IMPLANTAÇÃO E DESENVOLVIMENTO DO PROCESSO DE ENFERMAGEM NO HOSPITAL-ESCOLA

O trabalho relata a implantação e desenvolvimento do processo de enfermagem em Hospital-Escola, analisado sob um prisma de mudança na organização do Departamento de Enfermagem. Assumindo um caráter inovador a proposta exige um comportamento adaptativo do enfermeiro, da equipe de enfermagem e da equipe multiprofissional para que a implementação da assistência, nessa perspectiva, possa ser efetiva e atinja um alto nível de qualidade. Salienta, ainda, o estabelecimento de programas de treinamento e atualização de enfermeiros no sentido de torná-los competentes para o cumprimento de seu papel de coordenador da assistência de enfermagem.The work relates the implantation and development of the nursing process in school-hospital, analyzed by a point of changing in the nursing departament organization. Assuming an innovating nature, the proposal demands an adaptative behavior of the nurse,the nursing and multiprofessional staffs, so that implementation of the assistence, in this perspective, can be effective and come to a high quality level. The work still points out, the stablishing of the training program and up-to-date nurses program in order to make them cut out for accomplishment of their roles as coordinator of nursing assistence

Newborn Hearing Screening And Early Diagnostic In The Nicu

The aim was to describe the outcome of neonatal hearing screening (NHS) and audiological diagnosis in neonates in the NICU. The sample was divided into Group I: neonates who underwent NHS in one step and Group II: neonates who underwent a test and retest NHS. NHS procedure was automated auditory brainstem response. NHS was performed in 82.1% of surviving neonates. For GI, referral rate was 18.6% and false-positive was 62.2% (normal hearing in the diagnostic stage). In GII, with retest, referral rate dropped to 4.1% and false-positive to 12.5%. Sensorineural hearing loss was found in 13.2% of infants and conductive in 26.4% of cases. There was one case of auditory neuropathy spectrum (1.9%). Dropout rate in whole process was 21.7% for GI and 24.03% for GII. We concluded that it was not possible to perform universal NHS in the studied sample or, in many cases, to apply it within the first month of life. Retest reduced failure and false-positive rate and did not increase evasion, indicating that it is a recommendable step in NHS programs in the NICU. The incidence of hearing loss was 2.9%, considering sensorineural hearing loss (0.91%), conductive (1.83%) and auditory neuropathy spectrum (0.19%). © 2014 Maria Francisca Colella-Santos et al.2014Leite, A.J.M., Cunha, A.J.L.A., Victora, C.G., Rouquayrol, M.Z., Silva, M.G.C., Epidemiologia da saúde da criança (2013) Epidemiologia & Saúde, , Rio de Janeiro, Brazil MedbookJiang, Z.D., Wilkinson, A.R., Normal brainstem responses in moderately preterm infants (2008) Acta Paediatrica, 97 (10), pp. 1366-1369. , 2-s2.0-51349084179 10.1111/j.1651-2227.2008.00935.xSininger, Y.S., Doyle, K.J., Moore, J.K., The case for early identification of hearing loss in children: Auditory system development, experimental auditory deprivation, and development of speech perception and hearing (1999) Pediatric Clinics of North America, 46 (1), pp. 1-14. , DOI 10.1016/S0031-3955(05)70077-8Yoshinaga-Itano, C., Sedey, A., Language, speech, and social emotional development of children who are deaf or hard of hearing: The early years (2000) The Volta Review, 100 (5). , article 298Busa, J., Harrison, J., Chappell, J., Yoshinaga-Itano, C., Grimes, A., Brookhouser, P.E., Epstein, S., Mason, P., Year 2007 position statement: Principles and guidelines for early hearing detection and intervention programs (2007) Pediatrics, 120 (4), pp. 898-921. , http://pediatrics.aappublications.org/cgi/reprint/120/4/898, DOI 10.1542/peds.2007-2333Northern, J.L., Downs, M.P., (2002) Hearing in Children, , Lippincott Williams & WilkinsGravel, J.S., Hood, L.J., Musiek, F.E., Rintelmann, W.F., Pediatric audiologic assessment (1999) Contemporary Perspectives in Hearing Assessment, , Boston, Mass, USA Allyn and BaconHall III, J.W., Smith, S.D., Popelka, G.R., Newborn hearing screening with combined otoacoustic emissions and auditory brainstem responses (2004) Journal of the American Academy of Audiology, 15 (6), pp. 414-425. , 2-s2.0-16544383016 10.3766/jaaa.15.6.3Barreiro, S.A.B., González, J.C.F., Yanes, J.B., Bermúdez, J.L.P., Cano, Z.L.C., Macías, A.R., Results of an early hearing detection program (2013) Acta Otorrinolaringológica Española, 64 (2), pp. 92-96Gilbey, P., Kraus, C., Ghanayim, R., Sharabi-Nov, A., Bretler, S., Universal newborn hearing screening in Zefat, Israel: The first two years (2013) International Journal of Pediatric Otorhinolaryngology, 77 (1), pp. 97-100. , 2-s2.0-84871529411 10.1016/j.ijporl.2012.10.004Tanon-Anoh, M.J., Sanogo-Gone, D., Kouassi, K.B., Newborn hearing screening in a developing country: Results of a pilot study in Abidjan, Côte d'ivoire (2010) International Journal of Pediatric Otorhinolaryngology, 74 (2), pp. 188-191. , 2-s2.0-72649100374 10.1016/j.ijporl.2009.11.008Johnson, J.L., White, K.R., Widen, J.E., Gravel, J.S., James, M., Kennalley, T., Maxon, A.B., Holstrum, J., A multicenter evaluation of how many infants with permanent hearing loss pass a two-stage otoacoustic emissions/automated auditory brainstem response newborn hearing screening protocol (2005) Pediatrics, 116 (3), pp. 663-672. , http://pediatrics.aappublications.org/cgi/reprint/116/3/663.pdf, DOI 10.1542/peds.2004-1688Bevilacqua, M.C., Alvarenga, K.D.F., Costa, O.A., Moret, A.L.M., The universal newborn hearing screening in Brazil: From identification to intervention (2010) International Journal of Pediatric Otorhinolaryngology, 74 (5), pp. 510-515. , 2-s2.0-77951629006 10.1016/j.ijporl.2010.02.009Cavalcanti, H.G., Guerra, R.O., The role of maternal socioeconomic factors in the commitment to universal newborn hearing screening in the Northeastern region of Brazil (2012) International Journal of Pediatric Otorhinolaryngology, 76 (11), pp. 1661-1667. , 2-s2.0-84867704921 10.1016/j.ijporl.2012.07.041Grandori, F., Lutman, M.E., European consensus statement on neonatal hearing screening finalised at the European Consensus Development Conference on Neonatal Hearing Screening 15-16 May 1998, Milan, Italy (1998) Scandinavian Audiology, 27 (4), pp. 259-260. , DOI 10.1080/010503998420577(2010) Newborn and Infant Hearing Screening: Current Issues and Guiding Principles for Action, , http://www.who.int/blindness/publications/ Newborn_and_Infant_Hearing_Screening_Report.pdfErenberg, A., Lemons, J., Sia, C., Tunkel, D., Ziring, P., Adams, M., Holstrum, J., Strickland, B., Newborn and infant hearing loss: Detection and intervention (1999) Pediatrics, 103 (2), pp. 527-530. , DOI 10.1542/peds.103.2.527Kamal, N., Newborn hearing screening: Opportunities and challenges (2013) Egyptian Journal of Ear, Nose, Throat and Allied Sciences, 14, pp. 55-58Van Dommelen, P., Mohangoo, A., Verkerk, P., Van Der Ploeg, C., Van Straaten, H., Risk indicators for hearing loss in infants treated in different neonatal intensive care units (2010) Acta Paediatrica, 99 (3), pp. 344-349. , 2-s2.0-77249132294 10.1111/j.1651-2227.2009.01614.xFrançozo, M.F.C., Masson, G.A., Rossi, T.R.F., Lima, M.C.M.P., Santos, M.F.C., Adherence to a neonatal hearing screening program (2010) Saúde e Sociedade, 19 (4), pp. 910-918Clemens, C.J., Davis, S.A., Bailey, A.R., The false-positive in universal newborn hearing screening (2000) Pediatrics, 106 (1). , article E7 2-s2.0-0034223102Connolly, J.L., Carron, J.D., Roark, S.D., Universal newborn hearing screening: Are we achieving the Joint Committee on Infant Hearing (JCIH) objectives? (2005) Laryngoscope, 115 (2), pp. 232-236. , DOI 10.1097/01.mlg.0000154724.00787.49Shulman, S., Besculides, M., Saltzman, A., Ireys, H., White, K.R., Forsman, I., Evaluation of the universal newborn hearing screening and intervention program (2010) Pediatrics, 126 (1), pp. S19-S27. , 2-s2.0-77955433774 10.1542/peds.2010-0354FRai, N., Thakur, N., Universal screening of newborns to detect hearing impairment - Is it necessary? (2013) International Journal of Pediatric Otorhinolaryngology, 77 (6), pp. 1036-1041. , 2-s2.0-84877801659 10.1016/j.ijporl.2013.04.006Coenraad, S., Goedegebure, A., Van Goudoever, J.B., Hoeve, L.J., Risk factors for sensorineural hearing loss in NICU infants compared to normal hearing NICU controls (2010) International Journal of Pediatric Otorhinolaryngology, 74 (9), pp. 999-1002. , 2-s2.0-77955550833 10.1016/j.ijporl.2010.05.024Coenraad, S., Hoeve, L.J., Goedegebure, A., Incidence and clinical value of prolonged I-V interval in NICU infants after failing neonatal hearing screening (2011) European Archives of Oto-Rhino-Laryngology, 268 (4), pp. 501-505. , 2-s2.0-79955931725 10.1007/s00405-010-1415-8Feirn, R., Sutton, G., Parker, G., Sirimanna, T., Lightfoot, G., Wood, S., (2013) Newborn Hearing Screening and Assessment: Guidelines for the Assessment and Management of Auditory Neuropathy Spectrum Disorder in Young Infants, , http://hearing.screening.nhs.uk/audiologyprotocols#fileid16503Kang, M.-Y., Jeong, S.-W., Kim, L.-S., Changes in the hearing thresholds of infants who failed the newborn hearing screening test and in infants treated in the neonatal intensive care unit (2012) Clinical and Experimental Otorhinolaryngology, 5 (1), pp. S32-S36. , 2-s2.0-84862283300 10.3342/ceo.2012.5.S1.S32Bento, R.F., (2013) Tratado de Otologia, , São Paulo, Brazil AtheneuBorges, L.R., Paschoa, J.R., Colella-Santos, M.F., (Central) Auditory Processing: The impact of otitis media (2013) Clinics, 68 (7), pp. 954-959. , 2-s2.0-84881034318 10.6061/clinics/2013(07)11Paludetti, G., Conti, G., Di Nardo, D., De Corso, E., Rolesi, R., Picciotti, P.M., Fetoni, A.R., Infant hearing loss: From diagnosis to therapy official report of xxi conference of italian society of pediatric otorhinolaryngology (2012) Acta Otorhinolaryngologica Italica, 32 (6), pp. 347-370. , 2-s2.0-84871858735Amatuzzi, M., Liberman, M.C., Northrop, C., Selective inner hair cell loss in prematurity: A temporal bone study of infants from a neonatal intensive care unit (2011) Journal of the Association for Research in Otolaryngology, 12 (5), pp. 595-604. , 2-s2.0-80054101465 10.1007/s10162-011-0273-4Van Dommelen, P., Van Straaten, H.L.M., Verkerk, P.H., Ten-year quality assurance of the nationwide hearing screening programme in Dutch neonatal intensive care units (2011) Acta Paediatrica, 100 (8), pp. 1097-1103. , 2-s2.0-79960078616 10.1111/j.1651-2227.2011.02230.xMuller-Mazzotta, J., Zemlin, M., Berger, R., Hanschmann, H., Influence of postconceptional age on universal newborn hearing screening in NICU-babies (2012) Audiology Research, 2 (1), pp. 1-3. , 10.4081/audiores.2012.e1Coenraad, S., Goedegebure, A., Hoeve, L.J., An initial overestimation of sensorineural hearing loss in NICU infants after failure on neonatal hearing screening (2011) International Journal of Pediatric Otorhinolaryngology, 75 (2), pp. 159-162. , 2-s2.0-78650968000 10.1016/j.ijporl.2010.10.026Korres, S., Nikolopoulos, T.P., Peraki, E.E., Tsiakou, M., Karakitsou, M., Apostolopoulos, N., Economides, J., Ferekidis, E., Outcomes and efficacy of newborn hearing screening: Strengths and weaknesses (success or failure?) (2008) Laryngoscope, 118 (7), pp. 1253-1256. , 2-s2.0-47149086791 10.1097/MLG.0b013e31816d726cOlusanya, B.O., Wirz, S.L., Luxon, L.M., Community-based infant hearing screening for early detection of permanent hearing loss in Lagos, Nigeria: A cross-sectional study (2008) Bulletin of the World Health Organization, 86 (12), pp. 956-963. , 2-s2.0-57149107570 10.2471/BLT.07.050005Holster, I.L., Hoeve, L.J., Wieringa, M.H., Willis-Lorrier, R.M.S., De Gier, H.H.W., Evaluation of hearing loss after failed neonatal hearing screening (2009) Journal of Pediatrics, 155 (5), pp. 646-650. , 2-s2.0-71749102175 10.1016/j.jpeds.2009.05.003Bielecki, I., Horbulewicz, A., Wolan, T., Risk factors associated with hearing loss in infants: An analysis of 5282 referred neonates (2011) International Journal of Pediatric Otorhinolaryngology, 75 (7), pp. 925-930. , 2-s2.0-79957855764 10.1016/j.ijporl.2011.04.007Hille, E.T., Van Straaten, H.L.M., Verkerk, P.H., Van Straaten, I., Verkerk, P., Hille, E., Baerts, W., Bos, A., Prevalence and independent risk factors for hearing loss in NICU infants (2007) Acta Paediatrica, International Journal of Paediatrics, 96 (8), pp. 1155-1158. , DOI 10.1111/j.1651-2227.2007.00398.

Evolução da enfermagem no contexto do hospital-escola: depoimentos de enfermeiros representantes da década de 70 Evolución de la enfermería en el contexto de hospital-escuela: declaraciones de enfermeros de la década de 70 Nursing evolution at university hospitals: declarations of nurses who worked in the 1970s

Este estudo é parte de um projeto mais amplo que visa resgatar aspectos significativos relacionados a revolução da assistência de enfermagem da década de 50 a 90. Este resgate é feito através da técnica de depoimentos orais de enfermeiros em exército e aposentados, no contexto de um hospital-escola do interior paulista. O presidente estudo particulariza os resultados obtidos, referentes a década de 70. Como resultado evidencia-se o esforço empreendido pelos enfermeiros na luta pelo reconhecimento e prestígio da profissão, as transformações intensas e profundas aos novos papéis da enfermeira enquanto líder da equipe e membro da equipe médica.<br>Este estudio es parte de un proyecto más amplio intentando la captación de aspectos significativos relacionados a la evaluación de la asistencia de enfermería en las décadas de 50 a 90. La captación se ha realizado a través de la técnica de declaraciones orales de los enfermeros en ejercicio de la profesión, en el contexto de un hospital-escuela de interior del Estado de São Paulo. El presente estudio particulariza los resultados obtenidos, referentes a la década de 70. Como resultados se evidencian el esfuerzo imprimido por las enfermeras en la lucha por el reconocimiento y prestigio de la profesión. Las transformaciones intensas y profundas relacionadas a los nuevos roles de la enfermera como líder de los trabajadores de enfermería y miembro del grupo de la salud.<br>This study is part of a more extensive project that proposes to recover significant aspects related to nursing care evolution from 1950s. This study is developed through the technique of oral declaration by active and retired registered nurses, in the context of an university-hospital from São Paulo State. The present study emphasizes the outcomes referring to the 1970s. As result becomes evident the undertaken effort by nurses in the struggle for profession's recognition and prestige; intense and deep transformations related to nurse's new roles as leadership of nursing staff and member of medical team