Objetivou-se com esta pesquisa analisar a produção do conhecimento de enfermagem em saúde do trabalhador com base no conjunto de dissertações e teses defendidas nos programas de pós-graduação em enfermagem do Brasil e o diagnóstico dessa produção na divulgação do conhecimento em periódicos científicos nacionais e internacionais indexados. A pesquisa foi composta por três fases. Na primeira, levantou-se a existência de linha de pesquisa e disciplina de saúde do trabalhador, através de um instrumento enviado aos coordenadores dos 25 programas de pós-graduação em enfermagem credenciados pela CAPES. Ainda, analisou-se o relatório anual da CAPES sobre os programas de pós-graduação em enfermagem, 2004, pela dificuldade na coleta de dados. Na segunda, investigou-se no catálogo do Centro de Estudos e Pesquisas em Enfermagem - informações sobre pesquisas e pesquisadores em Enfermagem da Associação Brasileira de Enfermagem (CEPEn/ABEn), no período de 1977 a 2004, as dissertações de mestrado e teses de doutorado produzidas na temática. E na terceira, buscou-se nas bases de dados Lilacs, Medline e ISI, os artigos extraídos das pesquisas investigadas na fase anterior. Obteve-se resposta de 13 (52%) coordenadores, sendo que apenas em quatro (30,77%) programas constatou-se a existência de linha e disciplina. Evidenciou-se, com a análise do relatório da CAPES-2004 que nove (36%) dos programas de pós-graduação em enfermagem trabalhavam com linhas de pesquisa e disciplinas englobando a temática. Observou-se, também, relacionando os dois procedimentos, incoerência de informações provenientes dos coordenadores e do relatório consultado. A investigação no CEPEn resultou em 140 dissertações de mestrado e 44 teses de doutorado na temática de saúde do trabalhador, sendo que Escola de Enfermagem da Universidade de São Paulo – USP e a Escola de Enfermagem de Ribeirão Preto – EERP/USP as maiores produtoras nesta ordem. Constatou-se, neste momento, que o resultado desta investigação não contemplou a totalidade das informações geradas pelos programas sobre as dissertações e teses concluídas na temática, enfatizando que os estudos concluídos em 2005 não se encontravam cadastrados. As pesquisas produziram 50 artigos, 36 (72%) oriundos das dissertações e 14 (28%) das teses, perfazendo 27,17% do total de estudos produzidos no período, constatando-se maior produção das duas instituições citadas, com alteração na ordem. As revistas de enfermagem, em 81,81% dos artigos, foram as divulgadoras, sendo que 56,81% foram publicados nos periódicos da instituição de origem. Este estudo não só traz contribuições para a identificação do conhecimento produzido pela enfermagem sobre a relação saúde e trabalho, mas também fornece subsídios para os programas de pós-graduação no que se refere a analise da qualidade das informações emitidas para futuras pesquisas e para o catálogo do CEPEn/ABEn. Por sua vez mostra a necessidade, da referida instituição, rever sua forma de catalogação das dissertações e teses. / This study aimed to analyze the production of nursing knowledge on worker’s health, based on the theses and dissertations defended in Brazilian graduate nursing programs, as well as the diagnosis of this production in knowledge dissemination through national and international indexed scientific journals. The research involved three phases. First, we surveyed the existence of a research line and subject on worker’s health, using an instrument that was sent to the coordinators of the 25 graduate nursing programs accredited by CAPES – Coordination for the Improvement of Higher Education Personnel. We also analyzed CAPES’ annual report about graduate nursing programs for 2004, due to data collection difficulties. In the second phase, we examined master’s theses and doctoral dissertations about the subject in the catalogue of the Nursing Study and Research Center, issued by the Brazilian Nursing Association (CEPEn/ABEn), which contains information about nursing research and researchers, for the period from 1977 to 2004. In the third phase, we searched the databases Lilacs, Medline and ISI for articles extracted from the studies examined in the previous phase. Thirteen (52%) coordinators answered the questionnaire, revealing that only 4 (30.77%) programs offered a research line and subject on worker’s health. Our analysis of the CAPES report 2004 showed that 9 (36%) graduate nursing programs were working in research lines and subjects about this theme. When relating both procedures, we observed incoherence between information given by the coordinators and published in the report. Our investigation at CEPEn resulted in 140 master’s theses and 44 doctoral dissertations about worker’s health, most of which were produced by the University of São Paulo College of Nursing (EE-USP) and Ribeirão Preto College of Nursing (EERP-USP), in this order. The results of this investigation did not cover all information about theses and dissertations produced by the program, as studies concluded in 2005 had not been registered yet. The produced studies gave rise to 50 articles, 36 (72%) from theses and 14 (28%) from dissertations, corresponding to 27.17% of the total number of studies produced in this period. The above mentioned institutions were again responsible for the greatest production, with a change in order. Nursing journals were responsible for disseminating 81.81% of the articles, and 56.81% were published in the journals issued by the institution of origin. This research not only contributes to the identification of nursing knowledge about the relation between work and health, but also supports the graduate programs by analyzing the quality of the information they publish, with a view to future studies and the CEPEn/ABEn catalogue. In turn, this reveals the need for this institution to review the way it catalogues the theses and dissertations.

O propósito desta pesquisa descritiva foi examinar o conhecimento e a prática de enfermeiros referente à prevenção e tratamento da úlcera de pressão e as fontes utilizadas para obter informação. Após a aprovação pelo Comitê de Ética em Pesquisa, foi solicitado que os enfermeiros de um hospital geral do interior paulista fornecessem os dados demográficos, completassem o teste de conhecimento sobre úlcera de pressão e que identificassem a freqüência de ocorrência de algumas práticas nas situações clínicas referentes à prevenção, ao tratamento e à fonte de informação utilizada. Dos 25 participantes, 96% eram mulheres entre 30 e 40 anos de idade, tendo terminado a graduação em 5 anos ou menos. Somente 8% tinham feito algum curso de especialização. Dos 46 ítens do teste, os enfermeiros responderam corretamente entre 31,1% e 89,1%. O escore mais baixo foi 18 e o mais alto foi 41. O escore médio foi 32,48 (DP 4,7). Nove enfermeiros (36%) responderam corretamente entre 51% a 69,9% dos ítens e 15 (60%) responderam corretamente mais de 70% dos ítens. Considerando os ítens relacionados a avaliação da úlcera, os escores mais baixos foram relacionados a descrição do descolamento e a presença do tecido desvitalizado no leito da ferida. Em relação à classificação da úlcera, os escores mais baixos foram relacionados a descrição do estágio I e II. Os ítens do conhecimento sobre a prevenção que obtiveram escores mais baixos foram em relação ao significado da escala de Braden e recomendações quanto a técnicas de posicionamento. Considerando a prática dos enfermeiros, 56% relataram que sempre fazem a avaliação do risco do paciente na admissão, e que documentam as medidas preventivas no prontuário do paciente (76%). Entretanto, 50% dos enfermeiros mencionaram realizar práticas inadequadas como massagem nas regiões de proeminências ósseas. Na opinião dos enfermeiros, o curativo da ferida é sempre feito pelo auxiliar de enfermagem (83.3%); entretanto, a decisão sobre o tratamento é sempre realizada pelo enfermeiro (79.2%), e às vezes pelo médico (66.7%). As práticas do tratamento da ferida mostraram uma grande variação. Alguns enfermeiros ainda usam luvas com água para proteger os calcâneos dos pacientes e às vezes usam almofadas com orifício no meio para tratar úlceras de estágio I e II. Em relação às fontes de nformações para manter-se atualizados 12,24% mencionaram que sempre participam de cursos, discussões científicas ou eventos e grupos de estudo, e 75,5% reportaram que participam às vezes. Alguns (12%) enfermeiros reportaram que sempre assinam revistas científicas ou lêem artigos científicos ou usam a biblioteca, enquanto 66,21% mencionaram que algumas vezes fazem estas atividades. Enquanto 58,3% dos enfermeiros mencionaram sempre ter acesso à Internet, somente um (4%) citou um site específico sobre úlcera de pressão. A maior parte dos enfermeiros (68%) sempre procuram outros enfermeiros da mesma instituição como fonte de informação, enquanto médicos e enfermeiros pesquisadores são consultados com menor freqüência. Os enfermeiros que referiram sempre participar em atividades de educação continuada oferecidas pela instituição(73,7%) obtiveram escores mais elevados no teste. A pesquisa identificou que, apesar dos enfermeiros apresentarem um bom nível de conhecimento no teste, algumas áreas da prevenção e tratamento da úlcera precisam de investimentos para facilitar a implementação das recomendações baseadas em pesquisa ou outras evidências para que a prática clínica seja aperfeiçoada. / The purpose of this descriptive research was to examine a group of nurses’ knowledge concerning pressure ulcers’ prevention and management, and the sources used to get information for nursing care. Twenty-five nurses, working in a middle size general hospital in an inner city of Sao Paulo state, were asked to provide demographic information, to complete the Pressure Ulcer Knowledge Test as well to identify the frequency of some practice at clinical setting related to pressure ulcer prevention and management, and their source of information. Most nurses were female (96%), in their 30’s (56%), and had finished their BSN in 5 years or less (48%). Only 8% had any specialty education after graduating from university. Of the 46 items, nurses correctly answered between 34,1% to 89,1% . The lowest score was 18 and the highest was 41. The average score was 32,48 (SD 4,7). Nine nurses (36%) correctly answered 51% to 69,9% of the items; and 15 (60%) answered correctly more than 70% of the items. Considering the items related to pressure ulcer evaluation, lower scores were obtained related to description of undermining and the presence of slough in wound bed. Related to ulcer staging, lower scores were obtained related to description of stage II and III. Knowledge about pressure ulcer prevention was lower related to meaning of Braden scale, positioning techniques while sitting or use of the 30 degree sidelying . Regarding ulcer management, nurses reported that they always (56%) performed patient’s risk evaluation at admission and document prevention measures on patients’ records (76%). However, 50% of nurses mentioned inadequate practices as giving massages on bone prominence; 12.5% reported always giving massages, 37.5% sometimes. In the nurses’ opinion, wound care is mostly performed by nurses’ aides (83.3%); however, the decision of treatment is always made by nurses (79.2%), and sometimes by the physician (66.7%). Wound care practices showed a great variability. Some nurses still use water filled gloves to protect patients’ heels and sometimes use ring cushions to treat stage I and stage II ulcers. Related to sources of information to keep updated knowledge, 12,24% of nurses mentioned that always participated of courses, scientific discussions or meetings and study groups and 75,5 % reported that participated sometimes. Some nurses (12 %) reported that always subscribes a scientific journal or reads scientific articles or uses the library, while 66,21% mentioned that sometimes do those activities. While 58,3% of nurses always had access to the Internet, only one (4%) mentioned a specific site about pressure ulcers. Most of nurses (68%) always seek nurses from the same institution as source of information and physicians and nurse researcher are seeing less frequently. Nurses that refered to always participating in activities of continuing education offered by the institution (73,7%), obtained better scores on the knowledge test. The research has shown that although nurses have a good level of knowledge in some areas of pressure ulcer prevention, more needs to be done to facilitate the implementation of research or evidenced based recommendations in this institution in order to enhance clinical practice.

Smart infusion pump technology (SIPT) was designed to enhance safety with intravenous medication administration, but has introduced new patient safety risks and harm when nurses initiate workarounds that bypass SIPT safety features. This study sought to develop a grounded theory explaining nurses' experiences with SIPT, their perceptions of safety features, the rules and resources used in response to safety features, the actions taken in response to SIPT workflow blocks, and conditions contributing to nurse-initiated workarounds. Corbin and Strauss's (2008) grounded theory approach guided this study. Semi-structured interviews were conducted with 28 nurses who used SIPT across 13 adult patient care areas in a single Midwest teaching hospital. The grounded theory Nurse-Technology Interplay was developed through constant comparison analysis of transcribed interview data. The four categories of interacting with SIPT, making meaning, taking action, and consequences, were linked through relational statements and theoretically integrated to develop the grounded theory. The grounded theory explicates the continual interplay that occurs as nurses interact with SIPT, and the cognitive and physical processes used to resolve workflow blocks in the context of care delivery. Interacting with SIPT reflected the learning curves faced by nurses, the context of patient-care unit characteristics, and encountered workflow blocks. Making meaning reflected the cognitive processes used by nurses as they encountered workflow blocks with SIPT, and was influenced by individual perspectives, as well as shared learning. Taking action often occurred simultaneously with making meaning, and represented processes of doing, such as rechecking programming activities, seeking assistance, or engaging in workarounds. Consequences of using SIPT included patient outcomes with medication administration and the impact on practice as nurses experienced disruptions in care delivery, dependency on SIPT, a loss of calculation skills, and alarm overload. The grounded theory of Nurse-Technology Interplay provides an understanding of how nurses make sense of, and respond to, workflow blocks with SIPT safety features. The study yielded valuable insights into the complexity of SIPT implementation and the challenges nurses face while providing safe, effective, patient-centered care in the midst of juggling competing priorities. The findings have implications for nursing practice and nurse leaders. Critical to moving forward is a more purposeful approach to SIPT education and training within a patient safety framework, a systematic evaluation of organizational processes that impact SIPT, optimization the SIPT drug library to facilitate nurses' work, and promotion of a learning organization that capitalizes on the lessons that can be learned from workarounds.

<p>Syftet med denna litteraturstudie var att enligt vetenskapliga studier, publicerade mellan år 2002 och 2007, beskriva omvårdnad av patienter med kronisk hjärtsvikt. Metoden som användes var en litteraturstudie med beskrivande design. Information hämtades från databaserna Medline, Academic Search Elite och Cochrane Library, samt ur Vård i Nordens webbarkiv. Sökorden som användes var ”chronic heart failure” och ”nursing”. Totalt inkluderades 22 studier i denna litteraturstudie. Ur studierna kunde fem inriktningar inom omvårdnaden av patienter med hjärtsvikt identifieras. Dessa var omvårdnad genom patientutbildning, telefonrådgivning, fysisk träning, hemsjukvård och hjärtsviktsmottagning. Resultatet visade på ett positivt samband mellan fysisk träning och ökad livskvalitet hos patienter med hjärtsvikt i samtliga studier som undersökte dessa två variabler. Majoriteten av studierna som undersökte effekten av telefonrådgivning till patienter med hjärtsvikt fann att antalet inläggningar på sjukhus hade minskat efter att patienterna under en period fått telefonrådgivning. I de studier som granskats låg fokus till stor del på att stärka patienternas egenvård. Två inriktningar inom omvårdnaden av patienter med hjärtsvikt utmärkte sig som de mest effektiva metoderna. Dessa var fysisk träning och telefonrådgivning.</p> / <p> </p><p>The aim of this literature study was to describe the care of patients with chronic heart failure according to scientific studies published between the years 2002 and 2007. A descriptive design was used. Information was gathered from the following databases: Medline, Academic Search Elite and Cochrane Library. Vård i Norden webb archive was also used for collecting articles. Keywords used in the search were "chronic heart failure" and "nursing". A total of 22 articles were included in this study. The articles in this study showed five different themes in the care of patients with heart failure, these were: patient education, telephone care, physical exercise, home-based care and heart failure clinics. The result showed a positive correlation between physical exercise and quality of life, this was found in every article covering these two variables. Most studies concerning telephone care found that the number of hospital readmissions decreased after an intervention based on telephone care. In the included studies a lot of focus was on strengthening patient's ability to self care. In this study physical exercise and telephone care were the most effective methods of care for patients with heart failure.</p>

Syftet med denna litteraturstudie var att enligt vetenskapliga studier, publicerade mellan år 2002 och 2007, beskriva omvårdnad av patienter med kronisk hjärtsvikt. Metoden som användes var en litteraturstudie med beskrivande design. Information hämtades från databaserna Medline, Academic Search Elite och Cochrane Library, samt ur Vård i Nordens webbarkiv. Sökorden som användes var ”chronic heart failure” och ”nursing”. Totalt inkluderades 22 studier i denna litteraturstudie. Ur studierna kunde fem inriktningar inom omvårdnaden av patienter med hjärtsvikt identifieras. Dessa var omvårdnad genom patientutbildning, telefonrådgivning, fysisk träning, hemsjukvård och hjärtsviktsmottagning. Resultatet visade på ett positivt samband mellan fysisk träning och ökad livskvalitet hos patienter med hjärtsvikt i samtliga studier som undersökte dessa två variabler. Majoriteten av studierna som undersökte effekten av telefonrådgivning till patienter med hjärtsvikt fann att antalet inläggningar på sjukhus hade minskat efter att patienterna under en period fått telefonrådgivning. I de studier som granskats låg fokus till stor del på att stärka patienternas egenvård. Två inriktningar inom omvårdnaden av patienter med hjärtsvikt utmärkte sig som de mest effektiva metoderna. Dessa var fysisk träning och telefonrådgivning. / The aim of this literature study was to describe the care of patients with chronic heart failure according to scientific studies published between the years 2002 and 2007. A descriptive design was used. Information was gathered from the following databases: Medline, Academic Search Elite and Cochrane Library. Vård i Norden webb archive was also used for collecting articles. Keywords used in the search were "chronic heart failure" and "nursing". A total of 22 articles were included in this study. The articles in this study showed five different themes in the care of patients with heart failure, these were: patient education, telephone care, physical exercise, home-based care and heart failure clinics. The result showed a positive correlation between physical exercise and quality of life, this was found in every article covering these two variables. Most studies concerning telephone care found that the number of hospital readmissions decreased after an intervention based on telephone care. In the included studies a lot of focus was on strengthening patient's ability to self care. In this study physical exercise and telephone care were the most effective methods of care for patients with heart failure.

Omvårdnadsforskningen har ökat i takt med att fler sjuksköterskor har en akademisk utbildning. Studier på området har fokuserat på i vilken omfattning sjuksköterskor använder sig av evidensbaserad forskning samt vilka barriärer som finns för användandet. Resultaten är entydiga om att det är svårt att integrera forskningsresultat i det kliniska arbetet. Följden av detta kan bli att kunskap inte når ut i det kliniska omvårdnadsarbetet. Syftet med litteraturstudien var att beskriva omvårdnadsforskningens integrering i det kliniska omvårdnadsarbetet. En systematisk litteraturstudie med integrativ metod genomfördes. I resultatet framkom olika möjligheter till integrering av forskning i klinisk verksamhet. Ett öppet klimat med gemensamma mål för integrering av omvårdnadsforskning samt ett tydligt ledarskap som ger resurser i form av ekonomi, utbildning och tid. För att integreringen av forskning i det kliniska arbetet ska öka behövs ett samarbete mellan universitet/ högskolor och klinisk verksamhet så att sjuksköterskor kan få det stöd som behövs för att utveckla den omvårdnad som ges till patienten. I litteraturen finns få empiriska studier i ämnet varför det vore av intresse att fortsätta utforska detta område. / Nursing research has increased as more nurses have a university education. Studies in this area have focused on the extent to which nurses use evidence-based research as well as the barriers that exist for their use. The results are clear that it is difficult to integrate research findings into clinical practice. The consequence of this may be that knowledge does not reach the clinical nursing practice. The purpose of this study was to describe nursing research integration in clinical nursing. A systematic study with integrative approach was implemented. The result shows various possibilities for the integration of research into clinical practice. An open climate with common goals for the integration of nursing research and clear leadership that provides resources in terms of finance, education and time. For the integration of research into clinical practice will increase the need for collaboration between universities / colleges and clinical practice so that nurses can get the support needed to develop the care given to the patient. In the literature, there are few empirical studies on the subject why it would be of interest to continue exploring this area.

Thesis (Ph. D.)--University of Missouri--Columbia, 1999. / Typescript. Vita. Includes bibliographical references (leaves 127-129). Also available on the Internet.

Diss. Universiẗat Witten/Herdecke, 2008. / Originaltitel im Buch nicht angegeben; Titel der Diss.: To elucidate the subjective feeling, or absence, of distress during certain nursing procedures in patients who have visual privacy and those who do not; Deutsch: Analyse des subjektiven Empfindens bei (oder Fehlens von) Leid von Patienten mit visueller Privatsphäre und solchen ohne während bestimmter pflegerischer Behandlungsmethoden. Literaturverz. S. 107-110. Literaturverz.

Thesis (Ph. D.)--University of Missouri--Columbia, 2002. / Typescript. Vita. Includes bibliographical references (leaves 76-81). Also available on the Internet.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2010.