Desenvolvimento, aplicação e avaliação de um programa nacional de educação a distância para profissionais da área da saúde sobre resistência microbiana e uso racional de antimicrobianos. / A national wide web-based course for healthcare professionals on antimicrobial resistance and rational antimicrobial use.

Carla Morales Guerra

Background: Education and updating of health professionals should be considered as an integral part of strategies to resistance control and to maintain quality of care and patient safety. Objective: To develop and apply a Web-based program on infection control practices and antimicrobial resistance for healthcare workers involved with healthcare-acquired infection from different demographic Brazilian regions, and to assess the knowledge and perceptions of participants. To evaluate the perception and attitude of professionals working in committees hospital infection control registered for the course of the infection control program in their institutions. Method: The study was conducted at the Division of Infectious Diseases and Department of Informatics and Health of Federal University of São Paulo. Were developed and implemented two courses: RMcontrole, directed to health professionals in general and ATMracional, directed only antimicrobial prescribers (physicians and dentists). Professionals should register on line in the site of the course. The selection of students prioritized professionals from the Midwest and North of the country involved in the area of hospital infection control. The course was offered free to the professionals. The program involved production of a printed booklet and a CD-ROM sent to the address of work, beyond the creation of website. One of the features of this work was the use of e-learning platform Moodle. The activities of each student tutors were monitored by specialists in hospital infection control and to pass the course was required score of 70% in the proposed activities and assessments. Results: The total number of professionals registered for the course RMcontrole was 6256 and the course was ATMracional 2856, among whom were selected in 1172 and 917 professionals for each course respectively. The dropout rate in the course RMcontrole was 9.1% and ATMracional was 8.0%, the approval rate was 96.4% and 93.5% and disapproval rate was 3.6% and 6.5 %, respectively. For most participants this was the first participation in a distance course even so, few students reported difficulties with the study via the Internet. The study tool preferred by most professional was the book printed, but approximately 20.0% of professionals reported prefer to study via the Internet. The assessment of participants on the course content showed that in relation to the scope and update more than 95.5% were satisfied or extremely satisfied. The discussions between tutors and participants surpassed the mark of 1,000 posts in each course. Analysis of the scores in both courses showed that there was difference between the initial and final notes, allowing us to conclude that there was knowledge acquisition (p <0.001). Conclusion: This was the first free national program for training health professionals on microbial resistance. We believe that the improvement of this methodology will allow access to technical knowledge to a broader number of professionals and may become an important tool for training in prevention and control of infections related to health care and in facing the challenges of antimicrobial resistance. The evaluation of the perception and attitude of professionals working in infection control committees on the program of infection control in their institutions highlighted important information that could be used by the Brazilian authorities to direct strategies to improve the programs of hospital infection control in each region of the country.

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