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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
11

Desempenho de enfermeiros na coleta de material para o exame de papanicolau / Performance of nurses in the collection of material for the examination of Papanicolaou

Nancy Costa de Oliveira 20 January 2007 (has links)
CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / O exame de Papanicolaou tem reconhecimento mundial enquanto estratÃgia segura para detectar o cÃncer de colo uterino precocemente. Envolve trabalho manual, da coleta do material atà a emissÃo do resultado. Portanto, o desempenho dos recursos humanos contribui para a seguranÃa ou nÃo dos resultados. Este exame à realizado por mÃdicos e enfermeiros que compÃem as equipes do Programa SaÃde da FamÃlia (PSF), todavia, predominantemente, pelos enfermeiros. Neste contexto, decidiu-se pela realizaÃÃo deste estudo que teve por objetivo geral avaliar a coleta de material para o exame de Papanicolaou por enfermeiras e como objetivos especÃficos verificar o conhecimento e a prÃtica dessas profissionais com relaÃÃo à coleta citolÃgica; identificar a disponibilidade dos recursos materiais necessÃrios à realizaÃÃo da coleta e avaliar adequabilidade do material coletado baseado no laudo laboratorial. Trata-se de um pesquisa avaliativa, com carÃter exploratÃrio-descritivo. Realizou-se em unidades do Programa SaÃde da FamÃlia (PSF) de Maranguape-CE, cujos dados foram coletados de agosto a outubro de 2006 por observaÃÃo estruturada direta e participativa junto Ãs 21 (100%) enfermeiras, em seus sÃtios de atuaÃÃo, e atravÃs da revisÃo dos laudos laboratoriais de 63 lÃminas coletadas. A observaÃÃo estruturada seguiu o Instrumento de Reconhecimento da Qualidade da Metodologia Proquali, sendo os dados anotados mediante sistema de checagem. Dados da observaÃÃo participativa foram registrados em diÃrio de campo. Os resultados foram apresentados nos itens: caracterizaÃÃo das enfermeiras; formaÃÃo, acesso a manuais tÃcnicos e conhecimentos para lidar com a coleta citolÃgica; desempenho das enfermeiras na coleta de material para o exame (medidas de biosseguranÃa, conforto e seguranÃa das mulheres durante exame e tÃcnica de coleta); disponibilidade de recursos para a realizaÃÃo do procedimento; e adequabilidade das lÃminas. A maioria das enfermeiras tinha entre nove e 11 anos de formadas. Dezessete (81%) se auto-avaliaram seguras para realizar o procedimento e 16 (76%) demonstraram ter conhecimento adequado sobre o local da coleta citolÃgica. O acesso à prÃtica de coleta citolÃgica na GraduaÃÃo foi referida por somente 7 (33%) das enfermeiras. Apenas 4 (19%) lavaram as mÃos antes do procedimento, 21 (100%) utilizaram luvas de procedimento nas duas mÃos e o descarte do lixo mostrou-se inadequado em todas as unidades. O conforto da usuÃria avaliado sob o ponto de vista de certificar-se se a mulher havia esvaziado a bexiga antes do exame e explicÃ-lo para usuÃria foi atendido por 2 (9,5%) e 4 (19%) das enfermeiras, respectivamente. A privacidade, avaliada pelos critÃrios de cobrir a mulher, manter a porta do consultÃrio fechada e impedir o âentra e saiâ de pessoas durante o exame foi alcanÃado por 20 (95%), 17 (81%) e 14 (67%), respectivamente. A tÃcnica da coleta foi satisfatÃria entre 90,5% ou mais dos enfermeiros em sete dos 11 itens avaliados e a adequabilidade das lÃminas mostrou-se satisfatÃria em 100% dos 63 laudos. O desempenho das enfermeiras foi o ideal esperado em termos de garantir lÃminas de qualidade ao rastreamento do cÃncer de colo, todavia, lavagem das mÃos, descarte adequado do lixo, conforto e seguranÃa da usuÃria e entrevista sobre condiÃÃes da mulher para a realizaÃÃo da coleta precisam melhorar. Risco de dessecamento, presenÃa de sangue e material hipocelular foram observados, porÃm nÃo geraram lÃminas insatisfatÃrias, sobre o que se sugere que estudos sejam realizados com o objetivo de avaliar recomendaÃÃes desnecessÃrias ou excessivas à coleta. / The Pap test has world-wide recognition as a safe strategy to detect cervical cancer early. Its execution includes manual work, from the material collection to the result emission. Thus, the performance of human resources contributes to the security or not of the results. This is carried out by doctors and nurses that compose the teams of Health Family Program (PSF), but mainly by nurses. In this context, it was decided to carry out this study which had as a general objective to evaluate the material collection for the Pap test by nurses and as specific objectives to verify knowledge and practice of these professionals in relation to cytological collection; to identify the availability of material resources which are necessary for the execution of the collection and to evaluate if the collected material is adequate based on the laboratorial report. It is an evaluative research, with descriptive exploratory character. It was executed in units of the Family Health Program (PSF) in Maranguape-CE, whose data was collected from August to October, 2006, through the direct and participative structured observation made with 21 (100%) nurses, in their area, and through the review of the laboratorial reports of 63 collected slides. The structured observation followed the Instrument of Quality Recognition of Proquali Methodology, and the data was annotated using checking system. The participative observation data was registered in field books. The results were presented under nurse characterization; formation, access to technical handbooks and knowledge to deal with cytological collection; performance of nurses in the material collection for the exam (biosecurity measures, comfort and security of women during exam and collection technique); availability of resources for the execution of the procedure and; suitability of the slides. Most nurses were graduated for 9 to 11 years and had 8 years of experience with cytological collection. Seventeen (81%) evaluated themselves as secure to execute the procedure and sixteen (76%) showed to have the adequate knowledge about the exact localization of the cytological collection. The access to the practice of cytological collection at college was referred by only 7 (33%) of them. Only 4 (19%) washed the hands before the procedure, 21 (100%) used procedure gloves in both hands and the discard of the trash was inadequate in all the units. Usersâ comfort was evaluated according to the standpoint of making sure if the woman had emptied the bladder before the exam and of explaining it to the user and was achieved by 2 (9,5%) and 4 (19%) of the nurses respectively. The privacy was evaluated by the criteria of covering the woman, maintaining the officeâs door closed and preventing peopleâs getting in and out during the exam. It was achieved by 20 (95%), 17 (81%) and 14 (67%), respectively. The collection technique was satisfactory with 90,5% or more of the nursed in 7 of the 11 evaluated items and the suitability of blenders was satisfactory in 100% of the 63 reports. The nursesâ performance was the ideal expected in terms of guaranteeing slides with good quality to search cervical cancer. However, practice at college, washing of hands, adequate discard of the trash, usersâ comfort and security and the interview about womenâs conditions for the execution of the collection need improvement. It was observed risk of desiccation, presence of blood and hypocelular material, but unsatisfactory slides were not generated. It is suggested that studies need to be carried out with the objective of evaluating unnecessary or excessive recommendations for the collection.

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