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08-30-2024
Fatores determinantes para à hesitação vacinal contra a COVID-19 em brasileiros: estudo utilizando modelagem de equações estruturais
Revista Brasileira de Enfermagem. 2024;77:e20240112
Abstract
Fatores determinantes para à hesitação vacinal contra a COVID-19 em brasileiros: estudo utilizando modelagem de equações estruturais
Revista Brasileira de Enfermagem. 2024;77:e20240112
DOI 10.1590/0034-7167-2024-0112
Views0See moreRESUMEN
Objetivos:
investigar los factores que influyen en la vacilación ante la vacuna contra la COVID-19 entre los brasileños.
Métodos:
esta investigación empleó un enfoque observacional y analítico, utilizando una encuesta en línea. La recolección de datos se llevó a cabo en 2020 y el análisis de los datos se realizó utilizando el modelado de ecuaciones estructurales.
Resultados:
la prevalencia de la vacilación ante la vacuna fue del 27,5% (1182 individuos). Existe una correlación negativa entre la creencia en teorías de conspiración y la influencia social. Entre las diversas creencias asociadas con las intenciones de vacunación, solo las creencias en conspiraciones mostraron un valor predictivo significativo. Así, los resultados sugieren que las creencias personales impactan significativamente la vacilación ante la vacunación y también indican que la confianza en los órganos gubernamentales está inversamente relacionada con la vacilación.
Conclusiones:
la vacilación ante la vacuna emerge como un fenómeno multifacético influenciado por una amplia gama de factores, incluyendo las creencias personales, la confianza en los órganos gubernamentales y los sistemas de salud.
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ORIGINAL ARTICLE08-30-2024
Determining factors for COVID-19 vaccine hesitancy among Brazilians: a study using structural equation modeling
Revista Brasileira de Enfermagem. 2024;77:e20240112
Abstract
ORIGINAL ARTICLEDetermining factors for COVID-19 vaccine hesitancy among Brazilians: a study using structural equation modeling
Revista Brasileira de Enfermagem. 2024;77:e20240112
DOI 10.1590/0034-7167-2024-0112
Views0See moreABSTRACT
Objectives:
to investigate the factors influencing vaccine hesitancy against COVID-19 among Brazilians.
Methods:
this research employed an observational and analytical approach, utilizing a web-based survey. Data collection took place in 2020, and data analysis was conducted using structural equation modeling.
Results:
the prevalence of vaccine hesitancy was found to be 27.5% (1182 individuals). There is a negative correlation between belief in conspiracy theories and social influence. Among the various beliefs associated with vaccination intentions, only conspiracy beliefs exhibited significant predictive value. Thus, the findings suggest that personal beliefs significantly impact hesitancy towards vaccination, and also indicate that trust in governmental bodies is inversely related to hesitancy.
Conclusions:
vaccine hesitancy emerges as a multifaceted phenomenon influenced by a complex array of factors, including personal beliefs, trust in governmental bodies, and healthcare systems.
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ORIGINAL ARTICLE08-30-2024
Factors associated with university students’ knowledge about HIV and pre- and post-exposure prophylaxis
Revista Brasileira de Enfermagem. 2024;77:e20240092
Abstract
ORIGINAL ARTICLEFactors associated with university students’ knowledge about HIV and pre- and post-exposure prophylaxis
Revista Brasileira de Enfermagem. 2024;77:e20240092
DOI 10.1590/0034-7167-2024-0092
Views0See moreABSTRACT
Objectives:
to analyze the factors associated with university students’ knowledge about HIV and pre- and post-exposure prophylaxis.
Methods:
a cross-sectional study was conducted with 503 university students from a southern state in Brazil; data were collected using a characterization tool and a questionnaire containing 16 statements about the topic; descriptive measures and Poisson regression models with robust variance were used for analysis.
Results:
the prevalence of adequate knowledge (i.e., scoring more than 12 correct answers) was 27.83%; students older than 24 years, enrolled in health-related courses, who had not engaged in sexual relations in the last quarter, with a history of rapid HIV testing, and who knew or had heard about the prophylaxes showed a higher likelihood of scoring more than 12 correct answers.
Conclusions:
generally, the knowledge of young people about HIV and its prophylaxes was found to be inadequate and influenced by sociodemographic, educational, and behavioral factors.
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ORIGINAL ARTICLE08-30-2024
Accessibility to prenatal care at the Street Outreach Office: nurse perceptions in northern Brazil
Revista Brasileira de Enfermagem. 2024;77:e20240090
Abstract
ORIGINAL ARTICLEAccessibility to prenatal care at the Street Outreach Office: nurse perceptions in northern Brazil
Revista Brasileira de Enfermagem. 2024;77:e20240090
DOI 10.1590/0034-7167-2024-0090
Views0See moreABSTRACT
Objectives:
to understand nurse perspectives regarding homeless pregnant women’s accessibility to prenatal care.
Methods:
a qualitative study, with analysis based on the concept of accessibility. Semi-structured interviews were carried out with 11 nurses who work at the Street Outreach Office in northern Brazil.
Results:
nurses are faced with geographic barriers and dangerous situations in border regions, recognizing that there is a context of physical, sexual and psychological violence that involves homeless pregnant women who seek care at the Street Outreach Office. Street Outreach Office nurses’ work occurs in conjunction with other services in the Health Care Network. The implementation of educational measures is a powerful strategy, as is establishing links with women.
Final Considerations:
the Street Outreach Office’s work provides meetings with pregnant women on site in the territory, which can provide geographic and socio-organizational accessibility to prenatal care.
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ORIGINAL ARTICLE08-30-2024
Risk of smoking cessation treatment dropout: a cohort to help (re)think care
Revista Brasileira de Enfermagem. 2024;77:e20230537
Abstract
ORIGINAL ARTICLERisk of smoking cessation treatment dropout: a cohort to help (re)think care
Revista Brasileira de Enfermagem. 2024;77:e20230537
DOI 10.1590/0034-7167-2023-0537
Views0See moreABSTRACT
Objectives:
to evaluate the relative risk of smoking cessation treatment dropout during its intensive phase.
Methods:
a retrospective and quantitative cohort study was developed from the electronic medical records of individuals who started smoking cessation treatment between 2015 and 2019 at a specialty clinic in a city in the interior of São Paulo, Brazil. The relative risk of dropping out of treatment was calculated using the Poisson regression model.
Results:
it was observed that out of the 396 (100.0%) individuals who started the treatment, 109 (27.5%) abandoned it before the end of the intensive phase. For each one-year increase in age, the risk of dropping out of smoking cessation treatment decreased by an average of 2%.
Conclusions:
the risk of dropping out of smoking cessation treatment is higher among younger individuals. It is necessary to rethink the care offered to younger adults to promote the continuity of treatment.
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REVIEW08-30-2024
Impact of financial toxicity on adults with cancer during the COVID-19 pandemic: an integrative review
Revista Brasileira de Enfermagem. 2024;77:e20240078
Abstract
REVIEWImpact of financial toxicity on adults with cancer during the COVID-19 pandemic: an integrative review
Revista Brasileira de Enfermagem. 2024;77:e20240078
DOI 10.1590/0034-7167-2024-0078
Views0See moreABSTRACT
Objectives:
to identify the repercussions of financial toxicity on the lives of adult cancer patients during the COVID-19 pandemic.
Methods:
an integrative review was conducted using the PubMed, Web of Science, Scopus, and Embase databases, as well as the Virtual Health Library portal, in March 2023.
Results:
out of 62 studies found, 13 were included for analysis. The primary repercussions of financial toxicity included difficulties in covering basic expenses such as food, housing, medication, transportation, and internet access; increased anxiety and concerns related to health and financial situations; reduction or absence of income; challenges in obtaining treatment or accessing healthcare services; rising expenses; and telemedicine as a less burdensome alternative.
Conclusions:
the pandemic has exacerbated financial toxicity; therefore, healthcare teams must recognize it as an adverse event of oncological treatment and understand its potential to affect various aspects of patients’ lives.
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ORIGINAL ARTICLE08-30-2024
Negative affectivity in university students and its relationship with academic performance and professional outlook after COVID-19
Revista Brasileira de Enfermagem. 2024;77:e20240040
Abstract
ORIGINAL ARTICLENegative affectivity in university students and its relationship with academic performance and professional outlook after COVID-19
Revista Brasileira de Enfermagem. 2024;77:e20240040
DOI 10.1590/0034-7167-2024-0040
Views0See moreABSTRACT
Objectives:
to evaluate the prevalence of negative affectivity in university students in the post-COVID-19 pandemic context and its relationship with academic performance and professional outlook.
Methods:
a cross-sectional study was conducted with undergraduate students from a public university in Minas Gerais between September 2022 and September 2023. Data were collected using a sociodemographic and psychosocial characterization questionnaire and the Depression, Anxiety, and Stress Scale 21. The relationships between negative affectivity, academic performance, and professional outlook were verified using the Kruskal-Wallis test, with a significance level of 5%.
Results:
a total of 585 students participated in the study. A high prevalence of depression, anxiety, and stress was found among university students in the post-COVID-19 context, with a notable severity of anxiety. A negative association was detected between the investigated negative affectivity, academic performance, and professional outlook.
Conclusions:
the results indicate an emotional vulnerability in university students, with a relationship between negative affectivity and a decline in academic performance and professional outlook.
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REVIEW08-30-2024
Educational actions conducted during the pandemic with primary health care professionals: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20230352
Abstract
REVIEWEducational actions conducted during the pandemic with primary health care professionals: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20230352
DOI 10.1590/0034-7167-2023-0352
Views0See moreABSTRACT
Objectives:
to map the educational actions conducted with primary health care professionals during the COVID-19 pandemic.
Methods:
a scoping review conducted in August 2023, which covered databases such as CINAHL, Medline, LILACS, IBECS, BDENF, and Web of Science. In total, 32 publications were analyzed through content analysis.
Results:
the primary beneficiaries of the educational actions included 69% physicians, 56% nurses, 25% pharmacists, 13% social workers and dentists, 9% psychologists, community health agents, and laboratory professionals, and 6% nursing technicians, nutritionists, and physical educators. The predominant educational interventions were training sessions (mentioned in 19 publications), followed by Continuing Health Education (10 publications) and Continuing Education (three publications).
Final Considerations:
the educational interventions demonstrated positive impacts on professional practice, particularly the Continuing Health Education actions, which were notable for stimulating critical problem-solving among professionals.
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01-01-2015
A Pesquisa em Enfermagem e os novos rumos a partir do SENPE
Revista Brasileira de Enfermagem. 2015;68(4):571-572
Abstract
A Pesquisa em Enfermagem e os novos rumos a partir do SENPE
Revista Brasileira de Enfermagem. 2015;68(4):571-572
DOI 10.1590/0034-7167.2015680401i
Views0Após quase meio século do início da pesquisa em Enfermagem no Brasil, ainda há necessidade de investimentos para considerá-la consolidada. Os seminários nacionais que discutem a investigação nesta área demonstram esta afirmação ao longo de 17 eventos, por seus resultados e participação da categoria de pesquisadores e prestadores de serviço.O 18º Seminário Nacional de Pesquisa […]See more -
01-01-2015
Comprehensive health care: dilemmas and challenges in nursing
Revista Brasileira de Enfermagem. 2015;68(2):333-338
Abstract
Comprehensive health care: dilemmas and challenges in nursing
Revista Brasileira de Enfermagem. 2015;68(2):333-338
DOI 10.1590/0034-7167.2015680221i
Views0See moreABSTRACT
Objective:
this article discusses comprehensive care as a guiding tenet of the Brazilian Unifi ed Health System (SUS), outlining health care practices, especially nursing, and the relationships built by subjects in action by means of different knowledge.
Methods:
this is a theoretical refl ection that aims to propose dimensions of analysis (access to services, reception, links, lines of care, accountability, and responsiveness), with an emphasis on the dilemmas and challenges of nursing. The proposed dimensions analyze the production of care and its political and technical aspects.
Conclusion:
care should be the focus of all health care work, bearing in mind that intervention for technological action of each profession goes beyond the core of isolated knowledge, as is the case of nursing, which is connected to other professional practices, and can peruse other territories that operate through relational technologies, entering into the world of the needs of users and families.
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01-01-2015
Gender and violence against women in nursing literature: a review
Revista Brasileira de Enfermagem. 2015;68(2):325-332
Abstract
Gender and violence against women in nursing literature: a review
Revista Brasileira de Enfermagem. 2015;68(2):325-332
DOI 10.1590/0034-7167.2015680220i
Views0See moreABSTRACT
Objective:
considering the potential of nursing to expand understanding on this theme, this study aims to learn what is being published on gender and violence against women in the main Brazilian nursing journals.
Method:
an integrative review of online publications between 2000 and 2012 was conducted. Of the 138 articles selected, 25 addressed gender and violence against women as social constructs.
Results:
there was a predominance of qualitative approaches (60%), empirical research (60%), academic (100%), authors who were nurses (96%), spousal violence (32%) and domestic violence (20%). Violence against women in the light of gender was associated in only 32% of the articles.
Conclusion:
there is a need for increased studies in partnership with the public health care service, and to expand discussions on the dynamics of power and resistance, which are the basis of the concept of gender.
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01-01-2015
Nasal colonization in nursing professionals from units specialized in HIV/AIDS
Revista Brasileira de Enfermagem. 2015;68(2):320-324
Abstract
Nasal colonization in nursing professionals from units specialized in HIV/AIDS
Revista Brasileira de Enfermagem. 2015;68(2):320-324
DOI 10.1590/0034-7167.2015680119i
Views0See moreABSTRACT
Objective:
to investigate the presence of microorganisms in the nostrils of the nursing professionals of a Brazilian teaching hospital.
Method:
cross-sectional study in two inpatient units specialized in HIV/AIDS. Nasal secretion samples of nursing professionals were collected in one month. The samples were processed at the microbiology laboratory of the institution and analyzed using the Statistical Package for the Social Sciences (SPSS) software, version 19.0. Ethical aspects were abided.
Results:
from the 73 members of the nursing staff, samples of nasal secretions were collected from 61 (80.2%). Six types of microorganisms were isolated in 22 (41.0%) positive cultures. It is noteworthy that Staphylococcus aureus accounted for 22.9%, four of them oxacillin-resistant (MRSA).
Conclusion:
Staphylococcus aureus microorganism accounted for the largest prevalence in individuals of this study.
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01-01-2015
Evaluation of nursing students about learning with clinical simulation
Revista Brasileira de Enfermagem. 2015;68(2):311-319
Abstract
Evaluation of nursing students about learning with clinical simulation
Revista Brasileira de Enfermagem. 2015;68(2):311-319
DOI 10.1590/0034-7167.2015680218i
Views0See moreABSTRACT
Objective:
to describe the contributions of clinical simulation for learning cognitive and procedural attributes through debriefi ng, from the perspective of nursing students.
Method:
descriptive exploratory study. Twenty nursing undergraduate students from a university in the interior of the state of São Paulo participated in this study. Data collection was performed at the debriefi ng stage. Student’s perceptions about the simulation, positive aspects and what they could have done differently were registered. The students’ statements were grouped according to the central themes and the framework of Bardin’s content analysis (2011) and were analyzed using descriptive statistics.
Results:
enhancement of active, critical and refl ective learning (47.5%) was identifi ed due to the closeness to reality in nursing care (20.3%), manifestation of feelings experienced during the simulation (15.3%) and composition of the scenario (15.3%).
Conclusion:
the clinical simulation followed by debriefi ng promotes the understanding of the link between action and achievements in learning.
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01-01-2015
Risk assessment of patient falls while taking medications ordered in a teaching hospital
Revista Brasileira de Enfermagem. 2015;68(2):305-310
Abstract
Risk assessment of patient falls while taking medications ordered in a teaching hospital
Revista Brasileira de Enfermagem. 2015;68(2):305-310
DOI 10.1590/0034-7167.2015680217i
Views0See moreABSTRACT
Objective:
to stratify prescribed medication in a fall risk scale, identifying subgroups of drugs and inpatient units with higher risk of falls.
Method:
retrospective study on prescription order forms given by medical clinic, surgical clinic, and general intensive care unit. Risk factors under consideration: 1) orthostatic hypotension; 2) arterial hypotension; 3) arterial hypertension; 4) bradycardia; 5) psychomotor agitation; 6) mental confusion; 7) dizziness; 8) drowsiness/sedation; 9) reduced eyesight; 10) seizures; 11) atonia/dystonia/muscle weakness; 12) hypoglycemia; 13) urgent urination and 14) urgent defecation/diarrhea. Risk levels adopted: 0: 0 factor; I: 1-2 factors; II: 3-5 factors; III: 6-9 factors; IV: 10-14 factors.
Results:
3893 drugs were analyzed and stratifi ed in levels: 0 22.7%; I 33.5%; II 28%; III 15.1%; IV 0.7%. Levels III and IV more often refer to drugs for stomach acid disorders, 22.6%, and psycholeptics, 100%.
Conclusion:
knowing the risk factors associated with medication may help prevent and reduce falls, especially when therapeutic regimens cannot be modifi ed.
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01-01-2015
Knowledge and practice of the nurse about leprosy: actions of control and elimination
Revista Brasileira de Enfermagem. 2015;68(2):297-304
Abstract
Knowledge and practice of the nurse about leprosy: actions of control and elimination
Revista Brasileira de Enfermagem. 2015;68(2):297-304
DOI 10.1590/0034-7167.2015680216i
Views0See moreABSTRACT
Objective:
to assess the knowledge and practice of primary health care nurses about control and elimination actions of leprosy.
Method:
evaluation study with qualitative approach, using the Discourse of the Collective Subject, data were collected through semi-structured interviews conducted with 16 nurses.
Results:
the data collected revealed that health professionals have suffi cient knowledge about the National Policy on Control and Elimination of Leprosy (NPCEL) and that the main actions preconized were applied, however, notifi cation of suspected or confi rmed cases and social reintegration of the patient were not mentioned.
Conclusion:
keeping patients in treatment, overload of work, lack of interdisciplinarity and treatment performed at other locations outside of the community were diffi culties reported by professionals. Nurses know the actions addressed at assistance of leprosy patients, however, the study points to the need for a practice which is more aligned to what advocates NPCEL.
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01-01-2015
Weaknesses of vaccine storage in Primary Healthcare Centers
Revista Brasileira de Enfermagem. 2015;68(2):291-296
Abstract
Weaknesses of vaccine storage in Primary Healthcare Centers
Revista Brasileira de Enfermagem. 2015;68(2):291-296
DOI 10.1590/0034-7167.2015680215i
Views0See moreABSTRACT
Objective:
assessment through qualitative approach of vaccine storage in Primary Healthcare Centers.
Method:
assessment study of qualitative approach in which 30 interviews were conducted with nurses, nursing technicians or assistants and technical reference in immunization, in 12 vaccine rooms that had 100% of the structural criteria evaluated. Recorded testimonials of the subjects were organized and analyzed using thematic Content Analysis.
Results:
the assessment pointed to absence of knowledge on the parts of nurses and nursing technicians and assistants with respect to the effects of low temperature on vaccines. Barriers were also encountered in relation to the supervision of nurses in the vaccine room activities and in relation to the knowledge needed by workers to care for preservation of vaccines.
Conclusion:
vaccine storage is inadequate and may compromise the quality of the immunobiologicals dispensed to the populace.
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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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