Profile of environmental service managers and workers in Brazilian hospitals.

INTRODUCTION: Contamination through the hands of professionals and surfaces is one of the main agents involved in health care-associated infections in health services. Flaws in the execution of hospital housekeeping can lead to the contamination of surfaces and health equipment though, representing a risk for patient safety and highlighting the need to maximize the quality of cleaning processes in these institutions. OBJECTIVE: To describe the profile of managers and environmental service workers (ESWs) in Brazilian hospitals. METHODS: A cross-sectional study was undertaken in January 2018, involving 155 participants, being 12 managers and 143 workers from the housekeeping team of two health institutions, being one private and the other public. RESULTS: Most participants were female (86%), with a mean age of 45 years and primary education level, 52% being outsourced workers. The participants positively assessed their job satisfaction, satisfaction with training, basic knowledge and performance; nevertheless, situations were identified that were perceived as risks for patient safety and occupational health. The questions involving motivational incentives received the lowest scores. CONCLUSION: Inconsistencies were found in the housekeeping professionals'. Preparation, indicating that the institutions studied do not value this type of service and that an investment policy in these workers' motivation is lacking.

Cultural adaptation and validity evidence of the Student Nurse Stressor-15 (SNS-15) Scale for Brazil.

OBJECTIVES: to carry out the cultural adaptation and evaluation of validity evidence of the Student Nurse Stressor-15 (SNS-15) Scale for use in Brazil. METHODS: psychometric study, conducted from the stages of translation, synthesis, back-translation, review by a committee of seven experts, pre-test and evaluation of measurement properties with 32 and 238 nursing students, respectively. Descriptive statistics, Exploratory Factor Analysis (EFA), and Confirmatory Factor Analysis (CFA) were performed. The reliability of the instrument was estimated using McDonald's Omega (ω). RESULTS: EFA subsidized the distribution of the fifteen SNS-15 items into four factors. Using AFC, satisfactory fit indices were achieved (Comparative Fit Index = 0.94; Tucker-Lewis Index = 0.93; Root Mean Square Error of Approximation = 0.06; Standardized Root Mean Square Residual = 0.16) and ω = 0.86. CONCLUSIONS: the Brazilian version of the SNS-15 presents evidence that confirms its validity and reliability.

Production and validation of an educational video on the use of the Z-Track Technique.

OBJECTIVE: to create and validate an educational video on intramuscular drug administration using the Z-track technique. METHODS: the Delphi Technique was used to validate the script. PhDs in Nursing and PhDs in Social Communication with experience in the production of educational videos participated in the process. After editing, the video was validated by three nursing professors and assessed by students of the undergraduate nursing program at a public university. RESULTS: the video was validated by the examiners with 100% agreement in three rounds for script validation and in two for video validation after editing. The duration of the video was 9 minutes. CONCLUSION: after validation by the examiners, students assessed the video and considered it suitable for learning. We This video is expected to aid in the training of nursing professionals and the enhancement of patient care.

Positive and negative aspects of psychological stress in clinical education in nursing: A scoping review.

BACKGROUND: Even though clinical practice is crucial for nursing students' personal and professional development, it is recurrently associated with stress. However, stressful situations may not only elicit negative responses, but positive responses as well, and such aspects should be further investigated. AIM: To explore the literature addressing the positive and negative aspects of stress experienced by nursing students during clinical practicum. DESIGN: This scoping review followed the Joanna Briggs Institute (JBI) and PRISMA-ScR guidelines. DATA SOURCES: CINAHL, MEDLINE/PubMed, PsycINFO, Web of Science, IBECS, LILACS, BDENF and two theses and dissertations repositories. REVIEW METHODS: Searches were conducted from June to August 2022. Studies addressing the positive and negative aspects of stress experienced by nursing students during clinical practice were included regardless of the method adopted. RESULTS: This review included 32 studies published between 1999 and 2022 in 25 countries across four continents: Africa, America, Asia, and Europe. Stress can positively influence academic performance, especially in mobilizing a search for learning and professional development and in integrating theoretical knowledge and improving clinical skills and competencies. Negatively, stress can cause biopsychosocial symptoms that compromise a student's academic performance and can cause doubts and uncertainties about the construction of their professional identity. CONCLUSIONS: Although the negative aspects stand out over the positive ones, it is evident that both are present in the clinical practice environment. When considering stress of nursing students, educators should conduct the teaching-learning process in order to reduce the negative impact and promote the positive side of stressful situations.

Reuse of hospital bedpans.

OBJECTIVES: to evaluate the results of two methods of hospital bedpan reprocessing. METHODS: cross-sectional study. Hospital bedpans containing a biological material contamination simulator or organic matter were submitted to manual cleaning followed by disinfection with 70% alcohol solution or thermodisinfection. Permanence of simulated contamination was evaluated by using the fluorescence technique and presence of organic matter was verified by carrying out the protein detection test. RESULTS: the contamination simulator was found in bedpans submitted to both processes. The seat was dirtier after manual cleaning (p=0.044) in comparison with the result obtained with thermodisinfection. Automatized decontamination led to worse results when compared to the manual procedure for the scoop and external bottom (p=0.000). The protein detection test was positive in two items after thermodisinfection. CONCLUSIONS: manual cleaning followed by rubbing with 70% alcohol solution proved more effective than automatized cleaning in the reprocessing of hospital bedpans. There are relevant issues regarding reuse of hospital bedpans.

Management of cardiopulmonary arrest in an educational video: contributions to education in pediatric nursing.

OBJECTIVE: to make and validate an educational video about the management of pediatric cardiopulmonary arrest caused by respiratory failure. METHOD: methodological study developed in three stages: preparation and validation of a clinical case; production; and validation of educational video. To build the educational video, the Fleming, Reynolds and Wallace methodological framework was used. RESULTS: the clinical case was validated by ten expert referees, who worked as nurses in different regions in Brazil, by completing an online form, with one round of evaluation and calculation of the content validity index. The educational video was validated by three expert judges and 25 nursing students in an evaluation round and contains six scenes, with duration of nine minutes and 56 seconds. An agreement over 80% was reached for most of the items in both the clinical case and the educational video. CONCLUSION: the educational video proved valid regarding face and content. This educational technology has the potential to meet the demands of students, who are digital natives, related to teaching of management of pediatric cardiopulmonary arrest caused by respiratory failure.

Mapping of advanced practice nursing actions in the Family Health Strategy.

OBJECTIVES: to map advanced practice nursing actions implemented in the Family Health Strategy context. METHODS: cross-sectional exploratory study carried out with Family Health Strategy nurses. Data obtained in the mapping were compared to the characteristics that define advanced practice nurses and are adopted internationally by using a checklist based on the International Council of Nurses Guidelines. RESULTS: the mapping allowed to identify advanced practice nursing actions, such as advanced assessment, judgement, decision-making, and diagnostic reasoning skills and authority to diagnose and prescribe medications, diagnostic testing, and therapeutic treatments. However, evidence found in the educational preparation domain indicated evident fragility, expressed as the low percentage of nurses credentialed with a professional master's degree. CONCLUSIONS: the present study showed that nurses in the Family Health Strategy carry out advanced practice nursing actions without the professional master's degree recommended for credentialing, with pertinent legislation, which requires initiatives to be taken by nursing leaders to overcome this deficiency.

VIDA-Nursing v1.0: immersive virtual reality in vacuum blood collection among adults.

OBJECTIVE: to develop and validate the first immersive virtual reality simulation addressing vacuum blood collection in adult patients - VIDA-Nursing v1.0. METHOD: methodological study to validate 14 steps of the vacuum blood collection procedure in adults, designed to develop the immersive virtual reality simulator VIDA-Nursing v1.0. It was assessed by 15 health workers and 15 nursing undergraduate students in terms of visual, interactive, movement simulation reality, teaching and user-friendly aspects. RESULTS: the workers considered 79.6% of the items to be valid, while the students considered 66.7% of the items valid; most of the demands can be implemented in the system by improving future versions. CONCLUSION: the simulator was considered a promising and innovative tool to teach vacuum blood collection in adults as it can be combined with other resources currently used to introduce this topic and technique in the education of undergraduate nursing students.

Real and illusory perceptions of patients in induced coma.

OBJECTIVE: To identify, in the scientific literature, real and illusory perceptions of adult patients in induced coma. METHODS: This is an integrative review of 15 primary studies from the Medline, Web of Science, LILACS, CINAHL and SCOPUS databases. RESULTS: The main memories reported after induced coma were thirst, cold, and pain. In some studies, patients reported they were unable to tell whether they were awake or dreaming, whether it was real or unreal. Satisfactory memories were reported by patients related to the care received and the use of bedside journals. CONCLUSION: Evidence showed a number of studies aiming to identify delirium, but without a focus on analyzing real or illusory perceptions of patients after induced coma. Thus, this integrative review identified scientific evidence of memories related to perceptions of sedated patients in the intensive care unit.

Cultural adaptation and validity evidence of the Student Nurse Stressor-15 (SNS-15) Scale for Brazil / Adaptación cultural y evidencia de validez de la Student Nurse Stressor-15 (SNS-15) Scale para Brasil / Adaptação cultural e evidências de validade da Student Nurse Stressor-15 (SNS-15) Scale para o Brasil

ABSTRACT Objectives: to carry out the cultural adaptation and evaluation of validity evidence of the Student Nurse Stressor-15 (SNS-15) Scale for use in Brazil. Methods: psychometric study, conducted from the stages of translation, synthesis, back-translation, review by a committee of seven experts, pre-test and evaluation of measurement properties with 32 and 238 nursing students, respectively. Descriptive statistics, Exploratory Factor Analysis (EFA), and Confirmatory Factor Analysis (CFA) were performed. The reliability of the instrument was estimated using McDonald's Omega (ω). Results: EFA subsidized the distribution of the fifteen SNS-15 items into four factors. Using AFC, satisfactory fit indices were achieved (Comparative Fit Index = 0.94; Tucker-Lewis Index = 0.93; Root Mean Square Error of Approximation = 0.06; Standardized Root Mean Square Residual = 0.16) and ω = 0.86. Conclusions: the Brazilian version of the SNS-15 presents evidence that confirms its validity and reliability.

RESUMEN Objetivos: realizar adaptación cultural y evaluación de evidencia de validez de la Student Nurse Stressor-15 (SNS-15) Scale para su uso en Brasil. Métodos: estudio psicométrico, realizado desde las etapas de traducción, síntesis, retrotraducción, revisión por un comité de siete expertos, pretest y evaluación de propiedades de medición con 32 y 238 estudiantes de enfermería, respectivamente. Se realizó estadística descriptiva, Análisis Factorial Exploratorio (AFE), Análisis Factorial Confirmatorio (AFC). La confiabilidad del instrumento se estimó mediante el Omega de McDonald (ω). Resultados: AFE subvencionó la distribución de los quince ítems del SNS-15 en cuatro factores. A través de la AFC se lograron índices de ajuste satisfactorios (Comparative Fit Index = 0,94; Tucker-Lewis Index = 0,93; Root Mean Square Error of Approximation = 0,06; Standardized Root Mean Square Residual = 0,16) y ω = 0,86. Conclusiones: la versión brasileña del SNS-15 presenta evidencias que confirman su validez y confiabilidad.

RESUMO Objetivos: realizar a adaptação cultural e a avaliação das evidências de validade da Student Nurse Stressor-15 (SNS-15) Scale para uso no Brasil. Métodos: estudo psicométrico, conduzido a partir das etapas de tradução, síntese, retrotradução, revisão por um comitê de sete especialistas, pré-teste e avaliação das propriedades de medida com 32 e 238 estudantes de enfermagem, respectivamente. Realizou-se estatística descritiva, Análise Fatorial Exploratória (AFE), Análise Fatorial Confirmatória (AFC). Estimou-se a confiabilidade do instrumento através do Ômega de McDonald's (ω). Resultados: a AFE subsidiou a distribuição dos quinze itens da SNS-15 em quatro fatores. Mediante AFC, alcançou-se índices satisfatórios de ajuste (Comparative Fit Index = 0,94; Tucker-Lewis Index = 0,93; Root Mean Square Error of Approximation = 0,06; Standardized Root Mean Square Residual = 0,16) e ω = 0,86. Conclusões: a versão brasileira da SNS-15 apresenta evidências que confirmam sua validade e confiabilidade.

Clinical case studies in mental health by means of the on-line discussion.

This descriptive and exploratory study with a qualitative design aimed to describe and analyze discussions in online chats about mental disorders in a psychiatric nursing course as part of an undergraduate nursing program. The sample consisted of 32 undergraduate students who attended the course. Data analysis showed that the discussions through online chat sessions permeated the acquisition of knowledge, procedures, attitudes and values and promoted students' active participation. The results reaffirm the discussions' importance for students' learning and showed the potential of technology resources, such as real-time communication tools, to support and improve teaching possibilities in psychiatric nursing.

Nursing and Global Health: social determinants of health in the training of nurses.

OBJECTIVE: To evaluate to which extent nursing professors understand how social determinants of health impact on health, and whether the topic is addressed in nursing undergraduate education in Brazil. METHOD: This is a methodological study carried out with 222 nursing faculty members from Brazilian higher education institutions. The answers of the domain "Social and environmental determinants of health", concerning a questionnaire on "Core Competencies in Global Health", were analyzed. RESULTS: Most professors have over 10 years of experience in nursing higher education. A large part of the participants strongly agreed or agreed on the importance of college subjects related to the above-mentioned topic for the education of the nurses. CONCLUSION: The professors in this study agreed that social and environmental health determinants must be taught in Nursing school, since it is necessary that nurses value this knowledge, slowly making it a part of the curriculum framework.

Administração de medicamentos por via intramuscular: caracterização dos vídeos brasileiros veiculados no YouTube® / Intramuscular drug administration: characterization of Brazilian videos on YouTube®

RESUMO Objetivo caracterizar os vídeos que contém a demonstração do procedimento de administração de medicamentos por via intramuscular em indivíduos adultos. Métodos estudo de corte transversal descritivo, foram selecionados 44 vídeos brasileiros disponíveis no YouTube® que abordavam o procedimento de administração de medicamentos por via intramuscular. Resultados a maioria dos vídeos selecionados é de origem pessoal (86,4%), tem como autor um técnico de Enfermagem (59,1%), adota a região dorsoglútea como local de injeção (54,5%), foi produzido em ambiente de saúde utilizando um paciente para a demonstração do procedimento (52,3%). Nenhum vídeo apresentou a completude do procedimento, sendo identificada grande frequência de erros em todas as etapas do procedimento. Observou-se uma diferença estatisticamente significante entre os testes de confiabilidade e popularidade dos vídeos (p=0,042). Conclusão os vídeos que abordam o procedimento de administração de medicamentos por via intramuscular disponíveis na plataforma YouTube® foram considerados atuais, de pouca relevância, elaborados por fontes não confiáveis, de baixa acurácia e frágil finalidade. Contribuições para a prática os vídeos disponíveis na plataforma YouTube® sobre a administração de medicamentos por via intramuscular não devem ser indicados como material educativo para a formação ou atualização profissional.

ABSTRACT Objective to characterize videos that contain a demonstration of the procedure for administering drugs intramuscularly to adults. Methods a descriptive cross-sectional study, 44 Brazilian videos available on YouTube® were selected which addressed the procedure of intramuscular drug administration. Results the majority of the videos selected are of personal origin (86.4%), were made by a Nursing technician (59.1%), used the dorsal gluteal region as the injection spot (54.5%), and were produced in a healthcare environment using a patient to demonstrate the procedure (52.3%). No video showed the completeness of the procedure, and a high frequency of errors was identified at all stages of the procedure. There was a statistically significant difference between the reliability and popularity tests of the videos (p=0.042). Conclusion the videos on intramuscular drug administration available on the YouTube® platform were considered to be up-to-date, of little relevance, produced by unreliable sources, of low accuracy, and with a weak purpose. Contributions to practice the videos available on the YouTube® platform on intramuscular drug administration should not be used as educational material for professional training or updating.

Perenniality of brazilian nursing journals: recovery and reaffirmation of the journals' social commitment to science / Perpetuidad de las revistas científicas de enfermería brasileñas: recuperación y reafirmación del compromiso social de las revistas con la ciencia / Perenidade dos periódicos brasileiros de enfermagem: resgate e reafirmação do compromisso social da ciência

ABSTRACT Objective: to reflect upon the challenges that permeate the development and perenniality of nursing journals published in Brazil for becoming entities at the service of the scientific community and heritage of the history of science for future generations. Method: the reflective method grounded on the principles of complexity and pertinent literature was adopted. Results: the perennial commitment to scientific publishing emerged as the starting point for this reflection; hence, the role played by sponsoring institutions as the guardians of scientific journals, the need for investments, and to valorize the management, professionalization, and internationalization of the editorial team are emphasized, along with the ability to expand communication breaking paradigms in the connections between science and society. Conclusion: this reflection is expected to reaffirm the concept of scientific periodicals being perennial devices and, thus, survive the dynamics of time amidst the challenges science faces worldwide. In this sense, it indicates the importance of institutions supporting scientific journals as a condition to ensure their perenniality.

RESUMEN Objetivo: reflexionar sobre los desafíos relacionados al desarrollo y la perpetuidad de las revistas de enfermería publicadas en Brasil, considerándolas como entidades al servicio de la comunidad científica actual y patrimonio de la historia de la ciencia para las generaciones futuras. Método: Se utilizó el método reflexivo, con base en principios de complejidad y en la literatura pertinente al objeto de reflexión. Resultados: El compromiso perenne por la publicación científica surgió como punto de partida de una reflexión que destaca la importancia de las instituciones patrocinadoras como guardianas de las revistas científicas; la necesidad de inversiones y potenciación de la gestión, profesionalización e internacionalización del equipo editorial; la capacidad de expandir la comunicación rompiendo paradigmas en las conexiones entre ciencia y sociedad. Conclusión: esta reflexión puede contribuir a reafirmar el concepto de las revistas científicas como dispositivos que deben diseñarse en una perspectiva perenne y que, por tanto, sobrevivan a la dinámica de los tiempos en medio de los desafíos de la ciencia global. En este sentido, señala la importancia de las instituciones que mantienen las revistas como condición para garantizar su perpetuidad.

RESUMO Objetivo: refletir sobre os desafios que permeiam o desenvolvimento e perenidade dos periódicos de enfermagem, editados no Brasil, tomando-os como entidades à serviço da comunidade científica atual e patrimônio da história da ciência para as gerações vindouras. Método: utilizou-se do método reflexivo, ancorado em princípios da complexidade e na literatura pertinente ao objeto da reflexão. Resultados: a perenidade do compromisso com a editoração científica emergiu como ponto de partida para a reflexão que destaca a importância das instituições mantenedoras como guardiãs dos periódicos científicos; a necessidade de investimentos e valorização da gestão, profissionalização e internacionalização da equipe editorial; a capacidade de ampliar a comunicação rompendo paradigmas nas conexões entre ciência e sociedade. Conclusão: esta reflexão poderá contribuir para reafirmar o conceito dos periódicos científicos como dispositivos que devem ser projetados em uma perspectiva perene e que, portanto, sobreviva à dinâmica dos tempos em meio aos desafios da ciência global. Nesse sentido, aponta para a importância das instituições mantenedoras dos periódicos como condição para garantia de sua perenidade.

Semantic validation of the short versions of the Empathy-Systemizing Quotient Scales.

OBJECTIVE: to perform the semantic validation of the short versions of the Empathy-Systemizing Quotient Scales, intended to measure the empathetic and systemizing profiles of individuals. The scales originated in Cambridge and were validated in Portugal, and were assessed for their psychometric properties. METHOD: methodological study included the scales' semantic validation (content validity) and verification of their psychometric properties (internal consistency). Five judges participated in the semantic validation. The Content Validity Index was calculated, a pretest was conducted with 18 undergraduate nursing students, and, finally, the scales were applied to a sample. RESULTS: the sample was composed of 215 undergraduate nursing students, 186 (86.51%) of whom were women aged 21 years old, on average. The scales presented good internal consistency with global Cronbach's alphas equal to 0.83 and 0.79 for the Empathy Quotient and the Systemizing Quotient, respectively. Correlations between the scales and subscales of the Empathy Quotient and Systemizing Quotient were all positive and significant according to the Pearson correlation coefficient. CONCLUSION: the scales are reliable and valid to measure the empathetic and systemizing profile of undergraduate nursing students and the final version was named "versões curtas das Escalas de Medição do Quociente de Empatia/Sistematização - Brasil" [short versions of the Empathy-Systemizing Quotient Scales - Brazil].

Patient safety in nursing care during medication administration.

OBJECTIVE: to evaluate the conformity of care practices of the nursing team during the administration of drugs through central vascular catheter. METHOD: a descriptive, prospective, observational study conducted in an Intensive Care Unit. The non-probabilistic intentional sample consisted of 3402 observations of drug administrations in patients with central vascular catheters. The previously validated collection instrument was constructed based on the Guideline for Prevention of Intravascular catheter-related infections. Data was collected through direct observations of nursing practices performed by the nursing team. The analysis used analytical, descriptive and inferential statistics (Chi-square test and Fisher's exact test). RESULTS: a total of 3402 procedures of drug administrations were observed. Female nursing technicians performed the highest number of actions. In none of the procedures did the professional perform all necessary actions. 0.2% of drug administrations were preceded by hand hygiene and 1.3% by disinfection of the multidose vial, ampoule or injectors. CONCLUSION: the practice evaluated was classified as undesirable. Failure to achieve the desired conformity was probably due to the low adherence of professionals to the practice of hand hygiene and disinfection of materials, injectors and connectors.

Production and validation of an educational video on the use of the Z-Track Technique / Preparación y validación de un vídeo educativo sobre el uso de la Técnica Z / Elaboração e validação de vídeo educativo sobre a utilização da Técnica em Z

ABSTRACT Objective: to create and validate an educational video on intramuscular drug administration using the Z-track technique. Methods: the Delphi Technique was used to validate the script. PhDs in Nursing and PhDs in Social Communication with experience in the production of educational videos participated in the process. After editing, the video was validated by three nursing professors and assessed by students of the undergraduate nursing program at a public university. Results: the video was validated by the examiners with 100% agreement in three rounds for script validation and in two for video validation after editing. The duration of the video was 9 minutes. Conclusion: after validation by the examiners, students assessed the video and considered it suitable for learning. We This video is expected to aid in the training of nursing professionals and the enhancement of patient care.

RESUMEN Objetivo: construir y validar un vídeo educativo sobre la administración intramuscular de fármacos, utilizando la Técnica Z. Métodos: se utilizó la técnica Delphi para validar el guion. Participaron en el proceso dos doctores en enfermería y dos doctores en comunicación social con experiencia en la producción de vídeos educativos. Tras su edición, el vídeo fue validado por tres docentes de enfermería y evaluado por estudiantes del curso de licenciatura en enfermería de una universidad pública. Resultados: el vídeo fue validado por los expertos con un 100% de acuerdo en tres rondas para la validación del guion y dos para la validación del vídeo después de la edición. La duración del vídeo fue de 9 minutos. Conclusión: tras la validación por parte de los expertos, los estudiantes evaluaron el vídeo y lo consideraron adecuado para el aprendizaje. Se espera que este vídeo pueda contribuir a la formación de los profesionales de enfermería y mejorar la asistencia a los pacientes.

RESUMO Objetivo: construir e validar um vídeo educativo sobre a administração de medicamentos por via intramuscular, com utilização da Técnica em Z. Métodos: utilizou-se a Técnica Delphi para a validação do roteiro. Participaram do processo doutores em enfermagem e doutores em comunicação social com experiência na produção de vídeos educativos. Após a edição, o vídeo foi validado por três docentes de enfermagem e avaliado por estudantes do Curso de Graduação em Enfermagem de uma universidade pública. Resultados: o vídeo foi validado pelos juízes com 100% de concordância ocorrida em três rodadas para validação do roteiro e duas para validação do vídeo após a edição. A duração do vídeo foi de 9 minutos. Conclusão: Após a validação pelos juízes, estudantes avaliaram o vídeo e o consideraram adequado para o aprendizado. Espera-se que esse vídeo possa contribuir para a formação do profissional de enfermagem e melhoria da assistência ao paciente.

Volume residual de frascos-ampola e subdosagens de medicamentos preparados pela equipe de enfermagem / Residual volume of ampoule-vials and underdosing of medications prepared by a nursing staff / Volumen residual de frascos ampolla y subdosificación de medicamentos preparados por el equipo de enfermería

RESUMO Objetivo: Identificar o volume residual em frascos-ampola, após o preparo de injetáveis, associando os erros relacionados a subdoses com as classes dos medicamentos. Método: Estudo descritivo, de abordagem quantitativa. Os dados foram coletados no período de dezembro de 2020 a setembro de 2021, em um serviço ambulatorial privado de um município brasileiro localizado a nordeste do Estado de São Paulo. Foram analisados 562 frascos-ampola de medicamentos preparados pela equipe de enfermagem. Utilizou-se formulário contendo o nome comercial do medicamento, classe/indicação terapêutica, data e horário de reconstituição, volume utilizado para reconstituição do medicamento e volume residual de cada frasco. Os dados foram tabulados e analisados por estatística descritiva e teste ANOVA. Resultados: 462 (82,2%) frascos-ampola continham volume residual que variou de 0,1 ml a 1,5 ml e 165 (29,4%) continham 0,2 ml de solução residual, com perda média de 4,5% da solução. Não houve diferença na perda de solução entre as diferentes classes de medicamentos. Conclusão: Os achados destacam a necessidade de intervenções para a redução de falhas, nas fases de preparo dos medicamentos, com ênfase nos erros associados às subdosagens terapêuticas.

ABSTRACT Objective: Identify the residual volume in ampoule-vials after the preparation of injectables, associating the errors related to underdosing with the classes of drugs. Method: This is a descriptive study with a quantitative approach. Data were collected between December 2020 and September 2021, in a private outpatient service located in a Brazilian municipality in the northeast of the state of São Paulo. A total of 562 ampoule-vials of medications prepared by a nursing staff were analyzed. A form was used containing the commercial name of the medication, therapeutic class/indication, reconstitution date and time, volume used to reconstitute the medication and residual volume of each vial. The data were tabulated and analyzed using descriptive statistics and the ANOVA test. Results: the residual volume of 462 (82.2%) ampoule-vials varied between 0.1 ml and 1.5 ml, whereas 165 (29.4%) ampoule-vials had 0.2 ml of residual volume, with a mean loss of 4.5% of the solution. There was no difference in the loss of solution between the different classes of drugs. Conclusion: The findings highlight the need for interventions to reduce failures in the medication preparation phases, with emphasis on errors associated with therapeutic underdosing.

RESUMEN Objetivo: Identificar volúmenes residuales en frascos ampolla luego de prepararse inyectables, asociando los errores relacionados a subdosificaciones con las clases de los medicamentos. Método: Estudio descriptivo, de abordaje cuantitativo. Datos recolectados entre diciembre de 2020 y setiembre de 2021 en servicio ambulatorio privado de un municipio brasileño del noreste del Estado de São Paulo. Fueron analizados 562 frascos ampolla de medicamentos preparados por el equipo de enfermería. Se utilizó formulario, consignando nombre comercial del medicamento, clase/indicación terapéutica, fecha y hora de reconstitución, volumen utilizado para reconstituir el medicamento y volumen residual de cada frasco. Los datos fueron tabulados y analizados por estadística descriptiva y test ANOVA. Resultados: 462 (82,2%) frascos ampolla contenían volumen residual de entre 0,1 ml y 1,5 ml, y 165 (29,4%) contenían 0,2 ml de solución residual, con una pérdida media del 4,5% de solución. No se observó diferencia de pérdida de solución entre las diferentes clases de medicamentos. Conclusión: Los hallazgos destacan la necesidad de intervenciones para reducir fallos en las fases de preparación de medicamentos, haciendo énfasis en los errores asociados con subdosificaciones terapéuticas.

Validation of the adherence questionnaire for Brazilian chronic kidney disease patients under hemodialysis.

Objective: To validate the evaluation questionnaire on adherence of chronic kidney disease (CKD) patients under hemodialysis. Method: We verified the following psychometric properties of the instrument: reliability (stability and internal consistency) and validity (face, content, and construct). Results: The intraclass correlation coefficient reached a value of 0.98 for the adherence questions and 0.91 for the perception questions. Regarding the kappa of the 14 questions examined, 12 had a value > 0.8, whereas the Cronbach's alpha had a value of 0.57. Experts ensured the face and content validity of the instrument, giving it an overall content validity index of 0.96. Construct validity, analyzed by Mann-Whitney test, was achieved as all domains showed a significant association with p<0.01. Conclusion: We verified, by the presented results, that the instrument has been validated for use in Brazil.

Objetivo: Validar o questionário de avaliação sobre a adesão do portador de doença renal crônica em hemodiálise. Método: Foram verificadas as seguintes propriedades psicométricas do instrumento: confiabilidade (estabilidade e consistência interna) e validade (de face, de conteúdo e de construto). Resultados: O coeficiente de correlação intraclasse atingiu valor de 0,98 para as questões de adesão e 0,91 para as questões de percepção. Quanto ao kappa das 14 questões analisadas, 12 obtiveram um valor > 0,8. Já o alfa de Cronbach obteve valor de 0,57. Os especialistas asseguraram a validade de face e de conteúdo do instrumento, conferindo-lhe um índice de validade de conteúdo global de 0,96. A validade de construto, analisada por meio do teste de Mann-Whitney, foi alcançada na medida em que todos os domínios apresentaram uma associação significativa com p < 0,01. Conclusão: Verifica-se, pelos resultados apresentados, que o instrumento foi validado para uso no Brasil.