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ORIGINAL ARTICLE03-27-2023
Prevalence of characteristics associated with sarcopenia in elders: a cross-sectional study
Revista Brasileira de Enfermagem. 2023;76(2):e20220209
Abstract
ORIGINAL ARTICLEPrevalence of characteristics associated with sarcopenia in elders: a cross-sectional study
Revista Brasileira de Enfermagem. 2023;76(2):e20220209
DOI 10.1590/0034-7167-2022-0209
Views0See moreABSTRACT
Objectives:
to identify the prevalence and characteristics associated with sarcopenia in elders in Primary Health Care Units.
Methods:
cross-sectional study with 384 elders. To evaluate sarcopenia, we measured: strength and muscle mass, and physical performance. The elderly were classified as having: probable sarcopenia; sarcopenia; or severe sarcopenia. The chi-squared test and the multinomial logistic regression method were used.
Results:
the prevalence of probable sarcopenia was 25.52%; of sarcopenia, 11.98%; and of severe sarcopenia, 9.90%. Probable sarcopenia is 1.75 times more prevalent in men; osteoporosis is 2.16 times more prevalent in people with severe sarcopenia; polypharmacy is 1.57 times more likely in individuals with probable sarcopenia; and calf circumference below 31 cm is 2.24 times more likely in patients with sarcopenia and 2.19 times more likely in patients with severe sarcopenia.
Conclusions:
the highest prevalence was of probable sarcopenia, and the characteristics associated with sarcopenia were sex, osteoporosis, polypharmacy, overweight, obesity, and calf circumference.
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ORIGINAL ARTICLE03-27-2023
RESVECH 2.0: cross-cultural adaptation for Brazil, reliability and validity for the evaluation of venous ulcers
Revista Brasileira de Enfermagem. 2023;76(2):e20220185
Abstract
ORIGINAL ARTICLERESVECH 2.0: cross-cultural adaptation for Brazil, reliability and validity for the evaluation of venous ulcers
Revista Brasileira de Enfermagem. 2023;76(2):e20220185
DOI 10.1590/0034-7167-2022-0185
Views0See moreABSTRACT
Objectives:
to cross-culturally adapt the scale Resultados en la valoración y evolución de la cicatrización de las heridas – RESVECH 2.0 for Brazilian Portuguese; to estimate the internal consistency and construct and criterion validity of the scale in the evaluation of venous ulcers.
Methods:
methodological study, based on international guidelines for studies of this type. Wounds were evaluated using the RESVECH 2.0 and Pressure Ulcer Scale of Healing 3.0 (PUSH). Descriptive analysis, confirmatory factor analysis, Cronbach’s alpha and Spearman’s correlation (p<0.05) were used.
Results:
12 nurses and 77 people with 153 venous ulcers participated in the study. The translation was successful, the proposed factor model was validated, and Cronbach ‘s alpha = 0.832 (95%CI, 0.780-0.880) and correlation coefficient (RESVECH 2.0 and PUSH 3.0) = 0.74 were obtained.
Conclusions:
the adaptation of RESVECH 2.0 to Brazilian Portuguese is robust. Reliability and validity show compatibility for use in the country in the evaluation of venous ulcers.
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ORIGINAL ARTICLE03-17-2023
Characteristics of work in primary care identified in the collective exercise of application of the SWOT matrix
Revista Brasileira de Enfermagem. 2023;76(2):e20220443
Abstract
ORIGINAL ARTICLECharacteristics of work in primary care identified in the collective exercise of application of the SWOT matrix
Revista Brasileira de Enfermagem. 2023;76(2):e20220443
DOI 10.1590/0034-7167-2022-0443
Views0See moreABSTRACT
Objective:
to understand how variables strengths, weaknesses, opportunities and threats make it possible to characterize work in Primary Health Care, to collectively propose strategies for systematizing this process with Family Health teams.
Methods:
methodological research, with 23 participants in direct relationship with Primary Care, including representatives of segments: care (work), management and social control. In one of the three pedagogical meetings, the SWOT matrix was used as a tool for organizational work planning.
Results:
applying the matrix resulted in the following thematic categories: Teamwork and regulations: key elements for interprofessionality at work; Continuing Health Education: path to autonomy and participatory management (co-management).
Final considerations:
the study promoted the systematization of teams’ work, through the mobilization of sectors and distribution of tasks, involving professionals in the co-management of the process.
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ORIGINAL ARTICLE03-17-2023
Production and validation of an educational video on the use of the Z-Track Technique
Revista Brasileira de Enfermagem. 2023;76(2):e20220439
Abstract
ORIGINAL ARTICLEProduction and validation of an educational video on the use of the Z-Track Technique
Revista Brasileira de Enfermagem. 2023;76(2):e20220439
DOI 10.1590/0034-7167-2022-0439
Views0ABSTRACT
Objective:
to create and validate an educational video on intramuscular drug administration using the Z-track technique.
Methods:
the Delphi Technique was used to validate the script. PhDs in Nursing and PhDs in Social Communication with experience in the production of educational videos participated in the process. After editing, the video was validated by three nursing professors and assessed by students of the undergraduate nursing program at a public university.
Results:
the video was validated by the examiners with 100% agreement in three rounds for script validation and in two for video validation after editing. The duration of the video was 9 minutes.
Conclusion:
after validation by the examiners, students assessed the video and considered it suitable for learning. We This video is expected to aid in the training of nursing professionals and the enhancement of patient care.
Keywords:EducationInjectionsInstructional Film and VideoIntramuscularNursingValidation StudyVideo-Audio MediaSee more -
ORIGINAL ARTICLE03-17-2023
Professional autonomy in dealing with complications: discourse of obstetric nurses working in planned home births
Revista Brasileira de Enfermagem. 2023;76(2):e20220388
Abstract
ORIGINAL ARTICLEProfessional autonomy in dealing with complications: discourse of obstetric nurses working in planned home births
Revista Brasileira de Enfermagem. 2023;76(2):e20220388
DOI 10.1590/0034-7167-2022-0388
Views0See moreABSTRACT
Objective:
to understand the exercise of professional autonomy by obstetric nurses in dealing with complications in planned home births.
Methods:
this is a qualitative study, supported by the Discourse of the Collective Subject methodological framework, whose data collection took place from January to March 2021, through interviews guided by a semi-structured script, in which seven midwives who are members of a childbirth care collective in northeastern Brazil and who work in the home context participated.
Results:
four central ideas emerged from the collective discourses related to the exercise of professional autonomy by obstetric nurses: shared decisions; theoretical-practical instrumentalization; professional expertise; and teamwork.
Final considerations:
obstetric nurses’ autonomy in the face of complications reflects the safety of planned home births and is based on collective critical thinking, reinforcing this professional’ leading role in obstetrics.
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ORIGINAL ARTICLE03-17-2023
Features of the triggering of the yellow code and factors associated with the occurrence of adverse events
Revista Brasileira de Enfermagem. 2023;76(2):e20220181
Abstract
ORIGINAL ARTICLEFeatures of the triggering of the yellow code and factors associated with the occurrence of adverse events
Revista Brasileira de Enfermagem. 2023;76(2):e20220181
DOI 10.1590/0034-7167-2022-0181
Views0See moreABSTRACT
Objective:
to analyze the characteristics of the activation of the yellow code in wards and identify the factors associated with adverse events after the Rapid Response Team.
Methods:
a cross-sectional study with retrospective analysis of medical records of adults admitted to medical or surgical clinic wards of the University Hospital of São Paulo.
Results:
among the 91 patients, the most frequent signs of triggers (n=107) were peripheral oxygen saturation of less than 90% (40.2%) and hypotension (30.8%). Regarding the associated factors the research identified each minute of attendance of the Rapid Response Team in the wards increased by 1.2% odds of adverse events (twenty-four unplanned admission in the ICU and one cardiac arrest) in the sample (p=0.014).
Conclusions:
decreased oxygen saturation and hypotension were the main reasons for the triggering, and the length of care was associated with the frequency of adverse events.
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ORIGINAL ARTICLE03-06-2023
The self-care process of community-dwelling older adults during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76:e20220644
Abstract
ORIGINAL ARTICLEThe self-care process of community-dwelling older adults during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76:e20220644
DOI 10.1590/0034-7167-2022-0644
Views0See moreABSTRACT
Objectives:
to understand the self-care process of community-dwelling older adults during the COVID-19 pandemic.
Methods:
this is an explanatory study with a qualitative approach based on the constructivist Grounded Theory, carried out with 18 community-dwelling older adults. Data collection took place through interviews and content was analyzed through initial and focused coding.
Results:
two categories were obtained: “Building connections to support self-care practices” and “Living with the risk group stigma”. From their interaction, the phenomenon “Performing self-care in old age during the COVID-19 pandemic” emerged.
Final Considerations:
it was possible to identify how older adults’ experiences curing the COVID-19 pandemic had repercussions on their self-care process, being influenced by factors such as information about the disease and the impacts of risk group stigmas.
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RESEARCH01-01-2016
Pressure ulcer healing with Plenusdermax® Calendula officinalis L. extract
Revista Brasileira de Enfermagem. 2016;69(2):250-257
Abstract
RESEARCHPressure ulcer healing with Plenusdermax® Calendula officinalis L. extract
Revista Brasileira de Enfermagem. 2016;69(2):250-257
DOI 10.1590/0034-7167.2016690207i
Views0See moreABSTRACT
Objective:
to evaluate the therapeutic benefits of the bioactive extracts of Plenusdermax®Calendula officinalis for pressure ulcer healing.
Method:
an observational cohort study, including 41 patients with a diagnosis of pressure ulcer that was stable in size for more than three months. Patients were evaluated every two weeks, over 30 weeks, for: reduction of the wound area, infection control, types of tissue and exudate, and ulcer microbiology.
Results:
the proportions of patients who were completely healed after 15 and 30 weeks of treatment were 63% and 88%, respectively, and the mean healing time was 12.5±7.8 weeks. No adverse events were observed during treatment.
Conclusion:
the results of the study indicate that bioactive C. officinalis Plenusdermax® is a safe treatment that promotes healing of pressure ulcers.
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RESEARCH01-01-2016
Quality of life assessment for health promotion groups
Revista Brasileira de Enfermagem. 2016;69(2):242-249
Abstract
RESEARCHQuality of life assessment for health promotion groups
Revista Brasileira de Enfermagem. 2016;69(2):242-249
DOI 10.1590/0034-7167.2016690206i
Views0See moreABSTRACT
Objective:
to analyze the use of quality of life assessment (QOL) as a strategy to evaluate the work with health promotion groups in the community.
Method:
cross-sectional, descriptive and analytical study. Participants of two elderly groups (n=46) were individually interviewed to fill the sociodemographic instruments, WHOQOL-BREF and WHOQOL-OLD.
Results:
the participants were women with up to 79 years, who did not live with a partner, with up to four years of study, retired, with individual income of up to a minimum salary. The mean scores on the WHOQOL-BREF were higher on “Social Relations” and lower in the “Environment”. For the WHOQOL-OLD, the highest scores were achieved in facets “Social Participation” (G1) and “Past, Present and Future Activities” (G2), while “Death and Dying” facet obtained lower scores in both groups.
Conclusion:
the assessment of QOL appears to be useful in helping to identify the coordination aspects of life of elderly people that need to be better developed in groups.
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RESEARCH01-01-2016
Transcultural adaptation and validation of the Brazilian version of Treatment Spirituality/Religiosity Scale
Revista Brasileira de Enfermagem. 2016;69(2):235-241
Abstract
RESEARCHTranscultural adaptation and validation of the Brazilian version of Treatment Spirituality/Religiosity Scale
Revista Brasileira de Enfermagem. 2016;69(2):235-241
DOI 10.1590/0034-7167.2016690205i
Views0See moreABSTRACT
Objective:
to perform the translation and transcultural adaptation to Brazilian Portuguese, and analyze the psychometric properties of the instrument Treatment Spirituality/Religiosity Scale (TSRS).
Method:
the sample consisted of 188 nursing students of technical and higher education. The reliability analysis by test-retest was performed one month after the first application of the instrument. To measure the construct validation, a factorial analysis was carried out.
Results:
the Brazilian version of the TSRS consisted of 10 items, with two factors. The reliability by test-retest showed a Kappa coefficient ranging from 0.22 to 0.47, and a global internal consistency Cronbach’s alpha of 0.85.
Conclusion:
the Brazilian version of the TSRS showed satisfactory values of validity and internal consistency, being suitable for use in the national context.
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RESEARCH01-01-2016
Epidemiological characteristics and causes of deaths in hospitalized patients under intensive care
Revista Brasileira de Enfermagem. 2016;69(2):229-234
Abstract
RESEARCHEpidemiological characteristics and causes of deaths in hospitalized patients under intensive care
Revista Brasileira de Enfermagem. 2016;69(2):229-234
DOI 10.1590/0034-7167.2016690204i
Views0ABSTRACT
Objective:
to describe the epidemiological and sociodemographic characteristics of patients hospitalized in an ICU.
Method:
an epidemiological, descriptive and retrospective study. Population: 695 patients admitted from January to December 2011. The data collected were statistically analyzed with both absolute and relative frequency distribution.
Results:
61.6% of the patients are male, aged 40 to 69 years, and most of them came from the surgery rooms. The most frequent reason for admission was diseases of the circulatory system (23.3%). At discharge from the ICU, 72.4% of the patients were sent to other units of the same institution, 31.1% to the intermediate care unit, and 20.4% died, of which 24.6% from diseases of the circulatory system. The afternoon shift had 45.8% of the admissions and 53.3% of the discharges.
Conclusion:
the description of the sociodemographic and epidemiological features guides the planning of nursing actions, providing a better quality service.
Keywords:Critical CareDescriptive EpidemiologyIntensive Care UnitMorbidityMortality IndicatorsNursingSee more -
RESEARCH01-01-2016
Hospital discharge of premature newborns: the father’s experience
Revista Brasileira de Enfermagem. 2016;69(2):221-228
Abstract
RESEARCHHospital discharge of premature newborns: the father’s experience
Revista Brasileira de Enfermagem. 2016;69(2):221-228
DOI 10.1590/0034-7167.2016690203i
Views0See moreABSTRACT
Objective:
To describe the father’s experience with his premature child discharge of the Neonatal Intensive-Care Unit and to point out interventions to promote this experience.
Method:
Qualitative research with eight fathers, adopting the Symbolic Interactionism as theoretical reference and thematic narrative research as methodological frame.
Results:
The analysis of data has allowed us to describe the experience of the father from three thematic units: “fatherhood boundaries”, “high responsibility for the child” and “social network and support”.
Conclusion:
The father feels insecure with the idea of taking care of his child at home because of the lack of professional support and the initial contact with the child in the Neonatal Intensive-Care Unit.
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RESEARCH01-01-2016
Nurses from the Mobile Emergency Service: profile and developed activities
Revista Brasileira de Enfermagem. 2016;69(2):213-220
Abstract
RESEARCHNurses from the Mobile Emergency Service: profile and developed activities
Revista Brasileira de Enfermagem. 2016;69(2):213-220
DOI 10.1590/0034-7167.2016690202i
Views0See moreABSTRACT
Objective:
to characterize the profile and identify the activities developed by nurses from the Mobile Emergency Care Service of a state of southern Brazil.
Method:
an exploratory, descriptive study. Data were collected through a questionnaire with 63 nurses.
Results:
the profile showed a workforce predominantly female, young and having specialized training. The activities were organized in the dimensions of caring, managing and educating, verifying the predominance of the first one. Care actions involved multiple procedures, but the use of the Systematization of Nursing Care (SNC) was not mentioned in the development of care activities. Then, the managerial dimension with a predominance of bureaucratic activities was emphasized. Educational activities were less prominent.
Conclusion:
care actions are the focus of the activities of nurses, predominantly the prescribed institutional care without the use of instruments such as SNC that could contribute to the greater visibility of their professional work.
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EDITORIAL01-01-2016
Challenges and leadership imperatives in cooperation with the World Health Organization
Revista Brasileira de Enfermagem. 2016;69(2):207-208
Abstract
EDITORIALChallenges and leadership imperatives in cooperation with the World Health Organization
Revista Brasileira de Enfermagem. 2016;69(2):207-208
DOI 10.1590/0034-7167.2016690201i
Views0When an institution promotes strategic innovations, it starts the rupture with tradition, causing changes and, consequently, altering the expectations and prospects of both their internal clients, as their external clients.The engines of the adopted innovations are driven by a broader view of the organization’s purposes, expanding its borders in terms of breadth and depth, which […]See more -
EDITORIAL01-01-2016
Desafios e imperativos de liderança na cooperação com a Organização Mundial da Saúde
Revista Brasileira de Enfermagem. 2016;69(2):207-208
Abstract
EDITORIALDesafios e imperativos de liderança na cooperação com a Organização Mundial da Saúde
Revista Brasileira de Enfermagem. 2016;69(2):207-208
DOI 10.1590/0034-7167.2016690201i
Views0Quando uma instituição promove inovações estratégicas, é colocado em curso o rompimento com a tradição, provocando mudanças e, por consequência, alterando as expectativas e as perspectivas tanto dos seus clientes internos, quanto dos seus clientes externos.Os motores das inovações adotadas são acionados por uma visão ampliada dos fins da organização, alargando suas fronteiras em termos […]See more
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ERRATUM01-13-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e08
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e08
DOI 10.1590/0034-7167.20247706e08
Views0In the article “Brazilian nursing specific situation, middle and micro-range theories: a bibliometric study”, with DOI number: , published in Revista Brasileira de Enfermagem, 2024;77(4):e20230520, Chart 1:Where it read:[…]See more -
ERRATUM01-13-2024
ERRATA
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e07
Abstract
ERRATUMERRATA
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e07
DOI 10.1590/0034-7167.20247706e06pt
Views0No artigo “Crenças e atitudes de pais ou responsáveis legais sobre a vacinação infantil: revisão de escopo”, com número DOI: , publicado no periódico Revista Brasileira de Enfermagem, 2024;77(4):e20240126, página 5:Onde se lia:[…]See more -
ORIGINAL ARTICLE01-13-2024
Indicators associated with severity and mortality in hospitalized people with HIV: A retrospective cohort
Revista Brasileira de Enfermagem. 2024;77(6):e20240204
Abstract
ORIGINAL ARTICLEIndicators associated with severity and mortality in hospitalized people with HIV: A retrospective cohort
Revista Brasileira de Enfermagem. 2024;77(6):e20240204
DOI 10.1590/0034-7167-2024-0204
Views0See moreABSTRACT
Objectives:
to compare the sociodemographic and clinical severity indicators of hospitalized people with HIV in relation to clinical outcomes and urgent hospital admission.
Methods:
a retrospective cohort study was conducted with 102 medical records of HIV-infected individuals hospitalized in a hospital in southern Brazil. In addition to descriptive analysis, Fisher’s exact test, Pearson’s Chi-square, and logistic regression were used.
Results:
the data showed a significant direct effect on severity indicators in the following variables: male sex (p=0.013), skin color (p=0.023), level of education (p=0.000), urgent admissions (p=0.000), late diagnosis (p=0.001), diabetes mellitus (p=0.001), hypertension (p=0.004), kidney disease (p=0.002), high viral load (p=0.006), CD4+ count below 200 (p=0.005), fever (p=0.016), weight loss (p=0.013), co-infection with hepatitis C (p=0.004), and mortality (p=0.007).
Conclusions:
three sociodemographic and thirteen clinical markers were identified as being associated with the risk of clinical deterioration in hospitalized people with HIV.
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ORIGINAL ARTICLE01-13-2024
Nurses’ perspectives on the use of telemonitoring in the management of people with diabetes and hypertension
Revista Brasileira de Enfermagem. 2024;77(6):e20230481
Abstract
ORIGINAL ARTICLENurses’ perspectives on the use of telemonitoring in the management of people with diabetes and hypertension
Revista Brasileira de Enfermagem. 2024;77(6):e20230481
DOI 10.1590/0034-7167-2023-0481
Views1See moreABSTRACT
Objectives:
to understand the perspective of nurses on the use of telemonitoring in the management of people with type 2 diabetes mellitus and arterial hypertension in primary care.
Methods:
this qualitative research involved sixteen nurses from eight municipalities in Paraná. Data were collected between November 2022 and January 2023 through inperson or remote interviews, which were audio-recorded and subjected to content analysis.
Results:
according to the nurses, telemonitoring enhances users’ knowledge about these conditions, communication and connection with the team, and productivity. However, the lack of electronic resources and equipment, high staff turnover, low user adherence, and the limited availability of professional time present significant challenges.
Final Considerations:
the effective implementation and operation of telemonitoring in the management of people with diabetes and hypertension involve both potential benefits and barriers. It is essential to have the availability of human and technological resources, managerial support, and the commitment of professionals and users.
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ORIGINAL ARTICLE01-13-2024
Knowledge, Attitudes, and Practices of nurses regarding blood culture collection
Revista Brasileira de Enfermagem. 2024;77(6):e20230424
Abstract
ORIGINAL ARTICLEKnowledge, Attitudes, and Practices of nurses regarding blood culture collection
Revista Brasileira de Enfermagem. 2024;77(6):e20230424
DOI 10.1590/0034-7167-2023-0424
Views0ABSTRACT
Objectives:
to investigate the knowledge, attitudes, and practices of nurses regarding blood culture collection.
Methods:
a cross-sectional study was conducted in five Brazilian public hospitals with 112 nurses. Data were collected using an adapted questionnaire and analyzed through descriptive and inferential statistics.
Results:
nurses who did not consider themselves capable of collecting blood cultures had a 72% lower chance of performing the collection at the recommended site and an 83% lower chance of using the same needle for blood inoculation into the vials. Nurses working in the emergency department had a 75% lower chance of knowing the international benchmark for blood culture contamination rates, and those with less than 5 years in the position decreased their chance of accuracy in this matter by 79%.
Conclusions:
there are gaps in the knowledge, attitudes, and practices of nurses regarding blood culture collection. Standardization of the technique, periodic education, supervision and guidance of the collection team, and process auditing are recommended coping strategies.
Keywords:Blood CultureBlood Specimen CollectionHealth Knowledge, Attitudes, PracticeNursing CareQuality of Health CareSee more -
ORIGINAL ARTICLE01-13-2024
Evaluation of care for people with HIV in Primary Health Care: construct validation
Revista Brasileira de Enfermagem. 2024;77(6):e20230190
Abstract
ORIGINAL ARTICLEEvaluation of care for people with HIV in Primary Health Care: construct validation
Revista Brasileira de Enfermagem. 2024;77(6):e20230190
DOI 10.1590/0034-7167-2023-0190
Views0ABSTRACT
Objectives:
to verify the construct validation of an instrument for evaluating care for people living with HIV in Primary Health Care.
Methods:
methodological study carried out in 2021 with 260 health professionals in Recife, PE. Validation based on the internal structure was carried out at this stage using exploratory and confirmatory factor analysis, and validity based on item response theory.
Results:
the validation determined the retention of five factors and 63 items. The instrument’s internal consistency and quality of fit was 0.90, the Tukey-Lewis index was 0.915 and the comparative fit index was 0.918 in the confirmatory factor analysis. The indication for the absolute majority of items is adequate fit.
Conclusions:
the instrument has construct validity, making it possible to use it to evaluate the decentralization process and care for People Living with HIV in Primary Health Care.
Keywords:Acquired Immunodeficiency SyndromeComprehensive Health CareHIVPrimary Health CareProgram EvaluationSee more -
ORIGINAL ARTICLE01-10-2024
Inventory of ethical problems in mobile pre-hospital care
Revista Brasileira de Enfermagem. 2024;77:e20230539
Abstract
ORIGINAL ARTICLEInventory of ethical problems in mobile pre-hospital care
Revista Brasileira de Enfermagem. 2024;77:e20230539
DOI 10.1590/0034-7167-2023-0539
Views0See moreABSTRACT
Objective:
to construct and validate the content of an inventory of ethical problems experienced by nurses in mobile pre-hospital care.
Method:
a psychometric approach study, developed with the following stages: (1) instrument construction through a theoretical matrix based on deliberative bioethics, scoping review and online qualitative research; (2) content validity by judges; (3) pre-testing with Mobile Emergency Care Service nurses in various Brazilian states. For content validity analysis, the Content Validity Ratio was calculated (CVR>0.45 for judges and CVR>0.35 for the target population).
Results:
the instrument had 44 items, distributed across four dimensions.
Final considerations:
the constructed instrument presented sources of evidence of content validity, providing good psychometric measurements and constituting a useful tool for nurses’ practice in the pre-hospital setting.
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