Cultura de segurança do doente no bloco operatório: subsídios para a qualidade dos cuidados de saúde

Dissertação de Mestrado em Enfermagem Médico-Cirúrgica apresentada na Escola Superior de Saúde do Instituto Politécnico de Viana do CasteloA cultura de segurança do doente é um requisito essencial à qualidade dos cuidados de saúde e está relacionada com as atitudes, crenças, valores e premissas que influenciam a forma como os profissionais percebem e agem sobre as questões de segurança de uma organização. Um baixo índice de cultura de segurança do doente pode levar à ocorrência de eventos adversos potencialmente evitáveis, resultando na descrença das organizações e dos profissionais de saúde, além de representarem um pesado ónus social e económico. A Organização Mundial de Saúde e a União Europeia recomendam que o ciclo de melhoria contínua da qualidade passe pela avaliação da cultura de segurança do doente através da identificação, avaliação e hierarquização dos riscos, promovendo ações de melhoria nas áreas problemáticas. O objetivo desta investigação passou pela análise dos fatores associados da perceção dos profissionais de saúde, que exercem funções no bloco operatório, relativamente à cultura de segurança do doente neste serviço. Foi efetuado um estudo de abordagem quantitativa, descritivo-correlacional e transversal, onde se aplicou a versão portuguesa do Hospital Survey on Patient Safety Culture a uma amostra de 113 profissionais de saúde de um hospital da região Norte do Serviço Nacional de Saúde. A análise dos resultados seguiu a metodologia dos autores da versão original do instrumento de colheita de dados. Observou-se que a dimensão com maior número de respostas positivas foi o Trabalho em equipa dentro das unidades (64,38%). Nas dimensões Transições, Abertura da comunicação, Trabalho em equipa entre unidades, o número de respostas positivas situou-se entre os 40-50%. Com valores intermédios (20-30%) encontraram-se as dimensões Expetativas do supervisor/gestor e ações que promovam a segurança do doente, Perceção geral da segurança do doente, Aprendizagem organizacional – melhoria contínua, Resposta não punitiva ao erro, Dotação de profissionais, Comunicação e feedback acerca do erro e Apoio da gestão hospitalar para a segurança do doente. A dimensão com valor mais baixo de respostas positivas foi a Frequência da notificação de eventos/ocorrências com 12,98%. Em síntese, os resultados sugerem uma cultura de segurança do doente problemática em várias dimensões, com grande potencial de melhoria. Este estudo pretende dar o contributo da investigação à melhoria contínua da prestação de cuidados e ao desenvolvimento da profissão de enfermagem, sustentando a sua praxis numa tomada de decisão científica, técnica e eticamente fundamentada.The patient's safety culture is an essential requirement for the quality of health care and is related to the attitudes, beliefs, values and assumptions that influence the way professionals perceive and act on the security issues of an organization. A low patient safety culture index can lead to potentially avoidable adverse events resulting in disbelief of organizations and healthcare professionals, as well as a heavy social and economic burden. The World Health Organization and the European Union recommend that the cycle of continuous quality improvement should include assessing the patient safety culture by identifying, assessing and prioritizing risks and promoting actions to improve problematic areas. The aim of this investigation was to analyze the factors related to the perception of health professionals, who perform functions in the operating room, regarding the patient’s safety culture in this service. A quantitative, descriptive-correlational and cross-sectional study was carried out, where the Portuguese version of the Hospital Survey on Patient Safety Culture was applied to a sample of 113 health professionals from a hospital in the northern region of the National Health Service. The analysis of the results followed the methodology of the authors of the original version of the data collection instrument. The dimension with the highest number of positive responses was Teamwork within units (64.38%). In the Transitions, Communication Openness, Teamwork between units dimensions, the number of positive responses was between 40-50%. With intermediate values (20-30%) the dimensions Expectations of supervisor/manager and actions that promote patient safety, General perception of patient safety, Organizational learning - continuous improvement, Non-punitive error response, Staffing, Communication and feedback about the error and Hospital management support for patient safety were found. The dimension with the lowest value of positive responses was the Frequency of notification of events/occurrences with 12.98%. In summary, the results suggest a problematic patient safety culture in various dimensions with great potential for improvement. This study aims to make the contribution of research to the continuous improvement of care delivery and the development of the nursing profession, supporting its praxis in a scientific, technical and ethically grounded decision making

Digital technologies review for manufacturing processes

It is apparent the industrial processes transformations caused by industry 4.0 are in advance in some countries like China, Japan, Germany and United States. But, in return, the developing countries, as the emergent Brazil, seem like to have a long way to achieve digital era. Considering manufacturing processes as the starting point the rise of industry 4.0, this research aims to show a review about the most important technologies used in smart manufacturing, including the main challenges to implement it at Brazil. The papers were collected from Web of Science (WoS), comprising 114 articles and 2 books to underpin this study. This exploratory research resulted in the presentation of some challenges faced by Brazilian industry to join the new industrial era, such as poor technological infrastructure, besides lack of investment in technologies and training of qualified people. Even though the primary motivation of this research was to present a panorama of smart manufacturing for Brazil, this study results contributes to the most of emergent countries, bringing together general concepts and addressing practical applications developed by several researchers from the international academic community

Transformation of Plastic Waste into Fuel by Pyrolysis

Given the scenario of difficulty of equalizing treatment and disposal costs, environmental risks and reduction of mass and volume of waste, the pyrolysis process presents itself as a promising option of heat treatment for the most varied types of waste. The present work aims to enable the transformation of plastic waste into combustion engine fuels. And specifically, perform the pyrolysis process for fuel generation through plastic waste, and describe the benefits generated by the transformation process. The methodology used is the case study, with qualitative approach. To obtain the fuel, it was necessary to use equipment that can degrade the plastic waste by heating it, being possible with the use of a pyrolysis oven. Heating the plastic residue inside the oven without the presence of oxygen causes the residue to melt without burning, releasing vapors, which upon exiting the heating chamber and finding the condensation chamber turns the vapor into liquid, more precisely into fuel oil. However, it was noticed that the transformation of plastic waste into fuel through pyrolysis causes the reduction of the impacts generated by solid waste disposal in the environment, water and air. In addition, it enables a new form of fuel generation, since previously it could only generate fuel from oil

Management System Design Using Smart-Grids in Manaus

With the large increase in population among the capitals of the Brazilian states Manaus is a city with great energy potential being in the national interconnected system (SIN), reconciling the expansion of its generation capacity fits the scope provided for in the Ten Year Plan for Expansion of Electricity that The objective is for the energy sector planning, with benefits in terms of increased reliability, reduction of production costs and reduction of environmental impacts, already in the plan through distributed generation, which aims to fit micro generation of as a way to increase supply capacity the plan that provides targets for the country to comply with the COP24 Plan of Countries with the largest amount of clean energy to reduce the environmental impacts caused by the warming of the atmosphere caused by emission of pollutant gases such as the case of CO_2, thinking about how to improve the use of energy juice generated in its capital and partially supplied by the national system, this work has the purpose of collecting data pertinent to the consumption in order to create a possible projection of the increase and influence of renewable energies in Manaus City through the Smart Grid system as an insertion model the diversification of the capital\u27s generation park

Economic analysis of an automated lighting system with presence sensor at a state school in the city of Manacapuru-AM

This work addresses the consumption of electricity in a state school in the interior of Amazonas, highlighting the importance of the search for available technologies to reduce energy consumption. In this context, the main objective of this study is to demonstrate the energy costs in the lighting system of a state school in the city of Manacapuru, and also to analyze economically the feasibility of an automated lighting system with presence sensor in classrooms. Since, the lighting of the classrooms is manual and depends exclusively on the need for a public servant to turn on and off the switches, thus, the energy consumption of the luminaires and the time in which the exacerbated consumption occurs directly affects the energy bills of the place. In the development of research, it was found that the use of presence sensors would result in both financial savings and an environmental issue. The results showed that it is possible to have a saving of 31.43% in the value of energy compared to the value currently paid. Therefore, the amount of the investment that costs R$ 1.998,00 would be paid in two and a half months. This way, it would contribute to the useful life of the lamps and thus avoid their early disposal, thus avoiding an environmental impact because the replacement and disposal of these materials are usually very harmful to the environment

Adaptation of Leopold Matrix for Assessment of Environmental Impacts Caused by the Flower Avenue Project in Manaus City - Amazonas

This study aims to describe the effects generated by the construction of Avenida das Flores, has the objective of evaluating the effects caused by an urban mobility project, located in Manaus-AM, and the use of some neighborhoods of the city is prohibited. . Through this process of urban expansion, it is necessary to search for alternatives to urban problems, in addition to seeking solutions for the traffic disorder, a lack of urban mobility due to the difficulty of movement of people living in the more remote neighborhoods of central Manaus. . In this context, formulate the Matrix method of use based and adapted in the Leopold Interaction, which par excellence is dedicated to making relationships, noting the most relevant impacts. The survey allowed to obtain results that could indicate the negative effects caused by the environment in compartments such as: alteration (soil quality, area and microclimate), biotic reduction (reduction of endemic species and forest areas) and social (increase of vehicle circulation, attraction of new constructions and services, serving as a source of decision making, allowing to identify the most relevant effects for the use of instrument in decision making

A Sustainability Analysis of Different Types of Asphalts

The present work aimed to analyze ecological asphalts, aiming at their influence on the tripod of sustainability in the social, environmental and economic spheres. The option of using eco-rubber asphalt and EVA as a raw material for paving roads and highways is a bet for a more resistant material that requires less nature degradation and easier maintenance. One of the main reasons for the degradation of flexible pavement is the wear caused by the time of use, as well as the traffic of vehicles carrying excessive loads. This study reports some alternatives to multiply the improvement of reverse logistics of waste tires and EVA (ethyl vinyl acetate) plastics, facing problems related to environmental impacts, which directly affect the Brazilian population. This project is important because it is directly linked to sustainability and the development of the environment, facing renewable and suitable alternatives to be employed, such as ecological asphalts, and their benefits. Among the benefits of ecological asphalt we can mention the contribution to the environment by reducing the amount of waste tires improperly discarded in nature and the durability of ecological asphalt compared to conventional asphalt where it showed greater resistance to climate fatigue. The research used the qualitative method being a study based on bibliographies, analyze and discuss the reuse of solid waste and the mitigation of environmental impacts through asphalt. Ecological asphalt seems to be more expensive than the bituminous asphalt used today, however it is environmentally friendly and its effectiveness, durability and safety are noticeable advantages

Mobile Android APP Proposal Using an Inventor Platform Applied to Energy Efficiency and Sustainability

This paper reports on the implementation of the efficient Manaus project, with the objective of developing a mobile application that expires on energy saving, related to environmental issues, since energy production, advanced natural resources. This application is designed to be used in a residential unit to provide residents with information on formula applications that explain the generation and energy expenditure of household electrical appliances, use or usage tests, and usage of the device. lowering values ​​and minimizing the use of environmental resources. Thus, through a process of raising awareness of the knowledge gained from research in recent years, as well as providing quality content and ease of access, use the Google platform "APP INVENTOR" as a framework for testing results. Therefore, compile information on the best use of energy from a variety of information, including the elaboration of a Quiz, which addresses questions such as: where does electricity come from; tariff flags; efficient equipment; and electricity security, implemented in the application where they were supported by tools such as cartridges, and information from the agencies that reference each of these themes. This mode generates positive expectations for the future, which can create numerous other applications with information that helps to understand products, processes, changes in the sustainability context, to minimize impacts by new technologies

Autonomous temporal pseudo-labeling for fish detection

The first major step in training an object detection model to different classes from the available datasets is the gathering of meaningful and properly annotated data. This recurring task will determine the length of any project, and, more importantly, the quality of the resulting models. This obstacle is amplified when the data available for the new classes are scarce or incompatible, as in the case of fish detection in the open sea. This issue was tackled using a mixed and reversed approach: a network is initiated with a noisy dataset of the same species as our classes (fish), although in different scenarios and conditions (fish from Australian marine fauna), and we gathered the target footage (fish from Portuguese marine fauna; Atlantic Ocean) for the application without annotations. Using the temporal information of the detected objects and augmented techniques during later training, it was possible to generate highly accurate labels from our targeted footage. Furthermore, the data selection method retained the samples of each unique situation, filtering repetitive data, which would bias the training process. The obtained results validate the proposed method of automating the labeling processing, resorting directly to the final application as the source of training data. The presented method achieved a mean average precision of 93.11% on our own data, and 73.61% on unseen data, an increase of 24.65% and 25.53% over the baseline of the noisy dataset, respectively.info:eu-repo/semantics/publishedVersio

Bayesian Regularizers of Artificial Neural Networks applied to the reliability forecast of internal combustion machines in the short-term

Predictive as well as preventive maintenance are tools of maintenance programs that aim to increase or maintain the life expectancy of an equipment through computational techniques and tools. Bearing in mind that the power generation industry has a high maintenance rate with machines and / or electric generators stopped, this research aims to develop a computational model for predicting the Reliability Key Performance Indicator (KPI) to identify how available the equipment will be in a time span of 22 days, for this the methodology to be used will be based on analyzes and tests of artificial neural network (ANN) architectures using the Bayesian Regularizers training algorithm, alternating the transfer functions in the layers hidden to find the best state of convergence and the minimum Root Mean Square Error (RMSE) value calculated between the real and simulated outputs. According to the results obtained by the training, validation and test steps, the algorithm presented a RMSE rate of 0.0000104202 and a 99.9% correlation between the real and simulated values, thus the model is able to identify which machine will have the greatest efficiency and less efficiency within the defined time span