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RESUMEN Objetivo: Determinar los factores asociados al desempeño laboral en el personal de salud del Hospital Carlos Showing Ferrari, Huánuco, periodo 2022. Materiales y métodos: Estudio observacional, correlacional y prospectivo, cuya población estuvo constituida por 146 profesionales de la salud y su muestra, por 86. La información se recolectó mediante un cuestionario, donde la variable desempeño laboral fue evaluada con la escala de desempeño laboral individual de Koopmans et al. (Individual Work Performance Questionaire), validada y con confiabilidad alfa de Cronbach mayor a 0,8, y los factores fueron sociodemográficos, laborares y académicos. El análisis estadístico de los datos se realizó mediante la prueba de chi cuadrado, evaluado en el programa SPSS, versión 25. Resultados: Se evidenció que la gran parte de los profesionales de salud mostró un desempeño laboral de nivel muy alto (60,47 %). De manera inferencial, los factores sociodemográficos como las edades de 31 a 45 años (p = 0,027) y de 46 a 60 años (p = 0,045) se asociaron de manera significativa al desempeño laboral de nivel muy alto. En relación con los factores laborales, el tiempo laboral mayor e igual a 21 años (p = 0,049) fue el único factor asociado de manera significativa al desempeño laboral de nivel muy alto. No hubo asociación entre los factores académicos y el desempeño laboral de nivel muy alto (p > 0,05). Conclusiones: Los factores asociados significativamente al desempeño laboral de nivel muy alto en el personal de salud fueron las edades de 31 a 45 años y de 46 a 60 años y el tiempo laboral mayor e igual a 21 años.
ABSTRACT Objective: To determine the factors associated with work performance among the health personnel of Hospital Materno Infantil Carlos Showing Ferrari, Huánuco, in 2022. Materials and methods: An observational, correlational and prospective study with a population of 146 health professionals and a sample size of 86 individuals. The information was collected through a questionnaire, where the variable work performance was evaluated with the Individual Work Performance Questionnaire by Koopmans et al. and validated with Cronbach's Alpha greater than 0.8. The factors analyzed encompassed sociodemographic, work-related and academic variables. The statistical analysis was conducted using the chi-square test and the data were analyzed with IBM SPSS Statistics V25. Results: Most health professionals showed a very high-level work performance (60.47 %). Inferentially, sociodemographic factors such as age 31 to 45 years (p = 0.027) and 46 to 60 years (p = 0.045) were significantly associated with a very high-level work performance. Concerning work-related factors, work time greater than and equal to 21 years (p = 0.049) was the only factor significantly associated with a very high-level work performance. There was no association between academic factors and a very high-level work performance (p > 0.05). Conclusions: The factors significantly associated with a very high-level work performance among the health personnel were age 31 to 45 years and 46 to 60 years and work time greater than and equal to 21 years.
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Introducción: El proceso fisiológico de envejecer conlleva a situaciones de riesgo, así como al deterioro acelerado de la salud, que incluye la fragilidad. Objetivo: Determinar el estado del desempeño profesional del médico de la familia para la atención al adulto mayor frágil. Método: Se realizó un estudio observacional descriptivo, la población estuvo constituida por 28 médicos de familia. Se evaluaron 4 dimensiones (cognitiva, asistencial, bioética y científica-investigativa) y 18 indicadores. Se efectuó triangulación metodológica para establecer problemas y potencialidades. En el procesamiento estadístico se realizó el análisis porcentual. Resultados: Hubo poco dominio por los médicos encuestados del criterio de fragilidad, así como de sus síntomas y signos (78,5 %), reflejaron un deficiente enfoque terapéutico en los adultos mayores frágiles (57,5 %). Se constató una baja frecuencia de realización de actividades de promoción de salud (85,7 % de los casos) e insuficiente utilización de los instrumentos necesarios para la evaluación multidimensional de los adultos mayores, empleados solo por el 23,0 % de los facultativos estudiados. Entre las potencialidades se observó buena disposición de los médicos a participar en cursos sobre fragilidad y aplicación correcta de los principios éticos y morales. Conclusiones: Se comprueba un insuficiente desempeño de los médicos de familia en la atención integral de los adultos mayores frágiles.
Introduction: The physiological process of aging leads to risk situations, as well as the accelerated deterioration of health that includes frailty. Objective: To determine the state of the professional performance of the family doctor for the care of the frail elderly. Method: An observational descriptive study was carried out, the population consisted of 28 family doctors. Four dimensions (cognitive, care, bioethics and scientific-investigative) and 18 indicators were evaluated. Methodological triangulation was carried out to establish problems and potentialities. In the statistical processing, the percentage analysis was performed. Results: There was little mastery of the respondents of the frailty criteria, knowledge of the symptoms and signs (78.5%), as well as a deficient therapeutic approach in frail older adults (57.5%). The frequency of carrying out health promotion activities (85.7% of the cases) and the use of instruments for the multidimensional evaluation of the elderly was low, used only by 23,0 %. Among the potentialities, a willingness of doctors to participate in courses on frailty and correct application of ethical and moral principles was observed. Conclusions: An insufficient performance of family doctors in the comprehensive care of frail older adults was determined.
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Performance appraisal of public hospitals have given a guidance for the development of public hospitals at all levels.A Class A tertiary hospital reviewed the problems in the development of the hospital at the present stage and focused on the following four aspects:①insufficient fine management;②No clear orientation of discipline development;③The bottleneck of the improvement of medical operation efficiency;④New challenges in the reform of payment mode.The tertiary hospital launched a fine management practice in May 2022,in order to solve the problems by taking the Department of Surgery as a pilot area,laying the foundation for fine management through information system construction,improving the efficiency of medical operation through management process optimization,improving the overall competitiveness of disciplines through the construction of sub-specialty and Discipline Alliance and adjusting the performance appraisal index system to play the role of performance incentives.The measures effectively improve the overall capacity and efficiency of hospital medical services and help the hospital to achieve high-quality development.
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The high-quality development requirements for public hospitals,national examination orientations,and DIP medical insurance payment reforms present significant challenges to the refined management of public hospitals.Therefore,it is essential to enhance the operational management of these institutions.This paper aims to develop an operation evaluation index system for clinical departments using the Delphi method for assessing the efficiency of resource input and output across various clinical departments.It provides a scientific basis for decision-making regarding resource allocation,transformation towards re-fined management,and the enhancement of operational guidance for departments.
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The performance appraisal of public hospitals is the most official and authoritative assessment and evaluation of tertiary public hospitals in China,and it is an important measure to guide hospitals to improve their internal management level and achieve high-quality development.In this study,a data monitoring management system based on the performance appraisal indicators of national tertiary public hospitals was developed and constructed through intelligent collection and reporting,report in-tegration,visual analysis,data drilling,etc.,which realized the one-stop dynamic management of indicators,optimized the data filling process of national examination indicators,improved the data quality and credibility,and promoted the integration of na-tional assessment and hospital assessment.the intelligent management level of the hospital has been improved,which provides strong support for the hospital's refined operation management and scientific decision-making.
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The reform of public hospital salary system is an important part of China's medical and health system reform,and it is also the key and difficult point to be solved in the high-quality development of public hospitals.Through literature research and comparative analysis,it sorts out the reform process of China's public hospital salary system and the salary status of medical personnel,and compares the differences between the salary systems of public hospitals in some developed countries;Some difficult problems exist in this field,such as insufficient and unbalanced government financial investment,weak guarantee of salary system,low salary level of medical personnel and unrea-sonable internal gap,and unscientific performance appraisal distribution.Countermeasures and suggestions are put forward from five aspects:strengthening government financial input,implementing system guarantee,improving performance appraisal and distribution system,non-economic compensation,and strengthening information sup-port,so as to provide reference for further improving the reform effect.
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It is of great significance to construct an information platform for performance appraisal of tertiary public hospitals to realize real-time monitoring and intervention of appraisal indicators, which is conducive to the transmission of responsibility for index optimization to departments and medical groups, and to promote the fine management of hospitals and promote high-quality development.This paper introduced the practice and effect of building a performance appraisal information platform for tertiary public hospitals in four aspects: accurate data filling, timely dynamic monitoring, visual display and safety management since 2022. At the same time, suggestions were put forward for platform optimization from four aspects: data quality control, co-construction and sharing, promotion and application, and system integration, in order to provide reference for other hospitals.
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OBJECTIVE To provide reference for improving the work efficiency of staff and promoting the discipline construction of pharmacy department. METHODS By analyzing the current situation of performance management in the pharmacy department of our hospital， the key successful factors were sorted out， strategic decoding was carried out and key performance indicators were extracted. The quarterly and annual performance appraisal forms were formulated for the departments of pharmacy warehouse， outpatient pharmacy， ward pharmacy， clinical pharmacy department， prescription examination center， laboratory and other departments； the performance management information platform was built. The work efficiency and output of each department were compared half a year before and after the implementation of the performance management plan. RESULTS After the implementation of the program， the average queuing time for drug collection in the outpatient department was shortened from 5 minutes to 3 minutes， the average number of dispensing infusion bags per hour in the pharmacy intravenous admixture services increased from 50 bags to 60 bags， and antibacterial use density of the hospital decreased from 42.7 DDD（defined daily doses） to 40.2 DDD. The number of academic papers published had increased from 8 to 10， and the satisfaction of clinical departments with ward pharmacies increased from 85% to 95%. CONCLUSIONS The performance management system has been successfully established in pharmacy department of our hospital， which can improve the enthusiasm of pharmacists， reflect the value of pharmaceutical care， and promote the discipline construction of pharmacy.
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Objective:To improve the public welfare attributes of public hospitals through the optimization of the performance ap-praisal system of public hospitals,stimulate the enthusiasm of medical staff,and continuously improve the quality and level of medi-cal services.Methods:From the perspective of value co-creation,the three-party value subjects of hospitals,patients and depart-ments are considered,and the core indicators of Diagnosis Related Group(DRG)and Resource-based Relative Value Scale(RBRVS)accounting methods are introduced to construct a performance appraisal system at the level of medical departments in public hospi-tals.Results:The sample hospital applied DRG and RBRVS-based medical department performance appraisal system,and found that the equity of performance evaluation,the efficiency of hospital operation ability,and the satisfaction of patients and medical staff were significantly improved.Conclusion:Based on the theory of value co-creation,the performance appraisal system of the case hos-pital is optimized into three dimensions:cost control assessment,KPI index assessment and workload assessment,so as to achieve consistency between performance appraisal work objectives,and the the result variables of value co-creation,promote the balance of service quality and quantity of medical service providers,and promote the optimization of the effect of hospitals,departments and pa-tients.
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Resumo Objetivo Verificar convergências e divergências entre a autoavaliação de enfermeiros assistenciais e as avaliações de gerentes imediatos na perspectiva de rol de competências profissionais de enfermagem. Métodos Estudo descritivo de abordagem quantitativa. Participaram 58 enfermeiros de um hospital universitário federal da região Norte do Brasil. Os dados foram obtidos utilizando-se dois questionários, um de autoavaliação do profissional e um de avaliação desses profissionais por seus gerentes de enfermagem imediatos. A análise dos dados foi realizada por meio de estatística descritiva, com centralização dos dados no programa Microsoft Excel 2016. Resultados Os enfermeiros adotavam competências profissionais Gerenciais, Assistenciais, Atitudinais e de Ensino. Os grupos Gerenciais e Assistenciais obtiveram maior destaque. Trabalho em Equipe e Supervisão da Equipe foram as competências Gerenciais mais evidenciadas. A maioria das competências identificadas apresentou convergência entre a autoavaliação e a avaliação de desempenho pelos gerentes dos serviços. Educação Permanente e Dimensionamento da Equipe surgiram de forma assimétrica entre as duas modalidades de avaliação. Entre as competências Assistenciais, Sistematização da Assistência de Enfermagem e Raciocínio Clínico foram as mais evidenciadas. As competências Atitudinais foram o grupo com maior divergência entre as avaliações, seguidas da competência Ensino/Preceptoria. Conclusão Evidenciou-se subjetividade nos processos de avaliação e autoavaliação de competências profissionais de enfermagem na instituição estudada, comumente gerando dissonâncias quando realizadas. A maioria das competências identificadas estava nos grupos Gerenciais e Assistenciais, apresentando convergência entre a avaliação de desempenho dos profissionais pelos gerentes dos serviços e sua autoavaliação.
Resumen Objetivo Verificar las convergencias y divergencias entre la autoevaluación de enfermeros asistenciales y la evaluación de jefes inmediatos bajo la perspectiva del rol de competencias profesionales de enfermería. Métodos Estudio descriptivo de enfoque cuantitativo. Participaron 58 enfermeros de un hospital universitario federal de la región Norte de Brasil. Los datos se obtuvieron a través de dos cuestionarios: uno de autoevaluación profesional y uno de evaluación de estos profesionales por parte de sus jefes de enfermería inmediatos. El análisis de datos se realizó mediante estadística descriptiva, utilizando el programa Microsoft Excel 2016 para la centralización de los datos. Resultados Los enfermeros adoptaban competencias profesionales gerenciales, asistenciales, actitudinales y de enseñanza. Los grupos gerenciales y asistenciales fueron los más destacados. El trabajo en equipo y la supervisión del equipo fueron las competencias gerenciales con mayor evidencia. La mayoría de las competencias identificadas presentó convergencia entre la autoevaluación y la evaluación de desempeño de los jefes de los servicios. La educación permanente y el dimensionamiento del equipo se presentaron de forma asimétrica entre las dos modalidades de evaluación. Entre las competencias asistenciales, la sistematización de la atención de enfermería y el razonamiento clínico fueron las más destacadas. El grupo con más divergencia entre las evaluaciones fue el de las competencias actitudinales, seguido por la competencia enseñanza/mentoría. Conclusión Se evidenció subjetividad en los procesos de evaluación y autoevaluación de competencias profesionales de enfermería en la institución estudiada, que normalmente causan discrepancias cuando se realizan. La mayoría de las competencias identificadas se encontraba en los grupos gerenciales y asistenciales y se observó convergencia entre la evaluación de desempeño de los profesionales por parte de los jefes de los servicios y su autoevaluación.
Abstract Objective To verify convergences and divergences between the self-assessment of nursing assistants and the assessments of immediate managers from the perspective of the list of professional nursing competencies. Methods A descriptive study with a quantitative approach. Fifty-eight nurses from a federal university hospital in northern Brazil took part. Data was obtained using two questionnaires, one for professional self-assessment and one for the assessment of these professionals by their immediate nursing managers. Data analysis was carried out using descriptive statistics, with data centralization in the Microsoft Excel 2016 software. Results Nurses adopted Managerial, Assistance, Attitudinal and Teaching professional competencies. The Managerial and Assistance groups stood out the most. Teamwork and Team Supervision were the most prominent Managerial competencies. Most of the competencies identified converged between self-assessment and performance evaluation by service managers. Continuing Education and Team Sizing appeared asymmetrically between the two types of evaluation. Among the care competencies, Systematization of Nursing Care and Clinical Reasoning were the most prominent. The Attitudinal competences were the group with the greatest divergence between the evaluations, followed by the Teaching/Preceptorship competence. Conclusion There was evidence of subjectivity in the processes of evaluation and self-assessment of professional nursing competencies in the institution studied, which commonly generate dissonance when they are carried out. Most of the competences identified were in the Management and Care groups, showing convergence between the evaluation of professionals' performance by service managers and their self-assessment.
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ABSTRACT The article discusses the evolution of the Brazilian College of Surgeons (CBC) specialist title exam, highlighting the importance of evaluating not only theoretical knowledge, but also the practical skills and ethical behavior of candidates. The test was instituted in 1971, initially with only the written phase, and later included the oral practical test, starting with the 13th edition in 1988. In 2022, the assessment process was improved by including the use of simulated stations in the practical test, with the aim of assessing practical and communication skills, as well as clinical reasoning, in order to guarantee excellence in the assessment of surgeons training. The aim of this study is to demonstrate the performance of candidates in the last five years of the Specialist Title Test and to compare the performance results between the different surgical training groups of the candidates. The results obtained by candidates from the various categories enrolled in the test in the 2018 to 2022 editions were analyzed. There was a clear and statistically significant difference between doctors who had completed three years of residency recognized by the Ministry of Education in relation to the other categories of candidates for the Specialist Title..
RESUMO O artigo aborda a evolução da prova de título de especialista do Colégio Brasileiro de Cirurgiões (CBC), destacando a importância de avaliar não apenas o conhecimento teórico, mas também as habilidades práticas e o comportamento ético dos candidatos. A prova foi instituída em 1971, inicialmente com apenas a fase escrita, e posteriormente foi incluída a prova prática oral, a partir da 13ª edição em 1988. Em 2022, foi aprimorado o processo de avaliação, incluindo na prova prática o uso de estações simuladas, visando avaliar habilidades práticas e de comunicação, além do raciocínio clínico, buscando garantir a excelência da avaliação da formação dos cirurgiões. O objetivo deste estudo é demonstrar o desempenho dos candidatos nos últimos cinco anos da Prova de Título de Especialista e comparar os resultados dos desempenhos entre os diferentes grupos de formação cirúrgica dos candidatos. Foram analisados os resultados obtidos pelos candidatos das diversas categorias inscritas na prova nas edições de 2018 a 2022. Ficou evidente e estatisticamente significativa a diferença entre os médicos que fizeram três anos de residência reconhecida pelo MEC em relação aos demais categorias de candidatos ao Título de Especialista.
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ABSTRACT Objective: To identify how stress measured by salivary cortisol during clinical simulation-based education, or simulation and another teaching method, impacts performance. Method: Systematic review of the association between cortisol and performance in simulations. The following databases were used: PubMed, LIVIVO, Scopus, EMBASE, Latin American and Caribbean Health Sciences Literature (LILACS) and Web of Science. Additional searches of gray literature were carried out on Google Scholar and Proquest. The searches took place on March 20, 2023. The risk of bias of randomized clinical trials was assessed using the Cochrane Collaboration Risk of Bias Tool (RoB 2). Inclusion criteria were: simulation studies with salivary cortisol collection and performance evaluation, published in any period in Portuguese, English and Spanish. Results: 11 studies were included which measured stress using salivary cortisol and were analyzed using descriptive synthesis and qualitative analysis. Conclusion: Some studies have shown a relationship between stress and performance, which may be beneficial or harmful to the participant. However, other studies did not show this correlation, which may not have been due to methodological issues.
RESUMEN Objetivo: Identificar cómo el estrés medido por el cortisol salival durante la enseñanza basada en la simulación clínica, o la simulación y otro método de enseñanza, influye en el rendimiento. Método: Revisión sistemática de la asociación entre cortisol y rendimiento en simulaciones. Se utilizaron las siguientes bases de datos: PubMed, LIVIVO, Scopus, EMBASE, Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS) y Web of Science. Se realizaron búsquedas adicionales de literatura gris en Google Scholar y Proquest. Las búsquedas se realizaron el 20 de marzo de 2023. El riesgo de sesgo de los ensayos clínicos aleatorios se evaluó mediante la Herramienta de Riesgo de Sesgo (RoB 2) de la Colaboración Cochrane. Los criterios de inclusión fueron: estudios de simulación con recogida de cortisol salival y evaluación del rendimiento, publicados en cualquier periodo en portugués, inglés y español. Resultados: Se incluyeron 11 estudios que midieron el estrés mediante cortisol salival y se analizaron mediante síntesis descriptiva y análisis cualitativo. Conclusión: Algunos estudios mostraron una relación entre el estrés y el rendimiento, que puede ser beneficiosa o perjudicial para el participante. Sin embargo, otros estudios no mostraron esta correlación, lo que puede no haberse debido a cuestiones metodológicas.
RESUMO Objetivo: Identificar como o estresse mensurado por cortisol salivar durante a educação baseada em simulação clínica ou simulação e outro método de ensino, tem impacto no desempenho. Método: Revisão sistemática da associação do cortisol com o desempenho em simulações. Foram utilizadas as seguintes bases de dados: PubMed, LIVIVO, Scopus, EMBASE, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Web of Science. Pesquisa adicional de literatura cinzenta foi realizada no Google Scholar e no Proquest. As buscas ocorreram em 20 de março de 2023. O risco de viés dos ensaios clínicos randomizados, foi avaliado pela ferramenta Cochrane Collaboration Risk of Bias Tool (RoB 2). Foram critérios de inclusão: estudos de simulação com coleta de cortisol salivar e avaliação de desempenho, publicados em qualquer período em português, inglês e espanhol. Resultados: 11 estudos foram incluídos, os quais mensuraram o estresse utilizando o cortisol salivar e analisados através da síntese descritiva e da análise qualitativa. Conclusão: Alguns estudos mostraram haver relação entre estresse e desempenho, podendo ser benéfico ou prejudicial ao participante. Porém, outros estudos não apresentaram essa correlação que pode não ter ocorrido por questões metodológicas.
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Humans , Stress, Psychological , Hydrocortisone , Systematic Review , Employee Performance Appraisal , Simulation TrainingABSTRACT
Objetivo: relacionar las competencias profesionales de los enfermeros de urgencia y emergencia con el producto del cuidado de enfermería. Método: estudio transversal, realizado en las unidades de urgencia y emergencia de dos hospitales públicos. Participaron 91 enfermeros, 3 residentes de enfermería, 4 coordinadores y 1 gestor. Se utilizaron dos instrumentos validados: 1) Escala de Competencia de las Acciones de los Enfermeros en Emergencias y 2) Evaluación del Producto del Cuidado de Enfermería. Se utilizaron factores y dominios, respectivamente. Se aplicaron estadística descriptiva, alfa de Cronbach, pruebas de Wilcoxon y correlación de Spearman (p<0,05). Resultados: para las competencias profesionales se registraron valores más altos en la autoevaluación (p<0,001). En las 1.410 evaluaciones del producto del cuidado de enfermería, prevaleció el puntaje "bueno" (n=1034 - 73,33%). El dominio "dimensionamiento del personal de enfermería" se relacionó con los factores "práctica profesional" r=0,52719, "relaciones en el trabajo" r=0,54319, "desafío positivo" r=0,51199, "acción dirigida" r=0,43229, "conducta constructiva" r=0,25601 y "adaptación al cambio" r=0,22095; el dominio "seguimiento y transferencia del cuidado", con "práctica profesional" r=0,47244, "relaciones en el trabajo" r=0,46993, "desafío positivo" r=0,41660 y "adaptación al cambio" r=0,31905 y el dominio "satisfacción de las necesidades asistenciales", con "práctica profesional" r=0,32933, "relaciones en el trabajo" r=0,31168, "desafío positivo" r=0,29845 y "adaptación al cambio" r=0,28817. Conclusión: hay relación entre las competencias profesionales y los dominios del producto del cuidado de enfermería.
Objective: to relate urgency and emergency nurses' professional competencies with the Nursing care product. Method: a cross-sectional study conducted in the urgency and emergency units of two public hospitals. The participants were 91 nurses, 3 Nursing residents, 4 coordinators and 1 manager. Two validated instruments were used: 1) Competence Scale of Actions of Nurses in Emergencies and 2) Nursing Care Product Evaluation. Factors and domains were used, respectively. Descriptive statistics were applied, as well as Cronbach's alpha, Wilcoxon and Spearman's correlation tests (p<0.05). Results: in the professional competencies, higher values were verified for self-evaluation (p<0.001). In all 1,410 Nursing care product assessments, there was predominance of the "Good" score (n=1,034 - 73.33%). The "Nursing staffing" domain was related to the "Professional practice" (r=0.52719), "Relationships at work" (r=0.54319), "Positive challenge" (r=0.51199), "Targeted action" (r=0.43229), "Constructive behavior" (r=0.25601) and "Adaptation to change" (r=0.22095) factors; the "Care monitoring and transfer" domain, with "Professional practice" (r=0.47244), "Relationships at work" (r=0.46993), "Positive challenge" (r=0.41660) and "Adaptation to change" (r=0.31905) and the "Meeting care needs" domain, with "Professional practice" (r=0.32933), "Relationships at work" (r=0.31168), "Positive challenge" (r=0.29845) and "Adaptation to change" (r=0.28817). Conclusion: there is a relationship between professional competencies and the Nursing care product domains.
Objetivo: relacionar as competências profissionais do enfermeiro em urgência e emergência com o produto do cuidar em enfermagem. Método: estudo transversal, realizado nas unidades de urgência e emergência de dois hospitais públicos. Participaram 91 enfermeiros, 3 residentes em enfermagem, 4 coordenadores e 1 gerente. Utilizaram-se dois instrumentos validados: 1) Escala de Competências das Ações dos Enfermeiros em Emergências e 2) Avaliação do Produto do Cuidar em Enfermagem. Utilizaram-se fatores e domínios, respectivamente. Aplicaram-se estatística descritiva, alfa de Cronbach, testes Wilcoxon e correlação de Spearman (p<0,05). Resultados: em competências profissionais, verificaram-se maiores valores para autoavaliação (p<0,001). Nas 1.410 avaliações do produto do cuidar em enfermagem, predominou o escore "bom" (n=1034 - 73,33%). O domínio "dimensionamento de pessoal de enfermagem" relacionou-se com os fatores "prática profissional" r=0,52719, "relações no trabalho" r=0,54319, "desafio positivo" r=0,51199, "ação direcionada" r=0,43229, "conduta construtiva" r=0,25601 e "adaptação à mudança" r=0,22095; o domínio "acompanhamento e transferência do cuidado", com "prática profissional" r=0,47244, "relações no trabalho" r=0,46993, "desafio positivo" r=0,41660 e "adaptação à mudança" r=0,31905 e o domínio "atendimento das necessidades assistenciais", com "prática profissional" r=0,32933, "relações no trabalho" r=0,31168, "desafio positivo" r=0,29845 e "adaptação à mudança" r=0,28817. Conclusão: existe relação entre as competências profissionais e os domínios do produto do cuidar em enfermagem.
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Humans , Professional Competence , Professional Practice , Cross-Sectional Studies , NursesABSTRACT
El sector de la salud se encuentra actualmente con una alta demanda de atención tanto en la atención primaria como de emergencia dentro de los centros hospitalario. Por ello, los profesionales de la salud tienen una alta probabilidad de desarrollar cuadros de estrés laboral por las características de su trabajo, y la rapidez en la atención con la cual tienen que lidiar día tras día. Objetivo. Evaluar la relación del síndrome de burnout con el desempeño laboral en el sector salud de Perú. Materiales y métodos. El estudio se estableció bajo el enfoque cuantitativo, de análisis correlacional, con diseño no experimental, de corte transversal. La muestra considerada fue de 75 servidores de salud perteneciente a un centro de salud del territorio peruano; como la técnica se usó encuesta y el instrumento el utilizado fue el cuestionario tipo Likert. Resultados. Se evidencio que un 41,4% los encuestados consideran que existe un alto nivel de síndrome de burnout, y que se tiene un nivel regular de desempeño laboral en un 45,3%, adicionalmente un valor de -0,637 de Rho de Spearman con una significancia de 0,000. Conclusiones. El síndrome de burnout se relaciona de forma negativa moderada con el desempeño laboral en el sector salud del Perú, denotando que en la medida que se tenga un nivel bajo de síndrome de burnout, genera un mejor desempeño laboral y viceversa.
The health sector is currently facing a high demand for care in both primary care and emergency care within hospital centers. Therefore, health professionals have a high probability of developing occupational stress due to the characteristics of their work, and the speed of care with which they have to deal day after day. Objective. To evaluate the relationship between burnout syndrome and work performance in the Peruvian health sector. Materials and methods. The study was established under a quantitative approach, correlational analysis, with a non-experimental, cross-sectional design. The sample considered was 75 health workers belonging to a health center in Peru; the technique used was a survey and the instrument used was a Likert-type questionnaire. Results. It was found that 41.4% of the respondents consider that there is a high level of burnout syndrome, and that 45.3% have a regular level of work performance, in addition to a value of -0.637 of Spearman's Rho with a significance of 0.000. Conclusions. burnout syndrome is moderately negatively related to work performance in the Peruvian health sector, indicating that the lower the level of burnout syndrome, the better the work performance and vice versa.
Atualmente, o setor de saúde enfrenta uma alta demanda tanto de atendimento primário quanto de atendimento de emergência em hospitais. Como resultado, os profissionais de saúde têm uma alta probabilidade de desenvolver estresse relacionado ao trabalho devido às características de seu trabalho e à velocidade do atendimento com que têm de lidar diariamente. Objetivo. Avaliar a relação entre a síndrome de burnout e o desempenho no trabalho no setor de saúde no Peru. Materiais e métodos. O estudo foi realizado com uma abordagem quantitativa, análise correlacional, com um desenho não experimental e transversal. A amostra considerada foi de 75 profissionais de saúde pertencentes a um centro de saúde no Peru; a técnica utilizada foi uma pesquisa e o instrumento utilizado foi um questionário do tipo Likert. Resultados. Verificou-se que 41,4% dos entrevistados consideram que há um alto nível de síndrome de burnout e que 45,3% têm um nível regular de desempenho no trabalho, além de um valor de -0,637 de Spearman's Rho com uma significância de 0,000. Conclusões. A síndrome de burnout está moderadamente relacionada de forma negativa ao desempenho no trabalho no setor de saúde peruano, indicando que quanto menor o nível de síndrome de burnout, melhor o desempenho no trabalho e vice-versa.
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O Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica foi parte importante do processo de negociação e pactuação das três esferas de gestão do Sistema Único de Saúde e objetiva avaliar os resultados da Atenção Básica. O objetivo deste estudo foi avaliar como se comportaram os indicadores de estrutura nas Unidades de Saúde brasileiras que participaram do segundo e terceiro ciclo do PMAQAB, a fim de compará-los. Trata-se de estudo ecológico transversal, com análise de banco de dados de acesso público dos municípios brasileiros. Os desfechos considerados foram o número de indicadores de estrutura para cada equipe e a variação na quantidade de indicadores de estrutura. O nordeste foi a região com maior adesão de equipes de saúde foi a Nordeste. Entre os indicadores de estrutura, houve melhora significativa na construção de salas de vacina e salas para dispensação de medicamentos.
The National Program for the Improvement of Access and Quality of Primary Health Care was an important part of the negotiation and agreement process among the three levels of management of the Brazilian Unified Health System, aiming to evaluate theresults of Primary Care.The objective of this study was to evaluate how structure indicators behaved in Brazilian health units that participated in the second and third cycles of the program, in order to discuss the hypothesis that resources produce improvements in structure indicators. This is a cross-sectional ecological study that analyzed publicly available databases of Brazilian municipalities. The outcomes considered were the number of structure indicators for each team and the variation in the quantity of structure indicators.The Northeast region had the highest adherence of health teams. Among the structure indicators, there was a significant improvement in the construction of vaccination rooms and rooms for dispensing medication.
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RESUMO Objetivos: construir e validar cenário simulado e checklist para avaliação de habilidades no atendimento do paciente hemodinamicamente instável com evolução à Parada Cardiorrespiratória; e testar aplicabilidade à população-alvo, avaliando habilidades e satisfação/autoconfiança com a aprendizagem. Método: estudo metodológico realizado em três etapas (desenvolvimento do cenário e checklist, validação por juízes e teste-piloto) no período entre abril de 2020 e setembro de 2021, no estado de Minas Gerais, Brasil. Participaram 14 juízes e 24 estudantes de enfermagem. Resultados: o cenário e checklist alcançaram Coeficiente de Validade de Conteúdo superior a 90. As habilidades foram desenvolvidas adequadamente, com média 4,71 ± 0,24 na escala de satisfação-autoconfiança, e 4,83 ± 0,25 para design da simulação. Conclusão: o cenário poderá contribuir para: aperfeiçoar as atividades educativas na graduação e educação em saúde; e subsidiar estudos futuros, a fim de ampliar a qualidade do atendimento e da assistência ao paciente hemodinamicamente instável com evolução à parada cardiorrespiratória.
ABSTRACT Objectives: to build and validate a simulated scenario and checklist to assess skills in the care of hemodynamically unstable patients with evolution to Cardiorespiratory Arrest, and to test applicability to the target population, assessing skills and satisfaction/self-confidence with learning. Method: methodological study carried out in three stages (development of the scenario and checklist, validation by judges and pilot test) between April 2020 and September 2021, in the state of Minas Gerais, Brazil. Fourteen judges and 24 nursing students participated. Results: the scenario and checklist achieved a Content Validity Coefficient greater than 90. The skills were adequately developed, with a mean of 4.71 ± 0.24 on the satisfaction-self-confidence scale, and 4.83 ± 0.25 for simulation design. Conclusion: The scenario may contribute to improving educational activities in undergraduate and health education and subsidize future studies to increase the quality of care and assistance to hemodynamically unstable patients with evolution to cardiac arrest.
RESUMEN Objetivos: construir y validar un escenario simulado y una lista de verificación para evaluar las habilidades en la atención de pacientes hemodinámicamente inestables con evolución a Parada Cardiorrespiratoria; y probar la aplicabilidad a la población objetivo, evaluando las habilidades y la satisfacción/autoconfianza con el aprendizaje. Método: estudio metodológico realizado en tres etapas (desarrollo del escenario y lista de verificación, validación por jueces y prueba piloto) entre abril de 2020 y septiembre de 2021, en el estado de Minas Gerais, Brasil. Participaron 14 jueces y 24 estudiantes de enfermería. Resultados: el escenario y la lista de verificación alcanzaron un Coeficiente de Validez de Contenido superior a 90. Las habilidades se desarrollaron adecuadamente, con una media de 4,71 ± 0,24 en la escala de satisfacción-autoconfianza, y de 4,83 ± 0,25 para el diseño de la simulación. Conclusión: el escenario puede contribuir a: mejorar las actividades educativas de pregrado y formación sanitaria; y subvencionar futuros estudios para aumentar la calidad de la atención y asistencia a pacientes hemodinámicamente inestables con evolución a parada cardiaca.
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Objetivo : Conocer la satisfacción laboral en los académicos de la licenciatura de Cirujano Dentista del Facultad de Estudios Superiores Zaragoza, Universidad Nacional Autónoma de México en el período 2019. Material y métodos : Estudio observacional, prolectivo, transversal, descriptivo. La población de estudio estuvo conformada por 123 académicos, a los que se les aplicó un cuestionario de 20 ítems con respuestas en escala Likert (α de Cronbach 0.845). Resultados : Del total de encuestados, el 45% (55) del sexo masculino, 55% (68) del femenino, con una media de edad de 36.5 (± 9.6) años. El 48% (59) de los académicos se encuentran satisfechos con el trabajo docente que realizan, en contraste, el 25% (31) está muy insatisfechos. Entre los factores que influyen en la insatisfacción se encontró: La carga horaria, sobre todo los que tienen en turno mixto, el poco apoyo que la institución da para estudiar un posgrado, el estrés que conlleva la responsabilidad de supervisar a los estudiantes en el área clínica en la atención a pacientes. La insatisfacción se presenta en mayor proporción en académicos con una edad ≥ 50 años. Conclusiones : Los factores referidos que influyen en la insatisfacción son: el bajo salario, las inadecuadas instalaciones para impartir clase, la falta de apoyo para la capacitación por parte de la institución, el no reconocimiento al trabajo realizado. Llama la atención que, en la licenciatura de Cirujano Dentista donde el trabajo en equipo es de suma importancia, este no se dé o se dé muy pocas veces.
Objective : To know the job satisfaction in the Dental Surgeon academics from the Facultad de Estudios Superiores Zaragoza, Universidad Nacional Autónoma de México, during 2019. Methods : Observational, prolective, cross-sectional, descriptive study. The study population consisted of 123 academics, to whom a 20-item questionnaire was applied with responses on the Likert scale (Cronbach's α 0.845). Results : Of the total number of respondents, 45% (55) were male, 55% (68) were female, with a mean age of 36.5 (± 9.6) years. 48% (59) of the academics are satisfied with the teaching work they do, in contrast, 25% (31) are very dissatisfied. Among the factors that influence dissatisfaction, the following was found: The workload, especially those who have a mixed shift, the little support that the institution gives to study a postgraduate course, the stress that comes with the responsibility of supervising students in the area clinic in patient care. Dissatisfaction occurs in a higher proportion in academics aged ≥ 50 years. Conclusions : The referred factors that influence dissatisfaction are: low salary, inadequate facilities to teach classes, lack of support for training by the institution, non-recognition of the work done. It is striking that, in the Dental Surgeon degree where teamwork is of the utmost importance, this does not occur or occurs very rarely.
Subject(s)
Humans , Young Adult , Stress, Psychological , Teaching , Employee Performance Appraisal , Educational Personnel , Job Satisfaction , Dentists , Observational StudyABSTRACT
The performance appraisal for tertiary public hospitals provides means for the rational management of drug use in public hospitals. Starting from October 2021, Hospital Z had established a drug performance appraisal system based on the relevant requirements for rational drug use in the performance appraisal for tertiary public hospitals, in view of the actual situation. The system included four indexes: weighted outpatient per capita drug cost, weighted inpatient per capita drug cost, rational drug use rate, and intensity of antibacterial drug use. Different scores were assigned to each indexi and scoring methods were developed. By dividing all drugs in the hospital medication catalog into three categories A, B, and C and assigning them different weights, as well as setting reasonable target values for each indexi, the hospital guided clinical departments to use drugs rationally. The proportion of drugs in hospital Z decreased from 28.75% in 2020 to 25.44% in 2022, the proportion of medical service revenue increased from 22.97% to 28.40%, the per capita outpatient drug cost decreased from 170 yuan to 166 yuan, and the per capita inpatient drug cost decreased from 7 318 yuan to 5 983 yuan. The number of departments with a 100% reasonable drug use rate increased from 11 in September 2021 to 16 in September 2022, and the intensity of antibacterial drug use decreased by 35.84%. The opplication of this drug performance appraisal system partly optimized the hospital′s income structure, controlled the growth of drug costs, promoted the rational use of drugs, so as to provid references for the rational drug use management of tertiary public hospitals.
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OBJECTIVE To further improve the rational drug use control mechanism based on performance appraisal， explore new paths of pharmaceutical care and promote the rational clinical drug use management to deepen development. METHODS The reform of pharmaceutical management system in our hospital was performed through implementing the “ten-point system of prescription behavior management”， supplemented by the two carriages of “strengthening prescription review” and “standardizing clinical medication”. By implementing a number of auxiliary measures such as man-machine integration pre-prescription review， improving pharmacists’ prescription review ability， optimizing prescription review mechanism in real time， regulating physicians’ off-label drug use behavior， and improving drug evaluation mechanism， pre-control and in-process intervention were completed. The evaluation results were incorporated into performance assessment by referring to the “ten-point system of prescription behavior management”， so as to realize multi-dimensional and fully closed-loop rational drug use management. The effects of management were evaluated by comparing the statistical results of related indexes before and after the management. RESULTS Compared with before management， irrational rate of prescriptions and medical orders in our hospital in 2022 decreased significantly， compared to the same period in 2020； the irrational rate of inpatient medical orders decreased from 5.00% in 2020 to 2.69% in 2022， and that of outpatient prescriptions decreased from 4.59% to 2.48%； the frequency of communication between clinical pharmacists and physicians increased； the times of clinical consultations increased from 16 to 58， and doctors’ acceptance of intervention for irrational drug use had improved from 52％ to 87％ ； physicians had a deeper understanding and recognition of clinical pharmaceutical care， the awareness of clinical rational drug use had been significantly improved. CONCLUSIONS The rational drug use control mechanism guided by performance appraisal further standardizes the issuance of prescriptions and medical orders， and makes physician-pharmacist cooperation more prominent， so as to realize the closed-loop pharmaceutical management of “pre- review， in-process supervision and post-evaluation”， and promote rational drug use in clinical practice.
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The performance appraisal of tertiary public hospitals is key to their high-quality development. Since 2019, Children′s Hospital of Zhejiang University School of Medicine has taken the following measures to leverage performance appraisal. Namely promoting medical technology innovation to enhance the diagnosis and treatment capabilities of difficult and critical diseases; Reasonably setting a target system, improving the performance appraisal mechanism of the hospital; Improving operational efficiency, enhancing the sense of gain by children patients; Building a high-quality talent pool, promoting sustainable development, and effectively promoting high-quality development of hospitals. These measures can provide reference for promoting the high-quality development of hospitals.