Fernanda Maria Togeiro Fugulin

Sistema de classificação de pacientes: identificação do perfil assistencial dos pacientes das unidades de internação do HU-USP

This exploratory-descriptive study aimed to identify the patient care profile at the Hospitalization Units of the University Hospital-USP to support human resource allocation, to evaluate the nursing staff and to ground decision-making processes on nursing care organization and planning. In order to get to know the patients’ care complexity profile, the patient classification instrument was used, developed and established at the Medical Clinic Unit of the UH-USP since 1990. The study results allowed us to evaluate the adequacy of the classification system used and provided information on the patients’ care profile and the work load at each Hospitalization Unit, thus, supporting management decisions on human resource allocation, care planning and service organization in view of clients’ demands.

Absenteísmo - doença na equipe de enfermagem: relação com a taxa de ocupação

This is a qualitative descriptive, transversal study aiming to analyze the amount and causes of sick leave of nursing professionals and its relationship with the occupation tax of the hospitalization units in a teaching hospital. The methodology was divided into two phases: demographic characterization of professionals and identification and analysis of absences regarding the amount and type of sick leaves, medical diagnosis and its relationship with the occupation tax of the Hospital. The nursing professionals presented the greatest amount of sick leaves. Diseases of the osteomuscular system and of the connective tissue represented 4,957 days (41.5%) of absences and mental and behavioral disorders 3,393 days (28.4%). The monthly percentage of sick licenses was inversely proportional to the occupation tax, suggesting that professionals were absent due to diseases after being submitted to greater work load.This is a qualitative descriptive, transversal study aiming to analyze the amount and causes of sick leave of nursing professionals and its relationship with the occupation tax of the hospitalization units in a teaching hospital. The methodology was divided into two phases: demographic characterization of professionals and identification and analysis of absences regarding the amount and type of sick leaves, medical diagnosis and its relationship with the occupation tax of the Hospital. The nursing professionals presented the greatest amount of sick leaves. Diseases of the osteomuscular system and of the connective tissue represented 4,957 days (41.5%) of absences and mental and behavioral disorders 3,393 days (28.4%). The monthly percentage of sick licenses was inversely proportional to the occupation tax, suggesting that professionals were absent due to diseases after being submitted to greater work load.Estudio de naturaleza descriptiva, transversal, elaborada con el objetivo de analisar la cantidad y las causas del afastamiento por enfermedad de los profesionales de enfermeria y su relacion com la tasa de ocupacion de las unidades de internacion de un hospital de ensenanza. La metodologia fue desarrollada en dos etapas: caracterizacion demografica de los profisionales y la identificacion y analisis de las ausencias en relacion a la cantidad y tipos de afastamiento por enfermedad, a los diagnosticos medicos y en relacion con la tasa de ocupacion en el hospital. Los tecnicos de enfermeria fueron los que presentaron la mayor cantidad de licencias por enfermedad. Las enfermedades del sistema osteomuscular y del tejido conjuntivo representaron 4,957 dias (41.5%) de ausencias y los trastornos mentales y comportamentales 3.393 dias (28.4%). El percentual mensal de licencias por enfermedad fue inversamente proporcional a la tasa de ocupacion, sugeriendo que los profesionales se ausentaron por enfermedad despues de haberen sido sometidos a ritmos mayores de trabajo

Aplicação do nursing activities score em pacientes de alta dependência de enfermagem

ABstrAct: The objectives of this exploratory-descriptive study were to evaluate the applicability of the Nursing Activities Score as an instrument to measure workload in caring for patients classified into the category of high dependency on nursing care and to correlate the obtained mean scores with mean time of assistance proclaimed by the Brazilian Federal Nursing Council. Data was collected to determine the Nursing Activities Score in the period from July 13th to August 1, 2007 through means of consulting the patient charts of those interned in the high dependency ward of an out-patient clinic of a Medical Clinical Unit. Data analysis was performed by descriptive statistics and measure of variability. The instrument was effective for these patients, while the establishment of guidelines was needed for its application. It was concluded that the patient classified as high dependant on nursing care needs on average of 12.3 hours of assistance within a 24-hour period. resUmen: Estudio de tipo exploratorio-descriptivo, cuyos objetivos fueron: evaluar la aplicabilidad delEstudio de tipo exploratorio-descriptivo, cuyos objetivos fueron: evaluar la aplicabilidad del Nursing Activities Score como instrumento de medida de la carga de trabajo en la asistencia a los pacientes de la categoria de cuidados de alta dependencia de enfermeria, y ademas, relacionar la puntuacion media obtenida con los tiempos medios de asistencia establecidos por el Consejo Federal de Enfermeria. La recoleccion de los datos fue hecha en el periodo de 13 de julio a 1 de agosto de 2007, por medio de la consulta a los prontuarios de los pacientes internados en la enfermeria de alta dependencia de una Unidad de Clinica Medica. El analisis de los datos se realizo por estadistica descriptiva y por la medida de la variabilidad. El instrumento de analisis mostro ser eficaz para esos pacientes, siendo necesario el establecimiento de directrices para su aplicacion. Este estudio concluyo que el paciente clasificado como de alta dependencia de enfermeria necesita una media de 12,3 horas de asistencia, en un periodo de 24 horas.

Distribuição do tempo de trabalho das enfermeiras em unidade de emergência

La investigacion, de naturaleza cuantitativa, descriptiva, del tipo de estudio de caso, tuvo por objetivo identificar y analizar la distribucion del tiempo de trabajo de las enfermeras en una unidad de emergencias. Para alcanzar tales objetivos se utilizo el metodo de muestreo de trabajo. La identificacion de las actividades de enfermeria realizadas por las enfermeras se efectuo a traves de evaluacion de las fichas de atencion de los pacientes y de la observacion directa de las enfermeras en su rutina de trabajo en la Unidad. Las actividades identificadas fueron posteriormente categorizadas de acuerdo con un sistema estandarizado de lenguaje. Se verifico que el 35% del tiempo de las enfermeras fui destinado a las intervenciones de cuidado indirecto, otro 35% a las intervenciones de cuidado directo, 18% a actividades de tiempo personal y 12% a actividades asociadas. La productividad media de las profesionales evaluadas correspondio a un 82%. Con este estudio se ponen en evidencia perspectivas para la realizacion de nuevas investigaciones que contribuyan en la identificacion de parametros que ayuden al proceso de dimensionar personal de enfermeria en unidades de emergencias.

Ausências previstas e não previstas da equipe de enfermagem das unidades de internação do HU-USP

O estudo, exploratorio-descritivo, teve por objetivo identificar o percentual de ausencias previstas e nao previstas da equipe de enfermagem das Unidades de Internacao do HU-USP. Os dados referentes as ausencias nao previstas foram levantados das escalas mensais, do ano 2000, dos funcionarios da equipe de enfermagem dessas Unidades. Os percentuais de ausencias previstas referentes as folgas semanais remuneradas, feriados e ferias corresponderam, respectivamente, a 19%, 3,9% e 8,9%. O levantamento do percentual de ausencias nao previstas mostrou uma variacao entre os indices encontrados em cada Unidade, indicando a possibilidade de estar ocorrendo sobrecarga de trabalho em algumas Unidades de Internacao.: The objective of this exploratory-descriptive study was to identify expected and unexpected absences of the nursing team at the inpatient units of the University Hospital at the University of Sao Paulo. Data regarding unexpected absences of the nursing staff employees of these inpatient units were assessed on a monthly basis for the year 2000. The percentage of the expected absences regarding remunerated weekly time off, holidays and vacations corresponded to 19%, 3:9% and 8.9%, respectively. The survey of percentage of unexpected absences showed a variation among indices found in each unit, thus indicating the possibility of an excess workload in some inpatient units.

O tempo no processo de trabalho em saúde: uma abordagem sociológica

El concepto de tiempo, del cual hacemos uso, se situa en un alto nivel de generalizacion y de sintesis, siendo uno de los mas ricos patrimonios sociales del saber. Se percibe, a lo largo de la evolucion humana, que la concepcion del tiempo pasa por varias fases, iniciandose de una forma ciclica, discontinua y cualitativa, hasta asumir el sentido lineal, progresivo y cuantitativo, cuando surge el sentimiento de irreversibilidad. El tiempo ha merecido destaque especial, principalmente en el campo de las ciencias humanas y sociales, pues se descubrio su valor en las organizaciones, es decir, en el trabajo y tambien fuera de el. El descubrimiento de ese valor lo convirtio en un elemento clave en la gestion de recursos de las organizaciones, contribuyendo tanto para el desempeno individual, cuanto para el colectivo. Por tanto, este articulo propone una reflexion sobre el tiempo en el trabajo, dentro de una perspectiva sociologica, correlacionandolo con el desarrollo y evolucion de la sociedad, asi como con el proceso de trabajo en salud.

Distribuição do tempo das enfermeiras: identificação e análise em Unidade Médico-Cirúrgica

Diante do impacto da distribuicao do tempo de trabalho da profissional enfermeira na determinacao de parâmetros para a operacionalizacao do processo de dimensionar pessoal de enfermagem, este estudo teve por objetivo identificar e analisar a distribuicao do tempo de trabalho das enfermeiras em uma unidade de internacao medico-cirurgica. Para a consecucao dos objetivos da pesquisa considerou-se, como populacao estatistica, as atividades de enfermagem realizadas pelas enfermeiras durante os turnos de trabalho. Verificou-se que 50% do tempo destas profissionais foram dedicados as intervencoes de cuidado indireto, 22% as intervencoes de cuidado direto, 18% as atividades de tempo pessoal e 10% as atividades associadas. Estes dados corroboram a indicacao de pesquisadores que apontam a necessidade de serem considerados o tempo pessoal dos trabalhadores de enfermagem e a realizacao das atividades associadas nos metodos de dimensionamento de pessoal preconizados pelos orgaos oficiais.

A regulação das relações de trabalho e o gerenciamento de recursos humanos em enfermagem

This paper is aimed at discoursing on the regulation of labor relations in Nursing and at giving subsidies to the nurses managerial practice concerning the rights and obligations of employees and employers based on the Brazilian Labor Law and the Federal Constitution. It emphasizes some regulations that are not clear enough and give rise to doubts and conflicts on the nurses daily professional activities, such as working hours, resting periods in and between journeys, extra pay for overtime work, weekly paid rest and changes in work schedule. The adequacy of nursing practice to legal rules should allow nurses to get more knowledge, resulting in more confidence and safer actions. By having professional and patients rights respected, occasional juridical problems inherent to labor rights and obligations will be reduced.Este artigo tem a finalidade de discorrer sobre a regulacao das relacoes de trabalho na enfermagem, subsidiando a pratica gerencial do enfermeiro, no que se refere aos direitos e obrigacoes de empregados e empregadores, baseando-se na Consolidacao das Leis Trabalhistas (CLT) e das normas constitucionais. Enfatiza algumas normatizacoes que suscitam duvidas e conflitos no cotidiano profissional do enfermeiro, tais como: duracao da jornada de trabalho, periodos de descanso intra e entre jornadas, horas extraordinarias, descanso semanal remunerado e alteracoes de turnos de trabalho, considerando que a conformacao do exercicio profissional com o processo legal amplia as possibilidades do enfermeiro atuar junto a equipe com mais propriedade e seguranca, respeitando os direitos dos profissionais e dos clientes, reduzindo, ainda, eventuais problemas juridicos inerentes aos direitos e deveres trabalhistas.

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 setting of research production by nursing and management graduate programs in Brazil

This documental, descriptive study was performed using a quantitative approach with the objective to characterize the production by nursing graduates in Brazil in the 2007-2009 triennium, with emphasis on nursing management. Data was collected from the CAPES database, which allows access to the abstracts of theses and dissertations. The material was analyzed and categorized according to areas/fields and the respective lines of research, as defined in Nursing. The overall production analysis was descriptive and analytical in the field of organization, namely management. The results showed that, compared to previous studies, production underwent some changes in the triennium, with an increase in the area of health care, maintenance in the organizational area, and decrease in the professional area. Regarding the management theme, most studies addressed health assessment, the conceptions/perceptions regarding planning/organizing work-services and permanent education.This documental, descriptive study was performed using a quantitative approach with the objective to characterize the production by nursing graduates in Brazil in the 2007-2009 triennium, with emphasis on nursing management. Data was collected from the CAPES database, which allows access to the abstracts of theses and dissertations. The material was analyzed and categorized according to areas/fields and the respective lines of research, as defined in Nursing. The overall production analysis was descriptive and analytical in the field of organization, namely management. The results showed that, compared to previous studies, production underwent some changes in the triennium, with an increase in the area of health care, maintenance in the organizational area, and decrease in the professional area. Regarding the management theme, most studies addressed health assessment, the conceptions/perceptions regarding planning/organizing work-services and permanent education.