Navegando por Palavras-chave "Assistência a saúde"

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    Avaliação do impacto de um programa de intervenções para prevenção de infecção do trato urinário associada ao uso de sonda vesical em pacientes transplantados renais
    (Universidade Federal de São Paulo (UNIFESP), 2010-05-26) Regagnin, Dejanira Aparecida [UNIFESP]; Medeiros, Eduardo Alexandrino Servolo de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The urinary tract infection is one of the most ordinary complications after a renal transplant and it may lead to rejection, donor kidney failure, long hospital stay period and increased cost. Although the use of a urinary catheter as its period of stay is considered a risk factor, little has been studied about the nursing staff knowledge to prevent urinary tract infection due to a urinary catheter. Objectives: Evaluate the nursing staff practice and knowledge related to the maintenance of a urinary catheter as the risks of its use, implement an intervention guide and measure its impact on the incidence of urinary tract infection and also on the nursing assistance to patients undergoing renal transplantation. Method: A prospective interventional study was performed in a hospital in São Paulo, from August first 2008 to July 31st 2009, and divided into two phases. In the first phase, which occurred from August 2008 to January 2009, the urinary catheter insertion and the procedures for its safe maintenance were observed and a questionnaire to access the nurses’ information about the subject was applied as well. In the second phase, from February first to July 31st 2009, a group of new actions based on data collected from the first round were implemented, the same questionnaire was applied once more followed by another period of observation which the main purpose was to verify the effect and changes caused by the new guide developed. Results: The nursing professionals’ theoretical knowledge assessment showed a meaningful statistical difference between the distinct study phases such as urethral meatus hygiene procedure (p=0,007), hygiene frequency urethral meatus (p<0.001), the cleaning product used in the hygiene of the urethral meatus (p<0,001), the catheter exchange frequency (p<0,001) and HRIM infection rates (p<0,001) awareness indicating an improvement after the intervention. The practice observation also showed a hand hygiene improvement among physicians: 9,1% of frequency before procedure and 68,2% after the procedure. Among the nursing staff members again positive results were noticed: 26,7% to 48% of hand washing before procedure and 76% to 86,7% after procedure. Better adherence to the use of personal protective equipment comparing 60 to 75% in the first round against 98% to 100% in the second. There were 44 (11,33%) cases of urinary tract infection in the first phase of the study, 26 deceaseddonor while 17 living-donor, which 37 (84,09%) due to urinary catheter presence. The average time between the urinary tract infection diagnosis and the kidney transplant was 13,5 days (5 to 30 days). In both phases, there was a bacterial infection predominance being the gram-negatives responsible for 97,7% of the infections in the first round against 82,25% in the second. E. coli itself was responsible for 34 (32%) cases of infection, followed by K. pneumoniae which caused 18 (16,9%) cases of infection. Conclusions: A meaningful practice and theoretical knowledge improvement can be noticed due to the educational program. Despite all the better results achieved in the second phase of this study, with reduction of urinary tract infection associated with vesical catheter (p=0,674), any impact on decreasing urinary tract infections could be demonstrated.
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    Itinerários de sujeitos no contexto do cracke as variações do cuidado
    (Universidade Federal de São Paulo (UNIFESP), 2015-04-14) Heise, Maira [UNIFESP]; Castro-Silva, Carlos Roberto de [UNIFESP]; http://lattes.cnpq.br/0357820757162104; http://lattes.cnpq.br/2360762263821350; Universidade Federal de São Paulo (UNIFESP)
    The use of drugs is characterized as present practice since the beginning of mankind and currently its abuse achieved worrying dimensions, setting a picture as a public health problem. Care becomes one of the major axis driversof public policies aimed at people who use crackand its driving gains a variety of meanings that comes to the scene. The theme of this research is inserted in this context which investigated and analyzed the intinerary of the individuals who are crackusers and care demonstrations from their experience in the streets. This is a qualitative research using the ethnographic method using the document research and the participant observation as tools for recognizing the reality and valuation of the marked individuals through meetings held within five months of observation. Also, evaluations were prepared targeting deepening the knowledge of individuals. The field diaries were the main drivers of the entire analytical process using the analysis and interpretation of the information used to Depth Hermeneutics. The information was organized from the three levelsof analysis: social and historical analysis, formal analysis andinterpretation / reinterpretation. From this methodological reference emerged three axes which contribute to a better understanding of the itineraries: path of life and care, experience and office in the streets and the subjective production of care. It was noticed that the itineraries of those who use crackare a complex phenomenon to be subsumed into generality. The itineraries are simultaneous and natural resulting of life trajectories, variations in care expressions and contexts of different relationships which involve people as well as communities and institutions. Daily follow-up also allowed us an enlarged view of health care aiming promoting actions of life and the valuation of good meetings in micro political spaces.