Pressure ulcers prevalence indicators and patient falls incidence in teaching hospitals in the city of São Paulo. / Indicadores de prevalência de úlcera por pressão e incidência de queda de paciente em hospitais de ensino do município de São Paulo.

Objective To measure the prevalence of pressure ulcers and the incidence of patient falls in three teaching hospitals in the city of São Paulo. Method Quantitative, exploratory and descriptive study. Data were collected from August 2012 to July 2013 using a form. They were analyzed according to descriptive and inferential statistics. Results The annual mean of pressure ulcers overall prevalence (PU) was of 10.1%, and the incidence of patient falls was of 13.8%. Conclusion Patients of Hospital 3 were the most vulnerable to pressure ulcers and falls, probably due to the aggressiveness of the disease and the complex treatments these patients were undergoing. Implementation of such indicators has enabled benchmarking and review of both assistance and management institutional protocols.

Nursing workers health and patient safety: the look of nurse managers. / Saúde dos trabalhadores de enfermagem e a segurança do paciente: o olhar de gerentes de enfermagem.

Objective To understand the perception of nurse managers about the relationship between nursing workers health and patient safety. Method A qualitative survey was conducted using the social phenomenology approach of Alfred Schütz, accomplished through individual interviews with nine nurse managers from five Brazilian university hospitals. Results Nurse managers' perception of the relationship between nursing workers health and patient safety was evidenced in the following categories: "The suffering to balance workers health and patient safety" and "Interventions in everyday work life". Conclusion Managers' experience showed an everyday work life marked by suffering and concern, due to high rates of absenteeism and presenteeism resulting from illness and incapability of workers, and the need to ensure patient safety through qualified nursing care.

Association between patient safety culture and professional quality of life among nursing professionals.

OBJECTIVE: To analyze the association between patient safety culture and professional quality of life in nursing professionals. METHOD: Correlational study carried out in a hospital in Salvador, Bahia, Brazil, with 180 participants. The data were collected through the Hospital Survey on Patient Safety Culture and Professional Quality of Life Scale and analyzed with correlation tests. RESULTS: The use of the Quality of Professional Life model, which encompasses Compassion Satisfaction, Burnout and Traumatic Stress, showed that a better assessment of the safety culture was negatively associated with Burnout. Regarding the dimensions of culture, better evaluations of the general perception of safety, teamwork and staffing were negatively associated with Burnout and Traumatic Stress. Higher Burnout was negatively associated with better handoffs and greater Traumatic Stress was positively associated with error communication. CONCLUSION: Higher levels of Burnout were associated with worse perception of safety culture and worse teamwork evaluations; staffing and general perception of safety were associated to a higher level of Burnout and Traumatic Stress, which emphasizes the importance of investment in these areas.

[The use of the quality model of Parasuraman, Zeithaml and Berry in health services]. / O emprego do modelo de qualidade de Parasuraman, Zeithaml e Berry em serviços de saúde.

This is an article about the theoretical model for assessing quality in health services proposed by Parasuraman, Zheitaml and Berry, in order to measure the degree of satisfaction of users. This model is based on the analysis of expectations and perceptions of users of health services, by means of five dimensions: tangibility, reliability, responsiveness, assurance and empathy. From the difference between what is expected by the user and the service offered, gaps or shortcomings are derived that may be the main obstacle for users to perceive the provision of such services with quality. It was observed that the use of the psychometric scale called Service Quality (SERVQUAL) in some studies about satisfaction, obtained very favorable results in the institutions in which it was employed. The analysis revealed the need to improve the existing models of evaluation, as well as the importance of measuring user satisfaction in health institutions.

[Nursing staff absenteeism rates as a personnel management indicator]. / Taxa de absenteísmo da equipe de enfermagem como indicador de gestão de pessoas.

Absenteeism in nursing is a difficult problem for health organizations; hence it is an indicator that must be monitored. The objective of this study was to analyze the absenteeism rate of nursing professionals in a public hospital. Absenteeism data were collected monthly, from January to July 2008, and calculated by means of an electronic program. The mean absenteeism index for nurses varied from 5.6% to 9.7% for technicians/nursing aides. Sick leaves were the most prevalent reason for absences. The data revealed the major cause of absenteeism and pointed at the need to change policies for hiring nursing professionals, in addition to reviewing the working processes in order to improve the workers' health conditions.

The profile of EEUSP graduates of the stricto sensu program in nursing management. / Perfil de egressos da Pós-Graduação stricto sensu na área de Gerenciamento em Enfermagem da EEUSP.

The objectives of the present study were to identify and discuss on the profile of the graduates form the stricto sensu program in Nursing Administration/Management of the University of São Paulo School of Nursing, from October 2008 to June 2011, regarding the knowledge areas the graduates worked on during their master and doctoral program. This is an exploratory, descriptive, retrospective study, using documental analysis. The study population consisted of 250 graduates, 169 of which were masters and 81 doctorates. The graduates' profile permitted to identify and discuss on the retention rate for the doctorate; the type of institution that absorbs the master and doctorate graduate and the fields they work in.

The use of computer tools by the elderly of a center of reference and citizenship for the elderly. / Utilização de ferramentas computacionais por idosos de um centro de referência e cidadania do idoso.

The objective of this exploratory, descriptive study was to identify the use of computer tools by a group of elderly users of a Center of Reference and Citizenship for the Elderly in the city of São Paulo. Among the 55 subjects, it was found that 33 (60.0%) have a computer at home, 42 (76.4%) referred having taken a computer course; 22 (58.2%) have been using the computer for less than two years, and 40 (85.5%)use the tool for up to two hours a day. The most used communication tools were: e-mails by (41; 75.0%), instant messaging (25; 45.0%), dating websites (17; 31.0%). The reported purposes for using technology tools were: to update and obtain information, for research, for fun, and to talk to relatives and friends. In conclusion, nurses should be aware of this technological profile that is being outlined among the elderly population and search for ways to include computer tools in the care provided to this group.

Analysis of the learning evaluation process of nursing staff actions. / Análise do processo de avaliação da aprendizagem de ações educativas de profissionais de enfermagem.

The objective of this study was to analyze the learning evaluation process of nursing staff training programs, regarding its effectiveness and instrument validity. This is an empirical study whose findings support theoretical formulations for the construction of an evaluation methodology. The analysis consisted of learning evaluations related to six training programs, totaling 993 evaluations. The results of these six training programs showed the need to propose an evaluation methodology, defining criteria, instruments and indicators for this purpose. Furthermore, it is important to improve the diagnosis process on training needs and teaching strategies.

National Patient Safety Program in Brazil: Incidents Reported Between 2014 and 2017.

OBJECTIVE: The aim of the study was to analyze the patient safety incidents reported to the Brazilian National Health Surveillance System from March 2014 to March 2017. METHOD: A documentary study that used the records of the incidents published in the Reports of Adverse Events (AE) in Brazil. The following variables were selected: number of incidents by type, type of health service, hospital unit, and degree of harm. To find whether there was a significant difference across the Brazilian regions by notifications related to general incidents, AE, and deaths, the analysis of variance and the Tukey tests were used. RESULTS: A total of 109,082 incidents were reported, of which 75,088 were AE, with 649 deaths. In relation to the types of incidents reported, there was a higher frequency in the categories other (30.04%) and failures during health care (26.72%). A total of 93.90% of the incidents occurred in hospitals, with 54,950 cases registered in hospitalization units and 30,141 cases in intensive care units. Statistically significant differences across the Brazilian regions were observed in the number of incidents (P = 0.004), AE (P = 0.004), and deaths (P = 0.024). CONCLUSIONS: A significant underreporting of incidents was found in Brazil, demonstrating only the tip of a giant iceberg. More than half of the incidents were reported as AE and were registered in hospitals, reiterating the importance of establishing public health policies at national, state, and municipal levels, with adequate supervision of the health service regarding the implementation of the Patient Safety Nuclei and the preparation of new protocols based on the most prevalent incidents.

[The implementation of a quality management tool at a university hospital]. / Implantação de ferramenta de gestão de qualidade em Hospital Universitário.

The objective of this study was to understand the perception of a multidisciplinary health team regarding the implementation of a quality management took at a teaching hospital. The setting of this qualitative study was the University Hospital at University of São Paulo (HU-USP). Participants were seven workers from the Committee for the Implementation of the 5S Program. Data collection was performed through semi-structured interviews and the statements were analyzed according to Janesick. Two categories emerged from the statements: The perception of the multidisciplinary team participating in the implementation of the 5S Program and Factors that affect the implementation of the 5S Program. The categories were interpreted following the Donabedian framework. This study permitted to understand the perception of the multidisciplinary team regarding the implementation of a quality management tool. It is believed that the present findings will contribute with evaluating the 5S Program at the HU-USP, and provide the necessary support for reorganizing activities at that hospital.

[Assessment levels of the user's satisfaction in a private hospital]. / Análise da satisfaçã dos usuários de um hospital privado.

The objective of this study was to analyze the satisfaction of the users of a private hospital in terms of a number of attributes of the services in units. This exploratory, descriptive study used a quantitative approach and was developed in a private hospital in the city of São Paulo. The casuistry consisted of 71 users and data collection was performed during the period from March to August 2007, using a derivative of the scale model of the Service Quality (SERVQUAL) of the evaluative model of Parasuraman et al. The level of overall satisfaction ranged around 95%. The assurance (96%) and reliability (96%) were considered the most important dimensions of quality, followed by empathy (95%), responsiveness (93%) and tangibility (88%). Medical and nursing staffs introduced high levels of satisfaction. 91% has intention to recommend the hospital. This research provided the knowledge of the attributes most important in terms of satisfaction and contributed to confirming or reshaping assistance and management processes.

[Theoretical background for the construction and establishment of quality indicators in health]. / Subsídios teóricos para a construção e implantação de indicadores de qualidade em saúde.

The indicators integrate a number of important tools to evaluate and monitor quality of a service, concerning access to effectiveness, efficacy, confidence and completeness of work processes, which can be a valuable practice to assess health services. Thus, the aim of this study is to describe the elements of this construction and to establish indicators. Consequently, theoretical background of various specialists and organizations were adopted, in order to discuss quality issues and evaluate health services. It was concluded that in the management area, the use of indicators favors the identification of problems, subsidize actions and effective decisions, monitoring its development. Regarding the assistance area, it facilitates the review of the adopted protocols and of the obtained results, aiming to reach patterns of excellence. In the teaching and research areas, it makes available a valid instrument for the scientific community, articulating interests and demands of services and researches.

Interventions to reduce patient identification errors in the hospital setting: a systematic review protocol.

REVIEW QUESTION: The question of this review is: how effective are the interventions that may prevent or reduce patient identification errors in the hospital setting?

Avaliação da cultura de segurança do paciente: percepção de trabalhadores de enfermagem e fatores associados / Evaluación de la cultura de seguridad del paciente: percepción de los trabajadores de enfermería y factores asociados / Evaluation of patient safety culture: perception of nursing workers and associated factors

Objetivos: avaliar a cultura de segurança do paciente na percepção de trabalhadores de enfermagem e identificar a associação dessa cultura com variáveis sociodemográficas e profissionais dos trabalhadores. Método: estudo transversal, com abordagem quantitativa, desenvolvido em hospital público geral de Salvador, Bahia, Brasil, com 180 trabalhadores de enfermagem. Foi empregado o questionário Hospital Survey on Patient Safety Culture e utilizou-se estatística descritiva, testes de associação e de correlação para análise dos dados. Resultados: nenhuma dimensão da cultura foi considerada fortalecida, a nota de segurança foi classificada como regular por 58,0% dos trabalhadores e 63,9% revelaram não efetuar notificação no último ano. A cultura esteve associada ao sexo, à categoria profissional, ao tipo e à quantidade de vínculo trabalhista, ao local de trabalho, à idade e à experiência profissional e no serviço. Conclusão: a cultura revelou-se fragilizada apontando para necessidade de intervenções, especialmente no que tange aos fatores associados.

Objetivos: evaluar la cultura de seguridad del paciente en la percepción de trabajadores de enfermería e identificar la asociación de esa cultura con variables sociodemográficas y profesionales de los trabajadores. Método: estudio transversal, con abordaje cuantitativo, desarrollado en hospital público general de Salvador, Bahía, Brasil, con 180 trabajadores de enfermería. Se empleó el cuestionario Hospital Survey on Patient Safety Culture y se utilizó estadística descriptiva, pruebas de asociación y de correlación para el análisis de los datos. Resultados: ninguna dimensión de la cultura fue considerada fortalecida, la nota de seguridad fue clasificada como regular por 58,0% de los trabajadores y 63,9% revelaron no efectuar notificación en el último año. La cultura estuvo asociada al sexo, a la categoría profesional, al tipo y a la cantidad de vínculo laboral, al lugar de trabajo, a la edad y a la experiencia profesional y en el servicio. En conclusión: la cultura se ha mostrado debilitada señalando la necesidad de intervenciones, especialmente en lo que respecta a los factores asociados.

Objectives: to evaluate the patient safety culture in the perception of nursing workers and to identify the association of this culture with sociodemographic and professional variables of workers. Method: cross-sectional study with a quantitative approach, developed in a general public hospital in Salvador, Bahia, Brazil, with 180 nursing workers. The Hospital Survey on Patient Safety Culture questionnaire was used and descriptive statistics, association and correlation tests were used to analyze the data. Results: no dimension of the culture was considered strengthened, the safety grade was classified as acceptable by 58.0% of the workers and 63.9% revealed no notification in the last year. Culture was associated with gender, professional category, type and amount of employment, workplace, age and professional and service experience. Conclusion: the culture proved to be fragile pointing to the need for interventions, especially regarding the associated factors.

[Evaluation of quality indicators for human resources management in nursing]. / Indicadores para avaliação de qualidade do gerenciamento de recursos humanos em enfermagem.

This is qualitative study aiming to retrieve with the academic professors of the nursing administration, the constitutive criteria of quality indicators of human resources management in Nursing. Ten academic professors of a public teaching institution, in the city of São Paulo, took part of this study. Data collection was performed by means of semi -structured interviews and analyzed according to Bardin. The results pointed out to the Institutional and Professional categories. In the first category, the human resource policy predominated as well as the participation in decisive processes. In the second one, it was observed satisfaction at work and absenteeism. The referred indicators must be applied and validated for their consolidation.

Percepção de pessoas idosas acerca da transição de cuidados prestados por uma equipe multiprofissional de atenção domiciliar / Aged people's perception about the transitional care provided by a multiprofessional home-based assistance team / Percepción de los adultos mayores sobre la transición del cuidado brindado por un equipo multiprofesional de atención domiciliaria

RESUMO Objetivo: compreender a percepção de pessoas idosas acerca da assistência prestada por uma Equipe Multiprofissional de Atenção Domiciliar do município de São Paulo - Brasil. Método: estudo qualitativo, com o emprego da história oral de vida. Coleta de dados entre agosto de 2020 até outubro de 2021, com entrevistas semiestruturadas. Amostra foi de nove idosas atendidas pela Equipe Multiprofissional de Atenção Domiciliar. Os dados foram tratados de acordo com a história oral de vida, apresentados na forma de narrativas e categorizados. Resultados: das narrativas emergiram sete categorias temáticas. A percepção dos participantes acerca da assistência à saúde prestada pela equipe, mostrou-se positiva e necessária, por sobretudo favorecer o acesso aos recursos disponibilizados pelo Sistema Único de Saúde. Conclusão: destaca-se a importância da atenção domiciliar para a continuidade do cuidado das pessoas idosas. Reforçou a necessidade de incluir o processo de finitude no planejamento nas ações de cuidado dos serviços de saúde.

ABSTRACT Objective: to understand the aged people's perception about the care provided by a Multiprofessional Home-based Assistance Team in the city of São Paulo - Brazil. Method: a qualitative study using oral life stories. The data were collected between August 2020 and October 2021 by means of semi-structured interviews. The sample consisted of nine aged women assisted by the Multidisciplinary Home-based Assistance Team. The data were treated according to oral life stories, presented in the form of narratives and categorized. Results: seven thematic categories emerged from the narratives. The participants' perception of the health care provided by the team was positive and necessary, mainly because it favored access to the resources provided by the Unified Health System. Conclusion: the importance of home-based care for care continuity for aged people is highlighted. The study reinforced the need to include the finitude process in the planning of care actions in health services.

RESUMEN Objetivo: comprender la percepción de los adultos mayores sobre la asistencia prestada por un Equipo Multiprofesional de Atención Domiciliaria en la ciudad de San Pablo, Brasil. Método: estudio cualitativo, que usa la historia oral de vida. Recolección de datos entre agosto de 2020 y octubre de 2021, con entrevistas semiestructuradas. La muestra estuvo compuesta por nueve mujeres de tercera edad que atendidas por el Equipo Multidisciplinario de Atención Domiciliaria. Los datos fueron tratados como historia oral de vida, presentados en forma de narraciones y categorizados. Resultados: siete categorías temáticas surgieron de las narrativas. La percepción de los participantes sobre la asistencia sanitaria que prestó el equipo fue que era positiva y necesaria, principalmente porque favoreció el acceso a los recursos que brinda el Sistema Único de Salud. Conclusión: se destaca la importancia de la atención domiciliaria para la continuidad del cuidado del adulto mayor. Reforzó la necesidad de incluir el proceso de finitud en la planificación de las acciones de cuidado en los servicios de salud.

Relação entre satisfação por compaixão, burnout e estresse traumático com a segurança do paciente / Relación entre satisfacción por compasión, burnout y estrés traumático con la seguridad del paciente / Relationship among compassion satisfaction, burnout and traumatic stress with the patient safety

Objective: to analyze the relationship among compassion satisfaction, burnout, and secondary traumatic stress with the patient safety culture. Method: cross-sectional study with nurses (n = 201) from hospitals in Portugal. The Professional quality scale and the three sections of Hospital survey on patient safety culture were used to data collection. Correlation and regressions tests were implemented. Results: compassion satisfaction was positively related to four of the five patient safety culture dimensions and with the patient safety grade, while burnout had a negative relationship with all the dimensions and with the patient safety grade and secondary traumatic stress had a negative relationship with three patient safety culture dimensions. Conclusions: measures aimed at increasing compassion satisfaction and decreasing burnout and secondary traumatic stress should be implemented to improve the quality of professional life and patient safety.(AU)

Objetivo: analizar la relación entre satisfacción por compasión, burnout y estrés traumático secundario con la cultura de seguridad del paciente. Método: estudio transversal con enfermeras (n = 201) de hospitales de Portugal. Para la recopilación de datos se utilizaron la Professional quality scale y tres secciones de la Hospital survey on patient safety culture. Se implementaron pruebas de correlación y regresión. Resultados: la satisfacción por compasión se relacionó positivamente con cuatro de las cinco dimensiones de cultura de seguridad del paciente y con el grado de seguridad, mientras que burnout tuvo una relación negativa con todas las dimensiones y con el grado de seguridad y estrés traumático secundario tuvo una relación negativa con tres dimensiones. Conclusiones: se deben implementar medidas destinadas a aumentar la satisfacción por compasión y disminuir el burnout y el estrés traumático secundario para mejorar la calidad de vida profesional y la seguridad del paciente.(AU)

Objetivo: analisar a relação entre satisfação por compaixão, burnout e estresse traumático secundário com a cultura de segurança do paciente. Método: estudo transversal com enfermeiros (n = 201) de hospitais de Portugal. Para a coleta de dados, utilizou-se a Professional quality scale e três seções do Hospital survey on patient safety culture. Testes de correlação e de regressão foram implementados. Resultados: a satisfação por compaixão foi positivamente relacionada com quatro das cinco dimensões da cultura de segurança do paciente e com o grau de segurança do paciente, enquanto o burnout teve relação negativa com todas as dimensões e com o grau de segurança do paciente e o estresse traumático secundário teve relação negativa com três dimensões. Conclusões: medidas que visem aumentar a satisfação por compaixão e diminuir o burnout e o estresse traumático secundário devem ser implementadas visando melhorar a qualidade de vida profissional e a segurança do paciente.(AU)

[Planing in health organizations: analysis under systematic view]. / O planejamento nas organizações de saúde: análise da visão sistêmica.

Health planning in Latin America is marked by the request from Pan American Health Organization to Centro de Estudios del Desarrollo (Center of Development Studies) to write a document focusing on planning concepts. The training of technicians in planning promoted the dissemination of this methodology. Systemic planning was adopted, aligned with the ideas of functional society in the sixties. This article discusses the following methodological steps: situational analysis; establishment of aims and plans; implementation of the proposal, process monitoring, and strategic, tactical, and operational planning levels and their correlation with power structures within the organizations.

Emprego da ferramenta SBAR na transição do cuidado: Uma técnica para a comunicação efetiva / Empleo de la herramienta SBAR en la transición del cuidado: técnica para la comunicación efectiva / Employment of the SBAR tool for patient handover: a technique for effective communication

Objetivo: Relatar a experiência da implantação da ferramenta Situation-BackgroundAssessment-Recommendation para a padronização da comunicação entre profissionais durante a transição do cuidado. Método: Relato de experiência de atividades realizadas em hospital universitário, que abrangeu discussão e análise de eventos adversos decorrentes de falhas de comunicação. Resultados: As condutas no processo de transição do cuidado foram padronizadas por meio de elaboração e revisão de protocolos; emprego da ferramenta Situation-Background-Assessment-Recommendation nas transferências de pacientes entre unidades e estabelecimento de fluxos de admissão e atendimento. Conclusão: A ferramenta propiciou a padronização de ações no processo de transição do cuidado, contribuindo para melhorias no processo de trabalho da equipe interdisciplinar e, consequentemente, para a segurança do paciente(AU)

Objective: To report the experience of the implementation of the Situation-BackgroundAssessment-Recommendation tool for the standardization of communication among professionals during the handover. Method: Experience report of activities performed in a university hospital, which included discussion and analysis of adverse events due to communication failures. Results: The conducts in the process of handover were standardized through elaboration and revision of protocols; use of the Situation-Background-AssessmentRecommendation tool in patient transfers between units and establishment of admission and care flows. Conclusion: the tool provided standardization of actions in the patient handover, contributing to improvements in the work process of the interdisciplinary team and, consequently, to patient safety(AU)

Objetivo: Relatar la experiencia de la implantación de la herramienta Situation-BackgroundAssessment-Recommendation para la estandarización de la comunicación entre profesionales durante la transición del cuidado. Método: Relato de experiencia de actividades realizadas en hospital universitario, que abarcó discusión y análisis de eventos adversos resultantes de fallas de comunicación. Resultados: Las conductas en el proceso de transición del cuidado fueron estandarizadas por medio de elaboración y revisión de protocolos; empleo de la herramienta Situation-Background-Assessment-Recommendation en las transferencias de pacientes entre unidades y establecimiento de flujos de admisión y atención. Conclusión: La herramienta propició la estandarización de acciones en el proceso de transición del cuidado, contribuyendo para mejoras en el proceso de trabajo del equipo interdisciplinario y, consecuentemente, para la seguridad del paciente(AU)

[Exploring the photovoice in an ethnographic research: a strategy for data collection]. / Explorando a "fotovoz" em um estudo etnográfico: uma estratégia de coleta de dados.

This article describes the use of the photography for data collection in an ethnographic research. This study aims to understand the women's perception related to the hospital where they were supposed to give birth. These women were invited to take pictures of the hospital. After developing the pictures, the researcher appointed interviews and the pictures gave voice to them. The women pointed out positive and negative aspects related to the hospital, that were the reasons for their anxiety and stress. The use of photography allowed to dispel the myth of the factors that influence on the birth process.