Segurança do paciente na administração de medicamentos por via endovenosa na pediatria: treinamento da equipe de enfermagem

• Ano de defesa: 2020
• Autor(a) principal: Matias, Érica Oliveira
• Orientador(a): Lima, Francisca Elisângela Teixeira
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Área do conhecimento CNPq: CNPq: Ciências da Saúde
• Link de acesso: http://repositorio.ufc.br/handle/riufc/81123

To promote patient safety, it is necessary to develop strategies to train professionals in the process of administering medicines in pediatrics. The objective was to evaluate the effect of intravenous drug administration training with nursing professionals working in pediatrics. This is a quasi-experimental study divided into two phases: 1- Construction and validation of training instruments; and 2- Implementation and evaluation of training on intravenous drug administration in pediatrics. To this end, instruments on medication administration were developed and validated, which were analyzed by seven specialists for content validation through the Content Validity Coefficient (CVC). The training took place in a municipal pediatric hospital in Fortaleza, Ceara, with 33 nursing professionals who met the inclusion criteria and participated in the training, divided into seven moments. The training evaluation was performed by measuring the levels of reaction (level 1), learning (level 2), and behavior (level 3), proposed by Kirkpatrick and Kirkpatrick (2010a, 2010b). The evaluation of the reaction was carried out immediately after the training, with the application of a questionnaire to measure the satisfaction of each participant. In the learning assessment, a pre-test and a post-test were applied elaborated according to the recommendations of the Safety Protocol on Prescription, Use, and Administration of Medicines, of the Brazilian Ministry of Health. In the behavior assessment, a simulation methodology was adopted as a strategy to measure the changes generated by training in the behavior of professionals. The data were analyzed in SPSS 20.0. The binomial test was used to compare the performance of the actions and a quality evaluation of the assistance was made using the Positivity Index (PI). The McNemar test was used for inferential analyzes comparing proportions, before and after the simulation. The pre-test and post-test comparisons were performed using the Wilcoxon test. The study was approved by the local Ethics and Research Committee. The results showed, in regard to the validation of the instruments used for measuring participants' reactions and behaviors, the following Total Content Validity Coefficient (TCVC): theoretical relevance (0.96; 0.97), language clarity (0.92; 0.95), and practical relevance (0.95; 0.96). The training participants were female, with a predominance of nursing technicians (93.9%) and average age of 41.8 years. In the assessment of reactions, there was positive satisfaction (97%). In the assessment of learning, the average of correct answers in the pre-test was 17 correct answers (53.4%) and in the post-test was 23 (72.5%) with a statistically significant difference (p <0.05). In the assessment of behaviors, twenty actions (1, 6, 7, 8, 10, 11, 12, 13, 14, 17, 18, 20, 29, 30, 35, 36, 37, 38, 39, and 47) presented a desirable PI, three actions ( 32, 33, and 34) an adequate PI, five actions (3, 4, 31, 40, and 41) a secure PI, six actions (9, 23, 26, 42, 43, and 52) a borderline PI, and 15 actions (2, 5, 15, 16, 19, 21, 22, 24, 25, 27, 28, 46, 49, 51, and 56) a poor PI. It is concluded that the training followed by the intervention including a dialogued class, a demonstration, and a simulation of the procedure of intravenous drug preparation and administration in pediatrics, were effective.