Graciele Fernanda da Costa Linch
@ufcspa.edu.br
Departamento de Enfermagem
Universidade Federal de Ciências da Saúde de Porto Alegre
Scopus Publications
Scopus Publications
Aline Fritzen, Danielle Pletes dos Santos, Bianca Silva da Rocha, Marielli Trevisan Jost, Rita Catalina Aquino Caregnato, and Graciele Fernanda da Costa Linch
FapUNIFESP (SciELO)
ABSTRACT Objective: To implement, on health management software, electronic records of the perioperative nursing process and the stages of transoperative and immediate postoperative nursing diagnoses, based on the NANDA International taxonomy. Method: Experience report conducted from the completion of the Plan-Do-Study-Act cycle, which allows improvement planning with a clearer purpose, directing each stage. This study was carried out in a hospital complex in southern Brazil, using the software Tasy/Philips Healthcare. Results: For the inclusion of nursing diagnoses, three cycles were completed, predictions of expected results were established, and tasks were assigned, defining “who, what, when, and where”. The structured model covered seven possibilities of aspects, 92 symptoms and signs to be evaluated, and 15 nursing diagnoses to be used in the transoperative and immediate postoperative periods. Conclusion: The study allowed implementing electronic records of the perioperative nursing process on health management software, including transoperative and immediate postoperative nursing diagnoses, as well as nursing care.
Nathália Duarte Bard, Daniela Dos Reis Carazai, Aléxia Garcês Maciel, Karina Vieira Pinheiro, Nicole Hertzog Rodrigues, G. Linch and Adriana Aparecida Paz
OBJECTIVE
To develop and validate the content of a professional training course in mental health nursing care for hospitalized adult medical-surgical patients.
METHOD
Content validation research, with the participation of eight experts recruited in 2019, focused on a hospital institution in the southern region of Brazil. Data were collected online and treated by descriptive and analytical statistics.
RESULTS
Four items of the course were evaluated, obtaining a Content Validation Index (CVI) of 0.98 in the item "concepts in mental health and its applicability to hospitalized medical-surgical patients"; 0.93 in the item "Pre- and post-course on evaluation of knowledge in mental health"; 0.95 in the item "Global overview of the systematization of nursing care in mental health"; and 0.94 in the item "Flowchart of the new mental health tree".
CONCLUSION
The validation of the professional training course showed satisfactory CVI, and its content validated for use.
Rúbia Knobeloch dos Santos, Eluiza Macedo, Bárbara Rodrigues Araujo, Ana Amélia Antunes Lima, Graciele Fernanda da Costa Linch, and Rita Catalina Aquino Caregnato
FapUNIFESP (SciELO)
ABSTRACT Objective: To report the actions developed by a group in the Nursing Now campaign and its impact on nursing education. Method: It is an experience report about the execution of the work group formed by nurse professors, nursing academics and master's students at a federal university in Brazil focusing on the Nursing Now campaign, developing actions in the second half of 2019. Results: The actions developed involve the creation of a work group and the active participation of the group in four major events resulted in the visibility and appreciation of the work developed by the profession. Conclusion: The organized group promoted actions that had a positive impact inside and outside the University, expanding visibility to the profession and the actions developed. The academic environment, associated to the worldwide mobilization of the campaign, promoted a favorable context for the debate about the valorization of the category and leadership in nursing.
Cíntia da Costa and Graciele Fernanda da Costa Linch
Wiley
INTRODUCTION
The quality of nursing care is related to the execution of the nursing process, which should be properly documented. In this context, there is an evident need to implement electronic health records with the use of standardized languages.
OBJECTIVE
To implement electronic records related to nursing diagnoses in a computerized health management system.
METHODOLOGY
The project followed four stages, based on the plan-do-check-act tool. This tool guided the activities to be carried out in the axes: planning, execution of activities, evaluation, and action. The activities performed included: registration of nursing diagnoses and related factors, as well as the association of these in the Tasy software, test execution, and applicability assessment.
RESULTS
We included 229 nursing diagnoses and these were associated with 1,664 related factors, a decision tree with 436 defining characteristics was also constructed, which allows the software to suggest nursing diagnoses according to the related signs and symptoms.
CONCLUSION
The practical consolidation of the steps of the nursing process was verified as well as the possibility of nurses assessing the patients by way of a clinical reasoning and decision making in coherence with the human needs of the patient.
Jéssica Strube Holztrattner, Graciele Fernanda da Costa Linch, Adriana Aparecida Paz, Helga Geremias Gouveia, and Débora Fernandes Coelho
Universidade Federal do Parana
Objetivo: analisar a ocorrência e a associação da sífilis congênita com a realização do pré-natal e tratamento da gestante e do parceiro.Método: estudo retrospectivo do período de 2006 a 2015, observando dados do Brasil, Rio Grande do Sul e Porto Alegre, com base em indicadores do Ministério da Saúde.Resultados: a taxa de sífilis congênita em menores de um ano de idade aumentou de 2 para 6,5 no Brasil, de 1,5 para 11,5 no Rio Grande do Sul e de 4,4 para 30,2 em Porto Alegre. Em torno de 74% de mulheres realizaram o pré-natal nas três esferas. Das gestantes 80% não realizaram o tratamento ou o fizeram de maneira inadequada. O percentual de tratamento do parceiro não ultrapassou 20,5%. Conclusão: esse estudo observou o aumento da ocorrência da sífilis congênita. Ainda, a realização do pré-natal não assegurou tratamento adequado das gestantes e de seus parceiros.
Eneida Rejane Rabelo-Silva, Marco Aurélio Lumertz Saffi, Graziella Badin Aliti, Maria Karolina Feijó, Graciele Fernanda da Costa Linch, Jaquelini Messer Sauer, and Silvia Marinho Martins
FapUNIFESP (SciELO)
Resumo OBJETIVO Descrever os fatores precipitantes de descompensação da insuficiência cardíaca entre pacientes aderentes e não aderentes ao tratamento. MÉTODOS Estudo transversal de uma coorte multicêntrica. Pacientes acima de 18 anos com insuficiência cardíaca descompensada (classe funcional III/IV) foram elegíveis. Para a coleta dos dados foi utilizado um questionário estruturado avaliando os motivos da descompensação. O uso irregular de medicação prévio à internação, controle inadequado de sal e líquidos foram considerados como grupo de má adesão ao tratamento. RESULTADOS Foram incluídos 556 pacientes, com idade média de 61±14 anos, 362(65%) homens. O principal fator de descompensação foi a má adesão, representando 55% da amostra. Os pacientes que referiram o uso irregular das medicações na última semana apresentaram 22% mais risco de internação por má adesão quando comparados aos pacientes aderentes. CONCLUSÃO O estudo EMBRACE demonstrou que em pacientes com insuficiência cardíaca, a má adesão mostrou-se como o principal fator de exacerbação.
Taís Trombetta Dalla Nora, Giulliana Weigert Herrera, Graciele Fernanda da Costa Linch, and Adriana Aparecida Paz
Universidade Federal do Parana
Objetivo: verificar os registros dos dados sobre o uso de imunobiológicos e insumos nas salas de vacinas da rede pública. Método: estudo transversal, realizado em oito salas de vacinas da atenção básica, com 106 observações em novembro e dezembro de 2016, em um município do Rio Grande do Sul. Resultados: em 64(60,4%) atendimentos os usuários estavam cadastrados no programa e 104(98,1%) tiveram as vacinas registradas corretamente. Os dados foram registrados adequadamente após a vacinação do usuário no programa em 89(84%) atendimentos, entretanto, a movimentação do imunobiológico foi preenchida em 17(11%) observações. O registro no boletim diário da temperatura do refrigerador ocorreu em 80(75,5%) observações. Conclusão: foi possível obter subsídios para a elaboração de ações estratégicas no município, com a finalidade da qualificação do processo de trabalho quanto à organização, manutenção e registros dos imunobiológicos nas salas de vacina.
José Luís Guedes dos Santos, Carla Simone Bittencourt Netto de Souza, Francis Solange Vieira Tourinho, Luciara Fabiane Sebold, Silvana Silveira Kempfer, and Graciele Fernanda da Costa Linch
FapUNIFESP (SciELO)
RESUMO Objetivo: analisar as estratégias didáticas utilizadas no processo de ensino e aprendizagem de gestão em enfermagem. Método: revisão integrativa da literatura na base de dados Literatura Latino-Americano e do Caribe em Ciências da Saúde e Scientific Electronic Library Online, utilizando-se os seguintes descritores e palavras-chave: ensino, enfermagem, gestão, administração, gerenciamento, educação em enfermagem, organização e administração, educação a distância e gestão em saúde. A amostra foi composta por 23 publicações. Resultados: as estratégias didáticas utilizadas no ensino de gestão em enfermagem estão relacionadas, principalmente, ao método de trabalho independente e método de trabalho em grupo. Destacaram-se as estratégias que possibilitam a articulação entre teoria e prática, tais como: planejamento estratégico situacional, metodologia da problematização com o método do Arco de Maguerez, seminários, oficinas e exposições dialogadas interativas. Conclusão: o ensino de gestão em enfermagem está acompanhando as mudanças pedagógicas da educação superior na área da saúde.
Eneida Rejane Rabelo-Silva, Ana Carla Dantas Cavalcanti, Maria Cristina Ramos Goulart Caldas, Amália de Fátima Lucena, Miriam de Abreu Almeida, Graciele Fernanda da Costa Linch, Marcos Barragan da Silva, and Maria Müller-Staub
Wiley
AIMS AND OBJECTIVES
To assess the quality of the advanced nursing process in nursing documentation in two hospitals.
BACKGROUND
Various standardised terminologies are employed by nurses worldwide, whether for teaching, research or patient care. These systems can improve the quality of nursing records, enable care continuity, consistency in written communication and enhance safety for patients and providers alike.
DESIGN
Cross-sectional study.
METHODS
A total of 138 records from two facilities (69 records from each facility) were analysed, one using the NANDA-International and Nursing Interventions Classification terminology (Centre 1) and one the International Classification for Nursing Practice (Centre 2), by means of the Quality of Diagnoses, Interventions, and Outcomes instrument. Quality of Diagnoses, Interventions, and Outcomes scores range from 0-58 points. Nursing records were dated 2012-2013 for Centre 1 and 2010-2011 for Centre 2.
RESULTS
Centre 1 had a Quality of Diagnoses, Interventions, and Outcomes score of 35·46 (±6·45), whereas Centre 2 had a Quality of Diagnoses, Interventions, and Outcomes score of 31·72 (±4·62) (p < 0·001). Centre 2 had higher scores in the 'Nursing Diagnoses as Process' dimension, whereas in the 'Nursing Diagnoses as Product', 'Nursing Interventions' and 'Nursing Outcomes' dimensions, Centre 1 exhibited superior performance; acceptable reliability values were obtained for both centres, except for the 'Nursing Interventions' domain in Centre 1 and the 'Nursing Diagnoses as Process' and 'Nursing Diagnoses as Product' domains in Centre 2.
CONCLUSION
The quality of nursing documentation was superior at Centre 1, although both facilities demonstrated moderate scores considering the maximum potential score of 58 points. Reliability analyses showed satisfactory results for both standardised terminologies.
RELEVANCE TO CLINICAL PRACTICE
Nursing leaders should use a validated instrument to investigate the quality of nursing records after implementation of standardised terminologies.
Graciele Fernanda da Costa Linch, Ana Amélia Antunes Lima, Emiliane Nogueira de Souza, Tais Maria Nauderer, Adriana Aparecida Paz, and Cíntia da Costa
FapUNIFESP (SciELO)
ABSTRACT Objective: to evaluate the impact of an educational intervention on the quality of nursing records. Method: quasi-experimental study with before-and-after design conducted in a hospital. All the nurses in the cardiac intensive care unit of the hospital received the intervention, which consisted of weekly meetings during five months. To collect data, the instrument Quality of Diagnoses, Interventions and Outcomes was applied to the patients’ charts in two moments: baseline and after intervention. Results: the educational intervention had an impact on the quality of the records, since most of the items presented a significant increase in their mean values after the intervention, despite the low values in the two moments. Conclusion: the educational intervention proved to be effective at improving the quality of nursing records and a lack of quality was identified in the evaluated records, revealed by the low mean values and by the weakness of some questions presented in the items, which did not present a significant increase. Therefore, educational actions focused on real clinical cases may have positive implications for nursing practice.
Cíntia da Costa, Graciele Fernanda da Costa Linch, and Emiliane Nogueira de Souza
Wiley
PURPOSE
The aim was to identify the main signs and symptoms of cardiac patients hospitalized in a unit of intensive cardiology care in order to infer the main nursing diagnoses (NDs).
METHODS
We performed a cross-sectional study; the sample consisted of 77 randomly selected records. Those records included only patients hospitalized for cardiovascular causes and with electronic chart available.
FINDINGS
Signs and symptoms identified at admission were psychic (40.3%), compressive dressing on arterial puncture site (33.8%), chest pain (29.9%), tachycardia (22.1%), and hemodynamic instability (20.8%).
CONCLUSIONS AND PRACTICAL IMPLICATIONS
According to the data collected, we were able to infer that acute pain, excess of fluid volume, decreased cardiac output, spontaneous ventilation impaired, anxiety and impaired skin integrity are priority for the NDs in the studied population.
OBJETIVO
identificar os principais sinais e sintomas de pacientes cardiacos internados em uma unidade de cuidados intensivos de cardiologia, visando inferir os diagnosticos de enfermagem prioritarios.
METODO
Estudo transversal; a amostra foi composta por 77 registros selecionados aleatoriamente. Incluiram-se apenas pacientes internados por causa cardiovascular e com registro eletronico disponivel.
RESULTADOS
Os sinais e sintomas identificados na admissao foram psiquicos (40,3%), curativo compressivo em sitio de puncao arterial (33,8%), dor toracica (29,9%), taquicardia (22,1%) e instabilidade hemodinâmica (20,8%).
CONCLUSOES E IMPLICACOES PARA A PRATICA
De acordo com os dados levantados foram inferidos Dor Aguda, Volume de Liquidos Excessivo, Debito Cardiaco Diminuido, Ventilacao Espontânea Prejudicada, Ansiedade e Integridade da Pele Prejudicada como diagnosticos de enfermagem prioritarios para a populacao estudada.
Graciele Fernanda da Costa Linch, Eneida Rejane Rabelo-Silva, Gail Maria Keenan, Maria Antonieta Moraes, Janet Stifter, and Maria Müller-Staub
Wiley
PURPOSE
To assess the reliability and validity of Quality of Diagnoses, Interventions, and Outcomes (Q-DIO) in Brazil and in the United States.
METHODS
The sample comprised 180 records: centers 1 (electronic records and standardized language) and 2 (paper-based records without standardized language in Brazil, and center 3 (electronic records without standardized language) in the United States. Reliability and discriminant construct validity was analyzed.
FINDINGS
Cronbach's alpha for all 29 Q-DIO items were greater than or equal to 0.70 for all centers; construct validity was significantly different between the three study centers.
CONCLUSIONS
These results indicate that Q-DIO is valid and reliable for assessing the quality of nursing records.
IMPLICATIONS FOR NURSING PRACTICE
The Q-DIO may be useful to assess the quality and accuracy of nursing records.
Caroline Dal Piva, Eliane Vaz, Maria Antonieta Moraes, Silvia Goldmeyer, Graciele Fernanda da Costa Linch, and Emiliane Nogueira de Souza
Elsevier BV
ABSTRACT Background Complaints of patients undergoing invasive percutaneous procedures are a frequent finding. Our objective was to assess the discomfort of patients undergoing cardiac catheterization using femoral or radial approach. Methods Cross-sectional study with a non-probabilistic sample of adults undergoing catheterization. Data were collected through a questionnaire. Results We included 228 patients, of whom 205 underwent the procedure via the femoral approach and 23 by the radial approach. A 6 F arterial sheath was used in all patients. Mean age was 60.0 ± 11.5 years and most of them were male (50.4%). The main complaints were lumbar pain in 65.8% and malaise in 32.0% of the cases. In a scale of 0 to 10, the average value assigned for lumbar pain intensity was 5.0 ± 4.2 and 1.5 ± 2.7 for pain at the puncture site. Patients who used the radial approach reported having more pain at the puncture site than patients who used the femoral access (26.8% vs. 52.2%; p = 0.01). However, patients who used the femoral approach most often reported lumbar pain (69.8% vs. 30.4%; p Conclusions The predominant discomfort after femoral puncture was lumbar pain and in patients undergoing radial puncture it was pain at the access site. Our findings corroborate the recommendations for a clinical practice that promotes better patient care, including comfort measures, such as the use of cushions, changes in body position, supervised ambulation and the creation of a welcoming environment.
Rayssa Thompson Duarte, Graciele Fernanda da Costa Linch, and Rita Catalina Aquino Caregnato
FapUNIFESP (SciELO)
OBJECTIVES: to investigate the principle nursing interventions/actions, prescribed in the immediate post-operative period for patients who receive lung transplantation, recorded in the medical records, and to map these using the Nursing Interventions Classification (NIC) taxonomy.METHOD: retrospective documental research using 183 medical records of patients who received lung transplantation (2007/2012). The data of the patients' profile were grouped in accordance with the variables investigated, and submitted to descriptive analysis. The nursing interventions prescribed were analyzed using the method of cross-mapping with the related interventions in the NIC. Medical records which did not contain nursing prescriptions were excluded.RESULTS: the majority of the patients were male, with medical diagnoses of pulmonary fibrosis, and underwent lung transplantation from a deceased donor. A total of 26 most frequently-cited interventions/actions were found. The majority (91.6%) were in the complex and basic physiological domains of the NIC. It was not possible to map two actions prescribed by the nurses.CONCLUSIONS: it was identified that the main prescriptions contained general care for the postoperative period of major surgery, rather than prescriptions individualized to the patient in the postoperative period following lung transplantation. Care measures related to pain were underestimated in the prescriptions. The mapping with the taxonomy can contribute to the elaboration of the care plan and to the use of computerized systems in this complex mode of therapy.
Sevinc Tastan, Graciele C.F. Linch, Gail M. Keenan, Janet Stifter, Dawn McKinney, Linda Fahey, Karen Dunn Lopez, Yingwei Yao, and Diana J. Wilkie
Elsevier BV
OBJECTIVE
To determine the state of the science for the five standardized nursing terminology sets in terms of level of evidence and study focus.
DESIGN
Systematic review.
DATA SOURCES
Keyword search of PubMed, CINAHL, and EMBASE databases from 1960s to March 19, 2012 revealed 1257 publications.
REVIEW METHODS
From abstract review we removed duplicate articles, those not in English or with no identifiable standardized nursing terminology, and those with a low-level of evidence. From full text review of the remaining 312 articles, eight trained raters used a coding system to record standardized nursing terminology names, publication year, country, and study focus. Inter-rater reliability confirmed the level of evidence. We analyzed coded results.
RESULTS
On average there were 4 studies per year between 1985 and 1995. The yearly number increased to 14 for the decade between 1996 and 2005, 21 between 2006 and 2010, and 25 in 2011. Investigators conducted the research in 27 countries. By evidence level for the 312 studies 72.4% were descriptive, 18.9% were observational, and 8.7% were intervention studies. Of the 312 reports, 72.1% focused on North American Nursing Diagnosis-International, Nursing Interventions Classification, Nursing Outcome Classification, or some combination of those three standardized nursing terminologies; 9.6% on Omaha System; 7.1% on International Classification for Nursing Practice; 1.6% on Clinical Care Classification/Home Health Care Classification; 1.6% on Perioperative Nursing Data Set; and 8.0% on two or more standardized nursing terminology sets. There were studies in all 10 foci categories including those focused on concept analysis/classification infrastructure (n=43), the identification of the standardized nursing terminology concepts applicable to a health setting from registered nurses' documentation (n=54), mapping one terminology to another (n=58), implementation of standardized nursing terminologies into electronic health records (n=12), and secondary use of electronic health record data (n=19).
CONCLUSIONS
Findings reveal that the number of standardized nursing terminology publications increased primarily since 2000 with most focusing on North American Nursing Diagnosis-International, Nursing Interventions Classification, and Nursing Outcome Classification. The majority of the studies were descriptive, qualitative, or correlational designs that provide a strong base for understanding the validity and reliability of the concepts underlying the standardized nursing terminologies. There is evidence supporting the successful integration and use in electronic health records for two standardized nursing terminology sets: (1) the North American Nursing Diagnosis-International, Nursing Interventions Classification, and Nursing Outcome Classification set; and (2) the Omaha System set. Researchers, however, should continue to strengthen standardized nursing terminology study designs to promote continuous improvement of the standardized nursing terminologies and use in clinical practice.
Graciele Fernanda da Costa Linch, Maria Müller-Staub, Maria Antonieta Moraes, Karina Azzolin, and Eneida Rejane Rabelo
Wiley
PURPOSE
To describe the cross-cultural adaptation of the Quality of Diagnoses, Interventions and Outcomes instrument into Brazilian Portuguese.
METHOD
This process entailed translation, synthesis, back-translation, expert committee review, and pretesting.
FINDINGS
Six items were altered in the Brazilian version, and the scoring system was changed from a five-point to a three-point Likert-type scale. Pretesting was conducted on a sample of 40 randomly selected nursing records. Overall reliability as measured by Cronbach's alpha was 0.96.
CONCLUSIONS
Adaptation resulted in a preliminary version of the instrument.
IMPLICATIONS FOR NURSING PRACTICE
Assessment of the psychometric properties of the instrument in a larger sample of nursing records is required, and such a study is underway.
Laura de Azevedo Guido, Graciele Fernanda da Costa Linch, Luiza de Oliveira Pitthan, and Juliane Umann
FapUNIFESP (SciELO)
Estudo quantitativo com o objetivo de identificar estressores, nível de estresse dos enfermeiros, estado geral de saúde e formas de enfrentamento utilizadas pelos enfermeiros no ambiente de trabalho. Os dados foram coletados utilizando-se três instrumentos: formulário para levantamento de atividades diárias; inventário de estratégias de coping; inventário sobre o estado geral de saúde. A população deste estudo foi composta de 143 enfermeiros e a maioria encontra-se com baixo nível de estresse (55,25%) e com estado regular de saúde (50,35%). Em relação às formas de enfrentamento, identificou-se resolução de problemas como o fator de maior média. Concluindo, ações educativas devem ser incentivadas, a fim de disponibilizar ferramentas para que o profissional desenvolva estratégias de coping resolutivas em seu dia a dia, minimizando o efeito do estresse no seu estado de saúde e no seu trabalho.
Graciele Fernanda da Costa Linch, Laura de Azevedo Guido, and Simone de Souza Fantin
FapUNIFESP (SciELO)
Este estudo transversal objetivou caracterizar o perfil sociodemográfico e profissional do enfermeiro atuante em unidade de hemodinâmica e identificar questões referentes ao trabalho e profissão. Dados foram coletados por questionário. Os resultados foram considerados estatisticamente significantes se p<0,05 e com intervalo de 95,00% de confiança. Foram elegíveis 63 enfermeiros com perfil predominantemente feminino (90,50%), jovens, no início de carreira e com curto período de atuação em unidade de hemodinâmica, sendo que a maioria dos enfermeiros cursou pós-graduação (77,80%). Em relação às questões voltadas ao trabalho pode-se constatar que a maioria dos enfermeiros recebeu treinamento (58,73%), não fazia esforço para ir trabalhar (85,71%), estava satisfeita com o trabalho (85,71%), não considerava o dia de trabalho interminável (84,13%) e não tinha vontade de mudar de profissão (90,48%). Contudo, as unidades contam com enfermeiros altamente satisfeitos e capacitados para que gerenciar seu processo de trabalho, e para desenvolver suas competências, assim como as dos demais membros da equipe.