Gestão do tempo no planeamento de cuidados de enfermagem

INTRODUCTION: Time management is an area where organizations seek to intervene in terms of planning and implementation of products and services, trying to adapt the procedures to the professional’s individual and collective performances in the formal aspects of operational issues, in order to influence their levels of productivity. In the context of nursing there have also been studies directed to the Organization of work and working methods, so as to influence the Organization in terms of productivity. OBJECTIVES: The present study aims to account the time of nursing care provided directly to patients in the Medicine and Surgery services in the morning shift and the quantification of time available for other cares. METHODS: An observational, quantitative, transversal and descriptive-correlational study was carried out, on a hospital in the central region of the province of Beira Alta, through observation of 159 nurses, mostly females (94,3%), with an average age of 37 years and average service time of 12 years, during the provision of direct care to patients in the morning shift, with a nurse/patient ratio of 1/5 on the Medicine and 1/6 on the Surgery Services. RESULTS: The 159 observations of nurses during the provision of care to patients aged 66 years or over (73,6%), totally dependent (50,9%) and in need of an average 5,5 hours of care per day, according to the Patients Classification system in nursing (SCD/E), have resulted in an average time of 31’ for the execution of direct care per patient, being 37’ in the Medicine and 26’ in the Surgery services. Facing the nurse/patient ratio, the time available for other nursing interventions that do not require the presence of the patient, was 44’ per patient, after removing the shift rotation, morning break and meal time. The interventions related to the preparation and administration of therapy, hygiene and implementation of dressings for the treatment of wounds and tissue regeneration, consumed the largest average times in the shift, respectively of 7,83’, 6,37’ and 3,44’. The nurses time of service was a predictor of the care time on the shift (r=-0,439; p = 0,034). CONCLUSIONS: A nurse/patient ratio per service in accordance with the norms facing the needs of hours of care was observed, but the times used in the provision of care fall short of the recommended by the Order of Nurses and legislation, in particular with regard to the treatment of wounds (30’) and medication administration (15’). On the other hand, it was found that the longer the professionals time of service, the lower the direct care time provided at the shift. The allocation of more time on the part of professionals for other care that does not require the presence of the patients, in particular records, was noticed, which leads us to assume the need for more time to the execution of the same, despite the introduction of new technologies and software support, keeping nurses away from the patients.