Nurses' perception regarding the implementation of computer-based clinical nursing documentation

This qualitative, exploratory, descriptive study was performed with the objective of understanding the perception of the nurses working in medical-surgical units of a university hospital, regarding the strategies developed to perform a pilot test of the PROCEnf-USP electronic system, with the purpose of computerizing clinical nursing documentation. Eleven nurses of a theoretical-practical training program were interviewed and the obtained data were analyzed using the Content Analysis Technique. The following categories were discussed based on the references of participative management and planned changes: favorable aspects for the implementation; unfavorable aspects for the implementation; and expectations regarding the implementation. According to the nurses' perceptions, the preliminary use of the electronic system allowed them to show their potential and to propose improvements, encouraging them to become partners of the group manager in the dissemination to other nurses of the institution.Este estudio cualitativo y exploratorio-descriptivo busca comprender la percepción de enfermeras de unidades clínico-quirúrgicas de un hospital universitario referente a las estrategias desarrolladas para el testeo piloto del sistema digital PROCEnf-USP, apuntando a la informatización de la documentación clínica de enfermería. Once enfermeras participantes de un programa de capacitación teórico-práctico fueron entrevistadas y los datos obtenidos se analizaron mediante la Técnica de Análisis de Contenido. Las categorías aspectos favorables a la implementación; aspectos desfavorables a la implementación y expectativas en la implementación fueron discutidas en la perspectiva de los referenciales de administración participativa y de cambio planificado. Según la percepción de estas enfermeras, el uso preliminar del sistema digital les permitió evidenciar sus potencialidades y proponer mejoras, lo que las incentivó a asociarse al grupo gestor en la divulgación junto al resto de los enfermeros de la institución.Este estudo qualitativo e exploratório-descritivo busca compreender a percepção de enfermeiras de unidades clínico-cirúrgicas de um hospital universitário referente às estratégias desenvolvidas para o teste piloto do sistema eletrônico PROCEnf-USP, visando à informatização da documentação clínica de enfermagem. Onze enfermeiras participantes de um programa de capacitação teórico-prático foram entrevistadas e os dados obtidos foram analisados por meio da Técnica de Análise de Conteúdo. As categorias aspectos favoráveis à implementação; aspectos desfavoráveis à implementação e expectativas na implementação foram discutidas na perspectiva dos referenciais da administração participativa e da mudança planejada. Com base na percepção das enfermeiras, o uso preliminar do sistema eletrônico lhes possibilitou evidenciar suas potencialidades e propor melhorias, o que as incentivou a tornarem-se parceiras do grupo gestor na divulgação junto aos demais enfermeiros da instituição

NURSES' PERCEPTION REGARDING THE IMPLEMENTATION OF COMPUTER-BASED CLINICAL NURSING DOCUMENTATION

This qualitative, exploratory, descriptive study was performed with the objective of understanding the perception of the nurses working in medical-surgical units of a university hospital, regarding the strategies developed to perform a pilot test of the PROCEnf-USP electronic system, with the purpose of computerizing clinical nursing documentation. Eleven nurses of a theoretical-practical training program were interviewed and the obtained data were analyzed using the Content Analysis Technique. The following categories were discussed based on the references of participative management and planned changes: favorable aspects for the implementation; unfavorable aspects for the implementation; and expectations regarding the implementation. According to the nurses' perceptions, the preliminary use of the electronic system allowed them to show their potential and to propose improvements, encouraging them to become partners of the group manager in the dissemination to other nurses of the institution

Custo total com pessoal para implementação de um sistema de apoio à decisão em enfermagem

OBJECTIVE: to identify the direct labor (DL) costs to put in practice a decision support system (DSS) in nursing at the University Hospital of the University of São Paulo (HU-USP). METHOD: the development of the DSS was mapped in four sub-processes: Conception, Elaboration, Construction and Transition. To calculate the DL, the baseline salary per professional category was added to the five-year additional remuneration, representation fees and social charges, and then divided by the number of hours contracted, resulting in the hour wage/professional, which was multiplied by the time spend on each activity in the sub-processes. RESULTS: the DL cost corresponded to R$752,618.56 (100$ 26,000.00 (3.45%) of which were funded by a funding agency, while R$726,618.56 (96,55$ 752.618,56 (100%), siendo R$26.000.00 (3,45$ 726.618,56 (96,55%) de recursos del Hospital y de la Universidad. CONCLUSIÓN: del costo total con MOD, 72,1% se refirió a los honorarios de los profesionales de empresa de consultoría en informática y 27,9% se destinó a la MOD de profesionales del HU y de la Escuela de Enfermería.OBJETIVO: identificar os custos com mão de obra direta para a implementação de um sistema de apoio a decisão em enfermagem no Hospital Universitário da Universidade de São Paulo. MÉTODO: o desenvolvimento do sistema de apoio à decisão foi mapeado em quatro subprocessos: concepção, elaboração, construção e transição. Calculou-se a mão de obra direta utilizando-se a somatória do salário-base, por categoria profissional, mais os quinquênios, verbas de representação e encargos sociais, dividindo-os pelo número de horas contratuais, obtendo-se o salário-hora/profissional que foi multiplicado pelo tempo despendido em cada atividade dos subprocessos. RESULTADOS: o custo da mão de obra direta correspondeu a R$752.618,56 (100$26.000.00 (3,45%) procedentes de financiamento de órgão de fomento e R$726.618,56 (96,55%) de recursos do Hospital e da Universidade. CONCLUSÃO: do custo total com mão de obra direta, 72,1% referiu-se aos honorários dos profissionais de empresa de consultoria em informática e 27,9% destinou-se à mão de obra direta de profissionais do Hospital Universitário e da Escola de Enfermagem

NOVOS DIREITOS E O ATIVISMO JUDICIAL NO BRASIL: UMA REFLEXÃO A PARTIR DO OLHAR CRÍTICO DE ENRIQUE DUSSEL

Apresenta a proposta de Enrique Dussel relativa ao surgimento e reconhecimento dos novos direitos fundamentais. Analisa a judicialização do direito, como ferramenta político-jurídica de efetivação de novos direitos e, por fim, discute vieses do ativismo judicial, face mais complexa da atuação recente dos tribunais brasileiros. As lutas sociais têm transposto as ruas e passaram a ser travadas nas pautas de julgamento dos Tribunais. Os precedentes destas cortes têm se convertido em essencialidade do direito vigente, com legitimidade outorgada pelas instituições e justificada pela necessidade de conferir efetividade e concretização aos direitos fundamentais

Efecto del riego deficitario sobre la producción de Tiftón 85

Deficit irrigation consists of application of amounts of water less than plant requirements for satisfying water deficiencies of the crop, and this may maximize efficiency of water use. The aim of this study was to evaluate the effect of deficit irrigation on production of Tifton 85 grass. The experiment was carried out on the Santa Helena Farm in the municipality of Bom Despacho, MG, Brazil. Five levels of irrigation were used as treatments (28%, 42%, 57%, 71%, and 85% of the crop coefficient value) in randomized blocks with three replications. The following variables were evaluated: dry matter production (kg ha-1), leaf/stem ratio, height (cm), dead plant material (%), leaf area index, leaf area ratio (m2 kg-1), leaf weight ratio (kg kg-1), and specific leaf area (m2 kg-1). A difference was observed for Tifton 85 production in which the greatest average yield (6126.35 kg ha-1) was obtained through application of 71% Kc. For the other characteristics, there was no difference for any of the variables evaluated.El riego deficitario consiste en la aplicación de láminas inferiores a las necesarias para satisfacer las deficiencias hídricas de un cultivo, además que puede maximizar la eficiencia en el uso del agua. El objetivo de este trabajo fue estudiar el efecto del riego deficitario en la producción del cultivo Tifton 85. El experimento fue realizado en la Hacienda Santa Helena situada en el municipio de Bom Despacho, Minas Gerais (MG) Brasil. Los tratamientos utilizados fueron: cinco láminas de riego (28%, 42%, 57%, 71% y 85% del valor de coeficiente de cultivo) en bloques aleatorios con tres repeticiones. Fueron evaluadas las siguientes variables: producción de materia seca (kg ha-1), relación hoja/altura, altura (cm), materia muerta (%), índice de área foliar, relación de área foliar (m2 kg-1), relación de peso foliar (kg kg-1) y área foliar especifica (m2 kg-1). Se observó una diferencia en la producción de Tifton 85, donde el mayor promedio de producción (6126.35 kg ha-1) se obtuvo con la aplicación de las láminas 71% Kc. Para las demás características no hubo diferencia en ninguna de las variables estudiadas.Fil: Silva, Anita Cristina Costa da.Fil: Lima, Luiz Antonio.Fil: Almeida, Willian Fernandes de.Fil: Thebaldi, Michael Silveira.Fil: Silva, Antônio Carlos da

Cost of nursing staffing adequacy in a neonatal unit

The objectives of this descriptive, quantitative study were: to identify the mean nursing care time provided and required by newborns (NB) hospitalized at the Neonatal Unit of the University of São Paulo University Hospital; to calculate the cost of the mean nursing care time provided and required, by NB; to assess the cost of the nursing staffing adequacy required to assist the NB. The mean nursing care times, provided by the nursing staff and required by NBs, were calculated using equations available in the literature and by applying the Nursing Activities Score. The costs of the mean nursing care times and to make nursing staffing adequate were calculated based on the hourly cost of nurses and nursing technicians. The financial impact of nursing staffing adequacy accounted for a 30% increase over the cost of the current situation.Este estudio descriptivo cuantitativo objetivó identificar el tiempo promedio de atención de enfermería dispensado y requerido por Recién Nacidos (RN) internados en Unidad Neonatal de Hospital Universitario de Universidad de São Paulo; calcular costo de tiempo promedio de atención de enfermería dispensado y requerido por RN, verificar monto financiero de adecuación del cuadro de profesionales de enfermería requerido para atender a RN. Los tiempos promedio de atención dispensados por el equipo y requeridos por los RN fueron calculados mediante ecuaciones disponibles en literatura y aplicación del Nursing Activities Score. El costo de tiempos promedio de atención y monto financiero de adecuación del cuadro de profesionales se calculó con base en costo/hora de enfermeros y técnicos de enfermería. El impacto financiero de adecuación cuantitativa de profesionales de enfermería correspondió a un incremento de 30% sobre el costo del cuadro existente.Este estudo descritivo, de natureza quantitativa, visou: identificar o tempo médio de assistência de enfermagem despendido e requerido pelos Recém-Nascidos (RN) internados na Unidade Neonatal do Hospital Universitário da Universidade de São Paulo; calcular o custo do tempo médio de assistência de enfermagem despendido e requerido por RN; verificar o montante financeiro da adequação do quadro de profissionais de enfermagem requerido para assistir os RN. O tempo médio de assistência despendido pela equipe de enfermagem e requerido pelos RN foi calculado por meio de equações disponíveis na literatura e aplicação do Nursing Activities Score. O custo do tempo médio de assistência e do montante financeiro da adequação do quadro de profissionais foi calculado com base no custo/hora dos enfermeiros e dos técnicos de enfermagem. O impacto financeiro da adequação quantitativa de profissionais de enfermagem correspondeu a um acréscimo de 30% no custo do quadro existente

STANDARDIZATION OF ACTIVITIES IN AN ONCOLOGY SURGICAL CENTER ACCORDING TO NURSING INTERVENTION CLASSIFICATION

Este estudo teve como objetivos identificar em um centro cirúrgico especializado em oncologia, as atividades de enfermagem realizadas no período transoperatório, classificar e validar as atividades em intervenções, segundo a Classificação das Intervenções de Enfermagem (NIC). O levantamento das atividades foi realizado por meio dos registros e da observação direta da assistência de enfermagem, nos quatro turnos de trabalho. As atividades foram classificadas em intervenções de enfermagem da NIC utilizando-se a técnica mapeamento cruzado. O elenco de intervenções foi validado por profissionais de enfermagem, em oficinas de trabalho. Identificaram-se 49 intervenções: 34 de cuidados diretos e 15 de cuidados indiretos. O reconhecimento das intervenções de enfermagem permite medir o tempo despendido na sua execução, variável fundamental para quantificar e qualificar a carga de trabalho dos profissionais de enfermagem.This study was undertaken in a surgical center specializing in oncology, and it aimed to identify nursing activities performed during the perioperative period and to classify and validate intervention activities according to the Nursing Interventions Classification (NIC). A survey of activities was conducted using records and by direct observation of nursing care across four shifts. Activities were classified as NIC nursing interventions using the cross-mapping technique. The list of interventions was validated by nursing professionals in workshops. Forty-nine interventions were identified: 34 of direct care and 15 of indirect care. Identifying nursing interventions facilitates measuring the time spent in their execution, which is a fundamental variable in the quantification and qualification of nurses' workloads.Este estudio tuvo como objetivos identificar en un centro quirúrgico especializado en oncología las actividades de enfermería realizadas en el periodo perioperatorio; clasificar y validar las actividades de las intervenciones según la Clasificación de Intervenciones de Enfermería (NIC). El relevamiento de las actividades se hizo a través de los registros y de la observación directa de los cuidados de enfermería en los cuatro turnos de trabajo. Las actividades fueron clasificadas como intervenciones de enfermería, de acuerdo con la NIC, y se utilizó técnica de mapeo cruzado. El conjunto de intervenciones fue validado por profesionales de enfermería en talleres de actividades. Se identificaron 49 intervenciones: 34 intervenciones de cuidados directos, 15 intervenciones de cuidados indirectos. El reconocimiento de las intervenciones de enfermería permite medir el tiempo empleado en su ejecución, variable fundamental para cuantificar y calificar la carga de trabajo del personal de enfermería

Investigating the relation between self-assessment and patients' assessments of physicians-in-training empathy: a multicentric, observational, cross-sectional study in three teaching hospitals in Brazil

This study investigated the associations between self-assessed empathy levels by physicians in training and empathy levels as perceived by their patients after clinical encounters. The authors also examined whether patient assessments were valid and reliable tools to measure empathy in physicians in training. Objectives This study investigated the associations between self-assessed empathy levels by physicians in training and empathy levels as perceived by their patients after clinical encounters. The authors also examined whether patient assessments were valid and reliable tools to measure empathy in physicians in training. Design A multicentric, observational, cross-sectional study. Setting This study was conducted in three public teaching hospitals in Brazil. Participants From the 668 patients invited to participate in this research, 566 (84.7%) agreed. Of these, 238 (42%) were male and 328 (58%) were female. From the invited 112 physicians in training, 86 (76.8%) agreed. Of the 86 physicians in training, 35 (41%) were final-year medical students and 51 (59%) were residents from clinical and surgical specialties. The gender distribution was 39 (45%) males and 47 (51%) females. Primary and secondary outcome measures Physicians in training filled the Jefferson Scale of Physician Empathy (JSE) and the Interpersonal Reactivity Index. Patients answered the Jefferson Scale of Patient’s Perceptions of Physician Empathy (JSPPPE) and the Consultation and Relational Empathy Scale (CARE). Results This study found non-significant correlations between patient and physicians-in-training self-assessments, except for a weak correlation (0.241, p<0.01) between the JSPPPE score and the JSE compassionate care subscore. CARE and JSPPPE scales proved to be valid and reliable instruments. Conclusions Physicians-in-training self-assessments of empathy differ from patient assessments. Knowledge about empathy derived from self-assessment studies probably does not capture the perspective of the patients, who are key stakeholders in patient-centred care. Future research on the development of physician empathy or on outcomes of educational interventions to foster empathy should include patient perspectives.Fundação de Amparo à Pesquisa do Estado de São Paulo - FAPESP' (grant number: 2016/11908-1) and by the ’Conselho Nacional de Desenvolvimento Científico e Tecnológico - CNPq' (grant number: 202319/2017-2

Costs of most frequent nursing activities in highly dependent hospitalized patients

This quantitative study aimed to identify the costs of the most frequent nursing activities in highly dependent hospitalized patients at a medical clinic. The non-probabilistic convenience sample corresponded to 607 observations regarding oral feeding activities (OF), blood pressure verification (BP)/heart rate (HR), body temperature checking (BTC), performance of intimate hygiene and management of feeding probe. The costs identified corresponded to R$2.40 (SD+/-2.64) for OF feeding; R$1.26 (SD+/-0.48) to verify the BP/HR; R$1.17 (SD+/-0.46) for BTC; R$15.59 (SD+/-8.62) to perform intimate hygiene and R$5.95 (SD+/-2.13) for management of feeding probe. This study will facilitate cost management, with a view to avoiding waste related to unnecessary resource consumption and establish a correlation between costs and care delivery results. Supported by Pro-Reitoria de Pesquisa, Universidade de Sao Paulo, Brazil.Pro-Reitoria de Pesquisa, Universidade de Sao Paulo, BrazilProReitoria de Pesquisa, Universidade de Sao Paulo, Brazi