Basic nursing education and its importance in surgery quality

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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-mailrturrini_at_usp.br

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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
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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)

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Frequency Frequency Frequency
Region N acum
Southeast 377 44,9 44,9
North 191 22,7 67,6
South 129 15,3 82,9
Midwest 87 10,3 93,2
North 57 6,8 100,0
Total 841 100,0
Frequency of nursing programs according to the
region. Brazil, 2011.
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State of Amazon and cities with 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)
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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)
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Nursing Programs (bachelor degree)
Perioperative nursing course loads

• 147 (92,6) answers
• average 94,7h (SD?80h)
• median 80h ( range 5 to 330h)
• interquartile range 60h

Figure - Distribution of perioperative nursing
course load. Brazil, 2011
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• 133 (83,6) answers
• mean 56,1h (SD?29,9h)
• median 45h (range 0 to 200h)
• interquartile range 60h

• 134 (84,3) answers
• mean 42,3h (SD?33,2)
• median de 34,5h (0 198)
• Interquartile range 40h

Theoretical course load
Practical course load
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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

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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
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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 (n14 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

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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

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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 (n13 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 (n7 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.

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Nursing technicians and bachelor education
Weaknesses? Strengths? Challenges?

• 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.

• Portal do SISEP

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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.

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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
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Behind the technology .....
Person Human being
Knowledge Skills/abilities Shared responsability
Rhytm Synchrony
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THANK YOU FOR THE ATTENTION