Clima educativo hospitalario y síndrome de burnout en internos de medicina / Hospital educational climate and burnout syndrome in foundation years

INTRODUCCIÓN: El clima educativo hospitalario facilita el aprendizaje significativo y depende de la percepción de los integrantes; el síndrome de burnout aparece en profesionales que trabajan de manera directa con otras personas: ambos pueden influir de manera importante en la formación y desempeño de los futuros médicos. OBJETIVO: Evaluar la correlación entre el clima educativo en los hospitales y el síndrome de burnout en los internos de medicina humana de la región Lambayeque en 2018. MATERIAL Y MÉTODOS: Estudio descriptivo, transversal y observacional. La muestra estuvo constituida por todos los internos de medicina de la región Lambayeque en 2018. Se utilizó la encuesta Postgraduate hospital educational environment measurement (PHEEM) para medir el clima educativo, la Maslach Burnout Inventory-Human Services Survey para el síndrome de burnout y una encuesta sociodemográfica-laboral. RESULTADOS: Se encontró que el 28% de los internos presentó síndrome de burnout. En 5 hospitales de la región Lambayeque se observó un clima educativo más positivo que negativo (PHEEM = 80-120) y solo en un hospital referencial del Ministerio de Salud hubo un clima educativo con muchos problemas (PHEEM = 40-80). Hay una correlación estadísticamente significativa (p = 0,019), inversa y baja (r = -0,19) entre el clima educativo hospitalario y el síndrome de burnout en internos de medicina de la región Lambayeque. Además, se encontró una correlación significativa de los factores sociodemográficos laborales con síndrome de burnout, inversa y baja con horas de sueño (r = -0,22 y p = 0,009) y directa y baja con horas de trabajo (r = 0,28 y p = 0,001). CONCLUSIONES: Existe una correlación baja e inversa entre clima educativo y síndrome de burnout

INTRODUCTION:The educational hospital climate provides meaningful learning, and is dependent on the perception of its staff. Burnout syndrome appears in professionals who work directly with other people, and both can have a significant influence on the training and performance of future physicians. OBJECTIVE: To evaluate the correlation between the educational environment of hospitals and the Burnout syndrome in the Foundation of doctors in the Lambayeque region of Peru during 2018. MATERIAL AND METHODS: A descriptive, cross-sectional and observational study was conducted on a sample that consisted of all foundation year doctors from the Lambayeque region during 2018. The Postgraduate Hospital Educational Environment Measurement (PHEEM) questionnaire was used to measure the educational climate, the Maslach Burnout Inventory-Human Services Survey to measure burnout syndrome, as well as a socio-demographic-occupational questionnaire. RESULTS: It was found that 28% of the foundation year doctors had burnout syndrome. A more positive than negative educational climate was observed in 5 hospitals in the Lambayeque region (PHEEM = 80-120), and only in a reference hospital of the Ministry of Health there was an educational climate with many problems (PHEEM = 40-80). There was a statistically significant correlation (p = 0.019), and an inverse and low correlation (r = -0.19) between hospital educational climate and burnout syndrome in foundation year doctors in the Lambayeque region. In addition, a significant correlation was found between the sociodemographic occupational factors and burnout syndrome, inverse and low with hours of sleep (r = -0.22 and p = 0.009), and direct and low with hours of work (r = 0.28 and p = .001). CONCLUSIONS: There is a low and inverse correlation between educational climate and burnout syndrome

Características y capacitaciones en administración en el personal que trabaja en el sector salud de la ciudad y periferia de Huancayo, Perú / Characteristics and training in administration in personnel working in the health sector of the city and periphery of Huancayo-Peru

Introducción. Se intentó determinar las características y capacitaciones en administración del personal que trabaja en el sector salud de la ciudad y periferia de una ciudad de la serranía peruana. Sujetos y métodos. Estudio transversal analítico. Se encuestó a 1.002 trabajadores de los diversos niveles de atención. Se preguntó acerca de su capacitación y participación en áreas administrativas y la percepción que tenían de ellas. Resultados. De los 1.002 encuestados, la mayoría de los hombres trabajaba en el sector urbano (61%). Los trabajadores de seguridad social (EsSalud) trabajaban más en el sector urbano (p < 0,001) y desde hace más años (p = 0,003), los del primer nivel de atención estaban más en el sector rural (p < 0,001), y los de una clínica o consultorio lo hacían más en el sector urbano (p < 0,001). En todas las instituciones evaluadas, el rango de haber tenido un cargo administrativo estuvo en el 25,0-43,2%, y no hubo diferencias estadísticamente significativas si se trabajaba en una zona urbana/rural. El 55% sí postularía a un cargo administrativo, el 68% se siente preparado para asumir un cargo administrativo y el 72% estaría dispuesto a participar en un curso de posgrado del tema administrativo. Conclusiones. Hubo diferencias importantes según el lugar de trabajo, lo que debe tenerse en cuenta para generar intervenciones en educación y gestión. Un poco más de la mitad postularía a un cargo administrativo, y siete de cada 10 profesionales se sienten preparados para asumir un cargo administrativo y estarían dispuestos a participar en un curso de posgrado del tema administrativo

Introduction. We tried to determine the characteristics and skills in administration of the personal working in the health sector of the city and periphery of a city in the Peruvian highlands. Subjects and methods. Analytical cross-sectional study. 1,002 workers from the various levels were surveyed. He wondered about their training and participation in administrative areas and the perception they had of it. Results. Of the 1,002 respondents, the majority of men worked in the urban sector (61%). Social security workers (EsSalud) worked more in the urban sector (p < 0.001) and during more years (p = 0.003); those working in the first level of care were more in the rural sector (p < 0.001), those working in a clinic did more in the urban sector (p < 0.001). In all the institutions evaluated, the rank of having an administrative position was between 25.0-43.2%, and there were no statistically significant differences according to the work in the urban/rural area. 55% would apply for an administrative position, 68% would feel prepared to assume an administrative position, and 72% would be willing to participate in a post-graduate course on administrative matters. Conclusions. There were important differences depending on where they work, and should be taken into account to generate interventions in education and management. A little more than half would apply for an administrative position, and seven out of ten professionals feel prepared to take up an administrative position and would be willing to participate in a post-graduate course on the administrative subject

Shared governance: one way to engage employed physicians.

To work better with employed physicians, finance leaders should: Understand classic management theories on what motivates employees. Learn from shared governance models with nurses at Magnet hospitals. Apply best practices in management to all employees, not just physicians.

Use of a simulated administrative decision-making exercise in an online master's Nursing Administration course.

To simulate the type of ethical and informed decision making required of today's nurse executives, a unique role-playing exercise was developed in a graduate Nursing Administration course. This exercise included evidence-based information about the safety issues inherent in 12-hour nursing shifts. It then explored the decision-making process that a nurse executive would follow to weigh the conflicting concerns of safety and staff satisfaction. A blog format was used for a role-playing exercise in which students were assigned various roles, and the assignment was designed to mimic a roundtable discussion. The final step was to assume the role of the chief nurse executive and make a decision regarding the ethical dilemma of staff satisfaction versus evidence-based safety concerns. Students demonstrated an understanding of acknowledging input from others, as well as the ability to synthesize points on a difficult question.

O psicólogo no processo de intervenção da política nacional de humanização / The psychologist in the intervention process of the national policy of humanization

Como uma forma de efetivar os princípios, as bases e as diretrizes propostas pelo SUS no cotidiano das práticas de atenção e de gestão, em 2003, o Ministério da Saúde instituiu a Política Nacional de Humanização. Considerando o que preconiza essa política, este trabalho visa problematizar o lugar do psicólogo na gestão de um hospital da rede pública de Brasília. Discute-se a importância da formação do psicólogo, a qual deve se pautar em referenciais teóricos que permitam uma prática mais comprometida com as instituicões/organizaçoes de saúde pública sempre contextualizadas cultural, social, política e economicamente com a realidade de nossa população.(AU)

As a way to give effect to the principles, basis and guidelines proposed by SUS in the daily practices of care and management, in 2003 the Brazilian Ministry of Health created the National Policy of Humanization. Whereas advocating this policy, this paper aims to problematize the place of the psychologist in the management of a public hospital in Brasilia. It discusses the importance of the psychologist's education, which must be guided in a theoretical framework allowing the practice as more committed to the institutions/organizations of public health contextualized culturally, socially, politically and economically with the reality of our population.(AU)

O psicólogo no processo de intervenção da política nacional de humanização / The psychologist in the intervention process of the national policy of humanization

Como uma forma de efetivar os princípios, as bases e as diretrizes propostas pelo SUS no cotidiano das práticas de atenção e de gestão, em 2003, o Ministério da Saúde instituiu a Política Nacional de Humanização. Considerando o que preconiza essa política, este trabalho visa problematizar o lugar do psicólogo na gestão de um hospital da rede pública de Brasília. Discute-se a importância da formação do psicólogo, a qual deve se pautar em referenciais teóricos que permitam uma prática mais comprometida com as instituicões/organizaçoes de saúde pública sempre contextualizadas cultural, social, política e economicamente com a realidade de nossa população.

As a way to give effect to the principles, basis and guidelines proposed by SUS in the daily practices of care and management, in 2003 the Brazilian Ministry of Health created the National Policy of Humanization. Whereas advocating this policy, this paper aims to problematize the place of the psychologist in the management of a public hospital in Brasilia. It discusses the importance of the psychologist's education, which must be guided in a theoretical framework allowing the practice as more committed to the institutions/organizations of public health contextualized culturally, socially, politically and economically with the reality of our population.

Directing child and adolescent psychiatry training for residents.

Directing child and adolescent psychiatry (CAP) training for residents is a complex and challenging administrative task that encompasses the broad creativity of the orchestral conductor, the social and interpersonal effectiveness of the best politician, and the orientation to details of the finest accountant. This article examines these roles in detail, recognizing the leadership, administrative, and managerial achievements of the successful child and adolescent program director. Resources for optimizing the chances for success in each of these areas, and the common pitfalls to avoid, are identified and discussed. The article concludes with suggestions for CAP training directors to influence medical student education. Although challenging and sometimes frustrating, the role of the program director in CAP training is almost always exciting and rewarding.

A residência médica: articulações entre a prática e o ensino / Medical residence: articulations between practice and teaching

O objetivo desta tese de doutorado é o estudo da residência médica e de suas articulações com o campo educacional e o da saúde. Propõe-se uma análise histórico - dialética, tomando como ponto de partida a articulação da medicina e da educação na estrutura social. Parte-se da concepção segundo a qual a prática e o saber no campo educacional e na saúde estão ligados à transformação histórica do processo de produção econômica. Essa compreensão remete à chamada determinação em última instância: a estrutura econômica determina o lugar e a forma de articulação da medicina e da educação na estrutura social. Para compreender as peculiaridades do ensino e da residência médica no Brasil faz-se uma caracterização da assistência médica, sobretudo do papel assumido pelo Estado na configuração do campo: primeiro, a adoção de um sistema em que compete ao Estado a responsabilidade pela universalização da atenção básica, através de serviços próprios ou em parceria com organizações não governamentais; segundo, a atenção especializada, com maior incorporação tecnológica, seria prestada pelo setor privado, mediante incentivos concedidos pelo Estado. Dessa divisão, resulta, no desenho atual, ao invés de um único sistema, a conformação de dois ou mais sistemas de saúde, em que a segmentação da assistência implica em práticas diferenciadas. O efeito desta divisão no mercado de trabalho repercute na escola e na residência médicas. A residência, em particular, por suas características de treinamento em serviço, responde diretamente aos condicionantes do mundo do trabalho, reproduzindo o modelo de prática hegemônica.

Operational competency development in E and F grade nursing staff: preparation for management.

There is limited literature for operational management competency development in E and F grade nursing staff. These grades of nursing staff have to take over from G grade nurses ward managers on a regular basis. With human resources doing less of the operational management and taking more of an advisory role, nursing staff are now required to deal with disciplinary procedures and other management issues in a more consistent manner. Therefore, this development programme in a Scottish primary care NHS psychiatric service was designed to enable E and F grade nurses to take over from ward managers and to enable ward managers to 'succession plan' for times when they will be absent. The literature is reviewed, the background to the development programme described and the design of the development programme is explained. The results from both the pilot study (n=13) and first group (n=8) through the course are presented, evaluated discussed.

Incentivos que brinda la CCSS, su conocimiento y propuesta de estrategias para darlos a conocer en el Hospital Dr. Tony Facio Castro / Incentives that offer the CCSS, its knowledge and proposal of strategies to present to us in the Hospital Dr. Tony Facio Castro

Esta investigación se ha realizado con el propósito de determinar el grado de conocimiento que tienen los empleados del Hospital Dr. Tony Facio Castro para crear un modelo de promoción de los incentivos que brinda la Caja Costarricense de Seguro Social (Caja). Por medio de una muestra piloto, que consistió en preguntar a 100 empleados si conocían los incentivos que ofrece la Institrución, se determinó que el 80 por ciento de los trabajadores del hospital desconocen o no toman como tal los incentivos existentes en la Caja. Para llevar a cabo el análisis situacional se utilizaron los métodos de investigacion descriptiva y aplicada, pues por medio de ellos se definen los procedimientos a seguir y los elementos que sustenten el contenido de la propuesta. Los datos, que provienen de fuentes primarias, se obtuvieron por medio de once entrevistas a jefaturas, al administrador y al director médico y cuestionarios aplicados a 257 trabajadores es cogidos al azar del área médica y adminstrativa; el detalle de la información secundaria se obtuvo del Manual y Reglamento de Incentivos de la Institución. Al evaluar los datos, se concluyó que los incentivos existentes son poco conocidos por algunas jefaturas y por los trabajadores en general. Conscientes de la necesidad de dar a conocer estos estímulos, para elevar el nivelde motivación y mejorar los servicios brindados, se ideó la Propuesta de un Modelo para la Promoción de los Incentivos que Bridda la CCSS en el Hospital Dr. Tony Facio Castro. Con este ensayo se prentende dotar a la dirección del hospital un documento que le permita motivar eficazmente al personal, logrando así una prestación de mejor calidad.