Abstract This diploma thesis, titled "Ensuring intimacy and dignity in patients on urgent reception, self-evident or a luxury?", highlights the issue of respecting human dignity and ensuring intimacy in treating patients on urgent admission. The above issues are currently lagging the prestige of modern healing and nursing practices. In intensive care and therefore in urgent arrivals, an inpatient health care system is being developed, where maintaining the dignity of a person and ensuring his intimacy is very complicated. At a slow pace, this issue moves to the forefront of the public's interests, both professional and lay, particularly from the point of view of patients who have some experience with healthcare. The aim of this diploma thesis was to map the provision of intimacy and respect for dignity in patients on emergency reception by treating staff. The theoretical part of this thesis describes areas such as dignity, intimacy, holism, the needs of the sick, as well as communication and burnout syndrome and the functioning of urgent income as such in a brief description. The practical part of the work was elaborated by the method of qualitative research using the techniques of semi-structured interview with patients who were treated for urgent income and with emergency care staff, combined with the secret observation of the work of the emergency care staff. Interviews and observation took place in April 2017, at the Emergency in Hospital. Permit for research was issued by the Deputy Minister for Nursing. The research group consisted of 10 nurses working on urgent admissions and 10 patients treated in this department. The research shows that nurses have a very good knowledge of dignified care and patient intimacy, but in terms of putting this knowledge into practice, this area is under the supervision of the department's staff to work on it and to deal with it more closely. In patients pointed out to insufficient awareness of the course of treatment, applied medications, and a lack of privacy in nursing. Almost the most discussed issue is communicating personal data and health problems in the emergency waiting room to a nurse, without any possibility of privacy. Some factors that interfere with dignified and intimate care relate to areas of rather structural and organizational adjustments to the department and will be proposed for further solutions.

Made available in DSpace on 2014-12-17T14:47:04Z (GMT). No. of bitstreams: 1 KisnaYAA_DISSERT.pdf: 3597363 bytes, checksum: e93daa258fbca2cb9d05dce2355b4c24 (MD5) Previous issue date: 2014-02-07 / The reports of adverse events date from 1990 up to the present day. Conceptually, these adverse events are unintentional injuries unrelated to the underlying disease, causing measurable lesions in patients, extending the period of hospitalization, or leading to death. These issues require discussions with regard to patient safety, improved quality of service, and preventing medical errors. In the Intensive Care Units, this concern is greater because these are sectors of intensive care to individuals with hemodynamic changes and imminent risk of death. Therefore, it is essential to conduct evaluation processes to investigate aspects of quality of nursing care and patient safety in these spaces. For that reason, we aimed to propose the Evaluation protocol of nursing care and patient safety in Intensive Care Units. For its achievement, we needed to: 1) analyze the evolution of the patient safety concept used in scientific productions, under Rodgers evolutionary concept; 2) identify the necessary items to build the evaluation protocol of nursing care and patient safety in the Intensive Care Unit, from the available evidence in literature; 3) construct an instrument for content validation of the evaluation protocol of nursing care and patient safety in the Intensive Care Unit; and 4) describe and evaluate the appropriateness of the content for an evaluation protocol of nursing care and patient safety in the Intensive Care Unit. This is a methodological study for the content validation of the abovementioned protocol. To meet the first three specific objectives, we used the integrative literature review in Theses Database of the Coordination for the Improvement of Higher Education Personnel and the portal of the Collaborating Centre for Quality of Care and Patient Safety. The fourth specific objective happened through the participation of judges, located from the Lattes curricula, in the content validation process developed in two stages: Delphi 1 and Delphi 2. As instrument, we used the electronic form of Google docs. We present in tables the answers from the evaluation instruments by Delphi consensus and Content Validity Index (CVI) of the entire protocol. We summarized the results in articles entitled Analysis of the patient safety concept: Rodgers evolutionary concept ; Scientific evidence regarding patient safety in the Intensive Care Unit ; Technological device for the content validation process: experience report ; and Evaluation protocol of nursing care and patient safety in Intensive Care Units. The Embodied Opinion of the Research Ethics Committee of the Universidade Federal do Rio Grande do Norte, No. 461,246, under CAAE 19586813.2.0000.5537, approved the study. Thus, we conclude the protocol valid in its content, constituting an important tool for evaluating the quality of nursing care and patient safety in Intensive Care Units / Os relatos sobre eventos adversos datam desde 1990, contemporizando-se at? os dias atuais. Conceitualmente, os eventos adversos s?o inj?rias n?o intencionais e sem rela??o com a doen?a de base, provocando les?es mensur?veis em pacientes, prolongamento do per?odo de interna??o ou ?bito. S?o tem?ticas que demandam discuss?es, no tocante ? seguran?a do paciente, melhorias na qualidade do servi?o e na preven??o de erros no atendimento ao paciente. Na Unidade de Terapia Intensiva, essa preocupa??o ? ampliada, pois s?o setores de cuidados intensivos aos indiv?duos com altera??es hemodin?micas e iminente risco de morte. Assim, ? fundamental a realiza??o de processos avaliativos para investigar os aspectos de qualidade do cuidado de enfermagem e da seguran?a do paciente nesses espa?os. Diante disso, objetivou-se propor o Protocolo de avalia??o do cuidado de enfermagem e da seguran?a do paciente nas Unidades de Terapia Intensiva . Para alcan??-lo, fez-se necess?rio: 1) analisar a evolu??o do conceito seguran?a do paciente empregado nas produ??es cient?ficas, sob a vis?o evolucion?ria de Rodgers; 2) identificar os itens necess?rios para compor o protocolo de avalia??o do cuidado de enfermagem e da seguran?a do paciente na Unidade de Terapia Intensiva, a partir das evid?ncias da literatura; 3) construir um instrumento para valida??o de conte?do do protocolo de avalia??o do cuidado de enfermagem e da seguran?a do paciente na Unidade de Terapia Intensiva; e 4) descrever e avaliar a adequa??o do conte?do para um protocolo de avalia??o do cuidado de enfermagem e da seguran?a do paciente na Unidade de Terapia Intensiva. Trata-se de um estudo metodol?gico, para valida??o de conte?do do protocolo supracitado. Para atender os tr?s primeiros objetivos espec?ficos, utilizou-se a revis?o integrativa da literatura no Banco de Teses da Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior e no portal do Centro Colaborador para a Qualidade do Cuidado e a Seguran?a do Paciente. O quarto objetivo espec?fico foi concretizado pela participa??o de ju?zes, localizados atrav?s dos curr?culos Lattes, no processo de valida??o de conte?do desenvolvido em duas etapas: Delphi 1 e Delphi 2. Como instrumento, utilizou-se o formul?rio eletr?nico do google docs. As respostas provenientes dos instrumentos de avalia??o s?o apresentadas, mediante consenso de Delphi e ?ndice de Validade de Conte?do (IVC) de todo o protocolo, em tabelas. Os resultados foram sintetizados nos artigos intitulados A an?lise do conceito seguran?a do paciente: a vis?o Evolucion?ria de Rodgers , Evid?ncias cient?ficas acerca da seguran?a do paciente na Unidade de Terapia Intensiva ; Dispositivo tecnol?gico para processo de valida??o de conte?do: relato de experi?ncia ; e Protocolo de avalia??o do cuidado de enfermagem e da seguran?a do paciente nas Unidades de Terapia Intensiva . O estudo foi aprovado pelo Parecer Consubstanciado do Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte, n? 461.246, sob CAAE n? 19586813.2.0000.5537. Conclui-se que o protocolo, v?lido em seu conte?do, constitui uma importante ferramenta de avalia??o da qualidade do cuidado de enfermagem e da seguran?a do paciente em Unidades de Terapia Intensiva

Submitted by MARCIA ROVADOSCHI (marciar@unifra.br) on 2018-08-22T13:12:01Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_CarineAlvesGomes.pdf: 2618912 bytes, checksum: e1861048bbed444a15e3c572e4cecbe6 (MD5) / Made available in DSpace on 2018-08-22T13:12:01Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_CarineAlvesGomes.pdf: 2618912 bytes, checksum: e1861048bbed444a15e3c572e4cecbe6 (MD5) Previous issue date: 2017-05-11 / The practice of prescribing, dispensing and diluting drugs in the hospital organization involves different professionals. For the nursing team it is the preparation and the administration that requires knowledge, attention and responsibility, mainly to avoid the error. The present study aimed to evaluate the possible contributions of the Drug Dilution Unit from the perspective of health professionals and managers. This is a qualitative and quantitative descriptive exploratory study, carried out from June to October 2016, in a medium-sized hospital, including a description of the process of implementation of the Drug Dilution Unit, the experiences, knowledge and needs for the creation of thistechnology. A sample of thirty professionals, composed of nursing technicians, nurses, pharmacists and managers, answered a self-administered questionnaire, structured with 12 closed questions (Likert-scale response) and 12 open questions about dilution unit technology in relation to quality and attention to the medication administration process, nursing care qualification and cost-effectiveness.The average score obtained in relation to patient safety was 14.8 points, reaching the percentage of 77.8% of the expected. The optimization in the medication assistance obtained 15.5 (81.8%), the qualification in the assistance, 14.7 (81.7%) and the cost-effectiveness, 15.8 (87.8%). In the perception of professionals, the unit promoted patient safety, benefited dilution standardization, adequate conference, asepsis of medications and effectiveness in the control, besides the organization and optimization of the time in the work processes, improvement in the qualification of the assistance of Nursing care in relation to patient care, reducing the number of adverse events and drug waste, resulting in a decrease in spending on drugs and materials. The implementation of the dilution unit had an impact on the hospital service with the disruption of the paradigms in relation to the medication assistance, since the change from routine preparation, dilution, to administration, underwent changes to obtain safety in the process. The new service was satisfactory as it stimulated the ability to rethink and seek innovations to transform work routines by qualifying care, medication and professional resources, providing greater patient safety. In view of the results, it can be concluded that the implementation of the Drug Dilution Unit favored the service for the offered advantages, of a technical, therapeutic, care and economic nature.This study allowed: favorable technical opinion of the Regional Nursing Council of Rio Grande do Sul (COREN-RS) and the 4th Regional Health Coordination of Santa Maria-RS; customization of computerized labels for drug identification; and, writing of dilution manual, standardized for the institution that allows to improve the routines of the unit. / A prática de prescrição, dispensação e diluição de medicamentos na organização hospitalar envolve diferentes profissionais. Para a equipe de enfermagem cabe o preparo e a administração que exige conhecimento, atenção e responsabilidade, principalmente para evitar o erro. O presente estudo teve como objetivo avaliar as possíveis contribuições da Unidade de Diluição de Medicamentos na perspectiva de profissionais de saúde e gestores. Trata-se de pesquisa quali-quantitativa descritiva exploratória, realizada no período junho aoutubro de 2016, em hospital de médio porte, incluindo adescrição do processo de implementação da Unidade de Diluição de Medicamentos, as experiências, vivências e as necessidades para a criação desta tecnologia. Uma amostra de trinta profissionais, composta por técnicos de enfermagem, enfermeiros, farmacêuticos e gestores, responderam a um questionário autoaplicável, estruturado com 12 questões fechadas (resposta em escala Likert) e 12 abertas, sobre a tecnologiada unidade de diluição em relação à qualidade e à atenção no processo de administração de medicamentos, à qualificação na assistência de enfermagem e ao custo- efetividade. A pontuação média obtida em relação à segurança do paciente foi de 14,8 pontos, atingindo o percentual de 77,8% do esperado. A otimização na assistência medicamentosa obteve 15,5 (81,8%), a qualificação na assistência, 14,7 (81,7%) e o custo-efetividade, 15,8 (87,8%). Na percepção dos profissionais a unidade promoveu a segurança do paciente, beneficiou a padronização da diluição, a conferência adequada, a assepsia dos medicamentos e a eficácia no controle, além da organização e otimização do tempo nos processos de trabalho, melhoria na qualificação da assistência de enfermagem em relação ao atendimento dos pacientes, reduzindo o número de eventos adversos e desperdícios de medicamentos, resultando em uma diminuição de gastos com medicamentos e materiais. A implementação da unidade de diluição causou impacto no serviço hospitalar com o rompimento dos paradigmas em relação à assistência medicamentosa, pois a mudança da rotina desde o preparo, diluição, até a administração, sofreram mudanças para obter segurança no processo. O novo serviço foi satisfatório, pois estimulou a capacidade de repensar e buscar inovaçõespara transformar rotinas de trabalho qualificando a assistência, medicamentos e os recursos profissionais, proporcionando maior segurança para o paciente. Frente aos resultados pode-se concluir que a implementação da Unidade de Diluição de Medicamentos favoreceu o serviço pelas vantagens propiciadas, de ordem técnica, terapêutica, assistencial e econômica. Este estudo possibilitou: parecer técnico favorável do Conselho Regional de Enfermagem do Rio Grande do Sul (COREN-RS) e da 4a Coordenadoria Regional de Saúde de Santa Maria-RS; customização de etiquetas informatizadas para identificação dos medicamentos; e, redação de manual de diluição,padronizado para a instituição que possibilita aprimorar as rotinas da unidade.