Revista gaucha de enfermagem / EENFUFRGS最新文献

Objective: To analyze the strengths, weaknesses, opportunities, and threats in using the Kanban method for hospital bed management.

Method: This qualitative descriptive study was conducted with 23 healthcare professionals from a university hospital, using semi-structured interviews between August and October 2023. Data were analyzed using the Discursive Textual Analysis technique, and IRAMUTEQ® software was used for processing.

Results: Identified weaknesses included insufficient human resources, work overload, lack of continuing education, resistance to change, prioritization of direct care, high staff turnover, and limitations in information systems. Threats involved the fragility of the community care network and patients' social vulnerability, which hindered hospital discharge. Strengths included improved team communication, monitoring of length of stay, and identification of care-related issues. Opportunities highlighted Kanban's potential to enhance clinical management and improve regulation of healthcare access.

Final considerations: The identification of strengths, weaknesses, opportunities, and threats showed that the effectiveness of Kanban depends on the connection between organizational structure, team engagement, and intra- and extra-institutional support. Thus, the method should be considered part of a broader process of hospital management and healthcare networks.

Objective: To identify scientific advances related to the use of Artificial Intelligence (AI) in supporting the implementation of the Nursing Process.

Method: Scoping review developed according to the Joanna Briggs Institute (JBI) methodological guidelines and registered on the International Open Science Framework platform. The search was conducted in the Scopus, Virtual Health Library (BVS), SciELO, and PubMed databases between February and March 2024. Data analysis followed a descriptive approach, with thematic categorization and narrative synthesis.

Results: Thirteen scientific studies were included, revealing significant advances in the application of AI to nursing practice. Contributions were highlighted in four main thematic categories, aligned with the stages of the Nursing Process: support for documentation and records - assessment/evaluation; support for diagnostic inference - diagnosis; prediction of adverse events - planning; and qualification and personalization of care - intervention. Additionally, two cross-cutting categories emerged in support of the implementation of the Nursing Process: professional education and training, and the integration of AI into the work process.

Conclusion: Artificial Intelligence is a promising ally in the implementation of the Nursing Process, provided its incorporation is accompanied by technical training, ethical regulation, and active engagement of professionals.

Objective: To investigate the relationship between antiretroviral therapy (ART) interruption and sociodemographic and clinical variables in hospitalized people living with HIV.

Method: A retrospective, documentary cohort study conducted in a teaching hospital in southern Brazil. Data were collected from August 2023 to April 2024 through the analysis of medical records of patients hospitalized between January 1, 2022, and January 31, 2024. The outcome was ART interruption. Data analysis employed multiple correspondence and cluster analysis.

Results: A total of 219 individuals were included. The group that interrupted ART (n=98; 44,7%) and presented worse prognoses was predominantly composed of men, self-identified as Black, with less than eight years of schooling, without a stable partner, and were alcohol users. Clinically, they had high viral load, low lymphocyte counts, and an AIDS diagnosis. In addition, they had a history of previous treatment interruptions, infection-related signs and symptoms, use of a third or subsequent ART regimen, travel time greater than 31 minutes to collect medications, and some progressed to death (n=68; 91,9%).

Conclusion: The group with worse prognoses was closely related to social inequities, associated with access barriers, lower quality of care, and difficulties in adhering to ART.

Objective: to describe the process of collective construction of the Continuing Health Education Center based on a survey of health workers' needs.

Method: action research conducted between 2021 and 2025, using multiple qualitative and quantitative data collection techniques. The exploratory phase identified the absolute frequency of educational needs, which were validated in a focus group, guiding educational initiatives. Concurrently, a working group held workshops/meetings to develop the documentation necessary to formalize the Continuing Health Education Center.

Results: the thematic priorities for education were "humanization of care for people with mental health problems" in primary and tertiary care, and "management of situations of violence" in secondary care. Three educational initiatives were implemented: humanization for receptionists; basic life support for mid-level professionals; and patient safety for hospital professionals and patients/families receiving care. Finally, the process of establishing the center began with a workshop to develop an action plan and a monthly follow-up. However, political barriers, such as the absence of the position in the municipal organizational chart, hindered the formalization of the sector.

Final considerations: the collective discussion of Continuing Health Education fostered dialogue between the different levels of care. The process of collectively building a Continuing Health Education Center is challenging. Furthermore, it requires the participation of managers, professionals, and healthcare services while overcoming organizational and political barriers.

Objective: To evaluate the performance of the Modified Early Warning Score (MEWS) in predicting severe adverse events (SAEs) in adult trauma patients.

Method: A retrospective cohort study was conducted in a trauma hospital between July and October 2022. Adult trauma inpatients were included. Demographic and clinical data, along with MEWS scores, were collected every 6 hours for 30 days. Performance was assessed at 6, 12, 18, and 24 hours prior to the outcome using ROC curves, sensitivity, specificity, predictive values, and likelihood ratios. The outcome was defined as an SAE (cardiac arrest, ICU admission, or death). The optimal cutoff point for prediction was determined.

Results: Medical records of 670 patients (mean age 49.4±21.3 years) were reviewed, with 20 (3%) requiring intensive care unit admission and no deaths. The best performance was observed within 6 hours prior to the outcome (AUC-ROC 0.86) at a cutoff of ≥4, with sensitivity of 80%, and specificity of 73%. Subgroup analyses indicated distinct optimal cutoff points.

Conclusion: MEWS demonstrated good predictive ability, particularly within six hours prior to the outcome, with a cutoff of ≥4, favoring early detection of clinical deterioration.

Objective: To analyze the clinical and epidemiological profile of remote consultations evaluated by the Reference Center for Special Immunobiologicals of Minas Gerais, Brazil, between 2005 and 2022.

Method: Cross-sectional and retrospective study. Data collection was performed by extracting data from the request forms evaluated in virtual consultations. The statistical program Stata® was used for the analysis. Categorical variables were described using absolute and relative frequencies, and continuous variables were described using median and interquartile range.

Results: Of the 84,800 forms evaluated, 32,750 individuals were eligible to receive special immunobiologicals, with 65,521 doses prescribed. Among these individuals, 11,505 (35.1%) were children, 1,943 (6.0%) were adolescents, 12,024 (36.7%) were adults, and 7,278 (22.2%) were people over 60 years of age. There was a predominance of males with white skin color. The prescription of the Pneumococcal 23 vaccine was more prevalent among adolescents, adults, and the elderly (30.8%, 34.9%, and 63.6%, respectively).

Conclusion: This study analyzed the clinical and epidemiological profile of patients treated at the Reference Center for Special Immunobiologicals in Minas Gerais over a period of 17 years. The characterization of users and prescribed immunobiologicals made it possible to identify this profile, highlighting the relevance of the service.

Objective: To identify the technologies used in the management of Continuing Health Education (CHE) in Public Health Schools across federal states and in Federal University Hospitals, focusing on the organization of practice settings and training of health professionals.

Method: A qualitative, exploratory, and descriptive study. Managers from 23 healthcare education institutions in Brazil participated. Data collection was conducted between July and September 2024 through an electronic questionnaire. The results were analyzed using Bardin's content analysis method.

Results: More than one-third of the surveyed institutions do not have specific tools dedicated to managing processes related to Continuing Health Education, relying instead on Excel® spreadsheets for recordkeeping, which leads to operational challenges and rework. Strengths identified in the study included the integration between education and service, and the implementation of the National Policy on Continuing Health Education by managers.

Conclusion: Although Continuing Health Education is established through public policy, it still faces challenges in being implemented and monitored within Public Health Schools and Federal University Hospitals, which lack innovations in process management. The need for a specific tool that ensures work quality, data security, and prevents rework was clearly identified.

Objective: To conduct a scoping review of the literature on the right to be forgotten in healthcare and discuss its ethical, legal, and technological implications.

Method: A scoping review based on the Joanna Briggs Institute method. The inclusion criteria were descriptive, qualitative, quantitative studies, and systematic literature reviews that included patients from health services on the right to be forgotten, between 2018 and 2025. Editorials, theses, dissertations, experience reports, theoretical essays, abstracts of scientific events, and books were excluded. The search was conducted in the PubMed, MedLine, and Web of Science databases.

Results: Five articles were analyzed. One discusses a position statement highlighting recent data on cancer cure and social rehabilitation of patients; another addresses the right to be forgotten in transgender people; the third analyzes the challenges that the General Data Protection Regulation presents for hospital management; and two deal with the use of intelligent health systems as a means of applying the regulation.

Conclusion: The right to be forgotten may be essential for individuals who have mitigated situations of heightened health risk, but it may also conflict with the rights to memory and legal certainty. It is necessary to define ethical and legal criteria for deleting health data (right to be forgotten) and invest in technology that ensures the protection and integrity of information.

Objective: To describe the development of an educational booklet on anxiety and depression in the puerperium.

Method: This is a technological development study that resulted in a booklet. The booklet was developed in three stages: preparation of an integrative review study, preparation of the booklet, and evaluation with the target audience. Pregnant women in the third trimester of pregnancy undergoing prenatal care in Primary Health Care in a city in Rio Grande do Sul were included in the evaluation.

Results: The booklet was prepared in printed and digital formats and its content addresses topics such as anxiety and depression in the postpartum period, using clear language and attractive illustrations. The booklet was evaluated by 43 women and considered adequate in terms of its objective, content, language, illustrations and ease of comprehension, with a Content Validity Index of 1.0 for all items.

Conclusion: The booklet evaluated with the target audience demonstrated acceptability and potential for use. And, as it is a practical and accessible educational technology, it contributes to maternal and child health care practices.

Objective: To understand the experience of family members of children with cleft lip and palate in relation to fasting and thirst during the perioperative period of primary and secondary surgeries.

Method: This is a descriptive-exploratory study with a qualitative approach, based on the theoretical framework of Family-Centered Care, conducted at the Associação de Apoio ao Fissurado Lábio-Palatal de Maringá, Paraná, Brazil. The semi-structured interviews with family members were conducted between August and September 2024, via Google Meet®, recorded, fully transcribed and analyzed through content analysis, thematic modality. The study was approved by the Ethics Committee for Research with Human Beings.

Results: Seven family members of children with cleft lip and palate participated. Three categories emerged that demonstrate that fasting and thirst in the surgical context can generate emotional distress not only in the children, but also in their caregivers. Family members reported shared food restrictions, use of toys and prior conversation with the child as strategies used during the period. Clear communication from the team, consistent with family-centered care, reduces family discomfort.

Conclusion: Fasting and thirst in the perioperative period cause emotional distress to the child and family, making individualized management focused on family support essential, in line with Family-Centered Care.