ABSTRACT
Resumo Objetivo construir um curso online e autoinstrucional para enfermeiros que realizam assistência às crianças em uso de cateter venoso central no domicílio e validar o conteúdo do curso por especialistas. Método estudo metodológico, alicerçado no Design Instrucional pelo modelo ADDIE, desenvolvido em duas etapas entre setembro de 2019 e maio de 2020: construção do curso; e validação do conteúdo por um comitê de oito especialistas, recrutados pelo método bola de neve por meio eletrônico. Utilizou-se o Instrumento de Validação de Conteúdo Educativo em Saúde, com ponto de corte ≥0,8 para a validação de conteúdo. Resultado s: elaboram-se 25 produtos tecnológicos para a produção final do curso: quatro planos de ação pedagógica, seis storyboards, nove recursos educativos em vídeo e 6 módulos do curso em formato Sharable Content Object Reference Model, aplicável em diferentes plataformas. Todos os módulos apresentaram Índice de Validade de Conteúdo ≥0,80 em todos os domínios e na avaliação global. Conclusão e implicações para a prática o conteúdo de todos os módulos foi validado pelos especialistas. O curso contribui para a prática assistencial, permitindo atualização com base em conteúdo atual e validado cientificamente. Ele pode ser utilizado em outras propostas pedagógicas, desde que atendidas as premissas da Licença Creative Commons 4.0 Internacional.
Resumen Objetivo construir un curso en línea y de auto instrucción para enfermeras que brindan atención a niños utilizando un catéter venoso central en el hogar y validar el contenido del curso por especialistas. Método estudio metodológico, basado en Diseño Instruccional por el modelo ADDIE, desarrollado en dos etapas entre septiembre de 2019 y mayo de 2020: construcción del curso; y validación del contenido por un comité de ocho especialistas, reclutados por el método bola de nieve, electrónicamente. Se utilizó el Instrumento de Validación de Contenidos Educativos en Salud y se adoptó el punto de corte ≥0.8 para la validación de contenidos. Resultados en siete meses, se elaboran 25 productos tecnológicos para la producción final del curso: cuatro planes de acción pedagógica, seis storyboards, nueve recursos educativos de video y 6 módulos del curso en formato Sharable Content Object Reference Model, aplicables en diferentes plataformas. Todos los módulos mostraron un Índice de Validez de Contenido ≥0,80 en todos los dominios y en la evaluación general. Conclusión e implicaciones para la práctica el contenido de los módulos ha sido respaldado por especialistas. El curso contribuye a la práctica del cuidado, permitiendo la actualización a partir de contenidos actualizados y científicamente validados. Puede ser utilizado en otras propuestas pedagógicas, siempre que se cumplan las premisas de la Licencia Creative Commons 4.0 Internacional.
Abstract Objective to construct an online, self-instructional course for nurses who provide care to children using a central venous catheter at home and validate the course content by experts. Method this is a methodological study, based on Instructional Design using the ADDIE model, developed in two stages between September 2019 and May 2020: course construction; and content validity by a committee of eight experts, recruited by the snowball method through electronic. The Educational Content Validation Instrument in Health was used, with a cut-off point ≥0.8 for content validity. Results twenty-five technological products are created for the course's final production: four pedagogical action plans, six storyboards, nine educational video resources and 6 course modules in Sharable Content Object Reference Model format, applicable on different platforms. All modules presented a Content Validity Index ≥0.80 in all domains and in the overall assessment. Conclusion and implications for practice the content of all modules has been validated by experts. The course contributes to care practice, allowing updating based on current and scientifically validated content. It can be used in other pedagogical proposals, as long as the Creative Commons Attribution 4.0 International License premises are met.
Subject(s)
Humans , Child , Catheterization, Central Venous/nursing , Child Health Services , Education, Distance , Education, Nursing, Continuing , Home Care ServicesABSTRACT
OBJECTIVES: Data on multidisciplinary programs dedicated to home parenteral nutrition (HPN) in Latin America are limited. This study describes the results of the first multidisciplinary pediatric intestinal rehabilitation program for HPN at a public tertiary hospital in Brazil. METHODS: We retrospectively reviewed patients aged 0-18 years with intestinal failure (IF) who required parenteral nutrition (PN) for >60 days between January/2014 and December/2020. RESULTS: Fifty-four patients were discharged on HPN (15 achieved enteral autonomy, 34 continued on HPN at the end of the study, 1 underwent intestinal transplantation, and 4 died). The median (IQR) age at the study endpoint of patients who achieved enteral autonomy was 14.1 (9.7-19) versus 34.7 (20.4-53.9) months in those who did not achieve enteral autonomy. Overall prevalence of catheter-related thrombosis was 66.7% and catheter-related bloodstream infection rate was 0.39/1000 catheter-days. Intestinal failure-associated liver disease (IFALD) was present in 24% of all patients; none of the patients who achieved enteral autonomy had IFALD. All patients showed significant improvement in anthropometric parameters during the HPN period. The sociodemographic characteristics of the patients' family members were mothers less than 20 years old (7.5%), schooling time more than 10 years (55.5%), and household income between 1 and 3 times the minimum wage (64.8%). The 5-year survival rate for HPN is 90%, and 27.7% of patients achieve enteral autonomy. CONCLUSION: The treatment of pediatric patients with IF followed by a multidisciplinary pediatric intestinal rehabilitation program with HPN is feasible and safe in the Brazilian public health system.
