How to cite this article:Alves DFS, Guirardello EB. Nursing work environment, patient safety and quality of care in pediatric hospital. Rev Gaúcha Enferm. 2016 jun;37 (2) RESUMEN Objetivos:Describir las características del ambiente de trabajo, las actitudes hacia la seguridad, el cuidado de la calidad medida por el personal de enfermería de las unidades de pediatría, así como analizar la evolución de los indicadores de bienestar y desempeño de los hospitales. Métodos: Estudio descriptivo con 136 profesionales en un asilo de ancianos hospital pediátrico, realizado a través de la forma de caracterización personal y profesional, Enfermería Índice de Trabajo -Revisado, Actitudes Seguridad Cuestionario -Short Form 2006 y los indicadores de calidad. Resultados: Los profesionales perciben el ambiente tan favorable a la práctica profesional y de la buena calidad de la atención, una reducción de los eventos adversos y la estancia hospitalaria. Satisfacción en el trabajo se consideró favorable para la seguridad del paciente. Conclusiones: El ambiente de trabajo es propicio para la práctica de los profesionales de enfermería que aprueban la calidad de la atención y la reducción de puntos de indicadores de los eventos adversos y la estancia hospitalaria Palabras clave: Ambiente de instituciones de salud. Seguridad del paciente. Calidad de la atención de salud. Satisfacción en el trabajo. Evaluación del resultado de la atención al paciente.

Initiatives to improve the professional practice environment can improve the safety of paediatric patients and the well-being of professional nurses.

Investments to reduce emotional exhaustion and to improve job satisfaction among professional nurses allocated to paediatric hospitals might contribute to the patients' safety.

Objectives: The objective was to assess the stress levels of parents of children with cancer and to identify correlations among demographic data and anxiety levels. Methods: A descriptive, crosssectional study, conducted in two Brazilian institutions, with 101 parents of children with cancer.Through interviews, parents responded to two instruments: Pediatric Inventory for Parents -Brazilian version, which assesses stress levels, and State-Trait Anxiety Inventory, for the measurement of anxiety. The correlations between the instruments and the sociodemographic variables of the parents and children were evaluated using the Spearman correlation coefficient.Results: Higher levels of stress and anxiety were seen by young parents, young children and with less time since diagnosis. The fear of death and the disease impact on the life of a child were the events considered the most stressful for the parents. Conclusions: In clinical practice, the nurse who can identify the occurrence of these symptoms becomes capable of planning nursing care that includes the family in decisions about the care. Moreover, she can provide support to help parents manage their stress levels and positively face the illness of their children.

ABSTRACT:Methodological study aimed at translating and adapting The Bates-Jensen Wound Assessment Tool for the Brazilian culture, through five stages: translation, synthesis, back translation, review by an expert panel, and, testing of the translated version. The Portuguese version was evaluated by 28 nurses who tested the understanding and practicality of the items. The expert panel evaluated the equivalence between the original and translated versions, resulting in concordance lower than 80% for seven items of the General Guidelines, which were modified. In the instrument, 13 items obtained a concordance rate exceeding 80%, except for Wound Status Continuum, which achieved 40%. Testing the translated version indicated good practicality. The Bates-Jensen Wound Assessment Tool is available in Brazil for research and use in clinical practice. Reliability and validity testing should be considered in future studies. DESCRIPTORS:Translation. Nursing, methodology research. Wound healing. Nursing assessment. TRADUÇÃO E ADAPTAÇÃO DO BATES-JENSEN WOUND TRADUCCIÓN Y ADAPTACIÓN DE LA BATES-JENSEN WOUNDASSESSMENT TOOL PARA LA CULTURA BRASILEÑA RESUMEN: Estudio metodológico destinado a la traducción y la adaptación del Bates-Jensen Wound Assessment Tool para la cultura brasileña a través de cinco etapas: traducción, síntesis, retro-traducción, revisión por un panel de expertos y las pruebas de la versión traducida. La versión en portugués fue evaluada por 28 enfermeras que verificaron la comprensión de los elementos y la practicidad. El comité de especialistas evaluó la equivalencia entre las versiones originales y traducidas, lo que resulta en una menor concordancia del 80% para siete de los ítems de la guía, que posteriormente fueron modificados. En el instrumento, los 13 ítems obtuvieron una tasa de concordancia superior al 80%, excepto para el ítem de la evaluación de la herida, que obtuvo el 40%. La prueba de la versión pre-final demostró buena factibilidad. El Bates-Jensen Wound Assessment Tool está disponible en Brasil para su uso en la investigación y la práctica clínica. La fiabilidad y la validez de las pruebas deben ser consideradas en futuros estudios DESCRIPTORES:Traducción. Investigación metodológica em enfermería. Cicatrización de heridas. Evaluación en enfermería.

Aim To test a theoretical model aiming to understand which characteristics of the professional nursing practice environment most affect patients, professionals and institution outcomes. Design A cross‐sectional and correlational study, using a structural equation model. Methods One thousand seven hundred and seventy‐three staff nurses were recruited using convenience sampling in five Brazilian hospitals from November 2017 to July 2018. Structural equation modelling was used to assess the relationship between the characteristics of the nursing work environment and patients (climate of safety and quality of care), nursing professionals (job satisfaction and emotional exhaustion) and institutions (intention to leave the job) outcomes. The model was tested using the partial least squares method, considering the bootstrapping technique to estimate the results. The path coefficients and their respective 95% confidence intervals were calculated. The quality of fit of the structural model was assessed by calculating the coefficient of determination (R2), the predictive validity coefficient (Q2) and the effect size (f2). Results The characteristics that most affected the outcomes for patients were Nurse manager ability, leadership and support of nurses (λ=0.27), and Staffing and resource adequacy (λ=0.26); for nursing professionals, Staffing and resource adequacy (λ=−0.19), and Collegial nurse–physician relations (λ=0.19); and for institutions, Nurse manager ability, leadership and support of nurses (λ=−0.10), and Collegial nurse–physician relations (λ=−0.10). Conclusion The characteristics of the professional nursing practice environment that most contribute to achieving better outcomes include nurse manager ability, leadership and support of nurses, staffing and resource adequacy, and collegial nurse–physician relations. Impact This study allowed us to assess which strategies should be prioritized in the professional nursing practice environment to achieve better results. Thus, investment in the training of leadership, in the adequacy of resources, and in physician–nurse relations will bring better results for patients, nursing professionals, and institutions.

OBJECTIVES: to assess the construct validity and reliability of the Pediatric Patient Classification Instrument. METHODS: correlation study developed at a teaching hospital. The classification involved 227 patients, using the pediatric patient classification instrument. The construct validity was assessed through the factor analysis approach and reliability through internal consistency. RESULTS: the Exploratory Factor Analysis identified three constructs with 67.5% of variance explanation and, in the reliability assessment, the following Cronbach's alpha coefficients were found: 0.92 for the instrument as a whole; 0.88 for the Patient domain; 0.81 for the Family domain; 0.44 for the Therapeutic procedures domain. CONCLUSIONS: the instrument evidenced its construct validity and reliability, and these analyses indicate the feasibility of the instrument. The validation of the Pediatric Patient Classification Instrument still represents a challenge, due to its relevance for a closer look at pediatric nursing care and management. Further research should be considered to explore its dimensionality and content validity.

Objective: To assess the reliability and validity of the Brazilian version of the Nursing Work Index-Revised among nursing aides and technicians. Methods: A methodological cross-sectional study was conducted in two teaching hospitals. The sample consisted of 150 subjects and data were collected with the use of a personal and professional information sheet, the Brazilian version of the Nursing Work Index-Revised for nursing aides and technicians and the Maslach Burnout Inventory. Results: Cronbach's alpha varied from 0.58 to 0.77 among the subscales of the Nursing Work Index-Revised and all its subscales obtained significant correlation with the subscales of the Maslach Burnout Inventory and the "job satisfaction," "intention to leave the job," and "nurse perception of quality of care" variables. Conclusion: The instrument presented reliability and validity for evaluating the practice environment of these professionals. ResumoObjetivo: Avaliar a confiabilidade e validade da versão brasileira do Nursing Work Index -Revised entre auxiliares e técnicos de enfermagem. Métodos: Estudo metodológico, transversal, realizado em dois hospitais de ensino. A amostra foi composta por 150 sujeitos e para a coleta de dados foram utilizados: a ficha de caracterização pessoal e profissional, a versão brasileira do Nursing Work Index -Revised para auxiliares e técnicos de enfermagem e o Inventário de Burnout de Maslach. Resultados: O coeficiente alfa de Cronbach variou de 0,58 a 0,77 entre as subescalas do Nursing Work Index -Revised e todas as suas subescalas obtiveram correlação significativa com as subescalas do Inventário de Burnout de Maslach e as variáveis "satisfação com o trabalho", "intenção de deixar o emprego" e "percepção da qualidade do cuidado". Conclusão: O instrumento demonstrou confiabilidade e validade satisfatórias para avaliar o ambiente da prática desses profissionais.