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      CLASSIFICAÇÃO DE PACIENTES E DIMENSIONAMENTO DE PESSOAL DE ENFERMAGEM EM UNIDADE DE INTERNAÇÃO PEDIÁTRICA Translated title: CLASIFICACIÓN DE PACIENTES Y DIMENSIONAMIENTO DEL PERSONAL DE ENFERMERÍA EN UNA UNIDAD DE HOSPITALIZACIÓN PEDIÁTRICA Translated title: PATIENT CLASSIFICATION AND NURSING STAFF DIMENSIONING IN A PEDIATRIC INPATIENT UNIT

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          Abstract

          RESUMO Objetivo: descrever a implantação do Sistema de Classificação de Pacientes e o dimensionamento do pessoal de enfermagem em unidade de internação pediátrica. Método: estudo descritivo, transversal e retrospectivo, realizado em um hospital universitário do Centro-Oeste do Brasil. Depois da implantação do Sistema de Classificação de Pacientes pediátricos, compilaram-se dados das classificações do nível de complexidade assistencial (N=4.639) entre pacientes (n=608) internados de janeiro a dezembro de 2019. Empregou-se análise estatística descritiva, incluindo metodologia própria para dimensionamento de pessoal. Resultados: houve prevalência de pacientes de cuidados intermediários. Pelo dimensionamento do pessoal, constatou-se superávit (+10) de trabalhadores de nível médio, e o quantitativo de enfermeiros projetado (seis) era compatível com o disponível. Conclusão: a implantação/emprego estratégico do Sistema de Classificação de Pacientes foi indispensável para a previsão de pessoal de enfermagem pediátrica, considerando que o superávit de pessoal constatado deve ser apreciado com cautela.

          Translated abstract

          RESUMEN Objetivo: describir la implantación del Sistema de Clasificación de Pacientes y el dimensionamiento del personal de enfermería en una unidad de hospitalización pediátrica. Método: estudio descriptivo, transversal, retrospectivo, realizado en un hospital universitario del Centro-Oeste de Brasil. Tras la implantación del Sistema de Clasificación de Pacientes Pediátricos, se recopilaron los datos de las clasificaciones del nivel de complejidad asistencial (N=4.639) entre los pacientes (n=608) ingresados de enero a diciembre de 2019. Se utilizó el análisis estadístico descriptivo, incluida nuestra propia metodología de dimensionamiento del personal. Resultados: prevalencia de pacientes de cuidados intermedios. En cuanto a la dimensión del personal, se constató un superávit (+10) de trabajadores de nivel medio, y el número de enfermeros proyectado (seis) era compatible con el disponible. Conclusión: la implementación/empleo estratégico del Sistema de Clasificación de Pacientes fue indispensable para la previsión del personal de enfermería pediátrica, considerando que el excedente de personal encontrado debe ser apreciado con cautela.

          Translated abstract

          ABSTRACT Objective: to describe the implementation of the Patient Classification System and the dimensioning of the nursing staff in a pediatric inpatient unit. Method: a descriptive, cross-sectional, and retrospective study, carried out at a university hospital in the Midwest of Brazil. After the implementation of the Pediatric Patient Classification System, we compiled data from the classifications of the level of care complexity (N=4,639) among patients (n=608) admitted from January to December 2019. Descriptive statistical analysis was employed, including proprietary methodology for staff sizing. Results: there was a prevalence of intermediate care patients. According to the staff dimensioning, there was a surplus (+10) of mid-level workers, and the projected number of nurses (six) was compatible with the available number. Conclusion: the strategic implementation/employment of the Patient Classification System was indispensable for the pediatric nursing staffing forecast, considering that the staffing surplus found should be appreciated with caution.

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          Pediatric patient classification system: improvement of an instrument

          Objective Improve the content validity of the instrument for classification of pediatric patients and evaluate its construct validity. Method A descriptive exploratory study in the measurement of the content validity index, and correlational design for construct validation through exploratory factor analysis. Results The content validity index for indicators was 0.99 and it was 0.97 for graded situations. Three domains were extracted in the construct validation, namely: patient, family and therapeutic procedures, with 74.97% of explained variance. The instrument showed evidences of content and construct validity. Conclusion The validation of the instrument occurred under the approach of family-centered care, and allowed incorporating some essential needs of childhood such as playing, interaction and affection in the content of the instrument.

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            Nurses’ Perceptions of Workload Burden in Pediatric Critical Care

            Quantifying nurses’ perceptions of workload burden when managing critically ill patients is essential for designing interventions to ease nurses’ workday. To explore pediatric intensive care unit (PICU) nurses’ perceptions of their workload when caring for critically ill patients and managing protocolized therapies. This study was embedded in a multicenter randomized clinical trial where participants were assigned to receive either lower-target or higher-target glucose control. Nurses from 35 participating PICUs completed a baseline survey containing questions about their perceptions of PICU workload in general. They completed an intervention survey after caring for a study patient. Two workload measurement instruments, the Subjective Workload Assessment Technique (SWAT) and the National Aeronautics and Space Administration–Task Load Index (NASA-TLX), were embedded in these surveys. Baseline surveys were completed by 1476 PICU nurses, predominantly female with a bachelor’s degree and a median (interquartile range) of 6 (3-11) years of nursing experience and 4 (2-9) years of PICU experience. Most nurses (65%) rated time burden as the most important component of their workload, followed by cognitive (22%) or psychological stress (13%) burden. Work performance was selected most often as contributing to workload, followed by cognitive demand, time pressure, effort, and physical demand. Intervention surveys were completed by 73% of enrolled participants (505 of 693). Nurses managing the lower glucose target group reported higher levels of workload burden as measured by the SWAT (P = .002) and NASA-TLX (P < .001). This study describes the workload burden perceived by PICU nurses when managing critically ill patients in general and when managing protocolized therapies.
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              Interrupções e seus efeitos sobre a dinâmica de trabalho do enfermeiro

              RESUMO Objetivos Investigar a percepção de enfermeiros sobre as interrupções durante a dinâmica de trabalho e suas implicações no ambiente de prática profissional. Métodos Pesquisa survey conduzida junto a 133 enfermeiros de um hospital de ensino no interior do Estado de São Paulo nos meses de outubro de 2015 a março de 2016, mediante utilização de um questionário autoadministrado. Empregou-se os testes Qui-quadrado e Fisher para análise estatística. Resultados A maioria dos enfermeiros relatou interrupções constantes e recorrentes durante atividades de trabalho. Os processos interruptivos são mais frequentes durante o processo de documentação (n=118; 91,5%) e orientação ao paciente/família (n=58; 45%). São ocasionados por toque de telefone (n=114; 87%) e resolução de problemas na unidade (n=107; 81,7%). Conclusões No parecer dos enfermeiros, os processos interruptivos repercutem sobre a dinâmica de trabalho, o processo de cuidar e a segurança dos pacientes.
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                Author and article information

                Journal
                ce
                Cogitare Enfermagem
                Cogitare enferm.
                Universidade Federal do Paraná (Curitiba, PR, Brazil )
                1414-8536
                2176-9133
                2023
                : 28
                : e83871
                Affiliations
                [2] Cuiaba orgnameUniversidade Federal de Mato Grosso Brazil
                [4] Porto Alegre Rio Grande do Sul orgnameUniversidade Federal do Rio Grande do Sul orgdiv1Escola de Enfermagem Brazil
                [1] Cuiaba MT orgnameHospital Universitario Julio Muller/ Universidade Federal de Mato Grosso Brasil
                [3] Porto Alegre RS orgnameHospital de Clínicas de Porto Alegre Brasil
                Article
                S1414-85362023000100301 S1414-8536(23)02800000301
                10.1590/ce.v28i0.83871
                8e037d06-e0d0-4ff6-a612-8340c912870b

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 29 November 2021
                : 26 September 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 17, Pages: 0
                Product

                SciELO Revista de Enfermagem

                Categories
                Artigos Originais

                Reducción de Personal,Hospital.,Staff,Inpatient Care Units,Workload,Pediatric Nursing,Staffing Adjustment,Personal de Enfermería en Hospital.,Unidades de Internación,Carga de Trabajo,Enfermería Pediátrica,Recursos Humanos de Enfermagem no Hospital.,Unidades de Internação,Carga de Trabalho,Enfermagem Pediátrica,Ajuste de Pessoal

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