A formação do enfermeiro e a ampliação do escopo de prática na Atenção Básica no Brasil.

Detalhes bibliográficos
Autor(a) principal: Magnago, Carinne
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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spelling 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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dc.identifier.citation.fl_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.
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.
url http://www.bdtd.uerj.br/handle/1/4764
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dc.publisher.program.fl_str_mv Programa de Pós-Graduação em Saúde Coletiva
dc.publisher.initials.fl_str_mv UERJ
dc.publisher.country.fl_str_mv BR
dc.publisher.department.fl_str_mv Centro Biomédico::Instituto de Medicina Social
publisher.none.fl_str_mv Universidade do Estado do Rio de Janeiro
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