RESUMO
OBJECTIVES: to identify and analyze the factors that contribute to safety incident occurrence in the processes of prescribing, preparing and dispensing antineoplastic medications in pediatric oncology patients. METHODS: a quality improvement study focused on oncopediatric pharmaceutical care processes that identified and analyzed incidents between 2019-2020. A multidisciplinary group performed root cause analysis (RCA), identifying main contributing factors. RESULTS: in 2019, seven incidents were recorded, 57% of which were prescription-related. In 2020, through active search, 34 incidents were identified, 65% relating to prescription, 29% to preparation and 6% to dispensing. The main contributing factors were interruptions, lack of electronic alert, work overload, training and staff shortages. CONCLUSIONS: the results showed that adequate recording and application of RCA to identified incidents can provide improvements in the quality of pediatric oncology care, mapping contributing factors and enabling managers to develop an effective action plan to mitigate risks associated with the process.
Assuntos
Antineoplásicos , Erros de Medicação , Análise de Causa Fundamental , Humanos , Análise de Causa Fundamental/métodos , Antineoplásicos/efeitos adversos , Erros de Medicação/estatística & dados numéricos , Criança , Melhoria de Qualidade , Segurança do Paciente/normas , Segurança do Paciente/estatística & dados numéricos , Neoplasias/tratamento farmacológico , Pediatria/métodos , Pediatria/estatística & dados numéricos , Pediatria/normasAssuntos
Ecocardiografia , Sociedades Médicas , Criança , Humanos , Ecocardiografia/normas , Ecocardiografia/métodos , Cardiopatias Congênitas/diagnóstico por imagem , Cardiopatias Congênitas/cirurgia , Pediatria/normas , Pediatria/métodos , Sociedades Médicas/normas , Estados Unidos , Guias de Prática Clínica como AssuntoRESUMO
Frente a la pandemia del CoVID-19, resulta fundamental establecer estrategias manteniendo distanciamiento social, que permitan educar a profesionales de la salud sobre aspectos relacionados con SARS-CoV-2. La Sociedad Chilena de Neumología Pediátrica creó un E-learnig de contingencia de acceso libre. OBJETIVO: Describir las características del curso online "Desafíos de la pandemia CoVID-19 en Pediatría", y evaluar el grado de satisfacción de quienes lo cursaron. Estudio transversal. Todos los inscritos en el curso, entre mayo 2020 y julio 2020. Se grabaron 12 clases dictadas por especialistas con representación académica de Chile. Se realizó una prueba final y una encuesta de satisfacción, con puntaje de 1 a 7. Se realizó análisis descriptivo e inferencial, evaluando asociación entre clasificación final del curso, profesión y zona geográfica de los participantes con test de Kruskal Wallis, significancia estadística p<0,05. Aprobado por comité ética. Participaron 2541 alumnos, 73% mujeres. Mediana de edad 32,7 años. 90,7% de Chile, de estos 63,2% de regiones. De procedencia extranjera destacó Bolivia (2,9%) y Ecuador (2,5%). De los que realizaron la prueba, el 98,6% aprobó. Existió diferencia entre notas según profesión, Médicos-Kinesiólogos(p=0.025) y Médicos-Enfermeros(p=0.002); y según procedencia, Región Metropolitana (RM)-Otras regiones (p=0.041), RM-Internacional(p<0,001) y Otras regiones-Internacional(p<0,001). La evaluación de contenidos ponderó 6,6 y la accesibilidad 6,8. El 98% contestó que el curso cumplió sus expectativas. Concluimos que se inscribió un gran número de alumnos de Chile y Latinoamérica. Más del 98% aprobó la prueba final y refirió un alto nivel de satisfacción. Sugerimos emplear estrategias similares en situaciones de catástrofes sanitarias.
In the face of the CoVID-19 pandemic, it is essential to establish strategies, maintaining social distancing, that allow educating health professionals on aspects related to SARS-CoV-2. The Chilean Society of Pediatric Pulmonology created a free access contingency E-learning. OBJECTIVE: To describe the characteristics of the online course "Challenges of the CoVID-19 pandemic in Pediatrics", and to evaluate the grade of satisfaction of those who attended it.Transversal study. All those enrolled in the course, between May 2020 and July 2020. 12 classes taught by specialists with academic representation from Chile were recorded. A final test and a satisfaction survey were carried out, with a score from 1 to 7. A descriptive and inferential analysis was implemented, evaluating the association between the final classification of the course, profession and geographical area of the participants with the Kruskal Wallis test, statistical significance p< 0.05. Approved by ethics committee. 2541 students participated, 73% women. Median age 32.7 years. 90.7% from Chile, of these 63.2% from regions. Of foreign origin, Bolivia (2.9%) and Ecuador (2.5%) stand out. Of those who took the test, 98.6% were successful. There was a difference between grades according to profession, Physicians-Kinesiologists(p=0.025) and Physicians-Nurses(p=0.002); and according to origin, Metropolitan Region (RM)-Other regions (p=0.041), RM-International (p<0.001) and Other regions-International (p<0.001). The content evaluation pondered 6.6 and accessibility 6.8. 98% responded that the course met their expectations. CONCLUSION: A large number of students from Chile and Latin America were enrolled. More than 98% passed the final test and reported a high level of satisfaction. We suggest using similar strategies in situations of health catastrophes.
Assuntos
Humanos , Masculino , Feminino , Criança , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Pediatria/métodos , Estudantes de Ciências da Saúde/psicologia , Pessoal de Saúde/psicologia , Educação a Distância/métodos , COVID-19 , Aprendizagem , Satisfação Pessoal , Chile , Estudos Transversais , Inquéritos e Questionários , Educação Médica/métodos , PandemiasRESUMO
Resumen La presente es una síntesis de resultados de una investigación mayor, cuyo objetivo principal fue conocer las perspectivas de familias y equipo de salud respecto de la presencia de clowns de hospital trabajando en cuidados paliativos pediátricos en una unidad en Chile. Guiado por un paradigma interpretativo, estrictos criterios de calidad y éticos, la metodología utilizada fue de tipo cualitativo, aplicando las técnicas de recolección de datos de entrevistas en profundidad, análisis de documentos y grupos de discusión. La sección de datos sobre el equipo aquí presentados, se analizó a través de las técnicas análisis de contenido y análisis crítico del discurso. Los resultados indican que la figura del clown es percibida como un mediador y valorada como terapia complementaria, especialmente por las competencias socioemocionales de esos profesionales y el juego que se utiliza como herramienta de intervención. Las conclusiones señalan que las competencias socioemocionales que promueve el clown de hospital son fundamentales para el trabajo en cuidados paliativos.
Abstract This is a synthesis of results of a major research which main objective was to know the perspectives of families and the health team regarding the presence of hospital clowns working in pediatric palliative care in a unit in Chile. Guided by an interpretivist paradigm, strict quality and ethical criteria, the methodology used was qualitative, applying in-depth interviews, document analysis and discussion groups as data collection techniques. The data section presented here about the health team was analyzed through content analysis and critical discourse analysis techniques. The results indicate that the figure of the clown is perceived as a mediator, valued as complementary therapy, especially due to the socio-emotional competences of these professionals and play used as an intervention tool. The conclusions indicate that the socio-emotional competences promoted by the hospital clown are fundamental to work in palliative care.
Resumo A presente é uma síntese de resultados de uma investigação maior, cujo objetivo principal foi conhecer as perspectivas de famílias e equipe de saúde a respeito da presença de clowns de hospital trabalhando em cuidados paliativos pediátricos em uma unidade no Chile. Guiado por um paradigma interpretativo, critérios estritos de qualidade e éticos, a metodologia utilizada foi de tipo qualitativo, aplicando as técnicas de coleta de dados de entrevistas em profundidade, análise de documentos e grupos de discussão. Os dados sobre a equipe aqui apresentados, foram analisados através das técnicas de análise de conteúdo e análise crítica do discurso. Os resultados indicam que a figura do clown é percebida como um mediador e valorizada como terapia complementar, especialmente pelas capacidades sócio-emocionais desses profissionais e o jogo que se utiliza como ferramenta de intervenção. As conclusões apontam que as capacidades sócio-emocionais que promovem o clown de hospital são fundamentais para o trabalho em cuidados paliativos.
Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Cuidados Paliativos/métodos , Pediatria/métodos , Pessoal de Saúde/psicologia , Terapia do Riso , Habilidades Sociais , Jogos e Brinquedos , Entrevistas como Assunto , Pesquisa Qualitativa , HospitaisRESUMO
There is little data on the experience of managing pediatric Intestinal Failure (IF) in Latin America. This study aimed to identify and describe the current organization and practices of the IF teams in Latin America and the Caribbean. An online survey was sent to inquire about the existence of IF teams that managed children on home parenteral nutrition (HPN). Our questionnaire was based on a previously published European study with a similar goal. Twenty-four centers with pediatric IF teams in eight countries completed the survey, representing a total number of 316 children on HPN. The median number of children on parenteral nutrition (PN) at home per team was 5.5 (range 1-50). Teams consisted of the following members: pediatric gastroenterologist and a pediatric surgeon in all teams, dietician (95.8%), nurse (91.7%), social worker (79.2%), pharmacist (70.8%), oral therapist (62.5%), psychologist (58.3%), and physiotherapist (45.8%). The majority of the centers followed international standards of care on vascular access, parenteral and enteral nutrition, and IF medical and surgical management, but a significant percentage reported inability to monitor micronutrients, like vitamins A (37.5%), E (41.7%), B1 (66.7%), B2 (62.5%), B6 (62.5%), active B12 (58.3%); and trace elements-including zinc (29.2%), aluminum (75%), copper (37.5%), chromium (58.3%), selenium (58.3%), and manganese (58.3%). Conclusion: There is wide variation in how IF teams are structured in Latin America-while many countries have well-established Intestinal rehabilitation programs, a few do not follow international standards. Many countries did not report having an IF team managing pediatric patients on HPN.