Tikslas: Remiantis slapto paciento metodika ištirti galimybę įsigyti antibiotikus Lietuvos visuomenės vaistinėse be recepto ir įvertinti pacientui suteikiamą informaciją konsultacijos metu. Uždaviniai: 1. Nustatyti galimybę įsigyti antibiotikus be recepto Lietuvos visuomenės vaistinėse. 2. Palyginti antibiotikų išdavimą be recepto slaptam pacientui simuliuojant alerginio rinito ir peršalimo simptomus. 3. Įvertinti pacientui suteikiamą informaciją, kai antibiotikai išduodami be recepto. 4. Išanalizuoti pacientui pateikiamą informaciją, kai antibiotikai be recepto neišduodami. Metodika: Tyrimui naudota slapto paciento metodika. Tyrimas vykdytas nuo 2011 m. rugsėjo iki 2012 m. birželio mėn. Tyrimo metu aplankyta 264 Lietuvos visuomenės vaistinės 4 Lietuvos miestuose: Vilniuje, Kaune, Panevėžyje ir Alytuje. Tyrimo metu buvo pateikti du skirtingi scenarijai: vaistinėje buvo simuliuojamos peršalimo ir alerginio rinito simptomai. Surinkta informacija buvo žymima tyrimo formoje. Duomenys analizuoti statistine programa SPSS 17.00. Rezultatai: 8 proc. (p<0,001) iš aplankytų vaistinių išdavė antibiotikus be recepto. Antibiotikai dažniau buvo išduoti simuliuojant peršalimo simptomus – 10 proc. ir rečiau simuliuojant alerginio rinito simptomatiką - 5 proc. Daugiau nei pusė farmacijos specialistų (57 proc.), kurie atsisakė išduoti antibiotikus, tęsė bendravimą su pacientais. 45 proc. farmacijos specialistų, atsisakiusių išduoti antibiotikus, kaip priežastį, nurodė sveikatos įstatymą, 17... [toliau žr. visą tekstą] / Aim: To explore availability of antibiotics without prescription in Lithuanian community pharmacies and to evaluate the provision of appropriate health information. Tasks: 1. To identify potential to obtain antibiotics without prescription in community pharmacies 2. Compare antibiotics issuing when cold and allergy rhinitis are simulating. 3. To evaluate information for patient when antibiotics are issued. 4. To estimate information for patient when antibiotics are not issued. Methodology: A research was developed based on the methodology of secret patient. Total 264 pharmacies in 4 different Lithuanian cities were visited. Study was performed from September 2011 through June 2012. Two different cases were presented at pharmacies. The secret patient tried to buy amoxicillin without providing a prescription for cold symptoms and for allergy rhinitis symptoms. The reason for dispensing or refusing to dispense antibiotics was recorded in standardized visit form. Data were entered and analyzed with the SPSS Statistics 17.0 package. Results: Antibiotics were dispensed in 8 % (p<0,001) of visited pharmacies. They were obtained from 10% of pharmacies when cold was simulated and from 5% of pharmacies when allergic rhinitis was simulated. More than half pharmacy specialists (57 %), that refused to sell antibiotics without prescription continued consultation. 45 % of visited pharmacy specialists refused to dispense antibiotics because of health law. Pharmacy specialists from 17 % of... [to full text]

The two longitudinal case studies that make up this dissertation sought to explain and predict the relationship between usability and clinician acceptance of a health information system. The overall aim of the research study was to determine what role usability plays in the acceptance or rejection of systems used by clinicians in a healthcare context. The focus was on the end users (the clinicians) rather than the views of the system designers and managers responsible for implementation and the clients of the clinicians. A mixed methods approach was adopted that drew on both qualitative and quantitative research methods. This study followed the implementation of a community health information system from early beginnings to its established practice. Users were drawn from different health service departments with distinctly different organisational cultures and attitudes to information and communication technology used in this context. This study provided evidence that a usability analysis in this context would not necessarily be valid when the users have prior reservations on acceptance. Investigation was made on the initial training and post-implementation support together with a study on the nature of the clinicians to determine factors that may influence their attitude. This research identified that acceptance of a system is not necessarily a measure of its quality, capability and usability, is influenced by the user’s attitude which is determined by outside factors, and the nature and quality of training. The need to recognise the limitations of the current methodologies for analysing usability and acceptance was explored to lay the foundations for further research.

The internet has radically changed the way people obtain and interact with information about diseases, treatments, and conditions. Yet, our understanding of how people access and use health information to make decisions- in other words, their health literacy- has not progressed. The overall aim of this thesis is to assess the extent to which health literacy is a valid and useful construct for policy and practice related to online health resources. A mixed-methods research programme of five studies was undertaken, influenced by realist evaluation methodology. First, to ascertain engagement with user-generated online health content (UGC) in the UK, analysis of a large European survey was undertaken. Then, the uncertainty regarding the relationship between health literacy and outcomes was addressed by a systematic review and qualitative analysis of health literacy measures. Results of these two studies informed interviews carried out with 13 'key informants': policymakers and primary care clinicians in the UK with a particular interest in health literacy and/or online information. A systematic review, incorporating a traditional narrative review and a realist review, evaluated existing trials addressing how effects of online resources vary by health literacy level. Finally, data were analysed from a feasibility randomized controlled trial, comparing usage and outcomes of accessing a 'personal experiences'-based asthma website (representing curated user-generated content) versus a 'facts and figures'-based website. Participant health literacy was assessed using an index identified from the systematic review of measures, and website usage was tracked. Approximately 25% of UK internet users engage with UGC at least monthly. The most frequent users were younger, more likely to be male, and to be carers for someone with a long-term illness. Three themes were identified from health literacy measurement: 'appropriate health decisions', 'ability to obtain healthcare services', and 'confidence'. Key informants noted the lack of clarity about how health literacy influences outcomes, and suggested that personal preferences and digital access and skills may be more relevant than health literacy for policy and practice. Existing trials of online resources in which participant health literacy was measured were mostly at high risk of bias; some possible explanations of how these interventions should work in people with low health literacy were that they may experience higher data entry burden related to chronic diseases, and that they may prefer simulated face-to-face communication. Finally, there were no differences between health literacy groups in the feasibility trial regarding usage or outcomes related to either the 'facts and figures' or 'personal experiences' websites. Taken together, these results question the validity and appropriateness of health literacy as a key objective or consideration in the development or use of online resources. While health literacy has value as a general idea, this thesis demonstrates that it may no longer be the right construct to guide intervention development and implementation to improve health outcomes.

The purpose of this study was to show how information from the District Health Information System can be used to empower managers to make evidence-based decisions that will strengthen the health care system to reduce the under-five mortality rate. A quantitative, contextual, exploratory evaluative and descriptive approach was followed and a data extraction framework, based on systems theory, was developed to guide the process of extracting existing routine data. A results-based approach was used to measure under-five mortality related health care in terms of impact, outcomes, outputs, processes and inputs. The study has highlighted that proxy indicators obtained this way places health care managers in the position to monitor progress towards achieving the Millennium Development Goal for child mortality in the interim periods between large population surveys. The findings displayed in the diagnostic performance profile revealed that drastic interventions are required to reduce the under-five mortality rate. / Health Studies / M.A. (Health Studies)

Made available in DSpace on 2016-06-02T19:16:40Z (GMT). No. of bitstreams: 1 6199.pdf: 1873408 bytes, checksum: 91c82661db981c18431a3551dfae86a1 (MD5) Previous issue date: 2014-02-24 / Financiadora de Estudos e Projetos / Scientific and technological advances bring individual and collective psychosocial implications. Thus, the inclusion of the elderly in the context of development of new technologies of information and communication is needed. The present study investigated whether participants do searches about health on the internet and how these searches influence the life quality of the elderly, relating the reported diseases, considering the CTS field perspective and the area of gerontology. In this sense, the aim of this study was to analyze the access and use of health information through a technological resource, by a group of elderly people from a program of digital inclusion, in this case the Programa de Inclusão Digital (PID) of the Fundação Educacional de São Carlos (FESC) which is a government entity created to develop and promote educational programs for all ages. The study was conducted in seven steps, been the data collection divided into three phases. In the first phase of data collection, after the approval of the Committee of research ethics, an invitation to participants was done, having attended 19 elderly people, 8 male and 11 female on which they answered a semistructured questionnaire. For the second stage 8 elderly people participated in a directed study, in which issues of access to health information through the internet were addressed. In the third phase the data collection was done through a focus group divided into 2 men and 4 women. The main results show that the average age of the elderly is 67 years old, with college degree and earning up to three minimum wages, from the participants only 1 doesn t have a computer with internet access at home and those who own do searches for information and news. The study also shows that the participants of the third stage believe that the search for health information on the internet is important and influences their life quality. / Os avanços científicos e tecnológicos trazem implicações psicossociais individuais e coletivas. Com isso, se faz necessário a inserção das pessoas idosas no contexto de desenvolvimento das novas tecnologias da informação e comunicação. O presente estudo buscou investigar se os participantes fazem buscas sobre saúde na internet e como estas buscas influenciam na qualidade de vida da pessoa idosa, relacionando as doenças que os mesmos relataram ter, considerando a perspectiva do campo CTS e abrangendo a área da gerontologia. Neste sentido, o objetivo deste estudo foi analisar o acesso e uso de informação em saúde através de um recurso tecnológico, por um grupo de pessoas idosas de um programa de inclusão digital, neste caso o Programa de Inclusão Digital (PID) da Fundação Educacional de São Carlos (FESC) que é uma entidade governamental criada para promover e desenvolver questões de ordem educacional para todas as idades. O estudo foi desenvolvido em sete etapas, sendo a coleta de dados subdividida em três fases. Na primeira fase de coleta de dados, após aprovação do Comitê de Ética em Pesquisa, foi feito o convite aos participantes, comparecendo 19 pessoas idosas, sendo 8 do sexo masculino e 11 do sexo feminino, tendo respondido a um questionário semiestruturado. Para a segunda fase 8 pessoas idosas participaram de um estudo dirigido, no qual foram abordadas questões sobre o acesso à informação em saúde através da internet. Na terceira fase a coleta de dados foi realizada por grupo focal, divididos em 2 homens e 4 mulheres. Os principais resultados apontam que a idade média dos idosos é de 67 anos, com nível superior completo e renda de até três salários mínimos em sua maioria as pessoas idosas participantes não fazem busca de informação sobre saúde na internet mas consideram importante saber fazer e que essa busca influencia na qualidade de vida dos mesmos.

Made available in DSpace on 2014-12-17T14:55:40Z (GMT). No. of bitstreams: 1 WilmaMCM.pdf: 1186058 bytes, checksum: 6e290882faed8cfbcd44afc878b5d7b0 (MD5) Previous issue date: 2009-04-24 / The sharing of knowledge and integration of data is one of the biggest challenges in health and essential contribution to improve the quality of health care. Since the same person receives care in various health facilities throughout his/her live, that information is distributed in different information systems which run on platforms of heterogeneous hardware and software. This paper proposes a System of Health Information Based on Ontologies (SISOnt) for knowledge sharing and integration of data on health, which allows to infer new information from the heterogeneous databases and knowledge base. For this purpose it was created three ontologies represented by the patterns and concepts proposed by the Semantic Web. The first ontology provides a representation of the concepts of diseases Secretariat of Health Surveillance (SVS) and the others are related to the representation of the concepts of databases of Health Information Systems (SIS), specifically the Information System of Notification of Diseases (SINAN) and the Information System on Mortality (SIM) / O compartilhamento de conhecimentos e integra??o de dados ? um dos maiores desafios da ?rea da sa?de e essencial para contribui??o de melhoria da qualidade da assist?ncia em sa?de. Uma vez que a mesma pessoa recebe atendimento em diversas institui??es de sa?de ao longo de sua vida, suas informa??es ficam distribu?das em diferentes sistemas de informa??o que s?o executados em plataformas de hardware e software heterog?neas. Este trabalho prop?e um Sistema de Informa??o em Sa?de Baseado em Ontologias (SISOnt) para compartilhamento de conhecimento e integra??o de dados em sa?de, que permite inferir novas informa??es a partir de bases de dados e da base de conhecimento. Para esse fim foram criadas tr?s ontologias representadas atrav?s dos padr?es e conceitos propostos pela Web Sem?ntica. A primeira ontologia prov? a representa??o dos conceitos de agravos da Secretaria de Vigil?ncia em Sa?de (SVS) e as demais est?o relacionadas ? representa??o dos conceitos das bases de dados dos Sistemas de Informa??o em Sa?de (SIS), especificamente do Sistema de Informa??o de Agravos de Notifica??o (SINAN) e do Sistema de Informa??es sobre Mortalidade (SIM)

Submitted by Jean Medeiros (jeanletras@uepb.edu.br) on 2017-07-17T11:52:47Z No. of bitstreams: 1 PDF - Júlia Cibelle Freire de Queiroz Arnaud.pdf: 23071946 bytes, checksum: 1107c01b26b40906b0869fa7c2cee053 (MD5) / Approved for entry into archive by Secta BC (secta.csu.bc@uepb.edu.br) on 2017-07-20T12:23:22Z (GMT) No. of bitstreams: 1 PDF - Júlia Cibelle Freire de Queiroz Arnaud.pdf: 23071946 bytes, checksum: 1107c01b26b40906b0869fa7c2cee053 (MD5) / Made available in DSpace on 2017-07-20T12:23:22Z (GMT). No. of bitstreams: 1 PDF - Júlia Cibelle Freire de Queiroz Arnaud.pdf: 23071946 bytes, checksum: 1107c01b26b40906b0869fa7c2cee053 (MD5) Previous issue date: 2017-03-31 / The number of health information systems is increasing in quantity and complexity, and their quality is essential to improve the quality of the services delivered to the population. Normally, the development of medical device software presents requirements that normally are not addressed by the traditional software development of non-safety critical industry. In this sense, projects of health information systems start to face new challenges imposed by regulators, society and suppliers since they start to interact with medical devices, personal health devices and diagnostic solutions. Requirements engineering processes are very important for the reduction of the involved risks in the development of these systems. Most agile processes used by several companies, although following well established activities for software development, have some gaps in the requirements engineering activities, turning the way in which requirements are developed in the context for health often incomplete. Health system development should be supported by an appropriate requirements engineering process, which in addition to guiding the development process, also fits in the treatment of specific requirements that these software products need. This work proposes the definition of a requirements engineering process that enables the development and management of requirements in a traceable way, while at the same time aligning with the agile development process. The process defines activities, inputs, outputs and guidelines that, in an integrated way and guides the requirements engineering in an effective way. Finally, an experimental study is presented in the context of health information systems to evaluate the viability of the proposed process. / O número de sistemas de informação em saúde está aumentando em quantidade e complexidade, e sua qualidade é essencial para melhorar a qualidade dos serviços prestados à população. O desenvolvimento de software para dispositivo médico apresenta requisitos que normalmente não são abordados pelo desenvolvimento de software tradicional. Neste sentido, os projetos de sistemas de informação de saúde começam a enfrentar novos desafios impostos pelos reguladores, sociedade e fornecedores, uma vez que começam a interagir com os dispositivos médicos, dispositivos pessoais de saúde e soluções de diagnóstico. Os processos de engenharia de requisitos são muito importantes para a redução dos riscos envolvidos no desenvolvimento destes sistemas. Muitos dos processos ágeis utilizados por várias empresas, apesar de seguir um ciclo de atividades para o desenvolvimento do software, apresentam algumas lacunas nas atividades da engenharia de requisitos, tornando a forma com que os requisitos são desenvolvidos no contexto para saúde muitas vezes incompleta. O desenvolvimento de sistemas na área da saúde deve ser apoiado por um processo de engenharia de requisitos apropriado, que além de guiar processo de desenvolvimento, também se encaixe no tratamento de requisitos específicos que estes produtos de software necessitam. Este trabalho propõe a definição de um processo de engenharia de requisitos que possibilite o desenvolvimento e gerenciamento dos requisitos de maneira rastreável, ao mesmo tempo que se alinha ao processo de desenvolvimento ágil. O processo define atividades, entradas, saídas e diretrizes que de forma integrada, orientam a engenharia de requisitos de maneira eficaz. Finalmente é apresentado um estudo experimental no contexto de sistemas de informação em saúde para avaliar a viabilidade do processo proposto.

Esta pesquisa investigou o emprego da informação no sistema de trabalho das Equipes Saúde da Família (EqSF), nas Unidades Básicas de Saúde (UBS), visando identificar que fatores interferem no emprego da informação em um ambiente de alta complexidade, de difícil controle e descentralizado. Para responder essa questão, foram identificados o processo de tratamento e o uso das informações. Tem como objetivo também compreender a discrepância entre a intenção do uso e o uso efetivo das informações e suas causas. Foi utilizado o método de estudo de casos múltiplos e, para isso, foram estudadas sete EqSF que fazem parte de três UBS, gerenciadas por uma Organização Social (OS), a Fundação da Faculdade de Medicina da USP, na região oeste do município de São Paulo. As EqSF são grupos multiprofissionais que promovem a atenção básica e a prevenção à saúde para os pacientes de determinado território. Buscou-se compreender como, nesse contexto, são feitos a captura, o registro, a disponibilização e o emprego das informações, já que elas são recursos relevantes para a produção de serviço desses profissionais e são coletadas tanto no domicílio do paciente quanto na UBS. Para realizar o atendimento dentro dos níveis de qualidade previsto pela OS e Secretaria Municipal de Saúde (SMS), os profissionais criam diversos sistemas de informação paralelos (cadernos, planilhas, etc.) de uso individual, uma vez que os sistemas eletrônicos da SMS e do Ministério da Saúde não atendem suas necessidades e as informações que contém nem sempre são usadas. Isso acontece devido ao não alinhamento entre os sistemas de informação e a infraestrutura disponível (BOSTROM; HEINEN, 1997a), requisito que é superado por meio de esforços individuais e coletivos. Essa situação corrobora as considerações de DeLone e McLean (1992, 2002, 2003) que afirmam haver uma relação entre o uso da informação e a satisfação do usuário com a qualidade do sistema, a qualidade da informação e a qualidade do serviço informacional. Os profissionais costumam memorizar dados para registro posterior, possibilitando redundância, erros e perdas de detalhes. As informações são registradas de acordo com o interesse do profissional e não há um sistema estruturado para a consolidação das informações. / This research investigated the use of information in the work of the Family Health Teams (EqSF), the Basic Health Units (UBS), to identify factors that interfere with the use of information in an environment of high complexity, difficult to control and decentralized. To answer this question, it was identified the treatment process and use information. It aims also to understand the discrepancy between the intended use and effective use of information and its causes. We used the method of multiple case study and, therefore, we studied seven EqSF three that are part of UBS, managed by a Social Organization (OS), the Foundation of the Faculty of Medicine, USP, in the western region of São Paulo. The EqSF are multidisciplinary groups that promote primary and preventive health care for patients of the territory. We sought to understand how, in this context, are made to capture, registration, delivery and use of information resources as they are relevant to the production of professional service and are collected in both the patient\'s home and in UBS. To perform the service within the quality standards set by the OS and the Municipal Health Secretariat (SMS), professionals create several parallel information systems (notebooks, spreadsheets, etc.). Individual use, since the electronic systems of SMS and Ministry of Health did not meet their needs and the information it contains are not always used. This is due to non-alignment between information systems and infrastructure available (BOSTROM; HEINEN, 1997a), a requirement which is overcome through individual and collective efforts. This situation confirms the considerations of Delone and McLean (1992, 2002, 2003) who claim to be a relationship between information use and user satisfaction with system quality, information quality and service quality of information. Professionals tend to store data backlog, enabling redundancy, errors and loss of detail. Information is recorded according to the interest of professional and there is no structured system for the consolidation of information.

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2015-10-08T15:33:17Z No. of bitstreams: 2 Dissertação - Raphael Brandão Pereira - 2014.pdf: 5605844 bytes, checksum: 196cfb8206d12ce4391303dcba120f92 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2015-10-08T15:37:31Z (GMT) No. of bitstreams: 2 Dissertação - Raphael Brandão Pereira - 2014.pdf: 5605844 bytes, checksum: 196cfb8206d12ce4391303dcba120f92 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2015-10-08T15:37:31Z (GMT). No. of bitstreams: 2 Dissertação - Raphael Brandão Pereira - 2014.pdf: 5605844 bytes, checksum: 196cfb8206d12ce4391303dcba120f92 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2014-09-29 / The information and communication technologies havebeen increasingly incorporated to nursing practices, to support the use and the record of nursing process, demanding the monitoring of its results achieved and intervenient factors on a continuous basis. The present study had the objective of providing an analysis of record of nursing process supported by communication and information technologies and the intervenient factors intervenient factors in the nurses’ perception. It is a study of a single integrated case, carried out at the neonatal intensive care unit of a university hospital, located at the Midwest region of the country, from January to April 2014. The new technologies consisted of a data collection/nursing development protocol, specific for a neonatal intensive care unit, and the use of support software to the diagnostic steps, health care planning (target, objective and prescription statements), implementation and evaluation. The data collection was held through the application of a questionnaire and data collected from nurses’ records at patients’ medical files. The study integrated unit consisted of seven nurses, who worked in the section before (from September to November 2010) and after (from September to November 2012) the implementation of the communication and information technologies to support the use and record of the nursing process. The level of application of the nursing process (NAPE) was classified from 1 to 5, according to its accuracy. The records number in each stage of the nursing process was calculated for each day of nursing attendance during the study period. The quantitative data was analyzed through descriptive statistics. The nurses’ statements on intervenient factors were analyzed using the Donabedian health assessment model (1984). There was an increase of records units by nursing service delivery days (UR/DAY), during data collection stages from 55.2 UR/DAE to 80.4% UR/DAE, new nursing diagnostic records to 0.3 UR/DAE, of targets and objectives (1.0 UR/DAE), and of nursing evaluation (0.2 UR/DAE). The stage of nursing prescription had a decrease from 2.1 UR/DAE to 1.9% UR/DAE and the implementation from 4.4 UR/DAE to 3.1 UR/DAE. It was possible to identify the record of more stages of the nursing process if compared with the period before the new technologies started to be used. Nevertheless this increase was not so significant. Among the intervenient factors, time availability was considered enough for the nursing process (PE) application, and besides that, the record remained incipient. Nurses that reported receiving satisfactory or very satisfactory training on the PE or on the use of new communication and information technologies, also reported more stages of the PE. Considering the strategic relevance of adequate record of nursing service delivery and of the legal and ethical requirement of the nursing process, even small improvements may be relevant. However, in general, it is possible to conclude that the insertion of new technologies associated to the training process did not have a significant impact in the stages of the nursing process at the context of the study. / Tecnologias de comunicação e informação de diferentes tipos estão sendo empregadas na enfermagem para apoiar o uso e o registro do processo de enfermagem, gerando a necessidade de análise contínua dos resultados alcançados e dos fatores intervenientes. Esse estudo teve como objetivo analisar o registro do processo de enfermagem apoiado por tecnologias de informação e comunicação e os fatores intervenientes na percepção dos enfermeiros. Trata-se de um estudo de caso único integrado, realizado na UTI neonatal de um hospital de ensino da região centro-oeste do Brasil, de janeiro a abril de 2014. As novas tecnologias consistiram em um protocolo de coleta de dados/evolução de enfermagem, específico para o cenário de UTI neonatal, e um software de apoio ao uso das etapas de diagnóstico, planejamento (declaração de metas, objetivos, prescrições) e implementação e avaliação da assistência. Realizou-se coleta de dados mediante aplicação de questionário e extração de dados das anotações das enfermeiras nos prontuários. As unidades integradas do estudo de caso foram sete enfermeiras, que atuaram no setor antes (setembro a novembro de 2010) e após (setembro a novembro de 2012) a implantação das novas tecnologias de informação e comunicação para apoio ao uso e registro do processo de enfermagem. O nível de aplicação do processo de enfermagem (NAPE) foi classificado de 1 até 5, de acordo com sua completude. O número de registros de cada etapa do processo de enfermagem foi calculado para cada dia de atendimento de enfermagem no período estudado. Os dados quantitativos foram analisados por meio de estatística descritiva. Os depoimentos dos enfermeiros sobre os fatores intervenientes foram analisados à luz do modelo de avaliação em saúde de Donabedian (1984). Verificou-se aumento das unidades de registro por dias de atendimento de enfermagem (UR/DIA) na etapa de coleta de dados de 55,2 UR/DAE para 80,4 UR/DAE, surgimento de registros de diagnóstico de enfermagem para 0,3 UR/DAE, das metas e objetivos (1,0 UR/DAE), e da avaliação de enfermagem (0,2 UR/DAE). A etapa de prescrições de enfermagem apresentou diminuição de 2,1 UR/DAE para 1,9UR/DAE e a implementação de 4,4 UR/DAE para 3,1 UR/DAE. Verificou-se o registro de mais etapas do processo de enfermagem em comparação com o período em que as novas tecnologias não eram utilizadas. Contudo esse incremento foi pouco expressivo. Entre os fatores intervenientes, disponibilidade do tempo foi considerada suficiente para aplicação do PE e apesar disso,o registro permaneceu incipiente. Enfermeiras que relataram ter recebido capacitaçãosatisfatória ou muito satisfatória em PE e no uso das novas tecnologias de comunicação e informação registraram mais etapas do PE.Tendo em vista a importância estratégica do registro adequado do atendimento de enfermagem e da exigência ético legal do uso do processo de enfermagem, pequenos avanços podem ser relevantes, contudo, de modo geral, conclui-se que a inserção das novas tecnologias associada ao processo de capacitação não obteve impacto expressivo no registro das etapas do processo de enfermagem no cenário estudado.

Neste trabalho é apresentada a implantação de um servidor de imagens médicas com a implementação e integração de módulos para recuperação textual e baseada em conteúdo para o Serviço de Radiodiagnóstico do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto (HCFMRP) da Universidade de São Paulo (USP). O sistema permite a aquisição, gerenciamento, armazenamento e disponibilização das informações dos pacientes, seus exames, laudos e imagens através da internet. Os exames radiológicos e suas respectivas imagens podem ser recuperados por informações textuais ou por similaridade do conteúdo pictório das imagens. As imagens utilizadas são de ressonância magnética nuclear e tomografia computadorizada e são geradas no padrão DICOM 3.0. O sistema foi desenvolvido contemplando tecnologias para Web com interfaces amigáveis para recuperação das informações. Ele é composto por três módulos integrados, sendo o servidor de imagens, o módulo de consulta textual e o módulo de consulta por similaridade. Os resultados apresentados indicam que as imagens são gerenciadas e armazenadas corretamente, bem como o tempo de retorno das imagens é clinicamente satisfatório, tanto para a consulta textual como para a consulta por similaridade. As avaliações da recuperação por similaridade apresentam que o extrator escolhido pode ser considerado relevante para separar as imagens por região anatômica. / This work introduces an the development of a server of medical images with the implementation and integration of modules to query/retrieve text information and content-based to Radiology Service of Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto (HCFMRP) at Universidade de São Paulo (USP). The system allows the acquisition, management, archiving and availability of the patients information, theirs exams, results and images through of internet. The radiological exams and theirs respectives images can be retrieved by text information or similarity of pictorial content of images. Images are from magnetic resonance nuclear and computadorized tomography and are given using DICOM 3.0 protocol. The system has been developed considering web technologies with friendly interfaces to retrieval of information. It is composed by three integrated modules: the image server module, the query text module and query by similarity module. Results show that images are managed and archived exactly, retrieval time of images is clinically satisfactory, considering both the text query as well as the query by similarity. The evaluation of the retrieval by similarity shows the chosen extractor can be considerated relevant to separate the images by anatomic region.