Moral distress and moral resilience of nurse managers.

BACKGROUND: Moral distress is a phenomenon that can lead to an imbalance of the mind and body. There are many coping strategies to overcome the obstacles that lead the subject to this condition. Some coping strategies are capable of being achieved through the cultivation of moral resilience. AIM: The aim is to identify the strategies of moral resilience in the nursing management of University Hospitals in Brazil. RESEARCH DESIGN: The research design is the qualitative study with discursive textual analysis. PARTICIPANTS AND RESEARCH CONTEXT: : 44 nurse managers and nurses in leadership positions participated in a total of 30 University Hospitals in Brazil. Data were collected online, using a questionnaire with open questions. ETHICAL CONSIDERATIONS: The Ethics Committee approved the study. Participants received information about the research, agreed to respond to the questionnaire, and were guaranteed anonymity. FINDINGS: Personal adaptive strategies (intrapersonal and interpersonal) and organizational collaborative strategies (intrinsic and transformational management) emerged from this process. The intrapersonal strategies involved elements of rationality, flexibility, rebalancing practices, moral courage, and detachment. The interpersonal strategies addressed support networks, team involvement, and dialog. Organizational strategies dealt with actions which reorient ethical infrastructure, ethical education, and psychological protection, as well as fostering dialogical relationships, empowerment, and cooperation. CONCLUSION: From the perspective of social historical construction, it is understood that developing personal and organizational strategies is essential to cultivating moral resilience.

Philosophy and conceptual framework: collectively structuring nursing care systematization. / Filosofia e marco conceitual: estruturando coletivamente a sistematização da assistência de enfermagem.

OBJECTIVE: To build the Nursing Philosophy and Conceptual Framework that will support the Nursing Care Systematization in a hospital in southern Brazil with the active participation of the institution's nurses. METHODS: Convergent Care Research Data collection took place from July to October 2014, through two workshops and four meetings, with 42 nurses. As a result, the nursing philosophy and conceptual framework were created and the theory was chosen. Data analysis was performed based on Morse and Field. RESULTS: The philosophy involves the following beliefs: team nursing; team work; holistic care; service excellence; leadership/coordination; interdisciplinary team commitment. The conceptual framework brings concepts such as: human being; nursing; nursing care, safe care. The nursing theory defined was that of Wanda de Aguiar Horta. CONCLUSIONS: As a contribution, it brought the construction of the institutions' nursing philosophy and conceptual framework, and the definition of a nursing theory.

[Nursing students' point of view on biosecurity and patient safety]. / A biossegurança e segurança do paciente na visão de acadêmicos de enfermagem.

This study is aimed at identifying the knowledge of nursing students about the subject area of patient safety and its relationship with the teaching of biosecurity. Exploratory qualitative study conducted at the Universidade Federal de Santa Catarina (Federal University of Santa Catarina), with 17 students in the third phase of the Undergraduate Nursing Program. Three categories emerged after an exhaustive reading of the responses caring for self and others; biosecurity and care for the environment; biosecurity: health education and continuing education in health services. The following issues were identified, students' concern about risk prevention, care and self care as prerogatives for patient's safety; and education as a proposal for the minimization of risks. The study of biosecurity is considered important in undergraduate studies, minimizing losses and mistakes in the undergraduate students' conduct.

[Nursing workloads and working conditions: integrative review]. / Cargas de trabalho e condições de trabalho da enfermagem: revisão integrativa.

This study reviews theoretical production concerning workloads and working conditions for nurses. For that, an integrative review was carried out using scientific articles, theses and dissertations indexed in two Brazilian databases, Virtual Health Care Library (Biblioteca Virtual de Saúde) and Digital Database of Dissertations (Banco Digital de Teses), over the last ten years. From 132 identified studies, 27 were selected. Results indicate workloads as responsible for professional weariness, affecting the occurrence of work accidents and health problems. In order to adequate workloads studies indicate some strategies, such as having an adequate numbers of employees, continuing education, and better working conditions. The challenge is to continue research that reveal more precisely the relationships between workloads, working conditions, and health of the nursing team.

Biological and ergonomic risks of radiology technicians in a conventional radiology service.

Introduction: Radiology technicians are exposed to occupational risks in their daily work. Among these, there are biological and ergonomic risks. Objectives: To describe the biological and ergonomic risks in the work process of radiology technicians in a conventional radiology service. Methods: This was a qualitative, descriptive, and exploratory research. Data collection was conducted through semi-structured interviews with 12 radiology technicians, participant observation, and consensual validation with nine workers. Content analysis was based on the assumptions of the thematic analysis. Results: Exposure to body fluids, contamination of work instruments by biological agents, no disinfection, and no use of personal protective equipment were found to be biological risks. Excessive weight manipulation, inappropriate physical structure, night work, and work instruments that do conform to the principles of body mechanics were identified as ergonomic risks. Conclusions: The mentioned occupational risks are related to the work conditions of the health service and to inadequate body positioning of radiology technicians.

Introdução: Os profissionais de radiologia estão expostos a riscos ocupacionais no seu cotidiano profissional. Entre eles, temos os biológicos e os ergonômicos. Objetivos: Descrever os riscos biológicos e ergonômicos presentes no processo de trabalho dos profissionais de radiologia em um serviço de radiologia convencional. Métodos: Pesquisa qualitativa, descritiva e exploratória. Utilizou-se como técnica de coleta de dados entrevista semiestruturada com 12 profissionais de radiologia, observação participante e validação consensual com nove trabalhadores. A análise do conteúdo embasou-se nos pressupostos da análise temática. Resultados: Exposição a fluidos corporais, contaminação de instrumentos de trabalho por agentes biológicos, não realização de desinfecção e não uso de equipamentos de proteção individual foram evidenciados como riscos biológicos. Manipulação excessiva de peso, planta física inadequada, trabalho noturno e instrumentos de trabalho que não respeitam os princípios da mecânica corporal foram identificados como riscos ergonômicos. Conclusões: Os riscos ocupacionais evidenciados estão relacionados às condições de trabalho do serviço de saúde e a posturas inadequadas dos profissionais de radiologia.

Psychological exhaustion of radiological nursing workers in nuclear medicine services.

OBJECTIVE: to analyze the psychic exhaustion experienced by nursing workers in nuclear medicine services. METHOD: a qualitative study that used the methodological assumptions of Psychodynamics of Work. The study was 12 nursing workers from two nuclear medicine services. For data analysis and treatment, Collective Subject Discourse was used with help of the software QualiQuantSoft®. RESULTS: the psychic exhaustion experienced by nursing workers originates mainly from work organization, conditions and relationships, and can compromise the quality of care provided and workers' quality of life. Psychic exhaustion is manifested by stress, tiredness and apathy in activities performed outside the work environment. FINAL CONSIDERATIONS: individuals who work also live socially, so psychic health maintenance will impact on work activity. The service should include workers in the organization and offer spaces for dialogue and collective support.

Professional master program: Preparing the nurse of the future.

OBJECTIVE: Analyze the results of knowledge production from a graduate program for master's degree in nursing. METHOD: This is a qualitative retrospective documentary study. Data were collected from the university library repository and the program website. In total, 83 dissertations were found, analyzed and arranged into five groups: worker's health, care management, systematization of nursing care, health education, and nursing care. RESULTS: The results indicate good practices such as manuals, guides, protocols, software, and products for systematization of care. They indicate concern about changing the reality with care practices and interventions, health education and continuing education. FINAL CONSIDERATIONS: This study showed student commitment to the fields of practice when choosing the project theme. Students presented an intention to improve care, management, education and research, in the various dimensions of the profession.

[Issuing technologies of ionizing radiation and the need of permanent education for a safe praxis in radiological nursing]. / Tecnologias emissoras de radiação ionizante e a necessidade de educação permanente para uma práxis segura da enfermagem radiológica.

Reflecting about radiological technologies and the need for permanent education to address issues related to the application of ionizing radiation on radiological nursing practice is of a great importance, due to the technological progress that revolutionized practices in health and, consequently, the nursing care. So, these technologies strongly focus on labor and worker's qualification. This reflection happens in the acting areas of radiological nursing in the Radiology Services and Image Diagnosis (SRDI), as well as the need for permanent education to the safe praxis on this specialty which is presented through some authors' studies. Primarily, in relation to the radiological protection and need to qualify these workers.

[Knowledge production about the work process in nursing]. / Produção do conhecimento sobre o processo de trabalho na enfermagem.

This article is a reflection on the production of knowledge about the work process based on some questions: who talks, and from where, about the work in Nursing? In this context, it is highlighted the role of the post-graduation courses and of the ABEn in the production of knowledge in the work process. Concerning the role of the post-graduation courses, the research areas focused on this theme are identified and an analysis of that production based on studies performed by a research group (Práxis/UFSC) identified its strengths and its fragilities in two studies about the group's production showed in doctorate thesis and masters dissertations. The categories approached were: the organization of work and the worker's health and the gaps identified were related to studies on the objects and the products of the work process, the evaluation of the quality of assistance, the needs of the care subjects, the aim of the work and the praxis itself in the social-historical scenario. Finally it is reaffirmed the importance of studies about our own work in its multiple possibilities of objects and approaches.

[Leadership in critical care settings: reflections and challenges for the Brazilian Nursing]. / Liderança em ambientes de cuidados críticos: reflexões e desafios à Enfermagem Brasileira.

The objective of this study was to reflect on the leadership, especially in the intensive care nursing, based on the prospect of nurses, teachers, nursing students and in the literature on the subject. The leadership of the nurse in intensive care units faces challenges and paradoxes and is present in the planning of care, in the moments of ethical and bioethical conflicts, in the supervision of care, in capacity of making decisions quickly and safety, in knowing deal with the issues involving the process of living and dying.

Sources of exhaustion among hospital conventional radiology technicians in Santa Catarina, Brazil.

BACKGROUND: Health care workers, including radiology technicians, are exposed to work burdens liable to cause exhaustion. OBJECTIVE: To describe sources of exhaustion within the work process of technicians at a hospital department of conventional radiology in Santa Catarina, Brazil. METHODS: Qualitative, descriptive and exploratory study in which data were collected from 12 radiology technicians by means of semi-structured interviews. The data were subjected to thematic analysis. RESULTS: Three sources of exhaustion stood out: musculoskeletal, represented by shoulder and back pain, mental, corresponding to stress and emotional and psychological overload, and respiratory, manifested as colds, pneumonia and rhinitis. CONCLUSION: The present study makes visible sources of exhaustion within the work process of radiology technicians, which are similar to those that affect other categories of health care workers.

INTRODUÇÃO: Os profissionais da saúde estão expostos a cargas de trabalho que interagem com o corpo e podem gerar desgastes. Entre esses profissionais, temos os das técnicas radiológicas. OBJETIVO: Descrever os desgastes presentes no processo de trabalho dos profissionais das técnicas radiológicas em serviço hospitalar de radiologia convencional no estado de Santa Catarina. METODOLOGIA: Trata-se de uma pesquisa qualitativa, descritiva e exploratória. A técnica de coleta de dados foi entrevista semiestruturada, realizada com 12 profissionais técnicos em radiologia. A análise ocorreu por meio da análise temática. RESULTADOS: Destacaram-se três categorias de desgaste: os osteoarticulares, que foram manifestados por dores no ombro e na coluna vertebral; os psíquicos, que abordaram o estresse e o desgaste emocional e psicológico; e os do sistema respiratório, manifestando-se por meio de resfriado, pneumonia e rinite. CONCLUSÕES: A pesquisa permitiu dar visibilidade aos desgastes ocasionados pelo processo de trabalho dos profissionais das técnicas radiológicas em radiologia convencional. Evidenciou-se que esses desgastes são similares aos de outras categorias profissionais na área da saúde.

Analysis of the patient care flow in hemodynamics supported by lean thinking / Análisis del flujo de la atención provista a pacientes de un servicio de hemodinámica sustentado en la filosofía lean / Análise do fluxo do atendimento de pacientes em hemodinâmica sustentado no pensamento lean

ABSTRACT Objective: to analyze the patient care flow in a Hemodynamics service grounded on Lean Thinking based on Value Stream Mapping. Method: an exploratory-descriptive case study carried out in the Hemodynamics service of a public university hospital from southern Brazil. Data collection was conducted through participant observation with twelve members of the multiprofessional team and interviews with five participants from May 2021 to February 2022. The analysis was based on the Lean framework and on the stages foreseen in Value Stream Mapping. Results: the Value Stream Map of the current situation of the service was prepared, identifying suppliers and customers of the process and their requirements. A total of 61 problems related to unmet requirements were listed, of which 12 were prioritized in order to promote improvement planning. Conclusion: with Value Stream Mapping it was possible to establish improvement priorities that exert impacts on operational performance of the service. It was identified that improvements related to standardization of the activities minimize waste from failures and waiting times, which were the most prevalent in the service, among others observed.

RESUMEN Objetivo: analizar el flujo de la atención provista a los pacientes en un servicio de Hemodinámica, sustentado en la filosofía Lean sobre la base del Mapa de Flujo de Valor. Método: estudio de casos, exploratorio y descriptivo, realizado en el servicio de Hemodinámica de un hospital público universitario del sur de Brasil. Los datos se recolectaron por medio de observación participante con doce integrantes del equipo multiprofesional y de entrevistas con cinco participantes entre mayo de 2021 y febrero de 2022. El análisis se sustentó en el referencial Lean y en las etapas previstas en el Mapa de Flujo de Valor. Resultados: se elaboró el Mapa de Flujo de Valor correspondiente a la situación actual del servicio, con la debida identificación de proveedores y clientes del proceso y sus requisitos. Se elaboró una lista con 61 problemas relacionados a requisitos no cumplidos, 12 de los cuales 12 fueron priorizados con el fin de promover la planificación de mejoras. Conclusión: con el Mapa de Flujo de Valor fue posible establecer prioridades de mejora que ejercieron un impacto sobre el desempeño operativo del servicio. Se identificó que las mejoras relacionadas con la estandarización de las actividades minimizan los desperdicios por fallas y esperas, que fueron los más prevalentes en el servicio, entre otros observados.

RESUMO Objetivo: analisar o fluxo do atendimento de pacientes em um serviço de hemodinâmica sustentado no pensamento Lean com base no Mapa de Fluxo de Valor. Método: estudo de caso, exploratório-descritivo, realizado no serviço de hemodinâmica de um hospital público universitário do sul do Brasil. A coleta de dados ocorreu por meio de observação participante com doze integrantes da equipe multiprofissional e entrevistas com cinco participantes no período de maio de 2021 a fevereiro de 2022. A análise sustentou-se no referencial Lean e nas etapas previstas no Mapa de Fluxo de Valor. Resultados: elaborou-se o Mapa de Fluxo de Valor da situação atual do serviço, identificando-se fornecedores e clientes do processo e seus requisitos. Elencaram-se 61 problemas relacionados a requisitos não atendidos, dos quais 12 foram priorizados, a fim de promover o planejamento de melhorias. Conclusão: com o Mapa de Fluxo de Valor foi possível estabelecer prioridades de melhoria que impactam no desempenho operacional do serviço. Identificou-se que melhorias relacionadas à padronização das atividades minimizam os desperdícios de falha e espera, que foram os mais prevalentes no serviço, entre outros observados.

Nursing and design in the creation of health products: approaching areas and solving problems / Enfermería y diseño en la creación de productos en salud: áreas de aproximación y solución de problemas / Enfermagem e design na criação de produtos para a saúde: aproximando áreas e resolvendo problemas

ABSTRACT Objective: to describe a methodological proposal for product development in the health area through the perspective of design. Method: Theoretical and methodological reflection, based on the experience and knowledge of the authors in studies related to technological production and innovation in nursing. Results: the methodological proposal consists of the following steps: 1) Briefing; 2) data collection; 3) analysis of the problem; 4) concept; 5) generation of alternatives; 6) selection of the best alternative; 7) refining the solution; 8) prototype; 9) tests; 10) modifications; and 11) implementation. The design proposal is shown as a method of investigation and seeks to equip health professionals and related areas for the elaboration of studies with the potential to develop products, at all stages. Conclusion: the approximation of knowledge and practices in the area of design with that of nursing enables the identification of problems and their resolution with creativity and empathy, contributing to innovation and knowledge production.

RESUMEN Objetivo: describir una propuesta metodológica para el desarrollo de productos sanitarios desde la perspectiva del diseño. Método: reflexión teórica y metodológica, a partir de la experiencia y conocimiento de los autores en estudios relacionados con la producción e innovación tecnológica en enfermería. Resultados: la propuesta metodológica está compuesta por los pasos: 1) Briefing; 2) recopilación de datos; 3) análisis de problemas; 4) concepto; 5) generación de alternativas; 6) selección de la mejor alternativa; 7) refinamiento de la solución; 8) prototipo; 9) pruebas; 10) modificaciones; y, 11) implementación. La propuesta de diseño se muestra como un método de investigación y busca equipar a los profesionales de la salud y áreas afines para realizar estudios con potencial para desarrollar productos, en todas sus etapas. Conclusión: la aproximación de saberes y prácticas en el área de diseño con la de enfermería posibilita la identificación de problemas y su resolución con creatividad y empatía, contribuyendo a la innovación y producción de conocimiento.

RESUMO Objetivo: descrever proposta metodológica de desenvolvimento de produtos à área da saúde através da perspectiva do design. Método: reflexão teórica e metodológica, a partir da experiência e conhecimento das autoras em estudos relativos à produção tecnológica e inovação em enfermagem. Resultados: a proposta metodológica é composta pelas etapas: 1) Briefing; 2) levantamento de dados; 3) análise do problema; 4) conceito; 5) geração de alternativas; 6) seleção da melhor alternativa; 7) refino da solução; 8) protótipo; 9) testes; 10) modificações; e, 11) implementação. A proposta do design se mostra como um método de investigação e busca instrumentalizar os profissionais da saúde e áreas afins para elaboração de estudos com potencial de desenvolver produtos, em todas as etapas. Conclusão: a aproximação dos saberes e práticas da área do design com a da enfermagem possibilita a identificação de problemas e sua resolução com criatividade e empatia, contribuindo para inovação e produção de conhecimento.

Indicadores para a avaliação do processo transfusional: revisão integrativa* / Indicadores para la evaluación del proceso transfusional: revisión integradora / Transfusion process assessment indicators: integrative review

Objetivo: identificar os indicadores relacionados ao processo transfusional. Método: revisão integrativa de literatura realizada entre março e maio de 2022, em nove fontes de informação no período de 2001 a 2021. Como estratégia de busca, utilizaram-se os descritores "Indicadores de Qualidade em Assistência à Saúde", "Indicadores de Serviços", "Indicadores Básicos de Saúde", "Serviço de Hemoterapia", "Transfusão de Sangue", "Segurança do Sangue", com os operadores boleanos "AND" e "OR" em três idiomas, sendo analisados 49 artigos. Resultados: foram identificados 53 indicadores, os quais se agruparam para: gestão do estoque de hemocomponentes, de produção do processo transfusional, para avaliação do processo transfusional e de suporte do processo transfusional. Conclusão: os indicadores identificados possibilitam avaliação do processo transfusional, apesar de atividades, como a avaliação do cuidado, apresentarem poucos indicadores, evidenciando a necessidade de estudos sobre a temática e construção de novos indicadores para dar sustentação à avaliação mais aprimorada do processo transfusional.

Objective: to identify transfusion-related indicators. Method: an integrative literature review carried out between March and May 2022, in nine sources of information from 2001 to 2021. As a search strategy, the descriptors "Quality Indicators in Health Care", "Service Indicators", "Basic Health Indicators", "Hemotherapy Service", "Blood Transfusion", "Blood Safety" were used, with Boolean operators "AND" and "OR" in three languages, with 49 articles being analyzed. Results: a total of 53 indicators were identified, which were grouped for: blood component stock management, transfusion process production, transfusion process assessment and transfusion process support. Conclusion: the identified indicators make it possible to assess the transfusion process, although activities, such as care assessment, present few indicators, highlighting the need for studies on the subject and the construction of new indicators to support a more improved transfusion process assessment.

Objetivo: identificar indicadores relacionados con el proceso de transfusión. Método: revisión integrativa de la literatura, realizada entre marzo y mayo de 2022, en nueve fuentes de información de 2001 a 2021. Como estrategia de busca, se utilizaron los descriptores "Indicadores de Calidad en la Atención de Salud", "Indicadores de Servicio", "Indicadores Básicos de Salud", "Servicio de Hemoterapia", "Transfusión de Sangre", "Seguridad de la Sangre", con operadores booleanos "AND" y "OR" en tres idiomas, analizando 49 artículos. Resultados: se identificaron 53 indicadores, los cuales fueron agrupados en: gestión del stock de hemocomponentes, producción del proceso transfusional, evaluación del proceso transfusional y apoyo al proceso transfusional. Conclusión: los indicadores identificados posibilitan la evaluación del proceso transfusional, aunque actividades, como la evaluación del cuidado, presenten pocos indicadores, destacando la necesidad de estudios sobre el tema y la construcción de nuevos indicadores que apoyen una evaluación más perfeccionada del proceso de transfusión.

Challenges for work in healthcare: comparative study on University Hospitals in Algeria, Brazil and France. / Desafios para o trabalho em saúde: um estudo comparado de Hospitais Universitários na Argélia, Brasil e França.

This study compares the challenges for work in emergency services of publicuniversity hospitals in Algeria, Brazil and France. The description and analysis are organized in three topics: context and trajectory of the health systems; hospitals and emergency services; and the challenges that are faced. The research carried out interviews, surveys, observation and "groupes de rencontre du travail" / GRT. The data analysis was done using participatory appraisal techniques associated to triangulation of sources and data. The main challenges found were: workforce deficit; lack of hospitals beds in inpatient units; deficit of infrastructure and materials; excess of "chronophagic activities"; generational transition; and violence by patients and families.Despite their particularities, the countries coincide regarding the challenges. Measures to rationalize and restrain spending have a greater impact on Algeria and Brazil due to the low level of public funding, but they also occur in France. The hospital management cannot be dissociated from healthcare system planningconsidering the increasing pressures of the demographic and epidemiological transition. In medium term, measures that may mitigate "chronophagic activities", materials deficit and the violence should be considered to improve work in emergencies.

O estudo compara os desafios no trabalho em serviços de emergência de hospitais universitários públicos na Argélia, Brasil e França. A descrição e a análise estão organizadas em três eixos: contexto e trajetória dos sistemas, hospitais e serviços de emergência, e os desafios enfrentados. Nos serviços foram feitas entrevistas, questionários, observação e "groupes de rencontre du travail"/GRT. Para o processo analítico utilizou-se técnicas do "participatory appraisal" complementadas com triangulação de fontes e dados. Os principais desafios referidos foram: déficit da força de trabalho; falta de leitos nos serviços de internação; déficit de infraestrutura e materiais; excesso de atividades cronofágicas; transição geracional; violência pelos usuários e familiares. Medidas de racionalização e contenção de gastos repercutem de modo mais intenso na Argélia e no Brasil onde há um baixo patamar de financiamento público. Nota-se que a gestão hospitalar não pode estar dissociada do planejamento da rede de atenção, tendo em vista as crescentes pressões do complexo produtivo, da transição demográfica e epidemiológica. A médio prazo, medidas que possam atenuar atividades cronofágicas, o deficit de materiais e a violência devem ser consideradas na melhoria do trabalho em emergências.

Distresse moral vivenciado por gestores enfermeiros no contexto de hospitais universitários federais / Distrés moral vivenciado por gestores enfermeros en el contexto de hospitales universitarios federales / Moral distress experienced by nurse managers in the context of federal university hospitals

Resumo Objetivo Analisar a frequência e a intensidade de distresse moral em gestores de enfermagem de Hospitais Universitários Federais. Métodos Estudo transversal desenvolvido com gestores de enfermagem atuantes em diferentes níveis hierárquicos de Hospitais Universitários Federais por meio da aplicação da Escala Brasileira de Distresse Moral em Enfermeiros e questionário sociodemográfico e laboral. Para análise utilizou-se a estatística descritiva, teste de qui-quadrado e teste t para amostras independentes. Resultados Participaram do estudo 126 enfermeiros gestores, 32 do segmento estratégico e 94 do operacional. Um nível moderado de frequência e intensidade de distresse moral foi observado, com médias de 3,07(DP=1,21) e 3,55(DP=1,35), respectivamente. As maiores médias estiveram relacionadas aos fatores Equipe de trabalho, Cuidado seguro e qualificado e Condições de trabalho. Na comparação de grupos, o gestor operacional apresentou os maiores níveis de frequência e intensidade, com médias de 3,33(DP=1,20) e 3,76(DP=1,26), respectivamente. Conclusão Constatou-se que o distresse moral em enfermeiros gestores de hospitais universitários federais se encontra em nível moderado de frequência e intensidade, sendo que os enfermeiros do grupo Gestor de Enfermagem, apresentaram o maior escore de Distresse moral quando comparado ao grupo chefe de Divisão de Enfermagem.

Resumen Objetivo Analizar la frecuencia y la intensidad del distrés moral en gestores de enfermería de Hospitales Universitarios Federales. Métodos Estudio transversal desarrollado con gestores de enfermería que actúan en distintos niveles jerárquicos de Hospitales Universitarios Federales por medio de la aplicación de la Escala Brasileña de Distrés Moral para Enfermeros y el cuestionario sociodemográfico y laboral. Para el análisis se utilizó la estadística descriptiva, prueba chi-cuadrado y prueba t para muestras independientes. Resultados Participaron del estudio 126 enfermeros gestores, 32 del sector estratégico y 94 del operativo. Se observó un nivel moderado de frecuencia e intensidad de distrés moral, con promedios de 3,07(DP=1,21) y de 3,55(DP=1,35), respectivamente. Los mayores promedios estuvieron relacionados con los factores Equipo de trabajo, Cuidado seguro y calificado y Condiciones de trabajo. En la comparación de grupos, el gestor operativo presentó los mayores niveles de frecuencia y de intensidad, con promedios de 3,33(DP=1,20) y de 3,76 (DP=1,26), respectivamente. Conclusión Se verificó que el distrés moral de enfermeros gestores de hospitales universitarios federales se encuentra en un nivel moderado de frecuencia y de intensidad y los enfermeros del grupo Gestor de Enfermería presentaron la mayor puntuación de Distrés moral cuando comparado con el grupo jefe de la División de Enfermería.

Abstract Objective To analyze the frequency and intensity of moral distress in nursing managers of Federal University Hospitals. Methods Cross-sectional study conducted with nursing managers working at different hierarchical levels of Federal University Hospitals through the application of the Brazilian Scale of Moral Distress in Nurses and a sociodemographic and working questionnaire. For analysis, we used descriptive statistics, chi-square test and t test for independent samples. Results 126 nurse managers participated in the study, 32 from the strategic segment and 94 from the operational one. We have observed a moderate level of frequency and intensity of moral distress, mean 3.07(SD=1.21) and 3.55(SD=1.35), respectively. The greatest means were related to the factors Work team, Safe and qualified care and Working conditions. When comparing groups, the operational manager had the highest levels of frequency and intensity, mean 3.33 (SD=1.20) and 3.76 (SD=1.26), respectively. Conclusion We have found that moral distress in managing nurses of federal university hospitals is at a moderate level of frequency and intensity, and nurses in the Nursing Manager group had the highest Moral Distress score when compared to the head group of the Nursing Division.

Sisprad: software for radiological protection management in a hospital environment / Sisprad: software para gestión de protección radiológica en entorno hospitalario / Sisprad: software para gestão da proteção radiológica em ambiente hospitalar

ABSTRACT Objective: to describe the software for the management of radiological protection, SisPRad, and its construction process, as well as to analyze its implementation and use in a radiodiagnosis service. Method: a methodological and quasi-experimental research study carried out between November 2016 and October 2019. The study population consisted of the professionals who make up the Radiological Protection Committee of the service. The model chosen for software engineering was the cascade model. In the implementation phase, an evaluation and analysis of the usability of the software was carried out. Results: the software for radiological protection management presents the structure of the technology and its functionalities. The usability evaluation showed that SisPRad is a tool that will assist the multi-professional and interdisciplinary team of the hospital radiology service in the management of radiological protection. The computerization of the systems and the integration of the sectors that need shared data in the work routines enhance the management of hospital radiological protection for the multi-professional team. The technology was positively evaluated by the multi-professional team working in the hospital radiodiagnosis service. SisPRad generated registration n.. 512019002125-8 by the National Institute of Industrial Property. Conclusion: this tool was developed aiming at the safety of the professionals working in the radiodiagnosis service and of its users, in addition to enabling the constant improvement of the tool, and it can be adapted in other institutions.

RESUMEN Objetivo: describir el software para la gestión de protección radiológica, SisPRad, su proceso de construcción y analizar su implementación y uso en un servicio de radiodiagnóstico. Método: investigación metodológica y cuasiexperimental realizada entre noviembre de 2016 y octubre de 2019. La población de estudio estuvo constituida por los profesionales que integran el Comité de Protección Radiológica del servicio. Para la ingeniería de software, se eligió el modelo en cascada. En la etapa de implementación se realizó la evaluación y el análisis de usabilidad del software. Resultados: el software de gestión de protección radiológica presenta la estructura de la tecnología y sus funcionalidades. La evaluación de usabilidad mostró que SisPRad es una herramienta que ayudará al equipo multidisciplinario e interdisciplinario del servicio de radiología del hospital en la gestión de la protección radiológica. La informatización de sistemas y la integración de sectores que requieren datos en común en las rutinas de trabajo potencian la gestión de la protección radiológica hospitalaria del equipo multidisciplinario. La tecnología fue valorada positivamente por el equipo multiprofesional que cumple sus funciones en el servicio de radiodiagnóstico del hospital. SisPRad generó el registro 512019002125-8 en el Instituto Nacional de Propiedad Industrial. Conclusión: esta herramienta fue desarrollada con el objetivo de promover la seguridad de los profesionales que trabajan en el servicio de radiodiagnóstico y de sus usuarios, además de permitir la mejora constante de la herramienta, que puede ser adaptada a otras instituciones.

RESUMO Objetivo: descrever o software para gestão da proteção radiológica, SisPRad, seu processo de construção e analisar sua implantação e utilização em um serviço de radiodiagnóstico. Método: pesquisa metodológica e quase-experimental realizada entre novembro de 2016 e outubro de 2019. A população do estudo foi constituída pelos profissionais que compõem o Comitê de Proteção Radiológica do serviço. O modelo escolhido para a engenharia do software foi o modelo em cascata. Na fase de implantação foi realizada avaliação e análise da usabilidade do software. Resultados: o software de gestão para proteção radiológica apresenta a estrutura da tecnologia e suas funcionalidades. A avaliação da usabilidade evidenciou que o SisPRad é uma ferramenta que irá auxiliar a equipe multiprofissional e interdisciplinar do serviço de radiologia hospitalar na gestão da proteção radiológica. A informatização dos sistemas e a integração dos setores que necessitam de dados em comum nas rotinas de trabalho potencializam a gestão da proteção radiológica hospitalar para a equipe multiprofissional. A tecnologia foi avaliada positivamente pela equipe multiprofissional atuante no serviço de radiodiagnóstico hospitalar. O SisPRad gerou o registro 512019002125-8 pelo Instituto Nacional de Propriedade Industrial. Conclusão: essa ferramenta foi desenvolvida visando a segurança dos profissionais atuantes no serviço de radiodiagnóstico e seus usuários, além de possibilitar a melhora da ferramenta constantemente, podendo ser adaptada em outras instituições.

Fortalecendo a articulação da rede de atenção psicossocial municipal sob a perspectiva interdisciplinar / Fortaleciendo la articulación de la red de atención psicosocial municipal bajo la perspectiva interdisciplinaria / Strengthening the articulation of the municipal psychosocial network from an interdisciplinary perspective

RESUMO Objetivo: elaborar estratégias de fortalecimento para articulação dos serviços municipais que compõem a rede de atenção psicossocial. Método: pesquisa participante, de abordagem qualitativa, realizada em março e abril de 2019 em um município do sul do Brasil. A coleta de dados envolveu análise documental, questionário e grupo focal. Amostra composta por treze profissionais da Atenção Básica, Núcleo Ampliado Saúde da Família, Policlínica Municipal, Centro de Atenção Psicossocial e Hospital Geral. Análise dos dados de acordo com Minayo, elaboradas as estratégias através da triangulação dos dados. Resultados: potencialidades e fragilidades encontradas no cotidiano profissional, organização e articulação da rede, e estratégias para fortalecê-la. Dentre as estratégias elaboradas, destacamse a necessidade do matriciamento nos serviços de saúde, capacitação, empoderamento dos profissionais. Conclusão: A literatura é escassa sobre as estratégias para articulação da rede, recomendando-se novos estudos. A atual pesquisa mostra a importância e inevitalidade da articulação, contribuindo na melhora da prática.

RESUMEN: Objetivo: elaborar estrategias de fortalecimiento para la articulación de los servicios municipales que componen la red de atención psicosocial. Método: pesquisa participante con aproximación cualitativa, realizada en marzo y abril de 2019 en un municipio en el sur de Brasil. La recolección de datos implico el análisis documental, cuestionario y grupo focal. Muestra compuesta por trece profesionales de Atención Básica, Núcleo Ampliado de Salud Familiar, Policlínica Municipal, Centro de Atención Psicosocial y Hospital General. El análisis de los datos según Minayo y elaboración de estrategias mediante la triangulación de los datos. Resultados: potencialidades y fragilidades encontradas en la vida profesional cotidiana, organización y articulación de la red, y estrategias para fortalecerla. Entre las estrategias elaboradas se destacan la necesidad de apoyo matricial en los servicios de salud, la capacitación y el empoderamiento de los profesionales. Conclusión: Hay escasez de literatura sobre estrategias para la articulación de la red y se recomiendan nuevos estudios. La actual investigación indica la importancia e inevitabilidad de la articulación, lo que contribuye a mejorar la práctica.

ABSTRACT Objective: to elaborate strategies of strengthening for articulating the municipal services that make up the psychosocial care network. Method: participant research with qualitative approach, carried out in the months of March and April 2019 in a municipality of the South of Brazil. Data collection involved a documental analysis, questionnaire and focus group. Sample composed by thirteen professionals of Basic Health Care, Expanded Nucleus of Family Health, Municipal Polyclinic, Psychosocial Care Center and General Hospital. Data analysis according to Minayo and elaboration of strategies through data triangulation. Results: potentialities and weaknesses found in daily professional work, organization and articulation of the network, and strategies to strengthen it. Among the strategies elaborated, the need for matrix support in health services, training and empowerment of professionals stand out. Conclusion: Literature is scarce on strategies for network articulation, and new studies are recommended. The current research shows the importance and unavoidability of articulation, contributing for the improvement of practice.

Professional Master's Degree: potential contribution to Advanced Practice Nursing.

A reflection articleabout the contribution of Master's Degree Programs in Advanced Practice Nursing and the Universal Health Coverage and the Universal Health Access, topicsthat have been discussed by the Pan American Health Organization, and which the Brazilian Nursingrequires not just appropriate, but further studyto reflect in order to define directions for our profession.

Nursing Doctorates in Brazil: research formation and theses production.

OBJECTIVE: to analyze the formation of nursing doctorates in Brazil, from theses production, disciplines and other strategies focusing on research offered by courses. METHOD: a descriptive and analytical study of the performance of 18 doctoral courses in nursing, running from 1982 to 2010, and defended their theses between 2010-2012. RESULTS: 502 theses were defended in this period, most linked to the online research process of health and nursing care. There are gaps in the knowledge of theoretical and philosophical foundations of care, nursing history and ethics. There are also weaknesses in the methodological design of the theses, with a predominance of descriptive and/or exploratory studies. This was consistent with international standards set with regards to the proposition of research of disciplines and complementary strategies in forming the doctorate. CONCLUSION: despite the efforts and advances in research formation, it is essential to expand to more robust research designs with a greater impact on production knowledge that is incorporated into practice.