scholarly journals 200 Years of Florence and the challenges of nursing practices management in the COVID-19 pandemic

2020 ◽  
Vol 28 ◽  
Author(s):  
Daniela Savi Geremia ◽  
Carine Vendruscolo ◽  
Ianka Cristina Celuppi ◽  
Edlamar Kátia Adamy ◽  
Beatriz Rosana Gonçalves de Oliveira Toso ◽  
...  
Keyword(s):  
Health System ◽  
Nurse Managers ◽  
Scientific Evidence ◽  
Public Health Practice ◽  
Knowledge Based ◽  
Florence Nightingale ◽  
Unified Health System ◽  
Analysis Technique ◽  
Main Ideas ◽  
Operational Capacity

Objective to analyze the main challenges of nursing in facing Coronavirus Disease-19 under the perspective of nurse managers in the west macro-region of Santa Catarina. Method it consists of a qualitative study, whose data collection was done through interviews with nurses who represent the management of health care network in the region. The analysis technique used was the Discourse of the Collective Subject (DCS). Results the legacy of Florence Nightingale to contemporary nursing practice; the weaknesses and the technical operational capacity with which nursing faces in the Unified Health System (Sistema Único de Saúde - SUS); the strategies for strengthening the Unified Health System and qualification of nursing practices; and the potentialities identified in the pandemic scenario were the main ideas that emerged. In the bicentennial year of Florence Nightingale, nurses recognize her legacy to public health practice and management. Several variables interfere in professional practice, such as epidemiological aspects, working conditions, and care management in a pandemic. Conclusion the pandemic scenario has taken nursing to a position of practical and scientific protagonism as a result of its proactivity and leadership in the search for knowledge based on scientific evidence.

OP131 Rapid Review For Policy: Interchangeability Of Biological Medicines

2019 ◽  
Vol 35 (S1) ◽  
pp. 30-30
Author(s):  
Daniela Rego ◽  
Cecilia Farinasso ◽  
Roberta Borges Silva ◽  
Dalila Fernandes Gomes ◽  
Aurelina Aguiar de Aguiar ◽  
...  
Keyword(s):  
Health System ◽  
Systematic Reviews ◽  
Evidence Synthesis ◽  
Scientific Evidence ◽  
National Policy ◽  
Primary Objective ◽  
Rapid Review ◽  
Pharmacovigilance System ◽  
Independent Manner ◽  
Unified Health System

IntroductionDue to the high judicialization rates which pressure the financing of biologic medicines by the Brazilian Unified Health System (Sistema Único de Saúde - SUS), it has been decided to formulate the National Policy for Biologic Medicines. After identification of problems and prioritization, interchangeability based only on economic criteria was the main problem to be confronted. The primary objective of this study was to identify political options to approach the problem of interchangeability in systematic reviews.MethodsWe conducted a rapid evidence synthesis for policy based on an adaptation of the SUPPORT tools, and searched in six literature databases. The selection of studies was performed in a systematic, transparent and independent manner. The International Network of Agencies in Health Technology Assessment (INAHTA) members were consulted to learn how this practice occurs worldwide.ResultsWe included seven systematic reviews and one policy brief, whose options to approach the problem were: production of robust scientific evidence on interchangeability; implementation of a pharmacovigilance system; appreciation of the clinical efficacy in the practice of interchangeability; and educational strategies for healthcare professionals in Brazil. Nine countries responded to our query.ConclusionsEvidence-informed policy has a central role for the Brazilian Ministry of Health. The present rapid evidence synthesis for policy will subsidize decision making regarding the interchangeability of biologic medicines within the Brazilian Unified Health System.

scholarly journals Health care for transgender people in Brazil: a systematic review protocol

2020 ◽  
Author(s):  
Rafael Rodolfo Tomaz de Lima ◽  
Taiana Brito Menezes Flor ◽  
Alexandre Bezerra Silva ◽  
Luiz Roberto Augusto Noro
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health System ◽  
Scientific Evidence ◽  
Empirical Studies ◽  
Assessment Tools ◽  
Systematic Review Protocol ◽  
Transgender People ◽  
Unified Health System ◽  
Review Protocol

Abstract Background At the global level, transgender people (transvestites and transsexuals) live in worse health and living conditions due to the stigma and violence they face, including within health services. In Brazil, the Unified Health System must offer comprehensive care to the population, regardless of social class and gender. The aim of this article is to establish a systematic review protocol to analyze how health care occurs for the transgender population in the Unified Health System. Methods This protocol was guided by PRISMA-P and the bases SCIELO, LILACS, BVS and PUBMED will be consulted. Empirical studies, with a qualitative or quantitative approach, that deal with health care for the transgender population in the Unified Health System, where the respondents are transgender people, health professionals or health managers, will be included in the systematic review. For the definition of the final sample, the articles will undergo an assessment of methodological quality and risk of bias, with the help of the critical assessment tools of the Joanna Briggs Institute, using a specific checklist for each type of study. The synthesis of the findings will be carried out through the formal narrative and the presentation of tables with summarized data, with the final writing of the review guided by PRISMA. Discussion Based on scientific evidence, it is intended to present an overview of health care for the transgender population in the Unified Health System. In addition, to point out possible strategies to qualify the political, organizational and attitudinal aspects related to health care for that population. Systematic review registration: PROSPERO CRD42020188719.

scholarly journals Retrospective study of the distribution of doctors in municipalities of extreme poverty in Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
B L O Luizeti ◽  
E M M Massuda ◽  
L F G Garcia
Keyword(s):  
Public Health ◽  
Health System ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Extreme Poverty ◽  
The Public ◽  
The North ◽  
Unified Health System ◽  
Shortage Of Doctors ◽  
Demographic Distribution

Abstract In view of the national scenario of scarcity of material and human resources in public health in Brazil, the survey verified the demographics of doctors who attend the Unified Health System (SUS) in municipalities of extreme poverty. An observational, analytical and cross-sectional study was carried out, based on secondary quantitative data from the Department of Informatics of the SUS using the TABNET of December 2019. The care networks variable was restricted to infer the number of physicians who attend the SUS in extreme poverty municipalities in Brazil. Municipalities of extreme poverty are those that at least 20% of the population have a household income of up to 145 reais per capita monthly. In Brazil, there are 1526 municipalities in extreme poverty, 27.4% of the country's total municipalities. 14,907 doctors linked to SUS work in this condition, 3.19% of the total of these professionals in Brazil. There is still disproportion between regions: North concentrates 11.2% of the municipalities in extreme poverty and 8.61% of the total number of doctors; Northeast, with 61.33% of these municipalities, for 61.5% of doctors; Southeast, with 15.46% of the municipalities in this condition, has 20.6% of doctors; South concentrates 10.87% of the municipalities under discussion with 5.61% of doctors and the Midwest, with 4.87% of these municipalities, has 3.54% of doctors. Between 2009 and 2018, there was a 39% increase in the number of doctors in these locations, however, for 2019, there was a decrease of 3.89%. The medical demographic distribution in Brazil is uneven, especially in the North. There is also the vulnerability of this population in view of the observed reduction in the number of professionals between 2018 and 2019 in municipalities of extreme poverty, for political reasons. It is evident the need to restructure the health system to guarantee access to health for this population, through the attraction and fixation of doctors in needy regions in Brazil. Key messages Shortage of doctors in extreme poverty municipalities reinforces the health vulnerability of the population in Brazil. The uneven medical demography in Brazil requires restructuring in the public health system.

scholarly journals The Quest to Extend Health Services to Vulnerable Substance Users in Rio de Janeiro, Brazil in the Context of an Unfolding Economic Crisis

2016 ◽  
Vol 47 (3) ◽  
pp. 477-488 ◽  
Author(s):  
Noa Krawczyk ◽  
Deanna Kerrigan ◽  
Francisco Inácio Bastos
Keyword(s):  
Health Services ◽  
Health System ◽  
Economic Crisis ◽  
Rio De Janeiro ◽  
Crack Cocaine ◽  
Access To Health Services ◽  
Government Programs ◽  
Substance Users ◽  
Unified Health System ◽  
Harsh Criticism

Calls to address crack-cocaine use in Brazil among homeless and street-frequenting populations who are in urgent need of health services have questioned the capacity of the Brazilian Unified Health System to attend to the nation’s most marginalized citizens. In recent years, Brazil has launched several actions to escalate care for substance users, yet many obstacles hindering accessibility and effectiveness of services remain. Paradoxically, these actions have been implemented in the context of a growing economic crisis, and expanding services for a population of poor and stigmatized substance users while cutting other government programs tends to elicit harsh criticism from citizens. In consequence of such prospects, this commentary aims to discuss barriers marginalized substance users face in accessing health services that are at risk of worsening with government cutbacks. Using Rio de Janeiro as an example, we explore two primary issues: the resource-strained, under-staffed and decentralized nature of the Brazilian Unified Health System and the pervading stigma that bars vulnerable citizens from official structures and services. Abandoning initiated government efforts to increase access to health services would risk maintaining vulnerable citizens at the margins of public structures, inhibiting the opportunity to offer this population humane and urgently needed treatment and care.

scholarly journals Changes in contraception use among Brazilian women after childbirth, 2006-2013

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Felisbino-Mendes ◽  
B Barrozo Siqueira
Keyword(s):  
Health System ◽  
Secondary Data ◽  
Reproductive Age ◽  
Cross Sectional ◽  
Regional Inequalities ◽  
Unified Health System ◽  
Contraception Use ◽  
High Prevalence ◽  
Modern Methods ◽  
Low Prevalence

Abstract Introduction There are gaps in knowledge regarding the neglected and vulnerable subgroups of FP actions in Brazil, such as postpartum women and women in general, regardless of their marital status. Objective To assess changes in the prevalence of use and in the contraceptive pattern of Brazilian women up to two years after pregnancy, between 2006 and 2013. Methods Cross-sectional, descriptive and analytical study which used secondary data from national surveys. We studied Brazilian women with up to 2 years postpartum, of reproductive age, sexually active, non-pregnant and menstruating, and compared them with all the other women. We estimated the prevalence of use, contraception pattern of contraception and ranking of modern methods. Percentual change in indicators between the years was evaluated by calculating the difference between estimates. Results 85% of Brazilian women used CM, remaining stable in 2006 and 2013, with a high prevalence of modern methods use. An increase in the use of CM was observed among those with up to six months postpartum (71.0% to 89.0%). Pills and condoms accounted for about 60% of modern methods used in the postpartum period in both surveys. There was an increase in dual protection (2.9% to 10.1%) and contraceptive insecurity (1.6% to 5.7%) and a reduction in sterilization (16.2% to 13.4%) and traditional methods (2.1% to 1.4%). Conclusions Even with the maintenance of a high prevalence of use of CM and with the increase in contraception among women with up to six months postpartum, regional inequalities in access to CM and low prevalence of the use of other methods made available by the Unified Health System (SUS) persist, pointing out the maintenance of the insufficient care, failures in the means to regulate fertility and that public policies still hinder to guarantee the sexual and reproductive rights of the most vulnerable population. Key messages Regional inequalities in access to contraceptive methods and low prevalence of other methods made available by the Unified Health System (SUS) persist. There was an increase in contraception use among women with up to six months postpartum in Brazil.

scholarly journals Management of pharmaceutical services in the Brazilian primary health care

2017 ◽  
Vol 51 (suppl.2) ◽  
Author(s):  
Letícia Farias Gerlack ◽  
Margô Gomes de Oliveira Karnikowski ◽  
Camila Alves Areda ◽  
Dayani Galato ◽  
Aline Gomes de Oliveira ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Pharmaceutical Services ◽  
Limiting Factors ◽  
Health Board ◽  
Complex Samples ◽  
Financial Autonomy ◽  
Unified Health System ◽  
Primary Health

OBJECTIVE: To identify limiting factors in the management of pharmaceutical services in the primary health care provided by the Brazilian Unified Health System (SUS). METHODS: This study was based on the data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos no Brasil (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines), and it was conducted by interviews with professionals responsible for pharmaceutical services in Brazilian cities, in 2015. To identify the management limiting factors, we considered the organizational, operational, and sustainability indicators of the management. For the analyses, we included the weights and structure of analysis plan for complex samples. The results were expressed by frequencies and measures of central tendency with 95% confidence interval, considering the Brazilian geographic regions. RESULTS: We identified the following limiting factors: lack of pharmaceutical services in the Municipal Health Secretariat organization chart (24%) and in the health plan (18%); lack of participation of managers in the Health Board and the absence of reference to this topic in the agenda of meetings (58.4%); lack of financial autonomy (61.5%) and lack of knowledge on the available values (81.7%); lack of adoption of operational procedures (about 50%) for selection, scheduling, and acquisition; and the fact that most professionals evaluate the organization of pharmaceutical services as good and great (58.8%), despite the worrisome indicators. CONCLUSIONS: Pharmaceutical services management is currently supported by a legal and political framework that should guide and contribute to improve the pharmaceutical services in the Brazilian Unified Health System primary health care. However, there is a mismatch between the goals established by these guidelines and what is actually happening

scholarly journals Evidence-Based Medicine in judicial decisions concerning right to healthcare

2016 ◽  
Vol 14 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Eduardo Rocha Dias ◽  
Geraldo Bezerra da Silva Junior
Keyword(s):  
Health Insurance ◽  
Evidence Based Medicine ◽  
Private Health Insurance ◽  
Scientific Evidence ◽  
Federal Court ◽  
Public Healthcare ◽  
Evidence Based ◽  
Unified Health System ◽  
The Individual ◽  
Based Medicine

ABSTRACT Objective To analyze, from the examination of decisions issued by Brazilian courts, how Evidence-Based Medicine was applied and if it led to well-founded decisions, searching the best scientific knowledge. Methods The decisions made by the Federal Courts were searched, with no time limits, at the website of the Federal Court Council, using the expression “Evidence-Based Medicine”. With regard to decisions issued by the court of the State of São Paulo, the search was done at the webpage and applying the same terms and criterion as to time. Next, a qualitative analysis of the decisions was conducted for each action, to verify if the patient/plaintiff’s situation, as well as the efficacy or inefficacy of treatments or drugs addressed in existing protocols were considered before the court granted the provision claimed by the plaintiff. Results In less than one-third of the decisions there was an appropriate discussion about efficacy of the procedure sought in court, in comparison to other procedures available in clinical guidelines adopted by the Brazilian Unified Health System (Sistema Único de Saúde) or by private health insurance plans, considering the individual situation. The majority of the decisions involved private health insurance plans (n=13, 68%). Conclusion The number of decisions that did consider scientific evidence and the peculiarities of each patient was a concern. Further discussion on Evidence-Based Medicine in judgments involving public healthcare are required.

scholarly journals Overview of hemodialysis treatment funded by the Brazilian Unified Health System - An economic perspective

2015 ◽  
Vol 37 (3) ◽  
Author(s):  
Fabiana Gatti de Menezes ◽  
Daniela Veit Barreto ◽  
Rodrigo Martins Abreu ◽  
Fabiana Roveda ◽  
Roberto Flavio Silva Pecoits Filho
Keyword(s):  
Health System ◽  
Economic Perspective ◽  
Hemodialysis Treatment ◽  
Unified Health System

scholarly journals Nursing care in the anesthetic procedure: an integrative review

2016 ◽  
Vol 50 (1) ◽  
pp. 154-162 ◽  
Author(s):  
Cassiane de Santana Lemos ◽  
Aparecida de Cassia Giani Peniche
Keyword(s):  
United States ◽  
Health System ◽  
Patient Care ◽  
Nursing Care ◽  
Scientific Evidence ◽  
The United States ◽  
Nurse Anesthetists ◽  
Integrative Review ◽  
Nursing Professional

Abstract OBJECTIVE To search for the scientific evidence available on nursing professional actions during the anesthetic procedure. METHOD An integrative review of articles in Portuguese, English and Spanish, indexed in MEDLINE/PubMed, CINAHL, LILACS, National Cochrane, SciELO databases and the VHL portal. RESULTS Seven studies were analyzed, showing nurse anesthetists' work in countries such as the United States and parts of Europe, with the formulation of a plan for anesthesia and patient care regarding the verification of materials and intraoperative controls. The barriers to their performance involved working in conjunction with or supervised by anesthesiologists, the lack of government guidelines and policies for the legal exercise of the profession, and the conflict between nursing and the health system for maintenance of the performance in places with legislation and defined protocols for the specialty. Conclusion Despite the methodological weaknesses found, the studies indicated a wide diversity of nursing work. Furthermore, in countries absent of the specialty, like Brazil, the need to develop guidelines for care during the anesthetic procedure was observed.

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