Vivendo o bem estar no desconhecido: experiência da mulher com a presença do acompanhante no processo de parto

The humanization of the birth process is a current health policy priority. Within that perspective, the presence of a partner during the birth is a benefit guaranteed by the Law 111008/05. The purpose of this study is to comprehend the woman s experience with the presence of a birth partner as a legal right. It is a qualitative descriptive study based on Symbolic Interactionism and conducted using the grounded theory methodology. Data were collected by semi-structured interviews conducted during August to December 2006, with women that had the presence of a partner during their birth experience and that were in the first 24 hours of puerperium. Data analysis resulted in the identification of the phenomena: FEELING GOOD, RECOGNIZING THE BOND WITH THE PARTNER, RECOGNIZING THE IMPORTANCE OF THE EXPERIENCE and NOT KNOWING THE RIGHT. These enabled the identification of the central phenomenon LIVING THE WELL-BEING IN THE UNKNOWN. The study demonstrated that the birth experience with the presence of partner is a positive one, resulting in benefits such as tranquility, support, and assurance, which, in that context, signify well-being. However, the women do not visualize the experience as a right, therefore remaining alienated from their civic practice. The understanding of the experience was enabled by the conceptual construction obtained from the categories of the interactions between the women and their birth partners during the event. The explanation of the phenomenon LIVING THE WELL-BEING IN THE UNKNOWN reflects the theoretical structure obtained from the integration of the identified concepts. The study points out the need for health professionals to improve the information given to women during the birth process and to work the civic duties of the women in reproductive health

Segurança do paciente no sistema de medicação: análise de enfermeiros de um hospital de ensino

This study aimed to identify and describe the factors related to Patient Safety in a medication system according to the nurses analysis in a teaching hospital from the photographic analysis method. This was a cross-sectional, descriptive study with mixed approach in a teaching hospital in Rio Grande do Norte. The population consisted of 42 nurses from inpatient units, of which 34 composed the study sample. As eligibility criteria, we defined nurses from public service and nurses who agreed to participate. Ethical determinations were observed, the study was submitted to the Ethics and Research of the University Hospital Onofre Lopes, obtaining the assent with ethical assessment certificate (CAAE 0098.0.051.294-11). For data collection, we used the photographic method (Photographic Analysis Technique) by Patricia Marck (Canada). It was developed in two phases: at first, we randomly captured photos from the medication system, resulting in 282 images; then we selected/processed the photographs, which were reduced to 10 images in Microsoft Excel 2010; in the second phase, the nurses answered the questionnaire divided into socio-professional profile and Digital Photography Scoring Tool (questions a and b ). For analysis of the question a , we used the content analysis technique, and for b , we used the Statistical Package for the Social Sciences 20.0 (temporary license). The socio-professional profile revealed the predominance of females; age group 34-43 years; professionals with specialization; 10-18 years of length of service; and nurses working exclusively in the hospital and who know the Patient Safety. The photographic analysis in relation to Patient Safety resulted in specific categories for each stage of the medication system. Regarding disposal, we identified Proper verification ; Improper verification ; Correct identification ; Disposal in single doses ; and Improper Environment , with predominance of that last category. As for storage: Proper storage ; Improper storage ; Risk of exchange/disappearance ; and Poor hygiene , with special reference to improper storage. In preparation: Risk of exchanging medication/patient ; Inappropriate physical space ; and Inadequate 9 preparation of controlled drugs , highlighting the first category. In drug administration: Lack of Personal Protective Equipment ; Use of Personal Protective Equipment ; Improper administration technique ; Proper administration technique ; Correct drug identification ; Incorrect drug identification ; and Peripheral venous access without identification . From the safety assessment of 10 photographs, by adapting the scores (1-10) to the Likert Scale, we identified three Totally Unsafe (Level 1), three Unsafe (Level 2), three Partially Safe (Level 3), one Safe (Level 4), and no photograph considered Totally Safe. This study identified the prevalence of unsafety in the medication system in the nurses opinion. We were also able to understand that, although nurses identify safety aspects, the most prevalent categories characterize an unsafe assessment. Nursing needs to reflect on its practice, identifying gaps in the medication system in order to achieve a proper and safe care

Protocolo de avaliação do cuidado de enfermagem e da segurança do paciente em unidades de terapia intensiva

The reports of adverse events date from 1990 up to the present day. Conceptually, these adverse events are unintentional injuries unrelated to the underlying disease, causing measurable lesions in patients, extending the period of hospitalization, or leading to death. These issues require discussions with regard to patient safety, improved quality of service, and preventing medical errors. In the Intensive Care Units, this concern is greater because these are sectors of intensive care to individuals with hemodynamic changes and imminent risk of death. Therefore, it is essential to conduct evaluation processes to investigate aspects of quality of nursing care and patient safety in these spaces. For that reason, we aimed to propose the Evaluation protocol of nursing care and patient safety in Intensive Care Units. For its achievement, we needed to: 1) analyze the evolution of the patient safety concept used in scientific productions, under Rodgers evolutionary concept; 2) identify the necessary items to build the evaluation protocol of nursing care and patient safety in the Intensive Care Unit, from the available evidence in literature; 3) construct an instrument for content validation of the evaluation protocol of nursing care and patient safety in the Intensive Care Unit; and 4) describe and evaluate the appropriateness of the content for an evaluation protocol of nursing care and patient safety in the Intensive Care Unit. This is a methodological study for the content validation of the abovementioned protocol. To meet the first three specific objectives, we used the integrative literature review in Theses Database of the Coordination for the Improvement of Higher Education Personnel and the portal of the Collaborating Centre for Quality of Care and Patient Safety. The fourth specific objective happened through the participation of judges, located from the Lattes curricula, in the content validation process developed in two stages: Delphi 1 and Delphi 2. As instrument, we used the electronic form of Google docs. We present in tables the answers from the evaluation instruments by Delphi consensus and Content Validity Index (CVI) of the entire protocol. We summarized the results in articles entitled Analysis of the patient safety concept: Rodgers evolutionary concept ; Scientific evidence regarding patient safety in the Intensive Care Unit ; Technological device for the content validation process: experience report ; and Evaluation protocol of nursing care and patient safety in Intensive Care Units. The Embodied Opinion of the Research Ethics Committee of the Universidade Federal do Rio Grande do Norte, No. 461,246, under CAAE 19586813.2.0000.5537, approved the study. Thus, we conclude the protocol valid in its content, constituting an important tool for evaluating the quality of nursing care and patient safety in Intensive Care Units

Clima e cultura de segurança do paciente em uma maternidade escola: percepção dos profissionais de enfermagem em terapia intensiva

Since the publication of the report "To Err is Human" by the Institute of Medicine (IOM) , which estimated that between 44.000 to 98.000 Americans die annually as a result of errors in health care, patient safety spent gaining prominence, emerging studies assess the safety culture by measuring the safety climate. In this context, the aim of this study was to identify safety culture perceived by nursing professionals working in the intensive care unit of a maternity school in Natal/RN through the Security Attitudes Questionnaire (SAQ). This was a descriptive study, cross-sectional and quantitative approach undertaken in the Intensive Care Unit Maternal and Neonatal a maternity school in Natal/RN. The project was submitted to and approved by Brazil Platform Zip/UFRN under number 309 540 and CAAE 16489713.7.0000.5537. It was used to collect data two instruments: a questionnaire in order to collect socio-demographic data of the subjects and the Questionário Atitudes de Segurança , a cultural adaptation to Portuguese of the instrument of the World Health Organization titled Safety Attitudes Questionnaire - (SAQ ) Short Form 2006. The collected data were analyzed quantitatively by the organization in electronic databases in Microsoft Excel 2010 spreadsheet and exported to statistical software for free access to be coded, tabulated and analyzed using descriptive statistics. The study included a total of 50 nurses, 31 and 19 of the NICU Maternal ICU, predominantly female, mean age 35 years, median time of 10 years training and working in maternity, mostly, less than 05 anos. As a result, two articles were produced. The first refers to the first two domains of the instrument entitled "climate of teamwork" and "climate security" . The scores of the two areas were slightly higher in Maternal ICU compared to the NICU, but no sector has reached the ideal minimum score of 75: in the first domain Maternal ICU had an average of 74.77, with medians of 75 and 100, while Neonatal ICU reached an average of 69.61 with median also 75 and 100, while the second field means were 69.35 and 66.01 for Maternal and Neonatal ICUs respectively, with a median of 100 in the two sectors. The second article relates to the field "Perception Management Unit and Hospital", which 9 assessed the perception of management units and motherhood by professionals. In general, the items of the domain in question also obtained scores below the ideal minimum: 63.68 to 51.02 and maternal ICU for neonatal, featuring a clear separation between the management and the professionals who work in direct care. These findings indicate a warning sign for the institution and point to the need to implement actions aimed at patient safety

Um estudo da aplicação do conceito de risco na conscientização e conhecimento de estudantes de ensino técnico sobre riscos de segurança e saúde ocupacional em laboratório de soldagem

This dissertation presents a discussion on the level of risk awareness of students who have welding practice in the laboratories at CEFET/PI, both in Teresina and Floriano. Its main goal is to investigate risk factors involving students, teachers and employees that work in these laboratories. It s an empirical survey, held among a certain amount of students from the course in Mechanic Technology. For data analysis, the concept of risk was compared to the students direct measure of perception. The main results suggest the students must be better informed, more risk aware and more competent, in order to avoid accidents. They also point to a strong need for a more formal and effective performance to assure full consciousness about the risks involving the welding practice.

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

Melhoria da segurança pública: uma proposta para alocação de unidades policiais utilizando o modelo das p-medianas e do caixeiro viajante

The decrease in crime is one of the core issues that cause concern in society today. This study aims to propose improvements to public safety from the choice of points to the location of police units, ie the points which support the car and the police. For this, three models were developed in order to assist decision making regarding the best placement of these bases. The Model of Police Units Routing has the intention to analyze the current configuration of a given region and develop optimal routes for round preventative. The Model of Allocation and Routing for New Police Units (MARNUP) used the model of facility location called p-median weighted and traveling salesman problem (TSP) combined aiming an ideal setting for regions that do not yet have support points or to assess how far the distribution is present in relation to that found in solution. The Model Redefinition and Routing Unit Police (MRRUP) seek to change the current positioning taking into account the budgetary constraints of the decision maker. To verify the applicability of these models we used data from 602 points to instances of police command that is responsible for the capital city of Natal. The city currently has 31 police units for 36 of these 19 districts and police have some assistance. This reality can lead to higher costs and higher response times for answering emergency calls. The results of the models showed that in an ideal situation it is possible to define a distance of 500 km/round, whereas in this 900 km are covered by approximately round. However, a change from three-point lead reduced to 700 km / round which represents a decrease of 22% in the route. This reduction should help improve response time to emergency care, improving the level of service provided by the increase of solved cases, reducing police shifts and routing preventive patrols

Um estudo do perfil de formação dos técnicos de segurança do trabalho no Brasil na perspectiva de sistemas de gestão de segurança e saúde ocupacional

This work provides great contribution to the documental study of the Work Safety courses offered by CEFETs in Brazil, under the perspective of safety management and occupational health, using as a referential the specification OHSAS 18001 (BSI, 1999), as well as directions provided by OIT (ILO, 2001). The theoretical research compares technical and managing competences of the projects of Work Safety courses at CEFETs with the international legislation mentioned above. For field research, questionnaires containing open and close questions were answered by teachers and students aiming at identifying the importance of technical and managing competences for the formation of Work Safety technicians, besides trying to identify which level of minimal formal knowledge should be required to perform managing activities in the area of Work Safety Management Systems and Occupational Health (SGSSO, in Portuguese). The results of the theoretical research point out differences between the projects of the Work Safety technical courses at CEFETs under the perspective of SGSSO. The field research shows that students and teachers opinions converge about most technical and managing competences. In relation to academic formation, the research suggests divergences to the criterion stated by the norm ISO 19011(ABNT, 2002)

Modelagem de arranjos institucionais para implementação da diretriz de sistema de gestão de segurança e saúde ocupacional da organização internacional do trabalho ILO/OSH 2001 no brasil

The commitment assumed by Brazil to ILO in order to pursue actions toward the ILO/OSH-2001 adoption in the country poses the issue of modeling the institutional arrangement the set roles and relationship between government, standards organizations, health and safety organizations, professionals and other institutions to deploy the ILO/OSH-2001. This Thesis develop institutional arrangement models based on the current model and also in the ISO 9000 scheme and others. It is studied the US case with OSHA and VPP, the OHSAS 18001 and ANSI/AIHA Z-10, in addition to actual context of the regulating norms NR s. The scenarios developed are put to evaluation on feasibility, potential changes and effects on current MTE auditors work scheme. The main results are five scenarios developed and that the MTE auditors tend to be reactive to the change toward the ILO/OSH-2001.

Uma contribuição à reformulação da norma regulamentadora 13 (NR-13) na perspectiva da adoção de sistema de gestão de segurança e saúde ocupacional

This Master s Thesis deals with an analysis of the Regulatory Standards NR-9 e NR-13 on the perspective of occupational health and safety management systems (OHSMS) such as ILO deployed ILO/OSH-2001. Since the revamped OHSAS 18001:2007 complies with the ILO/OSH-2001 model it is used as benchmark to compare against the NR-9 and NR-13. The analysis suggests that the NR-9 has some important features present on the OHSAS 18001:2007 but lacks important others. The NR-13 turns out to be far from a modern model of OHSMS such as OHSAS 18001:2007 and a deep reformulation should be done in order to achieve the Brazil commitment with ILO to adopt OHSMS. Also, a small survey with companies with ISO 9000 certificates suggests that a NR-13 revised toward OHSMS would be welcome, but also that some more advanced issues present in ILO/OSH-2001 should be imposed by law in order to be achieved

Fatores influenciadores da implementação de ações de gestão de segurança da informação :um estudo com executivos e gerentes de tecnologia da informação das empresas do Rio Grande do Norte

Information is one of the most valuable organization s assets, mainly on a global and highly competitive world. On this scenery there are two antagonists forces: on one side, organizations struggle for keeping protected its information, specially those considered as strategic, on the other side, the invaders, leaded by innumerous reasons - such as hobby, challenge or one single protest with the intention of capturing and corrupting the information of other organizations. This thesis presents the descriptive results of one research that had as its main objective to identify which variables influence the Executives´ and CIOs´ perceptions toward Information Security. In addition, the research also identified the profile of Rio Grande do Norte s organizations and its Executives/CIOs concerning Information Security, computed the level of agreement of the respondents according to NBR ISO/IEC 17799 (Information technology Code of practice for information security management) on its dimension Access Control. The research was based on a model, which took into account the following variables: origin of the organization s capital, sector of production, number of PCs networked, number of employees with rights to network, number of attacks suffered by the organizations, respondent´s positions, education level, literacy on Information Technology and specific training on network. In the goal´s point of view, the research was classified as exploratory and descriptive, and, in relation of the approach, quantitative. One questionnaire was applied on 33 Executives and CIOs of the 50 Rio Grande do Norte s organizations that collected the highest taxes of ICMS - Imposto sobre Circulação de Mercadorias on 2000. After the data collecting, cluster analysis and chi-square statistical tools were used for data analysis. The research made clear that the Executives and CIOs of Rio Grande do Norte s organizations have low level of agreement concerning the rules of the NBR ISO/IEC 17799. It also made evident that the Executives and CIOs have its perception toward Information Security influenced by the number of PCs networked and by the number of attacks suffered by the organizations

Segurança da informação no correio eletrônico com base na ISO/IEC 17799 :um estudo de caso em uma instituição superior com foco no treinamento

The electronic mail service is one of the most Internet services that grow in the corporate environment. This evolution is bringing several problems for the organizations, especially to information that circulates inside of the corporate net. The lack of correct orientation to the people, about the usage and the security importance of these resources, is leaving breaches and causing misusage and overuse of service, for example. In recent literature, it starts to coming out several ideas, which has helped to rganizations how to plain and how to implement the information security system to the electronic mail in computer environment. However, these ideas are still not placed in practice in many companies, public or private. This dissertation tries to demonstrate the results of a research that has like goal, identify the importance that user training has over the information security policy, through a case study inside of private superior education institute in this state. Besides, this work had by basic orientation the ISO/IEC 17799, which talk about People Security. This study was developed over a proposed model to this research, which looked for offer conditions to guide the institution studied, how to plan better a information security policy to the electronic mail. Also, this research has an exploratory and descreptive nature and your type, qualitative. Firstly, it was applied na questionary to the information technology manager, as better way to get some general data and to deepen the contact which still then, it was being kept through e-mail. Thereupon this first contact, eleven interviews were done with the same manager, beside one interview with twenty-four users, among employees e students. After that to collect and transcript the interviews, were review with the manager all informations given, to correct any mistakes and to update that informations, to then, start the data analyze. The research suggests that the institution has a pro attitude about the information security policy and the electronic mail usage. However, it was clear that answers have their perception about information security under a very inexperient way, derived of a planning lack in relation to training program capable to solve the problem

Estabilidade e robustez de um controlador adaptativo indireto por um modelo de referência e estrutura variável

In this thesis, it is developed the robustness and stability analysis of a variable structure model reference adaptive controller considering the presence of disturbances and unmodeled dynamics. The controller is applied to uncertain, monovariable, linear time-invariant plants with relative degree one, and its development is based on the indirect adaptive control. In the direct approach, well known in the literature, the switching laws are designed for the controller parameters. In the indirect one, they are designed for the plant parameters and, thus, the selection of the relays upper bounds becomes more intuitive, whereas they are related to physical parameters, which present uncertainties that can be known easier, such as resistances, capacitances, inertia moments and friction coefficients. Two versions for the controller algorithm with the stability analysis are presented. The global asymptotic stability with respect to a compact set is guaranteed for both cases. Simulation results under adverse operation conditions in order to verify the theoretical results and to show the performance and robustness of the proposed controller are showed. Moreover, for practical purposes, some simplifications on the original algorithm are developed

Reconhecimento de voz através de unidades menores do que a palavra, utilizando Wavelet Packet e SVM, em uma nova estrutura hierárquica de decisão

The automatic speech recognition by machine has been the target of researchers in the past five decades. In this period have been numerous advances, such as in the field of recognition of isolated words (commands), which has very high rates of recognition, currently. However, we are still far from developing a system that could have a performance similar to the human being (automatic continuous speech recognition). One of the great challenges of searches for continuous speech recognition is the large amount of pattern. The modern languages such as English, French, Spanish and Portuguese have approximately 500,000 words or patterns to be identified. The purpose of this study is to use smaller units than the word such as phonemes, syllables and difones units as the basis for the speech recognition, aiming to recognize any words without necessarily using them. The main goal is to reduce the restriction imposed by the excessive amount of patterns. In order to validate this proposal, the system was tested in the isolated word recognition in dependent-case. The phonemes characteristics of the Brazil s Portuguese language were used to developed the hierarchy decision system. These decisions are made through the use of neural networks SVM (Support Vector Machines). The main speech features used were obtained from the Wavelet Packet Transform. The descriptors MFCC (Mel-Frequency Cepstral Coefficient) are also used in this work. It was concluded that the method proposed in this work, showed good results in the steps of recognition of vowels, consonants (syllables) and words when compared with other existing methods in literature

Avaliação de robustez, desempenho e aplicação do controlador adaptativo por posicionamento de pólos e estrutura variável

In this work, the variable structure adaptive pole placement controller (VS-APPC) robustness and performance are evaluated and this algorithm is applied in a motor control system. The controller robustness evaluation will be done through simulations, where will be introduced in the system the following adversities: time delay, actuator response boundeds, disturbances, parametric variation and unmodeled dynamics. The VS-APPC will be compared with PI control, pole placement control (PPC) and adaptive pole placement controller (APPC). The VS-APPC will be simulated to track a step and a sine reference. It will be applied in a three-phase induction motor control system to track a sine signal in the stator reference frame. Simulation and experimental results will prove the efficiency and robustness of this control strategy