5 resultados para care pathways, patient satisfaction, patient flow, staff attitudes

em Universidade Federal do Rio Grande do Norte(UFRN)


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The aim of this study was to establish the profile of the pharmacist technician responsible for community pharmacies in the city of Natal/RN, featuring personal elements, perceived their role and place of pharmaceutical care, levels of job satisfaction, type and quality of services provided in human and structural framework. To that end, we made an exploratory cross-sectional study applying a questionnaire containing open and closed questions, which was applied to pharmaceutical technicians responsible for community pharmacies in Natal/RN, from September 2010 to September 2011. The sample was established by calculating the simple random sample, with a confidence level of 95% and a significance level of 0.05. To evaluate the satisfaction level of the activities performed by pharmacists in community pharmacies was used Simple Satisfaction Scale (Likert, 1935). To assess the attitudes and perceptions of pharmacists in relation to aspects of pharmaceutical care, we used the Model Attitude toward the object (Fishbein, Ajzen, 1975). The answers were converted into data were analyzed statistically using Epi Info 3.5.2 The results showed that the strengths and weaknesses in relation to the profile of the pharmacist and their activities in community pharmacies in Natal/RN are not different in other cities in the country . The most important aspects were: 51% (n = 90) of the establishments visited, the pharmacist was absent; 46% (n = 80) did not have postgraduate and of those who are or have completed 33% (n = 51) are in the area of Clinical Analysis; 56% (n = 98) 08h for day work and 64% (n = 111) claim that this load influence its performance; 83% (n = 146) receive as salary, the floor pharmacist regarding the state of Rio Grande do Norte; 44% (n = 76) are unhappy about the salary, which is the main difficulty cited; 78% (n = 136) say they are always sought by users and the receptivity of these considered good (52%, n = 91). The activities of higher satisfaction are those related to pharmaceutical care and lower the administrative. As regards attitudes and perceptions, the score was more negative to the question 'if the pharmacist feels working as a team with the doctor', in which 59% (n = 103) responded 'never'. 49% (n = 86) reported being "able" to take questions from users and 39% (n = 68) are 'dissatisfied' with respect to the structure of the practice of pharmacy to pharmaceutical care. Action is needed on the obstacles to the exercise of the pharmacist in the solution and minimize the negative and positive stimulus to

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

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To characterize patients according to gender, age category, internment time, diagnostical hypothesis and location of the pressure ulcer; to identify the susceptibility conditions, intrinsical and extrinsical factors present on ICU patients and to verify on the existence of association between the susceptibility conditions and the intrinsecal and extrinsecal factors on the occurrence of PU. Methods: It is a descriptive study, of longitudinal design of the panel type, with quantitative approach, performed on two ICU s of a private hospital located in Natal/RN, with 40 patients interned at these units. The data collection was performed on all three shifts through a structured observation and physical exam of the patients' skin form seeking to identify the presence of PU. Results: The greatest occurence of PU was on individuals of the male gender (70%) when compared to the female gender (30%), that difference being statistically significant (p=0,0267), with the male gender presenting 4,3 times greater chance of developing PU than the female; the predominant age category was from 60 years of age on (85%), 60,0% presented 1 to 2 PU s after 7 (seven) days of permanence in the ICU s, the predominant diagnostical hypothesis on the patients with PU were the respiratory diseases (42,3%) and the most frequent locations of PU were the sacral region (40,0%) and heels (36,0%). 25 PU s of stage I were diagnosed on 50,0% of the followed patients, with general incidence of 50,0% on both ICUs. from the 88 variables researched, 75 were identified on the patients from the study, being the predominant conditions (anemia, hypotension, leukocytosis, other diseases hypertension blood pressure, cardiac insuffience, pneumonia - and ansiolythic), the intrinsecal factors (diminished muscular strenght and/or mass, discrete edema, totally compromised mobile coordination and total inability for movement on the bed) and the extrinsecal factors (inadequate mattress type, permanence on a single position for >2 hours, shearing/friction force, bed clothes with folds that leave marks on the body, pressure force) predominated on patients with PU. The male gender variables (p=0,0267,OR=4,3), sedation (p=0,0006,OR=4,1), psychomotive agitation (p=0,0375,OR=5,8) and leukocytosis (p=0,0285,OR=5,0) presented a significant statistical diference when analyzed independently. We verified an association of 17,3%, statistically significant (p=0,0384), between the susceptibility conditions (anemia, leukocytosis and hypotension), the intrinsecal factors (age equal or above 60 years, diminished/absent pain sensibility and smooth, fine or delicate skin) and the extrinsecal factors (inadequate mattress, pressure forces, shearing/friction force, permanence on a single position for more than 2 hours, elevation between 30 to 45 degrees and inadequate bed clothes' conditions), with a chance ratio of 4,6 times the risk of occurrence of PU on the patients that presented the referred association. Conclusion: The incidence of PU detected on the ICU-interned patients was high and we made evident the existence of association between the susceptibility conditions, the intrinsecal and extrinsecal factors on the occurrence of PU s on the ICUinterned patients, and thus we accept the alternative hypothesis proposed on the study

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The objective of this research is the verification of the competition in the intecity market, after the entrance of new competitors (vans and microbus) regulated and clandestine. For verification of this new view was effected one research of documentary character for the knowledge of the regulation and exploratory character of the system Natal - territory of the Seridó, for thus in making will know this problematic, well as its characteristics, attractivenesses and development of the territory of the Seridó, and its link with the Capital (Natal). Later, through a descriptive exploratory research of the type survey with the passengers to know as these are being taken care and its satisfaction in relation to the regulated companies. With the drivers if focus effected one group, and with the staff of the of sale ticket a research survey, aiming at to know the strategies used for the only company of bus that takes care of the territory of the Seridó, the implantation of these and the consequence of the user. In accordance with the generic tipologia of Porter and its strategies, were perceived that the bus company adopted the strategy of price leadership being competitive, using to advantage its bigger space in the market, already vans and the microbuses with its limited participation bet in a strategy of "differentiation" in its service, effecting faster trips and in the strategy of "approach" we find the not regulated services earn the service to the taste of the user

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Tuberculosis is a serious disease with high incidence and prevalence, and in many countries a priority public health problem, with persisting high epidemiological significance. Seeing the person with tuberculosis it is important to observe his/her self care, as well as the difficulties intertwined in this process, since it can be directly impacting the health/disease process. The aim of this study was to analyze the self care of people with tuberculosis. Descriptive study with qualitative approach, conducted in West Sanitary District of the city of Natal, RN. Data collection occurred through a semi-structured interview guided by questions concerning sociodemographic and about the disease, treatment, and self care, between the months of July to September 2012 and met the ethical precepts of research with human beings. To analyze the results we used the technique of thematic content analysis of Laurence Bardin, through the prism of the theoretical-philosophical self care discussed by Michel Foucault. From the analysis emerged two categories, the first being, Meaning of tuberculosis, with subcategories: tuberculosis as sadness and unhappiness and tuberculosis as a normal issue, and the second, Beware yourself to tuberculosis, which had subcategories: self care as attention to the health care of oneself as satisfaction of basic needs and difficulties to self care. Tuberculosis represents for some people, something really sad, causing psychological suffering, however the other presents as normal. Self care of persons with tuberculosis in this study are related in great part to seek health care and the satisfaction of basic needs. About the difficulties related to the practice of self-care, it is observed that these are tied to food, time for rest, slowness of health services for scheduling appointments and tests, as well as related habits and dependencies in the lives of these people. This study contributed to a reflection of the users with tuberculosis and self care, revealing aspects that healthcare professionals should pay attention to watch these people, being able to see everyday on the run, the need for a space and time for oneself