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ORIGINAL ARTICLE07-29-2024
Adaptation strategies for preparing for childbirth in the context of the pandemic: Roy’s Theory
Revista Brasileira de Enfermagem. 2024;77(3):e20230159
Abstract
ORIGINAL ARTICLEAdaptation strategies for preparing for childbirth in the context of the pandemic: Roy’s Theory
Revista Brasileira de Enfermagem. 2024;77(3):e20230159
DOI 10.1590/0034-7167-2023-0159
Views0See moreABSTRACT
Objectives:
to understand the process of adapting to childbirth during the COVID-19 pandemic from the perspective of a group of pregnant women.
Methods:
a qualitative, descriptive-exploratory study was conducted with 23 women. Data were collected between October and December 2021 through documentation and semi-structured interviews, which were analyzed using Minayo’s methodology and Roy’s Adaptation Model.
Results:
various types of stimuli – focal, contextual, and residual – were identified as influencing childbirth preparation. The online group was essential for facilitating pregnant women’s adaptation, offering significant support and generating positive feedback for childbirth preparation.
Final Considerations:
the importance of pregnant women’s groups as a strategy for improving adaptation to childbirth was identified, underscoring the effectiveness of this support among professionals and participants, as well as among pregnant women. This support network strengthened preparation for childbirth during a challenging period like the pandemic.
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ORIGINAL ARTICLE07-29-2024
Profile of patients in private home care who developed ventilator-associated pneumonia
Revista Brasileira de Enfermagem. 2024;77(3):e20230146
Abstract
ORIGINAL ARTICLEProfile of patients in private home care who developed ventilator-associated pneumonia
Revista Brasileira de Enfermagem. 2024;77(3):e20230146
DOI 10.1590/0034-7167-2023-0146
Views0ABSTRACT
Objectives:
to analyze the profile and clinical outcomes of patients who developed Ventilator-Associated Pneumonia (VAP) in private home care and to compare the incidence with national data.
Methods:
this was a retrospective study with data collected from July 2021 to June 2022 from patient records at a private clinic. Patients using intermittent ventilation or without ventilatory support were excluded.
Results:
the utilization rate of mechanical ventilation was 15.9%. The incidence density of pneumonia in pediatrics was 2.2 cases per 1000 ventilation-days and in adults was 1.7 cases per 1000 ventilation-days, figures lower than those reported by the National Health Surveillance Agency. There were 101 episodes of pneumonia in 73 patients, predominantly male (65.8%), adults (53.4%), and those with neurological diseases (57.5%). The treatment regimen predominantly took place at home (80.2%), and there was one death.
Conclusions:
patients in home care showed a low incidence and mortality rate from ventilator-associated pneumonia.
Keywords:ArtificialHealth Systems AgenciesHome Care ServicesIntensive Care UnitsPneumoniaRespirationVentilator-AssociatedSee more -
ORIGINAL ARTICLE07-29-2024
Impact of educational intervention on understanding health recommendations after liver transplantation
Revista Brasileira de Enfermagem. 2024;77(3):e20230132
Abstract
ORIGINAL ARTICLEImpact of educational intervention on understanding health recommendations after liver transplantation
Revista Brasileira de Enfermagem. 2024;77(3):e20230132
DOI 10.1590/0034-7167-2023-0132
Views0See moreABSTRACT
Objectives:
to evaluate the impact of educational intervention on understanding health recommendations after liver transplantation.
Methods:
randomized and prospective clinical trial, with 68 liver transplant recipients in two institutions. The level of understanding was assessed using a statement agreement scale and the understanding score was classified. Chi-square test was used to compare groups.
Results:
the level of understanding was reasonable in 77.9% of patients, 73.5% in the Control Group and 82.3% in the Intervention Group (p=0.399). For topics covered after educational action, there were more than 80% correct answers regarding nutrition, frequent hydration, usage and function of immunosuppressants. However, there were less than 10% correct answers regarding hand hygiene, contact with animals and crowds of people. The use of the patient’s audio, visual and tactile resources led to improved understanding of skin care (p=0.014).
Conclusions:
the level of understanding acquired regarding health recommendations was only reasonable.
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ORIGINAL ARTICLE07-29-2024
Trends in cesarean section rates in Brazil by Robson classification group, 2014-2020
Revista Brasileira de Enfermagem. 2024;77(3):e20230099
Abstract
ORIGINAL ARTICLETrends in cesarean section rates in Brazil by Robson classification group, 2014-2020
Revista Brasileira de Enfermagem. 2024;77(3):e20230099
DOI 10.1590/0034-7167-2023-0099
Views0ABSTRACT
Objectives:
to evaluate the trends in cesarean sections from 2014 to 2020 across both public and private sectors, utilizing the Robson Classification.
Methods:
this time series study analyzed the proportion of women who underwent cesarean sections between 2014 and 2020, considering both the Robson classification and the type of healthcare service. Trend analysis was conducted using the Prais-Winsten regression.
Results:
higher proportions of cesarean sections were observed in all Robson groups within the private sector compared to the public sector. This was despite a decreasing trend in the private sector and an increasing trend in the public sector. Notably, elevated proportions of cesarean sections were recorded in groups that are typically favorable to normal childbirth (Robson 1, 4, and 5).
Conclusions:
although there was a decreasing trend in cesarean sections within the private sector, an increasing trend was observed in the public sector. Additionally, there was a high proportion of cesarean sections among women with conditions favorable to normal childbirth. It is crucial to continuously monitor these indicators to evaluate and implement interventions aimed at reducing unnecessary cesarean sections.
Keywords:Cesarean SectionMaternal Health ServicesNursingObstetricReproductive HealthTime Serie StudiesSee more -
ORIGINAL ARTICLE07-29-2024
Healthcare judicialization: an analysis of indicators and official data on medications
Revista Brasileira de Enfermagem. 2024;77(3):e20220413
Abstract
ORIGINAL ARTICLEHealthcare judicialization: an analysis of indicators and official data on medications
Revista Brasileira de Enfermagem. 2024;77(3):e20220413
DOI 10.1590/0034-7167-2022-0413
Views0ABSTRACT
Objectives:
to analyze judicial demands for medications in Campo Grande, Brazil, between July 2018 and June 2020.
Methods:
the four dimensions of the Manual of Indicators for Evaluation and Monitoring of Judicial Demands for Medications were examined.
Results:
676 judicial processes were identified, corresponding to 1006 requests for 284 different medications. In 92.74% of the processes, access to medications was granted, with 88.80% granted on an urgent basis. The median time between the decision and delivery of the medication was 146 days. The average monthly cost of acquiring medications was R$ 2,183.68 Brazilian reais. Among the identified medications, 90.22% had at least one therapeutic alternative available in the public healthcare system.
Conclusions:
characterizing and analyzing judicial demands related to medications can support discussions on updating medication lists and clinical protocols, organizing healthcare services, allocating resources, and implementing actions to reduce judicialization.
Keywords:Health CareHealth LitigationHealth Services AccessibilityPharmaceutical ServicesProcess AssessmentRight to HealthSee more -
ORIGINAL ARTICLE07-19-2024
Nursing students’ perception: Escape Room use in teaching leadership skills
Revista Brasileira de Enfermagem. 2024;77(2):e20230414
Abstract
ORIGINAL ARTICLENursing students’ perception: Escape Room use in teaching leadership skills
Revista Brasileira de Enfermagem. 2024;77(2):e20230414
DOI 10.1590/0034-7167-2023-0414
Views0See moreABSTRACT
Objectives:
to understand nursing students’ perception regarding Escape Room use to develop leadership skills.
Methods:
a qualitative exploratory-descriptive study, with 97 nursing students. Escape Room game sessions were held, totaling ten. Subsequently, a debriefing and analysis was carried out using the Discourse of the Collective Subject method, through the focus group technique. Ethical procedures were respected.
Results:
students’ perceptions about using this methodology to develop leadership skills were positive and significant. The effectiveness of the game in teaching and developing these skills in nursing practice stands out.
Final Considerations:
the game was an effective active methodology in approaching the proposed content, promoting satisfaction and easy assimilation.
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ORIGINAL ARTICLE07-19-2024
Validation of an instrument for patient classification to support obstetric nursing care
Revista Brasileira de Enfermagem. 2024;77(2):e20230401
Abstract
ORIGINAL ARTICLEValidation of an instrument for patient classification to support obstetric nursing care
Revista Brasileira de Enfermagem. 2024;77(2):e20230401
DOI 10.1590/0034-7167-2023-0401
Views0ABSTRACT
Objectives:
to develop and validate an instrument for the classification of pregnant and postpartum women according to the demand for nursing care.
Methods:
a methodological study conducted in three stages: 1) construction of the instrument based on literature review; 2) content validation using the Delphi technique with 12 experts; and 3) Evaluation of the convergent construct validity through the correlation between the scores of the constructed instrument and the Fugulin instrument.
Results:
an instrument with ten indicators of specific care for pregnant and postpartum women was developed. A content validity index higher than 0.9 was obtained, requiring only one round of the Delphi technique. The Spearman coefficient was 0.64 between the instruments, indicating a strong correlation.
Conclusions:
the classification instrument specifically constructed for pregnant and postpartum women showed evidence of content validity and convergent construct validity with a widely used instrument in the national territory.
Keywords:Hospital AdministrationNursing AssessmentObstetric NursingPersonnel ManagementValidation StudySee more -
ORIGINAL ARTICLE07-19-2024
The use of spirituality/religiosity by oncology nurse residents in nursing care
Revista Brasileira de Enfermagem. 2024;77(2):e20230383
Abstract
ORIGINAL ARTICLEThe use of spirituality/religiosity by oncology nurse residents in nursing care
Revista Brasileira de Enfermagem. 2024;77(2):e20230383
DOI 10.1590/0034-7167-2023-0383
Views0See moreABSTRACT
Objectives:
to analyze the use of spirituality/religiosity by oncology nurse residents in caring for patients with cancer.
Methods:
a census, descriptive, sectional study, with 46 nurse residents from three public hospitals in Rio de Janeiro. Data collection took place between August 2020 and January 2021, using a sociodemographic questionnaire, including a question about the use of spirituality/ religiosity to deal with work situations. Descriptive analysis was carried out using SPSS software version 22.0.
Results:
participants stated that they use religiosity/spirituality in work situations related to patients or themselves. In relation to patients, death was the most mentioned situation among professionals, and for themselves, everyday situations and emotional vulnerability were the most mentioned.
Final Considerations:
spirituality and religiosity are dimensions that guide oncology nurse residents’ attitudes.
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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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ORIGINAL ARTICLE05-03-2024
Preditores de volume excessivo de líquidos em pacientes em hemodiálise: estudo observacional
Revista Brasileira de Enfermagem. 2024;77(1):e20220816
Abstract
ORIGINAL ARTICLEPreditores 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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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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