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12-04-2023
General Law on Personal Data Protection and applicability to Nursing
Revista Brasileira de Enfermagem. 2023;76:e20230126
Abstract
General Law on Personal Data Protection and applicability to Nursing
Revista Brasileira de Enfermagem. 2023;76:e20230126
DOI 10.1590/0034-7167-2023-0126
Views0See moreABSTRACT
Objectives:
to reflect on the impacts of the General Personal Data Protection Law on Nursing practice.
Methods:
reflection article, through the intentional collection of materials relating to the topic.
Results:
legislation regulates confidentiality, processing and data sharing, requiring institutional protection measures. The nursing team is responsible for acting preventively, both in care and in the management role, in order to avoid the misuse of the patient’s personal data. The law allows academic research to be carried out as long as the purpose is clear, data collection occurs with an explicit purpose and data is anonymized.
Final Considerations:
although the General Personal Data Protection Law requires greater care in relation to data processing, it is established on precepts of good faith and respect for the rights of the individual, concepts aligned with the nursing code of ethics.
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REVIEW12-04-2023
Supervision of professional nursing practice in Brazil: a scoping review
- Andrezza Gabrielly dos Santos Soldera
, - Letícia da Silva Penha ,
- Dieimes Leandro da Silva ,
- Sebastião Junior Henrique Duarte ,
- Rodrigo Guimarães dos Santos Almeida
Abstract
REVIEWSupervision of professional nursing practice in Brazil: a scoping review
Revista Brasileira de Enfermagem. 2023;76:e20230077
DOI 10.1590/0034-7167-2023-0077
- Andrezza Gabrielly dos Santos Soldera ,
- Letícia da Silva Penha ,
- Dieimes Leandro da Silva ,
- Sebastião Junior Henrique Duarte ,
- Rodrigo Guimarães dos Santos Almeida
Views0See moreABSTRACT
Objectives:
to map studies that analyze the audit process of nursing councils.
Methods:
this is a scoping review, anchored in the JBI framework, with the guiding question: what is the evidence of the audit process of legal practice of nursing by class councils (COFEN/COREN system)? The searches were carried out in October and November 2022 without limitation of language and year.
Results:
of the 9 selected studies, all are Brazilian and published from 2014 onwards. Among the topics addressed are the role, challenges, costs and difficulties in nurse auditors’ daily work process, in addition to the contribution of the audit sector in Brazil.
Conclusions:
the studies gathered discuss aspects related to costs, challenges and difficulties, but there is no focus on corrective, disciplinary and educational activities as well as little is said about the audit process, its reporting, referral and outcomes.
- Andrezza Gabrielly dos Santos Soldera
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ORIGINAL ARTICLE12-04-2023
Burnout, ethical climate and work organization in covid-19 intensive care units: mixed method study
- Ademir Jones Antunes Dorneles ,
- Graziele de Lima Dalmolin ,
- Edison Luiz Devos Barlem ,
- Rosemary Silva da Silveira ,
- Rafaela Andolhe , [ … ],
- Valdecir Zavarese da Costa
Abstract
ORIGINAL ARTICLEBurnout, ethical climate and work organization in covid-19 intensive care units: mixed method study
Revista Brasileira de Enfermagem. 2023;76:e20220684
DOI 10.1590/0034-7167-2022-0684
- Ademir Jones Antunes Dorneles ,
- Graziele de Lima Dalmolin ,
- Edison Luiz Devos Barlem ,
- Rosemary Silva da Silveira ,
- Rafaela Andolhe ,
- Silviamar Camponogara ,
- Tânia Solange Bosi de Souza Magnago ,
- Valdecir Zavarese da Costa
Views0See moreABSTRACT
Objectives:
to analyze the association between burnout and the perception of the ethical climate in nursing professionals in the covid-19 Intensive Care Unit and the relationship with the organization of work from the perspective of managers of these units.
Methods:
mixed method study conducted in three university hospitals in southern Brazil from December 2021 to March 2022. A cross-sectional study was developed with 110 nursing professionals, followed by an exploratory-descriptive study through semi-structured interviews with six managers. Descriptive and analytical statistics and discursive textual analysis were used.
Results:
the prevalence of burnout was 10% and the perception of negative ethical climate was 24.5%. The association between burnout and ethical climate revealed overload and fatigue during working hours, related to tension, fear, and stress that emerged from the consequences of the organization and relations of work in the covid-19 Intensive Care Unit.
Conclusions:
there was an association between burnout and ethical climate and elements of the work organization.
- Ademir Jones Antunes Dorneles
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ORIGINAL ARTICLE12-04-2023
Incidence and risk factors of pressure injuries in critically ill patients with COVID-19
- Aline de Oliveira Ramalho ,
- Rodrigo Augusto Gonçalves Fonseca ,
- Eliane Mazócoli ,
- Alessandra Marin ,
- Paula Cristina Nogueira
Abstract
ORIGINAL ARTICLEIncidence and risk factors of pressure injuries in critically ill patients with COVID-19
Revista Brasileira de Enfermagem. 2023;76:e20220553
DOI 10.1590/0034-7167-2022-0553
- Aline de Oliveira Ramalho ,
- Rodrigo Augusto Gonçalves Fonseca ,
- Eliane Mazócoli ,
- Alessandra Marin ,
- Paula Cristina Nogueira
Views0See moreABSTRACT
Objective:
to analyze pressure injury (PI) incidence and risk factors in patients with COVID-19 admitted to an Intensive Care Unit and characterize the identified PIs.
Method:
a retrospective cohort study, consisting of 668 patients, carried out between March 2020 and February 2021. Clinical/demographic and PI variables were collected from medical records and electronic database. Data were analyzed using descriptive and inferential statistics. Logistic regression was performed to analyze risk factors for PI.
Results:
PI incidence was 30.2% (n=202), with the majority located in the sacral region (52.9%) and in stage 1 (39%). Risk factors were age (p<0.001), Diabetes Mellitus (p=0.005), length of stay (p<0.001), immunosuppression (p=0.034), nutritional risk (p=0.015) and mechanical ventilation (p<0.001).
Conclusion:
PI incidence in critically ill patients with COVID-19 was high.
- Aline de Oliveira Ramalho
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ORIGINAL ARTICLE12-04-2023
Work-related stress among nurses in the COVID-19 pandemic: What are the contributing factors?
- Tita Rohita ,
- Nursalam Nursalam ,
- Muhammad Hadi ,
- Iqbal Pramukti ,
- Dedeng Nurkholik , [ … ],
- Ika Adelia Susanti
Abstract
ORIGINAL ARTICLEWork-related stress among nurses in the COVID-19 pandemic: What are the contributing factors?
Revista Brasileira de Enfermagem. 2023;76:e20220586
DOI 10.1590/0034-7167-2022-0586
- Tita Rohita ,
- Nursalam Nursalam ,
- Muhammad Hadi ,
- Iqbal Pramukti ,
- Dedeng Nurkholik ,
- Arifah Septiane ,
- Idyatul Hasanah ,
- Ika Adelia Susanti
Views0See moreABSTRACT
Objective:
To analyze the contributing factors of work-related stress among nurses in the COVID-19 pandemic.
Methods:
A cross-sectional study was conducted with 101 nurse practitioners from two hospitals in West Java, Indonesia. We distributed an online questionnaire to evaluate work-related stress and the data were analyzed using ordinal logistic regression.
Results:
More than half of the nurses experienced moderate work-related stress. The study revealed that nurses aged over 35 years old had a lower likelihood of experiencing work-related stress (AOR: 0.173; 95%CI: 0.038-0.782). Married nurses had a higher likelihood (AOR: 7.156; 95% CI: 1.456-35.163). Additionally, nurses with low and moderate workloads had a lower likelihood (AOR: 0.003; 95%CI: 0.000-0.051) and (AOR: 0.025; 95%CI: 0.005-0.116), respectively.
Conclusion:
The consideration of age, marital status, and workload is essential in effectively addressing work-related stress among nurse practitioners.
- Tita Rohita
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ORIGINAL ARTICLE12-04-2023
Factors affecting the community’s attitude toward COVID-19 vaccination: cross-sectional study
- Chintia Gracelia Amalo ,
- Ezra Amarya Ekaristy ,
- Maretty Wattileo ,
- Martina Pakpahan ,
- Ester Silitonga
Abstract
ORIGINAL ARTICLEFactors affecting the community’s attitude toward COVID-19 vaccination: cross-sectional study
Revista Brasileira de Enfermagem. 2023;76:e20220597
DOI 10.1590/0034-7167-2022-0597
- Chintia Gracelia Amalo ,
- Ezra Amarya Ekaristy ,
- Maretty Wattileo ,
- Martina Pakpahan ,
- Ester Silitonga
Views0See moreABSTRACT
Objective:
The study aimed to analyze the factors that affect the community’s attitude towards COVID-19 vaccination in Tangerang District.
Methods:
A cross-sectional study was used. Convenience sampling was used to select 400 respondents. Inclusion criteria are living in Tangerang District, aged between 18 and 55, and earning a living. An online questionnaire was used and passed validity and reliability tests. This study received ethical approval.
Results:
Most respondents had a high level of education (48.50%), low income (72.50%), high knowledge (78%), and a positive attitude (76.50%) regarding vaccination against COVID-19. The Chi-square test revealed a correlation between knowledge and attitudes towards COVID-19 vaccination (p=0.001), as well as education levels (p=0.001), but there was no correlation between income and attitudes (p=0.094).
Conclusions:
Health professionals should engage in extensive socialization and face-to-face visits with people with limited access to information to promote a positive attitude and expand the scope of COVID-19 vaccination.
- Chintia Gracelia Amalo
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ORIGINAL ARTICLE12-04-2023
Assessment of the quality of life and mental health of healthcare students during the COVID-19 pandemic
- Pedro Henrique Batista de Freitas ,
- Adriana Lúcia Meireles ,
- Mery Natali Silva Abreu ,
- Bruna Carolina Rafael Barbosa ,
- Waléria de Paula , [ … ],
- Clareci Silva Cardoso
Abstract
ORIGINAL ARTICLEAssessment of the quality of life and mental health of healthcare students during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76:e20230068
DOI 10.1590/0034-7167-2023-0068
- Pedro Henrique Batista de Freitas ,
- Adriana Lúcia Meireles ,
- Mery Natali Silva Abreu ,
- Bruna Carolina Rafael Barbosa ,
- Waléria de Paula ,
- Clareci Silva Cardoso
Views0See moreABSTRACT
Objective:
to evaluate the quality of life (QOL) and the presence of symptoms related to depression, anxiety, and stress among students in the healthcare field, in comparison to the period before the COVID-19 pandemic.
Methods:
A comparative cross-sectional research was conducted at a Brazilian public university. QOL was assessed using the WHOQOL-bref scale, while symptoms of depression, anxiety, and stress were evaluated using the DASS-21 scale. Descriptive and inferential analyses were employed to compare the two time periods.
Results:
A total of 355 students participated in this study. During the pandemic, there were significant increases in severe depression symptoms (15.1% versus 24.8%), moderate anxiety (18.3% versus 29.4%), and moderate stress (40.9% versus 53.8%) observed among the participants. Additionally, a significant reduction in QOL was noted, particularly in the domain of social relationships (65.2 versus 59.6, p-value 0.029).
Conclusion:
The study highlights a deterioration in both the quality of life and the mental health of healthcare students during the COVID-19 pandemic.
- Pedro Henrique Batista de Freitas
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12-04-2023
The ethics of nursing care for transgender people
Revista Brasileira de Enfermagem. 2023;76:e20220797
Abstract
The ethics of nursing care for transgender people
Revista Brasileira de Enfermagem. 2023;76:e20220797
DOI 10.1590/0034-7167-2022-0797
Views0See moreABSTRACT
Objectives:
to discuss ethical aspects in nursing care for transgender people.
Methods:
reflective study based on the dilemmas that emerges in nursing care for transgender people. The report was structured around the four bioethical principles.
Results:
health care for trans people is complex, transversal to many devices and specialties and longitudinal in time, that is why it requires coordinated action. There is an ethical framework in which the nursing care must be observed in the care of this group.
Final Considerations:
the nurse as a health worker can assume several general lines in the care of transgender patients. So, complementary training should be provided not only to professionals, but also to students of nursing and other health sciences.
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ORIGINAL ARTICLE02-03-2023
Quality of life and satisfaction of students with auriculotherapy in the covid-19 pandemic: a quasi-experimental study
- Caroline de Castro Moura ,
- Bárbara Guimarães Lourenço ,
- Bruna de Oliveira Alves ,
- Bianca Bacelar de Assis ,
- Luana Vieira Toledo , [ … ],
- Tânia Couto Machado Chianca
Abstract
ORIGINAL ARTICLEQuality of life and satisfaction of students with auriculotherapy in the covid-19 pandemic: a quasi-experimental study
Revista Brasileira de Enfermagem. 2023;76:e20220522
DOI 10.1590/0034-7167-2022-0522
- Caroline de Castro Moura ,
- Bárbara Guimarães Lourenço ,
- Bruna de Oliveira Alves ,
- Bianca Bacelar de Assis ,
- Luana Vieira Toledo ,
- Ludmila de Oliveira Ruela ,
- Tânia Couto Machado Chianca
Views0See moreABSTRACT
Objectives:
to evaluate the quality of life before and after the application of auriculotherapy and the satisfaction of university students with the treatment during the covid-19 pandemic.
Methods:
quasi-experimental study conducted with 44 students in a University Health Center. The intervention consisted of ten sessions of auriculotherapy focusing on emotional changes with quality of life assessment before and after treatment. The study also investigated the satisfaction concerning the intervention.
Results:
predominated among the students: women, from health courses, in use of psychotropic drugs and complaining of emotional changes. There was a statistically significant increase in all domains of quality of life, and students were satisfied with the treatment.
Conclusions:
auriculotherapy improved the quality of life of university students during the covid-19 pandemic, and the level of satisfaction with the treatment was high.
- Caroline de Castro Moura
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ORIGINAL ARTICLE08-16-2021
Management in clinical simulation: a proposal for best practices and process optimization
- Patrícia Ilha Schuelter ,
- Francis Solange Vieira Tourinho ,
- Vera Radünz ,
- Viviane Euzébia Pereira Santos ,
- Vivian Costa Fermo , [ … ],
- Sarah Soares Barbosa
Abstract
ORIGINAL ARTICLEManagement in clinical simulation: a proposal for best practices and process optimization
Revista Brasileira de Enfermagem. 2021;74:e20200515
DOI 10.1590/0034-7167-2020-0515
- Patrícia Ilha Schuelter ,
- Francis Solange Vieira Tourinho ,
- Vera Radünz ,
- Viviane Euzébia Pereira Santos ,
- Vivian Costa Fermo ,
- Sarah Soares Barbosa
Views0See moreABSTRACT
Objectives:
to develop a best practices document with facilitating components and processes for simulation management.
Methods:
the methodological research was conducted between April and October 2017, using four approaches: observational research, conducted in an international simulation institution; Definition of theoretical framework, from the International Nursing Association for Clinical Simulation and Learning; integrative literature review, in international databases; and comparative analysis. It used Bardin’s analysis for the categorization of the information.
Results:
creation of a document with good practices in simulation regarding management and practice in simulation and management of resources and data, highlighting the use of technology and the training of professionals as the most important allies for overcoming the main limitations found.
Final Considerations:
the product of this study is a compilation of strategies for simulation management as a tool to enhance the application of the method with greater effectiveness.
- Patrícia Ilha Schuelter
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ORIGINAL ARTICLE08-19-2019
Health promotion by nursing technicians from the nurses’ perspective
- Antonia de Fátima Zanchetta Serradilha ,
- Marli Teresinha Cassamassimo Duarte ,
- Vera Lucia Pamplona Tonete
Abstract
ORIGINAL ARTICLEHealth promotion by nursing technicians from the nurses’ perspective
Revista Brasileira de Enfermagem. 2019;72(4):979-987
DOI 10.1590/0034-7167-2018-0552
- Antonia de Fátima Zanchetta Serradilha ,
- Marli Teresinha Cassamassimo Duarte ,
- Vera Lucia Pamplona Tonete
Views0See moreABSTRACT
Objective:
to analyze education and practice of nursing technicians in health promotion, from the perspective of teaching nurses of technical course and Primary Health Care nurses.
Method:
an exploratory study with qualitative data analysis, carried out in the city of São Paulo, through semi-structured interviews with nine public technical professors and 16 nurses from the basic health network. Data thematic analysis was carried out.
Results:
three thematic categories have emerged: Conceptions and experiences on health promotion; Nursing technician’s practice in health promotion; and Nursing technician education on health promotion.
Final considerations:
it is necessary to review the centrality given to technicalism in the education and practice of nursing technicians, contemplating the health promotion and seeking the development of professional competence for the construction of transformative practices aimed at valuing the autonomy and proactivity of the people in health and quality of life production.
- Antonia de Fátima Zanchetta Serradilha
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REFLECTION02-15-2021
The belief in health in the adoption of COVID-19 prevention and control measures
- Khelyane Mesquita de Carvalho ,
- Cynthia Roberta Dias Torres Silva ,
- Sarah Giulia Bandeira Felipe ,
- Marcia Teles de Oliveira Gouveia
Abstract
REFLECTIONThe belief in health in the adoption of COVID-19 prevention and control measures
Revista Brasileira de Enfermagem. 2021;74:e20200576
DOI 10.1590/0034-7167-2020-0576
- Khelyane Mesquita de Carvalho ,
- Cynthia Roberta Dias Torres Silva ,
- Sarah Giulia Bandeira Felipe ,
- Marcia Teles de Oliveira Gouveia
Views0See moreABSTRACT
Objective:
Reflect, in the light of the Health Belief Model, on the adoption of behavioral measures in the context of COVID-19.
Methods:
Theoretical-reflective essay, based on the Health Belief Model, to reflect on adherence to preventive behaviors in the pandemic of COVID-19.
Results:
Adherence to preventive behaviors is strongly influenced by socioeconomic, territorial, political and individual factors in the face of critical health situations. In addition, the spread of false news modulates the thinking and execution of behavioral actions in the population.
Final Considerations:
It is necessary to understand the importance of health communication processes and the use of tools aimed at responsible human behavior and engaged in the adoption of a preventive posture.
- Khelyane Mesquita de Carvalho
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ORIGINAL ARTICLE04-07-2023
Suicide attempts by adolescents assisted in an emergency department: a cross-sectional study
- Vanessa Dias Fogaça ,
- Danton Mateus de Souza ,
- Lucía Silva ,
- Danila Maria Batista Guedes ,
- Flavia Domingues , [ … ],
- Lisabelle Mariano Rossato
Abstract
ORIGINAL ARTICLESuicide attempts by adolescents assisted in an emergency department: a cross-sectional study
Revista Brasileira de Enfermagem. 2023;76(2):e20220137
DOI 10.1590/0034-7167-2022-0137
- Vanessa Dias Fogaça ,
- Danton Mateus de Souza ,
- Lucía Silva ,
- Danila Maria Batista Guedes ,
- Flavia Domingues ,
- Isadora Trinquinato ,
- Lisabelle Mariano Rossato
Views1See moreABSTRACT
Objectives:
to identify and characterize the care provided to adolescents admitted to an emergency department due to a suicide attempt.
Methods:
an observational, cross-sectional, descriptive study with a retrospective approach, carried out with medical records of adolescents aged 10 to 19 admitted for suicide attempts, between January 2015 and July 2020, in an emergency department. Data were subjected to descriptive and inferential analysis.
Results:
eighty-eight service occurrences were identified, mainly to females, exposed to multiple risk factors. Exogenous intoxication was the main method used, occurring at home and on weekdays. There were systemic repercussions, requiring multiple interventions and hospitalizations. Only 26% of cases were notified.
Conclusions:
adolescents treated for suicide attempts were exposed to multiple risk factors, with intoxication as the main means used. There is concern about the underreporting of cases and the logic of clinical care and medicalization.
- Vanessa Dias Fogaça
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ORIGINAL ARTICLE09-07-2020
Profile and entrepreneurial intention of nursing students: a comparison between Brazil and Chile
- Rosana Maria Barreto Colichi ,
- Verónica Gómez-Urrutia ,
- Andres Eduardo Jimenez-Figueroa ,
- Hélio Rubens de Carvalho Nunes ,
- Silvana Andrea Molina Lima
Abstract
ORIGINAL ARTICLEProfile and entrepreneurial intention of nursing students: a comparison between Brazil and Chile
Revista Brasileira de Enfermagem. 2020;73(6):e20190890
DOI 10.1590/0034-7167-2019-0890
- Rosana Maria Barreto Colichi ,
- Verónica Gómez-Urrutia ,
- Andres Eduardo Jimenez-Figueroa ,
- Hélio Rubens de Carvalho Nunes ,
- Silvana Andrea Molina Lima
Views0See moreABSTRACT
Objective:
to identify and compare factors associated with profile, intentions, motivations, and barriers to entrepreneurial behavior of nursing students from Brazil and Chile.
Methods:
this cross-sectional study was carried out between March and September 2018 including 889 nursing students. A form was used to assess the socio-demographic profile, professional claims, entrepreneurial intentions and motivations. Statistical analysis used Chi-Square and Fisher’s Exact tests, with a 5% significance level, and a simple logistic regression model.
Results:
there are significant differences between countries in the profile of students and in the motivations studied, but not in professional pretensions and entrepreneurial intentions. Lack of education on the subject reveals itself as an important barrier to entrepreneurship.
Conclusion:
given the lack of teaching entrepreneurship in undergraduate nursing courses and the characteristics inherent to students, education must be appropriate to different cultures to prepare future professionals for other areas of practice.
- Rosana Maria Barreto Colichi
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REVIEW10-05-2020
Self-efficacy of health professionals in hand hygiene practice: is it possible to measure?
- Eliana Borges Silva Pereira ,
- Álvaro Francisco Lopes de Sousa ,
- Cristiane Martins Cunha ,
- Isabel Craveiro ,
- Denise de Andrade
Abstract
REVIEWSelf-efficacy of health professionals in hand hygiene practice: is it possible to measure?
Revista Brasileira de Enfermagem. 2020;73:e20190873
DOI 10.1590/0034-7167-2019-0873
- Eliana Borges Silva Pereira ,
- Álvaro Francisco Lopes de Sousa ,
- Cristiane Martins Cunha ,
- Isabel Craveiro ,
- Denise de Andrade
Views0See moreABSTRACT
Objective:
To identify in the literature the tools used to measure self-efficacy of health professionals in hand hygiene.
Methods:
Integrative literature review carried out by consulting the databases PubMed, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Europe PubMed Central, and Science Direct using the descriptors Self Efficacy, Hand Hygiene, and Health Personnel.
Results:
Six articles, all of which with observational design, were selected. It was possible to infer that four studies used validated instruments to measure self-efficacy of health professionals in the conformity with the recommendations for hand hygiene. The other studies used questionnaires that were not validated.
Final considerations:
Despite the extensive literature on hand hygiene, there is a lack of scientific evidence regarding the use of validated instruments to measure self-efficacy of health professionals in the procedure. The use of properly validated psychometric instruments is useful to guarantee the quality of results in studies.
- Eliana Borges Silva Pereira
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ORIGINAL ARTICLE05-24-2021
Content validation of an educational booklet for asthma control and management in children
- Kamila Ferreira Lima ,
- Ana Lúcia Araújo Gomes ,
- Emanuella Silva Joventino Melo ,
- Flávia Ximenes Vasconcelos ,
- Janaina Landim de Sousa , [ … ],
- Lorena Pinheiro Barbosa
Abstract
ORIGINAL ARTICLEContent validation of an educational booklet for asthma control and management in children
Revista Brasileira de Enfermagem. 2021;74:e20200353
DOI 10.1590/0034-7167-2020-0353
- Kamila Ferreira Lima ,
- Ana Lúcia Araújo Gomes ,
- Emanuella Silva Joventino Melo ,
- Flávia Ximenes Vasconcelos ,
- Janaina Landim de Sousa ,
- Mariana Cavalcante Martins ,
- Lorena Pinheiro Barbosa
Views0See moreABSTRACT
Objective:
to validate the content and appearance of the educational booklet “You can control your child’s asthma – let’s learn together?” with parents and caregivers of children with asthma.
Methods:
this is a methodological study, carried out with 34 mothers and caregivers of children, from two to 10 years old, diagnosed with asthma. The educational booklet validation was performed using Content Validity Index (CVI) and assessment of comprehension, attractiveness, self-efficacy, persuasion, and cultural acceptance domains.
Results:
the booklet was considered clear (99.8%) and relevant (100%), with a global CVI of 0.99. Domain assessment proved to be an easy-to-understand tool, culturally appropriate, attractive, with persuasive power and promoting self-efficacy.
Conclusion:
the booklet is valid and adequate for promoting the self-efficacy of parents and caregivers in childhood asthma control and management, potentially scalable to other realities of outpatient care.
- Kamila Ferreira Lima
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