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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
Views0ABSTRACT
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.
Keywords:COVID-19Health Care Evaluation MechanismsHealth PersonnelHealth Services ResearchPrimary Health CareSee 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
Views0ABSTRACT
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.
Keywords:AgedCardiovascular DiseasesCosts and Cost AnalysisLearning Health SystemPrimary Health CareSee more -
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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ORIGINAL ARTICLE07-10-2023
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
ORIGINAL ARTICLEMetodologia 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
Views0RESUMEN
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.
Keywords:Administração em SaúdeFluxo de TrabalhoGestão da QualidadeMelhoria de QualidadeUnidades de Terapia IntensivaSee more -
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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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 -
REVIEW06-26-2023
Barriers to Pre-Exposure Prophylaxis (PrEP) use for HIV: an integrative review
Revista Brasileira de Enfermagem. 2023;76(3):e20210963
Abstract
REVIEWBarriers to Pre-Exposure Prophylaxis (PrEP) use for HIV: an integrative review
Revista Brasileira de Enfermagem. 2023;76(3):e20210963
DOI 10.1590/0034-7167-2021-0963
Views0ABSTRACT
Objectives:
to identify and synthesize scientific evidence on the barriers and difficulties for Pre-exposure Prophylaxis (PrEP) use and compliance for HIV.
Methods:
an integrative literature review, using the MEDLINE/PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Academic Search Premier and Scopus (Elsevier) databases.
Results:
all (100%) the articles included identified that PrEP users experience some type of structural barrier related to health services such as long distance from the units, suboptimal logistics for taking pills and professional resistance to prescribing PrEP. Furthermore, 63.21% identified social barriers, such as stigma about sexuality and HIV, in addition to individual barriers such as alcohol use, adverse effects, and concerns about long-term toxicity.
Conclusions:
the barriers to PrEP use are multifactorial. Effective interventions are needed to support PrEP users in accessing, complying with, and retaining health services.
Keywords:Access to Health ServicesAnti-HIV AgentsPre-Exposure ProphylaxisPrevention and ControlSexual HealthSee more
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REVIEW04-22-2020
Polycyclic aromatic hydrocarbons and development of respiratory and cardiovascular diseases in workers
Revista Brasileira de Enfermagem. 2020;73(3):e20180965
Abstract
REVIEWPolycyclic aromatic hydrocarbons and development of respiratory and cardiovascular diseases in workers
Revista Brasileira de Enfermagem. 2020;73(3):e20180965
DOI 10.1590/0034-7167-2018-0965
Views0ABSTRACT
Objectives:
to identify the scientific evidence on the development of cardiovascular and respiratory diseases due to workplace contamination by polycyclic aromatic hydrocarbons.
Methods:
integrative literature review. The search for primary articles was held in October 2017 in the Medical Literature Analysis and Retrieval System Online (through Pubmed), Web of Science and Latin American and Caribbean Literature in Health Sciences (LILACS).
Results:
the 16 studies analyzed showed that exposure to polycyclic aromatic hydrocarbons was associated with cardiovascular diseases, such as increased blood pressure, heart rate variation, and ischemic heart disease; and respiratory disorders, such as decreased lung function, chronic obstructive pulmonary disease, asthma, wheeze, coughing, pulmonary wheezing, chest tightness, effort dyspnea, and sore throat.
Conclusions:
polycyclic aromatic hydrocarbons cause deleterious effects on the cardiovascular and respiratory systems through mutations and cellular inflammation, being a risk to exposed individuals.
Keywords:Cardiovascular DiseasesPolycyclic Aromatic HydrocarbonsRespiratory DiseasesVolatile Organic CompoundsWorkersSee more -
ORIGINAL ARTICLE08-14-2020
Education to prevent ventilator-associated pneumonia in intensive care unit
Revista Brasileira de Enfermagem. 2020;73(6):e20190477
Abstract
ORIGINAL ARTICLEEducation to prevent ventilator-associated pneumonia in intensive care unit
Revista Brasileira de Enfermagem. 2020;73(6):e20190477
DOI 10.1590/0034-7167-2019-0477
Views0INTRODUCTIONVentilator-Associated Pneumonia (VAP) is one of the complications related to the care of patients hospitalized in the Intensive Care Unit (ICU), which, according to consulted authors, exceeds the mortality rates of other Healthcare Related Infections (HRI). VAP is the second most frequent infection in patients admitted to the ICU, as well as the most prevalent […]Keywords:EducationInfection ControlIntensive Care UnitPatient SafetyPneumonia, Ventilator-AssociatedSee more -
ORIGINAL ARTICLE12-13-2019
Mobile health technology for gestational care: evaluation of the GestAção’s app
Revista Brasileira de Enfermagem. 2019;72:266-273
Abstract
ORIGINAL ARTICLEMobile health technology for gestational care: evaluation of the GestAção’s app
Revista Brasileira de Enfermagem. 2019;72:266-273
DOI 10.1590/0034-7167-2018-0641
Views0ABSTRACT
Objective:
to evaluate the GestAção application, based on the experience of pregnant women use.
Method:
an evaluative, applied, methodological, quantitative-qualitative study. This tool was evaluated by 13 pregnant women through questionnaires for sociodemographic profile characterization and Likert scale use to calculate Content Validity Index (CVI); and semi-structured interview, with analysis based on Semiotics.
Results:
the study evidenced a significant level of satisfaction of pregnant women with the application use, considering the objectives (CVI = 0.92), structure and presentation (CVI = 0.86), and relevance (CVI = 0.92).
Final considerations:
the GestAção application obtained an overall CVI of 0.90, evidencing it as a facilitating and supporting technology in the empowerment of pregnant women interested in obtaining knowledge about pregnancy. It has been proved to be a powerful tool to qualify good practices in nursing consultation.
Keywords:Health Technology AssessmentsMobile Health UnitsPortable Electronic AppsPrimary Care NursingTelemedicineSee more -
Degree in Nursing: education through problem-based learning
Revista Brasileira de Enfermagem. 2019;72(4):1071-1077
Abstract
Degree in Nursing: education through problem-based learning
Revista Brasileira de Enfermagem. 2019;72(4):1071-1077
DOI 10.1590/0034-7167-2018-0298
Views0See moreABSTRACT
Objective:
To describe how undergraduate courses in Nursing are using the problem-based learning (PBL).
Method:
Integrative literature review, from searches in the databases Education Resources Information Center (ERIC), Latin American and Caribbean Health Sciences Literature (Lilacs), and PubMed, from 2010 to 2015. 36 articles were analyzed.
Results:
A teaching method used in all continents, the PBL enables improvement of the critical thinking, autonomy, motivation for learning, active search attitude, ability to work in teams, and problem-solving. Difficulties and challenges relate to the training of students and teachers to understand the principles of the method.
Final considerations:
The benefits of PBL coincide with the needs of nursing training, but its applicability demands constant review in seeking to develop the skills necessary for this training.
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REFLECTION10-21-2019
Clinical supervision and preceptorship/tutorship: contributions to the Supervised Curricular Internship in Nursing Education
Revista Brasileira de Enfermagem. 2019;72(6):1730-1735
Abstract
REFLECTIONClinical supervision and preceptorship/tutorship: contributions to the Supervised Curricular Internship in Nursing Education
Revista Brasileira de Enfermagem. 2019;72(6):1730-1735
DOI 10.1590/0034-7167-2018-0785
Views0See moreABSTRACT
Objective:
To reflect on the contributions of the clinical supervision and preceptorship/tutorship as means to approach and engage nurses of healthcare services in activities related to the Supervised Curricular Internship, discussing conceptual, theoretical, and practical approaches for higher education in nursing.
Method:
This is a reflection based on the discursive formulation concerning clinical supervision and preceptorship/tutorship.
Results:
Clinical supervision has been widely used by international healthcare institutions to qualify the work processes of nurses, supporting their self-development. Currently, is has been supporting the work of nurses who are preceptors/tutors and monitors students on clinical internships.
Final considerations:
The clinical supervision of nursing students features a robust and effective strategy for the development of interns and for the completion of the teaching-service integration.
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ORIGINAL ARTICLE07-10-2020
Profile of nursing students: quality of life, sleep and eating habits
Revista Brasileira de Enfermagem. 2020;73:e20190365
Abstract
ORIGINAL ARTICLEProfile of nursing students: quality of life, sleep and eating habits
Revista Brasileira de Enfermagem. 2020;73:e20190365
DOI 10.1590/0034-7167-2019-0365
Views0See moreABSTRACT
Objective:
to profile and analyze sleep quality, quality of life and eating habits of nursing students.
Methods:
a cross-sectional, comparative and correlational study with the following variables: sociodemographic characteristics, Pittsburgh sleep quality index, quality of life and eating habits. One hundred ninety-five students participated in the study.
Results:
participants were on average 24 years old. Results showed that females were prevalent (87.1%); 71.0% of the students had poor sleep quality; 98.9% used electronic devices before bedtime. Self-perception of quality of life was indifferent (38.3%), and self-perception of general health, 36.9% expressed satisfaction. Among the participants, 45.13% consumed one portion of fruit and 40.66% two to three portions of vegetables daily.
Conclusion:
the study allowed the profile of these students, sedentary, overweight and poor sleep quality young students who studied and worked.
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ORIGINAL ARTICLE10-23-2020
Building and validating an educational video for elderly individuals about fall risks
Revista Brasileira de Enfermagem. 2020;73:e20200010
Abstract
ORIGINAL ARTICLEBuilding and validating an educational video for elderly individuals about fall risks
Revista Brasileira de Enfermagem. 2020;73:e20200010
DOI 10.1590/0034-7167-2020-0010
Views0ABSTRACT
Objective:
to build and validate educational video for elderly individuals about fall risks.
Methods:
methodological study with video building. validated by 22 judges and assessed by 22 elderly individuals. Content was selected from the Fall Prevention Model and items from the Falls Risk Awareness Questionnaire. Items with an agreement greater than 0.80 were considered valid. verified through Content Validation Index (CVI) and binomial test.
Results:
building the video was guided by the Cognitive Theory of Multimedia Learning. Digital animation and audio narration were used. It lasted ten minutes and five seconds and included biological. socioeconomic. behavioral and environmental risks as well as precautions to avoid them. The CVI of judges had an average of 0.99. and of elderly individuals. an average of 1.0.
Conclusion:
the video was built and validated for content and understanding and can be used to prevent falls in elderly individuals.
Keywords:Accidental FallsEducational TechnologyHealth EducationHealth of the ElderlyInstructional Films and VideosSee more -
REFLECTION03-05-2021
The nurse’s work in the context of COVID-19 pandemic
Revista Brasileira de Enfermagem. 2021;74:e20200594
Abstract
REFLECTIONThe nurse’s work in the context of COVID-19 pandemic
Revista Brasileira de Enfermagem. 2021;74:e20200594
DOI 10.1590/0034-7167-2020-0594
Views0See moreABSTRACT
Objective:
Reflect on the work experienced by the nurse in coping with the COVID-19 pandemic in a public hospital of the State of Rio Grande do Norte.
Methods:
Reflective essay based in the professional experience in a public reference hospital for the care of patients affected by COVID-19 in the State of Rio Grande do Norte. Results were organized in two empirical categories, which emphasize potentialities and barriers in the nurse’s work in the face of the COVID-19, presented by means of Ishikawa diagram.
Results:
Two categories emerged from the experiences: Nursing leadership in organizing health services to face COVID-19; and the performance of nursing care management in the COVID-19 pandemic.
Final considerations:
It is necessary to value the nurse’s work in all its attributes, as well as strengthen the interdisciplinary work processes, which collaborate to overcome the crisis caused by the pandemic.
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