Silvia Helena De Bortoli Cassiani

Strategy for universal access to health and universal health coverage and the contribution of the International Nursing Networks

Last October 2014, the 53rd Directing Council of the Pan American Health Organization, including the ministers of health or their representatives, of all countries in the Americas, approved Resolution CP53.14 about the “Strategy for universal access to health and universal health coverage”(1). Health coverage is defined as “the capacity of the health system to serve the needs of the population, including the availability of infrastructure, human resources, health technologies (including medicines) and financing. Universal access is defined as the absence of geographical, economic, sociocultural, organizational or gender barriers”(1). Universal access is achieved through the progressive elimination of the barriers that impede all people from using the integral health services, equitably established at the national level. The universal access to health and the universal health coverage are necessary to improve the health results and other fundamental objectives of the health systems, and are based on all people’s right to enjoy the maximum level of health, equality and solidarity. The universal health coverage strategy is being used to bring all program interests in health under an inclusive umbrella and explain its relation with the increased healthy life expectancy, according to the most recent discussions on the millennium development goals after 2015(2). The human resources in health are one of the central pillars for the Universal Access to Health and Universal Health Coverage. Nevertheless, profound disequilibria and gaps remain in the availability, distribution, composition, competency and productivity of the human resources in health, mainly in primary care. Eleven countries in the region face an absolute shortage of health professionals (less than 25 physicians, nurses and certified midwives per 10,000 inhabitants). To expand the effective and equitable health coverage, many countries in Latin America need to improve the training and distribution of human resources in health(3). Nursing plays a fundamental role for the countries to achieve the target of Universal Health Coverage and Universal Access to health services. Nurses and nursing personnel can act in health services at all care levels. The nurses’ education should prepare them to use and apply scientific knowledge, for the critical and reflexive analysis of their professional practice and context, and for the use of technical, scientific and interpersonal relationship skills in human care. Challenges remain internal and external to the profession. These challenges, some of which have historical backgrounds, are cultural, related to gender and knowledge and the tireless struggle for a professional space Strategy for universal access to health and universal health coverage and the contribution of the International Nursing Networks1

Desenvolvimento e avaliação de ambiente virtual de aprendizagem em curso profissionalizante de enfermagem

This study aimed to: develop and evaluate a Virtual Learning Environment in the theme administering medications in a professional nursing course in Curitiba/PR, Brazil. The programs elaboration was divided in three phases: 1- Virtual Learning Environment development Guide. Phase 2, corresponded to implementation and assessment of its use. Phase 3, learning Evaluation. The program evaluations demonstrate that it is in accordance to the educational goals intended to develop and implement an educational technology. The assessment on learning showed that the students answered correctly 85% of the questions discussed. The possibility of elaborating new educational technologies can be helpful in the teaching/learning process, as well as in the development of future nursing professionals.This study aimed to: develop and evaluate a Virtual Learning Environment in the theme administering medications in a professional nursing course in Curitiba/PR, Brazil. The programs elaboration was divided in three phases: 1- Virtual Learning Environment development Guide. Phase 2, corresponded to implementation and assessment of its use. Phase 3, learning Evaluation. The program evaluations demonstrate that it is in accordance to the educational goals intended to develop and implement an educational technology. The assessment on learning showed that the students answered correctly 85% of the questions discussed. The possibility of elaborating new educational technologies can be helpful in the teaching/learning process, as well as in the development of future nursing professionals.

Development and evaluation of a virtual learning environment in professional nursing courses

This study aimed to: develop and evaluate a Virtual Learning Environment in the theme administering medications in a professional nursing course in Curitiba/PR, Brazil. The programs elaboration was divided in three phases: 1- Virtual Learning Environment development Guide. Phase 2, corresponded to implementation and assessment of its use. Phase 3, learning Evaluation. The program evaluations demonstrate that it is in accordance to the educational goals intended to develop and implement an educational technology. The assessment on learning showed that the students answered correctly 85% of the questions discussed. The possibility of elaborating new educational technologies can be helpful in the teaching/learning process, as well as in the development of future nursing professionals.This study aimed to: develop and evaluate a Virtual Learning Environment in the theme administering medications in a professional nursing course in Curitiba/PR, Brazil. The programs elaboration was divided in three phases: 1- Virtual Learning Environment development Guide. Phase 2, corresponded to implementation and assessment of its use. Phase 3, learning Evaluation. The program evaluations demonstrate that it is in accordance to the educational goals intended to develop and implement an educational technology. The assessment on learning showed that the students answered correctly 85% of the questions discussed. The possibility of elaborating new educational technologies can be helpful in the teaching/learning process, as well as in the development of future nursing professionals.

A Rede Regional de Educação Interprofissional em Saúde da OPAS/OMS

Pan American Health Organization/World Health Organization (PAHO/WHO), the countries of the Region of the Americas reaffirmed their commitment to the Strategy of Universal Access to Health and Universal Health Coverage (Universal Health)(1). Improvements in primary care resolution capacity, and the distribution, training, and qualification of human resources for health, are important factors in achieving Universal Health in the Region(2). There are several obstacles to access universal, comprehensive, good-quality health services in the Region of the Americas(1). Despite advances in economic and social development and the consequent strengthening of health systems in the Region, collaboration across health, education, and labor sectors needs to be better aligned to promote education that will prepare professionals to meet the health needs of the population and the countries(3-4). Interprofessional collaboration is a promising strategy for mitigating the workforce crisis and improving health care that, if carried out by interprofessional health teams, enables optimization of skills and holistic, high-quality, people-centered care(5-6). Effective collaboration among health team members requires health professional education based on the interprofessional education (IPE) approach. As defined by the WHO, IPE “occurs when students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes”(5). Evidence indicates that IPE 1) promotes the development of attitudes, knowledge, skills, and behaviors conducive to collaborative practice and 2) improves teamwork by developing respect for and recognition of individuals’ skills(7). This type of training enables health professionals to use the full capacity of their training(3-4,8). If used throughout professional training rather than as isolated components of the educational curriculum, IPE can strengthen health sector human resources capacity, improve outcomes, and thus strengthen health Editorial Rev. Latino-Am. Enfermagem 2017;25:e2866 DOI: 10.1590/1518-8345.0000.2866 www.eerp.usp.br/rlaeOrganización Panamericana de la Salud/Organización Mundial de la Salud (OPS/OMS), los países de la Región de las Américas reafirmaron su compromiso con la Estrategia para el Acceso Universal a la Salud y la Cobertura Universal de Salud (Salud Universal) (1). Mejoras en la capacidad resolutiva del primer nivel de atención y en la distribución, capacitación y cualificación de los recursos humanos para la salud son factores importantes para el logro de la Salud Universal en la Región(2). Existen varios obstáculos para acceder a servicios de salud universales, integrales y de buena calidad en la Región de las Américas(1). A pesar de los avances en el desarrollo económico y social y el consiguiente fortalecimiento de los sistemas de salud en la Región, la colaboración entre los sectores de la salud, la educación y el trabajo debe estar mejor alineada para promover una educación que prepare a los profesionales para satisfacer las necesidades de salud de la población y de los países(3-4). La colaboración interprofesional es una estrategia prometedora para mitigar la crisis de personal sanitario y mejorar la atención de salud que, si se lleva a cabo por equipos interprofesionales de salud, permite la optimización de las competencias y la prestación de asistencia sanitaria holística, de alta calidad y centrada en las personas(5-6). La colaboración efectiva entre los miembros de un equipo de salud requiere de una educación profesional en salud basada en el enfoque de la educación interprofesional (EIP). Según la definición de la OMS, la EIP “ocurre cuando los estudiantes de dos o más profesiones aprenden sobre los demás, con los demás y entre sí, para permitir una colaboración eficaz y mejorar los resultados de salud”(5). La evidencia indica que la EIP 1) promueve el desarrollo de actitudes, conocimientos, habilidades y comportamientos que conducen a la práctica colaborativa y 2) mejora el trabajo en equipo, desarrollando el respeto y el reconocimiento de las habilidades de los individuos(7). Este tipo de formación permite a los Editorial Rev. Latino-Am. Enfermagem 2017;25:e2866 DOI: 10.1590/1518-8345.0000.2866 www.eerp.usp.br/rlae

The situation of nursing education in Latin America and the Caribbean towards universal health

Objective: to assess the situation of nursing education and to analyze the extent to which baccalaureate level nursing education programs in Latin America and the Caribbean are preparing graduates to contribute to the achievement of Universal Health. Method: quantitative, descriptive/exploratory, cross-sectional study carried out in 25 countries. Results: a total of 246 nursing schools participated in the study. Faculty with doctoral level degrees totaled 31.3%, without Brazil this is reduced to 8.3%. The ratio of clinical experiences in primary health care services to hospital-based services was 0.63, indicating that students receive more clinical experiences in hospital settings. The results suggested a need for improvement in internet access; information technology; accessibility for the disabled; program, faculty and student evaluation; and teaching/learning methods. Conclusion: there is heterogeneity in nursing education in Latin America and the Caribbean. The nursing curricula generally includes the principles and values of Universal Health and primary health care, as well as those principles underpinning transformative education modalities such as critical and complex thinking development, problem-solving, evidence-based clinical decision-making, and lifelong learning. However, there is a need to promote a paradigm shift in nursing education to include more training in primary health care.Objective: to assess the situation of nursing education and to analyze the extent to which baccalaureate level nursing education programs in Latin America and the Caribbean are preparing graduates to contribute to the achievement of Universal Health. Method: quantitative, descriptive/exploratory, cross-sectional study carried out in 25 countries. Results: a total of 246 nursing schools participated in the study. Faculty with doctoral level degrees totaled 31.3%, without Brazil this is reduced to 8.3%. The ratio of clinical experiences in primary health care services to hospital-based services was 0.63, indicating that students receive more clinical experiences in hospital settings. The results suggested a need for improvement in internet access; information technology; accessibility for the disabled; program, faculty and student evaluation; and teaching/learning methods. Conclusion: there is heterogeneity in nursing education in Latin America and the Caribbean. The nursing curricula generally includes the principles and values of Universal Health and primary health care, as well as those principles underpinning transformative education modalities such as critical and complex thinking development, problem-solving, evidence-based clinical decision-making, and lifelong learning. However, there is a need to promote a paradigm shift in nursing education to include more training in primary health care.Objetivo: evaluar la situacion de la educacion en enfermeria y analizar en que grado los programas de educacion de enfermeria a nivel de grado en America Latina y el Caribe estan preparando a los graduados para contribuir al logro de la Salud Universal. Metodo: se llevo a cabo un estudio transversal, cuantitativo, descriptivo y exploratorio en 25 paises. Resultados: participaron en el estudio 246 escuelas de enfermeria. El porcentaje de profesores con titulos de doctorado fue de 31,3%; pero, si se excluye a Brasil esta cifra se reduce a 8,3%. La proporcion de la experiencia clinica adquirida en los servicios de atencion primaria de salud en relacion con la adquirida en servicios hospitalarios fue de 0,63, lo que indica que los estudiantes adquieren la mayor parte de su experiencia clinica en entornos hospitalarios. Los resultados mostraron una necesidad de mejorar el acceso a internet; la tecnologia de la informacion; la accesibilidad para las personas discapacitadas; la evaluacion de los programas, de los profesores y de los estudiantes; y los metodos de ensenanza y aprendizaje. Conclusiones: hay heterogeneidad en la educacion en enfermeria en America Latina y el Caribe. En general, los programas de estudios de enfermeria han adoptado los principios y los valores de la Salud Universal y la atencion primaria de salud, asi como los principios que sustentan las modalidades de educacion transformadora, como son el desarrollo del pensamiento critico y complejo, la solucion de problemas, la toma de decisiones clinicas basadas en la evidencia y el aprendizaje a lo largo de toda la vida. Sin embargo, hay necesidad de promover un cambio en el paradigma de la educacion en enfermeria, a fin de que abarque mas capacitacion en la atencion primaria de salud.

A Situação da Educação em Enfermagem na América Latina e no Caribe Rumo à Saúde Universal

Objective: to assess the situation of nursing education and to analyze the extent to which baccalaureate level nursing education programs in Latin America and the Caribbean are preparing graduates to contribute to the achievement of Universal Health. Method: quantitative, descriptive/exploratory, cross-sectional study carried out in 25 countries. Results: a total of 246 nursing schools participated in the study. Faculty with doctoral level degrees totaled 31.3%, without Brazil this is reduced to 8.3%. The ratio of clinical experiences in primary health care services to hospital-based services was 0.63, indicating that students receive more clinical experiences in hospital settings. The results suggested a need for improvement in internet access; information technology; accessibility for the disabled; program, faculty and student evaluation; and teaching/learning methods. Conclusion: there is heterogeneity in nursing education in Latin America and the Caribbean. The nursing curricula generally includes the principles and values of Universal Health and primary health care, as well as those principles underpinning transformative education modalities such as critical and complex thinking development, problem-solving, evidence-based clinical decision-making, and lifelong learning. However, there is a need to promote a paradigm shift in nursing education to include more training in primary health care.Objective: to assess the situation of nursing education and to analyze the extent to which baccalaureate level nursing education programs in Latin America and the Caribbean are preparing graduates to contribute to the achievement of Universal Health. Method: quantitative, descriptive/exploratory, cross-sectional study carried out in 25 countries. Results: a total of 246 nursing schools participated in the study. Faculty with doctoral level degrees totaled 31.3%, without Brazil this is reduced to 8.3%. The ratio of clinical experiences in primary health care services to hospital-based services was 0.63, indicating that students receive more clinical experiences in hospital settings. The results suggested a need for improvement in internet access; information technology; accessibility for the disabled; program, faculty and student evaluation; and teaching/learning methods. Conclusion: there is heterogeneity in nursing education in Latin America and the Caribbean. The nursing curricula generally includes the principles and values of Universal Health and primary health care, as well as those principles underpinning transformative education modalities such as critical and complex thinking development, problem-solving, evidence-based clinical decision-making, and lifelong learning. However, there is a need to promote a paradigm shift in nursing education to include more training in primary health care.Objetivo: evaluar la situacion de la educacion en enfermeria y analizar en que grado los programas de educacion de enfermeria a nivel de grado en America Latina y el Caribe estan preparando a los graduados para contribuir al logro de la Salud Universal. Metodo: se llevo a cabo un estudio transversal, cuantitativo, descriptivo y exploratorio en 25 paises. Resultados: participaron en el estudio 246 escuelas de enfermeria. El porcentaje de profesores con titulos de doctorado fue de 31,3%; pero, si se excluye a Brasil esta cifra se reduce a 8,3%. La proporcion de la experiencia clinica adquirida en los servicios de atencion primaria de salud en relacion con la adquirida en servicios hospitalarios fue de 0,63, lo que indica que los estudiantes adquieren la mayor parte de su experiencia clinica en entornos hospitalarios. Los resultados mostraron una necesidad de mejorar el acceso a internet; la tecnologia de la informacion; la accesibilidad para las personas discapacitadas; la evaluacion de los programas, de los profesores y de los estudiantes; y los metodos de ensenanza y aprendizaje. Conclusiones: hay heterogeneidad en la educacion en enfermeria en America Latina y el Caribe. En general, los programas de estudios de enfermeria han adoptado los principios y los valores de la Salud Universal y la atencion primaria de salud, asi como los principios que sustentan las modalidades de educacion transformadora, como son el desarrollo del pensamiento critico y complejo, la solucion de problemas, la toma de decisiones clinicas basadas en la evidencia y el aprendizaje a lo largo de toda la vida. Sin embargo, hay necesidad de promover un cambio en el paradigma de la educacion en enfermeria, a fin de que abarque mas capacitacion en la atencion primaria de salud.

La situación de la educación en enfermería en América Latina y el Caribe hacia el logro de la salud universal

Objective: to assess the situation of nursing education and to analyze the extent to which baccalaureate level nursing education programs in Latin America and the Caribbean are preparing graduates to contribute to the achievement of Universal Health. Method: quantitative, descriptive/exploratory, cross-sectional study carried out in 25 countries. Results: a total of 246 nursing schools participated in the study. Faculty with doctoral level degrees totaled 31.3%, without Brazil this is reduced to 8.3%. The ratio of clinical experiences in primary health care services to hospital-based services was 0.63, indicating that students receive more clinical experiences in hospital settings. The results suggested a need for improvement in internet access; information technology; accessibility for the disabled; program, faculty and student evaluation; and teaching/learning methods. Conclusion: there is heterogeneity in nursing education in Latin America and the Caribbean. The nursing curricula generally includes the principles and values of Universal Health and primary health care, as well as those principles underpinning transformative education modalities such as critical and complex thinking development, problem-solving, evidence-based clinical decision-making, and lifelong learning. However, there is a need to promote a paradigm shift in nursing education to include more training in primary health care.Objective: to assess the situation of nursing education and to analyze the extent to which baccalaureate level nursing education programs in Latin America and the Caribbean are preparing graduates to contribute to the achievement of Universal Health. Method: quantitative, descriptive/exploratory, cross-sectional study carried out in 25 countries. Results: a total of 246 nursing schools participated in the study. Faculty with doctoral level degrees totaled 31.3%, without Brazil this is reduced to 8.3%. The ratio of clinical experiences in primary health care services to hospital-based services was 0.63, indicating that students receive more clinical experiences in hospital settings. The results suggested a need for improvement in internet access; information technology; accessibility for the disabled; program, faculty and student evaluation; and teaching/learning methods. Conclusion: there is heterogeneity in nursing education in Latin America and the Caribbean. The nursing curricula generally includes the principles and values of Universal Health and primary health care, as well as those principles underpinning transformative education modalities such as critical and complex thinking development, problem-solving, evidence-based clinical decision-making, and lifelong learning. However, there is a need to promote a paradigm shift in nursing education to include more training in primary health care.Objetivo: evaluar la situacion de la educacion en enfermeria y analizar en que grado los programas de educacion de enfermeria a nivel de grado en America Latina y el Caribe estan preparando a los graduados para contribuir al logro de la Salud Universal. Metodo: se llevo a cabo un estudio transversal, cuantitativo, descriptivo y exploratorio en 25 paises. Resultados: participaron en el estudio 246 escuelas de enfermeria. El porcentaje de profesores con titulos de doctorado fue de 31,3%; pero, si se excluye a Brasil esta cifra se reduce a 8,3%. La proporcion de la experiencia clinica adquirida en los servicios de atencion primaria de salud en relacion con la adquirida en servicios hospitalarios fue de 0,63, lo que indica que los estudiantes adquieren la mayor parte de su experiencia clinica en entornos hospitalarios. Los resultados mostraron una necesidad de mejorar el acceso a internet; la tecnologia de la informacion; la accesibilidad para las personas discapacitadas; la evaluacion de los programas, de los profesores y de los estudiantes; y los metodos de ensenanza y aprendizaje. Conclusiones: hay heterogeneidad en la educacion en enfermeria en America Latina y el Caribe. En general, los programas de estudios de enfermeria han adoptado los principios y los valores de la Salud Universal y la atencion primaria de salud, asi como los principios que sustentan las modalidades de educacion transformadora, como son el desarrollo del pensamiento critico y complejo, la solucion de problemas, la toma de decisiones clinicas basadas en la evidencia y el aprendizaje a lo largo de toda la vida. Sin embargo, hay necesidad de promover un cambio en el paradigma de la educacion en enfermeria, a fin de que abarque mas capacitacion en la atencion primaria de salud.

Estratégia para o acesso universal à saúde e cobertura universal de saúde e a contribuição das Redes Internacionais de Enfermagem

Last October 2014, the 53rd Directing Council of the Pan American Health Organization, including the ministers of health or their representatives, of all countries in the Americas, approved Resolution CP53.14 about the “Strategy for universal access to health and universal health coverage”(1). Health coverage is defined as “the capacity of the health system to serve the needs of the population, including the availability of infrastructure, human resources, health technologies (including medicines) and financing. Universal access is defined as the absence of geographical, economic, sociocultural, organizational or gender barriers”(1). Universal access is achieved through the progressive elimination of the barriers that impede all people from using the integral health services, equitably established at the national level. The universal access to health and the universal health coverage are necessary to improve the health results and other fundamental objectives of the health systems, and are based on all people’s right to enjoy the maximum level of health, equality and solidarity. The universal health coverage strategy is being used to bring all program interests in health under an inclusive umbrella and explain its relation with the increased healthy life expectancy, according to the most recent discussions on the millennium development goals after 2015(2). The human resources in health are one of the central pillars for the Universal Access to Health and Universal Health Coverage. Nevertheless, profound disequilibria and gaps remain in the availability, distribution, composition, competency and productivity of the human resources in health, mainly in primary care. Eleven countries in the region face an absolute shortage of health professionals (less than 25 physicians, nurses and certified midwives per 10,000 inhabitants). To expand the effective and equitable health coverage, many countries in Latin America need to improve the training and distribution of human resources in health(3). Nursing plays a fundamental role for the countries to achieve the target of Universal Health Coverage and Universal Access to health services. Nurses and nursing personnel can act in health services at all care levels. The nurses’ education should prepare them to use and apply scientific knowledge, for the critical and reflexive analysis of their professional practice and context, and for the use of technical, scientific and interpersonal relationship skills in human care. Challenges remain internal and external to the profession. These challenges, some of which have historical backgrounds, are cultural, related to gender and knowledge and the tireless struggle for a professional space Strategy for universal access to health and universal health coverage and the contribution of the International Nursing Networks1

Desarrollo y evaluación de un ambiente virtual de aprendizaje en cursos profesionalizantes en enfermería

This study aimed to: develop and evaluate a Virtual Learning Environment in the theme administering medications in a professional nursing course in Curitiba/PR, Brazil. The programs elaboration was divided in three phases: 1- Virtual Learning Environment development Guide. Phase 2, corresponded to implementation and assessment of its use. Phase 3, learning Evaluation. The program evaluations demonstrate that it is in accordance to the educational goals intended to develop and implement an educational technology. The assessment on learning showed that the students answered correctly 85% of the questions discussed. The possibility of elaborating new educational technologies can be helpful in the teaching/learning process, as well as in the development of future nursing professionals.This study aimed to: develop and evaluate a Virtual Learning Environment in the theme administering medications in a professional nursing course in Curitiba/PR, Brazil. The programs elaboration was divided in three phases: 1- Virtual Learning Environment development Guide. Phase 2, corresponded to implementation and assessment of its use. Phase 3, learning Evaluation. The program evaluations demonstrate that it is in accordance to the educational goals intended to develop and implement an educational technology. The assessment on learning showed that the students answered correctly 85% of the questions discussed. The possibility of elaborating new educational technologies can be helpful in the teaching/learning process, as well as in the development of future nursing professionals.