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Resumo Objetivo Comparar o número de horas da demanda de cuidados de enfermagem ao paciente no pós-operatório de transplante renal, por meio dos instrumentos de Sistema de Classificação de Pacientes (SCP) e do Escore de Atividade de Enfermagem (NAS). Métodos Estudo de Coorte Prospectivo. A população foi composta pelos pacientes submetidos ao transplante renal com doador falecido no Hospital São Lucas da PUCRS, a avaliação ocorreu de 6 a 24 horas no pós-operatório imediato, nos dias subsequentes até a alta da UTI Cirúrgica e no 15º dia pós-operatório ou no dia da alta (o que tenha ocorrido primeiro). Resultados Completaram o estudo 73 pacientes, a média do SCP na primeira avaliação foi de 31,6 (cuidado intermediário), já no NAS a média foi de 86,5% (cuidado intensivo). Na última avaliação a pontuação encontrada no SCP foi de 15,5 (cuidado mínimo), no NAS a mediana foi de 50,1% (cuidado semi-intensivo). Não houve diferença significativa quando comparadas as pontuações obtidas na alta da UTI cirúrgica e na alta hospitalar. Conclusão Os achados deste estudo sugerem que há diferença entre o número de horas da demanda de cuidados ao transplantado renal no pós-operatório quando comparados os instrumentos SCP e NAS, e isso repercute também no tipo de cuidado.
Resumen Objetivo Comparar el número de horas de la demanda de cuidados de enfermería al paciente en posoperatorio de trasplante renal, por medio de los instrumentos de Sistema de Clasificación de Pacientes (SCP) y de la escala Nursing Activities Score (NAS). Métodos Estudio de cohorte prospectivo. La población fue formada por pacientes sometidos a trasplante renal con donante fallecido en el Hospital São Lucas de la universidad PUCRS. La evaluación se llevó a cabo de 6 a 24 horas en el posoperatorio inmediato, en los días subsiguientes hasta el alta de la UCI Quirúrgica y en el 15° día del posoperatorio o el día del alta (lo que haya sucedido primero). Resultados El estudio lo completaron 73 pacientes, el promedio del SCP en la primera evaluación fue 31,6 (cuidado intermedio) y en el NAS el promedio fue 86,5% (cuidado intensivo). En la última evaluación, la puntuación del SCP fue 15,5 (cuidado mínimo) y en el NAS la mediana fue 50,1% (cuidado semintensivo). No hubo diferencia significativa al comparar las valoraciones obtenidas en el alta de la UCI Quirúrgica y en el alta hospitalaria. Conclusión Los resultados de este estudio sugieren que hay diferencia entre el número de horas de la demanda de cuidados al trasplantado renal en el posoperatorio al comparar los instrumentos SCP y NAS, y eso repercute también en el tipo de cuidado.
Abstract Objective To compare the number of hours of nursing care demand for patients in the postoperative period after kidney transplantation, using the Patient Classification System (SCP) and Nursing Activity Score (NAS) tools. Methods a prospective cohort study. The population consisted of patients who underwent deceased donor kidney transplantation at PUCRS São Lucas Hospital. Assessment was carried out from 6 to 24 hours in the immediate postoperative period, on the days following discharge from the Surgical ICU and on the 15thpostoperative day or on the day of discharge (whichever occurred first). Results A total of 73 patients completed the study. The mean SCP in the first assessment was 31.6 (intermediate care), while in NAS the mean was 86.5% (intensive care). In the last assessment, the score found in the SCP was 15.5 (minimum care); In the NAS, the median was 50.1% (semi-intensive care). There were no significant differences when comparing the scores obtained at discharge from surgical ICU and discharge from hospital. Conclusion The findings of this study suggest that there is a difference between the number of hours of postoperative kidney transplant care demand when compared to the SCP and NAS tools, and this affects the type of care.
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Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Kidney Transplantation/nursing , Personnel Delegation , Health Services Needs and Demand , Cohort Studies , Observational Studies as Topic , Nursing CareABSTRACT
Resumen: En el presente artículo el autor analiza los presupuestos y límites del principio de confianza como criterio de concreción del cuidado debido exigible a los médicos. Para ello, se distingue entre división horizontal y vertical del trabajo. En el ámbito de la división horizontal, se destaca la relevancia que tiene una clara delimitación de ámbitos de responsabilidad para la vigencia del principio de confianza. En el plano de la división vertical, se explica la delegación de actividades médicas en enfermeras y auxiliares paramédicos (contemplada en el inc. 2º del art. 113 del Código Sanitario), así como los deberes de elección, instrucción y supervigilancia que han de cumplirse para que los facultativos puedan confiar en la correcta ejecución de las tareas delegadas.
Resumo: No presente artigo o autor analisa os pressupostos e limites do princípio da confiança como critério de materialização do cuidado devido exigido dos médicos. Para isso se distingue entre divisão horizontal e vertical do trabalho. No âmbito da divisão horizontal se destaca a relevância que tem uma clara delimitação de âmbitos de responsabilidade para a vigência do princípio da confiança. No plano vertical se explica a delegação de atividades médicas para enfermeiras e auxiliares paramédicos (contemplada no parágrafo 2º do artigo 113 do Código Sanitário), assim como os deveres de eleição, instrução e supervigilância que se tem de cumprir para que os médicos possam confiar na correta execução das tarefas delegadas.
Abstract: In the present article, the author analyzes the pre-requisites and boundaries of the principle of reliance as a criterion for determining the due care that can be demanded from physicians. For that purpose, a distinction is made between horizontal and vertical division of labour. Regarding horizontal division, the relevance of a clear delimitation of scopes of responsibility for the principle of reliance to apply is highlighted. Regarding vertical division, an explanation about delegation of medical activities to nurses and paramedic auxiliaries (contemplated in indent 2 of article 113 of the Sanitary Code) is offered, as well as one about the duties of selection, instruction and supervision that must be fulfilled for the physicians to be allowed to trust in the correct execution of the delegated tasks.
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Humans , Physicians , Criminal Liability , Trust , Personnel DelegationABSTRACT
Background: Clinical research sites are hiring more non-licensed personnel to coordinate clinical trials and to replace licensed nurse counterparts. Revised regulatory documents heavily emphasize research staff training and research activity delegation of authority. The Scope and Standards of Practice for Clinical Research Nursing, published by the American Nurses’ Association and based on role delineation studies for nurses, is the guidance document for clinical research nurses participating in research activities. Policy making related to research activity delegation of authority would be informed by data that correlate protocol deviation rates with licensure and education of research staff. Protocol deviations can lead to invalid clinical trial results, adverse events, and ethical concerns related to participant risk exposure. Outcome data are lacking, which directly compare frequency of protocol deviations by licensed nurse study coordinators to deviation rates of non-licensed study coordinators.Methods: This pilot study reviewed 45 monitoring reports for 3 clinical research studies and associated research sites staffed with licensed RN study coordinators and research sites staffed with non-licensed, non-RN study coordinators to compare deviation rates related to informed consent, protocol endpoints, participant eligibility and adverse events.Results: We identified 101 deviations. Adverse event and endpoint deviations were the highest frequency. Differences were evident in overall deviation rates; however, specific deviation comparisons failed to show statistical significance due to low sample size. Conclusions: This study illustrates a useful method for planning future studies using monitoring reports for deviation tracking and comparison across staffing levels.
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Objective:To explore the reform of procurement management of university under the policy of streamlining administration and delegating power, combination of delegation and management, and optimizing service (delegation, management and services).Methods: Through analyzed the current status of the procurement management of university to explore the method of implementing the policy of "delegation, management and services" from deepening institutional reform, enhancing management efficiency and innovating service level and other aspects.Results: A set of system of procurement institution that conformed with the requirement of "delegation, management and services" has been established. Through formulated prevention and control measure of integrity risk and adopted informatization method to omnibearingly promote the normalization of procurement service.Conclusion: System of science and reasonability and mean of informatization management can ensure the procurement management to preferably serve the teaching and research work of university.
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En el presente texto queremos examinar la experiencia del dolor en el espacio comunitario. Se examina aquí la escena de la tragedia Suplicantes de Eurípides, donde Teseo invita a Adrasto para que deje de llorar y comience a hablar, pues sólo en el habla todo llega a término. Esta escena nos permite mostrar cómo se articula la experiencia del sufrimiento humano con el fenómeno de la delegación como descarga del peso del dolor. Esto muestra también cómo la existencia humana está vinculada a una vulnerabilidad esencial que surge desde nuestra corporalidad. Así podemos tomar distancia de la ontología del cuidado desarrollada por Heidegger y complementar la analítica existencial con la antropología filosófica de Blumenberg.
In this text, we want to examine the experience of pain in the community space. We examine here the scene of the tragedy of Euripides Suppliant where Theseus invites Adrasto to stop mourn and start talking, because only in speech everything comes to an end. This scene allows us to show how the experience of human suffering with the phenomenon of the delegation as discharge burden of pain is articulated. This also shows how human existence is linked to a critical vulnerability that arises from our physicality. Therefore, we can take away from the ontology of care developed by Heidegger and complement the existential analysis with philosophical anthropology by Blumenberg.
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PURPOSE: The purpose of this study was to develop and test the validity and reliability of the Korean version of nurses' attitudes toward delegation and preparedness to delegate (APD). METHODS: The Korean version of APD was developed through forward-backward translation methods. Internal consistency reliability, criterion validity, and construct validity using exploratory and confirmatory factor analysis were conducted using IBM SPSS Statistics 19 and AMOS 20.0. Survey data were collected from 161 nurses working in 2 general hospitals. RESULTS: The Korean version of APD showed Cronbach's alphas of .68 and .85. Factor loadings of the 8 attitude items on the 3 subscales ranged from .60 to .86 and the 15 preparedness items on the 4 subscales ranged from .47 to .90. The model of 3 subscales for the Korean nurses' attitude toward delegation and the model of 4 subscales for the Korean nurses' preparedness to delegate were both validated by confirmatory factor analysis(NC.90, RMSEA<.10). Criterion validity compared to job satisfaction showed significant correlation. CONCLUSION: The findings of this study demonstrate that this modified Korean version of APD is applicable for measuring Korean nurses' attitude toward delegation and preparedness to delegate.
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Hospitals, General , Job Satisfaction , Reproducibility of ResultsABSTRACT
In modern business organizations the effective problem solving and taking corrective decision for organization by top level management and middle level management is being too complex and difficult. Delegation and empowerment are the two key aspect which can help the top and middle level management to face and perform in these situation effectively. The empowerment and delegation are the two side of a single coin which are deeply interconnected with each other and plays an important role in organizational business development process. Some measures are kept to develop empowered delegation skill in the employees, if they are not capable to take responsibility of organization effectively and making them productive for organization betterment. With the help of effective empowered delegation of work to subordinate, productivity of organization can be enhanced and product quality also improved which leads to achievement of organizational goals and objectives.
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The paper gives an account of the background, feasible model, content and procedure of the reform in community health services in Zhabei District of Shanghai and the content, method and preliminary conclusions of periodic evaluations of the reform. Taking the management system as its starting point, selecting the model of delegation management, and focusing on the basic idea of “separation of two powers and delegation of three powers”, the reform went ahead on two fronts: the health bureau and the centers for community health services. Experts making external periodic evaluations hold that the adoption of delegation management contributes to innovations in the internal operating systems, the improvement of community health services and the enhancement of economic compensation capability. However, some problems still remain to be solved. [