Quality indicators applied in a nursing continuing education program of a high complexity university hospital from Brazil: IV - training indicator versus sizing and workload

Abstract

Despite the fact that lacks of personnel and excessive workload have been previously reported as limiting factors to participation in continuing education activities, there is an absence of studies which assess directly this association. In this scenario, the aim of this study was to analyze the relationship of workload and personnel sizing with the training indicator, mean hours of training per professional per unit of the one Continuing Education Program focused on nursing staff in a Brazilian University Hospital. For this, we used a sizing based on Patient Classification Systems (Adult, Pediatric and Psychiatric) or on Functional Site System methodologies proposed by the Federal Council of Nursing and then we associated the mean value of these sizing indicators with the mean number of hours of training per professional from each unit of the Hospital. While with inpatient services the increased workload is related to an increase in the training indicator, outpatient units and support services show the contrary, where an increase in workload decreases participation in the Continuing Education Program. The number of professionals in the unit or the percentage of adequacy of sizing, which represents the appropriateness or not of the sizing, were not associated with the number of hours of training per professional. We concluded that the complexity of the patient is one of the most important factors in the demand for training compared to sizing. Apparently the workload itself is not the limiting factor, at least for inpatient units. The workload affected the outpatients negatively, probably because the focus of the Continuing Education Program is more related to direct assistance to the patient. We concluded that the complexity of the patient was a relevant factor in the participation in the program, showing that professionals who deal with these more complex patients seek improvement.