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ORIGINAL ARTICLE09-20-2024
Predictor variables effect on the development of Burnout Syndrome in higher education professor
Revista Brasileira de Enfermagem. 2024;77(4):e20240132
Abstract
ORIGINAL ARTICLEPredictor variables effect on the development of Burnout Syndrome in higher education professor
Revista Brasileira de Enfermagem. 2024;77(4):e20240132
DOI 10.1590/0034-7167-2024-0132
Views0See moreABSTRACT
Objectives:
to correlate the development of Burnout Syndrome in higher education professors with the following variables: sociodemographic, economic, work, sleep pattern, level of anxiety and quality of life.
Methods:
observational, analytical, cross-sectional study with a quantitative approach. Data collection took place from August to November 2022, with 140 professors from a private higher education institution in the Western Brazilian Amazon.
Results:
professors who carried out activities outside institutional hours and who had sleep duration < 5 hours, presented lower scores in the personal fulfillment dimension of burnout, with (p=0.002) and (p=0.001), respectively. The higher the scores for the physical (p=0.001), psychological (p=0.000) and social relationships (p=0.002) domains of quality of life, the lower the personal fulfillment scores for the syndrome.
Conclusions:
through linear regression, it was evidenced that several variables explain the development of burnout. Institutional and governmental actions can minimize the negative influence of these variables.
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ORIGINAL ARTICLE09-20-2024
Construction and enhancement of a prototype for a medical-hospital equipment for hypodermoclysis: a qualitative study
Revista Brasileira de Enfermagem. 2024;77(4):e20240059
Abstract
ORIGINAL ARTICLEConstruction and enhancement of a prototype for a medical-hospital equipment for hypodermoclysis: a qualitative study
Revista Brasileira de Enfermagem. 2024;77(4):e20240059
DOI 10.1590/0034-7167-2024-0059
Views0See moreABSTRACT
Objectives:
to construct a Subcutaneous Hydration Device semi-functional prototype and gather initial information to improve this prototype design and realize its acceptance potential.
Methods:
a qualitative, descriptive and exploratory study, which used focus group, following the Technology Acceptance Model. The group was held at the Escola Superior de Enfermagem de Coimbra, Portugal, in December 2022, composed of nine participants from six different disciplinary areas, and followed thematic analysis.
Results:
four topics emerged associated with the device components: elastomeric infusion pump; needle/access device; clamp; administration set. From these topics, topics were triggered that highlighted: characteristics about the target population; ease of use and accessories; patient comfort and safety; and device application context.
Final Considerations:
the Subcutaneous Hydration Device semi-functional prototype is viable and interesting for the clinic. The results support its improvement and direct future investments for experimental studies.
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REVIEW09-20-2024
Brazilian nursing specific situation, middle and micro-range theories: a bibliometric study
Revista Brasileira de Enfermagem. 2024;77(4):e20230520
Abstract
REVIEWBrazilian nursing specific situation, middle and micro-range theories: a bibliometric study
Revista Brasileira de Enfermagem. 2024;77(4):e20230520
DOI 10.1590/0034-7167-2023-0520
Views0See moreABSTRACT
Objectives:
to map the nursing theories developed in stricto sensu graduate programs in nursing in Brazil.
Methods:
a bibliometric study, carried out on the Coordination for the Improvement of Higher Education Personnel Theses and Dissertations Portal in October 2023. The controlled descriptors “Nursing Theory” and “Nursing Models” and the uncontrolled descriptors “Theories” and “Middle-Range Theory” were used. Selected studies were cataloged for analysis, which was conducted by the study authors, who have a doctoral degree and expertise in research on nursing theories.
Results:
thirty-nine nursing theories were mapped, with a predominance of middle-range theories (79.5%), focusing on nursing diagnostic concepts and use of the theoretical-methodology strategy of theoretical-causal validity.
Conclusions:
the study identified nursing theories developed in Brazil, recognizing trends, development strategies, theorized objects of disciplinary interest and investments necessary for practical application in Brazilian contexts.
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ORIGINAL ARTICLE09-20-2024
Cross-cultural adaptation and validation of the Healthy Work Environment Assessment Tool in Brazilian culture
Revista Brasileira de Enfermagem. 2024;77(4):e20230505
Abstract
ORIGINAL ARTICLECross-cultural adaptation and validation of the Healthy Work Environment Assessment Tool in Brazilian culture
Revista Brasileira de Enfermagem. 2024;77(4):e20230505
DOI 10.1590/0034-7167-2023-0505
Views0See moreABSTRACT
Objectives:
to adapt and validate the content of the Healthy Work Environment Assessment Tool for Brazilian culture, and evaluate the practical aspects of its application.
Methods:
methodological study that followed six stages: translation; synthesis; back translation; content validation by a group of experts, pre-testing and approval of the process by the author of the original instrument.
Results:
the first three stages were carried out by contracted companies. In the committee, two items and the title of a subscale were evaluated in a second round, when consensus was reached among experts. In the pre-test, more than 93% of professionals agreed that the tool was easy to understand. The average completion time was 8.53 minutes. The American Association of Critical-Care Nurses authorized publication of the results.
Conclusions:
the adaptation of the tool to Brazilian culture was completed following the adopted framework. In addition to the evidence of content validity, the tool appears promising for managerial use.
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ORIGINAL ARTICLE09-20-2024
Construction and validation of a checklist for the management of totally implanted catheters in children
Revista Brasileira de Enfermagem. 2024;77(4):e20230447
Abstract
ORIGINAL ARTICLEConstruction and validation of a checklist for the management of totally implanted catheters in children
Revista Brasileira de Enfermagem. 2024;77(4):e20230447
DOI 10.1590/0034-7167-2023-0447
Views0See moreABSTRACT
Objectives:
to construct and validate the content of a checklist for the management of totally implanted catheters in hospitalized children and adolescents.
Methods:
methodological research conducted from October 2021 to December 2022 in two stages: development of the instrument with care guidelines and content validation of the checklist. The instrument, containing 23 items presented in Likert format, was evaluated online by specialists in two rounds. The Content Validity Index was applied, considering indices above 0.8 as valid.
Results:
the final checklist included four domains and 22 checklist items, validated with a Content Validity Index of 0.98. The overall evaluation of the instrument presented a global score of 9.9.
Conclusions:
the validation and application of instruments that standardize procedures, in addition to supporting professionals, promote autonomy and quality of care for children and adolescents using this device.
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ORIGINAL ARTICLE09-20-2024
Transgender people’s knowledge about the adverse effects of cross-hormonization: challenges for nursing
Revista Brasileira de Enfermagem. 2024;77(4):e20230346
Abstract
ORIGINAL ARTICLETransgender people’s knowledge about the adverse effects of cross-hormonization: challenges for nursing
Revista Brasileira de Enfermagem. 2024;77(4):e20230346
DOI 10.1590/0034-7167-2023-0346
Views0See moreABSTRACT
Objectives:
to identify trans women’s and men’s knowledge about the adverse effects of cross-hormonization and understand the repercussions of hormonization practices on trans women’s and men’s health.
Methods:
exploratory, descriptive, qualitative research, developed with 41 participants, from July 2019 to February 2020, in a trans health outpatient clinic. Thematic-categorical content analysis was used.
Results:
from the analysis, the categories emerged: Knowledge about the adverse effects of cross-hormonization; and Cross-hormonization practices and their meaning.
Final Considerations:
nursing practices, based on the identification of knowledge about adverse effects and the understanding of cross-hormonization practices in trans women’s and men’s health, can result in more inclusive care.
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ORIGINAL ARTICLE09-20-2024
Sociocognitive factors determining compliance with standard precautions by nursing professionals during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2024;77(4):e20230301
Abstract
ORIGINAL ARTICLESociocognitive factors determining compliance with standard precautions by nursing professionals during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2024;77(4):e20230301
DOI 10.1590/0034-7167-2023-0301
Views0See moreABSTRACT
Objectives:
to assess the socio-cognitive factors determining adherence to standard precautions by nursing professionals in care practice during the COVID-19 pandemic in Brazil.
Methods:
an analytical cross-sectional study, carried out with 9,039 nursing professionals in Brazil, using an electronic form containing participant sociodemographic, training and work variables, and the Brazilian version of the Standard Precautions Questionnaire. Descriptive and inferential statistics were used using the statistical software R.
Results:
participants recognize standard precautions as effective measures to reduce infections and report intention to perform them. Training regarding standard precautions was evidenced as a facilitator of adherence (4.72; SD: 0.73), and problems related to materials (3.78; SD: 1.45) were a hindrance.
Conclusions:
among the determining factors, facilitating organization presented the highest score, followed by intention to perform. Facilitating and hindering factor identification makes it possible to develop intervention strategies to strengthen patient safety and reduce occupational risks among professionals.
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ORIGINAL ARTICLE09-20-2024
Middle-range theory of the existential dimension of being-in-the-world of chronic kidney disease: Grounded Theory
Revista Brasileira de Enfermagem. 2024;77(4):e20230152
Abstract
ORIGINAL ARTICLEMiddle-range theory of the existential dimension of being-in-the-world of chronic kidney disease: Grounded Theory
Revista Brasileira de Enfermagem. 2024;77(4):e20230152
DOI 10.1590/0034-7167-2023-0152
Views0See moreABSTRACT
Objectives:
to develop a middle-range theory of the existential dimension of being-in-the-world of chronic kidney disease in the light of humanistic nursing theory.
Methods:
exploratory-descriptive, qualitative, Grounded Theory study, whose guiding question was: what theoretical relationships can be established between clinical practice carried out in the context of renal replacement therapies and the concepts of humanistic nursing theory? Data were collected through semi-structured interviews with nursing staff and chronic kidney disease patients.
Results:
a theory was developed that describes and explains the existential dimension of being-in-the-world of chronic kidney disease, identifying the qualitative evidence present in this context.
Final Considerations:
the theory contributes to clinical nursing practice qualification in nephrology, consolidating nursing as an art and science, because it arises from care practice and research, in addition to rescuing what differentiates it within the health disciplines, which is care par excellence.
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01-01-2015
Polysomnography assessment of sleep and wakefulness in premature newborns
Revista Brasileira de Enfermagem. 2015;68(6):1109-1115
Abstract
Polysomnography assessment of sleep and wakefulness in premature newborns
Revista Brasileira de Enfermagem. 2015;68(6):1109-1115
DOI 10.1590/0034-7167.2015680616i
Views0See moreABSTRACT
Objective:
to describe the total sleep time and its stages, total wake time, heart rate values and oxygen saturation shown by premature infants, and the influence of the periods of the day on sleep and physiological parameters.
Method:
a descriptive study was conducted of 13 hospitalized premature infants. Data collection was performed using polysomnography and unstructured observation for 24 uninterrupted hours.
Results:
the newborns remained asleep for 59.6% of the day, predominantly in quiet sleep, with a higher mean heart rate during wakefulness (p<0.001). No difference was found between the variables related to sleep, physiological parameters and periods of the day, but in the morning a predominance of quiet sleep was observed (p=0.002).
Conclusion:
the preterm newborn presented more total sleep time than wakefulness; quiet sleep was the predominant stage, and heart rate was higher during wakefulness.
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01-01-2015
Learning Incubator: an instrument to foster entrepreneurship in Nursing
Revista Brasileira de Enfermagem. 2015;68(6):1103-1108
Abstract
Learning Incubator: an instrument to foster entrepreneurship in Nursing
Revista Brasileira de Enfermagem. 2015;68(6):1103-1108
DOI 10.1590/0034-7167.2015680615i
Views0See moreABSTRACT
Objective:
this study aimed to know the contributions of the Learning Incubator to the process of lifelong education in health.
Method:
this is a qualitative field research whose data was collected from August to December 2014 by the focus group technique. The research had 34 employees of a Teaching Hospital in the central region of the state of Rio Grande do Sul that participated previously in the incubation process.
Results:
from the data encoded by content analysis, three themes were selected: Learning Incubator – welcoming and integrating space; An instigating instrument that enhances possibilities; Continuous and lifelong education strategy.
Conclusion:
the Learning Incubator is an important instrument to foster entrepreneurship in nursing and other health areas due to its capacity of rethinking mechanized practices, to the possibility of instigating new ways of being and acting, and to the ability of creating and developing new ideas based on individual and institutional needs.
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01-01-2015
Estratégias não farmacológicas para diminuição da ansiedade no cateterismo cardíaco: revisão integrativa
Revista Brasileira de Enfermagem. 2015;68(6):1093-1102
Abstract
Estratégias não farmacológicas para diminuição da ansiedade no cateterismo cardíaco: revisão integrativa
Revista Brasileira de Enfermagem. 2015;68(6):1093-1102
DOI 10.1590/0034-7167.2015680614i
Views0See moreRESUMEN
Objetivo:
identificar y revisar los estudios de literatura que abordan las estrategias no farmacológicas utilizadas para reducir la ansiedad en los pacientes que reciben un cateterismo cardíaco.
Método:
revisión integradora. La investigación se llevó a cabo utilizando las bases de datos LILACS, SciELO, Medline (BVS y PubMed) y Scopus. Los estudios se analizaron de acuerdo con sus objetivos, la metodo, los instrumentos utilizados para la evaluación de la ansiedad de los pacientes, y los resultados obtenidos.
Resultados:
la estrategia dirigida más para reducir la ansiedad en los pacientes que recibieron cateterización cardíaca fue la musicoterapia. No se encontró estudio, sin embargo, identificando el momento más adecuado para esta intervención (antes, durante y / o después de este procedimiento). Otras estrategias identificados en esta revisión eran videos educativos, masajes y terapia de palma.
Conclusión:
los resultados sugieren que la ansiedad se puede reducir el uso de estrategias no farmacológicas.
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01-01-2015
Non-pharmacological strategies to decrease anxiety in cardiac catheterization: integrative review
Revista Brasileira de Enfermagem. 2015;68(6):1093-1102
Abstract
Non-pharmacological strategies to decrease anxiety in cardiac catheterization: integrative review
Revista Brasileira de Enfermagem. 2015;68(6):1093-1102
DOI 10.1590/0034-7167.2015680614i
Views0See moreABSTRACT
Objective:
to identify and review the literature on non-pharmacological strategies used for reducing anxiety in patients receiving cardiac catheterization.
Method:
this study was an integrative literature review. The research was conducted using the databases LILACS, SciELO, Medline (through BVS and PubMed) and Scopus. Studies were analyzed according to their objective, method, instruments used for evaluating patients’ anxiety, and the results obtained.
Results:
the most used strategy for reducing anxiety in patients receiving cardiac catheterization was music therapy. However, no study identifying the most appropriate time for this intervention (before, during and/or after the procedure) was found. Other strategies identified in this review were educational videos, massage, and palm therapy.
Conclusion:
the results found suggest that anxiety can be reduced using non-pharmacological strategies.
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01-01-2015
Convergence, divergence and diagnostic accuracy in the light of two nursing terminologies
Revista Brasileira de Enfermagem. 2015;68(6):1086-1092
Abstract
Convergence, divergence and diagnostic accuracy in the light of two nursing terminologies
Revista Brasileira de Enfermagem. 2015;68(6):1086-1092
DOI 10.1590/0034-7167.2015680613i
Views0See moreABSTRACT
Objective:
compare divergences and convergences between the nursing diagnoses established for a case study, in the light of two nursing terminologies.
Method:
a descriptive research was undertaken. The participants were 24 nurses from public teaching hospitals (N=12) and hospital care institutions (N=12) in the Northeast of Brazil.
Results:
in group A (6 faculty members and 6 clinical professionals), 51 diagnoses were established according to NANDA-I: 54.9% of high accuracy, 23.5% zero, 15.7% low and 5.9% moderate accuracy. In group B (6 faculty members and 6 clinical professionals), 43 declarations were established using the ICNP®: 44.2% of zero accuracy, 39.5% high, 16.3% low. Four out of fi ve diagnostic titles of high accuracy in group A and the seven titles in group B converged; divergences were attributed to the number of combinations among the focus, judgment and location axes of the ICNP®.
Conclusion:
a range of titles was observed with different diagnostic inferences and low diagnostic accuracy in both groups.
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01-01-2015
Family caregivers articulating the social network of a child with special health care needs
Revista Brasileira de Enfermagem. 2015;68(6):1078-1085
Abstract
Family caregivers articulating the social network of a child with special health care needs
Revista Brasileira de Enfermagem. 2015;68(6):1078-1085
DOI 10.1590/0034-7167.2015680612i
Views0See moreABSTRACT
Objective:
the study sought to characterize the social network of the child and analyze the role of the family in its creation.
Method:
a qualitative approach was developed through five dynamics (Speaking Map) based on the creative sensitive method, with five groups of families (12 participants) in their homes.
Results:
the critical discourse analysis of the caregivers (grandparents, siblings and neighbors) showed that the mother plays the main role in articulating the social network, with its points being linked by the hospital, primary and rehabilitation care, household, school, etc. Familial care becomes more visible at home and within the community.
Conclusion:
with the insufficient public policy that articulating healthcare facilities for CSHCN in the community, family members shape a social network characterized by a dense and fluid mesh.
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01-01-2015
Speeches of managers about the policy of the directly observed treatment for tuberculosis
Revista Brasileira de Enfermagem. 2015;68(6):1069-1077
Abstract
Speeches of managers about the policy of the directly observed treatment for tuberculosis
Revista Brasileira de Enfermagem. 2015;68(6):1069-1077
DOI 10.1590/0034-7167.2015680611i
Views0See moreABSTRACT
Objective:
to analyze the managers’ speeches about the policy transfer of the directly observed treatment (DOT) for tuberculosis control in the city of João Pessoa, Paraíba, Brazil.
Method:
this is a qualitative study developed in May and June, 2013 through semi-directed interviews with twenty health professionals in five health districts in João Pessoa/PB. The empirical material produced was analyzed according to the theoretical-analytical basis of the French Discourse Analysis by Pêcheux.
Results:
the study demonstrated weaknesses in the conduction and organization of actions in relation to the DOT. It revealed that the lack of knowledge of the managers about this policy has direct implications to the care of tuberculosis patients.
Conclusion:
the management should trace strategic plans to rethink the care practices and thus, reorganize the entire care network to users in order to effectively contribute to user adherence in the fight against tuberculosis.
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01-01-2015
Conceptions of mid-level nursing professionals facing those with a chemical dependency
Revista Brasileira de Enfermagem. 2015;68(6):1063-1068
Abstract
Conceptions of mid-level nursing professionals facing those with a chemical dependency
Revista Brasileira de Enfermagem. 2015;68(6):1063-1068
DOI 10.1590/0034-7167.2015680610i
Views0See moreABSTRACT
Objective:
to describe and understand the conceptions of nursing assistants working in Psychosocial Care Centers for alcohol and drugs (CAPS ad), about the patient with addictions.
Method:
sixteen nursing assistants and technicians from nine of the CAPS ad in São Paulo were interviewed, and data were analyzed using the constant comparative method.
Results:
performing the functions in the CAPS ad enabled the change in staff’s conception from a stigmatizing and prejudiced view, to the concept of chemical dependence as a disease and those who are chemically dependent as patients with comorbidities and family problems, in need of help and treatment.
Conclusion:
professional practice in specialized services for alcohol and other drugs enables changes in the staff’s conceptions about chemically dependent individuals, highlighting the need to include the subject of alcohol and drugs in the school curriculum.
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ORIGINAL ARTICLE07-31-2023
Primary Health Care assessment in the COVID-19 pandemic from physicians’ and nurses’ perspective
Revista Brasileira de Enfermagem. 2023;76:e20220475
Abstract
ORIGINAL ARTICLEPrimary Health Care assessment in the COVID-19 pandemic from physicians’ and nurses’ perspective
Revista Brasileira de Enfermagem. 2023;76:e20220475
DOI 10.1590/0034-7167-2022-0475
Views0See moreABSTRACT
Objectives:
to assess the operationalization of Primary Health Care in the COVID-19 pandemic, according to Primary Care Assessment Tool: PCATool-Brasil attributes, from physicians’ and nurses’ perspective.
Methods:
a cross-sectional study, carried out with 99 physicians and nurses from Basic Health Units in a state in northeastern Brazil, with the aid of the adapted instrument PCATool-Brasil.
Results:
Essential Score was classified as high performance (6.6) and General Score as low performance (6.5). First Contact Access, Care Integration, and Community Guidance scores were <6.6. The best performances were attributed to the Longitudinality, Comprehensiveness and Family Guidance services (scores>6.6).
Conclusions:
the attributes of Primary Health Care, in general, showed values above or close to the cut-off point in the assessment. These data can support strategies for local and national managers to strengthen Primary Health Care in the COVID-19 pandemic and future public health emergencies.
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07-31-2023
Breastfeeding prevalence in newborns of mothers with COVID-19: a systematic review
Revista Brasileira de Enfermagem. 2023;76:e20220173
Abstract
Breastfeeding prevalence in newborns of mothers with COVID-19: a systematic review
Revista Brasileira de Enfermagem. 2023;76:e20220173
DOI 10.1590/0034-7167-2022-0173
Views0See moreABSTRACT
Objectives:
to compare exclusive breastfeeding prevalence versus artificial feeding in newborns of mothers with COVID-19.
Methods:
a systematic review of prevalence, according to JBI. Searches in PubMed®, Embase, CINAHL, LILACS and Web of Science™ databases in August 2021. Cross-sectional, longitudinal or cohort studies were selected, without language and time limitations that showed breastfeeding prevalence or that allowed calculation.
Results:
fifteen articles published in 2020 and 2021, cohort (60%) or cross-sectional (40%) were analyzed. The average of exclusive breastfeeding in mothers with COVID-19 was 56.76% (CI=39.90–72.88), and artificial breastfeeding, 43.23% (CI = 30.99 – 55.88), without statistically significant differences.
Conclusions:
despite the recommendations for maintaining breastfeeding, there was a reduction worldwide, when compared to periods prior to the pandemic. With advances in science, these rates have improved, showing the impact of evidence on practices. As limitations, study sources are cited. It is recommended to carry out new studies. PROSPERO registration CRD42021234486.
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ORIGINAL ARTICLE07-10-2023
Correlation between symptoms of depression, attitude, and self-care in elderly with type 2 diabetes
Revista Brasileira de Enfermagem. 2023;76(3):e20220741
Abstract
ORIGINAL ARTICLECorrelation between symptoms of depression, attitude, and self-care in elderly with type 2 diabetes
Revista Brasileira de Enfermagem. 2023;76(3):e20220741
DOI 10.1590/0034-7167-2022-0741
Views0See moreABSTRACT
Objectives:
to correlate depressive symptoms, attitude, and self-care of elderly people with type 2 diabetes.
Methods:
study developed with 144 elderly people with diabetes; carried out in Family Health Units. A semi-structured instrument was used to obtain data on the sociodemographic profile; the Geriatric Depression Scale (15 items), the Questionário de Atitudes Psicológicas do Diabetes [Psychological Attitudes of Diabetes Questionnaire], and the Diabetes Self-Care Activities Questionnaire (DSCA) were also used.
Results:
it was identified that 24.3% of the participants presented depressive symptoms, and 93.8% presented negative attitudes of coping. A greater adherence to self-care activities related to the practice of medication was observed. In the correlation between the scales, a negative and inversely proportional correspondence was noted between depressive symptomatology and physical activity (p=0.010) and foot care (p=0.006), likewise between attitude and foot care (p=0.009).
Conclusions:
self-care in elderly people with diabetes mellitus is influenced by depressive symptoms and negative coping attitudes.
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07-10-2023
Metodologia Lean Seis Sigma para melhoria do processo de alta em uma unidade de terapia intensiva
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
Abstract
Metodologia Lean Seis Sigma para melhoria do processo de alta em uma unidade de terapia intensiva
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
DOI 10.1590/0034-7167-2022-0538
Views0See moreRESUMEN
Objetivos:
describir el proceso de implementación de Lean Six Sigma para mejorar el proceso de alta en una unidad de cuidados intensivos brasileña.
Métodos:
estudio prospectivo siguiendo el método de desarrollo de proyectos denominado DMAIC (Define-Measure-Analyze-Improve-Control). Este método consta de cinco fases, a saber: definición del proyecto, medición del punto de partida y recolección de datos, análisis de resultados, mejora en los procesos y control estadístico.
Resultados:
la aplicación de la metodología Lean Six Sigma fue efectiva para mejorar el proceso de alta de la unidad de cuidados intensivos a la unidad de hospitalización. Esta mejora representó una reducción en el tiempo promedio de alta de 189 a 75 minutos, totalizando una mejora del 61%.
Conclusiones:
este artículo demuestra la efectividad de la aplicación de la metodología Lean Six Sigma para mejorar el flujo de descarga en una unidad crítica, lo que resulta en la reducción de tiempo y desperdicio.
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REVIEW07-10-2023
Lean Six Sigma methodology to improve the discharge process in a Brazilian intensive care unit
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
Abstract
REVIEWLean Six Sigma methodology to improve the discharge process in a Brazilian intensive care unit
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
DOI 10.1590/0034-7167-2022-0538
Views0ABSTRACT
Objectives:
to describe the Lean Six Sigma implementation process to improve the discharge process in a Brazilian health institution’s ICU.
Methods:
prospective study following the Define-Measure-Analyse-Improve-Control project development method. This method consists of five phases, namely: project definition, measurement of the starting point and data collection, analysis of results, improvement in processes, and statistical control.
Results:
applying Lean Six Sigma methodology following the Define-Measure-Analyse-Improve-Control in the discharge process from the intensive care unit to the inpatient unit was effective in improving processes. This improvement represented a reduction in the mean patient transfer time to the inpatient unit from 189 minutes to 75 minutes, representing a 61% improvement in discharge time.
Conclusions:
this article demonstrates the effectiveness of applying Lean Six Sigma methodology to improve the discharge flow in a critical unit, resulting in time and waste reduction.
Keywords:Health Services AdministrationIntensive Care UnitsPatient DischargeTotal Quality ManagementWorkflowSee more -
ORIGINAL ARTICLE07-10-2023
Primary care in supplementary health: assessment of costs in the care of older adult patients with heart diseases
Revista Brasileira de Enfermagem. 2023;76(3):e20220486
Abstract
ORIGINAL ARTICLEPrimary care in supplementary health: assessment of costs in the care of older adult patients with heart diseases
Revista Brasileira de Enfermagem. 2023;76(3):e20220486
DOI 10.1590/0034-7167-2022-0486
Views0See moreABSTRACT
Objectives:
to identify whether implementing a supplementary Primary Health Care (PHC) system makes it possible to reduce care costs for older adults with heart diseases.
Methods:
a retrospective cohort of 223 patients with heart disease aged ≥ 60 years. Data were obtained from medical records and cost databases, assessed for a period of one year before and after PHC implementation. The results were expressed as mean absolute frequencies for number of hospitalizations and as average annual expenses expressed in dollars (US$) in relation to cost data.
Results:
there was a reduction in hospitalization expenses after implementing supplementary PHC (p=0.01) and a decrease in the frequency of hospitalizations for the entire sample (p=0.006). There was a reduction in the frequency of consultations at the Emergency Room among frail older adults (p=0.011).
Conclusions:
there was a reduction in hospitalization costs and frequency of visits to the Emergency Room after supplementary PHC.
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ORIGINAL ARTICLE07-10-2023
Occurrence and preventability of adverse events in hospitals: a retrospective study
Revista Brasileira de Enfermagem. 2023;76(3):e20220025
Abstract
ORIGINAL ARTICLEOccurrence and preventability of adverse events in hospitals: a retrospective study
Revista Brasileira de Enfermagem. 2023;76(3):e20220025
DOI 10.1590/0034-7167-2022-0025
Views0See moreABSTRACT
Objectives:
to analyze the incidence of preventable adverse events related to health care in adult patients admitted to public hospitals in Brazil.
Methods:
observational, analytical, retrospective study based on medical records review.
Results:
medical records from 370 patients were evaluated, 58 of whom had at least one adverse event. The incidence of adverse events corresponded to 15.7%. Adverse events were predominantly related to healthcare-related infection (47.1%) and procedures (24.5%). Regarding the adverse event severity, 13.7% were considered mild, 51.0% moderate, and 35.3% severe. 99% of adverse events were classified as preventable. Patients admitted to the emergency room had a 3.73 times higher risk for adverse events.
Conclusions:
this study’s results indicate a high incidence of avoidable adverse events and highlight the need for interventions in care practice.
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