Classification of patients and nursing staff's sizing: contributions of a management technology. / Classificação de pacientes e dimensionamento de profissionais de enfermagem: contribuições de uma tecnologia de gestão.

OBJECTIVE: Applying PRAXIS® technology resources for patient classification and nursing professional sizing in university hospital inpatient unit. METHOD: Convergent Care Research following the design and instrumentation phases - defined the research theme and purpose, performed in a medical clinic hospital unit involving 633 participants; scrutiny - classification of patients during 30 days of June 2016, followed by sizing, analysis and interpretation of the results - elaborated with the support of the management theorization in hospital nursing. RESULTS: Amongst the total of 633 classifications made, 29.38% were patients in minimal care, 35.71% were intermediate care patients, 33.02% were highly dependent, 1.42% were semi-intensive and 0.47% were in intensive care. Two references were used to carry out the sizing; in both the available team showed to be in deficit. CONCLUSION: The classification of patients and the sizing of nursing professionals are directly related, they are indispensable for management in nursing and difficult to perform daily. Computerized technologies are useful for performing these activities.

Behavior of nursing managers and leaders when errors are disclosed in the media. / Posicionamento de gestores e lideranças de enfermagem diante dos erros divulgados na mídia.

OBJECTIVE: To analyze the behavior of nursing managers and leaders when nursing errors are disclosed in the media. METHODOLOGY: A qualitative, retrospective, documental study of the collection carried out in newspapers in Brazil and Portugal, between 2012 and 2016. Analysis performed at Atlas.ti, using a Ricoeur technique based on Habermas Theory of Communicative Action. RESULTS: Managers and caretakers focused on the workforce, continuing with the opening of internal syndication, removal of position and dismissal. How to lead the discipline process, carrying out inspections, requesting documents and questioning about the facts, as well as repudiating some disclosed notes. CONCLUSION: Leaderships in nursing played a crucial role in developing a complex problem strategy. However, this was not done efficiently.

Establishment of lactaton rooms in public and private companies: potentialities and difficulties. / Implantação de salas de apoio à amamentação em empresas públicas e privadas: potencialidades e dificuldades.

OBJECTIVE: To know how managers of public and private companies view lactation support rooms and their implantation. METHOD: This is study is based on qualitative, exploratory, and descriptive research. Twenty managers from Greater Florianópolis participated in the research, in 2015. Data were collected by means of semi-structured/projective interviews, and subjected to content analysis associated with Atlas.ti software. RESULTS: Data analysis led to the following two categories: difficulties and facilities of establishing a lactation room, with a predominance of financial difficulties and the lack of physical space. Dialectically, the subjects also recognised the low cost involved, which facilitates establishment. CONCLUSION: Financial, cultural, and political aspects make it difficult to set up lactation rooms, but the importance of this measure was acknowledged. Although the success of breastfeeding partly depends on these support rooms, it also requires multiple actions, especially the effective participation of nurses and other health workers.

Practical Approach to Care Kit: Innovation for nurses' clinical practice in HIV management.

OBJECTIVE: to analyze the use of the Practical Approach to Care Kit as a technology adopted in nurses' clinical practice for HIV management in Primary Health Care. METHOD: an exploratory and descriptive research study anchored in the methodological framework of the Constructivist Grounded Theory. The participants were defined through initial sampling, with 12 nurses, and theoretical sampling, with five managers, totaling 17 participants. The data were collected by means of intensive interviews and documentary analysis, and they were analyzed in two stages: 1) Initial coding; and 2) Focused coding. RESULTS: the professionals identified the Practical Approach to Care Kit as a technological innovation that contributed to expanding the clinical practice and to empowering nurses in the clinical management of HIV infection. They also highlighted its importance as a tool for guiding the different responsibilities and duties while sharing care, contributing to the provision of evidence-based practices. CONCLUSION: The Practical Approach to Care Kit is a technological innovation that has transformed nurses' clinical practice in HIV management, expanding their scope of activities in carrying out the diagnosis, assessing the health condition and counseling, evaluating adherence to the treatment, adverse effects and prescription of exams, medications, and immunobiological.

Refugees and access to employment in Brazil: implications for health and sociability.

This is a reflective study with the objective of analyzing the possibilities of access to employment by refugees in the Brazilian territory, in view of the socio-legal conditions in Brazil, understanding the relationship between work and health. Refugees experience the penalty of restricted access to employment, which has a significant impact on their lives. By remaining disconnected from work, they are pushed to the margins of society. In addition to this, they face difficulties in accessing adequate housing, healthcare services, education, healthy food, among others, all of which deeply affect their way of life in a foreign country with a different culture. The work becomes relevant in the discussion about access to health, goods and services necessary to live with dignity, and its implications in the work-health-disease relationship. Collaborative actions at a global level are necessary to ensure that employment opportunities are available for refugees. In this regard, this reflection articulates two basic ideas: the recognition of the importance of work in social life and living conditions, and the understanding that the determination of the health-disease process goes beyond the biological and individual choices, having historicity and a social and cultural character.

Ethical problems in nursing teleconsultations for people living with HIV during the Covid-19 pandemic.

OBJECTIVES: to understand the ethical problems experienced by primary health care nurses in using nursing teleconsultations for people living with the human immunodeficiency virus during the coronavirus pandemic. METHODS: qualitative research, anchored in Constructivist Grounded Theory. Data was collected between July and September 2020, with 17 participants. RESULTS: the first category highlights the ethical problems in conducting teleconsultations, managing high demand, communication barriers, and risks related to data security. The second emphasizes the potential of teleconsultations in communication and access, by generating changes in the work process and the use of protocols to guide clinical practice. CONCLUSIONS: nurses' work in digital mode requires professional qualification, with a view to stimulating reflection on teleconsultation practice, ethical-moral deliberation and combating stigma, and also adopting data security-centered conduct.

Management in the Family Health Strategy: workloads and structured institutional violence.

OBJECTIVES: to understand the relationship between workloads and institutional violence in Family Health Strategy managers' practice. METHODS: qualitative research using theoretical triangulation and data from semi-structured interviews. Participants were 35 managers of Basic Health Units in the five Regions of Brazil, who worked in the Family Health Strategy. We used thematic analysis and ATLAS.ti for data analysis. RESULTS: workloads were analyzed, showing relationships with institutional violence. Thematic categories emerged: "related to the management work itself"; "related to other instances of health system management"; "related to users and community". There was an interrelationship between increased managers' workloads and institutional violence. FINAL CONSIDERATIONS: the Family Health Strategy is relevant for universal access to health and requires favorable institutional conditions for its effectiveness. Adverse scenarios lead to increased workloads, approaching institutional violence.

The voice of those who provide care during the pandemic - a lexicographic study in Brazil-Portugal.

OBJECTIVE: To analyze the most frequent words in interviews given by nurses during the coronavirus pandemic. METHOD: This is a qualitative, exploratory, descriptive study, carried out with 45 interviews granted by nurses to newspapers of great circulation in Brazil and Portugal. The data were processed using the ATLAS.ti® software and analyzed using the word cloud tool. RESULTS: The seven most frequent words were: "home" (respect for isolation), "nurses" (valuing of the profession and structural problems), "patients/diseased" and "care" (referring to the severity of the disease), "family" (missing her own family/emotional stress) and "fear" (fear of contamination of oneself and others). FINAL CONSIDERATIONS: The word cloud revealed how straining nurses' experiences have been and reinforced the urgent need to rethink nursing work and the risks faced. Reflections like this contribute to the construction of more valued nursing and public policies for the protection of nurses.

Nursing societies in Santa Catarina state (1975-2018).

OBJECTIVES: to understand nursing representative entities' articulations and the influence on nursing. METHODS: a qualitative study of a historical-social approach with a conceptual framework by nurse Denise Elvira Pires de Pires. With a historical profile from 1975 to 2018, five former presidents of Brazilian Nursing Association - Santa Catarina Section and Regional Nursing Board of Santa Catarina were interviewed. The methodology for understanding data was through Bardin's content analysis. RESULTS: the board structuring and performance generated changes in the relations between the two entities and debate about the role and power of representation of each one. There were periods of approach and removal, with consequences for professional representation effectiveness. CONCLUSIONS: nursing valuation and recognition as a profession in society has a strong influence on entities' performance that represent it. The union of them, politically or organizationally, is necessary and urgent.

Nursing practices in the family health strategy in Brazil: interfaces with illness.

OBJECTIVE: To identify Nursing practices in the Family Health Strategy in Brazil and interfaces in the illness of these professionals. METHOD: Qualitative research, carried out in the five Regions of Brazil, with 79 nursing professionals from 20 health units. Data were collected from 2015 to 2017, using interviews, observation and documentary study. The analysis with the aid of the software ATLAS.ti 8.0, guided by the theorization of the Work Process and Workloads. RESULTS: The practices of the care dimension prevailed, followed by the administrative-managerial and educational dimensions. The illness resulting from workloads, predominantly psychic, was related to care practices, potentiated by overload and poor working conditions. CONCLUSION: The centrality of nursing practices in the dimension of care and administrative management characterized the professional work in Primary Care. The findings indicate that improved working conditions may minimize the wear and tear of these professionals in this scenario.

Nursing appeals on social media in times of coronavirus.

OBJECTIVE: to know and analyze the nursing appeals on social media during the COVID-19 pandemic. METHOD: it is a documentary, qualitative, descriptive, and exploratory research with data collected in publications in two social media. Two hundred ninety-five publications of nursing professionals published on Twitter and Instagram between March 11 and 20, 2020 were submitted to content analysis using ATLAS.ti resources. RESULTS: four thematic categories emerged: #stayathome, #whereismyPPE, #nowweareheroes, #nothingnewinthefrontline, according to frequency of communications. The appeals show a relationship with the social relevance of nursing professional work and with the conditions required for its exercise. Final considerations: old and new challenges of the profession were placed on the agenda in social media, especially related to the workforce and instruments of labor. These speeches can serve as a foundation for policies to improve working conditions and promote appreciation of the profession.

Thematic content analysis using ATLAS.ti software: Potentialities for researchs in health.

OBJECTIVE: to describe the most important tools of ATLAS.ti Software and to associate them with the procedures of Thematic Content Analysis. METHOD: It is a theoretical reflection of the Content Analysis phases of Laurence Bardin, associating them with software tools Atlas.ti and showing its usefulness for data analysis in qualitative research. RESULTS: historical contextualization and the available resources of Atlas.ti software with presentation of health research involving the phases of thematic content analysis. FINAL CONSIDERATIONS: The Atlas.ti software assists in the accomplishment of the thematic content analysis being this promising association in health research.

Workloads in the Family Health Strategy: interfaces with the exhaustion of nursing professionals. / Cargas de trabalho na Estratégia Saúde da Família: interfaces com o desgaste dos profissionais de enfermagem.

OBJECTIVE: To identify the workloads of nursing teams working in the Family Health Strategy in the five regions of Brazil and their interfaces with their feelings of exhaustion. METHOD: Qualitative study with nursing professionals from 20 Family Health Units, from eight cities in the five regions of the country. Data were collected through interviews, observation and analyzed according to the precepts of thematic analysis and the theoretical framework of workloads. RESULTS: A total of 79 professionals participated in the study. Workloads were related to structural and managerial problems. Workloads that stood out were psychological workload, due to excessive demands and staff shortages; physiological workload, due to the overload of activities that generate physical pain and exhaustion; physical and mechanical workload, due to inadequacies in the work environment and equipment; biological workload, due to the presence of microorganisms; and chemical workload, due to exposure to dust and smoke. CONCLUSION: The sources that increase workloads are similar in the five regions, indicating that there is a strong influence of psychological and physiological loads on exhaustion among workers. However, workloads are reduced by dividing and planning team actions and by the affinity with the assistance model.

Nursing work and competence in hemotherapy services: an ergological approach.

OBJETIVES: to analyze the ingredients of the competence that the nurses use in the performance of their work in hemotherapy. METHODS: qualitative study with 22 nurses, accomplished through documentary study, observation and semi-structured interview, with resources of Atlas.ti software based on the foundations of Historical Materialism Dialectic and Ergology. Performed Content Analysis. RESULTS: the domain of specific knowledge of hemotherapy and the time of experience in the area, allied to the motivation of the worker and the ability to work in a team favor the competent action in the work activities. On the other hand, the lack of adequate work conditions, especially in relation to adequate materials, equipment and structure, impairs the work of the nurse in hemotherapy. FINAL CONSIDERATIONS: experience gained is critical to successful decision making. In addition, adequate working conditions, updating of knowledge and ability in teamwork favor a scenario of safe practices.

Nurses' workload: lights and shadows in the Family Health Strategy. / Cargas de trabalho de enfermeiros: luzes e sombras na Estratégia Saúde da Família.

This study was multicenter with a qualitative approach, which sought to identify the elements that can increase or reduce the workloads of the Family Health nurse. Forty nurses were interviewed, from 36 teams from five regions of Brazil, considered successful according to the requirements of the National Policy of Primary Care and with good evaluation in the National Program for Improvement in Primary Care Access and Quality. Data collection was performed by instrument triangulation, using a semi-structured interview, observation and documentary study, from 2013 to September 2016. The findings were analyzed based on the Thematic Content Analysis and categorized with the help of Atlas.ti software. It was identified that the elements that most influence the increase of the workloads are the precariousness and deficits in the work environment, materials and equipment, added to the numerical deficit of the workforce and the excess of health care demand. However, teamwork, recognition for the performed work, bonding with users and good interpersonal relationships, all contribute to reduce the workloads. We highlight the dialectic present in the elements of the work process. They can increase or decrease workloads influenced by objective conditions, the moment and way they are handled.

Estudo multicêntrico, de abordagem qualitativa, que buscou identificar os elementos que podem aumentar ou reduzir as cargas de trabalho do enfermeiro da Saúde da Família. Foram abordados 40 enfermeiros, de 36 equipes, das cinco Regiões do Brasil, consideradas exitosas segundo o prescrito na Política Nacional da Atenção Básica e com boa avaliação no Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica. A coleta de dados foi realizada pela triangulação de instrumentos, utilizando-se entrevista semiestruturada, observação e estudo documental, de 2013 a setembro de 2016. Os achados foram analisados com base na Análise Temática de Conteúdo e categorizados com auxílio do software Atlas.ti. Identificou-se que os elementos que mais influenciam o aumento das cargas são a precariedade e déficits no ambiente de trabalho, materiais e equipamentos, somados ao déficit numérico da força de trabalho e ao excesso de demanda assistencial. Entretanto, o trabalho em equipe, reconhecimento pelo trabalho realizado, vínculo com usuários e bom relacionamento interpessoal contribuem para diminuir as cargas. Ressalta-se a dialética presente nos elementos do processo de trabalho com influência de condições objetivas, do momento e da forma como são manejados.

Management in primary health care: implications on managers workloads. / Gestão na atenção primária: implicações nas cargas de trabalho de gestores.

OBJECTIVE: To identify which aspects of primary health care management, evidenced in current literature, can influence manager workloads. METHODOLOGY: Integrative literature review with data collection conducted in April 2016, in five databases, with articles published in English, Spanish and Portuguese between 2006 and 2016. RESULTS: The results of the 78 studies were organized into two macro categories: increased workloads, especially due to the challenge of managing a new care model and deficits in working conditions; and workloads reduction related to the training of the teams and managers, the autonomy and the support for the managers. CONCLUSION: In addition to identifying factors that increase and decrease the workloads of managers, this study highlights the promising line of research, given the importance of management for the health sector and effectiveness of Primary Health Care.

Work process: a basis for understanding nursing errors. / Processo de trabalho: fundamentação para compreender os erros de enfermagem.

OBJECTIVE: To identify work process-related causes associated with nursing errors reported in newspapers. METHOD: This was a documentary and qualitative study based on the work process theory and hermeneutic analysis that examined 112 news articles published between 2012 and 2016 in 21 high-circulation Brazilian newspapers, organized and codified using Atlas.ti software. RESULTS: The causes associated with the reported errors were associated with workforce (lack of professionals and training, turnover, work overload, lack of information, recklessness, negligence, and distraction); work instruments (similar labels or packages, storage, lack of product identification and information, and medical prescriptions); and the object of nursing work (overcrowding and specific characteristics of patient). CONCLUSION: Analysis of the possible causes of reported errors identified the negative outcomes of nursing work, while also identifying elements of the work process that influenced these results. The findings emphasize the importance of understanding these errors so they can be avoided and of reviewing nursing work conditions to guarantee quality and safety of care.

Nursing errors in the media: patient safety in the window.

OBJECTIVE: To analyze the nursing errors reported by the journalistic media and interpret the main implications of this communication for the visibility of this problem. METHOD: Documental research, qualitative, descriptive and exploratory, with data collected in news reports from Brazil and Portugal, analyzed through hermeneutics with resources of Atlas Software. RESULTS: We analyzed 112 news items published between 2012 and 2016 that resulted in six categories: Year - highest occurrence in 2012; Age group of the patient - children; Professional category - nurses; Type of error - medication; Outcome - death; Possible attributed cause - occupational conditions. FINAL CONSIDERATIONS: Nursing mistakes are a challenge for the profession, and the way they are communicated by the media is not very explanatory, contributing to a negative visibility of the profession, and to making society insecure. Improving the way they are served in the media contributes to the visibility of the problem without affecting the professional image.

Refugees and access to employment in Brazil: implications for health and sociability / Refugiados y acceso al empleo en Brasil: implicaciones para la salud y la sociabilidad / Refugiados e o acesso ao emprego no Brasil: implicações na saúde e sociabilidade

ABSTRACT This is a reflective study with the objective of analyzing the possibilities of access to employment by refugees in the Brazilian territory, in view of the socio-legal conditions in Brazil, understanding the relationship between work and health. Refugees experience the penalty of restricted access to employment, which has a significant impact on their lives. By remaining disconnected from work, they are pushed to the margins of society. In addition to this, they face difficulties in accessing adequate housing, healthcare services, education, healthy food, among others, all of which deeply affect their way of life in a foreign country with a different culture. The work becomes relevant in the discussion about access to health, goods and services necessary to live with dignity, and its implications in the work-health-disease relationship. Collaborative actions at a global level are necessary to ensure that employment opportunities are available for refugees. In this regard, this reflection articulates two basic ideas: the recognition of the importance of work in social life and living conditions, and the understanding that the determination of the health-disease process goes beyond the biological and individual choices, having historicity and a social and cultural character.

RESUMEN Se trata de un estudio reflexivo con el objetivo de analizar las posibilidades de acceso al empleo por refugiados en el territorio brasileño, frente a las condiciones socio-jurídicas en Brasil, comprendiendo la relación entre trabajo y salud. Los refugiados experimentan la penalización del acceso al empleo como el mayor impacto en sus vidas, ya que al mantenerse alejados del trabajo, se les coloca en los márgenes de la sociedad. A esto se suman las dificultades para acceder a una vivienda adecuada, servicios de salud, educación, alimentación saludable, entre otros, con profundas implicaciones en la forma de vida en un país y cultura diferentes. El trabajo adquiere relevancia en la discusión sobre el acceso a la salud, los bienes y servicios necesarios para vivir con dignidad y sus repercusiones en la relación trabajo-salud-enfermedad, requiriendo acciones colaborativas a nivel global para asegurar que haya empleo disponible para los refugiados. En ese sentido, esta reflexión articula dos ideas básicas: el reconocimiento de la importancia del trabajo en la vida social y en las condiciones de vida, y la comprensión de que la determinación del proceso salud-enfermedad va más allá de las elecciones biológicas e individuales, teniendo una historicidad y carácter social y cultural

RESUMO Trata-se de estudo reflexivo com o objetivo de analisar as possibilidades de acesso ao emprego por refugiados no território brasileiro, frente às condições sociojurídicas do Brasil, compreendendo as relações entre trabalho e saúde. Os refugiados vivenciam a penalização de acesso ao emprego com maior impacto em sua vida, pois ao manterem-se afastados do trabalho, são colocados à margem da sociedade. Somam-se a isto as dificuldades de acesso a moradias adequadas, aos serviços de saúde, educação, alimentação saudável, dentre outros, com implicações profundas no modo de viver em um país distinto do seu e de sua cultura. O trabalho adquire relevância na discussão sobre o acesso à saúde, bens e serviços necessários para viver com dignidade e suas repercussões na relação trabalho-saúde-doença, sendo necessárias ações colaborativas em nível global para garantir que o emprego esteja disponível para refugiados. Neste sentido, a presente reflexão articula duas ideias básicas: reconhecimento da importância do trabalho na vida social e nas condições de vida; e que a determinação do processo saúde-doença ultrapassa o biológico e as escolhas individuais, tendo uma historicidade e caráter social e cultural.

Ethical problems in nursing teleconsultations for people living with HIV during the Covid-19 pandemic / Problemas éticos en la teleconsulta de Enfermería para personas con VIH en la pandemia de Covid-19 / Problemas éticos na teleconsulta de Enfermagem às pessoas com HIV na pandemia de Covid-19

ABSTRACT Objectives: to understand the ethical problems experienced by primary health care nurses in using nursing teleconsultations for people living with the human immunodeficiency virus during the coronavirus pandemic. Methods: qualitative research, anchored in Constructivist Grounded Theory. Data was collected between July and September 2020, with 17 participants. Results: the first category highlights the ethical problems in conducting teleconsultations, managing high demand, communication barriers, and risks related to data security. The second emphasizes the potential of teleconsultations in communication and access, by generating changes in the work process and the use of protocols to guide clinical practice. Conclusions: nurses' work in digital mode requires professional qualification, with a view to stimulating reflection on teleconsultation practice, ethical-moral deliberation and combating stigma, and also adopting data security-centered conduct.

RESUMEN Objetivos: comprender los problemas éticos experimentados por enfermeros de la atención primaria a la salud en el uso de la teleconsulta de enfermería a personas que viven con el virus de inmunodeficiencia humana en la pandemia del coronavirus. Métodos: investigación cualitativa, basada en la Teoría Fundamentada en los Datos Constructivista. Los datos fueron recolectados entre julio y septiembre de 2020, con la participación de 17 sujetos. Resultados: la primera categoría muestra los problemas éticos en la realización de teleconsultas, en la gestión de la alta demanda, las barreras de comunicación y los riesgos relacionados con la seguridad de los datos. La segunda enfatiza las posibilidades de la teleconsulta en la comunicación y el acceso, al generar cambios en el proceso de trabajo y el uso de protocolos para orientar la práctica clínica. Conclusiones: el trabajo del enfermero en la modalidad digital requiere capacitación profesional, para fomentar la reflexión sobre la práctica de la teleconsulta, la deliberación ético-moral, la lucha contra el estigma y la adopción de medidas centradas en la seguridad de los datos.

RESUMO Objetivos: compreender os problemas éticos vivenciados por enfermeiros da atenção primária à saúde no uso da teleconsulta de enfermagem às pessoas que vivem com o vírus da imunodeficiência humana na pandemia do coronavírus. Métodos: pesquisa qualitativa, ancorada na Teoria Fundamentada nos Dados Construtivista. Os dados foram coletados entre julho e setembro de 2020, com 17 participantes. Resultados: a primeira categoria evidencia os problemas éticos na realização de teleconsultas, no manejo da alta demanda, barreiras na comunicação e riscos relacionados à segurança dos dados. A segunda enfatiza potencialidades da teleconsulta na comunicação e acesso, por gerar mudanças no processo de trabalho e uso de protocolos para orientação da prática clínica. Conclusões: o trabalho do enfermeiro na modalidade digital requer qualificação profissional, com vistas a estimular a reflexão sobre a prática da teleconsulta, a deliberação ético-moral e o combate ao estigma, bem como a adoção de condutas centradas na segurança dos dados.