Care management instruments used by nurses in the emergency hospital services.

OBJECTIVE: To describe the instruments used by nurses for the management of care in face of the demands of the emergency hospital service. METHOD: This is a qualitative study, with triangulation of data from interviews, focus groups, and documents, conducted with nurses from an Emergency Hospital Service in a state in southern Brazil. Data were subjected to thematic content analysis. RESULTS: Seventeen nurses participated in the study. The categories emerging from this study were view of the whole picture, definition of priorities, and physical instruments. These instruments are used by nurses to manage multiple tasks and provide adequate care to patients with different levels of complexity, in the face of an intense and unpredictable work process due to the constant demand for care. CONCLUSION: The instruments used by nurses in their work process are mainly skills and attitudes developed as a coping strategy at an intense and complex work environment.

Prevention of pressure injury in the operating room: Heels operating room pressure injury trial.

The objective was to evaluate the efficacy of multi-layered silicone foam (intervention) compared with transparent polyurethane film (control) in preventing heel pressure injuries caused by surgical positioning of individuals undergoing elective surgery. It was designed an intra-patient, open, parallel, randomised controlled trial was conducted in a university hospital in southern Brazil, from March 2019 to February 2020, with patients undergoing elective surgeries of cardiac and gastrointestinal specialties. The patients who met the selection criteria constituted, simultaneously, a single group receiving the intervention and active control, through paired analysis of the cutaneous sites (right heel and left heel). The outcome was the occurrence of PI, within the follow-up period was 72 hours. Brazilian Registry of Clinical Trials: RBR-5GKNG5. There was analysis of 135 patients/270 heels, with an overall incidence of 36.7%. The pressure injury incidence was significantly lower in the intervention group (26.7%), compared with the control group (P = .001); relative risk of 0.57. In the intervention group, the estimated pressure injury-free time (survival) was 57.5 hours and in the control group, 43.9 hours. It was concluded that Multi-layered silicone foam (intervention) is more efficacious than transparent polyurethane film (control) in the prevention of pressure injuries caused by surgical positioning of individuals undergoing elective surgery.

Care management instruments used by nurses in the emergency hospital services / Instrumentos de gestión del cuidado utilizados por enfermeros en el servicio hospitalario de emergências / Instrumentos de gestão do cuidado utilizados por enfermeiros no serviço hospitalar de emergência

ABSTRACT Objective: To describe the instruments used by nurses for the management of care in face of the demands of the emergency hospital service. Method: This is a qualitative study, with triangulation of data from interviews, focus groups, and documents, conducted with nurses from an Emergency Hospital Service in a state in southern Brazil. Data were subjected to thematic content analysis. Results: Seventeen nurses participated in the study. The categories emerging from this study were view of the whole picture, definition of priorities, and physical instruments. These instruments are used by nurses to manage multiple tasks and provide adequate care to patients with different levels of complexity, in the face of an intense and unpredictable work process due to the constant demand for care. Conclusion: The instruments used by nurses in their work process are mainly skills and attitudes developed as a coping strategy at an intense and complex work environment.

RESUMEN Objetivo: Describir los instrumentos utilizados por los enfermeros para la gestión del cuidado en función de las demandas del servicio hospitalario de emergencias. Método: estudio cualitativo, con triangulación de datos provenientes de entrevistas, grupo focal y documentos, realizado con enfermeros de un Servicio Hospitalario de Emergencias de una provincia al sur de Brasil. Los datos fueron sometidos al análisis de contenido temático. Resultados: Participaron 17 enfermeros. Las clases que resultaron tras el estudio fueron: visión global, definición de prioridades e instrumentos físicos. Esos instrumentos son utilizados por los enfermeros para manejar múltiples tareas y proporcionar un cuidado adecuado a los pacientes con diferentes niveles de complejidad ante un proceso de trabajo intenso e imprevisible debido a la demanda constante de atendimiento. Conclusión: Los instrumentos utilizados por los enfermeros en su proceso de trabajo son principalmente habilidades y actitudes desarrolladas como estrategia de enfrentamiento al ritmo intenso y ambiente complejo de trabajo.

RESUMO Objetivo: Descrever os instrumentos utilizados pelos enfermeiros para a gestão do cuidado frente às demandas do serviço hospitalar de emergência. Método: Estudo qualitativo, com triangulação de dados advindos de entrevistas, grupo focal e documentos, realizado com enfermeiros de um Serviço Hospitalar de Emergência de um estado do sul do Brasil. Os dados foram submetidos à análise de conteúdo temática. Resultados: Participaram 17 enfermeiros. As categorias que emergiram deste estudo foram: visão do todo, definição de prioridades e instrumentos físicos. Esses instrumentos são utilizados pelos enfermeiros para gerenciar múltiplas tarefas e proporcionar um cuidado adequado aos pacientes com diferentes níveis de complexidade, diante de um processo de trabalho intenso e imprevisível em função da demanda constante de atendimento. Conclusão: Os instrumentos utilizados pelos enfermeiros em seu processo de trabalho são principalmente habilidades e atitudes desenvolvidas como estratégia de enfrentamento ao ritmo intenso e complexo ambiente de trabalho.

[Nursing governance: an integrative review of the literature]. / Governança em enfermagem: revisão integrativa da literatura.

The objective of this study was to identify and characterize types of nursing governance, with emphasis on its impact on nursing practice and health care. This integrative review covered reports published from 2007 to 2011 and indexed in MEDLINE, CINAHL, LILACS, and the Scientific Electronic Library Online (SciELO). Keywords used were governance and nursing , which retrieved 25 manuscripts. Most studies were from the United States and the United Kingdom. We identified three models of governance: shared governance, clinical governance, and public governance. The effects of the models identified included quality care improvement, more autonomy for nursing professionals, improved connections among health services, and greater satisfaction among nursing professionals. Additional studies on nursing governance in Latin America are needed to evaluate its applicability in different contexts.

[Communication conceptions in hospital nursing management between head nurses in a university hospital]. / Concepções de comunicação na gerência de Enfermagem Hospitalar entre enfermeiros gerentes de um hospital universitário.

The objective of the following study was to analyze the conceptions that head nurses of a university hospital have about nursing communication management. It is a descriptive-exploratory study with an interpretative qualitative approach. The set of data was produced between September and October 2007 through interviews with 19 head nurses in a university hospital in Southern Brazil and submitted to thematic analysis. The nurses recognize the relevance of communication in nursing management, but have different perceptions: part of the research group understands communication from its interactive and dialogical perspective; others understand formal communication, based on the transmission and maintenance of standards and hospital routines, with emphasis on written communication. Further discussion about the triad communication, management and dialogue is required in order to build more interactive forms of hospital nursing care management.

Grounded theory--conceptual and operational aspects: a method possible to be applied in nursing research.

This is a descriptive-reflective study based on literature and qualitative design. It aimed to discuss conceptual aspects of Grounded Theory (GT) and to present the applicability of this methodology within the nursing field. GT consists of an interpretative and systematic framework that extracts significant aspects from experiences of social actors and which enables researchers to construct theoretical frameworks and intensify expansion of knowledge. It has been shown to be an important and consistent framework for objects of study that involve human interactions and which include phenomena concerning professional practice and which have not yet been properly examined and understood according to the rigor required for the construction of knowledge in qualitative designs.