O processo de formação em saúde: o saber resíduos sólidos de serviços de saúde em vivências práticas

What do tomorrow's doctors need to learn about ecosystems? - A BEME Systematic Review: BEME Guide No. 36

BACKGROUND

Human health is fundamentally determined by the health of ecosystems. Guidance is lacking about how to address the topic of ecosystems within medical education.

AIMS

To determine the nature of discussions around ecosystems in the educational, medical and medical education literature. To identify learning needs of tomorrow's doctors.

METHODS

A narrative synthesis approach was used. Systematic searches were completed in 14 databases. Two independent reviewers screened results. Preliminary synthesis included textual descriptions and quality appraisal. Data were analysed using the Education for Sustainable Healthcare framework and thematic analysis. Relationships between studies were explored. Best evidence synthesis, contacting authors of primary studies and critical reflection reinforced robustness.

RESULTS

Six thousand seven hundred and fifty-three abstracts and 123 full texts were screened. Twenty-seven studies were included. Many studies lacked clear reporting. Medical students and doctors displayed knowledge about ecosystems, but lacked confidence to enact sustainable practices. Education about causes and consequences of environmental change is required. Few studies proposed specific learning objectives.

CONCLUSIONS

To prepare for roles as health care workers and leaders, medical students must learn about relationships between ecosystems, health and health care. The Education for Sustainable Healthcare framework outlines essential knowledge and attitudes but requires addition of practical competencies. Further research should explore the framework's relevance in different contexts, in order to structure training accordingly.

[Nursing workers' perceptions regarding the handling of hazardous chemical waste]

The objectives of this study were to identify the perceptions of nursing workers regarding the handling of hazardous chemical waste at the University of São Paulo University Hospital (HU-USP), and develop a proposal to improve safety measures. This study used a qualitative approach and a convenience sample consisting of eighteen nursing workers. Data collection was performed through focal groups. Thematic analysis revealed four categories that gave evidence of training deficiencies in terms of the stages of handling waste. Difficulties that emerged included a lack of knowledge regarding exposure and its impact, the utilization of personal protective equipment versus collective protection, and suggestions regarding measures to be taken by the institution and workers for the safe handling of hazardous chemical waste. The present data allowed for recommending proposals regarding the safe management of hazardous chemical waste by the nursing staff.

[Solid healthcare waste: a snapshot of the commitment of the nursing staff]

This work investigated knowledges and attitudes of nurses from the staff of Hospital de Clínicas de Porto Alegre (HCPA), Rio Grande do Sul, Brazil, on solid healthcare waste (SHCW). This is an exploratory descriptive research with a qualitative approach. The data were obtained from semi-structured interviews applied to 24 nurses from the staff. Content analysis was used to categorize the data. Four categories were identified: Meaning of the phrase solid healthcare waste; Separation of solid healthcare waste; Realization of the course/knowledge; and Professionals who do not separate. Results confirmed the importance to treat this issue more seriously, emphasizing the need of access to appropriate guidance.