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Publication
Gestão Operacional da Passagem de Turno para a Garantia da Qualidade e Segurança dos Doentes
| Name: | Description: | Size: | Format: | |
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| 1.98 MB | Adobe PDF |
Advisor(s)
Abstract(s)
A segurança do doente representa, atualmente, um dos grandes desafios na gestão dos cuidados de saúde. Cerca de 70% dos eventos adversos ocorrem pelas falhas de comunicação entre os profissionais de saúde, pelo que a DGS emitiu a norma nº 001/2017 sobre comunicação eficaz na transição de cuidados para a segurança do doente, referindo que esta deve ser normalizada utilizando a técnica ISBAR, tendo o enfermeiro gestor a responsabilidade de implementar e formar a sua equipa para a sua utilização.
O estudo é de natureza mista, foi realizada a observação da passagem de turno com recurso a uma grelha de observação, sendo a amostra obtida a partir de 82 observações calculadas a partir de um universo de 1068 considerando uma amostra aleatória sistemática. A pesquisa qualitativa foi efetuada através da realização de uma entrevista semiestruturada a vinte enfermeiros. Apresenta como objetivos: Identificar as áreas relevantes a abordar na passagem de turno num serviço de uma unidade local de saúde do Norte do país; Analisar a perceção dos enfermeiros sobre a metodologia desenvolvida na passagem de turno; Compreender a diferença entre o que se observa e o que os enfermeiros expressam.
Após análise, verificou-se que a comunicação na passagem de turno apresenta lacunas: pelo tempo despendido, pela omissão de informação essencial, pela informação desnecessária à prestação dos cuidados, pelas interrupções constantes e que poderão provocar dano ao cliente. Existem diferenças entre o que os enfermeiros expressam e o que se observa na passagem de turno sendo, contudo os itens que reuniram maior consenso foram: Identificação do doente, identificação do cuidador informal, descrição do motivo de internamento, meios complementares de diagnóstico e terapêutica, antecedentes clínicos, nível de dependência, alergias, terapêuticas invasivas realizadas, presença/risco de colonização, identificação da situação social, problemas ativos, alterações do estado de saúde significativas, terapêutica medicamentosa e não medicação, focos de atenção, diagnóstico, intervenções, identificação das necessidades do cuidador informal e informação sobre consultas e meios complementares de diagnóstico e terapêutica
Patient safety currently represents one of the greatest challenges in healthcare management. Around 70% of adverse events occur due to communication failures between healthcare professionals, which is why the DGS issued standard no. 001/2017 on effective communication in the transition of care for patient safety, stating that this should be standardized using the ISBAR technique, with the nurse manager being responsible for implementing and training his team to use it. The study is of a mixed nature, observation of shift change was carried out using an observation grid, with the sample obtained from 82 observations calculated from a universe of 1068 considering a systematically examined sample. A qualitative research was carried out by conducting a semi-structured interview with twenty nurses. Its objectives are: to identify the relevant areas to address when changing shifts in a service at a local health unit in the North of the country; Analyze nurses' perception of the methodology developed during shift change; Understand the difference between what is observed and what nurses express. After analysis, we found that communication at shift change presents gaps: due to the time spent, the omission of essential information, unnecessary information for the provision of care, constant interruptions that can cause harm to the client. There are differences between what nurses express and what is observed during shift change, however, the items that gathered the greatest consensus were: Identification of the patient, identification of the informal caregiver, description of the reason for hospitalization, complementary diagnostic and therapeutic means, clinical history, level of dependence, allergies, invasive therapies performed, presence/risk of colonization, identification of social situation, active problems, serious changes in health status, drug and non-medication therapy, focus of attention, diagnosis, interventions, identification of needs of the informal caregiver and information about consultations and complementary diagnostic and therapeutic means
Patient safety currently represents one of the greatest challenges in healthcare management. Around 70% of adverse events occur due to communication failures between healthcare professionals, which is why the DGS issued standard no. 001/2017 on effective communication in the transition of care for patient safety, stating that this should be standardized using the ISBAR technique, with the nurse manager being responsible for implementing and training his team to use it. The study is of a mixed nature, observation of shift change was carried out using an observation grid, with the sample obtained from 82 observations calculated from a universe of 1068 considering a systematically examined sample. A qualitative research was carried out by conducting a semi-structured interview with twenty nurses. Its objectives are: to identify the relevant areas to address when changing shifts in a service at a local health unit in the North of the country; Analyze nurses' perception of the methodology developed during shift change; Understand the difference between what is observed and what nurses express. After analysis, we found that communication at shift change presents gaps: due to the time spent, the omission of essential information, unnecessary information for the provision of care, constant interruptions that can cause harm to the client. There are differences between what nurses express and what is observed during shift change, however, the items that gathered the greatest consensus were: Identification of the patient, identification of the informal caregiver, description of the reason for hospitalization, complementary diagnostic and therapeutic means, clinical history, level of dependence, allergies, invasive therapies performed, presence/risk of colonization, identification of social situation, active problems, serious changes in health status, drug and non-medication therapy, focus of attention, diagnosis, interventions, identification of needs of the informal caregiver and information about consultations and complementary diagnostic and therapeutic means
Description
Keywords
Enfermeiro gestor Segurança do doente Metodologia ISBAR