Cuidado de enfermagem ao potencial doador de órgãos em morte encefálica: uma reflexão sobre a prática

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

Protocolo de avaliação do cuidado de enfermagem e da segurança do paciente em unidades de terapia intensiva

The reports of adverse events date from 1990 up to the present day. Conceptually, these adverse events are unintentional injuries unrelated to the underlying disease, causing measurable lesions in patients, extending the period of hospitalization, or leading to death. These issues require discussions with regard to patient safety, improved quality of service, and preventing medical errors. In the Intensive Care Units, this concern is greater because these are sectors of intensive care to individuals with hemodynamic changes and imminent risk of death. Therefore, it is essential to conduct evaluation processes to investigate aspects of quality of nursing care and patient safety in these spaces. For that reason, we aimed to propose the Evaluation protocol of nursing care and patient safety in Intensive Care Units. For its achievement, we needed to: 1) analyze the evolution of the patient safety concept used in scientific productions, under Rodgers evolutionary concept; 2) identify the necessary items to build the evaluation protocol of nursing care and patient safety in the Intensive Care Unit, from the available evidence in literature; 3) construct an instrument for content validation of the evaluation protocol of nursing care and patient safety in the Intensive Care Unit; and 4) describe and evaluate the appropriateness of the content for an evaluation protocol of nursing care and patient safety in the Intensive Care Unit. This is a methodological study for the content validation of the abovementioned protocol. To meet the first three specific objectives, we used the integrative literature review in Theses Database of the Coordination for the Improvement of Higher Education Personnel and the portal of the Collaborating Centre for Quality of Care and Patient Safety. The fourth specific objective happened through the participation of judges, located from the Lattes curricula, in the content validation process developed in two stages: Delphi 1 and Delphi 2. As instrument, we used the electronic form of Google docs. We present in tables the answers from the evaluation instruments by Delphi consensus and Content Validity Index (CVI) of the entire protocol. We summarized the results in articles entitled Analysis of the patient safety concept: Rodgers evolutionary concept ; Scientific evidence regarding patient safety in the Intensive Care Unit ; Technological device for the content validation process: experience report ; and Evaluation protocol of nursing care and patient safety in Intensive Care Units. The Embodied Opinion of the Research Ethics Committee of the Universidade Federal do Rio Grande do Norte, No. 461,246, under CAAE 19586813.2.0000.5537, approved the study. Thus, we conclude the protocol valid in its content, constituting an important tool for evaluating the quality of nursing care and patient safety in Intensive Care Units

Atuação e o conhecimento dos profissionais de enfermagem quanto a morte encefálica e manutenção do potencial doador de órgãos e tecidos para transplantes

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

O cidadão técnico em enfermagem :analisando as mudanças na sua profissionalização

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

Modelos para análise e dimensionamento de painéis de alvenaria estrutural

The main objective of this thesis was the study of bracing panels of structural masonry, by applying the Finite Element Method and Strut and Tie Method. It was analyzed the following aspects: the effect of orthotropy on the behavior of the panels; distribution of horizontal forces between panels for buildings; comparison between Equivalent Frame and Finite Elements models; panels design with the Strut and Tie Method. The results showed that one should not disregard the orthotropy, otherwise this can lead to models stiffer than the real. Regarding the distribution of horizontal forces, showed that the disregard of lintels and shear deformation leads to significant differences in the simplified model. The results showed also that the models in Finite Element and Equivalent Frame exhibit similar behavior in respect to stiffness of panels and stress distribution over the sessions requested. It was discussing criteria for designing Strut and Tie Method models in one floor panels. Then, the theoretical strength these panels was compared with the rupture strength of panels tested in the literature. The theoretical maximum strength were always less than the rupture strength of the panels obtained in tests, due to the fact that the proposed model cannot represent the behavior of the masonry after the start of the panel cracking due to plasticization of the reinforcement

Dimensionamento de sistemas de aterramento em linhas de transmissão para escoamento eficiente de correntes de surtos atmosféricos

This work presents in a simulated environment, to analyze the length of cable needed counterweight connected to ground rod, able to avoid the phenomenon of flashover return, back flashover, the insulator chains of transmission lines consisting of concrete structures when they are subjected to lightning standardized regarding certain resistivity values of some kinds of soil and geometric arrangements of disposal of grounding systems structures

Ensaios de tratabilidade aplicados a determinação de parâmetros para dimensionamento de processos de tratamento de água de manancial eutrofizado

Eutrophication is a growing process present in the water sources located in the northeast of Brazil. Among the main consequences of these changes in trophic levels of a water source, stands out adding complexity to the treatment to achieve water standards. By these considerations, this study aimed to define, on a laboratory scale, products and operational conditions to be applied in the processing steps using raw water from Gargalheiras dam, RN, Brazil. The dam mentioned shows a high number of cyanobacteria, with a concentration of cells / ml higher than that established by Decree No. 518/04 MS. The same source was also considered by the state environmental agency in 2009 as hypereutrophic. The static tests developed in this research simulated direct filtration (laboratory filters) and pre-oxidation with chlorine and powdered activated carbon adsorption. The research included the evaluation of the coagulants aluminum hydrochloride (HCA) and alum (SA). The development of the research investigated the conditions for rapid mixing, the dosages of coagulants and pHs of coagulation by the drawing of diagrams. The interference of filtration rate and particle size of filtering means were evaluated as samples and the time of contact were tested with chlorine and activated carbon. By the results of the characterization of the raw water source it was possible to identify the presence of a high pH (7.34). The true color was significant (29 uH) in relation to the apparent color and turbidity (66 uH and 13.60 NTU), reflecting in the measurement of organic matter: MON (8.41 mg.L-1) and Abs254 (0.065 cm-1). The optimization of quick mix set time of 17", the speed gradient of 700 s-1 in the coagulation with HCA and the time of 20" with speed gradient of 800 s-1 for SA. The smaller particle sizes of sand filtering means helped the treatment and the variation in filtration rate did not affect significantly the efficiency of the process. The evaluation of the processing steps found adjustment in standard color and turbidity of the Decree nº 518/04 MS, taking in consideration the average values found in raw water. In the treatment using the HCA for direct filtration the palatable pattern based on the apparent color can be achieved with a dose of 25 mg L-1. With the addition of pre-oxidation step, the standard result was achieved with a reduced dose for 12 mgHCA.L-1. The turbidity standard for water was obtained by direct filtration when the dose exceeds 25 mg L-1 of HCA. With pre-oxidation step there is the possibility of reducing the dose to 20 mg L-1.The addition of CAP adsorption, promoted drinking water for both parameters, with even lower dosage, 13 mg L-1 of HCA. With coagulation using SA removal required for the parameter of apparent color it was achieved with pre-oxidation and 22 mgSA.L-1. Despite the satisfactory results of treatment with the alum, it was not possible to provide water with turbidity less than 1.00 NTU even with the use of all stages of treatment

A ousadia como horizonte: religando vida e ideias na formação em enfermagem

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

Responsabilidade do profissional de saúde sobre a notificação de casos de violência doméstica

A notificação da violência doméstica pelos profissionais de saúde contribui para o dimensionamento epidemiológico do problema, permitindo o desenvolvimento de programas e ações específicas. O objetivo do trabalho foi verificar a responsabilidade desses profissionais em notificar a violência, especialmente a doméstica e as possíveis implicações legais e éticas a que estão sujeitos. Assim, foi realizada pesquisa na legislação brasileira e códigos de ética da medicina, odontologia, enfermagem e psicologia. Quanto à legislação, as sanções estão dispostas na Lei das Contravenções Penais, Estatuto da Criança e Adolescente, Estatuto do Idoso e na lei que trata da notificação compulsória de violência contra a mulher. Também existem penalidades em todos os códigos de ética analisados. Conclui-se que o profissional de saúde tem o dever de notificar os casos de violência que tiver conhecimento, podendo inclusive responder pela omissão.

Dimensão pessoal do processo de trabalho para enfermeiras de Unidades de Terapia Intensiva

OBJETIVO: Compreender os aspectos da dimensão pessoal do processo de trabalho para enfermeiras que atuam em Unidades de Terapia Intensiva (UTI) de um hospital universitário do interior do Estado de São Paulo. MÉTODOS: Estudo de abordagem qualitativa utilizando o método fenomenológico. Foram entrevistadas 12 enfermeiras que trabalhavam nas UTI de adulto, pediátrica e coronariana dessa instituição hospitalar e para análise dos relatos, utilizou-se o referencial da estrutura do fenômeno situado. RESULTADOS: A análise dos relatos permitiu identificar a categoria: dimensão pessoal do trabalho na UTI, com os temas - trabalho gratificante, trabalho desgastante e (des) valorização do trabalho. CONCLUSÃO: Os resultados do estudo revelam que as enfermeiras das UTI selecionadas identificam-se com o trabalho, porém vivenciam situações desmotivadoras decorrentes da elevada carga de trabalho, que dificulta o desenvolvimento do processo de trabalho e compromete a qualidade do cuidado.

Limitantes inferiores par ao problema de dimensionamento de lotes em máquinas paralelas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Modelagem para dimensionamento de tanque de escorva para instalações de bombeamento utilizando a Lei de Boyle

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação em saúde coletiva nos cursos de enfermagem da Cascavel - PR

Pós-graduação em Educação - FFC

A prática de ensino como exercício pedagógico construído pelas licenciandas em enfermagem: ampliando o conceito de saúde

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Formulações fortes para o problema integrado de dimensionamento e sequenciamento da produção

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)