Quem é o doente? Um estudo sobre as vivências dos acompanhantes de pacientes adultos em hospital público no Rio Grande do Norte

The aim of this research is to reveal how caregivers have lived the experiences from adult patients admitted in a Rio Grande do Norte’s state hospital. This is a study where the use of the participant observation, associated with the use of interviews and informal conversations handled categories such as the mismatch between the prerogatives of Brazilian Health Care Policies (HumanizaSUS) and practices performed in hospitals, the relationships established between the caregivers and the other subjects of the research field, family relationships, permanence of women as caregivers, therapeutic itineraries, dramas, religiosity and secrets. To sew up it appears the role of a caregiver is more than emotional support or help, it is a complex act in several directions.

As repercussões dos serviços hospitalares em diferentes contextos: uma análise de profissionais de saúde

This study has as general object: to verify as the health professionals that work in different hospitals evaluate the hospital services; and specific objectives: identify how health professionals evaluate the work conditions in different hospitals and verify the central nucleus and the peripheral elements of the social representations elaborated by these professionals about these institution. This is a descriptive study realized in Natal, capital of Rio Grande do Norte. Were collected 213 questionnaires. Concerning the evaluation of the health services, high averages had been verified in the philanthropic hospital, for example, quality of the customer service. At the state hospital was observed lowest ones: respect to the privacy of the patients. Similar results were found about work conditions. It was observed as central nucleus the categories Overcrowded and Humanized care, in the state and philanthropic hospital respectively, and as peripheral elements Low wages and Overcrowded. Being thus the conflicts in this scene are inevitable because of the poor structure of some public hospitals, however, these problems can be foresee and solvable if the hospital has a free expression channel accessible to all agents. The evaluation has to become integrant part of the culture of the organization, a time that this will guide the steps in direction to the best quality in the hospital assistance

Relações interpessoais no ambiente de trabalho da equipe de enfermagem: uma ação comunicativa

The current study strives to address the interpersonal relationships of the nursing team from the perspective of the communicative action, by contributing to the health work process. It aims to analyze the interpersonal relationships of the nursing team in its work environment. This is a descriptive study with a qualitative approach. Data collection wal held from interviews, guided by a script with open questions. The study was conducted at a state hospital in the city of Natal/RN/Brazil. The research subjects were the workers of the nursing team, including nurses, nursing technicians and nursing assistants, totaling 16 subjects. The capture of information was performed in April 2012. The project was approved by the Ethics Research Committee, under CEP/UFRN protocol n. º 262/11 and Certificate of Presentation for Ethical Consideration n. º 0289.0.051.000-11. The analysis was performed from the categories that emerged from the research through a dialogue with the authors studied in the theoretical framework of the Theory of communicative action , by Jürgen Habermas, as well as The changing in the world of work, by Ricardo Antunes, and Characterization of the team , by Marina Peduzzi. The outocomes point out that the interpersonal relationship of the nursing team is very troubled, with no interaction among the individuals involved in this process, among themselves and with other health professionals. We have developed a particular concept about team, which is comprised of three essential elements: multiplicity of individuals, common objective and heterogeneity. In the studied environment, it was realized the existence of grouping teams. The interpersonal relationship of the nursing can be a facilitator or an obstacle in the workplace in such a way that causes positive or negative consequences, both to the health workers, and to the sicks. In this context, the interviewees have intensified their viewpoints with regard to the weaknesses that permeate the nursing relationship, by pointing them more frequently than the strengths. The work conditions have signaled a failing situation, which is evidenced by the constant improvisation process before the lack of human and material resources, low wages, deficit in recognizing the nursing worker, and physical and emotional wear, by creating a professional exhaustion. The devaluation of the worker also became a strong factor for this study, because it was characterized a reason of job dissatisfaction, due to the lack of valuation policies, which should be prepared by the institution or, even, they are unknown by the worker itself. The worker participation in the design of these policies has emerged as a relevant factor. The poor work conditions lead the worker to a process of professional demotivation and dissatisfaction, by causing the feeling of devaluation within its work environment. Hence, it was found in this research that the lack of communication leads to situations of inadequate interpersonal relationships, which are creators of an unsuitable environment for the performance of the nursing team

Metodologia para gerenciamento de projetos em tecnologia da informação baseada no guia PMBOK: um estudo de caso na Secretaria de Estado da Saúde Pública do Rio Grande do Norte

Nowadays the search for growth makes organizations seeking competitive advantages, project management shares this goal, through techniques that assist in the search for an improved management of the various fields of knowledge through a design methodology. The world is driven by projects and the search for ways to better manage activities such as time, cost and term towards the success of a particular project is something constant. A major contribution that IT can make to the health sector is the support for the management area. IT can integrate processes, optimize the interconnection between the various sectors, make hospitals have access to inside information of good quality, as well as support in the healthcare area, sharing pictures, uniting the various aspects of nursing and nursing service. The major challenge faced by the SESAP Information Technology sector at present is in project management in IT , which does not exist makes investments in the area are increasingly difficult due to this deficiency in management develop their own systems without cost additional to the State. This study seeks to build and strengthen the Project Management within the Department of Health through the implementation of a project office that will manage the final result of this work methodology based on PMBOK, and still show the functionality applied to development the state Hospital Management System that will later be installed on all Regional Health Units and proposing measures for the sustainability and development of the sector amid the difficulties of the current public service. Such action will result in a savings of more than R$ 107,000.00 (one hundred seven thousand) regarding spending private software currently used by the assignment of invested by the State of Rio Grande do Norte user licenses, representing more than 5 % of the total budget of the State Department of Public Health of the State

As múltiplas dimensões da garantia dos direitos do paciente idoso internado: o caso de uma instituição hospitalar pública no município de Natal/RN

In the context of current capitalist society, marked by the logic that restricts the human person their status as workforce, in order to generate profits, old age is often treated as an underprivileged life stage. This reality becomes more intense considering the sharp aging process that affects brazilian society is accompanied by the country's entry into a globalized world and tensioned by the dictates of capital. Thus, despite the increasing development of policies to strengthen the guarantee of elderly rights, it is necessary to establish effective strategies of these measures to ensure a higher quality of life to these subjects. Therefore, it is necessary to develop studies that problematize the issue of the elderly, which represent a growing portion of the population, and hence have more visible demands, including in health. With the increase in the elderly population in Brazil it is possible to realize the country is going through a demographic transition and epidemiological changes that contribute to change the landscape of health care of the elderly, especially the hospitalization. Thus, this study aimed to analyze the multiple aspects of ensuring the rights of elderly patients admitted to the State Hospital Dr. Ruy Pereira dos Santos (HRPS), located in Natal / RN, whose most patients are elderly. Specifically sought to understand the aging process, its social consequences and the vulnerability to which it is exposed, especially during the disease situation; understand the process of construction of the Brazilian public health and their actions for older people; learn the expressions of citizenship formation in Brazil with regard to policies for older people; and investigate the design of health professionals about the guarantee of the right of hospitalized elderly. Starting from an integrated coordinated theoretical and practical possibilities, a qualitative research and literature character, documentary and field was held. For this, there were four semi-structured interviews with health research locus Hospital professionals - namely, two social workers, a doctor and a nurse - as well as life stories with the hospitalized elderly patients, one in each deck the said Hospital, totaling three. The results pointed to the difficulty of health policy become effective as law and stressed one historical scenario violation of the rights of elderly hospitalized patients, which persists due to the precarious situation and the difficulty of effective implementation of the Unified Health System (SUS ) and other public policies to that end.

Passado e presente: a enfermagem do Hospital Universitário Onofre Lopes

This is a historically focused study with a qualitative approach whose main purpose is to investigate the trajectory of Nursing at the Hospital Universitário Onofre Lopes (HUOL) and how it associates with the teaching of Nursing at the Federal University of Rio Grande do Norte (UFRN). Motivation for carrying out this study is due, firstly, to a liking for history and, secondly, to the nonexistence of records on Nursing in one of the institutions with the most teaching tradition in the area of health and nursing in the state of Rio Grande do Norte. The objectives of the study were to analyze the historical development of Nursing at the HUOL and its association with the teaching of Nursing at the UFRN; describe the historical development of the Hospital referred to; and to establish a relationship between the development of nursing at the HUOL and the teaching of Nursing at the UFRN. Empirical investigation was carried out based on the study of historical documents such as reports, minutes, letters, by-laws, decrees and administrative directives, as well as photographs and interviews with people who lived through this history or who kept vivid memories of it. From this research it can be gathered that Nursing at the HUOL was at first closely identified with the empirical stage of the profession. Its development is a result of the institutionalization of teaching whose starting point is an authorization for running the Nursing Aid School of Natal in 1955. Since then, gradually, teaching has enabled those who practiced nursing at that institution to become professionals through a partnership between the Nursing Aid School and the Nursing Department at the Hospital whose administration had been in charge of a professor for many years. Upon the creation of the undergraduate program in Nursing in 1973, nursing at the HUOL underwent a new transformation process with new nurses being hired. Likewise, the creation of post-graduate specialization and master s degree programs in 1982 and 1996, respectively, opened the way to the growth of the academic qualifications of nurses at that institution. Therefore, it must be asserted that Nursing at the HUOL has, over the years, gone through a continuous process of qualification of its members and in such trajectory the teaching of Nursing that is carried out at different levels at the UFRN stands as a hallmark

Caracterização do acidente de trânsito e gravidade do trauma: um estudo em vítimas de um hospital de emergência de Natal

Descriptive exploratory study, with quantitative approach and prospective data performed on the Monsenhor Walfredo Gurgel Hospital Complex (MWGH), in Natal/RN, aiming to classify the type of motor vehicle involved in the accident, the public roadway s user quality and the more frequent injuries; to evaluate the severity of trauma in traffic accident victims; characterized the severity of the injuries and the trauma, and the type of motor vehicle involved. The population comprises 605 traffic accident victims, with data collected between October and December 2007. We used as a support for the evaluation of severity of injuries and trauma the Glasgow Coma Scale (GCSl), the Condensed Abbreviated Injury Scale (CAIS) and the Injury Severity Score (ISS). The results show that 82.8% of the victims were male; 78.4% were aged 18 to 38; the victims originating from the State s Countryside prevailed (43.1%); 24.3% of the population had completed middle-level instruction; 23.1% worked on commerce and auxiliary activities; most (79.4%) was catholic; 48.8% were married/consensual union; 76.2% earned up to two monthly minimum wages; Sunday was the day with the most accidents (25.1%); 47.4% were attended to in under an hour after the event; the motorcycle on its own was responsible for 53.2% of the accidents; 42.3% were attended to by the SAMU; 61.8% were victims of crashes; over half (53.4%) used individual protection equipment (IPE); 49.4% were helmets and 4.0% the seatbelt; 61.3% were motorcycle drivers; 43.3% of the accidents took place in the afternoon shift; from 395 drivers, 55.2% were licensed, and 50.7% among those had been licensed for 1 to 5 years; 90.7% of the victims had GCS1 between 13 and 15 points at the time of evaluation; the body area most affected was the external surface (35.9%); 38.8% of the injuries were light or moderate (AIS=1 and AIS=2); 83.2% had light trauma (ISS between 1 and 15 points). In face of the results, we can conclude that there is a risk for the elevation of injury severity and trauma resulting from traffic accidents, when these events are related to certain variables such as gender, age, weekday, the interval between the accident and the first care, ingestion of drugs, type of accident, the public roadway s user quality, the use of IPE, day shift, body regions and the type of motor vehicle involved in the accident

Trajetória do hospital dia Dr. Elger nunes: um recorte histórico da psiquiatria e saúde mental no Rio Grande do Norte

In Brazil, the mental health network proposed by the Psychiatric Reform inserts the intermediate and replacement services in the pursuit of alignment or resocialization of patients with mental and behavioral disorder in the community. Was adopted, among other services, the Center for Psychosocial Care, Home Therapy, Sheltered Home, Day Hospital and psychiatric beds in general hospital. In this context, the State of Rio Grande do Norte implanted the Day Hospital Dr. Elger Nunes (HDEN) in Natal / RN in 1996, linked to State Department of Public Health. At HDEN happened a multi and interdisciplinary therapeutic work, besides being the scene of disciplinary practices, and extension projects for graduate courses in Higher Education Institutions in the city. However, with the process of decentralization of local services, the hospital was terminated by an administrative state act in 2006, leaving damage to the activities provided to users, disciplinary practices and extension activities. From this breakdown, the objective was to narrate the trajectory of HDEN through a multidisciplinary team of professionals and teachers who used it as a field of disciplinary practices. It is characterized as a documental and qualitative, backed in the technique of thematic oral history, following the phases: authorization of the interviewee, interview recording, transcription, textualization and transcreation of the material obtained. We used documents, ordinances, general reports of activities, among others, plus interviews to fifteen employees who used this service, being thirteen part of the multidisciplinary team of professionals and two graduation professors of health care area, nursing and medicine. The stories collected were organized according to the technique chosen, respecting its steps. In preparing the body subjected to ALCESTE computer program, priority was given to the vital tone for the formation of categories and classes elected by the program, structured in three thematic areas. In the first axis, called Trajectory of HDEN, were recalled the beginning of its activities, the steps of that time, their activities, and its actors - users, families, professionals, and teaching practices. The second axis has dealt with the process of extinction of HDEN, rescuing the feelings of employees, the main reasons given at the time and immediate postextinction scenario. And the third axis revealed in an articulated form the situation of mental health in Natal / RN, listing to the challenges and prospects for the psychosocial care, starting from the trajectory of HDEN with emphasis on activities. Moreover, the trajectory of HDEN provides recognition of the historical basis outlined in the constitution of the network of substitute services present in the current scenario of psychosocial care in the city of Natal and in RN.

Fatores da satisfação, fidelidade e recomendação em serviço de saúde: estudo em setor ambulatorial de hospital

This thesis deals with the factors affecting customer satisfaction, loyalty and recommendation in the health care sector. It is adapted a model proposed by Johnson et al. (2001) of quality and loyalty antecedent factors and it is conducted a survey with a sample of 109 customers of a hospital on the ambulatory in Natal city, a capital of a Northeastern State of Brazil. It is carried descriptive and multiple regression statistical analysis. The main findings related to satisfaction are that quality factors of doctor professionalism, clerical staff efficiency, consultancy room comfort, time to provide the medical consultancy but also hospital localization are the most significant factors affecting satisfaction. Regarding personal full loyalty, satisfaction with the hospital and affective commitment are the main factors yet for partial loyalty image and calculate commitment play the main role. For recommendation satisfaction, image and brand are the main factors. The overall model used fairly explains the satisfaction, loyalty and recommendation outcomes with varying factors regarding each final purpose, e.g. loyalty or recommendation

Reflexões sobre a política de descentralização em saúde: uma análise a partir do Hospital Monsenhor Walfredo Gurgel em Natal (RN)

The process of decentralization of health policy in Brazil has evolved throughout the second half of the twentieth century, advancing by leaps and bounds in the last two decades. The various public institutions have assumed the function of responding to a growing demand for medical care and hospital. Monsenhor Hospital Walfredo Gurgel - H.M.W.G. fits into this context as an institution par excellence-oriented service the demand for medium and high complexity. This paper presents some questions about the process of decentralization and devolution occurred in Brazil. To do so is a brief historical background and politics, showing the concepts of reform and counter-reform and how the processes mentioned in the Country Correlates develop local social development of the decentralization process and discusses the modifications in policies social intervention in recent decades and the state health policies. Presents the implementation of a Health System in Brazil and the state showing how the decentralization of health policy occurs in Rio Grande do Norte. Finally, it explores the role of H.M.W.G. in health policy in RN. For this, portrays the institution and is located within the decentralized structure of health policy in the state and capital. An analysis of the demand for hospital care and the budget situation is realized at the close of work, correlating the role of HMWG with the decentralization of health policy in Brazil and Rio Grande do Norte. The methodology used for the preparation of this work was based on documentary research, systematic nonparticipant observation, field diary and analysis of data, documents and content. This set shows a quantitative and qualitative methodology that strips the institution, enabling the understanding of their role, boundaries, threats and opportunities

O trabalho dos assistentes sociais no âmbito hospitalar: as particularidades da sua inserção no Hospital Universitário Onofre Lopes (HUOL), em Natal/RN/

This study aimed to analyze the work of social workers at the Hospital Universitário Onofre Lopes (HUOL), with the analytical approach the contracting process with the HUOL with the National Health System (SUS), which is set from 2004. Thus, this study sought in times of state reform, restructuring and tension between enlargement / reduction of social and labor rights, understanding the limits and possibilities of social work in HUOL, analyzing how these determinations bounce in the practice of social workers included in the collective process of health work. From a theoretical and methodological historical and dialectical materialism, we conducted literature search, in which developed book report and readings of texts, articles, books that focus on the central categories of the study, namely: Work, Social Work, Health, Health Reform , Project ethical and professional politician. Operationalized also a documentary research, on the Brazilian Public Health Policy, (SUS) and of the Education, as well as research field in which we conducted interviews with 11 social workers, employees packed the HUOL. We conclude that social workers did not participate in the discussion process of contracting the HUOL with the Municipal Health Secretariat of Natal, RN, manager of health and full resetting of user access, via reference setting - counter-referral services provided by the hospital brought the main demands on Social Work guidance regarding the functionality of SUS, and the social intervention in the struggle to guarantee such access. However, the data show that the expansion of demands that require the intervention of the social worker at HUOL is not associated with quantitative growth of these professionals need. Such conditions inflect the possibilities of materialization of the professional ethical-political project, even though that these professionals worry and seek the intellectual improvement, quality of service and to guarantee the social rights of users in the professional practice everyday