Mestrado Profissional em Enfermagem
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- ItemExercício da responsabilidade técnica em enfermagem : uma proposta de tecnologia educacional(Universidade Federal do Espírito Santo, 2025-03-24) Oliveira, Andressa Barcellos de; Massaroni, Leila ; https://orcid.org/0000-0001-7327-887X; http://lattes.cnpq.br/1280356644652701; Bringuente, Maria Edla de Oliveira; https://orcid.org/0000-0002-5151-5368; http://lattes.cnpq.br/5786594324498349; https://orcid.org/0000-0002-3720-6198; http://lattes.cnpq.br/5742762785651498; Silva, Rita Inês Casagrande da ; https://orcid.org/0000-0001-8289-9117; http://lattes.cnpq.br/8602876967833382; Pontes, Mônica Barros de ; https://orcid.org/0000-0003-3629-236X; http://lattes.cnpq.br/2027806297684753; Fiorin, Bruno Henrique; https://orcid.org/0000-0002-1629-9233; http://lattes.cnpq.br/9684030018018529; Vilela, António Carlos Lopes; https://orcid.org/0000-0002-7072-0359; http://lattes.cnpq.br/7521723809237664Introduction: Care management requires the improvement of professional practices, and the organization of the work process. However, technically responsible nurses need professional development to manage nursing services, since their academic training is insufficient for this function, which involves exclusive technical and ethical duties. However, the managerial skills of technically responsible nurses are not yet adequately addressed in undergraduate courses. Objective: To propose an educational technology to train nurses in the exercise of technical responsibility. Method: This is a methodological study, with a quantitative-qualitative approach, divided into three stages: (1) scoping review mapped publications on the managerial skills necessary for the exercise of technical responsibility by nurses; (2) empirical study, which used an online questionnaire with closed and open questions as a data production instrument, whose quantitative data were analyzed in SPSS and the qualitative data followed Bardin's content analysis, with support from IRaMuTeQ; (3), Proposal of an educational technology for technical responsible nurses, based on the first and second stages. Results: The scoping review revealed gaps in the literature on the subject. The empirical study highlighted limitations in the organization of nursing services, related to the lack of management training in undergraduate courses and the need for institutional support. The proposal consists of a self-instructional Massive Open Online Course, addressing legal foundations, planning, organization, service evaluation, continuing education and document management. Discussion: The research highlighted a mismatch between academic training and the demands of professional practice, especially regarding care management. In response to this gap, the proposal for an educational technology emerges as a product based on the scope review and empirical study, configuring itself as a training strategy capable of offering targeted, practical learning aligned with current regulations, strengthening the qualified exercise of Technical Responsibility in nursing. Final Considerations: The implementation of educational technology contributes to the managerial training of nurses, strengthening care management, promoting patient safety and qualifying services. The initiative represents a viable way to address training deficiencies and empower nurses in professional practice
- ItemMedidas de prevenção de infecção para cirurgia cardíaca: estudo de implementação(Universidade Federal do Espírito Santo, 2024-11-04) Barbieri, Bruna Moraes; Fiorin, Bruno Henrique ; https://orcid.org/0000-0002-1629-9233; http://lattes.cnpq.br/9684030018018529; https://orcid.org/0000-0001-7470-2118; http://lattes.cnpq.br/2448133242936971; Lima, Eliane de Fátima Almeida; https://orcid.org/0000-0001-5128-3715; http://lattes.cnpq.br/4640538188376728; Fioresi, Mirian; https://orcid.org/0000-0002-8560-4385; http://lattes.cnpq.br/2275021494677338; Rozetti, Cindy Medici Toscano; https://orcid.org/0000-0001-9865-6208; http://lattes.cnpq.br/9543458093185280Introduction: Surgical site infections are among the three most frequent types of infection in hospitalized patients, and are particularly worrying in cardiovascular surgeries with sternotomy, due to the risk of deep infections that increase mortality, making it essential to take a managerial look at the processes related to this adverse event. This study is carried out within the research line Organization and evaluation of health care systems. This study is one of the outcomes supported by funding from the CAPES/COFEN Cooperation Agreement, under Call for Proposals No. 08/2021. Objectives: To develop and implement a manual for the prevention and control of surgical site infections in the intraoperative period of cardiovascular surgery. Method: This is participatory research with a quantitative and qualitative approach, based on the theoretical framework of implementation science, carried out in the operating room of a university hospital in the state of Espírito Santo. The nursing and medical teams involved in intraoperative cardiovascular surgery took part in the study. The research followed five activities using the Plan-Do-Check-Act cycle: situational diagnosis, creation of a working group to draw up the manual, awareness-raising workshop, post implementation audit with assessment of barriers and facilitators, and planning of sustainability actions. Results and Products: Four new technical products were developed to meet an institutional need; a manual on measures to prevent and control surgical site infections during cardiac surgery, an infographic on antibiotic prophylaxis in cardiovascular surgery, and two scientific articles. To this end, a group was set up made up of employees responsible for caring for cardiac patients and a representative of the institution's infection control committee, which generated discussions based on scientific evidence, resulting in innovative technical products. After implementing the manual, some improvements were observed in the audit, such as: the rate of SSI in cardiovascular surgeries with sternotomy fell from 17.55% to 10.77%; adequacy in the indication of prophylactic antibiotics increased from 74.47% to 85.90%; and adherence to recording the time of administration of the antimicrobial and the surgical incision reached compliance in 42.2% of cases. There was also a significant increase in the collection of intraoperative blood glucose, from 28.72% to 87.5%. The recording of the validity of surgical instruments rose from 54.79% to 82.8%, with low rates of proof of sterilization through integrators being maintained. In addition, 95% compliance with preoperative cleaning of the operating room was recorded, a result similar to the adequacy of surgical gowns. Antisepsis of the patient's skin showed compliance in 97% of cases. Surgical instruments were considered adequate in 94% of the observations, and the procedure for cleaning instruments during surgery took place in 97% of the cases. There was 19% of misinformation about sterile dressing techniques. Conclusion: The Manual was published by the institution’s Quality sector and incorporated into the institution's work processes, favoring changes in practice, as well as maintaining evidence-based care. This research is relevant due to its potential to be extended nationally, as it systematically describes an innovative method with the steps and resources needed to implement good practices for the control and prevention of surgical wound infection.
- ItemConhecimento, atitude e prática de pacientes submetidos ao cateterismo cardíaco e à intervenção coronária percutânea(Universidade Federal do Espírito Santo, 2024-10-23) Souza Netto, Priscilla Gabriel de; Lima, Eliane de Fátima Almeida; Fioresi, Mirian; https://orcid.org/0000-0002-8560-4385; Sipolatti, Walckíria Garcia Romero; Pedraza, Leticia Lópes; Furieri, Lorena Barros; Filetti, Filipe MartinuzoIntroduction: Within the context of interventional cardiology, the nurse plays a crucial role in providing care, not only during the hemodynamic procedure but also as an educator. The guidance provided by this professional is fundamental to ensuring patient safety and preventing misconceptions that could pose risks in the pre- procedure, during, and post-procedure phases. Analyzing the knowledge, attitudes, and practices (KAP) of elective patients who will undergo cardiac catheterization and percutaneous coronary intervention (PCI) will provide support for the development of educational actions that can enhance accuracy and safety in the preparation and execution of these procedures. This will, therefore, contribute to the management planning of actions aimed at this target population, promoting optimal handling and reducing the risk of complications. General Objective: To evaluate the knowledge, attitudes, and practices (KAP) of patients undergoing cardiac catheterization and percutaneous coronary intervention. Methodology: This dissertation consists of two interdependent studies conducted in Vitória, Espírito Santo: 1) a methodological study for the construction and validation of a KAP questionnaire, conducted between August 2023 and June 2024; 2) a cross-sectional study aimed at evaluating the knowledge, attitudes, and practices of elective patients undergoing cardiac catheterization and percutaneous coronary intervention, with data collection from June to July 2024. The methodological study was conducted in two phases: a) identification of the domains and preparation of the KAP survey questions; b) validation of the KAP survey. The cross-sectional phase involved the application of the KAP survey to 49 patients admitted for cardiac catheterization or percutaneous coronary intervention at a university hospital in the Southeast Region. Data analysis was based on the responses regarding patients' knowledge, attitudes, and practices about cardiac catheterization and percutaneous coronary intervention. Descriptive and inferential statistics were used for data analysis. Results: All domains of the KAP survey demonstrated content validity (CVC greater than 0.8) and nearly perfect internal consistency, with Cronbach's alpha values exceeding 0.80. The final questionnaire included the following domains: (1) Sociodemographic characteristics, with 22 items; (2) Pre-procedure knowledge, comprising 13 items related to cardiac catheterization and 5 items related to percutaneous coronary intervention, totaling 18 items. The overall evaluation of pre-procedure knowledge revealed that only 3 patients (6.1%) had "good" knowledge. In contrast, 34 patients (69.4%) displayed positive attitudes, and 42 (85.7%) demonstrated good practices. The post-procedure evaluation of the KAP survey showed that only 14 (28.6%) patients had "good" knowledge, while 44 (89.8%) and 46 (93.4%) patients exhibited positive attitudes and practices, respectively. Variables associated with higher knowledge, positive attitudes, and proactive practices concerning CAT and PCI included patients’ desire for information about the procedures, owning a mobile phone, and education level, particularly those with at least a high school diploma compared to illiterate individuals. Conclusion: This dissertation produced a KAP survey for elective patients undergoing cardiac catheterization (CAT) and percutaneous coronary intervention (PCI), which is freely available online for use throughout Brazil. The cross-sectional study provided insights into these patients' knowledge, attitudes, and practices, including their preparation for the procedure, self-care management, and recognition of complications. It is anticipated that these findings will assist in the development and implementation of educational programs aimed at imroving the self-management practices of these patients.
- ItemChatbot para apoio a consulta de enfermagem à gestante em investigação para toxoplasmose e às infectadas(Universidade Federal do Espírito Santo, 2024-09-06) Zamboni, Rafaela Cassiano; Lima, Eliane de Fátima Almeida ; https://orcid.org/0000-0001-5128-3715; http://lattes.cnpq.br/4640538188376728; Prado, Thiago Nascimento do ; https://orcid.org/0000-0001-8132-6288; http://lattes.cnpq.br/6388559394015871; https://orcid.org/0000-0002-1801-3016; http://lattes.cnpq.br/3164634420951406; Almeida, Márcia Váleria de Souza; https://orcid.org/0000-0002-1318-7084; http://lattes.cnpq.br/9372951429429767; Carmona, Ana Paula dos Reis; https://orcid.org/0000-0003-0301-2261; http://lattes.cnpq.br/; 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; http://lattes.cnpq.br/Introduction: Toxoplasmosis is a disease that affects a significant number of pregnant women, whose infection can occur at any stage of conception. Maternal involvement can cause complications to the fetus, therefore, it is essential that nurses act in capturing infected pregnant women in the investigative process carried out during prenatal care, requiring professionals to perform interventions based on multifactorial assistance, with a view to an immediate approach, anchored in use of technologies that enable teaching on the subject and guaranteeing the patient a safe pregnancy. Objective: Develop and evaluate a conversational technology to assist nurses in tracking toxoplasmosis in pregnant women and monitoring those infected. Method: This is applied technological development research. This study will be developed in three stages. In the first stage, the content was developed through documentary research by surveying the main needs related to pregnant women with toxoplasmosis. In the second stage, the script was developed, the platform was chosen, the chatbot conversational design and the development of educational technology were developed. In the third stage, the usability assessment of the technology will be carried out using the System Usability Scale (SUS) applied to nurses who will participate in the research. Product: Guiding conversational technology to assist in tracking toxoplasmosis in pregnant women and treating those infected. Result/Product: The tool was developed to assist nurses in tracking toxoplasmosis in pregnant women and monitoring those infected. The tool has synthesized information to cover the actions recommended by the Ministry of Health in less time and making teaching viable. The Toxobot application is unprecedented and serves as support for the execution of prenatal activities, advising the Primary Care nurse in clinical reasoning and in making diagnostic decisions in an assertive manner. Conclusion: the study made it possible to create a tool to support teaching learning with adequate and synthesized information for tracking toxoplasmosis in pregnant women and monitoring those infected, constituting a disease surveillance strategy and allowing the necessary interventions, having potential for organizing the work process of PHC nurses, being a relevant product for scientific and technological development, with the potential to generate impact and be applied at a local, regional and national level, as they can be used by other professionals and health services when carrying out pre-service -Christmas. The technology is a demand from the municipality of Vila Velha that was validated with the Primary Care nurses
- ItemBurnout e fadiga por compaixão em trabalhadores de enfermagem do serviço de nefrologia(Universidade Federal do Espírito Santo, 2024-09-30) Ribeiro, Lisiane Silva; Co-orientador1; https://orcid.org/; http://lattes.cnpq.br/; Co-orientador2; https://orcid.org/; http://lattes.cnpq.br/; Co-orientador3; https://orcid.org/; http://lattes.cnpq.br/; Co-orientador4; ID do co-orientador4; Lattes do co-orientador4; Batista, Karla de Melo ; https://orcid.org/; http://lattes.cnpq.br/; Orientador2; https://orcid.org/; http://lattes.cnpq.br/; https://orcid.org/; http://lattes.cnpq.br/; 1º membro da banca; https://orcid.org/; http://lattes.cnpq.br/; 2º membro da banca; https://orcid.org/; http://lattes.cnpq.br/; 3º membro da banca; https://orcid.org/; http://lattes.cnpq.br/; 4º membro da banca; http://lattes.cnpq.br/; 5º membro da banca; https://orcid.org/; http://lattes.cnpq.br/; 6º membro da banca; https://orcid.org/; http://lattes.cnpq.br/; 7º membro da banca; https://orcid.org/; http://lattes.cnpq.br/Introduction: Burnout Syndrome and Compassion Fatigue are conditions that negatively affect the physical and mental health of nursing workers, resulting in physical exhaustion, anxiety, depression and depersonalization in relation to work. The quality of care provided is also compromised, due to fatigue and decreased empathy when interacting with patients. Signs of Burnout have been observed among nephrology nursing staff, with effects on the health of the worker and the work environment. Objective: To identify the determinants of Burnout Syndrome and Compassion Fatigue, to describe Burnout and Compassion Fatigue in nursing workers, to analyze the perception of nursing workers in relation to Burnout and Compassion Fatigue, and to build an educational technology for coping with Burnout and Compassion Fatigue for nursing workers. Method: Applied research, with technological production, carried out with nursing workers from the nephrology service of a university hospital in the southeast. The research was carried out in four stages: 1) Literature review; 2) Quantitative data collection; 3) Qualitative data collection; 4) Technology development. Results: The integrative literature review includes work overload, lack of institutional support and continuous contact with situations of suffering as the main determinants for the development of Burnout and Compassion Fatigue among nursing workers in the nephrology sector. These factors were corroborated by the study's findings. In the quantitative analysis, 47% of the participants showed high levels of stress and 53% showed signs of Burnout; in addition, 65% reported symptoms of Compassion Fatigue, and the majority of those affected were women, 70%. In the qualitative analysis, the following categories emerged: emotional and work overload, lack of professional recognition and lack of psychological support. Product: Chatbot-type educational technology, with an artificial intelligence interface and self-management, in which the virtual secretary can identify workers' demands regarding Burnout Syndrome and Compassion Fatigue, presenting personalized strategies based on user interactions. Final considerations: This study revealed an overview of the information collected in the assessments of Burnout Syndrome and Compassion Fatigue among nursing workers in the Nephrology Unit. Using quantitative and qualitative methods, it was possible to measure the severity of these conditions using psychometric scales and to explore the professionals' subjective perceptions. The quantitative analysis revealed high levels of stress and emotional exhaustion, while the qualitative analysis highlighted categories such as emotional overload, lack of professional recognition and absence of psychological support. Based on these findings, educational technology was developed in the form of a chatbot, designed to help professionals self-manage Burnout and Compassion Fatigue, responding to the specific needs of workers