Resumo: Introdução: Os técnicos de enfermagem são os profissionais que dedicam a maior parte de sua carga horária laboral à cuidados diretos ao paciente, fato esse que contribui para uma maior probabilidade de se envolver em incidentes, logo, a compreensão da sua rotina e de suas percepções podem facilitar a identificação de fragilidades e fortalezas que inviabilizam e auxiliam, respectivamente, a cultura de segurança do paciente nesse tipo de serviço. Objetivo: Analisar a percepção dos técnicos de enfermagem sobre cultura de segurança na urgência e emergência. Métodos: Estudo transversal de abordagem qualitativa, realizado no setor de urgência e emergência de um hospital estadual do nordeste brasileiro. A coleta dos dados ocorreu em janeiro e fevereiro de 2019, para qual realizou-se uma pergunta aberta aos participantes. A amostra compôs-se de 88 técnicos de enfermagem. Para a análise dos dados recorreu-se ao apoio do software Interface de R pour les Analyses Multidimensionneles de textes et Questionnaires, a partir da Classificação Hierárquica Descendente e da Análise de Similitude. Resultados: Mediante a análise das respostas emergiram-se quatro classes: gestão organizacional e de pessoas; perspectivas para promover a cultura de segurança; obstáculos processuais na cultura de segurança e ações necessárias para fomento da cultura de segurança. Conclusões: Denotou-se que apesar dos técnicos de enfermagem reconhecerem a importância da cultura de segurança, ainda há alguns entraves para sua implementação de forma efetiva.

Abstract: Introduction: Nursing technicians are professionals who dedicate most of their working hours to direct patient care, a fact that contributes to a greater probability of being involved in incidents, therefore, the understanding of their routine and their perceptions can facilitate the identification of weaknesses and strengths that make unfeasible and help, respectively, the patient safety culture in this type of service. Goal: To analyze the perception of nursing technicians about safety culture in urgency and emergency. Methods: A cross-sectional study with a qualitative approach, carried out in the urgency and emergency sector of a state hospital in northeastern Brazil. Data collection took place in January and February 2019, for which an open question was asked to the participants. The sample consisted of 88 nursing technicians. Data analysis was carried out with the support of the Interface de R pour les Analyzes Multidimensionneles de textes et Questionnaires software, based on Descending Hierarchical Classification and Similitude Analysis. Results: Through the analysis of the responses, four classes emerged: organizational and people management; perspectives to promote a culture of safety; procedural obstacles in the safety culture and necessary actions to promote the safety culture. Conclusions: It was noted that despite the nursing technicians recognizing the importance of a safety culture, there are still some obstacles to its effective implementation.

RESUMO Objetivo: Conhecer a percepção dos profissionais de enfermagem quanto aos aspectos essenciais para a prestação de um cuidado seguro ao paciente politraumatizado no serviço de emergência. Método: Estudo descritivo e misto, realizado por meio de grupo focal e técnicas projetivas. A amostra foi composta por sete profissionais de enfermagem. A análise dos dados ocorreu por meio dos softwares Interface de R pour Analyses Multidimensionnelles de Textes et de Questionneires e SPSS 22.0. Resultados: Com base na análise das falas dos participantes, três partições de conteúdo emergiram na Classificação Hierárquica Descendente: 1) Estrutura: necessidade de mudanças; 2) O processo: segurança nas ações da equipe de enfermagem; e 3) A assistência livre de danos como resultado almejado. Conclusão: A segurança do paciente em situação de emergência deve ser pautada na adequação do ambiente e organização do setor, condições de transporte do paciente, uso de rotinas e protocolos, identificação e organização do leito.

ABSTRACT Objective: To know the perception of nursing professionals about the essential aspects to provide safe care to polytraumatized patients in emergency services. Method: Descriptive and mixed study, performed with a focus group and projective techniques. The sample was made of seven nursing professionals. Data analysis took place through the Interface de R pour Analyses Multidimensionnelles de Textes et de Questionneires and SPSS 22.0 softwares. Results: Based on the analysis of participants’ speeches, three content partitions emerged in the Descending Hierarchical Classification. 1) Structure: need for changes; 2) The process: safe actions by the nursing team; and 3) Care free from damage as the sought result. Conclusion: Patient safety in emergency situations must rely on a proper environment and an organized sector, good conditions to transport patients, use of routines and protocols, identification and organization of the beds.

RESUMEN Objetivo: Conocer la percepción de los profesionales de enfermería en cuanto a los aspectos esenciales para la prestación de un cuidado seguro al paciente politraumatizado en el servicio de emergencia. Método: Estudio descriptivo y mixto, realizado por medio de un grupo focal y técnicas proyectivas. La muestra fue compuesta por siete profesionales de enfermería. El análisis de los datos ocurrió por medio de los softwares de R pour Analyses Multidimensionnelles de Textes et de Questionneires y el SPSS 22.0. Resultados: Con base en el análisis de las hablas de los participantes, tres particiones de contenido emergieron en la Clasificación Jerárquica Descendente: 1) Estructura: necesidad de cambios; 2) El proceso: seguridad en las acciones del equipo de enfermería; y 3) La asistencia libre de daños como resultado deseado. Conclusión: La seguridad del paciente en situación de emergencia debe ser pautada en la adecuación del ambiente y organización del sector, las condiciones de transporte del paciente, el uso de rutinas y protocolos, además de la identificación y organización del lecho.

ABSTRACT Objective: To know the perception of nursing professionals about the essential aspects to provide safe care to polytraumatized patients in emergency services. Method: Descriptive and mixed study, performed with a focus group and projective techniques. The sample was made of seven nursing professionals. Data analysis took place through the Interface de R pour Analyses Multidimensionnelles de Textes et de Questionneires and SPSS 22.0 softwares. Results: Based on the analysis of participants’ speeches, three content partitions emerged in the Descending Hierarchical Classification. 1) Structure: need for changes; 2) The process: safe actions by the nursing team; and 3) Care free from damage as the sought result. Conclusion: Patient safety in emergency situations must rely on a proper environment and an organized sector, good conditions to transport patients, use of routines and protocols, identification and organization of the beds.

RESUMEN Objetivo: Conocer la percepción de los profesionales de enfermería en cuanto a los aspectos esenciales para la prestación de un cuidado seguro al paciente politraumatizado en el servicio de emergencia. Método: Estudio descriptivo y mixto, realizado por medio de un grupo focal y técnicas proyectivas. La muestra fue compuesta por siete profesionales de enfermería. El análisis de los datos ocurrió por medio de los softwares de R pour Analyses Multidimensionnelles de Textes et de Questionneires y el SPSS 22.0. Resultados: Con base en el análisis de las hablas de los participantes, tres particiones de contenido emergieron en la Clasificación Jerárquica Descendente: 1) Estructura: necesidad de cambios; 2) El proceso: seguridad en las acciones del equipo de enfermería; y 3) La asistencia libre de daños como resultado deseado. Conclusión: La seguridad del paciente en situación de emergencia debe ser pautada en la adecuación del ambiente y organización del sector, las condiciones de transporte del paciente, el uso de rutinas y protocolos, además de la identificación y organización del lecho.

RESUMO Objetivo: Conhecer a percepção dos profissionais de enfermagem quanto aos aspectos essenciais para a prestação de um cuidado seguro ao paciente politraumatizado no serviço de emergência. Método: Estudo descritivo e misto, realizado por meio de grupo focal e técnicas projetivas. A amostra foi composta por sete profissionais de enfermagem. A análise dos dados ocorreu por meio dos softwares Interface de R pour Analyses Multidimensionnelles de Textes et de Questionneires e SPSS 22.0. Resultados: Com base na análise das falas dos participantes, três partições de conteúdo emergiram na Classificação Hierárquica Descendente: 1) Estrutura: necessidade de mudanças; 2) O processo: segurança nas ações da equipe de enfermagem; e 3) A assistência livre de danos como resultado almejado. Conclusão: A segurança do paciente em situação de emergência deve ser pautada na adequação do ambiente e organização do setor, condições de transporte do paciente, uso de rotinas e protocolos, identificação e organização do leito.

Abstract Background: Malnutrition is associated with morbidity and mortality in patients with heart failure (HF). Thus, it is essential to apply reliable indicators to assess the nutritional status of these individuals. Objective: To evaluate the thickness of the adductor pollicis muscle (APM) in patients with HF as an indicator of somatic protein status and correlate the obtained values with conventionally used parameters and electrical bioimpedance (EBI) markers. Methods: Cross-sectional study with patients with HF undergoing regular outpatient treatment. APM thickness was measured in the dominant arm, and the values obtained were classified according to gender and age. The anthropometric parameters assessed included the body mass index (BMI) and specific parameters to assess the muscle (arm muscle circumference [AMC] and arm muscle area [AMA]). Values of phase angle (PA), standard PA (SPA), and lean mass were obtained by EBI. Statistical analyses were performed with the software Statistical Package for the Social Sciences, version 19, using unpaired Student’s t, Mann-Whitney, or one-way analysis of variance (ANOVA) tests for comparisons between groups, as appropriate. The correlation between variables of interest was performed using Pearson’s or Spearman’s correlation coefficient, as adequate. The level of significance was set at 5%. Results: About 70% of the 74 patients evaluated were classified as malnourished according to the APM thickness. Values of AMC, AMA, and lean mass correlated positively with APM thickness (p < 0.005). The APM thickness also correlated positively with PA and SPA (r = 0.49, p < 0.001 and r = 0.31, p = 0.008, respectively). Conclusion: Patients with HF presented a high frequency of protein malnutrition when APM thickness was used as an indicator of nutritional status. APM thickness values correlated with conventional measures of somatic protein evaluation and may be related to the prognosis of these patients, since they correlated positively with PA and SPA.

Recently, it was suggested that maternal hepatitis B surface antigen antibodies (anti-HBs) acquired transplacentally could play a negative role in newborn infants' immune response to the hepatitis B vaccine. We compared the hepatitis B virus (HBV) vaccine response in infants born to mothers previously vaccinated against HBV (n = 91) to infants born to mothers who were not previously vaccinated (n = 221). All newborn infants received three intramuscular doses (10 μg) of HBV vaccine (Butang®) at 0,1 and six months. The first dose was administered at the maternity hospital within 12 h of birth. The geometric mean titres of anti-HBs were not different among newborn infants born to mothers who were anti-HBs-negative (492.7 mIU/mL) and anti-HBs-positive (578.7 mIU/mL) (p = 0.38). Eight infants did not respond to the HBV vaccine. Of them, six were born to anti-HBs-negative mothers and two were born to mothers with anti-HBs titres less than 50 mlU/mL. Despite the mother's anti-HBs-positive status, our data show a good immunogenicity of the Brazilian HBV recombinant vaccine in neonates.

Hemodialysis patients are at high risk for hepatitis B virus (HBV) infection. A survey was conducted in the hemodialysis population of the state of Goiás, Central Brazil, aiming to assess the prevalence of HBV infection, to analyse associated risk factors, and also to investigate HBV genotypes distribution. A total of 1095 patients were interviewed in 15 dialysis units. Serum samples were screened for HBV serological markers by enzyme-linked immunosorbent assay. Hepatitis B surface antigen (HBsAg) positive samples were tested for HBV DNA by polymerase chain reaction and genotyped by restriction fragment length polymorphism. Global HBV infection prevalence was 29.8% (95% CI: 27.1-32.5). Multivariate analysis of risk factors showed that male gender, length of time on hemodialysis, and blood transfusion before 1993 were associated with HBV positivity. HBV DNA was detected in 65.4% (17/26) of the HBsAg-positive samples. Thirteen of 17 HBV DNA positive samples were genotyped. Genotype D (61.5%) was predominant, followed by A (30.8%), while genotype F was detected in only one (7.7%) sample.