O gerenciamento de risco vem sendo utilizado pelas organizações de saúde como um processo investigativo e técnico-científico para alcançar a qualidade da prestação de serviços e a segurança dos pacientes e dos profissionais de saúde. Este estudo objetivou compreender a percepção dos enfermeiros acerca do gerenciamento de risco hospitalar e analisar as dificuldades e facilidades encontradas. Trata-se de um estudo com abordagem qualitativa, de caráter exploratório, descritivo, com a participação de 29 enfermeiros assistenciais e gerenciais de dois hospitais de caráter privado e de grande porte localizado no interior de Minas Gerais. As entrevistas foram audiogravadas, utilizando-se roteiro semiestruturado. Os dados foram submetidos à técnica de análise de conteúdo, resultando em cinco categorias: deficiência na conceituação do gerenciamento de risco, gerenciamento de risco qualificando a assistência, necessidade de mudança de cultura para operacionalização do gerenciamento de risco, o gerenciamento de risco percebido como notificação e os recursos humanos influenciando no gerenciamento de risco. Os resultados mostraram que os enfermeiros relacionam o gerenciamento de risco como ferramenta de qualidade e segurança na assistência ao paciente. Constatou-se que, mesmo havendo a comunicação dos eventos adversos, muitas vezes há subnotificação por falta de tempo no preenchimento dos formulários, sobrecarga de trabalho, medo da represália e punição mediante o erro. A sensibilização da equipe, os programas de educação permanente e o apoio diretivo são estratégias sugeridas para avançar nos processos de trabalho.
Objective To compare the characteristics of the work environment that enable the professional practice of nurses in private and public organizations.Methods A quantitative, exploratory, cross-section study, carried out in four health organizations - one public and three private, with 188 registered nurses. Participants answered the Brazilian version of the Nursing Work Index − Revised, which aims to evaluate the presence of characteristics that favor the development of nursing activities through 15 items distributed into three subscales: autonomy, control over the practice setting and relationships with physicians. The measurement scale used is Likert, and lower scores represent better evaluation of the environment, i.e. , more favorable characteristics are present to assist the development of nursing activities.Results The means of the responses of participants of private hospitals were smaller in all subscales of the instrument, as compared to those from public hospitals.Conclusion The environment of private hospitals showed more favorable characteristics to the professional practice of registered nurses than the public hospital environment.
Este artigo apresenta, de forma simples, a definição e fundamentos da pesquisa qualitativa, de forma a introduzir a temática da importância desta metodologia de investigação, para as ciências da nutrição e alimentação e os nutricionistas. Ao contrário da metodologia quantitativa, a pesquisa qualitativa é realizada através de uma abordagem interpretativa e naturalística do tema de estudo. Com o foco nos significados atribuídos pelos indivíduos ao objeto de estudo, a investigação qualitativa oferece um percurso científico propício à compreensão de um fenómeno tão complexo como o alimentar e nutricional. Não obstante o atual reconhecimento científico da importância da evidência qualitativa, a utilização desta metodologia é ainda muito reduzida e/ou pouco valorizada. O estabelecimento de mecanismos de educação e formação nesta temática e a elaboração de processos de colaboração interdisciplinar na realização de estudos científicos tornam-se assim vitais para o desenvolvimento da utilização desta metodologia, na área das ciências da nutrição e alimentação.
Objective: To identify the knowledge of responsible technical nurses in relation to the general and management skills required to perform this function. Method: Qualitative case study with 14 nurses. The semi-structured interviews were recorded and the data analyzed through the thematic content analysis. Results: Two categories stood out: Main Responsibilities for the Position of Technical Manager: Leadership, Interpersonal Relationship and Systemic view; and Developing Skills: Dissociation between Theory and Practice. Final considerations: The fact that only three skills have been recognized as necessary for the exercise of the function of technical leader and the perception of the interviewees about the dissociation between theory and practice during graduation should be explored by the teaching and health institutions, because to exercise this nurses must develop the technical-scientific, socio-educational and ethical-political skills to be able to lead the organization to positive results..
RESUMO: O objetivo foi conhecer os sentimentos experimentados por equipes de enfermagem acerca dos erros de medicação e quais estratégias utilizadas pelos profissionais para preveni-los. O estudo foi exploratório qualitativo, realizado num hospital em Minas Gerais, Brasil, em 2014. Participaram onze profissionais de enfermagem que responderam entrevista por meio do instrumento semiestruturado. No resultado da análise temática emergiram quatro categorias: 1) deficiência na conceituação do erro, 2) sentimentos negativos associados ao erro, 3) condutas adotadas perante erro de medicação, e 4) estratégias de prevenção contra os erros de medicação. Constatou-se fragilidade na conceituação do erro; a percepção do sentimento de medo não relacionado à punição; a presença das competências, de responsabilidade e de comunicação usadas frente ao erro e a aplicação de barreiras e estratégias preconizadas para prevenção do erro. Sugere-se a implantação da sensibilização contínua focada em segurança como estratégia para alcançar aprendizado, disseminar as condutas assertivas dos profissionais e promover ações para aliviar os sentimentos dos envolvidos. DESCRITORES: Emoções; Erros de medicação; Gerenciamento de segurança; Cuidados de Enfermagem; Segurança do paciente. SENTIMENTOS EXPERIMENTADOS POR EQUIPES DE ENFERMAGEM ACERCA DOS ERROS DE MEDICAÇÃO FEELINGS EXPERIENCED BY NURSING TEAMS AFTER THE OCCURRENCE OF MEDICATION ERRORSABSTRACT: The present study aimed to identify the feelings experienced by nursing teams regarding medication errors and the strategies used to prevent them. Exploratory and descriptive study carried out in a hospital in Minas Gerais, Brazil,in2014. Data was collected through semi-structured interviews Semi-structured interviews were conducted with the eleven participants. Four categories emerged from thematic analysis: 1) inadequate conceptualization of error, 2) negative feelings associated to the error, 3) Nurses' responses to medication errors;and 4) strategies for preventing medication errors. Inability to define error was observed; perception of a feeling of fear not related to punishment; the existence of skills/competences, responsibility and communication in response to error, and the use of barriers and strategies recommended for the prevention of errors. SENTIMIENTOS EXPERIMENTADOS POR EQUIPOS DE ENFERMERÍA ACERCA DE LOS ERRORES DE MEDICACIÓNRESUMEN: Fue objetivo del estudio conocer los sentimientos experimentados por equipos de enfermería acerca de los errores de medicación y cuales son las estrategias utilizadas por los profesionales para prevenirlos. Es un estudio exploratorio cualitativo, realizado en un hospital en Minas Gerais, Brasil, en 2014. Participaron 11 profesionales de enfermería que contestaron entrevista por medio de instrumento semiestructurado. Resultaron del análisis temático cuatro categorías: 1) deficiencia en la conceptuación del error, 2) sentimientos negativos asociados al error, 3) conductas adoptadas delante del error de medicación, y 4) estrategias de prevención cont...
Objective: To identify the nonconformities of the enteral diet therapy process. Method: Exploratory case study, using as a theoretical framework the philosophy of Lean Healthcare in an inpatient unit of a large hospital in Minas Gerais State. The sample consisted of 19 professionals from the multidisciplinary team involved in the enteral nutritional therapy process and the unit's documentary sample. For the data collection, we used a semi-structured script, participant observation and documentary analysis. Results: There were eight nonconformities related to enteral diet therapy. During the participant observation, there was a lack of a management model that seeks the continuous improvement of the process, as well as resistance to change. Conclusion: Although enteral diet therapy is important in the patient's evolution, there are adverse events that could be prevented and the Lean philosophy assists in the identification of process nonconformities.
The Doctor of Nursing Practice is a proposal for doctoral training of nurses inserted in the job market. The program is a reality of the international scenario, since in the national literature publications are scarce and the program has not yet been implemented. The objective was to reflect on the Doctor of Nursing Practice, exploring the strengths and weaknesses of the program. This is a reflective study based on publications indexed in the following electronic databases: Scielo, BDENF, SCOPUS, MEDLINE and Web of Science. A combined search was performed using the controlled keywords nursing and advanced practice nursing and the uncontrolled descriptor doctor of nursing practice. The reflections that emerged are the aspects related to the historical context and to the characteristics of the program, the strengths and weaknesses of this proposal and its insertion in the international scenario. This study presents an overview on the subject, so as to support the reflection and discussion about a potential doctoral training in the national scenario.
Objectives: To know the most used types of touch and understand their meanings for physical therapists working in a hospital environment, from the perspective of their feelings, attitudes and behaviors during care. Materials and methods: Qualitative case study conducted by physical therapists working at a hospital in Brazil. For data collection, participant observation and semi-structured interviews were used as techniques. Data were analyzed according to the thematic content analysis proposed by Minayo. Results: 16 physical therapists participated in the study and, from the analysis of the empirical material, four thematic categories emerged: Instrumental touch as a fundamental resource of hospital physical therapy assistance; expressive touch: Its little presence does not mean absence of affection; physical therapist’s feelings related to touch and difficulty talking about touch means that there is a deficiency in training. Conclusions: The underuse of expressive touch revealed the lack of knowledge and unpreparedness in the formation of the physical therapist, which, added to the lack of self-knowledge, hinders the affection and the creation of bonds in relationships. All of this justifies the rare studies on affective touch in health, which reflects an area to be explored and the need to sensitize professionals to influence the quality and humanization of care.
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