Oral health of institutionalized elderly: management and primary health care

Objective: The purpose of this paper was to evaluate the actions developed in oral health directed toward the institutionalized senior population from the perspective of municipal health managers and oral health professionals in primary care in Brazil. Methods: A qualitative, observational, and analytical study was developed and carried out in 11 municipalities between 2008 and 2010. Semi-structured interviews and analysis by ALCESTE software were used. The results from 48 subjects were analyzed. Results: The analysis revealed a 64% and 77% success rate for the corpus of health managers and oral health professionals, respectively. An Ishikawa diagram was generated using the subjects’ responses to identify the quality problem. Conclusions: This study verified that there is a lack of implementation of public policies directed toward seniors and also highlighted that there was lack of incentives and training to assist seniors in the municipalities. Therefore, it is necessary to invest in greater attention for senior patients who reside in homes for the aged

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

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Produção científica em saúde coletiva pós-implantação do Programa Nacional de Segurança do Paciente

Objetivo: Caracterizar as dissertações e teses produzidas nos programas de pós-graduação da área da saúde coletiva relacionadas à segurança do paciente pós-implantação do Programa Nacional de Segurança do Paciente no Brasil. Métodos: Trata-se de pesquisa documental, de abordagem quantitativa, desenvolvida a partir da coleta de dados de dissertações e teses disponíveis no Catálogo de Teses e Dissertações da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, acessado por meio eletrônico. Os dados foram obtidos em março de 2019 e analisados por estatística descritiva simples. Resultados: A maioria das pesquisas foi desenvolvida nos cursos stricto sensu de mestrado profissional (73,02%) e acadêmico (23,81%). Em relação às instituições de ensino superior, o maior percentual se caracterizou como pública (85,72%) e da região Nordeste (50,17%). Dos estudos, 63,49% não estavam relacionados com nenhum dos protocolos básicos de segurança do paciente. Conclusão: Identificou-se maior investigação em nível de mestrado, bem como o desenvolvimento de pesquisas predominantemente em hospitais, e que abordam, com maior intensidade, a segurança no uso de medicamentos, a cultura de segurança nos serviços de saúde e os incidentes e eventos adversos nos serviços de saúde

Melhoria da qualidade do atendimento a pacientes com sepse no contexto de um serviço de emergencia

Objective: To describe the process of implementing a participatory and multifaceted intervention to improve sepsis care and its effects on improving the quality of care.Materials and methods: This is a before-after quasi-experimental study conducted in 2017/2018 in the emergency service of a hospital in Northeast Brazil. The quality of care of 564 patients diagnosed with sepsis was assessed using nine process criteria and one result criterion. The intervention was participatory and multifaceted, being applied for 10 months.Results: After the intervention, the number of non-conformities decreased by 67% (843 vs 506), and all 10 criteria improved, with a significant improvement (p<0.05) in eight of them. Lethality decreased by 10% (p=0.005).Conclusion: The intervention model presented was effective in improving the quality of care for sepsis in the emergency service, with the possibility of scaling up its use in Brazilian hospitals.  Objetivo: Describir el proceso de implementación de una intervención participativa y multifacética para mejorar la atención de la sepsis y sus efectos en la mejora de la calidad de la atención.Materiales y métodos: Se trata de un estudio cuasi-experimental del tipo antes-después realizado en 2017/2018 en el servicio de urgencias de un hospital del noreste de Brasil. La calidad de la atención de 564 pacientes diagnosticados con sepsis, se evaluó utilizando nueve criterios de proceso y un criterio de resultado. La intervención fue participativa y multifacética, con una duración de 10 meses.Resultados: Después de la intervención, el número de incumplimientos disminuyó en un 67% (843 vs 506), y los 10 criterios mejoraron, con una mejora significativa (p <0,05) en ocho de ellos. La letalidad disminuyó en un 10% (p = 0,005).Conclusión: El modelo de intervención presentado fue eficaz para mejorar la calidad de la atención de la sepsis en el servicio de urgencias, con la posibilidad de ampliar su uso en los hospitales brasileños.Objetivo: Descrever o processo de implementação de uma intervenção participativa e multifacetada para melhorar o atendimento à sepse e seus efeitos na melhoria da qualidade do atendimento.Materiais e métodos: Trata-se de um estudo quase-experimental do tipo antes-depois realizado em 2017/2018 no serviço de emergência de um hospital do Nordeste do Brasil. A qualidade do atendimento de 564 pacientes com diagnóstico de sepse foi avaliada por meio de nove critérios de processo e um critério de resultado. A intervenção foi participativa e multifacetada, com duração de 10 meses.Resultados: Após a intervenção, o número de não conformidades diminuiu 67% (843 vs 506), e todos os 10 critérios melhoraram, com uma melhoria significativa (p <0,05) em oito deles. A letalidade diminuiu 10% (p = 0,005).Conclusão: O modelo de intervenção apresentado foi eficaz na melhoria da qualidade do atendimento à sepse no serviço de emergência, com possibilidade de ampliar sua utilização nos hospitais brasileiros

Improving the quality of care for patients with sepsis in the context of an emergency service

Objetivo: Describir el proceso de implementación de una intervención participativa y multifacética para mejorar la atención de la sepsis y sus efectos en la mejora de la calidad de la atención. Materiales y métodos: Se trata de un estudio cuasi-experimental del tipo antes-después realizado en 2017/2018 en el servicio de urgencias de un hospital del noreste de Brasil. La calidad de la atención de 564 pacientes diagnosticados con sepsis, se evaluó utilizando nueve criterios de proceso y un criterio de resultado. La intervención fue participativa y multifacética, con una duración de 10 meses. Resultados: Después de la intervención, el número de incumplimientos disminuyó en un 67% (843 vs 506), y los 10 criterios mejoraron, con una mejora significativa (p <0,05) en ocho de ellos. La letalidad disminuyó en un 10% (p = 0,005). Conclusión: El modelo de intervención presentado fue eficaz para mejorar la calidad de la atención de la sepsis en el servicio de urgencias, con la posibilidad de ampliar su uso en los hospitales brasileños. Palabras clave: Sepsis; Mejoramiento de la Calidad; Servicios Médicos de Urgencia; Gestión de Riesgos; Administración de la SeguridadObjetivo: Descrever o processo de implementação de uma intervenção participativa e multifacetada para melhorar o atendimento à sepse e seus efeitos na melhoria da qualidade do atendimento. Enfermería GlobalNº 67 Julio 2022Página 2Materiais e métodos: Trata-se de um estudo quase-experimental do tipo antes-depois realizado em 2017/2018 no serviço de emergência de um hospital do Nordeste do Brasil. A qualidade do atendimento de 564 pacientes com diagnóstico de sepse foi avaliada por meio de nove critérios de processo e um critério de resultado. A intervenção foi participativa e multifacetada, com duração de 10 meses. Resultados: Após a intervenção, o número de não conformidades diminuiu 67% (843 vs 506), e todos os 10 critérios melhoraram, com uma melhoria significativa (p <0,05) em oito deles. A letalidade diminuiu 10% (p = 0,005). Conclusão: O modelo de intervenção apresentado foi eficaz na melhoria da qualidade do atendimento à sepse no serviço de emergência, com possibilidade de ampliar sua utilização nos hospitais brasileirosObjective: To describe the process of implementing a participatory and multifaceted intervention to improve sepsis care and its effects on improving the quality of care. Materials and methods: This is a before-after quasi-experimental study conducted in 2017/2018 in the emergency service of a hospital in Northeast Brazil. The quality of care of 564 patients diagnosed with sepsis was assessed using nine process criteria and one result criterion. The intervention was participatory and multifaceted, being applied for 10 months.Results: After the intervention, the number of non-conformities decreased by 67% (843 vs 506), and all 10 criteria improved, with a significant improvement (p<0.05) in eight of them. Lethality decreased by 10% (p=0.005). Conclusion: The intervention model presented was effective in improving the quality of care for sepsis in the emergency service, with the possibility of scaling up its use in Brazilian hospitals