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

Segurança do paciente no sistema de medicação: análise de enfermeiros de um hospital de ensino

This study aimed to identify and describe the factors related to Patient Safety in a medication system according to the nurses analysis in a teaching hospital from the photographic analysis method. This was a cross-sectional, descriptive study with mixed approach in a teaching hospital in Rio Grande do Norte. The population consisted of 42 nurses from inpatient units, of which 34 composed the study sample. As eligibility criteria, we defined nurses from public service and nurses who agreed to participate. Ethical determinations were observed, the study was submitted to the Ethics and Research of the University Hospital Onofre Lopes, obtaining the assent with ethical assessment certificate (CAAE 0098.0.051.294-11). For data collection, we used the photographic method (Photographic Analysis Technique) by Patricia Marck (Canada). It was developed in two phases: at first, we randomly captured photos from the medication system, resulting in 282 images; then we selected/processed the photographs, which were reduced to 10 images in Microsoft Excel 2010; in the second phase, the nurses answered the questionnaire divided into socio-professional profile and Digital Photography Scoring Tool (questions a and b ). For analysis of the question a , we used the content analysis technique, and for b , we used the Statistical Package for the Social Sciences 20.0 (temporary license). The socio-professional profile revealed the predominance of females; age group 34-43 years; professionals with specialization; 10-18 years of length of service; and nurses working exclusively in the hospital and who know the Patient Safety. The photographic analysis in relation to Patient Safety resulted in specific categories for each stage of the medication system. Regarding disposal, we identified Proper verification ; Improper verification ; Correct identification ; Disposal in single doses ; and Improper Environment , with predominance of that last category. As for storage: Proper storage ; Improper storage ; Risk of exchange/disappearance ; and Poor hygiene , with special reference to improper storage. In preparation: Risk of exchanging medication/patient ; Inappropriate physical space ; and Inadequate 9 preparation of controlled drugs , highlighting the first category. In drug administration: Lack of Personal Protective Equipment ; Use of Personal Protective Equipment ; Improper administration technique ; Proper administration technique ; Correct drug identification ; Incorrect drug identification ; and Peripheral venous access without identification . From the safety assessment of 10 photographs, by adapting the scores (1-10) to the Likert Scale, we identified three Totally Unsafe (Level 1), three Unsafe (Level 2), three Partially Safe (Level 3), one Safe (Level 4), and no photograph considered Totally Safe. This study identified the prevalence of unsafety in the medication system in the nurses opinion. We were also able to understand that, although nurses identify safety aspects, the most prevalent categories characterize an unsafe assessment. Nursing needs to reflect on its practice, identifying gaps in the medication system in order to achieve a proper and safe care

Método de avaliação do gerenciamento de resíduos em canteiro de obras da construção civil : proposta baseada em empresas construtoras da cidade de Natal-RN

According to great concern between the developed industrial activities and resultant impacts over the environment, an association of several factors have occurred, procedures to the efficient management of the rotation between economical development and the environment have been improved. A research in field have been realized inside building sites of companies in order to provide knowledge about the implemented and accomplish actions according to the resolution from CONAMA nº307. Trough the interview among the representations of the companies and photographic survey in loco, such as, what makes the companies implement this management, reutilization and recycling, transport and disposition. The present study had as objective: analyze the insertion of the used tools to residuals management, proposing improvements, in a way that it can be easily identified during the procedures execution in the building sites of the building companies of the city of Natal/RN. To reach the goal, in the first place a revision of the pertinent literature was performed; there for, it can be seen the relation between residues management and environment sustainability, once it happens in a continued way it may prevent the waste and reduces the risk that the activities way bring to the employees, community and environment; once found the great difficult faced with regard to labors, material, equipment, project, planning, costumer s interference, furnisher. And still, it could be verified wich materials generate greater indexes of residues in the works and the main occurrences of waste and loss. However a greater transparency is needed coming from the high administration in the commitment with the continued actions, to make it so, there must be a cultural change inside the company. There for there will be a greater productivity and quality of the under taking such as costumer s satisfaction

Diagnóstico Socioambiental da disposição final dos resíduos sólidos no distrito de Guajiru São Gonçalo do Amarante/RN, ressaltando a situação socioeconômica dos catadores

One of the concerns of this century is with the handling and the final destination of urban solid waste (RSU), where depending on the form as they will be made use, they can cause diverse problems, they are of ambient or social order, being able to generate the loss of the quality of life and illnesses to the population, of direct or indirect form. The objective of the present work was to diagnosis the environmental partner situation of the Final Destination of the urban solid residues in the District of Guajiru, city of São Gonçalo do Amarante/RN, standing out the partner-economic situation of the scavengers. The research was carried through in the period of March of 2008 the October of 2009, with a methodology developed through analyzes them of documents made available for the state ambient agency, the Air base of Christmas and managing agencies of the city. For collection of the date, it was used directly application of the questionnaire with 20 existing scavengers in points of destination of residues, evaluation of the old place of final destination through the use of the spread sheet of the IQR (Index of Quality of the Residues), developed for the CETESB, identification of the matter dump and photographic register. For effect of treatment of the data, a descriptive analysis with regard to the answers of the interviewed scavengers was carried through. The acquired date, Scale had been according to tabulated and analyzed in Excel 2003, where they had been generated graphical to observe the behavior of the data. The results show that of the twenty interviewed scavengers, 35% possess age between 20 and 30 years; 75% possess incomplete basic education; 60% inhabit in houses of waal or huts (cardboard or wood); 55% do not make use of system of water supply and system of sanitary exhaustion; with regard to income monthly for scavengers, 35% had presented income between R$ 200,00 and R$300,00 and 20% possess income above of R$ 500,00 for possessing another source of income; 80% of the interviewed ones, use some type of equipment of individual protection; In the year of 2009, confirming what it was informed by the State agency of Environment, during the field visit, we evidence that the city of Is Gonçalo do Amarante, currently, destines its residues in Sanitary landfill of São Region Metropolitan of Natal in the District of Massaranduba in the city of Ceará-Mirim, after some interventions of the State Public prosecution service. However, in the district of Guajiru some diggings still exist that today are used as final destination of RCD' s (Residues of Construction and Demolition) of the cities of Natal and São Gonçalo do Amarante, as well as private dumps that are used by scavengers that deviate the final destination (Sanitary landfill) of the residues of the great generators (supermarkets, shopping Center and hotels), with presence of urubus, generating a new ambient problem for the city and the aeroportuária security. Ahead of this scene, the study it suggests viable alternatives for the elimination of the private dumps and for the social situation of the escavengers, aiming at to improve its quality of life and 10 to minimize the ambient impacts caused by the inadequate destination of the solid waste in the community of Guajiru, São Gonçalo do Amarante/RN, being able to contribute so that the public managers carry through action in the handling and the control of the final destination of the urban solid waste

Produção pesqueira artesanal: diagnóstico ergonômico e bases para um planejamento nutricional situado e a promoção da saúde dos jangadeiros

The traditional fishing with rafts is characterized by unpredictability, high stakes and inadequate work conditions. The extensive working hours, physical wear, inadequate nutrition, unsanitary conditions, lack of salvage equipment and instruments suitable working, added by the presence of changes in the nutritional status of fisherman, that contribute to the picture of insecurity in high seas, injuries and health. This study aimed to analyze the activity of the fisherman s from Ponta Negra, Natal / RN, and check the conditions of supply of these fishermen and their implications on health and development of their work. To this finality, was used a methodology based on the ergonomic work analysis employing techniques such as observational and interactional conversational action, listening to the answers, observation protocols, photographic and video records. The script conversational dynamic action was developed from literature searches about the artisanal fisheries, culture and food habits of this population, and analyzes the overall situation of focus and two reference situations. To collect data on the usual diet of fisherman as well as quantitative and qualitative analysis that was used for data analysis and 24h recall the Food Frequency Questionnaire (FFQ). The impact of this power to the health of fisherman was evaluated performing a nutritional assessment. The results revealed that the fishermen carry out their activities with poor working conditions, health and nutrition. Feeding practices of these fishermen undertake development work, making it even more stressful, as well contributing to the emergence of Chronic Noncommunicable Diseases. The management of the activity, as well as the current structure of the vessel, also contributes to the adoption of inappropriate feeding practices during the shipment of catch. The results of this indicate the need for adequate interventions in order to assist in recovery and / or maintenance of health of fisherman minimizing reflections of nutritional disorders for the development activity by improving the quality of life in this population

Nova centralidade em Mossoró (RN): expansão urbana e o bairro Bela Vista

This research aims to reconstruct the process of the recent expansion of the urban area of Mossoró (RN), particularly the dynamics of the Bela Vista neighborhood has been established as a new urban centrality. We start from the perspective that the process of urbanization as a result of the transformation of the capitalist system have profound impacts on the restructuring of urban space, which includes resetting and training of new urban centralities. The basic assumption accepts that recent economic changes have led to the adoption of new strategies for the location of large commercial equipment and services, contributing to urban expansion and redefinition of its centrality, leading to the formation of new urban centralities. The research strategy adopted consists of a case study oriented based on the analysis of qualitative information, but also incorporates quantitative information. Interviews with qualified informants were conducted, as well as field surveys, photographic documentation, in order to grasp the phenomenon observed. The survey results show that the Bela Vista neighborhood can be considered a new urban center, housing the specialized trade and service activities, as well as townhouses, which differentiates it from other areas of the city

Processo de cuidar de crianças hospitalizadas com câncer

The objective was to understand the process of care in the perception of hospitalized children with cancer. This is a descriptive study of qualitative approach. Data were collected between the months of October 2013 and January 2014, through photographic records and semi-structured interview consisting of questions relating to the identification of age, sex, diagnosis and length of stay and a script of questions related to the recorded pictures. Eight children were included aged between six and twelve who were admitted to a pediatric oncology sector, located in the city of Natal / RN. The criteria used in the sample were: being hospitalized for cancer treatment; and present favorable physical conditions for carrying out the data collection. For the treatment of collected material was used content analysis, thematic modality. The study followed the ethical and legal principles governing scientific research with human beings and took place with the approval of the project by the Ethics and Research Committee of the Northern League Riograndense against Cancer, with opinion registered under number 329 015 and CAAE 16097613.9.0000.5293. According to the results it was found that, for the child, the care happens through technical activities, such as making procedures and the use of personal protective equipment, as well as through the dialogic relationship, which favors the establishment of confidence in care professional. Caring also means developing activities that promote well-being, the fun and the social and cognitive development, highlighting thus the playful, during hospitalization, as an auxiliary tool in the care process. During hospitalization, the child identifies two individuals responsible for their care, accompanying family and professional, and nursing professionals the most cited in moments of care. , Also of note, the promotion of care, in the perception of the child related to the infrastructure of the institution, environmental cleaning, personal hygiene, the medicalization and the food. It is concluded that care understood by the child, whilst still maintaining relations with the biomedical model, points to a new perspective that should consider the biological, social and psychological of acquiring cancer without unlink them of the development child. 9 Moreover, we see the child as an active social actor in this process, and therefore needs to be heard and answered their needs