Cuidado de enfermagem ao potencial doador de ��rg��os em morte encef��lica: uma reflex��o sobre a pr��tica

Despite of the technological advances that favor the transplant process, there are issues of effectiveness of care necessary for the maintenance of potential organ donors with brain death, which contribute to the no realization of transplants of organs and tissues of these patients. It is presupposed that the problems could be related to perceptions and understandings that the professionals of the units of internment have about the care required by the diagnosis of brain death. The aim of this study was to understand the meaning of the nursing care of the potential organ donor with brain death to the nursing staff. Descriptive study with qualitative approach guided by Action Science Theory and the critic-reflexive research methodology accomplished with five nurses and 19 nursing technicians from Operative Rehabilitation Center in a public hospital at Natal / RN, Brazil, between March and May 2013. Data were collected through semi-structured interviews with individual reflection about the care and through group interview, after approval by the Ethics and Research Committee, CAAE No.: 04255612.7.0000.5537. The analysis was performed in a thematic way according to Bardin. During the group meeting the participants were driven in a discussion about the need for change and how to perform them. The results indicate that the professionals actions are consistent with those required for maintenance of potential organ donors, although the material and human resources are not adequate. That situation leads the professionals to develop a meaning of care as one labor more, demanding more than they can give. They express beliefs and feelings concerning the hope that their care brings a greater good that is to save lives. The reflection for a possible change of action was difficult to accomplish due to professionals not to be able to self evaluate, what lead to direct your changes suggestions for other team members. It is concluded that the care provided to these patients is a difficult care, evidenced by suffering both death situation of the person cared and pain of their families, as the dehumanizing conditions of work, helping themselves to keep distance from patients to not suffer so much. The knowledge impregnated in their act, are scientific, ethical, aesthetic and personal kind with a predominance of the scientific followed by the personal. The study was also relevant to the practice of nursing in maintaining the potential donor, in that it allowed the identification of the knowledge used by nurses in their care practice and the meaning understanding of the professionals on the care provided, as a good action that brings satisfaction when the transplanting is executed. Other experiences are suggested with the critic-reflexive research methodology, both in research as in teaching nursing

Processo de trabalho na estrat��gia sa��de da fam��lia: potencialidades e fragilidades da atua����o do enfermeiro

The present study aims to analyze the nurse s work process at Family Health Strategy, considering its basic elements and dynamic, and searching to identify aspects that may constitute strengths and weaknesses in its development. This is an analytical case study, with qualitative approach and theoretical-conceptual mark grounded in Dialectic Hermeneutics. Empirical research fields were the Family Health Units of Natal, RN, Brazil. The subjects are nurses working in this Strategy. Data collection was conducted through semi-structured individual interviews combined with field observation. The research was initiated after approval by the Ethics Committee of Universidade Federal do Rio Grande do Norte, according to the guidelines and rules for research involving humans (Resolution 466/12), ensuring proper ethical precepts. The project was approved by register number 398.929, CAAE 19588813.7.0000.5537. From the 9 interviewed nurses, 8 were female and 1 male, average age of 52 years, average graduation time of 27 years and average time they stayed at the same Family Health territory of 7 years. It was found that it is up to the professional nurse in the Family Health care the important role of taking care of human beings in their life, family and community contexts, producing conditions to meet their needs through therapeutic act in health, using for such purpose both materials and immaterial instruments. It was possible to relate aspects that characterize strengths and weaknesses in the work process of nurses in the ESF, according to the speech of the interviewed workers, including the meanings and contradictions. Among the potentialities observed, it was possible to highlight the wide role of the nurse at Family Health; the perception of nurses about teamwork; the relative autonomy of nurses; the commitment of professionals to work; Humanization as a technology; the presence of other agents at work, such as directors and officers at the primary health units; the professional s experience time and contract type in the case studied. As weaknesses in the work process of nurses at Family Health Strategy, were highlighted the limited skills of the workforce; the difficulty in 10 identifying specific limits of the work of nurses in this scenario; the disturbances that occur in the process, the existing gaps in multiprofessional teams; Structural deficits of the units in the studied case, the low coverage of the Family Health in the county, and the political vulnerability of the work conditions. It is considered necessary to understand the dilemmas experienced in everyday life of nurses at Family Health Strategy as part of multiprofessional teams, facing actual achievement of changes in work processes necessary for the reorientation of health care in Brazil. In accordance, it is necessary to promote proper working conditions and welfare of labor agents which are protagonists the work at the United Health System

Clima e cultura de seguran��a do paciente em uma maternidade escola: percep����o dos profissionais de enfermagem em terapia intensiva

Since the publication of the report "To Err is Human" by the Institute of Medicine (IOM) , which estimated that between 44.000 to 98.000 Americans die annually as a result of errors in health care, patient safety spent gaining prominence, emerging studies assess the safety culture by measuring the safety climate. In this context, the aim of this study was to identify safety culture perceived by nursing professionals working in the intensive care unit of a maternity school in Natal/RN through the Security Attitudes Questionnaire (SAQ). This was a descriptive study, cross-sectional and quantitative approach undertaken in the Intensive Care Unit Maternal and Neonatal a maternity school in Natal/RN. The project was submitted to and approved by Brazil Platform Zip/UFRN under number 309 540 and CAAE 16489713.7.0000.5537. It was used to collect data two instruments: a questionnaire in order to collect socio-demographic data of the subjects and the Question��rio Atitudes de Seguran��a , a cultural adaptation to Portuguese of the instrument of the World Health Organization titled Safety Attitudes Questionnaire - (SAQ ) Short Form 2006. The collected data were analyzed quantitatively by the organization in electronic databases in Microsoft Excel 2010 spreadsheet and exported to statistical software for free access to be coded, tabulated and analyzed using descriptive statistics. The study included a total of 50 nurses, 31 and 19 of the NICU Maternal ICU, predominantly female, mean age 35 years, median time of 10 years training and working in maternity, mostly, less than 05 anos. As a result, two articles were produced. The first refers to the first two domains of the instrument entitled "climate of teamwork" and "climate security" . The scores of the two areas were slightly higher in Maternal ICU compared to the NICU, but no sector has reached the ideal minimum score of 75: in the first domain Maternal ICU had an average of 74.77, with medians of 75 and 100, while Neonatal ICU reached an average of 69.61 with median also 75 and 100, while the second field means were 69.35 and 66.01 for Maternal and Neonatal ICUs respectively, with a median of 100 in the two sectors. The second article relates to the field "Perception Management Unit and Hospital", which 9 assessed the perception of management units and motherhood by professionals. In general, the items of the domain in question also obtained scores below the ideal minimum: 63.68 to 51.02 and maternal ICU for neonatal, featuring a clear separation between the management and the professionals who work in direct care. These findings indicate a warning sign for the institution and point to the need to implement actions aimed at patient safety

An��lise de conceito do diagn��stico de enfermagem autocontrole ineficaz da sa��de em pacientes submetidos �� hemodi��lise

The concept analysis process carefully examines the description and uses of a word or term, enabling the standardization of language, in addition to providing representation to the profession, and facilitate the work of taxonomies. The aim of the study was to analyze the concept of nursing diagnosis ineffective self-health in patients undergoing hemodialysis. Study concept analysis, based on Walker and Avant model and operationalized through integrative literature review. The databases searched were: SCOPUS, CINAHL, PUBMED, LILACS and COCHRANE, with descriptors: Selfmanagement, Adherence and Hemodialysis. The inclusion criteria were: articles published in the last five years, complete articles are available free in selected databases; articles available in Portuguese, English or Spanish; and articles that address the self-concept of health, the antecedents and the consequent. And Exclusion: editorials, letters to the editor, theses and dissertations. The survey of the articles occurred in the months from January to March 2014. The initial sample of 16785 articles, with 11748 in PUBMED, 4767 in Scopus, 174 in CINAHL, the Cochrane 70 and 26 in LILACS. After applying the criteria, 76 articles were selected, 19 in CINAHL, 18 in PUBMED, 30 in Scopus, and 9 in LILACS. In analyzing the data, given that the concept was sought in the literature was self-health, was held interpretation to ineffective self-health diagnosis through the transposition in the denial of the attributes, antecedents and consequences identified. It is noteworthy that the terms identified in the literature as defining characteristics and related factors of the diagnosis under study were added to the survey, not even the transposition into opposite term is possible. The results show that the concept developed for the inefficient self-health diagnosis was: the patient's inability to control habits and achieve the negotiated with professionals therapeutic targets, resulting in health complications. 33 antecedents relating to social, psychological and therapeutic aspects and 16 consequential, involving physiological, social, psychological and therapeutic aspects were identified. Thus, it is concluded that the ineffective self-health concept is broad and involves individual patient factors and the therapeutic relationship between patient and professionals. It is believed that the study contributed to the improvement of diagnosis in renal clientele, besides being an important base for the growth of the scientific body of nursing, subsidizing the development of own technology area

Avalia����o da estrutura e processo de trabalho dos centros de aten����o psicossocial

Objective: Evaluate the work structure and process in Psychos ocial Care Centers (CAPS) and the professionals profile, the satisfaction, conditions and work overload. Methods: Cross - sectional study conducted in five CAPS in Campina Grande city. The study sample consisted of five coordinators, 42 graduate professional s, 26 mid - level (technical and auxiliary nurses, and caregivers), and the medical records pertaining to 413 users followed up. Data were collected using validated questionnaires (CAPSUL - rating CAPS in southern Brazil) and adapted to the study, between July and October 2014. The questionnaires were double entered and submitted to validation in the sub - program ���Validate Epi Info 3.5.4��� , used along with the ���SPSS 17.0��� for processing the statistical analyzes. Measures of central tendency and dispersion were ap plied to the descriptive analyzes; ���Fisher's��� exact test to check the CAPS impact on hospital admissions and the ���Bonferroni��� adjusted to verify the diagnoses according to sex. 5% significance level was adopted. The study was approved by the Ethics Committ ee of the Rio Grande do Norte Federal University (UFRN), protocol 719.435, of 05.30.2014. Results: From the structure analysis were identified contextual factors that influenced the work process of CAPS professionals, such as: deficiencies with regard to h uman resources; forms of health professionals employment and qualifications; temporary contract existence. As to process dimension, it was found that the home visits performance by health professionals shows to be ineffective, given its insufficiency and i rregularity, which can be explained by the high demand, reduced staff and transportation lack. It was low coverage of items inherent to Therapeutic Individual Project, as the income generation program, insertion at work and home visit. The reference and co unter reference flow are still not satisfactorily organized. There was statistically significant difference for the diagnosis, with a predominance of mood disorders related to stress among women and those related to alcohol and other drugs among men (p <0. 05). There was an association between the degree of health professionals satisfaction and working conditions, overload and factors related to the content and working conditions, the security measures, comfort and CAPS appearance, contact between the teams and users, families treatment by the teams, temporary employment relationship. Conclusion: The data collected indicate the need for the CAPS organization through increased investments in the sector in order to enhance the infrastructure as potentiating el ement of practices with a view to changing the care model for mental health proposed by the Psychiatric Reform. It is hoped therefore that this research will contribute to better planning in CAPS unit management, with another tool to improve the dimensions involving the structure and the professional work process and improve this mental health care model.

Avalia����o do ensino da obstret��cia e da assist��ncia ao parto sob a percep����o 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 Janu��rio 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.

Magnitude da morbidade relacionada ao trabalho no Rio Grande do Norte

Diseases and disorders related to work sets up an important public health problem in Brazil and worldwide. However, the reality of these diseases still constitutes a gap with regard to its characterization and epidemiological situation, especially in Brazil. In this context, this study aims to analyze the magnitude of morbidity related to work from the injuries and illnesses reported by Health the Diseases Notifiable of Health of the State Public River Health Department worker Reference Center Information System services Grande do Norte from 2007 to 2014. It is ecological study, quantitative cross-sectional study in which the analysis unit of the municipalities of Rio Grande do Norte. Data were collected from the state base of Diseases Notifiable Information System Centre of the Secretariat of State Workers' Health Reference Public Health of Rio Grande do Norte, between March and June 2015, after the approval of the Committee of Ethics in Research of the Federal University of Rio Grande do Norte, Opinion 014/2014. The population was represented by the universe of cases of diseases and disorders related to work that were reported and shut down the system from 2007 to 2014. Data were analyzed using descriptive and inferential statistics, presented in tables, graphs, charts and figures. For this, we used the Microsoft Excel 2007 and SPSS version 20.0. To check the significance level we opted for the application of the chi-square or Fisher tests. We adopted the significance level of p <0.05. Of the 10,161 cases of diseases related to the reported work, the biological work accidents had the highest percentage (52.84%) followed by serious occupational accidents (37.49%). For diseases, the highlights were musculoskeletal (4.82%), mental disorders (2.19%) and exogenous intoxication (1.97%). Among men, there was a predominance of major accidents (91.80%), mental disorders (70.00%) and exogenous poisoning (52.84%). Women were most affected by biological accidents (77.50%) and musculoskeletal diseases (64.10%). Among workers who have suffered injuries predominated mulatto (%), mean age of 35.86 years, low education (%) and workers in the formal sector (%). Among the accidents, biological (n = 5,369) accounted for 52.84% of cases occurred predominantly among nursing professionals (48.31%). The percutaneous exposure was the most frequent (73.05%) and the occurrence of circumstances was improper disposal of sharps (45.28%), the needle the most common agent (66.62%) and the organic material was blood (72.99%). Most injured workers were vaccinated against hepatitis B (68.13%), but no information as to the assessment of the vaccine response. In the course of the disease predominated ignored the situation with loss of monitoring of clinical follow-up (55.62%). There was also an increase in the notification of serious industrial accidents predominantly male (91.80%) workers aged 25-44 years (54.3%) and typical accidents (76.3%). The temporary disability was the most common outcome (55.53%) and hand the most affected part (33.00%); the mining and construction industry had the highest number of cases (25.1%) in registered employee (34.2%). The findings of this study show a positive result in relation to increased mandatory reporting of injuries and illnesses related to work together to health services that meet victimized workers, towards the occurrence of knowledge of these accidents for decision making in public plans and policies of health. However, the information system still needs improvement in both the coverage and the quality of the data to demonstrate with greater reliability the magnitude of events to support the planning of workers' health into shares in the state.

A ci��ncia-a����o: fundamentos filos��ficos e relev��ncia para a enfermagem

ENDERS,Bertha Cruz, FERREIRA,Priscila Brigolini Porf��rio, MONTEIRO, Akemi Iwata.A ciencia-a��ao: fundamentos filosoficos e relevancia para a enfermagem. Revista Texto Contexto em Enfermagem, Florian��polis, v.19, n.1,p.161-7.Jan/Mar.2010.

An��lise conceitual e pensamento cr��tico: uma rela����o complementar na enfermagem

ENDERS, Bertha Cruz ; BRITO RS ; MONTEIRO, Akemi Ywata. Analise conceitual e pensamento critico: uma relacao complementar na enfermagem. Rev Gaucha Enferm, Porto Alegre (RS) 2004 dez;25(3):295-305.

Promo����o da sa��de e trabalho: um ensaio anal��tico

CAVALCANTE,Cleonice Andr��a Alves, N��BREGA, Jussara Azevedo Bezerra da, ENDERS,Bertha Cruz, MEDERIROS, Soraya Maria de. Promo����o da sa��de e trabalho: um ensaio anal��tico. Revista Eletr��nica de Enfermagem. v.10,n.1 p.241-248.2008. Dispon��vel em :<http://www.fen.ufg.br/revista/v10/n1/v10n1a23.htm>.

O est��gio extracurricular remunerado no cuidar da enfermagem nos hospitais de ensino

OLIVEIRA,Jonas S��mi Albuquerque de; ENDERS, Bertha Cruz; MENEZES, Rejane Maria Paiva de MEDEIROS, Soraya Maria de. O est��gio extracurricular remunerado no cuidar da enfermagem nos hospitais de ensino. Revista Ga��cha de Enfermagem, Porto Alegre(RS),v.30,n.2, p.311-8,jun.2009.

O acompanhamento do crescimento e do desenvolvimento da crian��a: uma a����o coletiva da enfermagem

Relatar sobre a experi��ncia da implementa����o de uma proposta de a����o coletiva da enfermagem para o acompanhamento do Crescimento e Desenvolvimento de crian��as(CD). M��todo: estudo descritivo, tipo relato de experi��ncia, sobre a implementa����o de uma proposta de a����o da enfermagem para o acompanhamento coletivo do CD das crian��as atendidas na Unidade de Sa��de da Fam��lia de Cidade Nova (USFCN) no munic��pio de Natal���RN, Brasil, realizado por meio de reuni��es mensais com pais/cuidadores e crian��as de acordo com a ��rea de abrang��ncia do servi��o. Este estudo teve o projeto de pesquisa aprovado pelo Comit�� de ��tica em Pesquisa da Universidade Federal do Rio Grande do Norte (CEP-UFRN), tendo com parecer final n�� 201/2009. Resultados: o processo de trabalho do enfermeiro experimentou ganhos no exerc��cio de uma pr��xis educativa e transformadora junto �� comunidade. Pais e cuidadoras tiveram acesso �� aprendizagem de novos conhecimentos, troca de experi��ncias e aux��lio nos cuidados domicili��rios, atrav��s de uma nova din��mica de fazer a aten����o �� sa��de da crian��a. Conclus��o: os resultados mostram que pais/cuidadores tornaram-se co-participantes do processo de cuidar, mas sem desobrigar as profissionais enfermeiras do compromisso na presta����o do atendimento

O processo de enfermagem na concep����o de profissionais de Enfermagem de um hospital de ensino

Este estudo objetiva descrever as concep����es dos profi ssionais de Enfermagem sobre o processo de enfermagem, a fi m de embasar as a����es de implementa����o do processo na institui����o do estudo. Trata-se de um estudo qualitativo, desenvolvido durante uma pesquisa a����o, com a equipe de Enfermagem de um hospital pedi��trico de ensino. O processo de enfermagem �� concebido como um instrumento para organizar a assist��ncia e prescrever os cuidados de Enfermagem. As rotinas de trabalho evidenciam as atividades t��cnicas. As expectativas com a implementa����o do processo de enfermagem envolvem a melhoria da qualidade da assist��ncia. O estudo refor��a a import��ncia de incluir os membros da equipe de enfermagem, na implementa����o das etapas do processo de enfermagem e aponta o desafi o de enfrentar as rotinas tecnicistas

A ci��ncia-a����o: fundamentos filos��ficos e relev��ncia para a enfermagem

A pr��tica de enfermagem envolve o enfermeiro da cl��nica como agente de delibera����o e a����o, confrontando situa����es do cotidiano e assumindo, atrav��s de conhecimento cient��fico, experi��ncias anteriores ou por conceitos pr��prios e intuitivos, formas espec��ficas de ver e agir na pr��tica. O agir constitui fonte de conhecimento pass��vel de acesso por m��todos de investiga����o interpretativos. O objetivo deste trabalho �� apresentar, analiticamente, a filosofia da Ci��ncia-A����o em sua rela����o com a constru����o do conhecimento na enfermagem. Explica-se a Ci��ncia-A����o como m��todo inovador de inqu��rito e a sua tradi����o filos��fica na abordagem nas ci��ncias sociais, e se discute a sua articula����o com a proposta epistemol��gica da enfermagem. Sugere-se a ado����o dessa vertente em estudos de enfermagem, pelo seu enfoque na reflex��o sobre as a����es do enfermeiro e na pr��tica como fonte de conhecimento. Conclui-se que a Ci��ncia-A����o possui potencial para o avan��o da teoria espec��fica da pr��tica da enfermagem, do conhecimento pr��prio da enfermagem

Vacina����o: o fazer da enfermagem e o saber das m��es e/ou cuidadores

Observa-se na pr��tica das unidades de sa��de, ainda hoje, o pouco conhecimento das m��es sobre o processo de vacina����o e pouco envolvimento do enfermeiro nesse processo, principalmente na ��rea de educa����o em sa��de. O objetivo �� identificar as a����es de enfermagem na sala de vacina e descrever o conhecimento das m��es/cuidadores acerca da vacina����o infantil. Estudo explorat��rio-descritivo com abordagem quantitativa. A popula����o foi composta por 43 m��es e/ou cuidadores e 10 profissionais de enfermagem. Ocorreu em duas Unidades de Sa��de da Fam��lia, na Zona Oeste de Natal/RN, em novembro e dezembro/2008. A maioria das m��es (88,4%) conhece a import��ncia de vacinar a crian��as, embora n��o saibam quais as vacinas est��o sendo dadas e para quais doen��as s��o destinadas. A maioria dos profissionais prioriza mais a t��cnica do que a atividade educativa. Percebe-se, portanto, que h�� lacunas no saber das m��es/cuidadores e nas a����es de enfermagem que visem um trabalho promocional na sala de vacina����o