Elza Lima da Silva

Pensamento Lean e cuidado do paciente em morte encefálica no processo de doação de órgãos

A doacao de orgaos e um processo complexo que desafia os profissionais e gestores do sistema de saude. Este estudo objetiva apresentar um modelo teorico de organizacao do cuidado ao paciente em morte encefalica e o processo de doacao de orgaos, balizado pelas principais ideias do pensamento Lean que possibilitam a melhoria da producao a partir de ciclos de planejamentos e criacao de um ambiente propicio para o sucesso da sua implementacao. O pensamento Lean pode tornar mais eficaz e eficiente o processo de doacao de orgaos e contribuir com a sua melhoria, a partir da sistematizacao das informacoes e capacitacao dos profissionais para a excelencia do cuidado. O modelo apresentado configura-se como um referencial disponivel para validacao e aplicacao pelos profissionais e gestores de saude e enfermagem na pratica da gestao do cuidado ao paciente potencial doador de orgaos em morte encefalica e respectiva demanda por transplante.Organ donation is a complex process that challenges health system professionals and managers. This study aimed to introduce a theoretical model to organize brain-dead patient assistance and the organ donation process guided by the main lean thinking ideas, which enable production improvement through planning cycles and the development of a proper environment for successful implementation. Lean thinking may make the process of organ donation more effective and efficient and may contribute to improvements in information systematization and professional qualifications for excellence of assistance. The model is configured as a reference that is available for validation and implementation by health and nursing professionals and managers in the management of potential organ donors after brain death assistance and subsequent transplantation demands.

Lean thinking and brain-dead patient assistance in the organ donation process

A doacao de orgaos e um processo complexo que desafia os profissionais e gestores do sistema de saude. Este estudo objetiva apresentar um modelo teorico de organizacao do cuidado ao paciente em morte encefalica e o processo de doacao de orgaos, balizado pelas principais ideias do pensamento Lean que possibilitam a melhoria da producao a partir de ciclos de planejamentos e criacao de um ambiente propicio para o sucesso da sua implementacao. O pensamento Lean pode tornar mais eficaz e eficiente o processo de doacao de orgaos e contribuir com a sua melhoria, a partir da sistematizacao das informacoes e capacitacao dos profissionais para a excelencia do cuidado. O modelo apresentado configura-se como um referencial disponivel para validacao e aplicacao pelos profissionais e gestores de saude e enfermagem na pratica da gestao do cuidado ao paciente potencial doador de orgaos em morte encefalica e respectiva demanda por transplante.Organ donation is a complex process that challenges health system professionals and managers. This study aimed to introduce a theoretical model to organize brain-dead patient assistance and the organ donation process guided by the main lean thinking ideas, which enable production improvement through planning cycles and the development of a proper environment for successful implementation. Lean thinking may make the process of organ donation more effective and efficient and may contribute to improvements in information systematization and professional qualifications for excellence of assistance. The model is configured as a reference that is available for validation and implementation by health and nursing professionals and managers in the management of potential organ donors after brain death assistance and subsequent transplantation demands.

Rastreamento oportunístico do câncer de mama entre mulheres jovens no Estado do Maranhão, Brasil

Although breast cancer is infrequent in women under 40 years of age, it deserves attention, since diagnosis requires a high rate of clinical suspicion. Thus, preventive practices should be emphasized in childbearing-age women, with opportunistic screening as a relevant strategy. This study focused on breast cancer prevention practices adopted by young women in Maranhao State, Brazil. This was a population-based descriptive study conducted from June 2007 to January 2008. The majority of the women had low income (42.1%) and fewer than eight years of schooling (62.6%). Some 30% reported breast self-examination. Among women older than 35, 71.6% had never had a mammogram. The most common preventive measure was clinical examination (35.2%), which had increased by 11.5% in the previous ten years. Such information on opportunistic breast cancer screening in Maranhao should help produce specific public health policies for the State.

Lean thinking in health and nursing: an integrative literature review

ABSTRACT Objectives: to demonstrate the scientific knowledge developed on lean thinking in health, highlighting the impact and contributions in health care and nursing. Method: an integrative literature review in the PubMed, CINAHL, Scopus, Web of Science, Emerald, LILACS and SciELO electronic library databases, from 2006 to 2014, with syntax keywords for each data base, in which 47 articles were selected for analysis. Results: the categories were developed from the quality triad proposed by Donabedian: structure, process and outcome. Lean thinking is on the rise in health surveys, particularly internationally, especially in the USA and UK, improving the structure, process and outcome of care and management actions. However, it is an emerging theme in nursing. Conclusion: this study showed that the use of lean thinking in the context of health has a transforming effect on care and organizational aspects, promoting advantages in terms of quality, safety and efficiency of health care and nursing focused on the patient.Objectives: to demonstrate the scientific knowledge developed on lean thinking in health, highlighting the impact and contributions in health care and nursing. Method: an integrative literature review in the PubMed, CINAHL, Scopus, Web of Science, Emerald, LILACS and SciELO electronic library databases, from 2006 to 2014, with syntax keywords for each data base, in which 47 articles were selected for analysis. Results: the categories were developed from the quality triad proposed by Donabedian: structure, process and outcome. Lean thinking is on the rise in health surveys, particularly internationally, especially in the USA and UK, improving the structure, process and outcome of care and management actions. However, it is an emerging theme in nursing. Conclusion: this study showed that the use of lean thinking in the context of health has a transforming effect on care and organizational aspects, promoting advantages in terms of quality, safety and efficiency of health care and nursing focused on the patient.

Significados do cuidado de enfermagem ao paciente em morte encefálica potencial doador

Objetivo: Compreender os significados do cuidado ao paciente em morte encefalica potencial doador para enfermeiros, e construir um modelo teorico. Metodo: Estudo qualitativo sustentado na Teoria Fundamentada nos Dados, realizado em dezembro/2010 a junho/2011, por meio de entrevista aberta com 12 enfermeiros de Hospital Universitario, distribuidos em tres grupos amostrais. Resultados: O fenomeno Desvelando relacoes e interacoes multiplas do enfermeiro na complexidade do cuidado ao paciente em morte encefalica potencial doador sustenta-se por cinco categorias e emerge pela necessidade de organizacao das praticas de cuidado no contexto da unidade de terapia intensiva, considerando as interveniencias na relacao entre enfermeiros, equipe e familia e revela desafios para o enfermeiro diante da complexidade do processo de cuidar. Conclusoes: O significado do cuidado ao paciente em morte encefalica potencial doador esta em entender sua complexidade para alem de um ser morto, mas como gerador de vida por meio da doacao de orgaos. Palavras-chave: Cuidados de enfermagem. Morte encefalica. Obtencao de tecidos e orgaos. Relacoes enfermeiro-paciente. Cuidados criticos.OBJECTIVE To understand the meanings of care to brain dead potential organ donors for nurses, and construct a theoretical model. METHOD Qualitative study based on the Grounded Theory approach. Data were collected through open interviews with 12 nurses, distributed in three sample groups in a university hospital in northeastern Brazil, from December 2010 to June 2011. RESULTS The phenomenon Unveiling multiple relationships and interactions of nurses in the complexity of patient care in brain dead potential donors is supported by the interrelationship of five categories and results from the need to organize care practices in the context of the intensive care unit, considering the factors involved in the relationship between nurses, staff and family and reveals challenges for nurses imposed by the complexity of the care process. CONCLUSIONS The meaning of care to brain dead potential donors involves understanding the complexity of this patient who can save somebodys life through organ donation.

Pensamiento Lean y cuidado del paciente con muerte encefálica en el proceso de donación de órganos

A doacao de orgaos e um processo complexo que desafia os profissionais e gestores do sistema de saude. Este estudo objetiva apresentar um modelo teorico de organizacao do cuidado ao paciente em morte encefalica e o processo de doacao de orgaos, balizado pelas principais ideias do pensamento Lean que possibilitam a melhoria da producao a partir de ciclos de planejamentos e criacao de um ambiente propicio para o sucesso da sua implementacao. O pensamento Lean pode tornar mais eficaz e eficiente o processo de doacao de orgaos e contribuir com a sua melhoria, a partir da sistematizacao das informacoes e capacitacao dos profissionais para a excelencia do cuidado. O modelo apresentado configura-se como um referencial disponivel para validacao e aplicacao pelos profissionais e gestores de saude e enfermagem na pratica da gestao do cuidado ao paciente potencial doador de orgaos em morte encefalica e respectiva demanda por transplante.Organ donation is a complex process that challenges health system professionals and managers. This study aimed to introduce a theoretical model to organize brain-dead patient assistance and the organ donation process guided by the main lean thinking ideas, which enable production improvement through planning cycles and the development of a proper environment for successful implementation. Lean thinking may make the process of organ donation more effective and efficient and may contribute to improvements in information systematization and professional qualifications for excellence of assistance. The model is configured as a reference that is available for validation and implementation by health and nursing professionals and managers in the management of potential organ donors after brain death assistance and subsequent transplantation demands.