Nursing Education & Research

She is the Assistant Professor of the Fernando Pessoa University, Portugal. She did her Post-Doctoral at the University of São Paulo- School of Nursing in the year 2016. In 2014, she completed her PhD in Nursing Sciences by the Abel Salazar Institute of Biomedical Sciences, University of Porto and also she is the postgraduate in Postgraduate in Clinical Supervision, Postgraduate in Continuing Care and Palliative Care and Postgraduate in Management of Health Units from 2009-2012. In 2007, she did her Specialization in Rehabilitation Nursing, by the Nursing School of Porto.

Objective: \r\nAging and associated chronic diseases, as well as the limitations that this can bring to the individual, associated with the cognitive and functional losses of the advancing age, have been fomenting the need for home care and changes in the daily life of many families (Pedreira & Oliveira, 2012). Family relationships change when a family member presents a health problem, especially when a family member assumes the role of caregiver (Fernandes & Ângelo, 2016). It is widely recognized that the role of caregiver creates physical and emotional pressure on family members during adversity (Coyne et al., 2017).\r\nThis study aimed to describe the implementation of a playful strategy as instrument for family assessment. The game was used with the purpose of exploring the dynamics of family functioning, enabling its execution in a shorter time.\r\n\r\nMethodology:\r\nThis is an exploratory-descriptive study with a qualitative approach of the case study type. The game developed is a board game titled \"Give Voice to Caregivers\". The prototype of the game was applied to a family with a caregiver, consisting of eight elements and with one hour duration. The course of the board retraces the phases in the process of becoming a family caregiver. The objective of the game is to move from the starting point to the finish line. The caregiver is the main player and rolls the dice, moves the marker as many spaces as the dice indicated. According to the colour of the house, purple, green and blue, a card of the respective colour is collected and in it there are questions that will be addressed to the caregiver or family or health professional. The game was recorded, transcribed and the data obtained analyzed. Throughout the course, the ethical principles associated with research were safeguarded, namely obtaining the free and informed consent of the participants. \r\n\r\nResults:\r\nThe game as an evaluation instrument allowed, through the playful, to collect information about the family. The game was played for an hour. From the analysis of the implementation of the game, family information in the following categories was obtained: instrumental functioning, alliances, emotional communication, verbal communication, nonverbal communication, circular communication, problem solving, roles, influence and power, beliefs, expressive functioning, satisfaction and cohesion. From the evaluation of the game by the family, advantages essentially related to the communication in the familiar system were evidenced, this because through the game \"The family will approach themes throughout the game that they may have never approached before, and they will realize what each one thinks (E2). \" \r\n\r\nDiscussion:\r\nThis course described the implementation of a game as a family assessment instrument, with communication being the central theme of this experiment. The game cards integrating circular questions, allowed a greater depth of data obtained, namely relationships, or connections between individuals, events, ideas or beliefs, that aim to facilitate change (Wright & Leahey, 2009). We can design serious games so that players are automatically asked to reflect on their performance during the game (Wouters et al., 2013). Existing family assessment instruments, in addition to being very structured and too closed, hamper the climate of closeness and openness necessary to understand a family and understand the needs of family caregivers. And why a Game? Because it allows you to talk about serious things…Playing!\r\n\r\n

He is a Register Nurse at MEDICAL-SURGICAL CLINIC Nossa Senhora da Guia, Portugal.rnHe is a PhD student in Nursing Sciences by the Abel Salazar Institute of Biomedical Sciences, University of Porto. He did his Masters in Science in Nursing. His Specialization in Rehabilitation Nursing, by the Nursing School of Porto.In 2000, He completed his degree in nursing and Bachelor\'s Degree in Nursing in 1993.rn

Objective: rnOne of the hospital areas where major changes have occurred in recent years is certainly the one that refers to the operating room. Costs related to surgical interventions seem to have been steadily increasing, mainly due to the constant technological innovation, in particular of clinical equipment and devices, and the requirement for highly specialized and differentiated human resources, although it is not known exactly how they have evolved (Ministry of Health, 2013). However, increasing complexity also increases surgical risk and costs associated with health care (Farrokhi et al., 2015). The World Health Organization, confronted with worldwide evidence of damage in public health due to poor patient safety, adopted a resolution in 2002 to encourage countries to increase health care safety and to implement monitoring systems (WHO, 2009). The operating room is one of the most complex units of a hospital institution, due to the numerous processes and subprocesses linked, directly or indirectly, to the production of surgeries (Duarte and Ferreira, 2006). The introduction of modern techniques and management models and the use of new instruments and methods for assessing the quality of health services with the aim of ensuring efficiency, effectiveness and accuracy in the management of resources, as well as meeting the expectations of patients, requires increasing responsibilities, namely from nurses (Gomes et al., 2016). The construction and monitoring of specific quality indicators can thus guide the management process, signalling deviations (Jericó et al., 2011). Conscious of this need, this study sought to gather the consensus of some experts on operating rooms, through a focus group, analyzing the set of items to be integrated in a comprehensive and representative instrument to measure the \"Quality in the Operating Room\".rnrnMethodology: rnThis is a qualitative, exploratory and descriptive study, whose method of data collection used the focus group. Focus groups provide an open and accessible debate around a topic of common interest to participants, are preferably adopted in exploratory research, and can be used as the main source of data (Trad, 2009). Participants in the study should have more than two years of professional experience in the operating room and be physicians and nurses. The ethical procedures associated with any investigation, including authorization through informed consent, have been guaranteed. rnrnResults: The Focus Group was composed of 5 nurses and three physicians, with an average of 17.5 years of specific professional experience in the operating room. Discussion of 42 items from 71 indicators that had not obtained absolute consensus from the participants was conducted. Some indicators were changed. Regarding the structure, the associated issues were: dimensions required for the operating room and dimensions of the recovery unit; preoperative and immediate postoperative activities, namely the pre and postoperative visit of the nurse of the operating room and the preoperative visit of the anaesthesiologist. With regard to the process, the indicator associated with leadership was changed. Finally, the results were changed in the indicators associated with waiting times between surgeries, the monitoring of teamwork and the performance evaluation of the operating room professionals. After about two hours of discussion of the topics, the final instrument consisted of 58 items. rnrnDiscussion: The implementation of quality and efficiency efforts should be a concern of all professionals. Progress requires a cultural change in the operating room environment in order to prioritize health quality and safety. The instrument presented in this journey is inspired by the Donabedian model, which proposes the creation and use of quality indicators based on the triad: structure, process and outcome. In 1966, Donabedian introduced for the first time a health quality evaluation model based on three essential pillars: structure, process and outcome. This model is still a reference in the evaluation of health quality and is used by several organizations. It should be emphasized, however, that the strength of the Donabedian model lies in the relationships between these indicators, that is, the structure influences the process and the process, in turn, influences the outcome. Therefore, the global evaluation of health care requires an understanding of the three elements individually, but also the relationships between them (Gomes et al., 2016)rnGiven the multiplicity of variables to be integrated in this instrument, its design would be unattainable without a previous qualitative analysis. The use of a focus group with experts on the field proved to be especially useful in this research, emphasizing the need to consider the perspective of the different actors of the phenomenon under analysis, incorporating the set of knowledge of each participant.rnrn

Teresa is a nurse since 1998. She has 15 years of experience in clinical and administration field and in university teaching. She has worked in different areas like primary care, rural nursing, hospital nursing, nursing homes, and laboratory. She has worked also in Continuing Education (formal or informal courses to advance or update knowledge of health professionals). Her lines of interest have always been adapted to work requirements, although she have been specially involved in Transcultural Nursing, which is why her doctoral thesis focused in the field of immigrant health. In the university area she taught in basic nursing, taxonomies nurses NANDA, NOC and NIC, nursing based on evidence etc. During the last years, much of the training focused on electronic clinical history forms.

Since Hospital General Universitario Santa Lucía (Cartagena, Spain) was selected as a Best Practice Spotlight Organization (BPSO) candidate, records related to the Pain Assessment and Management Guide implementation have been thoroughly reviewed. In elderly patients with dementia, pain is frequently underdiagnosed and, therefore, undertreated1. Althogh pain assessment tools have been specifically developed for patients with dementia, they are scarcely used due to professionals lack of knowledge2 and insufficient electronic clinical history forms.rnrnObjective: rnThe aim of the study was to select, on the basis of expert consensus, a pain assessment tool for patients with dementia which was validated in the Spanish clinical setting.rnrnMethod: rnThe project was developed in two phases: in a first phase, a literature search provided validated tools; the second part of the study consisted on consensus-building for tool selection, by the modified Delphi technique3.rnrnResults & Conclusions:rnThe literature search provided 34 pain assessment tools for patients with dementia4, of which only 5 were linguistically and culturally validated in Spanish: the Abbey Pain Scale, Doloplus, Algoplus, Painad-Sp and EDAD5. In an initial round, the main selection criteria of the tools were established by expert consensus: ease of use and discrimination capacity between dementia and pain symptoms in patients with dementia. During a second round, experts evaluated the different tools by a 5-point-Likert-scale, showing the Algoplus scale the best scores.rn

Juan Vicente Robles is Internal Nursing Resident in Family and Community Nursing at General University Hospital Reina Sofia. He is Member of the Official Nursing College of Región de Murcia and Member of the board of directors of Family and Community Nursing Society of Murcia (SEAPREMUR).

Introduction: ICTs are the technologies that allow greater accessibility and access to the information. Specifically in health, it allows rapid interaction with the information of the patients, and helps giving a diagnosis, a treatment or taking preventive actions.rnExamples of these technologies may include: devices such as telecommunications, remote assistance and telemedicine. And also the full incorporation of electronic health records to write the evolution of patients, which in some hospitals is made even bedside, using tablets.rnObjectives: To analyze the importance of the use of new information and communication technologies to improve the care provided to patients. To identify the most used information and communication technologies in health.rnMaterials and Methods: We´ve done a bibliographic search in PubMed and Schiele databases, Cochrane Library, Health Guide and Dynamed Plus, using the words: technology and medicine. The search has been restricted with studies of 5 years ago and as language: English and Spanish.rnrnResults: Finally, 18 results were obtained, of which we could access to 6. From these, It was obtained that the main applications used by nursing are computerized medical records, telemedicine and mobile phones, mainly for requesting and reminding appointments. The telecare is increasingly incorporating to more people, and it is intended that in the future it will include the entire population with chronic disability and elderly diseases.The ICTs also represent a new paradigm, by offering new methods and techniques to provide care, solve troubles, and reduce hospitalization times.rnrnConclusions: ICTs offer a new way of quality care by improving the care provided today. Both, professionals and patients, should familiarize with these to achieve a more effective care. Accessibility is also important, in order to extend its use to the entire population.rn