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      Good practices for patient safety in the operating room: nurses' recommendations Translated title: Buenas prácticas para seguridad del paciente en centro quirúrgico: recomendaciones de enfermeros Translated title: Boas práticas para segurança do paciente em centro cirúrgico: recomendações de enfermeiros

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          Abstract

          ABSTRACT Objective: To describe nurses' recommendations for good patient safety practices in the operating room. Method: Quantitative, descriptive and exploratory research developed from an online survey of 220 operating room nurses from different regions of Brazil. The data processing for textual analysis was performed by the software IRAMUTEQ. Results: There were eight recommendations: (1) Involvement of the multiprofessional team and the managers of the institution; (2) Establishment of a patient safety culture; (3) Use of the safe surgery checklist; (4) Improvement of interpersonal communication; (5) Expansion of nurses' performance; (6) Adequate availability of physical, material and human resources; (7) Individual search for professional updating; and (8) Development of continuing education actions. Conclusion: These recommendations can be used as care management strategies by nurses for patient safety in the operating room.

          Translated abstract

          RESUMEN Objetivo: Describir las recomendaciones de enfermeros para buenas prácticas de seguridad del paciente en el centro quirúrgico. Método: La investigación cuantitativa, del tipo descriptivo y exploratorio, desarrollada a partir de un survey on-line con 220 enfermeros de centro quirúrgico de diferentes regiones de Brasil. El procesamiento de los datos para el análisis textual fue realizado por el software IRAMUTEQ. Resultados: Se obtuvieron ocho recomendaciones: (1) La participación de un equipo multidisciplinario y los gestores de las instituciones; (2) Establecimiento de una cultura de seguridad del paciente; (3) Uso del checklist de cirugía segura; (4) Mejora de la comunicación interpersonal; (5) Ampliación de la actuación del enfermero; (6) Disponibilidad adecuada de recursos físicos, materiales y humanos; (7) Búsqueda individual por actualización profesional; y (8) Desarrollo de acciones de educación continuada. Conclusión: Estas recomendaciones pueden ser utilizadas como estrategias de gestión de cuidado por los enfermeros para la seguridad del paciente en centro quirúrgico.

          Translated abstract

          RESUMO Objetivo: Descrever as recomendações de enfermeiros para boas práticas de segurança do paciente em centro cirúrgico. Método: Pesquisa quantiqualitativa, do tipo descritiva e exploratória, desenvolvida a partir de um survey on-line com 220 enfermeiros de centro cirúrgico de diferentes regiões do Brasil. O processamento dos dados para analise textual foi realizado pelo software IRAMUTEQ. Resultados: Obtiveram-se oito recomendações: (1) Envolvimento da equipe multiprofissional e dos gestores da instituição; (2) Estabelecimento de uma cultura de segurança do paciente; (3) Utilização do checklist de cirurgia segura; (4) Melhoria da comunicação interpessoal; (5) Ampliação da atuação do enfermeiro; (6) Disponibilidade adequada de recursos físicos, materiais e humanos; (7) Busca individual por atualização profissional; e, (8) Desenvolvimento de ações de educação continuada. Conclusão: Essas recomendações podem ser utilizadas como estratégias de gestão de cuidado pelos enfermeiros para a segurança do paciente em centro cirúrgico.

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          Decision-making in nursing practice: An integrative literature review

          Aims and Objectives Identify and summarize factors and processes related to registered nurses’ patient care decision-making in medical-surgical environments. A secondary goal of this literature review was to determine whether medical-surgical decision-making literature included factors that appeared to be similar to concepts and factors in Naturalistic Decision Making. Background Decision-making in acute care nursing requires an evaluation of many complex factors. While decision-making research in acute care nursing is prevalent, errors in decision-making continue leading to poor patient outcomes. Naturalistic Decision Making may provide a framework for further exploring decision-making in acute care nursing practice. A better understanding of the literature is needed to guide future research to more effectively support acute care nurse decision-making. Design Pubmed and CINAHL databases were searched and research meeting criteria was included. Data were identified from all included articles and themes were developed based on these data. Results Key findings in this review include nursing experience and associated factors; organization and unit culture influences on decision-making; education; understanding patient status; situation awareness; and autonomy. Conclusions Acute care nurses employ a variety of decision-making factors and processes. informally identify experienced nurses to be important resources for decision-making. Incorporation of evidence into acute care nursing practice continues to be a struggle for acute care nurses. This review indicates that Naturalistic Decision Making may be applicable to decision-making nursing research.
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            Donabedian's structure-process-outcome quality of care model: Validation in an integrated trauma system.

            According to Donabedian's health care quality model, improvements in the structure of care should lead to improvements in clinical processes that should in turn improve patient outcome. This model has been widely adopted by the trauma community but has not yet been validated in a trauma system. The objective of this study was to assess the performance of an integrated trauma system in terms of structure, process, and outcome and evaluate the correlation between quality domains.
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              Permanent education in health: a review

              OBJECTIVE To undertake a meta-synthesis of the literature on the main concepts and practices related to permanent education in health. METHODS A bibliographical search was conducted for original articles in the PubMed, Web of Science, LILACS, IBECS and SciELO databases, using the following search terms: “public health professional education”, “permanent education”, “continuing education”, “permanent education health”. Of the 590 articles identified, after applying inclusion and exclusion criteria, 48 were selected for further analysis, grouped according to the criteria of key elements, and then underwent meta-synthesis. RESULTS The 48 original publications were classified according to four thematic units of key elements: 1) concepts, 2) strategies and difficulties, 3) public policies and 4) educational institutions. Three main conceptions of permanent education in health were found: problem-focused and team work, directly related to continuing education and education that takes place throughout life. The main strategies for executing permanent education in health are discussion, maintaining an open space for permanent education, and permanent education clusters. The most limiting factor is mainly related to directly or indirect management. Another highlight is the requirement for implementation and maintenance of public policies, and the availability of financial and human resources. The educational institutions need to combine education and service aiming to form critical-reflexive graduates. CONCLUSIONS The coordination between health and education is based as much on the actions of health services as on management and educational institutions. Thus, it becomes a challenge to implement the teaching-learning processes that are supported by critical-reflexive actions. It is necessary to carry out proposals for permanent education in health involving the participation of health professionals, teachers and educational institutions.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                reben
                Revista Brasileira de Enfermagem
                Rev. Bras. Enferm.
                Associação Brasileira de Enfermagem (Brasília, DF, Brazil )
                0034-7167
                1984-0446
                2018
                : 71
                : suppl 6
                : 2775-2782
                Affiliations
                [1] Florianópolis Santa Catarina orgnameUniversidade Federal de Santa Catarina Brazil
                Article
                S0034-71672018001202775
                10.1590/0034-7167-2018-0449
                30540056
                fbb7944d-bc71-4807-963c-6b22d90bfea8

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 08 June 2018
                : 26 July 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 38, Pages: 8
                Product

                SciELO Revista de Enfermagem

                Categories
                Research

                Operating Rooms,Patient Safety,Gerenciamento da Prática Profissional,Qualidade da Assistência à Saúde,Enfermagem de Centro Cirúrgico,Centros Cirúrgicos,Segurança do Paciente,Operating Room Nursing,Calidad de la Atención de Salud,Enfermería de Quirófano,Centros Quirúrgicos,Seguridad del Paciente,Practice Management,Quality of Health Care,Gestión de la Práctica Profesional

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