[Management of technology in intensive care]

Use of technologies in intravenous therapy: contributions to a safer practice

ABSTRACT Objectives: To identify what are the difficulties of the nursing staff in the management of technologies during intravenous therapy (IVT) and discuss the difficulties identified under the perspective of patient's safety. Method: Descriptive study of qualitative approach with data collected by semi-structured interview and analyzed by the Alceste software. Results: The greatest difficulty of cognitive and technical emphasis was the lack of training; and regarding administrative emphasis, the greatest difficulty was the lack of material and human resources. Infusion pumps and their proper use were highlighted as the technological resource that most contributed to patient safety. Final considerations: The lack of training is presented as the greatest difficulty of nursing professionals and permeates safety issues of both patient and professional when using the hard technologies in IVT. Training is essential to the development of techniques, considered nursing tools.

[Medical-hospital material management and the working process in a public hospital]

This article presents an exploratory-descriptive study structured in a qualitative approach. The main objective was to identify the perception of medical-hospital materials on the work process of professionals in a medium complexity public hospital. Information has been collected using the research question: How does the materials management process influence work process? The report analysis has identified five different categories: lack of autonomy in the choice of materials, lack of maintenance of equipment, bureaucracy in the purchasing process, poor quality and absence of professional involvement in the materials management. It is concluded that the materials management is focused on the nursing direction, which requires greater involvement of other professionals in the materials choice used to reduce the weakness in that process.

Ultra-sonografia na punção intravenosa periférica: inovando a prática de enfermagem para promover a segurança do paciente

Este estudo teve por finalidade descrever o uso da ultra-sonografia como método para direcionar a punção de veias periféricas, prática que vem sendo descrita na literatura desde os primeiros anos da década de 1990. Esta técnica tem a premissa de promover cuidados mais efetivos e eficazes, pois as punções venosas periféricas destacam-se como um dos procedimentos mais freqüentemente realizados em instituições de saúde. Assim, possibilitar a melhora desta intervenção de enfermagem pode resultar em incremento da segurança e satisfação do paciente e família com o cuidado prestado. O desenvolvimento de equipamentos de ultra-som portáteis, para uso à beira do leito, possibilita a realização de estudos de inovação da prática de enfermagem, contribuindo para a melhora da assistência prestada à população.

[Management in nursing: a critical view about the knowledge produced in Brazilian journals (2000-2004)]

This study aimed at analyzing the scientific production about management in nursing in Brazilian journals through bibliographic research in the period from 2000 to 2004. This bibliographic study considered data bases and libraries during the period of May to July 2005. From the texts submitted to categorization apprehended the following categories: general considerations about management; the formation of nurse in management area; models of management in nursing in practice and management theories used; difficulties in nursing management; suggestions of changes and solutions to be searched. The confronts and reflections pointed out the need of transformation of management in direction to a participative and flexive posture, valuing the human potential.

[Application of the therapeutic intervention scoring system (TISS 28) at an intensive care unit to evaluate the severity of the patient]

Prospective cohort study realized in the adult intensive care unit (ICU) of a University Hospital to evaluate the utility of the TISS 28 score, using a protocol applied to 1641 patients from January 2000 to December 2002, based on the direct observation of patients and medical and nurse registers of therapeutic procedures and monitoring. The Chi-square test, Student's t test and Kruskal-Wallis were used to compare the TISS 28 score and some characteristics of survivors and no survivors patients. The results showed that the TISS 28 score stratified the patients by severity level and evidenced the relation between high scores and mortality of the analyzed patients.

Tecnologias educacionais, assistenciais e gerenciais: uma reflexão a partir da concepção dos docentes de enfermagem

Estudo realizado com os docentes de dezesseis Cursos de Enfermagem das Instituições de Ensino Superior do Estado do Rio Grande do Sul, com objetivo de identificar as tecnologias assistenciais, educacionais e gerenciais que vêm sendo utilizadas e/ou produzidas em sua práxis profissional nas disciplinas profissionalizantes. Este texto apresenta um recorte da investigação realizada e centra-se nas concepções das diferentes tipologias de tecnologias abordadas pelos docentes. Os dados foram coletados através de questionário com perguntas fechadas e abertas e, após, foram categorizados e analisados, apoiados nos referenciais metodológicos de análise de conteúdo. Ficou evidenciado que a maioria dos docentes apresentou concepção conceitual restrita a respeito da temática, manifestando dificuldades para produção e utilização de tecnologias e sugerindo formas de assessoramento para suprir as dificuldades na perspectiva de melhoria da práxis profissional.

Patient safety initiatives in Brazil: a nursing perspective

The science development and technology application improvement in all areas of knowledge, including health care, represent an advance in patient care. The health care providers face challenges to accomplish complex procedures and treatments, which demand infrastructure, defined framework, constant process establishment and redesign of nursing care, based on a continuous outcomes evaluation. Therefore, this development requires nurses with advanced knowledge and skills. As the main health care provider in Brazilian hospitals, the nursing staff perform and control the majority of direct patient care procedures, and as such, nursing professionals can be responsible for triggering adverse events that can compromise patient safety. Research conducted in Brazil showed that the quality of health care delivery system and the results of care have significant variation nationwide. Health care professionals should be valued as the one who can promote patient safety, providing high quality care within cost-effective services. Technology is a key element to support and enhance the professional's performance. However, it is also important to promote and facilitate its implementation and development to retain a creative, engaged, skilled, satisfied, competent, and accountable professional capable of identifying and using technology resources in order to assure the quality of care for the population.