Objective:To describe the workload of the nursing team and relate it with patient safety outcomes in clinical and surgical inpatient units of a university hospital. Method: Crosssectional study, carried out from October 2013 to September 2015. The factor under study was the workload, expressed as the ratio between the mean number of patients and the number of nursing professionals in 24 hours and in the day shifts. Results: The sample consisted of 157,481 patients, 502 nursing professionals and 264 observations of safety outcomes. The ratios of patients per nurse and per nursing technician in day shifts indicate a mean estimate of 14-15 and 5-6 patients per professional, respectively. There was a significant association between the workloads in the inpatient units and average length of stay, urinary infection related to invasive procedure and the satisfaction of patients with nursing care. Conclusion: The increase in the workload of the nursing team had an impact on quality of care and safety for patients. An adequate staffing promotes a safer care environment.

According to several studies, nursing, especially in hospital settings, is one of the most stressful professions. The objective of this study was to identify the sources of stress related to the administrative tasks of nurses working in a hospital, as well as the main health changes that stress caused these professionals. The quantitative survey was carried out in 1996 with a sample of 207 nurses at a university hospital in the city of Porto Alegre, in the state of Rio Grande do Sul, Brazil. A questionnaire was used to collect data on stress sources and symptoms. The questionnaire also gathered demographic data, as well as information on the nurses' feelings about their working conditions. The average age of the study participants was 35.8 years, and the average time working at the hospital was 8.5 years. Among participants, 48% were considered to be stressed. Work overload was the stress source that best predicted relative risk of stress (6.1). In terms of stress symptoms, the most commonly reported ones were cardiovascular changes. However, gastrointestinal changes were related to a higher risk of stress (5.3). Managing other staff was the stress source that had the greatest number of significant correlations with stress symptoms. On the other hand, immunologic changes were the symptoms that had the highest correlation with stress sources. Our results suggest that stress related to administrative tasks in nursing may trigger changes in nurses' health.

RESUMO Objetivo Levantar pontos críticos do processo de medicação, suas repercussões nas demandas de trabalho da equipe de enfermagem e riscos para a segurança dos pacientes. Método Estudo descritivo, com abordagem qualitativa, na perspectiva ecológico-restaurativa. Os dados foram coletados por meio de grupos focais e fotografias. Participaram enfermeiros e técnicos de enfermagem. Resultados Três categorias emergiram da análise temática: Desafios nos processos de prescrição e dispensação de medicamentos; Administração de medicamentos – organização no turno de trabalho; Uso de novas tecnologias para diminuir erros de medicamentos. Os resultados apontam que o processo de medicação assume um caráter de centralidade na organização do trabalho da equipe de enfermagem, sendo que estes profissionais configuram-se como a última barreira para detectar falhas de prescrição e dispensação de medicamentos. Conclusão Para a identificação de vulnerabilidades na etapa de administração de medicamentos, o uso de tecnologias, sem dúvida, agrega valor para o processo de cuidado seguro.

Objective: To analyze how nurses recognize and use quality indicators, aimed at contributing to the management of best practices in Health. Method: Case study with a qualitative approach, conducted with twelve nurses from a hospital in southern Brazil from March to May 2016. For data collection, semi-structured interviews and focus groups were used. Data were subjected to content analysis, in the thematic modality. Results: The data showed that quality indicators are regarded as a tool for measuring health care outcomes, promoting the improvement of continuous care, assisting in the clinical decision-making and being present in discussions with the nursing team, in addition to contributing to the management of best practices in Health. Final Consideration: Quality indicator may support improvements in health services and in the nursing work, strengthening health policies.

Objectives: To identify the expectations of the nursing staff in relation to the leadership of a future manager. Methods: This was an exploratory, descriptive research study, conducted in a university hospital. Data were collected by means of semi-structured interviews with 62 professionals in the field of nursing. The transcribed interviews were analyzed according to the reference of content analysis. Results: Four categories of expectations emerged from the analysis: the behavior of the future manager, working with the nursing staff, working with other teams, and the work environment. The results showed that the nursing staff is concerned with the abilities and characteristics of the future manager facing the assignments in health services. Conclusion: The nursing staff expected that the future nursing managers would have the abilities for leading a team and providing a favorable work environment. ResumoObjetivos: Identificar as expectativas da equipe de enfermagem em relação à liderança do futuro chefe. Métodos: Trata-se de pesquisa exploratória, descritiva, realizada em hospital universitário. Os dados foram coletados por meio de entrevistas semiestruturadas com 62 profissionais da área de enfermagem. Os depoimentos transcritos foram analisados de acordo com o referencial da análise de conteúdo. Resultados: Da análise emergiram quatro categorias de expectativas: comportamento do futuro chefe, trabalho com a equipe de enfermagem, trabalho com outras equipes e ambiente de trabalho. Os resultados evidenciaram que a equipe de enfermagem preocupa-se com as habilidades e características do futuro chefe frente às atribuições nos serviços de saúde. Conclusão: As equipes de enfermagem esperam que os futuros chefes de enfermagem tenham habilidades para liderar uma equipe e proporcionar um ambiente favorável ao trabalho.

The process of choosing heads can be strategic to achieve desired results in nursing care.This study presents an exploratory and descriptive research that aims to analyze the process of choosing heads for the ward, in the nursing area of a teaching hospital in Porto Alegre.Data was collected from registered nurses, technicians and nursing auxiliaries through a semi-structured interview technique and free choice of words. Three theme categories emerged from content analysis: process of choosing heads, managerial competences of the head-to-be and team articulation. Leadership was the word most frequently associated with the process of choosing heads. The consultation process for the choice of the leader also contributes to the success of the manager, as it makes the team members feel coresponsible for the results achieved and legitimizes the head-to-be in their group. Liderazgo en enfermería: análisis del proceso de elección de jefesEl proceso de elección de dirigentes se reviste de importancia estratégica para el alcance de los resultados deseados en el cuidado de enfermería. Este estudio presenta una investigación exploratoria descriptiva, con el objetivo de analizar el proceso de elección de jefes de unidad, en el área de enfermería de un hospital de enseñanza, habiendo recolectado datos con enfermeros, técnicos y auxiliares de enfermería, mediante entrevista semiestructurada y evocación libre de palabras. Del análisis de contenido, emergieron tres categorías temáticas: 1) proceso de elección de jefes, 2) competencias administrativas del futuro jefe y, 3) articulación del equipo. La palabra liderazgo fue la más frecuentemente asociada al proceso de elección de jefes. El proceso de consulta para la elección de jefes contribuye para el éxito de la administración, ya que responsabiliza a los miembros del equipo por los resultados alcanzados y otorga legitimidad al futuro jefe del grupo.Descriptores: Liderazgo; Gestión en Salud; Equipo de Enfermería; Comportamiento de Elección. IntroductionCare continuity is one of the characteristics of hospital nursing work, where professional alternate in sequential work shifts so as to guarantee continuous 24-hour care delivery to users. In this context, nursing care production results from teamwork and its dynamics goes beyond the mere addition of individual efforts. To achieve qualified care results, an equally compatible leadership standard in teamwork is fundamental. This, in turn, is driven and enhanced when a strategic and integrative coordination exists, capable of articulating collective work with a view to achieving common objectives.In this sense, unequivocal leadership skills are presupposed, which should permeated the role of head, although not all heads are leaders . Nevertheless, in organizations, expecting every head to be a leader turns into a gold standard.Besides, in the current stage of work relations, special importance has been granted to leading and 1101 www.eerp.usp.br/rlae Moura GMSS, Magalhaes AMM, Dall'agnol CM, Juchem BC, Marona DS.pro-active teams, ...

Objective: To unveil patient satisfaction attributes related to safety and quality of care. Methods: Qualitative study carried out in a public university hospital in the south region of Brazil. Data were collected in November 2018 through 24 interviews with patients/families from 12 clinical and surgical hospitalization units. Thematic analysis was carried out. Results: The satisfaction attributes were categorized in terms of structure, process, and care outcome, and they were related to: access to the service, amount of personnel, environment, interaction with the health team, staff’s technical competence, perception of safety with the presence of a relative, assistance patterns present in the care, and change in the health status of the patients. Conclusions: It was verified that the structural aspects were relevant in the patient’s experience, besides the relationship established with the health team in the care process, and the technical assistance standards perceived in the staff’s work.

Objective: To analyze the patient safety culture perceived by health professionals working in a hospital and to understand the elements influencing it. Methods: A sequential explanatory mixed methods study, conducted in 2017 in two interrelated stages in a hospital. The quantitative stage was carried out by applying the questionnaire to 618 professionals and the qualitative stage, with ten, using the focus group technique. The analysis was descriptive statistics for the quantitative data and of content for the qualitative data. Subsequently, the data were submitted to integrated analysis. Results: Of the 12 dimensions, seven were considered weak, the most critical being “non-punitive response to error” with 28.5% of positive answers. Bureaucratic, poorly designed and uncoordinated processes, regional decisions, communication failures, hierarchy, overload, punishment and judicialization were related to the perception. Conclusions: The patient safety culture was considered weak, and elements related to work organization, people management and legal risk influenced this negative perception.