Theoretical-practical acquisition of topics relevant to patient safety: dilemmas in the training of nurses

Bim, Lucas Lazarini; Bim, Felipe Lazarini; Silva, Andrea Mara Bernardes da; Sousa, Alvaro Francisco Lopes de; Hermann, Paula Regina de Souza; Andrade, Denise de; Hass, Vanderlei José

doi:10.1590/2177-9465-EAN-2017-0127

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RESEARCH • Esc. Anna Nery 21 (4) • 2017 • https://doi.org/10.1590/2177-9465-EAN-2017-0127 copy

Theoretical-practical acquisition of topics relevant to patient safety: dilemmas in the training of nurses^a a Originated from the thesis entitled: "Segurança do paciente no ensino de graduação: subsídios para repensar as disciplinas na perspectiva do guia curricular multiprofissional da Organização Mundial da Saúde" (Patient safety in undergraduate education: subsidies to rethink disciplines in the perspective of the multi-professional curriculum guide of the World Health Organization), presented to the Ribeirão Preto College of Nursing at the University of São Paulo in 2016.

Adquisición teórico-práctico de tópicos relevantes sobre seguridad del paciente: dilemas en la formación de enfermeros

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To investigate content associated with patient safety included in the curricula of undergraduate nursing courses of two Brazilian higher educational institutions.

Method:

A descriptive survey study was carried out with 119 students of nursing courses (licentiate and bachelor degree), from August to September 2016. The topics investigated were based on the WHO patient safety curriculum guide: multi-professional edition. Armed with the data, univariate and bivariate analyses were carried out.

Results:

Of the 46 content areas investigated in the questionnaire, two scored high in non-achievement in theoretical or practical activities, namely "the culture of blame" and "community-acquired infection." Licentiate and bachelor degree students reported a higher acquisition in theoretical classes (p = 0.012), whereas bachelor degree students reported similar acquisition in theory and practice (p = 0.013).

Conclusion:

The content mostly included theoretical and practical approaches at least once throughout the course. However, when considering content associated with patient safety-related sociocultural aspects, lower scores were found.

Keywords:
Patient Safety; Education, Higher; Education, Nursing; Curriculum

	N	%
Gender
Male	16	13.4
Female	103	86.6
Age group
18 to 25	106	89.1
26 to 30	8	6.7
Older than 30	5	4.2
Regime of the course
Licentiate and Bachelor degree	40	33.6
Bachelor degree	79	66.4
Did the student carry out scientific initiation?
Yes	80	67.2
No	39	32.8
Did the student have previous skills or training in the healthcare area?
Nursing technician	8	6.7
Nursing aide	3	2.5
Other(s)	2	1.6
No	106	89.1
Does the student work or did work as a professional in the healthcare area?
Yes	10	8.4
No	109	91.6

Topic	Tracking terms	Theoretical classes	Practical classes	Theory and practice	Not achieved
Topic	Tracking terms	%	%	%	%
What is patient safety?	Notions of patient safety	37.0	0.8	61.3	0.8
	Care with focus on patients	30.3	4.2	64.7	0.8
	Adverse events	70.6	0.8	24.4	4.2
	Errors involving human, environmental, or organizational factors	63.9	0.8	30.8	5.0
	Culture of blame	26.1	7.6	4.2	62.2
Reasons why the application of human factors is important for patient safety	Use of ergonomic principles in patient care	28.6	4.2	49.6	17.6
	Fatigue and stress during professional performance	50.4	14.3	23.5	11.8
	Safety in the use of equipment	20.2	3.4	75.6	0.8
	N95 or PFF2	42.9	2.5	31.9	22.7
	Regulatory Standard no. 32 (NR32)	25.2	0.8	68.1	5.9
	Standard precautions/Use of personal protective equipment	10.9	0	89.1	0
	Workers’ immunization	40.3	0	55.5	4.2
Effective team	Work’s organizational structure	51.3	1.7	42.0	5.0
	Interdisciplinarity/Healthcare team	35.3	3.4	59.7	1.7
	Effective leadership	48.7	2.5	44.5	4.2
	Resolution of conflicts	42.9	5.9	36.1	15.1
	Supervision	45.4	3.4	44.5	6.7
	Communication process in the work environment	31.9	1.7	61.3	5.0
Learning through errors to prevent damage	Errors/Types of errors	37.0	1.7	61.3	0
	How to learn with errors	37.0	12.6	31.9	18.5
	Notification of errors	50.4	11.8	24.4	13.4
Use of quality improvement methods for improvement in care	Indicators of quality of care	45.4	2.5	45.4	6.7
Use of quality improvement methods for improvement in care	Improvement in care	31.9	0	63.9	4.2
Medication safety	Side effects	69.7	0.8	24.4	5.0
	Medication system and processes of prescription, distribution, and administration of medications	16.8	3.4	76.5	3.4
	Medication errors	47.9	0.8	48.7	2.5
Interaction with patients and caregivers	Legislations and rights of healthcare system users	73.1	0.8	19.3	6.7
	Respect for patients’ healthcare needs (cultural aspects and beliefs)	28.6	0	71.4	0
	Family’s responsibility and integration in patient care	26.9	2.5	68.9	1.7
Prevention and control of infections	HAIs	63.9	1.7	26.9	7.6
	Hospital infection	53.8	1.7	42.0	2.5
	Community acquired infection	48.7	0	9.2	42.0
	Biofilm	71.4	1.7	16.0	10.9
	Pandemic	72.3	5.9	21.8	0
	Epidemic	73.9	0.8	19.3	5.9
	Outbreak	56.3	0.8	21.8	21.0
	Infection risks	37.0	0	62.2	0.8
	Infection chain and cross-infection	62.2	1.7	30.3	5.9
	Hand hygiene	10.1	1.7	87.4	0.8
	Disinfection	25.2	0	73.9	0.8
	Antisepsis	7.6	0.8	90.8	0.8
	Antisepsis techniques	16.8	1.7	80.7	0.8
	Precautionary and control measures of infections	22.7	0	75.6	1.7
	Isolation	25.2	1.7	70.6	2.5
	Microbial resistance	60.5	0.8	32.8	5.9
	Processing of contaminated articles	47.1	38.6	14.3	0

Outcome	Regime of the course	N	Mean	Standard deviation	p value
Number of tracking terms reported (theoretical classes)	Licentiate and Bachelor degree	40	16.10	7.64	0.012
Number of tracking terms reported (theoretical classes)	Bachelor degree	79	20.45	9.32
Number of tracking terms reported (practical classes)	Licentiate and Bachelor degree	40	1.12	2.62	0.930
Number of tracking terms reported (practical classes)	Bachelor degree	79	1.08	1.82
Number of tracking terms reported (theory and practice)	Licentiate and Bachelor degree	40	25.17	9.35	0.013
Number of tracking terms reported (theory and practice)	Bachelor degree	79	20.51	9.54

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[1] Corresponding author: Denise de Andrade. E-mail: dandrade@eerp.usp.br