Avaliação do ambiente da prática profissional da enfermagem em instituições de saúde

Abstract

Resumo Objetiv Avaliar o ambiente hospitalar onde a enfermagem exerce sua prática comparando hospitais públicos e privados e descrever as características que receberam avaliação desfavorável (≤ 2,5 pontos) na percepção dos profissionais. Métodos Estudo comparativo e transversal realizado em cinco hospitais (dois públicos - A e B e três privados - C, D e E) de um município do interior do estado de São Paulo, com 1773 profissionais de enfermagem. Os instrumentos utilizados foram: ficha para caracterização da amostra e a versão brasileira da Practice Environment Scale. Na análise dos dados, foram utilizadas estatísticas descritivas e inferenciais. Para comparar os hospitais foi utilizado o teste Kruskall Wallis, seguido pelo pós-teste de Dunn e a regressão multinomial. Resultados Na comparação dos hospitais, os hospitais D e E alcançaram médias superiores aos demais e diferenças significantes (p<0,0001) foram obtidas com relação às cinco subescalas do instrumento utilizado. Na regressão multinomial, o hospital D obteve 5,8; o E 5,2; o C 3,0 e o A 2,7 chances de possuir um ambiente mais favorável, quando comparados ao hospital B. Os itens com nota inferior a 2,5 foram associados, especialmente, a falta de oportunidade de desenvolvimento, reconhecimento, gestão participativa e dimensionamento adequado. Conclusão Os hospitais privados apresentaram melhor desempenho quando comparados aos públicos e as características que receberam pior avaliação estavam relacionadas à participação dos enfermeiros nos assuntos hospitalares, fundamentos voltados para a qualidade, suporte dos gestores à equipe e adequação de recursos.

Nurses’ Coaching Leadership Related to Practice Environment Within Primary Health Care

“…Note that, even though the subscale "Adequate staffing and resources" obtained positive scores, both the AG (2.71) and NG (2.51) obtained low means. This finding has been reported worldwide [23][24][27][28][29] , not only because the nursing team is understaffed 30 , which leads to work overload and consequently harm work processes 1 , but also because the nurses do not have opportunities to discuss the care delivered to patients with other nurses and not infrequently, there are no services supporting them in the perform the of tasks.…”

Nursing leaders profile in a hospital service / Perfil de liderança dos enfermeiros de um serviço hospitalar

“…18 In this context, the adequate dimensioning of the professionals minimizes the workload, since the relocation of the team within the hospital institution must be consistent with the local complexities. 19 In view of this, 68 (96%) of the nurses in the total sample, assume the leadership style of "persuading" in their work process. This style gives high emphasis on the task and the relationship, is appropriate for the leader to employ with leaders with low/moderate level of maturity, who are not yet able to perform the task, but has the willingness to take responsibility and has confidence in himself, needing only be trained.…”

“…When the leader is among the low/moderate levels, as presented in the study, the leader must offer guidance and monitoring necessary for the leader to develop autonomy in his actions. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] In this sense, the styles are adopted depending on the variables of behavior: task, relationship and maturity of the nursing team. Being that the variable "task" is that the leaders adopt to organize and to define functions, to explain activities and to establish patterns; the variable of relationship is adopted to maintain personal relations, opening channels of communication between collaborators.…”

Instruments for assessing professional nursing practice environments: An integrative review

“…Although health research has already focused on the professional practice environments (1,3) for more than a decade, the appeal launched by the ICN on May 12 th , 2007, had a positive impact, culminating in the establishment of "favorable environments for the practice" as a priority program. Since in some countries there are different levels of training in Nursing, nurses, technicians and nursing assistants have been considered for the assessment of the professional practice environments (4) .…”