Showing papers in "Revista Latino-americana De Enfermagem in 2013"
TL;DR: It was observed that nursing staff with fewer patients presented best results of care-related and management-related patient safety indicators and the tenets of ecological and restorative thinking contributed to the understanding of some of the aspects in this intricate relationship from the standpoint of nursing providers.
Abstract: OBJECTIVE: The aim of this study was to analyze the potential association between nursing workload and patient safety in the medical and surgical inpatient units of a teaching hospital. METHOD: a mixed method strategy (sequential explanatory design). RESULTS: the initial quantitative stage of the study suggest that increases in the number of patients assigned to each nursing team lead to increased rates of bed-related falls, central line-associated bloodstream infections, nursing staff turnover, and absenteeism. During the subsequent qualitative stage of the research, the nursing team stressed medication administration, bed baths, and patient transport as the aspects of care that have the greatest impact on workload and pose the greatest hazards to patient, provider, and environment safety. CONCLUSIONS: The findings demonstrated significant associations between nursing workload and patient safety. We observed that nursing staff with fewer patients presented best results of care-related and management-related patient safety indicators. In addition, the tenets of ecological and restorative thinking contributed to the understanding of some of the aspects in this intricate relationship from the standpoint of nursing providers. They also promoted a participatory approach in this study.
97 citations
TL;DR: It was perceived that some professionals seem to use ethical coping strategies, in order to ensure and preserve their professional values, however, often the choice of some nursing professionals may be to relapse into immobility and the absence of building strategies of endurance.
Abstract: OBJECTIVE: To know the strategies of resistance adopted by nursing staff, facing situations of moral distress, from an ethical perspective. METHOD: The authors conducted qualitative research through semi-structured interviews, with fifteen nursing staff members of a university hospital in the extreme south of Brazil, using textual discourse analysis and the theoretical reference of Foucault. RESULTS: Two categories were constructed: denial of oneself and the other - in which one perceives that the nursing staff can perform actions that are governed predominantly by immobility and conformism, avoiding confrontations with whoever represents power in situations that provoke moral distress in them; possibility to care for oneself and for the other - in which nursing workers in situations that provoke moral distress for them exercise power and endurance. CONCLUSION: it was perceived that some professionals seem to use ethical coping strategies, in order to ensure and preserve their professional values. However, often the choice of some nursing professionals may be to relapse into immobility and the absence of building strategies of endurance. This situation may represent their reduced exercise of power and insufficient resistance in the face of ethical problems, contributing to the intensification of their invisibility in the area of health.
91 citations
TL;DR: Evaluated characteristics of the professional nursing practice environment and its relationship with burnout, perception of quality of care, job satisfaction and the intention to leave the job in the next 12 months revealed the mediating role of emotional exhaustion may negatively influence care delivery.
Abstract: OBJECTIVE: to evaluate the characteristics of the professional nursing practice environment and its relationship with burnout, perception of quality of care, job satisfaction and the intention to leave the job in the next 12 months. METHOD: cross-sectional study with a quantitative approach to data. The sample was composed of 129 nurses working in adult Intensive Care Units from a region in the interior of Sao Paulo, Brazil. RESULTS: The structural equation modeling, using path analysis, revealed that characteristics of the environment influence job satisfaction, perception of quality of care, and having an intention to leave their job, when mediated by emotional exhaustion. Nurses with limited autonomy, poor control over their practice, and poor relationships with physicians, experience a greater level of emotional exhaustion, which can negatively influence their perception of quality of care, job satisfaction and an intention to abandon their jobs. CONCLUSION: the mediating role of emotional exhaustion may negatively influence care delivery. Therefore, there is a need to adopt strategies to minimize this condition among nurses.
89 citations
TL;DR: Students with higher levels of stress are more prone to present depression, deserving educators' attention, as recorded by other studies on this issue.
Abstract: OBJECTIVE: to identify the presence of stress and depression among final year students of two nursing courses, and the association between these variables. METHOD: an exploratory-descriptive study, undertaken with final-year students from the Bachelor's degree and Licenciate's degree courses at the Ribeirao Preto College of Nursing, of the University of Sao Paulo. The Perceived Stress Scale (PSS) and Beck Depression Inventory (BDI) were applied. RESULTS: of the total of 88 participants in the study, 69.8% have no depression, 18.2% presented dysphoria, 6.8% moderate depression, and 5.7% severe depression, which is a low rate compared to the general population. Medium stress levels were the most frequent (76.9%). There was no significant statistical difference in the stress score between the two groups of students (Student's t-test: p=0.295>0.05). The data showed a relation between the stress and the presence of indicative signs of depression, especially severe depression (Pearson: r-0.755 and p<0.01). Discussion: The majority did not show signs of depression. The depressive states found among the students on the two courses accompanied proportionately those who obtained high stress scores, as recorded by other studies on this issue. CONCLUSION: Students with higher levels of stress are more prone to present depression, deserving educators' attention.
63 citations
TL;DR: There is overwhelming evidence of the feminization of practically all health care professions included in the study, with higher levels of job satisfaction among women than men, and elderly professionals showed higher satisfaction compared to younger professionals.
Abstract: Objective: to analyze the influence of gender and age on the quality of the professional lives of health care professionals at a university hospital. Method: a total of 546 professionals completed a general questionnaire that measured sociodemographic variables and evaluated job satisfaction using a scale adopted from the NTP 394 Job Satisfaction scale and translated into Spanish. Results: overall, 77.2% of the professionals surveyed were satisfied with the work they perform. With regards to gender, we found overwhelming evidence of the feminization of practically all health care professions included in the study, with higher levels of job satisfaction among women than men. Regarding age, 20-30-year-olds and professionals over 61 years old showed higher satisfaction levels than did middle-aged professionals. Higher levels of dissatisfaction were reported by professionals between 41 and 50 years old. Conclusions: we were able to detect the influence of gender and age on the level of job satisfaction, finding significant associations between job satisfaction and both of these variables. Generally, women expressed more satisfaction than men, and elderly professionals showed higher satisfaction compared to younger professionals. Management policies should focus on taking action to correct the conditions that produce dissatisfaction among certain groups of employees.
61 citations
TL;DR: Durante a etapa qualitativa subsequente, a equipe of enfermagem destacou os cuidados relacionados a administracao de medicacao, banho of leito e transporte de pacientes, como aqueles that mais repercutem na carga de trabalho e mais representam riscos para a seguranca do paciente, dos profissionais e do ambiente.
Abstract: El estudio tuvo por objetivo analizar la carga de trabajo de enfermeria y su potencial relacion con la seguridad del paciente en unidades de internacion de las areas clinica y quirurgica de un hospital universitario. Se adopto un metodo mixto de investigacion con diseno secuencial explicativo. Los resultados de la etapa cuantitativa indican que el aumento del numero de pacientes atribuidos al equipo de enfermeria implica en elevacion de las tasas de caida de cama, infeccion relacionada a cateter vascular central, turnover y absentismo. En la etapa cualitativa, el equipo de enfermeria destaco los cuidados relacionados con la administracion de medicacion, bano de cama y transporte de pacientes como aquellos que mas repercuten en la carga de trabajo y representan riesgos para la seguridad de los pacientes, de los profesionales y del ambiente. Los resultados mostraron asociaciones significativas entre la carga de trabajo y la seguridad del paciente. La mejor dotacion de personal mostro mejores resultados para el manejo y para el cuidado del paciente. Los principios del pensamiento ecologico y restaurativo contribuyeron a la comprension de algunos de los aspectos involucrados en esta intricada relacion, a partir de las miradas de los profesionales, con un enfoque participativo.
49 citations
TL;DR: The strategy of home visits to patients who were recently hospitalized with decompensated heart failure was effective in improving the outcomes assessed and its implementation deserves to be considered in Brazil aiming at avoiding unplanned hospitalizations.
Abstract: OBJECTIVE: To verify the effect of an educative nursing intervention composed of home visits and phone calls on patients' knowledge about the disease, self-care and adhesion to the treatment. METHODS: Randomized clinical trial with patients with recent hospitalization caused by decompensated heart failure. There were two groups: the intervention group, which has received four home visits and four phone calls to reinforce the guidelines during six months of follow up; and the control group, which has received conventional follow up with no visits or phone calls. RESULTS: Two hundred patients were randomized (101 in the intervention group and 99 in the control group). After six months, a significant improvement was observed in self-care and knowledge about the disease in the intervention group (P=0.001 and P<0.001), respectively; the adhesion to the treatment, measured and compared between the groups, was significantly higher in the intervention group (P=0.001). CONCLUSION: the strategy of home visits to patients who were recently hospitalized with decompensated heart failure was effective in improving the outcomes assessed and its implementation deserves to be considered in Brazil aiming at avoiding unplanned hospitalizations. NCT-01213862
48 citations
47 citations
TL;DR: The study reinforces that religious/spiritual coping is an important strategy for coping with cancer, and contributes to an understanding of the same as a useful tool for spiritual care.
Abstract: OBJECTIVE: to investigate the use of religious/spiritual coping among people with cancer undergoing chemotherapy. METHODS: a quantitative, descriptive and cross-sectional study of 101 patients undergoing intravenous chemotherapy in an oncology outpatients center in a public hospital in Minas Gerais, made in the first semester of 2011. For data collection, an interview was held, using a questionnaire for characterizing the sample and the Brief Spiritual/Religious Coping Scale. RESULTS: all subjects made use of religious/spiritual coping (mean=3.67; sd=0.37); the younger individuals, those with no religion and those who consider spiritual support unimportant tend to use coping negatively; individuals who would like to receive spiritual support and who participate in support groups for cancer patients, on the other hand, use coping positively. CONCLUSIONS: the study reinforces that religious/spiritual coping is an important strategy for coping with cancer, and contributes to an understanding of the same as a useful tool for spiritual care.
47 citations
TL;DR: The results show that the Brazilian adapted version of the Edmonton Frail Scale is reliable and can be used as a tool to improve geriatric nursing care in Brazil.
Abstract: Objective: to verify the inter and intra-rater reproducibility of the Brazilian adapted version of the Edmonton Frail Scale (EFS) in an elderly group of residents. Method: in order to test the inter-rater reproducibility, two assessments were independently conducted by two researchers on the same day but at different times, in a sample of 103 elderly. Concerning the intra-rater reproducibility, the instrument was administered to 83 elderly (80.6% of the initial sample) by the same researcher in a time gap of 15 days between the two assessments. Results and Discussion: in relation to the inter-rater test, the Kappa was 0.81 (CI 0.61-1.00) and the Intraclass Correlation Coefficient (ICC) corresponded to 0.87 (CI 0.82-0.91, p<0.001). In relation to the intra-rater test, the Kappa was 0.83 (CI 0.72-0.94) and the ICC 0.87 (CI 0.81-1.00, p<0.001). Conclusion: the results show that the EFS is reliable and can be used as a tool to improve geriatric nursing care in Brazil.
45 citations
TL;DR: Being institutionalized did not influence the older adults' perceptions of QOL, but the socio-demographic characteristics and self-assessments of health did.
Abstract: OBJECTIVES: to compare the perceptions of quality of life (QOL) and to identify factors associated with QOL among seniors living in the community in Porto Alegre, RS and institutionalized seniors from the countryside of Minas Gerais, Brazil. METHOD: this study used secondary data from two cross-sectional epidemiological studies. The sample consisted of 288 seniors living in the community and 76 institutionalized seniors. An instrument addressing socio-demographic data and the WHOQOL-BREF were administered. RESULTS: bivariate analysis showed that age, gender, schooling, self-reported health, and leisure presented statistically significant differences between institutionalized and non-institutionalized seniors. The Psychological and Social Relationships domains also presented statistically significant differences. The variables that presented significant correlation in multivariate analysis in relation to the Psychological domain were education, assessments of health, leisure and in relation to the Social domain, education and age. CONCLUSION: being institutionalized did not influence the older adults' perceptions of QOL, but the socio-demographic characteristics and self-assessments of health did.
TL;DR: In this paper, the authors describe the experiences of families of criancas with paralisia cerebral that live in situacao de vulnerabilidade social, in which they are confronted with the effects of social influence.
Abstract: OBJETIVO: descrever e analisar a experiencia de familias de criancas com paralisia cerebral que vivem em situacao de vulnerabilidade social. METODO: foram entrevistadas seis familias, residentes em area com essa caracteristica. Optou-se pelo Interacionismo Simbolico como referencial teorico e Analise de Conteudo Tematica de Bardin como metodo de analise dos dados. RESULTADO: a experiencia de tais familias esta representada nos temas: Reestruturando a Vida, com as categorias "Desvelando o caminho" e "Acomodando a rotina", e Travando uma Luta Constante, com as categorias: "Cuidador principal tendo sobrecarga", "Convivendo com o preconceito", "Tendo dificuldade de locomocao" e "Vivendo com dificuldades financeiras". CONCLUSAO: a vulnerabilidade social influencia em como a familia vive a condicao cronica. Profissionais e estrategias de saude publica sao uma potencia para minimizar impactos, inclusive os relativos ao orcamento familiar, mas nao tem sido efetivos. Eles precisam ser sensibilizados para se tornar recursos de suporte, oferecer e orientar o acesso as redes de apoio e acionar o servico social, quando necessario. Este estudo agrega conhecimento ao ja produzido, ao apontar peculiaridades da vivencia familiar em situacoes de duas variaveis de dificil manejo: cronicidade e vulnerabilidade social, evidenciando o papel do profissional na busca de solucao conjunta, com a familia, para o enfrentamento de demandas e sofrimentos.
TL;DR: The stressors identified are mainly related to organizational aspects and work conditions, and the coping strategies chosen are aimed at resolving problems and improving the nurses’ well-being.
Abstract: OBJECTIVE: to identify sources of stress and coping strategies in nurses who work in three Head and Neck Surgery Oncology Services, in three central hospitals in Portugal. METHOD: a cross-sectional descriptive-exploratory study, whose sample was made up of the 96 nurses from the three services. The following were used in the data collection: a socio-demographic questionnaire; the 12-item General Health Questionnaire; and the Occupational Stress Inventory; Brief COPE. RESULTS: reasonable levels of general health were ascertained. The most-mentioned stressors were: burden with work; low pay; the physical space where they work; emotionally-disturbing situations and lack of recognition of the profession. The most-used coping strategies were: planning; active coping; acceptance and self-distraction. CONCLUSION: the stressors identified are mainly related to organizational aspects and work conditions, and the coping strategies chosen are aimed at resolving problems and improving the nurses' well-being. A significant percentage of the nurses presents high levels of pressure and depressed emotions. The results presented corroborate previous studies which warn of the importance of developing strategies for preventing these stress levels.
TL;DR: In this article, the authors identify values which structure and guide nursing as social practice, including the tension between technique, organization and ethics in the nurse's practice; historical carry-overs of the values which run through nursing practice; attention to ethics, to reform of the health system, and to the humanization of care.
Abstract: OBJECTIVE: to identify values which structure and guide nursing as social practice. METHOD: qualitative meta-synthesis. RESULTS: three concepts were identified: The tension between technique, organization and ethics in the nurse's practice; Historical carry-overs of the values which run through nursing practice; Attention to ethics, to reform of the health system, and to the humanization of care. These led to the synthesis of the principal variables 'planning' and 'care', which represent, respectively, guiding values of the technical-operative and ethical-moral elements of the social practice of nursing. CONCLUSION: these values are articulated through the prism of ordering so as to care well. Their recognition contributed to a better understanding of the process of health care and nursing care.
TL;DR: It is recommended that institutions should adopt a policy of planning and managing human resources so as to encourage the participation of health professionals in decision-making, with a view to reducing job stress among nurses.
Abstract: OBJECTIVE: To analyze the association between job stress and self-rated health among nurses in public hospital emergency units METHODS: This is a cross-sectional study undertaken through the administration of a self-administered questionnaire in a sample of 134 health professionals, using the brief version of the Job Stress Scale Descriptive analyses of the socio-demographic, health and work variables were undertaken, as was multivariate analysis through unconditional logistic regression for adjustment of the association between job stress and poor self-rated health, in accordance with potential confounding variables, with a level of significance of 5% RESULTS: 70% of the interviewees were classified as passive workers or as with high strain Poor self-rated health was significantly greater among health professionals with high demand and low control, compared to those with low strain, after adjusting for co-variables CONCLUSIONS: Low control, allied with low demand, can serve as a demotivating factor, contributing to the increase in professional dissatisfaction It is recommended that institutions should adopt a policy of planning and managing human resources so as to encourage the participation of health professionals in decision-making, with a view to reducing job stress among nurses
TL;DR: The evidence suggests that educational and support programs have a positive impact on the reduction of caregiver burden when compared to standard care, and the inclusion of these programs in institutions providing care to the elderly is effective and should be encouraged.
Abstract: OBJECTIVE: This study's objective was to analyze the effectiveness of educational and support programs for caregivers on reducing their burden. METHOD: The method used was a systematic review. The following were searched; MEDLINE, LILACS, Embase, Cochrane, Web of Science, SciELO and CINAHL. RESULTS: Seven randomized clinical studies were included. These studies compared an educational program with standard care delivery, assessing the burden of caregivers through the Zarit Burden Interview. After the analysis of sensitivity, four studies were grouped in the meta-analysis showing a statistically significant reduction in caregiver burden among the participants of educational and support programs. CONCLUSION: The evidence obtained in this study suggests that educational and support programs have a positive impact on the reduction of caregiver burden when compared to standard care. Therefore, the inclusion of these programs in institutions providing care to the elderly is effective and should be encouraged. These programs should also share non-pharmacological management strategies for the behavioral and psychological symptoms of dementia.
TL;DR: Understanding moral distress allows us to go beyond solving the problems of the workers themselves, enabling the development of an ethics of active individuals and wide opportunities, defined mainly by the relationship with oneself.
Abstract: OBJECTIVE: to analyze the frequency and intensity of moral distress experienced by nursing personnel in southern Brazil, covering elements of their professional practice. METHOD: a survey was undertaken in two hospitals in Rio Grande do Sul, Brazil, with 247 nurses. Data was collected by means of the adapted Moral Distress Scale. RESULTS: the perception of situations that lead to moral distress is enhanced in nurses and in nursing staff working in institutions with greater openness to dialogue, which hold team meetings, with fewer working hours and a greater ratio of professionals to patients. CONCLUSION: understanding moral distress allows us to go beyond solving the problems of the workers themselves, enabling the development of an ethics of active individuals and wide opportunities, defined mainly by the relationship with oneself.
TL;DR: There is a need to intensify educational activities that seek to develop cognitive, affective and social skills aimed at improving the way adolescents face the vulnerabilities, in these activities, nursing has a fundamental role.
Abstract: OBJECTIVE: to analyze the health vulnerabilities in adolescence associated with socioeconomic conditions, social networks, drugs and violence from the perspective of students. METHOD: cross-sectional study with 678 students between 14-15 years old in Contagem, Brazil. A self-administered questionnaire divided into modules by subject was used. Quantitative, descriptive and stratified analyses were performed by sex. RESULTS: high percentage of adolescents (40.4%) were beneficiaries of Government financial support called "Bolsa Familia" and 14.6% had a job, 57.1% and 23.6% had tried alcohol and tobacco, respectively. We identified 15% of aggression and 26.7% of bullying. The majority informed they never/rarely talk to parents about the daily difficulties (64.5%) and 22% reported insomnia and/or feelings of loneliness. CONCLUSION: the results indicated that there is a need to intensify educational activities that seek to develop cognitive, affective and social skills aimed at improving the way adolescents face the vulnerabilities, in these activities, nursing has a fundamental role.
TL;DR: The reclusive nature of care for these children inside the family circle contributes to their social invisibility, and it is recommended that Nursing participate in the care that is focused on these children's families, with particular attention to their socio-cultural conditions.
Abstract: OBJECTIVE: to describe appropriate sources and resources for caregivers of children with special health needs in the community. METHOD: A qualitative study that used the creativity and sensitivity dynamics speaking map, part of the sensitive creative method, involving 11 caregivers of children with special health needs who are assisted in a university hospital located in the South of Brazil. RESULTS: the maps graphically represented through the genogram and ecomap showed that the caregiving women consistently and regularly use the resources of the internal and external family network; they eventually and irregularly access the community social network for physical and psychological support. CONCLUSION: the reclusive nature of care for these children inside the family circle contributes to their social invisibility. Based on this new information, it is recommended that Nursing participate in the care that is focused on these children's families, with particular attention to their socio-cultural conditions.
TL;DR: In this article, the authors describe the process of transcultural adaptation and validation of the Stanford Presenteeism Scale for Brazilian Portuguese, which involved 153 nursing staff and included six aspects of equivalence.
Abstract: OBJECTIVE: describe the process of transcultural adaptation and validation of the Stanford Presenteeism Scale for Brazilian Portuguese. METHODS: Methodological study of the cultural adaptation and validation of the tool which involved 153 nursing staff and included six aspects of equivalence, obtained through the following stages: translation, first version of consent, retranslation, specialist committee, pre-test, study of test-retest credibleness and dimensional validity. RESULTS: The stability of the items varied from moderate to almost perfect and the sequence constancy was almost perfect. Two factors were identified through the exploratory fact analysis: the first one included the physical aspects - completing work; and the second one the psychological aspects - avoided distraction . CONCLUSIONS: the results suggest adequacy of the tool in the Brazilian Portuguese version, indicating its use in the context of the study group and in similar groups, contributing to the study of evidences which consolidate strategies that favor the health conditions of the jobholders.
TL;DR: The scale ended up having 25 items and two domains (family hygiene and general/eating practices) which assess the maternal self-efficiency for the prevention of diarrhea in their children, thereby contributing to the planning of nursing interventions.
Abstract: OBJETIVO: descrever a validacao aparente e de conteudo da escala de autoeficacia materna para a prevencao da diarreia infantil. METODO: este e um estudo metodologico com realizacao da validacao aparente e de conteudo por sete juizes; da analise semântica, por 30 maes de criancas menores de 5 anos e do pre-teste, por 31 maes, selecionadas por conveniencia. Considerou-se necessaria uma concordância de pelo menos 70% entre os juizes para a validacao aparente e o minimo de 80% para a pertinencia e indice de validade de conteudo. RESULTADOS: verificou-se que a maioria dos itens foi considerada clara/compreensivel e pertinente pelos juizes. O indice de validade de conteudo final da escala foi de 0,96. As sugestoes das maes foram acatadas. CONCLUSAO: a escala ficou com 25 itens e dois dominios (higiene da familia e praticas alimentares/gerais), que avaliam a autoeficacia materna para prevenir diarreia em seus filhos, contribuindo para o planejamento das intervencoes de enfermagem.
TL;DR: Both the professional hours and the domestic work hours need to be taken into account in studies about health, self-care and also the care provided within the context of nursing workers, particularly among women.
Abstract: OBJECTIVE: to analyse the differences between genders in the description in the professional, domestic and total work hours and assess its association with health-related behaviour among nurses. METHODS: this is a transversal study carried out in 18 different public hospitals in the municipality of Rio de Janeiro. The data collection procedure was based on questionnaires. All nurses working with assistance were considered eligible (n=2,279). RESULTS: men and women showed significant differences in relation to working hours. The female group showed longer domestic and total work hours when compared to the group of men. In contrast, the number of hours spent on professional work was higher among men. For the women, both the professional hours and total work hours were often associated with excessive consumption of fried food and also coffee, lack of physical exercise and also the greater occurrence of overweight and obesity. CONCLUSION: both the professional hours and the domestic work hours need to be taken into account in studies about health, self-care and also the care provided within the context of nursing workers, particularly among women. The results add weight to the need for actions for health promotion in this occupational group and the importance of assessing the impact of long working hours on the health of workers.
TL;DR: Communication is an efficacious element in the care provided to the child with cancer and is extremely important to promoting palliative care when it is based on Humanistic Nursing Theory.
Abstract: OBJECTIVE: to investigate and analyze communication in palliative care contexts from the perspective of nurses, based on Humanistic Nursing Theory. METHOD: this is a field study with a qualitative approach, in which ten nurses working in the pediatric oncology unit of a Brazilian public hospital participated. Semi-structured interviews were used to collect data. The testimonies were qualitatively analyzed using Humanistic Nursing Theory and based on the five phases of Nursing Phenomenology. RESULTS: two thematic categories emerged from the analysis of the study's empirical material: "strategy to humanize nursing care, with an emphasis on relieving the child's suffering" and "strategy to strengthen ties of trust established between nurse and child." CONCLUSION: communication is an efficacious element in the care provided to the child with cancer and is extremely important to promoting palliative care when it is based on Humanistic Nursing Theory.
TL;DR: In this paper, the potential association between nursing workload and patient safety in the medical and surgical inpatient units of a teaching hospital was analyzed, and the findings demonstrated significant associations between nurse workload and patients' safety.
Abstract: OBJECTIVE: The aim of this study was to analyze the potential association between nursing workload and patient safety in the medical and surgical inpatient units of a teaching hospital. METHOD: a mixed method strategy (sequential explanatory design). RESULTS: the initial quantitative stage of the study suggest that increases in the number of patients assigned to each nursing team lead to increased rates of bed-related falls, central line-associated bloodstream infections, nursing staff turnover, and absenteeism. During the subsequent qualitative stage of the research, the nursing team stressed medication administration, bed baths, and patient transport as the aspects of care that have the greatest impact on workload and pose the greatest hazards to patient, provider, and environment safety. CONCLUSIONS: The findings demonstrated significant associations between nursing workload and patient safety. We observed that nursing staff with fewer patients presented best results of care-related and management-related patient safety indicators. In addition, the tenets of ecological and restorative thinking contributed to the understanding of some of the aspects in this intricate relationship from the standpoint of nursing providers. They also promoted a participatory approach in this study.
TL;DR: The research demonstrated the acceptability of the practice evaluated, bringing an important response to the area of health, in particular to Nursing, which most undertakes procedures of concurrent cleaning /disinfecting of these work surfaces.
Abstract: OBJECTIVE: To evaluate the disinfectant effectiveness of alcohol 70% (w/v) using friction, without previous cleaning, on work surfaces, as a concurrent disinfecting procedure in Health Services. METHOD: An experimental, randomized and single-blinded laboratory study was undertaken. The samples were enamelled surfaces, intentionally contaminated with Serratia marcescens microorganisms ATCC 14756 106 CFU/mL with 10% of human saliva added, and were submitted to the procedure of disinfection WITHOUT previous cleaning. The results were compared to disinfection preceded by cleaning. RESULTS: There was a reduction of six logarithms of the initial microbial population, equal in the groups WITH and WITHOUT previous cleaning (p=0.440) and a residual microbial load ≤ 102 CFU. CONCLUSION: The research demonstrated the acceptability of the practice evaluated, bringing an important response to the area of health, in particular to Nursing, which most undertakes procedures of concurrent cleaning /disinfecting of these work surfaces.
TL;DR: The Preterm Oral Feeding Readiness Assessment Scale is considered valid to assist health professionals to initiate preterm feeding in view of promoting safe and objective breastfeeding.
Abstract: INTRODUCTION: Health professionals have great difficulties to establish the adequate and safe time to start breast feeding in preterm infants. There is a need to develop a standardized tool to help health professionals to comprehensively evaluate preterm infant readiness to transition preterm infants´ feeding from gastric to oral, and encourage breast feeding practice in neonatal units. Aims: To clinical validate the accuracy of a Preterm Oral Feeding Readiness Assessment Scale with 60 clinically stable preterm infants. METHODS: Global accuracy, sensitivity and specificity of Preterm Oral Feeding Readiness Assessment Scale cut-offs, compared to milk intake through translactation, were estimated through ROC curves (Receiver Operating Characteristic Curves). RESULTS: The global accuracy of Preterm Oral Feeding Readiness Assessment Scale was 74.38%. The highest sensitivity and specificity were obtained for three cut-offs: 28, 29 and 30. Since higher specificity (75.68%) for the Preterm Oral Feeding Readiness Assessment Scale was found at a score cut-off=of 30 showed higher specificity (75.68%), it should be used as a cut-off score to select initiate breastfeeding the preterm newborns' oral feeding readiness. CONCLUSION: The Preterm Oral Feeding Readiness Assessment Scale is considered valid to assist health professionals to initiate preterm feeding in view of promoting safe and objective breastfeeding.
TL;DR: The data indicates that caring for an elderly person after a cerebrovascular accident is a challenge for the family and allows for a proposal for a model for the organization of the work, with a view to holistic care delivery in the health services, forming a care network, which constitutes an advance for the area of nursing.
Abstract: OBJECTIVE: to examine the transition of care in families caring for elderly persons who suffered the first episode of a cerebrovascular accident. METHODOLOGY: an instrumental ethnographic case study was used. The sample comprised 20 subjects: 10 caregivers and 10 elderly persons aged 65 or over, of both sexes, with diagnoses of first episode of cerebrovascular accident, capable of communicating, and requiring care from a main carer in their family. The data was collected through interviews, observation, existing documentation and field notes. Qualitative analysis techniques were used to codify and classify the data and to formulate significant categories, which generated typologies of care. RESULTS AND DISCUSSION: The central idea was the Transition of Care and showed the context in three typologies: The care process for the dependent elderly person, Strategies for the care process and Impact and acceptance of the limitations. CONCLUSION: The data indicates that caring for an elderly person after a cerebrovascular accident is a challenge for the family. The data permitted it possible to elaborate a proposal for a model for the organization of the work, with a view to holistic care delivery in the health services, forming a care network, which constitutes an advance for the area of nursing.
TL;DR: The findings evidence the impact of occupational illnesses on the absenteeism of nursing workers, and can be used to demonstrate the importance of institutional investments in occupational health surveillance.
Abstract: OBJECTIVE: to analyze the workloads, strain processes and sickness absenteeism among nursing workers from a teaching hospital in the Brazilian Central-West. METHOD: a descriptive and cross-sectional study was developed with a quantitative approach, based on the theoretical framework of the social determination of the health-disease process. Data were collected between January and December 2009, based on records of complaints related to occupational exposure among nursing professionals, filed in the software Monitoring System of Nursing Workers' Health. For the sake of statistical analysis, relative and absolute frequencies of the variables and the risk coefficient were considered. RESULTS: 144 notifications of occupational exposure were registered across the analysis period, which represented 25% of the total nursing population at the hospital. The physiological and psychic workloads were the most representative, corresponding to 37% and 36%, respectively. These notifications culminated in 1567 days of absenteeism for disease treatment. CONCLUSIONS: the findings evidence the impact of occupational illnesses on the absenteeism of nursing workers, and can be used to demonstrate the importance of institutional investments in occupational health surveillance.
TL;DR: In this paper, the authors evaluated the association between psychological demands, control over the work and the reduction of work ability of nursing professionals and found that a high prevalence of reduced work ability was observed.
Abstract: OBJECTIVE: to evaluate the association between psychological demands, control over the work and the reduction of work ability of nursing professionals. METHOD: this cross-sectional study involved 498 nursing professionals of a university hospital in the State of Rio Grande do Sul, Brazil. Data collection was carried out in 2009 using the Brazilian versions of the Work Ability Index and Job Stress Scale, with logistic regression models used for the data analysis. RESULTS: the prevalence of 43.3% for reduced work ability and 29.7% for high-strain in the job (high psychological demand and low control) were observed. The chances for professionals presenting reduced work ability under high-strain were higher and significant when compared to those classified as being under low-strain, even after adjusting for potential confounders, except for age and gender. CONCLUSION: a high prevalence of reduced work ability was observed. This evidence indicates the need for investigation and detailed analysis of the psychosocial aspects of the professionals with regard to the health/disease process of nursing professionals.
TL;DR: It is concluded that accidents involving exposure to biological material need to be avoided, however, it was not possible to confirm the influence of organizational values or practices on workers' behavior concerning the occurrence of these accidents.
Abstract: OBJECTIVES: to analyze work accidents involving exposure to biological materials which took place among personnel working in nursing and to evaluate the influence of the organizational culture on the occurrence of these accidents. METHOD: a retrospective, analytical study, carried out in two stages in a hospital that was part of the Network for the Prevention of Work Accidents. The first stage involved the analysis of the characteristics of the work accidents involving exposure to biological materials as recorded over a seven-year period by the nursing staff in the hospital studied, and registered in the Network databank. The second stage involved the analysis of 122 nursing staff members' perception of the institutional culture, who were allocated to the control group (workers who had not had an accident) and the case group (workers who had had an accident). RESULTS: 386 accidents had been recorded: percutaneous lesions occurred in 79% of the cases, needles were the materials involved in 69.7% of the accidents, and in 81.9% of the accident there was contact with blood. Regarding the influence of the organizational culture on the occurrence of accidents, the results obtained through the analysis of the two groups did not demonstrate significant differences between the average scores attributed by the workers in each organizational value or practice category. It is concluded that accidents involving exposure to biological material need to be avoided, however, it was not possible to confirm the influence of organizational values or practices on workers' behavior concerning the occurrence of these accidents.