Redução de danos e o saber-fazer de profissionais de um CAPS ad em Natal-RN

The present study had as a main objective to analyze how the professionals at a CAPS ad unit in Natal-RN conceive the knowledge-practice process with regard to the Harm Reduction Policy (HRP) towards alcohol and other drugs. For the accomplishment of this proposal, it was intended: 1) Verifying the possibilities and limits of the HRP implementation at a CAPS ad unit in Natal-RN; 2) Relating the professionals knowledge at a CAPS ad unit in Natal in regard to the Harm Reduction Policy; 3) Enumerating the HRP programmatic actions at the institution. The research had exploratory, descriptive and qualitative approach aspects, guided by the concepts of biopower and self care proposed by Michel Foucault. Data collection occurred in June and July 2011, in which the focal group technique was used. After that, collect field material was analyzed through the content analysis method proposed by Minayo. The results showed some conceptual and practical approach between the harm reduction strategy and the knowledge-practice of the professionals at this CAPS ad unit. The discursive models about drug usage, especially the moral-legal model, still have a significant role in the daily lives of these professionals, being amplified by some demands of their jobs or even through the instituted discourse. The individuals recognize the need for less prohibited practices and more socializing ones, identifying them with the Harm Reduction (HR) logic, when there is a coherent and well-founded understanding about HR among the professionals. Distorted and reductionist views about HR as considering the simple instrumental function of this strategy (distribution of basic supplies) among the professionals, represent one of the main barriers for its implementation. There are few programmatic activities that are related to the RD strategy at this CAPS ad unit which makes a more effective appropriation by the working team difficult to reach. The working processes and the postures adopted by this CAP ad unit professionals have been showing that many of their practices and conceptions were modified to the detriment of new necessities emerged from the demands. Consequently, the self care notion is revealed which brings the need for the valorization of these care agents roles, that is, their collective and individual contribution.

Violência contra a mulher : estudo de caso em uma instituição de ensino

The study research case with a quantitative approach and prospective data, carried out between December 2010 and February 2011 with the aim of identifying the profile of women in the study, to characterize the acts of violence in the type, frequency, location occurrence and aggressor, analyze the steps taken after the occurrence of acts of violence and the main consequences on the victims. The population consisted of 285 workers in a tertiary institution in Rio Grande do Norte. The results showed that 99 (34.74%) have between 51 to 60 years of age, 78 (27.37%) of 41 to 50 and 62 (21.75%) between 20 and 30 years, are considered color white, 162 (56.84%) have completed higher education, 171 (60.00%) and of these 97 (56.73%) reported having some post-graduate degrees, are married, 141 (49.47%) and have from zero to one child, 148 (51.93%) reside in the south of the city of Natal, 146 (51.23%) have a monthly income of three to five minimum wages, 171 (60.00%) and are mostly in the Technical Administrative Sciences 152 (53.33%), 77 (27.02%) reported having experienced violence, 60 (62.50%) episodes of verbal aggression, 26 (27.08%) of bullying , 05 (5.21%) of physical abuse and 05 (5.21%) sexual harassment; 05 (100.00%) assaults were made by the spouse or partner of the victims and co-workers is another profession were responsible for 18 (30.00%) verbal aggression, 15 (57.69%) bullying and 03 (60.00%) sexual harassment, 02 (40.00%) of victims of physical aggression and 18 (30.00 %) of verbal abused only once, 10 (38.46%) of bullying and 02 (40.00%) of sexual harassment experienced four or more times 05 (100.00%) assaults occurred at domestic and work stood out with 36 (60.00%), verbal abuse, 22 (84.62%), moral harassment and 04 (80.00%) sexual harassment, 35 (36.46%) told colleagues work and 31 (32.29%) for family and friends in 75 (78.13%) cases there was no intervention, 07 (7.29) were unable to respond if something had been done and 14 (14.58% ) have been reported intervention of these, 09 (64.29%) were taken by the heads of the victims, 26 (32.10%) did not notify the fact on the ground that no action would be taken, 62 (80.52%) felt stress , 5 (1.76%) of women turned away from work after the episode of violence, accounting for 198 days of absenteeism. It is concluded that there is a high rate of violence against women, even when they have a good socioeconomic status, and in this sense is important to establish bases of new proposals for improving control of cases of health professionals, especially nurses, to approach patients with a more investigative, and that by identifying a case of violence, be instructed about the paths to be followed for notification while providing psychological support to victims.

Reinternações psiquiátricas no Rio Grande do Norte: implicações e impacto das novas estratégias de atenção à saúde mental

The Brazilian Psychiatric Reform based on the desinstitucionalization of the assistance, translated to the emphasis on community/territorial treatment and in the social inclusion of the mental suffering, promoted advances in the psychiatric restructuring. In the Rio Grande do Norte (RN), we can enumerate as advances of the Brazilian Psychiatric Reform the expansion of the mental health care chain and the implementation of some strategies that, together, aims to further the psychosocial attention of the individual with psych suffering and to reduce the indices of psychiatrics readmissions in the state. In the current Brazilian‟s mental health situation we were interesting in answered the following question: what the impact of the substitutes services‟ extension in the revolving door phenomenon? This search aims to analyze the revolving door phenomenon occurrences based on the news strategies of mental health care in the Rio Grande do Norte. This is a descriptive-exploratory study with a qualitative approach, oriented by the theoretical framework of critical-dialectical approach about the Brazilian Psychiatric Reform and using the thematic oral history as method of information collects. The search was realized on the Hospital João Machado (HJM), estate reference in psychiatric treatment, and the participants was 20 professionals that work on it. The collection of information had started after the approval of the UFRN Research Ethics Committee with the opinion number 216/2011 and CAAE number 0021.0.051.000-11 and was realized using the direct observation and semi-structured interview. The study‟s results were categorized in two categories and five subcategories of analysis. CATEGORY 1) Current situation of the mental health care chain in the RN, with the subcategories: 1.1 Impact of the new services of mental health care in the revolving door phenomenon in the RN; 1.2 Implications of the new services of mental health care in assisting user to the HJM; 1.3 Issues the permeate the mental health care chain in the RN. CATEORY 2) Main causes of the revolving door phenomenon in HJM, with the categories: 2.1 Family problems; 2.2 Lack of assistance after discharge from psychiatric hospital. In summary, we conclude that the extension of the mental health care chain contributed for the reduction of the psychiatrics re-hospitalization‟s indices in RN. However, we realized that territorial services of mental health care are not the only responsible for the revolving door phenomenon. Factors as family problems and the disarticulation of the assistance after the discharge from hospital influence on the perpetuation of hospitalizations and re-hospitalizations in the local scenario. To study the revolving door phenomenon that occur in the psychiatrics‟ assistance considering the news strategies of mental health care allowed us to approach the advances and challenges brought by the RPb and by the desinstitucionatization in the state, indicating the need for further discussions and problem-solving strategies of psychosocial care.

Viabilidade do processo de enfermagem no contexto hospitalar

The Nursing Process (NP) is considered as the dynamics of the systemized and inter-related actions of human care. We believe that the nursing manager, as the representative of all the nursing care provided in the hospital setting, is an important agent for the implementation of institutional policies, such as the NP, in the service. However, there is little information in the literature about the NP in the perspective of the nurse manager. The objective of this study was to analyze the viability of the Nursing Process in the hospital context based on the attitudes of the nurse managers toward the Process. We conducted a descriptive-exploratory research study, of quantitative approach, with a population of 45 nurse managers that worked in the state hospitals located in Natal, RN and in the university hospitals of the UFRN. Two instruments were used for the collection of data: a nursing process questionnaire, constructed for use in this study, and the scale for the measurement of the attitudes titled Positions on the Nursing Process. The population is predominantly feminine (91,0%) and have relative nursing practice experience (Mean=17,6 years). However, they have little experience in management (Mean=8,6 years). They express little knowledge of the PE nursing terms and little experience with the Process. They have a positive atitude toward the NP (Mean = 110,9); are favorable to its developement in the service (86,7%); 48,9% indicated little possibility of institutionalization in the service and 37,8% indicated large possibility. The Spearman test for association between the variables of attitude about the NP and the possibility of its institutionalization demonstrated a weak negative association in the total individual scores of the attitudes (-,316) as in the 20 itens of the instrument, with coefficients varying from 0,014 to 0,464. Factorial analysis of the instrument identified three underlying factors to the attitudes of the managers in this study: relevance, operationalization and collaboration, with Cronbach Alpha coeficients of 0,955, 0,844 and 0,807, respectively, and 0,956 for the whole instrument, indicating that the scale and its factorial subscales have internal consistency. We conclude that there is a weak tendency for the managers with a favorable attitude to have a negative perception about the possibility of institutionalization of the NP in the service. The favorable position does not appear to be sufficient for the viability of this methodology in the hospital sector, results that is worrisome for nursing. This situation suggests that the difficulties with the institution of the NP in the hospitals may be related to other factors, including the organizational conditions. We believe that the institucionalization of the NP in a servisse where it is not known and not practiced, constitutes the introduction of an innovative work technology that involves many demands, among them the adherence of the persons to the proposed innovation. This demands time and the institutional adjustments and the human resources necessary. In this process, the involvement of the health professional of the institution is necessary. This situation brings to light the discussions of professional autonomy, the action limits and perspectives, the redefinition of roles, delimiation (or consensus) of the objects of study and of the work processes, among others.

Aconselhamento em HIV/AIDS: ações e reflexões dos profissionais do Centro de Testagem e Aconselhamento (CTA)

The counseling on HIV/Aids consists in a prevention strategy that contributes to increase the diagnosis of HIV and start earlier the treatment. The counseling has as pillars the emotional and educational support, risks evaluation that aim at the adoption of safe practices and the individual s responsibility for his own health. To accomplish these results, it is necessary that health workers understand counseling as a unique educational moment that stimulates the user s critical-reflection when it comes to his role as an active subject in this process. This study aimed to analyze the counseling on HIV/Aids conducted by the professionals of the Testing and Counseling Center (CTA), based on the educational perspective of Paulo Freire . This is a descriptive qualitative study with a critical reflexive design based on the principles of Action-Science. All the professionals acting as counselors in the Joao Pessoa, PB CTA, eight in total, took part in the study. Data were collected during the month of March, 2011, through non participative observation and semi-structured interviews with a critical-reflexive focus, analyzed according to the tenets of the critical-reflexive methodology, and discussed taking into consideration the Paulo Freire s pedagogy and pertinent literature. It was observed that most of the professionals expressed the work philosophy of CTA as the diagnosis and prevention of the disease, associated with the utilization and demonstration of condoms. However, upon observation of their counseling sessions, these ideas were not converted in actions. Educational themes were not covered and the condom wasn t offered at any time. The counseling actions focused on the provision of information and filling out the paper forms which are necessary for attendance. The sessions were conducted with brief dialogues and little opportunity for the users to expose or complement their thoughts and needs. The professionals mentioned as facilitating conditions for counseling, the team interaction and physical structure. The difficulties focused on the users low cognition, the large demand for attendance, aspects related to the service organization, and the counselors absences and delays. After reflecting about the actions observed in the counseling, the majority of professionals admitted the need to modify their practice in the incorporation of educational principles for the achievement of a broader prevention, and seemed to be willing to work in this perspective. In conclusion, although the counselors show ideas consistent with the purposes of CTA, these ideas are limited when it comes to the understanding of the meaning of prevention in HIV/Aids. Taking into consideration that they express a certain comprehension and act differently during the counseling, they demonstrate a lack of bond between the theories in use and the proposed ones, in accordance with the contribution of the action-science theory. The counseling, as an educative practice, doesn t materialize in the counseling itself and the orientation for reflection is not given during the attendance. These findings suggest the need to include the process of reflection in the execution of the actions of counseling, so that these practices are guided by reflexive practice, aiming at transforming the way of thinking and acting into a more educational perspective toward a more democratic and holistic assistance.

Qualidade da assistência e o conhecimento sobre o direito à saúde das pessoas com úlcera venosa crônica

The study aimed to identify the quality of care and knowledge of health rights of people with chronic venous ulcers (VU) in Brasilian National Health Care System (SUS). It is a cross-sectional study, with quantitative approach, performed at the University Hospital Onofre Lopes (HUOL). The study was approved by the Ethics Committee of HUOL (CAAE nº 0148.0.051.000-10). The sample by accessibility was composed for 30 people with VU treated at the outpatient surgical clinic of HUOL. For data collection we used a structured questionnaire composed of two parts: sociodemographic characteristics and of health, of care and the clinical course of VU; and knowledge of people with VU about the rights of health. The results were processed using SPSS 15.0 and analyzed by descriptive statistics. Given the characterizations sociodemographic and health presented, we identified a clientele of users with VU predominantly female (76,7%), aged from 60 years (66,7%), married/ stable union (60,0%), low education level (83,3%), family income lower than a minimum wage (73,3%), unemployeds and with chronic diseases (53,3%), sleep greater than or equal to 6 hours (76,7%) and were not alcoholics or smokers (93,3%). In relation to clinical conditions, were shown the presence of one or more relapses of VU (73,3%), predominance of granulation tissue/epithelialization in the bed of VU (60,0%), exudate serosanguineous (43,3%), in quantity medium/large (60,0%), with no predominance of presence or absence of odor (50,0%), all patients with tissue loss in grade III / IV, no signs of infection (73,3%) and presence of intense pain (50,0%). In the last 30 days the main venue of achievement of dressing was the HUOL (100,0%), the main compression therapy used was the Unna boot (60,0%) and on inability to perform the dressing on the unit were the own patients who made the exchange at home (40,0%). The majority of respondents listed out more positive factors associated with quality of care (56,7%) were satisfied with the care of SUS (76,7%), claimed to have knowledge about their rights (70,0%), but at the same time did not know the meaning of the acronym SUS (90,0%) and classified their level of information as inappropriate (70,0%). We realize that people with VU identified as good the quality of care and demonstrated inadequate knowledge about their rights to health in the SUS, but showed interest in acquiring more information. The basic rights to entry in the SUS are constitutionally guaranteed and need to be disseminated in order to make them known to the population, so it can be implemented and ensured a greater resolution assistance in treating this type of injury

Análise dos marcos teóricos e estruturais do currículo de graduação em enfermagem no Rio Grande do Norte

This research had as its guiding question: what theoretical and structural milestone of graduation nursing curriculum of public universities in the State of Rio Grande do Norte? The objectives of this study were: Analyze theoretical and structural milestones of graduation nursing curriculum of public universities in the State of Rio Grande do Norte; Identify the theoretical milestone and training models that guide the structural milestones of nursing curriculum courses of public universities studied; Analyze the training concepts of curriculums from the voices of the coordinators of the courses. This is a qualitative study, analytical, with discussions of the documentary and empirical research. Ten teachers participated who act as coordinators of the graduation courses in nursing or academic advisors, in UFRNCentral Campus in Natal and Health Sciences College (Facisa), in Santa Cruz-and on UERN -Campus Caicó, Mossoró and Pau dos Ferros. The information collected by interview was analyzed by sociology or symbolic cartography of Boaventura de Sousa Santos. The research was approved by the Research Ethics Committee of the UERN by the CAAE: 03610912.7.0000.5294. All the participants signed the Free Consent and clarified Term The results and discussion were presented in four scientific articles. The first article, titled the Pedagogical projects in nursing analysis in the light of the symbolic cartography, features the use of cartographic method in the researches and in the study of nursing curriculums. In the article The Analysis of theoretical-philosophical, structural and referential milestones in nursing curriculums, these milestones are renowned in curriculums of UERN and UFRN. The main challenges faced in the implementation of supervised internship in nursing provide a reflection on the difficulties that the internship supervisors present, especially with the relationship between education/service and the articulation theory/practice. In the last article are discussed the changes in nursing training from the former student profile, who won a boost from the curricular changes proposed by the national curriculum guidelines. The study concluded, by the analysis of theoretical and structural milestones of nursing curriculum courses of public universities of Rio Grande do Norte, that there is an explicit intention to train nurses for the health system and a search on innovative teaching projects in accordance with the national curriculum guidelines for the area of nursing. The thesis defended in this investigation was that the curriculum of public institutions of higher education in nursing in the State of Rio Grande do Norte advanced from a training focusing on biologicist model, flexneriana guidelines, for teaching able to articulate the health with the social, political and cultural issues

No caleidoscópio o estresse da equipe de enfermagem da UTI de um Hospital Universitário em Natal-RN

This study aimed to analyze stress on nursing staff of intensive care at the Teaching Hospital Onofre Lopes. The study sample consisted of thirty-eight (38) nursing professionals, including technicians and nurses working in the ICU of the hospital Data were collected between September to November 2011 in two stages.The first was the application of the Lipp Stress Symptoms Inventory (LSSI), which allowed us to measure the stress phase in which each team member was. After that, data were tabulated in Microsoft Excel spreadsheets and analyzed according to the 2010 inventory guidelines proposed by the author. After this analysis it was possible to complete the second phase of the research, which consisted of a semi-structured interview designed for those workers who were in the second phase of stress, resistance. Data analysis was based on Bardin 2004 content analysis, enabling the creation of categories based on grouping the ideas present in the interviewees' statements. It was found that the study population was mostly female (78.9%) aged from 30 to 39 years (50%), married (52.3%) and with dual-employment (65.7%). The most predominant phase, according to the Lipp inventory, was the stress resistance, present in 44.7% of the team and having as most predominant physical symptoms the constant feeling of physical exhaustion, verified in 16.8% of the participants, and psychological, the excessive irritability and emotional sensitivity in 26.3%. Regarding the qualitative data it was possible to establish three categories and four subcategories, with the following categories: the stressors of the workplace, overwork and the interpersonal relationships of the nursing staff in the ICU. And as subcategories: Routine care in the ICU; Pressures and Individual Charges; double journey: professional reflections on daily life, the night shift nursing staff and the body suffers, the manifestations of stress; deficient communication between team members. Thus, this study allowed the visualization of the stress phenomenon on nursing staff of the Teaching Hospital Onofre Lopes as a kaleidoscope of thoughts, feelings and experiences perceived by these professionals in different areas of their lives. It was also verified that the strengthening of the stress theme among nursing professionals need to be exploited and stimulated in several nursing areas of discussion so these workers are encouraged to take better care of themselves so they can take care of others health

Qualidade de vida medida pelo "WHOQOL-bref": estudo comparativo de pacientes em hemodiálise e pós-transplante renal

Exploratory descriptive study, prospective with quantitative approach, performed in the nefrology outpatient service from the Onofre Lopes University Hospital (HUOL), Natal/RN, aiming to identify aspects that concern Quality of Life (QOL) on transplanted and hemodialysis patients, as measured by WHOQOL-bref and describe the aspects that differentiate QL between the two groups as measured by the same instrument. The population was of 62 renal patients in hemodialysis and 58 transplantd, with data collected from february to march 2006. The instrument used was WHOQOL-bref, translated to and validated for Portuguese by the multicentric group of the World Health Organization (WHO) in Brazil. The results show predominance of the masculine gender both in the post-transplant group (55,17%), as well as in the hemodialysis group (51,61%); the age strip of 28 to 43 prevailed, among which were 53,45% transplanted and 48,99% hemodialysis patients; 79,93% of the hemodialysis patients and 62,07% of the transplanted were provenient from ouside the capital of the state; from the hemodialysis population, 59,68% were married, while among the transplanted 48,28% were single; 58,06% of the hemodialisys patients had 1 to 3 children, while the majority of the transplanted, 44,83%, had no children; regarding scholarity level on both groups, there was a predominance of incomplete fundamental school, representing 62,9% of the hemodialysis patients and 46,6% of the transplanted; regarding work status, 98,39% of those in hemodialysis informed not to be working, and the same applied to the transplanted, with 75,86%; regarding treatment time, most patients of both populations were in the 1- to 4-year interval, of which were 62,9% of the hemodialisys patients and 53,45% of the transplanted. The analysis of WHOQOL-bref reliability through Crobach s Alpha coefficient had a value of 0,8816, demonstrating good internal consistency for the instrument. Regarding description of QOL tests, the average scores of the post-transplant were (Q-1) 18,14 e (Q-2) 18,69, and 12,3 (Q-1) and 11,29 (Q-2) for the group in hemodialisys. Regarding the aspects that differentiate QOL on the two groups observed through average scores from the Domains: Physical, 15,91 for the post-transplant group and 12,71 for the hemodialisys group; Psychological, 16,75 for the post-transplant group and 14,84 for the hemodialisys group; Social Relations, 17,79 on the post-transplant group and 16,58 on the hemodialisys group; Environment, 14,16 on the post-transplant group and 12,38 on the hemodialisys group. On every evaluated item, the post-transplant group achieved higher scores when compared to the hemodialisys group. The diference in QOL for both populations was significant on all items evaluated with a p<0,005

Atuação do enfermeiro na estratégia de atenção integrada às doenças prevalentes na infância

This study aimed to describe nurses' actions in the strategy of Integrated Management of Childhood Illness in the city of Natal, Rio Grande do Norte. This is a qualitative study with descriptive approach. The universe consisted of nurses from the Family Health Strategy, totaling 16 participants. For the research project was submitted for approval by the Ethics Committee of the Universidade Federal do Rio Grande do Norte, obtaining Opinion No. 187/2012. Data were obtained in two ways: a questionnaire survey to profile the training of nurses and an interview guided by a structured interview. Interviews were treated in the light of analysis of thematic category Bardin. The results showed the central thematic study "Integrated Management of Childhood Illness in the context of nursing activities" category and three analyzes: "Understanding the Integrated Management of Childhood Illness", "Difficulties invibializam use IMCI "and" Working conditions for nurses in the Integrated Management of Childhood Illness. " It is observed that nurses consider the Integrated Management of Childhood Illness useful, effective and important to keep sick children within the logic curative. However disregard the character of health promotion and disease prevention thereof. It was found that the participants still hold the attendance of crinaças within the biomedical model and that these same professionals are subjected to increasingly precarious working conditions and unhealthy due to lack of human and material resources. It was found that the interviewees do not follow the protocols of strategy because of barriers related to prescription medications by nurses, the medical, the lack of incentives, training and supervision by the municipal health and the Regional Nursing Council

O estudo da morte na formação do enfermeiro: percepção de estudantes

This study is aimed to understand the nurse student s perception on death approach during the undergraduate course, to reveal feelings and meanings generated from studying this topic. The research was undertaken when the project has been approved by the ethics committee of UFRN in accordance to the Opinion Number nº 234/2012. Through a qualitative approach using a phenomenological design, grounding on the ideas of the German philosopher Martin Heidegger. It was interviewed ten students who answered the following questions: When during your undergraduate course the topic death and dying is approached? What kind of feelings that theme awakens? What is the significance of studying this subject in nursing education? The speeches analysis shows that the issue of death and dying is addressed in a very timely manner in different disciplines, there is no dialogue between them. Students reveal the fear and anxiety as feelings present when studying the topic; recognize as an important moment of reflection to understand that death is not a health care failure, but an opportunity to understand it as a natural phenomenon. In this perspective, we can conclude that the student need to be conducted in the undergraduate process, not being separated from itself to your world-with-others, but linking their concepts, understanding their feelings as human being then, respect and care for individuals as a being-toward-death. Therefore, the big challenge facing nursing education is to create an environment where death can be discussed about, between teachers and students, mainly in the disciplines that address the issue

Integridade tissular de pacientes com úlceras venosas: um estudo baseado na Classificação dos Resultados de Enfermagem

The venous ulcer is an epidemiological problem of high prevalence, causing disability and dependence. Assess the tissue impairment level of patients with venous lesions, within a nursing referential, is relevant for the implementation of a directed assistance to specific clientele. Thus, this work aims to characterize the health status regarding the integrity the lower limbs skin of patients with venous ulcers, according to the of tissue integrity outcome indicators from the Nursing Outcomes Classification. A cross-sectional study conducted in a university hospital in Natal - Rio Grande do Norte. The sample consisted of 50 participants, selected through consecutive sampling. Data collection occurred through a interview and physical examination form and a operational definitions tool for indicators of the nursing Tissue Integrity outcome directed to patients with venous ulcer, applied from February to June 2012. Data analysis was done by descriptive statistics and nonparametric tests (Spearman, Kruskal-Wallis and Mann-Whitney tests). The project was approved by the Research Ethics Committee with protocol 608/11 and Presentation Certificate to Ethical Consideration No. 0038.0.294.000-11. The results were presented using three scientific articles derivatives of research. It was found that the indicators show moderate impairment, light and not impaired, as the median. The respondents had an average of 59.72 years, 66% female, 50% were retired, 60% with a partner, 44% had arterial hypertension, 26% allergies, 20% diabetes mellitus, 96% were sedentary, 14% drank alcohol and 6% were smokers. There was a statistically significant correlation of low intensity between age and hydration (p=0.032; rs=-0.304) and skin desquamation (p=0.026; rs=-0.316), family income and necrosis (p=0.012; rs=-0.353); Ankle Brachial Index and tissue perfusion (p=0,044; rs=-0,329); Diabetes Mellitus and texture (p=0.015) and tissue perfusion (p=0.026); allergy and texture (p=0.034), physical activity and hydration (p=0.034), smoking and thickness (p=0.018), and alcohol consumption and exudate (p=0.045). We conclude that the patients had light to moderate impairment, indicating a good state of health on the integrity of the skin of the lower limbs, according to the indicators of the outcome of tissue integrity Classification Nursing Outcomes valued in the present study. It is believed that the evaluation of impairment tissue using a self-nursing system and its relation with socioeconomic, clinical and risk factors are unique tools in the care planning and in the wound healing

Atuação do enfermeiro no acompanhamento do crescimento e desenvolvimento da criança

The nurses assistance in monitoring the growth and development of children has been characterized mostly a service based on the biological dimension of illness, when in reality, the actions should be combined in the reorientation of care model of the Family Health Strategy. Thus, the research aimed to examine the role of nurses in the growth and development of children. This is an exploratory and descriptive, qualitative approach. The project was approved by the Ethics Committee of the Universidade Federal do Rio Grande do Norte under Opinion No. 191/2012. Data collection was developed in the Health Units from the city of Natal, RN, Brazil. Survey participants were nurses who worked in the Family Health Strategy for at least two years and who performed the monitoring of child growth and development in the health unit selected. Data were collected through an in-depth interview, and seized material from speeches was treated as categorical thematic analysis proposed by Bardin. This process revealed three themes, which were analyzed in the light of Relief Models and Process Work in Health and Nursing and discussed based on the findings literary. The results elucidated that nurses consider their performance satisfactory as it has favored the accession of mothers of children under one year nursing visits, contributing to the reduction of morbidity and mortality due to prevalent diseases, as well as the establishment of a connection between the professionals and mothers. It was shown that despite having a promotion and prevention with the use of lightweight technologies, the nurses also emphasized the care of mothers in complaints and signs and symptoms of children, followed by referrals to professionals in the unit or to other sectors. Furthermore, we found that the process of working nurses face challenges regarding the organizational structure of services and social situation of the family. Given these statements, it is observed that despite the strong interference from hegemonic health model in the performance of nurses, it is found that these professionals have been investing in promotion and prevention to injuries to children in care, with a focus on family context. Thus, nurses are embarking on making the reorientation of health care through the use of relational technologies, which has contributed to solving the integral care to the pediatric population

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

Ensino do processo de enfermagem: significados percepções docentes na formação do enfermeiro

The implementation of the nursing process should be experienced by all nurses during their formative years. However, the lack of implementation of the nursing process for care planning during the educational process and the existing disorder in the formation process prompted the following research questions: What is the meaning of teaching the nursing process to the nursing professors? Do nursing professors use strategies and methods that promote critical thinking in their students? The objective of the study was to analyze the meaning that teaching of the nursing process has for the nursing faculty of the bachalaureate nursing course. Qualitative descriptive study conducted with a sample of 30 faculty members that taught nursing care courses in the nursing program of the Federal University of Rio Grande do Norte (UFRN) in Natal, RN. Two instruments were used, a questionaire and an interview guide. The questionnaire was designed to obtain sociodemographic, educational and work information, of faculty activities and of the teaching of nursing care. The guide was composed of five open questions regarding the understanding and perceptions of the nursing process, its utilization in teaching, and the nursing care teaching strategies. Interview data were submitted to content analysis techniques and interpreted according to the principles of Symbolic Interactionism. Six categories related to the analytical themes were identified: the nursing process as the guide for the care actions; clinical rationality; use of the care activities; teaching relevance; teaching barreirs; teaching strategies with focus on the abilities and competencies of the clinical rationale. Faculty perceptions regarding the teaching of the nursing process; nursing care approach in the nurses‟ formation. The study indicates that the participants understand the relevance of the nursing process a work instrument and that the use of this method during the nurses‟ formation enhances the abilities and competencies for critical thinking that is essencial for care. The strategies for teaching of abilities and competencies were identified, however the nursing faculty should use codes, direction and the influence so that the students can Interact and therefore stimulate the use of the nursing process