Metodologia de implantação da construção enxuta: estudo de caso em construtora de porte médio

In recent years, the Brazilian construction industry has gone by changes like currency stability, increasing competition, shortage of skilled labor and increasing quality importance required by the customer, who made the sector companies seek solutions through new management practices in order to become more efficient. A alternative to these management practices is known as Lean Construction which is derived from the Toyota System Production. Lean Construction main goals are to reduce parts of activities that do not add value, increase product value by considering customer needs, reduce variability and production cycle time, simplify process by reducing the number of parts or steps, increase the flexibility in the product execution and transparency process, focus the control on overall process, introduce continuous improvement process, maintain a balance between improvements in flows and conversions and seek to learn from practices adopted by competitors. However, the construction industry is characterized by having nomadic activity, which undertakes an unique product with high cost of production and big inertia for behavioral change, making it difficult to implement the philosophy of lean construction in companies. In this sense, the main objective of this study is to develop a methodology for implementation of the principles of Lean Construction. The method of implementing the proposed management system was designed with the aid of 5W2H tool, and the implementation process is divided into three phases. The first one aims to know in a macro way the current operation of construction, identify who is its target audience and what are the products and services offered to the Market. The second phase aims to describe what actions should be taken and which documents are needed to be created or modified; finally, the third step goal consists in how to control and monitor established processes, where through Strategic Planning the company goals would be set along with their respective targets and indicators in order to keep the system working, aiming for continuous improvement with focus on the customer. This methodology was conceived as a case study analyzing a medium size construction with more than 18 years of activity and certified for almost 10 years with ISO9001 and level A in PBQP-H. We also conclude that this implementation process can be used in any developer and / or builder

Análise da influência da qualidade em um ciclo de serviços na satisfação do cliente: estudo de caso em uma instituição de ensino.

With the increasing offer of education services in Brazil, it is necessary to evaluate the quality of service in education, especially in those institutions for vocational education which have a greater interaction with the labor market, in order to form qualified professionals and meet the growing demand that the country has today[A1] . In Brazil, the evaluation of the quality of library services has influenced the assessment of educational institutions and in this context, there needs to be a process to monitor the quality of services provided by libraries. However, the service is not done in a single moment and thus to a more detailed assessment it needs to be measured and evaluated each different time the customer uses it. Therefore, the aim of this work consists in measuring the quality in every moment of truth of a cycle of library services to assess which are the most relevant moments in the client's perspective at the library of the Federal Institute of Education, Science and Technology of Rio Grande do Norte (IFRN) Campus João Câmara in building the overall quality of service. In the literature review, internal secondary sources were used, from the database of the institution studied, and also external sources, through literature in books, articles, dissertations, theses and journals on compost quality, service quality, cycle services, measuring quality, satisfaction, teaching activities, and on library services specifically. We applied a questionnaire to students in the library based on models of quality measurement SERVPERF and SERVQUAL and its variations such as SERVQUAL pondered and SERVPERF pondered . Through analysis based on concepts of reliability and validity of measuring instruments, it was found that the SERVPERF model is the instrument that most closely matches the dimensions of quality assessed in the library with customer satisfaction measured by the questionnaire. From there, the search results as measured by statistical techniques of analysis, indicated that the initial and final moments of truth of the cycle of service quality had the greatest influence on overall customer satisfaction with the library service

Diagnósticos de enfermagem do domínio nutrição em pacientes submetidos à hemodiálise

The study aimed to analyze the nursing diagnoses of the nutrition domain from NANDA International in patients undergoing hemodialysis. This is a transversal study conducted in a university hospital in northeastern Brazil, with 50 hemodialysis patients. The data collection instrument was an interview form and a physical examination, in digital format, applied between the months of December 2013 to May 2014. Data analysis was divided into two stages. In the first, defining characteristics, related factors and risk factors were judged as to their presence by the researcher, according to the data collected. In the second stage, based on data from the first, diagnostic inference by experts was held. The results were organized in tables and analyzed using descriptive and inferential statistics for the diagnoses that showed higher frequencies than 50%. The project was approved by the Ethics Committee responsible for the research institution (protocol number 392 535), with Certificate Presentation to Ethics Assessment 18710613.4.00005537 number. The results indicate a median of 7 (± 1.51) nursing diagnoses of the nutrition domain per patient. Six diagnoses with greater frequency than 50% were identified, namely: Risk for electrolyte imbalance, Risk for unstable blood glucose level, Excess fluid volume, Readiness for enhanced fluid balance, Readiness for enhanced nutrition and Risk for deficient fluid volume. The defining characteristics, related and risk factors presented an average of 34.78 (± 6.86), 15.50 (± 3.40) and a median of 4 (± 1.93), respectively, and 11 of these components had statistically significant association with the respective diagnoses. Were identified associations between adventitious breath sounds, edema and pulmonary congestion with the diagnosis Excess fluid volume; Expressed desire to increase fluid balance with the nursing diagnosis Readiness for enhanced fluid balance; It feeds regularly, Attitude to food consistent with the health goals, Consume adequate food, expresses knowledge about healthy food choices, expresses desire to improve nutrition, expresses knowledge about liquid healthier choices and following appropriate standard supply with diagnosis Readiness for enhanced nutrition. It is concluded that the diagnosis of the nutrition domain related to electrolyte problems are prevalent in customer submitted to hemodialysis. The identification of these diagnoses contributes to the development of a plan of care targeted to the needs of these clients, providing better quality of life and advance in the practice of care