Objective: to analyze the influence of workload, stress, Burnout, work satisfaction, the nursing team's perception of the care environment, and the presence of adverse events in a Trauma Intensive Care Units.Method: an observational study conducted at the Intensive Trauma Therapy Unit 195 patients were prospectively followed for the collection of incidents, and instruments were used to measure Nursing workload, stress, Burnout, job satisfaction and work environment assessment by the nursing team. Data were analyzed using appropriate statistics for the study.Results: we observed 1,586 incidents, predominantly no harm incidents (78.44%). Among the nursing staff, 77.40% had average levels of stress; 17.00% presented Burnout; 56.6% were dissatisfied and considered the environmental characteristics to be inadequate. Nursing workload was high (73.24%). An association between incident and length of stay was found. No harm incidents were associated with nursing workload. Método: estudio observacional en la Unidad de Cuidados Intensivos de Trauma. Para la recolección de los incidentes fueron seguidos prospectivamente 195 pacientes siendo utilizados instrumentos para medir la carga de trabajo de enfermería, el estrés, el Burnout, la satisfacción laboral y el trabajo de evaluación del entorno de trabajo por parte del personal de enfermería. Los datos se analizaron usando el estudio estadístico apropiado. ConclusionResultados: ocurrieron 1.586 incidentes predominantemente incidentes sin daño (78,44%). Entre el personal de enfermería, 77.40% tenían niveles medios de estrés; 17,00% mostró Burnout; y el 56,6% estaban insatisfechos y consideraron inadecuadas las características ambientales. La carga de trabajo de enfermería fue alta (73,24%). Se observó una asociación entre la incidencia y la duración de la estancia. Incidentes sin lesiones se asociaron con la carga de trabajo de enfermería.Conclusión: La identificación de factores asociados puede prevenir la aparición de incidentes. DESCRIPTORES:Seguridad del paciente. Unidades de cuidados intensivos. Carga de trabajo. Agotamiento profesional. Enfermería.
Rev Dor. São Paulo, 2011 jul-set;12(3):221-25 RESUMO JUSTIFICATIVA E OBJETIVOS: O trauma tem importância no âmbito mundial por ser uma das principais causas de morte e invalidez. A dor aguda sempre acompanha os pacientes vítimas de trauma e os profissionais da saúde têm dificuldade em identificá-la e consequentemente controlá-la. O objetivo deste foi caracterizar a percepção e as dificuldades da equipe de enfermagem frente à identificação, quantificação e manuseio da dor dos pacientes vítimas de trauma e treiná-la para sua avaliação e adequado tratamento. cientes vítima de trauma. Foi aplicado um questionário com perguntas relacionadas à caracterização dos profissionais e a maneira pela qual eles identificam, quantificam e intervêm no tratamento da dor, antes e depois de um curso de capacitação dos profissionais, no qual foram ministradas aulas que abordavam os temas contidos no questionário. RESULTADOS: A maioria dos profissionais incluídos no estudo conhecia o conceito "dor o quinto sinal vital", os instrumentos para quantificar a dor, os medicamentos utilizados no tratamento e seus efeitos adversos, porém com treinamento, o conhecimento sobre a avaliação e tratamento da dor aumentou significativamente. CONCLUSÃO: A maioria dos profissionais de enfermagem tem conhecimento insuficiente sobre a identificação, quantificação e tratamento da dor. O treinamento propiciou a sua atualização, para atuar de forma mais adequada e eficiente no controle e alívio da dor. Descritores: Dor, Medição da dor, Traumatismo múlti-plo, Unidade de terapia intensiva. MÉTODO: SUMMARY BACKGROUND AND OBJECTIVES:Trauma is globally important for being one of the major causes of death and disability. Trauma is also followed by acute pain and health professionals have difficulties to identify and control it. This study aimed at characterizing nursing teams perceptions and difficulties to identify, quantify and manage pain of trauma patients and at training the nursing team to adequately evaluate and treat it. METHOD: Prospective and quantitative study involving 51 nursing professionals working in an intensive
We evaluated the seroprevalence of SARS-CoV-2 and risk factors among 4,987 oligo/asymptomatic HCW. The seroprevalence was 14% and factors associated with being infected with SARS-CoV-2 were lower educational level(aOR of 1.93;95%CI1.03-3.60), using public transport to work (aOR of 1.65;95%CI 1.07-2.62), and working in cleaning or security (aOR of 10.1;95%CI 3.40-26.9).
Objective: To estimate the cost of nursing care required and available through the use of the Nursing Activities Score. Method: Quantitative study, direct costing of nursing care required and available in the Intensive Care Units. Data collection included variables of the patients, nursing professionals and nursing workload measured by the Nursing Activities Score. The cost of nursing care was estimated by multiplying the cost of each hour with the total number of hours of care per category. Results: The negative difference of R$ 94,791.5 between the cost of available and required nursing care indicated an increase of 3.2 nurses and 7.0 nursing technicians. Conclusion: The cost of nursing care required identified through the application of the Nursing Activities Score, which is higher than the cost of available care, indicates the need to adjust the number of professionals to meet patients' demands.
Dialysis treatment has also developed greatly, due to scientific and technological advances, and it has happened more and more frequently at ICUs.Since the advent of dialysis treatments andICUs, a steady increase in the severity of baseline diseases has been observed, which present AcuteRenal Failure (ARF) as an associated complication (1) . ARF, which affects patients hospitalized atICUs, presents a particular mortality and epidemiological profile (2) . The Brazilian Society of Nephrology (BSN) informs that these patients' mortality is close to 50% and that the condition of current patients with ARF is more severe than formerly (3) .Despite efforts and investments in the area, the mortality of patients with ARF in ICUs remains high.Renal substitution therapy is a complex procedure, demands precise equipment, specific material and duly trained professionals. It involves the multiprofessional ICU and Dialysis teams so that they can work together; because the first attends the patient directly and the later fully masters the specialty. Thus, the association between these parts is necessary in order to increase the actions' effect and save resources.The limited availability of resources is a serious problem that affects not only public hospitals, which makes it necessary to identify the costs in care delivery. CASES AND METHODThis is an exploratory, descriptive, retrospective, Thus, to calculate the nurses' labor cost in each procedure, the hour cost of R$ 22.50 was multiplied by the total hours of each procedure. Input cost calculationIn the analysis of each procedure registered on the patients' files, the quantities of material, medication and volumes of solutions used were computed and, next, this information was registered in a worksheet.Unit cost data of the inputs were obtained by consulting the Material Administration System (MCS), an internal computer system. Some medications and solutions produced in the Institutions were consulted directly at the Pharmacy Division.Three kinds of solutions can be used at the institution. Two are industrialized (peritoneal dialysis and lactate-based dialysis) and the other is prepared at the unit itself by the nurse who performs the procedure. Two kinds of solutions can be used for the anticoagulation: citrate and heparine solutions or, due to the patients' clinical condition, only washing the system with physiological solution more intensely, according to the medical prescription.Some standards were set for the charge of some inputs, for example: the infusion pump is changed every 72 hours, according to institutional routine; a piece of 20cm of wide microporous adhesive tape used was considered in the turnoff for computation, and others.After finishing the cost calculation of each of the 93 procedures in the data collection instrument, amounts were transferred to an electronic worksheet for analysis with the study variables. RESULTS Socio-Demographic and Clinical Characterization of PatientsMen predominated (62%) in the sample. The ARF diagnosis was described for 76% of t...
2006. RESUMOO procedimento dialítico em Unidade de Terapia Intensiva (UTI) tem evoluído muito nos últimos anos e exigido equipamentos precisos, materiais específicos e profissionais devidamente treinados. Tem havido um aumento progressivo desses procedimentos, sobretudo da Hemodiálise Veno-Venosa Contínua (CVVHD), o que tem gerado questionamentos, pois a limitação de recursos na área da saúde é um problema que atinge as organizações, gerando a necessidade de conhecer os custos da assistência prestada. Este trabalho teve como objetivos: caracterizar a clientela submetida ao tratamento dialítico com CVVHD em UTIs; levantar o tempo de duração dos procedimentos; calcular o custo de mão-de-obra dos enfermeiros e estimar o custo médio direto dos procedimentos. A pesquisa foi do tipo exploratória, descritiva, retrospectiva, documental com abordagem quantitativa. O estudo foi desenvolvido em um hospital-escola público no Município de São Paulo. A amostra constituiu-se de 93 procedimentos realizados em 50 pacientes. Para a coleta de dados, foi elaborado 1 instrumento com 2 partes: uma para o levantamento dos dados da clientela e duração do procedimento e outra para o levantamento e cálculo dos materiais, medicações e soluções utilizadas. Os resultados mostraram predominância do sexo masculino (62%), a idade média foi de 60,8 anos e o tempo de permanência na UTI foi em média 19,2 dias. A insuficiência renal aguda esteve presente em 76% dos pacientes e 24% apresentaram insuficiência renal crônica. Os principais motivos de internação na UTI foram: insuficiência respiratória (30%), rebaixamento do nível de consciência (18%), pós operatório (16%) e choque séptico (12%). A média de procedimentos foi de 1,9 por paciente e 86% evoluíram a óbito. A duração média foi de 26,6 horas variando de 1 a 80 horas. O custo total médio do procedimento foi de R$ 2.
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