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Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article analyzes the organizational context for the provision of nursing care in a public hospital in Corrientes. descriptive, observational, cross-sectional study was carried out. The population consisted of 53 nurses. The instrument used was the Nursing Works Index Nursing Practice Environment Scale, which consists of 31 items, grouped into 5 dimensions. Among the characteristics and profile of the participants, there was a massive presence of women (77.4%), 43.4% had a Bachelor's degree in Nursing. In the analysis of the environments, although a higher score was observed in the male gender than in the female gender, when comparing the three that make up the questionnaire, no significant differences were found in any of them. The same behavior was found in the behavior of these factors in relation to the level of education. When analyzing the correlation between the factors of the practice environment with the age of the participants only a statistically significant negative correlation was found with the "Fundamentals of quality of care". Conclusions: An assessment was successfully developed using the PES-NWI tool. Improving awareness of this issue in the workplace is one of the main strategies of the organization in the development of its professionals.

Introduction: The nursing team plays an important role in the healthcare context, in which it is necessary to align high-cost control with safety and quality of care, which can contribute to management decisions and to the design of public policies capable of influencing outcomes for professionals, patients, and healthcare services. Objective: To evaluate working conditions, quality of nursing care, job satisfaction, and intention to remain in the current job and in the profession from the perspective of nursing professionals. Methods: This was a cross-sectional, descriptive, and correlational study carried out in three general hospitals in Brazil. Data were collected with the support of a form containing personal and professional characterization and evaluation of care, organizational and work aspects. Results: A total of 452 nursing professionals participated. The nursing professionals are satisfied with their work, reported their intention to remain in their current job and in the profession for the next 12 months and reported good working conditions. Conclusion: The institution that had hospital accreditation showed better results, suggesting that quality certifications may favor the perception of nursing professionals regarding the evaluation of care, organizational and work aspects. [ABSTRACT FROM AUTHOR]

Copyright of Salud, Ciencia y Tecnología is the property of Fundacion Salud, Ciencia y Tecnologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Salud, Ciencia y Tecnología is the property of Fundacion Salud, Ciencia y Tecnologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Texto & Contexto Enfermagem is the property of Universidade Federal de Santa Catarina, Programa de Pos-Graduacao de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

S. aureus es considerado uno de los patógenos de mayor importancia en la práctica clínica diaria. Su patogenicidad está relacionada con la producción de determinantes de virulencia que incluyen factores de adherencia celular y secreción de toxinas. Se recolectaron 200 muestras de superficies ambientales de diferentes servicios hospitalarios, con la finalidad de detectar S. aureus e identificar genes que codifican para hemolisinas (hla, hlb, hld, hlg), TSST-1(tst) y PVL (lukF/lukS). La frecuencia de aislamiento fue de 3%; 6/200. La distribución fue la siguiente: emergencia (2), rayos X (1), ecografía (1), odontología (1) y vestidores (1). Los genes hla y hld fueron los más frecuentes (67% cada uno), tst se obtuvo en la mitad de las cepas y hlg se identificó en menor proporción (33%). No se detectaron genes para PLV y hemolisina β. En cada aislamiento se obtuvo dos o más genes de virulencia. Los perfiles genéticos fueron los siguientes: hla/hld (1 cepa), tst/hla/hld (1 cepa), tst/hla/hld/hlg (2 cepas). Aunque la frecuencia de S. aureus fue baja, no se debe desestimar la importancia de los ambientes hospitalarios como reservorio y fuente de trasmisión; más aún, si se considera que las cepas portaban combinaciones de genes para la TSST-1 y hemolisinas

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

ABSTRACT Objective: to propose and analyze a theoretical model to measure the effect of nurses’ perceptions about the practice environment on safety climate, job satisfaction, intention to stay employed and in the profession, and burnout syndrome. Method: correlational study with probabilistic sample of 465 nurses. In the theoretical model, the dimensions of the nursing practice environment were considered as independent variables and job satisfaction, safety climate, intention to stay employed and in the profession, and burnout were considered the outcome variables. Structural Equation Modeling was the method used in the analysis. Results: small adjustments were made in the model and the dimensions of practice environment predicted job satisfaction (R2 = 43%), safety climate (R2 = 42%) and burnout (R2 = 36%), as well as the intention to stay in the job (R2 = 22%) and in the profession (R2 = 17%). Conclusion: the practice environment showed a strong impact on job satisfaction, safety climate and burnout, with a moderate impact on the intention to stay in the institution and in the profession. The findings can be used to manage care in health institutions, focusing on promoting nurse retention and improving the safety climate.

OBJECTIVE: to understand the meaning of the Adult Intensive Care Unit environment of care, experienced by professionals working in this unit, managers, patients, families and professional support services, as well as build a theoretical model about the Adult Intensive Care Unit environment of care.METHOD: Grounded Theory, both for the collection and for data analysis. Based on theoretical sampling, we carried out 39 in-depth interviews semi-structured from three different Adult Intensive Care Units.RESULTS: built up the so-called substantive theory "Sustaining life in the complex environment of care in the Intensive Care Unit". It was bounded by eight categories: "caring and continuously monitoring the patient" and "using appropriate and differentiated technology" (causal conditions); "Providing a suitable environment" and "having relatives with concern" (context); "Mediating facilities and difficulties" (intervenienting conditions); "Organizing the environment and managing the dynamics of the unit" (strategy) and "finding it difficult to accept and deal with death" (consequences).CONCLUSION: confirmed the thesis that "the care environment in the Intensive Care Unit is a living environment, dynamic and complex that sustains the life of her hospitalized patients".

Introduction: The evaluation of Burnout syndrome among nursing professionals becomes fundamental given its influence on the outcomes for patients, professionals and institutions. The aim of this study was to evaluate the incidence of Burnout among nursing professionals in three public hospitals. Materials and Methods: A cross-sectional study was conducted with 452 nursing professionals from the State of Minas Gerais, Brazil. A personal and professional information form and the Maslach Burnout Inventory (Human Services Survey) were used. Results: Most participants showed low levels of emotional exhaustion (38.94%), depersonalization (45.80%) and reduced personal accomplishment (39.16%). The variables age (p = 0.010), hospital (p < 0.001), professional bond type (p < 0.001), time spent in hospital (p = 0.010) and in the department (p = 0.017) were related to emotional exhaustion. Gender (p = 0.013) and time spent in hospital (p =0,007) and the department (p = 0,020) were related to depersonalization. Personal accomplishment was better among professionals working on a certified hospital (p<0.001), during the day shift (p = 0.049), who had a fixed position (p<0.001) and who were older (p = 0.023). Discussion: Emotional exhaustion was characterized as fundamental for Burnout to arise among nursing professionals and depersonalization frequently coincide with emotional exhaustion. The exact definition of the participation of each individual in the outcome of care is difficult to delimit as it might influence the perception of professionals regarding personal accomplishment in work. Conclusions: Personal and professional characteristics were associated with Burnout among nursing professionals. It is important to promote actions that can reduce the incidence of Burnout among nursing professionals. [ABSTRACT FROM AUTHOR]

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

AIM: To establish whether there is any relationship between the work environment and nursing leadership at intensive care units (ICUs).METHOD: Correlational study conducted at four ICUs in southern São Paulo (SP), Brazil. The study population was comprised of 66 pairs (nurses and nursing technicians) established by lottery. The nurses responded to three instruments: 1) characterization; 2) a validated Portuguese version of the Nursing Work Index Revised (B-NWI-R); and 3) Grid & Leadership in Nursing: ideal behavior. The nursing technicians responded to 1) characterization and to 2) Grid and Leadership in Nursing: actual behavior, relative to the corresponding randomly-assigned nurse. The data were analyzed by means of analysis of variance (ANOVA) at p ≤ 0.05.RESULTS: The work environment was not associated with actual nursing leadership (p = 0.852). The public or private nature of the institutions where the investigated ICUs were located had no significant effect on leadership (p = 0.437). Only the nurse-physician relationship domain stood out (p = 0.001).CONCLUSION: The choice of leadership styles by nurses should match the ICU characteristics. Leadership skills could be developed, and the work environment did not exert any influence on the investigated population.

OBJECTIVES: to assess how nurses perceive autonomy, control over the environment, the professional relationship between nurses and physicians and the organizational support and correlate them with burnout, satisfaction at work, quality of work and the intention to quit work in primary healthcare.METHOD: cross-sectional and correlation study, using a sample of 198 nurses. The tools used were the Nursing Work Index Revised, Maslach Burnout Inventory and a form to characterize the nurses. To analyze the data, descriptive statistics were applied and Spearman's correlation coefficient was used.RESULTS: the nurses assessed that the environment is partially favorable for: autonomy, professional relationship and organizational support and that the control over this environment is limited. Significant correlations were evidenced between the Nursing Work Index Revised, Maslach Burnout Inventory and the variables: satisfaction at work, quality of care and the intent to quit the job.CONCLUSION: the nurses' perceptions regarding the environment of practice are correlated with burnout, satisfaction at work, quality of care and the intent to quit the job. This study provides support for the restructuring of work processes in the primary health care environment and for communication among the health service management, human resources and occupational health areas.

Objective. to determine the evidence-based practice (EBP) competence of Spanish and Latin-American nurses participating in professional forums on the Internet and estimate the influence of socio-demographic and professional factors on their competence, which was defined as knowledge of, attitude towards, and implementation of EBP. Methodology: An online survey was administered to a convenience sample of nurses active in Internet forums, comprising validated Spanish versions of the Evidence-Based Practice Questionnaire (EBPQ) and Practice Environment Scale of the Nursing Work Index (PES-NWI) and socio-demographics and professional variables. Results: 314 questionnaires were obtained (76.96%). The mean EBPQ score was 5.02 out of 7 (95%CI, 4.89-5.14). The variables associated with a higher competence in EBP were academic level, (p

Objective: To identify and analyze the production of knowledge about the strategies that health care institutions have implemented to humanize care of hospitalized children. Method: This is a systematic review conducted in the Virtual Health Library - Nursing and SciELO, using the seven steps proposed by the Cochrane Handbook. Results: 15 studies were selected, and strategies that involved relationship exchanges were used between the health professional, the hospitalized child and their families, which may be mediated by leisure activities, music and by reading fairy tales. We also include the use of the architecture itself as a way of providing welfare to the child and his/her family, as well as facilitating the development of the work process of health professionals. Conclusion: Investments in research and publications about the topic are necessary, so that, the National Humanization Policy does not disappear and that the identified strategies in this study do not configure as isolated and disjointed actions of health policy.

Copyright of Interface - Comunicação, Saúde, Educação is the property of Fundacao UNI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Nasal colonization of Staphylococcus aureus in health personnel and contamination of hospital surfaces may precede nosocomial infection. This study aimed to characterize the isolates of Staphylococcus aureus found in hospital environments and healthcare staff in a hospital in the city of Cali. Materials and Methods: A total of 164 samples (86 from the healthcare staff and 78 from the hospital wards) were used in this study. The characterization was based on the antibiogram analysis and PCR amplification of the mecA and agr genes. The methicillin-resistant S. aureus associated with the hospital (MRSA-AH) or the MRSA associated with the community (MRSA-AC) were established by analyzing these genes. Results: S. aureus recorded 21.3% prevalence, and it was detected in healthcare staff (9.1%) and the hospital environment (12.2%). S. aureus found in the intensive care unit was significant with higher risk than 3 (6.1%; OR = 3.143, min = 1.086, max = 9.099; p = 0.031). Three resistance profiles were identified (I, II, and III), and the hospital environment presented a higher risk of having isolates with resistance profile I (20%; OR = 3.500; CI95% min = 0.050, max = 16.430; p = 0.147). However, isolates classified in profile III with multi-resistance to antibiotics were most prevalent in the healthcare staff (25.7%) and the hospital environment (20%). The MRSA isolates were found colonizing 11.4% health care staff and 17.1% on surfaces of the hospital environment. All MRSA isolates were SCC mec type II, compatible with hospital origin. According to the analysis of agr locus, it was possible to identify three agr groups; 51.4% belonging to agr group 1, 22.8% to agr 2, and 25.7% to agr 3. Conclusion: This study evidenced the presence of MRSA in the healthcare staff and different wards of the hospital. This condition could be a risk factor for developing infections acquired in the hospital. [ABSTRACT FROM AUTHOR]

Os objetivos deste estudo foram identificar os elementos constitutivos do conceito de ambiente nos documentos oficiais da Política Nacional de Humanização e analisar as relações entre eles e a promoção de ambiente de cuidado preconizada pela enfermagem. MÉTODOS: Estudo qualitativo e descritivo, cujas fontes foram as onze Cartilhas HumanizaSUS do Ministério da Saúde. Realizou-se análise de conteúdo, tipo lexical, por meio do programa ALCESTE®. RESULTADOS: A classe lexical específica sobre o ambiente como instrumento de humanização evidenciou elementos aproximados ao conhecimento da enfermagem sobre os cuidados com o espaço físico promotor de conforto e bemestar e o acolhimento dos usuários e seus familiares. CONCLUSÃO: Concluiu-se que os elementos constitutivos do conceito de ambiente na Política Nacional de Humanização se coadunam com o pensamento Nightingaleano, que serve de base aos fundamentos da enfermagem, à sua ciência e à sua arte.

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: evaluar las características del ambiente de la práctica profesional de los enfermeros y su relación con el burnout, percepción de la calidad del cuidado, satisfacción en el trabajo y la intención de dejar el empleo en los próximos doce meses. MÉTODO: estudio transversal de abordaje cuantitativo de los datos. La muestra fue compuesta por 129 enfermeros de Unidades de Terapia Intensiva de adulto de una región del interior del Estado de Sao Paulo, Brasil. RESULTADOS: el modelaje de ecuaciones estructurales, por medio del análisis de caminos, mostró que las características del ambiente de la práctica influyen en la satisfacción en el trabajo, percepción de la calidad del cuidado y en la intención de dejar el empleo, cuando mediadas por el sentimiento de agotamiento emocional. El enfermero con poca autonomía, menor control sobre el ambiente y con peores relaciones con el médico, presenta mayor nivel de agotamiento emocional, lo que puede influenciar negativamente su percepción de la calidad del cuidado, satisfacción con el trabajo y la intención de dejar el empleo. CONCLUSÍON: la posición mediadora del agotamiento emocional puede influenciar negativamente en los resultados de la asistencia, habiendo, así, necesidad de adoptar estrategias que minimicen ese sentimiento en el enfermero. OBJETIVO: avaliar as características do ambiente da prática profissional dos enfermeiros e sua relação com o Burnout, percepção da qualidade do cuidado, satisfação no trabalho e a intenção de deixar o emprego nos próximos doze meses. MÉTODO: estudo transversal de abordagem quantitativa dos dados. A amostra foi composta por 129 enfermeiros de unidades de terapia intensiva de adulto de uma região do interior do Estado de São Paulo, Brasil. RESULTADOS: a modelagem de equações estruturais, por meio da análise de caminhos, mostrou que as características do ambiente da prática influenciam na satisfação no trabalho, percepção da qualidade do cuidado e na intenção de deixar o emprego, quando mediadas pelo sentimento de exaustão emocional. O enfermeiro com pouca autonomia, menor controle sobre o ambiente e com piores relações com o médico, apresenta maior nível de exaustão emocional, o que pode influenciar negativamente na sua percepção da qualidade do cuidado, satisfação com o trabalho e na intenção de deixar o emprego. CONCLUSÃO: a posição mediadora da exaustão emocional pode influenciar negativamente nos resultados da assistência, havendo, portanto, a necessidade de adoção de estratégias que minimizem esse sentimento no enfermeiro.

O presente estudo teve como objetivo identificar o nível de burnout nos enfermeiros de um hospital público do interior do estado de São Paulo. A pesquisa descritiva e transversal foi realizada com 69 enfermeiros de diferentes setores do hospital. Foram utilizados uma ficha para caracterização da amostra e o Inventário de Burnout de Maslach (IBM). A maioria da amostra era do sexo feminino, solteira, com pós-graduação, sem nenhum outro vínculo empregatício e lotada nas unidades de clínica médica/cirúrgica. As médias encontradas para as subescalas do intrumento foram: 21,4 para exautão emocional; 9,3 para despersonalização; e 31,3 para diminuição da realização pessoal, revelando um nível moderado da síndrome de burnout. Destaca-se a importância de se avaliar a prevalência da síndrome entre os diferentes profissionais, pois o seu desenvolvimento pode acarretar resultados negativos para os profissionais, pacientes e instituições.Este estudio tiene como propósito identificar el nivel del Burnout en los enfermeros de un hospital público del interior del estado brasileño de São Paulo. La investigación, descriptiva y transversal (cross-sectional), fue realizada con 69 enfermeros de diferentes sectores del hospital. Fueron utilizadas cédulas de caracterización de la amuestra y el Inventario de Burnout de Maslach (IBM). La mayoría de la amuestra era de mujeres, solteras, con posgrado, no poseían otro vínculo laboral y trabajaban en la unidad de clínica médica/quirúrgica. Las medias encontradas para las subescalas del instrumento fueron: 21,4 para el agotamiento emocional; 9,3 para despersonalización; y 31,3 para la disminución de la realización personal, revelando un nivel moderado del Síndrome Burnout. Se destaca la importancia de evaluar la prevalencia del síndrome entre los diferentes profesionales, porque su desenvolvimiento puede causar resultados negativos para los profesionales, pacientes e instituciones.This study has the objective of identifying the level of Burnout in the nurses of a public hospital in the countryside of the Brazilian state of São Paulo. The descriptive and cross-sectional research was made with 69 nurses of different sectors of the hospital. The sample composition questionnaire and the Maslach Burnout Inventory (MBI) were used. The majority of the sample was female, single, had postgraduate degrees, did not have another formal employment contract and worked in the medical/surgical clinic. The averages that were found for the subscales of the instrument were: 21,4 for the emotional exhaustion; 9,3 for the depersonalization; and 31,3 for the personal fulfillment decrease, revealing a moderate level of the Burnout syndrome. It is underscored the importance in evaluating the prevalence of this syndrome in different professionals, because its development can cause negative results for the health care professionals, patients and institutions.

Estudo exploratório com abordagem qualitativa desenvolvido com 117 graduandos e profissionais da área da saúde, no interior paulista, com o objetivo de identificar os fatores ambientais que interferem na comunicação do profissional da saúde com o idoso. As respostas puderam ser ordenadas e analisadas em sete agrupamentos: fatores sonoros e vibratórios, decorativos e espaciais, luminosos, cores e texturas, térmicos e ventilatórios, higiênicos e de segurança profissional e sinalizadores visuais. Considera-se que a utilização dos fatores ambientais durante o processo de cuidar seja uma possibilidade efetiva do cuidado, uma vez que interfere no bem estar do idoso, na sua recuperação e no relacionamento entre o binômio profissional-idoso.

Estudo qualitativo que partiu da questão: como vêm sendo construídas as teorias e modelos de cuidado de enfermagem, focalizando o processo de construção da teoria substantiva, referente à Tese que teve como objetivos compreender o significado do ambiente de cuidados em Unidade de Terapia Intensiva e construir um modelo teórico sobre ele. O método utilizado foi a Grounded Theory. Realizaram-se 39 entrevistas com 47 sujeitos diferenciados de três Unidades de Terapia Intensiva Adulto, em Florianópolis/SC, Santa Maria/RS e Pelotas/RS, entre junho de 2009 a setembro de 2010. A teoria "Sustentando a vida no ambiente complexo de cuidados em Unidade de Terapia Intensiva" foi delimitada por oito categorias. Conclui-se que sustentar a vida no ambiente de Unidade de Terapia Intensiva significa investir intensivamente no cuidado de pacientes instáveis, com auxílio de tecnologias diferenciadas e profissionais capacitados, trabalhando em equipe, onde se convive com estresse/conflitos e dificuldades para lidar com a morte.Estudio cualitativo, empieza con la pregunta: ¿cómo se construyen las teorías y modelos de atención de enfermería, centrándose en el proceso de construcción de la teoría sustantiva de la Tesis cuyo objetivo fue comprender el significado del entorno de la atención en la Unidad de Cuidados Intensivos y construir un modelo teórico sobre el mismo. Se utilizó la Teoría Fundamentada. Se realizaron 39 entrevistas a 47 sujetos de 3 Unidades de Cuidado Intensivo Adulto, en Florianópolis/SC, Santa Maria/RS y Pelotas/RS, entre junio de 2009 y septiembre de 2010. Se construyó una teoría de "mantenimiento de la vida en el complejo entorno de la atención en la unidad de cuidados intensivos", definida por 8 categorías. Sostener la vida en el entorno de la Unidad de Cuidados Intensivos significa invertir intensamente en el cuidado de los pacientes ingresados y que no se encuentran en una situación estable, con la ayuda de diferentes tecnologías y profesionales cualificados, que trabajan en equipo, vivir con familiares angustiados, con tensión y conflictos, y con la dificultad para hacer frente a la muerte.Qualitative study, merged from the issue: how the theories and models of nursing care have being constructed, focusing on the process of building a substantive theory based on the Thesis that had as objectives to comprehend the meaning of the environment of care in the Intensive Care Unit and to construct a theoretical model about it. The method used was the Grounded Theory. Thirty-nine interviews were conducted with forty-seven differentiated subjects from three Adult Intensive Care Units in Florianópolis/SC, Santa Maria/RS and Pelotas/RS between June of 2009 and September of 2010. It was possible to construct the theory "Sustaining life in the complex care environment of the Intensive Care Unit", delimited by eight categories. Sustain life on the environment of care in the Intensive Care Unit means investing intensively in the care of patients admitted who are in an unstable situation, with the help of different technologies and skilled professionals who work in teams, coexists with relatives distressed, with stress and conflict, and the difficulty to deal with the death.

Objetivos: Establecer el diagnóstico de los factores que los profesionales de enfermería perciben como facilitadores para una práctica clínica basada en la evidencia (PCBE) en el Servicio de Salud de las Islas Baleares, identificando posibles diferencias en función de las características de los profesionales y de los entornos en que ejercen. Métodos: Estudio observacional transversal multicéntrico, tomando como población de estudio los 3129 profesionales de enfermería en plantilla del Servicio de Salud de las Islas Baleares en 2009, a quienes se encuestó con los instrumentos Evidence Based Practice Questionnarie: (EBPQ) y Nursing Work Index: (PES-NWI). La estrategia de análisis comprendió análisis exploratorio, análisis bivariado con pruebas paramétricas y no paramétricas en función de la naturaleza de las distribuciones (correlación, ANOVA, Kruskall-Wallis, ji cuadrado) y multivariado, entre las principales variables del estudio y los factores de los cuestionarios PES-NWI y EBPQ. Los análisis se realizaron con un nivel de confianza del 95%. Resultados: Se recibieron 1753 encuestas (participación del 56,02%). Los resultados de los dos cuestionarios muestran diferencias significativas al analizar el entorno hospitalario y de atención primaria (pObjectives: To determine the factors that nursing professionals perceive as facilitating evidence-based clinical practice (EBCP) in the Balearic Islands Health Service (Spain) by identifying possible differences according to nurses' characteristics and their occupational settings. Methods: We performed a multicenter, cross-sectional, observational study of 3,129 staff nurses in the Balearic Islands Health Service in 2009, who were surveyed using the Evidence-Based Practice Questionnaire (EBPQ) and the Nursing Work Index (PES-NWI). The strategy for the analysis encompassed an exploratory analysis, bivariate analysis with parametric and non-parametric tests according to the nature of the distributions (correlation, ANOVA, Kruskall-Wallis, chi square) and multivariate analysis of the main study variables and factors on the PES-NWI and EBPQ questionnaires. The analyses had a confidence level of 95%. Results: A total of 1,753 questionnaires were received, corresponding to a participation rate of 56.02%. The results established significant differences between the two questionnaires in the analysis of the hospital setting and primary care (p

Revisão de literatura, utilizando a Análise Temática, com o objetivo de apreender as interações no ambiente de cuidado a partir de publicações em quatro periódicos brasileiros de enfermagem, de circulação internacional, no período de 2000 a 2007. Foi realizada leitura atenta do título, resumo e palavras-chave para seleção de textos, sendo analisados 2.548 artigos e selecionados 331. Destes, 78,6% eram pesquisas científicas e 88% apresentavam doutores na autoria. Reconheceram-se cinco unidades temáticas: atitude de interação; o processo interativo e suas finalidades; cuidado mediado e ampliado pelo processo interativo; interação prejudicada; interação como instrumento de gestão e formação do sistema de saúde. Os pesquisadores reconhecem a complexidade destas relações como fundamento do cuidado em saúde e Enfermagem.

Este texto propõe uma discussão sobre o ambiente hospitalar saudável e sustentável destacando-se as contribuições da enfermagem nesse processo. As bases filosóficas encontram-se ancoradas na teoria ecossistêmica que analisa as sensibilidades necessárias para entender a natureza e os elementos estruturantes do ambiente/espaço hospitalar. Enfatiza-se a força aglutinadora das Unidades Produtivas que, de maneira interdependente e inter-relacionada, devem buscar o espaço sustentável e saudável através da cooperação, flexibilidade e parceria dos elementos constituintes. Reitera-se que a realimentação constante do conhecimento, envolvendo de forma sistêmica todas as Unidades Produtivas, pode facilitar as atualizações necessárias para acompanhar as modificações e transformações do espaço e, assim, do próprio cosmos. Compreende-se que o profissional de enfermagem, ao favorecer a construção de inter-relações em um processo de interconexões, pode ser o agente de transformação e representar os nós conectivos que tecem a rede viva da organização do ambiente hospitalar, levando-o à sustentabilidade e a ser mais saudável.Se propone una reflexión del ambiente hospitalario saludable y sustentable destacando las contribuciones de la enfermería en este proceso. Las bases filosóficas se encuentran arraigadas en la teoría ecosistémica que analiza las sensibilidades necesarias para entender la naturaleza y los elementos de estructura del ambiente/espacio hospitalario. Enfatiza la fuerza aglutinadora de las Unidades Productivas que, de manera dependiente y relacionada entre si, deben buscar el espacio sustentable y saludable a través de la cooperación, flexibilidad y unión. Reitera el feedback constante del conocimiento, envolviendo sistémicamente todas las Unidades Productivas, puede posibilitar las actualizaciones necesarias para acompañar las transformaciones del espacio/cosmos. El profesional de enfermería, al favorecer la construcción de relaciones en un proceso de conexiones entre si puede ser el agente de la transformación y representar los nudos conectores que tejen la malla viva de la organización del ambiente hospitalario, lo llevando a la sustentabilidad y a ser más saludable.This discussion is about a healthy and sustainable hospital environment pointing out the nursing contributions in this process. The philosophical bases are anchored on the echo systemic theory which analyses the necessary sensibilities to understand nature and the structural elements of the hospital environment/space, and the joining forces of the Productive Unities by the cooperation, flexibility and partnership of the constituent elements. It is reaffirmed that the continuous feedback of the knowledge, involving in a systemic form all the Productive Unities, may favors the necessary up dates to accompany the modifications and transformations of the space and the cosmos itself. It is understood the nursing professional, when favoring the construction of interrelations in a process of interconnections can be the transforming agent and represent the connective knots which weave the net of the lively organization of the hospital environment, leading it to a more sustainable and more healthy one.

This was a descriptive, correlational study designed to evaluate the capacity to direct attention (CDA) of the nurse and to verify an association between the CDA and attention demand situations. For data collection the instruments used were: the Attentional Function Index and the Directed Attention Demands. The participants were 169 nurses of a teaching hospital in the State of São Paulo. The mean perception of performance or CDA was 60.4 which differed between the variables: unit of work (p=0.013), work hours (p=0.044), presence of health problems (p=0.026) and problems of a psychological nature (p=0.005). There was a negative association between the situations of demand and CDA (r = - 0.294, pSe trata de un estudio descriptivo y correlacional que tuvo por objetivo evaluar la capacidad que tiene el enfermero de dirigir su atención (CDA) y verificar se hay asociación entre CDA y situaciones de demanda de atención. Para la recolección de datos se utilizó los instrumentos: Attentional Function Index y Demandas de Atención. Participaron del estudio 169 enfermeros de un hospital de enseñanza del interior del estado de Sao Paulo. El promedio de la percepción de desempeño (CDA) fue de 60,4 y tuvo resultados diferentes entre las variables: unidad de trabajo (p=0,013); carga horaria (p=0,044); presencia de algún problema de salud (p=0,026) y problema de orden psicológico (p=0,005). Existe una asociación negativa entre las situaciones de demanda y CDA (r=- 0,294; pEste é um estudo descritivo e correlacional, cujo objetivo foi avaliar a capacidade de direcionar atenção (CDA) do enfermeiro e verificar se há associação entre CDA e as situações de demanda de atenção. Para a coleta de dados foram utilizados os instrumentos: Attentional Function Index e Demandas de Atenção. Participaram do estudo 169 enfermeiros de um hospital de ensino do interior do Estado de São Paulo. A média da percepção de desempenho, ou CDA, foi de 60,4 e diferiu entre as variáveis: unidade de trabalho (p=0,013), carga horária (p=0,044), presença de algum problema de saúde (p=0,026) e problema de cunho psicológico (p=0,005). Existe associação negativa entre as situações de demanda e CDA (r=-0,294; p

This descriptive study aimed to identify attention demand situations experienced by nurses in their workplace and to verify if these demands were judged differently depending on socio-demographic variables. Data were collected through the "Directed Attention Demands" instrument, translated and validated in Brazil. SAS statistics software was used for data analysis. The following demand situations scored higher: "watching a patient suffer", "a number of rapid decisions had to be made", "caring for families with emotional needs", "not enough time to provide emotional support to a patient", and "family teaching required". There were statistical differences for variables such as: age, marital status, professional qualification, work shift and number of hours worked weekly. The importance of these findings should be pointed out to managers and administrators in the adoption of strategies that can minimize these sources of demand for nurses.Este estudio descriptivo busca identificar las situaciones de demanda vivenciadas por enfermeros en su ambiente laboral y verificar si hay diferencias en el juício de las demandas en relación a las variables sociodemograficas. Para colectar datos, se utilizó el Instrumento Demandas de Atención Dirigida, traducido y validado en Brasil. En el análisis de los datos, se utilizó el programa estadístico SAS. Las situaciones de demandas de atención con mayores medias aritméticas fueron: observar el sufrimiento del paciente, tomar muchas decisiones rápidas, cuidar de familias con necesidades emocionales, tiempo insuficiente para apoyar emocionalmente al paciente y necesidad de orientar a la familia. Los datos mostraron diferencias estadísticamente significantes para las variables: edad, estado civil, calificación profesional, turno del trabajo y carga horaria semanal. Se resalta la importancia de los hallazgos para gerentes y administradores en el sentido de adoptar estrategias para minimizar esas fuentes de demanda para los enfermeros.Trata-se de estudo descritivo que visa identificar as situações de demanda de atenção, vivenciadas por enfermeiros em seu ambiente de trabalho, e verificar se existem diferenças no julgamento dessas demandas em função das variáveis sociodemográficas. Para a coleta de dados, utilizou-se o instrumento Demandas de Atenção Dirigida, traduzido e validado no Brasil. Na análise dos dados, utilizou-se o programa estatístico SAS. Dentre as situações de maior demanda destacam-se: "observar o sofrimento de um paciente", "muitas decisões rápidas tiveram que ser tomadas", "cuidar de famílias com necessidades emocionais", "tempo insuficiente para dar apoio emocional a um paciente" e "necessidade de dar orientação à família". Os dados mostraram que há diferenças estatisticamente significativas para variáveis como: idade, estado civil, qualificação profissional, turno de trabalho e carga horária semanal. Ressalta-se a importância dos achados para gerentes e administradores na adoção de estratégias que minimizem essas fontes de demandas para os enfermeiros.

Desenvolvemos uma reflexão sobre as transformações ocorridas durante o século XX, no Brasil, em relação à recepção de obras de arte produzidas em situações clínicas ou, de qualquer outro modo, fora do espaço instituído da arte. A abertura da arte para acolher essas produções dissidentes é vista por nós como índice de uma mutação na sensibilidade contemporânea, que produz um deslocamento nas relações entre os campos da arte, da clínica e da loucura.

A utilização das cores no ambiente da Unidade de Terapia Intensiva - UTI pode interferir no bem-estar dos profissionais e clientes. Este estudo teve como objetivo analisar percepções de profissionais e pacientes quanto às cores utilizadas no ambiente de terapia intensiva, identificando aquelas consideradas agradáveis e desagradáveis. Trata-se de pesquisa descritivo-exploratória, com enfoque quanti-qualitativo. A amostra foi constituída de clientes internados e profissionais que trabalham em três UTIs de hospitais públicos localizados em Goiânia. As cores consideradas mais agradáveis para serem utilizadas em UTI foram o azul-claro e o verde-claro. Além dessas, apontaram o amarelo-claro, palha, cinza, rosa e goiaba. O vermelho e o preto foram consideradas as cores mais desagradáveis para um ambiente de UTI. Os profis-sionais e clientes referem preferência por cores variadas, as quais podem ser utilizadas no sentido de melhorar o clima da UTI.La utilización de los colores en el ambiente de la Unidad de Cuidados Intensivos - UCI puede interferir en el bienestar de los profesionales y clientes. En este estudio se tuvo como objetivo analizar las percepciones de profesionales y pacientes en cuanto a los colores utilizados en el ambiente de cuidados intensivos, identificando aquellas consideradas agradables y desagradables. Se trata de una investigación descriptivo-exploratoria, con enfoque cuanti-cualitativa. La muestra estuvo constituida de clientes internados y de profesionales que trabajan en tres UCIs de hospitales públicos localizados en Goiânia. Los colores considerados más agradables para ser utilizadas en UCI fueron el celeste y el verde claro. Además de ellos, señalaron el amarillo, paja, gris, rosado y guayaba. El rojo y el negro fueron considerados los colores más desagradables para un ambiente de UCI. Los profesionales y clientes refirieron preferencia por colores variados, los cuales pueden ser utilizados en el sentido de mejorar el clima de la UCI.The use of colors in the environment of an Intensive Care Unit (ICU) may interfere in the welfare of both professionals and patients. This study is aimed at analyzing the perceptions of professionals and patients regarding the colors used in the intensive care environment, identifying those considered pleasant and unpleasant. This is a descriptive-exploratory research with a quantitative-qualitative focus. The sample was comprised of hospitalized patients and professionals at three public hospitals ICUs in the city of Goiânia, State of Goiás. The colors considered most pleasant for ICUs were light blue and light green. Light yellow, beige, gray, pink and guava were also pointed out as pleasing. Red and black were appointed as the most unpleasant. Professionals and patients demonstrated preference for varied colors, something that can be used as a way of improving the atmosphere of ICUs.

Copyright of Journal of Nursing UFPE / Revista de Enfermagem UFPE is the property of Revista de Enfermagem UFPE and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Nursing UFPE / Revista de Enfermagem UFPE is the property of Revista de Enfermagem UFPE and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Gaucha de Enfermagem is the property of Revista Gaucha de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Estudo de caso descritivo, qualitativo, acerca da perspectiva de clientes quanto ao ambiente da unidade de quimioterapia. Os objetivos: descrever os fatores ambientais considerados como determinantes de bem/mal estar da unidade de quimioterapia na perspectiva dos clientes e analisar os fatores ambientais considerados pelos clientes como determinantes de bem/mal-estar, como indicativos para o enfermeiro na gestão do ambiente. A pesquisa foi realizada no Hospital Geral de Bonsucesso, na cidade do Rio de Janeiro, no período de janeiro a março de 2005. Participaram do estudo vinte clientes em tratamento na referida unidade. Os resultados revelaram como fatores de bem estar: atitude carinhosa da equipe e, conforto da sala de aplicação de quimioterapia; como fator de mal-estar: desconforto da sala de espera. Conclui-se que a perspectiva dos clientes indica que a gestão desse ambiente deve contemplar os aspectos físico, psicológico e social. Além disso, o enfermeiro deve incluir, no planejamento da sua assistência, o momento que antecede a aplicação da quimioterapia na sala de espera.Estudio de caso descriptivo, cualitativo, acerca de la perspectiva de clientes cuanto al ambiente de la unidad de la quimioterapia. Los objetivos: descrbir los factores ambientales considerados como determinantes del bienestar y del malestar en la unidad de la quimioterapia en la perspectiva de los clientes y analizar esos factores ambientales así considerados como indicativos para el enfermero en la gestión del ambiente. La pesquisa fue cumplida en el Hospital General de Bonsucesso, en la ciudad de Rio de Janeiro - Brasil, en el período de enero a marzo de 2005. Participaram del estudio 20 clientes en tratamiento en la dicha unidad. Los resultados revelaron como factores de bienestar: actitud cariñosa del equipo y conforto de la sala de aplicación de quimioterapía; como factor de malestar: incomodidad de la sala de espera. Concluyese que la perspectiva de los clientes indica que la gestión de ese ambiente debe contemplar los aspectos físico, psicológico y social. Además de eso, el enfermero debe incluir, en el planeamiento de su asistencia, el momento que, en la sala de espera, precede la aplicación de la quimioterapía.Study of descriptive case, qualitative, concerning the perspective of customers about the environment of the Unit of chemotherapy. The objectives are to analyze the vision of customers concerning the Unit of Chemotherapy of the Bonsucesso General Hospital and to discuss the environment factors considered by the customers as determiners of well being and discomfort in the Unit of Chemotherapy, as indicative for the nurse in the management of the environment. Twenty adult customers in treatment in the related unit had participated of the study. The results have disclosed that the customers consider that the determining factors of well being are related to the loving attitude of the team and to the comfort of the room of chemotherapy application. The factor pointed as generators of discomfort were the uncomfortable area used as waiting room. It is conclude that the perspective of the customers indicates a philosophy of management that contemplates the physical, psychological and social aspects of the environment. And that it is up to the nurse to include the planning of his/her assistance the moment that precedes the application of the chemotherapy.

Com o movimento global atual sobre segurança na área da saúde, pesquisadores tem chamado a atenção para o referencial da abordagem do sistema como um meio de melhorar a segurança dos ambientes e pacientes. Entretanto, quais tipos de teorias do sistema devem guiar as pesquisas sobre a segurança de pacientes? Nesse artigo, argumenta-se que enfermeiros e outros profissionais podem usar as teorias e princípios da restauração ecológica, ou seja da reparação de ecossistemas danificados, para estudar e fortalecer a segurança de ambientes. Usando a ciência da restauração para teorizar sobre sistemas de saúde, serão desenvolvidas habilidades para pensar ecologicamente sobre nossas relações com o outro e com os ambientes que dividimos, entre eles o ambiente hospitalar. A aplicação do conhecimento da ciência da restauração em conjunto ao da enfermagem e área da saúde, pode fortalecer a criação de sistemas seguros para todos a custos adequados.Con el movimiento global actual sobre seguridad en el área de la salud, investigadores llaman la atención para el referencial del abordaje de sistema como un medio para mejorar la seguridad del ambiente y de los pacientes. ¿Sin embargo, cuales tipos de teorías de sistemas deben guiar las investigaciones sobre la seguridad de los pacientes? En este artículo se argumenta que enfermeros y otros profesionales pueden utilizar las teorías y principios de la restauración ecológica, o sea, de la reparación de ecosistemas damnificados, para estudiar y fortalecer la seguridad de los ambientes. Utilizando la ciencia de la restauración para teorizar sobre sistemas de salud, serán desarrolladas habilidades para pensar ecológicamente sobre nuestras relaciones con los otros y con los ambientes que dividimos, entre estos el ambiente hospitalario. La aplicación del conocimiento de la ciencia de la restauración, junto al de enfermería y del área de la salud, puede fortalecer la creación de sistemas seguros para todos, con un costo adecuado.As a global safety movement gathers momentum, experts call for a "systems approach" to improve the safety of today's health care environments. Yet, what kinds of systems theories should guide the field of patient safety research? In this paper, it is argued that nurses and other health professionals can use theory and principles from the field of ecological restoration, which is the repair of damaged ecosystems, to study and strengthen the safety of health care environments around the world. When we use restoration science to theorize about health care systems, we develop the ability to think ecologically about our relations with each other and with the environments we share. As we integrate knowledge of restoration science with nurses' knowledge and other knowledge in health care, we may actually create safer health care systems for all at a human and material cost that we are able and willing to pay.

O estudo refere-se a propés e sapatos privativos, realizado em 2003, e teve como objetivo a busca de evidência científica sobre sua relação direta no controle de contaminação e/ou infecção do ar ambiente e do sítio cirúrgico por microrganismos oriundos do piso. A metodologia utilizada foi a revisão sistemática de pesquisas básicas, desde 1950 até 2003, por meio de busca em fontes eletrônicas, bibliografias de estudos relevantes e anais de eventos científicos. Do total de publicações encontradas, somente 10 constituíram pesquisas básicas, as quais foram analisadas quanto ao escopo, tipo de investigação, metodologia, resultados, conclusões e comentários dos analisadores. A análise foi auxiliada por dois pesquisadores, ambos com experiência na temática e um em metodologia de pesquisa. Observou-se, nesta análise, diversidade e problemas dos métodos de investigação utilizados, sendo que apenas 4 pesquisas obtiveram dispersão de microrganismos do piso para o ar ambiente, porém não significativa, e nenhuma relacionada diretamente com contaminação e/ou infecção do sítio cirúrgico. Obteve-se evidências sobre: 1) a capacidade de barreira e de transferência de microrganismos no piso de uma área para outra depende do tipo de cobertura de sapatos; 2) contaminação ocupacional durante remoção e colocação de propés. Como conclusão, não há evidência de que propés e sapatos privativos evitem a contaminação do ambiente e da ferida cirúrgica, e a decisão pela continuidade do seu uso precisa ser técnica e administrativamente controlada.Este estudio de revisión sistemática de investigaciones básicas sobre calzados de seguridad y zapatos exclusivos buscó evidencias de su eficacia en el control de la contaminación e infección del sitio quirúrgico por microorganismos del ambiente procedentes del piso. Fueron identificadas 10 investigaciones básicas a partir de una búsqueda electrónica y de listas de referencias de artículos de relevancia, en el período de 1950 a 2003, que fueron analizadas de acuerdo con: el objetivo, el tipo de investigación, el diseño metodológico, los resultados, las conclusiones y los comentarios de los investigadores. Los resultados no sugieren evidencia directa de esta eficacia, aunque hay evidencias de que la capacidad de barrera y de transferencia de microorganismos de un área para otra del piso depende del tipo de calzados de seguridad, siendo menor con zapatos exclusivos y calzados de seguridad. El riesgo de contaminación ocupacional durante la remoción y la puesta de calzados de seguridad también es evidente. La decisión por la continuidad del uso de estos elementos necesita ser controlada técnica y administrativamente.The study is about shoe cover and private shoe usage and aimed to find scientific evidence on their direct relation in the control of surgical site contamination and/or infection transmitted by floor microorganisms. A systematic review of basic research on shoe covers and private shoes usage was carried out, covering the period from 1950 to 2003, by means of a search in electronic sources, bibliographies of relevant studies and proceedings of scientific events. The analysis was supported by two researchers, both of whom were experienced in this theme and one of them in research methodology. The research methods revealed a diverse range and various problems. Only 4 studies obtained a dispersion of floor microorganisms to the air environment, although not significant, and none of them was directly related to surgical site contamination and/or infection. Results do not suggest direct evidence on their efficacy but there is evidence, nonetheless, that barrier and microorganisms transfer from one specific area to another depend on the type of shoe cover, with lower transfer rates when private shoes and shoe covers are employed. Occupational contamination risk during shoe cover attire and removal is also evident and the decision about continuity of their usage needs to be technically and administratively controlled.

Copyright of Investigacion & Educacion en Enfermeria is the property of Universidad de Antioquia, Facultad de Enfermeria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)