Assessment of the product of nursing care in specialized hospitals

To evaluate the product of care in units of specialized hospitals, identifying the items that most contributed to the score; to compare the product of care among hospitals, units, and shifts; to verify the association between demographic and professionals variables and the product of care.

Method:

Descriptive study, conducted in eight units of two specialized hospitals in the State of São Paulo. The evaluation of the product of care was performed by applying an instrument to 44 nurses.

Results:

"Multidisciplinary interaction and performance" obtained the lowest median in both hospitals, and the "Meeting assistance needs" and "Nursing care planning" were the better assessed ones. "Dimensioning of nursing staff" was the item that most contributed to the total score. There was a weak correlation between socio-demographic variables and score.

Conclusion:

The product of care, as found in both hospitals, was predominantly considered "good." The tool enabled the identification of critical aspects of the nursing work.

Descriptors:
Nursing Assessment; Process Assessment (Health Care); Professional Practice; Health Services Management; Specialized Hospitals

Classification	Hospital A n (%)	Hospital B n (%)	Total n (%)
Bad	-	-	-
Regular	18 (24.6)	11 (16.9)	29 (21)
Good	47 (64.3)	49 (75.3)	96 (69.5)
Great	8 (10.9)	5 (7.6)	13 (9.4)
Md Total Score (Q1; Q3)^* * Md: Median. Q1; Q3: Quartiles.	24 (21;26)	24 (22;26)	-
Md Score of the items (Q1; Q3)^* * Md: Median. Q1; Q3: Quartiles.	3 (2.5;3)	4 (3;4)	-

Items^* * Items: 1 - Nursing care planning; 2 - Resources required to providing care; 3 - Dimensioning of nursing staff; 4 - Educational actions and professional development; 5 - Care monitoring and transfer; 6 - Multidisciplinary interaction and performance; 7 - Patient/family care; 8 - Meeting the care needs.	Surgical	Clinic	Hematologic	BMT^* ***** BMT: Bone Marrow Transplantation.
	Md (IQR)^ Md: Median; IQR: Inter-quartile range.	Md (IQR)	Md (IQR)	Md (IQR)
1 - Care planning	3 (1)	2 (2)	3 (1.5)	3 (2)
2 - Required resources	3 (1)	4 (1)	4 (1)	4 (1)
3 - Dimensioning	3 (1)	3 (0.7)	3 (1)	4 (3)
4 - Educational actions	3 (1)	3 (1.7)	3 (1)	3 (1.5)
5 - Monitoring	3 (1)	3 (1)	3 (1.5)	3 (1)
6 - Interaction/performance	2 (2)	3 (2)	2 (2)	2 (3)
7 - Patient/family care	3 (2)	3 (1)	4 (1)	4 (0.5)
8 - Meeting/needs	3 (0)	3 (1)	4 (1)	4 (1)

Items^* * Items: 1 - Nursing care planning; 2 - Resources required to providing care; 3 - Dimensioning of nursing staff; 4 - Educational actions and professional development; 5 - Care monitoring and transfer; 6 - Multidisciplinary interaction and performance; 7 - Patient/family care; 8 - Meeting the care needs.	Kangaroo	ICU Neo⁺ + ICU Neo: Neonatal intensive care unit.	ICU Ped⁺⁺ ++ ICU Ped: Pediatric intensive care unit.	Maternity Unit
	Md (IQR)^ Md: Median; IQR: Inter-quartile range.	Md (IQR)	Md (IQR)	Md (IQR)
1 - Care planning	4 (1)	4 (1)	3 (1.5)	4 (1)
2 - Required resources	3 (1)	3 (1)	3 (0)	3 (0.7)
3 - Dimensioning	2 (1)	3 (1)	3 (1.5)	3 (0)
4 - Educational actions	4 (0)	3 (1)	3 (1)	3.5 (1.7)
5 - Monitoring	4 (2)	4 (1)	3 (0.5)	3 (1.7)
6 - Interaction/performance	4 (2)	2 (2)	2 (1.5)	3 (0.2)
7 - Patient/family care	4 (1)	3 (0)	3 (1)	3 (0.2)
8 - Meeting/needs	4 (0)	4 (1)	3 (1)	3 (1.7)

Instrument items	Factorials Loadings	Commonalities
1 - Care planning	0.20	0.70
2 - Required resources	0.70	0.52
3 - Dimensioning	0.78	0.61
4 - Educational actions	0.05	0.71
5 - Monitoring	0.29	0.64
6 - Interaction/performance	0.26	0.53
7 - Patient/family care	0.49	0.46
8 - Meeting/needs	0.57	0.58

Classification	Morning	Afternoon	Night	Total	p
H_A xH_B	45	46	47	138	0.01
- regular	13	12	4	29
- good	30	28	38	96
- great	2	6	5	13
H_A	25	22	26	73	0.08
- regular	8	6	4	18
- good	16	13	18	47
- great	1	3	4	8
H_B	20	24	21	65	0.10
- regular	5	6	-	11
- good	14	15	20	49
- great	1	3	1	5

Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

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[1] CORRESPONDING AUTHOR Mayara Ruiz Chotolli E-mail: mayarachotolli@hotmail.com