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O trabalho teve como objetivo avaliar o percentual de adequação ao uso da pulseira de identificação por impressão térmica em pacientes de um hospital público de ensino do Norte do Paraná. Trata-se de um estudo quantitativo, descritivo e transversal realizado em 12 unidades assistenciais, de março a dezembro de 2017, por meio de auditoria operacional visando avaliar a efetividade da implantação do protocolo de identificação segura do paciente. Foram avaliados 3.853 pacientes, e 94,59% encontravam-se com a pulseira de identificação, mas foi constatada ausência principalmente nas unidades de pronto-socorro e pediatria. Quanto à legibilidade dos dados na pulseira houve 96,5% de adequação e mais de 98,0% das pulseiras apresentavam dados de identificação, com a integridade da pele em conformidade. Os resultados demonstraram a adequação desta meta de segurança do paciente na instituição podendo-se afirmar que esta prática foi consolidada enquanto estratégia gerencial de melhoria da qualidade da assistência.(AU)

The objective of this study was to evaluate the percentage of adequacy to the use of the thermal wristband in patients of a public teaching hospital in the North of the state of Paraná. This is a quantitative, descriptive, and cross-sectional study carried out in 12 care units, from March to December 2017, through an operational audit to evaluate the effectiveness of the implementation of the protocol for the patient's safe identification. A total of 3,853 patients were evaluated, 94.5% were found with the identification wristband, and the absence was observed mainly in the emergency department and pediatric units. As for the readability of the data on the wristband, there was 96.5% suitability, and more than 98.0% of the wristbands had identification data, with accordingly skin integrity. The results demonstrated the adequacy of this patient safety goal in the institution, and it can be affirmed that this practice was consolidated as a management strategy to improve the quality of care. (AU)

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BACKGROUND: Most patients with diabetes mellitus (DM) are followed by primary care physicians, who often lack knowledge or confidence to prescribe insulin properly. This contributes to clinical inertia and poor glycemic control. Effectiveness of traditional continuing medical education (CME) to solve that is limited, so new approaches are required. Electronic games are a good option, as they can be very effective and easily disseminated. OBJECTIVE: The objective of our study was to assess applicability, user acceptance, and educational effectiveness of InsuOnline, an electronic serious game for medical education on insulin therapy for DM, compared with a traditional CME activity. METHODS: Primary care physicians (PCPs) from South of Brazil were invited by phone or email to participate in an unblinded randomized controlled trial and randomly allocated to play the game InsuOnline, installed as an app in their own computers, at the time of their choice, with minimal or no external guidance, or to participate in a traditional CME session, composed by onsite lectures and cases discussion. Both interventions had the same content and duration (~4 h). Applicability was assessed by the number of subjects who completed the assigned intervention in each group. Insulin-prescribing competence (factual knowledge, problem-solving skills, and attitudes) was self-assessed through a questionnaire applied before, immediately after, and 3 months after the interventions. Acceptance of the intervention (satisfaction and perceived importance for clinical practice) was also assessed immediately after and 3 months after the interventions, respectively. RESULTS: Subjects' characteristics were similar between groups (mean age 38, 51.4% [69/134] male). In the game group, 69 of 88 (78%) completed the intervention, compared with 65 of 73 (89%) in the control group, with no difference in applicability. Percentage of right answers in the competence subscale, which was 52% at the baseline in both groups, significantly improved immediately after both interventions to 92% in the game group and to 85% in control (P<.001). After 3 months, it remained significantly higher than that at the baseline in both groups (80% in game, and 76% in control; P<.001). Absolute increase in competence score was better with the game (40%) than with traditional CME (34%; P=.01). Insulin-related attitudes were improved both after the game (significant improvement in 4 of 9 items) and after control activity (3 of 9). Both interventions were very well accepted, with most subjects rating them as "fun or pleasant," "useful," and "practice-changing." CONCLUSIONS: The game InsuOnline was applicable, very well accepted, and highly effective for medical education on insulin therapy. In view of its flexibility and easy dissemination, it is a valid option for large-scale CME, potentially helping to reduce clinical inertia and to improve quality of care for DM patients. TRIAL REGISTRATION: Clinicaltrials.gov NCT001759953; https://clinicaltrials.gov/ct2/show/NCT01759953 (Archived by WebCite at http://www.webcitation.org/6oeHoTrBf).

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OBJECTIVE: We performed a pilot study to assess usability and playability of "InsuOnLine," a serious game for education of primary care physicians on insulin therapy for diabetes mellitus. MATERIALS AND METHODS: A multidisciplinary team has designed and developed "InsuOnLine," using Andragogy and Problem-Based Learning principles, with game elements to improve players' motivation. The prototype was tested by four medical doctors and two medical students, using the System Usability Scale (SUS) and a questionnaire to assess playability. These results were used to guide corrections, after which the beta version was retested by 14 medical students and 6 residents. RESULTS: Out of a maximum score of 100 on the SUS, the "InsuOnLine" prototype was rated 88, and some areas for improvement were identified (game instructions, controls). After corrections, the beta version was rated 92.5 on the SUS. Users have found the beta version to be fun, engaging, challenging, relevant, and realistic. Users said that the game has increased their knowledge on diabetes and insulin, that it has made them feel more confident for prescribing insulin, and that it would have impact on how they treated patients with diabetes. Most users said they have learned more from the game than they would have from a lecture. Lessons learned were the need of early piloting, preferably by users with very little or very much gaming experience, on their own computers and free patterns of use. CONCLUSIONS: "InsuOnLine" was rated by users as easy to play, fun, and useful for learning. Further studies will assess its educational effectiveness. "InsuOnLine" is a promising tool for large-scale continuing medical education on insulin, helping to fight clinical inertia in diabetes.

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OBJECTIVE: This study assessed habits and opinions of medical educators and students from a Brazilian medical school about electronic games for learning or for fun. MATERIALS AND METHODS: A questionnaire was sent to Universidade Estadual de Londrina medical school faculty members and undergraduate students. RESULTS: From the 50 faculty members, 20 percent reported regular use of electronic games (at least once a week), spending 1 hour/week with games (median). Among 302 medical students, 37 percent reported regular gaming. Students spent 3 hours/week playing games (median). Male students played games 4.4 times more often than female students. About 90 percent of faculty members and students believed that games are useful for medical education, and >80 percent would like to play games for education of health professionals, but only one-third of students and one-fifth of faculty had already played one of such games. More than 80 percent of faculty would like to use a game for their educational activities. The main obstacles to incorporation of games into medical education, reported by faculty members, were associated with lack of knowledge on available options, lack of time to develop new activities, and lack of resources or institutional support. CONCLUSIONS: Playing electronic games is common among medical faculty and students, who both present very positive opinions about games for learning, but the scarcity of available options and the lack of institutional support prevent a more widespread adoption of medical education games.

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BACKGROUND: Physicians´ lack of knowledge contributes to underuse of insulin and poor glycemic control in adults with diabetes mellitus (DM). Traditional continuing medical education have limited efficacy, and new approaches are required. OBJECTIVE: We report the design of a trial to assess the educational efficacy of InsuOnline, a game for education of primary care physicians (PCPs). The goal of InsuOnline was to improve appropriate initiation and adjustment of insulin for the treatment of DM. InsuOnline was designed to be educationally adequate, self-motivating, and attractive. METHODS: A multidisciplinary team of endocrinologists, experts in medical education, and programmers, was assembled for the design and development of InsuOnline. Currently, we are conducting usability and playability tests, with PCPs and medical students playing the game on a desktop computer. Adjustments will be made based on these results. An unblinded randomized controlled trial with PCPs who work in the city of Londrina, Brazil, will be conducted to assess the educational validity of InsuOnline on the Web. In this trial, 64 PCPs will play InsuOnline, and 64 PCPs will undergo traditional instructional activities (lecture and group discussion). Knowledge on how to initiate and adjust insulin will be assessed by a Web-based multiple choice questionnaire, and attitudes regarding diabetes/insulin will be assessed by Diabetes Attitude Scale 3 at 3 time points-before, immediately after, and 6 months after the intervention. Subjects´ general impressions on the interventions will be assessed by a questionnaire. Software logs will be reviewed. RESULTS: To our knowledge, this is the first research with the aim of assessing the educational efficacy of a computer game for teaching PCPs about insulin therapy in DM. We describe the development criteria used for creating InsuOnline. Evaluation of the game using a randomized controlled trial design will be done in future studies. CONCLUSIONS: We demonstrated that the design and development of a game for PCPs education on insulin is possible with a multidisciplinary team. InsuOnline can be an attractive option for large-scale continuous medical education to help improving PCPs´ knowledge on insulin therapy and potentially improving DM patients´ care. TRIAL REGISTRATION: Clinicaltrials.gov: NCT01759953; http://clinicaltrials.gov/show/NCT01759953 (Archived by WebCite at http://www.webcitation.org/6Dq8Vc7a6).