Carga de trabalho de enfermagem e infecções relacionadas à assistência à saúde na unidade de terapia intensiva

In recent decades, the search for quality care has been widely discussed by the institutions and health professionals. In this context, it is the nurse coordinator of the process of providing nursing staff, reflecting the commitment to quality of care. In this process, it is the appearance of Infections Related to health care and its potential association with the workload in nursing as a valuable indicator of quality of care. Thus, this research contributes to studies to characterize the demand of nursing work to promote a safe healthcare practice. This study aimed to identify the association of nursing workload with the number of cases of Ventilator-Associated Pneumonia, urinary tract infection and central venous catheter infection in the intensive care unit. This is a quantitative research approach, descriptive, cross-sectional and prospective, held at Unimed Hospital in Natal-RN. The study population consisted of all patients treated in the Intensive Care Unit, Hospital for a period of 90 consecutive days in 2011. The convenience sample was compostapelos patients admitted to the ICU during the period of data collection, a total sample of 286 patients. To perform the data analysis software were used: Statistica 6.0, SPPS (Statistical Package for Social Sciences) version 17.0 (2004) and Excel 2007. In the descriptive analysis, we used Measures of Central Tendency and Measures of Dispersion or Variability and the use of nonparametric tests. Of the 286 patients, 88 were from the ICU and 198 ICU II II. Males predominated in the ICU I (51.1%) and female ICU II (57.6%) patients in the ICU I were aged 61-80 years (39.8%) followed by greater than 80 years (39.8%). In the ICU II, most of the patients were aged 61-80 years (38.9%) and then from 41 to 60 years (24.2%). In relation to the class of TISS inlet predominant class II in the two ICUs (59.1%), followed by Class III also in the two units (34.6%). Most patients (70.6%) out of the ICUs belonging to class II TISS. In the ICU I, the average number of forms of the TISS 28 was 6, has in ICU II this value drops to 3.2 forms. The overall mean was 19.9 TISS points in ICU patients I and ICU II.the 17 points in the average hours required to provide adequate nursing care to patients in the ICU I found that is 10 , 7 hours, and the ICU II 9.2 hours. It was found that the time provided by the nursing staff were higher in ICU II, with an average of 19 hours available for nurses in this sector. In the ICU I, which showed higher need of available hours, it was found that the mean value of 12.7 available hours. It was found that only 2.4% of patients had these units Ventilator-Associated Pneumonia, 1.0% were infected central venous catheter and 1.4% of patients had urinary tract infection. Infection associated with health care occurs, on average, on the tenth day of hospitalization. In the ICU II, this average value extends to the twelfth day with an excess of 2.7 hours of nursing care while in ICU I value decays to the ninth day of hospitalization with a deficiency of 12-hour assistance. It is concluded that patients generally showed a need for classification of semi-intensive care and has been assisted in their need to load. As for his association with the Related Infections Health will assist this analysis could not be performed due to the small number of notifications in this period. It is suggested further study how other factors related to infections me a longer period of analysis

Nursing Activities Score: avaliação da carga de trabalho de enfermagem em unidade de terapia intensiva adulto

The sizing of nursing human resources is an essential management tool to meet the needs of the patients and the institution. Regarding to the Intensive Care Unit, where the most critical patients are treated and the most advanced life-support equipments are used, requiring a high number of skilled workers, the use of specific indicators to measure the workload of the team becomes necessary. The Nursing Activities Score is a validated instrument for measuring nursing workload in the Intensive Care Unit that has demonstrated effectiveness. It is a cross-sectional study with the primary objective of assessing the workload of nursing staff in an adult Intensive Care Unit through the application of the Nursing Activities Score. The study was conducted in a private hospital specialized in the treatment of patients with cancer, which is located in the city of Natal (Rio Grande do Norte – Brazil). The study was approved by the Research Ethics Committee of the hospital (Protocol number 558.799; CAAE 24966013.7.0000.5293). For data collection, a form of sociodemographic characteristics of the patients was used; the Nursing Activities Score was used to identify the workload of nursing staff; and the instrument of Perroca, which classifies patients and provides data related to the their need for nursing care, was also used. The collected data were analyzed using a statistical package. The categorical variables were described by absolute and relative frequency, while the number by median and interquartile range. Considering the inferential approach, the Spearman test, the Wald chi-square, Kruskal Wallis and Mann-Whitney test were used. The statistically significant variables were those with p values <0.05. The evaluation of the overall averages of NAS, considering the first 15 days of hospitalization, was performed by the analysis of Generalized Estimating Equations (GEE), with adjust for the variable length of hospitalization. The sample consisted of 40 patients, in the period of June to August 2014. The results showed a mean age of 62,1 years (±23,4) with a female predominance (57,5%). The most frequent type of treatment was clinical (60,0%), observing an average stay of 6,9 days (±6,5). Considering the origin, most patients (35%) came from the Surgical Center. There was a mortality rate of 27,5%. 277 measures of NAS score and Perroca were performed, and the averages of 69,8% (±24,1) and 22,7% (±4.2) were obtained, respectively. There was an association between clinical outcome and value of the Nursing Activities Score in 24 hours (p <0.001), and between the degree of dependency of patients and nursing workload (rp 0,653, p<0,001). The achieved workload of the nursing staff, in the analyzed period, was presented high, showing that hospitalized patients required a high demand for care. These findings create subsidies for sizing of staff and allocation of human resources in the sector, in order to achieve greater safety and patient satisfaction as a result of intensive care, as well as an environment conducive to quality of life for the professionals

Análise da atividade de trabalho profissional de gerentes de hotel à luz da abordagem da ergonomia

This Masters degree dissertation presents a research that aims at analyzing the activities regarding within a hotel managers work in Natal/RN - Brazil, This Masters degree dissertation presents the research that aims at analyzing the activities regarding the hotel managers work in Natal / RN - Brazil, performing diagnosis of their activities and relating the aspects that impact the quality and productivity of hotel services and managers occupational health. This research is characterized as a case study with a qualitative approach, taking the method of Ergonomic Work Analysis which is the analysis of the managers work activity as a reference to the focus; and combining the use of observational and interactional methods. Ergonomics and macroergonomics are used in this study not only to understand the physical, cognitive and organizational constraints of the manager s duties, but also to characterize the work organizational architecture and design of that hotel. High workload, accumulation of tasks and diversion of functions performed by managers were noticed, increasing thereby the physical and psychological suffering for them. It was found that the activity of managers is characterized by the ambivalence of power, limited autonomy, cooperation, interdependence between managers and the fear of incompetence. It was also noticed that managers devote more time to the day job (37%), another time to sleep (30%), while only 33% of the rest of the day are meant for activities like taking care of health, family, social life and study. Although there are few studies addressing the health and safety of hotel managers, this research revealed that 84% of the surveyed hotel managers complain of musculoskeletal pain which 50% are obese and are 100% sedentary. It was also observed that managers adopt unsuitable postures for carrying out the work activities that contribute to becoming injured or work-related musculoskeletal disorders in the near future. Ergonomic measures were recommended as an investment in the skills and the training of managers, encouraging cooperative work, appropriateness of workload, limiting overtime, preserving the enjoyment of breaks during work and weekly holidays, changing the layout of the work sector , usage of communication technology to prevent displacement, compensatory physical activities, furniture adaptation, among others

Modelo matemático para predição do VO2máx em cicloergômetro baseado na análise dos gases expirados

Existem diversas equações para predição do VO2máx a partir de variáveis dentro do teste ergométrico em vários ergômetros, no entanto equação semelhante utilizando os limiares ventilatórios na ergoespirometria em teste sub-máximo no cicloergômetro não está disponível. O objetivo do presente estudo foi avaliar a precisão de modelos de predição do VO2máx com base em indicadores de esforço sub-máximo. Neste sentido foram testados em protocolo incremental máximo no cicloergômetro 7.877 voluntários, sendo 4640 indivíduos do sexo feminino e 3147 do sexo masculino, todos saudáveis não atletas, com idades acima de 20 anos, divididos randomicamente em dois grupos: A de estimação e B de validação. A partir das variáveis independentes massa corporal (MC) em kg, carga de trabalho no limiar 2 (WL2) e freqüência cardíaca no limiar 2 (FCL2) foi possível construir um modelo de regressão linear múltipla para predição do VO2máx. Os resultados demonstram que em indivíduos saudáveis não atletas de ambos os sexos é possível predizer o VO2máx com um erro mínimo (EPE = 1,00%) a partir de indicadores submáximos obtidos em teste incremental. O caráter multidisciplinar do trabalho pôde ser caracterizado pelo emprego de técnicas que envolveram pneumologia, educação física, fisiologia e estatística

Análise antropotecnológica do desenvolvimento de novos produtos na produção artesanal : caso das rendeiras de bilro da Vila de Ponta Negra em Natal, RN

Brazilian craft production plays an important role in the generation of employment and income for many families in every state across Brazil. In Natal, Rio Grande do Norte, Brazil, among many types found, identifies itself with the production of bobbin-lace, still practiced in Ponta Negra Village for ancient craftswomens of city that try to preserve the art and tradition of bobbin-lace. This work presents the results of an analysis conducted based in concepts of anthropotechnology, on the effects of a design workshop held with bobbin-lace craftswomen in the village of Ponta Negra in July of 2006. The workshop was intended to propose a new concept of products and a new alternative for production in the activity of the craftswomen, on the premise that the laces could be used as a detail inserted into other industrial products such as shirts, bags, towels, etc. Evaluations after the workshop showed that none of the artisans continued to work, indicating that actions focused solely on products did not generate representative results in the production of bobbin-lace. Evaluations also indicated that knowledge about the artisan's personal and professional characteristics, organization, pace, workload, and cultural and historical issues that permeate the activity are essential to the success of technology transfer, particularly when the transfer affects the craft production as it relates to the inseparable aspects of the craftswomen's work and lifestyle

O papel da leitura nas aulas de inglês: uma análise segundo a percepção dos professores do ensino médio de escolas públicas estaduais de Natal

This dissertation aims at investigating the teachers beliefs about the role of the reading ability in English at public state high schools in Natal and identifying the social value of the process of learning English for students of a foreign language. From the understanding of studies on reading, both in the field of Cognitive Psychology, as in Gibson & Levin (1975), as in the area of Psycholinguistics, as in Goodman (1970) and Del Re (2006), We researched the teachers perceptions about the skills and competencies that should permeate their educational practices, through their knowledge about theories of language acquisition as Cognitivism (Piaget, 1961) and Social Interactionism (Vygotsky, 1979) and the official documents (PCNEM, 1999; PCN+, 2002 ) that are the parameters for teaching a foreign language. We took into consideration other factors that influence the choice of the goals and the objectives to be worked out, such as: intensity of teachers workload, number of classes and students per class for each teacher, materials and technologies available, among other factors that will play an important role in the choice of the appropriate methodologies. To conduct a case study, two questionnaires were used in the construction of direct interviews with fourteen English teachers in twenty schools. According to data on the teachers beliefs we could find that for them the reading ability does not seem to have an special treatment in the teaching of a foreign language due to factors that undermine this process and therefore make teachers do not realize the real objectives of teaching English at public state high schools in Natal. As a consequence, the current process of education complicates the formation of autonomous learners capable of fighting for a social transformation

Avaliação da usabilidade de um sistema informatizado de controle acadêmico: um estudo com coordenadores e secretários de cursos stricto sensu da UFRN

The aim of this study is to assess the usability of the Integrated Management System for Academic Activities (SIGAA) for the sensu stricto postgraduate programs at Universidade Federal do Rio Grande do Norte. The study was based on ergonomic criteria proposed by Bastien and Scapin (1993) and the Federal Government s Handbook of Usability (2010). The methodology used was a descriptive data survey involving an online questionnaire, and a sample of 46 system users, composed of coordinators and secretaries from the sensu stricto postgraduate programs. In addition to this procedure, open interviews were held with the users as well as a documental analysis of calls registered by them at the SIGAA between May 2012 and June 2013. Data analysis showed that a number of additional usability criteria need to be implemented, primarily related to ergonomic problems of orientation, error management and workload. Based on the analyses, several changes were proposed that may streamline secretarial activities, as well as provide greater satisfaction and interaction between the SIGAA and its users

Efeitos do turno fixo sobre a saúde mental em operadores de petróleo :um estudo de caso em dois ativos produção da Petrobrás

Un conjunto de cambios viene siendo implantado en la Petrobrás procurando que sus unidades de negocios resulten más modernas y competitivas para atender las necesidades del mercado. Dentro de esta perspectiva, un nuevo régimen de trabajo, denominado turno fijo , ha sido implantado en dos activos de producción de la provincia de Rio Grande do Norte. Tal situación originó varios reclamos de los petroleros y, consecuentemente, el interés del SINDIPETRO-RN en obtener una evaluación más precisa de las consecuencias de los mismos. Este estudio, realizado a partir de la demanda sindical de esos trabajadores, ha tenido como objetivo central analizar los efectos del turno fijo sobre la salud mental de los operadores de producción, actualmente lotados en los referidos activos. El estudio ha sido realizado con 39 operadores que representan el 82,9% de la población objeto de este estudio. La muestra ha sido homogénea en cuanto al género, grado de instrucción, edad y tiempo de servicio en la compañía, lo que ha posibilitado un mayor control de las variables y un estudio comparativo entre los dos activos. Para el desarrollo del estudio, se han aplicado los siguientes instrumentos de colecta de datos: una escala de medida probada y validada (QSG-12), un cuestionario abierto, entrevistas individuales y una ficha socio-demográfica. Las respuestas del cuestionario abierto han sido categorizadas mediante la aplicación de análisis de contenido. Los resultados de ese tratamiento y las respuestas del QSG-12 han sido registradas en la forma de banco de datos del SPSS for Windows (Statical Package for social sciense for Windows) para luego procederse con el desarrolllo de los análisis estadísticos. Los principales resultados encontrados en el estudio han sido que la mitad de los participantes de la muestra han presentado resultados de deteriorización de la autoeficacia más elevado que 1,44 (un una escala de 0 a 3) y, en tensión emocional y depresión, el resultado es más elevado que 1,67; la mayoría se da cuenta del aumento de carga de trabajo, revela acentuado sufrimiento con el distanciamiento de la familia, y 58,8% presenta enfermedades psicosomáticas crónicas. La percepción de los operadores sobre el turno fijo e el análisis de éste, conforme el modelo vitamínico de Warr, conducen a la conclusión de que el turno fijo es uno de los factores que está influyendo negativamente en la salud mental de esos trabajadores

LCD-OpenPACS: sistema integrado de telerradiologia com auxílio ao diagnóstico de nódulos pulmonares em exames de tomografia computadorizada

Lung cancer is one of the most common types of cancer and has the highest mortality rate. Patient survival is highly correlated with early detection. Computed Tomography technology services the early detection of lung cancer tremendously by offering aminimally invasive medical diagnostic tool. However, the large amount of data per examination makes the interpretation difficult. This leads to omission of nodules by human radiologist. This thesis presents a development of a computer-aided diagnosis system (CADe) tool for the detection of lung nodules in Computed Tomography study. The system, called LCD-OpenPACS (Lung Cancer Detection - OpenPACS) should be integrated into the OpenPACS system and have all the requirements for use in the workflow of health facilities belonging to the SUS (Brazilian health system). The LCD-OpenPACS made use of image processing techniques (Region Growing and Watershed), feature extraction (Histogram of Gradient Oriented), dimensionality reduction (Principal Component Analysis) and classifier (Support Vector Machine). System was tested on 220 cases, totaling 296 pulmonary nodules, with sensitivity of 94.4% and 7.04 false positives per case. The total time for processing was approximately 10 minutes per case. The system has detected pulmonary nodules (solitary, juxtavascular, ground-glass opacity and juxtapleural) between 3 mm and 30 mm.

Eutrofização e capacidade de carga de fósforo de seis reservatórios a bacia do Rio Seridó, região semi-árida do Estado do RN

The eutrofization is a natural process of accumulation of nutrients in aquatic´s body that it has been accelerated for the human´s actives, mainly the related with the activities of camp, industrial and the inadequate disposition of the domestic sewage. The enrichment of the aquatic´s body with nutrients, mainly the nitrogen and the phosphorus, and the consequent proliferation of algae and Cyanobacteria can commit the quality of the water for the public provisioning, for the fish farming and for other ends. The problem becomes more critical when there is a shortage of water naturally as in the semi-arid area of the Brazilian northeast. Before that problem this work had as objective evaluates the trophic state of six reservoirs of the basin of River Seridó of Rio Grande of Norte and also estimate the capacity of load of match of the reservoir and risk probabilities based on the established limits by the resolution Conama 357/05. The results demonstrate that the six reservoirs are eutrofization, with concentration of total phosphorus and cloro a in the water upster to 50 e 12 μg l-1. The results show that space homogeneity exists in the state trophic of the reservoirs, but a significant variation interanual in function of the increase of the concentrations of nutrients and decrease of the transparency of the water with the reduction of the body of water accumulated in the reservoirs.The results of the simulation risk estocastic show that the reservoirs could receive annually from 72 to 216 Kg of P, assuming a risk of 10% of increasing in more than 30 μg l-1 the annual medium concentrations of total match in the water of these reservoirs. This load could be high in until 360 kg of P a year in case the managers assume a risk of 10% of increasing in more than 50 μg l-1 the annual medium concentrations of total phosphorus in the waters of these reservoirs

Estudo da perda de carga e calor no poço injetor no processo De drenagem gravitacional assistida por vapor (SAGD)

The oil companies in the area in general are looking for new technologies that can increase the recovery factor of oil contained in reservoirs. These investments are mainly aimed at reducing the costs of projects which are high. Steam injection is one of these special methods of recovery in which steam is injected into the reservoir in order to reduce the viscosity of the oil and make it more mobile. The process assisted gravity drainage steam (SAGD) using steam injection in its mechanism, as well as two parallel horizontal wells. In this process steam is injected through the horizontal injection well, then a vapor chamber is formed by heating the oil in the reservoir and, by the action of gravitational forces, this oil is drained down to where the production well. This study aims to analyze the influence of pressure drop and heat along the injection well in the SAGD process. Numerical simulations were performed using the thermal simulator STARS of CMG (Computer Modeling Group). The parameters studied were the thermal conductivity of the formation, the flow of steam injection, the inner diameter of the column, the steam quality and temperature. A factorial design was used to verify the influence of the parameters studied in the recovery factor. We also analyzed different injection flow rates for the model with pressure drop and no pressure drop, as well as different maximum flow rates of oil production. Finally, we performed an economic analysis of the two models in order to check the profitability of the projects studied. The results showed that the pressure drop in injection well have a significant influence on the SAGD process.

Efeito da perda de carga e calor no poço injetor no processo de drenagem gravitacional assistido com vapor e solvente

Nowadays, most of the hydrocarbon reserves in the world are in the form of heavy oil, ultra - heavy or bitumen. For the extraction and production of this resource is required to implement new technologies. One of the promising processes for the recovery of this oil is the Expanding Solvent Steam Assisted Gravity Drainage (ES-SAGD) which uses two parallel horizontal wells, where the injection well is situated vertically above the production well. The completion of the process occurs upon injection of a hydrocarbon additive at low concentration in conjunction with steam. The steam adds heat to reduce the viscosity of the oil and solvent aids in reducing the interfacial tension between oil/ solvent. The main force acting in this process is the gravitational and the heat transfer takes place by conduction, convection and latent heat of steam. In this study was used the discretized wellbore model, where the well is discretized in the same way that the reservoir and each section of the well treated as a block of grid, with interblock connection with the reservoir. This study aims to analyze the influence of the pressure drop and heat along the injection well in the ES-SAGD process. The model used for the study is a homogeneous reservoir, semi synthetic with characteristics of the Brazilian Northeast and numerical simulations were performed using the STARS thermal simulator from CMG (Computer Modelling Group). The operational parameters analyzed were: percentage of solvent injected, the flow of steam injection, vertical distance between the wells and steam quality. All of them were significant in oil recovery factor positively influencing this. The results showed that, for all cases analyzed, the model considers the pressure drop has cumulative production of oil below its respective model that disregards such loss. This difference is more pronounced the lower the value of the flow of steam injection

O trabalho em saúde como espaço pedagógico: desafios e possibilidades

The ongoing transformations in brazilian society, arising from technical and organizational changes in the working world, are making, with much emphasis, heated debates resurge related to themes and issues that refer to the relationship between work, skills and education. Thus, this study is inserted in the link between education and work, pointing to the work as an educational principle according to Antonio Gramsci. This paper aims to discuss the interfaces between education and work in the everyday health care teams and learn about the activities developed by health teams related to the learning processes in and with the work to analyze the opportunities and challenges of transforming spaces of health work in an environment of lifelong learning. This is a descriptive, exploratory with a qualitative approach case study developed from semi-structured interviews with the health staff professionals of the Unidade de Terapia Intensiva da Casa de Saúde Dix-Sept Rosado in Mossoró / RN , who answered open questions about the relationship between education and work. The interviews were conducted during the month of January 2010, the same being recorded, transcribed and analyzed, culminating in the production of new knowledge on the subject. It is understood that work and education activities are eminently human, therefore only the human being works and educates. Given the statements of participants, it is noticed that all work processes in health are learning moments. This happens through new demands imposed by the everyday of the services, by interaction with a multidisciplinary team, participation in educational activities and individual study. It was noticed that the institution in this case does not promote study courses related to Intensive Care and that there are obstacles to the realization of educational activities on and with the work, such as: excessive workload, inability to release staff to participate in events, low pay, which leads the worker to have more than one employment, rejection of new knowledge by some workers and lack of physical infrastructure and incentives for the activities. The daily situations must be transformed in learning, selfanalyzing the problems of practice and valuing the work process itself in its intrinsic context. We conclude that dealing with the web of relationships between educational processes and production processes of health services, unraveling the intricacies of the world of work and education requirements in this sector are increasingly on the agenda of Sistema Único de Saúde workers and managers. The continuing consideration of this issue becomes an essential condition for the proper discharge of their responsibilities. We consider that bringing the education to everyday life is the result of recognition of the educational potential of the work situation

Avaliação do uso do DCP em areias para controle da capacidade de carga em fundações diretas e controle de compactação de aterros

This work presents results of field and laboratory tests using a Dynamic Cone Penetrometer, DCP. The tests were performed in order to evaluate the use of the equipment in sand for the control of bearing capacity of shallow foundations and fill compaction. For shallow foundations, the laboratory tests were conducted on sand placed in a metallic mould by the method of sand pluviation. Although the results show the inability to reproduce field conditions in the laboratory it was possible to verify the ability of the DCP to identify less resistant soil layers. The DCP tests for the analysis of compaction control were performed in a strong box with inside dimensions of 1,40 m x 1,40 m and 0,70 m in height. The soil layers were compacted with different densities though the use of a vibrating plate in order to obtain correlations between penetration index, DPI, and soil relative density. Other tests were also conducted to assess the influence of soil moisture on tests results. Among other findings, the results showed the great potential for the use of DCP to control the compaction of sand fills

Provas de carga estática com carregamento lateral em estacas escavadas hélice contínua e cravadas metálicas em areia

An experimental study has been conducted to investigate the behavior of continuous flight auger (cfa) bored piles and metalic driven H-section piles under lateral loading in cohesionless soils. The piles were tested in two different areas at the same site. Both areas consisted of a 3-m thick compacted superficial fill of pure fine sand, underlain by layers of naturally occurring pure fine-thick sand. Fills are differentiated by the relative densities which were compressed, 45% e 70%, respectively. Each area received one identical pair of cfa piles and two identical pairs of H-piles. A static lateral loading test was performed in each pair of piles. In this work, the pile load test results are reported and interpreted. The horizontal coefficient of subgrade reaction was determined from the results of the loading tests and compared with values determined by correlations based on penetration resistance index of SPT tests (NSPT). p-y formulations describing the static behavior of the piles were applied to the problem under evaluation. Back Analyses were made through theoretical and experimental p-y curves for obtaining input parameters for the analytic models, among which the coefficient of horizontal reaction. The soil pile system horizontal loading at rupture was determined by the theoretical methods and the results were compared with the experimental results, checking its validity