Práticas de liderança em enfermagem hospitalar: uma self de enfermeiros gestores

OBJETIVO Evaluar la frecuencia de las prácticas de liderazgo llevadas a cabo por los enfermeros gestores de instituciones hospitalarias y su asociación con las variables del perfil socioprofesional. MÉTODO Estudio transversal, descriptivo y correlacional, realizado en cuatro hospitales de un municipio del interior del Estado de São Paulo. Se utilizó un cuestionario sociodemográfico y el instrumento Leadership Practices Inventory. La recolección y el análisis de datos se fundaron en un Modelo de Prácticas para Liderazgo ejemplar. RESULTADOS Participaron 85 enfermeros gestores. Los promedios de las prácticas de liderazgo utilizados por los enfermeros fueron: capacitar a los otros a actuar (50,6), animar el corazón (48,2), trazar el camino (46,7), desafiar el proceso (43,3) e inspirar una visión compartida (43,1). En el análisis de datos también se constató correlación entre la práctica "anime el corazón" y las variables tiempo de asistencia y vínculo de empleo. CONCLUSIÓN El estudio constató la presencia de enfermeros gestores ejerciendo liderazgo moderado, promoviendo el trabajo en equipo, proporcionando un clima de confianza y visión horizontal. Sin embargo, los valores moderados también desvelaron aspectos de gestión que los líderes deben perfeccionar mediante herramientas y/o estrategias organizativas en búsqueda de mejores prácticas de liderazgo.OBJETIVO Avaliar a frequência das práticas de liderança executadas pelos enfermeiros gerentes de instituições hospitalares e sua associação às variáveis do perfil socioprofissional. MÉTODO Estudo transversal, descritivo e correlacional, realizado em quatro hospitaisde um município do interior paulista. Utilizou-se de questionário sociodemográfico e do instrumento Leadership Practices Inventory. A coleta e a análise de dados foram fundamentadas em um Modelo de Práticas para Liderança exemplar. RESULTADOS Participaram 84 enfermeiros gerentes. As médias das práticas de liderança utilizadas pelos enfermeiros foram: capacitar os outros a agir (50,6), encorajar o coração (48,2), traçar o caminho (46,7), desafiar o processo (43,3) e inspirar uma visão compartilhada (43,1). Na análise dos dados também se constatou correlação entre a prática encoraje o coração e as variáveis tempo de assistência e vínculo empregatício. CONCLUSÃO O estudo constatou a presença de enfermeiros gerentes exercendo liderança moderada, promovendo o trabalho em equipe, propiciando um clima de confiança e visão horizontalizada. No entanto, os valores moderados também revelam aspectos gerenciais a serem aprimorados pelos líderes, por meio de ferramentas e/ou estratégias organizacionais em busca de melhores práticas de liderança.OBJECTIVE To assess the frequency of the leadership practices performed by the manager nurses of hospital institutions and their association with the variables of the socioprofessional profile. METHOD Cross-sectional, descriptive, correlational study conducted in four hospitals in a city of the state of São Paulo. A sociodemographic questionnaire and the instrument Leadership Practices Inventory were used. Data collection and analysis were based on an exemplary Leadership Practices Model. RESULTS Eighty-four manager nurses participated in the study. The mean values of the leadership practices used by the nurses were: enable others to act (50.6); encourage the heart (48.2); model the way (46.7); challenge the process (43.3); and inspire a shared vision (43.1). Data analysis also evidenced a correlation between the practice encourage the heart and the variables time of care and employment relationship. Conclusion The study evidenced the presence of manager nurses exercising moderate leadership, and promoting teamwork, an environment of trust, and a horizontal vision. However, moderate values also reveal managerial aspects to be improved by the leaders by means of organizational strategies and/or tools aimed at best leadership practices

COMPETÊNCIAS PROFISSIONAIS PARA ENFERMEIROS: A VISÃO DE DISCENTES DE GRADUAÇÃO EM ENFERMAGEM

Objetivo: caracterizar as competências profissionais para os enfermeiros na visão de discentes de graduação em enfermagem, bem como as estratégias mobilizadas para aquisição dessas competências. Método: estudo qualitativo que utilizou a entrevista semiestruturada na coleta de dados ocorrida de janeiro a julho de 2015. Para análise dos dados foi utilizado o método de análise temática indutiva. Resultados: participaram da pesquisa 54 discentes, sendo 87% do sexo feminino e 13% do sexo masculino, na faixa etária entre 21 e 46 anos, 27,77% possuíam formação técnica em enfermagem. Quanto à procedência dos participantes, a maior parte (64,81%) era da região de Ribeirão Preto. Conclusão: na visão dos discentes, as competências profissionais para os enfermeiros foram conhecimento teórico-prático, liderança, comunicação, gerenciamento, relacionamento interpessoal e trabalho em equipe e competências pedagógicas. As estratégias mobilizadas para aquisição dessas competências foram experiência prática, aprimoramento profissional, grupos de estudo e apoio dos docentes.Descritores: Competência Profissional; Enfermagem; Bacharelado em Enfermagem; Educação Superior

Processo de trabalho em uma unidade de saúde da família: um relato de experiência/ Work process in a family health unit: an experience report

Por meio da Reforma Sanitária brasileira, a Constituição Federal de 1988 (CF/88) definiu três grandes bases para o sistema de saúde brasileiro: o conceito ampliado de saúde; a saúde como direito do cidadão e dever do Estado e a instituição do Sistema Único de Saúde (SUS). Nas últimas décadas, a Atenção Primária à Saúde (APS) tem sido tema central nas discussões devido à sua grande importância dentro do SUS, concentrando serviços de saúde pessoais e focando na continuidade dos cuidados. Desta forma, o presente estudo tem como objetivo relatar as experiências vivenciadas por acadêmicos de medicina na observação do processo de trabalho em uma Unidade de Saúde da Família (USF).  Para tanto, foi realizado um estudo descritivo, qualitativo, do tipo relato de experiência, ao longo do módulo horizontal de Atenção à Saúde I, durante os dias três e dez de março de 2020, em uma USF da Cidade de João Pessoa, com ênfase na territorialização e acompanhamento do Agente Comunitário de Saúde (ACS). No primeiro encontro, os alunos realizaram o reconhecimento do território acompanhados por um ACS, e, no segundo encontro, foi apresentado o processo de trabalho do ACS. Tal experiência foi de extrema importância para a formação médica, tanto no momento que foi possível conhecer possíveis futuros ambientes de trabalho, como também, para compreender o processo de territorialização em saúde

ATLANTIC EPIPHYTES: a data set of vascular and non-vascular epiphyte plants and lichens from the Atlantic Forest

Epiphytes are hyper-diverse and one of the frequently undervalued life forms in plant surveys and biodiversity inventories. Epiphytes of the Atlantic Forest, one of the most endangered ecosystems in the world, have high endemism and radiated recently in the Pliocene. We aimed to (1) compile an extensive Atlantic Forest data set on vascular, non-vascular plants (including hemiepiphytes), and lichen epiphyte species occurrence and abundance; (2) describe the epiphyte distribution in the Atlantic Forest, in order to indicate future sampling efforts. Our work presents the first epiphyte data set with information on abundance and occurrence of epiphyte phorophyte species. All data compiled here come from three main sources provided by the authors: published sources (comprising peer-reviewed articles, books, and theses), unpublished data, and herbarium data. We compiled a data set composed of 2,095 species, from 89,270 holo/hemiepiphyte records, in the Atlantic Forest of Brazil, Argentina, Paraguay, and Uruguay, recorded from 1824 to early 2018. Most of the records were from qualitative data (occurrence only, 88%), well distributed throughout the Atlantic Forest. For quantitative records, the most common sampling method was individual trees (71%), followed by plot sampling (19%), and transect sampling (10%). Angiosperms (81%) were the most frequently registered group, and Bromeliaceae and Orchidaceae were the families with the greatest number of records (27,272 and 21,945, respectively). Ferns and Lycophytes presented fewer records than Angiosperms, and Polypodiaceae were the most recorded family, and more concentrated in the Southern and Southeastern regions. Data on non-vascular plants and lichens were scarce, with a few disjunct records concentrated in the Northeastern region of the Atlantic Forest. For all non-vascular plant records, Lejeuneaceae, a family of liverworts, was the most recorded family. We hope that our effort to organize scattered epiphyte data help advance the knowledge of epiphyte ecology, as well as our understanding of macroecological and biogeographical patterns in the Atlantic Forest. No copyright restrictions are associated with the data set. Please cite this Ecology Data Paper if the data are used in publication and teaching events. © 2019 The Authors. Ecology © 2019 The Ecological Society of Americ

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Perception of nursing students about behaviours and ethical aspects involved in patient data collection

Objective. To identify the perception of nursing students in relation to the behaviors and ethical issues involved in data collection from patients. Methodology. Descriptive and exploratory study with a qualitative approach, using the content analysis proposed by Bardin as the theoretical framework. Participants were students in the 7th period of the nursing undergraduate course at a public university located in the state of Minas Gerais, Brazil, in 2011. Data were collected through interviews. Results. From the analysis of the results, the following categories emerged: preservation of patients� intimacy and privacy, respect for patients� autonomy, experiences and feelings of students and training strategies relating to the nursing process during the undergraduate course. Conclusion. The nursing students are concerned with the ethical approach during data collection from patients and the preservation of their rights. Pedagogical practices should be reinforced that take into consideration the technical aspects, as well as those related to behaviors and ethics.Objetivo. Identificar a percepção dos estudantes de enfermagem sobre os comportamentos e os aspectos éticos implicadas na recolha de dados dos pacientes. Metodologia. Estudo descritivo e exploratório com abordagem qualitativa, que utilizou como referencial metodológico a análise de conteúdo proposto por Bardin. No estudo participaram estudantes de enfermagem do sétimo período de uma universidade pública de Minas Gerais, Brasil, em 2011. Os dados foram coletados por meio de entrevistas. Resultados. Emergiram da análise dos resultados as seguintes categorias: preservação da privacidade e intimidade do paciente, o com respeito à autonomia do paciente, experiências e sentimentos dos estudantes, e as estratégias de ensino do processo de enfermagem durante a formação do aluno. Conclusão. Há preocupação dos estudantes de enfermagem pelo enfoque ético da recolha de dados do paciente e pela preservação de seus direitos. Devem-se reforçar práticas pedagógicas que tenham em conta não só os aspectos técnicos, senão também os relacionados com o comportamento e a ética.Objetivo. Identificar la percepción de los estudiantes de enfermería sobre los comportamientos y los aspectos éticos implicados en la recolección de datos de los pacientes. Metodología. Estudio descriptivo y exploratorio con abordaje cualitativo, que utilizó como referencial metodológico el análisis de contenido propuesto por Bardin. En el estudio participaron estudiantes de enfermería del séptimo período de una universidad pública de Minas Gerais, Brasil, en 2011. Los datos fueron recolectados por medio de entrevistas. Resultados. Emergieron del análisis de los resultados las siguientes categorías: preservación de la privacidad e intimidad del paciente, el respeto a la autonomía del paciente, experiencias y sentimientos de los estudiantes, y las estrategias de enseñanza del proceso de enfermería durante la formación del alumno. Conclusión. Hay preocupación de los estudiantes de enfermería por el enfoque ético de la recolección de datos del paciente y por la preservación de sus derechos. Se deben reforzar prácticas pedagógicas que tengan en cuenta no solo los aspectos técnicos, sino también los relacionados con el comportamiento y la ética

Perception of nursing students about behaviors and ethical aspects involved in patient data collection

Objective. To identify the perception of nursing students in relation to the behaviors and ethical issues involved in data collection from patients. Methodology. Descriptive and exploratory study with a qualitative approach, using the content analysis proposed by Bardin as the theoretical framework. Participants were students in the 7th period of the nursing undergraduate course at a public university located in the state of Minas Gerais, Brazil, in 2011. Data were collected through interviews. Results. From the analysis of the results, the following categories emerged: preservation of patients' intimacy and privacy, respect for patients' autonomy, experiences and feelings of students and training strategies relating to the nursing process during the undergraduate course. Conclusion. The nursing students are concerned with the ethical approach during data collection from patients and the preservation of their rights. Pedagogical practices should be reinforced that take into consideration the technical aspects, as well as those related to behaviors and ethics

Cervical Cytology of Samples with Ureaplasma urealyticum, Ureaplasma parvum, Chlamydia trachomatis, Trichomonas vaginalis, Mycoplasma hominis, and Neisseria gonorrhoeae Detected by Multiplex PCR

Introduction. Despite increasing application of molecular diagnostic methods for the detection of sexually transmitted infections, the cytological findings in pap smears of patients with pathogens that can be identified only by PCR are not yet well described. The aim of this study was to describe the most common cytological features in cervical pap smears of patients with Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis, Mycoplasma hominis, Ureaplasma urealyticum, and Ureaplasma parvum detected by multiplex PCR. Methods. Cervical samples for conventional and liquid-based cytology and for multiplex PCR were collected from women ranging from 23 to 54 years old, who underwent routine screening at a gynecological Unit. Results. Multiplex PCR was positive in 36.2% of the samples: Ureaplasma parvum 14.9%, Chlamydia trachomatis 10.6%, Trichomonas vaginalis 10.6%, Mycoplasma hominis 8.5%, Ureaplasma urealyticum 4.2%, Neisseria gonorrhoeae 2.1%, and Mycoplasma genitalium (0). Multiple pathogens were observed in 12.8% of samples. Microscopic cervicitis (≥10 polymorphonuclear leukocytes/epithelial cell) and normal (predominantly lactobacillary) microbiota were the most frequent findings in the samples in which the pathogens were detected alone or in multiple infections, except for samples with Trichomonas vaginalis in which the coccobacillary microbiota was the most common. In samples with microscopic cervicitis and normal microbiota, those with at least one pathogen identified by multiplex PCR were significantly more frequent than those with no pathogen, 66.6% versus 33.3%. Conclusion. Failure to identify an inflammatory agent in pap smear with intense neutrophil exudate may suggest the presence of Ureaplasma parvum, Ureaplasma urealyticum, Chlamydia trachomatis, or Trichomonas vaginalis. A remark on the intensity of inflammation should be made in the reports of cervical pap smears so that this cytological finding can be correlated with clinical and PCR results