Fatores que afetam a satisfação de pacientes em serviços de saúde :um estudo em setor ambulatorial de hospital

This thesis shows concepts and models related to customer satisfaction measurement, focusing in detail on patients satisfaction evaluations in a policlinic sector of a hospital located in Natal RN. To reach this aim, two hundred and fifty one patients of this hospital were interviewed. The methodology approach includes a theoretical basis through a review and study of previous research on the topic, governmental initiatives and management systems which deal with excellence and need more reports concerning customers perceptions about satisfaction. Furthermore, it was included some models of nationals index about customer satisfaction. The Norwegian model was used in this thesis. The use of this approache, together with a multiple regression analysis, led to results that shows the factors which affect patients satisfaction in a policlinic sector. They are four as following: The evaluation of physician attendance; its results; simplicity of accessibility when health services are needed; and both support and tranquility given by the hospital. The study results can support researches of a conceptual model to determinate the aspects which affect the patient s satisfaction and could be a contribution to a development of a national costumer satisfaction index

Modelo de gerenciamento de estoques de peças de reposição para empresas de transporte urbano de passageiros

This work searches to offer a model to improve spare parts stock management for companies of urban passenger transport by bus, with the consequent progress in their maintenance management. Also known as MRO items (Maintenance, Repair and Operations), these spare parts, according their consumption and demand features, cost, criticity to operation, lead-time, quantity of suppliers, among other parameters, shouldn´t have managed their inventory like normal production items (work in process e final products), that because their features, are managed by more predictable models based, for example, in economic order quantity. In the case specifically of companies of urban passenger transport by bus, items MRO have significant importance in their assets and a bad management of these inventories can cause serious losses to company, leading it even bankrupticy business, in more severe situations which missing spare part provokes vehicles shutdown indefinitely. Given slight attention to the issue, which translates in little literature available about it when compared to that literature about normal items stocks, and due the fact that MRO items be critical to bus urban transport of passengers companies´, it is necessary, so, deepen in this theme searching to give technical and scientific subsidies to companies that work, in many times, empirically, with these so decisive inputs to their business. As a typical portfolio problem, in which there are n items, separated into critical and noncritical, while competing for the same resource, it was developed a new algorithm to aid in a better inventory management of spare parts used only in corrective maintenance (whose failures are unpredictable and random), by analyzing the cost-benefit ratio, which compares the level of service versus cost of each item. The model was tested in a company of urban passenger transport by bus from the city of Natal, who anonymously provided their real data to application in this work

Análise de desempenho na rede metropolitana de saúde da Universidade Federal do Rio Grande do Norte : um dimensionamento aplicado a telemedicina e a telessaúde utilizando QoS baseado no padrão IEEE 802.1Q

It s notorious the advance of computer networks in recent decades, whether in relation to transmission rates, the number of interconnected devices or the existing applications. In parallel, it s also visible this progress in various sectors of the automation, such as: industrial, commercial and residential. In one of its branches, we find the hospital networks, which can make the use of a range of services, ranging from the simple registration of patients to a surgery by a robot under the supervision of a physician. In the context of both worlds, appear the applications in Telemedicine and Telehealth, which work with the transfer in real time of high resolution images, sound, video and patient data. Then comes a problem, since the computer networks, originally developed for the transfer of less complex data, is now being used by a service that involves high transfer rates and needs requirements for quality of service (QoS) offered by the network . Thus, this work aims to do the analysis and comparison of performance of a network when subjected to this type of application, for two different situations: the first without the use of QoS policies, and the second with the application of such policies, using as scenario for testing, the Metropolitan Health Network of the Federal University of Rio Grande do Norte (UFRN)

Reaproveitamento e caracterização dos resíduos orgânicos provenientes do Programa MESA DA SOLIDARIEDADE da CEASA/RN

As an auxiliary tool to combat hunger by decreasing the waste of food and contributing for improvement of life quality on the population, CEASA/RN has released from August/03 to August/05 the program MESA DA SOLIDARIEDADE. Despite of the positive results of this program, that has already distributed around 226 tons of food, there is still food being thrown in the trash as the deliver of the same food in its natural form would be a health risk to those who would consume it and only the correct processing of this food can make it edible. This work has as a goal the reuse of solid residues of vegetal origin generated by the CEASA/RN, through the Program MESA DA SOLIDARIEDADE and the characterization of the product obtained so it might be used as a mineral complement in the human diet. To the collecting of samples (from September until December /2004) it was developed a methodology having as a reference the daily needs of mineral salts for infants at the age of seven to ten. The sample was packed in plastic bags and transported in an ambient temperature to the laboratory where it was selected, weighted, disinfected, fractionated and dried to 70ºC in greenhouse. The dry sample was shredded and stored in bottles previously sterilized. The sample in nature was weighted in the same proportion of the dry sample and it was obtained a uniform mass in a domestic processor. The physical-chemical analyses were carried out in triplicate in the samples in nature and in the dry product, being analyzed: pH, humidity, acidity and soluble solids according to IAL (1985), mineral salts contents (Ca, K, Na, Mg, P and Fe) determined by spectrophotometry of Atomic Absorption, caloric power through a calorimetric bomb and presence of fecal traces and E. coli through the colilert method (APHA, 1995). During this period the dry food a base of vegetables presented on average 5,06% of humidity, 4,62 of pH, acidity of 2,73 mg of citric acid /100g of sample, 51,45ºBrix of soluble solids, 2.323,50mg of K/100g, 299,06mg of Ca/100g, 293mg of Na/100g, 154,66mg of Mg/100g, 269,62mg of P/100g, 6,38mg of Fe/100g, caloric power of 3,691Kcal/g (15,502KJ/g) and is free of contamination by fecal traces and E..coli. The dry food developed in this research presented satisfactory characteristics regarding to its conservation, possessing low calories, constituting itself a good source of potassium, magnesium, sodium and iron that can be utilized as a food complement of these minerals

Avaliação de diferentes processos oxidativos avançados no tratamento de resíduos de petróleo

The petroleum industry deals with problems which are difficult to solve because of their relation to environmental issues. This is because amounts of residue are generated which vary in type and danger level. The soil contamination by non aqueous liquid phase mixtures, specifically hydrocarbon petroleum has been a reason for great concern, mainly the aromatic and polycyclic aromatic, which present risk to human health due to its carcinogenic and mutagenic character. The Advanced Oxidative Processes (AOP) are efficient technologies for destruction of organic compounds of difficult degradation and, often, they are present in low concentrations. They can be considered clean technologies, because there is no formation of solid by-products or the transfer of pollutor phases. This work focuses on the study of the degradation of petroleum industrial waste, by Advanced Oxidation Processes. Treatments tackling petroleum residues, contaminated soil, and water occurring in the production of petroleum reached the following Polycyclic Aromatic Hydrocarbons (PAH) degradation levels: solid residues 100% in 96 treatment hours; water residue - 100% in 6 treatment hours; soil contamination (COT degradation) - 50.3% in 12 treatment hours. AOP were effective in dealing with petroleum residues thus revealing themselves to be a promising treatment alternative

Avaliação da eficiência de lagoas de estabilização no tratamento de resíduos esgotados de fossas sépticas

Because of disability in public policy development in mind to attend issues of sanitation in the municipalities, companies known as "clean-blue" appeared proposing to solve a simple collection and management of wastewater produced in single or multifamily residences, commercial, hospitals, etc. In the case of an activity in which there are no worries about the fate of sewage, emerged some doubts about the degree of health and environmental safety in these companies. Traditionally, most of them makes the provision of waste depleted soil or wetland, open, usually located on the outskirts of cities (MENESES, 2001). In turn, the sludge from septic tanks exhausted, provided no technical criteria - in the soil, rivers and as an agricultural fertilizer put in risk the health of the population and environmental quality. This work was entered in the search network 5 of the Notice of the Research Program in Sanitation - PROSAB-5, aimed to study the theme 'Characterization and study of alternative ways of treating sludge from septic tanks in the city of Natal, RN', proposing to evaluate the performance of the use of stabilization ponds as a system to handle waste from septic tanks exhausted. A series of lakes studied belong to one of the largest clean-pit of Natal, consisting of two anaerobic ponds, one facultative and maturation, and a tank disinfection, the wastewater being released in the Potengi River. Samples were collected between the months of October 2007 to October 2008, at six points previously defined and judged as more appropriate to what is proposed study. The analysis results in field and laboratory showed the most significant removal of COD (88.93%), total suspended solids (94.87%), organic nitrogen (66.87%) and thermotolerant coliforms (99.88%). Some results have not reached the expected because the system under study had operating problems that have undermined the efficiency of the reactors

Análise da salubridade do meio urbano com base na utilização de índices ambientais: aplicação na bacia de drenagem XII da cidade do Natal-RN

The growing accumulation of people in urban centers caused chronic problems of the cities to begin to take an increasingly unsustainable. Primarily related to lack of infrastructure coupled with sanitation and lack of investment in critical sectors such as health, education, housing and transportation, these problems start to deteriorate markedly the quality of life of city dwellers and put into test management policies of the spaces urbanized. To reverse this situation, shows is essential to the use of tools (highlighting this harvest rates and environmental indicators) that help in assessing the current conditions and may assist in predicting future scenarios. From the information listed above, now put the research seeks to present an index called ISBA Environmental (Sanitation Index) which looks at the four urban systems (water, sewer, solid waste and urban drainage) from the viewpoint of application in a geographical cutout specific - in this case the Drainage Basin XII, defined by the Plan of Urban Drainage Stormwater in the city of Natal, capital of Rio Grande do Norte. This index, together with analysis of other factors sought to trace the current conditions of the basin and thus, assist in proposing the best solutions. For the preparation of the index was applied a questionnaire with a sample of 384 (three hundred eighty-four) households that aimed to study two variables: access to services and satisfaction of the population in relation to these. The ISBA has shown that the system is the most deficient collection and disposal of effluents (ICE = 47.66%), followed by the drainage of rainwater (IDAP = 54.17%), water supply (AAI = 61, 36) and solid waste collection (IRS = 78.28). With the ISBA was possible to verify that the qualitative data shows whose subjectivity is evident (as is the case of user satisfaction) can be of great importance when an assessment, since we obtained the correlation coefficient between the variables "Access" and " Satisfaction "equal to 0.8234, showing a strong correlation between the existence / quality of service offered and the impressions of the population that receives them

Desenvolvimento e implantação de um sistema de gestão de pedidos de informação endereçados à Universidade Federal do Rio Grande do Norte a partir do serviço de informações ao cidadão (E-SIC)

Among the numerous policy changes that the world has experienced in recent years, occupies a prominent place in the quest for greater transparency of public agencies. Transparency has been an important tool in the accountability of the State to promote greater participation of the society by providing information that was previously restricted knowledge of public agencies. Brazil, following this trend, promulgated in May 2012 the Access to Information Act that seeks to disclose the actions of the State at all levels, in all public administration agencies. On the same day of the enactment of the law is provided society with a site that is empowering citizens to make their requests for information to government agencies. The Federal University of Rio Grande do Norte, which at that time had no a tool to assist them in managing this demand. This project has the objective to describe, build and implement a solution to solve this problem using Design Science Research as methodology. As result, the solution built in this research became a new module of the institution s ERP became it capable to control the entire process, and will be helpful to others partners which use our system ERP

Caracterização do processo de trabalho do cirurgiãodentista na estratégia de saúde da família do município de Parnamirim-RN

Family Health Strategy (FHS), founded in 1994 has appeared to play a strategic role in the SUS construction and consolidation. It has reaffirmed its Principles and Guidelines and has elected family as core of attention. The principle that has guided the work concerns the quality of the relationship between professional and family. Thus, the FHS has the family as a subject of health-disease process, and relations with its own characteristics and can be partners in building their health and improvement of quality of life of its members and the entire community. This study aims to characterize the surgeon-dentist (SD) working process in the family health strategy, from the knowledge of the SD integration with other team members; organization of services; development of shares, changes perceived by SDs, as well as knowing the surgeon-dentist profile who is part of this strategy. The collecting tool used was a semi-structured questionnaire, in which participated 30 professionals. As for profile, most professionals were women, completed the graduation in public university and did not have any training to work by joining the FHS. Almost all have other public or private working ties. They often carry out activities with students, and occasionally do home visits. In relation to team work, in activities such as home visits, school health, community activities, among others, they sometimes seek the cooperation of other members. The way of accessing for users in the most part has occurred through the schedule. The most frequently activities made to the Centro Especialidades Odontológicas (CEO), are in Endodontics and Prosthesis. The majority of them participate in team meetings, but they do not have frequency set to happen. As for the planning and programming of activities to be conducted, most said that individually develops them. Concerning the performance of their duties, most reported being satisfied, but that improvements could happen. Besides, they reported improvements in dental care following the inclusion of SD in the FHS in various aspects, such as access, organization, humanization, care and oral disease prevention. The professionals had poor integration with other team members, in addition to have a profile to more individualistic work, a fact seized by way of development and planning of actions. They work the actions in individual and curative way, in detriment promotion and collective ones. They work humanization, definition of territory and adscript population. Thus, it is concluded that the working process developed by SDs, includes the part which is advocated by FHS. This points out to a greater undertaking of this process aiming to detect the weakness met in order to reach the potential that the FHS represents in organization of basic attention

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

Percepção dos idosos sobre saúde bucal

The assessment of oral health status in elderly patients is essential for the development of specific health policies. The prevalence of oral diseases is high in this population. The self-perception of oral health conditions influences the demand for oral care and quality of life for seniors. The aim of this study was to assess self-perception of oral health status in 100 elderly of both sexes, aged 60 years or older and functionally independent the Basic Health Unit of Felipe Camarão II, Natal, Brazil. For comparison of self-perception data was collected in Bom Pastor, Natal / RN. In this research data were collected a questionnaire grouped into two parts. The first part with the socio-demographic data, subjective and objective condition of oral health and access to the service, the second part GOHAI Index. This index consists of 12 items that make it possible to obtain information involving aspects of chewing, speech, phonation, and self-assessed oral health. The results were subjected to statistical tests of Mann-Whitney and Kruskal-Wallis test (α = 0.05), to identify possible predictors of self-evaluation. As a result, 69% were female, ages ranged from 60 to 86 years, with a median of 65 years. In relation to marital status 48% were married. For the years of study, the sample had an average of 3 years. For the last visit to the dentist, only 27% of seniors had visited the Dentist for less than a year. Regarding the questions about the presence of gingival and dental problems were answered by 46% and 21% respectively. The data on the perception of your teeth and gums, 44%. The index showed GOHAI value for self-perception of 30 points to Felipe Camarão and 28 points for the Bom Pastor, both considered a low perception. We identified predictors of self-rated number of people in the room, participate in any associational activity, there is problems with your teeth and your gums. Concluded a negative self-perception of oral health condition by Gone in both areas, influenced by socioeconomic and cultural issues, although they realize the importance given to oral health, but by the misfortunes of other prominent favored little valuing of oral health

Avaliação em saúde bucal na perspectiva do usuário: enfoque ao estudo da acessibilidade organizacional

Due to the fact of oral health sector reestructuration within Brazilian public health politics, this work had the object of evaluating, under users point of view, the accessibility to oral health services in Santa Cruz (RN), focusing on the organizational aspect. To achieve this, questionnaires were given to users in their homes, considering the censitary sector. Nine sectors of the urban zone were evaluated, selected by chance, and one from the rural zone, selected by convenience. The sample was composed by 194 users, calculated considering the estimated prevalence of event represented by the indicator I ve never been to the dentist + I ve been to the dentist more than three years ago from the Projeto SB Brasil Report . To complement the results, interviews were made with others actors involved in the process of oral health care: professionals (dentists) and manager (Health Municipal Secretary). From the data obtained it was possible to identify that 12,9% of the population had never visited the dentist, and that the search for the service was not influenced by the users individual and socioeconomics characteristics, excepting the gender. It was verified that 36,1% of the users went to the dentist in less than one year, with the youngests (p<0,05) being among those who went to the dentist more frequently. 63,3% of the interviewed related that they found some kind of difficulty when they search for dentistry services, with the difficulties for schedule, the queues and the long wait among the most cited. It was identified that 43,2% of the users wait three weeks or more for the appointment. It is still pointed out that 71,4% of the interviewed find difficulties to get urgency appointment, the long wait to be attended by the dentist was the most found. 92,9% and 94,1% of the interviewed had never been headed to especialized appointments and complementary exams, respectively. Due to the data founded, it was possible to verify that the accessibility to oral health services in Santa Cruz (RN) is damaged by factors related to the organization of public polices developed, mainly in relation to the working process

A relação trabalho e saúde no setor calçadista de Franca, São Paulo

Este texto busca evidenciar a relação trabalho e saúde em um lócus determinado: a produção calçadista em Franca, interior do estado de São Paulo. A discussão privilegia o processo sócio-histórico da referida atividade econômica em Franca, com ênfase na reestruturação produtiva que, a partir na década de 1990, disseminou parte da produção para as residências dos trabalhadores, constituindo as denominadas Bancas de Pespontos e de Corte em Calçados. Desse modo, a partir do conhecimento empírico, subsidiado pelas visitas a estes empreendimentos e de entrevistas com os trabalhadores e ainda com um relato de caso, enfatiza-se as relações sociais de trabalho que podem agredir à saúde. Todavia, diante da informalidade acabam não sendo consideradas na relação entre saúde e a atividade funcional exercida, ficando estes infortúnios distantes das negociações coletivas, fiscalizações, ou seja, de possíveis mudanças.

O ambulatório de Saúde Mental no contexto da Reforma Psiquiátrica em Natal/RN

The years 1990 disclose the consolidation of the Brazilian Psychiatric Reform project, assumed as official politics by the Health Department, also stirring up discussions, lines of direction and new ways of care. Substitutive services to the psychiatric hospital as CAPS, conviviality centers, therapeutical residences and ambulatory clinics are implemented. This work analyzes the relations that the Specialized Ambulatory Clinic of Ribeira establishes to the services of Mental Health of the public system in the city of Natal/RN, as well as its adjustment to the proposal of the Psychiatric Reform. Through semi-structured interviews and observation, it was possible to gather data which allowed picturing a general characterization of the service: activities, technical group, joint with other institutions, daily routine organization. Such institution develops activities that surpass the traditional character of a clinic- in other words, the psychological/medical appointments - and it mainly greets the ones proceeding from CAPS and psychiatric hospitals. It offers group activities, psychiatric appointments, therapeutical workshops, sheltering and strolls, among others. The institution is composed by a multi-professional team of psychiatrists, psychologists, occupational therapists, nurse s aide and art-educator. The joint of this service with others that make part of the Mental Health Assistance network in Natal is incipient. Due to this fact, some actions and activities that could and should be developed together are just not. Although facing difficulties, the professionals of the Ambulatory Clinic of Ribeira are able to achieve good results and establish care in Mental Health that prioritize sheltering, listening and respect to the user s individuality. The Ambulatory Clinic of Ribeira is organized according to the paradigm of the Psychiatric Reform. Therefore, it offers an attention that stimulates the re-socialization of the users and the exercise of the citizenship and autonomy of those

Análise do uso de SIG no roteamento dos veículos de coleta de resíduos sólidos domiciliares

Relata-se neste trabalho, a análise do uso de um Sistema de Informação Geográfica - SIG como ferramenta para roteirização de veículos de coleta de resíduos sólidos domiciliares. O software utilizado foi o TransCAD, versão 3.2, que permite desenvolver rotas utilizando algoritmos que incluem o procedimento de roteirização em arco. O objetivo é minimizar a extensão total a ser percorrida pelos veículos coletores. O estudo de caso foi realizado na cidade de Ilha Solteira - SP. Os dados coletados e os resultados obtidos pelo TransCAD foram processados no software Microsoft Excel. Os resultados obtidos demonstraram reduções percentuais de até 41% na distância total percorrida e de 68% no tempo total de percurso em relação ao serviço atual.