À beira do leito : sentimentos de pacientes durante a passagem de plantão em Unidade de Terapia Intensiva

This study aims to understand the feelings of patients admitted to the Intensive Care Unit (ICU) that experienced a change of shift at the bedside. The change of shift is one of the routines used by nursing in their work process and of great significance for the patient; therefore, deserves careful analysis in seeking to perfect themselves for the improvement of nursing care. It is a descriptive research, with a qualitative approach. The collection of information was performed using semi-structured interview, in August and September of 2011, after authorization from the Ethics Committee of the Federal University of Rio Grande do Norte, as opinion 290/2011. The analysis, based on interviews of patients, took the humanization as the thread of investigation backed by authors who deal on the subject and the theory of the gift of Marcel Mauss that sits on drug give-receive-return. The results indicate that the change of shift at the bedside but has not configured, the content of the speech of patients interviewed, as a moment that has generated fear and anxiety, could be deduced by the expression of silence, tears and other signs during interviews, how hard it is to live this experience. Nevertheless, despite this apparent tranquility, revealed uncertainty and apprehension face the speech of professional, during the visit at the bedside, particularly when referring to their health and their neighbors. On the other hand, the indifference to the participation of the patient at the time of the visit, expressing an attitude of merely technical nature, dehumanizes the act of taking care, the essence of nursing. And, for all the patients that we understand, about the visit to the bedside, as well as the ICU, we can infer that there is suffering for them. However, we understand your feelings and revelations seeking support in the theory of Mauss's gift: the patient receives the gift (care), and imbued with a feeling of gratitude, the rewards in the form of compliments and courtesies. Precisely for this reason, we need to sharpen our sensitivity to deal about the human condition in all its vulnerability.

Atendimento Pré-hospitalar Móvel. Mapeando Riscos e Prevenindo Erros

The attention with safety of the patients is important in the quality of the nursing and health care. In the pre-hospital care, such care is essential on site with the purpose of avoiding possible consequences to the individual, ensuring a fast and appropriate care, with improvement of the morbidity and reduction of the mortality. This medical attention is equally associated with the significant risks of adverse events and serious mistakes, which can be reduced with the awareness of the professionals, organization and quality management. It is a descriptive, transversal research, of quantitative approach, with the objective of identifying the risks for the safety of the patient during the mobile pre-hospital care under the view of the nurses, in a city of the Brazilian Northeast. The sample was formed by 23 nurses. The inclusion criteria: to have at least two years of experience and accept to participate on the research. The data collection was done in two steps, first photo collection, through the adapted method of photographic analysis, and the second with the application of questionnaire, divide in two parts: socio-professional data and digital photo punctuation instrument of the patient s safety. The majority of the nurses had an average working time in the mobile pre-hospital care of six years and six months, in the age group of 38 to 53 years old (69,56%) and with Lato sensu specialization (73,91%), being (29,41%) emergency and (29,41%) in intensive care. The (74%) have the Advance Cardiac Life Support (ACLS) and (100%) have the Pre-Hospital Trauma Life Support (PHTLS); (91, 30%) know the thematic safety of the patient. On the pictures it was observed a bigger variability of the categories (risks) where 44% of variance emerged on the first picture of the research. The pictures 4 and 9 with the average below 5 were classified as very insecure, while pictures 7 and 3 with an average above 7, very secure. On the results of risks observed for the patient s safety in the mobile pre-hospital care five categories emerged: organization and packaging of the equipment and materials, routines and specificities in the mobile pre-hospital care, risks on the management of medications, for traumas and infections. Starting from the analysis of these risks, it was proposed ten steps for the safety in the mobile pre-hospital care: 1- Identify the patient; 2- Safety related to prevention of infection; 3- Safety in the management of medications; 4- Safety and standardization of the packaging of equipment and materials; 5- Attention to the specificities of the mobile pre-hospital care; 6- Incentive and value the participation of the patient and family; 7- Promote the communication with the central of regulation; 8- Prevention of traumas and falls; 9- Protect the skin from additional injuries; 10- Understand the benefit of all the equipment in the ambulance. The multiple risks and their emerged combinations on the research indicate a variety of actions to be developed and stimulated, like the use of steps for the patient s safety in the mobile pre-hospital care which contributes with the aid and management of risks, reduction of mistakes, disabilities and death

Trajetória de vida de mulheres mastectomizadas integrantes de um grupo de auto ajuda a luz da História Oral

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Validação de conteúdo de instrumentos sobre conhecimento e habilidade em sondagem nasogástrica

Este estudo teve como objetivo construir e validar conteúdo de instrumentos avaliativos sobre conhecimento e habilidade de enfermagem no procedimento de sondagem nasogástrica. Trata-se de um estudo metodológico realizado na Universidade Federal do Rio Grande do Norte (UFRN) e na Universidade do Estado do Rio Grande do Norte (UERN). A amostra foi composta por 23 juízes, selecionados a partir dos critérios de inclusão: serem enfermeiros, docentes nas disciplinas de Semiologia e/ou Semiotécnica de Enfermagem, ter no mínimo um ano de experiência nestas disciplinas e ser das instituições selecionadas para o estudo. A pesquisa se desenvolveu em três etapas: (A) construção de dois instrumentos com base na revisão da literatura que resultou em um roteiro de observação da habilidade estruturado composto por 28 itens e um questionário sobre o conhecimento com 12 questões; (B) submissão dos instrumentos aos juízes, no período de junho a setembro de 2012, os quais deveriam julgar cada item como adequado , adequado com alterações ou inadequado , além de fazer uma avaliação geral de cada instrumento baseada em 10 critérios adaptados do referencial metodológico de Pasquali; e (C) validação com a verificação do nível de concordância entre os juízes, por meio da aplicação do Índice de Validade de Conteúdo (IVC) e do Índice Kappa. Utilizou-se o nível de consenso maior que 0,75 para o IVC e maior que 0,61 (bom) para o Índice Kappa. Estudo aprovado pelo Comitê de Ética em Pesquisa do Hospital Universitário Onofre Lopes (CEP/HUOL), sob CAAE nº 0002.0.294.000-10. Após serem codificados e tabulados, os dados foram analisados por meio de estatística descritiva. Dos 23 juízes, 87% eram do sexo feminino, com média de idade de 36,5 anos, 73,9% atuavam na UFRN, 78,3% possuíam mestrado acadêmico e 69,6% atuavam exclusivamente na docência. A média de tempo de experiência na docência foi de 7,9 anos e nas disciplinas de Semiologia e/ou Semiotécnica de Enfermagem foi de 5,6 anos. No julgamento do roteiro de observação estruturado e do questionário sobre o conhecimento, nenhum item/questão considerou-se inadequado, uma vez que todos obtiveram nível de concordância dentro dos índices estabelecidos (IVC > a 0,75 e Kappa > 0,61). Em relação ao roteiro estruturado para avaliar habilidade, dos 28 itens presentes, 13 apresentaram índice de concordância perfeito (IVC=1,00; Kappa= 1,00) e outros 15 foram considerados adequados com alterações, principalmente no que diz respeito à sequência instrucional dos tópicos, clareza e vocabulário. No questionário sobre o conhecimento, dentre as 12 questões que o compunham, 03 apresentaram índice de concordância perfeito e as demais adequadas com alterações quanto aos critérios vocabulário, clareza, atualização e precisão. Em relação à avaliação geral dos instrumentos, o roteiro estruturado de habilidade obteve IVC de 0,95 e Kappa de 0,91 e o questionário do conhecimento, IVC de 0,97 e Kappa de 0,94. Os dois instrumentos mostraram-se válidos quanto ao seu conteúdo, e constituem ferramentas para fomentar a qualidade da assistência de enfermagem em relação ao conhecimento e à habilidade em sondagem nasogástrica

Hanseníase: a implicação da educação em saúde para o autocuidado

A hanseníase é um problema de saúde em nível mundial devido principalmente ao seu potencial incapacitante. A estratégia de combate à doença adotada pelo Ministério de Saúde é o diagnóstico e tratamento precoces, prevenção e tratamento de incapacidades físicas e vigilância dos contatos domiciliares. Tudo isso fundamentado na educação em saúde como sustentáculo para compreensão do processo de adoecimento, da doença em si, sua aceitação e, principalmente, das ações de autocuidado para prevenção de sequelas. Nesse contexto, questiona-se: Qual a implicação da assistência de enfermagem focada na educação em saúde para o autocuidado em portadores de hanseníase? O objetivo geral desse estudo é avaliar os conhecimentos adquiridos pelos portadores de hanseníase sobre a doença, o tratamento e autocuidado abordados durante a consulta de enfermagem. Trata-se de um estudo exploratório-descritivo com abordagem qualitativa, realizado no Hospital Universitário Onofre Lopes. Respeitou a resolução 466/12 do Conselho Nacional de Saúde e foi aprovado pelo comitê de ética sob nº 387.769 e CAAE 17468213.0.0000.5537. Envolveu 14 portadores de hanseníase em tratamento no ambulatório de dermatologia do HUOL. Os dados foram coletados no período de 23 de setembro a 04 de novembro de 2013 por meio de entrevista semi-estruturada; e analisados a partir da analise de conteúdo de Bardin. Os resultados e discussões são apresentados através de um artigo, o qual atende os objetivos propostos, denominado O autocuidado realizado por portadores de hanseníase . Esse objetivou identificar as ações de autocuidado de portadores de hanseníase em uma unidade de referência a partir de três eixos temáticos emersos dos discursos dos sujeitos: 1.as complicações/sequelas da hanseníase conhecidas pelos portadores da doença; 2. as ações de autocuidado adotadas pelos portadores de hanseníase; 3. as possíveis contribuições de um grupo de autocuidado para os portadores de hanseníase. Constou-se aparente superficialidade no conhecimento dos pacientes sobre as complicações da hanseníase, como também, das ações de autocuidado realizadas por eles. Verificou-se também a importância da assistência de enfermagem ao portador de hanseníase, tanto na atenção primária, quanto nos demais níveis de complexidade 11 da assistência. Considera-se que o enfermeiro é um potencial colaborador da educação em saúde como alicerce para o controle e eliminação da hanseníase

Trajetória de pessoas com AIDS em situação de vulnerabilidade social: à luz da história oral de vida

The epidemic caused by HIV presents a global, dynamic and unstable phenomenon, which depends on the individual and collective human behavior. Efforts to deconstruct the stigmatized image caused by infection of AIDS are still often associated with adoption of socially unacceptable behavior to be a circumscribed the susceptibilities of vulnerable individuals and communities to infection, illness and death by HIV. This study aimed to: narrate the trajectory of life of people with AIDS more vulnerable enrolled in the Municipal Social Assistance Parnamirim / RN. It is a study of qualitative, exploratory and descriptive approach, taking oral history of life as technical and methodological framework. The colony consisted of 186 people with AIDS. The network was comprised of 13 employees of both sexes, aged between 19 and 62 years old with positive diagnosis and agreed to voluntarily participate. After approval by the Ethics Committee of the Federal University of Rio Grande do Norte (CEP / UFRN), in the opinion No. 719,926 CAAE: 30408114.5.0000.5537 on 6 June 2014 data were collected from August to September 2014. The employees signed the Informed Consent and Informed and letter of assignment. Held transcribing the interviews and later returned to respondents to retest, ie so that they confer what allowed us to carry out transcreation after consecutive readings. The reports were analyzed through Bardin content analysis. Guiding the analysis of the accounts of employees, we find three themes: Prejudice and discrimination in living with AIDS; Reacting to the diagnosis and the accession process to antiretroviral treatment; and religious coping in people with AIDS. It can be concluded in this study, that employees have shown great emotional impact after positive diagnosis for HIV / AIDS, especially with regard to social life, the family ties, work and above all to the prejudice of society. Treatment with antiretroviral drugs was seen as a motivation to regain dreams and plans for a future once uncertain, and even if it is not a cure therapy, provided the employees improved quality of life.

Trajetória de pessoas com AIDS em situação de vulnerabilidade social: à luz da história oral de vida

The epidemic caused by HIV presents a global, dynamic and unstable phenomenon, which depends on the individual and collective human behavior. Efforts to deconstruct the stigmatized image caused by infection of AIDS are still often associated with adoption of socially unacceptable behavior to be a circumscribed the susceptibilities of vulnerable individuals and communities to infection, illness and death by HIV. This study aimed to: narrate the trajectory of life of people with AIDS more vulnerable enrolled in the Municipal Social Assistance Parnamirim / RN. It is a study of qualitative, exploratory and descriptive approach, taking oral history of life as technical and methodological framework. The colony consisted of 186 people with AIDS. The network was comprised of 13 employees of both sexes, aged between 19 and 62 years old with positive diagnosis and agreed to voluntarily participate. After approval by the Ethics Committee of the Federal University of Rio Grande do Norte (CEP / UFRN), in the opinion No. 719,926 CAAE: 30408114.5.0000.5537 on 6 June 2014 data were collected from August to September 2014. The employees signed the Informed Consent and Informed and letter of assignment. Held transcribing the interviews and later returned to respondents to retest, ie so that they confer what allowed us to carry out transcreation after consecutive readings. The reports were analyzed through Bardin content analysis. Guiding the analysis of the accounts of employees, we find three themes: Prejudice and discrimination in living with AIDS; Reacting to the diagnosis and the accession process to antiretroviral treatment; and religious coping in people with AIDS. It can be concluded in this study, that employees have shown great emotional impact after positive diagnosis for HIV / AIDS, especially with regard to social life, the family ties, work and above all to the prejudice of society. Treatment with antiretroviral drugs was seen as a motivation to regain dreams and plans for a future once uncertain, and even if it is not a cure therapy, provided the employees improved quality of life.

Applicability of non-pharmacological strategies for pain relief in parturient: integrative review

MORAES, Maísa Suares Teixeira; ROLIM, Lariane Thays Albuquerque; ENDERS, Bertha Cruz; FARIAS, Glaucea Maciel de; DAVIM, Rejane Marie Barbosa. Applicability of non-pharmacological strategies for pain relief in parturient: integrative review. Revista de Enfermagem UFPE on line, v.4, n.especial, p.131-136, May/June 2010. Disponivel em:< http://www.ufpe.br/revistaenfermagem/index.php/revista/>.

Prevenção de úlceras por pressão segundo a perspectiva do enfermeiro intensivista

Analisar a atuação dos enfermeiros de unidade de terapia intensiva na prevenção da úlcera por pressão. Método: trata-se de estudo descritivo desenvolvido com 13 enfermeiros da unidade de terapia intensiva do Hospital Universitário Onofre Lopes (HUOL), em Natal-RN. Foi aplicado um questionário, submetido à análise de conteúdo temática. O estudo foi aprovado pelo Comitê de Ética da Universidade Federal do Rio Grande do Norte (UFRN), sob o CAAE n. 0240.0.051.000-10. Resultados: os enfermeiros reportaram a realização da mudança de decúbito, a avaliação de risco, a discussão com os colegas sobre as medidas adotadas, a higiene e hidratação da pele do paciente através de uso de ácidos graxos essenciais e hidratante corporal, o cuidado com a disposição dos lençóis, de forma a evitar dobras, a utilização de colchão de ar e a aplicação de placas de hidrocoloide nas proeminências ósseas. Conclusão: a prática da prevenção das úlceras por pressão aplicada pelos enfermeiros da unidade de terapia intensiva ocorre sem padronização dos cuidados

Avaliação do ensino da obstretícia e da assistência ao parto sob a percepção dos graduandos em medicina e enfermagem na Universidade Federal do Rio Grande do Norte

OBJETIVE: To evaluate the perception of Medical and Nursing students of Medicine and Nursing graduation courses at the Federal University of Rio Grande do Norte (UFRN), on obstetrics teaching and labor assistance in the context of the maternal care provided by the Maternity Hospital Januário Cicco (MEJC) and contribute to curricular updating planning of teaching obstetrics, in accordance with the principles of humanization. METHODS: It was conducted a study of cross-cutting approach and qualitative and quantitative descriptive method, with students in medicine and nursing of UFRN, who were attending or had been attended the midwifery disciplines medicine; and women's health in nursing. The data were collected through a questionnaire with objective and subjective questions, and stored in a database, spreadsheet software Excel / Office 2010 with all the variables. RESULTS: We interviewed 169 students, 118 of medical school and 51 from the nursing program, of which 46.75% were male and 53.25% female. The largest number of medical respondents is the 11th period (40.67%), and nursing, on 10, (43.15%). These students witnessed 1,073 births, and (61.8%) vaginal deliveries. The obstetricians were the most performed vaginal deliveries (40%). Nurses performed only (8.13%). The assistance provided to women during the process of labor and delivery, was configured as suitable for 87.58% of respondents and these glimpsed humane conduct. Students who performed deliveries, 76.27% were medical and 11.76% were nursing. All had guidance while doing them. A total of 19.50% medical students reported that there is a prejudice against vaginal delivery, particularly for the humanized birth, unlike all nursing students (100%) who reported that there is this prejudice. Most students (73%) showed preference for vaginal delivery, especially nursing students. On the knowledge of myths in relation to vaginal delivery, 60.35% answered that they know some. CONCLUSION: This study presents itself as a highly relevant, since the results may contribute to curricular changing and updating related to obstetrics teaching, but also serve as a resource for analysis of humanization practices that should be developed in educational institutions and which are recommended by the Ministry of Health.

Processo de enfermagem aplicado a um paciente com síndrome de marfan associado a aneurisma aórtico

Trata-se de um caso clínico que teve como objetivo traçar diagnósticos, intervenções e resultados de enfermagem em um paciente com Síndrome de Marfan internado na unidade de terapia intensiva no pós-operatório de correção de aneurisma de aorta. Foi desenvolvido em um Hospital Universitário, localizado no município de Natal-Brasil, em abril de 2011. Entre os principais diagnósticos de enfermagem identificados, destaca-se: Débito Cardíaco Diminuído; Risco de Infecção; Dor Aguda; Risco de Glicemia Instável; Integridade da Pele Prejudicada e Ansiedade. Percebeu-se que a aplicação do processo de enfermagem neste paciente contribuiu para delimitar o campo de atuação específico da enfermagem, bem como identificar os cuidados prioritários, contribuindo para uma melhoria na qualidade da assistência

Passado e presente: a enfermagem do Hospital Universitário Onofre Lopes

This is a historically focused study with a qualitative approach whose main purpose is to investigate the trajectory of Nursing at the Hospital Universitário Onofre Lopes (HUOL) and how it associates with the teaching of Nursing at the Federal University of Rio Grande do Norte (UFRN). Motivation for carrying out this study is due, firstly, to a liking for history and, secondly, to the nonexistence of records on Nursing in one of the institutions with the most teaching tradition in the area of health and nursing in the state of Rio Grande do Norte. The objectives of the study were to analyze the historical development of Nursing at the HUOL and its association with the teaching of Nursing at the UFRN; describe the historical development of the Hospital referred to; and to establish a relationship between the development of nursing at the HUOL and the teaching of Nursing at the UFRN. Empirical investigation was carried out based on the study of historical documents such as reports, minutes, letters, by-laws, decrees and administrative directives, as well as photographs and interviews with people who lived through this history or who kept vivid memories of it. From this research it can be gathered that Nursing at the HUOL was at first closely identified with the empirical stage of the profession. Its development is a result of the institutionalization of teaching whose starting point is an authorization for running the Nursing Aid School of Natal in 1955. Since then, gradually, teaching has enabled those who practiced nursing at that institution to become professionals through a partnership between the Nursing Aid School and the Nursing Department at the Hospital whose administration had been in charge of a professor for many years. Upon the creation of the undergraduate program in Nursing in 1973, nursing at the HUOL underwent a new transformation process with new nurses being hired. Likewise, the creation of post-graduate specialization and master s degree programs in 1982 and 1996, respectively, opened the way to the growth of the academic qualifications of nurses at that institution. Therefore, it must be asserted that Nursing at the HUOL has, over the years, gone through a continuous process of qualification of its members and in such trajectory the teaching of Nursing that is carried out at different levels at the UFRN stands as a hallmark

Sentimentos de profissionais de enfermagem diante da morte de recém-nascidos em uma unidade de terapia intensiva

To understand the feelings of nursing professionals when faced with the death of newborn babies in an intensive care unit is the purpose of this investigation. Motivation was triggered by the countless hardships we go through everyday, as professionals, and the scarcity of publications in this specific area of knowledge. The aim is to describe the experience of the nursing professionals and identify their feelings when faced with the death of newborn babies in an intensive care unit. As a methodological procedure, this research is based on a qualitative, phenomenology-focused approach and on the following leading question addressed to the interviewed nurses and nursing technicians who work at the unit: How do you feel when you are faced with the death of a newborn baby in the ICU at which you work? Answers to this question on such phenomenon revealed a diversity of feelings, such as, loss, guilt, failure, negation, compassion, and sorrow, coupled with anguish, fear, and anxiety, resulting in an experience of the sensitive world of everyone. Theoretical support to this analysis was based on works by authors who discuss phenomenology, as well as authors who study the theme of death. An understanding of the phenomenon thus studied enables us to affirm that the death of a newborn baby is, for the nursing professional who takes care of the baby in the space of the ICU, an experience of conflicting, sometimes painful feelings, on account of their complexity. This is true not only in respect of their feelings for the baby, but for the family as well, especially the parents

A educação no processo de trabalho da enfermagem: o caso do hospital de ensino

It is in the work environment that occurs the relations of production, economy, personal development and professional growth. Thus, this environment characterizes for being a propitious way to the intellectual development diligent them. In this context, this study it had as objective to analyze the possibilities and challenges of the education to consist integrant part of the process of work of the nursing, in an education hospital. One is about a research of analytical matrix and qualitative boarding, that had as collaborating fifteen professionals of the nursing, middle- and upper-level, of a hospital of education in Natal/RN. It followed the metodológicos estimated ones of the thematic verbal history, which looks for to promote the agreement or clarification of determined situations, catching experiences of made use people to say on aspects of its life, keeping a commitment with the social context. The information then had been gotten by means of a research instrument that made possible the accomplishment of interviews, which had been marked anticipatedly and counted on the assent of that in they had participated. The interviews had been recorded in proper equipment, so that you say them of the collaborators transcribing and they were analyzed with the support of pertinent literature. The content of you say them was classified in empirical categories, as the nuclei of felt that they presented. With the analysis of the data, one evidenced that the education in the process of work of the nursing is something possible to occur, but that diverse they are the challenges that the same one has that to face to promote this phenomenon in its daily one of work. The collaborators had affirmed that the worker is necessary to remain itself permanently in study so that, thus, it grows professionally and improves its assistance. They had still affirmed that she is possible to work and to study, but that this requires determination of who intends such intention. E also guarantees that the diverse forms of education directed toward the care in nursing can have resolution, since that has collective compromising of the institution. This, as education hospital, recognizes to be necessary to possess one politics of education for its workers and is if considering implementation the same one through a structuralized program already. Therefore, the results of this research show the necessity of changes in the current scene where if they find the workers of nursing of the institution in study. These changes can be reached through one politics of investment in the workers, allowing, beyond other benefits, the reach of new knowledge that take them to a significant learning in favor of the population, reflecting in the quality of the given assistance

Vacinação e biossegurança: o olhar dos profissionais de enfermagem

The present study analyzes the conceptions and the nursing workers' practices about the relationship between vaccination and biosecurity in a public hospital of reference in communicable diseases in Natal/RN. It is treated, therefore, of a exploratory/descriptive study with qualitative and quantitative approach. They were constituted as collaborators of the research twenty-two nursing professionals, being five nurses, three auxiliary and fourteen technicians in nursing. The information were obtained through the interview technique with semi-structured route. In the quantitative approach, the information were analyzed by statistics and presented in form of tables and graphs to characterize the workers and the aspects related to the vaccination situation of the same ones; and in the qualitative approach, we used the method of content analysis. The analysis was accomplished starting from the categories empiric coming from the process of analysis of the field material, measure through inferences and interpretations based on the authors studied in the theoretical referential of the research. Starting from the analysis of the results, we verified that the nursing interviewees' workers establish in a clear way and it aims at, in your speeches, a direct relationship between vaccination and biosecurity besides attributing a meaning of great importance with relationship to the use of the vaccines in your professional lives in what refers to the control and decrease of the risks, above all the biological ones, to the which are exposed in the daily exercise of your functions. However, when analyzing those workers' vaccination situation, we verified that the vaccination covering still meets on this side of the expected for the vaccines of occupational interest, with prominence just for the vaccines against diphtheria and tetanus and to against hepatitis B, that presented coverings considered very good and above the national average. Considering that the institution, although has a service of health occupational active and offer some vaccines of occupational interest, it still presents a work of little mobilization in what refers to the consciousness and the workers' permanent education with relationship to the need and importance of the occupational vaccination, not only for your workers' protection, as well as measure in the infection control and, therefore, as safety for your patients/clients. We understood that that work type didn't still become politics guided by ministries of Health or of the Labor, however, it falls to the institutions that work for the interest of the workers' health to struggle for all and any action and mobilization that have as objective protects the workers of the risks in your work atmosphere