Avaliação do cuidado de enfermagem na perspectiva da segurança do paciente em unidades de terapia intensiva: na visão de profissionais, pacientes e familiares

Technological advances combined with healthcare assistance bring increased risks related to patient safety, causing health institutions to be environments susceptible to losses in the provided care. Sectors of high complexity, such as Intensive Care Units have such characteristics highlighted due to being spaces designed for the care of patients in serious medical condition, when the use of advanced technological devices becomes a necessity. Thus, the aim of this study was to assess nursing care from the perspective of patient safety in intensive care units. This is an evaluative research, which combines various forms of data collection and analysis in order to conduct a deepened investigation. Data collection occurred in loco, from April to July 2014 in hospitals equipped with adult intensive care unit services. For this, a checklist instrument and semi-structured interviews conducted with patients, families, professionals were used in order to evaluate the structure-process-outcome triad. The instrument for nursing care assessment regarding Patient Safety included 97 questions related to structure and processes. Interviews provided data for outcome analysis. The selection of interviewees/participants was based on the willingness of potential participants. The following methods were used to collect data resulting from the instrument: statistical analysis of inter-rater reliability measure known as kappa (K); observations from judges resulting from the observation process; and added information obtained from the literature on the thematic. Data analysis from the interviews was carried out with IRAMUTEQ software, which used Descending Hierarchical Classification and Similarity analysis to aid in data interpretation. Research steps followed the ethical principles presented by Resolution No. 466 of December 12, 2012, and the results were presented in three manuscripts: 1) Evaluation of patient safety in Intensive Care Units: a focus on structure; 2) Health evaluation processes: a nursing care perspective on patient safety; 3) Patient safety in intensive care units: perception of nurses, family members and patients. The first article, related to the structure, refers to the use of 24 items of the employed instrument, showing that most of the findings were not aligned with the adequacy standards, which indicates poor conditions in structures offered in health services. The second article provides an analysis of the pillar of Processes, with the use of 73 items of the instrument, showing that 50 items did not meet the required standards for safe handling due to the absence of adequate scientific guidance and effective communication in nursing care process. For the third article, results indicate that intensive care units were safe places, yet urges for changes, especially in the physical structure and availability of materials and communication among professionals, patients and families. Therefore, our findings suggest that the nursing care being provided in the evaluated intensive care units contains troubling shortcomings with regards to patient safety, thereby evidencing an insecure setting for the assistance offered, in addition to a need for urgent measures to remedy the identified inadequacies with appropriate structures and implement protocols and care guidelines in order to consolidate an environment more favorable to patient safety.

Avaliação clínica e da qualidade de vida utilizando dois protocolos para recuperação miofuncional em pacientes que se submeteram à cirurgia ortognática: resultados preliminares

The objective of this randomized, blind and prospective clinical trial was to compare the pain, the edema, the mandibular movements, the masticatory efficiency and life quality, in the first 60 days after surgery using 2 different clinical protocols for myofunctional recovery, in patients who underwent orthognathic surgery. A sample of 19 patients was used and divided into 2 groups. The control group (CG) consisted of 10 patients who had postoperative rehabilitation guided by a standard protocol, conducted by the Service of Surgery and Traumatology Oral and Maxillofacial. In other hand, the experimental group (EC) totaled 9 patients who received the speech therapy rehabilitation protocol specialized, by professionals in the area. The variables pain, edema and mandibular movements were analyzed during 48h, 96h, 7 days, 14 days, 30 and 60 days post-surgery. The masticatory efficiency and the quality of life were classified with 60 days after surgery . The data were submitted an analysis of variance, Student's t-test and Fisher's independence, at the level of 5% probability. It was identified that patients of GE have benefited in the first 14 days(p<0,001), as they have had reported less pain than those in the CG. Significant statistics differences between groups for pain parameters (after 14 days) (p=0,065), edema(p=0,063), mandibular movements(p=0,068), masticatory efficiency(p=0,630) and the impact on quality of life (p=0,813) were not observed on this study. The speech therapy protocol for myofunctional recovery (EG), although it has not obtained statistical results superiors than the CG in the general context, presents itself as a viable alternative to conventional therapy assumed by many maxillofacial surgeons, allowing the surgeon to optimize time with patients in the period postoperatively.

Responsabilidade social empresarial: uma avaliação do projeto "Escola de Informática e Cidadania" da Mineradora "Y" situada no Estado do Pará

The subject Responsibility Enterprise Social (RSE) is relatively recent in the half national academic and the world of the management businesses as practical. For the lack of socialization of experiences and clarity of concepts, shunting lines in the agreement of the subject and the conduction of the interventions occur. It was looked to inquire, in this research, the development of the project of Social Responsibility Enterprise ―School of Computer science and Citizenship‖ of a situated company in the State of Pará, objectifying to evaluate it and later to understand it. For this, one searched to describe the characteristics and structure of the School, to identify to the lines and lines of direction adopted for this Project and to identify to the influence and results of the same in the life of pupils, professors and egresses of the School. It is characterized for a study of case with qualitative boarding of descriptive character, carried through interviews structuralized in a sample of 21 divided members of the School between professors, pupils and egresses. It was used of the analysis of categorical content, having as axle for the interpretation of the data the Social Responsibility, the Digital Inclusion and the Education. The gotten results inform that the infrastructure has challenges to face, point disparities between the conception and practical of the categories characterized in the Politician-Pedagogical Project of the EIC and the influence that, exactly under limits, the life of the professors, pupils reaches and egress. One evidenced that Social action for damages of this company when come back toward this project, they had not been evidenced. For this prism, these actions had only remained in the assistencialist speech and not structural, being thus, the company is not fulfilling its paper of transforming element of the reality of its clientele and the population that lives in it s around

A cidade sem barreiras é para todos?: avaliação das condições de deslocamento no bairro da Cidade Alta, Natal/RN

In this present work, the conditions of displacements and the behaviors of the users are evaluated, face to the physical adequacies in accessibility in the inserted area in the central quadrilateral of the Quarter of Cidade Alta, in the City of Natal/RN, space clipping established by its great meaning historical and cultural. For this reason such area was a target of an integrated actions plan during the years of 1993 and 1998, with the implantation of part of the Project CIDADE SEM BARREIRAS (City without Barriers) and, later, the implementation of the Project CIDADE PARA TODOS's proposals (City for All), having as supports the constant Brazilian norms inserted into the NB9050/1994 and in the Municipal law number 4.090/92, effective ones in the period of the interventions. Considering that the carried through actions at the time were directed to the elimination of the architectural barriers to guarantee the right to go and to come, the research received a human universe formed by all the people in situation of displacement in the central area of the interventions in the quarter of the Cidade Alta, independently of their locomotive or sensorial conditions, emphasizing the aspects most excellent how much to the accessibility of the sidewalk, as promotional of mobility, integration and urban organization, as well as of the public squares of that one quadrilateral, conceived, originally, as spaces of aggregation and social inclusion. The work appealed to the direct comment and the gotten results had been collated with the ex port facto law and technique norms, of the year of 2004, and with the legal devices contained in the Federal Decree number 5.296/2004, as way to certify the levels of efficiency of these adaptations in that it says respect to the current conditions of demanded accessibility and urban mobility

Reassentamentos de famílias em projetos de habitação social: avaliação de procedimentos e resultados do projeto Planalto II, Natal /RN

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior