0See moreABSTRACT
Objective:
To estimate the prevalence of multimorbidity in elderly people and its association with sociodemographic characteristics, lifestyle, and anthropometry.
Methods:
This was a cross-sectional study using data from the National Health Survey, 2019. A total of 22,728 elderly individuals from all 27 Brazilian states were randomly selected. Poisson regression models with robust variance were employed, and a significance level of 5% was adopted.
Results:
The prevalence of multimorbidity was 51.6% (95% CI: 50.4-52.7), with the highest estimates observed in the South and Southeast. Multimorbidity was associated with being female (aPR = 1.33; 95% CI: 1.27-1.39), being 80 years old or older (aPR = 1.12; 95% CI: 1.05-1.19), having low education (aPR = 1.16; 95% CI: 1.07-1.25), past cigarette use (aPR = 1.16; 95% CI: 1.11-1.21), insufficient physical activity (aPR = 1.13; 95% CI: 1.06-1.21), and screen use for 3 hours or more per day (aPR = 1.13; 95% CI: 1.08-1.18).
Conclusion:
Multimorbidity affects more than half of the elderly population in Brazil and is associated with social, demographic, and behavioral factors.
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ORIGINAL ARTICLE04-22-2024
Nurses’ perception of the nursing process and its relationship with leadership
Revista Brasileira de Enfermagem. 2024;77(1):e20230371
Abstract
ORIGINAL ARTICLENurses’ perception of the nursing process and its relationship with leadership
Revista Brasileira de Enfermagem. 2024;77(1):e20230371
DOI 10.1590/0034-7167-2023-0371
Views0See moreABSTRACT
Objectives:
to describe Nurses’ perception of the Nursing Process and its relationship with leadership.
Methods:
action research conducted between September/2021 and April/2022 with nurses from a medium-sized hospital in southern Brazil. The data investigated, one of the stages of the method, was collected using the Focus Group technique and submitted to Strategic Focus Analysis.
Results:
three categories emerged from the organized and analyzed data, namely: Nursing Process: a tool that qualifies nursing care; Conditions that weaken the Nursing Process; and Strategies that enhance the Systematization of Nursing Care.
Final Considerations:
the perception of the Nursing Process and its relationship with leadership are not always understood as complementary themes. Although they recognize that the Nursing Process is sometimes imposed as normative, nurses do not perceive the importance of the role of the leader, who is considered a key player in conducting and boosting the Systematization of Nursing Care.
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ORIGINAL ARTICLE04-22-2024
Adherence to Covid-19 vaccination during the pandemic: the influence of fake news
Revista Brasileira de Enfermagem. 2024;77(1):e20230284
Abstract
ORIGINAL ARTICLEAdherence to Covid-19 vaccination during the pandemic: the influence of fake news
Revista Brasileira de Enfermagem. 2024;77(1):e20230284
DOI 10.1590/0034-7167-2023-0284
Views0See moreABSTRACT
Objectives:
to understand how fake news has influenced adherence to Covid-19 immunization, from the perspective of health professionals.
Methods:
a qualitative, descriptive-exploratory study was conducted in Campo Grande – MS. Twenty nursing professionals working in vaccine rooms or managing immunobiologicals participated through semi-structured interviews. The interviews were audio-recorded, fully transcribed, and subjected to thematic content analysis.
Results:
two categories emerged in which the professionals highlighted an increase in vaccine hesitancy among the population, influenced by fake news and denialist actions, which negatively interfered with the population’s trust in vaccines and in the professionals administering them.
Final Considerations:
concerns about vaccine safety and denialist actions by authorities and media outlets can contribute to the phenomenon of non-vaccination. The valorization of science, the promotion of educational actions, and raising public awareness about immunization were presented as strategies to increase vaccine coverage
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ORIGINAL ARTICLE04-22-2024
Mothers’ perception of the care of newborn in the home environment
Revista Brasileira de Enfermagem. 2024;77(1):e20230080
Abstract
ORIGINAL ARTICLEMothers’ perception of the care of newborn in the home environment
Revista Brasileira de Enfermagem. 2024;77(1):e20230080
DOI 10.1590/0034-7167-2023-0080
Views0See moreABSTRACT
Objectives:
to identify mothers’ perceptions about caring for newborns in the home environment, from the perspective of complexity thinking.
Methods:
qualitative, exploratory and descriptive research, carried out between November/2022 and February/2023. Data were collected through individual interviews with 21 mothers from southern Brazil who cared for newborns at home and analyzed using the thematic analysis technique.
Results:
the four thematic axes resulting from the data analysis: Living amidst order and disorder; embracing singularities; dealing with the certain and the uncertain; support network in the (re)organizing process demonstrate that the mother caring for a newborn in their home environment experiences a distinct and plural adaptive process, which must be welcomed and understood by health professionals who work within the family environment.
Final Considerations:
the care of newborns in a home environment, in the perception of mothers, requires differentiated attention and a formal or informal support network that considers the unique specificities of each woman/mother in the personal, family and social spheres. Therefore, in addition to the social support network, it is important to rethink home intervention approaches.
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ORIGINAL ARTICLE04-22-2024
Learning difficulties in school children: health and education professionals’ perceptions
Revista Brasileira de Enfermagem. 2024;77(1):e20230074
Abstract
ORIGINAL ARTICLELearning difficulties in school children: health and education professionals’ perceptions
Revista Brasileira de Enfermagem. 2024;77(1):e20230074
DOI 10.1590/0034-7167-2023-0074
Views0ABSTRACT
Objectives:
to understand health and education professionals’ perceptions regarding children’s learning difficulties in public schools.
Methods:
qualitative research, of the participatory action type, linked to Paulo Freire’s Research Itinerary. Forty-five professionals participated, through interviews and a Virtual Culture Circle. The analysis was developed through careful reading, reflection and interpretation of highlighted topics.
Results:
professionals discussed the (in)visibility of learning difficulties, strategies and resources in the educational sector and the search for solutions in the health sector. It was found that the production of complaints related to school learning is attributed predominantly as an individual problem of children or their family, exempting the educational institution from this process.
Final Considerations:
greater investment in professional training and development policies is urgently needed to facilitate coordination between sectors, with a view to overcoming outdated pedagogical and health models.
Keywords:Child HealthLearning DisabilitiesLow School PerformancePrimary Health CareSchool Health ServicesSee more
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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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