Nasogastric/Nasoenteric tube-related incidents in hospitalised patients: a study protocol of a multicentre prospective cohort study.

INTRODUCTION: Hospitalised patients with nasogastric/nasoenteric tube (NGT/NET) are at constant risk of incidents; therefore, healthcare professionals need to routinely monitor risks and adopt strategies for patient safety and quality of care. AIM: This study aimed to evaluate the NGT/NET-related incidents in hospitalised patients and associated factors. METHODS: This is a multicentre study, with a prospective cohort design. Data will be collected at the general medical ward of seven Brazilian hospitals in the north, northeast, southeast and south. The sample will consist of 391 patients that require an NGT/NET during hospitalisation. Three different methods will be used to identify the incidents: (1) healthcare professionals and patients/caregivers will be required to report any NGT/NET-related incidents; (2) researchers will visit the wards to get information about the incidents with healthcare professionals and patients/caregivers; (3) the researchers will review the medical records looking for information on the occurrence of any NGT/NET-related incidents. Demographic, clinical and therapeutic details will be obtained from the medical records and will be registered in an electronic data collection tool developed for the purposes of this study. The complexity of patients will be assessed by the Patient Classification System, and the severity of comorbid diseases will be assessed through the Charlson Comorbidity Index. IMPLICATION FOR PRACTICE: The results may encourage the use of evidence effectively to influence the scientific foundation for clinical practice and the development of evidence-based policies that will prevent, manage and eliminate complications caused by NGT/NET-related incidents, and improve the quality and safety of care provided to hospitalised patients. ETHICS AND DISSEMINATION: The study has been approved by the Research Ethics Committee. Detailed information about the study can be provided by the principal investigator. The findings will be reported through academic journals, seminar and conference presentations, social media, print media, the internet and community/stakeholder engagement activities.

As ações dos trabalhadores de saúde: o enfoque na assistência em hanseníase / The health action of workers: the approach on the leprosy assistance

Este estudo tomou como objeto as práticas e os saberes que operam nas ações de saúde dos trabalhadores de dois centros de referência em hanseníase de um determinado território do Município de São Paulo. Trata-se de um estudo descritivo, cujo objetivo geral foi caracterizar as ações de saúde que operam na assistência dos agentes em saúde, em serviços de referência à hanseníase. O material empírico foi obtido por um formulário semi-estruturado, no período de agosto a novembro de 2006 e foram entrevistados 11 profissionais, após permitirem sua participação na pesquisa. Para a análise, foram utilizados os procedimentos, segundo a análise de conteúdo de Bardin, que possibilitaram a visualização das seguintes categorias empíricas: práticas de saúde; processo de trabalho em saúde e processo saúde-doença. A análise mostrou que os processos de trabalho, de interação dos trabalhadores nas equipes e o de qualificação dos trabalhadores na área da hanseníase expressam-se de forma homogênea e deficitária entre os estudados. Permitiu também, evidenciar que as práticas de saúde dos trabalhadores dos serviços estudados estão fortemente vinculadas à assistência respaldada no modelo biológico, pois realizam práticas de saúde centradas na atenção individualizada e pautados na multicausalidade do processo saúde-doença. Neste estudo, evidencia-se a necessidade de que as práticas de saúde na área da hanseníase sejam incorporadas a um saber ampliado à intervenção do coletivoque possibilite trazer contribuições para a meta de eliminação da doença e que sejam redefinidos os processos de trabalho, baseados no âmbito da determinação e não só nos resultados do processo saúde-doença.

This study has taken as object the practice and knowledge that are performed in the health action of workers in two reference centers of leprosy in a specific area in São Paulo. It’s a descriptive study which has had as main objective the characterization of health action that has been performed in the agent’s assistance in health, in a reference center of leprosy. The empiric material was obtained through the semi-structured form, from August to November 2006 and eleven professionals were interviewed after taking part on this study. To the analysis, the procedures were used according to Bardin content analysis which enabled the visualization of the following empiric categories: health practice; work process in health and health-disease processes. The analysis showed that the work process, the way of worker’s interaction in the groups and their qualification in the leprosy area express a homogenous and deficient way among the people studied. Through the analysis it was evident that the health practice of workers in the studied service are closely related to the repaired assistance in the biological model which perform health practice focused on the individualized attention and centered on the multi-causes of the health-disease process. It is clear in this study, the necessity of these health practices of leprosy to be incorporated an enlarged knowledge into the group intervention in order to bring contributions to the disease removal target and tore-define the work processes based on the ambit of determination and not only on the results of the health-disease process.