Ambiente da prática de enfermagem em unidades de terapia intensiva

Abstract

Resumo Objetivo Analisar o ambiente da prática de enfermagem em unidades de terapia intensiva. Métodos Estudo descritivo, de abordagem quantitativa, realizado com 209 profissionais de enfermagem de três hospitais de ensino brasileiros. O ambiente da prática de enfermagem foi avaliado através da Practice Environment Scale. Os dados foram analisados descritivamente, assumindo nível de significância de 5% (p<0,05). O coeficiente Alfa de Cronbach foi utilizado para examinar a consistência interna dos construtos. Resultados Os profissionais de enfermagem consideraram desfavoráveis quatro das cinco dimensões do ambiente da prática profissional: participação dos enfermeiros na discussão dos assuntos hospitalares; fundamentos de enfermagem voltados para a qualidade do cuidado, habilidade, liderança e suporte dos coordenadores/supervisores de enfermagem aos enfermeiros/equipe de enfermagem; e adequação da equipe e de recursos. Apenas a dimensão relações colegiais entre profissionais de enfermagem e médicos apresentou avaliação positiva. Enfermeiros reconheceram mais fortemente atributos desfavoráveis no ambiente de prática do que técnicos de enfermagem. Conclusão O ambiente mostrou-se desfavorável para a prática dos profissionais de enfermagem. Esforços são necessários para tornar o ambiente de prática mais atrativo aos profissionais de enfermagem, e assim estimular melhorias na qualidade e na segurança da assistência prestada.

Nursing practice environment in intensive care unit and professional burnout

“…The relationship between nursing and doctors was favorable, both in the findings of this study and in several other national studies (6,(22)(23) . This collaboration between different professional categories in intensive care units can also be explained by the sector's own characteristics, in which the cooperation of the multiprofessional team is more required for the recovery of critically ill patients with complex care.…”

Safety in Equipment and Dressing Changes for Central Vascular Catheters: An Observational Study

“…16 Regarding the professional profile, most of them are nursing technicians, which corroborates with other studies carried out in Brazil, where the ICU nursing team, through a specific regulation, is reported as one nursing technician for every two patients, while there is one nurse for every 10 patients. 9,17 The direct observation of the professionals has shown low adherence to hand hygiene, especially before procedures, as well as low adherence to disinfection of materials, injectors and invasive devices used.…”

“…A research study, which assessed the prevention and control practices for bloodstream infection related to the CVC, showed that, unlike equipment changes, the practices related to the dressing change frequency (93.1%) and to the record of dressing exchange (91.7%) presented high rates of compliance. 17 It is assumed that, because it was performed exclusively by nurses, the dressing change obtained better compliance values, due to the higher qualification and preparation of this professional category, with regard to the care for critical patients.…”

Quality improvement programs and the professional nursing practice environment: an integrative review

“…In 2002, the NWI-R was revised generating a new version known as PES, with the same objective of evaluating the professional nurse practice environment. It consists of 31 items structured in five sub-scales: nurse participation in hospital affairs, nursing fundamentals in quality of care, nurse leadership management, adequacy of human resources in quality of care and collegiate relations between nurses and physicians (16,18,20,25) . Both NWI-R and PES assess characteristics using a Likert scale with scores from 1 to 4, but differ in the mode of evaluations: in NWI-R, averages below 2.5 indicate a favorable environment; in PES, the higher the score, the higher the favorability (24)(25) .…”