Desafios relacionados ao clima organizacional da equipe de enfermagem de um hospital público - percepção dos enfermeiros / Challenges related to the organizational climate of the nursing team in a public hospital - nurses' perception

Resumo O ambiente organizacional está relacionado com o grau de motivação de seus colaboradores. Essa percepção é essencialmente sentida, não se vê e nem se toca, mas tem uma existência real. Este estudo objetiva identificar as dificuldades e potencialidades relacionadas ao clima organizacional dos servidores de enfermagem de um hospital público do Distrito Federal. Metodologicamente foi realizado um estudo descritivo e exploratório caracterizado por uma abordagem qualitativa. A análise de conteúdo temática conduziu a três dimensões interpretativas: ambiente e condições de trabalho; comunicação, relacionamento interpessoal e fluxos de trabalho; e motivação para a melhoria do ambiente de trabalho. Os resultados apontam para um déficit de recursos humanos, escassez de recursos materiais, insumos, estrutura física precária, além de problemas de relacionamento interpessoal, como a (des)valorização do profissional enfermeiro e da enfermagem. Os desafios postos para os gestores estão para além da dimensão técnica e estrutural, da complexidade tecnológica dos equipamentos sem manutenção, desdobra-se pela dimensão humana, pelos sentimentos e pelas necessidades não atendidas (de valorização) da enfermagem, que precisa ser cuidada, valorizada, ouvida e vista no seu processo de cuidar.

Abstract The organizational climate is related to the degree of motivation of its employees. This perception is essentially felt, it is neither seen nor touched, but it is real. This study aims to identify difficulties and potentialities related to the organizational climate of the nursing staff at a public hospital in the Federal District. Methodologically, a descriptive and exploratory study was carried out characterized by a qualitative approach. The thematic content analysis led to three interpretative dimensions: environment and working conditions; communication, interpersonal relationship and work flows; motivation to improve the work environment. The results indicate a deficit of human resources, scarcity of material resources, supplies, precarious physical structure, in addition to interpersonal relationship problems, such as the (de)valuation of professional nurses and nursing. The challenges posed to managers go beyond the technical and structural dimension, the technological complexity of equipment without maintenance, as it unfolds through the human dimension, feelings and unmet needs (of appreciation) of nursing, which needs to be cared for, valued, heard and seen in their care process.

Análise qualitativa sobre a atuação e as experiências dos enfermeiros na gestão hospitalar frente à COVID-19 / Qualitative analysis of nurses' performance and experiences in hospital management in the face of COVID-19

Resumo Objetivou-se analisar a atuação dos enfermeiros na gestão hospitalar frente à COVID-19. O estudo teve uma abordagem qualitativa, do tipo descritivo e exploratório. O cenário foi um hospital que se transformou totalmente para atendimento de pacientes com COVID-19. No momento da coleta de dados, dez enfermeiros estavam à frente da gestão dos serviços, e todos participaram da entrevista semiestruturada. Os dados, após análise temática, foram apresentados em três categorias representativas dos elementos da tríade de Donabedian, ou seja, estrutura, processo e resultado. A categoria 1 realçou a reconfiguração da estrutura hospitalar a partir da gestão de materiais e das pessoas; a categoria 2 abordou a reestruturação do processo de trabalho para alcance das metas com segurança e qualidade; e a categoria 3 focou nas experiências dos enfermeiros na descrição dos resultados alcançados e esperados. A análise evidenciou a importância do trabalho em equipe, do envolvimento e da adaptação do gestor diante dos desafios da doença nova e ameaçadora da vida, dos recursos escassos e da complexidade das relações humanas na crise. Na liderança transformacional esses enfermeiros incentivaram a mudança de comportamento, o crescimento profissional, e resiliência.

Abstract This study aimed to analyze the role of nurses in hospital management in the face of COVID-19. The study had a qualitative, descriptive, and exploratory approach. The setting was a hospital that was completely transformed to care for patients with COVID-19. At the time of data collection, ten nurses managed the services, and all participated in the semi-structured interview. After thematic analysis, the data were presented in three categories, representing the elements of Donabedian's triad: structure, process, and result. Category 1 highlighted the hospital structure reconfiguration based on material and people management; category 2 addressed the work process restructuring to achieve goals with safety and quality; and category 3 focused on nurses' experiences in describing the results achieved and expected. The analysis highlighted the importance of teamwork, involvement, and adaptation of managers in the face of the challenges of a new and life-threatening disease, scarce resources, and the complexity of human relationships in the crisis. In transformational leadership, these nurses encouraged behavior change, professional growth, and resilience.

The wet nurses of the Hospital Real of Santiago de Compostela between 1803 and 1808 / Las nodrizas del Hospital Real de Santiago de Compostela entre 1803 y 1808 / As amas de leite do Hospital Real de Santiago de Compostela entre 1803 e 1808

Objective. To analyze the duties of wet nurses at the Hospital Real in Santiago de Compostela (Spain). The secondary objectives were to compare the mortality rate and distribution by parish of the foundlings under the care of the Royal House between 1803 and 1808; and to determine the origin of the Galician foundlings who participated in the Royal Philanthropic Expedition of the Smallpox Vaccine in 1803. Methods. Historiographic study that analyzed sorted and not sorted in series indirect positional and quantitative historical sources.Results. The duties of wet nurses during the studied period were to provide basic care and cultural instruction. The mortality rate of foundlings fluctuated during that period and their distribution by parish (functional unit of healthcare services at that time) was similar in those years, with a predominance in the provinces of A Coruña and Pontevedra. A total of 5 Galician foundlings from the House analyzed were part of the smallpox vaccine expedition, their names were Juan Antonio, Jacinto, Gerónimo María, Francisco Florencio and Juan Francisco. Conclusion. During the observed period the wet nurses of the Hospital Real of Santiago de Compostela were in charge of pediatric care. Wet nurses were vital in the role of keeping the foundlings alive and can be considered as one of the forerunners of the pediatric nurse profession at that time.

Objetivo. analizar las funciones que realizaban las amas de leche en el Hospital Real de Santiago de Compostela (España). Los objetivos secundarios han sido: comparar la mortalidad y distribución por parroquias de los niños expósitos a cargo de la Real Casa entre 1803 y 1808, determinar la procedencia de los niños expósitos gallegos que participaron en la Real Expedición Filantrópica de la Vacuna de la viruela en 1803. Métodos. Estudio historiográfico que analizó fuentes históricas posicionales indirectas y cuantitativas seriadas y no seriadas. Resultados. las funciones de las nodrizas durante el período de estudio eran proporcionar los cuidados básicos e instrucción cultural; la mortalidad de los expósitos sufrió oscilaciones a lo largo del período analizado. La distribución por parroquias (unidad funcional de las áreas de salud en la época) fue similar en estos años, con predominancia de las provincias de A Coruña y Pontevedra. Un total de 5 niños expósitos gallegos de la Casa analizada han participado en la expedición filantrópica de la viruela, sus nombres fueron: Juan Antonio, Jacinto, Gerónimo María, Francisco Florencio y Juan Francisco. Conclusión. Durante el período de observación, las amas de leche del Hospital Real de Santiago de Compostela realizaban cuidados pediátricos. Las nodrizas cumplieron un rol fundamental para el mantenimiento con vida de los niños expósitos y pueden ser consideradas como una de las figuras precursoras de la profesión enfermera pediátrica en la época.

Objetivo. Analisar as funções desempenhadas pelas nutrizes no Hospital Real de Santiago de Compostela (Espanha). Os objetivos secundários foram: comparar a mortalidade e distribuição por freguesia dos enjeitados responsáveis pela Casa Real entre 1803 e 1808, determinar a origem dos enjeitados galegos que participaram na Real Expedição Filantrópica da Vacina contra a Varíola em 1803. Métodos. Estudo historiográfico que analisou fontes históricas posicionais indiretas e quantitativas seriadas e não seriadas. Resultados. As funções das amas de leite durante o período do estudo eram fornecer cuidados básicos e instrução cultural; A mortalidade dos enjeitados oscilou ao longo do período analisado. A distribuição por freguesias (unidade funcional das áreas de saúde da época) foi semelhante nestes anos, com predominância das províncias da Corunha e Pontevedra. Na expedição filantrópica contra a varíola participaram um total de 5 crianças galegas da Casa analisada, os seus nomes eram: Juan Antônio, Jacinto, Gerônimo María, Francisco Florencio e Juan Francisco. Conclusão. Durante o período de observação, as nutrizes do Hospital Real de Santiago de Compostela prestaram cuidados pediátricos. As amas de leite desempenharam um papel fundamental na manutenção da vida dos enjeitados e podem ser consideradas uma das figuras precursoras da profissão de enfermagem pediátrica da época.

Occupational stress and coping strategies of nursing staff in times of Covid-19 / Estresse ocupacional e as estratégias de enfrentamento da equipe de enfermagem em tempos de Covid-19

INTRODUCTION: The increase in the workload of health professionals and the degree of complexity of patients, attribute greater risk to psychosocial stress. OBJECTIVE: To evaluate the associations between occupational stress, quality of life at work, and coping strategies by the hospital nursing team during the COVID-19 pandemic. METHODS: Cross sectional, quantitative study with convenience sampling, data collection from August to December 2020; in two units of the private hospital network, with sociodemographic, occupational and health questionnaires; visual analogue scale for assessing quality of life at work; Demand-Control-Support (DCS); Occupational Coping Scale. RESULTS: The total sample consisted of 196 nursing professionals. There was significant certainty (negative, however, the dimension "Demand" of the DCS and QWL (<0.001, r=-0.367). Control over work-related work has a significant quality (but the "Control" dimension of the DCS and QWL (=0.025, r=0.160); and significantly negative, however, between the "Social Support" dimension of DCS and "Negative Equivalence" of Coping (p=0.003, r=-0.2013). CONCLUSION: The findings of this study allowed the correlation between occupational stress, coping and quality of life at work, showing that the lower the social support, the greater the use of avoidance strategies and consequently decline in quality of life at work. They also allowed us to identify the coping strategies used by the nursing staff and quality of life at work in the face of occupational stress during the COVID-19 pandemic.

INTRODUÇÃO: O aumento da carga de trabalho dos profissionais de saúde e o grau de complexidade dos pacientes, atribuem maior risco para o estresse psicossocial. OBJETIVO: Avaliar as associações entre o estresse ocupacional, a qualidade de vida no trabalho e as estratégias de enfrentamento pela equipe de enfermagem hospitalar na pandemia de COVID-19. MÉTODOS: Estudo transversal, quantitativo com amostragem por conveniência, coleta de dados de agosto a dezembro de 2020; em duas unidades da rede hospitalar privada, com questionário sociodemográfico, ocupacional e de saúde; escala visual analógica de avaliação da qualidade de vida no trabalho; Escala de Demanda-Controle-Apoio Social (DCS); Escala de Coping ocupacional. RESULTADOS: A amostra total foi de 196 profissionais de Enfermagem. Houve correlação significativa negativa, porém fraca, entre a dimensão "Demanda" da DCS e QVT (p<0,001, r=-0,367). O controle sobre o trabalho relacionado à qualidade de vida no trabalho possui correlação significativa positiva, porém fraca, entre a dimensão "Controle" da DCS e QVT (p=0,025, r=0,160); e correlação significativa negativa, porém fraca, entre a dimensão "Apoio social" da DCS e "Esquiva" de Coping (p=0,003, r=-0,213). CONCLUSÃO: Os achados deste estudo permitiram a correlação entre o estresse ocupacional, coping e qualidade de vida no trabalho, mostrando que quanto menor o apoio social, maior uso das estratégias de esquiva e consequentemente declínio na qualidade de vida no trabalho. Permitiram também identificar as estratégias de enfrentamento (coping) utilizadas pela equipe de enfermagem e qualidade de vida no trabalho frente ao estresse ocupacional durante a pandemia da COVID-19.

Atenção hospitalar em saúde mental no Rio Grande do Norte: contribuições do planejamento e avaliação em saúde / Atención hospitalaria en salud mental en Rio Grande do Norte: aportes de la planificación y evaluación en salud / Hospital mental health care in Rio Grande do Norte: contributions of health planning and evaluation

Introdução: O componente hospitalar da Rede de Atenção Psicossocial preconiza o fechamento progressivo de hospitais psiquiátricos e a implementação de leitos de saúde mental em hospital geral, capazes de fornecer atendimento para os casos agudos que necessitem de internação de forma articulada com os demais pontos de atenção da rede. Objetivo: Diante disso, o objetivo do presente artigo foi analisar a distribuição do número de leitos de atenção hospitalar em saúde mental no Rio Grande do Norte entre 2012 e 2022 e apresentar uma proposta de planejamento e avaliação para fortalecer a Rede de Atenção Psicossocial do estado. Metodologia: Trata-se de um estudo ecológico realizado no estado do Rio Grande do Norte, Brasil, no período de 2012 a 2022, usando dados secundários sobre as internações, seguido de um estudo propositivo com base em referências de planejamento e avaliação em saúde. Resultados: Observa-se uma redução do número de leitos psiquiátricos ao longo do tempo, mas que não se mostra suficiente e não se traduz em um crescimento satisfatório de leitos de saúde mental em hospital geral. Foram propostas cinco ações com o intuito de fortalecer a Rede de Atenção Psicossocial através da implantação e qualificação de leitos de saúde mental em hospitais gerais. Conclusão: Conclui-se que o movimento de constituição do componente hospitalar da Rede de Atenção Psicossocial do Rio Grande do Norte tem se apresentado em movimento irregular e o número de leitos de saúde mental em hospital geral é insuficiente. Espera-se que as intervenções e avaliações sugeridas possam contribuir para subsidiar importantes encaminhamentos no âmbito das políticas públicas de saúde mental do Rio Grande do Norte, Brasil (AU).

Introduction: The hospital component of the Psychosocial Care Network (PCN) advocates the progressive closure of psychiatric hospitals and the implementation of mental health beds in general hospitals, capable of providing care for acute cases that require hospitalization in conjunction with other network attention points. Objective: In view of this, the objective of this article was to analyze the quantitative distribution of hospital mental health care beds in Rio Grande do Norte between 2012 and 2022 and present a planning and evaluation proposal to strengthen the state's PCN. Methodology: This is an ecological study carried out in the state of Rio Grande do Norte, Brazil, from 2012 to 2022 using secondary data on hospitalizations, followed by a proactive study based on health planning and evaluation references. Results:There has been a reduction in the number of psychiatric beds over time, but not sufficient andnot translated into a satisfactory growth in mental health beds in general hospitals. Five actions were proposed with the aim of strengthening the PCN through the implementation and qualification of mental health beds in general hospitals.Conclusion: It is concluded that the movement to establish the hospital component of PCN in Rio Grande do Norte has been irregular and the number of mental health beds in general hospitals is insufficient. It is expected that the suggested interventions and evaluations may contribute to supporting important developments within the scope of public mental health policies in Rio Grande do Norte, Brazil (AU).

Introducción: El componente hospitalario de la Red de Atención Psicosocial (RAPS) aboga por el cierre progresivo de los hospitales psiquiátricos y la implementación de camas de salud mental en los hospitales generales, capaces de brindar atención a casos agudos que requieran hospitalización en conjunto con otros puntos de atención de la red. Objetivo:Ante esto, el objetivo de este artículo fue analizar la distribución del número de camas hospitalarias de atención a la salud mental en Rio Grande do Norte entre 2012 y 2022 y presentar una propuesta de planificación y evaluación para fortalecer el RAPS del Estado. Metodología:Se trata de un estudio ecológico realizado en el Estado de Rio Grande do Norte, Brasil, de 2012 a 2022, utilizando datos secundarios sobre hospitalizaciones, seguido de un estudio propositivo basado en referencias de planificación y evaluación de la salud. Resultados:Hay una reducción en el número de camas psiquiátricas a lo largo del tiempo, pero esto no es suficiente y no se traduce en un crecimiento satisfactorio de camas de salud mental en los hospitales generales. Se propusieron cinco acciones con el objetivo de fortalecer el RAPS a través de la implementación y habilitación de camas de salud mental en hospitales generales. Conclusión:Se concluye que el movimiento para establecer el componente hospitalario del RAPS en Rio Grande do Norte ha sido irregular y el número de camas de salud mental en un hospital general es insuficiente. Se espera que las intervenciones y evaluaciones sugeridas puedan contribuir a apoyar derivaciones importantes dentro del alcance de las políticas públicas de salud mental en Rio Grande do Norte, Brasil (AU).

Etiología bacteriana en teléfonos celulares del personal de salud de una clínica de Chiclayo / Bacterial etiology in cell phones of health personnel from a clinic in Chiclayo

RESUMEN El estudio buscó describir la etiología y frecuencia bacteriana en los teléfonos celulares del personal de salud en el Hospital de Clínicas de Chiclayo, Perú, de marzo a agosto de 2022. Se analizaron 30 teléfonos de médicos, enfermeros y técnicos en áreas de hospitalización y Unidad de Vigilancia Intensiva (UVI). Se tomaron muestras de las pantallas, se cultivaron y se identificaron las bacterias mediante pruebas bioquímicas. Se registró y analizó la información con Microsoft Excel 2013. El 56,7 % de los teléfonos presentó colonización bacteriana: Gram positivas en 33,3 % y Gram negativas en 23,3 %. Predominaron Staphylococcus coagulasa negativa (35,3 %) y Escherichia coli (23,5 %) en hospitalización, y Staphylococcus aureus (23,5 %) en UVI. El 66,7 % desinfectaba los teléfonos poco y el 40 % lavaba las manos con poca frecuencia. Staphylococcus coagulasa negativa, S. aureus y E. coli fueron los agentes más frecuentes, sugiriendo deficiencias en la higiene hospitalaria

ABSTRACT The study aimed to describe the etiology and bacterial frequency on the cell phones of healthcare personnel at the Hospital de Clínicas de Chiclayo, Peru, from March to August 2022. Thirty phones from doctors, nurses, and technicians in hospitalization areas and the Intensive Vigilance Unit (IVU) were analyzed. Samples were taken from the phone screens, cultured, and bacteria were identified using biochemical tests. The data was recorded and analyzed with Microsoft Excel 2013. Bacterial colonization was found on 56.7% of the phones: Gram-positive bacteria on 33.3% and Gram-negative bacteria on 23.3%. Staphylococcus coagulase-negative (35.3%) and Escherichia coli (23.5%) predominated in hospitalization, while Staphylococcus aureus (23.5%) predominated in the IVU. 66.7% of the personnel rarely disinfected their phones, and 40% washed their hands infrequently. Staphylococcus coagulase-negative, S. aureus, and E. coli were the most frequent agents, suggesting deficiencies in hospital hygiene practices.

Atenção psicológica às puérperas na maternidade: relato de experiência / Psychological care for postpartum women in the maternity ward: experience report / Atención psicológica a la puérpera en la maternidad: relato de experiencia

OBJETIVO: Relatar a experiência de realizar intervenções em saúde mental desenvolvidas com puérperas internadas por razão de pósparto imediato. MÉTODO: Relato de prática profissional sobre a criação e implantação do Programa de Saúde Mental da Recém-mamãe, realizado no período de fevereiro de 2019 a fevereiro de 2024 com mulheres hospitalizadas após o parto, independente da via (cesárea ou normal) em uma maternidade pública do interior paulista. Fundamentada pela Terapia Cognitivo Comportamental (TCC), as ações do programa foram organizadas em um Protocolo de Conduta, para a psicóloga da instituição e elaboração de questionário intitulado "Escala Perceptiva de Experiência do Parto", objetivando abordar sobre a percepção da mulher com relação à sua vivência de parir, bem como, emoções e sentimentos envolvidos no momento, viabilizando um acolhimento mais assertivo de acordo com a demanda da participante. RESULTADOS: As ações do programa basearam-se em escuta qualificada, dando ênfase à narrativa da participante. A atenção à recém-mãe seguiu as seguintes diretrizes de atuação: abordagem com o questionário desenvolvido; atendimento psicológico de acordo com a demanda da participante; interconsulta com médico para tratamento medicamentoso, avaliação com instrumentos de saúde mental; encaminhamentos para serviço de psicologia externo; orientações sobre os aspectos emocionais do pós-parto; entrega de relatório à diretoria da instituição buscando fomentar ações de melhoria no que tange a gestão em saúde. CONSIDERAÇÕES FINAIS: A implantação do Programa permitiu um cuidado mais sensível, personalizado e assertivo, promovendo nova dinâmica de atenção à saúde mental materna no ambiente hospitalar.

OBJECTIVE: To report the experience of carrying out mental health interventions developed with postpartum women hospitalized for immediate postpartum reasons. METHOD: Professional practice report on the creation and implementation of the Programa de Saúde Mental da Recém-mamãe (New Mother's Mental Health Program), carried out from February 2019 to February 2024 with women hospitalized after childbirth, regardless of the route (cesarean section or normal) in a maternity ward public sector in the interior of São Paulo. Based on Cognitive Behavioral Therapy (CBT), the program's actions were organized into a Conduct Protocol, for the institution's psychologist and preparation of a questionnaire entitled "Escala Perceptiva de Experiência do Parto" ("Perceptual Scale of Childbirth Experience"), aiming to address the woman's perception in relation to their experience of giving birth, as well as the emotions and feelings involved in the moment, enabling a more assertive reception according to the participant's demands. RESULTS: The program's actions were based on qualified listening, placing emphasis on the participant's narrative. Care for the new mother followed the following guidelines: approach with the developed questionnaire; psychological care according to the participant's demand; consultation with a doctor for drug treatment, assessment with mental health instruments; referrals to external psychology services; guidance on the emotional aspects of postpartum; delivery of a report to the institution's board of directors seeking to encourage improvement actions regarding health management. FINAL CONSIDERATIONS: The implementation of this program allowed for more sensitive, personalized and assertive care, promoting new dynamics of maternal mental health care in the hospital environment.

OBJETIVO: Relatar la experiencia de realización de intervenciones en salud mental desarrolladas con puérperas hospitalizadas por motivos de posparto inmediato. MÉTODO: Informe de práctica profesional sobre la creación e implementación del Programa de Salud Mental de la Nueva Madre, realizado de febrero de 2019 a febrero de 2024 con mujeres hospitalizadas después del parto, independientemente de la vía (cesárea o normal) en una maternidad del sector público del interior de São Paulo. Con base en la Terapia Cognitivo Conductual (TCC), las acciones del programa se organizaron en un Protocolo de Conducta, para el psicólogo de la institución y la elaboración de un cuestionario denominado "Escala Perceptual de la Experiencia del Parto", con el objetivo de abordar la percepción de la mujer en relación con su experiencia de dar nacimiento, así como las emociones y sentimientos involucrados en el momento, posibilitando una recepción más asertiva de acuerdo con las demandas del participante. RESULTADOS: Las acciones del programa se basaron en la escucha calificada, poniendo énfasis en la narrativa de los participantes. El cuidado de la nueva madre siguió las siguientes pautas: abordaje con el cuestionario desarrollado; atención psicológica según la demanda del participante; consulta con médico para tratamiento de drogas, valoración con instrumentos de salud mental; derivaciones a servicios externos de psicología; orientación sobre los aspectos emocionales del posparto; entrega de un informe al directorio de la institución buscando incentivar acciones de mejora en materia de gestión en salud. CONSIDERACIONES FINALES: La implementación del Programa permitió una atención más sensible, personalizada y asertiva, promoviendo nuevas dinámicas de atención a la salud mental materna en el ambiente hospitalario.

Health care notifications related to surgery in a university hospital / Notificaciones sanitarias relacionadas con cirugías en un hospital universitario / Notificações de assistência à saúde relacionadas a cirurgia em um hospital universitário

Objective: To characterize healthcare notifications related to surgery reported in a university hospital in Rio Grande do Sul. Method: A cross-sec-tional study conducted at a university hospital in the Southern Region of Brazil, analyzing notifications of surgery-related incidents contained in the Health Surveillance and Hospital Care Risk Management Application (Vigilância em Saúde e Gestão de Riscos Assistenciais Hospitalares - VIGIHOSP) data-base, from 2014 to 2022. Data analysis was performed using descriptive statistics. Results: A total of 258 notifications were identified, with a notable inci-dence of material-related incidents (24%), of which 57.8% were classified as incidents without harm. The most prevalent type of incident was related to medical-hospital articles (21%). Contributing factors to these events included organizational culture (58.1%), communication (57.4%), protocols/poli-cies/procedures (53.1%), and team organization (51.9%). Conclusion: The study findings contribute to the improvement of work processes, serving as indicators of care outcomes and assisting in the prevention of incidents and enhancement of care for surgical patients. (AU)

Objetivo: Caracterizar las notificaciones de asistencia sanitaria relacionadas con cirugías notificadas en un hospital universitario de Rio Grande do Sul. Método: Estudio transversal realizado en un hospital universitario ubicado en la Región Sur de Brasil, en el cual se analizaron las notificaciones de incidentes relacionados con cirugías, contenidas en la base de datos del Aplicativo de Vigilancia en Salud y Gestión de Riesgos Asistenciales Hospitalarios (VIGIHOSP), en el período de 2014 a 2022. El análisis de los datos se realizó mediante estadística descriptiva. Resultados: Se identificaron 258 notifica-ciones, destacándose los incidentes relacionados con materiales (24%), de los cuales el 57,8% fueron clasificados como incidentes sin daño. En cuanto al tipo de incidente, la prevalencia estuvo relacionada con los artículos médico-hospitalarios (21%) y, entre los factores contribuyentes a estos eventos, se destacaron la cultura organizacional (58,1%), la comunicación (57,4%), el protocolo/políticas/procedimientos (53,1%) y la organización del equipo (51,9%). Conclusión: Los hallazgos del estudio contribuyen al perfeccionamiento de los procesos de trabajo, ya que se configuran como indicadores del resultado de la asistencia, ayudando en la prevención de incidentes y en las mejoras en el cuidado del paciente quirúrgico. (AU)

Objetivo: Caracterizar as notificações de assistência à saúde relacionadas a cirurgia notificadas em um hospital universitário do Rio Grande do Sul. Método: Estudo transversal realizado em um hospital universitário localizado na Região Sul do Brasil, no qual foram analisadas as notificações de incidentes relacionados a cirurgia, contidas no banco de dados do Aplicativo de Vigilância em Saúde e Gestão de Riscos Assistenciais Hospitalares (VIGIHOSP), no período de 2014 a 2022. A análise dos dados deu-se por meio da estatística descritiva. Resultados: Foram identificadas 258 notificações, com destaque para os incidentes relacionados a materiais (24%), das quais 57,8% foram classificadas como incidente sem dano. Quanto ao tipo de inci-dente, a prevalência foi relacionada aos artigos médico-hospitalares (21%) e, dentre os fatores contribuintes desses eventos, destacaram-se a cultura orga-nizacional (58,1%), a comunicação (57,4%), o protocolo/políticas/procedimentos (53,1%) e a organização da equipe (51,9%). Conclusão: Os achados do estudo contribuem para o aperfeiçoamento dos processos de trabalho, visto que se configuram como indicadores do resultado da assistência, auxiliando na prevenção de incidentes e melhorias no cuidado com o paciente cirúrgico. (AU)

Environmental health practice and quality of Nursing care: a protocol for systematic review

OBJECTIVE: To systematically synthesize studies that analyze the relationship between a healthy practice environment and quality of nursing care in hospital settings; to identify the most commonly used instruments to assess nurses' perceptions of a healthy practice environment; to identify the most commonly used instruments to assess nurses' perceptions of quality of nursing care. METHOD: A systematic literature review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The literature search will be conducted in the principal databases. Review of international scientific articles published in the last ten years, accessed through the database of the Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, on nurses' perceptions of the influence of the environment on healthy nursing practice and quality of care. Inclusion: Articles published after 2012 in Portuguese, Spanish, and English. The identified, selected and included studies will be highlighted for the selection process using the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols (PRISMA-P). If possible, quantitative data will be pooled into a meta-analysis using the Joanna Briggs Institute (JBI) Meta-Analysis of Statistics Assessment and Review Instrument (MASTARI).

Construction of performance management system for pharmacy department of tertiary public hospitals under new situation / 中国药房

OBJECTIVE To provide reference for improving the work efficiency of staff and promoting the discipline construction of pharmacy department. METHODS By analyzing the current situation of performance management in the pharmacy department of our hospital， the key successful factors were sorted out， strategic decoding was carried out and key performance indicators were extracted. The quarterly and annual performance appraisal forms were formulated for the departments of pharmacy warehouse， outpatient pharmacy， ward pharmacy， clinical pharmacy department， prescription examination center， laboratory and other departments； the performance management information platform was built. The work efficiency and output of each department were compared half a year before and after the implementation of the performance management plan. RESULTS After the implementation of the program， the average queuing time for drug collection in the outpatient department was shortened from 5 minutes to 3 minutes， the average number of dispensing infusion bags per hour in the pharmacy intravenous admixture services increased from 50 bags to 60 bags， and antibacterial use density of the hospital decreased from 42.7 DDD（defined daily doses） to 40.2 DDD. The number of academic papers published had increased from 8 to 10， and the satisfaction of clinical departments with ward pharmacies increased from 85% to 95%. CONCLUSIONS The performance management system has been successfully established in pharmacy department of our hospital， which can improve the enthusiasm of pharmacists， reflect the value of pharmaceutical care， and promote the discipline construction of pharmacy.

Analysis on the evaluation indicators of medical quality in TCM hospitals - taking Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine as an example / 国际中医中药杂志

To improve the evaluation indicators of medical quality in TCM hospitals; To realize objective, fair, and accurate evaluation of the quality of TCM. Based on relevant literature on medical quality in traditional Chinese medicine hospitals research and thematic group discussions, 21 evaluation indicators for TCM characteristics were formed. A questionnaire survey was conducted among 40 experts, and 37 were effectively collected, with a positive coefficient of 92.50%. After two rounds of expert consultation, the evaluation indicators were determined to be: the intensity of outpatient use of TCM decoction pieces (utilization rate of TCM decoction pieces, prescription number of TCM decoction pieces, dosage of TCM decoction pieces, and service price of TCM decoction pieces), the intensity of the use of TCM technology (proportion of TCM technology, number of TCM projects, cost of TCM technology, and course of treatment). Case studies were conducted on relevant data from 10 departments using the operational decision support system (BI) platform of Yueyang Integrated Traditional Chinese and Western Medicine Hospital affiliated with Shanghai University of Traditional Chinese Medicine to verify the rationality of indicators. The 10 departments were analyzed and evaluated, and the results obtained were basically consistent with the actual medical quality situation of the hospital. The indicators used in this study can reflect the actual medical quality situation, and have a certain degree of scientificity, feasibility, and applicability, providing reference for improving the medical quality evaluation indicators of TCM hospitals.

Practiceand exploration of the reform of super-department system under the guidance of party building to promote high-quality development of hospital / 现代医院

Establishing a governance structure and an operational model that is compatible with modern hospital manage-ment systems,deepening the reform of hospital management institutions,and exploring the implementation of Super-department System with unified functions are inevitable requirements for promoting the high-quality development of public hospitals.Hospital of Stomatology of Sun Yat-sen University takes the Xi Jinping Thought on Socialism with Chinese Characteristics for a New Era as a guide and fully implements the"Opinions of the General Office of the State Council on Promoting the High Quality Development of Public Hospitals,"integrates party building work and vocational work,carries out practical exploration of the reform of the Su-per-department System,and leads the hospital to achieve phased results in high-quality development.

Research on the current status,hotspots,and evolution trends of integrity construction in public hospi-tals:a citespace visualization analysis / 现代医院

Objective To explore the research status,hot topics and trends in the construction of integrity in public hos-pitals in China,provide references for the research on integrity construction in public hospitals and promote their high-quality de-velopment.Methods The relevant literature on the construction of integrity in public hospitals from 2009 to 2022 was collected from the China National Knowledge Infrastructure(CNKI)database.CiteSpace software was used to analyze the selected litera-ture in terms of publication timeline,author co-citation,institution co-citation,keyword co-occurrence,keyword clustering and keyword burst analysis,and visualize the knowledge graph.Results The research on the construction of integrity in public hos-pitals in China showed an upward trend from 2009 to 2022.The hot topics in the research mainly focused on incorruptible medical practices,integrity risks and integrity culture.The keyword burst analysis revealed that discipline inspection and supervision,in-formation platforms and institutional development were the future research directions.Conclusion The research on the construc-tion of integrity in public hospitals in China has a clear policy orientation,and various subfields are being explored.Internal inde-pendent research is predominant,while collaboration among multiple scholars and institutions needs to be strengthened.The con-struction of integrity in public hospitals in China mainly focuses on three areas.

New path exploration of public hospitals party brand building to promote the deep integration of party and medical services / 现代医院

Objective To explore the path and methods of deeply integrating party building with professional routine work in public hospitals through the creating of party building brands.Methods Taking the establishment of grassroots party brand in a hospital in shanghai as an example,using the brand creation as a starting point,we build a carrier,in order to explore the positive effect of Party building brand's creating on the integration and development of grass-roots Party building and profes-sional routine work in public hospitals.Results Through brand creation,the party building alliance was formed.The core unit was created to play a radiating role of the regional medical center,and a system disease was used as a breakthrough for the inte-gration of party building and professional routine work,where party building pays a great role in promoting business development.Conclusion As a carrier,Party building brand can play a leading role in Party building,deeply integrating Party building of governmental hospitals and medical work,thereby,improving the effectiveness of Party building and promoting high-quality devel-opment of public hospitals under the guidance of Party building.

On the"3W"principles of Party building in public hospitals / 现代医院

With the implementation of Party building in public hospitals in the new era,and the deep integration of Party building of administration departments and healthcare services as well,the high-quality development of hospitals through high-quality Party building is realized,which is a topic that needs to be explored in Party building in public hospitals.The Party build-ing in public hospitals has its unique functional positioning.With the requirements of Party building in the new era and the de-mand for high-quality development of public hospitals,Party building in public hospitals needs to solve the problems of"What","How"and"Well"from the ideological perspective,top-level design and practical level respectively,which are called the"3W"principles.

Thecontinuous practice and exploration of the construction of the public hospital medical union party construction alliance / 现代医院

In the context of comprehensively strengthening party building in public hospitals,multiple medical institu-tions have extended party building to the construction of medical union,explored the establishment of medical union party building alliances,and accumulated rich experience in the integration and development of party building and business.This article takes the Medical Union of the First People's Hospital of Suqian City as an example to deeply summarize and analyze the experience,practices,and existing problems in the process of medical union construction,propose countermeasures and suggestions,and pro-vide beneficial practice and exploration for other medical union party building.

Analysis of potential risks of clean government in public hospitals and research on preventive measures / 现代医院

Clean governance risk management is one of the important tasks of the Party building in public hospitals in the new era.This article reviews and analyzes the corruption case judgments of public hospitals in 2020 and 2021 published on the China Judgment Document Network,summarizes the high incidence of potential corruption risks in public hospitals,and proposes risk prevention strategies based on the requirements of high-quality development of public hospitals in the new era,in order to provide new ideas and countermeasures for future anti-corruption risk management in public hospitals.

Talents work promote the high-quality development of public hospitals / 现代医院

Talents are the core driving force to promote the high-quality development of public hospitals,and the talent team building is an important factor for hospitals to get sustainable development and improve comprehensive competitiveness.In view of the shortage of high-level talents,the imperfect talent reserve system,and the lagging personnel management mechanism of public hospitals and the resulting unreasonable talent team structure and talent gap,public hospitals should take talent team building as the starting point,pay equal attention to the introduction and training of talents,interact with discipline construction and talent construction,vigorously promote the construction of personnel management system and mechanism innovation,form a standardized,scientific,refined and efficient modern hospital management system,so that the effectiveness of talents can be max-imized,and provide intellectual support for the high-quality development of public hospitals.

Case study on functional orientation in a tertiary public hospital against the backdrop of performance appraisal of tertiary public hospitals / 现代医院

Performance appraisal of public hospitals have given a guidance for the development of public hospitals at all levels.A Class A tertiary hospital reviewed the problems in the development of the hospital at the present stage and focused on the following four aspects:①insufficient fine management;②No clear orientation of discipline development;③The bottleneck of the improvement of medical operation efficiency;④New challenges in the reform of payment mode.The tertiary hospital launched a fine management practice in May 2022,in order to solve the problems by taking the Department of Surgery as a pilot area,laying the foundation for fine management through information system construction,improving the efficiency of medical operation through management process optimization,improving the overall competitiveness of disciplines through the construction of sub-specialty and Discipline Alliance and adjusting the performance appraisal index system to play the role of performance incentives.The measures effectively improve the overall capacity and efficiency of hospital medical services and help the hospital to achieve high-quality development.

The application of intelligent medical insurance supervision system in the management of specific out-patient diseases in hospitals / 现代医院

As the medical insurance system continually evolves,the sustainable development of hospitals necessitates the establishment of an intelligent medical supervision system.With this system,hospitals can strengthen the management of specific outpatient diseases,achieve intelligent,standardized medical insurance management,and enable real-time supervision throughout the entire process.This article first outlines the background for applying the intelligent medical insurance supervision system in the management of specific outpatient diseases.It then delves into the problems in the application of this system and proposes strategies for solving the problem.These strategies include continuation of effective medical insurance cost control and decision-making management,improvement of a payment supervision system for specific diseases,establishment of an intelligent evaluation and review system for specific outpatient diseases,and development of a financial management system for specific diseases.