BDTD - Biblioteca Digital de Teses e Dissertações
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Master Thesis Educação pelo trabalho e a integração ensino-serviço na gestão em saúde pública(Universidade Federal do Rio Grande do Norte, 2025-11-24) Luduvico, Maura Roberta Guilherme de Lima; Almeida Júnior, José Jailson de; https://orcid.org/0000-0001-7448-0703; http://lattes.cnpq.br/8768677759534396; http://lattes.cnpq.br/4512684892862311; Sobreira, Maura Vanessa Silva; http://lattes.cnpq.br/4231913524179274; Telles, Mauricio Wiering Pinto; https://orcid.org/0000-0002-5568-6877; http://lattes.cnpq.br/3146268167204989It is the responsability of the Public Health System (Sistema Único de Sáude – SUS) to finance the acquiring of Human Resources (RH) in order for attending health and improving the development of knowledge, so that Public Services that are part of Public Health System may serve as a field for the practice of teaching and research. The Ministry of Health has developed many strategies and policies aimed at adapting the training and qualification of workers in order to attend better the health needs of the community and the development of the Public Health System, through the Secretariat for Labor and Health Education Management (SGTES), which is responsible for creating The National Policy on Permanent Health Education (Política Nacional de Educação Permanente em Saúde – PNEPS). For reaching this goal is necessary to pay attention and integrate these four pillars – Teaching – Service – Management – Social Control. The Objective of this study was to analyze the integration of teaching and service in the professional training of academics in the regional context of State Health Management. An exploratory- descriptive study with a qualitative approach was conducted, using field research through very well structured interviews as a data collection strategy. The target audience included studants in supervised and extracurricular internships as well as course coordinators, nursing and phsycology internships coordinators from Trairi Faculty of Health Sciences (FACISA/UFRN), in addition to service preceptors, totaling 20 participants. The research was initiated after approval by the ethics and research Committee (CEP), according to CAAE Nº 83014524.0.0000.5568. The study had the purpose to understand how the State Department of Public Health (Secretaria de Estado da Saúde Pública – SESAP), which coordinates the management and healthcare network in the regions of the state, can influence the process of teaching and learning, with a commitment to make the state service available as a field of work for professionals under training or even students. Besides, the research also had the purpose to highlight the role of the V Regional Public Health Unit (V URSAP) as a support mechanism for the implementation of the State Policy for continuing education and strengthening of teaching- service integration, with a focus on the State Management of the SUS. The results indicated that internship´s carried out in the State Management enviroment a significant contribution to the training of the studants, by making them more prepared and confident towards their future professional practice within the SUS. It’s also important to signalize the potential of internships in Public Health Management scenarios, with the integration between teaching and service, according to the view of the actors involved into the process. It can afford the construction or revision of curricular proposals, with the purpose of training critical and reflective professionals in order to make them more familiar with the community health reality, therefore, enabling an understanding of the relevance of the organization, planning and execution of actions and services from the perspective of state and regional management.Master Thesis Aprendizado de máquina aplicado nos cuidados com a pele do recém-nascido(Universidade Federal do Rio Grande do Norte, 2025-12-03) Queiroz, Luciana Maria Varela de; Lins, Hertz Wilton de Castro; Silva, José Adailton da; https://orcid.org/0000-0002-6037-7649; http://lattes.cnpq.br/0353536075419724; https://orcid.org/0000-0003-1138-4276; http://lattes.cnpq.br/7712686175574736; http://lattes.cnpq.br/2446858665103220; Freitas, Cijara Leonice de; http://lattes.cnpq.br/3435619523270147; Nagem, Danilo Alves Pinto; https://orcid.org/0000-0003-4828-1107; http://lattes.cnpq.br/5934458385325202During the neonatal period, preserving skin integrity is a fundamental aspect of nursing care. Around 80% of newborns develop some skin injury within the first month of life, especially premature babies, so it is essential to have a qualified team. Studies carried out in Brazil demonstrate that the incidence of skin lesions in hospitalized newborns is approximately 40.4%, with diaper dermatitis being the most common lesion. Therefore, this study aims to build a decision tree for newborn skin care. This is methodological research with a quantitative approach where the population will be composed of nurses who carry out their activities in the neonatal intensive care unit of Maternidade Escola Januário Cicco, with the sample consisting of 16 professionals. The study was conducted two phases: the first involved a systematic review, and the second phase comprised data collection, which was carried out through interviews, followed by the construction and validation of the decision tree. For processing the collected data, the instruments were numbered, and the variables were coded and entered into a data spreadsheet embedded in the Excel program for Windows. This work was submitted to the Institution's Ethics and Research Committee, in accordance with Resolution No. 466/12 of the National Health Council. It is expected that this research will contribute to the knowledge of the nursing team regarding the prevention of skin lesions in newborns. born, as well as improving teaching/research practice in the hospital environment. Furthermore, strengthening patient safety and preventing harm, also reducing infection rates and length of stay.Master Thesis Atividades de educação permanente em saúde e registros clínicos: ações junto à equipe multiprofissional de um hospital geral público(Universidade Federal do Rio Grande do Norte, 2025-12-15) Costa, Paloma Batista; Azevedo, Dulcian Medeiros de; http://lattes.cnpq.br/7071042889558651; http://lattes.cnpq.br/1906061913877471; Lucena, Eudes Euler de Souza; http://lattes.cnpq.br/6969519171915250; Carvalho, Rhanna Emanuela Fontenele Lima de; https://orcid.org/0000-0002-3406-9685; http://lattes.cnpq.br/1388111488949476Communication among the multidisciplinary team is essential for continuity of care and patient safety, with the medical record as the primary tool. Failures in the records compromise the quality of care and highlight the need for Continuing Health Education (CHE) initiatives. The objective was to develop Continuing Health Education activities focused on clinical record in medical charts, aiming to promote reflection, improve knowledge, and strengthen record practices among the multidisciplinary team. This is an intervention study, with a qualitative approach, developed through action-research, conducted with professionals from the multidisciplinary team of the Telecila Freitas Fontes State Hospital (HETFF), located in the city of Caicó/RN. Thirty-seven professionals participated in the research between May and July 2025. The methodological path included the following phases: exploratory (diagnostic questionnaire), planning (structuring of workshops), action (three educational workshops with active methodologies and a final seminar) with the following themes: initiation of clinical record; safe practices; safe practices and standardization; and evaluation (descriptive analysis of the questionnaires and qualitative discussion with the support of a field diary). The technical product of the study was the creation of a orientations guide for clinical records keeping. The study revealed a predominantly female professional profile, young, and qualified, with emphasis on nurses and social workers. During the workshops, four themes were addressed: introduction to clinical records, ethical and legal implications, safe practices, and standardization of records in the interdisciplinary perspective, totaling six training sessions. The activities, based on active methodologies such as discussion groups, case studies, simulations, and collaborative production, promoted critical reflection, multi-professional integration, and improvement of clinical records practices. Advances were observed in the understanding of record as an act of care and an ethical and legal instrument, although challenges related to low participation in workshops persist. The CHE actions promoted reflection and improvement of practices, although challenges such as low participation in training and structural limitations still persist. The participatory development of a orientations guide was consolidated as a practical and sustainable tool, reinforcing the culture of continuous improvement. Systematic integration of CHE into institutional routines and investment in technologies that optimize records are recommended.Master Thesis Metodologias de ensino de ultrassom point of care para estudantes de medicina e seus resultados: scoping review(Universidade Federal do Rio Grande do Norte, 2025-12-29) Cruz, Isabel Dutra da; Costa, Raphael Raniere de Oliveira; https://orcid.org/0000-0002-4199-9696; http://lattes.cnpq.br/4311190570015694; http://lattes.cnpq.br/1475500110078847; Lucena, Eudes Euler de Souza; http://lattes.cnpq.br/6969519171915250; Mazzo, Alessandra; https://orcid.org/0000-0001-5074-8939; http://lattes.cnpq.br/2640044420444521; Araújo, Marilia Souto de; https://orcid.org/0000-0002-6975-8683; http://lattes.cnpq.br/9165569425489092Point-of-Care Ultrasound (POCUS) has become established as a rapid, safe, and non-invasive diagnostic tool at the bedside, whose incorporation into medical education requires structured and standardized methodologies to ensure adequate training for students. This study aimed to identify the methodologies used in POCUS teaching and their results for undergraduate medical students. This is a scoping review, conducted according to the Joanna Briggs Institute guidelines and the PRISMA-ScR checklist, with a guiding question based on the PCC approach. Systematic searches were performed in six databases (PubMed/MEDLINE, Web of Science, Scopus, Embase, CINAHL, and ERIC), with a protocol registered with the OSF (DOI: 10.17605/OSF.IO/WCB5P). After screening 220 studies, 60 articles comprised the final sample, encompassing students from different stages of undergraduate studies, residents, and professionals involved in POCUS teaching. The identified methodologies included supervised practice with real patients, highfidelity simulators, handcrafted models, interactive lectures, active learning methodologies (flipped classroom, peer-assisted learning), short and long-term courses, and educational technologies (e-learning, portable devices, virtual reality). Assessments involved OSCEs, questionnaires, and theoretical/practical tests. The main observed effects were increased confidence and practical autonomy, improved diagnostic accuracy, clinical performance, and skill retention, as well as high student acceptance. Integrated methodologies and supervised practice proved more effective than isolated methods. Challenges related to standardization, implementation feasibility, and program sustainability persist. The findings support the development of longitudinal POCUS curricula, supported by simulation and active learning methodologies, with potential impact on medical training and patient safety.Master Thesis Protocolo de encaminhamento personalizado para pacientes com condições ortopédicas em uma clínica escola(Universidade Federal do Rio Grande do Norte, 2024-04-30) Cruz, Handerson Raphael Fernandes Vale da; Morais, Hécio Henrique Araújo de; Mota, Kelly Samara de Lira; http://lattes.cnpq.br/2261625982115257; https://orcid.org/0000-0002-6450-1483; http://lattes.cnpq.br/9568109998934778; http://lattes.cnpq.br/9933321965699392; Costa, Marcelo Viana da; https://orcid.org/0000-0002-3673-2727; http://lattes.cnpq.br/1801687907907663; Dutra, Laio da Costa; http://lattes.cnpq.br/3771001331054627The challenge of decentralizing and regionalizing the health system in Brazil is notable due to regional disparities and the complexity involving multiple agents. Although decentralization provides greater autonomy to municipalities, it reveals challenges, especially in specialized care, due to the fragmented organization of health services. The SUS National Regulation Policy seeks to operationalize regulatory functions, highlighting Referral Protocols as tools that guide clinical and management decisions, aiming to improve the effectiveness and efficiency of the health system. In this context, the present research aims to develop a personalized referral protocol for patients with orthopedic conditions in a teaching clinic. This is a descriptive case study with a qualitative approach. Data collection was carried out at the clinic of the Multicampi School of Medical Sciences in the city of Caíco – RN and included the analysis of the efficiency of care, the effective use of resources available at the clinic and the flow of referral of patients from the Basic Health Units. Health for orthopedic specialty care. Data were collected through direct observations and documentary records. To formulate the referral protocol, the 5W2H tool was applied. The results showed that despite the strengths of the current system, challenges related to the referral of orthopedic patients were identified, such as: referrals without due justification or reason for referral, lack of Rheumatology professionals in the municipality and referrals only for medical report purposes. The creation of a clear flowchart and a standardized referral form are important initiatives in this process, facilitating communication between the different actors involved and ensuring that all the information necessary for adequate patient care is listed. These tools not only optimize the referral process, but also contribute to more effective and personalized assistance, aligned with the specific needs of each patient. Additionally, the Orthopedic Referral Protocol presents a systematic approach to different orthopedic conditions, providing criteria to guide healthcare professionals in making decisions about the need for referral.Master Thesis Gestão de produtos para saúde em uma casa da gestante, bebê puérpera: ciclo de melhoria da qualidade(Universidade Federal do Rio Grande do Norte, 2025-08-19) Lopes, Emeline Moura; Vale, Sancha Helena de Lima; https://orcid.org/0000-0002-0972-1678; https://orcid.org/0000-0001-7405-1247; Saraiva, Cecilia Olívia Paraguai de Oliveira; https://orcid.org/0000-0003-4225-5194; Viana, Eugenie Desirèe Rabelo Néri; https://orcid.org/0000-0003-1958-0853Introduction: The inadequate management of stocks in healthcare units can affect their performance and put patient care at risk. The waste of the stocks is a critical factor within organizations, as it can hide problems due to lack of planning and processes. In a scenario of care for pregnant women, postpartum women and newborns, this premise becomes even more relevant. The implementing tools that support effective inventory management provides safe service, as well as impacts the financial management of an institution. Objective: Develop a quality improvement cycle in the management of supplies in a Maternity, Baby and Postpartum Home. Methodology: Quasi-experimental study, without a control group of the before and after type, which aimed to evaluate the effectiveness of the implemented actions, comparing the results obtained before and after the intervention, in which the stages of the quality improvement cycle were followed, with a quantitative approach. Conducted at a Maternity, Baby, and Postpartum Center in the capital of Ceará, the first stage of the study identified opportunities for improvement. Subsequently, the intervention evaluation criteria were defined and validated: "All health products must be within their expiration date"; and "All health products must have an expiration date greater than 2 months." The judges' validation of the criteria demonstrated 100% agreement. A flowchart was then designed to support the monitoring of the supply management actions. Once implemented, it provided quantitative data, which were analyzed in absolute and relative frequencies and presented in graphs. Results: After analyzing the root cause of the improvement opportunity, the main causes were identified as a lack of inventory, consumption history, and routine inventory reporting. Following the steps of the defined flowchart for input management, pre-intervention inventories were assessed, as well as after each of the four improvement cycles. Waste was reduced from 28.9% to zero. Conclusion: The applied methodology proved to be useful and appropriate for the proposed objective, considering that after the application of four improvement cycles, guided by a pre-defined flow of activities, the expected result was achieved.Master Thesis Validação de instrumento para comunicação efetiva da enfermagem na transferência intersetorial de paciente em uma maternidade escola(Universidade Federal do Rio Grande do Norte, 2025-12-22) Flor, Cynthia Priscyla Pereira Soares; Mendonça, Ana Elza Oliveira de; Ribeiro, Katia Regina Barros; https://orcid.org/0000-0002-3513-7483; https://orcid.org/0000-0001-9015-211X; https://orcid.org/0009-0006-4106-1856; Araújo, Michelly Guedes de Oliveira; Pennafort, Viviane Peixoto dos SantosIntroduction: Handover is a critical moment in the routine of healthcare professionals, especially in nursing, requiring effective communication to ensure favorable outcomes and patient safety. Failures in this process compromise the continuity of the care plan and the quality of assistance. Given this scenario, it is essential to use tools that standardize the flow of information between units. Objective: To validate an instrument designed for effective communication among the nursing team during intersectoral patient transfers in a teaching maternity hospital. Method: A methodological study of instrument development and validation, conducted in a maternity hospital in Northeast Brazil. The stages consisted of a literature review, construction of the instrument (adapted from the SBAR tool), and content and appearance validation by experts via the Delphi technique in two rounds. Data analysis used the Content Validity Index (CVI), with a cutoff point of 80%. Results: In the first round, the CVI ranged between 77.8% and 100% for clarity, pertinence, and relevance. The judges' suggestions allowed for the refinement of items such as patient identification, inclusion of vital signs, and objectivity of the fields. The second round confirmed the effectiveness of the adjustments, achieving a CVI of 100% in all criteria, providing final consistency to the instrument. Conclusion: The instrument was considered valid in content and appearance, constituting a standardized tool to promote effective communication. Its practical application has the potential to minimize errors, ensure continuity of care, and increase patient safety in obstetric environments.Master Thesis Implementação de um módulo educacional de Segurança do Paciente para estudantes de Farmácia no Laboratório de Análises Clínicas(Universidade Federal do Rio Grande do Norte, 2025-12-09) Lima, Norma Kelly Freire; Moreira, Simone da Nóbrega Tomaz; Freitas, Marise Reis de; http://lattes.cnpq.br/9028554205811163; http://lattes.cnpq.br/3642294168997314; https://orcid.org/0009-0005-8351-1010; http://lattes.cnpq.br/2329964952696505; Gonçalves, Carla Beatrice Crivellaro; http://lattes.cnpq.br/1343071938334566; Moreira, Francisca Sueli Monte; https://orcid.org/0000-0001-7069-750X; http://lattes.cnpq.br/5764849324594620Introduction: Patient Safety was placed on the global agenda as a global health priority following the impact of the report “To Err is Human: Building a Safer Health System,” which highlighted that several patient-safety–related problems could be prevented. Thus, teaching patient safety, combined with the development of communication and teamwork skills for future healthcare professionals, is strategic for improving the quality of care and patient safety. Objective: To design and implement an educational module on communication and teamwork for pharmacy students in their curricular internship at the clinical analysis laboratory of a university hospital. Method: This is an action research study with a qualitative approach, conducted in the Clinical Analysis Laboratory of a University Hospital located in Northeastern Brazil. This hospital serves as a curricular internship field for undergraduate Pharmacy students. The study was carried out in three stages: Situational Diagnosis, Educational Intervention, and Evaluation of the Educational Intervention. To analyze the skills, the Objective Structured Clinical Examination was applied, and for the evaluation of the proposal, debriefings and semi-structured interviews were conducted with the participants. Results: The analysis of the situational diagnosis revealed gaps in the Pharmacy Program’s Pedagogical Project at UFRN regarding the incorporation of patient safety, communication, and teamwork. The educational module developed and implemented based on the World Health Organization’s Multiprofessional Patient Safety Curriculum Guide and the Patient Safety Movement Foundation’s Patient Safety Curriculum, which integrates the Actionable Patient Safety Solutions, used active methodologies, including case studies, simulation, debriefing, and the Objective Structured Clinical Examination, promoting meaningful learning and student engagement. The results showed that participants perceived improvements in communication, leadership, and teamwork competencies, as well as increased awareness of safe practices in the clinical analysis laboratory. For educational purposes in the health field, and e-book entitled “Patient Safety Educational Module for Pharmacy Students in the Clinical Analysis Laboratory” was developed. Final Considerations: The implemented educational module proved effective for developing communication and teamwork competencies among Pharmacy students, strengthening patient safety in the laboratory context. The integration of active methodologies, critical reflection, and practical assessment enabled the internalization of essential concepts and skills for professional practice. The results suggest that the systematic incorporation of patient safety-related content into Pharmacy curricula is strategic for training critical professionals who are prepared to work in the complex contexts of healthcare delivery.Master Thesis Construção de um Massive Online Open Course (MOOC) nas habilidades básicas em centro cirúrgico(2025-10-30) Barbalho, Lidiane de Azevedo; Medeiros, Paulo José de; http://lattes.cnpq.br/4442982996337554; https://orcid.org/0000-0002-4816-6646; http://lattes.cnpq.br/9932397148807244; Lino, Cristiane Ribeiro de Melo; https://orcid.org/0000-0002-8684-4065; http://lattes.cnpq.br/4601757822031286; Tinoco, Jéssica Dantas de Sá; http://lattes.cnpq.br/2880143838500945This study aims to develop a Massive Online Open Course (MOOC) focused on basic operating room skills regarding surgical hand antisepsis and surgical gowning and gloving, targeting students and healthcare practitioners. This is a technological production study. Initially, the practices of hand antisepsis and surgical gowning/gloving of 10th-period medical interns from the Federal University of Rio Grande do Norte (UFRN) were observed in an outpatient surgical center. The study was developed in three stages: Diagnostic evaluation of the medical interns' knowledge level, Development of an online course, and the offering of the course on the Unified Health System's (SUS) virtual learning environment (AVASUS) platform. Data was collected using a checklist in an Objective Structured Clinical Examination (OSCE), which served as the foundation for the construction of the massive course, which is offered on the AVASUS platform. This study hopes that the implementation of a virtual course, entitled Basic Skills in the Surgical Center: Hand Antisepsis and Surgical Gowning, can contribute to the development and improvement of attitudes and competencies related to basic skills in the surgical center. This improvement aims to promote good health practices and favorable outcomes for patients. We believe that the course offered will provide flexible and accessible learning for students and healthcare professionals regardless of geographical and time limitations.Master Thesis Análise clínica e econômica da conversão do pantoprazol intravenoso para oral em pacientes críticos(Universidade Federal do Rio Grande do Norte, 2025-12-12) Rodrigues, Cássio Alexandre Oliveira; Moreira, Francisca Sueli Monte; Martins, Rand Randall; https://orcid.org/0000-0001-9668-0482; http://lattes.cnpq.br/8062199269259772; https://orcid.org/0000-0001-7069-750X; http://lattes.cnpq.br/5764849324594620; https://orcid.org/0000-0003-3700-856X; http://lattes.cnpq.br/6280233630813832; Oliveira, Luana Cristina Lins de Medeiros; https://orcid.org/0000-0001-9595-1949; http://lattes.cnpq.br/8550362587549379; Diniz, Rodrigo dos Santos; http://lattes.cnpq.br/0085346724655944Introduction: Proton Pump Inhibitors (PPIs) are widely prescribed in hospital care, mainly for stress-related gastric ulcer prophylaxis in critically ill patients. However, many prescriptions have inappropriate indications, and there is excessive use of the intravenous (IV) route even when the oral (PO) route is eligible, an endemic problem in this setting, further intensified by care dynamics. Objective: To evaluate the clinical and economic outcomes of interventions promoting intravenous to oral therapy conversion in critically ill patients receiving intravenous pantoprazole, including physician acceptance and the effects on duration of use by route of administration, length of hospital stays and mortality. Method: A quasi-experimental cost-minimization study conducted in a private ICU from 2019 to 2023, including 172 patients (86 in the intervention group – IG; 86 in the control group – CG). In the IG, the pharmacist recommended IV-to-PO conversion to physicians; in the CG, patients were only observed. Costs (medications and supplies), conversion rate, and clinical outcomes were compared using univariate analysis (p < 0.05). Results: Intravenous to oral therapy conversion occurred in 100% of patients in the IG versus 17.4% in the CG (p < 0.001). The daily cost of oral therapy was 50 times lower (R$ 0.23 vs. R$ 11.12; p < 0.001), resulting in a substantial reduction in total cost (R$ 178.71 vs. R$ 13,959.30). There was also a shorter mean duration of IV use (4.4 vs. 10.5 days; p = 0.001) and longer oral use (7.1 vs. 1.5 days; p < 0.001), with no differences in mortality or length of hospital stay. Conclusion: interventions promoting intravenous to oral therapy conversion reduced costs and the unnecessary use of intravenous pantoprazole, with high physician acceptance and no adverse clinical impact, establishing it as a sustainable, multidisciplinary strategy for optimizing pharmacotherapy in critically ill patients.