RCAAP Repository

ABSTRACT Objectives: to investigate the scientific evidence on the use of Bloom’s taxonomy for developing competence in nursing professionals and students in clinical simulation. Methods: integrative review of the National Library of Medicine (NLM), National Institutes of Health (NIH), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Latin American and Caribbean Literature in Health Sciences (LILACS), Web of Science and SCOPUS databases, using the Rayyan application. Results: a total of 871 studies were identified; four composed the sample. The development of clinical competence occurred through the coordination of knowledge, skills, and attitudes. To develop the cognitive domain, the objectives of knowledge and comprehension of the Bloom’s taxonomy were mobilized. The psychomotor domain required development of the skills demanded by the proposed clinical care. The affective domain was developed through will and motivation to learn. Conclusions: it is possible to develop clinical competence in nursing by adopting Bloom’s taxonomy in each phase of clinical simulation.

ABSTRACT Objectives: to analyze the production of scientific articles about the pharmacological and non-pharmacological management of delirium in adult hospitalized cancer patients. Methods: integrative review whose sample was obtained from the databases Scopus, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Web of Science, and from the portals Biblioteca Virtual em Saúde, and PubMed. Results: among the ten studies analyzed, 80% described exclusively the pharmacological management, especially with regard to the use of haloperidol; 20% mentioned, superficially, non-pharmacological interventions/actions (educational actions) associated to pharmacological management, and adjusting them could result in the diminution and control of psychomotor agitation, contributing for the safety and comfort of the patient. Conclusions: there are few studies addressing pharmacological and non-pharmacological interventions/actions to manage delirium. As a result, it is essential to develop studies focused on increasing and advancing scientific knowledge with regard to the theme, especially in the national context.

ABSTRACT Objectives: to identify and synthesize the concept of Ineffective Health Control. Methods: Concept Analysis from the perspective of Walker and Avant, operationalized by an integrative review in the databases Scopus, LILACS, PubMed, CINAHL, Web of Science, Science Direct e Cochrane, using the descriptors: Adhesion to Medication; Cooperation and Adherence to Treatment and Acquired Immunodeficiency Syndrome. Results: five critical attributes were identified for the concept, namely: patient’s refusal to follow the therapeutic plan; abandoning treatment and worsening signs and symptoms; difficulty in reaching agreed goals; difficulty following health professionals’ guidelines; multifactorial and dynamic process. Conclusions: the concept of Ineffective Health Control is characterized by a multifactorial and dynamic process evidenced by the patient’s refusal to follow a therapeutic plan, favouring the abandonment of treatment and resulting in the worsening of signs and symptoms and failure to reach goals.

ABSTRACT Objectives: to identify and map the invasive procedures performed by nursing that can cause Healthcare-Associated Infections in patients in Intensive Care Units. Methods: this is a scoping review carried out in the first half of 2018, based on search for studies in national and international databases, in which 2,209 studies were found, of which 35 constituted the final sample. The data were analyzed and organized by simple descriptive statistics. Results: among the invasive procedures performed by nursing that provide Healthcare-Associated Infections, delayed bladder catheter was indicated in 34 (66.67%) studies, the nasogastric catheter in 10 (19.61%) and the nasoenteral catheter in two (03.92%). Conclusions: in the face of such problems, better nursing planning and guidance for care in these invasive techniques becomes relevant and thus minimizes the incidence of infections.

ABSTRACT Objectives: to reflect about the vulnerability of the family, using the book The Human Condition by Hannah Arendt as reference, to better understand how this institution has been structured in today’s world. Results: the rupture of assistance relations among family members represents a situation of vulnerability that weakens the family institution, leading to the loss of the assertiveness in the society. Support for the development of human capabilities in families and in the territory provides the benefit of strengthening them to face of vulnerabilities. Conclusions: the vulnerability of the family presents itself as a historic milestone, condition on which the family institution was built and organized as a public and private property, putting in evidence the importance to develop a more holistic and integrate care to the people, based on health public policies and social assistance.

ABSTRACT Objectives: to highlight the main attributes of Convergent Care Research that ratify it as a method of scientific research. Methods: it is a theoretical-reflective study on Convergent Care Research's theoretical-methodological assumptions. Development: Convergent Care Research is compatible with the Social Constructionism paradigm. Convergent Care Research projects have two approaches: practical and conceptual. The Convergent Care Research process corpus contains five phases: conception; instrumentation; scrutiny; analysis and theorizing. Final Considerations: Convergent Care Research rigor encompasses the relationship between research and care practice, and this corresponds to the convergence of these two dimensions. Due to its theoretical foundation and criteria of methodological rigor, Convergent Care Research is aligned with scientific research methods.

ABSTRACT Objectives: to discuss specific laws and public policies for workplace violence in the health sector, highlighting possibilities for the collective confrontation of this phenomenon in Brazil. Methods: this is a reflective and argumentative study that refers to some previous experiences regarding the implementation of legal aspects to curb workplace violence directed at health professionals. Results: there are experiences regarding the existence of legislation or public policies to specifically contain workplace violence in the health sector, but these are still restricted to some places or countries. The literature provides resources for developing specific strategies for managing this phenomenon, highlighting prevention programs and conducts for case management. Final Considerations: implementation of legal aspects or public policies at the municipal, regional, state and/or national level is a strategy with potential to confront workplace violence in health services in a collective and sustainable way.

ABSTRACT Objectives: to share the contributions of culture circles for teaching, research, and professional nursing practice, having as framework Paulo Freire’s Research Itinerary. Methods: this is an experience report of a culture circle, with participation of three professors and ten students, enrolled in a course of a Graduate Program in Nursing in southern Brazil. In this culture circle, a tree was built in which the roots formed the thematic investigation, the stem, coding and decoding, and the leaves, the Research Itinerary critical unveiling. Results: participants demonstrated empowerment of Paulo Freire’s assumptions, and building a tree made it possible to discuss in a pleasant and playful way culture circle use in teaching, research, and professional nursing practice. Final Considerations: the culture circle promoted reflection and action on nursing praxis, turning Freirean thoughts into something concrete and transforming realities.

ABSTRACT Objectives: to describe the main aspects and relevant results of the implementation of the Nursing Services Management Model in hospitals managed by social health organization, from 1998 to 2018. Methods: experience report of the model implemented in 16 hospitals in the state of São Paulo, Brazil. Results: the actions and monitoring of the implementation were based on protocols considering: management model and structure of the nursing service in hospitals; care process and main nursing care results; and people development. Final Considerations: the implementation of methods that ensure the well-being of nursing professionals is directly related to effective care, in which the practice is driven by quality and autonomy. Promoting a culture of care excellence, at different levels of management and care, has generated better expectations and motivation. It was found that the commitment of managers, by providing resources, resulted in improvements in the quality of nursing services.

ABSTRACT Objective: To analyze factors associated with the implementation of software systems of the e-SUS Primary Care strategy in municipalities of Minas Gerais. Methods: This is a cross-sectional study conducted with municipal managers of the e-SUS Primary Care strategy. A sample of cities stratified according to population size was selected. Descriptive, bivariate, and multivariate analyzes were performed to identify factors associated with the implementation of the systems. Results: In 49.1% (95%CI: 39.5-58.8) of the municipalities investigated, some of the e-SUS Primary Care systems were implemented. Time working as a strategy manager (OR: 3.03) and training for Primary Care professionals in the municipality (OR: 2.28) were associated with the implementation of the systems. Conclusion: The presence of a trained manager leading the implementation process impacted the implementation of the e-SUS AB strategy software systems in the municipalities of Minas Gerais. It is also essential to highlight the need to improve the technological infrastructure for the computerization of Primary Care.

ABSTRACT Objectives: to analyze the practices of a home care team and their implications for caregivers’ performance. Methods: qualitative study with data obtained from observation of 21 users, 30 caregivers and 6 professionals from the home health care service in a municipality in Minas Gerais, from February to June 2018. The material was analyzed from the perspective of discourse analysis according to Michel Foucault. Results: team interference upon caregivers is exercised by disciplinary practices and prescriptive, authoritative and surveilling behaviors. The team’s knowledge-power relationship determines caregivers’ acceptance through convincing or through difficulty of understanding assigned orientations. Educational practices would enable caregivers to be constituted as active, participative, empowered and reflective subjects. Final Considerations: team practices interfere with caregivers’ ways of acting and being and they have implications in objectification and subjectification processes.

ABSTRACT Objective: to analyze the facilities and difficulties in the use by nurses of the care flow for patients with chest pain. Methods: descriptive analytical study, with a qualitative approach, conducted with 17 nurses from an emergency care unit in a municipality of the State of Ceara, in 2018. Data collected through documents and interviews, analyzed in a descriptive manner, in absolute and relative frequencies and through content analysis thematic. Results: the use of assistance flow streamlines the process of transferring to referral units, reducing serious and lethal complications in the patient. It considers teamwork and communication as facilitating points in the care of patients with chest pain. The lack of permanent education, physical structure, equipment, transport delay and patient regulation as factors that hamper. Final considerations: investments in physical structure and equipment, in the reorganization of the care network and in permanent education to enable benefits to the service of excellence in health care.

ABSTRACT Objectives: to investigate the association between workaholism and quality of life in stricto sensu graduate professors in Nursing. Methods: a cross-sectional study developed with a total of 333 professors working in the Graduate Programs of Brazilian public universities. Data collection took place in the second semester of 2018, using an electronic form containing a characterization questionnaire, the Dutch Work Addiction Scale and the World Health Organization Quality of Life Instrument-BREF. The data were analyzed by univariate and multiple logistic regression. Results: it was observed that 82.3% of the professors reported low general quality of life and 19.5%, high level of excessive work and 20.1% of compulsive work. Professors who worked compulsively and excessively were less likely to have a high quality of life in the overall, physical, psychological, social relations and environment domains (p<0.05). Conclusions: the high work demands that are characteristic of the stricto sensu professors’ work process are directly associated with low quality of life.

ABSTRACT Objectives: to develop an ICNP® terminology subset to care for people with tuberculosis. Methods: a methodological research that followed the following steps: identification and validation of empirical indicators of altered needs relevant to people with tuberculosis based on literature; cross-mapping of the empirical indicators of altered needs identified with ICNP® 2017 terms; construction of nursing diagnoses/outcomes and interventions; assessment of relevance of nursing diagnoses /outcomes and interventions and ICNP® terminology subset structuring. Results: an ICNP® terminology subset was developed to care for people with tuberculosis with 51 diagnoses/outcomes and 264 nursing interventions, assessed by nurses from Primary Health Care and structured according to Wanda Horta’s Theory of Basic Human Needs. Final Considerations: the subset is a technological instrument through which it is possible to identify the elements of nursing practice from the affected human needs.

ABSTRACT Objective: to identify the implementation process of the World Health Organization Surgical Safety Checklist in Brazilian hospitals. Methods: this is a cross-sectional study with 531 participants during a Congress of Perioperative Nursing, promoted by the Brazilian Association of Operating Room Nurses, Anesthetic Recovery and Material and Sterilization Center, in 2017. Results: among the nursing professionals included, 84.27% reported the checklist implementation in the workplace. Regarding daily application in the Sign-in stage, 79.65% of professionals confirmed patient identification with two indicators; in the Time-out stage, 51.36% of surgeries started regardless of confirmation of one of the items. In the Sign-out stage, 69.34% of professionals did not count or occasionally counted the surgical instruments and suture needles, and only 36.36% reviewed concerns about postoperative recovery. Conclusion: this study identified needs for improvements in applying the checklist in the Brazilian reality, to guarantee safer surgical procedures.

ABSTRACT Objectives: to know the care implemented by the nursing team to prevent medical device-related pressure injuries in critically ill patients. Methods: this is a qualitative research conducted with 15 nursing professionals from Intensive Care Unit. Sampling was carried out by theoretical saturation. For data analysis, the Discourse of the Collective Subject technique was used. Results: six speeches emerged, whose central ideas were interventions for medical device-related pressure injury prevention: care in fixation; frequent repositioning; protection and padding of body areas in contact; preferences for flexible materials, when available; attention of professionals so that they do not comer under patients; early assessment and removal, when clinically possible. Final Considerations: nursing care was directed mainly to respiratory devices, catheters in general and monitoring equipment, indicating that professionals have the knowledge to provide safe assistance consistent with the literature.

ABSTRACT Objectives: to identify and confirm the priority nursing diagnosis of International Classification for Nursing Practice® for home nursing consultation to adults in Primary Health Care. Methods: qualitative study, of methodological and validation type. The 5-point Likert scale was used, with a minimum Content Validity Index of 80% consensus among judges., considering the answers “priority” or “very priority” for the list of nursing diagnoses presented. 23 expert judges participated in this survey. Results: a hundred and eleven nursing diagnoses of prepared statements lists have been grouped by human systems and sociodemographic characteristics. were grouped by human systems and sociodemographic characteristics. Eighty-three of them (74.77%) had a Content Validity Index equal or higher to 0.8; and 27 (32.5%) had an index of 1.0 (100%) among judges. Conclusions: nursing diagnosis validated can be used to assist clients in home nursing consultations in Primary Health Care.

ABSTRACT Objective: To investigate the critical nodes related to nursing care for patients in the postoperative period of cardiac surgery. Methods: Exploratory study with a qualitative approach. Data collected through semi-structured interviews with 27 members of the nursing team working in the Intensive Care Unit. Material submitted to thematic analysis. Results: Three categories emerged: Flaws in the professional qualification for patient care in the postoperative period of cardiac surgery; Team challenges concerning specific patient care in the postoperative period of cardiac surgery; and (dis) organization of work in the Intensive Care Unit and its impact on nursing care for patients in the postoperative period of cardiac surgery. Final considerations: Given the identification of the critical nodes, the professionals presented suggestions to overcome daily difficulties: investments in strategies for Permanent Education in Health; creation of tools to guide patient assistance in the postoperative of cardiac surgery; and provision of adequate human resources.

ABSTRACT Objective: to assess the implementation of actions for early detection of breast cancer in Primary Care and to verify the adequacy of these actions with the Ministry of Health recommendations. Method: a cross-sectional study conducted from September 2017 to March 2018 with 736 women registered in Basic Health Units in two municipalities in Acre. For data collection, a validated questionnaire was used. In statistical analysis, the chi-square test or Fisher’s exact test was applied. Results: the frequency of mammography was 42%. Of the women at standard risk for breast cancer, only 5,8% underwent mammography properly. Conclusion: there was a low compliance of early detection actions to the Ministry of Health recommendations; thus, the need to adopt measures to increase professionals’ adherence to government proposals is highlighted, as well as continuous actions assessments.

ABSTRACT Objectives: to assess the reliability and validity of the 46 items version of the comfort scale for family members of people in critical condition. Methods: a methodological study, carried out with 278 family members of critically ill patients, admitted to adult and pediatric intensive care units, in a city in the interior of the state of São Paulo, in Brazil. The analyzes were based on the Classical Test Theory and Item Response Theory. Results: Horn’s parallel analysis and exploratory and confirmatory factor analysis did not identify the scale’s unidimensionality nor the tridimensionality. The maximum factor loads were positive. The scale proved to be reliable (α=0.93 and Ω=0.63), most item-total correlations were greater than 0.28 and the discrimination coefficients were greater than one. Conclusions: the scale showed satisfactory reliability and relative construct validity. However, the recommended tridimensional structure for the scale has not been confirmed.