Enfermeiros no atendimento de urgência em presídios: explorando razões do chamado e local da assistência / Enfermeras en atención de urgencia en cárceles: explorando razones de la llamada y local de la asistencia / Nurses in urgent care in prisons: exploring reasons for the call and place of assistance

RESUMO Objetivo: analisar as percepções dos enfermeiros do Serviço de Atendimento Móvel de Urgência (SAMU) em atendimentos realizados em penitenciárias perante as razões das demandas e o local da assistência. Método: trata-se de um estudo exploratório e descritivo de abordagem qualitativa. Realizaram-se entrevistas nos meses de agosto a dezembro de 2017, individuais e audiogravadas, seguindo roteiro semiestruturado com 91 enfermeiros que atuavam no SAMU de cidades do estado da Paraíba, Brasil. Aplicou-se o referencial metodológico da Análise de Conteúdo proposta por Bardin para categorização dos dados obtidos. Resultados: das análises das falas dos participantes emergiu a presença de dificuldades como demandas não pertinentes ao serviço, local inadequado para assistência, falta de privacidade durante os atendimentos e de escolta para transporte quando necessário. Considerações finais: os problemas relatados evidenciam a necessidade do estabelecimento de estratégias para melhorar as condições da assistência potencializando a capacidade de resolutividade do serviço e para problemas que não podem ser resolvidos em uma única visita de profissionais do SAMU no ambiente prisional, que seja garantido a continuidade da assistência em outros serviços articulados a ele e para isso são necessários fortes laços intersetoriais.

RESUMEN Objetivo: analizar las percepciones de los enfermeros del Servicio de Atención Móvil de Urgencia (SAMU) en atenciones realizadas en prisiones ante las razones de las demandas y el lugar de la asistencia. Método: se trata de un estudio exploratorio y descriptivo de enfoque cualitativo. Se realizaron entrevistas en los meses de agosto a diciembre de 2017, individuales y audiograbadas, siguiendo guion semiestructurado con 91 enfermeros que actuaban en el SAMU de ciudades del estado de Paraíba, Brasil. Se aplicó el referencial metodológico del Análisis de Contenido propuesto por Bardin para categorización de los datos obtenidos. Resultados: de los análisis de los relatos de los participantes surgió la presencia de dificultades como demandas no pertinentes al servicio, local inadecuado para asistencia, falta de privacidad durante las atenciones y de escolta para transporte cuando necesario. Consideraciones finales: los problemas relatados evidencian la necesidad de que se establezcan estrategias para mejorar las condiciones de la asistencia, perfeccionando la capacidad de resolución del servicio y para problemas que no pueden ser resueltos en una sola visita de profesionales del SAMU en el ambiente carcelario, que se garantice la continuidad de la asistencia en otros servicios articulados a él y para ello son necesarios fuertes lazos intersectoriales.

ABSTRACT Objective: to analyze the perceptions of nurses from the Mobile Emergency Care Service (SAMU) in care provided in penitentiaries regarding the reasons for the calls and the place where care is provided. Method: this is an exploratory and descriptive study with a qualitative approach. Individual and audio-recorded interviews were carried out from August to December 2017 following a semi-structured script with 91 nurses who worked in the SAMU in cities in the state of Paraíba, Brazil. The methodological framework of Content Analysis proposed by Bardin was applied to categorize the data obtained. Results: the presence of difficulties emerged from the analysis of the speeches of the participants. They included calls for reasons not relevant to the service, inadequate place for assistance, lack of privacy during consultations, and lack of escort for transport when necessary. Final considerations: the reported problems highlight the need to establish strategies to improve the conditions of care provision so as to enhance the service's ability to solve problems that cannot be solved in a single visit by SAMU professionals in the prison environment, which guarantees the continuity of assistance in other services articulated to it, making strong intersectoral links necessary.

Scoping review exploring the impact of digital systems on processes and outcomes in the care management of acute kidney injury and progress towards establishing learning healthcare systems.

OBJECTIVES: Digital systems have long been used to improve the quality and safety of care when managing acute kidney injury (AKI). The availability of digitised clinical data can also turn organisations and their networks into learning healthcare systems (LHSs) if used across all levels of health and care. This review explores the impact of digital systems i.e. on patients with AKI care, to gauge progress towards establishing LHSs and to identify existing gaps in the research. METHODS: Embase, PubMed, MEDLINE, Cochrane, Scopus and Web of Science databases were searched. Studies of real-time or near real-time digital AKI management systems which reported process and outcome measures were included. RESULTS: Thematic analysis of 43 studies showed that most interventions used real-time serum creatinine levels to trigger responses to enable risk prediction, early recognition of AKI or harm prevention by individual clinicians (micro level) or specialist teams (meso level). Interventions at system (macro level) were rare. There was limited evidence of change in outcomes. DISCUSSION: While the benefits of real-time digital clinical data at micro level for AKI management have been evident for some time, their application at meso and macro levels is emergent therefore limiting progress towards establishing LHSs. Lack of progress is due to digital maturity, system design, human factors and policy levers. CONCLUSION: Future approaches need to harness the potential of interoperability, data analytical advances and include multiple stakeholder perspectives to develop effective digital LHSs in order to gain benefits across the system.

Handheld electronic device use in patient care: the emergency department patient perspective-a cross-sectional survey.

BACKGROUND: Staff use of smartphones and tablets in the healthcare setting is increasingly prevalent, but little is known about whether this use is acceptable to patients. Staff are concerned that the use of handheld electronic devices (HEDs) may be negatively misconstrued by patients. The HED can be a valuable tool, offering the emergency clinician access to a wealth of resources; it is therefore vital that patient views are addressed during their widespread adoption into clinical practice. METHODS: Patients, or those accompanying them, within the ED of the Royal Derby Hospital between April and June 2017 were asked to complete a survey consisting of 22 questions. Data collection took place to include all times of day and every day of the week. Every eligible individual within the department during a data collection period was approached. RESULTS: A total of 438 respondents successfully completed the survey with a response rate of 92%. Only 2% of those who observed staff using HEDs during their ED visit thought that they were being used for non-clinical purposes. 339 (78%) agreed that staff should be allowed to use HEDs in the workplace. Concerns expressed by respondents included devices being used for non-clinical purposes and data security. The main suggestion by respondents was that the purpose of the HEDs should be explained to patients to avoid misinterpretation. CONCLUSION: Our survey shows that the majority of survey respondents felt that clinical staff should be allowed to use HEDs in the workplace and that many of the concerns raised could be addressed with adequate patient information and clear governance.

Exploring The Netley British Red Cross Magazine: An example of the development of nursing and patient care during the First World War.

Netley Hospital played a crucial role in caring for the wounded during the nineteenth century and twentieth century, becoming one of the busiest military hospitals of the time. Simultaneously, Florence Nightingale delved into the concept of health and developed the theoretical basis of nursing. This research aims to describe the experiences related to nursing and patient care described in The Netley British Red Cross Magazine during the First World War. The analysis displays different nurses' roles and the influence of environmental factors in the delivery of the soldiers' care. There are indications that Nightingale's ideas would have infiltrated the nursing practices and other aspects of the soldiers' recovery at Netley. The history of the Netley Red Cross Hospital shows the theoretical and practical advancement of nursing care towards a holistic approach.

Hospital Environmental Effects on Sleep in Adults With Traumatic Brain Injury in Rehabilitation.

PURPOSE: The aim of this study was to describe sleep patterns of adults with traumatic brain injury and examine effects of environmental stressors (patient care activities and light) on patterns of sleep. DESIGN: A descriptive, correlational, explanatory design was used for this study. METHODS: Sixty-three subjects with traumatic brain injury (>18 years) on an acute traumatic brain injury rehabilitation unit wore an Actiwatch for 48 hours to collect light and sleep data. Patient care activity data were collected between 11 p.m. and 7 a.m. FINDINGS: Patient care activities and light occurred between 11 p.m. and 7 a.m. Nighttime sleep duration and sleep efficiency were explained by patient care activities, whereas light explained wake time after sleep onset. CONCLUSION: Patient care activities and light serve as environmental stressors that affect sleep. CLINICAL RELEVANCE: Results necessitate examining the need and timing of nursing care activities and light during nighttime. Findings provide a basis for policy changes that optimize sleep.

Effectiveness of Kinesio taping on peripheral facial paralysis: A protocol for systematic review and meta-analysis.

BACKGROUND: Peripheral facial paralysis is a rapid unilateral facial paralysis or paralysis of unknown etiology. Nearly 30% of patients leave sequela that have a negative impact on the patient's quality of life, both physically and psychologically. As its safety, convenience and effectiveness, Kinesio taping has been gradually used in the rehabilitation of peripheral facial paralysis. However, whether Kinesio taping is effective for peripheral facial paralysis is still unknown. The purpose of this systematic review (SR) and meta-analysis will summarize the current evidence of Kinesio taping used as an intervention for peripheral facial paralysis. METHODS AND ANALYSIS: We will search the following electronic databases for randomized controlled trials (RCTs) and controlled clinical trials (CCTs) to evaluate the effectiveness of Kinesio taping in treating peripheral facial paralysis: China National Knowledge Infrastructure (CNKI), Wanfang Date, SinoMed, Technology Periodical Database (VIP), PubMed, Embase, Web of Science, and The Cochrane Library. Each database will be searched from inception to April 2020. Studies that present clear descriptions of Kinesio taping in treating peripheral facial paralysis administration are published in peer-reviewed journals in any languages and are published in full will be taken into consideration. The entire process will include study selection, data extraction, risk of bias assessment and meta-analyses. Assessment of risk of bias and data synthesis will be conducted using Review Manager 5.3 software. RESULTS: The current evidence on the Kinesio taping for managing peripheral facial paralysis will be illustrated using subjective reports and objective measures of performance. The primary outcome is the effective rate. Secondary outcomes include House-Brackmann scale, Portmann score, facial nerve conduction velocity, Facial Disability Index, Facial Disability Index include Facial Function score and social Function score. CONCLUSION: This protocol will present evidence on the efficacy of Kinesio taping in relieving peripheral facial paralysis. ETHICS AND DISSEMINATION: Since all the data used in this SR and meta-analysis have been published, ethical approval is not required for this review. The results of this SR will be published in a peer-reviewed journal or presented at conferences. INPLASY ID:: (INPLASY2020100008).

COVID-19: atenção hospitalar na urgência e emergência

O Debate Virtual do Conass desta sexta-feira (7/8), às 17 horas irá tratar da atenção à Covid-19 nas urgências e emergências dos estados e municípios brasileiros, enfatizando a importância da integração da atenção hospitalar à Rede de Atenção à Saúde (RAS), considerando a continuidade do cuidado dos pacientes curados pela Atenção Primária à Saúde (APS). A iniciativa faz parte da implantação do Guia Orientador do Enfrentamento da Covid-19 na Rede de Atenção à Saúde, elaborado em parceria com o Conselho Nacional de Secretarias Municipais de Saúde (Conasems). Participarão do debate o médico especialista em terapia intensiva e medicina de emergência do Hospital Sírio-Libanês, Welfane Cordeiro Júnior; o diretor geral do Hospital Regional de Nova Andradina/Mato Grosso do Sul, Norberto Fabri Junior; o diretor geral do Hospital Municipal de Teixeira de Freitas/Bahia, Allan Jacqueson Barbosa Lobo; e a coordenadora estadual do Apoio Rede Colaborativa do Espírito Santo, Marfiza Machado de Novaes. A mediação do debate será feita pela assessora técnica do Conass, Rita Catanelli. Perguntas poderão ser enviadas pelo www.conass.org.br/participe O debate será transmitido pelo Portal do Conass: www.conass.org.br e pelos canais do Conselho no YouTube: www.youtube.com/conassoficial; e no FaceBook: www.facebook.com/conassoficial. Participe!

Especial COVID-19: acompanhamento da APS para pessoas com condições especiais de saúde

Especial Covid-19 - “A continuidade dos casos que de fato precisam de cuidado presenciais ainda vem acontecendo quando não é possível o teleatendimento”, explica Felipe Perini, gerente de Integração Assistencial da Secretaria de Saúde de Florianópolis

COVID-19: O tratamento é o mesmo para todas as pessoas doentes? [libras]

"COVID - 19: Perguntas e respostas" é resultado de uma parceria entre o Laboratório Aberto de Interatividade para a Disseminação do Conhecimento Científico e Tecnológico (LAbI), o Laboratório de Tradução Audiovisual da Língua de Sinais (LATRAVILIS) e o projeto InformaSUS, todos vinculados à Universidade Federal de São Carlos (UFSCar).

Se ainda não existe tratamento, que cuidados as pessoas infectadas recebem nos hospitais? [libras]

"COVID - 19: Perguntas e respostas" é resultado de uma parceria entre o Laboratório Aberto de Interatividade para a Disseminação do Conhecimento Científico e Tecnológico (LAbI), o Laboratório de Tradução Audiovisual da Língua de Sinais (LATRAVILIS) e o projeto InformaSUS, todos vinculados à Universidade Federal de São Carlos (UFSCar).

Unwitting Accomplices: Endocrine Disruptors Confounding Clinical Care.

Burgeoning evidence over the last 25 years has identified myriad synthetic chemicals with the capacity to alter various aspects of hormone synthesis and action. These endocrine-disrupting chemicals (EDCs) have been linked to various diseases, including reproductive disorders, metabolic diseases, and developmental abnormalities, among others. Exposure to EDCs arises from industrial activity, use of personal and home care products, and consumption of contaminated food and water; however, the role of healthcare in exposing individuals to EDCs is grossly underappreciated. Indeed, through the use of medications as well as medical equipment and devices, healthcare providers are unknowing mediators of exposure to EDCs, chemicals that might not only promote disease but that may also antagonize the efficacy of treatments. The ethical implications of provider-dependent exposure are profound. A failure to disclose the endocrine-disrupting properties of medical interventions violates core principles of nonmaleficence, patient autonomy, and justice as well as the practice of informed consent. Furthermore, physicians' lack of knowledge regarding EDCs in medical practice artificially skews risk-benefit calculations that are fundamental to informed medical decision-making. To combat this underappreciated ethical challenge, urgent action is required. Healthcare providers must be educated about endocrine disruption. Known EDCs, defined by endocrinologists, should be clearly labeled on all medical products, and all medication components and devices should be screened for endocrine-disrupting properties. Finally, communication strategies must be devised to empower patients with knowledge about these risks. Providing ethically competent care requires an open acknowledgment of endocrine risks imposed by the medical community that have heretofore been ignored.

Manejo do paciente com COVID-19 internado em enfermaria

Covid-19: live interativa começa já já! Hoje a gente aborda o manejo clínico do paciente internado em enfermaria. Profissionais de saúde têm nova oportunidade para esclarecerem dúvidas sobre o coronavírus (Covid-19). Especialistas abordam o manejo clínico do paciente em leitos de enfermaria durante live interativa.

A situação do Coronavírus em Sergipe e manejo na APS

CORONAVÍRUS - O papel dos serviços de APS/ESF no manejo e controle da infecção Covid-19 com os médicos especialistas: João Cavalcante e Marco Aurélio Góes. (ESTE VÍDEO FOI GRAVADO NO DIA 20/03/2020) O vídeo vocês irão encontrar instrumentos de orientação clínica para os profissionais que atuam na porta de entrada do SUS, tais como: - Origem do Coronavírus; - Emergência de saúde pública de importância internacional; - Conceitos biológicos do vírus; - Conceitos de transmissão; - Disseminação; - Período de incubação; - Casos notificados, suspeitos e descartados; - Como retardar o pico da epidemia; - Níveis de ativação da contingência; - Manifestações clínicas; - Taxa de mortalidade; - Outras epidemias; - Prevenção; - Plano de Contingência Estadual; - E por fim, os profissionais respondem as perguntas. Fiquem atentos as novas webpalestras ao vivo no link: https://telessaude.se.gov.br/ e não perca a oportunidade de tirar suas dúvidas ao vivo ou nos comentários. Temos teleconsultores para responder as dúvidas, acesse o link: https://telessaude.se.gov.br/telecons... Dá uma olhadinha até o final que está bem esclarecedora essa aula. CONTATOS PARA DÚVIDAS DO CORONAVÍRUS - Whatapp da Secretária do Estado da Saúde (79) 98877-8489 - Telessaúde Brasil Redes: 0800-6446543 - https://unasus.gov.br/especial/covid19 - https://maismedicos.gov.br/images/pro... - Curso AVASUS: https://avasus.ufrn.br/local/avasplug... Acesse nosso site: www.telessaude.se.gov.br E nos siga nas redes sociais: Facebook: facebook.com/telessaudesergipe Instagram: https://www.instagram.com/?hl=pt-br Twitter: https://twitter.com/telessaudese Ou fale conosco pelo whatsapp 79 9 8862-5029

Coronavírus: a maioria dos casos precisa de internação?

Saiba mais em www.saopaulo.sp.gov.br/coronavirus

Live from WHO headquarters: COVID-19 daily press briefing 15 April 2020

Originally broadcast live on 15 April 2020, the daily press briefing on coronavirus COVID-19, direct from WHO Headquarters, Geneva Switzerland with Dr Tedros WHO Director-General, Dr Micheal Ryan, Executive Director of the Health Emergencies Programme, and Dr Maria Van Kerkhove, Technical lead, Health Emergencies Programme.

Guia para os cuidados críticos de pacientes adultos graves com coronavírus (COVID-19) nas Américas. Versão longa, v1 (3 de abril de 2020) / Guía para el cuidado crítico de pacientes adultos graves con Coronavirus (COVID-19) en las Américas (Versión larga) / Guide for Critical Care of Serious Adult Patients with Coronavirus (COVID-19) in the Americas. Long version, v1 (April 3, 2020)

Este documento inclui os resultados de um processo de adaptação rápida de guias. As informações incluídas neste guia refletem as evidências na data publicada no documento. As recomendações se basearam nas evidências disponíveis e em sua qualidade (metodologia GRADE) quando o guia foi publicado. No entanto, reconhecendo que existem numerosos ensaios clínicos em andamento, a OPAS atualizará periodicamente essas revisões e respectivas recomendações.

Este documento incluye los resultados de un proceso de adaptación rápida de guías. La información incluida en esta guía refleja la evidencia en la fecha publicada en el documento. Las recomendaciones se basaron en la evidencia disponible y su calidad (metodología GRADE) cuando se publicó la guía. Sin embargo, reconociendo que hay numerosos ensayos clínicos en curso, la OPS actualizará periódicamente estas revisiones y recomendaciones.