RESUMO
Objetivo: Explorar las percepciones, preocupaciones y necesidades del personal de salud en una Central de Emergencias de Adultos (CEA) de Argentina. Métodos: Investigación o acción participativa, coordinada y ejecutada por el propio personal de la CEA, que incluyó médicos/as, personal de enfermería y administrativo/as para participar activamente en la recolección de información y en el análisis. Se utilizaron metodologías mixtas: análisis documental de quejas y reclamaciones escritas por parte de los pacientes, 10 entrevistas individuales y 2 grupos focales reflexivos con 10 integrantes del personal de salud (de diferente cargo y antigüedad, y residentes en formación). Resultados: Los tópicos emergentes fueron factores laborales que inducen al error y atentan contra el encuentro clínico centrado en la persona: la sobrecarga y la falta de tiempo, la sobreutilización de recursos por medicina defensiva y la tecnología que reemplaza el contacto físico. El personal de salud manifestó episodios de agresiones de pacientes o sus familiares, cuando las largas esperas y las insuficiencias estructurales (como falta de camas, saturación de sala de espera, incomodidad) atentan contra la paciencia y la tolerancia. A partir de esta reflexión se generaron mejoras en diversas áreas de la CEA.Conclusiones: La identificación de las problemáticas realizadas por los propios actores de la CEA resultó un método pertinente para generar un proceso de cambio de gestión colectiva, promover la reflexión y concientizar, permitir identificar áreas de mejora, diseñar estrategias y propuestas concretas (AU)
Introduction: To explore perceptions, concerns and needs of healthcare professionals in an emergency department (ED) from Argentina.Methods: Participatory action research, coordinated and carried out by ED healthcare professionals, which included physicians, nurses and administrative staff who actively en-gaged in both data collection and analysis. Mixed methodologies were used: documentary analysis of complaints and written claims by patients, 10 individual interviews, and two reflective focus groups of 10 healthcare professionals (who differed in occupation, seniority and experience, including residents in training).Results: The topics that emerged were work factors that lead to errors and threaten pa-tient-centered clinical encounters: work overload and lack of time, the overuse of resources for defensive medicine purposes and technology that replaces physical contact. Healthcare professionals reported episodes of aggression by patients or their families, when long waits and structural insufficiencies (such as lack of beds, saturation of the waiting room, discom-fort) threaten patience and tolerance. From these insights, improvements were generated in various areas of the ED.Conclusions: The identification of problems by the ED stakeholders l was a relevant ap-proach that led to a process of collective management change, promoted reflection and raised awareness, allowing the identification of areas for improvement, design strategies and concrete feasible proposals (AU)
Assuntos
Humanos , Serviço Hospitalar de Emergência , Atitude do Pessoal de Saúde , Esgotamento Profissional , Pesquisa Qualitativa , Entrevistas como Assunto , Grupos Focais , ArgentinaRESUMO
In 2015, glyphosate was classified as "Group 2A - probably carcinogenic to humans" by the International Agency for Research on Cancer (IARC). Therefore, public concerns about the environmental and health risks of this substance have rapidly increased. Considering its toxicokinetic characteristics, urinary levels of glyphosate could be a powerful tool for human biomonitoring. Nevertheless, the physicochemical properties of this molecule and the complexity of the matrix make this purpose particularly challenging. In order to solve this problem, the presented study describes a simple LC-MS/MS method for the quantification of glyphosate in human urine after pre-column derivatization with FMOC-Cl. Method development was focused on the optimization of the derivatization reaction in human urine, adjusting critical variables such as pH of borate buffer, FMOC-Cl concentration and derivatization time. Besides, chromatographic separation and spectrometric parameters were also established. The analytical method was fully validated according international guidelines for selectivity, carry over, linearity, accuracy, precision, lower limit of quantitation, matrix effect and stability under different conditions. All performance parameters were within the acceptance criteria. In addition, the method was successfully applied to 52 urine samples obtained from exposed subjects from northern Argentina, laying the foundation for future epidemiological studies.
