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ORIGINAL ARTICLE12-08-2024
Initial nipple damages in breastfeeding women: analysis of photographic images and clinical associations
Revista Brasileira de Enfermagem. 2024;77(1):e20220773
Abstract
ORIGINAL ARTICLEInitial nipple damages in breastfeeding women: analysis of photographic images and clinical associations
Revista Brasileira de Enfermagem. 2024;77(1):e20220773
DOI 10.1590/0034-7167-2022-0773
Views0See moreABSTRACT
Objective:
to analyze the initial nipple damage degree by breastfeeding practice and to associate findings with clinical manifestations of breastfeeding women.
Methods:
a retrospective, cross-sectional study with primary data and photographic images database from two randomized clinical trials. Photographic images were analyzed by two independent evaluators using the Nipple Trauma Score. For analysis, the chi-square, Mann-Whitney tests and Kappa coefficient were applied.
Results:
115 breastfeeding women and their respective 186 photographic images were analyzed. The degree of agreement of evaluators using the Nipple Trauma Score was 93.6%. The nipple pain score during breastfeeding was moderate and compromised more than 25% of the nipple surface area.
Conclusions:
assistance to breastfeeding women should prioritize nipple pain intensity instead of the nipple damage size.
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ORIGINAL ARTICLE12-08-2024
Safe practices for bed bathing in the intensive care unit: validation of a checklist
- Juliana Cristina Silva
, - Márcia Marques dos Santos Felix ,
- Rosa Helena Aparecida Gonçalves ,
- Isadora Braga Calegari ,
- Maria Beatriz Guimarães Raponi , [ … ],
- Maria Helena Barbosa
Abstract
ORIGINAL ARTICLESafe practices for bed bathing in the intensive care unit: validation of a checklist
Revista Brasileira de Enfermagem. 2024;77(1):e20230135
DOI 10.1590/0034-7167-2023-0135
- Juliana Cristina Silva ,
- Márcia Marques dos Santos Felix ,
- Rosa Helena Aparecida Gonçalves ,
- Isadora Braga Calegari ,
- Maria Beatriz Guimarães Raponi ,
- Maria Helena Barbosa
Views0See moreABSTRACT
Objective:
To validate a checklist for safe bathing in critically ill patients.
Methods:
This is a methodological and quantitative study. Researchers developed a checklist for safe bathing in critically ill patients consisting of 41 items, which were submitted to the apparent and content validation process, evaluated by eleven judges, and interobserver reliability. For reliability analysis, the instrument was applied in 54 bed bath procedures in the ICU; Kappa and CHF tests were used.
Results:
In the apparent and content validation, adjustments were made according to the judges’ suggestions. Kappa values ranged from moderate to almost perfect (0.462 to 0.962), and, in some items, there was 100% agreement; the reliability of the instrument was excellent (ICC = 0.962).
Conclusion:
The instrument proved to be dependable and easy to apply. Its use will contribute to safe bed bathing and subsidize interventions aimed at increasing the quality of care.
- Juliana Cristina Silva
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REVIEW11-29-2024
Assessment of knowledge in oncology about care for transgender people: a scoping review
- Fernanda Fachetti Xavier de Almeida ,
- Cremilson de Paula Silva ,
- Ricardo Souza Evangelista Sant’Ana ,
- Ruan Nilton Rodrigues Melo
Abstract
REVIEWAssessment of knowledge in oncology about care for transgender people: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20230532
DOI 10.1590/0034-7167-2023-0532
- Fernanda Fachetti Xavier de Almeida ,
- Cremilson de Paula Silva ,
- Ricardo Souza Evangelista Sant’Ana ,
- Ruan Nilton Rodrigues Melo
Views0See moreABSTRACT
Objective:
to identify evidence available in the literature on instruments and methodologies used to assess healthcare professionals’ knowledge about cancer care for the transgender population.
Methods:
a scoping review was conducted in seven databases, including studies that answered the question: what is the healthcare professionals’ level of knowledge about cancer care for the transgender population?
Results:
forty-one articles were selected that dealt specifically with healthcare professionals’knowledge in relation to care for the LGBTQIAPN+ population, especially the transgender population. Eighteen studies assessed patients’ perceptions of professionals’knowledge, whereas other studies used their own assessment tools, considering the global context of LGBTQIAPN+ health.
Conclusions:
there is no tested and validated instrument that assesses the knowledge about the transgender population’s oncological health, highlighting the need to construct and validate an instrument focused on this population’s needs.
- Fernanda Fachetti Xavier de Almeida
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ORIGINAL ARTICLE11-29-2024
Sleep quality of vulnerable elderly people: associated factors
- Ariene Angelini dos Santos-Orlandi ,
- Ana Carolina Ottaviani ,
- Elén dos Santos Alves ,
- Tábatta Renata Pereira de Brito ,
- Keika Inouye
Abstract
ORIGINAL ARTICLESleep quality of vulnerable elderly people: associated factors
Revista Brasileira de Enfermagem. 2024;77:e20230283
DOI 10.1590/0034-7167-2023-0283
- Ariene Angelini dos Santos-Orlandi ,
- Ana Carolina Ottaviani ,
- Elén dos Santos Alves ,
- Tábatta Renata Pereira de Brito ,
- Keika Inouye
Views0See moreABSTRACT
Objective:
To identify factors associated with poor sleep quality in elderly dependent individuals in social vulnerability.
Method:
Cross-sectional study with 59 elderly dependent individuals assisted by Family Health Units in São Carlos/SP. The following tools were used: Katz Index, Lawton and Brody Scale, Pittsburgh Sleep Quality Index, Addenbrooke’s Cognitive Examination Revised, Fried’s Frailty Phenotype, Geriatric Depression Scale (15 items), Perceived Stress Scale, Family APGAR, Social Support Scale from the Medical Outcomes Study, and World Health Organization Quality of Life, abbreviated and “old” versions.
Results:
The majority of participants were women (52.5%), aged 60-74 years (71.1%), and had poor sleep quality (76.2%). Stress (OR=1.12; 95%CI=1.02-1.22) and polypharmacy (OR=7.39; 95%CI=1.22-44.73) increased the chances of poor sleep quality, while physical activity decreased these chances (OR=0.15; 95%CI=0.02-0.79).
Conclusion:
Stress and polypharmacy are associated with poor sleep quality in elderly dependent individuals.
- Ariene Angelini dos Santos-Orlandi
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REVIEW11-22-2024
Transition to family parenting in the face of the first child: a scoping review
- Maria Isabel Ventura Araújo ,
- Alberto Carlos Marques Duarte ,
- Maria Henriqueta de Jesus Silva Figueiredo ,
- Carmen Maria da Silva Maciel Andrade
Abstract
REVIEWTransition to family parenting in the face of the first child: a scoping review
Revista Brasileira de Enfermagem. 2024;77(5):e20230487
DOI 10.1590/0034-7167-2023-0487
- Maria Isabel Ventura Araújo ,
- Alberto Carlos Marques Duarte ,
- Maria Henriqueta de Jesus Silva Figueiredo ,
- Carmen Maria da Silva Maciel Andrade
Views1See moreABSTRACT
Objectives:
to identify and summarize the elements that characterize the family transition process in relation to the first child.
Methods:
a scoping review was carried out based on JBI methodology, in six databases, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist.
Results:
ten articles were included with factors characterizing the transition, such as hindering/facilitating conditions that influence the process, important support structures in adaptation and strategies/responses used in the transition process.
Final Considerations:
elements characterizing the transition process in relation to the first child were identified. However, no theoretical explanation for this was identified. Further research should be carried out to obtain a deeper understanding of this process.
- Maria Isabel Ventura Araújo
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11-22-2024
Social Technology in the Prevention of Adolescent Violence: documentary production
- Daiane de Paulo Paltanin Silva ,
- Laura Christina Macedo ,
- Rafaela Gessner Lourenço ,
- Thammy Novakovski dos Santos
Abstract
Social Technology in the Prevention of Adolescent Violence: documentary production
Revista Brasileira de Enfermagem. 2024;77(5):e20230298
DOI 10.1590/0034-7167-2023-0298
- Daiane de Paulo Paltanin Silva ,
- Laura Christina Macedo ,
- Rafaela Gessner Lourenço ,
- Thammy Novakovski dos Santos
Views0See moreABSTRACT
Objective:
To report the development of a technological innovation in the form of a documentary, aimed at disseminating actions for preventing violence against adolescents within the context of Primary Health Care.
Methods:
The documentary was developed through action research and interventions with adolescents in the territory of a Health Unit, conducted between 2020 and 2022, using Social Technology as both an action strategy and a conceptual reference.
Results:
The Social Technology proposal, created through workshops and seminars, resulted in a documentary focusing on violence prevention, involving 48 adolescents. The documentary’s script, collectively developed, portrays a soccer match between teams symbolizing peace and violence, with peace ultimately prevailing. The documentary is six minutes long.
Final Considerations:
The documentary has proven to be an effective Social Technology tool among adolescents, as it fosters critical thinking, is accessible, has potential for digital dissemination, and appeals to the target audience.
- Daiane de Paulo Paltanin Silva
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ORIGINAL ARTICLE11-22-2024
Prevalence of prescription and effectiveness of analgesia for treating vaginal delivery pain
- Juan Ignacio Calcagno ,
- Sarah Iribarren ,
- Cristiane Flora Villarreal ,
- Patricia Santos de Oliveira ,
- Amado Nizarala de Ávila
Abstract
ORIGINAL ARTICLEPrevalence of prescription and effectiveness of analgesia for treating vaginal delivery pain
Revista Brasileira de Enfermagem. 2024;77(5):e20230327
DOI 10.1590/0034-7167-2023-0327
- Juan Ignacio Calcagno ,
- Sarah Iribarren ,
- Cristiane Flora Villarreal ,
- Patricia Santos de Oliveira ,
- Amado Nizarala de Ávila
Views0See moreABSTRACT
Objectives:
to assess pain management during labor.
Methods:
a cross-sectional study was carried out by reviewing medical records and conducting postpartum interviews. Prevalence and effectiveness of analgesia were assessed.
Results:
the prevalence of non-pharmacological analgesia was 61.86% of 215 women in labor in Obstetric Center and 82.51% of 62 in midwife-led unit. Prevalence of severe pain, on the Visual Analogue Scale, before and after non-pharmacological analgesia, was from 92.16% to 64.04% (p=0.00) in Obstetric Center and from 85.96% to 52.63% (p=0.01) in midwife-led unit. Prevalence of pharmacological analgesia in Obstetric Centers was 15.81%, with no variation in severe pain (p=0.57). Patients’ request for analgesia was associated with education (p=0.00) and pain intensity (p=0.02).
Conclusions:
non-pharmacological analgesia improved pain intensity. Prevalence of pharmacological analgesic prescription was lower than that identified in developed countries. Pain management needs to consider the preferences and needs of women in labor.
- Juan Ignacio Calcagno
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ORIGINAL ARTICLE11-22-2024
Perceptions from people with physical disabilities about accessibility and social conditions: interventions for rehabilitation nursing
- Rute Salomé da Silva Pereira ,
- Salomé Sobral Sousa ,
- Maria Manuela Martins ,
- Wiliam César Alves Machado ,
- Soraia Dornelles Schoeller
Abstract
ORIGINAL ARTICLEPerceptions from people with physical disabilities about accessibility and social conditions: interventions for rehabilitation nursing
Revista Brasileira de Enfermagem. 2024;77(5):e20240005
DOI 10.1590/0034-7167-2024-0005
- Rute Salomé da Silva Pereira ,
- Salomé Sobral Sousa ,
- Maria Manuela Martins ,
- Wiliam César Alves Machado ,
- Soraia Dornelles Schoeller
Views0ABSTRACT
Objectives:
to analyze the experiences of people with acquired physical disabilities regarding accessibility and social conditions; to identify nurse-led rehabilitation interventions for accessibility and social conditions; to determine nursing-sensitive indicators to improve accessibility and social conditions.
Methods:
a descriptive-exploratory qualitative study employed semi-structured interviews with people with acquired physical disabilities through purposive snowball sampling to address all objectives. Data analysis followed Bardin’s content analysis principles. Furthermore, objectives 2 and 3 were achieved through a reflective theoretical approach.
Results:
the 27 participants reported accessibility challenges, impacting activities of living and social conditions. This influences rehabilitation nursing, leading to three intervention fields: Assess the ability to perform activities of living and influencing factors; Develop and implement training to perform activities of living; Promote mobility, accessibility, and social participation.
Final Considerations:
based on participants experiences, we identified nurse-led rehabilitation interventions to promote accessibility and social conditions.
Keywords:Architectural AccessibilityPeople with DisabilitiesRehabilitation NursingSocial ConditionsSustainable Development GoalsSee more
- Rute Salomé da Silva Pereira
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02-05-2021
Contents related to nursing professionals during the COVID-19 pandemic on the Youtube™ platform
- Evanilda Souza de Santana Carvalho ,
- Paulo Roberto Lima Falcão doVale ,
- Karina Araújo Pinto ,
- Sílvia Lúcia Ferreira
Abstract
Contents related to nursing professionals during the COVID-19 pandemic on the Youtube™ platform
Revista Brasileira de Enfermagem. 2021;74:e20200581
DOI 10.1590/0034-7167-2020-0581
- Evanilda Souza de Santana Carvalho ,
- Paulo Roberto Lima Falcão doVale ,
- Karina Araújo Pinto ,
- Sílvia Lúcia Ferreira
Views0See moreABSTRACT
Objective:
to characterize the content of Youtube™ videos related to nursing professionals during the COVID-19 pandemic.
Method:
a qualitative study that examined 47 videos on Youtube™ posted between 11/03 and 11/04 2020, which were subjected to thematic analysis.
Results:
four categories emerged: “the role of nurses in care production during the pandemic”, which addresses the management of services and individual care; “Overview of the pandemic from the perspective of nurses in different countries”, presenting experiences and encouraging physical distance; “Tributes and motivation to mobilize the category”, in addition to targeted tributes, calls for nurses to claim their rights; “Criticisms and demands to improve working conditions”, which highlights the insecurity of care provision settings.
Final considerations:
nursing work conditions in different countries, recognition of the importance of professionals during the pandemic, and claims of the category to improve working conditions were the main content found on Youtube™.
- Evanilda Souza de Santana Carvalho
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REVIEW07-13-2020
Prevention and control measures for neonatal COVID-19 infection: a scoping review
- Bruna Hinnah Borges Martins de Freitas ,
- Mayrene Dias de Sousa Moreira Alves ,
- Maria Aparecida Munhoz Gaíva
Abstract
REVIEWPrevention and control measures for neonatal COVID-19 infection: a scoping review
Revista Brasileira de Enfermagem. 2020;73:e20200467
DOI 10.1590/0034-7167-2020-0467
- Bruna Hinnah Borges Martins de Freitas ,
- Mayrene Dias de Sousa Moreira Alves ,
- Maria Aparecida Munhoz Gaíva
Views0See moreABSTRACT
Objective:
to identify with the literature the measures to prevent and control neonatal infection by COVID-19.
Methods:
a scope review carried out by searching for studies in databases and institutional health websites. The final sample was 25 articles.
Results:
among the main measures are the use of masks by suspected or infected people in contact with healthy newborns, hand hygiene before and after each care and feeding as well as the tools used for milking. It is indispensable to use personal protective equipment by health professionals in neonatology services to maintain a private room for infected newborns or to use physical barriers. Early diagnosis and timely case management is essential to reduce virus transmissibility.
Conclusions:
the research contributed to elucidate health and nursing actions in preventing and controlling neonatal infection by COVID-19.
- Bruna Hinnah Borges Martins de Freitas
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REVIEW06-17-2020
Prevention and conduct against the Extravasation of antineoplastic chemotherapy: a scoping review
- João Marcos Alves Melo ,
- Patrícia Peres de Oliveira ,
- Raíssa Silva Souza ,
- Deborah Franscielle da Fonseca ,
- Thaís Fonseca Gontijo , [ … ],
- Andrea Bezerra Rodrigues
Abstract
REVIEWPrevention and conduct against the Extravasation of antineoplastic chemotherapy: a scoping review
Revista Brasileira de Enfermagem. 2020;73(4):e20190008
DOI 10.1590/0034-7167-2019-0008
- João Marcos Alves Melo ,
- Patrícia Peres de Oliveira ,
- Raíssa Silva Souza ,
- Deborah Franscielle da Fonseca ,
- Thaís Fonseca Gontijo ,
- Andrea Bezerra Rodrigues
Views0See moreABSTRACT
Objectives:
to identify and synthesize scientific evidence on prevention and management of extravasation of antineoplastic agents in adult patients by nurses.
Methods:
scoping review, according to Joanna Briggs Institute and PRISMA-ScR. Research was conducted in five electronic databases, Cochrane Library and eight catalogs of theses and dissertations. Data collection occurred from April to July 2018, with no time limit. The extracted data were analyzed and synthesized in a narrative way.
Results:
a total of 3,110 records were retrieved and 18 studies were kept for review. Most publications (66.6%) had a qualitative approach and addressed both aspects, i.e., prevention and management of extravasation of chemotherapy in adult patients.
Conclusions:
the implementation of protocols based on scientific evidence on prevention and management of extravasation of antineoplastic agents is paramount in order to provide patient safety and support to the nursing staff.
- João Marcos Alves Melo
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REFLECTION09-07-2020
Training and work process in Multiprofessional Residency in Health as innovative strategy
- Mariana da Silva Bernardo ,
- Greici Capellari Fabrizzio ,
- Marina Leite Souza ,
- Thiago Oliveira dos Santos ,
- Selma Regina de Andrade
Abstract
REFLECTIONTraining and work process in Multiprofessional Residency in Health as innovative strategy
Revista Brasileira de Enfermagem. 2020;73(6):e20190635
DOI 10.1590/0034-7167-2019-0635
- Mariana da Silva Bernardo ,
- Greici Capellari Fabrizzio ,
- Marina Leite Souza ,
- Thiago Oliveira dos Santos ,
- Selma Regina de Andrade
Views0See moreABSTRACT
Objectives: To
reflect about education in health and work process on three programs of multiprofessional residency in Florianópolis/SC.
Method:
Reflexive study about Multiprofessional Residency Health Programs of Florianópolis.
Results:
Multiprofessional Residency characterizes training health professionals through service education. Developing these professionals’ specialization with assignments that promote professional exercise and magnifies multiprofessional work at the same time, for excellency in unabridged healthcare.
Final Considerations:
Multiprofessional Residency Programs make interdisciplinary education, sharing knowledge between residents and other professionals stimulating development of innovation skills.
- Mariana da Silva Bernardo
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ORIGINAL ARTICLE06-08-2020
Understanding the dramatic therapeutic play session: a contribution to pediatric nursing
Revista Brasileira de Enfermagem. 2020;73(4):e20180812
Abstract
ORIGINAL ARTICLEUnderstanding the dramatic therapeutic play session: a contribution to pediatric nursing
Revista Brasileira de Enfermagem. 2020;73(4):e20180812
DOI 10.1590/0034-7167-2018-0812
Views0See moreABSTRACT
Objectives:
to understand how the dramatic therapeutic play session occurs within the care of hospitalized children.
Methods:
qualitative multiple case study, using theoretical references, such as symbolic interactionism and Vygotsky’s theory of symbolic play. Twenty play sessions performed with six children from 3 to 10 years old were analyzed, each corresponding to one case.
Results:
these sessions demonstrated that a dramatic therapeutic play session is a process of four interdependent and complementary steps: bonding, exploring, dramatizing, and play cessation. They also revealed the imaginary situations externalized by the child, the importance of the exploration step for which they manage the imaginary situation and catharsis, and how her higher psychological faculties are articulated during this process.
Final Considerations:
the results contribute to the understanding of the conduct and analysis of the dramatic therapeutic play session, reinforcing the importance of its use in pediatric nursing care practice.
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ORIGINAL ARTICLE02-10-2020
Motivation and difficulties to reduce or quit smoking
- Maria Odete Pereira ,
- Bianca Cristina Silva de Assis ,
- Natália de Magalhães Ribeiro Gomes ,
- Alisson Rubson Alves ,
- Amanda Márcia dos Santos Reinaldo , [ … ],
- Mark Anthony Beinner
Abstract
ORIGINAL ARTICLEMotivation and difficulties to reduce or quit smoking
Revista Brasileira de Enfermagem. 2020;73(1):e20180188
DOI 10.1590/0034-7167-2018-0188
- Maria Odete Pereira ,
- Bianca Cristina Silva de Assis ,
- Natália de Magalhães Ribeiro Gomes ,
- Alisson Rubson Alves ,
- Amanda Márcia dos Santos Reinaldo ,
- Mark Anthony Beinner
Views0See moreABSTRACT
Objective:
To understand what factors motivate people to reduce or stop tobacco use and what difficulties they face in this process.
Method:
Qualitative, empirical and interpretative research that used a focal group technique for data collection and Discourse Analysis as a theoretical reference for analysis.
Results:
The responses centered on the following aspects: motivation for reduction or cessation of smoking, family and community support received during treatment, benefits from cessation of tobacco, difficulties encountered and strategies for overcoming triggers.
Final Considerations:
The results showed that the users expressed their desire for cessation of tobacco use and that to achieve this goal, family and group support, professional help and changing habits are key factors for this process.
- Maria Odete Pereira
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ORIGINAL ARTICLE02-10-2020
Common mental disorders in nursing students of the professionalizing cycle
- Elias Barbosa de Oliveira ,
- Regina Célia Gollner Zeitoune ,
- Cristiane Helena Gallasch ,
- Eugenio Fuentez Pérez Júnior ,
- Alexandre Vicente da Silva , [ … ],
- Thiago Carvalho de Souza
Abstract
ORIGINAL ARTICLECommon mental disorders in nursing students of the professionalizing cycle
Revista Brasileira de Enfermagem. 2020;73(1):e20180154
DOI 10.1590/0034-7167-2018-0154
- Elias Barbosa de Oliveira ,
- Regina Célia Gollner Zeitoune ,
- Cristiane Helena Gallasch ,
- Eugenio Fuentez Pérez Júnior ,
- Alexandre Vicente da Silva ,
- Thiago Carvalho de Souza
Views0See moreABSTRACT
Objectives:
to verify the suspicion of common mental disorders in nursing students of the professionalizing cycle and the association with sociodemographic features.
Method:
cross-sectional study with a sample of 85 students from a public university in the state of Rio de Janeiro (RJ) who responded to the Self-Report Questionnaire-20 and sociodemographic questions.
Results:
the suspicion prevalence of common mental disorders (CMD) in the sample was 55.3% and it was identified the association with the consumption of alcohol. Of the most frequent SRQ-20 complaints, 95.3% reported “feeling nervous, tense or worried”, 72.9% “having difficulty making decisions”, 60% “sleeping poorly” and 37.6% “having lost interest by things “.
Conclusion:
high prevalence of CMD in the sample and the association with the consumption of alcohol requires preventive and therapeutic actions among the students that minimize the possibility of severe mental disorders related to the consumption of alcohol and other drugs.
- Elias Barbosa de Oliveira
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ORIGINAL ARTICLE06-27-2019
Insertion of central vascular catheter: adherence to infection prevention bundle
- Eliana Ofelia Llapa-Rodríguez ,
- Júlian Katrin Albuquerque de Oliveira ,
- Fernanda Carneiro Melo ,
- Gilvan Gomes da Silva ,
- Maria Cláudia Tavares de Mattos , [ … ],
- Vinicius Paraíso Macieira Jr
Abstract
ORIGINAL ARTICLEInsertion of central vascular catheter: adherence to infection prevention bundle
Revista Brasileira de Enfermagem. 2019;72(3):774-779
DOI 10.1590/0034-7167-2018-0124
- Eliana Ofelia Llapa-Rodríguez ,
- Júlian Katrin Albuquerque de Oliveira ,
- Fernanda Carneiro Melo ,
- Gilvan Gomes da Silva ,
- Maria Cláudia Tavares de Mattos ,
- Vinicius Paraíso Macieira Jr
Views0See moreABSTRACT
Objective:
To evaluate the compliance of the care process involving insertion of central vascular catheter (CVC) in hemodialysis.
Method:
Cross-sectional quantitative approach developed at the hemodialysis service of a reference hospital in Sergipe, Brazil. Sample consisting of 1,342 actions evaluated, corresponding to 122 forms for monitoring and control of CVC insertion. Data collection was held from July to December 2016.
Results:
The adherence rate to the use of the insertion form was 54.9%. The procedure evaluated achieved 93% overall compliance. Of the 11 specific actions observed, seven (64%) presented 100% compliance. The density of the overall incidence of primary bloodstream infections reduced from 10.6 to 3.1 infections per 1,000 patients/day.
Conclusion:
Although the observed actions reached specific desired conformities, the use of the checklist was lower than expected. Strategies for monitoring, coaching and educational and organizational actions can contribute to safe care.
- Eliana Ofelia Llapa-Rodríguez
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