Nursing Care Systematization: Applicability to Primary Care

2020 ◽  
Vol 42 ◽  
pp. e48465
Author(s):  
Emilli Karine Marcomini ◽  
Nanci Verginia Kuster de Paula ◽  
Daiane Cortez Raimondi
Keyword(s):  
Primary Care ◽  
Nursing Care ◽  
Cross Sectional Study ◽  
Health Centers ◽  
Care Practice ◽  
Cross Sectional ◽  
Primary Care Teams ◽  
Time Availability ◽  
Health Zone ◽  
Nursing Professionals

Nursing Care Systematization (NCS) is an organized and systematized process that concerns nursing professionals who provide quality assistance, being a mandatory tool in all health centers. Despite this factor, there is a visible resistance from nursing to the operationalization of a systematized care. Thus, the present study aims to analyze the applicability of nursing care systematization and the knowledge that primary care nurses have of this process. This is a descriptive, cross-sectional study with quanti-qualitative approach, conducted with nurses working in primary care teams from a regional health zone in the state of Paraná, Brazil. Out of the 44 participant nurses, only 20.5% claimed to take all steps in the nursing process during their care practice, and 43.2% do not know about the Resolution of the Federal Nursing Council that addresses NCS application. This low NCS applicability is worrisome, since it is related to the quality, resolution and security of care provision. The applicability of the systematization within the assessed teams is quite fragmented and small; besides, their NCS knowledge is insufficient considering that this is such a relevant tool to a nurse’s professional practice. It is possible to notice numerous fragilities and difficulties in the application of NCS to primary care, with highlight to time availability, overworked nurses, and need for training.

scholarly journals SEXUAL DYSFUNCTION AMONG WOMEN AT FOUR TO SIX MONTHS POSTPARTUM: A STUDY IN A PRIMARY CARE SETTING

2020 ◽  
Vol 20 (1) ◽  
pp. 235-243
Author(s):  
Norafini Salamon ◽  
Syahnaz Mohd Hashim ◽  
Norfazilah Ahmad ◽  
Suzaily Wahab
Keyword(s):  
Primary Care ◽  
Sexual Dysfunction ◽  
Care Setting ◽  
Primary Care Setting ◽  
Cross Sectional Study ◽  
Care Practice ◽  
Cross Sectional ◽  
Maternal Characteristics ◽  
Local Setting ◽  
Arousal Disorder

Sexual dysfunction in women is a significant health problem that harms marriage stability. Women in the Western countries were reportedly being affected by this condition after childbirth but the magnitude of the problem in our local setting is still unknown. The aim of this cross-sectional study was to determine the prevalence of women with sexual dysfunction at four to six months postpartum and its possible risk factors in an urban primary care setting. The participants were given a set of questionnaire, consisting of three parts; i) sociodemographic and maternal characteristics ii) Malay version of Female Sexual Function Index and iii) Malay DASS-21 questionnaire. Responses from 249 women were analyzed. More than half (57.0%,n=142) were found to have sexual dysfunction. The most prevalent types of sexual dysfunction reported by the affected women were sexual satisfaction disorder (98.6%), followed by arousal disorder (58.5%) and lubrication disorder (28.9%). Three factors were found to be significantly associated with sexual dysfunction; household income of less than RM2000 (adj OR = 0.31, 95% CI 0.14, 0.70), Malay ethnic group (adj OR = 1.93,95% CI 1.02, 3.66) and breastfeeding (adj OR = 2.24,95% CI 1.03, 4.85). In conclusion, the prevalence of sexual dysfunction in the postpartum period was considerably high. Efforts should be made to incorporate sexual health as part of the routine postnatal assessment in primary care practice.

scholarly journals Patient safety culture, missed Nursing care and its reasons in Obstetrics

2021 ◽  
Vol 29 ◽  
Author(s):  
Silvana Cruz da Silva ◽  
Bruna Xavier Morais ◽  
Oclaris Lopes Munhoz ◽  
Juliana Dal Ongaro ◽  
Janete de Souza Urbanetto ◽  
...  
Keyword(s):  
Patient Safety ◽  
Nursing Care ◽  
Safety Culture ◽  
Vital Signs ◽  
Patient Safety Culture ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Labor Resources ◽  
Missed Nursing Care ◽  
Nursing Professionals

Objective: to assess the correlations between the patient safety culture, the missed Nursing care, and the reasons for the omission in the obstetric area. Method: a cross-sectional study, conducted in 2019, with 62 Nursing professionals working in the obstetric area of a teaching hospital in southern Brazil. The MISSCARE-Brasil and Hospital Survey on Patient Safety Culture instruments were used. The data were analyzed using descriptive statistics, means comparison test and Spearman correlation. Results: the overall mean of positive answers for the safety culture was 34.9 (± 17.4). The care of assessing the vital signs and monitoring capillary blood glucose were the most prioritized, with airway aspiration and oral hygiene being the most overlooked. The main reasons for the omissions refer to labor resources and to inadequate staffing. A significant and inversely proportional correlation was found between the patient safety culture and overlooked nursing care (r=-0.393). Conclusion: the safety culture of the obstetric area was assessed as fragile by the Nursing professionals. The more the safety culture is strengthened and the greater investment in labor and human resources, the less care is overlooked.

scholarly journals General Practitioners’ Perceptions of Whether Teleconsultations Reduce the Number of Face-to-face Visits in the Catalan Public Primary Care System: Retrospective Cross-Sectional Study

10.2196/14478 ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. e14478 ◽  
Author(s):  
Francesc López Seguí ◽  
Josep Vidal-Alaball ◽  
Marta Sagarra Castro ◽  
Anna García-Altés ◽  
Francesc García Cuyàs
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Care Service ◽  
Cross Sectional Study ◽  
Clinical Value ◽  
Cross Sectional ◽  
Face To Face ◽  
Primary Care Teams ◽  
Ease Of Access ◽  
Demand For Health

Background eConsulta is a teleconsultation service involving general practitioners (GPs) and patients. It is part of the information system belonging to Catalonia’s primary care service. It has been in operation since the end of 2015 in conjunction with face-to-face consultations with Primary Care Teams as one of the services offered in the patient’s Personal Health Folder. Objective This study aimed to assess the ability of using eConsulta to reduce the number of face-to-face visits to Primary Care Teams. Methods Using 13 categories proposed by the researchers, 18 GPs from the Central Catalonia Health Region retrospectively classified 2268 cases managed with eConsulta and indicated whether, in their opinion, the teleconsultations reduced the number of face-to-face visits. Results There was broad consensus among the GPs that eConsulta has the potential to resolve patient queries for every type of consultation. eConsulta avoided the need for a face-to-face visit in 87.9% of cases. In addition, the GPs reported that the ease of access increased the demand for health care support in 27.7% of cases; otherwise, the patient would not have initiated the queries. Therefore, based on the equation (88% x [1-28%]), eConsulta could replace 63%-88% of conventional appointments. The most frequent uses of the teleconsultation service were for management of test results (35.2%), medical enquiries (16.0%), and the management of repeat prescriptions (12.2%). On average, the teleconsultations consisted of a mean 1.57 messages (SD 0.54 messages); 45.9% (1040/2268) of the teleconsultations consisted of 1 message, and the majority of the remaining teleconsultations consisted of 2-5 interactions. The patient initiated 60.0% (1361/2268) of the teleconsultations. Conclusions Based on the GPs’ perceptions, eConsulta could replace 63%-88% of conventional appointments. Therefore, asynchronous teleconsultations between practitioners and patients in primary care could avoid interactions that have limited added clinical value.

DIABETES MANAGEMENT AT COMMUNE HEALTH CENTERS OF THUA THIEN HUE PROVINCE

2019 ◽  
pp. 106-108
Author(s):  
Duc Toan Vo ◽  
Nam Hung Nguyen ◽  
Ho Thi Quynh Anh Le ◽  
Minh Tam Nguyen
Keyword(s):  
Primary Care ◽  
Early Detection ◽  
Diabetes Management ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Health Centers ◽  
Key Words Diabetes ◽  
Diabetes Diagnosis ◽  
Cross Sectional ◽  
Management Services

Diabetes and its consequences have become serious public health problems in many countries. Enhancing continuity of care and diabetes management at primary care plays a crucial, sustainable and cost-effective role in health care. Objectives: To describe the current situation of diabetes management at commune health centers (CHCs) in Thua Thien Hue province. Methods: A cross-sectional study was conducted in the total 152 CHCs in Thua Thien Hue province. Service availability and readiness assessment (SARA-WHO) instrument was used to assess diabetes management of CHCs. Results: Diabetes diagnosis and/or treatment were available at 40.8% of CHCs surveyed. There was a low percentage of CHCs fully equipped for screening and early detection of diabetes (18.4%). Most of CHCs delivered prevention services regarding risk factors of diabetes. All CHCs weren’t equipped with adequate medication for diabetes management prescribed by the Ministry of Health. Metformin (33.6%) and gliclazide (28.3%) were offered at the CHCs. Conclusion: Diabetes prevention and management services at grassroots level have not been fully and widely deployed throughout the province. It’s strongly recommended to enhance the availability and readiness of diabetes management services and to invest the essential supplies and medication for diabetes screening, early detection and treatment at primary care, particularly for CHCs in the rural and mountainous areas. Key words: Diabetes management, commune health center, primary care, SARA

scholarly journals Socioeconomic status and benzodiazepine and Z-drug prescribing: a cross-sectional study of practice-level data in England

2019 ◽  
Author(s):  
Stephanie Soyombo ◽  
Rhian Stanbrook ◽  
Harpal Aujla ◽  
David Capewell ◽  
Mary Shantikumar ◽  
...  
Keyword(s):  
Primary Care ◽  
Socioeconomic Status ◽  
Cross Sectional Study ◽  
Care Practice ◽  
Drug Prescribing ◽  
Sectional Study ◽  
Cross Sectional ◽  
Data Set ◽  
Practice Level ◽  
Age And Sex

Abstract Background Benzodiazepines and Z-drugs (such as zopiclone) are widely prescribed in primary care. Given their association with addiction and dependence, understanding where and for whom these medications are being prescribed is a necessary step in addressing potentially harmful prescribing. Objective To determine whether there is an association between primary care practice benzodiazepine and Z-drug prescribing and practice population socioeconomic status in England. Methods This was a cross-sectional study. An aggregated data set was created to include primary care prescribing data for 2017, practice age and sex profiles and practice Index of Multiple Deprivation (IMD) scores—a marker of socioeconomic status. Drug doses were converted to their milligram-equivalent of diazepam to allow comparison. Multiple linear regression was used to examine the association between IMD and prescribing (for all benzodiazepines and Z-drugs in total, and individually), adjusting for practice sex (% male) and older age (>65 years) distribution (%). Results Benzodiazepine and Z-drug prescribing overall was positively associated with practice-level IMD score, with more prescribing in practices with more underserved patients, after adjusting for age and sex (P < 0.001), although the strength of the association varied by individual drug. Overall, however, IMD score, age and sex only explained a small proportion of the overall variation in prescribing across GP practices. Conclusion Our findings may, in part, be a reflection of an underlying association between the indications for benzodiazepine and Z-drug prescribing and socioeconomic status. Further work is required to more accurately define the major contributors of prescribing variation.

Scarcity of Primary Care Positions May Divert Physician Assistants Into Specialty Practice

2016 ◽  
Vol 74 (1) ◽  
pp. 109-122 ◽  
Author(s):  
Perri Morgan ◽  
Kristine A. Himmerick ◽  
Brandi Leach ◽  
Patricia Dieter ◽  
Christine Everett
Keyword(s):  
Primary Care ◽  
Physician Assistants ◽  
Partial Solution ◽  
Cross Sectional Study ◽  
Care Practice ◽  
Market Demand ◽  
Cross Sectional ◽  
Primary Care Workforce ◽  
Specialty Practice ◽  
Job Postings

Background: Physician assistants (PAs) are often suggested as a partial solution to predicted primary care workforce shortages, but a declining proportion of PAs are entering primary care practice. Policy efforts have focused on increasing primary care PA supply, but low labor market demand might be constricting the primary care PA pipeline. Method: In this descriptive, cross-sectional study, we compare primary care and specialty job postings to each other and to occupied PA positions. Job posting data for 2014 are from a leading labor analytics firm. Results: Only 18% of job postings were in primary care, compared with 27% of occupied PA positions. The proportion of postings that were for primary care varied widely by state (9% to 40%) and were highest in the West. Discussion: Job availability is a potential barrier to PAs practicing in primary care, especially in some locations. Other job factors are examined and policy solutions are suggested.

scholarly journals Omission of nursing care in hospitalization units

2020 ◽  
Vol 28 ◽  
Author(s):  
Juliana Carvalho de Lima ◽  
Ana Elisa Bauer de Camargo Silva ◽  
Maria Helena Larcher Caliri
Keyword(s):  
Nursing Care ◽  
Cross Sectional Study ◽  
Descriptive Statistics ◽  
Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Material Resources ◽  
High Prevalence ◽  
Nursing Professionals ◽  
Administrative Tasks

Objective: to describe the prevalence and reasons for omission of nursing care, according to the perception of nursing professionals working in a teaching hospital. Method: a cross-sectional study was carried out with 267 professionals from ten hospitalization units. Data were collected by the MISSCARE-Brasil instrument. Descriptive statistics and Pearson’s Chi-square or Fisher’s exact tests were used to compare differences in the prevalence of omission among professional categories. Results: among the elements of nursing care, the highest prevalence of omission consisted in: to sit up the patient out of bed (70.3%), ambulation three times a day (69.1%), and participation in the discussion of the interdisciplinary team on patient’s health care (67.2%). The most frequent reasons were: inadequate number of staff (85.4%), inadequate number of staff for providing care or in administrative tasks (81.6%), and unexpected increase in the number and/or greater severity of patients (79.8%). Nurses reported major omission than nursing technicians/auxiliaries in four elements of care (p<0.05). Conclusion: according to our study, there is high prevalence of omission of nursing care elements from the professionals’ perspective. Factors related to human and material resources were more reported as causes for such omission.

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