The observed high turnover of nursing staff in some public hospitals in Luanda was assumed to give rise to staff shortages, resulting in work overload for the remaining nurses and poor service delivery. The aim of this study was to determine the reasons for the high turnover of nurses in public hospitals in the city of Luanda, and to determine the actual turnover over a two-year period. The researcher adopted a quantitative approach with an exploratory and descriptive design, using a questionnaire for data collection from a sample of 100 respondents consisting of the Directors of Nursing, Directors of Human Resources and Heads of Departments (ward/units) in seven public hospitals. The study found that the most common reasons for the resignation of nurses were retirement, ill health, and better remuneration and working conditions elsewhere. Lack of motivation could be ascribed to the perceived low remuneration, insufficient supplies and equipment, being overworked due to staff shortages, unsafe working environment and poor conditions of service. Recommendations were made to tackle these issues. It was however not possible to determine the actual extent of nurses resigning from the public hospitals. / Health Studies / M.A. (Health Studies)

Made available in DSpace on 2015-12-10T14:22:19Z (GMT). No. of bitstreams: 0 Previous issue date: 2015-02-26. Added 1 bitstream(s) on 2015-12-10T14:28:23Z : No. of bitstreams: 1 000851792.pdf: 1282972 bytes, checksum: 6801b965347d792aa16caa4236a814fd (MD5) / O ambiente de trabalho é um dos fatores intervenientes da qualidade assistencial ao usuário. Os processos de acreditação hospitalar avaliam a qualidade e contribuem para o alcance da excelência. Correlacionar o ambiente de trabalho com a certificação de qualidade pode contribuir com o conhecimento nessa temática. Dentre as possibilidades de identificar o ambiente de trabalho das organizações de saúde o instrumento Nursing Work Index - Revised (NWI-R) tem sido utilizado em diferentes culturas e ambientes da prática do enfermeiro. O NWI-R foi traduzido, adaptado e validado para a cultura brasileira e denominado Nursing Work Index - Revised - Versão Brasileira (B-NWI-R). Esse estudo tem como objetivo analisar o ambiente de trabalho do enfermeiro de dois hospitais públicos, comparar o ambiente de trabalho desses hospitais e compreender os fatores relacionados ao ambiente de trabalho do enfermeiro que mais interferem no processo de trabalho. Foi realizado estudo na abordagem quantitativa e qualitativa. Na quantitativa foram dois estudos transversais em paralelo, com enfermeiros assistenciais dos hospitais entre janeiro a setembro de 2014. O hospital A não era acreditado e o hospital B acreditado (nível 1). A coleta de dados foi por meio de um questionário com dados sóciodemográficos laborais e o B-NWI-R com 57 itens e quatro domínios: autonomia, controle sobre o ambiente, relacionamento médico e enfermeiro e suporte organizacional. A confiabilidade do instrumento foi medida pelo alpha de Cronbach. Responderam o instrumento 106 enfermeiros, 50 do hospital A e 56 do B. Na qualitativa adotou-se a análise de conteúdo, com oito gerentes de enfermagem. A coleta dos dados utilizou entrevistas audiogravadas e semiestruturadas com a questão norteadora: Segundo sua perspectiva, quais são os fatores relacionados ao ambiente de trabalho do enfermeiro que mais interferem no processo de trabalho deles? As entrevistas duraram... / The working environment is one of the influencing factors of service quality to the user. The hospital accreditation process evaluates the quality and contributes to the achievement of excellence. Correlating the working environment with quality certification can contribute to the knowledge in this subject. Among the possibilities of identifying the working environment of health organizations the source Nursing Work Index - Revised (NWI-R) has been used in different cultures and nursing practice environments. The NWI-R was translated, adapted and validated for the Brazilian culture and called Nursing Work Index - Revised - Brazilian version (B-NWI-R). This study aims to analyze the working environment of nurses from two public hospitals, compare their environment and understand the factors related to nurses' workplace that affect the work process. A study was conducted in quantitative and qualitative approach. The quantitative research covered two cross-sectional studies in parallel, with hospital nurses between January and September 2014. Hospital A was not accredited and Hospital B was accredited (level 1). Data collection was carried through a questionnaire with labor socio-demographic data and the B-NWI-R with 57 items and four areas: autonomy, control over the working environment, doctor and nurse relationship and organizational support. The reliability of such resource was measured by Cronbach's alpha. The test was answered by 106 nurses, 50 from Hospital A and 56 from Hospital B. The qualitative research adopted the content analysis, with eight nursing managers. Data collection used audio recorded and semi-structured interviews with the guiding question: According to your perspective, what are the factors related to the nursing working environment that interfere in the working process? The interviews lasted 30 minutes. The research was approved by the Research Ethics Committee, Platform Brazil No. 23304713.4.0000.5411. The ...

Made available in DSpace on 2014-06-11T19:35:14Z (GMT). No. of bitstreams: 0 Previous issue date: 2013-08-09Bitstream added on 2014-06-13T18:46:44Z : No. of bitstreams: 1 barbosa_vba_dr_botfm.pdf: 741959 bytes, checksum: 25e85fe76264eee97444ad1a4b8c7fd2 (MD5) / Trata-se de pesquisa de abordagem qualitativa para compreender a experiência do enfermeiro no processo de implantação da educação permanente, no Hospital das Clínicas, Unidade Materno Infantil do Complexo Assistencial Famema e, elaborar um modelo teórico que a represente. A saturação teórica se configurou mediante a análise da 11a entrevista do tipo não diretiva, estas foram audiogravadas, transcritas na íntegra e analisadas segundo os passos da Teoria Fundamentada nos Dados. Emergiram dois subprocessos: perseverando-se no papel de agente transformador da práxis, retroalimentado pelo apoio de gestores na concretude de suas experiências com a educação permanente e, reconhecendo a necessidade de investimentos em trabalhadores na área de enfermagem para a educação permanente prosperar. Do realinhamento dos componentes desses subprocessos originou a categoria central, processo que abarca toda a experiência, intitulado: “Relação de confiança com o gestor como componente interveniente para o enfermeiro assumir o papel de agente transformador de sua práxis”. A discussão dos resultados foi subsidiada pelos referenciais da pedagogia libertadora de Paulo Freire, educação permanente e gestão em saúde. O modelo teórico foi validado junto aos atores e sinalizou o restabelecimento das relações de confiança enfermeiros-gestores, como primeiro passo para que houvesse a sensibilização desse profissional a tornar-se agente multiplicador da educação permanente e consequentemente, consciente de seu papel junto à sua equipe. O modelo ainda aponta que, para o enfermeiro estabelecer essas relações é preciso que o mesmo a conceba muito além do oferecimento de um espaço seguro para ocorrer discussões e trocas de experiências. O gestor precisa demonstrar capacidade de empreender movimento de reconhecimento e oferecimento de... / This is research in the qualitative approach to understand the experience of the nurse with the implantation of permanent education at the Hospital das Clínicas Unidade Materno Infantil do Complexo Assistencial Famema and elaborate a theoretical model to represent it. The theoretical saturation was configured by analyzing the 11th interview of the non-directive, which were full audio recorded, transcribed and analyzed according to the steps of Grounded Theory. Which emerged two subprocesses: persevering on the role of change agent of praxis, fed by support managers in the materiality of their experiences with the permanent education and recognizing the need to invest in workers in the nursing area to thrive the permanent education. From realignment of these subprocesses originated the core category, a process that comprise the whole experience, entitled: trusting relationship with the manager as intervening component for nurses to assume the role of transforming agent for their practice. The discussion of the results was supported by the references of liberating pedagogy of Paulo Freire, permanent education and health management. The theoretical model was validated with the actors and signaled the recuperation of trusts among nurses-managers as a first step so that there were awareness of theses professional to become a multiplier of permanent education and consequently conscious of his role in his team. The model also shows that the nurses to establish these relationships is necessary besides offering to the nurse a secure space that occur and exchange experiences. It is necessary that the manager demonstrates capacity to undertake motion recognition and providing working conditions for nurses to feel encouraged to continue to manage the challenges that emerge from the group reflections. Moreover, the manager needs to ensure the continuity ...(Complete abstract click electronic access below)

Made available in DSpace on 2014-06-11T19:28:20Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-08-26Bitstream added on 2014-06-13T20:17:58Z : No. of bitstreams: 1 higashi_p_me_botfm.pdf: 288507 bytes, checksum: ffb5e370265ebf5fa4087baf056fbd6a (MD5) / Ministério da Saúde / A melhoria da qualidade dos serviços de saúde é uma das metas das instituições, sendo a acreditação hospitalar da Organização Nacional de Acreditação (ONA) uma das possibilidades de certificação e promoção da qualidade. Porém, o estresse envolvido no processo de trabalho pode afetar a qualidade do serviço como um todo. Este estudo é do tipo transversal e teve por objetivo avaliar a percepção de estresse dos enfermeiros, considerando-se a situação de acreditação do hospital em que trabalham. Foi desenvolvido em um hospital acreditado de Bauru/SP e em dois hospitais não acreditados, um de Bauru e outro de Marília/SP. A coleta de dados foi realizada por meio de questionário contendo o Inventário de Estresse para Enfermeiros (IEE), que avalia as situações que podem potencialmente gerar estresse/tensão inseridas em quatro categorias: Fatores Intrínsecos ao Trabalho, Relações no Trabalho, Papéis Estressores na Carreira e Estrutura e Cultura organizacional. A análise estatística foi realizada pelo qui quadrado, teste de proporções e teste t para amostras independentes, considerando-se nível crítico para p<0,05. Ser acreditado, foi proteção contra a percepção de estresse em situações que envolveram estrutura física, material e de recursos humanos, incluídas na categoria Fatores Intrínsecos ao Trabalho. Na categoria do IEE Relações no Trabalho, ser acreditado foi risco para percepção de estresse nas situações começar nova função, conciliar questões profissionais e familiares, prestar assistência a pacientes graves e atender familiares. Na categoria Papéis Estressores da Carreira, não houve diferença estatisticamente significativa e para Estrutura e Cultura Organizacional, ser acreditado foi risco para a percepção de estresse... / The improvement of health services quality is one of the goals of institutions, being the hospital accreditation of the National Accreditation Organization (NAO) one of the possibilities of certification and promotion of quality. However, the stress involved on the work process may affect the quality of the service as a whole. This study is the transversal type, and has had as a goal to evaluate the nurses’ stress perception, considering the accreditation situation of the hospital in which they work. It was developed in an accredited hospital in Bauru/SP and in two non-accredited hospitals, one in Bauru/SP e another in Marília/SP. The data collection was performed through questionnaire containing the Stress Inventory for Nurses (SIN), that evaluates the situations that may potentially generate stress/tension inserted in four categories: intrinsic factors to work, work relations, stressing roles in career and organizational structure and culture. The statistical analysis was performed through the chi-square, proportions test and t test for independent samples, considering critical level for p<0,05. Being accredited was a protection against the stress perception in situations that involved physical, material and human resources structure, included on the Intrinsic Work Factors category. On the category SIN Work Relations, being accredited was a risk for stress perception on the situations of start a new occupation, conciliate professional and family matters, assist serious condition patients and assist families. On the category Stressing Role of the Career there was no statistically significant difference and for Structure and Organizational Culture, being accredited was a risk for the stress perception on the situations to supervise the work of others and to do alternate shifts and protection for the lack of space to discuss... (Complete abstract click electronic access below)

Orientador: Cristina Maria Garcia de Lima Parada / Coorientador: Janete Pessuto Simonetti / Banca: Wilza Carla Spiri / Banca: Marta Maria Melleiro / Resumo: A melhoria da qualidade dos serviços de saúde é uma das metas das instituições, sendo a acreditação hospitalar da Organização Nacional de Acreditação (ONA) uma das possibilidades de certificação e promoção da qualidade. Porém, o estresse envolvido no processo de trabalho pode afetar a qualidade do serviço como um todo. Este estudo é do tipo transversal e teve por objetivo avaliar a percepção de estresse dos enfermeiros, considerando-se a situação de acreditação do hospital em que trabalham. Foi desenvolvido em um hospital acreditado de Bauru/SP e em dois hospitais não acreditados, um de Bauru e outro de Marília/SP. A coleta de dados foi realizada por meio de questionário contendo o Inventário de Estresse para Enfermeiros (IEE), que avalia as situações que podem potencialmente gerar estresse/tensão inseridas em quatro categorias: Fatores Intrínsecos ao Trabalho, Relações no Trabalho, Papéis Estressores na Carreira e Estrutura e Cultura organizacional. A análise estatística foi realizada pelo qui quadrado, teste de proporções e teste t para amostras independentes, considerando-se nível crítico para p<0,05. Ser acreditado, foi proteção contra a percepção de estresse em situações que envolveram estrutura física, material e de recursos humanos, incluídas na categoria Fatores Intrínsecos ao Trabalho. Na categoria do IEE Relações no Trabalho, ser acreditado foi risco para percepção de estresse nas situações começar nova função, conciliar questões profissionais e familiares, prestar assistência a pacientes graves e atender familiares. Na categoria Papéis Estressores da Carreira, não houve diferença estatisticamente significativa e para Estrutura e Cultura Organizacional, ser acreditado foi risco para a percepção de estresse... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The improvement of health services quality is one of the goals of institutions, being the hospital accreditation of the National Accreditation Organization (NAO) one of the possibilities of certification and promotion of quality. However, the stress involved on the work process may affect the quality of the service as a whole. This study is the transversal type, and has had as a goal to evaluate the nurses' stress perception, considering the accreditation situation of the hospital in which they work. It was developed in an accredited hospital in Bauru/SP and in two non-accredited hospitals, one in Bauru/SP e another in Marília/SP. The data collection was performed through questionnaire containing the Stress Inventory for Nurses (SIN), that evaluates the situations that may potentially generate stress/tension inserted in four categories: intrinsic factors to work, work relations, stressing roles in career and organizational structure and culture. The statistical analysis was performed through the chi-square, proportions test and t test for independent samples, considering critical level for p<0,05. Being accredited was a protection against the stress perception in situations that involved physical, material and human resources structure, included on the Intrinsic Work Factors category. On the category SIN Work Relations, being accredited was a risk for stress perception on the situations of start a new occupation, conciliate professional and family matters, assist serious condition patients and assist families. On the category Stressing Role of the Career there was no statistically significant difference and for Structure and Organizational Culture, being accredited was a risk for the stress perception on the situations to supervise the work of others and to do alternate shifts and protection for the lack of space to discuss... (Complete abstract click electronic access below) / Mestre

Orientador: Silvia Cristina Mangini Bocchi / Coorientador: Wilza Carla Spiri / Banca: Carmem Maria Casquel Monti Juliani / Banca: Mariana Peduzzi / Banca: Regina Stella Spagnuolo / Banca: Antonio Carlos Siqueira Junior / Resumo: Trata-se de pesquisa de abordagem qualitativa para compreender a experiência do enfermeiro no processo de implantação da educação permanente, no Hospital das Clínicas, Unidade Materno Infantil do Complexo Assistencial Famema e, elaborar um modelo teórico que a represente. A saturação teórica se configurou mediante a análise da 11a entrevista do tipo não diretiva, estas foram audiogravadas, transcritas na íntegra e analisadas segundo os passos da Teoria Fundamentada nos Dados. Emergiram dois subprocessos: perseverando-se no papel de agente transformador da práxis, retroalimentado pelo apoio de gestores na concretude de suas experiências com a educação permanente e, reconhecendo a necessidade de investimentos em trabalhadores na área de enfermagem para a educação permanente prosperar. Do realinhamento dos componentes desses subprocessos originou a categoria central, processo que abarca toda a experiência, intitulado: "Relação de confiança com o gestor como componente interveniente para o enfermeiro assumir o papel de agente transformador de sua práxis". A discussão dos resultados foi subsidiada pelos referenciais da pedagogia libertadora de Paulo Freire, educação permanente e gestão em saúde. O modelo teórico foi validado junto aos atores e sinalizou o restabelecimento das relações de confiança enfermeiros-gestores, como primeiro passo para que houvesse a sensibilização desse profissional a tornar-se agente multiplicador da educação permanente e consequentemente, consciente de seu papel junto à sua equipe. O modelo ainda aponta que, para o enfermeiro estabelecer essas relações é preciso que o mesmo a conceba muito além do oferecimento de um espaço seguro para ocorrer discussões e trocas de experiências. O gestor precisa demonstrar capacidade de empreender movimento de reconhecimento e oferecimento de... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: This is research in the qualitative approach to understand the experience of the nurse with the implantation of permanent education at the Hospital das Clínicas Unidade Materno Infantil do Complexo Assistencial Famema and elaborate a theoretical model to represent it. The theoretical saturation was configured by analyzing the 11th interview of the non-directive, which were full audio recorded, transcribed and analyzed according to the steps of Grounded Theory. Which emerged two subprocesses: persevering on the role of change agent of praxis, fed by support managers in the materiality of their experiences with the permanent education and recognizing the need to invest in workers in the nursing area to thrive the permanent education. From realignment of these subprocesses originated the core category, a process that comprise the whole experience, entitled: trusting relationship with the manager as intervening component for nurses to assume the role of transforming agent for their practice. The discussion of the results was supported by the references of liberating pedagogy of Paulo Freire, permanent education and health management. The theoretical model was validated with the actors and signaled the recuperation of trusts among nurses-managers as a first step so that there were awareness of theses professional to become a multiplier of permanent education and consequently conscious of his role in his team. The model also shows that the nurses to establish these relationships is necessary besides offering to the nurse a secure space that occur and exchange experiences. It is necessary that the manager demonstrates capacity to undertake motion recognition and providing working conditions for nurses to feel encouraged to continue to manage the challenges that emerge from the group reflections. Moreover, the manager needs to ensure the continuity ...(Complete abstract click electronic access below) / Doutor

Thesis (MTech (Human Resource Management))--Cape Peninsula University of Technology, 2015. / Occupational challenges exist in all working environments, and affect all levels of organisational personnel from top management to employee levels. State hospitals in South Africa place occupational demands mainly upon registered nurses who make up most of the hospital staff. The focus of the research investigation concentrated mainly on a population of three groups of registered nurses at a state hospital in Cape Town. They are staff nurses, professional nurses and enrolled nursing assistants. These nurses are experiencing a decline in morale, due to staff shortages, a lack of resources and a perceived lack of leadership. They experience various levels of stress, which affect their personal health and morale. The objective of the research was to analyse the impact on the state registered nurses of three main contributors of occupational challenges faced by these nurses, namely a lack of resources, staff shortages and a perceived lack of good leadership. The nurses are employed to provide quality care for patients in state hospitals.

The purpose of this study was to describe staff nurses' perceptions of their power bases in their work environment. Power, the capacity to set conditions, make decisions and take action that influences others, is an increasingly important issue within the nursing profession. In the nursing literature, nurses have been encouraged to consider the power to influence nursing care as an attainable goal and a necessary element in the change process. Empowering staff nurses may become a strategy for coping with the nursing manpower shortage. However, research about nursing power has focused on the nurse manager and little is written about staff nurses' perception of their power. A grounded theory research design was used to collect and analyze data. Data were collected through interviews of nine staff nurses in a 369 bed British Columbia community hospital. A comparative content analysis was used to analyze the data. The findings showed that the staff nurse participants were able to recognize certain factors in their work environment that impacted on their sense of power. The nature of nurses' work and the communication of information were found to be the most significant factors. The communication of information was perceived to positively influence nurses' sense of power, while the nature of nurses' work was found to limit nurses' sense of power. Nurses' lack of control over client care was found to contribute to a sense of powerlessness and was linked to units using team nursing. The eight power bases outlined in Randolph's framework, were useful as a basis for describing the staff nurses' perceptions of their organizational power bases. The staff nurses studied were found to have the most affinity for referent, expert, information, and connection power bases. These nurses were found to have the least affinity for reward, coercion, legitimate, and resource power bases. Primary nursing was found to enhance legitimate power while team nursing was found to enhance connection power. The source of power most frequently mentioned by the nurse participants was personal power in relation to oneself. This did not fit into Randolph's framework and was not well defined. This has implications for nursing since support for the professional nature of nurses' work was found to strenghthen nurses' sense of personal power. Knowledge about the perceptions described by the subjects in this investigation provides information to assist nurses' to identify power bases that they may not recognize. As well, increased understanding about staff nurses' perceptions of power should enable nursing administration to identify strategies for retaining nurses and enhancing client care. / Applied Science, Faculty of / Nursing, School of / Graduate

There is alleged to be a severe nursing shortage in Canada. While the shortage is attributed in large part to fiscal restraint in the hospital sector in the early 1990s, there are competing claims addressing why nursing employment levels changed over this period. Supply-side proponents argue that deteriorating working conditions and stagnant wages led nurses to voluntarily leave the profession, province, or country for better employment prospects. Demand-side proponents argue that hospitals reduced staff levels in response to a decline in inpatient utilization. There is also considerable disagreement on what impact, if any, reduced nursing employment levels had on access to hospital care. However, while there is no shortage of anecdotal evidence and plausible rhetoric, the debate is being carried out in a largely data-free environment. This thesis attempts partially to fill this void. Part I of this thesis examines trends in the nursing employment level in Canada over the hospital restructuring period. Results indicate that the number of nurses employed in hospitals decreased significantly during the cut-backs period and that the decrease was particularly severe among young nurses. The employment level is decomposed into three separate components for each age group: the change in the potential supply of nurses, the change in the employment rate of this group and the change in the likelihood that an individual will work in the nursing profession conditional on being employed. Results indicate that the third factor is most important. To determine whether the observed shift toward non-nursing employment was voluntary, an occupational sector choice model is developed and the pattern of nursing wages, non-nursing wages, and hospital expenditure (a proxy for demand) is examined. The evidence strongly suggests that the reduction in the nursing employment level in hospitals during the downsizing period was a result of a decrease in the demand for nursing labour and did not represent voluntary movement out of the nursing sector. That the decrease in demand primarily affected young nurses appears to reflect the influence of seniority in the highly unionized nursing sector. / Arts, Faculty of / Vancouver School of Economics / Graduate

Indiana University-Purdue University Indianapolis (IUPUI) / The Bureau of Labor Statistics projected a shortage of registered nurses (RNs) growing to an estimated 581,500 by the year 2025 (an increase of 22 percent since 2008). Recent economical downturns have found many healthcare organizations experiencing a positive effect with the stabilization of nursing turnover. Once the economy begins to recover, however, experts predict the profession of nursing will still face the largest shortage in history according to projections by the American Nurses Association. Because lack of job satisfaction is a precursor to resignation, additional research regarding the identification of interventions that increase RN job satisfaction may result in retaining professionally qualified and prepared staff. This study proposed to identify through focus groups, staff nurse perceptions of nurse manager behaviors that influence RN staff nurse job satisfaction. A sample of 28 RNs, each participating in one of five focus groups, answered questions related to satisfaction with nurse manager behaviors. The investigator used qualitative content analysis to identify patterns within and across focus group data. Major findings of the study resulted in the identification of two conceptual categories (manager behaviors supportive of RNs and RN’s perceived disconnect of work issues from the manager’s role) and three major themes related to supportive behaviors (communication, respect, and feeling cared for). The results suggest the following as staff nurse preferences for nurse manager behaviors: open and honest communication that involves listening, consistency, and confidentiality; an increased level of respect including fairness and recognition of a job well done; and the sense of feeling cared for as when a manager meets individual needs and supports staff as professionals. The investigator compared the categories and themes to previous tools used in healthcare, which indicate the need for further item and/or tool development as well as further research regarding RNs’ perceived disconnect of work issues from the manager’s role.