ATENDIMENTO DE PACIENTES REALIZADOS PELOS ACADÊMICOS EM PERÍODO DE ESTÁGIO DO CURSO DE FISIOTERAPIA

Orientador: MERGENER, Cristian RobertPesquisadores: TRAVERSO, Maria Esther, BROL, Angela, MATHIA, Gisiane Bareta, LINDEN JUNIOR, Eduardo, TAKEMOTO, Celso, HELLER, Patricia, PRONER, João; ZAMPRONA, Geovana Teo; SARETTO, Chrystianne Curso: FisioterapiaÁrea: Área das Ciências da Vida Resumo: Os estágios curriculares do curso de Fisioterapia da Unoesc campus de Joaçaba compreendem componentes teórico-práticos onde são desenvolvidas atividades de participação em situações reais de atendimento de pacientes, voltadas a sua formação profissional. Com o objetivo de aproximar a universidade da comunidade e promover o desenvolvimento curricular e a qualificação acadêmica, o estágio obrigatório do curso desenvolve competências e habilidades contempladas pelos acadêmicos no transcorrer do mesmo. Destacam-se respeitar os princípios éticos inerentes ao exercício profissional; atuar em todos os níveis de atenção à saúde; contribuir para a manutenção da saúde, bem-estar e qualidade de vida das pessoas, famílias e comunidade; realizar consultas, avaliações e reavaliações do paciente colhendo dados, solicitando, executando e interpretando exames que permitam elaborar o diagnóstico cinético-funcional, para eleger e quantificar as intervenções fisioterapêuticas. O estágio visa, o aprendizado do acadêmico associado a prestação do atendimento fisioterápico para a comunidade carente e com dificuldade de acesso a esse tipo de serviço. Os atendimentos são realizados na Clínica Escola (CEPAF), Hospital Universitário Santa Terezinha (HUST) e em diversas cidades da região com o atendimento em Unidades Básicas de Saúde (UBS), contemplando diversas áreas de atuação fisioterápica, entre elas o estágio ambulatorial de Fisioterapia Musculoesquelética, Neurofuncional, Uroginecológica e Pós-Mastectomias, Cardiorrespiratória e Hospitalar. No primeiro semestre de 2017 foram atendidos 336 pacientes, totalizando 3633 atendimentos individuais na CEPAF, HUST e UBS, em diferentes áreas da atuação profissional, todos com supervisão presencial e integral dos docentes do curso.Palavras-chave: Estágios curriculares obrigatórios. Serviço comunitário. Atendimento em fisioterapia.E-mail: [email protected]

Ventilator-associated pneumonia prevention: Barriers and facilitators of provider guideline adherence

Background. Various clinical guidelines have been developed to prevent ventilator-associated pneumonia (VAP). However, the availability of guidelines does not ensure adherence by clinicians to recommended strategies. Studies indicate prevention practices for VAP differ across settings. To date, there has been no study that comprehensively describes factors that influence VAP guideline adherence, nor the relationship between provider guideline adherence and VAP occurrence. Aim. The purpose of this study was to identify factors that influence VAP prevention guideline adherence. The specific aims were to: (a) describe guideline user-related factors, guideline qualities, and contextual factors associated with guideline adherence; (b) test the relationships among these factors and guideline adherence rates; and (c) explore the relationships between adherence rates and VAP occurrence. This study examined institution specific VAP prevention guidelines and non-pharmacologic VAP prevention interventions (oral hygiene, head of bed elevated patient positioning, spontaneous breathing trial, and hand hygiene). Methods. A cross-sectional descriptive study was guided by a conceptual model. A survey was created to capture guideline user characteristics, qualities of the clinical guideline, and contextual factors that influence clinicians' guideline adherence. Results. A total of 576 critical care nurses and 15 directors of infection control, critical care educators, and nurse managers from eight hospitals participated in the study. Each hospital had unique VAP prevention guidelines. In general, nurses had positive attitudes and reported to adhere to the guidelines always to most of the time. However, there were variations among the units. Also, factors associated with guideline adherence were different by intervention. The guideline user attitude scale was the strongest and most consistent predictor of guideline adherence across interventions (OR 3.89–19.68). Guideline quality and context indicators were also significant predictors (OR 1.54–3.57). For unit level analyses, VAP rates were correlated with HOB adherence scores (−.52, p≤.05). Conclusion. Use of clinical guidelines has become a norm in patient care. To maximize the benefit of guideline implementation, efforts must be made to enhance nurses' attitudes, guideline quality, and environmental support

Ventilator-Associated Pnuemonia Prevention: Barriers and Facilitators of Provider Guideline Adherence

BACKGROUND: Various clinical guidelines have been developed to prevent ventilator-associated pneumonia (VAP). However, the availability of guidelines does not ensure adherence by clinicians to recommended strategies. Studies indicate prevention practices for VAP differ across settings. To date, there has been no study that comprehensively describes factors that influence VAP guideline adherence, nor the relationship between provider guideline adherence and VAP occurrence. AIM:The purpose of this study was to identify factors that influence VAP prevention guideline adherence. The specific aims were to: (a) describe guideline user-related factors, guideline qualities, and contextual factors associated with guideline adherence; (b) test the relationships among these factors and guideline adherence rates; and (c) explore the relationships between adherence rates and VAP occurrence. This study examined institution specific VAP prevention guidelines and non-pharmacologic VAP prevention interventions (oral hygiene, head of bed elevated patient positioning, spontaneous breathing trial, and hand hygiene). METHODS: A cross-sectional descriptive study was guided by a conceptual model. A survey was created to capture guideline user characteristics, qualities of the clinical guideline, and contextual factors that influence clinicians' guideline adherence RESULTS: A total of 576 critical care nurses and 15 directors of infection control, critical care educators, and nurse managers from eight hospitals participated in the study. Each hospital had unique VAP prevention guidelines. In general, nurses had positive attitudes and reported to adhere to the guidelines always to most of the time. However, there were variations among the units. Also, factors associated with guideline adherence were different by intervention. The guideline user attitude scale was the strongest and most consistent predictor of guideline adherence across interventions (OR 3.89-19.68). Guideline quality and context indicators were also significant predictors (OR 1.54-3.57). For unit level analyses, VAP rates were correlated with HOB adherence scores (-.52, p<=.05). CONCLUSION: Use of clinical guidelines has become a norm in patient care. To maximize the benefit of guideline implementation, efforts must be made to enhance nurses' attitudes, guideline quality, and environmental support

Psychometric analysis of the leadership environment scale (LENS) : Outcome from the Oregon research initiative on the organisation of nursing (ORION)

Aim The purpose of this study was to establish the psychometric properties of the new 16-item leadership environment scale. Background The leadership environment scale was based on complexity science concepts relevant to complex adaptive health care systems. Methods A workforce survey of direct-care nurses was conducted (n = 1,443) in Oregon. Confirmatory factor analysis, exploratory factor analysis, concordant validity test and reliability tests were conducted to establish the structure and internal consistency of the leadership environment scale. Results Confirmatory factor analysis indices approached acceptable thresholds of fit with a single factor solution. Exploratory factor analysis showed improved fit with a two-factor model solution; the factors were labelled ‘influencing relationships’ and ‘interdependent system supports’. Moderate to strong convergent validity was observed between the leadership environment scale/subscales and both the nursing workforce index and the safety organising scale. Reliability of the leadership environment scale and subscales was strong, with all alphas ≥.85. Conclusions The leadership environment scale is structurally sound and reliable. Implications for Nursing Management Nursing management can employ adaptive complexity leadership attributes, measure their influence on the leadership environment, subsequently modify system supports and relationships and improve the quality of health care systems. The leadership environment scale is an innovative fit to complex adaptive systems and how nurses act as leaders within these systems