Organizational downsizing is a prevalent, cost-reduction corporate strategy that executives often use to deal with dynamic competitive environments. Several studies have examined the financial implications of downsizing by evaluating the relationship between downsizing strategies and organizational performance and/or profitability. Other researchers have focused upon the responses and behaviors of layoff victims, survivors, and managers as a result of downsizing. Relatively few studies however, have investigated the impacts of layoff characteristics on the cognitions of the managers who plan and implement organizational downsizing. It has been argued that the process of layoff implementation potentially generates dissonance for the layoff agents as a result of the requirement to perform actions that are inconsistent with their cognitions and beliefs concerning workplace norms and behaviors (Margolis & Molinsky, 2008; Parker & McKinley, 2008; Sronce & McKinley, 2006). This study builds upon Festinger's (1957) cognitive dissonance theory that individuals experiencing cognitive dissonance have motivation to adopt dissonance reduction strategies, such as changing their behaviors or their cognitions, in order to balance the conflict between their beliefs in managerial role and actions of implementing layoffs. Four hypotheses are proposed to compare responses among participants facing different layoff characteristics. More specifically, drawing upon the free-choice paradigm (Brehm, 1956) of cognitive dissonance theory (Festinger, 1957), I anticipate that the subjects who make a more difficult layoff decision under certain layoff circumstances will experience more cognitive dissonance and will be motivated to adopt more positive perceptions of downsizing as a dissonance-reduction method than those who make an easier layoff decision. To evaluate the above relationships, a two-by-two factorial between-subjects experiment with various layoff conditions was carried out to investigate the impacts of layoff attributes on layoff agency-induced cognitive dissonance and layoff agents' perceptions of downsizing. Multivariate Analysis of Covariance (MANCOVA) methods were performed with gender and family layoff victimhood as control variables. The analyses found supports for hypothesis 1 and 3. Namely, individuals who make more difficult layoff decisions tend to experience more cognitive dissonance. The results of this study draw attention to how different layoff attributes affect layoff agents' responses especially in terms of their cognitions.

This study traced the history of the outplacement industry from 1960 to 1997 through the stories of seven outplacement firms, the three organizations that emerged from the industry and the changes that occurred in the design and delivery of outplacement services. The history was studied in the context of the changes that occurred in the social and economic environment that formed the American workplace between 1960 and 1997 and the subsequent impact those changes had on corporations, their employees and the outplacement industry. Outplacement has its roots in the job search counseling service designed and delivered by Bernard Haldane following WW II to assist veterans with their reentry into the post war workplace. In the 1960s, entrepreneurs expanded Haldane's service to include consulting with corporate managers on how to terminate employees, remove them from corporate payrolls and support their job search efforts until they found new positions. They called this service outplacement. The primary data for this study came from personal interviews with industry founders, leaders and practitioners, the archives of the AOCFI, industry newsletters and published materials. The study traced the changes that occurred in the reasons corporations purchased outplacement services and the affect those changes had on the way corporations bought and distributed outplacement services for their terminated employees. The study traced modifications outplacement firms made to their services in response to corporate demands and the affect those changes had on the future of the industry. The study traced the evolution of outplacement services from a personal consulting service to a new curriculum of learning resources from which corporate buyers of outplacement services selected services to meet the diverse learning needs of terminated employees. The study traced the growth and decline of the industry, the subsequent impact on the industry's trade, professional member and certification organizations and the difficulties those organizations experienced as they attempted to respond to their members changing needs. This study traces a history of the industry from the collected stories of industry founders, leaders, practitioners and industry archives and relates those stories to the rise and decline of the outplacement industry. / Ed. D.

Submitted in partial fulfilment of the requirements for the degree of Masters in Business Administration, Durban University of Technology, 2008. / Strategic change within an organisation is inevitable. Due to the competitive global landscape, organisations have to continuously adapt their strategies to remain in the market. Strategy change is most often met with resistance, and more so when the change involves downsizing. The effects of downsizing on employee morale, performance and commitment have been studied by numerous authors and a number of models for strategy change implementation consequently suggested. However, South Africa is faced with very particular challenges when dealing with change, including a high level of unemployment, fierce resistance to change in the form of collective action such as strikes, stay-aways or go-slows, political and social transformation happening simultaneously, global competition and the conflict between social and free markets within an emerging economy. Irrespective of the vast amount of international literature available on change management, there is a distinct lack of literature investigating the impact of strategy change in an emerging economy and a knowledge gap in terms of applying existing change theories in non-Western environments. This study was aimed at determining the impact of strategy change, particularly downsizing, on employee morale, performance and commitment at a global South-African based Telecommunication Company. The objectives of the study was to determine whether employees in South Africa are negatively affected by downsizing, and provide useful information to strategic managers in terms of implementation of strategy change in a South African environment. To determine the impact of downsizing as a strategy change, a questionnaire was designed based on the literature review to ascertain responses to three sections of questions, respectively measuring morale, performance and commitment. A sample of the target population was chosen based on their position/ employment type i.e. management, supervisor or general staff. The results of the empirical study revealed some very interesting points. Although all respondents demonstrated optimism in terms of their morale, performance and commitment, it was found that comparatively, managers are more negatively impacted during times of downsizing. The Telecommunication Company’s structured nature, advances in political and social reform, and solid Training and Development policy shielded the employees from the full negative impacts of downsizing because of their positive core self evaluation. The substantial amount of neutral responses (especially under management) indicated that not all respondents revealed their true feelings, a common characteristic amongst collective people. It also surfaced that even though the majority of responses indicated positive morale and performance, most respondents were considering positions outside the organisation. Based on the literature review and results from the empirical investigation, a model was proposed to assist strategic managers in South Africa with change implementation.

Major changes in organizational structural paradigms have been occurring. Recent journal articles propose that the older philosophies of expanding organizations and increasing internal specialization are no longer viable means to enhance competitiveness as espoused in earlier journal articles. Downsizing, rightsizing, and business process reengineering have all been used as methods of accomplishing organizational work force reduction (OWFR) and enhancing organizational posture. It has been established that as organizations grow, specialization increases. Causes for OWFR have not been established nor have effects upon structure been studied. Previous structural factor studies have focused upon organizations engaged in end-game strategies done during periods of internal and economic growth. This study evaluates the impacts of OWFR and its relationship to the structural factor of specialization during a non-munificent economic period. Three independent variables, dis-integration, change in the number of employees, and change in technology, were used as measures to determine whether specialization decreased when organizations downsized. The dependent variable, specialization, was obtained through a pre-tested questionnaire. The three independent variables were obtained using the Compustat data base as a secondary source of information. The Compustat data was verified using data from Compact Disclosure. Questionnaires were mailed to fifty-one fully integrated oil companies. Forty were returned after three mailings yielding a response rate of seventy-eight percent. The unit of analysis for the data collected was the firm. The data were analyzed using multiple regression to determine the strength of the relationship between the variables. Results indicate a significant relationship between two of the independent variables and the dependent variable: dis-integration and specialization and change in the number of employees and specialization. Findings were insignificant for the third independent variable and the dependent variable: change in technology and specialization. Analysis of the quantitative results and the qualitative responses of the participants show that dis-integration and a change in the number of employees are both useful for measuring structural change for organizations engaged in organizational work force reduction.

Made available in DSpace on 2014-08-06T17:29:44Z (GMT). No. of bitstreams: 2 Ana Paula Albuquerque.pdf: 545006 bytes, checksum: 13e9e703c0e1c3cca5435d26360ba9de (MD5) license.txt: 1914 bytes, checksum: 7d48279ffeed55da8dfe2f8e81f3b81f (MD5) Previous issue date: 2010 / Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Departamento de Ensino. Programa de Pós-Graduação em Saúde da Criança e da Mulher. Rio de Janeiro, RJ, Brasil. / Estudo transversal, de abordagem quantitativa, para aplicação de um instrumento de medida de carga de trabalho. Foi realizado na Unidade Neonatal Cirúrgica do Instituto Fernandes Figueira, no período de 03 de julho de 2009 a 31 de agosto de 2009. Teve como objetivo avaliar a carga de trabalho da unidade neo cirúrgica através do instrumento NAS (Nursing Activities Score). Reviu-se a literatura sobre carga de trabalho, relacionando com dimensionamento de pessoal de enfermagem. A amostra foi composta por 23 RN que sofreram intervenção cirúrgica e que permaneceram internados por um período mínimo de 24h. O NAS foi aplicado 904 vezes na unidade estudada. Foi utilizado um tutorial para a melhor interpretação das atividades do NAS que facilitou a compreensão do instrumento. A pontuação média do NAS foi 77,2. Em média, 77% do tempo de um profissional de enfermagem é dedicado aos cuidados dos RN na unidade. Considerando que cada ponto NAS equivale a 14.4min, foi identificada na pesquisa, uma média de 18,5h de assistência por RN/24h. O valor médio para a equipe de enfermagem calculada pela pontuação NAS através da fórmula utilizada por Fugulin foi 36,9 profissionais. Em média, a equipe disponível no serviço foi de 24 profissionais. O número médio de profissionais projetado pelo instrumento NAS foi 54% mais elevado do que no quadro de profissionais de enfermagem disponível na unidade estudada. Isso indica que nessa unidade deve haver sobrecarga de trabalho. / Cross-sectional study of quantitative approach to implementation of an instrument for measuring workload. Was conducted at the Neonatal Surgical Fernandes Figueira Institute, the period of 03 July 2009 to August 31, 2009. Was to evaluate the workload of the unit neo surgical instrument through the NAS (Nursing Activities Score). We review the literature on workload in relation to dimensioning of nursing staff. The sample consisted of 23 infants who underwent surgery and remained hospitalized for a minimum of 24 hours. NAS was applied 904 times in the unit studied. We used a tutorial for the best interpretation of the activities of the NAS that facilitated the understanding of the instrument. The average score of NAS was 77,2. On average, 77% of the time of a nursing professional is dedicated to the care of newborns in the unit. Since each point equals NAS 14.4min, was identified in the survey, an average of 18,5 hours of assistance RN / 24h.The average value for the nursing staff NAS score calculated by the formula used by professionals Fugulin was 36.9. On average, the team was available in the service of 24 professionals. The average number of professional instrument designed by the NAS was 54% higher than in the context of nurses available in the unit studied. This indicates that this unit should be no work overload.

Assegurar um quadro de trabalhadores adequado aos objetivos e finalidades da instituição constitui um desafio permanente, na medida em que se tomam, por referência, processos assistenciais qualificados. A presente pesquisa teve o objetivo de analisar o quantitativo de trabalhadores de enfermagem do Centro Cirúrgico de um hospital de ensino de um município do norte do Paraná. Trata-se de um estudo de abordagem quantitativa, de corte transversal, descritivo tipo estudo de caso. A população foi constituída por sete enfermeiros, 16 técnicos e 24 auxiliares de enfermagem que atenderam aos critérios de inclusão. O período de coleta compreende o período de agosto de 2011 a julho de 2012 e as fontes de coleta de dados foram a Diretoria de Recursos Humanos, Serviço de Estatística e arquivo documental da unidade. Para caracterização sociodemográfica e profissional dos participantes e da instituição, foram realizadas entrevistas e utilizado questionário estruturado. Para o cálculo de pessoal de enfermagem do Centro Cirúrgico, utilizou-se o modelo de dimensionamento desenvolvido por Possari (2001), baseado na metodologia de Gaidzinski (1998). A coleta de dados foi realizada, identificando-se inicialmente o tempo cirúrgico intraoperatório, seguido pelas etapas propostas no método: classificação das cirurgias segundo o porte cirúrgico; identificação do tempo de espera na recepção do Centro Cirúrgico, do tempo de limpeza da sala de operação e do tempo médio de assistência de enfermagem; determinação do percentual de cada categoria profissional; identificação da jornada de trabalho e identificação das ausências previstas e não previstas da equipe de enfermagem. Foram realizadas 5797 cirurgias, sendo 2666 eletivas e 3131 de urgência/emergência, sendo que, em relação ao porte cirúrgico, o maior percentual de cirurgias foi de porte I, com 43,4% (2518), seguida pelas de porte II, com 38,3% (2219), de porte III, com 12,2% (705), e de porte IV, com 7,2% (415). A quantificação do tempo médio de intraoperatório para as cirurgias eletivas apontou um tempo de 75,5 minutos para as cirurgias de porte I; 175,2 minutos, para as cirurgias de porte II; 293,2 minutos, para as cirurgias de porte III, e de 459,3 minutos, para as cirurgias de porte IV. A média geral de intraoperatório das cirurgias eletivas foi de 176,4 minutos. Para as cirurgias de urgência/emergência, o tempo médio de intraoperatório para o porte I foi de 83 minutos, para o porte II, de 170,2 minutos; para o porte III, de 290,7 minutos, e para as de porte IV, 469,6 minutos. A média geral de intraoperatório obtida para as cirurgias de urgência/emergência foi de 154,6 minutos. No período de estudo, a clínica que mais realizou cirurgias eletivas foi a Ortopedia, com 453 (17,0%) cirurgias, e, em relação às cirurgias de urgência/emergência, o Pronto Socorro Cirúrgico foi a clínica com maior volume cirúrgico, 810 (25,9%). O tempo médio total de assistência para as cirurgias eletivas foi de 5,9 horas, sendo 2,5 horas para o porte I; 5,8 horas para as de porte II, 9,8 horas para as de porte III e 16,7 horas para as de porte IV. Para as cirurgias de urgência/emergência, o tempo médio de assistência de enfermagem, segundo o porte cirúrgico, foi de 5,2 horas, sendo 2,8 horas para o porte I; 5,7 horas para o porte II; 9,7 horas para o porte III, e 15,7 horas para o porte IV. Utilizando as equações propostas por Possari (2001), projetou-se o quadro total de funcionários da equipe de enfermagem para o período intraoperatório, que foi composto por 42 profissionais, assim distribuídos: 6 enfermeiros e 36 auxiliares/técnicos de enfermagem. Esse resultado indicou um equilíbrio entre o quadro de pessoal existente e o projetado pelo modelo utilizado. Recomenda-se, entretanto, que cada instituição e cada unidade de Centro Cirúrgico realize sua investigação de modo a obter um quantitativo de profissionais compatível com as demandas e na perspectiva da realidade institucional / Ensuring an adequate cadre of professionals for the objectives and purposes of the institution is a permanent challenge because qualified care processes are taken by reference. This study aimed to analyze the quantitative nursing staff of the Surgical Center of a teaching hospital in a city in the north of Paraná. This study uses a quantitative approach, of a cross- sectional, descriptive type like a study case. The population consisted of seven nurses, 16 technicians and 24 nursing assistants who met the inclusion criteria. The collecting period covers the period from August, 2011 to July, 2012 and the sources of data were the Human Resources Department, Bureau of Statistics and archive documentary unit. Interviews by using structured questionnaires were conducted for social demographic and professional characterization of the participants and the institution. For the calculation of the nursing staff of the Surgical Center, it was used the dimensional modeling developed by Possari (2001) based on the methodology of Gaidzinski (1998). The data collection was performed at first identifying intraoperative surgical time followed by the steps in the proposed method: classification of the kind of surgery, identification of the waiting time in the Surgical Center reception, the cleaning time of the operating room and the nursing care average time, establishing the percentage of each professional category, identification of the workday and identification of planned and unplanned absences of the nursing team. According to the number of surgeries performed, they were 5797. It means that 2666 were elective and 3131 were urgent or of emergency. In relation to the size of the surgery, the highest percentage of surgeries was size I with 43.4 % (2518), followed by size II with 38.3 % (2219), size III with 12.2 % (705) and size IV with 7.2 % (N415). The intraoperative for the elective surgery showed a time of 75.5 minutes for surgeries sized I, 175.2 minutes for surgeries of size II , 293.2 minutes for surgeries of size III and 459.3 minutes for the surgeries size IV . The intraoperative average time in elective surgery was 176.4 minutes. For urgent surgeries / emergencies, the intraoperative time for size I was 83.0 minutes, for size II, 170.2 minutes, 290.7 minutes for size III and 469.6 minutes for size IV. The intraoperative average time obtained for urgent surgeries / emergencies was 154.6 minutes. During the study, the clinic that more performed elective surgeries was the Orthopaedics with 453 (17.0%) and the Emergency Surgical Clinic also had a greate surgical volume, 810 (25.9%). The total assistance for elective surgery was 5.9 hours, 2.5 hours for size I, 5.8 hours for size II, 9.8 hours for the size III and 16.7 hours for size IV. For urgent surgeries / emergencies, the average nursing care according to the surgical duration was 5.2 hours, 2.8 hours for size I, 5.7 hours for size II, 9.7 hours for size III and 15.7 hours for size IV. By using the equations proposed by Possari (2001), it was designed the total nursing staff for the intraoperative period, which was composed of 42 professionals, distributed as follows: 6 nurses and 36 nursing technicians. This result indicated a balance between existing staff and the one designed by the model. However, it is recommended that each institution and each Surgical Center unit conduct their own research in order to get a quantitative of professional compatible with the demands and the prospect of their institutional reality

Para garantir a segurança dos pacientes e os resultados de qualidade da assistência faz-se necessário investir na melhoria da prática assistencial de enfermagem, uma vez que essa pode ser influenciada diretamente pela gestão organizacional. Um ambiente de trabalho favorável deve levar em consideração vários fatores, entre os quais, a complexidade dos pacientes, carga de trabalho e composição qualiquantitativa dos profissionais de enfermagem. A identificação de fatores individuais e sistêmicos em ambientes de cuidados, particularmente naqueles de alta complexidade, como as Unidades de Terapia Intensiva (UTI), podem beneficiar a prática profissional do enfermeiro e de sua equipe, bem como subsidiar a implantação de ações que contribuam para o alcance de padrões de qualidade nos indicadores relacionados à assistência ao paciente. O objetivo desse estudo foi caracterizar os ambientes de prática profissional, a carga de trabalho e a omissão de cuidados de enfermagem segundo a percepção dos enfermeiros. Trata-se de um estudo descritivo, de corte transversal, realizado em três UTI\'s de grande porte de uma cidade do interior do Estado de São Paulo. A população foi constituída pelos enfermeiros lotados nessas unidades, envolvidos na assistência direta ao paciente, com tempo de experiência profissional na instituição superior a três meses e presentes na unidade no período de realização do estudo entre dezembro de 2017 a março de 2018. A coleta de dados foi feita por meio da aplicação dos instrumentos autoaplicáveis de caracterização pessoal e profissional, do PRACTICE ENVIRONMENT SCALE (PES) - versão brasileira e do MISSCARE-BRASIL. Utilizou-se estatística descritiva para análise e tratamento dos dados e os testes de Wilcoxon e exato de Fischer para testar associação entre variáveis. Participaram do estudo 29 enfermeiros, sendo a maioria do sexo feminino, com média de 35,5 anos de idade, 8,6 anos na função e 4,5 anos de experiência em terapia intensiva. A carga horária semanal desses profissionais foi em média de 34,4 horas, tendo trabalhado ainda 36,4 horas extras, em média, nos últimos 3 meses. A carga de trabalho medida pelo NAS variou de 64,76 a 89,98 pontos e tempo de assistência requerida pelos pacientes foi de 15,5 a 21,5 horas. Em relação ao ambiente de trabalho, as UTI\'s 1 e 3 foram consideradas ambientes mistos e a UTI 2, ambiente favorável a prática profissional, com melhores pontuações nas subescalas \"Relações colegiais entre médicos e enfermeiros\" nas UTI\'s 1 e 3 e \"Habilidade, liderança e suporte dos coordenadores/supervisores de enfermagem aos enfermeiros/equipe de enfermagem\" na UTI 2. No tocante a omissão de cuidados de enfermagem segundo a percepção dos enfermeiros participantes, aquele mais relatado nas três unidades foi \"Deambulação três vezes ao dia ou conforme prescrito\", sendo que o motivo \"Número inadequado de pessoal\" predominou nas UTI\'s 1 e 3. As maiores razões para a não realização de cuidados estiveram relacionadas aos recursos de \"Gerenciamento e liderança\" na UTI 1 e \"Recursos Laborais\" nas UTI 2 e 3. Os resultados relativos aos testes de associação evidenciaram que apenas a relação de pacientes atendidos por turno se mostrou estatisticamente significante ao ambiente de trabalho. Entretanto, os enfermeiros do ambiente favorável não relataram intenção de deixar o cargo, estando mais satisfeitos com o trabalho em equipe e em ser enfermeiro da sua unidade. O estudo possibilitou identificar elementos do ambiente de trabalho em terapia intensiva favoráveis à prática profissional e os pontos de enfrentamento passíveis de mudanças que demandam uma análise criteriosa por parte dos gestores de enfermagem, a fim de garantir o desenvolvimento de uma assistência com qualidade e segurança / In order to ensure patient safety and quality of care results, it is necessary to invest on improvements in nursing care practice, which can be directly influenced by management. To achieve a favorable work environment a few factor should be taken into account, such as patient complexity, workload, and qualitative and quantitative composition of nursing professionals. The identification of individual and systemic factors in care environments, particularly in those with high complexity, such as Intensive Care Units (ICU\'s), can benefit the professional practice of the nurses and their staff, as well as subsidize the implementation of actions that contribute to the achievement of quality standards in the indicators related to patient care. The objective of this study was to characterize the professional practice environments, the workload, and the omission of nursing care according to the nurses\' perception. This is a cross-sectional descriptive study performed in three large ICU\'s of a city in the interior of the State of São Paulo, Brazil. The population was composed of nurses filled in these units, involved in direct patient care, with professional experience in the institution over three months, and present at the unit during the study period between December 2017 to March 2018. The data collection was done through the application of the personal and professional self-applying tools of PRACTICE ENVIRONMENT SCALE (PES) - Brazilian version and MISSCARE-BRASIL. Descriptive statistics were used for data analysis and treatment, and the Wilcoxon and Fischer exact tests were used to test association between variables. Twenty-nine nurses participated in the study, the majority being female, with a mean 35.5 years of age, 8.6 years in function, and 4.5 years of experience in intensive care. The weekly workload of these professionals averaged 34.4 hours, and they also have worked an extra 36.4 hours on average in the last 3 months. The workload measured by the NAS ranged from 64.76 to 89.98 points, and the care time assistance required by the patients was 15.5 to 21.5 hours. Regarding the work environment, ICU\'s 1 and 3 were considered as mixed environments, and ICU 2 as a favorable environment for professional practice, with better scores in the subscales \"Collegial relations between doctors and nurses\" in ICUs 1 and 3 and \"Ability, leadership and support of coordinators / supervisors to the nurses / nursing team\" in the ICU 2. Regarding the omission of nursing care according to the perception of the nurses, the one most reported in the three units was \"Ambulation three times a day or as prescribed\", with the reason \"Inadequate number of personnel\" predominant in ICU\'s 1 and 3. The major reasons for not performing care were related to the \"Management and leadership\" resources in ICU 1 and \"Labor Resources\" in the ICU\'s 2 and 3. The results related to the association tests showed that only the \'\'ratio of patients seen per shift\'\' was statistically significant to the work environment. However, the nurses of the favorable environment did not report intention to leave the position, being more satisfied with teamwork and being a nurse in their unit. The study made it possible to identify elements of the work environment in intensive care favorable to professional practice and the points of confrontation that can be changed, which require a careful analysis by the nursing managers, in order to ensure the development of patient safety and quality of assistance

Assegurar um quadro de trabalhadores adequado aos objetivos e finalidades da instituição constitui um desafio permanente, na medida em que se tomam, por referência, processos assistenciais qualificados. A presente pesquisa teve o objetivo de analisar o quantitativo de trabalhadores de enfermagem do Centro Cirúrgico de um hospital de ensino de um município do norte do Paraná. Trata-se de um estudo de abordagem quantitativa, de corte transversal, descritivo tipo estudo de caso. A população foi constituída por sete enfermeiros, 16 técnicos e 24 auxiliares de enfermagem que atenderam aos critérios de inclusão. O período de coleta compreende o período de agosto de 2011 a julho de 2012 e as fontes de coleta de dados foram a Diretoria de Recursos Humanos, Serviço de Estatística e arquivo documental da unidade. Para caracterização sociodemográfica e profissional dos participantes e da instituição, foram realizadas entrevistas e utilizado questionário estruturado. Para o cálculo de pessoal de enfermagem do Centro Cirúrgico, utilizou-se o modelo de dimensionamento desenvolvido por Possari (2001), baseado na metodologia de Gaidzinski (1998). A coleta de dados foi realizada, identificando-se inicialmente o tempo cirúrgico intraoperatório, seguido pelas etapas propostas no método: classificação das cirurgias segundo o porte cirúrgico; identificação do tempo de espera na recepção do Centro Cirúrgico, do tempo de limpeza da sala de operação e do tempo médio de assistência de enfermagem; determinação do percentual de cada categoria profissional; identificação da jornada de trabalho e identificação das ausências previstas e não previstas da equipe de enfermagem. Foram realizadas 5797 cirurgias, sendo 2666 eletivas e 3131 de urgência/emergência, sendo que, em relação ao porte cirúrgico, o maior percentual de cirurgias foi de porte I, com 43,4% (2518), seguida pelas de porte II, com 38,3% (2219), de porte III, com 12,2% (705), e de porte IV, com 7,2% (415). A quantificação do tempo médio de intraoperatório para as cirurgias eletivas apontou um tempo de 75,5 minutos para as cirurgias de porte I; 175,2 minutos, para as cirurgias de porte II; 293,2 minutos, para as cirurgias de porte III, e de 459,3 minutos, para as cirurgias de porte IV. A média geral de intraoperatório das cirurgias eletivas foi de 176,4 minutos. Para as cirurgias de urgência/emergência, o tempo médio de intraoperatório para o porte I foi de 83 minutos, para o porte II, de 170,2 minutos; para o porte III, de 290,7 minutos, e para as de porte IV, 469,6 minutos. A média geral de intraoperatório obtida para as cirurgias de urgência/emergência foi de 154,6 minutos. No período de estudo, a clínica que mais realizou cirurgias eletivas foi a Ortopedia, com 453 (17,0%) cirurgias, e, em relação às cirurgias de urgência/emergência, o Pronto Socorro Cirúrgico foi a clínica com maior volume cirúrgico, 810 (25,9%). O tempo médio total de assistência para as cirurgias eletivas foi de 5,9 horas, sendo 2,5 horas para o porte I; 5,8 horas para as de porte II, 9,8 horas para as de porte III e 16,7 horas para as de porte IV. Para as cirurgias de urgência/emergência, o tempo médio de assistência de enfermagem, segundo o porte cirúrgico, foi de 5,2 horas, sendo 2,8 horas para o porte I; 5,7 horas para o porte II; 9,7 horas para o porte III, e 15,7 horas para o porte IV. Utilizando as equações propostas por Possari (2001), projetou-se o quadro total de funcionários da equipe de enfermagem para o período intraoperatório, que foi composto por 42 profissionais, assim distribuídos: 6 enfermeiros e 36 auxiliares/técnicos de enfermagem. Esse resultado indicou um equilíbrio entre o quadro de pessoal existente e o projetado pelo modelo utilizado. Recomenda-se, entretanto, que cada instituição e cada unidade de Centro Cirúrgico realize sua investigação de modo a obter um quantitativo de profissionais compatível com as demandas e na perspectiva da realidade institucional / Ensuring an adequate cadre of professionals for the objectives and purposes of the institution is a permanent challenge because qualified care processes are taken by reference. This study aimed to analyze the quantitative nursing staff of the Surgical Center of a teaching hospital in a city in the north of Paraná. This study uses a quantitative approach, of a cross- sectional, descriptive type like a study case. The population consisted of seven nurses, 16 technicians and 24 nursing assistants who met the inclusion criteria. The collecting period covers the period from August, 2011 to July, 2012 and the sources of data were the Human Resources Department, Bureau of Statistics and archive documentary unit. Interviews by using structured questionnaires were conducted for social demographic and professional characterization of the participants and the institution. For the calculation of the nursing staff of the Surgical Center, it was used the dimensional modeling developed by Possari (2001) based on the methodology of Gaidzinski (1998). The data collection was performed at first identifying intraoperative surgical time followed by the steps in the proposed method: classification of the kind of surgery, identification of the waiting time in the Surgical Center reception, the cleaning time of the operating room and the nursing care average time, establishing the percentage of each professional category, identification of the workday and identification of planned and unplanned absences of the nursing team. According to the number of surgeries performed, they were 5797. It means that 2666 were elective and 3131 were urgent or of emergency. In relation to the size of the surgery, the highest percentage of surgeries was size I with 43.4 % (2518), followed by size II with 38.3 % (2219), size III with 12.2 % (705) and size IV with 7.2 % (N415). The intraoperative for the elective surgery showed a time of 75.5 minutes for surgeries sized I, 175.2 minutes for surgeries of size II , 293.2 minutes for surgeries of size III and 459.3 minutes for the surgeries size IV . The intraoperative average time in elective surgery was 176.4 minutes. For urgent surgeries / emergencies, the intraoperative time for size I was 83.0 minutes, for size II, 170.2 minutes, 290.7 minutes for size III and 469.6 minutes for size IV. The intraoperative average time obtained for urgent surgeries / emergencies was 154.6 minutes. During the study, the clinic that more performed elective surgeries was the Orthopaedics with 453 (17.0%) and the Emergency Surgical Clinic also had a greate surgical volume, 810 (25.9%). The total assistance for elective surgery was 5.9 hours, 2.5 hours for size I, 5.8 hours for size II, 9.8 hours for the size III and 16.7 hours for size IV. For urgent surgeries / emergencies, the average nursing care according to the surgical duration was 5.2 hours, 2.8 hours for size I, 5.7 hours for size II, 9.7 hours for size III and 15.7 hours for size IV. By using the equations proposed by Possari (2001), it was designed the total nursing staff for the intraoperative period, which was composed of 42 professionals, distributed as follows: 6 nurses and 36 nursing technicians. This result indicated a balance between existing staff and the one designed by the model. However, it is recommended that each institution and each Surgical Center unit conduct their own research in order to get a quantitative of professional compatible with the demands and the prospect of their institutional reality

Para garantir a segurança dos pacientes e os resultados de qualidade da assistência faz-se necessário investir na melhoria da prática assistencial de enfermagem, uma vez que essa pode ser influenciada diretamente pela gestão organizacional. Um ambiente de trabalho favorável deve levar em consideração vários fatores, entre os quais, a complexidade dos pacientes, carga de trabalho e composição qualiquantitativa dos profissionais de enfermagem. A identificação de fatores individuais e sistêmicos em ambientes de cuidados, particularmente naqueles de alta complexidade, como as Unidades de Terapia Intensiva (UTI), podem beneficiar a prática profissional do enfermeiro e de sua equipe, bem como subsidiar a implantação de ações que contribuam para o alcance de padrões de qualidade nos indicadores relacionados à assistência ao paciente. O objetivo desse estudo foi caracterizar os ambientes de prática profissional, a carga de trabalho e a omissão de cuidados de enfermagem segundo a percepção dos enfermeiros. Trata-se de um estudo descritivo, de corte transversal, realizado em três UTI\'s de grande porte de uma cidade do interior do Estado de São Paulo. A população foi constituída pelos enfermeiros lotados nessas unidades, envolvidos na assistência direta ao paciente, com tempo de experiência profissional na instituição superior a três meses e presentes na unidade no período de realização do estudo entre dezembro de 2017 a março de 2018. A coleta de dados foi feita por meio da aplicação dos instrumentos autoaplicáveis de caracterização pessoal e profissional, do PRACTICE ENVIRONMENT SCALE (PES) - versão brasileira e do MISSCARE-BRASIL. Utilizou-se estatística descritiva para análise e tratamento dos dados e os testes de Wilcoxon e exato de Fischer para testar associação entre variáveis. Participaram do estudo 29 enfermeiros, sendo a maioria do sexo feminino, com média de 35,5 anos de idade, 8,6 anos na função e 4,5 anos de experiência em terapia intensiva. A carga horária semanal desses profissionais foi em média de 34,4 horas, tendo trabalhado ainda 36,4 horas extras, em média, nos últimos 3 meses. A carga de trabalho medida pelo NAS variou de 64,76 a 89,98 pontos e tempo de assistência requerida pelos pacientes foi de 15,5 a 21,5 horas. Em relação ao ambiente de trabalho, as UTI\'s 1 e 3 foram consideradas ambientes mistos e a UTI 2, ambiente favorável a prática profissional, com melhores pontuações nas subescalas \"Relações colegiais entre médicos e enfermeiros\" nas UTI\'s 1 e 3 e \"Habilidade, liderança e suporte dos coordenadores/supervisores de enfermagem aos enfermeiros/equipe de enfermagem\" na UTI 2. No tocante a omissão de cuidados de enfermagem segundo a percepção dos enfermeiros participantes, aquele mais relatado nas três unidades foi \"Deambulação três vezes ao dia ou conforme prescrito\", sendo que o motivo \"Número inadequado de pessoal\" predominou nas UTI\'s 1 e 3. As maiores razões para a não realização de cuidados estiveram relacionadas aos recursos de \"Gerenciamento e liderança\" na UTI 1 e \"Recursos Laborais\" nas UTI 2 e 3. Os resultados relativos aos testes de associação evidenciaram que apenas a relação de pacientes atendidos por turno se mostrou estatisticamente significante ao ambiente de trabalho. Entretanto, os enfermeiros do ambiente favorável não relataram intenção de deixar o cargo, estando mais satisfeitos com o trabalho em equipe e em ser enfermeiro da sua unidade. O estudo possibilitou identificar elementos do ambiente de trabalho em terapia intensiva favoráveis à prática profissional e os pontos de enfrentamento passíveis de mudanças que demandam uma análise criteriosa por parte dos gestores de enfermagem, a fim de garantir o desenvolvimento de uma assistência com qualidade e segurança / In order to ensure patient safety and quality of care results, it is necessary to invest on improvements in nursing care practice, which can be directly influenced by management. To achieve a favorable work environment a few factor should be taken into account, such as patient complexity, workload, and qualitative and quantitative composition of nursing professionals. The identification of individual and systemic factors in care environments, particularly in those with high complexity, such as Intensive Care Units (ICU\'s), can benefit the professional practice of the nurses and their staff, as well as subsidize the implementation of actions that contribute to the achievement of quality standards in the indicators related to patient care. The objective of this study was to characterize the professional practice environments, the workload, and the omission of nursing care according to the nurses\' perception. This is a cross-sectional descriptive study performed in three large ICU\'s of a city in the interior of the State of São Paulo, Brazil. The population was composed of nurses filled in these units, involved in direct patient care, with professional experience in the institution over three months, and present at the unit during the study period between December 2017 to March 2018. The data collection was done through the application of the personal and professional self-applying tools of PRACTICE ENVIRONMENT SCALE (PES) - Brazilian version and MISSCARE-BRASIL. Descriptive statistics were used for data analysis and treatment, and the Wilcoxon and Fischer exact tests were used to test association between variables. Twenty-nine nurses participated in the study, the majority being female, with a mean 35.5 years of age, 8.6 years in function, and 4.5 years of experience in intensive care. The weekly workload of these professionals averaged 34.4 hours, and they also have worked an extra 36.4 hours on average in the last 3 months. The workload measured by the NAS ranged from 64.76 to 89.98 points, and the care time assistance required by the patients was 15.5 to 21.5 hours. Regarding the work environment, ICU\'s 1 and 3 were considered as mixed environments, and ICU 2 as a favorable environment for professional practice, with better scores in the subscales \"Collegial relations between doctors and nurses\" in ICUs 1 and 3 and \"Ability, leadership and support of coordinators / supervisors to the nurses / nursing team\" in the ICU 2. Regarding the omission of nursing care according to the perception of the nurses, the one most reported in the three units was \"Ambulation three times a day or as prescribed\", with the reason \"Inadequate number of personnel\" predominant in ICU\'s 1 and 3. The major reasons for not performing care were related to the \"Management and leadership\" resources in ICU 1 and \"Labor Resources\" in the ICU\'s 2 and 3. The results related to the association tests showed that only the \'\'ratio of patients seen per shift\'\' was statistically significant to the work environment. However, the nurses of the favorable environment did not report intention to leave the position, being more satisfied with teamwork and being a nurse in their unit. The study made it possible to identify elements of the work environment in intensive care favorable to professional practice and the points of confrontation that can be changed, which require a careful analysis by the nursing managers, in order to ensure the development of patient safety and quality of assistance

Face aux normes actuelles et futures de plus en plus draconiennes en termes d’émissions polluantes, les constructeurs automobiles cherchent en permanence à améliorer le rendement des moteurs à allumage commandé. L’une des voies efficaces et applicables à court terme pour réduire les émissions de dioxyde de carbone (CO2) consiste à réduire la cylindrée des moteurs tout en conservant leur performance grâce à la sur-alimentation : c’est l’approche de l’éco-suralimentation ou « downsizing ». L’une des particularités de ce mode de fonctionnement est le fort niveau de pression et de taux de dilution dans lequel se propage la flamme de prémélange. La simulation de la combustion turbulente de prémélange est devenue un outil incontournable pour la R&D. Toutefois, les hypothèses sur lesquelles reposent les modèles de combustion, tout particulièrement le modèle de flammelettes, peuvent être sujettes à discussion dans le cas d’un fonctionnement de type « downsizing ». Le but de ce travail de thèse est donc d’étudier expérimentalement les régimes de combustion de manière à valider ou non l’utilisation de ces modèles. Les grandeurs caractéristiques de la turbulence ont alors été caractérisées lors de la phase de compres-sion pour différentes pressions d’admission à l’aide de la vélocimétrie par imagerie de particules. La vitesse de combustion de laminaire a, quant à elle, été estimée à partir d’un mécanisme cinétique réduit. L’utilisation de la tomographie laser par diffusion de Mie avec et sans suivi temporel, nous a permis de caractériser la vitesse de combustion turbulente et la structure du front de flamme pour différentes pressions d’admission et différents taux de dilution. Lors de cette étude, nous avons ainsi pu mettre en évidence une cassure dans l’évolution de la PMI et de la vitesse de combustion turbulente à partir d’un taux de dilution de 25% : cette cassure a été reliée à la transition entre le régime de flammelette et le régime des flammes plissées épaissies. / Faced with the current and future more and more drastic standards for pollutant emissions, car manufacturers try to improve the efficiency of Spark Ignition engine. One effective and applicable ways to reduce the greenhouse emissions (CO2) in the short run is based on the reduction of the engine size while preserving their performance thank to turbocharging: eco-supercharging or « downsizing » approaches. One of the characteristics of this operating mode is the high level of the pressure and of the dilution rate of the medium in which the premixed flame propagates. The simulation of turbulent premixed flame is nowadays an indispensable tool for R&D. However, the assumptions on which the combustion models are based, particularly the flamelet model, can be prone to discussion in the « downsizing » conditions. The objective of this work is thus to study experimentally the combustion regimes in order to validate or not the use of these models. Turbulence parameters and flow fields were then characterized out during the compression stroke for several intake pressures by using Particle Imaging Velocimetry technique. The laminar burning velocity was estimated by using reduced chemical kinetic schemes. The Mie scattering laser tomography technique with and without temporal follow-up, enabled us to characterize the turbulent burning velocity and the flame front structure for different intake pressures and dilution rates. In this study, a break in the evolution of the IMEP and the turbulent burning velocity for a dilution rate of 25% has been obtained: this break was linked to the transition between the flamelet zone and the distributed reaction zones.