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Doctoral Thesis
DOI
10.11606/T.22.2013.tde-26092013-182224
Document
Author
Full name
Andréia Rodrigues Moura da Costa Valle
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2013
Supervisor
Committee
Andrade, Denise de (President)
Giordani, Annecy Tojeiro
Luz, Maria Helena Barros de Araújo
Muñoz, Susana Segura
Pereira, Maria José Bistafa
Title in Portuguese
Competências do enfermeiro para ações preventivas na atenção domiciliar com ênfase nos riscos de infecção
Keywords in Portuguese
Assistência Domiciliar
Competência Profissional
Enfermagem
Infecção
Prevenção e Controle
Abstract in Portuguese
A Atenção Domiciliar (AD) é uma modalidade de assistência que deve ser concebida como a capacidade de mobilizar, articular e colocar em prática conhecimentos, habilidades e atitudes necessárias ao desempenho efetivo das competências dos enfermeiros. Em se tratando do risco de infecção as pesquisas nessa área são escassas no Brasil, principalmente na perspectiva das ações preventivas. O estudo representa uma contribuição para com a atenção domiciliar, no que concerne às competências do enfermeiro em atuar nos fatores de risco para infecção e, assim, avançar nas diretrizes de prevenção e controle da infecção. Trata-se de um estudo de natureza quase-experimental considerando a primeira etapa e, pesquisa metodológica na construção das diretrizes. Utilizou-se como referencial teórico os princípios de Durand (2000) e, a avaliação de consenso foi subsidiada na técnica Delphi. O cenário envolveu as Unidades Básicas de Saúde do município de Teresina - PI. Os participantes foram divididos em dois grupos sendo um com 19 enfermeiros atuantes nas equipes da ESF e, o outro grupo com 15 pesquisadores/enfermeiros recrutados pelo método snow-ball (representando as quatro diferentes regiões do País). Para a organização dos dados utilizou-se o software Alceste 4.8, e a análise estatística descritiva foi ordenada em quartis. A lista de competências, referente à primeira rodada da Técnica Delphi totalizou 48 itens, sendo 26 classificadas como competências gerais e 22 específicas. Na segunda rodada, exclui-se apenas um item após análise de concordância entre os sujeitos. E, na terceira rodada foram mantidas as 47 competências, das quais as classificaram em três dimensões: conhecimentos, habilidades e atitudes. Esta organização tomou como base o referencial teórico, bem como as justificativas dos participantes. Dessa forma, 61 competências foram identificadas quando analisadas a luz do referencial teórico, e, articulada as praticas de prevenção e controle da infecção no ambiente domiciliar. Observa-se que, embora de modos heterogêneos, o conceito de competência para a prevenção da infecção tem sido apropriado de modo fértil pelos enfermeiros. Por fim, os resultados desse estudo mostram a relevância da atuação dos enfermeiros no manejo dos riscos de infecção, na manutenção do ambiente domiciliar biologicamente seguro, e no enfrentamento dos desafios da utilização de políticas públicas direcionadas para esse foco. Conclui-se que as práticas de prevenção e controle da infecção na atenção domiciliar são competências fundamentais reconhecidas pelos enfermeiros e, precisam ser incrementadas na formação em Enfermagem.
Title in English
Competences of the nurse in preventive actions in home care with emphasis on infection risks
Keywords in English
Home Care
Infection
Nursing
Prevention and Control
Professional Competence
Abstract in English
Home Care (AD) is a form of assistance that should be conceived as the ability to mobilize, articulate and apply knowledge, skills and attitudes necessary for the effective performance of the competences of nurses. In what concerns the risk of infection, research in this area is scarce in Brazil, especially in the perspective of preventive actions. This study represents a contribution to home care, in relation to the skills of nurses to act on risk factors for infection and thus advance the guidelines for prevention and control of infections. This is a study of quasi-experimental nature and, considering the second step in constructing the guidelines, a methodological research. Durand (2000) principles were used as theoretical references and the consensus evaluation was supported in Delphi techniques. The scenario involved Basic Health Units in the city of Teresina - PI. The subjects were divided into two groups being the first with 19 nurses working in the ESF teams for at least two years. The second group was attended by 15 researcher nurses who were recruited by the snow-ball method, until the establishment of a network representing four different regions of the country. For data organization Alceste4.8 software, and statistical, descriptive analysis sorted in quartiles were utilized. The list of skills on the first round of the Delphi totaled 48 items, with 26 classified as general and 22 specific competence. In the second round, after the analysis of agreement among subjects one competence was excluded, for not reaching the level of consensus determined. And in the third and final round of the Delphi technique were maintained 47 skills from the analysis of consensus, which were divided among the three dimensions, namely: knowledge, skills and attitudes. This organization was based on the theoretical reference as well as the justifications of the subjects, as a result, 61 competences were developed. The respective items were analyzed in light of the theoretical references, and we proceeded to the recovery of such knowledge, skills and attitudes for the prevention and control of infection in home environment. It is observed that although in heterogeneous ways, the concept of competence for the prevention of infection has been appropriated in a fertile way by nurses. Finally, the results of this study show the importance of the role of nurses in the management of the risks of infection, the maintenance of biologically safe home environment and in facing the challenges to contribute to the formulation and use of public policies directed to this focus. We conclude that the practices of prevention and infection control in home care are a core competence recognized by nurses and needs to be improved in Nursing graduation.
 
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Publishing Date
2014-01-17
 
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