Resilience of Healthcare Systems in the face of COVID-19: an experience report.

OBJECTIVE: to report the professional experience of a nurse manager facing the challenges of restructuring a hospital service in the face of the COVID-19 pandemic. METHOD: this is an experience report, based on the perspective of system resilience in a public hospital. RESULTS: the challenges faced were: internal service flow reorganization to assist suspected cases of COVID-19; institution of structural changes and adaptations, from entry into the emergency room to the wards and intensive care unit; equipment and supply acquisition for patient care with a focus on their quality and functionality; staff training, with the restructuring of work processes; staff sizing, considering the time of exposure to the virus; staff's professional qualification, absenteeism, stress, physical and psychological illness, with a view to safe and quality care; nursing staff leadership to deal with conflicts generated by professionals' stress and illness. CONCLUSION: healthcare service resilience is critical for hospital restructuring in the COVID-19 pandemic; however, patient care and healthcare professionals' physical and mental health must be considered.

Resilience of Healthcare Systems in the face of COVID-19: an experience report / Resiliencia de los Sistemas de Salud frente al COVID-19: relato de experiencia / Resiliência de Sistemas de Assistência à Saúde no enfrentamento da COVID-19: relato de experiência

ABSTRACT Objective: to report the professional experience of a nurse manager facing the challenges of restructuring a hospital service in the face of the COVID-19 pandemic. Method: this is an experience report, based on the perspective of system resilience in a public hospital. Results: the challenges faced were: internal service flow reorganization to assist suspected cases of COVID-19; institution of structural changes and adaptations, from entry into the emergency room to the wards and intensive care unit; equipment and supply acquisition for patient care with a focus on their quality and functionality; staff training, with the restructuring of work processes; staff sizing, considering the time of exposure to the virus; staff's professional qualification, absenteeism, stress, physical and psychological illness, with a view to safe and quality care; nursing staff leadership to deal with conflicts generated by professionals' stress and illness. Conclusion: healthcare service resilience is critical for hospital restructuring in the COVID-19 pandemic; however, patient care and healthcare professionals' physical and mental health must be considered.

RESUMEN Objetivo: relatar la experiencia profesional de una enfermera gestora frente a los desafíos de la reestructuración de un servicio hospitalario frente a la pandemia de la COVID-19. Método: relato de experiencia, basado en la perspectiva de resiliencia del sistema en un hospital público. Resultados: los desafíos enfrentados fueron: reorganización del flujo interno de atención para la atención de casos sospechosos de COVID-19; institución de cambios y adaptaciones estructurales, desde el ingreso al departamento de urgencias y emergencias hasta las salas y unidad de cuidados intensivos; adquisición de equipos e insumos para la atención de pacientes con enfoque en su calidad y funcionalidad; formación de equipos con la reestructuración de los procesos de trabajo; dimensionamiento del personal, considerando el tiempo de exposición al virus, cualificación profesional, ausentismo, estrés, enfermedad física y psíquica del equipo, con miras a un cuidado seguro y de calidad y liderazgo del equipo de enfermería para el enfrentamiento de los conflictos generados por el estrés y la enfermedad de los profesionales. Conclusión: la resiliencia del servicio de salud es fundamental para la reestructuración hospitalaria en la pandemia del COVID-19, sin embargo, se debe considerar la atención al paciente y la salud física y mental de los profesionales de la salud.

RESUMO Objetivo: relatar a experiência profissional de um enfermeiro gestor frente aos desafios da reestruturação de um serviço hospitalar diante da pandemia da COVID-19. Método: relato de experiência, baseado na perspectiva da resiliência do sistema em um hospital público. Resultados: os desafios enfrentados foram: reorganização do fluxo de serviço interno para atender os casos suspeitos de COVID-19; instituição de mudanças e adaptações estruturais, desde a entrada na urgência e emergência, até nas enfermarias e unidade de terapia intensiva; aquisição de equipamentos e insumos para o atendimento dos pacientes com foco na qualidade e funcionalidade destes; treinamento das equipes, com a reestruturação dos processos de trabalho; dimensionamento de pessoal, considerando o tempo de exposição ao vírus; qualificação profissional, absenteísmo, estresse, adoecimento físico e psicológico da equipe, com vistas à uma assistência segura e de qualidade; liderança da equipe de Enfermagem para lidar com os conflitos gerados pelo estresse e adoecimento dos profissionais. Conclusão: a resiliência do serviço de saúde é fundamental para a reestruturação hospitalar na pandemia da COVID-19, no entanto, devem-se considerar o cuidado dos pacientes e a saúde física e mental dos profissionais de saúde.

Anxiety and performance of nursing students in regard to assessment via clinical simulations in the classroom versus filmed assessments.

OBJECTIVE: To compare the level of anxiety and performance of nursing students when performing a clinical simulation through the traditional method of assessment with the presence of an evaluator and through a filmed assessment without the presence of an evaluator. METHODOLOGY: Controlled trial with the participation of Brazilian public university 20 students who were randomly assigned to one of two groups: a) assessment through the traditional method with the presence of an evaluator; or b) filmed assessment. The level of anxiety was assessed using the Zung test and performance was measured based on the number of correct answers. RESULTS: Averages of 32 and 27 were obtained on the anxiety scale by the group assessed through the traditional method before and after the simulation, respectively, while the filmed group obtained averages of 33 and 26; the final scores correspond to mild anxiety. Even though there was a statistically significant reduction in the intra-groups scores before and after the simulation, there was no difference between the groups. As for the performance assessments in the clinical simulation, the groups obtained similar percentages of correct answers (83% in the traditional assessment and 84% in the filmed assessment) without statistically significant differences. CONCLUSION: Filming can be used and encouraged as a strategy to assess nursing undergraduate students.