Avaliação da dor pós-operatória: análise em pacientes submetidos a cirurgias abdominais em um hospital universitário de Natal/RN

It is an exploratory and descriptive study made by a quantitative approach, developed among February and May 2010, aiming to assess the pain of patients underwent abdominal surgeries in a University Hospital, in Natal/RN; to identify the local and intensity of the pain based on Numerical Estimative Scale; to analyze the pain related to the sensorial-discriminative, motivational-affective and cognitive-assessment dimensions, using the McGill Questionnaire pain; to establish a relation between the pain process and age, gender, religion, and king of surgery; to identify the medicines efficiency used to control postoperative pain. The sample was composed by 253 patients underwent abdominal surgeries. The results showed a total of 63.63% females between 38 and 47 years of age (21.34%); illiterates (21.73%); married (64.03%), living in Natal and surroundings (67.97%) and Catholics (74.30%). In their first assessment, 84.19% showed postoperative pain; the pain was considered light in 18.97% of them, moderate in 21.74% and severe in 43.48%. The mean number of descriptors chosen through the McGill Questionnaire Pain was 10.78 (DP= 6.09) and pain rating 23.65 (DP= 15.93). The descriptors selected with higher frequency were: sickening pain (69.01%), tired (65.25%), thin (62.44%), bored (58.69%), ardor (46.48%), pointed (38.50%) and colic (35.21%). In their second assessment, 57.71% of patients didn t relate any postoperative pain and 42.29% were still complaining about the pain. After taking analgesic medication, just 41.90% of patients who had complete pain relief. The Pharmacological groups most used were: simple analgesic (37.86%), weak opioids (32.98%), AINES (19.85%) and strong opioid (9.31%). It was not found a significant postoperative pain variation related to the sexes, religion and kind of surgery. It was concluded there were a high level in the number of patients with postoperative pain, mainly in a severe scale. Less than half of patients had the pain relief. Then, it was observed there was not coherence between the pain intensity and the analgesic it was used. To solve or relieve this kind of problems is necessary a permanent education to the health professionals who works in this area

Avaliação da dor oncológica: estudo comparativo com pacientes internados em um hospital de referência em Natal/RN

Quasi-experimental study, with prospective data, comparative with quantitative approach, performed in a reference hospital, aiming to identify the effectiveness of the Numerical Rating Scale (NRS) and McGill Pain Questionnaire, used simultaneously, to evaluate a group of patients with oncologic pain (Experimental Group); to identify the effectiveness of the Numerical Rating Scale (NRS) to evaluate a group of patients with oncologic pain (Control Group); to identify the resolution of pain according to prescribed medication, considering the result of the rating scales, and to compare it between the two groups of patients in the study. The population consisted of 100 patients, with both the experimental and control groups being composed of 50 people, with data collected from February to April 2010. The results show that in the experimental group, 32% of the patients were aged 60 to 69, 80% were female; 30% had a primary tumor in the breast, 58% had metastasis, and on 70% the disease was localized. In the first pain evaluation, 26% identified it as light; 46%, moderate; and 28%, severe; with an average of 5.50. In the second pain evaluation, 2% reported no pain; 70%, light; 26%, moderate. and 2%, severe, with an average of 3.30. On those with moderate pain, 60% used non-opioid medicine, 25% under severe pain were medicated with non-opioids and 41.67% with weak opioids. Regarding the Pain Management Index (PMI), 44.0% were rated as "-1". In the control group, 28% were aged 40 to 49, and 54% were male; 20% had primary tumor in the breast and genital-urinary system, consecutively; 56% presented metastasis; on 64% the disease was localized. In the first pain evaluation, 14% considered it light; 42%, moderate; and 44%, severe; with an average of 6.26. In the second pain evaluation, 18% did not signal pain; on 38% pain was light; 40%, moderate; and 4%, severe; with an average of 3.0. Regarding medicine therapy, 71.43% with moderate pain used non-opioids, 22.73% with severe pain used non-opioids and 27.27% weak opioids. Considering PMI, 42% were rated "-1"; and 42%, rated "0". We conclude that, despite the importance of pain as the 5th vital sign, it is still under-identified and under-treated by professionals. Nevertheless, studied oncologic patients had a tendency to report pain more easily when evaluated with the NRS instrument than with the combined use of NRS and MPQ. We believe, however, that the combination of these two instruments represents a more effective evaluation of pain, as it allows comprehension of its quantitative and qualitative aspects. We recommend, however, the replication of this study on a larger population, for a longer span of time, and consequently generating more evaluations, so this can confirm or deny the hypothesis that NRS and MPQ can, together, better evaluate pain on the oncologic patient

Ações de profissionais relativas ao banco de leite humano : uma perspectiva de mudança

This is an exploratory and descriptive study that aimed to investigate the actions of professionals in the context of breastfeeding, on the assumption that the actions taken by employees working together to postpartum and newborn are not competing to effect the distribution of pasteurized human milk so that it meets the needs of infants who depend on it. Thus, the study aimed to analyze the actions of medical and nursing staff of the distribution of pasteurized human milk to the newly born. The investigation was developed by action research in a federal hospital, located in the capital the state of Rio Grande do Norte, Brazil, reference assistance to women during pregnancy, childbirth and postpartum high risk in 2010. Study participants were fifty-five professionals chosen from the following inclusion criteria: to act in the NICU or rooming, being a pediatrician and / or neonatologists, nurses and technical nursing. According to the methodology of action research a questionnaire was applied, techniques in focus groups and courses were developed, and, finally, action evaluation. The project was submitted to the Ethics Committee at the Federal University of Rio Grande do Norte and approved with no protocol 448/2009. The problems identified in the responses issued by the social research were grouped into categories according to the similarity between them. The answer to the question of the survey - How is the need for pasteurized human milk for the newborns in neonatal intensive care unit and rooming identified? - Brought subsidies for action planning and implementation of strategies for change in the practice of professionals working in rooming and ICU. Thus, the study has relevance in social care and, when at the local level, will compete for the distribution pasteurized human milk to take effect as best as possible, as recommended by the Ministry of Health. It is also conceived that, in a macro view of society, it could contribute to minimizing the health problem that involves the child population

Processo de alimentação do Sistema de Informação do HiperDia: Estudo de Caso no município de Natal/RN

Although the records indicate the involvement of the City Christmas in the feeding system HiperDia, a survey conducted by the Health Ministry in 2004 found that the number of entries made in Natal was well below estimate. In order to understand the functioning of HiperDia, we performed this study to analyze the actions taken by the professionals involved in power system HiperDia in Natal / RN. The research has developed into a quantitative perspective, with the design of exploratory case study conducted in the health services that integrate the various levels of the organization who are directly involved with the process of system power HiperDia in Natal / RN , represented here by SMS, health districts and the Family Health Units in the period from August to October 2008.Study participants were 110 professionals, including nurses, physicians, operators, administrator and a coordinator. The survey results showed that feeding HiperDia in Natal was maintained mainly by health professionals and operators. Activities include carrying out the state registration, monitoring, and updating of data transfer routines. They report that the difficulties in the process of feeding data are related to the work of teams and / or lack of structure of the Program of Hypertension and Diabetes (HA and DM), the discontinuity of federal investments in improving the HiperDia and lack of training. We can see then that the process of feeding system on Christmas HiperDia therefore is developing the three levels (SMS, districts and health units), however is not matching the expectations established by MS, considering that the gaps the flow of information are undermining the end result of this process

Aconselhamento em HIV/AIDS: ações e reflexões dos profissionais do Centro de Testagem e Aconselhamento (CTA)

The counseling on HIV/Aids consists in a prevention strategy that contributes to increase the diagnosis of HIV and start earlier the treatment. The counseling has as pillars the emotional and educational support, risks evaluation that aim at the adoption of safe practices and the individual s responsibility for his own health. To accomplish these results, it is necessary that health workers understand counseling as a unique educational moment that stimulates the user s critical-reflection when it comes to his role as an active subject in this process. This study aimed to analyze the counseling on HIV/Aids conducted by the professionals of the Testing and Counseling Center (CTA), based on the educational perspective of Paulo Freire . This is a descriptive qualitative study with a critical reflexive design based on the principles of Action-Science. All the professionals acting as counselors in the Joao Pessoa, PB CTA, eight in total, took part in the study. Data were collected during the month of March, 2011, through non participative observation and semi-structured interviews with a critical-reflexive focus, analyzed according to the tenets of the critical-reflexive methodology, and discussed taking into consideration the Paulo Freire s pedagogy and pertinent literature. It was observed that most of the professionals expressed the work philosophy of CTA as the diagnosis and prevention of the disease, associated with the utilization and demonstration of condoms. However, upon observation of their counseling sessions, these ideas were not converted in actions. Educational themes were not covered and the condom wasn t offered at any time. The counseling actions focused on the provision of information and filling out the paper forms which are necessary for attendance. The sessions were conducted with brief dialogues and little opportunity for the users to expose or complement their thoughts and needs. The professionals mentioned as facilitating conditions for counseling, the team interaction and physical structure. The difficulties focused on the users low cognition, the large demand for attendance, aspects related to the service organization, and the counselors absences and delays. After reflecting about the actions observed in the counseling, the majority of professionals admitted the need to modify their practice in the incorporation of educational principles for the achievement of a broader prevention, and seemed to be willing to work in this perspective. In conclusion, although the counselors show ideas consistent with the purposes of CTA, these ideas are limited when it comes to the understanding of the meaning of prevention in HIV/Aids. Taking into consideration that they express a certain comprehension and act differently during the counseling, they demonstrate a lack of bond between the theories in use and the proposed ones, in accordance with the contribution of the action-science theory. The counseling, as an educative practice, doesn t materialize in the counseling itself and the orientation for reflection is not given during the attendance. These findings suggest the need to include the process of reflection in the execution of the actions of counseling, so that these practices are guided by reflexive practice, aiming at transforming the way of thinking and acting into a more educational perspective toward a more democratic and holistic assistance.

A intenção e o gesto :ações gerenciais de enfermeiros em espaços hospitalares

The present study analyses the supervisory practice of the nurse in the hospital environment. It has, as its main objective identify the use of planning, supervision and evaluation, as managerial instruments in the daily nursing practice. It tries also to identify the importance given to these instruments in their supervisory actions and the difficulties encountered in their use. It deals with an exploratory and analytical investigation with a qualitative approach having as its main point of analysis the principles of strategic planning. In order for it to be done 10 nurses were interviewed, distributed in three public hospitals in the city of Natal/RN. The results show that, although the nurses recognize the importance of the managerial instruments, they do not put them into practice in an effective and systematic way. They justify it because of the existence of personal, professional and institutional difficulties. On the other hand we could conclude from what they say that there is the desire to overcome the eminently burocratic vision of the management. Thus, they express a feeling for change and point in the direction of looking for ways that will contribute to innovate this practice

Avaliação de economias de escala e escopo no desempenho de equipes de serviços aplicando Análise de Envoltória de Dados DEA: um estudo em Empresa de Telecomunicações no Brasil

This Master s Thesis proposes the application of Data Envelopment Analysis DEA to evaluate economies of scale and economies of scope in the performance of service teams involved with installation of data communication circuits, based on the study of a major telecommunication company in Brazil. Data was collected from the company s Operational Performance Division. Initial analysis of a data set, including nineteen installation teams, was performed considering input oriented methods. Subsequently, the need for restrictions on weights is analyzed using the Assurance Region method, checking for the existence of zero-valued weights. The resulting returns to scale are then verified. Further analyses using the Assurance Region Constant (AR-I-C) and Variable (AR-I-V) models verify the existence of variable, rather than constant, returns to scale. Therefore, all of the final comparisons use scores obtained through the AR-I-V model. In sequence, we verify if the system has economies of scope by analyzing the behavior of the scores in terms of individual or multiple outputs. Finally, conventional results, used by the company in study to evaluate team performance, are compared to those generated using the DEA methodology. The results presented here show that DEA is a useful methodology for assessing team performance and that it may contribute to improvements on the quality of the goal setting procedure.

Método de avaliação do gerenciamento de resíduos em canteiro de obras da construção civil : proposta baseada em empresas construtoras da cidade de Natal-RN

According to great concern between the developed industrial activities and resultant impacts over the environment, an association of several factors have occurred, procedures to the efficient management of the rotation between economical development and the environment have been improved. A research in field have been realized inside building sites of companies in order to provide knowledge about the implemented and accomplish actions according to the resolution from CONAMA nº307. Trough the interview among the representations of the companies and photographic survey in loco, such as, what makes the companies implement this management, reutilization and recycling, transport and disposition. The present study had as objective: analyze the insertion of the used tools to residuals management, proposing improvements, in a way that it can be easily identified during the procedures execution in the building sites of the building companies of the city of Natal/RN. To reach the goal, in the first place a revision of the pertinent literature was performed; there for, it can be seen the relation between residues management and environment sustainability, once it happens in a continued way it may prevent the waste and reduces the risk that the activities way bring to the employees, community and environment; once found the great difficult faced with regard to labors, material, equipment, project, planning, costumer s interference, furnisher. And still, it could be verified wich materials generate greater indexes of residues in the works and the main occurrences of waste and loss. However a greater transparency is needed coming from the high administration in the commitment with the continued actions, to make it so, there must be a cultural change inside the company. There for there will be a greater productivity and quality of the under taking such as costumer s satisfaction

Avaliação dos indicadores de desempenho de instituições federais de educação tecnológica doBrasil na abordagem do balanced scorecard

This Master of Science Thesis deals with a study on applying the BSC Balanced Scorecard to assess the performance of Federal Institution for Technological Education Institution in Brazil, a government organizations non for profit. It s accomplished a literature review in order to understand the BSC and its application to non for profit organizations and as a main result it is proposed a BSC conceptual model with an inversion of the main BSC perspective from financial to customer/society. It is used the annual management report of thirteen Institutions and applied a Pearson correlation analysis in order to verify a cause-effect situation between indicators. The main findings suggest that the model teachers qualification in terms of degree earned, quantity of teachers in full time job, and rate of students by teacher in full time job having good pearson correlation with the results expected of quality, throughput, social and demand response. However, the student unit cost use as the sole financial indicator did not get any reasonable correlation with the results, as so the quality and quantity of books in the libraries. Although it suggests a need for improvement in the model, the general model adopted appears to be satisfactory as a starting point to a BSC-like performance measuring system to this kind of Institutions

Participação pública em programas ambientais :um estudo em área suscetível à desertificação no Estado do Rio Grande do Norte

The natural resources degradation and its consequences to the society life have provided several discussions about the evaluation methods and environmental management, and the available means to minimize the effects of man s actions over the environment. Amongst these actions is the encouragement to the community participation in the process of carrying out the environmental programs, considering government and enterprises representatives or residents of certain places as social actors. Within these context, this paper had as a goal the investigation of the public participation in the environmental programs in areas that are susceptible to desertification, specificly in Parelhas/RN. The choice for this town was due to its insertion in an area considered as a desetification nucleous, which is, a region that suffers land degradation as a consequence of climate variations or human activities. Therefore, the research in question, of a descriptive and exploratory type, had as an instrument a structured questionnaire, applied to a sample of 223 people out of an 11,068 over 20 years of age residents population. The data have been tabled from Statistics for Windows Program and later interpreted based on the theoretical reference over the subject. As a result, corroborating to the literature of the area, it was found that the community participation in any type of action or debate about environmental questions is associated to the perception and knowledge about the problems. Although the people who were interviewed believe in the responsibility of the ceramic industry in causing environmental problems, they also believe that the benefits brought by the sector overcome such problems

Avaliação de desempenho em mercados reguladores de transporte urbano por ônibus :proposição de um modelo aplicável ao caso de Natal

Increased competition in the market of urban transport, characteristic of the Brazilian cities from years 90, has required actions of the managing agencies to ensure the universality of service, enhancing efficiency and consumer welfare. It grows in the Brazilian municipalities, the need to adopt a systematic performance evaluation in terms of management system of indicators and targets appropriate to the regulatory context, which has the purpose of evaluating the accomplishment and compliance by dealers, of the services granted during the contract period, marked by increasingly long periods. The introduction of an index operational performance in permission contracts/concession in urban buses is intended to establish a regulatory performance, giving the contract a pro-competitive feature and to allow the managing agency the systematic and continuous monitoring of the performance of the delegated service to avoid major deviations from desired performance. A performance assessment model of public transportation companies by bus, and applicable to the case of Natal is proposed. Sought to add the particularities found in the transport system in order to assess the performance of enterprises, contribute to improving the service quality to the population and enable decision-makers a detailed knowledge of the behavior of the licensees

Aspectos linguístico-ergonômicos em rótulos: avaliação da linguagem verbo-visual de rótulos de embalagens para alimentos achocolatados

We have been living in a world of packed products. The package and the labels support the companies to communicate with the customers in addition to give protection, storage and convenience in proportion to the products that move in the price list. The labels mainly add up a value which helps the companies differ their products and increase the value of the brands among the final customers. However, the information given in the label are not clear sometimes. It displays a verbal-visual defective language resulted from a poor visibility, legibleness and comprehensibleness of the verbal and visual marks. The aim of this research is to verify, according to the costumers‟ view, the level of the clarity in the informative texts, harmony and ergonomic conformity of the package labels in the chocolate powder of the Claralate brand, considering the linguistic aspects presented on the labels. The criteria to evaluate the chocolate package selected were based on the linguistic field: the organization and the structure of the text derided from the classification of the textual genre; the clarity and the comprehension of the language utilized on those labels. From the ergonomic view, the informative and ergonomic conformity, based on the following requirements: legibility, symbols, characters, reading fields and intermission of the written lines. Therefore, the research done july 2007 and added july 2011 had a structured questionnaire in the interview put to the 118 customers of the chocolate package that go shopping in one of the two supermarkets in Floriano, Piauí São Jorge and/or Super Quaresma. The main results of the investigation show that the linguistic aspects in the informative texts of the labels provide the customers‟ expectancy partially, while the consideration of the informative ergonomic analyzed can contribute to the improvement of the information and consequent visual progress of those, on the labels of chocolate package investigated. As recommendation towards the maker of the product, the outcome of the research indicates: harmonize the proportion of the letters and numbers; enlarge the letters size; make the visual information more comprehensive determined by the reading field; put the expiry date in a better visual place

Gestão de organizações sem fins lucrativos: uma avaliação de desempenho através do balanced scorecard

The methodology Balanced Scorecard (BSC) focuses on the major critical issues of modern organizations, whether with or without profit. The measurement of the effective performance of the latter is by evaluating the successful implementation of organizational strategy. The aim of this paper is to present the development of a system of performance measurement strategy for a nonprofit organization, whose object of study is the Associação de Apoio as Comunidades do Campo - AACC, in the context of the BSC methodology of Kaplan and Norton. The methodology of this case study is an exploratory, descriptive and qualitative, and diagnose the coherence of the Strategy Map in an organization, based strategic planning from 2010 to 2012. Initially conducted a literature review covering the main aspects of strategy maps and performance evaluation involving the translation of the BSC and strategy evaluation. The main results of the proposed approach refers to evaluation of overall scores for each dimension of the BSC methodology, financial, customer, internal processes, learning and growth. These results are able to help the organization evaluate and revise their strategy and, in general, to adopt management methods more accurately. Data collection is centered on interviews with semi-structured questionnaire. The findings highlight on balancing and alignment of strategic objectives, low causality map, strategic communication insufficient and fragmented. For interviewees organizational culture is the biggest impediment to structuring a management model based on indicators and strategic process should be initiated by non-financial indicators gradually. The performance indicators of the AACC/RN portray more meritocracy operational procedures of social projects in the context of the Strategic Map determined in a shortterm over the long term. However, there is evidence of improved performance management and strategic taken as a basis of planning as both the strategic map structured. Therefore, the nonprofits need to adopt a form of management that enables planning, setting objectives and targets that provide the continuity of its activities, and generating instruments that can measure the financial performance and non-financial, in order to develop strategic actions for growth and sustainability

Avaliação dos processos de seleção utilizados nos programas de fomento a inovação nas micro e pequenas empresas da fundação de amparo à pesquisa do Rio Grande do Norte

Technological innovation promotes the generation of economic value by creating a new product, process or organizational management model, being classified as dynamic and multidimensional. Government intervention has the role of acting through government grant programs to foster the integration of innovative processes in small companies, due to the high costs and risks of development, strengthening the country`s economy in this phase. The distribution of this grant is determined by criteria, based especially in subjective judgments, which are based on the beliefs and perceptions about the technological opportunities and market actors involved in the process, being very difficult to measure the probability of success of the project under evaluation. This study aims to identify the most relevant selection criteria that must be inserted in grants programs at Rio Grande do Norte executed by Fundação de Pesquisa do Rio Grande do Norte (FAPERN). Initially, there was a systematization of 18 countries, covering 41 programs in foreign countries and 29 in Brazil. Based on the data collected, we conducted one survey containing four programs of FAPERN (INOVA I, INOVA II , INOVA III and INOVA IV), covering 44 companies and analyzing their responses according to the Likert scale , obtaining the degree of importance given by the respondent to each of the criteria in the questionnaire . As a result, drew up a proposal for new criteria to be used in the next FAPERN´s grants, containing 13 new criteria. It is expected, therefore, to contribute to a better spending of public funds invested in companies subsidized in Brazil

Avaliação da importância dos sistemas de gestão da qualidade nas universidades federais

This thesis aims at analyzing from the perspective of the manager the importance of the use of quality management tools and concepts in Federal Universities. It was motivated by the following research problem: do Federal University managers consider it to be relevant the quality management in their institution? Therefore, we sought to gather evidence for a satisfactory approach that addresses the complexity of the topic researched: quality, higher education and quality management systems. We chose to adopt an applied study, the exploratory-descriptive research as to the objective and the quantitative and qualitative research as to the approach to the problem. The object of study is composed by the Planning Provosts of Federal Universities listed in the University Ranking Sheet - (RUF) in 2013. We chose to restrict the sample listing only the provosts of the 20 best-placed universities in the ranking of the Federal Universities. The research instrument was composed of 26 questions, of which 6 questions were designed to identify the profile of the manager, 16 questions of perception (manifested variables) on the importance of quality management in the University, where the managers assigned values (answers) to the affirmatives (that address the main topic of this thesis) based on a Likert scale of 5 points, and 4 open and optional questions, in order to identify general management practices used. It was used for statistical analysis (data analysis) descriptive and factorial statistics. The responses collected through the questionnaire portray the managers´ perception regarding the importance of quality management in their institutions. Sixteen variables were addressed, the results of factor analysis of importance were "Important" and "Very Important", where the variable (V2) was "Important" and all others "Very important." With this information, it is possible to prioritize some areas that deserve immediate action. As it was observed that some variables are "Very important" for the vast majority of managers, others did not show the same result as example (V2, V10, V11). It is concluded that the manager´s perception of quality management in his or her institution is relevant, but the same importance is not given to quality programs implemented in other segments of the economy, and that, despite the advancements offered by SINAES, the model does not evaluate the institution in a global way. Thus, with the results, it is expected to contribute to the advancement of the subject, trying to arouse interest from the managers of Federal Universities in the subject, emphasizing the importance of quality management systems as a necessary tool to raise the institutional quality