Multidimensional assessment of institutionalized elderly: the reality of a brazilian institution

Background: The population aging in Brazil is characterized by the accumulation of progressive disabilities in their functional activities and daily life. To consider the elderlies in his/her multiple dimensions turns out to be a critical issue to improvetheir assistance to an institu-tionalized level, improving their health and quality of life. To perform a mini-overall evaluation of institutionalized elderly person to trace their profile in relation to the socio-demographic, functional capacity, nutritional status and cognition. Methods: Descriptive study, with a cross-sectional design and quan-titative approach performed in a long - stay institution for the elderly in Natal, RN. The research was approved by the Research Ethics Com-mittee of the Federal University of Rio Grande do Norte, under opinion number 164/2011.Results: 63.3% of the elderly were female, with ages varying from 61 to 103 years. 60.0% were single; 56.7% were literate. 66.7% had no children and 55% lived with their families before the institutio-nalization. As for the institutionalization time, 63.3% resided in the institution for four years. As what concerns the aspects of health, 73.3% of the elderly presented hearing difficulties, 90% make use of medicines predominantly to diabetes and hypertension. There is clear evidence that the institutionalization has been harmful to the elderly as with regards basic activities of daily living, nutritional status and cognitive aspects. Conclusion: The progressive disability in functional activities of daily life interferes directly in the quality of life, increasing dependency and minimizing the autonomy of these individuals. It is necessary to effec-tive implementation of public policies directed to the institutionalized elderly from the perspective of effective actions for improved attention and assistance

Protocol Proposal For The Care Of The Person With Venous Ulcer

Objective: To propose a care protocol for the care of the person with a venous ulcer in highly complex services. Methods and results: This is a methodological study, in three stages: literature review, validation of content and validation in the clinical context. The literature review was carried out from June to August/2011, being the basis for the construction of the Protocol for Venous Ulcers. The content validation included 53 judges (44 nurses, 8 physicians and 1 physiotherapist) selected through the Lattes platform to evaluate the items of the protocol. Validation in the clinical context occurred at the University Hospital Onofre Lopes, in Natal/RN with four judges (nurses), who worked in pairs, evaluating 32 patients with venous ulcers. The protocol was validated with 15 categories: sociodemographic data; anamnesis; examinations; ulcer characteristics; care with the lesion and perilesional area; medicines used to treat the lesion; evaluation and treatment of pain; surgical treatment of chronic venous disease; recurrence prevention (clinical and educational strategies); reference; counter-reference; and quality of life. Conclusion: The validated protocol regarding content and clinical context was applicable. Its implementation is a viable measure that assists in the reorientation of the team in high complexity services, aiming at wound healing and restoration of the patient´s integral health. Keywords: Varicose ulcer; Tertiary Health Care; Protocols; Validation studies

Immediate Care To The Newborn Of Women With Human Immunodeficiency Virus: A Proposal Of Evaluation

Introduction: women living with human immunodeficiency virus (HIV) have 15% of the 45% chance of transmitting the virus to their children during pregnancy, childbirth or breastfeeding. However, this risk is reduced to 2% when the treatment and monitoring are carried out since the gestational period until the birth of the child. Objective: build a logical model to subsidize the immediate care of health professionals to the newborn of women with HIV.  Method: study described. It is the construction of a logical model based on "clinical Protocol and therapeutic guidelines for management of HIV infection in children and adolescents", manual of the Ministry of health, Brazil, 2014, in order to guide health professionals who, watch newborns in the first few minutes of life. Results: were listed eight components that are essential to the care of the newborn, such as: greeting, umbilical cord clamping, suctioning the airway, administering of vitamin K, shower, breastfeeding, administration of anti-retroviral and reference to specialized service. Conclusion: it is believed that the logical model will contribute to reducing the risks of mother-to-child transmission of the virus, since it includes the flow of care clearly and objectively. Keywords: health professionals; immediate care; newborn; vertical transmission of HIV. &nbsp

Quality Of Care Indicators Of A Pre-Hospital Mobile Emergency: A Review

Objective: To identify the quality of care indicators in pre-hospital mobile emergency services. Methods and results: This study is a systematic review conducted in December/2015 in eight databases using the keywords: quality indicators in health care; pre-hospital care; and quality, access, and evaluation of the health care. Seventeen studies were selected and the following indicators were identified: conservation of the ambulances; physical structure; comfort in the ambulance; material resources; safety for the patient/professional; continuing education; response time; professional remuneration; professional/patient satisfaction; access; host; humanization; performed service; safety demonstrated by the team; privacy to the patient; guidelines on care; relationship between the professional/patient; opportunity of the patient to complaint. Conclusion: The establishment the of the quality of care indicators the in mobile emergency services will allow the construction of instruments to evaluate this type of service to search for excellence results in mobile emergency services

Evaluation Of The Quality Of Assistance In An Pre-Hospital Mobile Emergency Service

Background: to evaluate the quality of the assistance of a Mobile Emergency Care Service and to compare the evaluation of professionals according to training and level of education. Methods and Findings: this is a cross-sectional study, with a Donabedian theoretical reference. The sample was all the professionals of a Mobile Emergency Service and data collection performed by a previously validated quality assessment instrument. Some aspects of the service structure were evaluated negatively, and the process was evaluated in a positive way, in general. When comparing the evaluation of quality according to professional category and education, it was verified that the indicators of structure and process were considered appropriate by the professionals of average level and inadequate by the personnel of superior level. Conclusion: the professionals identified flaws in the service structure, which can impact the assistance provided. The level of education influenced the evaluation of the quality of the service. Keywords: Emergency medical services; Health Evaluation; Prehospital care; Evaluation studies; Health services &nbsp

Characterization of Publications on Burns in Brazil and Changes Resulting from Trauma in Brazil: Systematic Review of the Literature

Objective: Characterize the profile of scientific publications on burns in Brazil and systemic changes resulting from the trauma. Methods and results: This is a bibliographical, retrospective and descriptive research with a quantitative approach. It was held between April and May, 2016 in the databases Latin American and Caribbean Center on Health Sciences (LILACS); Nursing Database (BDENF); Medical Literature Analysis and Retrieval System Online (MEDLINE), Scientific Electronic Library Online (SciELO) and the Journal Portal of Higher Education Personnel Improvement Coordination (CAPES). After the analysis of the inclusion criteria (articles available in full, in Portuguese, published between 2011 and 2015), there were 49 productions, and 16 were selected. Analyzing the sample for the event characteristics, it was observed a higher incidence of accidents in males. The main causes of burns were heated by liquid, followed by direct flame. Regarding the classification, the most frequent injury was the 2nd degree, but also there were burns reports with mixed classification. Also, the upper limbs and trunk were the body parts most affected. In addition to these data, it was also highlighted the most frequent types of systemic changes caused by burns, which were respiratory complications, infection and/or sepsis and metabolic sequels.  Conclusion: The study showed the need to characterize of the publications in burns, since the crossing of this information provides a better understanding of the main causal factors, distribution and identification of risk groups. It also enables the planning of prevention strategies to help to reduce accidents, favoring the reduction of injuries and the number of hospitalizations. Moreover, it is extremely important that health professionals know about the epidemiological profile, to provide support in the evaluation and organization of care, and to prevention campaigns, aiming to decrease burn rates. Keywords: Profile; Burns; Burn Units