Diagnostic concordance among nursing clinical decision support system users: a pilot study.

OBJECTIVE: To analyze the nursing diagnostic concordance among users of a clinical decision support system (CDSS), The Electronic Documentation System of the Nursing Process of the University of São Paulo (PROCEnf-USP®), structured according to the Nanda International, Nursing Intervention Classification and Nursing Outcome Classification (NNN) Taxonomy. MATERIALS AND METHODS: This pilot, exploratory-descriptive study was conducted from September 2017 to January 2018. Participants were nurses, nurse residents, and nursing undergraduates. Two previously validated written clinical case studies provided participants with comprehensive initial assessment clinical data to be registered in PROCEnf-USP®. After having registered the clinical data in PROCEnf-USP®, participants could either select diagnostic hypotheses offered by the system or add diagnoses not suggested by the system. A list of nursing diagnoses documented by the participants was extracted from the system. The concordance was analyzed by Light's Kappa (K). RESULTS: The research study included 37 participants, which were 14 nurses, 10 nurse residents, and 13 nursing undergraduates. Of the 43 documented nursing diagnoses, there was poor concordance (K = 0.224) for the diagnosis "Ineffective airway clearance" (00031), moderate (K = 0.591) for "Chronic pain" (00133), and elevated (K = 0.655) for "Risk for unstable blood glucose level" (00179). The other nursing diagnoses had poor or no concordance. DISCUSSION: Clinical reasoning skills are essential for the meaningful use of the CDSS. CONCLUSIONS: There was concordance for only 3 nursing diagnoses related to biological needs. The low level of concordance might be related to the clinical judgment skills of the participants, the written cases, and the sample size.

The Use of the Borg Rating of Perceived Exertion Scale in Cardiopulmonary Resuscitation. / O Uso da Escala de Borg na Percepção do Esforço em Manobras de Reanimação Cardiopulmonar.

BACKGROUND: A cardiopulmonary arrest is a critical event whose survival rate is related to the quality of resuscitation maneuvers combined with the use of technology. It is important to understand the perception of fatigue during this procedure, aiming to improve the effectiveness of compressions to increase the chances of survival. OBJECTIVES: To apply the Borg rating of perceived exertion scale (Borg scale) to analyze the exertion perceived by nurses during cardiopulmonary resuscitation maneuvers using a feedback device. METHODS: Experimental study with a randomized distribution of nurses in a teaching hospital. Perceived exertion during simulated cardiopulmonary resuscitation with/without a feedback device was assessed using the Borg scale. The statistical significance level of 5% was adopted. RESULTS: 69 nurses working in critical and non-critical adult care units were included. Perceived exertion and heart rate were lower in the intervention group (p<0.001), influenced by the feedback device, with no significant difference between critical and non-critical units. CONCLUSIONS: The Borg scale proved to be adequate for the proposed objectives. The feedback device contributed to lower exertion and heart rate reduction during resuscitation maneuvers. The low cost and ease of application favor its use during training and real-time resuscitation attempts to assess performance using a feedback device to reduce exertion and perception of fatigue. It allows reflection on the intervening factors and resources that can influence the quality of resuscitation attempts and the chances of survival.

FUNDAMENTO: A parada cardiorrespiratória é um evento crítico cuja taxa de sobrevivência é relacionada à qualidade das manobras de reanimação, aliada à tecnologia. É importante compreender a percepção do cansaço durante esse procedimento visando a efetividade das compressões e o aumento das chances na sobrevida. OBJETIVO: Aplicar a Escala de Borg para analisar o esforço percebido por enfermeiros durante as manobras de reanimação cardiopulmonar com dispositivo de feedback. MÉTODO: Estudo experimental com distribuição randomizada de enfermeiros em hospital de ensino, simulando parada cardiorrespiratória, para avaliação da percepção do esforço utilizando a escala de Borg durante a reanimação cardiopulmonar com/sem dispositivo de feedback. Foi adotado nível de significância estatística 5%. RESULTADOS: Foram incluídos 69 enfermeiros atuantes em unidades críticas e não críticas de atendimento ao adulto. A percepção de esforço e a frequência cardíaca foi menor no grupo intervenção (p<0,001), influenciadas pelo dispositivo de feedback, sem diferença significativa quanto às unidades de atuação. CONCLUSÃO: A escala de Borg mostrou-se adequada para os objetivos propostos. O dispositivo de feedback contribuiu no menor esforço e redução da frequência cardíaca durante as manobras de reanimação. O baixo custo e a facilidade de aplicação favorecem o uso em treinamentos e atendimentos em tempo real para avaliar o desempenho durante a reanimação, utilizando dispositivo de feedback por reduzir os esforços e a percepção do cansaço. Também permite a reflexão sobre os fatores intervenientes e recursos que podem influenciar na qualidade da assistência e nas chances de sobrevivência.

O Uso da Escala de Borg na Percepção do Esforço em Manobras de Reanimação Cardiopulmonar / The Use of the Borg Rating of Perceived Exertion Scale in Cardiopulmonary Resuscitation

Resumo Fundamento A parada cardiorrespiratória é um evento crítico cuja taxa de sobrevivência é relacionada à qualidade das manobras de reanimação, aliada à tecnologia. É importante compreender a percepção do cansaço durante esse procedimento visando a efetividade das compressões e o aumento das chances na sobrevida. Objetivo Aplicar a Escala de Borg para analisar o esforço percebido por enfermeiros durante as manobras de reanimação cardiopulmonar com dispositivo de feedback. Método Estudo experimental com distribuição randomizada de enfermeiros em hospital de ensino, simulando parada cardiorrespiratória, para avaliação da percepção do esforço utilizando a escala de Borg durante a reanimação cardiopulmonar com/sem dispositivo de feedback. Foi adotado nível de significância estatística 5%. Resultados Foram incluídos 69 enfermeiros atuantes em unidades críticas e não críticas de atendimento ao adulto. A percepção de esforço e a frequência cardíaca foi menor no grupo intervenção (p<0,001), influenciadas pelo dispositivo de feedback, sem diferença significativa quanto às unidades de atuação. Conclusão A escala de Borg mostrou-se adequada para os objetivos propostos. O dispositivo de feedback contribuiu no menor esforço e redução da frequência cardíaca durante as manobras de reanimação. O baixo custo e a facilidade de aplicação favorecem o uso em treinamentos e atendimentos em tempo real para avaliar o desempenho durante a reanimação, utilizando dispositivo de feedback por reduzir os esforços e a percepção do cansaço. Também permite a reflexão sobre os fatores intervenientes e recursos que podem influenciar na qualidade da assistência e nas chances de sobrevivência.

Abstract Background A cardiopulmonary arrest is a critical event whose survival rate is related to the quality of resuscitation maneuvers combined with the use of technology. It is important to understand the perception of fatigue during this procedure, aiming to improve the effectiveness of compressions to increase the chances of survival. Objectives To apply the Borg rating of perceived exertion scale (Borg scale) to analyze the exertion perceived by nurses during cardiopulmonary resuscitation maneuvers using a feedback device. Methods Experimental study with a randomized distribution of nurses in a teaching hospital. Perceived exertion during simulated cardiopulmonary resuscitation with/without a feedback device was assessed using the Borg scale. The statistical significance level of 5% was adopted. Results 69 nurses working in critical and non-critical adult care units were included. Perceived exertion and heart rate were lower in the intervention group (p<0.001), influenced by the feedback device, with no significant difference between critical and non-critical units. Conclusions The Borg scale proved to be adequate for the proposed objectives. The feedback device contributed to lower exertion and heart rate reduction during resuscitation maneuvers. The low cost and ease of application favor its use during training and real-time resuscitation attempts to assess performance using a feedback device to reduce exertion and perception of fatigue. It allows reflection on the intervening factors and resources that can influence the quality of resuscitation attempts and the chances of survival.

Project-based learning in remote teaching for undergraduate nursing students.

OBJECTIVE: To report the experience of using the Project-Based Learning methodology, in emergency remote teaching, with undergraduate nursing students. METHOD: The study was carried out in the course "Educational Actions in Nursing Practice", developed remotely in 2020, during the pandemic caused by the new coronavirus, in the Bachelor's and Licanciate Degrees in Nursing at a public university in the state of São Paulo. The course used Project-Based Learning through the following phases: anchoring; driving question; investigation and research; creation and development; and presentation of the results as an active learning methodology, with the formation of small groups of students and tutors and process evaluation. RESULTS: The students developed educational projects in health through a virtual learning environment, platforms, and digital tools. CONCLUSION: The methodology adopted and the use of digital technologies allowed the achievement of the proposed objectives, the motivation and autonomy of the students throughout the remote teaching process, and the development of competences for the elaboration of projects in health education for nursing training.

Project-based learning in remote teaching for undergraduate nursing students / Aprendizaje basado en proyectos en la enseñanza a distancia para estudiantes de enfermería / Profissional Aprendizagem baseada em projetos no ensino remoto para estudantes ingressantes da graduação em enfermagem

ABSTRACT Objective: To report the experience of using the Project-Based Learning methodology, in emergency remote teaching, with undergraduate nursing students. Method: The study was carried out in the course "Educational Actions in Nursing Practice", developed remotely in 2020, during the pandemic caused by the new coronavirus, in the Bachelor's and Licanciate Degrees in Nursing at a public university in the state of São Paulo. The course used Project-Based Learning through the following phases: anchoring; driving question; investigation and research; creation and development; and presentation of the results as an active learning methodology, with the formation of small groups of students and tutors and process evaluation. Results: The students developed educational projects in health through a virtual learning environment, platforms, and digital tools. Conclusion: The methodology adopted and the use of digital technologies allowed the achievement of the proposed objectives, the motivation and autonomy of the students throughout the remote teaching process, and the development of competences for the elaboration of projects in health education for nursing training.

RESUMEN Objetivo: Relatar la experiencia del uso de la metodología de Aprendizaje Basado en Proyectos, en la enseñanza a distancia de emergencia, con estudiantes de enfermería. Método: El estudio fue realizado en la disciplina de "Acciones Educativas en la Práctica de Enfermería", desarrollada remotamente en 2020, durante el período de la pandemia provocada por el nuevo coronavirus, en el Curso de Bachillerato y Licenciatura en Enfermería de una universidad pública. La disciplina utilizó el Aprendizaje Basado en Proyectos a través de las fases: ancla; pregunta orientadora; investigación; creación y desarrollo; y presentación de los resultados, como metodología de aprendizaje activo, con formación de pequeños grupos de alumnos y tutores y evaluación del proceso. Resultados: Los estudiantes desarrollaron proyectos educativos en salud a través de un entorno virtual de aprendizaje, plataformas y herramientas digitales. Conclusión: La metodología adoptada y el uso de tecnologías digitales posibilitaron el logro de los objetivos propuestos, la motivación y autonomía de los estudiantes a lo largo del proceso de enseñanza remota, y el desarrollo de habilidades para la elaboración de proyectos en educación para la salud en la formación de enfermeros.

RESUMO Objetivo: Relatar a experiência do uso da metodologia de Aprendizagem Baseada em Projetos, no ensino remoto emergencial, com estudantes ingressantes da graduação em enfermagem. Método: O estudo foi realizado na disciplina de "Ações educativas na prática de enfermagem", desenvolvida de maneira remota no ano de 2020, durante o período da pandemia causada pelo novo coronavírus, no Curso de Bacharelado e Licenciatura em Enfermagem de uma universidade pública do estado de São Paulo. A disciplina utilizou a Aprendizagem Baseada em Projetos por meio das fases: âncora; questão motriz; investigação e pesquisa; criação e desenvolvimento; e apresentação dos resultados, como metodologia ativa de aprendizagem, com a formação de pequenos grupos de estudantes e tutores e avaliação processual. Resultados: Os estudantes desenvolveram projetos educativos em saúde por meio de ambiente virtual de aprendizagem, plataformas e ferramentas digitais. Conclusão A metodologia adotada e a utilização das tecnologias digitais permitiram alcançar os objetivos propostos, a motivação e a autonomia dos estudantes durante todo o processo de ensino remoto, e o desenvolvimento de competências para a elaboração de projetos no ensino em saúde na formação do enfermeiro.

Do automated real-time feedback devices improve CPR quality? A systematic review of literature.

AIM: Automated real-time feedback devices have been considered a potential tool to improve the quality of cardiopulmonary resuscitation (CPR). Despite previous studies supporting the usefulness of such devices during training, others have conflicting conclusions regarding its efficacy during real-life CPR. This systematic review aimed to assess the effectiveness of automated real-time feedback devices for improving CPR performance during training, simulation and real-life resuscitation attempts in the adult and paediatric population. METHODS: Articles published between January 2010 and November 2020 were searched from BVS, Cinahl, Cochrane, PubMed and Web of Science, and reviewed according to a pre-defined set of eligibility criteria which included healthcare providers and randomised controlled trial studies. CPR quality was assessed based on guideline compliance for chest compression rate, chest compression depth and residual leaning. RESULTS: The selection strategy led to 19 eligible studies, 16 in training/simulation and three in real-life CPR. Feedback devices during training and/or simulation resulted in improved acquisition of skills and enhanced performance in 15 studies. One study resulted in no significant improvement. During real resuscitation attempts, three studies demonstrated significant improvement with the use of feedback devices in comparison with standard CPR (without feedback device). CONCLUSION: The use of automated real-time feedback devices enhances skill acquisition and CPR performance during training of healthcare professionals. Further research is needed to better understand the role of feedback devices in clinical setting.

Quality of the documentation of the Nursing process in clinical decision support systems.

OBJECTIVE: to compare the quality of the Nursing process documentation in two versions of a clinical decision support system. METHOD: a quantitative and quasi-experimental study of the before-and-after type. The instrument used to measure the quality of the records was the Brazilian version of the Quality of Diagnoses, Interventions and Outcomes, which has four domains and a maximum score of 58 points. A total of 81 records were evaluated in version I (pre-intervention), as well as 58 records in version II (post-intervention), and the scores obtained in the two applications were compared. The interventions consisted of planning, pilot implementation of version II of the system, training and monitoring of users. The data were analyzed in the R software, using descriptive and inferential statistics. RESULTS: the mean obtained at the pre-intervention moment was 38.24 and, after the intervention, 46.35 points. There was evidence of statistical difference between the means of the pre- and post-intervention groups, since the p-value was below 0.001 in the four domains evaluated. CONCLUSION: the quality of the documentation of the Nursing process in version II of the system was superior to version I. The efficacy of the system and the effectiveness of the interventions were verified. This study can contribute to the quality of documentation, care management, visibility of nursing actions and patient safety.

Evaluation of the Accuracy of Nursing Diagnoses Determined by Users of a Clinical Decision Support System.

PURPOSE: To analyze the accuracy of nursing diagnoses determined by users of a clinical decision support system (CDSS) and to identify the predictive factors of high/moderate diagnostic accuracy. METHODS: This is an exploratory-descriptive study carried out from September 2017 to January 2018. Participants were nurses, resident nurses, and senior year undergraduates. Two written case studies provided the participants with the clinical data to fill out the assessment forms in the CDSS. The accuracy of the selected diagnostic labels was determined by a panel of experts using the Diagnostic Accuracy Scale, Version 2. Descriptive statistics were used to describe the level of accuracy according to each group of participants. Analysis of variance was used to compare the mean percentages of accuracy categories across groups. A linear regression model was used to identify the predictors of diagnostic accuracy. The significance level was 5%. The study was approved by the Ethics Committee. RESULTS: Fifteen undergraduates, 10 residents, and 22 nurses were enrolled in the study. Although resident nurses and students had selected predominantly highly accurate diagnoses (51.8 ± 19.1 and 48.9 ± 27.4, respectively), and nurses had selected mostly diagnoses of moderate accuracy (54.7 ± 14.7), there were no differences in the accuracy level of selected diagnoses across groups. According to the linear regression model, each diagnosis added by the participants decreased the diagnostic accuracy by 2.09% (p = .030), and no experience or a low level of experience using the system decreased such diagnostic accuracy by 5.41% (p = .022). CONCLUSIONS: The CDSS contributes to decision making about diagnoses of less experienced people. Adding diagnoses not indicated by the CDSS and experience with the system are predictors of diagnostic accuracy. CLINICAL RELEVANCE: In-service education regarding the use of CDSSs seems to be crucial to improve users' clinical judgment and decision making.

Empathic listening: welcoming strategy for nursing Professional in coping with with the coronavirus pandemic.

OBJECTIVE: to reflect on empathic listening use as a welcoming strategy for nursing professionals to cope with the challenges during the pandemic caused by the new coronavirus. METHODS: this is a reflection study based on updated data surveys and theoretical-conceptual aspects of Non-Violent Communication and empathic listening. RESULTS: in the performance during the COVID-19 pandemic, nursing professionals are exposed to violence of different natures related to occupational stress, work overload, anguishes and silenced suffering, with implications for the workers' health, who can be benefited and strengthened with empathetic listening. FINAL CONSIDERATIONS: the health crisis has highlighted the weaknesses of the health system. Nursing acts as the largest contingent of the health workforce in coping with the pandemic. Empathetic listening is a powerful strategy in caring for and strengthening nursing professionals.

Quality of the documentation of the Nursing process in clinical decision support systems / Qualidade da documentação do processo de enfermagem em sistemas de apoio à decisão clínica / Calidad de la documentación del proceso de Enfermería en sistemas de apoyo a la decisión clínica

Objective: to compare the quality of the Nursing process documentation in two versions of a clinical decision support system. Method: a quantitative and quasi-experimental study of the before-and-after type. The instrument used to measure the quality of the records was the Brazilian version of the Quality of Diagnoses, Interventions and Outcomes, which has four domains and a maximum score of 58 points. A total of 81 records were evaluated in version I (pre-intervention), as well as 58 records in version II (post-intervention), and the scores obtained in the two applications were compared. The interventions consisted of planning, pilot implementation of version II of the system, training and monitoring of users. The data were analyzed in the R software, using descriptive and inferential statistics. Results: the mean obtained at the pre-intervention moment was 38.24 and, after the intervention, 46.35 points. There was evidence of statistical difference between the means of the pre- and post-intervention groups, since the p-value was below 0.001 in the four domains evaluated. Conclusion: the quality of the documentation of the Nursing process in version II of the system was superior to version I. The efficacy of the system and the effectiveness of the interventions were verified. This study can contribute to the quality of documentation, care management, visibility of nursing actions and patient safety.

Objetivo: comparar a qualidade da documentação do processo de enfermagem em duas versões de um sistema de apoio à decisão clínica. Método: estudo quantitativo, quase-experimental do tipo antes e depois. O instrumento utilizado para mensurar a qualidade dos registros foi o Quality of Diagnoses, Interventions and Outcomes Versão Brasileira, que possui quatro domínios e escore máximo de 58 pontos. Foram avaliados 81 registros na versão I (pré-intervenção), 58 registros da versão II (pós-intervenção) e comparados os escores obtidos nas duas aplicações. As intervenções consistiram em planejamento, implantação piloto da versão II do sistema, treinamento e acompanhamento dos usuários. Os dados foram analisados no software R, utilizando-se estatística descritiva e inferencial. Resultados: a média obtida na pré-intervenção foi de 38,24 e pós-intervenção, 46,35 pontos. Houve evidências de diferença estatística entre as médias dos grupos pré e pós-intervenção, visto que o valor-p foi menor que 0,001 nos quatro domínios avaliados. Conclusão: a qualidade da documentação do processo de enfermagem na versão II do sistema foi superior à versão I. A eficácia do sistema e a efetividade das intervenções foram comprovadas. Este estudo pode contribuir para a qualidade da documentação, gerenciamento do cuidado, visibilidade das ações de enfermagem e segurança do paciente.

Objetivo: comparar la calidad de la documentación del proceso de Enfermería en dos versiones de un sistema de apoyo a la decisión clínica. Método: estudio cuantitativo y cuasi-experimental del tipo antes y después. El instrumento que se usó para medir la calidad de los registros fue la versión brasileña del Quality of Diagnoses, Interventions and Outcomes, que contiene cuatro dominios y puntaje máximo de 58 puntos. Se evaluaron 81 registros en la versión I (pre-intervención), 58 registros de la versión II (post-intervención) y se compararon las puntuaciones logradas en las dos aplicaciones. Las intervenciones consistieron en planificar, implementar de forma piloto la versión II del sistema, entrenar y realizar un seguimiento a los usuarios. Los datos se analizaron en el software R, utilizando estadística descriptiva e inferencial. Resultados: el promedio obtenido en el momento pre-intervención fue de 38,24 y en la post-intervención fue de 46,35 puntos. Se registraron evidencias de diferencia estadística entre los promedios de los grupos pre- y post-intervención, visto que el valor-p fue menor que 0,001 en los cuatro dominios evaluados. Conclusión: la calidad de la documentación del proceso de Enfermería en la versión II del sistema fue superior a la versión I. Se comprobó la eficacia del sistema y la efectividad de las intervenciones. Este estudio pudo contribuir para la calidad de la documentación, gerenciamiento de la atención, visibilidad de las acciones de Enfermería y seguridad del paciente.

Empathic listening: welcoming strategy for nursing Professional in coping with with the coronavirus pandemic / Escucha empática: estrategia de bienvenida para los profesionales de enfermería para hacer frente a la pandemia de coronavirus / Escuta empática: estratégia de acolhimento aos profissionais de enfermagem no enfrentamento da pandemia por coronavírus

ABSTRACT Objective: to reflect on empathic listening use as a welcoming strategy for nursing professionals to cope with the challenges during the pandemic caused by the new coronavirus. Methods: this is a reflection study based on updated data surveys and theoretical-conceptual aspects of Non-Violent Communication and empathic listening. Results: in the performance during the COVID-19 pandemic, nursing professionals are exposed to violence of different natures related to occupational stress, work overload, anguishes and silenced suffering, with implications for the workers' health, who can be benefited and strengthened with empathetic listening. Final considerations: the health crisis has highlighted the weaknesses of the health system. Nursing acts as the largest contingent of the health workforce in coping with the pandemic. Empathetic listening is a powerful strategy in caring for and strengthening nursing professionals.

RESUMEN Objetivo: reflexionar sobre el uso de la escucha empática como estrategia de acogida de los profesionales de enfermería para afrontar los retos durante la pandemia provocada por el nuevo coronavirus. Métodos: estudio de reflexión, basado en datos actualizados y aspectos teóricos y conceptuales de la Comunicación No Violenta y la escucha empática. Resultados: en el desempeño durante la pandemia COVID-19, el profesional de enfermería se encuentra expuesto a violencias de diversa índole relacionadas con el estrés ocupacional, sobrecarga laboral, angustias y sufrimientos silenciados, con implicaciones para la salud del trabajador, que pueden ser beneficiadas y fortalecidas. con escucha empática. Consideraciones finales: la crisis sanitaria ha puesto de manifiesto las debilidades del sistema sanitario. La enfermería actúa como el mayor contingente del personal sanitario para hacer frente a la pandemia. La escucha empática es una poderosa estrategia en el cuidado y fortalecimiento de los profesionales de enfermería.

RESUMO Objetivo: refletir sobre a utilização da escuta empática como estratégia de acolhimento aos profissionais de enfermagem no enfrentamento dos desafios durante a pandemia pelo novo coronavírus. Métodos: estudo do tipo reflexão, realizado com base em levantamentos de dados atualizados e aspectos teórico-conceituais da Comunicação Não Violenta e escuta empática. Resultados: na atuação durante a pandemia de COVID-19, o profissional de enfermagem está exposto a violências de diferentes naturezas relacionadas ao estresse ocupacional, sobrecarga de trabalho, angústias e sofrimentos silenciados, com implicações na saúde do trabalhador, que pode ser beneficiado e fortalecido com a escuta empática. Considerações finais: a crise sanitária tem evidenciado as fragilidades do sistema de saúde. A enfermagem atua como o maior contingente da força de trabalho em saúde no enfrentamento da pandemia. A escuta empática é uma estratégia potente na atenção e fortalecimento dos profissionais de enfermagem.

System for reception and risk classification in obstetrics: a technical quality assessment.

OBJECTIVE: to assess the technical quality of a decision support system for reception and risk classification in obstetrics. METHOD: a methodological study of assessment of the system. 12 nurses and 11 information technology (IT) professionals were invited to evaluate the Obstetrics Reception and Risk Classification System (Sistema de Acolhimento e Classificação de Risco em Obstetrícia, SACR-O). Based on the standards of the International Organization for Standardization, the minimum number of evaluators and the characteristics to be evaluated were established: functional suitability, reliability, usability, performance efficiency, compatibility, safety, maintainability, and portability. The characteristics assessed should be given a ≥70% positive assessment to be considered suitable. RESULTS: the characteristics assessed by the nurses and the IT professionals, respectively, were considered adequate: Functional suitability (97% and 98%), Reliability (91% and 94%), Usability (89% and 93%), Performance efficiency (97% and 98%), Compatibility (93% and 100%), and System security (95% and 97%). Maintainability (87%) and Portability (97%) were also evaluated by IT professionals. CONCLUSION: the technical quality of the SACR-O system was considered excellent by nurses and IT professionals.

Expert assessment of the "Neonatal Pain Assessment Program" online course.

OBJECTIVES: to assess layout quality, visual identity and content of the "Neonatal Pain Assessment Program" (Programa de Avaliação da Dor Neonatal) online course. METHODS: a descriptive exploratory study. The course was assessed by 24 experts in pain, neonatology and education. A form containing 20 questions on technical, interface and educational aspects was used. For each item, the score ranged from 0 to 1. Mean scores above 0.7 were considered indicative of high quality of the items. Descriptive statistics were used for data analysis. RESULTS: navigation, clarity, ease of localization, content relevance, contextualization, content correction, multiple windows, ease of use, ease of return, ergonomics, esthetics, special brands, audiovisual resources, information and portability were assessed. All aspects obtained a mean ≥ 0.70 and no changes were required. CONCLUSIONS: the Neonatal Pain Assessment Program is considered as quality educational technology and promising strategy for health education.

Effectiveness of the Manchester Triage System on time to treatment in the emergency department: a systematic review.

OBJECTIVE: The objective of this review was to synthesize the best available evidence on the effectiveness of the Manchester Triage System (MTS) on time to treatment (TtT) for patients who visit the emergency department (ED). INTRODUCTION: The objectives of the MTS are to define a safe wait time for medical attention. Triage systems, such as the MTS, use criteria to ensure patient safety by determining appropriate wait times for each individual who visits the ED. The TtT is the time interval between arrival at the ED to initiation of therapeutic interventions. A short TtT is important in different clinical situations and may reduce infections and mortality. The MTS may have an impact on the TtT. INCLUSION CRITERIA: This review considered studies that included any patients visiting the ED with any complaints or medical diagnoses who were triaged using the MTS by nurses or doctors, and the TtT was measured. This review considered randomized controlled trials, as well as quasi-experimental, before-and-after, case-control and analytical cross-sectional studies. Studies published after 1994 in English, Spanish, Portuguese, French and German were considered for inclusion. METHOD: This systematic review was conducted in accordance with JBI methodology. The search strategy aimed to find both published and unpublished studies in MEDLINE, CINAHL, Lilacs, Web of Science, Embase, Scopus, Cochrane Central Register of Controlled Trials, Google Scholar, Banco de Teses - CAPES, and Digital Dissertations. The results of this search were assessed by one reviewer who excluded duplicate results. Titles and abstracts were screened by two independent reviewers for assessment against the inclusion criteria. The full texts of potentially eligible papers were retrieved and independently assessed by two reviewers using a standardized critical appraisal instrument from JBI. Data were extracted from studies included in the review and were presented using a narrative form. Tables were used to summarize the characteristics and findings of the studies. RESULTS: The review included two before-and-after studies, with a total of 2265 participants. One study was of moderate quality, and the other was of high quality. One study included only patients with acute ischemic stroke, while the other included patients with any complaint. Both studies were performed with consecutive samples. The median TtT was 10 minutes before implementing the MTS and 12 minutes after implementing the MTS in the study that included patients with any complaints. In the study including patients with acute ischemic stroke, the median TtT decreased by 15 minutes after implementing the MTS (from 75 to 60 minutes). Because of the heterogeneity in the characteristics of the populations of the two studies, the results could not be pooled. CONCLUSIONS: The MTS reduced the median TtT for patients triaged at the highest priority levels (orange and yellow), but it did not decrease the median TtT in all patients. The existing evidence base regarding the effectiveness of the MTS comes from two studies with methodological limitations that could not be pooled. The evidence indicates the MTS may confer benefit to some patients who visit the ED by reducing TtT, but not for all patients. Further research is needed before firm conclusions can be made.

Expert assessment of the "Neonatal Pain Assessment Program" online course / Evaluación de expertos del curso en línea "Programa de evaluación del dolor neonatal" / Avaliação por especialistas do curso online "Programa de Avaliação da Dor Neonatal"

ABSTRACT Objectives: to assess layout quality, visual identity and content of the "Neonatal Pain Assessment Program" (Programa de Avaliação da Dor Neonatal) online course. Methods: a descriptive exploratory study. The course was assessed by 24 experts in pain, neonatology and education. A form containing 20 questions on technical, interface and educational aspects was used. For each item, the score ranged from 0 to 1. Mean scores above 0.7 were considered indicative of high quality of the items. Descriptive statistics were used for data analysis. Results: navigation, clarity, ease of localization, content relevance, contextualization, content correction, multiple windows, ease of use, ease of return, ergonomics, esthetics, special brands, audiovisual resources, information and portability were assessed. All aspects obtained a mean ≥ 0.70 and no changes were required. Conclusions: the Neonatal Pain Assessment Program is considered as quality educational technology and promising strategy for health education.

RESUMEN Objetivos: evalúe la calidad del diseño, la identidad visual y el contenido del curso en línea "Programa de Evaluación del Dolor Neonatal" (Programa de Avaliação da Dor Neonatal). Métodos: estudio exploratorio descriptivo. El curso fue evaluado por 24 especialistas en las áreas de dolor, neonatología y educación. Se utilizó un formulario con 20 preguntas sobre aspectos técnicos, de interfaz y educativos. Para cada ítem, los puntajes variaron de 0 a 1. Los puntajes promedio por encima de 0.7 se consideraron indicativos de alta calidad de ítems. Se utilizaron estadísticas descriptivas para el análisis de datos. Resultados: se evaluaron: navegación libre, claridad, facilidad de localización, relevancia de contenido, contextualización, corrección de contenido, ventanas múltiples, facilidad de uso, facilidad de retorno, ergonomía, estética, marcas especiales, recursos audiovisuales, información y portabilidad. Todos los aspectos obtuvieron una media ≥ 0,70 y no se requirieron cambios. Conclusiones: el Programa de Evaluación del Dolor Neonatal se considera una tecnología educativa de calidad y una estrategia prometedora para la educación para la salud.

RESUMO Objetivos: avaliar a qualidade do layout, da identidade visual e do conteúdo do curso online "Programa de Avaliação da Dor Neonatal". Métodos: estudo exploratório descritivo. O curso foi avaliado por 24 especialistas nas áreas de dor, neonatologia e educação. Foi utilizado um formulário contendo 20 questões sobre aspectos técnicos, de interface e educacionais. Para cada item, a pontuação variou de 0 a 1. Escores médios acima de 0,7 foram considerados indicativos de alta qualidade dos itens. Utilizou-se estatística descritiva para análise dos dados. Resultados: foram avaliados: navegação livre, clareza, facilidade de localização, pertinência do conteúdo, contextualização, correção de conteúdo, múltiplas janelas, facilidade de aprendizagem, eficiência de utilização, facilidade de retorno, ergonomia, estética, marcas especiais, recursos audiovisuais, informações e portabilidade. Todos os aspectos obtiveram média ≥ 0,70, não sendo necessárias modificações. Conclusões: considera-se o Programa de Avaliação da Dor Neonatal como tecnologia educacional de qualidade e estratégia promissora para a educação em saúde.

System for reception and risk classification in obstetrics: a technical quality assessment / Sistema para acolhimento e classificação de risco em obstetrícia: avaliação de qualidade técnica / Sistema de recepción y clasificación de riesgos en obstetricia: evaluación de calidad técnica

Objective: to assess the technical quality of a decision support system for reception and risk classification in obstetrics. Method: a methodological study of assessment of the system. 12 nurses and 11 information technology (IT) professionals were invited to evaluate the Obstetrics Reception and Risk Classification System (Sistema de Acolhimento e Classificação de Risco em Obstetrícia, SACR-O). Based on the standards of the International Organization for Standardization, the minimum number of evaluators and the characteristics to be evaluated were established: functional suitability, reliability, usability, performance efficiency, compatibility, safety, maintainability, and portability. The characteristics assessed should be given a ≥70% positive assessment to be considered suitable. Results: the characteristics assessed by the nurses and the IT professionals, respectively, were considered adequate: Functional suitability (97% and 98%), Reliability (91% and 94%), Usability (89% and 93%), Performance efficiency (97% and 98%), Compatibility (93% and 100%), and System security (95% and 97%). Maintainability (87%) and Portability (97%) were also evaluated by IT professionals. Conclusion: the technical quality of the SACR-O system was considered excellent by nurses and IT professionals.

Objetivo: avaliar a qualidade técnica de um sistema de apoio à decisão para acolhimento e classificação de risco em obstetrícia. Método: estudo metodológico de avaliação de sistema. Foram convidados a avaliarem o Sistema de Acolhimento e Classificação de Risco em Obstetrícia (SACR-O) 12 enfermeiros e 11 profissionais de informática. A partir das normas da Organização Internacional de Normatização se estabeleceu o número mínimo de avaliadores e as características a serem avaliadas: adequação funcional, confiabilidade, usabilidade, eficiência de desempenho, compatibilidade, segurança, manutenibilidade e portabilidade. As características avaliadas deveriam ter avaliação positiva ≥70% para serem consideradas adequadas. Resultados: as características avaliadas por enfermeiros e profissionais de informática, respectivamente, foram consideradas adequadas, a saber: Adequação funcional (97% e 98%), Confiabilidade (91% e 94%), Usabilidade (89% e 93%), Eficiência de desempenho (97% e 98%), Compatibilidade (93% e 100%) e Segurança do sistema (95% e 97%). Por profissionais de informática foram também avaliadas as características de Manutenibilidade (87%) e Portabilidade (97%). Conclusão: a qualidade técnica do sistema SACR-O foi considerada como excelente por enfermeiros e profissionais de informática.

Objetivo: evaluar la calidad técnica de un sistema de soporte de decisiones para la recepción y clasificación de riesgos en obstetricia. Método: estudio metodológico de evaluación del sistema. Fueron invitados a evaluar el Sistema de Recepción y Clasificación de Riesgos en Obstetricia (SACR-O) 12 enfermeros y 11 profesionales de la informática. Con base en las normas de la Organización Internacional de Estandarización, se estableció el número mínimo de evaluadores y las características a evaluar: adecuación funcional, fiabilidad, usabilidad, eficiencia de desempeño, compatibilidad, seguridad, mantenibilidad y portabilidad. Las características evaluadas deberían tener una evaluación positiva ≥70% para considerarse adecuadas. Resultados: las características evaluadas por enfermeros y profesionales de la informática, respectivamente, se consideraron adecuadas, a saber: Adecuación funcional (97% y 98%), Fiabilidad (91% y 94%), Usabilidad (89% y 93%), Eficiencia de desempeño (97% y 98%), Compatibilidad (93% y 100%) y Seguridad del sistema (95% y 97%). Por los profesionales de informática también fueron evaluados las características de Mantenibilidad (87%) y Portabilidad (97%). Conclusión: la calidad técnica del sistema SACR-O fue considerada excelente por los enfermeros y los profesionales de la informática.

Electronic and manual registration of Manchester System: reliability, accuracy, and time evaluation.

OBJECTIVE: to evaluate the degree of reliability, accuracy and timing to perform the Manchester Triage System in electronic and manual records. METHOD: exploratory-descriptive research. Case series corresponded to a total of 20 validated simulated clinical cases applied to a sample of 10 nurses. For data collection each participant received 4 clinical cases in 2 different phases of the study, using manual and electronic registration. The variables related to the triage were: incomplete data filling, discriminator, flowchart, priority level, vital signs and triage timing. RESULTS: moderate reliability for choosing flowcharts and substantial reliability for determining discriminators in both records; substantial and moderate, for priority, respectively, in manual and electronic registration. For vital signs, it was weak in manual recording and substantial in electronic. Accuracy showed a statistically significant difference related to vital signs. The average timing on triage was shorter with the use of electronic registration. CONCLUSION: the use of electronic registration has advantages regarding reliability, accuracy and timing to perform the triage, pointing to the importance of adopting technologies in the management and care work process in health services.

Instructional design in the development of an online course on Basic Life Support.

OBJECTIVE: To develop and evaluate an online course on Basic Life Support. METHOD: Technological production research of online course guided by the ADDIE (Analysis, Design, Development, Implementation, Evaluation) instructional design model based on Andragogy and the Meaningful Learning Theory. The online course was constructed in the platform Moodle, previously assessed by a group of experts, and then presented to the students of the Nursing School of the University of São Paulo, who assessed it at the end of the course. RESULTS: The course was evaluated by the experts and obtained a mean score of 0.92 (SD 0.15), considered as good quality (between 0.90-0.94), and by the students, with a mean score of 0.95 (SD 0.03), considered as high quality (0.95-1.00). CONCLUSION: The instructional design used was found to be appropriate to the development of the online course. As an active educational strategy, it contributed to the learning on Basic Life Support during cardiac arrest-related procedures in adults. In view of the need for technological innovations in education and systematization of care in cardiopulmonary resuscitation, the online course allows the establishment of continuous improvement processes in the quality of resuscitation in the care provided by students and professionals.

Curso on-line sobre suporte avançado de vida em parada cardiorrespiratória: inovação para educação permanente / Online course on advanced life support in cardiorespiratory arrest: innovation for continuing education

Objetivo: construir e validar curso on-line para enfermeiros sobre suporte avançado de vida na parada cardiorrespiratória em adultos. Métodos: pesquisa metodológica, de produção tecnológica, fundamentada no Design Instrucional Contextualizado, seguindo as fases de análise, design, desenvolvimento, implementação e avaliação, norteada pelos pressupostos da Andragogia e Teoria da Aprendizagem Significativa. Resultados: curso estruturado em nove unidades de aprendizagem, incluindo jogos digitais, simulações virtuais e casos clínicos. Foi disponibilizado no ambiente virtual Moodle® e avaliado por 16 enfermeiros especialistas, obtendo índices de alta e boa qualidade em 15 (75,0%) critérios referentes ao conteúdo, à interatividade, navegação, ergonomia e estética. Conclusão: a avaliação positiva de especialistas credencia o curso on-line sobre suporte avançado de vida na parada cardiorrespiratória em adultos como recurso válido, capaz de integrar tecnologias e estratégias educacionais inovadoras a enfermeiros para atendimento na reanimação cardiopulmonar. (AU)