Competences in the training of nurses to assist the airway of adult patients in urgency and emergency situations

Objective:

construction and validation in appearance and content of the competence frameworks and of the Entrustable Professional Activities to develop skills in the training of nurses to assist the airway of adult patients in urgency and emergency situations.

Method:

a descriptive and methodological study developed in four phases: in the first, a workshop was held, composed of experts, for the construction of the competence frameworks; in the second, the material was validated using the Snowball Technique and the Delphi Technique, in the third, content analysis and calculation of the Content Validation Index were conducted; and in the fourth phase, the Entrustable Professional Activities were built, validated in simulated workshops.

Results:

the competence frameworks were built and validated, with a resulting CVI≥0.85 in all the items. The Entrustable Professional Activities were validated by experts regarding their applicability; of these, 44% stated they were applicable in simulated environments, 100% that they were useful content and with appropriate language, 22% suggested the insertion of new items to assess competence, 11% reported the difficulty of assessing competence individually in the clinical settings, and 11% of the experts referred to the need for prior training of the teacher/facilitator to use it.

Conclusion:

the study resulted in the construction of competence frameworks and six Entrustable Professional Activities relating them to the domains of essential competences in the training of nurses to assist the airway of adult patients in urgency and emergency situations. The participation of experts in the construction and validation of this material was essential to guarantee the theoretical and practical relevance of the result.

Confirmatory factorial analysis of the Maslach Burnout Inventory - Human Services Survey in health professionals in emergency services

OBJECTIVE

to confirm the factorial validity of the Maslach Burnout Inventory - Human Services Survey version in a sample of health professionals from the emergency services.

METHOD

a quantitative, exploratory, descriptive and analytical study. Two hundred and eighty-two health professionals participated in the study. For data collection, a sociodemographic questionnaire and the Maslach Burnout Inventory were used. The psychometric sensitivity for the MBI-HSS items was estimated by measures of central tendency, variability and the distribution shape. Internal consistency was estimated using Cronbach's alpha coefficient and the adequacy of the sample was verified using the Kaiser-Meyer-Olkin (KMO) index. As indexes for assessing the quality of fit of the model, the chi-square ratio by the degrees of freedom (χ2/DoF), the comparative fit index (CFI), the goodness of fit index (GFI), the Tucker Lewis index (TLI) and the root mean square error of approximation (RMSEA) were considered. To test data fit, the maximum likelihood method was used.

RESULTS

the three-factor structure of the Maslach Burnout Inventory was confirmed. Items 9, 12, 15 and 16 had a factorial weight below what was considered appropriate and were removed from the model. The second order hierarchical model with the aforementioned modifications presented an adequate adjustment to the data and can be considered the best and most parsimonious model tested according to the information theory indexes. The internal consistency of the instrument's factors was recalculated considering the exclusion of the items and the three factors were considered adequate.

CONCLUSION

the results obtained show that the Maslach Burnout Inventory is a reliable and factorially valid instrument for measuring the burnout syndrome in emergency service professionals in Brazil.

Construction and validation of competency frameworks for the training of nurses in emergencies

Objective:

to build and validate competency frameworks to be developed in the training of nurses for the care of adult patients in situations of emergency with a focus on airway, breathing and circulation approach.

Method:

this is a descriptive and methodological study that took place in three phases: the first phase consisted in a literature review and a workshop involving seven experts for the creation of the competency frameworks; in the second phase, 15 experts selected through the Snowball Technique and Delphi Technique participated in the face and content validation, with analysis of the content of the suggestions and calculation of the Content Validation Index to assess the agreement on the representativeness of each item; in the third phase, 13 experts participated in the final agreement of the presented material.

Results:

the majority of the experts were nurses, with graduation and professional experience in the theme of the study. Competency frameworks were developed and validated for the training of nurses in the airway, breathing and circulation approach.

Conclusion:

the study made it possible to build and validate competency frameworks. We highlight its originality and potentialities to guide teachers and researchers in an efficient and objective way in the practical development of skills involved in the subject approached.