Gestão de estoques: uma proposta de reposição contínua para material médico hospitalar e medicamentos em um hospital universitário federal do estado do Rio Grande do Norte

The inventory management in hospitals is of paramount importance, since the supply materials and drugs interruption can cause irreparable damage to human lives while excess inventories involves immobilization of capital. Hospitals should use techniques of inventory management to perform replenishment in shorter and shorter intervals, in order to reduce inventories and fixed assets and meet citizens requirements properly. The inventory management can be an even bigger problem for public hospitals, which have restrictions on the use of resources and decisionmaking structure more bureaucratized. Currently the University Hospital Onofre Lopes (HUOL) uses a periodic replacement policy for hospital medical supplies and medicines, which involves one moment surplus stock replenishment, the next out of stock items. This study aims to propose a system for continuous replenishment through order point for inventory of medical supplies and medicines to the hospital HUOL. Therefore, a literature review of Federal University Hospitals Management, Logistics, Inventory Management and Replenishment System in Hospitals was performed, emphasizing the demand forecast, classification or ABC curve and order point system. And also, policies of inventory management and the current proposal were described, dealing with profile of the mentioned institution, the current policy of inventory management and simulation for continuous replenishment order point. For the simulation, the sample consisted of 102 and 44 items of medical and hospital drugs, respectively, selected using the ABC classification of inventory, prioritizing items of Class A, which contains the most relevant items in added value, representing 80 % of the financial value in 2012 fiscal year. Considering that it is a public organization, subject to the laws, we performed two simulations: the first, following the signs for inventory management of Instruction No. 205 (IN 205 ), from Secretary of Public Administration of the Presidency ( SEDAP / PR ), and the second, based on the literature specializing in inventory management hospital. The results of two simulations were compared to the current policy of replenishment system. Among these results are: an indication that the system for continuous replenishment reorder point based on IN 205 provides lower levels of safety stock and maximum stock, enables a 17% reduction in the amount spent for the full replenishment of inventories, in other words, decreasing capital assets, as well as reduction in stock quantity, also the simulation made from the literature has indicated parameters that prevent the application of this technique to all items of the sample. Hence, a change in inventory management of HUOL, with the application of the continuous replenishment according to IN 205, provides a significant reduction in acquisition costs of medical and hospital medicine

A transformação da Associação de Professores do Rio Grande do Norte (APRN) em Sindicato dos Trabalhadores em Educação (1986-1990)

El estudo que ahora apresentamos habla a respecto ala transformaçión de la Asociación de maestros del Rio Grande del Norte (APRN en sindicato de los trabajadores en educación (SINTE) en el período de 1986 1990. Tratase basicamiente de las razones que llebaran historicamente la APRN la reorganizar sus luchas, su cultura política y el su movimiento reivindicatório; que impulsionaran la construción del próprio sindicato el único de la categoria, após el regime militar em el país especialmente en el gobierno Sarney, y en el ánbito estadual com la resistência la política econômica y la repreción policial del gobierno Geraldo Melo, la época. El estudo también apunta algunas caraterísticas marcantes del contexto histórico de la educación nacional, enfatizando la asención de la escuela nueva en el Brasil en las décadas de 1920 y 1930, inclusive delante del movimiento sindical, controlado por el gobierno Vargas que tênia uma praetica corporativista. Es importante decir que esas características estavan juntas del contexto local, en el rato en que se percebia la primer gestan del prof Anfilóquio Cámara, como el primer presidente de la APRN, al partir de la su fundación (1920), y que tênia um relacionamento bastante estrecho com el poder público estadual de caráter liberal. Habia una discución sobre la abertura política y la atuación política de las clases médias brasileñas ya em 1979, y al mismo tiempo analisabase el desencandeamiento del nuevo sindicalismo en el ABC Paulista, mientras uno movimiento sindical, autônomo y democrático que tênia el objetivo de juntar lãs luchas de los operários dentro y fuera de las fábricas reivindicando basicamiente: la redución de la jornada del trabajo, reajuste de sueldo y condición del trabajo, bien como lãs sus consecuencias para el movimiento de los educadores potigurares. Al hacer en septembre de 1989, el sindicato de los trabajadores en educación del Rio Grande del Norte se desvincula definitivamiente de uma estructura sindical vertical (tradicional), que la ex-APRN herdo al longo de su História del gobierno Vargas, siempre controlada pelo Estado y que en las décadas de 1980 y 1990 fue fortalecido por la CNTE (Confederación Nacional de los Trabajadores en la, educación), principalmente, a partir del Congreso Nacional de Unificación de los Trabajadores en la Educación, realizado en Aracaju/SE em el período de 25 a 28 de enero de 1990 en el sentido tambien de las sus principais reivindicaciones: escuela pública, gratuita y de cualidades en todos los pasos, verbas públicas solamiente para las escuelas públicas, reposición de los reajustes de sueldo, condición del trabajo, sueldo unificado nacional y la eradicación del analfabetismo

A satisfação e a intenção de continuidade de uso em servços de e-learning:validação empírica de um modelo aplicado no serviço público

The present study aims to investigate the constructs of Technological Readiness Index (TRI) and the Expectancy Disconfirmation Theory (EDT) as determinants of satisfaction and continuance intention use in e-learning services. Is proposed a theoretical model that seeks to measure the phenomenon suited to the needs of public organizations that offer distance learning course with the use of virtual platforms for employees. The research was conducted from a quantitative analytical approach, via online survey in a sample of 343 employees of 2 public organizations in RN who have had e-learning experience. The strategy of data analysis used multivariate analysis techniques, including structural equation modeling (SEM), operationalized by AMOS© software. The results showed that quality, quality disconfirmation, value and value disconfirmation positively impact on satisfaction, as well as disconfirmation usability, innovativeness and optimism. Likewise, satisfaction proved to be decisive for the purpose of continuance intention use. In addition, technological readiness and performance are strongly related. Based on the structural model found by the study, public organizations can implement e-learning services for employees focusing on improving learning and improving skills practiced in the organizational environment

O serviço público de fornecimento de água nas regiões metropolitanas: cooperação entre entes da federação e desenvolvimento

This work aims to study the material conflict of jurisdiction as to the ownership of public water supply, between the municipalities and the Member States, in metropolitan areas. One of the important points of analysis is the realization of the fundamental right of access to water, a right that is implicit in the Constitution of 1988, being prevented from having their achievement considering the lack of definition of the ownership of the service. Knowing discussed the essential public service, in all its stages, it will realize it is a complex activity that depends for its operation, joint activities of federal entities and the society. In its pursuit of development (understood as better conditions of life), that in view of the Federal Law nº 11.445 of 2007 is the universal access to service, require the adoption of popular participation and the positive benefits of the state, such as planning. Moreover, it will find cooperation between federal entities (after the study of Brazilian federalism) peaceful solution to the conflict through the adoption of joint management or shared, depending on the factual situation and legal

Assistência odontológica diferenciada para crianças de 0 a 3 anos: avaliação de impacto no Serviço Público Municipal em Natal-RN

In Brazil, 0-5 years old children just have an oral health care system since 1990 s. Innumerable experiences of implantation of the attendance to the babies in the cities had appeared throughout the years, but it hasn´t been evaluated the comparative effect between children displayed and not displayed to the program. In this regard, the main of this research was describe the Early Childhood Oral Health Care in public health service in Natal, Rio Grande do Norte, Brazil and evaluate the impact of this specific oral health care for babies by comparison of indicators between exposed and non-exposed children. It was created an experimental group, formed by children covered by program which was paired, based on sex, age and socioeconomic status, with a control group, formed by uncovered children. After filling ethical application, the parents of children were questioned about some risk factors to dental caries and, in sequence, it was accomplish an oral examination in the child. It was verified the Visible Plaque Index (VPI), Gingival Bleeding Index (GBI), dmf-s and verification of caries activity. The sample was 40 children in each group. The results showed, for VPI, a difference of 7 percentile points for the experimental group, however this difference had no statistical significance, obtained by Student s t test (p=0.314). In relation to GBI, the control group showed a low mean (0.8%) comparing with experimental group (2.77%) and this difference was statistically significant (p=0.003). The results for dmf-s and evaluation of caries activity showed no statistical difference between groups. Among the probable reasons for absence of impact of intervention, could be included: (a) the practice model was the same in two groups, or the difference was very weak and (b) the oral health care has intrinsic limitations for to impact on oral health in low income populations

Dependência química em mulheres :um estudo sobre o consumo de medicamentos ansiolíticos no serviço público de saúde de Natal/RN

This work was concerned to investigate the meaning attributed to anxiolytic drugs by women, in public health service. It proposes a joint analysis through a link between three dimensions: the woman, the drug, and public health service itself, in an hegemonic medical assistance model. It is observed that the relation between these elements has a great influence over the use and construction of a particular meaning, by the user. The medication is analysed as a consumption merchandise and as an health symbol. In this way, it reflects a biologized vision, which believes the drug as a solution for all health problems. It tries to analyse the generalized medical prescription for anxiolythics and it s consequences. It focalizes also the production and utilization of public health services by patients, mainly women. The question related to the use of anxiolytics and the meaning construted by women is analysed focusing the way that relations of masculine/feminine gender are organized in our society. At this point of view, it tries to understand the dimension that these questions have in subjectivity production, and how it acts in the health/disease process. Finally, this work tries to understand, in a broad sense, the use of anxiolytics looking at the problem not only as a biological question, but also as a cultural matter. The research was done over seventeen women, all of them anxiolytic users. It was used, as research instrument, semi-structured interview associated with methodological analysis of user s speeches

Impacto do racionamento nos resultados das empresas concessionárias do serviço público de distribuição de energia elétrica: um estudo nas empresas privadas da Região Nordeste

This work verifies the impact caused by the Emergencial Program of Reduction of Consumption of Electric Energy (energy-rationing program) in the results of the concessionary private companies of the public service of electric energy distribution localized in the Northeast Area. As the rationing invigorated from June 2001 to February 2002, its effects are diluted in the results presented by these companies in the second semester of 2001 and first quarter of 2002, with prominence for the last quarter of 2001, when the revenue of extraordinary tariff restore was instituted by the National Agency of Electric Energy (ANEEL), consequence of the so-called General Agreement of the Electric Sector made between the federal government and the companies of the electric sector. The structure of a generic electric sector and a historical review of the Brazilian electric sector from the time it was controlled by the private enterprises, including the State control period, about 1960, and returning to the control of the private enterprises in 1990, under a new regulation structure are presented. An explanation of the models of economic regulation that Brazil used for the electric sector is made, with prominence for the price cap that is the actual effective model. The process of tariff revision foreseen in the concession contracts signed by the federal government and the concessionary companies is presented, highlighting its two stages: the tariff rebalancing that defines the new price cap and the calculation of the factor X that establishes the efficiency goals for the companies. There is made a presentation of the Emergencial Program of Reduction of Consumption of Electric Energy and of the consequent General Agreement of the Electric Sector, which created the revenue of extraordinary tariff restore. A conceptual revision on reviews is presented, regarding to concepts, accomplishment and recognition. A brief review of the six companies that made part of the worked sample is also presented. Analyzing the quarters historical review and of amount of sold energy, it was possible to conclude that the energy-rationing altered the results of the studied companies significantly and that alteration was masked by the accounting process of the revenue of extraordinary tariff restore

Depreciação no serviço público: reconhecimento e evidenciação nas demonstrações contábeis dos estados e municípios brasileiros

Public institutions, as well as other entities, if use of various assets for development of its activities. These assets are tools that help with the generation of benefit present and future. For the assets that compound the Property, Plant and Equipament, this loss of generation of future benefits is called Depreciation and must be recognized as an expense in the period in which it occurs. This way, be considered as an expense, the depreciation has negative influence on the composition of the entity’s income, as this is the result of the confrontation between revenue and expenditure incurred in the same period. The Brazilian legislation regulates it is necessary to recognize and disclosure in the financial statements, all of the situations that interfere with the composition of economic and financial income of the public institution. The main objective of this work was to verify if the states and cities recognize and disclosure the depreciation on their Statements of Financial Position. The data were extracted from datas of the Brazilian public administration’s entities.. The sample analyzed is 100% of the States (including the Federal District) and 91% of the Brazilian cities. The research found the historical evolution of the expenditure with depreciation, evidenced in the balance sheets of the Brazilian cities, in the last 10 years, in the period 1999 to 2008. The results indicate that 10 Brazilian states (37 %) did not show the depreciation of fixed assets in the Statements of Financial Position of the year 2008. The situation is even more worrying in relation to cities, because 4,971 (98.4 %) of 5,050 municipalities not evidenced the depreciation. The evidence found in this study indicate that public entities do not recognize the expense with depreciation, which may indicate that the economic income and financial position presented in the financial statements of these public entities does not accurately reflect the actual situation of institutional performance.

A satisfação e a intenção de continuidade de uso em servços de e-learning:validação empírica de um modelo aplicado no serviço público

The present study aims to investigate the constructs of Technological Readiness Index (TRI) and the Expectancy Disconfirmation Theory (EDT) as determinants of satisfaction and continuance intention use in e-learning services. Is proposed a theoretical model that seeks to measure the phenomenon suited to the needs of public organizations that offer distance learning course with the use of virtual platforms for employees. The research was conducted from a quantitative analytical approach, via online survey in a sample of 343 employees of 2 public organizations in RN who have had e-learning experience. The strategy of data analysis used multivariate analysis techniques, including structural equation modeling (SEM), operationalized by AMOS© software. The results showed that quality, quality disconfirmation, value and value disconfirmation positively impact on satisfaction, as well as disconfirmation usability, innovativeness and optimism. Likewise, satisfaction proved to be decisive for the purpose of continuance intention use. In addition, technological readiness and performance are strongly related. Based on the structural model found by the study, public organizations can implement e-learning services for employees focusing on improving learning and improving skills practiced in the organizational environment

Diagnóstico do usuário no aprimoramento dos serviços de tecnologia da informação: um projeto de intervenção para o Ministério Público do Estado do Rio Grande do Norte

The information tecnology (IT) has, over the years, gaining prominence as a strategic element and competitive edge in organizations, public or private. In the judiciary, with the implementation of actions related to Judiciário Eletrônico, information technology (IT), definitely earns its status as a strategic element and significantly raises the level of dependence of the organs of their services and products. Increasingly, the quality of services provided by IT has direct impact on the quality of services provided by the agency as a whole. The Ministério Público do Estado do Rio Grande do Norte (MPRN) deployments shares of Electronic Government, along with an administrative reform, beyond these issues raised, caused a large increase in institutional demand for products and services provided by the Diretoria de Tecnologia da Informação (DTI), a sector responsible for the provision of IT services. Taking as starting point strategic goal set by MPRN to reach a 85% level of user satisfaction in four years, we seek to propose a method that assists in meeting the goal, respecting the capacity constraints of the IT sector. To achieve the proposed objective, we conducted a work in two distinct and complementary stages. In the first step we conducted a case study in MPRN, in which, through an internal and external diagnosis of DTI, accomplished by an action of internal consulting and one research of the user satisfaction, we seek to identify opportunities of change seeking to raise the quality perceived of the services provided by the DTI , from the viewpoint of their customers. The situational report, drawn from the data collected, fostered changes in DTI, which were then evaluated with the managers. In the second stage, with the results obtained in the initial process, empirical observation, evaluation of side projects of quality improvement in the sector, and validation with the managers, of the initial model, we developed an improved process, gazing beyond the identification of gaps in service a strategy for the selection of best management practices and deployment of these, in a incremental and adaptive way, allowing the application of the process in organs with little staff allocated to the provision of information technology services

Os rumos do fundo público no capitalismo contemporâneo: uma análise sobre o financiamento da Política de saúde no estado do Rio Grande do Norte

This work analizes the financing of Health Policies on the state of Rio Grande Do Norte, starting at the presumption that SUS is “Bombarded” by fiscal ajustments, as a neoliberal strategy to face capital crises.The trafectory of the financing of SUS demands the comprehension of two principles which are, in essence, contradictory: the “principle of universatility”, which is caracterized by the uncompromising defence of the fundaments of the Sanitary Reform, and the “principle of containment of social costs”, articulating the macroeconomic policy that has being developed in Brazil since the 1990s and which substantiantes itself on the 2000s.This last defends the reduction of the social costs, the maintanance of primary surplus and the privatization of public social services. Considering these determinations, the objective of this research constitues in bringing a critical reflection sorrounding the financing of the Health Policies on the state of Rio Grande do Norte, on the period from 2004 to 2012.Starting from a bibliografic and documentary research, it sought out to analyze the budget planning forseen on the Budget Guideline Law (LDO) and on the Multiannual Plans (PPA), investigating the reports of the Court of Auditors of the State of RN and gathering information about expenses with health, available on the System of Information About Public Budgeting in Health (SIOPS).The Analises of the data obtained, in light of the theoretic referece chosen, reveals trends in the public budget setting for health on the State of Rio Grande do Norte, which are: a tiny share of investment expenditure on health, when compared to other expenses, the amount used in daily fees and advertising; the high expense in personnel expenses, especially for hiring medical cooperatives;the strong dependence of the state on revenue transferences from the Union; the aplication of resources in actions of other nature considered as health, in exemple of the expenditures undertaken by the budgeting unit Supplying Center S/A (CEASA) on the function of health and subfunction of prophylactic and therapeutic and on the Popular Pharmacy program. Since 2006, expenses refering to Regime Security Servers (RPPA) on the area of health also have being considered as public actions and services in health for constitutional limit ends, beyond the inconsistencies on the PPAs with the actions performed efectively.

Atuação e desempenho do Ministério Público do Estado do Rio Grande do Norte no contexto da gestão pública: perspectiva estratégica

The present dissertation analyzes the performance and acting of the Rio Grande do Norte Public Ministery, in the strategic perspective, while responsible Institution for the defense of the collective rights. The comprehension of this theme inserts in a context of modernization of the public administration, in which is inserted, as well as their functional and structural changes, in a reality of innovations there is passing the organizations, looking to rescue the legitimacy of the government organizations, aligning them to the democratic values of the society. It detaches the strategic administration and the public administration and it exposes the strategic performance about the central point of the study, focusing in the development of the organization in the last four years, and other relative subjects to the acting. It is a unic case study, framed in the characteristics of the qualitative approaches - descriptive and exploratory. The analysis showed, through the method of content analysis, by the criterion of thematic categorization, that MP / RN come developing in an intense way,and it detaches that the changes already happened reflect a good strategic acting of the Institution, especially in the structural and functional areas, showing the strategic conscience of this, although that is not still enough to consider it as a strategic organization, and it concludes that there is still a lot for doing, and that the occurrence of an administration typically strategic in the extent of MP/RN is possible, with the conscience and participation of all, members and servants

O modelo de gestão estratégica do Ministério Público do Estado do Rio Grande do Norte: a análise da implantação do Balanced Scorecard

The goal of this research was to analyze the model of strategic management of the MPRN concerning the methodological guidelines presented by Balanced Scorecard. It is based in a theoretical referential which contemplates the themes, new public management, strategic management and Balanced Scorecard, focusing on applying the methodology in the public sector. This research is classified as descriptive and exploratory. According to the methods applied, it is a case study and, according to its approach, it is qualitative. The subjects of this research are members of the institution involved in the process of its strategic management. The data was collected by means of semi-structured interviews and document analysis, done by means of method content analysis. Concerning the goal of this research, it points out that the MPRN has not concluded the implantation cycle of Balanced Scorecard, furthermore, important flaws in the steps of organizational alingment have been identified, specially when it refers to communication policy, implementing incentive actions and focused training in developing competences. It yet reveals that the implantation of BSC has allowed the introduction of changes in the Institution dynamics to seek better results, however the MPRN has faced and has not adequately gotten over the same difficulties reported in various cases of BSC implantation in public organizations

Construção e implementação do Balanced Scorecard em uma organização educacional: o caso do Serviço Nacional de Aprendizagem Comercial do Rio Grande do Norte SENAC RN

The changes that have taken place in the organizational environment in recent decades have led to new performance measurement systems being proposed, given the inadequacy of traditional models. The Balanced Scorecard (BSC) emerged as an instrument to translate financial and non-financial assets into real values for all interested parties in the organization, allowing the introduction of strategies to achieve the desired goals. Research shows that most errors committed with the use of this method are related to the implementation process. Thus, the aim of this dissertation is to analyze the process of building and implementing the BSC in an organization. This empirical exploratory study is based on the classic case study method, which enables the researcher to work with a set of evidence, including direct observation, interviews and document analysis. The results show that the use of BSC in the company investigated posed problems during the process of building and implementing the method. These problems were caused mainly by the lack of involvement on the part of upper management and the team s scant knowledge of Balanced Scorecard. One of the gains obtained from adopting the system was the introduction and/or consolidation of a culture of strategic planning and participative management. The continuous implementation phase was highlighted in the monitoring program, created by the organization in an attempt to reverse existing problems, using the BSC as a third generation strategic management system, which led to significant gains, better use of the system and stronger management practices

Avaliação do risco ocupacional de trabalhadores expostos a agrotóxicos no município de Touros/Rio grande do Norte

The use of pesticides is being used intensively with severe consequences for exposed farmers. This study aimed to describe the socioeconomic and health profiles of 60 farmers in the city of Touros / RN through the questionnaire recommended by: (International Commission for Protection against Environmental Mutagens and Carcinogens (ICPEMC). The analysis of these data allowed to prove the importance of knowledge about the socioeconomic and health profile of rural farmers as a way to understand the reality of this population, that is vulnerable to exposure due to the lack of knowledge and conditions. Aiming to analyze the frequency of micronucleus (MN) and other nuclear abnormalities in oral mucosa cells of 54 farmers that work in the city of Touros / RN it was applied the micronucleus test (MN) in oral mucosa. Our results showed an increased frequency of MN and other nuclear abnormalities related to the exposure and effects of pesticides on health. Based on the results, it is clear that farmers are using pesticide in the wrong way and compromising their health. A Cordel has been developed as a method to taking the results to the people affected by the pesticides. Therefore this study alerts to the need for profound changes in the social, cultural and health context to reduce health risks for both people and for the environment