According to a report of the Auditor General of the City of Buenos Aires (AGCBA), "one of the main obstacles to improving health" public is the "staff shortages" nursing record services intensive care and neonatal hospital Buenos Aires, where more than 400 agents are missing.

The watchdog analyzed the work done in 2013 by the Operational Management of Nursing, Ministry of Health of the City office that administers endowments workers of all acute care hospitals, more pediatric Ricardo Gutierrez, Maternity Sarda and Arthur Illia, and found that this dependence "does not have a strategic plan to guide their action." "In fact, says research-, there is no formal analysis of the situation that allows to know the reality of the resource it manages, the objectives proposed in the short and medium term, and the strategies to address the needs of the services was not evident", mentioned the report.

In numbers, the report adopted this year notes that, following legislation in force for 20 years, that just set the organization and functioning of the wards in the health centers, "deficit of 61 agents nursing intensive care was detected in the Santojanni Hospitals Fernandez Velez Sarsfield, Sarda, Alvarez, Zubizarreta, Rivadavia, Argerich and Tornú ". All of this, without counting the so-called "hours module", that were also reviewed by the audit.

In addition, as indicators of the health centers themselves and the rules already mentioned, also "a deficit of 348 agents nursing neonatology at the Santojanni Hospitals Fernandez, Rivadavia, Gutierrez, Sarda, Velez Sarsfield, Pirovano, Ramos Mejia, Argerich was detected, and Pinero Durand."

Thus the AGCBA concluded that the shortage of nurses for services, neonatology and intensive care amounts to 409 hospitals in all local hospitals.

Replacement, Retirement and Modules

Moreover, the survey recognizes that "although it has tended to fill vacant posts" adding that "the method selected was an instrument whose exceptional quality has become habitual."

It refers to the audit module system, consisting in assigning personnel overtime in activity. It is a methodology that was first used in 2006, just as an exceptional measure, to address the lack of nurses who already at that time affected the hospitals of the city.

A module is six hours and, under current regulations, a nurse can serve up to seven hours per day, a day that is reduced to six if the agent is engaged in intensive care.

And, as the City authorizes up to 20 modules per month, in recent years cases of nurses who worked 12 hours per day were given. On the impact of this methodology is worth remembering a report adopted in 2013 by the AGCBA, in which it was noted that the overload agents generated between 2010 and 2011 at least 370 cases of "professional diseases long treatment, with problems related to the musculoskeletal system, mental and behavioral disorders".

As the last survey of the watchdog repeats the diagnosis, it ensures that the method causes "work overload, increased risk factors for agents and also suffers the quality of nursing care provided to patients."

The audit also adds that "not complies with the unhealthy or hazardous tasks (set out in a national law in 1991 and a decree of 2007) in the sample hospitals." And, beyond overload "performing nursing tasks in critical areas by an amount exceeding hours (which imposes regulations) distorts the proper service delivery and limits the comprehensive patient care."

To complete this picture, the report says "there is no strategic plan to plan ahead replacements low (given in the schools of Buenos Aires hospitals) by retirements" in the aforementioned Operational Management Nursing.