Adherence to precautions for preventing the transmission of microorganisms in primary health care: a qualitative study.

BACKGROUND: Health care associated infections (HAIs) are a source of concern worldwide. No health service in any country can be considered HAI risk-free. However, there is scarcity of data on the risks to which both patients and health workers are subject in non-hospital settings. The aim of this study was to identify issues that determine the adherence of professionals to precautions for preventing transmission of microorganisms in primary health care. METHOD: This was a qualitative study, using focus groups of primary health care staff, in two Brazilian municipalities. The data were analysed using content analysis. RESULTS: Four focus groups were conducted with 20 professionals (11 community health workers, 5 nursing assistants and 4 nurses), and the analysed content was organized into four thematic categories. These categories are: low risk perception, weaknesses in knowledge, insufficient in-service training and infrastructure limitations. Participants expressed their weaknesses in knowledge of standard and transmission based precautions, mainly for hand hygiene and tuberculosis. A lack of appropriate resources and standardization in sharps disposal management was also highlighted by the participants. CONCLUSION: The study points out the need to provide in-service training for professionals on the transmission of microorganisms in primary health care to ensure adequate level of risk perception and knowledge. Further recommendations include investment to improve infrastructure to facilitate adherence to precautions and to minimize the risk of disease transmission for both patients and health care workers.

An innovative strategy for nursing training on standard and transmission-based precautions in primary health care: A randomized controlled trial.

BACKGROUND: Strategies to improve adherence to standard and transmission-based precautions are essential to reduce the risk of health care-associated infections. This study aims to evaluate the effectiveness of an educational strategy on precautions among nursing staff in primary health care settings. METHODS: A randomized nonblinded controlled trial was conducted with 100 nursing staff working in 28 primary health care units. Groups were allocated randomly. The intervention group received a WebQuest educational strategy: a guided, creative method designed to engage participants in developing learning tasks, organized in 5 dimensions. The control group did not receive any training. Knowledge and self-reported adherence were assessed at 3 time points in the intervention group and at 2 time points in the control group. Data analyses were performed using Pearson's chi-square or Fisher's exact for categorical data, and Mann-Whitney and Repeated Measures analysis of variance for quantitative data. RESULTS: A higher level of knowledge was identified in the postintervention for the dimensions of risk assessment, hand hygiene, and mask use and cough etiquette (all P values P < .05). The self-reported adherence increased in intervention (P = .008) and control groups (P = .005). The differences decreased after 6 months. CONCLUSIONS: The educational intervention increased the knowledge and self-reported adherence to standard and transmission-based precautions.

[Panorama of nursing distance education in Brazil]. / Panorama da educação à distância em enfermagem no Brasil.

The development of distance education is associated with the popularization and democratization of the accessibility to information and communication technologies. Nursing has been using this modality of education in both undergraduate and graduate courses, which has provided knowledge about other technologies, an easier accessibility, flexibility of time and space, and reduced costs. The objective of this study is map the national higher education distance nursing courses. This exploratory, descriptive study was developed by visiting governmental, non-governmental and institutional websites. Two undergraduate and nine graduate courses in nursing were found, which is considered to be a low number, considering that distance education is an appropriate pedagogical tool that permits to prepare a large number of nurses who are geographically dispersed and who do not have access to the conventional educational processes.

Assessment of patient safety culture in Brazilian hospitals through HSOPSC: a scoping review.

OBJECTIVES: to describe, from literature, the characteristics of patient safety culture in Brazilian hospitals that applied the Hospital Survey on Patient Safety Culture. METHODS: this is a scoping review. A search was performed in the databases LILACS, PubMed, SciELO, CINAHL, Web of Science, Scopus and in the CAPES Dissertations and Theses Database in September and October 2020. RESULTS: thirty-six studies were identified. Nine studies identified strengthened areas such as: "teamwork within the units", "expectations of supervisor/boss and actions promoting safety", "organizational learning", "support of hospital management for patient safety" and "frequency of report of events". As a critical area, the dimension "non-punitive response to error" was evidenced in 30 of 36 studies. CONCLUSIONS: the identification of areas of strength and critical areas of safety culture is relevant to encourage improvement of patient safety problems in an institution.

Construction and validation of a sepsis simulation scenario: a methodological study. / Construção e validação de um cenário de simulação sobre sepse: estudo metodológico.

OBJECTIVE: To build, validate and test a high-fidelity clinical simulation scenario for sepsis management. METHOD: Methodological study developed in three phases: construction of a simulation scenario using the framework Model of Nursing Training Simulation and protocols established by the Latin-American Sepsis Institute, content validation by nine judges, and scenario testing by two nurses from a hospital institution. Data analysis was carried out through Content Validity Index, with values > 0.90 among the judges being considered satisfactory. RESULTS: The simulation scenario was observed to be appropriate and obtained an overall value > 0.90. However, some adjustments to the scenario and the test were performed concerning textual clarity, functionality, and the protocol's pertinence, following the judges' suggestions. CONCLUSION: The validated simulation scenario is expected to be a facilitator instrument for educators and professionals in the permanent/continued education nuclei of teaching and health institutions.

Strategies to minimize medication errors in emergency units: an integrative review.

OBJECTIVE: To assess the strategies used by the Nursing team to minimize medication errors in emergency units. METHOD: Integrative literature review in the PubMed, BDenf, Cochrane and LILACS databases. Timeless research, without language limitation, performed by peers. Articles published in full that answered the guiding question were included in research. RESULTS: Educational strategies (conducting campaigns, elaborating explanatory manuals, creating a multidisciplinary committee involved in the prevention and reduction of adverse drug events); organizational (meetings, Deviance positive, creation of protocols and changes in the work process) and new technologies (implementation of prescription by computerized system, introduction of the unit doses and of the bar code in the administration of medicines) were evidenced in the studies with the purpose of minimizing medication errors in an emergency unit. CONCLUSION: The strategies identified were effective in minimizing medication errors in emergency units.

Serious games as an educational strategy to control childhood obesity: a systematic literature review1.

OBJECTIVES: to identify in the literature the efficacy of serious games to improve knowledge for and/or behavioral changes among overweight or obese children. METHOD: Systematic Literature Review. The Cochrane Systematic Reviews Handbook was used. The studies were collected from the following databases: Public Medline; Web Of Science; Science Direct; Latin American and Caribbean Health Sciences Literature; and the Health Game Research and Cumulative Index to Nursing & Allied Health Literature. The descriptors were video games and obesity, while the key word was serious games. Inclusion criteria were: studies classified as Randomized Clinical Trials written in English, Spanish or Portuguese and in which children were the subjects of the study. RESULTS: 2,722 studies were identified in the initial search and six studies remained in the final sample. The papers focused on encouraging behavioral changes in players, including physical exercise and improved eating habits. The studies report that serious games are a potential strategy to encourage positive coping with childhood obesity. CONCLUSION: research in this field is an expanding and promising strategy and serious games represent an alternative means to provide health education to children.

Knowledge about precautions in Primary Health Care: tool validation.

OBJECTIVE: To elaborate and validate a tool to assess knowledge and behavior of nursing professionals about standards and specific precautions in the Primary Health Care. METHOD: Methodological study of the elaboration and validation of the tool by thirteen experts judges, using a Likert scale of 4 points, with Content Validity Index ≥ 0.80, on clarity, relevance and pertinence. RESULTS: A tool composed of 47 dichotomous questions to assess knowledge and 12 questions, with five options of answers, for the referred behavior. In the validation, only one item was deleted, related to the "Hands Hygiene" axis and one item was reformulated, regarding "Use of Common Gloves" and another 11 changed writing. The tool as a whole was assessed for relevance, comprehensiveness and representativeness within the scope of the topic investigated. CONCLUSION: The developed tool has been validated and is now available for use in Primary Health Care.

Adherence to standard precaution in the peripheral vascular access.

This prospective and quantitative study was carried out in a small private general hospital, where the adherence to standard precaution in the peripheral vascular access was evaluated. The data were collected through a questionnaire aiming to characterize the nursing team's knowledge and opinion about standard precautions and the availability of materials. In addition, a systemized observation of the procedures of vein puncture and medicine administration was performed. It was identified that 84.4% of the punctures had been carried out without gloves or previous hand washing; in 29.7% of the procedures, needles were recapped and 93.2% of the professionals reported adequate material supply. Concluding, the professionals expose themselves and patients to unnecessary risks of infection. The nursing team must be the focus of continuous interventions and future actions in order to minimize the risk of infection in the procedure of peripheral vascular access.

[Characterization of knowledge production on the patient care system in Brazil]. / Caracterização da produção do conhecimento sobre sistematização da assistência de enfermagem no Brasil.

This is a bibliographical study that has as its aim characterizing the Brazilian scientific production on the "Patient Care System" and visualizing its trends. A retrospective bibliogra-phical study (1990-2002) was carried out taking into consideration the items: date, title of the journal, type of research and approach of the publication. Production average was 13.4 publications/ year and articles were distributed among 23 journals, with a majority of them dealing with hospitals (63.2%). Cardiology was the theme of 17.6% of the articles, and 78.6% of them were focused on the implementation, development and evaluation of SAE models. NANDA taxonomy was men-tioned in 40.2% of the production, and Wanda Horta in 40.5%. There are still some blanks in this area of knowledge, but the increasing availability of the scientific production on this subject may help professionals in the implementation of the patient care system.

Assessment of the usability of a digital learning technology prototype for monitoring intracranial pressure.

OBJECTIVE: to assess the usability of a digital learning technology prototype as a new method for minimally invasive monitoring of intracranial pressure. METHOD: descriptive study using a quantitative approach on assessing the usability of a prototype based on Nielsen's ten heuristics. Four experts in the area of Human-Computer interaction participated in the study. RESULTS: the evaluation delivered eight violated heuristics and 31 usability problems in the 32 screens of the prototype. CONCLUSION: the suggestions of the evaluators were critical for developing an intuitive, user-friendly interface and will be included in the final version of the digital learning technology. OBJETIVO: avaliar a usabilidade de um protótipo educacional digital sobre um novo método para monitoração da pressão intracraniana de forma minimamente invasivo para enfermeiros e médicos. MÉTODO: estudo descritivo com abordagem quantitativa sobre a avaliação de usabilidade de um protótipo com base nas dez Heurísticas de Nielsen. Participaram quatro especialistas da área de Interação Humano Computador. RESULTADOS: a avaliação resultou em oito heurísticas violadas e 31 problemas de usabilidade nas 32 telas do protótipo. CONCLUSÃO: as sugestões dos avaliadores foram cruciais para o desenvolvimento de uma interface amigável e intuitiva e serão consideradas na versão final da tecnologia educacional digital. OBJETIVO: evaluar la usabilidad de un prototipo educacional digital sobre un nuevo método para monitorización de la presión intracraneal, de manera mínimamente invasiva. MÉTODO: estudio descriptivo con abordaje cuantitativo sobre la evaluación de usabilidad de un prototipo con base en las diez reglas Heurísticas de Nielsen. Participaron cuatro especialistas del área de Interacción Humana Computador. RESULTADOS: la evaluación resultó en ocho reglas heurísticas violadas y 31 problemas de usabilidad en las 32 pantallas del prototipo. CONCLUSIÓN: las sugestiones de los evaluadores fueron cruciales para el desarrollo de una interfaz amigable e intuitiva y éstas serán consideradas en la versión final de la tecnología educacional digital.

Assessment of patient safety culture in Brazilian hospitals through HSOPSC: a scoping review / Evaluación de la cultura de seguridad del paciente en los hospitales brasileños a través del HSOPSC: revisión de alcance / Avaliação da cultura de segurança do paciente em hospitais brasileiros através do HSOPSC: scoping review

ABSTRACT Objectives: to describe, from literature, the characteristics of patient safety culture in Brazilian hospitals that applied the Hospital Survey on Patient Safety Culture. Methods: this is a scoping review. A search was performed in the databases LILACS, PubMed, SciELO, CINAHL, Web of Science, Scopus and in the CAPES Dissertations and Theses Database in September and October 2020. Results: thirty-six studies were identified. Nine studies identified strengthened areas such as: "teamwork within the units", "expectations of supervisor/boss and actions promoting safety", "organizational learning", "support of hospital management for patient safety" and "frequency of report of events". As a critical area, the dimension "non-punitive response to error" was evidenced in 30 of 36 studies. Conclusions: the identification of areas of strength and critical areas of safety culture is relevant to encourage improvement of patient safety problems in an institution.

RESUMEN Objetivos: describir, a partir de la literatura, las características de la cultura de seguridad del paciente en los hospitales brasileños que aplicaron el Hospital Survey on Patient Safety Culture. Métodos: esta es una revisión de alcance. Se realizaron búsquedas en las bases de datos LILACS, PuBMed, SciELO, CINAHL, Web of Science, Scopus y el Banco de Disertaciones y Tesis CAPES en septiembre y octubre de 2020. Resultados: se identificaron 36 estudios. Nueve estudios identificaron áreas fortalecidas como: "trabajo en equipo dentro de las unidades", "expectativas del supervisor/jefe y acciones que promuevan la seguridade", "aprendizaje organizacional", "apoyo a la gestión hospitalaria para la seguridad del paciente" y "frecuencia de notificación de eventos". Como área crítica, la dimensión "respuesta no punitiva al error" se evidenció en 30 de los 36 estudios. Conclusiones: la identificación de áreas de fortaleza y áreas críticas de la cultura de seguridad es relevante para incentivar la mejora de los problemas de seguridad del paciente en una institución.

RESUMO Objetivos: descrever, a partir da literatura, as características da cultura de segurança do paciente nos hospitais brasileiros que aplicaram o Hospital Survey on Patient Safety Culture. Métodos: trata-se de uma scoping review. Foi realizada busca nas bases de dados LILACS, PuBMed, SciELO, CINAHL, Web of Science, Scopus e no Banco de Dissertações e Teses da CAPES, em setembro e outubro de 2020. Resultados: foram identificados 36 estudos. Nove estudos identificaram áreas fortalecidas como: "trabalho em equipe dentro das unidades", "expectativas do supervisor/chefe e ações promotoras da segurança", "aprendizado organizacional", "apoio da gestão hospitalar para a segurança do paciente" e "frequência da notificação de eventos". Como área crítica, a dimensão "resposta não punitiva ao erro" foi evidenciada em 30 dos 36 estudos. Conclusões: a identificação de áreas de força e áreas críticas da cultura de segurança é relevante para incitar a melhoria de problemas de segurança do paciente em uma instituição.

Serious game development as a strategy for health promotion and tackling childhood obesity.

OBJECTIVES: to develop and assess a serious game on healthy eating and physical activity to promote health and tackle childhood obesity. METHOD: a descriptive, applied and methodological study.For the development of the game, the following steps were taken: conceptualization, pre-production with the development of the game documentation, prototyping, production and assessment of thecomputer and health experts. RESULTS: a prototype has been developed up to beta version. The game was positively assessed both in terms of gameplay and mechanics, and in relation to the content presented, standing out as a powerful strategy for health promotion. The information from the assessment phase contributed to the settings in the software in order to make it available in the future for the target population of this research. The greatest advantage of the proposed game is the fact that it is an open educational resource. CONCLUSIONS: the expert assessments showed that the game has great educational potential and it is considered suitable for future application to the target audience.The serious game can become a technological teaching resource available for use in schools and health facilities, and can also be reused for the production of other educational games by accessing its source code. OBJETIVOS: desenvolver e avaliar um serious game (Jogo sério) sobre alimentação saudável e exercício físico para promoção da saúde e auxílio ao enfrentamento da obesidade infantil. MÉTODO: estudo descritivo, aplicado e metodológico. Para o desenvolvimento do jogo, foram percorridas as seguintes etapas: conceituação, pré-produção com desenvolvimento da documentação do jogo, prototipagem, produção e avaliação de especialistas de computação e saúde. RESULTADOS: desenvolveu-se um protótipo até a versão beta. O jogo foi avaliado positivamente tanto em relação à jogabilidade e mecânica, quanto em relação ao conteúdo apresentado, destacando-se como uma estratégia potente para a promoção de saúde. As informações oriundas da fase de avaliação serviram de subsídio para adequações no software com a finalidade de disponibilizá-lo futuramente à população alvo da pesquisa. O grande diferencial do jogo proposto é o fato do mesmo ser um recurso educacional aberto. CONCLUSÕES: as avaliações com especialistas demonstraram que o jogo tem grande potencial educacional e considerado adequado para a aplicação futura com o público-alvo. O serious game pode ser um recurso didático tecnológico acessível para uso em escolas e unidades de saúde, além de poder ser reutilizado para a produção de outros jogos educacionais através do acesso de seu código fonte. OBJETIVOS: desarrollar y evaluar un serious game (Juego serio) sobre alimentación saludable y ejercicio físico para la promoción de la salud y ayudar en el enfrentamiento de la obesidad infantil. MÉTODO: estudio descriptivo, aplicado y metodológico. Para el desarrollo del juego, se iniciaron los siguientes pasos: conceptualización, pre-producción con el desarrollo de la documentación del juego, creación de prototipos, producción y evaluación por expertos informáticos y en salud. RESULTADOS: un prototipo se ha desarrollado hasta la versión beta. El juego se evaluó positivamente tanto en términos de jugabilidad y mecánica como en relación con el contenido presentado, destacándose como una poderosa estrategia para la promoción de la salud. La información de la fase de evaluación contribuyó a los ajustes en el software con el fin de que esté disponible en el futuro para la población objetivo de esa investigación. La gran vantaja del juego propuesto es el hecho de que es un recurso educativo abierto. CONCLUSIONES: las evaluaciones de los expertos mostraron que el juego tiene un gran potencial educativo y es considerado adecuado para la aplicación futura para el público objetivo. El serious game puede convertirse en un recurso para la enseñanza tecnológica disponible para uso en las escuelas y en los centros de salud, y también puede ser reutilizado para la producción de otros juegos educativos mediante el acceso a su código fuente.

Avaliação de serious game em programa de enfrentamento da obesidade infantil / Evaluación de serious game en programa de combate a la obesidad infantil / Serious game assessment in a child obesity tackling program

Resumo Objetivo Avaliar um serious game enquanto estratégia educativa para crianças em um programa de enfrentamento de sobrepeso e obesidade. Métodos Pesquisa metodológica, com abordagem quantitativa e de corte transversal. Participaram do estudo as crianças pertencentes a um programa de condicionamento físico com games interativos para crianças obesas e/ou sobrepeso (n=13). Foi feito o perfil dos participantes por meio de dados antropométricos, questionários sobre seus hábitos alimentares e de atividade física. Posteriormente, o serious game DigesTower foi apresentado como uma estratégia adicional ao programa e realizada a avaliação do jogo pelo público-alvo. Resultados Participaram crianças de sete a 11 anos com sobrepeso e obesidade. O DigesTower foi bem recebido pelos participantes, que afirmaram ter imersão, motivação e estímulo para melhoria do seu conhecimento. A versão final do jogo foi desenvolvida e disponibilizada online de forma gratuita e pública. Conclusão O estudo buscou incentivar o uso de ferramentas inovadoras para auxiliar como intervenções educativas no âmbito da obesidade infantil e o serious game foi avaliado como uma potencial estratégia educativa para crianças. Almeja-se que este estudo inspire futuras pesquisas em que seus objetos de estudo sejam o desenvolvimento de jogos digitais para o público infantil.

Resumen Objetivo Evaluar un serious game como estrategia educativa para niños en un programa de combate al sobrepeso y a la obesidad. Métodos Investigación metodológica, con enfoque cuantitativo y de corte transversal. Participaron en el estudio niños que forman parte de un programa de acondicionamiento físico con games interactivos para niños obesos o con sobrepeso (n=13). El perfil de los participantes fue elaborado mediante datos antropométricos, cuestionarios sobre sus hábitos alimentarios y de actividad física. Luego se presentó el serious game DigesTower como una estrategia adicional del programa, y el público destinatario realizó la evaluación del juego. Resultados Participaron niños de 7 a 11 años con sobrepeso y obesidad. El DigesTower fue bien recibido por los participantes, que afirmaron tener inmersión, motivación y estímulo para mejorar sus conocimientos. La versión final del juego fue desarrollada y se puso a disposición en línea de forma gratuita y pública. Conclusión El estudio buscó incentivar el uso de herramientas innovadoras para ayudar con intervenciones educativas en el ámbito de la obesidad infantil, y el serious game fue evaluado como una posible estrategia educativa para niños. Se espera que este estudio inspire futuras investigaciones que tengan como objeto de estudio el desarrollo de juegos digitales para el público infantil.

Abstract Objective To assess a serious game as an educational strategy for children in a program to tackle overweight and obesity. Methods This is methodological, quantitative and cross-sectional research. Children from a physical conditioning program with interactive games for obese and/or overweight children participated in the study (n=13). Participants' profile was made through anthropometric data, questionnaires about their eating habits and physical activity. Subsequently, the serious game DigesTower was presented as an additional strategy to the program and the game was assessed by the target audience. Results Children aged seven to 11 years with overweight and obesity participated. DigesTower was well received by the participants, who claimed to have immersion, motivation and encouragement to improve their knowledge. The final version of the game was developed and made available online for free and publicly Conclusion The study sought to encourage the use of innovative tools to assist as educational interventions in the field of childhood obesity and the serious game was assessed as a potential educational strategy for children. It is hoped that this study will inspire future research in which its objects of study are the development of digital games for children.

[Participating in the construction of a teaching project for nursing]. / Participando da construção de um projeto pedagógico da enfermagem.

The aim of the present paper is to report the authors' experience in the construction process of the teaching project for the Nursing Course at the Federal University of São Carlos. The study presents the course and the aspects related to the new proposal concerning the professional nurse profile, and the structure of the subjects distributed in modules are briefly reported. The collective construction and the difficulties regarding the curriculum reformulation process are placed in context. The integrated curriculum proposal should become effective in 2005, which will bring about the efforts of teachers in their search for the articulation of theory and practice without fragmentation. In order to succeed, the new teaching project will require efforts from teachers, students and the university administrative staff so that paths to overcome upcoming difficulties can be found.

Construção e validação de um cenário de simulação sobre sepse: estudo metodológico / Construcción y validación de un escenario de simulación sobre la sepsis: estudio metodológico / Construction and validation of a sepsis simulation scenario: a methodological study

RESUMO Objetivo Construir, validar e testar um cenário de simulação clínica de alta fidelidade para o manejo da sepse. Método Estudo metodológico desenvolvido em três fases: construção do cenário de simulação utilizando o framework Modelo de Simulação de Ensino em Enfermagem e os protocolos instituídos pelo Instituto Latino Americano de Sepse; validação do conteúdo por nove juízes; e o teste do cenário por dois enfermeiros de uma instituição hospitalar. A análise dos dados se deu pelo Índice de Validade de Conteúdo, considerando-se adequado um valor > 0,90 entre os juízes. Resultados O cenário de simulação mostrou-se apropriado, obtendo valor geral > 0,90. No entanto, foram feitos alguns ajustes no cenário e no teste no que tange à clareza da redação, às funcionalidades e à pertinência de protocolos, conforme sugestão dos juízes. Conclusão Espera-se que o cenário de simulação validado seja um instrumento facilitador para docentes e profissionais de núcleos de educação permanente/continuada de instituições de ensino e saúde.

RESUMEN Objetivo Construir, validar y probar un escenario de simulación clínica de alta fidelidad para el manejo de la sepsis. Método Estudio metodológico desarrollado en tres fases: construcción del escenario de simulación utilizando el framework del Modelo de Simulación de Enseñanza de Enfermería y los protocolos instituidos por el Instituto Latinoamericano de Sepsis; validación del contenido por nueve jueces; y prueba del escenario por dos enfermeras de una institución hospitalaria. Los datos fueron analizados por el Índice de Validez de Contenido, considerando un valor > 0,90 entre los jueces. Resultados El escenario de la simulación fue apropiado, obteniendo un valor global > 0,90. Sin embargo, se hicieron algunos ajustes en el escenario y la prueba en cuanto a la claridad de la redacción, la funcionalidad y la pertinencia de los protocolos, como sugirieron los jueces. Conclusión Se espera que el escenario de simulación validado sea una herramienta facilitadora para los profesores y profesionales de los centros de educación permanente/continuada de las instituciones de educación y salud.

ABSTRACT Objective To build, validate and test a high-fidelity clinical simulation scenario for sepsis management. Method Methodological study developed in three phases: construction of a simulation scenario using the framework Model of Nursing Training Simulation and protocols established by the Latin-American Sepsis Institute, content validation by nine judges, and scenario testing by two nurses from a hospital institution. Data analysis was carried out through Content Validity Index, with values > 0.90 among the judges being considered satisfactory. Results The simulation scenario was observed to be appropriate and obtained an overall value > 0.90. However, some adjustments to the scenario and the test were performed concerning textual clarity, functionality, and the protocol's pertinence, following the judges' suggestions. Conclusion The validated simulation scenario is expected to be a facilitator instrument for educators and professionals in the permanent/continued education nuclei of teaching and health institutions.

[Development of an on-line course on medication administration]. / Desenvolvimento de um curso on-line sobre o tema administração de medicamentos.

The study describes the development of an on-line course on medication administration. The World Wide Web Course Tools (WebCT) that was used is software that provides various tools for supervisors and access to a number of environments for students who have a password. The course material is presented in a series of websites which are sub-divided into eight illustrated topics concerning medication administration routes, in addition to questions for knowledge assessment. A sample of undergraduate students at the University of São Paulo at Ribeirão Preto College of Nursing has positively evaluated the course. It is now intended to be included as curricular course in the undergraduate program as an additional resource for student learning.

Strategies to minimize medication errors in emergency units: an integrative review / Estrategias para minimizar los errores de medicación en unidades de emergencia: una revisión integrativa / Estratégias para minimizar erros de medicação em unidades de emergência: revisão integrativa

ABSTRACT Objective: To assess the strategies used by the Nursing team to minimize medication errors in emergency units. Method: Integrative literature review in the PubMed, BDenf, Cochrane and LILACS databases. Timeless research, without language limitation, performed by peers. Articles published in full that answered the guiding question were included in research. Results: Educational strategies (conducting campaigns, elaborating explanatory manuals, creating a multidisciplinary committee involved in the prevention and reduction of adverse drug events); organizational (meetings, Deviance positive, creation of protocols and changes in the work process) and new technologies (implementation of prescription by computerized system, introduction of the unit doses and of the bar code in the administration of medicines) were evidenced in the studies with the purpose of minimizing medication errors in an emergency unit. Conclusion: The strategies identified were effective in minimizing medication errors in emergency units.

RESUMEN Objetivo: Evaluar las estrategias utilizadas por el equipo de Enfermería para minimizar los errores de medicación en las unidades de emergencia. Método: Revisión integrativa de la literatura realizada en las bases de datos PubMed, BDenf, Cochrane y LILACS. Búsqueda atemporal, sin limitación de idioma, realizada por pares. Se incluyeron en esta investigación artículos publicados en su totalidad que respondieran a la pregunta orientadora. Resultados: Las estrategias educativas (realización de campañas, elaboración de manuales explicativos, creación de una comisión multidisciplinaria involucrada con la prevención y la reducción de los eventos adversos a los medicamentos); organizacionales (reuniones, Deviance positive, creación de protocolos y cambios en el proceso de trabajo) y nuevas tecnologías (la aplicación de prescripciones por un sistema informatizado, la implantación de la dosis unitaria y el código de barras en la administración de medicamentos) fueron evidenciadas en los estudios con la finalidad de minimizar los errores de medicación en la unidad de emergencia. Conclusión: Las estrategias identificadas se mostraron eficaces para minimizar los errores de medicación en las unidades de emergencia.

RESUMO Objetivo: Avaliar as estratégias utilizadas pela equipe de Enfermagem para minimizar os erros de medicação nas unidades de emergência. Método: Revisão integrativa da literatura realizada nas bases de dados PubMed, BDenf, Cochrane e LILACS. Pesquisa atemporal, sem limitação de idioma, realizada por pares. Foram incluídos nesta pesquisa artigos publicados na íntegra que respondessem à pergunta norteadora. Resultados: As estratégias educacionais (realização de campanhas, elaboração de manuais explicativos, criação de comissão multidisciplinar envolvida com a prevenção e redução dos eventos adversos aos medicamentos); organizacionais (reuniões, Deviance positive, criação de protocolos e mudanças no processo de trabalho) e novas tecnologias (implementação de prescrição por sistema informatizado, implantação da dose unitária e do código de barras na administração de medicamentos) foram evidenciadas nos estudos com a finalidade de minimizar os erros de medicação em unidade de emergência. Conclusão: As estratégias identificadas mostraram-se eficazes para minimizar erros de medicação nas unidades de emergência.

Serious games as an educational strategy to control childhood obesity: a systematic literature review / Serious games como estratégia educativa para controle da obesidade infantil: revisão sistemática da literatura / Serious games como estrategia educativa para control de la obesidad infantil: revisión sistemática de la literatura

ABSTRACT Objectives: to identify in the literature the efficacy of serious games to improve knowledge for and/or behavioral changes among overweight or obese children. Method: Systematic Literature Review. The Cochrane Systematic Reviews Handbook was used. The studies were collected from the following databases: Public Medline; Web Of Science; Science Direct; Latin American and Caribbean Health Sciences Literature; and the Health Game Research and Cumulative Index to Nursing & Allied Health Literature. The descriptors were video games and obesity, while the key word was serious games. Inclusion criteria were: studies classified as Randomized Clinical Trials written in English, Spanish or Portuguese and in which children were the subjects of the study. Results: 2,722 studies were identified in the initial search and six studies remained in the final sample. The papers focused on encouraging behavioral changes in players, including physical exercise and improved eating habits. The studies report that serious games are a potential strategy to encourage positive coping with childhood obesity. Conclusion: research in this field is an expanding and promising strategy and serious games represent an alternative means to provide health education to children.

RESUMO Objetivo: identificar, na literatura, a eficácia do uso de serious games para a melhoria do conhecimento e/ou das mudanças de comportamentos em crianças com sobrepeso ou obesidade. Método: realizou-se uma revisão sistemática da literatura. Tomou-se como base o método para revisão sistemática da Cochrane. Os estudos foram coletados nas bases de dados Public Medline, Web Of Science, ScienceDirect, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Health Games Research e Cumulative Index to Nursing & Allied Health Literature. Utilizaram-se os descritores "videogames" e "obesity" e a palavra-chave "serious games". Os critérios de inclusão estabelecidos foram: estudos classificados como ensaios clínicos randomizados, nos idiomas inglês, espanhol e português e que tivessem crianças como público-alvo. Resultados: 2.746 estudos foram localizados na busca inicial e seis foram selecionados para a amostra final. Os artigos focaram tanto no estímulo a mudanças de comportamento do jogador quanto no incentivo à atividade física e melhoria de hábitos alimentares. Os estudos mostraram que o uso de serious games como estratégia pode auxiliar positivamente no enfrentamento da obesidade infantil. Conclusão: acredita-se que a pesquisa nessa área é uma estratégia em expansão e promissora e que tais jogos figuram como alternativas na educação em saúde de crianças.

RESUMEN Objetivos: identificar, en la literatura, la eficacia del uso de serious games para la mejora del conocimiento y/o realizar cambios de comportamientos en niños con sobrepeso u obesidad. Método: se realizó una Revisión Sistemática de la Literatura. Se tomó como base el método para revisión sistemática de la Cochrane. Los estudios fueron recogidos de las bases de datos Public Medline, Web Of Science, Science Direct, Literatura Latinoamericana y del Caribe en Ciencias de la Salud, Health Game Research y Cumulative Index to Nursing & Allied Health Literature. Los descriptores utilizados fueron video games y obesity y la palabra clave serious games. Los criterios de inclusión establecidos fueron estudios clasificados como Ensayos Clínicos Aleatorios; en tres idiomas inglés, español y portugués; y que fuesen sobre niños (población de interés). Resultados: en la busca inicial, 2.722 estudios fueron localizados, siendo seis estudios seleccionados para la muestra final. Los artículos enfocaron en el estímulo a introducir cambios de comportamiento del niño jugador; por ejemplo, incentivar la actividad física y mejorar los hábitos alimenticios. Los estudios mostraron que el uso de serious games, como una estrategia, puede auxiliar positivamente al enfrentamiento de la obesidad infantil. Conclusión: se piensa que la investigación en esa área es una estrategia en expansión y promisora. Los serious games se presentan como alternativas en la educación en salud de niños.

Knowledge about precautions in Primary Health Care: tool validation / Conocimiento sobre precauciones en la Atención Primaria a la Salud: validación de instrumento / Conhecimento sobre precauções na Atenção Primária à Saúde: validação de instrumento

ABSTRACT Objective: To elaborate and validate a tool to assess knowledge and behavior of nursing professionals about standards and specific precautions in the Primary Health Care. Method: Methodological study of the elaboration and validation of the tool by thirteen experts judges, using a Likert scale of 4 points, with Content Validity Index ≥ 0.80, on clarity, relevance and pertinence. Results: A tool composed of 47 dichotomous questions to assess knowledge and 12 questions, with five options of answers, for the referred behavior. In the validation, only one item was deleted, related to the "Hands Hygiene" axis and one item was reformulated, regarding "Use of Common Gloves" and another 11 changed writing. The tool as a whole was assessed for relevance, comprehensiveness and representativeness within the scope of the topic investigated. Conclusion: The developed tool has been validated and is now available for use in Primary Health Care.

RESUMEN Objetivo: Elaborar y validar instrumento para evaluación del conocimiento y comportamiento referido de los profesionales de enfermería sobre precauciones estándar y específica en la Atención Primaria a la Salud. Método: Estudio metodológico de elaboración y validación del instrumento, por trece jueces especialistas, por medio de escala tipo Likert de 4 puntos, con Índice de Validez de Contenido ≥ 0,80, sobre claridad, relevancia y pertinencia. Resultados: Instrumento compuesto por 47 preguntas dicotómicas para evaluar el conocimiento y 12 preguntas, con cinco opciones de respuestas, para el comportamiento referido. En la validación, sólo un ítem fue excluido, relativo al eje "Higiene de las manos" y un ítem fue reformulado, relativo a "Uso de guantes" y otros 11 pasaron por alteración de redacción. Se evaluó el conjunto del instrumento en cuanto a la relevancia, alcance y representatividad dentro del alcance del tema investigado. Conclusión: La herramienta desarrollada ha sido validada y está ahora disponible para su uso en la Atención Primaria a la Salud.

RESUMO Objetivo: Elaborar e validar instrumento para avaliação do conhecimento e comportamento referido dos profissionais de enfermagem sobre precauções padrão e específica na Atenção Primária à Saúde. Método: Estudo metodológico de elaboração e validação do instrumento, por treze juízes especialistas, por meio de escala tipo Likert de 4 pontos, com Índice de Validade de Conteúdo ≥ 0,80, sobre clareza, relevância e pertinência. Resultados: Instrumento composto por 47 perguntas dicotômicas para avaliar o conhecimento e 12 perguntas, com cinco opções de respostas, para o comportamento referido. Na validação, apenas um item foi excluído, relativo ao eixo "Higiene das mãos" e um item foi reformulado, relativo a "Uso de luvas" e outros 11 passaram por alteração de redação. Foi avaliado o conjunto do instrumento quanto à relevância, abrangência e representatividade dentro do escopo do tema investigado. Conclusão: A ferramenta desenvolvida foi validada e está agora disponível para uso na Atenção Primária à Saúde.