Objective:To carry out a documentary study on the rules, guidelines, policies and
institutional support for the nurse to prescribe medicines and request tests
with a view to the advanced practice in the scope of Primary Health Care.
Methods:Documentary research using open-access institutional documents - Federal
Nursing Council (COFEN), its regional representations in the respective
Brazilian states (COREN) and the Brazilian Nursing Association (ABEN). Results:Most of the news/notices were issued by the Regional Nursing Councils in the
different Federative Units. The argumentation regarding the prescription of
medicines and request for tests by nurses is based on three categories:
Autonomy and competencies for the prescription of medicines and/or request
of tests; Corporate policies that undermine the full exercise of nursing;
and Transformation of health and nursing care in Primary Health Care. Conclusion:The prescriptive practice by nurses integrates health care and has been
defended by the institutions that represent the category. It emerges as an
important element of advanced practice and in the transformation of care in
the context of health teams.
The indiscriminate use of drugs by the youth is growing steadily in Brazil and worldwide. This study was aimed at reflecting about the professional nursing practice's ethical approach in providing care to adolescents who are users of legal and illegal drugs. This is a theoretical and reflective study based on narrative literature review, using books and scientific articles. Reflections about addiction to psychoactive substances in expansion among adolescents have emerged, and resulted in the discussion about professional nursing practice's ethical approach to drug-using adolescents. Nurses can prioritize care directed to the promotion of the adolescents' health approach, based on an emancipatory perspective of the youth in the prevention of drug use. It was concluded that nurses should use an ethical approach to drug-dependent adolescents, taking into consideration their context and subjectivity.
RESUMOO uso indiscriminado de drogas entre os jovens cresce progressivamente no Brasil e no mundo. Este estudo objetivou refletir acerca da abordagem ética da enfermagem na atenção a adolescentes usuários de drogas lícitas e ilícitas. Trata-se de um estudo teórico de caráter reflexivo fundamentado em uma revisão bibliográfica do tipo narrativa, utilizando livros e artigos científicos. Emergiram reflexões sobre a dependência de substâncias psicoativas em expansão na adolescência que culminaram na discussão sobre a abordagem ética da enfermagem ao adolescente usuário de drogas. O enfermeiro pode priorizar uma assistência voltada para a promoção da saúde do adolescente em uma perspectiva emancipatória dos jovens na prevenção do uso de drogas. Concluiu-se que o enfermeiro deve realizar uma abordagem ética aos adolescentes dependentes químicos, considerando seu contexto e sua subjetividade.Enfermagem; Drogas ilícitas; Transtornos relacionados ao uso de substâncias; Bioética.
RESUMENEl uso indiscriminado de drogas entre los jóvenes aumenta progresivamente en Brasil y en el mundo. Este estudio tuvo como objetivo reflejar sobre el abordaje ético de la enfermería en la atención a adolescentes usuarios de drogas lícitas e ilícitas. Se trata de un estudio teórico de carácter reflexivo, basado en una revisión bibliográfica de tipo narrativa, utilizándose de libros y artículos científicos. Emergieron reflexiones sobre la dependencia de sustancias psicoactivas en expansión en la adolescencia, que culminaron en la discusión sobre el abordaje ético de la enfermería junto al adolescente usuario de drogas. El enfermero puede priorizar una asistencia direccionada a la promoción de la salud del adolescente en una perspectiva emancipadora del joven en la prevención del consumo de drogas. Se concluyó que las enfermeras deben realizar un enfoque ético a los adolescentes dependientes, considerando su contexto y su subjetividad.Enfermería; Drogas ilícitas; Trastornos relacionados al uso de sustancias; Bioética.
Objective: to analyze the influence of contextual indicators on the performance of
municipalities regarding potential access to primary health care in Brazil and to
discuss the contribution from nurses working on this access. Method: a multicenter descriptive study based on secondary data from External Evaluation
of the National Program for Access and Quality Improvement in Primary Care, with
the participation of 17,202 primary care teams. The chi-square test of proportions
was used to verify differences between the municipalities stratified based on size
of the coverage area, supply, coordination, and integration; when necessary, the
chi-square test with Yates correction or Fisher's exact test were employed. For
the population variable, the Kruskal-Wallis test was used. Results: the majority of participants were nurses (n=15.876; 92,3%). Statistically
significant differences were observed between the municipalities in terms of
territory (p=0.0000), availability (p=0.0000), coordination of care (p=0.0000),
integration (p=0.0000) and supply (p=0.0000), verifying that the municipalities
that make up area 6 tend to have better performance in these dimensions. Conclusion: areas 4,5 and 6 performed better in every analyzed dimension, and the nurse had a
leading role in the potential to access primary health care in Brazil.
Resultados: não há exigência de pré-requisitos na maioria dos protocolos; há possibilidade de diagnóstico pelo enfermeiro na gravidez, nutrição infantil e doenças sexualmente transmissíveis; observou-se variados graus de autonomia; amplo grupo de medicamentos prescritos por enfermeiros. Conclusão: no Brasil, confirma-se uma prática prescritiva sem requisitos, diversidade de orientações induzindo à multiplicidade de ações que pode afetar a qualidade da prescrição. Palavras-chave: Enfermeiro; prescrição de medicamentos; atenção primária à saúde; protocolos clínicos.
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