Stress in healthcare workers in Hospitals and Emergency Care Units in Sergipe public health service during COVID-19 pandemic time

The objective of this work was to assess the stress in healthcare workers (HCW) and its correlation with perception of stressors in their work environments - hospitals and emergency care units in the public health system in the state of Sergipe, Brazil, during the COVID-19 pandemic. This is a cross-sectional study carried out by non-probabilistic sampling with 58 HCW, using specific questionnaires and a validated scale (Job Stress Scale) about sociodemographic issues, job stress and COVID-19. Using the demand-control-support assessment model, the work performed was classified as passive, active, low strain and high strain, according work's demand and the range of decision-making freedom. Estimated correlations between each questionnaire were performed using Pearson's correlation coefficient through SPSS software, and descriptive statistics, through Excel. Most of the participants were shown to be under high psychological demand (93.10%) and found themselves with high control (89.66%). Some factors affected the HCW’s perception of social support in the workplace, these were their team’s knowledge about COVID-19, the availability of personal protective equipment, and their physical comfort while using it. HCW were involved in active work; although they were not in the worst scenario in relation to psychological stress, they were still under great psychological strain, which reinforces the need to adopt effective measures to reduce it.

Assessment of Organ and Tissue Procurement Knowledge in Health Care Workers Associated to Critical and Emergency Care Units

Objetivo: Evaluar el nivel de conocimiento de profesionales en salud frente a la donación de órganos y tejidos en Barranquilla. Metodología: Estudio transversal con encuesta semiestructurada sobre el conocimiento de la donación de órganos y tejidos en el personal de salud entre junio hasta diciembre de 2019. Se incluyen 232 profesionales de la salud en los servicios de Unidad de Cuidado Intensivo (UCI) adultos o pediátrica y Urgencias en seis Instituciones Prestadoras de Salud (IPS) de Barranquilla. Resultados: El 75 % de nuestros encuestados fueron mujeres. Se incluyó auxiliares de enfermería (43,5 %), enfermeras profesionales (25,4 %), médicos (22,8 %) y fisioterapeutas (8,2 %). El 84,5 % de los evaluados definió correctamente la muerte encefálica (ME); 50,4% tiene conocimiento adecuado sobre la presunción en donación; el 52,4 % identifica apropiadamente la legislación, y el 78,9% conoce la activación de alerta en donación. No se encontraron resultados estadísticamente significativos en nivel de conocimiento comparado entre IPS (p=0.42), aunque se encontró una diferencia entre el concepto de presunción legal de la donación entre los servicios UCI adulto, pediátrica y Urgencias (p=0.000) y la definición de ME entre los profesionales asociados (p=0.001). Conclusión: Este diagnóstico del nivel de conocimiento en donación y trasplantes identificó una contundente necesidad de educación y entrenamiento continuo que podría ser gestionada con esfuerzos regionales en pro del mejoramiento del proceso y la tasa de donación de órganos y tejidos.

Nursing Team Training to Use a Flowchart to Care for Patients with Chest Pain

Background: chest pain, of multicausal etiology, associated with a cardiac cause or not, is one of the most frequently presented symptoms by patients in Emergency Care Units. Despite its high prevalence in health services, there is still a deficiency in care standardization, which raises difficulties in acute coronary syndrome diagnosis and delay in treatment. The objective was to assess the efficiency of professional training of nursing teams in Emergency Care Units on the use of a flowchart to care for patients with chest pain. Methods and Findings: this educational intervention study was conducted with 25 nursing team professionals. It has been developed in four steps: Step 1 referred to prior application of the validated research instrument. Step 2 comprised training to use the flowchart with an expository lesson on care of patients with chest pain and guidance regarding the flowchart to be implemented. Step 3 reapplied the validated instrument after class. Step 4 reapplied the instrument after 2 months of training for flowchart implementation. When comparing the results of the instrument applied to nursing team professionals, post-training and follow-up performance surpassed that of pre-training. It was observed that professionals with less than five years of experience showed better performance. This study had as limitation the small sample of health professionals participating in the offered training. Conclusion: training was satisfactory and significant, and professionals demonstrated content assimilation, obtaining higher scores than at the beginning of the research.

Information to the relatives of children admitted to emergency care units

Objetivo: Analisar a atuação da enfermagem na transmissão das informações às famílias das crianças na emergência. Métodos: Pesquisa qualitativa. Os participantes foram 16 membros da equipe de enfermagem do setor de emergência de um hospital pediátrico público do Rio de Janeiro. O procedimento para a coleta dados foi à entrevista não diretiva em grupo, e os depoimentos foram submetidos à analise temática, à luz da Política Nacional de Humanização. Resultados: As informações transmitidas ao familiar/acompanhante foram relacionadas ao ambiente, normas e rotinas hospitalares, higiene corporal, procedimentos invasivos, e medicamentos. Três momentos distintos para a transmissão de informações foram identificados: admissão da criança, permanência na unidade e alta. Conclusão: A equipe de enfermagem reconhece o direito à informação das famílias das crianças e atua em todos os momentos da assistência à criança no setor de emergência. Acredita-se que a capacitação dos enfermeiros é fundamental para promover transformações na atuação da enfermagem.

Care profile of the elderly population in Emergency Care Units in the city of Rio de Janeiro

RESUMO No atual contexto de transição epidemiológica, as Unidades de Pronto Atendimento (UPA) passaram a exercer papel fundamental no atendimento à população idosa, com destaque para diagnósticos relacionados com trauma, doenças cardiovasculares e doenças respiratórias. Este trabalho teve como objetivo fazer uma análise do atendimento à população de idosos nas UPA do município do Rio de Janeiro entre os anos 2013 e 2015, levando em conta os diagnósticos mais prevalentes de acordo com a Classificação Internacional de Doenças, as classificações de risco relativas a cada grupo de doenças e os desfechos após o atendimento médico. Detectou-se maior prevalência de atendimentos do sexo feminino, assim como um aumento considerável no número de diagnósticos atendidos em idosos com o passar dos anos. Observou-se que a maioria desses idosos foi classificada como risco Amarelo, e a maior parte dos desfechos foi alta ou encaminhamento a especialistas. A rede de atenção à saúde deve preparar-se para o aumento das demandas desse grupo etário, sendo especialmente necessário um incentivo à procura pela atenção primária em busca da prevenção.

Does the “Morning Morality Effect” Apply to Prehospital Anaesthesiologists? An Investigation into Diurnal Changes in Ethical Behaviour

The “morning morality effect”—the alleged phenomenon that people are more likely to act in unethical ways in the afternoon when they are tired and have less self-control than in the morning—may well be expected to influence prehospital anaesthesiologist manning mobile emergency care units (MECUs). The working conditions of these units routinely entail fatigue, hunger, sleep deprivation and other physical or emotional conditions that might make prehospital units predisposed to exhibit the “morning morality effect”. We investigated whether this is in fact the case by looking at the distribution of patient transports to hospital with and without physician escort late at night at the end of the shift as a surrogate marker for changing thresholds in ethical behaviour. All missions over a period of 11 years in the MECU in Odense were reviewed. Physician-escorted transports to hospital were compared with non-physician-escorted transports during daytime, evening, and night-time (which correlates with time on the 24 h shifts). In total, 26,883 patients were transported to hospital following treatment by the MECU. Of these, 27.4% (26.9%–27.9%) were escorted to the hospital. The ratio of patient transports to hospital with and without physician escort during the three periods of the day did not differ (p = 1.00). We found no evidence of changes in admission patterns over the day. Thus, no evidence of the expected “morning morality effect” could be found in a prehospital physician-manned emergency care unit.