Abstract
Resumo Objetivo Analisar o ambiente da prática de enfermagem em unidades de terapia intensiva. Métodos Estudo descritivo, de abordagem quantitativa, realizado com 209 profissionais de enfermagem de três hospitais de ensino brasileiros. O ambiente da prática de enfermagem foi avaliado através da Practice Environment Scale. Os dados foram analisados descritivamente, assumindo nível de significância de 5% (p<0,05). O coeficiente Alfa de Cronbach foi utilizado para examinar a consistência interna dos construtos. Resultados Os profissionais de enfermagem consideraram desfavoráveis quatro das cinco dimensões do ambiente da prática profissional: participação dos enfermeiros na discussão dos assuntos hospitalares; fundamentos de enfermagem voltados para a qualidade do cuidado, habilidade, liderança e suporte dos coordenadores/supervisores de enfermagem aos enfermeiros/equipe de enfermagem; e adequação da equipe e de recursos. Apenas a dimensão relações colegiais entre profissionais de enfermagem e médicos apresentou avaliação positiva. Enfermeiros reconheceram mais fortemente atributos desfavoráveis no ambiente de prática do que técnicos de enfermagem. Conclusão O ambiente mostrou-se desfavorável para a prática dos profissionais de enfermagem. Esforços são necessários para tornar o ambiente de prática mais atrativo aos profissionais de enfermagem, e assim estimular melhorias na qualidade e na segurança da assistência prestada.
Highlights
IntroductionThe nursing practice environment has been understood as the organizational characteristics of a work context that facilitate or hinder professional practice
Healthcare systems all over the world are constantly challenged to meet communities’ health demands, facing budget constraints, which limit the potential of structures and affect working conditions.[1,2] it is increasingly evident that these conditions impact on the professionals’ capacity to provide care with quality and safety, especially on the nursing staff, as they spend more time in care environments and have a stronger interaction with the structure and culture of the organizations.[3]The nursing practice environment has been understood as the organizational characteristics of a work context that facilitate or hinder professional practice
In Brazil, the evaluation of the nursing work environment was boosted over the last years using predominantly the Nursing Work Index (NWI).(5) This instrument was developed in the 1980’s, aiming to describe the hospital organizational characteristics that are attractive to nursing
Summary
The nursing practice environment has been understood as the organizational characteristics of a work context that facilitate or hinder professional practice. It is the sum of material resources, personnel, corporate atmosphere and all others elements that affect directly or indirectly the care delivered to patients.[4]. Internal validity and evidence combined to the nursing body of knowledge, the use of the PES has been recommended and disseminated as a preferential measure in the nursing practice environment by the National Quality Forum (NQF) of the United States of America (USA) and as an effectiveness indicator of nursing care in the accreditation protocols of the Joint Commission.[6] its use is still limited in Brazil, considering that only one Brazilian study using the PES instrument was found after reviewing the literature.[7]. The PES has been proved as a fundamental tool in the management process of health decision makers, in the strategic planning focused on the nursing workforce, and in supporting actions for the improvement of professional and organizational performance.
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