A hipótese principal testada nesse estudo foi que a qualidade de vida do indivíduo está diretamente correlacionada com a qualidade de vida no trabalho, ou seja, quanto maior a qualidade de vida no trabalho, maior a qualidade de vida. O objetivo geral foi avaliar e correlacionar as variáveis qualidade de vida e qualidade de vida no trabalho de profissionais de enfermagem atuantes em unidades do Bloco Cirúrgico de quatro hospitais da cidade de Londrina – PR. Trata-se de um estudo descritivo e correlacional, do tipo corte transversal do qual participaram 105 trabalhadores. A coleta de dados foi realizada com a utilização de três questionários: caracterização sociodemográfica, Escala Adaptada de Qualidade de Vida de Flanagan e o Índice de Satisfação Profissional de Stamps. Ambos os instrumentos foram usados nas versões adaptadas para o português e mostraram valores do alfa de Cronbach de 0,81 para as duas escalas, o que indica a confiabilidade das mesmas na população estudada. Dos participantes, a maioria era do sexo feminino (82,9%) e casado (62,9%). Quanto à caracterização profissional, 12 eram enfermeiros, um técnico, 73 auxiliares e 18 atendentes que atuavam em Centro Cirúrgico (55,2%), Central de Material e Esterilização (33,3%) ou em ambos locais (11,5%). O tempo médio de atuação nas instituições foi de 9,82 anos (intervalo de seis meses a 29 anos). Os resultados relacionados à qualidade de vida nos quais, em um intervalo possível de 16 a 112, quanto maior o valor, maior a satisfação com a vida, obtivemos uma mediana de 77 e média de 77,2+10,5. A média de todos os 16 itens foi de 4,83+0,65 (resultado avaliado entre nem insatisfeito/nem satisfeito e satisfeito). O item de menor satisfação foi atividades recreacionais e esportivas e o de maior satisfação relacionamento com amigos. No que se refere à qualidade de vida no trabalho, os valores obtidos variaram entre 114 a 227 (intervalo possível de 44 a 308), sendo que quanto maior o valor, maior a satisfação com o trabalho. A média obtida foi de 169,7+25,9 e a mediana de 170. O valor médio obtido para os 44 itens foi de 3,85, mostrando que os trabalhadores estavam entre insatisfeitos e nem satisfeitos/ nem insatisfeitos com os aspectos abordados pelo instrumento de qualidade de vida no trabalho. Entre os seis domínios avaliados pelo instrumento, obtivemos que a Remuneração foi considerada como fonte de menor satisfação entre os trabalhadores, enquanto o domínio Status profissional, o de maior satisfação. Para testar a correlação entre as variáveis QV e QVT usamos o teste não paramétrico de Spearman e obtivemos um valor de 0,17 (p=0,07). Assim, constatamos que não houve correlação entre as variáveis, o que não comprovou a nossa hipótese inicial. / The hypothesis tested in this study was that the quality of life of a person is directly correlated to the quality of life at work. Therefore, the better the quality of life at work, better will be the quality of life. The general aim was to evaluate and correlate the variables quality of life at work among nursing professionals working at the surgical unit of four hospitals located in the city of Londrina, state of Paraná. This is a descriptive and correlational study, of the cross sectional type, with a sample of 105 professionals. Data were collected through a questionnaire containing Flanagan’s Adapted Quality of Life Scale and Stamps’ Index of Work Satisfaction. Both instruments were used in their versions adapted to Portuguese and showed values of Cronback alpha of 0.81 for both scales, indicating their reliability in the population studied. Among the participants, the majority were women (82.9%) and married (62.9%). With respect to professional characterization, 12 were nurses, 1 technician, 73 auxiliaries and 18 aids who worked at the Surgical Unit (55.2%), Sterilization and Material Unit (33.3%) or both (11.5%). The average time of work at the institutions was of 9.82 years (interval between six months and 29 years). Considering the results related to the quality of life in which, in a possible interval of 16 to 112 years, greater the value, greater will be life satisfaction, the author found a median of 77 and average of 77.2+10.5. The average of all the 16 items was of 4.83+0.65 (results evaluated between neither satisfied nor dissatisfied and satisfied). The item with lower satisfaction level was related to recreational and sports activities and the one with higher satisfaction rate was relationship with friends. Regarding quality of life at work, values varied between 114 and 227 (possible range of 44 to 308), considering that greater the value, greater will be the work satisfaction. The average was of 169.7+25.9 and the median of 170. The average value obtained for the 44 items was of 3.85, showing that workers were dissatisfied and neither satisfied nor dissatisfied with the aspects mentioned in the instrument on quality of life at work. Among the six domain evaluated by the instrument, the author found that remuneration was considered the source of lower satisfaction among workers, while the domain professional status was the one with higher satisfaction level. In order to test the correlation between the two variables, the Spearman non parametric test was applied and the author found a value of 0.17 (p=0.07). Thus, there were no correlation among the variables and the initial hypothesis was not confirmed.

Balancing trade-offs between production cost and holding cost is critical for production and operations management. Utilization of an operating room affects production cost, which relates to makespan, and patient flowtime affects holding cost. There are trade-offs between two objectives, to minimize makespan and to minimize flowtime. However, most existing constructive heuristics focus only on single-objective optimization. In the current literature, NEH is the best constructive heuristic to minimize makespan, and LR heuristic is the best to minimize flowtime. In this thesis, we propose a current and future deviation (CFD) heuristic to balance trade-offs between makespan and flowtime minimizations. Based on 5400 randomly generated instances and 120 instances in Taillard’s benchmarks, our CFD heuristic outperforms NEH and LR heuristics on trade-off balancing, and achieves the most stable performances from the perspective of statistical process control.

The Institute of Medicine's report in 2000, To Err Is Human: Building a Safer Health System, highlighted the seriousness of medical errors in the U.S. health care system. The unintentional retention of foreign objects in surgical patients is one of those errors. At the time of this study, there was no standardized counting policy and process across operating rooms in the United States. The purpose of this project was to develop a best practice educational counting program to help prevent the unintentional retention of foreign objects in surgical patients. The Logic Model was used to guide the design of the educational program and expected learning outcomes. A draft of the educational program was distributed to 10 perioperative stakeholders for an initial formative review. Changes were incorporated into the program and it was distributed to 6 perioperative experts for an additional summative assessment and content validation utilizing the AGREE II Instrument. The overall quality evaluation of the educational program was 85%, indicating that it was of high quality. Four of the respondents recommended the educational program for implementation without any changes and 2 recommended it for implementation with some minor modifications related to rewording of one question in the pretest-posttest. There were no recommended modifications in the content of the educational program. As a result, the project was recommended for adoption as a best practices-based educational program to prevent the unintentional retention of foreign objects in surgical patients. The study promotes positive social change by providing suggestions to improve the provision of safe care to surgical patients and decrease health care costs.

<p>En operationssjuksköterska kan under sin yrkesverksamma tid förväntas att ansvara vid en operation där patienten konstaterats hjärndöd och det beslutats att organdonation ska genomföras. Syftet med denna studie var att beskriva operationssjuksköterskors erfarenheter vid organdonation när donatorn är hjärndöd. Studien har en kvalitativ ansats, där forskarna strävar efter en helhetsförståelse av det studerade intresseområdet. Datainsamling utfördes via ostrukturerade intervjuer med öppna frågor. Sju intervjuer genomfördes med operationssjuksköterskor som medverkat vid organdonation när donatorn var hjärndöd. Innehållsanalys genomfördes och fyra huvudkategorier framträdde: <em>Inför donation, Genomförande av donation, Efter donation </em>och<em> Etiska aspekter vid donation</em>. Resultatet visade att operationssjuksköterskorna hade liknande erfarenheter vid organdonation när donatorn var hjärndöd som vid andra operationer angående arbetsuppgifter och ansvarsområden. Teamarbete hade en central roll och vikten av värdighet i vården framträdde tydligt. Många olika tankar och känslor väcktes hos operationssjuksköterskorna i samband med en organdonation. En operationssjuksköterska kan under sin yrkesverksamma tid förväntas att ansvara vid en operation där patienten konstaterats hjärndöd och det beslutats att organdonation ska genomföras. Syftet med denna studie var att beskriva operationssjuksköterskors erfarenheter vid organdonation när donatorn är hjärndöd. Studien har en kvalitativ ansats, där forskarna strävar efter en helhetsförståelse av det studerade intresseområdet. Datainsamling utfördes via ostrukturerade intervjuer med öppna frågor. Sju intervjuer genomfördes med operationssjuksköterskor som medverkat vid organdonation när donatorn var hjärndöd. Innehållsanalys genomfördes och fyra huvudkategorier framträdde: <em>Inför donation, Genomförande av donation, Efter donation </em>och<em> Etiska aspekter vid donation</em>. Resultatet visade att operationssjuksköterskorna hade liknande erfarenheter vid organdonation när donatorn var hjärndöd som vid andra operationer angående arbetsuppgifter och ansvarsområden. Teamarbete hade en central roll och vikten av värdighet i vården framträdde tydligt. Många olika tankar och känslor väcktes hos operationssjuksköterskorna i samband med en organdonation.</p>

En operationssjuksköterska kan under sin yrkesverksamma tid förväntas att ansvara vid en operation där patienten konstaterats hjärndöd och det beslutats att organdonation ska genomföras. Syftet med denna studie var att beskriva operationssjuksköterskors erfarenheter vid organdonation när donatorn är hjärndöd. Studien har en kvalitativ ansats, där forskarna strävar efter en helhetsförståelse av det studerade intresseområdet. Datainsamling utfördes via ostrukturerade intervjuer med öppna frågor. Sju intervjuer genomfördes med operationssjuksköterskor som medverkat vid organdonation när donatorn var hjärndöd. Innehållsanalys genomfördes och fyra huvudkategorier framträdde: Inför donation, Genomförande av donation, Efter donation och Etiska aspekter vid donation. Resultatet visade att operationssjuksköterskorna hade liknande erfarenheter vid organdonation när donatorn var hjärndöd som vid andra operationer angående arbetsuppgifter och ansvarsområden. Teamarbete hade en central roll och vikten av värdighet i vården framträdde tydligt. Många olika tankar och känslor väcktes hos operationssjuksköterskorna i samband med en organdonation. En operationssjuksköterska kan under sin yrkesverksamma tid förväntas att ansvara vid en operation där patienten konstaterats hjärndöd och det beslutats att organdonation ska genomföras. Syftet med denna studie var att beskriva operationssjuksköterskors erfarenheter vid organdonation när donatorn är hjärndöd. Studien har en kvalitativ ansats, där forskarna strävar efter en helhetsförståelse av det studerade intresseområdet. Datainsamling utfördes via ostrukturerade intervjuer med öppna frågor. Sju intervjuer genomfördes med operationssjuksköterskor som medverkat vid organdonation när donatorn var hjärndöd. Innehållsanalys genomfördes och fyra huvudkategorier framträdde: Inför donation, Genomförande av donation, Efter donation och Etiska aspekter vid donation. Resultatet visade att operationssjuksköterskorna hade liknande erfarenheter vid organdonation när donatorn var hjärndöd som vid andra operationer angående arbetsuppgifter och ansvarsområden. Teamarbete hade en central roll och vikten av värdighet i vården framträdde tydligt. Många olika tankar och känslor väcktes hos operationssjuksköterskorna i samband med en organdonation.

Bakgrund: I en operationssal arbetar ett multiprofessionellt team. För att effektivt kunna bedöma och utvärdera kvaliteten på det intraoperativa teamarbetet, samt stärka patientsäkerheten, är det av stor betydelse att få en djupare förståelse för operationssjuksköterskors upplevelser kring begreppet teamarbete. Syfte: Syftet med studien var att belysa operationssjuksköterskors uppfattningar om det intraoperativa teamarbetet. Metod: Semistrukturerade intervjuer genomfördes med 14 operationssjuksköterskor från två sjukhus i mellersta Norrland. Insamlad data analyserades med hjälp av kvalitativ innehållsanalys. Resultat: Utifrån analysen framkom tre kategorier och tio underkategorier. De tre kategorierna var: Operationssjuksköterskans upplevelser av sin roll i teamet, Interaktionen mellan de olika yrkeskategorierna i teamet och Betydelsen av att utveckla och förbättra teamet. Att planera arbetet och ligga steget före beskrevs som att ha kontroll över situationen. Ett väl fungerande teamarbete präglades av tydlig kommunikation och att bekräfta varandra stärkte teamkänslan. Slutsats: Studien belyser en rad faktorer kring operationssjuksköterskornas uppfattningar om vad som kan bidra till ett väl fungerande intraoperativt teamarbete. Mer forskning av kvalitativ ansats behövs för att tydliggöra och få en större förståelse av operationssjuksköterskans upplevelser i samband med detta. / Background: The operating room is a place where multidisciplinary teamwork is carried out. In order to effectively assess and evaluate the quality of intraoperative teamwork, and enhance patient safety, it is of great importance to gain a deeper understanding of operating room nurses’ perceptions around the concept of teamwork. Aim: The purpose of the study was to describe operating room nurses’ perceptions of the intraoperative teamwork. Method: Semi-structured interviews were carried out with 14 operating room nurses at two hospitals in north central Sweden. Collected data was analyzed using qualitative content analysis. Result: Three categories and ten sub-categories emerged from the analysis. The three categories were: Operating room nurses’ perceptions of their professional role in the team, Interaction between professionals in the team and, The importance of building and improving the team. To plan work and stay ahead were described as achieving control of the situation. Effective teamwork was characterized by clear communication and, team spirit was strengthened by acknowledging each other. Conclusion: This study demonstrates a number of factors surrounding the operating room nurses’ perceptions of what may contribute to a high functioning intraoperative teamwork. Further research with a qualitative approach is needed to clarify and gain a greater understanding of operating room nurses’ perceptions in the context of teamwork.

The efforts to improve health care delivery usually involve studies and analysis of patient populations and healthcare systems. In this dissertation, I present the research conducted in the following areas: identifying patient groups, improving treatments for specific conditions by using statistical as well as data mining techniques, and developing new operation research models to increase system efficiency from the health institutes’ perspective. The results provide better understanding of high risk patient groups, more accuracy in detecting disease’ correlations and practical scheduling tools that consider uncertain operation durations and real-life constraints.

Darbo tikslas: Įvertinti operacinės slaugytojų susižeidimų adatomis ir kitais aštriais instrumentais riziką. Tyrimo objektas - operacinės slaugytojų susižeidimų adatomis ir kitais aštriais instrumentais rizika. Darbo uždaviniai: 1. Įvertinti operacinės slaugytojų susižeidimų adatomis ir kitais aštriais instrumentais dažnumą, pobūdį bei susižeidimų priežastis. 2. Išanalizuoti saugią operacinės darbo aplinką lemiančius veiksnius. 3. Ištirti operacinės slaugytojų požiūrį į susižeidimų adatomis ir kitais aštriais instrumentais pranešimą ir jų registraciją. Tyrimo metodika: Tyrimas atliktas 2013 metų sausio – balandžio mėnesiais Vilniaus ir Kauno miestų tretinio lygio ligoninėse. Tyrimui panaudota vokiečių mokslininkės dr. Sabine Wicker sudarytos anketos: „Atsitiktinis susižeidimas“ (‚,Ein stich stecktan“) ir „Sumažinti pavojų užsikrėsti – vengti adatos dūrio“ (,,Infektionsrisiken senken – Nadelstichverletzungen vermeiden“). Anketos išverstos į lietuvių kalbą. Viso buvo išdalinta 200 anketų, grižo 185 anketos, iš jų nepilnai atsakytos 10. Statistinei analizei buvo naudotos 175 užpildytos anketos. Statistiniam duomenų apdorojimui naudoti SPSS 17.0 ir Microsoft Excel programų paketai. Statistinis duomenų reikšmingumas tikrintas pagal chi kvadrato (χ2) kriterijų ir statistinį reikšmingumą (p). Duomenų skirtumas reikšmingas, kai p<0,05. Tyrime naudotas faktorinės analizės metodas. Rezultatai ir išvados: Analizuojant tyrimo duomenis, nustatyta, kad tarp apklaustųjų nebuvo nei vieno... [toliau žr. visą tekstą] / Research aim: to assess the risk of operating room nurses injuries with needles and other sharp instruments. Research object: operating room nurses injuries with needles and other sharp instruments. Research objectives: 1. To asses frequency, type and reasons of operating room nurses injuries with needles and other sharp instruments. 2. To analyse influencing causes for safe operating room environment. 3. To analyse the operating room nurses attitudes towards registration and reporting of injuries inflicted by needles and other sharp instruments. Research methodology: Research was done in January–April 2013 in Vilnius and Kaunas 3rd level hospitals. For this research two types of questionnaires, written by German scientist Dr. Sabine Wicker, were used: „Incidental Injury“ („Ein stich Stecktan“) and „Minimizing the danger of infection – prevent the needle puncture“ (,,Infektionsrisiken senken – Nadelstichverletzungen vermeiden“). Questionnaires were translated to Lithuanian language. There were 200 questionnaires distributed in total, 185 of them were returned and 10 were not fully answered. 175 fully answered questionnaires were used for statistical analysis. SPSS 17.0 and Microsoft Excel programs were used for statistical data analysis. Statistical data meaningfulness was verified by chi quadrant (χ2) criteria and statistical meaningfulness. Data difference is meaningful when p<0,05. Factor analysis method was used for the research. Results and conclusions: During the... [to full text]

In April 2008, the Ontario government announced its top two healthcare priorities for the next 4 years, one of which is reducing wait time in emergency rooms. To study the wait time in emergency rooms or any other departments in a hospital, one must investigate resource planning, scheduling, and utilization within the hospital. This thesis provides hospitals with a set of simulation and optimization tools to help identify areas of improvement, particularly when there are a number of alternatives under consideration. A simulation tool (a Monte Carlo simulation model) estimates patient demand for beds in a hospital during a typical week. Two optimization tools (an integer programming mathematical model and a heuristics model) demonstrate opportunities for smoothing the patient demand for beds by adjusting the operating room schedule.

In April 2008, the Ontario government announced its top two healthcare priorities for the next 4 years, one of which is reducing wait time in emergency rooms. To study the wait time in emergency rooms or any other departments in a hospital, one must investigate resource planning, scheduling, and utilization within the hospital. This thesis provides hospitals with a set of simulation and optimization tools to help identify areas of improvement, particularly when there are a number of alternatives under consideration. A simulation tool (a Monte Carlo simulation model) estimates patient demand for beds in a hospital during a typical week. Two optimization tools (an integer programming mathematical model and a heuristics model) demonstrate opportunities for smoothing the patient demand for beds by adjusting the operating room schedule.