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- Patient Safety Culture in Portuguese PrimaryPublication . Ornelas, Marta Dora; Pais, D; Sousa, PIntroduction: According to the European Commission more than 37 million Primary Healthcare (PHC) users suffer Adverse Events (AE). When we talk about these unintentional and undesirable events, most of the time we are dealing with acts committed by competent and dedicated professionals, who often work in disorganized systems, and who are not very oriented towards patient safety and health care professional safety. The adoption of a safety culture is a proven useful tool to make AE less likely to occur and to minimize its consequences when these inevitably take place. Methods: The authors describe some pertinent issues that have made the evaluation of AE and Patient Safety Culture (PSC) in Portuguese PHC particularly challenging and describe the preliminary results of a project for the assessment of PSC using the Medical Office Survey on Patient Safety Culture (MOSOPSC). This instrument has been translated, adapted and validated by the authors for the study population. Results: Studies about AE in PHC are scarce, but admittedly necessary. Despite the socio-economic instability experienced in Portugal, the preliminary results obtained by the authors promise a proactive PSC with dedicated health professionals, working as a team and recognizing the problem of adverse events in PHC of the Madeira Island. Discussion: The concepts and methodologies used in other studies cannot simply be applied to specific populations. On the Madeira Island (one autonomous region of Portugal), the issue of patient safety (PS) is difficult to approach but, nevertheless, with information and discussion it was possible to measure the PSC in PHC. Conclusion: After some adjustments, the MOSOPSC questionnaire, in addition to assessing safety culture, has helped to initiate the dialogue and discussion on the issue of PS among the various professionals. This approach has allowed these professionals to anticipate and prevent the occurrence of AE and, whenever such is not possible, notify, discuss, share and learn from those same events.
- Chvostek sign ( Clin case reports)Publication . Rodrigues, Roberto; Teles, LuísCareful anamnesis can act as gasometry in services with few resources. In this clini- cal case, a detailed clinical history made it possible to suspect the presence of acute hypocalcemia, a biochemical anomaly after confirmed in gasometry. Acute hypoc- alcemia can be life threatening, necessitating urgent treatment. Sometimes it can be managed with oral ambulatory treatment.
- Assessing Adverse Events in Madeira PrimaryPublication . Ornelas, Marta Dora; Sousa, PauloIn last three decades, several epidemiological studies have been developed in order to assess the magnitude, nature and type of adverse events (AEs). Most of these studies focus on hospital settings, where the activities are more standardised, but imultaneously more complex and involving higher risks. However, in the last years, there is a growing movement and strong evidence that point out the importance of studying other healthcare contexts, such as primary care and long-term care. In Portugal, studies on primary care setting are scarce and still in the early stages. In this article, the authors describe the AEs assessment in Portuguese Primary Health Care (PHC) units in Madeira Island/Portugal. This study was quantitative, cross-sectional, observational and analytical, with probability sampling. We quantify and analyse the AEs registered by healthcare providers using the APEAS-PT formulary. A link to the APEAS–PT form was sent to 520 healthcare professionals (111 specialist in Family Medicine, 27 medical students, 382 nurses) who worked in 32 PHC centres. These professionals identified and analysed 85 AEs and 42 incidents, which corresponds to a prevalence of 3.9 AEs per 10,000 visits,with a 95% confidence interval (CI) between 3.7 and 4 AE. Most of the AEs were preventable (96%). The most frequent causal factors of AEs were associated with medication (69%), health care provided to users (54%), communication (41%) and diagnosis (22%). This analysis of AEs in Madeira island PHC contributed to reinforce patient safety culture and to better understand quaternary prevention.