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01-01-2016
ERRATUM
Revista Brasileira de Enfermagem. 2016;69(5):1002-1002
Abstract
ERRATUM
Revista Brasileira de Enfermagem. 2016;69(5):1002-1002
DOI 10.1590/0034-7167.20166905e01
Views0Article “Alcohol and alcoholism: attitudes of nursing students”, with number of DOI: http://dx.doi.org/10.1590/S0034-71672013000100013, published in the journal Revista Brasileira de Enfermagem, v66(1):84-9, page 89 that read: “18. Miranda SP, Vargas D. Satisfação de pacientes de um centro de atenção Psicossocial álcool e drogas com o atendimento do enfermeiro. SMAD, Rev Eletrônica Saúde Mental Alcool Drog […]See more -
01-01-2016
Research methodology for nursing and health: a book review
Revista Brasileira de Enfermagem. 2016;69(5):1000-1001
Abstract
Research methodology for nursing and health: a book review
Revista Brasileira de Enfermagem. 2016;69(5):1000-1001
DOI 10.1590/0034-7167-2015-0135
Views1For those interested in nursing and health, the book entitled “Research methodology for nursing and health: from theory to practice”() was released in October 2015, at the 67th Brazilian Congress of Nursing, sponsored by National ABEn. The interest emerged from two organizers: Dr. Maria Ribeiro Lacerda (UFPR) and Dr. Regina Gema Santini Costerano (UNIFRA). Forty-seven […]See more -
01-01-2016
Violence in the workplace in Nursing: consequences overview
Revista Brasileira de Enfermagem. 2016;69(5):996-999
Abstract
Violence in the workplace in Nursing: consequences overview
Revista Brasileira de Enfermagem. 2016;69(5):996-999
DOI 10.1590/0034-7167-2015-0133
Views0See moreABSTRACT
Objective:
to reflect on the consequences of workplace violence experienced by nursing professionals.
Methods:
this is a reflection paper based on recent publications related to the subject, particularly researches carried out in Brazil and in other countries.
Results:
exposure to workplace violence has been associated with health problems in nursing professionals, which may be physical damage, emotional manifestations, and psychic disorders. It also affects the employee performance, his or her family and social interactions.
Conclusion:
this phenomenon is potentially noxious and costly, for it leads to suffering, illness, absence from work, and even death. This reflection calls attention moreover to the importance of a safe and adequate health care work environment.
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REFLECTION01-01-2016
Construcción de la enfermera de práctica avanzada en Catalunya (España)
Revista Brasileira de Enfermagem. 2016;69(5):991-995
Abstract
REFLECTIONConstrucción de la enfermera de práctica avanzada en Catalunya (España)
Revista Brasileira de Enfermagem. 2016;69(5):991-995
DOI 10.1590/0034-7167.2016690507
Views0RESUMEN
El desarrollo de la enfermera de práctica avanzada (EPA) ha supuesto un reto para las enfermeras en países como EE.UU., Canadá, Gran Bretaña y Australia, entre otros, y desde hace escasos años está siendo considerada en Catalunya y España como un sistema para desarrollar nuevos roles que aporten eficacia y eficiencia al sistema sanitario. El presente artículo pretende conceptualizar la EPA y los modelos de referencia así como contextualizar y reflexionar sobre la EPA en Catalunya, desde el punto de vista de formación y de la implantación de los denominados nuevos roles de enfermería, asimilándolos a la práctica avanzada.
Keywords:Competencia ClínicaEnfermeríaEnfermería de Práctica AvanzadaPráctica ProfesionalRol de la EnfermeraSee more -
01-01-2016
Developing the Advanced Practice Nurse in Catalonia
Revista Brasileira de Enfermagem. 2016;69(5):991-995
Abstract
Developing the Advanced Practice Nurse in Catalonia
Revista Brasileira de Enfermagem. 2016;69(5):991-995
DOI 10.1590/0034-7167.2016690507
Views0See moreABSTRACT
The development of advanced practice nurses (APN) has proved a challenge for nurses in countries such as the USA, Canada, Great Britain, and Australia among others. It is only in recent years that the system has been considered in Catalonia and Spain as a way to develop new roles to bring effectiveness and efficiency to the health system. From the standpoint of training and implementation of the above-mentioned new nursing roles, the following article aims to conceptualise APN and its reference models, as well as to contextualise and reflect on APN in Catalonia in order to assimilate them into advanced practice.
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01-01-2016
International academic mobility in nursing education: an experience report
Revista Brasileira de Enfermagem. 2016;69(5):986-990
Abstract
International academic mobility in nursing education: an experience report
Revista Brasileira de Enfermagem. 2016;69(5):986-990
DOI 10.1590/0034-7167-2015-0128
Views0See moreABSTRACT
Objective:
report the experience of international academic mobility in Ireland through the program Science Without Borders during undergraduate education in nursing.
Method:
a report of experience presented in chronological order, with a descriptive nature.
Results:
the opportunity to know and be able to discuss questions regarding health and nursing in Ireland allowed the review of concepts and a more reflective perspective regarding nursing practices. Additionally, the exchange promoted personal strengthening regarding the confrontation and solution of problems, development of technical and scientific abilities, improvement of linguistic competences and construction of personality, independence and maturity.
Conclusion:
regarding such constructive and enriching experience that this mobility provides to students, to the governing authorities, to the population and to Brazilian nursing, sharing this experience is expected to serve as encouragement for those who search for new horizons, with the objective of adding knowledge for their personal and professional life.
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01-01-2016
Online training for health professionals in three regions of Brazil
Revista Brasileira de Enfermagem. 2016;69(5):981-985
Abstract
Online training for health professionals in three regions of Brazil
Revista Brasileira de Enfermagem. 2016;69(5):981-985
DOI 10.1590/0034-7167.2016690506
Views0See moreABSTRACT
Objective:
to describe online training experience aimed at professionals working in the public health service in 27 Neonatal and Pediatric Intensive Care Units, and to reflect concerning the training process and possible improvements in this process.
Method:
this is an experience report study about the online training with multidisciplinary content, planned from the situational diagnosis of 27 institutions. The training target set was 10 participants per institution and per module, including the following topics: Indicators of Quality as a Management Tool, Hand Hygiene, Patient Safety, Intravenous Therapy and Patients’ Chart Record.
Results:
a total of 2,071 active students in the modules, with 1,046 approved. The mean of 76 students per module exceeded the target set.
Conclusion:
experience has shown that online training is comprehensive as a potential tool for the professional technical development and digital inclusion. The online learning system becomes weakened if participants are unaware of the technological resources.
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01-01-2016
Technologies in intensive care: causes of adverse events and implications to nursing
Revista Brasileira de Enfermagem. 2016;69(5):972-980
Abstract
Technologies in intensive care: causes of adverse events and implications to nursing
Revista Brasileira de Enfermagem. 2016;69(5):972-980
DOI 10.1590/0034-7167.2016690505
Views0See moreABSTRACT
Objective:
to identify the causes of adverse events affecting clients resulting from the use of equipment in intensive care services; to point out the main recommendations for clinical practice to minimize these events and, then, discuss the implications to nursing care.
Method:
integrative and descriptive review on the SciELO, Medline, LILACS, and PubMed databases. Articles were selected based on the inclusion criteria and the structured instrument was applied.
Results:
altogether, 11 articles were selected where three evidence units were outstanding: Equipment failure; inadequate use of equipment; and team failure. Permanent education of professionals; evaluation of production and availability of equipment; and use of checklists are recommended.
Conclusion:
preventing adverse events related to equipment is one of the nursing responsibilities and requires the establishment of defensive barriers to prevent these.
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ORIGINAL ARTICLE12-04-2023
Work-related stress among nurses in the COVID-19 pandemic: What are the contributing factors?
Revista Brasileira de Enfermagem. 2023;76:e20220586
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
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.
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ORIGINAL ARTICLE12-04-2023
Incidence and risk factors of pressure injuries in critically ill patients with COVID-19
Revista Brasileira de Enfermagem. 2023;76:e20220553
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
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.
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12-04-2023
Enfermagem e os Objetivos de Desenvolvimento Sustentável (ODS): Um Compromisso Essencial
Revista Brasileira de Enfermagem. 2023;76(6):e760601
Abstract
Enfermagem e os Objetivos de Desenvolvimento Sustentável (ODS): Um Compromisso Essencial
Revista Brasileira de Enfermagem. 2023;76(6):e760601
DOI 10.1590/0034-7167.2023760601pt
Views0Os Objetivos de Desenvolvimento Sustentável (ODS) são uma iniciativa global lançada pela Organização das Nações Unidas (ONU) em setembro de 2015 como parte da Agenda 2030 para o Desenvolvimento Sustentável, cujos objetivos sumarizam um apelo universal à ação para acabar com a pobreza, proteger o meio ambiente e garantir que todas as pessoas tenham acesso […]See more -
12-04-2023
Nursing and the Sustainable Development Goals (SDGs): An Essential Commitment
Revista Brasileira de Enfermagem. 2023;76(6):e760601
Abstract
Nursing and the Sustainable Development Goals (SDGs): An Essential Commitment
Revista Brasileira de Enfermagem. 2023;76(6):e760601
DOI 10.1590/0034-7167.2023760601
Views0The Sustainable Development Goals (SDGs) are a global initiative launched by the United Nations (UN) in September 2015 as part of the 2030 Agenda for Sustainable Development, whose objectives summarize a universal call to action to end poverty, protect the environment and ensure that all people have access to opportunities and well-being, all in an […]See more -
ERRATUM12-04-2023
ERRATUM
Revista Brasileira de Enfermagem. 2023;76(6):e2023n6e06
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2023;76(6):e2023n6e06
DOI 10.1590/0034-7167.20237606e06
Views0In the article “Undergraduate nursing students’ knowledge and experience in infusion therapy and peripheral vascular acces”, with DOI number: , published in Revista Brasileira de Enfermagem, 2023;76(3): e20220219, authored:Where it read:[…]See more -
12-04-2023
Elder abuse: a conceptual analysis
Revista Brasileira de Enfermagem. 2023;76(6):e20230150
Abstract
Elder abuse: a conceptual analysis
Revista Brasileira de Enfermagem. 2023;76(6):e20230150
DOI 10.1590/0034-7167-2023-0150
Views0See moreABSTRACT
Objective:
to analyze the concept of elder abuse and identify its respective antecedents, attributes and consequents.
Methods:
this is a conceptual analysis according to Walker and Avant’s proposition. The search for the concept was mediated by an integrative review in the LILACS, PubMed, CINAHL, Web of Science and BDENF databases.
Results:
as antecedents, female, family member, low social support and low income or socioeconomic conditions stand out. Attributes were threats and/or intimidation, intentional use of physical force, using resources without authorization, unwanted sexual activity, offering low insufficient amount of nutrients for older adults and not meeting older adults’ affective/emotional needs. Consequents were psychological disorders, dependence on aggressors, environment of insecurity and damage/loss of human rights or human dignity.
Final considerations:
the phenomenon under discussion is broad and multifaceted, suggesting expansion of studies related to the theme in order to explore it in detail.
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ORIGINAL ARTICLE12-04-2023
Meanings of nurses’ role in Child and Adolescent Psychosocial Care Centers
Revista Brasileira de Enfermagem. 2023;76(6):e20230124
Abstract
ORIGINAL ARTICLEMeanings of nurses’ role in Child and Adolescent Psychosocial Care Centers
Revista Brasileira de Enfermagem. 2023;76(6):e20230124
DOI 10.1590/0034-7167-2023-0124
Views0See moreABSTRACT
Objective:
to analyze the meaning attributed to nurses’ role in mental health care in Child and Adolescent Psychosocial Care Centers.
Methods:
qualitative research, anchored in the paradigm of complexity. Data collection was carried out through online semi-structured interviews with ten nurses from São Paulo, between March and September 2022, being analyzed thematically.
Results:
the diversity and specificity of a child and adolescent mental health clinic, with the need for expanded, territorial and intersectoral care, were unveiled in addition to a fragmented training in the area. There was a need for a deconstruction of being a nurse to make it possible to produce more inclusive and salutogenic practices.
Final considerations:
the need for training nurses with adequate knowledge and skills to care for the mental health of children, adolescents and their families is reinforced as well as permanent education of working teams.
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12-04-2023
Quantification of blood loss for the diagnosis of postpartum hemorrhage: a systematic review and meta-analysis
Revista Brasileira de Enfermagem. 2023;76(6):e20230070
Abstract
Quantification of blood loss for the diagnosis of postpartum hemorrhage: a systematic review and meta-analysis
Revista Brasileira de Enfermagem. 2023;76(6):e20230070
DOI 10.1590/0034-7167-2023-0070
Views0See moreABSTRACT
Objective:
to compare the effectiveness of different diagnostic methods to estimate postpartum blood volume loss.
Methods:
a systematic review of effectiveness according to PRISMA and JBI Protocol. Searches in PubMed/MEDLINE, LILACS, Scopus, Embase, Web of Science and CINAHL, with descriptor “Postpartum Hemorrhage” associated with keyword “Quantification of Blood Loss”. Tabulated extracted data, presented in metasynthesis and meta-analysis was applied to quantitative data. To assess risk of bias, JBI Appraisal Tools were applied.
Results:
fourteen studies were included, published between 2006 and 2021. Quantification of loss by any method was superior to visual estimation and is highly recommended, however the studies’ high heterogeneity did not allow estimating this association.
Conclusion:
the studies’ high heterogeneity, with a probable margin of error given the uncontrolled factors, indicates the need for further studies, however quantification proved to be effective in relation to visual estimate. PROSPERO registration CRD 42021234486.
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06-01-2015
Workers of CEASA: factors associated with fatigue and work ability
Revista Brasileira de Enfermagem. 2015;68(3):460-466
Abstract
Workers of CEASA: factors associated with fatigue and work ability
Revista Brasileira de Enfermagem. 2015;68(3):460-466
DOI 10.1590/0034-7167.2015680312i
Views0See moreABSTRACT
Objective:
to investigate the socio-demographic characteristics, lifestyle and health conditions related to fatigue and the work ability.
Method:
a cross-sectional study was conducted in 2011 and the sample was composed by 90 workers from the supply center of Campinas. Three questionnaires were used: Fatigue; Work ability index; and socio-demographic characteristics.
Results:
in the univariate regression analysis, the variables associated with work ability were: education, use of medicine, stress, pain in the last six months and pain in the last week. In univariate regression analysis the variables associated with fatigue were: education, stress, sleepiness, pain in the last six months, pain in the last week and health problems.
Conclusion:
these results indicate the need for health promotion program implementation among these workers.
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06-01-2015
Nursing Terminology defines domestic violence against children and adolescents
Revista Brasileira de Enfermagem. 2015;68(3):452-459
Abstract
Nursing Terminology defines domestic violence against children and adolescents
Revista Brasileira de Enfermagem. 2015;68(3):452-459
DOI 10.1590/0034-7167.2015680311i
Views0See moreABSTRACT
Objective:
Identifi cation of terminology relating to nursing practices aimed at children and adolescents at risk of domestic violence.
Methods:
bibliographic descriptive research which selected 40 articles from the Virtual Health Library on domestic violence against children and adolescents, its manifestations, causes, and consequences, in association with nursing procedures for its confrontation and prevention, and which also identifi ed terminology via computer tools.
Results:
17,365 terms that, after standardization and uniformity procedures, resulted in a listing of 915 terms.
Conclusion:
The terminology selected focused on the individual biopsychic nexus and the historic manifestation of this phenomenon was partially identifi ed in terms that appear less frequently in these articles, thereby explaining the contradiction between the formal identifi cation logic of such terminology and the dialectic logic that recognizes the historic reasons for, and dynamicity of, such phenomena.
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06-01-2015
Instrumento para avaliação de estilo de vida sedentário em pacientes com hipertensão
Revista Brasileira de Enfermagem. 2015;68(3):445-451
Abstract
Instrumento para avaliação de estilo de vida sedentário em pacientes com hipertensão
Revista Brasileira de Enfermagem. 2015;68(3):445-451
DOI 10.1590/0034-7167.2015680310i
Views0See moreRESUMEN
Objetivo:
este artículo describe la precisión diagnóstica del International Physical Activity Questionnaire en la identifi cación del diagnóstico enfermero Estilo de vida sedentario.
Método:
un estudio de precisión diagnóstica se desarrolló con 240 individuos con hipertensión arterial establecida. El análisis de precisión diagnóstica se basó en medidas de sensibilidad, especifi cidad, valores predictivos, razones de verosimilitud, efi ciencia, odds ratio diagnóstica, índice de Youden y área bajo la curva característica receptor-operador.
Resultados:
diferencias estadísticas entre los sexos se observaron para las actividades intensidad moderada y la actividad física total. La edad se correlacionó negativamente con la actividad de intensidad moderada y la actividad física total.
Conclusión:
el análisis del área bajo la curva característica receptor-operador para las actividades de intensidad moderada, de caminar, y la actividad física total mostró que el International Physical Activity Questionnaire presenta moderada capacidad para clasificar correctamente los sujetos con y sin el estilo de vida sedentario.
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06-01-2015
Instrument for evaluation of sedentary lifestyle in patients with high blood pressure
Revista Brasileira de Enfermagem. 2015;68(3):445-451
Abstract
Instrument for evaluation of sedentary lifestyle in patients with high blood pressure
Revista Brasileira de Enfermagem. 2015;68(3):445-451
DOI 10.1590/0034-7167.2015680310i
Views0See moreABSTRACT
Objective:
this article describes the diagnostic accuracy of the International Physical Activity Questionnaire to identify the nursing diagnosis of sedentary lifestyle.
Method:
a diagnostic accuracy study was developed with 240 individuals with established high blood pressure. The analysis of diagnostic accuracy was based on measures of sensitivity, specifi city, predictive values, likelihood ratios, effi ciency, diagnostic odds ratio, Youden index, and area under the receiver-operating characteristic curve.
Results:
statistical differences between genders were observed for activities of moderate intensity and for total physical activity. Age was negatively correlated with activities of moderate intensity and total physical activity.
Conclusion:
the analysis of area under the receiver-operating characteristic curve for moderate intensity activities, walking, and total physical activity showed that the International Physical Activity Questionnaire present moderate capacity to correctly classify individuals with and without sedentary lifestyle.
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06-01-2015
Potentialities and weaknesses in the care network of people with HIV/AIDS
Revista Brasileira de Enfermagem. 2015;68(3):438-444
Abstract
Potentialities and weaknesses in the care network of people with HIV/AIDS
Revista Brasileira de Enfermagem. 2015;68(3):438-444
DOI 10.1590/0034-7167.2015680309i
Views0See moreABSTRACT
Objective:
to understand the strengths and weaknesses in the care network of people with HIV/AIDS in a referral center in the state of Santa Catarina-SC.
Method:
participants were eight subjects and their care network, totaling 18 participants. Data were collected through interviews and examined by content analysis, theoretically supported by symbolic interaction.
Results:
the analysis resulted in the following categories: The network offering care to people with acquired immunodefi ciency syndrome, and Facing Barriers in care, which refl ect the strengths and weaknesses in the care network. The fi rst depicts the provision of emotional and humanized care, and the second a restricted network formed by health professionals and a family member.
Conclusion:
the professional care network is important, despite the increased number of assistances in a physical structure and amount of professionals who no longer meet the growing demand.
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06-01-2015
AIDS epidemic in the triple frontier: subsidies for professional practice
Revista Brasileira de Enfermagem. 2015;68(3):429-437
Abstract
AIDS epidemic in the triple frontier: subsidies for professional practice
Revista Brasileira de Enfermagem. 2015;68(3):429-437
DOI 10.1590/0034-7167.2015680308i
Views0See moreABSTRACT
Objective:
to analyze the AIDS epidemic trend from 1988 to 2012, in a tri-border area.
Method:
Ecological time-series study with data from the Department of informatics from the Brazilian Unifi ed Health System (SUS).
Results:
A total of 1427 cases of AIDS were registered, and 82.1% were aged 20-49 years and 56% in males. The relationship man/woman went from 9/1 to 1/1 and increased the number of cases among individuals with more years of education, also, people aged more than 50 years old the age group from 20 to 34 years old. The most common exposure category was heterosexual, significantly higher among women; on the other hand, drug injection use was associated with male gender.
Conclusion:
seeking to embrace the changes in the epidemiological scenario of AIDS, nursing professionals should implement intervention strategies for people identified as the most vulnerable to HIV infection.
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06-01-2015
The Informal Caregiver Burden Assessment Questionnaire: validation for Brazil
Revista Brasileira de Enfermagem. 2015;68(3):421-428
Abstract
The Informal Caregiver Burden Assessment Questionnaire: validation for Brazil
Revista Brasileira de Enfermagem. 2015;68(3):421-428
DOI 10.1590/0034-7167.2015680307i
Views0See moreABSTRACT
Objectives:
to analyze the dimensionality, convergent construct validity and internal consistency of the Informal Caregiver Burden Assessment Questionnaire (QASCI) after its semantic adaptation to Brazil.
Method:
this methodological study was developed with 132 informal caregivers of elders who are dependent of help for basic or instrumental activities of daily living, in a capital city in Northeast Brazil. Quality of life measures related to health, anxiety and depression were used in the analysis of the convergent construct validity of the QASCI.
Results:
the results of the instrument construct validation evidenced statistically signifi cant correlations with the three measures. The confi rmatory factor analysis evidenced good adjustment of the theoretical model of seven factors (domains) of the version used in the group studied. Cronbach’s alpha for the scale total was 0.92.
Conclusion:
the Brazilian version of the QASCI was considered to be valid and reliable for assessing the burden of informal elder caregivers.
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06-01-2015
Study of billing audits in a teaching hospital
Revista Brasileira de Enfermagem. 2015;68(3):414-420
Abstract
Study of billing audits in a teaching hospital
Revista Brasileira de Enfermagem. 2015;68(3):414-420
DOI 10.1590/0034-7167.2015680306i
Views0See moreABSTRACT
Objectives:
to determine which component items of hospital bills, examined by nurse auditors, were adjusted the most during pre-analysis; to identify the impact upon revenue caused by the adjustments to bills analyzed by physician and nurse auditors; and to identify disallowances related to items checked by the audit team.
Method:
quantitative, exploratory, descriptive, singlecase study.
Results:
after analysis of 2,613 bills, it was found that the item most included by nurses was gas (90.5%) and the most excluded was inpatient drugs (41.2%). Hemodynamics materials, gases and equipment had the greatest impact on upward adjustments. Downward adjustments were the result of improper entries on bills and did not generate revenue losses. Of total disallowances, 52.24% were related to the pre-analysis of nurses and 47.76% to that of physicians.
Conclusion:
this study of the pre-analysis process provides input that enhances knowledge about hospital bill audits.
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