Cross-cultural adaptation for Brazil and validity of a guide to assist nursing students' clinical reasoning.

PURPOSE: To assess the validity of a Written Clinical Reasoning Prompt (WCRP) to help nursing students' clinical reasoning (CR). METHOD: This is a methodological study of translation and cross-cultural adaptation into Brazilian Portuguese of instruments that aim to promote CR improvement, composed of (1) WCRP; (2) two case studies; (3) a questionnaire about students' perceptions during decision-making in case studies; (4) a scoring rubric for correcting case studies. For translation and cross-cultural adaptation, stages 1-8 of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Consortium Network were adopted. Agreement values among experts >80% and content validity coefficient (CVC) > 0.8 were considered satisfactory. For the pretest, a randomized clinical trial was carried out with 24 nursing students (intervention group, n = 14, using the WCRP to solve case studies; control group, n = 10, without using the WCRP). FINDINGS: The WCRP was translated and adapted into Brazilian Portuguese, requiring minimal adjustments to obtain agreement among the judges above 80% and CVC above 0.80. Regarding face validation, an adequate agreement was obtained in the assessment by students. There was no difference in the accuracy of nursing diagnoses between the intervention and control groups in the pretest. CONCLUSION: The WCRP was translated and adapted into Brazilian Portuguese and had adequate face and content validity estimates; however, there was no association with improving nursing students' diagnostic accuracy. IMPLICATIONS FOR NURSING PRACTICE: The translated and adapted versions of all instruments into Brazilian Portuguese had adequate evidence of content and face validity. The use of WCRP was not associated with a significant improvement in nursing students' diagnostic accuracy. New studies with larger samples, a sample power of at least 80%, and a level of significance of 5% are needed.

Diferencias entre los profesionales de enfermería y medicina respecto a la cultura de la seguridad del paciente quirúrgico / Differences between nursing and medical professionals regarding the surgical patient safety culture

Objetivo: Investigar si la percepción de la cultura de la seguridad de los pacientes quirúrgicos difiere entre los profesionales de enfermería y medicina que trabajan en una institución educativa pública brasileña.Método:Survey, estudio transversal realizado en un hospital en el sur de Brasil. El cuestionario Hospital Survey on Patient Safety Culture fue aplicado a 158 profesionales entre mayo y septiembre de 2017. Las 12 dimensiones se analizaron mediante estadísticas descriptivas e inferenciales y pruebas de coherencia interna. Las dimensiones con índices del 75% se consideraron reforzadas.Resultados:Hubo fragilidad en la cultura de seguridad, con un índice más bajo en la dimensión “Respuesta no punitiva al error”, con 23,9% y 13,9%, respectivamente, entre la enfermería y la medicina. Las puntuaciones más positivas fueron consideradas por la enfermería en ocho dimensiones, con diferencia (p<0.05) en relación con los profesionales médicos.Conclusión:La cultura de seguridad difiere entre las dos categorías profesionales, con respuestas más positivas por la enfermería; sin embargo, son necesarias acciones para fortalecer la seguridad de los pacientes quirúrgicos en ambos grupos profesionales. (AU)