Contenido del artículo principal
Resumen
Introdução: A parada cardiorrespiratória é um evento crítico para o paciente dialítico, que necessita de uma equipe de enfermagem na hemodiálise apta a realizar o procedimento de ressuscitação cardiopulmonar.
Jstifica-se nesse contexto a educação permanente em enfermagem, que por meio da simulação in situ,
pode contribuir com a construção das competências em ressuscitação cardiopulmonar.
Objetivo: Verificar se diferentes periodicidades de formação utilizando a simulação in situ, influenciam
na construção de competências para a ressuscitação cardiopulmonar no ambiente da hemodiálise.
Material e Método: Trata-se de um estudo experimental não randomizado, realizado com profissionais de enfermagem de uma unidade de diálise situada em um Hospital Universitário de grande porte da região sul do Brasil. Os participantes foram alocados em 3 grupos que receberam periodicidades diferentes de intervenção (2, 4, e 8 meses).
Resultados: Os resultados apontaram diferenças estatisticamente significativa na análise do
conhecimento, no grupo de periodicidade de 4 meses. Na avaliação das habilidades, observou-se resultado significativo (p=0,048) para o grupo de periodicidade de 4 meses, na técnica da compressão torácica.
Conclusão: Com este estudo demonstramos que a simulação in situ promoveu a construção de competências no intervalo a cada 4 meses, corroborando com o fato de que a aprendizagem por meio da experimentação e a reflexão, e dentro do contexto profissional, podem contribuir com a educação permanente em saúde. Mais estudos no contexto da diálise são necessários para confirmar e generalizar os achados.
Palabras clave
Detalles del artículo
Aviso de derechos de autor/a
© Los autores ceden de forma no exclusiva los derechos de explotación de los trabajos publicados y consiente en que su uso y distribución se realice con la Licencia Creative Commons Atribución - No comercial 4.0 Internacional (CC BY-NC 4.0). Puede consultar desde aquí la versión informativa y el texto legal de la licencia. Esta circunstancia ha de hacerse constar expresamente de esta forma cuando sea necesario.
Referencias
- Passman R. Prevention of sudden cardiac death in dialysis patients: drugs, defibrillators or what else? Blood Purif. 2013;35:49-54.
- Hersog CA, Mangrum M, Passman R. Sudden cardiac death and dialysis patients. Semin Dial 2008; 21(4):300-7.
- Karnik JA, Young BS, Lew NL, Herget M, Dubinsky C, Lazarus JM et al. Cardiac arrest and sudden death in dialysis units. Kidney Int. 2001;60:350-7.
- Vázquez E, Sánchez-Perales C, García-García F, García-Cortés MJ, Torres J, Borrego F et al. Sudden death in incident dialysis patients. Am J Nephrol. 2014;39:331-6.
- Wang AY-M, Lam CW-K, Chan IH-S, Wang M, Lui S-F, Sanderson JE. Sudden cardiac death in end-stage renal disease patients a 5-year prospective analysis. Hypertension 2010; 56:210-6.
- Genovesi S, Boriani G, Covic A, Vernooij RWM, Combe C, Burlacu A et al. Sudden cardiac death in dialysis patients: different causes and management strategies. Nephrol Dial Transplant. 2019 Sep 20:gfz182. [En prensa]
- Davis TR, Young BA, Eisenberg MS, Rea TD, Copass MK, Cobb LA. Outcome of cardiac arrests attended by emergency medical services staff at community outpatient dialysis centers. Kidney Int. 2008;73:933-9.
- Hersog CA. Cardiac arrest in dialysis patients: approaches to alter an abysmal outcome. Kidney Int. 2003;63(Suppl 84):S197-200.
- Wong SPY, Kreuter W, Curtis JR, Hall YN, O´Hare A.M. Trends in In-Hospital Cardiopulmonary Resuscitation. JAMA Intern Med. 2015;175(6): 1028-35.
- Pun PH, Dupre ME, Starks MA, Tyson C, Vellano K, Svetkey LP et al. Outcomes for hemodialysis patients given cardiopulmonary resuscitation for cardiac arrest at outpatient dialysis clinics. J Am Soc Nephrol. 2019 Março; 30(3):461-70.
- National Kidney Foundation: Diretrizes de Prática Clínica da Iniciativa de Qualidade de Resultados de Doenças Renais (KDOQI) para doenças cardiovasculares em pacientes em diálise: Diretriz 8 Desfibrilação externa. [Internet] 2005 [Consultado 25 abr 2020]. Disponível em: http://kidneyfoundation.cachefly.net/professionals/KDOQI/guidelines_cvd/index.htm.
- American Heart Association. Destaques da American Heart Association 2015: Atualização da Diretrizes de RCP e ACE. [Internet] 2015 [Consultado 12 set 2019] [aprox. 36 p.]. Disponível em:https://eccguidelines.heart.org/wp-content/uploads/2015/10/2015-AHA-Guidelines-Highlights-Portuguese.pdf.
- Borges BLC, Machado AAV. Problematizando a assistência de enfermagem durante ressucitação cardiopulmonar em unidade de HD: desafio para o enfermeiro educador. Interbio. 2007;1(2):38-43.
- Martins JCA, Mazzo A, Mendes IAC, Rodrigues MA. A simulação no ensino de enfermagem. Coimbra: Unidade de Investigação em Ciências da Saúde: Enfermagem. [Internet] 2014 [Consultado 9 out 2019] [aprox. 310 p.]. Disponível em: https://web.esenfc.pt/v02/pa/conteudos/downloadArtigo.php?id_ficheiro=730.
- Rosen MA, Hunt EA, Pronovost PJ, Federowicz MA, Weaver SJ. In Situ Simulation in Continuing Education for the Health Care Professions: A Systematic Review. J Contin Educ Health Prof. 2012; 32(4):243-54.
- Kalaniti K. In situ simulation: let’s work, practice and learn together. Acta Paediatr. 2014;103(12): 1219-20.
- Mondrup F, Brabrand M, Folkestad L, Oxlund J, Wiborg KR, Sand NP, Knudsen T. In-hospital resuscitation evaluated by in situ simulation: a prospective simulation study. Scand J Trauma Resusc Emerg Med. 2011 Oct 6;19:55.
- Van Schaik SM, Plant J, Diane S, Tsang L, O’Sullivan P. Interprofessional Team Training in Pediatric Resuscitation: A Low-Cost, In Situ Simulation Program That Enhances Self-Efficacy Among Participants. Clin Pediatr (Phila) 2011;50(9):807-15.
- Yang CW, Yen ZS, McGowan JE, Chen HC, Chiang WC, Mancini ME et al. A systematic review of retention of adult advanced life support knowledge and skills in healthcare providers. Resuscitation 2012;.83(9):1055-60.
- Conway JM. Factors that influence skill decay and retention: A quantitative review and analysis. Hum Perform. 1998;11(1):29-55.
- Thomé FS, Sesso RC, Lopes AA, Lugon JR, Martins CT. Inquérito brasileiro de diálise crônica 2017. Braz. J. Nephrol. 2019;41(2):208-14.
- Meira FS, Figueiredo AE, Zemiarcki J, Pacheco J, Poli de Figueiredo CE, d’Avila DO . Two Variable Sodium Profiles and Adverse Effects During Hemodialysis: A Randomized Crossover Study. Ther Apher Dial 2010;.14(3):328-33.
- TruhlárˇA, Deakin CD, Soar J, Khalifa GEA, Alfonzo A, Bierens JJLM. European Resuscitation Council guidelines for resuscitation 2015 section 4. Cardiac arrest in special circumstances. Resuscitation 2015; 95:148-201.
- Mundell WC, Kennedy CC, Szostek JH, Cook DA. Simulation technology for resuscitation training: A systematic review and meta-analysis. Resuscitation 2013;84(9):1174-83.
- Bingham AL, Sen S, Finn LA, Cawley MJ. Retention of advanced cardiac life support knowledge and skills following high-fidelity mannequin simulation training. Am J Pharm Educ. 2015;.79(1):12.
- Tawalbeh LI, Tubaishat A. Effect of Simulation on Knowledge of Advanced Cardiac Life Support, Knowledge Retention, and Confidence of Nursing Students in Jordan. J Nurs Educ. 2014; 53(1):38-44.
- Smith KK, Gilcreast D, Pierce K. Evaluation of staff’s retention of ACLS and BLS skills. Resuscitation 2008;.78(1):59-65.
- Cepeda Brito JR, Hughes PG, Firestone KS, Ortiz Figueroa F, Johnson K, Ruthenburg T et al. Neonatal Resuscitation Program Rolling Refresher: Maintaining Chest Compression Proficiency Through the Use of Simulation-Based Education. Adv Neonatal Care. 2017;17(5):354-61.
- Rubio-Gurung S, Putet G, Touzet S, Gauthier-Moulinier H, Jordan I, Beissel A et al. In situ simulation training for neonatal resuscitation: an RCT. Pediatrics 2014;134(3):790-7.
- Carolan-Olah M , Kruger G , Brown V , Lawton F , Mazzarino M . Development and evaluation of a simulation exercise to prepare midwifery students for neonatal resuscitation. Nurse Educ Today 2016;36: 375-80.
- Sullivan NJ, Duval-Arnould J, Twilley M, Smith SP, Aksamit D, Boone-Guercio P et al. Simulation exercise to improve retention of cardiopulmonary resuscitation priorities for in-hospital cardiac arrests: A randomized controlled trial. Resuscitation 2015;86:6-13.
- Dewey J. Experiência e Educação. São Paulo: Companhia Editora Nacional; 1971.
- Bhanji F, Finn JC, Lockey A, Monsieurs K, Frengley R, Iwami T et al. Part 8: Education, implementation, and teams: 2015 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Circulation 2015;132(Suppl 2):42-68.
- Greif R, Lockey AS, Conaghan P, Lippert A, De Vries W, Monsieurs KG et al. European Resuscitation Council Guidelines for Resuscitation 2015. Section 10. Education and implementation of resuscitation. Resuscitation 2015;95:288-301.
Referencias
Passman R. Prevention of sudden cardiac death in dialysis patients: drugs, defibrillators or what else? Blood Purif. 2013;35:49-54.
Hersog CA, Mangrum M, Passman R. Sudden cardiac death and dialysis patients. Semin Dial 2008; 21(4):300-7.
Karnik JA, Young BS, Lew NL, Herget M, Dubinsky C, Lazarus JM et al. Cardiac arrest and sudden death in dialysis units. Kidney Int. 2001;60:350-7.
Vázquez E, Sánchez-Perales C, García-García F, García-Cortés MJ, Torres J, Borrego F et al. Sudden death in incident dialysis patients. Am J Nephrol. 2014;39:331-6.
Wang AY-M, Lam CW-K, Chan IH-S, Wang M, Lui S-F, Sanderson JE. Sudden cardiac death in end-stage renal disease patients a 5-year prospective analysis. Hypertension 2010; 56:210-6.
Genovesi S, Boriani G, Covic A, Vernooij RWM, Combe C, Burlacu A et al. Sudden cardiac death in dialysis patients: different causes and management strategies. Nephrol Dial Transplant. 2019 Sep 20:gfz182. [En prensa]
Davis TR, Young BA, Eisenberg MS, Rea TD, Copass MK, Cobb LA. Outcome of cardiac arrests attended by emergency medical services staff at community outpatient dialysis centers. Kidney Int. 2008;73:933-9.
Hersog CA. Cardiac arrest in dialysis patients: approaches to alter an abysmal outcome. Kidney Int. 2003;63(Suppl 84):S197-200.
Wong SPY, Kreuter W, Curtis JR, Hall YN, O´Hare A.M. Trends in In-Hospital Cardiopulmonary Resuscitation. JAMA Intern Med. 2015;175(6): 1028-35.
Pun PH, Dupre ME, Starks MA, Tyson C, Vellano K, Svetkey LP et al. Outcomes for hemodialysis patients given cardiopulmonary resuscitation for cardiac arrest at outpatient dialysis clinics. J Am Soc Nephrol. 2019 Março; 30(3):461-70.
National Kidney Foundation: Diretrizes de Prática Clínica da Iniciativa de Qualidade de Resultados de Doenças Renais (KDOQI) para doenças cardiovasculares em pacientes em diálise: Diretriz 8 Desfibrilação externa. [Internet] 2005 [Consultado 25 abr 2020]. Disponível em: http://kidneyfoundation.cachefly.net/professionals/KDOQI/guidelines_cvd/index.htm.
American Heart Association. Destaques da American Heart Association 2015: Atualização da Diretrizes de RCP e ACE. [Internet] 2015 [Consultado 12 set 2019] [aprox. 36 p.]. Disponível em:https://eccguidelines.heart.org/wp-content/uploads/2015/10/2015-AHA-Guidelines-Highlights-Portuguese.pdf.
Borges BLC, Machado AAV. Problematizando a assistência de enfermagem durante ressucitação cardiopulmonar em unidade de HD: desafio para o enfermeiro educador. Interbio. 2007;1(2):38-43.
Martins JCA, Mazzo A, Mendes IAC, Rodrigues MA. A simulação no ensino de enfermagem. Coimbra: Unidade de Investigação em Ciências da Saúde: Enfermagem. [Internet] 2014 [Consultado 9 out 2019] [aprox. 310 p.]. Disponível em: https://web.esenfc.pt/v02/pa/conteudos/downloadArtigo.php?id_ficheiro=730.
Rosen MA, Hunt EA, Pronovost PJ, Federowicz MA, Weaver SJ. In Situ Simulation in Continuing Education for the Health Care Professions: A Systematic Review. J Contin Educ Health Prof. 2012; 32(4):243-54.
Kalaniti K. In situ simulation: let’s work, practice and learn together. Acta Paediatr. 2014;103(12): 1219-20.
Mondrup F, Brabrand M, Folkestad L, Oxlund J, Wiborg KR, Sand NP, Knudsen T. In-hospital resuscitation evaluated by in situ simulation: a prospective simulation study. Scand J Trauma Resusc Emerg Med. 2011 Oct 6;19:55.
Van Schaik SM, Plant J, Diane S, Tsang L, O’Sullivan P. Interprofessional Team Training in Pediatric Resuscitation: A Low-Cost, In Situ Simulation Program That Enhances Self-Efficacy Among Participants. Clin Pediatr (Phila) 2011;50(9):807-15.
Yang CW, Yen ZS, McGowan JE, Chen HC, Chiang WC, Mancini ME et al. A systematic review of retention of adult advanced life support knowledge and skills in healthcare providers. Resuscitation 2012;.83(9):1055-60.
Conway JM. Factors that influence skill decay and retention: A quantitative review and analysis. Hum Perform. 1998;11(1):29-55.
Thomé FS, Sesso RC, Lopes AA, Lugon JR, Martins CT. Inquérito brasileiro de diálise crônica 2017. Braz. J. Nephrol. 2019;41(2):208-14.
Meira FS, Figueiredo AE, Zemiarcki J, Pacheco J, Poli de Figueiredo CE, d’Avila DO . Two Variable Sodium Profiles and Adverse Effects During Hemodialysis: A Randomized Crossover Study. Ther Apher Dial 2010;.14(3):328-33.
TruhlárˇA, Deakin CD, Soar J, Khalifa GEA, Alfonzo A, Bierens JJLM. European Resuscitation Council guidelines for resuscitation 2015 section 4. Cardiac arrest in special circumstances. Resuscitation 2015; 95:148-201.
Mundell WC, Kennedy CC, Szostek JH, Cook DA. Simulation technology for resuscitation training: A systematic review and meta-analysis. Resuscitation 2013;84(9):1174-83.
Bingham AL, Sen S, Finn LA, Cawley MJ. Retention of advanced cardiac life support knowledge and skills following high-fidelity mannequin simulation training. Am J Pharm Educ. 2015;.79(1):12.
Tawalbeh LI, Tubaishat A. Effect of Simulation on Knowledge of Advanced Cardiac Life Support, Knowledge Retention, and Confidence of Nursing Students in Jordan. J Nurs Educ. 2014; 53(1):38-44.
Smith KK, Gilcreast D, Pierce K. Evaluation of staff’s retention of ACLS and BLS skills. Resuscitation 2008;.78(1):59-65.
Cepeda Brito JR, Hughes PG, Firestone KS, Ortiz Figueroa F, Johnson K, Ruthenburg T et al. Neonatal Resuscitation Program Rolling Refresher: Maintaining Chest Compression Proficiency Through the Use of Simulation-Based Education. Adv Neonatal Care. 2017;17(5):354-61.
Rubio-Gurung S, Putet G, Touzet S, Gauthier-Moulinier H, Jordan I, Beissel A et al. In situ simulation training for neonatal resuscitation: an RCT. Pediatrics 2014;134(3):790-7.
Carolan-Olah M , Kruger G , Brown V , Lawton F , Mazzarino M . Development and evaluation of a simulation exercise to prepare midwifery students for neonatal resuscitation. Nurse Educ Today 2016;36: 375-80.
Sullivan NJ, Duval-Arnould J, Twilley M, Smith SP, Aksamit D, Boone-Guercio P et al. Simulation exercise to improve retention of cardiopulmonary resuscitation priorities for in-hospital cardiac arrests: A randomized controlled trial. Resuscitation 2015;86:6-13.
Dewey J. Experiência e Educação. São Paulo: Companhia Editora Nacional; 1971.
Bhanji F, Finn JC, Lockey A, Monsieurs K, Frengley R, Iwami T et al. Part 8: Education, implementation, and teams: 2015 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Circulation 2015;132(Suppl 2):42-68.
Greif R, Lockey AS, Conaghan P, Lippert A, De Vries W, Monsieurs KG et al. European Resuscitation Council Guidelines for Resuscitation 2015. Section 10. Education and implementation of resuscitation. Resuscitation 2015;95:288-301.