Julgamento clínico e autoeficácia de enfermeiros para o manejo da sepse: uso da simulação clínica
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFSCAR |
Texto Completo: | https://repositorio.ufscar.br/handle/ufscar/10994 |
Resumo: | The use of active methodologies has demonstrated efficacy in the teaching and learning process in nursing. Thus, realistic simulation emerges as a strategy that, in addition to allowing real experimentation without the exposure of a patient, allows reflection on the actions developed within the scenario. The aim of the study was to evaluate the efficacy and clinical judgment of nurses for the management of sepsis based on high fidelity clinical simulation. The research was carried out in two stages. In stage I, a methodological study was carried out, with a quantitative approach, consisting of three phases: i) elaboration of the clinical simulation scenario and knowledge test on sepsis; ii) validation of the content by nine judges; and iii) scenario test with nurses . The theoretical framework used was that of meaningful learning. For the construction of the clinical scenario, we chose the Simulation model of the National League for nursing and the content was based on the protocols proposed by the Latin American Sepsis Institute. The analysis of content was given by the Content Validity Index, considering a value> 0.90. In stage II, a quasi-experimental study of the before and after type was performed, consisting of 28 nurses from a teaching hospital. Participants were submitted to three moments of the research: (i) prior to delivery of the study material; (ii) prior to the simulation; and (iii) after the simulation to evaluate clinical judgment, self-efficacy, and knowledge test on sepsis. For the analysis of this step, Spearman correlations and scatter plots were used to compare the relationship of clinical judgment and self-efficacy. The nonparametric Wilcoxon test was used for independent samples and the orthogonal contrasts were applied to compare the times. The results of stage I demonstrated that the instruments were adequate, obtaining general value> 0.90. Nevertheless, some adjustments of the scenario and the test, regarding the clarity of the writing, the functionalities and the pertinence of protocols were changed, according to suggestion of the judges. While in stage II, the mean values at the three times of each outcome were high. The clinical judgment presented a statistically significant difference between the times. The clinical judgment (p = 0.0252) and self-efficacy (p = 0.0269) of the participants in the simulation scenario were statistically higher in relation to the listeners and a strong correlation was found between self-efficacy and clinical judgment (p = 0.001). It is expected that the knowledge test and the clinical simulation scenario on sepsis will be facilitators for teachers and professionals of the permanent / continuing education centers of health institutions in the training of nurses and nursing students. In addition, it is expected that more training with the use of the simulation will be performed with professionals trained for risk-free care, ensuring patient safety. |
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Carvalho, Lilian Regina deZem-Mascarenhas, Silvia Helenahttp://lattes.cnpq.br/0185144417072417http://lattes.cnpq.br/8329953593386274cdb58522-b70b-4574-bf9a-ff6971800b462019-02-19T13:39:01Z2019-02-19T13:39:01Z2018-11-23CARVALHO, Lilian Regina de. Julgamento clínico e autoeficácia de enfermeiros para o manejo da sepse: uso da simulação clínica. 2018. Tese (Doutorado em Enfermagem) – Universidade Federal de São Carlos, São Carlos, 2018. Disponível em: https://repositorio.ufscar.br/handle/ufscar/10994.https://repositorio.ufscar.br/handle/ufscar/10994The use of active methodologies has demonstrated efficacy in the teaching and learning process in nursing. Thus, realistic simulation emerges as a strategy that, in addition to allowing real experimentation without the exposure of a patient, allows reflection on the actions developed within the scenario. The aim of the study was to evaluate the efficacy and clinical judgment of nurses for the management of sepsis based on high fidelity clinical simulation. The research was carried out in two stages. In stage I, a methodological study was carried out, with a quantitative approach, consisting of three phases: i) elaboration of the clinical simulation scenario and knowledge test on sepsis; ii) validation of the content by nine judges; and iii) scenario test with nurses . The theoretical framework used was that of meaningful learning. For the construction of the clinical scenario, we chose the Simulation model of the National League for nursing and the content was based on the protocols proposed by the Latin American Sepsis Institute. The analysis of content was given by the Content Validity Index, considering a value> 0.90. In stage II, a quasi-experimental study of the before and after type was performed, consisting of 28 nurses from a teaching hospital. Participants were submitted to three moments of the research: (i) prior to delivery of the study material; (ii) prior to the simulation; and (iii) after the simulation to evaluate clinical judgment, self-efficacy, and knowledge test on sepsis. For the analysis of this step, Spearman correlations and scatter plots were used to compare the relationship of clinical judgment and self-efficacy. The nonparametric Wilcoxon test was used for independent samples and the orthogonal contrasts were applied to compare the times. The results of stage I demonstrated that the instruments were adequate, obtaining general value> 0.90. Nevertheless, some adjustments of the scenario and the test, regarding the clarity of the writing, the functionalities and the pertinence of protocols were changed, according to suggestion of the judges. While in stage II, the mean values at the three times of each outcome were high. The clinical judgment presented a statistically significant difference between the times. The clinical judgment (p = 0.0252) and self-efficacy (p = 0.0269) of the participants in the simulation scenario were statistically higher in relation to the listeners and a strong correlation was found between self-efficacy and clinical judgment (p = 0.001). It is expected that the knowledge test and the clinical simulation scenario on sepsis will be facilitators for teachers and professionals of the permanent / continuing education centers of health institutions in the training of nurses and nursing students. In addition, it is expected that more training with the use of the simulation will be performed with professionals trained for risk-free care, ensuring patient safety.O uso de metodologias ativas tem demonstrado eficácia no processo de ensino e aprendizagem na enfermagem. Sendo assim, a simulação realística surge como uma estratégia que, além de permitir a experimentação real sem a exposição de um paciente, possibilita a reflexão acerca das ações desenvolvidas dentro do cenário. O objetivo da pesquisa foi o de avaliar a resposta da autoeficácia e do julgamento clínico de enfermeiros para o manejo da sepse a partir de simulação clínica de alta fidelidade. O desenvolvimento da pesquisa ocorreu em duas etapas. Na etapa I, foi realizado um estudo metodológico, de abordagem quantitativa, composto por três fases: i) elaboração do cenário de simulação clínica e teste de conhecimento sobre sepse, ii) validação do conteúdo por nove juízes e iii) teste do cenário com enfermeiros. O referencial teórico utilizado foi o da aprendizagem significativa. Para a construção do cenário clínico, optou-se pelo modelo de Simulação da National League for nursing e o conteúdo foi fundamentado nos protocolos proposto pelo Instituto Latino Americano de Sepse. A análise de conteúdo se deu pelo Indíce de Validade de Conteúdo, considerando adequado um valor >0,90. Na etapa II, foi realizado um estudo quase-experimental do tipo antes e depois composto por 28 enfermeiros de um hospital de ensino. Os participantes foram submetidos a três momentos da pesquisa, sendo eles: i) antes da entrega do material para estudo, ii) antes da simulação e iii) após a simulação para avaliar o julgamento clínico, a autoeficácia e o teste de conhecimento sobre sepse. Para a análise dessa etapa, utilizou-se as correlações de Spearman e gráficos de dispersão para comparar a relação do julgamento clínico e a autoeficácia. O teste não paramétrico de Wilcoxon foi utilizado para amostras independentes e os contrastes ortogonais foram aplicados para comparar os tempos. Os resultados da etapa I demostraram que os instrumentos foram adequados, obtendo valor geral >0,90. No entanto, alguns ajustes do cenário e do teste, no que tange à clareza da redação, às funcionalidades e à pertinência de protocolos foram alterados, conforme sugestão dos juízes. Enquanto que na etapa II, os valores médios nos três tempos de cada desfecho mostrou-se elevado. O julgamento clínico apresentou diferença estatisticamente significativa entre os tempos. O julgamento clínico (p=0,0252) e a autoeficácia (p=0,0269) dos participantes do cenário de simulação foram estatisticamente maiores em relação aos ouvintes e uma forte correlação foi encontrada entre a autoeficácia e o julgamento clínico (p=<0,001). Espera-se que o teste de conhecimento e o cenário de simulação clínica sobre sepse sejam facilitadores para docentes e profissionais dos núcleos de educação permanente/continuada de instituições de saúde na capacitação de enfermeiros e estudantes de enfermagem. Além disso, espera-se que mais treinamento com o uso da simulação seja realizado com profissionais formados para uma assistência livre de riscos, assegurando a segurança do paciente.Não recebi financiamentoporUniversidade Federal de São CarlosCâmpus São CarlosPrograma de Pós-Graduação em Enfermagem - PPGEnfUFSCarTreinamento por simulaçãoJulgamento clínicoAutoeficáciaEnfermagemSimulaçãoTraining by simulationClinical judgmentSelf-efficacyNursingSimulationCIENCIAS DA SAUDE::ENFERMAGEMJulgamento clínico e autoeficácia de enfermeiros para o manejo da sepse: uso da simulação clínicaClinical judgment and self-efficacy of nurses for the management of sepsis: use of clinical simulationJuicio clínico y autoeficacia de enfermeros para el manejo de la sepsis: uso de la simulación clínicainfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisOnline600600c4ff86eb-83e6-436a-98cd-317c4bfa2c1binfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFSCARinstname:Universidade Federal de São Carlos (UFSCAR)instacron:UFSCARORIGINALJULGAMENTO CLÍNICO E AUTOEFICÁCA NA SIMULAÇÃO PARA ENFERMEIROS.pdfJULGAMENTO CLÍNICO E AUTOEFICÁCA NA SIMULAÇÃO PARA ENFERMEIROS.pdfapplication/pdf3641075https://repositorio.ufscar.br/bitstream/ufscar/10994/1/JULGAMENTO%20CL%c3%8dNICO%20E%20AUTOEFIC%c3%81CA%20NA%20SIMULA%c3%87%c3%83O%20PARA%20ENFERMEIROS.pdf91845de3e5def9d8aded859eda1bf7a7MD51LICENSElicense.txtlicense.txttext/plain; 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dc.title.por.fl_str_mv |
Julgamento clínico e autoeficácia de enfermeiros para o manejo da sepse: uso da simulação clínica |
dc.title.alternative.eng.fl_str_mv |
Clinical judgment and self-efficacy of nurses for the management of sepsis: use of clinical simulation |
dc.title.alternative.spa.fl_str_mv |
Juicio clínico y autoeficacia de enfermeros para el manejo de la sepsis: uso de la simulación clínica |
title |
Julgamento clínico e autoeficácia de enfermeiros para o manejo da sepse: uso da simulação clínica |
spellingShingle |
Julgamento clínico e autoeficácia de enfermeiros para o manejo da sepse: uso da simulação clínica Carvalho, Lilian Regina de Treinamento por simulação Julgamento clínico Autoeficácia Enfermagem Simulação Training by simulation Clinical judgment Self-efficacy Nursing Simulation CIENCIAS DA SAUDE::ENFERMAGEM |
title_short |
Julgamento clínico e autoeficácia de enfermeiros para o manejo da sepse: uso da simulação clínica |
title_full |
Julgamento clínico e autoeficácia de enfermeiros para o manejo da sepse: uso da simulação clínica |
title_fullStr |
Julgamento clínico e autoeficácia de enfermeiros para o manejo da sepse: uso da simulação clínica |
title_full_unstemmed |
Julgamento clínico e autoeficácia de enfermeiros para o manejo da sepse: uso da simulação clínica |
title_sort |
Julgamento clínico e autoeficácia de enfermeiros para o manejo da sepse: uso da simulação clínica |
author |
Carvalho, Lilian Regina de |
author_facet |
Carvalho, Lilian Regina de |
author_role |
author |
dc.contributor.authorlattes.por.fl_str_mv |
http://lattes.cnpq.br/8329953593386274 |
dc.contributor.author.fl_str_mv |
Carvalho, Lilian Regina de |
dc.contributor.advisor1.fl_str_mv |
Zem-Mascarenhas, Silvia Helena |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/0185144417072417 |
dc.contributor.authorID.fl_str_mv |
cdb58522-b70b-4574-bf9a-ff6971800b46 |
contributor_str_mv |
Zem-Mascarenhas, Silvia Helena |
dc.subject.por.fl_str_mv |
Treinamento por simulação Julgamento clínico Autoeficácia Enfermagem Simulação |
topic |
Treinamento por simulação Julgamento clínico Autoeficácia Enfermagem Simulação Training by simulation Clinical judgment Self-efficacy Nursing Simulation CIENCIAS DA SAUDE::ENFERMAGEM |
dc.subject.eng.fl_str_mv |
Training by simulation Clinical judgment Self-efficacy Nursing Simulation |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::ENFERMAGEM |
description |
The use of active methodologies has demonstrated efficacy in the teaching and learning process in nursing. Thus, realistic simulation emerges as a strategy that, in addition to allowing real experimentation without the exposure of a patient, allows reflection on the actions developed within the scenario. The aim of the study was to evaluate the efficacy and clinical judgment of nurses for the management of sepsis based on high fidelity clinical simulation. The research was carried out in two stages. In stage I, a methodological study was carried out, with a quantitative approach, consisting of three phases: i) elaboration of the clinical simulation scenario and knowledge test on sepsis; ii) validation of the content by nine judges; and iii) scenario test with nurses . The theoretical framework used was that of meaningful learning. For the construction of the clinical scenario, we chose the Simulation model of the National League for nursing and the content was based on the protocols proposed by the Latin American Sepsis Institute. The analysis of content was given by the Content Validity Index, considering a value> 0.90. In stage II, a quasi-experimental study of the before and after type was performed, consisting of 28 nurses from a teaching hospital. Participants were submitted to three moments of the research: (i) prior to delivery of the study material; (ii) prior to the simulation; and (iii) after the simulation to evaluate clinical judgment, self-efficacy, and knowledge test on sepsis. For the analysis of this step, Spearman correlations and scatter plots were used to compare the relationship of clinical judgment and self-efficacy. The nonparametric Wilcoxon test was used for independent samples and the orthogonal contrasts were applied to compare the times. The results of stage I demonstrated that the instruments were adequate, obtaining general value> 0.90. Nevertheless, some adjustments of the scenario and the test, regarding the clarity of the writing, the functionalities and the pertinence of protocols were changed, according to suggestion of the judges. While in stage II, the mean values at the three times of each outcome were high. The clinical judgment presented a statistically significant difference between the times. The clinical judgment (p = 0.0252) and self-efficacy (p = 0.0269) of the participants in the simulation scenario were statistically higher in relation to the listeners and a strong correlation was found between self-efficacy and clinical judgment (p = 0.001). It is expected that the knowledge test and the clinical simulation scenario on sepsis will be facilitators for teachers and professionals of the permanent / continuing education centers of health institutions in the training of nurses and nursing students. In addition, it is expected that more training with the use of the simulation will be performed with professionals trained for risk-free care, ensuring patient safety. |
publishDate |
2018 |
dc.date.issued.fl_str_mv |
2018-11-23 |
dc.date.accessioned.fl_str_mv |
2019-02-19T13:39:01Z |
dc.date.available.fl_str_mv |
2019-02-19T13:39:01Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
format |
doctoralThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
CARVALHO, Lilian Regina de. Julgamento clínico e autoeficácia de enfermeiros para o manejo da sepse: uso da simulação clínica. 2018. Tese (Doutorado em Enfermagem) – Universidade Federal de São Carlos, São Carlos, 2018. Disponível em: https://repositorio.ufscar.br/handle/ufscar/10994. |
dc.identifier.uri.fl_str_mv |
https://repositorio.ufscar.br/handle/ufscar/10994 |
identifier_str_mv |
CARVALHO, Lilian Regina de. Julgamento clínico e autoeficácia de enfermeiros para o manejo da sepse: uso da simulação clínica. 2018. Tese (Doutorado em Enfermagem) – Universidade Federal de São Carlos, São Carlos, 2018. Disponível em: https://repositorio.ufscar.br/handle/ufscar/10994. |
url |
https://repositorio.ufscar.br/handle/ufscar/10994 |
dc.language.iso.fl_str_mv |
por |
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por |
dc.relation.confidence.fl_str_mv |
600 600 |
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c4ff86eb-83e6-436a-98cd-317c4bfa2c1b |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.publisher.none.fl_str_mv |
Universidade Federal de São Carlos Câmpus São Carlos |
dc.publisher.program.fl_str_mv |
Programa de Pós-Graduação em Enfermagem - PPGEnf |
dc.publisher.initials.fl_str_mv |
UFSCar |
publisher.none.fl_str_mv |
Universidade Federal de São Carlos Câmpus São Carlos |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UFSCAR instname:Universidade Federal de São Carlos (UFSCAR) instacron:UFSCAR |
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Universidade Federal de São Carlos (UFSCAR) |
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UFSCAR |
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UFSCAR |
reponame_str |
Repositório Institucional da UFSCAR |
collection |
Repositório Institucional da UFSCAR |
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MD5 MD5 MD5 MD5 |
repository.name.fl_str_mv |
Repositório Institucional da UFSCAR - Universidade Federal de São Carlos (UFSCAR) |
repository.mail.fl_str_mv |
|
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1813715599958736896 |