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Basic nursing education and its importance in surgery quality. Ruth Natalia Teresa Turrini Associate Professor Nursing School – São Paulo University E-mail:rturrini@usp.br. Factors that influence education policies on health. Differences regarding Geography of the country
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Basic nursing education and its importance in surgery quality Ruth Natalia Teresa Turrini Associate Professor Nursing School – São Paulo University E-mail:rturrini@usp.br
Factors that influence education policies on health • Differences regarding • Geography of the country • Socioeconomic and cultural factors • Accessibility to health care services • Demands for health care • Health policies • nursing education-related laws and regulations • “generalist nurse” different interpretations – “primary health care”
Nursing Programs (bachelor degree) • Study developed in 2011 • Objective: to identify how the contents of perioperative nursing is taught in nursing programs in Brazil. • Data collection: questionnaire sent by e-mail to the coordinators of the nursing programs • Total nº of nursing programs registered in the Ministery of Education: 841 • Total number of completed questionnaires: 159 • Around 20% in each region, except the Northeast (10%)
Frequency of nursing programs according to the region. Brazil, 2011.
State of Amazon and citieswith a bachelor's degree in Nursing. Brazil, 2011. Capital: Manaus (158,1 hab/km2 - 9 programs) Nº cities: 62 Nº cities with nursing programs: 2 (3,2%) Population: 3.483.985 Territorial extension: 1.559.161,68km2 (2,2hab/km2)
State of São Paulo and cities with a bachelor's degree in Nursing. Brazil, 2011. Capital: São Paulo (7.387,69 hab/km2 - 49 programs) Nº cities: 645 Nº cities with nursing programs: 78 (12,1%) Population: 41.262.199 Territorial extension: 248.196,96km2 (166,25 hab/km2)
Nursing Programs (bachelor degree) Perioperative nursing course loads • 147 (92,6%) answers • average 94,7h (SD80h) • median 80h ( range 5 to 330h) • interquartile range 60h Figure - Distribution of perioperative nursing course load. Brazil, 2011
133 (83,6%) answers • mean 56,1h (SD29,9h) • median 45h (range 0 to 200h) • interquartile range 60h • 134 (84,3%) answers • mean 42,3h (SD33,2) • median de 34,5h (0 – 198) • Interquartile range 40h Theoretical course load Practical course load
How are delivered the contents ? • 107 (67,3%) have a course of Perioperative Nursing • 52 (32,7%) – perioperative nursing contents are inserted into the Surgical Nursing course or other ones • 16 (10,1%) deliver only theoretical contents Some respondents mentioned the local of the practical learning: • 12 (9,4%) - hospitals • 25(18,5%) - central material supply • 12 (8,9%) - surgical unit and operating room • 6 (4,4%) – ambulatory operating room • 1 (0,7%) – just post anesthesia recovery room
Contents frequently delivered • Physical infrastructure of the operating room and human resources • Perioperative nursing process • Admission and discharge of patients • Surgical scrub • Circulation room • Post anesthesia recovery • Material supply processing and sterilization • Prevention and control of infection in surgical site Patient safety • prevention of adverse events • prevention of complications Quality of care
Specialization programs • 20 baccalaureate colleges deliver specialization programs • 11 (55,5%) are located in Southeast, 4 (20,0%) Northeast, 3 (15,0%) North and two (10,0%) South. • Frequently delivered at colleges with a perioperative nursing course (n=14; 70,0%) • 12 (60,0%) are private schools • 2 colleges (states of Bahia and Santa Catarina) did not get enough registers to offer the specialization program
Professors of the baccalaureate programs • 99 (63,9%) - have professors with specialization program in Perioperative Nursing • 53 (33,5%) - do not have professors with specialization program in Perioperative Nursing • 39 (73,6%) worked in surgical settings • 2 (3,8%) were surgical instrument technicians
Graduation programs • Spontaneous mentioning, so the number can be higher • 19 (12,0%) – master degree and 18 (11,4%) doctorate degree. • Professors with master degree (n=13; 8,1% nursing programs) • 11 (57,9%) – worked in private schools • 15 (78,9%) – tought in nursing programs with perioperative nursing courses • 10 (52,5%) colleges of Southeast, 6 (5,3%) Northeast, 2 (10,5%) South and 1 (7,7%) Midwest • Professors with doctorate degree (n=7; 4,4% nursing programs) • 10 (55,5%) – worked in private schools • 15 (83,3%) – tought in nursing programs with perioperative nursing courses • 11 (61,1%) colleges of Southeast, 6 (33,3%) Midwest e um (5,6%) South.
Nursing technicians and bachelor education Weaknesses? Strengths? Challenges? Portal do SISEP • Many, many... Programs • Programs and schools are not evaluated/monitored • Programs do not have basic uniform contents • Registration at the Ministry of Education • Not updated • Incomplete information of some programs • The form for technicians schools does not have items for important information, as positions.
Schools of nursing technician education • City of São Paulo • 115 schools registered • 294 programs registered • 103 schools registered without specifying the vocational program offered • There are programs offered in • Baccalaureate schools • Hospitals • Private schools.
Improving nursing programs... • Knowledge and skills in leadership, quality improvement, and patient safety are necessary to provide high quality health care • Professional nursing practice is grounded in the translation of current evidence into practice • Knowledge and skills in information management and patient care technology are critical in the delivery of quality patient care • Communication and collaboration among surgical team are critical to delivering high quality and safe patient care • Engage in case study discussions/dialogue with a variety of healthcare and other professionals • Engage in interprofessional and intraprofessional care in simulation labs. • Develop interprofessional community projects American Association of Colleges of Nursing, 2009
Behind the technology ..... Person “Human being” Knowledge Skills/abilities Shared responsability Rhytm Synchrony