This study aimed to analyze user satisfaction with access and care in Primary Health Care (PHC) based on non-urgent demand for emergency services. 28 non-urgent users of emergency services were intentionally interviewed across five health districts in the city of Riberão Preto in São Paulo State. These users had been treated in PHC at least once in the previous six months prior to data collection aimed at evaluating the services. Content analysis was used to analyze the interviews. The results showed there to be satisfaction with care received from health professionals in PHC and dissatisfaction with delays in arranging an appointment and with difficulty to receive care based on spontaneous demand. There was found to be no difference in the levels of satisfaction between the users from different health districts. The article concludes that obstacles to access to PHC services represent a barrier for populations wishing to receive care, with repercussions in terms of user satisfaction and high demand for emergency care. To ensure universal, equal, and organized access to actions and services at different levels, healthcare networks were created that constitute organizational arrangements of sets of health services coordinated among themselves through common goals and cooperative and interdependent actions that enable the provision of continuous and comprehensive care to the population, coordinated by primary health care (PHC). 2 However, profound changes must be made in order for this form of care organization to overcome a fragmented healthcare system that does not ensure continuity and is centered on acute conditions, through emergency care units (ECUs). 2 Emergency care units are also defined as points of entry to initial health care by SUS users. 3 However, the guarantees set forth in Brazilian legislation represent one step among many required to construct the SUS. For the right to health to become a reality, changes must occur in the social model, because in practice, access is still selective, focalized, and excludisionary. 4 From this perspective, even though they are considered a point of entry to the system, ECUs treat only the main complaints that led users to the health service. 5 This frequent search for emergency care demonstrates that the health needs of users are not being met by PHC. When users resort to health services, they are looking for something or some action from health professionals that will resolve, or at least minimize, the problem that led them to seek out that service. Thus, it is understood that if a point of entry fails, necessary care is postponed. 6 Health needs are related to social production and reproduction, and accessibility to health actions. Additionally, health care must be planned, considering existing demand, COMUNICAÇÃO SAÚDE EDUCAÇÃO 2018; 22(65):387-98and that health services that must be willing to address these needs, understanding their meanings and the subjects involved in the production and consumption of health. 7 According to this logic, humanization means tak...

O objetivo deste estudo qualitativo foi compreender a percepção do enfermeiro sobre a supervisão das atividades realizadas em sala de vacina de unidades de atenção primária à saúde. As salas selecionadas fizeram parte de estudo preliminar, com abordagem quantitativa, que analisou as melhores salas de vacina da Macrorregião Oeste de Minas Gerais, das quais 12 salas atenderam a 100% dos critérios estruturais. Foram entrevistados os enfermeiros responsáveis por essas salas e os dados obtidos submetidos à análise de conteúdo na modalidade temática. Os resultados demonstraram ausência de um processo de supervisão pelos enfermeiros, o que pode ter ocorrido pela quantidade de ações assumidas por eles. O enfermeiro necessita de atitude proativa com ações educativas e acompanhamento mais efetivo das atividades em sala de vacina, evitando a ocorrência de falhas nos procedimentos que podem acarretar reflexo na qualidade dos imunobiológicos, disponibilizados para a população.

The results of this review can help policy developers and researchers develop instruments to compare advanced practice nursing services in various contexts and to examine their association with related outcomes.

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The support provided by nurse managers is the most highly valued factor in this practice environment, while workforce adequacy is perceived as the lowest. Nurses in posts of responsibility and those possessing a higher degree of training perceive their practice environment more favourably. Knowledge of the factors in the practice environment is a key element for health care organizations to optimize provision of care and to improve health care results.