RESUMO
A comunicação buco-sinusal, uma conexão direta entre boca e seios maxilares, ocorre comumente pela extração de dentes próximos ao seio maxilar e outros procedimentos. O diagnóstico precoce é crucial para prevenir complicações graves. A abordagem terapêutica varia conforme o tamanho do defeito, presença de infecção e localização específica. Realizou-se uma breve revisão de literatura qualitativa abordando as principais complicações da comunicação buco sinusal na cirurgia bucal e como intervi-las. Buscou-se artigos científicos indexados nas seguintes bases de dados: Google Scholar, Pubmed e Biblioteca Scielo com lapso temporal de 2013 a 2023. Foram utilizados para esta busca os seguintes descritores: Comunicação buco-sinusal; Complicações; Seio maxilar. Os critérios de inclusão desta pesquisa foram artigos em inglês, português e espanhol, sendo selecionados 26 trabalhos. Os principais critérios de exclusão foram artigos com mais de 10 anos de publicação. A prevenção e gestão eficaz das complicações na comunicação oral em cirurgias são essenciais. Identificar fatores de risco, usar técnicas cirúrgicas precisas e agir imediatamente diante de sinais de comunicação com os seios da face são medidas cruciais para garantir a segurança do paciente e aprimorar os resultados cirúrgicos.
Oral-sinusal communication, a direct connection between the mouth and maxillary sinuses, commonly occurs due to the extraction of teeth close to the maxillary sinus and other procedures. Early diagnosis is crucial to prevent serious complications. The therapeutic approach varies according to the size of the defect, presence of infection and specific location. A brief qualitative literature review was carried out looking at the main complications of oral sinus communication in oral surgery and how to intervene. We searched for scientific articles indexed in the following databases: Google Scholar, Pubmed and Scielo Library with a time span from 2013 to 2023. The following descriptors were used for this search: Oral-sinus communication; Complications; Maxillary sinus. The inclusion criteria for this study were articles in English, Portuguese and Spanish, and 26 papers were selected. The main exclusion criteria were articles published more than 10 years ago. The prevention and effective management of oral communication complications during surgery are essential. Identifying risk factors, using precise surgical techniques and acting immediately in the event of signs of communication with the sinuses are crucial measures to ensure patient safety and improve surgical outcomes.
Assuntos
Cirurgia Bucal , Fatores de Risco , Diagnóstico Precoce , Segurança do Paciente , Seio MaxilarRESUMO
OBJECTIVE: To assess whether conditional bedside alarm triggers can reduce the frequency of nonactionable alarms without compromising patient safety and enhance nursing and family satisfaction. STUDY DESIGN: Single-center, quality improvement initiative in an acute care cardiac unit and pediatric intensive care unit. Following the 4-week preintervention baseline period, bedside monitors were programmed with hierarchical time delay and conditional alarm triggers. Bedside alarms were tallied for 4 weeks each in the immediate postintervention period and 2-year follow-up. The primary outcome was alarms per monitored patient day. Nurses and families were surveyed preintervention and postintervention. RESULTS: A total of 1509 patients contributed to 2034, 1968, and 2043 monitored patient days which were evaluated in the baseline, follow-up, and 2-year follow-up periods, respectively. The median number of alarms per monitored patient day decreased by 75% in the pediatric intensive care unit (P < .001) and 82% in the acute care cardiac unit (P < .001) with sustained effect at the 2-year follow-up. No increase of rapid response calls, emergent transfers, or code events occurred in either unit. Nursing surveys reported an improved capacity to respond to alarms and fewer perceived nonactionable alarms. Family surveys, however, did not demonstrate improved sleep quality. CONCLUSIONS: Implemented changes to bedside monitor alarms decreased total alarm frequency in both the acute care cardiac unit and pediatric intensive care unit, improving the care provider experience without compromising safety.
Assuntos
Alarmes Clínicos , Unidades de Terapia Intensiva Pediátrica , Melhoria de Qualidade , Humanos , Segurança do Paciente , Monitorização Fisiológica/instrumentação , Monitorização Fisiológica/métodos , Feminino , Masculino , Criança , Unidades de Cuidados Coronarianos , Fadiga de Alarmes do Pessoal de Saúde/prevenção & controle , SeguimentosRESUMO
OBJECTIVES: to understand nurses' experience regarding patient safety in mobile pre-hospital care. METHOD: a qualitative, exploratory and descriptive study, conducted with nurses active in mobile pre-hospital care services. Semi-structured interviews were conducted, audio-graved and submitted to Bardin's content analysis. RESULTS: from four thematic categories established, nurses reported the care and management skills necessary to work in this service. They demonstrated a commitment to ensuring safe care for patients, staff and spectators. They highlighted the actions taken to prevent and mitigate incidents. However, they based their experiences on practice protocols and individual actions, expressing the need to improve knowledge about patient safety. FINAL CONSIDERATIONS: mobile pre-hospital care nurses' experience in relation to patient safety was limited, suggesting the need for training on the subject, alignment of work processes and implementation of strategies, aiming to guarantee safe care.
Assuntos
Enfermeiras e Enfermeiros , Segurança do Paciente , Pesquisa Qualitativa , Humanos , Segurança do Paciente/normas , Enfermeiras e Enfermeiros/psicologia , Enfermeiras e Enfermeiros/estatística & dados numéricos , Feminino , Adulto , Masculino , Serviços Médicos de Emergência/métodos , Serviços Médicos de Emergência/normas , Pessoa de Meia-Idade , Atitude do Pessoal de Saúde , Entrevistas como Assunto/métodosRESUMO
OBJECTIVE: To develop and validate the content of checklists for safe admission and discharge in Neonatal Intensive Care Units. METHODS: A methodological study conducted between 2018 and 2020 in four stages: 1) literature review; 2) checklist construction; 3) content validity by 32 neonatal nursing specialists from different Brazilian states, predominantly from the southeastern region; 4) development of the final version of the instruments. Validity was performed using a Likert-type scale. Items with a Content Validity Index of 0.90 or higher were accepted. Descriptive statistics were used for data analysis. RESULTS: The contents of two checklists were constructed and validated: one for admission, with 18 items, and another for discharge, with seven items. For the admission checklist, 41.03% of items were validated in the first round, 33.33%, in the second, and 23.08%, in the third. One item was excluded for not achieving the minimum Content Validity Index (>0.90). For the discharge checklist, all items achieved a CVI ≥ 0.90, with 64.7% validated in the first round and 35.3% in the second round. No items were excluded. CONCLUSION: The content of patient safety checklists for admission and discharge in Neonatal Intensive Care Units was considered valid.
Assuntos
Lista de Checagem , Unidades de Terapia Intensiva Neonatal , Admissão do Paciente , Alta do Paciente , Humanos , Unidades de Terapia Intensiva Neonatal/normas , Recém-Nascido , Brasil , Segurança do Paciente , Reprodutibilidade dos Testes , Enfermagem Neonatal/normasRESUMO
INTRODUÇÃO: A segurança do paciente é uma prioridade na assistência à saúde, visando minimizar o risco de danos desnecessários. A Organização Mundial da Saúde (OMS) desenvolveu a Classificação Internacional de Segurança do Paciente para fornecer diretrizes, estratégias e recomendações. A Seção de Cardiologia Intervencionista realiza procedimentos diagnósticos e terapêuticos complexos, com abordagem minimamente invasiva. A equipe de enfermagem desempenha um papel crucial em todas as etapas do cuidado ao paciente, desde preparo do paciente pré, trans e pós procedimento na sala de recuperação pós anestésica da Hemodinâmica. O enfermeiro atua no gerenciamento de recursos humanos e materiais, atividades assistenciais e implementação de processos relacionados à qualidade e segurança. A Instituição Pública Especializada em Cardiologia, busca certificação de Acreditação Hospitalar, implementando práticas alinhadas com metas internacionais de segurança do paciente. OBJETIVO(s): Descrever a implementação de estratégias de segurança do paciente incorporadas em um serviço de hemodinâmica. MÉTODOS: Estudo observacional, descritivo sobre processos implementados para segurança do paciente em um serviço de hemodinâmica. Realizado em uma instituição de grande porte especializada em Cardiologia do município de São Paulo. Para a implementação de estratégias seguiram-se as metas internacionais de segurança do paciente. RESULTADOS: Identificou-se das estratégias implementadas para segurança do paciente em procedimento intervencionista hemodinâmico - Conferência de Identificação do paciente com Prontuário Eletrônico; o uso do SBAR (Situação, Contexto, Avaliação e Recomendação): como Ferramenta desenvolvida para transição de cuidado e melhora da Comunicação: a Dupla Checagem de medicamentos de alta vigilância eficiente para melhora da segurança dos medicamentos; Implementação de checklist cirúrgico adaptado para a Hemodinâmica (início fevereiro de 2024); Práticas de Promoção e Prevenção de controle das infecções como práticas assépticas, a sensibilização do uso da higienização das mãos e barreiras adotadas para Prevenção de Quedas. CONCLUSÃO: As estratégias aplicadas por toda equipe multiprofissional, reduzem os riscos de danos ao paciente, promovendo uma cultura de segurança e melhorando a qualidade dos serviços prestados.
Assuntos
Equipe de Assistência ao Paciente , Serviço Hospitalar de Cardiologia , Segurança do Paciente , Monitorização Hemodinâmica , EnfermeirosRESUMO
to develop and validate two clinical simulation guides to support and disseminate a culture of safety in the surgical environment.methodological study supported by the International Nursing Association for Clinical Simulation and Learning theoretical framework. The snowball technique was used to validate the clinical guidelines with experts on the subject. Two scales validated for Brazil were used for the pilot test.89 operating room professionals took part, including 41 doctors, 40 nursing technicians, four nurses, two radiology technicians, and two nursing trainees. Two guides were created, one on conflict management and teamwork in patient safety during the transfer of the patient from the operating room to the post-anesthetic recovery room, and the other dealing with the assistance of the healthcare team in the transfer of care in the post-anesthetic recovery room. The evaluation of Satisfaction with Simulated Clinical Experiences had an average score of 8.3 and Satisfaction and Self-confidence in learning 4.1.the guides have been validated and are suitable for replication in any surgical environment. We believe that this technology could contribute to improving the safety culture in the operating room by providing an opportunity for reflection and critical thinking.
(1) Clinical guidelines developed based on demand from participants. (2) Production of two clinical guidelines applied in the operating room and recovery room. (3) Validation of the clinical guidelines by experienced specialists in the field. (4) High satisfaction rates among pilot test participants. (5) Recognition of simulation as a strategy that supports a culture of safety.
Assuntos
Salas Cirúrgicas , Segurança do Paciente , Humanos , Segurança do Paciente/normas , Salas Cirúrgicas/normas , Tecnologia Educacional , Treinamento por Simulação/métodos , Masculino , Feminino , Adulto , Guias de Prática Clínica como AssuntoRESUMO
OBJECTIVE: To analyze the relational and functional aspects of patient safety through the experiences reported by the patients themselves and/or their caregivers in intensive care units. METHOD: Scoping review developed with searches, in September 2021 and updated in November 2022, in the following databases: Virtual Health Library, considering only the LILACS, BDENF, IBECS, ColecionaSUS databases; SCIELO, PsycINFO, EMBASE, COCHRANE, CINAHL, SCOPUS and Web of Science. RESULTS: The final selection included 14 articles highlighting communication as an essential relational factor for care safety. The most predominant functional aspects were physical care environment, structured protocols, and the performance of professionals in the care process. CONCLUSION: Communication processes were predominant in relational aspects and were decisive for functional aspects, with emphasis on the performance of professionals in the care process. Instruments developed for quality process analysis were used in most of the studies.
Assuntos
Cuidadores , Cuidados Críticos , Segurança do Paciente , Humanos , Cuidadores/psicologia , Unidades de Terapia Intensiva , ComunicaçãoRESUMO
OBJECTIVE: To analyze the effect of an improvement project on the implementation of Basic Patient Safety Protocols in Brazilian public hospitals. METHOD: This is an intervention study aimed at comparing measurements before-and-after the implementation of an improvement project in 35 public hospitals across three Brazilian regions, between July 2021 and September 2023. The intervention consisted of a set of activities to support the implementation of six Basic Patient Safety Protocols, with semimonthly collection of indicators. The data were analyzed using descriptive statistics, with the use of trend charts to demonstrate improvements, considering the first seven collection points as the baseline for comparisons. RESULTS: After the intervention period, all Patient Safety Protocols showed improvements in their indicators. The prevention of falls and safe surgery stood out, with a 73% reduction in prevalence and a 675% increase in adherence to the safe surgery checklist, respectively, compared to the group of hospitals. CONCLUSION: The improvement project had a positive effect on patient safety in the institutions, evidenced by the improvement in indicators of all analyzed protocols.
Assuntos
Lista de Checagem , Hospitais Públicos , Segurança do Paciente , Melhoria de Qualidade , Segurança do Paciente/normas , Humanos , Brasil , Hospitais Públicos/normas , Protocolos Clínicos , Acidentes por Quedas/prevenção & controle , Indicadores de Qualidade em Assistência à SaúdeRESUMO
La presente publicación , teniendo en cuenta que aproximadamente uno de cada diez pacientes sufre algún tipo de daño cuando se le presta atención de salud, y que cada año se producen más de tres millones de muertes en todo el mundo a causa de una atención de salud insegura, describe los derechos de los pacientes en el contexto de la seguridad, en particular dado que más del 50% de esos daños son evitables. Se promueve la defensa de los derechos del paciente a la seguridad, tal como lo establecen las normas internacionales en materia de derechos humanos, para todas las personas, en todas partes, independientemente de su edad, género, etnia o raza, lengua, religión, discapacidad, situación socioeconómica o cualquier otra condición. La Carta ayudará a las partes interesadas a formular políticas y legislación, y a crear mecanismos que garanticen el respeto, la protección y el cumplimiento de los derechos de los pacientes a una atención segura
Assuntos
Humanos , Assistência Integral à Saúde , Direitos do Paciente , Atenção à Saúde , Segurança do Paciente , Fatores de Proteção , Identidade de Gênero , Direitos HumanosRESUMO
OBJECTIVE: To assess the implementation of the bedside medication preparation process in an Intensive Care Unit, following a quality improvement cycle. METHOD: A quasi-experimental study with non-paired samples, pre- and post-implementation, conducted in an Intensive Care Unit of a public hospital in southern Brazil, from September 2022 to April 2023, following the guidelines of the Standards for Quality Improvement Reporting Excellence 2.0. Adherence to bedside medication preparation, interruptions during preparation, adequate storage, identification and validity of multidose medications, and recording of storage refrigerator temperature were evaluated. Shapiro-Wilk and Mann-Whitney U tests were used for data analysis, and Carter's Positivity Index was used to determine compliance with observed practices. RESULTS: Forty-five audits were conducted pre-intervention and 122 audits three months after the implementation of the improvement cycle. All variables showed significant improvements. Overall compliance increased from 46% to 80% in the pre- and post-implementation periods, respectively, indicating a transition from "undesirable" to "safe" care stratum. CONCLUSION: The study revealed a positive relationship between the implementation of a quality improvement cycle focused on medication preparation and improvements in patient safety.
Assuntos
Unidades de Terapia Intensiva , Melhoria de Qualidade , Humanos , Brasil , Composição de Medicamentos/normas , Erros de Medicação/prevenção & controle , Armazenamento de Medicamentos/normas , Segurança do Paciente , Fidelidade a Diretrizes , Hospitais Públicos/normas , Cuidados Críticos/normasRESUMO
BACKGROUND: The incidence of biliary duct injuries remains higher in laparoscopic cholecystectomy (LC) in comparison to open surgery. The Critical View of Safety (CVS) was introduced by Strasberg as a strategy for reducing this catastrophic complication. AIM: The aim of this study was to evaluate how often an adequate CVS is achieved during LC, the determining factors for its success, and the associated surgical outcomes. METHODS: This is a prospective study. CVS photographs of all patients who underwent LC by the same surgeon between 2020 and 2023 were taken. Success in achieving CVS was analyzed by the surgeon herself and posteriorly by hepatobiliary specialists. Patients were classified into two groups: CVS achieved and CVS not achieved. Finally, multivariable logistic regression was used to examine the association between preoperatory factors and surgical complications. RESULTS: Three hundred and nine consecutive patients were submitted to LC. There were 73.5% elective CL and 26.5% acute cholecystitis. The age ranged from 14 to 87 years, and 76.8% were female. The median body mass index was 26.7. Previous abdominal surgeries were present in 64%, and 26% were obese. The CVS was achieved in 79.9% of the patients, and there were no surgical complications in this group. The factors associated with nonachievement were acute cholecystitis (p=0.007), male sex (p=0.014), and previous surgeries (p=0.021). Three patients needed a subtotal cholecystectomy due to severe inflammation. There was no statistical correlation between the identification of CVS and surgical complications. CONCLUSIONS: The CVS is achieved in most patients. Acute cholecystitis, male sex, and previous abdominal operations are associated with difficulties in obtaining CVS.
Assuntos
Colecistectomia Laparoscópica , Humanos , Colecistectomia Laparoscópica/efeitos adversos , Colecistectomia Laparoscópica/métodos , Feminino , Masculino , Estudos Prospectivos , Pessoa de Meia-Idade , Adulto , Idoso , Adulto Jovem , Adolescente , Idoso de 80 Anos ou mais , Fotografação , Doença Iatrogênica/prevenção & controle , Complicações Intraoperatórias/prevenção & controle , Complicações Pós-Operatórias/prevenção & controle , Complicações Pós-Operatórias/epidemiologia , Ductos Biliares/lesões , Segurança do PacienteRESUMO
INTRODUCTION: The global rise in aesthetic surgery has led to an increase in aesthetic medical tourism (AMT). As patients pursue surgical interventions abroad, concerns about the elevated complication rates in AMT have emerged. This study explores the complexities of AMT, emphasizing the intersection of plastic surgery and aerospace medicine, to elucidate the incidence of complications, identify associated variables, and introduce aeromedical considerations to proactively enhance patient safety. METHODS: A comprehensive retrospective observational cohort study was conducted using data spanning 2004 to 2023 from a private plastic surgery practice in Bogota, Colombia. The study included 3367 patients, of whom 26% were international patients. Sociodemographic and clinical variables, flight details, and surgical complications were analyzed. Statistical analyses involved descriptive statistics, odds ratios, and multiple regression analyses. RESULTS: Of the 865 AMT patients, 75 exhibited complications. Infection and wound dehiscence were the most prevalent; no severe complications or mortality was reported. The study revealed that AMT patients have a higher risk of complications compared to those locally treated (adjusted odds ratio = 4.6; 95% confidence interval = 2.6-8.2). Flight time exceeding 4 h was a factor associated with nonaesthetic complications. DISCUSSION: This study reveals that AMT is linked to a higher risk of nonaesthetic complications, with flight duration being a significant contributing factor. Despite the increased risk, complication rates for AMT patients did not surpass thresholds reported in the literature; this may be attributed to the safety protocols implemented. Aeromedical considerations played a crucial role in mitigating physiological stress associated with air travel. Hoyos AE, Ramirez B, Benavides J, Perez Pachon ME, Varela A. Aeromedical considerations for patient safety in aesthetic medical tourism. Aerosp Med Hum Perform. 2024; 95(10):765-770.
Assuntos
Medicina Aeroespacial , Turismo Médico , Segurança do Paciente , Humanos , Estudos Retrospectivos , Masculino , Colômbia/epidemiologia , Feminino , Turismo Médico/estatística & dados numéricos , Adulto , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Cirurgia Plástica/estatística & dados numéricos , Estudos de Coortes , Adulto Jovem , Idoso , AdolescenteRESUMO
Jornal na sua 10ª edição (outubro 2024) com a análise e elaboração de conteúdo pela gerência de IST/AIDS e gerência de Hepatites Virais - SES- RJ.
Assuntos
Pesquisadores , Sistema Único de Saúde , Exames Médicos , Pessoal de Saúde , Segurança do Paciente , Monitoramento EpidemiológicoRESUMO
OBJECTIVES: to assess patient safety culture during the COVID-19 pandemic and identify the dimensions that need to be improved in hospital settings and which sector, open or closed, direct or indirect care, exhibits a higher level of safety culture. METHODS: a descriptive and cross-sectional study. The validated version for Brazil of the Hospital Survey on Patient Safety Culture instrument was applied to assess patient safety culture. Those dimensions with 75% positive responses were considered strengthened. RESULTS: all dimensions presented results lower than 75% of positive responses. Closed sectors showed a stronger safety culture compared to open ones. Indirect care sectors had a low general perception of patient safety when compared to direct care sectors. CONCLUSIONS: with the pandemic, points of weakness became even more evident, requiring attention and incisive interventions from the institution's leaders.
Assuntos
COVID-19 , Pandemias , Segurança do Paciente , SARS-CoV-2 , Humanos , Estudos Transversais , COVID-19/epidemiologia , Brasil/epidemiologia , Segurança do Paciente/normas , Segurança do Paciente/estatística & dados numéricos , Inquéritos e Questionários , Gestão da Segurança/métodos , Gestão da Segurança/normas , Hospitais , Cultura OrganizacionalRESUMO
Objetivo: Construir e validar um Procedimento Operacional Padrão para os cuidados de enfermagem no banho de aspersão, no cotidiano de uma Instituição de Longa Permanência para Idosos (ILPI). Metodologia: Estudo metodológico, desenvolvido em três etapas: revisão integrativa da literatura; entrevista individual; e validação de conteúdo por experts no cuidado com idoso. Resultados: A revisão integrativa da literatura foi composta por 13 artigos selecionados em seis bases de dados. Após análise dos dados qualitativos provenientes das entrevistas dos profissionais atuantes na instituição de longa permanência, emergiram duas categorias centrais: rotinas do banho de aspersão; e potências e limites no banho de aspersão. Conclusão: O Procedimento Operacional Padrão para os cuidados de Enfermagem no banho de aspersão no cotidiano de uma instituição de longa permanência para idosos é um recurso necessário para a segurança do idoso, qualifica a prática e promove melhor desempenho profissional. (AU)
Objective: Build and validate a Standard Operating Procedure for nursing care in the spray bath, in the daily life of a Long-Term Institution for the Elderly (LTCF). Methodology: Methodological study, developed in three stages: integrative literature review; individual interview; and content validation by experts in elderly care. Results: The integrative literature review consisted of 13 articles selected from six databases. After analyzing the qualitative data from interviews with professionals working in the long-term care institution, two central categories emerged: spray bath routines; and powers and limits in the spray bath. Conclusion: The Standard Operating Procedure for Nursing care in the spray bath in the daily routine of a long-term care institution for the elderly is a necessary resource for the safety of the elderly, qualifies the practice and promotes better professional performance.(AU)
Objetivo: Construir y validar un Procedimiento Operativo Estándar para el cuidado de enfermería en el baño de aspersión, en el cotidiano de una Institución de Larga Estancia para Adultos Mayores (LTCF). Metodología: Estudio metodológico, desarrollado en tres etapas: revisión integrativa de la literatura; entrevista individual; y validación de contenidos por parte de expertos en el cuidado de personas mayores. Resultados: La revisión integrativa de la literatura estuvo compuesta por 13 artículos seleccionados de seis bases de datos. Después de analizar los datos cualitativos de las entrevistas con profesionales que trabajan en la institución de cuidados a largo plazo, surgieron dos categorías centrales: rutinas de baños de spray; y poderes y límites en el baño de spray. Conclusión: El Procedimiento Operativo Estándar para el cuidado de Enfermería en el baño de aspersión en el día a día de una institución de atención a personas mayores es un recurso necesario para la seguridad de las personas mayores, califica la práctica y promueve un mejor desempeño profesional.(AU)
Assuntos
Banhos , Segurança do Paciente , Instituição de Longa Permanência para Idosos , Cuidados de EnfermagemRESUMO
Objetivo: Identificar a compreensão dos estudantes do curso de técnico em enfermagem sobre o erro humano e a segurança do paciente. Método: Pesquisa quantitativa, exploratória e descritiva, realizada entre abril e maio de 2023, por meio de um questionário online. Resultados: Participaram 312 discentes de uma instituição de ensino de São Paulo. Dentre os aspectos conceitu-ais 95,5% dos alunos concordaram que trabalhar com maior cuidado é uma efetiva estratégia de prevenção de futuros erros; em relação aos aspectos atitudinais 66,8% dos participantes concordaram que atuam em instituições que promovem boas práticas para a promoção da segurança do paciente. Conclusão: Foi possível identificar a presença de lacunas de conhecimento dos estudantes entre os aspectos conceituais e atitudinais avaliados pelo questionário. Portanto, sugere-se uma abordagem mais enfática acerca da segurança do paciente durante a formação desses futuros profissionais.(AU)
Objective: To identify nursing technician students' understanding of human error and patient safety. Method: Quantitati-ve, exploratory and descriptive research, carried out between April and May 2023, using an online questionnaire. Results: 312 students from an educational institution in São Paulo took part. Among the conceptual aspects, 95.5% of the students agreed that working with greater care is an effective strategy for preventing future errors; in relation to the attitudinal aspects, 66.8% of the participants agreed that they work in institutions that promote good practices to promote patient safety. Conclusion: It was possible to identify gaps in students' knowledge between the conceptual and attitudinal aspects assessed by the questionnaire. Therefore, a more emphatic approach to patient safety during the training of these future professionals is suggested.(AU)
Objetivo: Identificar la comprensión de los estudiantes de técnico de enfermería sobre el error humano y la seguridad del paciente. Método: Investigación cuantitativa, exploratoria y descriptiva, realizada entre abril y mayo de 2023, mediante cuestionario online. Resultados: Participaron 312 estudiantes de una institución de enseñanza de São Paulo. Entre los aspectos conceptuales, 95,5% de los alumnos concordaron que trabajar con mayor cuidado es una estrategia eficaz para prevenir errores futuros; en relación a los aspectos actitudinales, 66,8% de los participantes concordaron que trabajan en instituciones que promueven buenas prácticas para promover la seguridad del paciente. Conclusiones: Fue posible identificar brechas en el conocimiento de los estudiantes entre los aspectos conceptuales y actitudinales evaluados por el cuestionario. Por lo tanto, se sugiere un abordaje más enfático de la seguridad del paciente durante la formación de estos futuros profesionales.(AU)
Assuntos
Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Qualidade da Assistência à Saúde , Educação em Saúde , Segurança do PacienteRESUMO
BACKGROUND: The use of technologies has had a significant impact on patient safety and the quality of care and has increased globally. In the literature, it has been reported that people die annually due to adverse events (AEs), and various methods exist for investigating and measuring AEs. However, some methods have a limited scope, data extraction, and the need for data standardization. In Brazil, there are few studies on the application of trigger tools, and this study is the first to create automated triggers in ambulatory care. OBJECTIVE: This study aims to develop a machine learning (ML)-based automated trigger for outpatient health care settings in Brazil. METHODS: A mixed methods research will be conducted within a design thinking framework and the principles will be applied in creating the automated triggers, following the stages of (1) empathize and define the problem, involving observations and inquiries to comprehend both the user and the challenge at hand; (2) ideation, where various solutions to the problem are generated; (3) prototyping, involving the construction of a minimal representation of the best solutions; (4) testing, where user feedback is obtained to refine the solution; and (5) implementation, where the refined solution is tested, changes are assessed, and scaling is considered. Furthermore, ML methods will be adopted to develop automated triggers, tailored to the local context in collaboration with an expert in the field. RESULTS: This protocol describes a research study in its preliminary stages, prior to any data gathering and analysis. The study was approved by the members of the organizations within the institution in January 2024 and by the ethics board of the University of São Paulo and the institution where the study will take place. in May 2024. As of June 2024, stage 1 commenced with data gathering for qualitative research. A separate paper focused on explaining the method of ML will be considered after the outcomes of stages 1 and 2 in this study. CONCLUSIONS: After the development of automated triggers in the outpatient setting, it will be possible to prevent and identify potential risks of AEs more promptly, providing valuable information. This technological innovation not only promotes advances in clinical practice but also contributes to the dissemination of techniques and knowledge related to patient safety. Additionally, health care professionals can adopt evidence-based preventive measures, reducing costs associated with AEs and hospital readmissions, enhancing productivity in outpatient care, and contributing to the safety, quality, and effectiveness of care provided. Additionally, in the future, if the outcome is successful, there is the potential to apply it in all units, as planned by the institutional organization. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/55466.
Assuntos
Assistência Ambulatorial , Aprendizado de Máquina , Humanos , Brasil , Segurança do PacienteRESUMO
Objectives: To explore speaking up behaviours, barriers to openly expressing patient safety concerns, and perceived psychological safety climate in the clinical setting in which healthcare trainees from Ibero-America were receiving their practical training. Methods: Cross-sectional survey of healthcare trainees from Colombia, Mexico, and Spain (N = 1,152). Before the field study, the Speaking Up About Patient Safety Questionnaire (SUPS-Q) was translated into Spanish and assessed for face validity. A confirmatory factor analysis was conducted to establish the construct validity of the instrument, and the reliability was assessed. The SUPS-Q was used to evaluate voice behaviours and the perceived psychological safety climate among Ibero-American trainees. Descriptive and frequency analyses, tests for contrasting means and proportions, and logistic regression analyses were performed. Results: Seven hundred and seventy-one trainees had experience in clinical settings. In the previous month, 88.3% had experienced patient safety concerns, and 68.9% had prevented a colleague from making an error. More than a third had remained silent in a risky situation. Perceiving concerns, being male or nursing student, and higher scores on the encouraging environment scale were associated with speaking up. Conclusion: Patient safety concerns were frequent among Ibero-American healthcare trainees and often silenced by personal and cultural barriers. Training in speaking up and fostering safe interprofessional spaces is crucial.
Assuntos
Segurança do Paciente , Humanos , Estudos Transversais , Masculino , Feminino , Adulto , Inquéritos e Questionários , Espanha , México , Colômbia , Adulto Jovem , Reprodutibilidade dos Testes , Atitude do Pessoal de SaúdeRESUMO
OBJECTIVES: to map the constituent elements of the safe mobility concept present in hospital care for older adults. METHODS: a scoping review of 35 articles searched in databases and gray literature - BDENF/VHL, Scopus, CINAHL/EBSCO, Embase, Web of Science, PEDro, MEDLINE/PubMed and CAPES Theses and Dissertations Catalog. No time or language cut-off was established. RESULTS: none of the studies presented a clear safe mobility concept, however its constituent elements involve factors related to patient (behavioral factors, conditions, diseases, signs and symptoms, nutritional status, age, balance, strength, gait quality, sleep), the institution (environment, treatment devices, guidelines, medications and polypharmacy, material and human resources and clothing/shoes) and the nature of the interventions (related to the patient, institution and family). FINAL CONSIDERATIONS: the constituent elements of safe mobility express hospital units' capacity to guarantee care and protection from fall accidents for hospitalized older adults.
Assuntos
Acidentes por Quedas , Humanos , Acidentes por Quedas/prevenção & controle , Acidentes por Quedas/estatística & dados numéricos , Idoso , Hospitalização/estatística & dados numéricos , Cuidados de Enfermagem/métodos , Cuidados de Enfermagem/normas , Segurança do Paciente/normas , Segurança do Paciente/estatística & dados numéricos , Idoso de 80 Anos ou maisRESUMO
OBJECTIVE: To analyze the association between patient safety culture and professional quality of life in nursing professionals. METHOD: Correlational study carried out in a hospital in Salvador, Bahia, Brazil, with 180 participants. The data were collected through the Hospital Survey on Patient Safety Culture and Professional Quality of Life Scale and analyzed with correlation tests. RESULTS: The use of the Quality of Professional Life model, which encompasses Compassion Satisfaction, Burnout and Traumatic Stress, showed that a better assessment of the safety culture was negatively associated with Burnout. Regarding the dimensions of culture, better evaluations of the general perception of safety, teamwork and staffing were negatively associated with Burnout and Traumatic Stress. Higher Burnout was negatively associated with better handoffs and greater Traumatic Stress was positively associated with error communication. CONCLUSION: Higher levels of Burnout were associated with worse perception of safety culture and worse teamwork evaluations; staffing and general perception of safety were associated to a higher level of Burnout and Traumatic Stress, which emphasizes the importance of investment in these areas.