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01-01-2016
Nasal colonization with Staphylococcus aureus in nursing students: ground for monitoring
Revista Brasileira de Enfermagem. 2016;69(6):1046-1051
Abstract
Nasal colonization with Staphylococcus aureus in nursing students: ground for monitoring
Revista Brasileira de Enfermagem. 2016;69(6):1046-1051
DOI 10.1590/0034-7167-2016-0210
Views0See moreABSTRACT
Objective:
to monitor bacterial strains of Staphylococcus aureus that are resistant or not to oxacillin in nursing undergraduate students, with an emphasis on the process of colonization.
Method:
cross-sectional prevalence study carried out with 138 nursing students. The biological samples of the nasal cavity were collected in June 2015, by means of sterile swabs, which were subsequently submitted to confirmatory tests of catalase and coagulase. Isolated Staphylococcus aureus had their sensitivity profile determined by means of the Kirby Bauer method. Descriptive, univariate and bivariate analyses were performed.
Results:
the prevalence of Staphylococcus aureus was 21.7. Regarding the resistance profile, 24.1% of strains were resistant to oxacillin, with ampicillin being the antimicrobial with the greatest resistance (82.8%).
Conclusion:
the nasal cavity is an important bacterial flora of S. aureus in nursing students. The profile of isolated strains highlights the increase of Staphylococcus aureus resistance to antimicrobials such as oxacillin.
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01-01-2016
Factors associated with the occurrence of adverse events in critical elderly patients
Revista Brasileira de Enfermagem. 2016;69(6):1039-1045
Abstract
Factors associated with the occurrence of adverse events in critical elderly patients
Revista Brasileira de Enfermagem. 2016;69(6):1039-1045
DOI 10.1590/0034-7167-2016-0199
Views0See moreABSTRACT
Objective:
to identify the factors associated with the occurrence of adverse events in critical elderly patients admitted to intensive care unit according to demographic and clinical characteristics.
Method:
a retrospective cohort study was conducted in nine units of a teaching hospital. Data were collected from medical records and from monitoring of nursing shift change. We used the t-test/Mann-Whitney, chi-square and logistic regression to test associations. Significance level of 5% was used.
Results:
out of the 315 elderly, 94 experienced events. Those who experienced events were men (60.6%) with mean age of 70.7 years, length of hospital stay of 10.6 days and survivors (61.7%). Most of the 183 events were clinical processes and procedures (37.1%). There was an association between adverse event and length of hospital stay in the unit (p=0.000; OR=1.10, 95% CI [1.06, 1.14]).
Conclusion:
the identification of associated events and factors in the elderly subsidize the prevention of these occurrences before the vulnerability of this age group.
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01-01-2016
Challenges to implementation of advance directives of will in hospital practice
Revista Brasileira de Enfermagem. 2016;69(6):1031-1038
Abstract
Challenges to implementation of advance directives of will in hospital practice
Revista Brasileira de Enfermagem. 2016;69(6):1031-1038
DOI 10.1590/0034-7167-2016-0085
Views0See moreABSTRACT
Objective:
to understand the difficulties and limitations in the implementation of advance directives of will in the hospital context.
Method:
qualitative, exploratory and descriptive study conducted by means of semi-structured interviews with nurses, resident physicians and family caregivers. The data were analyzed by using discursive textual analysis based on the framework of bioethics principles.
Results:
the following categories emerged: Terminality as an expression of loss and cure as an option for care; concerns about legal implications; advance directives of will demand patient autonomy and proper communication.
Conclusion:
limitations and difficulties in practice of advance directives of will from the perspective of the participants show, apart from countless conflicts and dilemmas regarding end-of life matters, that impending death experiences obstruct patients’ wishes.
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01-01-2016
Experience and coping strategies in relatives of addicts
Revista Brasileira de Enfermagem. 2016;69(6):1024-1030
Abstract
Experience and coping strategies in relatives of addicts
Revista Brasileira de Enfermagem. 2016;69(6):1024-1030
DOI 10.1590/0034-7167-2015-0044
Views0See moreABSTRACT
Objective:
to understand the experience and coping strategies in relatives of drug addicts.
Method:
a study was developed with 87 relatives of addicts, registered in two Basic Health Units. The focus group was used as the study method, and content analysis was applied.
Results:
four categories were chosen: perception of relatives about the drug addiction of their family members; feelings and attitudes related to being a relative of an addict; difficulties found in the process; and, coping strategies. The findings reflected the difficulty when mentioning the subject, and the need of being cared for. Relatives believed that the addict needs to have the will to get into treatment, and they faced challenges in dealing with sporadic disappearances. They pointed to feelings of pity, impotence, disgust, hate, shame, fear of aggressiveness, and humiliation.
Conclusion:
the biggest difficulties were dealing with relapses, and the lack of public resources. Religiosity and faith, isolation and advice were used as coping strategies; ambivalence in thoughts and attitudes was demonstrated.
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01-01-2016
Leadership and cooperation: 25 years of mission as a WHO collaborating center
Revista Brasileira de Enfermagem. 2016;69(6):1017-1023
Abstract
Leadership and cooperation: 25 years of mission as a WHO collaborating center
Revista Brasileira de Enfermagem. 2016;69(6):1017-1023
DOI 10.1590/0034-7167-2016-0058
Views0See moreABSTRACT
Objective:
analyse the evolution in the mission and vision of a World Health Organization Collaborating Centre in Nursing in Brazil in the context of the implementation of its terms of reference.
Method:
Historical-social documentary research with a qualitative approach.
Results:
During the 25 years of its activities as a Collaborating Centre, its mission to “promote and stimulate the development of nursing research in the region, with a focus on Latin America” triggered activities in the context of its terms of reference in four areas: Human Resource Formation for Research, Knowledge Production, Knowledge Dissemination, Encouragement of Exchange and Stimulus of Partnerships.
Conclusion:
The activities developed were consolidated through the strengthening of Brazilian and international partnerships, further stimulated by the five redesignations of the Collaborating Centre in the period analysed. Thus, its vision of becoming leader and driving agent of innovations in the academic, care and political context of nursing could be put in practice.
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01-01-2016
ABEn 90 years and the Brazilian Journal of Nursing
Revista Brasileira de Enfermagem. 2016;69(6):1011-1012
Abstract
ABEn 90 years and the Brazilian Journal of Nursing
Revista Brasileira de Enfermagem. 2016;69(6):1011-1012
Views0In this special edition, we celebrate 90 years of the Brazilian Nursing Association (ABEn), at the same time in which we celebrate the creation and maintenance of the first scientific nursing journal in Brazil. Emerging in 1932, it has shone a light on the production of knowledge and the constitution of nursing in Brazil today.As […]See more -
01-01-2016
ABEn 90 anos e a Revista Brasileira de Enfermagem
Revista Brasileira de Enfermagem. 2016;69(6):1011-1012
Abstract
ABEn 90 anos e a Revista Brasileira de Enfermagem
Revista Brasileira de Enfermagem. 2016;69(6):1011-1012
Views0Neste número temático, celebramos os 90 anos da Associação Brasileira de Enfermagem (ABEn), ao mesmo tempo em que comemoramos a criação e manutenção da primeira revista científica de enfermagem do Brasil, que, desde 1932, despontou trazendo luz para a produção do conhecimento e a constituição do que é a enfermagem no Brasil atual.A ABEn, como […]See more -
01-01-2016
ERRATUM
Revista Brasileira de Enfermagem. 2016;69(5):1003-1003
Abstract
ERRATUM
Revista Brasileira de Enfermagem. 2016;69(5):1003-1003
DOI 10.1590/0034-7167.20166905e02
Views1Article “Association between self-care and hospital readmissions of patients with heart failure”, with number of DOI: 10.1590/0034-7167.2016690312i, published in the journal Revista Brasileira de Enfermagem, v69(3):469-74, page 469 that read:“Amanda Chlalup LinnI, Karina AzollinII,III, Emiliane Nogueira de SouzaII,IV“.[…]See more
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01-01-2015
A Pesquisa em Enfermagem e os novos rumos a partir do SENPE
Revista Brasileira de Enfermagem. 2015;68(4):571-572
Abstract
A Pesquisa em Enfermagem e os novos rumos a partir do SENPE
Revista Brasileira de Enfermagem. 2015;68(4):571-572
DOI 10.1590/0034-7167.2015680401i
Views0Após quase meio século do início da pesquisa em Enfermagem no Brasil, ainda há necessidade de investimentos para considerá-la consolidada. Os seminários nacionais que discutem a investigação nesta área demonstram esta afirmação ao longo de 17 eventos, por seus resultados e participação da categoria de pesquisadores e prestadores de serviço.O 18º Seminário Nacional de Pesquisa […]See more -
01-01-2015
Comprehensive health care: dilemmas and challenges in nursing
Revista Brasileira de Enfermagem. 2015;68(2):333-338
Abstract
Comprehensive health care: dilemmas and challenges in nursing
Revista Brasileira de Enfermagem. 2015;68(2):333-338
DOI 10.1590/0034-7167.2015680221i
Views0See moreABSTRACT
Objective:
this article discusses comprehensive care as a guiding tenet of the Brazilian Unifi ed Health System (SUS), outlining health care practices, especially nursing, and the relationships built by subjects in action by means of different knowledge.
Methods:
this is a theoretical refl ection that aims to propose dimensions of analysis (access to services, reception, links, lines of care, accountability, and responsiveness), with an emphasis on the dilemmas and challenges of nursing. The proposed dimensions analyze the production of care and its political and technical aspects.
Conclusion:
care should be the focus of all health care work, bearing in mind that intervention for technological action of each profession goes beyond the core of isolated knowledge, as is the case of nursing, which is connected to other professional practices, and can peruse other territories that operate through relational technologies, entering into the world of the needs of users and families.
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01-01-2015
Gender and violence against women in nursing literature: a review
Revista Brasileira de Enfermagem. 2015;68(2):325-332
Abstract
Gender and violence against women in nursing literature: a review
Revista Brasileira de Enfermagem. 2015;68(2):325-332
DOI 10.1590/0034-7167.2015680220i
Views0See moreABSTRACT
Objective:
considering the potential of nursing to expand understanding on this theme, this study aims to learn what is being published on gender and violence against women in the main Brazilian nursing journals.
Method:
an integrative review of online publications between 2000 and 2012 was conducted. Of the 138 articles selected, 25 addressed gender and violence against women as social constructs.
Results:
there was a predominance of qualitative approaches (60%), empirical research (60%), academic (100%), authors who were nurses (96%), spousal violence (32%) and domestic violence (20%). Violence against women in the light of gender was associated in only 32% of the articles.
Conclusion:
there is a need for increased studies in partnership with the public health care service, and to expand discussions on the dynamics of power and resistance, which are the basis of the concept of gender.
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01-01-2015
Nasal colonization in nursing professionals from units specialized in HIV/AIDS
Revista Brasileira de Enfermagem. 2015;68(2):320-324
Abstract
Nasal colonization in nursing professionals from units specialized in HIV/AIDS
Revista Brasileira de Enfermagem. 2015;68(2):320-324
DOI 10.1590/0034-7167.2015680119i
Views0See moreABSTRACT
Objective:
to investigate the presence of microorganisms in the nostrils of the nursing professionals of a Brazilian teaching hospital.
Method:
cross-sectional study in two inpatient units specialized in HIV/AIDS. Nasal secretion samples of nursing professionals were collected in one month. The samples were processed at the microbiology laboratory of the institution and analyzed using the Statistical Package for the Social Sciences (SPSS) software, version 19.0. Ethical aspects were abided.
Results:
from the 73 members of the nursing staff, samples of nasal secretions were collected from 61 (80.2%). Six types of microorganisms were isolated in 22 (41.0%) positive cultures. It is noteworthy that Staphylococcus aureus accounted for 22.9%, four of them oxacillin-resistant (MRSA).
Conclusion:
Staphylococcus aureus microorganism accounted for the largest prevalence in individuals of this study.
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01-01-2015
Evaluation of nursing students about learning with clinical simulation
Revista Brasileira de Enfermagem. 2015;68(2):311-319
Abstract
Evaluation of nursing students about learning with clinical simulation
Revista Brasileira de Enfermagem. 2015;68(2):311-319
DOI 10.1590/0034-7167.2015680218i
Views0See moreABSTRACT
Objective:
to describe the contributions of clinical simulation for learning cognitive and procedural attributes through debriefi ng, from the perspective of nursing students.
Method:
descriptive exploratory study. Twenty nursing undergraduate students from a university in the interior of the state of São Paulo participated in this study. Data collection was performed at the debriefi ng stage. Student’s perceptions about the simulation, positive aspects and what they could have done differently were registered. The students’ statements were grouped according to the central themes and the framework of Bardin’s content analysis (2011) and were analyzed using descriptive statistics.
Results:
enhancement of active, critical and refl ective learning (47.5%) was identifi ed due to the closeness to reality in nursing care (20.3%), manifestation of feelings experienced during the simulation (15.3%) and composition of the scenario (15.3%).
Conclusion:
the clinical simulation followed by debriefi ng promotes the understanding of the link between action and achievements in learning.
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01-01-2015
Risk assessment of patient falls while taking medications ordered in a teaching hospital
Revista Brasileira de Enfermagem. 2015;68(2):305-310
Abstract
Risk assessment of patient falls while taking medications ordered in a teaching hospital
Revista Brasileira de Enfermagem. 2015;68(2):305-310
DOI 10.1590/0034-7167.2015680217i
Views0See moreABSTRACT
Objective:
to stratify prescribed medication in a fall risk scale, identifying subgroups of drugs and inpatient units with higher risk of falls.
Method:
retrospective study on prescription order forms given by medical clinic, surgical clinic, and general intensive care unit. Risk factors under consideration: 1) orthostatic hypotension; 2) arterial hypotension; 3) arterial hypertension; 4) bradycardia; 5) psychomotor agitation; 6) mental confusion; 7) dizziness; 8) drowsiness/sedation; 9) reduced eyesight; 10) seizures; 11) atonia/dystonia/muscle weakness; 12) hypoglycemia; 13) urgent urination and 14) urgent defecation/diarrhea. Risk levels adopted: 0: 0 factor; I: 1-2 factors; II: 3-5 factors; III: 6-9 factors; IV: 10-14 factors.
Results:
3893 drugs were analyzed and stratifi ed in levels: 0 22.7%; I 33.5%; II 28%; III 15.1%; IV 0.7%. Levels III and IV more often refer to drugs for stomach acid disorders, 22.6%, and psycholeptics, 100%.
Conclusion:
knowing the risk factors associated with medication may help prevent and reduce falls, especially when therapeutic regimens cannot be modifi ed.
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01-01-2015
Knowledge and practice of the nurse about leprosy: actions of control and elimination
Revista Brasileira de Enfermagem. 2015;68(2):297-304
Abstract
Knowledge and practice of the nurse about leprosy: actions of control and elimination
Revista Brasileira de Enfermagem. 2015;68(2):297-304
DOI 10.1590/0034-7167.2015680216i
Views0See moreABSTRACT
Objective:
to assess the knowledge and practice of primary health care nurses about control and elimination actions of leprosy.
Method:
evaluation study with qualitative approach, using the Discourse of the Collective Subject, data were collected through semi-structured interviews conducted with 16 nurses.
Results:
the data collected revealed that health professionals have suffi cient knowledge about the National Policy on Control and Elimination of Leprosy (NPCEL) and that the main actions preconized were applied, however, notifi cation of suspected or confi rmed cases and social reintegration of the patient were not mentioned.
Conclusion:
keeping patients in treatment, overload of work, lack of interdisciplinarity and treatment performed at other locations outside of the community were diffi culties reported by professionals. Nurses know the actions addressed at assistance of leprosy patients, however, the study points to the need for a practice which is more aligned to what advocates NPCEL.
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01-01-2015
Weaknesses of vaccine storage in Primary Healthcare Centers
Revista Brasileira de Enfermagem. 2015;68(2):291-296
Abstract
Weaknesses of vaccine storage in Primary Healthcare Centers
Revista Brasileira de Enfermagem. 2015;68(2):291-296
DOI 10.1590/0034-7167.2015680215i
Views0See moreABSTRACT
Objective:
assessment through qualitative approach of vaccine storage in Primary Healthcare Centers.
Method:
assessment study of qualitative approach in which 30 interviews were conducted with nurses, nursing technicians or assistants and technical reference in immunization, in 12 vaccine rooms that had 100% of the structural criteria evaluated. Recorded testimonials of the subjects were organized and analyzed using thematic Content Analysis.
Results:
the assessment pointed to absence of knowledge on the parts of nurses and nursing technicians and assistants with respect to the effects of low temperature on vaccines. Barriers were also encountered in relation to the supervision of nurses in the vaccine room activities and in relation to the knowledge needed by workers to care for preservation of vaccines.
Conclusion:
vaccine storage is inadequate and may compromise the quality of the immunobiologicals dispensed to the populace.
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ORIGINAL ARTICLE11-10-2023
Construction and validity of a storyboard about breast cancer for women deprived of liberty
Revista Brasileira de Enfermagem. 2023;76:e20220436
Abstract
ORIGINAL ARTICLEConstruction and validity of a storyboard about breast cancer for women deprived of liberty
Revista Brasileira de Enfermagem. 2023;76:e20220436
DOI 10.1590/0034-7167-2022-0436
Views0See moreABSTRACT
Objectives:
to build storyboards based on health literacy about breast cancer for women deprived of liberty for later production of videos and e-books.
Methods:
a methodological study, construction and validity of storyboards with 10 expert judges. The Educational Content Validation Instrument in Health and the Suitability Assessment of Materials were used. For validity, an agreement criterion greater than 80% was considered, verified from the Content Validation Index, with 40-100% for suitability.
Results:
the storyboards’ overall Content Validity Index was 0.99, combined with the measurement of suitability of 81% and readability percentage of 73.2, categorizing the material as superior and easy to read.
Conclusions:
the educational technology built proved to be valid and reliable, and can be transformed into an e-book and video to promote self-care for women deprived of liberty.
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ORIGINAL ARTICLE11-10-2023
Construction and validity of educational technology in audiovisual media on premature newborn care
Revista Brasileira de Enfermagem. 2023;76:e20220403
Abstract
ORIGINAL ARTICLEConstruction and validity of educational technology in audiovisual media on premature newborn care
Revista Brasileira de Enfermagem. 2023;76:e20220403
DOI 10.1590/0034-7167-2022-0403
Views0See moreABSTRACT
Objectives:
to construct and validate an educational video storyboard about care for premature newborns at home.
Methods:
a methodological study, with the construction of an educational video storyboard, validated with 14 judges. Content was selected from scoping review. For data collection, a validated instrument was used. The criterion for validity was agreement greater than 80%, analyzed using the Content Validity Index.
Results:
the storyboard construction was guided by the Cognitive Theory of Multimedia Learning theoretical framework. Construction and validity took place from May to December 2020. The storyboard’s final version lasted 10 minutes, and was validated in terms of objective, structure, presentation and relevance, with a Content Validity Index of 0.9.
Conclusions:
the storyboard of the educational video proved to be valid and adequate for health promotion in developing care for premature newborns at home.
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11-10-2023
ERRATA
Revista Brasileira de Enfermagem. 2023;76(5):e2023n5e04
Abstract
ERRATA
Revista Brasileira de Enfermagem. 2023;76(5):e2023n5e04
DOI 10.1590/0034-7167.20237605e04pt
Views0No artigo “Primeira graduada do Mestrado em Enfermagem em Prática Avançada em Oncologia no Chile”, com número DOI: , publicado no periódico Revista Brasileira de Enfermagem, 2023; 2023(Suppl 4):e76suppl401, no segundo parágrafo:Onde se lia:[…]See more -
ERRATUM11-10-2023
ERRATUM
Revista Brasileira de Enfermagem. 2023;76(5):e2023n5e04
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2023;76(5):e2023n5e04
DOI 10.1590/0034-7167.20237605e04
Views0In the article “First graduate of the Master of Nursing in Advanced Practice in Oncology in Chile”, with DOI number: , published in Revista Brasileira de Enfermagem, 2023(Suppl 4):e76suppl401, in the second paragraph:Where it read:[…]See more -
11-10-2023
Time to act sustainably: Why can’t we wait any longer?
Revista Brasileira de Enfermagem. 2023;76(5):e20220813
Abstract
Time to act sustainably: Why can’t we wait any longer?
Revista Brasileira de Enfermagem. 2023;76(5):e20220813
DOI 10.1590/0034-7167-2022-0813
Views0See moreABSTRACT
Objectives:
to raise reflections on the need for health services and professionals to implement sustainable actions, aiming at their own survival and that of the planet.
Methods:
reflective essay based on international reports regarding the impact of climate change on people’s health and the role of institutions in this context.
Results:
the article focused on three fundamentals: climate change continues to be a threat to the health and well-being of all beings on Earth; the institutions that should contribute to health are great agents of contamination of the environment and emission of gases that aggravate the greenhouse effect; and there are several benefits for health institutions to act sustainably.
Final Considerations:
we cannot wait any longer; we must develop policies and management models aimed at environmentally responsible, economically viable, and socially more collaborative healthcare.
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REVIEW11-10-2023
Applying Lean Healthcare in the hospitalization and patient discharge process: an integrative review
Revista Brasileira de Enfermagem. 2023;76(5):e20220751
Abstract
REVIEWApplying Lean Healthcare in the hospitalization and patient discharge process: an integrative review
Revista Brasileira de Enfermagem. 2023;76(5):e20220751
DOI 10.1590/0034-7167-2022-0751
Views0See moreABSTRACT
Objectives:
to identify scientific evidence regarding the use of Lean Healthcare approach in the hospitalization and patient discharge process.
Methods:
this is an Integrative Review conducted in the PubMed, LILACS, SCOPUS, CINAHL, Web of Science, and Embase databases.
Results:
out of 904 records identified, three were included in this review. The studies demonstrated that when applied to discharge planning, the Lean philosophy brings favorable results, promoting improvements in the communication process, as well as assisting in workflow organization, with a reduction in length of stay and improvement in the quality of care.
Final Considerations:
although the Lean methodology presents positive results, it is considered that the application of the philosophy in healthcare institutions is still not sustainable, as it is often restricted to specific departments or services. Thus, to maximize the success of implementation, the Lean philosophy needs to be incorporated into the organizational culture, representing the greatest challenge.
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11-10-2023
A eficácia do uso de livros interativos multimodalidade em enfermagem pediátrica na implementação do programa Merdeka Belajar
Revista Brasileira de Enfermagem. 2023;76(5):e20220599
Abstract
A eficácia do uso de livros interativos multimodalidade em enfermagem pediátrica na implementação do programa Merdeka Belajar
Revista Brasileira de Enfermagem. 2023;76(5):e20220599
DOI 10.1590/0034-7167-2022-0599
Views0See moreRESUMEN
Objetivos:
analizar la efectividad del uso de libros interactivos multimodales en enfermería pediátrica sobre los resultados de aprendizaje de los estudiantes en la implementación del Programa Merdeka Belajar.
Métodos:
investigación cuasi-experimental con un diseño de grupo de control posterior a la prueba. En este estudio, la muestra incluyó 52 estudiantes de enfermería del cuarto semestre del Instituto de Ciencias de la Salud Suaka Insan Banjarmasin que recibieron el curso de Enfermería Pediátrica. Fue utilizada la técnica de muestreo total y la prueba t dependiente en el análisis de datos.
Resultados:
el libro interactivo multimodal de enfermería pediátrica fue efectivo en la mejora del logro de aprendizaje de los estudiantes de cuarto semestre con un valor de significancia de 0,015 < 0,05. Hay una diferencia en el valor promedio de los cursos de enfermería pediátrica para la clase A y la clase B, que es de 3,173.
Conclusiones:
el uso de libros multimodales interactivos es muy bueno para que los profesores los apliquen en la enseñanza para ayudar a los estudiantes a comprender el material que están aprendiendo.
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ORIGINAL ARTICLE11-10-2023
The effectiveness of using interactive multimodality books in pediatric nursing in implementing Merdeka Belajar program
Revista Brasileira de Enfermagem. 2023;76(5):e20220599
Abstract
ORIGINAL ARTICLEThe effectiveness of using interactive multimodality books in pediatric nursing in implementing Merdeka Belajar program
Revista Brasileira de Enfermagem. 2023;76(5):e20220599
DOI 10.1590/0034-7167-2022-0599
Views0See moreABSTRACT
Objectives:
to analyzing the Effectiveness of Using Interactive Multimodality Books in Pediatric Nursing on Student Learning Outcomes in Implementing the Merdeka Belajar Program.
Methods:
the research design used a quasi-experimental approach with a posttest control group design. The sample in this study was the fourth-semester nursing students of Institute of Health Science Suaka Insan Banjarmasin who received the Pediatric Nursing course, a total of 52 students. The sampling technique used is total sampling. Data analysis used the dependent t-test.
Results:
the interactive multimodality pediatric nursing book was effective in improving the learning achievement of fourth-semester students with a significance value of 0.015 < 0.05. There is a difference in the average value of pediatric nursing courses for class A and class B, which is 3.173.
Conclusions:
the use of interactive multimodality books is very good for lecturers to apply in teaching to help students understand the material they are learning.
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