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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
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
- Paula dos Santos Brito
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ORIGINAL ARTICLE07-31-2023
Parenting of mothers of children in early childhood during the COVID-19 pandemic: qualitative research
- Ricardo Barros Gurgel ,
- Juliane Lima Pereira Da Silva ,
- Estela Maria Leite Meirelles Monteiro ,
- Suzana Lins da Silva ,
- Tereza Rebecca de Melo e Lima , [ … ],
- Maria Wanderleya de Lavor Coriolano-Marinus
Abstract
ORIGINAL ARTICLEParenting of mothers of children in early childhood during the COVID-19 pandemic: qualitative research
Revista Brasileira de Enfermagem. 2023;76:e20220478
DOI 10.1590/0034-7167-2022-0478
- Ricardo Barros Gurgel ,
- Juliane Lima Pereira Da Silva ,
- Estela Maria Leite Meirelles Monteiro ,
- Suzana Lins da Silva ,
- Tereza Rebecca de Melo e Lima ,
- Maria Wanderleya de Lavor Coriolano-Marinus
Views0See moreABSTRACT
Objectives:
to understand practices of mothers of children in early childhood who live in contexts of poverty in the face of the COVID-19 pandemic.
Methods:
an exploratory, descriptive and qualitative study. Participants were selected in the community context, composing an intentional sample to be collected through semi-structured online interviews. Data were analyzed inductively and anchored in the Bioecological Model of Human Development.
Results:
eight mothers participated in the research. Mothers highlighted pleasure in taking care of their children, although they were overloaded with activities and comprehensive care at the time of the pandemic. Children, in mothers’ perception, showed a higher frequency of challenging behaviors, which may be related to negative parenting practices, such as punishment and physical violence.
Final Considerations:
interventions to support parenting become urgent in the face of changes brought about by the COVID-19 pandemic in families living in a context of poverty.
- Ricardo Barros Gurgel
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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
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 - Geórgia Silva Marques
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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
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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
- 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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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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REVIEW06-26-2023
Barriers to Pre-Exposure Prophylaxis (PrEP) use for HIV: an integrative review
- Marcela Antonini ,
- Ingred Evangelista da Silva ,
- Henrique Ciabotti Elias ,
- Larissa Gerin ,
- Aliete Cunha Oliveira , [ … ],
- Renata Karina Reis
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
- Marcela Antonini ,
- Ingred Evangelista da Silva ,
- Henrique Ciabotti Elias ,
- Larissa Gerin ,
- Aliete Cunha Oliveira ,
- Renata Karina Reis
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
- Marcela Antonini
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REVIEW04-16-2021
Clinical outcomes of patient navigation performed by nurses in the oncology setting: an integrative review
- Rodrigo Lima Rodrigues ,
- Franciane Schneider ,
- Luciana Puchalski Kalinke ,
- Silvana Silveira Kempfer ,
- Vânia Marli Schubert Backes
Abstract
REVIEWClinical outcomes of patient navigation performed by nurses in the oncology setting: an integrative review
Revista Brasileira de Enfermagem. 2021;74(2):e20190804
DOI 10.1590/0034-7167-2019-0804
- Rodrigo Lima Rodrigues ,
- Franciane Schneider ,
- Luciana Puchalski Kalinke ,
- Silvana Silveira Kempfer ,
- Vânia Marli Schubert Backes
Views0ABSTRACT
Objective:
to evidence the clinical outcomes of navigation performed by nurses in cancer patients.
Methods:
this is an integrative literature review with collection in MEDLINE via PUBMED, LILACS, Web of Science, Scopus, and CINAHL databases. The final sample consisted of seven studies. The data were analyzed and presented descriptively. Data related to clinical outcomes were compiled and described in full. The Agency for Healthcare Research and Quality categorization was used to assess the level of evidence.
Results:
the clinical outcomes demonstrated were decreased distress, anxiety and depression, improved control and management of symptoms, improved physical conditioning, improved quality and continuity of care, improved quality of life, reduced time to start treatment.
Final considerations:
there is research that shows better clinical outcomes in cancer patients through navigation by nurses across the continuum of health care.
Keywords:Evidence-based NursingOncology NursingOutcome Assessment (Health Care)Patient NavigationTreatment OutcomeSee more
- Rodrigo Lima Rodrigues
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ORIGINAL ARTICLE12-13-2019
Perceptions and expectations of pregnant women about the type of birth
- Roberta Marielle Arik ,
- Cristina Maria Garcia de Lima Parada ,
- Vera Lúcia Pamplona Tonete ,
- Fernanda Cristina Manzini Sleutjes
Abstract
ORIGINAL ARTICLEPerceptions and expectations of pregnant women about the type of birth
Revista Brasileira de Enfermagem. 2019;72:41-49
DOI 10.1590/0034-7167-2017-0731
- Roberta Marielle Arik ,
- Cristina Maria Garcia de Lima Parada ,
- Vera Lúcia Pamplona Tonete ,
- Fernanda Cristina Manzini Sleutjes
Views0See moreABSTRACT
Objective:
to understand the perceptions and expectations of pregnant women about the type of birth.
Method:
this is a qualitative research, based on the assumptions of the Humanization of Obstetric Care. 15 pregnant women were interviewed twice at the beginning and the end of gestation between October 2015 and May 2016. Data were analyzed according to the method of the Discourse of the Collective Subject.
Results:
the discourses were associated with four themes: Advantages of vaginal birth over cesarean section; Fear and unpredictability of vaginal birth; Importance of the doctor in the definition of the type of birth; and Influence of family and friends in choosing the type of birth.
Final considerations:
according to pregnant women, vaginal birth has more benefit compared to cesarean section. However, during gestation and birth, fear of pain and the unexpected, and medical opinions of friends and family against vaginal birth strongly influence the choice of cesarean section.
- Roberta Marielle Arik
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REVIEW08-14-2020
Nursing practice environment in Primary Health Care: a scoping review
Revista Brasileira de Enfermagem. 2020;73(6):e20190479
Abstract
REVIEWNursing practice environment in Primary Health Care: a scoping review
Revista Brasileira de Enfermagem. 2020;73(6):e20190479
DOI 10.1590/0034-7167-2019-0479
Views0INTRODUCTIONKnowledge and scientific evidence about nursing practice environments (NPE) in the context of Primary Health Care (PHC) is scarce.Policy makers, health and professional organizations have proposed to redesign the health system in PHC with the aim of increasing citizens’ accessibility, improving customer outcomes and maximizing efficiency. […]See more
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REVIEW09-30-2020
Telenursing in care, education and management in Latin America and the Caribbean: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20190317
Abstract
REVIEWTelenursing in care, education and management in Latin America and the Caribbean: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20190317
DOI 10.1590/0034-7167-2019-0317
Views0See moreABSTRACT
Objective:
Analyze the knowledge generated about telenursing related to the roles of nurses (care, education and management) in Latin America and the Caribbean, based on scientific evidence.
Methods:
Integrative review, for the years 2009 to 2019, in scientific databases from Latin America and the Caribbean. Twelve articles were selected.
Results:
Nine studies focused on care and three on education. The information and communication technology used in the studies was telephony directed toward non-communicable diseases. There were concerns about the remote communication process. With respect to education, two focused on educating health teams and one on educating patients.
Conclusion:
It is necessary to conduct studies on telenursing that generate changes in care practices, explore information and communication technology resources and provide communication training focused on this new care model.
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ORIGINAL ARTICLE04-09-2020
High-risk areas of leprosy in Brazil between 2001-2015
- Rayssa Nogueira Rodrigues ,
- Heloisy Alves de Medeiros Leano ,
- Isabela de Caux Bueno ,
- Kleane Maria da Fonseca Azevedo Araújo ,
- Francisco Carlos Félix Lana
Abstract
ORIGINAL ARTICLEHigh-risk areas of leprosy in Brazil between 2001-2015
Revista Brasileira de Enfermagem. 2020;73(3):e20180583
DOI 10.1590/0034-7167-2018-0583
- Rayssa Nogueira Rodrigues ,
- Heloisy Alves de Medeiros Leano ,
- Isabela de Caux Bueno ,
- Kleane Maria da Fonseca Azevedo Araújo ,
- Francisco Carlos Félix Lana
Views0See moreABSTRACT
Objectives:
to identify high-risk areas of leprosy in Brazil from 2001 to 2015.
Methods:
this is an ecological study of spatial analysis based on Brazilian municipalities. Spatial scan statistics were used to identify spatial clustering and measure the relative risk from the annual detection rate of new cases of leprosy. By criterion based on the Gini index, only secondary clusters were considered.
Results:
spatial scan statistics detected 26 clusters, in which the detection rate was 59.19 cases per 100 thousand inhabitants, while in the remainder of the country it was 11.76. Large part of the cluster area is located in the Legal Amazon. These groups included only 21.34% of the total population, but 60.40% of the new cases of the disease.
Conclusions:
Leprosy remains concentrated in some areas, showing the need for control programs to intensify actions in these municipalities.
- Rayssa Nogueira Rodrigues
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ORIGINAL ARTICLE06-29-2020
Personal Protective Equipment in the coronavirus pandemic: training with Rapid Cycle Deliberate Practice
Revista Brasileira de Enfermagem. 2020;73:e20200303
Abstract
ORIGINAL ARTICLEPersonal Protective Equipment in the coronavirus pandemic: training with Rapid Cycle Deliberate Practice
Revista Brasileira de Enfermagem. 2020;73:e20200303
DOI 10.1590/0034-7167-2020-0303
Views0See moreABSTRACT
Objective:
to discuss the application of Rapid Cycle Deliberate Practice for attire and unattire training in the context of COVID-19 and structure a practical guide to the application at this juncture.
Methods:
this methodological study described theoretical and practical aspects of the application of a simulation strategy as a technological training tool. An application guide was constructed from the search for evidence from the main health authority bodies in Brazil.
Results:
maximizing time in Deliberate Practice, feedback with evidence and psychological security are the principles of this strategy. The dynamic involves repetition and feedback. The application guide presents the sequence of actions for attire and unattire.
Final considerations:
coping with this pandemic requires appropriate use of personal protective equipment. The authors suggest the Rapid Cycle Deliberate Practice as a technological educational tool for attire/unattire, since it encourages mastery performance.
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ORIGINAL ARTICLE08-19-2019
Interruptions and nursing workload during medication administration process
Revista Brasileira de Enfermagem. 2019;72(4):1001-1006
Abstract
ORIGINAL ARTICLEInterruptions and nursing workload during medication administration process
Revista Brasileira de Enfermagem. 2019;72(4):1001-1006
DOI 10.1590/0034-7167-2018-0680
Views0See moreABSTRACT
Objective:
To investigate the sources and causes of interruptions during the medication administration process performed by a nursing team and measure its frequency, duration and impact on the team’s workload.
Métodos:
This is an observational study that timed 121 medication rounds (preparation, administration and documentation) performed by 15 nurses and nine nursing technicians in a Neonatal Intensive Care Unit in the countryside of the state of São Paulo.
Resultados:
63 (52.1%) interruptions were observed. In each round, the number of interruptions that happened ranged from 1-7, for 127 in total; these occurred mainly during the preparation phase, 97 (76.4%). The main interruption sources were: nursing staff – 48 (37.8%) − and self-interruptions – 29 (22.8%). The main causes were: information exchanges – 54 (42.5%) − and parallel conversations – 28 (22%). The increase in the mean time ranged from 53.7 to 64.3% (preparation) and from 18.3 to 19.2% (administration) – p≤0.05.
Conclusão:
Interruptions in the medication process are frequent, interfere in the workload of the nursing team and may reflect on the safety of care.
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ORIGINAL ARTICLE02-10-2020
Depression among nursing students and its association with academic life
- Adriano Machado Facioli ,
- Ângela Ferreira Barros ,
- Manuela Costa Melo ,
- Ivone Crispim Moura Ogliari ,
- Renan Joseph de Moraes Custódio
Abstract
ORIGINAL ARTICLEDepression among nursing students and its association with academic life
Revista Brasileira de Enfermagem. 2020;73(1):e20180173
DOI 10.1590/0034-7167-2018-0173
- Adriano Machado Facioli ,
- Ângela Ferreira Barros ,
- Manuela Costa Melo ,
- Ivone Crispim Moura Ogliari ,
- Renan Joseph de Moraes Custódio
Views0See moreABSTRACT
Objective:
To measure the levels of depression among Nursing students from a public institution of higher education and the association with aspects of academic life.
Method:
Analytical and quantitative study with 203 students from a higher education institution that uses active methodologies. We used Beck’s Depression Inventory and the Likert type scale of academic factors.
Results:
We verified that 19.2% had moderate or severe levels of depression. Higher levels of depression were associated with female gender (p=0.003), working more than 40 hours per week (p=0.047), spending more than 90 minutes to reach academic activities (p=0.043) and with 12 academic factors specific to routines of the studied institution.
Conclusion:
The results contribute to managers’ and professors’ reflection and analysis concerning nursing students’ mental health, in addition to indicating in which aspects there is a need to provide greater support to these students.
- Adriano Machado Facioli
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