Diagnostico de competencia transversal autoevaluada de las y los tutores clínicos de Especializaciones en Enfermería / Diagnóstico da competência transversal autoavaliada dos tutores clínicos das Especializações de Enfermagem / Diagnosis of self-assessed transversal competence of clinical tutors of Nursing Specializations

Introducción: La evaluación diagnóstica de competencias transversales de los tutores clínicos de especialización en enfermería es necesaria para sistematizar la práctica clínica, en la cual un especialista acompaña a sus estudiantes. Objetivo: Analizar la competencia transversal de las y los Tutores Clínicos del Programa Único de Especializaciones en Enfermería de la UNAM. Metodología: Cuantitativo, descriptivo y transversal. Se diseñó y validó por jueces la "Escala de Autoevaluación de Competencias Transversales de la y el Tutor Clínico de Especialización en Enfermería". La muestra se obtuvo a partir de la fórmula de poblaciones finitas, y participaron 95 Tutores Clínicos del PUEE-UNAM. La recolección de los datos se llevó a cabo en noviembre del 2022 y se analizaron los datos a través del programa estadístico "IBM SPSS Statistics". Resultados: Los resultados muestran que 73% fueron mujeres y 27% hombres, 56% cuenta con actualización docente mediante cursos, diplomados o certificaciones. Con respecto a la competencia transversal, las y los tutores clínicos promediaron un 88.87% en "Nivel alto". Aunque en general la valoración de las competencias fue alta, se identificaron competencias con porcentajes bajos: Capacidad para diseñar escenarios de aprendizaje del cuidado especializado (68.40%), Capacidad para evaluar el aprendizaje en el entorno práctico (71.60%), Capacidad para promover el trabajo colaborativo (76.80%). Conclusiones: El diagnóstico de la competencia transversal de las y los tutores clínicos del PUEE-UNAM muestra que existen áreas de fortaleza y de oportunidad que demandan capacitación y formación continua en capacidades docentes, socioafectivas e interpersonales

Introduction: The diagnostic evaluation of transversal competencies of clinical tutors specializing in nursing is necessary to systematize clinical practice, in which a specialist accompanies their students. Objective: Analyze the transversal competence of the Clinical Tutors of the Unique Program of Specializations in Nursing of the UNAM. Methodology: Quantitative, descriptive and transversal. The "Self-Evaluation Scale of Transversal Competencies of the Nursing Specialization Clinical Tutor" was designed and validated by judges. The sample was obtained from the finite population formula, and 95 Clinical Tutors from PUEE-UNAM participated. Data collection took place in November 2022 and the data was analyzed through the statistical program "IBM SPSS Statistics". Results: The results show that 73% were women and 27% men, 56% have teaching updating through graduate courses or certifications. Regarding transversal competence, the clinical tutors averaged 88.87% in "High level". Although in general the assessment of the competencies was high, competencies with low percentages were identified: Ability to design specialized care learning scenarios (68.40%), Ability to evaluate learning in the practical environment (71.60%), Ability to promote collaborative work (76.80%). Conclusions: The diagnosis of the transversal competence of the PUEE-UNAM clinical tutors shows that there are areas of strength and opportunity that demand training and continuous training in teaching, socio-affective and interpersonal skills

Introdução: A avaliação diagnóstica das proficiências interdisciplinares dos tutores clínicos de especialização em enfermagem é necessária para sistematizar a prática clínica, na qual um especialista acompanha os seus estudantes. Objetivo: Analisar a proficiência transversal das e dos Tutores Clínicos do Programa Único de Especializações em Enfermagem da UNAM. Metodologia: Quantitativa, descritiva e interdisciplinar. Juízes desenharam e validaram a "Escala de Autoavaliação de Competências Transversais da e do Tutor Clínico de Especialização em Enfermagem. A amostra foi obtida a partir da fórmula de populações finitas, da qual participaram 95 Tutores Clínicos do PUEE-UNAM. A compilação de dados foi feita em novembro de 2022, na qual foram analisados dados mediante o programa estatístico "IBM SPSS". Resultados: Os resultados mostram que, do total de participantes, 73% foi de mulheres e 27% de homens; 56% conta com atualização docente ­ obtida mediante cursos, programas de graduação ou certificações. No que diz respeito à competência transversal, 88,87% das e dos tutores clínicos atingiu o "Nível Alto". Embora a apreciação tenha sido alta em geral, foram também identificadas percentagens baixas: Capacidade para projetar cenários de aprendizado de cuidado especializado (68,40%), Capacidade para avaliar o aprendizado em uma atmosfera prática (71,60%), Capacidade para promover o trabalho colaborativo (76,80%). Conclusões: O diagnóstico da competência transversal das e dos tutores clínicos do PUEE-UNAM demonstra que existem áreas de fortaleza e de oportunidade para melhorar que precisam de capacitação e de formatura contínua em capacidades docentes, socioafetivas e interpessoais

Facilitadores y barreras para el uso de la práctica basada en evidencia / Facilitators and barriers to the use of evidence-based practice / Facilitadores e barreiras ao uso de práticas baseadas em evidências

Objetivo: Conocer los facilitadores y barreras para el uso de la práctica basada en evidencia (PBE) en profesionales de enfermería que laboran en el área clínica. Método: Estudio cuali-tativo de tipo exploratorio descriptivo, con análisis de discurso, se realizaron 6 grupos focales conformados por 3 a 7 participantes para un total de 32 personas, se utilizó un muestreo inten-cional; en promedio fueron grabados entre 60 a 90 minutos por grupo focal. Para el análisis se empleó la fragmentación, codificación y categorización de las entrevistas obteniendo categorías temáticas, subcategorías y códigos a partir del uso del programa Atlas Ti versión 8. Resultados: El 69 % de los entrevistados respondió que el pregrado o posgrado habían recibido algún tipo de formación en PBE, la principal fuente de información cuando tienen alguna duda en la práctica clínica son los protocolos institucionales o los compañeros con más experiencia. Los facilitado-res identificados en este estudio fueron: tiempo para investigar, formación en PBE, iniciativa, grupos de investigación y compañeros; las barreras fueron: falta de apoyo institucional, poca formación en PBE, falta de tiempo, idioma, desmotivación profesional y el rechazo frente al cambio. Conclusiones: Se describen los facilitadores y barreras que presentan los profesionales de enfermería que laboran en el área clínica. Sin embargo se requieren investigaciones adicion-ales que permitan reconocer el fenómeno desde otras perspectivas en el contexto Colombiano y latinoamericano

Objective: To find out the facilitators and barriers to the use of evidence-based practice (EBP) in nursing professionals working in the clinical area. Method: Qualitative descrip-tive exploratory study, with discourse analysis, 6 focus groups were carried out with 3 to 7 participants for a total of 32, a purposive sampling was used; an average of 60 to 90 minutes were recorded per focus group. For the analysis we used the fragmentation, coding and cate-gorisation of the interviews obtaining thematic categories, subcategories and codes from the use of Atlas Ti version 8. Results: 69 % of the interviewees responded that the undergraduate or postgraduate had received some kind of training in EBP, the main source of information when they have any doubt in clinical practice are the institutional protocols or colleagues with more experience. Facilitators identified in this study were: time to investigate, training in EBP, initiative, research groups and peers; barriers were: lack of institutional support, little training in EBP, lack of time, language, professional demotivation and rejection in the face of change. Conclusions: The facilitators and barriers presented by nursing professionals working in the clinical area are described. However, further research is needed to recognise the phenomenon from other perspectives in the Colombian and Latin American context.

Objetivo: Descobrir os facilitadores e as barreiras ao uso da prática baseada em evidências (PBE) em profissionais de enfermagem que atuam na área clínica. Método: Estudo exploratório descritivo qualitativo, com análise de discurso; foram realizados 6 grupos focais com 3 a 7 participantes, totalizando 32; foi usada uma amostragem intencional; foi registrada uma média de 60 a 90 minutos por grupo focal. Para a análise utilizou-se a fragmentação, codificação e categorização das entrevistas obtendo-se categorias temáticas, subcategorias e códigos a partir da utilização do Atlas Ti versão 8. Resultados: 69% dos entrevistados responderam que a grad-uação ou pós-graduação havia recebido algum tipo de treinamento em PBE, a principal fonte de informação quando têm alguma dúvida na prática clínica são os protocolos institucionais ou colegas com mais experiência. Os facilitadores identificados neste estudo foram: tempo para in-vestigar, treinamento em PBE, iniciativa, grupos de pesquisa e colegas; as barreiras foram: falta de apoio institucional, pouco treinamento em PBE, falta de tempo, idioma, desmotivação profis-sional e rejeição diante de mudanças. Conclusões: São descritos os facilitadores e as barreiras apresentados pelos profissionais de enfermagem que trabalham na área clínica. No entanto, são necessárias mais pesquisas para reconhecer o fenômeno de outras perspectivas no contexto co-lombiano e latino-americano

High-fidelity simulation: A practice model for nurse educators at a South African private higher education institution

Background. The clinical skills development of student nurses is one of many challenges facing nursing education owing to a lack of available clinical placements and learning opportunities. Simulation training as an optional teaching-learning method creates an environment where clinical skills are developed and students are prepared for the nursing profession. The successful implementation of high-fidelity simulation (HFS) strategies as part of the nursing curricula requires nurse educators to have knowledge and skills. At the South African private higher education institution (SAPHEI) where the research for this study was done, it became evident that nurse educators do not have the required knowledge, skills or support to implement HFS. The absence of evidence in the literature of a practice model for a SAPHEI to facilitate the implementation of HFS reveals a gap in the practice base of nursing education.Objective. To develop a practice model for nurse educators at a SAPHEI to facilitate the implementation of HFS.Methods. The researcher used a theory-generative research design. The study was conducted in two phases, with two steps in each phase, to address four objectives in all.Results. Phase 1 identified and described the main and related concepts. A resulting conceptual framework was used for the development of the practice model. Phase 2 addressed the relational meaning of the main and related concepts, as well as the construction of the practice model through theory synthesis.Conclusion. The main aim of this research study was to develop a practice model for nurse educators at a SAPHEI to facilitate the implementation of HFS as part of the clinical skills development of student nurses. The practice model offers a schematic outline that represents HFS as a teaching-learning method. The importance of the outline lies therein that it specifies the context and situations in which the model is useful

A Glance at the Barriers and Enablers of the Nursing Role in Pandemics: An Integrative Review Authors / Una mirada a las barreras y los factores facilitadores del rol de la enfermería en las pandemias: revisión integrativa / Uma visão às barreiras e aos fatores facilitadores do papel da enfermagem nas pandemias: revisão integrativa

Objetivo: analizar los factores facilitadores y las barreras para el cumplimiento del rol profesional de las enfermeras y enfermeros en tiempos de pandemia y desastres. Material y método: revisión integrativa según método analítico SALSA, realizada en ocho bases de datos: Medline, Proquest, CINAHL, Web of Science, BVS, SpringerLink, Scopus y Pubmed. Los descriptores utilizados fueron: 'rol de la enfermera' AND 'pandemia' AND 'paciente' AND 'infección por coronavirus', en idiomas inglés, español y portugués. A los 11.031 artículos encontrados se aplicaron filtros y criterios de inclusión y exclusión; después de ello un total de 32 artículos conformaron la muestra final. Resultados: considerando los objetivos planteados y los resultados obtenidos, se advierte que todas las acciones se enfocaban en tres instancias principales: a) formación y actualización para el desempeño del rol; b) factores predictores, facilitadores y barreras para ejercer el rol frente a una pandemia; y c) evidencia el rol frente a pandemias. Conclusión: este estudio hizo posible conocer, tanto las barreras, como los aspectos facilitadores que permiten el cumplimiento del rol profesional de enfermería frente a pandemias o catástrofes. Además, dejo claro que las enfermedades infecciosas emergentes deben abordarse en forma inmediata, colaborativa y multidisciplinaria. La experiencia, el liderazgo y la formación profesional de enfermeras y enfermeros son atributos claves que estos profesionales poseen, para permitir que su rol sea más proactivo durante una situación de emergencia.

Objective: to analyze the enablers and barriers to nurses' professional role fulfillment during pandemics and disasters. Materials and methods: this was an integrative review based on the SALSA analytical method, carried out in eight databases, namely: Medline, Proquest, CINAHL, Web of Science, BVS, SpringerLink, Scopus, and Pubmed. The descriptors used were the following: 'nurse's role' AND 'pandemic' AND 'patient' AND 'coronavirus infection', in English, Spanish and Portuguese. Filters along with inclusion and exclusion criteria were applied to the 11,031 articles found, after which the final sample consisted of a total of 32 articles. Results: considering the objectives set and the results obtained, it is noted that all actions focused on three main instances, namely: a) training and updating for role performance; b) predictors, enablers, and barriers for exercising the role in the face of a pandemic; and c) evidence of the role in the face of pandemics. Conclusion: this study allowed understanding both the barriers and the enablers that allow the fulfillment of nurses' professional role in the face of pandemics or catastrophes. It also clarified that emerging infectious diseases must be addressed in an immediate, collaborative, and multidisciplinary way. Nurses' experience, leadership, and professional training are key attributes that these professionals possess to enable their role to be more proactive during an emergency situation.

Objetivo: analisar os fatores facilitadores e as barreiras para o cumprimento do papel profissional de enfermeiros e enfermeiras em tempos de pandemia e desastres. Materiais e método: revisão integrativa segundo método analítico SALSA, realizada em oito bases de dados: Medline, Proquest, CINAHL, Web of Science, BVS, SpringerLink, Scopus e PubMed. Os descritores utilizados foram: "papel da enfermeira" AND "pandemia" AND "paciente" AND "infecção por coronavírus", em inglês, espanhol e português. Aos 11 031 artigos encontrados, foram aplicados filtros e critérios de inclusão e exclusão. Depois disso, 32 artigos conformaram a amostra final. Resultados: considerando os objetivos propostos e os resultados, constata-se que todas as ações se enfocavam em três instâncias principais: a) formação e atualização para o desempenho do papel; b) fatores preditores, facilitadores e barreiras para exercer o papel ante uma pandemia e c) evidência do papel profissional ante pandemias. Conclusões: este estudo torna possível conhecer tanto as barreiras quanto os aspectos facilitadores que permitem o cumprimento do papel do profissional de enfermagem ante pandemias e catástrofes. Além disso, deixa claro que as doenças infecciosas emergentes devem ser abordadas de forma imediata, colaborativa e multidisciplinar. A experiência, a liderança e a formação profissional de enfermeiras e enfermeiros são atributos-chave desses profissionais para permitir que seu papel seja mais proativo durante uma emergência.

Adverse reactions to food: navigating the maze in primary health care

Primary health care providers are often confronted with patients describing adverse reactions to food. With a multiplex of differential diagnoses, it is essential to have a structured approach to these complaints. Just as allergies can have a negative impact on quality of life, inappropriate food allergy labelling can cause unnecessary distress and hardship for patients. Understanding the diagnostic approaches to adverse food reactions, alongside an appreciation of multidisciplinary collaboration, can assist the clinician in making appropriate decisions in the management of these patients. Keywords: food allergy; food hypersensitivity; food intolerance; allergy-focused history; allergy diagnosis.

Enfermería, pandemia y fatiga por compasión: una reflexión general sobre el 2020 / Nursing, Pandemic, and Compassion Fatigue: A General Reflection on 2020 / Enfermagem, pandemia e fadiga por compaixão: uma reflexão geral sobre 2020

La actual pandemia por COVID-19 ha significado para los profesio-nales de la enfermería un escenario en el que se ha hecho evidente el impacto que el ejercicio profesional puede tener sobre su cali-dad de vida. Justo cuando el 2020 fue escogido por la Organización Mundial de Salud como el año de la enfermería, se ha evidenciado un panorama poco favorecedor para el ejercicio del cuidado, en el que no sólo se han visto afectados pacientes, familias, sistemas de salud, sino también los propios profesionales que prestan atención a pacientes diagnosticados con el nuevo virus. En el presente artículo de reflexión se realizó un análisis de uno de los efectos de las con-diciones actuales de trabajo de los profesionales de enfermería: la fatiga por compasión, la cual constituye una afectación de la calidad de vida; también se presentan las recomendaciones actuales disponi-bles, para hacer frente a este fenómeno en Colombia

The current COVID-19 pandemic has meant for nursing professio-nals a scenario in which the impact that professional practice can have on their quality of life has become evident. Just when 2020 was chosen by the WHO (World Health Organization) as the year of nursing, an unflattering panorama has been evidenced for the exercise of care in which not only patients, families, health systems have been affected, but also the professionals who care for patients diagnosed with the new virus. In this reflection article, an analysis of one of the effects of the current working conditions of nursing professionals was carried out: compassion fatigue, which constitutes an impairment of the quality of life, as well as the current recommendations available to make faced with this phenomenon in Colombia

A atual pandemia pela COVID-19 tem significado para os enfermeiros profissionais um senário que evidenciou o impacto do exercício profissional pode ter sobre a qualidade de vida. Justo quando o 2020 foi escolhido pela Organização Mundial da Saúde como o ano da enfermagem, tem se evidenciado um panorama pouco favorecedor para o exercício de prestar cuidados, onde não só os pacientes, famílias e sistemas de saúde têm sido os afetados, como também os profissionais que prestam atenção aos diagnosticados com o novo vírus. No presente artigo de reflexão realizou-se uma análise dos efeitos das condições atuais de trabalho dos profissionais de enfermagem: a fadiga por compaixão, constituindo uma afetação da qualidade de vida; tam-bém se apresentam as recomendações atuais disponíveis, para fazer frente a esse fenômeno em Colômbia.

Nursing representativity in television health series / Representatividad de la enfermería en las series de televisión sobre salud / Representatividade da enfermagem nos seriados de saúde da televisão

ABSTRACT Objective: to analyze how nursing is represented by the series that portray the context of clinical health care. v Method: a descriptive, exploratory study carried out in a public Higher Education Institution. Data collection was carried out through semi-structured interviews with nursing students. Data analysis was performed through content analysis, supported by IRAMUTEQ version 0.7 and Statistical Package for the Social Sciences version 22.0 software. Results: the analysis of the data allowed for the identification of two categories directly related to the role of nursing and to the power relations between the characters. Yet, although television series are common among nursing students, they have not influenced them in choosing the course. However, the positive perception on the part of some interviewees was related to admiration for the field of human health, but not with the nursing characters represented in the television shows. Conclusion: nursing in health series is not perceived as a leading category in its responsibilities in the care process, but only as an auxiliary group. It is noticed that the media reproduces the biomedical model, emphasizing the medical professional as the central character in clinical care.

RESUMEN Objetivo: analizar cómo se representa la Enfermería en las series de televisión que retratan el contexto de los cuidados clínicos de la salud. Método: estudio descriptivo y exploratorio realizado en una Institución de Enseñanza superior pública. Los datos se recopilaron por medio de entrevistas semiestructuradas con estudiantes de la carrera de grado de Enfermería. El análisis de los datos se realizó por medio del análisis de contenido, con la ayuda de los programas IRAMUTEQ versión 0.7 y Statistical Package for the Social Sciences versión 22.0. Resultados: el análisis de los datos permitió identificar dos categorías relacionadas directamente al rol de la enfermería y las relaciones de poder entre los personajes. Sin embargo, a pesar de que los estudiantes de Enfermería son espectadores habituales de las series televisivas, estas no los influenciaron al elegir su carrera. No obstante, por parte de algunos entrevistados, la percepción positiva estuvo relacionada con la admiración al campo de la salud de los seres humanos, aunque no con los personajes de Enfermería representados en los programas de televisión. Conclusión: en las series de salud, la Enfermería no se percibe como una categoría protagonista en sus responsabilidades inherentes al proceso del cuidado, sino solamente como un grupo auxiliar de profesionales. Se percibe que los medios de comunicación reproducen el modelo biomédico, enfatizando al profesional de la Medicina como el personaje central en los cuidados clínicos.

RESUMO Objetivo: analisar como a enfermagem é representada pelos seriados que retratam o contexto dos cuidados clínicos em saúde. Método: estudo descritivo e exploratório, realizado em uma Instituição de Ensino Superior Pública. A coleta de dados foi realizada por meio de entrevistas semiestruturadas com graduandos de enfermagem. A análise de dados foi feita por meio da análise de conteúdo, subsidiada pelos softwares IRAMUTEQ versão 0.7 e Statistical Package for the Social Sciences versão 22.0. Resultados: a análise dos dados permitiu a identificação de duas categorias relacionadas diretamente ao papel da enfermagem e as relações de poder entre os personagens. Ainda, apesar dos seriados televisivos serem comum entre os estudantes de enfermagem, estas não influenciaram os acadêmicos na escolha do curso. Entretanto, a percepção positiva, por parte de alguns entrevistados, esteve relacionada com a admiração ao campo da saúde humana, mas não com as personagens de enfermagem representadas nos shows televisivos. Conclusão: a enfermagem nos seriados de saúde não é percebida como categoria protagonista em suas responsabilidades no processo de cuidar, mas, somente como um grupo auxiliar. Percebe-se que a mídia reproduz o modelo biomédico, enfatizando o profissional médico como o personagem central no cuidado clínico.

Competencias clínicas y carga laboral del profesional de Enfermería en la Unidad de Cuidado Intensivo adulto / Clinical competencies and nursing workload in Adult Intensive Care Units / Competências clinicas e carga de trabalho de enfermagem nas Unidades de Terapia Intensiva de adultos

Objetivo: Describir las competencias clínicas y la carga laboral del profesional de enfermería en las unidades de cuidado intensivo adulto de algunas instituciones prestadoras de servicios de Salud. Materiales y métodos: estudio observacional de corte transversal. Se estudiaron seis unidades de cuidado intensivo adulto y se trabajó con 40 profesionales de enfermería. Se diseñó y validó un instrumento mediante ronda de expertos en docencia e investigación, para evaluar las competencias clínicas de profesionales de enfermería. La carga laboral fue evaluada mediante el instrumento validado y adaptado al español, Nursing Activities Score. Resultados: las competencias clínicas que los profesionales de enfermería realizan en menores porcentajes son: apoyo a familiares por al menos una hora 2,7%; comunicación con familiares 2,7%; centrando su atención en administración de medicación, excluidos fármacos vaso activos 89,2%; tareas administrativas rutinarias y de organización con dedicación de 2 horas en el turno, investigación, actualización de protocolos, tramitación de ingresos y altas. El promedio del Nursing Activities Score, auto diligenciado fue de 68 puntos y en el observacional de 53. La diferencia entre los promedios no fue estadísticamente significativa p 0.078, lo que indica mayores niveles de sobrecarga percibidos por los profesionales, en escala de cien puntos. Conclusión: la evaluación de las competencias clínicas y la carga laboral del profesional de enfermería que labora en las Unidades de Cuidado Intensivo, favorecen la toma de decisiones y las prácticas de la disciplina, en beneficio de la calidad del cuidado de enfermería en unidades especializadas.

Objective: Describe the nursing competency and nursing workload of the nursing professional in the adult intensive care units from some Institutional Health Service Providers. Materials and Methods: Observational study of cross-sectional data. Six adult intensive care units were studied and worked with 40 nursing professionals. An instrument was designed and validated by expert teachers and researchers, to evaluate the nursing competency of the nursing professionals; the work overload was evaluated through an instrument that was validated and adapted to Spanish, Nursing Activities Score. Results: The clinical competences of nursing professionals made in lower percentages are family support for at least one hour (2.7%), communication with the family (2.7%), focusing their attention to medication administration, excluding vasoactive drugs (89.2%), dedicated administrative and organization daily tasks for 2 hours during the shift, research, updating protocols, processing admission and release of patients. The Nursing Activities Scores instrument, which was self-filled had an average of 68 points, and the observational instrument had an average of 53 points. The difference between the averages was not statistically significant p=0.078, indicating higher levels of work overload perceived by the professionals, with a scale of 100 points. Conclusion: The evaluation of nursing competency and workload of the nursing professional who work at the Intensive Care Unit, favor decision-taking and practices of the discipline in benefit of the nursing care quality given at the specialized Intensive Care Units.

Objetivo: Descrever as competências clínicas e carga ocupacional do enfermeiro nas Unidades de Terapia Intensiva (UTI) de adultos de algumas instituições de serviços de saúde. Materiais e métodos: Estudo observacional de corte transversal. Estudaram-se seis UTI de adultos, trabalhou-se com 40 enfermeiros. Formulou-se e validou-se um questionário por expertos em docência e pesquisa para avaliar as competências clínicas de enfermeiros; a carga de trabalho avaliou-se pelo instrumento adaptado ao espanhol, Nursing Activities Score. Resultados: As competências clínicas que os enfermeiros realizam em menos proporção são: apoio familiar pelo menos por uma hora (2,7%), comunicação com os familiares (2,7%) sendo o eixo do seu trabalho a administração de medicação, excluindo os fármacos vasoativos (89,2), tarefas administrativas rotineiras e de organização com duração de duas horas no plantão, pesquisa atualização de protocolos e gestão do ingresso e a alta hospitalar. A média do Nursing Activities Score, auto preenchido foi de 68 pontos e do observacional de 53 pontos, sem diferenças estatísticas entre ambas aferições (p=0.078), indicando maiores níveis de sobrecarga de trabalho percebidos na escala de cem pontos. Conclusão: A avaliação das competências clínicas e a carga ocupacional do enfermeiro que trabalha nas UTI de adulto, favorecem a toma de decisões e as práticas da disciplina beneficiando a qualidade do cuidado de enfermagem em unidades especializadas.

Patient Safety Management Activities of Clinical Nurse: A Modified Theory of Planned Behavior / 간호행정학회지

PURPOSE: The purpose of this study was to develop a structural model for patient safety management activities and to identify the influencing factors of organizational and individual dimensions that promote patient safety management activities and to suggest effective intervention plans.METHODS: A structured self-report questionnaire was used to measure organizational factor, attitude, subjective norm, perceived behavior control, and patient safety management activities. The questionnaires were distributed to 300 nurses and 275 were included in the analysis. SPSS 25.0 and AMOS 21.0 were used to analyze the model fitness, indirect effect, and direct effect of the model.RESULTS: The hypothetical model for patient safety management activities was appropriate. Among the 8 pathways, 6 direct pathways were significant. Organizational factor affected individual attitudes, subjective norms, and perceived behavior control. Perceived behavior control, and subjective norm affected behavioral intention. Behavioral intention affected patient safety management activities. Perceived behavior control did not affect patient safety management activities.CONCLUSION: Organizations and individuals must change together to promote patient safety management activities. The organization should establish practical education and training, systems and regulations. Individuals should increase behavioral intention by strengthening perceived behavioral control and subjective norm.

Training in nutritional counseling: knowledge assessment and applicability in child's healthcare / Capacitação em aconselhamento nutricional: avaliação de conhecimento e aplicabilidade na atenção à saúde da criança

Abstract Objectives: to assess the primary healthcare professionals' knowledge before and after the training in nutritional counseling and the applicability in child's healthcare. Methods: a non-controlled 'before and after' intervention study, in a quantitative approach was conducted in Itupeva city in, Sao Paulo State. Training as an intervention was implemented for nurses, nursing assistants (NA) and community health agents (CHA), based on the critical-reflexive education. The professionals' knowledge was evaluated by applying a test with 16 multiple choice questions before and after the training. The nutritional counseling applicability in the services was evaluated by an open question test. The descriptive statistics and Fisher's Exact Test with significance of 5% were used Results: after training, the 'satisfactory' knowledge increased 71% in the nurses group and the NA/CHA groups. The professionals pointed out that training as an opportunity for qualification but the applicability lacks on political support and service organization. Conclusions: training in nutritional counseling contributes to expand the primary care professionals' knowledge, although, the applicability in the routine depends on the efforts of local management and service organization.

Resumo Objetivos: avaliar conhecimento de profissionais da atenção básica antes e após capacitação em aconselhamento nutricional e sua aplicabilidade na saúde da criança. Métodos: estudo de intervenção não controlado, tipo antes e depois, de abordagem quantitativa, desenvolvido no município de Itupeva, São Paulo. Capacitação como intervenção foi implementada para enfermeiros, auxiliares de enfermagem (AE) e agentes comunitários de saúde (ACS), com base na educação crítico-reflexiva. Aplicou-se teste de conhecimento com 16 questões de múltipla escolha antes e após a capacitação. Aplicabilidade da capacitação em aconselhamento nutricional na rotina dos serviços foi avaliada por questão aberta. Utilizou-se estatística descritiva e Teste Exato de Fisher com significância de 5%. Resultados: após capacitação, o conhecimento 'satisfatório' aumentou 71% no grupo Enfermeiros e no grupo AE/ACS. Os profissionais apontaram a capacitação como uma oportunidade de qualificação, mas para sua aplicabilidade, falta suporte político e organização dos serviços. Conclusões: a capacitação contribui para ampliação do conhecimento de profissionais da atenção básica, porém a aplicabilidade na rotina depende de esforços da gestão local e organização dos serviços.

Implementación de la práctica basada en evidencia en el currículo de Enfermería / Implementation of evidence based practice in the nursing curriculum

En la última década la enseñanza de la investigación en los currículos de enfermería se ha centrado en la práctica basada en evidencia. El objetivo del presente artículo es describir un modelo de implementación de esta práctica en el currículo de pregrado, posgrado y educación continua de una escuela de enfermería. Con este fin se seleccionaron cursos teórico-clínicos, se formaron académicos y enfermeras de los campos clínicos para cautelar la continuidad del aprendizaje de los estudiantes. Se establecieron los contenidos y competencias a enseñar y evaluar en cada nivel de formación. En conclusión, la Escuela de Enfermería de la Pontifica Universidad Católica de Chile ha logrado instalar un cuidado basado en evidencia, con el desarrollo de habilidades en estudiantes y profesionales para otorgar un cuidado basado en evidencia y/o sintetizar evidencia para ser utilizada por otros profesionales(AU)

In the last decade, the teaching of research in nursing curricula has focused on evidence-based practice. The objective of this article is to describe a model for implementing this practice in the undergraduate, postgraduate and continuing education curriculum of a nursing school. In view of this, theoretical-clinical courses were selected, and both scholars and nurses from the clinical fields were trained to ensure the continuity of student learning. The contents and competences to be taught and evaluated at each level of training were established. To conclude, the School of Nursing at Pontifical Catholica University of Chile has managed to implement evidence-based care, with the development of skills in students and professionals, in order to provide evidence-based care and/or synthesize evidence so that it be used by other professionals(AU)

Research nurses contributions to research practice: an oncology nursing experience in Brazil

Background: The creation and evolution of research nurse, connected with some specialty, brings a new path to be covered and structured inside nursering. The position of Researcher Nurse was initially created decentralized only one Department. In past the years and after the role of work was being consolidating. This paper describes the creations and evolution of Research Nurses in the scene an Oncology Research Practice at a Cancer Center. Methods: Behind of a timeline description the information that in 10 years give us the number of participant departments increased, with an increase of the scientific production, besides the construction of the position of Research Nurses. Results: Throughout these years, integration and interdepartmental action were developed, with a role and seat in Biobanco, Ethics Committee in Research, Operative Systems of medical Informatics, as well as participation in multicentric, institutional projects within the Brazilian and world Oncology. Conclusions: The role of Research Nurses being

The Effectiveness of Multidisciplinary Team-Based Education in the Management of Type 2 Diabetes / 임상당뇨병

BACKGROUND: Although clinicians, nurse specialists, pharmacists, and nutritionists expend significant time and resources in optimizing care for patients with diabetes, the effectiveness of integrated diabetes care team approach remains unclear. We assessed the effects of a multidisciplinary team care educational intervention on glycated hemoglobin (HbA1c) levels among diabetes patients. METHODS: We conducted a matched case-control study in Korean patients with type 2 diabetes, comparing the propensity scores pertaining to the effectiveness in reducing HbA1c levels between a group receiving an educational intervention and a control group. We included 40 pairs of patients hospitalized between June 2014 and September 2016. HbA1c values measured at baseline, 3 months, and 6 months were compared between the two groups. RESULTS: The educated group showed an improvement in HbA1c levels compared to the control group at 3 months (6.3 ± 2.3% vs. 9.5 ± 4.0%; P = 0.020) and at 6 months (7.5 ± 1.5% vs. 9.6 ± 3.0%; P = 0.106). There was a significant difference in the change in mean HbA1c from baseline to 3 months between the two groups (−35.7 ± 26.1% vs. −9.1 ± 20.5%; P = 0.013). CONCLUSION: A multidisciplinary team care education intervention was advantageous for improving glucose control in patients with type 2 diabetes, and may help to optimize glycemic control in clinical practice.

The Current Status of Professional Medical Support Staffs in General Hospitals less than 500 Beds / 임상간호연구

PURPOSE: This study aimed to investigate the current statistics of professional medical support staffs(PMSSs) working in general hospitals with less than 500 beds. METHODS: This study was conducted on 35 general hospitals with less than 500 beds from September 11th to October 27th, 2017. RESULTS: Four hundred fifty one PMSSs were currently providing medical support. The number of clinical nurse experts was the highest among the roles, followed by Physician Assistants(PA) and Advanced Practice Nurses. The mean job satisfaction score was 3.07 out of 5. In the case of PA group, most of the delegated prescriptions were performed, however the delegated roles were not much documented in written format. The paucity of documentation requires a development of a committee for PMSSs, including a development of selection criteria and a scope of practice in each institution. CONCLUSION: The results of this study suggested the composition of a committee for PMSSs in the medical institutions and renaming the specified titles of PMSSs.

The Frequency of Job Performance of the Korean Professional Medical Support Staff at Medical Institutions over 500 Beds / 중환자간호학회지

PURPOSE: This study was intended to investigate the frequency of job performance of the Korean professional medical support staffs (PMSS).METHOD: The data of 1,666 PMSS from 36 hospitals and over 500 beds were analyzed. The participants were divided into 5 groups: advanced practice nurses (APN), clinical nurse experts, physician assistants (PA), coordinators, and others.RESULTS: Among the 5 main domains of job performance, advanced clinical practice has the highest frequency (111.36 d/y), followed by consultation/collaboration (75.66 d/y), education/counseling (53.54 d/y), leadership (23.90 d/y), and research (19.14 d/y). There was a significant difference in the frequency of job performance between the 5 groups of participants. The invasive activities were more frequent in the PA group. In the education and counseling domain, APNs had a higher level of job frequency than others (p < .001). In the research and leadership domains, APNs and coordinators had more prominent performance frequency than other groups (p < .01). However, there are some ambiguities in the job performance of the 5 groups depending on institutional characteristics.CONCLUSION: To establish the scope of work of PMSS, organizational and individual efforts are needed to promote and expand the leadership and research domains. To resolve the ambiguities of PMSS' roles, it is necessary to reorganize their titles.

Estilo de liderazgo en profesionales de enfermería según su función en los sectores público o privado en Temuco, Chile, 2015 / Leadership Style among Nursing Professionals According to their Role in the Public or Private Sectors in Temuco, Chile - 2015 / Estilo de liderança em profissionais de enfermagem segundo sua função nos setores público ou privado em Temuco, Chile, 2015

RESUMEN Introducción: el liderazgo de enfermería se considera una competencia fundamental, por su clara repercusión en la calidad de los cuidados. Objetivo: conocer el estilo de liderazgo que ejercen enfermeras(os) asistenciales, docentes y supervisoras(es). Material y método: investigación cuantitativa, descriptiva y transversal. La muestra está constituida por 165 profesionales de enfermería del área adulto-pediátrica, en una ciudad del sur de Chile. La recolección de datos se realizó mediante el Cuestionario Multifactorial de Liderazgo, en su forma corta, adaptado a la población chilena por Vega y Zabala. Resultados: se evidencia que los profesionales en enfermería asistenciales desarrollan en menor grado los estilos transformacional y transaccional. Por el contrario, aquellos de las áreas docente y de supervisión utilizan preferentemente un liderazgo transaccional, donde se destaca la recompensa contingente en docentes y la consideración individualizada en supervisores, como las principales. Según el sexo, las mujeres utilizan con mayor frecuencia las conductas motivación inspiracional y carisma inspiracional. Además, el liderazgo transaccional está más presente en mujeres, al igual que la consideración individualizada. Conclusión: se aprecia el predominio del liderazgo transaccional en enfermeras(os) docentes y supervisoras(es), que afecta el desarrollo y el fortalecimiento de un liderazgo transformador esencial para una gestión del cuidado de calidad.

ABSTRACT Introduction: Nursing leadership is considered a fundamental competence, due to its impact on the quality of care. Objective: Know the style of leadership exercised by nurses, nursing assistants, nursing teachers and supervisors. Materials and method: This is a quantitative, descriptive and transversal study. The sample is comprised of 165 nursing professionals from the adult-pediatric area in Temuco, southern Chile. Data collection was done through the Multifactorial Leadership Questionnaire, in its short form, adapted to the Chilean population by Vega and Zabala. Results: It was shown that nursing professionals develop transformational and transactional styles to a lesser degree. In the teaching and supervisory areas, they exercise transactional leadership, and contingent reward in teachers and individualized consideration in supervisors are elements that stand out. According to gender, women most often use inspirational motivational behavior and inspirational charisma. In addition, transactional leadership is found more in women, as is individualized consideration. Conclusion: The predominance of transactional leadership in nurses (teachers) and supervisors (s), which favors the development and reinforcement of transformative leadership, is essential to quality care management.

RESUMO Introdução: a liderança de enfermagem é considerada uma competência fundamental por sua repercussão na qualidade dos cuidados. Objetivos: conhecer o estilo de liderança que exercem enfermeiros(as) assistenciais, docentes e supervisores(as). Materiais e método: pesquisa quantitativa, descritiva e transversal. A amostra está constituída por 165 profissionais de enfermagem da área adulto-pediátrica, em Temuco, no sul do Chile. A coleta de dados foi realizada mediante o Questionário Multifatorial de Liderança, em sua forma curta, adaptado à população chilena por Vega e Zabala. Resultados: evidencia-se que os profissionais em enfermagem assistenciais desenvolvem em menor grau os estilos transformacional e transacional; nas áreas docente e de supervisão, exercem liderança transacional e destaca-se a recompensa contingente em docentes e a consideração individualizada em supervisores. Segundo o sexo, as mulheres utilizam com maior frequência os comportamentos motivação inspiracional e carisma inspiracional. Além disso, a liderança transacional está mais presente em mulheres, assim como a consideração individualizada. Conclusões: observa-se o predomínio da liderança transacional em enfermeiros(as) docentes e supervisores(as), que favorece o desenvolvimento e o fortalecimento de uma liderança transformadora essencial para uma gestão do cuidado de qualidade.

Development of Pre-discharge Group Education Program for Liver Transplant Patients / 대한이식학회지

BACKGROUND: This study was conducted to develop a pre-discharge group education program for liver transplant patients, and to contribute to improving the knowledge and performance of self-management after discharge. METHODS: This investigation was a methodological study consisting of analysis, design, development, operation, and evaluation stages. RESULTS: The constituent items of the pre-discharge group education program for liver transplant patients include medication management, infection management, emergency management, outpatient management, complication management, nutrition management, exercise management, wound and drainage management, disability registration, and sex life. The pre-discharge group education program for liver transplant patients was conducted once a week, 30 minutes for the coordinator, 40 minutes for the clinical nurse specialist (including 10 minutes for wound and drainage management), 30 minutes for pharmacists, 20 minutes for the nutritionist, and 20 minutes for social workers. Additionally, the contents of the lecture announced by PowerPoint were made the same as the booklet. The overall knowledge level before and 3 months after the pre-discharge group education program for liver transplantation patients increased significantly from 17.32±1.53 to 19.74±0.89. At the 3-month time point, the overall compliance was 77.39±3.04 out of 80. Overall satisfaction was 9.32±0.93 on a scale of 10. Finally, the need for medication was the highest at 3 months. CONCLUSIONS: It is expected that this program can be utilized in the clinical field as an effective nursing education intervention.

Trends in US Nursing Research: Links to Global Healthcare Issues / 간호행정학회지

Nursing research in the United States (US) spans several decades. Many of the priorities/trends have stayed through the years. Today, the goal of producing evidence to support nursing care interventions coupled with the drive for Magnet Recognition has encouraged academic nurses (faculty) to work with nurse clinicians to form research teams. Interdisciplinary research teams have also formed to address growing concerns over patient safety and quality care. These issues are not just US issues but global ones. This article addresses US trends with the link to global research trends. The role that organizations such as the International Council of Nurses (ICN), the World Health Organization (WHO), and the Council of International Neonatal Nurses, Inc. (COINN) pay in shaping research agendas and promoting nursing research is highlighted. It emphasizes the key role that nurses, especially nurse leaders/administrators play in changing health outcomes through support of nursing research.

The Current Status of Professional Medical Support Staffs in Medical Institutions with over 500 Beds / 임상간호연구

PURPOSE: This study was to investigate the nationwide operational status of the professional medical support staffs (PMSS) who practice the expanded roles in the hospital setting. METHODS: The data were obtained through survey from 36 hospitals with over 500 beds from 25th May to 12th July 2016. Data from 1,666 PMSS were analyzed. RESULTS: Since the job titles varied, we classified them into 5 groups according to their roles; advanced practice nurse, clinical nurse expert, PA (physician assistant), coordinator, and others. There were differences in the operation status of PMSSs depending on the region, nurse staffing grade and number of hospital beds. Qualification criteria varied from hospital to hospital, and almost half of the hospitals didn't have any qualification standards for them. There were differences in age, educational level, clinical careers, rewards, and job satisfaction in 5 groups. Especially PA group had low salary, poorer working conditions, more difficulties in performing their work, and lower job satisfaction than other groups. Most PMSS (99.5%) were using a delegated prescription authority, however only 68.3% had job description and 19.9% had documented delegated role. CONCLUSION: Adequate training curriculum, documented delegated roles, and the protocols for legal protection and efficient medical services are needed.

Factors Affecting Nurse Clinicians' Knowledge and Attitude of Organs Procurement from Brain Dead Patients / 중환자간호학회지

PURPOSE: This study investigated factors affecting the knowledge and attitude of organ procurement from brain dead patients in nurse clinicians.METHODS: A survey was conducted with 160 clinical nurses from a university hospital in Seoul. Descriptive statistics, t-tests, an ANOVA, Scheffé's test, Pearson's correlation coefficient, and a multiple regression analysis were used.RESULTS: The mean score for knowledge of organ procurement from brain dead patients was 12.41 ± 2.16 (mean correct answers = 62.1). Factors influencing the knowledge of organ procurement among nurse clinicians were working department (β = .454, p < .001), a recent family death (β = .187, p = .014), experience recognizing potential brain dead patients (β = .182, p = .033), and experience referring to potential brain dead patients (β = -.192, p = .048).CONCLUSION: To ensure effective organ procurement from brain dead patients, it is necessary to continually educate nurse clinicians to improve their attitude and knowledge concerning organ donation.