Mestrado Profissional em Enfermagem
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- ItemProtocolo de cuidados com fístula e enxerto arteriovenosos para pacientes em hemodiálise(Universidade Federal do Espírito Santo, 2024-11-14) Coelho, Giselle dos Santos; Furieri, Lorena Barros; https://orcid.org/0000-0003-3859-2227; http://lattes.cnpq.br/0526203649991750; https://orcid.org/0009-0000-9332-3770; http://lattes.cnpq.br/6464454190129762; Fioresi, Mirian; https://orcid.org/0000-0002-8560-4385; http://lattes.cnpq.br/2275021494677338; Vicari, Alessandra Rosa; https://orcid.org/0000-0003-3325-152X; http://lattes.cnpq.br/2371230213777447; Nunes, Karolini Zuqui; https://orcid.org/0000-0003-3433-4925; http://lattes.cnpq.br/6888896554912256; Rozetti, Cindy Medici Toscano; https://orcid.org/0000-0001-9865-6208; http://lattes.cnpq.br/9543458093185280The durability of vascular access for hemodialysis depends on multiple factors, ranging from its creation to cannulation techniques and access maintenance. The adoption of preventive and corrective measures that promote vascular access patency is directly associated with reduced morbidity and mortality in hemodialysis patients. Objective: To develop a care protocol for patients undergoing hemodialysis focused on arteriovenous fistulas and grafts. Methodology: This is a methodological study conducted in three phases: (1) assessment of existing clinical guidelines for vascular access in hemodialysis; (2) a scoping review on care practices for arteriovenous fistulas and grafts; and (3) development of a specific care protocol. Results: Seven clinical guidelines published between 2014 and 2024 on hemodialysis vascular access were identified and analyzed. Most scored above 50% across all domains of the AGREE II (Appraisal of Guidelines for Research & Evaluation) tool. The scoping review included 104 publications, categorized into the following themes: preoperative vascular mapping, pharmacological interventions for access maturation, clinical monitoring, physical examination, exercise regimens, cannulation techniques (including ultrasound-guided methods), and self-care practices. The protocol was constructed using six of the evaluated guidelines and the evidence synthesized from the scoping review. Its structure followed the standard model established by HUCAM (Cassiano Antônio Moraes University Hospital), in accordance with the norms of the Unit for Quality and Patient Safety Management (UGQSP). Conclusion: This study resulted in a care protocol for arteriovenous fistulas and grafts tailored to hemodialysis patients. Additionally, a scoping review was conducted, identifying key practices and technologies essential for optimizing vascular access management.
- ItemCurso sobre cuidados parentais, utilizando metodologia OSCE, melhora a ansiedade e conhecimento de gestantes(Universidade Federal do Espírito Santo, 2025-04-22) Schereder, Lorrainy da Silva Rosa; Furieri, Lorena Barros; https://orcid.org/0000-0003-3859-2227; http://lattes.cnpq.br/0526203649991750; https://orcid.org/0009-0005-5273-1942; http://lattes.cnpq.br/1984122144498397; Fioresi, Mirian; https://orcid.org/0000-0002-8560-4385; http://lattes.cnpq.br/2275021494677338; Fonseca, Luciana Mara Monti; https://orcid.org/0000-0002-5831-8789; http://lattes.cnpq.br/2405356819478086; Almeida, Márcia Valéria de Souza; https://orcid.org/0000-0002-1318-7084; http://lattes.cnpq.br/9372951429429767; Filetti, Filipe Martinuzo; https://orcid.org/0000-0002-8141-4007; http://lattes.cnpq.br/4884418349921023Introduction: Maternal care is a priority in the public health policies of the Brazilian Unified Health System (SUS). However, during prenatal consultations, there may be limitations in the transmission of essential information, leading to insecurity among pregnant women. In this context, the present study aimed to evaluate pregnant women's knowledge of newborn care after attending a prenatal course designed to promote parental care. The course was based on Anne Casey’s Partnership Model of Nursing theory and used the Objective Structured Clinical Examination (OSCE) methodology for assessment. Methodology: This was a methodological study with a cross-sectional and quantitative design, aimed at developing and validating a prenatal course based on nursing theory and incorporating skill stations following the OSCE methodology. Additionally, a quasi-experimental study was conducted, in which 64 pregnant women were allocated into two groups (traditional and OSCE) and assessed regarding gestational anxiety, knowledge, and retention of theoretical information on neonatal care, immediately after the course and three weeks later. The methodological study supported the implementation of the prenatal course, using nursing theory as a foundation and the OSCE methodology to evaluate skills through structured checklists and feedback. The quasi-experimental study statistically compared knowledge acquisition between participants in the traditional course and those in the OSCE-based course.Results: The findings showed similar levels of understanding between the two methods on the course day for the Heimlich maneuver, baby bathing, and breastfeeding. However, after three weeks, the OSCE group showed a higher prevalence of sustained comprehension, particularly regarding baby bathing, whereas the traditional method demonstrated greater variation in responses over time. In terms of gestational anxiety, there was an overall reduction after the course. Product: This study developed technical-technological resources, including a prenatal course based on Anne Casey’s nursing theory, skill stations, structured checklists, and training for structured feedback. These elements proved to be an effective strategy for enhancing family involvement and neonatal care. Furthermore, a manuscript was produced detailing a nursing intervention using the OSCE methodology to promote parental care in pregnant women and reduce gestational anxiety. Conclusion: The OSCE methodology was found to be more effective in knowledge retention and reducing gestational anxiety compared to the more theoretical and less interactive traditional model. The skill stations and structured feedback played a crucial role in increasing participants’ autonomy, underscoring the importance of active learning strategies. The significant reduction in anxiety among women who participated in the OSCE course suggests that practical experiences enhance maternal confidence in their new role. Thus, this study highlights the importance of active pedagogical methodologies in training lay caregivers and promoting maternal mental health during pregnancy.
- ItemTransporte intra-hospitalar de pacientes adultos graves: elaboração de protocolo(Universidade Federal do Espírito Santo, 2022-12-12) Cruz, Ana Paula Gomes da; Lima, Eliane de Fátima Almeida; https://orcid.org/0000-0001-5128-3715; http://lattes.cnpq.br/4640538188376728; https://orcid.org/0000-0002-0913-8060; http://lattes.cnpq.br/7158413233791532; Primo, Cândida Caniçali; https://orcid.org/0000000151412898; http://lattes.cnpq.br/4739920753105018; Massaroni, Leila; https://orcid.org/0000-0001-7327-887X; http://lattes.cnpq.br/1280356644652701; Coutinho, Verônica Rita Dias; https://orcid.org/0000000151412898; http://lattes.cnpq.br/4739920753105018; Figueiredo, Karla Crozeta; https://orcid.org/0000-0003-3544-5643; http://lattes.cnpq.br/8027027232828519Introduction: Among the integral actions of care in health institutions directly interconnected with patient safety and with exposure to the risk of incidents and adverse events, there is intra-hospital transport. Aiming to meet an institutional demand for the standardization of intra-hospital transport of critically ill patients in the adult intensive care sector in which the researcher is inserted, this study was developed in partnership with the intensive care team, quality management and institution management. This project is aligned with the line of research on the organization and evaluation of health care systems. Objectives: To develop and validate an intra-hospital transport protocol for critically ill adult patients. Method: This is action research, carried out in a public university hospital in the Southeast region, from December/2021 to June/2022. The population consisted of members of the multidisciplinary team. To prepare the protocol, a scope review was carried out, a Planning Group was formed, and nine seminars were held for the development and validation of the protocol. The seminars were audio recorded and recorded in a field diary. Results: The review selected 22 studies, which formed the basis for the elaboration of the transport pilot protocol. 39 professionals participated in the elaboration of the protocol, through 9 seminars developed in face-to-face, online and mixed formats, with a moment of test application of the transport checklist by nurses of the adult intensive care unit. The protocol was approved by the hospital's quality sector for implementation and dissemination to the hospital community. Products: Institutional intra-hospital transport protocol with checklist and 5 flowcharts. The process took place with the active and collaborative participation of all study participants, with an important exchange of formal and informal knowledge. The protocol, with its flowcharts and checklist, will make it possible to standardize tasks and conducts, helping and directing professionals in decision-making and execution of work routines, ensuring safer and better-quality assistance in the intra-hospital transport of critically ill adult patients. Conclusion: This research has the potential to generate impact and be applied locally, regionally, nationally and internationally, as it systematically describes the steps and resources needed to develop an intra-hospital transport protocol for critically ill adult patients. The protocol, checklist and flowcharts are relevant for scientific and technological development, and will contribute to direct the actions of professionals, act as support in decisions and in the establishment of new work processes, with the aim of improving the quality of patient care during the transport. The hospital started the process of structuring intra-hospital transport and created a Technical Work Group on Safe Transport, which the master's student in this study was invited to join and has among its objectives to lead the implementation process of the protocol elaborated in this dissertation
- ItemGuia digital interativo sobre documentação de enfermagem(Universidade Federal do Espírito Santo, 2025-07-03) Mattiuzzi, Thaís Duarte Araújo; Fioresi, Mirian; https://orcid.org/0000-0002-8560-4385; http://lattes.cnpq.br/2275021494677338; https://orcid.org/0009-0009-8455-7909; http://lattes.cnpq.br/2379031754520132; Nunes, Karolini Zuqui; https://orcid.org/0000-0003-3433-4925; http://lattes.cnpq.br/6888896554912256; Almeida, Miriam de Abreu; https://orcid.org/0000-0002-4942-9882; http://lattes.cnpq.br/5814144892283070; Furieri, Lorena Barros; https://orcid.org/0000-0003-3859-2227; http://lattes.cnpq.br/0526203649991750Introduction: Nursing documentation is an essential practice to ensure the continuity, quality, and safety of patient care. Despite its importance, challenges related to fragmented records, inconsistencies in the language used, and lack of standardization are still frequent, which compromises the quality of information and, consequently, patient safety. The digital guide is configured as an educational technology that significantly contributes to promoting health education in different care settings. In this context, the following question arises: how to develop an interactive digital guide for nurses and nursing technicians on nursing documentation? Objective: To develop an interactive digital guide on nursing documentation. Methodology: This is a participatory action research study structured in four phases: problem identification, planning, action, and evaluation. The study was conducted between March and June 2025 with a sample of 61 nursing professionals. The inclusion criteria comprised professionals working in direct patient care in all hospital sectors (inpatient units, adult ICU, and neonatal ICU) with at least one year of experience in the role and who agreed to participate after being informed about the study's objectives. For the document and process validation phase, nurses with at least two years of experience in nursing processes and documentation were invited to act as expert judges. In accordance with institutional protocol, the judges were required to hold the position of nursing supervisors. Professionals who were on leave or on vacation during data collection were excluded from the study. Data analysis was conducted using a qualitative approach. The project was approved by the Research Ethics Committee under CAAE nº 76275323.1.0000.5060 and opinion nº 6.712.504, issued on March 20, 2024. Results: The results showed that the majority of participants were female (88.5%), aged between 20 and 30 years. Of these, 68.8% were nursing technicians and 31.2% were nurses, of whom 58% held a specialization. Regarding documentation, 93.4% recognized the potential of the interactive digital guide to facilitate and standardize records. While 72% reported performing continuous documentation, 12.5% did so only occasionally or rarely. The quality of the records was rated as adequate by 62.3%, whereas 36.1% reported inconsistencies, with the main difficulties related to lack of time, lack of knowledge about the standards, errors, and missing information. The professionals highlighted the importance of standardized models, guidelines, practical examples, and interactive educational resources to improve documentation practices. The validation of the digital guide indicated high acceptance, with Content Validity Indexes ranging from 0.85 to 1.00, demonstrating its applicability and relevance to professional practice. Conclusion: The development of the interactive digital guide on nursing documentation proved to be an effective strategy to qualify and standardize nursing records. Its dynamic and accessible structure promoted professional engagement, highlighting its potential to minimize technical-operational weaknesses and contribute to improving care practice
- ItemDesenvolvimento de um agente conversacional para orientação e incentivo ao exame preventivo do câncer do colo do útero(Universidade Federal do Espírito Santo, 2025-05-23) Fernandes, Renata Esteves Palacio; Lima, Eliane de Fátima Almeida; https://orcid.org/0000-0001-5128-3715; http://lattes.cnpq.br/4640538188376728; Freitas, Paula de Souza Silva; https://orcid.org/0000-0001-9066-3286; http://lattes.cnpq.br/6676352092840927; https://orcid.org/0009-0000-5707-9950; http://lattes.cnpq.br/0546774908623667; Almeida, Márcia Valéria de Souza; https://orcid.org/0000-0002-1318-7084; http://lattes.cnpq.br/9372951429429767; Carmona, Ana Paula; https://orcid.org/ 0000-0002-6750-0187; ; Primo, Cândida Caniçali ; https://orcid.org/0000-0001-5141-2898 ; http://lattes.cnpq.br/4739920753105018; Nunes, Elisabete Maria Garcia Teles; https://orcid.org/0000-0001-7598-0670;Introdução: No Brasil, um dos mais graves problemas relacionados à saúde da mulher ainda é o câncer do colo do útero, e quanto mais precoce a sua detecção, maiores são as chances de cura e reabilitação. Portanto, o acesso ao exame citopatológico do câncer de colo de útero é decisivo para o enfrentamento dessa problemática de saúde pública. Apesar dos avanços para aumentar a cobertura do exame no país, ainda há baixa procura, muitas vezes relacionada à falta de conhecimento das mulheres sobre o exame, dificuldade de acesso à Estratégia Saúde da Família, de agendamentos dos exames, quantidade insuficiente de materiais para coleta, de profissionais capacitados e, ainda, pelos sentimentos que esse exame causa nas usuárias. Desse modo, emergiu a ideia de criar um “chatbot” como agente educacional sobre câncer do colo do útero e facilitador na procura do exame citopatológico. Objetivos: Desenvolver e avaliar um chatbot orientativo sobre a prevenção do câncer do colo do útero. Metodologia: pesquisa aplicada de desenvolvimento tecnológico, realizada na Estratégia Saúde da Família do Município de Muqui, Espírito Santo. O estudo consiste no desenvolvimento de um chatbot orientativo sobre o exame citopatológico do câncer do colo do útero, dividido em quatro etapas para sua implementação. Na primeira etapa, foi elaborado o conteúdo sobre o câncer do colo do útero por meio de pesquisa bibliográfica, a partir das recomendações estabelecidas nas Diretrizes Brasileiras para o Rastreamento do câncer do colo do útero (2018). Na segunda etapa, foi organizado o roteiro do chatbot e realizada a contratação de empresa de tecnologia para o seu desenvolvimento. Na terceira etapa, a avaliação da usabilidade do chatbot foi realizada com usuárias cadastradas na Estratégia Saúde da Família Camará, que não haviam realizado o exame citopatológico nos últimos 3 anos. As participantes foram captadas pelo prontuário eletrônico, uma plataforma de tecnologia em software que atende todas as estruturas de saúde pública do município. A seleção das participantes foi feita de forma aleatória, garantindo que fossem escolhidas de maneira imparcial, com base em um número amostral para assegurar a representatividade dos resultados. O convite foi feito pela autora por meio de solicitação na residência das mulheres, em conjunto com a Agente Comunitária de Saúde responsável. Após aceitarem participar, foi disponibilizado um link para acesso à tecnologia, permitindo que as usuárias interagissem com o agente conversacional. Em seguida, foi aplicado um questionário que avaliou a usabilidade da tecnologia por meio da Escala de Usabilidade do Sistema. Na quarta etapa, foi iniciado o processo de implementação do chatbot com base nos resultados da análise dos requisitos. Resultados: Foram elaborados os diálogos e a estruturação do fluxograma e das telas. Para o desenvolvimento da tecnologia, foram considerados cinco momentos: conteúdo, agente, roteirização, conversação e revisão do diálogo. A elaboração do chatbot envolveu a construção cuidadosa de diálogos sobre o câncer do colo do útero por meio de pesquisa bibliográfica, a estruturação dos fluxogramas, a construção do chatbot e a avaliação da tecnologia, O produto resultante consiste em uma ferramenta digital acessível e interativa, disponibilizada diretamente nos dispositivos móveis das usuárias. Trata do chatbot Flora, desenvolvido com o objetivo de oferecer orientações sobre a prevenção do câncer do colo do útero, além de disponibilizar a funcionalidade de agendamento de consultas. Conclusão: O estudo viabilizou o desenvolvimento e a avaliação de um chatbot orientativo, projetado para fornecer informações sobre o câncer do colo do útero e facilitar o agendamento de exames citopatológicos. Esse recurso inovador representa um marco na aplicação de tecnologia à saúde pública, com potencial para ampliar a eficiência e a acessibilidade dos serviços. Além de facilitar o acesso a informações e procedimentos, a ferramenta contribuiu para a educação e conscientização sobre a relevância do exame citopatológico. Ao promover uma abordagem mais organizada e centrada no paciente, o chatbot também tem o potencial de otimizar o processo de trabalho dos profissionais de saúde, fortalecendo a integração entre tecnologia e cuidado