Power relations and knowledge of neonatal teams in the Kangaroo Mother Care implementation and dissemination.

OBJECTIVE: to analyze the power relations and knowledge among health teams that permeate the Kangaroo Mother Care implementation and dissemination in the state of Santa Catarina. METHOD: socio-historical qualitative research, carried out in the state of Santa Catarina, from January to November 2019, based on interviews with 12 health professionals. Data were analyzed in the light of Foucault's genealogical proposal, with the help of Atlas.ti Cloud®. RESULTS: the relationships of neonatal team members strengthened Kangaroo Mother Care actions in the state, articulating services and favoring health professionals' autonomy. However, Kangaroo nurses stand out in this process, and the hegemonic medical discourse often still represses the other professional categories. CONCLUSION: professionals develop strategies to negotiate changes in the practice of care, moving between the plots of power and knowledge, sometimes exercising it, sometimes being passive to it.

Care bundle for family interview for pediatric organ donation.

PURPOSE: to develop a care bundle for best practices in conducting the family interview for organ and tissue donation with the families of children and adolescents. DESIGN AND METHODS: methodological study, with a qualitative approach, developed in Brazil, in three stages: literature review, qualitative study with professionals and family members, and development of the care bundle. RESULTS: Nine studies were selected and 17 health professionals and nine family members were interviewed. With this data, the care bundle was developed in three categories: communication of death, emotional support and information about organ and tissue donation. The recommendations were evaluated by five external professionals and all of them assessed the bundle as having the highest possible quality. CONCLUSIONS: the care bundle was built following the stages of integrative literature review and interviews with professionals working in this scenario and family members who have already gone through a family interview for organ and tissue donation of children and adolescents. PRACTICE IMPLICATIONS: the use of this material is seen as an important resource to support the professional during the conduction of the family interview in a scenario as sensitive and challenging as the care to family members facing death and the decision of organ and tissue donation of children and adolescents. Furthermore, the care bundle can increase the quality of family interviews and impact the reduction of family refusals. DESCRIPTORS: Practice Guideline as Topic. Tissue and Organ Procurement. Patient Care Team. Nursing. Pediatrics. Communication.

Power relations and knowledge of neonatal teams in the Kangaroo Mother Care implementation and dissemination / Relaciones de poder y saberes del equipo neonatal en la implementación y difusión del Método Canguro / Relações de poder e saber da equipe neonatal na implantação e disseminação do Método Canguru

ABSTRACT Objective: to analyze the power relations and knowledge among health teams that permeate the Kangaroo Mother Care implementation and dissemination in the state of Santa Catarina. Method: socio-historical qualitative research, carried out in the state of Santa Catarina, from January to November 2019, based on interviews with 12 health professionals. Data were analyzed in the light of Foucault's genealogical proposal, with the help of Atlas.ti Cloud®. Results: the relationships of neonatal team members strengthened Kangaroo Mother Care actions in the state, articulating services and favoring health professionals' autonomy. However, Kangaroo nurses stand out in this process, and the hegemonic medical discourse often still represses the other professional categories. Conclusion: professionals develop strategies to negotiate changes in the practice of care, moving between the plots of power and knowledge, sometimes exercising it, sometimes being passive to it.

RESUMEN Objetivo: analizar las relaciones de poder y saber, entre el equipo de salud, que permean la implementación y difusión del Método Madre-Canguro en el estado de Santa Catarina. Método: investigación sociohistórica, con enfoque cualitativo, realizada en el estado de Santa Catarina, de enero a noviembre de 2019, a partir de entrevistas con 12 profesionales de la salud. Los datos fueron analizados a la luz de la propuesta genealógica de Foucault, con la ayuda del software Atlas.ti Cloud®. Resultados: las relaciones del equipo neonatal fortalecieron las acciones del Método Madre-Canguro en el estado, articulando los servicios y favoreciendo la autonomía de los profesionales de la salud. Sin embargo, la enfermera canguro se destaca en este proceso, y el discurso médico hegemónico muchas veces aún reprime a las demás categorías profesionales. Conclusión: los profesionales desarrollan estrategias para negociar cambios en la práctica del cuidado, moviéndose entre las tramas del poder y del saber, a veces ejerciendo, a veces siendo pasivos frente a él.

RESUMO Objetivo: analisar as relações de poder e saber, entre a equipe de saúde, que permeiam a implantação e disseminação do Método Canguru no estado de Santa Catarina. Método: pesquisa sócio-histórica, com abordagem qualitativa, realizada no estado de Santa Catarina, no período de janeiro a novembro de 2019, a partir de entrevistas com 12 profissionais de saúde. Os dados foram analisados à luz da proposta genealógica de Foucault, com auxílio do software Atlas.ti Cloud®. Resultados: as relações da equipe neonatal fortaleceram as ações do Método Canguru no estado, articulando os serviços e favorecendo a autonomia dos profissionais de saúde. Entretanto, a enfermeira Canguru se destaca nesse processo, e o discurso médico hegemônico, muitas vezes, ainda reprime as demais categorias profissionais. Conclusão: os profissionais desenvolvem estratégias para negociar as mudanças na prática do cuidado, transitando entre as tramas do poder e saber, ora o exercendo, ora sendo passivo a ele.

Simulação realística como ferramenta de ensino na comunicação de situação crítica em cuidados paliativos / Simulación realista como herramienta de enseñanza en comunicación de situaciones críticas en cuidados paliativos / Realistic simulation as a teaching tool in critical situation communication in palliative care

RESUMO Objetivo Identificar a percepção, habilidades e competências dos estudantes de enfermagem frente à comunicação da situação crítica em cuidados paliativos por meio da simulação realística. Método Estudo descritivo quali-quantitativo, desenvolvido com 41 estudantes do Curso de Graduação em Enfermagem de uma universidade do sul do Brasil. Pesquisa realizada no laboratório de práticas simuladas, entre março e maio de 2019. Resultados A média de idade dos estudantes era 23,4 anos. Quanto à percepção deles sobre comunicação da situação crítica: 39% pontuam como difícil; 75,6% nunca participaram de uma comunicação em situações críticas e; 36,60% se sentem bastante estressados nesse contexto. Da análise dos dados qualitativos, emergiram duas categorias: Sentimentos e dificuldades do estudante frente à comunicação de situações críticas em cuidados paliativos e; Principais competências adquiridas por meio da ferramenta de ensino-simulação. Conclusão e implicações para a prática da enfermagem A simulação clínica é importante ferramenta no processo ensino-aprendizagem, faz emergir a observação e torna os estudantes confiantes na habilidade de manter diálogos interprofissionais e com a família. Implica, desta maneira, na prática profissional no tocante às tomadas de decisão, na comunicação de más notícias.

RESUMEN Objetivos Identificar la percepción, habilidades y competencias de los estudiantes de enfermería con respecto a la comunicación de la situación crítica en los cuidados paliativos a través de la simulación realista. Método Estudio descriptivo cuali-cuantitativo, desarrollado con 41 estudiantes universitarios de enfermería de una universidad del sur de Brasil. Investigación realizada en el laboratorio de prácticas simuladas, entre marzo y mayo de 2019. Resultados El edad promedio de los estudiantes era 23,4 años. En cuanto a su percepción de comunicar la situación crítica: el 39% califica como difícil; el 75,6% nunca participó en la comunicación en situaciones críticas y; el 36,6% se siente bastante estresado en este contexto. Del análisis de datos cualitativos, surgieron dos categorías: Sentimientos y dificultades del alumno frente a la comunicación de situaciones críticas en cuidados paliativos y Competencias principales adquiridas a través de la herramienta de enseñanza-simulación. Conclusión e implicaciones para la práctica de enfermería La simulación clínica es una herramienta importante en el proceso de enseñanza-aprendizaje, hace emerger la observación y hace que los estudiantes confíen en la capacidad de mantener diálogos interprofesionales y familiares. Implica, de esta manera, en la práctica profesional sobre la toma de decisiones, en la comunicación de malas noticias.

ABSTRACT Objectives To identify the perception, skills and competencies of nursing students regarding the communication of the critical situation in palliative care through realistic simulation. Method Qualitative and quantitative descriptive study, developed with 41 undergraduate Nursing students from a university in southern Brazil. Research conducted in the laboratory of simulated practices, between March and May 2019. Results The average age of students was 23.4 years. Regarding their perception about communication of critical situation: 39% scored it as difficult; 75.6% never participated in communication in critical situations and; 36.6% feel quite stressed in this context. From the analysis of qualitative data, emerged two categories: Feelings and difficulties of the student facing the communication of critical situations in palliative care and; Main competences acquired through the teaching-simulation tool. Conclusion and implications for nursing practice Clinical simulation is an important tool in the teaching-learning process, brings about observation and makes students confident in the ability to maintain interprofessional and family dialogues. It implies, in this way, in professional practice regarding decision making, in the communication of bad news.