Permanent education in the vaccination room: what is the reality?

Diagnosis of vaccination rooms in Brazilian primary health care centers taking part in the PlanificaSUS project, 2019

OBJECTIVE

To describe the diagnosis of vaccination rooms in primary healthcare centers in Brazil.

METHODS

This was a cross-sectional study with secondary data of convenience sampling comprised of 25 rooms. Results of a checklist adapted from the Vaccine Room Supervision Tool of the National Immunization Program in 2019 regarding the dimensions 'general organization', 'general aspects', 'technical procedures', 'cold chain', 'information system', 'adverse events following vaccination', 'special immunobiological agents', 'epidemiological surveillance' and 'health education', were used. Percentages of scores, both overall and by dimensions were described in median, interquartile range, minimum and maximum values.

RESULTS

The overall median was 77.1%, higher for 'health education' (100.0%) and 'cold chain' (86.7%), and lower for 'special immunobiological agents' (50.0%) and 'general organization' (58.3%).

CONCLUSION

Using the checklist enabled the diagnosis in different macro-regions, inter- and intra-regional differences were found in the dimensions, and positive results and opportunities for improvement in the general plan.

Professional Safety in the daily life of primary health care: grounded theory

OBJECTIVE

to understand Professional Safety in daily life in Primary Health Care.

METHODS

this is a study on the Grounded Theory method and the Symbolic Interactionism theoretical framework with 82 health professionals.

RESULTS

it presents the category "Professional Safety in Daily Life in Primary Health Care: a Grounded Theory" and two subcategories determining and conditioning Professional Safety in PHC: professional training, infrastructure, support and technical responsibility; Professional Safety: physical protection, psychological support, distress and feelings reveal the (un)safe conditions. Professional Safety is mentioned in several dimensions that include professionals' knowledge, decision-making skills, the practice of the profession and what regulates it, the structure and organization of the Unified Health System and services, permanent education. It presents the context of primary care and the factors that impact an (unsafe) work.

FINAL CONSIDERATIONS

this study contributes to reflect on Professional Safety to strengthen safety culture in Primary Health Care.

Vaccine fake news: an analysis under the World Health Organization's 3Cs model

OBJECTIVE

To analyze fake news about immunobiologicals using as reference vaccine hesitancy in the World Health Organization's 3Cs model (confidence, complacency and convenience).

METHOD

This is an exploratory qualitative research that used content analysis to analyze fake news on three national news-checking sites.

RESULTS

Twenty fake news related to immunobiologicals were analyzed, with 55% published in 2018 and 63% related to yellow fever vaccine. From analysis of results, two empirical categories have emerged: Immunobiologicals have a potential risk of death/sequel; Immunobiologicals are ineffective.

CONCLUSION

Fake news have the potential to produce vaccine hesitancy based on the 3Cs model. Therefore, it is necessary to rethink communicative health practices that do not underestimate the asymmetries and inequities that characterize the unequal Brazilian society. Considering that nursing is the largest workforce in immunization rooms, there is a need for professionals' engagement as an active vehicle of truthful information in immunobiologicals for the population.

Evaluation of the Usability of the Immunization Information System in Brazil: A Mixed-Method Study

Introduction: Usability is a quality attribute that can evaluate the ease of use of user interfaces, based on standards called usability heuristics. Objective: To evaluate the usability components of the Brazilian Immunization Information System (IIS), focusing on the users and their interaction and agility with the interfaces. Materials and Methods: It was a concomitant and convergent mixed-method study that used a cross-sectional design for the quantitative approach and the indirect method of heuristic evaluation for the qualitative approach. Participants were 137 nursing professionals working in vaccination rooms, who completed a structured questionnaire on standards of usability quality, and 4 specialists in information technology, who used a semistructured form to carry out a software inspection. Descriptive and inferential statistics and the heuristic inspection were used for the analyses. Results: The evaluation resulted in 10 violated heuristics and identified 14 usability problems on the 68 screens of the IIS. The system presented simple usability problems (grade 2 severity), which can be repaired, with a low correction priority. The heuristics best evaluated were error prevention (3.03 ± 0.54) and help and documentation (3.00 ± 0.68); and the worst evaluated was visibility of system status, with a mean of 2.62 ± 0.55. Professionals with a technical education level presented a higher score on the scales for the recognition rather than recall heuristic when compared with the nurses (2.77 ± 0.49 vs. 3.67 ± 0.66, p = 0.003). Conclusion: The system provides easy access for users, however, has weaknesses in its ability to allow the users to easily achieve their goals of interaction with the interface.

Retrospective study of immunization errors reported in an online Information System

Objective:

to analyze the immunization errors reported in an online Information System.

Method:

retrospective study conducted with data from the Adverse Event Following Immunization Surveillance Information System. Immunization errors were analyzed with respect to demographic characteristics and the vaccination process. Frequencies and error incidence rates have been calculated. Binomial and chi-square tests were used to verify differences in the proportions of the variables.

Results:

501 errors were analyzed, the majority involving routine doses (92.6%), without Adverse Event Following Immunization (90.6%) and in children under five years old (55.7%). The most frequent types of errors were inadequacy in the indication of the immunobiological (26.9%), inadequate interval between doses (18.2%) and error in the administration technique (14.2%). The overall error incidence rate was 4.05/100,000 doses applied; the highest incidences of routine vaccines were for human rabies vaccine, human papillomavirus and triple viral; the incidence rate of errors with Adverse Events Following Immunization was 0.45/100,000 doses applied.

Conclusion:

it was found that immunization errors are a reality to be faced by the health systems, but they are amenable to prevention through interventions such as the adoption of protocols, checklists and permanent education in health.

Resources, objectives and guidelines in a Psychosocial Care Network structure

OBJECTIVE

to analyze a Psychosocial Care Network structure, based on the compromise of its resources and meeting objectives and guidelines recommended in Ordinance 3,088/2011.

METHOD

an empirical, quantitative study with 123 primary care professionals, psychosocial and emergency care, who work at Western Network of the city of São Paulo. Questionnaires and statistical analysis were applied through the Exact Fisher's test with 5% significance considering p= <0.05.

RESULTS

there is compromise of physical resources in the absence of mental health beds in a general hospital (p=0.047); of technological resources in the lack of discussion forums (p=0.036); of human resources in number of teams (p=0.258); and of financial resources (p=0.159). Psychosocial care is the one that most meets the objectives and guidelines.

CONCLUSION

there are insufficient physical, technological, human, and financial resources for the work articulated in the three care modalities that are heterogeneous in terms of meeting the objectives and guidelines.

Analysis of professional implication as a tool of permanent education in health

Objective:

analyze professional implication with the support of humanization and articulators of permanent education in health as a tool of Permanent Education in Health.

Method:

this is an interventional study of qualitative approach, based on the theoretical reference of Institutional Analysis. Thirty-five humanization supporters and/or permanent education articulators participated in this study. Semi-structured interviews, monthly meetings, restitution meetings and a daily logbook were used as tools for data production. The material was analyzed according to the principles of the study reference and the results were presented according to the ideological, organizational and libidinal dimensions of professional implication.

Results:

this study identified a contradiction when finding a professional profile for the development of support and articulation; feelings of discouragement, pessimism and optimism in the development of these roles; influences of the nursing profession on the development of support and articulation; length of professional service; and the absence/presence of desire in such development.

Conclusion:

the analysis of professional implication consisted of a powerful tool generating training processes. It allowed learning and reflection of the practice through analysis of the actions performed by the professionals, generating changes in the conception of work in health.

Vaccination in everyday life: experiences indicate Permanent Education

Abstract Objective: To understand Permanent Education in the daily work in the vaccination room, from the professional’s perspective. Method: A holistic-qualitative multiple-case study, based on the Quotidian Comprehensive Sociology, and carried out in four micro-regions of Minas Gerais State, Brazil, with 56 professionals working in seven municipalities. To analyze the data, the Thematic Content Analysis was used associated to the cases’ cross-synthesis. Results: The frequent changes in immunization, adverse events, professional accountability, as well as the daily difficulties of working in the vaccination room point to the need for Permanent Education. There is a need for doctors and community health agents to be trained in immunization, just as nurses are previously trained. The importance of Permanent Education for safe work and patient safety in vaccination is evidenced. Conclusion and implications for practice: Considering the relevance and complexity of work in the vaccination room, Permanent Education has the potential to strengthen teamwork, positively impact the care provided to users and provide professionals with more security in the practices carried out.