Development and Validation of the "Program to Promote Positive Nursing Practice Environments": Modified Delphi Study.

Positive nursing practice environments benefit clients, professionals, and institutions, specifically for professionals, by improving professional visibility, recognition, retention intentions, well-being, commitment, job satisfaction, and reducing stress and burnout. Clients experience better quality care, safety, satisfaction, engagement, and fewer care omissions. Institutions favored reduced absenteeism and turnover, improved efficiency, lower costs, and better health outcomes. This study aimed to document the development of the "Program to Promote Positive Nursing Practice Environments" and analyze expert perceptions to reach a consensus. Using a two-round modified online Delphi technique with 22 experts, we examined perspectives on the program's goals, duration, organization, and content. Initial feedback showed agreement on the program's duration but mixed opinions on the number and length of sessions due to concerns about participant workload and fatigue. Adjustments led to a strong consensus and positive feedback on the program's coverage of essential nursing practice environment constructs. The program includes sessions on client, professional, and institutional dynamics, focusing on key attributes and outcomes for fostering positive nursing environments. By equipping nurses with knowledge and skills, the program aims to enhance work environments effectively. These findings provide a substantial advancement in the field, offering a robust framework for future initiatives.

Development and Validation of a Game for Older Adults on Lifestyles and Frailty.

BACKGROUND: Games are a promising strategy for rehabilitating older adults. The effect of games on promoting healthy lifestyles and preventing frailty remains uncertain. This article aims to describe the process of development and validation of the game "Bem-me-quer para a saúde"® to promote the acquisition of healthy lifestyles and prevent frailty in over 65-year-olds. METHODS: This study comprised three distinct phases, spanning from December 2023 to June 2024. The first phase comprised a thorough review of the scientific literature on the frailty and lifestyles of older adults, a second phase of game design, and a third phase of content and semantic validation conducted by specialized nurses and older adults. RESULTS: After revising literature, this study utilized an e-Delphi with a panel of 14 specialist nurses who underwent two rounds of evaluation. The "Bem-me-quer para a saúde"® game includes a puzzle board with 54 pieces and 30 educational cards. In the final phase, we evaluated the game on a cohort of 50 older adults, highlighting its reflective, interactive, and educational aspects. CONCLUSIONS: The game presented sufficient evidence of content validity and relevance to clinical practice. We should conduct additional research to evaluate its impact on lifestyle modification and frailty prevention.

Scale for the environments evaluation of professional nursing practice-shortened version: Psychometric evaluation.

AIM: The aim of this study is to test the validity and reliability of the shortened version of the Scale for the Environments Evaluation of Professional Nursing Practice (SEE-Nursing Practice). METHODS: This methodological, cross-sectional study was conducted between September and December 2022. The original version of the SEE-Nursing Practice was administered in questionnaire format across 17 hospitals. Exploratory and confirmatory factor analyses were conducted to identify relevant items for the new shortened version of the scale and evaluate its construct validity. RESULTS: The study involved 1713 registered nurses from various regions of Portugal. From the exploratory factor analysis, the SEE-Nursing Practice was condensed to 59 items and 3 subscales. In the structure subscale, 14 items were removed, and the remaining 29 items distributed over four factors; in the process subscale, 18 items were removed, and the remaining 19 items organized into three factors; in the outcome subscale, 2 items were removed, and the remaining 11 items distributed over two factors. The Cronbach's alpha for the three subscales exceeded 0.90, indicating high reliability. Confirmatory factor analyses provided support for the validity of the 59-item model. CONCLUSION: The shortened version of the SEE-Nursing Practice shows adequate validity and reliability, reducing the burden associated with its longer version.

Nurses' perspectives on nurses' work methods.

OBJECTIVES: To analyze nurses' perspectives on nurses' work methods in the hospital context. METHODS: A descriptive study with a qualitative approach was conducted in a hospital in northern Portugal, involving 17 nurses. Semi-structured interviews were used for data collection. Data collected between May and June 2023 underwent content analysis, supported by Atlas.ti software. RESULTS: Three thematic areas emerged: "Nurses' work methods in a hospital context," highlighting the conception and components of work methods and the methods in use; "Implementation of nurses' work methods," emphasizing influencing factors and challenges to implementation; and "Impact of nurses' work methods on patients, nurses, and institutions." FINAL CONSIDERATIONS: Nurses' work methods constitute the structure of nursing care. Some factors influence and some challenges arise in the implementation of these methods, producing impacts on patients, nurses, and institutions.

Safety climate in the operating room in the pre-pandemic and pandemic period of COVID-19: A mixed method study.

INTRODUCTION: To verify whether the COVID-19 pandemic has had an impact on the safety climate based on the perception of the multiprofessional team in the operating room and to analyze the domains of the safety climate during the pre-pandemic and pandemic period of COVID-19, demonstrating the intersections of quantitative and qualitative approaches. METHODS: Mixed-method research using a convergent approach strategy, carried out in the operating room of a university hospital, located in Rio de Janeiro, Brazil. The nature of the quantitative phase was cross-sectional, and the nature of the qualitative phase was descriptive. We used the Pillar Integration Process to integrate the data. This research considered the pre-pandemic period was defined as before March 2020 and for the pandemic period, the 2nd and 3rd global waves. Research was approved by the institution's board management and ethics committee. RESULTS: 145 health professionals participated in the quantitative approach, and 20 in the qualitative approach. The impact of the COVID-19 pandemic was highlighted in the domains 'Perceived stress' (p-value = 0.017); 'Working conditions' (p-value = 0.040). Six categories emerged from the qualitative analysis, namely: Stress and professional performance due to COVID-19; Patient safety protocols in the operating room; Responsibility for patient safety, lack of effective communication and performance feedback; Biosafety of the professional staff in the operating room; Security culture maturity; Fair culture, organizational learning, and reporting mistakes. As a result of the data integration, 6 pillars were identified: Perception of communication in the operating room; Evolution of safety culture; Overview of protocol management and implementation; Fair organizational culture; Perception of stress due to COVID-19; Perception of professional performance due to COVID-19. CONCLUSIONS: The impact that COVID-19 had on the safety climate in the operating room is evident. It underlines the need to implement strategies that support the solidification of attitudes aimed at patient safety, even in emergencies.

Habilidades nas transferências para desempenho das atividades cotidianas de pessoas com lesão da medula espinal / Skills in transfers to perform the daily activities of people with spinal cord injury / Habilidades en transferencias para realizar las actividades diarias de personas con lesión médula espinal

Objetivo: refletir sobre a importância do trabalho das equipes de reabilitação, orientando e habilitando os cadeirantes para o desempenho seguro das transferências diárias, fundamentais na realização das atividades cotidianas e inclusão social. Métodos: trata-se de estudo teórico-reflexivo fundamentado na teoria do déficit de autocuidado, com a utilização integrada dos diagnósticos de enfermagem, da classificação internacional das práticas de enfermagem e do instrumento de avaliação das transferências, adequados às necessidades de pessoas com lesão medular, atendidas nos ambientes institucionais de cuidados, visando o preparo para o desempenho das atividades cotidianas. Resultados: cabe aos enfermeiros assumir liderança nas equipes de reabilitação física, norteando suas intervenções no treinamento dessas pessoas e seus cuidadores para o desempenho e ajuda segura nas transferências para cuidar de si. Conclusão: considerando a lesão medular entre os maiores problemas da saúde coletiva que afeta a humanidade contemporânea, tanto pelos comprometimentos na qualidade de vida das pessoas, quanto no aumento das despesas hospitalares e reabilitação requeridos, a adoção de estratégias de cuidados preventivos de complicações musculoesqueléticas é sempre bem-vinda. Essas pessoas, quando não orientadas, executam movimentos repetitivos para se deslocar em transferências de uma superfície para outra, correndo elevados riscos de contrair lesões nas articulações, pele e mucosas. (AU)

Objective: to reflect on the importance of the work of rehabilitation teams, guiding and enabling wheelchair users to safely perform daily transfers, essential for carrying out daily activities and social inclusion. Methods: this is a theoretical-reflective study based on the theory of self-care deficit, with the integrated use of nursing diagnoses, the international classification of nursing practices and the transfer assessment instrument, adapted to the needs of people with spinal cord injury, attended in institutional care environments, aiming to prepare for the performance of daily activities. Results: it is up to nurses to assume leadership in physical rehabilitation teams, guiding their interventions in the training of these people and their caregivers for performance and safe help in transfers to take care of themselves. Conclusion: considering spinal cord injury among the biggest collective health problems that affect contemporary humanity, both because of the compromises in people's quality of life, as well as the increase in hospital and rehabilitation expenses required, the adoption of preventive care strategies for musculoskeletal complications is always welcome. These people, when not guided, perform repetitive movements to move in transfers from one surface to another, running high risks of contracting injuries to the joints, skin and mucous membranes. (AU)

Objetivo: reflexionar sobre la importancia del trabajo de los equipos de rehabilitación, orientando y capacitando a los usuarios de silla de ruedas para realizar con seguridad las tranferencias cotidianas, indispensables para el desarrollo de las actividades cotidianas y la inclusión social. Métodos: se trata de un estudio teórico-reflexivo basado en la teoría del déficit de autocuidado, con el uso integrado de los diagnósticos de enfermería, la clasificación internacional de prácticas de enfermería y el instrumento de evaluación de la transferencia, adaptado a las necesidades de las personas con lesión medular. asistidos en ambientes de atención institucional, con el objetivo de preparar para el desempeño de las actividades diárias. Resultados: corresponde a los enfermeros asumir el liderazgo en los equipos de rehabilitación física, orientando sus intervenciones en la formación de esas personas y sus cuidadores para el desempeño y ayuda segura en las transferencias para cuidarse. Conclusion: considerando la lesión medular entre los mayores problemas de salud colectiva que afectan a la humanidad contemporánea, tanto por los compromisos en la calidad de vida de las personas, como por el aumento de los gastos hospitalarios y de rehabilitación requeridos, la adopción de estrategias de atención preventiva de las complicaciones musculoesqueléticas siempre es bienvenido Estas personas, cuando no están guiadas, realizan movimientos repetitivos para moverse en transferencias de una superficie a otra, corriendo un alto riesgo de contraer lesiones en las articulaciones, piel y mucosas. (AU)

The impact of nursing practice environments on patient safety culture in primary health care: a scoping review.

BACKGROUND: Patient safety has in recent decades become a global concern. It is a key priority area of healthcare organisations, and has a direct impact on patient health and wellbeing. Work environments can strongly impact nurses' wellbeing and may ultimately produce different outcomes for both professionals and patients. The adverse events occurrence is an example of how work environments influence outcomes, and there is evidence of this correlation in several studies conducted in recent years. AIM: To map the knowledge regarding the impact that nursing practice environments have on safety culture in primary healthcare settings, as primary health care concentrates a significant portion of the population's care. DESIGN & SETTING: This review was conducted following the methodology proposed by the Joanna Briggs Institute (JBI) for scoping reviews. METHOD: Study selection, data extraction, and synthesis were performed by two independent reviewers. Based on Population (or participants), Concept, and Context (PCC) framework, studies were considered that addressed nurses' practice environment and patient safety culture in primary health care. All studies published or unpublished from 2002 to the present were considered. RESULTS: Seven studies were included in this review; however, the existing evidence on the relation between nurses' practice environments and patient safety is still limited in primary healthcare settings. Although clear evidence was not found, several characteristics of nursing practice environments that may impact healthcare safety were found, such as leadership, communication, and organisational culture and policies. CONCLUSION: More research directed at primary healthcare nursing practice settings is needed and could be valuable in defining and implementing strategies that promote the safety of care.

Hemodialysis vascular access coordinator: Three-level model for access management.

Management of vascular access is a challenge for the dialysis team, particularly to keep the arteriovenous access working. The vascular access coordinator can positively contribute to increase the number of arteriovenous fistulas and reduce central venous catheters. In this article, we introduce a new approach to vascular access management centered on (the results of setting up) the role of vascular access coordinator. We described the three-level model (3Level_M) for vascular access management organized in three levels: vascular access nurse manager, vascular access coordinator, and vascular access consultant. We defined the instrumental skills and training required to be developed by each element and clarify the articulation between the model and all members of the dialysis team related to vascular access.

Validation of the scale for the environment evaluation of professional nursing practice for brazil / Validación de la scale for the environment evaluation of professional nursing practice para su uso en brasil / Validação da scale for the environment evaluation of professional nursing practice para o brasil

ABSTRACT Objective: to perform the linguistic, cultural and validation adaptation of Scale for the Environment Evaluation of Professional Nursing Practice (SEE - Nursing Practice) for Brazil. Method: a methodological study with a sample of 291 nurses working in eight Brazilian hospitals. Data collection occurred from July to October 2021. Internal consistency of the instrument was evaluated by means of the Cronbach's alpha coefficient, and validity of the structure of the scale by domains was evaluated via exploratory factor analysis with extraction by principal components and Varimax rotation, as well as adequacy and measureability measures. Results: in the subscale of the Structure dimension, a 6-factor solution explained 63.1% of the total variance, consisting of 40 items, distributed in six factors. In the subscale of the Process dimension, the exploratory five-factor analysis explained 62% of the total variance and consisted of 33 items. The exploratory factor analysis of the Outcome dimension subscale indicated a two-factor solution that explained 67.7% of the total variance and consisted of 13 items. The subscales of SEE - Nursing Practice (Structure, Process and Outcome) obtained internal consistency values of 0.956, 0.929 and 0.937, respectively. Conclusion: the Brazilian version of SEE - Nursing Practice is a valid and reliable tool used to assess whether professional Nursing practice environments promote care quality.

RESUMEN Objetivo: realizar la adaptación lingüística y cultural y validar la escala Scale for the Environment Evaluation of Professional Nursing Practice (SEE - Nursing Practice) para Brasil. Método: estudio metodológico con una muestra de 291 enfermeros que trabajan en ocho hospitales de Brasil. La recolección de datos ocurrió de julio a octobre de 2021. La consistencia interna del instrumento se evaluó por medio del coeficiente alfa de Cronbach y la validez de la estructura de la escala por dominios se evaluó a través de Análisis Factorial Exploratorio con extracción por componentes principales y rotación Varimax, además de medidas de adecuación y esfericidad. Resultados: en la subescala de la dimensión Estructura, una solución de 6 factores explicó el 63,1% de la varianza total, con 40 ítems distribuidos en seis factores. En la subescala de la dimensión Proceso, el Análisis Factorial Exploratorio de cinco factores explicó el 62% de la varianza total y constó de 33 ítems. El Análisis Factorial Exploratorio de la subescala de la dimensión Resultado indicó una solución de dos factores que explicaron el 67,7% de la varianza total y estuvo compuesta por 13 ítems. Las subescalas de la escala SEE - Nursing Practice (Estructura, Proceso y Resultado) obtuvieron valores de consistencia interna de 0,956, 0,929 y 0,937, respectivamente. Conclusión: la versión brasileña de la escala SEE - Nursing Practice es una herramienta válida y confiable que se utiliza para evaluar se los ambientes de práctica profesional de la Enfermería promueven calidad de asistencia.

RESUMO Objetivo: realizar a adaptação linguística, cultural e validação da Scale for the Environment Evaluation of Professional Nursing Practice (SEE - Nursing Practice) para o Brasil. Método: estudo metodológico utilizando uma amostra de 291 enfermeiros, atuantes em oito hospitais brasileiros. A coleta de dados ocorreu no período de julho a outubro de 2021. A consistência interna do instrumento foi avaliada pelo coeficiente alfa de Cronbach e a validade da estruturação da escala por domínios foi avaliada pela Análise Factorial Exploratória com extração por componentes principais e rotação Varimax e medidas de adequação e de esfericidade. Resultados: na subescala da dimensão Estrutura uma solução de 6 fatores explicou 63,1% da variância total, ficando constituída por 40 itens, distribuídos em seis fatores. Na subescala da dimensão Processo, a análise factorial exploratória de cinco fatores, explicou 62% da variância total e ficou constituída por 33 itens. A análise factorial exploratória da subescala da dimensão Resultado apontou uma solução de dois fatores que explicaram 67,7% da variância total e constituída por 13 itens. As subescalas da SEE - Nursing Practice - Estrutura, Processo e Resultado obtiveram uma consistência interna de 0,956, 0,929 e 0,937, respectivamente. Conclusão: a versão brasileira da SEE - Nursing Practice é uma ferramenta válida e confiável utilizada para avaliar se os ambientes de prática profissional de enfermagem são promotores de qualidade de atendimento.

Nurses' perspectives on nurses' work methods / Mirada de los enfermeros sobre los métodos de trabajo en enfermería / Olhar dos enfermeiros sobre os métodos de trabalho em enfermagem

ABSTRACT Objectives: To analyze nurses' perspectives on nurses' work methods in the hospital context. Methods: A descriptive study with a qualitative approach was conducted in a hospital in northern Portugal, involving 17 nurses. Semi-structured interviews were used for data collection. Data collected between May and June 2023 underwent content analysis, supported by Atlas.ti software. Results: Three thematic areas emerged: "Nurses' work methods in a hospital context," highlighting the conception and components of work methods and the methods in use; "Implementation of nurses' work methods," emphasizing influencing factors and challenges to implementation; and "Impact of nurses' work methods on patients, nurses, and institutions." Final Considerations: Nurses' work methods constitute the structure of nursing care. Some factors influence and some challenges arise in the implementation of these methods, producing impacts on patients, nurses, and institutions.

RESUMEN Objetivos: Analizar percepción de enfermeros sobre métodos de trabajo en enfermería en contexto hospitalario. Métodos: Estudio descriptivo con abordaje cualitativa, realizado en un hospital del norte de Portugal, con participación de 17 enfermeros. Como instrumento de recolecta de datos, recorrido a la entrevista semiestructurada. Datos recolectados entre mayo e junio de 2023, pasaron por análisis de contenido, con suporte del software Atlas.ti. Resultados: Emergieron tres áreas temáticas: "Métodos de trabajo de enfermeros en contexto hospitalario", destacándose la concepción y componentes de métodos de trabajo y en uso; "Implementación de métodos de trabajo", señalándose factores influenciadores y desafíos a la implementación; e "Impacto de métodos de trabajo de enfermeros para los pacientes, enfermeros e instituciones". Consideraciones Finales: Los métodos de trabajo constituidos como la estructura de asistencia de enfermería. Hay factores que influencian y desafíos que se quedan a la implementación de esos métodos, produciendo impacto en pacientes, enfermeros e instituciones.

RESUMO Objetivos: Analisar a percepção dos enfermeiros sobre os métodos de trabalho em enfermagem no contexto hospitalar. Métodos: Estudo descritivo com abordagem qualitativa, realizado num hospital do norte de Portugal, com participação de 17 enfermeiros. Como instrumento de coleta de dados, recorreu se à entrevista semiestruturada. Os dados, recolhidos entre maio e junho de 2023, passaram por análise de conteúdo, com suporte do software Atlas.ti. Resultados: Emergiram três áreas temáticas: "Métodos de trabalho dos enfermeiros em contexto hospitalar", destacando-se a concepção e componentes dos métodos de trabalho e os métodos em uso; "Implementação dos métodos de trabalho", salientando-se fatores influenciadores e desafios à implementação; e "Impacto dos métodos de trabalho dos enfermeiros para os pacientes, enfermeiros e instituições". Considerações Finais: Os métodos de trabalho constituem-se como a estrutura da assistência de enfermagem. Existem fatores que influenciam e desafios que se colocam à implementação desses métodos, produzindo impacto nos pacientes, enfermeiros e instituições.

Percepção de enfermeiros sobre as 3S ­ Smart Safe Shoes: meias para prevenção de quedas / Nurses perception of the 3S - Smart Safe Shoes: socks to prevent falls / Percepción de enfermeros sobre los 3S - Smart Safe Shoes: calcetines para prevenir caídas

Objetivo: analisar a percepção dos enfermeiros sobre o uso das 3S - Smart Safe Shoes na sua fase de protótipo e os resultados da avaliação do seu uso por idosos internados. Método: estudo de carater exploratório, descritivo e misto, entre novembro de 2021 e março de 2022. Incluiu idosos internados com capacidade de deambulação e identificados com risco de queda; e enfermeiros especialistas. Os dados quantitativos foram analisados por estatística descritiva e os qualitativos a partir de análise temática. Resultados: participaram 28 idosos e sete enfermeiros, ambos concordaram que as 3S ­ Smart Safe Shoes são confortáveis. Os enfermeiros consideram que as meias se adaptaram perfeitamente às diferentes regiões anatômicas do pé e que apresentam propriedades antiderrapantes nos pisos testados; e na maioria das situações, permitem uma boa mobilidade dos dedos, em todos os movimentos tibiotársicos (86%). Todos os enfermeiros destacam a facilidade de calçar as meias e consideram que estas devem ser incluídas como um elemento em estratégia de prevenção de quedas. Conclusão: as 3S - Smart Safe Shoes reunem as características necessárias para garantir uma marcha segura em idosos internados e o seu uso deve ser considerado em outros contextos.

Objective: to analyse nurse's perception about 3S - Smart Safe Shoes use in their prototype phase and describe their evaluation about this use by hospitalized elderly patients. Method: exploratory, descriptive and mixed study, between November 2021 and March 2022. It included hospitalized elderly people who were able to walk and identified as being at risk of falling; and specialist nurses. Quantitative data were analyzed using descriptive statistics and qualitative data using thematic analysis. Results: 28 seniors and seven nurses participated, both agreed that the 3S ­ Smart Safe Shoes are comfortable. The nurses consider that the socks adapt perfectly to the different anatomical regions of the foot and that they have non-slip properties on the tested floors; and in most situations, they allow good mobility of the fingers, in all tibiotarsal movements (86%). All nurses highlight the ease of putting on stockings and consider that these should be included as an element in a fall prevention strategy. Conclusion: 3S - Smart Safe Shoes have the necessary characteristics to guarantee a safe gait in hospitalized elderly patients and their use should be considered in other contexts.

The impact of nursing practice environments on patient safety culture in primary health care: a scoping review protocol.

BACKGROUND: Patient safety is a key priority for healthcare organisations. It impacts directly on patient health and wellbeing. The increasing complexity of current healthcare settings, which are associated with high work demands and increasingly stressful professional practice environments, contributes to an increased likelihood of errors and adverse events. Primary health care, given its comprehensiveness of care, makes up a large proportion of the care delivered to the population. AIM: To map the knowledge about the impact that nursing practice environments have on safety culture in the primary healthcare setting. This knowledge is essential for a more effective and appropriate understanding of this phenomenon and to enable the definition of strategies that can promote the provision of safer care to the population. DESIGN & SETTING: A scoping review will be conducted based on the method proposed by the JBI, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) will be used. METHOD: Study selection, data extraction, and synthesis will be performed by two independent reviewers. Based on the Population (or participants), Concept, and Context (PCC) framework, this scoping review will consider studies that address nurses' practice environment and patient safety culture in primary health care. The review will consider all studies, published or unpublished, from 2002 to the present. CONCLUSION: The results from this scoping review are expected to provide an overview of the importance of the nursing practice environments on patient safety culture, which will be crucial to define an appropriate range of strategies to promote the delivery of the safest health care to the population.

Nurses' Work Methods Assessment Scale: a study of content validation.

OBJECTIVE: To develop and validate the content of the Nurses' Work Methods Assessment Scale. METHODS: Methodological study conducted between January and February 2022, based on the Quality Standards for Nursing Care and Imogene King's framework. A literature review was previously undertaken to design the scale. The content validation was carried out by 23 experts. RESULTS: The initial version consisted of 40 items organized in four work methods identified in the literature. In the first dimension, from ten items, seven were considered, and one was reformulated. Seven of the initial ten items were considered in the second version. The third dimension consisted of seven items. In the fourth dimension, three items were reformulated, and three were excluded, leaving seven items. The final version ended with 28 items, whose Content Validity Index ranged between 0.83 and 1. CONCLUSIONS: The involvement of experts has become pivotal in the development and validation of the items, providing confidence to the continuity of psychometric procedures.

From the first to the fourth critical period of COVID-19: what has changed in nursing practice environments in hospital settings?

BACKGROUND: The COVID-19 pandemic reinforced the need to invest in nursing practice environments and health institutions were led to implement several changes. In this sense, this study aimed to analyze the impact of the changes that occurred in nursing practice  environments between the first and fourth critical periods of the pandemic. METHODS: Quantitative, observational study, conducted in a University Hospital, with the participation of 713 registered nurses. Data were collected through a questionnaire with sociodemographic and professional characterization and the Scale for the Environments Evaluation of Professional Nursing Practice, applied at two different points in time: from 1 to 30 June 2020 and from 15 August to 15 September 2021. Data were processed using descriptive and inferential statistics. RESULTS: Overall, the pandemic had a positive impact on nursing practice environments. However, the Process component remained favourable to quality of care, while the Structure and Outcome components only moderately favourable. Nurses working in Medicine Department services showed lower scores in several dimensions of the Structure, Process and Outcome components. On the other hand, nurses working in areas caring for patients with COVID-19 showed higher scores in several dimensions of the Structure, Process and Outcome components. CONCLUSIONS: The pandemic had a positive impact on various dimensions of nursing practice environments, which denotes that regardless of the adversities and moments of crisis that may arise, investment in work environments will have positive repercussions. However, more investment is needed in Medicine Department services, which have historically been characterised by high workloads and structural conditions that make it difficult to promote positive and sustainable workplaces.

How to choose the appropriate cannulation technique for vascular access in hemodialysis patients.

The cannulation technique is important for the survival of the arteriovenous access. Choosing the appropriate technique is a complex decision. Such choice must be customized to patients, considering their characteristics, the type of arteriovenous access and the experience of the hemodialysis team. We describe seven items that can help nurses to identify the appropriate cannulation technique: type of arteriovenous access; drainage vein; hygienic self-care profile; experience of the nursing staff in the cannulation technique and nurse-to-patient ratio; hemodialysis treatment method; patient's condition; and patient's decision. Such items can help nurses in decision-making on the "ideal" cannulation technique for each patient.

Effect of the Active Aging-in-Place-Rehabilitation Nursing Program: A Randomized Controlled Trial.

(1) Background: It is of great importance to promote functional capacity and positive lifestyles, since they contribute to preventing the progression of frailty among the older adults. The aim of this study was to evaluate the effect of active aging-in-place−rehabilitation nursing program (AAP-RNP) on the functional capacity and lifestyles of frail older adults. (2) Methods: This was a single-blinded, two-group, randomized, controlled trial of 30 frail older people enrolled at a Health-care unit in Portugal between 2021 and 2022. The duration of the program was 12 weeks, and the sessions took place at the participants' homes. We used as instruments the Tilburg Frailty Indicator; Fried frailty phenotype; Senior Fitness Test battery; Barthel Index; Lawton Index; handgrip strength measurement; Tinetti Index; Individual lifestyle profile; and Borg's perception of effort. (3) Results: Post-program, there was an improvement in multidimensional and physical frailty, functional capacity, balance, and perceived exertion (p < 0.05) in the experimental group. Among the older adults' lifestyles, we observed significant improvements in physical activity habits, relational behavior, and stress management. (4) Conclusions: Rehabilitation nurses have a relevant role, and the AAP-RNP seems to be effective in improving functional capacity and lifestyles in frail older adults.

Epidemiological profile of spinal cord injury in Brazil.

OBJECTIVE: To identify and analyze the biosocioeconomic profile associated with the occupation and education of persons with spinal cord injury (SCI) from Brazil. DESIGN: Analytical, quantitative, descriptive, cross-sectional. PARTICIPANTS: Sample composed of 618 Brazilian adults with SCI and access to the internet. SETTING: Community-based, Brazil. METHODS: An online form was developed and publicized on Brazilian social media to voluntarily register for participation in research. Pearson's Chi-squared test was used to analyze the association between categorical variables and the Kruskal Wallis test was used for comparisons and adjusted Odds Ratio with a 95% Confidence Interval. RESULTS: Among the 618 participants, 68.9% were men, with mean age of 38.04 years (SD = 9.85); 58.7% were people with paraplegia and most injuries were traumatic (78.5%), most caused by road traffic accidents (40.8%) and weapons (17.5%). The majority were graduates or post-graduates (49.5%) and received an income of up to US$ 749.58 (55.1%); 70.9% of the participants were beneficiaries of social welfare (63.6%) or unemployed (7.3%). There was a reduction in the employment rate from 91.3% to 15.2% after SCI. An association was found between education and current occupation (P ≥ 0.001). Participants with higher education had higher odds (7.48) to being employed relative to those with elementary education. CONCLUSION: A serious employment situation after SCI was found, with high unemployment and dependence on social welfare. This shows the need for investment in public policies for the rehabilitation, focused on participation, return to the labor market, and ending dependence on social welfare.

Nurses' Work Methods Assessment Scale: a study of content validation / Escala de evaluación de los métodos de trabajo de los enfermeros: un estudio de validez de contenido / Escala de avaliação dos métodos de trabalho dos enfermeiros: um estudo de validação de conteúdo

ABSTRACT Objective: To develop and validate the content of the Nurses' Work Methods Assessment Scale. Methods: Methodological study conducted between January and February 2022, based on the Quality Standards for Nursing Care and Imogene King's framework. A literature review was previously undertaken to design the scale. The content validation was carried out by 23 experts. Results: The initial version consisted of 40 items organized in four work methods identified in the literature. In the first dimension, from ten items, seven were considered, and one was reformulated. Seven of the initial ten items were considered in the second version. The third dimension consisted of seven items. In the fourth dimension, three items were reformulated, and three were excluded, leaving seven items. The final version ended with 28 items, whose Content Validity Index ranged between 0.83 and 1. Conclusions: The involvement of experts has become pivotal in the development and validation of the items, providing confidence to the continuity of psychometric procedures.

RESUMEN Objetivo: Construir y validar contenido de Escala de Evaluación de Métodos de Trabajo de Enfermeros. Métodos: Estudio metodológico realizado entre enero y febrero de 2022, basado en Estándares de Calidad de Atención de Enfermeríay referencial de Imogene King. Para construcción de Escala, realizado previamente revisión de literatura. La validez de contenido contó con 23 peritos. Resultados: La versión inicial contenía 40 items, organizados en cuatro métodos de trabajo identificados en la literatura. La primera dimensión, de diez items, fueron considerados siete y uno fue reformulado. La segunda, de diez iniciales, fueron considerados siete. La tercera dimensión constituída por siete ítems. La cuarta dimensión, reformulados tres y excluidos tres, quedando siete. La versión final quedó con 28 items, cuyo Índice de Validez de Contenido osciló entre 0,83 y 1. Conclusiones: Recorrer a peritos volvió fundamental en la construcción y validez de los items, confiriendo seguridad a continuidad de procedimientos psicométricos.

RESUMO Objetivo: Construir e validar o conteúdo da Escala de Avaliação dos Métodos de Trabalho dos Enfermeiros. Métodos: Estudo metodológico realizado entre janeiro e fevereiro de 2022, baseado nos Padrões de Qualidade dos Cuidados de Enfermagem e no referencial de Imogene King. Para construção da Escala, realizou-se previamente revisão de literatura. A validação de conteúdo contou com 23 peritos. Resultados: A versão inicial continha 40 itens, organizados nos quatro métodos de trabalho identificados na literatura. Na primeira dimensão, dos dez itens, foram considerados sete e um foi reformulado. Na segunda, dos dez iniciais, foram considerados sete. A terceira dimensão constituiu-se por sete itens. Na quarta dimensão, reformularam-se três e excluíram-se três, ficando sete. A versão final ficou com 28 itens, cujo Índice de Validade de Conteúdo oscilou entre 0,83 e 1. Conclusões: Recorrer aos peritos tornou-se fundamental na construção e validação dos itens, conferindo segurança à continuidade dos procedimentos psicométricos.

Validity of a technological rehabilitation nursing program for people undergoing knee arthroplasty / Validación del programa de enfermería tecnológica en rehabilitación de personas realizadas en artroplastia de rodilla / Validação do programa de enfermagem de reabilitação tecnológico para pessoas submetidas a artroplastia do joelho

ABSTRACT Objective: to validate a Technological Rehabilitation Nursing Program for people undergoing total knee arthroplasty. Methods: this is a qualitative study, carried out through a focus group, with 12 nurses, considered experts in the area of rehabilitation. The program was developed using digital technology, such as an application for a mobile device. Experts assessed the program structure, the content made available to people undergoing total knee arthroplasty pre-operatively and post-operatively and the follow-up and communication strategies with nurses. Results: after content validity by experts, the final version of the program integrated three thematic areas and their respective categories: Rehabilitation program (Program phases, Program operationalization, Exercise plans included in the program); Useful information (Preparation for surgery, Care to be taken during surgery recovery); and Communication channel with nurses (Talk to a rehabilitation nurse, Self-assessment of health condition and Help with decision-making). Conclusion: experts' contributions made it possible to achieve the content validity of the program and, consequently, improve patient literacy about the procedure, complication prevention and self-care; training patients to carry out exercise plans in the pre- and post-operative periods; and communication with nurses through application.

RESUMEN Objetivo: validar un Programa Tecnológico de Enfermería de Rehabilitación para personas sometidas a artroplastia total de rodilla. Métodos: estudio cualitativo, realizado a través de un focus group, con 12 enfermeros, considerados expertos en el área de rehabilitación. El programa fue desarrollado utilizando tecnología digital, como una aplicación para un dispositivo móvil. Los expertos evaluaron la estructura del programa, los contenidos puestos a disposición de las personas sometidas a artroplastia total de rodilla en el preoperatorio y postoperatorio, y las estrategias de seguimiento y comunicación con la enfermera. Resultados: luego de la validación de contenido por parte de expertos, la versión final del Programa integró tres áreas temáticas y sus respectivas categorías: Programa de rehabilitación (Fases del programa, Operacionalización del programa, Planes de ejercicio incluidos en el programa); Información útil (Preparación para la cirugía, Cuidados a tener durante la recuperación quirúrgica); y Canal de Comunicación con la Enfermera (Hablar con una enfermera de rehabilitación, Autoevaluación del estado de salud y Ayuda en la toma de decisiones). Conclusión: los aportes de los expertos permitieron lograr la validez de contenido del programa y, en consecuencia, mejorar la alfabetización de los pacientes sobre el procedimiento, la prevención de complicaciones y el autocuidado; entrenar al paciente para que lleve a cabo planes de ejercicios en los períodos pre y postoperatorios; y comunicación con la enfermera a través de la aplicación.

RESUMO Objetivo: validar um Programa de Enfermagem de Reabilitação Tecnológico para pessoas submetidas à artroplastia total do joelho. Métodos: estudo qualitativo, realizado por meio de focus group, com 12 enfermeiros, considerados peritos na área de reabilitação. O Programa foi desenvolvido com recurso de uma tecnologia digital, do tipo aplicativo para dispositivo móvel. Os peritos avaliaram a estrutura do Programa, os conteúdos disponibilizados às pessoas submetidas a artroplastia total do joelho no pré-operatório e pós-operatório e as estratégias de acompanhamento e comunicação com o enfermeiro. Resultados: após a validação de conteúdo pelos peritos, a versão final do Programa integrou três áreas temáticas e suas respectivas categorias: Programa de Reabilitação (Fases do Programa, Operacionalização do Programa, Planos de exercícios incluídos no Programa); Informação Útil (Preparação para a cirurgia, Cuidados a ter durante a recuperação cirúrgica); e Canal Comunicacional com o Enfermeiro (Fale com enfermeiro de reabilitação, Autoavaliação da condição de saúde e Ajuda na tomada de decisão). Conclusão: os contributos dos peritos permitiram alcançar a validade de conteúdo do Programa e, consequentemente, melhorar a literacia do paciente sobre o procedimento, prevenção de complicações e autocuidado; instrumentalização do paciente para a realização dos planos de exercícios nos períodos pré e pós-operatório; e a comunicação com o enfermeiro pelo aplicativo.

Challenges faced by nurse-managers at work in brazilian and portuguese hospitals: a mixed-methods study / Desafíos enfrentados por enfermeros gerentes en su trabajo en hospitales de brasil y portugal: estudio de métodos mixtos / Desafios de enfermeiros gestores no trabalho em hospitais brasileiros e portugueses: estudo de métodos mistos

ABSTRACT Objective: to analyze the challenges found in nurse-managers' work in the Brazilian and Portuguese hospital contexts. Method: a mixed-methods research study with a sequential explanatory approach, carried out between March 2019 and March 2020 with nurse-managers from four hospitals. The study was initiated with the quantitative stage, applying a survey to 143 participants and analyzing the data by means of analytical and inferential statistics. The qualitative stage was carried out with 71 of these participants using interviews, in order to understand the challenges inherent to this job, and the data were submitted to content analysis. Integration of the findings was performed through data connection. Results: in the quantitative stage, the results evidenced that the managerial activities carried out by nurses by scenario included planning, people management, management of care processes, management of materials, quality management and leadership, with higher mean values for the first four. The qualitative stage allowed deepening the previous findings, contrasting invisibility of the planning, confirming people management as the common challenge to the realities, explaining the mean values in the national and Portuguese scopes. Integration of the findings detailed the relevance of the conflicts and the deficit of professionals in people management and leadership. Conclusion: managing people, care processes and materials are challenges for nurses in hospital management in both countries. Nurses lack structural support and ongoing training for better management and improvement of planning and leadership.

RESUMEN Objetivo: analizar los desafíos presentes en el trabajo de enfermeros gerentes en el contexto hospitalario, tanto en Brasil como en Portugal. Método: investigación de métodos mixtos con enfoque explicativo secuencial, realizado entre marzo de 2019 y marzo de 2020 con enfermeros gerentes de cuatro hospitales. El estudio se inició con la etapa cuantitativa, aplicando una encuesta a 143 participantes y analizando los datos por medio de estadística analítica e inferencial. La etapa cualitativa se condujo con 71 de estos participantes por medio de entrevistas para comprender los desafíos de este trabajo, y los datos se sometieron a análisis de contenido. La integración de los hallazgos se realizó por medio de conexión de datos. Resultados: en la etapa cuantitativa, los resultados evidenciaron que las actividades de gestión realizadas por los enfermeros y por escenario incluyeron planificación, gestión de personas, de procesos asistenciales, de materiales, de la calidad, y liderazgo, con valores medio más elevados para las cuatro primeras. La etapa cualitativa permitió profundizar los hallazgos anteriores, contrastando la invisibilidad de la planificación y confirmando que la gestión de personas es un desafío común am ambas realidades, explicando los valores medios en los ámbitos de Brasil y de Portugal. La integración de los hallazgos detalló la relevancia de los conflictos y el déficit de profesionales en la gestión de personas y en el liderazgo. Conclusión: gerenciar personas, procesos asistenciales y materiales se erige como un desafío que deben afrontar los enfermeros en la gestión hospitalaria en ambos países. Los enfermeros carecen de soporte estructural y de formación continua para una mejor gestión y para perfeccionar la planificación y el liderazgo.

RESUMO Objetivo: analisar os desafios presentes no trabalho de enfermeiros gestores no contexto hospitalar, no Brasil e em Portugal. Método: pesquisa de métodos mistos, abordagem explanatório sequencial, realizada com enfermeiros gestores de quatro hospitais, entre março de 2019 e março de 2020. O estudo iniciou com a etapa quantitativa, aplicando um survey a 143 participantes e dados analisados por estatística analítica e inferencial. A etapa qualitativa foi realizada com 71 destes participantes utilizando entrevistas, para compreender os desafios deste trabalho, e os dados foram submetidos à análise de conteúdo. A integração dos achados foi realizada por meio de conexão de dados. Resultados: na etapa quantitativa os resultados evidenciaram que as atividades de gestão realizadas pelos enfermeiros por cenário, incluíram planejamento, gestão de pessoas, de processos assistenciais, de materiais, da qualidade e liderança, com maiores médias para os quatro primeiros. A qualitativa permitiu aprofundar os achados anteriores, contrastando a invisibilidade do planejamento, confirmando a gestão de pessoas como o desafio comum às realidades, explicando as médias nas realidades nacional e portuguesa. A integração dos achados detalhou na gestão de pessoas e liderança a relevância dos conflitos e do déficit de profissionais. Conclusão: gerenciar pessoas, processos assistenciais e materiais se mostram desafios dos enfermeiros na gestão hospitalar nos dois países. Os enfermeiros carecem de suporte estrutural e formação continuada para melhor gestão e aprimoramento do planejamento e liderança.