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PESQUISA01/01/2017
Health education with older adults: action research with primary care professionals
Revista Brasileira de Enfermagem. 2017;70(4):792-799
Resumen
PESQUISAHealth education with older adults: action research with primary care professionals
Revista Brasileira de Enfermagem. 2017;70(4):792-799
DOI 10.1590/0034-7167-2016-0349
Visualizações0Ver maisABSTRACT
Objective:
To assess the development and implementation of permanent education action.
Method:
Quantitative-qualitative research based on action research in three phases (diagnosis of reality, implementation of activity and evaluation), performed with health professionals and managers of basic health units. The evaluation was on the perception of changes immediately following the activity and after 120 days.
Results:
In the first phase, 110 professionals took part, 36.4% of whom indicated the existence of groups for older adults at work. In the second phase, 98 professionals participated, pointing out interferences of the group in the life of older adults, items of importance and facilitation in forming groups and developing reality-based activities. The third phase showed, in the quantitative analysis, positive impact of the training, and in the qualitative analysis, reassessment of groups, greater knowledge and confidence in managing groups and increased respect for older adults.
Final considerations:
Permanent education opens pathways for the construction of differentiated care for older adults based on respect and health promotion.
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PESQUISA01/01/2017
Older adults abuse in three Brazilian cities
Revista Brasileira de Enfermagem. 2017;70(4):783-791
Resumen
PESQUISAOlder adults abuse in three Brazilian cities
Revista Brasileira de Enfermagem. 2017;70(4):783-791
DOI 10.1590/0034-7167-2017-0114
Visualizações0Ver maisABSTRACT
Objective:
To analyze the police reports filed by older adults who suffered abuse in order to identify the socio-demographic characteristics of victims and aggressors, type of violence, location, as well as to compare rates in three Brazilian cities in the period from 2009 to 2013.
Method:
Ecological study, in which 2,612 police reports registered in Police Stations were analyzed. An instrument was used to obtain data from the victim, the aggressor and the type of violence.
Results:
Psychological abuse predominated and most cases occurred in the older adults own home. In the cities of Ribeirão Preto and João Pessoa, the older adults presented similar rates for both gender. Regarding the standardized rates, in João Pessoa, there was a rise of this type of abuse in the two first years, and later there was a certain stability. In the city of Teresina, there was an increase, also observed in the city of Ribeirão Preto in the three first years, followed by a decrease.
Conclusion:
Older adults abuse is a cultural phenomenon difficult to be reported by them, since it occurs in the family context.
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PESQUISA01/01/2017
Validation of educational booklet for HIV/Aids prevention in older adults
Revista Brasileira de Enfermagem. 2017;70(4):775-782
Resumen
PESQUISAValidation of educational booklet for HIV/Aids prevention in older adults
Revista Brasileira de Enfermagem. 2017;70(4):775-782
DOI 10.1590/0034-7167-2017-0145
Visualizações0Ver maisABSTRACT
Objective:
To describe the process of manufacturing and validation of an educational booklet for HIV/Aids prevention in older adults
Methods:
Methodological study developed in two phases – manufacturing of the booklet and validation of the educational material by judges. The manufacturing process involved a situational diagnosis with older adults, and its result indicated gaps in the knowledge with respect to HIV/Aids. The validation process was performed by nine judges, selected by convenience. It was considered an agreement index of at least 0.80, analyzed through the content validity index.
Results:
We opted for a dialogue between two older adults divided into three categories: myths and taboos; ignorance; and prevention and importance of diagnosis. The average of the items was 0.90. The suggestions made by the judges were observed and modified for the final version.
Conclusion:
The material had relevant content for the judges, in addition to being able to be used by health professionals in the education and clarification of issues on the subject.
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PESQUISA01/01/2017
Association between filial responsibility when caring for parents and the caregivers overload
Revista Brasileira de Enfermagem. 2017;70(4):767-774
Resumen
PESQUISAAssociation between filial responsibility when caring for parents and the caregivers overload
Revista Brasileira de Enfermagem. 2017;70(4):767-774
DOI 10.1590/0034-7167-2017-0133
Visualizações0Ver maisABSTRACT
Objective:
To analyze the association between filial responsibility and the overload of the children when caring for their older parents.
Method:
Cross-sectional study with 100 caregiver children of older adults. Filial liability was assessed by the attitudes of the responsible child (scale of expectation and filial duty) and by care behaviors (assistance in activities of daily living, emotional and financial support, and keeping company). The overload was assessed by the Caregiver Burden Inventory. To assess the associations, the correlation coefficients of Pearson and Spearman, Kruskal-Wallis Test, and Mann-Whitney were employed. Variables that presented p-value<0.20 in the bivariate analysis were inserted in a multivariate linear regression model.
Results:
The factors associated with overload were: formal employment (p=0.002), feelings regarding family life (p<0.001), financial support (p=0.027), and assistance with Activities of Daily Living (ADLs) (p<0.001).
Conclusion:
Children who were more involved with the ADLs and provided financial support showed higher levels of overload.
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PESQUISA01/01/2017
Religiosity and spirituality as resilience strategies among long-living older adults in their daily lives
Revista Brasileira de Enfermagem. 2017;70(4):761-766
Resumen
PESQUISAReligiosity and spirituality as resilience strategies among long-living older adults in their daily lives
Revista Brasileira de Enfermagem. 2017;70(4):761-766
DOI 10.1590/0034-7167-2016-0630
Visualizações0Ver maisABSTRACT
Objective:
to investigate religiosity and spirituality as a resilience strategy for the long-living older adults in their daily lives.
Method:
Qualitative research of phenomenological approach based on Martin Heidegger thoughts. Interviews were conducted with 14 older adults registered at a family health unit in the city of Jequié, BA, Brazil. The data were analyzed in the light of Being and Time.
Results:
The results revealed that God occupies a central position in their lives, and the reading of the bible, praying the rosary and prayers are resilience strategies used for coping with unfavorable situations, recovery and/or maintenance of health, personal and family protection, and, above all, the experience of a satisfactory aging.
Final considerations:
Religiosity and spirituality were presented as an important resilience strategy in the existence of older adults, showing that through them it is possible to achieve well-being and cope with health and social problems.
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PESQUISA01/01/2017
Family of older adults with mental disorder: perception of mental health professionals
Revista Brasileira de Enfermagem. 2017;70(4):753-760
Resumen
PESQUISAFamily of older adults with mental disorder: perception of mental health professionals
Revista Brasileira de Enfermagem. 2017;70(4):753-760
DOI 10.1590/0034-7167-2016-0646
Visualizações0Ver maisABSTRACT
Objective:
to understand the perceptions of healthcare professionals of the Psychosocial Care Centers regarding the family of older adults with mental disorders.
Method:
study of a Qualitative Case conducted with 12 healthcare professionals from a Psychosocial Care Center, with a convenient and exhaustive sample. Conducting semi-structured interviews to collect data, which were analyzed with the Content Analysis technique.
Results:
the following categories stood out: «Family exhaustion and deterioration in the perception of the healthcare professional» and «The abandonment of older adults by family members and their distancing in the perception of the healthcare professional.»
Final considerations:
culpability of older adults and penalization of the family were verified by healthcare professionals. To bring awareness about the difficulties faced in the attempt to bring the family closer to the healthcare service, it is necessary to analyze the care given to the older adult and to overcome challenges in the effective construction of the bond between family, healthcare user and mental health service.
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PESQUISA01/01/2017
Frailty in the elderly: prevalence and associated factors
Revista Brasileira de Enfermagem. 2017;70(4):747-752
Resumen
PESQUISAFrailty in the elderly: prevalence and associated factors
Revista Brasileira de Enfermagem. 2017;70(4):747-752
DOI 10.1590/0034-7167-2016-0633
Visualizações0Ver maisABSTRACT
Objective:
to know the prevalence and factors associated with frailty in elderly assisted by the Centro Mais Vida de Referência em Assistência à Saúde do Idoso (Mais Vida Health Reference Center for the Elderly) in the North of Minas Gerais, Brazil.
Method:
cross-sectional study, with sampling by convenience. Data collection occurred in 2015. Demographic and socioeconomic variables, morbidities, use of health services and the score of the Edmonton Frail Scale were analyzed. The adjusted prevalence ratios were obtained by multiple analysis of Poisson regression with robust variance.
Results:
360 elderly aged 65 or older were evaluated. Frailty prevalence was 47.2%. The variables associated with frailty were the following: advanced age elderly, who live without a partner, have a caregiver, present depressive symptoms, osteoarticular disease, as well as history of hospitalization and falls in the last twelve months.
Conclusion:
knowledge of factors associated with frailty allows development of health actions aimed at the elderly.
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PESQUISA01/01/2017
Falls in long-term care institutions for elderly people: protocol validation
Revista Brasileira de Enfermagem. 2017;70(4):740-746
Resumen
PESQUISAFalls in long-term care institutions for elderly people: protocol validation
Revista Brasileira de Enfermagem. 2017;70(4):740-746
DOI 10.1590/0034-7167-2017-0109
Visualizações1Ver maisABSTRACT
Objectives:
To validate the content of a fall management risk protocol in long-term institutions for elderly people.
Methods:
Methodological, quanti-qualitative study using the Delphi technique. The tool, based on the literature, was sent electronically to obtain consensus among the 14 experts that meet the defined inclusion criteria.
Results:
The 27 indicators of the protocol are organized in three dimensions: prepare for the institutionalization (IRA=.88); manage the risk of falls throughout the institutionalization (IRA=.9); and lead the communication and formation (IRA=1), with a CVI=.91. Two rounds were performed to get a consensus superior to 80% in every item.
Conclusion:
The values obtained in the reliability test (>0.8) show that the protocol can be used to meet the intended goal. The next step is the clinic validation of the protocol with residents of long-term care institutions for elderly people.
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14/04/2021
Child behavior during the social distancing in the COVID-19 pandemic
- Eny Dórea Paiva
, - Luciana Rodrigues da Silva ,
- Maria Estela Diniz Machado ,
- Rosane Cordeiro Burla de Aguiar ,
- Karina Rangel da Silva Garcia , [ … ],
- Paloma Gonçalves Martins Acioly
Resumen
Child behavior during the social distancing in the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2021;74:e20200762
DOI 10.1590/0034-7167-2020-0762
- Eny Dórea Paiva ,
- Luciana Rodrigues da Silva ,
- Maria Estela Diniz Machado ,
- Rosane Cordeiro Burla de Aguiar ,
- Karina Rangel da Silva Garcia ,
- Paloma Gonçalves Martins Acioly
Visualizações0Ver maisABSTRACT
Objective:
To describe the daily activities performed by children from 6 to 12 years of age incomplete and analyze children’s behavior during social distancing in the face of the COVID-19 pandemic.
Methods:
Cross-sectional study with children in a learning stage living in Brazil. The data were collected via online form. Fisher’s exact test was applied to analyze the association of categorical variables with child behavior; when significant, it was used the odds ratio. It was considered results considered statistically significant those presenting values of p < 0.05.
Results:
Data from 530 children were analyzed: 50.3% female, 71.3% from the Southeast Region, 73% in fulltime social distancing, 52% presented anxiety, which was significantly associated with changes in sleep and appetite.
Conclusion:
The results indicate the need for parents/caretakers to stimulate moments for the child to express themselves, not minimizing their feelings and providing emotional support to mitigate the negative impact of these feelings on the child’s mental and physical health.
- Eny Dórea Paiva
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05/12/2019
Hospital care and urinary incontinence in the elderly
- Roberta Pereira Góes ,
- Larissa Chaves Pedreira ,
- Rose Ana Rios David ,
- Cláudia Fernanda Trindade Silva ,
- Cláudia Almeida Ribeiro Torres , [ … ],
- Juliana Bezerra do Amaral
Resumen
Hospital care and urinary incontinence in the elderly
Revista Brasileira de Enfermagem. 2019;72:284-293
DOI 10.1590/0034-7167-2018-0273
- Roberta Pereira Góes ,
- Larissa Chaves Pedreira ,
- Rose Ana Rios David ,
- Cláudia Fernanda Trindade Silva ,
- Cláudia Almeida Ribeiro Torres ,
- Juliana Bezerra do Amaral
Visualizações0Ver maisABSTRACT
Objective:
to identify factors inherent in hospital care that favor urinary incontinence in the elderly.
Method:
an integrative review with Scopus, CINAHL and Pubmed searches. Includes original articles, no language restriction, published between 2008 and 2018. Rated level of recommendation and level of evidence were assessed using the Oxford Center for Evidence-Based Medicine classification. Exploited content through thematic analysis in light of the Donabedian model.
Results:
13 articles constituted the sample. There were factors such as the unjustified and indiscriminate use of devices such as the geriatric diaper; hospital structure adversely affecting the needs of the elderly; and deficit in screening, risk identification and underreporting of the problem favor urinary incontinence in the hospitalized elderly.
Conclusion:
modifiable factors related to hospital structures and care processes favor both the onset and worsening of urinary incontinence in the elderly.
- Roberta Pereira Góes
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ARTÍCULO ORIGINAL21/10/2019
Hipermídia educativa sobre assistência de enfermagem ao parto: construção e validação de conteúdo e aparência
- Lara Leite de Oliveira ,
- Igor Cordeiro Mendes ,
- Marianne Maia Dutra Balsells ,
- Elizian Braga Rodrigues Bernardo ,
- Régia Christina Moura Barbosa Castro , [ … ],
- Ana Kelve de Castro Damasceno
Resumen
ARTÍCULO ORIGINALHipermídia educativa sobre assistência de enfermagem ao parto: construção e validação de conteúdo e aparência
Revista Brasileira de Enfermagem. 2019;72(6):1471-1478
DOI 10.1590/0034-7167/2018-0163
- Lara Leite de Oliveira ,
- Igor Cordeiro Mendes ,
- Marianne Maia Dutra Balsells ,
- Elizian Braga Rodrigues Bernardo ,
- Régia Christina Moura Barbosa Castro ,
- Priscila de Sousa Aquino ,
- Ana Kelve de Castro Damasceno
Visualizações1Ver maisRESUMO
Objetivo:
construir uma hipermídia educativa sobre a assistência de enfermagem ao parto de risco habitual e realizar a validação de conteúdo e de aparência.
Método:
pesquisa metodológica, realizada seguindo as seguintes etapas: levantamento do conteúdo e planejamento dos módulos; produção das mídias e organização das unidades tutoriais; organização do espaço do aluno, tutor e de comunicação entre eles; elaboração da hipermídia; disponibilização da hipermídia; avaliação por especialistas em Enfermagem e Informática; e implementação das sugestões propostas.
Resultados:
a hipermídia educativa mostrou-se como um material validado, visto que apresentou um ótimo índice de validade de conteúdo global de 0,97 e significância estatística no teste binomial para o conteúdo e aparência.
Conclusão:
acredita-se que o uso deste material com alunos da graduação em Enfermagem contribuirá com a qualidade da assistência obstétrica, tendo em vista que se constitui em uma tecnologia ilustrada capaz de favorecer o ensino-aprendizagem sobre parto normal humanizado.
- Lara Leite de Oliveira
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ARTÍCULO ORIGINAL30/03/2020
Boas Práticas de segurança nos cuidados de enfermagem em Terapia Intensiva Neonatal
- Sabrina da Costa Machado Duarte ,
- Sílvia Schoenau de Azevedo ,
- Gabrielle da Costa de Muinck ,
- Tainara Ferreira da Costa ,
- Maria Manuela Vila Nova Cardoso , [ … ],
- Juliana Rezende Montenegro Medeiros de Moraes
Resumen
ARTÍCULO ORIGINALBoas Práticas de segurança nos cuidados de enfermagem em Terapia Intensiva Neonatal
Revista Brasileira de Enfermagem. 2020;73(2):e20180482
DOI 10.1590/0034-7167-2018-0482
- Sabrina da Costa Machado Duarte ,
- Sílvia Schoenau de Azevedo ,
- Gabrielle da Costa de Muinck ,
- Tainara Ferreira da Costa ,
- Maria Manuela Vila Nova Cardoso ,
- Juliana Rezende Montenegro Medeiros de Moraes
Visualizações0RESUMO
Objetivos:
identificar a percepção dos profissionais de enfermagem sobre o erro humano nos cuidados de enfermagem na Unidade de Terapia Intensiva Neonatal; analisar as estratégias de Boas Práticas propostas por esses profissionais para a segurança do paciente nos cuidados de enfermagem.
Métodos:
estudo quanti-qualitativo, descritivo. Cenário: Unidade de Terapia Intensiva Neonatal. Participantes: 22 profissionais de enfermagem. Coleta dos dados realizada por meio de entrevistas e submetidos a análise temática.
Resultados:
erro humano nos cuidados de enfermagem, identificando-se perdas de cateteres e erros no processo de medicação; causas para o erro nos cuidados de enfermagem, destacando-se a sobrecarga de trabalho; Boas Práticas para a segurança do paciente nos cuidados de enfermagem, como capacitação profissional e melhorias das condições de trabalho.
Conclusões:
demonstra-se a importância de investir em estratégias de Boas Práticas para a Segurança do Paciente, buscando-se sedimentar a cultura de segurança organizacional e estimular um ambiente propício ao gerenciamento do erro.
Palavras-chave: EnfermagemErros MédicosGestão de SegurançaSegurança do PacienteUnidades de Terapia Intensiva NeonatalVer mais - Sabrina da Costa Machado Duarte
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ARTÍCULO DE REVISIÓN29/09/2022
Nursing students’ learning from involvement in research projects: an integrative literature review
- David de Sousa Loura ,
- Rafael Alves Bernardes ,
- Cristina Lavareda Baixinho ,
- Helga Rafael Henriques ,
- Isa Brito Félix , [ … ],
- Mara Pereira Guerreiro
Resumen
ARTÍCULO DE REVISIÓNNursing students’ learning from involvement in research projects: an integrative literature review
Revista Brasileira de Enfermagem. 2022;75(1):e20210053
DOI 10.1590/0034-7167-2021-0053
- David de Sousa Loura ,
- Rafael Alves Bernardes ,
- Cristina Lavareda Baixinho ,
- Helga Rafael Henriques ,
- Isa Brito Félix ,
- Mara Pereira Guerreiro
Visualizações0Ver maisABSTRACT
Objective:
To identify the learning outcomes and skills obtained of undergraduate nursing students involved in research projects.
Methods:
This was an integrative literature review, based on a research protocol in the CINAHL Complete databases; Cochrane Central Register of Controlled Trials; Cochrane Database of Systematic Reviews; Cochrane Methodology Register; MedicLatina; MEDLINE, Scopus and JBI, including primary and secondary studies, published between 2015 and 2020.
Results:
A total of five heterogeneous articles were included, which were categorized using Kirkpatrick’s (adapted) model. Seventeen learning outcomes acquired through participation in research projects were identified, from the learning of new knowledge and skills to the development of new attitudes and behaviors.
Final considerations:
The involvement of nursing students in research projects is important to their professional development. Future investment in research on this topic can help cement the potential of this type of student involvement.
- David de Sousa Loura
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ARTÍCULO ORIGINAL05/12/2019
Qualidade de vida relacionada à saúde em pacientes com insuficiência cardíaca
- Larissa Ferreira de Araújo Paz ,
- Carolina de Araújo Medeiros ,
- Silvia Marinho Martins ,
- Simone Maria Muniz da Silva Bezerra ,
- Wilson de Oliveira Junior , [ … ],
- Maria Beatriz Araújo Silva
Resumen
ARTÍCULO ORIGINALQualidade de vida relacionada à saúde em pacientes com insuficiência cardíaca
Revista Brasileira de Enfermagem. 2019;72:140-146
DOI 10.1590/0034-7167-2018-0368
- Larissa Ferreira de Araújo Paz ,
- Carolina de Araújo Medeiros ,
- Silvia Marinho Martins ,
- Simone Maria Muniz da Silva Bezerra ,
- Wilson de Oliveira Junior ,
- Maria Beatriz Araújo Silva
Visualizações1RESUMO
Objetivo:
Avaliar a qualidade de vida relacionada à saúde dos pacientes com insuficiência cardíaca e relacionar aos dados sociodemográficos e clínicos.
Método:
Trata-se de estudo observacional, de corte transversal, com abordagem quantitativa realizado em ambulatório de insuficiência cardíaca no estado de Pernambuco.
Resultados:
Na amostra (n=101) houve predominância de homens, maiores de 60 anos, casados, profissionalmente inativos. A qualidade de vida relacionada à saúde, a partir do questionário Minnesota Living With Heart Failure Questionnaire foi considerada moderada (34,3±21,6), apresentando relação significativa com idade (p=0,004), classe funcional (p<0,001) e em pacientes com cardiopatia chagásica (p=0,02).
Conclusão:
A qualidade de vida no grupo IC de etiologia chagásica esteve mais comprometida, especialmente na dimensão emocional. Sugere-se a realização de estudos abordando as hipóteses de que maior tempo de acompanhamento ambulatorial melhora a qualidade de vida e que ter doença de Chagas interfere negativamente na qualidade de vida de pacientes com insuficiência cardíaca.
Palavras-chave: Assistência AmbulatorialDoença de ChagasEnfermagemInsuficiência CardíacaQualidade de VidaVer mais - Larissa Ferreira de Araújo Paz
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ARTÍCULO DE REVISIÓN21/12/2020
Aplicação da metodologia Lean Seis Sigma nos cenários de assistência à saúde: revisão integrativa
Revista Brasileira de Enfermagem. 2020;73:e20190861
Resumen
ARTÍCULO DE REVISIÓNAplicação da metodologia Lean Seis Sigma nos cenários de assistência à saúde: revisão integrativa
Revista Brasileira de Enfermagem. 2020;73:e20190861
DOI 10.1590/0034-7167-2019-0861
Visualizações0RESUMO
Objetivo:
analisar a produção científica sobre os resultados da metodologia Lean Six Sigma nas instituições de assistência à saúde.
Métodos:
revisão integrativa da literatura, com a seguinte pergunta: quais são os resultados nas instituições de saúde com a utilização da metodologia Lean Six Sigma e Six Sigma? A busca foi realizada nas bases de dados MEDLINE, LILACS, BDENF, CINAHL, Web of Science e Scopus, sem recorte temporal.
Resultados:
foram incluídos 34 artigos, publicados entre 2005 e 2019, sendo 52,9% provenientes dos Estados Unidos da América. As melhorias mais comumente encontradas foram em instituições hospitalares e na perspectiva dos clientes e processos internos.
Conclusão:
a utilização da metodologia Lean Six Sigma se demonstrou eficaz nos diversos cenários de assistência à saúde, se destacando uma lacuna em sua aplicação quanto ao engajamento e capacitação de pessoas.
Palavras-chave: Administração em SaúdeAssistência à SaúdeControle de QualidadeGestão da Qualidade TotalMelhoria de QualidadeVer mais
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ARTÍCULO ORIGINAL17/02/2020
Análise dos registros de técnicos de enfermagem e enfermeiros em prontuários
- Larissa de Lima Ferreira ,
- Flávia Barreto Tavares Chiavone ,
- Manacés dos Santos Bezerril ,
- Kisna Yasmin Andrade Alves ,
- Pétala Tuani Candido de Oliveira Salvador , [ … ],
- Viviane Euzébia Pereira Santos
Resumen
ARTÍCULO ORIGINALAnálise dos registros de técnicos de enfermagem e enfermeiros em prontuários
Revista Brasileira de Enfermagem. 2020;73(2):e20180542
DOI 10.1590/0034-7167-2018-0542
- Larissa de Lima Ferreira ,
- Flávia Barreto Tavares Chiavone ,
- Manacés dos Santos Bezerril ,
- Kisna Yasmin Andrade Alves ,
- Pétala Tuani Candido de Oliveira Salvador ,
- Viviane Euzébia Pereira Santos
Visualizações0RESUMO
Objetivos:
analisar as principais não conformidades dos registros de enfermagem de um hospital público do Nordeste na cidade de Natal.
Métodos:
estudo descritivo, transversal, abordagem quantitativa. Realizado em enfermarias médicas e cirúrgicas. Amostra composta de 120 prontuários de pacientes internados entre outubro e dezembro de 2016. Os dados obtidos foram tabulados e analisados por estatística simples em frequência absoluta e relativa com o software Microsoft Excel 2013. Para avaliar as não conformidades dos registros, usou-se o Diagrama de Pareto.
Resultados:
como principais problemas nos registros de enfermagem, destacou-se a ausência da categoria profissional e número do conselho, responsáveis por 41,8% das não conformidades nos registros de técnicos de enfermagem, enquanto nas anotações dos enfermeiros foram a ausência de hora e as letras ilegíveis, com 61,2%.
Conclusões:
o estudo evidenciou que os profissionais de enfermagem realizam seus registros de forma incompleta e que muitas vezes não documentam o cuidado prestado.
Palavras-chave: ComunicaçãoEnfermagemPesquisa sobre Serviços de SaúdeRegistros de EnfermagemSegurança do PacienteVer mais
- Larissa de Lima Ferreira
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