Programa de Pós-graduação em Enfermagem e Saúde
URI Permanente desta comunidade
Navegar
Navegando Programa de Pós-graduação em Enfermagem e Saúde por Por Tipo de Defesa "Tese"
Agora exibindo 1 - 20 de 39
Resultados por página
Opções de Ordenação
Item Violência contra o docente na prática pedagógica em saúde: uma abordagem intercultural(Universidade Federal de Goiás, 2021-09-17) Alves, Angela Gilda; Rodriguéz Martín, Dolores Dolores; http://lattes.cnpq.br/6242953215193998; Barbosa, Maria Alves; http://lattes.cnpq.br/5025797873585225; Barbosa, Maria Alves; Guix Comelles, Eva Maria; Pereira, Edna Regina Silva; Santos, José Luis Guedes dos; Martins, Cleusa AlvesIntroduction. Operationalizing the concept of violence, especially against higher education teachers, is difficult. In addition to the various concepts, the violence is presented in expressions of hatred, anger, revenge, acts contrary to social norms of coexistence, prejudice against those that are different, and mistreatment directed toward the teachers, which can lead to consequences and cause harm even in the pedagogical sphere. Intercultural differences enable different spaces, which represent hermeneutical, epistemological and methodological resources. All of this contributes to a dialogic process with other contexts and thoughts that range from the acquisition of information to the emergence of new theories capable of rethinking and transforming learning. Objective. To analyze violence against teachers in the Health pedagogical practice through an intercultural approach. Methodology. This was a multimethod study developed at a University in the Central Region of Brazil, in which the phenomenon of violence was analyzed from different angles, supported by literature reviews (integrative and scoping), the Delphi method, and a qualitative study with the analysis partially using the Constructivist Grounded Theory (CGT). The target population consisted of all teachers at the Faculty of Nursing of the Federal University of Goiás. Data collection took place through recorded and transcribed interviews and, with the use of the NVivo software, analysis categories were created. The analysis used a step of the Grounded Theory. Results. The theoretical contributions of the study were presented, including the concepts of violence and its relationship with the teaching practice in health education. The discussion of knowledge in Higher Education in Health considering Vygotskian theory evidenced convergent terminologies. Violence against teachers can be defined as a set of actions and situations provoked by students in an insidious or chronic way in the workplace and/or through digital media, mediated by the perception of violence, the teacher's coping mechanism and the organizational management of violence. Indicators of violence against the teacher were defined as any threat, attempt, or actual aggressive act, as well as ignoring or disrespecting the teacher through speech, engaging in sexual harassment, homophobia, receiving coercion from the student's family, as well as using information and communication technologies to perform such acts. The factors that lead teachers to suffer violence in Higher Education in Brazil are characterized by the institutional culture, gender, the perception of violence by the teacher and the triggers that lead students to practice violence. Conclusion. Violence by students against teachers deserves pedagogically important reflections. Social origin converted into inequalities triggers positions of domination and, consequently, creates a fertile ground for violence. Teachers will be able to develop actions that blossom into the construction of skills and attitudes for coping with violence, recognize it and intervening in order to prevent aggressive behavior from spreading, causing mutual illness and weakening interpersonal relationships.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 Regulação da saúde no estado do Pará: um estudo na região metropolitana de Belém(Universidade Federal de Goiás, 2019-03-11) Bastos, Luzia Beatriz Rodrigues; Barbosa, Maria Alves; http://lattes.cnpq.br/5025797873585225; Barbosa, Maria Alves; Duarte, Célia Scapin; Nogueira, Douglas José; Ferreira, Ilma Pastana; Vila, Vanessa da Silva CarvalhoINTRODUCTION. Regulatory structures can become determinants in the organizational process of health management, since it has the possibility of giving more effective responses to the requesting units and, above all, to the user. It would be up to the establishment of flows for the intended service not only implying optimization of expenses. Objective. To analyze the regulation of health services, in the Metropolitan Region I of the state of Pará, in view of complex and regulatory centers, recommended by the Brazilian Unified Health System (SUS). METHODOLOGY. An exploratory descriptive study with a mixed focus developed in the complexes and central regulators of the municipalities of Belém, Ananindeua, Marituba and Benevides, whose sample was composed of eighteen managers and seventy regulators, from September / 2017 to January 2018. It was applied the questionnaire in the first phase of the research and after that 40 semi-structured interviews were carried out. RESULTS. In the process of calculating the quantitative data it was found that the officials of the regulation, are female, with average age of 39 years; salary range of 2 minimum wages; majority of administrative assistants with effective ties. As limiting factors were found: great demand; lack of indication of priority cases and failure to refer to regulatory criteria; unavailability of beds, systemic difficulties in relation to the agreed services and the SISREG; difficult scheduling and execution procedures; increased demand for repressed elective procedures; problems in the flow of information between primary care and regulation, among others. As main potentialities in health regulation, the following stand out: increase of financial resources to health; reorganization of internal regulatory procedures; meeting the needs of users; health training for regulatory professionals, and strengthening of primary health care. CONCLUSION. The study showed that it is difficult to concentrate higher level professionals to perform the tasks of regulators of medium and high complexity procedures of SUS; there are obstacles in operationalizing the regulatory process, because the regulatory structures created coexist with insufficient resources, unconditional agreements with the reality of the municipalities of the north of the country; there is recognition of the need for a strong regulatory component by the State in guaranteeing qualified health access to the population, one of the greatest challenges being to understand the multiplicity of scenarios, subjects and interests, and to implement strategies focused on the user that needs health services.Item Estratégias de atenção aos cuidadores informais de idosos: pesquisa participante baseada na comunidade(Universidade Federal de Goiás, 2017-03-27) Borges, Cristiane José; Munari, Denize Bouttelet; http://lattes.cnpq.br/8409035360598716; Munari, Denize Bouttelet; Stacciarini, Jeanne Marie Rodrigues; Medeiros, Marcelo; Santana, Rosimere Ferreira; Pagotto, ValériaINTRODUCTION: The process of population aging is a worldwide phenomenon and, simultaneously, a new social role emerges - the informal caregiver-, seen as an essential component to promote elderly’s quality of life in some dependency situation at home. OBJECTIVE: To describe the construction and implementation of care and support strategies for elderlies’ informal caregivers through the Community Based Participatory Research. METHOD: A descriptive study guided by Community Based Participatory Research (CBPR) principles and carried out through the organization of a Community Advisory Committee (CAC), which involved academic and community participants. The study was attended by 384 people, nine community partners, 255 professionals working in family health strategies and 120 elderlies’ informal caregivers. The research was divided into the following phases: 1 - establishment of the community partnership; 2 - identification of problems related to elderly’s informal caregiver; 3 - prioritization of problems related to elderly’s informal caregiver; 4 - capacity survey of community strengths, dynamics and resources; 5 – arrangement of strategies, method, support and care interventions to elderly’s informal caregiver; 6 - implementation of strategies, method, support and care interventions to elderly’s informal caregiver; 7 - data analysis by CAC members; 8- dissemination of results obtained with CAC partnership; 9 - maintenance, CAC sustainability and partnerships evaluation. For the results’ analytical process, the content analysis proposed by Bardin was used for qualitative data and the descriptive statistical analysis was used for quantitative data. The Bioecological Theory of Human Development was adopted as a complementary basis for data analysis. RESULTS: Through the CAC constitution, there were identified, in a collective way, 17 problems faced in the elderly’s informal caregiver daily life. The use of the Severity, Urgency and Trend matrix allowed these problems prioritization for decision making. This process mobilized the construction of an action plan composed by five strategies: 1 - teaching of CAC members about the concepts recommended to define the caregiver role; 2 -raising the knowledge of Family Health Strategy professionals about the importance of including the informal caregiver as a care focus; 3 - performance of the 1st Multiprofessional Care Meeting for Elderly and Informal Caregiver; 4 - recording of the city’s informal caregivers of elderly people; 5 - qualification of the elderlies’ informal caregivers. CONCLUSION: The use of Community Based Participatory Research enabled the community partners’ empowerment, that mobilized themselves in support of elderlies’ informal caregivers, developing actions that included the mapping of the city’s informal caregivers of elderly people, mobilization and qualification of the Family Health Strategy professionals, and the organization of care spaces. In this process, it was verified that this research approach strengthens health democratization by promoting greater involvement and social protagonism of community partners, creating ideas and concrete actions for the establishment of care strategies for the elderlies’ informal caregivers.Item Qualidade da assistência especializada a pessoas com diabetes mellitus e hipertensão arterial segundo o Chronic Care Model(Universidade Federal de Goiás, 2022-04-27) Borges, Dalma Alves Pereira; Brasil, Virginia Visconde; http://lattes.cnpq.br/1940761888797180; Brasil, Virginia Visconde; Vila, Vanessa da Silva Carvalho; Vitorino, Priscila Valverde de Oliveira; Zanini, Claudia Regina de Oliveira; Rezende, Marina Aleixo DinizINTRODUCTION: Support for self-management of chronic conditions and health literacy are essential elements in the development of person-centered services. The use of integrated care models that focus on the person, and not just on the specific disease, represent a viable solution for effective care. The Chronic Care Model is a model that is based on the relationship between motivated and informed users and the proactive and prepared health team. However, there is evidence of gaps in the attention and care that should be provided in the care of chronic conditions, especially in hypertension and diabetes. OBJECTIVE: To characterize the quality of care provided and the health literacy conditions reported by people with arterial hypertension and diabetes mellitus in a secondary care service. METHODS: Crosssectional study, carried out in an outpatient clinic that is a reference in the care of arterial hypertension, in a large Brazilian center, where diabetes is prevalent morbidity. Eighty-two people with diabetes mellitus and arterial hypertension were evaluated, with a follow-up of at least five years and ten consultations. Sociodemographic and clinical data were obtained through a nursing consultation. The Patient Assessment of Care for Chronic Conditions - PACIC questionnaire was applied, with 20 questions and five scales. Higher scores (> 3.0) indicate a perception of greater involvement in self-management and support. Three scales from the Brazilian version of the Health Literacy Questionnaire - HLQ-Br were also used. The score of each scale indicates the person's strengths and weaknesses in relation to their health literacy. Internal consistency was evaluated; Mann-Whitney test, Spearman test and significance of 5% were applied. RESULTS: The mean age of the participants was 68.98±8.79 years, female (82.93%), with a median of 4 years of study (IQR 3 - 8). Most parents (70.73%) did not study. Less than half of the users had controlled values of glycated hemoglobin - HbA1c (34.15%) and blood pressure (36.59%). The Cronbach alpha of PACIC was 0.85 and that of HLQ-Br was 0.75. There was a positive correlation between the time of diagnosis of diabetes and HbA1c. The overall PACIC score was 3.4 (IQR 2.8-3.8) out of a high of 5.0. The highest score was evidenced on the scale of care/decision-making model (4.3) and the lowest on the scale of coordination of care/follow-up (2.8). Support for selfmanagement is assessed by the treatment adherence scores (3.0), problem-solving / follow-up contextualization (3.0), and goal setting (3.8). Those with ≥ 4 years of schooling had higher scores for Attention Coordination / Follow-up (p=0.039). Participants whose parents had some schooling had higher scores for Adherence to treatment (p=0.038), Coordination of care / Follow-up (p=0.042) and general PACIC (p=0.026). Lower scores were identified among participants who did not have HbA1c control, on the Goal Setting scale (p=0.003). Health literacy showed mean scores of 4.07 ± 0.87 on the Ability to interact with the team scale; 3.02±1.31 in Understanding the information and 2.84±1.25 in Finding good information. Male users had higher scores for interacting with professionals, finding information and understanding information (p=0.039, p=0.00 and p=0.003). Those with ≥ to 4 years of schooling had higher scores for Finding and Understanding information (p=0.002 and p< 0.001), as well as those whose parents had some schooling (p=0.036 and p=0.037). Those who were overweight had a higher score for Understanding the information (p= 0.040). There was a positive correlation between the time of diagnosis of diabetes and HbA1c and no correlation was identified between the general value of PACIC and the HLQ-Br scales. CONCLUSIONS: The quality of care was considered high according to the general PACIC, and moderate in terms of the person's participation in decision-making and the contextualization of the treatment plan. Weakness was identified in the dependence on other people to be able to access and understand written information, but the ease of involvement with professionals can favor the use of communication strategies to improve health self-management.Item Fatores associados à qualidade de vida relacionada à saúde do portador de doença renal crônica em tratamento pré-dialítico(Universidade Federal de Goiás, 2014-12-19) Cordeiro, Jacqueline Andréia Bernardes Leão; Brasil, Virginia Visconde; http://lattes.cnpq.br/1940761888797180; Brasil, Virginia Visconde; Canhestro, Mônica Ribeiro; Barbosa, Maria Alves; Vila, Vanessa da Silva Carvalho; Freitas, Ana Tereza Vaz de SouzaChronic kidney disease is considered a worldwide public health problem because of the high mortality rates and the physical, social and emotional limitations that interfere significantly in quality of life. The evaluation of the quality of life of chronic kidney disease carrier has demonstrated commitment to many aspects of life of these individuals and it was directed mainly to patients on dialysis. The number of referrals for pre - dialysis monitoring, resulting from complications due to comorbidities such as hypertension and diabetes mellitus is growing, and it requires that the focus of assistance is not only early diagnosis and treatment of disease, but also, aspects related to subjectivity, the perceptions of individuals in relation to their well - being and quality of life (QOL). At present there is no specific instrument to assess QOL of individuals in pre- dialysis treatment. This study aimed to analyze the factors associated with QOL related to the health of the chronic kidney disease carrier in pre- dialysis treatment. An analytical cross-sectional study was developed in three nephrology clinics of large hospitals in the city of Goiânia/Goiás, with 130 patients in stage IV and V of chronic kidney disease. Data collection was done through the application of socio - demographic - clinical - laboratory questionnaire and the specific QOL instrument for kidney disease, KDQOL -SF. A total of 57.7% of patients were male and the group average age was approximately 64 years old. Most patients were classified as stage 4 (69.2%) and some had no schooling (54.6 %). Among the comorbidities detected hypertension was more prevalent, followed by diabetes mellitus and 28.5% of patients had hemoglobin levels lower than expected. The dimensions of quality of life "the professional role" (25.38) and "the physical function" (28.08) showed lower values while "the stimulus by the clinic staff" (88.37) and "the cognitive function" (86.00) had the highest average. QOL is more compromised in women and in patients with five or more children who do not work and have no income, who are obese, hypertensive and show alterations especially in urea and creatinine. It was shown that QOL is influenced by chronic kidney disease, especially when there is change in laboratory parameters which control may extend the start of dialysis therapy or even minimize possible organic misfits. The KDQOL -SF was adequate to evaluate the QOL of individuals in pre- dialysis treatment. The gaps shown by the assessment of QOL in this study showed the importance of care to the kidney patient in the pre- dialysis phase, requiring more effective attention to the subjective demands. This could be achieved if the individual is taught to manage his condition, and it is essential a multidisciplinary monitoring to consider the level of patient understanding, so he can transform the information provided in benefits for his own health.Item Gravidez na adolescência e sua prevenção: sentidos atribuídos por um grupo de adolescentes escolares de Porto Velho – Rondônia(Universidade Federal de Goiás, 2019-12-11) Fernandes, Daiana Evangelista Rodrigues; Medeiros, Marcelo; http://lattes.cnpq.br/3009722217245952; Medeiros, Marcelo; Silva, Joana Aparecida Fernandes da; Reis, Mary Lopes; Santos, Walterlânia Silva; Barbosa, Maria AlvesRecent World Health Organization data show that approximately 16 million girls aged 15-19 each year and 1 million girls under 15 annually become mothers worldwide. Teenage pregnancy is an important public health problem that can affect the mother-child binomial in social, biological and psychological aspects. The aim of this study is to identify and analyze the meanings attributed by school adolescents to teenage pregnancy and its prevention. Qualitative study, approaching the principles of ethnography, conducted in a public school in the city of Porto Velho - RO, from October 2017 to November 2018. Participants were 20 adolescents of both sexes, aged 16 or 17 years. who had sexually active lives or not and were in the first or second year of high school. Data were obtained during the fieldwork, through participant observation and individual interviews, following a semi-structured script. The interviews were analyzed by the meanings interpretation method. From the process of analysis of the qualitative material obtained two themes emerged. The first, “Information for the prevention of teenage pregnancy”, shows that mothers are the people who talk and report the most about aspects related to their children's sexual health. Participants also reported as sources of information, leaflets, lectures, classes at school, advertisements and television programs. Regarding contraceptive methods, they reported mainly condom use and oral contraception. The theme “Repercussions of teenage pregnancy” shows that, in general, adolescents consider pregnancy at this stage of life something wrong, which undermines their studies and imposes the need to work. In addition, they evidenced the desire to complete their studies and develop in various professions in order to obtain financial stability and material goods so that only then can they have children. The study showed that participants referred more about their plans and dreams for development as people and future professionals than the desire for a teenage pregnancy. In contrast, the process of sexual and reproductive health education for these adolescents was weakened. Information is fragmented and there is no necessary dialogue between family, school and health service, and others who could participate in this continuum of actions for health promotion. Similarly, the use of contraceptive methods was not stable. However, participants demonstrated the use of the information to which they had access and adopted contraceptive measures motivated by future desires and dreams.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 Reanimador manual: quando trocar no mesmo paciente(Universidade Federal de Goiás, 2016-03-31) Gomes, Giselle Pinheiro Lima Aires; Pereira, Milca Severino; http://lattes.cnpq.br/9304767101674108; Souza, Adenícia Custódia Silva; http://lattes.cnpq.br/5966034868102264; Souza, Adenícia Custódia Silva; http://lattes.cnpq.br/5966034868102264; Oliveira, Adriana Cristina; Tipple, Anaclara Ferreira Veiga; Leão, Lara Stefânia Netto de Oliveira; Brasil, Virginia ViscondeINTRODUCTION: The manual resuscitator is a widely used respiratory assist device that has been reported to be a reservoir and a source of contamination from various microorganisms. At present, there is no criteria to replacement of manual resuscitator when it is in successive use in the same patient. AIM: To evaluate the safest amount of time the manual resuscitator can be successively used in the same patient. METHODS: An open, prospective cohort study was conducted from October to November, 2014 using 30 patient connector valves from manual resuscitator devices obtained from Intensive Care Units of a general hospital located in a region north of Brazil. The samples were collected through swab friction on the manual resuscitator that was used by the same patient, at zero (ready use), 24 and 48 hours. Bacterial identification and antibiotic susceptibility were performed automatically (Vitek 2 Compact®). RESULTS: Of the 30 resuscitators evaluated, 20 (66.6%) were found to be contaminated. There was a significant difference between the microbial load on the manual resuscitators in use at zero and 24 hours (p = 0.03). Associated risk factors for the contamination of manual resuscitators identified were frequency and time of use. The presence of visible soil was not detected on 19 manual resuscitators in use, however, 95.0% were contaminated. The number of microorganisms isolated at zero, 24 and 48 hours were five, 11 and 24, respectively. Thirteen devices were contaminated with two or more bacterial species. Of the Gram-positive cocci, 38.9% (n = 18) were methicillin-resistant Staphylococcus aureus and 11.1% were methicillin-resistant coagulase-negative Staphylococcus, all were constitutive MLSB resistant. Of the Gram-negative rods (n = 36), Acinetobacter baumannii (36.1%), Pseudomonas aeruginosa (19.4%), Serratia marcescens (22.2%) and Proteus spp. (8.3%) dominated. Over 50% of these were resistant to carbapenems, second, third and fourth cephalosporins generations, and ampicillin/sulbactam. CONCLUSION: Manual resuscitators in successive use in the same patient were contaminated even in the absence of visible dirt. Multi- and extensively-resistant bacteria of clinical importance were also detected. Frequency and time of use were identified as risk factors in the contamination of manual resuscitators. The longer the time of use, the greater the number of contaminated resuscitators and bacterial species isolated. These results point to failures in reprocessing, and therefore highlights the importance of having thorough discussions among regulators about the recommendations for the reprocessing of semi-critical medical devices, especially, those for ventilatory assistance. Furthermore, the results highlight the need to replace manual resuscitators every 24 hours after use as a strategy for infection control and to minimize the risk of re-colonization or -infection of the respiratory tract.Item A efetividade de escovas descartáveis e submetidas à desinfecção para a higiene bucal em pacientes ventilados mecanicamente: ensaio clínico(Universidade Federal de Goiás, 2019-04-30) Gonçalves, Fernanda Alves Ferreira; Torres, Ieda Maria Sapateiro; http://lattes.cnpq.br/0836649494981715; Campos, Cerise de Castro; http://lattes.cnpq.br/9109822142576433; Brasil, Virginia Visconde; http://lattes.cnpq.br/1940761888797180; Brasil, Virginia Visconde; Souza, Adenícia Custódia Silva e; Roriz, Virgílio Moreira; Melo, Dulcelene de Sousa; Tipple, Anaclara Ferreira VeigaINTRODUCTION: Invasive ventilatory and intubated patients are dependent on the nursing team. The mechanical removal of the biofilm with toothbrush is the first option, but after single use it can be contaminated by microorganisms from the oral cavity, as well as from the external environment. The use of the brush should be associated with chemical control of chlorhexidine digluconate, which is semi-critical and requires high level disinfection or be discarded. Peracetic acid is a high-level disinfectant, but has not been tested for use on toothbrushes. AIM: To compare the effectiveness of the use of disposable toothbrushes and disinfection with peracetic acid used for oral hygiene (OH) of patients under mechanical ventilation. MATERIALS AND METHODS: Randomized-controlled clinical trial performed at an intensive care unit of a public hospital in Goiânia / GO. Data were collected from 31 patients, intubated and under mechanical ventilation, between June 2017 and August 2018. The patients were divided into Control Group (OH with disinfected brushes) and Intervention Group (HB with brushes discarded). A dental evaluation was performed on day 1. Saliva collection was performed on day 1, day 3 and day 5 for counting of colony forming units (CFU). HB was performed twice a day, for up to five days, with 0.12% CHX gel and disinfected or discarded brushes. RESULTS: At admission, patients presented poor oral hygiene, periodontal disease, periodontitis and gingivitis. Most of the participants were male, with a mean age of 59.0 ± 14.4 years and mean of 19 teeth. Throughout the days of HB there was a decreasing tendency of buccal and lingual biofilms, however, there was no significant reduction of UFC, with no difference between the groups that used disposable brushes and disinfected brushes. In relation to the bacteria isolated on the fifth day, there was homogeneity in both groups, with predominance of Pseudomonas aeruginosa, Enterococcus faecium, Klebsiella pneumoniae and Staphylococcus haemolyticus. CONCLUSIONS: There was no difference in tooth and tongue brushing, performed with single use brushes, discarded or disinfected at each use. The important thing is to brush properly, following established protocols.Item Diagnósticos, intervenções e resultados de enfermagem à pessoas em tratamento hemodialítico: validação de consenso por especialistas(Universidade Federal de Goiás, 2015-10-20) Lemes, Maria Madalena Del Duqui; Bachion, Maria Márcia; http://lattes.cnpq.br/8503907944360635; Lemes, Maria Madalena Del Duqui; http://lattes.cnpq.br/8503907944360635; Barbosa, Dulce Aparecida; Brasil, Virgínia Visconde; Munari, Denize Bouttelet; Almeida, Miriam de AbreuINTRODUCTION: Among the health problems experienced by adult and elderly people, who have a strong impact on the quality of life, stands out chronic kidney disease (CKD). The nursing process improves the clinical practice of care in hemodialysis, however, is still in its infancy and the scope of the phenomenas described in the taxonomies of diagnoses, interventions and nursing results, as the focus on hemodialysis scenario has not yet been described. OBJECTIVES: To validate nursing diagnoses as priorities by expert nurses; Validate interventions for diagnosis identified as priority by expert nurses; Validate relevant nursing results for diagnoses identified as priority by expert nurses. METHODOLOGY: A descriptive, cross-sectional study, validation of nursing diagnoses, interventions and priority outcomes for patients with chronic kidney disease on hemodialysis people, from the NANDA-I Terminology / NIC / NOC. Participated 12 hemodialysis units that served 1788 patients and 55 nurses working. From the occupational profile of these nurses was identified 21 experts. Of these, nine validated diagnoses, interventions and nursing outcomes, through a focus group, for people with chronic kidney disease. RESULTS: There were 36 validated diagnostic, 124 interventions and 119 nursing results. Of validated nursing diagnoses, 13 are recognized more often in literature and 23, little mentioned or not mentioned. CONCLUSION: The diagnoses, interventions and nursing outcomes validated by experts in hemodialysis give visibility to a qualified clinical practice proposal for systematization of nursing care in accordance with the reality of unity.Item Análise dos registros de curativos em prontuários de um hospital de ensino do Estado de Goiás(Universidade Federal de Goiás, 2016-06-21) Lemos, Lucimeire Fermino; Barbosa, Maria Alves; http://lattes.cnpq.br/5025797873585225; Almeida, Alessandra Rodrigues de; Barbosa, Nelson Bezerra; Bezerra, Ana Lúcia Queiroz; Prado, Marinésia Aparecida do; Barreto, Regiane Aparecida dos Santos SoaresHealth records are important for keeping effective communication among all professionals involved in the process of taking care as well as for legitimating the team actions in the face of patients and families. The records must be clear and objective because they are sources of information for judicial, research, teaching, billing and auditing issues. This study has an objective to analyze the records of procedures of Level II Curative in medical records of hospitalized patients, from the nurses’ perspective, before and after the pedagogical intervention, in a Brazilian teaching hospital in the Midwest region. It was a descriptive study with both qualitative and quantitative research and was developed in many stages. The first stage included the nurses’ profiles and the identification of the main reasons why the nursing actions were not recorded. The second stage was the analysis of the records before and after the pedagogical action, which was the third stage. At last, the nurses were interviewed about their perception of the importance of the records for billing. It was observed among the sample of nurses the predominance of women (87,2%), post-graduated (82,1%) and statuary civil servants (80,4%). Even though 53,6% of the nurses said that they do not have double employment relationships, 46,4% said they do. The nurses said that it was not possible to record the procedures due to lack of time (50%), work overload (20%), lack of human resources and access to the records (12,5%), interruptions and lack of guidance (2,5%). The objective of the intervention was to discuss the importance of health records, and specially, in relation to the level II curative. 45,2% of the nurses of this institution took part in this event. In the analysis of the records, before and after the intervention, it was possible to observe the increase of the records of the curatives (82,3%), the detailing of the quantity of curatives per patient (69,9%), the classification of the wounds (63,5%), the description of the materials used in the procedures (67,3%), and also the scheduling (74%) and the checking (71,4%). The data shows that the quantity of material used maintained still. However, there was a rise of curative prescription by the nurses (79,4%) and a fall of curative prescription by the doctors (18,3%). It was also possible to observe that the performed and not prescribed procedures or prescribed and not verified procedures, in both cases, were not billed. Nevertheless, the hospital overturn related to this procedure has an increase, from July 2015. The interviews with the nurses showed that they take the responsibility in the treatment of wounds for themselves. However, it is necessary to standardize the prescriptions and the evolutions of the procedure. The complete record of this intervention is important to safeguard the institution in case of auditing. In conclusion, nurses have an important role in recording the wound treatment. The obligation of recording should be reinforced due to the quality of the service and the profession´s visibility as well as for a better material and input control and billing.Item Cobertura vacinal em crianças assentadas, quilombolas e ribeirinhas do estado de Goiás, nascidas entre 2010 e 2017(Universidade Federal de Goiás, 2021-08-05) Lima, Juliana de Oliveira Roque e; Rosso, Claci Fátima Weirich; http://lattes.cnpq.br/1137218060736306; Caetano, Karlla Antonieta Amorim; http://lattes.cnpq.br/0112036159794570; Caetano, Karlla Antonieta Amorim; Pagotto, Valéria; Minamisava, Ruth; Pessoni, Grécia Carolina; Junqueira, Ana Luiza NetoVaccination is considered one of the most cost-effective and most effective measures in healthcare services. On the other hand, some population groups that live in geographic and cultural isolation have been showing low rates of vaccination. In Brazil, there are no data evaluating adherence to vaccines recommended by the National Program for the Immunization of Unified Health System, better known by the acronym SUS considering children from rural and traditional communities. Therefore, this study aimed to evaluate vaccination coverage according to the national calendar of vaccination of children for the first year of life, and their distributions in space and trends in time in children living in rural settlements, communities of quilombolas, and riverside dwellers in the state of Goiás, born from 2010 to 2017. This is an epidemiological, retrospective cohort study, carried out in 40 municipalities of Goiás, followed by an ecological study. The sample consisted of 616 children born between 2010 and 2017, residents of a settled, quilombolas or riverside dwellers community in Goiás. To calculate the vaccination coverage, the percentage of children with a complete general vaccination schedule or by the vaccine was considered, with a 95% confidence interval. In the time-series, trend analysis was estimated for communities according to mesoregions of Goiás, and for this purpose, the Prais-Winsten linear regression was used, with robust variance. Trends were classified as increasing, decreasing, or stationary, according to the p-value and regression coefficient. The spatial distribution of vaccination coverage, according to the mesoregions of Goiás, was carried out along the time-series. In total, 616 children had their vaccine data evaluated, most were male (53.7%) and belonging to the quilombolas community (54.7%). The overall vaccination coverage for the recommended vaccines during the first year of life at 12 months and at 18 months was 52.4% (CI95%: 48.5% - 56.3%) and 57.8% (CI95%: 53.9% - 61.6%), respectively. For children born in 2017, just the yellow fever vaccine and measles/mumps/rubella vaccine had vaccination coverage > 90%. According to the birth cohort from 2010 to 2017, in Goiás, of the ten vaccines evaluated, six showed an increasing trend in vaccination coverage (POLIO, 10-valent pneumococcal, human rotavirus, meningococcal, yellow fever, and measles/mumps/rubella). Considering the spatial and temporal distribution, according to the mesoregions where the communities are located, a decreasing trend for vaccination coverage was only observed in the Center Goiano mesoregion for the hepatitis B vaccine. In the North Goiano mesoregion, increasing temporal trends were observed for most vaccine coverage, the exception was for BCG and measles/mumps/rubella vaccines. Despite this, the North Goiano mesoregion was the only one in which no vaccine achieved 90% coverage in the period of birth cohort 2016/2017. The results present an unequal scenario in the access to vaccination services for rural populations and traditional Brazilians and point to the need for urgent strategies to achieve and ensure equity in health for a group with distinct traditions and characteristics of the urban population of Brazil.Item Instrumental ortopédico de conformação complexa: avaliação do processamento, formação de biofilme e suas implicações(Universidade Federal de Goiás, 2016-12-20) Lopes, Lillian Kelly de Oliveira; Watanabe, Evandro; http://lattes.cnpq.br/6142675059689994; Tipple, Anaclara Ferreira Veiga; http://lattes.cnpq.br/4288704233343920; Tipple, Anaclara Ferreira Veiga; http://lattes.cnpq.br/4288704233343920; Hunt, Alessandra Marçal Agostinho; Lima, Ana Beatriz Mori; Melo, Dulcelene de Sousa; Caetano, Karlla Antonieta AmorimINTRODUCTION: Depth gauge and flexible drill bite cutter are orthopedic surgical instruments of complex conformation and they are into loanered instrumentation box to different healthcare facilites. The challenge is to ensure that appropriatly cleaning was done to prevent the formation of biofilm in these instruments´models. There are no experimental or clinical studies analyzing the impact of different cleaning protocols on formation of biofilm on surfaces those two surgical instruments. OBJECTIVES: To validate and to evaluate laboratory method to formation of biofilms in stainless steel. To evaluate microbial load and to determine formation of biofilms after laboratory contamination and processing for several cycles in surgical instruments of complex conformation used in surgeries of orthopedic implants. METHOD: Experimental study was developed from November/2014 to March/2016, at the Laboratory of Macquarie University, Sydney (AU). Method´s validation: new forceps halsted hemostatic mosquito were contaminated within contaminant solution containing S. aureus (ATCC 25923) and sterilized in saturated steam. Forceps were divided into three groups according to cleaning: 1) rinsing, 2) manual cleaning and 3) manual cleaning followed by automated cleaning. After 6th, 13th and 20th three forceps from each protocol were analised for microbial load and protein amount (Bicinchoninic Acid Assay) and visual analysis by scanning electronic microscopy. The same method was used on new flexible drill bite cutters and depth gauges, and analised after 10th and 20th reprocessing. RESULTS: Method´s validation: forceps submitted to protocols 1 (positive control of cleaning) and 2 showed coccus in biofilms and forceps sumitted to protocol 3 showed organics residues after 20 reprocessing. No microbial load or residual protein was found. Complex instruments: flexible drill bite cutters submitted to rinsing presented high amount of protein with increase of 1699μg of protein from 10th to 20th reprocessing (P = 0.03). Depth gauge submitted protocol 1 presented high amount of protein, however there was no statistically significant difference from 10th to 20th processing (P = 0.60). All instruments submitted to manual and/or automated cleaning did not present residual protein. It was possible to identify residue and biofilm into lumen of surgical instruments after 20 reprocessing. CONCLUSION: Experimental techniques to formation and evaluation of biofilm in surgical instruments manufactures in stainless steel were validated and 20 inappropriated cleaning processing were enough to buildup biofilm. Biofilm was formed within lumens of flexible drill bite cutter and depth gauge, after 20 processing despite the instruments were submitted to “gold standard” cleaning, also accumulation of protein on flexible drill bite cutters. Depth gauge lumen allowed accumulation of waste using manual cleaning followed by automation cleaning and manual cleaning allowed buildup residue on its external surface. Manual cleaning allowed accumulation residue on deep gauge. It was not possible to recover viable S. aureus in biofilm on instrumental surface, but it indicates that design of instruments evaluated is not safe to processing. It is presumed have risk ratio for aseptic loss of prostheses and infection related to healthcare, since they are instruments of difficult cleaning control and circulate in numerous healthcare facilites using different cleaning protocols.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 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 Risco biológico nas etapas finais do sistema de medicação em serviços de urgência e emergência e a implementação de uma estratégica educativa pautada no Arco de Maguerez(Universidade Federal de Goiás, 2013-11-04) Mendonça, Katiane Martins; Tipple, Anaclara Ferreira Veiga; http://lattes.cnpq.br/4288704233343920; Tipple, Anaclara Ferreira Veiga; Pereira, Milca Severino; Vila, Vanessa da Silva Carvalho; Queiroz, Maria Goretti; Souza, Adenícia Custódia Silva eINTRODUCTION: the prepare and the administration medications´s are activities performed by nursing staff and involve the biological risk to users and to professionals. This risk may be exacerbated when work activities are developed in areas such as emergency care that require immediate decisions. For intervention in this reality is necessary be based on situational analysis and involve all staff in the change process. OBJECTIVES: the general was to analyze the biological risk in the final stages of the medication system in the context of emergency services. And the specifics were to identify the recognition by nursing staff on the occurrence of behaviors that are characterized as biological risk in the final stages of the medication system, in the context of emergency services; characterize cases of accidents with biological material during the administration of medication in emergency services; describe ways to reduce the occurrence of accidents, indicated by the victims during the administration of medications in emergency services and describe the process of implementing an educational intervention on the biological risk in the prepare and the administration medications´s based on Problematization Methodology with Maguerez´s Arch. METHOD: The study was divided into two stages. The first presented an analytical design. Data collection occurred from October/2011 to April/2012, using a questionnaire, with demographic data and related accidents with biological material and Likert scale, with 44 items about risk behaviors previously observed among the study participants. The instruments were subjected to pilot testing. The data were processed by SPSS / IBM 20.0. In the second stage there was a descriptive exploratory study with a qualitative approach. The sources of information were recordings of the group discussions, field notes and record the speeches in the posters. The data´s collection, analysis and presentation were guided by the stages of the Arch and the guidelines of Bogdan and Biklen (2010). The educational intervention was performed in 44 meetings 34 professionals, in small groups, from August to December 2012. All went through by the stages of Maguerez´s Arch (reality observation, problem definition, key points, theorizing, possible solutions and application to reality). The project was approved by the Ethics Committee number 065/08 and 118/08 and all participants signed the informed consent. RESULTS: The scale showed the recognition by professionals of the existence of conduct that characterized the biological risk. The scale showed satisfactory reliability (Cronbach's alpha of 0.75 overall) and showed the recognition by professionals of the existence of conduct that characterized the biological risk. The conducts were related to the practice of hand washing, protective equipment, maintenance of aseptic chain, waste of health services and occupational accidents. The accident rate was 41.7% and most of the victims worked at night and said it had not received training to work in the emergency department. The protection items were neglected. Individual and organizational issues were identified as ways to reduce accidents. The educational intervention in these departments required adaptations. Were held 44 meetings with the participation of 34 professionals (87.2% of the population), six nurses and 28 nursing technicians, divided into small groups, from August to December/2012. All went through the steps of the Maguerez´s Arch (observation of reality, problem definition, key points, theorizing, possible solutions and application to reality). From the proposal for discussion of the problem related to the practice of preparation and administration of medications in emergency care unit, the key points prioritized contemplated infrastructure, human and material resources and staff qualification. Theorizing complemented the stage of the search for possible solutions, among which could be implemented in the short, medium and long term. The evaluation of the implementation of this strategy showed the commitment of professionals with field experience and successful methodology. CONCLUSION: all accidents reflected the configuration of risk behaviors recognized. The essence of this study was to understand the practice where it gives, with our own eyes, the eyes of the other and together seek a path to transformation. We found that the route chosen for the study provided us subsidies to analyze and reflect on the process of intervening in questions about the biological risk units with the wealth of specifics, such as emergency departments and direct strategies for use in units with characteristics like.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.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 Planejamento de sucessão: uma ferramenta para potencializar a liderança em enfermagem(Universidade Federal de Goiás, 2018-04-26) Nogueira, Alyne Leite Gomes; Ribeiro, Luana Cássia Miranda; http://lattes.cnpq.br/1727326201446926; Munari, Denize Bouttelet; http://lattes.cnpq.br/8409035360598716; Bezerra, Ana Lucia Queiroz; Munari, Denize Bouttelet; Siqueira, Karina Machado; Coelho, Maria Alice; Haddad, Maria do Carmo Fernandez LourencoSuccession planning (SP) for nursing leadership allows leaders to prepare new professionals to carry on or improve care quality in institutions. It is an innovative tool in the management of people. The objective of this study was to create a succession planning model for nursing leaderships at a hospital institution, based on an appreciative reflection of nurses. A descriptive exploratory study, using a qualitative approach and grounded on appreciative inquiry (AI), was developed at a public federal hospital in the Center-West region of Brazil. The study took place in two stages. In the first stage, the participants were 36 nurses with different hierarchical positions, from managers to care staff. The authors investigated the experience of the participants on leadership and their perspectives as regards leadership succession in nursing by means of individual interviews with application of the snowball technique. The second stage consisted of a group intervention with 22 nurses who participated in the first stage, using the AI methodology. The collected data were submitted to thematic content analysis and organized using the WebQDA 2016 software. Two categories emerged from the first stage: Current leadership: foundation for a succession planning; and Succession planning: a necessary tool for leadership in the institution. The second category included the creation of the Leadership Succession Planning, according to the 4D cycle methodological structure, which comprises four phases (Discovery, Dream, Design, and Destiny). At Discovery, positive points of the institution regarding leadership succession were presented and, at the Dream phase, nine desirable dreams for an ideal future in terms of leadership succession, the institution’s internal policy, and shared management and leadership development. At the Design phase, five goals were defined, along with their respective deadlines, whereas at the Destiny, there was the creation of one or more plans for each of the goals, including what had to be done in order to achieve them, with the definition of actions and those responsible for carrying them out. At the end of the 4D cycle, the group developed the Succession Planning for Nursing Leadership for the institution, which contributed to organize and strengthen this process. The use of the AI was a powerful tool in the development of collective work with the group of nurses and an important ally in the generation of changes. Considering that the subject of nursing leadership is not addressed systematically in Brazilian healthcare institutions, this study proposes a new way of thinking over the subject in the different institutional settings and, therefore, presents an innovative character for the field of management in health and nursing. Hence, this study can inspire nurses and researchers who are committed to offering quality care to their patients.