Autonomia do enfermeiro na atenção primária à saúde: revisão integrativa

Abstract

Introduction. The organization of health care within the SUS was conceived as a hierarchical network based on increasing levels of complexity and articulated between Primary, Secondary and Tertiary Care. It is noteworthy that the National Policy for Primary Care (PNAB) in Brazil, the primary health services, are decentralized in an approximate way to the population, and as a priority gateway to the system. Nurses within the scope of PHC stand out in the social context and increase recognition among members of the health team and users. In this sense, to guide the health actions in PHC, the portfolio of services, a document published by the Ministry of Health, aims to strengthen the provision of care provided by PHC. Objective. Describe the autonomy and contributions of nurses in the context of Primary Health Care, in light of publications on the subject. Methodology. It is an integrative literature review, characterized as a method that provides the synthesis of knowledge and the incorporation of the applicability of results of significant studies in practice. This type of study is based on six phases that include: 1) Elaboration of the guiding question; 2) Search or sampling in the literature; 3) Data collection; 4) Critical analysis of the included studies; 5) Discussion of results; 6) Presentation of the integrative review. Results and Discussion. The characterization of the profile of the 06 selected studies was evidenced, with emphasis on the actions of nurses working in Primary Health Care, as well as approaches specifically related to information on the intervening factors in the autonomy of nurses to enhance actions relevant to Portfolio of Primary Health Care Services. Three evaluation categories emerged, which were presented in the context of Structure, Process and Result, in an interconnected way and relevant to the autonomy of the professional nurse working in Primary Health Care. Final Considerations. It was concluded that nurses have skills and abilities to act in adverse and difficult situations, but in favorable working conditions, they have facilities in planning, organization, coordination, monitoring and execution of activities and actions relevant to the Primary Care Services Portfolio to Health, which allows you greater autonomy and resoluteness during professional practice.