Avaliação de um programa admissional para a equipe de enfermagem / Evaluation of an admission program for the nursing team

Objetivo: Avaliar a eficácia dos treinamentos ministrados à equipe de enfermagem, no período de integração. Métodos: Pesquisa de avaliação somativa e experimentação desenvolvida com 52 profissionais de enfermagem. Para a coleta de dados, foram consideradas a avaliação de reação, que mensurou o sentimento do profissional em relação ao instrutor e ao conteúdo do treinamento, e a avaliação da aprendizagem, que mensurou a eficácia do treinamento, por meio de questões técnicas de múltipla escolha sobre o conteúdo ministrado em dois momentos: antes do início e no término do período de integração. Resultados: As médias da avaliação de reação do treinamento prático e de laboratório foram consideradas excelentes, e as notas do pré e pós-teste foram, respectivamente, 5,9 e 7,2 pontos (p < 0,0001). Conclusão: Os treinamentos ministrados durante o período de integração foram eficazes e desenvolveram as competências necessárias para a melhoria da qualidade da assistência e segurança do paciente.

Institutional and matrix support and its relationship with primary healthcare.

OBJECTIVE: To analyze whether the level of institutional and matrix support is associated with better certification of primary healthcare teams. METHODS: In this cross-sectional study, we evaluated two kinds of primary healthcare support - 14,489 teams received institutional support and 14,306 teams received matrix support. Logistic regression models were applied. In the institutional support model, the independent variable was "level of support" (as calculated by the sum of supporting activities for both modalities). In the matrix support model, in turn, the independent variables were the supporting activities. The multivariate analysis has considered variables with p < 0.20. The model was adjusted by the Hosmer-Lemeshow test. RESULTS: The teams had institutional and matrix supporting activities (84.0% and 85.0%), respectively, with 55.0% of them performing between six and eight activities. For the institutional support, we have observed 1.96 and 3.77 chances for teams who had medium and high levels of support to have very good or good certification, respectively. For the matrix support, the chances of their having very good or good certification were 1.79 and 3.29, respectively. Regarding to the association between institutional support activities and the certification, the very good or good certification was positively associated with self-assessment (OR = 1.95), permanent education (OR = 1.43), shared evaluation (OR = 1.40), and supervision and evaluation of indicators (OR = 1.37). In regards to the matrix support, the very good or good certification was positively associated with permanent education (OR = 1.50), interventions in the territory (OR = 1.30), and discussion in the work processes (OR = 1.23). CONCLUSIONS: In Brazil, supporting activities are being incorporated in primary healthcare, and there is an association between the level of support, both matrix and institutional, and the certification result.

Institutional and matrix support and its relationship with primary healthcare / Apoio institucional e matricial e sua relação com o cuidado na atenção básica à saúde

OBJECTIVE To analyze whether the level of institutional and matrix support is associated with better certification of primary healthcare teams.METHODS In this cross-sectional study, we evaluated two kinds of primary healthcare support - 14,489 teams received institutional support and 14,306 teams received matrix support. Logistic regression models were applied. In the institutional support model, the independent variable was "level of support" (as calculated by the sum of supporting activities for both modalities). In the matrix support model, in turn, the independent variables were the supporting activities. The multivariate analysis has considered variables with p < 0.20. The model was adjusted by the Hosmer-Lemeshow test.RESULTS The teams had institutional and matrix supporting activities (84.0% and 85.0%), respectively, with 55.0% of them performing between six and eight activities. For the institutional support, we have observed 1.96 and 3.77 chances for teams who had medium and high levels of support to have very good or good certification, respectively. For the matrix support, the chances of their having very good or good certification were 1.79 and 3.29, respectively. Regarding to the association between institutional support activities and the certification, the very good or good certification was positively associated with self-assessment (OR = 1.95), permanent education (OR = 1.43), shared evaluation (OR = 1.40), and supervision and evaluation of indicators (OR = 1.37). In regards to the matrix support, the very good or good certification was positively associated with permanent education (OR = 1.50), interventions in the territory (OR = 1.30), and discussion in the work processes (OR = 1.23).CONCLUSIONS In Brazil, supporting activities are being incorporated in primary healthcare, and there is an association between the level of support, both matrix and institutional, and the certification result.

OBJETIVO Analisar se o grau de apoio institucional e matricial está associado à melhor certificação das equipes da atenção básica à saúde.MÉTODOS Neste estudo transversal analisamos dois tipos de apoio na atenção básica, sendo que 14.489 equipes receberam apoio institucional e 14.306 equipes receberam apoio matricial. Foram aplicados modelos de regressão logística. No de apoio institucional, a variável independente foi grau de apoio (calculado pelo somatório de atividades de apoio das duas modalidades), enquanto no de apoio matricial, as variáveis independentes foram as atividades de apoio. A análise multivariada considerou variáveis que apresentaram p < 0,20. O ajuste do modelo foi realizado pelo teste de Hosmer-Lemeshow.RESULTADOS As equipes contavam com atividades de apoio institucional e matricial em 84,0% e 85,0%, respectivamente, sendo que 55,0% realizavam entre seis e oito atividades. Para o apoio institucional, observamos chances de 1,96 e 3,77 de possuir certificação ótima ou boa quando as equipes possuíam médio e alto grau de apoio, respectivamente. Para o apoio matricial, as chances de possuir certificação ótima ou boa foram de 1,79 e 3,29, respectivamente. Quanto à associação entre atividades de apoio institucional e a certificação, a certificação ótima ou boa associou-se positivamente com autoavaliação (OR = 1,95), educação permanente (OR = 1,43), avaliação compartilhada (OR = 1,40) e monitoramento e avaliação de indicadores (OR = 1,37). Quanto ao apoio matricial, a certificação ótima ou boa associou-se positivamente com educação permanente (OR = 1,50), intervenções no território (OR = 1,30) e discussão nos processos de trabalho (OR = 1,23).CONCLUSÕES No Brasil, as atividades de apoio estão sendo incorporadas na atenção básica, existindo associação entre o grau de apoio tanto matricial quanto institucional e o resultado da certificação.

Safety climate and verbal abuse among public hospital-based workers in Costa Rica.

OBJECTIVE: Low levels of safety climate and training have been associated with higher occurrence of occupational-related health outcomes; workplace violence and verbal abuse could be considered an early indicator of escalating psychological workplace violence. We examined whether low level of safety factors were associated with a higher prevalence of verbal abuse at the workplace. METHODS: We used data from a cross-sectional survey administered among a stratified random sample of 1,000 employees from 10 of the 29 public hospitals in Costa Rica. Odds ratios (OR) and 95% confidence intervals (95%CI) were calculated using survey logistic regression models to estimate the association between safety factors and verbal abuse from the following sources: administrators, supervisors, patients, patients' relatives and coworkers. RESULTS: There was a high prevalence of verbal abuse among the healthcare workforce from both external (i.e., patients and patients' relatives) and internal workplace sources (i.e., coworkers, supervisors and administrators). A low level of safety climate was associated with verbal abuse from all sources with associations ranging from verbal abuse from administrators (OR=6.07; 95%CI: 2.05-17.92) to verbal abuse from patients (OR=2.24; 95%CI: 1.23-4.09). CONCLUSION: These results highlight the need to address organizational characteristics of the workplace that may increase the risk of verbal abuse for the future development of prevention interventions in this setting.

Impact of an education program on the incidence of central line-associated bloodstream infection in 2 medical-surgical intensive care units in Brazil.

An intervention study was undertaken to evaluate the impact of an education program on the incidence of central line-associated bloodstream infection (CLABSI) in 2 intensive care units. There was a nonsignificant reduction in the incidence of CLABSI (odds ratio, 0.46 [95% confidence interval, 0.21-1.02]; P=.04) despite a significant increase in knowledge of CLABSI prevention by the staff of both intensive care units after the education program.

Adherence to an occupational blood borne pathogens exposure management program among healthcare workers and other groups at risk in Argentina

We conducted a retrospective review of 130 occupational blood borne pathogens exposure (BBP-OE) records at Centro de Estudios Médicos e Investigaciones Clínicas, a university hospital with an ongoing educational program and a postexposure management program for healthcare workers (HCWs) since 1995, in order to evaluate adherence to a hospital BBP-OE management program. We compared HCWs from our institution (Group 1) and HCWs from independent institutions that contract our postexposure management program (Group 2). Compliance with standard precautions in Group 1 was inadequate in 77 percent, 23 percent, and 16 percent of nurses, physicians, and others, respectively. A greater proportion of HCWs in Group 1 (74 percent vs. 40 percent) reported occupational accidents within two hours after exposure (p = 0.0001). No difference was observed regarding compliance with adherence to schedule, partial adherence, and loss at follow-up (14 percent, 33 percent, and 53 percent; p > 0.05). Adherence to the standard of care for BBP-OE, including postexposure prophylaxis, was low (HIV: 53 percent and HBV: 63 percent). Knowledge of the seropositive status of the source patient did not improve adherence. We conclude that postexposure programs do not guarantee appropriate behavior by HCWs. General interventions and ongoing personnel education to modify individual attitudes are needed, as are continued efforts to assess HCWs' experiences with these programs, as well as the identification of strategies to improve adherence.

[Professional competence and contraceptive care]. / Competência profissional e assistência em anticoncepção.

OBJECTIVE: To evaluate the technical competence of professionals carrying out activities related to contraceptive care. METHODS: Evaluative research in the field of health was conducted in eight districts of the State of Ceara from July to September 2003. Data was collected by means of interviews with 29 nurses working in the Family Health Care Program within these districts and 50 people being attended by this program. Observations of the Family Health Care Units were a complementary source of data within this study. RESULTS: The majority of nurses had received some form of training regarding contraception and the technical norms regulating their use. However, professional barriers were reported by the nurses and others were identified by lay persons being attended by the program, that indicate the need to provide better training for professionals engaged in this area of care. The nurses recognized they had deficits in information and communication skills as well as technical deficits in dealing with contraception. CONCLUSIONS: There are gaps in professional competence with regard to contraceptive care that, when associated to the lack of systematization of team work, generates distortions in the quality of care. Team work was characterized by the lack of definition of team members' specific attributions and tasks.

Adherence to an occupational blood borne pathogens exposure management program among healthcare workers and other groups at risk in Argentina.

We conducted a retrospective review of 130 occupational blood borne pathogens exposure (BBP-OE) records at Centro de Estudios Médicos e Investigaciones Clínicas, a university hospital with an ongoing educational program and a postexposure management program for healthcare workers (HCWs) since 1995, in order to evaluate adherence to a hospital BBP-OE management program. We compared HCWs from our institution (Group 1) and HCWs from independent institutions that contract our postexposure management program (Group 2). Compliance with standard precautions in Group 1 was inadequate in 77%, 23%, and 16% of nurses, physicians, and others, respectively. A greater proportion of HCWs in Group 1 (74% vs. 40%) reported occupational accidents within two hours after exposure (p = 0.0001). No difference was observed regarding compliance with adherence to schedule, partial adherence, and loss at follow-up (14%, 33%, and 53%; p > 0.05). Adherence to the standard of care for BBP-OE, including postexposure prophylaxis, was low (HIV: 53% and HBV: 63%). Knowledge of the seropositive status of the source patient did not improve adherence. We conclude that postexposure programs do not guarantee appropriate behavior by HCWs. General interventions and ongoing personnel education to modify individual attitudes are needed, as are continued efforts to assess HCWs' experiences with these programs, as well as the identification of strategies to improve adherence.

Elaboración y validación de un programa piloto de apoyo continuo interactivo de educación sexual a través de internet, destinados a docentes capacitados en educación sexual en CEMERA: parte I: diagnóstico / Elaboration and validation of a program pilot of interactive continuous support of sexual education through Internet, destined to educational enabled in sexual education in CEMERA: part I: diagnosis

El objetivo de este estudio es conocer las necesidades, dificultades y experiencia, que los profesores han tenido en su desempeño como docentes en el área de la Educación Sexual y el interés por tomar parte en un Programa de apoyo interactivo en esta temática, a través de Internet. Estudio de cohorte, en el cual se envía vía correo con sistema de respuesta pagada un cuestionario especialmente diseñado y probado a todos los profesores capacitados por CEMERA durante los años 1993 a 1997 (n=593). Resultados: responden el cuestionario 160 profesores (27 por ciento). De estos el mayor porcentaje corresponde a la región Metropolitana (33,7 por ciento), a la VIII (25 por ciento) y a la V Región 11,2 por ciento. El 84,9 por ciento ha trabajado en Educación Sexual; esta cifra es menor a la encontrada en estudio previo de seguimiento a un año de recibida la capacitación (91,1 por ciento). Al relacionar haber trabajado en educación sexual y asignatura que enseñan, se observa que los orientadores, presentan una mayor tendencia ha realizar actividades de educación sexual, en comparación con los profesores que sirven asignaturas y cargos directivos (p=0,07). Al relacionar haber trabajado en educación sexual a través de talleres con Edad en que hizo el curso en CEMERA, y Nivel en que sirve, los profesores de menor edad y aquellos que han trabajado en Educación Media, en mayor porcentaje han realizado actividades de Educación Sexual, a través de cursos con talleres (p=0,05 y p=0,02, respectivamente). Con relación a las necesidades que presentan los profesores para desarrollar actividades de educación sexual, estas tienen que ver principalmente con falta de material didáctico (49,1 por ciento). Respecto a las dificultades que presentan los profesores para desarrollar actividades de educación sexual, estas están relacionadas con la disposición de la comunidad escolar para abordar el tema, en un 62,1 por ciento, que sumado con la resistencia a la Educación Sexual por parte de Padres / Apoderados y comunidad escolar se llega al 75 por ciento. Llama también la atención en este rubro que el antecedente “No tener material de apoyo y herramientas para desarrollar sus actividades en educación sexual” es más bien secundario (21,5 por ciento). Los profesores están en un 80,0 por ciento muy dispuestos a participar en un Programa de Apoyo en Educación Sexual a través de Internet.

Trabajo del tercer módulo del curso de gerencia distrito 02 cotagaita / sss

La importancia de este curso de gerencia para el personal de Salud del ámbito de a Secretaría Regional de Salud del ámbito de la Secretaría Regional de Salud Tupiza que cumplen funciones ejecutivas, juega un papel importante, porque mediante esta capacitación por módulos y en el mismo aprendizaje nos permite con un criterio mas cabal identificar áreas críticas, establecer prioridades y alternativas de solución para los diferentes problemas de salud

Seguimiento de profesores capacitados en educación sexual / Follow-up of trained teachers in sexual education

Se muestran los resultados del seguimiento de profesores, 12 meses después de un Curso de Capacitación Docente en Educación Sexual, y se determina la proporción que trabajó en este campo educativo en el establecimiento en que se desempeñaban profesionalmente. Así mismo, se indaga acerca de quiénes fueron los beneficiarios de su trabajo y en qué ámbito de sus vidas tuvo utilidad el curso. Por otra parte se conocen sus opiniones acerca de los profesionales para los cuales sería conveniente tomar el curso; los temas que más recordaban y aquellos que les gustaría profundizar. Los resultados señalan que el 91,1 por ciento de los profesores capacitados independientemente de su sexo y estado civil trabajaron en educación sexual. Este trabajo estuvo centrado fundamentalmente en alumnos (76,1 por ciento) y secundariamente en padres y apoderados (56,6 por ciento). El 92,5 por ciento de los profesores que percibió el curso como de mucha utilidad, sea en lo profesional o personal, trabajó en educación sexual, comparado con el 77,3 por ciento de aquellos que lo percibieron de mediana o poca utilidad. Metodológicamente recurrieron en un 78 por ciento a charlas. El 8,6 por ciento opina que el curso sería necesario para los orientadores, el 72,5 por ciento para padres y apoderados y alrededor del 65 por ciento para directores y personal de las Unidades Técnicas Pedagógicas. Los temas más recordados estuvieron referidos a los talleres participativos (81,8 por ciento), embarazo en adolescentes (68,6 por ciento) y sexualidad-afectividad (64,4 por ciento). El interés por profundizar apuntó a metodologías en educación sexual (73,7 por ciento), talleres (73,7 por ciento), y conocimientos, actitudes y prácticas sexuales en adolescentes (66,5 por ciento). La conclusión final de esta experiencia fue que la mejor estrategia para introducir la educación sexual en la escuela, es el entrenamiento de profesores en metodología de enseñanza de la educación sexual