Work objective in emergency wards: professionals' conceptions

Garlet, Estela Regina; Lima, Maria Alice Dias da Silva; Santos, José Luís Guedes dos; Marques, Giselda Quintana

doi:10.1590/s0104-11692009000400016

Cited by 12 publications

(12 citation statements)

References 7 publications

(12 reference statements)

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“…Health professionals appoint divergences between the health needs that make users turn to the urgency unit and the work goal at this site, revealing dissatisfaction with patients' excessive demands, whose needs can be classified as urgency or emergency (13) . Thus, some authors highlight the need for public policy strategies to enhance the efficiency and quality of urgency services (14) .…”

Section: Discussionmentioning

confidence: 99%

Risk classification in an emergency room: agreement level between a Brazilian institutional and the Manchester Protocol

Souza¹,

Toledo

Tadeu

et al. 2011

Rev. Latino-Am. Enfermagem

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The aim of this study was to assess the level of agreement between an institutional protocol and the Manchester protocol for the risk assessment of patients attended in an emergency room of a public hospital in Belo Horizonte -MG -Brazil. This is a descriptive and comparative study, in which 382 patients' reports were evaluated and the risk was classified, using the institutional protocol and the Manchester protocol. Rates were calculated through weighted and unweighted kappa, in order to determine the level of agreement between the protocols.The results showed that the correlation between the protocols is average when considering that classification errors occurred between neighboring colors (kappa=0.48), and good when considering that classification errors occurred between extreme colors (kappa=0.61).The Manchester protocol increased the patients' level of priority of patients and has been considered more inclusive. Clasificación de riesgo en primeros auxilios: concordancia entre un protocolo institucional brasileño y el de ManchesterEste estudio tuvo por objetivo verificar el grado de concordancia entre un protocolo institucional y el protocolo de Manchester para la clasificación de riesgo de pacientes atendidos en primeros auxilios de un hospital público de Belo Horizonte -MG -Brasil.Se trata de estudio descriptivo comparativo en el cual 382 fichas fueron evaluadas y, realizada la clasificación de riesgo utilizando los protocolos mencionados encima, a partir del registro realizado por los enfermeros. Índices kappa ponderado y no ponderado fueron calculados para determinar el grado de concordancia entre los protocolos.Los resultados mostraron que la concordancia entre los protocolos es media, cuando considerados los errores de clasificación ocurridos entre colores vecinos (kappa=0,48) y buena, cuando considerados los errores de clasificación ocurridos entre colores extremos (kappa=0,61). Se concluye que el protocolo de Manchester aumentó el nivel de prioridad de los pacientes, demostrando ser un protocolo que incluye más.

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Section: Discussionmentioning

confidence: 99%

Risk classification in an emergency room: agreement level between a Brazilian institutional and the Manchester Protocol

Souza¹,

Toledo

Tadeu

et al. 2011

Rev. Latino-Am. Enfermagem

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“…Actually, there is a mismatch between what users and health professionals think, regarding the purpose of the emergency department work. (11) The difficulty of the healthcare team of patient acceptance, which is seen as a product of the failure of the network and inadequate for emergency care, may be faced by humanization policies, strategies of awareness and acceptance of emergency as the possible and legitimate gateway into the current healthcare system. Furthermore, it is important to discuss how to integrate within the network this type of patient to the other possible gateways and prepare to serve them, since the demands are generated by cultural factors and the deficiency of technological and social resources.…”

Section: Discussionmentioning

confidence: 99%

Desafios para a gerência do cuidado em emergência na perspectiva de enfermeiros

et al. 2013

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Objective: To analyze the challenges for the management of care in a hospital emergency department, based on the perspective of nurses. Methods: A qualitative, descriptive and exploratory study, conducted from June to September 2009, through semi-structured interviews with 20 nurses in the Emergency Department of a university hospital in southern region of Brazil. Data were analyzed using thematic analysis. Results: The main challenges of nursing in managing care in emergency units were: management of overcrowding, maintaining quality of care, and utilization of leadership as a management tool. The suggestions mentioned to overcome these were: reorganization of the health system to focus on emergencies, changes in the flow of patient care, and implementation of training on nursing management. Conclusion: Such challenges and strategies represented a boost to the development of new practices through collaborative and coordinated work with the emergency care network. ResumoObjetivo: Analisar os desafios para a gerência do cuidado em um serviço hospitalar de emergência, com base na perspectiva de enfermeiros. Métodos: Pesquisa qualitativa, do tipo descritiva e exploratória, realizada de junho a setembro/2009, por meio de entrevista semiestruturada com 20 enfermeiros do Serviço de Emergência de um Hospital Universitário da Região Sul do Brasil. Os dados foram analisados mediante análise temática. Resultados: Os principais desafios dos enfermeiros na gerência do cuidado em emergência foram gerenciamento da superlotação, manutenção da qualidade do cuidado e utilização da liderança como instrumento gerencial. As sugestões citadas para superá-los foram reorganização do sistema de saúde para atenção às urgências, alteração no fluxo de atendimento dos pacientes e realização de capacitação sobre o gerenciamento de enfermagem. Conclusão: Tais desafios e estratégias representam um impulso para o desenvolvimento de novas práticas por intermédio de um trabalho colaborativo e articulado com a rede de atenção às urgências.

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“…The literature related to nursing diagnoses, the validation of data collection instruments, the evaluation of the trauma patient and the evaluation of the critical patient in an emergency situation defined the model (construction) of the data collection instrument (10)(11)(12)(13) . The NANDA2009-11 was used as a guide for selecting the diagnoses (5) .…”

Section: Methodsmentioning

confidence: 99%

Nursing diagnoses in trauma victims with fatal outcomes in the emergency scenario

Sallum

Santos

Lima

2012

Rev. Latino-Am. Enfermagem

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The objective of this study was to identify and analyze the nursing diagnoses that constitute risk factors for death in trauma victims in the first 6 hours post-event. This is a cross-sectional, descriptive and exploratory study using quantitative analysis. A total of 406 patients were evaluated over six months of data collection in a tertiary hospital in the municipality of São Paulo, according to an instrument created for this purpose. Of the total, 44 (10.7%) suffered death. Diagnósticos de enfermería en víctimas fatales provenientes de trauma en el escenario de la atención de emergenciaEl objetivo de este estudio fue identificar y analizar diagnósticos de enfermería que constituyen factores de riesgo para muerte en víctimas de trauma en las primeras 6 horas después del evento. Se trata de un estudio transversal, descriptivo y exploratorio con análisis cuantitativo. Se evaluó 406 pacientes durante seis meses de recolección en un hospital terciario del Municipio de São Paulo, según instrumento creado para esa finalidad. Del total, 44 (10,7%) evolucionaron para muerte. El análisis multivariado apuntó los diagnósticos de enfermería: patrón respiratorio ineficaz, ventilación espontánea perjudicada, riesgo de sangramiento y riesgo de perfusión tisular gastrointestinal ineficaz, como factores de riesgo para muerte; la desobstrucción ineficaz de vías aéreas, confort perjudicado y dolor agudo como factores de protección, datos que pueden orientar a los equipos de salud para realizar acciones intervencionistas diferenciadas frente a la complejidad del trauma.

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Work objective in emergency wards: professionals' conceptions

Cited by 12 publications

References 7 publications

Risk classification in an emergency room: agreement level between a Brazilian institutional and the Manchester Protocol

Risk classification in an emergency room: agreement level between a Brazilian institutional and the Manchester Protocol

Desafios para a gerência do cuidado em emergência na perspectiva de enfermeiros

Nursing diagnoses in trauma victims with fatal outcomes in the emergency scenario

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