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Fonseca, Paula Isabella Marujo Nunes da. "O autoconhecimento e sua multidimensionalidade aplicada à equipes de transplantes." Universidade Federal Fluminense, 2017. https://app.uff.br/riuff/handle/1/4008.
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Doutorado Acadêmico em Ciências do Cuidado em Saúde
Estudo buscou compreender o autoconhecimento como estratégia de manutenção da saúde mental das equipes de transplantes que realizam a entrevista familiar para doação de órgãos. Para isso investigou-se a experiência emocional vivenciada na entrevista familiar em âmbito nacional (Porto Alegre, Brasil) e internacional (Porto, Portugal). Objetivo geral: propor um modelo de desenvolvimento de perspectiva de autoconhecimento baseada nos referenciais teóricos e nos desvelares promovidos pela produção de dados. Objetivos específicos: 1) promover experimentações estéticas com os coordenadores avançados em transplantes para acessar os conteúdos inconscientes presentes no processo de doação de órgãos; 2) desvelar ações de promoção em saúde mental baseadas no autoconhecimento dos coordenadores avançados em transplantes observadas nos cenários nacionais e internacionais; 3) revelar por meio da produção de dados expressivos evidenciados através da Sociopoética, novas estratégias de enfrentamento das situações difíceis; 4) analisar a repercussão das estratégias de enfrentamento delineadas para as situações de comunicação difícil no cotidiano laboral dos coordenadores avançados em transplantes. Método: Pesquisa de abordagem Sociopoética, com parte de registro em diário de participante. A maior parte dos dados foram produzidos por meio de encontros com o grupo-pesquisador em abril de 2016, e outra parte foi coleta por meio das impressões observadas e registradas de diário de campo de outubro de 2016 à janeiro de 2017. Os participantes foram os coordenadores avançados em transplantes integrantes das equipes que atuam no processo de doação de órgãos em ambos os países investigados. A análise dos dados sociopoéticos foi do tipo, classificatória, transversal e filosófica, enquanto os dados internacionais foram submetidos a análise de conteúdo. Todos os dados produzidos têm como fonte principal de interpretação a perspectiva teórica de Juan Casassus e Jean Watson. Estudo aprovado no CEP respeitando os princípios éticos de pesquisas com seres humanos. Resultados e Discussão: De acordo com os dados foi possível observar a formação de três eixos principais que foram: Autoconhecimento, relacionado ao Coordenador e relacionado às Associações Inconscientes; Estratégias de enfrentamento das situações difíceis, sobre Si Mesmo (Lidar consigo mesmo); e , Ações de Promoção à Saúde Mental. Sendo assim, foi possível estabelecer trocas de saberes, não somente sobre o processo duro, quase aristocrático da doação, mas de saberes outros, socialmente construídos (FREIRE, 2002), muito relacionados ao seio familiar como os que envolvem valores, sentimentos, sensações, medos, inseguranças, que são trivialmente recalcados à turbulência existencial humana. Considerações Finais: Os coordenadores avançados em transplantes iniciaram o movimento de autoconhecimento ao fazerem associações de situações vivenciadas no processo de doação de órgãos com elementos do inconsciente tornando-os acessíveis ao nível consciente, em sequência, ao identificarem o desvelar de suas emoções e as representarem em situações ocorridas frequentemente, conseguiram observar que é preciso se posicionarem mais em relação a si mesmos, e se questionarem como estão enfrentando seus conflitos, aplicando tais conhecimentos na prática, de modo a se reorganizarem e a lidarem melhor com as situações difíceis concernentes a entrevista familiar para doação de órgãos
This study aimed to understand self-knowledge as a strategy for the maintenance of mental health of the transplant teams that perform in family interview for donation of organs. For that, the emotional experience experienced in the family interview at Porto Alegre, Brazil and at Porto, Portugal interviews was investigated. General objective: to propose a model of development of a perspective of self-knowledge based on the theoretical references and on the disclosures promoted by the production of data. Specific objectives: 1) to promote aesthetic experiments with the advanced coordinators in transplants to access the unconscious contents present in the process of organ donation; 2) unveil mental health promotion actions based on the self-knowledge of advanced transplant coordinators observed in national and international settings; 3) to reveal, through the production of expressive data evidenced through Sociopoetics, new strategies for coping with difficult situations; 4) to analyze the repercussion of coping strategies outlined for communication of difficult situations in the daily work of the advanced transplant coordinators.Method: Sociopoetic approach research, with onde part registered in field journal. Most of the data were produced through meetings with the researcher group in April 2016, and another part was collected through observed impressions and wsa registered in a field journal from October 2016 to January 2017. Participants were the Advanced coordinators in transplantation of the teams that work in the process of donating organs in both countries investigated. The analysis of sociopoetical data was of the type, classificatory, transversal and philosophical, while international data were submitted to content analysis. All the data produced have as main source of interpretation the theoretical perspective of Juan Casassus and Jean Watson. Study approved in the CEP respecting the ethical principles of researches with human beings. Results and Discussion: According to the data it was possible to observe the formation of three main axes that were: Self-knowledge, related to the Coordinator and related to the Unconscious Associations; Strategies to cope with difficult situations, about Self (Dealing with oneself); And, Actions to Promote Mental Health. Thus, it was possible to establish exchanges of knowledge, not only about the hard, almost aristocratic process of donation, but also about other socially constructed knowledges (FREIRE, 2002), which are closely related to the family as those involving values, feelings, Fears, insecurities, which are trivially repressed by human existential turbulence. Final Considerations: Advanced transplant coordinators initiated the self-knowledge movement by making associations of situations experienced in the process of organ donation with elements of the unconscious making them accessible to the conscious level in sequence by identifying the unveiling of their emotions and representing them in situations that have occurred frequently, have been able to observe that they need to position themselves more in relation to themselves, and question how they are facing their conflicts, applying such knowledge in practice, in order to reorganize themselves and to deal better with the difficult situations concerning the interview for organ donation
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Phillips, Martha A. "Improving the Transition of Care for Psychiatric Patients Moving from Inpatient to Outpatient Psychiatric Healthcare Settings." Thesis, University of Louisiana at Lafayette, 2019. http://pqdtopen.proquest.com/#viewpdf?dispub=10815412.
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Abstract The aim of this quality improvement (QI) project was to explore whether the implementation of an enhanced telephone reminder system improved the rate of attendance at initial follow-up appointment and medication adherence. A total of 86 patients, discharged from inpatient psychiatric units with a follow-up within 7 days of discharge, were eligible to receive the enhanced telephone contact reminder and follow-up text. A preliminary retrospective chart review was conducted to collect historical data on medication and attendance adherence. A prospective interventional design was used to implement the QI project. Patients received telephone contact within 24-72 hours of discharge and text message reminder strategies. A medication adherence assessment was completed at telephone contact and at initial follow-up appointment. An analysis of the data examined the impact of the TCM strategy on patient?s rate of adherence to medication and initial follow-up appointments. Descriptive analysis assessed the frequency of medication adherence in retrospective and implementation data. Inferential statistics analyzed factors of association such as prior clinic services and rate of attendance at follow-up appointment. In the retrospective chart review (n=57), data revealed a 28% attendance rate and an 81% medication adherence at the follow-up appointment, with no statistical difference in a 145 history of prior series on attendance. Implementation data on medication adherence at telephone contact and at first follow-up appointment revealed a 61.5% medication adherence rate at telephone contact and 80% adherence rate at first follow-up appointment. The predictor value of a prior history of service on attendance at first follow-up appointment revealed no statistically significant difference. The project, however, resulted in clinically significant benefits that promoted individual patients? medication-taking behaviors and decisions to attend follow-up appointments, and improved clinical practices at the BHC.
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Davies, Lesley. "Vicarious traumatization : the impact of nursing upon nurses : a thesis submitted to the Victoria University of Wellington in partial fulfilment of the requirements for the degree of Master of Nursing (Clinical) /." ResearchArchive@Victoria e-thesis, 2009. http://hdl.handle.net/10063/1227.
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Kwandt, Joanne. "The use of humor to relieve stress in psychiatric nurses." W&M ScholarWorks, 1992. https://scholarworks.wm.edu/etd/1539618879.
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The purpose of this study was to investigate the effectiveness of humor as a coping mechanism to relieve work stress of psychiatric registered nurses (RNs).;The population was selected from 31 volunteer RNs who worked thirty-two to forty hours a week in psychiatric hospitals in the Norfolk-Tidewater-Williamsburg-Richmond areas of Virginia. The RNs completed three pretest self-report measurements on stress. The Social Readiness Rating Scale (SRRS) was given to assess preexisting life stress. The Work Environment Scale (WES), and the Psychiatric Nurses' Occupational Stress Scales (PNOSS) were given to measure for pre-treatment work stress.;The RNs were then randomly assigned to one of three workshop groups. The treatment groups had workshops on the use of humor or an alternative coping skill (progressive relaxation) to relieve environmental stress. The control group workshop was on the use of neurological assessment. Each workshop lasted three hours. The first segment taught the basic theory and introduced the skill. The second segment taught the RNs how to use what they learned. The third segment allowed the RNs to practice their new tool. All RNs in all the groups were encouraged to practice their new skills within the hospital environment. The progressive relaxation RNs had a relaxation tape and tape recorder available to use on breaks.;Six weeks after the workshops, the RNs were mailed a packet containing a certificate stating they attended the workshop and two self-report measurements on the WES and PNOSS which were completed and returned to the researcher.;The pretest and posttest measurements were scored by hand. Descriptive statistics were used to measure the central tendency or average and the amount of dispersion or spread. The hypotheses were analyzed by one-way analysis of covariance.;The findings were not significant to the p {dollar}>{dollar} =.05 confidence level. With the particular sample population and the groups, it was concluded that the treatment was not successful in reducing work stress or occupational stress or in changing attitudes in the workplace. However, the study indicates that with a greater sample size and more specificity concerning what work stress is to be measured, significant findings are possible.
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Murtagh, Lynley. "The impacts of working with people experiencing suicidal ideation : mental health nurses describe their experience : a thesis submitted to the Victoria University of Wellington in partial fulfilment of the requirements for the degree of Master of Arts (Applied) in Nursing /." Researcharchive @Victoria, 2008. http://hdl.handle.net/10063/881.
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Myers, Beverly J. "Organizational support, perceived social support, and intent to turnover among psychiatric nurses a mixed methods study /." Thesis, Birmingham, Ala. : University of Alabama at Birmingham, 2010. https://www.mhsl.uab.edu/dt/2010p/myers.pdf.
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Bock, Theresa Melodie. "Assessment of attitudes related to the management of aggression and violence in four psychiatric hospitals." Thesis, Stellenbosch : University of Stellenbosch, 2011. http://hdl.handle.net/10019.1/6835.
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Thesis (MCur)--University of Stellenbosch, 2011.ENGLISH ABSTRACT: The aim of this descriptive survey was to investigate the attitudes of mental health care providers with regards to the management of aggression and violence. The absence of scientific data describing the attitudes of nurses towards the management of aggression and violence motivated the researcher to conduct this study. The researcher undertook a descriptive survey to describe the attitudes of nurses towards the management of aggression and violence. The management of aggression and violence attitude scale (MAVAS) was administered to N92 nurses with different qualifications these nurses are employed in the acute admission units of four psychiatric hospitals in a province in South Africa. The results showed no significant differences in attitudes between the different categories of nurses in most of the questions. Enough evidence was gathered that indicated, compared to trained staff, staff without a qualification in psychiatric nursing science had found it difficult to calm patients down, had not understood the effect of the environment on a patient, had felt that patients should control their feelings and had lacked the perception of trained nurses, with regards to the effect of negotiation and poor communication on violent and aggressive mental healthcare users. These findings can make significant contributions towards the implementation of training programmes and policies to assist staff to deal with patient related aggression and violence. Furthermore the data generated can contribute towards future research in this field with subsequent expansion of skills programmes.
AFRIKAANSE OPSOMMING: Die doelstelling van hierdie navorsings studie was om die houding van psigiatriese gesondheidsdiens voorsieners ten opsigte van die hantering van aggresie en geweld te bepaal. Die afwesigheid van wetenskaplik gefundeerde data het die navorser genoop om hierdie studie te onderneem. Die navorser het derhalwe ʼn beskrywende studie gedoen om die houding van verpleegsters ten opsigte van die hantering van aggressie en geweld te bepaal. Die “management of aggression and violence attitude scale” (MAVAS) is deur N92 verpleegsters met verskillende kwalifikasies voltooi. Hierdie verpleegsters is indiens van vier verskillende psigiatriese hospitale in ʼn provinsie in Suid- Afrika. Die verpleegsters werk in die akute opname eenhede van die onderskeie hospitale. Die resultate het geen noemenswaardige verskille tussen die onderskeie kategorieë verpleegsters se houding teenoor die hantering van aggressie en eweld aangedui nie. Genoegsame bewys is ingesamel wat aandui; dat in vergelyking met opgeleide personeel, personeel sonder ʼn kwalifikasie in psigiatriese verpleeg wetenskappe, dit moeiliker vind om pasiënte te kalmeer, nie verstaan watter effek die omgewing op ʼn pasiënt het nie. Dié kategorieë voel pasiënte moet hul gevoellens beheer en het ook nie dieselfde persepsie ten opsigte van die effek van onderhandeling en swak kommunikasie op aggressiewe en geweldadige psigiatriese gesondheids diens verbruikers as hul kollegas nie. Hierdie bevindings is ʼn belangrike bydrae ten opsigte van die implementering van opleidings programme en beleid ten einde personeel te ondersteun om pasiënt verwante aggressie en geweld te hanteer. Die nuwe data gegenereer deur dié navorsings studie kan bydra tot toekomstige navorsing in hierdie veld asook gevolglike uitbreiding van vaardigheids programme.
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Butterworth, Charles A. "Psychiatric nursing in the community: the application of new technologies to an organization in transition." Thesis, Aston University, 1986. http://publications.aston.ac.uk/12158/.
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MaGee-Rodgers, Tamiko R. "Character Strengths of Nursing Home Administrators Who Lead Exemplary Long-Term Care." Thesis, Indiana Wesleyan University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10930255.
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The growth in the older adult population will result in an increasing number of individuals with functional and cognitive limitations. The demand for nursing home administrators will grow proportionately with the aging population and the need for effective leadership within nursing homes is and will continue to be imperative as the population ages. Identifying top-rated nursing homes that provide quality care is essential to understanding the operations of successful long-term care facilities. Nursing home administrators (NHAs) are tasked with leading and directing provision of skilled, intermediate and rehabilitation care on a 24-hour basis while ensuring high quality operations. Identifying the character strengths of nursing home administrators who lead exemplary nursing homes may benefit other nursing home leaders who lead lower rated or underperforming facilities. In this qualitative study, 19 nursing home administrators who lead exemplary facilities across Indiana completed the Value in Action Inventory Strengths (VIA-IS) questionnaire and engaged in face-to-face interviews. Analysis of the interview data via NVivo indicated how the use of character strengths is crucial to effective leadership within long-term care. Creativity, fairness, bravery, perspective, and judgment were identified by a majority of study participants as essential to decisionmaking and problem solving, especially in a heavily regulated environment. Humor, hope, courage, and spirituality were acknowledged as contributing to a positive and optimistic environment. Humor, hope, courage, and spirituality were also noted as coping mechanisms when faced with stress and adversity. Honesty, kindness, love, teamwork, and gratitude were emphasized by the study participants as essential to relationship development and formation of trust with staff, residents, and families. This study allowed participants the opportunity to reflect on their own character strengths and leadership both personally and professionally. This reflection resulted in increased self-awareness and appreciation of their staff, residents, and roles as nursing home administrators.
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Harris, Iesiah M. "Evaluating directors of nursing| Self-perceptions on leadership, job satisfaction, and personnel retention." Thesis, Capella University, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3601086.
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Leaders within the long-term care industry face a myriad of challenges as the U.S. population ages at exponential rates. Long term care is an industry that requires strong, well-developed leaders; yet, while Directors of Nursing (DONs) are viewed as key leaders in the long term care setting, few studies have focused on their leadership styles. The goal of this quantitative, non-experimental research was to determine if a relationship existed between leadership styles, personnel retention, and job satisfaction. Based on findings from this study, the `PST2 Leadership Model' was developed. This model is unique as it conceptualized various leadership theories and offers suggestions for implementation of specific leadership styles. This model may prove useful as an important teaching instrument within the long term care arena. As healthcare leaders and stakeholders continue to evaluate salient matters within the long term care community, it is prudent to utilize research such as this and comparable studies to guide the decision making process as this evidence may contribute to the viability of a challenged long term care system.
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Fransson, Sellgren Stina. "Nursing management at a Swedish University hospital : leadership and staff turnover /." Stockholm : Karolinska institutet, 2007. http://diss.kib.ki.se/2007/978-91-7357-330-6/.
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Palm, Bonita. "Gungstolsterapi – en omvårdnadsåtgärd i psykiatrisk heldygnsvård : En stol som berör." Thesis, Röda Korsets Högskola, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-2537.
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Bakgrund: Gungstolsterapi som omvårdnadsåtgärd är outforskat inom den psykiatriska heldygnsvården. Vetenskapliga studier av den typ av gungstol som här studerats har inte gått att hitta. Syfte: Syftet med studien var att utvärdera gungstolsterapi som omvårdnadsåtgärd vid en psykiatrisk heldygnsvårdsavdelning. Metod: En naturalistisk studie med både kvantitativa och kvalitativa inslag genomfördes. Under studieperioden fick patienter som vårdades på en psykiatrisk heldygnsvårdsavdelning lämna självskattningar på en VAS-skala avseende sitt mående före och efter genomförd gungstolsterapi. Patienterna kunde också lämna en skriftlig kommentar om gungningen. Resultat: Resultatet visar att deltagarna skattat en genomsnittlig förbättring motsvarande 16%-enheter i sitt generella mående efter genomförd gungning. Genomsnittliga gungtid var 33 min/gungtillfälle. Majoriteten av patienterna som deltog i studien har bipolär sjukdom. Många deltagare föredrog att gunga en viss del av dygnet. Innehållsanalysen av kommentarerna ledde till att fem kategorier bildades som sammanfattades i temat "En stol som berör". Den genomförda studien visar att patienterna generellt sett upplevde ett ökat välbefinnande efter gungstolsterapin. Studien visar också att inga allvarliga händelser inträffat vid användningen av gungstolen. Resultatet i de båda delarna av studien harmonierar väl med varandra. Slutsats: Studien ger underlag att rekommendera patienter gungstolsterapi för att förbättra sitt mående eller i symtomlindrande syfte. Genomgången visar att många patienter har individuella preferenser för sitt gungande. Gungstolsterapi bör ses som en hälsofrämjande egenvårdsåtgärd som patienten kan utföra dygnet runt och som kan läggas in i patientens vårdplan.Background: Rocking chair therapy has been poorly researched. There are no scientific research studies where the current rocking chair was evaluated. Aim: The aim of the study was to evaluate rocking chair therapy as a nursing intervention in an inpatient psychiatric setting. Method: A mixed method design, combining quantitative and qualitative approaches, was used. The participants were asked to rate their well-being in a form by using a Visual Analogue Scale (VAS) before and after rocking chair therapy. Participants also had the possibility to leave free text comments in the form. Results: The participants rated a 16% increase in their well-being after using the rocking chair. The average rocking time was 33 minutes. The majority of the participants are diagnosed with bipolar disorder. Many participants preferred to use the rocking chair during a specific time frame every day. The content analysis resulted in five categories and the underlying meaning could be expressed by the theme "Moving emotions". No adverse effects were recorded during the study. Both the quantitative and qualitative analysis show positive results and there are no contradictions in the results. Conclusion: This study support the mental health nurse to recommend psychiatric patients to try rocking chair therapy as a way to increase well-being or reduce distress, it is also a method well suited for self-management. Each patient has his/her own preferences for using rocking chair therapy. The use of rocking chair therapy can easily be included in the patient’s personal care plan.
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Hedlund, Mathilde. "Coping, Psychiatric Morbidity and Perceived Care in Patients with Aneurysmal Subarachnoid Haemorrhage." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ-bibl. [distributör], 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-109761.
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Rice, Judy A. "Managing Difficult Students in the Classroom." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/7627.
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Sekatane, Patricia Thato. "A protocol for professional nurses regarding the management of nurse initiated management of antiretroviral therapy (NIMART) in the Ehlanzeni District, Mphumalanga Province, South Africa." Thesis, University of Limpopo, 2014. http://hdl.handle.net/10386/1377.
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Thesis (M.Cur.) -- University of Limpopo, 2014The purpose of the study was to develop protocol for professional nurses regarding NIMART management that is based on data and specific challenges that are faced in the Ehlanzeni district by professional nurses. A quantitative, descriptive and cross-sectional research design was used for this study. The population consisted of all professional nurses who are NIMART trained, managing and initiating patients on ARV’s at primary health care clinics. Systematic random sampling method was used to select 135 respondents. Data was collected through the self-developed questionnaire. The questionnaire was pre tested. Reliability was ensured through self-administered questionnaire and with the guide of literature review. The questionnaire was also pre tested by conducting a pilot study. Validity was ensured through undertaking extensive literature review, giving operational definitions of concepts, questionnaires were given to supervisors, questions constructed according to the objectives of the study and congruence was ensured between research questions, objectives, findings and recommendations. Data analysis was done through descriptive studies, using SPSS statistics 21.0 programme of data analysis with the assistance of the statistician. The findings indicate that challenges faced by professional nurses regarding nurse initiated and management of antiretroviral therapy are be lack of professional nurses, fear of infecting themselves while treating HIV positive patients, patients do not come on their return dates, encountering problems when they trace defaulters and shortage of retroviral drugs. The study recommends that staff shortage should be addressed, medicine supply should be monitored, a competent HIV trained doctor should be appointed and dedicated outreach team should be appointed. Keywords: NIM-ART, HIV/AIDS, Professional nurse
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Crawford, H., and Jean Croce Hemphill. "Bridging the Gap in Care Transitions by Implementing an Electronic Homeless Resource Toolkit for Case Management Personnel: Hospital to Community." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/7574.
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Schröder, Agneta. "Quality of care in the psychiatric setting : perspectives of the patient, next of kin and care staff /." Linköping : Linköping University, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-8044.
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Shum, Wai-man, and 沈慧文. "Assessing the effectiveness of the human resources management for nursing staff of the Hospital Authority in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B46759773.
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Haines, Fiona Imelda. "Error management in nursing amongst registered nurses working in a tertiary hospital in Saudi Arabia." Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/80226.
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Thesis (MCurr)--Stellenbosch University, 2013.ENGLISH ABSTRACT: Healthcare organizations have implemented numerous safety initiatives to address errors due to the impact on the patient, families, healthcare provider and the organization as highlighted in the Institute of Medicine report. However, error identification, reporting and management remain a challenge. Nurses have been identified as the healthcare provider with the greatest potential for errors. Supportive work environments are needed to provide optimal care to the nurse who makes an error; which may be minor to severe repercussions. The patient is identified as the first victim and the nurse who makes the error as the second victim. How nurse errors are reported, managed and disclosed is dependent on the response of leaders and peers which may be in a shame and blame or just culture approach. The aim of the study was to assess error management in nursing amongst registered nurses working in a tertiary hospital in Saudi Arabia. The objectives were to identify the occurrence of nursing related errors, determine the current process of reporting nursing errors, describe the management of nursing errors and explore the factors impacting on the management of nursing errors. The research methodology for this study was a descriptive, quantitative approach which is applicable when exploring the unknown. Ethical approval was obtained from the Ethics Board, University of Stellenbosch and the Institutional Review Board, King Faisal Specialist Hospital and Research Centre (General Organization) -Jeddah (KFSH&RC-J). The population was registered nurses working in KFSH&RC-J and assigned to the job descriptions of Staff Nurse 1&2, Clinical Nurse Coordinators and Assistant/Head nurses. Sample was selected using proportional allocation for nationality and simple random selection for nursing specialty; 215 RNs from these three groups. Data was collected using a questionnaire developed by the researcher and analysis completed using SPSS and regression analysis to identify factors which influences the reporting and management of errors. Data was presented in the form of frequency tables and graphs using the EXCEL program to analyze the data. The main findings of the study; there was significant difference in nurse leaders and professional nurses ability to identify nursing errors; questioning of the practice of peers, views of a non-punitive environment and the ability to differentiate between error and negligence. The nurse executive was positively associated with the average positive responses received. RNs of Middle Eastern nationality and the Adult nursing division were found to be slightly more negative in their perceptions about error reporting and management than other respondents. Improvements are needed in the processes of error reporting and management which include education; leadership development, underreporting of errors, feedback and communication, nurse manager support and disclosure of errors. Recommendations are the implementation of the Just Culture principles within the organization and leadership development to address error reporting and management. The need to develop a national database for error reporting in Saudi Arabia is recommended. Nursing errors occurred in one tertiary hospital in Saudi Arabia and an on-line system is available to report errors. However, nurses do not report errors as they fear being blamed and shamed. The process of error management within the organization has not been clearly defined.
AFRIKAANSE OPSOMMING: Gesondheidsorganisasies het talle veiligheids inisiatiewe geïmplementeer om foute aan te spreek weens die invloed wat dit het op die pasiënt, families, die gesondheidsverskaffer en die organisasie soos uitgelig in die Mediese Verslag van die Instituut. Nietemin, die identifisering van foute, verslaggewing en bestuur bly ’n uitdaging. Verpleegsters is geïdentifiseer as die gesondheidsverskaffers wat oor die grootste potensiaal beskik om foute te begaan. Ondersteunende werkomgewings word benodig om optimale sorg aan die verpleegster te verskaf wat ’n fout van ’n mindere aard tot die met ernstige gevolge begaan. Die pasiënt word geïdentifiseer as die eerste slagoffer en die verpleegster wat die fout begaan as die tweede slagoffer. Die manier hoedat verpleegfoute gerapporteer, bestuur en openbaar gemaak word, is afhanklik van die reaksies van leiers en portuurgroepe wat ’n skaamte- en blameerbenadering of “just culture”-benadering kan wees. Die doel van die studie was om die hantering van verpleegfoute tussen geregistreerde vepleegkundiges wat in n tersiêre hospital in Saudi werk te ondersoek. Die doelwitte is om die voorkoms van verpleegverwante foute te identifiseer, die huidige proses van verslaggewing van verpleegfoute te bepaal, die bestuur van verpleegfoute te beskryf en die faktore te ondersoek wat ’n impak het op die bestuur van verpleegfoute. Die navorsingsmetodologie vir hierdie studie is ’n beskrywende, kwantitatiewe benadering wat van toepassing is wanneer die onbekende ondersoek word. Etiese goedkeuring is verkry van die Etiese Raad aan die Universiteit Stellenbosch en die Institusionele Beoordelingsraad, King Faisal Specialist Hospitaal en Navorsingssentrum (Algemene Organisasie) – Jeddah (KFSH & RC-J). Die teikengroep is geregistreerde verpleegsters wat werk in KFSH & RC-J aan wie die posbeskrywing van stafverpleegster 1 & 2 toegeken is, Kliniese Verpleegkoördineerders en Assistent/Hoofverpleegsters. Die steekproef is geselekteer deur gebruik te maak van proporsionele toekenning vir nasionaliteit en ’n eenvoudige ewekansige steekproef vir verpleegspesialiteit; 215 geregistreerde verpleegsters van hierdie drie groepe. Data is gekollekteer deur gebruik te maak van ’n vraelys wat deur die navorser ontwikkel is en die analise is voltooi deur gebruik te maak van SPSS en regressie-analise om faktore te identifiseer wat verslaggewing en bestuur van foute beïnvloed. Data is aangebied in die vorm van frekwensie-tabelle en grafieke deur gebruik te maak van die EXCEL-program om die data te analiseer. Die vernaamste bevindinge van die studie is dat daar beduidende verskille tussen verpleegleiers en professionele verpleegsters se vermoë is om verpleegfoute te identifiseer; bevraagtekening van die praktyke van portuurgroepe; beskouinge van nie-strafgerigte omgewing en die vermoë om te onderskei tussen foute en nalatigheid. Die verpleegeksekuteur is positief geassosieer met die gemiddelde positiewe response wat ontvang is. Geregistreerde verpleegsters van Midde-Oostelike nasionaliteit en die Volwasse Verpleegafdeling is gevind om effens meer negatief te wees in hulle persepsies van fouteverslaggewing en bestuur, as ander respondente. Verbeterings is nodig in die prosesse van verslaggewing van foute en bestuur daarvan wat opvoeding daarvan insluit; leierskapontwikkeling, onderverslaggewing van foute, terugvoer en kommunikasie, ondersteuning van verpleegbestuur en bekendmaking van foute. Aanbevelings is die implementering van die “Just”-kultuur beginsels binne die organisasie en leierskap ontwikkeling om die verslag van foute en bestuur aan te spreek. Die behoefte om ’n nasionale databasis te ontwikkel vir die verslag van foute in Saoedi-Arabië word aanbeveel. Verpleegfoute het in een tersiêre hospitaal in Saoedi-Arabië plaasgevind en ’n aanlyn sisteem is beskikbaar gestel om foute te rapporteer. Nietemin, verpleegsters rapporteer nie foute nie, want hulle vrees om geblameer te word en beskaamd te staan. Hierdie proses van foutebestuur binne die organisasie is nog nie duidelik gedefinieer nie.
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Crouse, Marlene. "Satisfaction and importance of job communication and interpersonal relationships among nurses and first-line supervisors." Virtual Press, 1996. http://liblink.bsu.edu/uhtbin/catkey/1036195.
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Job-communication satisfaction and its importance to nursing staff and first-line supervisors is important because people in complex health care delivery systems tend to dehumanize communication (Duldt, 1989, 1990b). The purpose of the study is to determine the level of satisfaction first-line supervisors and staff nurses have of job-communication and interpersonal relationships, and the degree of importance staff members and first-line supervisors place on job-communication and interpersonal relationships within a mid-sized acute care facility in an urban area. The theoretical framework is Duldt's Humanistic Nursing Communication Theory (Hersey & Duldt, 1989).The population was all staff nurses and first-line supervisors employed in inpatient services at a midwest hospital. The sample was comprised of about 231 registered nurses and 61% first-line supervisors who volunteered to answer the Job-Communication Satisfaction Importance Questionnaire (JCSI). The JCSI was developed by B. W. Duldt (1990) based on the work of Downs, Hazen, and Thiry as cited in Duldt (1990a). The procedures for the protection of human subjects were followed.Findings revealed that supervisors and staff nurses were satisfied with aspects of job-communication. Supervisors and staff nurses rated six of the eight topics on the JCSI as important aspects of job-communication. Aspects of job-communication and interpersonal relationships were important to supervisors and staff nurses in the facility studied.The conclusions from the study were: (a) satisfaction with job-communication and interpersonal relationships can be improved, (b) aspects of job-communication and interpersonal relationships identified in the study were important to supervisors and staff nurses. Nursing supervisors are in key positions to influence job -communication satisfaction. Organizations undergoing rapid changes need to develop and maintain communication which is satisfactory to human beings working in the organization.School of Nursing
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Magana, Grace Wanjeri. "Contextual factors influencing the turnover of nurses in specified intensive care units in the Cape Metropole." Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/80149.
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Thesis (MCurr)--Stellenbosch University, 2013.ENGLISH ABSTRACT: The shortage of nurses in the intensive care units (ICU) affects both the nurse and the patient with regard to quality care and the quality of work life. Job satisfaction as well as factors within the organisation and work environment predisposes dissatisfaction. Identifying these factors may improve the quality of life at work and reduce staff shortages. The aim of this study is to evaluate the contextual factors influencing the turnover of intensive care nurses in specified hospitals in the Cape Metropole. The objectives were: • To determine the factors influencing the turnover of intensive care nurses in specified hospitals in the Cape Metropole. • To compare the findings of the data in the specified hospitals. An explorative, descriptive design with a quantitative approach has been applied. The research sample consists of all nurses working in the intensive care units in the specified hospitals at the time of the study. A convenience sampling was applied. A structured questionnaire containing predominantly closed-ended questions was used and data collection was conducted by the researcher herself. A pilot study consisting of 10% (N=21) of the sample was done in one of the hospitals to validate the reliability of the questionnaire. The 21 participants who completed the pilot test did not participate in the actual study. The reliability and validity of the findings was assured by the utilization of the statistician and experts in the nursing department. The data is presented in tables and histograms. A Chi -square test is used to test the statistical significance association between variables. Spearman’s ranks (rho) order correlation is used to show the strength of the relationship between two continuous variables. The findings of the study show that discontent with salaries, inferior working environments, organisational factors, physical as well as emotional stress and the lack of career development opportunities, were major determinants in the poor quality of life at work with regard to the two set objectives. Recommendations include those for better remuneration, improved career opportunities and the creation of a safe as well as a friendly work environment. The aim is to create a positive work environment and improve the quality of life at work.
AFRIKAANSE OPSOMMING: ’n Tekort aan verpleegsters in die intensiewesorgeenheid beïnvloed beide die verpleegster en die pasient sovêr dit die gehalte van sorg lewering en die kwaliteit van arbeidservarings in die werkplek betref. Werkstevredenheid, sowel as faktore binne die organisasie en omgewingsfaktore in die werkplek, is aanleidend tot ontevredenheid binne die organisasie. Deur hierdie faktore te identifiseer, mag die kwaliteit van werkslewe verbeter word en die verlies aan personeel verminder word. Die doel van hierdie studie is om die kontekstuele faktore wat die personeel omset van intensiewesorgverpleegsters in spesifieke hospitale in die Kaapse Metropool beïnvloed, te evalueer. Die doelwitte was: • Om die faktore wat die omset van intensiewesorgverpleegsters in spesifieke hospitale in die Kaapse metropool beinvloed, te bepaal • Om die bevindinge van die studie binne verskeiehospitale te vergelyk Om hierdie navorsingsvrae te beantwoord, is ’n verkennende en beskrywende ontwerp met ’n kwantitatiewe benadering aangewend. Die steekproef het bestaan uit alle verpleegspersoneel werksaam in die intensiewesorg-eenhede in die gespesifiseerde hospitale binne die studie vermeld . ’n Gerieflikheids-steekproef is uitgevoer. ‘n Goedgestruktueerde vraelys met hoofsaaklik geslote vrae is gebruik vir datainsameling en vraelyste was persoonlik deur die navorser ingeneem. ’n Loodsstudie wat 10% van die steekproef beslaan, (N= 21), is in een van die hospitale onderneem om sodoende die betroubaarheid van die vraelys te bevestig. Die 21 deelnemers was nie deel van die werklike studie nie. Die betroubaarheid en geldigheid van die betrokke studie is bevestig deur die statistikus en kenners in die verplegingsdepartement van sodanige inrigting. Data is voorgelê in die vorm van tabelle en histogramme. ’n Chi-vierkanttoets is gebruik om die statistiese-beduidends verwantskap tussen veranderlikes te toets. Spearman se rangorde (rho) korrelasie is gebruik om die sterkte van die verhouding tussen twee aaneenlopende veranderlikes aan te dui. Die bevindinge dui aan dat ontevredenheid oor salarisse, ‘n swak werksomgewing en organisatoriese faktore, sowel as fisiese en emosionele stres, asook ’n gebrek aan loopbaanontwikkeling, groot bepalers was van swak werkskwaliteit in terme van die twee voorgestelde doelwitte. Aanbevelings bestaan uit voorstelle vir beter salarisse, die skepping van loopbaangeleenthede en die daarstelling van ’n veilige, vriendelike, werksomgewing. Die doel is om ’n positiewe werksomgewing te skep en om die kwaliteit van werkslewe te verbeter.
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Tuswa, Bulelwa Martha. "Experiences of professional nurses working in rural primary health care clinics regarding the nursing management of mentally ill clients in the Eastern Cape." Thesis, Nelson Mandela Metropolitan University, 2016. http://hdl.handle.net/10948/18507.
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In South Africa, mental health care is being integrated into primary health care services. The integration of services was aimed at increasing the accessibility and availability of all health care services at primary health care level. The integration was well intentioned, and it was hoped that mentally ill clients would benefit from having a service near their homes. However, the process of integration is fraught with challenges, for instance, staff shortages, which lead to ineffective nursing management of mentally ill clients at the primary health care clinics. As a result, one professional nurse is often allocated to manage the clinic services on a daily basis with the assistance of an enrolled nurse or auxiliary nurse. The professional nurses therefore experience high levels of stress due to gross staff shortages and lack of time to conduct proper nursing assessments. This led to the research question: “What are the experiences of professional nurses with regards to the nursing management of mentally ill clients in rural primary health care clinics in the O.R. Tambo District in the Eastern Cape?’’ The proposed objectives of the study were to explore and describe the experiences of professional nurses working in rural primary health care clinics with regard to the nursing management of mentally ill clients. The researcher thereafter made recommendations to the district managers regarding effective nursing management of mentally ill clients in rural primary health care clinics. A qualitative, exploratory, descriptive and contextual design was used. The research population comprised of professional nurses working in rural primary health care clinics in the O.R. Tambo District in the Eastern Cape. Purposive sampling was used to identify participants and the sample number was determined by data saturation. Unstructured interviews and observation notes were used to collect data. The eight steps of data analysis suggested by Tesch were utilized to analyze the data. The researcher conducted an in-depth literature review in order to identify research gaps pertaining to the study. To ensure that a high level of validity and reliability was exercised throughout the study, the researcher conformed to Lincoln and Guba’s model of trustworthiness. The study was conducted in an ethical manner and ethical principles were adhered to. Findings: Three themes with subthemes emerged. The study showed that professional nurses experienced challenges related to the nursing management of mentally ill clients. These challenges included shortage of staff, a heavy workload, and lack of resources, lack of in-service training and workshops related to mental health issues coupled with lack of support from the supervisors. Due to the challenges, the mentally ill clients were not getting quality nursing care leading to complications and relapse. Conclusion: It emerged from the study that matters pertaining to mental illness and mental discomfort were still a serious problem in rural areas. The problems were related to the challenges which prevented professional nurses from providing quality nursing care to mentally ill clients with subsequent complications and relapse. Recommendations: Recommendations were made as an effort to ensure that the nursing management of mentally ill clients in rural primary health care clinics is improved. These recommendations were categorized as related to nursing practice, nursing education and nursing research.
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LaFave, Lea R. Ayers. "Nursing Practice as Knowledge Work Within a Clinical Microsystem: A Dissertation." eScholarship@UMMS, 2008. https://escholarship.umassmed.edu/gsn_diss/9.
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Nurses have a key role in keeping patients safe from medical errors because they work at the point of care where most errors occur. Nursing work at the intersection of patients and health care systems requires high levels of cognitive activity to anticipate potential problems and effectively respond to rapidly evolving and potentially harmful situations. The literature describes nursing work at the intersection of patient and health care system as well as barriers to providing safe patient care. However, little is known about the systems knowledge nurses use to negotiate the health care system on their patients’ behalf, or how this systems information is exchanged between nurses.
Using the clinical microsystem as the conceptual framework, this qualitative descriptive investigation identified and described: 1) the components of systems knowledge needed by nurses, 2) how systems information is exchanged between nurses, and 3) systems information exchanged between staff nurses and travel nurses. Data were collected from a stratified maximum variation sample of 18 nurse leaders, staff nurses, and travel nurses working within a high-functioning neonatal intensive care nursery within a large academic medical center in New England. Data collection methods included participant observation, document review, individual interviews, and a focus group session. Data were analyzed through constant comparison for emerging themes and patterns. Findings were compared for commonalities and differences within and across groups.
Three components of systems knowledge emerged: structural, operational, and relational. Systems information exchange occurred through direct and indirect means. Direct means included formal and informal mechanisms. The formal mechanism of orientation was identified by each participant. Informal mechanisms such as peer teaching, problem solving, and modeling behaviors were identified by participants from each of the three nurse groups. Travel nurses’ descriptions of the common themes focused on individual efficacy. Staff nurses focused on fostering smooth unit functioning. Nurse leaders described common themes from a perspective of unit development. Four overarching domains of systems information were exchanged between staff nurses and travel nurses: practice patterns; staffing patterns and roles; tips, tricks, tidbits, and techniques; and environmental elements. Communication emerged as a common theme across nurse groups and domains of systems information exchanged. These findings have implications for nursing orientation and staff development, continuous improvement at the local level, and curriculum development.
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Bonner, Alice F. "Certified Nursing Assistants’ Perceptions of Nursing Home Patient Safety Culture: Is There a Relationship to Clinical or Workforce Outcomes?: A Dissertation." eScholarship@UMMS, 2008. https://escholarship.umassmed.edu/gsn_diss/10.
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Patient safety culture (PSC) is a critical factor in creating high reliability healthcare organizations. However, few studies to date have correlated PSC measures with actual safety outcomes. In particular, nursing home studies have only recently appeared in the literature. Nursing homes differ from hospitals in that the vast majority of direct care is provided by certified nursing assistants (CNAs), not licensed nurses. Thus nursing home PSC could differ in important ways from PSC in acute care institutions.
This dissertation was a secondary data analysis that examined whether CNAs’ perceptions of patient safety culture were correlated with clinical outcomes in a random sample of 74 nursing homes in five randomly selected states. This study matched CNA PSC survey data using the Hospital Survey of Patient Safety Culture (HSOPSC) with Minimum Data Set (MDS), Area Resource File (ARF) and Online Survey Certification and Reporting (OSCAR) data from those same homes during the first two quarters of 2005. In the original study, 1579 nurse aides out of 2872 completed the survey, for a 55% response rate.
In addition to clinical outcomes, this study examined the relationship between CNA PSC scores and staff turnover. The relationship between certain demographic variables, such as level of education, tenure as a CNA, and PSC scores was evaluated. The relationship between certain facility characteristics, such as profit status and bed occupancy was also assessed. An exploratory factor analysis of the original HSOPSC instrument was re-run for this nursing home CNA sample.
Data were analyzed using Poisson regression and multilevel techniques; descriptive statistics were compiled for demographic data. Major findings from the regression analyses and combined GEE models suggest that certain factors, such as CNA turnover and LPN staffing may predict CNA PSC scores. CNA PSC scores were associated with rates of falls and restraint use, but were not associated with differences in pressure ulcer rates in this sample. Few associations for CNA PSC with individual subscales were identified. The exploratory factor analysis revealed some potential differences in how items and subscales factored in this nursing home CNA population.
This dissertation represents an important step in the evaluation of CNA PSC in nursing homes and the relationship of PSC to safety outcomes. Future work on nursing home PSC and clinical and workforce outcomes is described.
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Al-Kuwari, Wasmiya Dalhem M. D. "Information management within the Nursing Department at Hamad Medical Corporation (HMC), Qatar." Thesis, Loughborough University, 2005. https://dspace.lboro.ac.uk/2134/7811.
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Hamad Medical Corporation, the main healthcare provider in the state of Qatar, sponsored this study to investigate the use of electronic records management as the basis for a novel information management system in its Nursing Department. To assess the viability of an electronic records management system a questionnaire survey of a representative sample of the staff and interviews with key post holders were under taken. Results obtained indicated a wide spread dissatisfaction with the existing manual system. However, introduction of any computer-based technology requires great care. To assist with identifying any issues with this technological change, Soft System Methodology (SSM) was employed to discern what changes could be made to improve the current problematic situation found in the Nursing Department. In fact the change archetypes uncovered (procedural, attitudinal, structural and cultural) formed an innovative input into obtaining a roadmap for development of the electronic staff records system. This roadmap was facilitated by the use of Nominal Group Technique (NGT) and Interpretive Structural Modelling (ISM): In fact the roadmap was an ISM intent structure. The roadmap suggested that change could be affected by having written policy documents and the top goal to be achieved reflected an improvement in manpower placing and budgetary forecasts. The use of a multi-methods approach meant that as well as this study's main objectives being reached, the process encompassed some methodological innovations. This study is the first to use the output of SSM to facilitate the NGT and ISM interactions. Equally, it is the first study of its sort to be applied to the Nursing Department at HMC, Qatar, which is an example of a cross-cultural eastern philosophical tradition. The methods used here revealed some significant findings, and have helped in the development of an electronic records management system for use at HMC, Qatar.
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George, Janet C. "Nurses' perceived autonomy in a shared governance setting." Virtual Press, 1996. http://liblink.bsu.edu/uhtbin/catkey/1036188.
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The basic philosophy of shared governance includes the right for staff nurses to practice in an environment that allows participation in the decision making process at all levels of the organization. Autonomy and responsibility support shared governance. The purpose of this study was to examine nurses’ perceptions of autonomy in a well established shared governance setting. The Neuman Systems Model served as the theoretical framework.A convenience sample of 83 (42%) staff nurses at Saint Joseph’s Hospital of Atlanta, Georgia completed the Schutzenhofer Professional Nursing Autonomy Scale. Three open ended questions were included in the questionnaire to further explore staff nurses’ perceptions of the professional practice environment. Demographic data were also collected.Findings in this study revealed no significant correlations between selected demographic variables and autonomy. More than between selected demographic variables and autonomy. More than half (65.1%) ranked in the higher level of professional autonomy, 34.9% (29) ranked in the mid level and none in the lower level. Qualitative data revealed that nurses working in a well established shared governance setting perceived control over the nursing care of patients and appreciated and the ability to make decisions regarding patient care. Respondents overwhelmingly indicated that nurses should be compensated for participation in governance activities.Conclusions from this study were that implementation of professional practice models such as shared governance improve nurses’ perceptions of autonomy and create an atmosphere in which nurses can practice the art of nursing while clearly articulating a vision for the future. Consistent and appropriate decision making by nurses facilitates the interdisciplinary plan of care and encourages trusting relationships among professional disciplines.Nurse managers are in an ideal position to create a vision by designing structures that promote staff involvement. Managers must build formal recognition programs into shared governance systems and provide nurses with the time to attend meetings. Today’s nursing leaders must be ready to create a vision, facilitate change, mentor, nurture, coach and advise staff.School of Nursing
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Van, Dyk Anneline Lynette. "Die bepaling van standaarde vir die eenheidsbestuurder in geselekteerde hospitale." Thesis, Stellenbosch : Stellenbosch University, 2000. http://hdl.handle.net/10019.1/51692.
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Thesis (MCur)--Stellenbosch University, 2000.ENGLISH ABSTRACT: The traditional management practice of the unit manager has changed dramatically in the past decade. She is responsible to supply nursing services in an environment which is characterized by smaller operational budgets, rapid developments and changes in every sphere. The researcher has identified deficiencies in the management process of the unit manager. This led to the evaluation of the management activities of the unit manager in a selected group of hospitals. A quantitative, non-experimental, descriptive approach was followed with a questionnaire survey as research design. Standards were set and the management activities were evaluated against these standards. The main findings were: • The unit manager was not 100% involved in her comprehensive management task • The unit manager did not have the necessary training to empower her to manage effectively. The researcher recommends that the unit manager should be empowered by inservice education programmes but should also follow the formal management programmes at a recognized tertiary education institution. Keywords: Unit management / Standard formulation
AFRIKAANSE OPSOMMING: Die tradisionele bestuurspraktyk van die eenheidsbestuurder het oor die afgelope dekade dramaties verander. Sy is verantwoordelik vir die verskaffing van verpleegdienste in 'n omgewing wat gekenmerk word deur kleiner operasionele begrotings, vinnige vooruitgang en veranderinge op alle gebiede, Die navorser het leemtes in die bestuursproses van die eenheidsbestuurder geïdentifiseer. Dit het gelei tot die evaluering van die bestuursaktiwiteite van die eenheidsbestuurder in 'n geselekteerde groep hospitale. 'n Kwantitatiewe, nie-eksperimentele beskrywende navorsingsbenadering is gebruik met 'n vraelysopname as navorsingsontwerp. Standaarde is gestel waarteen die bestuursaktiwiteite geëvalueer is. Die belangrikste bevindinge was dat: • Die eenheidsbestuurder nie 100% betrokke was by haar omvangryke bestuurstaak nie • Die eenheidsbestuurder nie oor die nodige opleiding beskik wat haar bemagtig om hierdie bestuurstaak effektief te verrig nie. Die navorser beveel aan dat die eenheidsbestuurder bemagtig moet word deur middel van indiensopleidingsprogramme maar ook deur formele bestuursopleiding aan 'n erkende tersiêre opvoedkundige intansie moet te volg. Sleutelwoorde: Eenheidsbestuur/standaard formulering
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Smuts, Nicolette. "The elaboration and empirical evaluation of a partial talent management competency model in the nursing profession." Thesis, Stellenbosch : Stellenbosch University, 2011. http://hdl.handle.net/10019.1/17786.
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Thesis (MComm)--Stellenbosch University, 2011.ENGLISH ABSTRACT: This study stems from an urgent need to understand which factors contribute to nurse practitioners’ intention to quit, and consequently what organisations can do to retain these practitioners. There is increased pressure on the healthcare sector, more specifically nursing, due to a severe shortage in this discipline. These shortages are not an isolated phenomenon, but influence the private as well as public sector worldwide, as well as in South Africa. A multitude of factors contribute to the fact that nursing is a scarce skill worldwide. Some factors are controllable, others not. By isolating the controllable factors, organisations and managers can be equipped to put action plans in place to decrease the impact of this crisis. Processes and action plans to enlarge the nursing pool, and also to retain the current workforce, can contribute to overcoming this challenge. There is proof that the implementation of a structured talent management programme can contribute to overcoming this challenge. Line managers and their competence regarding the management of personnel play a key role in such a talent management programme. This study has as its objective to re-evaluate an existing talent management competency model for line managers, and to propose additional variables that can influence organisational outcomes like job satisfaction, organisational commitment and turnover intention. By understanding which line manager competencies influence organisational outcomes, and the manner in which they influence these outcomes, line managers as well as organisations can be equipped to formulate processes and programmes that can contribute to the retention of a scarce skill, and importantly, also minimise the impact of a worldwide crisis. The results of the study indicated that the operationalisation of the talent management competencies failed. The originally proposed model consequently had to be reduced by deleting all talent management latent variables from the model. Poor model fit was obtained for the reduced model. Modifications were, however, made to the reduced model based on modification index suggestions derived from the data. The modified model showed good fit and support was obtained for all the paths in the modified model. Crossvalidation of the modified model was recommended.
AFRIKAANSE OPSOMMING: Hierdie studie spruit uit ‘n dringende behoefte om te verstaan watter faktore daartoe bydra dat verpleegkundiges die voorneme ontwikkel om ‘n organisasie te verlaat, en gevolglik wat organisasies kan doen om verpleegkundiges wel te behou. Toenemende druk word in die gesondheidsorgsektor ervaar, meer spesifiek op verpleging, weens ernstige tekorte in hierdie dissipline. Hierdie tekorte is nie ‘n geïsoleerde verskynsel nie, maar raak die privaatsektor sowel as die publieke sektor wêreldwyd, sowel as Suid-Afrika. ‘n Veelvoud van faktore dra daartoe by dat verpleegkunde ‘n skaars vaardigheid wêreldwyd is. Sekere faktore is beheerbaar, ander nie. Deur die beheerbare faktore te isoleer, kan organisasies en bestuurders aksieplanne in plek stel om die impak van hierdie krisis te verminder. Prosesse en aksieplanne om byvoorbeeld die verplegingpoel te vergroot, en ook om die huidige werksmag te behou, kan bydra tot die oorbrugging van hierdie uitdaging. Daar is bewyse dat die implementering van ‘n gestruktureerde talentbestuurprogram kan bydra om hierdie uitdaging te oorkom. ‘n Sleutelrol in so ‘n talentbestuurprogram, is die lynbestuurder en sy/haar bevoegdheid ten opsigte van die bestuur van personeel. Hierdie studie het ten doel om ‘n bestaande talentbestuurmodel vir lynbestuurders te her-evalueer en addisionele veranderlikes voor te stel wat organisasie-uitkomste soos werkstevredenheid, organisasie-verbondenheid en voorneme om te bedank beïnvloed. Deur te verstaan watter lynbestuurbevoegdhede organisasie-uitkomste beïnvloed en die wyse waarop hierdie bevoegdhede op hierdie uitkomste inwerk, kan lynbestuurders, sowel as organisasies, toegerus word om prosesse en programme te formuleer. Hierdie programme kan ‘n bydra lewer tot die behoud van ‘n skaars vaardigheid, en sodoende die impak van ‘n wêreldwye krisis minimaliseer. Die resultate van die studie het aangetoon dat die operasionalisering van die talentbestuurbevoegdhede onsuksesvol was. Die oorspronklik voorgestelde model moes gevolglik gereduseer word deur die talentbestuur-latente veranderlikes uit die model te verwyder. Swak modelpassing is vir die gereduseerde model bevind. Wysigings is egter aan die gereduseerde model aangebring gebaseer op modifikasie-indeksvoorstelle afgelei uit die data. Die gewysigde model het goeie passing getoon en steun is vir al die bane in die gewysigde model gevind. Kruisvalidasie van die gewysigde gereduseerde model is aanbeveel.
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Hilmersson, Ilona, and Minda Rundqvist. "Case Management : Sjuksköterskans uppfattning om arbetsmodellens effekt för patienter med missbruk och samtidig psykisk störning." Thesis, Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-23346.
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Syftet med denna pilotstudie var att beskriva hur sjuksköterskor som arbetar som Case Managers uppfattar effekterna av denna arbetsmodell avseende medicinsk vård, social situation, missbruk, vård- och omsorgskvalitet samt samordning för patienter med missbruk och samtidig psykisk störning. Metoden var kvantitativ och genomfördes med en webbenkät. Resultatet visade att respondenterna anser att Case Management haft en positiv påverkan på patienternas medicinska vård och sociala situation. Det ledde också till en bättre kontakt med patienten, och förbättrad bedömning av patientens sammansatta situation. Sammantaget framkom en övervägande positiv uppfattning även av vård- och omsorgskvaliteten, samordningen och de arbetsmetoder som använts. Vad gäller missbruket uppgav en del av respondenterna att det påverkades positivt och en del av respondenterna uppgav att det inte påverkades alls. Vid en fullskalig studie hade det varit intressant att göra enkäten mer nyanserad med fler svarsalternativ och även ha med bakgrundsvariabler för att se samband och göra jämförelser. Pilotstudien indikerar att Case Management är en arbetsmodell som kan underlätta omvårdnadsarbetet för patienter med komplex problematik och stort behov av vård och stöd, och även vara en metod för att lättare samordna insatser från olika vårdgivare. Sjuksköterskan kan genom Case Management arbeta hälsofrämjande för att stödja patienter med missbruk och samtidig psykisk störning i olika områden som påverkar hälsan.The aim of this pilot study was to describe how nurses who work as Case Managers perceive the effect of this approach for medical treatment, social status, substance abuse, quality of health care and coordination for patients with substance abuse and concurrent psychiatric disorder. The method was quantitative and was conducted with a web survey. The results showed that the respondents believe that case management had a positive impact on patients' medical care and social situation. It also led to a better contact with the patient, and improved assessment of the patient's complex situation. Overall, the answers also revealed a generally positive perception of the care quality, the coordination and used methods. As for the abuse, some respondents answered that Case Management had affected the abuse in a positive way, and others that it had not been affected at all. In a full scale study it would have been interesting to make the questionnaire more nuanced with more response options, and also have the background variables to make comparisons. The pilot study indicate that case management is an approach that can facilitate nursing care for patients with complex problems and need of care and support, and also be a method to help to coordinate the efforts of various health care providers. The nurse can through Case Management support patients with substance abuse and mental disorders in different areas of health.
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Sanchez, Balcells Sara. "Adaptación y validación de las escalas QPC "Quality in Psychiatric Care" en el ámbito de la hospitalización." Doctoral thesis, Universitat de Barcelona, 2019. http://hdl.handle.net/10803/667816.
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INTRODUCCIÓN:
Los países occidentales comparten cada vez más el interés en evaluar la calidad de la atención en el ámbito de la salud mental. Sin embargo, se sabe poco sobre cómo perciben la calidad de los cuidados, los pacientes y profesionales en unidades de hospitalización de psiquiatría. Son pocos los instrumentos que se conocen y que estén adecuadamente validados entorno a la calidad de la atención en el ámbito de la salud mental, y especialmente en el entorno hospitalario. Uno de los más relevantes es el “Quality in Psychiatric Care” (QPC).
OBJETIVOS:
Los objetivos generales fueron la traducción y adaptación al castellano de la escala “Quality in Psychiatric Care-Inpatient” (QPC-IP) y de la escala “Quality in Psychiatric Care-Staff” (QPC-IPS) y el análisis de las propiedades psicométricas. Otro objetivo fue analizar la invarianza configuracional de los ítems y las subescalas de los instrumentos utilizados.
METODOLOGÍA:
La investigación se organizó en tres estudios. La primera fase de los estudios 1 y 2 consistió en el proceso de traducción y retrotraducción de las escalas “Quality Psychiatric Care” del idioma sueco al castellano.
En la segunda fase, para el estudio 1 (Spanish QPC-IP) se reclutaron 150 pacientes que cumplían con los criterios de inclusión: mayores de 18 años, diagnosticados de trastorno mental según la clasificación DSM-V y estar ingresados en el momento del estudio.
En la segunda fase, para el estudio 2 (Spanish QPC-IPS) se reclutaron a 163 profesionales que cumplían con los criterios de inclusión: profesionales asistenciales que estaban activos laboralmente y que participaran voluntariamente en el estudio.
El tipo de muestreo utilizado fue no probabilístico, dado que la población incluida en ambos estudios fueron los que voluntariamente quisieron participar.
En el estudio 1 y 2 se realizó un análisis descriptivo de los ítems de las escalas y de las variables sociodemográficas y clínicas de la muestra.
La fiabilidad se realizó analizando la consistencia interna y la estabilidad temporal, administrando la escala de nuevo a los 7-14 días. Se realizó el análisis de la correlación de la escala Spanish QPC-IP con el cálculo del coeficiente de correlación de Pearson con el fin de determinar la validez convergente y discriminante. Sin embargo, en el estudio 2, la validez convergente se analizó mediante el análisis de correlación de Spearman (rho) con la escala de satisfacción laboral de NTP 394 administradas al mismo tiempo. Posteriormente, se realizó un análisis factorial confirmatorio.
Los análisis del estudio 3 se llevaron a cabo en una muestra total de 578 participantes (incluidos los pacientes suecos que completaron la Sweden QPC- IP). En la primera fase, se utilizó el análisis factorial confirmatorio y en la segunda fase, la estructura de medición fue confirmada a través del Modelo Exploratorio de Ecuaciones Estructurales (ESEM).
Para el análisis estadístico de los datos del estudio 1 y 2 se utilizó el paquete estadístico IBM® SPSS® Statistics 22.0 y el EQS® versión 6.2. para el análisis factorial confirmatorio.
Los estudios 1, 2 y 3 fueron aprobados por el Comité de Ética e Investigación Clínica de la Fundation Research de Sant Joan de Déu, CEIC PIC-128-15 de Barcelona (España).INTRODUCTION: Western countries are sharing increasing interest in evaluating and improving care quality in the setting of mental health. Nonetheless, little is known about how quality is perceived by patients and professionals in psychiatric inpatient units. There are a number of challenges, one of which is the fact that there is no general consensus on how to define quality, as it is considered a multidimensional concept. Secondly, unlike the concept of patient satisfaction, care quality includes the perspectives of all interested parties. OBJECTIVES: The general objectives were the translation and adaptation to Spanish of the “Quality in Psychiatric Care-Inpatient” (QPC-IP) questionnaire and of the Spanish of the “Quality in Psychiatric Care-Inpatient Staff” (QPC-IPS) and the analysis of psychometric properties in a sample of patients admitted to psychiatric inpatient units in two leading hospitals in the province of Barcelona (study 1 and study 2) . Study 3 analysed the configuration invariance of the items and domains of the instruments with the Swedish items and domains of the “Quality in Psychiatric Care-Inpatient” (Sweden QPC-IP) questionnaire. METHODOLOGY: The questionnaires underwent a process of transcultural adaptation to Spanish, and in the second phase a metric analysis of the questionnaires was conducted by means of a cross-sectional study. For study 1 (Spanish QPC-IP) 150 patients were recruited, all of whom met the established inclusion criteria: over 18 years of age, with a diagnosis of a mental disorder according to the DSM-V classification, and at the time of the study being an inpatient of one of the psychiatric units. In the second phase, for study 2 (Spanish QPC-IPS) a total of 163 professionals were recruited, all of whom met the following inclusion criteria: healthcare professionals, currently active, working in the psychiatric care units, and who wished to participate voluntarily in the study. The IBM® SPSS® Statistics 22.0 package was used for the statistical analysis of the data from studies 1 and 2, while EQS® 6.2 was used for the confirmatory factor analysis. In study 1 and in the study 2, a descriptive analysis of the items in the Spanish QPC-IP questionnaire and of the socio-demographic and clinical variables of the sample was conducted. Reliability was assessed by analysing internal consistency and temporal stability, after 7-14 days. The correlation analysis for the Spanish QPC-IP questionnaire was conducted with Pearson correlation coefficient, with the aim of determining the convergent and discriminant validity. In study 2, the convergent validity was analysed by Spearman's rank correlation coefficient (rho) of the Spanish QPC-IPS with the NTP 394 job satisfaction questionnaire administered at the same time. A confirmatory factor analysis was performed. Study 3 was conducted in the first half of 2019. The total sample consisted of 578 participants. The configuration invariance study was conducted in two phases: in the first phase of the analysis, the confirmatory factor analysis was used; and in the second phase, the measuring structure was confirmed with the exploratory structural equation model (ESEM). Studies 1, 2 and 3 were approved by the Independent Ethics Committee of the Sant Joan de Déu Research Foundation CEIC PIC-128-15 of Barcelona (Spain). RESULTS: Study 1: the results of the first phase yielded an instrument adapted and translated into Spanish by a process of translation and back-translation by independent translators. A Cronbach's Alpha of 0,94 was obtained for the entire QPC-IP instrument and values of 0,52-0,89 for the dimensions of the questionnaire. The intraclass correlation coefficient for the QPC-IP questionnaire was 0,69, whilst values of 0,62-0,74 were obtained in the individual dimensions, indicating an acceptable level of temporal stability. In terms of convergent and discriminant validity, dimension D1 (Therapeutic relationship) and dimension D2 (Patient participation) were more strongly correlated with the overall questionnaire (r=0,902 and r=0,892, respectively), and the stronger correlation between the sub-questionnaires was represented by dimension D1 (Therapeutic relationship) and dimension D3 (Support received) (r=0,744). The confirmatory factor analysis for the Spanish QPC-IP questionnaire revealed that the six factors are identical to those of the original Swedish questionnaire and the model fit indices are adequate. Study 2: The result obtained in the first phase was satisfactory in all four stages. A Cronbach's Alpha of 0.92 was obtained for the entire instrument and values of 0,45-0,85 for the dimensions of the questionnaire. With regard to test- retest reliability, the intraclass correlation coefficient was 0,91, whilst in the individual dimensions, values of 0,68-0,89 were obtained, indicating a good level of temporal stability. The convergent validity showed a positive correlation (0,58) with the NTP 394 questionnaire. The confirmatory factor analysis revealed that the six factors are the same as those of the original Swedish questionnaire and showed good model fit. The results of the Spanish version show adequate results in terms of validity and reliability. Study 3: The first phase of study 3 shows that the confirmatory factor analysis of the latent model of the three groups individually does not have a good fit. Nevertheless, the model fit index for the group of Swedish patients is adequate. In the second phase, the ESEM analysis indicates a better model fit, although the group of Spanish patients and professionals obtains lower scores than the adequate fit. The factor loadings for each group were significant. Factor 3 (item 24) showed a greater factor loading in all three study samples. In contrast, factor 2 (items 1 and 14) showed a low factor loading. CONCLUSIONS: This research has made it possible to adapt and validate the Spanish QPC-IP and the Spanish QPC-IPS questionnaires. The purpose of these instruments is to measure care quality from the perspective of patients admitted to psychiatric inpatient units and from the perspective of mental healthcare professionals in hospital settings.
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Ceccucci, Wency A. "Decision support systems design: a nursing scheduling application." Diss., Virginia Tech, 1994. http://hdl.handle.net/10919/40303.
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Hess, Edward Alan. "The impact of diabetes nurse care managers in outlying medical offices on quality of care: An empirical investigation." CSUSB ScholarWorks, 2001. https://scholarworks.lib.csusb.edu/etd-project/1744.
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The objective of this study is to evaluate the impact of the Diabetes Nurse Care Manager on an at-risk diabetic population using a Primary Group Visit Model in Outlying Medical Offices within the Kaiser-Permanente Health Care System upon the process and outcome of care in this population.
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Lombo, Nocawa Philomina. "Mental health care practitioners' perceptions of mental illness within the isiXhosa cultural context." Thesis, Nelson Mandela Metropolitan University, 2010. http://hdl.handle.net/10948/1179.
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This study sought to explore the perceptions of mental health care practitioners’ perceptions on mental illness within the isiXhosa cultural context. A qualitative exploratory descriptive and contextual design was used for the study. A non-probability purposive sampling method was used to select eight participants from Komani Hospital in Queenstown. Data was collected through semi-structured interviews. The services of an Independent Interviewer were used to avoid any bias as interviews took place where the researcher is employed. All interviews were transcribed verbatim and the data collected was analyzed according to Tesch’s eight steps of data analysis as described in Cresswell (1994:155). The researcher utilized services of an Independent Coder who verified the identified major themes. Four major themes emerged from the analysis of the interview: Mental health care practitioner’s perceptions of mental illness, perception of the causes of mental illness within the isiXhosa cultural context, mental health care practitioners’ views in the management and treatment of mental illness and suggestions put forward to improve the services to mental health care users. The major findings of this study were the lack of knowledge of culture of mental health care users. It is recommended that it would be proper if there could be co-operation between mental health care practitioners and traditional healers by working together as a team.
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Anthonie, Ramona F. G. "The experiences of critical nurses regarding staffing management in critical care units in private hospitals of the Cape Metropole." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/71776.
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Thesis (MCurr)--Stellenbosch University, 2012.ENGLISH ABSTRACT: Nurse managers are responsible to staff different hospital units and departments with sufficient, trained and experienced personnel. Most critical care units in the private healthcare in South Africa are staffed below maximum workload levels and additional staff is supplemented when needed. Current staffing management strategies comprises the application of the patient acuity score, the utilisation of contracted agency staff and ward staff who assist occasionally in the critical care unit (CCU). The aim of the study was to explore the experiences of critical care nurses regarding staffing management within critical care units in private health care institutions in the Western Cape. The following objectives were set to: - explore the experiences of CCNs regarding staffing management strategies such as o the patient acuity score o the employment of ad hoc agency staff and o the utilization of ward staff A descriptive design with a qualitative approach was applied. A sample size of n=15 was drawn from a total population of N=377, using purposive sampling technique. A pilot-test was also completed. The trustworthiness of this study was assured with the use of Lincoln and Guba’s criteria of credibility, transferability, dependability and confirmability. All ethical principles were met. The findings of the study demonstrated that nurses perceive the workload in critical care units as heavy. The utilisation of the acuity score does not really assist in relieving the workload as managers tend not to consider the staffing requirements as predicted by the acuity score due to budget constraints. The enrolled nurses who assist occasionally in the critical care unit require supervision as well as ongoing development to ensure safe and quality patient care. Yet agency nurses were perceived as either extraordinary good or incompetent.
AFRIKAANSE OPSOMMING: Verpleegbestuurders het die verantwoordelik om verskillende hospitaaleenhede en departemente met voldoende opgeleide en ervare personeel te voorsien. Die meeste kritieke sorgeenhede in Suid-Afrika word met minder as dan die maksimum werkladingsvlak beman en addisionele personeel word aangevul wanneer nodig. Huidige personeelbestuurstrategieë behels die toepassing van die pasiënt akuïteit telling, die gebruik van ingekontrakteerde agentskap-personeel en saalpersoneel wat per geleentheid in die kritiekesorgeenheid help. Die doel van die studie was om die ervaringe van kritieke-sorgverpleegsters ten opsigte van personeel bestuur binne die kritiekesorgeenhede in die privaat gesondheidsorginstellings in die Weskaap, te ondersoek. Die volgende doelwitte is gestel: - Om die ervaringe van kritieke-sorgverpleegsters aangaande personeelbestuur-strategieë te ondersoek, soos: o die pasiënt akuïteit telling o die gebruik van agentskapverpleegpersoneel en o die gebruik van saal personeel, te ondersoek ’n Beskrywende kwalitatiewe studie is toegepas. ’n Steekproef van n=15 is uit ’n totale populasie van N=377 getrek deur die doelgerigte steekproeftegniek te gebruik. ’n Loodstoetsing van die semi-gestruktureerde vraelys is ook gedoen. Die betroubaarheid van hierdie studie was verseker deur van Lincoln en Guba se kriteria vir geloofwaardigheid, oordraagbaarheid, betroubaarheid en bevestigbaarheid gebruik te maak. Daar is aan alle etiese vereistes voldoen. Die bevindings van die studie toon dat die verpleegpersoneel die werklading in die kritiekesorgeenheid as veeleisend ervaar. Die aanwending van die pasiënt akuïteit-telling dra nie werklik by tot verligting van die werklading nie, aangesien bestuurders weens begrotingsbeperkings neig om nie die personeelbenodigdhede soos deur die akuïteit-telling voorspel in ag neem nie. Die ingeskrewe verpleegsters wat per geleentheid in die kritieke-sorgeenheid hulp verleen, benodig toesig asook volgehoue ontwikkeling ten einde veilige en kwaliteit pasiëntsorg te verseker. Die agentskapverpleegpersoneel is egter as baie bekwaam of onbevoeg beskou.
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Bergström, Maria. "Sjuksköterskors möjligheter till självreflektion inom psykiatrisk vård : En litteraturstudie." Thesis, Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-7921.
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Bakgrund: Självreflektion innebär att kunna iaktta sig själv, sina reaktioner och att kunnasamtala med sig själv om sina handlingar och om sina upplevelser. Det är ett medvetetsökande efter förståelse. Reflektion ger möjlighet att utveckla yrkesmässig medvetenhet omsitt eget sätt att fungera och reagera. Genom systematisk reflektion kan individen utvecklasoch koppla teori till praktik. Individen måste medvetet utvärdera sina erfarenheter för attkunna dra lärdom av dem. Syfte: Syftet var att belysa sjuksköterskors möjligheter till självreflektion inom psykiatriskvård. Metod: En integrativ litteraturstudie användes som metod. Data inhämtades från databasernaCinahl plus, PubMed och PsycINFO.Sammanlagt sex artiklar ligger till grund för resultat. Material har analyserats medWhittemore och Knafls (2005) analysmetod. Resultat: Sjuksköterskor behövde skapa utrymme för självreflektion. Studier visade attarbetsgivare behövde möjliggöra att självreflektion kunde utövas på arbetsplatsen ochmedarbetare måste värdesätta att självreflektion kunde fungera som ett hjälpmedel i denpsykiatriska omvårdnaden. Det var också viktigt att lärare och utbildare, i enutbildningssituation, var intresserade av individens lärande och hade kunskap om hur man lärut självreflektion. Slutsats: Möjligheter till självreflektion är tid, kunskap och en tillåtande miljö därsjuksköterskan eller sjuksköterskestudenten kan och vågar ställa frågor och där det finns engemensam norm som värdesätter självreflektion på arbetsplatsen.Backgound: Self-reflection means being able to observe oneself, their reactions and beingable to talk to themselves about their actions and their experiences. It is a conscious search forunderstanding. Reflection provides the opportunity to develop professional awareness ofone ́s own way of functioning and reacting. Through systematic reflection, the individual candevelop and link theory to practice. The individual must consciously evaluate theirexperiences in order to learn from them. Aim: The purpose of this study is to elucidate nurses ́ opportunities for self-reflection inpsychiatric careMethod: An integrative literature study was used as a method. Data were obtained from thedatabases Cinahl Plus, PubMed and PSYCinfo. A total of six articles form the basis for theresult. The material has been analyzed using the Whittemore and Knafls (2005) method. Results: Nurses need to create space for self-reflection. The study showed that employersneeded to enable self-reflection to be exercised in the workplace and employees needed toappreciate that self-reflection could serve as an aid in psychiatric nursing. It was alsoeducators, in an educational situation, were interested in the individual ́s learning and hadknowledge of how to teach self-reflection. Conclusion: Opportunities for self-reflection are time, knowledge and a permissiveenvironment where the nurse or nurse student can and dare to ask questions and where there isa common norm that values self-reflection in the workplace.
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Crow, Katherine Mizell. "Increasing Knowledge About Food Allergy Management in the Preschool Setting." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/4848.
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The prevalence of food allergies is a growing concern in the United States. Approximately 8% of the pediatric population has some form of food allergy. Many of these children are either in the preschool and primary school setting, which is where the majority of allergic reactions occur. If the symptoms of a food allergy reaction are not treated within minutes of exposure, the results can be damaging or fatal. Evidence continues to demonstrate that preschool and school personnel do not feel trained or prepared should a severe reaction arise. The purpose of this evidence-based project was to determine if the implementation and instruction of food allergy guidelines and an educational in-service program on the treatment of food allergies would increase the knowledge and ability of preschool personnel to respond should a reaction occur. The adult learning theory of Knowles and Bandura's theory of self-efficacy were the theoretical frameworks for this project. This project incorporated a 40-minute educational in-service along with the introduction of food allergy guidelines including an emergency action plan and epinephrine auto-injector training. A pretest and posttest were administered prior to and following the educational in-service, respectively. A paired sample t test revealed there was a dramatic increase in knowledge following the educational in-service about food allergy management, recognition, and treatment. Preschool personnel felt more empowered to react should a food allergy reaction occur. By teaching preschool-personnel about food allergies, they will have the necessary resources that will support the creation of a safer environment for children challenged with food allergies.
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Bjerkenstedt, Monica. "Att arbeta enligt ACT-modellen : Specialistsjuksköterskans erfarenheter av sin kompetens i teamet." Thesis, Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-6179.
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Bakgrund: ACT- modellen växte fram under 70 och 80-talet i samband med att många psykiatriska kliniker stängdes i USA. Den ursprungliga ACT- modellen kan ses som en fullservicemodell men har sedan modifierats och anpassats efter samhällets och sjukvårdens rådande förhållanden. Som det ser ut idag så har flera modeller utvecklats med utgångspunkt från ACT-modellen men kan särskiljas av vilka komponenter som ingår. Modellen har visat positiva resultat avseende patienters delaktighet och återhämtning. Sjuksköterskan har en bred yrkesbakgrund och anses ha en viktig roll i teamet. Med sin kompetens har de grundläggande kunskaper för att utföra medicinsk och psykiatrisk omvårdnad men flera studier har visat att det finns ett behov av specialistutbildade sjuksköterskor då många av patienterna är svårt sjuka. Syfte: Syftet var att beskriva psykiatriska specialistsjuksköterskors erfarenheter av sin kompetens och roll i team som arbetar enligt ACT-modellen Metod: En kvalitativ design har valts. Datainsamling skedde med semi-strukturerade intervjuer. En kvalitativ innehållsanalys med induktiv ansats användes för att bearbeta materialet. Resultat: Innehållsanalysen resulterade i två huvudkategorier, Kompetensen med in i teamet samt Den mångsidiga sjuksköterskan, med tillhörande sex underkategorier. Diskussion: Resultatet diskuterades utifrån de två huvudkategorierna Kompetensen med in i teamet och Den mångsidiga sjuksköterskan. Som stöd i diskussionen användes till ämnet relevanta artiklar och litteratur samt Phil Barkers tio förpliktelser som utgångspunkt.Background: The ACT model developed in the 70's and 80's when many psychiatric clinics were closed in the United States. The original ACT model can be seen as a full service model but has since been modified and adapted to the current conditions of society and health care. As it appears today, several models have been developed based on the ACT model but can be distinguished by which components are included. The model has shown positive results regarding patient participation and recovery. The nurse has a wide professional background and is considered to be an important part of the team. With their skills, they have the basic knowledge to perform medical and psychiatric care, but several studies have shown that there is a need for specialist educated nurses, as many of the patients are severely ill. Aim: The aim of this study was to describe the psychiatric specialist nurse's experience of their competence and role in teams working under the ACT model. Method: A qualitative design has been selected. Data collection was done with semi-structured interviews. A qualitative content analysis with inductive approach was used to process the material. Results: The content analysis resulted in two main categories, skills in the team and the versatile nurse, with six associated subcategories. Discussions: The result was discussed based on the two main categories, skills in the team and the versatile nurse. In support of the discussion, relevant topics and literature were used as well as Phil Barker's ten obligations as a starting point.
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Balabanian, Yvete Carvalho Chaves 1965. "Rotatividade dos profissionais de enfermagem de um hospital universitário público." [s.n.], 2014. http://repositorio.unicamp.br/jspui/handle/REPOSIP/283889.
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Orientador: Maria Inês MonteiroDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Enfermagem
Made available in DSpace on 2018-08-25T17:34:14Z (GMT). No. of bitstreams: 1 Balabanian_YveteCarvalhoChaves_M.pdf: 2175763 bytes, checksum: c4a6dbb48d4e4cf4dc66c5c63b120739 (MD5) Previous issue date: 2014
Resumo: A rotatividade de profissionais de enfermagem é impactante para a qualidade e segurança da assistência prestada aos usuários, para o desgaste dos profissionais envolvidos na educação permanente, assim como para o dispêndio de valores para custear os processos demissionais e admissionais nas instituições empregadoras. A reposição do profissional depende de processos de seleção e contratação que demandam tempo para a sua admissão, período em que a equipe fica sobrecarregada pela sua ausência ou pela presença temporária de outro trabalhador não capacitado para as atividades específicas da unidade de trabalho. Portanto, é relevante para a gestão hospitalar o estudo do mecanismo que leva os profissionais a buscarem a troca de emprego nas instituições de saúde, os motivos e a análise dos índices da rotatividade, podendo elucidar as circunstâncias, as consequências e propor possíveis intervenções da administração da instituição para a retenção de trabalhadores, para que a assistência de enfermagem seja realizada por profissionais competentes, experientes, que visem à qualidade da assistência de forma humanizada. O presente estudo realizou a análise dos fatores relacionados à rotatividade dos trabalhadores de enfermagem, durante quatro anos, mediante as informações de um instrumento de coleta de dados do Departamento de Enfermagem de um hospital universitário público do interior do Estado de São Paulo, que foram preenchidos pelos próprios profissionais na vigência dos trâmites do processo demissional do trabalho. A amostra foi de 223 sujeitos, a maioria era técnicos de enfermagem, a mediana do tempo de permanência foi de um ano e meio, a mediana da idade dos profissionais foi 31,4 anos, 62 relataram algum problema de saúde durante a permanência do contrato com o hospital e o vínculo empregatício teve relevância nas demissões. Os motivos da rotatividade dos profissionais são multifatoriais e influenciados pelos aspectos econômicos, sociais e políticos, que se inter-relacionam em um panorama dinâmico. Os profissionais demissionários apresentaram pouco tempo de permanência no hospital, indicando que o trabalhador com menor tempo de trabalho apresenta maior facilidade de desvincular e procurar oportunidades no mercado de trabalho. O vínculo contratual demonstrou ser um fator significante para a rotatividade dos profissionais de enfermagem, com reflexo na satisfação com o salário e benefícios. Diminuir as diferenças nas condições de trabalho que geram insatisfação, como vínculos de trabalho diferentes para profissionais que exercem a mesma função e realizam as mesmas atividades é fundamental para o decréscimo da taxa de rotatividade
Abstract: The nursing professional turnover is impactful in the user assistance service quality and security, depletion of energy by the professional involved in permanent education and expenditure of amounts for cover resignation processes and hiring processes in employing institutions. The professional reposition depends of selection and hiring processes that demands time for the effective professional hiring, period in which the team is overloaded by the lack of professional or by the temporary presence of a non-trained member for specific activities of the work unit. Therefore, the study of the mechanism that leads the workers to change jobs in health institutions, their motives and turnover rate are relevant for the hospital management. This knowledge can clarify the circumstances and consequences and propose management interventions for the retention of professionals who are competent, experienced and able to provide high-quality and humanized assistance. This study accomplished the analysis of nursing employee turnover factors through the information of a collecting data instrument from the Nursing Department in a public university hospital in the state of São Paulo, which were answered by the professionals themselves in the validity of the dismissal procedures work process for a period of four years. The sample consisted of 223 subjects, most were nursing technicians, the median length of stay was a year and a half, the median age was 31.4 years of professional, 62 reported some health problem during the stay of the contract with the hospital and the employment relationship had relevance in employment layoffs. The grounds for the personnel turnover are multifactorial and affected by economic, social and political aspects, which are interrelated in a dynamic landscape. Retiring professionals showed little time spend in the hospital, indicating that professionals with less time on the job are more likely to disassociate and seek opportunities in the labor market. The contractual obligation demonstrated being a significant factor for the nursing employee turnover, reflecting in the satisfaction on the salary and benefits. In order to lessen the turnover rate, it is fundamental to diminish the differences between the working conditions that generates dissatisfaction, such as different working binding for professionals that are in the same position and do the same activities
Mestrado
Enfermagem e Trabalho
Mestra em Ciências da Saúde
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Ursin, Ronnie. "Level/Indicators of Job Satisfaction Among Unlicensed Assistive PersonnelEmployed in Acute Care." Case Western Reserve University Doctor of Nursing Practice / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=casednp1424367466.
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Oliveira, Caroline Ramos de. "O manejo da dor neonatal na perspectiva da equipe de saúde de uma maternidade de Ribeirão Preto-SP." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/22/22133/tde-10022015-192640/.
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A dor é um fenômeno que está presente na assistência em saúde aos neonatos, e sua identificação, avaliação e tratamento pela equipe de saúde são ações relevantes para o bem estar do bebê, visto que interfere no restabelecimento de sua saúde e pode gerar consequências deletérias a curto, médio e longo prazo. O presente trabalho trata-se de um estudo quali-quantitativo, descritivo exploratório, cujo objetivo foi identificar o manejo da dor neonatal sob a perspectiva da equipe de saúde de uma maternidade de Ribeirão Preto - SP. Na etapa quantitativa do estudo, participaram 81 profissionais de saúde da maternidade: 12 pediatras, 1 técnica do laboratório, 22 enfermeiras e 46 auxiliares/técnicas de enfermagem, que responderam a um questionário de autopreenchimento com questões objetivas sobre dados pessoais, profissionais e dados específicos sobre o conhecimento e a prática da avaliação e manejo não farmacológico da dor neonatal. Na segunda etapa, profissionais considerados líderes de equipe foram convidados a participar, de forma individual, de uma entrevista semiestruturada gravada em áudio que após a transcrição foram submetidas à análise de conteúdo. Da análise dos dados quantitativos, constatou-se que todos os médicos, enfermeiras, técnica do laboratório e a grande maioria (89,1%) das auxiliares/técnicas de enfermagem referiram que o recém-nascido é capaz de sentir dor. 83,3% dos médicos, 77,3% das enfermeiras e 54,3% das auxiliares/técnicas de enfermagem, acreditam que procedimentos potencialmente dolorosos repetidos podem gerar alguma consequência ao neonato. A maioria dos profissionais afirmou que avaliam a dor do recém-nascido, tendo como parâmetros mais frequentes o choro, a mímica facial, e movimentos, construindo uma avaliação subjetiva sem o uso de escalas. As medidas não farmacológicas de alívio da dor mais citadas pelos profissionais foram: a oferta de sacarose a 25%, a sucção não nutritiva e a amamentação, com um predomínio da utilização da sacarose como principal método de escolha. Poucos profissionais de saúde se preocupam em realizar o registro adequado sobre a avaliação e o manejo da dor aguda do recém-nascido. Da análise dos dados qualitativos, 5 categorias e 15 subcategorias surgiram a partir das verbalizações das participantes: 1) \"Fatores facilitadores do manejo da dor neonatal\" (atuação dos profissionais; a utilização de métodos não farmacológicos; o uso sacarose como principal escolha para o alívio da dor neonatal; outras intervenções não farmacológicas), 2) \"Fatores dificultadores do manejo da dor neonatal\" (falhas em como lidar com a dor; excesso de procedimentos dolorosos; fluxo de trabalho e quantidade de recursos humanos), 3) \"Avaliação da dor\" (como e quando avaliar a dor; a importância da avaliação a dor), 4) \"Mudanças necessárias para melhorar o manejo da dor na instituição\" (treinamentos; protocolos e utilização de escalas para avaliação da dor; mudança na atitude dos profissionais e sensibilização da equipe), 5) \"Participação dos pais e/ou família no manejo da dor neonatal\" (vantagens e apoio ao manejo da dor neonatal com participação da família; dificuldades na participação da família no manejo da dor neonatal). Concluiu-se que há um conhecimento superficial dos profissionais de saúde quanto à avaliação e o manejo não farmacológico da dor neonatal aguda nesta maternidade, assim como há falta de protocolos clínicos formais, registros e capacitação dos profissionais de saúde. Considerando-se as propostas do cuidado atraumático, desenvolvimental e humanizado ao recém-nascido, torna-se imperativo mudanças de ações e condutas da equipe de saúde no que se refere ao manejo da dor neonatal, que deverá ser movida e estimulada a partir capacitações profissionais fundamentadas na transferência de conhecimentoPain is a phenomenon that is present in the health care provided to neonates, and its identification, assessment and treatment by the health team are relevant actions for the welfare of the baby, since they interfere in the reestablishment of their health and may produce harmful consequences in the short, medium and long term. This is a quali-quantitative, descriptive and exploratory study with the aim to identify the management of neonatal pain from the perspective of the health team of a maternity hospital in Ribeirão Preto, São Paulo, Brazil. The quantitative stage of the study involved the participation of 81 health professionals from the maternity: 12 pediatricians, 1 laboratory technician, 22 nurses and 46 nursing technicians/aides, who answered a self-administered questionnaire containing objective questions regarding personal, professional and specific data on the knowledge and practice of the assessment and non-pharmacological management of neonatal pain. In the second stage, professionals who were considered to be team leaders were invited to participate, individually, in a semi-structured interview whose audio was recorded, transcribed and submitted to content analysis. The analysis of the quantitative data evidenced that all physicians, nurses, the laboratory technician and most of the nursing technicians/aides (89.1%) stated the newborn is capable of feeling pain. A total of 83.3% of the physicians, 77.3% of the nurses and 54.3% of the nursing technicians/aides believe that repetitive potentially painful procedures may bring some consequence to the neonate. Most of the professionals stated they assess the pain of the newborn, using their crying, facial mimics and movements as parameters, building a subjective assessment without the use of scales. The non-pharmacological measures for pain relief most commonly cited by the professionals were: offering a 25% sucrose solution, non-nutritional suction and breastfeeding, with prevalence for the use of sucrose as the main chosen method. Few health professionals care to make an appropriate record regarding the assessment and management of acute pain in the newborn. The analysis of the qualitative data generated 5 categories and 15 subcategories, based on the speeches of the participants: 1) \"Facilitating factors in the management of neonatal pain\" (performance of the professionals; use of non- pharmacological methods; use of sucrose as the main choice for relieving neonatal pain; other non- pharmacological interventions), 2) \"Complicating factors in the management of neonatal pain\" (failures in how to deal with the pain; excess of painful procedures; workflow and quantity of personnel), 3) \"Pain assessment\" (how and when to assess; the importance of pain assessment), 4) \"Necessary changes to improve pain management in the institution\" (trainings; protocols and the use of scales to assess pain; changing the attitude of professionals and making the team more sensitive), 5) \"Participation of the parents and/or family in the management of neonatal pain\" (advantages and support in the management of neonatal pain with the participation of the family; difficulties in the participation of the family for managing neonatal pain). In conclusion, health professionals have a superficial knowledge regarding the assessment and non-pharmacological management of acute neonatal pain in the studied maternity hospital. In addition, there is a lack of formal clinical protocols, records and qualification of health professionals. Considering the proposals for non-traumatic, developmental and humanized care to the neonate, it becomes imperative to make changes in actions and conducts of the health team in terms of neonatal pain management, as these professionals must be driven and encouraged based on professional qualifications grounded on knowledge transfer
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Griffiths, Debra. "Agreeing on a way forward management of patient refusal of treatment decisions in Victorian hospitals /." full-text, 2008. http://eprints.vu.edu.au/2036/1/griffiths_debra_thesis.pdf.
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The purpose of this study is to investigate and develop a substantive theory, of the processes adopted by nurses and medical practitioners when patients with serious illness refuse medical treatment. The study seeks to identify the main constraints confronting nurses and medical practitioners and to explain the key factors that moderate the processes of dealing with refusal decisions. Using a grounded theory method, a sample of 18 nurses and 6 medical practitioners from two public hospitals in Melbourne were interviewed. In addition, observations and documentary evidence were utilised. The basic social psychological problem shared by nurses and medical practitioners is conceptualized as Competing Perspectives: Encountering Refusal of Treatment, which reflects the diverse perceptions and beliefs that confront participants when patients decide to forgo therapy. In utilizing the grounded theory method of analysis, it is recognised that participants deal with this problem through a basic social psychological process conceptualized as Endeavouring to Understand Refusal: Agreeing on a Way Forward. This core variable represents the manner in which participants, to varying extents, deal with the situations they face and it incorporates the various influences which moderate their activities. Endeavouring to Understand Refusal: Agreeing on a Way Forward comprises a series of three transitions. The first involves a struggle for participants to come to terms with, or even recognize that patients are rejecting treatment. The second transition illustrates the varied responses of participants as they interact with patients, relatives and each other, in order to clarify and validate decisions made during episodes of care. The third transition reflects the degree to which patients and family members are incorporated into treatment decisions, and highlights a shift in emphasis, from a focus on the disease state, to the patient as a person with individualistic thoughts and wishes. The remaining social processes evident in the study consist of four categories. The first, Seeking Clarification, embodies exploration undertaken by participants and their recognition that treatment is actually being refused. The second category, Responding to Patients and Families, demonstrates the level of expertise of participants communicating, and their ability to encourage reciprocity in the professional-patient relationship. The third category, Advocating, highlights the extent and manner in which patient and family wishes are promoted to members of the treating team. The fourth category, Influencing, reveals the ability of participants to utilize a degree of authority or power in order to shape particular outcomes. The findings also indicate that over arching the core variable and categories are various contextual determinants that moderate the way nurses and medical practitioners deal with patient refusal of treatment. These determinants are categorized into three main influences: The Context of Work, describes the of the environment and organisational factors pertinent to public hospitals; Beliefs and Behaviours, illustrates the perceptions of, and values held, by four key groups involved in decisions, namely, nurses, medical practitioners, patients, and family members; and Legal and Ethical Frameworks, examines the existing principles that support or guide professional practice in situations where patients with serious illness refuse medical treatment.
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McIntosh, Jane. "An investigation into the effect of a staffing strategy on patient care in a selected hospital in Kwazulu-Natal." Thesis, Link to the online version, 2008. http://hdl.handle.net/10019/874.
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Manona, Wellman Wela. "Causative factors of turnover among public sector registered nurses." Thesis, Stellenbosch : Stellenbosch University, 2000. http://hdl.handle.net/10019.1/51645.
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Thesis (MPA)--Stellenbosch University, 2000.Full text to be digitised and attached to bibliographic record.
ENGLISH ABSTRACT: Managing human resources is crucial to the efficient and effective delivery of quality health care. However, turnover of nurses constitutes a major factor in the shortages of staff which are being experienced by the nursing profession in the Republic of South Africa. Shortages of trained nurses with experience, particularly in public sector hospitals, have adverse effects on the provision of efficient and effective quality health care to the consumers of this service. The aim of the study was to provide an understanding of and insight into those inherent problems in the health sector that propel nurses to leave public sector institutions. The overall objective was to investigate and identify some of the factors which exercised an influence on the turnover of registered nurses in public sector hospitals, so as to be able to provide suggestions to hospital managers on the more effective management of human resources, in order to retain nursing personnel. Theresearch was based on a model of nursing turnover which regarded voluntary withdrawal as a process in which feelings of satisfaction with pay, on the one hand, and the opportunity of obtaining alternative jobs in the labour market, on the other, were proposed as the primary causative factors of turnover behaviour. In addition the propositions, made in literature reviewed, that age, tenure, kinship responsibility, general training, education, professionalism, marital status, lintent to stay', job satisfaction, routinization, job autonomy and responsibility, instrumental communication, promotional opportunity, integration, supervisory relationships, distributive justice, work-load, and local kin acted as predictors of turnover, were also investigated. The research was conducted with a sample of 123 nurses in one hospital, Groote Schuur, situated in the Western Cape Province of the Republic of South Africa. The sample included registered nurses, senior professional (registered) nurses, and chief professional (registered) nurses. The data was gathered from respondents by means of a selfadministered questionnaire. In addition, data was gathered by means of semi-structured, open-ended discussions with nursing management. The hypothesised interactions between variables influencing nursing turnover were explored by means of basic statistics, which made it possible to assess the effects of both independent and dependent variables. The results of data analysis provided some support for the proposition contained in the hypothesis. The determinants whose increase produced a greater degree of turnover were firstly, the many jobs available outside the hospital and secondly, professionalism. The determinants whose increase resulted in reductions in turnover were "intent to stay" (which the researcher views as a dimension of commitment), the existence of local kin (kinship responsibilities), participation in making job-related decisions (job autonomy), the receipt of sufficient work-related information (instrumental communication and good supervisory relationships), and tenure. The determinants whose decreaseresulted in increased turnover werepromotional opportunities, distributive justice, pay satisfaction, job satisfaction, integration, opportunity for self-development,age and tenure. Turnover of nurses has serious ramifications for employers, patients, and the nursing profession itself. Effective management of employee turnover is of critical importance to health care providers, employees, and patients. Better control of turnover can improve the quality of patient care, reduce labour costs, and improve employee morale.
AFRIKAANSE OPSOMMING: Die bestuur van menslike hulpbronne is die deurslaggewende omstandigheid ten einde die lewering van effektiewe en doeltreffende gesondheidsorg van gehalte. Nietemin, dra die omset van verpleegkundiges grotendeels by tot die personeeltekort wat tans deur die verpleegprofessie in Suid-Afrika ondervind word. Die tekort aan ervare, opgeleide verpleegkundiges, veral in die openbare sektor staatshospitale, het 'n nadelige uitwerking op die voorsiening van effektiewe en doeltreffende gesondheidsorg van gehalte aan die verbruikers van hierdie diens. Die doelwit van die studie was om 'n begrip te ontwikkel vir, en 'n insig te probeer kry in, daardie inherente probleme binne die gesondheidsektor wat verpleegkundiges dryf om die staatsinstellings te verlaat. Die oorkoepelende doel was die ondersoek en identifikasie van sommige faktore wat die omset van geregistreerde verpleegkundiges in staatshospitale beïnvloed. Die doel hiervan was om voorstelle aan hospitaal bestuurders te kan voorsien ten opsigte van die meer doeltreffende bestuur van menslike hulpbronne, in die strewe na behoud van verpleegpersoneel. Die navorsing is gebaseer op 'n model van verpleegomset wat vrywillige onttrekking as 'n proses beskou het waar gevoelens van salaristevredenheid, aan die een kant, en geleentheid tot alternatiewe betrekkings in die arbeidsmark, aan die ander, as die primêre veroorsakende faktore van omset-gedrag voorgestel is. Daarbenewens is die stellings vanuit die literatuurstudie dat die volgende dien as voorspellers van omset ook ondersoek: ouderdom, ampstermyn of dienstyd, verantwoordelikheid teenoor familie, algemene opleiding, opvoeding, professionalisme, huwelikstatus, 'voorneme om te bly', werksbevrediging, roetine, selfbestuur en verantwoordelikheid in die werksomgewing, bevorderlike kommunikasie, bevorderingsgeleenthede, integrasie, toesighoudende verhoudings, toedelende gereg, werkslading en plaaslike naasbestaandes. Die navorsing is uitgevoer met gebruik van 'n monster van 123 verpleegkundiges van een hospital, die Groote Schuur Hospital, geleë in die Wes-KaapProvinsie van die Republiek van Suid Afrika. Die monster het geregistreerde verpleegkundiges, senior geregistreerde verpleegkundiges en hoof geregistreerde verpleegkundiges ingesluit. Die data is verkry van respondente deur middel van 'n self-toegediende vraelys. Daarbenewens is data versamel deur half-gestruktureerde, niegeslote besprekings met van die verpleegbestuur. Die interaksie tussen veranderlikes ten opsigte van verpleegomset wat veronderstel is, is ondersoek deur middel van basiese statistiek, dus kon die uitwerking van afhanklike en onafhanklike veranderlikes bepaal word. Die uitslae van data-ontleding het wel ondersteuning verleen aan die voorstelling soos uiteengesit in die hipotese. Die determinante wie se toename 'n toename in die omsetkoers tot gevolg gehad het was, eerstens, meer werksgeleenthede buite die hospitaal en, tweedens, professionalisme. Die determinante wie se toename tot 'n vermindering in omset bygedra het was 'voorneme om te bly' (wat die navorser as binne die omvang van toewyding beskou), deelname aan werksverwante besluitneming (werks outonomie), die ontvangs van genoegsame werksverwante inligting (bevorderlike kommunikasie en goeie toesighoudende verhoudings), en ampsduur (dienstyd). Die determinante wat tot 'n vermindering in omset lei is bevorderingsgeleenthede, toedelende gereg, salaris bevrediging, geleenthede tot self-ontwikkeling, ouderdom en ampsduur. Die omset van verpleegkundiges het verreikende gevolge vir werkgewers, pasiënte en die verpleegsberoep self. Doeltreffende bestuur van werknemer-omsetis van kritiese belang vir gesondheidsorg voorsieners, werknemers en pasiënte. Die meer effektiewe beheer van omset kan die kwaliteit van pasiëntesorg verbeter, arbeidsonkoste verminder en die moraal van werknemers verbeter.
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Rossetti, Ana Cristina. "Carga de trabalho de profissionais de enfermagem em pronto socorro: proposta metodológica." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/7/7140/tde-18012011-084203/.
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O objetivo deste estudo foi propor uma metodologia para identificar carga de trabalho de enfermagem em Pronto Socorro Geral. Trata-se de estudo descritivo exploratório, do tipo estudo de caso, realizado em um Hospital Geral, de atenção secundária que integra o Sistema Único de Saúde, com gestão por Organização Social, localizado no município de São Paulo. Os dados foram coletados de junho a agosto de 2010 por meio de instrumentos específicos. Para identificar a carga de trabalho das áreas em que houve atendimento para avaliação da gravidade e realização de procedimentos, como: Sala de choque, Sala de sutura e Sala de medicação/procedimentos de pacientes adultos e pediátricos, os dados foram coletados por meio de planilhas para registrar o tempo disponibilizado pela enfermagem para os pacientes. Nas áreas em que o paciente permaneceu em observação ou aguardando internação, como: Sala de emergência e Observações de pacientes adultos e pediátricos, utilizaram-se instrumentos reconhecidos na literatura. Para calcular a carga de trabalho da Sala de emergência, utilizou-se o Nursing Activities Score, considerando que essa área é similar a uma Unidade de Terapia Intensiva. Para as Observações de pacientes adultos e pediátricos foi utilizada a categoria de cuidado e o Sistema de Classificação de Pacientes específicos para unidades de internação de pacientes adultos e pediátricos. Pela característica da coleta de dados, obtiveram-se amostras distintas em cada área do PS. O tempo médio de assistência de enfermagem por paciente foi encontrado e a carga média diária de trabalho de cada área foi calculada por meio de equações e apresentada em horas e na relação entre enfermagem-paciente nas áreas em que o paciente permaneceu em observação ou aguardando internação. Na Triagem de classificação de risco, por tratar-se de consultórios que funcionam ininterruptamente, a carga diária de trabalho foi de 48 horas (1:1 consultório). Nas demais áreas, a carga média diária de trabalho encontrada foi: na Sala de choque, 27,8; na Sala de emergência, 170,7 (1:1,2); na Observação de pacientes adultos, 293,6 (1:3,5); na Observação de pacientes pediátricos, 108,7 (1:2,1); na Sala de medicação/procedimentos de pacientes adultos, 169,0; na Sala de medicação/procedimentos de pacientes pediátricos,63,8; e na Sala de sutura, 8,7. Os instrumentos utilizados para coleta de dados mostraram-se adequados, no entanto, os utilizados na Sala de choque e Sala de medicação e procedimentos de pacientes pediátricos não contemplaram a assistência por mais de um profissional de enfermagem para um paciente. Com este estudo, foi possível propor uma metodologia para identificação da carga de trabalho em Pronto Socorro geral e assim subsidiar o dimensionamento de profissionais de enfermagem.The aim of this study is to suggest a methodology to identify nursing workload in General Emergency Room (ER). This is an exploratory and descriptive study, case study type, carried out in General Public Hospital located in the city of São Paulo for secondary care, managed by social organization. Data was collected from June to August 2010 using specific instruments to identify workload of areas that have assistance to assess severity and procedures performed at shockroom, suture room and medication/procedure room for adults and pediatric patients. All data was registered in plans including length of time required to nursing assist patients. In areas that patients were at observation and waiting for hospital admission, such as: emergency room and outpatient observation room for adults and pediatric patients we used well-known instruments in the literature. To measure workload in emergency room the Nursing Activities Score was used, because this area is similar to an Intensive Care Unit. For adults and pediatrics patients observation, the category of care and patient classification system specific for hospital admission units were used. Given the characteristics of data collected, different samples were obtained in each area of ER. The mean time of nursing care and mean daily workload were found, and both were calculated using equations and presented in hours and nurse-patient ratio in the area that patients were kept at observation or waiting for hospital admission. In triage rooms, which function continuously, daily workload was 48 hours (1:1 triage room). In other areas, the mean daily workload was 27.8 in the shockroom, 170.7 (1:1.2) in the emergency room, 293.6 (1:3.5) in the outpatient observation room for pediatric patients, 108.7 (1:2.1) in the medication/procedure room for adults patients, 63.8 in the medication/procedure room for pediatric patients and 8.7 in the suture room. The instruments for data collection were adequate, however, those used in shockroom and medication/procedure room for pediatric patients did not provide care delivered by more than one nurse practitioner for a single patient. This study enables to propose a methodology to identify workload in general emergency room and helps to sizing the nursing professional.
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Machado, Bruna Parnov. "LIDERANÇA DE ENFERMEIROS-GERENTES NO CONTEXTO HOSPITALAR." Universidade Federal de Santa Maria, 2013. http://repositorio.ufsm.br/handle/1/7371.
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Coordenação de Aperfeiçoamento de Pessoal de Nível SuperiorMore than find the importance of the presence of active leaders in the hospital nursing context, we sought torescue the meanings attributed by nurses who experience the position of manager in nurse and that have their actionspermeated by possibilities for leadership development. View of this the research conducted object was the nurse manager leadership that act at the University Hospital in the countryside of Rio Grande do Sul. For this, was elaborated the guiding question: how the manager nurse exercises the leadership in a hospital context? Were outlined that objectives: to analyzes the leadership of University Hospital nurse managers, to describe the experiences related to leadership in nurses managementevery day and to elaborate a representative theoretical matrix of nurse managers experiences´ in relation to leadership. It is about a descriptive and qualitative research which scenario was the Santa Maria University Hospital (HUSM), Rio Grande do Sul. The participants were nurse managers and the data were collected in April and May 2012, using semi-structured interviews.The analysis had been started concomitant with the data collect, with theuse of Grounded Theory (GT), theoretical support of Symbolic Interactionism and others leadership studies.Were followed the ethical principles of Resolution No. 196/96 of the National Health Council, which regulates research involving humans.That way, the audio data´swere transcripts and coded according to the order: open coding, axial code and selective coding.The results originated the thematic categories: realizing a nurse manager, looking for meanings to the process of leading and being leader, experiencing the service reality, confronting management challenges, establishing interpersonal relationships and seeking improvements to the service.The interconnection of these, through the analysis with the paradigmatic model has made emerge a theoretical matrix, composed by the central phenomenon following:experiencing nursing management in a hospital context: meanings to leadership. Finally, it was possible identified that the nurse manager realizes the importance of their actions at the managerial dimension and seeks to achieve their objectivesthrough attitudes that approaches a participative leadership model.Thus, should be paid attention with regard the need to awaken a look that valuates interpersonal relationships and the development of the human potential inhealthcare organizations.
Mais do que constatar a importância da presença de líderes ativos no contexto da enfermagem hospitalar, buscou-se resgatar os significados dos enfermeiros que vivenciam a posição de gerentes em enfermagem e que possuem suas ações permeadas de possibilidades relativas ao desenvolvimento de liderança. Em vista disso, o objeto da pesquisa realizada foi a liderança de enfermeiros-gerentes que atuam em um Hospital Universitário do interior do Rio Grande do Sul. Para isso, elaborou-se a questão norteadora: como o enfermeiro-gerente exerce a liderança no contexto hospitalar? Foram traçados como objetivos: analisar a liderança de enfermeiros-gerentes de um Hospital Universitário, descrever as vivências relacionadas à liderança no cotidiano gerencial dos enfermeiros e elaborar uma matriz teórica representativa da experiência dos enfermeiros-gerentes em relação à liderança. Trata-se de uma pesquisa descritiva e qualitativa cujo cenário foi o Hospital Universitário de Santa Maria (HUSM), Rio Grande do Sul. Os sujeitos foram enfermeiros-gerentes, e os dados foram coletados em abril e maio de 2012, por meio de entrevistas semiestruturadas. A análise foi iniciada concomitante à coleta, com a utilização da Teoria Fundamentada nos Dados (TFD) e o respaldo teórico do Interacionismo Simbólico e estudos sobre liderança. Foram seguidos os princípios éticos da Resolução nº 196/96 do Conselho Nacional de Saúde que regulamenta a pesquisa envolvendo seres humanos. Dessa forma, os dados em áudio foram transcritos e codificados de acordo com a ordem: codificação aberta, codificação axial e codificação seletiva. Os resultados obtidos originaram as categorias temáticas: percebendo-se enfermeiro- gerente, buscando significados para o processo de liderar e ser líder, vivenciando a realidade do serviço, enfrentando desafios gerenciais, estabelecendo relações interpessoais e buscando melhorias para o serviço. A interconexão dessas, por meio da análise junto ao Modelo Paradigmático, fez emergir uma matriz teórica, composta pelo seguinte fenômeno central: vivenciando a gerência de enfermagem no contexto hospitalar: significações para a liderança. Por fim, foi possível identificar que o enfermeiro- gerente percebe a importância de suas ações na dimensão gerencial e busca atingir seus objetivos por meio de atitudes que se aproximam de um modelo de liderança participativa. Assim, deve-se atentar no que se refere à necessidade de despertar um olhar voltado para a valorização das relações interpessoais e ao desenvolvimento do potencial humano nas organizações de saúde.
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Spagnol, Carla Aparecida. "A trama de conflitos vivenciada pela equipe de enfermagem no contexto da instituição hospitalar : como explicitar seus nos?" [s.n.], 2006. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312132.
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Orientador: Solange L'AbbateTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: Nessa pesquisa, investiguei os conflitos vivenciados pela equipe de enfermagem do Hospital das Clínicas-UFMG, motivada pelo fato de o enfermeiro desempenhar atividade de gerência nos serviços de saúde e freqüentemente lidar com relações conflituosas. Os objetivos delineados foram: conhecer as diferentes percepções de conflito dos enfermeiros; identificar aqueles mais comuns e os principais fatores que geram esses conflitos; compreender como o enfermeiro lida com os conflitos no trabalho; levantar facilidades e dificuldades para lidar com os conflitos e propor aos enfermeiros a construção coletiva de um dispositivo socioanalítico, a ser utilizado como espaço de análise e reflexão da prática profissional, focalizando o objeto de estudo. Por se tratar de um fenômeno processual, optei pela abordagem qualitativa, desenvolvendo uma pesquisa-intervenção em duas fases. Na primeira, realizei uma pesquisa exploratória, com o objetivo de me aproximar dos sujeitos e do objeto de estudo, utilizando um questionário, que foi aplicado, em setembro de 2003, a cento e cinco enfermeiros (105), sendo que desses, trinta e sete (37), o devolveram. Na segunda, utilizei a perspectiva da socioanálise, para construir um dispositivo, visando a criação de um espaço que permitisse à pesquisadora e às pesquisadas realizarem, conjuntamente, análises e reflexões acerca da prática profissional, focalizando situações de conflito vivenciadas no trabalho. Foram realizados cinco encontros nos meses de setembro e outubro de 2005, com duração de duas horas cada, onde participaram seis enfermeiras que, no questionário, responderam afirmativamente quanto à sua continuidade no estudo. Nessa fase, as integrantes ao elaborarem a demanda de análise do grupo, expressaram vários motivos para participarem dessa investigação, dentre eles destaco suas implicações com a pesquisadora. Para as enfermeiras conflito é: diferença de pensamentos e de posições, coisa que incomoda e algo estressante. Apresentam uma visão bipolar desse fenômeno, pois, a princípio, são percebidos como negativos, mas dependendo do ângulo que se olha também o consideram como positivo, isso se forem discutidos com todos os envolvidos e conduzidos adequadamente. Identifiquei os seguintes tipos de conflitos: intrapessoal, interpessoal, intergrupal, de poder e de interesse. As principais causas que geram esses conflitos são: duplicidade de vínculo empregatício; deficiências na estrutura organizacional e no modelo de gerência implantado; escassez de recursos; centralização do trabalho; hierarquia; autoritarismo; imaturidade; escalas de serviço; falta de respeito e compromisso profissional, trazendo conseqüências para as relações interpessoais e para a assistência prestada. As enfermeiras lidam com situações de conflito, de forma racional, apresentando desejo de fuga, ao realizarem ações imediatistas, a fim de contornarem ou amenizarem a situação, assumindo que não são preparadas para conduzirem questões problemáticas ligadas ao comportamento e relacionamento interpessoal. Sendo assim, em determinadas situações, solicitam ajuda aos psicólogos da Diretoria de Recursos Humanos do hospital. O próprio dispostivo socioanalítico se constituiu em um analisador, permitindo explicitar instituídos e instituintes, implicações e transversalidades, presentes na organização hospital que é atravessada pelas 'instituições enfermagem e medicina¿. Diante das avaliações positivas relacionadas aos encontros grupais, sugiro desenvolvermos outros trabalhos tendo o dispositivo socioanalítico como um espaço coletivo de análise e reflexão das relações e práticas profissionais
Abstract: In this research, I investigated the conflicts experienced by a nursing team at the Federal University of Minas Gerais Hospital, motivated by the fact that nurses manage health care and frequently face conflict situations. The aims of this research were: to learn about nurses different perceptions regarding conflict; to identify the most common conflicts and the main factors that generate these conflicts; to understand how nurses manage conflicts at work; to find out motivations and difficulties to manage conflicts and propose to nurses a collective construction of a socio-analytical instrument to be used as a space for analysis and reflection of professional practice, focusing on the study object. As it is a process phenomenon, I used a qualitative approach, developing an intervention research in two phases. In the first phase, I developed an exploratory research with the purpose to get closer to the subjects and study object, using a questionnaire that was applied in September 2003 to 105 nurses. Among them, 37 responded and sent it back. In the second phase, I used the socio-analysis perspective to build an instrument, aiming at creating a space that would allow the researcher and research to be developed as well as analyses and reflections regarding professional practice, focusing on conflict situations experienced at work. Five meetings happened in September and October 2005, of two hours each, with the participation of six nurses that manifested in the questionnaire their intention to continue the study. In this phase, the members of the group expressed their motivations to participate in the study, emphasized its implications regarding the researcher. According to these nurses, conflict is a difference of thoughts and positions, something that may impair the relationship. They present a bipolar view of this phenomenon as at first they are perceived as negative, but depending on the way they are seen they can be considered positive, if they are discussed with all the persons involved and managed adequately. The following types of conflict were identified: intrapersonal, interpersonal, intergroup, of power and of interest. The main causes that generate these conflicts are: work in more than one place, problems regarding the organizational structure and management, lack of resources, work centralization, hierarchy, authoritarianism, immaturity, work shifts, lack of respect and professional commitment that influence interpersonal relations and the care provided. Nurses manage conflict situations in a rational way, presenting their desire to run away when they implement immediate actions, in order to minimize the situation, assuming that they are not prepared to conduct problems related to behaviors and interpersonal relationships. Therefore, in some situations they ask for help to psychologists from the Hospital Human Resources Division. The socio-analytical instrument was a means to analyze it, enabling them to expose the situations, implications and transversal intersections that are present at the hospital organization that is crossed by other institutions such as ¿nursing and medicine¿. Considering the positive evaluation of the group meetings, I suggest the development of other works based on socio-analytical instruments as a collective space for the analysis and reflection of relationships and professional practices
Doutorado
Saude Coletiva
Doutor em Saude Coletiva
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Kriel, Dora Jenice. "Perceptions of nurses with regard to staffing in the operating rooms of a private hospital." Thesis, Nelson Mandela Metropolitan University, 2017. http://hdl.handle.net/10948/18014.
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Despite a number of research studies showing the correlation between higher nurse staffing levels and improved outcomes, RCN members continues to report lower nurse-to-patient ratios than what research results suggests (RCN, 2011:1). This reflected a general concern within the nursing profession. The operating room requires appropriate staffing which is critical to the safety of surgical patients and quality of patient care. The research study was motivated by the researcher’s own experiences while working in an OR in a private hospital where continuous discussions were held with management about the shortage of skilled staff; and where a shortage of OR nurses resulted in the use of Central Sterilizing Department (CSD) staff to do OR duties. The objective of the study was to explore and describe the perceptions of nurses regarding staffing in the operating rooms of a private hospital in the Nelson Mandela Bay Health District. The researcher used qualitative methods and designs to explore and described the perception of nurses regarding staffing in the operating room (OR) of a private hospital in the Nelson Mandela Bay Health District. The research population of the study included all the nurses working in the OR of a private hospital. The total number of 20 OR nurses was individually interviewed by means of semi-structured interviews. Three main themes emerged that includes nurses ‘perceptions with regard to the implications of inadequate staffing in the OR; nurses experiences towards top management with regard to staffing in the OR and recommendations from participants to improve staffing in the OR. Research findings concluded that nurses have a perception that shortage of OR nurses causes lack of communication, physical, emotional and psychological strain. They also perceived OR nurses to work under unrealistic conditions and to receive added responsibilities due to staff shortages, which affect the overall delivery of quality patient care. Comments included failure of management to attend to staff complaints and the perception of high staff turnover due to a lack of recognition and acknowledgement of overworked staff.
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Ruiz, Paula Buck de Oliveira. "Custo da rotatividade da equipe de enfermagem em hospital de ensino." Faculdade de Medicina de São José do Rio Preto, 2014. http://hdl.handle.net/tede/316.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES
Introduction: The staff turnover is determined by the output of employees or exchanges of staff the organization and constitutes a poorly explored subject and subdued by the institutions, but it begins to take relevant due to the economic consequences. The management of this indicator may benefit the intellectual capital, the environment, the institution's image and cost control. Aims: Identify the types and reasons of dismissals of professionals and calculate the rate and cost of staff turnover. Methods: Study was exploratory, descriptive, and manner of case study, conducted in teaching hospital southeastern Brazil, in the period May-November 2013. The data were obtained through interviews shutdown provided by human resources in the period 2009-2012. For the calculation of the turnover was used the equation proposed by the Hospital Quality Commitment. For the measurement of cost, the collection was prospective (May-August 2013). and was used the Methodology of Calculation of Cost of Turnover in Nursing. The pre and post contract processes were mapped and the direct costs of labor were analyzed Results: There were 522 dismissal, the average of terminations was 76.3 (dp 97,3), personal reason was the predominant cause of shutdowns - 35.9%, mainly for nursing assistants. The average turnover rate/year was 9.4% nurses, 35.7 % and 11.2 % technical assistants. The total cost of turnover, during the period of 2013 May and August was R$314,605.62 and the average was R$2.759,69, and the cost of employees was R$8.279,09 (average turnover rate of 0.98%). The costs of pre-employment totaled R$101.004,60, and the vague process consumed – 29.5%, and the costs of post-employment totaled R$213.601,02, aimed mainly at subprocess decreased productivity – 63.6%. The cost of turnover/employee avarage R$2.221,42 to R$3.073,23 and the cost of dismissal/employee was R$8.279,09, from R$5.553,56 to R$16.811,75. Conclusion: This research showed a historical series regarding turnover and reasons for dismissals, as well as the financial impact of employees/off cost which represented three times the average salary of the nursing staff. These findings instrumentalize manager for improvement in reducing costs of these proceedings and directed will retain intellectual capital policies.
Introdução: A rotatividade de pessoal é determinada pela entrada e saída de colaboradores do quadro de pessoal da instituição e constitui um tema ainda pouco explorado e subestimado pelas instituições, mas que começa a tomar relevância em virtude das consequências econômicas. A gestão desse indicador poderá beneficiar o capital intelectual, o ambiente, a imagem da instituição e o controle dos gastos. Objetivos: Identificar os tipos e motivos dos desligamentos da equipe de enfermagem; Calcular a taxa e o custo de rotatividade desses profissionais. Métodos: Pesquisa quantitativa, exploratória, descritiva na modalidade de estudo de caso, realizada em hospital de ensino de capacidade extra na região sudeste do Brasil. Os dados foram obtidos por meio da entrevista de desligamento disponibilizado pelos recursos humanos no período de 2009 a 2012. Para o cálculo da rotatividade foi adotada a equação proposta pelo Compromisso com a Qualidade Hospitalar. A mensuração do custo da rotatividade da equipe de enfermagem foi prospectiva (maio a novembro de 2013) mediante a aplicação da Metodologia do Cálculo de Custo de Rotatividade na Enfermagem. Foram mapeados os processos de pré e pós-contratação e analisados os custos diretos da mão de obra. Resultados: Houve 522 desligados, com média anual de 76,3 (dp 97,3), o motivo pessoal foi a causa predominante dos desligamentos - 35,9%, principalmente para auxiliares de enfermagem. A taxa média de rotatividade foi de 9,4% enfermeiros, 35,7% técnicos e 11,2% auxiliares. A mensuração do custo total da rotatividade da equipe de enfermagem, no período de maio a agosto de 2013 foi de R$314.605,62, média rotatividade/colaborador de R$2.759,69 e o custo desligamento/colaborador R$8.279,09 (taxa média de rotatividade de 0,98%). Os custos decorrentes da pré-contratação totalizaram R$101.004,60, sendo que o subprocesso vagas consumiu - 29,5% e os pós-contratação totalizaram R$213.601,02, destinados principalmente ao subprocesso diminuição da produtividade - 63,6%. Conclusão: A presente pesquisa mostrou uma série histórica em relação à taxa de rotatividade e motivos de desligamentos, bem como, o impacto financeiro do custo desligamento/colaborador que representou três vezes o salário médio da equipe de enfermagem. Estes achados instrumentalizam o gestor para melhorias na redução de custos desses processos e de políticas direcionadas à retenção de capital intelectual.
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Kwocz, Fabienne. "Les cadres de santé à la croisée du management et du prendre soin : formation et usages de la recherche dans l'accompagnement des équipes soignantes." Thesis, Tours, 2017. http://www.theses.fr/2017TOUR2032/document.
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Le métier de cadre de santé de proximité dans les structures hospitalières publiques s’est profondément modifié depuis ces dix dernières années. Ses missions très largement tournées aujourd’hui vers des fonctions de management et de gestion, l’éloignent de celles d’encadrement des équipes soignantes vers une qualité de soins aux patients. Certains ne se retrouvent pas dans ce changement de profil et vivent très difficilement ces évolutions. L’intention de cette thèse est de porter un regard sur ce qui entre en jeu dans cette tension et d’interroger les éléments de la formation qui permettraient de la déjouer. Parmi ces éléments, la formation à la recherche - une certaine recherche dont les contours seront précisés - pourrait-elle permettre au cadre de santé de redonner sens à sa fonction ? L’auteur s’attache tout d’abord à définir, au travers de l’histoire, de son évolution et de sa formation, la fonction du cadre de santé. Puis, il examine ce qui la caractérise aujourd’hui à partir de trois notions principales : manager, encadrer, accompagner. Finalement, il éclaircit la question du prendre soin dans la fonction de cadre de santé. Ces éléments permettent de comprendre en quoi la démarche de recherche peut être un levier pour mettre en valeur l'art du prendre soin dans la pratique du cadre de santéThe position of nursing team managers in public hospital facilities has changed dramatically over the past ten years. It is now strongly focused on organization and administrative tasks, which draw them away from their role as nursing team managers dedicated to quality care to patients. Some of them resent this change in their job profile and find it very difficult to cope with this evolution. The intent of this thesis is to look into what causes this strain and to examine which elements in the training program could help prevent it. Among those elements, could research training (in a specific type of research to be defined further on) enable nursing team managers to enjoy their professional activity? First the author will define the function of nursing team manager through its history, its evolution and training methods. The author will then consider its specificities in the present day, based on three primary concepts: organization, management and support. Finally he will clarify the ‘care’ issue in the scope of the nursing team manager’s activity. These elements will give an understanding of how the research approach can promote the ‘art’ of ‘caring’ in the nursing team manager’s activity
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Pinho, Eurides Santos. "Processos de trabalho de um centro de atenção psicossocial tipo III: reflexão de práticas e saberes." Universidade Federal de Goiás, 2015. http://repositorio.bc.ufg.br/tede/handle/tede/6554.
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Comprehending the ongoing (re)building process of the substitutive psychosocial model to the nursing home care model for people suffering from mental disorders, it is worthwhile to know the healthcare dynamic of a substitutive service, in order to identify any issues within the team, which could interfere with the quality of care they provide. The aim of this study was to identify the working process of professionals at a Type III Psychosocial Care Center (PCC). This is an interventional study using a qualitative approach, that is based on the problem-based method, known as Arco de Maguerez. It consists of five stages: reality observation, key points, theorizing, problem-solving hypothesis, and application to reality. The development of the study was based on lightweight technology sources mediated by group technique. In the first stage, strong and weak points of the service were identified, followed by a discussion of issues related to the patient, family, teamwork, territory, and management. From this, the strengths and weaknesses of the staff and service were discussed. Following this, the participants emphasized the importance for discussion on the difficulty of integration and coordination of the Psychosocial Care Network. In the next step, problems regarding key points in question were expressed and this guided the active search in the literature for theorizing, which would guide in developing possible solution options. Therefore, permanent health education to perform the matricial and approaches to disclose the PCC territory were debated, and subsequently strategies were developed and applied to reality. Through the research process, the strengths of the team that would help them to overcome their shortcomings were identified. While some restraining forces that precluded this movement were also identified. In this context, the awareness-making process and the participants’ willingness to embrace change were evident throughout the study. This highlights the acceptance of the proposal of the interventional research that is based on the problematization of the service. It is evident that the spaces validity for the exchange of practices and knowledge, reflection-action-reflection, are imperative to the production of knowledge, which supports professionals for the qualification of care in mental health.
Entendendo o processo contínuo de (re)construção do modelo psicossocial substitutivo ao modelo de assistência asilar a pessoas com sofrimento ou transtornos mentais, considera-se fundamental conhecer a dinâmica assistencial de um serviço substitutivo, com vistas a delinear junto à equipe situações problemas que interferem na qualidade do cuidado que oferecem. A pesquisa teve o objetivo de conhecer os processos de trabalho dos profissionais de um Centro de Atenção Psicossocial tipo III. Estudo do tipo de intervenção, de abordagem qualitativa, direcionada pela metodologia problematizadora do Arco de Maguerez, que compreende cinco etapas sucessivas: Observação da Realidade, Pontos-chave, Teorização, Hipóteses de Soluções e Aplicação à Realidade. Seu desenvolvimento foi norteado utilizando-se essencialmente recursos das tecnologias leves, mediadas por técnicas grupais. Na etapa inicial, foram elencados pontos frágeis e fortes do serviço, seguidos da discussão de questões relativas ao usuário, família, equipe, território e gestão. A partir desse momento discutiram-se os entraves e pontos propulsores da equipe e do serviço. Na sequência, os participantes elegeram como ponto prioritário de discussão a dificuldade de integração e articulação da Rede de Atenção Psicossocial. A etapa seguinte privilegiou-se a problematização dos pontoschaves em questão, que orientaram a busca ativa na literatura para a teorização que orientaria as possíveis hipóteses de soluções. Assim, a educação permanente em saúde para realizar o matriciamento e formas de divulgação do CAPS no território foi debatida e, posteriormente, estratégias de ações foram aplicadas à realidade. No caminhar do processo de pesquisa, constataram-se forças propulsoras da equipe para o enfrentamento de suas dificuldades e também algumas forças restritivas que impediam este movimento. Neste contexto, os processos de tomada de consciência e de mudança dos participantes ficaram evidentes ao longo do estudo, salientandose a aceitação da proposta da pesquisa intervencionista, fundamentada na problematização do cotidiano do serviço. É perceptível a validez dos espaços de trocas de práticas e saberes, reflexão-ação-reflexão, para a produção de conhecimento que subsidiem os profissionais para a qualificação do cuidado em Saúde Mental.