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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
Views0See moreABSTRACT
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.
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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
Views0See moreABSTRACT
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.
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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
Views0See moreABSTRACT
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.
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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
Views0See moreABSTRACT
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.
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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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REVIEW12-08-2023
Educational technologies for accident prevention due to falls in childhood: a scoping review
Revista Brasileira de Enfermagem. 2023;76:e20220807
Abstract
REVIEWEducational technologies for accident prevention due to falls in childhood: a scoping review
Revista Brasileira de Enfermagem. 2023;76:e20220807
DOI 10.1590/0034-7167-2022-0807
Views1See moreABSTRACT
Objectives:
to map evidence on educational technology use for accident prevention due to falls in childhood.
Methods:
a scoping review, carried out in October and November 2022, in the MEDLINE, Web of Science, BDENF and CINAHL databases and LILACS bibliographic index. There was no delimitation of language or time. Data were extracted and analyzed descriptively by two independent researchers. The research protocol was registered in the Open Science Framework.
Results:
twenty-six studies were selected. Booklets, pamphlets and leaflets were the most used technologies, presenting health services as the most frequent environment to develop research on fall prevention. The technologies developed were important outcomes: increased knowledge of children, family members, caregivers, health and education professionals.
Conclusions:
educational technology use makes it possible to increase knowledge, adopt safe practices and reduce falls.
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ORIGINAL ARTICLE12-08-2023
Systematization of perioperative nursing care in robotic surgery: instrument validation
Revista Brasileira de Enfermagem. 2023;76:e20220666
Abstract
ORIGINAL ARTICLESystematization of perioperative nursing care in robotic surgery: instrument validation
Revista Brasileira de Enfermagem. 2023;76:e20220666
DOI 10.1590/0034-7167-2022-0666
Views0See moreABSTRACT
Objective:
To develop and validate an instrument to assist in the systematization of perioperative nursing care in robotic surgery.
Methods:
Methodological study developed in four phases: content survey; textual elaboration; content validation by the group of expert judges and target audience; and elaboration of the electronic instrument layout.
Results:
Eleven expert judges and seven evaluators of the target audience participated. For validation, the Content Validity Index (CVI) was used with a 0.78 cutoff point. The instrument total CVI after evaluation was 0.90 by the expert judges and 0.88 by the target audience.
Conclusion:
The tool built was proved satisfactory for the systematization of perioperative nursing care. The instrument construction was based on the updated scientific literature and validated by the expert judges and target audience.
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12-08-2023
Influência da deambulação precoce combinada a terapia dhikr no peristaltismo intestinal de pacientes submetidos a colecistectomia aberta
Revista Brasileira de Enfermagem. 2023;76:e20220636
Abstract
Influência da deambulação precoce combinada a terapia dhikr no peristaltismo intestinal de pacientes submetidos a colecistectomia aberta
Revista Brasileira de Enfermagem. 2023;76:e20220636
DOI 10.1590/0034-7167-2022-0636
Views0See moreRESUMEN
Objetivos:
analizar y determinar el efecto de una intervención que combinó la deambulación temprana y la terapia dhikr sobre la recuperación peristáltica intestinal de pacientes sometidos a colecistectomía abierta.
Métodos:
se utilizó un diseño preexperimental con un grupo pretest y postest. Las muestras incluyeron 15 pacientes sometidos a colecistectomía abierta y seleccionados mediante muestreo intencional. Los datos se recopilaron por medio de fichas de observación del instrumento y se analizaron mediante la prueba de Wilcoxon. La deambulación temprana utilizó el procedimiento operativo estándar en el hospital y la terapia dhikr se realizó durante 10 a 15 minutos, dos horas después de la operación.
Resultados:
la deambulación temprana asociada con la terapia dhikr afectó la recuperación peristáltica intestinal de los pacientes que se sometieron a colecistectomía abierta con anestesia general (Z =-3,442; p=0,001).
Conclusiones:
la combinación de la deambulación temprana con la terapia dhikr puede recomendarse como una intervención para mejorar el movimiento peristáltico intestinal de los pacientes después de una colecistectomía abierta con anestesia general.
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ORIGINAL ARTICLE12-08-2023
Early ambulation and dhikr complementary therapies effect on intestinal peristaltic in post-open cholecystectomy patients
Revista Brasileira de Enfermagem. 2023;76:e20220636
Abstract
ORIGINAL ARTICLEEarly ambulation and dhikr complementary therapies effect on intestinal peristaltic in post-open cholecystectomy patients
Revista Brasileira de Enfermagem. 2023;76:e20220636
DOI 10.1590/0034-7167-2022-0636
Views0ABSTRACT
Objectives:
to analyze and determine the effect of a combination intervention of early ambulation and dhikr therapy on intestinal peristaltic recovery in post-open cholecystectomy patients.
Methods:
a pre-experimental design with one group pre and post-test design was used. The samples were 15 post-open cholecystectomy patients which were selected using the purposive sampling technique. The data were collected using the instrument observation sheet and analyzed using the Wilcoxon test. Early ambulation used standard operational procedure in the hospital and dhikr therapy was carried out at 2 hours post-operation for 10-15 minutes.
Results:
there was an effect of early ambulation and dhikr therapy on intestinal peristaltic recovery in post-open cholecystectomy patients with general anesthesia (Z=-3.442; p=0.001).
Conclusions:
a combination of early ambulation and dhikr therapy can be recommended as interventions to improve intestinal peristaltic in a post-open cholecystectomy patient with general anesthesia.
Keywords:Anesthesia, GeneralCholecystectomyComplementary TherapiesEarly AmbulationPerioperative NursingSee more -
ORIGINAL ARTICLE12-08-2023
Workshop on pediatric trauma care: low-cost simulation
Revista Brasileira de Enfermagem. 2023;76:e20210485
Abstract
ORIGINAL ARTICLEWorkshop on pediatric trauma care: low-cost simulation
Revista Brasileira de Enfermagem. 2023;76:e20210485
DOI 10.1590/0034-7167-2021-0485
Views0See moreABSTRACT
Objective:
to assess nursing students’ and nurses’ knowledge, satisfaction and self-confidence after a theoretical workshop on emergency care for traumatized children and clinical simulation.
Methods:
a quasi-experimental study, carried out with nursing students and nurses residing at a public university in southern Brazil. A workshop on pediatric trauma care was created and a mannequin was created for simulations. A knowledge pre-test and post-test and the Student Satisfaction and Self-Confidence in Learning instrument were applied to measure satisfaction and self-confidence in learning. For analysis, descriptive statistics and the Wilcoxon test were used to compare means before and after intervention.
Results:
the difference between misses and hits was statistically significant (p<0.005), demonstrating an increase in participants’ knowledge after the workshop. Satisfaction and self-confidence were demonstrated in the instrument’s high scores.
Conclusions:
the effectiveness of the workshop in teaching-learning emergency care for pediatric trauma was demonstrated.
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ORIGINAL ARTICLE12-08-2023
Validation of telesimulation in the care of late preterm newborns with hypoglycemia for nursing students
Revista Brasileira de Enfermagem. 2023;76:20220438
Abstract
ORIGINAL ARTICLEValidation of telesimulation in the care of late preterm newborns with hypoglycemia for nursing students
Revista Brasileira de Enfermagem. 2023;76:20220438
DOI 10.1590/0034-7167-2022-0438
Views0See moreABSTRACT
Objective:
To develop and validate a telesimulation scenario for nursing students in the care of late preterm infants with hypoglycemia.
Methods:
A methodological study conducted between August 2021 and May 2022 in a virtual environment involved constructing and validating the scenario with 10 experts, and testing it with 10 students. The content validity index assessed validity, with a threshold of 80% or higher, and suggestions were analyzed using semantic approximation.
Results:
Validation confirmed the appropriateness of all 14 scenario items, with an overall index of 97.8% and clarity and relevance indices of 98.5%. During testing, the overall index was 99.7%, with the “resources” item receiving the lowest score. Adjustments were made to objectives, technical terms, resources, and target audience based on feedback.
Conclusion:
Telesimulation is a widely accepted educational technology for training nursing students, with potential to enhance teaching quality and neonatal care.
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ORIGINAL ARTICLE12-08-2023
Knowledge and practices about health among Quilombola men: contributions to health care
Revista Brasileira de Enfermagem. 2023;76:e20230138
Abstract
ORIGINAL ARTICLEKnowledge and practices about health among Quilombola men: contributions to health care
Revista Brasileira de Enfermagem. 2023;76:e20230138
DOI 10.1590/0034-7167-2023-0138
Views1See moreABSTRACT
Objective:
to analyze health knowledge and practices among Quilombola men.
Methods:
a qualitative, descriptive study, carried out with 40 men from two Quilombola communities in Santa Izabel do Pará, state of Pará, Brazil. Individual interviews were carried out using a semi-structured script. Text corpus was subjected to analysis with Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires 0.6, alpha 3, through Descending Hierarchical Classification.
Results:
among participants, eight (20.00%) were aged 55 to 59 years. 382 text segments were identified, with 299 (78.27%) being used, generating five lexical classes, which made up two subcorpora. The classes were organized into four thematic axes, covering knowledge about health and practices to prevent and solve health problems.
Final considerations:
men highlighted popular/traditional wisdom permeated by biomedical knowledge, translating their understanding of how to act to remain or become healthy.
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ORIGINAL ARTICLE12-08-2023
Simulation-based training in Leprosy: development and validation of a scenario for community health workers
Revista Brasileira de Enfermagem. 2023;76:e20230114
Abstract
ORIGINAL ARTICLESimulation-based training in Leprosy: development and validation of a scenario for community health workers
Revista Brasileira de Enfermagem. 2023;76:e20230114
DOI 10.1590/0034-7167-2023-0114
Views0See moreABSTRACT
Objectives:
To build and validate a clinical simulation scenario designed to instruct community health workers (CHWs) in active leprosy case detection.
Methods:
Methodological study involving the development of a simulated clinical scenario and content validation by experts. The Content Validity Index (CVI) was used to determine the level of agreement among the judging commitee, and a descriptive analysis of their recommendations was performed.
Results:
A simulated scenario with a simulated participant was developed — a simulation characterized by low complexity, moderate physical/environmental fidelity, moderate to high psychological fidelity, and high conceptual fidelity, lasting 50 minutes and capable of training up to 10 CHWs simultaneously. The scenario was validated by 14 experts, with a CVI exceeding 80% for all components.
Conclusions:
The validated clinical simulation possesses attributes that make it highly reproducible in various national health contexts, thereby contributing to the global “Towards Zero Leprosy” strategy.
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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
Views0See moreABSTRACT
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.
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07-31-2023
Breastfeeding prevalence in newborns of mothers with COVID-19: a systematic review
Revista Brasileira de Enfermagem. 2023;76:e20220173
Abstract
Breastfeeding prevalence in newborns of mothers with COVID-19: a systematic review
Revista Brasileira de Enfermagem. 2023;76:e20220173
DOI 10.1590/0034-7167-2022-0173
Views0See moreABSTRACT
Objectives:
to compare exclusive breastfeeding prevalence versus artificial feeding in newborns of mothers with COVID-19.
Methods:
a systematic review of prevalence, according to JBI. Searches in PubMed®, Embase, CINAHL, LILACS and Web of Science™ databases in August 2021. Cross-sectional, longitudinal or cohort studies were selected, without language and time limitations that showed breastfeeding prevalence or that allowed calculation.
Results:
fifteen articles published in 2020 and 2021, cohort (60%) or cross-sectional (40%) were analyzed. The average of exclusive breastfeeding in mothers with COVID-19 was 56.76% (CI=39.90–72.88), and artificial breastfeeding, 43.23% (CI = 30.99 – 55.88), without statistically significant differences.
Conclusions:
despite the recommendations for maintaining breastfeeding, there was a reduction worldwide, when compared to periods prior to the pandemic. With advances in science, these rates have improved, showing the impact of evidence on practices. As limitations, study sources are cited. It is recommended to carry out new studies. PROSPERO registration CRD42021234486.
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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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07-10-2023
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
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
Views0See moreRESUMEN
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.
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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
Views0See moreABSTRACT
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.
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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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