Daiana Bonfim

Identificação das intervenções de enfermagem na Atenção Primária à Saúde: parâmetro para o dimensionamento de trabalhadores

In Primary Health Care (PHC) there is empirical planning regarding the nursing staff, which causes a distortion between personnel distribution and the real needs of the health units. The objective was to identify the nursing interventions at the PHC that support personnel staffing. The following sources were: literature review of databases from 1999-2009; field observation at a Family Health Unit; survey of family forms; mapping of nursing activities and interventions according to the Nursing Interventions Classification; and validation of these interventions. A total of 169 activities were identified: 11 associated activities; five personnel activities and 153 direct and indirect care giving activities validated in seven domains, 15 classes and 46 NIC interventions. The study allowed for recognition of the nursing practices at the PHC by means of a standardized language, providing support for its application in the creation of instruments to identify the nursing workload.Na Atencao Primaria a Saude (APS) o quadro de trabalhadores de enfermagem e planejado de forma empirica, gerando distorcao entre a alocacao e a real necessidade das unidades de saude. O objetivo deste trabalho foi identificar as intervencoes de enfermagem na APS para subsidiar o dimensionamento dos trabalhadores. Foram utilizadas as seguintes fontes: revisao bibliografica em bases de dados no periodo de 1999-2009; observacao em campo em Unidade de Saude da Familia; levantamento em prontuarios de familias; mapeamento das atividades em intervencoes de enfermagem segundo a taxonomia Nursing Interventions Classification e validacao dessas intervencoes. Identificaram-se 169 atividades: 11 atividades associadas; 5 pessoais; e 153 de cuidados diretos e indiretos que foram mapeadas e validadas em 7 dominios, 15 classes e 46 intervencoes da NIC. O estudo possibilitou o reconhecimento das praticas de enfermagem na APS por meio de uma linguagem padronizada, subsidiando a sua aplicacao na construcao de instrumentos para a identificacao da carga de trabalho.

The Use of Nursing Interventions Classification (NIC) in Identifying the Workload of Nursing: An Integrative Review

PURPOSE To synthesize evidence related to the use of the Nursing Interventions Classification in order to identify nursing workload. METHOD An integrative literature review was conducted in June 2013. FINDINGS The search strategy yielded a total of 111 references, 18 of which were retrieved, read, and evaluated for relevance. A set of 10 articles met the selection criteria. CONCLUSION A review of papers regarding the Nursing Interventions Classification and workload revealed the following themes: the identification of nursing interventions in areas of expertise and estimated times for their completion, the distribution of interventions in direct and indirect care, and the prevalence of the type of care in a given healthcare setting.

[The identification of nursing interventions in primary health care: a parameter for personnel staffing].

In Primary Health Care (PHC) there is empirical planning regarding the nursing staff, which causes a distortion between personnel distribution and the real needs of the health units. The objective was to identify the nursing interventions at the PHC that support personnel staffing. The following sources were: literature review of databases from 1999-2009; field observation at a Family Health Unit; survey of family forms; mapping of nursing activities and interventions according to the Nursing Interventions Classification; and validation of these interventions. A total of 169 activities were identified: 11 associated activities; five personnel activities and 153 direct and indirect care giving activities validated in seven domains, 15 classes and 46 NIC interventions. The study allowed for recognition of the nursing practices at the PHC by means of a standardized language, providing support for its application in the creation of instruments to identify the nursing workload.Na Atencao Primaria a Saude (APS) o quadro de trabalhadores de enfermagem e planejado de forma empirica, gerando distorcao entre a alocacao e a real necessidade das unidades de saude. O objetivo deste trabalho foi identificar as intervencoes de enfermagem na APS para subsidiar o dimensionamento dos trabalhadores. Foram utilizadas as seguintes fontes: revisao bibliografica em bases de dados no periodo de 1999-2009; observacao em campo em Unidade de Saude da Familia; levantamento em prontuarios de familias; mapeamento das atividades em intervencoes de enfermagem segundo a taxonomia Nursing Interventions Classification e validacao dessas intervencoes. Identificaram-se 169 atividades: 11 atividades associadas; 5 pessoais; e 153 de cuidados diretos e indiretos que foram mapeadas e validadas em 7 dominios, 15 classes e 46 intervencoes da NIC. O estudo possibilitou o reconhecimento das praticas de enfermagem na APS por meio de uma linguagem padronizada, subsidiando a sua aplicacao na construcao de instrumentos para a identificacao da carga de trabalho.

Time standards of nursing in Primary Health Care: an observational study

OBJECTIVE To determine time standards for interventions and activities conducted by nursing professionals in Family Health Units (FHU) in Brazil to substantiate the calculation of work force. METHOD This was an observational study carried out in 27 FHU, in 12 municipalities in 10 states, in 2013. In each unit, nursing professionals were observed every 10 minutes, for eight work hours, on five consecutive days via the work sampling technique. RESULTS A total of 32,613 observations were made, involving 47 nurses and 93 nursing technicians/assistants. Appointments were the main intervention carried out by nurses, with a mean time of 25.3 minutes, followed by record-keeping, which corresponded to 9.7%. On average, nursing technicians/assistants spent 6.3% of their time keeping records and 30.6 intervention minutes on immunization/vaccination control. CONCLUSION The study resulted in standard times of interventions carried out by the FHU nursing team, which can underpin the determination of nursing staff size and human resource policies. Furthermore, the study showed the panorama of interventions currently employed, allowing for the work process to be reviewed and optimized.OBJECTIVE To determine time standards for interventions and activities conducted by nursing professionals in Family Health Units (FHU) in Brazil to substantiate the calculation of work force. METHOD This was an observational study carried out in 27 FHU, in 12 municipalities in 10 states, in 2013. In each unit, nursing professionals were observed every 10 minutes, for eight work hours, on five consecutive days via the work sampling technique. RESULTS A total of 32,613 observations were made, involving 47 nurses and 93 nursing technicians/assistants. Appointments were the main intervention carried out by nurses, with a mean time of 25.3 minutes, followed by record-keeping, which corresponded to 9.7%. On average, nursing technicians/assistants spent 6.3% of their time keeping records and 30.6 intervention minutes on immunization/vaccination control. CONCLUSION The study resulted in standard times of interventions carried out by the FHU nursing team, which can underpin the determination of nursing staff size and human resource policies. Furthermore, the study showed the panorama of interventions currently employed, allowing for the work process to be reviewed and optimized.

Comparação entre as intervenções de enfermagem realizadas e os registros em sistema informatizado para atenção básica

OBJECTIVE: Compare the interventions performed by the nursing staff in a Primary Health Care Unit with the interventions recorded in the information system. METHODS: Descriptive, exploratory study conducted in two stages at a Health Unit considered as having good practices in nursing. Stage 1: direct, non-participatory and structured observation for five days. Stage 2: application of the cross-mapping technique in the activities recorded in the computerized system, adapting them in standardized language for nursing interventions. RESULTS: It was found that 23.5% and 27.2% of the interventions made by the nursing staff and nurses were recorded in the computerized system. CONCLUSION: The computerized system displays insufficient fields to report the work carried out by the nursing team at the Primary Health Care Unit.

Application of the Workload Indicators of Staffing Need method to predict nursing human resources at a Family Health Service

Objetivo verificar la aplicacion del metodo Workload Indicators of Staffing Need en la prediccion de recursos humanos de enfermeria en Unidad de Salud de la Familia. Metodo estudio descriptivo, cuantitativo, realizado en una Unidad de Salud de la Familia, localizada en el municipio de Sao Paulo. Se utilizo el conjunto de operaciones secuenciales preconizadas por el metodo Workload Indicators of Staffing Need: definicion de la categoria profesional, tipo de unidad de salud y calculo del Tiempo de Trabajo Disponible; definicion de los componentes de la carga de trabajo; identificacion del tiempo promedio para los componentes de la carga de trabajo; cuantificacion de las necesidades de personal con base en el metodo, aplicacion e interpretacion de los datos. Resultado hubo equilibrio entre la carga de trabajo propuesta por el metodo Workload Indicators of Staffing Need y el numero de para los tecnicos/auxiliares de enfermeria disponibles en la Unidad Salud de la Familia. El indice Workload Indicators of Staffing Need, para enfermeros, fue de 0,6 y para los tecnicos/auxiliares de enfermeria 1,0. Conclusion la aplicacion del metodo Workload Indicators of Staffing Need mostro pertinencia para identificar la carga de trabajo de los profesionales de enfermeria. Por tanto, es recomendable como herramienta para la cuantificacion de profesionales de enfermeria en Unidad de Salud de la Familia, contribuyendo para el acceso y cobertura universal de la salud.

Instrumento de medida de carga de trabalho dos profissionais de Saúde na Atenção Primária: desenvolvimento e validação

Objetivo Proponer y validar un instrumento que contemple las intervenciones/actividades realizadas por el equipo de salud de la familia, como referencia para la planificacion de la fuerza de trabajo. Metodo investigacion metodologicadesarrollada en etapas.construccion del instrumento; validacion de contenido y prueba piloto en tres unidades, ubicadasen la region sudeste de Brasil. Resultados Fueron 39 intervencionesvalidadas con un unico instrumento para medir la carga de trabajo paramedico, cirujano dentista, tecnico/asistente de salud bucal, enfermero, tecnico/asistente de enfermeria y agente comunitario de salud. En la prueba piloto, el instrumento contemplo 100% de las intervenciones observadas, alcanzando 93,7% de concordancia entre los observadores. Conclusion El instrumento propuesto, inedito en su configuracion, subsidia la planificacion de la fuerza de trabajo en la atencion primaria.Objetivo Proponer y validar un instrumento que contemple las intervenciones/actividades realizadas por el equipo de salud de la familia, como referencia para la planificacion de la fuerza de trabajo. Metodo investigacion metodologicadesarrollada en etapas.construccion del instrumento; validacion de contenido y prueba piloto en tres unidades, ubicadasen la region sudeste de Brasil. Resultados Fueron 39 intervencionesvalidadas con un unico instrumento para medir la carga de trabajo paramedico, cirujano dentista, tecnico/asistente de salud bucal, enfermero, tecnico/asistente de enfermeria y agente comunitario de salud. En la prueba piloto, el instrumento contemplo 100% de las intervenciones observadas, alcanzando 93,7% de concordancia entre los observadores. Conclusion El instrumento propuesto, inedito en su configuracion, subsidia la planificacion de la fuerza de trabajo en la atencion primaria.Objective To develop and validate an instrument that addresses the interventions/activities carried out by the family health team as reference for staff planning. Method Methodological research developed in stages: instrument development, content validation, and pilot test in three units located in the southeastern region of Brazil. Results 39 interventions were validated in a single instrument to measure workload for clinician, dental surgeon, oral health technician/assistant, nurse, nurse assistant, and community health agent. In the pilot test, the instrument contained 100% of the interventions observed and the observers reached 93.7% agreement. Conclusion The proposed instrument is an innovating tool because of its configuration for health team and supports staff planning in primary health care.

Tecnologia móvel para coleta de dados de pesquisas em saúde

Abstract Objective: Describe the development of a mobile application for data collection in time and movement research with health professionals from the Family Health Strategy Program when conducting care interventions/activities. Methods: Applied research of technological production based on the concept of prototyping and the steps of definition, development, and maintenance, for the design and validation of the application: instrumento de medida de carga de trabalho dos profissionais de saude na atencao primaria (Workload measurement instrument for health professionals in primary [...]

Aplicación del método Workload Indicators of Staffing Need como herramienta de predicción de recursos humanos de enfermería en Unidad de Salud de la Familia

Objetivo verificar la aplicacion del metodo Workload Indicators of Staffing Need en la prediccion de recursos humanos de enfermeria en Unidad de Salud de la Familia. Metodo estudio descriptivo, cuantitativo, realizado en una Unidad de Salud de la Familia, localizada en el municipio de Sao Paulo. Se utilizo el conjunto de operaciones secuenciales preconizadas por el metodo Workload Indicators of Staffing Need: definicion de la categoria profesional, tipo de unidad de salud y calculo del Tiempo de Trabajo Disponible; definicion de los componentes de la carga de trabajo; identificacion del tiempo promedio para los componentes de la carga de trabajo; cuantificacion de las necesidades de personal con base en el metodo, aplicacion e interpretacion de los datos. Resultado hubo equilibrio entre la carga de trabajo propuesta por el metodo Workload Indicators of Staffing Need y el numero de para los tecnicos/auxiliares de enfermeria disponibles en la Unidad Salud de la Familia. El indice Workload Indicators of Staffing Need, para enfermeros, fue de 0,6 y para los tecnicos/auxiliares de enfermeria 1,0. Conclusion la aplicacion del metodo Workload Indicators of Staffing Need mostro pertinencia para identificar la carga de trabajo de los profesionales de enfermeria. Por tanto, es recomendable como herramienta para la cuantificacion de profesionales de enfermeria en Unidad de Salud de la Familia, contribuyendo para el acceso y cobertura universal de la salud.

Aplicação do método Workload Indicators of Staffing Need como preditor de recursos humanos de enfermagem em Unidade de Saúde da Família

Objetivo verificar la aplicacion del metodo Workload Indicators of Staffing Need en la prediccion de recursos humanos de enfermeria en Unidad de Salud de la Familia. Metodo estudio descriptivo, cuantitativo, realizado en una Unidad de Salud de la Familia, localizada en el municipio de Sao Paulo. Se utilizo el conjunto de operaciones secuenciales preconizadas por el metodo Workload Indicators of Staffing Need: definicion de la categoria profesional, tipo de unidad de salud y calculo del Tiempo de Trabajo Disponible; definicion de los componentes de la carga de trabajo; identificacion del tiempo promedio para los componentes de la carga de trabajo; cuantificacion de las necesidades de personal con base en el metodo, aplicacion e interpretacion de los datos. Resultado hubo equilibrio entre la carga de trabajo propuesta por el metodo Workload Indicators of Staffing Need y el numero de para los tecnicos/auxiliares de enfermeria disponibles en la Unidad Salud de la Familia. El indice Workload Indicators of Staffing Need, para enfermeros, fue de 0,6 y para los tecnicos/auxiliares de enfermeria 1,0. Conclusion la aplicacion del metodo Workload Indicators of Staffing Need mostro pertinencia para identificar la carga de trabajo de los profesionales de enfermeria. Por tanto, es recomendable como herramienta para la cuantificacion de profesionales de enfermeria en Unidad de Salud de la Familia, contribuyendo para el acceso y cobertura universal de la salud.