Marcia Raquel Panunto

Professional nursing practice: environment and emotional exhaustion among intensive care nurses

OBJECTIVE to evaluate the characteristics of the professional nursing practice environment and its relationship with burnout, perception of quality of care, job satisfaction and the intention to leave the job in the next 12 months. METHOD cross-sectional study with a quantitative approach to data. The sample was composed of 129 nurses working in adult Intensive Care Units from a region in the interior of São Paulo, Brazil. RESULTS The structural equation modeling, using path analysis, revealed that characteristics of the environment influence job satisfaction, perception of quality of care, and having an intention to leave their job, when mediated by emotional exhaustion. Nurses with limited autonomy, poor control over their practice, and poor relationships with physicians, experience a greater level of emotional exhaustion, which can negatively influence their perception of quality of care, job satisfaction and an intention to abandon their jobs. CONCLUSION the mediating role of emotional exhaustion may negatively influence care delivery. Therefore, there is a need to adopt strategies to minimize this condition among nurses.OBJETIVO: avaliar as caracteristicas do ambiente da pratica profissional dos enfermeiros e sua relacao com o Burnout, percepcao da qualidade do cuidado, satisfacao no trabalho e a intencao de deixar o emprego nos proximos doze meses. METODO: estudo transversal de abordagem quantitativa dos dados. A amostra foi composta por 129 enfermeiros de unidades de terapia intensiva de adulto de uma regiao do interior do Estado de Sao Paulo, Brasil. RESULTADOS: a modelagem de equacoes estruturais, por meio da analise de caminhos, mostrou que as caracteristicas do ambiente da pratica influenciam na satisfacao no trabalho, percepcao da qualidade do cuidado e na intencao de deixar o emprego, quando mediadas pelo sentimento de exaustao emocional. O enfermeiro com pouca autonomia, menor controle sobre o ambiente e com piores relacoes com o medico, apresenta maior nivel de exaustao emocional, o que pode influenciar negativamente na sua percepcao da qualidade do cuidado, satisfacao com o trabalho e na intencao de deixar o emprego. CONCLUSAO: a posicao mediadora da exaustao emocional pode influenciar negativamente nos resultados da assistencia, havendo, portanto, a necessidade de adocao de estrategias que minimizem esse sentimento no enfermeiro.

Nursing workload at a gastroenterology unit

One of the biggest challenges nurses face is the need to justify the quantity and quality of staff for care delivery. For this, management instruments are available which help them to determine the staff needed in the nursing team. This descriptive study aims to evaluate the nursing workload at a specialized clinical and surgical gastroenterology unit. To collect data, the Nursing Activities Score (NAS) was used during 30 consecutive days, with 1080 comments, obtained from the records of 149 patients. The mean NAS score was 34.9% and, considering that each point of NAS corresponds to 0.24 hour, on the average, 8.4 hours of nursing care were required within 24 hours. This means that this profile is of patients who demand intermediate and semi-intensive care, which suggests that the NAS study can be used to evaluate the workload of nurses at that unit.One of the biggest challenges nurses face is the need to justify the quantity and quality of staff for care delivery. For this, management instruments are available which help them to determine the staff needed in the nursing team. This descriptive study aims to evaluate the nursing workload at a specialized clinical and surgical gastroenterology unit. To collect data, the Nursing Activities Score (NAS) was used during 30 consecutive days, with 1080 comments, obtained from the records of 149 patients. The mean NAS score was 34.9% and, considering that each point of NAS corresponds to 0.24 hour, on the average, 8.4 hours of nursing care were required within 24 hours. This means that this profile is of patients who demand intermediate and semi-intensive care, which suggests that the NAS study can be used to evaluate the workload of nurses at that unit.

Carga de trabalho de enfermagem em Unidade de Terapia Intensiva de um hospital de ensino

Objective: To evaluate nursing workload in an adult intensive care unit (ICU), and to describe the profile of patients admitted to that unit. Methods: A descriptive study using the Nursing Activities Score (NAS) for 33 days in an ICU with a capacity of 18 beds. Results: 574 observations were obtained from the registry of 107 patients, and the mean NAS score was 62.2%. Conclusion: The NAS is in an important tool for measuring nursing workload in ICUs, as it considers various nursing activities performed in daily care. We stress the importance of its application on the everyday life of the nurse.OBJETIVO: Evaluar la carga de trabajo de enfermeria en una Unidad de Cuidados Intensivos (UCI) - adulto y describir el perfil de los pacientes, internados en ella. METODOS: estudio descriptivo realizado con el uso del Nursing Activities Score - NAS durante 33 dias en una UCI con capacidad para 18 camas. RESULTADOS: Se efectuaron 574 observaciones, obtenidas del registro de 107 pacientes y el promedio de la puntuacion del NAS fue de 62,2%. CONCLUSION: El NAS se constituye en un importante instrumento para mensurar la carga de trabajo de enfermeria en la UCI, ya que contempla diversas actividades de enfermeria realizadas en el dia a dia de la asistencia. Se resalta la importancia de que su aplicacion sea parte del cotidiano del enfermero.

Nursing workload in an intensive care unit of a teaching hospital

Objective: To evaluate nursing workload in an adult intensive care unit (ICU), and to describe the profile of patients admitted to that unit. Methods: A descriptive study using the Nursing Activities Score (NAS) for 33 days in an ICU with a capacity of 18 beds. Results: 574 observations were obtained from the registry of 107 patients, and the mean NAS score was 62.2%. Conclusion: The NAS is in an important tool for measuring nursing workload in ICUs, as it considers various nursing activities performed in daily care. We stress the importance of its application on the everyday life of the nurse.OBJETIVO: Evaluar la carga de trabajo de enfermeria en una Unidad de Cuidados Intensivos (UCI) - adulto y describir el perfil de los pacientes, internados en ella. METODOS: estudio descriptivo realizado con el uso del Nursing Activities Score - NAS durante 33 dias en una UCI con capacidad para 18 camas. RESULTADOS: Se efectuaron 574 observaciones, obtenidas del registro de 107 pacientes y el promedio de la puntuacion del NAS fue de 62,2%. CONCLUSION: El NAS se constituye en un importante instrumento para mensurar la carga de trabajo de enfermeria en la UCI, ya que contempla diversas actividades de enfermeria realizadas en el dia a dia de la asistencia. Se resalta la importancia de que su aplicacion sea parte del cotidiano del enfermero.

Ambiente da prática profissional e exaustão emocional entre enfermeiros de terapia intensiva

OBJECTIVE to evaluate the characteristics of the professional nursing practice environment and its relationship with burnout, perception of quality of care, job satisfaction and the intention to leave the job in the next 12 months. METHOD cross-sectional study with a quantitative approach to data. The sample was composed of 129 nurses working in adult Intensive Care Units from a region in the interior of São Paulo, Brazil. RESULTS The structural equation modeling, using path analysis, revealed that characteristics of the environment influence job satisfaction, perception of quality of care, and having an intention to leave their job, when mediated by emotional exhaustion. Nurses with limited autonomy, poor control over their practice, and poor relationships with physicians, experience a greater level of emotional exhaustion, which can negatively influence their perception of quality of care, job satisfaction and an intention to abandon their jobs. CONCLUSION the mediating role of emotional exhaustion may negatively influence care delivery. Therefore, there is a need to adopt strategies to minimize this condition among nurses.OBJETIVO: avaliar as caracteristicas do ambiente da pratica profissional dos enfermeiros e sua relacao com o Burnout, percepcao da qualidade do cuidado, satisfacao no trabalho e a intencao de deixar o emprego nos proximos doze meses. METODO: estudo transversal de abordagem quantitativa dos dados. A amostra foi composta por 129 enfermeiros de unidades de terapia intensiva de adulto de uma regiao do interior do Estado de Sao Paulo, Brasil. RESULTADOS: a modelagem de equacoes estruturais, por meio da analise de caminhos, mostrou que as caracteristicas do ambiente da pratica influenciam na satisfacao no trabalho, percepcao da qualidade do cuidado e na intencao de deixar o emprego, quando mediadas pelo sentimento de exaustao emocional. O enfermeiro com pouca autonomia, menor controle sobre o ambiente e com piores relacoes com o medico, apresenta maior nivel de exaustao emocional, o que pode influenciar negativamente na sua percepcao da qualidade do cuidado, satisfacao com o trabalho e na intencao de deixar o emprego. CONCLUSAO: a posicao mediadora da exaustao emocional pode influenciar negativamente nos resultados da assistencia, havendo, portanto, a necessidade de adocao de estrategias que minimizem esse sentimento no enfermeiro.

Carga de trabalho de enfermagem em uma unidade de gastroenterologia

One of the biggest challenges nurses face is the need to justify the quantity and quality of staff for care delivery. For this, management instruments are available which help them to determine the staff needed in the nursing team. This descriptive study aims to evaluate the nursing workload at a specialized clinical and surgical gastroenterology unit. To collect data, the Nursing Activities Score (NAS) was used during 30 consecutive days, with 1080 comments, obtained from the records of 149 patients. The mean NAS score was 34.9% and, considering that each point of NAS corresponds to 0.24 hour, on the average, 8.4 hours of nursing care were required within 24 hours. This means that this profile is of patients who demand intermediate and semi-intensive care, which suggests that the NAS study can be used to evaluate the workload of nurses at that unit.One of the biggest challenges nurses face is the need to justify the quantity and quality of staff for care delivery. For this, management instruments are available which help them to determine the staff needed in the nursing team. This descriptive study aims to evaluate the nursing workload at a specialized clinical and surgical gastroenterology unit. To collect data, the Nursing Activities Score (NAS) was used during 30 consecutive days, with 1080 comments, obtained from the records of 149 patients. The mean NAS score was 34.9% and, considering that each point of NAS corresponds to 0.24 hour, on the average, 8.4 hours of nursing care were required within 24 hours. This means that this profile is of patients who demand intermediate and semi-intensive care, which suggests that the NAS study can be used to evaluate the workload of nurses at that unit.

Perfil de doadores efetivos do serviço de procura de órgãos e tecidos

Objective To characterize the profile of effective organ and tissue donors and to understand which organs and tissues were donated for transplantation. Methods This was a quantitative, descriptive, exploratory, retrospective study that analyzed clinical data from 305 donors between January 2006 to December 2010. The data were then analyzed using descriptive analyses, generating frequency tables, measures of position (mean, minimum and maximum) and measures of dispersion (standard deviation) for data that was social and clinical in nature. Results There was an overall predominance of white (72%) and male (55%) individuals between the ages of 41 and 60 years (44%). The primary cause of brain death was cerebrovascular accident (55%). In the patient history, 31% of the patients were classified as overweight, 27% as hypertensive and only 4.3% as having diabetes mellitus. Vasoactive drugs were used in 92.7% of the donors, and the main drug of choice was noradrenaline (81.6%). Hyperglycemia and hypernatremia were diagnosed in 78% and 71% of the donors, respectively. Conclusion Significant hemodynamic changes were found, and the results indicate that the use of vasoactive drugs was the main strategy used to control these changes. Furthermore, most donors presented with hyperglycemia and hypernatremia, which were frequently reported in association with brain death. The persistent nature of these findings suggests that the organ donors were inadequately maintained.Objective: To characterize the profile of effective organ and tissue donors and to understand which organs and tissues were donated for transplantation. Methods: This was a quantitative, descriptive, exploratory, retrospective study that analyzed clinical data from 305 donors between January 2006 to December 2010. The data were then analyzed using descriptive analyses, generating frequency tables, measures of position (mean, minimum and maximum) and measures of dispersion (standard deviation) for data that was social and clinical in nature. Results: There was an overall predominance of white (72%) and male (55%) individuals between the ages of 41 and 60 years (44%). The primary cause of brain death was cerebrovascular accident (55%). In the patient history, 31% of the patients were classified as overweight, 27% as hypertensive and only 4.3% as having diabetes mellitus. Vasoactive drugs were used in 92.7% of the donors, and the main drug of choice was noradrenaline (81.6%). Hyperglycemia and hypernatremia were diagnosed in 78% and 71% of the donors, respectively. Conclusion: Significant hemodynamic changes were found, and the results indicate that the use of vasoactive drugs was the main strategy used to control these changes. Furthermore, most donors presented with hyperglycemia and hypernatremia, which were frequently reported in association with brain death. The persistent nature of these findings suggests that the organ donors were inadequately maintained.

PERCEPÇÃO DO CLIMA DE SEGURANÇA PELA EQUIPE DE ENFERMAGEM EM UM HOSPITAL ESPECIALIZADO EM SAÚDE DA MULHER

Resumo O clima de segurança é uma das formas de medir a cultura de segurança e esta pesquisa teve como objetivo avaliar a percepção da equipe de enfermagem sobre este aspecto. Estudo transversal realizado em um hospital de ensino especializado com 112 profissionais de enfermagem. Os resultados apontaram uma baixa percepção dos profissionais quanto a presença de atitudes que favorecem a segurança do paciente, exceto para a satisfação no trabalho.

Ambiente de la práctica profesional y el agotamiento emocional entre enfermeros de terapia intensiva

OBJECTIVE to evaluate the characteristics of the professional nursing practice environment and its relationship with burnout, perception of quality of care, job satisfaction and the intention to leave the job in the next 12 months. METHOD cross-sectional study with a quantitative approach to data. The sample was composed of 129 nurses working in adult Intensive Care Units from a region in the interior of São Paulo, Brazil. RESULTS The structural equation modeling, using path analysis, revealed that characteristics of the environment influence job satisfaction, perception of quality of care, and having an intention to leave their job, when mediated by emotional exhaustion. Nurses with limited autonomy, poor control over their practice, and poor relationships with physicians, experience a greater level of emotional exhaustion, which can negatively influence their perception of quality of care, job satisfaction and an intention to abandon their jobs. CONCLUSION the mediating role of emotional exhaustion may negatively influence care delivery. Therefore, there is a need to adopt strategies to minimize this condition among nurses.OBJETIVO: avaliar as caracteristicas do ambiente da pratica profissional dos enfermeiros e sua relacao com o Burnout, percepcao da qualidade do cuidado, satisfacao no trabalho e a intencao de deixar o emprego nos proximos doze meses. METODO: estudo transversal de abordagem quantitativa dos dados. A amostra foi composta por 129 enfermeiros de unidades de terapia intensiva de adulto de uma regiao do interior do Estado de Sao Paulo, Brasil. RESULTADOS: a modelagem de equacoes estruturais, por meio da analise de caminhos, mostrou que as caracteristicas do ambiente da pratica influenciam na satisfacao no trabalho, percepcao da qualidade do cuidado e na intencao de deixar o emprego, quando mediadas pelo sentimento de exaustao emocional. O enfermeiro com pouca autonomia, menor controle sobre o ambiente e com piores relacoes com o medico, apresenta maior nivel de exaustao emocional, o que pode influenciar negativamente na sua percepcao da qualidade do cuidado, satisfacao com o trabalho e na intencao de deixar o emprego. CONCLUSAO: a posicao mediadora da exaustao emocional pode influenciar negativamente nos resultados da assistencia, havendo, portanto, a necessidade de adocao de estrategias que minimizem esse sentimento no enfermeiro.

Carga de trabajo de enfermería en una Unidad de Cuidados Intensivos de un hospital de enseñanza

Objective: To evaluate nursing workload in an adult intensive care unit (ICU), and to describe the profile of patients admitted to that unit. Methods: A descriptive study using the Nursing Activities Score (NAS) for 33 days in an ICU with a capacity of 18 beds. Results: 574 observations were obtained from the registry of 107 patients, and the mean NAS score was 62.2%. Conclusion: The NAS is in an important tool for measuring nursing workload in ICUs, as it considers various nursing activities performed in daily care. We stress the importance of its application on the everyday life of the nurse.OBJETIVO: Evaluar la carga de trabajo de enfermeria en una Unidad de Cuidados Intensivos (UCI) - adulto y describir el perfil de los pacientes, internados en ella. METODOS: estudio descriptivo realizado con el uso del Nursing Activities Score - NAS durante 33 dias en una UCI con capacidad para 18 camas. RESULTADOS: Se efectuaron 574 observaciones, obtenidas del registro de 107 pacientes y el promedio de la puntuacion del NAS fue de 62,2%. CONCLUSION: El NAS se constituye en un importante instrumento para mensurar la carga de trabajo de enfermeria en la UCI, ya que contempla diversas actividades de enfermeria realizadas en el dia a dia de la asistencia. Se resalta la importancia de que su aplicacion sea parte del cotidiano del enfermero.