Rosilene Alves Ferreira

This qualitative exploratory study evaluated 25 nursing team members experienced in Robotic-Assisted Surgery (RAS) at a Brazilian university hospital. Data collection used a validated instrument (CVI = 1.0), and Bardin’s thematic analysis identified three competency domains: clinical practice/system configuration, management of inputs/logistics, and handling of complications/learning curve indicators. Participants were predominantly female (88%), averaging three years of RAS experience with high heterogeneity (CV ≈ 68%). All participants performed patient positioning and endoscope connection; 92% managed electrosurgical settings; and 80% handled decoupling and pre-cleaning. Basic system proficiency required a weighted average of 16 procedures, whereas safe intraoperative performance required 13.5 weeks of immersion. Emergency undocking was reported by 28% of participants, primarily caused by power failures or system instability. The perceived learning curve was non-linear and dependent on procedure frequency, specialty complexity, and institutional support. In conclusion, the learning curve is multidimensional and cannot be reduced to single targets. Brazilian nursing teams operate beyond formal regulatory boundaries, highlighting the need for competency-based training, specialty exposure, and emergency simulation protocols. The gap between perceived proficiency and objective thresholds shows self-reported learning reflects operational familiarity rather than complete clinical safety. Standardizing emergency undocking preparedness remains an essential patient safety priority. These findings establish a baseline for standardized nursing RAS training programs.

Background: The identification of the methodological path followed by researchers in psychometric studies can contribute to maintaining the transparency and rigor necessary for the study. Objective: This study aims to map the methodological practices of adaptation of health measurement instruments. Methods: The protocol is based on the method proposed by the Joanna Briggs Institute using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). The following databases were consulted: MEDLINE, CINAHL, Web of Science, LILACS, the Cochrane Library, and Embase. The search for data in gray literature sources was carried out in the following databases: WorldCat and the Brazilian Portal of Scientific Publications and Open Access Data (O Portal Brasileiro de Publicações e Dados Científicos em Acesso Aberto [OASISBR]). The search strategy was based on the participants, concept, and context framework: participants (researchers in methodological practices), concept (studies of adaptation of measuring instruments), and context (health area). The research will consider studies on methodological practices adopted to conduct adaptation studies of health measurement instruments. The selection of studies, data extraction, and synthesis will be carried out by 2 independent reviewers. Results: Data collection was carried out in the months of June and October 2025. The results will be presented in a narrative format and with tables or diagrams. The results are being prepared for publication and should be published by March 2026. Conclusions: This study will identify the current status and challenges faced by researchers in carrying out adaptation studies of health measurement instruments. The findings will contribute to the development of future research that promotes better psychometric evidence and advances science in nursing.

Objectives: This scoping review aims to map evidence or literature on improvement strategies used by health leaders and professionals to strengthen the safety climate in the operating room. Design: A scoping review was performed on the basis of the method proposed by the Joanna Briggs Institute and applied to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) extension. Data sources: 16 academic and grey literature data sources were searched using search terms on 17 January 2025, namely, Medical Literature Analysis and Retrieval System Online via Pubmed, Latin American and Caribbean Literature on Health Sciences via the Virtual Health Library, Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science, Embase, PsycINFO, Cochrane Library, WorldCat, Digital Library of Theses and Dissertations, Brazilian Association of Surgical Center Nurses, Center for Material and Sterilization and Anesthetic Recovery, Association of Portuguese Operating Room Nurses, Association of PeriOperative Registered Nurses, Institute for Healthcare Improvement, WHO and Agency for Healthcare Research and Quality. Eligibility: Study selection, data extraction and synthesis were based on the following eligibility criteria based on the acronym PCC (participants, concept, context): participants (health leaders and professionals), concept (strategies to improve the safety climate) and context (operating room). This scoping review considered studies published from 2009 onwards. Data extraction: Information on the objective, method and findings addressing improvement strategies employed to strengthen the safety climate in the surgical centre was retrieved. The findings are presented in tables and in a qualitative thematic summary. Results: A total of 26 studies were analysed, published between 2009 and 2024, with the USA as the country of origin of the publications with the highest number (11 studies). As for the methodological approach, intervention and quasi-experimental studies stand out. When the studies in this review were mapped, strategies that strengthened the safety climate in the operating room were identified and grouped into two main axes that are interrelated: communication tools and training programmes. Conclusion: It is evident that the implementation of tools that promote communication and training programmes enhances safe surgical care, as they contribute substantially to the domains of the safety culture. The use of communication protocols in the operating room is recommended as a perioperative safety tool. Trial registration number: This scoping review adhered to a protocol previously published in this journal and that is registered on the Open Science Framework website ( https://osf.io/zg8nu/ ).

Background: The nursing practice environment is widely recognized as a key factor in promoting care quality and safety. It is associated with greater professional satisfaction, improved nurse retention, and reduced adverse events. Despite its importance being broadly acknowledged in the literature, there are few structured interventions aimed at promoting the nursing practice environment. Objective: To evaluate the effectiveness of the Positive Nursing Practice Environment Promotion Program (PPAPEP) in improving primary care nurses’ perceptions of their work environment and attitudes toward patient safety. Methods: A randomized, controlled, parallel‐group, double‐blind clinical trial was conducted in primary healthcare units in Northern Portugal between September 2024 and April 2025. A total of 48 nurses participated, allocated by stratified randomization into intervention and control groups. The instruments Scale for the Environments Evaluation of Professional Nursing Practice‐Shortened Version and the Safety Attitudes Questionnaire‐Short Form were applied at three time points: preintervention, postintervention, and three‐month follow‐up. Statistical analysis included paired and independent t ‐tests, repeated‐measures ANOVA, and correlation analysis. Results: The PPAPEP produced modest improvements in overall perceptions of the nursing practice environment in the intervention group, with small significative changes in the structure and process subscales. No statistically significant changes were observed in the safety climate. Follow‐up analyses showed an inverted U‐shaped pattern, indicating that the immediate positive effects slightly decreased over time. Perceptions of the practice environment and safety climate were strongly correlated at all time points. Conclusions: The PPAPEP has demonstrated effectiveness in improving the nursing practice environment. Effects on the safety climate were limited, suggesting that sustained changes require continuous interventions, periodic reinforcement, and institutional involvement. The strong association between nurses’ perceptions of the work environment and the safety climate highlights the need for integrated strategies that simultaneously promote good working conditions and patient safety. Trial Registration: ClinicalTrials.gov.identifier: NCT06762015

Objective: To map the evidence on preoperative telenursing in the context of elective surgical procedures to promote patient safety. Method: This research was registered on the Open Science Framework (OSF) platform and was conducted using the methodology of the Joanna Briggs Institute (nowadays, JBI). That is, identification of the research question, identification of relevant studies, selection of studies, data extraction, data analysis, synthesis, and reporting. The search strategy was developed by consulting standardized descriptors and synonyms in electronic databases on health sciences, as well as repositories of dissertations and theses and websites of surgical societies or associations. All quantitative, qualitative, and mixed-method studies, all types of reviews, editorials, and gray literature, published or not, from 2009 to the present days, shall be considered. To this end, Rayyan software shall be used by two independent reviewers in a blinded manner, with subsequent resolution of conflicts by consensus meeting. The data shall be presented descriptively.

Aim: To synthesise the available evidence on the effect of artificial intelligence in promoting positive nursing practice environments, exploring outcomes for professionals, clients, and institutions.Background: Artificial intelligence has undergone significant advancements and shows great potential to transform nursing practice. However, this technological evolution is not without challenges, which must be identified and addressed.Methods: A systematic mixed‐methods review following the PRISMA 2020 guidelines and the methodology proposed by JBI. The search strategy was conducted in PubMed, CINAHL, Scopus, and Web of Science, including grey literature. Quantitative, qualitative, and mixed‐methods studies were included, and the selection process involved screening by two independent reviewers, who assessed all studies, their methodological quality and extracted their data.Results: From the conducted search, 11 studies were included, addressing how artificial intelligence has transformed nursing practice by optimising decision‐making, task execution, and patient safety. Artificial intelligence, through predictive models and assistants such as ChatGPT, can enhance nursing management. However, challenges such as privacy concerns, resistance to change, and the need for professional training must be addressed to maximise its effectiveness.Conclusion: Artificial intelligence has the potential to positively transform the nursing practice environment, optimising decision‐making, enhancing patient safety, and improving operational efficiency, with clear benefits for professionals, patients, and healthcare institutions.Relevance to Clinical Practice: This study analysed the impact of artificial intelligence on nursing, highlighting improvements in clinical decision‐making, patient safety, and institutional efficiency. Despite the identified benefits, the implementation of artificial intelligence in nursing is not without challenges and risks, which must be identified and addressed to ensure safe and effective adoption.Reporting Method: The review followed the PRISMA 2020 checklist.Patient or Public Contribution: No.

Objetivo: sintetizar às etapas da técnica de degermação das mãos pelas equipes cirúrgicas. Métodos: revisão integrativa em seis etapas realizada nas bases de dados MEDLINE, Embase, LILACS, BDENF, CINAHL, Web of Science, SCOPUS, Redalyc e SciELO, recorte temporal de 2009-2024. Realizada classificação do nível de evidência dos estudos. Resultados: inicialmente, foram identificados 647 estudos. Após aplicação dos critérios de elegibilidade e leitura minuciosa, 11 foram selecionados. A maioria das publicações foi proveniente das bases de dados SCOPUS (36,4%) e MEDLINE (36,4%), prevalentemente de origem brasileira, que avaliaram equipes multiprofissionais (90,9%), com predominância de estudos observacionais (63,6%), de nível de evidência IV (81,8%). Principais lacunas evidenciadas: baixa adesão à técnica completa, secagem inadequada das mãos, baixa adesão à limpeza das unhas, baixa adesão ao tempo recomendado, baixa adesão à retirada de adornos e enxágue inadequado. Conclusão: os achados revelam lacunas que comprometem a eficácia da técnica (tempo de fricção, limpeza das unhas e execução completa da técnica), mas reforçam sua importância para a segurança do paciente. Contribuições para a prática: espera-se que este estudo contribua para orientar intervenções educativas, auditorias e protocolos padronizados.

Introduction Strengthening the safety climate in surgical centres is essential for ensuring care and patient safety, which directly impacts the reduction in the occurrence of adverse events and complications. In this sense, used to strengthen the safety climate in the operating room. Methods and analysis A scoping review will be carried out on the basis of the method proposed by the JBI and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) will be applied. The selection of studies, data extraction and synthesis will occur on the basis of the following inclusion criteria: Participants (leaders and health professionals), Concept (strategies for improving the safety climate) and Context (operating room) framework. This scoping review considers studies that address improvement strategies employed to strengthen the safety climate within the operating room. The review encompasses all studies published from 2009 to the present. The results will be presented in a narrative format with tables or diagrams. Ethics and dissemination No ethics committee approval is required for this study as it does not involve human participants. The results of the study will be disseminated through peer-reviewed publications, presentations at scientific congresses and targeted knowledge-sharing sessions with relevant stakeholders.

Objetivo: compreender a percepção das equipes multiprofissionais em centros cirúrgicos universitários sobre os domínios de clima de segurança durante a pandemia da Covid-19. Método: estudo com abordagem qualitativa e delineamento descritivo-exploratório realizado em dois hospitais universitários. Utilizou-se um roteiro de entrevista semiestruturado criado a partir dos domínios do Questionário de Atitudes de Segurança/Centro Cirúrgico. A coleta dos dados ocorreu de fevereiro a maio de 2021 e de junho a julho de 2022, mediante aceite do profissional e a assinatura do Termo de Consentimento Livre e Esclarecido. Para análise de dados utilizou-se o IRaMuTeQ. Resultados: a comunicação em ambos os cenários foi considerada dificultosa. A percepção da gerência demonstrou-se considerável diante dos desafios do momento pandêmico, percepção trazida pelo fornecimento de equipamentos de proteção individual pelas unidades, porém com críticas a precária troca de informações entre gestão e equipe. Os profissionais sofreram com medo, ansiedade, além de cansaço físico e mental. Considerações finais: é necessário que a gestão avance construindo em conjunto com os profissionais, ouvindo-os e abandonando a cultura punitiva. É valioso adotar uma aprendizagem idealizada a partir dos erros e espaços onde a saúde mental dos profissionais possa ser valorizada.

Objetivo: mapear as características do processo de implementação da telenfermagem no pós-operatório mediato e tardio de todas as especialidades cirúrgicas. Método: Trata-se de protocolo de revisão de escopo conduzido pelo método JBI. Foi registrado no Open Science Framework. A questão da revisão foi: quais são as características do processo de implementação da telenfermagem no período pós-operatório mediato e tardio? Serão consultadas as bases de dados: Medline, CINAHL, Scopus e Embase via Elsevier, Literatura Latino-americana e do Caribe em Ciências da Saúde (LILACS) e Web of Science. E literatura cinzenta será consultada a Biblioteca Digital de Teses e Dissertações, WordCat e o Google Acadêmico, além dos sites de instituições nacionais e internacionais referente ao objeto. Os estudos selecionados serão exportados para a plataforma de seleção Rayyan, removido duplicatas. Os títulos e resumos serão revisados por dois pesquisadores independentes, os conflitos serão resolvidas por meio de reunião de consenso ou consultando um terceiro revisor, após ocorrerá a leitura na íntegra. A extração dos dados ocorrerá por dois revisores independentes utilizando um instrumento de extração de dados adaptado do modelo proposto pelo JBI.