Repositório RCAAP

ABSTRACT Objective: Identify nurse’s learning needs to be related to the reception with risk classification of spontaneous demand in Primary Health Care. Method: Quality study including 15 nurses from Primary Health Care through participatory observation, application of semi-structured instrument, focus group, and of thematic content analysis. Results: 80% of nurses never used the risk classification protocol in Primary Health Care. Knowledge gaps involving clinical aspects of care; protocol management, and the nurse’s role; and the historic, structural and cultural contradictions of the care model were confirmed. Final considerations: The recognition of learning needs for nurses that work in Primary Health Care implies in the construction or improvement of knowledge in order to develop, along with the health team, a risk classification of spontaneous demand, which requires a change in the education and continuity of their qualification for work and at work.

ABSTRACT Objectives: to analyze comprehensiveness elements in Primary Care in Brazil, between 2012 and 2018, considering preventive and assistance aspects, pointing out advances and obstacles to its improvement in different contexts. Methods: a retrospective longitudinal study using data from the Brazilian National Program for Improving Access and Quality in Primary Care. 15,378 teams were selected that participated in both 1st and 3rd cycles of the program. Results: improvements were found in the prevalence of teams that ensure preventive and assistance care for priority groups, who develop promotion actions, offer essential procedures, including oral health, carry out home visits, receive support from Extended Family Health and Primary Care Center, offer integrative and complementary practices and develop intersectoral actions. Conclusions: there has been an improvement in comprehensiveness in Primary Health services, but problems remain that still need to be faced for their improvement.

ABSTRACT Objectives: To analyze potential (in)compatibilities of intravenous drugs based on the scheduling prepared by the nursing team. Methods: historic cohort (retrospective) with 110 adults in critical units. Intravenous medications were identified concomitantly, whose pairs were analyzed for (in) compatibility using the screening system Trissel’s™ 2 Compatibility IV-Micromedex 2.0. Parametric and non-parametric statistic were used according to the nature of the variable. Results: 565 pairs of drugs were identified. Of these, 44.9% were compatible; and 8.8%, potentially incompatible. Most potentially incompatible pairs involved substances with alkaline pH such as phenytoin (32%) and sodium bicarbonate (8%) and weak acids such as midazolam (12%) and dobutamine (6%), which could result in precipitate formation. Conclusions: almost half of the mixtures simultaneously administrated was compatible, which indirectly reflects in the organized work between the nursing team and the clinical pharmaceutic in the discussions and decisions related to time scheduling.

ABSTRACT Objectives: to identify risk clusters for the occurrence of tuberculosis and its treatment outcomes. Methods: ecological study, in a city in Maranhão, using data from the Notifiable Diseases Information System. Point density analysis and isotonic scanning techniques were used to identify areas with the highest occurrence of treatment outcomes and identify risk areas for possible tuberculosis cases. Results: most tuberculosis cases occurred in the male, adult, brown-skinned population. Also, most of the reported cases were classified as pulmonary and as new cases that progressed to a cure. The areas with the highest density of cure, death and abandonment are located in the central region of the city. Conclusions: the central region of the urban area of the city, with high demographic density and poor sanitary and socioeconomic conditions, presented a greater cluster of tuberculosis cases.

ABSTRACT Objectives: to recognize the competencies for health promotion and their magnitude of expression in undergraduate health education based on the analysis of the pedagogical projects of the courses and from the teaching perspective. Methods: research with a mixed approach, carried out at a public university. The data collected from the pedagogical projects of the Nursing and Physical Education courses and through interviews and application of a matrix of Competencies in Health Promotion with 31 professors of the referred courses were analyzed in the light of Competencies Health Promotion. Results: all competencies investigated were recognized in the curricula and reports of nursing professors, but the possibility of changes was not identified in the pedagogical project of Physical Education, although this competency was recognized as extremely important by the professors, with a mode of 4.5. Final Considerations: the training process in the courses studied has favored the development of skills for health promotion.

ABSTRACT Objectives: to compare pedagogical supervisors’ and clinical supervisors’ perceptions about the errors made by nursing students in clinical clerkship. Methods: a qualitative exploratory-descriptive study developed with 105 participants. Data collection was performed with a questionnaire with open-ended questions. Content analysis performed according to the conceptual model of student errors in clinical teaching. Results: pedagogical supervisors perceive, in descending order, errors in transversal competencies, in the execution of care and medication. Clinical supervisors perceive, in descending order, the execution of care, medication, and transversal competencies. Final Considerations: there was coincidence and complementarity in clinical supervisors’ and pedagogical supervisors’ perceptions, although not in the same order, regarding the errors made. This study presents contributions related to the existing knowledge in relation to medication errors, which are not the most perceived, and those of transversal competencies, which take on a prominent position.

ABSTRACT Objectives: to analyze urinary incontinence prevalence and severity in prostatectomized men assessed by three different instruments. Methods: a cross-sectional study was conducted with 152 men. The pad test, pad used, and International Consultation on Incontinence Questionnaire - Short Form (self-report) were considered. Data were analyzed using Spearman’s correlation, Kappa index, considering a significance level of 0.05. Results: urinary incontinence prevalence was 41.4%, 46.7% and 80.3% according to pad used, pad test and self-report. Positive correlations and moderate to poor agreement were found between the instruments. As for severity, most participants had mild incontinence. The largest number of cases of mild and severe incontinence was identified by self-report. Conclusions: the self-report showed higher values for prevalence of mild and severe severity levels. Through the identified differences, we propose that the objective assessment (pad used and pad test) be associated with individuals’ perception (self-report) to better estimate prevalence and severity.

ABSTRACT Objectives: to validate the Nursing Critical Thinking in Clinical Practice Questionnaire regarding cultural aspects and metric properties. Methods: a methodological research carried out through cross-cultural adaptation, face and content validity, dimensional construct and known groups validity, test-retest reliability and internal consistency. 511 nurses from four hospitals participated in the study, of which 54 participated in retest. Results: the instrument validation for Brazilian Portuguese maintained equivalences, according to the original version. The dimensional validity demonstrated adjustment to the tetrafactorial structure of the original version (GFI=0.69). There were statistically significant differences in critical thinking skills between nurses with graduate degrees and who undertook training, reading articles, developing research and working in an institution with a longer time implementation of the Nursing Process. The instrument showed temporal stability (ICC 073-0.84; p<0.001) and adequate internal consistency (α=0.97). Conclusions: the instrument proved to be valid and reliable for the studied population.

ABSTRACT Objectives: to evaluate the results of two methods of hospital bedpan reprocessing. Methods: cross-sectional study. Hospital bedpans containing a biological material contamination simulator or organic matter were submitted to manual cleaning followed by disinfection with 70% alcohol solution or thermodisinfection. Permanence of simulated contamination was evaluated by using the fluorescence technique and presence of organic matter was verified by carrying out the protein detection test. Results: the contamination simulator was found in bedpans submitted to both processes. The seat was dirtier after manual cleaning (p=0.044) in comparison with the result obtained with thermodisinfection. Automatized decontamination led to worse results when compared to the manual procedure for the scoop and external bottom (p=0.000). The protein detection test was positive in two items after thermodisinfection. Conclusions: manual cleaning followed by rubbing with 70% alcohol solution proved more effective than automatized cleaning in the reprocessing of hospital bedpans. There are relevant issues regarding reuse of hospital bedpans.

ABSTRACT Objectives: to evaluate the effects of music on the physiological stress and distress of cancer patients being treated in a hospital. Methods: quasi-experimental study carried out with cancer patients hospitalized in the nursing wards of a public hospital. There was a single 15-minute intervention using music. It was individual, and headphones were used for patients to listen to three songs chosen by each one. The levels of stress and distress were measured before and after the intervention, using music to analyze the cortisol in the saliva and the answers to the distress thermometer. The significance level of the statistical analysis was 5%, using the non-parametric Wilcoxon test. Results: the mean age of the 26 patients was 56 years old. Most were female, white, and had breast cancer. After intervention, there were statistically significant diminutions in both stress and distress — p < 0.001. Conclusions: the use of music diminishes the stress and the distress of cancer patients.

ABSTRACT Objectives: to identify the main doubts regarding the immediate postoperative care of patients with orofacial clefts undergoing orthognathic surgery. Methods: cross-sectional, quantitative study, developed in a public and tertiary hospital, between November 2017 and May 2018. Data collection occurred through interviews during the preoperative nursing consultation. An instrument was used to describe doubts, which later were grouped according to the subject. Results: 48 patients participated. The doubts referred to sun exposure (56%), food/mastication (48%), the relationship between intermaxillary block-breathing-vomiting (48%), oral hygiene (31%), physical activity restriction (27%), nasopharyngeal cannula, removal of surgical stitches, hospitalization time and speech/communication (23%), bleeding, cryotherapy, facial massage, aesthetic and functional results, healing, edema/ecchymosis, postoperative pain, and changes in facial sensitivity (21%). Conclusions: the doubts were related to food, the period of convalescence, care for the surgical wound, postoperative complications, and medications.

ABSTRACT Objectives: to understand access in a day in the life Primary Health Care as a fundamental right to health, from users’ perspective. Methods: a holistic-qualitative multiple case study based on Comprehensive Sociology of Everyday Life. 77 Unified Health System (SUS) users participated in the study. Results: according to users’ voice, the right to health is still a matter of struggle, in more than 30 years of SUS. SUS is considered as the place where they have to appeal. The experiences are diverse, from the ease to the difficulty of access, neglecting users’ needs, but despite the inequality in relation to the offer of services, the solution always arrives. Final Considerations: to overcome this historical obstacle of comprehensive access to health, as a fundamental human right, it is necessary to overcome political and administrative decisions that hinder the construction of legitimate SUS, in a truly democratic participation of all social actors.

ABSTRACT Objectives: to develop a guide of care recommendations for good practices in care transition for adult patients undergoing liver transplantation. Methods: a methodological study, based on the Appraisal of Guidelines for Research & Evaluation in the updated version, II. Care recommendations were sustained by conducting an integrative literature review and qualitative research. Results: from evidence, three topics emerged: Care Transition Planning; Health Education for Self-Care; Care Management. Each of the central topics has respective subtopics, totaling six, giving rise to 30 care recommendations. Concerning evaluators’ scores, in all domains the scores were higher than 90%. Final Considerations: the proposed guide assists professionals in conducting care transition in liver transplantation, ensuring greater safety for patients in continuity of home care.

ABSTRACT Objectives: to describe the nursing team’s adherence to patient safety actions in neonatal units using a validated instrument. Methods: a cross-sectional study, carried out through direct observation of the nursing team and descriptive analysis of 182 records of the “Checklist for patient safety in nursing care during hospitalization in Neonatal Intensive Care Units” in a hospital in the municipality of Belo Horizonte. Results: there was evidence of adherence greater than 90.0% in the units concerning the use of the identification wristband and guidance of the companions. It was identified 79.0% of absence on the checking of wristband identification and 59.0% of the absence of an evaluation of the crib wheels’ locks. Three of the 21 items included in the checklist did not show non-conformities. Conclusions: partial adherence to patient safety actions was observed, especially regarding the target of patient identification and prevention of falls, which exposes newborns to preventable adverse events.

ABSTRACT Objectives: to identify the prevalence and factors associated with the development of acute kidney injury in critically ill patients. Methods: a cross-sectional study, conducted from June 2018 to August 2019. The Kidney Disease Improving Global Outcomes was used to classify acute kidney injury. A significant value was set at p<0.05. Results: a total of 212 patients were included, of whom 35.8% evolved into an acute kidney injury. Patients with acute kidney injury had hypertension, higher levels on severity scores and a higher baseline creatinine rate> 1.5 mg/dL, also, when applied logistic regression, were 7 times more likely to develop acute kidney injury, Odds Ratio 7.018. More than half (56.6%) of the patients with acute kidney injury died. Moreover, 26.7% of these patients developed pressure sore. Conclusions: the prevalence of kidney injury was high (35.8%). The patients who developed it had a higher severity, mortality, and pressure sore index.

ABSTRACT Objectives: to analyze nurses’ recommendations on the psycho-affective dimensions of patients hospitalized in nephrology. Methods: a qualitative, exploratory and descriptive study, carried out by applying a sociodemographic and training questionnaire, reading a clinical case and conducting a semi-structured interview. Fourteen nurses from a reference hospital in nephrology in the Southeast participated. In the technical input of data treatment, thematic content analysis was used. Results: the recommendations included the exercise of empathy; monitoring of emotions from the implementation of the nursing consultation; continuous sharing of tensions, anxieties and desires; knowledge of one’s emotion; increased availability to listen; effectiveness of the approach in teams and social groups. Conclusions: recognizing patients’ psycho-affective dimensions, in the context of nurses’ performance, favors the expansion of therapeutic listening spaces, welcoming and interpersonal coexistence in nephrology, essential in the production of comprehensive health care.

ABSTRACT Objectives: to identify the occurrence of oncology teaching in undergraduate nursing curricula. Methods: descriptive study, which data was obtained from curriculum and from Pedagogical Course Projects available on the websites from Brazilian public institutions, between June and July 2020. Results: 143 undergraduate nursing courses were identified. From them, 132 nursing courses (corresponding to 89 education institutions) had available the curriculum and/or Pedagogical Course Projects. Only 7 (5.3%) of them had oncology as a mandatory subject, 4 of them in the Midwest Region. Only 35 (26.5%) had elective subject in Oncology, most of them in the Northeast (45.7%). Conclusions: on third of nursing courses at public institutions has Oncology subject in the curriculum, which is few considering the high incidence and mortality from cancer in the country. The findings contribute for discussions, in curricular accommodation, on the relevance of oncology teaching in nursing curricula.

ABSTRACT Objectives: to describe the use of affinity chromatographies and laboratory serologies in the evaluation of immunodiagnoses during prenatal. Methods: quantitative study, characterized as a descriptive observational research. Data was collected from the records of 46 pregnant women who were in prenatal follow up in the Primary Health Care in a capital in the South of Brazil. The data found was codified and analyzed using descriptive statistics. Results: a mean of 43.1 days was found to take place between the request of laboratory serology and the evaluation by a professional. It was also found that 21.7% of pregnant women did not collect the serologies requested during the first prenatal consultation, and that the affinity chromatographies were only applied in 10.8% of the participants. Conclusions: in spite of the studies for the improvement of prenatal consultations, for the provision of new technologies and for the permanent education offered to the professionals, there are still questions that make the actual implementation of affinity chromatographies more difficult.

ABSTRACT Objectives: to analyze the impact of the Colombian Peace Agreement on the structural social determinants of health. Methods: a descriptive, ecological study, based on documentary data from 2008 to 2018. The records of victims, epidemiological indicators, and structural social determinants of health in Colombia were analyzed. Results: there was a correlation between the period in which the Peace Agreement process was developed and the indicators of structural determinants in health with p<0.05. With the Poisson regression analysis, the favorable correlations between the peace process and the determinants were confirmed, besides allowing the understanding of the changes in these indicators before the Peace Agreement. Conclusions: the implementation of the peace process has a positive impact on structural social determinants of health, which is observed by the beginning of the decrease of economic, educational, health, and social inequalities and inequities, a fact that offers the possibility of living in peace.

ABSTRACT Objectives: to compare tympanic and axillary body temperature values of critical patients before and after the traditional and dry bed bath. Methods: this is a randomized, open crossover clinical trial conducted with 50 adult critical patients. All patients received both types of bed bathing. The tympanic and axillary temperature values were measured at the beginning and end of the baths. The Wilcoxon test or paired Student’s t test was used. Results: elderly and male patients predominated. There was no significant difference between tympanic temperature medians measured during the traditional bed bath (p=0.707) and dry bath (p=0.101). Axillary temperature means reduced at the end of the baths (p=0.001), being 36.12ºC in the traditional bath and 35.92ºC in dry bath. Conclusions: bed bath, regardless of the method used, caused a reduction in critical patients’ axillary temperature.