Acurácia dos indicadores clínicos do diagnóstico de enfermagem volume de líquidos excessivo em pacientes submetidos à hemodiálise

Trasnversal study, with the objective of evaluating the accuracy of clinical indicators of nursing diagnosis excessive fluid volume in patients undergoing hemodialysis. The study occurred in two stages, the first consisted of the evaluation of the diagnostic indicators in study; and the second, the diagnostic inference conducted by nurse diagnosticians. The first stage occurred from december 2012 to april 2013, in a University Hospital and a Hemodialysis Clinic in Northeastern of Brazil, with a sample of 100 chronic renal failure patients on hemodialysis. The data were selected through an interview form and a physical examination, organized into spreadsheets and analyzed as to the presence or absence of the indicators of diagnosis excessive fluid volume. In the second step, the spreadsheets were sent to three nurses diagnosticians, who judged the presence or absence of diagnosis in the clientele searched. This step was conducted from july to september 2013. For analysis of the data, we used descriptive and inferential statistics. In the descriptive analysis, we used measures of central tendency and dispersion. In inferential analysis, we used the tests Chi- square, Fisher and prevalence ratios. The accuracy of the clinical indicators pertaining to the diagnosis were measured as to the specificity, sensitivity, predictive values, likelihood ratios and Diagnostic Odds Ratio. Also developed a logistic regression. The results were organized in tables and discussed with literature. This study was approved by the Ethics Committee in Research of the Federal University of Rio Grande do Norte, with Presentation Certificate for Ethics Appreciation nº 08696212.7.0000.5537. The results revealed that the diagnosis studied was present in 82% of patients. The characteristics with prevalence above 50 % that stood out were: azotemia, decreased hematocrit, electrolyte imbalance, intake exceeds output, anxiety, edema, decreased hemoglobin, oliguria and blood pressure changes. Eight defining characteristics were presented statistically significant association with the nursing diagnosis investigated: pulmonary congestion, intake exceeds output, electrolytes imbalance, jugular vein distension, edema, weight gain over short period of time, agitation and adventitious breath sounds. Among these, the 10 characteristics which showed higher prevalence ratios were: edema and weight gain over short period of time. The features with the highest sensitivity were edema, electrolytes imbalance and intake exceeds output and the standing out with greater specificity were: anasarca, weight gain over short period of time, change in respiratory pattern, adventitious breath sounds, pulmonary congestion, agitation and jugular vein distension. The indicators jugular vein distension, electrolytes imbalance, intake exceeds output, increased central venous pressure and edema, together, were identified in the logistic regression model as the most significant predictors. It is concluded that the identification of accurate clinical indicators allow a good prediction of the nursing diagnosis of excessive fluid volume in patients undergoing hemodialysis in order to assist the nurse in the inference process, which will contribute to the success of patient care. In addition, nurses will consider for diagnostic inference not only his clinical experience, but also scientific evidence of the occurrence of excessive fluid volume, contributing to the control of volemia in these patients

Balanced Scorecard: fatores relevantes de sua implantação na diretoria de mercado de capitais do Banco do Brasil

Este trabalho objetiva determinar que características do corpo funcional da DIMEC (Diretoria de Mercado de Capitais do Banco do Brasil) estão associadas aos principais entraves considerados relevantes pelos funcionários da área durante a implementação do Balanced Scorecard (BSC). Pretende-se salientar como entraves tais como a falta de apoio de Tecnologia de Informação e a falta de hábito dos funcionários em lidar com indicadores não financeiros podem se relacionar com as características de interesse do corpo funcional, tais como nível hierárquico , formação acadêmica e nível de conhecimento da ferramenta BSC , de forma a influenciar na implementação do modelo. Para tanto foi realizada revisão de literatura e estudo de caso no qual figuraram, como instrumentos de coleta de dados, a aplicação de questionários e a entrevista não-estruturada através dos quais funcionários da DIMEC demonstraram as relações entre as variáveis descritas de forma a destacar fatores de relevância para o desenrolar do processo de implantação da ferramenta BSC na referida empresa

Inovação e gestão do conhecimento no setor petrolífero do RN

Este trabalho apresenta um estudo da Gestão do Conhecimento (GC) no sistema petrolífero do Rio Grande do Norte, considerando possíveis inovações resultantes dessa gestão. Inicialmente, foi feita uma abordagem com relação as características do sistema de petróleo e gás do RN, com base em conceitos disponíveis na literatura. Visou atender aos seguintes objetivos: diagnosticar a rede de empresas do setor petrolífero do RN, identificando qual o estágio de GC em que elas se encontram; identificar e avaliar as práticas de GC utilizadas internamente na Petrobras e nas suas interações dentro da aglomeração; caracterizar a ocorrência das relações entre a UFRN (Universidade Federal do Rio Grande do Norte) x Petrobras. Para alcançar tais objetivos foi desenvolvido um formulário baseado em indicadores de GC e na PINTEC2005 (IBGE), o qual foi aplicado em três grupos: PETROBRAS, Fornecedores da PETROBRAS e UFRN. Como resultados obtidos têm-se: uma análise da GC na PETROBRAS, da GC nos Fornecedores e da cooperação para inovação entre os participantes do sistema, sendo apresentado um estudo da parceria para inovação entre a UFRN x PETROBRAS. Conclui-se que o sistema é uma aglomeração e que apresenta características de um Cluster. Conclui-se ainda que a GC na PETROBRAS encontra-se em fase avançada de implantação no âmbito da corporação, e a parceria entre UFRN e Petrobras pode ser utilizada como modelo de sucesso de integração entre empresas e instituições de pesquisa. Ao final são apresentados, em especial, os resultados obtidos com relação à gestão do conhecimento para a inovação na rede de empresas que operam o sistema petrolífero no Rio Grande do Norte, objetivo principal desta dissertação

Análise de desempenho de vendas em telecomunicações utilizando técnicas de mineração de dados

Nowadays, telecommunications is one of the most dynamic and strategic areas in the world. Organizations are always seeking to find new management practices within an ever increasing competitive environment where resources are getting scarce. In this scenario, data obtained from business and corporate processes have even greater importance, although this data is not yet adequately explored. Knowledge Discovery in Databases (KDD) appears then, as an option to allow the study of complex problems in different areas of management. This work proposes both a systematization of KDD activities using concepts from different methodologies, such as CRISP-DM, SEMMA and FAYYAD approaches and a study concerning the viability of multivariate regression analysis models to explain corporative telecommunications sales using performance indicators. Thus, statistical methods were outlined to analyze the effects of such indicators on the behavior of business productivity. According to business and standard statistical analysis, equations were defined and fit to their respective determination coefficients. Tests of hypotheses were also conducted on parameters with the purpose of validating the regression models. The results show that there is a relationship between these development indicators and the amount of sales

A influência da cultura organizacional na adoção de práticas de qualidade Seis Sigma: um estudo exploratório no segmento de farmácia de manipulação do Estado do Rio Grand do Norte

In recent debates about the issues of quality, the theme organizational culture and Six Sigma has appeared ever more frequently. In this context several authors suggest that the adoption of Six Sigma practices is influenced by culture. This work focuses on the relationship of organizational culture and quality to the practices of Six Sigma quality. Thus a descriptive-exploratory and correlational study of forty pharmacies of manipulation from Rio Grande do Norte was undertaken. Data collection identified features of companies and the level of use of the practices of Six Sigma quality that have been identified in the literature. For the Organizational Culture evaluation was used the Competitive Value Model (Cameron & Quinn, 1996), tested on north-American organizations and considered a high value academic and professional instrument. This model has been involved with the taximetrics created by Cameron who classifies quality culture in four levels. The results suggest that the Group and Developmental cultures are associated with higher levels of use of the practices of Six Sigma quality than the Rational and Hierarchical Cultures. Regarding the levels of the culture s quality, the highest levels were most frequently cited in Errors Prevention and Perpetual Improvement and Creativity, being the last one more positively related to the Six Sigma indicators

Responsabilidade social empresarial: modalidades e grau de participação em meios de hospedagem em Ponta Negra, Natal/RN

That work has as objective to investigate and to analyze the strategies which they were developed by companies of lodging means with ends of social responsibility in Rio Grande do Norte (RN). Therefore, it got data along with the Office of Tourism of the Municipal district of Natal , the Office of Tourism of RN and the cadasters of the firms of the lodging means in the district of Ponta Negra. In after research of field, it verified the enterprises that now develop lodging activities in that quarter in Ponta Negra. It applied Instrument of research which it was elaborated based on the set of indicators of social responsibility of Ethos Institute, structured with binary questions and some open ones. It shows as results which actions the investigated companies develop. Confronting these results with researched theoretical referencial, it points an intermediate degree of socially responsible actions. Comparing with the evaluation accomplished by Ethos Institute, the investigated firms are in incipient condition, with punctual actions, however, they already present the awakening about this thematic

Gestão da satisfação e fidelidade do cliente : um estudo dos fatores que influenciam na satisfação e fidelidade dos clientes corporativos de telefonia celular

The competition in the telecommunications industry has grown in Brazil since the privatization, forcing companies that are active in the market to a growing commitment to quality products and services in order to survive. In this context, this work aims to understand the main factors that influence the degree of satisfaction exists in respect of a mobile operator with its corporate customers. The research covered theoretical concepts and analytical models of quality management system and models of indices related to the measurement of customer satisfaction. For the field research was carried out in a practical application of the main approaches based on this thesis by a case study in corporate segment, through a questionnaire applied to 10 consultants and 40 corporate customers of that company. Comparing the results of research with the consultants and corporate clients there is the concern of respondents to the indicators that comprise the constructs of customer satisfaction, commitment calculated, the price index and the handling of complaints, denoting the dissatisfaction of the general assessment for corporate customers with the carrier, against its current expectations. It is concluded that the mobile operator of the telecommunications industry have a big challenge, after ten years of privatization and consequently the period of rapid expansion of customer base and with the depleted, retain corporate customers as highly strategic, thus avoiding that migrate to other companies. We emphasize the need for further research and analysis of different approaches through research and using the same models to specifically evaluate and measure customer satisfaction of mobile enterprise, to adjust the model to the national market. Finally, we suggest the creation of an effective customer loyalty program with a strategy of relationship and specific to the corporate sector of mobile telephony

Balanced Scorecard como ferramenta de avaliação da consistência estratégica: um estudo em instituição de ensino superior privada

This Master of Science Thesis investigates in an exploratory modeling the idea of strategy consistency applying as an assessment tool a model of performance indicators of a higher education institution based on the balanced scorecard (BSC). It is carried on a review of conceptual BSC perspective hierarchy models and of studies on higher education institution in Brazil and worldwide. From a BSC model with three indicators at each perspective is carried on a case study with directors and coordinators of a private higher education institution with a descriptive and multivariate analysis using cluster analysis. The main findings point to a different perception of respondents on the importance level of the perspectives with a higher importance level given to Learning and Growth and Process that to Customer and Financial. Particularly, the financial perspective got a importance level significantly lower that the others, what suggests an inconsistency on the strategy deployment on the institution considered in terms of the perception of the managerial levels of the importance level of the perspectives

Cultura organizacional e desempenho dos colaboradores :um estudo exploratório no setor hoteleiro

This work focuses on the relationship between organizational culture and quality culture in the hotel sector of NATAL/RN with respect to employee performance. The themes organizational culture and quality have been the research focus of administration theorists and a constant concern of professional managers, since the Japanese demonstrated effective forms or western management. In this study, the Competing Values Model (C.V.M.) (Quinn e Cameron, 1996; Quinn, 1998; Santos, 1998, 2000; Teixeira, 2001), which was tested on north-American organizations and considered a high value academic and professional instrument, was applied. The model maps the organizational culture on a profile with four elements: clan, adhocracy, market and hierarchy. The C.V.M., associated with the taximetrics created by Cameron (which classifies quality culture in for levels: status quo, error detection, error prevention and perpetual creative quality) has been related with organizational performance. In this study, these two models are used jointly and tested in the hotel sector. The results indicate that the strongest element of the profile is clan, which is characterized by internal focus, participation and people involvement, followed by the adhocracy element, which has an external focus, emphasizes flexibility and is characterized by dynamic enterprising and creativity. Regarding the level of the culture s quality in the hotel, the highest level, that of perpetual improvement and creativity, which attempts to enchant and to surprise the clients, was most frequently cited, followed by the error detection level, which has as its goal to discover and correct mistakes, trying, consequently, to reduce waste. The results suggest that employee performance as measured on some indicators is related to elements of the organizational culture profile and quality level

Estudo ergonômico do posto de atividade discente em instituição de ensino superior

This research carried through an ergonomic study of the rank of learning activity of a IES, was applied a questionnaire with ergonomic pointers structuralized in scale to intervalar of semantic differential of 0 the 10, in 290 pupils with ages between 18 and 52 years distributed for 5 courses in 9 classrooms, the sample was of the simple random probabilist type. The used statistical techniques had been the descriptive analysis and the analysis of clusters through statistica software 5,0 considering p £ 0,0500. Involving the following 0 variable: Layout; Colors; Acoustics; Illumination; Temperature; Position; Didactic furniture, and Equipment. The gotten results point to consider that the layout of the rooms, the perception of acoustic comfort, the position of the pupils and the furniture of the searched classrooms had been the condicionantes that had been more distinguished negative how much to the perception of comfort of the user. The the 91,5 NPS varied of 57,9 dB(A) values above of recommended for classrooms in accordance with NBR 10152; NR 15; NR 17; It would carry nº 3214/1978, of the Ministry of the Work and searched literature. The Illumination registered interval of 139 the 966 Lux, values are of the limits of interval recommended for classrooms according to NBR 5413 and NR 17. The thermal temperature registered interval of 24° 25,9ºC; URA 41,6 79.1% and the 0.1 air speed 1,0 m/s, values above of recommended for classrooms according to NBR the 6401 and NR 17. The research still suggests that it would have associations between pains in the body the positions of the pupils and the furniture of the classrooms. The results suggest research especially add for the conditions thermal and acoustics of the classrooms

Os princípios da organização focada na estratégia: um estudo em empresas vencedoras do prêmio nacional de qualidade

The Balanced Scorecard (BSC) has been used as a communication tool and strategy monitoring, helping organizations alignment, inserting a new vision with integrated use of performance indicators nonfinancial together with some financial measures. Their proper use leads to a new management style, focused on management strategies, using for this, basically three dimensions: strategy, which should be translated as the primary responsibility for the organizational agenda, the focus that should be concentrated, and the organization with the mobilization of employees. This paper deals with theoretical considerations about strategies, strategic planning, BSC and principles of the organization focused on strategy (OFE). Describes a study of four companies that won the National Quality Award - PNQ, among which, three have adopted the BSC and adopts a particular model of strategic management. The research aimed to make an analysis of the companies regarding adherence to the five principles of OFE, proposed by the BSC, seeking to answer whether the use of BSC is a prerequisite for accession to the Principles of OFE. The results showed that the BSC is a strategic management model that promotes focus and organizational alignment and is a major facilitator in the process, however, cannot be considered a prerequisite for accession to the principles of the OFE, because the four companies studied, including the one that adopt its own model of strategic management, have great levels of adherence to such principles. Making the organization focused on strategy can be considered a natural movement essential for the strategic management, which is not necessarily conditioned by the use of BSC

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

Proposta de um modelo de medição e avaliação de desempenho como ferramenta de gest ão - um estudo de caso num órgão público

The public sector performance has received much attention in the literature and due to that the purpose of this work is to develop a proposal for a model of performance measurement for a higher education institution unit. First, we performed a theoretical research on public organizations and private institutions of higher education, followed by a literature review on performance measurement and evaluation. This review presents some performance models that are quite frequent in the literature: Total Quality Management (Total Quality Management) - TQM and the PDCA cycle, SMART System, Balanced Scorecard and Môdef Ouanturn. In order to verify the possibility of implementing a performance measurement model for Higher Education Institutions, it was conducted a case study in a support unit of a University, located in the city of Natal, RN, Brazil. The study attempted to identify the key processes of the unit and proposed by the use of Quantum model in order to improve the management and operation of the same. The work aims to contribute to the advancement of knowledge in measurement and performance evaluation in higher education institutions that where still lacks scientific production of this subject compared to other areas. This study also identifies better practices and opportunities for improvement in processes to determine the expected performance indicators to aid a decision-making unit.

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

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