Competências de enfermeiras no modelo Buurtzorg: um estudo transversal no contexto brasileiro

Abstract

Introduction: healthcare organizations are paying attention to competencies that add value as a result. In healthcare and the ageing population, there is a need for innovative and sustainable models, such as Buurtzorg, where teams of nurses work in a self-managed and autonomous way. Objective: to assess the professional competencies of nurses working in the Buurtzorg Brazil model. Materials and methods: a cross-sectional study was carried out between August 2023 and March 2024 in different Brazilian regions, in the states of Bahia, Goiás, Rio de Janeiro, São Paulo and Sergipe; and in the Federal District, where the Buurtzorg Brazil model is practiced. Nurses working in this model were included, regardless of their length of service. For data collection, two online instruments were used: the sociodemographic and professional form for nurses, prepared by the researcher, and the second instrument used was the Instrument for Evaluating Competencies for Advanced Practice Nurses (IECEPA), adapted and validated for Brazilian culture. The analysis included descriptive analyses and the application of Fisher's Exact Test, Mann-Whitney Test, Kruskal-Wallis Test and Dunn's Test. This research followed ethical principles. Results: 57 nurses working in the Buurtzorg Brazil model participated, the majority of whom were women (93%). The highest mean scores related to professional competencies were: Professional Autonomy (Me=35.4), Research and Evidence-Based Practice (Me=25.6), and Care Management (Me=23.0). No significant differences were identified when comparing the groups with more and less time working in the model. Feelings of discrimination (p=0.011), burnout (p<0.001) and dissatisfaction (p=0.019) in relation to the job market were correlated with lower levels of professional skills related to research and evidence-based practice, care management and quality management. Factors such as professional burnout significantly decreased the level of skills related to research and evidence-based practice, care management and quality management. Conclusions: this is the first study on the professional competencies of nurses working in the Buurtzorg model in Brazil. The most developed competencies were professional autonomy, evidence-based practice and care management. The length of time working in the model was not a determining factor in the presence of competences. Professional attrition significantly reduced the level of competences related to research and evidence-based practice, care management and quality management. Dedication to learning and greater experience enhance teaching and health promotion.