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ORIGINAL ARTICLE12-16-2024
Health literacy development of Primary Health Care patients: qualitative research
Revista Brasileira de Enfermagem. 2024;77(6):e20240154
Abstract
ORIGINAL ARTICLEHealth literacy development of Primary Health Care patients: qualitative research
Revista Brasileira de Enfermagem. 2024;77(6):e20240154
DOI 10.1590/0034-7167-2024-0154
Views0See moreABSTRACT
Objectives:
to identify the process of health literacy development among primary care patients, relating it to their self-care practices.
Methods:
qualitative, prospective research with 22 patients from two Family Health Strategy units. Data were obtained through individual semi-structured interviews, examined through descriptive statistics and thematic content analysis.
Results:
the results discuss how participants learn about health and how this resonates in their behaviors, culminating in two thematic categories: “Health knowledge construction”; and “Dialogue between health knowledge construction and patient care actions”.
Final Considerations:
health knowledge is developed mainly through interpersonal relationships, mediated by health professionals through bonding and communication. Community educational actions and training of health professionals in communication can promote health literacy and self-care among patients.
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ORIGINAL ARTICLE12-16-2024
Analysis of omission of antimicrobial doses in Intensive Care Units
Revista Brasileira de Enfermagem. 2024;77(6):e20240102
Abstract
ORIGINAL ARTICLEAnalysis of omission of antimicrobial doses in Intensive Care Units
Revista Brasileira de Enfermagem. 2024;77(6):e20240102
DOI 10.1590/0034-7167-2024-0102
Views0See moreABSTRACT
Objectives:
to analyze the rate of antimicrobial dose omission in intensive care units.
Methods:
cross-sectional study carried out between March 1 and September 30, 2023, in intensive care units of a University Hospital in Rio de Janeiro.
Results:
the sample consisted of 452 prescriptions and 1467 antimicrobial doses. The dose omission rate was 4.29%. Each antimicrobial prescribed increased the chance of omission by 51%. The strategy of double-checking prescriptions helped prevent 30% of antimicrobial dose omissions (p=0.0001).
Conclusions:
monitoring the omission of antimicrobial doses can guide nursing actions to improve quality and patient safety, contributing to the prevention of medication errors, antimicrobial stewardship and the fight against antimicrobial resistance.
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REVIEW12-16-2024
Recommendations for guidelines for promoting mental health in the workplace: an umbrella review
Revista Brasileira de Enfermagem. 2024;77(6):e20240086
Abstract
REVIEWRecommendations for guidelines for promoting mental health in the workplace: an umbrella review
Revista Brasileira de Enfermagem. 2024;77(6):e20240086
DOI 10.1590/0034-7167-2024-0086
Views1See moreABSTRACT
Objectives:
to summarize the recommendations of guidelines for promoting mental health in the workplace.
Methods:
an umbrella review, according to Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses methodological assumptions. Data collection was carried out in January 2021 and updated in July 2023 in the American Psychological Association, Cochrane Library, EMBASE, National Library of Medicine, and Scopus databases. Systematic reviews that assessed guidelines with recommendations for mental health care for workers were included. PROSPERO registration CRD42023461845.
Results:
four systematic reviews published between 2015 and 2018 were identified. The abstracts highlighted actions that facilitate and inhibit the recommendations as well as three categories of intervention: primary prevention – worker protection; secondary prevention – promoting workers’ mental health; and tertiary prevention – supporting, monitoring and rehabilitating workers upon returning to work.
Conclusions:
the interventions are based on prevention, promotion and early recognition, support and rehabilitation of mental health problems.
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ORIGINAL ARTICLE12-16-2024
Psychometric analysis of ProQOL-BR in nursing: building hospital safety and protection
Revista Brasileira de Enfermagem. 2024;77(6):e20240085
Abstract
ORIGINAL ARTICLEPsychometric analysis of ProQOL-BR in nursing: building hospital safety and protection
Revista Brasileira de Enfermagem. 2024;77(6):e20240085
DOI 10.1590/0034-7167-2024-0085
Views0See moreABSTRACT
Objectives:
to analyze the psychometric properties of the ProQOL-BR instrument in hospital nursing professionals.
Methods:
a methodological study to validate the ProQOL-BR. Confirmatory factor analysis, assessment of local and global adjustment quality, Pearson hypothesis testing and Cronbach’s alpha internal consistency analysis were used.
Results:
a total of 490 professionals participated. The model presents adequate quality due to factor weights (λ≥ 0.40), acceptable overall fit quality and adequate chi-square ratio and degrees of freedom (χ2/g.1=2.51) for the parameters of CFI (0.923), GFI (0.902), TLI (0.914) and RMSEA (0.042). In terms of validity, it was shown to be adequate with CC=0.89. The internal consistency obtained by standardized Cronbach’s alpha was 0.761. Criterion validity was shown to be favorable with significant correlations (0.001).
Conclusions:
the instrument was validated regarding content, criteria and reliability. Three questions were removed from the original instrument, ProQOL-BR, leaving the final instrument with 25 questions.
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12-16-2024
GerenciaDOR™: development of digital technology by nurses for the assessment of patients with chronic pain
Revista Brasileira de Enfermagem. 2024;77(6):e20240050
Abstract
GerenciaDOR™: development of digital technology by nurses for the assessment of patients with chronic pain
Revista Brasileira de Enfermagem. 2024;77(6):e20240050
DOI 10.1590/0034-7167-2024-0050
Views0See moreABSTRACT
Objectives:
to develop a digital technological solution (prototype) for assessing patients with chronic pain.
Methods:
this is a methodological and technological development study based on the Human-Centered Design framework and the principles of Patient-Centered Care. The prototype guides patients through a body diagram and directs them to an evaluation using specific instruments that address the multidimensional aspects of chronic pain.
Results:
the GerenciaDOR* project enables navigation through the Web App screens, providing access to pain assessment features up to the presentation of results.
Final Considerations:
the study describes a systematic approach to pain assessment and expands nurses’ knowledge in pain management. Additionally, it can promote the development of other digital technologies for chronic pain assessment and contribute to a multidisciplinary, patient centered treatment.
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ORIGINAL ARTICLE12-16-2024
Respectful care for postpartum women with sickle cell disease: a netnographic study
Revista Brasileira de Enfermagem. 2024;77(6):e20230545
Abstract
ORIGINAL ARTICLERespectful care for postpartum women with sickle cell disease: a netnographic study
Revista Brasileira de Enfermagem. 2024;77(6):e20230545
DOI 10.1590/0034-7167-2023-0545
Views0See moreABSTRACT
Objectives:
to analyze principles of respectful maternity care in narratives of postpartum women with sickle cell disease, relating them to Sustainable Development Goals.
Methods:
netnographic study, with two videos published in 2020. Deductive iconographic and thematic analysis by Respectful Maternity Care Charter, organized in MAXQDA.
Results:
principles identified were the right to: freedom from harm and ill-treatment; information, informed consent, refusal of medical procedures, and respect for their choices and preferences including companion; be considered a person from birth, with dignified and respectful treatment; health at the highest possible level; newborns being with their parents or guardians. The Sustainable Development Goals for women by 2030 were not positively contemplated in postpartum women’s experience.
Final Considerations:
it is appropriate that health workers qualify themselves to provide respectful maternity care, with qualified listening, understanding, and resolution of unique demands of postpartum women with sickle cell disease, seeking equality in care for women.
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ORIGINAL ARTICLE12-16-2024
Construction and validation of an educational game on biosafety in the central sterile supply department
Revista Brasileira de Enfermagem. 2024;77(6):e20230478
Abstract
ORIGINAL ARTICLEConstruction and validation of an educational game on biosafety in the central sterile supply department
Revista Brasileira de Enfermagem. 2024;77(6):e20230478
DOI 10.1590/0034-7167-2023-0478
Views0See moreABSTRACT
Objectives:
to construct and validate an educational game on biosafety in the Central Sterile Supply Department of a hospital in Curitiba, PR.
Methods:
the study was conducted using a quantitative approach, employing applied and technological research with an exploratory design. The process was divided into six stages, from the definition of the theme to the validation and application of the game. The study was carried out from May to August 2022, involving 17 nursing professionals from a Central Sterile Supply Department during day and night shifts, as well as 9 judges.
Results:
the study resulted in the construction of a board game named by the authors as “My Health First.”
Conclusions:
the research achieved its objective of constructing and validating an educational game. By reflecting on professional practice and correlating the occupational risks present, the professionals were able to list safe actions, identify problems, and seek solutions.
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ORIGINAL ARTICLE12-16-2024
Training profile of intensive care nurses in Brazil: cross-sectional study
Revista Brasileira de Enfermagem. 2024;77(6):e20230460
Abstract
ORIGINAL ARTICLETraining profile of intensive care nurses in Brazil: cross-sectional study
Revista Brasileira de Enfermagem. 2024;77(6):e20230460
DOI 10.1590/0034-7167-2023-0460
Views0See moreABSTRACT
Objectives:
to describe the training profile of Brazilian intensive care nurses.
Methods:
a cross-sectional study carried out in two stages: a structured, self-administered questionnaire; mapping of the national supply of lato sensu postgraduate courses. Data was collected on the sociodemographic profile, training process and characterization of the courses.
Results:
in the first stage, 202 respondents were obtained. The majority were women (79.2%), aged between 26 and 45 (80.7%), graduated less than 5 years ago (44%), through lato sensu postgraduate courses (55.5%), which were marked by the absence of laboratory practice (57.5%) and guided tours (42.5%). In the second stage, 457 courses were identified, with face-to-face teaching (58.9%), a workload of 360 to 420 hours (51.2%), a duration of up to 6 months (41.8%) and variation in the sub-area of training.
Conclusions:
there was a predominance of professionals graduating from lato sensu post-graduate courses, with essentially theoretical teaching and heterogeneity in terms of modality, workload and sub-area of training.
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01-01-2016
Public actions for control of breast cancer in Brazil: integrative review
Revista Brasileira de Enfermagem. 2016;69(4):793-803
Abstract
Public actions for control of breast cancer in Brazil: integrative review
Revista Brasileira de Enfermagem. 2016;69(4):793-803
DOI 10.1590/0034-7167.2016690424i
Views0See moreABSTRACT
Objective:
to analyze the scientific production on “breast cancer” in the period from 2002 to 2013 and determine the public policies for screening and early diagnosis of breast cancer.
Method:
this is an integrative literature review conducted in the databases MEDLINE, LILACS, SciELO and Google Scholar. Inclusion criteria: year and period of publication; availability of the full article; publication in Brazil; and the cross-check of the keywords Breast Cancer, Primary Health Care, Screening Programs, and Early Detection of Cancer.
Results:
after analysis, four thematic categories were obtained: breast self-examination, clinical examination of breast, mammography, and factors that hinder the adherence to the screening.
Conclusion:
health professionals have deficits of knowledge on the area, indicating the need for other studies on the subject addressed and greater investment in continuing education of professionals.
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01-01-2016
Nursing diagnoses in patients with cerebral vascular accident: an integrative review
Revista Brasileira de Enfermagem. 2016;69(4):785-792
Abstract
Nursing diagnoses in patients with cerebral vascular accident: an integrative review
Revista Brasileira de Enfermagem. 2016;69(4):785-792
DOI 10.1590/0034-7167.2016690423i
Views0See moreABSTRACT
Objective:
to verify the nursing diagnoses in patients affected by CVAs.
Method:
this is an integrative review of the literature. The search was conducted on LILACS, Scielo, Medline, CINAHL, and Scopus databases between February and March 2015, using the following keywords: “Enfermagem”, “Acidente Vascular Cerebral”, “Diagnóstico de Enfermagem”; and “Nursing”, “Stroke”, and “Nursing Diagnosis”.
Results:
we found 9 articles published between 2009 and 2015; most of them were Brazilian, cross-sectional, and exploratory, with a level of evidence of 6. The evidence from the publications was classified as: “Evaluation and validation of specific nursing diagnoses for subjects affected by CVAs” and “Application of the nursing process on subjects affected by CVAs”.
Conclusion:
we noticed the publications focused on nursing diagnoses related to motor disorders, such as risk of falls and impaired physical mobility. Domains regarding safety/protection (domain 11) and sleep/resting (domain 4) were present in most evaluated publications.
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01-01-2016
Impact of educational interventions in reducing diabetic complications: a systematic review
Revista Brasileira de Enfermagem. 2016;69(4):773-784
Abstract
Impact of educational interventions in reducing diabetic complications: a systematic review
Revista Brasileira de Enfermagem. 2016;69(4):773-784
DOI 10.1590/0034-7167.2016690422i
Views0See moreABSTRACT
Objective:
To identify in the literature evidence of the effectiveness and efficacy of educational interventions in reducing metabolic and/or vascular complications in adults with diabetes mellitus.
Method:
A systematic review performed in LILACS, IBECS, CUMED, CINAHL and Medline databases and in the online library SciELO with studies published from 2004 to 2014.
Results:
Eleven studies were included (5 randomized clinical trials and 6 quasi-experimental). We only identified studies that analyzed vascular complications.
Conclusion:
Two clinical trials demonstrated efficacy in reducing cardiovascular complications, of cataract or retinopathy and nephropathy and all the quasi-experimental studies showed effectiveness in reducing feet ulcers, peripheral neuropathy and vasculopathy, and maintenance of kidney function.
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01-01-2016
The communication process in Telenursing: integrative review
Revista Brasileira de Enfermagem. 2016;69(4):765-772
Abstract
The communication process in Telenursing: integrative review
Revista Brasileira de Enfermagem. 2016;69(4):765-772
DOI 10.1590/0034-7167.2016690421i
Views0See moreABSTRACT
Objective:
to identify scientific evidence about the communication process in Telenursing and analyze them.
Method:
integrative review performed in March 2014. The search strategy, structured with the descriptors “telenursing” and “communication”, was implemented in the databases Medline, Bireme, Cinahl, Scopus, Web of Science, Scielo, and Cochrane.
Results:
ten studies were selected after inclusion and exclusion criteria. The main challenges were: the clinical condition of patients, the possibility for inadequate communication to cause misconduct, the absence of visual references in interactions without video, and difficulty understanding nonverbal communication.
Conclusion:
distance imposes communicative barriers in all elements: sender, recipient and message; and in both ways of transmission, verbal and nonverbal. The main difficulty is to understand nonverbal communication. To properly behave in this context, nurses must receive specific training to develop abilities and communication skills.
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01-01-2016
Health care for patients with acute coronary syndrome according to quality indicators
Revista Brasileira de Enfermagem. 2016;69(4):757-764
Abstract
Health care for patients with acute coronary syndrome according to quality indicators
Revista Brasileira de Enfermagem. 2016;69(4):757-764
DOI 10.1590/0034-7167.2016690420i
Views0See moreABSTRACT
Objective:
to assess in-hospital care for patients with Acute Coronary Syndrome according to quality indicators.
Method:
a longitudinal quantitative study was performed between November 2012 and March 2013 with 94 patients, including interviews and medical records.
Results:
a total of 39.4% of patients had unstable angina and 60.6% had myocardial infarction, of which 34% had ST segment elevation. Patients with TIMI and GRACE scores higher than four and 140 (p<0.05) respectively died. Admission to the intensive care unit totaled 2.1%; assessment of left ventricular (LV) ejection fraction, 83.0%; ASA within 24 hours of admission, 77.8%; statins, 72.7%; angiotensin-converting enzyme inhibitor, 62.8%; anti-smoking counseling, 53.3%; and timely reperfusion, 62.5%. Of all participants, 12.0% underwent an invasive strategy in 24h and 50.0% in 72h. Door-to-ECG time was 68.3±104.3 min and door-to-balloon time, 122±54.5 min.
Conclusions:
health care protocols are required to standardize practice and improve these indicators.
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01-01-2016
Quality of working life of call-center workers
Revista Brasileira de Enfermagem. 2016;69(4):751-756
Abstract
Quality of working life of call-center workers
Revista Brasileira de Enfermagem. 2016;69(4):751-756
DOI 10.1590/0034-7167.2016690419i
Views0See moreABSTRACT
Objective:
to analyze the profile and quality of working life (QWL) of call-center workers.
Method:
quantitative research, conducted in one call-center of the city of São José do Rio Preto – SP, using the QVP-35 questionnaire.
Results:
profile was composed by: 80.2% women; 66.3% were single, with high school diploma and 6 hours of daily working hours; mean age of 28 years; 92.9% had only one job with mean working experience of 3 years. Positive aspects of QWL: intrinsic motivation, working ability, available resources and social support. Negative aspects of QWL: workload and organizational support.
Conclusion:
the data obtained indicate the need for better organization of call-center working processes in the company and suggests other researches in this context.
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01-01-2016
Stressors perceived by patients in the immediate postoperative of cardiac surgery
Revista Brasileira de Enfermagem. 2016;69(4):741-750
Abstract
Stressors perceived by patients in the immediate postoperative of cardiac surgery
Revista Brasileira de Enfermagem. 2016;69(4):741-750
DOI 10.1590/0034-7167.2016690418i
Views0See moreABSTRACT
Objective:
to investigate stressors perceived by patients in the immediate postoperative of cardiac surgery and their association with sociodemographic and clinical characteristics.
Method:
a prospective correlational study conducted in a city in São Paulo, between August 2013 and December 2014. A non-probabilistic sample included patients submitted to their first coronary artery bypass graft or mitral valve surgery. The “Environmental Stressor Questionnaire” adapted to Portuguese was used.
Results:
105 patients participated in the study. The item “being thirsty” was evaluated as the most stressful and “the nursing staff member does not introduce himself/herself by the name” as the least stressful. Among sociodemographic and clinical variables (gender, age, type and time of surgery, pain, intubation time, use of psychotropic medications and length of stay in the intensive care unit), only pain presented a significant association with the stressors.
Conclusion:
knowing stressors can help implement practices associated with their reduction, favoring patients’ recovery.
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01-01-2016
Concepts and practices of teaching and exercise of leadership in Nursing
Revista Brasileira de Enfermagem. 2016;69(4):733-740
Abstract
Concepts and practices of teaching and exercise of leadership in Nursing
Revista Brasileira de Enfermagem. 2016;69(4):733-740
DOI 10.1590/0034-7167.2016690417i
Views0See moreABSTRACT
Objective:
to identify, describe and analyze characteristics of leadership, head nurses and participants in the teaching-learning process of leadership in Nursing, according to nurse professors who performed studies on this theme and taught such content between 1972 and 1994 in nursing schools of the state of São Paulo, southeastern Brazil.
Methods:
Thematic Oral History was used. A total of four nurse professors were interviewed, whose reports were submitted to content analysis.
Results:
the following aspects were approached in this study: the context in which students developed leadership, the influence of previous experiences on leadership qualification, its attributes, the importance of leadership, the value of teaching it, the possibilities of emancipation of a head nurse, the repercussions of teaching leadership for one’s professional life, the relationships between qualification and job market, the aspects of teaching qualification and students’ characteristics.
Conclusion:
although not essential for nursing qualification, leadership had a symbolic capital.
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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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