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Evaluating the intervening factors in patient safety: focusing on hospital nursing staff

OBJECTIVE To evaluate intervening factors in patient safety, focusing on hospital nursing staff. METHOD The study is descriptive, with qualitative approach, excerpt from a larger study with analytical nature. It was undertaken in a public hospital in Fortaleza, CE, Brazil, between January and June 2013, with semi-structured interviews to 70 nurses, using Thematic Content Analysis. RESULTS The principal intervening factors in patient safety related to hospital nursing staff were staff dimensioning and workload, professional qualification and training, team work, being contracted to the institution, turnover and lack of job security, and bad practice/disruptive behaviors. These aspects severely interfere with the establishment of a safety culture in the hospital analyzed. CONCLUSION It is necessary for managers to invest in nursing staff, so that these workers may be valued as fundamental in the promotion of patient safety, making it possible to develop competences for taking decisions with focus on the improvement of quality care.Objective: To evaluate intervening factors in patient safety, focusing on hospital nursing staff. Method: The study is descriptive, with qualitative approach, excerpt from a larger study with analytical nature. It was undertaken in a public hospital in Fortaleza, CE, Brazil, between January and June 2013, with semi-structured interviews to 70 nurses, using Thematic Content Analysis. Results: The principal intervening factors in patient safety related to hospital nursing staff were staff dimensioning and workload, professional qualification and training, team work, being contracted to the institution, turnover and lack of job security, and bad practice/disruptive behaviors. These aspects severely interfere with the establishment of a safety culture in the hospital analyzed. Conclusion: It is necessary for managers to invest in nursing staff, so that these workers may be valued as fundamental in the promotion of patient safety, making it possible to develop competences for taking decisions with focus on the improvement of quality care.

DIAGNÓSTICOS DE ENFERMAGEM PRESENTES EM PACIENTES RENAIS CRÔNICOS EM HEMODIÁLISE RELACIONADOS AO DOMÍNIO CONFORTO DA SAUDE DA NANDA-I.

Introdução: A Insuficiência Renal Crônica necessita de um método de substituição renal, como a hemodiálise. É um tratamento que faz uso de procedimentos invasivos, tornandose por vezes doloroso e desconfortável para o paciente. Assim, é importante o conhecimento dos diagnósticos de enfermagem relacionados ao conforto destes pacientes, para assim alertar a equipe de enfermagem sobre medidas para melhorar essa condição e tornar o tratamento menos sofrido. Objetivo: Identificar os Diagnósticos de Enfermagem presentes em Pacientes Renais Crônicos em Hemodiálise Relacionados ao Domínio Conforto da Nanda-I. Método: É um estudo descritivo e transversal realizado em Fortaleza-CE. No período de dezembro de 2014 a janeiro de 2015. A amostra foi composta por 25 pacientes renais crônicos em hemodiálise. A coleta de dados deu-se por entrevista semiestruturada. Foi feito o julgamento clínico dos dados encontrados, como base em Alfaro-LeFevre (2014). A pesquisa foi aprovada em Comitê de Ética em Pesquisa da Universidade Estadual do Ceará com parecer No 392.488 CAAE: 19640613.2.0000.5534. Resultados: Foram encontrados dois diagnósticos relacionados ao domínio de Conforto, são eles: Dor aguda com presente em 6 pacientes e Conforto prejudicado em 23 pacientes. O primeiro diagnóstico de Dor aguda foi caracterizado por relato verbal evidenciado por dor em fístula. O tipo de acesso venoso utilizado na hemodiálise relaciona-se ao tempo de tratamento, na pesquisa mostrou-se que 21 pacientes realizavam hemodiálise de 5 meses a 4 anos, mostrando que realizam o tratamento relativamente a pouco tempo. O tipo de acesso destes foram: 13 usava fístula e 12 cateter duplo lúmen. Em pacientes crônicos é recomendado acessos de longa permanência, como a fístula, visto que permite fluxo adequado de sangue e apresenta

ENFERMAGEM E METAS INTERNACIONAIS DE SEGURANÇA: AVALIAÇÃO EM HEMODIÁLISE

The objective of this study was to describe the nursing care offered at a hemodialysis hospital service based on international patient safety goals. A descriptive study was conducted at the hemodialysis service of a Brazilian public hospital, reference in care for acute and chronic kidney patients, between August and October, 2013. Twenty-five nursing professionals participated in the study. Data were collected through interviews, observation and a checklist based on the safety goals of the Joint Commission International. The goals found to be in conformity were: improving effective communication; reducing the risk of healthcare-associated infections; and reducing the risk of patient harm resulting from falls. The remaining goals, namely: identifying patients correctly; improving the safety of high-alert medications; and ensuring safe surgery, deserve attention from the researched team and the assessed institution. The research found a need for the implementation of protocols in the service aimed at patient and team safety.