Attitudes and influencing factors of nursing assistants towards hospice and palliative care nursing in chinese nursing homes: a cross-sectional study.

BACKGROUND: Hospice and palliative care nursing (HPCN) in China is mainly available at public primary care institutions, where nursing homes (NHs) are rarely involved. Nursing assistants (NAs) play an essential role in HPCN multidisciplinary teams, but little is known about their attitudes towards HPCN and related factors. METHODS: A cross-sectional study was designed to evaluate NAs' attitudes towards HPCN with an indigenised scale in Shanghai. A total of 165 formal NAs were recruited from 3 urban and 2 suburban NHs between October 2021 and January 2022. The questionnaire was composed of four parts: demographic characteristics, attitudes (20 items with four sub-concepts), knowledge (nine items), and training needs (nine items). Descriptive statistics, independent samples t-test, one-way ANOVA, Pearson's correlation, and multiple linear regression were performed to analyse NAs' attitudes, influencing factors, and their correlations. RESULTS: A total of 156 questionnaires were valid. The mean score of attitudes was 72.44 ± 9.56 (range:55-99), with a mean item score of 3.6 ± 0.5 (range:1-5). The highest score rate was "perception of the benefits for the life quality promotion" (81.23%), and the lowest score rate was "perception of the threats from the worsening conditions of advanced patients" (59.92%). NAs' attitudes towards HPCN were positively correlated with their knowledge score (r = 0.46, P < 0.01) and training needs (r = 0.33, P < 0.01). Marital status (ß = 0.185), previous training experience (ß = 0.201), location of NHs (ß = 0.193), knowledge (ß = 0.294), and training needs (ß = 0.157) for HPCN constituted significant predictors of attitudes (P < 0.05), which explained 30.8% of the overall variance. CONCLUSION: NAs' attitudes towards HPCN were moderate, but their knowledge should be improved. Targeted training is highly recommended to improve the participation of positive and enabled NAs and to promote high-quality universal coverage of HPCN in NHs.

Mobility Technicians: A Viable Solution to Early Ambulation of Total Joint Replacement Patients.

BACKGROUND: Early ambulation of patients with total joint replacement (TJR) has been shown to improve outcomes while reducing length of stay and postoperative complications. Limited physical therapy (PT) resources and late-in-the-day cases may challenge day-of-surgery (POD0) ambulation. At our institution, a Mobility Technician (MT) program, composed of specially trained nurse's aides, was developed to address this issue. PURPOSE: The purpose of this study was to compare the effectiveness of the MT model with a traditional PT model in the early ambulation of patients with TJR. METHODS: Patients undergoing unilateral primary TJR at a single institution between June 1, 2014, and October 31, 2018, were included. Ambulation measures were retrospectively assessed between pre- and post-MT program groups. RESULTS: This study included 11,777 patients with TJR. Following the MT program, number of POD0 ambulations, POD0 ambulation distance, and total distance ambulated all increased while time-to-first ambulation decreased. CONCLUSION: Preliminary analyses indicate that the MT program has been successful in the early ambulation of patients with TJR.

Qualification of palliative nursing assistance in the use of the subcutaneous route.

OBJECTIVES: to describe the experience of conducting workshops for teaching the subcutaneous fluid infusion therapy in palliative care patients. METHODS: experience report based on four workshops with a workload of nine hours each, addressing the teaching, implementation of the technique, and management in the use of subcutaneous fluid infusion therapy in patients in palliative care. The host institution was a private hospital, which had two care units in the state of Rio de Janeiro. RESULTS: we identified little knowledge about the theme. Due to the dynamics used, the workshops made it possible to qualify the participants to perform and manage the subcutaneous route in palliative care environments. CONCLUSIONS: the workshops were an important means of training, qualification, and dissemination of nursing care in a palliative care environment. The resources used to enable the qualification in the execution and management of the presented technique.

A formação do técnico em enfermagem: perfil de qualificação / Nursing technician training: qualification profile

Resumo A identificação do atual perfil de formação profissional de auxiliares e técnicos de enfermagem (A&TE) se torna elemento central na compreensão da dinâmica da qualificação desses trabalhadores em diferentes Estados, com o objetivo de revelar tanto a existência de tendências para sub e sobrequalificação, quanto a participação do setor público na oferta e expansão dos cursos de enfermagem no país. O artigo explora três aspectos relevantes da formação profissional a partir dos resultados encontrados na pesquisa "Perfil da Enfermagem no Brasil (FIOCRUZ/COFEN)": o nível de escolaridade/qualificação; a distribuição geográfica e a participação governamental na consolidação do quadro atual. Trata-se de um estudo analítico baseado na interpretação de indicadores definidos pelo Coeficiente de Assimetria de Pearson. O estudo utiliza o banco de dados gerado pela pesquisa, além de dados do MEC/Inep e do IBGE. Os resultados alcançados estabelecem relações entre as características de formação, distribuição de A&TE em todos os estados brasileiros com o fenômeno da superqualificação, além de evidenciar um aparente descolamento da Rede Federal de Educação com a real demanda por técnicos de enfermagem no país.

Abstract The identification of the current vocational training profile of nursing aides and technicians becomes a central element in understanding the dynamics of their qualification in several states, aiming to expose both the existence of trends for under- and overqualification and the participation of the public sector in the offer and expansion of nursing courses in the country. The article explores three relevant aspects of vocational training based on the results found in the research "Nursing Profile in Brazil (FIOCRUZ/COFEN)": the level of schooling/qualification; the geographical distribution and the governmental participation in the consolidation of the current situation. This is an analytical study based on the interpretation of indicators identified by Pearson's Asymmetry Coefficient. The study uses the database generated by the research, as well as data from MEC/Inep and IBGE. The achieved results establish relations between the characteristics of training, distribution of NA&T in all Brazilian states with the phenomenon of overqualification, besides revealing an apparent separation of the Federal Education Network from the actual demand for nursing technicians in the country.

Evaluation of a Palliative Care Program for Nursing Homes in 7 Countries: The PACE Cluster-Randomized Clinical Trial.

Importance: High-quality evidence on how to improve palliative care in nursing homes is lacking. Objective: To investigate the effect of the Palliative Care for Older People (PACE) Steps to Success Program on resident and staff outcomes. Design, Setting, and Participants: A cluster-randomized clinical trial (2015-2017) in 78 nursing homes in 7 countries comparing PACE Steps to Success Program (intervention) with usual care (control). Randomization was stratified by country and median number of beds in each country in a 1:1 ratio. Interventions: The PACE Steps to Success Program is a multicomponent intervention to integrate basic nonspecialist palliative care in nursing homes. Using a train-the-trainer approach, an external trainer supports staff in nursing homes to introduce a palliative care approach over the course of 1 year following a 6-steps program. The steps are (1) advance care planning with residents and family, (2) assessment, care planning, and review of needs and problems, (3) coordination of care via monthly multidisciplinary review meetings, (4) delivery of high-quality care focusing on pain and depression, (5) care in the last days of life, and (6) care after death. Main Outcomes and Measures: The primary resident outcome was comfort in the last week of life measured after death by staff using the End-of-Life in Dementia Scale Comfort Assessment While Dying (EOLD-CAD; range, 14-42). The primary staff outcome was knowledge of palliative care reported by staff using the Palliative Care Survey (PCS; range, 0-1). Results: Concerning deceased residents, we collected 551 of 610 questionnaires from staff at baseline and 984 of 1178 postintervention in 37 intervention and 36 control homes. Mean (SD) age at time of death ranged between 85.22 (9.13) and 85.91 (8.57) years, and between 60.6% (160/264) and 70.6% (190/269) of residents were women across the different groups. Residents' comfort in the last week of life did not differ between intervention and control groups (baseline-adjusted mean difference, -0.55; 95% CI, -1.71 to 0.61; P = .35). Concerning staff, we collected 2680 of 3638 questionnaires at baseline and 2437 of 3510 postintervention in 37 intervention and 38 control homes. Mean (SD) age of staff ranged between 42.3 (12.1) and 44.1 (11.7) years, and between 87.2% (1092/1253) and 89% (1224/1375) of staff were women across the different groups. Staff in the intervention group had statistically significantly better knowledge of palliative care than staff in the control group, but the clinical difference was minimal (baseline-adjusted mean difference, 0.04; 95% CI, 0.02-0.05; P < .001). Data analyses began on April 20, 2018. Conclusions and Relevance: Residents' comfort in the last week of life did not improve after introducing the PACE Steps to Success Program. Improvements in staff knowledge of palliative care were clinically not important. Trial Registration: ISRCTN Identifier: ISRCTN14741671.

An instrument to assess the education needs of nursing assistants within a palliative approach in residential aged care facilities.

BACKGROUND: Providing quality palliative care in residential aged care facilities (RACFs) (aged care homes) is a high priority for ageing populations worldwide. Older people admitted to these facilities have palliative care needs. Nursing assistants (however termed) are the least qualified staff and provide most of the direct care. They have an important role at the frontline of care spending more time with residents than any other care provider but have been found to lack the necessary knowledge and skills to provide palliative care. The level of competence of this workforce to provide palliative care requires evaluation using a valid and reliable instrument designed for nursing assistants' level of education and the responsibilities and practices of their role. METHOD: The overall study purpose was to develop and test an instrument capable of evaluating the knowledge, skills and attitudes of nursing assistants within a palliative approach in RACFs. Development consisted of a four-phase mixed-methods sequential design. In this paper, the results and key findings following psychometric testing of the instrument in Phase 4 is reported using data collected from a random sample of 17 RACFs and 348 nursing assistants in the Greater Sydney region. Study hypotheses were tested to confirm discriminative validity and establish the utility of the instrument in both research and training assessment. RESULTS: Individual item properties were analysed for difficulty, discrimination and item-total correlations. Discriminative and structural validity, and internal consistency and test-retest reliability were demonstrated. Three separate questionnaires comprising 40 items were finalised: The Palliative Approach for Nursing Assistants (PANA)_Knowledge Questionnaire (17 items), the PANA_Skills Questionnaire (13 items) and the PANA_Attitudes Questionnaire (10 items). CONCLUSIONS: This study provides preliminary evidence for the validity and reliability of three new questionnaires that demonstrate sensitivity for nursing assistants' level of education and required knowledge, skills and attitudes for providing a palliative approach. Implications for practice include the development of palliative care competencies through structured education and training across this workforce, and ongoing professional development opportunities for nursing assistants, especially for those with the longest tenure.

Administrators' Perceptions of Oral Health Care and Cancer Screening in Long-Term Care Nursing Facilities.

An estimated 1.7 million adults in the United States more than the age of 65 reside in long-term care nursing facilities (LTCNFs), and only 17% of them receive dental care. More than 83% of LTCNF residents require assistance with oral care. Adequate dental care is a preventative behavior for oral cancer. Adults more than age 65 will account for 60% of oral cancer-related deaths, despite an 80% cure rate for early diagnosis. This study sought to expand knowledge of the perceived benefits, barriers, and ability to perform or provide for oral health care and oral cancer screening as reported by Administrators and Directors of Nursing in LTCNFs. Findings indicate that competing demands for resources make oral health a low priority issue and low knowledge about oral cancer risk among nursing home residents, family members, and staff is a barrier. Potential interventions suggested by participants are discussed.

Outcomes of collaborative and interdisciplinary palliative education for health care assistants: A qualitative metasummary.

AIM: To explore collaborative and interdisciplinary palliative educational strategies and corresponding outcomes for health care assistants. BACKGROUND: Health care assistants are frontline staff who provide almost all hands-on care to seniors. Health care managers are responsible to provide ongoing support and a working environment conducive to health care assistants' abilities to provide quality, safe, evidence-based care. EVALUATION: A Qualitative metasummary of collaborative and interdisciplinary teaching strategies was conducted following guidelines developed by Sandelowski et al. (). KEY ISSUES: The gold standard of palliative care is interdisciplinary delivery of care, yet education is often monodisciplinary. Furthermore, evaluation of interdisciplinary continuing education is most often subjective via self-report questionnaires. CONCLUSIONS: Findings from 16 articles representing 15 studies conducted between 2007 and 2017 were grouped thematically and summarized. Collaborative or interdisciplinary palliative interventions offer health care assistants opportunities to debrief, build their confidence, and critically reflect on the importance of psychosocial care for patients, family and colleagues. IMPLICATIONS FOR NURSING MANAGEMENT: The metasummary provides six suggestions for managers who are considering implementing a collaborative palliative educational workshop and draws attention to the need to create contextual changes that support health care assistants to enact newly acquired knowledge and skills.

Programa de treinamento teórico/prático in loco para enfermagem acerca das manobras básicas em ressuscitação cardiopulmonar / An in loco theoretical and practical training program for nursing professionals regarding the basic maneuvers in cardiopulmonary resuscitation / Programa de formación teórico/práctico en loco de enfermería sobre las operaciones en reanimación cardiopulmonar básica

Objective: The study's purpose has been to evaluate an in loco theoretical and practical training program for nursing technicians and auxiliaries regarding the basic maneuvers in cardiopulmonary resuscitation. Methods: It is a quasi-experimental study that was carried out from August to October 2015. The study's participants were 96 nursing technicians and auxiliaries from a public hospital in the metropolitan region of São Paulo State. An instrument with twenty closed questions was applied before and immediately after the training. The results were analyzed by the Wilcoxon signed-rank test. Results: The nursing technicians and auxiliaries showed better performance in the post-test, respectively, 161% and 180%. The greatest performance was in the recognition of cardiorespiratory arrest (CRA), 83.3% for auxiliaries and 83.6% for technicians. One of the main limitations of the study is that there has been no data collection regarding the professional practice before and after the training. Conclusion: The training program proved to be effective since there was a significant increase in the correct post-test

Objetivo: Avaliar um programa de treinamento teórico/prático in loco para técnicos e auxiliares de enfermagem sobre manobras básicas em ressuscitação cardiopulmonar. Método: Estudo quase-experimental desenvolvido de agosto a outubro de 2015. Participaram 96 técnicos e auxiliares de enfermagem de um hospital público do interior de São Paulo. Foi aplicado um instrumento com vinte questões fechadas, antes e imediatamente após a capacitação. Os resultados foram analisados pelo teste de Wilcoxon pareado. Resultados: Os técnicos e auxiliares apresentaram melhor desempenho no pós-teste, respectivamente, 161% e 180 %. O maior desempenho foi no reconhecimento da parada cardiorrespiratória (PCR), 83,3 % para auxiliares e 83, 6 % para técnicos. Uma das principais limitações do estudo foi não se ter realizado nenhuma coleta de dados em relação à prática profissional antes e após o treinamento. Conclusão: A intervenção realizada mostrou-se eficaz, já que houve aumento significativo nos acertos do pós-teste

Objetivo: Evaluar un programa teórico / práctico en el lugar de los técnicos y auxiliares de enfermería en maniobras básicas de reanimación cardiopulmonar. Método: Estudio cuasi-experimental de agosto a octubre de 2015. Participó 96 técnicos y auxiliares de enfermería de un hospital público en el interior de Sao Paulo. Se aplicó un instrumento con veinte cuestiones cerrado antes e inmediatamente después se aplicó la formación. Los resultados se analizaron mediante el test de Wilcoxon. Resultados: Los técnicos y auxiliares tuvieron mejor desempeño en la prueba posterior, respectivamente, 161% y 180%. La mejor actuación fue en reconocimiento de parada cardiorrespiratoria (PCR), 83,3% de auxiliares y 83,6% para los técnicos. Una limitación importante de este estudio es no haber realizado ninguna recopilación de datos en relación con la práctica profesional antes y después del entrenamiento. Conclusión: La intervención realizada fue eficaz, con aumento significativo de éxitos posteriores a la prueba

Preparo e administração de medicamentos em idosos hospitalizados / Preparation and drug administration in elderly hospitalized / Preparación y administración de medicamentos en ancianos hospitalizados

Estudo descritivo observacional, desenvolvido em um hospital público de Fortaleza, Ceará, Brasil, com 12 técnicos de enfermagem, que objetivou identificar as ações realizadas pela equipe de enfermagem durante o preparo e administração de medicamentos em idosos hospitalizados. As observações possibilitaram a identificação de falhas ou problemas no processo de preparo e administração de medicamentos, revelando, portanto, a necessidade de uma prática profissional fundamentada em conhecimentos científicos e evidências clínicas.

Observational descriptive study, developed in a public hospital in Fortaleza, Ceara, Brazil, with 12 nursing technicians, aimed to identify the actions performed by the nursing team during the preparation and administration of medications in hospitalized elderly. The observations allowed the identification of failures or problems in the process of preparation and administration of drugs, revealing therefore the need for a professional practice based on scientific and clinical evidence.

Estudio observacional descriptivo, desarrollado en un hospital público de Fortaleza, Ceará, Brazil, con los técnicos de enfermería, 12 tenían como objetivo identificar las acciones realizadas por el equipo de enfermería durante la preparación y administración de medicamentos en ancianos hospitalizados. Las observaciones permitieron la identificación de fallas o problemas en el proceso de preparación y administración de medicamentos, revelando por tanto, la necesidad de una práctica profesional basada en la evidencia científica y clínica.

Oral health and cancer screening in long-term care nursing facilities: Motivation and opportunity as intervention targets.

OBJECTIVE: The objective of this study is to propose empirically and conceptually supported interventions that might increase the capability and opportunity to provide of oral hygiene care and oral cancer screening in long-term nursing care facilities. BACKGROUND: Improving the oral health in the older adult population is a priority of the Healthy People 2020 initiative. Poor oral health disproportionably affects older populations, which indicates lower participation in regular oral health care (OHC) that includes screening and early detection of oral cancer. MATERIAL AND METHODS: A rigorous recruitment protocol yielded a purposive sample of nursing home Administrators and Directors of Nursing who participated in nine discrete focus groups (n = 34) in several regions of Massachusetts. Interview data were integrated with a conceptual framework of the Health Belief Model and the "capability," "opportunity," "motivation" and "behavior" of the COM-B system to identify potential interventions to increase oral health and oral cancer screening. We used NVivo to identify conceptual themes related to potential intervention targets. RESULTS: Participants identified several impediments to oral hygiene and cancer screening in the context of the conceptual model. High barriers, low opportunities and low motivation were themes identified as potential targets for intervention. CONCLUSIONS: Our findings suggest that the intervention likely to increase OHC and consequently oral cancer screening include: training certified nurses' aides using dental students and volunteers; educating family members about OHC and oral cancer screening, and increasing oral cancer awareness.

Using an Interactive Video Simulator to Improve Certified Nursing Assistants' Dressing Assistance and Nursing Home Residents' Dressing Performance: A Pilot Study.

This pilot study examined the initial effects and estimated effect size of a computer-based simulation education program on certified nursing assistants' level of assistance when dressing nursing home residents with dementia and on residents' dressing performance. Nine dyads, assigned to either the experimental or control group, completed the study. Both groups received a traditional 1-hour education module delivered by a research assistant. The experimental group was then instructed to undertake an additional 2-hour intervention using a video simulator that enabled nursing assistants to practice level of assistance skills. The appropriateness of dressing assistance from nursing assistants and residents' dressing performance was measured before and 6 weeks after the intervention. The results showed that the two groups did not significantly differ in either appropriate levels of dressing assistance (P = .42) or residents' dressing performance (P = .38). A lack of effort by some assistants to properly assist residents and low statistical power may explain the lack of significance. The effect sizes of the experimental intervention on appropriate levels of dressing assistance and resident dressing performance were 0.69 and 0.89, respectively. Incorporating a strategy to improve motivation should be considered in future studies.

Palliative care for advanced dementia: Knowledge and attitudes of long-term care staff.

AIMS AND OBJECTIVES: To investigate the knowledge of and attitudes towards palliative care for advanced dementia and their associations with demographics among nursing staff, including nurses and nursing assistants, in long-term care settings. BACKGROUND: Nursing facilities are places where persons with dementia die; therefore, providing quality end-of-life care to residents with advanced dementia is crucial. To date, little attention has been paid to palliative care practice for patients with advanced dementia. DESIGN: A descriptive, cross-sectional, survey design was used. METHODS: In total, a sample of 300 nurses (n = 125) and nursing assistants (n = 175) working in long-term care settings in Taiwan participated in this study. Two instruments were administered: demographic characteristics and responses to the Questionnaire of Palliative Care for Advanced Dementia. Descriptive statistics and multiple regression were used for data analysis. RESULTS: Overall, the nurses and nursing assistants had moderate mean scores for both knowledge of and attitudes regarding palliative care for advanced dementia. Additionally, nursing staff who were nurses with greater work experience and those who had received palliative care and hospice training had greater knowledge of palliative care. In addition, nursing staff who had received dementia care training and who had worked in nursing homes had higher levels of positive attitudes towards palliative care. CONCLUSIONS: This study indicates the need to provide nurses and nursing assistants with more information about palliative care practice for people with advanced dementia. Particularly, providing education to those who are nursing assistants, who have less working experience, who have not received palliative and dementia care training, and who have not worked in nursing homes can improve overall nursing staff knowledge of and attitudes towards palliative care. RELEVANCE TO CLINICAL PRACTICE: Continuing education in principles of palliative care for advanced dementia is necessary for currently practicing nursing staff and should be developed according to their educational background and needs.

Education and Training in End-of-Life Care for Certified Nursing Assistants in Long-Term Care.

BACKGROUND: The growth in the number of older adults in the United States requires appropriately prepared health care providers at all levels who will be able to effectively care for this population. First-line caregivers such as certified nursing assistants (CNAs) need education and training in end-of-life care so they can provide high-quality care for residents and families in the long-term-care (LTC) setting. METHOD: CNAs were recruited from an LTC facility in western New York to attend an educational intervention consisting of six 45-minute sessions on various topics selected by the researchers using the curriculum from the Core Curriculum for the Hospice and Palliative Nursing Assistant. Pretests and posttests were administered to assess changes in knowledge, and a satisfaction survey was used for the CNAs to identify additional learning needs. RESULTS: Nineteen CNAs completed the six education and training sessions. Data analysis revealed a significant increase in knowledge for the participants. CNAs were also able to identify additional learning needs. CONCLUSION: Significant improvement in knowledge was seen after the CNAs attended the educational intervention. CNAs working in LTC facilities need education and training in end-of-life care so they can provide appropriate and effective care to residents and their families. Education and training for CNAs led to increased knowledge of end-of-life care and desire for more educational opportunities. J Contin Educ Nurs. 2017;48(2):81-85.

Carbohydrate Counting in the Acute Care Setting: Development of an Educational Program Based on Cognitive Load Theory.

The care of noncritically ill hospitalized patients with diabetes mellitus requiring insulin administration is multidisciplinary and complex. Evidence indicates that staff nurses may benefit from additional training in the nutritional management of patients with diabetes. In addition, unlicensed assistive personnel may be involved in the feeding and point-of-care testing of diabetic patients and thus play an important role in nursing care of such patients. Cognitive load theory assists educators in the identification of specific cognitive challenges that learners may face when presented with new material, but it also presents solutions to such challenges by way of specific instructional design methods to help overcome them. An educational program was piloted on a mixed audience of registered nurses and unlicensed assistive personnel at a community hospital; satisfaction with the program was found to be high.

Functional Assessment and Intervention by Nursing Assistants in Hospice and Palliative Care Inpatient Care Settings: A Quality Improvement Pilot Study.

This study assessed the impact of a nursing assistant-led functional intervention in an urban hospice. Thirty-three patients participated. A physical therapist trained 4 nursing assistants to assess 4 basic functional activities at admission and discharge and to provide daily activity training to intervention group participants. Control group participants were assessed at admission and discharge and received the usual standard of care. Both groups improved. The intervention group participants demonstrated significant improvement in the Timed up and Go test as well as their self-reported ability to achieve goals on the Patient-Specific Functional Scale. Control group participants made significant improvements in the ability to move from supine to sit in bed. These findings suggest that nursing assistants can provide activity-based assessment and intervention leading to improved function among patients in hospice.

Dying With Carolyn: Using Simulation to Improve Communication Skills of Unregulated Care Providers Working in Long-Term Care.

This article examines the development, implementation, and evaluation of a pilot project utilizing high-fidelity simulation (HFS) to improve frontline staff members' confidence and skills to communicate about death and dying in long-term care homes. The target group was unregulated care providers who provide palliative care for residents and their families. Eighteen participants engaged in the educational intervention and evaluation. Results supported the effectiveness of HFS as an educational tool for unregulated health care providers. Quantitative data showed statistically significant improvements in participants' self-efficacy scores related to communicating about death and dying and end-of-life care. Qualitative data indicated that the experience was a valuable learning opportunity and helped participants develop insights into their own values, beliefs, and fears providing end-of-life care. HFS is therefore recommended as an innovative training strategy to improve palliative care communication in long-term care homes.

Ensino da sistematização da assistência de enfermagem aos técnicos de enfermagem / Teaching the systematization of nursing care to nursing technicians / Enseñanza de la Sistematización de la Atención de Enfermería a los técnicos de enfermería

Objetivo: Compreender o típico ideal de técnicos de enfermagem acerca da sistematização da assistência de enfermagem (SAE), à luz do referencial teórico de Alfred Schutz. Métodos: Trata-se de uma investigação fenomenológica. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da UFRN. A coleta de dados ocorreu por grupo focal, em fevereiro de 2013, de acordo com a pedagogia vivencial humanescente, com trezes técnicos de enfermagem de um hospital universitário norte-riograndense. Resultados: A análise das falas, dos cartazes e das descrições escritas permitiu desvelar o típico ideal a partir de quatro eixos: tipificação do conceito da SAE; benefícios da SAE - os motivos-para acreditar na positividade dessa ferramenta de trabalho; problemas vivenciados, reveladores do mundo vida cotidiano dos profissionais de enfermagem; e possibilidades de melhoria. Conclusão: Concluiu-se que o técnico de enfermagem, apesar de ter tido uma formação acadêmica que não enfatizou os aspectos concernentes à SAE, acredita em sua positividade.

Objective: To understand the typical ideal of nursing staff about the systematization of nursing care (SAE) in the light of the AlfredSchutz's theoretical framework. Methods: This is a phenomenological investigation. The study was approved by the ResearchEthics Committee of UFRN (Federal University of Rio Grande do Norte). The data were collected by focus group in February2013, according to experiential pedagogy humanescent with thirteen nursing staff of a university hospital of Rio Grande do Norte.Results: The analysis of discourse, from posters and written descriptions allowed to reveal the typical ideal of participants fromfour axes: typifying the concept of SAE; benefits of SAE, which resulted in the reasons to believe in the positive-that workingtool; problems experienced, revealing the world of everyday life of nursing professionals, and possibilities of improvement.Conclusion: It was concluded that the nursing technician believes in the benefits of SAE.

Objetivo: Comprender el típico ideal de los técnicos en enfermería acerca de la Sistematización de la Atención de Enfermería(SAE) a la luz del referencial teórico de Alfred Schutz. Métodos: Investigación fenomenológica aprobada por el Comité de Éticaen Investigación de UFRN (Universidad Federal de Rio Grande do Norte). Los datos fueron recolectados en Febrero de 2013a partir de un grupo focal compuesto por trece técnicos de enfermería de un hospital universitario de Rio Grande do Norte yrealizado de acuerdo con la pedagogía experiencial humanescente. Resultados: El análisis del discurso, carteles y descripcionesescritas permitieron revelar el típico ideal de los participantes a partir de cuatro ejes: tipificación conceptual de la SAE;beneficios de la SAE; problemas del cotidiano de los profesionales de enfermería; oportunidades de mejora. Conclusión: Eltécnico de enfermería cree en los beneficios de la SAE, aunque su formación académica no haya enfatizado estos aspectos.

Applying a palliative care approach in residential care: effects on nurse assistants' work situation.

OBJECTIVES: The aim was to investigate the effects of an intervention that applies a palliative care approach in residential care upon nurse assistants' level of strain, job satisfaction, and view of leadership. METHOD: A quasi-experimental, pretest and posttest design was used. Study circles with workshops involving nurse assistants (n = 75) and their superiors (n = 9) focusing on emotional and existential issues in palliative care were evaluated using a questionnaire answered by the nurse assistants at baseline (November 2009), post-intervention (May 2010), and six-month follow-up (November 2010) in comparison with controls (n = 110). RESULTS: Directly after the intervention, the job satisfaction of the nurse assistants decreased and they perceived the leadership more negatively than before the intervention. Six months later, strain as a result of criticism from residents and their superiors and having difficulty in balancing emotional involvement had decreased. SIGNIFICANCE OF RESULTS: The intervention initially seemed to decrease the well-being of the nurse assistants, which could be the result of their increased awareness of the residents' and relatives' needs, in combination with limited support. More emphasis should be placed on the role of leadership when implementing changes in practice.

Conhecimento da equipe de enfermagem sobre avaliação comportamental de dor em paciente crítico / Conocimiento del equipo de enfermería en la evaluación del comportamiento del dolor en el paciente crítico / Nursing team knowledge on behavioral assessment of pain in critical care patients

Estudo transversal prospectivo que teve como objetivo descrever o conhecimento da equipe de enfermagem sobre uma avaliação comportamental de dor. Realizado em hospital privado da cidade de São Paulo, Brasil, em novembro de 2011, com profissionais de enfermagem de uma UTI geral adulto. Estes responderam a um questionário com dados sociodemográficos e questões referentes ao conhecimento sobre uma avaliação comportamental de dor. A análise dos dados foi descritiva e a média de acertos por categoria profissional foi comparada por teste Mann-Whitney. Dos 113 participantes, mais de 70% demonstraram ter conhecimento sobre os principais aspectos dessa avaliação e não houve diferença estatisticamente significativa entre as categorias profissionais. Concluiu-se que o conhecimento dos profissionais foi satisfatório, mas pode ser aprimorado.

Estudio transversal prospectivo que tuvo como objetivo describir el conocimiento del equipo de enfermería con relación a evaluación del comportamiento del dolor. Realizado en un hospital privado de la ciudad de São Paulo, Brasil en noviembre de 2011 con profesionales de enfermería de una UTI general adulto. La población estudiada respondió a un cuestionario con datos demográficos y preguntas relacionadas al conocimiento sobre una evaluación de comportamiento del dolor. El análisis de datos fue descriptivo y el promedio de aciertos por categoría profesional fue comparado por el test de Mann-Whitney. De los 113 participantes, el 70% demostró el conocimiento de los principales aspectos de esta evaluación y no hubo diferencia estadísticamente significativa entre las categorías profesionales. Se concluye que el conocimiento de los profesionales era satisfactorio, pero se puede mejorar.

This investigation consisted on a prospective cross-sectional study that aimed to describe the nursing team knowledge on behavioral assessment of pain. The study was conducted in a private hospital in the city of São Paulo, Brazil, in November 2011, with nursing professionals from a general adult intensive care unit. They answered a questionnaire that contained sociodemographic data and questions related to knowledge about a behavioral assessment of pain. Descriptive data analysis was carried out and the average positive score was compared among categories using the Mann-Whitney test. Out of the 113 participants, over 70% have demonstrated knowledge of the main aspects of this assessment and there was no statistical significant difference among the professional categories. It was concluded that the knowledge of the professionals was satisfactory, but it can be improved.