Dimensionamento do pessoal de enfermagem das unidades de internação do Hospital São Paulo
Data
2003
Autores
Matsushita, Mari Sahamura 
Orientadores
Adami, Nilce Piva
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Este estudo, do tipo descritivo, objetivou: classificar os pacientes internados no Hospital São Paulo (HSP) segundo niveis de cuidados de enfermagem por complexidade assistencial; verificar o tempo requerido de assistencia aos pacientes internados por categorias profissionais de enfermagem; identificar as ausencias nao previstas destes profissionais; e calcular o contingente de pessoal de enfermagem necessario, segundo o modelo adotado, e comparar os resultados encontrados com o quadro de pessoal de enfermagem dimensionado pela Diretoria de Enfermagem do hospital. A investigacao foi desenvolvida em 40 unidades de internacao desta instituicao, apos aprovacao do projeto pelo Comite de Etica em Pesquisa da Universidade Federal de São Paulo. O universo do estudo compreendeu os pacientes internados nestas unidades, visando a sua classificacao por niveis de complexidade assistencial durante tres meses, e documentos referentes as escalas de revezamento mensal dos profissionais de enfermagem que atuavam nestas unidades em 2001, para identificar as ausencias nao previstas. As tecnicas de coleta de dados foram: a observacao sistematica de natureza prospectiva, para classificar os pacientes por grau de complexidades assistencial, e a analise documental de cunho retrospectivo, para a coleta de informacoes sobre as ausencias nao previstas do pessoal de enfermagem. Os resultados obtidos demonstraram que, apesar do HSP ser categorizado como de nivel terciario, 30,8 por cento dos pacientes foram classificados como receptores de cuidados minimos, e a distribuicao dos pacientes segundo este sistema de classificacao foi diversificada nas unidades de internacao, com algumas excecoes, dificultando o provimento adequado de pessoal de enfermagem na rotina diaria destas unidades. As folgas representaram maior percentual de acrescimo devido as ausencias. As principais conclusoes foram: quanto aos niveis de complexidade dos cuidados de enfermagem, os pacientes internados demandaram, principalmente, cuidados minimos (30,8 por cento), seguidos pelos cuidados intermediarios (27,5 por cento), cuidados de alta dependencia (22,0 por cento), cuidados intensivos (12,0 por cento), e cuidados semi-intensivos (7,6 por cento). O tempo de assistencia de enfermagem destinado aos pacientes classificados foi maior para os de cuidados intensivos (30,9 por cento), seguidos pelos de alta dependencia (21,8 por cento), intermediarios (21,2 por cento), minimos (15,3 por cento) e semi-intensivos (10,7 por cento). Cerca de 50,0 por cento das ausencias nao previstas das enfermeiras foram referentes as licencas maternidade e a distribuicao deste tipo de ausencias para os tecnicos/auxiliares de enfermagem foi homogenea entre faltas, licencas medicas, licencas maternidade e outras. A comparacao entre os quadros de pessoal de enfermagem existente no Hospital São Paulo e o calculado segundo o modelo de Gaidzinski demonstrou carencia de 76 enfermeiras e superavit de 97 tecnicos/auxiliares de enfermagem
This descriptive study had the following aims: classify patients interned at Hospital São Paulo (HSP) by caring complexity, according to the levels of nursing care; verify how much timethose patients required from the different nursing staff categories of workers; identify the nonanticipated absences of these professionals; and calculate the staff number needed for providing nursing care, according to the chosen model, and compare the findings with the staff previously dimensioned by the hospital’s Nursing Direction. The investigation was developed in 40 wards of this institution, after being approved by the Research’s Ethics Committee of the Federal University of São Paulo. The universe of this study comprehended the patients interned at these wards, for the classification of caring complexity for three months, and the documents regarding the tables of monthly shift distribution of the nursing personnel that was working at these wards in 2001, in order to identify the non-anticipated absences. The data collection techniques were: prospective systematic observation, for the patients’ classification according to caring complexity, and retrospective documental analysis, to collect information about the nursing team’s non-anticipated absences. The results showed that even if HSP is categorized as a tertiary level institution, 30,8% of the patients were classified as minimum care receptors and their distribution according to this classification system was diversified among the hospital wards, with some exceptions, making difficult the adequate distribution of nursing personnel in the daily routine of those wards. Holidays represented the absences’ greater addition percentage. The main conclusions were: regarding the level of caring complexity, patients demanded mostly minimum care (30,8%), followed by intermediary care (27,5%), high dependency care (22,0%), intensive care (12,0%) and semiintensive care (7,6%). The time expended by nursing staff with caring of the classified patients was greater for those under intensive care (30,9%), followed by those under high dependency care (21,8%), intermediary care (21,2%), minimum care (15,3%) and semiintensive care (10,7%). About 50,0% of non-anticipated absences were due to maternity leaves and the distribution of this kind of absences for nursing technicians/auxiliaries was homogeneous among absences, medical leaves, maternity leaves and others. The comparison between the Hospital São Paulo’s existing nursing staff dimensioning and the one calculated according to the Gaidzinski’s model showed that there are a 76 registered nurses deficit and a 97 nursing technicians/auxiliaries superavit.
This descriptive study had the following aims: classify patients interned at Hospital São Paulo (HSP) by caring complexity, according to the levels of nursing care; verify how much timethose patients required from the different nursing staff categories of workers; identify the nonanticipated absences of these professionals; and calculate the staff number needed for providing nursing care, according to the chosen model, and compare the findings with the staff previously dimensioned by the hospital’s Nursing Direction. The investigation was developed in 40 wards of this institution, after being approved by the Research’s Ethics Committee of the Federal University of São Paulo. The universe of this study comprehended the patients interned at these wards, for the classification of caring complexity for three months, and the documents regarding the tables of monthly shift distribution of the nursing personnel that was working at these wards in 2001, in order to identify the non-anticipated absences. The data collection techniques were: prospective systematic observation, for the patients’ classification according to caring complexity, and retrospective documental analysis, to collect information about the nursing team’s non-anticipated absences. The results showed that even if HSP is categorized as a tertiary level institution, 30,8% of the patients were classified as minimum care receptors and their distribution according to this classification system was diversified among the hospital wards, with some exceptions, making difficult the adequate distribution of nursing personnel in the daily routine of those wards. Holidays represented the absences’ greater addition percentage. The main conclusions were: regarding the level of caring complexity, patients demanded mostly minimum care (30,8%), followed by intermediary care (27,5%), high dependency care (22,0%), intensive care (12,0%) and semiintensive care (7,6%). The time expended by nursing staff with caring of the classified patients was greater for those under intensive care (30,9%), followed by those under high dependency care (21,8%), intermediary care (21,2%), minimum care (15,3%) and semiintensive care (10,7%). About 50,0% of non-anticipated absences were due to maternity leaves and the distribution of this kind of absences for nursing technicians/auxiliaries was homogeneous among absences, medical leaves, maternity leaves and others. The comparison between the Hospital São Paulo’s existing nursing staff dimensioning and the one calculated according to the Gaidzinski’s model showed that there are a 76 registered nurses deficit and a 97 nursing technicians/auxiliaries superavit.
Descrição
Citação
MATSUSHITA, Mari Sahamura. Dimensionamento do pessoal de enfermagem das unidades de internação do Hospital São Paulo. 2003. 101 f. Dissertação (Mestrado) - Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, 2003.