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1.
Rev. enferm. UERJ ; 28: e35224, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1096015

RESUMO

Objetivo: investigar a atuação dos enfermeiros frente à amamentação cruzada e correlacionar com a atual questão da precarização do trabalho. Método: estudo qualitativo do tipo descritivo com base metodológica de análise do discurso, realizado com seis enfermeiras da Estratégia de Saúde da Família (ESF) por meio de um grupo focal. Resultados: o tema amamentação cruzada é apresentado como um indicador de conflitos ético-profissionais no processo de trabalho, expressando-se nos seguintes aspectos: conhecimento das prescrições de contraindicação, sensação de dificuldade em intervir e transferência à nutriz por qualquer dano à saúde da criança. Considerações finais: no cotejo entre esses resultados e uma organização de trabalho com normas e rotinas institucionalizadas, discutem-se como efeitos da não utilização de técnicas de aconselhamento, a fragilização da autonomia da nutriz, de forma imperceptível, reproduzidas por enfermeiros na assistência.


Objective: to investigate nurses' role related to cross-breastfeeding and to correlate with the current issue of precarious work.Method: descriptive andqualitative study based on methodological discourse analysis, carried out with six nurses from Estratégia de Saúde da Família (ESF) Program through a focus group. Results: cross-breastfeeding topic is presented as an indicator of ethical-professional conflicts in the work process, expressing itself in the following aspects: knowledge of prescriptions of contraindication, feeling of difficulty in intervening and transference to the nursing mother for any harm to the child's health. Final considerations: in the comparison between these results and a work organization with institutionalized norms and routines, we discuss the effects of not using counseling techniques, the fragility of nurses' autonomy, imperceptibly reproduced by nurses in care.


Objetivo: investigar el papel de las enfermeras relacionadas con la lactancia cruzada y su correlación con el tema actual del trabajo precario. Método: estudio descriptivo y cualitativo basado en el análisis metodológico del discurso, realizado con seis enfermeras del Programa Estratégia de Saúse da Familia (ESF) através de un grupo focal. Resultados: el tema de la lactancia cruzada se presenta como un indicador de conflictos ético-profesionales en el proceso de trabajo, expresándose en los siguientes aspectos: conocimiento de prescripciones de contraindicación, sensación de dificultad para intervenir y transferencia a la madre lactante por cualquier daño a la salud del niño Consideraciones finales: en la comparación entre estos resultados y una organización de trabajo con normas y rutinas institucionalizadas, discutimos los efectos de no utilizar técnicas de asesoramiento, la fragilidad de la autonomía de las enfermeras, reproducida imperceptiblemente por las enfermeras bajo cuidado.


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Qualidade da Assistência à Saúde/ética , Condições de Trabalho , Aleitamento Materno , Papel do Profissional de Enfermagem , Estratégia Saúde da Família , Contraindicações , Relações Trabalhistas , Brasil , Competência Clínica , Grupos Focais , Pesquisa Qualitativa
2.
J Law Med ; 27(4): 1008-1013, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32880416

RESUMO

Australian and international nursing regulators have specific requirements for continuing competence and the professional, safe practice of nurses and midwives. Requirements can dictate duration of practice, time away from/recency of practice, revalidation policies, and time between study program completion and practice commencement. Requirements vary between contexts and are periodically updated. To identify and examine Australian and international evidence for best regulatory practices relating to recency and the maintenance of professional competence among nurses and midwives, a scoping review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews will be undertaken. This protocol details the scope, inclusion criteria, and methodology that will guide the scoping review, which will inform an update to the Nursing and Midwifery Board of Australia's Registration Standard: Recency of Practice.


Assuntos
Tocologia , Enfermeiras Obstétricas , Enfermeiras Internacionais , Austrália , Competência Clínica , Protocolos Clínicos , Feminino , Humanos , Gravidez , Competência Profissional
4.
Adv Respir Med ; 88(4): 366-368, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32869274

RESUMO

We discuss the hypothesis that common Chest Drain Systems collected to a COVID-19 patient, could be a possible source of contamination for health care staff in a Thoracic Surgery ward and we propose an alternative way to minimize this further risk of transmission.


Assuntos
Tubos Torácicos/efeitos adversos , Infecções por Coronavirus/transmissão , Pneumonia Viral/transmissão , Procedimentos Cirúrgicos Torácicos/métodos , Competência Clínica , Infecções por Coronavirus/prevenção & controle , Drenagem/efeitos adversos , Humanos , Pandemias/prevenção & controle , Administração dos Cuidados ao Paciente/métodos , Pneumonia Viral/prevenção & controle , Medição de Risco , Toracostomia/métodos
5.
Tex Med ; 116(8): 34, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32866275

RESUMO

Medical schools typically have predictable schedules. The timing of lectures, clerkships, exams, and even extracurricular activities tend to follow in the same grooves year after year. Students can reliably block out even minor events months ahead of time and be confident they'll take place. All that changed with COVID-19. Since March, when the pandemic began closing down schools, businesses, and other institutions across the state, figuring out what comes next in medical school has been anything but predictable.


Assuntos
Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Faculdades de Medicina , Estresse Psicológico/etiologia , Estudantes de Medicina/psicologia , Betacoronavirus , Esgotamento Psicológico/psicologia , Competência Clínica , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Transmissão de Doença Infecciosa/prevenção & controle , Humanos , Inovação Organizacional , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Faculdades de Medicina/ética , Faculdades de Medicina/organização & administração , Faculdades de Medicina/tendências , Ensino/ética , Ensino/psicologia , Texas/epidemiologia , Incerteza
6.
J Oral Facial Pain Headache ; 34(3): 255-264, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32870954

RESUMO

Entrustable professional activities (EPAs) are a curriculum development and learner assessment tool that ensure a trainee is able to safely translate the skills they have learned during residency into unsupervised clinical practice. Although EPAs are used extensively across various health professions worldwide, dentistry is just beginning to call for their development at both the predoctoral and postgraduate levels. Given the complex, multifactorial nature of orofacial pain disorders and the need for an interdisciplinary approach to management, the specialty of orofacial pain is well suited to embracing EPAs to ensure program graduates are prepared for practice. Therefore, 10 EPAs have been developed in a combined effort from program directors from every CODA-accredited postgraduate orofacial pain residency program.


Assuntos
Educação Baseada em Competências , Internato e Residência , Competência Clínica , Dor Facial , Humanos
7.
Praxis (Bern 1994) ; 109(11): 834-840, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32873162

RESUMO

Reflections on Trends in the Undergraduate Curricula of Human Medicine at the Universities in Switzerland Abstract. Reflections on current trends and progressions in the undergraduate curricula of Human Medicine of the universities in Switzerland. Both updated modern learning objectives and the politically intended higher number of graduated swiss physicians will make an impact on clinical skills training and offers opportunities in focusing as well as in coordinating the curricula.


Assuntos
Currículo , Educação de Graduação em Medicina , Medicina , Competência Clínica , Humanos , Suíça , Universidades
8.
Praxis (Bern 1994) ; 109(11): 866-870, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32873166

RESUMO

Update Medical Studies 2020: Bern Abstract. The education of the young Bernese medical students is problem-based as well as practice-oriented. The didactical concept of the Bachelor Studies is a guided self-study accompanied by concept lectures and interactive tutorials. The clinical skills are taught in a highly structured way, beginning with e-learning, seminars and Bedside Teaching. The Master Studies are based on evidence-based clinical education. The well-structured internships are the heart of the Bernese Master Studies; they enable the early inclusion of the students in the medical practice of the various healthcare disciplines. The communication trainings as well as the sonography courses are examples for the innovative development of the Bernese curriculum. The rotations in GP practices give an insight into the primary healthcare.


Assuntos
Educação de Graduação em Medicina , Educação Médica , Estudantes de Medicina , Competência Clínica , Comunicação , Currículo , Humanos , Suíça
9.
Praxis (Bern 1994) ; 109(11): 871-878, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32873171

RESUMO

Studying Human Medicine at the University of Geneva: An Up-to-Date, Integrated Curriculum Abstract. The curriculum of human medicine at the Faculty of Medicine of the University of Geneva has been thoroughly renovated in 1995. It offers an integrated program allowing for a constant adaptation of the content to the explosion of biomedical knowledge and the changes in society. It uses active, student-centred learning methods. In line with the Bologna process since 2006, it has been accredited several times, most recently in 2019. It evolved to strengthen the importance of primary care and to introduce interprofessional training, in particular through its simulation centre. Through early and continuous clinical immersion, students acquire their practical skills in an integrated manner. These conditions are conducive to the introduction of new concepts, such as the Entrustable Professional Activities (EPAs) conveyed by the recent national competence framework PROFILES.


Assuntos
Currículo , Medicina , Competência Clínica , Humanos , Atenção Primária à Saúde , Suíça
11.
Nurs Educ Perspect ; 41(5): 280-284, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32732817

RESUMO

AIM: The purpose of the study was to evaluate the validity of the Clinical Simulation Competency Assessment Tool (ClinSimCAT). BACKGROUND: The 2011 Future of Nursing report encouraged nursing programs to move toward a competency-based approach to education. As no tool was found to holistically evaluate nursing student competency in clinical and simulation settings, we developed the ClinSimCAT based on the Institute of Medicine recommended competencies. METHOD: A Delphi study with three rounds was conducted. A national sample of nursing education and simulation leaders was used to achieve consensus about the competencies. RESULTS: The process resulted in a set of 20 competencies across eight domains (patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, informatics, professionalism, and systems-based practice). CONCLUSION: The ClinSimCAT has demonstrated evidence of content validity and can be used for evaluation of clinical and simulation across a variety of undergraduate nursing courses.


Assuntos
Competência Clínica , Bacharelado em Enfermagem , Educação em Enfermagem , Estudantes de Enfermagem , Humanos , Assistência Centrada no Paciente , Melhoria de Qualidade
13.
J Med Life ; 13(2): 183-186, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32742511

RESUMO

Clinical reasoning is the cornerstone of medical practice, and achieving this competence depends on a large number of factors. Internal medicine departments provide junior doctors with plentiful and varied patients, offering a comprehensive basis for learning clinical reasoning. In order to evaluate the usefulness of an early rotation at internal medicine departments, we compared, via script concordance tests, the evolution of residents' clinical reasoning after an initial internal medicine rotation compared to rotations through other medical specialties. Twenty-two residents were tested after six months of their internal medicine rotation and compared to twenty-five residents that had the first rotation in another specialty (control). We showed a significant difference in the improvement of the script concordance tests scores (p=0.015) between the beginning and the end of their first rotation between the internal medicine and the control groups, and this implies the lower improvement of clinical reasoning skills and spontaneous learning slope of the junior doctors in other departments.


Assuntos
Medicina Interna/educação , Internato e Residência , Aprendizagem , Competência Clínica , Avaliação Educacional , Humanos
15.
Med Clin North Am ; 104(5): 767-775, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32773044

RESUMO

Goals of care conversations are important but complex for clinicians caring for older adults. Although clinicians tend to focus on specific medical interventions, these conversations are more successful if they begin with gaining a shared understanding of the medical conditions and possible outcomes, followed by discussion of values and goals. Although training in the medical setting is incomplete, there are many published and online resources that can help clinicians gain these valuable skills.


Assuntos
Tomada de Decisão Compartilhada , Cuidados Paliativos , Planejamento de Assistência ao Paciente , Idoso , Competência Clínica , Humanos , Cuidados Paliativos/ética , Cuidados Paliativos/métodos , Cuidados Paliativos/psicologia , Planejamento de Assistência ao Paciente/ética , Planejamento de Assistência ao Paciente/normas , Relações Médico-Paciente
17.
J Nurs Adm ; 50(9): 442-448, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32826513

RESUMO

OBJECTIVE: The aim of this study was to examine acute care registered nurses' (RNs') fall prevention decision-making. BACKGROUND: The RN decision-making process related to fall prevention needs to be investigated to ensure that hospital policies align with nursing workflow and support nursing judgment. METHODS: Qualitative semistructured interviews based on the Critical Decision Method were conducted with RNs about their planning and decision making during their last 12-hour shift worked. RESULTS: Data saturation was achieved with 12 RNs. Nine themes emerged related to the RN decision-making process and included hospital-level (eg, fear of discipline), unit-level (eg, value of bed alarm technology), and nurse-level (eg, professional judgment) factors that could influence fall prevention. CONCLUSIONS: Nursing administrators should consider a multilevel approach to fall prevention policies that includes promoting a practice environment that embraces self-reporting adverse events without fear of shame or being reprimanded, evaluating unit-level practice and technology acceptance and usability, and supporting autonomous nursing practice.


Assuntos
Acidentes por Quedas/prevenção & controle , Atitude do Pessoal de Saúde , Tomada de Decisões , Enfermeiras e Enfermeiros/psicologia , Adulto , Competência Clínica , Feminino , Humanos , Entrevistas como Assunto , Masculino , Enfermeiras Administradoras
18.
J Nurs Adm ; 50(9): 468-473, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32826516

RESUMO

Nurse leaders seek effective strategies to engage nurses in decision-making when striving for clinical excellence. When leaders cultivate safe environments, nurses are encouraged to discover new knowledge and innovations. In our institution, nurse leaders designed a systematic guide using Liberating Structures to empower nurses to develop a professional practice model.


Assuntos
Liderança , Modelos de Enfermagem , Enfermeiras Administradoras , Cultura Organizacional , Prática Profissional , Desenvolvimento de Pessoal/organização & administração , Competência Clínica , Humanos , Enfermeiras Administradoras/organização & administração , Enfermeiras Administradoras/psicologia
20.
Curr Opin Anaesthesiol ; 33(5): 674-684, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32826622

RESUMO

PURPOSE OF REVIEW: Effective and safe regional anaesthesia and pain medicine procedures require clinicians to learn and master complex theoretical knowledge and motor skills. This review aims to summarize articles relevant to education and training in these skill sets in the previous 2 years. RECENT FINDINGS: Twenty-two articles were identified, investigating nine out of the 13 top-ranked research topics in education and training in regional anaesthesia. Research topics addressed by these articles included prerotation simulation, deliberate practice combined with formative assessment tools, validation of assessment tools, three-dimensional-printed models, and knowledge translation from simulation to clinical practice. Emerging concepts investigated for their applications in regional anaesthesia included eye-tracking as a surrogate metric when evaluating proficiency, and elastography aiding visual salience to distinguish appropriate perineural and inappropriate intraneural injections. SUMMARY: Research into education and training in regional anaesthesia covered multiple and diverse topics. Methodological limitations were noted in several articles, reflecting the difficulties in designing and conducting medical education studies. Nonetheless, the evidence-base continues to mature and innovations provide exciting future possibilities.


Assuntos
Anestesia por Condução/normas , Anestesiologia/educação , Educação Médica , Ultrassonografia de Intervenção/normas , Anestesia por Condução/métodos , Anestesiologia/normas , Competência Clínica/normas , Humanos , Dor
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