Basic nursing education and its importance in surgery quality Ruth Natalia Teresa Turrini Associate Professor Nursing School – São Paulo University

Factors that influence education policies on health Differences regarding Geography of the country Socioeconomic and cultural factors Accessibility to health care services Demands for health care Health policies nursing education-related laws and regulations “generalist nurse” different interpretations – “primary health care”

Nursing Programs (bachelor degree) Study developed in 2011 Objective: to identify how the contents of perioperative nursing is taught in nursing programs in Brazil. Data collection: questionnaire sent by to the coordinators of the nursing programs Total nº of nursing programs registered in the Ministery of Education: 841 Total number of completed questionnaires: 159 Around 20% in each region, except the Northeast (10%)

Frequency RegionN % acum Southeast37744,9 North19122,767,6 South12915,382,9 Midwest8710,393,2 North576,8100,0 Total841100,0 Frequency of nursing programs according to the region. Brazil, 2011.

State of Amazon and cities with a bachelor's degree in Nursing. Brazil, Capital: Manaus (158,1 hab/km programs) Nº cities: 62 Nº cities with nursing programs: 2 (3,2%) Population: Territorial extension: ,68km 2 (2,2hab/km 2 )

State of São Paulo and cities with a bachelor's degree in Nursing. Brazil, Capital: São Paulo (7.387,69 hab/km programs) Nº cities: 645 Nº cities with nursing programs: 78 (12,1%) Population: Territorial extension: ,96km 2 (166,25 hab/km 2 )

147 (92,6%) answers average 94,7h (SD  80h) median 80h ( range 5 to 330h) interquartile range 60h Figure - Distribution of perioperative nursing course load. Brazil, 2011 Nursing Programs (bachelor degree) Perioperative nursing course loads

133 (83,6%) answers mean 56,1h (SD  29,9h) median 45h (range 0 to 200h) interquartile range 60h Theoretical course load 134 (84,3%) answers mean 42,3h (SD  33,2) median de 34,5h (0 – 198) Interquartile range 40h Practical course load

How are delivered the contents ? 107 (67,3%) have a course of Perioperative Nursing 52 (32,7%) – perioperative nursing contents are inserted into the Surgical Nursing course or other ones 16 (10,1%) deliver only theoretical contents Some respondents mentioned the local of the practical learning: 12 (9,4%) - hospitals 25(18,5%) - central material supply 12 (8,9%) - surgical unit and operating room 6 (4,4%) – ambulatory operating room 1 (0,7%) – just post anesthesia recovery room

Contents frequently delivered Physical infrastructure of the operating room and human resources Perioperative nursing process Admission and discharge of patients Surgical scrub Circulation room Post anesthesia recovery Material supply processing and sterilization Prevention and control of infection in surgical site Patient safety prevention of adverse events prevention of complications Quality of care

Specialization programs 20 baccalaureate colleges deliver specialization programs 11 (55,5%) are located in Southeast, 4 (20,0%) Northeast, 3 (15,0%) North and two (10,0%) South. Frequently delivered at colleges with a perioperative nursing course (n=14; 70,0%) 12 (60,0%) are private schools 2 colleges (states of Bahia and Santa Catarina) did not get enough registers to offer the specialization program

99 (63,9%) - have professors with specialization program in Perioperative Nursing 53 (33,5%) - do not have professors with specialization program in Perioperative Nursing 39 (73,6%) worked in surgical settings 2 (3,8%) were surgical instrument technicians Professors of the baccalaureate programs

Graduation programs Spontaneous mentioning, so the number can be higher 19 (12,0%) – master degree and 18 (11,4%) doctorate degree. Professors with master degree (n=13; 8,1% nursing programs) 11 (57,9%) – worked in private schools 15 (78,9%) – tought in nursing programs with perioperative nursing courses 10 (52,5%) colleges of Southeast, 6 (5,3%) Northeast, 2 (10,5%) South and 1 (7,7%) Midwest Professors with doctorate degree (n=7; 4,4% nursing programs) 10 (55,5%) – worked in private schools 15 (83,3%) – tought in nursing programs with perioperative nursing courses 11 (61,1%) colleges of Southeast, 6 (33,3%) Midwest e um (5,6%) South.

Nursing technicians and bachelor education Portal do SISEP Many, many... Programs Programs and schools are not evaluated/monitored Programs do not have basic uniform contents Registration at the Ministry of Education Not updated Incomplete information of some programs The form for technicians schools does not have items for important information, as positions. Weaknesses? Strengths? Challenges?

Schools of nursing technician education City of São Paulo 115 schools registered 294 programs registered 103 schools registered without specifying the vocational program offered There are programs offered in Baccalaureate schools Hospitals Private schools.

Improving nursing programs... Knowledge and skills in leadership, quality improvement, and patient safety are necessary to provide high quality health care Professional nursing practice is grounded in the translation of current evidence into practice Knowledge and skills in information management and patient care technology are critical in the delivery of quality patient care Communication and collaboration among surgical team are critical to delivering high quality and safe patient care Engage in case study discussions/dialogue with a variety of healthcare and other professionals Engage in interprofessional and intraprofessional care in simulation labs. Develop interprofessional community projects American Association of Colleges of Nursing, 2009

Behind the technology..... Person “Human being” Knowledge Skills/abilities Shared responsability Rhytm Synchrony

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