Entrepreneurial management technology for nursing professionals

Tecnología de gestión emprendedora para la enfermería

ABSTRACT

Objectives:

to validate entrepreneurial management technology for the nursing practice.

Methods:

methodological study, carried out based on the development of an entrepreneurial management technology, based on literature review and, later, content validation by 11 experts, recognized by their peers as entrepreneurs. The validation process took place through Delphi conferences, between June and September 2018.

Results:

on the second round of Delphi conferences, at least 90% agreement was obtained on all items. In addition, all items were validated as pertinent and considered prospective and inducing of new thinking and acting among nursing professionals who wish to undertake and explore opportunities, goods, and services in the area.

Final Considerations:

it was noted that the experts, in general, showed good adherence to the initiative and ease in validating the theoretical-conceptual dimension and the dimension of “Personal/professional qualities necessary for the performance of entrepreneurial management”; however, they had difficulty in validating the methodological steps.

Descriptors:
Technology; Change Management; Nursing; Professional Autonomy; Validation Studies.

RESUMEN

Objetivos:

validar tecnología de gestión emprendedora para la enfermería.

Métodos:

estudio metodológico basado en desarrollo de una tecnología de gestión emprendedora, pautado en revisión de literatura y, posterior, validez de contenido por 11 expertos, reconocidos por sus pares como emprendedores. Proceso de validación ocurrió por conferencia Delphi, entre junio y septiembre de 2018.

Resultados:

pbtuvo, con la segunda rodada Delphi, por lo menos 90% de concordancia en todos ítems. Además, todos los ítems validaron como pertinentes y considerados prospectivos e inductores de un nuevo pensar y actuar entre los profesionales de enfermería que deseen emprender y explorar oportunidades, bienes y servicios en la área.

Consideraciones Finales:

denotó que los expertos, en general, presentaron buena adhesión a la iniciativa y facilidad en la validación de la dimensión teórico-conceptual y de la dimensión “Calidades personales/profesionales necesarias al desempeño de la gestión emprendedora”, pero presentaron dificultad en la validación de los pasos metodológicos.

Descriptores:
Tecnología; Gestión de Cambio; Enfermería; Autonomía Profesional; Estudios de Validación.

RESUMO

Objetivos:

validar tecnologia de gestão empreendedora para a enfermagem.

Métodos:

estudo metodológico realizado com base no desenvolvimento de uma tecnologia de gestão empreendedora, pautando-se na revisão de literatura e, posterior, validação de conteúdo por 11 experts, reconhecidos pelos seus pares como empreendedores. O processo de validação ocorreu por conferência Delphi, entre junho e setembro de 2018.

Resultados:

obteve-se, com a segunda rodada Delphi, pelo menos 90% de concordância em todos os itens. Além disso, todos os itens foram validados como pertinentes e considerados prospectivos e indutores de um novo pensar e agir entre os profissionais de enfermagem que desejam empreender e explorar oportunidades, bens e serviços na área.

Considerações Finais:

denotou-se que os experts, em geral, apresentaram boa adesão à iniciativa e facilidade na validação da dimensão teórico-conceitual e da dimensão “Qualidades pessoais/profissionais necessárias ao desempenho da gestão empreendedora”, contudo apresentaram dificuldade na validação dos passos metodológicos.

Descritores:
Tecnologia; Gestão de Mudança; Enfermagem; Autonomia Profissional; Estudos de Validação.

INTRODUCTION

Entrepreneurship has now become one of the most discussed and widespread themes in different areas of knowledge and with important theoretical and practical advances in the field of management. In addition to expanding employment possibilities, both in developed and developing countries, entrepreneurial management provides economic development and qualifies social and individual living standards by taking advantage of opportunities¹.

In the literature, entrepreneurship is used to define autonomous work or the start a new process. Additional definitions refer to the innovation and/or effect of (re)creating, evaluating and exploring opportunities, goods, and services. In this forward-looking direction, entrepreneurial management began to be associated with productivity, new investments, and the ability to leave the commonplace^1-2.

A more comprehensive approach defines the entrepreneur by his ability to create new ventures from something practically nonexistent. In other words, it translates into starting, making, reaching, and building new processes instead of watching, analyzing or describing something that already exists. It means being the protagonist of a new way of perceiving, conceiving, and realizing opportunities where others see only disorder and chaos³.

Although there is no consensus regarding the definition of entrepreneurship, one of the commonly cited descriptions is that of the economist Schumpeter, who used the economic model to explain the entrepreneurial process. The mentioned author defends five scenarios/spaces in which entrepreneurship can occur: the introduction of a new good or a new quality of a good; the introduction of a new production method; opening a new market; in the search of a new source of supply of raw materials; and in the fulfillment of a new organization/management/enterprise in any space⁴.

Based on this theoretical construction on the theme, the study suggests changing the focus of the analysis of the phenomenon of entrepreneurship and the attributes of the individual (entrepreneur) for the characteristics of an entrepreneurial management mode, that is, as a way of managing business and exploring new opportunities. The entrepreneurial management mode is characterized, therefore, in three dimensions: capacity for innovation; ability to take risks; and the ability to act proactively as a willingness to anticipate market needs and surpass your competitors⁵.

However, in the field of health, in a more incipient way, entrepreneurship constitutes a new trend to add social and health value, both in the public and private sectors. The third industrial revolution - based on the dissemination of new technologies, such as microelectronics, robotics, and information technology, as well as new production and management models - provides understanding for changes in the contemporary world. Such changes, in the management of human resources, overcame the mechanistic logic and formulated theories centered on the subjectivity of work, considering variables such as motivation, leadership, interpersonal relationships, and entrepreneurial management. Following this logic, the health sector is becoming more flexible to the demands of the user and, in turn, more open to entrepreneurial possibilities^5-6.

Nursing/health professionals need, based on this understanding, not only to create new ventures/technologies, but prospect sustainable projects, anchored in entrepreneurial management, understood by the willingness to conceive, develop and manage a product, service or business, through interactive approaches and associative with the various sectors of society. Therefore, it means transposing linearized vertical thinking and investing in horizontal and systemic processes to awaken possibilities and synergize individual and collective talents^7-8.

To overcome existing traditional models and leading new theoretical and methodological approaches to management in the nursing field requires professionals to be able to create their own future based on ethical principles and human and social values. In addition, the global scenario requires the exercise of proactive leadership and flexibility in view of continuous changes. This also demands dynamic multidisciplinary teams focused on lifelong learning⁹.

Thus, within the scope of prospective instigations of culture, of the market and of the emerging organizations, studies on entrepreneurial management find prominence in different areas of knowledge. Despite the significant number of studies on this topic, there are still conceptual gaps on entrepreneurial management in the health field, as well as the lack of validated studies on entrepreneurial management technologies for nursing, that is, technologies capable of articulating academic knowledge and the knowledge of entrepreneurial practice.

OBJECTIVES

To validate entrepreneurial management technology for nursing.

METHODS

Ethical aspects

The recommendations of Resolution No. 466/2012 of the National Health Council were followed. The project was submitted to and approved by the institutional Research Ethics Committee. The experts who participated in this study were informed about the purpose and nature of the study. Those who agreed to participate signed the Free and Informed Consent Form.

Theoretical-methodological reference

As a theoretical reference, the assumptions of social entrepreneurship were used; and for methodological reference, methodological research. It is argued that the nurse assumes, from the perspective of social entrepreneurship, a decisive and proactive role in terms of identifying the population’s care needs and society’s demands. Still, it is argued that the nursing professional moves as a proactive social agent, through dialogical and complementary processes, capable of transcending the biomedical model and prospecting new knowledge and practices, in addition to new possibilities for entrepreneurial management⁷.

Type of study

Qualitative research of a methodological character developed based on the conceptual structuring; definition of objectives and population; construction of items and a response scale; selection and organization of items; structuring the instrument; expert opinions; and content validity. Its approach has meanings that allow to expand perceptions, perspectives, and behaviors that cannot be reduced to linear variables¹⁰. The present investigation was structured and conducted based on the Consolidated Criteria for Reporting Qualitative Research (COREQ)¹¹.

Methodological procedure

Study scenario

The study does not have a specific scenario, considering that the experts who participated in the technology validation process were selected using the “snowball” method.

Eleven experts participated in the study (10 nurses and 1 university manager in the area of education). By judgment, those who met the following inclusion criteria were selected: extensive theoretical-practical experience in management and entrepreneurship, in addition to an entrepreneurial profile recognized by peers, as also adopted by studies previously carried out^12-13, in addition to having an article published in an indexed journal in an area of interest to this study. Experts who did not respond to the invitation to participate in the study were excluded.

For the identification of professionals, in addition to the “snowball” indication technique, a search for the Lattes and/or Vitae Curriculums was carried out, in order to analyze its context according to previously defined inclusion and exclusion criteria. In this process, 14 experts were identified, of whom 11 agreed to participate in the study.

Data source

For the construction of technology, a search was carried out on the Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) [Latin American and Caribbean Literature in Health Sciences], Scientific Electronic Library Online (SciELO), and Banco de Dados em Enfermagem (BDENF) [Nursing Databases] databases between April and June 2018. In this process, the descriptors “Entrepreneurship” and “Nursing” were used, without a previously defined search period, due to the limited number of publications in this area.

Among the selected articles, 16 were in LILACS, 13 in SciELO, and 9 in BDENF. Next, the 38 studies were read in full to identify which ones responded satisfactorily to the proposed theme. As a result, we obtained a sample of 19 articles which were carefully analyzed and discussed to compose the body of this study.

In the following phase, carried out between June and July 2018, the theoretical methodological outline was elaborated, that is, the preliminary validation instrument with the dimensions: Conceptual theoretical; Entrepreneurial qualities; and the methodological course (Entrepreneurial step by step) - as well as their respective items.

Data collection and organization

Finally, content validation of the dimensions and items of the instrument was carried out, based on previously established criteria. The experts were invited, by means of a guiding invitation letter, sent by e-mail, containing: the analysis matrix, the objective and methodology of the study, the description of the instrument, and the reason for their selection as a professional evaluator, as suggested by another study¹⁴. It is important to consider, in the content validation analysis, the clarity and understanding of the dimensions and items, the degree of relevance of the content of the theoretical methodological technology, among other aspects¹². The experts evaluated each of the items of the three dimensions, based on numerical values: (1) Not important; (2) Not too important; (3) Relatively important; (4) Important; (5) Very important - according to the Likert-type psychometric scale. It was granted, in the instrument, space for them to signal necessary suggestions or changes, which were incorporated in the final version.

For the creation of the layout and design of the theoretical-methodological technology, we relied on competent professionals in the design area. After a first construction, the draft was sent to the researchers part of the Research and Study Group in Social Entrepreneurship for Nursing professionals, who, through a Delphi conference, validated their final presentation.

Data analysis

Based on the Likert-type psychometric scale, the index score was calculated by adding the agreement of the items marked as “4” or “5”, by the experts (considered as relevant), divided by the total number of responses. In the qualitative analysis of the content validity, the Content Validity Index (CVI) was considered and, after the Delphi conference, the 80% agreement percentage as a decision criterion on the pertinence or modification of each of the items of the instrument.

RESULTS

11 experts participated in the content validation of entrepreneurial management technology in the light of social entrepreneurship, of which 10 nurses between 50 and 60 years old (5/45,45%), these were exclusively women, including a 68-year-old university manager. The training time of nursing professionals ranged from 20 to 30 years, and that of the university manager was 21 years in this function. Of the ten nurses, five have autonomous ventures and five work in teaching and research, with the last having a doctoral degree. Of the 11 experts, 7 are Brazilian, from five different states, and 4 are foreigners, 1 from Chile, 1 from Colombia, 1 from Switzerland, and 1 from Scotland. All were selected using the “snowball” indication technique, and the entrepreneurial profile of each was confirmed by the Lattes and/or Vitae curriculum.

For the choice of the first two experts who subsequently indicated the next participants, the entrepreneurial profile was considered based on the following characteristics: nurses who started an autonomous enterprise to provide nursing care; nurses with autonomous enterprise certified by a foreign organization; and nurses with some publication in the area of entrepreneurship, identified by searching the Lattes and/or Vitae curriculum.

Management technology for nursing in the light of social entrepreneurship was composed of 3 dimensions and 17 items, which were organized in a complementary and prospective way. It was intuited, under this focus, that nurses with a desire to undertake and explore new opportunities, goods and services in the area, have, in practice, scientifically validated management tools to guide their entrepreneurial path.

The first dimension (theoretical-conceptual) consists of five items that signal theoretical perceptions about entrepreneurial management. The second dimension describes, in eight items, the personal/professional qualities necessary for the performance of entrepreneurial management. The third dimension systematizes, in six items, the methodological steps to be considered by that professional who wishes to be the protagonists of new technologies/enterprises/means of caring.

Of the 17 items validated by the experts, 4 had the option “Important” checked; and 13, the “Very important” option. With the second round of Delphi, at least 90% agreement was obtained on all items. In addition, all items were validated as pertinent and considered prospective for nursing professionals who wish to invest in new professional spaces/enterprises.

Although the items have been described in clear and objective language to allow the understanding of the content among experts, some terms generated doubts and demanded adjustments: for example, the expression “affirmative endomarketing”, which was integrated into the item “Entrepreneurial strategic plan with short-, medium- and long-term goals”. Likewise, the expression “Unwavering passion” has been changed to “Persistence and creativity to overcome the calculable risks and the implications of the competitive landscape”; and the expression “Collaborative Networking” has been changed to “Management of theoretical and practical knowledge through interactive and collaborative networks”. The main changes were associated with the “Methodological path” dimension, whereas, of the ten items in the first round, only six resulted after the analysis of the second Delphi round, bearing in mind that the experts suggested significant integrations and/or deletions.

In the “methodological course” dimension, they made observations regarding the items: “Validation of the innovative character of the entrepreneurial idea based on scientific evidence and consumer market trends” and “Theoretical-practical knowledge management through interactive and collaborative networks”. These items were questioned, more specifically, by independent freelance experts, who claimed insufficient theoretical and scientific knowledge to support both ideas.

The experts, in general, demonstrated prompt adherence to the validation proposal and, in an interval of ten days, provided an affirmative feedback. The object of investigation was appreciated by all, although some expressed questions about some theoretical expressions, which were not in their conceptual domain, especially for self-employed professionals, without ties to the academy.

Next, we present the entrepreneurial management technology for nursing professionals validated by the experts.

Figure 1
Entrepreneurial management technology for nursing professionals

DISCUSSION

The study of entrepreneurship, in the scope of management, has grown in size and depth, constituting an important and consistent research axis in the different areas of knowledge. Although it is one of the themes that has aroused the interest of researchers and freelance professionals, the exclusivity of theoretical and methodological technologies in administration and economics is presented as a limitation in this study. Another limitation pertains to the scarcity of studies on the construction and validation of entrepreneurial management technologies for the nursing/health area, in order to favor the comparison and expansion of theoretical-practical discussions regarding the objective under investigation.

The analysis of the validation process allows us to consider that there is a certain accumulation of technical knowledge, above all, in relation to autonomous ventures, but often superficial and focused only on technical entrepreneurial skills and, to a lesser extent, in the field of entrepreneurial management. In addition to technical skills, conceptual theoretical assumptions, and the design of a prospective entrepreneurial management path, society’s demands must also be taken into account.

In this sense, studies demonstrate that it is not enough to accumulate or stock technical-scientific knowledge, but it is necessary to seek and explore opportunities for growth and change by overcoming traditional intervention processes. It is necessary for the information to be discussed, assimilated, and oriented towards the dissemination and protagonist of new ideas, spaces, technologies, and entrepreneurial ventures^1,4. Another study shows that the technical skills of entrepreneurial management must be transcended, by reaching prospective attitudes of self-management, leadership, teamwork, and commitment to social transformation¹⁵.

Still, in the same direction, a study recognizes that the way in which the entrepreneurial management process occurs can determine the success and/or failure of an enterprise. It is recommended that the entrepreneur has, in addition to technical skills and practical experience, associative potential to establish the necessary connections, as well as leadership to manage the venture with talent and thus generate healthy growth and sustainable development^16,17.

Investments in the training of entrepreneurs is, therefore, an important strategy for expanding interactive and systemic possibilities, as well as encouraging the development of proactive attitudes in line with society’s demands. Universities, in this field of discussions, play an important role through teaching, research, and making this knowledge part of curriculum, that is, as opinion makers by capitalizing on knowledge as a means to leverage society’s needs¹⁸.

Entrepreneurship is not configured, under this thinking, as an academic discipline with the meaning that is usually attributed to administration, economics, or any other consolidated discipline. The entrepreneur develops himself through the search for self-knowledge and through an attitude of openness to new experiences and paradigms. Entrepreneurship is a process that must be conceived and played out throughout life, through meaningful and forward-looking teaching and learning approaches¹⁷.

Regarding theoretical understanding, the items validated within “entrepreneurial management” corroborate the idea that entrepreneurship is a device that transcends linear and punctual concepts or ideas that can be reproduced within the scope of management. It is, therefore, a process that induces new possibilities, capable of providing something new and transforming, based on very little or almost nothing. Within nursing, in particular, entrepreneurial management is a strategic tool for setting goals related to both the organization and dynamization of the work process and the promotion of healthy living for individuals, families, and communities^7,18.

In the search for an expanded and entrepreneurial understanding of nursing care and in the sense of enabling effective mechanisms to intervene in the dynamics of healthy living - understood here as a unique, circular, and interactive process, dynamized through experiences of order and disorder⁷ - the nurse has been projecting himself as the protagonist of a new way of thinking and acting. When conceiving nursing as the science of promoting nursing care to human beings in their uniqueness and multidimensionality, articulated with other health professionals, it is admitted that only an expanded and prospective thinking of care/caring is able to account for the paradoxical movements of being - being in a continuous process of self-organization and healthy living^7,17.

Regarding entrepreneurial qualities, the common components described by most studies show similar connotations. In this process, the following stand out: initiative to create a new business and passion for what you do; taking advantage of available resources in a creative way, in order to transform the real social and economic environment; risk acceptance and the possibility of failing and formulating the necessary knowledge to support continuous strategic decisions^1,6.

Although studies have presented four phases of entrepreneurial management - identify and evaluate opportunities; develop a business plan; determine and raise the necessary resources; manage the organization^2,9 -, the present study validated its own prospectus, six stages, in order to broaden and deepen the theoretical-methodological perception, namely: Immersion in reality and recognition of the entrepreneurial idea; Analysis of the internal environment and the implications of the external environment; Validation of the innovative character of the entrepreneurial idea based on scientific evidence and consumer market trends; Entrepreneurial strategic plan with short, medium, and long term goals; Management of theoretical and practical knowledge through interactive and collaborative networks; and Monitoring and systematic assessment of the internal and external impact of the entrepreneurial plan.

Thus, it is necessary, in addition to the four or six phases of the entrepreneurial management process, that the professional (in this case, the nurse) focus on developing best practices that contribute to human and social development. Studies emphasize, under this focus, the importance of disseminating a training culture focused on social entrepreneurship, able to subordinate the economic to the human, the individual to the collective and the dream of solving social problems^6,19. It is important, therefore, that universities and different training spaces invest in the development of entrepreneurial pedagogical projects to foster social protagonism in different areas of knowledge and, thus, enable the necessary transformations.

Study limitations

As a limitation of this study, we consider the few current thematic studies on entrepreneurial management, as well as validated theoretical and methodological processes on the topic, in the area of nursing/health. Thus, the discussion of the results needed to consider, almost exclusively, research in areas of economic and social sciences.

Contributions to the nursing field

The theoretical-methodological technology on entrepreneurial management, validated by experts, can be used in training environments, health care spaces and, mainly, by professionals who wish to lead new knowledge and practices within the scope of organization and management. Technology will also contribute to the expansion of discussions on the assumptions of entrepreneurship and to the articulation between academic knowledge and entrepreneurial practice, by integrating theoretical perceptions and successful practical experiences in the area of entrepreneurship.

FINAL CONSIDERATIONS

It was noted that, in general, the experts showed good adherence to the initiative and ease in validating the theoretical-conceptual dimension and the “Personal/professional qualities necessary for the performance of entrepreneurial management” dimension. They presented some difficulty, however, in validating the methodological steps to be considered by those professionals with a desire to lead new entrepreneurial possibilities, which may be related to the few studies on the subject in the field of nursing.

At least 90% agreement was obtained through the Delphi conference on all items of technology validation. In addition, all items were validated by experts, as pertinent and considered prospective and inducing a new thinking and acting among nursing professionals who wish to undertake and explore opportunities, goods, and services in the area.

The study will contribute to the expansion of discussions on the assumptions of entrepreneurship and its articulation with management, especially in the area of nursing/health. It will also help in the process of articulation between academic knowledge and entrepreneurial practice, for the integration of theoretical perceptions and successful practical experiences in the area of entrepreneurship. In short, it is suggested that further studies be carried out to broadly validate, based on national and international scientific evidence, the phases/stages related to the entrepreneurial process in nursing/health.

REFERENCES

• ¹
  Turan N, Kaya N, Aydin GO. Strategies for the involvement of nurses as entrepreneurs in healthcare. PAP-WCTIE-V.4. 2017;(6):39-42. https://doi.org/10.17261/Pressacademia.2017.514
  » https://doi.org/10.17261/Pressacademia.2017.514
• ²
  Andrade AC, Ben LWD, Sanna MC. Entrepreneurship in Nursing: overview of companies in the State of São Paulo. Rev Bras Enferm. 2015;68(1):40-4. https://doi.org/10.1590/0034-7167.2015680106p
  » https://doi.org/10.1590/0034-7167.2015680106p
• ³
  Markiewicz VJA, Ljzerman MJ. Medical devices early assessment methods: systematic literature review. Int J Technol Assess Health Care. 2014;30(2):137-46. https://doi.org/10.1017/S0266462314000026
  » https://doi.org/10.1017/S0266462314000026
• ⁴
  Kovalainen A, Österberg-högstedt J. Entrepreneurship within social and health care: a question of identity, gender and professionalism. Int J Gender Entrepreneurship. 2013;5(1):17-35. https://doi.org/10.1108/17566261311305193
  » https://doi.org/10.1108/17566261311305193
• ⁵
  Castanhar JC. Desenvolvimento de um Modelo Empreendedor de Gestão. Est Adm Soc. 2017;2(1):42-66. https://doi.org/10.22409/eas.v2i1.31
  » https://doi.org/10.22409/eas.v2i1.31
• ⁶
  Dakoumi AH, Abdelwahed Y. Is entrepreneurship for you? effects of storytelling on entrepreneurial intention. Int J Bus Manag. 2014;9(9):176-92. https://doi.org/10.5539/ijbm.v9n9p176
  » https://doi.org/10.5539/ijbm.v9n9p176
• ⁷
  Backes DS, Zamberlan C, Colomé J, Souza MT, Marchiori MT, Erdmann AL, et al. Interatividade sistémica entre os conceitos interdependentes de cuidado de enfermagem. Aquichán. 2016;16(1):24-31. https://doi.org/10.5294/aqui.2016.16.1.4
  » https://doi.org/10.5294/aqui.2016.16.1.4
• ⁸
  Schaefer RM, Italo F. Educação empreendedora: premissas, objetivos e metodologias. Rev Pens Contemp Adm. 2016;6(5):60-81. https://doi.org/10.12712/rpca.v10i3.816
  » https://doi.org/10.12712/rpca.v10i3.816
• ⁹
  Franco MMS, Hashimoto M. Liderança empreendedora e práticas de RH: um estudo sobre a eficácia na promoção do empreendedorismo corporativo. Rev Emp Gestão Peq Emp. 2014;3(3):104-28. https://doi.org/10.14211/regepe.v3i3.121
  » https://doi.org/10.14211/regepe.v3i3.121
• ¹⁰
  Minayo MCS. O desafio do conhecimento: pesquisa qualitativa em saúde. 14ª ed. São Paulo: Hucitec; 2014.
• ¹¹
  Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349-57. https://doi.org/10.1093/intqhc/mzm042
  » https://doi.org/10.1093/intqhc/mzm042
• ¹²
  Oliveira SC, Lopes MVO, Fernandes AFC. Development and validation of an educational booklet for healthy eating during pregnancy. Rev Latino-Am Enfermagem. 2014;22(4):611-20. https://doi.org/10.1590/0104-1169.3313.2459
  » https://doi.org/10.1590/0104-1169.3313.2459
• ¹³
  Scarparo AF, Laus AM, Azevedo ALCS, Freitas MRI, Gabriel CS, Chaves LDP. Reflexões sobre o uso da técnica Delphi em pesquisas na enfermagem. Rev Rene[Internet]. 2015 [cited 2019 Jul 10];13(1):242-51. Available from: https://www.researchgate.net/publication/281497981_Reflexoes_sobre_o_uso_da_tecnica_Delphi_em_pesquisas_na_enfermagem
  » https://www.researchgate.net/publication/281497981_Reflexoes_sobre_o_uso_da_tecnica_Delphi_em_pesquisas_na_enfermagem
• ¹⁴
  Valladares PSDA, Vasconcellos MA, DI Serio LC. Capacidade de inovação: revisão sistemática da literatura. RAC. 2014;18(5):598-626. https://doi.org/10.1590/1982-7849rac20141210
  » https://doi.org/10.1590/1982-7849rac20141210
• ¹⁵
  Heinze KL, Banaszak-Holl J, Babiak K. Social entrepreneurship in communities. Nonprofit Manag Leadersh [Internet]. 2016 [cited 2019 Jan 05];26(7):313-30. Available from: https://onlinelibrary.wiley.com/doi/full/10.1002/nml.21198
  » https://onlinelibrary.wiley.com/doi/full/10.1002/nml.21198
• ¹⁶
  Backes DS, Weissheimer AS, Halberstadt BMK, Megier ER, Machado R. Socially entrepreneurial activities in nursing: contributions to health/healthy living. Esc Anna Nery. 2016;20(1)77-82. https://doi.org/10.5935/1414-8145.20160011
  » https://doi.org/10.5935/1414-8145.20160011
• ¹⁷
  Altman M, Brinker D. Nursing social entrepreneurship leads to positive change. Nurs Manag [Internet]. 2016 [cited 2018 Dec 08];47(7):28-32. Available from: https://journals.lww.com/nursingmanagement/fulltext/2016/07000/Nursing_social_entrepreneurship_leads_to_positive.9.aspx
  » https://journals.lww.com/nursingmanagement/fulltext/2016/07000/Nursing_social_entrepreneurship_leads_to_positive.9.aspx
• ¹⁸
  Lomba MLLF, Toson M, Weissheimer AS, Backes TSB, Büscher A, Backes DS. Social entrepreneurship: translation of knowledge and practices in Brazilian nursing students. Rev Enferm Ref. 2018;4(19):107-16. https://doi.org/10.12707/RIV18064
  » https://doi.org/10.12707/RIV18064
• ¹⁹
  Brochier RCR, Capellari VG. Processo empreendedor: estudo de caso na empresa ADM LOG Transportes rodoviários Ltda. Rev Empreend Inov Tecnol. 2014;1(2):20-30. https://doi.org/10.18256/2359-3539/reit-imed.v1n2p20-30
  » https://doi.org/10.18256/2359-3539/reit-imed.v1n2p20-30

Edited by

EDITOR IN CHIEF: Antonio José de Almeida Filho

ASSOCIATE EDITOR: Maria Elisabete Salvador

Publication Dates

• Publication in this collection
  16 Aug 2021
• Date of issue
  2021

History

• Received
  10 Dec 2019
• Accepted
  28 Dec 2020