Práticas assistenciais e ocorrências de eventos adversos: percepção dos enfermeiros

• Autor(a) principal: Amaral, Robson Tostes
• Data de Publicação: 2018
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UFG
• Texto Completo: http://repositorio.bc.ufg.br/tede/handle/tede/8534
• topic: Segurança do paciente; Cuidados de enfermagem; Dano ao paciente; Qualidade da assistência à saúde; Enfermagem; Patient safety; Nursing care; Damage to the patient; Quality of hhalth care; Nursing; CIENCIAS DA SAUDE::ENFERMAGEM

Objective: To analyze nurses' perceptions regarding nursing care practices and their relationship with risks and occurrence of adverse events in hospitalized patients. Method: Cross-sectional, correlational study developed in medical clinic units, surgical and renal replacement therapy of a public hospital of state education, with a population of 45 nursing assistants. Data collection was from January to May 2017, by means of the instrument "Adverse Events Associated with Nursing Practices", a self-administered questionnaire, with Likert type scales, translated and validated into Brazilian Portuguese. Results: The total number of participants was equivalent to 91.1% of the nurses working in the clinics surveyed, being 75.6% female, with an average age of 33 years, 53.7% had two or more employment relationships, average weekly working time of 56.2 hours and 63.4%, in the last 12 months, participated in a course on patient safety. In the general perception of nurses, 24.4% indicated that the occurrence of adverse events associated to care practices never/rarely compromises patient safety. Regarding the existence of risks and occurrence of adverse events were pointed out failures in the preventive practices, associated with inadequate clinical surveillance/judgment, defense deficit, falls, pressure injuries, medication errors, and health care-related infections. Maintain patient vigilance indicated a reduction in risk and occurrence of pressure injuries (p = 0.040). Preventive practices in pressure injuries (p = 0.0012), prevention of falls (p = 0.043), hand hygiene (p = 0.028) and care with personal protective equipment and environmental hygiene (p = 0.034), reduced adverse events in the medication process. In the nurses' perception, the existence of risk (24.4%) and occurrence (4.9%) of medication errors were high. Failures in the medication administration process increased the risk and occurrence of adverse events for falls (p = 0.049), pressure lesions (p = 0.012) and health care-related infections (p = 0.004). Failures in medication monitoring increased the risk and occurrence of falls (p = 0.035) and health care-related infections (p = 0.014). In the multiple regression analysis, medication preparation failures increased the risk and occurrence of adverse events in all phases of the medication process (p = 0.006). Considerations: Strategies related to the permanent training of the professionals in patient safety with approaches in the systemic errors associated to the organizational support for the learning is a way to be followed by the leaderships to minimize / mitigate occurrences of adverse events related to the assistance practices and with that to develop a safety culture focused on improvements in care quality in health and nursing services.