A formação do enfermeiro e a ampliação do escopo de prática na Atenção Básica no Brasil.
Autor(a) principal: | |
---|---|
Data de Publicação: | 2017 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da UERJ |
Texto Completo: | http://www.bdtd.uerj.br/handle/1/4764 |
Resumo: | The expansion of Primary Health Care (PHC) in Brazil has been restricted due to the scarcity and poor distribution of physicians, especially in less developed regions. As one of the strategies for coping with this scenario, we are studying the implementation of the PHC advanced practice nurse (APN), such as international experiences that provide evidence that the incorporation of medical practices by nurses results in equivalent or more effective qualified care, compared to those undertaken by doctors. This implementation should be preceded by a diagnosis of nurses' training in order to identify their adherence to the needs of the Unified Health System (UHS) and to evaluate whether the competencies that result from it are sufficient for advanced nursing practice. This study tried to prove the thesis that the training of nurses, at the undergraduate level, does not allow the extension of its scope of practice in PHC, through the incorporation of medical activities. For this, national exploratory research was developed between December 2015 and September 2016, through a survey (n=94) and in-depth interviews (n=16) with course coordinators, and documental analysis of pedagogical projects. Quantitative data was analyzed statistically and qualitative data was submitted to content analysis. Next, they were confronted with the National Curricular Guidelines (NCG) for undergraduate nursing courses and were discussed in the perspective of international experiences and the demands of PHC. There were pedagogical projects that showed adherence to the NCG and the needs of the UHS; however, the statements indicate institutional fragilities that make it difficult to materialize what is proposed. There were profiles of varied graduates, with a higher tendency towards basic or hospital health practices, with competencies for a fragmented health care, but they were strong for the development of actions of promotion, prevention, management and nursing techniques. From the procedural point of view of the training, the bachelor nurses can promote the advanced practices of nursing. From the point of view of the acquisition of competencies for these practices, there is limited potential for the development of actions understood as medical, especially prescription drugs. However, it is necessary to consider the legislative fragilities that govern and define the fields of action of health professionals, who acted as an intervening factor in the coordinators' response pattern. The fact is that, once the comparison of the PHC assignments of APN at the international level is established, and considering the NCGs and the legislation that governs the scope of the profession, the nursing graduates are able to develop a large part of the actions demanded by the PHC. It is necessary, however, to define the APN model to be adopted, to then identify if the competences developed in the undergraduate course are compatible. |
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Pierantoni, Célia Reginahttp://lattes.cnpq.br/9318963510352726Vianna, Cid Manso de Mellohttp://lattes.cnpq.br/6812480293653692Viana, Ana Luiza D'ávilahttp://lattes.cnpq.br/4521814670870285Vieira, Ana Luiza Stieblerhttp://lattes.cnpq.br/2997873430433813Silva, Ana Lucia Abrahão dahttp://lattes.cnpq.br/7027005675544329http://lattes.cnpq.br/9875118235955534Magnago, Carinne2020-08-02T16:54:57Z2017-09-132017-03-30MAGNAGO, Carinne. A formação do enfermeiro e a ampliação do escopo de prática na Atenção Básica no Brasil.. 2017. 218 f. Tese (Doutorado em Ciências Humanas e Saúde; Epidemiologia; Política, Planejamento e Administração em Saúde; Administra) - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2017.http://www.bdtd.uerj.br/handle/1/4764The expansion of Primary Health Care (PHC) in Brazil has been restricted due to the scarcity and poor distribution of physicians, especially in less developed regions. As one of the strategies for coping with this scenario, we are studying the implementation of the PHC advanced practice nurse (APN), such as international experiences that provide evidence that the incorporation of medical practices by nurses results in equivalent or more effective qualified care, compared to those undertaken by doctors. This implementation should be preceded by a diagnosis of nurses' training in order to identify their adherence to the needs of the Unified Health System (UHS) and to evaluate whether the competencies that result from it are sufficient for advanced nursing practice. This study tried to prove the thesis that the training of nurses, at the undergraduate level, does not allow the extension of its scope of practice in PHC, through the incorporation of medical activities. For this, national exploratory research was developed between December 2015 and September 2016, through a survey (n=94) and in-depth interviews (n=16) with course coordinators, and documental analysis of pedagogical projects. Quantitative data was analyzed statistically and qualitative data was submitted to content analysis. Next, they were confronted with the National Curricular Guidelines (NCG) for undergraduate nursing courses and were discussed in the perspective of international experiences and the demands of PHC. There were pedagogical projects that showed adherence to the NCG and the needs of the UHS; however, the statements indicate institutional fragilities that make it difficult to materialize what is proposed. There were profiles of varied graduates, with a higher tendency towards basic or hospital health practices, with competencies for a fragmented health care, but they were strong for the development of actions of promotion, prevention, management and nursing techniques. From the procedural point of view of the training, the bachelor nurses can promote the advanced practices of nursing. From the point of view of the acquisition of competencies for these practices, there is limited potential for the development of actions understood as medical, especially prescription drugs. However, it is necessary to consider the legislative fragilities that govern and define the fields of action of health professionals, who acted as an intervening factor in the coordinators' response pattern. The fact is that, once the comparison of the PHC assignments of APN at the international level is established, and considering the NCGs and the legislation that governs the scope of the profession, the nursing graduates are able to develop a large part of the actions demanded by the PHC. It is necessary, however, to define the APN model to be adopted, to then identify if the competences developed in the undergraduate course are compatible.A expansão da Atenção Primária à Saúde (APS) no Brasil tem se restringido em razão da escassez e má distribuição de médicos, especialmente em regiões menos desenvolvidas. Como uma das estratégias de enfrentamento a esse cenário, estuda-se implementar o enfermeiro de práticas avançadas (EPA) de APS, a exemplo de experiências internacionais que já fornecem evidências de que a incorporação de práticas médicas por enfermeiros resulta em cuidados qualificados equivalentes ou mais eficazes que os empreendidos pelos médicos. Essa implantação deve ser precedida de um diagnóstico da formação do enfermeiro a fim de identificar sua aderência às necessidades do Sistema Único de Saúde (SUS) e avaliar se as competências que dele resultam são suficientes para a prática avançada de enfermagem. Este estudo intentou comprovar a tese de que a formação de enfermeiros, em nível da graduação, não permite a ampliação de seu escopo de prática na APS, mediante incorporação de atividades médicas. Para isso, desenvolveu-se pesquisa exploratória nacional, entre dezembro de 2015 e setembro de 2016, por meio de survey (n=94) e entrevistas em profundidade (n=16) com coordenadores de curso, e análise documental de projetos pedagógicos. Os dados quantitativos foram analisados estatisticamente e os qualitativos submetidos à análise de conteúdo. Na sequência, foram confrontados com as Diretrizes Curriculares Nacionais (DCN) para os cursos de graduação em enfermagem e discutidos na perspectiva das experiências internacionais e das demandas da APS. Evidenciou-se projetos pedagógicos que se mostram aderentes às DCN e às necessidades do SUS, mas os depoimentos indicam fragilidades institucionais que dificultam a materialização do que se propõe. Verificou-se perfis de egressos variados, com maior tendência para as práticas de saúde básicas ou hospitalares, com competências para uma assistência à saúde fragmentada, mas pujantes para o desenvolvimento de ações de promoção, prevenção, gerenciamento e técnicas de enfermagem. Do ponto de vista processual da formação, as práticas avançadas de enfermagem podem se dar por enfermeiros bacharéis. Do ponto de vista da aquisição de competências para essas práticas, observa-se potencial limitado para o desenvolvimento de ações compreendidas como médicas, especialmente a prescrição de medicamentos. No entanto, é preciso considerar as fragilidades legislativas que regem e definem os campos de atuação dos profissionais de saúde, as quais atuaram como fator interveniente no padrão de respostas dos coordenadores. Fato é que, estabelecida a comparação das atribuições do EPA de APS em nível internacional, e considerando as DCN e a legislação que vige o campo de atuação da profissão, os egressos de enfermagem são aptos para desenvolver grande parte das ações demandadas pela APS. É preciso, no entanto, definir o modelo de EPA a ser adotado, para então identificar se as competências desenvolvidas na graduação são compatíveis.Submitted by Boris Flegr (boris@uerj.br) on 2020-08-02T16:54:57Z No. of bitstreams: 1 Tese_Carinne_final.pdf: 2989945 bytes, checksum: a292f8d135b6117bee3f3734fc9f803f (MD5)Made available in DSpace on 2020-08-02T16:54:57Z (GMT). No. of bitstreams: 1 Tese_Carinne_final.pdf: 2989945 bytes, checksum: a292f8d135b6117bee3f3734fc9f803f (MD5) Previous issue date: 2017-03-30Fundação de Amparo à Pesquisa do Estado do Rio de Janeiroapplication/pdfporUniversidade do Estado do Rio de JaneiroPrograma de Pós-Graduação em Saúde ColetivaUERJBRCentro Biomédico::Instituto de Medicina SocialEducation, HigherNursingPrimary Health CareLabor RegulationScopes of Professional PracticeEducação SuperiorEnfermagemAtenção Primária à SaúdeRegulação do TrabalhoEscopos de prática profissionalCNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVAA formação do enfermeiro e a ampliação do escopo de prática na Atenção Básica no Brasil.The training of nurses and the expansion of the scope of practice in Primary Health Care in Brazil.info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UERJinstname:Universidade do Estado do Rio de Janeiro (UERJ)instacron:UERJORIGINALTese_Carinne_final.pdfapplication/pdf2989945http://www.bdtd.uerj.br/bitstream/1/4764/1/Tese_Carinne_final.pdfa292f8d135b6117bee3f3734fc9f803fMD511/47642024-02-26 20:20:55.976oai:www.bdtd.uerj.br:1/4764Biblioteca Digital de Teses e Dissertaçõeshttp://www.bdtd.uerj.br/PUBhttps://www.bdtd.uerj.br:8443/oai/requestbdtd.suporte@uerj.bropendoar:29032024-02-26T23:20:55Biblioteca Digital de Teses e Dissertações da UERJ - Universidade do Estado do Rio de Janeiro (UERJ)false |
dc.title.por.fl_str_mv |
A formação do enfermeiro e a ampliação do escopo de prática na Atenção Básica no Brasil. |
dc.title.alternative.eng.fl_str_mv |
The training of nurses and the expansion of the scope of practice in Primary Health Care in Brazil. |
title |
A formação do enfermeiro e a ampliação do escopo de prática na Atenção Básica no Brasil. |
spellingShingle |
A formação do enfermeiro e a ampliação do escopo de prática na Atenção Básica no Brasil. Magnago, Carinne Education, Higher Nursing Primary Health Care Labor Regulation Scopes of Professional Practice Educação Superior Enfermagem Atenção Primária à Saúde Regulação do Trabalho Escopos de prática profissional CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA |
title_short |
A formação do enfermeiro e a ampliação do escopo de prática na Atenção Básica no Brasil. |
title_full |
A formação do enfermeiro e a ampliação do escopo de prática na Atenção Básica no Brasil. |
title_fullStr |
A formação do enfermeiro e a ampliação do escopo de prática na Atenção Básica no Brasil. |
title_full_unstemmed |
A formação do enfermeiro e a ampliação do escopo de prática na Atenção Básica no Brasil. |
title_sort |
A formação do enfermeiro e a ampliação do escopo de prática na Atenção Básica no Brasil. |
author |
Magnago, Carinne |
author_facet |
Magnago, Carinne |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Pierantoni, Célia Regina |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/9318963510352726 |
dc.contributor.referee1.fl_str_mv |
Vianna, Cid Manso de Mello |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/6812480293653692 |
dc.contributor.referee2.fl_str_mv |
Viana, Ana Luiza D'ávila |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/4521814670870285 |
dc.contributor.referee3.fl_str_mv |
Vieira, Ana Luiza Stiebler |
dc.contributor.referee3Lattes.fl_str_mv |
http://lattes.cnpq.br/2997873430433813 |
dc.contributor.referee4.fl_str_mv |
Silva, Ana Lucia Abrahão da |
dc.contributor.referee4Lattes.fl_str_mv |
http://lattes.cnpq.br/7027005675544329 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/9875118235955534 |
dc.contributor.author.fl_str_mv |
Magnago, Carinne |
contributor_str_mv |
Pierantoni, Célia Regina Vianna, Cid Manso de Mello Viana, Ana Luiza D'ávila Vieira, Ana Luiza Stiebler Silva, Ana Lucia Abrahão da |
dc.subject.eng.fl_str_mv |
Education, Higher Nursing Primary Health Care Labor Regulation Scopes of Professional Practice |
topic |
Education, Higher Nursing Primary Health Care Labor Regulation Scopes of Professional Practice Educação Superior Enfermagem Atenção Primária à Saúde Regulação do Trabalho Escopos de prática profissional CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA |
dc.subject.por.fl_str_mv |
Educação Superior Enfermagem Atenção Primária à Saúde Regulação do Trabalho Escopos de prática profissional |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA |
description |
The expansion of Primary Health Care (PHC) in Brazil has been restricted due to the scarcity and poor distribution of physicians, especially in less developed regions. As one of the strategies for coping with this scenario, we are studying the implementation of the PHC advanced practice nurse (APN), such as international experiences that provide evidence that the incorporation of medical practices by nurses results in equivalent or more effective qualified care, compared to those undertaken by doctors. This implementation should be preceded by a diagnosis of nurses' training in order to identify their adherence to the needs of the Unified Health System (UHS) and to evaluate whether the competencies that result from it are sufficient for advanced nursing practice. This study tried to prove the thesis that the training of nurses, at the undergraduate level, does not allow the extension of its scope of practice in PHC, through the incorporation of medical activities. For this, national exploratory research was developed between December 2015 and September 2016, through a survey (n=94) and in-depth interviews (n=16) with course coordinators, and documental analysis of pedagogical projects. Quantitative data was analyzed statistically and qualitative data was submitted to content analysis. Next, they were confronted with the National Curricular Guidelines (NCG) for undergraduate nursing courses and were discussed in the perspective of international experiences and the demands of PHC. There were pedagogical projects that showed adherence to the NCG and the needs of the UHS; however, the statements indicate institutional fragilities that make it difficult to materialize what is proposed. There were profiles of varied graduates, with a higher tendency towards basic or hospital health practices, with competencies for a fragmented health care, but they were strong for the development of actions of promotion, prevention, management and nursing techniques. From the procedural point of view of the training, the bachelor nurses can promote the advanced practices of nursing. From the point of view of the acquisition of competencies for these practices, there is limited potential for the development of actions understood as medical, especially prescription drugs. However, it is necessary to consider the legislative fragilities that govern and define the fields of action of health professionals, who acted as an intervening factor in the coordinators' response pattern. The fact is that, once the comparison of the PHC assignments of APN at the international level is established, and considering the NCGs and the legislation that governs the scope of the profession, the nursing graduates are able to develop a large part of the actions demanded by the PHC. It is necessary, however, to define the APN model to be adopted, to then identify if the competences developed in the undergraduate course are compatible. |
publishDate |
2017 |
dc.date.available.fl_str_mv |
2017-09-13 |
dc.date.issued.fl_str_mv |
2017-03-30 |
dc.date.accessioned.fl_str_mv |
2020-08-02T16:54:57Z |
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info:eu-repo/semantics/doctoralThesis |
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MAGNAGO, Carinne. A formação do enfermeiro e a ampliação do escopo de prática na Atenção Básica no Brasil.. 2017. 218 f. Tese (Doutorado em Ciências Humanas e Saúde; Epidemiologia; Política, Planejamento e Administração em Saúde; Administra) - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2017. |
dc.identifier.uri.fl_str_mv |
http://www.bdtd.uerj.br/handle/1/4764 |
identifier_str_mv |
MAGNAGO, Carinne. A formação do enfermeiro e a ampliação do escopo de prática na Atenção Básica no Brasil.. 2017. 218 f. Tese (Doutorado em Ciências Humanas e Saúde; Epidemiologia; Política, Planejamento e Administração em Saúde; Administra) - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2017. |
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http://www.bdtd.uerj.br/handle/1/4764 |
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UERJ |
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Centro Biomédico::Instituto de Medicina Social |
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Universidade do Estado do Rio de Janeiro |
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