The main purpose of this article is to analyze the impact of the workers' behavior in terms of their emotions and feelings in system's performance, i.e., one is looking at issues concerned with Organizational Sustainability. Indeed, one's aim is to define a process that motivates and inspires managers and personnel to act upon the limit, i.e., to achieve the organizational goals through an effective and efficient implementation of operational and behavioral strategies. The focus will be on the importance of specific psychosocial variables that may affect collective pro-organizational attitudes. Data that is increasing exponentially, and somehow being out of control, i.e., the question is to know the correct value of the information that may be behind these numbers.

System analyses deal with interrelationships between different variables that keep the system in balance. In many analysis of complex thinking, a system is viewed as a complex unit in which the ‘whole’ is not reduced to the ‘sum’ of its parts; the system becomes an ambiguous item because it consists of several entities that interact with unforeseen results or, in other words, it is situated at a transdisciplinary level, it is impossible for an area to have a complete reading of its complexity. It was also mentioned that the concept of the open system best describes complexity by stating that ‘the laws of the organization are not equilibrium, but an imbalance that is restored or compensated for by stabilized dynamics’. This idea originated from the field of thermodynamics and the second law, in which the imbalance that it maintains allows the system for an apparent balance. This fragile steady state has something of a paradox, since the structures remain the same, but their constituents are changeable. The concept of open system undoes the door to a theory of evolution that can only derive from the interactions between a system and its ecosystem. Within this systemic approach, the focus of the analysis takes into account the ambiguity, multidisciplinary and complexity associated with system adjustment, i.e. it is intended to qualify an employee job based on their experience and knowledge as a measure of their impact on the organization performance.

A confusão aguda é uma situação grave, que engloba alteração da atenção, da consciência e da cognição, desenvolvendo-se num curto período de tempo. Existem um conjunto de intervenções não farmacológicas que ajudam na sua prevenção, nas quais a atuação autónoma do enfermeiro é fundamental. OBJETIVO: Identificar as intervenções autónomas de enfermagem que previnem a confusão aguda em doentes adultos internados em Unidades de Cuidados Intensivos. MÉTODOS: Revisão integrativa da literatura, através da Pubmed, Repositórios Científicos de Acesso Aberto de Portugal, CINAHL, Medline e Scielo, utilizando os descritores: "Delirium" AND "Critical Care" AND "Nursing" AND "Disease prevention", durante Fevereiro e Março de 2019. Foram incluídos na revisão os artigos publicados entre 2014-2019; com texto integral de acesso livre; escritos em português; espanhol ou inglês; que dessem resposta ao objetivo do estudo. RESULTADOS: Foram incluídos 8 estudos na revisão, que correspondiam aos critérios de inclusão. Verificou-se que as intervenções não farmacológicas mais utilizadas pelos enfermeiros, para a prevenção da confusão aguda em pessoas adultas internadas em Unidades de Cuidados Intensivos, podem ser distribuídas por sete áreas: promoção da estimulação sensorial; promoção da orientação; envolvimento da família; gestão da dor; gestão ambiental; promoção do sono e mobilização precoce e posicionamento. Face a estas áreas elencou-se um conjunto de intervenções autónomas de enfermagem, com recurso a linguagem classificada, através da Classificação Internacional para a Prática de Enfermagem-CIPE®, versão 2017. CONCLUSÕES: Os resultados obtidos permitiram identificar um conjunto de intervenções autónomas de enfermagem, que são eficazes na prevenção da confusão aguda, em doentes adultos internados em Unidades de Cuidados Intensivos, o que se traduz em ganhos em saúde para o utente e ganhos económicos para a instituição.

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The aim of this study is to examine the effective communication process during shift changes in a transitional care unit; communication should be clear, concise and relevant. The caregivers should be able to understand their mates needs and wants, and they should understand what is happening. Indeed, it will be study if there is inconsistency in the communication process during shift change, since there are some factors that could be affecting the consistency, such as inadequate time for communication, lack of awareness about the needs of other team members and unclear expectations from managers, a process carried out by interviewing employees who have experience in transitional care. The interviewees are asked about their past experiences and what they think are the most important points for effective communication. No doubt this article will discuss the communication challenges and opportunities that arise when a caregiver transfers care from one shift to the next, with effective communication being the key. On the other hand, in this work is also set a Logic Programming based framework that nurses may use to optimize their insight into how caregivers may make their communication more effective by understanding the needs of both parties involved in the shift change process.