{"id":117561,"date":"2015-02-06T00:00:00","date_gmt":"2015-02-06T00:00:00","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/adecuacion-de-un-instrumento-de-medida-de-cargas-de-trabajo-y-analisis-de-su-nivel-de-cumplimiento-en-una-unidad-de-cuidados-intensivos-propuesta-de-oportunidad-de-mejora\/"},"modified":"2015-02-06T00:00:00","modified_gmt":"2015-02-06T00:00:00","slug":"adecuacion-de-un-instrumento-de-medida-de-cargas-de-trabajo-y-analisis-de-su-nivel-de-cumplimiento-en-una-unidad-de-cuidados-intensivos-propuesta-de-oportunidad-de-mejora","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/gestion-de-recursos-humanos\/adecuacion-de-un-instrumento-de-medida-de-cargas-de-trabajo-y-analisis-de-su-nivel-de-cumplimiento-en-una-unidad-de-cuidados-intensivos-propuesta-de-oportunidad-de-mejora\/","title":{"rendered":"Adecuaci\u00f3n de un instrumento de medida de cargas de trabajo y an\u00e1lisis de su nivel de cumplimiento en una unidad de cuidados intensivos: propuesta de oportunidad de mejora"},"content":{"rendered":"<h2>Tesis doctoral de <strong> Mar\u00eda  Fuensanta Hellin Gil <\/strong><\/h2>\n<p>En los \u00faltimos a\u00f1os, la profesi\u00f3n enfermera ha experimentado una evoluci\u00f3n acad\u00e9mica y asistencial, rompiendo su techo formativo y aplicando su propia metodolog\u00eda y taxonom\u00edas. A su vez, influyen  en ella factores externos, como el aumento de las nuevas tecnolog\u00edas, la humanizaci\u00f3n en la asistencia sanitaria, la calidad asistencial, y la crisis econ\u00f3mica, que propicia ajustes en recursos humanos, siendo enfermer\u00eda uno de los colectivos m\u00e1s afectado, al suponer una parte muy significativa del presupuesto de la empresa sanitaria. \tante esta situaci\u00f3n, es necesario ajustar las plantillas de enfermer\u00eda de forma m\u00e1s eficiente en t\u00e9rminos de gesti\u00f3n sanitaria, al mismo tiempo que se ofrece a los pacientes una atenci\u00f3n humana y de calidad, siguiendo los \u00faltimos avances tecnol\u00f3gicos y sin que suponga un freno a la evoluci\u00f3n de la profesi\u00f3n enfermera. Para ello, se hace imprescindible adecuar los recursos humanos de enfermer\u00eda en funci\u00f3n de las cargas de trabajo derivadas de las actividades que realizan durante cada turno, y todos los d\u00edas del a\u00f1o, sobre todo en unidades donde el nivel de cuidados, atenci\u00f3n y tecnificaci\u00f3n es m\u00e1s elevado, como ocurre en las unidades de cuidados intensivos (uci). en la uci objeto de nuestro estudio, utilizan desde hace a\u00f1os la escala nems como instrumento de medida de las cargas de trabajo de enfermer\u00eda, resultando inadecuada para la unidad, pacientes y profesionales, ya que no refleja la actividad real que desempe\u00f1an los enfermeros\/as, y presenta unos niveles de cumplimentaci\u00f3n insuficientes, que no permiten adecuar la ratio enfermera-paciente en funci\u00f3n de las cargas de trabajo existentes.   el objetivo de nuestro estudio, se centra en identificar el nivel de adecuaci\u00f3n de la escala nems a las caracter\u00edsticas de la unidad y sus pacientes, el tipo y cantidad de los resultados que se obtienen de ella, analizar c\u00f3mo se desarrolla y medir su nivel de cumplimiento. Adem\u00e1s, se plantea la escala nas como propuesta de mejora, analizando los resultados derivados de su aplicaci\u00f3n, al mismo tiempo que se conoce la opini\u00f3n\/satisfacci\u00f3n de los profesionales de enfermer\u00eda sobre las dos escalas de medida, una vez utilizadas en la pr\u00e1ctica. a trav\u00e9s de distintas metodolog\u00edas, como son las propias de  gesti\u00f3n de la calidad (ciclos de mejora), el dise\u00f1o y distribuci\u00f3n de cuestionarios a los profesionales, el an\u00e1lisis  retrospectivo de datos sobre el cumplimiento de la escala nems, y el trabajo de campo realizado al aplicar la escala nas, hemos obtenido unos resultados en los que el cumplimiento de la escala nems se sit\u00faa en un 67%, los d\u00edas evaluados, pudiendo valorar s\u00f3lo la carga de trabajo diaria, mientras que la escala nas, obtiene un cumplimiento del 82%,  se puede medir en todos los turnos, siendo el de mayor carga el turno de ma\u00f1ana, y permite el c\u00e1lculo de las enfermeras necesarias y de la ratio enfermera-paciente de forma m\u00e1s adecuada a la unidad y sus pacientes. Esta escala ha sido valorada con una puntuaci\u00f3n m\u00e1s elevada por los profesionales (7,20 puntos frente a 3,93 de la escala nems), que la ven m\u00e1s representativa del trabajo que desarrollan, al recoger casi todas las actividades de enfermer\u00eda que se realizan en uci. estos resultados, evidencian la necesidad de modificar tanto el proceso de medici\u00f3n de cargas de trabajo, como el instrumento utilizado, ya que no s\u00f3lo no resulta operativo ni eficaz para realizar la gesti\u00f3n del personal adecu\u00e1ndolo a las necesidades y demandas de los pacientes ingresados, sino que se ha demostrado que otros instrumentos alternativos como la escala nas pueden mejorar la gesti\u00f3n del personal de enfermer\u00eda, y en consecuencia la atenci\u00f3n sanitaria que se presta a los pacientes en situaci\u00f3n cr\u00edtica.  abstract in the last few years, the nursing profession has undergone an academic and healthcare evolution, surpassing its formative limit, and applying its own methodology and taxonomies. At the same time, external factors influence on them, such as the rising in the use of new technologies, the humanization and quality of health care and the global economic crisis, that propitiates adjustments in human resources, being the nursing profession one of the most affected groups, since they also involve a very significant part of the health enterprise&apos;s budget. it is necessary to adjust nursing templates in a more efficient way in terms of  health management, but we must also offer patients a humane, quality care, following the latest technology advances and without being a disincentive for the development of the nursing profession. For this reason, it is essential to adjust the nursing workforce in terms of workloads derived from activities performed in each of the shifts, and every day of the year, especially in those units where the level of care, attention and automation is higher, as in the intensive care unit (icu).  in our icu, the nems scale as a measure of nursing workload, has been used for years. This measurement process is inadequate for the unit, patients and nursing professionals, since it does not reflect the actual activity performed by the nurse in this unit, as well as it presents insufficient levels of completion that do not allow to adjust the nurse-patient ratio in role of existing workloads.  the aim of our study focuses on identifying the level of adequacy of the nems scale to the features of the unit and their patients, the type and quantity of the results obtained from it, and it analyzes how it develops and its level of compliance. In addition, an alternative scale is proposed for improvement, the nas scale, by which solutions are offered to the shortcomings of the previous one, analyzing the results derived from it, while the opinion\/satisfaction of nursing professionals is known about the two scales of measurement, once they have been implemented in practice.  some results have been obtained through the application of different methodologies, such as those typical of a program of quality management (improvement cycles), design and distribution of questionnaires to professionals, retrospective analysis of data on the performance of nems scale and fieldwork performed to implement the nas scale as a proposal for improvement. With the previously mentioned results, the accomplishment of the nems scale is set to 67% of days evaluated, being only able to assess the daily workload, while the nas scale, gets a compliance of 82%, and it can be measured in all shifts, being the one with the highest burden the morning shift, and it also allows the calculation of the necessary nurses and nurse-patient ratio in a more suitable way for the  unit and their patients, while it is valued with a higher score by professionals (7.20 points versus 3.93 in the nems scale), because they consider it to be more representative of the work they perform, collect nearly all nursing activities carried out in icu.  our study&apos;s results show the need to modify both the process of measuring nursing workload in the icu, as well as the instrument used for this purpose, since it is not operational or effective for adapting personnel management to the needs and demands of patients treated in the unit, but it has also been shown that alternative instruments can provide additional information and can complete this process in order to improve the management of nurses and consequently health care provided to patients in critical condition.<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Adecuaci\u00f3n de un instrumento de medida de cargas de trabajo y an\u00e1lisis de su nivel de cumplimiento en una unidad de cuidados intensivos: propuesta de oportunidad de mejora<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Adecuaci\u00f3n de un instrumento de medida de cargas de trabajo y an\u00e1lisis de su nivel de cumplimiento en una unidad de cuidados intensivos: propuesta de oportunidad de mejora <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Mar\u00eda  Fuensanta Hellin Gil <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Murcia<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 02\/06\/2015<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Mar\u00eda Jos\u00e9 L\u00f3pez Montesinos<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: Mar\u00eda  loreto Macia soler <\/li>\n<li>M\u00aa beatriz Lid\u00f3n cerezuela (vocal)<\/li>\n<li>blanca Torres manrique (vocal)<\/li>\n<li>joaqu\u00edn Uris selles (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Mar\u00eda Fuensanta Hellin Gil En los \u00faltimos a\u00f1os, la profesi\u00f3n enfermera ha experimentado una evoluci\u00f3n acad\u00e9mica y [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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