Consumo e custo de recursos materiais em unidades pediátricas de terapia intensiva e semi-intensiva

Abstract

Cost management of hospital material resources is a trendy research topic, especially in specialized health units. Nurses are pointed out as the main managers for costs and consumption of hospital materials resources. This study aimed to characterize Pediatric Intensive and Semi-Intensive Care Units of a teaching hospital and investigate costs and consumption of material resources used to treat patients admitted to these units. This is a descriptive exploratory study with retrospective data and quantitative approach. Data were obtained from a Hospital Information System and analyzed according to the ABC classification. The average expenditures were similar in both the neonatal and cardiac units, and lower in Pediatric Intensive and Semi-Intensive care units. There was a significant variation in the monthly consumption of materials. Higher cost materials had a greater impact on the budget of the studied units. The data revealed the importance of using a systematic method for the analysis of materials consumption and expenditure in pediatric units. They subsidize administrative and economic actions.

Dimensions of the work of the nurse in the hospital setting

“…The nurse manages the care when he plans it, delegates it or performs it, when he also interacts with the nursing team and with other professionals, occupying areas of articulation and negotiation in favor of the consecution of improvement of care (2,5,11,(16)(17)(18) , requiring from the subject the adoption of a participative attitude when interacting with the team and taking decisions, without imposing power, valuing the team work and leadership (2,5,11,17) . The harmonious organizational environments, with satisfactory professional relation which allows cooperation and trust between the management and the subordinates and subordinates among themselves, favoring the overcoming of barriers imposed by the work and the construction of strategies of defense which will allow the continuity of the productive process (19) .…”

“…The management of material resources in the assistance of nursing is an administrative process which involves the taking of decision, in the search for efficiency of the use of the available inputs, respecting both the needs of the clientele as well as the institutional purposes (20) . The nursing team is the greater user of material resources in the assistance in health and the management control of the nurse involves several measures: quantitative and qualitative determination of the material necessary to assistance, control and evaluation of the material, participation in the process of buying, assistance of the profile of consumption, process of communication stablished with the workers for the orientation of the rational use, adequacy of cost benefits of the physical areas and of the material resources (5,(10)(11)16,19) .…”

“…In this context, it is up to them to search for means to guarantee availability and quality of the material and infrastructure resources, providing the team a better performance in the assistance to situations of urgency, facing the needs of the patients, in order to conciliate the organizational objectives and the objectives of the nursing team aiming at a better quality of assistance rendered (5,(10)(11)(18)(19) .…”

“…When using the administrative knowledge and his practice, the nurse manages the unit and the care, which also involves the taking of decision, the supervision and the leadership of the nursing team (2,(10)(11)19) . So, the objects of acting of the nurse in the managerial process are the organization of the work and of the resources which are necessary to its operationalization.…”

Gestão de materiais no HCFMRP-USP: estudo de caso

“…Na instituição pública há controvérsias em relação ao estoque dos itens em dois aspectos: o tempo de aquisição devido ao processo moroso da licitação, ou seja, em função das várias etapas previstas no processo licitatório, o estoque por sua vez deverá ser maior para que não ocorra o desabastecimento em função de todos os percalços que possam ocorrer e também pelo fato de que o orçamento público é nomeado para cada tipo de emprego das aquisições, sendo custeio, medicamento, materiais permanentes, etc. Considerando que o orçamento detalha os grupos de natureza de despesa, a aquisição deverá utilizar o recurso específico, dessa forma não é possível remanejar os recursos definidos para a aquisição de medicamentos , para subsidiar a aquisição de material permanente, por exemplo , o que seria ilegal, nessa lógica o recurso deve ser consumido todo nas naturezas definidas em lei , daí talvez a controvérsia sobre os estoques na Previsão de demanda, baseando-se no histórico de consumo de cada item, analisar o comportamento do consumo de cada material e também projeções de permita suprir as necessidades de consumo, estoques menores e também facilitará o dimensionamento dos estoques suplementares, conhecidos como estoques de segurança. Redução do tempo de ressuprimento (reposição/lead time) e tempo 80% do valor, os itens B representam 30% dos itens e 15% do valor e os C representam 50% dos itens e 5% do valor (AZEVEDO NETO; SILVA, 2010).A Classificação ABC facilita ao gerenciamento dos estoques e pode ser aplicada na gestão de materiais e insumos usados nas instituições de saúde, permitindo evidenciar os materiais mais caros(ZULIANI et al, 2012). A quantidade de itens programados que correspondem a 80% do valor da programação; B: a quantidade de itens programados que correspondem de 81% a 95% do…”