Search

Objetivo: Analisar as percepções de profissionais de saúde quanto à cultura de segurança do paciente na sua interface com a liderança. Métodos: Pesquisa descritivo-exploratória, com abordagem quantitativa. Foi realizada entre abril a junho de 2014 em três unidades de um hospital universitário do Paraná. A amostra constituiu-se de 76 profissionais da equipe multidisciplinar, que responderam ao questionário “Hospital Survey on Patient Safety Culture”. A análise ocorreu por meio de estatística descritiva, das dimensões que tratam da cultura de segurança mediada pela liderança hospitalar do referido instrumento. Resultados: A maioria dos participantes demonstrou percepção de cultura de segurança favorável à liderança imediata e desfavorável à alta gestão hospitalar. Conclusão: Conclui-se que há necessidade de investimentos de promoção da cultura de segurança na alta direção da realidade investigada.

Aim: To analyze the patient safety culture regarding communication in view of hospital multidisciplinary team. Method: cross-sectional, descriptive, quantitative research. After employment eligibility. Seventy one professionals of multiple functions / formations from a public teaching hospital of Paraná participated. They responded to the questionnaire "Hospital Survey on Patient Safety Culture". Descriptive statistical analysis proceeded on the items that best depict the patient safety culture regarding communication. Results: there was a good perception of teamwork and internal communication within the unit of work. However, with greater expressiveness, there was unfavorable safety culture regarding communications and activities with external teams to the labor sector as well as weaknesses in passing duty. Conclusions: there is need to increase the communication between different units in the hospital organization, in addition to measures that result in improvements in sectors shift sections

Objetivo: dimensionar o quadro de pessoal de enfermagem de um Centro Cirúrgico e compará-lo ao quadro real. Métodos: pesquisa transversal, retrospectiva, documental e quantitativa. Os dados foram coletados entre fevereiro a abril de 2017, referentes às características sociodemográficas e clínicas dos pacientes; e de porte cirúrgico conforme número de horas de enfermagem no centro cirúrgico da amostra (n=1097) de procedimentos cirúrgicos eletivos (n=1006) e sítios funcionais nas operações de emergência (n=45). Resultados: procedeu-se análise estatística descritiva, utilizando equações próprias do dimensionamento de pessoal em centro cirúrgico, conforme a Resolução do Conselho Federal de Enfermagem nº543/2017. O quadro dimensionado se constituiu de 16 profissionais para a assistência ininterrupta no centro cirúrgico, sendo que o quadro real era constituído de 26 profissionais. Conclusão: há superávit de profissionais técnicos e déficit de enfermeiros na unidade.

Aim: to assess the level of care complexity and the dimensioning of the nursing staff attending in the emergency unit of a public hospital. Method: descriptive and documental study, performed with data extracted from patients’ records. Results: we assessed 998 records. There was a prevalence (73,3%) of patients requiring minimal care. Concerning the nursing staff, the situation according to work shifts corresponded to 32,6% for nurses and 91,5% for nursing auxiliary/technicians from the frame projected for the unit. Conclusions: the prevalence of patients needing minimal care may stem from an inadequate flow of care provided for the health services and, consequently, producing an unnecessary use of the tertiary health services and, so, increasing the number of attendances. This context is worsened by the reduced number of nursing workers available to provide a qualified and safe care

The objective was to dimension the nursing staff at an Intensive Care Unit for adults in the state of Paraná and compare it with the existing staff. Cross-sectional research using a documentary source. The data were collected during 122 uninterrupted days between June and September 2016 – concerning the sociodemographic and clinical characteristics and daily Nursing Activities Score of the patient sample (n=128); and concerning the professionals working at the sector. The collected data were subject to descriptive statistical analysis, application of an intensive care staff dimensioning equation and adjustment of the dimensioned staff to the professional category according to the new Resolution by the Brazilian Federal Nursing Council, No.543/2017. The average Nursing Activities Score at the unit was 1514.89. The comparison between the dimensioned (n=87) and the actual staff (n=60) revealed a shortage of 38 nurses and a surplus of 11 nursing technicians. The actual staff does not correspond to the need for nurses.

Objective: To investigate the dimensions of the nursing team of a hospital unit according to the official Brazilian parameters of 2004 and 2017 and compare the dimensioned conditions to the actual condition existing. Method: A cross-sectional study with data from patients (n = 325) hospitalized in the Neurology and Orthopedics unit of a university hospital in Paraná, Brazil. Data from the Patient Classification System related to nursing work, as well as sociodemographic and clinical variables of the clientele were compiled. The dimensioning of the nursing staff followed the Federal Nursing Council Resolutions of 2004 and 2017. Results: The profile of the patients showed predominantly men (66.46%) hospitalized for Orthopedics (49.58%). The negative difference of professionals dimensioned compared to the actual condition was more evident for the category of nurses, below both the parameters of 2004 (-8) and 2017 (-11). Conclusions: The number of nursing staff in the unit was insufficient.

This Longitudinal study, with an observational and quantitative approach, aimed to analyze the quality of nursing care in peripheral intravenous therapy, through the indicators, incidence of phlebitis, quality of coverage, and validity of the peripheral intravenous catheters. Data were collected from October 2012 to August 2013, in three units of a teaching hospital in the state of Paraná, Brazil, using a form created for this purpose. A total of 174 patients and 221 catheters were evaluated. The results indicated an incidence of phlebitis between 20% and 25.33%; identification and the validity of the venous accesses were classified as safe and adequate in the majority of cases, according to an analysis of the Positivity Index that classifies medical work. It was concluded that the evaluated indicators could mostly be interpreted as favorable for care quality.

http://dx.doi.org/10.5902/217976928772 Aim: determine the index of training of nursing professionals. Method: this paper consists in a retrospective, descriptive study based on a quantitative approach. It was developed in a teaching hospital in Paraná State and it focused on training activities related to nursing professionals as its object of study. Results: the index of training was found is about 16,20 related to nursing professionals and about 3,98 to technical nursing assistants and auxiliaries. Conclusion: the numbers found in this training index can be understood as favorable (positive) concerning about nursing professionals and unfavorable (negative) in relation to a nursing professional of meddium level (position), when all of them are compared to the shortage of literature produced by the nursing.

http://dx.doi.org/10.5902/217976929230 Aim: to identify the number of nurse professionals to meet the care needs of patients against their level of assessment complexity in units of Medical and Surgical Clinic and, Neurology and Orthopedics of a university hospital. Method: Descriptive study with a quantitative approach.Results: identified an average of 5.5 and 11.7 patients in semiintensive care, and 9.9 and 6.1 in patients in intensive care in the Units I and II respectively, indicating hospitalization in Intensive Care Unit that are treated in internment units common, however generally do not have adequate physical infrastructure and equipment to assist these clients. Conclusion: The proportion of quantitative of professionals is inadequate to assist with safety and quality, suggesting the need of reorganization of working process relative to the grouping of patients for assistance complexity.

Objetivo: verificar a associação da predição de lesão por pressão com os níveis de albumina, hematócrito e hemoglobina. Métodos: estudo documental, desenvolvido em uma Unidade de Terapia Intensiva para Adultos com prontuários de pacientes elegíveis (n=255). Foram extraídas variáveis de caracterização sociodemográfica e clínica, desenvolvimento de lesão por pressão e região; escore da escala de Braden e resultados dos marcadores bioquímicos. Fez-se análise estatística descritiva e inferencial, adotando-se nível de significância de 5,0%.Resultados: houve prevalência do sexo masculino (64,7%) e de pacientes cirúrgicos (69,8%). Não houve associação estatística significativa entre os marcadores de hematócrito e hemoglobina com a predição de lesão por pressão, diferentemente dos níveis de albumina (p=0,023). Conclusão: há associação de precisão de lesão por pressão no que se refere à albumina. O aporte proteico do paciente deve ser visto com maior rigor pela equipe de saúde.

Estudo na modalidade Revisão Integrativa, com objetivo de analisar a influência do dimensionamento do pessoal de enfermagem intensivista na qualidade do cuidado ao paciente crítico adulto. Foram incluídas apenas publicações científicas, das principais bases eletrônicas, veiculadas em periódicos de acesso livre e eletrônico, referentes à última década (janeiro de 2000 a janeiro de 2010), nos idiomas inglês, português e espanhol. Obteve-se um total de 10 publicações, dentre as quais três avaliaram a incidência de mortalidade e extubação acidental no pós-operatório; três avaliaram os reflexos no cuidado resultantes da redução no número de enfermeiros; dois avaliaram o desenvolvimento de infecções; e um, respectivamente, avaliou a incidência de quedas e de pneumonia associada à ventilação mecânica. Os estudos indicam relação entre o subdimensionamento de trabalhadores da enfermagem e o aumento nas taxas de infecções, mortalidade, quedas, pneumonia associada à ventilação mecânica e extubação acidental. The objective of this Integrative Review is to analyze the influence of dimensioning of intensive care nursing staff on the quality of critical adult patient care delivered. Only scientific publications from major electronic databases published in open access journals online during the last decade (January 2000 to January 2010) in English, Portuguese, and Spanish were included. A total of 10 publications were thus obtained, among which three evaluated the incidence of mortality and post-operational accidental extubation, three evaluated the reflections on care resulting from reduced nursing staff; two rated the development of infections; and one estimated the incidence of falls and ventilator-associated pneumonia. These studies indicate the relationship between sub-dimensioning nursing workers and increased infection rates, mortality, falls, ventilator-associated pneumonia, and accidental extubation. Se trata de un estudio de revisión integral, con el fin de analizar la influencia del cálculo del personal de enfermería intensivista en lo que se refiere a la calidad de la atención al paciente adulto en estado crítico. Sólo se incluyeron las publicaciones científicas, de las principales bases de datos electrónicas, difundidas en acceso abierto y electrónico, referentes a la última década (enero de 2000 hasta enero de 2010), en inglés, portugués y español. Se obtuvo un total de diez publicaciones, tres de ellas, evaluaron la incidencia de mortalidad y la extubación accidental en el postoperatorio, tres calificaron los reflejos en la atención derivada de la reducción en el número de enfermeras, dos calificaron la aparición de infecciones, y en un artículo se evaluó la incidencia de caídas y de neumonía asociada al ventilador. Los estudios indican la relación entre la infravaloración del personal de enfermería y un aumento en las tasas de infección, mortalidad, caídas, neumonía asociada al ventilador y la extubación accidental.

The policy of professional health education has been put into operation by the centers of professional health education in a decentralized way. Aiming to identify the needs of the health sector at a regional level, a survey was carried out to investigate the situation of workers in the public health network of 22 cities in the 10th Paraná Health District, Brazil. Questionnaires and document analysis were used in this qualitative and quantitative exploratory study. Results revealed that 35.6% of the workers did not participate in any educational activities between 2004 and 2006. In terms of work contracts, 78.7% had only one job, 50.2% were government employees, and 25.2% had unstable contracts, showing that the sector incorporated the productivity and flexibility rationales. The conclusion is that the centers of professional education, jointly with teaching and management institutions, need to clearly define policies for the health sector at a regional level.La política de educación continuada en salud ha sido ejecutada por los Polos de Educación Permanente, de manera descentralizada. Para identificar las necesidades regionales del sector, se llevó a cabo el levantamiento de la situación de los trabajadores de la red pública de salud de 22 municipios perteneciente a la 10ª Región de Salud de Paraná. La investigación exploratoria, con enfoque cualitativo y cuantitativo, se utilizó de cuestionarios y del análisis documental. Los resultados mostraron que 35,6% de los trabajadores no participó en ninguna actividad de formación entre 2004 y 2006. En relación al vínculo de trabajo, 78,7%, tenían solamente un empleo, el 50,2% eran funcionarios concursados y 25,2% tenían contratos precarios, poniendo de relieve la incorporación de la lógica de productividad y flexibilización en el sector. Se concluye por la necesidad de contar con una política para el sector de la salud a nivel regional, con participación de los órganos formadores y de gestión del sistema de salud.A política de educação permanente em saúde vem sendo operacionalizada pelos Polos de Educação Permanente, descentralizadamente. Visando contribuir para a identificação das necessidades regionais do setor, realizou-se levantamento da situação dos trabalhadores da rede pública de saúde de 22 municípios da 10ª Regional de Saúde do Paraná. A pesquisa exploratória, com abordagem qualitativa e quantitativa, utilizou de questionário e análise documental para a coleta de dados. Os resultados revelaram que 35,6% dos trabalhadores não participaram de nenhuma atividade de formação entre 2004 e 2006. Em relação ao vínculo empregatício, 78,7%, possui apenas um vínculo, 50,2% são estatutários e 25,2% são contratados de forma precária, evidenciando a incorporação da lógica da produtividade e da flexibilização no setor. Conclui-se pela necessidade de definição clara do Polo de política para o setor de saúde que envolva os órgãos formadores e de gestão do sistema de saúde em nível regional.

Objective: to identify the prevalence of phlebitis, related to demographic and clinical variables, in peripheral intravenoustherapy in adult patients admitted to a university hospital in Paraná, PR, Brazil. Method: this is an observational research,cross / prospective with a quantitative approach, carried out in three units of the hospital. Data collection took place fromOctober 2012 to August 2013, using a form to extract demographic and clinical variables from patients suitable to preestablishedeligibility requirements. For analysis, we used the calculation of point prevalence. Results: from 221 analyzedby venous access, there were 42 with presence of the clinical criteria definition of phlebitis. It was found a prevalence ofphlebitis in men; with evolution degree of 2; venous punctures were located on the back of the hand; 22G caliber/diametercatheters; with residence time of three days. Conclusion: It was concluded that through the prevalence of known phlebitis,nursing actions for the prevention and management of the event can be (re)designed.

This study aimed to analyze the hours required for nursing care of critically ill patients and the hours available by nurses and then compare the results with the Law of professional practice and the recommendations of the Federal Council of Nursing for the design of nursing professionals. This is a documentary descriptive study that collected data on 30 records of an intensive care unit of a university hospital in June 2012. The results indicated a significant deficit of nurses in the institution and showed a non-compliance with the applicable legal recommendations. This influences directly the quality of care, the patient’s safety, the quality and working conditions of the nurses, determining the need for adjustments in the quantity of nurses in the institution studied.