This thesis deals with the question of meeting the criteria for provision of nursing care. The theoretical part covers the most important areas related to the provision of the nursing care. These are as follows: 1. the nursing process, 2. standards, 3. audits, 4. ethical code, 5. documentation. It is the nursing process with all its steps, its quality and its three dimensions of management and assessment that is most important of all. Audits and its conclusions help to meet standards for ensuring quality patient care. Following health care ethical code and respecting patients' rights are necessary for patients' satisfaction. In addition to that the nurse is supposed to keep records of individual patients in the nursing documentation and create classification systems (NANDA domains) based on patient's care. Cooperation between doctors and nurses and the overall working atmosphere are important as well. The empirical part of this work was compiled as quantitive research. The basic goal was identified for the purposes of the diploma work. It is to find how certain criteria of nursing care, provided by the nurse in general medicine in real conditions, is met. The main research question was formulated in advance - "How the criteria of nursing care are met, especially the quality of provided nursing care and time spent with the patient from the patient's perspective." The empirical part also includes six hypotheses. The first theory that the criteria of nursing care is fulfilled, occur more frequently at university hospitals than in other hospitals, has not been proven. The patients deem the quality of care in all three hospitals rather identically. The second theory assumes that the most important criterion of nursing care for patients is the nurse's attitude. This hypothesis has not been proven. Half of the respondents think that the nurse's attitude is important and the second half the collaboration with the doctor. The third hypothesis was supposed to find if the nurse's reaction to patient's special requests is fast enough. Namely nurse's reaction to treating the pain and using the signal equipment. The hypothesis has been confirmed. Half of the patients are satisfied with the nurse's reaction to ease the pain as well as the use of the signalling. The fourth hypothesis focuses on nurses of general medicine. The hypothesis is the number of nurse of general medicines on duty is insufficient. This hypothesis has not been confirmed. The fifth hypothesis assumes that the quality of provided care depends on the nurse's mental state. This hypothesis has not been proven. Half of the nurses admit being stressed but they argue that it doesn't affect their quality of work. The sixth hypothesis presumes that the time devoted to documentation will take more of the working time. This hypothesis has not been confirmed. 93 % of the nurses of general medicine responded that they spend half or less than half of the working time on documention and the other 7% spend half or more working time. The purpose of this thesis is to analyse and synthesise the results of the research question. The results will be presented at the participating clinics and other places. They might contribute to improvement of the nursing care.

Nurses have a key role in keeping patients safe from medical errors because they work at the point of care where most errors occur. Nursing work at the intersection of patients and health care systems requires high levels of cognitive activity to anticipate potential problems and effectively respond to rapidly evolving and potentially harmful situations. The literature describes nursing work at the intersection of patient and health care system as well as barriers to providing safe patient care. However, little is known about the systems knowledge nurses use to negotiate the health care system on their patients’ behalf, or how this systems information is exchanged between nurses. Using the clinical microsystem as the conceptual framework, this qualitative descriptive investigation identified and described: 1) the components of systems knowledge needed by nurses, 2) how systems information is exchanged between nurses, and 3) systems information exchanged between staff nurses and travel nurses. Data were collected from a stratified maximum variation sample of 18 nurse leaders, staff nurses, and travel nurses working within a high-functioning neonatal intensive care nursery within a large academic medical center in New England. Data collection methods included participant observation, document review, individual interviews, and a focus group session. Data were analyzed through constant comparison for emerging themes and patterns. Findings were compared for commonalities and differences within and across groups. Three components of systems knowledge emerged: structural, operational, and relational. Systems information exchange occurred through direct and indirect means. Direct means included formal and informal mechanisms. The formal mechanism of orientation was identified by each participant. Informal mechanisms such as peer teaching, problem solving, and modeling behaviors were identified by participants from each of the three nurse groups. Travel nurses’ descriptions of the common themes focused on individual efficacy. Staff nurses focused on fostering smooth unit functioning. Nurse leaders described common themes from a perspective of unit development. Four overarching domains of systems information were exchanged between staff nurses and travel nurses: practice patterns; staffing patterns and roles; tips, tricks, tidbits, and techniques; and environmental elements. Communication emerged as a common theme across nurse groups and domains of systems information exchanged. These findings have implications for nursing orientation and staff development, continuous improvement at the local level, and curriculum development.

Made available in DSpace on 2015-07-22T20:49:13Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-07-30. Added 1 bitstream(s) on 2015-08-11T03:25:50Z : No. of bitstreams: 1 Publico-10908.pdf: 1020924 bytes, checksum: fe656f87f77f5e09f36f1bc149ccc68f (MD5) / O presente estudo teve por objetivo apreender, na ótica de enfermeiros atuantes em uma Unidade de Clínica Médico Cirúrgica de um hospital de grande porte da cidade de São Paulo, seus conceitos e suas formações a respeito da prática humanizada no cuidado ao paciente hospitalizado. A pesquisa, de natureza qualitativa, consistiu de uma análise descritiva e transversal, utilizando como instrumentos de coletas de dados questionários e entrevistas com roteiro semi-estruturado. Os resultados foram estudados por intermédio da análise temática, considerando-se aproximações de significados. Os profissionais não expressaram clareza a respeito de seu conceito de “humanização”, preferindo citar exemplos de “prática humanizada”. Coerentemente, o contato, durante a formação dos profissionais com discussões a respeito da humanização dos cuidados, foi escasso e tardio. Contudo, observou-se que todos expressavam a importância de uma prática humanizada, citando como fatores limitantes à mesma aspectos institucionais, relativos à sobrecarga de trabalho, dentre outros. Um dos dados considerado mais importante deste estudo foi o desejo, pela maioria dos profissionais, no seu aprimoramento para uma assistência mais humanizada, por intermédio de programas de educação continuada. Os dados indicam a importância de intervenções educativas nas equipes, que, se por um lado mostram-se sensibilizadas para a temática da humanização, por outro apontam para a lacuna de processos formativos, de cunho essencialmente reflexivo. / This study aimed at characterize, from the point of view of nurses who work in an Unit of Surgical Medical Clinic of an important health care institution in the city of Sao Paulo, their concepts and formations about humanized practice in the care of in-hospital patients. The research was conducted in a qualitative design and used questionaries and semi-structured interviews as instruments for obtainig data. The results were analysed considering closeness of significations. The professionals were not able to express clearly their concepts about “humanization” and prefered to refer situations of “humanized practice”. In their previous formation, they had few or no contact whith discussions about humanization of patients care. Meanwhile, all of them recognized the importance of work in an humanized way. The main drawbacks were related to institutional factors, such as hard work in turns. One of the most important results of this research was the wish, refered by most of the professionals, to improve the quality of the humanized care of patients, by means of continued education programs. The data point to the importance of educational activities with nursing groups. The professional showed a great degree of sensibilization towards this theme, but complained of lack of discutions and reflections about it. / TEDE

The thesis deals with the realization of the criteria for saturation of the patient's needs. In the current system of nursing care, the principles of modern nursing are failing to realize and therefore we want to find out the main obstacles of this situation and the possibilities of their removal. For the purpose of the thesis there were set three objectives. The first of them has set the objective of finding out the most common problems in meeting the criteria for saturation of the patient's needs. The research showed that the nurses see the problem in a lack of staff at the wards, a lack of time, excess of documentation, excessive demands for nurses. The purpose of the second objective was to find out what supports the realization of the criteria for saturation of the patient's needs. Results have shown that what helps nurses is a positive work environment, motivation, nurse´s personality, own scale of values, salary, good leadership, organization, nursing care. The third objective was to find out the opinion of nurses on meeting the criteria for saturation of the patient's needs. It turned out that the majority of respondents think that nurses do not effectively satisfy all the needs of patients for a number of reasons: there are few nurses and they are overloaded, the nurses do their best but still cannot satisfy all the patients´ needs. We also found out that the higher patients´ needs are omitted. Less than a third of the nurses indicated that nurses effectively meet all the patients´ needs. For the qualitative part of the research, we set two research questions in advance. Which criteria nurses use in patients´ needs saturation? The research showed that time, which is very valuable for nurses and very often is in short supply, is an important criteria for the saturation of the patient's needs. Furthermore, it is knowledge and manual dexterity when nurses additionally reported a lack of education of some nurses especially within the nursing process. As the next criteria, it was mentioned the cooperation with the patient as it is necessary to engage patient himself in care planning. The next criteria is monitoring of the patient´s response, which is included in every phase of the nursing process. Furthermore, the nurses agreed on criteria, which include communication as a key skill of every nurse, then individual care, a suitable environment and utilities, education, critical thinking, effective nursing process and empathy. The second research question tried to find out which obstacles prevent nurses in effective saturation of the patients´ needs. We found out that nurses are concerned about a lack of staff at wards and the excess of administrative load, which is related to a lack of time for patients. These three factors are also obstacles for nurses and prevent them from effective satisfying of the patients´ needs. The next obstacles in satisfying the needs are burnout, reluctance of nurses to work, excessive demands for nurses, poor workplace relationships, a lack of evaluation both in a form of praise and appreciation, and finance. We also found a lack of information, which is related to a lack of time, as nurses do not have a chance to collect all the information concerning the patient. As another possible obstacle, nurses also mentioned personal problems. The results of the thesis can be used as a small contribution to currently ongoing effort of the Czech Association of Nurses.

The thesis deals with the application of NIC, NOC classifications in cases of patients with chest drainage. Nurses use nursing classification, nursing process and nursing documentation for their work to make the patient care more effective. Several objectives were set to meet the main target of the thesis. Firstly, to map nursing care specifics of patients with chest drainage; secondly, to map nurses' knowledge of chest drainage care; thirdly, to map nurses' satisfaction with nursing documentation; fourthly, to find out which NIC activities are usually used by nurses in the care of patients with chest drainage; fifthly, to find out which NOC indicators are usually judged by nurses in the care of patients with chest drainage; sixthly, to find out the benefits of NIC, NOC classification in the care of patients with chest drainage. For the practical part of the thesis, the combination of qualitative and quantitative research was chosen. The quantitative research was conducted by a survey. The studied group consisted of 152 nurses. For the quantitative research, we set up the following hypothesis. H1 - the care of patients with chest drainage depands on particular department. H2 - nurses' knowledge of chest drainage care depands on particular department. H3 - nurses' satisfaction with nursing documentation depends on their education. The qualitative reserch was hold in two phases. In the first phase, a nursing documentation was created on the basis of NIC and NOC classification related to care of chest tubes. In the second phase of the qualitative research, we used a semi-structured interview to interview ten nurse who had worked with the particular nursing documentation and who had met the criteria for the selection of experts acording to Fehring . Several research questions were set for the qualitative research. What do the nurses think about the particular nursing documentation?

Submitted by Maria Suzana Diniz (msuzanad@hotmail.com) on 2015-11-13T13:56:42Z No. of bitstreams: 1 arquivototal.pdf: 1860082 bytes, checksum: ed7830b03936246099b71e05491d4280 (MD5) / Made available in DSpace on 2015-11-13T13:56:42Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 1860082 bytes, checksum: ed7830b03936246099b71e05491d4280 (MD5) Previous issue date: 2015-02-02 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Introduction: In Brazil, the wounds affect the population in general, regardless of sex, age or ethnicity, is a serious public health problem due to the large number of patients with changes in skin integrity, although few records of such calls . The high number of people with ulcers contributes to link public spending, in addition to interfering in their quality of life. It is important that nursing care is grounded in a theoretical model and the scientific methodology of the nursing process and documented, and a source of information. In this study, we chose to use the conceptual model of Basic Human Needs of Horta, who besides being one of the most widespread throughout the country, sets service of the chosen clientele. Objective: To build data collection tool for people with wounds grounded in the conceptual model of the basic human needs of Wanda de Aguiar Horta. Methodology: This is a methodological research, which was carried out in the wound care clinic Otacílio Gama Foundation of the Faculty of Medical Sciences of Paraíba, in João Pessoa – PB, developed in three stages: identification of empirical indicators Basic Human Needs; validation of empirical indicators for judges and construction of the data collection instrument. Results: Empirical indicators of Basic Human Needs were identified from the literature, organized into 350 indicators, divided into 279 physiological needs, 5 psychospiritual needs and 66 psychosocial needs, the validation of empirical indicators happened to nursing professors of the Facult of Medical Sciences of Paraiba and the Federal University of Paraíba. After the validated indicators remained 116 physiological needs, one need psychospiritual and 10 psychosocial needs, and built a data collection tool, organized according to the Basic Human Needs of Horta. Conclusions: This research will bring great contributions to the outpatient clinic of the Otacílio Gama Foudation of the Faculty of Medical Sciences of Paraíba, since the same instruments did not exist documenting a nursing care methodology. The construction of these instruments provide data related to nursing care in the wound care clinic, thinking about the operation of the nursing process, facilitating communication and registration assistance. / Introdução: no Brasil, as feridas acometem a população de forma geral, independente de sexo, idade ou etnia, constituem um sério problema de saúde pública, devido ao grande número de doentes com alterações na integridade da pele, embora sejam escassos os registros desses atendimentos. O elevado número de pessoas com úlceras contribui para vincular o gasto público, além de interferir na qualidade de vida da população. É importante que o cuidado de enfermagem esteja embasado em um modelo teórico e na metodologia científica do processo de enfermagem, bem como documentado, sendo fonte de informação. Neste estudo, optou-se pela utilização do modelo conceitual das Necessidades Humanas Básicas de Horta, o qual, além de ser um dos mais difundidos em todo o país, ajusta-se ao atendimento da clientela escolhida. Objetivo: construir instrumento de coleta de dados para pessoas com feridas embasado no modelo conceitual das necessidades humanas básicas de Wanda de Aguiar Horta. Metodologia: trata-se de uma pesquisa metodológica, realizada para comtemplar os pacientes do ambulatório de tratamento de feridas da Fundação Otacílio Gama da Faculdade de Ciências Médicas da Paraíba, na cidade de João Pessoa - PB. Desenvolvida em três etapas: identificação dos indicadores empíricos das Necessidades Humanas Básicas; validação dos indicadores empíricos por juízes e construção do instrumento de coleta de dados. Resultados: os indicadores empíricos das Necessidades Humanas Básicas foram identificados a partir da literatura, organizados em 350 indicadores, subdivididos em 279 necessidades psicobiológicas, 5 necessidades psicoespirituais e 66 necessidades psicossociais, a validação dos indicadores empíricos aconteceu com juízes da Faculdade de Ciências Médicas da Paraíba e Universidade Federal da Paraíba. Após os indicadores validados, permaneceram 116 necessidades psicobiológicas, 1 necessidade psicoespiritual e 10 necessidades psicossociais, sendo construído um instrumento de coleta de dados, organizado de acordo com as Necessidades Humanas Básicas de Horta. Considerações Finais: Esta pesquisa trará grandes contribuições para o ambulatório da Fundação Otacílio Gama da Faculdade de Ciências Médicas da Paraíba, uma vez que na mesma inexistiam instrumentos que documentassem uma metodologia de assistência da enfermagem. A construção destes instrumentos fornecerá dados relacionados ao cuidado de enfermagem no ambulatório de tratamento de feridas, pensando na operacionalização do processo de enfermagem, facilitando a comunicação e o registro da assistência.

The aim of this study was to survey evaluation and measurement techniques that are used in practice. I have chosen this topic because demands on individual work of nurses are increasing and evaluation techniques and rating scales may help nurses in their work.Through the quantitative survey using questionnaires, opinions of 354 nurses at the bedside, and 61 nurse managers from 22 hospitals in the Czech Republic were surveyed. We wanted to identify the most common scales used in our hospitals and to find the reason why those specific scales are used. What problems nurses find in evaluation by scales, or what benefits the scales bring about. The respondents were also asked questions relating to risk management and the use of scales in this field. If prevention is the primary objective by which nurses try to anticipate more serious complications, what benefits the system brings to patients. The results of the investigation could be a clue to the efficient use of scales in practice and suggestions for managerial decisions when choosing suitable, acceptable parameters that will meet patients´ as well as medical staff members´ requirements.

Este estudo de caso qualitativo busca compreender os significados atribuídos por enfermeiras assistenciais ao processo de implementação do diagnóstico de enfermagem no Sistema de Assistência de Enfermagem (SAE) do Hospital Universitário da Universidade de São Paulo. A coleta dos dados foi realizada por meio de entrevistas com oito enfermeiras da Unidade de Clínica Médica, que participaram de um teste piloto para a construção de um instrumento para implementação do diagnóstico de enfermagem como etapa do SAE. Os dados foram apresentados na forma de narrativa. Nos seus relatos as colaboradoras explicitaram ter percebido, inicialmente, a implementação do diagnóstico de enfermagem como uma imposição da chefia, o que gerou reações de resistência e sentimentos de desconforto. Evidenciaram que a capacitação teórico-prática e a possibilidade de participação, ao longo do processo, contribuíram para se tornarem agentes pró-ativas, em decorrência de uma transformação positiva em seus sentimentos a partir do desconforto inicial e da percepção desfavorável em relação ao processo. Relataram que os sentimentos compartilhados, durante a realização do teste piloto, foram trabalhados com mais facilidade uma vez que o grupo assumiu atitude pró-ativa em relação a eles, confiando que podiam lidar com esses sentimentos e superar as dificuldades. As colaboradoras revelaram, ainda, que o processo de implementação do diagnóstico de enfermagem, como etapa do SAE, continuava sendo um grande desafio a ser vivenciado. Entretanto, mostraram que a apropriação do processo permitiu além do compartilhamento das decisões e da responsabilidade pelos resultados, o desenvolvimento da crença de que serão capazes de superar as dificuldades quando forem vivenciar os acontecimentos. Fica evidente que o processo participativo é mais demorado, no entanto propicia a detecção das necessidades dos diferentes grupos, e de cada componente, fornecendo dados para que essas necessidades sejam atendidas. Dessa forma, proporciona autonomia aos participantes, gerando sentimentos de prazer e de auto-realização e, conseqüentemente, o resultado obtido é mais seguro e duradouro. / This qualitative case study searches for understanding the meanings attributed by nurses for the nursing diagnosis implementation process on the Nursing Care System (NCS) from the University Hospital at the University of Sao Paulo. Data collection was made through interviews with eight nurses from the Medical Clinic Unit, who attended a pilot test for building up an instrument for nursing diagnosis implementation as a stage of the NCS. Data was presented through a narrative way. The respondents told clearly on their reports having perceived initially the nursing diagnosis implementation as a management imposition, which generated resistance reaction and discomfort feelings. They evidenced that the theory-practice capability and the possibility of participation throughout the process helped them for being proactive agents, resulting from a positive transformation in their feelings starting from the initial discomfort and the unfavourable perception regarding to the process. They reported that shared feelings during the pilot test were worked up easier once the group assumed a proactive attitude for them. They trusted they could deal with these feelings and overcome difficulties. The respondents also revealed that the nursing diagnosis implementation process, as a NCS stage, keeps on being a big challenge to be lived. However, they showed that the appropriateness of the process allowed, besides the decision sharing and responsibility for the results, the development of a belief that they will be able to overcome difficulties when they face the facts. It becomes clear that the participative process takes longer; nonetheless, it offers the detection of needs from different groups and each of their components, providing data for meeting their needs. Thus, it gives autonomy for their participants, creating pleasure and self-satisfaction feelings and, consequently, the result obtained is safer and lasting.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / The nursing diagnoses identification in renal transplant patients is an adequate and important instrument, because it provides an own nursing language, facilitates the communication between the professional and the patient and defines the nurse competence working scope. This study aimed to analyze the nursing diagnoses distribution presents in renal transplanted patients of an academic hospital of Fortaleza. The population was formed by the renal transplanted who are accompanied in the renal transplant ambulatory of this hospital. It was a cross-sectional study of exploratory and descriptive character. Fifty eight renal transplant patients were evaluated between months of december/04 and april/05. The data collection instruments were: an interview script and a physical exam. The results show the masculine sex predominance, with age average about 40 years, the majority being married, with average about 2 children. The origin was of the countryside cities of the Cearà or of other country states, they had familiar income of four minimum wages on an average, they did not use any contraceptive method. The majority was retired, with low education, catholic, without alcoholic drink and tobacco use. They had a medium duration of 52 dialysis months, mostly the hemodilysis. The most had as renal graft donor a corpse and average six year and half of transplant. Were identified 39 nursing diagnoses, 10 of which above of percentil 75, with the presence of six domains of the 12 investigated. Regarding the associations among nursing diagnoses, we find relation between sleep Pattern disturbed and sexual Dysfunction, sleep Pattern disturbed and ineffective sexuality Patterns, sexual Dysfunction and ineffective sexuality Patterns. In the diagnoses disturbed sensory Perception: visual and disturbed sensory Perception: auditory were found media differences with the age and time of dialysis respectively. The first diagnosis manifested itself in renal transplanted patients with more advanced age. The second diagnosis was present in patients with larger time of dialysis. We realize that the nursing diagnoses study provided us a larger knowledge of these patientsâ reality, contributing for a possible implementation of effective nursing actions for the resolution of the identified problems. This can contribute to guide the nursing assistance to the renal transplanted and to provide a better life quality to this clientele. / A identificaÃÃo dos diagnÃsticos de enfermagem em pacientes com transplante renal à um instrumento adequado e de extrema importÃncia, pois proporciona uma linguagem prÃpria da enfermagem, facilita a comunicaÃÃo entre o profissional e o paciente e delimita o Ãmbito de trabalho de competÃncia do enfermeiro. Objetivou-se, neste estudo, analisar a distribuiÃÃo dos diagnÃsticos de enfermagem presentes em pacientes transplantados renais de um hospital universitÃrio localizado na cidade de Fortaleza-CE. A populaÃÃo foi composta pelos transplantados renais acompanhados no ambulatÃrio de transplante renal desse hospital. Trata-se de estudo quantitativo do tipo transversal de carÃter exploratÃrio e descritivo. Foram avaliados 58 pacientes com transplante renal entre os meses de dezembro/04 e abril/05. Os instrumentos de coleta de dados foram: roteiro de entrevista e exame fÃsico. Os resultados mostram o predomÃnio do sexo masculino, com mÃdia de idade de 40 anos, sendo casada a maioria, com mÃdia de 2 filhos. A procedÃncia era das cidades do interior do Cearà ou de outros estados do paÃs, tinham renda familiar de 4 salÃrios mÃnimos em mÃdia, nÃo usavam nenhum mÃtodo contraceptivo. A maioria era aposentada, com baixa escolaridade, catÃlica e nÃo faziam de bebida alcoÃlica nem de fumo. DuraÃÃo mÃdia de 52 meses de diÃlise, principalmente a hemodiÃlise. A maioria teve como doador do enxerto renal cadÃver e està em mÃdia com seis anos e meio de transplantado. Foram identificados 39 diagnÃsticos de enfermagem, dez dos quais acima do percentil 75, com presenÃa de seis domÃnios dos doze investigados. Em relaÃÃo Ãs associaÃÃes entre os diagnÃsticos de enfermagem, encontramos relaÃÃo entre PadrÃo de sono perturbado e DisfunÃÃo sexual, PadrÃo de sono perturbado e PadrÃes de sexualidade ineficazes, DisfunÃÃo sexual e PadrÃes de sexualidade ineficazes. Nos diagnÃsticos PercepÃÃo sensorial perturbada: visual e PercepÃÃo sensorial perturbada: auditiva foram encontradas diferenÃas de mÃdia com a idade e o tempo de diÃlise respectivamente. O primeiro diagnÃstico manifestou-se em pacientes transplantados renais com idade mais avanÃada. O segundo diagnÃstico esteve presente em pacientes com maior tempo de diÃlise. Percebemos que o estudo dos diagnÃsticos de enfermagem nos proporcionou um maior conhecimento da realidade desses pacientes, contribuindo para uma possÃvel implementaÃÃo de aÃÃes de enfermagem eficazes para a resoluÃÃo dos problemas identificados. Isto pode contribuir para nortear a assistÃncia de enfermagem ao transplantado renal e proporcionar uma melhor qualidade de vida a essa clientela.

INTRODUÇÃO: A legislação em enfermagem prevê o uso da Sistematização da Assistência de Enfermagem (SAE). As atitudes dos profissionais de enfermagem sobre o processo de enfermagem (PE) e o poder clínico que percebem ter para realizar mudanças são fatores potencialmente associados ao processo de implantação e manutenção da SAE. OBJETIVOS: Descrever as atitudes relacionadas ao PE (disposição sobre o PE e percepção de poder clínico) de auxiliares de enfermagem e enfermeiros; analisar associações entre atitudes relacionadas ao processo de enfermagem e variáveis selecionadas. MÉTODO: Estudo descritivo-exploratório de delineamento transversal, com amostra não probabilística de 973 auxiliares de enfermagem e 632 enfermeiros de 35 hospitais e ambulatórios vinculados à Secretaria de Estado da Saúde de São Paulo (86,9% do sexo feminino, idade média de 44,12 anos (DP= 9,55), 52,3% trabalhavam em hospitais gerais, cerca de 44 horas semanais, estavam nas instituições há 10 anos em média). Os dados foram coletados por meio de resposta ao instrumento de caracterização sociodemográfica e aos questionários padronizados Posições sobre o Processo de Enfermagem (PPE) adaptado para esse estudo e o Power as Knowing Participation in Change Tool- versão brasileira (PKPCT), que apresentaram boas estimativas de validade e confiabilidade. Testes não paramétricos foram usados para analisar associação entre as atitudes relacionadas ao PE e as variáveis selecionadas. RESULTADOS: O escore total médio no PPE foi de 112,37 (DP=22,28) e o escore total médio no PKPCT foi de 281,12 (DP= 38,72) para os 1605 respondentes. Houve associação entre as duas atitudes relacionadas ao PE e categoria profissional, a atitude dos enfermeiros sobre o PE foi mais favorável que a dos auxiliares de enfermagem (p=0,024) e a percepção de poder dos enfermeiros foi mais elevada que a dos auxiliares de enfermagem (p=0,004). Houve correlação positiva moderada entre os escores do PPE e do PKPCT para os auxiliares (r=0,480; p=0,000) e para os enfermeiros (r=0,460; p=0,000). Os auxiliares do sexo feminino tiveram disposição sobre o PE (111,93) mais favorável que os do sexo masculino (106,11) (p=0,018) e maior percepção de poder (279,75 vs 270,84) (p=0,020); na amostra de enfermeiros não houve associação entre essas variáveis. Apenas para os auxiliares de enfermagem ter pós-graduação associou-se significativamente a maiores médias de atitude sobre o PE (119,0, p=0,011). As enfermeiras que relataram ter cargo de chefia apresentaram escores de percepção de poder mais elevados (293,52) que as enfermeiras sem cargo de chefia (282,61 p=0,010), mas não houve associação entre cargo de chefia e atitude sobre o PE. As associações entre os escores do PPE e PKPCT e as variáveis idade, tempo de formado, atividade principal, satisfação com a carreira, satisfação com o local de trabalho, conhecimento e contato com a SAE foram de intensidade desprezível no caso das correlações ou não significantes ao nível de 5%. / INTRODUCTION: The Brazilian nursing legislation requires that the nursing process (NP) is documented in all health institution. Attitudes of nursing staff towards the nursing process (NP) and their perception on their own clinical power to make changes are factors potentially associated with implementation and maintenance of the NP. OBJECTIVES: To describe the attitudes towards NP (attitudes on NP and perception of clinical power) of auxiliary nurses and baccalaureate nurses; and to analyze associations between attitudes towards the NP and selected variables. METHODS: An exploratory descriptive study with cross-sectional design, with a non-probabilistic sample of 973 auxiliary nurses and 632 baccalaureate nurses from 35 health agencies linked to the Ministry of Health of São Paulo, Brazil (86.9% female, mean age = 44.12 years (SD = 9.55), 52.3% worked in general hospitals, about 44 hours per week, were in institutions for 10 years on average). Data were collected by self-report using a form for personal, educational and other social data, and the Positions on Nursing Process (PNP) tool, adapted for this study, and the Power as Knowing Participation in Change Tool-Brazilian version (PKPCT), which showed good estimates of validity and reliability. Nonparametric tests were used to test associations between attitudes towards the NP and the selected variables. RESULTS: The mean PNP total score was 112.37 (SD = 22.28) (possible range = 20-140) and the mean PKPCT total score was 281.12 (SD = 38.72) (possible range = 48-336) for 1605 subjects. There was an association between the two PNP-related attitudes and professional category; the attitude of baccalaureate nurses on the NP was more favorable than that of auxiliary nursing (p = 0.024) and perceived clinical power of the baccalaureate nurses was higher than that of the auxiliary nurses (p = 0.004). There was moderate positive correlation between the scores of the PNP and PKPCT for auxiliary nurses (r = 0,480, p = 0.000) and baccalaureate nurses (r = 0.460, p = 0.000). The female auxiliary nurses had higher scores on PNP (111.93vs 106.11; p = 0.018) and PKPCT (279.75vs. 270.84; p = 0.020) than the male ones. There were no associations between sex an attitudes towards NP among baccalaureate nurses. Only for auxiliary nurses sample attending a continuing education program was associated with higher NP scores (119.0, p = 0.011). Baccalaureate nurses serving in leadership positions had higher mean total score on PKPCT (293.52) than nurses serving in direct care (282.61 p = 0.010), but there was no association between leadership position and PNP scores. Association tests for scores of the PNP and PKPCT and the variables age, time since graduation, main activity, satisfaction with the career, satisfaction with the workplace, knowledge on NP and contact with the NP resulted in negligible correlation coefficients or non-significant coefficients at 5%.