Reflexivity, knowledge and ecological awareness: premises for responsible action in the hospital work environment

DISCUSSING THE CONSEQUENCES OF ENVIRONMENTAL EDUCATION ACTIONS IN A CONTEXT OF REFLECTIVE MODERNITY

ABSTRACT Objective: to discuss the reasons why the results of environmental education in hospitals do not correspond to the expected based on the concepts of Risk Society and Reflective Modernity, and pointing out alternatives for more effective educational actions in these institutions. Method: this was a qualitative research using a case study method by interviewing nine workers from the Environmental Education Nucleus of a hospital group. The data were collected by documentary research and semi-structured interview and analyzed by content analysis. Results: the two categories showed that some elements related to Reflective Modernity contributed to the low effectiveness of environmental education actions in hospitals. These included: the influence of abstract systems (specialists) regarding the thinking of individuals; The existence of protective cocoons, reflexivity without reflection, complicity and generalized irresponsibility in the face of ecological risks, and also the segmentation of the environments, which leads to the pluralization of the self in various selves. Conclusion: it is recommended to use educational experiences based on sensitivity, life and art, accompanied by reflection. This would make it possible to break with this logic of self-confrontation with environmental risks, without weaving a reflection on them, which is typical of Reflective Modernity. In addition, it is suggested that health institutions locally adopt and, locally, a sound pro-environmental policy.

Sustentabilidade ambiental nos processos de medicação realizados na assistência de enfermagem hospitalar

Resumo Objetivo Foram analisadas ações sustentáveis realizadas pela equipe de enfermagem de uma unidade de terapia intensiva durante os processos de medicação e proposto intervenções para a melhoria da sustentabilidade ambiental na área hospitalar. Métodos Estudo antes e depois usando a metodologia Lean Seis Sigma aplicada em uma unidade de terapia intensiva. A amostra foi composta por 648 processos de medicação realizados pela equipe de enfermagem. Os dados foram coletados por meio de roteiros de observação e analisados quantitativamente. Resultados Os resultados pós-intervenções incluíram a redução dos materiais como sacos plásticos (37,1%), redução de sobras de anti-inflamatórios hormonais (67,1%), aumento na remoção de etiquetas de sacos plásticos para serem reciclados (146,9%) e descarte correto de resíduos (32,2%) com diferença estatística significante (p ≤0.05). Conclusão As estratégias de intervenções implementadas a partir da análise do problema, validação e priorização das ações teve influência positiva na redução, reciclagem e disposição correta dos resíduos com benefícios para a instituição, meio ambiente e a saúde humana.

Evaluation of environmentally sustainable actions in the medication process

OBJECTIVE

to analyze sustainable actions from an environmental point of view in the medication process, from the reception of the prescription of the pharmacy to waste discard by nursing.

METHOD

study before and after performed through Lean Six Sigma methodology. The sample consisted of the amount and type of waste resulting from the pharmacy and nursing services of a medical-surgical clinical unit.

RESULTS

after the intervention was obtained at the pharmacy a reduction of 74.8% of chemical, infectious and sharps waste, an increase of 33.3% of common recyclable and 20% of common non-recyclable. In nursing, there was a reduction of 22.5% of chemical, infectious and sharps waste, an increase of 22.9% of common recyclable and an increase of 20% of common non-recyclable.

CONCLUSION

the practice of sustainable actions in the hospital is possible, contributing to the optimization of resources and waste production with benefits to the institution, environment, and health.

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.

Doctoral Theses from Nursing Postgraduate Programs in Brazil and their Association with the Millennium Development Goals

OBJECTIVES

The Millennium Development Goals are centered around combatting poverty and other social evils all over the world. Thus, this study seeks to identify the Millennium Development Goals as an object of study in theses from Postgraduate Nursing Programs in Brazil scoring 5 (national excellence) and 6 or 7 (international excellence), and evaluate the association between the score for the program and achieving the Millennium Development Goals.

METHOD

Exploratory descriptive document research. Data were collected from the Notes on Indicators/Coordination for Higher Education Personnel Improvement for the 15 Postgraduate Nursing Courses scoring between 5 and 7 in the three-year-period of 2010/2012.

RESULTS

of the 8 Millennium Development Objectives, 6 were dealt with in the theses. There was an association (Fisher's exact test p-value=0.0059) between the distribution of the theses and the program scores in relation to the Millennium Development Objectives (p-valor=0.0347)CONCLUSION: the doctoral theses were slightly related to the Millennium Development Objectives, covering the population's economic development, health conditions and quality of life. It is recommended that Postgraduate Programs in Nursing pay closer attention to the Millennium Development Objectives.