[Care and restraint, when the law questions nursing practice]. / Soins sous contrainte, quand le droit interroge la pratique.

With the reforms of 2011 and 2013 relating to psychiatric hospitalisation, raises the question of the suitability of modern psychiatric practice with regard to a person's recognised principles and basic rights. Achieving a balance is difficult and the Constitutional Council has joined the debate, bringing to an end any idea of compromise between safety and freedom. A decision which was made as a result of a clarification of certain regulations which have proved controversial from the point of view of individual liberties.

Atuação da enfermagem na prevenção e controle de infecção de corrente sanguínea relacionada a cateter / Actuación de la enfermería en la prevención y control de infección de torrente sanguíneo relacionada a catéter / Nursing care in the prevention and control of catheter-related bloodstream infections

Medidas preventivas relacionadas aos procedimentos com acesso vascular vêm sendo negligenciadas na prática por todos os profissionais envolvidos, com destaque para a equipe de enfermagem. Com o intuito de discutir o papel dessa equipe sob a perspectiva da prevenção e controle de infecções de corrente sanguínea relacionadas a cateter, procedeu-se à leitura e análise de textos científicos e normativas atuais, nacionais e internacionais. Apesar da existência de diretrizes, acreditamos que esforços devem ser direcionados para a formação profissional e para programas de educação permanentes, com foco na consciência crítica e posicionamento ético para transformação dessa realidade.

Preventive measures relating to vascular access procedures are being neglected in practice by all personnel involved, especially nursing staff. In order to discuss the role of the nursing team in the prevention and control of catheter-related bloodstream infections, related national and international scientific texts and current regulations were read and analyzed. Although guidelines do exist, we believe that efforts focusing on critical awareness and ethical attitudes need to be directed to nursing training and continuing professional development programs in order to change this situation.

Las medidas preventivas relacionadas con los procedimientos de acceso vascular han sido pasados por alto en la práctica por todos los profesionales implicados, especialmente el personal de enfermería. Con el fin de discutir el papel de ese equipo desde la perspectiva de la prevención y control de infecciones del torrente sanguíneo relacionadas con el catéter, se realizó la lectura y análisis de textos científicos y normas vigentes, nacionales e internacionales. A pesar de la existencia de directrices, creemos que esfuerzos deben dirigirse a la formación profesional y programas de educación permanentes, centrándose en la conciencia crítica y la posición ética para cambiar esa realidad.

Adequação do dimensionamento de pessoal de enfermagem em uma UTI segundo a Resolução COFEN nº 293/2004 / Adequacy of the dimension of nursing staff at an ICU according to COFEN´s Resolution nº 293/2004

O objetivo foi verificar o perfil de paciente atendido e realizar o dimensionamento da equipe de Enfermagem na UTI de um hospital filantrópico. É um estudo explorativo e descritivo utilizando o Sistema de Classificação de Pacientes e a Resolução COFEN 293/2004. A taxa de ocupação foi de 92,6 por cento. Dos pacientes atendidos 46 por cento são cuidados intensivos, 30,9 por cento semi-intensivos, 21,7 por cento intermediários e 1,29 por cento cuidados mínimos. A equipe de três enfermeiros e 19 técnicos técnicos de enfermagem deve ser adequada para 10 e 12 profissionais respectivamente. O dimensionamento é a etapa inicial para uma assistência ideal.

Educación Médica de Postgrado Estándares globales de la WFME para la mejora de la calidad / No disponible

No disponible

From a regulatory lens: a perspective on the delegation of nursing activities to unlicensed assistive personnel.

Along with the reforming of health care, nursing services and related regulatory approaches are concurrently adapting. As the health care environment changes, the number and preparation of individuals who perform health-related activities has increased dramatically. Heightened interest is expressed at both ends of the nursing care delivery spectrum, unlicensed and advanced nursing practice. Boards of nursing, the States' regulatory arm over the profession, pay particular attention to public health and safety issues attached to the delegation of nursing tasks to unlicensed assistive personnel (UAPs). Equally important to the appropriate use of delegation is the provision of adequate supervision of those who are serving in the role of "delegatee." Mechanisms exist in a number of states whereby professional nurses can ascertain the level of competence of a UAP and feel assured that safe and appropriate care can be delegated. It is the role of the professional nurse to provide the required supervision, once a nursing activity is delegated. Nurse practice acts should not be used as barriers to escape required and prudent alterations to the traditional delivery of nursing care. Conversely, these same acts should not be manipulatively circumvented solely in the name of cost containment and as a needed response to "health care reform." As health care reforms, humanity would be best served with public or patient safety and protection as a guiding principle.