Protocolo de avaliação do cuidado de enfermagem e da segurança do paciente em unidades de terapia intensiva

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

Proposta de um modelo de gestão da qualidade para micro e pequenas empresas integrando a estratégia seis sigma à NBR ISO 9001

This work has as its main purpose to set a model of Quality Management for micro and small companies integrating the management models: Six Sigma strategy to NBR ISO 9001:2000. An exploratory research is developed to collect technical and bibliographical information on both methods, emphasizing their integration. Then, a survey is carried out on 65 analysts/consultants of Quality Management Systems and it has detected, besides other factors, that current methodologies must be associated in order to reach better results. At last, it proposes the Sigma 9001 model, which aims to make it possible for micro and small companies to objectively and with low costs, implement a Quality Management System, able to assure competitive advantage through improvement identification in the processes, as well as an improvement in the companies management

Sistema de gestão da qualidade na hotelaria :um estudo comparativo da ISO 9000 com os modelos de classificação no Brasil

Este trabalho tem como objetivo estudar os sistemas de Classificações existentes para a garantia da gestão da qualidade no setor hoteleiro, tendo como foco principal a Matriz de Classificação para os Meios de Hospedagem da EMBRATUR e a ISO 9000, observando os benefícios que esses sistemas e/ou processos de gestão poderão vir a proporcionar para o setor hoteleiro no que se refere à qualidade de seus serviços. Para a obtenção dessas informações foi realizada uma análise comparativa dos sistemas de gestão da qualidade através de pesquisas bibliográficas e de questionários enviados para empreendimentos hoteleiros certificados e classificados, onde os principais resultados fornecidos pela pesquisa foram trabalhados de forma a apresentar, de maneira clara, a superioridade de um sistema em relação ao outro

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

A gestão da qualidade nos cursos de graduação a distância da UFRN/SEDIS : a percepção dos discentes

This dissertation has as objective at analyzing the students' perception about the quality of graduate courses distance of the Federal University of Rio Grande do Norte, which was motivated by the following research problem: the perception that graduate students of the distance of the UFRN have on the quality of the undergraduate? To this end, we sought to gather evidence for a satisfactory approach that addresses the complexity of the subject studied: quality management, distance learning and quality in the Higher Education Institutions. We chose to adopt as a research method, case study on the procedure of the research, exploratory research-descriptive about the objective and quantitative research when tackling the problem. The object of the study were six graduate courses distance UFRN/SEDIS, having as target the students of the courses. The sample was calculated using the Stratified sampling on which 217 students, the courses surveyed were selected. The survey instrument consisted of 21 structured questions, of which seven questions designed to identify the profile of students, seven issues of perceptions (manifest variables) on quality management in distance learning, where students have given values (responses) for 24 statements (which address the central theme of this dissertation) composite based on a 5-point Likert s scale, and six questions about general characteristics that may interfere with students' perception about the quality. Was used as statistical method (data analysis), descriptive statistics and exploratory factor analysis. The results show the identification of four latent factors (obtained by exploratory factor analysis), namely: (1) infrastructure and management - polo presence, (2) teaching-learning processes, (3) communication tools and integration; (4) tutors. We also observed that aspects related to infrastructure and management at the pole face had the lowest score among the factors observed, requiring special attention by the education institution. On the other hand, teachers and teaching learning processes were the items with better performance in the perception of students. It is concluded that the perception of students in relation to quality in distance education courses, the median is trending positive perception, ie the perception of overall quality of the courses is not assertive and unison, but tends to positive perception. Thus, the results, it is expected that the managers of the institution to focus attention on critical points in order to minimize them (or eliminate them) and maximize the positive aspects that are perceived by the students

Benefícios e dificuldades na adoção de um sistema de gestão da qualidade no Rio Grande do Norte

Taking competitive advantage or satisfy the client are the reasons why companies have been implementing a Quality Management System (QMS). It brings benefits such as the improvement in the processes, products and services; an enhancement in the image of the company (marketing) and satisfaction of the clients. As a whole, this paper aims to evaluate the results obtained from the implementation of the QMS in the certified companies in the ISO 9001 standard, contained in the database of INMETRO, of the Rio Grande do Norte State (RN). In order to achieve the goals, a bibliographical research about the theme quality management system was made and, subsequently a survey was made with the managers of the certified companies in RN, using the online questionnaire. Out of 27 companies that have the certificate in Rio Grande do Norte, 21 responded the data collection instrument. The data analysis was made through techniques of descriptive and multivariate statistics: cluster analysis. The research instrument used contained 20 questions that address the main theme of this dissertation. Using the cluster analysis, four groupings that possessed similarities concerning the survey answers were found. This analysis allowed us to conclude that the QMS boosts significant improvements in the organizations, such as: quality in the reputation of the company and sales increase. On the other hand, it allowed us to identify as main difficulties: the dissemination of the quality culture, lack of commitment of the whole organization and the resistance of the workers

Comparação entre métodos para a avaliação do vigor de lotes de sementes de couve-brócolos (Brassica oleracea L. var. italica Plenk)

Os testes de vigor e o teste de germinação são componentes essenciais no controle de qualidade das empresas de produção de sementes. Com o objetivo de verificar a eficiência de diferentes testes de vigor e de variações de suas metodologias na avaliação da qualidade de sementes de couve-brócolos visando diferenciação de lotes e previsão de emergência em bandeja, cinco lotes de sementes do híbrido Flórida foram submetidos aos seguintes testes: germinação; primeira contagem de germinação; emissão de raiz primária (após 48, 56, 72, 80 e 96 h após a instalação do teste de germinação); emergência de plântulas em substrato; envelhecimento acelerado com água (1g de sementes mantidas a 41ºC por 48 e 72 h a 100%UR); envelhecimento acelerado com solução saturada de sal (mesmo procedimento do item anterior, porém usando solução de NaCl, 40% e 76%UR); condutividade elétrica (50 sementes em 25 mL de água destilada a 25ºC e leituras após 2, 4, 6, 8 e 24 h). Todos os testes apresentaram correlação significativa com a porcentagem de emergência de plântulas em substrato, a 1% de probabilidade. Os testes de envelhecimento acelerado com solução saturada de sal por 48 h e de condutividade elétrica após 8 e 24 h de embebição foram eficientes e tiveram resultados semelhantes aos da emergência em substrato. Os testes da primeira contagem de germinação, emissão da raiz primária após 56 h e envelhecimento acelerado com solução saturada de sal por 72 h, apresentaram-se mais eficientes que a emergência de plântulas em substrato na diferenciação do vigor dos lotes.

Avaliação do vigor de sementes peliculizadas de tomate

Com o objetivo de verificar a eficiência de diferentes testes de vigor na avaliação da qualidade de sementes peliculizadas de tomate, cinco lotes do híbrido Saladinha foram submetidos aos seguintes testes: germinação; primeira contagem de germinação; emissão de raiz primária (determinada 56, 72, 80 e 96 horas após a instalação do teste de germinação); emergência de plântulas em substrato tipo Plantmax em bandeja de poliestireno; envelhecimento acelerado com água (1g de sementes mantidas a 41ºC por 48 e 72 horas a 100%UR); envelhecimento acelerado com solução saturada de sal (mesmo procedimento do item anterior mas usando solução de NaCl 40% e 76%UR); condutividade elétrica (50 sementes em 25 ml de água destilada a 25ºC e leituras após 2, 4, 6, 8 e 24 horas. ). O teste de germinação, a determinação da emissão de raiz primária (períodos de 56, 72 e 96 horas após a semeadura) e o teste de condutividade elétrica (2, 4, 6 e 8 horas de embebição) apresentaram correlação significativa com a porcentagem de emergência de plântulas em substrato. O teste de condutividade elétrica por períodos de 2 a 8 horas de embebição foi eficiente e teve resultados semelhantes aos da emergência em substrato. A determinação da emissão de raiz primária (após 56, 72 e 96 horas) mostrou-se promissora para a avaliação do vigor de sementes peliculizadas de tomate.

Efeitos da eletroestimulação percutânea na incontinência urinária e qualidade de vida pós-prostatectomia: registro de seis casos

Introduction: Radical prostatectomy surgery is the best treatment currently adopted by detecting prostate cancer. The urinary incontinence is one more common and difficult to treat postoperative complications, which causes a negative impact on quality of life of the individual prostatectomy . The surface electrical nerve stimulation involves the transmission of electrical impulses from an external stimulator for peripheral nerve through surface electrodes attached to skin. It is an easy and efficient technique, widely used for pain relief, rehabilitation and muscle strengthening. Objective: To analyze the effect of T10-L2 percutaneous electrical stimulation, in individuals with urinary incontinence who underwent radical prostatectomy by the laparoscopic technique. Methods: Six patients had previously undergone radical prostatectomy were submitted to 20 sections of surface electrical stimulation with frequency of 4 Hz, pulse width of 1ms during 20 minutes. All subjects fillid a quality of life - International Consultation on Incontinence Questionnaire- Short FormI - ICIQ-SF questionnaire evaluating. Results: Results showed reduction in the use of the number of pads, number of leaks before and after treatment, and reduced voiding frequency and consequent improvement in quality of life. No side effects were reported. Conclusion: Percutanous electrical stimulation in T10-L2 may be an effective technique to treat urinary incontinence (UI) after radical prostatectomy video laparoscopy

Influência da idade, do sexo e da hora do dia no desempenho em teste de labirinto

The increase of elderly population in the world and in Brazil has indicated the necessity of health systems capable to evaluate, to diagnose and to intervene in the conditions of health and disease of that segment. During that stage of human development, physical and cognitive changes happen and they are capable to influence the functional acting. It s important to distinguish the limit between the normal and the pathological. Besides the common changes during the aging, biological rhithmicity changes happen, as alterations in the cycle vigil-sleep that can influence in certain tasks performance. This study aimed to verify the influence of the age, of the sex and of the hour in a maze test performance. Eighty individuals were evaluated, 40 youths (20 men and 20 women) and 40 senior (20 men and 20 women). They were separated in 2 different groups that were tested at 9:00 o clock and at 15:00 o clock. Initially they were submitted to health evaluation, cognitive evaluation and of sleep quality and chronotype. They were instructed to accomplish the maze test whose time of execution was timed and registered. Significant differences were observed according to age for the masculine group between elderly in the morning and in the afternoon and in the feminine group between youth and elderly in the test accomplished in the morning and in the afternoon. Significant differences were not observed according to sex and hour of the day and also between attempts. In compare between the 30th and the31st, accomplished in a 15minutes of interval, significant difference was observed just for the elderly group in the morning and in the afternoon. We observed significant correlations in the maze test performance with the cronotype, with the age, with the education and with the cognitive acting. The maze test was capable to detect differences between age in the acting profile and in the evaluation of the information maintenance after 15 minutes, however it was not possible to verify difference between sex and hour of the day. Finally the correlations of the maze test with another varied may indicate your importance as coadjutant instrument in those functions evaluation

Evaluation of hybrid models for static and multistage transmission system planning

Neste trabalho é analisada a aplicação de algoritmos heurísticos para o Modelo Híbrido Linear - Hybrid Linear Model (HLM) - no problema de planejamento da expansão de sistemas de transmissão. O HLM é um modelo relaxado que ainda não foi suficientemente explorado. Assim, é realizada uma análise das características do modelo matemático e das técnicas de solução que podem ser usadas para resolver este tipo de modelo. O trabalho analisa em detalhes um algoritmo heurístico construtivo para o HLM e faz uma extensão da modelagem e da técnica de solução para o planejamento multi-estágio da expansão de sistemas de transmissão. Dentro deste contexto, também é realizada uma avaliação da qualidade das soluções encontradas pelo HLM e as possibilidades de aplicação deste modelo em planejamento de sistemas de transmissão. Finalmente, são apresentados testes com sistemas conhecidos na literatura especializada.

Medição de desempenho organizacional nas imobiliárias: um estudo na cidade do Natal-RN

The purpose of this paper is to identify how real estate companies from the city of Natal measure their organizational performance. Traditionally these companies measure their performance using financial measures; however, the technological improvement, the internationalization of the economy and the change in consumer behavior all demand better products and services, and other measuring models. Those changes motivate organizations to continually improve the quality of their products and services. In this way, these companies need to associate their financial results to their global performance. Therefore, it is necessary to have organizational performance models that associate financial and non-financial measures to the strategies of the companies. The research also tries to identify which performance indicators are used by these companies, as well as to test a model who questions: a) if there is any relationship between managers´ characteristics and performance measuring systems´ characteristics; b) if there is any relationship between the company s characteristics and the characteristics of the measuring system used to evaluate its organizational performance and c) finally to verify if there is a relationship between the characteristics of the measuring system and the company s performance. The information which served as a basis for the study was obtained through an empirical research, with questionnaires, answered by 66 (sixty six) companies from the city of Natal, capital of the state of Rio Grande do Norte. The results show that none of the companies investigated use any of the performance measurement models proposed in the modern literature. However, they use on an isolated way some of the measures those models, including some measures from adopted in the Balanced Scorecard, as well as the benchmarking process, making comparisons with the performance of their competitors. The research also reveals that either bigger companies, companies with more experienced managers or with better performance show better performance measurement systems

Síndrome de crouzon: fatores envolvidos no desenvolvimento neuropsicologico e na qualidade de vida

A síndrome de Crouzon é caracterizada por deformidade craniana, alterações faciais e exoftalmia. O retardo no desenvolvimento neuropsicomotor é observado em alguns casos. Este estudo tem como objetivo analisar a influência do momento da cirurgia, da classe sócio-econômica associada ao nível educacional dos pais e da ocorrência de malformações do sistema nervoso central no desenvolvimento cognitivo destes pacientes correlacionando estes achados à qualidade de vida deles e de suas famílias. Foram estudados 11 pacientes com diagnóstico de síndrome de Crouzon com idade entre um ano e quatro meses e treze anos. A avaliação multidisciplinar dos pacientes incluiu, avaliação social, avaliação cognitiva, estudo do encéfalo por ressonância magnética e avaliação da qualidade de vida. O quociente de inteligência variou de 46 a 102 (m=84,2) e foi correlacionado de forma inversa com o Fator 4 do Questionário de Recursos e Estresse Simplificado (incapacidade da criança); não se correlacionou com as alterações encefálicas, com a condição sócio-econômica dos pais e nem com o momento do tratamento neurocirúrgico.

Desempenho e qualidade dos ovos de codornas de quatro grupos genéticos

Avaliou-se o desempenho e a qualidade dos ovos de codornas de corte de quatro grupos genéticos, utilizando-se 288 aves com 42 dias de idade, em delineamento em blocos ao acaso com quatro tratamentos (grupos genéticos A, B, C e D) e seis repetições de 12 aves cada. A partir da primeira semana de alojamento, estabeleceu-se o programa de luz, iniciando-se com 14 horas diárias de fotoperíodo, com aumentos sucessivos de 30 minutos por semana até que atingisse 17 horas diárias de fotoperíodo. Semanalmente, os ovos e as sobras de ração de cada parcela foram pesados, para determinação do peso médio dos ovos e do consumo médio diário de ração. A cada 28 dias, foram coletados e analisados três ovos/parcela/dia por três dias consecutivos, para avaliação da qualidade externa e interna. Foram detectadas diferenças significativas entre os grupos genéticos para massa de ovos e peso médio dos ovos, de modo que o grupo genético B apresentou média superior à dos demais. Para gravidade específica e porcentagem de casca, foram observadas diferenças significativas entre os grupos genéticos, com médias superiores para o grupo genético D. Os grupos genéticos testados apresentaram boa produção e qualidade de ovos, comprovando que estas codornas de corte podem ser utilizadas como matrizes de pintainhos de corte.

Desordens temporomandibulares e dor orofacial: estudo da qualidade de vida medida pelo Medical Outcomes Study 36 - Item Short Form Health Survey

JUSTIFICATIVA E OBJETIVOS: O conhecimento de indicadores de qualidade de vida (QV) relacionados à saúde bucal é especialmente relevante para a Odontologia considerando o impacto que as condições bucais podem provocar no bem estar psicológico e social. Estudos sobre aspectos psicossociais contribuem para maior integração da conduta clínica e assistencial, preocupação compartilhada com profissionais da saúde. Integrar as áreas de Psicologia e Odontologia quebrando paradigmas interdisciplinares e o interesse em conhecer os aspectos psicológicos dos pacientes, motivou a realização deste estudo. O objetivo deste estudo foi avaliar a QV dos pacientes com disfunção temporomandibular e/ou dor orofacial. MÉTODO: Foi aplicado o Questionário Genérico de Avaliação de Qualidade de Vida - Medical Outcomes Study 36 - Item Short Health Survey (SF-36) a 91 pacientes, que buscaram atendimento por apresentarem sinais e/ou sintomas de disfunção temporomandibular (DTM) e dor orofacial (DOF). O SF-36 avalia 8 domínios: capacidade funcional (CF), aspectos físicos (AF), dor, estado geral de saúde (EGS), saúde mental (SM), aspectos emocionais (AE), aspectos sociais (AS) e vitalidade (V). RESULTADOS: A análise estatística descritiva e inferencial pela Correlação de Pearson (p-valor < 0,05) demonstrou, com exceção da capacidade funcional (73,2), valores médios entre 50 e 64 para os demais domínios: AF - 57,6; Dor - 50; EGS - 54,5; V - 53,4; AS - 63,6; AE - 51,8; SM - 58. Considerando-se que a pontuação varia de 0 a 100, ou seja, do pior para o melhor estado de saúde, os valores médios foram baixos. Verificou-se correlação entre CF e EGS (p-valor 0,01), tendência de significância para dor e EGS (p-valor 0,07). CONCLUSÃO: Os aspectos dor e capacidade funcional interferem no estado geral de saúde; os pacientes com DTM e DOF sofreram impacto negativo na qualidade de vida pelo prejuízo dos aspectos físicos e mentais.