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01-01-2016
Determining impacts and factors in ventilator-associated pneumonia bundle
Revista Brasileira de Enfermagem. 2016;69(6):1108-1114
Abstract
Determining impacts and factors in ventilator-associated pneumonia bundle
Revista Brasileira de Enfermagem. 2016;69(6):1108-1114
DOI 10.1590/0034-7167-2016-0253
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Objective:
Assessing the determining impacts and factors in ventilator-associated pneumonia (VAP) bundle.
Method:
descriptive retrospective longitudinal study, with quantitative approach, held at a public teaching hospital. Collection held between May 2014 and April 2015. Patients of the ICU with VAP participated in the research. For organizing data, the Microsoft Excel 2010 program was used. A critical analysis between the data collected and infection rates was performed. The survey was approved under no. 566,136.
Results:
an increase in the incidence of VAP after implementing the bundle was observed; the prevalent pathogens were gram-negative bacteria. Deaths were equal to or greater than 50%. Changes of professionals and lack of supplies were determining factors.
Conclusion:
in this context, the need for permanent qualification of the team is emphasized, with the purpose of promoting the adherence to the protocol and preventing VAP.
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01-01-2016
Multidisciplinary team of intensive therapy: humanization and fragmentation of the work process
Revista Brasileira de Enfermagem. 2016;69(6):1099-1107
Abstract
Multidisciplinary team of intensive therapy: humanization and fragmentation of the work process
Revista Brasileira de Enfermagem. 2016;69(6):1099-1107
DOI 10.1590/0034-7167-2016-0221
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Objective:
to understand the meaning of humanized care in intensive care units considering the experience of the multidisciplinary team.
Method:
descriptive and exploratory qualitative research. For this purpose, we conducted semi-structured interviews with 24 professionals of the heath-care team, and, after transcription, we organized the qualitative data according to content analysis.
Results:
from two main categories, we were able to understand that humanized care is characterized in the actions of health-care: effective communication, team work, empathy, singularity, and integrality; and mischaracterized in the management processes, specifically in the fragmentation of the work process and health-care, in the precarious work conditions, and in differing conceptual aspects of the political proposal of humanization.
Conclusion:
care activities in intensive therapy are guided by the humanization of care and corroborate the hospital management as a challenge to be overcome to boost advances in the operationalization of this Brazilian policy.
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01-01-2016
Humanized Care: insertion of obstetric nurses in a teaching hospital
Revista Brasileira de Enfermagem. 2016;69(6):1091-1098
Abstract
Humanized Care: insertion of obstetric nurses in a teaching hospital
Revista Brasileira de Enfermagem. 2016;69(6):1091-1098
DOI 10.1590/0034-7167-2016-0295
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Objective:
to evaluate the care provided at an Antepartum, Intrapartum, Postpartum (AIP) unit at a teaching hospital following the inclusion of obstetric nurses.
Method:
transversal study, performed at a AIP unit at a teaching hospital in the capital of the Brazilian state of Mato Grosso. The sample comprised data regarding the 701 childbirths that took place between 2014 and 2016. The data were organized using Excel and analyzed using version 7 of Epi Info software.
Results:
the results suggest that including obstetric nurses contributed towards qualifying the care provided during labor and childbirth, followed by a reduction in the number of interventions, such as episiotomy caesareans sections, and resulting in encouragement to employ practices that do not interfere in the physiology of the parturition process, which in turn generate good perinatal results.
Conclusion:
inserting these nurses collaborated towards humanizing obstetric and neonatal care.
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01-01-2016
Normative grounds of health care practice in Brazilian nursing
Revista Brasileira de Enfermagem. 2016;69(6):1082-1090
Abstract
Normative grounds of health care practice in Brazilian nursing
Revista Brasileira de Enfermagem. 2016;69(6):1082-1090
DOI 10.1590/0034-7167-2016-0228
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Objective:
to understand the normative grounds of health care practice in Brazilian nursing.
Method:
qualitative study with the use of document research, carried out based on resolutions of the Federal Nursing Council. From a total of 263 resolutions, in the period from 1975 to 2015, 38 which were in accordance with the objective of the study were selected.
Results:
three analytical categories were systematized: Normative grounds of health care practice by the nursing team, under coordination/supervision of the nurse; Normative grounds of the care performed privately by the nurse; and Management and administrative aspects which affect and permeate the practice of health care in nursing.
Conclusion:
the set of normative grounds of health care practice by the nursing team leads to the reflection on the possible overlapping of attributions between professional levels and requires expansion to the other fields of nursing which are coherent with the health care network model.
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01-01-2016
Palliative care and the intensive care nurses: feelings that endure
Revista Brasileira de Enfermagem. 2016;69(6):1074-1081
Abstract
Palliative care and the intensive care nurses: feelings that endure
Revista Brasileira de Enfermagem. 2016;69(6):1074-1081
DOI 10.1590/0034-7167-2016-0267
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Objective:
to know the feelings of nurses regarding palliative care in adult intensive care units.
Method:
qualitative study, which adopted the theoretical framework of Social Representations, carried out with 30 nurses of the state of Santa Catarina included by Snowball sampling. Data were collected through semi-structured interviews conducted from April to August 2015, organized and analyzed through the Collective Subject Discourse.
Results:
the results showed how central ideas are related to feelings of comfort, frustration, insecurity and anguish, in addition to the feeling that the professional training and performance are focused on the cure.
Conclusion:
the social representations of nurses regarding the feelings related to palliative care are represented mainly by negative feelings, probably as consequence of the context in which care is provided.
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01-01-2016
Multi-professional intervention in adults with arterial hypertension: a randomized clinical trial
Revista Brasileira de Enfermagem. 2016;69(6):1067-1073
Abstract
Multi-professional intervention in adults with arterial hypertension: a randomized clinical trial
Revista Brasileira de Enfermagem. 2016;69(6):1067-1073
DOI 10.1590/0034-7167-2016-0320
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Objective:
assess the influence of an intervention, comprised of counseling related to health and aerobic physical training for lowering pressure values, in anthropometric indicators and in the adjustment of biochemical parameters in individuals with hypertension.
Method:
intervention study of the randomized clinical trial variety, with 42 individuals. The intervention-group followed the protocol of health counseling, nutrition and physical activity.
Results:
two intervention groups were considered: intervention-group (a) and intervention-group (b). Intervention-group (a) showed significant decrease in measurements of systolic and diastolic arterial pressure, of high-density lipoprotein parameters, hip circumference values and waist-hip ratio. Intervention-group (b) presented significant decrease in systolic arterial pressure values.
Conclusion:
it was found that the health intervention in conjunction with physical activities were effective in decreasing and/or controlling values for pressure, biochemical and anthropometric indicators.
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01-01-2016
Clinical Caritas Processes in workshops for caregivers of institutionalized elderly people
Revista Brasileira de Enfermagem. 2016;69(6):1059-1066
Abstract
Clinical Caritas Processes in workshops for caregivers of institutionalized elderly people
Revista Brasileira de Enfermagem. 2016;69(6):1059-1066
DOI 10.1590/0034-7167-2016-0359
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Objective:
to describe the use of the Clinical Caritas Processes in workshops for caregivers of institutionalized elderly people, aimed at analyzing these professionals’ perception on humane care towards the institutionalized elderly.
Method:
a convergent care research was conducted with 18 caregivers of a long-term care institution for elderly people in the state of Paraíba, Brazil. Data were collected from June to November 2013, consisting of two months of interaction with the care service and ten meetings conducted in workshops for caregivers. Data were based on the theoretical framework of the Clinical Caritas Processes. Data analysis was based on content analysis and produced ten thematic categories based on the Caritas factors of caring.
Conclusion:
it was found that the use of the ten Caritas factors of caring were useful for humanistic formations when introducing the group to the conceptions of caring that value the self of the people providing the care and of the ones-being cared for.
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01-01-2016
Technological innovation for peripheral venipuncture: ultrasound training
Revista Brasileira de Enfermagem. 2016;69(6):1052-1058
Abstract
Technological innovation for peripheral venipuncture: ultrasound training
Revista Brasileira de Enfermagem. 2016;69(6):1052-1058
DOI 10.1590/0034-7167-2016-0125
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Objective:
to evaluate the training of nurses in the use of ultrasound in peripheral venipuncture.
Method:
descriptive research of quantitative approach performed with nurses as part of an analytical cross-sectional study in two patient care centers: an intensive care unit and an adult emergency center.
Results:
the results showed contributions of training for professional skill and visibility of nurses, requiring, however, more time for complete assimilation of this technological innovation as a safer clinical practice.
Conclusion:
as the use of this technology represents an innovation aimed to facilitate difficult venipuncture and to provide subsidies to the most appropriate clinical decision-making, it is urgent to qualify nurses for its use.
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ORIGINAL ARTICLE09-21-2020
Organizational flow chart of home care for children with special health care needs
Revista Brasileira de Enfermagem. 2020;73:e20190310
Abstract
ORIGINAL ARTICLEOrganizational flow chart of home care for children with special health care needs
Revista Brasileira de Enfermagem. 2020;73:e20190310
DOI 10.1590/0034-7167-2019-0310
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Objective:
To develop a workflow protocol for Home Care (HC) services in the HC2 modality for children with special health care needs (CSHCN) in the state of Parana.
Method:
Quantitative, descriptive, exploratory, multiple case studies. Data was collected with professionals from the eight home care services in Parana. Data were analyzed using the Strengths, Weaknesses, Opportunities and Threats (SWOT) methodology, from which a 5W2H method of action plan was developed, resulting in a flow chart.
Results:
Considering the strategies found in Home Care services, such as planned hospital discharge, caregiver training, organized transportation and singular therapeutic project, a flow organization protocol for children with special health care needs in Home Care services was developed.
Conclusion:
The protocol developed makes it possible to organize the care provided to children with special health care needs in home care.
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ORIGINAL ARTICLE09-21-2020
Adolescents in situations of poverty: resilience and vulnerabilities to sexually transmitted infections
Revista Brasileira de Enfermagem. 2020;73:e20190242
Abstract
ORIGINAL ARTICLEAdolescents in situations of poverty: resilience and vulnerabilities to sexually transmitted infections
Revista Brasileira de Enfermagem. 2020;73:e20190242
DOI 10.1590/0034-7167-2019-0242
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Objective:
To analyze the association between vulnerabilities to Sexually Transmitted Infections (STIs/HIV/AIDS) of adolescents in poverty and their level of resilience.
Method:
Cross-sectional study with 287 students between 11 and 17 years old in a school in the outskirts of Fortaleza-Ce. The study was conducted from August to October 2016. Three instruments related to characterization, vulnerability to STIs/HIV/AIDS and resilience were used. The association between the instruments was calculated using the Mann-Whitney and Kruskal-Wallis tests. Association between vulnerability to STIs/HIV/AIDS and resilience was assessed through the Spearman’s correlation coefficient. Statistical significance was set at p<0.05.
Results:
There was a significant association between the factors “housing” (p=0.022), “family income” (p=0.037) and vulnerability to STIs/HIV/AIDS. Adolescents whose father has completed high school (p=0.043) have moderately high resilience.
Conclusion:
Adolescents with low socioeconomic status and who live on less than a minimum wage tends to be more susceptible to vulnerabilities to STIs/HIV/AIDS and to have low resilience.
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ORIGINAL ARTICLE10-21-2019
Social determinants of health and vulnerabilities to sexually transmitted infections in adolescents
Revista Brasileira de Enfermagem. 2019;72(6):1595-1601
Abstract
ORIGINAL ARTICLESocial determinants of health and vulnerabilities to sexually transmitted infections in adolescents
Revista Brasileira de Enfermagem. 2019;72(6):1595-1601
DOI 10.1590/0034-7167-2018-0726
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Objective:
To verify the association between social determinants of health and the vulnerability of adolescents to Sexually Transmitted Infections (STIs).
Method:
Cross-sectional study, performed with 287 students aged 11 to 17 years, in the outskirts of Fortaleza, Ceará, Brazil, from August do September 2016. Two instruments were used, one destined to social determinants of health and another to investigating the vulnerability to STIs. The magnitude of associations was expressed through odds ratio and interval of confidence, considering a 5% significance level. This research was approved by the Research Ethics Committee of the Federal University of Ceará.
Results:
212 (73.9%) adolescents were considered more vulnerable, with a score ≥ 4. The intermediate social determinant “housing (home ownership)” obtained significant association with with the vulnerability to STIs (p of 0.022; CI 1.1 to 3.3; OR 1.9).
Conclusion:
The intermediate social determinant “type of housing” influences the vulnerability to STAs.
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ORIGINAL ARTICLE06-27-2019
Safety of the patient in an emergency situation: perceptions of the nursing team
Revista Brasileira de Enfermagem. 2019;72(3):753-759
Abstract
ORIGINAL ARTICLESafety of the patient in an emergency situation: perceptions of the nursing team
Revista Brasileira de Enfermagem. 2019;72(3):753-759
DOI 10.1590/0034-7167-2018-0544
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Objective:
To know the perception of nursing professionals about the essential aspects to provide safe care to polytraumatized patients in emergency services.
Method:
Descriptive and mixed study, performed with a focus group and projective techniques. The sample was made of seven nursing professionals. Data analysis took place through the Interface de R pour Analyses Multidimensionnelles de Textes et de Questionneires and SPSS 22.0 softwares.
Results:
Based on the analysis of participants’ speeches, three content partitions emerged in the Descending Hierarchical Classification. 1) Structure: need for changes; 2) The process: safe actions by the nursing team; and 3) Care free from damage as the sought result.
Conclusion:
Patient safety in emergency situations must rely on a proper environment and an organized sector, good conditions to transport patients, use of routines and protocols, identification and organization of the beds.
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ORIGINAL ARTICLE09-21-2020
Contexts of vulnerabilities experienced by adolescents: challenges to public policies
Revista Brasileira de Enfermagem. 2020;73:e20190224
Abstract
ORIGINAL ARTICLEContexts of vulnerabilities experienced by adolescents: challenges to public policies
Revista Brasileira de Enfermagem. 2020;73:e20190224
DOI 10.1590/0034-7167-2019-0224
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Objectives:
to understand the context of vulnerability experienced by adolescents from the perspective of health professionals from the Family Health Strategy.
Methods:
a descriptive-exploratory qualitative study developed with 80 Family Health Strategy professionals in the Midwest region of Brazil. Data collection was developed from July to September 2018 through a focus group, and submitted to Thematic Analysis.
Results:
it was understood that the vulnerability experienced by adolescents is not an exposure to something isolated, but is linked to risk and protection factors, socioeconomic and cultural contexts, public and health policies.
Final Considerations:
there are still gaps in public policies for this population, which impacts on the access and development of promotion actions by health professionals.
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ORIGINAL ARTICLE09-21-2020
The vulnerabilities of premature children: home and institutional contexts
Revista Brasileira de Enfermagem. 2020;73:e20190218
Abstract
ORIGINAL ARTICLEThe vulnerabilities of premature children: home and institutional contexts
Revista Brasileira de Enfermagem. 2020;73:e20190218
DOI 10.1590/0034-7167-2019-0218
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Objective:
To analyze situations in which premature children are vulnerable in home care, in the first six months after hospital discharge.
Method:
Qualitative study, from the perspective of philosophical hermeneutics, carried out in a Brazilian city on the border. In-depth interviews were conducted, with a data analysis considering the method of interpretation of meanings. 18 mothers of premature children discharged from a hospital unit participated. 25 home visits and 56 calls were made.
Results:
The reports from the mothers express situations of vulnerability, concerns, needs for care, singularities of the development of the premature baby, and repercussions of institutional routines in home care.
Final considerations:
There are vulnerable circumstances in prematurity that reaffirm interconnected individual, social, and institutional dimensions. It is important to highlight that the institutional dimension involves the responsibility of health professionals not to increase individual and social vulnerabilities, but to promote care and seek to reduce situations that generate risks, uncertainties, concerns, and damages.
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ORIGINAL ARTICLE12-05-2019
Self-care activities, sociodemographic variables, treatment and depressive symptoms among older adults with Diabetes Mellitus
Revista Brasileira de Enfermagem. 2019;72:22-29
Abstract
ORIGINAL ARTICLESelf-care activities, sociodemographic variables, treatment and depressive symptoms among older adults with Diabetes Mellitus
Revista Brasileira de Enfermagem. 2019;72:22-29
DOI 10.1590/0034-7167-2017-0579
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Objective:
to analyze the association between self-care activities of older adults with Type 2 Diabetes Mellitus (DM) and sociodemographic variables, type of treatment and depressive symptoms.
Method:
inferential and cross-sectional study, with 121 older adults with Type 2 DM in ambulatory care. We used a questionnaire for characterization of sociodemographic and health, questionnaire self-care activities with DM, Mini Mental State Examination and Geriatric Depression Scale. The association of variables was used (Fisher’s exact test) and for comparing the means (Student’s t-test and analysis of variance).
Results:
The mean age was 68.1 years, the majority were women (57.2%), retired (71.9%) and married (65.3%). The highest averages were for the activities: “to dry the spaces between the toes, after washing them” and smaller averages for “exercise”.
Conclusion:
In spite of high average for self-care activities, there is a need for enhanced performance and compliance to them.
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ORIGINAL ARTICLE09-16-2019
Social representations of the elderly about HIV/AIDS
Revista Brasileira de Enfermagem. 2019;72(5):1349-1355
Abstract
ORIGINAL ARTICLESocial representations of the elderly about HIV/AIDS
Revista Brasileira de Enfermagem. 2019;72(5):1349-1355
DOI 10.1590/0034-7167-2018-0296
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Objective:
to understand the representational content about HIV/AIDS among seropositive elderly people.
Method:
a qualitative study carried out from April to May 2017, in the city of Recife/PE, with 48 seropositive elderly people, through a semi-structured interview. The Social Representations Theory was used as theoretical framework and the method of lexical analysis through IRAMUTEQ software.
Results:
it was observed that the social representation of HIV is structured around the proximity of death and that it is a disease of restricted groups, leading to feelings of sadness. On the other hand, it is evident a transformation of the representation linked to the reified knowledge, leading to the process of naturalization of the disease.
Final considerations:
it is concluded that the elderly living with HIV, when they undergo a process of reframing about the disease, become more flexible to deal with their condition of seropositivity.
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