Development and assessment of learning objects about intramuscular medication administration

OBJECTIVES:

to develop and assess a learning object about intramuscular medication administration for nursing undergraduates and nurses.

METHOD:

a random, intentional and non-probabilistic sample was selected of nurses from a Brazilian social network of nursing and students from the Undergraduate Program at the University of São Paulo School of Nursing to serve as research subjects and assess the object.

RESULTS:

the participants, 8 nurses and 8 students, studied the object and answered an assessment instrument that included the following criteria: educational aspects (relevance of the theme, objectives and texts/hypertexts), interface of the environment (navigation, accessibility and screen design) and didactic resources (interactivity and presentation of resources). In total, 128 significant answers were obtained, 124 (97%) of which were positive, assessed as excellent and satisfactory, considered as a flexible, dynamic, objective resources that is appropriate to the nursing learning process.

CONCLUSION:

the educational technology shows a clear and easily understandable language and the teaching method could be applied in other themes, contributing to the education and training of nursing professionals, positively affecting nursing teaching, stimulating the knowledge, autonomous and independent learning, aligned with the new professional education requirements.     

Gaining a Doctorate in Nursing in Chile: a path not without its difficulties

OBJECTIVE:

to analyze in detail the current situation of doctorate training in Nursing in Chile.

METHODOLOGY:

through a historical and contextual analysis of the background to the development of postgraduate education in Nursing, especially at doctorate level.

RESULTS:

aspects that limit development were identified in national institutionalism of the sciences as well as in higher education and health institutions, especially the limited value placed on nursing as an area of knowledge in this country, the lack of clear institutional policies for postgraduate studies, as well as the postgraduate''s re-inclusion into the academic and care area, with access to national research funds difficult.

FINAL CONSIDERATIONS:

access to grants and funds, together with recognition as an area of knowledge belonging on academic schedules, especially in health institutions, are the main challenges to consolidation. One aspect that would enable a more rapid advance is through national and international inter-institutional agreements, adding together potential, with access to funds for studies and academic and student internships, enabling joint research to go ahead.     

Anxiety in children following hospitalization: a proposal for a nursing diagnosis

Objective:

to describe the process of developing a nursing diagnosis regarding child anxiety following hospitalization, which is to be submitted to the international classification for nursing practice, in accordance with the guidelines set out by the International Council of Nurses and the ISO standard 18104:2014.

Method:

this methodological study includes a conceptual analysis that bases itself on analyzing the phenomena of anxiety and hospitalization, while identifying the critical attributes of the concept and developing an operational definition.

Results:

all the criteria for including a new nursing concept were followed and there was no violation of the framework of the International Classification for Nursing Practice with the proposed inclusion, since the concept of anxiety already exists in this classification system and the concept of anxiety from hospitalization would be considered a species or subclass of this concept.

Conclusion:

this analysis of the concept of hospitalization anxiety in children allowed its meaning to be clarified and, consequently, understanding to be constructed regarding its practical applicability. This achievement contributed in terms of providing incentive to develop new proposals for nursing diagnoses to be included in the International Classification for Nursing Practice.     

Coordinated hospital-home care for kidney patients on hemodialysis from the perspective of nursing personnel

OBJECTIVE:

To examine, from the nursing perspective, the needs and challenges of coordinated hospital-home care for renal patients on hemodialysis.

METHODS:

A qualitative analysis was conducted with an ethnographic approach in a hemodialysis unit in San Luis Potosi, Mexico. Semistructured interviews were conducted with nine nurses, selected by purposeful sampling. Structured content analysis was used.

RESULTS:

Nurses recounted the needs and challenges involved in caring for renal patients. They also identified barriers that limit coordinated patient care in the hospital and the home, mainly the work overload at the hemodialysis unit and the lack of a systematic strategy for education and lifelong guidance to patients, their families and caregivers.

CONCLUSIONS:

This study shows the importance and necessity of establishing a strategy that goes beyond conventional guidance provided to caregivers of renal patients, integrating them into the multidisciplinary group of health professionals that provide care for these patients in the hospital to establish coordinated hospital-home care that increases therapeutic adherence, treatment substitution effectiveness and patient quality of life.     

The principle of integrality of care in the political-pedagogical projects of nursing programs

Objective:

to identify the political-pedagogical projects of the undergraduate nursing programs in Santa Catarina, Brazil according to the guidelines of the Ministries of Health and Education, considering the education of professionals under the principle of integrality.

Method:

documentary study with a qualitative approach. Nine projects were analyzed.

Results:

the colleges from the Southern region of Brazil are gradually incorporating the theoretical framework of the Brazilian health system and curricular guidelines, which includes the principle of integrality of care, into their political-pedagogical projects of undergraduate nursing programs. Some institutions strictly follow the curricular guidelines, while others make their own interpretation.

Conclusion:

most teaching institutions do not provide pedagogical support to students.     

Nursing leadership in intensive care units and its relationship to the work environment

AIM:

To establish whether there is any relationship between the work environment and nursing leadership at intensive care units (ICUs).

METHOD:

Correlational study conducted at four ICUs in southern São Paulo (SP), Brazil. The study population was comprised of 66 pairs (nurses and nursing technicians) established by lottery. The nurses responded to three instruments: 1) characterization; 2) a validated Portuguese version of the Nursing Work Index Revised (B-NWI-R); and 3) Grid & Leadership in Nursing: ideal behavior. The nursing technicians responded to 1) characterization and to 2) Grid and Leadership in Nursing: actual behavior, relative to the corresponding randomly-assigned nurse. The data were analyzed by means of analysis of variance (ANOVA) at p ≤ 0.05.

RESULTS:

The work environment was not associated with actual nursing leadership (p = 0.852). The public or private nature of the institutions where the investigated ICUs were located had no significant effect on leadership (p = 0.437). Only the nurse-physician relationship domain stood out (p = 0.001).

CONCLUSION:

The choice of leadership styles by nurses should match the ICU characteristics. Leadership skills could be developed, and the work environment did not exert any influence on the investigated population.     

Impact of a physical activity program on the anxiety,depression, occupational stress and burnout syndrome of nursing professionals

Objective

to assess the effects of a workplace physical activity (WPA) program on levels of anxiety, depression, burnout, occupational stress and self-perception of health and work-related quality of life of a nursing team in a palliative care unit.

Methods

the WPA was conducted five days per week, lasting ten minutes, during three consecutive months. Twenty-one nursing professionals were evaluated before and after the intervention, with the Hospital Anxiety and Depression Scale, the Maslch Burnout Inventory, and the Job Stress Scale. The changes in self-perceived health and work-related quality of life were measured using a semi-structured questionnaire.

Results

the WPA did not yield significant results on the levels of anxiety, depression, burnout or occupational stress. However, after the intervention, participants reported improved perceptions of bodily pain and feeling of fatigue at work.

Conclusion

the WPA did not lead to beneficial effects on occupational stress and psychological variables, but it was well accepted by the nursing professionals, who reported improvement in perceptions of health and work-related quality of life.     

Health needs: the interface between the discourse of health professionals and victimized women

Objective:

to understand the limits and the evaluative possibilities of the Family Health Strategy regarding the recognition of the health needs of women who experience violence.

Method:

a study with a qualitative approach, grounded in the perspective of gender, and which adopted health needs as the analytical category. The data were collected through interviews with health professionals and women who made use of a health service, and were analyzed using the method of discourse analysis.

Results:

the meeting between the discourses of women who use the services and the professionals of the health service revealed, as the interface, human needs, as in the example of autonomy and of bonds. The understanding regarding the needs was limited to the recognition of health problems of physical and psychological natures, just as the predominance of the recognition of needs for maintaining life in the light of essentially human needs was revealed in the professionals'' discourses as an important limitation of the practices.

Conclusion:

emphasis is placed on the perspective of gender as a tool which must be aggregated to the routine of the professional practices in health so as to confirm or deny the transformative character of the care in place regarding the recognition and confronting of the women''s health needs.     

Strengths and weaknesses of Problem Based Learning from the professional perspective of registered nurses

OBJECTIVE:

to identify competency strengths and weaknesses as perceived by nursing professionals who graduated with a integrated curriculum and competency-based through Problem Based Learning in small groups.

METHOD:

an intrinsic case study method was used, which analyzes this innovation through former students (from the first class) with three years of professional experience. The data were collected through a questionnaire and discussion groups.

RESULTS:

the results show that their competency level is valued in a very satisfactory manner. This level paradoxically contrasts with the lack of theoretical knowledge they perceived at the end of their education, when they started working in clinical practice.

CONCLUSIONS:

the teaching strategy was key to motivate an in-depth study and arouse the desire to know. In addition, Problem Based Learning favors and reinforces the decision to learn, which is that necessary in the course of professional life.     

Impact of "+Contigo" training on the knowledge and attitudes of health care professionals about suicide

OBJECTIVES:

to evaluate the results of "+Contigo" training, developed by nurses and directed at 66 health professionals of integrated school health teams in Primary Health Care.

METHOD:

quantitative with data collection through the Suicide Behavior Attitude Questionnaire, administered before and after the training.

RESULTS:

significant increases were observed in suicide prevention knowledge and in changing attitudes of health professionals towards individuals with suicidal behavior.

CONCLUSION:

these results allow us to affirm that nurses hold scientific and pedagogical knowledge that grant them a privileged position in the health teams, to develop training aimed at health professionals involved in suicide prevention.     

Theoretical assumptions of Maffesoli's sensitivity and Problem-Based Learning in Nursing Education

Objective

understand the everyday and the imaginary of Nursing students in their knowledge socialization process through the Problem-Based Learning (PBL) strategy.

Method

Action Research, involving 86 students from the second year of an undergraduate Nursing program in Spain. A Critical Incident Questionnaire and Group interview were used. Thematic/categorical analysis, triangulation of researchers, subjects and techniques.

Results

the students signal the need to have a view from within, reinforcing the criticism against the schematic dualism; PBL allows one to learn how to be with the other, with his mechanical and organic solidarity; the feeling together, with its emphasis on learning to work in group and wanting to be close to the person taking care.

Conclusions

The great contradictions the protagonists of the process, that is, the students experience seem to express that group learning is not a form of gaining knowledge, as it makes them lose time to study. The daily, the execution time and the imaginary of how learning should be do not seem to have an intersection point in the use of Problem-Based Learning. The importance of focusing on the daily and the imaginary should be reinforced when we consider nursing education.     

Use of Balanced Indicators as a Management Tool in Nursing

Objective:

to develop a proposal for a nursing panel of indicators based on the guiding principles of Balanced Scorecard.

Method:

a single case study that ranked 200 medical records of patients, management reports and protocols, which are capable of generating indicators.

Results:

we identified 163 variables that resulted in 72 indicators; of these, 32 nursing-related: two financial indicators (patient''s average revenue per day and patient''s revenue per day by product used); two client indicators (overall satisfaction rate of patient with nursing care and adherence rate to the patient satisfaction survey); 23 process indicators, and five learning and growth indicators (average total hours of training, total of approved nursing professionals in the internal selection process, absenteeism rate, turnover rate and index of performance evaluation).

Conclusion:

although there is a limit related to the amount of data generated, the methodology of Balanced Scorecard has proved to be flexible and adaptable to incorporate nursing services. It was possible to identify indicators with adherence to more than one area. Internal processes was the area with the higher number of indicators.