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01-01-2016
Prevention and monitoring of delirium in older adults: an educational intervention
Revista Brasileira de Enfermagem. 2016;69(4):725-732
Abstract
Prevention and monitoring of delirium in older adults: an educational intervention
Revista Brasileira de Enfermagem. 2016;69(4):725-732
DOI 10.1590/0034-7167.2016690416i
Views0See moreABSTRACT
Objective:
to conduct an educational intervention with the nursing team members of an intensive care unit (ICU), aiming to increase knowledge and to introduce improvements in their practices regarding prevention and monitoring of delirium in older patients.
Method:
this is an action research, in which workshops were conducted with eleven nurses and a nursing technician from an ICU unit in Salvador, Bahia, Brazil.
Results:
ten problems regarding nursing practices for prevention and monitoring of delirium were identified. Educational, practical, technical, and managerial actions were planned, involving cross-sector connections for planning ways to solve these problems. The groups reported significant changes in the practices, with the implementation of drug-free measures for preventing and managing the situation.
Conclusion:
the educational intervention contributed to improve the nursing practices in the ICU unit studied, and it also favored the development of critical thinking about the problems mentioned, thus enabling permanent review of offered treatments.
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01-01-2016
Technology-dependent children and the demand for pharmaceutical care
Revista Brasileira de Enfermagem. 2016;69(4):718-724
Abstract
Technology-dependent children and the demand for pharmaceutical care
Revista Brasileira de Enfermagem. 2016;69(4):718-724
DOI 10.1590/0034-7167.2016690415i
Views0See moreABSTRACT
Objective:
to understand the experience of mothers of technology-dependent children as regards pharmaceutical care.
Method:
this was a qualitative, descriptive-exploratory study developed based on open interviews using a structured characterization tool, and applied during home visits to 12 mothers caring for technology-dependent children. The data was submitted to inductive content analysis.
Results:
this study is split into two themes: (i) maternal overload during pharmaceutical care, demonstrating the need to administer drugs continuously and the repercussions of this exhaustive care on the caregivers; (ii) the ease or difficulty of access to the medicines required, showing informal strategies and support networks.
Conclusion:
pharmaceutical care is a daily challenge expressed in maternal overload and difficulty accessing the drugs, made worse by failures in the care network and coordinated care.
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01-01-2016
Fasting of less than eight hours in urgent and emergency surgeries versus complication
Revista Brasileira de Enfermagem. 2016;69(4):712-717
Abstract
Fasting of less than eight hours in urgent and emergency surgeries versus complication
Revista Brasileira de Enfermagem. 2016;69(4):712-717
DOI 10.1590/0034-7167.2016690414i
Views0See moreABSTRACT
Objective:
to verify the occurrence of intraoperative and postoperative complications in patients undergoing urgent and emergency surgical procedures between January and December 2012, with fasting time of less than 8 hours.
Method:
a quantitative study was conducted, of the retrospective cohort type, through the analysis of medical records.
Results:
we included 181 records of patients undergoing surgical procedures with average duration of 59.4 minutes. Fractures correction surgeries stood out, totalling 32% of cases. We observed complications in 36 patients (19.9%), vomiting being the most prevalent (47.2%); followed by nausea (16.7%); need for blood transfusion (13.9%); surgical site infection (11.1%); and death (11.1%). The average fasting time was 133.5 minutes. The fasting time showed no statistically significant correlation with the complications investigated.
Conclusion:
intraoperative and postoperative complications were associated with the clinical conditions of the patients and not with the fasting time.
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01-01-2016
Validation to Portuguese of the Debriefing Experience Scale
Revista Brasileira de Enfermagem. 2016;69(4):705-711
Abstract
Validation to Portuguese of the Debriefing Experience Scale
Revista Brasileira de Enfermagem. 2016;69(4):705-711
DOI 10.1590/0034-7167.2016690413i
Views1See moreABSTRACT
Objective:
to translate and validate to Portuguese the Debriefing Experience Scale jointly with individuals that used high-fidelity simulation in learning.
Method:
methodological and exploratory study for an instrument translation and validation. For the validation process, the event “III Workshop Brazil – Portugal: Care Delivery to Critical Patients” was created.
Results:
103 nurses attended. Validity and reliability of the scale, the correlation pattern among variables, the sampling adequacy test, and the sphericity test showed good results. Since there was no relationship among the groups established in the exploratory factor analysis, the option was to follow the division established by the original version.
Conclusion:
the version of the instrument was called Escala de Experiência com o Debriefing. The results showed good psychometric properties and a good potential for use. However, further studies will contribute to consolidate the validity of the scale and strengthen its potential use.
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01-01-2016
Factor analysis of an instrument to measure the impact of disease on daily life
Revista Brasileira de Enfermagem. 2016;69(4):697-704
Abstract
Factor analysis of an instrument to measure the impact of disease on daily life
Revista Brasileira de Enfermagem. 2016;69(4):697-704
DOI 10.1590/0034-7167.2016690412i
Views0See moreABSTRACT
Objective:
to verify the structure of factors of an instrument to measure the Heart Valve Disease Impact on Daily Life (IDCV) when applied to coronary artery disease patients.
Method:
the study included 153 coronary artery disease patients undergoing outpatient follow-up care. The IDCV structure of factors was initially assessed by means of confirmatory factor analysis and, subsequently, by exploratory factor analysis. The Varimax rotation method was used to estimate the main components of analysis, eigenvalues greater than one for extraction of factors, and factor loading greater than 0.40 for selection of items. Internal consistency was estimated using Cronbach’s alpha coefficient. Results: confirmatory factor analysis did not confirm the original structure of factors of the IDCV. Exploratory factor analysis showed three dimensions, which together explained 78% of the measurement variance.
Conclusion:
future studies with expansion of case selection are necessary to confirm the IDCV new structure of factors.
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01-01-2016
Associação da fragilidade em idosos internados e institucionalizados na comunidade
Revista Brasileira de Enfermagem. 2016;69(4):691-696
Abstract
Associação da fragilidade em idosos internados e institucionalizados na comunidade
Revista Brasileira de Enfermagem. 2016;69(4):691-696
DOI 10.1590/0034-7167.2016690411i
Views0See moreRESUMEN
Objetivo:
investigar la asociación entre la fragilidad y la internación e institucionalización, en un estudio de acompañamiento de residentes ancianos.
Método:
el estudio de acompañamiento fue realizado en 2008 y 2013, con ancianos de ambos sexos, de 65 años o más, los cuales vivían en la comunidad. El procedimiento de muestreo realizado fue probabilístico, con agrupamiento en dos etapas. Fueron entrevistados 512 ancianos en 2008 y 262 en 2013. Datos socioeconómicos y demográficos, morbilidad relatada por los mismos y datos específicos de internación e institucionalización han sido utilizados. La fragilidad fue medida por la escala Edmond Frail Scale (EFS) y la capacidad funcional por la escala Functional Independence Measure (FIM).
Resultados:
El promedio de la puntuación EFS fue mayor entre los residentes ancianos que fueron internados y hospitalizados, siendo estadísticamente significativa en los dos años investigados.
Conclusión:
La confirmación de la asociación entre la fragilidad y la internación e institucionalización refuerza la importancia del tema y enfatiza la fragilidad como un instrumento importante en la evaluación de los riesgos para estos eventos adversos.
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01-01-2016
Association of frailty in hospitalized and institutionalized elderly in the community-dwelling
Revista Brasileira de Enfermagem. 2016;69(4):691-696
Abstract
Association of frailty in hospitalized and institutionalized elderly in the community-dwelling
Revista Brasileira de Enfermagem. 2016;69(4):691-696
DOI 10.1590/0034-7167.2016690411i
Views0See moreABSTRACT
Objective:
to investigate the association between frailty with hospitalization and institutionalization in a follow-up study of elderly residents.
Method:
the follow-up study was performed in 2008 and 2013 with elderly of both genders, aged 65 years and older who were living in the community-dwelling. The sampling procedure performed was probabilistic, with dual-stage clustering. In 2008, 515 elderly people were interviewed and, in 2013, 262. We used the socioeconomic and demographic data, self-reported morbidity, specific data of hospitalization and institutionalization. Frailty was measured by the Edmonton Frail Scale (EFS), and functional capacity through the Functional Independence Measure.
Results:
we found the mean gross EFS score was higher among resident elderly who were hospitalized and institutionalized and was statistically significant in both investigated years.
Conclusion:
the confirmation of association between frailty and hospitalization and institutionalization reinforces the importance of the subject, and highlights frailty as an important tool for risk estimates for these adverse events.
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01-01-2016
Analysis of managerial and healthcare indicators after nursing personnel upsizing
Revista Brasileira de Enfermagem. 2016;69(4):684-690
Abstract
Analysis of managerial and healthcare indicators after nursing personnel upsizing
Revista Brasileira de Enfermagem. 2016;69(4):684-690
DOI 10.1590/0034-7167.2016690410i
Views0See moreABSTRACT
Objective:
analyze healthcare and managerial indicators after nursing personnel upsizing.
Method:
a retrospective, descriptive study was conducted using data from computer systems of a university hospital in southern Brazil. Healthcare and managerial indicators related to the first half of 2013 and 2014 were statistically analyzed.
Results:
increases of 40.0% in the number of nurses and 16.0% in the number of nursing technicians led to reductions of 12.0% in the number of sickness absences, 21.8% in positive balance for compensatory time off, 92.0% in paid overtime. Reductions of 75.0% in pressure ulcer rates, 10.5% in the number of falls and 50.0% in infections due to indwelling catheter use were also observed.
Conclusion:
nursing staff upsizing caused a positive impact on managerial and healthcare indicators and helped qualify care and improve work conditions for the nursing team.
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01-01-2015
Adverse events and safety in nursing care
Revista Brasileira de Enfermagem. 2015;68(1):144-154
Abstract
Adverse events and safety in nursing care
Revista Brasileira de Enfermagem. 2015;68(1):144-154
DOI 10.1590/0034-7167.2015680120i
Views0See moreObjective:
to identify the scientific publications about adverse events in nursing care in adult hospitalized patients and discuss the main adverse events in nursing care.
Method:
Integrative revision with a qualitative approach. The data were collected at LILACS, MEDLINE, BDENF and the library SCIELO and were submitted to thematic analysis.
Results:
three categories were developed: Adverse events in nursing care; The main causes of the adverse events in nursing care; Attitude of nursing professionals in face of errors. The main events were identified in nursing care with emphasis on the medication error, the failure to perform dressings and falls of patients. The importance of instruments was emphasized for notification of adverse events in the institutions. However the fear of punishment on professionals stimulates the underreporting of events.
Conclusion:
it is important to discuss effective prevention strategies that ensure patient safety in healthcare institutions.
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01-01-2015
Staphylococcus aureus meticilino resistente adquirido na comunidade: um problema mundial
Revista Brasileira de Enfermagem. 2015;68(1):136-143
Abstract
Staphylococcus aureus meticilino resistente adquirido na comunidade: um problema mundial
Revista Brasileira de Enfermagem. 2015;68(1):136-143
DOI 10.1590/0034-7167.2015680119p
Views0Objetivo:
descrever a epidemiologia dos casos de CA-MRSA no Brasil de forma a compreender sua ocorrência, fatores de risco associados e formas de manejo em relação à situação mundial.
Método:
revisão integrativa e para seleção dos estudos utilizou-se as bases de dados: Scopus, Science direct, Isi Web of Knowledge, PUBMED e BVS.
Resultados:
foram identificados dez artigos nacionais que descreveram 21 casos de CA-MRSA principalmente em crianças, adolescentes e adultos com quadro de infecção de pele e tecidos moles evoluindo para infecções graves relacionados ao clone Oceania Southwest Pacific Clone (OSPC) que resultaram em hospitalização.
Conclusão:
apesar do CA-MRSA ser considerado um micro-organismo de relevância mundial verificou-se a escassez de dados publicados sobre sua epidemiologia no Brasil, o que dificultam o delineamento da realidade do país frente ao CA-MRSA.
Keywords:Controle de InfecçõesFarmacorresistência BacterianaInfecções Comunitárias AdquiridasStaphylococcus Aureus Resistente à MeticilinaSee more -
01-01-2015
Prevention and non-pharmacological management of pain in newborns
Revista Brasileira de Enfermagem. 2015;68(1):131-135
Abstract
Prevention and non-pharmacological management of pain in newborns
Revista Brasileira de Enfermagem. 2015;68(1):131-135
DOI 10.1590/0034-7167.2015680118i
Views0See moreObjective:
to describe the main non-pharmacological interventions for pain relief in newborns available in Neonatal Intensive Care Unit.
Method:
an exploratory search of the MedLine, Lilacs and Scielo online databases was conducted to retrieve references of studies published from 2004 to 2013.
Results:
several non-pharmacological interventions were shown to be effective, to represent low risk for neonates and to have a low operational cost. The ones most often discussed in the literature were: oral administration of glucose/sucrose, non-nutritive sucking, breastfeeding, skin-to-skin contact, facilitated tucking and swaddling.
Conclusion:
healthcare teams should be familiar with these methods and use them more effectively in Neonatal Intensive Care Unit daily routines, so as to ensure that newborns receive qualified and more human care.
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01-01-2015
BANFISA e (IN)DICA-SUS na graduação em saúde: o lúdico e a construção de aprendizados
Revista Brasileira de Enfermagem. 2015;68(1):124-130
Abstract
BANFISA e (IN)DICA-SUS na graduação em saúde: o lúdico e a construção de aprendizados
Revista Brasileira de Enfermagem. 2015;68(1):124-130
DOI 10.1590/0034-7167.2015680117i
Views0See moreObjectives:
to analyze the learning built during the matches of the games by students of the subject Gestão de Políticas Públicas em Saúde at the Universidade de Brasília.
Method:
exploratory, descriptive research, in a qualitative approach, with 26 students from various graduation courses in health, using a questionnaire and participant observation.
Results:
participants reinvented rules, related issues addressed in the games to the reality, interacted with colleagues and had fun throughout the match. Comparing the games in relation to ludicity, the BANFISA was more attractive than the (IN) DICA-SUS, although they are complementary.
Conclusions:
learning constructed by the students goes beyond the content of the subject; involve the active participation in group and creativity.
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01-01-2015
Chinese auriculotherapy to improve quality of life of nursing team
Revista Brasileira de Enfermagem. 2015;68(1):117-123
Abstract
Chinese auriculotherapy to improve quality of life of nursing team
Revista Brasileira de Enfermagem. 2015;68(1):117-123
DOI 10.1590/0034-7167.2015680116p
Views0See moreObjective:
to evaluated the effi cacy of auriculotherapy for improving quality of life and reducing stress in nursing staff.
Method:
single-blind radomizad clinical trail envolving 175 subjects randomized in: Control (G1), Protocol Group (G2) and without Protocol Group (G3). They were evaluated by the Stress Symptoms List and SF36v2 at baseline, after 12 sessions and follow up (30 days), between January and July 2012.
Results:
both intervention groups reduced stress (p <0.05) with greater effect for G3 (d = 1.15). G3 was also higher for improving life quality especially the physical domain (p = 0.05).
Conclusion:
individualized auriculotherapy (G3) had greater effect compared to the protocol auriculotherapy (G2) for reducing stress and improving life quality.
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01-01-2015
Adherence to foot self-care in diabetes mellitus patients
Revista Brasileira de Enfermagem. 2015;68(1):111-116
Abstract
Adherence to foot self-care in diabetes mellitus patients
Revista Brasileira de Enfermagem. 2015;68(1):111-116
DOI 10.1590/0034-7167.2015680115p
Views0See moreObjective:
to analyze the self-care of patients with type 2 diabetes mellitus in the Family Health Strategy in Teresina-PI.
Method:
search cross selected by simple random sampling, 331 people with diabetes mellitus. Data collection took place from August to December 2012 with the use of Self-Care Activities Questionnaire with Diabetes and structured instrument for recording information socioeconomic and guidance received by the professional nurse.
Results:
the data revealed that patients have poor adherence to blood glucose monitoring, the physical exercise and foot care, but with good adherence to the medication. Only 38.7% of the sample examined the feet of fi ve to seven days a week. Statistically signifi cant association between self-care activities with their feet and orientations of nurses (p < 0,05).
Conclusion:
that there is need to raise awareness with regard to the development of skills for self-care.
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01-01-2015
Patients with disorders of consciousness: vital, facial and muscular responses to music or messages
Revista Brasileira de Enfermagem. 2015;68(1):102-110
Abstract
Patients with disorders of consciousness: vital, facial and muscular responses to music or messages
Revista Brasileira de Enfermagem. 2015;68(1):102-110
DOI 10.1590/0034-7167.2015680114p
Views1See morePurposes:
to compare vital signs, facial expression and basal electroneurographic signs with measures during stimuli music, message or “silence” in coma patients, vegetative status or sedated; and relating the score of Glasgow Results Scale with the intervention realized.
Method:
a Monoblind Transversal Controlled Clinical Trial to researcher. The distribution, among the three groups, was randomized (experiment with music, experiment with message or control). Two assessments (sessions) were performed with interval of 40 minutes on the same day.
Results:
most of the 76 patients were male, between 18 to 36 years old and hospitalized due to trauma. Statistically signifi cant changes were found in the variables referred to temperature, facial expression, electroneurography and Glasgow Results Scale; more frequent alterations in second session, in coma and vegetative patients, in frontal muscles and in experiment group.
Conclusions:
the facial expression and the electroneurography seem to be more trustworthy variables than vital signs to evaluate consciousness.
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01-01-2015
Prevalence of minor psychiatric disorders in socio-educational agents in the state of Rio Grande do Sul
Revista Brasileira de Enfermagem. 2015;68(1):93-101
Abstract
Prevalence of minor psychiatric disorders in socio-educational agents in the state of Rio Grande do Sul
Revista Brasileira de Enfermagem. 2015;68(1):93-101
DOI 10.1590/0034-7167.2015680113p
Views0See moreObjective:
to determine the prevalence and factors associated with minor psychiatric disorders (MPD) in socio-educational agents.
Method:
it is a cross-sectional study with 381 socio-educational agents the Centers for Socio-Educational Services in the State of Rio Grande do Sul, Brazil. The Brazilian versions of the Scale of Demand-control-social support at work and the Self Reporting Questionnaire-20 have been applied.
Results:
the results showed a prevalence of suspicion MPD of 50.1%. They showed to be related to suspicion of MPD : being female (55.7%), having age up to 44 years old (58.5%), no physical activity (57.4%), do not have time for leisure (75%), make use of medication (61.4%), require medical attention (56.9%) and psychological counseling (72.7%), not being satisfied with the workplace (61.7%) and need for time off from work (65.6%).
Conclusion:
the study provides important data about the mental health of agents, showing the need for the involvement of managers and of the health service of worker’s health in planning actions to promote health of these workers.
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ORIGINAL ARTICLE07-31-2023
Primary Health Care assessment in the COVID-19 pandemic from physicians’ and nurses’ perspective
- Paula dos Santos Brito
, - Lívia Maia Pascoal ,
- Mário Vinicius Teles Costa ,
- Lorrany Fontenele Moraes da Silva ,
- Liana Priscilla Lima de Melo , [ … ],
- Floriacy Stabnow Santos
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
- Paula dos Santos Brito ,
- Lívia Maia Pascoal ,
- Mário Vinicius Teles Costa ,
- Lorrany Fontenele Moraes da Silva ,
- Liana Priscilla Lima de Melo ,
- Marcelino Santos Neto ,
- Francisca Elisângela Teixeira Lima ,
- Floriacy Stabnow Santos
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.
- Paula dos Santos Brito
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07-31-2023
Breastfeeding prevalence in newborns of mothers with COVID-19: a systematic review
- Mariana Torreglosa Ruiz ,
- Karoline Faria de Oliveira ,
- Nayara Freitas Azevedo ,
- Marina Carvalho Paschoini ,
- Wellington Francisco Rodrigues , [ … ],
- Monika Wernet
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
- Mariana Torreglosa Ruiz ,
- Karoline Faria de Oliveira ,
- Nayara Freitas Azevedo ,
- Marina Carvalho Paschoini ,
- Wellington Francisco Rodrigues ,
- Carlo José Freire de Oliveira ,
- Jacqueline Faria de Oliveira ,
- Luciana Mara Monti Fonseca ,
- Monika Wernet
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.
- Mariana Torreglosa Ruiz
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ORIGINAL ARTICLE07-10-2023
Correlation between symptoms of depression, attitude, and self-care in elderly with type 2 diabetes
- Maria Cristina Lins Oliveira Frazão ,
- Lia Raquel de Carvalho Viana ,
- Gerlania Rodrigues Salviano Ferreira ,
- Cláudia Jeane Lopes Pimenta ,
- Cleane Rosa Ribeiro da Silva , [ … ],
- Kátia Neyla de Freitas Macedo Costa
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
- Maria Cristina Lins Oliveira Frazão ,
- Lia Raquel de Carvalho Viana ,
- Gerlania Rodrigues Salviano Ferreira ,
- Cláudia Jeane Lopes Pimenta ,
- Cleane Rosa Ribeiro da Silva ,
- Kaisy Martins de Albuquerque Madruga ,
- Patrícia Serpa de Souza Batista ,
- Kátia Neyla de Freitas Macedo Costa
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.
- Maria Cristina Lins Oliveira Frazão
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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
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ORIGINAL ARTICLE07-10-2023
Primary care in supplementary health: assessment of costs in the care of older adult patients with heart diseases
- Geórgia Silva Marques ,
- Alessandra Maciel Almeida ,
- Isabel Cristina Gomes ,
- Michele Renata Barbosa da Silva ,
- Bruno Almeida Rezende
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
- Geórgia Silva Marques ,
- Alessandra Maciel Almeida ,
- Isabel Cristina Gomes ,
- Michele Renata Barbosa da Silva ,
- Bruno Almeida Rezende
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.
- Geórgia Silva Marques
-
ORIGINAL ARTICLE07-10-2023
Occurrence and preventability of adverse events in hospitals: a retrospective study
- Antônio José de Lima Júnior ,
- Ariane Cristina Barboza Zanetti ,
- Bruna Moreno Dias ,
- Andrea Bernardes ,
- Francielly Marques Gastaldi , [ … ],
- Carmen Silvia Gabriel
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
- Antônio José de Lima Júnior ,
- Ariane Cristina Barboza Zanetti ,
- Bruna Moreno Dias ,
- Andrea Bernardes ,
- Francielly Marques Gastaldi ,
- Carmen Silvia Gabriel
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.
- Antônio José de Lima Júnior
-
06-26-2023
- Paulo Jorge dos Santos-Costa ,
- Margarida Maria da Silva Vieira ,
- João Manuel Garcia Nascimento Graveto
- Paulo Jorge dos Santos-Costa
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