Factores cognitivos en las conductas de bioseguridad del profesional de Enfermería que administra fármacos citotóxicos y citostáticos en los Centros Hospitalarios Costarricenses
Fecha
2022
Tipo
tesis de maestría
Autores
Acuña Rámirez, Estibaliz
Rodríguez Araya, María Lucía
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Resumen
Esta investigación es de enfoque cualitativo, exploratorio descriptivo. El objeto del estudio consiste en explorar los factores cognitivos en las conductas de bioseguridad del profesional de Enfermería que administra fármacos citotóxicos y citostáticos en los Centros Hospitalarios Costarricenses, empleando como sustento el modelo de promoción de la salud de Nola Pender. Se exploró la autoeficacia percibida, las barreras percibidas a la acción y las influencias situacionales del entorno.
En este estudio participaron 9 profesionales de Enfermería que laboran en distintos hospitales nacionales y que cuentan con experiencia en la administración de quimioterapia. La muestra fue determinada por muestreo intencional de tipo muestreo por criterio. El reclutamiento se realizó vía correo electrónico.
A través de la técnica de simulación, se recrearon 3 escenarios clínicos en el Centro de Simulación en Salud (CESISA) de la Escuela de Enfermería de la Universidad de Costa Rica. Cada participante debía realizar un procedimiento relacionado con la aplicación de conductas de bioseguridad en el manejo de quimioterapia. Se aplicó la observación estructurada no participante y grabación en video, previo consentimiento informado. Posteriormente, se aplicó la técnica de grupo focal con el fin de explorar y contrastar la información.
Se logró identificar que aun cuando los profesionales de enfermería cuentan con experiencia en la administración de quimioterapia, la mayoría no cuenta con una adecuada adherencia al equipo de protección personal o bien no tienen claro el nivel de protección que provee el equipo, según la calidad disponible.
Se identificaron como principales barreras alta demanda de trabajo, presión por cumplir con los compromisos de gestión, la baja adherencia del personal al uso de equipo de protección personal, la falta de conciencia del profesional, el tiempo, resistencia al uso del equipo, calor asociado al uso del equipo e insumos no disponibles.
En las influencias situacionales del entorno, se mencionó que el espacio es reducido, hay alta demanda de trabajo, hay hacinamiento, no hay adecuada ventilación, la infraestructura no cuenta con condiciones adecuadas, algún equipo está deteriorado.
En el área de la oncología, se deben optimizar las condiciones laborales de los profesionales en cuanto a equipo, entorno y compromisos de productividad con el fin de fomentar un ambiente y atención seguros, minimizando los riesgos de exposición ocupacional y fortaleciendo la adherencia al uso de equipo de protección personal y a las conductas de promoción de la salud.
This research has a qualitative, exploratory descriptive approach. The aim of study is to explore the cognitive factors in the biosafety behaviors of the Nursing professionals, who administer cytotoxic and cytostatic drugs in Costa Rican Hospital Centers using the Nola Pender´s Health Promotion Model as support to explore perceived self-efficacy, perceived barriers to action, and situational influences from the environment. The population consisted of nine nursing professionals, who work in different national hospitals, and who have experience in administering chemotherapy. The sample was determined by intentional capture of the criteria capture type. Recruitment was done via email. Through the simulation technique, the researchers recreated three clinical scenarios in the Center for Simulation in Health (CESISA) at the School of Nursing of the University of Costa Rica. Each participant had to perform a procedure related to the application of biosafety behaviors in the management of chemotherapy. They applied structured non-participant observation and video recording with informed consent. Subsequently, the researchers applied the focus group technique in order to explore and contrast the information. It was identified that even when nursing professional participants have experience in administering chemotherapy, most of them do not have adequate adherence to personal protective equipment or are not clear about the level of protection provided by the equipment, according to the quality available. The main barriers identified are high work demand, being under pressure to meet management commitments, low adherence to the use of personal protective equipment, lack of professional awareness, time restrictions, resistance to the use of the equipment, and associated heat to the use of the equipment, as well as the unavailable supplies of equipment. In the situational environment conditions, it was mentioned that the space is reduced, there is a high demand of services with limited amount of service personnel, there is overcrowding, there is no adequate ventilation, the infrastructure does not have adequate conditions, and some equipment is deteriorated. In the area of oncology, the working conditions of professionals must be optimized in terms of equipment, environment and productivity commitments in order to promote a safe environment and care, minimizing the risks of occupational exposure and strengthening behaviors that promote health.
This research has a qualitative, exploratory descriptive approach. The aim of study is to explore the cognitive factors in the biosafety behaviors of the Nursing professionals, who administer cytotoxic and cytostatic drugs in Costa Rican Hospital Centers using the Nola Pender´s Health Promotion Model as support to explore perceived self-efficacy, perceived barriers to action, and situational influences from the environment. The population consisted of nine nursing professionals, who work in different national hospitals, and who have experience in administering chemotherapy. The sample was determined by intentional capture of the criteria capture type. Recruitment was done via email. Through the simulation technique, the researchers recreated three clinical scenarios in the Center for Simulation in Health (CESISA) at the School of Nursing of the University of Costa Rica. Each participant had to perform a procedure related to the application of biosafety behaviors in the management of chemotherapy. They applied structured non-participant observation and video recording with informed consent. Subsequently, the researchers applied the focus group technique in order to explore and contrast the information. It was identified that even when nursing professional participants have experience in administering chemotherapy, most of them do not have adequate adherence to personal protective equipment or are not clear about the level of protection provided by the equipment, according to the quality available. The main barriers identified are high work demand, being under pressure to meet management commitments, low adherence to the use of personal protective equipment, lack of professional awareness, time restrictions, resistance to the use of the equipment, and associated heat to the use of the equipment, as well as the unavailable supplies of equipment. In the situational environment conditions, it was mentioned that the space is reduced, there is a high demand of services with limited amount of service personnel, there is overcrowding, there is no adequate ventilation, the infrastructure does not have adequate conditions, and some equipment is deteriorated. In the area of oncology, the working conditions of professionals must be optimized in terms of equipment, environment and productivity commitments in order to promote a safe environment and care, minimizing the risks of occupational exposure and strengthening behaviors that promote health.
Descripción
Palabras clave
BIOSEGURIDAD, FACTORES COGNITIVOS, ENFERMERIA ONCOLOGICA, EQUIPO DE PROTECCION PERSONAL, FARMACOS CITOTOXICOS, FARMACOS CITOSTATICOS, QUIMIOTERAPIA