Student perception on high-fidelity simulation during the medical clerkship.

The undergraduate medical students use high fidelity simulation associated with audio-visual resources in cardiology, trauma care and pediatrics during clerkship using scenarios consistent with knowledge and skills. The captured images are analyzed by all students as well as the facilitator to conduct the debriefing. Through a closed questionnaire students' perception were explored related to the use of this technology. We obtained positive results that support more investments to assure better performance to promote safety.

Nursing informatics education in the South: a Brazilian experience.

INTRODUCTION: Teaching and learning are critical factors to our survival, design our future and the way we live and determine the quality of our lives. METHODS: This article summarizes aspects of nursing informatics education in the South, more specifically focusing in some of the undergraduate and graduate nursing informatics programs in Brazil. Considering the Recommendations of the International Medical Informatics Association on Education in Biomedical and Health Informatics by IMIA, the content provides an overview of the disciplines and share experience in the implementation of a certificate program in health informatics. RESULTS AND CONCLUSIONS: Since the initial activities in nursing informatics in Brazil, nurses have faced many challenges. Nursing informatics is not completely integrated into the nursing curriculum and the nursing informatics competencies are not established at national level.

Nursing care systems: enhancing care processes in practice and management.

OBJECTIVE: To summarize aspects of nursing informatics application and introduces challenges that are currently being addressed by nurses around the world. METHODS: Key contributions in the field are surveyed and put in the perspective of the IMIA Nursing Informatics Strategic Plan. RESULTS: As a discipline, nursing informatics offers real and practical instruments and opportunities to delivery nursing care across settings, units of care and specialties. A variety of patient care systems are managed by nurses who are introduced to this link during their training embracing information networks, communication skills together with an ability to work both in practice and administrative positions in a variety of clinical and community settings. CONCLUSION: At a time when the tendency is toward a computer-based patient record, nurses must be able to identify what kind of nursing data and information will construct useable and useful nursing knowledge. There are many options for each area of application and the selection must be done carefully, considering the enhancement for organizational, technological and local requirements.

Patient safety initiatives in Brazil: a nursing perspective.

The science development and technology application improvement in all areas of knowledge, including health care, represent an advance in patient care. The health care providers face challenges to accomplish complex procedures and treatments, which demand infrastructure, defined framework, constant process establishment and redesign of nursing care, based on a continuous outcomes evaluation. Therefore, this development requires nurses with advanced knowledge and skills. As the main health care provider in Brazilian hospitals, the nursing staff perform and control the majority of direct patient care procedures, and as such, nursing professionals can be responsible for triggering adverse events that can compromise patient safety. Research conducted in Brazil showed that the quality of health care delivery system and the results of care have significant variation nationwide. Health care professionals should be valued as the one who can promote patient safety, providing high quality care within cost-effective services. Technology is a key element to support and enhance the professional's performance. However, it is also important to promote and facilitate its implementation and development to retain a creative, engaged, skilled, satisfied, competent, and accountable professional capable of identifying and using technology resources in order to assure the quality of care for the population.

Training in medical informatics: combining onsite and online instruction.

The Internet is promoting active exchange of teaching materials and discussion among geographically distant collaborators. We envision that training in medical informatics can be better achieved if both onsite and online instruction are combined, provided that cultural and technological barriers are anticipated and the training program is prepared accordingly. We describe our Brazil/USA program in medical informatics, which includes components of on-site and online education, and discuss lessons learned during its ongoing implementation. Three onsite courses and one workshop have been planned, and two online courses are being developed.

Collaborative efforts for representing nursing concepts in computer-based systems: international perspectives.

Current nursing terminology efforts have converged toward meeting the demand for a reference terminology for nursing concepts by building on the foundation of existing interface and administrative terminologies and by collaborating with terminology efforts across the spectrum of health care. In this article, the authors illustrate how collaboration is promoting convergence toward a reference terminology for nursing by briefly summarizing a wide range of exemplary activities. These include: 1) the International Classification of Nursing Practice (ICNP) activities of the International Council of Nurses (ICN), 2) work in Brazil and Korea that has contributed to, and been stimulated by, ICNP developments, 3) efforts in the United States to improve understanding of the different types of terminologies needed in nursing and to promote harmonization and linking among them, and 4) current nursing participation in major multi-disciplinary standards initiatives. Although early nursing terminology work occurred primarily in isolation and resulted in some duplicative efforts, the activities summarized in this article demonstrate a tremendous level of collaboration and convergence not only in the discipline of nursing but in multi-disciplinary standards initiatives. These efforts are an important prerequisite for ensuring that nursing concepts are represented in computer-based systems in a manner that facilitates multi-purpose use at local, national, regional, and international levels.

[Nursing diagnoses in women attending a family planning service]. / Diagnósticos de enfermagem em mulheres que freqüentam serviço de planejamento familiar.

The purpose of this study was to identify nursing diagnoses in women enrolled in a family planning program. An instrument of data collection was elaborated according to the Functional Health Patterns. The sample consisted of 100 adult women. Forty-nine nursing diagnoses, of which 9 with a frequency equal or higher to 45.0% were identified. Further studies are still needed in institutions that offer assistance in the area of family planning in order to examine if the nursing diagnoses found in these women can be generalized to the population.

Nursing Informatics in Brazil. A Brazilian experience.

Nursing Informatics in Brazil began around 1985. In 1990, the Nursing Informatics Group at the Federal University of São Paulo (NIEn/UNIFESP) was created. The first task was to prepare students and professors to use computers. Since its creation, members of NIEn/UNIFESP have been working in clinical practice, administration, education, and research areas of Nursing Informatics. Initially, the discipline was introduced in the Doctoral and Master programs. Subsequently, all specialization degrees and undergraduate programs were provided with the discipline as well. In the research area, the author explores the use of computers as a tool to support nursing research as well as the implications of computer resources in nursing practice, administration, and teaching. However, the use of the computer as an instrument to support nurses' activities in taking care of patients still needs investment. The majority of hospital information systems do not attend to the nature of nursing practice.

Is it useful to add an anticholinergic treatment to beta 2-adrenergic medication in acute asthma attack?

The aim of our study was to determine whether the combination of an anticholinergic treatment with a beta 2-adrenergic medication is a more effective treatment for acute asthma attack than the two treatments individually. The association of salbutamol-ipratropium was compared to treatment with salbutamol and ipratropium alone. It was a prospective double-blind study in children with acute asthma attack, participating as outpatients. Their clinical history and characteristics of bronchial obstruction were recorded on a standard form. Afterwards, they were included in one of the three following study groups: group one, 100 micrograms/inh salbutamol; group two, 20 micrograms/inh ipratropium; group three, 100 micrograms/inh of salbutamol plus 20 micrograms/inh ipratropium. There were 40 patients in each group, with Tal score +/- 5 and PEF < 80% of the predicted value. They were evaluated at the beginning (0 min), and at 15, 30, 45, 60, 80, 100 and 120 min. Each patient was treated with two inhalations of the study medication and was then evaluated for variations in Tal score. The mean age was 7.3 years; Tal score was 5.6, 5.6 and 6.0 at 0 min (p > 0.05). Decrease in Tal score after 15 min meant p < 0.01 for salbutamol-ipratropium and salbutamol vs. ipratropium. At 30 min p < 0.05 for salbutamol-ipratropium vs. salbutamol, and at 45 min p < 0.01 for salbutamol-ipratropium vs. salbutamol. PEF at 0 min was 70.9%, 71.3% and 68.6% (p > 0.05) increasing after 15 min. At 30 min p < 0.05 for salbutamol-ipratropium vs. salbutamol, and p < 0.01 vs. ipratropium. At 45 min p < 0.01 for salbutamol-ipratropium vs. salbutamol and ipratropium. A total 4.7 doses of salbutamol were needed to improve the asthma attack, 5.3 of ipratropium and 3.7 of salbutamol-ipratropium, with p < 0.01 for salbutamol-ipratropium vs. salbutamol and ipratropium. We conclude that the combination of salbutamol and ipratropium is more effective than each medication alone in treating acute asthma attacks in pediatric patients.