scholarly journals Teleconsultation and the challenges for maintaining health care in times of pandemic

2021 ◽  
Vol 11 (2) ◽  
pp. 5-9
Author(s):  
Jorge Gelvane Tostes ◽  
Carla Benedita da Silva Tostes ◽  
Rodrigo Petrim Cruz ◽  
Vanessa Santos de Souza ◽  
Maria das Graças Mota Cruz de Assis Figueiredo ◽  
...  

Telemedicine has proven to be an important tool for the assistance continuity facing the current COVID-19 pandemic. We discussed the role of tele-interconsultation and remote matrix support as resources, within the scope of the Unified Health System, in supporting primary care teams, aiming at maintaining quality and resolution, increasing demand for services, as well as the limitations to their implementation. There are difficulties in access by the population, the need for investment and resistance by professionals and managers. It is still necessary regulation of telemedicine activity in the country, given that the permission by the Federal Council of Medicine occured only during the pandemic. The ability to fill gaps and deficiencies left by specialized services and reference centers stands out, since there is an increase in demand in several areas. In addition, the opportunity for learning, safety in conduct and empowerment of primary care professionals is investigated.

2018 ◽  
Vol 9 (1) ◽  
Author(s):  
Elisabete Pimenta Araújo Paz ◽  
Carlos Leonardo Figueiredo Cunha ◽  
Edson Alves De Menezes ◽  
Gilmara Lúcia Dos Santos ◽  
Nádia Mattos Ramalho ◽  
...  

Objetivo: Refletir sobre questões ligadas às práticas de enfermagem na Atenção Primária à Saúde no contexto do sistema único de saúde que hoje são realizadas em uma perspectiva que possa favorecer a ampliação das ações de enfermagem com vistas à melhoria da cobertura universal e ampliação do acesso aos serviços de saúde. Reflete-se sobre a necessidade de ampliar o escopo das práticas de enfermagem que já são realizadas na Atenção Primária, à luz do conceito de Práticas Avançadas de Enfermagem. A ampliação de competências e da liderança dos enfermeiros em funções complexas em âmbito nacional requer estudos sobre a realidade nacional, superação dos desafios regionais e apoio dos órgãos representativos da enfermagem.Descritores: Enfermagem; Atenção Primária; Práticas Avançadas de EnfermagemADVANCED PRACTICES IN NURSING: REDISCOVERING THE VALORIZATION OF NURSES IN PRIMARY HEALTH CAREObjective: To reflect on the potential of Nursing Practices in Primary Health Care in the context of the Brazilian Unified Health System, with an expansion of the work performed by nurses. The paper reflects on the need to expand the scope of nursing practices in Primary Care, according to the concept of Advanced Nursing Practices. The expansion of the nurses’ competences and leadership in complex tasks at a national level requires studies on the Brazilian reality, the overcoming of regional challenges, and support to nursing representative bodies.Descriptors: Nursing; Primary Health Care; Advanced Nursing Practices xPRÁCTICAS AVANZADAS EN ENFERMERÍA: REDISCUTIENDO LA VALORIZACIÓN DEL ENFERMERO EN LA ATENCIÓN PRIMARIA A LA SALUDReflexionar sobre las potencialidades de las Prácticas de Enfermería en la Atención Básica de la Salud en el contexto del Sistema Único de Salud brasileño, con ampliación de las acciones realizadas por enfermeros. Se reflexiona sobre la necesidad de ampliar la gama de las prácticas de enfermería en la Atención Básica, a la luz del concepto de las Prácticas Avanzadas de Enfermería. La ampliación de competencias y del liderazgo de los enfermeros en funciones complejas en el ámbito nacional requiere estudios sobre la realidad nacional, la superación de los desafios regionales y el apoyo de los órganos representativos de la enfermería.Descriptores: Enfermería; Atención Básica; Prácticas Avanzadas de Enfermería


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Rachelle Ashcroft ◽  
Catherine Donnelly ◽  
Maya Dancey ◽  
Sandeep Gill ◽  
Simon Lam ◽  
...  

Abstract Background Integrated primary care teams are ideally positioned to support the mental health care needs arising during the COVID-19 pandemic. Understanding how COVID-19 has affected mental health care delivery within primary care settings will be critical to inform future policy and practice decisions during the later phases of the pandemic and beyond. The objective of our study was to describe the impact of the COVID-19 pandemic on primary care teams’ delivery of mental health care. Methods A qualitative study using focus groups conducted with primary care teams in Ontario, Canada. Focus group data was analysed using thematic analysis. Results We conducted 11 focus groups with 10 primary care teams and a total of 48 participants. With respect to the impact of the COVID-19 pandemic on mental health care in primary care teams, we identified three key themes: i) the high demand for mental health care, ii) the rapid transformation to virtual care, and iii) the impact on providers. Conclusions From the outset of the COVID-19 pandemic, primary care quickly responded to the rising mental health care demands of their patients. Despite the numerous challenges they faced with the rapid transition to virtual care, primary care teams have persevered. It is essential that policy and decision-makers take note of the toll that these demands have placed on providers. There is an immediate need to enhance primary care’s capacity for mental health care for the duration of the pandemic and beyond.


2017 ◽  
Vol 51 (suppl.2) ◽  
Author(s):  
Letícia Farias Gerlack ◽  
Margô Gomes de Oliveira Karnikowski ◽  
Camila Alves Areda ◽  
Dayani Galato ◽  
Aline Gomes de Oliveira ◽  
...  

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


2017 ◽  
Vol 51 ◽  
pp. 20s ◽  
Author(s):  
Juliana Álvares ◽  
Augusto Afonso Guerra Junior ◽  
Vânia Eloisa de Araújo ◽  
Alessandra Maciel Almeida ◽  
Carolina Zampirolli Dias ◽  
...  

OBJECTIVE: To evaluate the access to medicines in primary health care of the Brazilian Unified Health System (SUS), from the patients’ perspective. METHODS: This is a cross-sectional study that used data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Services, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines), conducted by interviews with 8,591 patients in cities of the five regions of Brazil. Evaluation of access to medicines used concepts proposed by Penshansky and Thomas (1981), according to the dimensions: availability, accessibility, accommodation, acceptability, and affordability. Each dimension was evaluated by its own indicators. RESULTS: For the “availability” dimension, 59.8% of patients reported having full access to medicines, without significant difference between regions. For “accessibility,” 60% of patients declared that the basic health unit (UBS) was not far from their house, 83% said it was very easy/easy to get to the UBS, and most patients reported that they go walking (64.5%). For “accommodation,” UBS was evaluated as very good/good for the items “comfort” (74.2%) and “cleanliness” (90.9%), and 70.8% of patients reported that they do not wait to receive their medicines, although the average waiting time was 32.9 minutes. For “acceptability,” 93.1% of patients reported to be served with respect and courtesy by the staff of the dispensing units and 90.5% declared that the units’ service was very good/good. For “affordability,” 13% of patients reported not being able to buy something important to cover expenses with health problems, and 41.8% of participants pointed out the expense with medicines. CONCLUSIONS: Results show 70%–90% compliance, which is compatible with developed countries. However, access to medicines remains a challenge, because it is still heavily compromised by the low availability of essential medicines in public health units, showing that it does not occur universally, equally, and decisively to the population


Author(s):  
Maria Y. Charumbira ◽  
Karina Berner ◽  
Quinette A. Louw

Abstract Aim: The aim of this study was to explore the perspectives of physiotherapists in four selected regions of sub-Saharan Africa regarding health system challenges impacting the integration of physiotherapy-led falls prevention services in the primary care of persons living with HIV (PLWH). Background: Falls may pose a significant problem among younger PLWH in low- and middle-income countries. Physiotherapists’ role in optimising function and quality of life can do much in the prevention of falls in PLWH and reducing the harm that results. However, falls prevention strategies have not been implemented effectively especially in primary health care settings in sub-Saharan Africa. Physiotherapists’ account of the health system challenges they encounter may provide insights into potential strategies that may be considered in optimising fall prevention for PLWH in poorly resourced settings. Methods: A descriptive qualitative study was conducted in selected urban districts in the capital cities of four sub-Saharan African countries. In-depth interviews were conducted with 21 purposively selected physiotherapists involved in the primary care of PLWH. Audio recordings of interviews were transcribed verbatim and analysed using deductive thematic content analysis. Findings: The main results are presented in the theme ‘Health care system challenges’ and in nine categories informed by the WHO health system framework: lack of policies and clinical practice guidelines, shortage/Inaccessible falls prevention services, inadequate human resource, physiotherapists not adequately equipped in falls prevention, inaccessible/No facilities for BMD measurement, inefficient data capturing systems, lack of evidence regarding falls among PLWH, unclear physiotherapy role descriptions, inefficient referral system. Physiotherapists highlighted the need for more information and research regarding fall prevention for PLWH, promote their role in the primary care of PLWH and adopt a patient-centred approach to fall prevention.


10.3823/2515 ◽  
2017 ◽  
Vol 10 ◽  
Author(s):  
Marília Gomes De Sousa Bezerra ◽  
Roseanne De Sousa Nobre ◽  
Artemizia Francisca De Sousa ◽  
Maísa De Lima Claro

Introduction: The Ministry of Health with the aim of improving the service provided by the Unified Health System has been creating work tools to identify which points need to receive more attention to be optimized. Objective: Description of the role of municipal management, infrastructure assessment and perception of users of primary care. Method: Cross-sectional and descriptive study, conducted with Basic Units of Piauí municipality in 2015. The data were represented by tables. Results: 90% of the units reported receiving support for the planning and organization of the work process. Only 14, 81% of the units have equipment and supplies for proper operation. Users recommend the service in 92,62% of the cases. Conclusion: despite the precarious structure of the basic units of the county, the population still recognizes them as the best care.


2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Cleise Cristine Ribeiro Borges Oliveira ◽  
Elaine Andrade Leal Silva ◽  
Mariluce Karla Bomfim de Souza

Abstract The objective was to analyze the functioning of the referral and counter-referral system for integral care in the Healthcare Network. Qualitative study performed through interviews with 66 participants - managers, workers and users of a town of the state of Bahia, Brazil, and upon approval by the Ethics Committee, opinion number nº 334.737. The material was analyzed using the Content Analysis proposed by Bardin, finished in 2014. Various conceptions of referral and counter-referral were identified, as follows: referral of users, user’s broader view; non-fragmented care; and integral care. For the users, the difficulties and facilities in the flows are concentrated in the Regulation and Scheduling Center and Family Health Units. It is concluded that, to enable the establishment of the network in an integral way, it is necessary to identify important strategies provided by the Unified Health System (SUS) and strengthen these strategies, as well as to identify any drawbacks to remedy them.


2004 ◽  
Vol 94 (5) ◽  
pp. 783-789 ◽  
Author(s):  
Allison L. Diamant ◽  
Ron D. Hays ◽  
Leo S. Morales ◽  
Wesley Ford ◽  
Daphne Calmes ◽  
...  

2018 ◽  
Vol 18 (6) ◽  
pp. 1017-1033
Author(s):  
Nayelhi I Saavedra ◽  
Shoshana Berenzon ◽  
Jorge Galván

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