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Objetivo: Construir e validar indicadores para o gerenciamento de enfermagem no processo transfusional. Métodos: Estudo metodológico que compreendeu as etapas de construção das fichas técnicas dos indicadores para o gerenciamento de enfermagem no processo transfusional e a validação dos indicadores para o gerenciamento de enfermagem no processo transfusional, realizada por 17 enfermeiros que atuam em agências transfusionais localizadas no Brasil. A análise dos dados ocorreu por meio de estatística descritiva, cálculo do índice de validade de conteúdo (IVC) e percentual de concordância (PC). Resultados: Foram validados 27 indicadores para o gerenciamento de enfermagem no processo transfusional, os quais apresentaram IVC entre 0,84 a 1,00 e PC 84% a 100% na primeira rodada, IVC 0,93 a 1,00 e PC 93% a 100% na segunda rodada e foram categorizados conforme o ambiente que avaliam: estrutura, processo e resultados. Discussão: Os oito indicadores validados para o ambiente estrutura avaliam o número de solicitações de transfusão de sangue recebidas; o descarte de hemocomponentes; monitoramento das não conformidades identificadas na avaliação da qualidade dos materiais e reagentes e na manutenção corretiva e preventiva dos equipamentos críticos; treinamento dos profissionais; registro dos hemocomponentes; e reuniões realizadas pelo comitê transfusional. Estes indicadores permitem avaliar as condições físicas, humanas e organizacionais, as quais impactam diretamente na manutenção da qualidade dos hemocomponentes e na segurança do processo transfusional. No que diz respeito ao ambiente processo, os 11 indicadores validados avaliam as solicitações de transfusão de hemocomponentes quanto ao preenchimento inadequado e indicação da transfusão conforme os protocolos clínicos; as inconsistências relacionadas aos exames pré-transfusionais; coleta de amostra de sangue e liberação do hemocomponente para transfusão; dupla checagem e sinais vitais antes da instalação do hemocomponente, bem como a busca ativa das reações transfusionais. Por meio destes indicadores se obtêm o monitoramento das ações de cuidado prestadas aos pacientes submetidos à transfusão de sangue, os exames e procedimentos. No ambiente resultado, os oito indicadores validados estão relacionados ao cumprimento das recomendações de compatibilidade durante a seleção de hemocomponentes; incidentes relacionados ao paciente, sendo eles o preparo, a identificação e a monitorização; as reações transfusionais; os registros da transfusão de sangue no prontuário e na Agência Transfusional; e incidentes na gestão da qualidade. Tais indicadores permitem demonstrar o resultado da assistência prestada e avaliar se as metas assistenciais foram atingidas. Conclusão: Os indicadores definidos possuem evidências iniciais de validade de conteúdo, o que viabiliza o seu uso para o gerenciamento de enfermagem no processo de transfusão de sangue, contribuindo para a melhoria contínua das atividades da equipe de enfermagem e para a segurança transfusional.

Objetivo: Construir e validar o conteúdo do mapeamento do processo de transfusão de sangue para o trabalho da enfermagem. Métodos: Trata-se de um estudo metodológico, realizado no período de julho a outubro de 2022, a partir de três etapas: 1) análise criteriosa das legislações vigentes para a identificação do processo de transfusão de sangue para o trabalho da enfermagem; 2) construção do mapeamento do processo de transfusão de sangue para o trabalho da enfermagem a partir da programa Bizagi Modeler®; 3) validação do conteúdo do mapeamento do processo de transfusão de sangue para o trabalho da enfermagem com um painel de juízes especialistas composto por seis enfermeiros que atuavam há mais de um ano em Agência Transfusional do estado de Santa Catarina. Para aferir o consenso entre os juízes especialistas, foram empregados o índice de validade de conteúdo (IVC) e o percentual de concordância (PC). Resultados: O mapeamento do processo de transfusão de sangue para o trabalho da enfermagem apresentou 26 atividades e oito subprocessos de apoio e as fontes iniciais de evidências de validade de conteúdo obteve um IVC de 0,98 e PC de 98% de concordância. Discussão: Pode-se notar que a maioria dos enfermeiros que participaram do estudo relatam possuir o mapeamento do processo da transfusão de sangue nas agências transfusionais em que atuam, sendo este um ponto positivo, visto que a modelagem auxilia na organização e na elaboração dos processos, constituindo um roteiro padronizado capaz de contribuir para o avanço na gestão, na assistência e na promoção da saúde. Contudo, apesar dos benefícios, ainda é incipiente estudos com enfoque no atendimento ao paciente como foco principal. Além disso, foi verificado na literatura que as 26 atividades mapeadas e os oitos subprocessos de apoio são essenciais para um processo transfusional seguro. Conclusão: O mapeamento mostrou-se válido, refletindo as etapas do processo de assistência realizada pela enfermagem ao paciente submetido à transfusão de sangue. No âmbito da hemoterapia, mais especificamente no trabalho da enfermagem no processo da transfusão de sangue, contribui para identificar as atividades desenvolvidas e os pontos a serem melhorados.

Objective: to analyze how motherhood is expressed in female prison units from the perspective of Bioethics of Protection., Method: qualitative research with an ethnographic approach, developed in two women's prison units. Participantes were: six mothers deprived of liberty, 15 health professionals, and nine prison officers. For data collection, semi-structured interviews and descriptive observation were used. Data analysis was based on the Content Analysis technique, thematic category., Results: three categories emerged: women and children violated behind bars (inequities); mothers and children in prison exacerbating imbalances, tensions and conflicts; and limits and references for resocialization., Final Considerations: the Bioethics of Protection proposal appears as a valid tool for the analytical direction of the process of confronting issues in the scope of public health in prison units, considering vulnerable groups and aiming at equity and human dignity.

Background and Purpose: To adapt and validate the Brazilian Scale of Moral Distress in Nurses for the mental health field. Methods: A cross-sectional methodological study was carried out, adapted with the contribution of 34 specialists, and validated by 173 mental health nurses. Results: The validated scale consists of 37 items divided into seven factors, and they were responsible for 77.2% of variance-working conditions, advocacy for the values and rights, professional safety and autonomy, ethical violations, social conflicts, ethical-professional competence, and conflicts with the management, with coefficient α at .972 for the entire instrument, and ranging from .852 to .949 for the constructs. Conclusion: The results provide evidence that the adapted instrument is reliable, valid, and consistent in measuring moral distress in mental health nurses., (© Copyright 2024 Springer Publishing Company, LLC.)

Objective: To identify and analyze the features and quality of self-management support of mobile applications available in Brazil for chronic low back pain in adults., Method: A systematic review on the Apple Store® and Google Play® digital platforms. The Self-Management Support Assessment Tool scale was used to assess self-management support and the Institute for Healthcare Informatics Functionality Score scale was used to assess functionality., Results: Seventeen applications were selected, which included around seven self-management skills. The applications that met the majority of self-management support skills were Pathways, Branch, Pancea, Pain Navigator, and Curable. The Curable, Branch and MoovButh applications had the highest scores, with ten features on the functionality scale., Conclusion: Some applications have the potential to complement in-person treatment in terms of validity, acceptability and clinical usefulness in pain management. However, barriers such as lack of partnership between healthcare providers and patients, limited evidence-based content, social support, cultural relevance, cost, language, security and privacy can limit their sustained use. PROSPERO Registration: CRD42022382686.

Background and Purpose: To describe the process of developing and validating the content of the Patient Advocacy Scale for Nurses in Intensive Care (EAPEnf-UTI). Methods: Methodological research. To achieve the elaboration objective, five stages were developed: (a) definition of the theme, (b) generation of the number of items, (c) determination of the measurement format, (d) validation of face and content, and (e) content adjustment. Results: The instrument elaborated from a survey and integrative literature review, and the measurement format chosen was the 5-point Likert scale. The validation of face and content was performed by expert judges and by pretest. The final instrument had 57 items. Conclusion: EAPEnf-UTI is a pioneering instrument built in the Brazilian context, whose future validation will allow the capturing of situations specific to intensive care units and the professional practice of intensive care nurses., (© 2023 Springer Publishing Company, LLC.)

Objectives: to understand the ethical problems experienced by primary health care nurses in using nursing teleconsultations for people living with the human immunodeficiency virus during the coronavirus pandemic., Methods: qualitative research, anchored in Constructivist Grounded Theory. Data was collected between July and September 2020, with 17 participants., Results: the first category highlights the ethical problems in conducting teleconsultations, managing high demand, communication barriers, and risks related to data security. The second emphasizes the potential of teleconsultations in communication and access, by generating changes in the work process and the use of protocols to guide clinical practice., Conclusions: nurses' work in digital mode requires professional qualification, with a view to stimulating reflection on teleconsultation practice, ethical-moral deliberation and combating stigma, and also adopting data security-centered conduct.

Objective: To assess the intensity and frequency of moral distress in mental health nurses in Brazil., Method: Cross-sectional study with 173 nurses from the Psychosocial Care Network in Brazil. The Brazilian Scale of Moral Distress in Nurses, adapted for the context of mental health, was used. For data processing, descriptive and inferential statistical analysis was used., Results: Mostly moderate levels of intensity and frequency of moral distress (medians between 2.25 - 3.73 and 2.00 - 3.22, respectively) were observed, with emphasis on the factors working conditions and social conflicts., Conclusion: The level of moral distress evidenced in mental health nurses in Brazil reflects the dimension and amplitude of the phenomenon in different points of the Psychosocial Care Network. The relevance of discussions on coping strategies for moral distress is highlighted, articulating elements such as sensitivity, resilience, and moral courage, so that ethical deliberation is applied in care and management settings.

to analyze the effectiveness of digital self-care in the management of pain and functional disability among people with spine musculoskeletal disorders. a systematic literature review, developed with the PRISMA checklist, of randomized clinical trials of people with spine musculoskeletal disorders and digital interventions accessed by means of computers, smartphones or other portable devices. Databases researched: National Library of Medicine, Excerpta Médica dataBASE, SciVerse Scopus, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Science Citation Indexes, Cumulative Index to Nursing and Allied Health Literature and Physiotherapy Evidence Database. The descriptive synthesis of the results and by means of meta-analyses (fixed-effects model) was performed with the Review Manager software. The methodological quality was evaluated with the Physiotherapy Evidence Database scale. a total of 25 trials were selected (5,142 participants), which showed statistically significant improvements (p <0.05) in 54% (12/22) in the pain levels and 47% (10/21) in functional disability in the Intervention Group. The meta-analyses showed moderate effects on pain intensity and small effects on functional disability. There was a predominance of medium quality studies. the digital care interventions showed a beneficial result in pain intensity and in functional disability, mainly for chronic low back pain. Digital care emerges as promising to support self-management of the spine musculoskeletal conditions. PROSPERO registry number CRD42021282102.

Background: Moral distress is a phenomenon that can lead to an imbalance of the mind and body. There are many coping strategies to overcome the obstacles that lead the subject to this condition. Some coping strategies are capable of being achieved through the cultivation of moral resilience., Aim: The aim is to identify the strategies of moral resilience in the nursing management of University Hospitals in Brazil., Research Design: The research design is the qualitative study with discursive textual analysis., Participants and Research Context: : 44 nurse managers and nurses in leadership positions participated in a total of 30 University Hospitals in Brazil. Data were collected online, using a questionnaire with open questions., Ethical Considerations: The Ethics Committee approved the study. Participants received information about the research, agreed to respond to the questionnaire, and were guaranteed anonymity., Findings: Personal adaptive strategies (intrapersonal and interpersonal) and organizational collaborative strategies (intrinsic and transformational management) emerged from this process. The intrapersonal strategies involved elements of rationality, flexibility, rebalancing practices, moral courage, and detachment. The interpersonal strategies addressed support networks, team involvement, and dialog. Organizational strategies dealt with actions which reorient ethical infrastructure, ethical education, and psychological protection, as well as fostering dialogical relationships, empowerment, and cooperation., Conclusion: From the perspective of social historical construction, it is understood that developing personal and organizational strategies is essential to cultivating moral resilience.

Objective: to analyze the processes of meaning production, based on the speeches of nursing professionals, about how they feel about the titles of "angels and heroes" given by society during the pandemic of COVID-19., Methods: a qualitative, documentary research. Data was collected in October and November 2020 and analyzed from the perspective of the Discourse Analysis proposed by Michel Foucault., Results: they were organized into two thematic categories: "Angels and heroes? The (not) heroic reality of nursing during the pandemic" and "The search for recognition of the professional work of nursing: between what is said and what is not said"., Final Considerations: the nurses' speeches enunciate the search for decent conditions for the execution of care, fair wages, and recognition of the professional work by society.

Objectives: to identify the characteristics of violence in the context of the teaching and learning of the undergraduate Nursing course, from the perspective of students., Methods: quantitative, cross-sectional study, developed with 208 undergraduate students in Nursing. The data was obtained through the application of a survey questionnaire and processed by descriptive and bivariate statistics., Results: of the participants, 69.2% (n = 144) have experienced some kind of violence. Violent acts of a psychological nature were the most frequent, but there were also reports of physical, sexual violence and deprivation or abandonment. Violence was practiced in a theoretical and practical learning environment. Teachers and classmates were the most frequent perpetrators. Most students had no reaction, told friends, family, and colleagues, or pretended that nothing happened in the face of the violent acts., Conclusions: violence is present at various moments in the undergraduate Nursing course and can negatively impact the quality of training in the area.

Objective: to identify the association between moral distress and the supporting elements of moral deliberation in Brazilian nurses., Method: a cross-sectional study conducted with Brazilian nurses working in health services at different complexity levels. The research protocol consisted of the Brazilian Scale of Moral Distress in Nurses, a sociodemographic and labor questionnaire, and a list of bases and ethical elements used for moral deliberation. For analysis, descriptive statistics, chi-square test, and Poisson regression were used., Results: 1,226 nurses took part in the study. The 12 elements associated with the moral deliberation process were classified as important for nurses' actions, especially the professional experience acquired, code of ethics/law of professional practice, and ethical and bioethical principles. The relationship of moral distress showed higher prevalence in the Beliefs, culture and values of the patient, Beliefs and personal values, and Intuition and Subjectivity elements., Conclusion: the results showed a balance between the subjective criteria of professional experience and the objective ones of deontology for moral deliberation.

Objective: To evaluate the frequency and intensity of moral distress in Brazilian nurses., Method: Cross-sectional study performed with nurses from 27 Brazilian states through application of the Brazilian Moral Distress Scale in Nurses (Portuguese acronym: EDME-Br) and descriptive statistical analysis., Results: Participation of 1,226 Brazilian nurses in the study. The intensity and frequency of overall moral distress were rated as moderate level, with averages of 3.08 (± 1.45) and 2.94 (± 1.37), respectively. Specifically, the highest intensity and frequency was related to the factors Acknowledgement, power and professional identity and Work teams, while the lowest was related to the factor Defense of values and rights., Conclusion: Moral distress occurs in precarious work environments, with little expressiveness of the nurses' role. One highlights the importance of the problem in terms of its amplitude and multicausality, reaching professionals acting in different work contexts.

Objective: to relate nonspecific low back pain within the nursing work context with their workloads, attrition processes and the risks of illness., Method: a cross-sectional study with 301 workers from a general hospital in the south of the country. The Nordic Musculoskeletal Questionnaire and the Work Context Assessment Scale composed of three dimensions were used: working conditions, work organization and socio-professional relations. The association of variables with low back pain was tested using bivariate and multivariate analyzes. The measure of association used was the Odds Ratio and its respective intervals with 95% confidence. The data collected were discussed under the theoretical framework of the work process within the marxist conception and the theory of social determination of the health-disease process., Results: there was a statistically significant association between the dimensions of work organization and working conditions with low back pain and they obtained a critical classification meaning moderate risks to the professional illness., Conclusion: the study allowed a better understanding of the nursing work process and its relation with nonspecific low back pain and signaled that changes in the organization and working conditions should occur in order to reduce the risks of nursing workers' illness.

Objective: To explore the actions and factors associated to patient advocacy by intensivist nurses using the Protective Nursing Advocacy Scale., Method: A quantitative, descriptive-exploratory, cross-sectional study. The questionnaire was answered by nurses who worked in Intensive Care Units in the South and Southeast regions of Brazil. A factorial exploratory analysis of the data, T-tests and the chi-square test were used for association between factors., Results: 451 nurses participated in the study. A greater number of nurses disagreed with the negative consequences that patient advocacy may have or bring to them. Greater dialogue among nursing staff would enhance teamwork results. Nurses with two or more job relationships need more physical and mental effort, which compromises their quality of life and work, leading to them being those who least practice patient advocacy., Conclusion: Nurses understand patient advocacy as an important part of their work, as well as factors which may influence their decision to defend their patients, but are still unaware of the benefits of advocacy.

Background and Purpose: To determine the psychometric properties of the Brazilian Moral Distress Scale in Nurses (MDSN-BR)., Design: In this methodological, cross-sectional study, the criterion, content, and construct validation stages were presented., Method: A 57-item questionnaire was applied to 1,227 brazilian nurses through an online form. The exploratory factor analyses revealed significant conceptual relations among its items in six constructs, expressing the consistency of the scale., Results: The validated version of the instrument consists of six constructs and 49 items-Cronbach's alpha .980 (instrument) and of constructs: (a) (.942) Acknowledgment, power, and professional identity; (b) (.961) Safe and qualified care; (c) (.924) Defense of values and rights; (d) (.944) Work conditions; (e) (.933) Ethical infractions; (f) (.914) Work teams., Conclusion: The results provide evidence supporting the reliability and trustworthiness of the scale in the selected population., (© Copyright 2019 Springer Publishing Company, LLC.)

Objective: To analyze the nursing errors reported by the journalistic media and interpret the main implications of this communication for the visibility of this problem., Method: Documental research, qualitative, descriptive and exploratory, with data collected in news reports from Brazil and Portugal, analyzed through hermeneutics with resources of Atlas Software., Results: We analyzed 112 news items published between 2012 and 2016 that resulted in six categories: Year - highest occurrence in 2012; Age group of the patient - children; Professional category - nurses; Type of error - medication; Outcome - death; Possible attributed cause - occupational conditions., Final Considerations: Nursing mistakes are a challenge for the profession, and the way they are communicated by the media is not very explanatory, contributing to a negative visibility of the profession, and to making society insecure. Improving the way they are served in the media contributes to the visibility of the problem without affecting the professional image.

Objective: identify the adverse reactions presented by blood donors and outline their sociodemographic profile., Method: a quantitative, cross-sectional retrospective study of 780 records of blood donors from a public hemocenter in the southern region of Brazil, from December 2015 to January 2016. For the analysis the descriptive statistics was used., Results: it was identified that throughout 12 months, the total blood donors corresponded to 27,300 people, in which 780 developed at least one reaction. They were characterized by female and recurrent donors, single, with a complete average level of education, ranging from 16 to 30 years, who triggered between 1 and 3 reactions. Mild reactions were more frequent, followed by moderate and severe reactions., Conclusion: There is a high rate of adverse reactions from donors emphasizing the need for changes in hemotherapy care practices.

Objective: To analyze the behavior of nursing managers and leaders when nursing errors are disclosed in the media., Methodology: A qualitative, retrospective, documental study of the collection carried out in newspapers in Brazil and Portugal, between 2012 and 2016. Analysis performed at Atlas.ti, using a Ricoeur technique based on Habermas Theory of Communicative Action., Results: Managers and caretakers focused on the workforce, continuing with the opening of internal syndication, removal of position and dismissal. How to lead the discipline process, carrying out inspections, requesting documents and questioning about the facts, as well as repudiating some disclosed notes., Conclusion: Leaderships in nursing played a crucial role in developing a complex problem strategy. However, this was not done efficiently.

Objective: To define a theoretical framework to guide the systematization of nursing care in a maternity unit in the South of Brazil., Method: This was the preliminary stage of a qualitative methodological study, based on an educational activity and the assumptions of Paulo Freire, involving 15 nurses, between August and November 2015. The aim of data analysis was to identify emerging themes., Results: The following themes emerged: knowledge of nurses about nursing theories; barriers to implementing and systematizing nursing care; the importance of a framework to guide practice and; educational activities as opportunities to systematize nursing care., Conclusion: The discussion process involved in establishing the theoretical framework enabled reflections about nursing practices, reinforcing the importance of theoretical frameworks to guide work processes and enhance quality of care.

Objective: to validate an instrument to identify situations that trigger moral distress in relation to intensity and frequency in primary health care nurses., Method: this is a methodological study carried out with 391 nurses of primary health care, applied to the Brazilian Scale of Moral Distress in Nurses with 57 questions. Validation for primary health care was performed through expert committee evaluation, pre-test, factorial analysis, and Cronbach's alpha., Results: there were 46 questions validated divided into six constructs: Health Policies, Working Conditions, Nurse Autonomy, Professional ethics, Disrespect to patient autonomy and Work Overload. The instrument had satisfactory internal consistency, with Cronbach's alpha 0.98 for the instrument, and between 0.96 and 0.88 for the constructs., Conclusion: the instrument is valid and reliable to be used in the identification of the factors that trigger moral distress in primary care nurses, providing subsidies for new research in this field of professional practice.

A qualitative study aimed at describing the situations experienced and the ethical dilemmas of nurses in the process of referring and receiving hospitalized patients by court order who require admission to the Intensive Care Unit (ICU). A partially structured interview was conducted with 10 nurses who worked in the ICU and 10 who worked in the Emergency Room (ER) in public and private hospitals in the metropolitan area of Porto Alegre, Brazil. The data was analyzed following the Semantic Analysis. The results indicated that nurses experienced ethical dilemmas associated with problems of overcrowding in emergency rooms and ICUs, poor specialized technology and orientation as to the benefits provided by law. We concluded that it is essential for nurses to participate in discussions that allow the planning of the different instances that have been promoting this often chaotic situation.

Objective: to discuss the professors' conceptions about the ethical dimension of nurse training based on the relationships which this establishes with the competencies with the professional profile; and to identify the spaces and strategies for the teaching of ethics in this process., Method: A qualitative study delineated as a case study. The data was collected based on focus groups with professors from six undergraduate nursing courses in the state of Santa Catarina, Brazil, totaling 50 subjects. Based on the professors' discourse, the conceptions and mutual relations between professional competencies, the formative process and ethics were analyzed., Results: The results were organized and the discussion explored through the thematic categories: The ethics constructed in the process of training nurses - the professors' conceptions, and spaces and strategies for the teaching of ethics in nurse training., Conclusions: The issue of ethics was shown to be transversal in the formative process. The study evidenced the challenge of creating spaces and strategies for teaching and fosters discussion about the new demands for changes placed upon the nursing schools, about the suitability of the care setting, and about the exercising of critical and problem-based education.

A qualitative study with an exploratory, descriptive and documentary design that was conducted with the objective of identifying the elements to constitute a method for the analysis of accusations of and proceedings for professional ethics infringements. The method is based on underlying elements identified inductively during analysis of professional ethics hearings judged by and filed in the archives of the Regional Nursing Board of Santa Catarina, Brazil, between 1999 and 2007. The strategies developed were based on the results of an analysis of the findings of fact (occurrences/infractions, causes and outcomes) contained in the records of 128 professional ethics hearings and on the structural elements (statements, rules and practices) identified in five example professional ethics cases. The strategies suggested for evaluating accusations of ethics infringements and the procedures involved in deliberating on ethics hearings constitute a generic proposal that will require adaptation to the context of specific professional ethics accusations.

Objective: The present study aimed to characterize the processes of ethical and professional nursing transacted at the Regional Nursing Council of Santa Catarina (Coren/SC), considering their factual elements (events/offenses, causes and outcomes)., Method: This descriptive, exploratory and documentary research with a quantitative approach was developed at Coren/SC. Data was collected from 128 professional ethical processes in nursing, between 1999 and 2007, analyzed descriptively with regard to the origin of the complaints and ethical processes, the denouncers, the accused, the subject of the complaint and the outcome of the process., Results: Considering the topics, out of the eight categories described, iatrogenesis was highlighted, as well as illegal professional practice, conflicting inter-professional relationships and professional responsibility of the nurse., Conclusion: The results show the need for discussion and intervention in concrete practical and arouse reflections about the process of professional training and continuous education in the institutional spaces of health, in order to reduce ethical occurrences in professional practice.

This is an exploratory study conducted in a general hospital in the greater Florianopolis in Santa Catarina State, Brazil using a qualitative/quantitative approach. The main objective is to describe the therapeutic route of patients seeking health assistance in an emergency hospital and their justifications for this choice, discussing it primarily from a socio-political and cultural point of view, without the intention to adhere to the theoretical philosophical aspects of these theories. The sample was composed of 35 subjects. The data was collected through semi-structured interviews, participant observation and medical charts. The data is presented in tables and using testimonials expressed by the subjects which were categorized by theme and discussed based on references that examine the issue. It was found that 82.6% of the subjects did not seek assistance at a Basic Health Unit and that the triage at the emergency hospital was performed by untrained staff. Assistance in emergency wards should be handled systematically and be focused on the user, reassessing and integrating the assistance practices and the work process.

The objective of the study is to know the perceptions of graduates of the Masters Course in Nursing at the Universidade Federal de Santa Catarina with its contributions on formation as regards to professional work. That was a study of qualitative approach, using a questionnaire applied to the egresses of master degree program (last 5 years), totaling 88 informants. Analysis presented elements of the graduates lent in relation to the general evaluation of the course, as related to the same contributions for change at work and the medium evaluation of its objectives. The masters degree program shows a space and the valorization of construction and consolidation of an innovative knowledge that can faces challenges that might occur to a new configuration of making health daily.

When Pharaoh refused to supply straw, productivity plummeted in the Egyptian brick industry. But Pharaoh had other concerns. Anyway, the costs fell on Israelites, not Egyptians. Productivity improvement in the health sector is similarly constrained by competing objectives, and by the distribution of resulting gains and losses. Furthermore, health services have value only insofar as they improve health outcomes. Increased output of ineffective services is not productivity in any meaningful sense. Yet most of the literature on health human resources productivity focuses on outputs, not outcomes, ignoring serious questions about effectiveness. Proposals to refine the treatment of the health sector within the national accounts are similarly flawed. Proliferation of beneficial, harmful or simply unnecessary services would all be recorded as "productivity growth."

The purpose of this study was to implement the Nursing Care Systematization--Sistematização da Assistência de Enfermagem (SAE)--with Wanda Aguiar Horta's Theory of Basic Human Necessities and the North American Nursing Diagnosis Association's (NANDA) Nursing Diagnosis as its references. The starting point was the evaluation of the knowledge of the nursing team about the SAE, including their participation in this process. This is a qualitative study, performed in the Intensive Care Unit in a hospital in the city of Brusque, Santa Catarina, from October, 2006 to March, 2007. It was observed that the nursing professionals know little about SAE, but they are greatly interested in learning and developing it in their daily practice. In conclusion, it was possible to execute the healthcare systematization in an easy way, with the use of simple brochures that provided all the necessary information for the qualified development of nursing care.