Sustentabilidade ambiental nos processos de medicação realizados na assistência de enfermagem hospitalar
Arquivos
Data
2015
Autores
Furukawa, Patricia de Oliveira 
Orientadores
Cunha, Isabel Cristina Kowal Olm
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: hospitais e serviços de saúde geram impactos ambientais que contribuem para a mudança climática e afetam a saúde humana. A Enfermagem tem um importante papel na melhoria da sustentabilidade ambiental nos serviços de saúde como grande consumidor de recursos e gerador de resíduos. Dentre as suas principais atividades, estão os processos de medicação. Objetivos: verificar ações relativas à sustentabilidade ambiental durante os processos de medicação realizados pela equipe de Enfermagem e propor intervenções para a promoção de práticas sustentáveis nesta área da assistência hospitalar. Método: estudo quase experimental (antes e depois) com a utilização da metodologia Lean Seis Sigma, aplicado em uma Unidade de Terapia Intensiva de um hospital do município de São Paulo. A amostra constituiuse de 324 processos de medicação realizados pela equipe de Enfermagem antes e após intervenções (total: 648). Os processos analisados envolveram 99 profissionais na fase préintervenção e 97 na fase pósintervenção. A variável independente consistiu de estratégias de melhorias nos processos de medicação e a variável dependente incluiu a prática de ações sustentáveis do ponto de vista ambiental na assistência de enfermagem hospitalar de acordo com a Política dos 3 R: reduzir, reutilizar e reciclar, contida no Plano de Ação Global para o alcance do desenvolvimento sustentável da Organização das Nações Unidas. Os dados foram coletados por meio de roteiros de observação e analisados quantitativamente. As variáveis foram associadas por meio de estatística inferencial, segundo a natureza das variáveis pesquisadas, sendo o nível de rejeição da hipótese de nulidade fixado em menor ou igual a 0,05. Resultados: houve aumento das ações ecologicamente sustentáveis realizadas pela equipe de Enfermagem com as intervenções (média de 69,5% no período préintervenção e de 79,9% no período pósintervenção com pvalor = 0.001). Como consequência, houve redução de materiais como sacos plásticos (37,1%), redução nas sobras de antiinflamatórios hormonais (67,18%), aumento na remoção de etiquetas de sacos plásticos para serem reciclados (146,9%) e descarte correto de resíduos (32,2%) relacionados a embalagens primárias de medicamentos considerados perigosos à saúde humana e ao meio ambiente com diferença estatística significante (p ≤0.05). O reúso de materiais como sacos plásticos, embora tenha tido aumento de 42,9%, não teve diferença estatística significante (pvalor = 0.417). Conclusões: a implementação de melhorias nos processos de medicação promoveu a prática de ações sustentáveis realizadas pela equipe de Enfermagem, reduzindo desperdícios mediante o uso racional de recursos, assim como a geração de resíduos, com benefícios não apenas ambientais, mas também econômicos para a instituição.
Introduction: Hospitals and health services generate environmental impacts that contribute to climate change and affect human health. Nurses have an important role in improving environmental sustainability in health services as large consumers of resources and waste generators. Among their main activities are the medication processes. Objectives: to verify actions related to environmental sustainability during medication processes performed by the Nursing staff and to propose interventions for the promotion of sustainable practices in this area of hospital care. Method: quasiexperimental (before and after design) study using Lean Six Sigma methodology applied in an Intensive Care Unit of a hospital in the city of Sao Paulo. The sample consisted of 324 medication processes performed by the Nursing staff before and after interventions (total: 648). The analyzed processes involved 99 professionals in the preintervention phase and 97 professionals in the postintervention phase. The independent variable consisted of improvement strategies in the medication processes and the dependent variable included the practice of sustainable actions from an environmental point of view in hospital Nursing care according to the policy of the 3 R: reduce, reuse and recycle contained in Global Action Plan to achieve sustainable development of the United Nations Organization. Data were collected through observation scripts and analyzed quantitatively. The variables were associated with inferential statistics, according to the nature of the variables studied, being set at less than or equal to 0.05 of the level of rejection of the null hypothesis. Results: There was an increase in environmentally friendly actions performed by Nursing staff after interventions (mean of 69.5% in the preintervention period and 79.9% in the postintervention period with pvalue = 0.001). Consequently, there was a reduction of materials use such as plastic bags (37.1%), reduction of residual steroidal antiinflammatories (67.1%), increased removal of labels from plastic bags so that they can be properly recycled (146.9%) and proper disposal of waste (32.2%) especially those related to primary packaging of drugs considered hazardous to the environment and human health, with a statistically significant difference (p <0.05). The reuse of plastic bags increased 42.9% but was not statistically significant. Conclusions: the implementation of improvements in medication processes promoted the practice of sustainable actions performed by the Nursing staff, reducing waste through the rational use of resources and the generation of waste, with social and environmental benefits, as well as for the economics aspects of the institution.
Introduction: Hospitals and health services generate environmental impacts that contribute to climate change and affect human health. Nurses have an important role in improving environmental sustainability in health services as large consumers of resources and waste generators. Among their main activities are the medication processes. Objectives: to verify actions related to environmental sustainability during medication processes performed by the Nursing staff and to propose interventions for the promotion of sustainable practices in this area of hospital care. Method: quasiexperimental (before and after design) study using Lean Six Sigma methodology applied in an Intensive Care Unit of a hospital in the city of Sao Paulo. The sample consisted of 324 medication processes performed by the Nursing staff before and after interventions (total: 648). The analyzed processes involved 99 professionals in the preintervention phase and 97 professionals in the postintervention phase. The independent variable consisted of improvement strategies in the medication processes and the dependent variable included the practice of sustainable actions from an environmental point of view in hospital Nursing care according to the policy of the 3 R: reduce, reuse and recycle contained in Global Action Plan to achieve sustainable development of the United Nations Organization. Data were collected through observation scripts and analyzed quantitatively. The variables were associated with inferential statistics, according to the nature of the variables studied, being set at less than or equal to 0.05 of the level of rejection of the null hypothesis. Results: There was an increase in environmentally friendly actions performed by Nursing staff after interventions (mean of 69.5% in the preintervention period and 79.9% in the postintervention period with pvalue = 0.001). Consequently, there was a reduction of materials use such as plastic bags (37.1%), reduction of residual steroidal antiinflammatories (67.1%), increased removal of labels from plastic bags so that they can be properly recycled (146.9%) and proper disposal of waste (32.2%) especially those related to primary packaging of drugs considered hazardous to the environment and human health, with a statistically significant difference (p <0.05). The reuse of plastic bags increased 42.9% but was not statistically significant. Conclusions: the implementation of improvements in medication processes promoted the practice of sustainable actions performed by the Nursing staff, reducing waste through the rational use of resources and the generation of waste, with social and environmental benefits, as well as for the economics aspects of the institution.
Descrição
Citação
FURUKAWA, Patrícia de Oliveira. Sustentabilidade ambiental nos processos de medicação realizados na assistência de enfermagem hospitalar. 2015. [209] p. Tese (Doutorado em Enfermagem) - Escola Paulista de Enfermagem (EPE), Universidade Federal de São Paulo (UNIFESP), São Paulo, 2015.