Indicadores de qualidade utilizados no gerenciamento da assistência de enfermagem hospitalar

Abstract

RESUMO: Este estudo objetivou identificar a opinião de enfermeiros sobre indicadores de qualidade da assistência de enfermagem. Trata-se de uma pesquisa descritiva, transversal, de abordagem quantitativa, realizada em quatro hospitais de média e alta complexidade do norte do Paraná, em 2012. A amostra foi composta por 64 enfermeiros que atuam na assistência de enfermagem. A coleta de dados utilizou um questionário que identificou a opinião dos participantes sobre os indicadores de qualidade no gerenciamento da assistência. Os enfermeiros atribuíram maior pertinência aos indicadores de processo e estrutura, entre eles, a incidência de úlcera por pressão, fato que pode estar relacionado à proximidade destes indicadores com a prática assistencial. Segundo os participantes, a avaliação por indicadores contribui para a elaboração de ações de educação continuada e permanente; entretanto, ocorre pouca discussão dessas informações com a equipe de enfermagem. O gerenciamento do cuidado fundamentado em avaliações por indicadores subsidia melhorias da qualidade dos serviços. Palavras-Chave: Avaliação em enfermagem; indicadores de qualidade; administração hospitalar; enfermagem.ABSTRACT: This descriptive, quantitative, cross-sectional study examined opinions of nursing care quality indicators among nurses at four secondary and tertiary hospitals in Northern Paraná State, in 2012. Sixty-four nurses who deliver health care directly participated in the study. Data were collected using a questionnaire that identified nurses' opinion of quality indicators in nursing care management. The nurses gave more importance to structure and process indicators, among them incidence of pressure ulcers, which may relate to these indicators' proximity to care activities. According to the participants, evaluation by indicators contributes to the development of permanent and continued education actions. However, this information is little discussed with the nursing teams. Care management based on assessment by indicators contributes to improving service quality.

Conhecimento de indicadores hospitalares por enfermeiros de unidades de internação

“…Esses dados mostram a diferença de serviços prestados e da complexidade do atendimento nos diferentes cenários da instituição, não necessariamente refletindo um mau ou bom desempenho, apenas evidenciando a importância de conhecer os indicadores gerados pelo serviço de saúde na fundamentação da prática profissional, uma vez que eles auxiliam no processo de análise da situação, no conhecimento do perfil da população atendida e no estabelecimento de objetivos e metas. 22 Posteriormente, ao comparar os dados dos enfermeiros formados em instituição pública com os formados em instituições privadas de ensino, podemos observar que não houve diferença estatística significante (p=0,211) em relação ao conhecimento de indicadores de saúde durante a formação acadêmica.…”

Absenteísmo, rotatividade e indicadores de qualidade do cuidado em enfermagem: estudo transversal

“…This aggravation also prolongs hospitalization stay, increases the costs of treatment and workload of the nursing team. Among the critical determinants for the origins of SI there is the intensity and the duration of the pressure over the tissues, and the tolerance of the skin and adjacent structures to support it (18) . These aspects are related to the mobility of the patient, understood as the capacity to change, keep, or sustain certain body positions; the ability to remove any pressure from regions of the skin/body to promote blood circulation; and the sensorial perception that implies in the level of consciousness, reflected in the capacity of the individual to perceive painful or uncomfortable stimuli and react, changing the position or asking for support to do it (18) .…”

“…Among the critical determinants for the origins of SI there is the intensity and the duration of the pressure over the tissues, and the tolerance of the skin and adjacent structures to support it (18) . These aspects are related to the mobility of the patient, understood as the capacity to change, keep, or sustain certain body positions; the ability to remove any pressure from regions of the skin/body to promote blood circulation; and the sensorial perception that implies in the level of consciousness, reflected in the capacity of the individual to perceive painful or uncomfortable stimuli and react, changing the position or asking for support to do it (18) . In agreement with these findings, Borghardt et al (19) classifies ICU patients as critical, as besides the clinical gravity and all the risks that intensive care involve, these patients are permanently in resting dorsal position for long periods of time, which favors the conditions to develop and worsen the injuries due to the excess of pressure over the occipital, sacral, and calcaneus regions.…”

Participatory planning and quality assessment: contributions of a nursing management technology

“…12 The use of indicators within the management sphere enables the identification of actual and potential problems and supports the implementation of effective actions, follow-up and the development of situations that are related to care tasks. 9,19,24 Quality and safety are basic components when the intention is to meet Data concerning quality indicators remained available in the electronic panel of PRAXIS®, on a dashboard alternating the display of data on a 50' TV placed in a nursing station. This system facilitates communication among the nursing and multiprofessional teams, patients as well as the patients' companions and families.…”

“…The development and validation of indicators that enable benchmarking between hospitals and other institutions is a concern for hospital service managers. 9 Current technological development has been intense, however, despite the great importance of hospital units in the delivery of care, technological innovations that contribute to the qualification of nursing management within such units are seldom implemented 1 . In this context, we highlight the University Hos-pital at the Federal University of Santa Catarina (UFSC), which holds, since 2013, a technological innovation that consists of an Inpatient Unit Management System called PRAXIS®, implemented in a pilot unit.…”