Alacoque Lorenzini Erdmann

Construindo um modelo de sistema de cuidados

OBJECTIVE: To develop an explanatory theoretical model of the system of care. METHOD: Grounded theory served as the conceptual framework to conduct this qualitative exploratory study. Unstructured interviews were conducted among 15 care professionals. RESULTS: The theoretical model was delimited from the phenomenon building complex system of care as determined by the following categories: dealing with a dynamic system of care and organizing the system of care through multiple interactions. CONCLUSION: The explanatory theoretical model of system of care was developed as a vital and dynamic system built from interactions among health care professional who share responsibilities and ways of knowing through multidisciplinary work.

Gestão das práticas de saúde na perspectiva do cuidado complexo

3 Cirurgia-dentista. Doutora em Enfermagem. Membro do GEPADES. ABSTRACT: Advances in health care management practices implicate a reflection on new approaches in knowledge construction for the understanding of the human being as a being of care, in the perspective of complex care accomplished by interconnected and potentialized health teams for the best practices in the existing care systems. This article proposes a reflection on the health care management practices, starting from this way of thinking and seeing the being of care as cognoscente, complex, political, a health care worker, an actor, and a builder of relationships, interactions, and associations in the exercise of care for healthier living, health care promotion, and the valorization of life. Addressing presuppositions constitutes a reference for health care management practices in the perspective of complex care.Advances in health care management practices implicate a reflection on new approaches in knowledge construction for the understanding of the human being as a being of care, in the perspective of complex care accomplished by interconnected and potentialized health teams for the best practices in the existing care systems. This article proposes a reflection on the health care management practices, starting from this way of thinking and seeing the being of care as cognoscente, complex, political, a health care worker, an actor, and a builder of relationships, interactions, and associations in the exercise of care for healthier living, health care promotion, and the valorization of life. Addressing presuppositions constitutes a reference for health care management practices in the perspective of complex care. RESUMEN: El progreso en la gestión de las prácticas de la salud implica la reflexión acerca de nuevos abordajes para la construcción del conocimiento en la comprensión del ser humano como un ser de cuidado, en la perspectiva del cuidado complejo realizado por los equipos de la salud interconectivos y potencializados para las mejores prácticas en los sistemas del cuidado. Éste artículo propone una reflexión en la gestión de las prácticas de la salud sobre esta manera de pensar y ver al ser del cuidado, cognoscente, complejo, político, trabajador de la salud, actor y constructor de las relaciones, interacciones y asociaciones en el ejercicio del cuidado para un vivir más saludable, la promoción de la salud y la valorización de la vida. El delineamiento de presuposiciones se constituye en una referencia para la gestión de las prácticas de la salud en la perspectiva del cuidado complejo. Endereço: Alacoque Lorenzini Erdmann R. Frei Caneca, 100, Bl. B, Ap. 501 88025-000 Agronômica, Florianópolis, SC. E-mail: alacoque@newsite.com.br Artigo original: Reflexão teórica Recebido em: 13 de março de 2006. Aprovação final: 05 de julho de 2006. PALAVRAS-CHAVE: Organização e Administração. Saúde. Enfermagem.

Práticas de enfermeiros na gerência do cuidado em enfermagem e saúde: revisão integrativa

Estudo com objetivo de evidenciar e analisar as praticas dos enfermeiros na gerencia do cuidado descritas na producao cientifica brasileira e internacional, por meio de uma revisao integrativa. Foram pesquisados artigos publicados entre 2005 e 2010, nas bases LILACS, SciELO, BDENF e CINAHL, a partir dos descritores Gerencia e Administracao, associados a Cuidado e Enfermagem, e os termos Nursing Management e Nursing Care, totalizando 27 publicacoes. A gerencia do cuidado realizada pelo enfermeiro relaciona-se diretamente a busca pela qualidade assistencial e de melhores condicoes de trabalho, por meio de acoes como: realizacao do cuidado, gerencia de recursos humanos e materiais, lideranca, planejamento da assistencia, capacitacao da equipe de enfermagem, coordenacao da producao do cuidado e avaliacao das acoes de enfermagem.This study aimed to highlight and analyze the nurses practices in care management described in the scientific production in Brazil and internationally, through an integrative review. It was examined articles published between 2005 and 2010, in the LILACS, SciELO, BDENF and CINAHL databases, with the descriptors Management and Administration, in conjunction with Care and Nursing, and the terms Nursing Management and Nursing Care, totaling 27 publications. The management of care performed by nurses is directly related to the search for quality care and better working conditions through actions such as: care realization, human and material resources management, leadership, assistance planning, nursing team training, care coordination and evaluation of nursing actions.

Compreendendo as dimensões de cuidado em uma unidade de emergência hospitalar

The objective of this qualitative study was to comprehend the meaning of the nursing care relationships in an emergency unit from the perception of the human receiving care and to provide theoretical subsidies in order to think about the care relationships established in day-to-day nursing work. Nineteen (19) subjects were interviewed in an emergency hospital unit in Santa Catarina, Brazil. The data was submitted to content analysis and interpreted according to complex thought. The care dimensions, presented in six categories, mobilize and articulate the multiple human competencies and techniques of/by caring beings in the comprehension of the nursing care process, from the perspective of those who receive care, including rethinking nursing practice itself and the multiple conditions of the environment as a space for care.Estudo qualitativo que objetivou compreender o significado das relacoes de cuidado de enfermagem em uma unidade de emergencia na percepcao do ser humano cuidado e proporcionar subsidios teoricos para pensar sobre as relacoes cuidativas estabelecidas no cotidiano do trabalho da enfermagem. Foram entrevistados 19 sujeitos em uma unidade de emergencia hospitalar de Santa Catarina. Os dados foram submetidos a analise de conteudo e interpretados pelo pensar complexo. As dimensoes de cuidado, apresentadas em seis categorias, mobilizam e articulam as multiplas competencias humanas e tecnicas dos/pelos seres cuidadores na compreensao do processo de cuidado em enfermagem, a partir da percepcao dos que sao cuidados, e no repensar a propria pratica e as condicoes multiplas do ambiente como o espaco do cuidado.

O cuidado de enfermagem como prática empreendedora: oportunidades e possibilidades

Objective: To understand the meaning and to develop a substantive theory about nursing care as an enterprising social practice. The Methods: Was based on the Grounded Theory which, in a systematic, creative and interactive manner allowed the development of the substantive theory: “Realizing the nursing care as an enterprising social practice.” The theoretical sample consisted of thirty-five subjects distributed among different groups of samples. Results: The nursing care as an enterprising social practice is associated with the system of relationships and interactions, the ability to interact with different social actors and, the ability to create new channels of communication and proactive actions. Conclusion: Considering the care as an enterprising practice is possible to act in a proactive, innovative and participatory way, without neglecting the emerging aspects of social contradictions.Objective: To understand the meaning and to develop a substantive theory about nursing care as an enterprising social practice. The Methods: Was based on the Grounded Theory which, in a systematic, creative and interactive manner allowed the development of the substantive theory: “Realizing the nursing care as an enterprising social practice.” The theoretical sample consisted of thirty-five subjects distributed among different groups of samples. Results: The nursing care as an enterprising social practice is associated with the system of relationships and interactions, the ability to interact with different social actors and, the ability to create new channels of communication and proactive actions. Conclusion: Considering the care as an enterprising practice is possible to act in a proactive, innovative and participatory way, without neglecting the emerging aspects of social contradictions.

Cuidando de si, do outro e "do nós" na perspectiva da complexidade

Trata-se de relato de experiencia de uma pratica reflexiva desenvolvida com profissionais de enfermagem em um hospital publico de Santa Catarina sobre a problematica das relacoes de cuidado de si, do outro e do nos, em diferentes dimensoes, na perspectiva do paradigma da Complexidade. Foram realizadas cinco oficinas, englobando tres momentos cada, com temas previamente escolhidos. A partir da analise sistematica do conteudo das falas dos participantes emergiram algumas unidades de significados. Esta pratica aproximou a compreensao acerca das interacoes e associacoes estabelecidas na relacao eu-outro-nos, enquanto seres humanos, na relacao eu-outro-nos-ambiente e na relacao de cada ser humano consigo mesmo, a partir das mobilizacoes/ondulacoes/trocas particulares e reciprocas do viver e do conviver num mundo/cenario complexo.This study is an experience report of a reflective practice developed with nursing professionals in a public hospital in Santa Catarina, Brazil about the problem of relationships in caring for ones self, another, and for us, in different dimensions, within the perspective of the Complexity paradigm. Five workshops were organized and carried out, encompassing three meetings each, with previously chosen themes. From the systematic analysis of the participants speech content, some units of meaning emerged. This practice brought comprehension concerning established iterations and associations in the I-other-us relationship closer together, as human beings, in the I-other-us-environment relationship, and in the relationship each human being has with him/herself, based on the mobilization/undulations/private and reciprocal exchanges of living and living with others in a complex world/scenario.

As organizações de saúde na perspectiva da complexidade dos sistemas de cuidado

The construction of new practices of care presupposes a new look for the health organizations. The objective of this text is to interpret the complexity theme in health and in Nurse fields in the care systems perspective, in order to promote a reflection of the practices of care in the health organizations context. The complex thought brings a new way to conceive the action and the human condition under different perspectives. It appears as a possibility for the visualization of a care system as a complex system in your structures and properties, in the movements of interretroactions in the organizational spaces and in possible auto-organizers processes. It is hoped a transforming action of the health organizations that considers the ambiguities, the uncertainties and the contemporary social dynamics for a healthier living.La construccion de nuevas practicas de cuidado presupone una nueva mirada a las organizaciones de salud. El objetivo de este ensayo es interpretar el tema de la complejidad en la salud y en Enfermeria en la perspectiva de los sistemas de cuidado, buscando un repensar de las practicas de cuidado en el contexto de las organizaciones de salud. El pensamiento complejo trae una nueva manera de concebir la accion y la condicion humana bajo diferentes perspectivas. Aparece como posibilidad para la visualizacion de un sistema de cuidado como sistema complejo en sus estructuras y propiedades, en los movimientos de inter-retroacciones en los espacios organizacionales y en sus posibles procesos auto-organizadores. Se espera una accion transformadora de las organizaciones de salud que considere las ambiguedades, las incertidumbres y la dinamica social contemporanea para un para vivir mas saludable.

Cuidado humano e tecnologia na enfermagem contemporânea e complexa

Este artigo tem como objetivo promover reflexoes sobre cuidado humano, tecnologias da informacao e o pensamento complexo no cenario contemporâneo da enfermagem. O texto relaciona os principais pressupostos do paradigma da complexidade com as tecnologias da informacao e o cuidado de enfermagem em suas multiplas dimensoes, destacando as relacoes do ser humano com tais tecnologias. Com base nos questionamentos e reflexoes, deduzimos que conceber o uso das tecnologias e contextualizar sua realidade profissional para compreender a complexidade e, para a enfermagem contemporânea, um desafio complexo. Vislumbramos a possibilidade de inovar a pratica do cuidado do outro de forma a corresponder as necessidades de um mundo globalizado, nao ignorando a convivencia entre os seres humanos, percebida como necessaria e importante para a gerencia de relacoes de cuidado saudaveis e construtivas. Abre-se para novos questionamentos na perspectiva de uma pratica de cuidado tecnologicamente melhor organizada e mais avancada.The objective of this article is to promote reflections concerning human care, information technologies, and complex thought in the contemporary scenario of nursing. The text relates the presupposed principles of the complexity paradigm with information technologies and nursing care in its multiple dimensions, highlighting human relationships with such technologies. From questioning and reflection, we deduce that conceiving the use of technologies and contextualizing their professional reality in order to better comprehend complexity is a complex challenge for contemporary nursing. We further point out the possibility for innovating care practices for others in a manner which corresponds to the necessities of a globalized world, not ignoring human interaction, seen as necessary and important for managing healthy and constructive care relationships. This opens up the possibility for new questions under the perspective of a more advanced and technologically better organized care practice. DESCRIPTORS: Information technology. Health. Nursing. Nursing care. Nursing services. EL CUIDADO HUMANO Y LA TECNOLOGIA EN LA ENFERMERIA CONTEMPORANEA Y COMPLEJA RESUMEN: El presente articulo tiene como objetivo promover la reflexion sobre el cuidado humano, la tecnologia de la informacion y el pensamiento complejo en el contexto contemporaneo de la enfermeria. El texto relaciona los principales postulados del paradigma de la complejidad con la tecnologia de la informacion y el cuidado de enfermeria en sus multiples dimensiones, destacando las relaciones de los seres humanos con esas tecnologias. A partir de preguntas y reflexiones, deducimos que concebir el uso de la tecnologia y contextualizar su realidad profesional para comprender la complejidad es para la enfermeria contemporanea un reto complejo. Imaginamos la posibilidad de innovar la practica del cuidado como una forma de satisfacer las necesidades de un mundo globalizado, sin ignorar la coexistencia entre los seres humanos, como necesaria e importante para la gestion de las relaciones de un cuidado sano y constructivo. Este estudio se abre a nuevas preguntas en la perspectiva de una practica de cuidado mejor organizada y mas avanzada tecnologicamente. DESCRIPTORS: Tecnologia de la informacion. Salud. Enfermeria. Atencion de enfermeria. Servicios de enfermeria.

Promovendo a cidadania por meio do cuidado de enfermagem

This study is the result of the project: networks care and social entrepreneurship: the autonomy and social commitment of nurses. The purpose of this qualitative study is to comprehend the meaning of nursing care as a social enterprising practice. The Grounded Theory was used as a methodological reference and the interview, conducted with 35 participants as technique of data collection. Data codification led to the central theme: Viewing Nursing Care as a Social Enterprising Practice. This theme is complemented by the category, characterized the cause condition: the social integration through the creation a political identity that expresses your involvement. The results showed that is necessary to learn and have a deep dialogic knowledge. In order to consolidate popular participation as a citizenship ideal, a critical professional attitude, base don the combination of care with liberty, participation end autonomy.Estudo e fruto de um projeto de pesquisa intitulado: Redes de cuidado e empreendedorismo social: a autonomia e o compromisso social do enfermeiro. Trata-se de um estudo qualitativo que objetivou compreender o significado do cuidado de enfermagem como pratica social empreendedora. Utilizou-se como referencial metodologico a Grounded Theory e como tecnica de coleta de dados a entrevista, realizada com 35 participantes. A codificacao e analise dos dados conduziram ao tema central: Vislumbrando o cuidado de enfermagem como pratica social empreendedora. Esse fenomeno e complementado pela categoria, caracterizada como condicao causal: A insercao social por meio da construcao de uma identidade politica que expresse o seu envolvimento responsavel. Os resultados evidenciaram que e necessario conhecer e aprender profundamente o principio da dialogica. Para que a participacao popular se consolide como ideal de cidadania e necessario uma postura profissional critica, fundamentada na combinacao de cuidado com liberdade, participacao e autonomia.

Paralelo entre educação permanente em saúde e administração complexa

A educacao e um processo politico, no qual a sociedade opera de forma constante sobre o desenvolvimento da pessoa, com intuito de integra-la ao modo de ser vivente. O estudo representa uma reflexao-teorica a partir de um paralelo entre as diretrizes da Politica Nacional de Educacao Permanente em Saude e os principios norteadores da Administracao Complexa. A partir de um breve resgate bibliografico, buscou-se contextualizar a Politica, bem como essa nova forma de administracao baseada na autonomia, cooperacao, agregacao e auto-organizacao. Defende-se que esta aproximacao entre educacao permanente e administracao complexa podera facilitar a realizacao do cuidado em enfermagem e saude, bem como as atividades gerenciais, impulsionar a autonomia, alem do crescimento pessoal, profissional e organizacional.Education is a political process, in which the society operates consistently on the development of the individual, aiming to integrate it into the way of living being. The present work represents a theoretical refection, from a parallel between the guidelines of the National Politics in Continuing Education in Health and the principles of the Complex Administration. From a brief review of the literature, it is attempted to contextualize the policy and this new form of administration based on freedom, cooperation, aggregation and self-organization. Results of the study suggest that the relation between continuing education and complex administration could facilitate the implementation of nursing care and health, as well as managements activities by promoting autonomy, as well as personal, professional and organizational growth.