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Notificação de incidentes e eventos adversos no departamento de pediatria: perceção dos profissionais de saúde
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| 2.18 MB | Adobe PDF |
Orientador(es)
Resumo(s)
RESUMO - Introdução: Os erros associados aos cuidados de saúde são um grave problema de
saúde pública, com consequências nefastas para doentes e sistemas de saúde. Na área
pediátrica existe uma maior probabilidade de erros devido à sua variedade e
complexidade. A existência dos sistemas de notificação é uma forma de identificação,
rastreio e prevenção de falhas nos sistemas de saúde, que contribui para a melhoria da
qualidade e da segurança do doente. Todavia, estes sistemas não são utilizados de
forma expectável e a subnotificação é uma realidade. Pouco foi investigado acerca das
notificações na área pediátrica, sendo que este estudo tem como objetivo explorar o
processo de notificação de incidentes e eventos adversos na perspetiva dos
profissionais de saúde no departamento de pediatria de um hospital da região de Lisboa.
Metodologia: Estudo observacional e analítico retrospetivo com abordagem mista
(qualitativa e quantitativo). Foram disponibilizados questionários a enfermeiros e
médicos e realizadas entrevistas às chefias intermédias do departamento de pediatria.
Resultados e Discussão: Os profissionais de saúde utilizam mais o sistema de
notificação interna do hospital, em detrimento do sistema nacional. 85% da amostra
referiu subnotificação no departamento onde trabalha. A notificação aumenta com a
gravidade dos eventos e com experiência profissional, sendo os enfermeiros a classe
profissional que mais notifica. As principais barreiras à notificação neste estudo foram
os near misses, a falta de tempo e o esquecimento. As principais intervenções adotadas
referem-se à formação e sensibilização, o feedback e chefias não punitivas. Foram
analisadas e exploradas perspetivas das chefias, sobre estratégias para valorizar as
notificações e dificuldades sentidos num posto de liderança, onde foi expresso a
existência de obstáculos acrescidos colocados pela administração hospitalar.
Conclusões: Investir na utilização dos sistemas de notificação deve ser uma prioridade
com o objetivo de rastrear, analisar e diminuir os incidentes e eventos adversos em
saúde. O aumento das notificações contribui para aumentar a segurança do utente e,
consequentemente, aumentar a qualidade em saúde. Identificar barreiras sentidas pelos
profissionais de saúde pode contribuir para implementar intervenções minimizadoras
das mesmas. Ações promotoras de reportes possibilitam, não só, melhorar os cuidados
de saúde, mas também tornar os sistemas de saúde mais eficientes e rentáveis.
ABSTRACT - Introduction: Medical errors are a serious public health problem, with harmful consequences for patients and healthcare systems. In the paediatric area, there is an increase in the possibility of occurring errors, due to their variety and complexity. Reporting systems are a way of identifying, tracking and preventing failures in health systems, which contributes to improving quality and patient safety. However, these platforms are not used as expected and underreporting is a reality. There is a lack of investigation regarding notifications in the paediatric area, the reason why the aim of this study is to explore the process of reporting incidents and adverse events from the perspective of health professionals in the pediatric department of a hospital in Lisbon. Methodology: Retrospective observational and analytical study with a mixed approach (qualitative and quantitative). A questionnaire was applied to nurses and physicians, and interviews were conducted with medical and nurse managers of the pediatric department. Results and discussion: Health professionals tend to use more the internal reporting system, compared to the national system. 85% of the sample stated underreporting in the pediatric department where they work. Notification increases with the severity of events and with professional experience, being nurses the ones who report the most. The main barriers to notification in this study were the near misses, lack of time and forgetfulness. The main interventions adopted were related to training and awareness, feedback and non-punitive managers. Managers' perspectives were analyzed and explored to value notifications and obstacles felt in a leadership position and expressed the existence of added obstacles placed by the hospital administration. Conclusion: Investing in reporting systems should be a priority in order to track, analyze and reduce health incidents and adverse events. Empowerment in notifications contributes to increasing patient safety and, consequently, health quality. Identifying barriers felt by health professionals can contribute to implementing interventions to minimize them. Actions to promote reporting may improve healthcare, making health systems more efficient and profitable.
ABSTRACT - Introduction: Medical errors are a serious public health problem, with harmful consequences for patients and healthcare systems. In the paediatric area, there is an increase in the possibility of occurring errors, due to their variety and complexity. Reporting systems are a way of identifying, tracking and preventing failures in health systems, which contributes to improving quality and patient safety. However, these platforms are not used as expected and underreporting is a reality. There is a lack of investigation regarding notifications in the paediatric area, the reason why the aim of this study is to explore the process of reporting incidents and adverse events from the perspective of health professionals in the pediatric department of a hospital in Lisbon. Methodology: Retrospective observational and analytical study with a mixed approach (qualitative and quantitative). A questionnaire was applied to nurses and physicians, and interviews were conducted with medical and nurse managers of the pediatric department. Results and discussion: Health professionals tend to use more the internal reporting system, compared to the national system. 85% of the sample stated underreporting in the pediatric department where they work. Notification increases with the severity of events and with professional experience, being nurses the ones who report the most. The main barriers to notification in this study were the near misses, lack of time and forgetfulness. The main interventions adopted were related to training and awareness, feedback and non-punitive managers. Managers' perspectives were analyzed and explored to value notifications and obstacles felt in a leadership position and expressed the existence of added obstacles placed by the hospital administration. Conclusion: Investing in reporting systems should be a priority in order to track, analyze and reduce health incidents and adverse events. Empowerment in notifications contributes to increasing patient safety and, consequently, health quality. Identifying barriers felt by health professionals can contribute to implementing interventions to minimize them. Actions to promote reporting may improve healthcare, making health systems more efficient and profitable.
Descrição
Palavras-chave
Gestão do risco Segurança do doente Notificação de incidentes Eventos adversos Pediatria Patient safety Health quality Reporting systems Adverse events Paediatrics