Challenges of the care network on reference and counter-reference: an integrative review

Objectives: To identify in scientific productions, which are the main challenges that network professionals face regarding the referral and counter-referral process. Methodology: This study is an integrative literature review, conducted in the first half of 2018, at the Virtual Health Library (VHL), based on the Latin American and Caribbean Health Sciences Literature, Data Base on the Nursing (BDENF), and MEDLINE (Online Medical Literature Analysis and Retrieval System). After considering inclusion and exclusion, they were used and analyzed through a synoptic table. Results: They were found 11 articles that met the inclusion criteria. The articles were about the attributes of Primary Health Care, negotiation and decision-making between users and professionals, the importance of PHC as coordinator ofhealth care, the assessments of references and counter references, the challenges to its implementation and the knowledge of nurses about them. Conclusion: Even the Reference and Counter- referral service being an important tool for effective communication between professionals, and ensuring continued care, it faces fragmentation of care, lack of coordination between the points of health attention and no counter-referral.