Efecto del Aprendizaje Basado en Problemas en habilidades de Gestión del Cuidado: Estudio cuasiexperimental / The effect of Problem-Based Learning on Care Management skills: A quasi-experimental study / O efeito da Aprendizagem Baseada em Problemas nas habilidades de Gestão do Cuidado: Estudo quase-experimental

Objetivo: evaluar el efecto preliminar del Aprendizaje Basado en Problemas en habilidades de Gestión del Cuidado. Método: cuasiexperimental pretest-postest, con alumnos de la carrera de Licenciatura en Enfermería de una institución educativa. Muestra de 29 alumnos (Grupo Experimental) y 74 (Grupo Control). El Grupo Experimental solucionó cuatro escenarios bajo el método de Aprendizaje Basado en Problemas con los 7 pasos propuestos por la Universidad de McMaster, en un programa de Gestión del Cuidado en modalidad a distancia. El instrumento autoinformado evaluó las habilidades de Gestión del Cuidado pretesty postesten ambos grupos. Se obtuvieron valores medios y se realizó estadística descriptiva e inferencial (t de Student, t pareada, regresión lineal). Resultados: el Grupo Experimental obtuvo puntuaciones más elevadas en habilidades analíticas, de acción y globales que el Grupo Control (p<0,05). No se registraron diferencias en las habilidades interpersonales ni en el uso de la información. El Grupo Control no presentó diferencias significativas antes y después de la enseñanza habitual, mientras que en el Grupo Experimental sí se reportaron diferencias (p<0,05). Conclusión: a pesar de que existe poca evidencia en el desarrollo de habilidades de Gestión del Cuidado en Enfermería, el presente estudio demuestra que el Aprendizaje Basado en Problemas es un método efectivo y significativo en educación a distancia.

Objective: to assess the preliminary effect of Problem-Based Learning on Care Management skills. Method: a quasi-experimental pre- and post-test conducted with students attending the Bachelor's Degree in Nursing offered by an educational institution. The sample was comprised by 29 (Experimental Group) and 74 (Control Group) students. The Experimental Group solved four scenarios under the Problem-Based Learning method with the 7 steps proposed by McMaster University, in a Care Management program in distance mode. The self-reporting instrument assessed the pre- and post-test Care Management skills in both groups. Mean values were obtained and descriptive and inferential statistics were performed (Student's t, paired t, linear regression). Results: the Experimental Group obtained higher scores in analytical, action-related and global skills than the Control Group (p<0.05). No differences were recorded in interpersonal skills or in use of the information. The Control presented no significant differences before and after usual teaching, whereas differences were in fact reported in the Experimental Group (p<0.05). Conclusion: despite the fact that there is little evidence on the development of Nursing Care Management skills, the current study shows that Problem-Based Learning is an effective and significant method in remote education.

Objetivo: avaliar o efeito preliminar da Aprendizagem Baseada em Problemas nas habilidades de Gestão do Cuidado. Método: pré e pós-teste quase experimental, realizado com alunos do curso de Bacharelado em Enfermagem de uma instituição de ensino. A amostra foi composta por 29 (Grupo Experimental) e 74 (Grupo Controle). O Grupo Experimental resolveu quatro cenários sob o método de Aprendizagem Baseada em Problemas com os 7 passos propostos pela McMaster University, em um programa de Gestão do Cuidado na modalidade à distância. O instrumento de autorrelato avaliou as habilidades de Gestão do Cuidado pré e pós-teste em ambos os grupos. Valores médios foram obtidos e estatísticas descritivas e inferenciais foram realizadas (t de Student, t pareado, regressão linear). Resultados: o Grupo Experimental obteve escores mais elevados em habilidades analíticas, de ação e globais do que o Grupo Controle (p<0,05). Não foram registradas diferenças nas habilidades interpessoais ou no uso da informação. O Grupo Controle não apresentou diferenças significativas antes e depois do ensino usual, enquanto as diferenças foram de fato relatadas no Grupo Experimental (p<0,05). Conclusão: apesar de haver poucas evidências sobre o desenvolvimento de habilidades de Gestão do Cuidado de Enfermagem, o presente estudo mostra que a Aprendizagem Baseada em Problemas é um método eficaz e significativo na educação à distância.

The effect of Problem-Based Learning on Care Management skills: A quasi-experimental study. / Efecto del Aprendizaje Basado en Problemas en habilidades de Gestión del Cuidado: Estudio cuasiexperimental.

OBJECTIVE: to assess the preliminary effect of Problem-Based Learning on Care Management skills. METHOD: a quasi-experimental pre- and post-test conducted with students attending the Bachelor's Degree in Nursing offered by an educational institution. The sample was comprised by 29 (Experimental Group) and 74 (Control Group) students. The Experimental Group solved four scenarios under the Problem-Based Learning method with the 7 steps proposed by McMaster University, in a Care Management program in distance mode. The self-reporting instrument assessed the pre- and post-test Care Management skills in both groups. Mean values were obtained and descriptive and inferential statistics were performed (Student's t, paired t, linear regression). RESULTS: the Experimental Group obtained higher scores in analytical, action-related and global skills than the Control Group (p<0.05). No differences were recorded in interpersonal skills or in use of the information. The Control presented no significant differences before and after usual teaching, whereas differences were in fact reported in the Experimental Group (p<0.05). CONCLUSION: despite the fact that there is little evidence on the development of Nursing Care Management skills, the current study shows that Problem-Based Learning is an effective and significant method in remote education.

Nursing practice environment and missed care at highly specialised hospitals in Mexico: A cross-sectional observational study.

BACKGROUND: The influence of the work environment on missed care and service quality has been well documented. However, available evidence concerning this relationship comes mostly from developed countries. Few studies have been conducted in low- or middle-income countries. We assessed the relationship between the work environment and missed nursing care in highly specialised hospitals in Mexico. METHODS: We conducted an observational cross-sectional study with data collected from January 2019 to February 2020 in 11 highly specialised hospitals (n = 510 nurses). We estimated missed nursing care utilising the MISSCARE questionnaire and used the Practice Environment Scale-Nursing Work Index instrument to assess the work environment. After describing the main attributes of the study sample according to the type of work environment, we constructed five adjusted fractional regression models, the first concerning the overall index of missed care, and the others pertaining to its various dimensions. RESULTS: The sample analysed was balanced as regards adjustment variables according to the type of work environment. The adjusted estimates confirmed an inverse relationship between the missed care index and enjoying an enhanced, or favourable, work environment. Overall, the difference was 9 percentage points (pp); however, by dimension of missed care, the major differences between enhanced and attenuated, or unfavourable, work environments were registered for basic care, followed by patient education and discharge planning (4pp) and individual needs (8pp). CONCLUSIONS: The work environment determines the frequency of missed nursing care, both overall and by dimension. Nursing managers need to create short- and mid-term strategies favouring positive work environments in order to improve working conditions for nursing professionals.

Missed nursing care in highly specialized hospitals: A Mexican case study.

OBJECTIVE: To assess the status of missed nursing care and the reasons for its occurrence in a highly specialised public hospital in Mexico. MATERIALS AND METHODS: An observational cross-sectional analysis with data collected from January to June 2019 at the National Institute of Rehabilitation Luis Guillermo Ibarra Ibarra in Mexico City. We assessed missed care and its causes by conducting the MISSCARE survey among 116 nursing professionals selected from a population of 162 nurses. This work presents the estimated rates of missed care-overall and broken down into its four dimensions-as well as the reasons for its occurrence, namely limited labour resources, inadequate material resources and communication problems among work teams. RESULTS: The overall score for missed care was 16% (95% CI: 11.84%-20.15%), with the following rates by dimension: 19.48% for basic care, 14.66% for individual needs, 6.47% for patient education and discharge planning, and 4.31% for continuous patient assessment. The main reason cited for missed care was inadequate material resources, followed by limited labour resources and communication problems among work teams. CONCLUSION: Basic care and individual needs interventions were the most frequently omitted services, primarily because of inadequate material resources, limited labour resources and communication problems among work teams. An increase in the frequency of missed care can be expected in light of the high demand for health services, particularly as regards labour and material resources, imposed by the SARS-CoV-2 pandemic.

Advanced Practice Nursing Roles: A Comparison Between Mexico and the United Kingdom.

The COVID-19 pandemic has placed nursing at the forefront of public attention across the globe and has highlighted the critical role of nursing in healthcare service provision. Advanced practice nursing has been recognized for more than 50 years, but the rate of its growth and development varies significantly across the world. One of the key aims of the Better Health Programme Mexico, which commenced in 2019, was to develop advanced practice nursing in Mexico. The Programme was based on the United Kingdom model, where advanced practice nursing has been in place-though not subject to statutory regulation-for more than 40 years. The aim of this article is to compare the frameworks that underpin advanced practice nursing in the United Kingdom and in Mexico. In the present article, current practice in both countries was researched, and the structure, systems, and processes relating to nursing regulation and the frameworks to support advanced practice nursing were examined. A gap analysis report undertaken as part of the Better Health Programme identified challenges in developing advanced practice nursing in Mexico and the United Kingdom and highlighted the need for stakeholders to agree on an approach toward a rigorous regulatory framework in both settings. In summary, this article highlights the issues facing nurses and regulators in both countries in terms of advanced practice nursing and identifies strategies that can be used to strengthen the advanced practice nurse role.

Labor Market Participation of Bachelor's Degree Prepared Nurses in Mexico: Lessons for Capacity Building.

BACKGROUND: Mexico has learned much from its five decades educating nurses, moving from nurses educated mostly at the technical degree level, to bachelor's degree prepared nurses educated in universities. Several salient lessons have emerged that may prove relevant for other countries seeking to increase their numbers of bachelors prepared nurses. This paper analyzes twenty years of nursing labor market data to highlight where significant social and policy changes helped facilitate increased production of bachelor's degree educated nurses in Mexico. METHODS: We conducted a two-stages analysis, starting with a descriptive stage and followed by a repeated cross-sectional analysis using data sources generated by the Secretariat of Health and the National Institute of Geography and Statistics. Data from the 2005 to 2019 period were analyzed for trends in production patterns and significant relationships in the labor market. RESULTS: Among Mexican nursing graduates, technical and bachelor nurses compete for employment in healthcare institutions. The public sector has greater success in hiring bachelors prepared nurses, but this varies by type of public sector institution. Technical degree nurses have higher underemployment rates and less job security overall. Private hospitals mainly hire technical degree nurses. The Mexican government not been able to properly regulate neither the production of new graduates nor the accreditation of schools, let alone to align roles according to the graduate's level of education. CONCLUSIONS: The success of Mexico in the twenty-first century shows that middle-income countries can increase the production and both private and public sector employment opportunities for nurses educated at both the technical and bachelor's degree level however, labor market challenges persist. The central lesson for other countries is that policies must be revised in order to optimize the use of a more educated nursing workforce.

Performance of the Mexican nursing labor market: a repeated cross-sectional study, 2005-2019.

BACKGROUND: The close link between human resources for health and the performance of health systems calls for a comprehensive study of the labor market. This paper proposes a performance metric for the nursing labor market, measures its magnitude and analyzes its predictors over the last 15 years. DESIGN AND METHODS: A repeated cross-sectional analysis using data from the quarterly population-based National Survey of Occupation and Employment 2005-2019 (ENOE in Spanish). An aggregate total of 19,311 Mexican nurses (population N = 4,816,930) was analyzed. Nursing labor market performance was defined as the level of non-precarious employment of nurses in the health sector. After describing the sociodemographic, labor and contextual characteristics of the nurses surveyed, we identified the key correlates of market performance using repeated cross-sectional multiple logistic regression analysis. We then estimated the adjusted prevalence of market performance according to the survey period and socioeconomic region of residence. RESULTS: The exogenous indicators analyzed shed light on various aspects of the market structure. Unemployment remained stable at 5% during the period examined, but underemployment rose by 26% and precarious employment, our endogenous indicator, also grew significantly. On the whole, our indicators revealed a notable deterioration in the structure of the nursing labor market; they varied by age and sex as well as between public and private institutions. Although the steepest deterioration occurred in the private sector, we observed an increase in precarious jobs among public institutions formerly protective of employment conditions. CONCLUSIONS: The deterioration of the labor market jeopardizes the ability of nursing professionals to participate in the market as well as to obtain secure jobs once they do enter. The Mexican Health System suffers from a chronic dearth of nurses, reducing its capacity to achieve its core objectives including enhanced coverage and increased effectiveness. Nursing workforce planning requires a context where the conditions in which the market currently operates, and its potential deterioration are considered.

Sociodemographic and work environment correlates of missed nursing care at highly specialized hospitals in Mexico: A cross-sectional study.

BACKGROUND: Despite its direct relevance to quality of care, little is known about missed nursing care or its sociodemographic and work environment correlates at highly specialized hospitals in low- and middle-income countries. OBJECTIVE: To analyze the frequency of missed nursing care among Mexican nursing professionals, and to assess its associated sociodemographic and labor-related predictors. DESIGN AND METHODS: A cross-sectional, observational study based on data collected from 315 nursing professionals in 11 highly specialized public hospitals in Mexico. We assessed missed nursing care both as a total figure and according to the four dimensions of the MISSCARE inventory. We estimated its sociodemographic and work-related predictors using fractional logistic analysis. RESULTS: The global score for missed nursing care was 15.21%: 7.94% concerned individual needs, 9.37% discharge planning and patient education, 18.10% basic care, and 1.59% care under continuous assessment. The odds of engaging in missed nursing care increased with age and were higher among women and night-shift workers. In contrast, they decreased among nursing professionals who were satisfied with their jobs, and among those working in suitable environments. CONCLUSIONS: Missed nursing care in highly specialized public hospitals is associated with the sociodemographic characteristics and labor-related conditions -including the work environments- of the nurses. Given its impact on both health-care users and institutions, further research on the subject is urgently needed. It is essential to improve the design, implementation and evaluation of comprehensive strategies aimed at reducing the frequency of missed nursing care and achieving universal health coverage.

Progress and challenges for advanced practice nursing in Mexico and the United Kingdom.

AIM: The aim of this study is to compare the advanced practice nursing development in Mexico with the United Kingdom. BACKGROUND: In spite of the involvement of global and local bodies to establish and develop advanced practice nursing worldwide, progress remains variable due to the lack of homogeneity in health care systems and policies. EVALUATION: Using thematic analysis from interviews of 29 health care professionals in Mexico, we identified four major issues that impact on the development of advanced practice nursing: (a) workforce, (b) organizational and institutional, (c) regulatory and legal and (d) academic and educational. KEY ISSUES: Learning from the UK experience in relation to overcoming some of these issues has been insightful in terms of how advanced practice nursing skills in Mexican nurses can be developed. CONCLUSIONS: Mexico is still in early stages of the development of APN. Based on the UK experience, the government may have to move forward to support higher level training, create labour market positions, establish new nursing functions, promote task-shifting and particularly implement solid regulation. IMPLICATIONS FOR NURSING MANAGEMENT: The development of advanced practice nursing represents important challenges for training and practice of nursing in Mexico and the United Kingdom; therefore, interested actors will have to reach key agreements that could work as the foundations of an assertive planning process.

Predictors of nursing students' academic performance in the National Autonomous University of Mexico, 2010-2019: A retrospective study.

BACKGROUND: The available literature suggests that diverse factors, including sociodemographic, academic, psychological, and occupational, can have impacts on nursing students' academic performance. Therefore, it follows that the institutional environment can mediate on these influences. OBJECTIVE: Based on a 10-years student performance follow-up information reservoir, to analyze the relationships between student performance and a set of sociodemographic and academic characteristics of students enrolled in the programs of Bachelor of Nursing (LE), and Bachelor of Nursing and Obstetrics (LEO), in the National School of Nursing and Obstetrics (ENEO) of the National Autonomous University of Mexico (UNAM). METHODOLOGY: The registers (n = 3984) from the Academic Control Integral System of the ENEO-UNAM were used. The students' main sociodemographic and academic characteristics were described, and multiple-regression models were estimated in order to identify predictors of school performance. RESULTS: Sustained increments in the enrolment of LE and LEO students during the study period. Changes were noticed regarding the sex distribution and the enrolment age. More students chose the LE program during this period. School performance was higher among female students, among students in their last semesters, and among students who had been granted a scholarship. In contrast, students who had previously failed a subject performed lower. CONCLUSION: The identified school performance predictors suggest the need to strengthen institutional policies aimed at promoting the achievement of academic excellence so that graduate students become better prepared to enter the labor markets and address the nursing demands of society.

Instrumento de auditoría de cumplimiento del protocolo de prevención de neumonía asociada a la ventilación mecánica / Audit instrument for compliance with the protocol for the prevention of pneumonia associated with mechanical ventilation

Introducción: la neumonía asociada a la ventilación mecánica (NAVM) es una de las infecciones vinculadas con la atención sanitaria más común en las unidades de cuidados intensivos (UCI). Las investigaciones recientes han centrado su atención en el cumplimiento de la atención de enfermería concebida como un proceso y han dejado de lado elementos relacionados con la estructura de las unidades y el resultado de la atención. Objetivo: diseñar y validar el instrumento de auditoría de cumplimiento del protocolo de prevención de NAVM en una UCI. Metodología: es un estudio observacional y analítico con dos mediciones realizado en una UCI de un hospital regional al sur de la Ciudad de México con 360 observaciones sobre las medidas de prevención no farmacológicas en la UCI para prevenir la NAVM. Para la elaboración del instrumento se seleccionaron fuentes documentales, con extracción de recomendaciones por grado de evidencia y el proceso de validación mediante panel de expertos. Resultados: se obtuvieron recomendaciones con grados de evidencia altos y se realizaron ajustes al instrumento durante su creación posterior. El tiempo de aplicación del instrumento fue de 25 a 30 minutos. Se aplicó la prueba de Kuder-Richardson 20 como índice de consistencia interna con un valor de 0.878 en la prueba preliminar y de 0.853 en la aplicación final; se identificaron relaciones entre las dimensiones del instrumento y las respuestas similares intraobservador estadísticamente significativas. No se obtuvieron dimensiones subyacentes del análisis factorial exploratorio. Conclusiones: el instrumento mostró características psicométricas deseables que respaldan la confiabilidad de su medición; previa adaptación cultural, se considera viable su aplicación en procesos de auditoría y proyectos de mejora en unidades de cuidados intensivos por su fácil aplicación, su exhaustividad y aproximación al modelo de evaluación de la calidad de la asistencia sanitaria.

Introduction: Pneumonia associated with mechanical ventilation (PAMV) is one of the most common healthcare-associated infections in intensive care units (ICU). Recent re- search has focused on the fulfillment of nursing care as a process, leaving aside elements related to the structure of the units, or the result of care. Objective: Design and validate the instrument for auditing compliance with the PAMV prevention protocol in an ICU. Methods: Observational, analytical study, with two measurements, carried out in an ICU of a Regional Hospital in south of Mexico City, with 360 observations on non-pharmacological prevention measures in the ICU to prevent PAMV. In the elaboration of the instrument, documentary sources were selected, of recommendations by level of evidence were extracted, and process of the validation was carried out by a panel of experts. Results: Recommendations were obtained with high levels of evidence, adjustments were made to the instrument during its subsequent creation. The application time of the instrument ranges from 25 to 30 minutes. The Kuder Richardson 20 test was applied as an internal consistency index with a value of 0.878 in a pilot test and in a final application of 0.853, associations were found between the dimensions of the instrument and similar statistically significant intra-observer responses. No underlying dimensions were obtained from the exploratory factor analysis. Conclusions: The instrument presented desirable psycho- metric characteristics that support the reliability of its measurement; after cultural adjustment, its application in audit processes and improvement projects in intensive care units is considered viable, due to its easy application, exhaustive- ness and closeness to observe the evaluation model of quality of health care.

Distance learning and patient safety: Report and evaluation of an online patient safety course.

Patient safety is a critical topic in health care globally, with implications for nurses, physicians, administrators, and most importantly, patients and their well-being. Online distance learning (ODL) is widely accepted among most disciplines in higher education and has been used to promote patient safety knowledge among health care students and professionals in diverse contexts. This article reports on an online Nursing and Patient Safety course developed in 2012 by the University of Miami School of Nursing and Health Studies in conjunction with the Pan American Health Organization and the International Network for Nursing and Patient Safety. The study's objectives are to describe the implementation of an international ODL program to enhance patient safety knowledge in nurses and nursing students, and to examine the participants' assessments of this online approach as an effective learning tool. Most participants who completed the Nursing and Patient Safety ODL course reported being satisfied with the course content and experience, and demonstrated increased knowledge on patient safety, as measured by post-module quizzes and self-report. Limitations of the study include the lack of a comparison group, disparity in the number of participants across the course's language formats (English, Portuguese, Spanish), and the large number of participants who registered for but did not complete the course. Future research should identify obstacles to course completion, explore participants' awareness of patient safety issues and perceived need for more instruction, and look at ways to disseminate the course to the broadest international population of nurses and nursing students.

La seguridad del paciente es un tema fundamental en la atención de la salud a nivel mundial, con repercusiones para los enfermeros, médicos, administradores y, lo que es más importante, para los pacientes y su bienestar. La educación a distancia en línea está ampliamente aceptada en la mayoría de las disciplinas de enseñanza superior y se ha empleado para difundir los conocimientos en materia de seguridad del paciente a los estudiantes de atención de salud y los profesionales en diversos contextos. En este artículo se informa sobre el curso en línea de enfermería y seguridad del paciente creado en el 2012 por la facultad de enfermería y estudios de salud de la Universidad de Miami, conjuntamente con la Organización Panamericana de la Salud y la Red Internacional de Enfermería y Seguridad del Paciente. Los objetivos del estudio son describir la ejecución de un programa internacional de educación a distancia en línea para mejorar el conocimiento sobre la seguridad del paciente de los enfermeros y los estudiantes de enfermería, y examinar las evaluaciones de los participantes sobre este enfoque en línea como herramienta eficaz de aprendizaje. La mayoría de los participantes en este curso afirmó sentirse satisfecho con su contenido y experiencia, y demostró un mayor conocimiento sobre la seguridad del paciente, de acuerdo con las mediciones de las encuestas posteriores al módulo y la autoevaluación. Entre las limitaciones del estudio se aprecia la falta de un grupo de comparación, una disparidad en el número de participantes entre las diferentes versiones lingüísticas del curso (español, inglés y portugués) y el gran número de participantes que se inscribieron sin llegar a finalizar el curso. Las futuras investigaciones deberán indicar cuáles son los obstáculos para la finalización del curso, explorar la concienciación de los participantes en temas relativos a la seguridad del paciente y las necesidades que perciben de una instrucción más profunda, así como considerar modos de mayor difusión del curso en la comunidad internacional de enfermeros y estudiantes de enfermería.

A segurança do paciente é um tema fundamental para a assistência de saúde em todo o mundo, com implicações para enfermeiros, médicos, administradores e, mais importante ainda, para os pacientes e o seu bem-estar. A educação à distância online (EDO) conta com grande aceitação na maioria das disciplinas do ensino superior e tem sido utilizada para transmitir conhecimentos sobre segurança do paciente a estudantes e profissionais da saúde em diversos contextos. Este artigo descreve um curso online de Enfermagem e Segurança do Paciente desenvolvido em 2012 pela Faculdade de Enfermagem e Estudos da Saúde da Universidade de Miami, em conjunto com a Organização Pan-Americana da Saúde e a Rede Internacional de Enfermagem e Segurança do Paciente. Os objetivos do estudo são descrever a implementação de um programa internacional de EDO para melhorar os conhecimentos de enfermeiros e estudantes de enfermagem sobre segurança do paciente e examinar a forma como os participantes avaliaram a eficácia desta abordagem online como uma ferramenta de aprendizagem. Em sua maioria, os participantes que completaram o curso online de Enfermagem e Segurança do Paciente afirmaram ter tido uma boa experiência com o curso e estar satisfeitos com o seu conteúdo; além disso, demonstraram maiores conhecimentos sobre segurança do paciente, medidos por questionários aplicados após os módulos e pela autoavaliação. As limitações deste estudo incluem a falta de um grupo de comparação, a disparidade no número de participantes nos diferentes formatos do curso (inglês, português, espanhol) e o grande número de participantes que se inscreveram mas não completaram o curso. A pesquisa futura deve identificar os obstáculos à conclusão do curso, explorar a conscientização dos participantes sobre questões de segurança do paciente e a necessidade de mais instrução e procurar formas de divulgar o curso para uma população internacional mais ampla de enfermeiros e estudantes de enfermagem.

Distance learning and patient safety: Report and evaluation of an online patient safety course

[ABSTRACT]. Patient safety is a critical topic in health care globally, with implications for nurses, physicians, administrators, and most importantly, patients and their well-being. Online distance learning (ODL) is widely accepted among most disciplines in higher education and has been used to promote patient safety knowledge among health care students and professionals in diverse contexts. This article reports on an online Nursing and Patient Safety course developed in 2012 by the University of Miami School of Nursing and Health Studies in conjunction with the Pan American Health Organization and the International Network for Nursing and Patient Safety. The study’s objectives are to describe the implementation of an international ODL program to enhance patient safety knowledge in nurses and nursing students, and to examine the participants’ assessments of this online approach as an effective learning tool. Most participants who completed the Nursing and Patient Safety ODL course reported being satisfied with the course content and experience, and demonstrated increased knowledge on patient safety, as measured by post-module quizzes and self-report. Limitations of the study include the lack of a comparison group, disparity in the number of participants across the course’s language formats (English, Portuguese, Spanish), and the large number of participants who registered for but did not complete the course. Future research should identify obstacles to course completion, explore participants’ awareness of patient safety issues and perceived need for more instruction, and look at ways to disseminate the course to the broadest international population of nurses and nursing students.

[RESUMEN]. La seguridad del paciente es un tema fundamental en la atención de la salud a nivel mundial, con repercusiones para los enfermeros, médicos, administradores y, lo que es más importante, para los pacientes y su bienestar. La educación a distancia en línea está ampliamente aceptada en la mayoría de las disciplinas de enseñanza superior y se ha empleado para difundir los conocimientos en materia de seguridad del paciente a los estudiantes de atención de salud y los profesionales en diversos contextos. En este artículo se informa sobre el curso en línea de enfermería y seguridad del paciente creado en el 2012 por la facultad de enfermería y estudios de salud de la Universidad de Miami, conjuntamente con la Organización Panamericana de la Salud y la Red Internacional de Enfermería y Seguridad del Paciente. Los objetivos del estudio son describir la ejecución de un programa internacional de educación a distancia en línea para mejorar el conocimiento sobre la seguridad del paciente de los enfermeros y los estudiantes de enfermería, y examinar las evaluaciones de los participantes sobre este enfoque en línea como herramienta eficaz de aprendizaje. La mayoría de los participantes en este curso afirmó sentirse satisfecho con su contenido y experiencia, y demostró un mayor conocimiento sobre la seguridad del paciente, de acuerdo con las mediciones de las encuestas posteriores al módulo y la autoevaluación. Entre las limitaciones del estudio se aprecia la falta de un grupo de comparación, una disparidad en el número de participantes entre las diferentes versiones lingüísticas del curso (español, inglés y portugués) y el gran número de participantes que se inscribieron sin llegar a finalizar el curso. Las futuras investigaciones deberán indicar cuáles son los obstáculos para la finalización del curso, explorar la concienciación de los participantes en temas relativos a la seguridad del paciente y las necesidades que perciben de una instrucción más profunda, así como considerar modos de mayor difusión del curso en la comunidad internacional de enfermeros y estudiantes de enfermería.

[RESUMO]. A segurança do paciente é um tema fundamental para a assistência de saúde em todo o mundo, com implicações para enfermeiros, médicos, administradores e, mais importante ainda, para os pacientes e o seu bem-estar. A educação à distância online (EDO) conta com grande aceitação na maioria das disciplinas do ensino superior e tem sido utilizada para transmitir conhecimentos sobre segurança do paciente a estudantes e profissionais da saúde em diversos contextos. Este artigo descreve um curso online de Enfermagem e Segurança do Paciente desenvolvido em 2012 pela Faculdade de Enfermagem e Estudos da Saúde da Universidade de Miami, em conjunto com a Organização Pan-Americana da Saúde e a Rede Internacional de Enfermagem e Segurança do Paciente. Os objetivos do estudo são descrever a implementação de um programa internacional de EDO para melhorar os conhecimentos de enfermeiros e estudantes de enfermagem sobre segurança do paciente e examinar a forma como os participantes avaliaram a eficácia desta abordagem online como uma ferramenta de aprendizagem. Em sua maioria, os participantes que completaram o curso online de Enfermagem e Segurança do Paciente afirmaram ter tido uma boa experiência com o curso e estar satisfeitos com o seu conteúdo; além disso, demonstraram maiores conhecimentos sobre segurança do paciente, medidos por questionários aplicados após os módulos e pela autoavaliação. As limitações deste estudo incluem a falta de um grupo de comparação, a disparidade no número de participantes nos diferentes formatos do curso (inglês, português, espanhol) e o grande número de participantes que se inscreveram mas não completaram o curso. A pesquisa futura deve identificar os obstáculos à conclusão do curso, explorar a conscientização dos participantes sobre questões de segurança do paciente e a necessidade de mais instrução e procurar formas de divulgar o curso para uma população internacional mais ampla de enfermeiros e estudantes de enfermagem.

The correlates of precarious working conditions in the Mexican nursing labour market from 2005 to 2018: A repeated cross-sectional study.

AIM: To analyse sociodemographic and labour correlates of labour precariousness among Mexican nurses from 2005 to 2018. BACKGROUND: The progressive loss of labour rights has led to a situation characterized by precarious working conditions among health workers globally. METHODS: A repeated cross-sectional and population-based study was carried out (N = 3,699,282). A generalized ordinal logistic regression model was estimated to assess correlates of precariousness. Precariousness was defined as a non-weighted score of the sum of five dichotomous variables: (a) non-written contract; (b) income lower than two times the minimum wage; (c) with a partial or an extended workday; (d) without social benefits; and (e) without social security. RESULTS: The labour precariousness level increased during the studied period, particularly among the younger and the older, the single ones and among those located in suburban and rural areas. Nurses with lower levels of training were more exposed to precarious conditions, as well as those with jobs in private health institutions or working outside the health sector. CONCLUSIONS: Precarious work is considered a combination of global and local labour factors, including the lack of protective labour policies in health institutions, which calls for the development of a public policy to protect jobs in the health sector. IMPLICATIONS FOR NURSING MANAGEMENT: Given that precarious work is considered a combination of global and local labour factors, including the lack of protective labour policies in health institutions, public health institutions should avoid nursing outsourcing employment as much as possible, and full-time contracts should respect the fundamental international and country-specific labour rights.

Distance learning and patient safety: Report and evaluation of an online patient safety course / Educación a distancia y seguridad del paciente: informe y evaluación de un curso en línea sobre seguridad del paciente / Aprendizagem à distância e segurança do paciente: descrição e avaliação de um curso online sobre segurança do paciente

ABSTRACT Patient safety is a critical topic in health care globally, with implications for nurses, physicians, administrators, and most importantly, patients and their well-being. Online distance learning (ODL) is widely accepted among most disciplines in higher education and has been used to promote patient safety knowledge among health care students and professionals in diverse contexts. This article reports on an online Nursing and Patient Safety course developed in 2012 by the University of Miami School of Nursing and Health Studies in conjunction with the Pan American Health Organization and the International Network for Nursing and Patient Safety. The study's objectives are to describe the implementation of an international ODL program to enhance patient safety knowledge in nurses and nursing students, and to examine the participants' assessments of this online approach as an effective learning tool. Most participants who completed the Nursing and Patient Safety ODL course reported being satisfied with the course content and experience, and demonstrated increased knowledge on patient safety, as measured by post-module quizzes and self-report. Limitations of the study include the lack of a comparison group, disparity in the number of participants across the course's language formats (English, Portuguese, Spanish), and the large number of participants who registered for but did not complete the course. Future research should identify obstacles to course completion, explore participants' awareness of patient safety issues and perceived need for more instruction, and look at ways to disseminate the course to the broadest international population of nurses and nursing students.(AU)

RESUMEN La seguridad del paciente es un tema fundamental en la atención de la salud a nivel mundial, con repercusiones para los enfermeros, médicos, administradores y, lo que es más importante, para los pacientes y su bienestar. La educación a distancia en línea está ampliamente aceptada en la mayoría de las disciplinas de enseñanza superior y se ha empleado para difundir los conocimientos en materia de seguridad del paciente a los estudiantes de atención de salud y los profesionales en diversos contextos. En este artículo se informa sobre el curso en línea de enfermería y seguridad del paciente creado en el 2012 por la facultad de enfermería y estudios de salud de la Universidad de Miami, conjuntamente con la Organización Panamericana de la Salud y la Red Internacional de Enfermería y Seguridad del Paciente. Los objetivos del estudio son describir la ejecución de un programa internacional de educación a distancia en línea para mejorar el conocimiento sobre la seguridad del paciente de los enfermeros y los estudiantes de enfermería, y examinar las evaluaciones de los participantes sobre este enfoque en línea como herramienta eficaz de aprendizaje. La mayoría de los participantes en este curso afirmó sentirse satisfecho con su contenido y experiencia, y demostró un mayor conocimiento sobre la seguridad del paciente, de acuerdo con las mediciones de las encuestas posteriores al módulo y la autoevaluación. Entre las limitaciones del estudio se aprecia la falta de un grupo de comparación, una disparidad en el número de participantes entre las diferentes versiones lingüísticas del curso (español, inglés y portugués) y el gran número de participantes que se inscribieron sin llegar a finalizar el curso. Las futuras investigaciones deberán indicar cuáles son los obstáculos para la finalización del curso, explorar la concienciación de los participantes en temas relativos a la seguridad del paciente y las necesidades que perciben de una instrucción más profunda, así como considerar modos de mayor difusión del curso en la comunidad internacional de enfermeros y estudiantes de enfermería.(AU)

RESUMO A segurança do paciente é um tema fundamental para a assistência de saúde em todo o mundo, com implicações para enfermeiros, médicos, administradores e, mais importante ainda, para os pacientes e o seu bem-estar. A educação à distância online (EDO) conta com grande aceitação na maioria das disciplinas do ensino superior e tem sido utilizada para transmitir conhecimentos sobre segurança do paciente a estudantes e profissionais da saúde em diversos contextos. Este artigo descreve um curso online de Enfermagem e Segurança do Paciente desenvolvido em 2012 pela Faculdade de Enfermagem e Estudos da Saúde da Universidade de Miami, em conjunto com a Organização Pan-Americana da Saúde e a Rede Internacional de Enfermagem e Segurança do Paciente. Os objetivos do estudo são descrever a implementação de um programa internacional de EDO para melhorar os conhecimentos de enfermeiros e estudantes de enfermagem sobre segurança do paciente e examinar a forma como os participantes avaliaram a eficácia desta abordagem online como uma ferramenta de aprendizagem. Em sua maioria, os participantes que completaram o curso online de Enfermagem e Segurança do Paciente afirmaram ter tido uma boa experiência com o curso e estar satisfeitos com o seu conteúdo; além disso, demonstraram maiores conhecimentos sobre segurança do paciente, medidos por questionários aplicados após os módulos e pela autoavaliação. As limitações deste estudo incluem a falta de um grupo de comparação, a disparidade no número de participantes nos diferentes formatos do curso (inglês, português, espanhol) e o grande número de participantes que se inscreveram mas não completaram o curso. A pesquisa futura deve identificar os obstáculos à conclusão do curso, explorar a conscientização dos participantes sobre questões de segurança do paciente e a necessidade de mais instrução e procurar formas de divulgar o curso para uma população internacional mais ampla de enfermeiros e estudantes de enfermagem.(AU)

Strengthening universal health: development of a nursing and midwifery education quality improvement toolkit.

OBJECTIVE: to present the development of a toolkit for education quality improvement in universal health and primary health care, targeting schools of nursing and midwifery in Latin American and Caribbean countries. METHODS: an expert work group conducted a systematic literature review, selected key content and completed toolkit drafting, using an iterative consensus approach. International partners reviewed the toolkit. Cognitive debriefing data were analyzed, revisions and new tools were integrated, and the final version was approved. RESULTS: twenty-two articles were identified and mapped as resources. The Model for Improvement, a data-driven approach to performance analysis, was selected for its widespread use and simplicity in carrying out the following steps: 1) organize a team, 2) assess improvement need regarding universal health and primary health care education, 3) set an aim/goal and identify priorities using a matrix, 4) establish metrics, 5) identify change, 6) carry out a series of Plan-Do-Study-Act learning cycles, and 7) sustain change. CONCLUSIONS: the Education Quality Improvement Toolkit, developed through stakeholder consensus, provides a systematic, and potentially culturally adaptable approach to improve student, faculty, and program areas associated with universal health coverage and access.

Utilización del control prenatal en gestantes de la delegación Iztapa lapa distrito federal de México / Use of antenatal care in pregnant women of the delegation Iztapalapa federal district of México

Objetivo: determinar la utilización adecuada del control prenatal en gestantes de la delegación Iztapalapa del Distrito Federal de México. Materiales y métodos: estudio descriptivo, retrospectivo (entre diciembre 2014 y abril de 2015), en la delegación de Iztapalapa del Distrito Federal de México, con una muestra de 135 mujeres. Para recolectar la información fue utilizada una encuesta para datos sociodemográficos basada en la ENSANUT, un cuestionario de caracterización familiar, que incluyó el APGAR familiar, para medir la percepción de la funcionalidad familiar, y un cuestionario de satisfacción con los servicios de salud recibidos. Resultados: fueron incluidas en el estudio 135 mujeres embarazadas, con un promedio de edad de 26,7 años, la media de controles prenatales fue de 5, la razón principal de asistir es la de detectar alteraciones tempranas, además se sienten satisfechas con la atención brindada por el personal de salud y perciben un adecuado apoyo familiar. Conclusiones: la utilización del control prenatal mejora entre las mujeres primíparas, que conviven en familias nucleares y normofuncionales..(AU)

Objective: to determinate the use of antenatal care in pregnant women of the delegation Iztapalapa in the Federal District of Mexico. Materials and methods: sudy descriptive, retrospective (December 2014 to April of 2015), in the delegation of Iztapalapa of the District Federal of Mexico, it shows was constituted by 135 women. To collect the information is used a survey to data socio-demographic and characterization family based in the ENSANUT. Also used the instrument of assessment of family functionality (APGAR family) and satisfaction with the services. Data were coded in an array of data in the Microsoft Excel program and its analysis was performed by descriptive statistics using the statistical software SPSS version 23. Results: were included in the study, 135 women pregnant women, with an average age of 26,7 years, prenatal median was 5, the main reason to attend is the detecting early alterations, also they are satisfied with the care provided by health personnel and they have adequate family support. Conclusions: the use of the control prenatal is greater among primiparous women, that living nuclear families and that perceived their families as functional..(AU)

Resultados de investigaciones en calidad y seguridad del paciente. Tema pendiente para la toma de decisiones

El martes 5 de diciembre, a las 11:00 hs en el Salón Rojo de la Secretaría de Graduados en Ciencias de la Salud de la Facultad de Ciencias Médicas (FCM) de la Universidad Nacional de Córdoba, se realizó la Conferencia Abierta "Resultados de investigaciones en calidad y seguridad del paciente. Tema pendiente para la toma de decisiones" a cargo de la Profesora Titular de la Escuela de Enfermería y Obstetricia de la Universidad Nacional Autónoma de México, Rosa Amarilis Zárate Grajales invitada por la Especialidad de Enfermerìa en el cuidado de el paciente crítico de la SGCS. FCM. UNC. Estuvieron presentes el Sr. Decano de la Facultad de Ciencias Médicas, el Secretario de Salud Pública y Ambiente y Autoridades de la Secretaría. La conferencia también se transmitió de manera virtual por la sala del Campus Virtual de Salud Pública de la OPS Nodo Argentina.