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01-01-2015
Risk classification in pediatrics: development and validation of a guide for nurses
Revista Brasileira de Enfermagem. 2015;68(5):913-922
Abstract
Risk classification in pediatrics: development and validation of a guide for nurses
Revista Brasileira de Enfermagem. 2015;68(5):913-922
DOI 10.1590/0034-7167.2015680521i
Views0See moreABSTRACT
Objective:
to develop and validate a short guide for the protocol to user embracement with risk classification in pediatrics.
Method:
methodological study developed in two stages: development of the guide, and face and content validation. The development involved the stratification of the protocol contents into five risk indicators according to the level of complexity; subsequently it was submitted to validation by nine experts divided in two groups: professors who were also researchers, and nurses.
Results:
in the face validation the experts considered the 25 items of the guide clear and understandable, with agreement levels above 70%. In the content validation, 17 (68%) items were considered relevant by 88.9% of the experts. The eight items considered irrelevant were changed according to suggestions of the experts, yielding an overall content validity index of 0.98.
Conclusion:
the study resulted in a guide for the classification of risks in pediatrics that is valid to assess children in emergency services.
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01-01-2015
Components of social learning theory in a tool for teaching Nursing
Revista Brasileira de Enfermagem. 2015;68(5):906-912
Abstract
Components of social learning theory in a tool for teaching Nursing
Revista Brasileira de Enfermagem. 2015;68(5):906-912
DOI 10.1590/0034-7167.2015680520i
Views0See moreABSTRACT
Objective:
to identify key components of the social learning theory in a computational tool to aid in teaching the reasoning process for the preparation of a nursing diagnosis.
Method:
qualitative study that analyzed the statements collected through a focus group of 18 teachers and students from two Brazilian nursing schools.
Results:
the themes were grouped into four categories related to the components of the theory and into 13 subcategories.
Conclusion:
the meaning of learning can be extended by the teacher’s didactics and corroborated by the relationship between systematization and reasoning. To learn by doing, some prerequisites are required as is a process of motivation and qualification, which are also inherent to learning by forming an identity in the group. In the feeling of belonging to a particular group, aspects related to the profession become visible as opposed to the aspects of belonging to a community of practice of learning.
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01-01-2015
Telephone call for post-discharge surveillance: validation and application of tool for video-assisted surgery
Revista Brasileira de Enfermagem. 2015;68(5):899-905
Abstract
Telephone call for post-discharge surveillance: validation and application of tool for video-assisted surgery
Revista Brasileira de Enfermagem. 2015;68(5):899-905
DOI 10.1590/0034-7167.2015680519i
Views0See moreABSTRACT
Objective:
to validate an instrument for post-discharge surveillance by telephone for video assisted surgeries.
Method:
a multi-method study with development, validation and application of the instrument. The validation was performed by experts considering the relevance, clarity and completeness of the contents in the calculation of the content validity index and valid questions that demonstrated 80% agreement. For the application of the instrument, the sample consisted of 68 women undergoing video-assisted surgery, and we conducted a descriptive analysis.
Results:
there was disagreement among experts in the first evaluation, and the instrument was redesigned obtaining agreement in the second evaluation. The response rate to the telephone contact was 88.2% (60/68). Complaints of abdominal pain, bleeding and incisional edema were more frequent. No patients presented with infection.
Conclusion:
the questionnaire was validated and applied and is available for use.
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01-01-2015
Managerial competences of coordinators of undergraduate nursing courses
Revista Brasileira de Enfermagem. 2015;68(5):890-898
Abstract
Managerial competences of coordinators of undergraduate nursing courses
Revista Brasileira de Enfermagem. 2015;68(5):890-898
DOI 10.1590/0034-7167.2015680518i
Views0See moreABSTRACT
Objective:
to analyze the experiences of how the managerial competences of coordinators, ideal and real, of undergraduate nursing course coordinators from the city of Belo Horizonte, Minais Gerais.
Method:
the theoretical framework presented a conceptual model of eight managerial roles (director, producer, monitor, coordinator, mentor, facilitator, broker and innovator) and three specific competences to the exercise of each one of them. Descriptive and qualitative research with 14 interviews conducted using semi-structured scripts, whose data were subjected to content analysis.
Results:
we highlighted the roles: mentor, director and facilitator as the most prominent, whose competences can be continually improved as a result of differentiated and permanent demands which the subject face, in addition to the natural ambiguities and contradictions of management function.
Conclusion:
the higher education institution can adjust their selection and evaluation processes for this position, including the difficulties of professional competences training required in the exercise of managerial function.
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01-01-2015
Participação familiar para a reabilitação de idosos com fratura de fêmur
Revista Brasileira de Enfermagem. 2015;68(5):883-889
Abstract
Participação familiar para a reabilitação de idosos com fratura de fêmur
Revista Brasileira de Enfermagem. 2015;68(5):883-889
DOI 10.1590/0034-7167.2015680517i
Views1See moreRESUMEN
Objetivo:
verificar si el modo de cuidar adoptado por los cuidadores favoreció la recuperación de la independencia funcional de los ancianos con y sin la presencia de enfermedad en el sistema nervioso y trastornos mentales y comportamentales y si enfermedades interfirieron en la independencia funcional.
Método:
estudio trasversal, con seguimiento por 12 meses de 89 ancianos brasileños (≥ 60 años), sometidos a cirugía de fémur proximal y sus cuidadores familiares.
Resultados:
los scores de la Medida de Independencia Funcional disminuyeron 0,7 puntos por año vivido y, en el caso de enfermedad en el sistema nervioso y trastorno mental y comportamental, esa pérdida aumentó para 20,5 puntos. El incentivo a la deambulación aumentó 18,9, al autocuidado 12,8 y al ocio 11,5 puntos de la Medida de Independencia Funcional.
Conclusión:
se recomienda el incentivo al movimiento y a la deambulación, al autocuidado y a las actividades de ocio, principalmente en aquellos ancianos con enfermedades en el sistema nervioso y trastorno mental y comportamental.
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01-01-2015
Family participation to elderly rehabilitation with femoral fracture
Revista Brasileira de Enfermagem. 2015;68(5):883-889
Abstract
Family participation to elderly rehabilitation with femoral fracture
Revista Brasileira de Enfermagem. 2015;68(5):883-889
DOI 10.1590/0034-7167.2015680517i
Views0See moreABSTRACT
Objective:
verify if the mode of care adopted by caregivers favored functional independence recovery by elderly with and without the presence of nervous system disease and mental and behavioral disorders; and, if disease interfered with their functional independence.
Method:
transversal study, with 12-month follow-up of 89 Brazilian elders (≥ 60 years) after proximal femoral surgery, and their family caregiver.
Results:
the Functional Independence Measure scores decreased by 0.7 points per year of life, and in the case of presenting nervous system disease and mental and behavioral disorders, this loss amounted to 20.5 points.
Conclusion:
The incentive to ambulate increased by 18.8 for self-care, 12.8 for self-care, and 11.5 for leisure activities on the Functional Independence Measure. Encouraging movement and ambulation, self-care and leisure activities, especially with those elderly with nervous system diseases and mental and behavioral disorders, is recommended.
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01-01-2015
Absenteeism – illness of the nursing staff of a university hospital
Revista Brasileira de Enfermagem. 2015;68(5):876-882
Abstract
Absenteeism – illness of the nursing staff of a university hospital
Revista Brasileira de Enfermagem. 2015;68(5):876-882
DOI 10.1590/0034-7167.2015680516i
Views0See moreABSTRACT
Objective:
to analyze absenteeism – illness of the nursing staff.
Method:
this was a retrospective study of a university hospital in the city of Goiânia, Goiás, Brazil, using a quantitative approach. Data were collected from functional records of the staff during the period from 2008 to 2012.
Results:
of 602 workers, 435 had 1574 medical certifi cates. Diseases of the musculoskeletal system and connective tissue, followed by mental and behavioral disorders were the major diseases for sick leave. The occupation with the highest number of medical certifi cates was the nursing technician. Females and the age group between 41-50 years prevailed in the sample. Ambulatory was the area with most frequent events, followed by the medical clinic and emergency room.
Conclusion:
absenteeism-illness affects the functioning of the service, the nursing staff and users, promoting work overload, and interfering in the quality of nursing care.
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01-01-2015
The nurse faced with early weaning in child nursing consultations
Revista Brasileira de Enfermagem. 2015;68(5):869-875
Abstract
The nurse faced with early weaning in child nursing consultations
Revista Brasileira de Enfermagem. 2015;68(5):869-875
DOI 10.1590/0034-7167.2015680515i
Views0See moreABSTRACT
Objective:
analyze the role of the nurse regarding early weaning in children younger than 6 months old.
Method:
qualitative and descriptive study. The nurses who performed the study did nursing consultation to children programmatically in family health units in Cuiabá – Mato Grosso. Data were collected in January and February 2012, through participant observation of nursing consultations. For data analysis, content analysis was used.
Results:
that nurses, in most cases, used appropriate strategies for the management of common problems in breastfeeding, although some behaviors have not yet proven scientifi c evidence about the benefi ts and/or damage to its practice.
Conclusion:
nurses addressed important aspects of breastfeeding during consultations and worked for the promotion and resumption of exclusive breastfeeding.
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01-01-2016
Factors associated with inconsistent condom use among people living with HIV/Aids
Revista Brasileira de Enfermagem. 2016;69(1):47-53
Abstract
Factors associated with inconsistent condom use among people living with HIV/Aids
Revista Brasileira de Enfermagem. 2016;69(1):47-53
DOI 10.1590/0034-7167.2016690106i
Views0See moreABSTRACT
Objective:
to analyze the prevalence and factors associated with inconsistent use of condoms among people living with HIV/ Aids (PLWHA).
Method:
it is a cross-sectional study with 228, with individual interviews conducted in 2011. A multivariate analysis was performed with a logistic regression model.
Results:
143 participants met the inclusion criteria, and the prevalence of inconsistent condom use was 28.7%. However, there was greater adherence among men (79.3%). In the multivariate analysis, the independent variable daily use of alcohol (OR=11.02; 95% CI 1.84, 65.92; p = 0.021) was associated with inconsistent condom use. The chance of men making consistent condom use was higher than women (OR = 0.36, 95% CI 0.15, 0.81; p = 0.015).
Conclusion:
the prevalence of inconsistent condom male use among PLWHA was low, however, evidenced greater compliance among men over women with a statistically significant difference and the daily use of alcohol was associated with inconsistent condom use.
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01-01-2016
Influence of sociodemographic and clinical characteristics at the impact of valvular heart disease
Revista Brasileira de Enfermagem. 2016;69(1):40-46
Abstract
Influence of sociodemographic and clinical characteristics at the impact of valvular heart disease
Revista Brasileira de Enfermagem. 2016;69(1):40-46
DOI 10.1590/0034-7167.2016690105i
Views0See moreABSTRACT
Objective:
to analyze the sociodemographic and clinical characteristics of patients with valvular heart disease and to verify the influence of these variables on the impact of valve disease in daily life.
Method:
the study involved 86 outpatients. Data collection was performed in two stages – face-to-face interview for sociodemographic and clinical characterization and through telephone contact for the application of the Instrument to Measure the Impact of Valvular Heart Disease on Patient’s Everyday Life (IDCV). Data were analyzed through descriptive statistics and multiple regression analysis.
Results:
it was noticed that the total score of IDCV and its domains were influenced by age, schooling, presence or absence of symptoms, use or not of diuretic.
Conclusion:
The impact of the disease was influenced by sociodemographic and clinical variables. The results provide subsidies for the design of nursing interventions aimed at reducing the impact of the disease on the patient’s daily life with valve disease.
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01-01-2016
Health indicators of workers of the hospital area
Revista Brasileira de Enfermagem. 2016;69(1):30-39
Abstract
Health indicators of workers of the hospital area
Revista Brasileira de Enfermagem. 2016;69(1):30-39
DOI 10.1590/0034-7167.2016690104i
Views0See moreABSTRACT
Objective:
to analyze the health indicators of workers of hospital area for exposure to workloads, wear processes and its consequences.
Method:
a retrospective, descriptive and exploratory study performed in a hospital in southern Brazil. The population consisted of 1,050 workers notifications of registered in the Monitoring System of Nursing Workers Health, in 2011.
Results:
80.8% of the records were female workers, with 34.2% aged between 31 to 40 years old, corresponding to 2478 working lost days. The results subsidized the implementation of nine indicators that showed the prevalence of respiratory and osteoarticular problems.
Conclusion:
the results allow the reflection and redirection of actions for workers’ health, as the processes of becoming ill are compounded by exposure to psychic burdens. These indicators, when monitored, can contribute to the transformation of the profile of morbidity of these workers.
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01-01-2016
Evaluation of environmentally sustainable actions in the medication process
Revista Brasileira de Enfermagem. 2016;69(1):23-29
Abstract
Evaluation of environmentally sustainable actions in the medication process
Revista Brasileira de Enfermagem. 2016;69(1):23-29
DOI 10.1590/0034-7167.2016690103i
Views0See moreABSTRACT
Objective:
to analyze sustainable actions from an environmental point of view in the medication process, from the reception of the prescription of the pharmacy to waste discard by nursing.
Method:
study before and after performed through Lean Six Sigma methodology. The sample consisted of the amount and type of waste resulting from the pharmacy and nursing services of a medical-surgical clinical unit.
Results:
after the intervention was obtained at the pharmacy a reduction of 74.8% of chemical, infectious and sharps waste, an increase of 33.3% of common recyclable and 20% of common non-recyclable. In nursing, there was a reduction of 22.5% of chemical, infectious and sharps waste, an increase of 22.9% of common recyclable and an increase of 20% of common non-recyclable.
Conclusion:
the practice of sustainable actions in the hospital is possible, contributing to the optimization of resources and waste production with benefits to the institution, environment, and health.
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01-01-2016
Nursing education: training evaluation by graduates, employers and teachers
Revista Brasileira de Enfermagem. 2016;69(1):16-22
Abstract
Nursing education: training evaluation by graduates, employers and teachers
Revista Brasileira de Enfermagem. 2016;69(1):16-22
DOI 10.1590/0034-7167.2016690102i
Views0See moreABSTRACT
Objective:
to support the assessment and the necessary changes in the curriculum of an undergraduate degree in Nursing.
Methods:
it is a descriptive study developed in two stages as an action research. In the first stage, the speeches of 19 graduates and 15 employers were interviewed and analyzed; in the second stage, five teachers participated in the focus group. For processing the data, the content analysis was adopted.
Results:
based on the assessment of the actors, an action plan was created with suggestions regarding the curriculum flexibility, content resizing, continuing education, practice enhancement, active methodologies and autonomy of the student.
Conclusion:
the participation of actors participants of the training process and performance of professional nurses in the evaluation of a curriculum pointed aspects to realignment and provided concrete benefits to improving the quality of undergraduate course curriculum, scenario of this study.
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01-01-2016
The challenge of the 67th Brazilian Conference of Nursing: In what direction is the Brazilian Nursing going?
Revista Brasileira de Enfermagem. 2016;69(1):7-9
Abstract
The challenge of the 67th Brazilian Conference of Nursing: In what direction is the Brazilian Nursing going?
Revista Brasileira de Enfermagem. 2016;69(1):7-9
DOI 10.1590/0034-7167.2016690101i
Views0Bringing together about 3,700 participants among conference participants, speakers, support staff, organizers and exhibitors, the 67th Brazilian Conference of Nursing extraordinary presented São Paulo with deep and meaningful reflections in an attempt to answer the question “In what direction is the Brazilian Nursing going?”.From the submission of the proposal to host the event until its […]See more -
01-01-2016
O desafio do 67º Congresso Brasileiro de Enfermagem: para onde caminha a Enfermagem brasileira?
Revista Brasileira de Enfermagem. 2016;69(1):7-9
Abstract
O desafio do 67º Congresso Brasileiro de Enfermagem: para onde caminha a Enfermagem brasileira?
Revista Brasileira de Enfermagem. 2016;69(1):7-9
DOI 10.1590/0034-7167.2016690101i
Views0Reunindo cerca de 3.700 participantes entre congressistas, palestrantes, equipe de apoio, organizadores e expositores, o 67º Congresso Brasileiro de Enfermagem agraciou São Paulo com reflexões profundas e significativas, na tentativa de dar sua resposta à questão “Para onde caminha a enfermagem brasileira?”.Desde a apresentação da proposta de sediar o evento até sua realização, o que […]See more -
06-01-2015
Anticipated directives and living will for terminal patients: an integrative review
Revista Brasileira de Enfermagem. 2015;68(3):524-534
Abstract
Anticipated directives and living will for terminal patients: an integrative review
Revista Brasileira de Enfermagem. 2015;68(3):524-534
DOI 10.1590/0034-7167.2015680321i
Views0See moreABSTRACT
Objective:
characterizing the national and international scientifi c literature about the advanced directives of living will as applied to the terminally ill patient.
Method:
integrative review considering the articles published in Portal Capes, SciELO, LILACS, MEDLINE, Journal of Bioethics and Bioethikos, with the descriptors: Advanced directives, Wills regarding life and Advance Directives, Living Will and Terminally Ill, totaling 44 articles submitted to content analysis.
Results:
three categories emerged: Students and professionals facing the advance directives of living will: Perceptions, opinions and practices; Patient’s receptivity to the Advance Directives of Living Will; The family facing the advance directives of living will.
Conclusion:
the relevance of the topic became evident as a guarantee of respect for the dignity and autonomy of the patient, as well as to reduce ethical confl icts faced by families and health professionals facing care at the end of life.
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01-01-2016
Pressure ulcer healing with Plenusdermax® Calendula officinalis L. extract
Revista Brasileira de Enfermagem. 2016;69(2):250-257
Abstract
Pressure 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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01-01-2016
Quality of life assessment for health promotion groups
Revista Brasileira de Enfermagem. 2016;69(2):242-249
Abstract
Quality 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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01-01-2016
Transcultural adaptation and validation of the Brazilian version of Treatment Spirituality/Religiosity Scale
Revista Brasileira de Enfermagem. 2016;69(2):235-241
Abstract
Transcultural 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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01-01-2016
Epidemiological characteristics and causes of deaths in hospitalized patients under intensive care
Revista Brasileira de Enfermagem. 2016;69(2):229-234
Abstract
Epidemiological 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
Views0See moreABSTRACT
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.
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01-01-2016
Hospital discharge of premature newborns: the father’s experience
Revista Brasileira de Enfermagem. 2016;69(2):221-228
Abstract
Hospital 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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01-01-2016
Nurses from the Mobile Emergency Service: profile and developed activities
Revista Brasileira de Enfermagem. 2016;69(2):213-220
Abstract
Nurses 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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01-01-2016
Challenges and leadership imperatives in cooperation with the World Health Organization
Revista Brasileira de Enfermagem. 2016;69(2):207-208
Abstract
Challenges 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 -
01-01-2016
Desafios e imperativos de liderança na cooperação com a Organização Mundial da Saúde
Revista Brasileira de Enfermagem. 2016;69(2):207-208
Abstract
Desafios 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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