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RESEARCH01-01-2018
Standard Operational Protocols in professional nursing practice: use, weaknesses and potentialities
Revista Brasileira de Enfermagem. 2018;71(1):126-134
Abstract
RESEARCHStandard Operational Protocols in professional nursing practice: use, weaknesses and potentialities
Revista Brasileira de Enfermagem. 2018;71(1):126-134
DOI 10.1590/0034-7167-2016-0621
Views0See moreABSTRACT
Objective:
to evaluate the use of Standard Operational Protocols (SOPs) in the professional practice of the nursing team based on the theoretical framework of Donabedian, as well as to identify the weaknesses and potentialities from its implementation.
Method:
Evaluative research, with quantitative approach performed with nursing professionals working in the Health Units of a city of São Paulo, composed of two stages: document analysis and subsequent application of a questionnaire to nursing professionals.
Results:
A total of 247 nursing professionals participated and reported changes in the way the interventions were performed. The main weaknesses were the small number of professionals, inadequate physical structure and lack of materials. Among the potentialities were: the standardization of materials and concern of the manager and professional related to patient safety.
Conclusion:
The reassessment of SOPs is necessary, as well as the adoption of a strategy of permanent education of professionals aiming at improving the quality of care provided.
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RESEARCH01-01-2018
Evaluation of the risk of misidentification of women in a public maternity hospital
Revista Brasileira de Enfermagem. 2018;71(1):120-125
Abstract
RESEARCHEvaluation of the risk of misidentification of women in a public maternity hospital
Revista Brasileira de Enfermagem. 2018;71(1):120-125
DOI 10.1590/0034-7167-2017-0134
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Objective:
To determine the frequency of similar names and hospital records of women in a public teaching maternity hospital and the risk of misidentification resulting from the similarity in spelling and pronunciation of the names and in records.
Method:
Quantitative, documental and case study of 5,975 admissions that occurred between 2011 and 2014. The data name, admission and discharge date, date of birth, hospital record and bed number were collected from an electronic information system. Analysis encompassed descriptive statistics and design of an algorithm for comparison of text and sound.
Results:
Examination of the names revealed that 86% of the misidentification cases resulted from identical surnames and 96.5% from a sound similarity in the first names. There were patients with identical first and last names at least one day a week.
Conclusion:
The risk of misidentification of patients is a reality, which stresses the importance of checking and pronouncing the complete names correctly.
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RESEARCH01-01-2018
Analysis of incidents notified in a general hospital
Revista Brasileira de Enfermagem. 2018;71(1):111-119
Abstract
RESEARCHAnalysis of incidents notified in a general hospital
Revista Brasileira de Enfermagem. 2018;71(1):111-119
DOI 10.1590/0034-7167-2016-0574
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Objective:
To evaluate the incidents spontaneously notified in a general hospital in Minas Gerais.
Method:
Retrospective, descriptive, quantitative study performed at a general hospital in Montes Claros – Minas Gerais State. The sample comprised 1,316 incidents reported from 2011 to 2014. The data were submitted to descriptive statistical analysis using Statistical Package for the Social Sciences version 18.0.
Results:
The prevalence of incidents was 33.8 per 1,000 hospitalizations, with an increase during the investigation period and higher frequency in hospitalization units, emergency room and surgical center. These occurred mostly with adult clients and relative to the medication supply chain. The main causes were noncompliance with routines/protocols, necessitating changes in routines and training.
Conclusion:
There was a considerable prevalence of incidents and increase in notifications during the period investigated, which requires the attention of managers and hospital staff. Nevertheless, we observed development of the patient safety culture.
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RESEARCH01-01-2018
Signs and symptoms in Gaucher Disease: priority nursing diagnoses
Revista Brasileira de Enfermagem. 2018;71(1):104-110
Abstract
RESEARCHSigns and symptoms in Gaucher Disease: priority nursing diagnoses
Revista Brasileira de Enfermagem. 2018;71(1):104-110
DOI 10.1590/0034-7167-2016-0434
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Objective:
Identify the signs and symptoms of patients with Gaucher Disease, inferring possible priority nursing diagnoses.
Method:
Cross-sectional study, developed in a specialized laboratory, between 2013 and 2015. The sample (n = 91) comprised the records of patients with genetic diagnosis for Gaucher Disease. The study respected research norms.
Results:
Prevalence of female sex (57.1%), age at diagnosis between 0 and 10 years, and origin from the Southeast Region of Brazil were prevalent. Hematologic changes, bone pain, hepatomegaly, splenomegaly, and fatigue were the most recurrent signs and symptoms. The inferred diagnoses for the studied population were: Risk for bleeding; Fatigue; Chronic pain and Acute pain; Impaired physical mobility; Imbalanced nutrition: less than body requirements; and Risk for Developmental Delay.
Conclusion:
The establishment of Priority Nursing Diagnoses based on signs and symptoms makes it possible to achieve expected outcomes for each individual in the care context.
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RESEARCH01-01-2018
Social determinants of health related to adhesion to mammography screening
Revista Brasileira de Enfermagem. 2018;71(1):97-103
Abstract
RESEARCHSocial determinants of health related to adhesion to mammography screening
Revista Brasileira de Enfermagem. 2018;71(1):97-103
DOI 10.1590/0034-7167-2016-0623
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Objective:
To identify proximal, intermediary and individual social determinants related to mammography adherence, according to the Social Determinants of Health model proposed by Dahlgren and Whitehead. Method: Correlational cross-sectional study, carried out with a sociodemographic and clinical data questionnaire and the Champion’s Health Belief Model Scale, translated and adapted for use in Brazil. Data analyzed by multiple linear regression, from the domains scale, and sociodemographic and clinical variables were used as predictors.
Results:
The age group of 60-64 years (55.0%) was highlighted, 22 (55.0%) women had a stable partner; and 14 (65.0%) completed higher education. The domain with the greatest influence on adhesion to mammography was perceived barriers.
Conclusion:
The social determinants of health are directly related to the levels of adherence to the exam among women, as well as the perceived benefits, susceptibilities and barriers.
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RESEARCH01-01-2018
Training of adolescent multipliers from the perspective of health promotion core competencies
Revista Brasileira de Enfermagem. 2018;71(1):89-96
Abstract
RESEARCHTraining of adolescent multipliers from the perspective of health promotion core competencies
Revista Brasileira de Enfermagem. 2018;71(1):89-96
DOI 10.1590/0034-7167-2016-0532
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Objective:
Recognize the domains of health promotion core competencies in the training process of adolescents carried out by nursing students.
Method:
Qualitative and descriptive study, which used the theoretical methodological contribution Developing Competencies and Professional Standards for Health Promotion Capacity Building in Europe (CompHP), carried out with 14 nursing students.
Results:
There were four domains: Enable Change; Mediate through Partnership; Communication; and Leadership. These domains came from the interest and commitment of adolescents in intersectoral partnership, the use of communication techniques, and the role of facilitator to catalyze learning and empowerment.
Conclusion:
There were some domains of core competency in the training of adolescents, suggesting that nursing students act as health promoters. Challenges for Nursing are the implementation of a theoretical contribution of CompHP in undergraduate and ongoing training to carry out health promotion action.
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RESEARCH01-01-2018
Validation of nursing diagnoses, interventions and outcomes in a pediatric clinic
Revista Brasileira de Enfermagem. 2018;71(1):80-88
Abstract
RESEARCHValidation of nursing diagnoses, interventions and outcomes in a pediatric clinic
Revista Brasileira de Enfermagem. 2018;71(1):80-88
DOI 10.1590/0034-7167-2016-0647
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Objectives:
To elaborate operational definitions for the Nomenclature nursing diagnoses, interventionsand outcomes of the Pediatric Clinic at a University Hospital and carry out a validation of the content and clinical aspects of this Nomenclature.
Method:
Methodological research, developed in two stages: documentary study, for the validation of content of the operational definitions of nursing diagnoses; and secondly applied research, via clinical cases, performed with children from 0 to 5 years.
Results:
The 126 diagnoses were submitted to consensus validation and 55.6% were validated. Six clinical case studies were carried out, using the phases of the nursing process, based on the theory of Basic Human Needs, identifying 24.3% of the validated diagnoses and 54.5% of the nursing interventions listed in the Nomenclature.
Conclusion:
The study showed the effectiveness of using the Nomenclature in the Pediatric Clinic, in order to optimize the care andquality of health services.
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RESEARCH01-01-2018
Cognitive changes in nurses working in intensive care units
Revista Brasileira de Enfermagem. 2018;71(1):73-79
Abstract
RESEARCHCognitive changes in nurses working in intensive care units
Revista Brasileira de Enfermagem. 2018;71(1):73-79
DOI 10.1590/0034-7167-2016-0513
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Objective:
To measure the levels of stress, anxiety, and depression of nurses working in ICUs, relating them to levels of attention before and after 24 hours.
Method:
An observational, quantitative, analytical study with 18 nurses undergoing an inventory of stress, anxiety, and depression, as well as assessment of attention levels and psychomotor functioning.
Results:
Sixty-one percent showed positive for stress. Depression was observed in 33%; and anxiety in 99.9%. A strong correlation between stress and depression (ρ = 0.564 with p <0.05) and anxiety (ρ = 1 with p <0.05) was observed. There was a weak correlation between stress and task execution time in M2 (ρ = 0.055) for TMT A, a fact that did not occur in M0 (ρ = -0.249).
Conclusion:
The study shows that the workload of the nurses working in 24-hour shifts in the ICU is correlated with high levels of stress, decreases in the attention process, and psychomotor decline.
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ORIGINAL ARTICLE06-27-2019
Validation of a clinical simulation setting in the management of postpartum haemorrhage
Revista Brasileira de Enfermagem. 2019;72(3):624-631
Abstract
ORIGINAL ARTICLEValidation of a clinical simulation setting in the management of postpartum haemorrhage
Revista Brasileira de Enfermagem. 2019;72(3):624-631
DOI 10.1590/0034-7167-2018-0065
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Objective:
To construct and validate a clinical simulation setting for postpartum haemorrhage.
Method:
Quantitative research of methodological development, carried out from May to July of 2016 with 22 expert judges and 30 students. Analysis was performed from descriptive statistics, Binomial Test and Content Validity Index (CVI), considering CVI ≥ 80%.
Results:
Setting construction was based on learning objectives, fidelity, evaluation tool, pre-setting activities and debriefing. Agreement, regarding its validity, was satisfactory in the 23 items analyzed. Items evaluated by judges had CVI> 0.90; in the evaluation by students, CVI was > 0.95.
Conclusion:
It was considered validated and suitable for training and use by nursing students. Other studies should be carried out in order to test its effectiveness in the construction of theoretical and practical knowledge of both nursing students and nurses during Permanent Education.
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REVIEW06-01-2020
Access of the black population to health services: integrative review
Revista Brasileira de Enfermagem. 2020;73(4):e20180834
Abstract
REVIEWAccess of the black population to health services: integrative review
Revista Brasileira de Enfermagem. 2020;73(4):e20180834
DOI 10.1590/0034-7167-2018-0834
Views1See moreABSTRACT
Objectives:
demonstrate and discuss how the black population’s access to health services occurs
Methods:
integrative literature review with the following question: How does the black population’s access to health services occur? The search was carried out in the Scholar, LILACS and SciELO databases and used the descriptor “access to health services” and the term “population,” resulting in a sample with twelve articles.
Results:
studies show that the difficulty of access is a fundamental factor for the quality of life of people, directly compromising preventive services, especially for women’s health and, in addition, it has significant impact on the illness process of the black population within its particularities.
Final Considerations:
several limiting factors compromise the black population’s access to health services, including institutional and structural factors
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ORIGINAL ARTICLE10-21-2019
Occupational stress and engagement in primary health care workers
Revista Brasileira de Enfermagem. 2019;72(6):1580-1587
Abstract
ORIGINAL ARTICLEOccupational stress and engagement in primary health care workers
Revista Brasileira de Enfermagem. 2019;72(6):1580-1587
DOI 10.1590/0034-7167-2018-0681
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Objective:
To evaluate levels of occupational stress and work engagement among primary health care workers.
Method:
A descriptive, correlational and transversal study was carried out in a small municipality in the countryside of São Paulo, with a non-probabilistic sample of convenience, with 85 workers. Three self-applied instruments were used: one developed by researchers, containing sociodemographic variables; Work Stress Scale (WSS) and Utrech Work Engagement Scale (UWES).
Results:
Prevalence of women (72.6%), 40 years old or more (45.9%), 4 years and 4 months of mean working time in primary care. Thirty-one workers (36.5%) presented significant stress (scores ≥2.5). Work engagement showed a mean of 4.1 (±1.2) to 4.4 (±1.4), classified as high in all dimensions. Occupational stress and work engagement correlated negatively.
Conclusion:
Workers presented high levels of work engagement; more than one-third had significant occupational stress. Workers with high levels of occupational stress tend to have lower work engagement.
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ORIGINAL ARTICLE07-01-2020
Patient safety culture: perception of nursing professionals in high complexity institutions
Revista Brasileira de Enfermagem. 2020;73(5):e20190174
Abstract
ORIGINAL ARTICLEPatient safety culture: perception of nursing professionals in high complexity institutions
Revista Brasileira de Enfermagem. 2020;73(5):e20190174
DOI 10.1590/0034-7167-2019-0174
Views1See moreABSTRACT
Objectives:
to analyze the perception of nursing professionals about patient safety culture in three highly complex hospital institutions.
Methods:
descriptive and quantitative study with professionals working in care. The Hospital Survey on Patient Safety Culture questionnaire was applied, classifying its dimensions according to the percentage of positive responses (strengthened: ≥75.0%; potential for improvement: <75.0% to> 50.0%; weakened: ≤50.0%).
Results:
four hundred sixty-seven professionals (79.6%), mostly women (88.4%), nursing technicians/assistants (57.2%), 20 to 39 years (60.8%), less than five years in the institution (57.8%) and exclusive bond (79.2%) participated in the study. Safety culture was considered fragile, seven dimensions assessed as such, highlighting “Openness to communication” and “Non-punitive responses to errors” with <30.0% positive responses.
Conclusions:
evidence of the need for discussion of the subject and strategies for change that promote quality and safety of care.
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ORIGINAL ARTICLE06-27-2019
Debriefing evaluation in nursing clinical simulation: a cross-sectional study
Revista Brasileira de Enfermagem. 2019;72(3):788-794
Abstract
ORIGINAL ARTICLEDebriefing evaluation in nursing clinical simulation: a cross-sectional study
Revista Brasileira de Enfermagem. 2019;72(3):788-794
DOI 10.1590/0034-7167-2018-0103
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Objective:
Evaluate the contribution of debriefing after clinical simulations for nursing students.
Method:
Quantitative study, conducted with 35 nursing students who participated in five clinical simulation scenarios with planned debriefings based on the model of the National League Nursing/Jeffries Simulation Theory. After the fifth scenario, students answered the Debriefing Evaluation Scale associated with the Simulation.
Results:
The items evaluated involved the psychosocial, cognitive, and affective values, and within a scale from one to five, the highest mean was found in cognitive value with 4.23 (±0.56) points, then in psychosocial value with 3.77 (±0.53), and finally in affective value with 3.71 (±0.63) points.
Conclusion:
The debriefing conducted after the clinical simulation scenarios was a reflective exercise that contributed to the student integrating multiple knowledges in affective, cognitive and psychosocial values, and thus develop the competencies required.
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REVIEW11-06-2020
Transitional care to caregivers of dependent older people: an integrative literature review
Revista Brasileira de Enfermagem. 2020;73:e20200394
Abstract
REVIEWTransitional care to caregivers of dependent older people: an integrative literature review
Revista Brasileira de Enfermagem. 2020;73:e20200394
DOI 10.1590/0034-7167-2020-0394
Views1See moreABSTRACT
Objective:
To identify the needs of caregivers of dependent older people related to self-care in the transition from hospital to home.
Methods:
Integrative literature review that followed a predefined protocol, carried out from March to May 2019 in the platforms EBSCO, B-On, Scopus, Web of Science, and Joanna Briggs Institute. Descriptors and eligibility criteria were defined for the bibliographic sample, which was ten articles. The search was limited to articles published between 2015 and 2019 to guarantee evidence topicality.
Results:
The needs of caregivers related to transitional care can be grouped into five categories: needs in the transition into the role of caregiver; needs related to self-care of caregivers themselves; health needs; economic needs; and social and collective needs.
Final considerations:
The work developed by nurses regarding transitional care of caregivers must have two focuses: managing care provided to dependent older people and managing the needs of caregivers and the care offered to them.
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REVIEW10-19-2020
Validation methods of nursing protocols: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20200050
Abstract
REVIEWValidation methods of nursing protocols: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20200050
DOI 10.1590/0034-7167-2020-0050
Views0See moreABSTRACT
Objective:
to identify scientific production about validation methods of nursing care protocols.
Method:
an integrative review with search at Scielo, Pubmed/MEDLINE, Virtual Health Library, Web of Science, Scopus, and EBSCOhost. The descriptors “validation studies”, “validation studies as topic”, “protocols”, “clinical protocols”, “practice guidelines as topic”, “nursing” and “nursing assessment” and the uncontrolled descriptor “validation” were used.
Results:
thirty-two articles were selected, most of them Brazilian. Content validation by experts was the most frequent method, with no consensus on the number of participants for the process. The collection instruments were mostly created by the authors. Data analysis was performed using descriptive statistics and Content Validity Index, with a variable consensus rate in the analyzed articles.
Conclusion:
protocols validated by experts are robust tools for use in clinical practice, with methodological rigor in development essential for its quality.
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EXPERIENCE REPORT04-09-2020
Implementation of an Artificial Intelligence Algorithm for sepsis detection
Revista Brasileira de Enfermagem. 2020;73(3):e20180421
Abstract
EXPERIENCE REPORTImplementation of an Artificial Intelligence Algorithm for sepsis detection
Revista Brasileira de Enfermagem. 2020;73(3):e20180421
DOI 10.1590/0034-7167-2018-0421
Views0See moreABSTRACT
Objectives:
to present the nurses’ experience with technological tools to support the early identification of sepsis.
Methods:
experience report before and after the implementation of artificial intelligence algorithms in the clinical practice of a philanthropic hospital, in the first half of 2018.
Results:
describe the motivation for the creation and use of the algorithm; the role of the nurse in the development and implementation of this technology and its effects on the nursing work process.
Final Considerations:
technological innovations need to contribute to the improvement of professional practices in health. Thus, nurses must recognize their role in all stages of this process, in order to guarantee safe, effective and patient-centered care. In the case presented, the participation of the nurses in the technology incorporation process enables a rapid decision-making in the early identification of sepsis.
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