Nurses, nursing technicians and assistants: who experiences more moral distress?

Objective: To identify the frequency and intensity of moral distress experienced by nurses, technicians and nursing assistants who worked in hospitals in the South of Rio Grande do Sul State. Method: A survey research was conducted with 334 nursing workers from three institutions, through a questionnaire of moral distress. Constructs were validated through factorial analysis and Cronbach’s alpha: lack of competence of the working team, disrespect to the patient’s autonomy, insufficient working conditions and therapeutic obstinacy. Results: With descriptive statistics and analysis of variance, it was found that nurses and nursing assistants have higher perception of moral distress when compared to nursing technicians. Organizational questions and ways of communication influence lower perception of moral distress.Conclusion: Implementation of actions to favor coping, decision making and autonomy exercise from those workers.


Occupational low back pain in nursing workers: massage versus pain

Objective: To assess the efficacy of massage for decreasing occupational low back pain in workers of a Nursing team in an Emergency Room. Method: A randomized controlled trial, using a socio-demographic/morbidity questionnaire and a Pain Numeric Scale. Forty-five subjects were randomly allocated for intervention (G1 – Massage by acupressure), placebo group (G2 – application of Garlium Arseneid Laser 904nm turned off) and control (G3 – no intervention). Results: The main triggering factor, as well as the worsening of pain, was the patient manipulation, both with a prevalence of 34.9%. The main treatment for low back pain before this research was the use of medication, with a prevalence of 44.2%. In accordance with a variance analysis, only G1 presented a significant statistical difference, with a better result after 12 sessions. Massage presented an enormous effect (d = 4.59), corresponding to 86% of reduction in the pain level. Conclusion: Massage was effective to decrease occupational low back pain of those Nursing workers.


Procedures’ costs related to outpatient chemotherapy treatment of women suffering from breast cancer

To identify the direct cost of procedures related to an outpatient chemotherapy treatment for women with breast cancer. Method: This is a quantitative research, using the case study methodology, performed in an outpatient chemotherapy of a private hospital. The total cost was calculated by multiplying the time spent by professionals involved in therapeutic procedures, the unit cost of direct labor, adding to the cost of materials, drugs and solutions. For performing the calculations, we used the Brazilian currency (R$). Results: The average total cost per chemotherapy session corresponded to R$ 1,783.01 (100%), being R$ 1,671.66 (93,75%) spent with drugs, R$ 74,98 (4.21%) with materials, R$ 28.49 (1.60%) with labor and R$ 7.88 (0.44%) with solutions. Conclusion: The results may support discussions and decision making for the management of costs related to chemotherapy aimed at reducing expenses and eliminating waste without harm to the care provided. 


The work environment and leadership in nursing: an integrative review

Objective: To investigate the relationship between the work environment and leadership in nursing. Method: An integrative review of literature which was based on data from LILACS, PubMed, CINAHL and the SciELO portal for journals covering the period from January to April 2013. The inclusion criteria were: the indexing of research covering leadership exercised by nurses over a team and whether the research was available in English, Spanish or Portuguese. Results: The sample consisted of 12 articles that met the criteria. Conclusion: The results showed that leadership had an impact on the work environment. However, no studies were found that showed the influence of the working environment on leadership in nursing.

Treatment of skin lesions in newborn children: meeting the needs of nursing staff

Objective To understand, together with nursing staff, the care needed to treat skin lesions in newborn children hospitalized in a neonatal unit. Method Qualitative research, of the convergent care type. The data was collected through semi-structured interviews, which were conducted from November to December 2012, in the neonatal unit of a hospital in southern Brazil. The participants were four auxiliary nurses, six nursing technicians and four nurses. Results The following three categories were designated: questions about what can be used in relation to newborn children; hospitalization can cause lesions on the skin of newborn children; and knowledge about care promotes professional autonomy. Conclusion There is an urgent need for staff to know more about the treatment of skin lesions, which would provide safer care for newborn children and would also support the autonomy of professional nurses in providing that care.


Gerontology course in the nursing undergraduate curricula

Objective To explores nursing faculty members’ attitudes towards older people, their thoughts about gerontological nursing education. Method Five focus groups and a survey were used with nursing faculty members 132 at the three nursing schools to explore their attitudes towards the care of older people and the perceived status of gerontological nursing education. The survey was given to 132 faculty members, including 76 clinical instructors, 40 associate professors and 16 professors. The nursing faculty in general had a positive attitude toward older people (M=3.36, SD 0.25), and teachers’ attitudes were higher than those of their nursing students (M=3.18, SD0.29). Results This study results suggests that Saudi nursing curricula should include more extensive gerontology content and clinical experience with older people. Conclusion This is the first time in Saudi Arabia that research has listened to their voices and examined their commitments toward gerontology education.


Higher education in nursing: the faculty work process in different institutional contexts

Objective To analyze the characteristics of faculty work in nursing higher education. Method An exploratory qualitative study with a theoretical-methodological framework of dialectical and historical materialism. The faculty work process was adopted as the analytical category, grounded on conceptions of work and professionalism. Semi-structured interviews were conducted with 24 faculty members from three higher education institutions in the city of São Paulo, classified according to the typology of institutional contexts. Results The faculty members at these higher education institutions are a heterogeneous group, under different working conditions. Intensification and precarious conditions of the faculty work is common to all three contexts, although there are important distinctions in the practices related to teaching, research and extension. Conclusion Faculty professionalization can be the starting point for analyzing and coping with such a distinct reality of faculty work and practice.


Violence as a research object and intervention in the health field: an analysis from the production of the Research Group on Gender, Health and Nursingi

The study aimed to describe how violence is revealed in the production of the Research Group on Gender, Health and Nursing. This is a historical research of qualitative approach, which evaluated the production of the Research Group, through content analysis. The results show gender as a central category in determining violence and health practices. This aspect determines limitations on professional practices of coping, such as the invisibility of the problem. The female autonomy, the use of alcohol and drugs and social vulnerability play an important relation with the phenomenon and the bond is revealed as potentiality of health practices to address the problem. Conclusion: The gender perspective in nursing research is an innovative field and counter-hegemonic, a possibility to assume a meaning of praxis by transforming potential of understanding and modes of intervention in the phenomenon of gender violence.

PERCEPTIONS AND EXPERIENCES OF ELDERLY RESIDENTS IN A NURSING HOME

The objective of this study was to evaluate the perception of the elderly residents of a long-stay nursing home on the process of institutionalization. We interviewed 14 subjects, five women and nine men, aged between 60 and 92 years. Data collection was conducted with a semi-structured sociodemographic interview, which presented the guiding question: “Tell me about how is your life, what do you do and how did you come to live here”. From the analysis, we found topics related to feelings of abandonment, loneliness, anger, ingratitude, living with chronic pain, satisfaction of property in the nursing home, productivity and social relationship. Given the thematic analysis, it was possible to group them into three categories such as: what the elderly feel, what the elderly perceive and what the elderly desire. As a result, we need public policies that addresses to the service provided by institutions regarding elderly expectations.

Narrative interviews: an important resource in qualitative research

Objetives This methodological study explain and emphasize the extent and fertility of the narrative interview in qualitative research. Methods To describe the narrative method within the qualitative research. Results The qualitative research method is characterized by addressing issues related to the singularities of the field and individuals investigated, being the narrative interviews a powerful method for use by researchers who aggregate it. They allow the deepening of research, the combination of life stories with socio-historical contexts, making the understanding of the senses that produce changes in the beliefs and values that motivate and justify the actions of possible informants. Conclusion The use of narrative is an advantageous investigative resource in qualitative research, in which the narrative is a traditional form of communication whose purpose is to serve content from which the subjective experiences can be transmitted.

Nursing Supervision: Studying the “Case” of the phenomenon of interorganizational articulation Nursing School and Hospital

The history of this research found a suitable ethos not only by the route of the researcher, but also by the current public policies of modernization and reform that are capable of regulating and transforming the educational and health systems, as well as their professional groups. The reflection meantime developed had raised a clear perception of the organizational change processes by which they interfered with the interorganizational coordination between School of Nursing and Hospital, where internship supervision would be the main protagonist, supported by the meanings that intervening actors have assigned to them. In this context, the search for explicit epistemological and methodological choices leads to look more attentively at the problem, ascertaining it, taking into account the organizational dimensions. In this regard, the choice of a case study was related to the fact that the method allowed to answer the purpose of knowing and understanding the interorganizational coordination phenomenon between School of Nursing and Hospital, namely through the supervision of internships.

COMPETENCY-BASED TRAINING IN NURSING: LIMITS AND POSSIBILITIES

Objective To analyze the possibilities and limits of competency-based training in nursing. Method An integrative review of the literature on the subject was carried out, and an analysis was made of the results of a survey evaluating a nursing course based on areas of competency. A dialog was then established between the review and the results of the research. Results On the question of which theoretical type of competency the articles from the literature relate to, there is a predominance of the constructivist perspective, followed by the functionalist approach and the dialog-based approach. In the dialog between the literature and the research, limits and possibilities were observed in the development of a training by areas of competency. Conclusion The dialog-based approach to competency is the proposition that most approximates to the profile defined by the National Curriculum Guidelines for training in nursing, and this was also identified in the evaluation survey that was studied. However, it is found that there are aspects on better work is needed, such as: partnership between school and the workplace, the role of the teacher, the role of the student, and the process of evaluation.

Construction and validation of nursing diagnoses for individuals with diabetes in specialized care

OBJECTIVE To construct statements of nursing diagnoses related to nursing practice for individuals with diabetes in Specialized Care, on the basis of the Database of Nursing Practice Terms related to diabetes, in the International Classification for Nursing Practice (ICNP®) and in the Theory of Basic Human Needs and to validate them with specialist nurses in the area. METHOD Methodological research, structured into sequential stages of construction, cross-mapping, validation and categorization of nursing diagnoses. RESULTS A list was indicated of 115 statements of diagnostic, including positive, negative and improvement statements; 59 nursing diagnoses present in and 56 nursing diagnoses absent from the ICNP® Version 2011. 66 diagnoses with CVI ≥ 0.50 were validated, being categorized on the basis of human needs. CONCLUSION It was observed that the use of the ICNP® 2011 favored the specifications of the concepts of professional practice in care with individuals with diabetes.

Educational intervention on malignant hyperthermia with nursing professionals of the operating room

OBJECTIVE To evaluate the effectiveness of an educational intervention on malignant hyperthermia with operating room nurses. METHOD A quasi-experimental study, aimed at an educational intervention of short duration with the nursing staff in the operating room of the institution hosting the research in the city of São Paulo, with the participation of 96 professionals. Pre-intervention tests and post-intervention tests were applied, which consisted of a lecture followed by simulation. RESULTS Considering the overall results of the intervention, there was a statistically significant difference (p<0.00). After the educational intervention, there was an increase of the minimum and maximum scores, and average growth of 2.64 points in the knowledge of professionals when compared to the previous step. CONCLUSION The educational intervention strategy favors the concept of the content developed by everyone involved and qualifies professionals to work safely.

Usability of computerized nursing process from the ICNP® in intensive care units

OBJECTIVE To analyze the usability of Computerized Nursing Process (CNP) from the ICNP® 1.0 in Intensive Care Units in accordance with the criteria established by the standards of the International Organization for Standardization and the Brazilian Association of Technical Standards of systems. METHOD This is a before-and-after semi-experimental quantitative study, with a sample of 34 participants (nurses, professors and systems programmers), carried out in three Intensive Care Units. RESULTS The evaluated criteria (use, content and interface) showed that CNP has usability criteria, as it integrates a logical data structure, clinical assessment, diagnostics and nursing interventions. CONCLUSION The CNP is a source of information and knowledge that provide nurses with new ways of learning in intensive care, for it is a place that provides complete, comprehensive, and detailed content, supported by current and relevant data and scientific research information for Nursing practices.