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1.
Texto & contexto enferm ; 29: e20190089, Jan.-Dec. 2020. graf
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-1101984

RESUMO

ABSTRACT Objective: to analyze the practices of novice graduated nurses in view of their social representations on intensive care to the critical patient provided in non-critical patient units. Method: a qualitative research, based on social representations, with 26 novice graduated nurses at a private university in Rio de Janeiro (Brazil). Data collection made between 2016 and 2017 by a semi-structured interview and lexical analysis by Alceste software. Results: the context of the Intensive Care Unit influences social representations, which mobilizes identity aspects of this environment that stereotype the ward as a disorganized place and that does not have material resources and trained professionals. Thus, when novice undergraduates act and despite the effort and dedication fail to transfer the patient, fear and lack of confidence are exacerbated, resulting in actions that can bring risks to the patient. Conclusion: there are stereotypes in relation to the clinic that limit the care actions of the novice undergraduates in relation to the critical patient, and should be re-signified in generalist education. It is recommended to develop follow-up programs for novice graduated nurses.


RESUMEN Objetivo: analizar las prácticas de enfermeros recién graduados sobre la base de sus representaciones sociales acerca del cuidado intensivodel paciente crítico prestado en unidades de pacientes no críticos. Método: investigación cualitativa, pautada en representaciones sociales, con 26 enfermeros recién graduados en una universidad privada de Rio de Janeiro (Brasil). La recolección de datos se realizó entre 2016 y 2017 mediante entrevistas semiestructuradas y análisis del tipo lexical por el software Alceste. Resultados: el contexto de la Unidad de Terapia Intensiva influye sobrelas representaciones sociales, y crea aspectos identitarios de este ambiente que marcan un estereotipo y estigmatizan a la enfermería como un lugar desorganizado que no dispone de recursos materiales ni de profesionales capacitados. En ese contexto, cuando actúan los recién graduados, y, a pesar de su esfuerzo y dedicación, no logran trasladar al paciente, se exacerban el miedo y la falta de confianza, que resultan en acciones que pueden implicar riesgos para el paciente. Conclusión: hay estereotipos en relación a la clínica que limitan los cuidados que el recién graduado presta al paciente crítico y que deben ser resignificados en la formación de grado. Se recomienda desarrollar programas de acompañamiento de enfermeros recién graduados.


RESUMO Objetivo: analisar as práticas de enfermeiros recém-formados em face das suas representações sociais sobre o cuidado intensivo ao paciente crítico prestado em unidades de pacientes não-críticos. Método: pesquisa qualitativa, pautada nas representações sociais, com 26 enfermeiros recém-formados em uma universidade privada do Rio de Janeiro (Brasil). Coleta de dados entre 2016 e 2017 por entrevista semiestruturada e análise do tipo lexical pelo software Alceste. Resultados: o contexto da Unidade de Terapia Intensiva influencia as representações sociais, o que mobiliza aspectos identitários deste ambiente que estereotipam a enfermaria como um local desorganizado e que não dispõe de recursos materiais e de profissionais capacitados. Com isso, quando os recém-formados agem e apesar do esforço e dedicação não conseguem transferir o paciente, exacerbam-se o medo e falta de confiança, resultando em ações que podem trazer riscos ao paciente. Conclusão: há estereótipos em relação à clínica que limitam as ações de cuidado do recém-formado frente ao paciente crítico, devendo ser resignificados na formação generalista. Recomenda-se desenvolver programas de acompanhamento dos enfermeiros recém-formados.


Assuntos
Humanos , Adulto , Adulto Jovem , Prática Profissional , Psicologia Social , Enfermagem , Cuidados Críticos , Cuidados de Enfermagem , Sistema Único de Saúde , Enfermeiras e Enfermeiros , Enfermeiros
2.
Texto & contexto enferm ; 29: e20180426, Jan.-Dec. 2020. tab, graf
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-1101974

RESUMO

ABSTRACT Objective: to know the issues in evidence in rural nursing. Method: a six-stage integrative review. Data was collected from May to July 2017, in the SciELO, CUIDEN, PubMed, and ScienceDirect databases, with "Rural nursing" as descriptor. The analysis used was qualitative with the construction of subsets and topics. Results: of the 30 articles analyzed, 32% addressed professional training; 25% collective health-related practices; 12% hospital care; 10% job satisfaction; 7% were dedicated to telehealth and 3% of the studies addressed the following topics: nurses' recruitment and permanence in rural areas, continuing education, and professional practice in urgency and emergency regulation centers. Conclusion: working in rural areas demands that nurses face particularities such as isolation, difficulty of access, diverse socioeconomic conditions and specific epidemiological profiles, which influence the professional practice, making it a challenge.


RESUMEN Objetivo: conocer los temas en evidencia en la enfermería en el territorio rural. Método: revisión integradora compuesta por seis etapas. Los datos se recolectaron de mayo a junio de2017 en las bases de datos SciELO, CUIDEN, PubMed y ScienceDirect, con el siguiente descriptor: "Rural nursing". El análisis empleado fue el cualitativo con la elaboración de subconjuntos y temas. Resultados: de los 30 artículos analizados, el 32% abordaron la formación profesional; el 25%, acciones relacionadas con la salud colectiva; el 12%, la atención hospitalaria; el 10%, la satisfacción en el trabajo; el 7% estaban dedicados a la telesalud y el 3% de los estudios trataron dos temas: reclutamiento y permanencia de las enfermeras en el Espacio rural, educación permanente y desempeño profesional en la central de regulación de urgencias y emergencias. Conclusión: para desempeñarse profesionalmente en el territorio rural, una enfermera debe hacer frente a diversas particularidades como el aislamiento, la dificultad de acceso, condiciones socioeconómicas diversas y perfiles epidemiológicos específicos, que influyen sobre la práctica profesional, factores que la convierten en un desafío.


RESUMO Objetivo: conhecer os temas em evidência na enfermagem no território rural. Método: revisão integrativa composta por seis etapas. Os dados foram coletados no período de maio a julho de 2017, nas bases SciELO, CUIDEN, PubMed, ScienceDirect, com o descritor "Rural nursing". A análise utilizada foi qualitativa com a construção de subconjuntos e tópicos. Resultados: dos 30 artigos analisados 32% abordavam a formação profissional; 25% ações relacionadas a saúde coletiva; 12% assistência hospitalar; 10% a satisfação no trabalho; 7% dedicaram a telessaúde e 3% dos estudos trataram dos temas: recrutamento e permanência das Enfermeiras no Espaço rural, educação permanente e a atuação profissional em central de regulação de urgência e emergência. Conclusão: a atuação no território rural demanda à enfermeira enfrentar particularidades como isolamento, dificuldade de acesso, condições socioeconômicas diversas e perfis epidemiológicos específicos, que influenciam a prática profissional, o que a torna um desafio.


Assuntos
Saúde Pública , Enfermagem Rural , Cuidados de Enfermagem , Prática Profissional , Zona Rural , Saúde da População Rural , Enfermagem em Saúde Comunitária
5.
Pharm. pract. (Granada, Internet) ; 18(3): 0-0, jul.-sept. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-194190

RESUMO

BACKGROUND: Discrimination towards pharmacists, as a public-facing health professional group, is reported but not well-studied. OBJECTIVES: The aims of this study were to identify accounts of discrimination in pharmacy practice and to explore the nature and impacts of and discrimination experienced by pharmacists. METHODS: A cross-sectional survey was emailed to practice-based preceptors associated with the School of Pharmacy at the University of Otago. The survey included demographic questions, in addition to questions asking about the frequency and sources of different types of discrimination and abuse encountered in practice. Survey respondents could also provide their contact information for follow-up interviews. Interviews occurred after completion of the survey to better understand the nature of discrimination in pharmacy practice. A thematic analysis of interview transcripts was conducted to identify pertinent themes. RESULTS: A total of 43 participants completed the survey. A total of 29 (67.4%) respondents reported experiencing discrimination in pharmacy practice. The most common types of discrimination experienced included discrimination based on gender, appearance, or past, present, or expected pregnancy. Verbal abuse and sexual harassment were also frequently reported. Most discrimination was sourced from patients, colleagues, or supervisors/leaders. Discrimination specific to pregnancy was largely sourced from supervisors/leaders. Verbal abuse was sources primarily from patients, patient's family, supervisors/leaders, and other healthcare professionals. Patients were the primary source of sexual harassment. Three themes were identified from the interview phase: Discrimination occurs for a variety of reasons from different sources with different behaviors, the impact on a person is individualized/personal, and preventative strategies can be broad and encompass multiple layers of society. CONCLUSIONS: Findings of this study support the notion that training programs must adjust to adequately train pharmacists with effective coping strategies, prevention mechanisms, and resilience building strategies. Pharmacist employers should also be accountable to creating zero tolerance workplaces and providing route maps for how pharmacists report and navigate situations when faced with discrimination. Doing so may result in a better equipped workforce that is able to navigate the pressures encountered through discrimination in practice


No disponible


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Discriminação Social , Prática Profissional , Farmacêuticos/psicologia , Assédio Sexual , Emprego , Resiliência Psicológica , Inquéritos e Questionários , Pesquisa Qualitativa
6.
Pharm. pract. (Granada, Internet) ; 18(3): 0-0, jul.-sept. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-194192

RESUMO

The central role of the Portuguese National Health Service (P-NHS) guarantees virtually free universal coverage. Key policy papers, such as the National Health Plan and the National Plan for Patient Safety have implications for pharmacists, including an engagement in medicines reconciliation. These primary health care reform, while not explicitly contemplating a role for pharmacists, offer opportunities for the involvement of primary care pharmacists in medicines management. Primary care pharmacists, who as employees of the P-NHS work closely with an interdisciplinary team, have launched a pilot service to manage polypharmacy in people living with multimorbidities, involving potential referral to community pharmacy. Full integration of community pharmacy into primary health care is challenging due to their nature as private providers, which implies the need for the recognition that public and private health sectors are mutually complementary and may maximize universal health coverage. The scope of practice of community pharmacies has been shifting to service provision, currently supported by law and in some cases, including the needle and syringe exchange program and generic substitution, remunerated. Key changes envisaged for the future of pharmacists and their integration in primary care comprise the development and establishment of clinical pharmacy as a specialization area, peer clinician recognition and better integration in primary care teams, including full access to clinical records. These key changes would enable pharmacists to apply their competence in medicines optimization for improved patient outcomes


No disponible


Assuntos
Humanos , Atenção Primária à Saúde/normas , Política de Saúde , Farmácias/normas , Farmacêuticos/normas , Assistência Farmacêutica/normas , Farmácias/organização & administração , Portugal , Assistência Farmacêutica/organização & administração , Prática Profissional , Papel Profissional
7.
Pharm. pract. (Granada, Internet) ; 18(3): 0-0, jul.-sept. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-194193

RESUMO

The practice of community pharmacy in low and middle-income countries, including in Indonesia, is often described as in the state of infancy with several intractable barriers that have been substantially and continuously hampering the practice. Such description might be valid in highlighting how pharmacy is practiced and the conditions within and beyond community pharmacy organizations. Therefore, it is not surprising that the concept of integrating community pharmacy into the primary care system may not be considered in the contemporary discourse despite the fact that community pharmacy has been operating within communities for years. However, in the case of Indonesia, we argue that changes in the health care system within the past decade particularly with the introduction of the universal health coverage (UHC) in 2014, may have significantly amplified the role of pharmacists. There is good evidence which highlights the contribution of pharmacist as a substantial health care element in primary care practice. The initiative for employing pharmacist, identified in this article as primary care pharmacist, in the setting of community health center [puskesmas] and the introduction of affiliated or contracted community pharmacy under the UHC have enabled pharmacist to work together with other primary care providers. Moreover, government agenda under the "Smart Use of Medicines" program [Gema Cermat] recognizes pharmacists as the agent of change for improving the rational use of medicines in the community. Community pharmacy is developing, albeit slowly, and is able to grasp a novel position to deliver pharmacy-related primary care services to the general public through new services, for example drug monitoring and home care. Nevertheless, integrating community pharmacy into primary care is relatively a new notion in the Indonesian setting, and is a challenging process given the presence of barriers in the macro, meso- and micro-level of practice


No disponible


Assuntos
Humanos , Atenção Primária à Saúde , Farmácias/normas , Farmacêuticos/normas , Prática Profissional , Farmácias/organização & administração , Assistência Ambulatorial/métodos , Assistência Ambulatorial/organização & administração , Indonésia , Integração Comunitária
8.
Pharm. pract. (Granada, Internet) ; 18(3): 0-0, jul.-sept. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-194194

RESUMO

BACKGROUND: The American College of Clinical Pharmacy (ACCP) prepared clinical pharmacist competencies that have specific recommendations. Recently, many efforts to advance clinical pharmacy services in Egypt exist. The literature revealed that no country has assessed the extent of applicability of ACCP competencies in its current pharmacy practice setting. Egyptian pharmacists can provide feedback about applicability of such competencies in clinical pharmacy settings in Egypt. OBJECTIVE: The objective of this study was to investigate the extent to which ACCP competencies were implemented by Egyptian clinical pharmacists and therefore evaluate development of clinical pharmacy practice in Egypt. The study also investigated factors affecting the applicability of such competencies in the current clinical pharmacy practice setting in Egypt. METHODS: Four hundred and ninety-five randomly selected clinical pharmacists from several hospitals were invited to participate in a cross sectional survey using a self-administered validated questionnaire composed of 31 questions classified into six domains. This questionnaire was designed to determine the pharmacists' perception about applicability of ACCP competencies to clinical pharmacy practice in Egypt. RESULTS: The response rate was 64% as 317 out of 495 pharmacists completed the questionnaire. These pharmacists were categorized according to age; gender; qualifications; years of previous work experience, years since BSc. and type of hospitals they are currently working at. Analysis of data revealed the professionalism domain to have the highest percentage of acceptance among pharmacists, while the system-based care & population health domain had the lowest percentage of acceptance. Results also showed that qualifications of participants did not affect their response in three domains; "Direct Patient Care", "Systems-based Care & Population Health" and "Continuing Professional Development" (p = 0.082, 0.081, 0.060), respectively. Nevertheless, qualifications of participants did affect their response in the other three domains; "Pharmacotherapy Knowledge", "Communication" and "Professionalism" (p < 0.05). The age of pharmacists, gender, years of previous work experience, and graduation year did not affect their responses in all six domains. The type of hospital they are currently working at, though, affected their responses where, there was a highly statistically significant increase of the mean score of all domains among participants working at the NGOs/private hospitals compared to governmental hospitals (p < 0.001). CONCLUSIONS: Egyptian pharmacists generally apply high percentage of ACCP competencies but the provided clinical pharmacy services need to be improved through applying the standards of best practice


No disponible


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Conselhos de Especialidade Profissional/normas , Prática Profissional , Profissionalismo , Egito , Sistemas de Informação em Farmácia Clínica/normas , Inquéritos e Questionários , Competência Profissional/normas , Estudos Transversais
9.
Pharm. pract. (Granada, Internet) ; 18(3): 0-0, jul.-sept. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-194195

RESUMO

BACKGROUND: Antibiotics are the most frequently used medicines worldwide with most of the countries defining these as prescription-only medicines. Though, dispensing non-prescribed antibiotics represent one of the chief causal factors to the irrational use of antibiotics that paves the way to the development of antimicrobial resistance. OBJECTIVE: We aimed at describing the practices and the enablers for non-prescribed antibiotic dispensing in Maputo city, Mozambique. METHODS: A qualitative study was conducted, between October 2018 and March 2019, in nine private pharmacies randomly selected across Maputo city. Eighteen pharmacists were contacted and seventeen enrolled through snowball sampling. In-depth interviews were conducted, audiotaped, and transcribed verbatim. Transcripts were coded and analysed though thematic analysis with guidelines from Braun and Clark. The Consolidated Criteria for Reporting Qualitative Studies (COREQ) checklist by (Tong, 2007) was performed. RESULTS: Out of seventeen, fifteen pharmacists admitted non-prescribed dispensing of antibiotics. Common antibiotic dispensing practices included; dispensing without prescription, without asking for a brief clinical history of patients, without clear explanation of the appropriate way of administering, without advising on the side effects. Reasons for non-prescribed antibiotic dispensing are linked to patients' behaviour of demanding for non-prescribed antibiotics, to the patients expectations and beliefs on the healing power of antibiotics, to the physicians' prescribing practices. Other reasons included the pressure for profits from the pharmacy owners, the fragile law enforcement, and absence of accountability mechanisms. CONCLUSIONS: The practices of non-prescribed antibiotic dispensing characterize the 'daily life' of the pharmacists. On the one hand, the patient's demand for antibiotics without valid prescriptions, and pharmacist's wish to assist based on their role in the pharmacy, the pressure for profits and on the understanding of the larger forces driving the practices of self-medication with antibiotics - rock. On the other hand, pharmacists are aware of the legal status of antibiotics and the public health consequences of their inappropriate dispensing practices and their professional and ethical responsibility for upholding the law - hard place. Highlighting the role of pharmacists and their skills as health promotion professionals is needed to optimizing antibiotic dispensing and better conservancy in Mozambique


No disponible


Assuntos
Humanos , Masculino , Feminino , Adulto , Prática Profissional , Medicamentos sem Prescrição/normas , Antibacterianos/uso terapêutico , Medicamentos de Venda Assistida/normas , Boas Práticas de Dispensação , Moçambique , Assistência Farmacêutica/normas , Saúde Pública
10.
Pharm. pract. (Granada, Internet) ; 18(3): 0-0, jul.-sept. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-194202

RESUMO

The Chilean healthcare system is composed of public and private sectors, with most of the higher-income population being covered privately. Primary healthcare in the public system is provided in more than 2,500 public primary care centers of different sizes with assigned populations within territories. Private insurance companies have their own healthcare networks or buy services from individual health providers. Patients from the public system receive most medications free of charge in primary care pharmacies embedded in each care center. Private patients must purchase their medicines from community pharmacies. Some government policies subsidize part of the cost of medications, but original medicines remain as the most expensive of Latin America. Three chain pharmacies have more than 90% of the market share, and these pharmacies have negative public perception because of price collusion court sentences. A non-profit, municipal pharmacy model was developed but has limited implementation. Most privately owned independent and chain community pharmacies do not provide pharmaceutical services as there is no remuneration or cover by insurers. The limited number of publicly owned Municipal pharmacies could implement pharmaceutical services in community settings as they are non-profit establishments and have full-time pharmacists but are not resourced for these services. A limited number of pharmaceutical services are almost exclusively provided in public primary care, including medication reviews, pharmaceutical education, home visits and pharmacovigilance services, but several barriers to their implementation remain. A risk-based multimorbidity care model was implemented in 2020 for public primary care with additional employment of part-time pharmacists to provide services. We believe that this model will help pharmacists to optimize their time by prioritizing the much-needed clinical tasks. We propose within this multimorbidity care model that the more time-consuming services are provided to higher risk patients. Pharmacy prescribing i.e. amending or approving changes in medications in primary care for chronic conditions could also be useful for the health system, but pharmacists would require additional training. The landscape for pharmaceutical services for primary care in Chile is promising, but the integration with community pharmacies will not be possible until they are funded by public and private insurance, and the public perception of these establishments is improved


No disponible


Assuntos
Humanos , Atenção Primária à Saúde/métodos , Farmácias , Farmacêuticos , Assistência Farmacêutica , Prática Profissional , Chile , Acesso aos Serviços de Saúde
11.
Pharm. pract. (Granada, Internet) ; 18(3): 0-0, jul.-sept. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-194203

RESUMO

The United States (US) has a complex healthcare system with a mix of public, private, nonprofit, and for-profit insurers, healthcare institutions and organizations, and providers. Unlike other developed countries, there is not a single payer healthcare system or a national pharmaceutical benefits scheme/plan. Despite spending over USD 10,000 per capita in healthcare, the US is among the worst performers compared to other developed countries in outcomes including life expectancy at birth, infant mortality, safety during childbirth, and unmanaged chronic conditions (e.g., asthma, diabetes). Primary care is delivered by physicians and advanced practice providers (i.e., nurse practitioners and physician assistants) in a variety of settings including large health systems, federally qualified health centers or free clinics that provide care to the underserved, or specific facilities for veterans or American Indian and Alaska native peoples. Since 2010, primary care delivery has shifted toward providing patient-centered, coordinated, comprehensive care focused on providing proactive, rather than reactive, population health management, and on the quality, versus volume, of care. Community pharmacy comprises a mix of independently owned, chain, supermarket and mass merchant pharmacies. Community pharmacies provide services such as immunizations, medication therapy management, medication packaging, medication synchronization, point-of-care testing and, in specific states where legislation has been passed, hormonal contraception, opioid reversal agents, and smoking cessation services. There has been criticism regarding the lack of standard terminology for services such as medication synchronization and medication therapy management, their components and how they should be provided, which hampers comparability across studies. One of the main challenges for pharmacists in the US is the lack of provider status at the federal level. This means that pharmacists are not allowed to use existing fee-for-service health insurance billing codes to receive reimbursement for non-dispensing services. In addition, despite there being regulatory infrastructure in multiple states, the extent of service implementation is either low or unknown. Research found that pharmacists face numerous barriers when providing some of these services. State fragmentation and the lack of a single pharmacy organization and vision for the profession are additional challenges


No disponible


Assuntos
Humanos , Atenção Primária à Saúde , Farmácias/normas , Farmacêuticos/normas , Prática Profissional , Assistência Farmacêutica/normas , Farmácias/organização & administração , Estados Unidos
14.
Tex Med ; 116(8): 20-25, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32866271

RESUMO

Ricardo Garza, MD, was still walking the tightrope: standing, but unable to withstand another gust of wind. COVID-19 swept away about 35% of the San Antonio solo cardiologist's practice revenue, and that was just what he could calculate as he waited for insurers to process straggling claims. But he had returned to in-office operations without any layoffs. While some practices are surviving - and trying their best to prepare for future threats - others weren't so lucky. On-the-ground experiences align with the Texas Medical Association's Practice Viability Survey in showing COVID-19 was, and still is, a disruptor unlike any other - challenging or torpedoing the viability of various practice types.


Assuntos
Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Prática Profissional , Telemedicina , Betacoronavirus , Infecções por Coronavirus/economia , Infecções por Coronavirus/epidemiologia , Tomada de Decisões Gerenciais , Transmissão de Doença Infecciosa/prevenção & controle , Humanos , Inovação Organizacional , Pandemias/economia , Pneumonia Viral/economia , Pneumonia Viral/epidemiologia , Padrões de Prática Médica/organização & administração , Padrões de Prática Médica/tendências , Prática Profissional/economia , Prática Profissional/tendências , Texas/epidemiologia
15.
Enferm. foco (Brasília) ; 11(1,n.esp): 10-23, ago. 2020. tab
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1116318

RESUMO

Objetivo: Descrever ações do Conselho Federal de Enfermagem através do Comitê Gestor de Crise para o Coronavírus no país. Método: descrição de atividades na modalidade de relato de experiência que teve seus dados coletados nos arquivos, documentos e relatório do Comitê Gestor de Crise em junho de 2020. Resultados: Identificou-se dez macro ações: criação do Comitê Gestor de Crise, Campanha "Juntos contra o Coronavírus", Observatório da Enfermagem, Ouvidoria e Denúncias, Equipamentos de Proteção Individual, Medidas Legais, Apoio em Saúde Mental, Capacitação Profissional e Plantão do Comitê de Crise. Considerações Finais: as ações desenvolvidas nesse período pelo Cofen contribuíram para aumentar sua interação com os profissionais de enfermagem, bem como para promover a valorização destes perante as agências de saúde governamentais nacionais e internacionais, poder público e mídia nacional e internacional, destacando-se frente a outros conselhos de classe no país. (AU)


Objective: To describe actions of the Federal Nursing Council through the Crisis Management Committee for Coronavirus in the country. Method: description of activities in the experience report modality that had its data collected in the files, documents and report of the Crisis Management Committee, in June 2020. Results: Ten macro actions were identified: creation of the Crisis Management Committee, "Together against Coronavirus" Campaign, Nursing Observatory, Ombudsman and Complaints, Personal Protective Equipment, Legal Measures, Mental Health Support, Professional Training and on-call the Crisis Committee. Final Considerations: the actions developed during this period by Federal Nursing Council contributed to increase their interaction with nursing professionals, as well as to promote their valorization before national and international government health agencies, public authorities and national and international media, standing out in front to other class councils in the country. (AU)


Objetivo: Describir las acciones del Consejo Federal de Enfermería a través del Comité de Manejo de Crisis para el Coronavirus en el país. Método: descripción de actividades en la modalidad de informe de experiencia que recolectó sus datos en los archivos, documentos e informe del Comité de Gestión de Crisis en junio de 2020. Resultados: Se identificaron diez macro acciones: creación del Comité de Gestión de Crisis, Campaña "Juntos contra el coronavirus", Observatorio de Enfermería, Defensor del Pueblo y Quejas, Equipo de Protección Personal, Medidas Legales, Apoyo a la Salud Mental, Capacitación Profesional y el Comité de Crisis de guardia. Consideraciones finales: las acciones desarrolladas durante este período por Cofen contribuyeron a aumentar su interacción con los profesionales de enfermería, así como a promover su valorización ante agencias de salud gubernamentales nacionales e internacionales, autoridades públicas y medios de comunicación nacionales e internacionales, destacándose a otros consejos de clase en el país. (AU)


Assuntos
Enfermagem , Prática Profissional , Administração Pública , Infecções por Coronavirus
16.
Cochrane Database Syst Rev ; 8: CD004398, 2020 07 31.
Artigo em Inglês | MEDLINE | ID: mdl-32748975

RESUMO

BACKGROUND: Printed educational materials are widely used dissemination strategies to improve the quality of healthcare professionals' practice and patient health outcomes. Traditionally they are presented in paper formats such as monographs, publication in peer-reviewed journals and clinical guidelines. This is the fourth update of the review. OBJECTIVES: To assess the effect of printed educational materials (PEMs) on the practice of healthcare professionals and patient health outcomes. To explore the influence of some of the characteristics of the printed educational materials (e.g. source, content, format) on their effect on healthcare professionals' practice and patient health outcomes. SEARCH METHODS: We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), HealthStar, CINAHL, ERIC, CAB Abstracts, Global Health, and EPOC Register from their inception to 6 February 2019. We checked the reference lists of all included studies and relevant systematic reviews. SELECTION CRITERIA: We included randomised trials (RTs), controlled before-after studies (CBAs) and interrupted time series studies (ITSs) that evaluated the impact of PEMs on healthcare professionals' practice or patient health outcomes. We included three types of comparisons: (1) PEM versus no intervention, (2) PEM versus single intervention, (3) multifaceted intervention where PEM is included versus multifaceted intervention without PEM. Any objective measure of professional practice (e.g. prescriptions for a particular drug), or patient health outcomes (e.g. blood pressure) were included. DATA COLLECTION AND ANALYSIS: Two reviewers undertook data extraction independently. Disagreements were resolved by discussion. For analyses, we grouped the included studies according to study design, type of outcome and type of comparison. For controlled trials, we reported the median effect size for each outcome within each study, the median effect size across outcomes for each study and the median of these effect sizes across studies. Where data were available, we re-analysed the ITS studies by converting all data to a monthly basis and estimating the effect size from the change in the slope of the regression line between before and after implementation of the PEM. We reported median changes in slope for each outcome, for each study, and then across studies. We standardised all changes in slopes by their standard error, allowing comparisons and combination of different outcomes. We categorised each PEM according to potential effects modifiers related to the source of the PEMs, the channel used for their delivery, their content, and their format. We assessed the risks of bias of all the included studies. MAIN RESULTS: We included 84 studies: 32 RTs, two CBAs and 50 ITS studies. Of the 32 RTs, 19 were cluster RTs that used various units of randomisation, such as practices, health centres, towns, or areas. The majority of the included studies (82/84) compared the effectiveness of PEMs to no intervention. Based on the RTs that provided moderate-certainty evidence, we found that PEMs distributed to healthcare professionals probably improve their practice, as measured with dichotomous variables, compared to no intervention (median absolute risk difference (ARD): 0.04; interquartile range (IQR): 0.01 to 0.09; 3,963 healthcare professionals randomised within 3073 units). We could not confirm this finding using the evidence gathered from continuous variables (standardised mean difference (SMD): 0.11; IQR: -0.16 to 0.52; 1631 healthcare professionals randomised within 1373 units ), from the ITS studies (standardised median change in slope = 0.69; 35 studies), or from the CBA study because the certainty of this evidence was very low. We also found, based on RTs that provided moderate-certainty evidence, that PEMs distributed to healthcare professionals probably make little or no difference to patient health as measured using dichotomous variables, compared to no intervention (ARD: 0.02; IQR: -0.005 to 0.09; 935,015 patients randomised within 959 units). The evidence gathered from continuous variables (SMD: 0.05; IQR: -0.12 to 0.09; 6,737 patients randomised within 594 units) or from ITS study results (standardised median change in slope = 1.12; 8 studies) do not strengthen these findings because the certainty of this evidence was very low. Two studies (a randomised trial and a CBA) compared a paper-based version to a computerised version of the same PEM. From the RT that provided evidence of low certainty, we found that PEM in computerised versions may make little or no difference to professionals' practice compared to PEM in printed versions (ARD: -0.02; IQR: -0.03 to 0.00; 139 healthcare professionals randomised individually). This finding was not strengthened by the CBA study that provided very low certainty evidence (SMD: 0.44; 32 healthcare professionals). The data gathered did not allow us to conclude which PEM characteristics influenced their effectiveness. The methodological quality of the included studies was variable. Half of the included RTs were at risk of selection bias. Most of the ITS studies were conducted retrospectively, without prespecifying the expected effect of the intervention, or acknowledging the presence of a secular trend. AUTHORS' CONCLUSIONS: The results of this review suggest that, when used alone and compared to no intervention, PEMs may slightly improve healthcare professionals' practice outcomes and patient health outcomes. The effectiveness of PEMs compared to other interventions, or of PEMs as part of a multifaceted intervention, is uncertain.


Assuntos
Disseminação de Informação/métodos , Manuais como Assunto , Avaliação de Processos e Resultados em Cuidados de Saúde , Prática Profissional , Análise de Variância , Estudos Controlados Antes e Depois , Difusão de Inovações , Análise de Séries Temporais Interrompida , Publicações Periódicas como Assunto , Guias de Prática Clínica como Assunto , Padrões de Prática Médica , Melhoria de Qualidade , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Tempo
17.
J Nurs Adm ; 50(9): 468-473, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32826516

RESUMO

Nurse leaders seek effective strategies to engage nurses in decision-making when striving for clinical excellence. When leaders cultivate safe environments, nurses are encouraged to discover new knowledge and innovations. In our institution, nurse leaders designed a systematic guide using Liberating Structures to empower nurses to develop a professional practice model.


Assuntos
Liderança , Modelos de Enfermagem , Enfermeiras Administradoras , Cultura Organizacional , Prática Profissional , Desenvolvimento de Pessoal/organização & administração , Competência Clínica , Humanos , Enfermeiras Administradoras/organização & administração , Enfermeiras Administradoras/psicologia
18.
Enferm. foco (Brasília) ; 11(2): 6-10, jul. 2020.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1103945

RESUMO

Objetivo: Descrever ações do Conselho Federal de Enfermagem através do Comitê Gestor de Crise para o Coronavírus no país. Método: descrição de atividades na modalidade de relato de experiência que teve seus dados coletados nos arquivos, documentos e relatório do Comitê Gestor de Crise em junho de 2020. Resultados: Identificou-se dez macro ações: criação do Comitê Gestor de Crise, Campanha "Juntos contra o Coronavírus", Observatório da Enfermagem, Ouvidoria e Denúncias, Equipamentos de Proteção Individual, Medidas Legais, Apoio em Saúde Mental, Capacitação Profissional e Plantão do Comitê de Crise. Considerações Finais: as ações desenvolvidas nesse período pelo Cofen contribuíram para aumentar sua interação com os profissionais de enfermagem, bem como para promover a valorização destes perante as agências de saúde governamentais nacionais e internacionais, poder público e mídia nacional e internacional, destacando-se frente a outros conselhos de classe no país. (AU)


Objective: To describe actions of the Federal Nursing Council through the Crisis Management Committee for Coronavirus in the country. Method: description of activities in the experience report modality that had its data collected in the files, documents and report of the Crisis Management Committee, in June 2020. Results: Ten macro actions were identified: creation of the Crisis Management Committee, "Together against Coronavirus" Campaign, Nursing Observatory, Ombudsman and Complaints, Personal Protective Equipment, Legal Measures, Mental Health Support, Professional Training and on-call the Crisis Committee. Final Considerations: the actions developed during this period by Federal Nursing Council contributed to increase their interaction with nursing professionals, as well as to promote their valorization before national and international government health agencies, public authorities and national and international media, standing out in front to other class councils in the country. (AU)


Objetivo: Describir las acciones del Consejo Federal de Enfermería a través del Comité de Manejo de Crisis para el Coronavirus en el país. Método: descripción de actividades en la modalidad de informe de experiencia que recolectó sus datos en los archivos, documentos e informe del Comité de Gestión de Crisis en junio de 2020. Resultados: Se identificaron diez macro acciones: creación del Comité de Gestión de Crisis, Campaña "Juntos contra el coronavirus", Observatorio de Enfermería, Defensor del Pueblo y Quejas, Equipo de Protección Personal, Medidas Legales, Apoyo a la Salud Mental, Capacitación Profesional y el Comité de Crisis de guardia. Consideraciones finales: las acciones desarrolladas durante este período por Cofen contribuyeron a aumentar su interacción con los profesionales de enfermería, así como a promover su valorización ante agencias de salud gubernamentales nacionales e internacionales, autoridades públicas y medios de comunicación nacionales e internacionales, destacándose a otros consejos de clase en el país. (AU)


Assuntos
Enfermagem , Prática Profissional , Infecções por Coronavirus , Enfermeiras e Enfermeiros
19.
World Neurosurg ; 142: e396-e406, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32679362

RESUMO

BACKGROUND: The coronavirus 2019 (COVID-19) pandemic has changed the practice of neurosurgery. Significant resources have been dedicated to the disease. The pandemic in the Indian subcontinent, compared with the rest of the world, is relatively delayed. The neurosurgical practice cannot remain unaffected by hugely disruptive measures such as a lockdown. The inevitable increase in COVID infections with the gradual relaxation of lockdown continues to pose a risk for health care providers. Therefore, it is imperative to evaluate whether the pandemic has had a discernible effect on health care providers, especially in terms of practice modifications in private establishments and publicly funded hospitals, the emotional impact on the surgeon, and the influence of social media on the psyche of the surgeon. METHODS: An online questionnaire-based survey was prepared, with questions related to the COVID-specific themes of precautions taken in outpatient services and operating theaters, the influence of social media, the economic loss incurred, and the perceptible impact of telemedicine and webinars. The links to the survey were mailed to neurosurgeons in private and public practice countrywide. The responses were anonymized to ensure free and unbiased answers to the survey questions. RESULTS: A total of 176 responses were received from across the Indian subcontinent. The median age of respondents was 39 years (range, 32-70 years) and the postresidency experience was 7 years (range, 0-34 years). Respondents were an equitable mix of public and private practitioners. Of respondents, 46% were practicing restricted outpatient services, more in public institutions (P = 0.22) which also had a higher incidence of tele-outpatient services (26% vs. 17%). Wearing surgical masks, N95 masks, and gloves were the most commonly practiced precautionary measures in outpatient services (>60%). Although private practitioners were continuing elective cases (40%), public institutes were more cautious, with only emergency patients being operated on (29%). The greatest fear among all practitioners was passing the infection to their family (75%). Social media were helpful for brainstorming queries and updating practice modifications, but some surgeons admitted to receiving threats on social media platforms (37.5%). Depression and economic losses were palpable for approximately 30% neurosurgeons. CONCLUSIONS: The survey highlights the perception of neurosurgeons toward the pandemic and the difference in public-private practice. Suspension of elective procedures, severe curtailment of regular outpatient appointments, drastic modifications of the normal outpatient department/operating room practices, and apprehensions related to inadequacy of safety provided by personal protective equipment use and financial losses of private establishments were some of the visible themes in our survey results. Although telemedicine has not been as widely adopted as expected, online education has been favorably received.


Assuntos
Assistência Ambulatorial , Infecções por Coronavirus , Procedimentos Cirúrgicos Eletivos , Neurocirurgiões , Procedimentos Neurocirúrgicos , Pandemias , Pneumonia Viral , Prática Profissional , Telemedicina , Centros Médicos Acadêmicos , Adulto , Idoso , Betacoronavirus , Depressão , Economia , Hospitais Privados , Hospitais Públicos , Humanos , Índia , Pessoa de Meia-Idade , Neurocirurgia , Equipamento de Proteção Individual , Mídias Sociais , Inquéritos e Questionários
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