Web App for prediction of hospitalisation in Intensive Care Unit by covid-19

OBJECTIVE

To develop a Web App from a predictive model to estimate the risk of Intensive Care Unit (ICU) admission for patients with covid-19.

METHODS

An applied technological production research was carried out with the development of Streamlit using Python, considering the decision tree model that presented the best performance (AUC 0.668).

RESULTS

Based on the variables associated with Precision Nursing, Streamlit stratifies patients admitted to clinical units who are most likely to be admitted to the Intensive Care Unit, serving as a decision-making support tool for healthcare professionals.

FINAL CONSIDERATIONS

The performance of the model may have been influenced by the start of vaccination during the data collection period, however, the Web App via Streamlit proved to be a feasible tool for presenting research results, due to the ease of understanding by nurses and its potential for supporting clinical decision-making.

Theoretical model for management of nursing research groups

OBJECTIVE

To develop a theoretical model for management of research groups in nursing graduate programs.

METHOD

This is a Grounded Theory developed in a stricto sensu nursing graduate program of a public university. Data collection was conducted from April to October 2018 and the theoretical sample consisted of 21 participants arranged in three sample groups.

RESULTS

Research activities are linked to research groups, which require human, material and financial resources to develop their studies. These conditions call for management strategies and national and international interactions that result in theoretical, scientific and technological development of the profession.

FINAL CONSIDERATIONS

The theoretical model for management of research groups can serve as a guide for graduate programs in nursing and health for planning the work process and so that they can contribute with research of great impact for society.

Nursing care management in radiation protection in interventional radiology

OBJECTIVE

To reflect on the elements of nursing care management in radiological protection in interventional radiology.

METHODOLOGY

A reflection paper based on national and international articles and laws addressing the nursing care management issue and radiological protection in interventional radiology.

RESULTS

From the conceptions of nursing care management and professional practice, the following elements were perceived in this management: expertise and applicability of the radiological protection principles, biological effects of ionizing radiation, occupational dose monitoring, personal and collective protective equipment, patient safety, training in radiological protection, quality assurance program.

CONCLUSION

The management of nursing care in radiological protection in interventional radiology is implemented in an elementary way regarding care aimed at dose reduction, either for workers or patients. There is a need to recognize, understand and characterize the management of nursing care in this scenario.

Nursing care as a systemic and entrepreneurial phenomenon

The objective is to produce a critical-reflexivity analysis of nursing care, from the perspective of complexity thinking and social entrepreneurship. Theoretical-reflective study, supported by the framework of complexity thinking and social entrepreneurship. The main characteristics that lead and support nursing care are analyzed from a systemic-entrepreneurial perspective. A parallel is conceived between vertical care, design from a hierarchical structure and nursing care in the systemic-entrepreneurial perspective, which leads to singularity, originality, circularity, complementarity and interactivity. The centrality of nursing care is reaffirmed as a tangible social good or not. Theoretical reflection on nursing care as a systemic and entrepreneurial phenomenon raises a unique and multidimensional perception of the human being/user, health, the nursing work process, in order to achieve an increasingly agile, dynamic, circular, complementary and interdependent care.

Entrepreneurship and entrepreneurial education in the context of postgraduate nursing

OBJECTIVE

To understand entrepreneurship and entrepreneurial education in the context of postgraduate nursing.

METHOD

Qualitative study based on Grounded Theory. The theoretical sample consisted of 15 master's and doctoral students and seven professors from a postgraduate nursing program at a university in southern Brazil. Individual interviews were conducted between August/2018 and February/2019 in a location defined by the participants, in general the University. The data were collected and analyzed simultaneously by initial and focused coding.

RESULTS

Three categories and 11 subcategories emerged that, interrelated, represented the phenomenon "Glimpsing entrepreneurship and entrepreneurial education in postgraduate nursing".

CONCLUSION

Entrepreneurship and entrepreneurial education, in the context of postgraduate nursing, were understood as incipient and promising processes. In this sense, it is necessary to intensify studies to demonstrate the entrepreneurial possibilities of the area.

Factors that influence the care of family members of patients with brain death

Objetivo: compreender os fatores intervenientes decorrentes do cuidado de Enfermagem aos familiares de pacientes com diagnóstico de morte encefálica. Métodos: estudo qualitativo com aporte teórico e metodológico na Teoria Fundamentada nos Dados (TFD). O cenário do estudo foi a Unidade de Terapia Intensiva de um hospital referência no cuidado ao paciente em morte encefálica e na doação de órgãos e tecidos no Sul do Brasil. A coleta de dados ocorreu de setembro a novembro de 2014, compondo a amostragem teórica 23 participantes distribuídos em três grupos amostrais. Resultados: os fatores intervenientes identificados foram: os familiares não possuíam clareza acerca do diagnóstico de morte encefálica e, consequentemente, de todo o processo de doação de órgãos e tecidos. O reconhecimento desses fatores evidencia a Enfermagem como profissão e ciência indispensável nesse contexto. A Comissão Intra-Hospitalar de Doação de Órgãos e Tecidos para Transplantes é um recurso importante para a instrumentalização da Enfermagem, no cuidado e abordagem dos familiares de pacientes com diagnóstico de morte encefálica. Conclusão: o reconhecimento desses fatores pelo enfermeiro pode orientar e otimizar a prática clínica de enfermagem nesse contexto, contribuindo para processos mais ágeis, seguros e assertivos.

Entrepreneurial Nursing interventions for the social emancipation of women in recycling

ABSTRACT Objective: To implement and signify entrepreneurial interventions in Nursing, with a view to the social emancipation of women working in an Association of Recyclable Materials. Method: Action-research with an intervention process based on an action alluding to Mother’s Day, carried out in a pandemic period, with the participation of 28 women from a Recycling Association. Results: The reflexive thematic analysis, which enabled the systematic recording of ideas, insights and the meanings of the intervention, gave rise to two categories: From apparent isolation to professional reinvention and from invisibility to dignity and the feeling of social equality. Conclusion: The interventions carried out in an Association of Recyclable Materials in a pandemic period provided, for its female workers, a sense of life, survival, dignity and empowerment, when they expected little or nothing. Enabling a social identity for the women of a Recycling Association implies, in short, overcoming linear interventions focused on assistance.

O cuidado de enfermagem como fenômeno sistêmico e empreendedor

The objective is to produce a critical-reflexivity analysis of nursing care, from the perspective of complexity thinking and social entrepreneurship. Theoretical-reflective study, supported by the framework of complexity thinking and social entrepreneurship. The main characteristics that lead and support nursing care are analyzed from a systemic-entrepreneurial perspective. A parallel is conceived between vertical care, design from a hierarchical structure and nursing care in the systemic-entrepreneurial perspective, which leads to singularity, originality, circularity, complementarity and interactivity. The centrality of nursing care is reaffirmed as a tangible social good or not. Theoretical reflection on nursing care as a systemic and entrepreneurial phenomenon raises a unique and multidimensional perception of the human being/user, health, the nursing work process, in order to achieve an increasingly agile, dynamic, circular, complementary and interdependent care.

Empreendedorismo e educação empreendedora no contexto da pós-graduação em enfermagem

RESUMO Objetivo Compreender o empreendedorismo e a educação empreendedora no contexto da pós-graduação em enfermagem. Método Estudo qualitativo, do tipo Teoria Fundamentada nos Dados. A amostragem teórica foi composta por 15 estudantes de mestrado e doutorado e sete docentes de um programa de pós-graduação em enfermagem de uma Universidade do sul do Brasil. Realizaram-se entrevistas individuais entre agosto/2018 e fevereiro/2019 em local definido pelos participantes, em geral a Universidade. Os dados foram coletados e analisados simultaneamente por codificação inicial e focalizada. Resultados Emergiram três categorias e 11 subcategorias que, interrelacionadas, representaram o fenômeno “Vislumbrando o empreendedorismo e a educação empreendedora na pós-graduação em enfermagem”. Conclusão O empreendedorismo e a educação empreendedora, no contexto da pós-graduação em enfermagem, foram compreendidos como processos incipientes e promissores. Nesse sentido, é preciso que se intensifiquem estudos para demostrar as possibilidades empreendedoras da área.

Gestão do cuidado em enfermagem na proteção radiológica em radiologia intervencionista

RESUMO Objetivo: Refletir sobre os elementos da gestão do cuidado em enfermagem na proteção radiológica em radiologia intervencionista. Metodologia: Estudo reflexivo realizado a partir de artigos e legislação nacional e internacional abordando a temática da gestão do cuidado em enfermagem e proteção radiológica em radiologia intervencionista. Resultados: A partir das concepções de gestão do cuidado em enfermagem e atuação profissional na prática vislumbrou-se como elementos dessa gestão: conhecimentos e aplicabilidade dos princípios de proteção radiológica, efeitos biológicos da radiação ionizante, monitoramento de dose ocupacional, equipamentos de proteção individual e coletiva, segurança do paciente, educação em proteção radiológica, programa de garantia de qualidade. Conclusão: A gestão do cuidado em enfermagem em proteção radiológica em radiologia intervencionista é implementada de forma incipiente no que tange aos cuidados voltados para redução de dose, seja para trabalhadores ou paciente. Torna-se necessário reconhecer, compreender e caracterizar a gestão do cuidado em enfermagem nesse cenário.

Changes implemented in the work environment of nurses in the COVID-19 pandemic

OBJECTIVE

to describe the changes implemented in the work environment of nurses in university hospitals considering the COVID-19 pandemic.

METHODS

this qualitative and descriptive research was developed from an online survey with 75 nurses from three Brazilian university hospitals. Data processing occurred through textual analysis with the aid of software IRAMUTEQ.

RESULTS

five semantic classes were obtained: Organization of units for exclusive care of patients with COVID-19; Adaptations in the use of personal protective equipment; Physical structure adaptation; Care flow institution; Increased number of beds and training courses. Final considerations: the results show the effort of healthcare and nursing professionals/managers in the development of structural adaptations and reorganizations of care processes, in the hospital context, to respond with quality and efficiency to the demands arising from the COVID-19 pandemic.

Entrepreneurship among Undergraduate Nursing Students at a public university

OBJECTIVES

to identify undergraduate nursing students' entrepreneurial tendency at a public university.

METHODS

cross-sectional study, with a quantitative approach, with 135 undergraduate nursing students from a public university in the interior of the state of Rio Grande do Sul, Brazil. Data were collected using a socio-professional characterization form and a General measure of Enterprising Tendency test and analyzed using descriptive statistics.

RESULTS

among the five entrepreneurial tendencies, students presented results equal or above average in two dimensions: Drive and Determination (82.2%) and Need for Success (51.1%). The Creative tendency was the dimension with the highest percentage of participants below the average (68.9%). However, students in research or extension groups scored equal or above average in all five entrepreneurial tendencies.

CONCLUSIONS

students showed low entrepreneurial tendencies, indicating the need for a broader approach to the subject in nursing education.

Managerial competences of researchers from Nursing research groups

Objective:

to analyze the managerial competences of researchers from research groups linked to a Graduate Program in Nursing.

Method:

a cross-sectional study with researchers from Nursing research groups, which analyzed the managerial competences by means of a Scale of Managerial Competences in Research Groups containing 50 items related to people management and research results (Factor 1) and resource provisioning and people management (Factor 2), with answers 4 and 5 considered as sufficient dexterity for each competence analyzed. For data analysis, logistic regression was used.

Results:

of the 219 participants evaluated, the prevalence was 48.86% of sufficient dexterity for factor 1 and 32.88% of sufficient dexterity for factor 2; with 41.21% of sufficient dexterity for Managerial Competences in research groups. A significant difference was identified in the proportions of the managerial competences for schooling, age group and performance in the group (p≤0.001). There were differences in mean age, time of experience with research and participation in the research group (p≤0.001), between the participants with sufficient and insufficient dexterity for the managerial competences.

Conclusion:

the results obtained in this study emphasize the potential of the research groups for the development of managerial competences of Nursing researchers, especially for people management.

Nursing Now and Nursing in the future: the experience of the unexpected irruptions

Objective:

to carry out a theoretical reflection on the Nursing Now Campaign and the experience of the unexpected irruptions facing the pandemic period.

Method:

a theoretical-reflective study, supported by the theoretical framework of complexity thinking. It aims at understanding the dialogic between the notions of order, disorder and organization, which translate the transition from simplification to complexity of the pandemic phenomenon and its relation to the theme of Nursing Now and Nursing in the future.

Results:

the universe of phenomena is simultaneously composed of order, disorder and organization. Reasserting the central role of Nursing in the health team, facing the irruptions and uncertainties caused by the current pandemic, implies the ability to dialog with disorder and raise a new and more complex global (re)organization of the being and doing Nursing.

Conclusion:

in addition to answers, theoretical reflection raises new questions and irruptions. The inseparability between the notions of order and disorder in the evolutionary dynamics of the Nursing system is conceived and the promotion of even more complex levels of organization, management and Nursing assistance to achieve universal access to health is advocated.

Work environment of hospital nurses during the COVID-19 pandemic in Brazil

AIM

To investigate the nurses' work environment in university hospitals during the COVID-19 pandemic in Brazil.

BACKGROUND

The COVID-19 pandemic brought challenging times for nurses worldwide. In Brazil, as well as in several countries, nurses are working hard in hospital settings caring for patients infected with the virus, sometimes with unfavourable work environment conditions.

METHODS

This study was a convergent embedded mixed methods research. The sample comprised 104 nurses from three Brazilian university hospitals. Data were collected in April-June 2020 from an online questionnaire with a self-reporting Likert scale survey designed to measure the nurses' perceptions of their work environment. Qualitative data in the form of written comments were also collected through an open question. Data were analysed using descriptive statistics and content analysis.

RESULTS

The quantitative results showed that the responses to 'I received training on the correct use of personal protective equipment' and 'I am afraid of being infected' items had the best and worst evaluations, respectively. The qualitative findings revealed five themes: feeling of insecurity, lack of personal protective equipment, lack of diagnostic tests, changes in the care flow and fear of the unknown.

CONCLUSION

The study has highlighted the challenges faced by hospital nurses while caring for patients with COVID-19.

IMPLICATIONS FOR NURSING AND NURSING POLICY

The gaps identified will assist the policymakers and hospital managers in developing policies to enhance the support offered to nurses and improve the care provided to patients with COVID-19 in university hospitals. The results also indicate the need for attention to the mental health of the professionals due to the increasing workload and treatment of an illness hitherto unknown.

The entrepreneurial nursing care inducing healthy practices in vulnerable communities

OBJECTIVE

To understand the meaning of entrepreneurial nursing care as inducer of healthy practices in vulnerable communities.

METHOD

Grounded theory, whose data collection took place between March and December 2019, from interviews with 19 participants from the central region of Rio Grande do Sul, Brazil and comparative data analysis.

RESULTS

The phenomenon was delimited: Experiencing small/big transformations in the invisibility of everyday life in promoting healthy practices in vulnerable communities. Conducted by the paradigmatic model, the categories were named based on the components: Condition: Making choices and negotiating non-negotiable exchanges; Action/interaction: Motivating oneself to maintain basic human needs; Consequence: Broadening perspectives and transcending personal and collective boundaries.

CONCLUSION

Entrepreneurial nursing care as inducer of healthy practices in vulnerable communities is not reduced to a scientific theory or to the linear and decontextualized apprehension of healthy living, but extends to reach small/big transformations that occur in the invisibility of everyday life.

Tecnologia da informação e comunicação na gestão de grupos de pesquisa em enfermagem

Resumo Objetivo este estudo teve como objetivo compreender como as Tecnologias da Informação e Comunicação são utilizadas na gestão de grupos de pesquisa de enfermagem. Método trata-se de uma pesquisa qualitativa ancorada teórica e metodologicamente na Teoria Fundamentada nos Dados (perspectiva straussiana), tendo como cenário de estudo 14 grupos de pesquisa vinculados a um Programa de Pós-Graduação em Enfermagem. A amostragem teórica do estudo foi composta por 21 pesquisadores. Os dados foram coletados por meio de entrevistas e analisados a partir do sistema de codificação. Resultados as Tecnologias de Informação e Comunicação são utilizadas pelos grupos de pesquisa para facilitar os processos de gestão e o desenvolvimento das pesquisas. Dividem-se em três funções principais: comunicação e armazenamento (Whatsapp® e e-mail), estratégias de visibilidade (site e mídias sociais) e estratégia operacional (software de análise de dados). Conclusão e implicações para a prática as Tecnologias de Informação e Comunicação constroem um elo entre a tecnologia e a construção do conhecimento científico, tecnológico e de inovação. Os Grupos de Pesquisa podem intensificar ainda mais o uso dessas ferramentas, tanto para recrutamento de amostra como para o desenvolvimento de redes colaborativas de pesquisa.

ACADEMIC GRADUATE PROGRAM IN NURSING AT UFSC: TECHNOLOGICAL, POLITICAL, SOCIAL AND ECONOMIC IMPACTS

ABSTRACT Objective: to discuss the different impacts - technological, political, social and economic - of Graduate Program in Nursing at the Universidade Federal de Santa Catarina, problematizing their indicators and their adequacy to the field of Nursing and Health, according to the genesis and nature of Nursing care, the Nursing science and its interfaces with other fields of knowledge. Method: a study conducted in July 2021 based on documentary sources extracted from an institutional form, for evaluating graduates and annual reports of the Program in the period between 2011 and 2020. The documentary data were submitted to descriptive analysis. Results: the technological, political, social and economic impacts and their respective indicators are presented as proposed by the Coordination for the Improvement of Higher Level Personnel for the evaluation of graduate programs. The evaluation of the impacts of graduate education in Nursing indicated that it represents a challenge to be faced, given the difficulties identifying quantitative and qualitative evidence allowing such verification. Conclusion: important impacts of the Program are evidenced; however, the indicators and respective criteria are questioned regarding the best adequacy and completeness to the field of Nursing and Health, according to the genesis and nature of Nursing care, the Nursing science and interfaces with the other fields of knowledge. Therefore, it is urgent to invest in studies and to propose indicators and criteria to evidence the real impact of the Graduate Programs in Nursing on society.

Contributions of Florence Nightingale as a social entrepreneur: from modern to contemporary nursing

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.

Professional interaction in management of the triad: Permanent Education in Health, patient safety and quality

Objective:

to understand how professional interaction takes place in the hospital organizational structure for the management of Permanent Education in Health, to guarantee patient safety and the quality of nursing care.

Method:

this is a qualitative study, which used the structuralist aspect of the Grounded Theory as a methodological framework. 27 interviewers participated in the study, who made up four sample groups.

Results:

six categories and 13 subcategories were presented, representing the studied phenomenon and highlighting particularities of the public health system and the influence of the manager’s support and management priority, the disposition of the organizational structure, the institutional culture, the external encouragement to institution, and the nurses’ initiative and leadership in the professional interaction for the management of the Permanent Education in Health, patient safety, and quality of care triad, revealing the need for cultural change through interdisciplinarity.

Conclusion:

the professional interaction in the hospital organizational structure requires the creation of new management models with an emphasis on more participative management, in order to improve the care processes in hospital institutions.

University educational management and clinical practice applied to nursing by the faculty of a public university

OBJECTIVE

to emphasize university educational management actions and their articulation to develop clinical practice in nursing training, designed by its faculty.

METHODS

a single-case study with qualitative approach. The sources were composed of documentary research, focused interview with key informant and direct non-participant observation. Data were organized with the help of NVivo®10. Analysis followed the explanation construction technique from the perspective of complex thinking.

RESULTS

three categories emerged: Characterization of university educational management actions; Articulation of university educational management with clinical practice and its repercussion; and Spaces to develop university educational management and clinical practice. Final considerations: university educational management actions are associated with the work of professors, supporting teaching, research, and extension in order to improve clinical knowledge in the general nursing training.

Limitations and possibilities in university management performed by nursing managers

OBJECTIVE

Understand limitations and possibilities in university management performed by nursing managers of the undergraduate nursing course of a public university.

METHOD

A qualitative study with theoretical and methodological framework anchored in the Grounded Theory. Data collection took place between May and September 2016, and the studied scenario was the Nursing Department of a public university in southern Brazil.

RESULTS

The entrepreneurial profile and the leadership in interpersonal relations were highlighted among the possibilities, in addition to the co-responsibility in raising public resources to solve the university educational demands; as limitations, the scarcity of financial resources and the high demand for bureaucratic activities which have repercussions on the slowness of university public management processes.

CONCLUSION

The nursing manager experiences limitations through their actions and interactions with people, and recognizes possibilities in the structure and processes of coordinating issues of collective interest in the university educational context.

Prevalence and Factors Associated with Burnout Syndrome among Primary Health Care Nursing Professionals: A Cross-Sectional Study

The objective of the study was to evaluate the prevalence and factors associated with Burnout Syndrome (BS) in Primary Health Care (PHC) nursing professionals from the state of Bahia, Brazil. A multicentre, cross-sectional population-based study was conducted in a cluster sample among 1125 PHC Nursing professionals during the years 2017 and 2018. We used a questionnaire that included sociodemographic, labor and lifestyle variables and the Maslach Burnout Inventory scale to identify BS. The associations were evaluated using a robust Poisson regression with the hierarchical selection of the independent variables. The prevalence of BS was 18.3% and the associated factors were ethnicity (prevalence ratio (PR) = 0.62, confidence interval (CI) 95% = 0.47–0.83), residence (PR = 2.35, CI 95% = 1.79–3.09), economic situation (PR = 1.40, CI 95% = 1.06–1.86), satisfaction with current occupation (PR = 1.75, CI 95% = 1.31–2.33), (PR = 1.60, CI 95% = 1.23–2.08), rest (PR = 1.83, 95% CI = 1.41–2.37), technical resources and equipment (PR = 1.37, CI 95% = 1.06–1.77), night shift (PR = 1.49, CI 95% = 1.14–1.96), physical activity practice (PR = 1.72; CI 95% = 1.28–2.31), smoking (PR = 1.82, CI 95% = 1.35–2.45), and satisfaction with physical form (PR = 1.34, CI 95% = 1.01–179). Strategies are needed to prevent BS, with an emphasis on implementing worker health programs in the context of PHC.

EMPOWERMENT OF NURSES FROM A HOSPITAL IN THE SOUTH OF CHILE

ABSTRACT Objective: to identify the level of empowerment among the nurses from a hospital located in the south of Chile and verify its potential association with personal and professional characterization variables. Method: cross-sectional and descriptive study conducted with 117 nurses from a hospital in the south of Chile. Data were collected in 2018 using a personal and professional characterization form and the Spanish version of the Conditions of Work Effectiveness Questionnaire II. Data were analyzed using descriptive and inferential statistics. Results: the means of the factors of the empowerment scale were: Opportunity (4.11±0.82); Information (3.81±0.90); Support (3.81±0.86), and Resources (3.13±0.97). Statistically significant differences were found between empowerment and having greater professional experience, working in the medical-surgical unit, having from 3 to 10 patients under responsibility, job satisfaction, and intention to quit their jobs. Conclusion: the nurses reported a positive perception of empowerment in their roles, especially concerning having opportunities to perform tasks that contribute to acquiring new knowledge and skills at work.

CORRELAÇÃO ENTRE MARCADORES DE VULNERABILIDADE SOCIAL FRENTE AO USO DO PRESERVATIVO POR TRABALHADORAS SEXUAIS

Objetivou-se analisar a correlação entre os marcadores de vulnerabilidade social com o uso do preservativo entre trabalhadoras sexuais. Estudo quantitativo, inferencial e de corte transversal realizado com 138 mulheres no sertão produtivo da Bahia, em abril de 2017. Foi utilizado o software SPSS, versão 22.0, para a realização dos testes estatísticos r de correlação, p de Pearson e Teste-t student; adotou-se o nível de significância de 5%. O teste r apontou correlação do uso de preservativo entre as mulheres com idade, cor autodeclarada e o tempo de serviço. No teste p de Pearson, a idade relacionada ao uso do preservativo, o resultado foi negativo, o Teste-t resultou em duas amostras r e p com variâncias equivalentes. As três correlações estabelecidas entre os marcadores de vulnerabilidade social e o uso de preservativo pelas trabalhadoras sexuais são significantes; ressalta-se que o nível de escolaridade não influenciou na adesão ao uso do preservativo.

Learning experiences in community health of nursing students

OBJECTIVE

Understand the learning experiences on health promotion and prevention of nursing interns during their community practice.

METHOD

This is a descriptive-interpretative study, with a qualitative approach, obtaining data from 19 nursing interns from a public university in Lima-Perú, using 3 focus groups.

RESULTS

Three categories were structured: considering the importance of the nursing teacher in their training; experiencing complexity in training for the prevention and promotion of health in the community; and considering the preventive-promotional area as a future professional practice.

FINAL CONSIDERATIONS

The students perceived the complexity of community practice in the prevention and promotion of health. They stated that teachers and students should know the context where they develop their practices and that teacher's exercise leadership in the community. The inclination of some nursing interns for their future professional practice in this area was also evident.

Resources and competencies for management of educational practices by nurses: integrative review

OBJECTIVE

To know the resources used and the necessary skills to the nurse for the management of educational practices in health services.

METHOD

This is an integrative literature review, carried out in the Latin American and Caribbean databases on Health Sciences Information (BIREME), PubMed Central (PMC), Scopus and Web of Science (WoS). After analysis resulted in 18 studies, published between the period 2011 to 2017, which were presented in three categories.

RESULTS

The results were presented in the categories: instrumental resources used in health education, technological resources applied to educational practices and competencies for management of educational practices.

CONCLUSION

This study brings as a contribution to the practice of nurses subsidies for the development of management of educational practices in health services through technological and instrumental resources and professional skills that aim at team development, user autonomy and institutional growth.

Contributions of the nurse's clinical practice to Primary Care

OBJECTIVE

To understand the repercussions of the nurse's clinical practice on Primary Health Care.

METHOD

Qualitative research with the theoretical and methodological contribution of Grounded Theory. Data collection took place between May and October 2016 in Florianópolis' Primary Care service. The theoretical sample was comprised of 18 nurses divided into two groups.

RESULTS

nurses' clinical practice has repercussions on the consolidation of the trust bond between individuals, families and communities, by amplifying the problem-solving efficacy of the Primary Health Care professional's clinical practice. This is due to the implementation of clinical nursing protocols, and also the use of the International Classification for Nursing Practice.

FINAL CONSIDERATIONS

Nurses' clinical practice has positive repercussions on the health of Primary Health Care users.

Management of prenatal nursing care at a Health Center in Angola

OBJECTIVE

To understand how care management in prenatal care in a Care Center in Angola happens.

METHOD

A qualitative study, which used the Constructivist Grounded Theory (GT) as a methodological framework. The theoretical sample consisted of 22 participants, including nursing professionals, pregnant women and nursing students from Huambo, Angola. The data were collected by interviews and analyzed according to initial and focused coding.

RESULTS

Five categories arose: Embracing the pregnant woman for prenatal care; Performing the prenatal consultation; Creating a bond and dialogical relationship with pregnant women; Establishing collaborative working relationships; and Inserting the pregnant woman's family into prenatal care.

CONCLUSION

The management of nursing care in the study setting is effective through complementary and interdependent steps, based on collaborative relationships among professionals and in the effort to establish bonds with pregnant women and their families.

CONTEXTO DA VIOLÊNCIA CONJUGAL EM TEMPOS DE MARIA DA PENHA: UM ESTUDO EM GROUNDED THEORY

Objetivo: desvelar o contexto da violência conjugal experienciados por mulheres em processo judicial. Método: pesquisa qualitativa baseada na Grounded Theory, realizado com 29 mulheres em processo judicial por violência conjugal e os nove profissionais que atuam junto a duas Varas de Justiça pela Paz em Casa, na Bahia, Brasil. A coleta dos dados foi realizada no período de janeiro a maio de 2015. Resultados: em que pese a Lei Maria da Penha, o estudo revela que as relações conjugais das mulheres são permeadas por abusos físicos, sexuais, psicológicos, morais e patrimoniais, inclusive expulsão do lar. Conclusão: o contexto de violência experienciado na conjugalidade feminina se manifesta de diferentes formas, passíveis de identificação por profissionais de saúde, o que possibilita ação de cuidado à mulher e enfrentamento da problemática.

Entrepreneurship in Nursing: an integrative literature review

ABSTRACT Objective: To demonstrate in the national and international literature the concept and typologies of entrepreneurship in Nursing. Method: Integrative review in six databases, with the descriptors entrepreneurship, entrepreneurs, entrepreneurial, entrepreneurialism, intrapreneurial, iniciativa empresarial, contrato de risco, nursing, nurse, nurses, enfermagem and enfermeira, making a final sample of 31 articles. Results: The concept of entrepreneurship in Nursing is related to personal and professional characteristics, such as autonomy, independence, flexibility, innovation, proactivity, self-confidence and responsibility. The typologies found were: social and business entrepreneurship, and intrapreneurship. Social entrepreneurship is a mechanism of social mobilization and transformation, entrepreneurship is one in which nurses are autonomous professionally and intrapreneurship relates to corporate entrepreneurs. Conclusion: Entrepreneurship can increase the visibility of the profession and foster the creation of new spaces for nurses.

BEST PRACTICES IN NEONATAL NURSING CARE MANAGEMENT

ABSTRACT Objective: to build a theoretical matrix of care system/organization of Nursing in a Neonatal Intensive Care Unit based on the meanings attributed by the Nursing Team professionals and other involved actors in the relationships and interactions of care in dealing with the fragility of living/surviving newborn. Method: a qualitative study adopting the theoretical framework the Complexity Paradigm and the Grounded Theory as research design. The participants were 22 subjects divided into four sample groups. Data was obtained from interviews and analyzed through comparative analysis, performed from May to August 2012. Results: nursing care practices management is based on the experience of the relationships/interactions with the family members and other health team actors, aiming to incorporate best practices. Thus, nursing care practices management seeks to address the fragility that surrounds prematurity, minimizing the sequelae when seeking newborn’s survival. Conclusion: the organization of nursing care system in a Neonatal Intensive Care Unit is complex, dynamic, interactive and interdependent with other health systems, mobilized by a management process of care and/or good care management practices that enables pre-term and his family a care focused on the fragility and uncertainties of living/surviving in singular conditions of life. The nurse stands out with the fundamental role of articulation in the light of the relationships/interactions in the care and organizational daily routine.

THE BREAST RECONSTRUCTION PROCESS OF WOMEN WITH BREAST CANCER: A THEORETICAL MODEL

ABSTRACT Objective: to build a theoretical model on the experience and meaning of the breast reconstruction process in women with breast cancer. Method: a qualitative research using Grounded Theory and Symbolic Interactionism as theoretical-methodological frameworks. Data collection and analysis occurred simultaneously, from April to October 2015, through theoretical sampling and theoretical saturation of the categories. Theoretical sample with 31 participants, 21 women and 10 health professionals, interviewed at home or at work, comprising four sample groups. Results: the theoretical model “Women face challenges and overcome difficulties: fear of death, breast mutilation and breast reconstruction, changing the way of being a woman” offers an explanation of the phenomenon and emerged from the systematic interrelation of the 11 study categories, with three causal categories, one category representing the context, five categories of intervening conditions, the strategies and the consequences represented by one category each. Conclusion: this study demonstrates the experience of the breast reconstruction process for women with breast cancer, the meaning of overcoming difficulties, value life and oneself, putting themselves first, taking care of themselves and learning to change, to be more tolerant, to value material things less and to face life with courage and faith. It also indicates that research on theoretical models on issues that plague our professional practices can enhance teaching and science and, consequently, improve care in women's health.

BREAST RECONSTRUCTION FROM THE PERSPECTIVE OF WOMEN SUBMITTED TO MASTECTOMY: A META-ETNOGRAPHY

ABSTRACT Objective: to analyze qualitative studies published in the national and international scientific literature on breast reconstruction after mastectomy for breast cancer, from the perspective of women. Method: systematic literature review using meta-ethnography, where the synthesis of knowledge is based on the induction and interpretation of the data found. Searches in the electronic databases identified 65 studies. 27 studides meet the inclusion and exclusion criteria. 13 studies compressed the analytical corpus of the review, according to the Critical Appraisal Skills Programme checklist. The data were synthesized by means of the meta-ethnographic approach. Results: the analyzed studies showed similarities regarding the women´s decision to perform breast reconstruction, the difficulty of choosing the type of surgery and to deal with the experience of the reconstruction, and that the women had difficulties in establishing relationships with certain health professionals, especially with doctors. They refer to the ambivalence of feelings regarding the expectations and results of breast reconstruction and complex process of "carrying on". Conclusion: this review synthesizes the scientific knowledge regarding women's perspective regarding the breast reconstruction process and highlights that health professionals must understand the perceptions of women undergoing mastectomy and breast reconstruction in order to improve the care provided.

Good practices for patient safety in the operating room: nurses' recommendations

OBJECTIVE

To describe nurses' recommendations for good patient safety practices in the operating room.

METHOD

Quantitative, descriptive and exploratory research developed from an online survey of 220 operating room nurses from different regions of Brazil. The data processing for textual analysis was performed by the software IRAMUTEQ.

RESULTS

There were eight recommendations: (1) Involvement of the multiprofessional team and the managers of the institution; (2) Establishment of a patient safety culture; (3) Use of the safe surgery checklist; (4) Improvement of interpersonal communication; (5) Expansion of nurses' performance; (6) Adequate availability of physical, material and human resources; (7) Individual search for professional updating; and (8) Development of continuing education actions.

CONCLUSION

These recommendations can be used as care management strategies by nurses for patient safety in the operating room.

REVASCULARIZAÇÃO MIOCÁRDICA: REFERÊNCIA E CONTRARREFERÊNCIA DO PACIENTE EM UMA INSTITUIÇÃO HOSPITALAR

RESUMO Objetivo: compreender o processo de referência e contrarreferência vivenciado pelo paciente com coronariopatia submetido à cirurgia de revascularização do miocárdio. Métodos: pesquisa qualitativa, ancorada na Teoria Fundamentada nos Dados. O cenário da pesquisa foi uma instituição hospitalar pública, referência em atendimento cardiovascular no Estado de Santa Catarina (Brasil). A coleta de dados ocorreu entre março de 2013 a junho de 2014, por meio de entrevista semiestruturada envolvendo 21 participantes, distribuídos em três grupos amostrais (pacientes, profissionais de saúde e profissionais gestores). Resultados: o processo de referência e contrarreferência aponta o fenômeno “Emergindo a alta complexidade como referência para a pessoa submetida à revascularização miocárdica diante da fragilidade da Atenção Primária à Saúde no acompanhamento e articulação com os demais níveis de atenção no Sistema Único de Saúde”, sustentado por cinco categorias. Conclusão: para que a referência aconteça há necessidade de consolidar o vínculo do paciente com coronariopatia com a atenção primária à saúde, uma vez que este encontra dificuldades no acompanhamento da sua condição na rede pública. Na contrarreferência evidenciou-se a desarticulação entre os serviços de atenção à saúde, a qual afeta o cuidado à pessoa submetida à revascularização miocárdica na manutenção da sua qualidade de vida.

Referral and counter-referral: repercussions of coronary artery bypass graft in the perspective of Primary Care

OBJECTIVE

to understand how repercussions of the referral and counter-referral of patients with indication/submitted to Coronary Artery Bypass Graft Surgery in the context of Primary Health Care.

METHOD

qualitative research with a theoretical-methodological contribution anchored in the Grounded Theory. Theoretical sampling was performed with 41 participants, divided into three sample groups (patients, health professionals and managers) in the Metropolitan Region and Western Region of Santa Catarina State.

RESULTS

the need for improvement in the process of recording clinical data in the regulation system emerged to strengthen patient referral; and the absence of a formal process of counter-referral and adaptation of lifestyle with repercussion in the counter-referral.

FINAL CONSIDERATIONS

the repercussions of the referral and counter-referral of patients with indication/submitted to the CABGS in the context of Primary Care are experienced through professional guidance and, in particular, by family support.

Myocardial revascularization: factors intervening in the reference and counter-reference in the hospital setting

OBJECTIVE

To understand the intervening factors in the process of reference and counter-reference of the individual with heart disease in the scenario of high complexity in the health care network.

METHOD

Research anchored in the Grounded Theory (Teoria Fundamentada nos Dados). It totaled 21 participants. The data collection scenario was a cardiovascular reference hospital in the south of Brazil and occurred between March and June 2014.

RESULTS

The intervening factors in the reference process were the difficulty to access the points of the network and telemedicine and the central to manage the flow of patients in the network. In the counter-reference, there was a link with the hospital and the lack of communication among network professionals.

CONCLUSION

It reveals the need to reorganize the service flow in HCN, enhancing PHC, expanding the performance of medium complexity and increasing the capacity of high complexity in order to carry out the process of reference and counter-reference.

Care management of a patient with Devic's Disease in Primary Health Care

OBJECTIVE

Describing the care management of a patient affected by Devic's Disease in the Primary Health Care setting.

METHOD

A clinical-qualitative case study based on the health status of a Devic's Disease patient in a Health Center of the municipality of Florianópolis, accompanied by the Family Health Team. Data collection was carried out by electronic medical records, documents of the patient's domain, as well as a semi-structured interview with the participant. Ethical aspects of research involving human beings were respected.

RESULTS

The categories were defined according to relevance criteria with the purpose of reporting the case study, presenting a unique implemented therapeutic project and describing the patient's perception of her situation.

CONCLUSION

Acupuncture and auriculotherapy were successfully performed, evidencing an improvement in the patient's pain, which may contribute to new possibilities of care. Despite this, not all the available care tools were implemented, considering the range of complementary care therapies that go beyond the medicinal approach.

Meaning of nursing care to brain dead potential organ donors

OBJECTIVE

To understand the meanings of care to brain dead potential organ donors for nurses, and construct a theoretical model.

METHOD

Qualitative study based on the Grounded Theory approach. Data were collected through open interviews with 12 nurses, distributed in three sample groups in a university hospital in northeastern Brazil, from December 2010 to June 2011.

RESULTS

The phenomenon Unveiling multiple relationships and interactions of nurses in the complexity of patient care in brain dead potential donors is supported by the interrelationship of five categories and results from the need to organize care practices in the context of the intensive care unit, considering the factors involved in the relationship between nurses, staff and family and reveals challenges for nurses imposed by the complexity of the care process.

CONCLUSIONS

The meaning of care to brain dead potential donors involves understanding the complexity of this patient who can save somebody's life through organ donation.

SEPSISCARE: AVALIAÇÃO DE APLICATIVO MÓVEL NO CUIDADO DE ENFERMAGEM AO PACIENTE COM SEPSE*

Objetivo: Avaliar um aplicativo móvel para a prevenção, identificação e cuidados de enfermagem ao paciente séptico. Método: Estudo descritivo que utilizou o Processo de Desenvolvimento de Produtos como método para desenvolvimento do aplicativo. Participaram do estudo seis enfermeiras da Unidade de Terapia Intensiva de um hospital público de Santa Catarina. A coleta dos dados ocorreu por meio de entrevistas nos meses de setembro de 2016 a janeiro de 2017, e utilizou-se a análise de conteúdo para análise dos dados. Resultado: O aplicativo SepsisCare foi desenvolvido na plataforma Mobincube®, com 28 telas, que na concepção dos enfermeiros é um recurso importante para a prática do enfermeiro no cuidado ao paciente com sepse. Conclusão: Acredita-se que o desenvolvimento deste aplicativo móvel facilitará a identificação, prevenção e gerência dos cuidados em torno da sepse, e contribuirá para a atualização desses profissionais, possibilitando, assim, um atendimento mais seguro e de qualidade.

University management nurse: a grounded theory

OBJECTIVE

to understand the meaning of the university management performed by nurses managers of the nursing undergraduate course of a public university.

METHOD

this is a qualitative research, based on the grounded theory. Data collection took place between May and September 2016, with open interviews, in the scenario of a federal public university. The technique of constant comparative analysis of the data was followed, obtaining a theoretical sample with 19 nurses, in two sample groups.

RESULTS

there were three categories emerged that shaped the phenomenon: Articulating complex collectives through university management for the qualified training of new nurses. The categories included: a) conditions, defined by perceiving the commitment to the collective, previous experiences, and training for health management, as motivations to be a teacher manager; b) actions/interactions, delimited by Knowing and recognizing, in practice, the university management process, limits and possibilities in the coordination of complex collective subjects; and, c) consequences, such as Improving teaching work and taking responsibility for university education.

CONCLUSION

the nurses teaching managers to explain university management as a set of individual and collective actions that, articulated in a complex social environment, promote conditions for the training of critical and reflexive nurses with the demands of society.

DESVELANDO O SIGNIFICADO DA EXPERIÊNCIA VIVIDA PARA O SER-MULHER NA AMAMENTAÇÃO COM COMPLICAÇÕES PUERPERAIS

RESUMO Objetivo: compreender o significado da experiência vivida para o ser-mulher na amamentação com complicações puerperais. Método: estudo qualitativo, de natureza fenomenológica, sustentado na fenomenologia da percepção e na hermenêutica. A coleta de dados ocorreu em duas maternidades da Região Nordeste do Brasil, por meio de entrevistas em profundidade com 28 puérperas, de fevereiro a outubro de 2014. A análise dos dados compreendeu: leitura das descrições, identificação das unidades temáticas e dos temas essenciais. Resultados: da análise das descrições emergiu como significado central: amamentar é mais importante do que a situação vivenciada na complicação puerperal, e como temas essenciais: percebendo o apoio da família e sentimentos percebidos ao vivenciar a amamentação com complicação. Conclusão: o estudo oportunizou compreender que a amamentação vivenciada pelo ser-mulher com complicação puerperal é composta por um conjunto de significados, e o conhecimento destes pelos profissionais de saúde, poderá contribuir para um cuidado mais integral.

Cirurgia de revascularização do miocárdio: características da internação e alterações relacionadas ao tempo de internação

O estudo teve como objetivo identificar as características da internação e alterações apresentadas por indivíduos submetidos à Cirurgia de Revascularização do Miocárdio e sua associação com tempo de internação para cirurgia. Estudo epidemiológico observacional e transversal, realizado entre março de 2013 a março de 2014, com 99 indivíduos submetidos à Cirurgia de Revascularização do Miocárdio.  Verificou-se que dor no peito e angina/dor torácica identificados no pré-operatório e insuficiência respiratória, hipertermia, Hipertensão Arterial Sistêmica e arritmias apresentadas no pós-operatório foram preditores para maior tempo de internação. A associação entre as características da internação e as alterações clínicas com o tempo de Internação de indivíduos submetidos à Cirurgia de Revascularização do Miocárdio fornecem subsídios para atuação do enfermeiro e demais profissionais de saúde e gestores, a fim de criar estratégias para detecção precoce de intercorrências relacionadas à Cirurgia de Revascularização do Miocárdio.