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Item Absenteísmo entre trabalhadores de enfermagem de um hospital público de Goiânia-Goiás(Universidade Federal de Goiás, 2011-03-31) Lima, Maisa Carolina de Castro; Barbosa, Maria Alves; http://lattes.cnpq.br/5025797873585225Absenteeism is the practice of an employee not being present at work for a period, when the work day has been assigned to him/her. That fact may cause negative effects to health service. There must be shortage of personnel, other workers must be overworked and there will consequently reduce the quality of medical care. We consider as absenteeism both planned and unplanned absences, including unauthorized absence, dental and medical licenses, statement of attendance and work accidents. All of them, considered unexpected absenteeism due to preventable cause, were addressed in this study. Ojective: to investigate the occurrence of unexpected absenteeism due to preventable cause in what concerns nursing staff at public hospitals in Goiânia-GO, from 2005 to 2009. This is a cross-sectional quantitative documentary study. We researched on 549 nursing workers, 86,15% of them have presented at least one episode of absenteeism due to preventable cause. From those, nursing technicians were the great majority. That is also the category with the highest percentage of unexpected absenteeism due to preventable causes (70.19%), while nurses were a small number in that list. We found unexpected absenteeism due to preventable cause was more frequent among workers aged 30 - 39 and 40-49 years old and worked up to seven years at that job. In what concerns workplace, it was more common among workers of Emergency and Surgical Clinic, locations that require large volumes of customer service, diversity and turnover of patients and the high degree of dependence on them. Medical licenses were 82,06% of the reasons for absenteeism due to preventable causes. Among the causes of absenteeism due to illness, there are the diseases of muscular system and connective tissue, followed by mental and behavioral disorder; conditions which influence physical/mental health and the contact in health services and respiratory diseases. Absenteeism rates had increased over the years, and remained, most of the time, above the level recommended by COFEN, demonstrating that the unexpected absenteeism due to preventable causes in the study institution was high. It is noteworthy that rate drop in 2009, which may be the deployment of APH. Through this study we could observe the unexpected absenteeism among workers due to avoidable causes depends on factors intrinsic to the individual: his/her health condition, personal elationships, including family members, his/her contact with the social apparatus, such as the transportation system, among others, but it is largely influenced by the conditions of the workplace: the physical environment itself, the activities performed and the way they have to be performed, relationships with colleagues and supervisors. All of them susceptible to intervention, so as to reduce absenteeism.Item Ação de detergentes e desinfetantes em biofilme tradicional e buildup no modelo MBEC(Universidade Federal de Goiás, 2016-12-20) Luciano, Cristiana da Costa; Alfa, Michelle J.; Tipple, Anaclara Ferreira Veiga; http://lattes.cnpq.br/4288704233343920; Hunt, Alessandra Marçal Agostinho; Watanabe, Evandro; Melo, Dulcelene de Souza; Teles, Sheila Araújo; Tipple, Anaclara Ferreira VeigaINTRODUCTION: Flexible Gastrointestinal Endoscopes (FGE) are used for diagnostic and therapeutic procedures, classified as semicritical health products (HP), requiring High-Level Disinfection (HLD) processing among users. The FGE designs are complex, making it difficult to process and favor the occurrence of faults that contribute to the accumulation of organic matter on the surface of the internal channels of the endoscopes, contributing to the formation of the biofilm. OBJECTIVE: To develop a Biofilm Buildup (BBF) accumulation model, based on repeated exposure of test soil containing Entercoccus faecalis and Pseudomonas aeruginosa by means of repeated cycles of fixation and to evaluate the ability of detergents and disinfectants to destroy and remove bacteria in the Traditional Biofilm (TBF) and Buildup. MATERIALS AND METHODS: TBF was developed in MBEC ™ peg, without hydroxyapatite, and BBF, with hydroxyapatite, over a period of eight days. For the development of both biofilms, E. faecalis and P. aeruginosa, containing 8 log10, colony forming units per cubic centimeters (CFU/cm2) were used. Prolystica Enzymatic (D1), Prolystica Neutral (D2), Neodisher (D3) and Endozime (D4) were tested alone and in combination with Glutaraldehyde (GLUT), Orthophthaldehyde (OPA) and Hydrogen Peroxide Accelerator (APH) to determine if both biofilms could be removed. The removal of the traditional biofilm and buidulp, using viable bacteria count, quantification of protein and carbohydrates and by means of scanning electron microscopy (SEM) was evaluated. RESULTS: After eight days of BBF development, 6.14 log10 CFU/cm2 of E. faecalis and 7.71 log10 CFU/cm2 of P. aeruginosa were reached. None of the detergents and disinfectants have been able to remove the traditional biofilms and buildup or reduce the level of bacteria. The combination of detergents and disinfectants tested in BBF provided a reduction of 3 to 5 log10 in viable bacteria, but no combination could provide the expected reduction of l log10. Only enzyme Prolystica and Endozime removed both E. faecalis (3.90 log10 colony forming units per milliliter (CFU/mL)) and P. aeruginosa (3.96 log10 CFU/mL) in suspension bacteria. None of the detergents tested removed > 1 log10 CFU/cm2 from the bacteria within the traditional biofilm. No combination of high-level disinfectant and detergent reduced the level of both E. faecalis and P. aeruginosa from the traditional biofilm interior (3 to 5 log10 CFU/cm2). Although the combination of Endozyme and Glutaraldehyde reduced 6 log10, it did not eliminate both bacteria in the traditional biofilm. CONCLUSION: Data indicate that if TBF and BBF accumulate in the EGF channels during repeated processing cycles, neither detergents nor high level disinfectants will provide the expected level of bacterial removal or destruction. Future research using the buildup model can help develop new cleaning and disinfection methods that can prevent or eliminate the BBF within the endoscope channels.Item Acessibilidade às pessoas com deficiência física nas unidades de saúde da atenção primária no estado de Goiás(Universidade Federal de Goiás, 2016-03-31) Mamed, Samira Nascimento; Rosso, Claci Fátima Weirich; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4709392U3; Rosso, Claci Fátima Weirich; Dalla Déa, Vanessa Helena Santana; Bezerra, Ana Lúcia QueirozIntroduction: Accessibility for disabled people at primary healthcare units has a fundamental role in the use of health services, as well as the organization of health services targeted at this population, since there is an impressive number of disabled people in the state of Goiás and in Brazil in general. Objective: To analyze accessibility of disabled people to primary healthcare services in the state of Goiás. Method: A descriptive cross-sectional study was conducted with secondary data from an external evaluation of the National Program for Improvement of Access and Primary Healthcare Quality (PMAQ-AB, as per its acronym in Portuguese). The study was developed in all 246 cities of Goiás. The sample was made up of 1,216 healthcare units and 677 healthcare professionals in the cycle 1 of PMAQ-AB; and 975 healthcare units and 1,180 healthcare professionals in the cycle 2 of PMAQ-AB. Data were collected between June and August 2012 in the cycle 1 and from January to March 2014 in the cycle 2. The variables were analyzed descriptively and presented by means of absolute numbers, frequencies and means. Results: Only 30% to 40% of the studied healthcare units had sidewalks, floors and ramps accessible to disabled people. Between 20% and 35% of the healthcare units had adapted doors and hallways, except for units in cities with up to 50,000 inhabitants in cycle 2, which accounted for almost 50% of the units with these elements. Regarding adapted restrooms, less than 20% of the healthcare units in cycle 1 had them, whereas between 20% and 55% of the units in cycle 2 presented this feature. As for the organization of healthcare services toward disabled people, almost 95% of the teams defined the coverage area, however only half of them had records on the number of cases of disabled people. Conclusion: Primary healthcare units and services in the state of Goiás are not structured in terms of accessibility to disabled people, which makes the delivery of care to this population poor. In this sense, there is a clear need for investments on the part of health managers and professionals for continuing education and financial resources to adapt these units and qualify healthcare teams to provide universal, comprehensive and humanized health care to disabled people.Item Acessibilidade e ambiência na atenção básica à saúde do estado de Goiás(Universidade Federal de Goiás, 2014-04-29) Ribeiro, Juliana Pires; Rosso, Claci Fátima Weirich; http://lattes.cnpq.br/1137218060736306; Rosso, Claci Fátima Weirich; Souza, Marta Rovery; Souza, Márcia Maria de; Silveira, Nusa de Almeida; Bezerra, Ana Lúcia QueirozIntroduction: Basic Health Units accessibility and ambience holds two fundamental importance links for the team work process development. The accessibility is intrinsically linked to meet the health services users’ needs and to ensure the solvability of assistance. Ambience is a concept that refers not only to physical space, but also to the social, made up of interpersonal and professional relationships in order to provide a solving, equitable and warm attention. Objective: To analyze the accessibility to health services and ambience of basic health care units in primary care in Goiás state. Methodology: A cross-sectional descriptive study performed in health care facilities in Primary Care in Goiás state in 2012. The study sample was done in 1216 basic health care units in Goiás state. Data were collected between July and September 2012 through a structured, tandardized and previously validated instrument. They were submitted to Ministry of Health database through the use of tablets and via internet to be analysed. After that these data were stored and grouped into modules I, II and III. Statistical analysis was performed using Statistical Package for the Social Sciences - SPSS software, version 19.0. The study respected ethical and legal aspects recommended by the Resolution 466/2012. Results: Two scientific articles were done. The first one "Accessibility to health care services in primary care in Goiás state" studied factors related to accessibility in health care facilities. The second article "Ambience of basic health care units in primary care in Goiás state " is about environment which provides better service and satisfaction to users and workers. Conclusion: Regarding accessibility and ambience in basic health units in primary care in Goiás state, we can conclude that the inaccessibility is contrary to the principle of integrality, hindering assistance and disrespecting those who need health services. It was also showed that there is a direct relationship between welcoming / humanized service and ambience. The lack of a suitable place for accommodation and care for users affects the development of actions in health care system. To change this reality, it will be necessary to invest in management in order to consolidate the Primary Health Care in a resolutely, equitable and welcoming way.Item Acidente com material biológico em uma instituição de ensino odontológico: perfil, notificação e sub-notificação(Universidade Federal de Goiás, 2008-09-03) SASAMOTO, Sandra Aragão de Almeida; LELES, Claudio Rodrigues; http://lattes.cnpq.br/6740286066154410; TIPPLE, Anaclara Ferreira Veiga; http://lattes.cnpq.br/4288704233343920Cross-sectional study of accidents with biological material developed at the Dental School, Federal University of Goiás (FO / UFG), Goiânia. The study aimed to: 1) to identify the occurrence of accidents involving biological material among academics and professionals, 2) to evaluate the occurrence of sub-reports and their causes, 3) to characterize the profile of accidents, 4) to identify protective measures adopted by professional and academic casualties. The study was approved by the Ethics Committee of the Federal University of Goiás, with protocol 058/2006, and were observed all ethical measures. Data were obtained by evaluation of 71 registration forms for accidents with biological material in the period October 2001 to July 2008, and by applying a questionnaire to all students registered in that period, technicians and teachers, totaling 566 subjects eligible. For this we developed a software: Evaluation and Management Distance System (EMDS), which allowed the circulation of the questionnaire electronically. Data were tabulated and analyzed by SPSS 16.0, and descriptive statistical analysis performed by the measures of frequency and inferential analysis through chi-square and logistic regression. Of the 71 reports, only 41 (57.7%) records had complete data. Of the subjects eligible for the questionnaire (EMDS), 266 (47.0%) participated, being 100.0% of technicians, 85.4% of teachers, 69.4% of academics and 21.0% of former students . The complete vaccination against hepatitis B was reported by 81.9%, and five (1.9%) reported not having been vaccinated. The result of antiHBs was known for 151 (69.3%) who claimed to be responders. Ninety-one (34.2%) claimed to have suffered accidents with biological material, and there was no difference in this occurrence among academics, technicians and teachers (p = 0.496). Only 24 (26.4%) reported formally to the exhibitions department, the rate of underreporting was 73.6%. The reasons cited for not reporting were not considered serious enough to notify (52.2%), considered the low risk (32.4%), did not know they should notify (22.0%). Accidents among students occurred more frequently in the 3rd and 4th years, and most, 71.4%, occurred during the procedure. The exposures were percutaneous in 76.9%, splash on intact skin in 25.3%, and splashes into mucous membranes in 24.2%. The most affected body parts were the fingers of the nondominant hand in 42.8% and 36.3% dominant hand. The biological materials involved in accidents were the saliva (68.1%) and blood (48.3%). Seventy-five subjects (82.4%) reported using all personal protective equipment, and have been neglected gloves (13.2%), face (11.0%), and goggles (7.7%). The accident percutaneous (p = 0.016) with involvement of blood (p = 0.013) presented significant for the notification. The lack of data in records of notifications, the high rates of accidents with biological material, as well as under-reporting signal the need to restructure the notification service, and the importance of disclosure of official protocol of the institution of post-exposure and preventive measures to be adopted by the academic communityItem Acidente com material biológico: risco, perfil e preparo do acadêmico de enfermagem(Universidade Federal de Goiás, 2015-05-28) Cardoso, Najara Queiroz; Tipple, Anaclara Ferreira Veiga; http://lattes.cnpq.br/4288704233343920; Tipple, Anaclara Ferreira Veiga; http://lattes.cnpq.br/4288704233343920; Galdino Júnior, Hélio; Sousa, Adenícia Custódia Silva e; Prado, Marinésia Aparecida do; Mendonça, Katiane MartinsFor nursing staff the biohazard is a major concern with physical and emotional impact on the health of these workers, with the graduates of this area under the same risk. The objectives of this study were to analyze the epidemiology of accidents with biological material involving nursing students in the scientific literature; describe the frequency and profile of accidents with biological material among nursing students of a higher education institution; identify activities of academic practice considered risk for accidents with biological material in the view of nursing graduates; characterize the preparation of the nursing academic front of an accident with biological material. This study results were presented in the form of two articles, the first being an integrative review of the literature on accidents involving biological material among nursing students, the descriptor available in the Descriptors in Health Sciences of the Virtual Health Library and the Medical Subject Headings in the PUBMED electronic databases Literature Analysis and Retrieval System Online (MEDLINE), Latin American and Caribbean Health Sciences (LILACS), Cumulative Index to Nursing and Allied Health Literature (CINAHL), no time frame. They found 1849 articles, these 37 met the inclusion criteria. The investigated items showed that the profile of accidents with biological material among undergraduate students follow the same profile of affected by nursing professionals and are associated with the lack of biosecurity measures, post-exposure recommendations and other factors intrinsic to the vocational training process . The second article was a cross-sectional descriptive study by means of an electronic questionnaire with the third nursing students the tenth periods of a public institution of higher education in the state of Goiás. The study was approved under protocol nº414258. The study included 126 undergraduate students with a mean age of 21.6 years. Among the activities of nursing practice the sharps handling was the most cited (64.4%) and 98.4% of the students said to have received prior guidance on the possibility of contact with body fluids during the course of practical activities. However, most did not know how to describe the post-exposure measures. There were four accidents (3.2%), more frequent exposure of the ocular mucosa (75.0%) with the blood longer present as biological material. Two students reported accidents to teachers who have followed all recommended behaviors. It was found that the communication of the accident to the teacher resulted in adherence to recommended post-exposure measures.Item Acidentes com material biológico entre pessoas sem risco presumido(Universidade Federal de Goiás, 2014-08-15) Salgado, Thaís de Arvelos; Tipple, Anaclara Ferreira Veiga; http://lattes.cnpq.br/4288704233343920; Tipple, Anaclara Ferreira Veiga; Oliveira, Adriana Cristina de; Teles, Sheila Araújo; Mendonça, Katiane Martins; Santos, Silvana de Lima Vieira dosMost recorded accidents with biological material are related to accidents in Health Care Facilities, which are considered unhealthy environments where the group with the highest exposure is professionals in the healthcare field. However, it should be understood that, any individual who passes through a healthcare facility is exposed to biological risk. The objectives of this study were: to identify the profile of victims of accidents with biological material, occurring in healthcare facilities among those with no presumed risk; to identify the frequency and profile of accidents in this group; to classify pre and post-exposure conduct in accidents with biological material in this group. This retrospective epidemiological study was conducted based on data from two service centers and accident reporting services: Hospital for Tropical Diseases in the State of Goias, Brazil, and the Center of Reference on Worker's Health (CEREST) in the city of Goiania. The two databases were linked. This study analyzed accidents reported by workers who were not trained in healthcare practice that had accidents with biological material inside the healthcare service independent of their professional duties. The study received approval in two Ethics Committee reports, the Hospital for Tropical Diseases, under protocol No. 033 / 2010, and by the IRB of the Hospital das Clinicas, Federal University of Goias, under protocol 414258/2013. There were 8,568 records of accidents with biological material recorded between 1989 and June 2012, 181 of these (2.1%) occurred in health services among those with no presumed risk. The highest frequency of accidents occurred among people between 20 and 29 years, female, and the most frequent occupation was the receptionist's office or lab, followed by administrative assistant. Needlestick accidents were most common (91.7 %) and involved a needle lumen, with higher incidence among females, and blood was the most common biological material. With regard to the circumstances of the accidents, most occurred due to inappropriate disposal of sharps, 20.1% referred to assistance activities such as recapping of needles, injections, or punctures, and material processing support procedures. Less than half of the subjects were vaccinated (49.7 %) against hepatitis B. The source patient was identified in 64 (35.6 %) cases, and of these, 43 (67.2 %) did not undergo serological testing. Post-exposure prophylaxis was recommended in 41 (22.6 %) and immunotherapy in 58 cases (32.0 %), and in 96 (53.0 %) cases completed, 74.0% indicated giving up clinical and laboratory monitoring. There were gaps in the data recorded in the notification forms, which reveals the need for professional training for the correct completion of notifications and active search for cases for follow-up. Data support the fact that healthcare facilities should have a organizational structure focused on resolution, prepared to provide care and / or refer the victim to postexposure prophylactic measures, since the office needs to be responsible for people who have accidents in their area, once the injured person, regardless of the employment relationship becomes a "victim of an accident with biological material" and in need of care, to minimize the risk of disease by taking proper preventive measures after the accident.Item Acidentes com material biológico entre trabalhadores da área da saúde da região metropolitana de Goiânia-GO: uma análise de 25 anos de registros(Universidade Federal de Goiás, 2016-03-30) Neves, Zilah Cândida Pereira das; Tipple, Anaclara Ferreira Veiga; http://lattes.cnpq.br/4288704233343920; Oliveira, Adriana Cristina de; Souza, Adenícia Custódia Silva e; Pereira, Milca Severino; Mendonça, Katiane Martins; Tipple, Anaclara Ferreira VeigaAccidents with biological material are reportable events, health care workers (TAS), victims of these accidents may be exposed to the hepatitis B and C and HIV, among others. The aims of this study were: to analyze the epidemiology of occupational accidents with biological material among health care workers of the metropolitan area of Goiania-GO (general); describe the socio-demographic and occupational profile of health care workers, victims of occupational accidents with biological material; describe the profile of accidents with biological material among health care workers; characterize the adoption of pre-exposure behaviours related to the latest accident; identify the serological status related to hepatitis B, C and HIV in victims of occupational accidents involving biological material and source patients, and establish the demographic and employment factors associated with the occurrence of multiple accidents among health care workers of the metropolitan area of Goiania-GO. Epidemiological Cross and analytical study which included all registration records of accidents involving biological material of HCW from two sources: A - records of injured HCW in a reference hospital for notification in Goiania, from the first record in 1989 to 2010, and B - records of Sinan, including the first record in 2006 until those available at 31/12/2014. Linkage of databases was performed and data analyzed using the Statistical Package for Social Sciences (SPSS). Socio-demographic and employment variables were the predictor variables and have suffered more than one accident, the outcome. Univariate analysis was performed and variables with P<0.10 were included in a logistic regression model. Ethical precepts were followed (Approval Ethics Committees: 033/2010 and 414.258/2013). A total of 11,536 accidents were recorded from 1989 to December 2014. Of these, 9,575 (83.0%) occurred among HCW and the majority was female. It was found that 665 (7.5%) of the HCW experienced more than one accident, while 70 (0.8%) experienced three or more accidents, totaling 8,825 victims. Nursing staff, auxiliary cleaning, physician, and dental and laboratory teams were the ones who were more frequently hurted, respectively. Most of the victims had completed high school (3,719 (48.0%). Blood/serum/plasma were the biological materials found to be the most involved (6,480/67.7%), at the time of administering medications/vascular access puncture occurring in 2.759 (28.9%), and involving needles with and without lumen in 6,097 (63.7%). A total of 6,653 (75.4%) HCW were vaccinated for hepatitis B. Incomplete information on Sinan records such as, use of PPE (gloves, masks, boots and safety glasses) and serological markers (HBsAg; Anti-HBs, Anti-HCV and Anti-HIV) was found to be the major factor that hampered data analysis. Age, type of material, and organic fluid were predictors risk factor for multiple accidents involving biological material among health care workers.Item Acidentes ocupacionais com material biológico : a per- cepção do profissional acidentado.(Universidade Federal de Goiás, 2005-03-21) DAMACENO, Ariadna Pires; PEREIRA, Milca Severino; http://lattes.cnpq.br/9304767101674108Occupational accidents involving biological materials may bring physical and psychological consequences to the injured professional Many workers commonly give less attention to such events not applying preventive steps as recommended for those procedures which represent risks to their health This paper aims at reporting the workers perception and undertanding on the context involving the accident with biological material including experimented feelings, reactions as well as actions taken The research has been done according to the presumptions of qualitative research and data was analysed in accordance with content analysis technique Data was collected by using questionnaires applied to health-care workers linked with a health care institution and later by an interview with the injured workers from an emergency and urgency reference unit in the city of Goiânia Firstly 382 health-care workers answered a questionnaire in order to identify those who had already suffered an accident 39 of those who had had an accident have participated in the interview concerning aspects related to the accidents The main causes to the accidents mentioned were: unattention non-adoption of preventive steps severity of injured patients hurry due to work overload and appliance structure and material-related deficiencies Among the feelings experimented we could highlight: insecurity fearing infection worries about the family rage and even calmness About half of the workers have reported that the accident had not brought any consequence into their lives The others reported that it had provided them with learning and growth All workers reported awareness of the risks related to the accident however we could note several inadequate conduct in their reports 18 professionals reported all the accidents they had 12 never reported any and 9 reported only those considered most serious Many manifested some difficulty in specifying the protective equipment used on the day of the accident mainly due to the amount of time from the day of the event to the research date The workers perception of such phenomenon is very different from one another regarding the same kind of accident Data shows the need of worker´s health self-valuing as well as programs aimed at improving the occupational safetyItem Ações de saúde mental na atenção primária à saúde: perspectivas para a enfermagem(Universidade Federal de Goiás, 2019-03-26) Stival, Ana Paula Cintra; Dallegrave, Daniela; http://lattes.cnpq.br/7963448404748668; Esperidião, Elizabeth; http://lattes.cnpq.br/1143743711641872; Esperidião, Elizabeth; Silva, Nathalia dos Santos; Santos, Patrícia Tavares dosResearch on the type of intervention with a descriptive-exploratory and qualitative approach, discusses aspects related to the integration process of mental health actions in Primary Health Care (PHC), in view of the need to extend mental health care to the people of community in the territory. With a view to strengthening the Psychosocial Attention Network and mental health care in the field studied, the objective was to identify and analyze the development of mental health actions from the perspective of the supervisors of the family health teams. The following specific objectives were identified: identifying the demands of the field of mental health in the Family Health Strategy (ESF); describe the actions of the mental health field offered by the family health teams; to investigate the factors that influence the development of actions in the field of mental health from the perspective of the supervisors of the Family Health Strategy, in addition to experiencing the implementation of Situational Strategic Planning as a tool for reflection and change in mental health practices in the Family Health Strategy. The research was developed in a medium-sized municipality in the Central West region of Brazil, in which nurses supervising the FHT participated. The data were collected through participant observation at the time of approach and immersion in the field under study, focus groups and by a self-administered questionnaire, aiming at obtaining the professional profile of the participants. Thematic content analysis was followed by qualitative data analysis software. As main results, it was observed that the mental health care in PHC, from a nursing perspective, comprises three dimensions: the reorganization / management of the nursing work process, changes in the professional's posture and effective permanent education plans. In addition, factors that influence the development of actions in the field of mental health by the FHT are described and analyzed. This study indicates the feasibility of instituting permanent education plans for the professionals who are at the forefront of PHC, given the pressing need pointed out by the participants themselves in the discussions undertaken during the research development, as well as highlighting the Situational Strategic Planning as an important strategy for reflection of mental health care actions in the sphere of PHC. Finally, it brings the analysis of these questions into the nursing training dimension.Item Acolhimento com avaliação e classificação de risco e qualidade dos serviços de urgência e emergência(Universidade Federal de Goiás, 2015-03-18) Cabral, Karynne Borges; Oliveira, Lizete Malagoni de Almeida Cavalcante; http://lattes.cnpq.br/2680821388094276; Oliveira, Lizete Malagoni de Almeida Cavalcante; Brasil, Virginia Visconde; Cordeiro, Jacqueline Andréia Bernardes Leão; Siqueira, Karina Machado; Faria, Dálete Delalibera Correa MotaINTRODUCTION: The host strategy with risk assessment and classification (AACR) aims to reduce the risk of deaths considered preventable, the extinction of the screening conducted by the doorman or professional not trained and prioritization of care according to clinical criteria and not in order of arrival. Given the concern about the quality of emergency care services offered in public institutions and that nurses play a key role in the effectiveness of the AACR, this study aimed to identify how nurses perceive the AACR classifiers in the context of improving the quality of health services. GOAL: To analyze the perceptions of nurses about the quality of care in urgent and emergency services that has AACR. METHODOLOGY: A descriptive exploratory study with a qualitative approach. The data were collected through semi-structured individual interviews, recorded on digital media, performed with seven nurses working in AACR urgent and emergency units of Goiânia-GO, in May and June, 2014. RESULTS: While acknowledging the difficulties, all participants agreed that the AACR has contributed to improving the quality of emergency care and emergency units, especially because it prevents deaths in queues, prioritizing the care of critically ill patients to the detriment of less severe. The high demand and structural problems such as inadequate human resources, lack of basic materials for patient assessment and inadequate physical space, in addition to the inadequate functioning of public health care facilities were identified as hindering factors of the service. Among the aspects that facilitate the work and contribute to improving the quality of care in the industry, they indicate full staff, acquisition / availability of minimally materials needed for proper evaluation of the patient, presence of a guard / security and the knowledge of the population about this service strategy. Other suggestions included the adequacy of the physical structure and space guarantee that allows privacy for the risk assessment. CONCLUSIONS: The results of the study confirm that the urgent and emergency services share the same difficulties already described for all public primary health care of the population. Although the AACR will contribute to improving the quality of these services, much remains to be done to ensure minimum conditions for the good performance of professionals working in the sector and thus enhance the benefits it can bring to the care of their users.Item Adaptação transcultural e validação do instrumento Patient Engagement in Patient Safety within Canadian Healthcare Organizations para uso no Brasil(Universidade Federal de Goiás, 2022-05-25) Sousa, Maiana Regina Gomes de; Pomey, Marie-Pascale; Silva, Ana Elisa Bauer de Camargo; http://lattes.cnpq.br/8388407861788466; Silva, Ana Elisa Bauer de Camargo; Bezerra, Ana Lúcia Queiroz; Sousa, Fernanda Raphael Escobar Gimenes de; Vila, Vanessa da Silva Carvalho; Freitas, Juliana Santana deINTRODUCTION: for more than two decades, patient safety has been highlighted as a global health challenge, requiring changes and implementation of initiatives to minimize risks, prevent care failures and prevent harm to patients. Patient engagement in patient safety has been one of the strategies used in the main international recommendations to improve the quality and safety of care, making relevant the existence of instruments to evaluate this practice. OBJECTIVE: to produce the Brazilian version of the instrument Patient Engagement in Patient Safety within Canadian Healthcare Organizations. METHOD: methodological study involving cross-cultural adaptation and validation of the instrument Patient Engagement in Patient Safety within Canadian Healthcare Organizations for use in Brazil, developed in two phases. The first phase, held between January 2020 and June 2021, consisted of the cross-cultural adaptation of the instrument for the Portuguese Brazilian and followed six steps: preparation, translation, back translation, pretest with nine health organizations, review, and documentation. The second phase, held between August and November 2021, was to validate of the content of the instrument using the Delphi technique, through the evaluation of a committee of experts in two sequential rounds. The semantic, conceptual, and normative equivalence of the items of the instrument were analyzed using the Coefficient of Agreement between evaluators, being considered satisfactory values greater than or equal to 90.0%. To analyze the content validity was used the Content Validity Index (CVI) and Inter-Rater Agreement (IRA), being considered approved values greater than 0.8, for both CVI and IRA. The analyses were performed using the Software R version 4.1.2. RESULTS: in cross-cultural adaptation, 97.9% of the items of the instrument were considered equivalent by 100% of the evaluators. For the items that presented agreement less than 90%, the best solutions were discussed, until a consensus was reached. The modifications made were approved by the authors of the original instrument. In content validation, most items had CVI approved in all three aspects, with 99.3% for coverage, 95.8% for clarity and 96.1% for relevance. About the IRA, 99.0% of the items presented satisfactory values for coverage, clarity, and relevance. Items with unsatisfactory values were changed and evaluated again by the expert committee and after approval by all the instrument was concluded, available for use in Brazil with the title “Engajamento do Pacientes na Segurança do Paciente em Organizações de Saúde”. CONCLUSION: the instrument is a reliable and valid tool to investigate patient engagement strategies in patient safety implemented in Brazilian health organizations, at different levels of governance.Item Adaptação transcultural e validação para uso no Brasil do instrumento Quality and Safety Education for Nurses Student Evaluation Survey(Universidade Federal de Goiás, 2019-05-22) Freitas, Juliana Santana de; Dolansky, Mary; Silva, Ana Elisa Bauer de Camargo; http://lattes.cnpq.br/8388407861788466; Silva, Ana Elisa Bauer de Camargo; Bezerra, Ana Lucia Queiroz; Brasil, Virginia Visconde; Vila, Vanessa da Silva Carvalho; Alves, Sergiane BisinotoINTRODUCTION: The development of quality and patient safety competencies in health education has been the object of study and focus of recommendations built and published in recent decades in several countries. The evaluation of the achievement of these competencies by the students is necessary, however, in Brazil there are no tools published for this purpose. The Quality and Safety Education for Nurses Student Evaluation Survey (QSEN SES) evaluates, through three scales, the knowledge, skills and attitudes of Nursing students related to the following competencies: Patient-centered care; Evidence-based practice; Teamwork and collaboration; Quality Improvement; Safety and Informatics. OBJECTIVES: To perform the cross-cultural adaptation of the QSEN SES for use in Brazil and to evaluate its initial psychometric properties. METHOD: Methodological study, developed in two phases. The first consisted of the cross-cultural adaptation of the QSEN SES instrument into Brazilian Portuguese and followed six stages: translation, synthesis, back translation, expert committee review, pre-test with 30 undergraduate Nursing students from a public university and validation by the author of the original instrument. In the second phase, the Brazilian version of the QSEN SES was applied to 130 undergraduate Nursing students from three public universities, who had already completed at least 50% of the total course workload. The construct validity and reliability of the instrument were analyzed through confirmatory factor analysis and internal consistency. The Mann-Whitney and Kruskall-Wallis tests were used to verify the possible relationship between the sociodemographic variables and the quality and safety skills and attitudes. RESULTS: The QSEN SES was cross-culturally adapted for use in Brazil, presenting good reliability (Skills scale: 0,70≥ α ≤0,94; Attitudes sale: 0,86≥ α ≤0,97). The confirmatory analysis had insufficient adjustment indices for the skills model (χ2 = 352.46, SRMR = 0.075, RMSEA = 0.084, CFI = 0.868) and for the attitudes model (χ2 = 981.02, SRMR = 0.112, RMSEA = 0.193, CFI = 0.608). There was evidence of association between skills and university and sex variables. The results of the application of the QSEN SES Br in Nursing undergraduate courses in Brazil pointed out that, in a general way, the students reported the exposure to the contents related to the quality and safety in their formation, they recognize the actions as very important, however, feel unprepared to execute them. CONCLUSION: The Brazilian version of the QSEN SES is equivalent to the original version, it is reliable, however, it is suggested new studies with a larger population sample, to confirm the validity of the construct. The application of QSEN SES in Nursing schools will allow a situational analysis of education, producing information that is fundamental for educators and managers to plan curricular reforms, innovations and changes, aligned with identified needs, sustainable, with greater potential for success and longevity.Item Adesão do paciente portador de diabetes Mellitus tipo 2 ao tratamento Goiânia(Universidade Federal de Goiás, 2006-06-30) VIEIRA, ângela Cristina Bueno; SOUSA, Ana Luiza Lima; http://lattes.cnpq.br/6578713509935374Item Adesão dos enfermeiros às precauções padrão à luz do modelo de crenças em saúde(Universidade Federal de Goiás, 2005-03-31) MELO, Dulcelene de Sousa; TIPPLE, Anaclara Ferreira Veiga; http://lattes.cnpq.br/4288704233343920; SOUZA, Adenicia Custodia Silva e; http://lattes.cnpq.br/5966034868102264This was a qualitative study done in a big-sized general public hospital in the city of Goiânia Goiás The aims was to analyze nurses´ adherence to standard precautions according to Rosenstock´s health belief model (HBM) (1974) Data were collected using a semi-structured interview guide based on principles of Critical Incidence Technique (CIT) The instrument was validated by judges and was then pre-tested The ethical-legal research principles were observed Among 90 nurses selected to participate in the study 82 agreed to take part in this study Inclusion criteria were nurses who were either in direct contact with patients or in supervisory positions in the hospital cleaning, laundry or sterilization services Data were analyzed in accordance with CIT The analysis categories were constructed using the dimensions of the HBM A total of 139 critical incidents were identified of which 66 were considered positive and 73 negative HBM dimensions were identified within 131 situations: 74 (56,5%) related to perceived susceptibility; 17 (13,0%) to perceived benefits and 40 (30,5%) to perceived barriers The majority of the reported critical incidents related to situations of occupational exposure to biological materials Among the Standard Precautions (SP) use of protective barriers was most frequently utilized Denial of susceptibility was indicated by the lack of use of protective barriers improper management of sharp objects and non-adherence to SP related to patients with multi-resistant pathogens Moderate perceived susceptibility was associated with partial adherence to SP in cases of patients requiring more complex levels of care; in situations following occupational exposure; and when patients needs took priority over personal protection High perceived susceptibility was observed in situations of caring for patients suspected or diagnosed with infections due to pathogens of epidemiological importance and those related to nurses responsibility Perceived seriousness was evident in behaviors and consequences related to critical incidences after occupational exposure in moments when nurses expressed feelings experienced psychosomatic symptoms and were diagnosed with an infection. Perceived benefits emerged above all from positive critical incidente with focus on protective barriers understood as protection strategies which lead to safety while procedures are executed Perceived barriers were: lack of personnel preparation lack of material resources insufficient personnel improper physical structure patient emergencies psychosocial factors lack of personnel policies for cases of exposure to biological material These barriers contribute to lower adherence of SP but they could be addressed by the Health Care Facilities since nurses have demonstrated adequate perception of susceptibility and benefits HBM dimensions were associated with nurses adherence to SP suggesting that plans should be developed to improve the nurses actions and decision-making in day-to-day nursing cars prioritizing the safety of those individuals involved in this processItem Adesão e imunogenicidade aos esquemas ultra-acelerado e acelerado de vacinação contra hepatite B entre homens em situação de rua(Universidade Federal de Goiás, 2019-08-29) Souza, Christiane Moreira; Souza, Sandra Maria Brunini de; http://lattes.cnpq.br/6928658354895859; Souza, Sandra Maria Brunini de; Souza, Márcia Maria de; Teles, Sheila Araújo; Oliveira, Adriana Cristina de; Minamisava, RuthConsidering the long duration of the classic hepatitis B virus (HBV) vaccination schedule, with the common loss of vaccine follow-up, alternative schemes have been proposed for vulnerable populations. The aim of this study was to evaluate the adhesion and immunogenicity of HBV vaccine in homeless men (HSR) under the accelerated (E-UA) and accelerated (E-A) vaccination regimens. Randomized, two-arm, controlled, non-inferiority trial was performed by identifying HBV-susceptible HSR, which were allocated at a 1:1 ratio for E-UA (doses at 0, 7, and 21 days) and E-A (doses at 0, 1 and 2 months). For those who completed the proposed regimen, immunogenicity assessment was performed at 30, 60 and 90 days after the last dose of each regimen. Study approved by the Research Ethics Committee and registered in the Brazilian Clinical Trials Registry (ReBEC) platform. Of the 156 screened HSR, 67 were excluded; 35 (22.4%; 95% CI: 16.6-29.6%) for having some marker of HBV exposure (2 HBsAg/positive total anti-HBc; 15 positive isolated total anti-HBc and 18 anti-HBc/anti-HBs positive) and 32 (20.5%; 95% CI: 14.9-27.5%) for isolated immunity. Of the 89 susceptible identified, 18 (20.2%) were absent at the start of the intervention and the 71 eligible were randomized and allocated to E-UA (n= 35) and E-A (n= 36). The E-UA adherence rate was 94.3% (95% CI: 81.4 -98.4%) and the E-A rate was 63.9% (95% CI: 47.6-77.5%), and E-UA was associated with higher vaccine adherence rate (RR: 1.3; 95% CI: 1.1-1.7). In the analysis of the geometric mean titre (MGT) of anti-HBs, 30 days after the last dose of the vaccine, the group submitted to E-UA had a MGT of 147.6 mIU/mL versus 224.8 mIU/mL of those submitted to the vaccine. E-A (p-value= 0.985). After 60 days, the MGT for E-UA patients was 231.7 mIU/mL versus 211.2 mIU/mL for E-A (p-value= 0.572). After 90 days, the MGT between E-UA and E-A was 259.6 mIU/mL versus 233.1 mIU/mL (p-value= 0.548). In the analysis of adequate immune response (anti-HBs titers ≥10 mIU/mL), after 30 days, 88.0% of E-UA individuals and 94.7% of E-A individuals responded to the vaccine (p-value = 0.622). After 60 days, the response to the vaccine was similar between the E-UA and E-A groups (95.5% versus 92.9%; p-value = 1,000). After 90 days, this rate was 94.7% for the E-UA group and 100.0% for the E-A group (p-value = 1,000). The use of E-UA and E-A was effective with regard to early immunogenicity. Regarding adherence, E-UA was statistically identified as the best vaccination schedule option in this study.Item Adesão medicamentosa e hospitalização por eventos cardiovasculares em hipertensos no centro-oeste brasileiro(Universidade Federal de Goiás, 2018-05-28) Pacheco, Jade Alves de Souza; Sousa, Ana Luiza Lima; http://lattes.cnpq.br/6578713509935374; Sousa, Ana Luiza Lima; Jardim, Paulo César Brandão Veiga; Cavalcante, Águeda Maria Ruiz ZimmerIntroduction: Systemic arterial hypertension is indicated as the main risk factor for cardiovascular diseases. The treatment and control are a challenge to the effective management of the hypertensive patient, even front to the vast technical and therapeutic apparatus available. In this context, a adherence is one of the main explanatory variables for the challenge of the clinical monitoring team of the hypertensive. Objective: To evaluate the relationship between hospitalization and adherence to antihypertensive therapy in patients hospitalized for cardiovascular diseases in hospital units in the city of Jataí (GO). Methods: This was a controlled, observational, cross - sectional study developed in Jataí, a small city in the state of Goiás. The study included hypertensive patients hospitalized for cardiovascular causes in hospital units (hospital network) and by hypertensive patients undergoing clinical follow up in primary care (primary care). The data were obtained between September and December of 2017, with the use of a data collection instrument and the Informed Consent Term to the eligible patients. For the evaluation of adhesion, the Morisky Levine Green Test (TMG) was applied. The analysis was performed through the SPSS IBM software version 23.0; Variables were analyzed using the Kolmogorov Smirnof test, for comparing the means with the Student's T-test for independent samples and the Mann Whitney test for comparison of medians, where it was not parametric. The categorical variables were compared with the chi-square test. All tests were true for a significance level of 5% and 95% confidence interval. Results: In the analysis between the groups there was a lower tendency in the group of patients of the hospital network, but without significance; a rate of adherence in the hospital was 38.1% and primary care 51.2%. An intentionality of non-adherence between the groups was similar. Compared with the primary care group, patients in the hospital had higher blood pressure levels. Pressure control, when analyzed between groups, had the lowest frequency (p = 0.038) among the patients in the hospital network. The mean frequency found was 76.8% with the previous diagnosis, with women recording a higher proportion; 63.4% had uncontrolled blood pressure and 74.4% of patients had multimorbidities. The frequency of previous hospitalizations among hospital patients was significantly higher. The hypertensive crisis was the main cause of hospital admission, being more prevalent among women (p = 0.016). Stroke was a third major cause of hospitalization, presenting greater importance among men. Conclusion: the study is not related to the statistically significant progression between treatment and hospitalization for cardiovascular disease. However, patients with sedentarism, previous hospitalization and multimorbity presented more risk about hospitalization for cardiovascular disease.Item Administração de medicamentos: vivências dos pacientes quanto às práticas assistenciais e estratégias para seu envolvimento no cuidado seguro(Universidade Federal de Goiás, 2024-11-26) Santos, Jânia Oliveira; Gomes, Giselle Pinheiro Lima Aires; http://lattes.cnpq.br/9861909209527904; Bezerra, Ana Lúcia Queiroz; http://lattes.cnpq.br/0088227879433410; Bezerra, Ana Lúcia Queiroz; Paranaguá, Thatianny Tanferri de Brito; Souza, Adrielle Cristina Silva; Barbosa, Maria Alves; Suzuki, KarinaINTRODUCTION: Patient involvement in medication administration has gained prominence since the publication of the Third Global Patient Safety Challenge in 2017. Incidents related to health practices in national and international scenarios, with emphasis on medication errors and adverse events, are independent of strategies implemented in recent decades to reduce them. It is believed that patients, when trained, are able to identify and intervene to avoid errors, constituting the last real barrier to preventing incidents related to medication administration. GENERAL OBJECTIVE: To analyze patients' experiences regarding nursing professionals' care practices and personal strategies to promote their involvement in safe care, in the medication administration stage, during hospitalization. METHODOLOGY: This is a single, descriptive case study with a qualitative approach. Sixty-four patients from a public hospital in the North Region of Brazil participated. Data were collected from June to August 2022 through semi-structured interviews. Descriptive statistics and content analysis were used according to Bardin's assumptions. The project was approved by the Research Ethics Committee, opinion No. 5,348,969. RESULTS: Most participants (72%) were male; 25% were between 31 and 40 years old; 22% were 61 years old or older. Of these, 67% completed the eighth grade; 11% had higher education and 3% were illiterate. Content analysis allowed the creation of four thematic categories: 1. Incidents in medication administration, concepts and experiences; 2. Nursing team care practices that enhance or weaken patient involvement in the medication administration stage; 3. Patient strategies for preventing incidents in the medication administration stage and 4. Patient experience for their safety during medication administration. Predominantly, patients understand the meaning of incidents in medication administration, and that they occur for various reasons; that among the care practices to enhance patient involvement in medication safety, professional/patient relationships and communication stand out as tools to improve the quality of guidance on the safe use of medications. The factors that weaken this are predominantly related to the management of the health service, with emphasis on the professional's attitude and communication. The following strategies were highlighted as patients' strategies for preventing incidents: asking about medications and observing procedures. Patients predominantly feel safe regarding the use of medications during hospitalization, because they trust the multidisciplinary team. FINAL CONSIDERATIONS: The study contributes to the care and organizational context by enabling practical reflections on patient participation in care based on their experiences as barriers to incident prevention and pointing out strategies adopted to increase their safety in care at the medication administration stage. The explicit evidence in the context of this study shows paths to follow, especially by strengthening the process of permanent education of the multidisciplinary team, aiming to value the practice of patient involvement for safe care in a hospital environment.Item Alterações macroscópicas do cordão umbilical em gestações de alto risco e suas repercussões neonatais(Universidade Federal de Goiás, 2014-03-25) Reis, Marilya Rodrigues; Guimarães, Janaina Valadares; Salge, Ana Karina Marques; http://lattes.cnpq.br/7766918925030041; Salge, Ana Karina Ferreira; Castral, Thaíla Corrêa; Vieira, FlavianaHypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM) are leading causes of maternal and fetal-neonatal morbidity and mortality. Their effects are believed to be associated with umbilical cord macroscopic changes. This study aimed to examine the association of umbilical cord macroscopic changes and newborn outcomes in high-risk pregnancies. A descriptive cross-sectional study was conducted in a public maternity hospital affiliated to the Brazilian National Health System (SUS) in the city of Goiânia, central-west Brazil, between January and December 2012. Medical information on high- (HDP and GDM) and normal-risk (control) pregnancy women and their newborns was collected in the postpartum period as well as information on the macroscopic characteristics of the umbilical cord of these infants. A total of 265 umbilical cords were examined. Of these, 126 were from the high-risk pregnancy group (64 of children of mothers with HDP and 62 of those of mothers with GDM) and 139 from the control group (73 HDP and 66 GDM controls). The most common umbilical cord macroscopic changes included true knots and non-central cord insertion in newborns of mothers with HDP and cord less than 35 cm long, true knots, and non-central cord insertion in those of mothers with GDM. Maternal age ≥36 years was significantly associated with single umbilical artery (SUA) (p = 0.03) in the control group. No statistically significant association was found between umbilical cord macroscopic changes and clinical characteristics of newborns of high-risk pregnancy women.Item Alterações neonatais e maternas relacionadas ao óbito infantil em crianças com gastrosquise(Universidade Federal de Goiás, 2015-04-17) Coelho, Amanda Santos Fernandes; Guimarães, Janaína Valadares; http://lattes.cnpq.br/0986934969522024; Salge, Ana Karina Marques; http://lattes.cnpq.br/7766918925030041; Salge, Ana Karina Marques; Siqueira, Karina Machado; Castral, Thaíla Correa; Vieira, Flaviana; Prado, Marinésia AparecidaInfant mortality is an important indicator of a country’s health. It is observed in several regions of the world a proportion of deaths attributable to congenital malformations. Worldwide, it is estimated that prevalence occurs in 9% of live births. Among the major abnormalities is gastroschisis, that is a congenital malformation in which there is an exteriorization of the viscera through the abdominal wall defect to the right of the umbilical cord, which is implanted in its normal position. The objective of this study was analyze the neonatal and maternal changes related to infant mortality in children with gastroschisis. This is a cross-sectional and retrospective study with a quantitative approach. It used for analysis, secondary data collected from medical records of patients treated at a public hospital in Goiânia-GO, from 2004 to 2014. The study included 123 patients diagnosed with gastroschisis, which met the criteria adopted. In relation to maternal variables, 57.7% of the women were younger than 20 years, 64.2% were first pregnancy, cesarean birth occurred in 65% of cases, there was an average of 4.8 ± 2.5 prenatal consultation. In relation to neonatal variables, 59% of the new born with gastroschisis were male. The gestational age at birth of the 123 pregnancies ranged from 29.4 to 40.4 weeks (average = 36.5 ± 1.8 weeks). The weight of the new born ranged from 890g to 3800g (average = 2351 ± 474,2g), the average of the Apgar index in the first minute was 6.6 ± 1.8. Associated malformations (not intestinal) were found in 10 (8.1%) patients and 17 (13.8%) patients had intestinal abnormalities, and at this last the most common was the intestinal atresia. By observing the eviscerated organs, 70.7% of patients had only exposed intestinal loops and about other herniated organs, the stomach has been externalized in 27.6% of cases. The general mortality rate was 41% of cases. Statistically significant association was observed between the occurrence of death and mothers who performed less monitoring in prenatal care (p = 0.027) and when there was no diagnosis of gastroschisis in prenatal care (p = 0.001). It was also observed statistically significant association between the occurrence of death and the presence of complex gastroschisis (p = 0.032) and herniation of other organs beyond just the intestine (p = 0.018). It is concluded that, in relation to maternal and neonatal profile of gastroschisis, the condition has no gender preference, particularly affecting children of young first-time mothers. Perinatal mortality of gastroschisis in this analysis seems to depend mainly on the reduced prenatal care, the absence of prior diagnosis at birth, the presence of complex gastroschisis and herniation of other organs than just the intestine.