Cláudia Patrícia da Costa Brás’s research while affiliated with Nursing School of Coimbra and other places

Introduction: Active teaching methodologies, particularly those using high-fidelity simulation, stand out in nursing education for their ability to facilitate the development of students' technical-scientific and non-technical skills, as well as prepare them for clinical practice. High-fidelity simulation using realistic models is an effective tool for improving students' communication skills, leadership and critical thinking. This study aims to explore nurse-midwifery students’ learning experiences in high-fidelity simulation.Methods: Explorative qualitative study using two focus groups interviews with nurse-midwifery students at the Higher School of Nursing. Qualitative data were analyzed using content analysis. Results: Two main themes emerged from content analysis: (i) Simulation-based learning and (ii) Simulation-based teaching. The first theme includes three categories: development of technical-scientific skills, development of non-technical skills, and preparation for internship. The second theme also includes three categories: enhancing theoretical knowledge, facilitating teaching, and post-scenario discussion (debriefing). Conclusions: The use of high-fidelity simulation as a teaching strategy in the training of nurse-midwifery students contributed to the development of technical and non-technical skills essential to nursing practice

Background and Purpose: An absence of specific and precise instruments that measure the construct of intrapersonal and interpersonal communication in nursing was verified. This study aimed to construct and validate the intrapersonal and interpersonal communication scale in nursing. Methods: A psychometric study was conducted on a sample of 360 nurses from a hospital and university center in the central region of Portugal. Reliability was assessed through internal consistency and construct validity through exploratory and confirmatory factor analyses. Results: Four factors were decided upon: “self-efficacy,” “empathy,” “assertiveness,” and “self-knowledge.” Good internal consistency was obtained with Cronbach’s alpha and adequate quality of adjustment indexes for the model. Conclusions: The key global indicators of the model’s adjustment and reliability analysis express their quality for the Portuguese population.

Objective: to assess the psychometric characteristics of the Hospital Survey on Patient Safety Culture, to characterize the patient safety culture, and to assess the influence of the sociodemographic and professional variables on the safety culture dimensions. Method: a methodological, observational, analytical and cross-sectional study conducted with 360 nurses in which the Hospital Survey on Patient Safety Culture questionnaire was used. The data were submitted to descriptive and inferential analysis, as well as to feasibility and validity studies. Results: the nurses' mean age is 42 years old, their mean time of professional experience is 19 years, and they are mostly female. Good internal consistency was obtained (Cronbach's alpha: 0.83), as well as acceptable model fit quality indices. Teamwork within units, Supervisor expectations and Feedback and communication about errors were the dimensions that obtained scores above 60%. Non-punitive response to error, Frequency of events reported, Support for patient safety and Staffing presented scores below 40%. These dimensions are influenced by age, schooling level and professional experience. Conclusion: the psychometric properties of the questionnaire certify its good quality. Teamwork can be considered as an enhancing factor for the safety culture. Assessing the safety culture allowed identifying problematic dimensions, thus enabling planning of future interventions.

Resumen Objetivo: evaluar las características psicométricas de la Hospital Survey on Patient Safety Culture, caracterizar la cultura de seguridad del paciente y evaluar la influencia de variables sociodemográficas y profesionales en las dimensiones de la cultura de seguridad. Método: estudio metodológico, observacional, analítico, transversal, realizado con 360 enfermeros, utilizando el cuestionario Hospital Survey on Patient Safety Culture. Los datos fueron sometidos a análisis descriptivo e inferencial y estudios de confiabilidad y validez. Resultados: los enfermeros tienen en promedio 42 años de edad, 19 años de experiencia profesional y la mayoría es de sexo femenino. Se obtuvo buena consistencia interna (alfa de Cronbach - 0,83) e índices aceptables de bondad de ajuste del modelo. El trabajo en equipo dentro de las unidades, las expectativas del supervisor, el feedback y la comunicación del error fueron las dimensiones que presentaron puntajes superiores al 60%. La respuesta al error no punitiva, la frecuencia de notificación, el apoyo a la seguridad por parte de los gestores, la dotación de personal, presentaron puntajes por debajo del 40%. Estas dimensiones son influenciadas por la edad, la educación y la experiencia profesional. Conclusión: las propiedades psicométricas del cuestionario certifican su calidad. El trabajo en equipo puede considerarse un factor que potencia la cultura de seguridad. La evaluación de la cultura de seguridad permitió identificar las dimensiones que tenían problemas y poder planificar futuras intervenciones.

Resumo Objetivo: avaliar as caraterísticas psicométricas do Hospital Survey on Patient Safety Culture, caracterizar a cultura de segurança do doente e avaliar a influência das variáveis sociodemográficas e profissionais nas dimensões da cultura de segurança. Método: estudo metodológico, observacional, analítico, transversal, realizado com 360 enfermeiros, utilizando o questionário Hospital Survey on Patient Safety Culture. Os dados foram submetidos à análise descritiva, inferencial e estudos de fiabilidade e validade. Resultados: os enfermeiros possuem em média 42 anos de idade, 19 anos de experiência profissional e são maioritariamente do sexo feminino. Obteve-se boa consistência interna (alfa de Cronbach - 0,83) e índices aceitáveis de qualidade de ajustamento do modelo. O trabalho em equipa dentro das unidades, expetativas do supervisor, feedback e comunicação sobre o erro, foram dimensões que apresentaram scores acima dos 60%. A resposta ao erro não punitiva, frequência da notificação, apoio à segurança pela gestão, dotação de profissionais, apresentaram scores abaixo dos 40%. Estas dimensões são influenciadas pela idade, escolaridade e experiência profissional. Conclusão: as propriedades psicométricas do questionário certificam a sua qualidade. O trabalho em equipa pode ser considerado um fator potenciador da cultura de segurança. Avaliar a cultura de segurança permitiu identificar dimensões problemáticas, possibilitando o planeamento de intervenções futuras.

Aim To explore nurse‐midwives' perceptions of safety culture in maternity hospitals. Design A descriptive phenomenological study was conducted using focus groups and reported following the Consolidated Criteria for Reporting Qualitative Research. Methods Data were obtained through two online focus group sessions in June 2022 with 13 nurse‐midwives from two maternity hospitals in the central region of Portugal. The first focus group comprised 6 nurse‐midwives, and the second comprised 7 nurse‐midwives. Qualitative data were analysed using content analysis. Findings Two main themes emerged from the data: (i) barriers to promoting a safety culture; (ii) safety culture promotion strategies. The first theme is supported by four categories: ineffective communication, unproductive management, instability in teams and the problem of errors in care delivery. The second theme is supported by two categories: managers' commitment to safety and the promotion of effective communication. Conclusion The study results show that the safety culture in maternity hospitals is compromised by ineffective communication, team instability, insufficient allocation of nurse‐midwives, a prevailing punitive culture and underreporting of adverse events. These highlight the need for managers to commit to providing better working conditions, encourage training with the development of a fairer safety culture and encourage reporting and learning from mistakes. There is also a need to invest in team leaders who allow better conflict management and optimization of communication skills is essential. Impact Disseminating these results will provide relevance to the safety culture problem, allowing greater awareness of nurse‐midwives and managers about vulnerable areas, and lead to the implementation of effective changes for safe maternal and neonatal care. Patient or Public Contribution There was no patient or public contribution as the study only concerned service providers, that is, nurse‐midwives themselves.

Objectives to construct and validate the Interprofessional Communication Scale in Health. Methods a psychometric study was carried out on a sample of 360 nurses from a hospital and university center in central Portugal. Reliability was assessed through internal consistency and construct validity through exploratory and confirmatory factor analysis. Results the Interprofessional Communication in Health Scale, consisting of 27 items, is organized into 3 factors: “Teamwork”, “Conflict management” and “Leadership”, with a total variance of 51.1%. Good internal consistency was obtained, with a Cronbach’s alpha of 0.842, and adequate Goodness of Fit Index model. Conclusions the Interprofessional Communication in Health Scale presents a factorial structure with adequate validity and reliability results, and may constitute a useful self-report instrument in assessing interprofessional communication in health. Descriptors: Communication; Patient Care Team; Nursing; Validation Study; Psychometrics.

Objectives to construct and validate the Interprofessional Communication Scale in Health. Methods a psychometric study was carried out on a sample of 360 nurses from a hospital and university center in central Portugal. Reliability was assessed through internal consistency and construct validity through exploratory and confirmatory factor analysis. Results the Interprofessional Communication in Health Scale, consisting of 27 items, is organized into 3 factors: “Teamwork”, “Conflict management” and “Leadership”, with a total variance of 51.1%. Good internal consistency was obtained, with a Cronbach’s alpha of 0.842, and adequate Goodness of Fit Index model. Conclusions the Interprofessional Communication in Health Scale presents a factorial structure with adequate validity and reliability results, and may constitute a useful self-report instrument in assessing interprofessional communication in health. Descriptors: Communication; Patient Care Team; Nursing; Validation Study; Psychometrics.

Objective to identify the safety culture dimensions that influence obstetric nurses’ clinical practice. Method an observational, analytical and cross-sectional study, carried out from September 2018 to May 2019 at two maternity hospitals integrated in a hospital center in the Central region of Portugal. A total of 70 obstetric nurses answered the Hospital Survey on Patient Safety Culture. The data were submitted to descriptive and inferential analysis. The dimensions were considered strong when they presented scores ≥ 75.0% of positive answers, and deemed as problematic with scores ≤ 50.0%. Results the “Teamwork within units” dimension was the one that obtained scores above 75.0%. The “Supervisor expectations”, “Feedback and communication about errors”, “Communication openness”, “Organizational learning” and “Hospital handoffs and transitions” dimensions obtained scores between 50.0% and 65.0%. The “Non-punitive response to error”, “Frequency of events reported”, “Management support for patient safety” and “Staffing” dimensions had scores below 40.0%. Conclusion the results of this study show that “Teamwork within units” is a strong safety culture dimension in maternity hospitals. However, the prevalence of a punitive culture, underreporting of adverse events, insufficient number of obstetrical nurses and little commitment of the hospital management are considered as problematic dimensions that influence obstetric nurses' practice. This assessment of the safety culture contributes to planning interventions that reduce the incidence of errors and improve the safety of obstetric care. DESCRIPTORS: Obstetric Nursing; Patient safety; Safety management; Organizational culture.

Objective to identify the safety culture dimensions that influence obstetric nurses’ clinical practice. Method an observational, analytical and cross-sectional study, carried out from September 2018 to May 2019 at two maternity hospitals integrated in a hospital center in the Central region of Portugal. A total of 70 obstetric nurses answered the Hospital Survey on Patient Safety Culture. The data were submitted to descriptive and inferential analysis. The dimensions were considered strong when they presented scores ≥ 75.0% of positive answers, and deemed as problematic with scores ≤ 50.0%. Results the “Teamwork within units” dimension was the one that obtained scores above 75.0%. The “Supervisor expectations”, “Feedback and communication about errors”, “Communication openness”, “Organizational learning” and “Hospital handoffs and transitions” dimensions obtained scores between 50.0% and 65.0%. The “Non-punitive response to error”, “Frequency of events reported”, “Management support for patient safety” and “Staffing” dimensions had scores below 40.0%. Conclusion the results of this study show that “Teamwork within units” is a strong safety culture dimension in maternity hospitals. However, the prevalence of a punitive culture, underreporting of adverse events, insufficient number of obstetrical nurses and little commitment of the hospital management are considered as problematic dimensions that influence obstetric nurses' practice. This assessment of the safety culture contributes to planning interventions that reduce the incidence of errors and improve the safety of obstetric care. DESCRIPTORS: Obstetric Nursing; Patient safety; Safety management; Organizational culture.