Erros dos estudantes de enfermagem em aprendizagem clínica. Resultados qualitativos em investigação de métodos mistos

Santos, Ana Paula Sousa

doi:10.1590/0034-7167-2018-0592

Acessibilidade / Reportar erro

Brasil

Revista Brasileira de Enfermagem

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Sumário

ORIGINAL ARTICLE • Rev. Bras. Enferm. 72 (1) • Jan-Feb 2019 • https://doi.org/10.1590/0034-7167-2018-0592 copiar

Erros dos estudantes de enfermagem em aprendizagem clínica. Resultados qualitativos em investigação de métodos mistos

Autoria SCIMAGO INSTITUTIONS RANKINGS

RESUMO

Objetivo:

analisar fatores associados aos erros dos estudantes de enfermagem durante a aprendizagem clínica e as suas perceções destes eventos constituírem oportunidade de aprendizagem e de desenvolvimento.

Método:

Investigação com desenho de Métodos Mistos de acordocom Creswell e Clark. A dimensão qualitativa incluiu entrevistas presenciais e pela internet. A análise de dados seguiu o método de Miles e Huberman.

Resultados:

Os erros dos estudantes foram revelados Segundo as suas perceções em todas as fases do processo de enfermagem e nas competências transversais. Os erros foram reconhecidos como oportunidades de aprendizagem e de desenvolvimento.

Considerações finais:

Os estudantes reconheceram o seus erros e atribuíram a sim mesmos as razões e o que teria prevenido a sua ocorrência. O Método Misto foi um desenho adequado para estudar o fenómeno. A dimensão qualitativa foi essencial para revelar e alcançar o objetivo. São apresentadas sugestões alicerçadas nos resultados.

Descritores:
Pesquisa em Enfermagem; Educação em Enfermagem; Estudantes de Enfermagem; Erros Médicos; Pesquisa Qualitativa

Category	Subcat. 1	Subcat. 2	Subcat. 3	Unit of analysis	Place
Contributions to error	Student himself/herslfelf	Fadigue		"With the last patient with a vesical probe that I had, I associated with my exhaustion. During my internship I was all wrapped up emotionally.	E2-2: L62-64; 97-98
				"Above all it was tiredness. I was not able of more. [...] I was really tired [...]."	E2-5: L30 31; 37-38; 66-77

Category	Subcategory 1	Subcategory 2	Examples - students' words/report
Errors in Implementing Care	Implementation of the procedures according to respective standard.		[...] make a dressing in the wrong way. [...] disinfected the surgical wound in a reversed manner. (E2-15: L32; 35; 38-39)
	Rationale of the procedures in nursing care.		There were moments of lack of knowledge either in pathologies and medication. (E4-32: L10-11; 53)
	Carry out planned care in a timely manner.		Patient was half shift without food, there was no need for that. (E2-6: 158-159; 211-213)
Medication Errors			For example a patient had a medication at eight and at noon. A certain dose at eight and a certain dose at twelve and I switched doses. [...] The one at noon I gave at eight and the one at eight I gave at twelve. [...]. (E2-6: L14-16: 18-19; 27-28) I did not verify that I took a bottle of bicarbonate. I know the intention was to get distilled water. (E4-9: L4-6)
Error in Needs identification	Identification of the patient's needs through the clinical process.		So I went to check if that patient really had prescribed acetaminophen. She had but it was in SOS. I did not check the last administration. (E4-42: L50-55)
Error in Needs identification	Identification of patient's needs through observation.		I was still not very accustomed to the numbering of the bed, and instead of going to a patient, I went to the next one. (E4-29: L5; 7-8)
Errors in Transversal Skills	Performance independent of the mentor's guidance		The reasoning being slowed down, the hand not sure. Mentor must help. (E2-8: L106-107) [The error was] not asking mentor for help on find the artery. (E2-24: L73-74)
Errors in Care Planning	Definition of Nursing Diagnostics according patient's needs in his different dimensions	Priorities establishment	[...] upon arriving at the ward I went directly to the nursing room to obtain the necessary forms for admission. It was a great failure for me not to have gone to my patient immediately [...] I had failed because I did not set the right priority. (E2-12: L25-29; 34-35)
Errors in Care Planning		Lack of attendance to patient	I left patient alone in the shower [...]. (E2-11: L19-20; 22-23)
Errors in Care Evaluation	Elaboration of records with useful information continuity of care.		I evaluated it and did recorded it and she [mentor] asked, "if you have done it why didn't you recorded it?" What I observed or performed I did not record [...] It took me a lot of time to hit records. (E2-5: L168-170; 175; 179)

Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

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[1] Corresponding Author Ana Paula Sousa Santos E-mail: ana.ps.santos@uac.pt