História da construção de saberes em enfermagem traumato-ortopédica / History of knowledge construction in trauma and orthopedic nursing care / Historia de la construcción del conocimiento en enfermería traumatológica ortopédica

Objetivo: analisar o desenvolvimento da enfermagem traumato-ortopédica a partir da primeira turma de residentes de um hospital especializado. Método: o estudo seguiu a metodologia histórica com abordagem qualitativa. As fontes foram documentos escritos e orais. Resultados: trabalhar em uma instituição especializada foi o ponto de partida para a busca por especialização de enfermeiras atuantes no cuidado traumato-ortopédico, que perceberam o saber/poder adquirido no trabalho assistencial, além da intenção de qualificar a assistência e elevar o hospital a instituto. Estratégias empregadas reúnem a busca por parcerias com instituições universitárias e associativas, além da criação de uma associação própria. Considerações finais: a enfermagem traumato-ortopédica ampliou seu espaço científico ao criar um curso de especialização com uma unidade acadêmica. Foi possível delimitar o poder acadêmico e institucional da enfermagem na instituição de saúde pela formação de enfermeiras especialistas constituindo um grupo de reconhecido pelo saber científico.

Objective: to analyze the development of trauma and orthopedic nursing care from the very first class of residents of a specialized hospital. Method: historical methodology study with a qualitative approach. The sources consisted of written and oral documents. Results: working in a specialized institution was the starting point for nurses who were seeking specialization in the field of trauma and orthopedic care as they noticed the power-knowledge acquired through care work, plus they were willing to improve assistance and take the hospital up to an institute level. Strategies used include the search for partnerships with universities and associative-type institutions, in addition to creating their own association. Final considerations: trauma and orthopedic nursing care expanded its scientific space by creating a specialization course together with an academic unit. It was possible to define the academic and institutional power of the nursing staff in the health institution by considering the training process of its nurse specialists, who consisted of a group recognized for their scientific knowledge.

Objetivo: analizar el desarrollo de la enfermería traumatológica ortopédica a partir del primer grupo de residentes de un hospital especializado. Método: estudio con metodología histórica con un enfoque cualitativo. Las fuentes fueron documentos escritos y orales. Resultados: el trabajo en una institución especializada fue el punto de partida para la búsqueda de la especialización de las enfermeras que trabajaban en la atención traumatológica ortopédica, quienes notaron el saber/poder adquirido en el trabajo asistencial, además de la intención de cualificar la atención y elevar el hospital al nivel de instituto. Las estrategias empleadas incluyen la búsqueda de alianzas con instituciones universitarias y asociaciones, y la creación de una asociación propia. Consideraciones finales: la enfermería traumatológica ortopédica amplió su espacio científico mediante la creación de un curso de especialización con una unidad académica. Se logró delimitar el poder académico e institucional de la enfermería en la institución de salud a través de la formación de enfermeros especialistas, que es un grupo reconocido por el conocimiento científico.

La gestión de la calidad y la acreditación ISO 15189 en los laboratorios clínicos de Latinoamérica / Quality management and ISO 15189 accreditation in clinical laboratories in Latin America / Gestão da qualidade e acreditação ISO 15189 nos laboratórios clínicos da América Latina

Resumen El presente trabajo fue realizado por el Grupo de Trabajo Gestión de Acreditación de la Confederación Latinoamericana de Bioquímica Clínica (COLABIOCLI) con el objetivo de conocer el estado de los Laboratorios Clínicos (LC) con respecto a la gestión de la calidad y el estatus de la acreditación ISO 15189 en Latinoamérica. La investigación fue de tipo observacional, transversal y descriptiva; se utilizó como herramienta la encuesta y como instrumento el cuestionario. Los resultados se expresaron en frecuencias simples y porcentajes y se analizaron por estadística descriptiva. En las 253 encuestas aceptadas participaron LC de 15 de 16 países integrantes de COLABIOCLI. El 80% de los LC tenían procedimientos de la fase preanalítica y posanalítica. Más del 85% contaba con registros de gestión de la calidad y participaban en programas de evaluación externa de la calidad (PEEC), principalmente en las disciplinas de química clínica (mayor del 80%) y hematología (mayor del 70%). El 7,51% estaban acreditados por ISO 15189 y 10,27% certificados por ISO 9001. La gestión de la calidad y los PEEC presentan un importante avance en los LC de Latinoamérica; sin embargo, es deseable que todas las partes interesadas armonicen intereses, para que este proceso sea introducido paulatinamente y como parte de las normativas y/o regulaciones obligatorias respectivas, lo que podrá contribuir a que más LC se acrediten en base a ISO 15189 en la región.

Abstract The present work was carried out by the Accreditation Management Working Group of the Latin American Confederation of Clinical Biochemistry (COLABIOCLI) with the aim of knowing the status of Clinical Laboratories (LC, for its acronym in Spanish) with respect to quality management and the status of the ISO 15189 accreditation in Latin America. The research was observational, cross-sectional, and descriptive, using the survey as a tool and the questionnaire as an instrument. The results were expressed in simple frequencies and percentages and analysed by descriptive statistics. LCs from 15 of the 16 member countries of COLABIOCLI participated in the 253 surveys accepted. Eighty percent of LCs had pre-analytical and post-analytic procedures, and more than 85% had quality management records and participated in external quality assessment services (EQAS), mainly in the disciplines of clinical chemistry (greater than 80%) and hematology (greater than 70%); 7.51% were ISO 15189 accredited and 10.27% ISO 9001 certified. Although quality management and EQAS represent an important advance in LCs in Latin America, it is desirable that all stakeholders harmonise interests, so that this process is introduced gradually and as part of the respective mandatory standards and/or regulations, thus contributing to more LCs being accredited based on ISO 15189 in the region.

Resumo O presente trabalho foi realizado pelo Grupo de Trabalho de Gestão de Acreditação da Confederação Latino-Americana de Bioquímica Clínica (COLABIOCLI) com o objetivo de conhecer o status dos Laboratórios Clínicos (LC) com relação à gestão da qualidade e o status da acreditação ISO 15189 na América Latina. A pesquisa foi observacional, transversal e descritiva, utilizando a enquete como ferramenta e o questionário como instrumento. Os resultados foram expressos em frequências simples e porcentagens e analisados por estatística descritiva. LCs de 15 dos 16 países membros do COLABIOCLI participaram das 253 pesquisas aceitas; 80% dos LCs tinham procedimentos da fase pré-analítica e pós-analítica, e mais de 85% tinham registros de gestão da qualidade e participavam de programas de avaliação externa da qualidade (PEEC), principalmente nas disciplinas de química clínica (maior de 80%) e hematologia (maior de 70%); 7,51% estavam acreditados pela ISO 15189 e 10,27% certificados pela ISO 9001. Embora a gestão da qualidade e os PEECs apresentem um importante avanço nos LCs da América Latina, é desejável que todas as partes interessadas harmonizem interesses, para que esse processo seja introduzido gradualmente e como parte das respectivas normas e/ou regulações obrigatórias, o que poderá contribuir para que mais LCs sejam acreditados com base na ISO 15189 na região.

Sistemas de acreditación de programas de formación en partería profesional en el mundo: una revisión de alcance / Accreditation systems for midwifery training programs worldwide: a scoping review

La acreditación de programas de formación de partería profesional pretende mejorar la calidad de la educación y la atención en obstetricia. El objetivo del estudio fue realizar un diagnóstico de los sistemas de acreditación de programas de partería en el mundo, identificando características, estándares y diferencias. Se realizó una revisión de alcance según marco de Arksey y O'Malley, mediante búsqueda en bases de datos, literatura gris y páginas web de sistemas de acreditación. Se identificaron 2574 artículos y 198 páginas web relacionados con la acreditación en educación, seleccionando 47 que abordaban programas de partería. Los resultados muestran que, si bien existe un sistema global de acreditación en partería de la Confederación Internacional de Matronas, ha sido escasamente utilizado. Asimismo, existe una heterogeneidad notable en los sistemas de acreditación, con países de mayor ingreso teniendo sistemas más robustos y específicos, mientras que en países de menor ingreso, la acreditación es menos común y a menudo depende de apoyo internacional. La diversidad en los sistemas de acreditación refleja variadas necesidades, recursos y enfoques culturales, lo cual genera la necesidad de estandarización y mejora global de los sistemas de acreditación. Fortalecer el sistema de acreditación de la Confederación Internacional de Matronas como sistema global, con estándares adaptables a cada país o región según sus contextos locales, podría ser clave para avanzar en la profesionalización y reconocimiento de la partería a nivel mundial.

Accreditation of midwifery training programs aims to improve the quality of midwifery education and care. The study aimed to diagnose the accreditation systems of midwifery programs worldwide, identifying characteristics, standards, and differences. According to Arksey and O'Malley's framework, a scoping review was conducted by searching databases, grey literature, and accreditation system websites. A total of 2574 articles and 198 websites related to education accreditation were identified, selecting 47 that addressed midwifery programs. The results show that while a global accreditation system in midwifery from the International Confederation of Midwives exists, it has been scarcely used. There is considerable heterogeneity across accreditation systems, with higher-income countries having more robust and specific systems. In contrast, accreditation is less common in lower-income countries and often depends on international support. The diversity across accreditation systems reflects differing needs, resources, and cultural approaches. The need for standardization and global improvement of accreditation systems is highlighted. Strengthening the International Confederation of Midwives accreditation system as a global system, with standards adaptable to each country or region according to their local contexts, could be key to advancing the professionalization and recognition of midwifery worldwide.

Avaliação estrutural das unidades de atenção integral às doenças inflamatórias intestinais no Brasil / Structural evaluation of inflammatory bowel disease comprehensive care units in brazil

ABSTRACT Background: The most efficient way to prevent complications from inflammatory bowel disease (IBD) is to provide patients with optimized care. Nonetheless, in Brazil, there is no validated methodology for evaluating health services recognized as comprehensive care units (CCU), making it difficult to assess the quality of care provided. Objective: To understand the current scenario, map the distribution of centers and identify strengths and weaknesses, considering local and regional characteristics. Methods: The study was carried out in three phases. Initially, the Brazilian Organization for Crohn's disease and colitis (GEDIIB) developed 22 questions to characterize CCU in Brazil. In the second phase, all GEDIIB members were invited to respond to the survey with the 11 questions considered most relevant. In the last phase, an interim analysis of the results was performed, using the IBM SPSS Statistics v 29.0.1.0 software. Descriptive statistics were used to characterize the center's profile. The chi-square test was used to compare categorical variables. Results: There were 53 responses from public centers (11 excluded). Most centers were concentrated in the Southeastern (n=22/52.4%) and only 1 (2.4%) in the Northern region of Brazil. Thirty-nine centers (92.9%) perform endoscopic procedures, but only 9 (21.4%) have access to enteroscopy and/or small bowel capsule endoscopy. Thirty-three centers (78.6%) offer infusion therapy locally, 26 (61.9%) maintain IBD patient records, 13 (31.0%) reported having an IBD nurse, 34 (81.0%) have specific evidence-based protocols and only 7 (16.7%) have a patient satisfaction methodology. In the private scenario there were 56 responses (10 excluded). There is also a concentration in the Southeastern and Southern regions. Thirty-nine centers (84.8%) have access to endoscopic procedures and 19 perform enteroscopy and/or small bowel capsule endoscopy, more than what is observed in the public environment. Infusion therapy is available in 24 centers (52.2%). Thirty-nine centers (84.8%) maintain a specific IBD patient database, 17 (37%) have an IBD nurse, 36 (78.3%) have specific evidence-based protocols, and 22 (47. 8%) apply a patient satisfaction methodology. Conclusion: IBD CCU in Brazil were mainly located in the Southeastern and Southern regions of the country. Most centers have dedicated multidisciplinary teams and IBD specialists. There is still a current need to improve the proportion of IBD nurses in IBD care in Brazil.

RESUMO Contexto: A forma mais eficiente de prevenir complicações da doença inflamatória intestinal (DII) é proporcionar aos pacientes cuidados otimizados. Contudo, no Brasil não existe uma metodologia validada para avaliação de serviços de saúde reconhecidos como unidades de atenção integral (UAI), dificultando a avaliação da qualidade da assistência prestada. Objetivo: Compreender o cenário atual, mapear a distribuição dos polos e identificar pontos fortes e fracos, considerando as características locais e regionais. Métodos: O estudo foi realizado em três fases. Inicialmente, a Organização Brasileira para Doença de Crohn e Colite (GEDIIB) desenvolveu 22 questões para caracterizar as UAI no Brasil. Na segunda fase, todos os membros do GEDIIB foram convidados a responder ao inquérito com as 11 questões consideradas mais relevantes. Na última fase foi realizada uma análise dos resultados, utilizando o software IBM SPSS Statistics v 29.0.1.0. Estatísticas descritivas foram utilizadas para caracterizar o perfil do centro. O teste qui-quadrado foi utilizado para comparar variáveis categóricas. Resultados: Houve 53 respostas de centros públicos (11 excluídas). A maioria das UAI concentrou-se na região sudeste (n=22/52,4%) e apenas 1 (2,4%) na região norte do Brasil. Trinta e nove centros (92,9%) realizam procedimentos endoscópicos, mas apenas 9 (21,4%) têm acesso à enteroscopia e/ou cápsula endoscópica. Trinta e três centros (78,6%) oferecem terapia de infusão localmente, 26 (61,9%) mantêm registros de pacientes com DII, 13 (31,0%) relataram ter uma enfermeira para DII, 34 (81,0%) têm protocolos específicos baseados em evidências e apenas 7 (16,7%) %) possuem uma metodologia de satisfação do paciente. No cenário privado houve 56 respostas (10 excluídas). Há também concentração nas regiões sudeste e sul. Trinta e nove centros (84,8%) têm acesso a procedimentos endoscópicos e 19 realizam enteroscopia e/ou cápsula endoscópica, mais do que o observado no ambiente público. A terapia infusional está disponível em 24 centros (52,2%). Trinta e nove centros (84,8%) mantêm um banco de dados específico de pacientes com DII, 17 (37%) têm uma enfermeira para DII, 36 (78,3%) têm protocolos específicos baseados em evidências e 22 (47,8%) aplicam uma metodologia de satisfação do paciente. Conclusão: As UAI do DII no Brasil estavam localizadas principalmente nas regiões sudeste e sul do país. A maioria dos centros possui equipes multidisciplinares dedicadas e médicos com experiencia em DII. Ainda há uma necessidade atual de melhorar a proporção de enfermeiros no tratamento de DII no Brasil.

Educação permanente para qualidade e segurança do paciente em hospital acreditado / Educación permanente para calidad y seguridad del paciente en hospital acreditado / Permanent education for quality and patient safety in an accredited hospital

Resumo Objetivo Compreender os desafios enfrentados pela educação permanente para o alcance da melhoria da qualidade e da segurança do paciente em um hospital público submetido à acreditação hospitalar. Métodos Estudo descritivo, transversal e com abordagem qualitativa. Realizaram-se entrevistas semiestruturadas com 22 profissionais, durando, em média, 22 minutos, as quais posteriormente foram analisadas e interpretadas por meio da análise de conteúdo temática de Bardin. Adotaram-se os softwares Iramuteq para a análise de corpus textual, e o BioEstat 5.3, para análise do perfil dos participantes. A coleta de dados ocorreu em junho de 2022, após aprovação nos Comitês de Ética em Pesquisa. Resultados Aplicou-se a análise de classificação hierárquica descendente, gerada pelo Iramuteq. Obtiveram-se três categorias: Desafios da Educação Permanente mediante o Processo de Melhoria Contínua; Educação Permanente para a Promoção da Qualidade e da Segurança do Paciente no Contexto da Acreditação Hospitalar; e Estratégias Educativas para a Melhoria da Qualidade e da Segurança do Paciente. Conclusão Identificaram-se desafios inerentes às ações de educação permanente em saúde, tais como resistência à mudança de cultura, adesão às atividades, alta rotatividade de profissionais e dificuldade para liberação da equipe de enfermagem para participar das atividades relacionadas à demanda de trabalho.

Resumen Objetivo Comprender los desafíos enfrentados por la educación permanente para lograr mejorar la calidad y la seguridad del paciente en un hospital público sometido a acreditación hospitalaria. Métodos Estudio descriptivo, transversal y con enfoque cualitativo. Se realizaron entrevistas semiestructuradas a 22 profesionales, con duración promedio de 22 minutos, que luego se analizaron e interpretaron mediante el análisis de contenido temático de Bardin. Se utilizaron los softwares Iramuteq para el análisis de corpus textual y BioEstat 5.3 para el análisis del perfil de los participantes. La recopilación de datos se llevó a cabo en junio de 2022, después de la aprobación de los Comités de Ética en Investigación. Resultados Se aplicó el análisis de clasificación jerárquica descendente, generado por Iramuteq. Se obtuvieron tres categorías: Desafíos de la educación permanente mediante el proceso de mejora continua, Educación permanente para la promoción de la calidad y de la seguridad del paciente en el contexto de la acreditación hospitalaria, y Estrategias educativas para la mejora de la calidad y la seguridad del paciente. Conclusión Se identificaron desafíos inherentes a las acciones de educación permanente en salud, tales como resistencia a cambios de cultura, adherencia a las actividades, alta rotación de profesionales y dificultad de autorizar al equipo de enfermería para participar en las actividades relacionadas con la demanda de trabajo.

Abstract Objective To understand the challenges faced in terms of permanent education in health, for achieving quality improvements and patient safety at a public hospital undergoing hospital accreditation. Methods This was a descriptive, cross-sectional study with a qualitative approach. Semi-structured interviews were conducted with 22 professionals, lasting an average of 22 minutes. The interviews were subsequently analyzed and interpreted using Bardin's thematic content analysis. The software Iramuteq was used to analyze the textual corpus, and BioEstat 5.3 was used to analyze the profile of the participants. The data collection took place in June 2022, following approval by the Research Ethics Committees. Results The descending hierarchical classification analysis, generated by Iramuteq, was applied, resulting in three categories: Challenges of Permanent Education through the Continuous Improvement Process, Permanent Education for the Promotion of Quality and Patient Safety in the Context of Hospital Accreditation, and Educational Strategies for Improving Quality and Patient Safety. Conclusion Challenges inherent to the actions of permanent education in health were identified, such as resistance to cultural change, adherence to activities, high turnover of professionals, and difficulty in releasing the nursing team to participate in activities, due to work demand.

Enfoque estratégico para la acreditación de la especialidad de Higiene y Epidemiología en Villa Clara / Strategic approach for the accreditation of the Hygiene and Epidemiology specialty in Villa Clara

La epidemiología es una ciencia básica de la Salud Pública porque sus fundamentos científicos permiten la toma de decisiones en los problemas de salud. Para controlar la calidad de la formación de los profesionales y perfeccionarla, se aplica el sistema de acreditación de escenarios docentes, proceso de gran importancia que garantiza la calidad del pregrado y el posgrado. En la Universidad de Ciencias Médicas de Villa Clara se realizó dicho proceso en la especialidad de Higiene y Epidemiología, fue utilizada la autoevaluación estratégica del escenario laboral como actividad previa. El interés de los autores es exponer el método seguido para cumplir con los requerimientos establecidos. Con la aplicación de esta matriz estratégica para lograr el estado deseado en el proceso docente de la especialidad de Higiene y Epidemiología en la Universidad de Ciencias Médicas de Villa Clara se logró una evaluación de excelente.

Epidemiology is a basic science of Public Health because its scientific foundations make possible decision-making regarding health problems. To control the training quality for professionals and improve it, the accreditation system for teaching scenarios is applied, a very important process that guarantees the quality of undergraduate and postgraduate training. At the University of Medical Sciences of Villa Clara, in the specialty of Hygiene and Epidemiology, this process was carried out; the strategic self-assessment of the work scenario as a prior activity, was used. To expose the method followed to comply with the established requirements, is the aim of the authors. By using this strategic matrix to achieve the desired state in the teaching process of the specialty of Hygiene and Epidemiology at the University of Medical Sciences of Villa Clara, an excellent evaluation was achieved.

Retomada à acreditação hospitalar no "pós-pandemia" da covid-19: perspectivas de lideranças / Resumption of hospital accreditation in the 'post-covid-19 pandemic' era: leadership perspectives / Reanudación de la acreditación hospitalaria tras la pandemia de covid-19: perspectivas de liderazgo

RESUMO Objetivo: compreender as perspectivas de lideranças sobre a retomada ao processo de Acreditação Hospitalar no contexto da "pós-pandemia" da COVID-19. Método: estudo de caso, qualitativo, desenvolvido em um hospital universitário de grande porte de Porto Alegre (RS), Brasil. A coleta de dados ocorreu com 10 lideranças estratégicas de agosto a setembro de 2022 por meio de uma entrevista semiestruturada. Empregou-se a Análise de Conteúdo Temática. Resultados: emergiram três categorias, a saber: "Mudanças e estratégias do hospital demandadas pela pandemia da COVID-19"; "Desafios da gestão da qualidade e segurança do paciente advindas do contexto pandêmico"; e, "Gerenciamento da retomada do processo de Acreditação Hospitalar pós-pandemia". Conclusão: a crise sanitária da COVID-19 impôs entraves para os processos antes bem sedimentados. As lideranças reconheceram a exaustão das equipes e trabalharam no sentido de motivar as pessoas e a capilarizar as informações necessárias ao êxito da recertificação de qualidade.

ABSTRACT Objective: To understand leaders' perspectives on the resumption of the Hospital Accreditation process in the context of the "post-pandemic" of COVID-19. Method: A qualitative case study was carried out in a large university hospital in Porto Alegre (RS), Brazil. Data was collected from 10 strategic leaders from August to September 2022 through a semi-structured interview. Thematic Content Analysis was used. Results: Three categories emerged: "Hospital changes and strategies demanded by the COVID-19 pandemic"; "Quality management and patient safety challenges arising from the pandemic context"; and, "Managing the resumption of the post-pandemic Hospital Accreditation process". Conclusion: The COVID-19 health crisis has imposed obstacles on previously well-established processes. The leadership recognized the exhaustion of the teams and worked to motivate people and spread the information necessary for the success of the quality recertification.

RESUMEN Objetivo: Conocer las perspectivas de los líderes sobre la reanudación del proceso de Acreditación Hospitalaria en el contexto de la "post-pandemia" de COVID-19. Método: estudio de caso cualitativo realizado en un gran hospital universitario de Porto Alegre (RS), Brasil. Se recogieron datos de 10 líderes estratégicos entre agosto y septiembre de 2022 mediante una entrevista semiestructurada. Se utilizó el análisis de contenido temático. Resultados: urgieron tres categorías: "Cambios y estrategias hospitalarias exigidos por la pandemia COVID-19"; "Gestión de la calidad y retos para la seguridad del paciente derivados del contexto pandémico"; y, "Gestión de la reanudación del proceso de Acreditación Hospitalaria pospandémica". Conclusión: La crisis sanitaria COVID-19 ha impuesto obstáculos a procesos previamente bien establecidos. La dirección reconoció el agotamiento de los equipos y trabajó para motivar a la gente y difundir la información necesaria para el éxito de la recertificación de la calidad.

Evaluación del impacto del programa de maestría Medios Diagnósticos en la universidad médica matancera / Impact Assessment of the Program of the Master's Degree in Diagnostic Means from the Matanzas Medical University

Introducción: El posgrado en salud, en especial el desarrollo de los programas de maestrías, constituye fuente de investigación para la evaluación del impacto, por la importancia que reviste para la calidad académica y la mejora continua de los programas de formación. Objetivo: Evaluar el impacto que produce a nivel individual, institucional y social-comunitario el programa de la maestría Medios Diagnósticos de la Universidad de Ciencias Médicas de Matanzas. Métodos: Se realizó un proyecto de evaluación de impacto, analítico, longitudinal y prospectivo, durante el período comprendido entre 2019 y 2022, con la aplicación de un procedimiento seleccionado que permitió demostrar la calidad del programa de la maestría objeto de estudio. Se aplicaron métodos teóricos, empíricos y estadísticos para determinar la calidad del programa de formación y sus transformaciones. Resultados: La evaluación del impacto de la maestría permitió conocer elementos esenciales para el desarrollo del programa en la institución y los rasgos que caracterizan los procedimientos existentes para dicho fin; asimismo, se obtuvo información relevante sobre la influencia del programa y las transformaciones obtenidas a nivel personal, institucional y social-comunitario. Conclusiones: La evaluación del impacto de la maestría objeto de estudio, con la aplicación del procedimiento seleccionado, constituyó una vía pertinente para medir los resultados del programa y su influencia en el desarrollo personal, institucional y en lo social-comunitario, lo que permitió la retroalimentación para la mejora continua del programa de formación(AU)

Introduction: Health postgraduate studies, especially the development of master's degree programs, are sources of research for assessing impact, due to their importance for academic quality and the continuous improvement of training programs. Objective: To assess the impact at the individual, institutional and social-community level produced by the program of the master's degree in Diagnostic Means from the Universidad de Ciencias Médicas de Matanzas. Methods: An analytical, longitudinal and prospective project for assessing impact was carried out during the period from 2019 to 2022, with the application of a selected procedure that allowed demonstrating the quality of the master's degree program under study. Theoretical, empirical and statistical methods were applied to determine the quality of the training program and its transformations. Results: The assessment of the impact of the master's degree program made it possible to know essential elements for the development of the program at the institution and the features that characterize the existing procedures for that purpose; likewise, relevant information was obtained on the influence of the program and the transformations obtained at the personal, institutional and social-community levels. Conclusions: The assessment of the impact of the master's degree under study, with the application of the selected procedure, was a pertinent way to measure the outcomes of the program and its influence on personal, institutional and social-community development, which allowed feedback for the continuous improvement of the training program(AU)

Facilitating quality improvement by implementing quality accreditation standards at primary health care centre in Panvel taluka of Raigad district Maharashtra

Background: The Indian public health standard and Kayakalp guidelines are the main driver for continuous improvement in quality and bench mark for assessing the functional and cleanliness status of health facilities. Objectives were to assess PHC on IPHS and Kayakalp standard for continuous quality improvement. To conduct baseline and peer assessment of quality parameters using Indian public health standards and Kayakalp standard at primary health centre. To perform gap analysis and suggest quality improvement measures for meeting accreditation standards. To establish public private partnership for strengthening health services at PHC level. Methods: Descriptive observational study was conducted from September 2022 to June 2023 at Ajiwali PHC-Panvel taluka was selected using simple random sampling technique. Sample size of 83 patients was calculated as per the monthly case load of PHC. IPHS and Kayakalp assessment checklist, patient satisfaction forms were used for the survey. Various statistical tests like frequency, mean, percentage, S.E of difference between two proportions and two means were applied. Results: Kayakalp checklist baseline assessment score was 52.5% while post assessment score 72.5% showing significant improvement. Patient satisfaction survey pre and post assessment shows significant improvement where p value was <0.001 which was highly significant. IPHS survey shows partial improvement in training and quality parameters while other indicator remained the same. Conclusions: Regular quality assessment and accreditation leads to continuous quality improvement. Training and capacity building of PHC staff should be undertaken at regular intervals. Public private partnership modelling for various departments or service delivery components should be undertaken.

Importancia de la acreditación internacional de facultades de medicina

A partir de 2024, egresados de facultades de medicina que deseen hacer estudios de postgrado en los EE.UU o el Canadá, deberán graduarse en escuelas de medicina con programas educativos de calidad avalados por agencias reconocidas capaces de otorgar una acreditación internacional. La World Federation for Medical Education (WFME) es una de estas agencias. La WFME aceptó la nueva política de acreditación del Educational Committee for Foreign Medical Education (ECFMG) por la que médicos que postulen para la certificación del ECFMG del 2024 en adelante, tendrán que haberse graduado en un centro universitario de medicina acreditado por una agencia de aseguramiento de calidad que se encuentre reconocida por la WFME. El COMAEM (Consejo Mexicano para la Acreditación de la Educación Médica) está avalado por la WFME y otros organismos internacionales que aseguran la calidad de la educación superior. La acreditación que concede el COMAEM es un reconocimiento que el programa de medicina cumple con los criterios, indicadores y parámetros de calidad establecidos por este organismo. A partir de 2024, los egresados de un programa acreditado podrán postular para la certificación del ECFMG a través del examen de licencia médica de los Estados Unidos o USMLE (United States Medical Licensing Examination) y así poder hacer una residencia de especialización o trabajar en EE. UU. En el Perú, solo la Facultad de Medicina Alberto Hurtado de la Universidad Peruana Cayetano Heredia ha completado el proceso de acreditación internacional a través de COMAEM y ha recibido dicha acreditación.

As of 2024, medical school graduates who wish to pursue graduate studies in the U.S. or in Canada, they must have graduated from medical schools with quality educational programs endorsed by recognized agencies, capable of granting international accreditation. The World Federation for Medical Education (WFME) is one of these agencies. The WFME accepted the new accreditation policy of the Educational Committee for Foreign Medical Education (ECFMG) whereby physicians applying for ECFMG certification from 2024 onwards, must have graduated from a university medical center accredited by a quality assurance agency that is recognized by the WFME. The COMAEM (Mexican Council for the Accreditation of Medical Education) is endorsed by the WFME and other international organizations that ensure the quality of higher education. The accreditation granted by COMAEM is a recognition that the medical program meets the criteria, indicators and quality parameters established by this organization. Starting in 2024, graduates of an accredited program will be able to apply for ECFMG certification through the United States Medical Licensing Examination (USMLE) and thus be able to do a specialty residency or work in the U.S. In Peru, only the Alberto Hurtado School of Medicine of the Cayetano Heredia Peruvian University has completed the international accreditation process through COMAEM and has received such accreditation.

Trayectoria de innovación integral en el Centro Nacional de Cirugía de Mínimo Acceso

Introducción: La innovación en la atención de la salud es una fuerza impulsora en la búsqueda de un equilibrio entre la limitación de costos y la calidad de la atención médica y, en la actualidad, emerge como paradigma la innovación integral que no descuida ninguna de sus dimensiones y se desarrolla en sus distintos niveles: de país, de institución y de las personas que la llevan a vías de hecho. Objetivo: Estudiar la trayectoria de innovación que, con un enfoque integral, ha llevado al Centro Nacional de Cirugía de Mínimo Acceso a convertirse en obligada referencia cuando se habla de instituciones hospitalarias con un alto nivel de calidad del servicio que se presta, en pro de la salud pública del país. Posicionamiento: La innovación integral, que combina la introducción de tecnologías médicas con innovaciones organizacionales en sistemas de gestión, permite alcanzar resultados importantes en la calidad de la atención médica y la formación de profesionales competentes en procederes terapéuticos y quirúrgicos mínimamente invasivos. Conclusiones: El análisis realizado permitió definir cuatro etapas en la trayectoria de innovación del Centro Nacional de Cirugía de Mínimo Acceso: Núcleo (1980-1992), Fundación (1993-2005), Consolidación (2006-2015), Acreditación y Certificación (2016-2022). Se caracterizan los elementos esenciales de cada etapa hasta llegar a la actual, en la que se logra que los resultados de la innovación organizacional y en tecnologías médicas del centro sean reconocidos en diferentes instancias y contribuyan a brindar servicios de salud de alta calidad.

Introduction: Innovation in health care is a driving force in the search for a balance between cost limitation and quality of medical care; today comprehensive innovation that does not neglect any of its dimensions, emerging as a paradigm. It is developed at its different levels: country, institution and the people who take it to reality. Objective: To study the trail of innovation that, with a comprehensive approach, has led the National Center for Minimum Access Surgery to become an unavoidable reference when talking about hospital institutions with a high level of quality of service, in favor of the public health of the country. Positioning: Comprehensive innovation, which combines the introduction of medical technologies with organizational innovations in management systems, allows achieving important results in the quality of medical care and the training of competent professionals in minimally invasive therapeutic and surgical procedures. Conclusions: The analysis carried out allowed us to define four stages in the innovation trajectory of the National Center for Minimum Access Surgery: Nucleus (1980-1992), Foundation (1993-2005), Consolidation (2006-2015), Accreditation and Certification (2016- 2022). The essential elements of each stage are characterized up to reaching the current one, in which the results of this institution's organizational innovation and medical technologies are recognized at different instances, and they contribute to providing high-quality health services.

Perspectivas teóricas para un enfoque dialógico de la acreditación de posgrado en México

Los procesos de acreditación se ubican en el marco de las megatendencias globales que colocan en el centro del debate las nociones excelencia y evaluación de la calidad en las instituciones de educación superior contemporáneas. El estudio se realiza en la Benemérita Universidad Autónoma de Puebla, parte de un enfoque cualitativo en el que el método análisis de contenidos ocupó el centro de las acciones para develar desde las epistemologías globales y regionales, las regularidades que se manifiestan en la dinámica de los procesos de acreditación con énfasis en las instituciones de educación mexicana. La unidad de análisis se ubica en los documentos normativos, foros e informes de buenas prácticas en el quehacer de la acreditación. Como resultado, se proponen las bases conceptuales que favorecen una dialógica en el proceso de evaluación aplicada a los programas de posgrado mexicano, el cual, con las adecuaciones necesarias podría aplicarse a otras universidades.

Accreditation processes are located within the framework of global megatrends that place the notions of excellence and quality assessment in contemporary higher education institutions at the center of the debate. The study presented here was carried out at the Benemérita Universidad Autónoma de Puebla, based on a qualitative approach in which the content analysis method was at the center of the actions to unveil from the global and regional epistemologies regularities that are manifested in the dynamics of accreditation processes with emphasis on Mexican educational institutions. The unit of analysis is located in the normative documents, forums and reports of good practices in accreditation. As a result, conceptual bases are proposed that can favor a dialogic in the evaluation process applied to Mexican graduate programs, which, with the necessary adaptations could be applied to con universities.

El valor de estar acreditados / The value of accreditation

Los laboratorios clínicos desempeñan un papel cada vez más central en el proceso de atención siendo líderes en el campo de la gestión de la calidad de la salud. Desde hace algunos años hay un creciente interés en la mejora de la calidad de aquellas actividades que tienen un alto impacto en la seguridad del paciente. En este contexto la acreditación constituye un recurso estratégico para garantizar un sistema de calidad. En el año 2020 el laboratorio obtiene la acreditación por norma IRAM ISO 15189, siendo el segundo laboratorio público acreditado por un estándar internacional en el país y el primero de un Hospital Pediátrico. Con un alcance inicial que involucra a las áreas de Química, Hematología, Serología, Endocrinología y Biología Molecular, continuamos trabajando para sostener y ampliar este alcance incluyendo entre otras, el área de Microbiología. Nuestra fortaleza más grande: el trabajo en equipo (AU)

Clinical laboratories play an increasingly central role in the care process and are leaders in the field of healthcare quality management. For some years now there has been a growing interest in improving the quality of those activities that have a high impact on patient safety. In this context, accreditation is a strategic resource to warrant the quality of the system. In 2020 the laboratory was granted accreditation by IRAM ISO 15189, being the second public laboratory accredited by an international standard in the country and the first in a pediatric hospital. With an initial coverage involving the areas of Chemistry, Hematology, Serology, Endocrinology, and Molecular Biology, we continue working to sustain and expand this coverage to include, among others, the area of Microbiology. Our greatest strength: teamwork (AU)

Impact of accreditation on knowledge and awareness of laboratory technicians about the aspects of laboratory quality in a tertiary care public-sector teaching hospital

Background: Laboratory diagnosis in Indian health-care setup is usually the mainstay of screening and diagnosis of diseases. Accreditation is a process of approval by establishing adherence of pre-defined quality standards to the existing system which can bring about utmost quality in service delivery by increasing accuracy and reliability and minimizing errors. Need for accreditation is ever-increasing in public sector health-care centers. Aim and Objectives: To ascertain and to quantify the impact of accreditation via training and exposure in the cadre of laboratory technicians in tertiary care public sector hospital. Materials and Methods: It was an interventional study to check competency of laboratory technicians in various domains of NABL standards, before and after training and exposure to accreditation process. It was carried out amongst MLT students and employed laboratory technicians in the clinical biochemistry department of a public sector, tertiary care, teaching hospital and lasted for 2 months. Preformed questionnaire was used. Difference between pre- and post-test results was compared with appropriate statistical analysis. Results: Marked difference was seen in the performance of study subjects before (27.6 ± 9.9) and after (56.7 ± 6.2) exposure to training and accreditation process (Max. score of 80). Average gain was 37.5%. The difference was highly significant for each domain. Domains of pre-analytical, analytical, and post-analytical procedures saw the highest difference. There was a significant difference in competence gain between student lab. techs. and employed lab. techs. Conclusion: Benefits of accreditation are immense, yet it is a voluntary process in our country. Strict adherence to already laid out standards and protocols at national level can be achieved by continuous sensitization and capacity building. Public sector laboratories need to gear up and embrace this need. The same should also be incorporated effectively in the curriculum of laboratory technician students.

La educación de postgrado actual en la neurocirugía de Argentina. Estrategias para su mejoramiento a partir de un análisis FODA / Current postgraduate education in neurosurgery in Argentina. Strategies for its improvement from a SWOT analysis

La educación de postgrado de la neurocirugía en Argentina ha sido una preocupación constante desde el inicio de la especialidad. Actualmente las organizaciones activas en educación de postgrado son la Asociación Argentina de Neurocirugía y el Colegio Argentino de Neurocirujanos. Ambas consideran que la residencia médica es el sistema de formación más apropiado para que un médico recién graduado pueda convertirse en un especialista. Para regular y organizar el desarrollo pedagógico de las mismas se diseñó un marco de referencia en donde se establecieron los estándares a alcanzar, junto con un programa de acreditación para lograr la homogeneidad de los parámetros de calidad, y además se crearon becas junto con el reglamento para su acreditación, para completar la formación en aquellos aspectos que durante la residencia no fueron suficientemente desarrollados. Como la certificación profesional es obligatoria para ejercer se crearon cursos ad hoc que constituyen la base teórica tanto para neurocirugía general como la cirugía de columna. Los postulantes deben completar una serie de requisitos y transitar por diferentes instancias de formación que incluyen, además, la residencia. Para mantener la calidad de la atención médica se creó un programa de revalidación o recertificación periódica. Toda la situación actual fue sometida a un análisis de sus fortalezas, oportunidades, debilidades y amenazas para diseñar las estrategias que permitan mejorarla(AU)

Postgraduate education in neurosurgery has been a constant concern since the beginning of the specialty. Currently active organizations in postgraduate education are the Asociación Argentina de Neurocirugía y el Colegio Argentino de Neurocirujanos. Both consider that medical residency is the most appropriate training system for a recently graduated doctor to become a specialist. To regulate and organize their pedagogical development, a reference framework was designed where the standards to be achieved were established, along with an accreditation program to achieve homogeneity of quality parameters, and fellowships were also created along with the regulations. for its accreditation, to complete the training in those aspects that were not sufficiently developed during the residency. Since professional certification is mandatory to practice, ad hoc courses were created that constitute the theoretical basis for both general neurosurgery and spinal surgery. Applicants must complete a series of requirements and go through different training instances that also include residence. To maintain the quality of medical care, a periodic revalidation or recertification program was created. The entire current situation was subjected to an analysis of its strengths, opportunities, weaknesses and threats to design strategies to improve it(AU)

Research on the Strategy of Improving the Efficiency of Multi-departmental Operation in the Ethics Review System of Traditional Chinese Medicine after CAP Certification / 中国医学伦理学

Capability Accreditation Program of Ethics Review for Chinese Medicine Research (CAP Accreditation) is the first medical ethics certification project in China. Institutions can further improve their ethics review work level after passing the CAP accreditation. However, the operational efficiency of each department in the ethics review system needs to be further improved when performing relevant functions in accordance with the certification requirements. Based on the experience and summary in the work of the ethical review system, this paper analyzed the main factors that affect the efficiency of the ethical review system and put forward improvement strategies from six aspects: organizational leadership, incentive policies, quality supervision, system construction, talent training, and promotion through evaluation, with a view to providing reference for improving the efficiency of ethical review, and promoting multi-department coordination and system integration.

Development and reform of the curriculum of engineering ethics education in biology and medicine under the background of "new engineering" / 生物工程学报

The "new engineering" concept requires that in addition to laying a solid professional foundation, engineering colleges and universities in China should also pay attention to improving the humanistic quality and developing a professional ethics education in training the engineering and technical talents. One important way is to carry out the engineering ethics education. By referring to the mature case-teaching ideas around the world and combining the practical experience accumulated in recent years, this paper focuses on the curriculum development and teaching reform of engineering ethics for students studying biological and medical engineering, from the perspectives of case selection and teaching method innovation. It also introduces some typical case studies, and summarizes the teaching effect analyzed from questionnaire.

Survey on the Construction Status of Forensic Virtual Autopsy Laboratory and the Applicability of Laboratory Accreditation / 法医学杂志

OBJECTIVES@#To survey the development status and actual needs of virtual autopsy technology in China and to clarify the applicability of forensic virtual autopsy laboratory accreditation.@*METHODS@#The questionnaire was set up included three aspects：(1) the current status of virtual autopsy technology development; (2) the accreditation elements such as personnel, equipment, entrustment and acceptance, methods, environmental facilities; (3) the needs and suggestions of practicing institutions. A total of 130 forensic pathology institutions were surveyed by online participation through the Questionnaire Star platform.@*RESULTS@#Among the 130 institutions, 43.08% were familiar with the characteristics of virtual autopsy technology, 35.38% conducted or received training in virtual autopsy, and 70.77% have establishment needs (including maintenance). Relevant elements were suitable for laboratory accreditation.@*CONCLUSIONS@#Virtual autopsy identification has gained social recognition. There is a demand for accreditation of forensic virtual autopsy laboratory. After the preliminary assessment, considering the characteristics and current situation of this technology, China National Accreditation Service for Conformity Assessment (CNAS) can first carry out the accreditation pilot of virtual autopsy project at large comprehensive forensic institutions with higher identification capability, and then CNAS can popularize the accreditation in a wide range when the conditions are suitable.

Analysis of accreditation results and development strategies of tertiary hospitals in Jiangsu province from 2018 to 2020 / 中华医院管理杂志

As an important measure starting for hospital management, hospital accreditation can effectively guide hospitals to improve their comprehensive service capabilities and management level. The accreditation results of 38 tertiary general hospitals in Jiangsu province from 2018 to 2020 showed that there were weaknesses existing in the development of hospitals, including the radiosity and influence of tertiary hospitals, patient service mode, construction of medical technology capabilities and disciplines, medical quality and safety, nursing quality management and specialized nursing, and information construction. The author suggested that hospitals should return to functional positioning, improve the service quality, strengthen construction of hospital disciplines and technical projects, consolidate the foundation of quality and safety management, improve the level of information technology construction, for references for promoting the high-quality sustainable development of tertiary general hospitals.

Sistema Obligatorio de Garantía de Calidad en Salud: aplicación al laboratorio clínico / Mandatory Quality Assurance System in Health: application to the clinical laboratory

En 1993, el Estado estableció el Sistema General de Seguridad Social en Salud, en el que se introdujeron los diferentes mecanismos legales para promover la calidad en las instituciones prestadoras de servicios de salud en el país. A partir de allí, se implantaron diferentes decretos. En la actualidad, el Sistema Obligatorio de Garantía de Calidad en Salud (SOGCS) se encuentra reglamentado en el Decreto 780 de 2016, Decreto Único Reglamentario del Sector Salud. El SOGCS está integrado por cuatro componentes principales: el Sistema Único de Habilitación (SUH), la Auditoría para el Mejoramiento de la Calidad, el Sistema Único de Acreditación (SUA) y el Sistema de Información para la Calidad en Salud, para dirigir y evaluar el desempeño de estas instituciones en términos de calidad y satisfacción social; además, se adoptó el Manual de Inscripción de Prestadores y Habilitación de Servicios de Salud, el cual contiene las condiciones mínimas que deben cumplir los servicios de salud ofertados y prestados en el país, para brindar seguridad a los usuarios en el proceso de la atención en salud. Dicho manual tiene por objeto definir las condiciones de verificación para la habilitación, como la capacidad técnico-administrativa, suficiencia patrimonial y financiera, y la capacidad tecnológica y científica. En este artículo se revisarán algunos conceptos generales del Sistema Obligatorio de Garantía de Calidad en Salud, así como los estándares y criterios de habilitación para laboratorios clínicos

In 1993, the State established the General System of Social Security in Health, in which different legal mechanisms were introduced to promote quality in the institutions providing health services in the country. From then on, different decrees were implemented. Currently, the Mandatory Health Quality Assurance System (SOGCS) is regulated by Decree 780 of 2016, the Sole Regulatory Decree of the Health Sector. SOGCS is made up of four main components: the Single Qualification System (SUH), the Audit for Quality Improvement, the Single Accreditation System (SUA) and the Health Quality Information System, to direct and evaluate the performance of these institutions in terms of quality and social satisfaction; in addition, the Health Services Provider Registration and Qualification Manual was adopted, which contains the minimum conditions that health services in the country must meet to provide security to users in the health care process. The purpose of this manual is to define the verification conditions for accreditation, such as technical-administrative capacity, patrimonial and financial sufficiency, and technological and scientific capacity. This article will review some general concepts of the Mandatory System of Quality Assurance in Health, as well as the standards and qualification criteria for clinical laboratories