Atuação da enfermagem frente à violência sexual contra crianças e adolescentes / Nursing actions face to sexual violence against children and adolescents / Actuación de la enfermería frente a la violencia sexual contra niños y adolescentes

Este estudo objetivou refletir sobre a violência sexual contra crianças e adolescentes, focalizando a atuação do enfermeiro à luz da sua prática profissional e da legislação brasileira. Trata-se de estudo bibliográfico em que foram analisadas 31 publicações, abrangendo os anos de 2005 a 2008. Para análise dos dados utilizou-se a análise de conteúdo, modalidade temática, evidenciando três núcleos temáticos: a atenção à saúde da criança e do adolescente, a notificação e a qualificação profissional. O enfermeiro deve estar apto a cuidar da criança e do adolescente com base nas leis que os protegem, sendo imperativo o envolvimento dos serviços de saúde, das entidades de classe e das universidades.

The objective of this work was to think over the sexual violence against children and adolescents, focusing on the nurses` performance regarding their professional practice and Brazilian legislation. This is a bibliographical study in which 31 publications covering the period from 2005 until 2008 were researched. Through content analysis, thematic modality, the knowledge characterization was obtained in three cores: attention towards children and adolescents' health, notification and professional qualifications. The nurse must be able to care of children and adolescents based on the laws that protect them, being an imperative for that the involvement of health services, class entities and universities.

Este estudio tuvo como objetivo reflexionar sobre la violencia sexual contra niños y adolescentes, enfatizando la actuación del enfermero con base en su práctica profesional y en la legislación brasileña. Se trata de un estudio bibliográfico en el que se analizaron 31 publicaciones, abarcando los años del 2005 al 2008. Para análisis de los datos se utilizó el análisis del contenido, modalidad temática, evidenciando tres núcleos temáticos: atención a la salud del niño y del adolescente, la notificación y la cualificación profesional. El enfermero debe estar apto para cuidar de los niños y de los adolescentes basándose en las leyes que los protegen, siendo fundamental la participación de los servicios de salud, de las entidades de clase y de las universidades.

Statewide and national impact of California's Staffing Law on pediatric cardiac surgery outcomes.

OBJECTIVE: The objective of the study was to examine the impact of staffing ratios on risk-adjusted outcomes for pediatric cardiac surgery programs in California and relative to other states combined. BACKGROUND: California performs 20% of the nation's pediatric cardiac surgery and is the only state with a nurse ratio law. Understanding the imposition of mandated ratios on pediatric outcomes is necessary to inform the debate about nurse staffing. DATA SOURCES: Patient variables were extracted from the Healthcare Cost and Utilization Project Kids' Inpatient Database. The American Hospital Association database was used for institutional variables. METHODS: Descriptive analyses were used to identify and describe patient, nursing, and hospital characteristics. Changes in nursing ratios and full-time equivalents (FTEs) between 2003 and 2006 were examined. Associations between nursing characteristics and each outcome variable were examined using general estimating equation models. The RACHS-1 (Risk Adjustment for Congenital Heart Surgery) risk adjustment method was used for mortality. RESULTS: Hospitals in California significantly increased RN FTEs (P = .025) and RN ratios (P = .036) after enactment of AB 394 in 2006. Neither RN FTEs nor RN ratios were associated with mortality, complications, or resource utilization after risk adjustment. After the law, California's standardized mortality ratio (SMR) decreased more (33%) than in all other states combined (29%). Standardized complication ratio (SCR) increased by 5% but decreased by 5% for all other states combined, and the increase in charge differential ($53,443) was more than twice the increase ($23,119) for other states combined. CONCLUSION: Hospitals in California made upward adjustments in nursing FTEs and ratios after enactment of AB 394. There was a substantial increase in California's charge differential, a decrease in SMR, and an increase in SCR after enactment of the legislation.