Anais da II Mostra Estadual de Educação Permanente em Saúde e I Mostra de Pesquisa Científica em Saúde: ciência e educação na saúde: transformando práticas / Proceedings of the 2nd State Exhibition of Permanent Education in Health and 1st Exhibition of Scientific Research in Health: science and education in health transforming practices

Anais da segunda Mostra Estadual de Educação Permanente em Saúde e da primeira Mostra de Pesquisa Científica em Saúde: Ciência e educação na saúde: transformando práticas realizadas em 7 e 8 de dezembro de 2022 em Palmas no Tocantins. Os temas abordados tratam de diferentes aspectos da área de saúde e suas práticas, com foco em melhorias nos processos de assistência, educação e gestão. São mencionados temas como primeiros socorros, humanização do atendimento hospitalar, segurança do paciente, planejamento estratégico, coleta de exames, regulamentação do trabalho na área da saúde, aleitamento materno, vigilância alimentar e nutricional, impactos da Covid-19, saúde mental, assistência odontológica, saúde do trabalhador, uso de tecnologia na capacitação em saúde, entre outros. As propostas e experiências relatadas buscam aprimorar a qualidade da assistência e dos serviços de saúde prestados à população, por meio da capacitação, atualização e aperfeiçoamento de profissionais, implementação de políticas públicas e melhoria dos processos de gestão e atendimento.

Proceedings of the Second State Exhibition on Permanent Education in Health and the First Scientific Research Exhibition in Health: Science and Education in Health: Transforming Practices held on December 7th and 8th, 2022, in Palmas, Tocantins. The topics covered deal with different aspects of the health field and its practices, focusing on improvements in the processes of assistance, education, and management. Topics such as first aid, humanization of hospital care, patient safety, strategic planning, examination collection, regulation of work in the health area, breastfeeding, food and nutritional surveillance, impacts of Covid-19, mental health, dental care, occupational health, use of technology in health training, among others, are mentioned. The proposals and experiences reported aim to improve the quality of assistance and health services provided to the population, through training, updating, and professional development, implementation of public policies, and improvement of management and care processes.

Actas de la Segunda Exhibición Estatal sobre Educación Permanente en Salud y la Primera Exhibición de Investigación Científica en Salud: Ciencia y Educación en Salud: Transformando Prácticas realizadas el 7 y 8 de diciembre de 2022 en Palmas, Tocantins. Los temas tratados abordan diferentes aspectos del campo de la salud y sus prácticas, enfocándose en mejoras en los procesos de asistencia, educación y gestión. Se mencionan temas como primeros auxilios, humanización de la atención hospitalaria, seguridad del paciente, planificación estratégica, recolección de exámenes, regulación del trabajo en el área de la salud, lactancia materna, vigilancia alimentaria y nutricional, impactos del Covid-19, salud mental, atención dental, salud ocupacional, uso de tecnología en la capacitación en salud, entre otros. Las propuestas y experiencias reportadas buscan mejorar la calidad de la asistencia y los servicios de salud proporcionados a la población, a través de la capacitación, actualización y desarrollo profesional, implementación de políticas públicas y mejora de los procesos de gestión y atención.

Comparison of specialties participating in the BEST-CLI trial to specialists treating peripheral arterial disease nationally.

BACKGROUND: The Best Endovascular vs Best Surgical Therapy for Patients with Critical Limb Ischemia (BEST-CLI) trial compares open surgery and endovascular therapy for the treatment of critical limb ischemia (CLI). This report describes the types and proportion of investigators participating in BEST-CLI and determines how these compare with those specialists treating peripheral artery disease (PAD) outside of the trial. METHODS: To be credentialed to enroll in BEST-CLI, investigators must be approved by the Surgical and Interventional Management Committee to have sufficient experience and skill in the management of patients with CLI. Investigators must attest to having completed at least 12 below-knee interventions in the last 2 years on CLI patients for endovascular approval and 10 lower extremity below-knee bypass procedures in the last 2 years for open surgical treatment. Investigators who met these criteria but were within their first year of practice were conditionally approved to do procedures under the oversight of a fully approved investigator. The type and proportion of specialists credentialed in BEST-CLI were compared with those treating PAD on a national basis by auditing 10% of Medicare claims for PAD. RESULTS: As of September 2017, a total of 865 physicians were credentialed to enroll in the BEST-CLI trial. Of these, 596 (69%) are vascular surgeons, 128 (15%) are interventional cardiologists, 123 (14%) are interventional radiologists, 7 (1%) are vascular medicine specialists, and 11 (1%) are other. Of the 596 vascular surgeons enrolling in the trial, 113 (19%) are credentialed for open surgery only, 409 (69%) are credentialed for both open surgery and endovascular therapy, and 3 (1%) are credentialed for only endovascular therapy. The remaining 71 participating vascular surgeons were conditionally approved. Of the 136 centers enrolling patients, multispecialty involvement is present in 98 (72%). In 38 (28%), vascular surgery alone is the service enrolling CLI patients. Endovascular treatment by specialty in BEST-CLI vs national Medicare claims is as follows: vascular surgery, 55% vs 51%; interventional cardiology, 17% vs 13%; interventional radiology, 16% vs 25%; and other, 2% vs 10%. CONCLUSIONS: BEST-CLI contains a diverse group of specialists enrolling and treating patients with CLI. Whereas a majority of the participating practitioners are vascular surgeons who do both open and endovascular procedures, a broad variety of specialists are represented in BEST-CLI in a pattern that represents national treatment patterns outside of the BEST-CLI trial. These treatment patterns will help ensure that findings from BEST-CLI are applicable to the real-world practice of treatments for PAD.

Pharmacist credentialing in pain management and palliative care.

A credential is documented evidence of a pharmacist's qualifications; while credentialing is the method used to acquire, confirm, determine, and document a pharmacist's qualifications to practice. Voluntary credentials are important in clinical pharmacy specialties to ensure proficiency in caring for patients with complex pharmacotherapy needs. This article discusses current and future pharmacy pain management and palliative care credentialing opportunities. Pharmacists wishing to pursue voluntary pain management and palliative care credentialing may elect to take a multidisciplinary pain credentialing exam offered by the American Society of Pain Educators (ASPE) or American Academy of Pain Management (AAPM) and/or complete an American Society of Health System Pharmacists (ASHP) Postgraduate Year 2 (PGY2) pain management and palliative care pharmacy residency. A palliative care credentialing exam is not currently available to pharmacists. Efforts are underway within the pharmacy profession to standardize the board certification process, design a pain and palliative certificate program, and create a specialty pain management and palliative care board certification examination.

Globalización y competitividad: contexto desafiante para la formación de enfermería / Globalization and competitivity: challenging context to nurses' professional education

En esto texto se trata de contextualizar la globalización y competitividad en cuanto a la formación de enfermería. Son discutidos los aspectos de nuestro tiempo con sus crisis, cambios veloces, desequilibrios por las transformaciones sociales y avances científicos y tecnológicos. La utopía de una esencial unión mundial non asegura los derechos civiles para todos, y aún menos la idea de ciudadanía, en todas las partes, principalmente en relación a los profesionales de enfermería y los clientes o usuarios del sistema de salud. Se discute a propósito los asuntos de la enfermería y la formación de recursos humanos como parte de la crisis. El abordaje es de análisis-discursiva con destaque para la globalización qui non es ecuánime para todos en el mondo y para la competitividad un desafío permanente los trabajadores en el campo de la salud. La autora non presenta resultados investigativos, pero asume su posición en relación a la formación de enfermería, para la cual presenta un modelo curricular adoptado en el Brasil. Un modelo de formación coherente con la función de enfermeros para emprender los cambios en la práctica asistencial, para la formación del espirito científico y para la investigación consistente con la producción de resultados y construcción del conocimiento para el área de enfermería.

Produção e difusão do conhecimento científico da enfermagem na atualidade: desafios e implicações na formação e qualificação do enfermeiro / Poduction and dissemination of nursing scientific knowledge today: challenges and implications for education and qualification of nurses

Para se discutir a produção e difusão do conhecimento de uma determinada área, tornam-se importantes e indispensáveisa sua articulação à pesquisa e o seu financiamento pelas agências nacionais de fomento encarregadas da política dedesenvolvimento da pós-graduação e da ciência e tecnologia, tendo em vista as áreas e estratégias prioritárias. Nessa lógica, a definição das prioridades de investimento em pesquisa se articula com a visão governamental sobre a ciência, a pesquisa e a tecnologia...

Trabalho e pessoas com deficiência: pesquisas, práticas e instrumentos de diagnóstico / Work and people with disabilities: research, practice and diagnostic tools

Este livro é o resultado do desenvolvimento de um conjunto de pesquisas e de articulações entre pesquisadores que têm investigado sobre a inserção de pessoas com deficiência no mercado de trabalho em várias regiões do Brasil. Traz ainda pesquisas desenvolvidas com pessoas que apresentam deficiência, tanto em situações de desemprego quanto inseridas no mercado de trabalho; práticas de inclusão desenvolvidas em organizações; perspectivas de análise do processo e instrumentos de diagnóstico que poderão ser utilizados tanto em pesquisas quanto em intervenções. O conteúdo do livro tangencia tópicos da Psicologia Organizacional e do Trabalho, da Administração, da Ergonomia, da Educação Corporativa, da Educação Especial e das Políticas Públicas. Diversas possibilidades são exploradas e questões novas são levantadas sobre a temática abordada. Trata-se de uma fonte inédita e valiosa para todos os interessados na inserção de pessoas com deficiência no mundo do trabalho.

Qualificação e competências do enfermeiro na área cardiovascular: o caso do Instituto Nacional de Cardiologia / Nurse´ s qualification and competences in the cardiovascular area: the case of the Instituto Nacional de Cardiologia

Este estudo aborda o processo de organização da prática da enfermagem em uma unidade hospitalar especializada em cardiologia e aprofunda a abordagem naestruturação do saber e do saber fazer. Objetivos: identificar como está organizada a prática dos enfermeiros que atuam em uma unidade hospitalar de alta complexidade cardiovascular; caracterizar as competências dos enfermeiros na área cardiovascular;identificar os meios utilizados pelos enfermeiros na busca de qualificação profissional na área cardiovascular e discutir a relação entre a qualificação e competências dos enfermeiros na área cardiovascular. Adotamos conceitos defendidos por educadores como Perrenoud, Thurler, Macedo, Machado, Allessandrini e Deluiz, enfermeiroscomo Benner, Valadares, Assad, Santos, Mattos e Waldow, que nos deram suporte a discutir questões pertinentes à qualificação profissional e aquisição de competências, além de conceitos formulados por Pierre Bourdieu: campo, habitus e capital. Trata-se de um estudo descritivo, de natureza qualitativa do tipo estudo de caso. Os sujeitosforam enfermeiros em atuação no Instituto Nacional de Cardiologia. A coleta de dados foi realizada através de entrevista com a utilização de questionário e obedeceu as normas éticas e legais preconizadas...

Simulation-based endovascular skills assessment: the future of credentialing?

OBJECTIVES: Simulator-based endovascular skills training measurably improves performance in catheter-based image-guided interventions. The purpose of this study was to determine whether structured global performance assessment during endovascular simulation correlated well with trainee-reported procedural skill and prior experience level. METHODS: Fourth-year and fifth-year general surgery residents interviewing for vascular fellowship training provided detailed information regarding prior open vascular and endovascular operative experience. The pretest questionnaire responses were used to separate subjects into low (<20 cases) and moderate (20 to 100) endovascular experience groups. Subjects were then asked to perform a renal angioplasty/stent procedure on the Procedicus Vascular Intervention System Trainer (VIST) endovascular simulator (Mentice Corporation, Gothenburg, Sweden). The subjects' performance was supervised and evaluated by a blinded expert interventionalist using a structured global assessment scale based on angiography setup, target vessel catheterization, and the interventional procedure. Objective measures determined by the simulator were also collected for each subject. A postsimulation questionnaire was administered to determine the subjects' self-assessment of their performance. RESULTS: Seventeen surgical residents from 15 training programs completed questionnaires before and after the exercise and performed a renal angioplasty/stent procedure on the endovascular simulator. The beginner group (n = 8) reported prior experience of a median of eight endovascular cases (interquartile range [IQR], 6.5-17.8; range, 4-20), and intermediate group (n = 9) had previously completed a median of 42 cases (IQR, 31-44; range, 25-89, P = .01). The two groups had similar prior open vascular experience (79 cases vs 75, P = .60). The mean score on the structured global assessment scale for the low experience group was 2.68 of 5.0 possible compared with 3.60 for the intermediate group (P = .03). Scores for subcategories of the global assessment score for target vessel catheterization (P = .02) and the interventional procedure (P = .05) contributed more to the differentiation between the two experience groups. Total procedure time, fluoroscopy time, average contrast used, percentage of lesion covered by the stent, placement accuracy, residual stenosis rates, and number of cine loops utilized were similar between the two groups (P > .05). CONCLUSION: Structured endovascular skills assessment correlates well with prior procedural experience within a high-fidelity simulation environment. In addition to improving endovascular training, simulators may prove useful in determining procedural competency and credentialing standards for endovascular surgeons.

Revalidação do título de especialista / Specialist's title revalidation

Neste artigo os autores discutem aspectos relacionados à revalidação do título de especialista, destacando a sua importância e fazendo um breve histórico do processo em nosso País.

Education and credentialing in respiratory care: where are we and where should we be headed?

Respiratory care is indeed at a crossroads. The profession will continue to develop by advancing the education and credentialing needed to function as physician extenders-true cardiopulmonary physician's assistants. As such, the respiratory therapist of the future will focus on patient assessment,care plan development, protocol administration, disease management and rehabilitation, and patient and family education, including tobacco education and smoking cessation. Respiratory therapists, through primary, secondary, and tertiary prevention activities, can positively affect peoples'quality of life. This advanced level professional will work in the intensive-and acute-care settings, applying sophisticated cardiopulmonary technologies, as well in clinics, physician offices, home care, long-term and rehabilitation facilities, industry, educational institutions, and research facilities. The alternative to this advanced practice is for the profession to remain a task-oriented technical field, focused on procedures and the technical aspects of oxygen and aerosol therapy, mechanical ventilatory support, and related diagnostic and monitoring techniques. Although there is a dignified and important role for the provision of the technical aspects of respiratory care, the authors believe that the future role of the respiratory specialist is that of physician extender. Higher-order performance will result in higher-order contributions to health care. This role will require increased numbers of baccalaureate and graduate degree programs in respiratory care and increased numbers of respiratory therapists who hold higher degrees,including the master's degree in respiratory care and doctoral degrees in related fields. Community colleges, 4-year colleges, and universities should be encouraged to develop effective articulation agreements and mechanisms to offer the bachelor of science degree in respiratory care to the community college student. Professional associations and accrediting agencies should promote the development of additional baccalaureate and master's degree programs in respiratory care. Education is best defined as positive behavior change. Amplified education can only improve the ability of respiratory therapists to contribute to the cardiopulmonary health of people worldwide.

Processo ensino-aprendizagem da assitência de enfermagem: açäo e reflexäo sobre a realidade com o corpo discente / Teaching-learning process of nurding assistance: action and reflection on the reality with students

O presente estudo teve dois objetivos principais: desenvolver uma prática assistencial educativa de enfermagem, e desvelar o processo ensino-aprendizagem da assistência de enfermagem, conforme percepçäo do corpo discente do ciclo profissionalizante da Faculdade de Enfermagem do Vale do Itajaí. Para o desenvolvimento deste trabalho, construiu-se um marco conceitual fundamentado na proposta pedagógica de Paulo Freire, e foi implementado através do processo de açäo e reflexao, orientado pelo seu itinerário de pesquisa. Através da realizaçäo do Círuculo de Cutura (Primeira etapa) e do diálogo efetuado com cada aluno, seguido da aplicaçäo de questionário (Segunda etapa) aos nove alunos participantes do estudo, levantaram-se e discutiram-se diversos temas geradores relacionados ao processo ensino-aprendizagem. A partir das discussöes efetuadas e mediante a concepçäo deste grupo, o qual näo representa a totalidade dos alunos do curso, ficou evidente que o ensino na escola estudada ainda permanece conservador, embora aponte indícios de avanço, no sentido de buscar caminhos para a sua melhoria. Percebe-se a necessidade de mudanças na escola visando o desenvolvimento de um processo educativo que gere indivíduos mais críticos e capazes de transformar a sua realidade. O exercício realizado no Círculo de Cultura despertou o espírito crítico nos integrantes do grupo e os auxiliou a tornarem-se mais participativos do processo ensino-aprendizagem que vivenciam.