Ziel der vorliegenden Masterarbeit ist die Entwicklung von Qualitätsindikatoren für den Prozess „Empfehlungen der Apotheke zur Weiterführung der Medikation“ im Klinikum Mutterhaus. Damit soll ein Instrument entwickelt werden, das patientenbezogene Dienstleistungen der Krankenhausapotheker an der intersektoralen Schnittstelle im Hinblick auf das Qualitätsziel Arzneimitteltherapiesicherheit messen und bewerten kann. Schwachstellen und Verbesserungspotentiale über den Verantwortungsbereich der Apotheke hinaus sollen identifiziert und in einen kontinuierlichen Verbesserungsprozess eingebracht werden können. Methodik: Zur Entwicklung der Qualitätsindikatoren wurde ein mehrstufiges Verfahren gewählt. Zunächst wurden die Qualitätsziele des Prozesses definiert und eine Prozessanalyse durchgeführt. Die Literaturrecherche auf nationaler und internationaler Ebene gab Anhaltspunkte zur Ableitung von Qualitätsindikatoren. Basierend auf der Prozessanalyse und der Literaturrecherche wurden Qualitätsindikatoren für den Prozess „Empfehlungen der Apotheke zur Weiterführung der Medikation“ entwickelt. Anhand einer retrospektiven Datenerhebung wurden die entwickelten Qualitätsindikatoren auf ihre Aussagekraft und Eignung geprüft. Der Prozess wurde mit Hilfe der Qualitätsindikatoren gemessen und bewertet. Schlussfolgerung: Mit Hilfe von fünf Qualitätsindikatoren-Sets kann der Prozess „Empfehlungen der Apotheke zur Weiterführung der Medikation“ umfassend untersucht werden. Die entwickelten Qualitätsindikatoren sind geeignet, die pharmazeutische Dienstleistung im Hinblick auf das Qualitätsziel Arzneimitteltherapiesicherheit zu messen und zu bewerten. Sie ermöglichen die Evaluation des Prozesses und zukünftiger Verbesserungsmaßnahmen. Anhand der Qualitätsindikatoren wird zukünftig ein Monitoring der Dienstleistung möglich sein. / Purpose: The aim of this thesis is the development of quality indicators for the process "recommendations of the pharmacy to continue patient’s medication" at Klinikum Mutterhaus. An instrument is to be developed that can measure and rate the patient-related services of the hospital pharmacist at the intersectoral interface in terms of quality target in medication safety. Weaknesses and potential improvements should be identified and incorporated into a continuous improvement process. Methods: A multistage process is selected for the development of the quality indicators. First, the quality objectives of the process are defined and a process analysis is performed. A literature review on national and international level shall provide evidence for the derivation of quality indicators. Based on the process analysis and the literature review the quality indicators for the "Recommendations of the pharmacy to continue patient`s medication” are developed. In a retrospective data collection, the developed quality indicators are tested for their validity and suitability. The process is finally measured by the quality indicators and evaluated. Conclusion: With the help of five quality indicator sets the process "recommendations of the pharmacy to continue patient’s medication" can be fully investigated. The developed quality indicators are suitable to measure and evaluate the process in terms of the quality target medication safety. So the evaluation of the process and future improvements are possible. On the basis of the quality indicators a monitoring of the process can be established in the future.

Made available in DSpace on 2016-06-02T19:39:21Z (GMT). No. of bitstreams: 1 3643.pdf: 19647341 bytes, checksum: a9bc4ab732e0263ea4ce28ea3f6ba6a2 (MD5) Previous issue date: 2011-02-24 / Financiadora de Estudos e Projetos / Throughout this dialogue we fetch describe and analyze the conceptions of an experienced teacher of Physical Education on Knowledge Teacher and about what, why and to what degree of proficiency of their students 3rd and 4th grades of Elementary School in a State School in São Paulo State, should know about physical education in their classrooms. For this, we rely on the following question: What, why and to what extent an experienced physical education teacher should know about the content in order to teach their students? And what, why and to what extent students Cycle II (3rd and 4th grades) of elementary school should know about this content? We keep the term "grades" because the school itself, at the time that there was monitoring, the nomenclature used for classes and, therefore, we recognize and value their provisions and curricular structures. Linked to the apprehension of these objectives also aim to perform analysis on educational indicators of professional development in teaching, which, emphasizing the processes of teaching and learning at school, could tell us, from the participant's response, aspects of the professional development of physical education teacher in their work context. In light of qualitative research, we used the technique to collect the semi structured interview. And to best to approach the phenomenon investigated, in addition to interviews, we conducted systematic visits to meet the participant's work context. We found that teachers have a profession that is eminently collective, but that also requires personal commitment and dedication, which indicates the need for autonomy and professional responsibility. As demonstrated by the participating teacher, professional development in teaching is an inherent element of the qualified performance in Physical Education as much sway over what each teacher intends to teach classes throughout the school. Beyond this specific area, we see it necessary for the Physical Education teacher to develop different strategies, using diverse methodologies and examples, optimize time and expand the opportunities for learning environments related to students' everyday life in and out of school, mobilize knowledge to that every child, every learner to appropriate the culture of body movement in a critical, independent and conscious. Amid all this process, it is the school community as a whole promotes opportunities, facilities and adequate periods for the development of teaching process, learning and teacher professional development. So it's important to establish analytical criteria, parameters and indicators that provide information contextualized these procedural elements. / Ao longo deste diálogo buscamos descrever e analisar as manifestações de um professor de Educação Física experiente sobre a Base de Conhecimento docente e sobre o que, por que e em que grau de proficiência seus alunos das 3ª e 4ª séries do Ensino Fundamental, em uma Escola Estadual do interior paulista, devem saber sobre a Educação Física nas suas aulas. Para tanto, baseamo-nos na seguinte questão de pesquisa: O que, por que e em que medida um professor de Educação Física experiente deve saber sobre os conteúdos para poder ensinar aos seus alunos? E o que, por que e em que medida seus alunos do Ciclo II (3ª e 4ª séries) do Ensino Fundamental devem saber sobre tais conteúdos? Mantemos o termo "séries" porque a própria escola, na época em que houve o acompanhamento, utilizava a referida nomenclatura para as turmas e, portanto, reconhecemos e valorizamos suas disposições e estruturas curriculares. Associada à apreensão destes objetivos, também almejamos realizar análises sobre indicadores educacionais de desenvolvimento profissional na docência, os quais, enfatizando os processos de ensinar e aprender na escola, poderiam nos revelar, a partir de respostas do participante, aspectos sobre o desenvolvimento profissional do professor de Educação Física em seu contexto de trabalho. Sob a luz das pesquisas qualitativas, utilizamos como técnica de coleta a entrevista semiestruturada. E para melhor nos aproximarmos do fenômeno investigado, além das entrevistas, realizamos visitas sistemáticas para conhecer o contexto de trabalho do participante. Observamos que os professores exercem uma profissão que é eminentemente coletiva, mas que também exige compromissos e dedicações pessoais, o que indica a necessidade da autonomia e da responsabilidade profissional. Assim como demonstrado pelo professor participante, o desenvolvimento profissional na docência é um elemento inerente à atuação qualificada na Educação Física Escolar tanto quanto o domínio sobre aquilo que cada professor se propõe a ensinar ao longo das aulas na escola. Além deste domínio específico, visualizamos ser necessário que o professor de Educação Física desenvolva diferentes estratégias de ensino, utilize exemplos diversificados, otimize o tempo e amplie os espaços de aprendizagens para ambientes relacionados ao cotidiano dos alunos dentro e fora da escola, mobilize conhecimentos necessários para que cada criança, cada aluno consiga apropriar-se da cultura corporal de movimento de maneira crítica, autônoma e consciente. Em meio a todo esse processo, cabe à comunidade escolar como um todo propiciar espaços, meios e períodos adequados ao desenvolvimento dos processos de ensino, aprendizagem e desenvolvimento profissional docente. Por isso se torna importante estabelecer critérios de análise, parâmetros e indicadores que forneçam informações contextualizadas destes elementos processuais.

Ziel der vorliegenden Masterarbeit ist die Entwicklung von Qualitätsindikatoren für den Prozess „Empfehlungen der Apotheke zur Weiterführung der Medikation“ im Klinikum Mutterhaus. Damit soll ein Instrument entwickelt werden, das patientenbezogene Dienstleistungen der Krankenhausapotheker an der intersektoralen Schnittstelle im Hinblick auf das Qualitätsziel Arzneimitteltherapiesicherheit messen und bewerten kann. Schwachstellen und Verbesserungspotentiale über den Verantwortungsbereich der Apotheke hinaus sollen identifiziert und in einen kontinuierlichen Verbesserungsprozess eingebracht werden können. Methodik: Zur Entwicklung der Qualitätsindikatoren wurde ein mehrstufiges Verfahren gewählt. Zunächst wurden die Qualitätsziele des Prozesses definiert und eine Prozessanalyse durchgeführt. Die Literaturrecherche auf nationaler und internationaler Ebene gab Anhaltspunkte zur Ableitung von Qualitätsindikatoren. Basierend auf der Prozessanalyse und der Literaturrecherche wurden Qualitätsindikatoren für den Prozess „Empfehlungen der Apotheke zur Weiterführung der Medikation“ entwickelt. Anhand einer retrospektiven Datenerhebung wurden die entwickelten Qualitätsindikatoren auf ihre Aussagekraft und Eignung geprüft. Der Prozess wurde mit Hilfe der Qualitätsindikatoren gemessen und bewertet. Schlussfolgerung: Mit Hilfe von fünf Qualitätsindikatoren-Sets kann der Prozess „Empfehlungen der Apotheke zur Weiterführung der Medikation“ umfassend untersucht werden. Die entwickelten Qualitätsindikatoren sind geeignet, die pharmazeutische Dienstleistung im Hinblick auf das Qualitätsziel Arzneimitteltherapiesicherheit zu messen und zu bewerten. Sie ermöglichen die Evaluation des Prozesses und zukünftiger Verbesserungsmaßnahmen. Anhand der Qualitätsindikatoren wird zukünftig ein Monitoring der Dienstleistung möglich sein. / Purpose: The aim of this thesis is the development of quality indicators for the process "recommendations of the pharmacy to continue patient’s medication" at Klinikum Mutterhaus. An instrument is to be developed that can measure and rate the patient-related services of the hospital pharmacist at the intersectoral interface in terms of quality target in medication safety. Weaknesses and potential improvements should be identified and incorporated into a continuous improvement process. Methods: A multistage process is selected for the development of the quality indicators. First, the quality objectives of the process are defined and a process analysis is performed. A literature review on national and international level shall provide evidence for the derivation of quality indicators. Based on the process analysis and the literature review the quality indicators for the "Recommendations of the pharmacy to continue patient`s medication” are developed. In a retrospective data collection, the developed quality indicators are tested for their validity and suitability. The process is finally measured by the quality indicators and evaluated. Conclusion: With the help of five quality indicator sets the process "recommendations of the pharmacy to continue patient’s medication" can be fully investigated. The developed quality indicators are suitable to measure and evaluate the process in terms of the quality target medication safety. So the evaluation of the process and future improvements are possible. On the basis of the quality indicators a monitoring of the process can be established in the future.

Une meilleure utilisation des ressources infirmières représente une avenue prometteuse dans l’amélioration de la performance des services de première ligne. La mesure de la performance des services infirmiers constitue une composante centrale à l’amélioration de leur organisation et à la qualité des soins dispensés dans ce secteur d’activités. Le but de cette recherche était de mesurer et de valider des indicateurs de performance des services infirmiers en première ligne à partir d’un cas traceur en soins de plaies ainsi que d’évaluer la fiabilité des données clinico-administratives utilisées pour mesurer les indicateurs à partir des dossiers cliniques. Cette étude a adopté un devis longitudinal corrélationnel. Les données ont été collectées sur une période d’une année dans un service de soins courants d’un Centre local de services communautaires (CLSC) à partir de données clinico-administratives contenues dans le système informatique I-CLSC. L’épisode de soins constituait l’unité d’analyse. Huit indicateurs ont été mesurés, dont cinq indicateurs de processus : 1) le suivi infirmier; 2) la continuité relationnelle; 3) l’enseignement; 4) l’évaluation initiale; et 5) la rencontre avec une infirmière spécialisée en soins de plaies, et trois indicateurs de résultats : 1) la fréquence; 2) la durée; et 3) l’intensité du suivi. Les objectifs de mesure et de validation ont été réalisés à partir d’un échantillon de 482 épisodes de soins de plaies d’une durée supérieure à sept jours. L’étude de fiabilité a été réalisée à partir d’un sous-échantillon de 107 épisodes. Des analyses descriptives et corrélationnelles ont été réalisées. Les résultats de validation ont démontré des associations fortes statistiquement significatives entre les indicateurs de suivi infirmier et de continuité et les trois indicateurs de résultats. Les résultats de fiabilité ont démontré un haut taux de concordance entre les données contenues dans les dossiers cliniques et les données clinico-administratives pour six des huit indicateurs à l’étude. En conclusion, des indicateurs de processus valides et pertinents dans la pratique infirmière de première ligne peuvent être mesurés de façon régulière par les gestionnaires à partir de données clinico-administratives fiables et facilement accessibles. / Better use of nursing resources is a promising avenue for improving the performance of primary care services. Measuring the performance of nursing services is a central component in improving their organization and the quality of care delivered in this sector. The aim of this study was to measure and validate primary care nursing performance indicators from a tracer case in wound care and to assess the reliability of clinical-administrative data used to measure indicators from clinical records. This study adopted a correlational longitudinal design. Data were collected over a one-year period in a Local community services centre (CLSC) using clinical-administrative data contained in the I-CLSC electronic database. The episode of care was the unit of analysis. Eight indicators were measured, including five process indicators: 1) nursing follow-up; 2) relational continuity; 3) teaching; 4) initial assessment; and 5) consultation with a specialized nurse, and three outcome indicators: 1) frequency; 2) duration; and 3) intensity. Measurement and validation objectives were performed using a sample of 482 episodes of wound care lasting more than seven days. The reliability study was based on a sub-sample of 107 episodes. Descriptive and correlational analyzes were performed. Validation results demonstrated very strong associations between nursing follow-up and continuity indicators and the three outcome indicators. Reliability results demonstrated a high concordance between clinical records and clinical-administrative data for six of the eight indicators. In conclusion, valid and relevant process indicators in primary care nursing can be measured on a regular basis by managers using reliable and easily accessible clinical-administrative data.