Clinical-audit-on-the-practice-of-documentation-at-preanesthetic-evaluation-in-teaching-institute

Introduction: The preanesthetic evaluation, documenting it and maintaining the record is the responsibility of anesthetist. Better documentation practices can improve the patient's outcome. It has the pivotal role in medicolegal aspects. However, the documentation is one of the challenges when it comes to quality of care. The objective of the study was to assess the practice of documentation at preanesthetic evaluation and completeness of Preanesthetic evaluation tools. The descriptive study was conducted in tertiary care hospital. Modied global quality index (GQI) isMethod: used to prepare the Predefined twenty-two indicators. The data analysis is done using SPSS version-20. A total ofResult: 300 pre-anesthetic evaluation tools (PAETs) were reviewed. There was different trend in terms of completion rate for elective and emergency cases. However, there was no PAETs found complete. Indicators with high completion rate (>90%) were signed a consent, past medical history (PMH), history of medication, allergy, surgical procedure, cardiovascular examination, airway examination and respiratory examination. Anesthetic plan, premedication, vital signs, a name, per-oral status and age were found with below average (<50%) completion rate. andConclusion recommendations: Documentation during the preanesthetic visit observed below the standard. Which need to be standardized for uniformity. Use of electronic system with prefilled formats and training of personnel involved in the process is the way forward

Research progress of evaluation tools for sexual health care of nurses in oncology department / 中国实用护理杂志

This paper introduces the concepts related to sexual health and sexual health care, summarizes the contents, application scope and limitations of sexual health care assessment tools for oncology nurses at home and abroad, analyzes the problems existing in the assessment tools and puts forward suggestions, aiming at providing theoretical reference for the localization development of sexual health care assessment tools and the development of sexual health care.

Research progress in the application of sleep assessment tools in breast cancer patients / 中华内分泌外科杂志

Breast cancer is the most common malignancy in women worldwide, and its incidence and mortality rate are among the highest in female cancers. Breast cancer patients often have sleep disorder due to a variety of factors, and sleep disorder is a prominent problem that plagues breast cancer patients, which not only affects the quality of life of patients, but also increases the risk of disease progression. Sleeping disorder is often not taken seriously in clinical work. The use of appropriate sleep assessment tools can help to identify the type, severity, and further to timely interven sleep disorders in this population. Sleep assessment tools can also reflect the effectiveness of interventions. So it is necessary to use sleep assessment tools to accurately evaluate patients with breast cancer sleep disorder, which can help patients with effective symptom control, and improve quality of life and prognosis. In this paper, the application of a variety of sleep assessment tools in breast cancer patients is reviewed, in order to help clinical medical staff rationally apply the assessment tools and timely and accurately assess the sleep disorder status of breast cancer patients.

Self-assessment video: An effective supplementary learning tool in the development of cardiovascular examination skills of medical students

@#<p style="text-align: justify;"><strong>Background:</strong> Self-evaluation can augment the facilitation of acquiring knowledge, skills and attitude through a reflective method. Self-assessment video (SAV) can be a very useful reflective method tool that is student-centered and self-directed.</p><p style="text-align: justify;"><strong>Objective:</strong> This study aimed to identify if SAV is an effective supplementary learning tool in improving cardiovascular examination knowledge, skills and attitude of second year medical students.</p><p style="text-align: justify;"><strong>Methodology:</strong> A quasi-experimental two-group design with pre- and post-test was used. The study population by convenience sampling involved second year medical students of the University of Santo Tomas Faculty of Medicine and Surgery. A structured direct observation checklist on cardiovascular precordial examination was used, done on two occasions in a week interval period. The said examinations were recorded in a video and evaluated and scored by two independent facilitators on these two occasions. The experimental group had the opportunity to review their videos immediately after the two examinations and accomplished self-assessment form. One-Way Repeated Measures Multivariate Analysis of Variance (One-Way RM-MANOVA), a parametric multivariate test for between- and within group comparison of multiple dependent variables was used.</p><p style="text-align: justify;"><strong>Results:</strong> It showed that there was a significant improvement in all parameters measured after the intervention (SAV in the experimental group compared to the control group).</p><p style="text-align: justify;"><strong>Conclusion:</strong> The study showed that SAV is an effective supplementary learning tool in cardiovascular examination attitude, knowledge, and skills, and can be a very useful teaching and learning self-evaluation tool.</p>

Pauta de pesquisa para apraxia del habla infantil en hispanohablantes: traducción y validación cultural / Check list for childhood apraxia of speech in spanish-speaking population: translation and validation

La apraxia del habla infantil (AHI) es un trastorno pediátrico poco común, en el que, si el niño o niña no es diagnosticado a tiempo, puede desencadenar graves consecuencias a futuro. Los métodos de diagnóstico existentes para este trastorno se encuentran disponibles en idiomas distintos al español, lo que conlleva una dificultad para encontrar un método de diagnóstico válido y consensuado por los fonoaudiólogos para aplicarse a la población hispanohablantes. Es por estoque este estudio pretende dar un primer aporte, realizando la traducción de una herramienta de pesquisa apta para el idioma español, que permita facilitar la labor fonoaudiológica en el diagnóstico. El método que se utilizará es el de traducción y validación de una herramienta de evaluación en salud, al cual se va a incorporar el análisis de un panel de expertos para brindarle validez al instrumento. Los resultados muestran una amplia aceptación del instrumento (94%resultados positivos) con un buen acuerdo entre jueces (IRR inter rater reliability) presentada como probabilidad de acuerdo para todo el instrumento de 0,57 (57%). En conclusión, este estudio brinda una pauta de pesquisa para la AHI, con el fin de facilitar la evaluación fonoaudiológica temprana de los niños y niñas, permitiendo que los usuarios puedan acceder a una atención especializada y confiable acordes con el diagnóstico.

Childhood apraxia of speech (CAS), is a rare disorder during childhood, and it can trigger serious consequences in the future if not treated promptly. The existing diagnostic methods for this disorder are found in the English language only, which leads to difficulties in finding valid and agreed diagnostic methods by speech therapists to apply to the Spanish-speaking population. Hence, this study aims to provide the translation of an evaluation tool which is suitable for Spanish-speaking countries and that facilitates phonoaudiological work in the diagnosis. The method that will be used is that of translation-retranslation, to which the analysis of an expert opinion will be incorporated to give validity to the instrument. The results expose a wide acceptance of the instrument (94% of positive results) with substantial agreement among experts (IRR inter rater reliability), presented as agreement probability for the entire instrument of 0.57 (57%). In conclusion, this study provides a research pattern for AHI, to facilitate the early phonoaudiological evaluation of children, allowing the patients to access reliable care regarding to diagnosis.

Guía metodológica para la observación y calificación del examen práctico estatal de Medicina / Methodological guide for observation and rating of the state practical examination of Medicine

Fundamento: la evaluación es una parte esencial del proceso enseñanza aprendizaje que posibilita su propia dirección, el control y la valoración de los modos de actuación de los estudiantes. Objetivo: describir la guía metodológica para la observación y calificación del examen práctico estatal diseñada y aplicada en la Universidad de Ciencias Médicas de Villa Clara desde el curso 2012-2013. Métodos: se realizó una investigación descriptiva, durante el primer semestre de 2016. En ella se utilizaron métodos del nivel teórico: análisis-síntesis e inducción-deducción, que permitieron analizar los principales referentes sobre el tema; y empíricos: el análisis documental. Resultados: se observó que existían carencias en algunos aspectos contenidos en la guía anterior, entre ellos: que poseía un grado de apreciación muy general que dificultaba la obtención de resultados homogéneos en los diferentes escenarios donde se realizaba el examen, no se estandarizaba correctamente el puntaje a otorgar, omitía acápites importantes, el examen físico se reflejaba muy general, y se apreciaron dificultades en el puntaje otorgado, entre otras; por lo cual se diseñó una guía para la observación y calificación del examen práctico estatal, que fue valorada por criterios de especialistas. Conclusiones: los especialistas aceptaron la propuesta de guía, por su pertinencia, su valor científico-metodológico y su factibilidad de aplicación, porque contiene la solución de todas las carencias diagnosticadas, y tanto sus orientaciones para el tribunal como los aspectos a evaluar quedaron bien conformados y facilitan la valoración del cumplimiento de los objetivos generales de la carrera como garantía de calidad del egresado.

Background: evaluation is an essential part of the teaching-learning process that allows its own management, control and evaluation of the students´ performance. Objective: to describe the methodological guide for observation and rating of the state practical exam designed and implemented at the University of Medical Sciences of Villa Clara in the academic year 2012-2013. Methods: a descriptive study was carried out during the first half of 2016. Theoretical methods were used: analysis-synthesis and induction-deduction, which allowed analyzing the main reference on the subject; and empirical: documentary analysis. Results: it was observed that there were shortcomings in some aspects contained in the previous guide, including: having a degree of very general assessment which made difficult to obtain consistent results in different scenarios where the test was performed it was not properly standardized the score to grant important sections, were omitted, the physical examination was reflected very general and difficulties were noted in the scores granted , among others; whereby a guide for observation and rating of the state practical examination was designed, which was assessed by specialists criteria. Conclusions: experts accepted the proposal guide for its relevance, scientific and methodological value and feasibility of implementation, because it contains the solution of all diagnosed deficiencies, and therefore its guidelines for the scoring board as the aspects to be evaluated they were well formed and facilitate the assessment of compliance with the overall objectives of the career as a graduate quality assurance.

Tradução e adaptação transcultural de um questionário de competências clínicas / Cross-cultural translation and adaptation of a clinical skills questionnaire

Resumo: A avaliação da competência clínica de estudantes de enfermagem envolve a integração de conhecimento, habilidades e atitude profissional. Para avaliar essa competência, professores e supervisores de campo necessitam de uma ferramenta capaz de mensurar o quanto esses futuros enfermeiros estão prontos para uma prática clínica competente. Em 2013 foi criado o instrumento denominado Clinical Competence Questionnaire (CCQ), com a finalidade de medir a percepção da competência clínica de estudantes concluintes da graduação em enfermagem. O instrumento, em sua versão original, consiste em 47 itens que representam competências categorizadas, tanto em Comportamentos Profissionais da Enfermagem (itens 1 a 16) quanto em Competências e Habilidades (itens 17 a 47). Este estudo metodológico teve como objetivo traduzir e adaptar transculturalmente o questionário de autoavaliação de competência clínica, para uso no Brasil pelos estudantes concluintes da graduação em enfermagem. A pesquisa, aprovada sob o nº 031754/2015 pelo Comitê de Ética da Universidade Federal do Paraná, foi realizada em seis estágios. O primeiro constituiu o processo de tradução do instrumento. O segundo visou analisar o consenso das traduções. O terceiro foi a retrotradução. O quarto, a reunião do Comitê de Especialistas. O quinto, a realização do pré-teste que possibilitou a análise da consistência interna do instrumento (etapa adicional), com 43 estudantes concluintes da graduação de enfermagem de duas instituições de ensino superior, uma da rede pública e outra da rede privada, da cidade de Curitiba, PR. O sexto estágio foi a apresentação, para os desenvolvedores, do processo de adaptação transcultural. Ao todo foram realizadas três reuniões de consenso, entre tradutores, retrotradutores e Comitê de Especialistas. Na reunião do Comitê de Especialistas identificou-se a necessidade de modificação das opções de resposta da escala Likert, do seu formato original, com a utilização de gerúndio, para a primeira pessoa do singular. Foram modificados seis itens, respeitando-se as equivalências semântica, cultural e conceitual. Essas modificações deram origem a alguns termos, e por isso foi sugerida a inclusão de um glossário ao final do questionário. O item 40 do instrumento original foi desmembrado na versão traduzida, uma vez que envolvia mais de uma habilidade técnica. Assim, a versão adaptada do Clinical Competence Questionnaire passou a ter 48 itens. O instrumento demonstrou, na opinião dos especialistas, validade de face e de conteúdo. No pré-teste para a obtenção da estatística de confiabilidade total, considerando-se os 48 itens, foi calculado o coeficiente Alfa de Cronbach, cujo valor foi de 0,90. Para os itens 1 a 16 o valor do coeficiente foi de 0,84, enquanto que para os itens 17 a 48 foi de 0,87, sendo considerados adequados. O índice de concordância dos itens entre os estudantes foi de 99,43%. Considera-se que a versão adaptada do Clinical Competence Questionnaire mostrou consistência interna satisfatória para a amostra estudada. Conclui-se que esse instrumento foi validado para mensurar a competência clínica de estudantes concluintes da graduação em enfermagem, além de ser potencialmente útil na avaliação de enfermeiros recém-formados e de enfermeiros que iniciam em um serviço.

Abstract: The evaluation of the clinical competence of nursing students involves knowledgeintegration, abilities and professional attitude. In order to evaluate this competence,teachers and field supervisors need an instrument able to measure how much futurenurses are ready to perform clinical practices competently. In 2013, an instrumentcalled Clinical Competence Questionnaire (CCQ) was designed with the aim ofmeasuring the perception of the clinical competence of graduating nursing students.The instrument, in its original version, consisted of 47 items that representedcategorized competences, in terms of Nursing Professional Behaviors (items 1 to 16)and Competencies and Skills (items 17 to 47). This methodological study aimed attranslating and adapting transculturally the self-evaluation questionnaire aboutclinical competence to be used in Brazil by graduating nursing students. Theresearch developed in 6 stages was approved by the Ethical Committee from theParaná Federal University under N? 031754/2015. The first stage consisted of thetranslation of the instrument. The second stage was a consensus meeting related tothe translations. The third stage was the retro translation. The fourth stage consistedof a meeting of the Specialist Committee. The fifth was the pre-test that allowed theanalysis of the internal consistency of the instrument, which was an additional stage,applied to 43 graduating nursing students in 2 institutions of Higher Education. Onefrom the public sector and another from the private sector in Curitiba, Pr. The sixthstage was the presentation of the transcultural adaptation process to the instrumentdesigners. There have been 3 consensus meetings, among translators, retrotranslators and the Specialist Committee. The Specialist Committee identified theneed to modify some of the options of the Likert scale, that is, the original formatuses the gerund and it was changed to the first person singular. Six items weremodified respecting the semantic, cultural and conceptual equivalents. From thesemodifications some terms originated and because of this it was suggested theinclusion of a glossary at the end of the questionnaire. Item 40 of the originalinstrument was divided into two items in the translated version, as in the original itinvolved more than one technical skill. Therefore, the adapted version of the ClinicalCompetence Questionnaire had 48 items. The instrument, according to thespecialists' opinion presented face and content validity. In order to obtain totalconfiability statistics, taking into consideration the 48 items, the Alfa coefficient ofCronbach was calculated, whose value was 0.90. For items 1 to 16 the coefficientvalue was 0.84, whereas for items 17 to 48 the value was 0.87, which wereconsidered adequate. The agreement index among students was 99,43%. Theadapted version of the Clinical Competence Questionnaire demonstrated satisfactoryinternal consistency for the sample studied. It is concluded that the instrument wasvalidated to measure the clinical competence of graduating nursing students, inaddition to being potentially useful in the evaluation of recent graduate and nurseswho are about to start a job.

Indicadores de calidad para un examen teórico de la especialidad de medicina general integral / Quality indicators for a theoretical exam of the Comprehensive General Medicine speciality

Se realizó un estudio descriptivo y transversal combinado con enfoques cualitativos, a fin de evaluar la calidad de los exámenes de control parcial aplicados a 30 médicos de primero y segundo años residentes en medicina general integral, que laboraban en el Hospital Clinicoquirúrgico Docente "Dr. Joaquín Castillo Duany" de Santiago de Cuba, durante el año 2014. Se emplearon métodos teóricos, empíricos y de procesamiento estadístico en el análisis de los instrumentos de evaluación. Ambos exámenes teóricos presentaron diferencias y similitudes constatadas a través de indicadores, tales como número de horas asignadas al contenido y cantidad de incisos empleados en la exploración, índice de dificultad por temáticas y preguntas, así como nivel de discriminación y consistencia interna del instrumento, todo lo cual ofreció validez y confiabilidad para el sistema de evaluación del aprendizaje.

A descriptive and cross-sectional study with qualitative approaches was carried out, in order to evaluate the quality of the exams of partial control applied to 30 doctors of first and second years of residency in Comprehensive General Medicine, who worked in "Dr. Joaquín Castillo Duany" Teaching Clinical Surgical Hospital from Santiago de Cuba, during the year 2014. Theoretical, empiric methods were used as well as those of statistical processing in the analysis of the evaluation tools. Both theoretical exams presented differences and similarities verified through indicators, such as number of hours assigned to the content and quantity of subsections used in the exploration, index of difficulty by theme and question, as well as discrimination level and internal consistency of the tool, all of which offered validity and reliability for the evaluation system of learning.

El profesor principal y su preparación para diseñar instrumentos de evaluación escritos / The head teachers and their training for designing written evaluation tools

Introducción: la calidad en el diseño de los instrumentos de evaluación escritos puede repercutir en su validez y confiabilidad, así como en los resultados académicos. Objetivo: identificar el nivel de preparación pedagógica de los profesores principales de las disciplinas integradoras en las carreras de Medicina, Estomatología y Enfermería con respecto al diseño de los exámenes escritos de sus asignaturas. Métodos: se realizó un estudio observacional, descriptivo y transversal en la Universidad de Ciencias Médicas de Villa Clara, durante el curso 2011-2012. Para ello, se aplicó una guía de evaluación a 21 exámenes, así como una entrevista a los 14 profesores principales de las asignaturas rectoras. Resultados: el mayor número de los profesores principales tienen categoría de asistente, más de seis años con experiencia docente y menos de cinco como responsable de la asignatura. Recibieron actividades de superación y formación académica en pedagogía y en especial sobre sistema de evaluación, que se evidencia en los criterios emitidos sobre las características que debe reunir un examen, dominio en las variantes de ítems a utilizar, así como sus ventajas y desventajas. No obstante, los resultados constatan dificultades en el diseño de los instrumentos de evaluación de tipo escrito en estas asignaturas rectoras. Conclusiones: se constatan algunas dificultades en el desempeño del profesor principal respecto al diseño de los instrumentos de evaluación escritos, por lo que resulta imperioso explotar las fortalezas del trabajo metodológico para perfeccionar esta actuación docente en los niveles de colectivos de asignatura y disciplina.

Introduction: the quality in the design of written evaluation tools may have effects on their validity and reliability, as well as in their academic results. Objective: to identify the level of pedagogical training of head teachers of the integrative disciplines in the courses of study of Medicine, Dentistry and Nursing, regarding the design of written exams in their subjects. Methods: an observational, descriptive and transversal study was done at the Medical Sciences University of Villa Clara, during the 2011-20l2 academic year. With this purpose, an evaluation guide was applied to 21 exams, and also an interview was done to the 14 head teachers of the main subjects. Results: most of the head teachers possess the teaching rank of Assistant Professor, they have over six years of teaching experience, and less than five years of experience as head of the subject teacher staff. They received upgrading activities and academic training in pedagogy, and especially, about the evaluation system. This training is evident in the criteria they express about the characteristics that an exam should have, their mastery on the variants of items to use, as well as their advantages and disadvantages. Nevertheless, these results also verify difficulties in the design of the written evaluation tools in these main subjects. Conclusions: some difficulties are verified in the performance of the head teachers regarding the design of the written evaluation tools. Therefore, it is an urgent need to improve the strength of the methodological work to perfect this teaching performance at the levels of subject teacher staff and discipline staff.

Matriz diseñada en toxicología ocupacional / Matrix designed in occupational toxicology

Se diseñó una matriz para prevenir el riesgo en toxicología ocupacional, estructurada en 3 secciones de evaluación (riesgo presumible, riesgo de asesoría y riesgo de condiciones de trabajo y daños a la salud). Se consideraron 5 menús en la primera (sector, agentes químicos, toxicidad referida, biomarcadores y eventos centinelas); 6 en la segunda (frecuencia de la exposición, duración de la exposición, proximidad a la fuente, medios de protección e influencia de puestos) y 2 en la tercera (evaluación de las condiciones de trabajo y daños a la salud). Toda vez que constituye un nuevo instrumento de gestión para estimar el riesgo toxicológico, contribuye a preservar la salud laboral.

A matrix was designed to prevent the risk in occupational toxicology, structured in 3 evaluation sections (presumed risk, advice risk and risk of working conditions and damages to health). Five menus were considered in the first section (sector, chemicals, referred toxicity, biomarkers and sentinel events); 6 in the second section (frequency of exposure, length of exposure, proximity to the source, means of protection and influence of posts) and 2 in the third one (evaluation of working conditions and damages to health). Given that it is a new management tool to estimate the toxicological risk, it contributes to preserve health in the work place.

Common Assessment Tools for Cerebral Palsy and Application (review) / 中国康复理论与实践

@#It is important to screen high-risk children with cerebral palsy early to reduce the incidence of disability. Various tools has been developed to assess the development, motor function, spasticity, and comprehensive capacity of the children at risk of brain injury or with cerebral palsy. This paper reviewed the commonly used tools, and suggested to choose one or more tools to meet the special purpose.

Avaliação em saúde: reflexões inscritas no paradigma sanitário contemporâneo / Health evaluation: reflections on contemporary sanitary paradigms

O presente estudo apresenta uma análise reflexiva dos métodos de avaliação em saúde em uma perspectiva do cuidado pensado e praticado segundo as necessidades dos usuários. Várias são as formas e abordagens dos processos avaliativos na busca de uma melhor apreensão do objeto de avaliação; neste contexto, a satisfação do usuário surge como um indicador de qualidade dos serviços de saúde, ligada à maior adequação e promoção de reais mudanças nas práticas de saúde. Diante da inovadora proposta do Programa Saúde da Família (PSF), baseado nos princípios de integralidade, cuidado à saúde e humanização, a participação e a satisfação do usuário surgem como elementos-chave na formulação de suas ações, possibilitando mudanças no modelo assistencial hegemônico, a saber, positivista, assistencialista e curativista. A presença do usuário no processo avaliativo irá permitir uma peculiar atuação, remodelando as práticas de saúde - quiçá tornando-as mais humanas, acolhedoras e, conseqüentemente, mais resolutivas.

This study presents a reflexive analysis on the health evaluation methods in the perspective of care conceived and performed according to the users' needs. There are several forms and approaches of the evaluative processes in search of a better apprehension of the object under evaluation. In this context, the user's satisfaction appears as an indicator for quality of health services, linked to better adaptation and promotion of real changes in health practices. Concerning the innovative proposal of the Family Health Program (PSF), based on the principles of integrality, reception, health care and humanization, the participation, the partnership and the users' satisfaction should be introduced as key elements in the formulation of their actions, therefore allowing changes in the hegemonic, healthcare model, that is positivistic, assistentialist and curativistic. The user's presence in the evaluation process will ensure a peculiar performance, remodeling health practices - probably making them more human, homelike, and consequently more resolutive.