Nursing & Healthcare

Biography

Abstract

Biography

Paulo Henrique Fernandes dos Santos has completed his Masters’ from Health Sciences and Technologies Program of the University of Brasilia, Brazil. Currently, he is Professor of Nursing Department, University of Brasilia, and conducts research about Human Aging, Nursing Process and Primary Healthcare.

Abstract

Objective: The objective is to evaluate the nursing diagnosis risk for falls of NANDA-I in the elderly in primary healthcare in the Federal District/Brazil.

Methodology: Descriptive, quantitative, cross-sectional study performed in two basic health units, with a sample of 156 elderly patients with chronic diseases. The data collection consisted in blood collection, nursing consultation and assessment of the risk of falls. The data were analysed in statistical software SPSS 21.0.

Results: The majority of the sample was female (79.5%), mean age of 67.9±5.8 years, with hypertension (80.8%), diabetes mellitus (59.6%), or both (48.1%). The elderly presented a high prevalence of history of falls (71.2%). The intrinsic risk factors of NANDA-I most prevalent were visual impairment (73.7%), impaired mobility (70.5%) and history of falls (69.9%), and the extrinsic factors were insufficient anti-slip material in the bathroom (60.3%) and use of throw rugs (58.3%). The intrinsic factors that increased the risk of falls were the use of assistive device (Odds Ratio–OR 3.50; p=0.030), difficulty with gait (OR 2.84; p=0.019) and alteration in cognitive functioning (OR 1.26; p=0.019); the extrinsic factor was throw rugs (OR 1.59; p=0.041).

Conclusion: This diagnosis has proved to be an effective tool that helps nurses in the screening of vulnerability to falls. The study contributed to remedy a gap of studies prepared to evaluate this nursing diagnosis in the elderly in the context of primary healthcare, in addition to demonstrating the importance of its use in conjunction with other tools for assessment the risk of falls, aiming at the planning of preventive actions of risk factors for these accidents.

Biography

Zaadoud Brahim is Faculty of Science at University Ibn Tofail and also extends his research work at the Laboratory of Agro physiology, Biotechnology, Environment and Quality.

Abstract

Objective: The subject of our research concerns the measurement of the performance in Primary Health Care Establishments (PHCE) and how to evaluate the impact of qualitative approaches on the perception of the actors of the PHCE and the level of performance in these establishments.

Method: The data collection was made through a questionnaire for the staff who exercises in the ESSP. This questionnaire contains three parts adapted according to the model of Donabedian (structure, processes and results), understanding seven domains. The first part concerns the structure dedicated to the quality planning, the leadership and the human resources management. The second part concerns the processes dedicated to the process management, the monitoring and the analysis. The third part handles the results of the quality and the user’s satisfaction. Every domain contains 4 to 9 questions handling an aspect with 46 questions. The questionnaire was sent to the concerned in an individual way either directly, or through emails, assuring the guarantors

Result: We note significant differences in the perception of the quality of the care of the health workers general. The steps of ACQ remain a good tool to improve the quality of the care. The satisfaction of the population remains high with a performance of (74%), the steps of ACQ are effective tools of the organizational change, the impact on the change of professional practices for our case (68%) have this image, which varies, enters average and low on the CQ. Continuity and integration of the care are assured only in 34% of the cases. The fragmentation of the services, the ineffective use of the suppliers of care, the bad quality of the collection and the management of the information, the lack of coordination, the lack of importance given to the prevention, as well as the deficits in the access to healthcare stand out as the main problems.

Conclusion: Even if the links are not established within the framework of a scientific research, quality approaches are generally recognized as an essential tool to help establishments to improve the quality and the safety of the patients. Tools proposed in quality approaches remain an essential lever for the promotion of quality approaches. They demonstrated positive effects on the quality of the care, but some constraints slow down their evolution. It is not still common to make evaluations of the quality of the care in the ESSP to obtain the relevant information on the benefit. The necessity of having measurement tools for performance which puts in coherence the piloting of the operational level with the strategy, to integrate the organizational objectives into the measures of operational performances and make estimate its structures towards a real management by the quality

Biography

Miriam I Siebzehner Deputy Director and Senior Researcher Israeli Center for Technology Assessment in Health Care (ICTAHC ). She holds two MA's in Nursing from Tel Aviv University and in Public Administration from Harvard’s John F Kennedy School of Government. She received her PhD in Health Management from Ben-Gurion University. She is the Chief Nurse Officer of the Central Health District, Ministry of Health. She has published more than 30 articles in professional Israeli and international journals. She has lectured in professional educational programs in Tel-Aviv University. During 20 years, she is a Consultant to the Israeli Foreign Ministry, Division for International Cooperation on Health Issues for Latin America and selected African countries. She has received professional awards: The International Council of Nurses and 3M, Israel Award for outstanding professional achievements, the Ministry of Health Outstanding Employee Award in recognition of highest level of excellence, The Prime Minister Office Civil Service Commission Outstanding Governmental Employee Award

Abstract

Introduction: Many medical technologies are used by the nursing staff and help provide the patients with better treatment. The nursing staff makes use of medical equipment during the course of their work, most of the time without having proper and adequate qualification. As a result, nurses learn how to use the equipment through working with it, as on the job training. This method of learning is inadequate therefore nurses feel threatened and decline from using the technologies.

Aim: To improve the nurses’ skills for using medical equipment in the hospital by providing an organized training program.

Methodology: The project was carried out according to the model of Shyuhart (Carr & Lietmann, 1995) and includes the following stages: planning, implementing, estimating and concluding. The planning stage consisted of selecting departments, and using pretest questionnaires. In the implementation stage the teams were divided in smaller groups, training and practicing skills away from patients. The training was on the use of existing and new equipment. The project was evaluated by filling of questionnaires.

Results: The results showed a rise in the level of knowledge on existing equipment and a high beginning level of knowledge for the new equipment. Levels of anxiety and feelings of security while using the equipment were tested, and a significant improvement was found in both cases.

Conclusions: It is possible to improve the introduction of medical equipment to be used by nurses into hospital wards throughout training programs.

Biography

Abstract

Biography

Marina Morato Stival has completed her Nursing from Health Sciences and Technologies Program of the University of Brasilia, Brazil. Currently, she conducts research on the subject of Human Aging and has published more than 30 papers in nationals and international journals

Abstract

Objective: To evaluate the nursing diagnosis of fragile elderly syndrome in the elderly with chronic diseases.

Methodology: Quantitative, descriptive and cross-sectional study with 78 elderly patients with arterial hypertension and/or diabetes mellitus treated in primary care. We used a socio-demographic questionnaire, mini mental state examination, anthropometric data (weight and height), sarcopenia evaluation, body composition (bone densitometry), muscle strength (dynamometer) and functional performance evaluation (timed up and go-TUG). The nursing consultation was performed for the identification of the nursing diagnosis of the Fragile Elderly Syndrome of NANDA-I. The data were analysed in statistical software SPSS 20.0.

Results: The majority of the elderly were female, with a mean age of 68.8±6.0 years and low schooling. The majority of the elderly had associated hypertension and diabetes mellitus (53.9%), 80.8% were overweight, 44.9% had cognitive deficits, 7.7% had sarcopenia and 3.8% had severe sarcopenia. The most prevalent related factors were: previous falls (79.5%), sedentary lifestyle (48.7%) and alteration in cognitive function (44.9%). The defining characteristics were identified: 93.6% with impaired memory; 93.6% impaired physical mobility; 82.1% fatigue; 76.9% impaired walking; 53.8% self-care deficit for dressing; 43.6% activity intolerance; 35.9% social isolation; 30.8% hopelessness; 29.5% self-care deficit for food; 29.5% for bath; 12.8% for intimate hygiene and 10.3% decreased cardiac output.

Conclusion: Elderly individuals with risks for geriatric disabilities were identified. The identification of this diagnosis in the elderly in the primary care showed to be relevant when demonstrating a holistic approach of this elderly with chronic disease. This research is essential in view of the high prevalence observed mainly related to mobility and cognition. Nurses should be aware of the diversity of signs and symptoms involved in syndrome, as they may interfere with diagnostic accuracy and problems be judged in isolation rather than approaching a syndrome

Biography

Luciano Ramos de Lima has completed his Master in Nursing from Health Sciences and Technologies Program of the University of Brasilia, Brazil. Currently, he conducts research on the subject of Diabetes mellitus, Chronic pain and Quality of life. He has published more than 30 papers in journals nationals and internationals

Abstract

Objective: To analyse the quality of life (QoL) of individuals with diabetic mellitus type 2 (DM2) with neuropathy and pain treated in primary care in Brazil.

Methodology: Transverse cohort study of quantitative approach conducted in two Basic Health Unit (UBS) users of the Unified Health System (SUS) of Brazil. The sample was 251 participants and we adopted instruments: demographic and socioeconomic profile, clinical, pain (Visual Analogue Scale). Diabetic neuropathy was investigated by the protective sensitivity loss (PSP) and by the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS). QoL was evaluated using SF-6D (Short-Form 6 Dimensions-SF-6D).

Results: The majority were 74.5% women, mean age 58.9±10.01 years, 68.5% with DM2 time less than 10 years. The neuropathic assessed by the LANSS was 16.3%, 97.1% had chronic pain, the neuropathic ones reported intense pain M=7.15±2.0 compared to non-neuropathic 6.4±2.3 (p=0.038), 51.2% had alteration in the monofilament test (p=0.001). The most mentioned pain descriptors were burn (p=0.004), tingling (p=0.002), and tuned and/or needling (p=0.003). The overall QOL was SF-6D averaged 0.78 points, patients with neuropathy had a lower score (mean=0.77) (p>0.05). In general, 91.2% of the QoLdor domain was the most affected among neuropathic patients, followed by mental health and vitality, and the domain less affected was social aspect, however, there was no difference between groups when compared between domains (p>0.05).

Conclusion: QoL was affected in the neuropathic mainly in the domains of QoL pain, mental health and vitality. Most had chronic pain of moderate or severe intensity. Nurses should be attending to DM2 to recognize neuropathy and prevent further QoL promotion...

Biography

Miriam I Siebzehner Deputy Director and Senior Researcher Israeli Center for Technology Assessment in Health Care (ICTAHC ). She holds two MA's in Nursing from Tel Aviv University and in Public Administration from Harvard’s John F Kennedy School of Government. She received her PhD in Health Management from Ben-Gurion University. She is the Chief Nurse Officer of the Central Health District, Ministry of Health. She has published more than 30 articles in professional Israeli and international journals. She has lectured in professional educational programs in Tel-Aviv University. During 20 years, she is a Consultant to the Israeli Foreign Ministry, Division for International Cooperation on Health Issues for Latin America and selected African countries. She has received professional awards: The International Council of Nurses and 3M, Israel Award for outstanding professional achievements, the Ministry of Health Outstanding Employee Award in recognition of highest level of excellence, The Prime Minister Office Civil Service Commission Outstanding Governmental Employee Award

Abstract

In recent decades, efforts have been made by migrant workers from third world countries, to immigrate to developed countries in order to improve their wages and quality of life. This is often done in contravention of immigration laws of the destination country, especially when seeking a better life, such as infiltration of migrant workers to the United States from Mexico. This phenomenon also existed in Israel, especially from the Egypt border. The possibility of sick illegal immigrant`s access to health care institutions in most European countries is limited to emergency situations. In the United States, hospitals deal with the constant need to health expenditures, some are choosing "unlawful" deportations of illegal patients in order to save money. Utilitarianism states that the ends justify the means’ i.e. the value of an action is determined by its contribution to overall utility and happiness while minimizing the suffering. This doctrine argues that actions are morally correct, as they tend to increase happiness. This philosophy depends on consequentiality and is considered as a selfish approach, as it doesn’t take into account any kind of suffering which the society may face due to a particular action plan. In contrast, deontology is based on fairness and social justice. The moral value of the action lies in the act itself. There are things that are worth doing and there are things that we will do and no matter what will be the outcome. The presentation will highlight the questions that arise from the debate about the morality of deportation of sick illegal immigrants, the ethical approaches involved and conclusions regarding health coverage for illegal immigrants..