Identificación de necesidades de aprendizaje en la realización de la Punción Lumbar en niños / Identification of the learning needs in the lumbar puncture realization in children

Introducción: la punción lumbar diagnóstica es un procedimiento frecuente en los servicios de urgencia y hospitalización infantiles, esencial para el diagnóstico de enfermedades infecciosas, inflamatorias, oncológicas y metabólicas. La Punción lumbar fallida o traumática necesariamente implica el ingreso y tratamiento antibiótico del paciente. Objetivos: identificar las causas subjetivas de la Punción lumbar fallida, según categoría ocupacional y orden de importancia y necesidades de aprendizaje, para el diseño de estrategias de capacitación. Método: estudio descriptivo, transversal mediante encuesta anónima a 63 profesionales de las áreas de atención de urgencias, que incluye especialistas, residentes y enfermeros. Resultados: las causas subjetivas más frecuentes fueron: la mala inmovilización del niño, mala técnica/habilidad del proceder y trócar no adecuado a la edad del paciente. Conclusiones: es necesario diseñar estrategias de capacitación al personal médico en formación y al personal de enfermería, para la adecuada competencia en la realización de la Punción lumbar en niños(AU)

Introduction: Diagnostic lumbar puncture is a frequent procedure in the emergency and hospitalization services for children, essential for the diagnosis of infectious, inflammatory, oncological and metabolic diseases. Failed or traumatic lumbar puncture necessarily implies the patient's antibiotic treatment and admission. Objectives: To identify the subjective causes of failed lumbar puncture, according to the occupational category and order of importance and learning needs, for the design of training strategies. Method: Descriptive, cross-sectional study by anonymous survey of 63 professionals from the emergency care areas, which includes specialists, residents and nurses.Results: The most frequent subjective causes were the children's poor immobilization, poor technique or ability to proceed, and trocar not adequate to the patient's age. Conclusions: It is necessary to design training strategies for the medical personnel being trained and for the nursing staff, for the appropriate competence in performing the lumbar puncture in children(AU)

Procedimentos diagnósticos e terapêuticos: processo de inserção de habilidades e competências médicas no currículo do curso de medicina da Anhanguera-Uniderp / Diagnostic and therapeutic procedures: defining skills and competencies in the medical curriculum of Anhanguera-Uniderp University

INTRODUÇÃO: Há pouca discussão na literatura sobre quais procedimentos médicos o estudante de Medicina deve ser capaz de realizar no final do curso de graduação e em qual momento do currículo escolar eles devem ser inseridos. METODOLOGIA: Uma comissão formada por especialistas de diversas áreas organizou uma lista de possíveis procedimentos médicos diagnósticos e terapêuticos, sugerida por estudos e debates do grupo e que estivessem de acordo com as Diretrizes Curriculares Nacionais de 2001. Após consenso do grupo, mediante aprovação de mais de 75% dos integrantes da comissão, os procedimentos que de fato deveriam integrar o currículo foram definidos. RESULTADOS: Mais de 50 procedimentos médicos foram definidos, de acordo com o nível de complexidade esperada para o aluno de graduação. Após esta definição, tais procedimentos foram distribuídos na matriz curricular e divididos didaticamente em momentos de aprendizagem de domínio cognitivo e domínio motor. CONCLUSÃO: O presente estudo apresentou uma proposta de definição das competências e habilidades relativas aos procedimentos médicos a serem alcançadas pelos estudantes de Medicina de graduação em nossa instituição e teve como objetivo sistematizar a sua distribuição na matriz curricular.

BACKGROUND: There is little discussion in the literature about which medical procedures students must be able to perform at the end of a medical course and at which point of the school curriculum they must be inserted. METHODOLOGY: A commission of specialists from different medical areas organized a list of possible diagnostic and therapeutic medical procedures, suggested by studies and group debates and followed the Brazilian curricular guidelines of 2001. Following group consensus with approval by over 75% of the commission members, the procedures that should actually be part of the school curriculum were defined. RESULTS: Over 50 medical procedures were grouped according to the level of complexity expected of the undergraduate student at the end of medical course. Once these were defined, they were distributed in the curricular grid and split into distinct learning times of the cognitive and motor domains. CONCLUSION: This study presented a proposal to define the competencies and skills relative to medical procedures to be attained by the undergraduate medicine students at our institution, with the objective of systematizing their distribution in the curricular matrix.

Presencia de los padres en procedimientos médicos invasivos realizados a sus hijos. Opinión de profesionales uruguayos de la salud / Parental presence in invasive medical procedures performed on their children. Review by Uruguayan health professionals

Padres y niños uruguayos quieren estar presentes y ser acompañados en los procedimientos médicos. Objetivo: conocer la opinión de los profesionales de la salud uruguayos respecto a la presencia de los padres durante la realización de procedimientos realizados a sus hijos. Metodología: encuesta anónima, entregada en el Congreso Uruguayo de Pediatría, agosto 2011. Incluía preguntas relativas a si permitían, estimulaban o consideraban conveniente la presencia de padres junto a sus hijos durante procedimientos y sus razones. Resultados: 171 respuestas. Médicos 74%, enfermeros 26%. Permitían la presencia durante punción venosa (PV): 88%; sutura (S): 82%; punción lumbar (PL): 45%; intubación orotraqueal (IOT): 10% y reanimación cardiopulmonar (RCP): 10%. Estimulaban: PV: 79%; S: 76%; PL: 36%; IOT: 7%; RCP: 9%. Consideraba conveniente: PV: 91%; S: 88%; PL: 53%; IOT: 24%; RCP: 25%. Razones: a) para permitir y estimular fueron: apoyo emocional al niño y es su derecho y b) para no permitir ni estimular: los padres no soportarían la situación, generarían ansiedad en el equipo. Respecto a quién debe tomar la decisión de la presencia de padres: 68% incluyen al médico, 24% incluyen al niño. Discusión: a mayor invasividad de los procedimientos, los profesionales permiten y estimulan en menor medida la participación de los padres. Se considera poco la opinión de los niños. Más de la mitad de los profesionales no recibió información ni formación al respecto. Conclusiones: es necesario que las instituciones educativas incluyan capacitación sobre: derechos de los niños y trabajo asertivo con inclusión activa de los padres en la atención pediátrica...

Preparação psicológica de pacientes submetidos a procedimentos cirúrgicos / Psychological preparation in patients undergoing surgical procedures

Este trabalho tem por objetivo identificar, entre artigos publicados em periódicos indexados pelo PubMed/MedLine, informações sobre as principais modalidades e efeitos de intervenção psicossocial em procedimentos pré e pós-operatórios com pacientes adultos, bem como, apontar algumas lacunas na produção científica acerca do tema. Foram selecionados 32 artigos, sendo oito teórico-conceituais e 24 empíricos, dos quais um era estudo de caso, nove se referiam à avaliação específica de efeitos de preparação psicológica e 14 tratavam de temas associados ao contexto de preparação psicológica e cuidados cirúrgicos. As intervenções psicológicas foram divididas em oito categorias, baseadas em características funcionais das respectivas intervenções. Verificou-se uma deficiência de estudos na área de atuação específica da Psicologia, sendo os profissionais de enfermagem e medicina os que mais produziram estudos sobre o tema. Constatou-se, também, a ausência de protocolos sistematizados de intervenção psicológica relacionados a procedimentos cirúrgicos.

This paper aims to identify information on the main types and effects of psychosocial intervention in pre- and post-operative adult patients in articles published in journals indexed by PubMed/MedLine. It also highlights gaps in scientific literature on the subject. We selected 32 articles: eight theoretical and 24 empirical. One of these was a case study; nine referred to the evaluation of the effects of psychological preparation; and 14 dealt with issues related to the context of psychological preparation and surgical care. Psychological interventions were divided into eight general categories, based on functional characteristics. We discovered an absence of research in the field of psychology on the subject, with the nursing and medical professions providing more material for study. We also noted an absence of systematised psychological intervention protocols related to surgical procedures.

The Development of Classification System of Medical Procedures in Korea / 예방의학회지

In recent years, the Korean Medical Association has undertaken the feat of establishing the Korean Standard Terminology of Medical Procedures with the dedicated help of 32 medical academic societies. However, because the project is being conducted by several different circles, it has yet to see a clear system of classification. This thesis, therefore, proposes the three principles of scientific properties, usefulness and ideology as the basis for classification system and has developed the Classification System of Medical Procedures in Korea upon their foundation. The methodology and organization of this thesis as follows. First, by adopting scientific classification system of Feinstein(1988), an analysis of the classification systems of the medical procedures in the United States, Japan, Taiwan, Who Was carried out to reveal the framework and the basic principles in each system. Second, the direction of classification system has been constructed by applying the normative principle of medical field in order to show the future direction of the medical field and realize its ideology. Third, a finalized framework for the classification system will be presented as based on the direction of classification system. Of the three basis principles mentioned above, the analysis on the principles of usefulness was left out of this thesis due to the difficulty of establishing specific standards of analysis. The results of the study are as follows. The overall structure of the thesis is aimed at showing the 'Prevention-Therapy-Rehabilitation' quality of comprehensive health care and consists of six chapters; I. Prevention and Health Promotion. II. Evaluation and Management . III. Diagnostic Procedures. IV. Endoscopy. V. Therapeutic Procedures. VI. Rehabilitation. Chapter three Diagnostic Procedures is divided into four parts; Functional Diagnosis, Visual Diagnosis, Pathological Diagnosis, Biopsy and Sampling. Chapter five Therapeutic Procedures is divided into Psychiatry, Non-Invasive Therapy, Invasive Therapy, Anaesthesia and Radiation Oncology. Of these sub-divisions, Functional Diagnosis, Biopsy and Sampling, Endoscopy and Invasive Therapy employs the anatomical system of classification. On the other hand, Visual Diagnosis, Pathological Diagnosis, Anesthesia and Diagnostic Radiology, namely those divisions in which there is little or no overlapping in services with other divisions, used the classification system of its own division. The classification system introduced in this thesis can be further supplemented through the use of the cluster analysis by incorporating the advice and assistance of other specialists.