Paulina Kurcgant

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

O desgaste do trabalhador de enfermagem: relaçäo trabalho de enfermagem e saúde do trabalhador

The study aims the understanding of the process health-illness, as it is experienced by nursing workers in the acting of its work, being bases in the social determination of that process. It evidences the particularities of the relationship between labor and health of a concrete reality. The adopted methodology permitted to establish the link between the valorization process, work process, loads and strain. This relationship of determination permit to show the unhealthy profile of those nursing workers. The sharp accidents, bones, muscles and joint diseases are characteristics damages of in this profile.O estudo busca a compreensao do processo saude-doenca, vivenciado pelos trabalhadores de enfermagem no desempenho de seu trabalho, fundamentado na determinacao social desse processo. Evidencia as particularidades da relacao trabalho-saude de uma realidade concreta, decompondo e recompondo as intermediacoes processo de valorizacao, processo de trabalho, cargas de trabalho e desgaste, o que permitiu explicitar o perfil de morbidade desses trabalhadores. Nesse perfil, os ferimentos perfuro-cortantes e as doencas osteo-musculo-articulares aparecem como danos caracteristicos desse grupo de trabalhadores de enfermagem.

A construção de indicadores de qualidade para a avaliação de recursos humanos nos serviços de enfermagem: pressupostos teóricos

A construcao de indicadores de qualidade visando a avaliacao de servicos de enfermagem nas instituicoes hospitalares, vem caracterizando-se como uma estrategia que possibilita a busca da eficiencia e da eficacia das estruturas organizacionais, dos processos de trabalho e dos resultados da assistencia prestada. Para explicitar os pressupostos teoricos envolvidos na construcao de indicadores que possibilitem avaliar os recursos humanos na enfermagem foi realizada uma revisao bibliografica, a qual subsidiou a construcao de estrategias para a avaliacao de recursos humanos em saude. Acredita-se que a elaboracao e a aplicabilidade de indicadores de qualidade guardam estreita relacao com a motivacao e satisfacao dos profissionais, repercutindo na assistencia prestada aos usuarios dos servicos de saude.

The incidence of pressure ulcers after the implementation of a prevention protocol

Even in the present, pressure ulcers still represent a severe health problem, particularly in Intensive Care Units (ICU). This study assesses the implementation of a protocol to prevent pressure ulcers in ICU inpatients. This prospective, descriptive and exploratory study verifies the incidence of pressure ulcers following the implementation of a prevention protocol. Data were collected from April 17th to July 15th 2009. The incidence observed in this study (23.1%) was below that reported in a similar study developed in the same institution (41.02%) before the implementation of the protocols to assess risk and prevent pressure ulcers. The prevention protocols are essential tools that have an impact on controlling the incidence of pressure ulcers, when used consistently.Even in the present, pressure ulcers still represent a severe health problem, particularly in Intensive Care Units (ICU). This study assesses the implementation of a protocol to prevent pressure ulcers in ICU inpatients. This prospective, descriptive and exploratory study verifies the incidence of pressure ulcers following the implementation of a prevention protocol. Data were collected from April 17th to July 15th 2009. The incidence observed in this study (23.1%) was below that reported in a similar study developed in the same institution (41.02%) before the implementation of the protocols to assess risk and prevent pressure ulcers. The prevention protocols are essential tools that have an impact on controlling the incidence of pressure ulcers, when used consistently.

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.

Reflexões sobre competência docente no ensino de enfermagem

Este estudo teorico-analitico tem como objetivo discutir os conceitos de competencias docentes no ensino de enfermagem no Brasil, partindo do resgate, deste conceito, no mundo do trabalho. O ensino de enfermagem realizado em um ambiente especifico, efetiva os fenomenos pedagogicos em meio a relacoes complexas, que ocorrem entre professor, aluno, paciente e familia. Assim, o docente e o enfermeiro-educador vivenciam as atividades de ensino-aprendizagem em enfermagem, nos processos de trabalho educacional, assistencial e gerencial. Para esta nova conformacao do processo de ensino-aprendizagem, e necessario que nao so os novos enfermeiros, mas tambem os atuais e futuros enfermeiros-professores, desenvolvam competencias que os possibilitem a pensar e agir com etica e ousadia.This theoretical-analytical study is aimed at discussing the concepts of teaching competences in Nursing courses in Brazil, with the starting point being the transfer of this concept from the professional practice. Nursing education takes place in a specific environment and puts into effect the pedagogical phenomena among the complex relations that occur between instructor, pupil, patient and family. Therefore, instructors and nurse-educators experience the activities of teaching-learning in Nursing in the processes of educational, caring and management work. For such new conformation of the teaching-learning process it is necessary not only that the new nurses, but the current and future nurse-instructors as well, develop abilities that make possible for them to think and act with ethics and boldness.

O processo de implementação do diagnóstico de enfermagem no Hospital Universitário da Universidade de São Paulo

More than two decades ago the Nursing Department at the University Hospital of the University of São Paulo implemented the care model called Nursing Care System (NCS), which is comprised of three phases: Background, Evaluation and Nursing Prescription. Since then, it is being developed by the Nursing Department nurses as a guiding instrument for care, teaching and research. Having in mind the automation of the NCS, the nurses began to discuss the need for changes that could speed up the work process with the proposal of implementation of the Nursing Diagnosis as another step of the NCS and with the review of nursing action/interventions. In order to do so, the adoption of a standardized system of the care process language became essential so as to make possible data capture, grouping and classification for analysis and their transformation into information. The present study aims at sharing with other nurses this experience on the implementation process of the Nursing Diagnosis as a second step of the NCS.More than two decades ago the Nursing Department at the University Hospital of the University of Sao Paulo implemented the care model called Nursing Care System (NCS), which is comprised of three phases: Background, Evaluation and Nursing Prescription. Since then, it is being developed by the Nursing Department nurses as a guiding instrument for care, teaching and research. Having in mind the automation of the NCS, the nurses began to discuss the need for changes that could speed up the work process with the proposal of implementation of the Nursing Diagnosis as another step of the NCS and with the review of nursing action/interventions. In order to do so, the adoption of a standardized system of the care process language became essential so as to make possible data capture, grouping and classification for analysis and their transformation into information. The present study aims at sharing with other nurses this experience on the implementation process of the Nursing Diagnosis as a second step of the NCS.

O ensino de administração em enfermagem no brasil: o processo de construção de competências gerenciais

The study had as objectives: the identification of the conceptual, methodological and pedagogical bases adopted in the teaching of Management in Nursing Schools in Brazil; the identification and characterization of managerial competences which have been developed in educational practices. The approach adopted was a quantitative-qualitative one, carried out in two moments: the first had as a scenario eight schools; the second had five, representing the five geo-political regions. Data was collected from the teaching guidelines, into consideration: objectives, hour load, duration, the moment of insertion, program content, pedagogical strategies and the form of evaluation. Results showed that, although there has been advancement in the conceptual bases, development of managerial competences is not made explicit in the teaching guidelines; moreover, the pedagogical proposals are traditional.The study had as objectives: the identification of the conceptual, methodological and pedagogical bases adopted in the teaching of Management in Nursing Schools in Brazil; the identification and characterization of managerial competences which have been developed in educational practices. The approach adopted was a quantitative-qualitative one, carried out in two moments: the first had as a scenario eight schools; the second had five, representing the five geo-political regions. Data was collected from the teaching guidelines, into consideration: objectives, hour load, duration, the moment of insertion, program content, pedagogical strategies and the form of evaluation. Results showed that, although there has been advancement in the conceptual bases, development of managerial competences is not made explicit in the teaching guidelines; moreover, the pedagogical proposals are traditional.

Indicadores de qualidade e a avaliação do gerenciamento de recursos humanos em saúde

The aim of this qualitative study was to subsidize an evaluation of human resources management (HR) in nursing and to apprehend how the nursing managers and academic professors experience the use of quality indicators. Twelve academic professors, 10 managers from four teaching and assistance, public and private institutions in the city of Sao Paulo took part of this study. Data collection was carried out from March to July 2007, by means of semi-structured interviews, recorded and analyzed according to the thematic analysis referential. Two categories emerged from the results: Institutional and Professional Dimensions; in the first category, perceptions, feelings and demands that the collaborators found inherent to the organization and that could be the counterpart in the institution relationship with the operative actors were recovered. In the second category, they reported the intervenient factors - reasons, interests, disposition and professionals´ needs when performing activities required by the Institution. This study showed the processual character of construction and validation of indicators as a quality management instrument in HR.