Valoraciones de docentes y evaluadores sobre evaluación del aprendizaje en la carrera de enfermería / Evaluations by Professors and Evaluators about Learning Assessment in the Nursing Major

Introducción: La evaluación del docente y del evaluador está centrada en criterios de valoración que la posiciona en el paradigma interpretativo, pues busca llegar a comprender e interpretar experiencias académicas sobre la calidad y el compromiso docente. Objetivo: Describir la valoración de docentes y evaluadores sobre evaluación del aprendizaje en la carrera de enfermería. Métodos: Estudio cuantitativo, descriptivo transversal, en la carrera de enfermería de la Universidad Estatal Península de Santa Elena, Ecuador, durante primer trimestre del 2018. Universo de 41 docentes y 9 evaluadores que impartieron docencia durante el periodo estudiado, se aplicó un cuestionario y lista de chequeo, validados por criterios de expertos. Se calcularon frecuencias absolutas, porcentajes y varianzas, las comparaciones para los grupos de docentes y evaluadores se realizaron con prueba U de Mann-Whitney. El nivel de significación si p ≤ 0,05. Resultados: Existieron consistencias y similitud entre las valoraciones de la heteroevaluación durante el proceso, los valores encontrados en docentes y evaluadores están entre intervalos 0,80 y 0,89, en evaluadores superior a 0,85, equivalente a resultado fiable, con consistencia interna del instrumento, el indicador con mayor tendencia negativa evidenció 24,39 por ciento, lo que significa que en la evaluación no se alcanzan los logros deseados. Conclusiones: Los evaluadores áulicos consideran que en la evaluación no se alcanzan los logros deseados, que se evidencian aspectos que no corresponden con los preceptos de la evaluación del aprendizaje y que por lo general resulta ser lo típico del proceso evaluativo tradicional, a pesar de estar normado por Reglamento Nacional para Evaluación Estudiantil en Ecuador(AU)

Introduction: Evaluation by any professor or evaluator is centered on assessment criteria belonging to the interpretive paradigm, since it is aimed at understanding and interpreting academic experiences concerning quality and commitment of the professor. Objective: To describe evaluation by professors and evaluators on learning assessment in the Nursing major. Methods: Quantitative, descriptive and cross-sectional study carried out, during the first trimester of 2018, in the Nursing major of Universidad Estatal Península de Santa Elena, Ecuador. The universe was made up of 41 teachers and nine evaluators teaching during the study period. A questionnaire and a checklist, validated using expert judgment, were applied. Absolute frequencies, percentages and variances were calculated. The comparisons for the groups of professors and evaluators were made using Mann-Whitney U test. Differences were statistically significant if P ≤ 0.05. Results: There were consistencies and similarity among the evaluations of heteroassessment during the process; the values found in professors and evaluators are in the intervals between 0.80 and 0.89. In evaluators, it is greater than 0.85, equivalent to a reliable result, with internal consistency of the instrument. The indicator with the greatest negative trend showed 24.39 percent, which means that the desired achievements were not reached in assessment. Conclusions: Classroom evaluators consider that the desired achievements are not reached in assessment, that aspects that do not correspond to the precepts of learning assessment are evidenced, and that, in general, it turns out to a typical characteristic in traditional assessment, despite being regulated by the National Regulation for Student Assessment in Ecuador(AU)

Validation of the Knowledge and Self-management Nursing Outcomes Classification for Adults With Diabetes.

People with diabetes have to self-manage their health conditions to promote, maintain, and restore their health. The Nursing Outcomes Classification provides two outcomes for people with diabetes to evaluate their knowledge and self-management behaviors. The purpose of this study was to validate these two Nursing Outcomes Classification outcomes for adults with diabetes. A descriptive exploratory design using the Delphi technique was used. Two groups of experts were invited for validation of the outcomes. Descriptive statistics were used to determine definition adequacy, clinical usefulness, and content similarity. The Outcome Content Validity method was used to evaluate each outcome and the indicators. A total of 16 nurse experts participated in this study. The definition adequacy of the two Nursing Outcomes Classification outcomes was rated higher than 4.0 out of 5. Clinical usefulness was rated higher than 4.0 out of 5. The range of content validity of the two Nursing Outcomes Classification outcomes was from 0.89 to 0.92 (perfect score is 1.0). The invited experts reported that the content of this outcome pair was very similar. By using validated Nursing Outcomes Classification outcomes, nurses who take care of patients with diabetes can evaluate patient outcomes effectively and determine the effect of nursing interventions accurately.

Instrumento para evaluar conocimientos en enfermeros sobre lesiones no intencionales en la infancia temprana / An Instrument for Assessing Nurses' Knowledge about Unintentional Injuries in Early Childhood

RESUMEN Introducción: Las lesiones no intencionales en la infancia temprana representan un problema de salud por su frecuencia, magnitud, severidad y trascendencia. La prevención de dichas lesiones es compleja y, en la atención primaria, el profesional de enfermería puede y debe ejercer una importante función dirigida a tal fin. Objetivo: Describir el diseño y validación de un instrumento para la evaluación del nivel de conocimientos que tienen los enfermeros sobre lesiones no intencionales en la infancia temprana. Métodos: Estudio metodológico que basó el diseño del instrumento en la literatura científica y la validación en criterio de expertos, que incluyó enfermeras nacionales e internacionales, pedagogos, médicos pediatras y epidemiólogos. El nivel de competencia fue medido por el coeficiente K. La concordancia se midió mediante el Índice Kappa de Cohen. Para medir la comprensión se realizó prueba piloto, con16 enfermeras del Policlínico Área I del municipio Cienfuegos. La confiablidad de consistencia interna se calculó con coeficiente Alfa de Cronbach mediante el programa estadístico Epidat. Resultados: Se obtuvo un instrumento fiable y válido que permite evaluar el nivel de conocimientos sobre lesiones no intencionales en la infancia temprana. Conclusiones: La utilización del instrumento diseñado y validado fue punto de referencia para la identificación nivel de conocimiento y el diseño de intervenciones educativas en la comunidad(AU)

ABSTRACT Introduction: Unintentional injuries in early childhood represent a health problem due to their frequency, magnitude, severity and transcendence. The prevention of such injuries is complex and in the primary care, the nursing professional can and should exercise an important function directed to that end. Objective: Describe the design and validation of an instrument for evaluation of the level of knowledge nurses have about unintentional injuries in early childhood. Methods: Methodological study that based the design of the instrument on the scientific literature and the validation in criterion of experts, who It included national and international nurses, pedagogues, pediatric doctors and epidemiologists. The level of competence was measured by the coefficient K. The concordance was measured by Cohen's Kappa Index. To measure comprehension, a pilot test was carried out, with 16 nurses from the Policlínico Área I of the Cienfuegos municipality. The reliability of internal consistency was calculated with the Cronbach's Alpha coefficient using the statistical program Epidat. Results: A reliable and valid instrument was obtained that allows assessing the level of knowledge about unintentional injuries in early childhood. Conclusions: The use of the designed and validated instrument was a point of reference for the identification level of knowledge and the design of educational interventions in the community(AU)

The economic impact of a nurse practitioner-directed lung cancer screening, incidental pulmonary nodule, and tobacco-cessation clinic.

OBJECTIVE: Lung cancer screening programs have become increasingly prevalent within the United States after the National Lung Screening Trial results. We aimed to review the financial impact after programmatic implementation of Advanced Registered Nurse Practitioner-led programs of Lung Cancer Screening and Tobacco Related Diseases, Incidental Pulmonary Nodule Clinic, and Tobacco Cessation Services. METHODS: We reviewed revenue from 2013 to 2016 by our nurse practitioner-led program. Encounters were queried for charges related to outpatient evaluation and management, professional procedures, and facility charges related to both outpatient and inpatient procedures. Revenue was normalized using 2016 data tables and the national Medicare conversion factor (35.8043). RESULTS: Our program evaluated 694 individuals, of whom 75% (518/694) are enrolled within the lung cancer-screening program. Overall revenue associated with the programs was $733,336. Outpatient evaluation and management generated revenue of $168,372. In addition, professional procedure revenue accounted for an additional $60,015 with facility revenue adding an additional $504,949. CONCLUSIONS: A nurse practitioner-led program of lung cancer screening, incidental pulmonary nodules, and tobacco-cessation services can provide additional revenue opportunities for a Thoracic Surgery and Interventional Pulmonology Division, as well as a health care system. The current national, median annual wage of a nurse practitioner is $98,190, and the cost associated directly to their salary (and benefits) may remain neutral or negative within certain programs. However, the larger economic benefit may be realized within the division and institution. This potential additional revenue appears related to evaluation of newly identified diseases and subsequent evaluations, procedures, and operations.

An intervention to change the approach to colorectal cancer screening in primary care.

PURPOSE: The purpose of this project was to increase colorectal cancer screening (CRC) rates in the state of Nevada. Research has shown that there are several interventions for providers to use to increase CRC screening rates in practice. The Nevada Colon Cancer Partnership (NCCP) has created a toolkit to assist providers to implement these interventions in practice. DATA SOURCES: Research has repeatedly shown that CRC screening has a great impact on the morbidity and mortality of CRC. Studies have shown that a fecal occult blood test can detect 60-85% of CRCs and a colonoscopy with polyp removal can reduce mortality by 60-90%. Multiple studies have shown that a provider's recommendation is the most consistently influential factor in cancer screening. Furthermore, offering patients a choice and encouraging active participation in health care decision making has proven to increase CRC screening rates. CONCLUSIONS: The NCCP has collaborated with the American Cancer Society to create a web based toolkit for use by providers to change practice and screen all eligible patients for CRC. The toolkit is designed to encourage providers to decrease the morbidity and mortality of CRC and other cancers. The toolkit is useful to facilitate efforts of office-based clinicians to reduce disparities by applying screening guidelines on a universal basis to the age-appropriate population. A team approach to screening is encouraged to promote an opportunistic or global approach to assure all eligible patients are reached. IMPLICATIONS FOR PRACTICE: As healthcare reform continues to evolve, Nurse Practitioners (NPs) will assume much of the primary care needs of our country. A preventive care model is an important aspect of the future of healthcare. NPs are in a perfect position to change the health of patients in a global way. The strategies and tools presented in this toolkit are designed to improve preventive care and assist the NP in assuring that every eligible patient receives the screening tests they need.

Nurse Practitioners' attitudes about cancer clinical trials and willingness to recommend research participation.

BACKGROUND: Recruitment and retention of human participants in cancer clinical trials remains challenging for all investigators. Nurse Practitioners (NPs) are in a prime position to discuss, educate and refer patients to clinical trials as many NPs work in ethnically and geographically diverse primary care settings in the U.S., yet they remain an untapped resource. We examined NPs' general attitudes toward cancer clinical trial recommendations and assessed their willingness to recommend such trials METHODS: We randomly surveyed 455 primary care NPs in the state of Pennsylvania during 2008 with an adjusted response rate of 55.3%. Descriptive statistics were used to characterize NPs' demographic and practice characteristics, and logistic regression was used to assess the relative influence of the various attitudes and beliefs on the likelihood that the NP would bring up clinical trials as a treatment option. RESULTS: NPs were more likely to bring up the topic of clinical trials with at least some patients if they were comfortable discussing treatment options with their cancer patients (OR=4.29, p=0.001), were comfortable discussing options of entering a clinical trial for treatment (OR=3.54, p=0.003), had adequate time during patients' visit to explain clinical trials (OR=3.40, p=0.008), and if they believed that patients in clinical trials were receiving the best medical treatment (OR=3.34, p=0.019). NPs who were comfortable discussing cancer clinical trials were almost 5 times more likely to think clinical trials were useful (OR=4.70; 95% CI=1.81-12.19; p=0.001). Nearly three-quarters (72.6%) of the entire responder sample reported three or more ethical concerns associated with clinical trials, including issues of randomization, informed consent, and patient burden. CONCLUSIONS: NPs are willing to recommend clinical trials but need more education about the benefits and burdens of clinical trials, the associated ethical concerns, and evidence regarding the translatability of research to clinical practice to increase their knowledge and comfort level with discussing clinical trials.

A multimethod approach for quality evaluation of clinical information systems.

There was failure to respond to nurses' demands for clinical information system quality that upholds nursing care as clinical information system quality was not measured in a systematic manner. This study identified measures of clinical information system quality by a literature review and used a multimethod approach combining questionnaire, interview, and observation to evaluate the quality of a clinical information system. The study participants were 20 nurses using a clinical information system. Quantitative data were analyzed for tool assessment and item mean values. Qualitative data were transcribed. A set of the criteria was used to integrate quantitative and qualitative data. Results show that the nurses' responses fell into the range of the quality measures included in the tool. Integration of quantitative and qualitative data showed that quality measures facilitated or disrupted nurses' performance on a clinical information system. Nurses' perceptions of and demands for quality in a clinical information system were identified. In conclusion, this study supports a multimethod approach for evaluating the quality of a clinical information system in the complex dynamics of clinical information system implementation. The identified quality dimensions and measures will serve as a foundation to evaluate the quality of a clinical information system. The criteria employed to integrate multiple data were very useful for this study.

Using latent transition analysis in nursing research to explore change over time.

BACKGROUND: Latent transition analysis is a method of modeling change over time in categorical variables. It has been used in the social sciences for many years, but not in nursing research. OBJECTIVE: The purposes of this study were to illustrate the utility of latent transition analysis for nursing research by presenting a case example (a secondary analysis of data from a previously conducted randomized control trial testing the effectiveness of a tailored psychoeducational intervention to decrease patient-related attitudinal barriers to cancer pain management) and to understand for whom and in what direction the tailored intervention resulted in change with respect to attitudinal barriers and pain symptoms. METHODS: The model was developed by (a) defining a class structure on the basis of individuals' barrier patterns, (b) adding demographic predictors and distal pain outcomes, and (c) modeling and testing transitions across classes. RESULTS: There were two classes of individuals: Low Barriers and High Barriers. Older, less educated individuals were more likely to be in the High Barriers class at Time 1. Individuals in either class did not have different pain outcomes at the end of the study. Of those individuals that transitioned across classes, those who received the intervention were statistically more likely to move in a favorable direction (to the Low Barriers class). Furthermore, there is evidence that some individuals in the control group had unfavorable outcomes. DISCUSSION: The results from the example provide useful information about for whom and in what direction the intervention resulted in change. Latent transition analysis is a valuable procedure for nurse researchers because it collapses large arrays of categorical data into meaningful patterns. It is a flexible modeling procedure with extensions allowing further understanding of a change process.

Comparing community and specialty provider-based recruitment in a randomized clinical trial: clinical trial in fecal incontinence.

Recruitment of participants to clinical trials remains a significant challenge, especially for research addressing topics of a sensitive nature such as fecal incontinence (FI). In the Fiber Study, a randomized controlled trial on symptom management for FI, we successfully enrolled 189 community-living adults through collaborations with specialty-based and community-based settings, each employing methods tailored to the organizational characteristics of their site. Results show that using the two settings increased racial and ethnic diversity of the sample and inclusion of informal caregivers. There were no differential effects on enrollment, final eligibility, or completion of protocol by site. Strategic collaborations with complementary sites can achieve sample recruitment goals for clinical trials on topics that are sensitive or known to be underreported.

[Instrument to assess nursing care delivery stystems "IzEP". Making nursing care systematically visible for practice, management and science]. / Instrument zur Erfassung von Pflegesystemen "IzEP". Pflegerische Organisation für Praxis, Management und Wissenschaft sichtbar machen.

Network activities and publications show a rising interest in nursing care delivery systems like primary nursing. There are aspects in quality and outcomes attributed to primary nursing to answer the changes in health care. To assign outcomes in nursing to different kinds of nursing care delivery systems and for systematic developing of primary nursing in a unit one needs a special assessment instrument. IzEP, the instrument to assess nursing care delivery systems, relates the nursing care delivery system of a unit to primary nursing. This article describes the development of the instrument, testing of reliability, validity and possibilities for using.

Development and psychometric testing of a tool to measure missed nursing care.

BACKGROUND: In a qualitative study, medical-surgical and intensive care staff nurses reported that they did not complete a significant amount of nursing care on regular basis. Thus, it was determined that a quantitative tool was needed to measure the amount and type of missed nursing care and the reasons for missing care. OBJECTIVE: The authors report the results of a psychometric evaluation of this tool (The Missed Nursing Care Survey [MISSCARE Survey]) to measure missed nursing care (part A) and the reasons for missed nursing care (part B). STUDY METHODS: Two studies were conducted--study 1 (n = 459) and study 2 (n = 639). A sample of staff nurses was drawn from 35 medical-surgical, rehabilitation, and intensive care patient units in 4 acute care hospitals. RESULTS: Acceptability was high, with 85% of the respondents answering all items on the survey. Factor analysis with Varimax rotation resulted in a 3-factor solution for part 2 (communication, labor resources, and material resources). Cronbach alpha values ranged from 0.64 to 0.86. Confirmatory factor analysis demonstrated a good fit of the data. Using a contrasting group approach, a comparison of nurse's perceptions of missed care on intensive care units versus rehabilitation units resulted, as hypothesized, in a significantly lower amount of missed care on intensive care units. Pearson correlation coefficient on a test-retest of the same subjects yielded a value of 0.87 on part A and 0.86 on part B. CONCLUSION: Although further validation of the MISSCARE Survey is needed, current evidence demonstrates that the tool meets stringent psychometric standards.

Relationships between patient-centered cancer nursing interventions and desired health outcomes in the context of the health care system.

A non-experimental longitudinal prospective study was conducted to examine the relationships between patient-centered nursing interventions (PCNIs), system characteristics, patient characteristics, and desired health outcomes (DHOs) for 173 hematology-oncology patients. Forty-nine nurse participants provided system characteristics data. Confirmatory factor analyses yielded parsimonious scales to operationalize the variables. In the path model, one PCNI-individualization-was positively related to three subsequent DHOs: authentic self-representation, optimism, and sense of well-being. Two additional PCNIs-responsiveness and proficiency-were positively related to subsequent trust in nurses. PCNIs did not vary with patient race, ethnicity, age, gender, or educational level. Patient-centeredness of care for cancer patients may be enhanced by quality improvement activities that measure and monitor these PCNIs and resultant outcomes.

Aspectos contemplados na consulta de enfermagem ao paciente com hipertensão atendido no Programa Saúde da Família / Aspects of the nursing appointments with hypertensive patients cared for in the Family Health Program / Aspectos considerados en la consulta de enfermería al paciente con hipertensión atendido en el Programa Salud de la Familia

Objetivou-se, neste estudo, averiguar os aspectos contemplados na consulta de enfermagem ao portador de hipertensão arterial (HA). É um estudo descritivo, desenvolvido em três unidades de saúde de Fortaleza. Os sujeitos foram 13 enfermeiros. A coleta de dados ocorreu por observação de três consultas de cada enfermeiro e, posteriormente, de uma entrevista com este profissional. Foi observado que, durante a anamnese, houve identificação do tratamento prévio, da ingestão de substâncias hipertensoras e da existência de fatores de risco associados. No exame físico, constatou-se a ocorrência de inspeções da aparência do paciente e verificações da pressão arterial e peso. As categorias identificadas foram: nuances do papel do enfermeiro na atenção básica; tratamento da HA e dificuldades cotidianas das pessoas com esta enfermidade. Concluímos que muitos aspectos não vêm sendo abordados durante a consulta de enfermagem, o que pode acarretar um atendimento deficiente das pessoas acompanhadas pelo programa de HA em tais unidades de saúde.

The objective was to observe the aspects of nursing appointments undergone by hypertensive patients. This is a descriptive study, developed in three healthcare centers in the city of Fortaleza. The subjects were 13 nurses, and data collection comprised the observation of three of each nurse's appointments, followed by an interview with this professional. It was observed that, during the anamnesis, the previous treatment, the ingestion of hypertensive substances and the existence of associated risk factors were identified. Inspections of the patient's appearance, blood pressure and weight were also evident. The identified categories were: aspects of the nurse's role in basic healthtcare; treatment of hypertension and day-to-day difficulties of people with this disease. We conclude that many aspects are not being approached during the nursing appointments, which can result in a low-quality healthcare service provided for people cared for the hypertension program in these basic healthcare centers.

El estudio tuvo por objetivo, investigar aspectos considerados en la consulta de enfermería para el portador de hipertensión arterial (HA). Estudio descriptivo realizado en tres unidades de salud de Fortaleza. Los sujetos fueron 13 enfermeros. La recolección de datos fue por observación durante tres consultas y posteriormente una entrevista con el profesional. Durante la anamnesis se identificó el tratamiento previo, la ingestión de sustancias hipertensivas y la existencia de factores de riesgo asociados. Durante el examen físico se inspeccionó la apariencia del paciente y se verificó presión arterial y peso. Categorías identificadas: variaciones en el rol del enfermero para la atención básica, tratamiento de HA y dificultades frecuentes de las personas con relación a la enfermedad. Concluimos que muchos aspectos no fueron abordados en la consulta de enfermería, lo cual podría llevar a una atención deficiente del paciente en el programa HA en estas unidades de salud.

Cateterismo cardíaco esquerdo: lacunas nas informações transmitida aos pacientes / Cardiac catheterization: gaps in the information transmitted to patients

Introdução: A prática dos procedimentos na cardiologia intervencionista está marcada por grandes avanços, mas o mesmo não se verifica no trato das informações e conhecimento dos pacientes acerca do tema. É imperativa a necessidade de consolidar as orientações transmitidas aos pacientes, instruindo-os sobre os benefícios alcançados pela sua compreensão sobre os exames invasivos. Objetivo: Verificar o conhecimento dos pacientes submetidos a cateterismo cardíaco em um hospital especializado em cardiologia. Método: Estudo transversal realizado por meio de entrevistas envolvendo 11 questões relacionadas ao entendimento sobre sua doença, sobre os benefícios e complicações potenciais do exame, e sobre os cuidados na sua recuperação. Um escore foi criado e definido um ponte de corte de mais ou menos 8 acertos para considerar conhecimento satisfatório. Resultados: Foram avaliados 148 pacientes, com média de idade e 60 mais ou menos 10 anos, sendo a maioria (55,4 por cento) do sexo masculino, dos quais 67,6 por cento estavam sendo submetidos a cateterismo cardíaco pela primeira vez. A média de acertos foi de 5,7 mais ou menos 2,0 questões e 17,6 por cento dos pacientes obtiveram pontuação considerada como conhecimento satisfatório. Pacientes com maior renda e escolaridade apresentaram melhor desempenho do conhecimento...

Background: The field of interventional cardiology have been marked by great advancements, but the way of dealing with information, passed on to the patients regardingthe procedures, has been put aside. It is imperative to consolidate the orientation transmitted to the patients, instructing them about the benefits which can be attained through their understanding of invasive procedures. Our objective was to assess the knowledge of patients submitted to cardiac catheterization in a specialized cardiology hospital. Method: Cross-section study, performed through interviews involving 11 questions related to the understanding of the patients regarding their disease, about the benefits and potential complications of the exam, and what care should be taken during their recovery. A score was developed and a cut-off point was established at 8 right answers to identify patients with a satisfactory level of knowledge. Results: One hundred and forty eight patients were assessed, with a mean age of 60 ± 10 years, 55.4% male gender and of which 67.6% were being submitted to cardiac catheterism for the first time. The average number of right answers was 5.7 ± 2.0 and 17.6% of the patients achieved a score considered of satisfactory knowledge. Patients with higher income and education levels showed a better performance in the score. Conclusion: The results of this study allow us to conclude that the patients demonstrated unsatisfactory knowledge regarding the outpatient catheterization procedure. These results stress the importance of expanding the activities of health care teams, as a way of reducing this scenario of misinformation.

Evaluating the effectiveness of preoperative interventions: the appropriateness of using the Children's Emotional Manifestation Scale.

AIMS: This study aimed to compare the effectiveness of two preoperative nursing interventions and examining the appropriateness of using the Children's Emotional Manifestation Scale in evaluating the effectiveness of preoperative interventions. BACKGROUND: There is some evidence that the Children's Emotional Manifestation Scale can be used as an objective assessment tool in documenting children's emotional responses. However, it is uncertain from previous study that whether the scale can be used in evaluating the effectiveness of preoperative interventions. DESIGN: A randomized controlled trial, between subjects design was carried out in a well-established day surgery unit. METHOD: Children (7-12 years of age; n = 203) admitted for elective day surgery during a 13-month period, were recruited. By using a simple randomization method, 97 of children were assigned to the experimental group receiving therapeutic play intervention and 106 children were assigned to the control group receiving routine information preparation. RESULTS: Children receiving therapeutic play preparation reported statistically significant lower anxiety levels, fewer negative emotions and lower heart rates and mean arterial blood pressures than children receiving information preparation. Children with high preoperative anxiety levels manifested more negative emotional behaviour during anaesthesia induction and were associated with faster heart rates and higher mean blood pressures. CONCLUSION: The study demonstrates the appropriateness of using the Children's Emotional Manifestation Scale in evaluating the effectiveness of preoperative nursing interventions and presents clear evidence to support the effectiveness of therapeutic play intervention in preparing children for surgery when compared with the information preparation approach. RELEVANCE TO CLINICAL PRACTICE: This study contributes towards enriching the experience of using child-sensitive research tools in evaluating the effectiveness of preoperative nursing interventions. The findings heighten the awareness of the importance of integrating therapeutic play as an essential component of holistic and quality nursing care to prepare children for surgery.

An assessment of the implementation of the provincial cervical screening programme in selected Primary Health Care Clinics in the Ilembe Region, KwaZulu-Natal.

Cervical cancer is almost completely preventable, yet it is the second most prevalent cancer amongst women in South Africa. KwaZulu-Natal (KZN) in particular has a high mortality rate of cervical cancer and 1: 40 women die from cancer of the cervix. Therefore, in 1997 a cervical screening policy and programme was implemented in the province. The purpose of the study was to evaluate the implementation of selected aspects of the Provincial cervical screening programme in selected Primary Health Care (PHC) clinics in Ilembe Region, KZN. Results indicated that there was a lack of resources needed for implementing the programme in rural clinics compared to urban clinics. However, all clinics in the study had an adequate supply of the drugs needed for the treatment of abnormal smears. On reviewing the records, the researcher noted that most of the results indicated that smears had adequate cells needed for analysis. However, the results indicated that there was a problem with follow-up of clients with abnormal smears. Feedback to the clinics from the referral hospital regarding the outcome of the visit was inadequate. The results indicated that the mechanisms of record keeping were inadequate. Therefore, the above results indicate that problems exist at the selected PHC clinics that may result in ineffective implementation of the cervical screening programme.

Currículo por competencias en la Universidad de La Sabana / Competence Curriculum at La Sabana University

La presente investigación tiene como objetivo analizar si el desarrollo de la práctica educativa de los profesores de las asignaturas de Cuidado de Enfermería corresponde a la formación por competencias, con relación a la planeación, ejecución y evaluación de los procesos de enseñanza y aprendizaje. El estudio, de tipo descriptivo cualitativo, se llevó a cabo durante el primer semestre de 2006 en la Facultad de Enfermería de la Universidad de La Sabana. Sus principales hallazgos son: con relación a la programación de las asignaturas se encontró que éstas tienen los elementos básicos de la educación por competencias, contemplando el saber ser, el conocer y el hacer propios de cada asignatura. Sin embargo, dentro de esta programación no se encuentra la metodología que se empleará en las clases. Tampoco hay una relación clara entre las estrategias didácticas, el proceso evaluativo y el logro de las competencias. En el desarrollo de las clases se encontró que los profesores manejan los temas en forma clara y concisa, pero hay diferencias entre el profesor novato, que se centra más en los contenidos, y el experto, que se ocupa de forma más natural por los procesos y por promover el análisis. La metodología más utilizada por los profesores durante las clases consiste en realizar y responder preguntas mientras se expone o se discute determinado tema. Con relación al proceso evaluativo, éste se centra principalmente en los contenidos, excepto en las prácticas donde se valora el saber, el hacer y el ser en forma integral. Falta evidenciar la autoevaluación y la coevaluación en todas las asignaturas, aspectos necesarios dentro de la formación por competencias. La recuperación es una herramienta valiosa que apunta a la educación por competencias, es aplicada en todas las asignaturas y permite valorar en forma individual los logros del alumno al establecer un plan de mejoramiento orientado por el profesor.

Nursing-sensitive outcome reliability testing in a tertiary care setting.

PURPOSE: To describe nursing outcomes classification (NOC) that are most relevant for, specialty acute care nursing practice, and to assess the adequacy of measures. METHODS: Data were collected on 434 patients during the 14-month data collection period at a tertiary care center: cardiac surgery intensive care (n = 76), cardiac transplant unit (n = 153), and medical unit (n = 205). FINDINGS: Thirty-six NOC outcomes were used 10 or more times during the study. Of those, 16 had an inter-rater reliability of 75% or higher. CONCLUSIONS: NOC outcomes show promise for accurately documenting the effectiveness of nursing interventions. Further study is needed to develop meaningful analysis of the documented NOC outcomes and efficiently integrate NOC into electronic documentation systems. PRACTICE IMPLICATIONS: Increased familiarity with NOC allowed nursing staff to determine which outcomes comprise core nursing-sensitive outcomes for their clinical setting.

A multimethod approach to evaluating critical care information systems.

There is increasing awareness of the importance of evaluating and measuring the impacts of a critical care information system (CCIS). Recent evaluation studies provide little information useful to a healthcare team in evaluating a CCIS in practice. A CCIS is expected to have many direct benefits, such as increased user job satisfaction and increased documentation efficiency, accuracy, and quality. This paper reviews a rigorous longitudinal evaluation methodology being employed by a freestanding tertiary care pediatric hospital as they implement a CCIS. The metrics are being used to document the impact, strengths, and limitations of the CCIS they are installing. The main phase of the implementation is currently under way, and results will be released when the evaluation is complete. This article serves to provide an overview of the evaluation methodology for others to consider as they embark on similar endeavors.

Sharing stories: narrative and dialogue in responsive nursing evaluation.

Responsive evaluation is an emerging vision and rationale for nursing evaluation. In this vision, evaluation is redefined as an engagement with all stakeholders about the value and meaning of their practice as a vehicle for learning, understanding, and improvement. In this article, the authors aim to illustrate the utility of a particular version of responsive evaluation, one that is connected with recent ideas about narrative and dialogue. They concentrate on methodological issues and use a case example to illustrate these issues. The case concerns a responsive evaluation of the quality of palliative care for cancer patients in a Dutch region. Methodological issues include the collection of stories through the use of conversational interviews. Stories can reveal the meaning and ambiguity of everyday situations. If evaluators listen to different stories and facilitate a dialogue about stories, this will enhance mutual understandings and promote respect, inclusiveness, and social equity.