Aline Marques Acosta

Frequent users of emergency services: associated factors and reasons for seeking care

Aim: to identify the profile of frequent users of emergency services, to verify the associated factors and to analyze the reasons for the frequent use of the services. METHOD: An explanatory sequential type mixed method was adopted. Quantitative data were collected from the electronic medical records, with a sample of 385 users attended four or more times in an emergency service, during the year 2011. Qualitative data were collected through semi-structured interviews with 18 users, intentionally selected from the results of the quantitative stage. Quantitative data were analyzed using descriptive and inferential statistics and qualitative data using thematic analysis. RESULTS: It was found that 42.9% were elderly, 84.9% had chronic diseases, 63.5% were classified as urgent, 42.1% stayed for more than 24 hours in the service and 46.5% were discharged. Scheduled follow-up appointment, risk classification, length of stay and outcome were factors associated with frequent use. The reasons for seeking the services were mainly related to the exacerbation of chronic diseases, to easier access and concentration of technology, to the bond, and to the scheduled appointments. CONCLUSIONS: The results contribute to comprehending the repeated use of emergency services and provide additional data to plan alternatives to reduce frequent use.Objetivo: identificar el perfil de usuarios frecuentes de servicios de emergencia, verificar los factores asociados y analizar los motivos para utilizacion frecuente de ese servicio. Metodo: se adopto un metodo mixto del tipo secuencial explicativo. Los datos cuantitativos fueron recolectados en registros de fichas electronicas, con muestra de 385 usuarios atendidos cuatro veces o mas, en un servicio de emergencia, durante el ano de 2011. Los datos cualitativos fueron obtenidos por medio de entrevistas semiestructuradas con 18 usuarios, seleccionados intencionalmente a partir de los resultados de la etapa cuantitativa. Los datos cuantitativos fueron analizados con estadistica descriptiva e inferencial y los cualitativos con analisis tematico. Resultados: se identifico que 42,9% eran ancianos, 84,9% tenian enfermedades cronicas, 63,5% fueron clasificados como urgentes, 42,1% permanecieron mas de 24 horas en el servicio y 46,5% tuvieron alta para el domicilio. El retorno programado, la clasificacion de riesgo, el tiempo de permanencia y el resultado, son factores asociados a la utilizacion frecuente. Los motivos de la busqueda por el servicio son relacionados, principalmente a: la agudizacion de enfermedades cronicas, la mayor facilidad de acceso y concentracion de tecnologia, los vinculos, y a los retornos programados. Conclusiones: los resultados contribuyen para la comprension del uso repetido de servicios de emergencia y ofrecen informaciones para planificar alternativas para reduccion de la utilizacion frecuente.Descriptores: Servicio de Urgencia en Hospital; Enfermeria de Urgencia; Necesidades y Demandas de Servicios de Salud.

Atendimento aos usuários em situação de violência: concepções dos profissionais de unidades básicas de saúde

O atendimento aos usuarios em situacao de violencia e um desafio aos profissionais das Unidades Basicas de Saude (UBS). Este estudo teve como objetivo analisar as concepcoes dos profissionais sobre o atendimento aos usuarios em situacao de violencia em UBS. Trata-se de uma pesquisa qualitativa realizada com enfermeiros, medicos, tecnicos/auxiliares de enfermagem e agentes comunitarios de saude por meio de entrevistas semi-estruturadas. Para analise dos dados utilizou-se a analise de conteudo tematico. Os profissionais atuam na identificacao das situacoes de violencia e elaboracao de estrategias de intervencao, visando o bem-estar dos usuarios por meio da recuperacao da sua saude fisica e mental. A desarticulacao da rede de assistencia a violencia, inseguranca, falta de profissionais capacitados e infra-estrutura inadequada sao alguns fatores que dificultam o atendimento. Os resultados podem subsidiar a elaboracao de politicas publicas que auxiliem a identificacao, o acolhimento e a assistencia aos individuos em situacao de violencia.

Atividades do enfermeiro nos sistemas de triagem/classificação de risco nos serviços de urgência: revisão integrativa

This present study aimed at identifying and assessing available literature regarding the activities of the nurse involved in assessing risk classification in emergency services. The integrative review carried out searches in the following databases: Science Direct, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (MEDLINE), Latin-American and Caribbean Health Sciences Database (LILACS), and Scientific Electronic Library Online (SCIELO). Twenty-two articles that met inclusion criteria were selected. Results indicated that the major attributions of this professional are the assessment of the patients healthcare status and decision-making, a process that demands clinical knowledge and experience The nurse is capable of organizing the workflow of patients according to the priority of the rendered care and service demands, and stands out as a professional of excellence in the development of triage/risk classification practices in emergency services.Objetivou-se identificar e avaliar as evidencias disponiveis na literatura sobre as atividades do enfermeiro na classificacao de risco nos servicos de urgencia. Realizou-se uma revisao integrativa, com busca nas bases de dados Science Direct, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrievel System Online (MEDLINE), Literatura Latino-Americana e do Caribe em Ciencias da Saude (LILACS) e Scientific Electronic Library Online (SCIELO). Foram selecionados 22 artigos que atenderam aos criterios de inclusao. Os resultados evidenciaram que as principais atribuicoes deste profissional sao a avaliacao do estado de saude do usuario e a tomada de decisao, processo que necessita de conhecimento clinico e de tempo de experiencia. O enfermeiro tem a capacidade de organizar o fluxo dos usuarios conforme a prioridade do atendimento e a demanda dos servicos, sendo um profissional de excelencia na execucao da triagem/classificacao de risco nos servicos de urgencia.

Activities of the nurse involved in triage/risk classification assessment in emergency services: an integrative review

This present study aimed at identifying and assessing available literature regarding the activities of the nurse involved in assessing risk classification in emergency services. The integrative review carried out searches in the following databases: Science Direct, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (MEDLINE), Latin-American and Caribbean Health Sciences Database (LILACS), and Scientific Electronic Library Online (SCIELO). Twenty-two articles that met inclusion criteria were selected. Results indicated that the major attributions of this professional are the assessment of the patients healthcare status and decision-making, a process that demands clinical knowledge and experience The nurse is capable of organizing the workflow of patients according to the priority of the rendered care and service demands, and stands out as a professional of excellence in the development of triage/risk classification practices in emergency services.Objetivou-se identificar e avaliar as evidencias disponiveis na literatura sobre as atividades do enfermeiro na classificacao de risco nos servicos de urgencia. Realizou-se uma revisao integrativa, com busca nas bases de dados Science Direct, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrievel System Online (MEDLINE), Literatura Latino-Americana e do Caribe em Ciencias da Saude (LILACS) e Scientific Electronic Library Online (SCIELO). Foram selecionados 22 artigos que atenderam aos criterios de inclusao. Os resultados evidenciaram que as principais atribuicoes deste profissional sao a avaliacao do estado de saude do usuario e a tomada de decisao, processo que necessita de conhecimento clinico e de tempo de experiencia. O enfermeiro tem a capacidade de organizar o fluxo dos usuarios conforme a prioridade do atendimento e a demanda dos servicos, sendo um profissional de excelencia na execucao da triagem/classificacao de risco nos servicos de urgencia.

Assistência em unidades básicas de saúde às vítimas de violência na concepção de enfermeiras - DOI: 10.4025/cienccuidsaude.v7i2.4997

This study is aimed at analyzing the understanding of nurses about the health care provided in Basic Health Units to users who are victims of violence, underscoring the necessary tools and the difficulties for providing attention. This is an exploratory-descriptive study with a qualitative approach. Data were collected through interviews with nurses. The technique of thematic content analysis was used. Results indicate that Basic Health Units play an important role in the attention to and prevention of violence. The strategies to face situations of violence refer to empathy, personal availability, attention, and listening to the signs and symptoms presented by the victims. Timing, personal experiences, and teamwork experiences are seen as crucial in early detection of cases. Results provide subsidies inputs for the qualification of work processes aiming at the integrality of care in the attention to victims of violence.

[Knowledge translation: translating research into policy and practice].

OBJECTIVE This paper provides a theoretical-reflective study of knowledge translation concepts and their implementation processes for using research evidence in policy and practice. RESULTS The process of translating research into practice is iterative and dynamic, with fluid boundaries between knowledge creation and action development. Knowledge translation focuses on co-creating knowledge with stakeholders and sharing that knowledge to ensure uptake of relevant research to facilitate informed decisions and changes in policy, practice, and health services delivery. In Brazil, many challenges exist in implementing knowledge translation: lack of awareness, lack of partnerships between researchers and knowledge-users, and low research budgets. CONCLUSIONS An emphasis on knowledge translation has the potential to positively impact health outcomes. Future research in Brazil is needed to study approaches to improve the uptake of research results in the Brazilian context.

Translação do conhecimento: traduzindo pesquisa para uso na prática e na formulação de políticas

OBJECTIVE This paper provides a theoretical-reflective study of knowledge translation concepts and their implementation processes for using research evidence in policy and practice. RESULTS The process of translating research into practice is iterative and dynamic, with fluid boundaries between knowledge creation and action development. Knowledge translation focuses on co-creating knowledge with stakeholders and sharing that knowledge to ensure uptake of relevant research to facilitate informed decisions and changes in policy, practice, and health services delivery. In Brazil, many challenges exist in implementing knowledge translation: lack of awareness, lack of partnerships between researchers and knowledge-users, and low research budgets. CONCLUSIONS An emphasis on knowledge translation has the potential to positively impact health outcomes. Future research in Brazil is needed to study approaches to improve the uptake of research results in the Brazilian context.

Patient satisfaction with nursing care in an emergency service

OBJECTIVE To analyze patient satisfaction with nursing care received at a hospital emergency service. METHODOLOGY This is a quantitative, descriptive, cross-sectional study. The sample was composed by 250 patients over 18 years old who used an emergency service in the south region of Brazil. Data were collected using an identification form and the Patient Satisfaction Instrument. RESULTS Results point to a good level of satisfaction of patients with the nursing care received, with the greatest mean found in the technical-professional care domain. Satisfaction was significantly associated with the room where the patient was and correlated to age, education and the length of stay in the service. CONCLUSION It was concluded that patients have good level of satisfaction with the care provided by nurses in emergency service.

Health care given to patients with violence situations: conceptions of professionals in basic health units

O atendimento aos usuarios em situacao de violencia e um desafio aos profissionais das Unidades Basicas de Saude (UBS). Este estudo teve como objetivo analisar as concepcoes dos profissionais sobre o atendimento aos usuarios em situacao de violencia em UBS. Trata-se de uma pesquisa qualitativa realizada com enfermeiros, medicos, tecnicos/auxiliares de enfermagem e agentes comunitarios de saude por meio de entrevistas semi-estruturadas. Para analise dos dados utilizou-se a analise de conteudo tematico. Os profissionais atuam na identificacao das situacoes de violencia e elaboracao de estrategias de intervencao, visando o bem-estar dos usuarios por meio da recuperacao da sua saude fisica e mental. A desarticulacao da rede de assistencia a violencia, inseguranca, falta de profissionais capacitados e infra-estrutura inadequada sao alguns fatores que dificultam o atendimento. Os resultados podem subsidiar a elaboracao de politicas publicas que auxiliem a identificacao, o acolhimento e a assistencia aos individuos em situacao de violencia.

Usuários frequentes de serviço de emergência: fatores associados e motivos de busca por atendimento

Aim: to identify the profile of frequent users of emergency services, to verify the associated factors and to analyze the reasons for the frequent use of the services. METHOD: An explanatory sequential type mixed method was adopted. Quantitative data were collected from the electronic medical records, with a sample of 385 users attended four or more times in an emergency service, during the year 2011. Qualitative data were collected through semi-structured interviews with 18 users, intentionally selected from the results of the quantitative stage. Quantitative data were analyzed using descriptive and inferential statistics and qualitative data using thematic analysis. RESULTS: It was found that 42.9% were elderly, 84.9% had chronic diseases, 63.5% were classified as urgent, 42.1% stayed for more than 24 hours in the service and 46.5% were discharged. Scheduled follow-up appointment, risk classification, length of stay and outcome were factors associated with frequent use. The reasons for seeking the services were mainly related to the exacerbation of chronic diseases, to easier access and concentration of technology, to the bond, and to the scheduled appointments. CONCLUSIONS: The results contribute to comprehending the repeated use of emergency services and provide additional data to plan alternatives to reduce frequent use.Objetivo: identificar el perfil de usuarios frecuentes de servicios de emergencia, verificar los factores asociados y analizar los motivos para utilizacion frecuente de ese servicio. Metodo: se adopto un metodo mixto del tipo secuencial explicativo. Los datos cuantitativos fueron recolectados en registros de fichas electronicas, con muestra de 385 usuarios atendidos cuatro veces o mas, en un servicio de emergencia, durante el ano de 2011. Los datos cualitativos fueron obtenidos por medio de entrevistas semiestructuradas con 18 usuarios, seleccionados intencionalmente a partir de los resultados de la etapa cuantitativa. Los datos cuantitativos fueron analizados con estadistica descriptiva e inferencial y los cualitativos con analisis tematico. Resultados: se identifico que 42,9% eran ancianos, 84,9% tenian enfermedades cronicas, 63,5% fueron clasificados como urgentes, 42,1% permanecieron mas de 24 horas en el servicio y 46,5% tuvieron alta para el domicilio. El retorno programado, la clasificacion de riesgo, el tiempo de permanencia y el resultado, son factores asociados a la utilizacion frecuente. Los motivos de la busqueda por el servicio son relacionados, principalmente a: la agudizacion de enfermedades cronicas, la mayor facilidad de acceso y concentracion de tecnologia, los vinculos, y a los retornos programados. Conclusiones: los resultados contribuyen para la comprension del uso repetido de servicios de emergencia y ofrecen informaciones para planificar alternativas para reduccion de la utilizacion frecuente.Descriptores: Servicio de Urgencia en Hospital; Enfermeria de Urgencia; Necesidades y Demandas de Servicios de Salud.