MU1 Professionals required in Bed Management |
Bed Management must be essentially composed of nursing professionals (14) (E). Other professionals were also mentioned, such as teams with nurses, doctors and social workers (12) (E). |
26 |
8.7 % |
MU2 Qualification and experience of the nurse in Bed Management |
To work in Bed Management, nurses must have knowledge of both management and care (30). For this, they can use instruments such as the Fugulin Scale and Nursing Staffing, and must have a vision focused on the financial sustainability of the hospital. The professional must have experience in management (6) and experience in care (31). They must know how the flow and the units of the hospital work (23). The knowledge the nurse acquires during their training - in technical-scientific courses and on the health-illness process in nursing undergraduate courses - were considered sufficient to work in the service (6). Qualification, at the level of graduation, was not considered as a requirement to work in this service (4). However, the doctors and residents pointed out the need for training in management and care (2). The nurse must have competences (3) such as: leadership, decision making and teamwork. Flexibility (10) negotiation (7), proactivity (2), communication and agility (3), were also mentioned (E) |
127 |
42.3 % |
MU3 Profile of patients in the hospital |
The Bed Management nurse assesses the patient profile as criteria for bed allocation, seeing, for example, if the patient is classified as elective, palliative, hospitalized for bone marrow transplantation, or critical (2) (D) |
02 |
0.7 % |
MU4 Physical, material and technological resources. |
It was observed that nurses use computer, telephone and pager. These resources are considered essential for communication with other units and services. Regarding the structure, the space is shared with other services, includes a bathroom and a kitchen, and is accessible, illuminated and ventilated (1) (O) |
01 |
0.3 % |
MU5 Workload and organization of the service |
Nurses in Bed Management work 12x36 hour shifts, with one professional per shift (1) (D). The service is organized by flow/itinerary, considering from entrance to the hospital to the other services involved (1) (D). |
02 |
0.7 % |
MU6 Difficulties |
Communication between Bed Management nurses, care nurses and resident physicians is fragile, which is also related to their lack of knowledge about the transfer flow of patients in hospital beds (25) (E, O). Another difficulty was the material and physical resources of the institution, such as isolation beds and the great demand in contrast with the lack of beds in the hospital (25) (E, O). The clinical profile of the patients admitted, which is incompatible with the care characteristics of the care unit, was a weakness in the perspective of the care nurses (12) (E). The culture of the professionals in the institution with their peers was mentioned by the Bed Management nurses as a barrier to their performance in the service (4) (E). Aspects that lead to hospital discharge (5) (E), the work overload of nurses in the healthcare units (4) (E), fragile medical support (3) (E) and access to previous patient information (3) (E) were other fragilities that were pointed out (E). |
81 |
27 % |
MU7 Advantages |
One advantage pointed out by the participants was the centralization of Bed Management in the hands of the Bed Management nurse, that is, only one service is responsible for this activity (22) (E). This makes allocation and/or transfer of patients quicker (10) (E, O), since nurses have an overview of hospital beds, while other professionals have a perspective limited to their unit/service (8) (E, O). The nurse can improve the work process by reducing the number of empty beds (2) (E). x |
42 |
14 % |
MU8 Aspects that lead to quality of life and work motivation from the perspective of nurses in Bed Management |
Personal satisfaction when meeting the patient's need and recognition of their work were important motivations for nurses' work in Bed Management (8). Accidents, injuries and illnesses related to work in Bed Management were not mentioned by the nurses of this service (5). Support from bosses, colleagues and services involved was considered an aspect of quality of life, as it provides a fluid working environment (3). For them, quality of life is also related to psychological preparation, as there is communication with different professionals and conflict mediation is necessary (2). The availability of resources to do the work was also mentioned (1) (E). |
19 |
6.3 % |
Total
|
300 |
100% |