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1.
Enferm. clín. (Ed. impr.) ; 29(6): 336-343, nov.-dic. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-184653

RESUMO

Objetivo: Conocer el grado el interés de los residentes en áreas formativas transversales de Enfermería Familiar y Comunitaria (EFyC) al inicio de su formación. Valorar el desarrollo de actividades comunitarias en los centros de salud y determinar el grado de satisfacción de los residentes con la formación recibida y actividades realizadas. Método: Se presenta una experiencia sobre metodología docente en salud pública y comunitaria en los residentes de EFyC desde el 2014 hasta el 2017. La formación se dividió en 3módulos formativos de 21h y se completó con 2actividades de campo: un programa de Educación para la Salud (EpS) y un mapeo de activos en la zona básica de salud (ZBS). Se cumplimentó un cuestionario de satisfacción del curso y de las actividades realizadas. Resultado: Durante este período se formaron 27 residentes. El 86,9% consideró la formación en atención comunitaria como muy necesaria. Se realizaron 26 programas de EpS y 17 mapeos de activos de sus ZBS. Con respecto a la satisfacción de la formación, se obtuvo una media global de 4,5 ± 0,1 sobre 5. Conclusiones: Los resultados evidencian un alto grado de interés en atención comunitaria, así como una valoración muy alta sobre las actividades realizadas y la formación recibida. La formación en salud comunitaria durante el período de residencia es un elemento esencial para integrar estas competencias en el rol profesional. Resulta imprescindible la dedicación por parte de las Unidades Docentes en el impulso en esta competencia, capacitando a los residentes en la integración del abordaje biopsicosocial, la orientación comunitaria y el trabajo en equipo en Atención Primaria


Objective: To determine the interest of nursing residents in the training areas of Family and Community Nursing (EFyC) at the beginning of their training, to evaluate community activities in health centres and to determine satisfaction with the training received and activities carried out. Method: We present the experience of training in the public and community health competencies of EFyC Nursing from 2014 to 2017 in a multiprofessional teaching unit. The training was divided into 3 theoretical modules. The training was completed with 2 activities: the design and development of a health education programme and an asset mapping in the basic health area. A questionnaire was completed on satisfaction with the course and the activities carried out. Result: During this period, 27 residents received training. As part of the training process, 26 health education programmes and 17 asset mappings were conducted in accredited health centres. The areas of intervention addressed were: lifestyles, life transitions and health problems. The overall satisfaction with the course was 4.5 ±.1 out of 5. Conclusions: The results show a high degree of interest in this area, as well as high evaluation of the activities carried out and the training received. Training in community health and health education during the period of residence is essential to include these competencies in the professional role. The dedication and involvement of the multiprofessional teaching units is essential in the development of these competences, training the residents through the integration of a biopsychosocial approach, community health and teamwork in primary care


Assuntos
Humanos , Enfermagem em Saúde Comunitária/educação , Enfermagem Familiar/educação , Educação em Enfermagem/tendências , Enfermeiras Especialistas/educação , Saúde Pública/educação , Estudos Transversais , Inquéritos e Questionários , Análise de Dados , Internato não Médico/métodos , Internato não Médico/organização & administração
5.
J Community Health Nurs ; 36(3): 139-146, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31291772

RESUMO

Patients that cannot come to their family medicine practice (i.e. who have difficulties with access) do not receive the same preventive screening activities and management of their chronic diseases as those who can. Community nurses who provide healthcare to patients in their homes were trained in additional competencies, including screening for risk factors for selected diseases and the management of patients with selected chronic diseases. The presented model enables equal management of all registered patients, regardless of accessibility. It also fosters exchange of information within the team members and thus improves the quality of the team management of patients.


Assuntos
Enfermagem em Saúde Comunitária/métodos , Assistência Integral à Saúde/organização & administração , Acesso aos Serviços de Saúde/organização & administração , Adulto , Asma/terapia , Enfermagem em Saúde Comunitária/educação , Enfermagem em Saúde Comunitária/organização & administração , Assistência Integral à Saúde/métodos , Disparidades em Assistência à Saúde , Humanos , Pessoa de Meia-Idade , Modelos Organizacionais , Doença Pulmonar Obstrutiva Crônica/terapia , Eslovênia
6.
Br J Community Nurs ; 24(7): 338-342, 2019 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-31265341

RESUMO

Antimicrobial stewardship (using antimicrobials responsibly) can reduce the risk of antimicrobial resistance (AMR). Many health professionals identify themselves as 'antibiotic guardians', but patient expectations, time constraints, and a lack of confidence or underdeveloped communication skills can influence decisions to prescribe. Nurse prescribers have an important role to play in antibiotic stewardship, and their numbers continue to grow. While nurse prescribers welcome this extension to their traditional role, they are often faced with barriers to antibiotic stewardship activities. These barriers may relate to their Capability (knowledge/skill), Opportunity (norms of practice, influence of patients, environmental factors), and Motivation (attitudes and beliefs, concern over outcome, emotion and habit) [COM-B]. Education, training and enablement can help to overcome these barriers, and the development of knowledge, confidence and effective communication skills should be of priority. Further, communication skills can help nurse prescribers understand patient expectations, with the use of open-ended questions, active listening and creation of a patient-centred consultation that leads to a mutually agreed end goal and way forward.


Assuntos
Gestão de Antimicrobianos/métodos , Comunicação , Enfermagem em Saúde Comunitária/métodos , Relações Enfermeiro-Paciente , Competência Clínica , Enfermagem em Saúde Comunitária/educação , Humanos , Participação do Paciente , Preferência do Paciente
7.
Metas enferm ; 22(6): 12-18, jul. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-184043

RESUMO

Objetivo: conocer el grado de satisfacción del alumnado de Enfermería y las dificultades encontradas con la metodología de aprendizaje-servicio en el desarrollo de la competencia de promoción de la salud, dentro de la asignatura de Salud Pública y Enfermería Comunitaria I. Método: el proyecto de aprendizaje-servicio fue llevado a cabo en tres fases: 1) formación del alumnado en conocimientos acerca de la Enfermería Comunitaria y Educación para la Salud; 2) contacto con las asociaciones cercanas a la universidad, y diseño de los talleres de salud y materiales que iban a ofrecer a las asociaciones (en grupos de 10 estudiantes); 3) implementación de los talleres por parte de alumnado. Se diseñó un cuestionario ad hoc para medir la satisfacción con el proyecto de aprendizaje-servicio. Para el análisis bivariante de la satisfacción con el sexo y la edad se utilizó la prueba de U de Mann-Whitney y el coeficiente de correlación de Spearman. Resultados: el alumnado tuvo un nivel de satisfacción muy alto (media: 8,07), con independencia del sexo y la edad. Se encontraron dificultades a la hora de poner en marcha esta metodología como la incompatibilidad de horarios entre el alumnado y las asociaciones, o la escasa asistencia de personas a las sesiones. Conclusiones: el desarrollo de actividades de aprendizaje-servicio para que el alumnado de Enfermería adquiera competencias en la promoción para la salud es una metodología con alto grado de satisfacción. No obstante, fueron encontradas barreras en su implementación como la dificultad en el cronograma entre alumnado y asociaciones


Objective: to understand the level of satisfaction among Nursing students and the difficulties found regarding the Service-Learning methodology in the development of Health Promotion skills, within the subject Public Health and Community Nursing I. Method: the Service-Learning Project was conducted in three stages: 1) training students in knowledge about Community Nursing and Health Education; 2) contact with those associations near the university, and design of Health Workshops and materials that would be offered to the associations (in 10-student groups); 3) implementation of workshops by the students. An ad hoc questionnaire was designed in order to measure the satisfaction with the Service-Learning project. The Mann-Whitney U Test and the Spearman Correlation Coefficient were used for the bivariate analysis of satisfaction with gender and age. Results: students had a very high satisfaction level (mean: 8.07), regardless of gender and age. Difficulties were found at the time of implementing this methodology, such as the incompatibility of schedules between students and the association, or the low attendance of people to the sessions. Conclusions: the development of Service-Learning activities for the Nursing students to acquire skills in Health Promotion is a methodology with a high level of satisfaction. However, barriers were found in its implementation, such as difficulties with the timetables of the students and the associations


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Estudantes de Enfermagem/estatística & dados numéricos , Educação em Enfermagem/tendências , Promoção da Saúde/métodos , Aprendizagem , Satisfação Pessoal , Enfermagem em Saúde Comunitária/educação , Processo de Enfermagem , Serviço Hospitalar de Enfermagem , Serviços de Enfermagem , Inquéritos e Questionários , Estilo de Vida Saudável
8.
PLoS One ; 14(3): e0211160, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30921338

RESUMO

INTRODUCTION: Community nursing and midwifery is changing in response to a shift in care from hospital to home, brought about by increasing costs to care because of an aging population and increasing chronicity. Until now, community nursing positions and scope of practice has been dependent on service focus and location, which has led to the role being unclearly defined. Lack of appeal for a career in community practice and a looming workforce shortage necessitates a review into how community nursing and midwifery transition to practice is supported. METHODS: This review sought to identify, assess and summarize available evidence relating to transitioning into community nursing and midwifery practice as a speciality. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach. A narrative synthesis was then undertaken on papers that examined community nursing and midwifery pathway perspectives which define, and enable or inhibit a contemporary pathway. Thematic analysis used a theoretical framework developed for early career and rapid transition to nursing specialty practice. RESULTS: There is a paucity of research that identifies community nursing and midwifery as a discreet scope of practice. Twelve papers were eventually included in the review. Verbatim findings were extracted from the papers and clustered into categories based on the chosen theoretical framework. Major themes were 'the self' (professional and personal); 'transition processes'; and, a 'sense of belonging'. Sub themes included narrative identifying inhibitors and enablers in each theme. DISCUSSION: No definition of community practice or pathway was identified in nursing, although midwifery was clearly defined. Community nursing practice was described as generalist in nature although specialist knowledge is required. Being part of the community in the professional sense and personal sense was considered important. The importance of transition was identified where pre-entry exposure to community practice was seen as important. Stages in transition to practice were recognised as pre-entry; incomer; insider; and, a sense of belonging. The process of transition should be planned and individualised acknowledging past experience whilst acknowledging the specialist nature of community-based practice.


Assuntos
Enfermagem em Saúde Comunitária/tendências , Tocologia/educação , Tocologia/tendências , Competência Clínica , Enfermagem em Saúde Comunitária/educação , Medicina Comunitária/educação , Humanos , Narração , Papel do Profissional de Enfermagem
10.
Nurse Educ ; 44(2): 102-105, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29912031

RESUMO

BACKGROUND: Animal-assisted activities (AAAs) show promise in providing emotional and social benefits to older adults and may be used as a tool to promote therapeutic communication between students and cognitively impaired older adults. PURPOSE: The purpose was to develop a program incorporating AAAs to enhance social engagement of cognitively impaired older adults in a community respite program and in turn enhance student comfort when caring for this vulnerable population. METHODS: The Dementia Attitudes Scale, a validated tool, was used to measure students' attitudes before and after AAA intervention. Data were analyzed using repeated-measures analysis of variance. RESULTS: Students were significantly more comfortable and demonstrated a gain in knowledge after AAAs were included in the community clinical experience. CONCLUSIONS: Incorporating AAAs into student community/service-learning clinical experience improved communication between students and cognitively impaired older adults, improving students' attitudes when caring for this population.


Assuntos
Terapia Assistida por Animais , Atitude do Pessoal de Saúde , Disfunção Cognitiva/enfermagem , Enfermagem em Saúde Comunitária/educação , Relações Enfermeiro-Paciente , Estudantes de Enfermagem/psicologia , Idoso , Animais , Comunicação , Cães , Humanos , Pesquisa em Educação de Enfermagem , Pesquisa em Avaliação de Enfermagem , Cuidados Intermitentes
13.
Int J Palliat Nurs ; 24(10): 474-481, 2018 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-30354900

RESUMO

BACKGROUND:: A key aspect to the provision of palliative care is maintaining the dignity of the individual being cared for. Nurses working in the community setting need knowledge and skills to meet the needs of individuals who need palliative care and their families. Dignity Care Intervention Ireland is a community-based pilot project designed to implement a dignity care intervention for individuals with a life-limiting condition living in their own home. As part of the overall intervention, an education programme was developed for nurses working in the community. METHOD:: Completion of a locally-designed questionnaire pre- and post-education. RESULTS:: Nurses working in the community setting welcomed and highly valued the Dignity Care Intervention Ireland education programme. There was an overall improvement in the understanding of palliative care for both groups and improved understanding of the principles of palliative care, with self-evaluated competence to apply these principles in daily clinical practice. CONCLUSION:: The importance of education about palliative care to support the delivery of dignity-preserving care cannot be underestimated. Ensuring nurses have the requisite knowledge will enhance future practice development and subsequently improve care for patients with life-limiting conditions and their families.


Assuntos
Enfermagem em Saúde Comunitária/educação , Enfermagem de Cuidados Paliativos na Terminalidade da Vida/educação , Recursos Humanos de Enfermagem no Hospital/educação , Recursos Humanos de Enfermagem no Hospital/psicologia , Pessoalidade , Direito a Morrer , Adulto , Atitude do Pessoal de Saúde , Currículo , Educação Continuada em Enfermagem/organização & administração , Feminino , Humanos , Irlanda , Masculino , Pessoa de Meia-Idade , Projetos Piloto
15.
Gac. sanit. (Barc., Ed. impr.) ; 32(supl.1): 82-85, oct. 2018.
Artigo em Espanhol | IBECS | ID: ibc-174236

RESUMO

La incorporación de contenidos docentes relativos a la salud comunitaria en los programas formativos de enfermería y medicina contribuye a acrecentar la calidad, el rigor y la sostenibilidad de las intervenciones comunitarias. En este artículo dialogamos sobre cómo la medicina familiar y comunitaria y la atención primaria siguen sin ser consideradas disciplinas nucleares y transversales en las facultades de medicina españolas. Durante la formación especializada médica y enfermera existe una gran variabilidad en el aprendizaje sobre salud comunitaria, dependiendo de la capacitación, las prioridades y la motivación de los profesionales de atención primaria, las unidades docentes y sus residentes. La creciente inestabilidad laboral y los actuales sistemas de contratación dificultan la puesta en práctica de las competencias adquiridas, el desarrollo de actividades comunitarias y la consolidación de espacios y redes para la formación. A pesar de las adversidades, existen iniciativas que potencian con ilusión una formación de calidad en salud comunitaria, y que merecen ser impulsadas y visibilizadas


Incorporating community health teaching in the undergraduate nursing and medicine curriculum and postgraduate training programmes contributes to enhance the quality, rigour and sustainability of health-promoting community interventions. In this article, we discuss the failure of Spanish Medical Universities to include family and community medicine and primary health care as integrated and cross-cutting disciplines on the undergraduate curriculum. During specialized medical and nursing training, community health teaching varies widely depending on the qualification, priorities and motivation of the primary health care workers, teaching units and trainees. Growing job instability and current nurse and medical recruitment systems, are hindering learning being put into practice, as well as the development of health-promoting community activities and the strengthening of training networks and facilities. Amid such adversity, there are initiatives that provide quality training on community health and should, accordingly, be fostered and acknowledged


Assuntos
Humanos , Serviços de Saúde Comunitária , Currículo/tendências , Educação Médica/tendências , Educação em Enfermagem/tendências , Agentes Comunitários de Saúde/educação , Capacitação Profissional , Atenção Primária à Saúde , Internato e Residência/tendências , Enfermagem em Saúde Comunitária/educação
16.
Gac. sanit. (Barc., Ed. impr.) ; 32(supl.1): 86-91, oct. 2018. ilus, tab, mapas
Artigo em Espanhol | IBECS | ID: ibc-174237

RESUMO

La vinculación de la universidad con la comunidad a la que pertenece es uno de los principios básicos en los que esta institución se sustenta. Una comunidad será saludable en la medida en que existan múltiples conexiones entre los individuos y las subagrupaciones que la integran. Al trabajar en promoción de la salud, hablar de participación y de modelos participativos implica asumir que personas y comunidades tienen el derecho de autogestionarse. Viabilizar la participación implicará abrir posibilidades para la cogestión, la autonomía, la comprensión de realidades dinámicas, la formalización de alianzas y la transformación de contextos y formas de relación. Implicará entender la salud como un derecho. El trabajo en red es fundamental en un mundo interconectado y global. El Proyecto de Universidades Promotoras de Salud se construye desde sus inicios con la participación de la comunidad universitaria con el objetivo de mejorar las condiciones para la salud, la calidad de vida y el bienestar de todos los miembros de la comunidad. Las universidades son escenarios idóneos para implementar estrategias de mejora de los estilos de vida de sus miembros, que además trasciendan a los espacios universitarios y afecten positivamente a la vida de las personas dentro y fuera de los campus. Las redes de Universidades Promotoras de la Salud en América Latina se institucionalizaron en el año 2003, y tomaron forma de Red Iberoamericana de Universidades Promotoras de la Salud en 2007, en el marco del III Congreso de Universidades Promotoras de la Salud desarrollado en Ciudad Juárez, México. En España se creó en 2008 la Red Española de Universidades Saludables con el objetivo de reforzar el papel de las universidades como entornos promotores de la salud y el bienestar tanto de sus estudiantes como de su personal y de la sociedad, liderando y apoyando procesos de cambio social


The connection of the University with the community to which it belongs is one of the basic principles on which the former is based. A community will be healthy as long as there are many connections between the individuals and sub-groups that form it. Working on health promotion, talking about participation and participatory models implies the assumption that people and communities have the right to self-manage. Implementing participation will involve opening up possibilities for co-management, autonomy, understanding of dynamic realities, the formalization of alliances, the transformation of contexts, and forms of relationship. It will involve understanding health as a right. Networking is fundamental in an interconnected and global world. Since its inception, the Project of Health Promoting Universities has been built with the participation of the university community towards improving the conditions for health, quality of life and well-being of all members of the community. Universities are ideal scenarios to implement strategies to improve the lifestyles of their members that also transcend to the university spaces and positively affect the lives of people on and off campus. The networks of Health Promoting Universities in Latin America were institutionalized in 2003, and took the form of the Ibero-American Network of Health Promoting Universities in 2007 within the framework of the third Conference on Health Promoting Universities held in the city of Juarez, Mexico. In 2008, the Spanish Network of Healthy Universities was created in Spain, in order to enhance the role of universities as environments that promote the health and well-being of their students, their staff and society, leading and supporting processes of social change


Assuntos
Humanos , Educação em Saúde/tendências , Promoção da Saúde/métodos , Enfermagem em Saúde Comunitária/educação , Medicina Comunitária/educação , Agentes Comunitários de Saúde/educação , Participação da Comunidade/tendências , Universidades/tendências , Redes Comunitárias/tendências , Programas Gente Saudável/organização & administração
17.
Nurse Educ Pract ; 33: 21-26, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30218947

RESUMO

Service-learning partnerships between nursing programs and health care settings in vulnerable communities may be challenging to initiate, but can offer multiple benefits for students, faculty, and the community served. The aim of this qualitative descriptive study was to explore the benefits and challenges of establishing a service-learning partnership between a university nursing program and an isolated community of internally-displaced persons in Medellin, Colombia. Semi-structured, in-depth interviews were conducted with 10 nursing professors and nine students who participated in the service-learning partnership. Interviews were audio-recorded, transcribed and analyzed using qualitative content analysis. Main benefits identified were: learning about the social determinants of health, development of compassion, appreciation for the community nursing role, professional growth and development, community engagement and increased access to care for community members. Challenges related to the service-learning experience included feelings of moral distress, lack of value for community nursing, and conflict with traditional biomedical approaches to care. Several threats to program sustainability were also identified. Professors and students offered several recommendations for program improvement, including interdisciplinary collaboration, documentation and dissemination of the service-learning experience, increased community autonomy and capacity for self-care, and curricular changes to enhance recognition of the importance of community nursing.


Assuntos
Enfermagem em Saúde Comunitária/educação , Relações Comunidade-Instituição , Docentes de Enfermagem/psicologia , Estudantes de Enfermagem/psicologia , Colômbia , Bacharelado em Enfermagem , Empatia , Humanos , Entrevistas como Assunto , Áreas de Pobreza , Pesquisa Qualitativa , Universidades
18.
J Nurs Educ ; 57(9): 566-569, 2018 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-30148521

RESUMO

BACKGROUND: Nursing education is a robust vehicle for change for community health nursing (CHN) in undergraduate programs. Nurses with a broad range of CHN competencies will be needed to meet the demands of community-based care in the coming years. METHOD: To meet the changing curricular demands around CHN, an experiential learning opportunity presented itself with the use of PechaKucha to support students. This experiential approach to learning the Canadian Community Health Nursing Professional Practice Model & Standards of Practice using a windshield and walkabout survey resulted in the students presenting the findings through the PechaKucha method. RESULTS: Kolb's experiential learning theory served as the theoretical foundation. The experiential application of the Canadian Community Health Nursing Professional Practice Model & Standards of Practice helps to create interest in CHN and develop future competent and confident community nurses. CONCLUSION: By discovering CHN applications through experiential learning, students are in a better position to understand the scope and role of CHN practice. [J Nurs Educ. 2018;57(9):566-569.].


Assuntos
Enfermagem em Saúde Comunitária/educação , Bacharelado em Enfermagem , Aprendizagem Baseada em Problemas , Canadá , Competência Clínica , Currículo , Humanos , Determinação de Necessidades de Cuidados de Saúde
19.
Br J Community Nurs ; 23(9): 439-448, 2018 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-30156899

RESUMO

District nursing has a long history as a service that provides care for patients in their home environment. Demographic changes and a need to optimise out of hospital care has impacted on the acuity of patients supported and the complexity of caseload management. District nurses, in order to effectively manage such increased demands on their busy service, need to possess excellent, assertive case management skills. This study explores and evaluates the impact of the Specialist Practice Qualification in district nursing on the assertiveness and leadership skills of students. A mixed methods approach was adopted, utilising a quantitative assertiveness questionnaire at three points during the programme across the 12 participating higher education institutions, alongside qualitative semi-structured interviews. Statistical analysis of assertiveness scores demonstrated a statistically significant increase in scores across the duration of the programmes, with no difference related to the academic level of programme studied. Qualitative analysis demonstrated wide ranging positive impacts of the programme, including the acquisition of knowledge of underpinning theory, enhanced leadership skills and the development of a voice to truly advocate for the patient. The Specialist Practice Qualification has a dramatic impact on the professional performance of students selected to undertake the programme. The programme is frequently at risk as a result of cuts in post-registration funding. This study effectively demonstrates the substantial impact of the programme; a programme that should remain an option for future district nurses.


Assuntos
Enfermagem em Saúde Comunitária/educação , Educação Continuada em Enfermagem , Adulto , Assertividade , Atitude do Pessoal de Saúde , Administração de Caso , Competência Clínica , Currículo , Inglaterra , Feminino , Humanos , Entrevistas como Assunto , Liderança , Masculino , Pessoa de Meia-Idade , Escócia , Especialidades de Enfermagem , Inquéritos e Questionários
20.
Rev. Rol enferm ; 41(7/8): 512-517, jul.-ago. 2018. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-179692

RESUMO

Las competencias en la especialidad de enfermería familiar y comunitaria las establece la ley, tanto en términos de formación como del ejercicio de la especialidad. Son de adquisición progresiva y plantean tres cuestiones: qué debemos enseñar cada año, qué no podemos enseñar porque no lo sabemos y qué no podemos enseñar porque no lo hacemos. Se describe una línea de investigación con metodología mixta que responde a dos objetivos: facilitar el aprendizaje de residentes y una guía a los tutores; y, de otra parte, conocer la autopercepción de conocimientos y necesidades de formación de las enfermeras de Atención Primaria en sus perfiles y lugares de trabajo. Se diferencian estilos de práctica enfermera entre práctica técnica, controladora y metodóloga. Esta propuesta se basa en cruzar el proceso de resolución de problemas con la actitud resolutiva de la enfermera y su requerimiento de información para documentar el proceso. El número de especialistas es importante y va a aumentar a corto plazo. Son un recurso humano con un alto nivel de competencia avalado por la ley y disponible para desplegar un arsenal de competencias que mejorarán sin duda la calidad del sistema sanitario, público y privado. Sin embargo, en la actualidad, no se les utiliza como prestadores de servicios avanzados. La ley abre la posibilidad de seguir avanzando en la acreditación de competencias y para ello se dispone de dos caminos aún inexplorados por las enfermeras. Uno dentro de la especialidad, las áreas de capacitación, y otro fuera, los diplomas de acreditación y acreditación avanzada. El enfoque de competencias abre oportunidades para todo el sistema: pacientes, usuarios y cuidadoras; enfermeras y otros profesionales de la salud. El reto es llevar a la práctica las ventajas que ofrece la especialidad con la visión de enfermería de práctica avanzada, en la gestión clínica, la mesogestión y la política sanitaria. Tal vez, la participación de las enfermeras en la política sanitaria marcará el camino para ello


In terms of training and practice, the competencies required for community and family health nursing are established by law. They are acquired progressively and raise three educative issues: what should we teach each year; what we cannot teach because we do not know; and what we cannot teach because we do not do. The following article describes a line of research based on a mixed methodology that responds to two objectives: to facilitate residents' learning process and to provide a guide for tutors; while at the same time to learn about the self-perception of knowledge and training needs of primary healthcare nurses, consistent with their profiles and workplaces. Nursing practice styles can be classified as technical, controlling and methodological. This proposal aims at crossing nurses' problem-solving process and problem-solving attitude, together with their need for information in order to document the nursing process. The number of nursing specialists is significant and will increase in the short term. These specialists are a human resource with a high level of competency guaranteed by law, and are readily available to deploy an arsenal of skills that will undoubtedly improve the quality of the public and private healthcare system. Unfortunately, they are currently not being harnessed as advanced service providers. The current law opens up the possibility for further progress in the accreditation of competencies, opening two paths that still remain unexplored. One relies within the specialty, in the area of training; and the other one can be found outside, among the accreditation diplomas and advanced accreditation. The competency-approach opens up opportunities for the entire healthcare system: patients, users and caretakers, together with nurses and other health professionals. The challenge is to put into practice the advantages offered by nursing specialties, consistent with the vision of advanced practice nursing in clinical management, meso-management and health policy. Perhaps the involvement of nurses in health policy will pave the way for the desired outcome


Assuntos
Humanos , Enfermagem em Saúde Comunitária/tendências , Enfermagem Familiar/tendências , Padrões de Prática em Enfermagem/tendências , /tendências , Enfermagem em Saúde Comunitária/educação , Enfermagem Familiar/educação , Educação em Enfermagem/tendências , Pesquisa em Enfermagem/tendências , Resolução de Problemas
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