scholarly journals Condutas de urgência e emergência na atenção básica sob a ótica de discentes de enfermagem

2020 ◽  
Vol 10 (31) ◽  
pp. 3-12
Author(s):  
Thatiana Mendes Pêgo ◽  
Amanda Rebeca Rebello ◽  
Renata Flavia Abreu da Silva ◽  
Andressa Teoli Nunciaroni ◽  
Vanessa De Almeida Ferreira Corrêa
Keyword(s):  
Health Care ◽  
Nursing Students ◽  
Health System ◽  
Emergency Services ◽  
Structured Interviews ◽  
Emergency Situations ◽  
Primary Health ◽  
La Red ◽  
Care Nursing ◽  
Emergency Professionals

A Atenção Básica em Saúde (ABS) é considerada como uma das portas de entrada dos usuários na rede de atenção à saúde, sendo necessário que os profissionais estejam preparados para atuar nas demandas de urgência e emergência neste cenário. Conhecer as condutas em situações de urgência e emergência desenvolvidas pelos profissionais de saúde na ABS sob a ótica de discentes de Enfermagem. Pesquisa descritiva, qualitativa. Os dados foram coletados por entrevistas semiestruturadas e a sistematização de conteúdo temático-categorial foi empregada para análise. Participaram 11 estudantes de enfermagem e construiu-se 04 categorias: Concepção de urgência e emergência; Profissionais que atuam nas situações de urgência e emergência; Condutas dos profissionais nas urgências e emergência; Fragilidades no atendimento nos serviços de urgência e emergência. Identificou-se, portanto, sob o olhar dos discentes, as condutas em situação de urgência e emergência na ABS, quais os profissionais atuantes, as fragilidades, as concepções relacionadas.Descritores: Atenção Primária à Saúde, Enfermagem, Emergências. Urgent and emergency care in primary health system from the perspective of nursing studentsAbstract: Primary Health System (PHS) is considered as a gateway for patients in the health care network, and professionals need to be prepared to act on urgent and emergency demands in this scenario. To know the conducts in urgent and emergency situations developed by health professionals in PHS from the perspective of nursing students. Descriptive, qualitative research. The data were collected through semi-structured interviews and the systematization of thematic-categorical content was used for analysis. 11 nursing students have participated on the study and 04 categories were built: Conception of urgency and emergency; Professionals working in urgent and emergency situations; Conduct of professionals in urgencies and emergencies; Weaknesses in provision of urgent and emergency services. Therefore, it was identified, from the perspective of nursing students, the behaviors in situations of urgency and emergency in PHS, who are the professionals working, the weaknesses, the related conceptions.Descriptors: Primary Health Care, Nursing, Emergencies. Cuidados de urgencia y emergencia en atención primaria desde la perspectiva de los estudiantes de enfermeríaResumen: La atención primaria de salud (APS) se considera como una puerta de entrada para los usuarios de la red de atención en salud, y los profesionales deben estar preparados para actuar ante demandas urgentes y de emergencia en este escenario. Conocer las conductas en situaciones de urgencia y emergencia desarrolladas por profesionales de la salud en APS desde la perspectiva de los estudiantes de enfermería. Investigación descriptiva, cualitativa. Los datos fueron recolectados a través de entrevistas semiestructuradas y la sistematización del contenido temático-categórico fue utilizada para el análisis. Participaron 11 estudiantes de enfermería y se construyeron 04 categorías: Concepción de urgencia y emergencia; Profesionales que trabajan en situaciones urgentes y de emergencia; Conducta de profesionales en urgencias y emergencias; Debilidades en la provisión de servicios urgentes y de emergencia. Por lo tanto, se identificó, desde la perspectiva de los estudiantes de enfermería, los comportamientos en situaciones de urgencia y emergencia en ABS, que son los profesionales que trabajan, las debilidades, las concepciones relacionadas.Descriptores: Atención Primaria de Salud, Enfermería, Urgencias Médicas.

scholarly journals DEMAND AND TYPE OF CARE PROVIDED IN EMERGENCY SERVICES IN THE CITY OF FLORIANÓPOLIS, BRAZIL

2017 ◽  
Vol 26 (1) ◽  
Author(s):  
Sonia da Silva Reis Cassettari ◽  
Ana Lúcia Schaefer Ferreira de Mello
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Emergency Services ◽  
Secondary Data ◽  
Emergency Situations ◽  
Department Of Health ◽  
Primary Health ◽  
The City ◽  
The Coordinator

ABSTRACT Objective: this study's aim was to characterize the demand of patients and the type of care provided in 2013, in emergency services, in the city of Florianópolis, SC, Brazil Method: this is a descriptive and analytical study with a quantitative approach. Secondary data were collected from general and managerial reports provided by the information system used by the city's department of health. Results: patients seek the emergency services nearest to their homes for situations not characterized as emergencies and that could be taken care of by primary health care units Conclusion: most patients originate from the same health district in which the emergency service is located and their reasons for seeking care could not be characterized as urgent or emergency situations. There is a need to qualify primary health care as the coordinator of care and instruct the population regarding the role of each service in the network

scholarly journals Polypharmacy: a challenge for the primary health care of the Brazilian Unified Health System

2017 ◽  
Vol 51 (suppl.2) ◽  
Author(s):  
Renata Cristina Rezende Macedo do Nascimento ◽  
Juliana Álvares ◽  
Augusto Afonso Guerra Junior ◽  
Isabel Cristina Gomes ◽  
Micheline Rosa Silveira ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Emergency Services ◽  
Chi Square ◽  
Cross Sectional ◽  
Inappropriate Use ◽  
Unified Health System ◽  
Primary Health ◽  
Main Challenge

OBJECTIVE: To characterize the polypharmacy in primary health care patients and to identify its associated factors. METHODS: This is a cross-sectional, exploratory, and evaluative study, part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015). The variable of interest was polypharmacy, defined as the use of five or more medicines. We sought to identify the association of sociodemographic variables and indicators of health conditions to polypharmacy. For group comparison, the Pearson’s Chi-square test was used. The association between polypharmacy and explanatory variables was evaluated by logistic regression model (p < 0.05). The quality of the adjustment was verified by Hosmer-Lemeshow test. RESULTS: The prevalence of polypharmacy among medicine users was 9.4% (95%CI 7.8–12.0) in the general population and 18.1% (95%CI 13.6–22.8) in older adults above 65 years old. We found statistically significant association between polypharmacy and age above 45 years, lower self-perception of health, presence of chronic diseases, having health insurance, care in emergency services, and region of the Country. South users presented the highest chances to polypharmacy. The most used medicines were those of the cardiovascular system, being compatible with the national epidemiological profile. CONCLUSIONS: Polypharmacy is a reality in the population met within the primary care of Brazilian Unified Health System and may be related to excessive or inappropriate use of medicines. The main challenge to qualify health care is to ensure that prescription of multiple medicines be appropriate and safe

scholarly journals Primary Health Care: care coordinator in regionalized networks?

2016 ◽  
Vol 50 (0) ◽  
Author(s):  
Patty Fidelis de Almeida ◽  
Adriano Maia dos Santos
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Emergency Services ◽  
Family Health ◽  
Structured Interviews ◽  
Cross Sectional Survey ◽  
Care Coordinator ◽  
Cross Sectional ◽  
Interprofessional Communication ◽  
Primary Health

RESUMO OBJECTIVE To analyze the breadth of care coordination by Primary Health Care in three health regions. METHODS This is a quantitative and qualitative case study. Thirty-one semi-structured interviews with municipal, regional and state managers were carried out, besides a cross-sectional survey with the administration of questionnaires to physicians (74), nurses (127), and a representative sample of users (1,590) of Estratégia Saúde da Família (Family Health Strategy) in three municipal centers of health regions in the state of Bahia. RESULTS Primary Health Care as first contact of preference faced strong competition from hospital outpatient and emergency services outside the network. Issues related to access to and provision of specialized care were aggravated by dependence on the private sector in the regions, despite progress observed in institutionalizing flows starting out from Primary Health Care. The counter-referral system was deficient and interprofessional communication was scarce, especially concerning services provided by the contracted network. CONCLUSIONS Coordination capacity is affected both by the fragmentation of the regional network and intrinsic problems in Primary Health Care, which poorly supported in its essential attributes. Although the health regions have common problems, Primary Health Care remains a subject confined to municipal boundaries.

scholarly journals Perceptions of underlying practice hierarchies: Who is managing my care?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tara N Officer ◽  
Karen McBride-Henry
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Professional ◽  
Health System ◽  
Nurse Practitioner ◽  
Health Service Delivery ◽  
Structural Barriers ◽  
Structured Interviews ◽  
Primary Health ◽  
Optimal Health

Abstract Background The introduction of new health professional roles, such as that of the nurse practitioner and pharmacist prescriber in primary health care can lead to changes in health service delivery. Consumers, having used these roles, often report high satisfaction. However, there is limited knowledge of how these individuals position nurse practitioner and pharmacist prescriber roles within existing practice structures. Methods Semi-structured interviews were conducted with 21 individuals receiving services from these practitioners in New Zealand primary health care. Interviews were recorded and transcribed verbatim for thematic analysis. Results Participant views reflect established practice hierarchies, placing advanced practitioners ‘below’ general practitioners. Participants are unable to articulate what it was about these practitioners that meant they operated at lower tiers and often considered practitioners to act as ‘their doctor’. They also highlight structural barriers impairing the ability of these providers to operate within their full scope of practice. Conclusions While seeing value in the services they receive, consumers are often unable to position nurse practitioner and pharmacist prescriber roles within health system contexts or to articulate how they value their practitioner’s skills. Embedded structural barriers may be more visible to consumers than their interactions with the health system suggest. This may influence peoples’ ability to receive intended or optimal health services. Consumer ‘health professional literacy’ around the functions of distinct health practitioners should be supported so that they may make informed service provision choices.

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 Violence against children and adolescents: the perspective of Primary Health Care

2017 ◽  
Vol 70 (3) ◽  
pp. 511-518 ◽  
Author(s):  
Diene Monique Carlos ◽  
Elisabete Matallo Marchesini de Pádua ◽  
Maria das Graças Carvalho Ferriani
Keyword(s):  
Health Care ◽  
Qualitative Research ◽  
Children And Adolescents ◽  
Structured Interviews ◽  
Work Processes ◽  
Violence Against Children ◽  
Primary Health ◽  
Agents Of Change ◽  
The Look ◽  
Basic Health Units

ABSTRACT Objective: To analyze the care provided by Basic Health Units (BHU) to families involved in domestic intrafamily violence against children and adolescents. Method: Qualitative research, based on the Paradigm of Complexity. Data collection was performed with 41 professionals through focus groups and semi-structured interviews. Results: The following categories emerged from data analysis: 'Everything comes here', which reflects the legitimate place of BHUs for the population and the actions taken to build care for families; and 'We only do what is really necessary', which brings the look to violence still based on the positivist and biomedical paradigm. Final considerations: The model of understanding and construction of work processes in the BHU is structured in the aforementioned paradigm. Nurses have the possibility to become agents of change, both in professionals' training and in the care thought and provided to communities.

scholarly journals Access to medicines by patients of the primary health care in the Brazilian Unified Health System

2017 ◽  
Vol 51 ◽  
pp. 20s ◽  
Author(s):  
Juliana Álvares ◽  
Augusto Afonso Guerra Junior ◽  
Vânia Eloisa de Araújo ◽  
Alessandra Maciel Almeida ◽  
Carolina Zampirolli Dias ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Developed Countries ◽  
Access To Medicines ◽  
Essential Medicines ◽  
Unified Health System ◽  
Primary Health ◽  
Significant Difference ◽  
Good For

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

scholarly journals Barriers Facing Primary Health Care Physicians When Dealing with Emergency Cases in Jeddah, Saudi Arabia

2015 ◽  
Vol 8 (8) ◽  
pp. 192 ◽  
Author(s):  
Majed A. Aloufi ◽  
Marwan A. Bakarman
Keyword(s):  
Health Care ◽  
Saudi Arabia ◽  
Primary Health Care ◽  
Emergency Services ◽  
Fine Tuning ◽  
Cross Sectional ◽  
Primary Health ◽  
Primary Health Care Centers ◽  
Primary Health Care Physicians ◽  
Health Care Centers

<p><strong>OBJECTIVES:</strong> To estimate the prevalence of emergency cases reporting to Primary Health Care centers (PHC), Jeddah, Saudi Arabia and to explore the barriers facing PHC physicians when dealing with such emergency cases.<strong></strong></p><p><strong>METHODS:</strong> A cross-sectional analytic study, where all physicians working in the PHC of the Ministry of Health (MOH) in Jeddah; were invited to participate (n=247). The study period was from July 2013 till December 2013. Data were collected through two sources. 1- A self-administered questionnaire used to determine the physicians’ perceived competence when dealing with emergency cases. 2- A structured observation sheet used to evaluate availability of equipment, drugs, ambulances and other supporting facilities required to deal with emergency cases.</p><p><strong>RESULTS:</strong> The response rate was 83.4%. The physicians’ age ranged between 25 and 60 years with a mean ±SD of 34.4±7.5 years. Majority of them (83.5%) did not attend ATLS courses at all whereas 60.7% never attended ACLS courses. The majority (97.1%) had however attended BLS courses. Physicians in the age group 36-45 years, non-Saudi, those who had SBFM, those who reported experience in working in emergency departments and physicians who reported more working years in PHCCs (&gt;5 years) had a significant higher score of perceived level of competence in performing emergency skill scale than others (P&lt;0.05). The prevalence of emergency cases attending PHC in Jeddah (2013) was 5.2%.</p><p><strong>CONCLUSION:</strong> Emergency services at PHC in Jeddah are functioning reasonably well, but require fine tuning of services and an upgrade in their quality.</p>

scholarly journals Integration between Primary Health Care and Emergency Services in Brazil: Barriers and Facilitators

2018 ◽  
Vol 18 (4) ◽  
Author(s):  
Liza Yurie Teruya Uchimura ◽  
Andréa Tenório Correia da Silva ◽  
Ana Luiza d’Ávila Viana
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Emergency Services ◽  
Barriers And Facilitators ◽  
Primary Health

scholarly journals Melhores práticas de enfermagem na saúde da pessoa idosa

2020 ◽  
Vol 14 ◽  
Author(s):  
Maria Alice De Freitas ◽  
Angela Maria Alvarez
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Best Practices ◽  
Methodological Approach ◽  
Family Health ◽  
The Elderly ◽  
Structured Interview ◽  
Primary Health ◽  
La Red ◽  
The Impact

Objetivo: compreender, dentro das melhores práticas, as experiências de busca por conhecimento e utilização da experiência profissional dos enfermeiros no cuidado da pessoa idosa na Atenção Primária à Saúde. Método: trata-se de um estudo qualitativo, descritivo e exploratório, com 30 enfermeiros atuantes nas Estratégias Saúde da Família. Utilizou-se um instrumento de entrevista semiestruturado. Analisaram-se os dados pela técnica de Análise de Conteúdo na modalidade Análise Temática. Resultados: revelaram-se a busca por conhecimento com outros profissionais e o acesso à rede de internet como fontes de conhecimento. Evidenciou-se a necessidade do estabelecimento de uma rotina de estudos sistematizada e agenda de educação permanente sob a temática do envelhecimento. Conclusão: conclui-se que o estudo confirma que os enfermeiros realizam ações que carecem de notoriedade e que estão preocupados com o impacto de suas ações para o usuário idoso, mas, para que as melhores práticas sejam completamente estabelecidas,  se faz necessária a imersão científica e metodológica dos profissionais e da gestão, além da busca por conhecimento e valorização da experiência, que já coexistem. Descritores: Idoso; Enfermagem; Conhecimento, Atenção Primária à Saúde; Saúde da Pessoa Idosa; Dinâmica Populacional.AbstractObjective: to understand, within the best practices, the experiences of searching for knowledge and using nurses' professional experience in the care of the elderly in Primary Health Care. Method: this is a qualitative, descriptive and exploratory study, with 30 nurses working in the Family Health Strategies. A semi-structured interview instrument was used. Data was analyzed using the Content Analysis technique in the Thematic Analysis modality. Results: the search for knowledge with other professionals and access to the internet network as sources of knowledge were revealed. The need to establish a systematic study routine and a permanent education agenda under the theme of aging became evident. Conclusion: it is concluded that the study confirms that nurses perform actions that lack notoriety and that they are concerned with the impact of their actions for the elderly user, but, for the best practices to be completely established, scientific immersion is necessary and methodological approach of professionals and management, in addition to the search for knowledge and appreciation of experience, which already coexist. Descriptors: Elderly; Nursing; Knowledge; Primary Health Care; Elderly health; Population Dynamics.ResumenObjetivo: comprender, dentro de las mejores prácticas, las experiencias de búsqueda de conocimiento y el uso de la experiencia profesional de los enfermeros en el cuidado de ancianos en Atención Primaria de Salud. Método: estudio cualitativo, descriptivo y exploratorio con 30 enfermeros activos en las Estrategias de Salud Familiar. Se utilizó un instrumento de entrevista semiestructurada. Los datos se analizaron utilizando la técnica de Análisis de Contenido en la modalidad de Análisis Temático. Resultados: se reveló la búsqueda de conocimiento con otros profesionales y el acceso a la red de Internet como fuentes de conocimiento. La necesidad de establecer una rutina de estudio sistemática y una agenda de educación permanente bajo el tema del envejecimiento se hizo evidente. Conclusión: se concluye que el estudio confirma que los enfermeros realizan acciones que carecen de notoriedad y que están preocupados por el impacto de sus acciones para el usuario mayor, pero, para que las mejores prácticas se establezcan por completo, es necesaria la inmersión científica y enfoque metodológico de profesionales y directivos, además de la búsqueda de conocimiento y valoración de la experiencia, que ya coexisten. Descriptores: Anciano; Enfermería; Conocimiento; Atencíon Primária de la Salud; Saúde do Idoso; Dinámica Poblacional.

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