Raimundo Augusto Martins Torres

Análise da atuação do enfermeiro na gerência de unidades básicas de saúde

Objetivou-se analisar o trabalho do enfermeiro gerente, conhecer suas acoes, verificar a importância atribuida ao planejamento e identificar fatores que interferem na gerencia. Pesquisa descritiva, realizada em 10 unidades basicas de saude de Fortaleza, CE com 10 enfermeiros, selecionados por ocuparem cargos de gerentes. A coleta dos dados deu-se em janeiro de 2008, atraves de entrevista estruturada. Desses a maioria era do sexo feminino na faixa etaria de 37 a 57 anos. Para sete dos enfermeiros gerentes a gestao de pessoas e o planejamento e o mais importante. Relataram dificuldades quanto a composicao incompleta das equipes, falta de capacitacao profissional e carencia de recursos financeiros. Essa pesquisa reune informacoes relevantes para conhecimento e analise das acoes gerenciais do enfermeiro na atencao basica.The purpose was to analyse the managerial work of the nurse, to know nurses’ actions, to verify the importance towards the planning and to identify some factors that interfere in the management. A descriptive research was accomplished in 10 basic health units in Fortaleza, CE, Brazil, with 10 nurses. Data collection was carried aout in january 2008, by means of a structured interview. Most of the nurses were female between 37 and 57 years-old. For seven nurses the management of people and the planning are the most important aspects. Some difficulties about the incomplete composition of the teams, lack of professional ability and low financial resource were reported. This research gathers information for knowledge and analisys of the management actions of the nurses in the basic atention.

Análise da organização e funcionamento dos conselhos de saúde e a gestão participativa em Fortaleza, CE

Informacoes acerca dos conselhos de saude sao importantes para se tracar estrategias que garantam a gestao participativa desses e seu pleno funcionamento. Objetivou-se analisar a organizacao e funcionamento do conselho municipal e dos seis conselhos regionais de saude de Fortaleza-CE. Para a coleta de dados deste estudo descritivo, utilizou-se consulta aos arquivos dos conselhos e entrevistas semi-estruturadas aplicadas aos conselheiros. Foram entrevistados quatro representantes do conselho municipal e tres representantes de cada um dos seis conselhos regionais, perfazendo um total de 22 conselheiros. A amostragem foi aleatoria e dependeu da decisao dos sujeitos em participarem do estudo. A analise dos dados foi realizada por meio de descricao das falas. Os dados foram apresentados por categorias. Verificou-se baixa frequencia dos conselheiros regionais as reunioes. Os sujeitos referiram dificuldades em reconhecer seu papel de conselheiros. Constatou-se que a maior parte dos conselhos regionais e o municipal possuem estrutura que permite o pleno funcionamento. Entretanto, aqueles considerados em pessimas condicoes em determinados aspectos, principalmente no estrutural, prejudicam o funcionamento, organizacao e a participacao popular no acompanhamento e fiscalizacao da gestao.

Educação popular e educação permanente em saúde: diálogos na formação de Agentes Comunitários de Saúde de um município do interior do Ceará

A construcao da formacao em saude se da em meio a paradigmas e linhas de fuga, na medida em que visualizamos um modelo hegemonico de formacao em contato com uma diversidade de mecanismos de subversao dessa hegemonia, produzindo alto grau de singularidade com multiplos modos de aprender e ensinar. Constitui objetivo do trabalho relatar a experiencia de edificacao de um Circulo de Cultura por parte do autor e dos Agentes Comunitarios de Saude de um municipio do interior do Ceara, utilizando os alicerces da pedagogia do oprimido em um processo de educacao permanente em saude. Realizou-se no municipio serrano de Pacoti. A experiencia contou com a participacao de 23 profissionais, todos os Agentes Comunitarios de Saude atuantes naquele periodo no municipio em questao. A experiencia foi vivenciada no periodo de agosto a dezembro de 2015. A experiencia do Circulo de Cultura, apos o periodo de imersao foi dividida em duas etapas, sendo elas: (1) O Encontro Inicial e (2) as Oficinas de Formacao. Experiencias como as aqui descritas atuam de modo a questionar instituidos. Apresentamos a experiencia de dialogo entre Educacao Popular e Educacao Permanente como alternativa pedagogica para as acoes de formacao em saude dos profissionais Agentes Comunitarios de Saude, agregando potencialidades do cotidiano dos servicos de saude no intuito de avancar no sentido de um cuidado de qualidade, implicado com a realidade social dos educandos e dos usuarios do sistema de saude. Palavras-chave: Educacao permanente, Educacao popular, Agentes comunitarios de saude.

The use of Facebook in health education: perceptions of adolescent students

OBJECTIVE understand the perceptions of adolescent students regarding the use of Facebook social media in sexual and reproductive health learning in the Family Health Strategy. METHOD a qualitative, descriptive study developed with 96 adolescents from a public school and a private school in Fortaleza-CE who concluded an educational intervention using Facebook. The information was collected in the online environment itself, as well as in a questionnaire applied in person. For the collection and analysis of this information, netnography was used. RESULTS Facebook contributed to the sexual and reproductive health education in an interactive, playful and practical way, reducing the embarrassment of some adolescents to converse on the subject, and brought adolescents closer to the health service, by strengthening their bond with Health professionals. FINAL CONSIDERATIONS health professionals should recognize that such virtual spaces on the Internet offer potential for the production of health care, especially among adolescents.

EDUCAÇÃO PERMANENTE EM SAÚDE NA ATENÇÃO QUALIFICADA DE GESTANTES NA ESTRATÉGIA DE SAÚDE DA FAMÍLIA

No setor da saude, Educacao Permanente e um conceito pedagogico utilizado para expressar as relacoes entre ensino, acoes e servicos, articulando docencia e atencao a saude. Esta pesquisa tem como descrever oficina de Educacao Permanente em Saude por meio da aplicacao do Arco de Manguerez com foco na atencao qualificada as gestantes na Estrategia de Saude da Familia. Trata-se de uma pesquisa-intervencao realizada na Unidade Basica de Saude Herbert de Sousa do bairro Padre Palhano do municipio de Sobral-CE, no periodo de agosto de 2013 a agosto de 2014, com 30 profissionais de saude. Realizaram-se oficinas facilitadas pelos atores que compoem o Sistema Saude Escola de Sobral, orientadas pelo referencial do Arco de Manguerez. Os dados foram coletados por meio da observacao participante e diario de campo. Utilizou-se a analise tematica de Minayo (2008). Foram seguidos os preceitos da Resolucao 466/12 e aprovado pelo CEP no 213.002. Percebemos que os participantes entendiam a educacao permanente em saude como educacao continuada, realizacao de cursos e aulas. Apontaram situacoes-limites referentes ao elevado numero de gestantes no territorio e dificuldades no acompanhamento pre-natal. Executou-se como ponto de partida de solucoes para os problemas uma oficina sobre pre-natal, no sentido de atender as necessidades dos participantes. A intervencao possibilitou o inicio do processo de mudanca nas praticas de saude do territorio, de forma participativa e transformadora.

The essence of care in health vulnerability: a Heideggerian construction

Objective: Reflect on the essence of care in health vulnerability from the phenomenological perspective of Martin Heidegger. Method: Theoretical-reflexive study, anchored in three essential parts: 1) Care in Heidegger; 2) The essence of care in health vulnerability; And 3) Nursing care actions on health vulnerability. Results: Vulnerability must be recognized as an indelible trait of the human condition and has its constituents in the human being, co-presence and care. Caring is an interactive process that reveals itself in the relationship with the other. Respecting the integrity of the Being in vulnerability must be a priority in nursing care, through behaviors that privilege the Being. Conclusion: Understanding ontological care and its relation to vulnerability under Heideggers phenomenological view allowed us to uncover the facets of care in health vulnerability by adding to the nursing knowledge body a comprehensive and reflective perspective. Objetivo: Refletir sobre a essência do cuidado na vulnerabilidade em saúde sob a perspectiva fenomenológica de Martin Heidegger. Método: Estudo teórico-reflexivo, ancorado em três partes essenciais: 1) O cuidado em Heidegger; 2) A essência do cuidado na vulnerabilidade em saúde; e 3) As ações do cuidar em enfermagem na vulnerabilidade em saúde. Resultados: A vulnerabilidade deve ser reconhecida como traço indelével da condição humana e tem seus constituintes na pessoa humana, co-presenças e cuidado. O cuidar é um processo interativo que se desvela na relação com o outro. Respeitar a integridade do Ser em vulnerabilidade deve ser prioridade no cuidar em enfermagem, por meio de comportamentos que privilegiem o Ser. Conclusão: Compreender ontologicamente o cuidado e a sua relação com a vulnerabilidade sob o olhar fenomenológico de Heidegger permitiu desvelar as facetas do cuidado na vulnerabilidade em saúde, agregando ao corpo de conhecimento da Enfermagem uma perspectiva compreensiva e reflexiva.

Caracterização das graduações em enfermagem segundo Exame Nacional de Desempenho de Estudantes

Objective: to characterize undergraduate nursing courses according to Enade (National Student Performance Exam) in 2010 and 2013. Method: a quantitative documental study was performed and descriptive statistics was used for data organization and analysis. Results: Enade report analysis enabled the identifi cation of a reduction in the total number of institutions providing undergraduate nursing courses that passed the evaluation process. The Southeastern, Northeastern and Southern regions of Brazil included the highest numbers of courses assessed and showed the best results in the two evaluation cycles. Additionally, the courses characterized as “without a ranking” were mainly held at private institutions. Conclusion: the results of these evaluation cycles are important to support investigative and intervention processes about and with undergraduate nursing courses.

Caracterización de cursos de enfermería según el Examen Nacional de Desempeño de Estudiantes

Objective: to characterize undergraduate nursing courses according to Enade (National Student Performance Exam) in 2010 and 2013. Method: a quantitative documental study was performed and descriptive statistics was used for data organization and analysis. Results: Enade report analysis enabled the identifi cation of a reduction in the total number of institutions providing undergraduate nursing courses that passed the evaluation process. The Southeastern, Northeastern and Southern regions of Brazil included the highest numbers of courses assessed and showed the best results in the two evaluation cycles. Additionally, the courses characterized as “without a ranking” were mainly held at private institutions. Conclusion: the results of these evaluation cycles are important to support investigative and intervention processes about and with undergraduate nursing courses.

Characterization of undergraduate nursing courses according to the National Student Performance Exam.

Objective: to characterize undergraduate nursing courses according to Enade (National Student Performance Exam) in 2010 and 2013. Method: a quantitative documental study was performed and descriptive statistics was used for data organization and analysis. Results: Enade report analysis enabled the identifi cation of a reduction in the total number of institutions providing undergraduate nursing courses that passed the evaluation process. The Southeastern, Northeastern and Southern regions of Brazil included the highest numbers of courses assessed and showed the best results in the two evaluation cycles. Additionally, the courses characterized as “without a ranking” were mainly held at private institutions. Conclusion: the results of these evaluation cycles are important to support investigative and intervention processes about and with undergraduate nursing courses.

Hospital services of risk management and implications for management of nursing care

Objective: to analyze the implications of a hospital service risk management for the management of nursing care. Method: a descriptive study of qualitative approach, developed in a public hospital of Ceará / EC of 30 clinical nu. Applied to semistructured interviews between January and March 2014, in the hospital. The recordings were transcribed in full and, after this step, passed through an analytical process supported by the Technical Thematic Analysis. Results: the actions of risk management service were unknown by most of the interviewees, that attributed to the sectors activities, especially the technical surveillance. However, they stood out positive implications, including support service to nursing care by encouraging professional training and patient safety. Conclusion: the risk management service studied have not allowed real improvements in the management of nursing care, being necessary to adopt a participative management to integrate the category of professionals in this activity. Descriptors: Nursing; Risk Management; Patient Safety; Quality of Health Care; Health Management. RESUMO Objetivo: analisar as implicações de um serviço hospitalar de gerenciamento de riscos para a gerência do cuidado de enfermagem. Método: estudo descritivo, de abordagem qualitativa, desenvolvido em hospital público do Ceará/CE com 30 enfermeiras assistenciais. Aplicou-se a entrevista semiestruturada, entre os meses de janeiro e março de 2014, no próprio hospital. Os registros foram transcritos na íntegra e, após esta etapa, passaram por um processo analítico apoiado na Técnica da Análise Temática. Resultados: as ações do serviço de gerenciamento de riscos eram desconhecidas pela maioria das entrevistadas, que as atribuíram às atividades do setor, principalmente à tecnovigilância. Porém, destacaram-se implicações positivas, incluindo o apoio do serviço ao cuidado de enfermagem através do estímulo à qualificação profissional e à segurança do paciente. Conclusão: o serviço de gerenciamento de riscos estudado não tem permitido melhorias efetivas na gerência do cuidado de enfermagem, sendo necessário instituir uma gestão participativa para integrar os profissionais da categoria nesta atividade. Descritores: Enfermagem; Gestão de Riscos; Segurança do Paciente; Qualidade da Assistência à Saúde; Gestão em Saúde. RESUMEN Objetivo: analizar las implicaciones de un servicio hospitalario de gerenciamiento de riesgos para la gerencia del cuidado de enfermería. Método: estudio descriptivo, de enfoque cualitativo, desarrollado en hospital público de Ceará/CE con 30 enfermeras asistenciales. Se aplicó la entrevista semi-estructurada, entre los meses de enero y marzo de 2014, en el propio hospital. Los registros fueron transcriptos en su íntegra y, después de esta etapa, pasaron por un proceso analítico apoyado en la Técnica del Análisis Temático. Resultados: las acciones del servicio de gerenciamiento de riesgos eran desconocidas por la mayoría de las entrevistadas, que las atribuían a las actividades del sector, principalmente a la tecno-vigilancia. Sin embargo, se destacaron implicaciones positivas, incluyendo el apoyo del servicio al cuidado de enfermería a través del estímulo a la calificación profesional y la seguridad del paciente. Conclusión: el servicio de gerenciamiento de riesgos estudiado no tiene permitido mejorías efectivas en la gerencia del cuidado de enfermería, siendo necesario instituir una gestión participativa para integrar los profesionales de la categoría en esta actividad. Descriptors: Enfermería; Gestión de Riesgos; Seguridad del Paciente; Calidad de la Asistencia a la Salud; Gestión en Salud. Nurse, Graduate, University of Ceará/UECE. Fortaleza, CE, Brazil. E-mail: mariana.cadete@gmail.com; Nurse, Post-Ph.D. Professor, Graduate Clinical Care Program in Nursing and Health – PPCCLIS, Universidade Estadual do Ceará/UECE, Fortaleza (CE), Brazil. E-mail: lucilanemaria@yahoo.com.br; Nurse, Ph.D., Postdoctoral Fellow, Graduate Clinical Care Program in Nursing and Health – PPCCLIS, State University of Ceará/UECE, Fortaleza (CE), Brazil. E-mail: roberta.meneses@uece.br; 4 Nurse, Teacher Master Degree in Nursing, Colleges Nordeste – FANOR, Fortaleza (CE), Brazil. E-mail: avale@fanor.edu.br; 5 Nurse, Professor, Graduate Clinical Care Program in Nursing and Health – PPCCLIS, State University of Ceará/UECE, Fortaleza (CE), Brazil. E-mail: augustomtorres70@gmail.com; 6 Nurse, Professor, Graduate Program in Public Health, State University of Ceará/UECE, Fortaleza (CE), Brazil. E-mail: rocineideferreira@gmail.com ORIGINAL ARTICLE Nogueira MCC, Silva LMS da, Oliveira RM et al. Hospital services of risk management and... English/Portuguese J Nurs UFPE on line., Recife, 10(7):2094-301, July., 2016 2295 ISSN: 1981-8963 DOI: 10.5205/reuol.9106-80230-1-SM1007201601 Ensuring the quality of care and safety for patients is a priority goal of health policy worldwide. This is a challenge faced by health services, considering the numerous difficulties related to structural, procedural, political and cultural factors related to the assistance. In this constant search for improvements in service quality, tools for the achievement of this attribute were established, highlighting the Risk Management (RM), a process that involves analysis, planning and direction of incidents that result in harm to the patient, and potential risk factors under conditions of uncertainty 1-3 In Brazil, there are protocols, work processes, regulatory instructions and guidelines to prevent damage and prevent failures that may occur due to ineffective communication or lack of assistance to be carried out, besides adjusting care not systematized by the teams and implement good health practices. In this context, the Risk Management Service is configured as a responsible sector for identifying nonconformities within the security processes in healthcare organizations, to propose preventive actions to improve the quality of care and ensure greater security for the patient. Also, it strengthens security practices in the nursing care. 4 Despite the constant dissemination of the importance of this service to the hospital environment, with regard to the incorporation of best practices in patient safety, a serious obstacle found in the institutions has been the lack of information and records on adverse events and their causal factors, preventing knowledge, evaluation and discussion of the consequences of these events for professionals, patients and caregivers. This gap undermines the actions of managers in the planning and development of organizational strategies for the adoption of safe practices, minimizing the events and improve care, jeopardizing patient safety. Given the above, since the risk management service is important for the promotion of quality and that nursing is the prime category, in that case, the question is: what are the implications and influences of the actions of risk management service for management Nursing care? Management of nursing care is understood as a process which aims to organize the care through diagnosis, planning, implementation, coordination, supervision and evaluation of nursing procedures and the individual and collective needs of users of health services. Therefore, this study aimed to analyze the implications of a hospital service risk management for the management of nursing care. Analyzing the performance of services like this, based on professional perspective directly involved in patient care, it is a strategy that may favor the rethinking of existing processes and the implementation of best practice as a continuous process of growth and organizational commitment. Descriptive study with a qualitative approach, developed in large public hospital institution, a member of the tertiary health system of the state of Ceará. This is a reference hospital in various specialties, responsible for serving large population demand and has the Risk Management Service installed since 2001 with an organizational culture already established and has shown interest in improving processes that involve the object of this study. The sample was for convenience and 30 nurses working at the hospital participated in the study, who were recruited according to the following inclusion criteria: assistant care and working for at least one year at the institution. Nurses who were on vacation or leave of any kind (remoteness, sick leave, maternity leave, etc.) in the period of data collection were excluded from the study. The amount of the subjects was established by theoretical saturation of data, a tool in which data recently collected no longer contribute to the desired theoretical elaboration. In the practice the research, it is common that the repetition data indicator is used to infer this redundancy. This concept refers to a particularity of qualitative methods, in which the variables are linked to subjectivity. Data collection was performed by applying a semi-structured interview schedule between January and March 2014, after the approval of the Research Ethics Committee, CAAE: 17073513.3.0000.5534. The production data was performed at the hospital after the call or in their intervals being invited nurses to participate and to direct to a reserved place. The interviews were recorded with the consent of professionals to ensure greater fluency, accuracy and agility to the process. The recordings were transcribed in full and, after this step, there was an analytical process based on the technique of Thematic Analysis, which aims to discover the core INTRODUCTION