Patrícia Madalena Vieira Hermida

Care management in nursing within emergency care units

OBJECTIVE Understand the conditions involved in the management of nursing care in emergency care units. METHODOLOGY Qualitative research using the methodological framework of the Grounded Theory. Data collection occurred from September 2011 to June 2012 through semi-structured interviews with 20 participants of the two emergency care units in the city of Florianopolis, Brazil. RESULTS Hindering factors to care management are: lack of experience and knowledge of professionals in emergency services; inadequate number of professionals; work overload of emergency care units in the urgent care network; difficulty in implementing nursing care systematization, and need for team meetings. Facilitating factors are: teamwork; importance of professionals; and confidence of the nursing technicians in the presence of the nurse. CONCLUSION Whereas the hindering factors in care management are related to the organizational aspects of the emergency care units in the urgency care network, the facilitating ones include specific aspects of teamwork.

MOBILE EMERGENCY MEDICAL SERVICES IN THE PSYCHOLOGICAL CRISIS AND THE PSYCHOSOCIAL PARADIGM

The objective was to know the perception and interventions of basic support teams of the mobile emergency medical service in a situation of psychic crisis. T...Objetivou-se conhecer a percepcao e as intervencoes de equipes de suporte basico do servico de atendimento movel de urgencia na situacao da crise psiquica. Estudo de abordagem qualitativa, descritiva, realizada em Santa Catarina, com quatro equipes de unidades de suporte basico do servico de atendimento movel de urgencia. Os dados foram coletados de abril a junho de 2011, mediante entrevista semiestruturada. Utilizou-se para a organizacao e analise dos dados o Discurso do Sujeito Coletivo e para a discussao, o paradigma psicossocial. Dos resultados emergiram tres discursos com as Ideias Centrais: crise como alteracao de comportamento e instabilidade psicologica; manifestacao com presenca de alucinacoes e agressividade; intervencao que ocorre com contencao fisica, medicamentosa e encaminhamento. Concluiu-se que a concepcao de crise pelos profissionais esta atrelada ao positivismo da psiquiatria e a atencao pre-hospitalar segue medidas protocolares no atendimento a pessoa em crise psiquica, distantes dos principios determinados pelo paradigma psicossocial.

Health promotion practices in primary care groups

This is a descriptive-exploratory study using a qualitative approach, conducted in ten municipalities in southern Brazil. Data were obtained by talking to 21 nurses from February to November 2012, through semi-structured interviews using questions to probe their health promotion practices. Data were analyzed through thematic analysis focused on health promotion concepts. We identified four themes about health promotion practices of family health nurses in Brazil: a) training of nurses for health promotion practice was weak; b) nurses formed health promotion groups around diseases and life stages; c) nurses formed groups to meet community needs; and d) nurses used health promotion techniques in group work. These family health nurses were somewhat aware of the importance of health promotion, and how to assist the population against various ailments using some health promotion strategies. The main weaknesses were the lack of understanding about health promotion concepts, and the difficulty of understanding the relevance of its practice, probably attributable to limitations in training. We conclude that primary care groups in Brazil’s unified health system could do better in applying health promotion concepts in their practice.

TYMPANIC AND TEMPORAL THERMOMETRY IN HYPOTHERMIA ASSESSMENT FOR ADULT IN INTRAOPERATIVE ABDOMINAL SURGERY

Objetivo: analizar la asociacion entre las caracteristicas sociodemograficas, clinicas, operatorias y ambientales con la ocurrencia de hipotermia medida por medio de termometros timpanicos y temporales, en pacientes adultos en el trans-operatorio sometidos a cirugias abdominales electivas con exposicion visceral. Metodos: estudio observacional, prospectivo, cuantitativo, correlacional. Los datos fueron recolectados mediante instrumento estructurado conteniendo las variables: edad; indice de massa corporal; classificacion American Society of Anesthesiologists; tipo de anestesia; tiempo de la cirugia; temperatura timpanica y temporal; temperatura y humedad relativa a la sala quirurgica. Fueron medidas las temperaturas por los metodos de afeccion timpanico y temporal en 63 pacientes. En el analisis de los datos se busco la asociacion de la hipotermia con las caracteristicas de los pacientes, del tipo de anestesia, del ambiente quirurgico segundo el metodo de afeccion y del tiempo quirurgico. Resultado: de los 63 pacientes, 15 (23,8%) presentaron hipotermia. Del total (n=15; 100%) de pacientes hipotermicos, 13 (80%) presentaron hipotermia leve. La hipotermia moderada fue identificada apenas por la termometria temporal, en tres (20%) pacientes. No hubo hipotermia grave y en dos (13,3%) pacientes a la hipotermia ocurrio apenas en la medida de la termometria temporal. En la relacion de las variables, identificacion que la hipotermia tuvo asociacion estadisticamente significante solamente con la edad (p=0,0027) y el sexo (p=0,015), en la afeccion de la temperatura timpanica. Conclusion: apenas el sexo y la edad interfirieron en la hipotermia en el trans-operatorio por la termometria timpanica y ninguna variable influencio por la termometria temporal.

ATENDIMIENTO MÓVIL DE URGENCIAS EN CRISIS PSÍQUICAS Y EL PARADIGMA PSICOSOCIAL

The objective was to know the perception and interventions of basic support teams of the mobile emergency medical service in a situation of psychic crisis. T...Objetivou-se conhecer a percepcao e as intervencoes de equipes de suporte basico do servico de atendimento movel de urgencia na situacao da crise psiquica. Estudo de abordagem qualitativa, descritiva, realizada em Santa Catarina, com quatro equipes de unidades de suporte basico do servico de atendimento movel de urgencia. Os dados foram coletados de abril a junho de 2011, mediante entrevista semiestruturada. Utilizou-se para a organizacao e analise dos dados o Discurso do Sujeito Coletivo e para a discussao, o paradigma psicossocial. Dos resultados emergiram tres discursos com as Ideias Centrais: crise como alteracao de comportamento e instabilidade psicologica; manifestacao com presenca de alucinacoes e agressividade; intervencao que ocorre com contencao fisica, medicamentosa e encaminhamento. Concluiu-se que a concepcao de crise pelos profissionais esta atrelada ao positivismo da psiquiatria e a atencao pre-hospitalar segue medidas protocolares no atendimento a pessoa em crise psiquica, distantes dos principios determinados pelo paradigma psicossocial.

ATENDIMENTO MÓVEL DE URGÊNCIA NA CRISE PSÍQUICA E OPARADIGMA PSICOSSOCIAL

The objective was to know the perception and interventions of basic support teams of the mobile emergency medical service in a situation of psychic crisis. T...Objetivou-se conhecer a percepcao e as intervencoes de equipes de suporte basico do servico de atendimento movel de urgencia na situacao da crise psiquica. Estudo de abordagem qualitativa, descritiva, realizada em Santa Catarina, com quatro equipes de unidades de suporte basico do servico de atendimento movel de urgencia. Os dados foram coletados de abril a junho de 2011, mediante entrevista semiestruturada. Utilizou-se para a organizacao e analise dos dados o Discurso do Sujeito Coletivo e para a discussao, o paradigma psicossocial. Dos resultados emergiram tres discursos com as Ideias Centrais: crise como alteracao de comportamento e instabilidade psicologica; manifestacao com presenca de alucinacoes e agressividade; intervencao que ocorre com contencao fisica, medicamentosa e encaminhamento. Concluiu-se que a concepcao de crise pelos profissionais esta atrelada ao positivismo da psiquiatria e a atencao pre-hospitalar segue medidas protocolares no atendimento a pessoa em crise psiquica, distantes dos principios determinados pelo paradigma psicossocial.

Metodologia ativa de ensino na formação do enfermeiro: inovação na atenção básica

Aim: to report the experience of applying an active methodology of teaching and learning with nursing students in primary health care. Method: experience report. Eight students and one teacher participated, in a morning of practical activity of a health unity in Florianopolis, Santa Catarina, Brazil. The methodology was applied in eight distinct, sequential and complementary phases. Results: the students were initially stimulated to represent a situation of health/disease and seek support at the Health Centre as users, posteriorly they observed the facility structure and socialized the individual experiences. During the whole process, the students were stimulated to reflect and share their experiences, to discuss the functioning of the service and the professionals’ roles. Final Considerations: it was an important experience in different ways of teaching and learning that involved both teachers and students

Gestión del cuidado de enfermería en las unidades de cuidados de emergencia

OBJECTIVE Understand the conditions involved in the management of nursing care in emergency care units. METHODOLOGY Qualitative research using the methodological framework of the Grounded Theory. Data collection occurred from September 2011 to June 2012 through semi-structured interviews with 20 participants of the two emergency care units in the city of Florianopolis, Brazil. RESULTS Hindering factors to care management are: lack of experience and knowledge of professionals in emergency services; inadequate number of professionals; work overload of emergency care units in the urgent care network; difficulty in implementing nursing care systematization, and need for team meetings. Facilitating factors are: teamwork; importance of professionals; and confidence of the nursing technicians in the presence of the nurse. CONCLUSION Whereas the hindering factors in care management are related to the organizational aspects of the emergency care units in the urgency care network, the facilitating ones include specific aspects of teamwork.

Gerência do cuidado de enfermagem em unidades de pronto atendimento

OBJECTIVE Understand the conditions involved in the management of nursing care in emergency care units. METHODOLOGY Qualitative research using the methodological framework of the Grounded Theory. Data collection occurred from September 2011 to June 2012 through semi-structured interviews with 20 participants of the two emergency care units in the city of Florianopolis, Brazil. RESULTS Hindering factors to care management are: lack of experience and knowledge of professionals in emergency services; inadequate number of professionals; work overload of emergency care units in the urgent care network; difficulty in implementing nursing care systematization, and need for team meetings. Facilitating factors are: teamwork; importance of professionals; and confidence of the nursing technicians in the presence of the nurse. CONCLUSION Whereas the hindering factors in care management are related to the organizational aspects of the emergency care units in the urgency care network, the facilitating ones include specific aspects of teamwork.

Métodos de aquecimento na prevenção da hipotermia no intraoperatório de cirurgia abdominal eletiva

Objective: To identify heating methods to prevent intraoperative hypothermia in elective abdominal surgery with visceral exposure, in adult patients. Methods: Quantitative, exploratory, descriptive and prospective study performed in a public hospital, in southern Brazil. The sample consisted of 63 patients. It was possible to observe the heating methods used and measure the tympanic temperature. For data processing, it was used descriptive statistics through the SEstatNet software. Results: Active and passive heating methods were used. The infusion of heated fluids for abdominal cavity irrigation was the most used measure (no 63; 100%) of the active process, while maintaining the cooling system off until the surgery beginning was the most used measurement (no 57; 90.5%) of the passive method. Conclusion: There was no severe hypothermia with the heating methods utilized. However, there are more efficient current methods that could prevent mild and moderate hypothermia found.Objetivo: Identificar os metodos de aquecimento para prevenir hipotermia em pacientes adultos no intraoperatorio de cirurgia abdominal eletiva com exposicao visceral. Metodos: Estudo quantitativo, exploratorio e descritivo, prospectivo, realizado num hospital publico da regiao sul do Brasil. Constituiu a amostra 63 pacientes. Observaram-se os metodos de aquecimento utilizados e foi aferida a temperatura timpânica. Para tratamento dos dados, aplicou-se a estatistica descritiva por meio do software SEstatNet. Resultados: Foram utilizados metodos de aquecimento ativo e passivo. A infusao de fluidos aquecidos para irrigacao da cavidade abdominal foi a medida mais empregada (no 63; 100%) do metodo ativo, enquanto que a manutencao do sistema de refrigeracao desligado ate o inicio da cirurgia foi a medida mais utilizada (no 57; 90,5%) do metodo passivo. Conclusao: Com os metodos de aquecimento empregados nao houve hipotermia grave, porem, existem metodos atuais mais eficientes que poderiam prevenir a hipotermia leve e moderada encontradas.