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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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Men’s mental health in the COVID-19 pandemic: is there a mobilization of masculinities?
Revista Brasileira de Enfermagem. 2021;74:e20200915
Abstract
Men’s mental health in the COVID-19 pandemic: is there a mobilization of masculinities?
Revista Brasileira de Enfermagem. 2021;74:e20200915
DOI 10.1590/0034-7167-2020-0915
Views0See moreABSTRACT
Objective:
to understand how the COVID-19 pandemic mobilizes masculinities in relation to mental health.
Methods:
qualitative study conducted with 400 men, in a virtual environment, in all regions of Brazil. The data were analyzed by the Discourse of the Collective Subject and based on Symbolic Interactionism.
Results:
the mobilization of masculinities emerged from men towards the recognition of weaknesses and psycho-emotional vulnerabilities, with narratives that reveal the expression of feelings, pain, discomfort and psychological suffering, and showed themselves to be sensitive and engaged in performing practices, including autonomous ones, of health care mental.
Final considerations:
the pandemic mobilizes masculinities as men print meanings and senses, in their interaction and interpretation of mental health, and is a marker for the nursing clinic conduct.
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ORIGINAL ARTICLE03-24-2021
Health promotion actions in the School Health Program in Ceará: nursing contributions
Revista Brasileira de Enfermagem. 2021;74(1):e20190769
Abstract
ORIGINAL ARTICLEHealth promotion actions in the School Health Program in Ceará: nursing contributions
Revista Brasileira de Enfermagem. 2021;74(1):e20190769
DOI 10.1590/0034-7167-2019-0769
Views1See moreABSTRACT
Objectives:
to compare health promotion actions carried out by Family Health teams in Ceará, linked to the School Health Program.
Methods:
a cross-sectional study involving the first and second cycles of an external assessment of 910 and 1,626 teams from 184 municipalities, which joined the Brazilian National Program for Improvement of Access and Quality of Primary Care. Eight clinical assessment and seven health promotion indicators were assessed, together with health professionals working in schools.
Results:
the interviewees were nurses (95.6% and 98.3%). Between the cycles, there was an increase in clinical assessment (78.7% and 91.3%), health promotion and disease prevention (82.5% and 89.3%) and survey of students for follow-up (41.4% and 66.4%) in schools.
Conclusions:
health actions at school advanced between cycles, with nurses as protagonists in school health, which can reduce vulnerabilities in children and adolescents and qualify Primary Care.
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REVIEW03-19-2021
Influence of burnout syndrome on the quality of life of nursing professionals: quantitative study
Revista Brasileira de Enfermagem. 2021;74:e20200298
Abstract
REVIEWInfluence of burnout syndrome on the quality of life of nursing professionals: quantitative study
Revista Brasileira de Enfermagem. 2021;74:e20200298
DOI 10.1590/0034-7167-2020-0298
Views0See moreABSTRACT
Objective:
To estimate the prevalence and factors associated with the burnout syndrome and quality of life among nursing professionals.
Methods:
Cross-sectional, analytical study, developed with 83 professionals in emergency care units in the city of Campina Grande-PB. A questionnaire was used to characterize the sample, the Maslach Burnout Inventory scale and the SF-36. Data was analyzed using descriptive and inferential statistics.
Results:
Most professionals showed low professional effectiveness (78.3; n=65), average depersonalization (53.0%; n=44) and average emotional exhaustion (55.4%; n=46). There was a statistical difference between the scores of the syndrome and the pain (p=0.03), vitality (p=0.04) and social aspect (p=0.03); significant correlation between the syndrome and vitality (p<0.001), mental health (p=0.01) and general quality of life (p=0.04).
Conclusion:
The burnout syndrome has an influence on the outcome of quality of life of nursing professionals, being more prevalent among professionals with older age, high income and among nurses.
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ORIGINAL ARTICLE05-03-2021
Medical device-related pressure injury prevention in critically ill patients: nursing care
Revista Brasileira de Enfermagem. 2021;74(2):e20200062
Abstract
ORIGINAL ARTICLEMedical device-related pressure injury prevention in critically ill patients: nursing care
Revista Brasileira de Enfermagem. 2021;74(2):e20200062
DOI 10.1590/0034-7167-2020-0062
Views0See moreABSTRACT
Objectives:
to know the care implemented by the nursing team to prevent medical device-related pressure injuries in critically ill patients.
Methods:
this is a qualitative research conducted with 15 nursing professionals from Intensive Care Unit. Sampling was carried out by theoretical saturation. For data analysis, the Discourse of the Collective Subject technique was used.
Results:
six speeches emerged, whose central ideas were interventions for medical device-related pressure injury prevention: care in fixation; frequent repositioning; protection and padding of body areas in contact; preferences for flexible materials, when available; attention of professionals so that they do not comer under patients; early assessment and removal, when clinically possible.
Final Considerations:
nursing care was directed mainly to respiratory devices, catheters in general and monitoring equipment, indicating that professionals have the knowledge to provide safe assistance consistent with the literature.
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ORIGINAL ARTICLE10-01-2022
Factors associated with presenteeism in nursing workers
Revista Brasileira de Enfermagem. 2022;75(1):e20201290
Abstract
ORIGINAL ARTICLEFactors associated with presenteeism in nursing workers
Revista Brasileira de Enfermagem. 2022;75(1):e20201290
DOI 10.1590/0034-7167-2020-1290
Views0See moreABSTRACT
Objective:
to analyze factors associated with presenteeism in nursing workers with sociodemographic variables, health and work conditions, productivity and musculoskeletal symptoms.
Methods:
this is a cross-sectional, descriptive and analytical study, with 306 nursing workers from a hospital and municipal emergency room in a Brazilian capital. The Stanford Presenteeism Scale, the Work Limitations Questionnaire, the Nordic Musculoskeletal Questionnaire and a demographic questionnaire on nursing professionals’ working conditions and health were used. Bivariate and multivariate analyzes were performed, respecting a significance level of 5%.
Results:
presenteeism was found in 43.8% of professionals and significant associations with CLT work (p=0.002), workplace – Intensive Care Units (p=0.008), physical exercise twice a week (p=0.008), presence of musculoskeletal symptoms, with low back pain being representative (p=0.001). The productivity loss was 8.8.
Conclusions:
the study confirms a high rate of presenteeism among nursing workers.
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EXPERIENCE REPORT06-07-2019
Humanitude in the humanization of elderly care: experience reports in a health service
Revista Brasileira de Enfermagem. 2019;72(3):825-829
Abstract
EXPERIENCE REPORTHumanitude in the humanization of elderly care: experience reports in a health service
Revista Brasileira de Enfermagem. 2019;72(3):825-829
DOI 10.1590/0034-7167-2017-0363
Views0ABSTRACT
Objective:
To describe the experience in the implementation of the Humanitude Care Methodology (MCH) in the humanization of care for the elderly.
Methodology:
This is an experience report about the implementation of the MCH, in a Health Service in Portugal, with capacity for 30 elderly people, most of them having cognitive alterations.
Results:
The implementation of the MCH has shown positive results in the humanization of care for the elderly, namely in the reduction of agitation behaviors and better acceptance of care. There was a change in organizational culture, more focused on the person and on the humanization of care.
Conclusion:
The results reflect the need to introduce innovative care methodologies in the training of health professionals, with a focus on interaction, for a professionalized relational care that dignifies the person cared for and the care giver.
Keywords:Evidence-based NursingHumanization of CareNeurocognitive DisordersNurse-Patient RelationsOrganizational InnovationPatient-Centered CareSee more -
ORIGINAL ARTICLE08-19-2019
Factors related to impaired comfort in chronic kidney disease patients on hemodialysis
Revista Brasileira de Enfermagem. 2019;72(4):889-895
Abstract
ORIGINAL ARTICLEFactors related to impaired comfort in chronic kidney disease patients on hemodialysis
Revista Brasileira de Enfermagem. 2019;72(4):889-895
DOI 10.1590/0034-7167-2018-0120
Views0See moreABSTRACT
Objective:
to analyze the factors related to the impaired comfort of chronic kidney diseases (CKD) patients on hemodialysis.
Method:
this is a cross-sectional study with 80 patients undergoing hemodialysis in a renal replacement therapy unit through interviews using two instruments, one for clinical and sociodemographic characteristics and the General Comfort Questionnaire, during the hemodialysis session. Mann-Whitney tests and the logistic regression model were used for data analysis.
Results:
the study found that being younger (p=0.045); being married (p=0.05); and absence of impaired physical mobility (p=0.007) were contributing factors for greater comfort in CKD patients on hemodialysis. Thus, when establishing the odds ratio, it was possible to observe that being 55 years of age or older, being single and having impaired physical mobility represents a 45.7% chance of developing this diagnosis.
Conclusions:
sociodemographic and clinical variables contribute to the study outcome, demanding attention during the planning of nursing interventions.
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