Práticas de profissionais de saúde na implantação do Programa de Segurança do Paciente: entre o prescrito e o real

• Ano de defesa: 2016
• Autor(a) principal: Andreia Guerra de Oliveira
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Minas Gerais; UFMG
• Palavras-chave em Português: Prática Profissional; Enfermagem; Segurança do Paciente; Qualidade da Assistência à Saúde; Pesquisa Qualitativa; Unidades de Internação; Dissetações Acadêmicas; Equipe de Enfermagem
• Link de acesso: http://hdl.handle.net/1843/ANDO-AHRJRM

The objective of the study was to understand the prescribed and actual dimension of the practices of health professionals in the implementation of the Patient Safety program. Study of qualitative approach, outlined by the strategy Case Study, based on Comprehensive Sociology. The research was carried out in a teaching hospital of the Minas Gerais, a scenario that develops some actions focused on quality, risk management and patient safety. Participants in the survey were members of the Patient Safety Center, and staff of the nursing team's inpatient unit, medical and surgical clinic. The choice of interviewing the ward ward team was based on the results of a survey in which the objective was to evaluate the incidence of adverse events in hospitals in Brazil. Their results showed that the infirmary was the most frequent site of adverse events (48.5%). The choice of core professionals came from understanding that they are the ones who manage and prescribe actions to achieve patient safety. Core members, nurses were interviewed, and the data saturation criterion was used for nursing technicians, totaling 31 participants. Data collection was performed using primary and secondary data. Secondary data were obtained through documental research (quality documents, reports, protocols, indicators, records and action plan of the nucleus), enabling the retrieval of prescribed sources, that is, the practices planned to achieve patient safety. The primary data were collected through interviews, with a semi-structured script, and observation, with a field journal record. Observation and interviews enabled the rescue of real sources. The interviews were recorded and transcribed in full, for analysis and interpretation of the data. Content Analysis was used to analyze the data. All ethical aspects were respected in accordance with Resolution 466/2012, under number 1,072,502. As results were identified as factors of insecurity in the studied institution: physical structure, inadequate facilities, lack of material resources or lack of quality of materials used, insufficient human resources, lack of an adequate relationship between leadership and other professionals, personal characteristics that influence behavior as, knowledge and professional qualification, influencing health practices. The transformations that took place, such as the creation of the nucleus and patient safety plan, implementation of protocols and indicators were more evident in prescriptive conceptions than in practice. In professional practice, there is a lack of interaction among core members with other professionals, team building, evaluation of actions with goals and work strategies. The practice of reporting adverse events was marked 7 by fear and presented gaps in knowledge. Necessary is the overcoming of the various ways of communicating the adverse event, overcoming the punitive reality and underreporting. In the hospitalization unit, it was possible to identify some changes in nursing practice such as changes in patient admission and identification, with an emphasis on risk management. The interaction with the medical staff proved to be fragile, with repercussions on patient safety. Patient safety was evidenced primarily within the prescribed scope of practice at the institution studied. Communication and managerial practice proved to be important obstacles between the prescribed and the real, and social relations as the main way to configure new practices.