Avaliação do cuidado de enfermagem na perspectiva da segurança do paciente em unidades de terapia intensiva: na visão de profissionais, pacientes e familiares

Technological advances combined with healthcare assistance bring increased risks related to patient safety, causing health institutions to be environments susceptible to losses in the provided care. Sectors of high complexity, such as Intensive Care Units have such characteristics highlighted due to being spaces designed for the care of patients in serious medical condition, when the use of advanced technological devices becomes a necessity. Thus, the aim of this study was to assess nursing care from the perspective of patient safety in intensive care units. This is an evaluative research, which combines various forms of data collection and analysis in order to conduct a deepened investigation. Data collection occurred in loco, from April to July 2014 in hospitals equipped with adult intensive care unit services. For this, a checklist instrument and semi-structured interviews conducted with patients, families, professionals were used in order to evaluate the structure-process-outcome triad. The instrument for nursing care assessment regarding Patient Safety included 97 questions related to structure and processes. Interviews provided data for outcome analysis. The selection of interviewees/participants was based on the willingness of potential participants. The following methods were used to collect data resulting from the instrument: statistical analysis of inter-rater reliability measure known as kappa (K); observations from judges resulting from the observation process; and added information obtained from the literature on the thematic. Data analysis from the interviews was carried out with IRAMUTEQ software, which used Descending Hierarchical Classification and Similarity analysis to aid in data interpretation. Research steps followed the ethical principles presented by Resolution No. 466 of December 12, 2012, and the results were presented in three manuscripts: 1) Evaluation of patient safety in Intensive Care Units: a focus on structure; 2) Health evaluation processes: a nursing care perspective on patient safety; 3) Patient safety in intensive care units: perception of nurses, family members and patients. The first article, related to the structure, refers to the use of 24 items of the employed instrument, showing that most of the findings were not aligned with the adequacy standards, which indicates poor conditions in structures offered in health services. The second article provides an analysis of the pillar of Processes, with the use of 73 items of the instrument, showing that 50 items did not meet the required standards for safe handling due to the absence of adequate scientific guidance and effective communication in nursing care process. For the third article, results indicate that intensive care units were safe places, yet urges for changes, especially in the physical structure and availability of materials and communication among professionals, patients and families. Therefore, our findings suggest that the nursing care being provided in the evaluated intensive care units contains troubling shortcomings with regards to patient safety, thereby evidencing an insecure setting for the assistance offered, in addition to a need for urgent measures to remedy the identified inadequacies with appropriate structures and implement protocols and care guidelines in order to consolidate an environment more favorable to patient safety.

Avaliação de qualidade da unidade de diálise no Hospital Universitário Onofre Lopes - HUOL

Over the years there has been a broader definition of the term health. At the same time it was found also an evolution of the concept of health care which in turn has led to changes in the approach to delivery of health services and hence in its management. In this regard, currently the nephrology services have been searching for quality technical and social need. In view of these innovations and the quest for quality, it elaborated the general objective: to develop a quality assessment protocol for dialysis service Onofre Lopes University Hospital. It is an intervention project effected through an action research, which consisted of 4 steps. Initially was identified through a literature search in scientific literature, which quality indicators would apply to a dialysis unit being selected as follows: infection rate in hemodialysis access site, microbiological control of water used for hemodialysis and Index User satisfaction. Through critical reflection on the theme researched in the previous step, it was drawn up three data collection instruments, interview form type, applied between the months of October and November 2015. In addition to the information obtained, also made up of the use of information retrieval technique. The results were organized in graphs and tables and analyzed using qualitative and exploratory technical approach. Then a reflective analysis of the data obtained and the diagnosis of reality studied was traced and confronted with the literature was performed. The data produced in this study revealed that the Dialysis Unit of HUOL is much to be desired, considering that some weaknesses have been identified in its structure. Faced with this finding have been proposed, as a contribution and aiming to guide the development of future actions, suggestions for improvement that should be implemented and monitored to be assured overcoming these difficulties, allowing an appropriate organizational restructuring, and resulting in improved service public offered. It was concluded that for hemodialysis treatment results are achieved and positive, it is necessary to have physical structure and adequate infrastructure, multidisciplinary team specialized, trained and in sufficient quantity, well designed processes for professionals to have standards to be followed decreasing the chance to err, and a risk management system to detect and control situations that endanger patient safety.

Avaliação de qualidade da unidade de diálise no Hospital Universitário Onofre Lopes - HUOL

Over the years there has been a broader definition of the term health. At the same time it was found also an evolution of the concept of health care which in turn has led to changes in the approach to delivery of health services and hence in its management. In this regard, currently the nephrology services have been searching for quality technical and social need. In view of these innovations and the quest for quality, it elaborated the general objective: to develop a quality assessment protocol for dialysis service Onofre Lopes University Hospital. It is an intervention project effected through an action research, which consisted of 4 steps. Initially was identified through a literature search in scientific literature, which quality indicators would apply to a dialysis unit being selected as follows: infection rate in hemodialysis access site, microbiological control of water used for hemodialysis and Index User satisfaction. Through critical reflection on the theme researched in the previous step, it was drawn up three data collection instruments, interview form type, applied between the months of October and November 2015. In addition to the information obtained, also made up of the use of information retrieval technique. The results were organized in graphs and tables and analyzed using qualitative and exploratory technical approach. Then a reflective analysis of the data obtained and the diagnosis of reality studied was traced and confronted with the literature was performed. The data produced in this study revealed that the Dialysis Unit of HUOL is much to be desired, considering that some weaknesses have been identified in its structure. Faced with this finding have been proposed, as a contribution and aiming to guide the development of future actions, suggestions for improvement that should be implemented and monitored to be assured overcoming these difficulties, allowing an appropriate organizational restructuring, and resulting in improved service public offered. It was concluded that for hemodialysis treatment results are achieved and positive, it is necessary to have physical structure and adequate infrastructure, multidisciplinary team specialized, trained and in sufficient quantity, well designed processes for professionals to have standards to be followed decreasing the chance to err, and a risk management system to detect and control situations that endanger patient safety.

Programa de aquisição de alimentos (2003-2010): avaliação da implementação pela CONAB no Rio Grande do Norte

This thesis aimed to evaluate the implementation of the Food Acquisition Program(PAA) through CONAB RN in the period of 2003-2010 with the perception of all agents involved in the implementation of the government program.For the methodological trajectory it was adopted a descriptive bibliographical and documentary approach with triangular qualitative and quantitative, also called evaluative research.The theoretical model was supported by the authors Draibe (2001), Aguilar and Ander-Egg (1994) and Silva(2001), among others, that focused on family farming and evaluation of implementation of public policy having as a category of analysis the size implementation of policy and the latter divided into 10 theoretical dimensions.The universe consisted of three groups: the first were the managers and technicians from CONAB(RN and Brasilia), totaling 15 subjects. The second group was of associations/cooperatives that participated in the programin 2010, totaling a sample in each access of 15 representatives. The third group of subjects totaled with 309 representatives of governmental and non-governmental organizations that received donations of food for the same period. Semi-structured interviews and forms were adopted as instruments of data collection.The data were processed qualitatively by the analysis of content (interviews and documents) and quantitatively by means of statistical tests that allowed inferences and adoption of frequencies. Among the key find ingests that the program is not standing as a structure supported by planning. The interests of the performers do not necessarily converge with the objectives of the Food Acquisition Program (PAA). A shockof goals was identified (within the same program) when comparingthe financial agent (Ministry of Rural Development and of Social Development and Fight Against Hunger Ministry r) and the executor, CONAB/RN. Within the assessed dimensions, the most fragileis the sub-managerial decision-making and Organizational Environment and internal assessment, still deserves attention the sizeof logistical and operational Subsystem, as this also proved weak.The focusin the quest toexpand thequantificationof the resultsof theFood Acquisition Program (PAA)by CONAB/RN does forget a quality management focused on what really should be:the compliance with the institutional objectives of the government program.Finally, the perspective for the traded implementation should be re-examined because excessive discretion by managers along with technical staff has characterized there al role of the Food Acquisition Program (PAA) as public policy. We conclude that the implementation model, which apparently aggregates values to the benefitted citizens, has weakened the context of work on family farms having the management model of the implementation process be reviewed by the Federal Government and point too ther paths, which have as a guide line the emancipation and developmentof the field or in the field andat the same time enables the reduction of nutritional deficiency of beneficiaries in a balanced and coherent way

Avaliação da política de segurança alimentar implementada através dos restaurantes populares do Rio Grande do Norte

This survey has to general objective to evaluate the Food Safety Policy implemented by Restaurantes Populares do Rio Grande do Norte. The survey is qualitative of type exploratory and descriptive. The universe of survey is all Units of Food and Nutrition (UAN) of the Restaurantes Populares do Rio Grande do Norte. To collects of data were used two instruments: interview and form. The interviews were intended to analyze the four axes of the Food Safety: access, food quality, production and marketing of food and organizational arrangement. The form was used to check the quality of nutrition and sanitary-hygienic food served. We used two types of forms: a spreadsheet with the weekly menu and the portions served to verify that the meals serve the nutritional needs proposed by the program; and the check-list of ANVISA to verify the sanitary-hygienic conditions in each unit. Through the survey data and analyses made observe that the access category have some problems such as lack of registration, lack of advertising of Restaurants and wastage of public resources, making policy that should be of included in a policy of exclusion. In the nutritional aspect there is neglect on the daily nutritional goal, because it is not accomplished nutritional analysis of menu offered, the nutritionists do not know what should be the nutritional value of meals served; in the hygienic-health aspect trough the problems identified is concludes that there is no guarantee of food quality hygienic-sanitary, committing the program as a Food Safety Program. About the production and marketing of food is observed some problems as: the goal of sale of meals is not achieved in full, the purchase of genres does not stimulate the local economy, nor generates jobs and income, and inefficient performance of the MEIOS's supervision. In the analysis of organizational arrangement is concluded that the partnerships are beneficial, despite some negative points, therefore, are these partnerships the problems of non-compliance, as both the MEIOS and Nutriti of important criteria established in the partnership. Therefore, it is understood that the Programa Restaurantes Populares in its original formulation is proposed to be a food safety policy, but has some problems that impossible to meet its goal, making it unprofitable like Food Safety Policy

Responsabilidade social empresarial: uma avaliação do projeto "Escola de Informática e Cidadania" da Mineradora "Y" situada no Estado do Pará

The subject Responsibility Enterprise Social (RSE) is relatively recent in the half national academic and the world of the management businesses as practical. For the lack of socialization of experiences and clarity of concepts, shunting lines in the agreement of the subject and the conduction of the interventions occur. It was looked to inquire, in this research, the development of the project of Social Responsibility Enterprise ―School of Computer science and Citizenship‖ of a situated company in the State of Pará, objectifying to evaluate it and later to understand it. For this, one searched to describe the characteristics and structure of the School, to identify to the lines and lines of direction adopted for this Project and to identify to the influence and results of the same in the life of pupils, professors and egresses of the School. It is characterized for a study of case with qualitative boarding of descriptive character, carried through interviews structuralized in a sample of 21 divided members of the School between professors, pupils and egresses. It was used of the analysis of categorical content, having as axle for the interpretation of the data the Social Responsibility, the Digital Inclusion and the Education. The gotten results inform that the infrastructure has challenges to face, point disparities between the conception and practical of the categories characterized in the Politician-Pedagogical Project of the EIC and the influence that, exactly under limits, the life of the professors, pupils reaches and egress. One evidenced that Social action for damages of this company when come back toward this project, they had not been evidenced. For this prism, these actions had only remained in the assistencialist speech and not structural, being thus, the company is not fulfilling its paper of transforming element of the reality of its clientele and the population that lives in it s around

Projeto café do trabalhador como promotor de segurança alimentar e nutricional: avaliação da eficácia da unidade Natal-RN

The evaluation of public policies that promote Food Security and Nutrition (FSN) it s a multidisciplinary activity extremely relevant to the effectiveness of actions to legitimize the Human Right to Adequate Food (HRAF). This study aimed at assessing the effectiveness of the unit project Natal-RN Café do Trabalhador in promoting SAN to its users. The theoretical framework is based on the public and political and on the dimensions of the concept of FSN (quantity and quality-regularity). Through a qualitative approach, methodologically this was the work of an evaluation of efficiency of the unit Natal-RN of Café do Trabalhador project in light of the assumptions of the concept of SAN. Data collection was conducted through retrospective archival research in official documents of the project, semi-structured interviews with managers involved in its implementation (representative of the Secretary of State for Employment, Housing and Care of RN SETHAS and third party), socioeconomic questionnaire applied to the users of the unit, check the amount, regularity and quality of meals offered for 15 days (menu routine) using the descriptive form menu and form filling type checklist for verification of compliance with good practices . Methods of analysis, we used content analysis, descriptive statistics and compared to previously established parameters for the project. As categories of analysis were defined organizational arrangement, access, user, food quantity-regularity and food quality. The results show that, it was found in the category arrangement that will implement the project dismissed technical criteria for choosing the districts and the quantitative distribution of meals for each location. It was found that the valuation of the shares of the company outsources technical SETHA has not been performed. We observed in the access category, the unit has a strategic location, but lack of space in the refectory. The main obstacle to economic access for users is the lack of a register for the beneficiaries. In the category of users, it was identified that the clientele of the project it is predominantly men, with more than 51 years, low education, earning wages less 1 obtained through informal employment, which they move up through the unit transport collective, go to all days of operation due primarily to price. About the meals category quantity-regularity of food showed that the menu serves 95% of the desired needs, and that holidays and weekends are periods of disrupting the regularity of supply of meals. Regarding the category of food quality, it was found that the nutritional aspect on the menu are food sources rich in sodium, nitrates and low in fiber. In the aspect of hygiene and sanitation are the main limitations related to waste management, lack of exposure controls of food prepared and inadequacies of the physical structure. The results showed that in general and the institutional arrangement of the organs attached to the project should establish a systematic evaluation project is to establish as a promoter of and FSN overcome these obstacles

Avaliação de projetos sociais: análise da metodologia utilizada pela Petrobrás

On the aggravation of social problems and the shortage of resources, the improvement of evaluation methods and control of its application, requiring more efficiency, efficacy, effectiveness and participation in its management, has been growing. As a result, emerges the importance of studying and developing such methodologies. The overall goal of this dissertation is to know what are the difficults to incorporate the point of view of executers and beneficiaries in evaluation process. To do so, has been done a research characterized as qualitative, with a field strategy using the case study of two social projects called Petrobras Child Program, situated in the metropolitan region of Natal, and Content Analysis technique for analyze the data. The conclusions of this work can assist in improving the process of projects evaluation financed by Petrobras, contributing with its social role, besides the possibility of encouraging a greater participation of other society actors, such as beneficiaries, in the evaluation process

Percepção dos usuários nos espaços públicos: avaliação pós-ocupação em três praças de Natal-RN

The research investigates the acting and the importance for the users of the public squares located predominantly in residential areas. It presents the results of the posoccupation evaluations accomplished in three squares, whose physical, environmental characteristics, equipments and fumitures are different in its qualities and amounts, taking in consideration aspects related to the users' physical and psychological comfort and of the inhabitants of the I spill. The collection of data involved physical risings and of files, observations behavious, application of questionnaires and interviews, analyzed qualitative as quantitatively so much for a larger precision and validity of the investigation. The results were obtained through the relationship among the users' perception the environmental attributes and the different levels of apropriation/use of the studied places. They indicate that the aspects composicionais of physical order of the space affects the type and the intensity of use of the squares intimately, contributing positive or negatively for its valor. It is evidenced like this, that the low freqüentation of the public squares of Natal, is due mainly to referring aspects to the physical quality and the amount of the fumitures and urban equipments. It is ended that the investments and the physical planning of these public spaces should be based in the real knowledge of the aspirations of the population objective, in way to allow its largest use and valor