João Manuel Garcia do Nascimento Graveto

The role of nurses and patients' involvement in the clinical decision-making process

El presente trabajo es de revision de literatura, esta basado en articulos de investigacion del area de enfermeria, abordando el tema: decision clinica compartida. Los objetivos fueron dirigidos a analizar el papel del enfermero y del paciente en el proceso de la toma de decisiones en contextos de la practica clinica. Para fundamentar esas tematicas, se hizo una revision de la literatura reciente, la que revelo los siguientes resultados: los pacientes prefieren compartir la toma de decisiones con los profesionales y los profesionales deben apoyar y dar informacion a los clientes de forma a diluir las barreras que dificultan su participacion en el proceso de decision. Quedo clara la necesidad de realizar mas estudios que presenten evidencias problematicas en el proceso de decision en el contexto clinico, con la finalidad de contribuir para la evolucion de los cuidados.O presente trabalho e de revisao de literatura, baseada em artigos de investigacao da area da enfermagem, abordando o tema: decisao clinica partilhada. Os objetivos estao direcionados para o analisar do papel do enfermeiro e do paciente no processo de tomada de decisao em contextos da pratica clinica. Para fundamentar essas tematicas, fez-se revisao de literatura recente que revelou os seguintes resultados: os pacientes preferem partilhar a tomada de decisao com os profissionais e os profissionais devem apoiar e dar informacao aos clientes de forma a diluir as barreiras que dificultam o seu envolvimento no processo de decisao. Ficou clara a necessidade de mais estudos que evidenciem problematicas no processo de decisao em contexto clinico, no sentido de contribuir para a evolucao dos cuidados.

Papel do enfermeiro e envolvimento do cliente no processo de tomada de decisão clínica

El presente trabajo es de revision de literatura, esta basado en articulos de investigacion del area de enfermeria, abordando el tema: decision clinica compartida. Los objetivos fueron dirigidos a analizar el papel del enfermero y del paciente en el proceso de la toma de decisiones en contextos de la practica clinica. Para fundamentar esas tematicas, se hizo una revision de la literatura reciente, la que revelo los siguientes resultados: los pacientes prefieren compartir la toma de decisiones con los profesionales y los profesionales deben apoyar y dar informacion a los clientes de forma a diluir las barreras que dificultan su participacion en el proceso de decision. Quedo clara la necesidad de realizar mas estudios que presenten evidencias problematicas en el proceso de decision en el contexto clinico, con la finalidad de contribuir para la evolucion de los cuidados.O presente trabalho e de revisao de literatura, baseada em artigos de investigacao da area da enfermagem, abordando o tema: decisao clinica partilhada. Os objetivos estao direcionados para o analisar do papel do enfermeiro e do paciente no processo de tomada de decisao em contextos da pratica clinica. Para fundamentar essas tematicas, fez-se revisao de literatura recente que revelou os seguintes resultados: os pacientes preferem partilhar a tomada de decisao com os profissionais e os profissionais devem apoiar e dar informacao aos clientes de forma a diluir as barreiras que dificultam o seu envolvimento no processo de decisao. Ficou clara a necessidade de mais estudos que evidenciem problematicas no processo de decisao em contexto clinico, no sentido de contribuir para a evolucao dos cuidados.

CELL PHONE USAGE BY HEALTH PERSONNEL: PREVENTIVE STRATEGIES TO DECREASE RISK OF CROSS INFECTION IN CLINICAL CONTEXT

Objective: with the intent of describing the characteristics of cell phone use by Health Personnel and identify strategies to prevent these equipments from acting as vectors of transmission for multiresistant microorganisms. Method: an integrative review of the literature was carried out following the PICOD Method. An appropriate research strategy was developed at each base/repository EBSCO platform, MEDLINE and CINAHL databases and search engines PubMed, B-on and Google Scholar to identify relevant studies. It was elaborated a formal protocol, including studies published from 2006 to 2016. The titles/abstracts were analyzed, excluding articles that do not meet the criteria defined in the protocol. Data extraction was performed from the remaining included articles. Results: 13 studies met the defined criteria for this review. After a comprehensive analysis, it can be concluded that healthcare personnel’cell phones constitute a reservoir of pathogenic microorganisms that may affect patient safety. Conclusion: user hand hygiene, cell phone disinfection and education of health personnel are the main preventive strategies. Technological innovation can be a strong ally for health personnel and organizations by creating new equipment such as antibacterial covers and films or ultraviolet light for sanitary purposes. This review opens the door for further research to be undertaken in this area. DESCRIPTORS: Health personnel. Cell phones. Strategies. Cross infection. USO DO TELEFONE CELULAR PELO PESSOAL DA SAÚDE: ESTRATÉGIAS PREVENTIVAS PARA REDUZIR O RISCO DE INFECÇÃO TRANSFRONTEIRA NO

Organizational commitment, psychometric qualities and invariance of the Meyer and Allen Questionnaire for Portuguese Nurses

ABSTRACT Objective: to evaluate the psychometric qualities of the Portuguese version of the Organizational Commitment Questionnaire for the nursing context, through confirmatory analysis and invariance, aiming to evaluate the reliability, internal consistency, construct validity and external validity of the instrument. Method: confirmatory factor analysis of the Portuguese version of the questionnaire was carried out with a sample of 850 nurses, in hospital context. The analysis was complemented using specification search. Goodness of fit was evaluated through different indices. Reliability, internal consistency and construct validity were estimated. The invariance of the model was evaluated in two subsamples of the same sample, in order to confirm the external validity of the factorial solution. Results: the refined model demonstrated good overall fit (χ2/df=6.37; CFI=0.91; GFI=0.92; RMSEA=0.08; MECVI=0.62). The factorial structure was stable (λ:Δχ2(14)=18.31; p=0;193; Intercepts: Δχ2(14)=22.29; p=0.073; Covariance: Δχ2(3)=6.01; p=0.111; Residuals: Δχ2(15)=22.44; p=0.097). Conclusion: the simplified model of the questionnaire demonstrated adequate goodness of fit, representing a stable factorial solution. The instrument was fit to monitor and evaluate the organizational commitment of Portuguese nurses.

Gestão do procedimento higiene das mãos por enfermeiros: desafios para saúde coletiva

OBJECTIVE To describe the determining factors in hand hygiene management among nurses and identify associated collective health challenges. METHOD Cross-sectional descriptive study. Data were collected using a questionnaire that was applied in four internal medicine units of a hospital of reference in Portugal. RESULTS The sample was composed of 50 nurses aged 26 to 55 years (mean age of 34.88 years); 80% were women, 58% had a Bachelors degree, and had 5-30 years of nursing practice (X̄ =11.94;±5.92). The vast majority of nurses (90%) reported complying with the existing recommendations on hand hygiene in pre-established moments. However, none of the nurses were able to identify all the moments for hand hygiene using water and soap or alcohol-based handrub. CONCLUSION This study shows that continuous training, adequate materials/structures in the units, and redesigned administration/supervision practices are determining factors to achieve higher levels of adherence to hand hygiene among nurses, as well as increased quality and safety in care delivery, which is a current collective health challenge.

Practice environment scale of the nursing work index: Portuguese version and psychometric properties

AIM To assess the psychometric properties regarding the Portuguese version of the Practice Environment Scale of the Nursing Work Index. BACKGROUND The Practice Environment Scale of the Nursing Work Index is the most widely used measure for assessing the practice environment. A model with a higher number of factors appears to be more adequate to Portuguese settings. METHOD A confirmatory factor analysis was performed to the Practice Environment Scale of the Nursing Work Index using a sample of 850 Portuguese nurses. Three models were tested: the original model, a seven-factor model and a higher-order model. An analysis of invariance was performed in two subsets to confirm the stability of the solution. RESULTS The seven-factor model fit better to the data than the original model. After refinement, this solution showed suitability and a stable factor structure. Reliability, convergent validity and discriminant validity were confirmed. A second-order factor solution also showed suitability. CONCLUSION The seven-factor structure of the Practice Environment Scale of the Nursing Work Index showed a better goodness-of-fit to Portuguese settings than the original structure. The second-order factor solution allows an overall assessment of practice environments. IMPLICATIONS FOR NURSING MANAGEMENT The Portuguese version of the Practice Environment Scale of the Nursing Work Index is a valuable tool for assessing Portuguese nursing practice environments. The seven-factor solution of the Practice Environment Scale of the Nursing Work Index showed high specificity.

Construção e Validação da Escala de Comportamentos de Abordagem aos Média por Enfermeiros

Enquadramento: As mensagens mediaticas sobre a saude em Portugal tendem a desvalorizar o contributo dos enfermeiros e podem originar representacoes redutoras do setor. Compreender como os enfermeiros abordam os media torna-se fundamental para caracterizar esta problematica.Objetivos: Construir e validar a Escala de Comportamentos de Abordagem aos Media por Enfermeiros.Metodologia: Realizou-se um estudo metodologico numa amostra de enfermeiros pertencentes a mesma rede social(n=528). O processo de validacao incluiu a analise fatorial, a analise da consistencia interna e da estabilidade temporal.Resultados: Obteve-se uma escala de 23 itens, distribuidos por 5 fatores, que explicam 70,98% da variância. O instrumento apresenta boa consistencia interna e valores aceitaveis de estabilidade temporal.Conclusao: O instrumento revelou-se valido e fiavel. O desenvolvimento de programas educativos sobre abordagem mediatica podera ajudar os enfermeiros a evidenciar publicamente o valor e contributos da profissao.

Papel del enfermero y participación del cliente en el proceso de toma de decisiones clínicas

El presente trabajo es de revision de literatura, esta basado en articulos de investigacion del area de enfermeria, abordando el tema: decision clinica compartida. Los objetivos fueron dirigidos a analizar el papel del enfermero y del paciente en el proceso de la toma de decisiones en contextos de la practica clinica. Para fundamentar esas tematicas, se hizo una revision de la literatura reciente, la que revelo los siguientes resultados: los pacientes prefieren compartir la toma de decisiones con los profesionales y los profesionales deben apoyar y dar informacion a los clientes de forma a diluir las barreras que dificultan su participacion en el proceso de decision. Quedo clara la necesidad de realizar mas estudios que presenten evidencias problematicas en el proceso de decision en el contexto clinico, con la finalidad de contribuir para la evolucion de los cuidados.O presente trabalho e de revisao de literatura, baseada em artigos de investigacao da area da enfermagem, abordando o tema: decisao clinica partilhada. Os objetivos estao direcionados para o analisar do papel do enfermeiro e do paciente no processo de tomada de decisao em contextos da pratica clinica. Para fundamentar essas tematicas, fez-se revisao de literatura recente que revelou os seguintes resultados: os pacientes preferem partilhar a tomada de decisao com os profissionais e os profissionais devem apoiar e dar informacao aos clientes de forma a diluir as barreiras que dificultam o seu envolvimento no processo de decisao. Ficou clara a necessidade de mais estudos que evidenciem problematicas no processo de decisao em contexto clinico, no sentido de contribuir para a evolucao dos cuidados.