Doutorado em Enfermagem e Saúde (FEN)
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Navegando Doutorado em Enfermagem e Saúde (FEN) por Por Orientador "Souza, Adenícia Custódia Silva e"
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Item O impacto do planejamento estratégico na elaboração e implementação do plano de gerenciamento de resíduos de serviços de saúde na atenção básica(Universidade Federal de Goiás, 2015-03-13) Alves, Sergiane Bisinoto; Tipple, Anaclara Ferreira Veiga; Souza, Adenícia Custódia Silva e; http://lattes.cnpq.br/5966034868102264; Souza, Adenícia Custódia Silva e; Takayanagui, Angela Maria Magosso; Pereira, Milca Severino; Rosso, Claci Fátima Weirich; Prado, Marinésia Aparecida doThe waste management is still deficient in many healthcare services. Those healthcare services smaller, as the primary healthcare offices, this problem becomes greater. Also important the destination for healthcare waste management generated by professionals and users in households. Faced with the expansion of the number and specificities of units in primary healthcare of occupational, environmental and social risks represent by healthcare waste generated in these environments, if not correctly managed, interventions in these realities are necessary and urgent. The objective was to evaluate the impact of the implementation of a healthcare waste management plan in primary healthcare unit and to check the approaches adopted by healthcare workers on the management of piercing and cutting waste generated by insulin users at households. This is a comparative and intervention study, pre and post, in a non-hospital unit to emergency care and also in a family healthcare unit, in the period from 2011 to 2014. The intervention performed consisted of: design and implementation of healthcare waste management plan using the situational strategic planning, educational and illustrative activities for users and multimodal permanent education, collective and individualized, for professionals for both healthcare units. A year after the intervention, all waste generated during a week in each healthcare unit were weighed and analyzed about the segregation. The values obtained were compared to those in the pre-intervention phase (Alves, 2010) that made the diagnosis in the same units and used the same methodology for the quantification and segregation analysis of the healthcare waste. The results show that the development and implementation of the waste management plan, using the situational strategic planning reduced healthcare waste generation and the inadequacies found about segregation in both units studied. It was also observed that there isn´t a management plan about management of piercing and cutting waste generated by users in households and that management is not assimilated in professional practice or in institutional procedures. The proposed intervention proved to be easy to apply and to involve all professionals and managers in prepare and implementation of a healthcare waste management plan in primary healthcare unit. The professionals and managers actively participated since the diagnosis of the healthcare waste management situation, discussion of alternatives to solve the problems listed until the decision making, resulting in a collective commitment to implement the healthcare waste management plan of healthcare services.Item Implicações pessoais e profissionais do acidente com material biológico para o trabalhador da saúde(Universidade Federal de Goiás, 2014-01-31) Melo, Dulcelene de Sousa; Souza, Adenícia Custódia Silva e; http://lattes.cnpq.br/5966034868102264; Souza, Adenícia Custódia Silva e; Tipple, Anaclara Ferreira Veiga; Lemes, Lila Maria Spadoni; Pereira, Milca Severino; Vila, Vanessa da Silva CarvalhoINTRODUCTION: The health of workers, in their everyday work, are exposed to various risks, among which, biological. This represents a danger important to public health, which may, in addition to physical injury, have broader implications, and impact various aspects of their lives. OBJECTIVE: To analyze the personal and professional implications of exposure to biological material for healthcare workers. METHODOLOGY: A qualitative study conducted with ten workers in the healthcare field who experienced accidents with biological material and who were treated by a reference healthcare service in Goiania, Brazil. Data were collected between October and November 2012, through interviews using the critical incident technique. Data processing used the content analysis methods proposed by Bardin, with the additional aid of Atlas ti 6.0 software. The discussion of findings was presented using theoretical frameworks of complex thinking from the perspective of Edgar Morin, as well as cultural theory of risk by Douglas. RESULTS: From the narratives of those experiences, for ten healthcare workers treated by three units of reference specializing in situations of exposure to biological material, four categories of analysis emerged: personal implications; professional implications, the workplace and risk management, and reference service and risk management. The results showed great psychological distress expressed through feelings of fear of contamination of self and family, worry, despair, lack of protection, guilt, anger, insecurity, introspection, helplessness, uncertainty, and awkwardness, among others. This suffering was reflected in the three spheres of interaction, as well as relationships between exposed workers. On the other hand, some might experience the solidarity from co-workers, patients, and professionals during service, through gestures and relationships that help in coping with tensions when such a situation arises. The structures in place at work and in referral services showed contradictions in such situations: support / helplessness; commitment / disengagement; climate of security / insecurity; careful / careless; organization / disorganization, respect / disrespect; acceptance / leaving at the mercy of fate. The accident was established as the driving force for workers to pay attention to their own safety and change their routines in this context, extending this reflection not only to themselves, but for those who they interact with professionally interaction. CONCLUSION: The experiences of these workers shows antagonistic, contradictory, and complementary aspects of complex systems for the health services worker. It suggests the need for a greater appreciation and consideration of the psycho-emotional consequences experienced by workers, along with review of treatment procedures as to their effectiveness and problem solving that improve quality of life to the healthcare worker.Item Uso e manuseio do jaleco: uma análise das condutas dos trabalhadores da saúde na prática clínica(Universidade Federal de Goiás, 2015-09-15) Neves, Heliny Carneiro Cunha; Santos, Silvana de Lima Vieira dos; http://lattes.cnpq.br/2461784381351166; Souza, Adenícia Custódia Silva e; http://lattes.cnpq.br/5966034868102264; Souza, Adenícia Custódia Silva e; Pereira, Milca Severino; Souza, Sandra Brunini de; Silva, Ana Elisa Bauer de Camargo; Melo, Dulcelene de SousaInappropriate behaviors of healthcare workers about the use and the handling lab coat represent a risk to the patient and the professional, family and community. The recommendations in this area are guided on limited evidences and the specific norms for the standardization of practices for use and handling is fragile. OBJECTIVE: To analyze the use and handling of lab coats by healthcare workers. METHODS: Cross-sectional, observational and analytical study conducted with 103 healthcare workers in a public teaching hospital, located in the Center-West of Brazil. The characteristics of the lab coats, the data regarding the transport and the handwashing practice before wearing and after removing the lab coat were observed at the arrival timing and exit of the unit and registered in check list. The use of clothes and larger contact areas with surfaces and patients were observed at the time of procedures execution. Sociodemographic and occupational data and the worker's conduct about lab coat handling were collected through interview after the observation period of each professional. To estimate the factors associated with misconduct of healthcare workers as hand hygiene, transportation and exchange frequency of lab coat the univariate analysis was performed. Then variables with p <0.10 were included in the Poisson regression model. The chi-square test was used to verify the differences between the ratios and p values <0.05 were considered statistically significant. RESULTS: The workers used the lab coat and the gown to the different clinical situations observed, without clarity when to use each clothes. Fists and abdominal region of lab coats and gown were areas that had higher patient contact and higher environmental surfaces contact. Workers had inappropriate handling about the lab coats transport, exchange frequency, washing process and hand hygiene. Were predictors for misconduct about the exchange frequency of lab coat, to be physicians and other healthcare workers male, with shorter professional practice and reporting inadequate practice to transport lab coats. Were associated with inadequate practices of lab coats transport, have misconduct about the exchange frequency and the physicians workers. CONCLUSIONS: The conduct of workers using their own lab coat like a protective equipment and transports to process at home are inadequate and can endanger the health and safety of workers, their families and patients. These findings show that the lab coat worker must not be used as personal protective equipment in clinical practice.