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ORIGINAL ARTICLE05-13-2024
Generalized Resistance Deficits in inmates with hypertension: missing resources that limit health
- Marta Cossetin Costa
, - Maria de Fátima Mantovani ,
- Fernanda Moura D’Almeida Miranda ,
- Ivonete Teresinha Schülter Buss Heidemann ,
- Aida Maris Peres
Abstract
ORIGINAL ARTICLEGeneralized Resistance Deficits in inmates with hypertension: missing resources that limit health
Revista Brasileira de Enfermagem. 2024;77(2):e20230246
DOI 10.1590/0034-7167-2023-0246
- Marta Cossetin Costa ,
- Maria de Fátima Mantovani ,
- Fernanda Moura D’Almeida Miranda ,
- Ivonete Teresinha Schülter Buss Heidemann ,
- Aida Maris Peres
Views0See moreABSTRACT
Objective:
to understand the Generalized Resistance Deficits of people deprived of liberty with hypertension in a Brazilian prison unit.
Method:
qualitative research, anchored in Salutogenesis, carried out with 38 people with hypertension from a Brazilian prison unit, from February to July 2022, with a semi-structured interview with open-ended questions, whose analysis was thematic, explaining the limitations to health in prison.
Results:
13 Generalized Resistance Deficits were reported, mostly related to the prison environment and, to a lesser extent, to the social group and the individual, respectively. Living in prison for people with hypertension implies living with a high number of Generalized Resistance Deficits, accentuating the movement towards the disease pole.
Final considerations:
knowing Generalized Resistance Deficits allows directing health promotion to support the use of available Generalized Resistance Resources and contributes to the expansion of intersectoral policies.
- Marta Cossetin Costa
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REVIEW05-13-2024
Lean methodology: contributions to improving work processes in health and nursing
- Fernanda Novaes Moreno Brancalion ,
- Lara Gonçalves de Souza ,
- Simone Berger ,
- Antônio Fernandes Costa Lima
Abstract
REVIEWLean methodology: contributions to improving work processes in health and nursing
Revista Brasileira de Enfermagem. 2024;77(2):e20230322
DOI 10.1590/0034-7167-2023-0322
- Fernanda Novaes Moreno Brancalion ,
- Lara Gonçalves de Souza ,
- Simone Berger ,
- Antônio Fernandes Costa Lima
Views0See moreABSTRACT
Objective:
to investigate the contributions of applying the Lean methodology to improve work processes in health and nursing and its impact on associated financial aspects.
Method:
an integrative review, carried out in six databases, whose sample of ten (100.0%) studies was analyzed and summarized descriptively.
Results:
the outcomes obtained were stratified into: benefits/barriers to Lean Healthcare implementation; economic aspects involving Lean Healthcare implementation; and process improvements through Lean Healthcare implementation. The majority of studies (60.0%) were carried out in university hospitals, contexts that need to continually improve the quality of services provided, generally with scarce and limited resources, which support the viability of maintaining the teaching, research and extension tripod.
Conclusion:
three (30.0%) studies highlighted the financial aspects associated with Lean methodology application. The others only mentioned the possibility of financial gains through improving processes and reducing waste.
- Fernanda Novaes Moreno Brancalion
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REVIEW05-13-2024
Stunting predictors among children aged 0-24 months in Southeast Asia: a scoping review
Revista Brasileira de Enfermagem. 2024;77(2):e20220625
Abstract
REVIEWStunting predictors among children aged 0-24 months in Southeast Asia: a scoping review
Revista Brasileira de Enfermagem. 2024;77(2):e20220625
DOI 10.1590/0034-7167-2022-0625
Views0See moreABSTRACT
Objective:
To identify predictors of stunting among children 0-24 months in Southeast Asia.
Methods:
This scoping review focused on articles with observational study design in English published from 2012 to 2023 from five international databases. The primary keyword used were: “stunting” OR “growth disorder” AND “newborn” AND “predict” AND “Southeast Asia”.
Results:
Of the 27 articles selected for the final analysis there are thirteen predictors of stunting in seven Southeast Asia countries. The thirteen predictors include the child, mother, home, inadequate complementary feeding, inadequate breastfeeding, inadequate care, poor quality foods, food and water safety, infection, political economy, health and healthcare, water, sanitation, and environment, and social culture factor.
Conclusion:
All these predictors can lead to stunting in Southeast Asia. To prevent it, health service providers and other related sectors need to carry out health promotion and health prevention according to the predictors found.
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05-13-2024
A influência da internet nas escolhas sobre a saúde e o bem-estar dos idosos
Revista Brasileira de Enfermagem. 2024;77(1):e20230321
Abstract
A influência da internet nas escolhas sobre a saúde e o bem-estar dos idosos
Revista Brasileira de Enfermagem. 2024;77(1):e20230321
DOI 10.1590/0034-7167-2023-0321
Views0See moreRESUMEN
Objetivos:
describir el perfil de los ancianos que acceden a internet para buscar información de salud e identificar los factores que pueden influir en las decisiones de los ancianos sobre su salud a partir de la información recopilada en línea.
Métodos:
391 ancianos respondieron a un cuestionario online sobre hábitos y satisfacción con la información de salud recogida en internet. El procesamiento de datos implicó regresión logística.
Resultados:
la educación superior reduce en un 44% la probabilidad de que un anciano siga las recomendaciones de salud en los sitios web. Sin embargo, las actividades sociales y la salud autopercibida aumentan la posibilidad de seguir las recomendaciones en un 83% y un 71%, respectivamente. La creencia de que internet promueve hábitos saludables aumenta 29,2 veces la probabilidad de que un anciano siga un consejo.
Consideraciones Finales:
conocer el perfil de los ancianos que utilizan internet puede ayudar a los profesionales a formular políticas públicas y construir buenas plataformas de información sobre salud y bienestar.
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ORIGINAL ARTICLE05-13-2024
The influence of the internet on choices about older adults’ health and well-being
Revista Brasileira de Enfermagem. 2024;77(1):e20230321
Abstract
ORIGINAL ARTICLEThe influence of the internet on choices about older adults’ health and well-being
Revista Brasileira de Enfermagem. 2024;77(1):e20230321
DOI 10.1590/0034-7167-2023-0321
Views0See moreABSTRACT
Objectives:
to describe the profile of older adults who access the internet to search for health information and identify the factors that can influence older adults’ decisions about their health based on information collected online.
Methods:
391 older adults answered an online questionnaire regarding habits and satisfaction with information about health collected on the internet. Data processing involved Logistic Regression.
Results:
higher education reduces by 44% the likelihood of an older adult following the health recommendations on internet sites. However, social activities and self-perceived health increase the possibility of following the recommendations by 83% and 71%, respectively. The belief that the internet promotes healthy habits increases by 29.2 times the probability of an older adult following the advice.
Final Considerations:
knowing the profile of older adults who use the Internet can help professionals formulate public policies and build good information platforms on health and well-being.
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REVIEW05-13-2024
Technologies used in the treatment of burn victims in intensive care: a scope review
- Kyohana Matos de Freitas Clementino ,
- Gabriela Duarte Bezerra ,
- Gleice Adriana Araujo Gonçalves ,
- Maria Corina Amaral Viana ,
- Luis Rafael Leite Sampaio , [ … ],
- Woneska Rodrigues Pinheiro
Abstract
REVIEWTechnologies used in the treatment of burn victims in intensive care: a scope review
Revista Brasileira de Enfermagem. 2024;77(1):e20220738
DOI 10.1590/0034-7167-2022-0738
- Kyohana Matos de Freitas Clementino ,
- Gabriela Duarte Bezerra ,
- Gleice Adriana Araujo Gonçalves ,
- Maria Corina Amaral Viana ,
- Luis Rafael Leite Sampaio ,
- Woneska Rodrigues Pinheiro
Views0See moreABSTRACT
Objectives:
to analyze the technologies used by the nursing team in the treatment of skin lesions caused by burns in patients under intensive care.
Methods:
this is a scope review conducted on the LILACS, Medline, PubMed, and CINAHL databases without temporal or language restrictions.
Results:
the highlighted technologies included the use of specialized dressings, biological agents such as probiotics and cyanobacteria, as well as negative pressure therapies and enzymes such as papain and collagenase. Some technologies, such as nanocrystalline silver, demonstrated efficacy in infection control.
Final Considerations:
the study identified essential technologies in burn care, emphasizing the need for further research on “soft” technologies. The findings support the promotion of evidence-based nursing care for burn patients in intensive care and enhance knowledge about effective treatments.
- Kyohana Matos de Freitas Clementino
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ORIGINAL ARTICLE05-03-2024
What is the burden of multimorbidity and the factors associated with its occurrence in elderly Brazilians?
- Danielle Samara Tavares de Oliveira-Figueiredo ,
- Matteus Pio Gianotti Pereira Cruz Silva ,
- Paula Yhasmym de Oliveira Feitosa ,
- Bruna Cardoso Leite ,
- Fabiana Lucena Rocha , [ … ],
- Luciana Dantas Farias de Andrade
Abstract
ORIGINAL ARTICLEWhat is the burden of multimorbidity and the factors associated with its occurrence in elderly Brazilians?
Revista Brasileira de Enfermagem. 2024;77(1):e20220809
DOI 10.1590/0034-7167-2022-0809
- Danielle Samara Tavares de Oliveira-Figueiredo ,
- Matteus Pio Gianotti Pereira Cruz Silva ,
- Paula Yhasmym de Oliveira Feitosa ,
- Bruna Cardoso Leite ,
- Fabiana Lucena Rocha ,
- Luciana Dantas Farias de Andrade
Views0See moreABSTRACT
Objective:
To estimate the prevalence of multimorbidity in elderly people and its association with sociodemographic characteristics, lifestyle, and anthropometry.
Methods:
This was a cross-sectional study using data from the National Health Survey, 2019. A total of 22,728 elderly individuals from all 27 Brazilian states were randomly selected. Poisson regression models with robust variance were employed, and a significance level of 5% was adopted.
Results:
The prevalence of multimorbidity was 51.6% (95% CI: 50.4-52.7), with the highest estimates observed in the South and Southeast. Multimorbidity was associated with being female (aPR = 1.33; 95% CI: 1.27-1.39), being 80 years old or older (aPR = 1.12; 95% CI: 1.05-1.19), having low education (aPR = 1.16; 95% CI: 1.07-1.25), past cigarette use (aPR = 1.16; 95% CI: 1.11-1.21), insufficient physical activity (aPR = 1.13; 95% CI: 1.06-1.21), and screen use for 3 hours or more per day (aPR = 1.13; 95% CI: 1.08-1.18).
Conclusion:
Multimorbidity affects more than half of the elderly population in Brazil and is associated with social, demographic, and behavioral factors.
- Danielle Samara Tavares de Oliveira-Figueiredo
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ORIGINAL ARTICLE05-03-2024
Cancer patient satisfaction regarding the quality of information received: psychometric validity of EORTC QLQ-INFO25
Revista Brasileira de Enfermagem. 2024;77(1):e20230358
Abstract
ORIGINAL ARTICLECancer patient satisfaction regarding the quality of information received: psychometric validity of EORTC QLQ-INFO25
Revista Brasileira de Enfermagem. 2024;77(1):e20230358
DOI 10.1590/0034-7167-2023-0358
Views0See moreABSTRACT
Objectives:
to psychometrically validate the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire EORTC QLQ-INFO25 instrument and identify the domains that influence patients’ perception of the information received.
Methods:
a cross-sectional methodology with cancer patients in a Brazilian philanthropic hospital institution. Sociodemographic and clinical instruments, EORTC QLQ-C30, EORTC QLQ-INFO25 and Supportive Care Needs Survey – Short Form 34 were used. Analysis occurred using Cronbach’s alpha coefficients, intraclass correlation, test-retest and exploratory factor analysis.
Results:
128 respondents participated. Cronbach’s alpha coefficient was 0.85. The test-retest obtained p-value=0.21. In the factor analysis, one item was excluded. Satisfaction with the information received was 74%, with three areas with averages below 70%. In open-ended questions, there was a greater desire for information.
Conclusions:
validity evidence was obtained with instrument reliability, consistency and stability. Respondents expressed satisfaction with the information received.
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REVIEW07-09-2021
Nursing care for patients in post-transplantation of hematopoietic stem cells: an integrative review
- Jéssica Alline Pereira Rodrigues ,
- Maria Ribeiro Lacerda ,
- Cristina Maria Galvão ,
- Ingrid Meireles Gomes ,
- Marineli Joaquim Meier , [ … ],
- Nayla Tamara de Godoi Caceres
Abstract
REVIEWNursing care for patients in post-transplantation of hematopoietic stem cells: an integrative review
Revista Brasileira de Enfermagem. 2021;74(3):e20200097
DOI 10.1590/0034-7167-2020-0097
- Jéssica Alline Pereira Rodrigues ,
- Maria Ribeiro Lacerda ,
- Cristina Maria Galvão ,
- Ingrid Meireles Gomes ,
- Marineli Joaquim Meier ,
- Nayla Tamara de Godoi Caceres
Views0See moreABSTRACT
Objectives:
to analyze the available evidence on the nursing care provided to patients after hematopoietic stem cell transplantation.
Methods:
integrative review with the search for primary studies in four databases and a virtual health library. A broad search strategy was used, including research published in English, Brazilian Portuguese, or Spanish, between 2008 and 2018, totaling a sample of 42 studies.
Results:
the studies were grouped into three categories: multiple nursing care (n=19), first-line care (n=18), and self-management of care (n=5).
Conclusions:
nursing care is critical, comprising patients’ physical, psychological and social aspects. It occurs in hospital and home contexts, mainly involving technical actions and health guidance. The evidence identified provide subsidies for decision-making; however, most studies are of the non-experimental type, indicating the need for conducting intervention research.
- Jéssica Alline Pereira Rodrigues
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ORIGINAL ARTICLE04-22-2020
Indicators of effectiveness of nursing care in the dimension of patient safety
- Leila Soares Seiffert ,
- Lillian Daisy Gonçalves Wolff ,
- Maria Manuela Frederico Ferreira ,
- Elaine Drehmer de Almeida Cruz ,
- Alexandra Lunardon Silvestre
Abstract
ORIGINAL ARTICLEIndicators of effectiveness of nursing care in the dimension of patient safety
Revista Brasileira de Enfermagem. 2020;73(3):e20180833
DOI 10.1590/0034-7167-2018-0833
- Leila Soares Seiffert ,
- Lillian Daisy Gonçalves Wolff ,
- Maria Manuela Frederico Ferreira ,
- Elaine Drehmer de Almeida Cruz ,
- Alexandra Lunardon Silvestre
Views0See moreABSTRACT
Objectives:
to validate nursing care effectiveness indicators of patient safety dimension.
Methods:
quantitative survey, using the electronic Delphi sampli, with 52 participants selected by the Snowball sampling. Eight indicators were evaluated regarding the attributes: availability, reliability, simplicity, representativeness, sensitivity, comprehensiveness, objectivity, cost, utility, stability and timeliness. For validation, the minimum agreement criterion was 70%.
Results:
Cronbach’s alpha (0.942) evidenced the high internal consistency among the attributes. The indicators fall with damage, hip fracture, and postoperative hip fracture, incidents related to equipment, incidents due to failures in patient identification, and pressure injury were validated in all attributes, and those of medication error and hand Hygiene were not validated.
Conclusions:
the validated indicators allow assessment of the effectiveness of hospital nursing care. Unavailability of data is an obstacle to monitoring patient safety.
- Leila Soares Seiffert
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ORIGINAL ARTICLE06-01-2020
Prisoners of suffering: perception of women on violence practiced by intimate partners
- Vanessa Carla Batista ,
- Sonia Silva Marcon ,
- Hellen Emília Peruzzo ,
- Aline Gabriela Bega Ruiz ,
- Pamela dos Reis , [ … ],
- Edir Nei Teixeira Mandú
Abstract
ORIGINAL ARTICLEPrisoners of suffering: perception of women on violence practiced by intimate partners
Revista Brasileira de Enfermagem. 2020;73:e20190219
DOI 10.1590/0034-7167-2019-0219
- Vanessa Carla Batista ,
- Sonia Silva Marcon ,
- Hellen Emília Peruzzo ,
- Aline Gabriela Bega Ruiz ,
- Pamela dos Reis ,
- Ana Maria Nunes da Silva ,
- Edir Nei Teixeira Mandú
Views0See moreABSTRACT
Objective:
to describe the perceptions of women, prisoners or partners of imprisoned men who experience/experienced intimate partner violence, and how they cope with this situation.
Method:
a descriptive exploratory study with a qualitative approach conducted with 21 women. Empirical data collected between March and August 2018, through audio-recorded semi-structured interviews, were submitted to thematic content analysis.
Results:
women reported experiencing different forms of violence, which triggered suffering and negative commitment in their lives, far beyond the act itself, especially by the emotional and physical marks and their consequences. They also realize that coping with violence is individual responsibility, lived in the counterpoint between the desire to overcome it and passivity.
Final considerations:
intimate partner violence was uniquely revealed by women as a solitary experience, with permanent consequences in the physical, emotional, patrimonial, sexual and moral spheres, and limited internal and external resources make it difficult to cope with it.
- Vanessa Carla Batista
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ORIGINAL ARTICLE06-01-2020
Performance of nurses in the bed management service of a teaching hospital
Revista Brasileira de Enfermagem. 2020;73(4):e20190349
Abstract
ORIGINAL ARTICLEPerformance of nurses in the bed management service of a teaching hospital
Revista Brasileira de Enfermagem. 2020;73(4):e20190349
DOI 10.1590/0034-7167-2019-0349
Views0See moreABSTRACT
Objectives:
to analyze the performance of nurses in the Bed Management service of a public teaching hospital.
Methods:
descriptive, qualitative research inspired by Dubois theoretical model. 32 participants from the bed management unit and care units of a public hospital were interviewed from February to May 2018. Observations and data records from the Bed Management service complemented data collection. Theme/Category-Based Content Analysis was used.
Results:
the performance of nurses was described in three analysis matrices, represented by the categories: acquisition, implementation and maintenance of nursing resources; transformation of nursing resources into nursing service and results of the work of the nurse in Bed Management.
Final Considerations:
understanding the performance of nurses in bed management contributes to the scenario of new practices and different roles that favor visibility and strengthening of the nurse’s identity.
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ORIGINAL ARTICLE12-13-2019
Support systems in the pediatric intensive therapy unit: family perspective
- Jéssica Stragliotto Bazzan ,
- Viviane Marten Milbrath ,
- Ruth Irmgard Bärtschi Gabatz ,
- Marilu Correa Soares ,
- Eda Schwartz , [ … ],
- Deisi Cardoso Soares
Abstract
ORIGINAL ARTICLESupport systems in the pediatric intensive therapy unit: family perspective
Revista Brasileira de Enfermagem. 2019;72:243-250
DOI 10.1590/0034-7167-2018-0588
- Jéssica Stragliotto Bazzan ,
- Viviane Marten Milbrath ,
- Ruth Irmgard Bärtschi Gabatz ,
- Marilu Correa Soares ,
- Eda Schwartz ,
- Deisi Cardoso Soares
Views0See moreABSTRACT
Objective:
to identify and to analyze the support systems used by family members for the adaptation process to the child’s hospitalization in the intensive care unit.
Method:
qualitative research, conducted in a hospital located in the Southern Brazil. Data were collected between June and July 2017, through semi-structured interviews with family members of hospitalized children. The adaptation model and thematic analysis were used for data processing.
Results:
four themes emerged: family and friends as a support system; the family members of other hospitalized children as a support system; spirituality as a support system; health team as a support system.
Final considerations:
identifying the support systems used in the process of family adaptation and their manifestations of interdependence was possible. The need of the nurses to intensify the listening to strengthen the support system of the family members of the children hospitalized in the unit studied.
- Jéssica Stragliotto Bazzan
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ORIGINAL ARTICLE04-22-2020
Freedom-deprived women: social representations of prison, violence, and their consequences
- Zeyne Alves Pires Scherer ,
- Edson Arthur Scherer ,
- Manoel Antonio dos Santos ,
- Jacqueline de Souza ,
- Sandra Cristina Pillon , [ … ],
- Nikolas Pires Scherer
Abstract
ORIGINAL ARTICLEFreedom-deprived women: social representations of prison, violence, and their consequences
Revista Brasileira de Enfermagem. 2020;73(3):e20180781
DOI 10.1590/0034-7167-2018-0781
- Zeyne Alves Pires Scherer ,
- Edson Arthur Scherer ,
- Manoel Antonio dos Santos ,
- Jacqueline de Souza ,
- Sandra Cristina Pillon ,
- Nikolas Pires Scherer
Views0See moreABSTRACT
Objective:
To understand the social representations that women deprived of their freedom have of imprisonment, violence, and their consequences.
Method:
An exploratory-descriptive qualitative study with 15 women from a female penitentiary in the State of São Paulo, Brazil. Semistructured interview was used. Data submitted to thematic content analysis and interpreted under Social Representations.
Results:
Categories identified: “Enclosed and abandoned in the prison environment”: loss of contact with relatives, difficulties living in prison, and right to be reinserted into society. “Imprisoned in a cycle of social inequality”: lack of support, access to education and employment opportunities, leading them to engage in new illicit activities and consequent imprisonment.
Final considerations:
The social representations of prisoners suggest that they perceive themselves to be doubly “imprisoned”, either from the objective point of view, as an individual deprived of freedom; or subjective, as citizens who have their rights disrespected and their possibilities of rehabilitation limited by the prison system.
- Zeyne Alves Pires Scherer
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ORIGINAL ARTICLE08-20-2021
Resilience of family caregivers of children and adolescents in treatment of neoplasms and associated factors
- Jaqueline Scalabrin da Silva ,
- Otavio Fereira Moraes ,
- Luiza Dressler Sabin ,
- Franciele Ormizinda Almeida ,
- Tânia Solange Bosi de Souza Magnago
Abstract
ORIGINAL ARTICLEResilience of family caregivers of children and adolescents in treatment of neoplasms and associated factors
Revista Brasileira de Enfermagem. 2021;74(6):e20190388
DOI 10.1590/0034-7167-2019-0388
- Jaqueline Scalabrin da Silva ,
- Otavio Fereira Moraes ,
- Luiza Dressler Sabin ,
- Franciele Ormizinda Almeida ,
- Tânia Solange Bosi de Souza Magnago
Views0See moreABSTRACT
Objectives:
analyze the level of resilience of family caregivers of children and adolescents hospitalized for cancer treatment and associated factors.
Methods:
cross-sectional study, carried out in 2018, with 62 family caregivers in a university hospital in the state of Rio Grande do Sul, Brazil. The instruments CDRisc-10-Br, SRQ20, PSS-14 and WHOQOL-Bref were used to measure resilience, minor psychological disorders, stress, and quality of life, respectively. Inferential statistics were used.
Results:
female caregivers, married, with one child and who practice some predominated religion. They were classified as having a moderate level of resilience (48.4%); with suspicion for minor psychological disorders (45%) and high level of stress (41%). In terms of quality of life, they were satisfied in the Physical, Psychological and Social Relations domains; and dissatisfied in the Environment domain.
Conclusions:
there were direct weak to moderate correlations between the level of resilience and quality of life and inversely with stress and minor psychological disorders.
- Jaqueline Scalabrin da Silva
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ORIGINAL ARTICLE08-18-2021
Mapping of advanced practice nursing actions in the Family Health Strategy
- Emerson Willian Santos de Almeida ,
- Simone de Godoy ,
- Ítalo Rodolfo Silva ,
- Orlene Veloso Dias ,
- Leila Maria Marchi-Alves , [ … ],
- Isabel Amélia Costa Mendes
Abstract
ORIGINAL ARTICLEMapping of advanced practice nursing actions in the Family Health Strategy
Revista Brasileira de Enfermagem. 2021;74:e20210228
DOI 10.1590/0034-7167-2021-0228
- Emerson Willian Santos de Almeida ,
- Simone de Godoy ,
- Ítalo Rodolfo Silva ,
- Orlene Veloso Dias ,
- Leila Maria Marchi-Alves ,
- Isabel Amélia Costa Mendes
Views0See moreABSTRACT
Objectives:
to map advanced practice nursing actions implemented in the Family Health Strategy context.
Methods:
cross-sectional exploratory study carried out with Family Health Strategy nurses. Data obtained in the mapping were compared to the characteristics that define advanced practice nurses and are adopted internationally by using a checklist based on the International Council of Nurses Guidelines.
Results:
the mapping allowed to identify advanced practice nursing actions, such as advanced assessment, judgement, decision-making, and diagnostic reasoning skills and authority to diagnose and prescribe medications, diagnostic testing, and therapeutic treatments. However, evidence found in the educational preparation domain indicated evident fragility, expressed as the low percentage of nurses credentialed with a professional master’s degree.
Conclusions:
the present study showed that nurses in the Family Health Strategy carry out advanced practice nursing actions without the professional master’s degree recommended for credentialing, with pertinent legislation, which requires initiatives to be taken by nursing leaders to overcome this deficiency.
- Emerson Willian Santos de Almeida
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