Carga de trabalho de enfermagem no sistema de alojamento conjunto

Abstract

The study of time expended on nursing interventions/activities has been shown essential to identify nursing workload. Time expended on nursing assistance is the most difficult variable and not easy to be evaluated, but its knowledge allows to adjust the quantitative and qualitative factors of professionals regarding care demand granting safety to the patients and the nursing staff. Specifically, in maternity wards which adopt the rooming-in system, we consider important our concern due to lack of time values for nursing assistance in relation to the motherchild binomial. Aiming to identify the burden of work in a rooming-in unit, in a teaching hospital, a descriptive, quantitative, observational, transversal, case study was carried out. The methodology used was divided into four phases: identification of mother-child binomial, analyzing patient clinical records and through observation of activities performed by the nursing staff; classification of mother-child binomial activities, according to Nursing Intervention Classification (NIC); validation of the intervention content using workshop techniques and measuring the amount of time expended on nursing interventions adopting the work sampling technique. Fortythree nursing interventions regarding the mother-child binomial assistance were identified and validated regarding six out of the seven NIC Domains. By the work sampling technique, we obtained 4,998 interventions measured which were performed by the nurse staff of this unit. The nurses expended 39% of their time in activities regarding direct care, 43% with indirect care, 11% in personal activities and 7% in work related-activities; yet, the nursing technicians/ assistants expended 50% in direct activities, 28% in indirect activities, 18% personal activities and 4% in work related-activities. The mean time used in the mother-child binomial assistance was 5.8 hours, of which 1.4 h for nurses and 4.5h for nursing technicians/ assistants. The staff productivity reached 85%, which was considered high in relation to data stated in the literature. The Domain of the adopted taxonomy of greatest representativeness for the nursing staff was the Health System Domain, being intervention of Documentation as the most frequent. For the nursing technician/assistants, the Medicament Administration intervention was the most mentioned. When comparing time expended on interventions performed in the rooming-in with estimated time on NIC, it was observed that the mean time measured is within the interval of estimated time expended on NIC, which was found in most of the analyzed interventions. The burden of work regarding mother-child binomial, in this study, corresponded to intermediate care patients, according to Fugulin et al. ´s Patient Classification System (1994), and with the mean time of intermediated assistance preconized by the COFEN Resolution n293/4.

Distribuição do tempo de trabalho das enfermeiras em unidade de emergência

“…Analisando estes resultados frente aos estudos desenvolvidos sobre a temática, observa-se que somente duas pesquisas (3,5) evidenciaram o tempo despendido pelas enfermeiras com passagem de plantão. Assim, verifica-se que o percentual encontrado na presente pesquisa é superior ao percentual encontrado nos estudos relacionados: 7,1% (3) e 4,8% (5) .…”

“…Nessa perspectiva, a carga de trabalho é determinada por meio da identificação das intervenções requeridas pelos pacientes (cuidados diretos e indiretos) e do tempo despendido pela equipe de enfermagem, na sua realização (5) .…”

“…A literatura evidencia diversos estudos (3,(5)(6) que procuraram analisar as atividades desenvolvidas pela equipe de enfermagem e, particularmente, aquelas realizadas pelas enfermeiras, com a finalidade de avaliar o tempo de trabalho desenvolvido por esta categoria profissional, identificar a carga de trabalho e a produtividade da equipe, bem como de revisar os processos de trabalho, com vistas à otimização do tempo das enfermeiras, melhoria da qualidade e redução dos custos assistenciais.…”

Atividades de enfermagem no Centro de Material e Esterilização: subsídios para o dimensionamento de pessoal

“…Nesta perspectiva, a carga de trabalho é determinada pelas necessidades cuidativas dos pacientes, considerando os cuidados diretos e indiretos ministrados e pelo tempo despendido pela equipe de enfermagem na realização dessas intervenções (3) .…”

“…2 Supervisão das atividades realizadas na unidade. 3 Definição da escala de trabalho em cada área de atuação da equipe de enfermagem. 4 Acompanhamento da equipe na execução das atividades, principalmente os trabalhadores novos.…”