Motivacoes, contradicoes e ambiguidades na lideranca de enfermeiros em cargo de chefia num hospital universitario

OBJETIVO: analizar las contradicciones y ambigüedades que permean la motivación de enfermeros para el ejercicio del liderazgo en cargo de jefatura, en un hospital universitario. MÉTODO: aproximación cualitativa, exploratorio-descriptiva, totalizando 33 entrevistas semiestructuradas, sometidas al análisis temático. RESULTADOS: las informaciones convergieron para cinco categorías: Motivación para asumir cargo de jefatura; La mirada de las jefaturas de enfermería sobre el ejercicio del liderazgo; El aspecto emblemático de trabajar con las personas; Liderazgo en enfermería - mediadora y conciliadora; El tiempo: un dilema entre administrar y asistir. CONCLUSIÓN: liderar personas ora es un gran estímulo, ora un aspecto dificultador, ante los matices del trabajo en equipo y la complejidad del contexto en el que se construye ese proceso. Además, las actitudes conciliadoras y de mediación se mostraron fundamentales para un clima organizacional sano y productivo. Sin embargo, la falta de tiempo fue indicada como un dilema entre administrar y asistir.OBJETIVO: analisar as contradições e ambiguidades que perpassam a motivação de enfermeiros para o exercício da liderança em cargo de chefia, em um hospital universitário. MÉTODO: abordagem qualitativa, exploratório-descritiva, totalizando 33 entrevistas semiestruturadas, submetidas à análise temática. RESULTADOS: as informações convergiram para cinco categorias: motivação para assumir cargo de chefia; o olhar das chefias de enfermagem sobre o exercício da liderança; a face emblemática de trabalhar com as pessoas; liderança em enfermagem - mediadora e conciliadora, e o tempo: um dilema entre gerenciar e assistir. CONCLUSÃO: liderar pessoas ora é um grande estímulo ora se torna um aspecto dificultador, tendo em vista as nuances do trabalho em equipe e a complexidade do contexto no qual se constrói esse processo. Além disso, as atitudes conciliadoras e de mediação mostraram-se primordiais para um clima organizacional saudável e produtivo, no entanto, a falta de tempo foi apontada como um dilema entre gerenciar e assistir.OBJECTIVE: to analyze the contradictions and ambiguities which permeate nurses' motivation for exercising leadership in management positions, in a university hospital. METHOD: this study has a qualitative approach and is exploratory and descriptive, and used a total of 33 semi-structured interviews which were submitted to thematic analysis. RESULTS: the information converged on five categories: Motivation to take on a management position; The view of nursing managers on the exercising of leadership; The emblematic aspect of working with people; Leadership in nursing - mediatory and conciliatory; Time: a dilemma between managing and caring. CONCLUSION: leading people can be both a great encouragement, and an impeding aspect, bearing in mind the nuances of teamwork and the complexity of the context in which this process is constructed. In addition to this, conciliatory and mediatory attitudes are shown to be fundamental for a healthy and productive organizational atmosphere; however, the lack of time was indicated as a dilemma between managing and caring

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Discutindo a educação ambiental no cotidiano escolar: desenvolvimento de projetos na escola formação inicial e continuada de professores

A presente pesquisa buscou discutir como a Educação Ambiental (EA) vem sendo trabalhada, no Ensino Fundamental e como os docentes desta escola compreendem e vem inserindo a EA no cotidiano escolar., em uma escola estadual do município de Tangará da Serra/MT, Brasil. Para tanto, realizou-se entrevistas com os professores que fazem parte de um projeto interdisciplinar de EA na escola pesquisada. Verificou-se que o projeto da escola não vem conseguindo alcançar os objetivos propostos por: desconhecimento do mesmo, pelos professores; formação deficiente dos professores, não entendimento da EA como processo de ensino-aprendizagem, falta de recursos didáticos, planejamento inadequado das atividades. A partir dessa constatação, procurou-se debater a impossibilidade de tratar do tema fora do trabalho interdisciplinar, bem como, e principalmente, a importância de um estudo mais aprofundado de EA, vinculando teoria e prática, tanto na formação docente, como em projetos escolares, a fim de fugir do tradicional vínculo “EA e ecologia, lixo e horta”.Facultad de Humanidades y Ciencias de la Educació

Construção e implantação de indicadores de qualidade assistencial de enfermagem

The present study aims to report the experience at a university hospital – Hospital de Clínicas de Porto Alegre (HCPA) – with the construction and implementation of quality indicators in nursing services. The indicators monitor the quality of services and improve the attention offered (to the patients). HCPA has been developing strategies to assess its services according to its institutional management policy of quality. In 2006 were established four indicators: pressure ulcer incidence, with its goal of < 10:1000 patients day/month, the incidence of bed falls which goal was established as < 2:1000 patients day/month. Regarding a very big hospital, our challenge was to build and implement these indicators as management tools to assess the quality of nursing services.El presente estudio tiene por objetivo relatar la experiencia de un hospital universitario - el Hospital de Clínicas de Porto Alegre (HCPA) - con la construcción y implantación de indicadores de calidad asistencial en los servicios de enfermería. Los indicadores monitorean la calidad de los servicios, posibilitando la mejoría del cuidado ofrecido. El HCPA viene desarrollando estrategias para evaluar sus servicios, considerando su política institucional de gestión por la calidad. En 2006, se establecieron 2 indicadores: incidencia de úlcera por presión, con objetivo de < 10:1000 pacientes día/mes; incidencia de caídas del lecho, cuya meta se estableció en < 2:1000 pacientes día/mes. Al tratarse de un hospital de gran porte, nuestro desafío fue construir e implantar esos indicadores como herramientas de gestión para verificar la calidad del cuidado de enfermería.O presente estudo tem por objetivo relatar a experiência de um hospital universitário – Hospital de Clínicas de Porto Alegre (HCPA) – com a construção e implantação de indicadores de qualidade assistencial nos serviços de enfermagem. Os indicadores monitoram a qualidade dos serviços, possibilitando a melhoria do cuidado oferecido. O HCPA vem desenvolvendo estratégias para avaliar seus serviços, considerando sua política institucional de gestão pela qualidade. Em 2006 foram estabelecidos 2 indicadores: incidência de úlcera de pressão, com meta de ?10:1000 pacientes dia/mês e incidência de quedas do leito, cuja meta foi estabelecida em ?2:1000 pacientes dia/mês. Em se tratando de um hospital de grande porte, nosso desafio foi construir e implantar esses indicadores como ferramentas gerenciais para aferir a qualidade do cuidado de enfermagem

Construção e implantação de indicadores de qualidade assistencial de enfermagem

The present study aims to report the experience at a university hospital – Hospital de Clínicas de Porto Alegre (HCPA) – with the construction and implementation of quality indicators in nursing services. The indicators monitor the quality of services and improve the attention offered (to the patients). HCPA has been developing strategies to assess its services according to its institutional management policy of quality. In 2006 were established four indicators: pressure ulcer incidence, with its goal of < 10:1000 patients day/month, the incidence of bed falls which goal was established as < 2:1000 patients day/month. Regarding a very big hospital, our challenge was to build and implement these indicators as management tools to assess the quality of nursing services.El presente estudio tiene por objetivo relatar la experiencia de un hospital universitario - el Hospital de Clínicas de Porto Alegre (HCPA) - con la construcción y implantación de indicadores de calidad asistencial en los servicios de enfermería. Los indicadores monitorean la calidad de los servicios, posibilitando la mejoría del cuidado ofrecido. El HCPA viene desarrollando estrategias para evaluar sus servicios, considerando su política institucional de gestión por la calidad. En 2006, se establecieron 2 indicadores: incidencia de úlcera por presión, con objetivo de < 10:1000 pacientes día/mes; incidencia de caídas del lecho, cuya meta se estableció en < 2:1000 pacientes día/mes. Al tratarse de un hospital de gran porte, nuestro desafío fue construir e implantar esos indicadores como herramientas de gestión para verificar la calidad del cuidado de enfermería.O presente estudo tem por objetivo relatar a experiência de um hospital universitário – Hospital de Clínicas de Porto Alegre (HCPA) – com a construção e implantação de indicadores de qualidade assistencial nos serviços de enfermagem. Os indicadores monitoram a qualidade dos serviços, possibilitando a melhoria do cuidado oferecido. O HCPA vem desenvolvendo estratégias para avaliar seus serviços, considerando sua política institucional de gestão pela qualidade. Em 2006 foram estabelecidos 2 indicadores: incidência de úlcera de pressão, com meta de ?10:1000 pacientes dia/mês e incidência de quedas do leito, cuja meta foi estabelecida em ?2:1000 pacientes dia/mês. Em se tratando de um hospital de grande porte, nosso desafio foi construir e implantar esses indicadores como ferramentas gerenciais para aferir a qualidade do cuidado de enfermagem

Motivations, contradictions and ambiguities in the leadership of nurses in management positions in a university hospital

OBJECTIVE: to analyze the contradictions and ambiguities which permeate nurses' motivation for exercising leadership in management positions, in a university hospital. METHOD: this study has a qualitative approach and is exploratory and descriptive, and used a total of 33 semi-structured interviews which were submitted to thematic analysis. RESULTS: the information converged on five categories: Motivation to take on a management position; The view of nursing managers on the exercising of leadership; The emblematic aspect of working with people; Leadership in nursing - mediatory and conciliatory; Time: a dilemma between managing and caring. CONCLUSION: leading people can be both a great encouragement, and an impeding aspect, bearing in mind the nuances of teamwork and the complexity of the context in which this process is constructed. In addition to this, conciliatory and mediatory attitudes are shown to be fundamental for a healthy and productive organizational atmosphere; however, the lack of time was indicated as a dilemma between managing and caring

Depoimentos de profissionais de saúde sobre sua vivência em situação de tragédia: sob o olhar da Política Nacional de Humanização (PNH)

O estudo apresenta pr&#225;ticas humanizadoras institu&#237;das em um hospital p&#250;blico no atendimento &#224;s v&#237;timas da trag&#233;dia de Santa Maria, RS, Brasil. O relato de experi&#234;ncia foi constru&#237;do por interm&#233;dio de depoimentos dos trabalhadores envolvidos no acolhimento dos familiares de v&#237;timas da trag&#233;dia. A articula&#231;&#227;o e parcerias entre os diferentes servi&#231;os da institui&#231;&#227;o; o acionamento de Protocolos de Cat&#225;strofes; a cria&#231;&#227;o de espa&#231;o de escuta, reordena&#231;&#227;o de fluxos e processos assistenciais foram pr&#225;ticas adotadas para exercer trocas solid&#225;rias empenhadas na produ&#231;&#227;o de sa&#250;de. Apontamos, por meio das diretrizes da Pol&#237;tica Nacional de Humaniza&#231;&#227;o (PNH), os mecanismos utilizados e como se produziu, nesse hospital, o acolhimento &#224;s vitimas da cat&#225;strofe. A experi&#234;ncia de cont&#225;gio da PNH desenvolvida na institui&#231;&#227;o, na l&#243;gica do apoio institucional, possibilitou interven&#231;&#245;es e novos modos de trabalho adaptados ao contexto e alinhados &#224; proposta da humaniza&#231;&#227;o na aten&#231;&#227;o/gest&#227;o em sa&#250;de

Motivations, contradictions and ambiguities in the leadership of nurses in management positions in a university hospital

OBJECTIVE: to analyze the contradictions and ambiguities which permeate nurses' motivation for exercising leadership in management positions, in a university hospital. METHOD: this study has a qualitative approach and is exploratory and descriptive, and used a total of 33 semi-structured interviews which were submitted to thematic analysis. RESULTS: the information converged on five categories: Motivation to take on a management position; The view of nursing managers on the exercising of leadership; The emblematic aspect of working with people; Leadership in nursing - mediatory and conciliatory; Time: a dilemma between managing and caring. CONCLUSION: leading people can be both a great encouragement, and an impeding aspect, bearing in mind the nuances of teamwork and the complexity of the context in which this process is constructed. In addition to this, conciliatory and mediatory attitudes are shown to be fundamental for a healthy and productive organizational atmosphere; however, the lack of time was indicated as a dilemma between managing and caring

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine