Valéria Castilho

A enfermagem e o gerenciamento de custos

This work intend to broach structural elements that motivate institutions and health professionals to know and develop studies about hospital costs, emphasize the subject importance for the nursing professional.O presente texto tem por objetivo abordar elementos estruturais que estao motivando instituicoes e profissionais da area da saude a conhecerem e desenvolverem estudos no campo dos custos hospitalares, ressaltando a importância deste tema para o profissional de enfermagem.

Classificação ABC dos materiais: uma ferramenta gerencial de custos em enfermagem

The implementation of costs management systems has been extremely helpful to healthcare area owing to their efficacy in cutting expenditures as well as improving service quality. The ABC classification is an applied strategy to stocktaking and control. The research, which consists of an exploratory/descriptive quantitative analysis, has been carried out in order to identify, in a year time period, the demand for supplies at Universidade de Sao Paulo’s Hospital. Of 1938 classified materials, 67 itens had been classified that they correspond to the materials with bigger costs for the hospital. 31,3% of these A-Class supplies catalogued items are the nursing materials, more used for the nursing team. Descriptors: Materials management, hospital; Hospital costs; Economics, nursing; Nursing records. RESUMENThe implementation of costs management systems has been extremely helpful to healthcare area owing to their efficacy in cutting expenditures as well as improving service quality. The ABC classification is an applied strategy to stocktaking and control. The research, which consists of an exploratory/descriptive quantitative analysis, has been carried out in order to identify, in a year time period, the demand for supplies at Universidade de Sao Paulos Hospital. Of 1938 classified materials, 67 itens had been classified that they correspond to the materials with bigger costs for the hospital. 31.3% of these A-Class supplies catalogued items are the nursing materials, more used for the nursing team.

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.

Produção do conhecimento em Enfermagem: da idéia da pesquisa à publicação em periódico qualificado

The motivations for writing this article were the difficulties found in producing and publishing Nursing knowledge and also to present scientific authors with suggestions that improve and streamline the process of elaborating and synthesizing knowledge, research results and reflections. Besides discussing the content of components that form the structure of a scientific text, this article will also provide publishing policies that assist authors in choosing the correct journal for publishing, the desirable characteristics of language and text elaboration, and the procedures for publishing a manuscript. This article will also evidence the partnership between authors, reviewers and editors on the process of creating and publishing articles, which is not always appraised by the main agents of the development and publishing of scientific texts that portray the development and the performance of the profession.The motivations for writing this article were the difficulties found in producing and publishing Nursing knowledge and also to present scientific authors with suggestions that improve and streamline the process of elaborating and synthesizing knowledge, research results and reflections. Besides discussing the content of components that form the structure of a scientific text, this article will also provide publishing policies that assist authors in choosing the correct journal for publishing, the desirable characteristics of language and text elaboration, and the procedures for publishing a manuscript. This article will also evidence the partnership between authors, reviewers and editors on the process of creating and publishing articles, which is not always appraised by the main agents of the development and publishing of scientific texts that portray the development and the performance of the profession.

Evidence-based practices published in Brazil: identification and analysis of their types and methodological approches

Revisao integrativa de estudos brasileiros sobre praticas baseadas em evidencias (PBE) em saude, publicados em periodicos ISI/JCR, nos ultimos 10 anos. O objetivo foi identificar as especialidades que mais realizaram estes estudos, seus enfoques e abordagens metodologicas. A partir de criterios de inclusao, foram selecionados 144 trabalhos. Os resultados indicam que a maior quantidade de estudos feitos em PBE foram sobre infância e adolescencia, infectologia, psiquiatria/saude mental e cirurgia. Os enfoques predominantes foram prevencao, tratamento/reabilitacao, diagnostico e avaliacao. As metodologias mais empregadas foram revisao sistematica sem ou com metanalise, revisao de protocolos ou sintese de estudos de evidencias ja disponiveis, e revisao integrativa. Constata-se forte expansao multiprofissional da PBE no Brasil, contribuindo para a busca de praticas mais criteriosas pela reuniao, reconhecimento e analise critica dos conhecimentos produzidos. O estudo contribui tambem para a propria analise dos modos de fazer pesquisa e novas possibilidades de investigacao.This is an integrative review of Brazilian studies on evidence-based practices (EBP) in health, published in ISI/JCR journals in the last 10 years. The aim was to identify the specialty areas that most accomplished these studies, their foci and methodological approaches. Based on inclusion criteria, 144 studies were selected. The results indicate that most EBP studies addressed childhood and adolescence, infectious diseases, psychiatrics/mental health and surgery. The predominant foci were prevention, treatment/rehabilitation, diagnosis and assessment. The most used methods were systematic review with or without meta-analysis, protocol review or synthesis of available evidence studies, and integrative review. A strong multiprofessional expansion of EBP is found in Brazil, contributing to the search for more selective practices by collecting, recognizing and critically analyzing the produced knowledge. The study also contributes to the analysis itself of ways to do research and new research possibilities.

Custo de pessoal na assistência direta de enfermagem em unidade de terapia intensiva

This quantitative case study aimed to learn and analyze the personnel cost in nursing direct care in the intensive care unit. We opted to use a therapeutic intervention score index, TISS-28, for the analysis of the indirect gravity of patients and the dimension of the nursing staff working time. Evaluating the cost by a gravity score presented to be a logical and relatively simple method to allocate costs per patient in the intensive care unit. In this exploratory and descriptive study, the average TISS-28 per patient was 31 points, requiring a daily expenditure of care hours of R

Cost survey of procedure with Unna boot in patients with venous ulcer

298.69. It was evidenced in this study that personnel costs are variable since there are patients with different complexities. Therefore is possible to estimate the nursing staff cost by assessing its work load.Con este estudio de caso con aproximación cuantitativa, pretendemos conocer y analizar el costo de los profesionales en la atención directa de enfermería en una unidad de cuidados intensivos. Optamos por la utilización de un índice de intervenciones terapéuticas, TISS-28, para análisis de la gravedad indirecta de los pacientes y dimensionamiento del tiempo de trabajo del equipo de enfermería. Al indagar el costo como un índice de gravedad éste se mostró un método lógico y relativamente sencillo de presupuestar costos por paciente en la unidad de cuidados intensivos. En este estudio, el TISS-28 promedio por paciente fue de 31 puntos, lo que demandó un costo diario de R

Billing of nursing procedures at an intensive care unit

298,69 de horas de atención de enfermería. En este trabajo, se identificó que el costo de los profesionales es variable, pues existen pacientes con diversas complejidades y muy diferentes, siendo posible, por medio de la evaluación de la carga de trabajo del equipo de enfermería, establecer estimativas individuales de su costo.This quantitative case study aimed to learn and analyze the personnel cost in nursing direct care in the intensive care unit. We opted to use a therapeutic intervention score index, TISS-28, for the analysis of the indirect gravity of patients and the dimension of the nursing staff working time. Evaluating the cost by a gravity score presented to be a logical and relatively simple method to allocate costs per patient in the intensive care unit. In this exploratory and descriptive study, the average TISS-28 per patient was 31 points, requiring a daily expenditure of care hours of R

Cost of nursing staffing adequacy in a neonatal unit

298.69. It was evidenced in this study that personnel costs are variable since there are patients with different complexities. Therefore is possible to estimate the nursing staff cost by assessing its work load.

Dimensionamento informatizado de profissionais de enfermagem: avaliação de um software

El objetivo fue identificar caracteristicas socio-demograficas y de las lesiones de los pacientes con ulcera venosa (UV), y calcular el costo total directo de los materiales y de personal de enfermeria utilizados en del procedimiento con bota de unna, por el costo total directo medio (CTDM) y por lo observado (CTDO). El referencial teorico adoptado para la medicion de los costos fue el sistema de costeo por absorcion por procedimiento o producto. El estudio fue realizado en el Consultorio Externo el Hospital Universitario de la Universidad de Sao Paulo (HUUSP). La muestra fue constituida por 65 procedimientos en nueve pacientes con UV. Los resultados muestran que la faja etaria predominante fue 49 a 56 anos (33,33%) y de 65 a 72 anos (33,33%) y del sexo femenino (77,78%). Cuanto a la enfermedad asociada, hubo predominio de Hipertension Arterial Sistematica (33,33%) y Diabetes Mellitus (22,22%). El CTDM fue de R