Riscos ocupacionais e acidentes de trabalho em um serviço de atendimento móvel de urgência do Rio Grande do Norte

Exploratory, descriptive and quantitative study with prospective data, performed in the Mobile Emergency Care Service in the metropolitan region of Natal/RN, in order to identify the knowledge of the multidisciplinary team about the rules of standard precautions and worker safety, to identify occupational hazards peculiar to the activities of this service; characterize work-related accidents (WRA) and know the procedures adopted after each WRA. The population consisted of 162 professionals and data were collected between the months of November and December 2010. As for personal and professional characteristics, of the 162 professional, 12,96% were physicians; 6,79%, nurses; 33,95%, nursing technicians, 46,29%, conductors; 74,70% were male; 43,21% were between 31 and 40 years old; 69,33% lived in Natal/RN, 50,00% had completed high school; 58,64% were married; 69,75% had children, 46,91% were between 1 and 4 years of training; 61,73% had improvement courses; 59,25% had 3 to 4 years of service; 54,32%, with 1-4 years experience in emergency; 44,44% received 1-2 minimum wages; 78,40% received insalubrity premium; 67,28% worked in Basic Support Unit (BSU); 83,95% had journey on SAMU Metropolitano of 31-40 hours per week; 52,47% had other employments. As for knowledge of rules of standard precautions, safety and occupational hazards, 99,38% knew what it was WRA; 62,96% gave incomplete answers; 74,07% knew the rules of prevent WRA; 46,67% acquired this knowledge in lectures; 53,09% knew Personal Protective Equipment (PPE); 71,60% gave incorrect answers about the importance of standard precautions; 45,06% never received an educational intervention on this issue; 89,51% said that educational interventions in the prevention of WRA are very important; 90,12% pointed out this as a very important issue in the workplace; 27,00% suggested guidance on the topic in the workplace; regarding the physical hazards, 34,57% considered noise as the most important; about chemical hazards, 78,40% chose the gases and smoke; for biological hazards, 48,77% reported contact with the blood; for mechanical hazards, 80,86% said that were transport accidents; about ergonomic risks, 40,12% say it is the tension/stress in the care of critically ill, psychiatric and aggressive patients; and there was an average of 4,5 to the feeling of safety in the workplace. Regarding the data on the WRAs occurred, 31,48% experienced at least one accident event; 72,55% did not notify it; 60,98% answered that there was no routine for notification; 56,86% were performing patient transportation; 49,02% were hurt in the Basic Support Unit/Rescue Unit (BSU/RH); 60,78% occurred during the day; 96,08% of professionals were in normal work schedule (24 hours on duty); 31,37% had contusion; 58.82% had damage to members/pelvic girdle; 43,14% had traffic accidents. About the evolution of the WRA, 62,75% did not have to take time away from work; 76,47% had no sequelae; 88,24% did not require rehabilitation; no professional had a change of occupation. And by means of univariate logistic regression, showed that the nurses and male sex were risk factors for the occurrence of WRA. We conclude that there were gaps in the knowledge of staff regarding WRA, emphasizing the need for continuing education in biosafety in the service.

Carga de trabalho de enfermagem e infecções relacionadas à assistência à saúde na unidade de terapia intensiva

In recent decades, the search for quality care has been widely discussed by the institutions and health professionals. In this context, it is the nurse coordinator of the process of providing nursing staff, reflecting the commitment to quality of care. In this process, it is the appearance of Infections Related to health care and its potential association with the workload in nursing as a valuable indicator of quality of care. Thus, this research contributes to studies to characterize the demand of nursing work to promote a safe healthcare practice. This study aimed to identify the association of nursing workload with the number of cases of Ventilator-Associated Pneumonia, urinary tract infection and central venous catheter infection in the intensive care unit. This is a quantitative research approach, descriptive, cross-sectional and prospective, held at Unimed Hospital in Natal-RN. The study population consisted of all patients treated in the Intensive Care Unit, Hospital for a period of 90 consecutive days in 2011. The convenience sample was compostapelos patients admitted to the ICU during the period of data collection, a total sample of 286 patients. To perform the data analysis software were used: Statistica 6.0, SPPS (Statistical Package for Social Sciences) version 17.0 (2004) and Excel 2007. In the descriptive analysis, we used Measures of Central Tendency and Measures of Dispersion or Variability and the use of nonparametric tests. Of the 286 patients, 88 were from the ICU and 198 ICU II II. Males predominated in the ICU I (51.1%) and female ICU II (57.6%) patients in the ICU I were aged 61-80 years (39.8%) followed by greater than 80 years (39.8%). In the ICU II, most of the patients were aged 61-80 years (38.9%) and then from 41 to 60 years (24.2%). In relation to the class of TISS inlet predominant class II in the two ICUs (59.1%), followed by Class III also in the two units (34.6%). Most patients (70.6%) out of the ICUs belonging to class II TISS. In the ICU I, the average number of forms of the TISS 28 was 6, has in ICU II this value drops to 3.2 forms. The overall mean was 19.9 TISS points in ICU patients I and ICU II.the 17 points in the average hours required to provide adequate nursing care to patients in the ICU I found that is 10 , 7 hours, and the ICU II 9.2 hours. It was found that the time provided by the nursing staff were higher in ICU II, with an average of 19 hours available for nurses in this sector. In the ICU I, which showed higher need of available hours, it was found that the mean value of 12.7 available hours. It was found that only 2.4% of patients had these units Ventilator-Associated Pneumonia, 1.0% were infected central venous catheter and 1.4% of patients had urinary tract infection. Infection associated with health care occurs, on average, on the tenth day of hospitalization. In the ICU II, this average value extends to the twelfth day with an excess of 2.7 hours of nursing care while in ICU I value decays to the ninth day of hospitalization with a deficiency of 12-hour assistance. It is concluded that patients generally showed a need for classification of semi-intensive care and has been assisted in their need to load. As for his association with the Related Infections Health will assist this analysis could not be performed due to the small number of notifications in this period. It is suggested further study how other factors related to infections me a longer period of analysis

O trabalho do enfermeiro de um hospital pediátrico de ensino e o SUS: desafios a enfrentar

This study analyzes the point of view of nurses working at a pediatric teaching hospital on their work process within the scope of the Brazilian unified healthcare system SUS, in order to identify factors that interfere with its development and find out how work relations are taking place between nurses, other nursing professionals and the multidisciplinary staff. It is a descriptive and analytical study, qualitative in nature, which starts with a consideration of a nurse s current practices and moves on to reflect on a perspective of transformation aiming at rethinking their work process pursuant to the principles of SUS. In order to attain these objectives, we decided on using the focal group as a data-collecting technique, which took place from November to December 2005, by using as instruments a questionnaire for the characterization of the persons being researched and a discussion outline. Theoretical support has approached transformations in the world of work, placing it in the context of healthcare and nursing and has tried, specifically, to understand the work process of a nurse engaged in the production of health services. Therefore, the discourse analysis of participants, in the light of theoretical support, has evinced an ambiguity inasmuch as though identified as such in their work process, nurses are also fulfilling multiple functions in health services. Through this study it has also been possible to identify several factors that interfere with the work of these professionals, including poor working conditions and excessive hiring of high school graduate interns as an attempt to make up for a meager nursing workforce, as well as reveal the possibilities brought about by the SUS in retargeting its professional practice to interdisciplinarity and integrality

Relações interpessoais no ambiente de trabalho da equipe de enfermagem: uma ação comunicativa

The current study strives to address the interpersonal relationships of the nursing team from the perspective of the communicative action, by contributing to the health work process. It aims to analyze the interpersonal relationships of the nursing team in its work environment. This is a descriptive study with a qualitative approach. Data collection wal held from interviews, guided by a script with open questions. The study was conducted at a state hospital in the city of Natal/RN/Brazil. The research subjects were the workers of the nursing team, including nurses, nursing technicians and nursing assistants, totaling 16 subjects. The capture of information was performed in April 2012. The project was approved by the Ethics Research Committee, under CEP/UFRN protocol n. º 262/11 and Certificate of Presentation for Ethical Consideration n. º 0289.0.051.000-11. The analysis was performed from the categories that emerged from the research through a dialogue with the authors studied in the theoretical framework of the Theory of communicative action , by Jürgen Habermas, as well as The changing in the world of work, by Ricardo Antunes, and Characterization of the team , by Marina Peduzzi. The outocomes point out that the interpersonal relationship of the nursing team is very troubled, with no interaction among the individuals involved in this process, among themselves and with other health professionals. We have developed a particular concept about team, which is comprised of three essential elements: multiplicity of individuals, common objective and heterogeneity. In the studied environment, it was realized the existence of grouping teams. The interpersonal relationship of the nursing can be a facilitator or an obstacle in the workplace in such a way that causes positive or negative consequences, both to the health workers, and to the sicks. In this context, the interviewees have intensified their viewpoints with regard to the weaknesses that permeate the nursing relationship, by pointing them more frequently than the strengths. The work conditions have signaled a failing situation, which is evidenced by the constant improvisation process before the lack of human and material resources, low wages, deficit in recognizing the nursing worker, and physical and emotional wear, by creating a professional exhaustion. The devaluation of the worker also became a strong factor for this study, because it was characterized a reason of job dissatisfaction, due to the lack of valuation policies, which should be prepared by the institution or, even, they are unknown by the worker itself. The worker participation in the design of these policies has emerged as a relevant factor. The poor work conditions lead the worker to a process of professional demotivation and dissatisfaction, by causing the feeling of devaluation within its work environment. Hence, it was found in this research that the lack of communication leads to situations of inadequate interpersonal relationships, which are creators of an unsuitable environment for the performance of the nursing team

Aumento da jornada de trabalho :qual a repercussão na vida dos trabalhadores da enfermagem?

The worker of the public service is loosing your acquisitive power by means of the politics of fiscal settlement. The ways out that were found in the health sector, especially in nursing, is being the increasing workday for beyond 40 or 20 hours established in the link of the work with the state. This survey has the object to identify the possible repercussion of the increasing workday in daily life workers from nursing in the public service of Rio Grande do Norte. The theory reference used was the work of Marx (1982) and Antunes (2000,2001) and the daily living in Heller (1991,1992). The methodology used was a qualitative survey in the exploration kind. The informations were gathered through interviews with open questions almost structured with workers of nursing, managers and representatives of entity. The analysis of informations were made through general categories, work, and daily life, using elements from dialetics-hermeneutics according to Minayo (1992,2002). In the analysis, it was identified that the ways that were found for the overcoming of the loss of acquisitive power were the many-employment; the extra scale of shift; the subletting of work posts and the substitution of friends in scales of work, and all of them being changed in increase. Other aspect realized was the move of rights, like vacation and medical license for the workers that act in extra scale. The tiredness, stress, and bad humor are influents factors in the development of work.. The reduction of free time makes in the workers ahguish because of the familiarity decreasement just as time to dedicate themselves to the technical-scientific improvement and for the cultivation of other aspects of subjectivity, as leisure, care and culture. The low salary and the non reajustment are the reasons for the adoption of part workers for the increasing workday, and government has been responsible for this situation. The conclusion was that the increasing workday has strong repercussions in the professional and personal daily life workers that made part of the survey

Conquistas e desafios do processo de trabalho de enfermagem: o caso dos CAPS em Natal/RN

The Brazilian Psychiatric Reform proposes creating linkages / interactions of the mentally ill with civil society , through promoting citizenship and assistance to the mentally ill. The deinstitutionalization of mental health advocates from the guidelines decreased supply of hospital beds and consequently the creation of substitute services for psychosocial care, especially with regard to therapeutic practices emancipatory. From this scenario, the present study aims to investigate the relevance and challenges of the process of nursing work in CAPS III in Natal / RN. It is descriptive research with a qualitative and exploratory. The subjects are employees of the nursing team in CAPS III East of Natal / RN. This service has actions for the psychosocial care of the subjects treated with daily multidisciplinary care by behaving the length of treatment and follow-up activities, industrial and cultural activities. Employ the semi-structured interview as a tool for data collection. The data analysis was done by means of thematic analysis proposed by Bardin. Thus, this sought to bring to the discussion of how this process is consolidated in the daily service. Thus, purposed to contribute to the debate on deinstitutionalization in psychosocial care as a guideline in the process of mental health nursing work in a CAPSIII, Natal / RN

Processo de trabalho na estratégia saúde da família: potencialidades e fragilidades da atuação do enfermeiro

The present study aims to analyze the nurse s work process at Family Health Strategy, considering its basic elements and dynamic, and searching to identify aspects that may constitute strengths and weaknesses in its development. This is an analytical case study, with qualitative approach and theoretical-conceptual mark grounded in Dialectic Hermeneutics. Empirical research fields were the Family Health Units of Natal, RN, Brazil. The subjects are nurses working in this Strategy. Data collection was conducted through semi-structured individual interviews combined with field observation. The research was initiated after approval by the Ethics Committee of Universidade Federal do Rio Grande do Norte, according to the guidelines and rules for research involving humans (Resolution 466/12), ensuring proper ethical precepts. The project was approved by register number 398.929, CAAE 19588813.7.0000.5537. From the 9 interviewed nurses, 8 were female and 1 male, average age of 52 years, average graduation time of 27 years and average time they stayed at the same Family Health territory of 7 years. It was found that it is up to the professional nurse in the Family Health care the important role of taking care of human beings in their life, family and community contexts, producing conditions to meet their needs through therapeutic act in health, using for such purpose both materials and immaterial instruments. It was possible to relate aspects that characterize strengths and weaknesses in the work process of nurses in the ESF, according to the speech of the interviewed workers, including the meanings and contradictions. Among the potentialities observed, it was possible to highlight the wide role of the nurse at Family Health; the perception of nurses about teamwork; the relative autonomy of nurses; the commitment of professionals to work; Humanization as a technology; the presence of other agents at work, such as directors and officers at the primary health units; the professional s experience time and contract type in the case studied. As weaknesses in the work process of nurses at Family Health Strategy, were highlighted the limited skills of the workforce; the difficulty in 10 identifying specific limits of the work of nurses in this scenario; the disturbances that occur in the process, the existing gaps in multiprofessional teams; Structural deficits of the units in the studied case, the low coverage of the Family Health in the county, and the political vulnerability of the work conditions. It is considered necessary to understand the dilemmas experienced in everyday life of nurses at Family Health Strategy as part of multiprofessional teams, facing actual achievement of changes in work processes necessary for the reorientation of health care in Brazil. In accordance, it is necessary to promote proper working conditions and welfare of labor agents which are protagonists the work at the United Health System

Doenças sem doentes: Ocorrência de Distúrbios Osteomusculares Relacionados ao Trabalho DORT nos operadores de caixa de um banco

The changes incurred in the financial system with the introduction of new technologies and new forms of administration of banks has caused impact on the health of workers. These changes, which passed in the process of work, generate a combined share of the risk factors that result in numerous injuries and illnesses among banks, notably between the operators of banks tellers. The Work-Related Musculoskeletal Disordes - WRMD represent a group of occupational diseases always present among these workers. Because of its high incidence and the amount of financial resour envolved to manage the problem has been the object of constant study. This paper aims to analyze the bank teller activity; search the occurrence of WRMD in the activity, identifying the factors determining the occurrence of WRMD in the activity and determine the real number of touchs on a keyboard made by the operator and propose solutions that influence the reduction of illness in the workplace of the bank teller. Methodological tools of ergonomics are used to provide a broad knowledge of aspects of work that have been studied and influential in the generation of occupational diseases studied. It was found that activity put workers to serious risk of occupational diseases. As the main contributory factors and determinants for this illness: the requirements and control the numbers daily endorsements; evaluation system based on performance targets for productivity; management system at time of service to customers; work with stressful factors (broken box); excess of time worked; furniture of workstations with ergonomic inadequacies and policy for the prevention of occupational diseases inefficient. They have also noted cases of illness for DORT workers without fulfilling the legal requirement of the issuance of the communication of labour accident and without the removal of the employee of the workplace

Uma análise exploratória da jornada flexível de trabalho sob a perspectiva de tutores na educação a distância

Information Age has been providing accelerated development of technologies in teaching, which is making the increase in distance courses and flexibility in the tutors everyday work. In this context, it was aimed to study the influence of flexible work in the development of activities and personal life of the tutors in Distance Education at Universidade Federal do Rio Grande do Norte. More specifically, they have been sought to compare the types of flexibility detected, identifying the extent of the day's work in mentoring; investigating the relationship between flexible working time and productivity; evaluating the Quality of Working Life (QWL) and for Work and Family Relationship of the tutors. Thus, work is justified by the importance of academic and organizational achievement. To meet the goals, it was obtained a sample of 75 respondents (45.73% of the population). The data collection instrument was comprised of 48 variables mainly based by Walton (1975) and Paschoal, Tamayo and Barham (2002). The statistical techniques used were: analysis of frequency, ratio test, factor analysis and regression. The results collected have shown that the presence and distance tutors experience similar realities, but have different profiles; the day of their work is on average three hours daily; in view of the tutors, flexibility has a relation with the production, QWL work-family balance were evaluated in a satisfactory manner and the statistical techniques used have shown significant influence between the QWL and flexible working day. It is therefore concluded that flexibility at work can influence the development of activities and personal life of the tutors. Thus, the flexible working day may be used in a strategy way of routine in many organizations

Um estudo do perfil de formação dos técnicos de segurança do trabalho no Brasil na perspectiva de sistemas de gestão de segurança e saúde ocupacional

This work provides great contribution to the documental study of the Work Safety courses offered by CEFETs in Brazil, under the perspective of safety management and occupational health, using as a referential the specification OHSAS 18001 (BSI, 1999), as well as directions provided by OIT (ILO, 2001). The theoretical research compares technical and managing competences of the projects of Work Safety courses at CEFETs with the international legislation mentioned above. For field research, questionnaires containing open and close questions were answered by teachers and students aiming at identifying the importance of technical and managing competences for the formation of Work Safety technicians, besides trying to identify which level of minimal formal knowledge should be required to perform managing activities in the area of Work Safety Management Systems and Occupational Health (SGSSO, in Portuguese). The results of the theoretical research point out differences between the projects of the Work Safety technical courses at CEFETs under the perspective of SGSSO. The field research shows that students and teachers opinions converge about most technical and managing competences. In relation to academic formation, the research suggests divergences to the criterion stated by the norm ISO 19011(ABNT, 2002)

Modelagem de arranjos institucionais para implementação da diretriz de sistema de gestão de segurança e saúde ocupacional da organização internacional do trabalho ILO/OSH 2001 no brasil

The commitment assumed by Brazil to ILO in order to pursue actions toward the ILO/OSH-2001 adoption in the country poses the issue of modeling the institutional arrangement the set roles and relationship between government, standards organizations, health and safety organizations, professionals and other institutions to deploy the ILO/OSH-2001. This Thesis develop institutional arrangement models based on the current model and also in the ISO 9000 scheme and others. It is studied the US case with OSHA and VPP, the OHSAS 18001 and ANSI/AIHA Z-10, in addition to actual context of the regulating norms NR s. The scenarios developed are put to evaluation on feasibility, potential changes and effects on current MTE auditors work scheme. The main results are five scenarios developed and that the MTE auditors tend to be reactive to the change toward the ILO/OSH-2001.

Análise da situação de trabalho do motorista em uma empresa de ônibus urbano da idade de Natal (RN)

The problem dealt with in this study concerns the analysis of bus drivers' working situation. It stemmed from the need to identify the difficulties faced by these professionals in accomplishing the results expected by the company. A case study was carried out in a public transportation company in the city of Natal. Records and observations made in the workplace, alongside perfomance indicators, such as absenteeism tax, staff turnover and traffic accidents, revealed problems in their activity. It was made clear that, in the company being studied, absenteeism was related to health problems, particularly psychiatric and musculoskeletal disorders, and that although the indicators of traffic accidents and staff turnover have declined over the years, they are still elevated. The interviews involved 50 of the 124 drivers who worked directly in the service, and contained questions covering eleven factors related to the drivers' work. They indicated a gap between the prescribed work and the work actually done, in that there were a series of embarassing or stressful situations involving traffic, itinerary length, road conditions, vehicle maintenance, physical environment (bus terminus), job post and supervision policies. On the other hand, factors such as enjoying driving, the work itself and being with workmates positively influenced the drivers' working conditions. In the propositions of the administration and human resources subsystems, some alternatives were found in order to remodel this activity

Análise da atividade de trabalho profissional de gerentes de hotel à luz da abordagem da ergonomia

This Masters degree dissertation presents a research that aims at analyzing the activities regarding within a hotel managers work in Natal/RN - Brazil, This Masters degree dissertation presents the research that aims at analyzing the activities regarding the hotel managers work in Natal / RN - Brazil, performing diagnosis of their activities and relating the aspects that impact the quality and productivity of hotel services and managers occupational health. This research is characterized as a case study with a qualitative approach, taking the method of Ergonomic Work Analysis which is the analysis of the managers work activity as a reference to the focus; and combining the use of observational and interactional methods. Ergonomics and macroergonomics are used in this study not only to understand the physical, cognitive and organizational constraints of the manager s duties, but also to characterize the work organizational architecture and design of that hotel. High workload, accumulation of tasks and diversion of functions performed by managers were noticed, increasing thereby the physical and psychological suffering for them. It was found that the activity of managers is characterized by the ambivalence of power, limited autonomy, cooperation, interdependence between managers and the fear of incompetence. It was also noticed that managers devote more time to the day job (37%), another time to sleep (30%), while only 33% of the rest of the day are meant for activities like taking care of health, family, social life and study. Although there are few studies addressing the health and safety of hotel managers, this research revealed that 84% of the surveyed hotel managers complain of musculoskeletal pain which 50% are obese and are 100% sedentary. It was also observed that managers adopt unsuitable postures for carrying out the work activities that contribute to becoming injured or work-related musculoskeletal disorders in the near future. Ergonomic measures were recommended as an investment in the skills and the training of managers, encouraging cooperative work, appropriateness of workload, limiting overtime, preserving the enjoyment of breaks during work and weekly holidays, changing the layout of the work sector , usage of communication technology to prevent displacement, compensatory physical activities, furniture adaptation, among others

Fatores estressores no ambiente de trabalho docente: uma investigação em uma universidade privada

Currently, it stress it comes negative affecting the life of the people. In this direction, the present dissertação had as purpose to investigate the factors stressor in the environment of teaching work in a private university. For its concretion, bibliographical studies had been carried through, applied questionnaires, which were elaborated in elapsing of this dissertação, and comment of the environment of work of the professors. From the analysis of Spearman, of studies and comments 7 groups of variable had been analyzed, of which three of them if had shown excellent in the sprouting of stress it negative, namely: Environment of Work, characterization of the teaching activity and organization of the time/institucional aspects. From the displayed one, it is observed that the factors most excellent, that influence in the sprouting of stress it negative in the professors are: the imperfections of communication, the wage and the instability how much to horary the load definition attributed to these professionals

Um ambiente de suporte ao trabalho cooperativo com aplicação à telemedicina

This dissertation presents a cooperative virtual multimedia enviroment for employing on time medical Field, using a TCP/IP computer network. The Virtual Diagnosis Room environment make it possible to perform cooperative tasks using classical image processing. Synchronous and assynchronous text conversation (chat) and content markup, in order to produce remote cooperative diagnosis. The dissertation also describes the tool in detail and its functions, that enables the interaction among users, along with implementation detals, contributions and weakness of this work