Les dispositifs de santé en France et dans le monde sont en tension. Les déterminants de ces pressions sont en lien avec la démographie des professions, l’économie et l’organisation des soins. Les pathologies chroniques non infectieuses sont en recrudescence. La maladie allergique est emblématique de ces pathologies. Elle concerne 25% d’individus en France (15 millions de personnes). En Europe, 100 millions de personnes souffrent de rhinites allergiques et 70 millions souffrent d’asthme. A l’horizon 2020, c’est 40% de la population mondiale qui sera atteinte d’une maladie allergique. La déclaration de RIO, texte fondateur du développement durable, place la santé comme une préoccupation majeure. Face à ce constat, il est nécessaire de repenser les modes de prise en charge, par des modèles innovants, de nouvelles formations et une répartition des compétences différente à partir de nouveaux périmètres de métier de la santé. L’objectif général de ce travail est d’identifier des modèles novateurs en santé dans une vision pluridisciplinaire systémique et éthique des soins. Les objectifs secondaires sont : définir le concept des pratiques innovantes en santé dans le système de santé français, préciser le cadre réglementaire des pratiques innovantes, déterminer les besoins de formation, la qualification, les nouveaux métiers et nouveaux outils, enfin, l’adéquation de la formation aux déterminants générationnels des étudiants des Sciences de la Santé. La méthode utilisée est une revue de la littérature portant sur le développement durable, la médecine environnementale, la formation des professions de santé. La confrontation au cadre réglementaire de la pratique infirmière à celui d’infirmier de pratiques avancées est réalisée. Le modèle d’étude est l’allergologie. Une enquête par questionnaire en ligne a évalué le niveau de compétences, de formation et de régulation des infirmières spécialisées en Europe. Cette étude a été réalisée en collaboration européenne avec le département de la Haute Ecole de Namur, l’Université de Nottingham, la Haute Ecole de Santé de Fribourg, l’Université de Porto, et l’Ecole des Hautes Etudes en Santé Publique de Rennes. Cette enquête a permis d’identifier 5 compétences de haut niveau d’expertise et de formation selon les descripteurs de Dublin pour les infirmiers de pratique avancée. Un programme de formation de niveau master de pratique avancée en allergologie est élaboré. Enfin, il a été identifié 4 phases constitutives de l’innovation : pilotage, appropriation, généralisation de la pratique et absorption par le système. L’innovation est un processus délibéré nécessitant la transformation des pratiques par l’introduction de nouveautés pédagogiques, organisationnelles et e-santé. L’évolution des outils d’aide à la décision thérapeutique infirmière appelée diagnostic infirmier est mis en lumière. Le diagnostic infirmier portant sur l’adaptation des individus à l’environnement est envisagé Les résultats soulignent la nécessité de développer des programmes de formation s’appuyant sur une pédagogie adaptée aux déterminants sociaux des étudiants en Sciences de la Santé ainsi qu’une révision du cadre réglementaire et juridique des professions de santé dites intermédiaires en France. / Health systems in France and in the world are in tension. The determinants of those pressures are linked to demography, economy and care organization Chronic non-infectious diseases are on the rising. Allergic disease alone respect 25% of individuals in France (15 million people). In Europe, 100 million people suffer from allergic rhinitis and 70 million suffer from asthma. By 2020, it is 40% of the world population will be suffering from an allergic disease. The declaration of RIO, founding text of sustainable development, puts health as a major concern. It is necessary to think of new management models, new training and distribution of different skills from new business perimeters for health caregivers. The primary objective of this research is to identify: innovative models of health in a systematic multidisciplinary vision and ethics of care. .the Secondary objective is to define the concept of innovative practices in health in the French health system, clarify the regulatory framework for innovative practices, identify training needs, qualification of new businesses and new tools and finally review the adequacy of generational training for health science students. The method used is a review of the literature on sustainable development, environmental medicine, training of health professionals. The confrontation with the regulatory framework of practice nurse at the nursing of advanced nursing practices is made. The study design is the allergy disease. An online survey assessed the level of skills, training and policy of nurses in Europe. This study was conducted in collaboration with the European department of Haute Ecole de Namur, the University of Nottingham, and High School of Health of Freiburg, University of Porto, and School of Advanced Studies in Public Health in Rennes. This survey identifies five high levels of expertise that are 5 skills training according to Dublin descriptors for advanced practice nurses. A master level training program for APRN in allergy practice is developed Finally four steps of innovation were identified: management, ownership, widespread practice and absorption by the system.The results highlight that innovation is a deliberate process requiring practice by introducing new pedagogical, organizational and e-Health .Changing nurse’s diagnosis decision and support tools are highlighted. The nursing diagnosis on individual adaptation to environment is also considered. Eventually, two main recommendations are presented, firstly to develop training program according to the new French law in France, and secondly to considered the social determinants of the students in health science to make those training.

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2017-04-24T13:12:15Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Andre_M_de_ Souza_MPA_CCSA_2016_DISSERTAÇÃO.pdf: 1370513 bytes, checksum: 7bb49fb148783f014d53dd8aae9f2087 (MD5) / Made available in DSpace on 2017-04-24T13:12:15Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Andre_M_de_ Souza_MPA_CCSA_2016_DISSERTAÇÃO.pdf: 1370513 bytes, checksum: 7bb49fb148783f014d53dd8aae9f2087 (MD5) Previous issue date: 2016-09-28 / O estudo teve por objetivo compreender, por meio das experiências dos coordenadores TAE´s da UFPE, como a gestão administrativa da UFPE pode ser considerada inovadora. Os objetivos específicos foram: verificar o grau de importância e o grau de utilização de práticas inovadoras de gestão na UFPE; identificar as principais práticas de gestão consideradas inovadoras e as respectivas barreiras à implementação destas na UFPE; e compreender o conceito de uma “gestão administrativa inovadora” implícito nas ideias, valores e crenças compartilhados pelos gestores. O referencial teórico fundamentou a compreensão da temática inovação em práticas de gestão (PAIVA; ROCHA-PINTO, 2015; BRANDÃO; BRUNOFARIA, 2013; COSTA et al, 2013); e da Teoria da cognição organizacional e o construto Teoria implícita (BASTOS, 2002; JANISSEK-DE-SOUZA, 2007). Trata-se de um estudo de caso, as técnicas de análise foram quantitativa e qualitativa, a amostra composta por 53 coordenadores e um questionário semi-aberto foi utilizado. Como resultados, a gestão administrativa da UFPE parece estar distante de um contexto considerado inovador; Por outro lado, o Plano de capacitação e qualificação dos servidores e a interiorização da UFPE foram as principais práticas de gestão consideradas inovadoras. As principais barreiras à implementação de práticas inovadoras foram: resistência às mudanças, recursos financeiros insuficientes e burocracia excessiva; o conceito de gestão administrativa inovadora da UFPE caracterizou-se pela existência de processos participativos, de incentivo à capacitação, de canais de comunicação eficazes e tecnologias integradas, de transparência pública. Para estudos futuros, sugere-se ampliar as observações com os demais servidores da UFPE, como também, o desenvolvimento de propostas de avaliação de desempenho no contexto das universidades federais. / The study aimed to understand, through the experiences of TAE's UFPE coordinators, as the administration of UFPE can be considered innovative. The specific objectives were to verify the degree of importance and the degree of use of innovative management practices at university; identify key management practices considered innovative and their barriers to implementing these at university; and understand the concept of an "innovative administrative management" implicit in the ideas, values and beliefs shared by managers. The theoretical reasons for the understanding of the subject innovation management practices (PAIVA; ROCK-PINTO, 2015; BRANDÃO; BRUNO-FARIA, 2013; Costa et al, 2013); and the theory of organizational cognition and construct Implicit theory (BASTOS, 2002; JANISSEK-DESOUZA, 2007). This is a case study, the analysis techniques were quantitatively and qualitatively, the sample of 53 engineers and a semi-open questionnaire was used. As a result, the administration of UFPE seems far be considered an innovative context; On the other hand, the training plan and training of servers and the internalization of UFPE were the main management practices considered innovative. The main barriers to the implementation of innovative practices were: resistance to change, insufficient financial resources and excessive bureaucracy; the concept of innovative administrative management of UFPE characterized by the existence of participatory processes, to encourage training, effective communication channels and integrated technologies, public transparency. For future studies, it is suggested to extend the observations to other UFPE servers, as well as the development of performance evaluation of proposals in the context of federal universities.

Made available in DSpace on 2016-03-15T19:32:30Z (GMT). No. of bitstreams: 1 Wagner Tadeu de Souza Carvilhe.pdf: 1507301 bytes, checksum: 92f717e866a1585af6990a67ed549f33 (MD5) Previous issue date: 2011-02-16 / Fundo Mackenzie de Pesquisa / This dissertation aims to conduct a qualitative research through a content analysis that intends to verify the winning companies of Transparency Award, sponsored by FIPECAFI - Institute of Accounting, Actuarial FEA / USP and ANEFAC - National Association of Financial Executives Administration and Accounting, innovative practices was adopted in their financial statements in a period of 10 years, from 1999 to 2008 with the publication date in financial year 2000 to year 2009. The written work reviews the literature on the topic and issues. Based on the review it was possible to develop a adequate research model. The research methodology used was content analysis, which has shown that innovative practices to publicly traded companies and Transparency Award winners, since that these companies are using in yours publications financial statements. The development work was made through the analysis of financial statements in which the company won the Award Transparency, compared with the immediately preceding year, in search of innovative practices that add important information to shareholders. As a result highlighted the administrative innovation adopted in the financial statements the companies winning the award transparencies. / Com esta dissertação realizou-se uma pesquisa qualitativa por meio de uma análise de conteúdo que pretendeu verificar se as empresas vencedoras do Prêmio Transparência, promovido pela FIPECAFI Fundação Instituto de Pesquisas Contábeis, Atuariais da FEA/USP e ANEFAC Associação Nacional dos Executivos de Finanças, Administração e Contabilidade, adotaram práticas inovadoras em sua demonstrações contábeis no período de 10 anos, do exercício de 1999 ao de 2008, com data de publicação das demonstrações do ano 2000 ao ano 2009. O trabalho realiza uma revisão bibliográfica sobre o tema e questões associadas. Com base na revisão foi possível elaborar um adequado modelo de pesquisa. A metodologia utilizada foi uma pesquisa documental com uma análise de conteúdo, que permitiu verificar quais práticas inovadoras as empresas de capital aberto e vencedoras do Prêmio Transparência passaram a utilizar nas publicações de suas demonstrações contábeis. O desenvolvimento do trabalho foi conduzido com base nas análises das demonstrações contábeis do exercício em que a empresa foi vencedora do Prêmio Transparência, comparado com o exercício imediatamente anterior, na busca de práticas inovadoras que agregassem informações importantes aos acionistas. Como resultado destacou-se a inovação administrativa adotada nas demonstrações contábeis das empresas vencedoras do Prêmio Transparência FIPECAFI/ANEFAC.