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ORIGINAL ARTICLE01-10-2024
Micro and macropolitical determinants for non-vaccination against COVID-19 in pregnant women in Belo Horizonte
Revista Brasileira de Enfermagem. 2024;77:e20230235
Abstract
ORIGINAL ARTICLEMicro and macropolitical determinants for non-vaccination against COVID-19 in pregnant women in Belo Horizonte
Revista Brasileira de Enfermagem. 2024;77:e20230235
DOI 10.1590/0034-7167-2023-0235
Views0See moreABSTRACT
Objective:
To analyze the determinants for non-vaccination against COVID-19 in pregnant women in Belo Horizonte, Minas Gerais, Brazil.
Methods:
An epidemiological study with a cross-sectional design was conducted using data from the project titled “Childbirth and Breastfeeding in Children of Mothers Infected by SARS-CoV-2,” developed during the pandemic in the city of Belo Horizonte, Minas Gerais, Brazil.
Results:
The study sample consisted of 360 pregnant women, of whom 77.89% received the COVID-19 vaccine. External, social, and institutional determinants can influence lower adherence to COVID-19 vaccination, especially the absence of employment during pregnancy, difficult access to prenatal consultations, and a compromised or deficient support network.
Conclusions:
In light of this scenario, greater encouragement for health education is necessary, especially during prenatal care, resulting in lower rates of morbidity and mortality and favorable perinatal outcomes.
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ORIGINAL ARTICLE01-10-2024
COVID-19: Training activities, adherence, and use of personal protective equipment in Primary Health Care
Revista Brasileira de Enfermagem. 2024;77:e20230179
Abstract
ORIGINAL ARTICLECOVID-19: Training activities, adherence, and use of personal protective equipment in Primary Health Care
Revista Brasileira de Enfermagem. 2024;77:e20230179
DOI 10.1590/0034-7167-2023-0179
Views0See moreABSTRACT
Objective:
to analyze the association between participation in training activities and the adherence to and use of personal protective equipment by workers and professionals involved in Health Residency Programs in Primary Health Care during the COVID-19 pandemic.
Methods:
a cross-sectional study in Brazil between August/2020 and March/2021. We utilized the EPI-APS COVID-19 instrument and its adapted version for resident professionals.
Results:
455 PHC workers and 102 residents participated in the study. Among them, 54.5% and 55.9%, respectively, engaged in training activities. We observed an association between participation in training activities and the proper use of gloves (p<0.001), gowns (p=0.009), goggles/face shields (p=0.002), and overall adherence (p<0.001) among PHC workers, and the proper use of surgical masks (p=0.028) among residents. Adherence rates of ≥75% were identified in 6.9% of PHC workers and none among the residents.
Conclusion:
training activities are associated with increased adherence to and proper use of PPE.
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ORIGINAL ARTICLE12-16-2024
Software for the care of people with cardiovascular risk: construction and evidence of validity
Revista Brasileira de Enfermagem. 2024;77(6):e20240276
Abstract
ORIGINAL ARTICLESoftware for the care of people with cardiovascular risk: construction and evidence of validity
Revista Brasileira de Enfermagem. 2024;77(6):e20240276
DOI 10.1590/0034-7167-2024-0276
Views0See moreABSTRACT
Objectives:
to build and validate software for the care of people with cardiovascular risk.
Methods:
a methodological study, applied to software development, anchored in a nursing theory and classification system, in three stages: 1) requirements engineering; 2) software architecture and coding; and 3) testing and content validity by 12 experts in computer science, with a Content Validity Ratio score.
Results:
called e-TEORISC, in software format, for nursing care for people with cardiovascular risk, online and offline, containing a database linked to the Nursing Process stages. Experts considered that the attributes of functional suitability, performance efficiency, reliability, maintainability, usability, safety and portability obtained desirable scores.
Conclusions:
e-TEORISC has evidence of validity to instrumentalize care for people at cardiovascular risk, with potential for technology transfer to the Brazilian Health System.
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ORIGINAL ARTICLE12-16-2024
Sleep quality of patients with heart failure and associated factors
Revista Brasileira de Enfermagem. 2024;77(6):e20240244
Abstract
ORIGINAL ARTICLESleep quality of patients with heart failure and associated factors
Revista Brasileira de Enfermagem. 2024;77(6):e20240244
DOI 10.1590/0034-7167-2024-0244
Views0See moreABSTRACT
Objectives:
to assess sleep quality of patients with heart failure and associated sociodemographic and clinical characteristics.
Methods:
a cross-sectional study, developed with 88 patients. Sleep quality was assessed by the Pittsburgh Sleep Quality Index. The data were analyzed using descriptive and inferential statistics.
Results:
the mean sleep quality score was 8.59 ± 3.60 points. 83% of participants were classified as poor sleepers. The number of hours of sleep was 5.99 ± 1.48. Family income of up to one minimum wage and functional class were significantly associated with poor sleepers. There was a positive correlation between functional class and poor sleep quality.
Conclusions:
a high frequency of poor sleepers was identified. Worse scores were associated with family income and symptomatic functional class. Health interventions are necessary to control sleep quality, especially in relation to health functionality.
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12-16-2024
Religión y experiencia profesional: ¿Serán predictores de la inteligencia espiritual de los enfermeros? Estudio transversal
Revista Brasileira de Enfermagem. 2024;77(6):e20240217
Abstract
Religión y experiencia profesional: ¿Serán predictores de la inteligencia espiritual de los enfermeros? Estudio transversal
Revista Brasileira de Enfermagem. 2024;77(6):e20240217
DOI 10.1590/0034-7167-2024-0217es
Views1See moreRESUMEN
Objetivos:
analizar la relación entre religión y experiencia profesional con la inteligencia espiritual en enfermeros.
Métodos:
estudio transversal y analítico realizado en 2021, participaron 544 profesionales de enfermería que laboraban en establecimiento de salud de Perú durante la pandemia por COVID-19. Para el análisis de los datos se emplearon el análisis de regresión múltiple y correlación de Pearson.
Resultados:
en los enfermeros predominó un nivel de inteligencia espiritual saludable (42,8%). Quienes no profesaban una religión tenían mayor probabilidad de tener menor puntaje de inteligencia espiritual (escala global y dimensiones); sin embargo, los enfermeros expertos tuvieron mayor probabilidad de tener mayor inteligencia espiritual (escala global y dimensiones) que los enfermeros novatos (p<0,05).
Conclusiones:
la inteligencia espiritual en los enfermeros fue predicha por la religión y la experiencia profesional. Este hallazgo sugiere que la inteligencia espiritual en enfermería se consolida mediante prácticas religiosas y durante el ejercicio profesional.
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ORIGINAL ARTICLE12-16-2024
Religion and professional experience: Are they predictors of nurses’ spiritual intelligence? Cross-sectional study
Revista Brasileira de Enfermagem. 2024;77(6):e20240217
Abstract
ORIGINAL ARTICLEReligion and professional experience: Are they predictors of nurses’ spiritual intelligence? Cross-sectional study
Revista Brasileira de Enfermagem. 2024;77(6):e20240217
DOI 10.1590/0034-7167-2024-0217
Views0See moreABSTRACT
Objectives:
to analyze the relationship between religion and professional experience with spiritual intelligence in nurses
Methods:
cross-sectional and analytical study carried out in 2021, with the participation of 544 nursing professionals working in health facilities in Peru during the COVID-19 pandemic. Multiple regression analysis and Pearson’s correlation were used to analyze the data.
Results:
in nurses, a healthy level of spiritual intelligence predominated (42.8%). Those who did not profess a religion were more likely to have a lower spiritual intelligence score (global scale and dimensions); however, experienced nurses were more likely to have higher spiritual intelligence (global scale and dimensions) than novice nurses (p<0.05).
Conclusions:
spiritual intelligence in nurses was predicted by religion and professional experience. This finding suggests that spiritual intelligence in nursing is consolidated through religious practices and during professional practice.
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ORIGINAL ARTICLE12-16-2024
Effectiveness of the modified Seldinger technique for peripheral central catheter in newborns: a randomized clinical trial
Revista Brasileira de Enfermagem. 2024;77(6):e20240189
Abstract
ORIGINAL ARTICLEEffectiveness of the modified Seldinger technique for peripheral central catheter in newborns: a randomized clinical trial
Revista Brasileira de Enfermagem. 2024;77(6):e20240189
DOI 10.1590/0034-7167-2024-0189
Views0See moreABSTRACT
Objectives:
to evaluate the effectiveness of peripheral central catheterization by comparing the modified Seldinger technique and the conventional technique in critically ill newborns.
Methods:
randomized unmasked clinical trial conducted in a public children’s hospital. Participation of 111 newborns with randomized allocation, 56 in the control group (conventional technique) and 55 in the experimental group (modified Seldinger). Success and absence of complications were evaluated as primary outcomes. The pain scale, difficulty in hemostasis, procedure time and number of punctures were considered secondary outcomes.
Results:
there was no statistical significance between groups, either for success (p=0.705) or absence of complications (p=0.347). A lower pain score, improved hemostasis, increased assertiveness with fewer punctures and reduced procedure time were not observed in the experimental group.
Conclusions:
the modified Seldinger technique did not prove to be a more effective insertion technology compared to the conventional method. Brazilian Clinical Trial Registry: RBR-69vks36.
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ORIGINAL ARTICLE12-16-2024
Narratives of sex workers: intimate partner violence and coping strategies
Revista Brasileira de Enfermagem. 2024;77(6):e20240180
Abstract
ORIGINAL ARTICLENarratives of sex workers: intimate partner violence and coping strategies
Revista Brasileira de Enfermagem. 2024;77(6):e20240180
DOI 10.1590/0034-7167-2024-0180
Views0See moreABSTRACT
Objectives:
to understand the narratives of sex workers about violence suffered by intimate partners and their coping strategies.
Methods:
qualitative research, focused on thematic oral history, carried out with six sex workers in southern Brazil, who responded to in-depth interviews using a flexible script. Thematic content analysis was used.
Results:
the study included cisgender women who self-identified as half black and half white. Most had children and were separated. They reported abusive relationships by their intimate partners, with emphasis on verbal, psychological, financial, and physical violence and attempted femicide. Such violence resulted in coping strategies, such as avoiding emotional bonds and maintaining a discreet life.
Final Considerations:
intimate partner violence is prevalent among participants, leading them to adopt strategies to preserve their safety and well-being, highlighting the need for public policies that meet their particularities and guarantee protection.
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REVIEW11-27-2023
Educational interventions for cervical cancer prevention: a scoping review
Revista Brasileira de Enfermagem. 2023;76(5):e20230018
Abstract
REVIEWEducational interventions for cervical cancer prevention: a scoping review
Revista Brasileira de Enfermagem. 2023;76(5):e20230018
DOI 10.1590/0034-7167-2023-0018
Views0See moreABSTRACT
Objectives:
to identify, map and describe characteristics of educational interventions for cervical cancer prevention in adult women.
Methods:
a scoping review conducted on eleven databases and the gray literature, including studies that described educational interventions aimed at preventing cervical cancer in adult women.
Results:
thirty-three articles with 151,457 participants were analyzed. The most used educational strategies were participatory discussions and educational leaflets. Most of the interventions took place in a single session, ranging from 40 to 60 minutes. The most used theoretical model in interventions to improve women’s compliance with Pap smear was the Health Belief Model.
Conclusions:
group discussions, lectures and educational brochures can increase knowledge and reduce barriers to cervical cancer prevention. Theory-based and culturally sensitive interventions can have a positive impact on women’s health.
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ORIGINAL ARTICLE11-27-2023
Validation of the hospital resources assessment scale for the preservation of urinary continence in the elderly
Revista Brasileira de Enfermagem. 2023;76(5):e20220805
Abstract
ORIGINAL ARTICLEValidation of the hospital resources assessment scale for the preservation of urinary continence in the elderly
Revista Brasileira de Enfermagem. 2023;76(5):e20220805
DOI 10.1590/0034-7167-2022-0805
Views0See moreABSTRACT
Objectives:
to validate the internal structure of the Hospital Resources Assessment Scale for the Preservation of Urinary Continence in the Elderly.
Methods:
validation study of the internal structure of a scale constructed based on the Donabedian conceptual model and an integrative review, with prior content validation. The scale was applied to the target population, and 124 nurses responded to the questionnaire. Exploratory Factor Analysis was performed using the FACTOR software, employing multiple techniques.
Results:
a factorial model with 11 items organized into two dimensions (support for human resources and material resources) was obtained. The “physical structure” dimension was removed from the initial model and adopted as a complementary checklist to the instrument, as it was not possible to obtain a factorable model with this dimension.
Conclusions:
we provide a valid scale that can measure indicators, identifying weaknesses and/or strengths related to hospital resources for the preservation of urinary continence in the elderly.
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11-27-2023
Implementación de estrategia de enfermería para autotrascendencia en adulto mayor: relato de experiencia
Revista Brasileira de Enfermagem. 2023;76(5):e20220745
Abstract
Implementación de estrategia de enfermería para autotrascendencia en adulto mayor: relato de experiencia
Revista Brasileira de Enfermagem. 2023;76(5):e20220745
DOI 10.1590/0034-7167-2022-0745es
Views0See moreRESUMEN
Objetivos:
relatar la experiencia de la implementación de una estrategia de enfermería para promover la autotrascendencia en adultos mayores que acuden a un centro de primer nivel de atención en salud.
Métodos:
relato de experiencia sobre implementación de una estrategia abordando la Teoría de Autotrascendencia por enfermería a adultos mayores de una unidad de salud de primer nivel, en San Luis Potosí, México, de octubre-noviembre del 2022.
Resultados:
participaron 14 adultos mayores y tres enfermeros. A partir de la expresión de sentimientos, charlas sobre autotrascendencia, fomento de espiritualidad y actividad física, la estrategia resultó satisfactoria. Se observaron cambios emocionales, cognitivos y espirituales en las diferentes dimensiones de la Teoría de Autotrascendencia.
Consideraciones Finales:
la estrategia de enfermería sobre autotrascendencia permitió plasmar momentos significativos que ayudaron a identificar puntos clave en los que se encontraban los adultos mayores; esto ayudó para intervenir desde una perspectiva del cuidado de persona a persona.
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EXPERIENCE REPORT11-27-2023
Implementation of a nursing strategy for self-transcendence in older adults: an experience report
Revista Brasileira de Enfermagem. 2023;76(5):e20220745
Abstract
EXPERIENCE REPORTImplementation of a nursing strategy for self-transcendence in older adults: an experience report
Revista Brasileira de Enfermagem. 2023;76(5):e20220745
DOI 10.1590/0034-7167-2022-0745
Views0See moreABSTRACT
Objectives:
to report the experience of implementing a nursing strategy to promote self-transcendence in older adults attended at a Primary Health Care center.
Methods:
an experience report on the implementation of a strategy addressing the Theory of Self-Transcendence by nursing to older adults in a primary health unit, in San Luis Potosí, Mexico, from October to November 2022.
Results:
fourteen older adults and three nurses participated. From the expression of feelings, speeches about self-transcendence, spirituality and physical activity promotion, the strategy was satisfactory. Emotional, cognitive and spiritual changes were observed in the different dimensions of the Theory of Self-Transcendence.
Final Considerations:
the nursing strategy on self-transcendence made it possible to identify significant moments that helped to identify the key points in which older adults were; it helped to intervene from a person-to-person care perspective.
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ORIGINAL ARTICLE11-27-2023
Analysis of the development of children discharged from the Neonatal Intensive Care Unit from parents’ point of view
Revista Brasileira de Enfermagem. 2023;76(5):e20220717
Abstract
ORIGINAL ARTICLEAnalysis of the development of children discharged from the Neonatal Intensive Care Unit from parents’ point of view
Revista Brasileira de Enfermagem. 2023;76(5):e20220717
DOI 10.1590/0034-7167-2022-0717
Views0See moreABSTRACT
Objectives:
to analyze the development of children discharged from the Neonatal Intensive Care Unit and how hospitalization interferes with child development, from parents’ point of view.
Methods:
a descriptive-exploratory, documentary and qualitative study, carried out with parents of children discharged from the Intensive Care Unit through a telephone survey and supplementation in medical records. Data were analyzed using Bardin’s tool and discussed according to scientific evidence.
Results:
from parents’ point of view, delay in physical development was not observed, however difficulties in breastfeeding and weight gain were reported. Changes in speech and changes in behavior considered abnormal were also delays in child evolution.
Final Considerations:
from parents’ point of view, changes in speech may be associated with hospitalization in an Intensive Care Unit, while difficulties related to breastfeeding and delays in cognition may be altered by conditions of prematurity and low weight at birth.
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ORIGINAL ARTICLE11-27-2023
Urinary incontinence in women: assessment with the aid of standardized nursing terminologies NANDA-I and NOC
Revista Brasileira de Enfermagem. 2023;76(5):e20220714
Abstract
ORIGINAL ARTICLEUrinary incontinence in women: assessment with the aid of standardized nursing terminologies NANDA-I and NOC
Revista Brasileira de Enfermagem. 2023;76(5):e20220714
DOI 10.1590/0034-7167-2022-0714
Views0See moreABSTRACT
Objectives:
to assess urinary impairment in incontinent women with the aid of standardized nursing terminologies NANDA-I and NOC.
Methods:
a cross-sectional study, carried out with 97 women attending the gynecology outpatient clinic of a university hospital. Data collection took place using a form that contained information about NANDA-I diagnoses related to urinary incontinence and NOC Urinary Continence indicators. Statistical analysis was performed to assess the impairment of NOC indicators in the presence of NANDA-I nursing diagnoses.
Results:
diagnosis Mixed Urinary Incontinence was the most prevalent (43.3%), and, in its presence, the most compromised indicators were voids in appropriate receptacle, gets to toilet between urge and passage of urine and empties bladder completely.
Conclusions:
urinary impairment was worse in women with elements of stress and urge urinary incontinence.
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REVIEW11-27-2023
Vaccination hesitation in children under five years of age: a scoping review
Revista Brasileira de Enfermagem. 2023;76(5):e20220707
Abstract
REVIEWVaccination hesitation in children under five years of age: a scoping review
Revista Brasileira de Enfermagem. 2023;76(5):e20220707
DOI 10.1590/0034-7167-2022-0707
Views0See moreABSTRACT
Objectives:
to synthesize scientific evidence on vaccine hesitancy in children under five years of age and its associated factors.
Methods:
a scoping review, conducted according to the methodological structure proposed by the JBI. Searches were carried out in the Latin American and Caribbean Center on Health Sciences Information, Scientific Electronic Library Online and PubMed databases, including gray literature. Studies in English, Spanish and Portuguese were included, without temporal delimitation. Editorials, studies that did not address vaccine hesitancy in children under five years of age and were not aligned with the objective and research question were excluded. The sample consisted of 18 articles.
Results:
misinformation, concern about adverse effects, distrust about efficacy, affliction regarding administration simultaneously, and insecurity in relation to the laboratories were the reported reasons.
Conclusions:
strategies are needed to combat the lack of information about immunobiological agents, as misinformation was the main factor in parents’ vaccine hesitation.
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ORIGINAL ARTICLE11-27-2023
ICNP® terminological subset for people with diabetic foot ulcer in primary health care
Revista Brasileira de Enfermagem. 2023;76(5):e20220668
Abstract
ORIGINAL ARTICLEICNP® terminological subset for people with diabetic foot ulcer in primary health care
Revista Brasileira de Enfermagem. 2023;76(5):e20220668
DOI 10.1590/0034-7167-2022-0668
Views0See moreABSTRACT
Objectives:
to elaborate an ICNP® terminological subset for people with diabetic foot ulcers in Primary Health Care.
Methods:
this is a methodological study that followed five steps: 1) Identification of relevant terms for the patients through an integrative literature review and official documents in the area; 2) Mapping of terms identified with ICNP® terms; 3) Construction of statements of nursing diagnoses, outcomes and interventions; 4) Structuring of a terminological subset with the Self-Care Deficit Theory; and 5) Content validity of statements constructed with nurses from a programmatic area in Rio de Janeiro.
Results:
the subset developed is composed of 81 diagnoses/outcomes and 583 nursing interventions, organized into universal, change and development requirements.
Conclusions:
the subset on screen was predominantly composed of statements inserted in self-care requirements related to health changes, reinforcing the importance of quality of life and recovery.
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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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