Competências gerenciais nas ações inovadoras realizadas por enfermeiras na atenção primária à saúde

Publication year: 2020
Theses and dissertations in Portugués presented to the Universidade Federal do Paraná to obtain the academic title of Mestre. Leader: Peres, Aida Maris

Para que a enfermagem possa alcançar seu pleno potencial na equipe de saúde é apropriado o desenvolvimento e aprimoramento de competências por meio das ações produzidas em serviço. Este estudo teve como objetivos analisar as relações entre as ações inovadoras e as competências gerenciais mobilizadas por enfermeiros na Atenção Primaria à Saúde (APS), caracterizar as ações inovadoras desenvolvidas e apreender as competências gerenciais que influenciam na prática dessas ações inovadoras. Trata-se de uma pesquisa qualitativa, descritiva e exploratória, de corte transversal, a qual teve a participação de 30 enfermeiros assistenciais e 46 enfermeiros gerenciais que atuavam na APS do município de Curitiba - PR. A coleta de dados ocorreu por meio de entrevistas com roteiro semiestruturado. Para o processamento dos dados, utilizou-se o software IRAMUTEQ, o qual faz análises estatísticas de dados qualitativos. A análise sucedeu por meio da análise especificidades fatorial de correspondências (AFC) e a Classificação Hierárquica Descendente.

A partir da análise surgiram as classes:

1) Atividades inovadoras na reorganização do fluxo assistencial; 2) O protagonismo das enfermeiras para envolver a equipe e população na atividade inovadora e, 3) a busca do conhecimento na aplicação da atividade inovadora. Cada uma das classes apresentou competências gerenciais as quais se destacaram na influência da implantação da atividade inovadora. A interpretação dos dados foi sustentada a partir da perspectiva teórica apresentada do Triplo Impacto da Enfermagem. Conclui-se que atividades inovadoras estão voltadas a assistência prestada aos usuários do serviço e as melhores condições no processo de trabalho em equipe, com ênfase nas dimensões assistir, administrar e ensinar. Quanto às competências gerenciais, observou-se que a comunicação, o trabalho em equipe e a liderança apresentaram similaridade entre as classes, a qual foi demonstrada em vertentes diferenciadas, salientando sua influência na execução das atividades inovadoras e a ênfase do papel do enfermeiro como agentes da mudança. Assim, infere-se que os enfermeiros dispõem de grande reservatório de talento e que estas ações são suficientes para serem compartilhadas, todavia, é importante que sejam compreendidas e alcancem melhor impacto. Este estudo permite novas vertentes de investigação voltadas aos demais âmbitos do sistema de saúde e dimensões de atuação do enfermeiro, de modo a oportunizar o conhecimento das atividades realizadas, bem como as competências gerenciais aplicadas.
For nursing to reach its full potential in the health team, it is necessary to develop and improve competences through actions developed in service. This study aimed to analyze the relationships between innovative actions and management competencies mobilized by nurses in Primary Health Care (PHC), to characterize the innovative actions developed and to learn the management competencies that influence the practice of these innovative actions. This is a qualitative, descriptive, exploratory, cross-sectional research, which was attended by 30 ward nurses and 46 managerial nurses who worked in the PHC of Curitiba - PR. Data collection was done through interviews with a semi-structured script. For data processing, IRAMUTEQ software was used, performing statistical analyses of qualitative data. The analysis was performed through the Factorial Analysis of Correspondence (FAC) and the Descending Hierarchical Classification.

From the analysis emerged the classes:

1) Innovative activities in the reorganization of care flow; 2) The role of nurses to involve the team and population in the innovative activity and, 3) the pursuit of knowledge in the application of the innovative activity. Each of the classes presented management competencies that stood out in the influence of the implementation of the innovative activity. Data interpretation was supported by the theoretical perspective of the Triple Impact of Nursing. It is concluded that innovative activities are focused on patient care and the best conditions in the teamwork process, with emphasis on assisting, managing and teaching dimensions. Regarding management competences, it was observed that communication, teamwork, and leadership showed similarity between the classes, which was demonstrated in different aspects, emphasizing its influence on the execution of innovative activities and the emphasis of the nurse's role as agents of change. Thus, it is inferred that nurses have a large reservoir of talent and that these actions are sufficient to be shared, however, they must be understood and achieve better impact. This study allows new strands of research focused on the other health system areas and dimensions of nursing performance, to provide the knowledge of the activities performed, as well as the applied management skills.

Abstract:

For nursing to reach its full potential in the health team, it is necessary to develop and improve competences through actions developed in service. This study aimed to analyze the relationships between innovative actions and management competencies mobilized by nurses in Primary Health Care (PHC), to characterize the innovative actions developed and to learn the management competencies that influence the practice of these innovative actions. This is a qualitative, descriptive, exploratory, cross-sectional research, which was attended by 30 ward nurses and 46 managerial nurses who worked in the PHC of Curitiba - PR. Data collection was done through interviews with a semi-structured script. For data processing, IRAMUTEQ software was used, performing statistical analyses of qualitative data. The analysis was performed through the Factorial Analysis of Correspondence (FAC) and the Descending Hierarchical Classification.

From the analysis emerged the classes:

1) Innovative activities in the reorganization of care flow; 2) The role of nurses to involve the team and population in the innovative activity and, 3) the pursuit of knowledge in the application of the innovative activity. Each of the classes presented management competencies that stood out in the influence of the implementation of the innovative activity. Data interpretation was supported by the theoretical perspective of the Triple Impact of Nursing. It is concluded that innovative activities are focused on patient care and the best conditions in the teamwork process, with emphasis on assisting, managing and teaching dimensions. Regarding management competences, it was observed that communication, teamwork, and leadership showed similarity between the classes, which was demonstrated in different aspects, emphasizing its influence on the execution of innovative activities and the emphasis of the nurse's role as agents of change. Thus, it is inferred that nurses have a large reservoir of talent and that these actions are sufficient to be shared, however, they must be understood and achieve better impact. This study allows new strands of research focused on the other health system areas and dimensions of nursing performance, to provide the knowledge of the activities performed, as well as the applied management skills.

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