Viabilidade do processo de enfermagem no contexto hospitalar

The Nursing Process (NP) is considered as the dynamics of the systemized and inter-related actions of human care. We believe that the nursing manager, as the representative of all the nursing care provided in the hospital setting, is an important agent for the implementation of institutional policies, such as the NP, in the service. However, there is little information in the literature about the NP in the perspective of the nurse manager. The objective of this study was to analyze the viability of the Nursing Process in the hospital context based on the attitudes of the nurse managers toward the Process. We conducted a descriptive-exploratory research study, of quantitative approach, with a population of 45 nurse managers that worked in the state hospitals located in Natal, RN and in the university hospitals of the UFRN. Two instruments were used for the collection of data: a nursing process questionnaire, constructed for use in this study, and the scale for the measurement of the attitudes titled Positions on the Nursing Process. The population is predominantly feminine (91,0%) and have relative nursing practice experience (Mean=17,6 years). However, they have little experience in management (Mean=8,6 years). They express little knowledge of the PE nursing terms and little experience with the Process. They have a positive atitude toward the NP (Mean = 110,9); are favorable to its developement in the service (86,7%); 48,9% indicated little possibility of institutionalization in the service and 37,8% indicated large possibility. The Spearman test for association between the variables of attitude about the NP and the possibility of its institutionalization demonstrated a weak negative association in the total individual scores of the attitudes (-,316) as in the 20 itens of the instrument, with coefficients varying from 0,014 to 0,464. Factorial analysis of the instrument identified three underlying factors to the attitudes of the managers in this study: relevance, operationalization and collaboration, with Cronbach Alpha coeficients of 0,955, 0,844 and 0,807, respectively, and 0,956 for the whole instrument, indicating that the scale and its factorial subscales have internal consistency. We conclude that there is a weak tendency for the managers with a favorable attitude to have a negative perception about the possibility of institutionalization of the NP in the service. The favorable position does not appear to be sufficient for the viability of this methodology in the hospital sector, results that is worrisome for nursing. This situation suggests that the difficulties with the institution of the NP in the hospitals may be related to other factors, including the organizational conditions. We believe that the institucionalization of the NP in a servisse where it is not known and not practiced, constitutes the introduction of an innovative work technology that involves many demands, among them the adherence of the persons to the proposed innovation. This demands time and the institutional adjustments and the human resources necessary. In this process, the involvement of the health professional of the institution is necessary. This situation brings to light the discussions of professional autonomy, the action limits and perspectives, the redefinition of roles, delimiation (or consensus) of the objects of study and of the work processes, among others.

Estratégias de intervenção utilizadas por enfermeiros da ESF do município de Natal/RN no controle do câncer do colo de útero

Cancer of the cervix (cervical cancer) is the second most prevalent cancer among Brazilian women. The high rates of cervical cancer in Brazil justify the implementation of effective strategies to control this, which include actions to promote health, primary prevention, early detection, screening, treatment and palliative care. Despite the existence of the National Programme for Control of the CCU there was no reduction in the incidence and mortality of this disease in Brazil. The Family Health Strategy (FHS) has the potential to facilitate such control and, in this context, one should consider that nurses play a central role. The study aimed to know the general intervention strategies used by nurses FHS of Natal / RN in CCU control, and how specific: analyzing the knowledge of these nurses on the CCU, the actions developed in the ESF for the control of CCU and identify the difficulties faced by them to perform it. This is a descriptive exploratory quantitative developed through a structured interview guide with 106 nurses who have experience in controlling the CCU in FHS teams of Natal / RN. Data analysis was performed using descriptive statistic s. The results pointed to actions taken in the FHS to control the CCU, collection of cervical cancer screening, health education activities, nursing consultation, referral of suspected cases for medical monitoring and active women with abnormal test result . The actions that were not mentioned by the nurses included: forming groups of prevention and health promotion; expand coverage of exams and office hours of consultations, establishment of alternatives to end the pent-up demand in the health units, participation in treatment or rehabilitation process users with the CCU; interventions for pain management, alliances and partnerships with schools, in dustry and the use of protocols. This study can be seen that the practice nurses partially shares to the CCU in Natal / RN. The participants of this study, when asked about the CCU, specifically for signs and symptoms of disease and risk factors in general showed important gaps. Difficulties such as lack of materials for collection of Pap smear; inadequate physical space in the Health Units; pent-up demand in the service, delay in arrival of the test results; obstacles in the actions of referral and counter-referral and cultural factors make the CCU control is compromised. It is believed in this research contributed to a reflection on the importance of the role of nurses in the development of the ESF control actions CCU, pointing out the factors that affect these. It is important to involve all nurses who comprise the ESF as knowledgeable of the risk factors, signs and symptoms, and existing tools for the early detection of cervical cancer in the pursuit of quality improvement actions to promote women`s health, contributing in planning future interventions that may reduce mortality from this disease in Natal / RN.

Metodologia de implantação da construção enxuta: estudo de caso em construtora de porte médio

In recent years, the Brazilian construction industry has gone by changes like currency stability, increasing competition, shortage of skilled labor and increasing quality importance required by the customer, who made the sector companies seek solutions through new management practices in order to become more efficient. A alternative to these management practices is known as Lean Construction which is derived from the Toyota System Production. Lean Construction main goals are to reduce parts of activities that do not add value, increase product value by considering customer needs, reduce variability and production cycle time, simplify process by reducing the number of parts or steps, increase the flexibility in the product execution and transparency process, focus the control on overall process, introduce continuous improvement process, maintain a balance between improvements in flows and conversions and seek to learn from practices adopted by competitors. However, the construction industry is characterized by having nomadic activity, which undertakes an unique product with high cost of production and big inertia for behavioral change, making it difficult to implement the philosophy of lean construction in companies. In this sense, the main objective of this study is to develop a methodology for implementation of the principles of Lean Construction. The method of implementing the proposed management system was designed with the aid of 5W2H tool, and the implementation process is divided into three phases. The first one aims to know in a macro way the current operation of construction, identify who is its target audience and what are the products and services offered to the Market. The second phase aims to describe what actions should be taken and which documents are needed to be created or modified; finally, the third step goal consists in how to control and monitor established processes, where through Strategic Planning the company goals would be set along with their respective targets and indicators in order to keep the system working, aiming for continuous improvement with focus on the customer. This methodology was conceived as a case study analyzing a medium size construction with more than 18 years of activity and certified for almost 10 years with ISO9001 and level A in PBQP-H. We also conclude that this implementation process can be used in any developer and / or builder

Balanced Scorecard: fatores relevantes de sua implantação na diretoria de mercado de capitais do Banco do Brasil

Este trabalho objetiva determinar que características do corpo funcional da DIMEC (Diretoria de Mercado de Capitais do Banco do Brasil) estão associadas aos principais entraves considerados relevantes pelos funcionários da área durante a implementação do Balanced Scorecard (BSC). Pretende-se salientar como entraves tais como a falta de apoio de Tecnologia de Informação e a falta de hábito dos funcionários em lidar com indicadores não financeiros podem se relacionar com as características de interesse do corpo funcional, tais como nível hierárquico , formação acadêmica e nível de conhecimento da ferramenta BSC , de forma a influenciar na implementação do modelo. Para tanto foi realizada revisão de literatura e estudo de caso no qual figuraram, como instrumentos de coleta de dados, a aplicação de questionários e a entrevista não-estruturada através dos quais funcionários da DIMEC demonstraram as relações entre as variáveis descritas de forma a destacar fatores de relevância para o desenrolar do processo de implantação da ferramenta BSC na referida empresa

Uma proposta para preparação de pequenas e médias empresas brasileiras prestadoras de serviços ao setor de telecomunicações para implantação da metodologia Seis Sigma

The objective of this work consists of considering a script so that operating companies in the telecommunications sector, mainly small and medium-sized enterprises, can reach excellency in its operations and get, thus, conditions to compete with companies consolidated in its niche of market. The proposal intends to lead the enterprises to a level of qualification of processes that to become them apt to adopt the Six Sigma method as part of its culture. From the analysis of the essential processes of the sector, methods and tools will be suggested for guarantee the continuous improvement of these processes, without forgetting the internal peculiarities of each company

Estratégias de aplicações sequenciais e paralelas da metaheurística otimização por enxame de partículas ao problema do caixeiro viajante

Particle Swarm Optimization is a metaheuristic that arose in order to simulate the behavior of a number of birds in flight, with its random movement locally, but globally determined. This technique has been widely used to address non-liner continuous problems and yet little explored in discrete problems. This paper presents the operation of this metaheuristic, and propose strategies for implementation of optimization discret problems as form of execution parallel as sequential. The computational experiments were performed to instances of the TSP, selected in the library TSPLIB contenct to 3038 nodes, showing the improvement of performance of parallel methods for their sequential versions, in executation time and results

Segurança Alimentar e Controle de Qualidade: um estudo da implantação do Programa Alimentos Seguros em supermercados de bairro

This study aimed to analyze the percentage of compliance, related to the requirements of Practice, achieved by 23 supermarkets in neighborhood after the deployment of Food Insurance Program. For its development research methodology adopted was the application start and end of a check-list (tool-specific SBP) in 23 supermarkets, target of this study. After the deployment of PAS was made a comparative study where it was possible to see that these companies need to improve conditions related to food safety, because according to the study, none of the 23 supermarkets evaluated met the criteria recommended by the SBP to 100% of compliance for the items critical of the check-list. Only 04 of the 23 supermarkets were in the range of 80 to 90% of the overall percentage of compliance, representing only 17.3% of the sample. Most of the sample submitted in a regular situation, according to the methodology of Cardoso (2001). Of the 23 supermarkets studied, 03 supermarkets were classified as poor (13.04%), 13 as scheduled (56.52%) as good and 07 (30.43%). You can see improvements in a small part of the sample, but the decline in the percentage of compliance of 02 companies after working for the implementation of the program, showing lack of responsibility and commitment of companies which should have as its top priority to food safety that market

Diagnóstico para implantação do sistema de gestão ambiental em postos revendedores de combustíveis no município de Paranamirim RN: um estudo de caso

natural resources that still enjoy, in the certainty that if we do not, could culminate at the end of that remains. The environmental contamination by fuels in the retail service of oil and biofuels, has been a subject of growing research in Brazil, due to the large pollution potential of this activity. The aim of this study was to evaluate the importance of implementing the Environmental Management System (EMS) in fuel retail service stations in the city of Parnamirim-RN, but also describe the current situation the same as licensing and environmental characterization; identify existing barriers to implementation of EMS on the costs, technologies, knowledge, vision, present the potential benefits for the implementation of the EMS (social, economic and environmental), to identify the existence of plans for future action to implement the EMS , as a subsidy to promote the implementation of it. The methodology was developed through analysis of documents provided by the environmental agency responsible for licensing of retail service stations and fuel pala ANP. For data collection, we used the questionnaire was applied directly to managers or managers of sub-stations. Data were collected in 12 of 30 posts in the municipality. For purposes of data treatment was performed a descriptive analysis with respect to the opinion of twelve managers (respondents). The data acquired, according to the Likert scale were tabulated and analyzed using software SPSS 17.0 and Excel 2003, it was generated tables and graphs to observe the behavior of the data. The results showed that most respondents have a schooling level higher (58.3%) of the jobs surveyed 50% work on average 6 to 10 years and 41.6% are in operation for over 11 years , 75.0% do not have a license to operate and 12 stations, 58.3% were sued for not having a license to operate and are therefore in full commercial activity, 83% of jobs have some practice environmentally responsible, 75% agree in making planning future action to implement 8 the EMS in their ventures, 70% in full agreement that the high cost is a form of impediment to implementation of EMS; 66.67% agreed that resistance to change is an impediment to implementation of EMS; 90.91% agreed that the implementation of EMS is very complex, 80% of respondents agreed in a very significant environmental legislation is also a key factor preventing the implementation of EMS is noteworthy that 100% of respondents agreed that the knowledge about the use of the EMS will help to solve environmental problems in the fuel retail service stations, the implementation of the EMS will benefit with increased efficiency of resources applied to the findings by the agreement of 91.66% of respondents, where only 8, 33% disagreed, there was also a percentage of 100%, agreed that the company's image will be a great benefit, but also a contribution to solving environmental problems in the fuel retail service stations. Thus, the importance of the implementation of EMS in the fuel retail service stations in the city of Parnamirim-RN, with an urgent need to be deployed. And the bodies responsible for policy on state-run and supervise more tightly and action, this type of activity, in order to regulate the sustainable functioning of retail service stations of fuel, thus promoting a better quality of life for the population of the municipality of natal-RN

Competição e regulamentação no transporte de passageiros: Um estúdio no transporte rodoviário intermunicipal

The objective of this research is the verification of the competition in the intecity market, after the entrance of new competitors (vans and microbus) regulated and clandestine. For verification of this new view was effected one research of documentary character for the knowledge of the regulation and exploratory character of the system Natal - territory of the Seridó, for thus in making will know this problematic, well as its characteristics, attractivenesses and development of the territory of the Seridó, and its link with the Capital (Natal). Later, through a descriptive exploratory research of the type survey with the passengers to know as these are being taken care and its satisfaction in relation to the regulated companies. With the drivers if focus effected one group, and with the staff of the of sale ticket a research survey, aiming at to know the strategies used for the only company of bus that takes care of the territory of the Seridó, the implantation of these and the consequence of the user. In accordance with the generic tipologia of Porter and its strategies, were perceived that the bus company adopted the strategy of price leadership being competitive, using to advantage its bigger space in the market, already vans and the microbuses with its limited participation bet in a strategy of "differentiation" in its service, effecting faster trips and in the strategy of "approach" we find the not regulated services earn the service to the taste of the user

Uma avaliação comparativa de estratégias de arranjos físicos para estaleiros de construção de embarcações metálicas de pequeno porte

The present study aims to analyse, in different levels of demand, what is the best layout strategy to adopt for the small metallic shipbuilding. To achieve this purpose, three simulation models are developed for analyze these production strategies under the positional, cellular and linear layouts. By the use of a simulation tool for compare the scenarios, Chwif and Medina (2010) and Law (2009)´s methodologies were adapted that includes three phases: conception, implementation and analysis. In conception real systems were represented by process mapping according to time, material resources and human resources variables required for each step of the production process. All of this information has been transformed in the cost variable. Data were collected from three different production systems, two located in Natal RN with cellular and positional layouts and one located in Belém-PA with linear layout. In the implementation phase, the conceptual models were converted in computacional models through the tool Rockwell Software Arena ® 13.5 and then validated. In the analysis stage the production of 960 ships in a year vessels were simulated for each layout noting that, for a production of until 80 units positional layout is the most recommended, between 81 and 288 units the cellular layout and more than 289 units the linear layout

Estratégias de avaliação de desempenho dos propagandistas de medicamentos utilizados pela indústria farmacêutica no nordeste do Brasil

A Indústria Farmacêutica é uma das mais competitivas indústrias do mundo contemporâneo, e um dos seus principais desafios está na comercialização de seus medicamentos, que na sua maioria depende da prescrição médica. O objetivo deste estudo é identificar as estratégias de avaliação de desempenho utilizadas pela Indústria Farmacêutica de origem multinacional que atua no nordeste Brasileiro e o papel dos seus gerentes, para avaliar os propagandistas vendedores de medicamentos. Para tanto, buscouse reunir elementos para uma abordagem satisfatória que contemple a complexidade da temática pesquisada: Avaliação de Desempenho, Estratégias da Indústria Farmacêutica, Propaganda Médica e Competências dos Propagandistas de Medicamentos. A temática justifica-se em razão da importância estratégica dos propagandistas de medicamentos para a indústria farmacêutica, que é uma das indústrias que mais investe em pesquisa na atualidade, e contribui para melhorar a qualidade de vida e a saúde humana. A metodologia é caracterizada como um survey, de natureza quali-quantitativa. O objeto de estudo é composto pelas empresas farmacêuticas multinacionais de origem Americanas, Europeias e Asiáticas, associadas à INTERFARMA que atuam no Nordeste do Brasil. A coleta de dados foi realizada através de um questionário fechado (instrumento de pesquisa), composto por 5 perguntas fechadas que abordam a temática central dessa dissertação, 27 afirmativas para medir a concordância(escala likert) e 1 tabela contendo 46 competências, aplicado junto a gerentes da indústria farmacêutica. A análise dos dados foi feita por meio das técnicas de estatística descritiva e uma análise quantitativa para estabelecer o Ranking Médio (RM) para a parte do questionário que utilizou escala tipo Likert de 5 pontos para mensurar o grau de concordância dos respondestes. Através dos resultados desta pesquisa foi possível identificar as estratégias de avaliação de desempenho, utilizadas pelas empresas farmacêuticas, que atuam no Nordeste do Brasil, na gestão dos propagandistas vendedores de medicamentos, e identificar as competências essenciais dos propagandistas de medicamentos, na percepção dos gestores. Os resultados demonstraram que a Indústria Farmacêutica desenvolve e utiliza várias estratégias para medir e avaliar o desempenho dos propagandistas de medicamentos no Brasil, assim como em outros países, e que na percepção dos gerentes da Indústria Farmacêutica existem competências consideradas essenciais ao bom desempenho profissional dos propagandistas de medicamentos da indústria farmacêutica, contribuindo de para avanço do conhecimento deste tema

Estratégias acadêmicas na avaliação de desempenho dos cursos de ciências contábeis no enade em NATAL - RN

O número de instituições de ensino superior no Brasil vem crescendo bastante nos últimos anos. Com isso a preocupação com a qualidade dos cursos ofertados também tem aumentado. Para avaliar essa qualidade do ensino o governo instituiu formas de avaliação e vem aperfeiçoando a cada ano. As instituições, por sua vez, buscam bons resultados nessas avaliações a fim de utilizar como item de vantagem competitiva, uma vez que as notas obtidas por elas chamam atenção de novos clientes. Dessa forma, o presente trabalho buscou analisar as principais estratégias acadêmicas utilizadas na avaliação de desempenho dos cursos de Ciências Contábeis, da região de Natal-RN, no ENADE. Trata-se de uma pesquisa de abordagem qualitativa e quantitativa, e foi aplicado um estudo de caso complementado por um survey. A parte qualitativa foi obtida através de entrevistas semiestruturadas realizadas com os coordenadores dos cursos e a quantitativa foi obtida através da aplicação de um questionário fechado aos alunos aptos a participarem do ENADE no ano de 2012. Foram estudadas todas as instituições em Natal que possuem o curso de Ciências Contábeis, modelo presencial, sendo ao todo 10 (dez) instituições identificadas. Os dados foram analisados por meio da análise de conteúdo (entrevistas) e do software SPSS® 18 (survey). Foram utilizados os métodos de análise fatorial, através da análise de componentes principais, com rotação Varimax e normalização Kaiser. Em relação à análise da importância do ENADE sob a perspectiva dos estudantes, foi utilizado o teste não paramétrico de Mann-Whitney. Como resultados da pesquisa, foi identificado que tanto os discentes como os coordenadores de curso entendem a importância do ENADE, também observou-se que a satisfação dos discentes com a instituição refletiu nos resultados obtidos por esta, bem como, o momento em que foi iniciada a preparação para o exame também refletiu nas notas recebidas pelas instituições

Estudo de estratégias de otimização para poços de petróleo com elevação por bombeio de cavidades progressivas

The progressing cavity pump artificial lift system, PCP, is a main lift system used in oil production industry. As this artificial lift application grows the knowledge of it s dynamics behavior, the application of automatic control and the developing of equipment selection design specialist systems are more useful. This work presents tools for dynamic analysis, control technics and a specialist system for selecting lift equipments for this artificial lift technology. The PCP artificial lift system consists of a progressing cavity pump installed downhole in the production tubing edge. The pump consists of two parts, a stator and a rotor, and is set in motion by the rotation of the rotor transmitted through a rod string installed in the tubing. The surface equipment generates and transmits the rotation to the rod string. First, is presented the developing of a complete mathematical dynamic model of PCP system. This model is simplified for use in several conditions, including steady state for sizing PCP equipments, like pump, rod string and drive head. This model is used to implement a computer simulator able to help in system analysis and to operates as a well with a controller and allows testing and developing of control algorithms. The next developing applies control technics to PCP system to optimize pumping velocity to achieve productivity and durability of downhole components. The mathematical model is linearized to apply conventional control technics including observability and controllability of the system and develop design rules for PI controller. Stability conditions are stated for operation point of the system. A fuzzy rule-based control system are developed from a PI controller using a inference machine based on Mandami operators. The fuzzy logic is applied to develop a specialist system that selects PCP equipments too. The developed technics to simulate and the linearized model was used in an actual well where a control system is installed. This control system consists of a pump intake pressure sensor, an industrial controller and a variable speed drive. The PI control was applied and fuzzy controller was applied to optimize simulated and actual well operation and the results was compared. The simulated and actual open loop response was compared to validate simulation. A case study was accomplished to validate equipment selection specialist system

Implantação de um sistema de detecção de vazamentos em oleodutos com tratamento de alarmes falsos

The pumping of fluids in pipelines is the most economic and safe form of transporting fluids. That explains why in Europe there was in 1999 about 30.000 Km [7] of pipelines of several diameters, transporting millíons of cubic meters of crude oil end refined products, belonging to COCAWE (assaciation of companies of petroleum of Europe for health, environment and safety, that joint several petroleum companies). In Brazil they are about 18.000 Km of pipelines transporting millions of cubic meters of liquids and gases. In 1999, nine accidents were registered to COCAWE. Among those accidents one brought a fatal victim. The oil loss was of 171 m3, equivalent to O,2 parts per million of the total of the transported volume. Same considering the facts mentioned the costs involved in ao accident can be high. An accident of great proportions can bríng loss of human lives, severe environmental darnages, loss of drained product, loss . for dismissed profit and damages to the image of the company high recovery cost. In consonance with that and in some cases for legal demands, the companies are, more and more, investing in systems of Leak detection in pipelines based on computer algorithm that operate in real time, seeking wíth that to minimize still more the drained volumes. This decreases the impacts at the environment and the costs. In general way, all the systems based on softWare present some type of false alarm. In general a commitment exists betWeen the sensibílity of the system and the number of false alarms. This work has as objective make a review of thé existent methods and to concentrate in the analysis of a specific system, that is, the system based on hydraulic noise, Pressure Point Analyzis (PPA). We will show which are the most important aspects that must be considered in the implementation of a Leak Detection System (LDS), from the initial phase of the analysis of risks passing by the project bases, design, choice of the necessary field instrumentation to several LDS, implementation and tests. We Will make na analysis of events (noises) originating from the flow system that can be generator of false alarms and we will present a computer algorithm that restricts those noises automatically

Análise de desempenho de estratégias de retransmissão para o mecanismo HCCA do padrão de redes sem fio IEEE 802.11e

This paper presents the performanee analysis of traffie retransmission algorithms pro¬posed to the HCCA medium aeeess meehanism of IEEE 802.11 e standard applied to industrial environmen1. Due to the nature of this kind of environment, whieh has eleetro¬magnetic interferenee, and the wireless medium of IEEE 802.11 standard, suseeptible to such interferenee, plus the lack of retransmission meehanisms, refers to an impraetieable situation to ensure quality of service for real-time traffic, to whieh the IEEE 802.11 e stan¬dard is proposed and this environment requires. Thus, to solve this problem, this paper proposes a new approach that involves the ereation and evaluation of retransmission al-gorithms in order to ensure a levei of robustness, reliability and quality of serviee to the wireless communication in such environments. Thus, according to this approaeh, if there is a transmission error, the traffie scheduler is able to manage retransmissions to reeo¬ver data 10s1. The evaluation of the proposed approaeh is performed through simulations, where the retransmission algorithms are applied to different seenarios, whieh are abstrae¬tions of an industrial environment, and the results are obtained by using an own-developed network simulator and compared with eaeh other to assess whieh of the algorithms has better performanee in a pre-defined applieation