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BACKGROUND: Enforcing practice standards for cardiac monitoring in intensive care units (ICUs) has been shown to reduce misdiagnoses and inappropriate interventions. Continuous professional development (CPD) programs are committed to aligning clinical practices with recommended standards. The crucial initial phase in CPD development involves assessing the training needs of the targeted population. OBJECTIVE: To assess the training needs of ICU nurses in cardiac monitoring. The overarching goal was to formulate a focused Continuous Professional Development (CPD) program geared towards implementing standard practices in cardiac monitoring. METHODS: This study employed a generic qualitative approach with a descriptive design, utilizing interviews and focus groups from July to September 2018. Involving 16 ICU nurses. Content analysis was employed, encompassing transcription, fluctuant and iterative reading, unitization, categorization, coding, description, and interpretation. RESULTS: All nurses recognized cardiac monitoring's importance in the ICU but reported barriers to its effective implementation which were related to factors that could addressed by a CPD as insufficient knowledge and skills. Training needs were identified in both clinical and technical aspects, with recommendations for practical and theoretical activities and e-learning strategies. Barriers related to organizational aspects (equipment and communication within the healthcare team) were also mentioned. CONCLUSION: ICU nurses presented clear and specific training needs related to cardiac monitoring as knowledge, skills, and competencies. Other organizational aspects were also reported as barriers. Addressing these learning needs through targeted CPD aligned with organizational initiatives can contribute to enhancing the quality of cardiac monitoring practices in ICUs.
RESUMEN
Introdução: O uso do Nursing Activity Score permite correlacionar a carga de trabalho de enfermagem com os índices de avaliação prognóstica na unidade de terapia intensiva e auxiliar no desenvolvimento do processo de trabalho dos enfermeiros por meio do dimensionamento adequado da equipe. Objetivo: Analisar a associação entre variáveis clínicas e demográficas de pacientes com carga de trabalho de enfermagem em uma Unidade de Terapia Intensiva Oncológica. Métodos: Coorte prospectiva, realizada no Instituto Nacional de Câncer José Alencar Gomes da Silva, no período de setembro a dezembro de 2016. A coleta de dados inclui a mensuração da carga de trabalho por meio do Escore de Atividades de Enfermagem. Foi realizada análise estatística descritiva dos dados. Em seguida, a associação das variáveis qualitativas com o NAS foi testada pelo teste de Kruskal-Wallis e as variáveis quantitativas foram analisadas por análise de regressão múltipla. Para o tratamento dos dados, foram consideradas significância p = 0,05 e 95 porcento de confiança. Resultado: A carga total de trabalho encontrada (79,04 porcento) corresponde a 18 horas e 57 minutos de assistência a cada paciente em 24 horas. A média da condição de saída do paciente é dividida em sobreviventes e não sobreviventes, com uma pontuação de 74,19 porcento (DP = 11,54) e 126,64 porcento (DP = 17,62), respectivamente. Conclusão: Apenas as variáveis status de desempenho de Karnofsky e condição de saída foram significativamente associadas à carga de trabalho(AU)
Introducción: El uso del Puntaje de Actividades de Enfermería permite correlacionar la carga de trabajo de enfermería con los índices de evaluación pronóstica en la unidad de cuidados intensivos y ayuda en el desarrollo del proceso de trabajo de las enfermeras a través del dimensionamiento del personal apropiado. Objetivo: Analizar la asociación entre variables clínicas y demográficas de pacientes con carga de trabajo de enfermería en una Unidad de Cuidados Intensivos de Oncología. Métodos: Estudio de cohorte prospectiva, realizada en Instituto Nacional del Câncer José Alencar Gomes da Silva de septiembre a diciembre de 2016. La recolección de datos incluye la medición de la carga de trabajo a través del Puntaje de Actividades de Enfermería. Se realizó un análisis estadístico descriptivo de los datos. Después, se probó la asociación de variables cualitativas con NAS mediante la prueba de Kruskal-Wallis y se analizaron las variables cuantitativas mediante análisis de regresión múltiple. Para el tratamiento de los datos, se consideró una significancia p = 0,05 y un 95 por ciento de confianza. Resultado: La carga de trabajo total encontrada (79,04 por ciento) corresponde a 18 horas y 57 minutos de asistencia a cada paciente dentro de las 24 horas. La media para la condición de salida de los pacientes se divide en sobrevivientes y no sobrevivientes, con un puntaje de 74,19 por ciento (SD = 11,54) y 126,64 por ciento (SD = 17,62), respectivamente. Conclusión: Solo las variables de estado de rendimiento de Karnofsky y la condición de salida se asociaron significativamente con la carga de trabajo(AU)
Introduction: The use of the Nursing Activity Score (NAS) makes it possible to correlate the nursing workload with prognostic evaluation indices in the intensive care unit and helps in the development of the nurses' work process through the sizing of the appropriate personnel. Objective: To analyze the association between clinical and demographic variables about patients with a nursing workload in an oncology intensive care unit. Methods: Prospective cohort study carried out at José Alencar Gomes da Silva National Cancer Institute, from September to December 2016. The data collection includes the measurement of the workload through the Nursing Activities Score. A descriptive statistical analysis of the data was performed. Afterwards, the association between qualitative variables and the NAS was tested using the Kruskal-Wallis test and the quantitative variables were analyzed using multiple regression analysis. For data treatment, significance was considered (P = 0.05; confidence interval 95 percent). Result: The total workload found (79.04 percent) corresponds to 18 hours and 57 minutes of assistance to each patient within 24 hours. The mean for the discharge condition of the patients is divided into survivors and non-survivors, with a score of 74.19 percent (SD=11.54) and 126.64 percent (SD=17.62), respectively. Conclusion: Only Karnofsky performance state variables and discharge condition were significantly associated with workload(AU)