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ORIGINAL ARTICLE12-08-2023
Sociodemographic factors associated with suicidal behavior at a federal public university in the Western Brazilian Amazon
Revista Brasileira de Enfermagem. 2023;76:e20230102
Abstract
ORIGINAL ARTICLESociodemographic factors associated with suicidal behavior at a federal public university in the Western Brazilian Amazon
Revista Brasileira de Enfermagem. 2023;76:e20230102
DOI 10.1590/0034-7167-2023-0102
Views0See moreABSTRACT
Objective:
to determine risk factors for suicidal behavior among students and employees of a federal public university in the Brazilian Western Amazon.
Methods:
an analytical cross-sectional study of survey and association between variables with a sample of 475 participants. Statistical analyzes were performed using the Mann-Whitney test, Pearson’s chi-square test, likelihood ratio test or Fisher’s exact test and a logistic regression model. A significance level of 5% was used (p-value< 0.05).
Results:
a higher proportion of suicidal behavior was found in younger participants, females, who had no religion or had one, but were non-practicing, who did not have children and/or had a monthly family income of less than two minimum wages. Lower proportions of suicidal behavior were identified in heterosexuals and/or married or in a stable relationship.
Conclusion:
the study suggests a relationship between sociodemographic factors and suicidal behavior in the studied academic community.
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ORIGINAL ARTICLE12-08-2023
Social support networks and life cycle stage of Venezuelan immigrant families
Revista Brasileira de Enfermagem. 2023;76:e20220790
Abstract
ORIGINAL ARTICLESocial support networks and life cycle stage of Venezuelan immigrant families
Revista Brasileira de Enfermagem. 2023;76:e20220790
DOI 10.1590/0034-7167-2022-0790
Views0See moreABSTRACT
Objective:
To understand the structures of social networks of interiorized Venezuelan immigrant families and the life cycle stage they are in.
Methods:
Qualitative multiple-case study with families from the Interiorization Program residing in the Greater Florianópolis, Brazil. Screening occurred through social networks and key informants. For data collection, the photovoice technique and semi-structured interviews were used, categorized with the help of the Atlas.ti software. Genograms and ecomaps were elaborated.
Results:
Of the 4 families interviewed, totaling 7 members with young children, the nuclear family was identified as the main informal support network. Formal networks included schools, churches, and civil society.
Conclusion:
Families rely heavily on their nuclear structure for support, with formal institutions acting as secondary resources. The predominant life cycle stage is focused on families with young children. More efforts are needed to strengthen formal support networks.
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ORIGINAL ARTICLE12-08-2023
Polypharmacy, potentially inappropriate medications and associated factors among older adults with hypertension in primary care
Revista Brasileira de Enfermagem. 2023;76:e20220785
Abstract
ORIGINAL ARTICLEPolypharmacy, potentially inappropriate medications and associated factors among older adults with hypertension in primary care
Revista Brasileira de Enfermagem. 2023;76:e20220785
DOI 10.1590/0034-7167-2022-0785
Views0See moreABSTRACT
Objective:
to identify the prevalence and associations of polypharmacy and potentially inappropriate medication use among older adults with hypertension treated in primary care.
Methods:
a cross-sectional study carried out with older adults with hypertension treated at a Family Health Strategy unit. Data collection included analysis of medical records, interviews and multidimensional assessment of older adults. Socio-demographic information and clinical variables were collected. Statistical analysis was performed by multiple logistic regression.
Results:
polypharmacy prevalence was 38.09%, and potentially inappropriate medication (PIM), 28.57%. There was a significant association between polypharmacy and PIM use, altered sleep and ethnicity. PIM use was associated with polypharmacy, worse family functioning, and absence of a caregiver. Cognitive decline reduces the prevalence of these medications.
Conclusions:
polypharmacy and PIM use among older adults with hypertension represent a problem in this population, especially among the most vulnerable.
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ORIGINAL ARTICLE12-08-2023
Care for older adults with disabilities in Long Term Care Facility
Revista Brasileira de Enfermagem. 2023;76:e20220767
Abstract
ORIGINAL ARTICLECare for older adults with disabilities in Long Term Care Facility
Revista Brasileira de Enfermagem. 2023;76:e20220767
DOI 10.1590/0034-7167-2022-0767
Views0See moreABSTRACT
Objective:
to analyze the constitution of care offered to older adults with disabilities, from Long Term Care Facility professionals’ perspective.
Methods:
this is a discourse analysis based on the post-structuralist framework. Participants in this study are professionals involved in the care for older adults, totaling 14 respondents, 13 women and one man.
Results:
from professionals’ perspective, there is a fine line between caring for older adults with disabilities and maintaining their autonomy. Care in which autonomy is restricted predisposes older adults to a process of dependency.
Final considerations:
caring for older adults with disabilities constitutes the challenge between caring and maintaining independence. Thus, older adult-centered care should be taken as a premise so that their individualities are respected.
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ORIGINAL ARTICLE12-08-2023
Fear of COVID-19 when experiencing pregnancy or childbirth in the pandemic: what are the associated factors?
Revista Brasileira de Enfermagem. 2023;76:e20220755
Abstract
ORIGINAL ARTICLEFear of COVID-19 when experiencing pregnancy or childbirth in the pandemic: what are the associated factors?
Revista Brasileira de Enfermagem. 2023;76:e20220755
DOI 10.1590/0034-7167-2022-0755
Views0See moreABSTRACT
Objective:
to identify factors associated with fear of COVID-19 among women who experienced pregnancy or childbirth during the pandemic.
Methods:
a cross-sectional study, nested within a prospective cohort, using an online survey, from August 2021 to February 2022, based on descriptive data analysis.
Results:
of the 431 participants, 52.8% were postpartum women and 20.1% were pregnant women. With regard to fear of COVID-19, a mean score of 20.46 was obtained (moderate fear). The highest fear scores were present in women whose newborns were admitted to hospital in neonatal critical units (p=0.032), and the lowest among those covered by supplementary health (insurance) (p=0.016).
Conclusion:
among pregnant and postpartum women, high fear of COVID-19 translated into the possibility of having newborns admitted to hospital in a critical unit. The importance of supporting actions to support pregnant/postpartum women’s mental health in relation to COVID-19 or other threats that may influence the neonatal outcome stands out.
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12-08-2023
A relação entre o nível de conhecimento e o comportamento de prevenção do corrimento vaginal para estudantes de enfermagem
Revista Brasileira de Enfermagem. 2023;76:e20220602
Abstract
A relação entre o nível de conhecimento e o comportamento de prevenção do corrimento vaginal para estudantes de enfermagem
Revista Brasileira de Enfermagem. 2023;76:e20220602
DOI 10.1590/0034-7167-2022-0602
Views0See moreRESUMEN
Objetivo:
la salud reproductiva de las adolescentes es muy importante. Determinar la relación entre el nivel de conocimientos y la conducta de prevención del flujo vaginal en estudiantes de enfermería.
Métodos:
estudio cuantitativo, transversal, con 155 estudiantes de primer año de una facultad privada de enfermería. Los datos se recopilaron de febrero a marzo de 2022 a través de un cuestionario electrónico.
Resultados:
los participantes con buen nivel de conocimientos correspondieron al 98,1% y los que practican buenas conductas para prevenir el flujo vaginal, el 92,3%.
Conclusión:
un buen conocimiento produce conductas de prevención adecuadas. El resultado de este estudio puede contribuir con reflexiones y referencias para un estudio más profundo de los factores que influyen en el nivel de conocimiento y comportamiento sobre la enfermedad de los genitales y los peligros del flujo vaginal patológico.
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ORIGINAL ARTICLE12-08-2023
The relationship between level of knowledge and vaginal discharge prevention behavior for nursing student
Revista Brasileira de Enfermagem. 2023;76:e20220602
Abstract
ORIGINAL ARTICLEThe relationship between level of knowledge and vaginal discharge prevention behavior for nursing student
Revista Brasileira de Enfermagem. 2023;76:e20220602
DOI 10.1590/0034-7167-2022-0602
Views0See moreABSTRACT
Objective:
Reproductive health in adolescent girls is very important. To determine the relationship between the level of knowledge and the behavior of preventing vaginal discharge among nursing students.
Methods:
a quantitative, cross-sectional study, with 155 first-year female students at a private faculty of nursing. Data were collected from February to March 2022, using an electronic questionnaire.
Results:
98.1% of participants have a good level of knowledge and 92.3% of participants practice good vaginal discharge prevention behavior.
Conclusion:
good knowledge produces appropriate prevention behavior. The result of this study can be used as a contribution of thoughts and references as a more in-depth study of the factors that influence the level of knowledge and behavior about the disease of the genitalia and the dangers of pathological vaginal discharge.
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12-08-2023
Nursing experiences in specialized services in child and adolescent mental health: a systematic review of qualitative studies
Revista Brasileira de Enfermagem. 2023;76:e20220550
Abstract
Nursing experiences in specialized services in child and adolescent mental health: a systematic review of qualitative studies
Revista Brasileira de Enfermagem. 2023;76:e20220550
DOI 10.1590/0034-7167-2022-0550
Views0See moreABSTRACT
Objective:
to synthesize evidence from qualitative studies on nursing experiences regarding child and adolescent mental health care in specialized services.
Method:
a systematic review with meta-synthesis of qualitative studies according to JBI guidelines. CINAHL, EMBASE, MEDLINE, LILACS, PSYCinfo, Scopus and Web of Science databases were used. The findings were classified according to the level of reliability and credibility and categorized by similarity between contents.
Results:
229 articles were identified, and five were included in the final sample and organized into the categories: Emotional impact; and Understanding nursing role. The level of evidence found was moderate.
Final considerations:
nursing experiences are permeated by emotional exhaustion, feelings of frustration and difficulty in understanding their professional role. The need for training spaces that qualify this care is highlighted.
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ORIGINAL ARTICLE12-13-2024
Nurses’ experience regarding patient safety in mobile pre-hospital care
Revista Brasileira de Enfermagem. 2024;77(5):e20230529
Abstract
ORIGINAL ARTICLENurses’ experience regarding patient safety in mobile pre-hospital care
Revista Brasileira de Enfermagem. 2024;77(5):e20230529
DOI 10.1590/0034-7167-2023-0529
Views0See moreABSTRACT
Objectives:
to understand nurses’ experience regarding patient safety in mobile pre-hospital care.
Method:
a qualitative, exploratory and descriptive study, conducted with nurses active in mobile pre-hospital care services. Semi-structured interviews were conducted, audio-graved and submitted to Bardin’s content analysis.
Results:
from four thematic categories established, nurses reported the care and management skills necessary to work in this service. They demonstrated a commitment to ensuring safe care for patients, staff and spectators. They highlighted the actions taken to prevent and mitigate incidents. However, they based their experiences on practice protocols and individual actions, expressing the need to improve knowledge about patient safety.
Final Considerations:
mobile pre-hospital care nurses’ experience in relation to patient safety was limited, suggesting the need for training on the subject, alignment of work processes and implementation of strategies, aiming to guarantee safe care.
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ORIGINAL ARTICLE12-13-2024
Repercussions of the pandemic on tuberculosis control actions from the perspective of health professionals
Revista Brasileira de Enfermagem. 2024;77(5):e20230477
Abstract
ORIGINAL ARTICLERepercussions of the pandemic on tuberculosis control actions from the perspective of health professionals
Revista Brasileira de Enfermagem. 2024;77(5):e20230477
DOI 10.1590/0034-7167-2023-0477
Views0See moreABSTRACT
Objectives:
to analyze the repercussions of the COVID-19 pandemic on tuberculosis control actions from the perspective of primary health care professionals.
Methods:
this descriptive study with a qualitative approach was conducted from November 2022 to April 2023, using semi-structured interviews with 11 key informant professionals from primary health care units in a Brazilian capital. Data were organized using Atlas.ti 22.0 software and subjected to thematic-categorical content analysis.
Results:
the pandemic scenario caused alterations in the work process, necessitating abrupt adaptations, and led to detrimental impacts on the health of professionals and tuberculosis control actions, which were reduced or discontinued.
Final Considerations:
there was evident unpreparedness and a lack of resources from various governmental levels and health services to handle the public health emergency situation without severe harm to the provision of essential services.
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12-13-2024
Training of Brazilian indigenous nurses: between human rights, valuing diversity and inclusion
Revista Brasileira de Enfermagem. 2024;77(5):e20230430
Abstract
Training of Brazilian indigenous nurses: between human rights, valuing diversity and inclusion
Revista Brasileira de Enfermagem. 2024;77(5):e20230430
DOI 10.1590/0034-7167-2023-0430
Views0See moreABSTRACT
Objectives:
to analyze the possibilities and potential of training indigenous nurses, given the Brazilian Health System (SUS), understanding the relationships between education and health.
Methods:
theoretical-reflective study, based on scientific literature, aligned with the experience, critical thinking of its authors and the Sustainable Development Goals in Brazil.
Results:
this text articulates three axes: Potential for including indigenous students in nursing training; Paths to achieving equity through inclusion and retention policies for indigenous students at different levels; and Implications of this for the SUS and global health.
Final Considerations:
indigenous students, beneficiaries of affirmative actions, face challenges of inclusion and retention in public universities that directly impact their academic training. Added to this are the difficulties identified in basic education, professor training and implementation of permanence policies, with consequences for services and training at other levels.
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ORIGINAL ARTICLE12-13-2024
Interobserver agreement in Reception and Risk Stratification in Obstetrics implementation
Revista Brasileira de Enfermagem. 2024;77(5):e20230361
Abstract
ORIGINAL ARTICLEInterobserver agreement in Reception and Risk Stratification in Obstetrics implementation
Revista Brasileira de Enfermagem. 2024;77(5):e20230361
DOI 10.1590/0034-7167-2023-0361
Views0See moreABSTRACT
Objectives:
to analyze interobserver agreement in the Reception and Risk Stratification in Obstetrics protocol implementation.
Methods:
a cross-sectional study carried out during Reception and Risk Stratification in Obstetrics implementation, conducted in a tertiary hospital in southern Brazil with 891 participants in January 2020. Descriptive and interobserver agreement analysis was carried out using the Kappa coefficient in the risk stratification assigned by the triage nurse and reviewed by the researcher.
Results:
around half of the calls (55.6%) were stratified as not very urgent (green), followed by urgent (yellow) (31.8%), very urgent (orange) (9.3%), not urgent (blue) (3.4%) and no emerging stratification (red). Agreement analysis of revised stratification found Kappa values of 0.20 (blue), 0.54 (green), 0.77 (yellow) and 0.80 (orange).
Conclusions:
most appointments were non-urgent. The agreement analysis between the revised and assigned risk stratification revealed greater interobserver agreement as the priority level increased.
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ORIGINAL ARTICLE12-13-2024
Adaptation and implementation of a Nursing care protocol for children in the Amazon Region
Revista Brasileira de Enfermagem. 2024;77(5):e20230245
Abstract
ORIGINAL ARTICLEAdaptation and implementation of a Nursing care protocol for children in the Amazon Region
Revista Brasileira de Enfermagem. 2024;77(5):e20230245
DOI 10.1590/0034-7167-2023-0245
Views0See moreABSTRACT
Objectives:
to describe the process of implementing an adapted protocol for pediatric nursing care in a health unit located in a municipality in the Amazon Region.
Methods:
methodological research conducted in a basic health unit with four family health teams in the state of Rondônia, involving seven nursing professionals. Data collection occurred between October 2020 and April 2022, following the research phases: situational diagnosis, exploratory phase, protocol definition, implementation, and evaluation.
Results:
the outcome was the adaptation and implementation of a nursing care protocol for children.
Final Considerations:
the adaptation and implementation process can be an effective approach to improving care, strengthening nursing as a profession with a solid foundation in scientific and clinical evidence. This facilitates early problem identification and appropriate guidance, leading to better health outcomes for children.
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ORIGINAL ARTICLE12-13-2024
Nurses’ experiences in caring for people with mental health problems hospitalized due to clinical comorbidities
Revista Brasileira de Enfermagem. 2024;77(5):e20230136
Abstract
ORIGINAL ARTICLENurses’ experiences in caring for people with mental health problems hospitalized due to clinical comorbidities
Revista Brasileira de Enfermagem. 2024;77(5):e20230136
DOI 10.1590/0034-7167-2023-0136
Views0See moreABSTRACT
Objectives:
to understand nurses’ experiences in caring for people with mental health problems hospitalized due to clinical comorbidities in non-psychiatric Inpatient Units.
Methods:
qualitative study, guided by Alfred Schutz’s social phenomenology. Sixteen phenomenological interviews were conducted. The content was analyzed and discussed based on the literature, through the composition of three categories of analysis.
Results:
three categories emerged in the study: Challenges in care faced by nurses; Fragmented care action; and Ideal care. The disarticulation of the clinic was revealed, as described by nurses, showing care as an action far removed from the comprehensiveness of a person. Nurses’ performance is guided predominantly by biomedical reference, disregarding appreciation of subjectivity.
Final Considerations:
it was observed that nurses attribute the responsibility for patient care to factors external to their life-world, when, in fact, these aspects should be components that help them in comprehensive care construction.
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REVIEW11-29-2024
Assessment of knowledge in oncology about care for transgender people: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20230532
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
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.
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ORIGINAL ARTICLE11-29-2024
Sleep quality of vulnerable elderly people: associated factors
Revista Brasileira de Enfermagem. 2024;77:e20230283
Abstract
ORIGINAL ARTICLESleep quality of vulnerable elderly people: associated factors
Revista Brasileira de Enfermagem. 2024;77:e20230283
DOI 10.1590/0034-7167-2023-0283
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.
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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
Views0See moreABSTRACT
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.
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07-31-2023
Breastfeeding prevalence in newborns of mothers with COVID-19: a systematic review
Revista Brasileira de Enfermagem. 2023;76:e20220173
Abstract
Breastfeeding prevalence in newborns of mothers with COVID-19: a systematic review
Revista Brasileira de Enfermagem. 2023;76:e20220173
DOI 10.1590/0034-7167-2022-0173
Views0See moreABSTRACT
Objectives:
to compare exclusive breastfeeding prevalence versus artificial feeding in newborns of mothers with COVID-19.
Methods:
a systematic review of prevalence, according to JBI. Searches in PubMed®, Embase, CINAHL, LILACS and Web of Science™ databases in August 2021. Cross-sectional, longitudinal or cohort studies were selected, without language and time limitations that showed breastfeeding prevalence or that allowed calculation.
Results:
fifteen articles published in 2020 and 2021, cohort (60%) or cross-sectional (40%) were analyzed. The average of exclusive breastfeeding in mothers with COVID-19 was 56.76% (CI=39.90–72.88), and artificial breastfeeding, 43.23% (CI = 30.99 – 55.88), without statistically significant differences.
Conclusions:
despite the recommendations for maintaining breastfeeding, there was a reduction worldwide, when compared to periods prior to the pandemic. With advances in science, these rates have improved, showing the impact of evidence on practices. As limitations, study sources are cited. It is recommended to carry out new studies. PROSPERO registration CRD42021234486.
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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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07-10-2023
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
Metodologia 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
Views0See moreRESUMEN
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.
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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 -
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
Views0See moreABSTRACT
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.
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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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