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Nursing Protocols: Macro and Micropolitics in Primary Health Care Management
Bruna Coelho1, Betina Hörner Schlindwein Meirelles1, Fernanda Karla Metelski2
1Universidade Federal de Santa Catarina. Florianópolis, Santa Catarina, Brazil.
Revista Brasileira De Enfermagem
|December 10, 2025
Summary
Nursing protocols are key to Primary Health Care (PHC) management, influencing clinical practice and strengthening nursing within the healthcare system. This study explores their macro and micropolitical dimensions.
Area of Science:
- Health Services Research
- Nursing Science
- Public Health Policy
Background:
- Primary Health Care (PHC) relies on effective care management.
- Nursing protocols are essential tools for standardizing care.
- Understanding the political context of protocol implementation is crucial.
Purpose of the Study:
- To explore the macro and micropolitical interactions surrounding nursing protocol use in PHC.
- To analyze how political factors influence the implementation and effectiveness of nursing protocols.
Main Methods:
- Qualitative research utilizing Constructivist Grounded Theory.
- In-depth interviews with 30 healthcare professionals (2023-2024).
- Two-stage data analysis (initial and focused coding) to identify theoretical relationships.
Main Results:
- Nursing protocols operate within complex macro and micropolitical spheres in PHC.
- Key themes include institutional partnerships, strengthening nursing roles, and evaluating PHC.
- Protocol effectiveness is linked to evidence-based practices, review, training, and tool utilization (e.g., Practical Approach to Care Kit).
Conclusions:
- Nursing protocols extend beyond clinical application, encompassing political dimensions.
- Effective use of protocols enhances care management and clinical practice.
- Protocols contribute significantly to strengthening both primary care services and the nursing profession.
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