Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 5.512
J Infus Nurs ; 42(4): 197-202, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31283662


In Iran, nurses are responsible for administering parenteral nutrition (PN) to hospitalized patients in intensive care units (ICUs). However, little information is available among nurses in Iran regarding best practices in PN administration. This study evaluates the performance of critical care nurses in Iran in the administration of PN. The performance of 50 nurses in the administration of PN in the ICU was observed 3 times during a 5-month period for a total of 150 observations. A researcher-developed checklist, "Critical Care Nurses' Performance in Parenteral Nutrition Administration," was used for data collection. The total score in this checklist ranged from 0 to 52. Based on the procedural steps in the checklist and whether the steps were performed appropriately, nurses' performance was scored as poor, moderate, or good. The mean score of nurses' performances in PN administration skills was 24.6 ± 2.5. This study found that 46 nurses had moderate skill levels in PN administration, and 3 demonstrated poor skills. Overall, the results indicated that critical care nurses in Iran have poor to moderate PN administration skills.

Lista de Checagem/normas , Enfermagem de Cuidados Críticos/normas , Avaliação de Desempenho Profissional/normas , Nutrição Parenteral/métodos , Adulto , Estado Terminal , Feminino , Humanos , Unidades de Terapia Intensiva , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade
Med Educ Online ; 24(1): 1635844, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31246539


Periodic review of resident performance is an important aspect of residency training. Amongst allopathic residency programs, it is expected that the performance of resident physicians which can be grouped based on the ACGME core competencies, be assessed so as to allow for effective feedback and continuous improvement. Review of monthly evaluation forms for residents in the core ACGME programs at Marshall University and the University of Toledo demonstrated a wide spread in the number of Likert questions that faculty were asked to complete. This number ranged from a low of 7 in Surgery to a high of 65 in Psychiatry (both Marshall Programs). Correlation and network analysis were performed on these data. High degrees of correlations were noted between answers to questions (controlled for each resident) on these forms at both institutions. In other words, although evaluation scores varied tremendously amongst the different residents in all the programs studied, scores addressing different competencies tended to be very similar for the same resident, especially in some of the programs which were studied. Network analysis suggested that there were clusters of questions that produced essentially the same answer for a given resident, and these clusters were bigger in some of the different residency program assessment forms. This seemed to be more the rule in the residency programs with large numbers of Likert questions. The authors suggest that reducing the number of monthly questions used to address the core competencies in some programs may be possible without substantial loss of information.

Avaliação de Desempenho Profissional/organização & administração , Internato e Residência/organização & administração , Competência Clínica , Coleta de Dados , Avaliação de Desempenho Profissional/normas , Humanos , Internato e Residência/normas , Avaliação de Programas e Projetos de Saúde
Health Care Manag (Frederick) ; 38(2): 179-186, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30920993


Organizational research started including neurosciences exploring pivotal phenomena and promoting organizational well-being. Leadership was investigated by assessing psychophysiological responses during performance review characterized by narrative or quantitative assessments and their effects on employees' well-being. As is known, rating could be perceived as threatening for employees' ranking and status perception, leading to avoidant behaviors. DESIGN AND METHODOLOGY: Here, manager-employee dyads were assigned to 2 conditions: in the nonrate scenario, managers were asked to describe the employee's performance; in the rate one, they had to provide a quantitative rating. Skin conductance level and response and heart rate indices were continuously recorded. FINDINGS: Dyads in nonrate condition showed higher arousal-related responses (skin conductance level and skin conductance response), perhaps highlighting an increased engagement triggered by a rewarding exchange. Conversely, in rate condition, employees showed higher heart rate, usually related to negative and stressful conditions, and avoidant behaviors. ORIGINALITY/VALUE: Results are discussed for their possible applications to employees' well-being.

Avaliação de Desempenho Profissional/estatística & dados numéricos , Satisfação no Emprego , Local de Trabalho/psicologia , Adulto , Feminino , Resposta Galvânica da Pele/fisiologia , Frequência Cardíaca/fisiologia , Humanos , Masculino
Aerosp Med Hum Perform ; 90(4): 389-395, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30922427


INTRODUCTION: A flight is composed of many flight performance aspects. However, not all of these aspects are equally important for the success and safety of a flight. When investigating the influence of a stressor on flight performance, it is important to understand not only which flight performance aspects are important for the success and the safety of the flight, but also which of these aspects will most likely be affected by reduced alertness.METHOD: A total of 136 helicopter pilots of the Royal Netherlands Air Force (RNLAF) of all qualification levels were invited to participate in a three-round ranking Delphi study.RESULTS: A total of 41 (30%) helicopter pilots completed the first questionnaire round and 20 (77%) flight instructors completed the ranking round. The top ten skills elements comprised seven nontechnical skills (NTS), namely, awareness of the environment, decision making, workload management, stress management, planning and coordinating, general knowledge, and basic fitness; and three technical skills (TS), that is, advanced aircraft handling, flight maneuvers and procedures, and abnormal and emergency procedures. The top three ranked skill elements (awareness of environment, decision making, and workload management) were considered by the flight instructors to be highly influenced by reduced pilot alertness.CONCLUSION: NTS are considered more important and more affected by reduced pilot alertness during operational helicopter flight compared to TS.Steinman Y, van den Oord MHAH, Frings-Dresen MHW, Sluiter JK. Flight performance aspects during military helicopter flights. Aerosp Med Hum Perform. 2019; 90(4):389-395.

Medicina Aeroespacial/estatística & dados numéricos , Avaliação de Desempenho Profissional/estatística & dados numéricos , Militares/estatística & dados numéricos , Estresse Ocupacional/psicologia , Pilotos/estatística & dados numéricos , Aeronaves , Conscientização/fisiologia , Técnica Delfos , Humanos , Países Baixos , Distribuição Aleatória , Inquéritos e Questionários/estatística & dados numéricos , Carga de Trabalho/psicologia
Nurse Educ Pract ; 36: 20-27, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30844629


This study compared final year nursing students' error rate and use of strategies to maintain SA when undertaking specific nursing care in a simulated clinical environment pre and 10 weeks post a planned SA education intervention. Students were observed using a Performance Based Situation Awareness Observation Schedule (PBSAOS) undertaking two tasks in a simulated clinical environment pre and post the SA education. For task 1, post educational intervention, there was no significant increase in the error rate for any performance measures, and there were significant decreases in the error rates for three performance measures. For task 2, post educational intervention, there was a significant decrease in the error rate for two measures and a significant increase in the error rates for seven performance measures. In considering the overall group error rate when excluding uncompleted tasks, there was a significant (x = .0001) decrease in the error rate for task 1 post educational intervention (41.4% compared to 26.6%), and significant (x = 0.01) increase in the error for task 2 post educational intervention (39.6% compared to 47.3%). The findings of this study demonstrate that the implementation of an intervention designed to increase SA actually appear to have resulted in hyper-vigilance and subsequent non-completion of required tasks.

Conscientização , Avaliação Educacional/métodos , Avaliação de Desempenho Profissional/métodos , Adulto , Competência Clínica/normas , Avaliação Educacional/normas , Feminino , Humanos , Masculino , Treinamento por Simulação/métodos , Inquéritos e Questionários
Implement Sci ; 14(1): 17, 2019 02 18.
Artigo em Inglês | MEDLINE | ID: mdl-30777080


BACKGROUND: While it is recommended that childcare services implement policies and practices to support obesity prevention, there remains limited evidence to inform policy and practice. The aim of this study is to examine the effectiveness of performance review and facilitated feedback in increasing the implementation of healthy eating and physical activity-promoting policies and practices in childcare services. METHODS: The study was conducted with childcare services in the Hunter New England region of New South Wales, Australia. Eligible services were randomised to a wait-list control group or to receive the implementation strategy. The strategy targeted the implementation of written nutrition, physical activity, and small screen recreation policies; providing information to families regarding healthy eating, physical activity, and small screen time; providing twice weekly healthy eating learning experiences to children; providing water and plain milk only to children; providing fundamental movement skills activities for children every day; and limiting the use of electronic screen time for educational purposes and learning experiences. Intervention services received a performance review and facilitated feedback process five times over the 10 months that included an assessment of current practices, goal setting, identification of barriers to implementation, problem-solving, and resource provision. The primary outcome was the proportion of services implementing all six policies and practices, assessed by nominated supervisor completion of a computer-assisted telephone interview at baseline and 12-month follow-up. RESULTS: One hundred and eight services took part. There were no significant differences in the proportion of services implementing all six practices at 12 months (mean difference 0.51; 95% CI 0.16 to 1.58; p = 0.24). There were also no differences between groups in the mean number of policies and practices implemented (mean difference 0.1; 95% CI - 0.4 to 0.6; p = 0.71), or the proportion implementing each of the six individual policies and practices at 12 months (OR range 0.57 to 1.85; p > 0.05). CONCLUSIONS: Further support may be required to assist childcare services to make recommended changes to their policies and practices. TRIAL REGISTRATION: The trial was registered retrospectively on 10 September 2014 with the Australian New Zealand Clinical Trials Registry ACTRN12614000972628 .

Serviços de Saúde da Criança/normas , Exercício , Implementação de Plano de Saúde/normas , Dieta Saudável , Obesidade Pediátrica/prevenção & controle , Saúde da Criança/normas , Pré-Escolar , Avaliação de Desempenho Profissional , Retroalimentação , Política de Saúde , Promoção da Saúde/normas , Humanos , New South Wales , Melhoria de Qualidade
Matern Child Nutr ; 15 Suppl 1: e12716, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30748111


Previous studies have described barriers to access of childhood severe acute malnutrition (SAM) treatment, including long travel distances and high opportunity costs. To increase access in remote communities, the International Rescue Committee developed a simplified SAM treatment protocol and low-literacy-adapted tools for community-based distributors (CBD, the community health worker cadre in South Sudan) to deliver treatment in the community. A mixed-methods pilot study was conducted to assess whether low-literate CBDs can adhere to a simplified SAM treatment protocol and to examine the community acceptability of CBDs providing treatment. Fifty-seven CBDs were randomly selected to receive training. CBD performance was assessed immediately after training, and 44 CBDs whose performance score met a predetermined standard were deployed to test the delivery of SAM treatment in their communities. CBDs were observed and scored on their performance on a biweekly basis through the study. Immediately after training, 91% of the CBDs passed the predetermined 80% performance score cut-off, and 49% of the CBDs had perfect scores. During the study, 141 case management observations by supervisory staff were conducted, resulting in a mean score of 89.9% (95% CI: 86.4%-96.0%). For each performance supervision completed, the final performance score of the CBD rose by 2.0% (95% CI: 0.3%-3.7%), but no other CBD characteristic was associated with the final performance score. This study shows that low-literate CBDs in South Sudan were able to follow a simplified treatment protocol for uncomplicated SAM with high accuracy using low-literacy-adapted tools, showing promise for increasing access to acute malnutrition treatment in remote communities.

Transtornos da Nutrição Infantil/terapia , Agentes Comunitários de Saúde/educação , Agentes Comunitários de Saúde/estatística & dados numéricos , Alfabetização , Desnutrição Aguda Grave/terapia , Adulto , Pré-Escolar , Serviços de Saúde Comunitária , Avaliação de Desempenho Profissional , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Terapia Nutricional/métodos , Projetos Piloto , Sudão do Sul , Adulto Jovem
Rev. bras. med. fam. comunidade ; 14(41): e1879, 02/2019. tab
Artigo em Português | LILACS, Coleciona SUS | ID: biblio-996057


Introdução: A Residência Médica de Medicina de Família e Comunidade e a residência Multiprofissional em Saúde da Família contribuem, para além do aprendizado, à qualidade do atendimento à comunidade, e a avaliação desse processo mantém a qualidade do serviço, sendo os indicadores instrumentos que permitem planejamentos em saúde. Objetivo: Avaliar o desempenho da Residência Médica de Medicina de Família e Comunidade e residência Multiprofissional em Saúde da Família da Atenção Básica pelo monitoramento dos indicadores de qualidade do PMAQ-AB. Métodos: Realizou-se estudo transversal com análise da série histórica de dados secundários do PMAQ-AB (2011 a 2013) referentes aos indicadores do 1º e 2º ciclo das equipes com residentes e ou egressos da residência da Atenção Básica. Realizou-se análise descritiva, com frequência absoluta e relativa, e média e desvio padrão dos dados. Resultados: 38,6% das equipes no 1º ciclo e 34,66% do 2º ciclo apresentavam egressos da residência. Atendimentos de pré-natal média de 8,75 (±2,24), gestantes com pré-natal em dia, média de 91,43% (±8,91). Crianças menores de quatro meses com aleitamento exclusivo, 82,51% (±13,17) e 93,91% (±6,59) de crianças menores de um ano com vacina em dia. Pessoas com diabetes 60,27% (±16,28) e hipertensão 61,31% (±12,04). Consultas médicas por cuidado continuado/programado com média de 26,00% (±22,22). Satisfação do usuário 100% com desempenho mediano ou acima da média. Conclusão: O estudo evidenciou predominância de avaliação positiva das equipes avaliadas acerca dos indicadores da saúde da mulher, criança, produção geral e avaliação externa, porém alcançou baixo desempenho no indicador de doenças crônicas.

Introduction: The Medical Residency of Family and Community Medicine and the Multiprofessional residence in Family Health contribute, in addition to learning, quality of care to the community, and the evaluation of this process maintains the quality of the service, the indicators being the instruments that allow planning in health. Objective: To evaluate the performance of the Medical Residency of Family and Community Medicine and Multiprofessional residence in Health of the Primary Care Family by monitoring the quality indicators of PMAQ-AB. Methods: A cross-sectional study was carried out with the analysis of the PMAQ-AB secondary data series (2011 to 2013) referring to the indicators of the first and second cycle of the teams with residents and/or graduates of the Primary Care residence. Descriptive analysis was performed, with absolute and relative frequency, and mean and standard deviation of the data. Results: 38.6% of the teams in the first cycle and 34.66% of the second cycle had their residency graduates. Average prenatal care of 8.75 (± 2.24), pregnant women with prenatal care on average, 91.43% (± 8.91). Children less than four months old exclusively breastfed, 82.51% (± 13.17) and 93.91% (± 6.59) of children under one year of age with up-to-date vaccine. People with diabetes 60.27% (± 16.28) and hypertension 61.31% (± 12.04). Medical consultations for continued/scheduled care averaging 26.00% (± 22.22). 100% user satisfaction with medium or above average performance. Conclusion: The study showed a predominance of positive evaluation of the teams evaluated in relation to indicators of women's, child's, general production and external evaluation, but it achieved a low performance in the indicator of chronic diseases.

Introducción: La Residencia Médica de Medicina de Familia y Comunidad y la residencia Multiprofesional en Salud de la Familia contribuyen, además del aprendizaje, calidad de la atención a la comunidad, y la evaluación de ese proceso mantiene la calidad del servicio siendo los indicadores instrumentos que permiten planificaciones en salud. Objetivo: Evaluar el desempeño de la Residencia Médica de Medicina de Familia y Comunidad y residencia Multiprofesional en Salud de la Familia de la Atención Básica a través del monitoreo de los indicadores de calidad del PMAQ-AB. Métodos: Se realizó un estudio transversal con análisis de la serie histórica de datos secundarios del PMAQ-AB (2011 a 2013) referentes a los indicadores del 1º y 2º ciclo de los equipos con residentes y/o egresados de la residencia de la Atención Básica. Se realizó un análisis descriptivo, con frecuencia absoluta y relativa, y media y desviación estándar de los datos. Resultados: El 38,6% de los equipos en el primer ciclo y el 34,66% del 2º ciclo presentaban egresados de la residencia. Los atendimientos de prenatal promedio del 8,75 (± 2,24), mujeres embarazadas con prenatal en día, promedio del 91,43% (± 8,91). Niños menores de cuatro meses con lactancia exclusiva, el 82,51% (± 13,17) y el 93,91% (± 6,59) de niños menores de un año con vacuna al día. Personas con diabetes 60,27% (± 16,28) e hipertensión 61,31% (± 12,04). Consultas médicas por cuidado continuado/programado con promedio del 26,00% (± 22,22). Satisfacción del usuario 100% con desempeño mediano o por encima de la media. Conclusión: El estudio evidenció predominio de evaluación positiva de los equipos evaluados a cerca de los indicadores de la salud de la mujer, niño, producción general y evaluación externa, pero alcanzó bajo desempeño en el indicador de enfermedades cónicas.

Humanos , Indicadores Básicos de Saúde , Avaliação de Desempenho Profissional , Pesquisa sobre Serviços de Saúde , Internato e Residência , Saúde da Criança , Saúde da Mulher
Rev Esp Quimioter ; 32(2): 130-136, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30727715


OBJECTIVE: Evaluate the efficacy of an information system addressed to nursing staff to lower the blood culture contamination rate. METHODS: A blind clinical trial was conducted at Internal Medicine and Emergency Departments during 2011. After following a reeducation program in BC extraction, participants were randomly selected in a 1:1 ratio. Every participant of the experimental group was informed of each worker's individual performance; whereas the control group was only informed of the global results. RESULTS: A total of 977 blood extractions were performed in 12 months. Blood culture contamination rate was 7.5%. This rate was higher in the Emergency Department than in Internal Medicine (10% vs. 3.8%; p=0.001). Factors associated with the higher risk of contamination were, in the univariate analysis, the extraction through a recently implanted blood route and the time of professional experience, while those associated with a lower risk were the extraction in Internal Medicine and through a butterfly needle. On multivariate analysis, extraction through a recently placed access was an independent risk factor for an increased contamination rate (OR 2.29; 95%CI 1.18-4.44, p=0.014), while individual information about the blood culture results (OR 0.11; 95%CI 0.023-0.57; p=0.008), and more than 9 years of professional experience were asso-ciated with fewer contaminations (OR 0.30; 95%CI 0.12-0.77; p=0.012). In the intervention group the contamination rate diminished by a 26 %. CONCLUSIONS: Drawing blood cultures through a recently taken peripheral venous access increased their risk of contamination. The intervention informing the nurse staff of the contamination rate is effective to decrease it.

Testes Hematológicos/normas , Sistemas de Informação , Recursos Humanos de Enfermagem/educação , Manejo de Espécimes/normas , Centros Médicos Acadêmicos , Adulto , Avaliação de Desempenho Profissional , Contaminação de Equipamentos , Feminino , Testes Hematológicos/instrumentação , Humanos , Masculino , Agulhas , Melhoria de Qualidade , Fatores de Risco , Dispositivos de Acesso Vascular
BMJ ; 364: l121, 2019 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-30700408


OBJECTIVES: To evaluate the changes in productivity when scribes were used by emergency physicians in emergency departments in Australia and assess the effect of scribes on throughput. DESIGN: Randomised, multicentre clinical trial. SETTING: Five emergency departments in Victoria used Australian trained scribes during their respective trial periods. Sites were broadly representative of Australian emergency departments: public (urban, tertiary, regional referral, paediatric) and private, not for profit. PARTICIPANTS: 88 physicians who were permanent, salaried employees working more than one shift a week and were either emergency consultants or senior registrars in their final year of training; 12 scribes trained at one site and rotated to each study site. INTERVENTIONS: Physicians worked their routine shifts and were randomly allocated a scribe for the duration of their shift. Each site required a minimum of 100 scribed and non-scribed shifts, from November 2015 to January 2018. MAIN OUTCOME MEASURES: Physicians' productivity (total patients, primary patients); patient throughput (door-to-doctor time, length of stay); physicians' productivity in emergency department regions. Self reported harms of scribes were analysed, and a cost-benefit analysis was done. RESULTS: Data were collected from 589 scribed shifts (5098 patients) and 3296 non-scribed shifts (23 838 patients). Scribes increased physicians' productivity from 1.13 (95% confidence interval 1.11 to 1.17) to 1.31 (1.25 to 1.38) patients per hour per doctor, representing a 15.9% gain. Primary consultations increased from 0.83 (0.81 to 0.85) to 1.04 (0.98 to 1.11) patients per hour per doctor, representing a 25.6% gain. No change was seen in door-to-doctor time. Median length of stay reduced from 192 (interquartile range 108-311) minutes to 173 (96-208) minutes, representing a 19 minute reduction (P<0.001). The greatest gains were achieved by placing scribes with senior doctors at triage, the least by using them in sub-acute/fast track regions. No significant harm involving scribes was reported. The cost-benefit analysis based on productivity and throughput gains showed a favourable financial position with use of scribes. CONCLUSIONS: Scribes improved emergency physicians' productivity, particularly during primary consultations, and decreased patients' length of stay. Further work should evaluate the role of the scribe in countries with health systems similar to Australia's. TRIAL REGISTRATION: ACTRN12615000607572 (pilot site); ACTRN12616000618459.

Serviço Hospitalar de Emergência , Avaliação de Desempenho Profissional/métodos , Médicos Hospitalares , Secretárias de Consultório Médico , Corpo Clínico Hospitalar , Administração de Recursos Humanos em Hospitais/métodos , Austrália , Análise Custo-Benefício , Eficiência , Serviço Hospitalar de Emergência/classificação , Serviço Hospitalar de Emergência/economia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Médicos Hospitalares/normas , Médicos Hospitalares/estatística & dados numéricos , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Secretárias de Consultório Médico/organização & administração , Secretárias de Consultório Médico/normas , Corpo Clínico Hospitalar/educação , Corpo Clínico Hospitalar/normas , Corpo Clínico Hospitalar/estatística & dados numéricos , Avaliação de Resultados (Cuidados de Saúde) , Melhoria de Qualidade , Tempo para o Tratamento/normas , Tempo para o Tratamento/estatística & dados numéricos
Einstein (Sao Paulo) ; 17(1): eGS4191, 2019 Jan 21.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30673055


OBJECTIVE: To analyze the leadership potential of physicians in a public hospital in the city of São Paulo. METHODS: A descriptive pilot study, in which 40 assistant physicians and medical residents were randomly selected to receive an electronic invitation of the company Caliper Estratégias Humanas do Brasil . To those who accepted it, a link was sent to fill out a personality evaluation focused on the work, comprising 112 alternatives related to 21 domains of 4 performance areas. According to the Caliper Profile Questionnaire, the ipsative measures expressed as a percentage are distributed on a Likert scale, and three categories are established based on behavioral tendencies at work: need for improvement, moderate and high potential. RESULTS: A total of 47.5% of physicians invited accepeted taking part in the study. Regarding to leadership, the need for improvement was over 30% among the evaluated physicians. In the interpersonal relationship analysis, only 18.4% of assistant physicians and 37% of medical residents required improvement. The percentage of physicians who needed improvement in problem-solving and decision-making was similar among the assistant and resident physicians (12.6% versus 14%). In the evaluation of personal organization and time management, we obtained similar percentages in assistant physicians and residents who needed improvement (14% in both groups). High potential leadership was observed in these domains (18.4% and 20% for assistant physicians and residents, respectively). CONCLUSION: The physicians assessed presented high leadership potential in 25% of the cases, requiring improvement in the performance domains, such as interpersonal relationship, problem solving, decision-making, personal organization and time management.

Avaliação de Desempenho Profissional/estatística & dados numéricos , Hospitais Públicos , Hospitais de Ensino , Liderança , Corpo Clínico Hospitalar/psicologia , Brasil , Tomada de Decisões Gerenciais , Humanos , Internato e Residência/estatística & dados numéricos , Corpo Clínico Hospitalar/estatística & dados numéricos , Inventário de Personalidade , Projetos Piloto , Autorrelato , Inquéritos e Questionários
REME rev. min. enferm ; 23: e-1160, jan.2019.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1005016


O objetivo deste estudo foi identificar os aspectos que dinamizam e/ou obstaculizam o processo de avaliação de desempenho de uma instituição hospitalar pública e discutir com os profissionais de saúde estratégias facilitadoras desse processo. Trata-se de pesquisa qualitativa, exploratório-descritiva realizada em um hospital público da região Sul do Brasil. A coleta de dados ocorreu por meio da realização de grupo focal e as informações foram submetidas à análise temática. Como resultados do estudo emergiram as categorias: na dialogicidade do grupo focal, ponderações sobre a finalidade do processo avaliativo; cultura sobre avaliação de desempenho como dinamizadora/obstaculizadora do processo de avaliação; e estratégias facilitadoras do processo de avaliação de desempenho. Os resultados reforçam a necessidade de conduzir a avaliação de desempenho alicerçada em um processo dialógico, reflexivo e que busque uma leitura crítica da realidade em que os profissionais estão inseridos.(AU)

This study aims to identify the aspects that optimize and/or hamper the process of performance appraisal in a public hospital and to discuss strategies that facilitate this process with health professionals. This is a qualitative, exploratory-descriptive study conducted in a public hospital in the southern region of Brazil. Data collection took place through focal group and information was submitted to thematic analysis. The following categories emerged as a result of this study: considerations about the purpose of the evaluation process in the dialogical process of the focal group; the culture of performance appraisal as an optimization / obstacle to the evaluation process; and strategies that facilitate the process of performance appraisal. The results reinforce the need for the institution to conduct performance appraisal based on a reflexive and dialogical process that seeks a critical analysis of the circumstances health professionals work in.(AU)

El objetivo de este estudio fue identificar los aspectos que dinamizan y/o obstaculizan el proceso de evaluación de desempeño de un hospital público y discutir con los profesionales de la salud estrategias facilitadoras de dicho proceso. Investigación cualitativa, exploratoria, descriptiva llevada a cabo en un hospital público del sur de Brasil. La recogida de datos se efectuó por medio de la realización del grupo focal; las informaciones fueron sometidas al análisis temático. Como resultados del estudio se generaron las siguientes categorías: en la dialogicidad del grupo focal, consideraciones...(AU)

Humanos , Pesquisa em Administração de Enfermagem , Gestão em Saúde , Avaliação de Desempenho Profissional , Administração Hospitalar
J Clin Nurs ; 28(9-10): 1528-1537, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30588721


AIMS AND OBJECTIVES: To explore staff nurses' discourses of workplace bullying, to critically examine how these discourses affect their responses to bullying. BACKGROUND: Workplace bullying has been identified as a pervasive problem within the nursing profession. Efforts to eradicate workplace bullying need to involve staff-targets as well as bystanders. By understanding how this population conceptualises workplace bullying, more effective and targeted solutions to the problem can be devised. DESIGN: This qualitative study used a critical discourse analysis method which was based on the work of Foucault. METHODS: Thirteen staff nurses who worked in a variety of settings in the USA were interviewed. COREQ checklist was used for this article. RESULTS: Three interrelated discursive strands were identified: "biased behaviour manifested as workplace bullying, workplace bullying disguised as performance review and workplace bullying as entrenched behaviour in nursing". Actions in response to bullying varied according to which discursive strand was invoked. CONCLUSIONS: The central theme at the intersection of the discursive strands was that workplace bullying is a mechanism for driving out nurses who are different. RELEVANCE TO CLINICAL PRACTICE: Efforts to address workplace bullying among nurses need to include training on legitimate methods of performance review, workshops on how to interact with diverse co-workers, and examination of how practices with nursing education contribute to the perpetuation of bullying in clinical settings.

Bullying/psicologia , Bullying/estatística & dados numéricos , Avaliação de Desempenho Profissional/normas , Recursos Humanos de Enfermagem no Hospital/normas , Local de Trabalho/psicologia , Local de Trabalho/normas , Adulto , Idoso , Atitude do Pessoal de Saúde , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Washington
BMC Health Serv Res ; 18(1): 995, 2018 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-30587171


BACKGROUND: As part of its efforts to improve efficiency, accountability and overall performance, the Ghana Health Service (GHS) introduced annual Performance-based Management Agreements (PMAs) in the year 2013. However, no assessment of this initiative has since been made in order to inform policy and practice. This paper provides an assessment of this policy initiative from the perspective of managers at various levels of service implementation. METHODS: Mixed methods were employed. Questionnaires were administered to managers through an online survey (using Google forms). Descriptive and inferential statistical methods were used to analyze and present quantitative results while qualitative data was analyzed via thematic analysis. RESULTS: The content and objectives of the PMAs were observed to be comprehensive and directed at ensuring high performance of directorates. Targets of PMAs were found to be aligned with overall health sector objectives and priorities. The directors felt PMAs were useful for delegating task to subordinates. PMAs were also found to increase commitment and contributed to improving teamwork and prudent use of resources. However, PMAs were found to lack clear implementation strategies and were not backed by incentives and sanctions. Also, budgetary allocations did not reflect demands of PMAs. Furthermore, directors at lower levels were not adequately consulted in setting PMAs targets as such district specific challenges and priorities are not usually factored into the process. Insufficient training of staff and lack of requisite staff were key challenges confronting the implementation of PMAs in most directorates. Weak monitoring and evaluation was also observed to significantly affect the success of PMAs. CONCLUSION: There is the need to address the weaknesses and improve on the existing strengths identified by this assessment in order to enhance the effectiveness of PMAs utilization in the Ghana health service.

Assistência à Saúde/normas , Serviços de Saúde/normas , Administração de Recursos Humanos/normas , Avaliação de Desempenho Profissional , Gana , Política de Saúde , Humanos , Garantia da Qualidade dos Cuidados de Saúde
Educ. med. super ; 32(4): 70-79, oct.-dic. 2018.
Artigo em Espanhol | LILACS | ID: biblio-989771


Introducción: El proceso de evaluación en las especialidades médicas es fundamentalmente cualitativo, de verificación de evidencias del desempeño para garantizar una adecuada formación profesional. El Programa de la especialidad de Ginecología y Obstetricia en Cuba, se ha enriquecido con nuevos contenidos desde su implementación, pero el sistema de evaluación del residente ha experimentado pocas modificaciones. Objetivo: Caracterizar el proceso de evaluación del desempeño del residente de Ginecología y Obstetricia en la Facultad de Ciencias Médicas "Finlay-Albarrán" para identificar los problemas y las potencialidades que permitan programar actividades para su mejoramiento. Métodos: Se realizó análisis documental e histórico-lógico. Se efectuó revisión documental. Se hicieron entrevistas, encuestas y la observación del desempeño del profesor durante el proceso docente educativo; parametrización y triangulación metodológica. Resultados: Se identificaron problemas en las tres dimensiones estudiadas entre los que se destacan: deficiente nivel de comprobación de los conocimientos de las ciencias básicas, limitada utilización del idioma inglés en la práctica profesional, insuficiente conocimiento entorno a la evaluación del desempeño y la insuficiente participación del profesor en actividades de superación profesional relacionadas con el proceso de evaluación. Se identificó una potencialidad. Conclusiones: La caracterización del proceso de evaluación del desempeño del residente de Ginecología y Obstetricia en la Facultad de Ciencias Médicas "Finlay-Albarrán" permitió la identificación de problemas y una potencialidad. Los resultados de esta investigación conducen al diseño y desarrollo de actividades que propicien el mejoramiento del sistema de evaluación con enfoque en el desempeño(AU)

Introduction: The process of evaluation in medical specialties is mainly a qualitative one, based on the verification of performance evidences that guarantee an adequate professional training. The specialty program for Gynecology and Obstetrics in Cuba has been enriched with new contents since its implementation, but the resident's evaluation system has undergone few modifications. Objective: To characterize the process of evaluation for the Gynecology and Obstetrics resident's performance in "Finlay-Albarrán" Medical School, in order to identify the problems and potentialities that allow to program activities for its improvement. Methods: Literature and historical-logical analyses were carried out. A documentary review was made. Interviews, surveys and the observation of the teacher's performance during the educational process; parametrization and methodological triangulation. Results: Problems were identified in the three dimensions studied; for example, a poor level of knowledge verification in basic sciences, limited use of the English language in the professional practice, insufficient knowledge about performance evaluation, and insufficient participation of the teacher in professional improvement activities related with the evaluation process. A potentiality was identified.Conclusions: The characterization of the process of performance evaluation for the Gynecology and Obstetrics resident in Finlay-Albarrán Medical School allowed the identification of problems and a potentiality. The results of this research lead to the design and development of activities that encourage the improvement of the evaluation system, with a focus on performance(AU)

Educação de Pós-Graduação , Avaliação de Desempenho Profissional , Ginecologia , Obstetrícia
Rev. psicol. trab. organ. (1999) ; 34(3): 123-133, dic. 2018. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-176732


Este estudio analizó la relación entre el capital psicológico y el desempeño contextual, proponiéndose un modelo de moderación que incluyó el apoyo social del trabajo. La muestra fue de 128 trabajadores de atención primaria de salud (82% mujeres, M = 42.8 años). Los resultados apoyan parcialmente la relación entre capital psicológico y desempeño contextual, existiendo diferencias en los resultados según la medida de desempeño; sin embargo, el análisis de regresión lineal confirma que el capital psicológico y la resiliencia predicen el desempeño contextual. La evidencia encontrada no apoya la relación entre desempeño contextual y apoyo social del trabajo y esta última no actúa como variable moderadora en el modelo propuesto para explicar la relación entre capital psicológico y desempeño contextual

This study analyzed the relationship between psychological capital and contextual performance, proposing a model of moderation that includes social support at work. The sample consisted of 128 primary health care workers (82% women, M = 42.8 years). The results support partially the relationship between the psychological capital and contextual performance variables, with differences in the results according to the measure of performance; however, linear regression analysis confirms that psychological capital and resilience predict contextual performance. The evidence found does not support the relationship between contextual performance and social support at work, and this last variable does not act as a moderating variable in the proposed model for the relationship between psychological capital and contextual performance

Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Adaptação Psicológica , Condições de Trabalho , Avaliação de Desempenho Profissional/métodos , Enquadramento (Psicologia) , Apoio Social , Pessoal de Saúde/psicologia , Atenção Primária à Saúde , Testes Psicológicos/estatística & dados numéricos
J Glob Health ; 8(2): 020418, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30333922


Background: Countries across sub-Saharan Africa are scaling up Community Health Worker (CHW) programmes, yet there remains little high-quality research assessing strategies for CHW supervision and performance improvement. This randomised controlled trial aimed to determine the effect of a personalised performance dashboard used as a supervision tool on the quantity, speed, and quality of CHW care. Methods: We conducted a randomised controlled trial in a large health catchment area in peri-urban Mali. One hundred forty-eight CHWs conducting proactive case-finding home visits were randomly allocated to receive individual monthly supervision with or without the CHW Performance Dashboard from January to June 2016. Randomisation was stratified by CHW supervisor, level of CHW experience, and CHW baseline performance for monthly quantity of care (number of household visits). With regression analysis, we used a difference-in-difference model to estimate the effect of the intervention on monthly quantity, timeliness (percentage of children under five treated within 24 hours of symptom onset), and quality (percentage of children under five treated without protocol error) of care over a six-month post-intervention period relative to a three-month pre-intervention period. Results: Use of the Dashboard during monthly supervision significantly increased the mean number of home visits by 39.94 visits per month (95% CI = 3.56-76.3; P = 0.031). Estimated effects on secondary outcomes of timeliness and quality were positive but not statistically significant. Across both study arms, CHW quantity, timeliness, and quality of care significantly improved over the study period, during which time all CHWs received dedicated monthly supervision, although effects plateaued over time. Conclusions: Our findings suggest that dedicated monthly supervision and personalised feedback using performance dashboards can increase CHW productivity. Further operational research is needed to understand how to sustain the performance improvements over time. Trial registration: (NCT03684551).

Agentes Comunitários de Saúde , Avaliação de Desempenho Profissional , Melhoria de Qualidade/organização & administração , Humanos , Mali , Avaliação de Programas e Projetos de Saúde
Am J Occup Ther ; 72(5): 7205195030p1-7205195030p10, 2018 Sep/Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30157011


OBJECTIVE: We sought to describe the occupational performance issues of a sample of bariatric surgery candidates and to explore the relationships among occupational performance, satisfaction with performance, demographic characteristics, and mental health factors. METHOD: We reviewed the health records of 241 bariatric surgery candidates and analyzed their scores on the Canadian Occupational Performance Measure (COPM) and standardized mental health questionnaires. RESULTS: Exercise and eating behavior were the most common occupational performance issues. Cognitive and affective issues were reported more frequently than physical issues. Occupational performance and satisfaction correlated negatively with anxiety and depression and positively with self-esteem. Self-esteem contributed 27% of the variance in occupational performance. CONCLUSION: COPM scores revealed a wide range of occupational performance issues and significant associations with mental health factors, supporting a psychosocial approach to occupational therapy with this population. Routine mental health screening can help ensure that mental health factors are adequately addressed.

Cirurgia Bariátrica/reabilitação , Avaliação de Desempenho Profissional , Obesidade Mórbida/reabilitação , Adulto , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/psicologia , Transtornos de Ansiedade/reabilitação , Cirurgia Bariátrica/psicologia , Canadá , Comorbidade , Demografia , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/psicologia , Transtorno Depressivo/reabilitação , Exercício/psicologia , Comportamento Alimentar/psicologia , Feminino , Humanos , Satisfação no Emprego , Masculino , Obesidade Mórbida/psicologia , Satisfação Pessoal , Psicometria , Autoimagem , Inquéritos e Questionários