Segurança do paciente: análise da influência de preditores para o desfecho dos eventos adversos relacionado à assistência à saúde em unidades de terapia intensiva do estado da Paraíba

• Autor(a) principal: Lopes, Vívian de Oliveira
• Data de Publicação: 2022
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UFPB
• Texto Completo: https://repositorio.ufpb.br/jspui/handle/123456789/26237
• topic: Pacientes - Paraíba; Segurança do paciente; Eventos adversos; Fatores contribuintes; Patients - Paraíba; Patient safety; Adverse events; Contributing factors; CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA

The objective of this study is to analyze the influence of possible predictors for the outcome of adverse events with regard to the degree of damage observed. The research was carried out through an exploratory and descriptive analysis, through a cross-sectional study with a quantitative approach, with a sample of 1,082 notifications, using variables from the database of the National Health Surveillance System - Notivisa, inserted from 01 January 2021 to December 31, 2021, where the logistic regression model was used, in which 1 is associated with the occurrence of a severe/death event and 0 is associated with the occurrence of mild/moderate cases. The adverse event reporting forms intended for health services in the intensive care unit sector were included in the study. To assess the phenomenon, the logistic regression model was adjusted to assess the bank's coding according to the listed predictors. As a result, among the significant variables estimated and according to their odds ratios, the professional contributing factors: Illegible information in the patient's medical record with odds ratio 319.79 and Risky/reckless behavior odds ratio 5.44 and the contributing factors related to patient: Absence forgetting odds ratio 6.08 and Neglectful behavior odds ratio 7.36 increase the chances for a serious adverse event and death. The model provided predictions that classified correctly in 75.4% of the cases and, therefore, it can be considered well-adjusted to the empirical data of the research. Non-compliance with standards (professional factor) and perceived understanding (patient factor) both with odds ratio <1 increase the chances of occurrence for a mild and moderate adverse event. With the model, it was also observed that male individuals aged between 18 and 55 years are more likely to be affected by serious adverse events and death. The model presented good predictive value when the adverse event presented a mild and moderate degree of damage, being correct 75.5% of the time and 70.8% when it predicted that the adverse event presented a degree of severe damage and death. Pressure injury was the most frequent adverse event in reports from patients in the Intensive Care Unit of Paraiba during the year 2021, however: failure involving venous catheter and accidental endotracheal extubation were the adverse events with the highest frequency of degree of serious damage/death. It is considered the need to strengthen the supply of the Notivisa system with strategies to encourage the practice of reporting adverse events related to health care by health services, because even with the limitations presented by the system, it is still possible through its coding classify the event according to the degree of damage and identify the main factors contributing to its prediction, enabling the implementation of new barriers to prevent damage related to health care and consequent provision of safer care by the intensive care units of the hospital. state of Paraiba.