Este estudo de caráter qualitativo e quantitativo, tipo exploratório-descritivo, trata da caracterização do trabalho de enfermagem em laboratórios de análises clínicas. O objetivo geral visa identificar os aspectos da atuação da enfermagem nos laboratórios de análises clínicas, que permitam caracterizar o processo de trabalho da enfermagem. Os objetivos específicos buscaram identificar os trabalhadores da saúde que atuam na coleta de exames; reconhecer as atividades desempenhadas pelos diferentes agentes da enfermagem e conhecer sua inserção na estrutura organizacional. O referencial teórico adotado pautou-se nos estudos do processo de trabalho e de recursos humanos em saúde e em enfermagem. Para a coleta de dados utilizou-se um questionário e a amostra foi composta por 45 instituições. A análise dos resultados revelou que, quanto à caracterização dos laboratórios, 15,6% não realizam treinamento em serviço e 60% fazem-no de modo isolado, não continuado; o enfermeiro é o profissional que assume majoritariamente a responsabilidade por essa ação. Quanto aos recursos humanos, 77,8% são auxiliares de enfermagem, 13% enfermeiros e 9,1% técnicos de enfermagem. Evidencia-se a divisão social e técnica do trabalho...

O estudo tem como tema a percepção dos enfermeiros assistenciais sobre os Estágios Curriculares do curso de graduação em Enfermagem desenvolvidos nas unidades de trabalho de um hospital de ensino. O objetivo geral da pesquisa foi conhecer as percepções do enfermeiro assistencial em relação ao Estágio Curricular desenvolvido em sua unidade de trabalho e os objetivos específicos foram: conhecer a percepção dos enfermeiros assistenciais em relação ao seu papel na formação dos alunos em Estágio Curricular; conhecer a influência que os alunos trazem para a unidade de trabalho onde se realiza o referido estágio; identificar os fatores que facilitam e dificultam nas atividades diárias do enfermeiro com a presença dos alunos em estágio; conhecer a percepção dos enfermeiros em relação a estrutura do estágio e sugestões de aprimoramento para o desenvolvimento desta disciplina em ambiente hospitalar e contribuir para o aprimoramento no desenvolvimento de estágios realizados em instituições de saúde. No estudo, denominamos o “Estágio Curricular” como a última disciplina que o aluno desenvolve no curso de graduação em Enfermagem, oferecida no último semestre do curso, possui uma carga horária abrangente e tem o acompanhamento e a supervisão indireta do docente responsável pela disciplina e o aluno fica em contato direto e constante com o enfermeiro assistencial da unidade a qual realiza o estágio. Com relação ao delineamento metodológico...

Tendo em vista a consolidação do Sistema Único de Saúde (SUS), criado pelo governo federal no Brasil, é fundamental considerar a importância das práticas de gestão, e particularmente as de gestão em enfermagem, bem como do ensino da gestão na graduação em enfermagem. Os objetivos deste estudo foram: analisar a dimensão gerencial da prática de enfermeiros que atuam em hospital e na rede básica de saúde, a partir de suas próprias percepções acerca de seu trabalho cotidiano, apreendendo sua proximidade ou afastamento das práticas de saúde e educação propostas pelo SUS, e apontar diretrizes e estratégias para o processo ensinoaprendizagem do exercício profissional do enfermeiro na prática da gestão. O delineamento teórico do estudo considerou o processo de construção e o atual contexto do SUS, as mudanças que vêm orientando as discussões sobre a formação de profissionais em enfermagem e a construção histórico-social da dimensão gerencial da prática do enfermeiro. A pesquisa qualitativa utilizou, na coleta de dados, as técnicas de entrevista e de grupo focal com 20 enfermeiros que atuam em um hospital filantrópico e na rede de atenção básica no município de Campo Grande, MS, em 2007. A análise temática permitiu identificar as seguintes categorias: A organização das práticas gerenciais do enfermeiro no cenário empírico do hospital (subcategorias: A relação entre as políticas de saúde e o trabalho cotidiano na instituição hospitalar...

RESUMO: O presente estudo, enquadra-se, no domínio do exercício profissional dos enfermeiros e na formação em serviço destes profissionais e teve por objectivo avaliar, num grupo de enfermeiros de um serviço de medicina, o impacto de uma intervenção educativa na melhoria dos procedimentos a executar na prática da terapêutica inalatória. A amostra do estudo (amostra por conveniência) foi constituída por oito enfermeiros do serviço de medicina do Hospital Curry Cabral (idades compreendidas entre os 24 a 43 anos de idade), sem anterior formação específica na área da terapêutica inalatória, mas com experiencia profissional prévia com doentes respiratórios. O estudo decorreu em dois momentos de avaliação: avaliação 0 (antes da intervenção educativa) e avaliação 1 (após a intervenção educativa). Entre estes dois momentos, foi ministrada, a todos os enfermeiros, uma acção de formação sobre terapêutica inalatória, com componente teórico-prática. Antes e depois da intervenção educativa foram aplicados dois instrumentos: para avaliação dos conhecimentos teóricos, construi-se e aplicou-se, um questionário de auto-avaliação de conhecimentos sobre terapêutica inalatória ao grupo dos enfermeiros...

This study had two aims: to describe the activities of a clinical training unit set up for the integrated management of sick children, and to evaluate the impact of the unit after its first four years of operation. The training unit was set up in the outpatient ward of a government hospital and was staffed by a paediatrician, a family medicine physician, two nurses and a nutritionist. The staff kept a computerized database for all patients seen and they were supervised once a month. During the first three years, the demand for first-time medical consultation increased by 477% for acute respiratory infections (ARI) and 134% for acute diarrhoea (AD), with an average annual increase of demand for medical care of 125%. Eighty-nine per cent of mothers who took their child for consultation and 85% of mothers who lived in the catchment area and had a deceased child received training on how to recognize alarming signs in a sick child. Fifty-eight per cent of these mothers were evaluated as being properly trained. Eighty-five per cent of primary care physicians who worked for government institutions (n = 350) and 45% of private physicians (n = 90) were also trained in the recognition and proper management of AD and ARI. ARI mortality in children under 1 year of age in the catchment area (which included about 25...

The scarcity of rural doctors has undermined the ability of health systems in low and middle-income countries like India to provide quality services to rural populations. This study examines job preferences of doctors and nurses to inform what works in terms of rural recruitment strategies. Job acceptance of different strategies was compared to identify policy options for increasing the availability of clinical providers in rural areas. In 2010 a Discrete Choice Experiment was conducted in India. The study sample included final year medical and nursing students, and in-service doctors and nurses serving at Primary Health Centers. Eight job attributes were identified and a D-efficient fractional factorial design was used to construct pairs of job choices. Respondent acceptance of job choices was analyzed using multi-level logistic regression. Location mattered; jobs in areas offering urban amenities had a high likelihood of being accepted. Higher salary had small effect on doctor, but large effect on nurse, acceptance of rural jobs. At five times current salary levels, 13% (31%) of medical students (doctors) were willing to accept rural jobs. At half this level, 61% (52%) of nursing students (nurses) accepted a rural job. The strategy of reserving seats for specialist training in exchange for rural service had a large effect on job acceptance among doctors...

Empathy is a basic facilitating element of the therapeutic helping relationship and the humanization process in health care. The objectives of this study were to identify the empathy level of health professionals working in the obstetrical sector of a university hospital recognized for its humanistic care and the perceptions of the women under their care regarding the empathic behavior shown by these professionals during hospitalization. We conducted a quanti/qualitative study with 47 health professionals that worked in the obstetrical sector (13 obstetricians, 12 nurses, 22 nurse technicians) and an intentional sample of 101 women that received cared from these professionals during the study period. We collected data by means of the Jefferson Empathy Scale for Health Professioals (JEPS-HR) and the Patient´s Perception of Health Professional Empathy (PPHPE), and two additional open questions designed to obtain the subjective opinion about the empathic behavior during the care. We utilized thematic analysis for the data obtained through the open questions and descriptive and inferential statistics for the quantitative data. We identified five thematic categories that represent the aspects valued by the professionals in their relationship with the women under their care: emotional involvement...

This book towards interventions in human resources for health in Ghana is a collaborative effort between the government of Ghana and the World Bank, was developed to assist the ministry of health to obtain an overview of the unique human resources for health (HRH) challenges that Ghana faces. Evidence on the stock, distribution, and performance of health workers in Ghana, as well as on some of the underlying determinants of these HRH outcomes, will help support the government resolve to develop strategies and interventions to address HRH concerns and ultimately strengthen its health system. The content of this book was developed, discussed, and validated by means of extensive consultations with the technical working group on (HRH) in Ghana. This book contents totally eight chapters: chapter one covers toward evidence-based interventions for HRH; chapter two covers the stock of health workers; chapter three covers the distribution of health workers; chapter four covers the performance of health workers; chapter five covers Ghana Agencies and their roles and responsibilities in HRH; chapter six covers interventions to increase stock and improve distribution and performance of HRH; chapter seven covers financing available for policy and interventions; and chapter eights covers the political economy of crafting policy.

Shortages, geographic imbalances, and poor performance of health workers pose major challenges for improving health service delivery in developing countries. In response, development agencies have increasingly recognized the need to invest in Human Resources for Health (HRH) to assist countries in achieving their health system goals. In this paper we analyze the HRH-related activities of three multilateral agencies the Global Alliance for Vaccines and Immunization (GAVI); the global fund for AIDS, Tuberculosis, and Malaria (the global fund); and the World Bank. First, we reviewed the type of HRH-related activities that are eligible for financing within each agency. Second, we reviewed the HRH-related activities that each agency is actually financing. Third, we reviewed the literature to understand the impact that GAVI, the global fund, and the World Bank investments in HRH have had on HRH in developing countries. Our analysis found that by far the most common activity supported across all agencies is short-term, in-service training. There is relatively little investment in expanding pre-service training capacity...

Laboratories have historically been under supported in developing country health systems resulting in poor quality diagnosis and inadequate disease surveillance. Laboratory professionals are predominantly male with relatively limited female labor participation, with potential gender based barriers to advancement. The focus on communicable diseases has meant that funding for broader public health laboratory services has been relatively neglected. In this paper the authors present a number of strategies to address these problems based on the outcomes from a literature review and case studies conducted in four African countries. Improved registration and human resource planning are required to establish the scale of the problem and to develop country specific strategies to address skills shortages. More high quality pre-service training is needed to supply the service with suitably skilled professional staff to address the current deficit. Innovative in-service training is essential to maintain competence and collaboration is required with the private sector to utilize their expertise. A clear career structure with transparent promotional opportunities is required to recruit and retain staff in the public sector. The establishment of suitable work environments and regulatory and representative bodies will also support recruitment and retention as well as enhance quality. It is also clear that this cadre has been underrepresented in human resources for health research and more activity in this area will lead to greater understanding of the problems and provide more potential solutions.

This report aims to provide an updated analysis of labor market trends for the health workforce in Peru, focusing on the basic health team, physician, nurse, and midwife, and other health professionals related to current priorities. Peru has been labeled as a country with a shortage of health professionals (that is, with less than 25 professionals per 10,000 inhabitants), and although the most recent numbers indicate that the situation has improved, the shortages are bound to become more acute as the country aims to achieve Universal Health Coverage. The authors found that the country trains both in public and private universities a large number of professionals, but that the majority of trained professionals do not then go on to work for the public sector. This dynamic had not been described before and challenges current assumptions of human resources needs and availability. There is very little reliable data on numbers, type and work conditions for human resources working outside the public sector, including the social security insurance health system (EsSalud)...

The paucity of qualified health workers in rural areas is a critical challenge for India's health sector. Although state governments have instituted several mechanisms, salary and non-salary, to attract health workers to rural areas, individually these mechanisms typically focus on single issues (e.g. salary). This qualitative study explores the career preferences of under-training and in-service doctors and nurses and identifies factors important to them to take up rural service. It then develops a framework for clustering these complex attributes into potential ?incentive packages for better rural recruitment and retention. The study was carried out in two geographically diverse Indian states, Uttarakhand and Andhra Pradesh. A total of 80 in-depth interviews were conducted with a variety of participants: medical students (undergraduate, postgraduate, and Indian system of medicine), nursing students, and doctors and nurses in primary health centers. The information collected was clustered by constructing several hierarchical displays...

Although Kenya's vision 2030 highlights investment in human development, public spending on health and education in Africa has not guaranteed results. Closing the gap between promises, spending, and results depend on what service providers know and what they do: provider behavior is key. The Service Delivery Indicators (SDI) aim to provide critical information to improve accountability for health and education results. The survey was implemented by the Kenya Institute of Public Policy Research and Analysis (KIPPRA) and Kimetrica with quality assurance and oversight from the World Bank. The surveys provide a representative snapshot of the learning environment and key resources in both public and private schools, and the quality of health service delivery and the physical environment within which services are delivered in public and private (nonprofit) health facilities. Improvements in service quality in Kenya can be accelerated through focused investments on reforms to the incentive environments facing providers...

India faces significant challenges in attracting qualified health workers to rural areas. In 2010 the authors conducted a Discrete Choice Experiment (DCE) in the Indian states of Uttarakhand and Andhra Pradesh to understand what health departments in India could do to make rural service more attractive for doctors and nurses. Specifically, we wanted to do the following: (a) examine the effect of monetary and nonmonetary job attributes on health worker job choices; and (b) develop incentive 'packages' with a focus on jobs in rural areas. The study sample included medical students, nursing students, in-service doctors and nurses at primary health centers. An initial qualitative study identified eight job attributes health center type, area, health facility infrastructure, staff and workload, salary, guaranteed transfer to city or town after some years of service, professional development, and job in native area. Respondents were required to choose between a series of hypothetical job pairs that were characterized by different attribute-level combinations. Bivariate probit and mixed logit regression was used for the statistical analysis of the choice responses. The findings suggest that the supply of medical graduates for rural jobs remained inelastic in the presence of individual monetary and nonmonetary incentives. In contrast...

This study examined nurses' attitudes toward computers before training and 2 months after training. A quantitative approach and a nonexperimental survey design were used in this study. Stronge and Brodt's (1985) instrument, Nurses' Attitudes Toward Computerization Questionnaire, was used to assess 27 nurses' attitudes prior to and 2 months after computer training. Demographic variables also were collected on the questionnaires. The results of this study showed that, overall, nurses had positive attitudes towards computers in both questionnaires. The results of the first questionnaire were consistent with other studies. There were no studies that involved a follow-up questionnaire using Stronge and Brodt's (1985) instrument. Attitude scores of Questionnaire 2 were higher than attitude scores of Questionnaire 1. More time for nursing tasks, less time for quality patient care, and threat to job security questions were found to be statistically significant. This study found no statistical significance between attitudes and demographic variables. Younger nurses a~d nurses with fewer years of computer experience were most likely to exhibit positive attitudes. Implications for practice and future research were discussed. Some limitations were identified and discussed.

O objetivo deste artigo é apresentar um programa de capacitação de enfermeiros recém-admitidos, implementado em unidades de internação de um hospital privado de São Paulo. O programa foi estruturado de forma a diminuir o tempo de treinamento e possibilitar a participação dos enfermeiros das unidades de internação. O programa está divido em três fases. A primeira destina-se à revisão técnica. Na segunda, com um monitor de treinamento, os ingressantes assumem a coordenação assistencial da unidade. Na terceira são revisados rotinas e temas administrativos. Este programa vem apresentando bons resultados em relação à individualização do treinamento e participação dos enfermeiros da instituição.; El objetivo de este artículo es presentar un programa de capacitación de enfermeros recién-admitidos, implementado en unidades de internamiento de un hospital privado de São Paulo. El programa fue estructurado de forma a disminuir el tiempo de entrenamiento y posibilitar la participación de los enfermeros de las unidades de internamiento. El programa está divido en tres fases. La primera se destina a la revisión técnica. En la segunda, con un monitor de entrenamiento, los ingresantes asumen la coordinación asistencial de la unidad. En la tercera se revisan las rutinas y temas administrativos. Este programa viene dando buenos resultados en relación a la individualización del entrena-miento y participación de los enfermeros de la institución.; The aim of this article is to describe a qualification program for newly hired nurses that has been implemented in internment units in a private hospital in São Paulo. The program was designed in such a way as to reduce training time and make possible the participation of the units' nursing staff. It is divided in three phases. Phase 1 is a technical revision. In Phase 2...

This study has the objective of understanding the training of nurses for comprehensive health care. It used data from interviews with teachers, students and service nurses submitted to discourse analysis. There is an understanding of comprehensive care in the training of nurses from the perspective of establishing a healthcare model in which care is directed to the patient. There are reflections regarding the technologies and the form of organization of the work, expressed in a permanent tension: Clinical versus Collective Health as a challenge for comprehensive care. It was identified that building completeness in the formation implies assuming acting in health as an educative principle in a new form of learning-teaching in health, which breaks up with preformed, out-of-context knowledge. The conclusion is that comprehensive health care is taken as an object of reflection in the movement for change in the pedagogical practices, and that it is reflected in health attention.; El estudio tiene como objetivo entender la formación de las enfermeras para el cuidado integral. Los datos fueron obtenidos de entrevistas con profesores, estudiantes y enfermeras del servicio sometidos a análisis de discurso. Fue reconocida la comprensión de la integralidad del cuidado en la perspectiva de un modelo de atención a la salud que tiene como orientación el cuidado centrado en el usuario. Suscitaron reflexiones sobre las tecnologías y la forma de organización del trabajo...

OBJETIVO: Avaliar a competência técnica de profissionais que atuam no cuidado em anticoncepção. MÉTODOS: Realizou-se pesquisa do tipo avaliativa, na área da saúde, em oito municípios do Estado do Ceará, de julho a setembro de 2003. Os dados foram coletados mediante entrevistas com 29 enfermeiros e 50 usuários do Programa Saúde da Família e observações feitas nas unidades de saúde. RESULTADOS: A maioria dos enfermeiros havia participado de alguma capacitação sobre anticoncepção e normas técnicas. No entanto, foi relatada a existência de barreiras profissionais pelos enfermeiros e outras foram identificadas pelos usuários, os quais mostraram a necessidade de melhor capacitação dos profissionais que atuam nessa área. Os enfermeiros reconheceram dificuldades, tanto na comunicação e informação quanto técnicas, no manejo dos anticoncepcionais. CONCLUSÕES: Há lacunas na competência profissional em anticoncepção que associadas a falta de sistematização do trabalho em equipe, geram distorções na qualidade da atenção. O trabalho em equipe foi caracterizado pela indefinição de atribuições e tarefas dos seus membros.; OBJECTIVE: To evaluate the technical competence of professionals carrying out activities related to contraceptive care. METHODS: Evaluative research in the field of health was conducted in eight districts of the State of Ceara from July to September 2003. Data was collected by means of interviews with 29 nurses working in the Family Health Care Program within these districts and 50 people being attended by this program. Observations of the Family Health Care Units were a complementary source of data within this study. RESULTS: The majority of nurses had received some form of training regarding contraception and the technical norms regulating their use. However...

BACKGROUND: New research findings, changes in legislation and the use of information technology in nursing, require continuous in-service training of psychiatric nurses to cope with, reflect on and modify their clinical practice based on emerging knowledge. Many international studies have been conducted on the importance of in-service training and authors agree that in-service training improves the quality of nursing care. However, few studies have been conducted on in-service training in South Africa and psychiatric nursing. OBJECTIVES: The objectives of the study were to explore and describe the needs and benefits of in-service training for psychiatric nurses; and to formulate recommendations for in-service training. METHOD: The research project followed a qualitative, explorative, descriptive and contextual approach. Six focus group interviews were conducted and the following questions were asked: 'What are your in-service training needs as psychiatric nurses?', 'What are the benefits of doing in service training?' and 'What can be done to ensure that in-service training is done continuously?' Data were analysed through the use of content analysis and Tesch's eight steps of data analysis were used. RESULTS: The findings of this research included three main themes...

This study had two aims: to describe the activities of a clinical training unit set up for the integrated management of sick children, and to evaluate the impact of the unit after its first four years of operation. The training unit was set up in the outpatient ward of a government hospital and was staffed by a paediatrician, a family medicine physician, two nurses and a nutritionist. The staff kept a computerized database for all patients seen and they were supervised once a month. During the first three years, the demand for first-time medical consultation increased by 477% for acute respiratory infections (ARI) and 134% for acute diarrhoea (AD), with an average annual increase of demand for medical care of 125%. Eighty-nine per cent of mothers who took their child for consultation and 85% of mothers who lived in the catchment area and had a deceased child received training on how to recognize alarming signs in a sick child. Fifty-eight per cent of these mothers were evaluated as being properly trained. Eighty-five per cent of primary care physicians who worked for government institutions (n = 350) and 45% of private physicians (n = 90) were also trained in the recognition and proper management of AD and ARI. ARI mortality in children under 1 year of age in the catchment area (which included about 25 000 children under 5 years of age) decreased by 43.2% in three years...