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Barreiras para a prática da enfermagem baseada em evidências no Brasil
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Abstract(s)
Introdução – Profissionais de enfermagem constituem grande parte da força de trabalho dos sistemas de saúde, motivo pelo qual estudos têm observado as barreiras enfrentadas por esses profissionais para o uso de evidências. Dentre elas são listadas pela literatura internacional: falta de apoio administrativo, falta de confiança em evidências em saúde, tempo insuficiente no trabalho para ler e implementar novas ideias, ausência de autonomia dos enfermeiros para alteração dos procedimentos clínicos, disponibilidade limitada de evidências em enfermagem, distância entre o meio académico e a prática clínica, cultura organizacional cristalizada e falta de treinamentos. Objetivos – Considerando-se estudos produzidos em outros países, objetivou-se verificar quais são as principais barreiras para a prática da enfermagem baseada em evidência em um contexto hospitalar brasileiro. Métodos – A pesquisa teve caráter quantitativo e obteve a participação de 100 enfermeiros que atuam em um hospital público, universitário, de referência nacional, que atende condições de alta complexidade, localizado no Brasil. Os participantes responderam a um questionário demográfico e a um questionário sobre o uso de evidências no contexto clínico. O estudo seguiu as diretrizes brasileiras de ética em pesquisa com seres humanos. Resultados – As dez principais barreiras para a prática da enfermagem baseada em evidências, mencionadas pelos participantes, foram: 1) a remuneração recebida não incentiva a prática baseada em evidências; 2) no local de trabalho não há tempo para acessar evidências; 3) no local de trabalho não há treinamentos sobre práticas baseadas em evidências; 4) no local de trabalho não há métodos de ensino que facilitem a prática baseada em evidências; 5) no local de trabalho não há uma política para a prática baseada em evidências; 6) no local de trabalho não há recursos tecnológicos que facilitem a prática baseada em evidências; 7) no local de trabalho não há incentivo à prática baseada em evidências; 8) no local de trabalho não há sistemas de apoio à pesquisa de evidências; 9) no local de trabalho, a cultura organizacional não facilita a prática baseada em evidências; 10) no local de trabalho, a gestão e a hierarquia organizacional não facilitam a prática baseada em evidências. Conclusões – Os resultados encontrados no Brasil são similares aos resultados encontrados em outros países. Porém, observa-se que os participantes brasileiros delegam, sobretudo, ao contexto institucional as barreiras para a prática da enfermagem baseada em evidências. A simples disponibilização de evidências em bases de dados especializadas ou em plataformas governamentais não garante que os profissionais de saúde façam uso dessas evidências durante a assistência em saúde. As unidades de saúde precisam desenvolver estratégias específicas para o uso de evidências no contexto clínico.
Introduction – Nursing professionals constitute a large part of the workforce of health systems, which is why studies have observed the barriers faced by these professionals for the use of evidence. Some of them are listed in the international literature: lack of administrative support, lack of confidence in health evidences, insufficient time at work to read and implement new ideas, lack of autonomy of nurses to change clinical procedures, limited availability of evidence in nursing, distance between the academic environment and clinical practice, crystallized organizational culture and lack of training. Objective – Considering studies produced in other countries, the objective was to verify the main barriers to the practice of evidence-based nursing in a Brazilian hospital context. Methods – The research had a quantitative character and obtained the participation of 100 nurses who work in a public tertiary care hospital, located in Brazil. Participants responded to a demographic questionnaire and a questionnaire about the use of evidence in the clinical setting. The study followed the Brazilian ethics guidelines in research with human beings. Results – The top 10 barriers to evidence-based nursing practice cited by participants were: 1) The remuneration received does not encourage evidence-based practice; 2) In the workplace, there is no time to access evidence; 3) In the workplace, there is no training on evidence-based practices; 4) In the workplace, there are no teaching methods that facilitate evidence-based practice; 5) In the workplace, there is no evidence-based practice policy; 6) In the workplace, there are no technological resources that facilitate evidence-based practice; 7) In the workplace, there is no incentive to evidence-based practice; 8) In the workplace, there are no systems to support the research of evidence; 9) In the workplace, organizational culture does not facilitate evidence-based practice; 10) In the workplace, management and organizational hierarchy do not facilitate evidence-based practice. Conclusion – The results found in Brazil are similar to the results found in other countries. However, it is observed that the Brazilian participants delegate, above all, to the institutional context the barriers to the practice of evidence-based nursing. The simple provision of evidence in specialized databases or on government platforms does not guarantee that health professionals make use of this evidence during health care. Health units need to develop specific strategies for the use of evidence in the clinical setting.
Introduction – Nursing professionals constitute a large part of the workforce of health systems, which is why studies have observed the barriers faced by these professionals for the use of evidence. Some of them are listed in the international literature: lack of administrative support, lack of confidence in health evidences, insufficient time at work to read and implement new ideas, lack of autonomy of nurses to change clinical procedures, limited availability of evidence in nursing, distance between the academic environment and clinical practice, crystallized organizational culture and lack of training. Objective – Considering studies produced in other countries, the objective was to verify the main barriers to the practice of evidence-based nursing in a Brazilian hospital context. Methods – The research had a quantitative character and obtained the participation of 100 nurses who work in a public tertiary care hospital, located in Brazil. Participants responded to a demographic questionnaire and a questionnaire about the use of evidence in the clinical setting. The study followed the Brazilian ethics guidelines in research with human beings. Results – The top 10 barriers to evidence-based nursing practice cited by participants were: 1) The remuneration received does not encourage evidence-based practice; 2) In the workplace, there is no time to access evidence; 3) In the workplace, there is no training on evidence-based practices; 4) In the workplace, there are no teaching methods that facilitate evidence-based practice; 5) In the workplace, there is no evidence-based practice policy; 6) In the workplace, there are no technological resources that facilitate evidence-based practice; 7) In the workplace, there is no incentive to evidence-based practice; 8) In the workplace, there are no systems to support the research of evidence; 9) In the workplace, organizational culture does not facilitate evidence-based practice; 10) In the workplace, management and organizational hierarchy do not facilitate evidence-based practice. Conclusion – The results found in Brazil are similar to the results found in other countries. However, it is observed that the Brazilian participants delegate, above all, to the institutional context the barriers to the practice of evidence-based nursing. The simple provision of evidence in specialized databases or on government platforms does not guarantee that health professionals make use of this evidence during health care. Health units need to develop specific strategies for the use of evidence in the clinical setting.
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Keywords
Enfermagem baseada em evidências Hospitais Brasil
Citation
Publisher
Associação Portuguesa de Documentação e Informação de Saúde