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Am J Clin Oncol ; 43(9): 660-666, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32889837


OBJECTIVE: The objective of this study was to assess sexual minority and heterosexual survivors' perceived quality of cancer care and identify demographic, clinical, and psychosocial characteristics associated with patient-centered quality of care. MATERIALS AND METHODS: Four cancer registries provided data on 17,849 individuals who were diagnosed with stage I, II, or III colorectal cancer an average of 3 years prior and resided in predetermined diverse geographic areas. A questionnaire, which queried about sexual orientation and other eligibility criteria was mailed to all cancer survivors. Of these, 480 eligible survivors participated in a telephone survey. Quality of cancer care was defined by 3 measures of interpersonal care (physician communication, nursing care, and coordination of care) and by rating cancer care as excellent. We used generalized linear models and logistic regression with forward selection to obtain models that best explained each quality of care measure. RESULTS: Sexual minority survivors rated physician communication, nursing care, and coordination of care similarly to heterosexual survivors, yet a significantly higher percentage of sexual minority survivors rated the overall quality of their cancer care as excellent (59% vs. 49%). Sexual minority survivors' greater likelihood of reporting excellent care remained unchanged after adjusting for demographic, clinical, and psychosocial characteristics. CONCLUSIONS: Sexual minority survivors' ratings of quality of colorectal cancer care were comparable or even higher than heterosexual survivors. Sexual minority survivors' reports of excellent care were not explained by their interpersonal care experiences.

Sobreviventes de Câncer/estatística & dados numéricos , Neoplasias Colorretais/terapia , Heterossexualidade/estatística & dados numéricos , Qualidade da Assistência à Saúde/estatística & dados numéricos , Minorias Sexuais e de Gênero/estatística & dados numéricos , Adulto , Sobreviventes de Câncer/psicologia , Neoplasias Colorretais/enfermagem , Comunicação , Procedimentos Clínicos/normas , Feminino , Pesquisas sobre Serviços de Saúde , Heterossexualidade/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados de Enfermagem/normas , Relações Médico-Paciente , Sistema de Registros , Minorias Sexuais e de Gênero/psicologia , Estados Unidos , Adulto Jovem
Palmas; [Secretaria de Estado da Saúde]; 20200000. 8 p.
Não convencional em Português | LILACS, Coleciona SUS, CONASS, SES-TO | ID: biblio-1120800


Orienta os serviços de Atenção Primária à Saúde (APS) ou Atenção Básica (AB), por meio da Estratégia Saúde da Família (ESF), no manejo e controle da infecção COVID-19. Indica os instrumentos de orientação clínica para os profissionais do Sistema Único de Saúde (SUS) a partir da transmissão do novo Coronavírus (COVID-19) no Tocantins.

It guides the Primary Health Care (PHC) or Basic Care (AB) services, through the Family Health Strategy (FHS), in the management and control of the COVID-19 infection. Indicates the instruments of clinical guidance for professionals of the Unified Health System (SUS) from the transmission of the new Coronavirus (COVID-19) in Tocantins.

Orienta a los servicios de Atención Primaria de Salud (APS) o Atención Básica (AB), a través de la Estrategia de Salud de la Familia (ESF), en el manejo y control de la infección por COVID-19. Indica los instrumentos de orientación clínica para profesionales del Sistema Único de Salud (SUS) a partir de la transmisión del nuevo Coronavirus (COVID-19) en Tocantins.

Humanos , Pneumonia Viral/prevenção & controle , Atenção Primária à Saúde/normas , Infecções por Coronavirus/prevenção & controle , Pandemias , Transporte de Pacientes/normas , Assistência Odontológica/normas , Cuidados de Enfermagem/normas
J Nurs Adm ; 50(7-8): 385-394, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32701643


OBJECTIVES: Study objectives were to: 1) explore how nursing care quality data (NCQD) was understood and interpreted; and 2) identify, compare, and contrast individual and group responses. BACKGROUND: Little evidence exists on how to best disseminate NCQD information. This study explores the outcomes of implementing an NCQD and human-interest information slide show across an inpatient surgery nursing service line using electronic screens. METHODS: Methods included semistructured interviews, qualitative analysis, and diagramming. RESULTS: The human-interest content most often attracted viewers' attention, but they were also exposed to NCQD. Interpretations and understandings differed among groups and between individuals. Among staff members, the human-interest content facilitated team-building, whereas NCQD provided meaningful recognition. Nursing care quality data evidenced the efforts that were being made to improve and provide excellent patient care. CONCLUSIONS: Using innovative dissemination methods can enhance understanding of NCQD among clinical providers. Creating microclimates of change and innovation within complex healthcare environments can benefit staff members and patients.

Disseminação de Informação , Microclima , Cuidados de Enfermagem/normas , Inovação Organizacional , Qualidade da Assistência à Saúde/normas , Adulto , Feminino , Humanos , Entrevistas como Assunto , Recursos Humanos de Enfermagem no Hospital/normas , Televisão
Rev Bras Enferm ; 73 Suppl 2: e20200476, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32667574


OBJECTIVE: To describe the experience of nursing, in adopting containment measures, in the care of patients undergoing hematopoietic stem cell transplantation to avoid COVID-19. METHODS: Experience report. RESULTS: Containment measures involve those recommended by major health organizations, such as hand hygiene, social isolation, identification and monitoring of suspected or confirmed cases; and also the local measures implemented in the health service, such as the reduction in the number of hospitalizations for transplantation, clinical screening of outpatients entering the service, monitoring of respiratory signs and symptoms, the allocation of specific isolation rooms for those suspected of the disease and testing of symptomatic patients. Final considerations: The nurse is responsible for the challenge of planning nursing care to prevent the spread of coronavirus in a high-risk population and to implement measures based on available evidence, periodically updated.

Transplante de Medula Óssea/enfermagem , Transplante de Medula Óssea/normas , Infecções por Coronavirus/prevenção & controle , Controle de Infecções/normas , Programas de Rastreamento/normas , Cuidados de Enfermagem/normas , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Guias de Prática Clínica como Assunto , Betacoronavirus , Humanos
Nurs Outlook ; 68(4): 468-475, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32359777


BACKGROUND: In 2018 a nursing 'sympathy strike' occurred. Although unionized nurses were directed to participate, many expressed questions about what a strike or sympathy strike was. Literature revealed no seminal article to define the term. A concept analysis for the nursing workforce was created. METHOD: The Hybrid Method of Concept Analysis, (theoretical literature analysis, qualitative stakeholder interviews; applicability) was used. 33 articles and 7 books were reviewed. Nine interviews took place. RESULTS: The literature and interviews agreed on the definition, antecedents, and consequences of a nursing strike. Strikes in the United States were defined as "a last resort effort, after significant bargaining on the issue between nurses and management has not allowed for agreement, where a work stoppage occurs and nurses leave the bedside." Interviews alone introduced the concept of duty to patients. A model case, contrary case and borderline case are offered. CONCLUSION: This study contains recommendations for practice.

Sindicatos , Cuidados de Enfermagem/normas , Recursos Humanos de Enfermagem/psicologia , Recursos Humanos de Enfermagem/normas , Guias de Prática Clínica como Assunto , Greve , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos
Am J Nurs ; 120(6): 1-4, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32443134


Free, evidence-based resources for health care providers, individuals, and families.

Cuidados de Enfermagem/normas , Minorias Sexuais e de Gênero/psicologia , Recursos em Saúde , Disparidades em Assistência à Saúde , Humanos , Cuidados de Enfermagem/psicologia , Estados Unidos
Nurs Stand ; 35(4): 29-34, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32202397


It is an established principle that nurses owe their patients a duty of care, which incorporates a legal, an ethical and a professional duty. However, they must also meet the standard of care deemed necessary to maintain safe and effective delivery of care to patients. Defining what is meant by the standard of care is complex, and meeting it can be challenging in an increasingly pressurised healthcare environment. This article describes the standard of care required using previous legal cases. It also explores some of the challenges involved in defining the standard of care in a rapidly changing healthcare environment.

Cuidados de Enfermagem , Padrão de Cuidado , Cuidados de Enfermagem/normas , Reino Unido
Am J Nurs ; 120(4): 64-68, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32218055


From its first issue in 1900 through to the present day, AJN has unparalleled archives detailing nurses' work and lives over more than a century. These articles not only chronicle nursing's growth as a profession within the context of the events of the day, but they also reveal prevailing societal attitudes about women, health care, and human rights. Today's nursing school curricula rarely include nursing's history, but it's a history worth knowing. To this end, From the AJN Archives highlights articles selected to fit today's topics and times.This month's article, from October 1969, is a classic piece by Virginia Henderson, known for her patient-focused theory of nursing practice and her extensive teaching and writing, including many thoughtful articles on the nature of nursing. Here, she illustrates her ideas about excellence in nursing by highlighting the accomplishments of several key nursing figures, from "Miss Nightingale" to 20th-century nursing innovators.Henderson's broad vision of nursing provides the framework for this discussion. She notes that "no one practices nursing except in relation to his or her times and in relation to the needs of a given society," and that nursing therefore calls for a social conscience and an interest in civic matters. "It seems hardly possible to me that an excellent nurse can be at the same time an indifferent or socially inexperienced citizen."Henderson's perspective seems more relevant and urgent today than even when it was written, during the turbulent 1960s. In this month's Viewpoint column, William E. Rosa builds upon her important work in his discussion of "Nurses as Global and Planetary Citizens."

História da Enfermagem , Cuidados de Enfermagem/normas , Assistência Centrada no Paciente/normas , Feminino , História do Século XIX , História do Século XX , Humanos
Creat Nurs ; 26(1): e1-e7, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-32024742


BACKGROUND: Guidelines for clinical practice are needed in order for nurses to provide consistent, standardized care and avoid preventable harm. AIMS: The present study aims to explore the barriers to and facilitators of nurses' adherence to clinical practice guidelines. METHODS: Detailed semistructured interviews were conducted with 14 nurses from two educational hospitals in Kurdistan University of Medical Sciences, Sanandaj, Iran, about their involvement with clinical practice guidelines. The text of the interviews was analyzed by qualitative content analysis. FINDINGS: Identified barriers to full adherence to clinical practice guidelines were work pressure, lack of facilities, paperwork, lack of motivational environment, and nonapplicability of guidelines. Facilitators identified were encouragement, improving working conditions, conscientiousness, training, and supervision. CONCLUSION: Interventions to remove barriers to and provide facilitators of adherence to clinical practice guidelines should be designed and implemented. Removing organizational barriers is the responsibility of nursing managers.

Atitude do Pessoal de Saúde , Fidelidade a Diretrizes/estatística & dados numéricos , Cuidados de Enfermagem/psicologia , Cuidados de Enfermagem/normas , Recursos Humanos de Enfermagem no Hospital/psicologia , Guias de Prática Clínica como Assunto , Adulto , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Adulto Jovem
Nurs Clin North Am ; 55(1): 29-37, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32005363


The complexity and rapidly changing environment of health care places significant pressure on nurses. How nurses make decisions within this environment has been an area of inquiry in the literature. Clinical decision making is the application of distinct thinking patterns and analysis of data at hand used to make judgements about patient care. Models of clinical decision making provide a foundation for understanding how nurses make decisions. Key factors associated with clinical decision making include experience, intuition, use of information and sources, and environment. Further work is needed to increase understanding of the processes by which nurses make clinical decisions.

Competência Clínica/normas , Tomada de Decisão Clínica , Cuidados de Enfermagem/normas , Recursos Humanos de Enfermagem no Hospital/normas , Sistemas Automatizados de Assistência Junto ao Leito/normas , Guias de Prática Clínica como Assunto , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Enfermagem
Adv Ther ; 37(2): 686-691, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31953806


Nowadays nurse practitioners are working in several acute hospital settings in different specialized departments. For decades, studies have shown the implications of nurse practice in peripheral vascular disease (PVD) and peripheral vascular intervention (PVI) to have several major benefits. However, there are very limited studies and data on this particular aspect. In this literature review, we briefly discuss the implication of nursing practice in PVD/PVI. This review briefly shows that nursing practice has a major contribution and implication in the treatment of patients with PVD or PVI, especially in patients with diabetes mellitus. From available research, we briefly discuss the implication of nursing practice pre- and postoperatively for PVI. Nurses also contribute significantly in catheter-directed thrombolytic therapy, in smoking cessation programs organized for patients with PVD, and in screening patients for PVD. The vascular nurse practitioners are also involved in providing healthcare advice in order to reduce the risk of disease progression. The major lack of research in this particular field should further inspire scientists to develop and carry out research to further investigate and demonstrate the contribution of nurses in the treatment and management of PVD or PVI, which is gradually becoming a major issue.

Profissionais de Enfermagem/normas , Papel do Profissional de Enfermagem , Cuidados de Enfermagem/normas , Doenças Vasculares Periféricas/enfermagem , Guias de Prática Clínica como Assunto , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
Enferm. glob ; 19(57): 423-438, ene. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-193657


Evaluar la adhesión y conocimiento a las Precauciones Estándar (PE) y el impacto de factores individuales, relativos al trabajo y organizacionales en la adhesión del equipo de enfermería a dichas medidas de seguridad. Estudio transversal, correlacional, descriptivo, por medio de los siguientes instrumentos: cuestionario sociodemográfico, cuestionario de Adhesión a las PE (CAPE), Cuestionario de Conocimiento sobre las PE (CCPE) y ocho escalas referentes a un modelo explicativo de adhesión a las PE. La muestra final se compone de 172 profesionales. El CAPE obtuvo un promedio de 71,94 puntos (DP = 6,40) y el CCPE, 15,44 (DP +/- 1,48). Se verificó una correlación significativa (p≤0,001) entre la adhesión y la personalidad de riesgo, percepción de riesgo, percepción de obstáculos para seguir las PE, entrenamiento y disponibilidad de EPI. Se concluye que los factores psicosociales y organizacionales estuvieron correlacionados con la adhesión. No se encontró significancia estadística del impacto del conocimiento en la adhesión a las PE. Sin embargo, se hace necesario la concienciación del carácter multifacético de la adhesión a las referidas de seguridad, que atraviesan factores individuales, pero también organizacionales y que, por lo tanto, necesitan de implicación directa y permanente de la gestión de las instituciones de salud, por medio de educación en la salud y la infraestructura necesaria para comportamientos seguros

Avaliar a adesão e conhecimento às Precauções-padrão (PP) e o impacto de fatores individuais, relativos ao trabalho e organizacionais na adesão da equipe de enfermagem as referidas medidas de segurança. Estudo transversal, correlacional, descritivo, por meio dos seguintes instrumentos: questionário sociodemográfico, Questionário de Adesão às PP (QAPP), Questionário de Conhecimento sobre as PP (QCPP) e oito escalas referentes a um modelo explicativo de adesão às PP. A amostra final constitui-se de 172 profissionais. O QAPP obteve média de 71,94 pontos (DP = 6,40) e o QCPP, 15,44 (DP+/-1,48). Verificado correlação significativa (p≤0,001) entre a adesão e a personalidade de risco, percepção de risco, percepção de obstáculos para seguir as PP, treinamento e disponibilidade de EPI. Conclui-se os fatores psicossociais e organizacionais estiveram correlacionados à adesão. Não foi encontrada significância estatística do impacto do conhecimento na adesão às PP. No entanto, faz-se necessário a conscientização do caráter multifacetado da adesão às referidas de segurança, que perpassam fatores individuais, mas também organizacionais e que, portanto, necessitam de envolvimento direto e permanente da gestão das instituições de saúde, por meio de educação em saúde e infraestrutura necessária para comportamentos seguros

Assess adherence and knowledge to Standard Precautions (SP) and the impact of individual, work-related and organizational factors on the adherence of the nursing team to the aforementioned safety measures. Cross-sectional, correlational, descriptive study using the following instruments: socio-demographic questionnaire, Standard Precautions Adherence Questionnaire (SPAQ), SP Knowledge Questionnaire (SPKQ) and eight scales referring to an explanatory model of SP adherence. The final sample consisted of 172 professionals. The SPAQ obtained a mean of 71.94 points (SD = 6.40) and the SPKC, 15.44 (SD +/- 1.48). Significant correlation (p≤0.001) between adherence and personality of risk, perception of risk, perception of obstacles to follow SP, training and availability of PPE was verified. We conclude that psychosocial and organizational factors were correlated with adherence. No statistical significance was found for the impact of knowledge on adherence to SP. However, it is necessary to raise awareness of the multifaceted nature of adherence to those referred to as security, which pervade individual but also organizational factors and therefore require direct and permanent involvement of management of health institutions, through education in health and infrastructure needed for safe behavior

Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Cuidados de Enfermagem/normas , Precauções Universais/estatística & dados numéricos , Fidelidade a Diretrizes/estatística & dados numéricos , Gestão da Segurança/normas , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Pesquisas sobre Serviços de Saúde/estatística & dados numéricos
J Clin Nurs ; 29(3-4): 447-458, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31738466


AIMS AND OBJECTIVE: To gain insight into nurse practitioners' (NP) leadership roles in Dutch hospital care, by exploring the perceptions regarding their current leadership role and the differences with their previous role as a registered specialised nurse. BACKGROUND: To meet today's challenges of the increasing healthcare demands, the employment of NPs is proliferating. NPs have the ideal position to play a pivotal role within healthcare reforms, yet full expansion of their scope of practice and expertise is having limited success. Long-term sustainability of NPs depends on the ability to perform and develop a leading role. DESIGN AND METHODS: This qualitative descriptive study was conducted in fifteen Dutch hospitals. Data were collected from April-July 2018, and purposive sampling was used for eighteen semi-structured interviews. This study is conducted and reported according to the COREQ checklist. RESULTS: Three main themes concerning NPs' current leadership role emerged, and they were all linked to a successful positioning of NPs. All themes seemed to be of influence on NPs' scope of daily practice. Direct patient care was emphasised, and leadership on other levels appeared to be underused. Most NPs desired to reshape their profession. However, unprofitable use of their leadership skills especially on professional and organisational level and lack of supportive factors seemed to hinder them. CONCLUSIONS: An adequate use of leadership is crucial for role development and positioning of NPs. Further development of the NP profession can help to better differentiate between the tasks of registered specialised nurses and NPs. RELEVANCE TO CLINICAL PRACTICE: Leadership in nursing contributes to the improvement of the quality and efficiency of health care. Further positioning of the NP profession depends on a profitable use of leadership competencies. Besides, NPs should collaborate with healthcare organisations, educational institutions and professional associations to value the NP profession in the current healthcare system.

Liderança , Profissionais de Enfermagem/psicologia , Cuidados de Enfermagem/normas , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos , Profissionais de Enfermagem/organização & administração , Papel do Profissional de Enfermagem , Recursos Humanos de Enfermagem no Hospital/organização & administração , Pesquisa Qualitativa
Res Nurs Health ; 43(1): 68-78, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31710134


INTRODUCTION: Hypertension is a chronic disease that requires continuous and long-term care to prevent or delay the development of associated complications. Although various interventions for hypertension exist, case management in Brazil's primary healthcare is understudied. We examined nursing case management effectiveness for controlling blood pressure among Brazilian adults with hypertension in the public healthcare system. METHOD: A randomized controlled trial with a 12-month follow-up was conducted at a primary healthcare clinic in southern Brazil. Adult patients with hypertension were randomly allocated to intervention (n = 47) and usual care groups (n = 47). The nursing case management model includes nursing consultations, telephone contact, home visits, health education, and appropriate referrals. Patient outcomes (blood pressure, body mass index, waist circumference, quality of life, treatment adherence) were assessed at baseline and 6- and 12-month follow-up for the intervention group and at baseline and 12-month follow-up for the usual care group. Data were collected from only the intervention group at T6 to avoid contact between the researcher and the usual care group, and to check the care plan and modify it if necessary. RESULTS: After the intervention, the intervention group's blood pressure decreased significantly compared to the usual care group. The differences in systolic and diastolic blood pressure between the groups was -8.3 (intervention)/1.1 (usual care) mmHg (p = .004) and -7.4/-0.6 mmHg (p = .007), respectively. The intervention group had significantly greater improvement in waist circumference (-2.0/1.2 cm), body mass index (- 0.4/0.3), and treatment adherence (4.8/-1.1) than the usual care group (all p < .05). CONCLUSION: Nursing case management in primary healthcare may be effective for improving outcomes among patients with hypertension.

Administração de Caso/normas , Doença Crônica/terapia , Hipertensão/enfermagem , Cuidados de Enfermagem/normas , Guias de Prática Clínica como Assunto , Atenção Primária à Saúde/normas , Adolescente , Adulto , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade