Revista Contexto & Saúde

001-004

Authors: Antônio José de Lima Junior, Luiza Maria Gerhardt

A segurança do paciente é definida como a redução do risco de danos desnecessários (eventos adversos), associados ao cuidado à saúde, a um nível mínimo aceitável (WORLD..., 2009). Relatos e preocupações com as questões de segurança do paciente são destacados desde Hipócrates (460 a 370 a.C.) como demonstrado pela célebre frase Primum non nocere – primeiro não cause o dano. E, ao longo da História, outros personagens históricos se destacaram devido à ênfase na temática segurança do paciente e qualidade, como Florence Nightingale, Ignaz Semmelweiss, Ernest Codman, Avedis Donabedian, John E. Wennberg, Archibald Leman Cochrane, entre outros (NEUHAUSER, 2003; BARR, 1955; ROBERTS; COALE; REDMAN, 1987; DONABEDIAN, 1990; WENNBERG, 2010; COCHRANE; BLYTHE, 1989, apud BRASIL, 2013b).

015-024

Authors: Danyllo do Nascimento Silva Junior, Yago Rodrigues Silva, Ellany Gurgel Cosme do Nascimento

The purpose of this study was to analyze the quality of data and information recorded by health care professionals regarding basic care in relation to the treatment of users with tuberculosis. This is a documentary research, with a quantitative approach, carried out in nine Basic Health Units of the urban area of the municipality of Pau dos Ferros, in the interior of Rio Grande do Norte. The data were collected from February to March 2014 by means of an instrument of the checklist type, which contained questions involving the user regarding the treatment for tuberculosis, such as onset and type of disease, initial symptoms, Adverse effects, sputum smear and sputum examination, presence of multiresistant bacteria, medications used, health professionals' guidelines, registry of home visits, Directly Observed Treatment (ODD), comorbidities, presence of the Sinan record in the medical records And other tests other than tuberculosis. The results evidenced the poor quality of the records and the absence of important data and information that should be included in the medical records, which compromises the quality of care provided to users, since essential details of their conditions are being neglected. In this sense, it is expected that the findings of this research may contribute to the improvement of the aspects discussed.

033-045

Authors: João Batista de Vasconcellos Siqueira, Teila Ceolin, Silvana Ceolin, Janaína do Couto Minuto, Stefanie Griebeler Oliveira, Aline Daiane Leal de Oliveira

Objetivo: Investigar el conocimiento sobre las plantas medicinales con los hipertensos y diabéticos de un equipo de la Estrategia de Salud de la Familia Rural de Pelotas. Método: Se utilizó un enfoque cualitativo, descriptivo y exploratorio. Los participantes fueron cinco miembros del grupo HiperDia de un equipo de Estrategia de Salud de la Familia Rural de Pelotas. Los datos se recogieron en septiembre de 2014. Los instrumentos utilizados fueron entrevistas semiestructuradas y observación sistemática de las plantas medicinales, recolección y registro fotografico. Para el análisis de los datos de la entrevista, se utilizó propuesta operativa. Resultados: Fueron citadas 22 plantas medicinales utilizadas de forma complementaria en el cuidado de la salud, combinada com otros cuidados, tales como el uso de medicamentos, atención nutricional, actividad física y el bienestar emocional. La mayoría de estas plantas medicinales tuvieron evidencia para las indicaciones mencionadas y su uso resulta a menudo de las costumbres tradicionales del entorno familiar y/o comunitario. Conclusión: Se destacó la importancia del intercambio de conocimientos, el fortalecimiento del vínculo entre la comunidad y profesionales de la salud, y la creciente necesidad de formación de los profesionales de la salud para satisfacer esta demanda.

055-066

Authors: Elitiele Ortiz dos Santos, Cristiane Kenes Nunes, Daiane de Aquino Demarco, Simone Coelho Amestoy

This study aimed to report the experience of post-graduation students on Problem-Based Learning in the teaching/learning process of nursing students. This is an experience report about the “case of paper” based on the methodology of ProblemBased Learning, with a class of the 4th semester of the Faculty of Nursing of the Federal University of Pelotas, in July 2013. The “paper case” is conducted in a small group with 12-15 students and a teacher/facilitator in two meetings, at the first moment called "opening the case" the problem situation is triggered and defined the learning issues, which will subsidize the search for references to the construction of a synthesis of the next meeting, called closure. Four meetings were followed, between openings and closings. There was a joint construction of knowledge, the student is considered the protagonist and the teacher acts as a mediator of the teaching/learning process.

075-084

Authors: Sônia Teresinha DeNegri, Simone Coelho Amestoy, Rita Maria Heck

Our objective is to focus on the history of Nutrition in Brazil from the inception of nutrition profession, to the current context. This is a search to reflective thought, using literature available in the classical canon of nutrition and scientific articles. From the beginning, nutrition has been under the influence of biology only studying the binomial of malnutritionnutrition and health, in a hospital setting. Gradually, the nutritionist began infiltrating other social spaces. The dialogue with other sciences will contribute to the expansion. Challenges are necessary to form professionals with generalist, humanist and critical profiles, who contribute to food security of the population.

093-101

Authors: Cássia Cassol Damo, Daiana Argenta Kümpel, Elisa Pelissaro, Ana Luisa Sant'Anna Alves, Tatiane Basso

This study aims to describe the measure of the thickness of the adductor pollicis muscle (APM) as a predictor of the undernutrition in oncologic patients. This is a quantitative study of cross-sectional design with oncologic treatment patients with diagnosis of cancer of head and neck. The data were collected by a nutritional anamnesis application that discusses demographic data, clinical and anthropometrics. For anthropometric assessment, we used the following parameters: body mass index (BMI), arm circumference (AC), triceps skinfold (TSF), arm muscle circumference (AMC), corrected arm muscle area (CAMA), dominant adductor pollicis muscle (DAPM), non dominant adductor pollicis muscle (NDAMP) and weight loss percentage (%WL). The results indicate, higher prevalence of males (82.1%) with an average age of 64,57±12,52 years. As for the location of the tumor we found a higher prevalence of larynx cancer (28.6%), followed by cancer of the oral cavity (25%) and oropharynx cancer (17.9%). According to BMI, the majority of the patients were eutrophic (46.4%). Undernutrition was more prevalent through measures of AC, TSF, CAMA, DAPM AND NDAMP. It was diagnosed that 78.6% of the patients were undernourished according to the measure of the APM of the dominant and non-dominant hands. The results suggest that the AMP can be a sensible method to the identification on the undernutrition, however, more studies are necessary with the objective of verifying the effectiveness of this measure, thus providing, a greater understanding of the use of the same for these patients.

115-123

Authors: Rosemeire Bueno, Lucas Vedeschi Ferreira, Daniele Malimpensa de Oliveira, Carlos Diego de Souza Rodrigues, Luciana Aparecida Giacomini, Andrea Varsone Carreri

Water is considered a key substance for the existence of man and needs to have a good quality, even under conditions of water scarcity in order to prevent waterborne diseases mortality. The purpose of this study was to analyze and monitor the microbiological and physico-chemical quality of the water used by the resident population in the Itu city, in a situation of water scarcity, aiming at raising awareness of the population regarding the storage methods and appropriate water treatment to ensure consumer safety. Were prioritized the collections in five public water distribution points consisting of 20,000-liter boxes, "bica" (artesian well) and a water distribution system for pockets, in the period from October to December 2014, corresponding to the water shortage experienced by the population of this municipality. Water samples were analyzed by using the MPN (Most Probably Number) technique in the enumeration of total and thermotolerants coliforms and Escherichia coli, according to the American Public Health Association. Analysis showed that 100% contained total and thermotolerants coliforms and E. coli and the samples did not meet the requirements of the Brazilian Health Ministry regulation 2914/2011, which advocates the absence of E. coli in 100 mL of water. Within the context, it is proposed that the need for greater public attention and adoption of simple control measures in order to avoid intake of contaminated water by microorganisms responsible for waterborne diseases by part of the population.

134-143

Authors: Christiane de Fátima Colet, Tania Alves Amador, Isabela Heineck

Introduction: Warfarin is one of the most commonly used oral anticoagulants (OACs) in primary health care. With narrow therapeutic window, it exhibits great variability of pharmacological response, and great susceptibility of adverse events,such as bleeding and venous thromboembolism. Objectives: To carry out a review of the literature on pharmacotherapeutic follow-up of outpatients using warfarin. Method: This is a review study. The keywords used for the selection of the articles were: Warfarin, Therapeutic Monitoring, Clinical Pharmacy, Oral Anticoagulants. Results: The use of warfarin is associated with adverse events, with hemorrhages being the most frequent, which can be prevented with INR monitoring. Monitoring of blood coagulation is of paramount importance in controlling patient efficacy and adherence to anticoagulant treatment. In a multiprofessional outpatient clinic for patients receiving warfarin, an increase was observed in the percentage of patients with INR in the therapeutic range, with the prolongation of the follow-up time in the outpatient clinic. Patients attending anticoagulation clinics tend to present more INR values in the therapeutic range ranging from 60 to 88%. Another important result related to the clinics was the lower frequency of supra-therapeutic INRs and longer time in the therapeutic range. In addition, pharmacist follow-up may result in lower costs of care and adverse events related to anticoagulation, hospital admissions, and emergency services. When ACOs are administered by pharmacists, there appears to be a shorter time to therapy stabilization and a greater percentage of time in the therapeutic range, as well as a decrease in the frequency of medication errors, longer time in the therapeutic INR range, and reduction of Drug interactions.