Teaching and learning nursing management in the hospital context: an approach in the light of Pichon-Rivière / Enseñar y aprender administración de enfermería en el marco hospitalario: un enfoque a la luz de pichon-rivière / Ensinar e aprender administração em enfermagem no contexto hospitalar: um enfoque à luz de Pichon-Rivière

Abstract OBJECTIVE Analyze the articulation of students, professors (supervisors of the undergraduate practicum) and nursing professionals in teaching and learning nursing management at graduation in a public university hospital. METHOD This is a study of qualitative approach, anchored in the operative group reference of Pichon-Rivière. Data collection was held between October 2013 and September 2014 and consisted of a self-administered questionnaire, participant observation and focus group. The information was submitted to thematic analysis. RESULTS The thematic analysis of the corpus resulted in four themes: the unknown and the inevitable; in coming and going, attitudes, values and new bonding; the dialogue and ways of acting in the teaching/learning; the emergence of praxis. CONCLUSION The articulation among students, supervisors and nursing professionals occurring in a coming and going of attitudes, values and new bonding, in which the dialogue enables ways of acting in the teaching/learning of nursing management in graduation, allowing the emergence of praxis.

Resumen OBJETIVO Analizar cómo se articulan los alumnos, profesores y profesionales de enfermería en la enseñanza y aprendizaje de la administración de enfermería en el pregrado, en un hospital universitario público. MÉTODO La investigación se inserta en el abordaje cualitativo, anclado en el marco de referencia de Pichon-Rivière acerca del grupo operativo. La recolección de las informaciones ocurrió entre octubre de 2013 y septiembre de 2014, se constituyó en un Cuestionario Autoadministrado, Observación Participativa y Grupo Focal. Las informaciones fueron sometidas al análisis temático. RESULTADOS Del corpus del análisis resultaron cuatro categorías temáticas: lo desconocido y lo inevitable; el ir y venir, actitudes, valores y nuevos vínculos; el diálogo y los modos de actuar en la enseñanza/aprendizaje; la urgencia de la praxis. CONCLUSIÓN La articulación entre alumnos, profesores y profesionales de enfermería se da en un ir y venir de actitudes, valores y nuevos vínculos en que el diálogo hace viable los modos de actuar en la enseñanza/aprendizaje de la administración de enfermería en el pregrado, posibilitando la urgencia de la praxis.

Resumo OBJETIVO Analisar como se articulam alunos, professores e profissionais de enfermagem no ensinar e aprender administração em enfermagem na graduação, em um hospital universitário público. MÉTODO A pesquisa insere-se na abordagem qualitativa, ancorada no referencial de Pichon-Rivière sobre grupo operativo. A coleta das informações deu-se entre outubro de 2013 e setembro de 2014 e consistiu em Questionário Autoadministrado, Observação Participante e Grupo Focal. As informações foram submetidas à análise temática. RESULTADOS Do corpus da análise resultaram quatro categorias temáticas: o desconhecido e o inevitável; no ir e vir, atitudes, valores e novos vínculos; o diálogo e modos de agir no ensinar/aprender; a emergência da práxis. CONCLUSÃO A articulação entre alunos, professores e profissionais de enfermagem dá-se em um ir e vir de atitudes, valores e novos vínculos em que o diálogo viabiliza os modos de agir no ensinar/aprender administração em enfermagem na graduação, possibilitando a emergência da práxis.

Métodos de pesquisa empregados na produção do conhecimento sobre administração em enfermagem / Research methods used in the production of knowledge on nursing administration

Este estudo teve por objetivo analisar e descrever as características de métodos de pesquisa empregados na produção de dissertações e teses sobre Administração em Enfermagem. Trata-se de pesquisa documental de abordagem quantitativa, contemplando 596 resumos de produtos de pesquisa sobre Administração em Enfermagem, analisados segundo as variáveis método de pesquisa, distribuição temporal, titulação e temáticas. Do total de resumos analisados, 49,8% eram pesquisas quantitativas e 43,1% qualitativas. As pesquisas descritivas somaram 74,8%, as exploratórias 21,5% e as transversais 86,7%. Quanto ao procedimento de coleta de dados, 46,8% eram estudos de caso e 25,7% levantamentos. O pensamento positivista iluminou 49,0% das pesquisas e a fenomenologia 19,3%. Apenas 38,3% das pesquisas aprofundaram a análise com referencial teórico-filosófico. Conclui-se que o conhecimento sobre Administração em Enfermagem foi constituído predominantemente de estudos quantitativos, descritivos, transversais e de estudos de caso, iluminados pelo pensamento positivista e pouco aprofundado por referencial teórico-filosófico de análise.

This study aimed to analyze and describe the characteristics of research methods used in the production of dissertations and theses on Nursing Administration. This is a documentary study of quantitative approach, covering 596 abstracts of research works on Nursing Administration, analyzed according to the variables of research method, temporal distribution, titles and themes. Of all analyzed abstracts, 49.8% were quantitative studies and 43.1% were qualitative. Descriptive studies amounted to 74.8%, exploratory to 21.5% and cross-sectional accounted for 86.7%. As for the data collection procedure, 46.8% were case studies and 25.7% were surveys. The positivist thought guided 49.0% of studies and phenomenology appeared in 19.3%. Only 38.3% of the studies deepened the analysis with the philosophical and theoretical framework. We concluded that the Nursing Administration knowledge was predominantly formed by quantitative, descriptive, cross-sectional and case studies, enlightened by the positivist thought and of little depth in the philosophical and theoretical framework of analysis.

Application of evidence-based practice through a float project.

Evidence-based practice must become a common, acceptable process for the bedside nurse. This paper demonstrates a process for engaging nurses in the use of evidence for direct practice. An example using the revision of a float policy is provided as a model for staff nurses to incorporate evidence in a mechanism to elicit change.

Nursing practice problems in private hospitals in Jordan: students' perspectives.

This paper grew from an exploration of clinical practice problems in a private hospital in Jordan. Senior nursing students in a governmental university studied these issues while focusing on leadership and management issues. The private sector is of a secondary focus in nursing research. In Jordan, nursing studies that explore the nursing profession and its related issues have been limited in the literature. A student assignment in the "Nursing Leadership and Management" course required the students to work in groups to identify a nursing practice problem, and its contributing causes and suggested solutions. The nursing shortage; job dissatisfaction; burnout; and turnover were the identified nursing practice problems. Causes and solutions of these problems were explored.

Mentoring the next generation of systems researchers.

As we consider our next generation of researchers, we need to be sure that we are doing the "right things" to position them for success. Surely their education will help, but we must go beyond the academic experience to insure that they have the opportunity to become accomplished and contributing professionals. It is incumbent upon us to become mentors for those promising researchers in the academic and practice pipelines to provide the guidance and opportunities required to prote ge s to situate them on a successful trajectory.

The cost and cost-effectiveness of nursing services in health care.

This article examines the literature on cost-effectiveness in nursing, and considers the relationship between this literature and decision-making in health care systems. Researchers have attempted to examine costs and benefits of nurse staffing and nursing interventions for decades. There are strong literatures for some topics, such as advanced practice nursing, clinical practices, occupational health nursing, and workplace training. However, there are gaps in the literature on the cost-effectiveness of nurse staffing patterns, the use of agency personnel, and changes in organizational structure. A review of 6 major health care management textbooks finds few references to cost-effectiveness analysis, suggesting that health care leaders have little education regarding how to conduct or evaluate economic studies. The agenda for nursing research on cost-effectiveness is daunting. Research must be based on large, representative samples; provide clear, compelling results; discuss the importance of both costs and benefits in decision-making; and be published in highly-visible journals.

Advanced nursing training in health policy: designing and implementing a new program.

Although the nursing profession has a growing role in the health policy arena, the rapidly changing health care environment means that clinicians need a sophisticated understanding of health policy. Nurses are assuming leadership roles in advocacy, research, analysis, and policy development, implementation, and evaluation, contributing to a growing need to educate nurses to specialize in health policy research and analysis. This article provides an overview of a new master's and doctoral educational program specializing in health policy for advanced practice nurses who are culturally diverse and sensitive to issues of diversity. The program, currently in its third year of operation at the University of California San Francisco, School of Nursing, is addressing the gap in nursing education and practice expertise in health policy. The program is supported through funding by the Department of Health and Human Services Health Resources and Services Administration, Advanced Nurse Training program.

Endomarketing: ensaio sobre possibilidades de inovação na gestão em enfermagem / Endomarketing: essay on possibilities of innovation in Nursing management / Endomarketing: ensayo sobre posibilidades de innovación en la gestión en enfermería

Este artigo tem como objetivo apresentar o endomarketing como ferramenta para o enfermeiro no processo de gestão, tendo em vista o contexto atual de mudanças no setor saúde, que exige também o desenvolvimento de habilidades que estão diretamente relacionadas à introdução de novas tecnologias e formas de organização do trabalho. Nossa reflexão deixa alguns pontos importantes a serem analisados por enfermeiros e educadores, na busca de melhores caminhos e alternativas para a formação de enfermeiros com maior satisfação profissional, com competência para gerenciar serviços de saúde. O grande desafio do endomarketing é, portanto, conciliar os objetivos e interesses do público interno com as necessidades e expectativas do público externo da organização.

This article is aimed at presenting endomarketing as a tool for nurses in the management process, taking into account the current context of changes in the healthcare sector, which also requires the development of skills that are directly related to the introduction of new technologies and ways of work organization. Our reflection leaves some important points to be analyzed by nurses and educators in the search for better ways and alternatives for educating nurses who will have greater professional satisfaction and competence to manage the healthcare services. The big challenge of endomarketing is, therefore, to combine the aims and interests of the internal public with the needs and expectations of the external public in the organization.

Este artículo tiene como objetivo presentar el endomarketing como una herramienta para el enfermero en el proceso de gestión, tomando en consideración el actual contexto de cambios que existe en el sector de salud, y que además exige el desarrollo de habilidades, las cuales están directamente relacionadas con la introducción de nuevas tecnologías y formas de organización del trabajo. Nuestra reflexión deja algunos puntos importantes para ser analizados por enfermeros y educadores, en la búsqueda de mejores caminos y mejores alternativas para la formación de enfermeros con más satisfacción profesional y con competencia para gerenciar servicios de salud. El gran desafío del endomarketing es, por lo tanto, conciliar los objetivos e intereses del público interno con las necesidades y expectativas del público externo de la organización.

[Endomarketing: Essay on possibilities of innovation in nursing management]. / Endomarketing: ensaio sobre possibilidades de inovação na gestão em enfermagem.

This article is aimed at presenting endomarketing as a tool for nurses in the management process, taking into account the current context of changes in the healthcare sector, which also requires the development of skills that are directly related to the introduction of new technologies and ways of work organization. Our reflection leaves some important points to be analyzed by nurses and educators in the search for better ways and alternatives for educating nurses who will have greater professional satisfaction and competence to manage the healthcare services. The big challenge of endomarketing is, therefore, to combine the aims and interests of the internal public with the needs and expectations of the external public in the organization.

Caracterização da disciplina "Noções de Administração de Enfermagem" dos Cursos de Técnico de Enfermagem / Caracteristics of the course "Basics of Nursing Administration" for Practical Nursing Program

Este estudo, do tipo exploratório e documental, teve como propósitos identificar as competências e os enfoques temáticos descritos nos Planos de Ensino da disciplina Noções de Administração de Enfermagem dos cursos Técnico de Enfermagem. A população foi composta por 26 Planos de Ensino das escolas/cursos, em sua maioria, entidades particulares, que formam Técnicos de Enfermagem já há entre 1 a 5 anos, com turmas de 21 a 30 alunos, nos três turnos. A disciplina em questão era trabalhada em diferentes momentos do curso, com carga horária entre 25 e 50h, ministrada por 1 (um) a 2 (dois) docentes nas aulas teóricas e no estágio supervisionado, sendo este último realizado em unidades de internação. Com relação às competências gerais e específicas descritas nos Planos de Ensino, obtivemos que a competência do saber fazer (59%, 54%) e do aprender a conhecer (34%, 45%) prevaleceram sobre a competência do saber ser (7%, 1%) mostrando que o saber fazer ainda é prevalente, mas também aponta que o aprender a conhecer é necessário à instrumentalização para o desenvolvimento do saber fazer. Dentre os resultados, relativos aos enfoques temáticos foram encontrados os processos de trabalho voltados para a assistência de enfermagem e a estrutura organizacional. Assim, acreditamos que este estudo possa contribuir àqueles que trabalham com a educação profissional em enfermagem, permitindo repensar as competências profissionais desejadas ao TE, conforme o perfil estabelecido bem como, estimulando a reflexão de como este pode atuar nos processos administrativos, sob a supervisão do enfermeiro.

This exploratory study was based on course descriptions and aimed at identifying the competences and the topics adressed, as reported in the course description of "Basics of Nursing Administration" for Practical Nursing programs. Twenty-six practical nursing programs were studied. Most programs have been offered by private schools/institutions for 1 to 5 years. Twenty-one to thirty students attended these courses, offered in the mornings, afternoons, and evenings. Basics of nursing administration was offered in the beginning, middle or end of the program, depending on the institution, an lasted 25-50 hours. One or two teachers were in charge of both theory and clinical practice, which took place in hospitals, mainly in patients units. When both general and specific competences described in the programs were analyzed, the "know to do" competence (59%, 54%) and the "learn to know" competence (34%, 45%) prevailed against the "know to be" competence (7%, 1%). This shows that the "know to do" competence prevails in practical nursing programs. It also shows that the "learn to know" competence is necessary as a tool for developing the "know to do" competence. Findings for topics adressed in the programs, as reported in the course description, show that working processes are aimed at nursing assistance and at organizational structure. Thus, we believe that this can contribute to those working in the field of professional nursing education as a tool to rethink professional competences required for practical nurses, according to the profile established. The study also encourages us to consider how practical nurses can effecty participate in the administrative processes, under the supervision of a registered nurse.

O processo de territorializaçäo da saúde sob a ótica dos alunos de enfermagem / The process of territorializacion of the health under the opties of the studients of nursing

O presente texto aborda um processo vivenciado na implementaçäo da Saúde em uma Unidade Básica, por alunos de graduaçäo em enfermagem da EERP/USP, na Disciplina Administraçäo de Enfermagem em Unidades de Saúde Pública, durante o período de agosto a dezembro de 1995. O objetivo do estudo é descrever e analisar experiência sobre a ótica dos alunos, buscando identificar as reflexöes despertadas sobre o conhecimento teórico-prático adquirida. O referencial teórico-metodológicofundamentou-se na cosntruçäo de uma prática integral de saúde e no inseridos no processo(alunos, docentes, equipes de saúde e usuários), os varios momentos da prática gerencial, buscando ultrapssar separaçäo entre informaçäo, decisäo ,execusäo e controle das açöes desenvolvidas no espaço territorial local. A técnica utilizada na coleta de dados foi um questionário alicado a 74 alunos no final da Disciplina, relacionando-o ao conteúdo teórico-práatico apreendido durante o curso. O discurso dos alunos evidenciou a incorporaçäo de conceitos e experiências que despertaram reflexöes sobre a nova abordagem da integralidade da atençäo, o exercicio da cidadania o aprendizado das relaçöes interpessoais e as estratégias de gerências participativa.

A survey of the ways master's level nursing students learn the research process.

Because of the need for advanced practice nurses to perform more outcome measurement, a survey was conducted in the fall of 1997 to determine how master's level students learned the research process. Three hundred four surveys were mailed to schools with master's programs, and 222 were returned for a return rate of 73%. Sixty-six percent of the programs surveyed required a thesis and/or a research project. However, there was great variation in the research projects. A comprehensive examination was used to measure research ability by 36 programs (16%), either in conjunction with a thesis or research project or alone. One hundred forty-six programs (66%) offered only one option, be it a thesis, research project, comprehensive examination, or the many other alternative activities described by respondents. Seventy-six programs (34%) offered a variety of options from which students could select. The major differences between the thesis and the research project were related to three issues: a) the nature of the supervision; b) whether the activity was an individual or group project; and c) the amount of participation of the students. Because of the variability of expectations and the ways students are taught research, it was recommended nurse educators determine whether master's level nurse graduates were prepared to conduct outcome measurement and whether the means used to teach the research process were effective considering that endeavor.

The impact of management of change projects on practice: a description of the contribution that one educational programme made to the quality of health care.

This paper is based on the authors' experience of teaching and supervising the first intake of the management unit of the diploma for charge nurses offered by the Department of Professional Development and Training, Glasgow College of Nursing and Midwifery, Glasgow, Scotland. The students on this course undertake a project comprising of a documented research-based action plan aimed at the achievement of a selected topic for change directly linked with their practice. All the students except one were G grade charge nurses from a wide variety of clinical backgrounds. This paper will briefly consider the work of Barriball et al. who suggest categories of outcomes of continuing professional education. This is contrasted with Scheller, who highlights three problems when attempting to measure the impact of continuing education on practice. Despite these problems, it is beneficial to attempt to consider the impact of continuing professional education on practice. The work of Francke et al. will be featured in which they ascertain the determinants of changes in nurses' behaviour after continuing professional education. The authors believe that the management of change project, undertaken by the students, enhances the possibility that knowledge gained from the management unit will impact on their practice. Two examples of students' projects will be used to support the paper. The first concerns changing to a 12-hour shift pattern in an intensive care setting and the second relates to the implementation of the named nurse system.