Jorge Vinícius Cestari Felix

Medidas de conforto e comunicação nas ações de cuidado de enfermagem ao paciente crítico

Descriptive, quantitative study carried out at a University Hospital in Curitiba-PR, Brazil. The objective was to analyze the caring actions performed at a semi-intensive care unit, from the perspective of the caring humanization, and also to evaluate the presence of comfort and communication measures in performing these actions. The data collection occurred under a systematic non-participant observation. The caring actions were grouped, according to its frequency, and presented in graphs. The comfort measures were present at 45% of the caring actions performed, and communication establishment was present at 40% of these actions. Even today, the comfort and communication measures, as reflected in the process of caring humanization, remain as an ideal speech. However, they are too far from reality of the health care systems users and workers.Estudio descriptivo con enfoque cuantitativo, realizado en un Hospital Universitario en Curitiba. Este estudio tuvo como objetivo analizar las acciones de atencion realizadas en un centro de terapia semi intensiva, segun la perspectiva de la humanizacion de la atencion, y evaluar la presencia de medidas de comodidad y de la comunicacion en la realizacion de estas acciones. La tecnica de recoleccion de datos fue la observacion sistematica sin participacion. Las acciones de atencion se agruparon, de acuerdo con su frecuencia, y son presentadas en graficos. Las medidas de comodidad estuvieron presentes en el 45% de las acciones de atencion desarrolladas, y la comunicacion estuve presente en el 40%. Incluso hoy en dia, las medidas de comodidad y la comunicacion, tal como se refleja en el proceso de humanizacion de la atencion, permanecen como un discurso ideal, pero lejos de la realidad para los usuarios y profesionales de la salud.

HEALTHCARE MANAGEMENT OF TUBERCULOSIS: INTEGRATING A TEACHING HOSPITAL INTO PRIMARY HEALTH CARE

Qualitative, exploratory and interventionist case study at a teaching hospital of Parana, with the objective of proposing a Tuberculosis Healthcare Management model focused on the hospital discharge, with a view to comprehensive care for patients with tuberculosis. Interviews were conducted with key informants (17 subjects), using the Theory of Nursing Praxis Intervention in Collective Health as the theoretical and methodological framework, with its three interdependent dimensions used as analytical categories. Weakness was revealed in the protocols for hospitalized patient care, insufficient integration between levels of care and the need for direct communication between the hospital and primary care nurses. In view of this result, a Healthcare Management Model, expressed as a flow of care with matrix support, nursing consultation and phone contact between nurses. The implementation of this model will lead to greater integration between the levels of care, permitting improvements in patient monitoring with greater probability of treatment compliance.Pesquisa de cunho qualitativo, exploratorio e intervencionista em hospital universitario do Parana, com o objetivo de propor um modelo de Gestao do Cuidado da Tuberculose voltado a alta hospitalar, buscando cuidado integral ao portador dessa doenca. Foram realizadas entrevistas com informantes-chave (17 sujeitos), tendo a Teoria da Intervencao Praxica de Enfermagem em Saude Coletiva como referencial teorico-metodologico, com suas tres dimensoes interdependentes, utilizadas como categorias analiticas. Ficou evidenciado fragilidade nos protocolos voltados ao cuidado do doente internado, insuficiente integracao entre niveis de atencao e necessidade de comunicacao direta entre enfermeiros do hospital e da atencao primaria. Diante desse resultado, foi proposto modelo de Gestao do Cuidado, traduzido em fluxo de atendimento com apoio matricial, consulta de enfermagem e contato telefonico entre enfermeiros. Acredita-se que a implantacao desse modelo trara maior integracao entre os niveis de atencao, melhora no processo de acompanhamento do doente com maior probabilidade de adesao ao tratamento.

Comfort and communication measures in nursing caring actions for critically ill patients

Descriptive, quantitative study carried out at a University Hospital in Curitiba-PR, Brazil. The objective was to analyze the caring actions performed at a semi-intensive care unit, from the perspective of the caring humanization, and also to evaluate the presence of comfort and communication measures in performing these actions. The data collection occurred under a systematic non-participant observation. The caring actions were grouped, according to its frequency, and presented in graphs. The comfort measures were present at 45% of the caring actions performed, and communication establishment was present at 40% of these actions. Even today, the comfort and communication measures, as reflected in the process of caring humanization, remain as an ideal speech. However, they are too far from reality of the health care systems users and workers.Estudio descriptivo con enfoque cuantitativo, realizado en un Hospital Universitario en Curitiba. Este estudio tuvo como objetivo analizar las acciones de atencion realizadas en un centro de terapia semi intensiva, segun la perspectiva de la humanizacion de la atencion, y evaluar la presencia de medidas de comodidad y de la comunicacion en la realizacion de estas acciones. La tecnica de recoleccion de datos fue la observacion sistematica sin participacion. Las acciones de atencion se agruparon, de acuerdo con su frecuencia, y son presentadas en graficos. Las medidas de comodidad estuvieron presentes en el 45% de las acciones de atencion desarrolladas, y la comunicacion estuve presente en el 40%. Incluso hoy en dia, las medidas de comodidad y la comunicacion, tal como se refleja en el proceso de humanizacion de la atencion, permanecen como un discurso ideal, pero lejos de la realidad para los usuarios y profesionales de la salud.

Assessment of the timeliness for notification of dengue in the state of Paraná

Objective To evaluate the timeliness for notification of dengue in the State of Parana. Methods Normative assessment study of the attribute timeliness, according to the Centers for Disease Control and Prevention and the parameters of the Ministry of Health. The population consists of the total of 132,979 dengue notifications registered in the Notifiable Diseases Information System (SINAN) online in the state of Parana in the periods of 2011/2012 and 2012/2013. It is a descriptive analysis of the time (in days) elapsed in steps of notification, investigation, typing and closure, median calculation, percentage, and cumulative percentage of intervals. Results Ninety percent of cases were notified within 6-12 days (mean: 2-4); 90% and more with investigations initiated on the day of notification; 90% entered in 10-74 days (mean: 10-74); and 80% closed within 38-61 days after notification (mean: 20-45). Conclusion Ninety percent and more of cases had their investigations initiated on the day of notification. Improvements are needed in the other steps to help in the control and prevention of dengue.

GESTIÓN DEL CUIDADO DE LA TUBERCULOSIS: INTEGRANDO UNO HOSPITAL DE DOCENTE A LA ATENCIÓN PRIMARIA DE SALUD

Qualitative, exploratory and interventionist case study at a teaching hospital of Parana, with the objective of proposing a Tuberculosis Healthcare Management model focused on the hospital discharge, with a view to comprehensive care for patients with tuberculosis. Interviews were conducted with key informants (17 subjects), using the Theory of Nursing Praxis Intervention in Collective Health as the theoretical and methodological framework, with its three interdependent dimensions used as analytical categories. Weakness was revealed in the protocols for hospitalized patient care, insufficient integration between levels of care and the need for direct communication between the hospital and primary care nurses. In view of this result, a Healthcare Management Model, expressed as a flow of care with matrix support, nursing consultation and phone contact between nurses. The implementation of this model will lead to greater integration between the levels of care, permitting improvements in patient monitoring with greater probability of treatment compliance.Pesquisa de cunho qualitativo, exploratorio e intervencionista em hospital universitario do Parana, com o objetivo de propor um modelo de Gestao do Cuidado da Tuberculose voltado a alta hospitalar, buscando cuidado integral ao portador dessa doenca. Foram realizadas entrevistas com informantes-chave (17 sujeitos), tendo a Teoria da Intervencao Praxica de Enfermagem em Saude Coletiva como referencial teorico-metodologico, com suas tres dimensoes interdependentes, utilizadas como categorias analiticas. Ficou evidenciado fragilidade nos protocolos voltados ao cuidado do doente internado, insuficiente integracao entre niveis de atencao e necessidade de comunicacao direta entre enfermeiros do hospital e da atencao primaria. Diante desse resultado, foi proposto modelo de Gestao do Cuidado, traduzido em fluxo de atendimento com apoio matricial, consulta de enfermagem e contato telefonico entre enfermeiros. Acredita-se que a implantacao desse modelo trara maior integracao entre os niveis de atencao, melhora no processo de acompanhamento do doente com maior probabilidade de adesao ao tratamento.

Hyaluronic acid covers in burn treatment: a systematic review

OBJECTIVE To evaluate the effectiveness of hyaluronic acid in the healing of partial thickness burns. METHOD Systematic review of randomized controlled trials on the use of hyaluronic acid for the topical treatment of skin burns, based on recommendations of the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS Two randomized controlled trials that analyzed 143 patients with partial thickness burns and/or deep partial thickness burns were selected. They compared the application of hyaluronic acid 0.2% associated to silver sulfadiazine 1% 5g/cm2 versus silver sulfadiazine 1% 5g/cm2 alone for the outcome of complete healing. CONCLUSION This review emphasizes the need for new well-designed randomized controlled trials to establish the therapeutic relevance of hyaluronic acid with respect to the healing of burns of partial thickness or deep partial thickness. OBJETIVO Avaliar a efetividade do ácido hialurônico na cicatrização de queimaduras de espessura parcial. MÉTODO Revisão sistemática de ensaios clínicos randomizados sobre a utilização de ácido hialurônico no tratamento tópico de queimaduras de pele, baseada nas recomendações do Cochrane Handbook for Systematic Reviews of Interventions. RESULTADOS Foram recuperados dois ensaios clínicos randomizados que analisaram 143 pacientes portadores de queimaduras de espessura parcial e/ou espessura parcial profunda, comparando a aplicação de Ácido Hialurônico 0,2% associado à Sulfadiazina de Prata 1% 5g/cm2, versus Sulfadiazina de Prata 1% 5g/cm2 isolada, para o desfecho cicatrização completa. CONCLUSÃO Esta revisão enfatiza a necessidade de novos ensaios clínicos randomizados bem delineados para estabelecimento da relevância terapêutica do ácido hialurônico no que tange à cicatrização de queimaduras de espessura parcial ou espessura parcial profunda.

Medidas de comodidad y comunicación en las acciones de atención de enfermería a pacientes críticos

Descriptive, quantitative study carried out at a University Hospital in Curitiba-PR, Brazil. The objective was to analyze the caring actions performed at a semi-intensive care unit, from the perspective of the caring humanization, and also to evaluate the presence of comfort and communication measures in performing these actions. The data collection occurred under a systematic non-participant observation. The caring actions were grouped, according to its frequency, and presented in graphs. The comfort measures were present at 45% of the caring actions performed, and communication establishment was present at 40% of these actions. Even today, the comfort and communication measures, as reflected in the process of caring humanization, remain as an ideal speech. However, they are too far from reality of the health care systems users and workers.Estudio descriptivo con enfoque cuantitativo, realizado en un Hospital Universitario en Curitiba. Este estudio tuvo como objetivo analizar las acciones de atencion realizadas en un centro de terapia semi intensiva, segun la perspectiva de la humanizacion de la atencion, y evaluar la presencia de medidas de comodidad y de la comunicacion en la realizacion de estas acciones. La tecnica de recoleccion de datos fue la observacion sistematica sin participacion. Las acciones de atencion se agruparon, de acuerdo con su frecuencia, y son presentadas en graficos. Las medidas de comodidad estuvieron presentes en el 45% de las acciones de atencion desarrolladas, y la comunicacion estuve presente en el 40%. Incluso hoy en dia, las medidas de comodidad y la comunicacion, tal como se refleja en el proceso de humanizacion de la atencion, permanecen como un discurso ideal, pero lejos de la realidad para los usuarios y profesionales de la salud.