Percepções de enfermeiros acerca da implementação da avaliação na atenção básica

Abstract

The continuous search for a model which reorganizes the management practices, focused on results that will provide the effectiveness of actions and services to the user is a challenge. The obstacles that the quality of the management of the public services faces is to reach the resolutiveness. In this configuration, several health evaluation initiatives have been developed by the Ministry of Health (MS), among them, the National Program for Improving Access and Quality of Basic Care (PMAQ-AB) is being established as an evaluation tool. The success of the program is based on the actions carried out by the multidisciplinary team. In this work context, the figure of the nurse who integrates the field and nucleus of knowledge is evidenced. Therefore, it is aimed to know the perception of the Nurses of Family Health Strategy (ESF) of the municipalities of the 19th Regional Health Coordination of the state of Rio Grande do Sul (CRS / RS) about the implementation of the PMAQ and the repercussions on health actions, questioning, what is the perception of the ESF nurses about the implementation of the PMAQ and the repercussion of this in the actions in health in the Primary Care? For that, a field study was developed, with a qualitative, exploratory and descriptive approach of a social nature. The scenario encompasses 26 municipalities of the 19th CRS / RS, of which the study integrates nurses working in ESF, agreed with the PMAQ. The data collection was done through interview with guiding questions, recorded and transcribed, making up the thematic analysis. It should be noted that all ethical precepts were complied with, pursuant to Resolution 466/2012. The implementation of the PMAQ enabled the institution of a new cycle of the National Program of Basic Attention (PNAB), intending the advances in the health and the strengthening of qualification of the actions offered in the public health. However, it does not minimize the day-to-day challenges the service faces, but it justifies MS's increased investment in maintaining the program, doubling federal investment in AB through PMAQ evaluative cycles, promoting standards for work practices and organization, fostering innovation and the quality of the use of information systems, strengthening the critical reflection of professionals and re-signifying the work process. Therefore, the implementation of actions depend on evaluation processes and the development and implementation of an appropriate pedagogical approach to increase the knowledge and actions of the actors involved. Therefore, the PMAQ can be considered a contribution and an expressive support in the work process, organization and planning, not only supported by the financial incentive, but by the elevation of the quality of the health services. The results of this research provide support for a more in-depth reflection on the role of nurses, ratified by their importance in relation to the PMAQ, especially in the organization of AB. Thus, this study has the social duty to contribute to the construction of knowledge on the subject, reaffirming the importance of establishing a permanent, efficient and efficient evaluation culture based on quality, concerned with work processes and especially with users of the health system.