-
01-01-2016
Determining impacts and factors in ventilator-associated pneumonia bundle
Revista Brasileira de Enfermagem. 2016;69(6):1108-1114
Abstract
Determining impacts and factors in ventilator-associated pneumonia bundle
Revista Brasileira de Enfermagem. 2016;69(6):1108-1114
DOI 10.1590/0034-7167-2016-0253
Views0See moreABSTRACT
Objective:
Assessing the determining impacts and factors in ventilator-associated pneumonia (VAP) bundle.
Method:
descriptive retrospective longitudinal study, with quantitative approach, held at a public teaching hospital. Collection held between May 2014 and April 2015. Patients of the ICU with VAP participated in the research. For organizing data, the Microsoft Excel 2010 program was used. A critical analysis between the data collected and infection rates was performed. The survey was approved under no. 566,136.
Results:
an increase in the incidence of VAP after implementing the bundle was observed; the prevalent pathogens were gram-negative bacteria. Deaths were equal to or greater than 50%. Changes of professionals and lack of supplies were determining factors.
Conclusion:
in this context, the need for permanent qualification of the team is emphasized, with the purpose of promoting the adherence to the protocol and preventing VAP.
-
01-01-2016
Multidisciplinary team of intensive therapy: humanization and fragmentation of the work process
Revista Brasileira de Enfermagem. 2016;69(6):1099-1107
Abstract
Multidisciplinary team of intensive therapy: humanization and fragmentation of the work process
Revista Brasileira de Enfermagem. 2016;69(6):1099-1107
DOI 10.1590/0034-7167-2016-0221
Views0See moreABSTRACT
Objective:
to understand the meaning of humanized care in intensive care units considering the experience of the multidisciplinary team.
Method:
descriptive and exploratory qualitative research. For this purpose, we conducted semi-structured interviews with 24 professionals of the heath-care team, and, after transcription, we organized the qualitative data according to content analysis.
Results:
from two main categories, we were able to understand that humanized care is characterized in the actions of health-care: effective communication, team work, empathy, singularity, and integrality; and mischaracterized in the management processes, specifically in the fragmentation of the work process and health-care, in the precarious work conditions, and in differing conceptual aspects of the political proposal of humanization.
Conclusion:
care activities in intensive therapy are guided by the humanization of care and corroborate the hospital management as a challenge to be overcome to boost advances in the operationalization of this Brazilian policy.
-
01-01-2016
Humanized Care: insertion of obstetric nurses in a teaching hospital
Revista Brasileira de Enfermagem. 2016;69(6):1091-1098
Abstract
Humanized Care: insertion of obstetric nurses in a teaching hospital
Revista Brasileira de Enfermagem. 2016;69(6):1091-1098
DOI 10.1590/0034-7167-2016-0295
Views0See moreABSTRACT
Objective:
to evaluate the care provided at an Antepartum, Intrapartum, Postpartum (AIP) unit at a teaching hospital following the inclusion of obstetric nurses.
Method:
transversal study, performed at a AIP unit at a teaching hospital in the capital of the Brazilian state of Mato Grosso. The sample comprised data regarding the 701 childbirths that took place between 2014 and 2016. The data were organized using Excel and analyzed using version 7 of Epi Info software.
Results:
the results suggest that including obstetric nurses contributed towards qualifying the care provided during labor and childbirth, followed by a reduction in the number of interventions, such as episiotomy caesareans sections, and resulting in encouragement to employ practices that do not interfere in the physiology of the parturition process, which in turn generate good perinatal results.
Conclusion:
inserting these nurses collaborated towards humanizing obstetric and neonatal care.
-
01-01-2016
Normative grounds of health care practice in Brazilian nursing
Revista Brasileira de Enfermagem. 2016;69(6):1082-1090
Abstract
Normative grounds of health care practice in Brazilian nursing
Revista Brasileira de Enfermagem. 2016;69(6):1082-1090
DOI 10.1590/0034-7167-2016-0228
Views0See moreABSTRACT
Objective:
to understand the normative grounds of health care practice in Brazilian nursing.
Method:
qualitative study with the use of document research, carried out based on resolutions of the Federal Nursing Council. From a total of 263 resolutions, in the period from 1975 to 2015, 38 which were in accordance with the objective of the study were selected.
Results:
three analytical categories were systematized: Normative grounds of health care practice by the nursing team, under coordination/supervision of the nurse; Normative grounds of the care performed privately by the nurse; and Management and administrative aspects which affect and permeate the practice of health care in nursing.
Conclusion:
the set of normative grounds of health care practice by the nursing team leads to the reflection on the possible overlapping of attributions between professional levels and requires expansion to the other fields of nursing which are coherent with the health care network model.
-
01-01-2016
Palliative care and the intensive care nurses: feelings that endure
Revista Brasileira de Enfermagem. 2016;69(6):1074-1081
Abstract
Palliative care and the intensive care nurses: feelings that endure
Revista Brasileira de Enfermagem. 2016;69(6):1074-1081
DOI 10.1590/0034-7167-2016-0267
Views0See moreABSTRACT
Objective:
to know the feelings of nurses regarding palliative care in adult intensive care units.
Method:
qualitative study, which adopted the theoretical framework of Social Representations, carried out with 30 nurses of the state of Santa Catarina included by Snowball sampling. Data were collected through semi-structured interviews conducted from April to August 2015, organized and analyzed through the Collective Subject Discourse.
Results:
the results showed how central ideas are related to feelings of comfort, frustration, insecurity and anguish, in addition to the feeling that the professional training and performance are focused on the cure.
Conclusion:
the social representations of nurses regarding the feelings related to palliative care are represented mainly by negative feelings, probably as consequence of the context in which care is provided.
-
01-01-2016
Multi-professional intervention in adults with arterial hypertension: a randomized clinical trial
Revista Brasileira de Enfermagem. 2016;69(6):1067-1073
Abstract
Multi-professional intervention in adults with arterial hypertension: a randomized clinical trial
Revista Brasileira de Enfermagem. 2016;69(6):1067-1073
DOI 10.1590/0034-7167-2016-0320
Views0See moreABSTRACT
Objective:
assess the influence of an intervention, comprised of counseling related to health and aerobic physical training for lowering pressure values, in anthropometric indicators and in the adjustment of biochemical parameters in individuals with hypertension.
Method:
intervention study of the randomized clinical trial variety, with 42 individuals. The intervention-group followed the protocol of health counseling, nutrition and physical activity.
Results:
two intervention groups were considered: intervention-group (a) and intervention-group (b). Intervention-group (a) showed significant decrease in measurements of systolic and diastolic arterial pressure, of high-density lipoprotein parameters, hip circumference values and waist-hip ratio. Intervention-group (b) presented significant decrease in systolic arterial pressure values.
Conclusion:
it was found that the health intervention in conjunction with physical activities were effective in decreasing and/or controlling values for pressure, biochemical and anthropometric indicators.
-
01-01-2016
Clinical Caritas Processes in workshops for caregivers of institutionalized elderly people
Revista Brasileira de Enfermagem. 2016;69(6):1059-1066
Abstract
Clinical Caritas Processes in workshops for caregivers of institutionalized elderly people
Revista Brasileira de Enfermagem. 2016;69(6):1059-1066
DOI 10.1590/0034-7167-2016-0359
Views0See moreABSTRACT
Objective:
to describe the use of the Clinical Caritas Processes in workshops for caregivers of institutionalized elderly people, aimed at analyzing these professionals’ perception on humane care towards the institutionalized elderly.
Method:
a convergent care research was conducted with 18 caregivers of a long-term care institution for elderly people in the state of Paraíba, Brazil. Data were collected from June to November 2013, consisting of two months of interaction with the care service and ten meetings conducted in workshops for caregivers. Data were based on the theoretical framework of the Clinical Caritas Processes. Data analysis was based on content analysis and produced ten thematic categories based on the Caritas factors of caring.
Conclusion:
it was found that the use of the ten Caritas factors of caring were useful for humanistic formations when introducing the group to the conceptions of caring that value the self of the people providing the care and of the ones-being cared for.
-
01-01-2016
Technological innovation for peripheral venipuncture: ultrasound training
Revista Brasileira de Enfermagem. 2016;69(6):1052-1058
Abstract
Technological innovation for peripheral venipuncture: ultrasound training
Revista Brasileira de Enfermagem. 2016;69(6):1052-1058
DOI 10.1590/0034-7167-2016-0125
Views0See moreABSTRACT
Objective:
to evaluate the training of nurses in the use of ultrasound in peripheral venipuncture.
Method:
descriptive research of quantitative approach performed with nurses as part of an analytical cross-sectional study in two patient care centers: an intensive care unit and an adult emergency center.
Results:
the results showed contributions of training for professional skill and visibility of nurses, requiring, however, more time for complete assimilation of this technological innovation as a safer clinical practice.
Conclusion:
as the use of this technology represents an innovation aimed to facilitate difficult venipuncture and to provide subsidies to the most appropriate clinical decision-making, it is urgent to qualify nurses for its use.
-
06-01-2015
Elderly families of South of Brazil in the Health Strategy
Revista Brasileira de Enfermagem. 2015;68(3):406-413
Abstract
Elderly families of South of Brazil in the Health Strategy
Revista Brasileira de Enfermagem. 2015;68(3):406-413
DOI 10.1590/0034-7167.2015680305i
Views0See moreABSTRACT
Objective:
to characterize families and health status of the elderly in the Family Health Strategy and to verify the association of family composition with sociodemographic characteristics and health of the elderly.
Method:
population-based study with 215 families and 266 elderly, linked to the Family Health Strategy from a city of Rio Grande do Sul state.
Results:
there was predominance of nuclear family composition, considered as the main source of informal support, families of female elderly (62.6%) and cardiovascular complication. The nuclear structure was signifi cantly associated with female gender (PR = 0.77; p = 0.025) and smoking (PR = 1.35; p = 0.009).
Conclusion:
the results reinforce the need to maintain a network of formal and informal support to the elderly and their families to preserve the independence or to postpone the decline in functional capacity.
-
06-01-2015
From real to ideal – the health (un)care of long-lived elders
Revista Brasileira de Enfermagem. 2015;68(3):398-405
Abstract
From real to ideal – the health (un)care of long-lived elders
Revista Brasileira de Enfermagem. 2015;68(3):398-405
DOI 10.1590/0034-7167.2015680304i
Views0See moreABSTRACT
Objective:
to analyze similarities and dissimilarities in the meanings assigned to health care by long-lived elders and nursing professionals in a healthcare setting.
Method:
ethnographic qualitative research, based on the Spradley-McCurdy method and the interpretive anthropology of Geertz and Kleinman. The sample consisted of 20 key informants. Data were collected through participatory observation and ethnographic interviews from March to October 2013 and analyzed in domains, taxonomies and cultural themes.
Results:
Six domains and cultural taxonomies emerged and revealed reasons, attributes, and resources in providing care in relationship to long-lived elders and nursing professionals; fi nally, the following cultural theme emerged: the real to the ideal – the health (un)care of long-lived elders.
Conclusion:
The study showed the distance between the desired and actual health care provided to aged people in the scenario studied.
-
06-01-2015
Rescuing the pleasure of playing of child with cancer in a hospital setting
Revista Brasileira de Enfermagem. 2015;68(3):391-397
Abstract
Rescuing the pleasure of playing of child with cancer in a hospital setting
Revista Brasileira de Enfermagem. 2015;68(3):391-397
DOI 10.1590/0034-7167.2015680303i
Views0See moreABSTRACT
Objective:
to dimension spaces and people that act on playing of children with cancer in outpatient treatment.
Method:
qualitative research developed with the creative sensitive method. A total of twenty two family members of seven children with cancer in outpatient treatment at a public hospital in Rio de Janeiro participated of this research. Data were generated in the family members’ homes, from September 2011 to May 2012.
Results:
after the diagnosis of childhood cancer, there was a change of scene and in the people who interact and play with children. Hospital has a central place for it, since children discover the pleasure of playing in this setting.
Conclusion:
the health care professional, especially nurses, who work on hospital care needs, should develop the ability of facilitate playing and therefore, enable care that promotes childhood development.
-
06-01-2015
Child Health Surveillance: nurses perspective
Revista Brasileira de Enfermagem. 2015;68(3):384-390
Abstract
Child Health Surveillance: nurses perspective
Revista Brasileira de Enfermagem. 2015;68(3):384-390
DOI 10.1590/0034-7167.2015680302i
Views0See moreABSTRACT
Objective:
to analyze conceptions of nurses on child health surveillance in family health units.
Method:
a qualitative study with thematic analysis of the data, based on the paradigm of Health Surveillance. Interviews were conducted with 13 nurses in a countryside city in the state of Sao Paulo.
Results:
nurses conceived child health surveillance as an active monitoring, which should be comprehensive, identifying risks/vulnerabilities, through multidisciplinary and intersectoral actions that are dependent on maternal involvement. We found partial development of these assumptions in practice, due to diffi culties such as lack of maternal involvement in the proposed actions, lack of time for discussion and adoption of measures in the units and disarticulation between levels and sectors of the city.
Conclusion:
a greater political and technical investment is needed to ensure the adoption of this model in different sectors and levels of care of the city.
-
06-01-2015
The many sides of Research Integrity: For Integrity in Nursing!
Revista Brasileira de Enfermagem. 2015;68(3):375-377
Abstract
The many sides of Research Integrity: For Integrity in Nursing!
Revista Brasileira de Enfermagem. 2015;68(3):375-377
DOI 10.1590/0034-7167.2015680301i
Views1We recently had the opportunity to participate in the 4th World Conference on Research Integrity in Rio de Janeiro. For us researchers, professors, authors, reviewers and scientific editors of nursing periodicals, the event was a watershed: From this point forward, we must step up our game and catch up with other areas that already discuss […]See more -
06-01-2015
As diversas faces da Integridade em Pesquisa: por uma Enfermagem íntegra!
Revista Brasileira de Enfermagem. 2015;68(3):375-377
Abstract
As diversas faces da Integridade em Pesquisa: por uma Enfermagem íntegra!
Revista Brasileira de Enfermagem. 2015;68(3):375-377
DOI 10.1590/0034-7167.2015680301i
Views0Recentemente, tivemos oportunidade de participar da 4ª Conferência Mundial de Integridade em Pesquisa, no Rio de Janeiro. Para nós, pesquisadores, docentes, autores, pareceristas e editores científicos de periódicos de Enfermagem foi um evento divisor de águas: de ora em diante precisamos apertar o passo para alcançar as áreas que já têm as questões de Integridade […]See more -
01-01-2015
Professional Master’s Degree: potential contribution to Advanced Practice Nursing
Revista Brasileira de Enfermagem. 2015;68(6):1186-1189
Abstract
Professional Master’s Degree: potential contribution to Advanced Practice Nursing
Revista Brasileira de Enfermagem. 2015;68(6):1186-1189
DOI 10.1590/0034-7167.2015680626i
Views0See moreABSTRACT
A reflection articleabout the contribution of Master’s Degree Programs in Advanced Practice Nursing and the Universal Health Coverage and the Universal Health Access, topicsthat have been discussed by the Pan American Health Organization, and which the Brazilian Nursingrequires not just appropriate, but further studyto reflect in order to define directions for our profession.
-
01-01-2015
Concept of family insufficiency in the aged: critical literature analysis
Revista Brasileira de Enfermagem. 2015;68(6):1176-1185
Abstract
Concept of family insufficiency in the aged: critical literature analysis
Revista Brasileira de Enfermagem. 2015;68(6):1176-1185
DOI 10.1590/0034-7167.2015680625i
Views0See moreABSTRACT
Objective:
to identify the attributes of the “family insufficiency” concept of the aged in the literature.
Method:
critical literature analysis.
Results:
family insufficiency is characterized as a complex process of psychosocial interaction, founded mainly on low social support of the aged and impaired family ties. Its antecedents are found in contemporary transformations within the family system, intergenerational conflicts, impaired family relationships and social vulnerability of the family. The consequences of family insufficiency include social vulnerability of the aged, decline of psychological and functional health, lower quality of life and unsuccessful aging. An original theoretical proposal was elaborated for the concept of family insufficiency in the elderly, with the identification of its attributes, antecedents and consequences.
Conclusion:
the findings of this study constitute a theoretical advancement in the Family Insufficiency Syndrome in elderly people and provide data for future field research in developing the concept.
-
01-01-2015
Health technologies for spatial analysis and situational diagnosis of the territories: contributions to nursing
Revista Brasileira de Enfermagem. 2015;68(6):999-1000
Abstract
Health technologies for spatial analysis and situational diagnosis of the territories: contributions to nursing
Revista Brasileira de Enfermagem. 2015;68(6):999-1000
DOI 10.1590/0034-7167.2015680601i
Views0In order to establish an organizational basis for work processes in primary health care geared towards a new social practice, it is important to recognize territories and their contexts, as these materialize human interactions, conflicts, health problems and human needs.In the process of recognition and situational diagnosis of territories, technologies for spatial analysis can facilitate […]See more -
01-01-2015
Tecnologias em saúde para análise espacial e diagnóstico situacional dos territórios: contribuições para a enfermagem
Revista Brasileira de Enfermagem. 2015;68(6):999-1000
Abstract
Tecnologias em saúde para análise espacial e diagnóstico situacional dos territórios: contribuições para a enfermagem
Revista Brasileira de Enfermagem. 2015;68(6):999-1000
DOI 10.1590/0034-7167.2015680601i
Views0Para a constituição de uma base organizativa dos processos de trabalho na Atenção Primária à Saúde em direção a uma nova prática social é importante o reconhecimento dos territórios e seus contextos, pois estes materializam as interações humanas, os conflitos, os problemas de saúde e necessidades humanas.Nesse processo de reconhecimento e diagnóstico situacional dos territórios, […]See more -
01-01-2015
CARTA DE FORTALEZA PARA A ENFERMAGEM BRASILEIRA
Revista Brasileira de Enfermagem. 2015;68(5):961-962
Abstract
CARTA DE FORTALEZA PARA A ENFERMAGEM BRASILEIRA
Revista Brasileira de Enfermagem. 2015;68(5):961-962
DOI 10.1590/0034-7167.2015680527
Views0APRESENTAÇÃOOs participantes do 18º Seminário Nacional de Pesquisa em Enfermagem (SENPE), promovido pela Associação Brasileira de Enfermagem (ABEn) e realizado pela ABEn Seção Ceará, aprovaram, em Sessão Plenária de Encerramento, no dia 03 de junho de 2015, a “Carta de Fortaleza para a Enfermagem Brasileira”. A ABEn vem a público divulgá-la, ao mesmo tempo em […]See more -
01-01-2015
Delayed surgical recovery: a concept analysis
Revista Brasileira de Enfermagem. 2015;68(5):953-960
Abstract
Delayed surgical recovery: a concept analysis
Revista Brasileira de Enfermagem. 2015;68(5):953-960
DOI 10.1590/0034-7167.2015680526i
Views0See moreABSTRACT
Objective:
analyze the concept of delayed surgical recovery.
Method:
the Rodgers’ concept analysis provided the procedural mechanisms to guide the study, and an integrative review was performed to achieve the second activity of the model adopted. The PubMed, CINAHL, EMBASE and LILACS databases were selected to search for primary studies.
Results:
sixty-six primary studies were included and served as basis to construct the use and meaning of delayed surgical recovery concept. In the analysis, six attributes were outlined, which are interrelated and underpin the research concept definition. Preliminary experience was identified as the antecedent. The consequences of the concept are expressed through clinical manifestations, re-interventions, dependence on care and reduced quality of life.
Conclusion:
the definition of the concept was constructed, and the antecedents and consequents were identified. The use and meaning of the delayed surgical recovery concept point to the use of the qualifier ‘impaired’ instead of ‘delayed’.
-
01-01-2015
Total Quality Management and hospital nursing: an integrative literature review
Revista Brasileira de Enfermagem. 2015;68(5):945-952
Abstract
Total Quality Management and hospital nursing: an integrative literature review
Revista Brasileira de Enfermagem. 2015;68(5):945-952
DOI 10.1590/0034-7167.2015680525i
Views0See moreABSTRACT
Objective:
to identify the available evidence in the literature on Total Quality Management in nursing administration.
Method:
integrative literature review of full text articles in Portuguese, English and Spanish, published between 2000 and 2011 in the LILACS, MEDLINE, SciELO and PubMed databases.
Results:
the sample comprises 24 periodical articles grouped by the following thematic categories: Theoretical assumptions; Practical application and Quality indicators. Despite the criticism of models derived from classic administration theories, experiences of success with the deployment of TQM have already marked the health and nursing setting in Brazil.
Conclusion:
Total Quality Management in managing of nursing care has being fully used in some health institutions, while others have adopted several of its principles. Two of the twenty four articles are intervention studies, which characterizes the necessity for clinical research in this area.
-
01-01-2015
Association between fatigue and functional capacity in patients with intermittent claudication
Revista Brasileira de Enfermagem. 2015;68(5):937-944
Abstract
Association between fatigue and functional capacity in patients with intermittent claudication
Revista Brasileira de Enfermagem. 2015;68(5):937-944
DOI 10.1590/0034-7167.2015680524i
Views0See moreABSTRACT
Objective:
to characterize fatigue and exertion fatigue in patients with intermittent claudication (IC), and to test their association with sociodemographic and clinical variables, walking capacity and level of physical activity.
Method:
forty-nine participants (66.6 years; 70% male) were studied. Validated questionnaires were used to assess fatigue (DUFS), exertion fatigue (DEFS), level of physical activity (BASIC) and walking capacity (WIQ).
Results:
participants had substantial fatigue (DUFS = 20.4+8.8) and substantial exertion fatigue (DEFS = 20.4+10.8). There was an association between the DUFS and marital status (p = 0,008). There was a statically significant association between DEFS with scores of the BASIC (r = .331; p = .02) and among DEFS with WIQ domains – walking distance (r=.359; p = .011) and climbing stairs (r=.331; p = .02).
Conclusion:
patients with IC have fatigue and exertion fatigue. Exertion fatigue might compromise the engagement of these patients in physical activity, one of the main components of IC treatment.
-
01-01-2015
Body mobilization for prevention of pressure ulcers: direct labor costs
Revista Brasileira de Enfermagem. 2015;68(5):930-936
Abstract
Body mobilization for prevention of pressure ulcers: direct labor costs
Revista Brasileira de Enfermagem. 2015;68(5):930-936
DOI 10.1590/0034-7167.2015680523i
Views0See moreABSTRACT
Objective:
to calculate the average total cost (ATC) on the direct labor costs (DLC) of nursing professionals in body mobilization of patients for the prevention of pressure ulcers.
Method:
this is a quantitative, exploratory and, descriptive research. We observed 656 preventive mobilizations and we calculated the cost by multiplying the time spent by professionals at a unitary DLC.
Results:
ATC with DLC for each Unit corresponded to: Medical Clinic R$ 5.38 for bed turning, R$ 5.26 for seating positions, R$ 5.55 for walking aid; Surgical Clinic R$ 2.42 for bed turning, R$ 2.30 for seating positions, R$ 2.96 for walking aid and Intensive Care Unit R$ 8.15 for bed turning, R$ 7.57 for seating positions, R$ 15.32 for walking aid.
Conclusion:
the knowledge generated can support management related to costs of human resources needed to efficiently and effectively nursing care.
-
01-01-2015
The mobilization of nurses for the non-interruption of nursing residence
Revista Brasileira de Enfermagem. 2015;68(5):923-929
Abstract
The mobilization of nurses for the non-interruption of nursing residence
Revista Brasileira de Enfermagem. 2015;68(5):923-929
DOI 10.1590/0034-7167.2015680522i
Views0See moreABSTRACT
Objective:
To analyze the strategies employed by nurses to maintain the nursing residence program at the Ophir Loyola Hospital and discuss the potential effects of this interruption on the state of Pará.
Method:
Social-historic research. Data were collected through primary sources, written documents, and oral testimonial; the secondary sources used were manuals and articles that approached the topic in question. The theoretical reference was based on the French sociologist Pierre Bourdieu’s ideas about the concepts of cultural, social, and symbolic capital, in addition to the habitus and field concepts.
Results:
During the nurses’ mobilization there was a strong political influence on the development of the crisis and the interruption of the nursing residence Program at the Ophir Loyola Hospital, with implications for the nurses’ qualifications and the health care delivered to the societyof Pará.
Conclusion:
The analysis showed the prevalence of partisan political interests at the expense of social interests, culminating in the interruption of the nursing residency.
Search
Search in:
Nuvem de Tags
Adolescente (85) Atenção Primária à Saúde (239) COVID-19 (91) Criança (91) Cuidados de Enfermagem (269) Educação em Enfermagem (151) Educação em Saúde (139) Enfermagem (930) Enfermagem Pediátrica (86) Estudantes de Enfermagem (77) Estudos de Validação (131) Família (87) Idoso (208) Promoção da Saúde (99) Qualidade de Vida (104) Saúde do Trabalhador (86) Saúde Mental (145) Saúde Pública (82) Segurança do Paciente (150) Tecnologia Educacional (100)