Carga de trabalho em centro de material e esterilização: subsídios para dimensionar pessoal de enfermagem / The workload in a material and sterilization center: the information needed for nursing staffing / Carga de trabajo en centro de material y esterilización: datos para dimensionar personal de enfermería

Estudo cujo objetivo foi mensurar a carga de trabalho média diária dos trabalhadores de enfermagem de um Centro de Material e Esterilização de um hospital de ensino. Após a construção de um sistema de classificação de pacotes esterilizados, foi desenvolvido instrumento para mensuração do tempo de processamento desses pacotes e outro para registro da quantidade de pacotes esterilizados processados diariamente. Durante 122 dias, foram registrados em instrumentos próprios os pacotes processados, de acordo com a classificação dos mesmos, incluindo a complexidade e quantidade dos artigos que compõem os pacotes esterilizados. Obtivemos a carga de trabalho por meio da média diária de pacotes processados e o tempo médio de processamento do conjunto de pacotes esterilizados. Concluiu-se que a produção média diária foi de 657 pacotes, com tempo médio de processamento de 10 minutos por pacote. Há necessidade de estudos complementares visando acrescentar atividades pontuais no tempo de processamento dos pacotes esterilizados.

The objective of this study was to measure the mean workload of nursing workers of a Material and Sterilization Center of a teaching hospital. After creating a classification system for the sterilized packages, an instrument was developed to measure the time invested to process those packages, and another instrument to record the quantity of sterilized packages that were processed per dat. For 122 days, the processed packages were recorded in specific instruments, according to their classification, including the complexity and quantity of articles contained in the sterilized package. We obtained the workload considering the mean number of packages processed per day and the mean processing time of the set of sterilized packages. In conclusion, the mean daily production was 657 packages, with a mean processing time of 10 minutes per package. Complementary studies are needed with the purpose of adding specific activities in the processing time of the sterilized packages.

Estudio que objetivó mensurar la carga laboral promedio diaria de los trabajadores de enfermería de un Centro de Material y Esterilización en hospital de enseñanza. Luego de construirse un sistema de clasificación de paquetes esterilizados, se desarrolló un instrumento de medición temporal de procesamiento de dichos paquetes y otro para registrar la cantidad de paquetes esterilizados procesados diariamente. Durante 122 días se registraron en instrumentos propios los paquetes procesados, acorde su clasificación, incluyéndose la complejidad y cantidad de artículos que componen cada paquete esterilizado. Obtuvimos la carga de trabajo mediante el promedio diario de paquetes procesados y el tiempo promedio de procesamiento del conjunto de paquetes esterilizados. Se concluyó en que la producción diaria promedio fue de 657 paquetes, con tiempo promedio de procesamiento de diez minutos por paquete. Se necesitan estudios complementarios apuntando a aumentar actividades puntuales en el tiempo de procesamiento de los paquetes esterilizados.

Caracteristicas de la organizacion de una unidad-servicio de enfermería / Characteristics of the organization of a unit-nursing service

El presente trabajo intenta describir y caracterizar el departamento de enfermeria del Sanatorio Allende a la vez de un diagnostico situacional de una unidad de enfermeria. considera importante contextualizar la institucion donde se encuentra, su esencia, su filosofia, politicas, sus objetivos como asi tambien a las personas que trabajan en la misma.

Poverty, philanthropy, and professionalism. The establishment of a district nursing service in Wellington, New Zealand, 1903.

The establishment in 1903 of a professional district nursing service in Wellington, New Zealand's capital city, was a philanthropic response to the need for skilled care for the sickpoor in their own homes, as hospital and charitable aid boards believed chronic patients drained their resources. This paper argues that it was the timely combination of the individual philanthropy of Sarah Ann Rhodes, the organisational philanthropy of the St John Ambulance Association and the new professional standing and availability of registered nurses such as Annie Holgate that ensured its successful foundation. It also argues that district nursing services blurred spatial, social, and public-private boundaries in new ways. Finally, it considers the district nurse's role as the philanthropist 's proxy, the means for realising the philanthropist's desire to help the sick poor.

[Health-sickness-care process and the street population]. / O processo saúde-doença-cuidado e a população em situação de rua.

This paper gives an empirical and contextualized presentation of the health-sickness-care process and its relation with poverty, emphasizing the problem of people who live in and of the street. We try to stimulate a reflection on the technical, scientific and political function of nursing care for the street population. This paper is structured in three topics: first, we present the problem of people living in the streets of São Paulo city, characterizing their peculiarities and emphasizing ways of survival. Next, we situate the theoretical study area, discussing the health-sickness-care process and its relation with poverty, as well as nursing care. Finally, we present some final considerations.

Poor systems and staffing problems led to poor patient outcomes.

The office of the Health Service Ombudsman regularly publishes reports of complaints investigated by its assessors. The cases presented here relate to failures of nursing care: some of the problems were found to be the result of inadequate staffing and training, others were due to poor documentation, lack of staff accountability and inadequate organisation.

A nocturnal enuresis service for a deprived inner city.

AIM: Glasgow is a city where 80% of the most deprived children in Scotland live within 20% of the overall population. Of 168,000 children in Glasgow, an estimated 5000 aged 5-15 y have primary nocturnal enuresis. The aim of this study was to establish a nocturnal enuresis service for Glasgow. METHODS: Needs assessment was performed and the incident cases were documented at school entry healthcare appraisal, at the age of 5 y. A cohort of these children was followed up at 8 y of age and symptom resolution was no better than natural remission. Parents, general practitioners, clinical medical officers and a hospital paediatrician were interviewed face-to-face about their need for a service. RESULTS: Ten of 11 general practitioners expressed a need for a specialist service. Ten school nurse-led local nocturnal enuresis clinics were established. Accommodation, funding, default and managing alarms were major problems. School nurses enjoyed extra training and quickly became skilled therapists. Two research projects highlighted that most children at first attendance did not believe they could ever be dry, which predicted outcome. Deprived families, once motivated, could successfully undertake complex behavioural therapies. CONCLUSION: A comprehensive nocturnal enuresis service begins when children stop using night nappies at the age of 3-4 y. Appropriate waterproof mattress, duvet and pillow coverings should be advocated until 5 y, when desmopressin may be helpful. For continued wetting at the age of 7 y, a local service should be led by a team of well-trained nurses using enuretic alarms.

Nursing shortage: not a simple problem - no easy answers.

The article examines the issue of nursing workforce planning within the present health system environment and addresses ethical issues related to the shortage. Numerous factors are influencing both the supply of registered nurses as well as the demand for nursing services. Of particular concern is the negative impact that the current nursing practice environment is having on the retention of registered nurses as well as the ability of the profession to recruit students. Other factors driving this present nursing shortage include the increasing age of working nurses and the potential for retirement; the aging of nursing faculty impacting the capacity of nursing schools; and poor wage compensation. The continual swing in the supply of and demand for nursing services will always be present; however, it is time that nursing sat at the policy-making table with the other decision makers to better anticipate the nature of these changes and how to address them.

The nursing shortage in California: the public policy role of the California strategic Planning Committee For Nursing.

California is experiencing a nursing shortage resulting from multiple factors. The purpose of this article is to summarize nursing shortage issues in California and present the role of the California Strategic Planning Committee for Nursing (CSPCN) in addressing the issues from a public policy perspective. Reasons for the development of CSPCN as well as goals, objectives, and phases of work are presented. Selected findings from CSPCN's 1999 synthesis of data on the demand for and supply of nurses as well as resulting recommendations are summarized. The role of CSPCN in public policy initiatives is described.

The nursing shortage: solutions for the short and long term.

With predictions that this nursing shortage will be more severe and have a longer duration than has been previously experienced, traditional strategies implemented by employers will have limited success. The aging nursing workforce, low unemployment, and the global nature of this shortage compound the usual factors that contribute to nursing shortages. For sustained change and assurance of an adequate supply of nurses, solutions must be developed in several areas: education, healthcare deliver systems, policy and regulations, and image. This shortage is not solely nursing's issue and requires a collaborative effort among nursing leaders in practice and education, health care executives, government, and the media. This paper poses several ideas of solutions, some already underway in the United States, as a catalyst for readers to initiate local programs.