118 resultados para Enfermagem Pediátrica


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This study aims to identify the concepts of professional nursing team on assistance in urgency and psychiatric emergencies in SAMU in Mossoró/RN, identifying the difficulties in implementing an emergency assistance to the user in psychiatric distress in this service and point strategies in pursuit of consolidation and expansion of comprehensive health care to the public. It is a descriptive research with qualitative and exploratory approach. The subjects were employees of the nursing staff of SAMU of that mentioned municipality. Semi-structured interviews are applied as tool for data collection. It was counted on the consent of the institution where the study was developed and approval by the Ethics Committee in Research of UFRN with CAAE No 17326513.0.0000.5537, besides signing the Informed Free Consent Term by the participants. Data analysis was done by means of thematic analysis proposed by Bardin. Thus , as a result of the research produced the following categories: mechanistic practice; dehumanization of care; need for qualification, barriers to assistance in urgency and psychiatric emergency and strategies in pursuit of comprehensive care, which proceeded in preparing two articles entitled "Nursing care to the emergency room and psychiatric emergencies in the mobile emergency care service" and "Barriers for emergency service and psychiatric emergencies in the mobile emergency care service". In the studied reality it was identified that nursing care offered to users in situations of urgency and psychiatric emergency is made based primarily on the use of chemical and physical restraints, as well as transportation to the general hospital, constantly using the police force support, which meets the guidelines of the Psychiatric Reform and thereby undermining the provision of an effective and humane care. This scenario is worsened by the lack of an organized network of services in mental health, where after the service the user is taken to a general hospital, considering that there is no ready or appropriate psychiatric emergency service as a Center of Psychosocial Care - CAPs III to reference it, thereby precluding the realization of a resolute and comprehensive care. Thus, it is concluded that nursing care is based on biologicist and medicine-centered model advocated by classical psychiatry, and that despite all the advances in psychiatric reform, still guides the mental health care, so the lack of service network organized in hierarchical and mental health, where the user in urgency and emergency service can be watched in full and the guidelines of the psychiatric reform can be realized in practice

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At the current time of demographic changes in the world , it is observed that the health sector requires restructuring of its practices in caring for the elderly , in order to enable a comprehensive and humane care . In this sense, we identify the need for qualified professionals to assist the elderly and, therefore , it is important that training curricula are adequate to this reality . The study aims to analyze how it develops teaching gerontological nursing component in undergraduate nursing . This is a descriptive , exploratory study with a qualitative approach, in two higher education institutions in the city of Natal / RN . The population involved corresponded to the coordinators of graduate courses in nursing and teachers who teach content of health care for the elderly, a total of seven participants . The data collection instruments were used: a questionnaire containing questions related to the characterization of the participants and the teaching of gerontological nursing in undergraduate courses in nursing and a form with items of analysis for pedagogical projects . The results were presented descriptively in tables and analyzed from coming themes of the main themes of the instruments defined in: knowledge about the research participants , knowledge of teaching gerontological nursing component and knowledge of pedagogical projects , discussed under Resolution paragraph . 03 of 7/11/2001 , which establishes standards for the nursing program , the educational projects of educational institutions , the Theoretical Donald Shoon and thematically relevant literature . The results indicate that the majority of participants were female (four), all have graduate though , none of them stated in the qualification of aging or elderly health area; the organization of the contents of the component in the curriculum, workload theoretical- methodological and practical teaching strategies presented was heterogeneous and sometimes diverging at the same institution . On the definition of gerontological nursing component was identified that is not well defined along the pedagogical design of educational institutions surveyed . It was concluded that in the context of this study , teaching gerontological nursing is present in the course of nursing education, but needs reevaluation and updating in order to teach a wider range of driving and health practices

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The present study aimed to analyze the vision of tutors from a university hospital about supervised internship in nursing. It is a descriptive nature research with qualitative approach, developed at the University Hospital Onofre Lopes (HUOL), located in Natal/RN. The population was composed of eleven assisting nurses engaged the precentorship of undergraduate course students in nursing, from the Federal University of Rio Grande do Norte (UFRN). For the empirical research, conducted in the period from September to November 2013, the semi-structured interview involving questions directed to the stage was used, as advocate the national curriculum guidelines, as regards this curricular component. With the consent of the institution where the study has been developed and approved by the Research Ethics Committee of UFRN, as n° 17800613.9.0000.5537, besides CAAE signing an informed consent by participants. The analysis of the information was held from the analysis of content, thematic mode. Thereby four categories were defined a priori, namely: the supervised internship in the vision of nurses; To be preceptor; The internship concerned: contributions and difficulties; Do the institutional actors communicate? The results indicate that in the view of the supervised internship preceptors is a sine qua non for the training of nurses, considering that it prepares for professional life. Besides being a moment conducive to the exercise of management and a greater rapprochement between theory and practice, stimulates the preceptor to upgrade to better exercise the function and also provides an exchange of knowledge between students and tutors, thus contributing to optimize the service. Nevertheless, the respondents indicate the existence of a distancing and little communication with the academic institution. In summary, it is realized that the nurses understand the importance of its function of tutors and supervised stage for vocational training. It is necessary, however, to reflect on the paths to be pinched in the confrontation of difficulties in this process, especially as regards the teaching/service relationship, which, while remaining at a distance, strengthens the existing dichotomy between theory and practice

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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 Questionário Atitudes de Segurança , 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

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The study analyzes the changes occurring in the professional qualification of the Nursing Technician in the Natal School of Nursing. It provides a historical discussion of Brazilian professional education, of the pertinent legislation in this type of teaching, and the repercussions related to the institutionalization of the Educational Directives Law. It interprets the discourse of the graduates of the complementary course of nursing auxiliary to nursing technician, for the year 2002, using the collective subject analysis and individual interviews. These revealed changes in the areas of knowledge-learning, knowledge-doing, knowledge-being, and an awakening to other changes besides the challenges being confronted. In this sense, nursing as a participant in a society that is effervescent with process changes, interacts socially, politically and professionally in this context, able to experience advances and retrogrades, depending on its political competency

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Nursing documentation is a literacy practice which is regulated by law. Among the written practices of the literacy field, nursing registration is understood as the attendance resume of the main problems and occurrences on duty. In other words it is a document and a communication instrument used by hospital orderly on duty. It s main goal is to keep a record of the information which is necessary to the continuity of the activities as well as to the assistance to the patients. Taking into consideration the complexity of this kind of literacy practice, this study which took place in a hospital context, aims at studying the nursing registration process in order to explain its implementation in the nursing field. The discussion is situated in the area of applied linguistics, and it makes a linkage between linguistics approaches and language questions which are related to the area of discourse at work. The theoretical foundations come from contemporary literacy studies such as Hamilton (2000) who proposes the following categories: participants, domain, artifacts and activities. The analysis was guided by the principles of the ethnographic methodology which proposes that the researcher spends much time in the field and uses a set of techniques in order to collect data related to the subjects speech as well as their deeds concerning the research main object. The data were collected through field observations, analysis of 100 nursing records, 04 reflective sessions and interviews as well involving 36 nurses. On one hand, the analysis reveals the importance of the nursing records in terms of documentation and communication. On the other hand, it shows informational, compositional as well as normative difficulties in terms of linguistics and legal aspects. For, we conclude that these questions need to be addressed through the process of intervention especially in events of teacher in service activities so that the professional nurses may improve their practice in relation to the elaboration of the nursing documentation on duty

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Cancer goes on to be a frightening disease by humanity, simetimes,it is considered as death, suffering and stigma synonym. Occurring at childhood, this meaning seems to acquire a more intense conotation, having in view of the perplexity and godliness feeling in the presence of the precocity of events, nearly always associated to the death. A psychologist co-existence with the cancer children is going acquiring, thus, a permeated sense by incognitas , fears and fantasy, which raised us the following question: how does the psychologist that answers children with cancer lives this experience? Therefore, the aim this research was to understand this co-existence experience. Our theoretical perspective comes from an existencial fenomenology and, more specifically, the Humanistic Approach and Martin Heidegger Existencial Ontology. The metodology is qualitative of phenomenological character. The access instrument to the experience was the narrative, such as purpose by Walter Benjamin. They were carried out nine semi-open interviews with psychologists who work on pediatric oncology services of Natal-RN city. Such interviews were recorded in cassette, transcripted and later, re-educated. These interviews were recorded, transcribed and later on edited with the help of the interviewee and turned into a text. The narrative comprehension was carried out on Heidegger Existencial Ontology, on dada exaustive reading and the clipping of indicative passages of experience sense of being psychologist on this area. The research suggests that the experience is oriented of clinic kowing-doing, being crossed by implications of key thematics which indicate the care as central ontologic element that orientates the way as these professionals come being in the world in association with the clientèle. Besides, the caring experience of these children acquire the sense of true living experience, since the cancer undoes the immortality illusion, launching the psychologist to his/her condition of being to the death and with that, calling him/her the authenticity. Is is only not dealt with to experience the anguish and the death imminence, but above all, re-meaning them in favour of a continual learning, of quality answering , besides other possibilities. Working with child cancer brings news perspectives and world views, making the psychologist a more human people and sensitive to the distracted needs. And we believe that, regardless of area which actuates, being psychologist is a particular way which choose to be citizen. Is is a project that will be delimited by society, history and culture and after all, by us like human being. Therefore, we understand that the results this research suggest the discussed thematic deepening on this intervention field in order to new sense possibilities can arise giving origin to other reflections about the clinical practice, the professional formation in Psychology and other possible developments

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The tales of children's literature, in their plots, mark existential dilemmas belonging in human‟s lives, such as death, situations of separation, loss, abandonment, fear, challenges, achievements and other elements that make them suitable material to assist children in their developmental process. Such elements, present in children‟s storybooks, are close to the experiences lived by the children in the context of hospitalization in a special manner. With that said this study focus on the understanding of the therapeutic possibilities of the tales of children's literature in the care of hospitalized children in Pediatric Intensive Care Units (UTIPED) based on the Heidegger's concept of Care and adopting the Phenomenology as the method. The UTIPED of a state public hospital located in the municipality of Natal/RN was elected as the study site and four hospitalized children aged between six and nine years, all males, presenting different clinical conditions were selected to participate in the study following age and clinical conditions as the selective criteria. The procedure of corpus construction included eight individual sessions of storytelling accompanied by the use of ludic resources. The phenomenological understanding about the therapeutic possibilities of tales was structured under three main elements: (1) the ludic axis; (2) the reflective axis; and (3) the affective axis. The appropriateness of the proposed therapy in the context of the UTIPED and the potential of the tales as a protection factor to the child was evident. The storytelling activity framed a scenario of care unusual in the context of intensive care units, establishing a symbolic space for children‟s expression. Therefore, this study indicates this therapeutic proposal for children‟s care in the UTIPED that considers their evolutionary stage, their clinical conditions at the time and especially their emotional needs during their immersion in a diverse and foreign environment which is filled with potentially harmful elements to their full development.

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A proposal of formation in health/nursing built on classic science, on reducing thought and flexnerian paradigm is insufficient to comprehend and intervening with an amplified way on health needs of population, given that it is produced by fragmentation of knowledge, rationalization of thought, mechanizing and biological attitudes. It is necessary that formation in health/nursing allows the construction of effectiveness of principles and guidelines of Unique System of Health (Sistema Único de Saúde - SUS). In this context of emergency of a complex formation in health/nursing, life trajectories and formation of the nurses: Abigail Moura, Francisca Valda and Raimunda Germano are examples of transgressor and successful experiences which allow inquietude, changing and transforming formation patterns and self-formation. The present study is built from the comprehension of method as strategy , defended by Morin and complexity sciences. Has as objects building biographies of formation of these three nurses who express a formation model more totalizing and humanitarian, analyzing and discussing starting from the three biographic fragments guiding principles for the current process of formation in health/nursing. From the biographies, the courage and humbleness emerge as landmarking principles of their experiences. Humbleness neither as self-depreciation nor humiliation but as consciousness of our uncompleted and unfinished essence, acceptance of boundaries and potential and reduction of intellectual vanity. Courage, for its part, is the human pulsing, uncertain for nature, which brings us to act, to face and persevere on moments of fear and difficulties. A formation in health and nursing based on courage and humbleness allows the subjects to be taken away from indifference, arrogance, inertia, pragmatism: bets on ethic and political subjects capable of minimizing unequal, inhumane and excluding processes. Na intellectual and Professional attitude which politizes the thought and science is what must be expected from a complex formation in health field, in latu mode on nursing, in particular

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On the health area, care is seen as an important concept for professionals. Recently there is a trend, the epistemological point of view, to think carefully as category allowing discuss and re (thinking) practices of humane health care. The objective of this study is to investigate the understanding of care in nursing staff in a Basic Health Unit (BHU) in the city of Natal. The participants were two nurses and two nursing technicians working on the BHU of Guarapes district, located on the west side of Natal - RN. As Theoretical support for data interpretation, was used the concept of care taking, using Heidegger’s theories as reference, through Ayre’s ideas. This is a qualitative research using autobiographical as a methodology. The methodological strategy approach used were focus group and individual interviews. The data were discussed by three angles: knowledge (concepts and theories behind the practical model), technical (the way to do), and ethics (values that bases practices) by hermeneutics Gadamer's dialectic. The results showed the necessity to expand the discussion on care, in practice the understanding of care seems to get narrower concerns with technical success by professionals. The care, as a meeting between beings, the desired humanized care, seems to be understood in parts in theory, but also distances itself from reality in professional practice.

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The study aims to examine the methodology of realistic simulation as facilitator of the teaching-learning process in nursing, and is justified by the possibility to propose conditions that envisage improvements in the training process with a view to assess the impacts attributed to new teaching strategies and learning in the formative areas of health and nursing. Descriptive study with quantitative and qualitative approach, as action research, and focus on teaching from the realistic simulation of Nursing in Primary Care in an institution of public higher education. . The research was developed in the Comprehensive Care Health discipline II, this is offered in the third year of the course in order to prepare the nursing student to the stage of Primary Health Care The study population comprised 40 subjects: 37 students and 3 teachers of that discipline. Data collection was held from February to May 2014 and was performed by using questionnaires and semi structured interviews. To do so, we followed the following sequence: identification of the use of simulation in the discipline target of intervention; consultation with professors about the possibility of implementing the survey; investigation of the syllabus of discipline, objectives, skills and abilities; preparing the plan for the execution of the intervention; preparing the checklist for skills training; construction and execution of simulation scenarios and evaluation of scenarios. Quantitative data were analyzed using simple descriptive statistics, percentage, and qualitative data through collective subject discourse. A high fidelity simulation was inserted in the curriculum of the course of the research object, based on the use of standard patient. Three cases were created and executed. In the students’ view, the simulation contributed to the synthesis of the contents worked at Integral Health Care II discipline (100%), scoring between 8 and 10 (100%) to executed scenarios. In addition, the simulation has generated a considerable percentage of high expectations for the activities of the discipline (70.27%) and is also shown as a strategy for generating student satisfaction (97.30%). Of the 97.30% that claimed to be quite satisfied with the activities proposed by the academic discipline of Integral Health Care II, 94.59% of the sample indicated the simulation as a determinant factor for the allocation of such gratification. Regarding the students' perception about the strategy of simulation, the most prominent category was the possibility of prior experience of practice (23.91%). The nervousness was one of the most cited negative aspects from the experience in simulated scenarios (50.0%). The most representative positive point (63.89%) pervades the idea of approximation with the reality of Primary Care. In addition, professors of the discipline, totaling 3, were trained in the methodology of the simulation. The study highlighted the contribution of realistic simulation in the context of teaching and learning in nursing and highlighted this strategy while mechanism to generate expectation and satisfaction among undergraduate nursing students

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The study aimed to analyze the nursing diagnoses of the nutrition domain from NANDA International in patients undergoing hemodialysis. This is a transversal study conducted in a university hospital in northeastern Brazil, with 50 hemodialysis patients. The data collection instrument was an interview form and a physical examination, in digital format, applied between the months of December 2013 to May 2014. Data analysis was divided into two stages. In the first, defining characteristics, related factors and risk factors were judged as to their presence by the researcher, according to the data collected. In the second stage, based on data from the first, diagnostic inference by experts was held. The results were organized in tables and analyzed using descriptive and inferential statistics for the diagnoses that showed higher frequencies than 50%. The project was approved by the Ethics Committee responsible for the research institution (protocol number 392 535), with Certificate Presentation to Ethics Assessment 18710613.4.00005537 number. The results indicate a median of 7 (± 1.51) nursing diagnoses of the nutrition domain per patient. Six diagnoses with greater frequency than 50% were identified, namely: Risk for electrolyte imbalance, Risk for unstable blood glucose level, Excess fluid volume, Readiness for enhanced fluid balance, Readiness for enhanced nutrition and Risk for deficient fluid volume. The defining characteristics, related and risk factors presented an average of 34.78 (± 6.86), 15.50 (± 3.40) and a median of 4 (± 1.93), respectively, and 11 of these components had statistically significant association with the respective diagnoses. Were identified associations between adventitious breath sounds, edema and pulmonary congestion with the diagnosis Excess fluid volume; Expressed desire to increase fluid balance with the nursing diagnosis Readiness for enhanced fluid balance; It feeds regularly, Attitude to food consistent with the health goals, Consume adequate food, expresses knowledge about healthy food choices, expresses desire to improve nutrition, expresses knowledge about liquid healthier choices and following appropriate standard supply with diagnosis Readiness for enhanced nutrition. It is concluded that the diagnosis of the nutrition domain related to electrolyte problems are prevalent in customer submitted to hemodialysis. The identification of these diagnoses contributes to the development of a plan of care targeted to the needs of these clients, providing better quality of life and advance in the practice of care

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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

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The sizing of nursing human resources is an essential management tool to meet the needs of the patients and the institution. Regarding to the Intensive Care Unit, where the most critical patients are treated and the most advanced life-support equipments are used, requiring a high number of skilled workers, the use of specific indicators to measure the workload of the team becomes necessary. The Nursing Activities Score is a validated instrument for measuring nursing workload in the Intensive Care Unit that has demonstrated effectiveness. It is a cross-sectional study with the primary objective of assessing the workload of nursing staff in an adult Intensive Care Unit through the application of the Nursing Activities Score. The study was conducted in a private hospital specialized in the treatment of patients with cancer, which is located in the city of Natal (Rio Grande do Norte – Brazil). The study was approved by the Research Ethics Committee of the hospital (Protocol number 558.799; CAAE 24966013.7.0000.5293). For data collection, a form of sociodemographic characteristics of the patients was used; the Nursing Activities Score was used to identify the workload of nursing staff; and the instrument of Perroca, which classifies patients and provides data related to the their need for nursing care, was also used. The collected data were analyzed using a statistical package. The categorical variables were described by absolute and relative frequency, while the number by median and interquartile range. Considering the inferential approach, the Spearman test, the Wald chi-square, Kruskal Wallis and Mann-Whitney test were used. The statistically significant variables were those with p values <0.05. The evaluation of the overall averages of NAS, considering the first 15 days of hospitalization, was performed by the analysis of Generalized Estimating Equations (GEE), with adjust for the variable length of hospitalization. The sample consisted of 40 patients, in the period of June to August 2014. The results showed a mean age of 62,1 years (±23,4) with a female predominance (57,5%). The most frequent type of treatment was clinical (60,0%), observing an average stay of 6,9 days (±6,5). Considering the origin, most patients (35%) came from the Surgical Center. There was a mortality rate of 27,5%. 277 measures of NAS score and Perroca were performed, and the averages of 69,8% (±24,1) and 22,7% (±4.2) were obtained, respectively. There was an association between clinical outcome and value of the Nursing Activities Score in 24 hours (p <0.001), and between the degree of dependency of patients and nursing workload (rp 0,653, p<0,001). The achieved workload of the nursing staff, in the analyzed period, was presented high, showing that hospitalized patients required a high demand for care. These findings create subsidies for sizing of staff and allocation of human resources in the sector, in order to achieve greater safety and patient satisfaction as a result of intensive care, as well as an environment conducive to quality of life for the professionals