RCAAP Repository

ABSTRACT Objective: to analyze the scientific production on the results of Lean Six Sigma methodology in health care institutions. Methods: an integrative literature review, with the following question: what are the results in health institutions using Lean Six Sigma and Six Sigma methodology? The search was carried out at MEDLINE, LILACS, BDENF, CINAHL, Web of Science, and Scopus, with no time frame. Results: thirty-four articles were included, published between 2005 and 2019, of which 52.9% came from the United States of America. The most commonly found improvements were in hospital institutions and from the perspective of customers and internal processes. Conclusion: using Lean Six Sigma methodology proved to be effective in the different health care settings, evidencing a gap in its application regarding people engagement and training.

ABSTRACT Objective: to investigate evidence that indicates the contribution of realistic high, medium or low fidelity simulation to acquire knowledge, skills and attitudes in safe medication administration by nursing students. Methods: an integrative review of experimental studies from MEDLINE, LILACS, Web of Science, Scopus and Science Direct. The descriptors “nursing students”, “simulation”, “high fidelity simulation training”, “medication errors” and “pharmacology” were used to identify 14 studies that answered the research question, and were assessed for accuracy methodological level and level of evidence. Results: there was a sample of quasi-experimental studies, (level 3 of evidence; 78.6%) and randomized clinical trials (level 2 of evidence; 21.4%), whose expressive majority showed superiority of the simulation strategy over the traditional methodology (71.4%). Conclusion: using low and high fidelity simulators, standardized patients and virtual simulation can promote acquisition of essential skills for patient safety.

ABSTRACT Objective: to demonstrate scientific evidence on incidence and factors associated with contrast-induced nephropathy in patients undergoing percutaneous coronary intervention. Methods: an integrative review carried out in the VHL, PubMed, VHL Regional Portal and SciELO databases, of articles published between 2014 and 2019. Results: the sample consisted of five original articles, two cohorts, two control cases and a clinical trial. The incidence of contrast-induced nephropathy ranged from 6% to 24%. It stands out among patients with advanced age, male gender, diabetes mellitus, systemic arterial hypertension, volume of contrast infused and osmolarity. Intravenous hydration, sodium bicarbonate, ascorbic acid and statin were important prophylactic agents. Conclusion: this study envisioned the main risk factors for contrast-induced nephropathy in patients undergoing percutaneous coronary intervention and elucidated preventive measures that guide multidisciplinary health care aiming at a quality and safe care.

ABSTRACT Objective: To identify the available evidence in the scientific literature about the strategies or interventions used to promote hope in people with chronic diseases. Method: An integrative literature review of literature published between 2009-2019, which was conducted in online browsers/databases: b-On, EBSCO, PubMed, Medline, ISI, SciELO, PsycINFO, Google Scholar. Forty-one studies were found, of which eight met the inclusion criteria. Results: Most studies used a quantitative approach. There was a predominance of studies from Asia and America, addressing patients with multiple sclerosis, diabetes, congestive heart failure, and cancer. Hope-based interventions were categorized by the hope attributes: experiential process, spiritual/transcendence process, rational thought process, and relational process. Conclusion: Hope-based interventions, in its essence, are good clinical practices in the physical, psychological, social and spiritual domains. This is congruent with the vision of nursing, first proposed by Florence Nightingale. There seem to be gaps in the literature regarding specific hope promoting interventions.

ABSTRACT Objectives: to reflect on the implementation of an integrated strategy to eradicate the Acquired Immunodeficiency Syndrome (AIDS) epidemic in Guinea-Bissau by 2030. Methods: a reflective study. Reflection: Guinea-Bissau is a Portuguese-speaking country located in Sub-Saharan Africa, in constant political and economic instability. Among its characteristics are sociocultural diversity and high rates of morbidity and mortality from causes related to infection by the Human Immunodeficiency Virus. In the quest to eradicate the AIDS epidemic by 2030, instituted especially by the United Nations, it is noted that political and socio-cultural factors transformed eradication of the AIDS epidemic by 2030 into a utopia. Final Considerations: international strategies, although ambitious, are considered opportunities for countries to propose and build public policies capable of changing the existing reality.

ABSTRACT Objective: Reflecting critically on the epistemological aspects of the of knowledge construction on Nursing Administration in Brazil. Methods: This is an article of theoretical reflection that aims to assess the epistemological aspects of the construction of knowledge about Nursing Administration. Results: The knowledge about Nursing Administration has a long way to go, as its epistemological repertoire is still timid. In addition, the lack of distinction of this knowledge in the communication of research products underestimates the production on Nursing Administration, as these products appear diluted in other areas of Nursing (care, research, and teaching). Final considerations: Due to the reflections, the need for new scientific evidence is highlighted, whose formulation of research questions can contribute to the delineation of phenomena that distinguish Nursing Administration as an area of research knowledge.

ABSTRACT Objective: To reflect on the transformations of modern and contemporary nursing as well as on Florence Nightingale’s social entrepreneurship. Method: This is a logical-reflective exhibition, with an emphasis on the theoretical assumptions of social entrepreneurship and the legacy of Florence Nightingale, from modern to contemporary nursing, based on readings of texts extracted from electronic databases, especially periodicals, books and theses. Results: The logical-reflective exhibition focuses on two fundamental aspects: 1) Florence Nightingale’s legacy as a social entrepreneur; 2) The evolution of Brazilian nursing: from modernity to contemporaneity. Final considerations: Florence Nightingale’s legacy is undeniable with regard to the evolution of modern and contemporary nursing and transcends different areas of knowledge. In addition to being a precursor to modern nursing, it is distinguished by its visionary attitude, humanitarian social value and potential for transforming the paths and realities present in the Contemporary Era.

ABSTRACT Objective: To reflect on the relationship and importance of the environmental theory regarding practices for promotion, prevention, and treatment of COVID-19. Methods: A theoretical-reflexive study about the COVID-19 pandemic in light of the environmental theory proposed by Florence Nightingale. Results: It is observed that the application of the theoretical foundations proposed by the environmental theory is related to the current practices used in the fight against the COVID-19 pandemic. Final Considerations: It is believed that the theoretical basis is fundamental for the critical-reflexive training of the nursing professional, for the consolidation of Nursing as a science; therefore, it could provide a foundation in nowadays battle against the pandemic.

ABSTRACT Objective: To report the experience of design and implementation of the Help2Care (an ehealth program that aims to support informal caregivers of dependent people); and to identify its structure and functionality. Methods: This is a Portuguese experience report about Help2Care, a practice-based action research project carried out between 2017 and 2019, having as a guiding axis Florence Nightingale’s concepts about the relevance of the home-care environment. Results: The Help2Care program revealed itself to be a valuable support tool for providing better healthcare learning, counselling, and assistance of the informal caregivers of dependent people. Different ehealth strategies were used to empower caregivers in self-care in order to have a safe transition between contexts of care at the time of patient discharge. Conclusion: Help2Care allows to inspire other ways of providing care, as well as a reduction in the readmission rate in health organizations for patients who reveal poor care support in home environments.

ABSTRACT Objectives: to understand the life stories and itineraries of transvestites and transsexuals in health services. Methods: study with a qualitative approach, anchored in the methodological framework of Oral History. Interviews were conducted and thematically analyzed. Results: two themes emerged: 1) gender and sexuality in life stories; and 2) the trajectories in health services. These revealed the challenges in the process of recognizing gender identity before the family and society. The reports show the dilemmas that transsexuals and transvestites face in health care, which ends up generating the removal of this population from services. Final Considerations: it has been demonstrated that Oral History can increase knowledge, especially about life histories and trajectories in the health services of transvestites and transsexuals; in addition, information was offered that can assist managers and health professionals in making decisions or caring for these people.

ABSTRACT Objectives: to analyze the perception and conflict management strategies used by nurses in the management of people in Portuguese health services. Methods: descriptive, correlational study, carried out in Portuguese health services, with an intentional non-probabilistic sample, totaling 95 nurse managers. A questionnaire and Conflict Management Scale were used, analyzing the variables of managerial activities and conflict management, with the aid of software. Results: it was identified that 60% of the managers, report having to mediate conflicts daily, and the majority report adopting dialogue in conduct. However, through the Kruskal-Wallis test, it was shown that enforcement strategies in conflict management prevail (p = 0.008), with collaborative ones being more restricted to monthly intervals (p = 0.049). Conclusions: managers perceive the importance of collaboration in the mediation of conflicts, however, in their daily lives; they tend to maintain imposing behaviors, signaling for a little transformational leadership style.

abstract Objectives: to describe the family’s experience in the process of discovering the diagnosis and initiation of treatment of children with Autism Spectrum Disorder. Methods: this qualitative and descriptive study interviewed nine relatives of eight children on autism spectrum. They were inserted in health services, public education, and Association of Parents and Friends of The Exceptional of cities in the countryside of the Center-West. Data were collected through open interviews from July to September 2017. Data was submitted to thematic analysis. Results: at the beginning, the family was difficult to perceive the first atypical signs presented by the children. Families experience situations of vulnerability, since support networks are insufficient. The school played a significant role in recognizing unexpected behaviors. Final Considerations: support, offered by nurses, health professionals, school and social support devices, is important to family and children in this trajectory.

ABSTRACT Objectives: to evaluate the psychometric properties of the Brazilian version of the Standard Precautions Questionnaire. Methods: this is a methodological study conducted with physicians and nursing professionals for the evaluation of psychometric properties. A reliability analysis was conducted using Cronbach’s alpha. Exploratory factor analysis was performed and scores were analyzed using the known-groups method. Results: the scale was applied to 300 professionals: 88 nurses, 163 nursing technicians and 49 physicians. Cronbach’s alpha was 0.71. All items presented satisfactory factor loading. Known-group validity showed sensitivity of differences in the scores of socio-cognitive factors, where nurses obtained a significant effect in scores of intention (4.77; p=0.000) and individual constraints (3.52; p=0.041) when compared to other health professionals. Conclusions: satisfactory construct reliability and validity were obtained for the Brazilian version of the questionnaire, allowing a valid and reliable instrument for the assessment of socio-cognitive determinants of compliance with standard precautions.

ABSTRACT Objectives: to analyze the Brazilian scientific integrative review production in postgraduation nursing programs. Methods: bibliometric design, carried out in the database of dissertations and theses of the Coordination for the Improvement of Higher Education Personnel, in October 2018. Results: 35 dissertations and 1 thesis were found. Most studies were carried out at the University of São Paulo; the main methodological reference was Mendes, Silveira and Galvão (2008); for data collection, it was Ursi (2005). The most used database was CINAHL, followed by LILACS and PubMed. The period of publication varied from 5 to 30 years; and the sample, from 6 to 299 texts. Some studies did not mention keywords, data collection period, exclusion criteria or publishing period. Conclusions: despite the growing popularity of integrative review studies, they are undervalued in the stricto sensu postgraduation program in nursing and there are shortcomings in the implementation of the method, related to the absence of important elements.

ABSTRACT Objectives: to develop the safe surgery checklist for liver transplantation according to the original model of the World Health Organization and perform content validation. Methods: a methodological research developed in four stages: integrative review; expert participation; consensus among researchers; and content validation using the Delphi technique in two rounds, by five judges. For data analysis, the Content Validation Index was used. Results: the first version of the checklist consisted of four surgical moments with 64 items of verification, with an average Content Validation Index of 0.80. After adjustments, in the second round the checklist maintained four surgical moments with 76 items and a Content Validation Index of 0.87. Conclusions: the checklist was validated and adequate for the safety of liver transplantation in the surgical environment, given that each item established must be mapped and managed for the success and effectiveness of the procedure.

ABSTRACT Objectives: to develop and evaluate the convergence of the instrument for the appearance validity of educational technologies in health. Methods: methodological study conducted in two steps. In step 1, the instrument items were developed, with subsequent content validity by nine specialists in the development of educational technologies in health. In step 2, the convergent validity between another instrument and the appearance instrument was performed. Correlation results above r> 0.3 and p <0.05 were considered as plausible convergent validity. Results: the ten items of the initial version of the appearance instrument were submitted to content validity that resulted in a final version with 12 items (Content Validity Index = 0.93). The correlation indexes were strong with the objective and appearance domains; moderate with motivation, organization and total; and weak with writing style. Conclusions: the appearance instrument demonstrated content validity and convergent validity, in addition to a strong correlation with the other instrument.

ABSTRACT Objectives: to investigate the process of implementing advance directives in palliative care teams in southern Brazil. Methods: an exploratory-descriptive study with a qualitative approach conducted with 51 professionals from seven palliative care teams from December 2018 to April 2019. Data were collected through semi-structured online interviews and submitted to discursive textual analysis. Results: the implementation process starts on approach of the advance directives with patients, so that their wishes and desires are the guiding axis for planning care and conduct. Final Considerations: the palliative philosophy is important with regard to advance directives, due to the preparation of these professionals in the search for dignity, quality of life and respect for patient autonomy, in addition to reducing suffering and offering dignified death, based on the understanding of human finitude as a natural process that belongs to life.

ABSTRACT Objectives: to discover what were the contributions of the Reflexive Group from the perspective of men being sued by marital violence, who participated in a social technology. Methods: qualitative study, resulting from the evaluation stage of an action-research, based on the perspective of Critical Freedom and carried out with 44 men who were being sued in the Peace at Home Courts, in Salvador, Bahia, Brazil. Results: the discourses of men being sued for marital violence showed that the reflections enabled them to share their experiences; understand their attitudes as disrespectful, violent, and liable in criminal courts; elaborate of strategies for a harmonious marital life; and become multipliers as a result of their willingness to socialize the information and knowledge that emerged from their group. Conclusions: the study presents a successful experience of the participation of men in reflexive groups and is a precedent for the validation of this social technology.

ABSTRACT Objectives: to identify anthropometric techniques and measurements related to nursing diagnoses and interventions, included in the NANDA International (NANDA-I) and Nursing Interventions Classification (NIC), respectively. Methods: descriptive study of the revision of the NANDA-I and NIC taxonomies by professors of Nursing of the Universidad Complutense de Madrid. Results: A total of 24 nursing diagnoses, 20 nursing interventions and 71 nursing activities were identified that require the use of anthropometric measurements. Conclusions: anthropometric measurements are necessary in the conduct of numerous nursing diagnoses and nursing interventions that are commonly used in healthcare practice. It would be useful to systematize the use of anthropometric techniques in the application of the nursing process and to standardize this training process.

ABSTRACT Objectives: to develop and validate an obstetric surgical safety checklist for intraoperative care. Methods: this is a methodological study with two phases: integrative review in databases, using selection criteria and descriptors to synthesize the evidence and develop the checklist; checklist content validation, with 37 judges, who answered a Likert-type questionnaire. For analysis, a >85% content validation index was applied. Results: the checklist’s first moment reached a 96.1 content validation index; the second moment, 95.5; the third moment, 98.9. Thus, the validation index of all verifying sections present in the three surgical moments was 97.1. Cronbach’s Alpha value was 95.57%. Conclusions: the checklist items were validated by judges, with improvement of some items and insertion of others.