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| 6.86 MB | Adobe PDF | |||
| 321.85 KB | Adobe PDF |
Advisor(s)
Abstract(s)
Numa unidade de cuidados críticos, onde a qualquer momento o doente pode desencadear uma paragem cardíaca ou respiratória, a intervenção da equipa de enfermagem e médica tem de ser imediata, eficiente e eficaz. O gestor de unidades de saúde deve ter a responsabilidade, e a consciência, da importância de os serviços estarem devidamente organizados e apetrechados, para fazerem face a situações de emergência. A inexistência ou inacessibilidade a Equipamentos de Suporte Vital (ESV) pode levar a eventos adversos com enorme impacto na segurança e vida dos doentes. A Unidade de Cuidados Intermédios neurocirúrgicos (UCINT) de um hospital da região de Lisboa, depara-se com problemas de layout e desenho arquitetónico, que levam enfermeiros a desperdiçar tempo, movimentos, transporte e potencial humano no acesso a ESV. Os objetivos desta dissertação são realçar a importância da aplicação da filosofia Lean, num serviço de saúde, para uma melhor assistência ao doente crítico, e reduzir, pelo menos para metade, os tempos, passos e distância percorrida no acesso a ESV. Em termos metodológicos recorreu-se à aplicação de metodologias Lean através de um estudo de investigação-ação, com abordagem mista e desenho longitudinal do tipo experimental antes-após com grupo único intra-sujeitos. Obtiveram-se resultados qualitativos de melhoria da assistência ao doente crítico e da organização e acessibilidade a ESV, alocando--os junto do ponto de uso o que permite intervenções quase imediatas. Otimizou-se a disposição, disponibilidade e localização de stocks, materiais e equipamentos. Quantitativamente, melhorou-se o conhecimento dos enfermeiros da existência e localização de ESV (100% a 200%), reduziu-se para menos de metade os tempos, passos e distância percorridas pelos enfermeiros na acessibilidade a ESV (-87.12% a -96.41%), melhorando-a (687.46% a 2,733.8%). Concluiu-se que a filosofia Lean mune o gestor de unidades de saúde com metodologias e ferramentas que o ajudam a criar ganhos em saúde, a implementar uma cultura de melhoria contínua da prestação de cuidados e ambiente de trabalho, a identificar e eliminar as barreiras e os desperdícios que limitam a atuação dos profissionais em prestar serviços de qualidade e em salvar vidas humanas.
In a critical care unit, where at any moment patients can trigger a cardiac or respiratory arrest, the intervention of nursing and medical staff must be immediate, efficient and effective. Health unit managers must have the responsibility, and consciousness, of the importance that services are properly organized and equipped to cope with emergencies. The unavailability or inaccessibility of Life Support Equipment (LSE) can lead to adverse events with huge impact on the safety and lives of patients. The neurosurgical Intermediate Care Unit of a hospital in the Lisbon region, faces with layout and architectural design problems, which leads nurses to waste time, movement, transportation and human potential accessing LSE. The aims of this dissertation are highlight the importance of applying Lean philosophy in a health care service, for an improved critically ill patient assistance, and reduce, at least by half, time, steps and distance traveled accessing LSE. The methodology followed an application of Lean methodologies through an action research investigation, supported by a longitudinal mixed method approach, within-subjects one group pretest-posttest experimental type design. The qualitative results were improved critically ill patients care as like improved organization and accessibility to LSE, placing them at the point of use and allowing almost immediate interventions. The layout, availability and location of stocks, materials and equipment were optimized. Quantitatively, nurses knowledge of LSE existence and location as improved (100% to 200%). Time, steps and distance traveled by nurses accessing LSE as reduced more than half (-87.12% to -96.41%), improving it (687.46% to 2,733.8%). Was concluded that Lean philosophy empowers health unit managers with tools and methodologies that helps them create health gains, implement a culture of care and working environment continuous improvement, identify and eliminate barriers and waste that limits the work of staff in providing quality services and saving lives.
In a critical care unit, where at any moment patients can trigger a cardiac or respiratory arrest, the intervention of nursing and medical staff must be immediate, efficient and effective. Health unit managers must have the responsibility, and consciousness, of the importance that services are properly organized and equipped to cope with emergencies. The unavailability or inaccessibility of Life Support Equipment (LSE) can lead to adverse events with huge impact on the safety and lives of patients. The neurosurgical Intermediate Care Unit of a hospital in the Lisbon region, faces with layout and architectural design problems, which leads nurses to waste time, movement, transportation and human potential accessing LSE. The aims of this dissertation are highlight the importance of applying Lean philosophy in a health care service, for an improved critically ill patient assistance, and reduce, at least by half, time, steps and distance traveled accessing LSE. The methodology followed an application of Lean methodologies through an action research investigation, supported by a longitudinal mixed method approach, within-subjects one group pretest-posttest experimental type design. The qualitative results were improved critically ill patients care as like improved organization and accessibility to LSE, placing them at the point of use and allowing almost immediate interventions. The layout, availability and location of stocks, materials and equipment were optimized. Quantitatively, nurses knowledge of LSE existence and location as improved (100% to 200%). Time, steps and distance traveled by nurses accessing LSE as reduced more than half (-87.12% to -96.41%), improving it (687.46% to 2,733.8%). Was concluded that Lean philosophy empowers health unit managers with tools and methodologies that helps them create health gains, implement a culture of care and working environment continuous improvement, identify and eliminate barriers and waste that limits the work of staff in providing quality services and saving lives.
Description
Keywords
Prestação de cuidados de saúde - Metodologia Learn - Gestão de qualidade Equipamento de suporte vital - Acessibilidade