Quality of prescription writing in Brazilian primary health care.

OBJECTIVE: To evaluate the quality of prescription writing in the context of public primary health care. BACKGROUND: Prescription errors are one of the leading patient safety problems in primary care and can be caused by errors in therapeutic decisions or in the quality of prescription writing. METHODS: Cross-sectional observational study conducted in a municipality in Northeastern Brazil. The assessment instrument (including 13 indicators and one composite indicator) was applied to a representative sample of drug prescriptions from the 24 Family Health Teams providing Primary Health Care in the municipality, dispensed in January 2021. Estimates of compliance and their 95% confidence intervals and graphical analysis of frequencies are assessed globally and stratified by dispensing units and prescribers. FINDINGS: The average composite prescription writing quality on a 0-100 scale was 60.2 (95% CI 57.8-62.6). No quality criteria had 100% compliance. The highest compliance rates were found for 'frequency of administration' (98.9%) and 'identification of the prescriber' (98.9%). On the other hand, 'recorded information on allergy' (0.0%), 'patient's date of birth' (1.7%), 'nonpharmacological recommendations' (1.7%), and 'guidance on the use of the drug' (25%) were the indicators with lower compliance, contributing to 69% of the noncompliances found. The type and frequency of the errors in the quality of prescription writing uncovered in this study confirm the continuing need to tackle this problem to improve patient safety. The results identify priority aspects for interventions and further studies on the quality of prescription writing in the context of Primary Health Care in Brazil.

[Semantic and conceptual equivalence of the observable indicatorsof Nursing Home Care Quality Instrument]. / Equivalência semântica, conceitual e de itens do Observable Indicators of Nursing Home Care Quality Instrument.

Long-term care facilities (LTCFs) for the elderly are an important health care alternative in the world, though Brazil does not yet have a valid instrument to monitor the quality of these institutions. This study sought to describe the initial stages of the cross-cultural adaptation of the Observable Indicators of Nursing Home Care Quality (OIQ) instrument used to assess the quality of care in LTCFs. Conceptual equivalence was conducted to assess the relevance and feasibility of the OIQ within the Brazilian context, using the Content Validity Index (CVI). The operational, idiomatic and semantic equivalence was then performed. This item consisted of 5 phases: (1) two translations; (2) the respective back translations; (3) formal appraisal; (4) review; and (5) application of the pre-test in three LTCFs. Significant changes were made to ensure the validity of the OIQ. The CVI instrument for the Brazilian contextwas 94.3% (viability) and 95.3% (relevance). The OIQ proved to be easy to understand and apply in the pre-test. Cross-cultural adaptation of the OIQ contributes to assessing and improving quality in Brazilian LTCFs, though the findings should be complemented by a psychometric evaluation of the instrument.

[Patient safety culture and related factors in a network of Spanish public hospitals]. / Cultura de seguridad del paciente y factores asociados en una red de hospitales públicos españoles.

The objectives were to describe Patient Safety Culture (PSC) in a regional network of public hospitals, according to the perceptions of health professionals, and analyze the influence of socio-professional factors. A survey was conducted with 1,113 professionals from eight Spanish hospitals, using a questionnaire that explores 12 dimensions of PSC. Perceptions were described through the Percentage of Positive (PPR) and Negative Responses (PNR) by dimension, and the association of factors was analyzed using multivariate linear regression. The dimension "Teamwork within the same Unit" had the highest PPR (73.5), and "Staffing" the highest PNR (61). The variables "Service" (Pharmacy, Surgical Center) and "Profession" (Nurses) were significantly associated to positive assessments. Thus, strategies to improve PSC should prioritize rational distribution of human resources, and take advantage of the positive perceived relationship within Units. Moreover, pharmaceutical and surgical services, as well as nurses should probably be benchmarked by other services and professionals.

Equivalência semântica, conceitual e de itens do Observable Indicators of Nursing Home Care Quality Instrument / Semantic and conceptual equivalence of the observable indicatorsof Nursing Home Care Quality Instrument

Resumo As Instituições de Longa Permanência para Idosos (ILPI) são uma importante alternativa de cuidado no mundo, porém o Brasil ainda não dispõe de instrumento válido para monitorar a qualidade dessas instituições. Portanto, o objetivo do presente artigo é descrever as etapas iniciais da adaptação transcultural do Observable Indicators of Nursing Home Care Quality Instrument (IOQ) usado para avaliar a qualidade do cuidado nas ILPI. Realizou-se a equivalência conceitual e de itens para avaliar a pertinência e a viabilidade do IOQ à realidade nacional através do Índice de Validade do Conteúdo (IVC). Em seguida, cumpriu-se a equivalência operacional, a idiomática e a semântica. Esta última tem 5 fases: (1) duas traduções e (2) duas respectivas retraduções; (3) apreciação formal; (4) revisão; e (5) aplicação do pré-teste em três ILPI. Modificações importantes foram realizadas para garantir a validade do IOQ. O IVC do instrumento referentes ao contexto brasileiro foi de 94,3% (viabilidade) e 95,3% (relevância). O IOQ mostrou-se compreensível e de fácil aplicação no pré-teste. A adaptação transcultural do IOQ contribui para avaliação e melhoria da qualidade nas ILPI brasileiras, mas os resultados devem ser complementados mediante avaliação psicométrica.

Abstract Long-term care facilities (LTCFs) for the elderly are an important health care alternative in the world, though Brazil does not yet have a valid instrument to monitor the quality of these institutions. This study sought to describe the initial stages of the cross-cultural adaptation of the Observable Indicators of Nursing Home Care Quality (OIQ) instrument used to assess the quality of care in LTCFs. Conceptual equivalence was conducted to assess the relevance and feasibility of the OIQ within the Brazilian context, using the Content Validity Index (CVI). The operational, idiomatic and semantic equivalence was then performed. This item consisted of 5 phases: (1) two translations; (2) the respective back translations; (3) formal appraisal; (4) review; and (5) application of the pre-test in three LTCFs. Significant changes were made to ensure the validity of the OIQ. The CVI instrument for the Brazilian contextwas 94.3% (viability) and 95.3% (relevance). The OIQ proved to be easy to understand and apply in the pre-test. Cross-cultural adaptation of the OIQ contributes to assessing and improving quality in Brazilian LTCFs, though the findings should be complemented by a psychometric evaluation of the instrument.

Cultura de seguridad del paciente y factores asociados en una red de hospitales públicos españoles / Patient safety culture and related factors in a network of Spanish public hospitals / Cultura de segurança do paciente e fatores associados em uma rede de hospitais públicos espanhóis

Este estudio objetivó describir la Cultura de Seguridad del Paciente (CSP) en una red de hospitales públicos, según las percepciones de los profesionales sanitarios, y analizar la asociación de factores sociolaborales. Se realizó una encuesta a 1.113 profesionales de ocho hospitales españoles, a través de un cuestionario con 12 dimensiones de la CSP. Las percepciones se describen mediante los Porcentajes de Respuestas Positivas (PRP) y Negativas (PRN) a cada dimensión, y se analiza la asociación de factores con regresión lineal múltiple. La dimensión "trabajo en equipo en la unidad" se destacó con el mayor PRP (73,5) y "dotación de personal" con el mayor PRN (61). Los factores más asociados a la CSP (p < 0,05) fueron el "servicio" (farmacéutico y quirúrgico) y la "profesión" (enfermería), ambos de forma positiva. Así, la mejora de la CSP debe centrarse en la racionalidad de la dotación del personal y aprovecharse de la buena relación dentro de las unidades, utilizando los servicios farmacéutico y quirúrgico, y los enfermeros, como benchmark para otros servicios y profesionales.

The objectives were to describe Patient Safety Culture (PSC) in a regional network of public hospitals, according to the perceptions of health professionals, and analyze the influence of socio-professional factors. A survey was conducted with 1,113 professionals from eight Spanish hospitals, using a questionnaire that explores 12 dimensions of PSC. Perceptions were described through the Percentage of Positive (PPR) and Negative Responses (PNR) by dimension, and the association of factors was analyzed using multivariate linear regression. The dimension "Teamwork within the same Unit" had the highest PPR (73.5), and "Staffing" the highest PNR (61). The variables "Service" (Pharmacy, Surgical Center) and "Profession" (Nurses) were significantly associated to positive assessments. Thus, strategies to improve PSC should prioritize rational distribution of human resources, and take advantage of the positive perceived relationship within Units. Moreover, pharmaceutical and surgical services, as well as nurses should probably be benchmarked by other services and professionals.

O estudo teve como objetivo descrever a Cultura de Segurança do Paciente (CSP) em uma rede de hospitais públicos, na percepção dos profissionais da saúde, e analisar a associação de fatores sociolaborais. Foi realizada uma pesquisa junto a 1.113 profissionais de oito hospitais espanhóis, através de um questionário com 12 dimensões da CSP. As percepções são descritas através dos porcentuais de respostas positivas (PRP) e negativas (PRN), em cada dimensão, e é analisada a associação de fatores com regressão linear múltipla. A dimensão "trabalho em equipe na unidade" se destacou, com o maior PRP (73,5) e "dotação em pessoal" com o maior PRN (61). Os fatores mais associados à CSP (p < 0,05) foram o "serviço" (farmacêutico e cirúrgico) e a "profissão" (enfermaria), ambos de forma positiva. Dessa forma, a melhoria da CSP deve focar-se na racionalidade da dotação de pessoal e aproveitar a boa relação dentro das unidades, utilizando os serviços farmacêutico e cirúrgico, e os enfermeiros, como benchmark para os demais serviços e profissionais.