RESUMO
OBJECTIVE: To compare the patient safety culture among the professional categories working in Primary Health Care. METHOD: A cross-sectional study carried out between April and May 2017 in a municipality in south Brazil, with 144 workers who answered the instrument "Research on Patient Safety Culture for Primary Care". In addition to the descriptive analysis, the Kruskal-Wallis test was used to compare the patient safety culture among the professional categories followed by the post hoc Dunn multiple comparisons test. RESULTS: The highest and lowest overall scores of positive responses to the patient's safety culture were respectively for nurses (67.70%) and community health agents (46.73%). In the comparative analyses, the physicians, community health agents, and dentists had significant differences in comparison to the other categories, tending toward a less positive culture. CONCLUSION: Differences were observed in the patient safety culture among professional categories investigated.
Assuntos
Atitude do Pessoal de Saúde , Ocupações em Saúde , Segurança do Paciente , Atenção Primária à Saúde/normas , Gestão da Segurança , Brasil , Estudos Transversais , Humanos , AutorrelatoRESUMO
OBJECTIVE: To understand the difficulties to implement patient safety strategies in the hospital environment from the perspective of nurse managers. METHODS: Descriptive, exploratory and qualitative study, carried out in four public university hospitals, using a semi-structured interview script, from January to March 2015. The sample was of 72 nurses. Content analysis was carried out, in the thematic modality. RESULTS: The following categories were identified: Inadequate sizing of nursing staff; Lack of support of the top management: from policies to concrete actions and; Lack of adherence of the professionals to patient safety strategies. CONCLUSIONS: In order for the institution to succeed in the implementation of patient safety strategies, it is necessary to have a continuous and permanent education policy, to raise awareness and to involve professionals from the top management to the front line employees.
Assuntos
Atitude do Pessoal de Saúde , Enfermeiros Administradores , Recursos Humanos de Enfermagem Hospitalar , Segurança do Paciente/normas , Adulto , Brasil , Hospitais Públicos , Hospitais Universitários , Humanos , Pessoa de Meia-Idade , Pesquisa QualitativaRESUMO
Cross-sectional and quantitative study, conducted in 2013, aiming to evaluate the implementation of User Embracement with Risk Rating (ACCR) in four Emergency Hospital Services. One hundred fifty six nurses participated and answered the questionnaire"User Embracement with Risk Rating". The data were treated through descriptive and inferential statistics, from the Kruskal-Wallis test. The implementation of ACCR was assessed as precarious, mainly due to the lack of referral of low complexity cases to the basic health system, the inadequate physical space for companions and the lack of discussion and periodic assessment of the flow of care in ACCR. The dimension Result of Implementation obtained a slightly higher score and Structure was the dimension with the lowest score. It was concluded that the negative assessments by nursing professionals of the referred dimensions in the investigated sites suggests the need for improvements, especially in the dimension Structure.
Assuntos
Serviço Hospitalar de Emergência , Pacientes/classificação , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Estudos Prospectivos , Medição de RiscoRESUMO
A multicenter, cross-sectional study took place from December 2009 to June 2010 and aimed to assess the quality of Nursing Prescription (NP) in two public teaching hospitals. The sample consisted of 1,307 NP and data were processed using the G-test and chi-square. The determination of the quality of NP was based on the classification indices reported in literature. Among the results, 1,083 (82.8%) correct and appropriate NP, 154 (11.8%) inadequate NP and 52 (3.9%) incomplete NP were found. In 18 (1.37%) patient charts, the NP was nonexistent. There was statistic signficance (alpha < 0.05) for incomplete and absent NP between the two hospitals (0.00), as well as inappropriate NP between age groups (0.03). It was concluded that, in the hospitals under study, the NP needs to be improved both in terms of quantity and quality.
Assuntos
Prescrições de Medicamentos/enfermagem , Prescrições de Medicamentos/normas , Auditoria de Enfermagem , Garantia da Qualidade dos Cuidados de Saúde , Adulto , Estudos Transversais , Feminino , Hospitais Públicos , Hospitais de Ensino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Descriptive, cross-sectional study, which aimed to evaluate the stress level of nighttime intensive care nurses. The Bianchi Stress Scale was applied to 26 (100%) nurses from five hospitals. In data analysis, the Pearson Chi-square test was used and it was noticed that the stress among nurses in a public (3.36 points) and private facility (3.02 points) was classified at the median level and there was no statistical significance (p = 0.90) forr stress, according to the type of institution. Variables that most contributed to the occurrence of stress were: working conditions (nighttime work closed and critical unit), patient severity, management activities associated with care. It was concluded that the workplace was positively associated with the stress in nurses working at nighttime and that its onset and effects can be minimized through improvements in the structure and organization of the place where the healthcare providers work.
Assuntos
Unidades de Terapia Intensiva , Recursos Humanos de Enfermagem Hospitalar , Doenças Profissionais/epidemiologia , Estresse Psicológico/epidemiologia , Tolerância ao Trabalho Programado/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Adulto JovemRESUMO
OBJECTIVE: To verify the association between a multiprofessional round with the use of checklists and patient safety practices by health professionals in an intensive care unit. METHOD: Mixed-method study, delineated by the sequential explanatory approach, conducted in a hospital in southern Brazil. Quantitative data were analyzed using Poisson regression, and qualitative data, using content analysis. The integrated analysis was performed through the explained/connected combination. RESULTS: In the post-implementation period of the rounds with systematic use of the checklist, there was a significant improvement in the prophylaxis of venous thromboembolism, light sedation, reduction in the days of use of mechanical ventilation, central venous catheter and indwelling urinary catheter. CONCLUSION: The multiprofessional round with the systematic use of checklist, associated with the improvement in patient safety practices, was considered as a strategy that ensures better care in intensive care and favors job satisfaction.
Assuntos
Lista de Checagem , Visitas de Preceptoria , Humanos , Segurança do Paciente , Cuidados Críticos/métodos , Unidades de Terapia IntensivaRESUMO
OBJECTIVES: to analyze the implementation of multidisciplinary checklist-directed rounds before health indicators and multidisciplinary team perception of an Intensive Care Unit. METHODS: a mixed methods study, with an explanatory sequential design, carried out at a hospital in southern Brazil, from September 2020 to August 2021. The integration of quantitative and qualitative data was combined by connection. RESULTS: after the implementation of checklist-directed rounds, there was a significant reduction in hospital stay from ventilator-associated pneumonia, urinary tract infection and daily invasive device use. The investigated practice is essential for comprehensive care, harm reduction, effective work and critical patient safety. CONCLUSIONS: the multidisciplinary rounds with checklist use reduced data on health indicators of critically ill patients and was considered a vital practice in the intensive care setting.
Assuntos
Pneumonia Associada à Ventilação Mecânica , Visitas de Preceptoria , Lista de Checagem , Cuidados Críticos/métodos , Humanos , Unidades de Terapia IntensivaRESUMO
This study aimed to analyze publications related to the activities of nurses managing the quality in the Emergency Services of Hospitals. An integrative literature review identified 4780 articles of which 8 were selected considering the criteria: full articles, published from 2000 to 2010; available in Portuguese; indexed in the databases of the Virtual Health Library. All the material was analyzed through Content Analysis. Two themes emerged Working in the structuring of the nursing staff to the quality of care and Nursing actions managing the quality of care. The conclusion is that the promotion of the quality of care provided in Hospitals' Emergency Services is linked to the actions promoting the humanization of both care and caregivers, and that the role of the nurse in the User Reception with Risk Rating is a key strategy for managing quality in services.
Assuntos
Enfermagem em Emergência , Serviço Hospitalar de Emergência , Gestão da Qualidade TotalRESUMO
OBJECTIVE: To understand the experience of judicialization due to error from the viewpoint of nursing professionals. METHOD: Qualitative study with two nursing professionals sued for error in a state in southern Brazil. The data were collected between January and June 2018 through an online survey and analyzed with the Oral History technique. RESULTS: The reports discussed the experience of error and its influence on professional practice. The perception of being unable to intervene in errors and the lack of support from institutions and professional associations were mentioned as causes of emotional suffering, a feeling of injustice, and revolt. Nonetheless, both participants mentioned receiving support from the local health sector union and hoping to carry on with their profession. CONCLUSION: Emotional suffering caused by judicialization is amplified by a feeling of helplessness regarding error prevention and lack of institutional support.
Assuntos
Atitude do Pessoal de Saúde , Brasil , Humanos , Pesquisa Qualitativa , Inquéritos e QuestionáriosRESUMO
OBJECTIVES: to analyze the legal outcomes of malpractices in perioperative care, and delivery and birth assistance related to nursing, from the perspective of legal support for malpractice prevention. METHODS: an exploratory, documentary, qualitative study, based on the cases tried by the Court of Justice of the State of Paraná, available online until April 2018. For the data analysis, we codified the processes and summarized the judicial outcome by the severity of the malpractice. Then, we recommended practices for the prevention of each case we presented. RESULTS: among the thirteen processes analyzed, eight corresponded to the perioperative period (mainly electrocautery burn), and five to nursing care for delivery and birth. The severity of the cases was high (n=7). The judicial outcome of most cases (n=11) was the conviction of the institution. CONCLUSIONS: despite the multifactorial nature of the malpractices, the identified ones are preventable since there is a description of good practices.
Assuntos
Imperícia , Cuidados de Enfermagem , Brasil , Instalações de Saúde , Humanos , Assistência PerioperatóriaRESUMO
OBJECTIVE: To analyze the Coaching Leadership exercised by nursing coordinators in the Mobile Emergency Care Service units, in the coordinators and nursing technicians' perception, in addition to its correlation with three sociodemographic variables. METHOD: Descriptive and analytical study carried out on nursing coordinators and nursing technicians from the pre-hospital care units, using the Coaching Leadership questionnaires and the Spearman correlation test to analyze the results. RESULTS: 11 nursing coordinators and 155 nursing technicians participated in the study. The Coaching Leadership exercise was observed in the perception of two professional categories: "giving and receiving feedback", which was the domain with the highest average for the coordinators (21.45; SD=2.84); and "communication" (20.43; SD=5.57) for technicians. Furthermore, in the coordinators' self-perception of the Coaching Leadership, there was an indirect correlation between the domains "giving and receiving feedback" (Spearman -0.720; p-value 0.012) and "total scale score" (Spearman -0.652 and p-value 0.029) with regard to "training time". CONCLUSION: The research results indicate significant contributions to nursing practices and denote this competence impact on the pre-hospital care nursing staff, in the work environment, and in the care provided to the patient.
Assuntos
Serviços Médicos de Emergência , Liderança , Tutoria , Recursos Humanos de Enfermagem , Humanos , Inquéritos e QuestionáriosRESUMO
OBJECTIVES: to understand the spirituality and the practice of euphemism experienced by nursing professionals in the hospital scenario. METHODS: a descriptive, exploratory research with a qualitative approach, carried out with 18 nursing professionals from a hospital in southern Brazil. Data collection took place from September to October 2018, through recorded audio interviews. The reports were submitted to thematic content analysis and the discussion was based on the theory of transpersonal care. RESULTS: four categories emerged from the speeches: Motivational reflection of spirituality in the work environment; Adherence to the practice of euphemism by nursing professionals; Satisfaction and frustration in the practice of euphemism by nursing professionals and; Spirituality as an increase in human faith. FINAL CONSIDERATIONS: professionals understand spirituality and the practice of euphemism as a tool that helps in motivating the team to face difficulties at work and increase the faith of hospitalized patients.
Assuntos
Terapias Espirituais , Espiritualidade , Brasil , Humanos , Equipe de Enfermagem , Percepção , Pesquisa QualitativaRESUMO
OBJECTIVE: To understand the relationship between accreditation and patient safety from the perspective of the nursing team. METHOD: A descriptive-exploratory study implementing a qualitative approach. It was developed with nursing workers from two Intensive Care Units in a hospital certified in excellence by Brazilian accreditation. The participants responded to individual semi-structured interviews guided by the question: "Tell me about the relationship between accreditation and patient safety in this hospital and unit". The corpus was transcribed in full, and the thematic content analysis technique was used. RESULTS: There were 14 professionals interviewed. There are several specific improvements in patient safety mediated by accreditation between the two emerging categories. The workers reported that at times the advances in safe care are transversally visible to the certification/maintenance of accreditation visit, and at times they point to safety as something independent of the quality seal. CONCLUSION: It was concluded that the investigated relationship was shown to be both dependent, as accreditation is a bridge for specific improvements, as well as independent, since patient safety goes beyond the certification process itself. In this context, criticality was revealed among nursing workers.
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Acreditação , Equipe de Enfermagem , Segurança do Paciente , Brasil , Hospitais , HumanosRESUMO
OBJECTIVE: to understand the meanings attributed by the Family Health Strategy (FHS) nurses to the management competencies essential to the performance of their actions. METHOD: explanatory, qualitative study, whose methodological framework was based on Grounded Theory. A total of 12 Family Health Strategy nurses from a municipality in southern Brazil participated through semi-structured interviews, between December 2018 and February 2019. RESULTS: the experience was understood by the phenomenon "Lapidating management competencies daily to play the role of a nurse in the context of the Family Health Strategy". As action/interaction strategies, the following categories emerged: "Evidencing the management skills of Family Health Strategy nurses" and "Recognizing the need for strategies to work on specificities in the context of the Family Health Strategy". FINAL CONSIDERATIONS: according to the meanings attributed by nurses, there are several essential management skills for the work in the Family Health Strategy, but they are still little worked and developed in this context, mainly because it is a complex health care scenario.
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Saúde da Família , Enfermeiras e Enfermeiros , Brasil , Teoria Fundamentada , Humanos , Pesquisa QualitativaRESUMO
The objective of this study is to perform the content validation often Nursing Care Quality Indicators in Adverse Event Prevention. Nine experts took part in this study and answered three forms. The results appointed the validity of the indicators, but with reformulations. The process yielded twelve indicators: identification of the patient's bed; identification of the risk of falling out of bed; Identification of peripheral venous accesses; Verification of skin lesions after infiltrations; Identification of venous infusion equipment; Identification of serum bottles and infusion speed control; Identification of peptic probes; Fixation of vesical delay probe and positioning of the urine collection bag; Checking of Procedures in Nursing Prescription; Control of Vital Signs; Checking of Nursing Procedures in Medical Prescription and Nursing elaboration of daily and complete prescription. The results confirm that the content validation procedure is indispensable for the development of evaluative measures.
Assuntos
Enfermagem/normas , Indicadores de Qualidade em Assistência à Saúde , Gestão da Segurança , HumanosRESUMO
OBJECTIVE: Analyze if the patient safety culture among professionals in the primary health care differs among health care teams. METHODS: Cross-sectional and quantitative study conducted in April and May 2017, in a city in Southern Brazil. A total of 144 professionals who responded to the questionnaire "Survey on Patient Safety Culture in Primary Health Care" participated in the study. Data were analyzed in the Statistical Analysis Software program and expressed in percentage of positive responses. The ethical principles established for research with human beings were applied. RESULTS: Patient safety culture is positive among 50.81% of the professionals, and the dimensions "your health service" (63.39%) and "patient safety and quality" (61.22%) obtained the highest average of positive responses. Significant differences were found between the family health and oral health teams (α = 0.05 and p < 0.05), in the dimensions "patient safety" (p = 0.0274) and "work at the health service" (p = 0.0058). CONCLUSIONS: We concluded that, although close to the average, patient safety culture among professionals in the Primary Health Care is positive and that there are differences in safety culture between family health and oral health teams in comparison with the primary health care teams.
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Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/estatística & dados numéricos , Equipe de Assistência ao Paciente/estatística & dados numéricos , Segurança do Paciente/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Gestão da Segurança/estatística & dados numéricos , Adulto , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade da Assistência à Saúde , Valores de Referência , Estatísticas não Paramétricas , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: to explain about the Advanced Nursing Practice and to discuss the possibilities of the Advanced Practice for the management of nursing care in Brazil. METHOD: this is a theoretical-reflexive trial, based on the international literature on advanced practices in nursing and analysis relevant to the profession and to the Brazilian context. RESULTS: the object of the study was described in the following driving axes: Advanced Practice Nurse: international examples and Brazilian reality; Reflections on the care management by the Advanced Practice Nurse in Brazil. Autonomy, qualified training, leadership and performance based on scientific evidences as the foundation of the best care management by the Advanced Nursing Practice, stand out. FINAL CONSIDERATIONS: while early and challenging, the work of Brazilian nursing towards advanced professional practice seems to be interesting, since the possibilities of managing the care of this modality of nurses' performance are evident.
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Prática Avançada de Enfermagem/métodos , Cuidados de Enfermagem/métodos , Brasil , Humanos , Cuidados de Enfermagem/normas , Cuidados de Enfermagem/tendênciasRESUMO
OBJECTIVE: to grasp the perspective of nurses on health education in the process of caring for people with Diabetes Mellitus in Primary Care. METHOD: a descriptive study of a qualitative nature carried out with 13 nurses from the Family Health Strategy in Southern Brazil. The data were collected in November and December of 2017, through recorded interviews, which were submitted to content analysis, thematic modality. RESULTS: three categories emerged, which show from the perspective of nurses, the influence of structural and assistance characteristics in the development of educational actions; outcomes of these actions, and possibilities to increase their quality as central to the nursing action. FINAL CONSIDERATIONS: there are still gaps in the structuring of public health policies, especially in the process of managing and caring for people with diabetes, which limits quantitatively and qualitatively the development of educational actions in Primary Care.
Assuntos
Diabetes Mellitus/terapia , Educação em Saúde/normas , Enfermeiras e Enfermeiros/psicologia , Percepção , Adulto , Brasil , Feminino , Educação em Saúde/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/normas , Pesquisa QualitativaRESUMO
OBJECTIVE: to understand the process that leads adult and family patients to support family presence in emergency care. METHOD: a qualitative study that adopted Symbolic Interactionism as a theoretical reference and the Grounded Theory as a methodological framework. The theoretical sample consisted of 15 relatives and 15 patients assisted at two emergency units in the South of Brazil. Data were analyzed using open, axial and selective coding. RESULTS: the central category "Convergence of ideas: family members and patients supporting family presence in emergency care" is supported by the categories: "Affectionate relationship among family members"; "Tacit obligation to care for the sick relative"; "Benefits for the family"; "Benefits for the patient"; and "Benefits for the health team". CONCLUSION: family presence in emergency care provides maintenance and strengthening of affectionate bonds among relatives and the experience of more sensitive and qualified care.
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Família/psicologia , Pacientes/psicologia , Visitas a Pacientes/psicologia , Adulto , Idoso , Brasil , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/normas , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Teoria Fundamentada , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes/estatística & dados numéricos , Pesquisa Qualitativa , Visitas a Pacientes/estatística & dados numéricosRESUMO
OBJECTIVE: Getting to know the perceptions of nursing professionals about the use of computerization in promoting patient safety. METHODS: Qualitative research performed at a hospital in the southern region of Brazil. Data collection was performed in November 2016, through a sociodemographic questionnaire and recorded interviews, guided by the question: "Tell me about the relationship between computerization and patient safety in this hospital". The transcribed statements were submitted to the thematic content analysis proposed by Bardin. RESULTS: Among the participants, 21 were nurses and 31 were nursing technicians. From the discourses, the following categories were created, Information Technology Contributions for the promotion of safe care, and Information Technology Fragilities: indirect implications for safe care. CONCLUSIONS: The participants perceived the computerized system as a resource that promoted greater patient safety. However, there is a need to improve the infrastructure and the technical capacity of the team for an efficient use of the system.