Lenice Gnocchi da Costa Reis

Efeitos adversos a medicamentos em hospital público: estudo piloto

The results from implementing a strategy for monitoring adverse effects from drugs in a public hospital in the municipality of Rio de Janeiro, Southeastern Brazil, in 2007, were analyzed. Based on retrospective analysis of 32 medical files, adverse effects were found in 16%. To identify these effects, 38 tracking criteria were needed. Among these, the main ones were the use of antiemetics, abrupt cessation of medication and over-sedation. Despite the difficulties, especially in relation to access to information and the record quality, application of these tracking criteria seems to be viable. To improve the implementation of the method, it is suggested that the data collection should be computerized and risk adjustment indicators should be sought.Fueron analizados los resultados de la implantacion de estrategia de monitoreo de efectos adversos a los medicamentos en hospital publico en Rio de Janeiro, Sureste de Brasil, en 2007. Con base en analisis retrospectivo de 32 prontuarios fueron encontrados efectos adversos en 16%. Para identificarlos, fueron necesarios 38 criterios rastreadores, de los cuales los principales fueron: uso de antiemeticos, interrupcion abrupta de medicamentos y sedacion excesiva. A pesar de las dificultades, sobre todo relacionadas con el acceso a las informaciones y a la calidad de los registros, la aplicacion de los criterios rastreadores parece ser viable. Para perfeccionar la implantacion del metodo, se sugiere informatizar la colecta de datos y buscar indicadores de ajuste del riesgo.

Maternidade segura no Brasil: o longo percurso para a efetivação de um direito

A mortalidade materna e uma questao complexa e permanece sendo um grave problema de saude publica. Este artigo se propoe a olhar esse fenomeno sob a otica do direito a saude, destacando que a opcao por trazer a discussao para o campo dos direitos humanos proporcionou a ampliacao de sua explicacao e uma apresentacao mais clara a sociedade. E apresentada breve trajetoria da insercao desse tema na agenda politica global, explorando algumas iniciativas internacionais e nacionais. O quadro atual da mortalidade materna no Brasil e apenas a face mais visivel da precariedade da atencao a saude das mulheres. A situacao se agrava quando sao considerados os casos de morbidade materna grave, que afeta um expressivo numero de mulheres. Apesar das iniciativas para a efetivacao do direito a maternidade segura, ainda sao poucos os avancos, e a sociedade deve exigir que o Estado reverta o quadro de injustica contra as mulheres.

Structure in Brazilian maternity hospitals: key characteristics for quality of obstetric and neonatal care

This study aimed to evaluate key characteristics of structure in a sample of maternity hospitals in Brazil. Structure was evaluated according to Ministry of Health criteria and included: geographic location, obstetric volume, presence of ICU, teaching activities, staff qualifications, and availability of equipment and medicines. The results showed differences in staff qualifications and availability of equipment in obstetric and neonatal care according to type of financing, region of the country, and degree of complexity. The North/Northeast and Central-West regions presented the most serious problems with structure. The public and mixed hospitals were better structured in the South/Southeast, reaching satisfactory levels on various items, similar or superior to the private hospitals. The current study contributes to the debate on quality of structure in Brazils hospital services and emphasizes the need to develop analytical studies considering process and results of obstetric and neonatal care.This study aimed to evaluate key characteristics of structure in a sample of maternity hospitals in Brazil. Structure was evaluated according to Ministry of Health criteria and included: geographic location, obstetric volume, presence of ICU, teaching activities, staff qualifications, and availability of equipment and medicines. The results showed differences in staff qualifications and availability of equipment in obstetric and neonatal care according to type of financing, region of the country, and degree of complexity. The North/Northeast and Central-West regions presented the most serious problems with structure. The public and mixed hospitals were better structured in the South/Southeast, reaching satisfactory levels on various items, similar or superior to the private hospitals. The current study contributes to the debate on quality of structure in Brazil’s hospital services and emphasizes the need to develop analytical studies considering process and results of obstetric and neonatal care.

Adverse effects from drugs in a public hospital: pilot study

The results from implementing a strategy for monitoring adverse effects from drugs in a public hospital in the municipality of Rio de Janeiro, Southeastern Brazil, in 2007, were analyzed. Based on retrospective analysis of 32 medical files, adverse effects were found in 16%. To identify these effects, 38 tracking criteria were needed. Among these, the main ones were the use of antiemetics, abrupt cessation of medication and over-sedation. Despite the difficulties, especially in relation to access to information and the record quality, application of these tracking criteria seems to be viable. To improve the implementation of the method, it is suggested that the data collection should be computerized and risk adjustment indicators should be sought.Fueron analizados los resultados de la implantacion de estrategia de monitoreo de efectos adversos a los medicamentos en hospital publico en Rio de Janeiro, Sureste de Brasil, en 2007. Con base en analisis retrospectivo de 32 prontuarios fueron encontrados efectos adversos en 16%. Para identificarlos, fueron necesarios 38 criterios rastreadores, de los cuales los principales fueron: uso de antiemeticos, interrupcion abrupta de medicamentos y sedacion excesiva. A pesar de las dificultades, sobre todo relacionadas con el acceso a las informaciones y a la calidad de los registros, la aplicacion de los criterios rastreadores parece ser viable. Para perfeccionar la implantacion del metodo, se sugiere informatizar la colecta de datos y buscar indicadores de ajuste del riesgo.

Estrutura das maternidades: aspectos relevantes para a qualidade da atenção ao parto e nascimento

This study aimed to evaluate key characteristics of structure in a sample of maternity hospitals in Brazil. Structure was evaluated according to Ministry of Health criteria and included: geographic location, obstetric volume, presence of ICU, teaching activities, staff qualifications, and availability of equipment and medicines. The results showed differences in staff qualifications and availability of equipment in obstetric and neonatal care according to type of financing, region of the country, and degree of complexity. The North/Northeast and Central-West regions presented the most serious problems with structure. The public and mixed hospitals were better structured in the South/Southeast, reaching satisfactory levels on various items, similar or superior to the private hospitals. The current study contributes to the debate on quality of structure in Brazils hospital services and emphasizes the need to develop analytical studies considering process and results of obstetric and neonatal care.This study aimed to evaluate key characteristics of structure in a sample of maternity hospitals in Brazil. Structure was evaluated according to Ministry of Health criteria and included: geographic location, obstetric volume, presence of ICU, teaching activities, staff qualifications, and availability of equipment and medicines. The results showed differences in staff qualifications and availability of equipment in obstetric and neonatal care according to type of financing, region of the country, and degree of complexity. The North/Northeast and Central-West regions presented the most serious problems with structure. The public and mixed hospitals were better structured in the South/Southeast, reaching satisfactory levels on various items, similar or superior to the private hospitals. The current study contributes to the debate on quality of structure in Brazil’s hospital services and emphasizes the need to develop analytical studies considering process and results of obstetric and neonatal care.

Cuidado obstétrico: desafios para a melhoria da qualidade

The point of departure for the following commentary is a research-intervention project focused on improvement of obstetric care in public maternity hospitals in a large Brazilian city from 2015 to 2017, in which we aimed to understand the context for implementation of the intervention. The sources were interactions with administrators from the Municipal Health Department and the maternity hospitals, and especially interviews with administrators, physicians, nurses, and postpartum primiparous women in the hospitals.

Estructura de los hospitales de maternidad: aspectos relevantes para la calidad de la atención durante el parto y el nacimiento

This study aimed to evaluate key characteristics of structure in a sample of maternity hospitals in Brazil. Structure was evaluated according to Ministry of Health criteria and included: geographic location, obstetric volume, presence of ICU, teaching activities, staff qualifications, and availability of equipment and medicines. The results showed differences in staff qualifications and availability of equipment in obstetric and neonatal care according to type of financing, region of the country, and degree of complexity. The North/Northeast and Central-West regions presented the most serious problems with structure. The public and mixed hospitals were better structured in the South/Southeast, reaching satisfactory levels on various items, similar or superior to the private hospitals. The current study contributes to the debate on quality of structure in Brazils hospital services and emphasizes the need to develop analytical studies considering process and results of obstetric and neonatal care.This study aimed to evaluate key characteristics of structure in a sample of maternity hospitals in Brazil. Structure was evaluated according to Ministry of Health criteria and included: geographic location, obstetric volume, presence of ICU, teaching activities, staff qualifications, and availability of equipment and medicines. The results showed differences in staff qualifications and availability of equipment in obstetric and neonatal care according to type of financing, region of the country, and degree of complexity. The North/Northeast and Central-West regions presented the most serious problems with structure. The public and mixed hospitals were better structured in the South/Southeast, reaching satisfactory levels on various items, similar or superior to the private hospitals. The current study contributes to the debate on quality of structure in Brazil’s hospital services and emphasizes the need to develop analytical studies considering process and results of obstetric and neonatal care.

Efectos adversos a medicamentos en hospital público: estudio piloto

The results from implementing a strategy for monitoring adverse effects from drugs in a public hospital in the municipality of Rio de Janeiro, Southeastern Brazil, in 2007, were analyzed. Based on retrospective analysis of 32 medical files, adverse effects were found in 16%. To identify these effects, 38 tracking criteria were needed. Among these, the main ones were the use of antiemetics, abrupt cessation of medication and over-sedation. Despite the difficulties, especially in relation to access to information and the record quality, application of these tracking criteria seems to be viable. To improve the implementation of the method, it is suggested that the data collection should be computerized and risk adjustment indicators should be sought.Fueron analizados los resultados de la implantacion de estrategia de monitoreo de efectos adversos a los medicamentos en hospital publico en Rio de Janeiro, Sureste de Brasil, en 2007. Con base en analisis retrospectivo de 32 prontuarios fueron encontrados efectos adversos en 16%. Para identificarlos, fueron necesarios 38 criterios rastreadores, de los cuales los principales fueron: uso de antiemeticos, interrupcion abrupta de medicamentos y sedacion excesiva. A pesar de las dificultades, sobre todo relacionadas con el acceso a las informaciones y a la calidad de los registros, la aplicacion de los criterios rastreadores parece ser viable. Para perfeccionar la implantacion del metodo, se sugiere informatizar la colecta de datos y buscar indicadores de ajuste del riesgo.