Hospital management is always based on its quality cost structure, which are the costs linked to quality control in the production, logistics of a product or service. It should be borne in mind that it is necessary to maintain permanent investments not only to acquire quality and to maintain it. The costs of intensive care continue to rise (since the 1970s). The implementation of protocols results in reduction of costs / gains for the patient, evidence-based practice results in gain, protocols for prevention of catheter-related infections and associated pneumonia Mechanical ventilation, use of sedation and analgesia in the ICU, associated with weaning and inadequate use of antibiotics and nutritional support. Strategic management involves patient satisfaction, through "talent retention" (specialist nurse maintenance) in order to achieve continuous improvement through training, in which alone it can achieve the success of an institution. It should be noted that the technical qualifications of nurses must be taken into account. The proportion of nurse / patient can be adjusted taking into account the competencies or other health professionals. Objective: to design basic knowledge in the area of ​​business management applied to health, in the strategic planning approach of a nursing professional Content: literature review including models studied in the human knowledge area, as well as the basic requirements recommendations in the ICU as well as the structural and organizational aspects Conclusion: Professional training as a culture of prevention and the role of nurses in the development of prevention and control of infection are highlighted. Education continues with strategies to implement more effective measures in the quest for quality of care. The basis of management is the education of the nurse and the care of the caregiver.

1. Hospital management and Nursing
Gestão hospitalar e Enfermagem
António José Lopes de Almeida (Lisbon - Portugal)
|Nurse; Master in Nursing|
Nurse – Unidade de Cuidados Intensivos de Neurocríticos, Hospital de São José , CHULC, Lisboa
Assistant professor – Escola Superior de Enfermagem de Lisboa (ESEL)
Member of the Nursing Section - Portuguese Society of Intensive Care
December 4, 2018

6. Cost
Objects –
Products Cost
Resource
Consumption
Costs

7. Quality Cost
The quality control related cost in production, logistics of a
product or service.
Quality costs can be divided into four groups:
1. prevention costs
2. inspection costs
3. costs of internal failures
4. costs of external failures
https://pt.wikipedia.org/wiki/Custo

8. Quality Cost
The quality control related cost in production, logistics of a
product or service.
Quality costs can be divided into four groups:
1. prevention costs
2. inspection costs
3. costs of internal failures
4. costs of external failures
https://pt.wikipedia.org/wiki/Custo
Are recorded all the
expenses that the company
incurred in order to avoid
failures

9. Quality Cost
The quality control related cost in production, logistics of a
product or service.
Quality costs can be divided into four groups:
1. prevention costs
2. inspection costs
3. costs of internal failures
4. costs of external failures
https://pt.wikipedia.org/wiki/Custo
The expenses related to the
inspection activities carried
out by the companies are
recorded

10. Quality Cost
The quality control related cost in production, logistics of a
product or service.
Quality costs can be divided into four groups:
1. prevention costs
2. inspection costs
3. costs of internal failures
4. costs of external failures
https://pt.wikipedia.org/wiki/Custo
Obligate the expenses related to
the work activities. Therefore, if
the inspection was not efficient, it
will be in this group the costs that
will be verified will be the expenses
for the adequacy of the product

11. Quality Cost
The quality control related cost in production, logistics of a
product or service.
Quality costs can be divided into four groups:
1. prevention costs
2. inspection costs
3. costs of internal failures
4. costs of external failures
https://pt.wikipedia.org/wiki/Custo
Relates to the costs related to
failures discovered by consumers.
Warranty covers, recall expenses,
etc. are recorded. The company
must keep in mind that it is
necessary to maintain permanent
investments not only to acquire the
quality but for its maintenance

12. Quality Cost
The quality control related cost in production, logistics of a
product or service.
Quality costs can be divided into four groups:
1. prevention costs,
2. inspection costs,
3. costs of internal failures,
4. costs of external failures
https://pt.wikipedia.org/wiki/Custo
The more investments in
the first two smaller groups
tend to be the costs of the
last two groups over time

14. Centro Hospitalar
Universitário de
Lisboa Central, EPE

16. Reducing Costs
Collaborating on the solution of health care
dilemma:
maintain quality
and
contain or reduce costs

17. HOW TO
INNOVATE?

20. BASIC CONCEPTS
Systems
Organization
Management
Management
systems
Quality
Strategies

21. Management in intensive care: concepts and innovations
Gestão em terapia intensiva: conceitos e inovações

22. COSTS MANAGEMENT
Costs in
intensive care
continue to rise
(since 1970 that
began his
accounting)
The question
"how much
does a life cost"
may sound
superficial, but
is part of the
reality
experienced in
an ICUs
Implementation
of protocols
results in a
reduction of
costs / gains for
the patient
Evidence-based
practice results
in a gain
Protocols for
the prevention
of infections
related to
catheters and
Ventilation, use
of sedation and
analgesia in
ICUs
Inadequate use
of antibiotics
and nutritional
support

23. STRATEGIC MANAGEMENT
Patient
satisfaction
"Retaining
talents"
Continuous
improvement
Financial
success

24. QUALITY MANAGEMENT
Equity
Legitimacy
Acceptability
of assistance
optimization
effectiveness
effciency

25. Management of the Intensive Care Unit
Caregiving is subject to a number of
factors that may contribute to failure:
• Lack of communication
• Difficulty in handling data
• Poor dialogue between different sectors
• Lack of strategic planning

26. Antibiotics represent a high-consumption item and
hospitals, particularly in the more severe patient’s unit,
such as ICUs. The inadequacy, abusive use of ATB and the
lack of criteria in the choice of empirical treatment rely on
imperative determining conditions for the emergence of
several resistant microorganisms in ICU
(Couto RC e col. Epidemiologia, controle e tratamento, Editora Médica e
Científica 2003)

27. 12 Breaking chain contagion
1 1 Isolate the pathogen
10 Interrupt when cured
9 Know how to say "no" to the vanco
8 Treating infection, not colonization
7 Treating infection, not contamination
6 Use local data
5 Use antibiotic control measures
4 Consult specialists
3 Identify the pathogen
2 Remove unnecessary catheters
1 Vaccinate
Prevent transmission
Using antimicrobials
in a sensible way
Diagnose and treat
indeed
Prevent infections
Centers of Disease Control, 2002
12 Steps to Preventing Antibiotic
Resistance: Adult Hospitalization
Campaign to prevent antibiotic resistance in health care

28. Professional training as a preventive culture
and the role of the nurse in the development
of infection prevention and control actions
are highlighted and continuing education
with strategies to implement more effective
measures in the search for quality of care
Preventive culture
Continuing education

29. Good Nursing Practices pass:
• urinary infection associated with urinary
catheterization
• intravascular catheterization related
infection
• Mechanical Ventilation-associated
Pneumonia
• Surgical site / surgical wounds infection
• Handwashing
• Hygiene care for the bedridden patient

30. urinary infection
associated with
urinary
catheterization

31. intravascular
catheterization related
infection

32. Mechanical
Ventilation-
associated
Pneumonia

34. Skin Flora of the
Sick
Fluids
contaminated
Colonization
Of the catheter
Hands of
professionals
Contamination
During insertion
Dissemination by
Bleeding tract
Infection entrance doors

35. Standardize measures to
prevent the dissemination /
propagation of infections
within the hospital

37. Handwashing

38. BACTERIA OF THE
APPARATUS TO THE
HANDS
MOBILE PHYSICIAN, SOURCE
OF INFECTIONS
...) The surface of the telephones
serves as a reservoir for
numerous hospital bacteria (...)
(...) The toilets should clean
the devices to not infect patients
(...)
Source: Elmundo.es
Maria Valério
Notícias » Saúde
6 / 03 / 2009 2:40(CET)
BACTERIA OF THE APPARATUS TO
THE HANDS

40. Hands that lead to
healing can not
transmit death

41. but allows
Save lifes,
improve the quality and safety of
care and reduce the final costs of
providing health care
The prevention and
control of Health Care
Associated Diseases
entails costs for the
institutions

42. Three levels of care:
Level I, II and III
Depends on pharmacological support
And technology support
To monitor the load of Nursing work per shift
in the ICU

43. The nurse / patient ratio can be adapted taking into
account the competencies of the professional
To monitor the load of Nursing work per shift
in the ICU

44. Various levels of care can be
integrated into an ICU.
The calculation of the capacity of the
ICU should be based on the ability to
work and not on the bed number
To monitor the load of Nursing work
per shift in the ICU

45. There are no "magic or miracle" solutions to managing a complex and expensive
industry. On the other hand, a simple and effective set of measures may be the
answer to the future of Intensive Care
Inovation

46. Different dimensions highlight an attitude of
proactivity towards the future and the
formulation of new challenges

47. Technological
plan
tecnology
Knowledge
inovation

48. Videoconferência-
Apoio Telemáticoà
GenéticaMédica
Videoconference -
TelematicSupport
for Medical
Genetics

49. Center for
Clinical Genetics
(CGC)

50. Information and
Communication
Technologies (ICT)

51. electronic patient
card

53. 6 steps to
reduce costs

54. Development and implementation of
care protocols
It changes the conduct of the professionals leading to the reduction
of examinations and the increase of the prescription of medicines /
treatments more cost-effective

55. Greater security in decision making
Use of
information
technology

56. Simplification and standardization of
administrative processes
Numerous paying sources lead to a bureaucratic increase and the time
spent by professionals

57. Encouraging competition and
transparency of prices and results
Professional fees and contract clauses

58. Integration of the
various levels of
assistance, especially
with regard to the
sharing of care
information
The number of day of
hospitalization is related to the
number of medical visits

59. Punitive action by the justice system against abusive
and fraudulent practices in the health system
The intentional provision of unnecessary or inadequate services
Billing of services that are not provided, often involving patients in fraud or using deceased
patient names
Misrepresentation of the cost of health care by insurers and health plans
Commission / Gratuity for referrals for unnecessary services
False labeling of a drug by a pharmaceutical company
Abuse of the health system by patients to receive services that may be harmful to their health

60. Hospital management and Nurse
Gestão hospitalar e Enfermagem

61. What makes a work
environment healthy?
O que torna um ambiente de trabalho saudável?

62. Skilled Communication
Habilidades nacomunicação
Be as proficient in communication skills as you are in clinical
skills

63. True
Collaboration
Verdadeiracolaboração
Be relentless in seeking and
promoting true collaboration

64. Effective Decision Making
Tomada dedecisão eficaz
Being a committed partner in policy making, directing and evaluating
clinical care, and conducting organizational operations

65. Appropriate
Staffing
Pessoaladequado
Ensure effective matching
between patient needs and
nursing competencies

66. Meaningful
Recognition
Reconhecimentosignificativo
Be recognized and recognize others for
the value that each brings to the work of
the organization

67. Authentic Leadership
Liderançaautêntica
Fully embrace the imperative of an authentic healthy work
environment, live and engage others in its realization

68. Interdependece
of healthy work,
environmente
clinical
excellence, and
optimal patient
outcomes

71. Let's take care
of who cares

73. antonioalmeidalx@gmail.com