Percepções de profissionais de enfermagem acerca da integração do técnico de enfermagem na sistematização da assistência / Perceptions of nursing professionals regarding the integration of nursing technicians in the systematization of care

Objetivo: Descrever as percepções de docentes e de profissionais da assistência acerca da integração do técnico de enfermagem na Sistematização da Assistência de Enfermagem (SAE). Métodos: Trata-se de estudo descritivo, de abordagem qualitativa. Participaram sete docentes e 13 técnicos de enfermagem vinculados a um hospital universitário do Nordeste brasileiro. A coleta de dados ocorreu a partir da técnica do grupo focal e o conteúdo textual foi submetido à análise lexicográfica. Resultados: As percepções dos docentes resultaram na análise de quatro classes: potencialidades da integração do técnico na SAE; entraves e fragilidades; formação dos técnicos; e ensino em serviço como primordial. Quanto às opiniões dos técnicos, três classes foram analisadas: representações subjetivas; potencialidades da SAE; e possibilidades de contribuição do técnico de enfermagem. Conclusão: Docentes e profissionais da assistência descrevem as potencialidades da integração do técnico de enfermagem na SAE e a reconhecem como condicionante para efetivação deste método de trabalho.

Use and influence of Delivery and Birth Plans in the humanizing delivery process / Uso e influência dos Planos de Parto e Nascimento no processo de parto humanizado / Uso e influencia de los Planes de Parto y Nacimiento en el proceso de parto humanizado

get to know, analyze and describe the current situation of the Delivery and Birth Plans in our context, comparing the delivery and birth process between women who presented a Delivery and Birth Plan and those who did not.

conhecer, analisar e descrever a situação atual dos Planos de Parto e Nascimento no contexto estudado, comparando o processo de parto e sua finalização entre as mulheres que apresentaram e as que não apresentaram um Plano de Parto e Nascimento.

conocer, analizar y describir la situación actual de los Planes de Parto y Nacimiento en nuestro entorno, comparando el proceso de parto y la finalización del mismo entre las mujeres que han presentado un Plan de Parto y Nacimiento y las que no lo han hecho.

Comparison of Families with and without a Suicide Prevention Plan Following a Suicidal Attempt by a Family Member

The frequency and extent of the existence of a familial suicide prevention plan may differ across cultures. The aim of this work was, therefore, to determine how common it was for families to develop a suicide prevention plan and to compare the main measures used by families with and without such a plan, after an attempt to commit suicide was made by a member of a family living in a rural area of Korea. On the basis of the presence or absence of a familial suicide prevention plan, we compared 50 recruited families that were divided into 2 groups, with Group A (31 families) employing a familial suicide prevention plan after a suicide attempt by a family member, and Group B (19 families) not doing so. The strategy that was employed most frequently to prevent a reoccurrence among both populations was promoting communication among family members, followed by seeking psychological counseling and/or psychiatric treatment. Contrary to our expectation, the economic burden from medical treatment after a suicide attempt did not influence the establishment of a familial suicide prevention plan. It is a pressing social issue that 38% (19 of 50) of families in this study did not employ a familial suicide prevention plan, even after a family member had attempted suicide. Regional suicide prevention centers and/or health authorities should pay particular attention to these patients and their families.

Assessment of the effect of implementation of global initiatives for asthma [GINA] guidelines in the outcome of asthma exacerbation in the Emergency Department

Asthma is a continuous significant health problem. Strategies for treating exacerbations are best adapted and implemented at a local level. Severe exacerbations are potentially life threatening, and their treatment requires close supervision. The severity of the exacerbation determines the treatment administered. Indices of severity, particularly peak expiratory flow [PEF], pulse rate, respiratory rate, and pulse oximetry should be monitored during treatment. The aim of this work was to assess the effect of the implementation of the Global Initiative for Asthma [GINA] guidelines in the prognosis and the outcome of asthma exacerbation in the emergency department. The study was conducted on one hundred asthmatic patients. All patients were informed about the study and gave their consents. Patients were subjected to full history taking and clinical evaluation. Investigations were done in the form of peak flow rate [PFR] measurement, pulse oximetry assessment, ABG analysis [for only 17 patients], chest X-ray [it is not routinely recommended] and complete blood count [if needed]. Then patients were classified according to their attacks. All patients were managed according to GINA guidelines. Older patients were significantly suffering from severe to life threatening attacks than younger patients. We found that 12% of patients had occupational related asthma in relation to 88% of patients had non-occupational related asthma. There were no statistical significant differences between classification of severity of current attack and previous emergency department [ED] visits/year. There were no statistical significant differences between the studied groups regarding temperature. Systolic and diastolic blood pressure had statistically significant lower values in patients with severe to life threatening attacks than those with mild to moderate attacks. Severe to life threatening group had respiratory rate higher than mild to moderate group. Mild to moderate group had PEF and SaO2% higher than severe to life threatening group. PEF was statistically higher post treatment than pre treatment. Three patients of 17 had PaCo2 >45 mmHg with hypoxemia and respiratory acidosis and they admitted to the intensive care unit [ICU]. All patients in ED were assisted to determine the severity of asthma concomitant with administration of initial treatment [plan A], which is oxygen to achieve O2 saturation >/= 92%, inhaled B2 adrenergic bronchodilator and an oral or intravenous dose of corticosteroids. Five patients met a good response so they enter in [plan C1]. Seventy-five patients met with the criteria of moderate episode they go to plan B1, 68 patients of them [about 90%] had a good response within 2 h so go to plan C1 and the rest 7 patients [10%] had an incomplete response go to plan C2. Twenty patients met with criteria of severe episode, 17 of them [85%] with incomplete response move to plan C2, and the rest 3 patients [15%] had a poor response and moved to plan C3, no improvement noticed so they were admitted to the ICU. Hospitalization was done to 11 patients who met a poor response [plan C2], 86 patients were discharged from the ED [73 patients from plan C1 and 13 patients from plan C2]. Severe to life threatening group stayed in ED longer than mild to moderate group. All patients presenting in the emergency department with asthma exacerbations should be evaluated and triaged immediately and must be treated according to their severity of classification using GINA guidelines. Measurements of airflow obstruction, using peak expiratory flow, can help to guide therapy for acute asthma. Continuous monitoring of oxyhaemoglobin saturation by pulse oximetry should be undertaken for all patients with acute exacerbation of asthma. We must; educate patients in ED about the nature of asthma and its therapy, educate patients how to use inhalers, encourage patients to use spirometer at home and discharge each patient with ED-asthma discharge plan

Veintisiete años de seguimiento de las clínicas integrales de la Facultad de Odontología de la Universidad de Antioquia (1970 - 1996). Parte III: evaluación del período 1990 - 1996 / A twenty-seven year evaluation of the comprehensive clinics

El propósito de esta investigación fue evaluar las clínicas integrales de la Facultad de Odontología de la Universidad de Antioquia, como método clínico en el aspecto de la atención odontológica al paciente y en componente curricular. Se encontraron problemas actidudinales y técnico-administrativos en ambos, especialmente por estar desfasado el método clínico docente con el nuevo currículo de la Facultad, y por los bajos resultados de los "índices de calidad" encontrados. Se plantea la necesidad de un cambio estructural y conceptual de la docencia clínica de la Facultad, acorde con los nuevos paradigmas docentes y de prestación de servicios

Formación de recursos humanos para la atención de víctimas pediátricas traumatizadas: cursos A.I.T.P., una experiencia docente / Teaching model in advanced pediatric trauma courses

Introducción: Se presenta la experiencia de 5 años de los Cursos A.I.T.P. Cursos de Atención Inicial en Trauma pediátrico. Los objetivos de este trabajo son: a) presentar la experiencia docente de los cursos avanzados sobre la atención inicial en trauma pediátrico, b) evaluar el desarrollo de los cursos, parte de un programa de formación de recursos humanos, inédito en nuestro medio y original en el campo de la Pediatría, c) evaluar el desempeño y características de los participantes y d) analizar la respuesta de los alumnos sobre los cursos. La experiencia comunicada en este trabajo se basa en el análisis de los cursos Atención Inicial en Trauma Pediátrico o Cursos A.I.T.P. del Programa Categorización y Atención del Paciente Pediátrico Accidentado (Programa C.A.P.P.A.). Método: Se describe la dinámica pedagógica de los Cursos A.I.T.P., y el tipo de datos recogidos en una base de datos sobre el desempeño de los participantes así como sobre la evaluación que hacen los mismos de los cursos. Resultados: Entre 1991 y 1995 se realizaron 15 Cursos A.I.T.P. en los cuales participaron 274 profesionales entre médicos y enfermeras. La edad media para los primeros fue de 30,4 años y la media de años de recibidos fue de 8,4 años. La distribución por sexo en los médicos fue predominante el masculino y en las enfermeras el femenino. El 94,9 por ciento profesionales de distintos puntos del país y un 5,1 por ciento fueron profesionales de países vecinos. El índice de ausentismo fue del 9 por ciento. El índice de aprobados fue del 81 por ciento. La evaluación por parte de los alumnos fue muy favorable en el 97 por ciento de las observaciones y el 100 por ciento recomendaría a sus colegas la participación en los Cursos A.I.T.P. Comentarios: Los Cursos A.I.T.P. son una experiencia docente original en el campo de formación de recursos humanos en el campo de la Pediatría. La presencia de profesionales de diversas especialidades, provenientes de Capital Federal y distintas provincias, revela el interés despertado en los equipos de salud por este tema. La participación de médicos y enfermeras extranjeros es parte de una importante tarea de integración entre países vecinos y de participación de los logros alcanzados en trauma pediátrico...