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      Prática interprofissional colaborativa no serviço de emergência: atribuições privativas e compartilhadas dos fisioterapeutas Translated title: Collaborative interprofessional practice in emergency services: specific and shared functions of physiotherapists

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          Abstract

          Resumo Consideradas a dinamicidade e complexidade dos serviços de emergência, bem como a recomendação de prática colaborativa interprofissional em saúde, este estudo foi desenvolvido para identificar as atribuições específicas e as compartilhadas dos fisioterapeutas que atuam nas equipes desses serviços. Foi realizada análise documental, para mapeamento das ações, e técnica Delphi, para consenso. Foram identificadas 26 atribuições, sendo cinco privativas do fisioterapeuta, 12 compartilhadas com médicos e enfermeiros e nove sem consenso. Isso mostra, de um lado, a ampliação do escopo de prática das profissões e a constituição de atribuições comuns entre os três profissionais, em especial entre fisioterapeutas e médicos. Por outro lado, também mostra que existem potenciais conflitos pela indefinição de um terço de atribuições. Há flexibilidade das fronteiras profissionais, o que pode contribuir para abordagem integral das necessidades dos pacientes e efetivo trabalho em equipe colaborativo.

          Translated abstract

          Resumen Considerando el dinamismo y la complejidad de los servicios de emergencia, así como la recomendación de práctica colaborativa interprofesional en salud, se desarrolló este estudio para identificar las atribuciones específicas y compartidas de los fisioterapeutas que actúan en los equipos de estos servicios. Se realizó análisis documental para el mapeo de las acciones y la técnica Delphi para consenso. Se identificaron 26 atribuciones, siendo cinco de ellas específicas del fisioterapeuta, 12 compartidas con médicos y enfermeros y nueve sin consenso. Eso muestra, por un lado, la ampliación del alcance de práctica de las profesiones y la constitución de atribuciones comunes entre los tres profesionales, en especial entre fisioterapeutas y médicos. Por el otro, hay potenciales conflictos debido a la indefinición de un tercio de las atribuciones. Hay flexibilidad de las fronteras profesionales, lo que puede contribuir para un abordaje integral de las necesidades de los pacientes y el efectivo trabajo en equipo colaborativo.

          Translated abstract

          Abstract Considering the dynamic and complex characteristic of emergency services, as well as the recommended collaborative interprofessional health practice, this study aims at identifying specific and shared functions of physiotherapists who work in this environment. A documentation analysis was used to map actions, and Delphi technique was carried out for consensus purposes. Twenty-six functions were identified: five of them were specific to physiotherapists, twelve were shared with doctors and nurses, and nine showed no consensus. On the one hand, this shows an expansion of the professions’ scope of practice and constitution of common functions among all three professionals, particularly between physiotherapists and doctors. On the other hand, there are potential conflicts due to lack of a definition of one third of the functions. Professional boundaries are flexible, which can contribute to a comprehensive approach of the patients’ needs and to effective collaborative teamwork.

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          Most cited references33

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          Systematic review of trends in emergency department attendances: an Australian perspective.

          Emergency departments (EDs) in many developed countries are experiencing increasing pressure due to rising numbers of patient presentations and emergency admissions. Reported increases range up to 7% annually. Together with limited inpatient bed capacity, this contributes to prolonged lengths of stay in the ED; disrupting timely access to urgent care, posing a threat to patient safety. The aim of this review is to summarise the findings of studies that have investigated the extent of and the reasons for increasing emergency presentations. To do this, a systematic review and synthesis of published and unpublished reports describing trends and underlying drivers associated with the increase in ED presentations in developed countries was conducted. Most published studies provided evidence of increasing ED attendances within developed countries. A series of inter-related factors have been proposed to explain the increase in emergency demand. These include changes in demography and in the organisation and delivery of healthcare services, as well as improved health awareness and community expectations arising from health promotion campaigns. The factors associated with increasing ED presentations are complex and inter-related and include rising community expectations regarding access to emergency care in acute hospitals. A systematic investigation of the demographic, socioeconomic and health-related factors highlighted by this review is recommended. This would facilitate untangling the dynamics of the increase in emergency demand.
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            Consensus measurement in Delphi studies - review and implications for future quality assurance

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              A amostragem bola de neve na pesquisa qualitativa: Um debate aberto

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                icse
                Interface - Comunicação, Saúde, Educação
                Interface (Botucatu)
                UNESP (Botucatu, SP, Brazil )
                1414-3283
                1807-5762
                2018
                : 22
                : suppl 2
                : 1685-1695
                Affiliations
                [1] São Paulo orgnameUniversidade Federal de São Paulo orgdiv1Departamento de Enfermagem Clinica e Cirúrgica Brazil ruth. ester@ 123456unifesp.br
                [2] São Paulo São Paulo orgnameUniversidade de São Paulo orgdiv1Departamento de Orientação Profissional Brazil peduzzimarina@ 123456gmail.com
                Article
                S1414-32832018000601685
                10.1590/1807-57622017.0755
                609ebc2f-2d2f-493a-bea6-b1b6f6245219

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 07 November 2017
                : 29 May 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 53, Pages: 11
                Product

                SciELO Public Health

                Categories
                Artigos

                Relaciones interprofesionales,Equipo de asistencia al paciente,Comportamiento cooperativo,Fisioterapia,Servicio de emergencia,Interprofessional relationships,Patient care team,Collaborative behavior,Physiotherapy,Emergency service,Relações interprofissionais,Equipe de assistência ao paciente,Comportamento cooperativo,Serviço de emergência

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