Cerebrovascular accident is a serious public health problem and requires the attention of professionals who can detect, diagnose, and provide care in a timely fashion. A quantitative quasi-experimental study was conducted using a mobile app called mSmartAVC for clinical evaluation of nursing care at the bedside. The study aimed at measuring the knowledge of nurses and nursing students in the detection and care of cerebrovascular accident. In this study, a total of 115 nurses from health services in the South of Brazil and 35 nursing students of a community university participated. The stages focused on development, modeling of clinical cases, problem-based learning, pretest (before) app use, and posttest (after) use of the app. The results of the pretest and posttest corrections showed a substantial statistical difference (P < .001), indicating a significant knowledge gain after the use of the app, particularly in terms of the detection scales and interpretation of the imaging tests. The mSmartAVC app used at the bedside supported decision-making for detection and nursing care. It was possible to confirm that the use of mobile apps plays an essential role as a learning tool for nurses and nursing students.

3 Doctoral student in Nursing at PEN/UFSC. CNPq and CAPES/Brazil fellow (program for international doctoral internshipProcess number 3858-10-3). Santa Catarina, Brazil. E-mail: danyccbarra@yahoo.com.br ABSTRACT: Integrative review publications that analyzed the contributions of electronic health records for patient safety in intensive care units. The survey was conducted in the databases CINAHL, MEDLINE and SciELO, using the keywords: electronic health records, information systems, nursing informatics, medical informatics, intensive care units, patient safety and security management. A total 64 articles were included and analyzed in two empirical categories: "Information systems and information technology: the electronic record for the continuity of nursing care", "decision support systems: contributions to patient safety" and "indicators of quality of care and patient safety from the records electronics". The studies pointed to contributions to continuity of care, decision making based on decision support systems and the creation of quality indicators and patient safety from electronic records. DESCRIPTORS:Electronic health records. Information systems. Nursing informatics. Safety management. Intensive care units. A SEGURANÇA DO PACIENTE EM TERAPIA INTENSIVA: UMA REVISÃO INTEGRATIVA RESUMO: Revisão integrativa que analisou nas publicações as contribuições dos registros eletrônicos em saúde para a segurança do paciente em unidades de terapia intensiva. A pesquisa foi realizada nas bases de dados CINAHL, MEDLINE e SciELO, utilizando os descritores: registros eletrônicos de saúde, sistemas de informação, informática em enfermagem, informática médica, unidades de terapia intensiva, segurança do paciente e gerenciamento de segurança. Foram incluídos 64 artigos, sendo analisados em três categorias: "sistemas de informação e informática em saúde: o registro eletrônico para a continuidade do cuidado de Enfermagem" e "sistemas de apoio à decisão: contribuições para a segurança do paciente" e "indicadores de qualidade do cuidado e de segurança do paciente partir dos registros eletrônicos". Os estudos apontaram como contribuições a continuidade do cuidado, a tomada de decisão baseada nos sistemas de apoio à decisão e a criação de indicadores de qualidade e segurança do paciente a partir dos registros eletrônicos. CONTRIBUIÇÕES DOS REGISTROS ELETRÔNICOS PARA DESCRITORES:Registros eletrônicos de saúde. Sistemas de informação. Informática em enfermagem. Gerenciamento de segurança. Unidades de terapia intensiva. CONTRIBUCIONES DE LOS REGISTROS ELECTRÓNICOS PARA LA SEGURIDAD DEL PACIENTE EN CUIDADOS INTENSIVOS: UNA REVISÓN INTEGRADORA RESUMEN:Revisión integrativa que analizó en las publicaciones las contribuciones de los registros electrónicos de salud para la seguridad de los pacientes en unidades de cuidados intensivos. La investigación se realizó en las bases de datos CINAHL, MEDLINE y SciELO, utilizando las palabras clave: registros médicos electrónicos, sistemas de información, informática de enfermería, informática méd...

Background The clinical decision-making process in pressure ulcer management is complex, and its quality depends on both the nurse's experience and the availability of scientific knowledge. This process should follow evidence-based practices incorporating health information technologies to assist health care professionals, such as the use of clinical decision support systems. These systems, in addition to increasing the quality of care provided, can reduce errors and costs in health care. However, the widespread use of clinical decision support systems still has limited evidence, indicating the need to identify and evaluate its effects on nursing clinical practice. Objective The goal of the review was to identify the effects of nurses using clinical decision support systems on clinical decision making for pressure ulcer management. Methods The systematic review was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) recommendations. The search was conducted in April 2019 on 5 electronic databases: MEDLINE, SCOPUS, Web of Science, Cochrane, and CINAHL, without publication date or study design restrictions. Articles that addressed the use of computerized clinical decision support systems in pressure ulcer care applied in clinical practice were included. The reference lists of eligible articles were searched manually. The Mixed Methods Appraisal Tool was used to assess the methodological quality of the studies. Results The search strategy resulted in 998 articles, 16 of which were included. The year of publication ranged from 1995 to 2017, with 45% of studies conducted in the United States. Most addressed the use of clinical decision support systems by nurses in pressure ulcers prevention in inpatient units. All studies described knowledge-based systems that assessed the effects on clinical decision making, clinical effects secondary to clinical decision support system use, or factors that influenced the use or intention to use clinical decision support systems by health professionals and the success of their implementation in nursing practice. Conclusions The evidence in the available literature about the effects of clinical decision support systems (used by nurses) on decision making for pressure ulcer prevention and treatment is still insufficient. No significant effects were found on nurses' knowledge following the integration of clinical decision support systems into the workflow, with assessments made for a brief period of up to 6 months. Clinical effects, such as outcomes in the incidence and prevalence of pressure ulcers, remain limited in the studies, and most found clinically but nonstatistically significant results in decreasing pressure ulcers. It is necessary to carry out studies that prioritize better adoption and interaction of nurses with clinical decision support systems, as well as studies with a representative sample of health care professionals, randomized study designs, and application of assessment instruments appropriate to the professional and institutional profile. In addition, long-term follow-up is necessary to assess the effects of clinical decision support systems that can demonstrate a more real, measurable, and significant effect on clinical decision making. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42019127663; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=127663

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INTRODUÇÃO: Uma partilha adequada de informação de enfermagem deve ser encarada como estratégia fundamental para a melhoria da continuidade de cuidados. A informação disponível e o encaminhamento da mesma na Unidade Local de Saúde de Matosinhos - Portugal, não tem dado uma resposta adequada às necessidades de informação sentidas pelos enfermeiros. OBJETIVOS: Este artigo apresenta o desenvolvimento e a definição de um modelo de organização e partilha de informação de enfermagem entre Hospital e Centro de Saúde. MÉTODOS: O estudo foi desenvolvido recorrendo à Técnica Delphi, com três rounds, integrando um painel de enfermeiros em exercício de funções nas diferentes áreas de actuação. RESULTADOS: Os consensos obtidos permitiram chegar a uma hierarquização de aspectos centrais do problema em estudo, nomeadamente dos pressupostos que devem guiar o desenvolvimento do sistema e da informação que deverá efectivamente ser partilhada entre hospital e centro de saúde, com indicação de níveis de prioridade de acesso. CONCLUSÕES: A articulação entre os diferentes contextos de cuidados de saúde deverá ser assegurada por um modelo que garanta a partilha recíproca e confidencial da informação de enfermagem, em tempo real, com recurso às Tecnologias de Informação e Comunicação.

Modern management, beyond its administrative components-planning, organizing, directing and control-requires a combination of knowledge, skills, attitudes and behaviors, such as leadership, performance management, strategic thinking and planning, negotiation, communication, human resource management and continual improvement, reflected on the intervention of head nurses. this article presents a part of a study developed in the Phd in nursing. Objective: to know the opinion of the directors of nurses from five hospitals in northern Portugal, in the areas of intervention of the head nurses. Method: this is a qualitative study in which a semi -structured interview to directors of nurses was used. data processing was performed using content analysis according to Bardin. Results: it is highlighted the convergence of views of respondents around care management, human resource management, materials and projects; strategic planning; nursing education; research and science. Conclusions:The head nurse is seen as a structural element in managing a care unit and driving force of development of care quality, professionals and services, making it essential to have a greater commitment in training these professionals.

Enquadramento: Ao longo dos anos foram-se verificando alterações substanciais ao nível da documentação em enfermagem resultantes da utilização de tecnologias da informação na atividade diária dos profissionais de saúde. Os médicos são os maiores consumidores da informação recolhida, processada e documentada pelos enfermeiros, dada a relevância dessa informação no seu processo de tomada de decisão clínica. Objetivos: Identificar e descrever a informação recolhida, processada e documentada pelos enfermeiros que é mais relevante para atividade profissional dos médicos. Metodologia: Estudo qualitativo e exploratório com recurso à observação participante (98 horas) e entrevistas semi-estruturadas (3) com informantes-chave, realizado em contexto hospitalar. Foi realizada a análise indutiva de conteúdo das notas de campo e entrevistas. Resultados: A informação mais relevante para os médicos depende do contexto dos sujeitos, da ação e das profissões, e foi agregada em três categorias: «parâmetros de vigilância»; «medicação e atitudes terapêuticas»; e «dados intercorrentes». Conclusão: As estratégias de recolha de dados mostraram-se capazes de gerar dados válidos para a identificação das categorias de informação mais relevantes para os médicos («parâmetros de vigilância», «medicação e atitudes terapêuticas» e «dados intercorrentes»). A informação relevante para os médicos não é influenciada por quem toma a decisão de prescrição da colheita dos dados. into three categories: "monitoring parameters"; "medication and therapeutic attitudes"; and "intercurrent data". Conclusion: Data collection strategies produced valid data to identify the most relevant information categories for physicians ("monitoring parameters", "medication and therapeutic attitudes" and "intercurrent data"). Relevant information for physicians is not influenced by the person who makes a decision on data collection.

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