Mestrado Profissional em Saúde Coletiva (PRPG)

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    Internações por condições sensíveis à atenção primária, no município de Goiânia, no período de 2008 a 2013
    (Universidade Federal de Goiás, 2015-03-12) Magalhães, Alessandro Leonardo Alvares; Morais Neto, Otaliba Libânio de;; Morais Neto, Otaliba Libânio de; Siqueira Júnior, João Bosco; Oliveira, Ellen Synthia Fernandes de; Turchi, Marília Dalva; Minamisava, Ruth
    The Hospital Admissions by Primary Care Sensitive Conditions (ICSAP), are health problems, which the hospitalization is liable to be avoided by qualified primary care, which is understood as accessibility and effectiveness in outpatient care. To evaluate the magnitude, profile, evolution and spatial pattern of occurrence of the risks of hospitalizations associated with Primary Care Sensitive Conditions of Goiânia´s dwellers in the period of 2008 to 2013 a transversal study was developed using secondary hospitalizations data available in the Hospital Information System of the Department of Regulation, Evaluation and Control of Municipal Health of Goiânia. All admissions were georeferenced linking the neighborhood of Hospitalization Authorization (AIH) to one of the 07 health sanitary districts of Goiânia and then the analyzes of proportion ICSAP were made considering the group of causes, age and Sanitary District and its evolution during the studied series. The analysis of ICSAP rates was made and also the respective 95% confidence intervals, using the average of hospitalizations in the period clustered by age and group of causes and region of the Sanitary District of Goiânia The results showed a reduction in the proportion of ICSAP in Goiânia and its Sanitary Districts along the studied series, but heterogeneously. A higher reduction was registered in the Northwest District. The Southern District had the highest ICSAP rate and the Southwest District the lowest rate of ICSAP, however when the rates were detailed by cause group, it was observed that the Northwest District had the highest rates for 09 causes groups and the Southern District in 08 of them. The highest proportion of ICSAP and the highest rates in ICSAP were observed extremity age groups (0-9 years and 60 years or more). The occurrence of spatial pattern showed inequality of ICSAP rates in Goiania´s Sanitary Districts in relation to groups of cause and age groups. The study showed some progress and identified insufficient coverage and effectiveness of primary care services in Goiânia, which has the potential to support the city health manager and the sanitary districts in the reorientation of work processes, the family health strategy, in the implementation of intersectoral policies, in the definition of areas for location of new units the definition of areas for location of new units
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    Cobertura midiática do Sistema Único de Saúde no Brasil: um recorte histórico
    (Universidade Federal de Goiás, 2019-06-25) Miranda, Lana Cristina Bueno; Villela, Edlaine Faria de Moura;; Villela, Edlaine Faria de Moura; Pereira, Edsaura Maria; Amorim, Linamar Teixeira de
    Contemporary society has witnessed the growth of the information flow at an enormous rate. The growing dissemination of information and data by the mass media covers diverse topics with little or no concern for the quality, truthfulness and context of the news presented. Studies have exposed the relationship between the media and health issues, evidencing the hypervaluation of irrelevant themes and the media silencing about important concerns. Considering the relationship between the media and the Unified Health System, this research aimed to investigate how the SUS image was built by the media at the time of its creation and as it is currently being conceived. For that, a survey and analysis of news and published reports about SUS was carried out in a newspaper and a magazine of great circulation in Brazil, in two periods, from January 1988 to December 1991 and from March 2016 to March 2018. The comparative study of these historical data made it possible to understand the socio-political context of the SUS and to identify the main issues addressed by the media throughout the during the study periods, leading to reflections and contributing to the consolidation and strengthening of SUS in its current scenario.
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    Protocolo multidisciplinar de atenção ao pré-natal de risco habitual
    (Universidade Federal de Goiás, 2018-04-03) Silva, Aline Pereira da; Almeida, Nilza Alves Marques;; Rosso, Claci Fátima Weirich;; Rosso, Claci Fátima Weirich; Souza, Marta Rovery de; Matão, Maria Eliane Liégio; Ribeiro, Luana Cássia Miranda; Mamed, Samira Nascimento
    INTRODUCTION Prenatal care in primary health care (PHC) allows the promotion of health education, the prevention of complications and contributes to the reduction of diseases and maternal and infant mortality. Promoting the quality of this assistance through protocols based on scientific evidence and recommendations from the Ministry of Health assists in the management of health services and the standardization of care flows. The protocol also provides healthcare professionals with an organization of care and establishes the responsibilities of each team member in prenatal care. OBJECTIVE: To elaborate the usual risk prenatal care protocol in the municipality of Morrinhos-GO. METHODOLOGY: This is an intervention study aimed at the elaboration of a Protocol with the multidisciplinary team in the prenatal care of usual risk in PHC in the municipality of Morrinhos-GO. The elaboration of the protocol had the participation of 24 health professionals of the APS of the mentioned municipality and was organized in three phases, the first one being a meeting of presentation of the project and sensitization of the team, the second the elaboration of the protocol and the third the evaluation of the protocol. RESULTS: Production of the Multidisciplinary Protocol for Attention to Normal Prenatal Risk for the municipality of Morrinhos-GO. In this multidisciplinary application protocol the following themes were addressed: ethical and legal guidelines for the professional exercise, attendance at the Basic Health Unit, reproductive planning, pregnancy diagnosis, gestational risk classification, prenatal consultations, prescription of dietary supplements, complementary examinations, vaccines during pregnancy, approaches to the most common complaints during pregnancy, clinical and obstetric complications, communicable diseases during pregnancy, educational actions, birth plans, puerperal care and breastfeeding. FINAL CONSIDERATIONS: This Multiprofessional Protocol for Attention to Normal Prenatal Risk is a tool to guide the organization of the service of care for pregnant women, the standardization of this care in the BHU and also the establishment of communication between the levels of attention of the municipality of Morrinhos -GO. It can be a model for the APS of other counties. It is suggested to carry out intervention research concerning the application of this protocol.
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    Atuação dos nutricionistas no núcleo ampliado de saúde da família e atenção básica
    (Universidade Federal de Goiás, 2019-02-22) Bessa, Géssica Pires; Silveira, Nusa de Almeida;; Lemos, Cristiane Lopes Simão;; Lemos, Cristiane Lopes Simão; Pereira, Edsaura Maria; Lima, Jacqueline Rodrigues de
    The Unified Health System strengthened the primary health care with the creation of the Expanded Nucleus of Family Health and Basic Care (NASF-AB), which expanded the diversity of professionals and made possible the insertion of the nutritionist. This work aimed to analyze the performance of the nutritionist of the NASF-AB of the municipalities of the health region Centro-Sul, Goiás. It consists of a quantitative and qualitative study developed from telephone interviews through Skype® and MP3 software Skype Recorder for audio recording, using a form with open and closed questions, made with the verbal consent of the interviewees. Thematic content analysis was carried out according to Minayo (2014). The quantitative data were analyzed by Excel® software. The professional profile of nutritionists is marked by a majority of female subjects (93.33%), with a mean age of 31 years, with a low remuneration in relation to the working day, presenting employment relationship, mainly in the form of a contract for the provision of services (66.67%), occupying the position of NASF-AB for less than 11 months (73.33%), who have the basic health units as their main workplace (60.00%), with a higher presence in the Health Program at School (93.33%), in the National Program for Tobacco Control (73.33%), in the Food and Nutrition Surveillance System (60.00%), in the National School Feeding Program (53.33%) and the Bolsa Família Program (53.33%). Through the qualitative analysis, it was possible to verify that important factors for the articulation of nutritionists with the Family Health teams (eSF) are: eSF support, communication, and planning and programming, whose work focuses on the development of support to the SFI in the technical-assistance dimension and the extended clinic. The articulation presents problems related to: precarious working conditions, difficulties with management, lack of adherence and lack of knowledge of the population about NASF-AB. The promotion of adequate and healthy food is developed as food and nutritional education, in lectures and groups, mainly in the BHUs and in the schools with weekly frequency, presenting greater participation of psychologists and of nurses and the public children and youth. The studied region lacks systematic strategies for the qualification of the workforce carried out by nutritionists, who presented misunderstanding about the Permanent Education in Food and Nutrition, as well as complaints about the lack of institutional qualification of this theme. This research was developed in the Professional Master in Collective Health of the Federal University of Goiás and can subsidize the planning of the nutritionist's work in NASF-AB.
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    Protocolo multiprofissional de atenção às urgências e emergências para imigrantes nos serviços de saúde
    (Universidade Federal de Goiás, 2019-01-31) Carvalho, Luciano de Moura; Souza, Marta Rovery de;; Souza, Marta Rovery de; Almeida, Nilza Alves Marques; Cordeiro, Jacqueline Andréia Bernardes Leão
    INTRODUCTION: In the history of mankind, there have always been displacements of people through persecution, conflict, war, poverty, extreme poverty and hunger. The International Organization for Migration (IOM) reported that the number of international migrants reached 259 million in 2017, demonstrating the need for a new policy with government actions that provide guarantees of basic health rights for the immigrant. In Brazil, the Emergency and Emergency Network (RUE) is one of the forms of access to health services, and must be qualified to meet this new demand. In this scenario, the adoption of evidence-based protocols assists in the management of health services and in the standardization of care flows, improving the quality of care provided. OBJECTIVE: The purpose of this study was to elaborate a multiprofessional protocol of health services in emergency and emergency care for the care of immigrants in a municipality of the State of Goiás. METHODOLOGY: The elaboration of the respective protocol was carried out from a study with approach in action research with the participation of 32 health professionals of the RUE of the city of Aparecida de Goiânia-GO, following three phases: (1) the health action for the knowledge and the approximation of the Haitian population, (2) project presentation meeting, information gathering, discussion and protocol construction, and (3) consolidation and training. RESULTS: The development of the protocol defined the following topics as more pertinent: the initial approach and the reception of the immigrant, the attendance with Risk Classification, the attendance sheet with translation into French, Spanish and English as a facilitator for assistance to the immigrant, social service and medical approach, among other aspects. FINAL CONSIDERATIONS: With this, this multiprofessional protocol was an important tool to guide the organization of the services of assistance to immigrants in addressing the emergencies and emergencies of the RUE in Aparecida de Goiânia-GO, and could be used as a model for RUE in other municipalities , especially those located in border regions, and it is also suggested to carry out intervention research concerning the application of this protocol.
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    Percepções e condutas dos cirurgiões-dentistas da saúde da família acerca da cárie precoce na infância
    (Universidade Federal de Goiás, 2018-12-19) Rodrigues, Maria Angélica Magalhães; Queiroz, Maria Goretti;; Queiroz, Maria Goretti; Marcelo, Vânia Cristina; Martorell, Leandro Brambilla
    Early Childhood Caries (ECC) may affect the quality of life and bio-psycho-social development of children. It is quite prevalent in Brazil and the measures proposed by the National Oral Health Policy have contributed little to its reduction. Thus, it is important that professionals involved are voiced and heard whilst elaborating action strategies. This work aims to acknowledge the perceptions and conducts, carried by dentists working on Family Health, around ECC. Being an exploratory descriptive research that follows a qualitative approach, the data collection was accomplished through semi structured interviews with 29 dentists acting on Family Health. Data was taken through the analysis of thematic-categorical content with the formulation of emergent categories. It was evidenced that most of the professionals perceived ECC as a problem in the area, because of the early acometiment, high prevalence and great destruction caused to deciduous dentition. ECC was perceived as a problem in the more peripheral city zones, under heavy influence of the Social Determinants of Health. Even though the macroeconomic and life condition aspects were studied, emphasis was given to the more proximal aspects, attached to family care. These children’s access to health and oral health is limited and late, attending with pain and great damage. Noticing the social determinants did not prove itself enough to promote new practices, which were centered on the privatist model. Dentists have shown difficulty in acting with primary attention according to to the health promotion and and amplified clinic principles, regardless of the health and prevention educative actions aimed towards early childhood. The largest noted obstacles were the lack of adhesion by families, both in prevention and control actions, compromising the continuity of attention. They presented as potentials, the priority and commitment as to child care. Reflection over conducts, difficulties and potentials is important when planning actions to overcome challenges faced while implementing local level health policies. Overcoming the fragmentation of tasks, as well as the isolation of health care teams are urgent priorities. The need for permanent education which allows the capacitation for pediatric dentistry attendance, empathy development and the comprehension of choices and habits presented by families, and health education methodology were hereby presented.
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    Análise das contribuições de uma regional de saúde do estado de Goiás na governança interfederativa da região
    (Universidade Federal de Goiás, 2018-12-14) Mendes, Patrícia Freitas; Silva, Marilúcia Batista Antônio;; Pereira, Edsaura Maria;; Pereira, Edsaura Maria; Souza, Marta Rovery de; Freitas, Revalino Antônio de; Silva, Marilúcia Batista Antônio
    Introduction: The Health Department of Goiás has 18 Health Regions acting as administrative support to articulate, refine and plan the health services offer, identifying priorities for intervention in order to allow greater access of citizens to services. The Pireneus Health Region, located within the central-north macroregion, is responsible for supporting a region that includes 10 municipalities, with a population of 500,652 people. Understanding the potential of Regional Health as a participant in guidelines for collective health actions in the region may favor the cooperation of each of the parts that make up the health region. Objective: To analyze the performance of the Regional of Pireneus Health of the State of Goiás before the process of regionalization of SUS. Methodology: Mixed, descriptive and qualitative study, using questionnaire applied to the servers of the Regional Health of the Pyrenees; documentary research and focal group interview with representatives of the workers of the Unified Health System and collegiate bodies of interfederative articulation (CIB, CIR and COSEMS). The analysis and comprehension of the data collected was based on the categorization of information, through spreadsheets and figures formulated in Microsoft Office (Excel) and by the use of MAXQDA 2018 software. Results: It was possible to correlate the demographic profile and the workforce of the Pireneus Health Region, to relate the actions performed and the level of satisfaction of the employees, and to discuss the political-administrative relations of the Pireneus Health Region. Regarding the Regional Health contributions to the region it was observed, it was observed that the team has sufficient technical capacity to support the municipalities and region and perform the administrative and support function for the region. As for the weaknesses pointed out, there is little integration among the regional sectors, difficulty in monitoring the actions and services carried out by the region, and absence of the situational diagnosis of the region with the implementation of the actions according to the demand due to insufficient human resources. Considerations: This research contributed to identify strengths and fragilities of the Pyrenean Health Region in order to subsidize the delimitation of its responsibilities and attributions. It is considered important to expand the technical capacity of professionals working in the region studied, institutionalize planning processes in all sectors using the monitoring and evaluation of actions performed, strengthening and encouraging the greater commitment of the institution's employees. This action can contribute to the technical needs of the municipalities, boosting the organization of health services in a regional manner defined by the municipalities and state, in the implementation, consolidation and management of health care networks according to the needs of the region.
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    Política nacional de promoção da saúde: práticas e saberes dos enfermeiros da estratégia saúde da família
    (Universidade Federal de Goiás, 2017-12-21) Barros, Anna Paula de Mendonça; Saddi, Fabiana da Cunha;; Lemes, Cristiane Lopes Simão;; Lemos, Cristiane Lopes Simão; Almeida, Nilza Alves Marques; Rocha, Bárbara Souza
    The National Health Promotion Policy (NHPP) considers the promotion of health as a set of strategies and ways of producing health, in the individual and collective scope, evidenced in the articulation and intra and intersectorial cooperation, formation and articulation of health care network with broad participation and social control. This policy was instituted in 2006 with the challenge of producing health, qualifying sanitary practices and expanding health promotion actions in SUS services and management. The NHPP undergoes extensive revision and reformulation in 2015, with the aim of increasing participation and capillarity, signaling new arrangements, good governance and fostering spaces for inter- and inter-sectoral articulation. In the same year of NHPP, the Ministry of Health establishes the Family Health Strategy (FHS) as a model for reorienting basic health care in the SUS, proposing changes in the health care paradigm, to overcome the existing biomedical model, health care as a right to citizenship, and to promote practices involved in strengthening health. Among the professionals who make up the Family Health team, nurses are assigned the responsibility of implementing actions to reduce health damage, influence the community's lifestyle and consolidate health promotion practices. This study analyzed the perception of this professional in a large city in the state of Goiás to investigate whether the discursive practices, or the actions taken by the language implicit in the NHPP, made possible the necessary changes in the FHS routine. This is a descriptive-exploratory study with a qualitative-quantitative approach. 38 nurses participated in the study. A self-administered questionnaire was used with information on the professional profile, knowledge about the NHPP, health promotion practices and motivations to work with health promotion. In the FHS, the nurse is predominantly female, married, aged between 26 and 35 years, graduated in private institutions, with 3 to 5 years of training, specialist in several health areas and works in the same team between 1 to 2 years. The nurses affirm that they know between 50% and 75% NHPP, but when indicating the practices performed in the routine of the FHS, observed actions different from those proposed in this Policy. They affirm that they feel motivated to work on health promotion through the possibility of following the users and believing in the FHT as a strategy of impact on the health quality of the population.
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    Incidentes em unidades de atenção primária em saúde: percepção da equipe de enfermagem
    (Universidade Federal de Goiás, 2018-10-26) Braga, Quéren de Pádua; Bezerra, Ana Lúcia Queiroz;; Bezerra, Ana Lúcia Queiroz; Souza, Marta Rovery de; Alves, Sergiane Bisinoto
    Introduction: Primary Health Care is the gateway and the first point of contact between the patient and the health system. Investigations focused on patient safety at this level of care are scarce but essential for diagnosing care processes for that preventive measures are taken to improve the quality of care and minimize possible incidents. There is a need for more nursing commitment to involve patients and professionals in the prevention of incidents in this context. Objective: To analyze the perception of professionals of the nursing team regarding the occurrence of incidents in patients attending primary healthcare units. Methodology: A cross-sectional descriptive study with a mixed approach, developed in 24 Basic Health Units of a municipality in the Central South Region of Goiás, with a population of 97 professionals from the nursing team. The data were collected in March 2018 through an interview with the PCISME (Primary Care International Study of Medical Errors) questionnaire to register incidents in APS, adapted and validated for the Brazilian reality. Descriptive analysis of quantitative data and content analysis of qualitative data were performed with the help of ATLAS.ti 7.5.4. Results / Discussion: We identified 88 incidents, divided into care: the most frequent were the vaccination, with 26 reports, followed by medication and fall; and administrative: being 11 related to administrative service and seven organizational structure and material resources. Among the incidents, 52 were considered adverse events, as they caused damage to the patient, two of which were permanent damage and two deaths. The professional category involved in the highest number of incidents were the nursing technicians in 45 reports, followed by doctors, administrative staff and nurses. The results presented the need to deepen this theme in other primary care services in order to improve the quality of care provided by qualified professionals and improve the quality of the organization of services and consequently the safety of patient care. Conclusions: The perception of nursing team's evidenced the need to sensitize managers and health professionals in order to expand strategies of permanent education, the use of instruments of notification of the incidents, since these actions contribute in the diagnosis of the health situation and professionals to promote improvements through safe and quality care. It should be emphasized that encouraging the production of research related to the subject in PHC is a way forward.
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    Impacto do núcleo de segurança do paciente na cultura de segurança em um hospital especializado
    (Universidade Federal de Goiás, 2018-08-30) Macedo, Stefane Arruda; Lima, Dione Marçal;; Provin, Mercia Pandolfo;; Provin, Mercia Pandolfo; Silva, Ana Elisa Bauer de Camargo; Alves, Sergiane Bisinoto
    The promotion of safety culture has now been seen as one of the main components of quality and one of the pillars of the movement for patient safety. It represents a strategy foreseen in the Patient Safety (PS) Plan established through the Resolution of the Collegiate Board of Directors (RDC) no 36/2013, by the National Agency of Sanitary Surveillance (ANVISA), which assigned Patient Safety Core (NSP) responsibility for the systemic dissemination of the safety culture. Promoting patient safety culture encourage professionals to identify the risks and weaknesses in care and reflects on the quality of services provided and possible strategies for improvements in work processes, thus preventing patients from being victims of adverse events. To demonstrate the evolution of Safety Culture after the implementation of the Patient Safety Core in a specialized hospital, describing the professional profile of the health professionals of the studied hospital and comparing the perception about PS before and after implantation of NSP in Reference Hospital in Infectious and Dermatological Diseases of the Midwest in Goiânia, State of Goiás, Brazil. Method: This was a serial cross-sectional study, whose data collection was performed in two stages: in 2013 (T0) and 2018 (Tf),when a questionnaire developed by Survey on Patient Safety Culture (HSOPSC) where applied. Participants in the study were professionals of both sexes who had direct contact or interaction with the patients and professionals whose work directly involves the patient care. The sample consisted of 266 (28.7%) professionals in 2013 and 193 (37.5%) in 2018. Results: In 2013, the sample group is mostly female nurses, with a mean of 41.1 years old, working for more than 10 years in the institution. In 2018, the participants' profiles were also women with superior education, but younger, 26.4 years old, and with more professional training. Although a specific strength area was not revealed, the following were the best evaluated areas: general perception of patient safety, frequency of event reporting, supervisor/ chief expectations, patient safety enhancement actions, organizational learning - continuous improvement, information feedback, error communication and hospital management support for patient safety. These dimensions, which presented the best performances, are those in which the participants' perception is that the hospital is taking measures to improve patient safety, and these measures are mostly triggered by the NSP. As critical areas that presented worsening in Tf, were identified: Non-punitive responses to errors, Teamwork within the units. Some areas did not present any change: opening of communication, adequacy of professionals, teamwork between units on duty and transfers. Conclusion: The organization did not present a dimension as a strength area and presented nine of its 12 dimensions as fragile areas, that is, priority attention areas. There is an urgency for initiatives for the development of a human resources policy that invests in practices that prioritize the stability of the workforce, and promotes satisfaction in the work environment, in order to reduce the high rate of rotation. In addition, it is necessary to strengthen a non- punitive culture, which stimulates organizational learning and efficient communication among professionals. Although it is a complex issue, progress in a patient's safety culture is achievable, but requires commitment from all levels of the institution, especially managers, who are responsible for promoting a fair safety culture, where professionals feel safe and are encouraged to rethink the patient care.
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    Análise de uma comissão intergestores regional do estado de Goiás na estruturação das redes de atenção à saúde
    (Universidade Federal de Goiás, 2018-08-28) Campos, Cláudio Silva; Alves, Carla Guimarães;; Pereira, Edsaura Maria;; Pereira, Edsaura Maria; Souza, Marta Rovery de; Barbosa, Nelson Bezerra
    INTRODUCTION: The decentralization process has brought the Unified Health System (UHS) closer to the needs of the population, giving managers the challenge of organizing health service networks and services. The strategy used to consolidate regionalization is the structuring of health care networks (HCN), by overcoming fragmented care models. One component employed in the construction of this model of attention is governance through inter- managers relations, mainly at the regional level, in the case of the Regional Inter-managers Commission (RIC). OBJECTIVES: To describe and analyze the nature of the deliberations of the RIC of the state of Goiás and to investigate its process of governance and structuring of HCN; to relate the composition of health services in this region; identify the profile of managers; to describe the organization of the RIC under study and to analyze the perception of the municipal health secretaries on RIC governance and the consolidation of HCN’s. METHOD: Descriptive study with a qualitative approach, using content analysis of data collected from interviews guided by a semi-structured script, with the managers that make up the CIR, associated with the analysis of documents produced by RIC, such as meeting minutes, resolutions and guidelines. RESULTS: The study showed that the RIC in question has a consolidated institutional structure, adequate organizational and technical structuring, with a collaborative and consensual governance process with no state representation in the decisions, and in relation to the HCN, there was a recognition of the importance of RIC as a key actor in governance, but the mechanisms for implementing this process have not been clearly defined. FINAL CONSIDERATIONS: This study pointed out the need to broaden the participation of other actors in the regional governance process, such as health regional, health councils and other, improving managers in relation to HCN’s, institutional and normative planning, institute processes for monitoring and evaluation of HCN’s and redefining the role and relationship of primary health care in HCN’s and their thematic networks.
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    As potencialidades e fragilidades do processo de acreditação hospitalar na perspectiva dos enfermeiros
    (Universidade Federal de Goiás, 2018-07-04) Barbosa, Valquíria Vicente da Cunha; Silva, Ana Elisa Bauer de Camargo;; Pereira, Edsaura Maria;; Pereira, Edsaura Maria; Souza, Marta Rovery de; Alves, Sergiane Bisnoto
    Health facilities have sought to achieve improvements in their services through quality management, aiming at safer patient care. In this context, the accreditation process emerges as a method to evaluate the resources of these establishments, aiming to guarantee the quality of the assistance through pre- established standards. The objective of this research was to analyze nurses' perceptions about the accreditation process in public hospitals of a state in the Midwest region of the country, to verify the meaning of this process for nurses and to identify the potentialities and fragilities arising from this process from the perspective of the nurses. A descriptive, exploratory qualitative approach was carried out. Data were collected through focal groups in March 2018, with nurses from two public hospitals accredited by the National Accreditation Organization (levels I and III). The Bardin content analysis method was used, considering the following steps: pre-analysis, material exploration and treatment and interpretation of results. The following categories were apprehended, with their respective subcategories: meaning of the accreditation process - premises, organization and tools of this process; potentialities of the accreditation process - advantages of the process for the professional, institution and patient; weaknesses of the accreditation process - negative impact on the professional, for institution and deficient knowledge about this process. It was identified that the nurses had knowledge about the accreditation process; that the most outstanding potentialities were professional development, continuous improvement and safety for the patient and professional; and that the most mentioned weaknesses were an increase in the workload, a lack of professionals' insertion in the process, an increase in bureaucracy and a decrease in the quality of patient care due to this process itself. Another important finding was that, although the participants affirmed, on several occasions, that the accreditation process aims to offer patients more safety, more advantages were scored for the professionals and institution than for the patients themselves. It is concluded that the potentialities seized were more prominent than fragilities, evidencing that the accreditation process offers more benefits to the health sector, than harm.
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    Notificação de eventos adversos: o saber e o fazer de enfermeiros
    (Universidade Federal de Goiás, 2018-07-09) Moreira, Isadora Alves; Bezerra, Ana Lúcia Queiroz;; Bezerra, Ana Lúcia Queiroz; Souza, Marta Rovery de; Alves, Sergiane Bisinoto; Junqueira, Ana Luiza Neto
    Introduction: Patient safety has been a topic of discussion in health institutions and the reporting of adverse events is one of the main indicators used to assess the quality of care provided. The nurse, supervisor of the nursing team, has a prominent role in risk management and through the systematic notification of these events should implement preventive strategies for improvements in the quality of care and patient safety. Objective: To analyze nurses' knowledge and performance through the process of reporting adverse events in hospitalized patients. Method: A descriptive, mixed-type cross-sectional study developed at a teaching hospital in the Center-West region of Brazil, with the participation of 60 nurses from the various Clinical Units. Quantitative data were obtained through VIGIHOSP reports, online hospital notification systems, for 2016 and 2017 and analyzed statistically by absolute and relative frequencies. Qualitative data were obtained through interviews with nurses through a structured instrument, in March 2018. The contents of the ATLAS.ti 8.0 software were analyzed and three contents were analyzed: The Nurse's Knowledge; The Making of the Nurse; Intervening factors for the reporting of adverse events. Results and Discussion: In VIGIHOSP, 2495 incidents were reported, the main ones related to surgeries (60.6%) and medications (23.3%). As for surgeries, 98.6% were cancellation of the surgical procedure, being 23.1% due to patient non-attendance, 18.4% due to lack of organizational structure and 15% due to lack of patient's clinical conditions. Of the drug-related incidents, 61.8% were prescription errors and 27.6% dispensing errors. As for the profile of the participants, 46.6% work at night or mixed shift, have more than one employment relationship, working for more than 40 hours a week. It was evidenced underreporting of incidents, since most nurses do not notify the events in the system. Although they reveal knowledge of the institution's event notification system, they do not know its flow, especially regarding the return to the notifier. Factors related to underreporting of incidents were lack of time, lack of professionals / human resources, unavailability of computers for notification and low qualification of some professionals to use the online program. Conclusions: The need for greater investment in nurses' training on the dynamics and flow of the hospital's notification system is evident through continuing education programsinvolving the communication of events as an educational strategy to achieve improvements in the quality of practice care and patient safety.
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    A organização do processo de trabalho do núcleo de apoio à saúde da família: potencialidades e desafios
    (Universidade Federal de Goiás, 2016-10-14) Dias, Leidiane Fabrisia; Teixeira, Ricardo Antonio Gonçalves;; Teixeira, Ricardo Antonio Gonçalves; Oliveira, Ellen Synthia Fernandes de; Barbosa, Nelson Bezerra
    The Support Center for Family Health (SCFH) was created by the Ministry of Health in 2008 to expand the coverage and the scope of the actions of primary care and its solvability. For this, it uses tools such as the matrix support, based on flatter and dialogical relations that allow exchange of knowledge, training and mutual responsibility for all professionals involved. However, this new organizational arrangement is a process still under construction, poses changes in professional practices and reviews in its implementation. Thus, this study aimed to evaluate the understanding and satisfaction of professional teams of the Family Health Strategy (FHS) and the SCFH the work process. An exploratory study, developed, descriptive quantitative and qualitative in 61 FHS teams receiving support from SCFH distributed in 13 municipalities that make up the Regional Health Southwest I of Goiás state. The subjects were nurses, members and coordinators of FHS teams, totaling 61 participants. Data were collected through a semi-structured questionnaire containing 05 open questions and 27 closed. The quantitative data analysis was done with software support Sphinx Lexical followed by descriptive analysis of data, and qualitative data was used to support the webQDA software and content analysis technique. In general, the results show that the professionals of the FHS teams are satisfied with the support received by professionals SCFH although difficult to understand and develop the methodological proposal of matrix support. It appears that the functioning and organization of NASF the work process still reflect difficulties in overcoming the health care model, fragmentation of care, and weaknesses for the development of joint work. So many challenges need to be overcome so that the professionals of the FHS and SCFH teams ownership is of the matrix support tool, expand the clinical and practices of comprehensive health care.
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    Fatores associados à reospitalização em idosos com doenças crônicas acompanhados em programa de atenção domiciliar
    (Universidade Federal de Goiás, 2018-05-29) Borges, Jackeline Gomes; Pereira, Edna Regina Silva;; Rassi Neto, Elias;; Rassi Neto, Elias; Souza, Marta Rovery de; Rezende Filho, Joffre
    Introduction: Due to the growth of the elderly population in Brazil, the burden of chronic diseases and functional disability tend to increase, as well as the number of people who needlong-term care. Home care is a health care modality that complements the care provided in basic care and in hospital services, promoting humanization and quality of life, assisting in dehospitalization and optimizing health resources. It is important to know the profile of the elderly served by this modality to obtain information that will help in the execution of public policies for the improvement of the home care. Objective: To describe the clinical- epidemiological profile of elderly people with chronic diseases, assisted in a home care program, and factors associated with rehospitalization. Methodology: An observational, analytical and cross-sectional study carried out in the elderly accompanied by the home care service of a Rehabilitation Center of Goiás from March 2014 to January 2017. Data collection through electronic medical records study. Data analysis was performed by the statistical program Stata, version 14.0 with descriptive, bivariate and multiple analysis to verify the association between independent and dependent variables. Results: A total of 109 elderly people with mean follow-up time of 5.4 (± 3.7) months, 51.4% female, 46.8% married and 42.2% with no schooling. The mean age was 75.9 years (± 9.6), and those with> 80 years corresponded to 36.7%. Among the chronic diseases that led to functional disability, the most frequent sequelae was cerebrovascular accident, with 56.9%. Comorbidity was present in 87.2% of patients, 54.1% had some auxiliary device (tracheostomy, gastrostomy, oxygen, mechanical ventilation) and 48.6% presented some type of infection. Rehospitalization were more prevalent in patients with ancillary devices, comorbidities and infections. Of the elderly, 31.2% evolved to death in the follow-up period. The factors related to statistically significant rehospitalization were: neuro-muscular disease, chronic obstructive pulmonary disease and the presence of tracheostomy. Conclusion: There is a relevant percentage of elderly people over 80 years old. The main chronic disease was stroke. The prevalence of patients with comorbidities, ancillary devices and infectious intercurrences was high. As the statistically significant factors related to rehospitalization are associated with respiratory problems (neuro-muscular disease, chronic obstructive pulmonary disease and the presence of tracheostomy), it is proposed to increase the frequency of speech therapy, respiratory physiotherapy and dental care.
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    Os sentidos do projeto: caderneta de saúde do adolescente em uma escola da rede pública de Goiânia, sob a perspectiva da pesquisa-ação
    (Universidade Federal de Goiás, 2018-05-21) Sousa, Deusa Simone Gomes; Teixeira, Ricardo Antonio Gonçalves;; Teixeira, Ricardo Antonio Gonçalves; Fernandes, Ellen Synthia; Oliveira Neto, Pedro Adalberto Gomes de
    A qualitative, descriptive and exploratory study conducted with adolescents of a public school, 9th grade, of elementary school, from the perspective of action research, proposed by Barbier (2007) and Morin (2004). The objective of the study was to understand the dynamics of the Project: Adolescent Health Book, with a view to the resignification of the actions, from the perspective of the actors / social authors involved in the proposal. The project in question works on the main themes of adolescence using the adolescent health booklet, created by the Ministry of Health, in 2009. The data collection took place after the acceptance of adolescents and legal guardians from August to September 2017. It was used questionnaire with closed and open questions for students and focus groups for parents and / or guardians and teachers. The analysis of the data of the questionnaire was carried out by the statistical package SPSS, version 23. The analysis of the content of the open questions of the questionnaire, as well as of the focus groups, came from the perspective of Bardin (2010) and Franco (2004). The results pointed to a positive evaluation of the project among students, managers and teachers. However, several critiques and suggestions were built, which contributed enormously to unveiling the project's senses from the perspective of the actors/authors involved and to improving the planning. The present research made a great contribution to the area of Collective Health and the SUS (Unified Health System), as it reaffirmed the importance of multiprofessional work; the interface between health and education; the transversality of the topic of health education, as well as the possibility of interaction between health / education, even without being in the mold of the School’s Health Program (PSE).
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    Análise situacional dos Núcleos de Apoio à Saúde da Família no estado de Goiás
    (Universidade Federal de Goiás, 2017-11-30) Souza, Ana Lúcia Ferreira de; Souza, Marta Rovery de;; Almeida, Nilza Alves Marques de; Veronezi, Rafaela Júlia
    Introduction: The Family Health Support Center is an innovative strategy that aims to support, expand and improve health practices and management through a range of professionals from different areas of knowledge who will work side by side along with the Family Health Teams, in view of the significance of this level of attention within the system and the lack of professionals in the daily lives of the teams. Objective: To characterize and describe the work developed by the Family Health Support Centers in the State of Goiás through the National Program for Improving Access and Quality of Primary Care, cycle II. Methodology: a cross-sectional descriptive study, which evaluated the results of National Program for Improving Access and Quality of Primary Care in Goiás. Secondary data were extracted from external evaluation database between November 2013 and February 2014. Participation in the study was 60 Family Health Support Center of the state of Goiás and 550 Family Health Teams that are supported by them. Results: the most mentioned professionals in the composition were physical educator, physiotherapist, veterinarian and nutritionist. Only 45% of the have clinics for exclusive use in health units. As for the work process, the planning and programming of the actions are carried out monthly by the majority (86.2%). The activities that stood out most were Health Education, Community Activities, Home Care and Therapeutic Groups. The frequency of meetings and activities between Family Health Support Center and Family Health Teams is quite variable and a small part does not work with defined periodicity. The average time for support to be taken care of was 7 days for 78% of ESF. Conclusion: the work done by the Family Health Support Center in the state of Goiás strengthens the Primary Health Care since the referrals to the specialized demand have been reduced and the health indicators have improved. However, there is still a lot to do to refine the work, and for that, one of the key factors is to increase the proximity and synchronism of the Family Health Support Center with the Family Health Teams, establishing partnership and really working together.
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    Processo de planejamento, avaliação e monitoramento da atenção básica no Estado de Goiás
    (Universidade Federal de Goiás, 2015-07-01) Silva, Patrícia Alves da; Souza, Marta Rovery de;; Pereira, Edsaura Maria;; Pereira , Edsaura Maria; Souza , Marta Rovery de; Barbosa, Nelson Bezerra; Nunes , Maria de Fátima; Almeida, Nilza Alves Marques
    Introduction: The social fight for public quality health Health Unic System. However, despite its institutionalization to be see like a important fact in a public health history of Brazil meant just the star of this achievement. The hospital model of curative medicine that prevailed in the country became difficult the development the actions to health promotion and prevention of diseases by Basic Attention (BA). With the transformations to people health and the life expectancy that changed in the world, the public health also needed to be changed to this reality, opening place to the development of actions to basic attention. However, it’s necessary to plan, evaluate and monitor better this level of attention. Methodology: It is a descriptive cross-sectional cohort study, that the selected information was done based on the national base database external evaluation of Improvement Program Access and Quality of Basic Attention (PMAQ-AB) in Goiás, accomplished between July and September of 2012. The sample consists of 677 professionals that answered the interviews about the external evaluation of the module II. Results: The identification profile of interviewers showed that nurses are most in Basic Attention Management. Although post-graduating index is considerable , few are who finished or are concluding postgraduate stricto sensu. The career plan isn't a priority on the municipalities, without recognizing the professional development. The permanent education, although is present everyday of groups of Basic Attention, sometimes doesn’t serve the needs of the teams. The development of actions to organizing of work process was cited by 82,1% of teams. On the other hand, the data analysis showed that the planning stages aren’t following the systematic form, even with institutional support and regular together in the most teams. The population without coverage, near the catchment area of most teams, can difficult this process. Noticed, important management tools like the search of satisfaction of user, aren't using that much the planning by teams analyzed. Conclusion: With the study , we can conclude that PMAQ-AB is the method that the search of Basic Attention and SUS consolidation. The analyzed data showed that Basic Attention in Goiás needs a better management process, like in all Brazilian reality. Thus, it’s necessary to produce new studies to measure the impact of PMAQ-AB in Goiás.
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    Atuação do agente comunitário de saúde durante a visita domiciliar na perspectiva do usuário
    (Universidade Federal de Goiás, 2017-11-07) Araújo, Kárita Silva; Queiroz, Maria Goretti;; Queiroz, Maria Goretti; Souza, Marta Rovery de; Rocha, Barbara Souza
    The action of the Community Health Agent (ACS) with the population attached is an essential condition for the organization of public health services. However, it is necessary to know how this work is developed and the users' satisfaction with these activities. Within this perspective, this study aimed to understand the performance of the ACS during home visits from the perspective of the population served by the Family Health Strategy (ESF) in a medium-sized municipality in Goiás. This study was carried out in a municipality located in the state of Goiás, with medium size, with a sample composed of 400 families attended by the ACS of the municipality. The data collection instrument was composed of a structured questionnaire, whose questions sought to collect data that allowed to understand the work of the ACS in the community served. It was tried to verify if the scope of work defined by the National Basic Attention Policy (BANP) for the ACS is being fulfilled, in addition to the establishment of a link, in the user's perception, since these assignments should be performed by the ACS during the visit household (VD). The questionnaire was submitted to the Cronbach Alpha Test, whose value was 0.83. Data were submitted to associations test, Student's t-test and chi-square test. Regarding the work of the ACS during the VD, it was observed that the population understands that the RV is important, that the ACS are prepared to perform them and that the number of visits made to the family and the time dedicated to each of these visits are satisfactory. The satisfaction with the RV for families with people with disabilities obtained lower indexes. Regarding the relationship between the ACS and the population, it was identified that the families consider the work of the ACS and the VD to be important, in addition to declaring that they trust this professional. However, this confidence does not turn into a demand for ACS in case of illness in the family. Women up to 59 years of age do not seek ACS in case of illness in the family. Regarding the fulfillment of the assignments provided for in the PNAB, it was observed that approximately half of the participants are satisfied with the followup of the ACS in case of illness. Regarding the guidelines for healthy food and eating disorders, less than half of the participants expressed satisfaction with the ACS 'performance, as well as with the demand for adolescents involved in drugs and sex and with the conference on the criteria of the Bolsa Família program. The need to improve the performance of ACS was identified, but it was not possible to indicate which aspects should be improved. The services available at the Basic Health Unit (UBS) had a higher rate of user satisfaction (72.1%). These results demonstrate that the population knows the ACS and recognizes the importance of their work and the RV, but these feelings are not turning into action, such as the search for ACS in case of illness in the families. The population surveyed does not understand that the ACS is performing all its duties, as provided in the PNAB. Thus, it is observed that there is a wide field of actions, which can be developed by the ACS, aiming to contribute to the fulfillment of its actions, as foreseen in the PNAB.
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    Hipodermóclise: uma proposta de protocolo de segurança do paciente em uso de infusão subcutânea
    (Universidade Federal de Goiás, 2017-05-19) Araújo, Camila Pinheiro; Junqueira, Ana Luiza Neto;; Junqueira, Ana Luiza Neto;; Queiroz, Ana Lúcia Bezerra de; Galdino Junior, Hélio
    Objective: Make an administration of drugs/infusion fluids protocol by subcutaneous path, to nursing professionals of an federal school hospital in the city of Goiânia_GO. Methodology: Elaboration of an intervention protocol which will be realized a bibliographic literature rewiew, between the months of march and august of 2016 ,with national and international publications preferentially on the last five years, that treats about drug/fluids administration by subcutaneous path. Results: The literature range used to compose this protocol shows that subcutaneous therapy back to discussion in several landscape practices. Final Considerations : This work postivly contributtes to nursing professinals , by presenting na hipodermoclysis protocol, based on pacient security , wth a large range technic to acadhemic , cienthific and professional centre.