The effects in assistance indicators of changes on a nursing team
Main Article Content
Abstract
Introduction: This article discusses the path of healthcare associated infections (HAI) indicators in the intensive care unit (ICU) of a public teaching hospital in Belo Horizonte, Minas Gerais, Brazil, after certain change in its nursing staff: pair of nursing caregivers. The model of a pair of caregivers consists in assigning one nurse and one nursing technician for every three patients. The indicators analyzed were infection related to central venous catheters (CVCs), the risk of HAI, turnover, and absenteeism. Objective: The objective of this paper is to understand the impact of the restructuring of the nursing staff in Human Resources and on the rate of infection in the ICU. Methods: As for methods, it is a qualitative and descriptive research carried out as a case study. Results: The results have shown that the risk of HAIs significantly increased after the change in staffing, but the density of vascular access infection associated with CVCs was drastically reduced. The results of turnover of nursing technics decreased and the turnover of nurses increased while the absenteeism of the nursing team decreased after the change. The interviews revealed that there was a gain at the care due to the change. Conclusion: As a conclusion, the results of the study have shown that the proposed nursing model caused a care gain, once the interviews exposed that and indicator directly related to nursing team care (infection associated with CVCs) decreased.
Downloads
Article Details
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC BY) that allows others to share and adapt the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.References
Azevedo CS, Sá MC, Cunha M, Matta GC, Miranda L, Grabois V. Racionalização e construção de sentido na gestão do cuidado: uma experiência de mudança em um hospital do SUS. Cienc Saude Coletiva. 2017;22(6):1991-2002. https://doi.org/10.1590/1413-81232017226.13312016
Townsend K, Wilkinson A. Managing under pressure: HRM in hospitals. Hum Resour Manag J. 2010;20(4):332-8. https://doi.org/10.1111/j.1748-8583.2010.00145.x
Pereira FGF, Chagas ANS, Freitas MMC, Barros LM, Caetano JA. Caracterização das infecções relacionadas à assistência à saúde em uma Unidade de Terapia Intensiva. Vigil Sanit Debate. 2016;4(1):70-7. https://doi.org/10.3395/2317-269x.00614
Haque M, Sartelli M, McKimm J, Abu Bakar MA. Health care-associated infections - an overview. Infect Drug Resist. 2018;11:2321-33. https://doi.org/10.2147/IDR.S177247
Busl KM. Healthcare-associated infections in the neurocritical care unit. Curr Neurol Neurosci Rep. 2019;19(10):76. https://doi.org/10.1007/s11910-019-0987-y
World Health Organization (WHO). Report of the burden of endemic health care-associated infection worldwide: clean care is safer care. Geneva: WHO, 2011.
Sousa FC, Pereira JC, Rezende DA, Laura C. Avaliação dos cuidados de enfermagem com o cateter venoso central em uma unidade de terapia intensiva adulto e pediátrica. Rev Adm Saude. 2018;18(70). http://dx.doi.org/10.23973/ras.70.92
Perin DC, Erdmann AL, Higashi GDC, Sasso GTMD. Evidências de cuidado para prevenção de infecção de corrente sanguínea relacionada a cateter venoso central: revisão sistemática sem metanálise. Rev Latino-Am Enfermagem. 2016;24:e2787. https://doi.org/10.1590/1518-8345.1233.2787
Brazil. Agência Nacional de Vigilância Sanitária (ANVISA). Programa nacional de prevenção e controle de infecções relacionadas à assistência à saúde (2016-2020). Brasília: Anvisa, 2016.
Ferreira CP, Querido DL, Christoffel MM, Almeida VS, Andrade M, Leite HC. A utilização de cateteres venosos centrais de inserção periférica na Unidade Intensiva Neonatal. Rev Eletr Enferm. 2020;22(56923):1-8. https://doi.org/10.5216/ree.v22.56923
Conselho Regional de Enfermagem de São Paulo (Coren-SP). Câmara técnica: Orientação Fundamentada nº 077/2014. Available from: https://portal.coren-sp.gov.br/sites/default/files/Orienta%C3%A7%C3%A3o%20Fundamentada%20-%20077.pdf.
Daud-Galloti RM, Costa SF, Guimarães T, Padilha KG, Inoue EN, Vasconcelos TN, et al. Nursing workload as a risk factor for healthcare associated infections in ICU: a prospective study. PLoS One. 2012;7(12):e52342. https://doi.org/10.1371/journal.pone.0052342
White EM, Aiken LH, McHugh MD. Registered Nurse Burnout, Job Dissatisfaction, and Missed Care in Nursing Homes. J Am Geriatr Soc. 2019;67(10):2065-71. https://doi.org/10.1111/jgs.16051
Ball JE, Bruyneel L, Aiken LH, Sermeus W, Sloane DM, Rafferty AM, Lindqvist R, Tishelman C, Griffiths P; RN4Cast Consortium. Post-operative mortality, missed care and nurse staffing in nine countries: A cross-sectional study. Int J Nurs Stud. 2018;78:10-15. https://doi.org/10.1016/j.ijnurstu.2017.08.004
Aiken LH. Evidence-based Nurse Staffing: ICN’s New Position Statement. Int Nurs Rev. 2018;65:469-71. https://doi.org/10.1111/inr.12499
Aiken LH, Sloane D, Griffiths P, Rafferty AM, Bruyneel L, McHugh M, et al. Nursing skill mix in European hospitals: cross-sectional study of the association with mortality, patient ratings, and quality of care. BMJ Qual Saf. 2017;26(7):559-68. https://doi.org/10.1136/bmjqs-2016-005567
International Council of Nurses (ICN). Evidence-based safe nurse staffing: position statement. Geneva: ICN, 2018. Available from: https://www.icn.ch/sites/default/files/inline-files/ICN%20PS%20Evidence%20based%20safe%20nurse%20staffing_0.pdf
Aiken LH, Clarke SP, Sloane DM, Sochalski J, Silber JH. Hospital nursing staff and patient mortality, nurse burnout and job dissatisfaction. JAMA. 2002;288(16):1987-93. https://doi.org/10.1001/jama.288.16.1987
Aiken LH, Clarke SP, Cheung RB, Sloane DM, Silber JH. Educational levels of hospital nurses and surgical patient mortality. JAMA. 2003;290(12):1617-23. https://doi.org/10.1001/jama.290.12.1617
Rodrigues JM, Torres HOG. Eficiência/desempenho hospitalar e resultados da gestão de recursos humanos – uma aproximação possível?. Rev Eletr Gestao Soc. 2015;9(24):1128-42. https://doi.org/10.21171/ges.v9i24.2077
Machado MH, Koster I, Aguiar Filho W, Wermelinger MCMW, Freire NP, Pereira EJ. Labor market and regulatory processes – Nursing in Brazil. Cienc Saude Coletiva. 2020;25(1):101-12. http://dx.doi.org/10.1590/1413-81232020251.27552019
Scalco SV, Lacerda JT, Calvo MCM. Modelo para avaliação da gestão de recursos humanos em saúde. Cad Saude Publica. 2010;26(3):603-14. http://dx.doi.org/10.1590/S0102-311X2010000300017
Antwi YA, Bowblis JR. The impact of nurse turnover on quality of care and mortality in nursing homes: evidence from the great recession. Am J Health Economics. 2018;4(2):131-63. https://doi.org/10.1162/ajhe_a_00096
Ball JE, Bruyneel L, Aiken LH, Sermeus W, Sloane DM, Rafferty AM, Lindqvist R, Tishelman C, Griffiths P; RN4Cast Consortium. Post-operative mortality, missed care and nurse staffing in nine countries: A cross-sectional study. Int J Nurs Stud. 2018;78:10-15. https://doi.org/10.1016/j.ijnurstu.2017.08.004
Carneiro TM, Fagundes NC. Absenteísmo entre trabalhadoras de enfermagem em unidade de terapia intensiva de hospital universitário. Rev Enferm UERJ. 2012;20(1):84-9.
Ferreira LL, Azevedo LMN, Salvador PTCO, Morais SHM, Paiva RM, Santos VEP. Nursing care in healthcare-associated infections: a scoping review. Rev Bras Enferm. 2019;72(2):476-83. http://dx.doi.org/10.1590/0034-7167-2018-0418
Zhao H. Research on the Impact of Strategic Human resource management on enterprise performance. Adv Soc Sci Educ Hum Res. 2017;96:113-17.
Lee KJ. Strategic human resource management for university-industry collaborations in Korea: financial incentives for academic faculty and employment security of industry liaison offices. Technol Anal Strat Manag. 2018;30(4):461-72. https://doi.org/10.1080/09537325.2017.1337885
Back CY, Hyun DS, Jeung DY, Chang SJ. Mediating Effects of Burnout in the Association Between Emotional Labor and Turnover Intention in Korean Clinical Nurses. Saf Health Work. 2020;11(1):88-96. https://doi.org/10.1016/j.shaw.2020.01.002
Costa FM, Vieira MA, Sena RR. Absenteísmo relacionado às doenças entre membros da equipe de enfermagem de um hospital escola. Rev Bras Enferm. 2009;62(1):38-44. http://dx.doi.org/10.1590/S0034-71672009000100006
Ticharwa M, Cope V, Murray M. Nurse absenteeism: An analysis of trends and perceptions of nurse unit managers. J Nursing Manag. 2019;27(1):109-16. https://doi.org/10.1111/jonm.12654
Harrison JM, Aiken LH, Sloane DM, Carthon JMB, Merchant RM, Berg RA, et al. In Hospitals With More Nurses Who Have Baccalaureate Degrees, Better Outcomes For Patients After Cardiac Arrest. Health Aff (Millwood). 2019;38(7):1087-94. https://doi.org/10.1377/hlthaff.2018.05064
Dorfey ES. Representações sociais das infecções relacionadas à assistência à saúde por profissionais de saúde que trabalham em unidades de terapia intensiva. [master´s thesis]. [Goiânia]: Pontifícia Universidade Católica de Goiás, 2016.
Needleman J, Liu J, Shang J, Larson EL, Stone PW. Association of registered nurse and nursing support staffing with inpatient hospital mortality. BMJ Qual Safety. 2020;29(1):10-18. http://dx.doi.org/10.1136/bmjqs-2018-009219
Nogueira JC, Padoveze MC, Lacerda RA. Governmental surveillance system of healthcare-associated infection in Brazil. Rev Esc Enfermagem USP. 2014;48(4):657-62. https://doi.org/10.1590/S0080-623420140000400012