-
ORIGINAL ARTICLE05-27-2024
Assessment of educational technology in lactation physiology by health students
- Daiani Oliveira Cherubim
, - Polyana de Lima Ribeiro ,
- Tassiane Ferreira Langendorf ,
- Cristiane Cardoso de Paula ,
- Stela Maris de Mello Padoin
Abstract
ORIGINAL ARTICLEAssessment of educational technology in lactation physiology by health students
Revista Brasileira de Enfermagem. 2024;77(2):e20230252
DOI 10.1590/0034-7167-2023-0252
- Daiani Oliveira Cherubim ,
- Polyana de Lima Ribeiro ,
- Tassiane Ferreira Langendorf ,
- Cristiane Cardoso de Paula ,
- Stela Maris de Mello Padoin
Views0See moreABSTRACT
Objectives:
to assess the suitability, facilitators, and barriers of using a video clip for teaching lactation physiology to health students.
Methods:
a cross-sectional study was conducted with online data collection at a higher education institution, using the Assistive Technology Assessment Instrument and open-ended questions. The sample consisted of 88 students.
Results:
the video clip was deemed suitable in all attributes. Facilitators identified included attractiveness, musicality, and ease of access. Barriers noted were the music’s speed and the necessity for prior knowledge. The video clip achieved adequate scores for interactivity (1.71), purpose (1.77), relevance (1.64), and clarity (1.77). The overall average of the attributes was 1.72.
Conclusions:
the video clip can serve as an effective learning strategy to enhance hybrid education, potentially contributing to the promotion and support of breastfeeding. However, some barriers underscore the importance of prior knowledge for a complete understanding of the content.
- Daiani Oliveira Cherubim
-
ORIGINAL ARTICLE05-27-2024
Technology for nursing care in a Maternal Intensive Care Unit: a methodological study
- Fabíola Nunes de Sá ,
- Jéssica Lourenço Carneiro ,
- Linicarla Fabiole de Souza Gomes ,
- Joselany Afio Caetano ,
- Ana Karina Bezerra Pinheiro , [ … ],
- Ana Kelve de Castro Damasceno
Abstract
ORIGINAL ARTICLETechnology for nursing care in a Maternal Intensive Care Unit: a methodological study
Revista Brasileira de Enfermagem. 2024;77(2):e20230202
DOI 10.1590/0034-7167-2023-0202
- Fabíola Nunes de Sá ,
- Jéssica Lourenço Carneiro ,
- Linicarla Fabiole de Souza Gomes ,
- Joselany Afio Caetano ,
- Ana Karina Bezerra Pinheiro ,
- Ana Kelve de Castro Damasceno
Views0See moreABSTRACT
Objectives:
to develop and validate a nursing care plan in a Maternal Intensive Care Unit.
Methods:
a methodological study, developed in stages: integrative review; Nursing History construction; care plan restructuring; appearance and content validity by judges.
Results:
the history was organized into sections: Identification; Basic Human Needs; Physical Examination; and Assessment of Basic Human Needs. A care plan was restructured with 34 diagnoses, organized according to basic human needs. A satisfactory level of appearance validity of the history and care plan was obtained (Concordance Index varying between 86.3 and 100 for both instruments), and content validity with average indexes of 90.8 and 92.8, respectively. Thirty-four diagnoses, their interventions and nursing actions were consolidated.
Conclusions:
the instruments were considered relevant and pertinent in terms of appearance and content, and their use in the institution under study as well as in other similar services may be recommended.
- Fabíola Nunes de Sá
-
ORIGINAL ARTICLE05-27-2024
Nursing care protocol for critical users with tracheostomy under mechanical ventilation
- Fernando Conceição de Lima ,
- Wagner Felipe dos Santos Neves ,
- André Lucas de Lima Dias ,
- Clarissa Porfírio Mendes ,
- Alzinei Simor , [ … ],
- Mary Elizabeth de Santana
Abstract
ORIGINAL ARTICLENursing care protocol for critical users with tracheostomy under mechanical ventilation
Revista Brasileira de Enfermagem. 2024;77(2):e20230337
DOI 10.1590/0034-7167-2023-0337
- Fernando Conceição de Lima ,
- Wagner Felipe dos Santos Neves ,
- André Lucas de Lima Dias ,
- Clarissa Porfírio Mendes ,
- Alzinei Simor ,
- Ingrid Magali de Souza Pimentel ,
- Helena Megumi Sonobe ,
- Mary Elizabeth de Santana
Views0See moreABSTRACT
Objectives:
to develop and assess a nursing care protocol for critically ill users with tracheostomy under mechanical ventilation.
Methods:
a methodological study, developed through two phases, guided by the 5W2H management tool: I) target audience characterization and II) technology development.
Results:
thirty-four nursing professionals participated in this study, who presented educational demands in relation to care for critical users with tracheostomy, with an emphasis on standardizing care through a protocol and carrying out continuing education.
Final Considerations:
the creation and validity of new technologies aimed at this purpose enhanced the participation of nursing professionals and their empowerment in the health institution’s microsectoral actions and in macrosectoral actions, highlighting the need for public policies that guarantee the conduct of a line of care for users with tracheostomy.
- Fernando Conceição de Lima
-
ORIGINAL ARTICLE05-27-2024
Fall Tailoring Interventions for Patient Safety Brazil Program: an evaluability study in a teaching hospital
Revista Brasileira de Enfermagem. 2024;77(2):e20230348
Abstract
ORIGINAL ARTICLEFall Tailoring Interventions for Patient Safety Brazil Program: an evaluability study in a teaching hospital
Revista Brasileira de Enfermagem. 2024;77(2):e20230348
DOI 10.1590/0034-7167-2023-0348
Views0See moreABSTRACT
Objectives:
to present the theoretical model, logic model, and the analysis and judgment matrix of the Fall TIPS Brazil Program.
Methods:
a qualitative, participatory research approach, in the form of an evaluability study, encompassing the phases (1) problem analysis; (2) program design, development, and adaptation to the Brazilian context; (3) program dissemination. Data were collected through document analysis and workshops.
Results:
through document analysis, workshops with stakeholders from the participating institution, and validation with key informants, it was possible to identify the program’s objectives, expected outcomes, and the target audience. This allowed the construction of theoretical and logic models and, through evaluative questions, the identification of indicators for the evaluation of the Fall TIPS Brazil Program.
Final Considerations:
this study has provided insights into the Fall TIPS program, the topic of hospital fall prevention, and the proposed models and indicators can be employed in the implementation and future evaluative processes of the program.
-
05-13-2024
Qualitative methodology: considerations and singularities regarding the implementation of person-centered interventions
Revista Brasileira de Enfermagem. 2024;77(3):e770301
Abstract
Qualitative methodology: considerations and singularities regarding the implementation of person-centered interventions
Revista Brasileira de Enfermagem. 2024;77(3):e770301
DOI 10.1590/0034-7167.2024770301
Views0Qualitative health research allows for an in-depth understanding of how a person experiences different health transitions, their relationship with healthcare professionals and their passage through different clinical practice environments. At the same time, it has the potential to support professionals’ clinical decision-making and to empower citizens in their autonomy and responsibility for the health-disease process, […]See more -
05-13-2024
Metodologia qualitativa: considerações e singularidades sobre a implementação de intervenções centradas na pessoa
Revista Brasileira de Enfermagem. 2024;77(3):e770301
Abstract
Metodologia qualitativa: considerações e singularidades sobre a implementação de intervenções centradas na pessoa
Revista Brasileira de Enfermagem. 2024;77(3):e770301
DOI 10.1590/0034-7167.2024770301pt
Views0A investigação qualitativa em saúde permite a compreensão aprofundada de como a pessoa experiencia as diferentes transições de saúde, a relação com os profissionais de saúde e a passagem pelos diferentes ambientes de prática clínica. Concomitantemente, tem o potencial de suportar a tomada de decisão clínica dos profissionais e de empoderar o cidadão na sua […]See more -
ORIGINAL ARTICLE05-13-2024
Factors associated with Community Health Agents’ knowledge about tuberculosis
- Clery Mariano da Silva Alves ,
- Tauana de Souza Amaral ,
- Fabiana Ribeiro Rezende ,
- Hélio Galdino Júnior ,
- Rafael Alves Guimarães , [ … ],
- Anaclara Ferreira Veiga Tipple
Abstract
ORIGINAL ARTICLEFactors associated with Community Health Agents’ knowledge about tuberculosis
Revista Brasileira de Enfermagem. 2024;77(2):e20220520
DOI 10.1590/0034-7167-2022-0520
- Clery Mariano da Silva Alves ,
- Tauana de Souza Amaral ,
- Fabiana Ribeiro Rezende ,
- Hélio Galdino Júnior ,
- Rafael Alves Guimarães ,
- Dayane de Melo Costa ,
- Anaclara Ferreira Veiga Tipple
Views0See moreABSTRACT
Objective:
To analyze the factors associated with the knowledge of Community Health Agents (ACS) about tuberculosis.
Methods:
A cross-sectional study was conducted with 110 ACS. A questionnaire was used to assess knowledge about pulmonary tuberculosis (component 1) and the work functions of ACS in the National Tuberculosis Control Program (component 2). The level of knowledge, according to the scores converted into a scale of 0 to 100, was classified as: 0-50% (low), 51-75% (medium), and over 75% (high). Multiple regression was used in the analysis of associated factors.
Results:
The global score (average of the scores of components 1 and 2) median knowledge was 68.6%. Overall knowledge about tuberculosis was positively associated with the length of professional experience, having received training on tuberculosis, and access to the tuberculosis guide/handbook.
Conclusions:
Investments in training and capacity-building strategies for ACS will contribute to increasing these professionals’ knowledge, resulting in greater success in tuberculosis control.
- Clery Mariano da Silva Alves
-
05-13-2024
Preditores de nanismo entre crianças de 0 a 24 meses no Sudeste Asiático: Uma revisão do escopo
Revista Brasileira de Enfermagem. 2024;77(2):e20220625
Abstract
Preditores de nanismo entre crianças de 0 a 24 meses no Sudeste Asiático: Uma revisão do escopo
Revista Brasileira de Enfermagem. 2024;77(2):e20220625
DOI 10.1590/0034-7167-2022-0625
Views0See moreRESUMEN
Objetivo:
Identificar indicadores de desnutrición crónica entre niños de 0 a 24 meses en el Sudeste Asiático.
Métodos:
Esta revisión de alcance se centró en artículos con diseño de estudio observacional publicados en inglés, entre los años 2012 y 2023 de cinco bases de datos internacionales. Las principales palabras clave utilizadas fueron: “stunting (Desnutrición crónica)” o “growth disorder (Desorden del crecimiento)”, y “newborn (Recién nacido)”, y “predict (Predecir)”, y “Southeast Asia (Sudeste Asiático)”.
Resultados:
De los 27 artículos seleccionados para el análisis final, se encontraron trece indicadores que influyen en la desnutrición crónica en siete países del Sudeste Asiático. Los trece indicadores incluyen el niño, la madre, el hogar, la alimentación inadequada complementaria, la lactancia materna inadecuada, la atención inadecuada, los alimentos de mala calidad, la seguridad de los alimentos y el agua, la infección, la economía política, la salud y la asistencia sanitaria, el agua, el saneamiento y el medio ambiente, y por último el factor sociocultural.
Conclusión:
Todos estos indicadores pueden provocar desnutrición crónica en niños del Sudeste Asiático. Para poder prevenirlo los prestadores de servicios de salud y otros sectores relacionados, necesitan realizar actividades de promoción y prevención de la salud de acuerdo con los indicadores encontrados en este artículo.
-
REVIEW07-10-2020
Acute Kidney Injury by SARS-CoV-2 virus in patients with COVID-19: an integrative review
- Matheus Santos Moitinho ,
- Angélica Gonçalves da Silva Belasco ,
- Dulce Aparecida Barbosa ,
- Cassiane Dezoti da Fonseca
Abstract
REVIEWAcute Kidney Injury by SARS-CoV-2 virus in patients with COVID-19: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20200354
DOI 10.1590/0034-7167-2020-0354
- Matheus Santos Moitinho ,
- Angélica Gonçalves da Silva Belasco ,
- Dulce Aparecida Barbosa ,
- Cassiane Dezoti da Fonseca
Views0See moreABSTRACT
Objective:
to assess scientific evidence on SARS-CoV-2 Acute Kidney Injury in patients with COVID-19.
Methods:
an integrative review, with adoption of PICO strategy and classification of the level of evidence, carried out on April 10, 2020 in the PubMed database, of articles available between December 2019 and April 2020.
Results:
the sample consisted of six original, five observational and one experimental articles. Observational studies addressed the clinical findings of patients with COVID-19 and association between kidney damage, infection, and morbidity-mortality.
Conclusion:
the studies addressed the mechanism of intracellular infection of SARS-CoV-2, its cytopathic effects on kidney cells and incidence of acute kidney injury in patients infected with SARS-CoV-2. Acute kidney injury is associated with increased mortality and morbidity in these patients. This review realizes the need for new research that can mention kidney care to patients with COVID-19.
- Matheus Santos Moitinho
-
ORIGINAL ARTICLE03-24-2021
Development, validation and application of clinical simulation scenarios for assessment of stomatherapy specialists
- Angélica Olivetto de Almeida ,
- Sônia Regina Pérez Evangelista Dantas ,
- Maria Angela Boccara de Paula ,
- Juliany Lino Gomes Silva ,
- Ednalda Maria Franck , [ … ],
- Ana Railka de Souza Oliveira-Kumakura
Abstract
ORIGINAL ARTICLEDevelopment, validation and application of clinical simulation scenarios for assessment of stomatherapy specialists
Revista Brasileira de Enfermagem. 2021;74(1):e20200360
DOI 10.1590/0034-7167-2020-0360
- Angélica Olivetto de Almeida ,
- Sônia Regina Pérez Evangelista Dantas ,
- Maria Angela Boccara de Paula ,
- Juliany Lino Gomes Silva ,
- Ednalda Maria Franck ,
- Ana Railka de Souza Oliveira-Kumakura
Views0See moreABSTRACT
Objectives:
to build and validate three clinical simulation scenarios and report the application with candidates for the specialist’s degree in stomatherapy.
Methods:
methodological study, building three scenarios and evaluation checklists; content validation with judges, using content validity index and Modified Kappa Coefficient; pre-test and application.
Results:
scenarios built based on nursing care for: 1. insufficiency and venous ulcer; 2. demarcation of intestinal stomia; and 3. Clean intermittent catheterization. In the content validation of the 24 items appreciated, 83%, 80%, and 92% were validated without change. In the pre-test, the objectives and checklists were adjusted. In the application, to standardize the evaluation, actors and evaluators were trained previously, and each candidate passed the three stations.
Conclusions:
scenarios built and with validated content, based on evidence and covering the three areas of stomatherapy. The pre-test allowed for adjustments in the scenarios, and the candidates achieved the expected objectives.
- Angélica Olivetto de Almeida
-
ORIGINAL ARTICLE07-15-2020
Cultural adaptation of Infant Feeding Intentions Scale (IFI) for pregnant women in Brazil
- Fernanda Garcia Bezerra Góes ,
- Beatriz Cabral Ledo ,
- Andressa Silva Torres dos Santos ,
- Fernanda Maria Vieira Pereira-Ávila ,
- Aline Cerqueira Santos Santana da Silva , [ … ],
- Marialda Moreira Christoffel
Abstract
ORIGINAL ARTICLECultural adaptation of Infant Feeding Intentions Scale (IFI) for pregnant women in Brazil
Revista Brasileira de Enfermagem. 2020;73:e20190103
DOI 10.1590/0034-7167-2019-0103
- Fernanda Garcia Bezerra Góes ,
- Beatriz Cabral Ledo ,
- Andressa Silva Torres dos Santos ,
- Fernanda Maria Vieira Pereira-Ávila ,
- Aline Cerqueira Santos Santana da Silva ,
- Marialda Moreira Christoffel
Views0See moreABSTRACT
Objectives:
to translate and culturally adapt the Infant Feeding Intentions Scale for pregnant women in Brazil.
Methods:
methodological study that included stages of translation, synthesis, face and content validation, back translation and semantic assessment. In the face and content and semantic validation stages, we used the Content Validity Index for individual items and for the overall scale for clarity and representativeness.
Results:
nine (100.0%) experts participated in face and content validation, and the average index obtained was 85.0% for representativeness. In the semantic assessment, performed with 31 (100.0%) pregnant women, the tool was considered clear, obtaining an average index of 91.0%.
Conclusions:
the Brazilian version of the scale was considered representative and clear. After assessing psychometric properties, the scale is expected to be valid and reliable to assess maternal intention to breastfeed exclusively until the infant’s six months of life in different Brazilian settings.
- Fernanda Garcia Bezerra Góes
-
ORIGINAL ARTICLE03-30-2020
Parental care for infants with feeding tube: psychosocial repercussions
- Fábio Luiz Banhara ,
- Francely Tineli Farinha ,
- Gesiane Cristina Bom ,
- Ana Paula Ribeiro Razera ,
- Maria de Lourdes Merighi Tabaquim , [ … ],
- Armando dos Santos Trettene
Abstract
ORIGINAL ARTICLEParental care for infants with feeding tube: psychosocial repercussions
Revista Brasileira de Enfermagem. 2020;73(2):e20180360
DOI 10.1590/0034-7167-2018-0360
- Fábio Luiz Banhara ,
- Francely Tineli Farinha ,
- Gesiane Cristina Bom ,
- Ana Paula Ribeiro Razera ,
- Maria de Lourdes Merighi Tabaquim ,
- Armando dos Santos Trettene
Views0See moreABSTRACT
Objectives:
to understand the psychosocial repercussions experienced by caregiving parents, resulting from care for the child with dysphagic cleft lip and palate.
Methods:
qualitative study, developed in a tertiary hospital in September 2016. The sample defined by theoretical saturation consisted of seven mothers. Data collection was performed by unstructured interview, being audio-recorded and fully transcribed. Symbolic Interactionism was used as theoretical framework, and Thematic Content Analysis as methodological framework.
Results:
the following themes emerged: diagnosisimpact and coping; coping with overload and stress; interaction between caregivers as an acceptance and coping strategy; impact on family and social life of caregivers; and curiosity coping, and family and community prejudice.
Final considerations:
despite the physical and emotional overload, the mother figure plays the main and determining role in care, reflecting the complexity of care.
- Fábio Luiz Banhara
-
ORIGINAL ARTICLE03-30-2020
Stomized children care practices: narratives of relatives
- Manuela Costa Melo ,
- Bárbara Natália Ferreira Vilas-Boas ,
- Brenda Limeira Martins ,
- Allan Willis Albernáz Vasconcellos ,
- Ivone Kamada
Abstract
ORIGINAL ARTICLEStomized children care practices: narratives of relatives
Revista Brasileira de Enfermagem. 2020;73(2):e20180370
DOI 10.1590/0034-7167-2018-0370
- Manuela Costa Melo ,
- Bárbara Natália Ferreira Vilas-Boas ,
- Brenda Limeira Martins ,
- Allan Willis Albernáz Vasconcellos ,
- Ivone Kamada
Views0See moreABSTRACT
Objectives:
to understand the practices adopted by relatives regarding ostomized children care.
Methods:
qualitative approach, conducted with 11 relatives of ostomized children. Methodological framework was used as narrative technique; NVivo® software for data categorization and information analysis; content analysis technique.
Results:
participants revealed unpreparedness in dealing with children, lack of knowledge about handling materials and equipment inherent to ostomy and challenges faced in the daily life of children in school. They are unanimous in telling they feel encouraged and strengthened by receiving support from nurses in child care. They suggested the development of strategies to guide ostomized children care, such as educational material use.
Conclusions:
to understand family members’ experience made it possible to support training and qualification of nursing professionals, and to establish priorities in care. Evidence found may contribute to reflections that aid health promotion and prevention of complications in ostomized children care.
- Manuela Costa Melo
-
ORIGINAL ARTICLE06-16-2021
Family interview for organ and tissue donation: good practice assumptions
- Neide da Silva Knhis ,
- Sabrina Regina Martins ,
- Aline Lima Pestana Magalhães ,
- Saulo Fábio Ramos ,
- Camila Telemberg Sell , [ … ],
- Laura Calvacanti de Farias Brehmer
Abstract
ORIGINAL ARTICLEFamily interview for organ and tissue donation: good practice assumptions
Revista Brasileira de Enfermagem. 2021;74(2):e20190206
DOI 10.1590/0034-7167-2019-0206
- Neide da Silva Knhis ,
- Sabrina Regina Martins ,
- Aline Lima Pestana Magalhães ,
- Saulo Fábio Ramos ,
- Camila Telemberg Sell ,
- Clarice Koerich ,
- Laura Calvacanti de Farias Brehmer
Views0See moreABSTRACT
Objectives:
to identify information that can support creating good practice assumptions to develop family interview for organ and tissue donation.
Methods:
this scoping study, conducted in two Brazilian hospitals in the southern, between April and December 2017, included integrative review and consultation with 15 families who experienced interview for organ donation. For data analysis, thematic content analysis was used.
Results:
three categories emerged: communication of death, which shows the need to know the history of hospitalization of patients; emotional support, the team must have mastery of the stages of mourning; information about donation, professionals need to know the stages of the donation process and respect families’ time.
Final Considerations:
good practice assumptions point to the need for team training, respect for family time and the use of simple language.
- Neide da Silva Knhis
-
ORIGINAL ARTICLE12-13-2019
Perception of women with breast cancer undergoing chemotherapy: a comprehensive analysis
- Marlise Barros de Medeiros ,
- Rose Mary Costa Rosa Andrade Silva ,
- Eliane Ramos Pereira ,
- Sérgio Henrique da Silva Melo ,
- Fabiana Lopes Joaquim , [ … ],
- Ticiane Roberta Pinto Goés
Abstract
ORIGINAL ARTICLEPerception of women with breast cancer undergoing chemotherapy: a comprehensive analysis
Revista Brasileira de Enfermagem. 2019;72:103-110
DOI 10.1590/0034-7167-2018-0165
- Marlise Barros de Medeiros ,
- Rose Mary Costa Rosa Andrade Silva ,
- Eliane Ramos Pereira ,
- Sérgio Henrique da Silva Melo ,
- Fabiana Lopes Joaquim ,
- Bianca Marques dos Santos ,
- Ticiane Roberta Pinto Goés
Views0See moreABSTRACT
Objective:
To comprehensively analyze the perception of women with breast cancer on the experience of undergoing chemotherapy.
Method:
This was a qualitative, descriptive, phenomenological study, supported by the Merleau-Ponty philosophy. It was conducted in a chemotherapy outpatient clinic with 20 participants who completed a phenomenological interview.
Results:
The phenomenological data analysis demonstrated that the perception of women about the experience of chemotherapy is about change, not only of the physical body, but of their identity, and that it considers existential aspects. Three categories emerged from the experience of alopecia, fatigue, and spirituality, respectively: the body itself, the current and habitual body, and transcendence.
Final considerations:
Bodily changes, and the existential implications perceived by the women in this study, analyzed from the Merleau-Ponty perspective, makes it possible to consider body concept, and provides support for humanized care based on singularity and the socio-cultural context.
- Marlise Barros de Medeiros
-
REVIEW07-14-2021
Symptom management theory applied to nursing care: scoping review
Revista Brasileira de Enfermagem. 2021;74(3):e20201004
Abstract
REVIEWSymptom management theory applied to nursing care: scoping review
Revista Brasileira de Enfermagem. 2021;74(3):e20201004
DOI 10.1590/0034-7167-2020-1004
Views0See moreABSTRACT
Objectives:
to identify publications about the applicability of the Symptom Management Theory in nursing care to pediatric, adolescent, adult and elderly patients.
Methods:
scoping review following the steps: definition of the objective, research question and inclusion criteria; search, selection and analysis of publications; synthesis of results. The search occurred in the VHL, SciELO, CAPES and PubMed Journals Portal bases, contemplating publications between 1994 and July 2020.
Results:
out of 3,286 studies, ten were selected, published between 2008 and 2019. They described the relationships between the participants and the domains (person, environment, health and disease), components (symptom experience, management strategies, results) and presented strategies for symptom management.
Conclusions:
the Symptom Management Theory was considered applicable to the participants of the studies and to nursing care. It was concluded that understanding the interaction of these elements is essential to plan actions aimed at controlling symptoms effectively.
Search
Search in:
Nuvem de Tags
Adolescente (85) Atenção Primária à Saúde (239) COVID-19 (91) Criança (91) Cuidados de Enfermagem (269) Educação em Enfermagem (151) Educação em Saúde (139) Enfermagem (930) Enfermagem Pediátrica (86) Estudantes de Enfermagem (77) Estudos de Validação (131) Família (87) Idoso (208) Promoção da Saúde (99) Qualidade de Vida (104) Saúde do Trabalhador (86) Saúde Mental (145) Saúde Pública (82) Segurança do Paciente (150) Tecnologia Educacional (100)