Programa de Pós-graduação em Enfermagem e Saúde
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Navegando Programa de Pós-graduação em Enfermagem e Saúde por Por Orientador "Bezerra, Ana Lúcia Queiroz"
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Item Práticas assistenciais e ocorrências de eventos adversos: percepção dos enfermeiros(Universidade Federal de Goiás, 2018-04-30) Amaral, Robson Tostes; Bezerra, Ana Lúcia Queiroz; http://lattes.cnpq.br/0088227879433410; Bezerra, Ana Lúcia Queiroz; Paranaguá, Thatianny Tanferri de Brito; Barreto, Regiane Aparecida dos Santos SoaresObjective: To analyze nurses' perceptions regarding nursing care practices and their relationship with risks and occurrence of adverse events in hospitalized patients. Method: Cross-sectional, correlational study developed in medical clinic units, surgical and renal replacement therapy of a public hospital of state education, with a population of 45 nursing assistants. Data collection was from January to May 2017, by means of the instrument "Adverse Events Associated with Nursing Practices", a self-administered questionnaire, with Likert type scales, translated and validated into Brazilian Portuguese. Results: The total number of participants was equivalent to 91.1% of the nurses working in the clinics surveyed, being 75.6% female, with an average age of 33 years, 53.7% had two or more employment relationships, average weekly working time of 56.2 hours and 63.4%, in the last 12 months, participated in a course on patient safety. In the general perception of nurses, 24.4% indicated that the occurrence of adverse events associated to care practices never/rarely compromises patient safety. Regarding the existence of risks and occurrence of adverse events were pointed out failures in the preventive practices, associated with inadequate clinical surveillance/judgment, defense deficit, falls, pressure injuries, medication errors, and health care-related infections. Maintain patient vigilance indicated a reduction in risk and occurrence of pressure injuries (p = 0.040). Preventive practices in pressure injuries (p = 0.0012), prevention of falls (p = 0.043), hand hygiene (p = 0.028) and care with personal protective equipment and environmental hygiene (p = 0.034), reduced adverse events in the medication process. In the nurses' perception, the existence of risk (24.4%) and occurrence (4.9%) of medication errors were high. Failures in the medication administration process increased the risk and occurrence of adverse events for falls (p = 0.049), pressure lesions (p = 0.012) and health care-related infections (p = 0.004). Failures in medication monitoring increased the risk and occurrence of falls (p = 0.035) and health care-related infections (p = 0.014). In the multiple regression analysis, medication preparation failures increased the risk and occurrence of adverse events in all phases of the medication process (p = 0.006). Considerations: Strategies related to the permanent training of the professionals in patient safety with approaches in the systemic errors associated to the organizational support for the learning is a way to be followed by the leaderships to minimize / mitigate occurrences of adverse events related to the assistance practices and with that to develop a safety culture focused on improvements in care quality in health and nursing services.Item Segurança do paciente na atenção primária: conhecimento dos profissionais de saúde(Universidade Federal de Goiás, 2015-02-18) Paranaguá, Thatianny Tanferri de Brito; Bezerra, Ana Lúcia Queiroz; http://lattes.cnpq.br/0088227879433410; Bezerra, Ana Lúcia Queiroz; Rosso, Claci Fátima Weirich; Minavisava, Ruth; Vieira, Maria Aparecida Da Silva; Coelho, Maria AliceThe general objective was to analyze the effect of an educational program on patient safety, developed by Tele-education, in the knowledge of professionals working in primary care. Study type intervention before and after, conducted with registered health professionals in Telehealth Network of Goiás. Were used self-report instruments, via web and carried out a descriptive statistical analysis. The results showed weaknesses in the knowledge of health professionals on patient safety, in the context of the practice, which subsidized the construction of an educational program which proved satisfactory to the expansion of knowledge about the studied subject. The reports of the incidents revealed the importance of acquiring knowledge on patient safety, to identify occurrences of the various incidents in primary care and highlighted the need to work conceptual aspects with greater depth in order to increase the accuracy of these professionals for the identification and monitoring of incidents arising from care. The study can be used globally, contributing to the diagnosis of knowledge about patient safety, to identify gaps that need to be worked for the management of health services, and the elaboration of educational policies that support the formation of a safety culture and quality in health services, in order to reduce the occurrence of incidents and prevent harm to patients who weeks care in primary care.Item Riscos e danos relacionados ao contexto do trabalho da equipe de enfermagem de unidades neonatais(Universidade Federal de Goiás, 2018-04-20) Silva, Ana Patrícia Batista; Bezerra, Ana Lúcia Queiroz; http://lattes.cnpq.br/0088227879433410; Bezerra, Ana Lúcia Queiroz; Barreto, Regiane Aparecida dos Santos Soares; Suzuki, KarinaTo analyze the work context and occupational damage, from the perspective of nursing staff professionals, in an Intensive Care Unit and Neonatal Intermediate Unit. METHODS: Cross-sectional, observational study with quantitative-qualitative approach performed at a large public health institution in the state of Goiás. The sample consisted of 44 workers from the neonatal units nursing team. Data collection was performed in the months of July and September of 2017 through observation and interview. For the data analysis, descriptive and analytical statistics were used using Student's t test and ANOVA for associations and Pearson's test for correlations, with a significance level of 5% (p ≤ 0,05). RESULTS: As for the professional profile, eight (18,2%) were nurses, 27 (61,4%) technicians and nine (20,4%) nursing assistants, female (100%), and mean age of 41,7 (± 9,7) years. The work context, from the perspective of the workers, was considered critical. For the organization of work, the items "excessive work rate" and "strong collection by results" presented higher averages (4,2±1,0), classified as severe. Concerning the working conditions, the highest averages corresponded to the "uncomfortable physical environment" (4,0±1,3), "a lot of noise in the environment" (4,1±1,1) and "inadequate physical space" (3,4±1,4). In the socio-professional relations, the highest averages involved "non-existent autonomy" (3,5±1,3) and "disputes among professionals" (3,5±1,1). A significant statistical difference was found between the two units for work organization factors (p=0,048), working conditions (p=0,046) and socio-professional relationships (p=0,0001). Regarding the occupational damage, the critical evaluation prevailed, with the psychological one having the highest mean (3,9±2,0) in the Intensive Care Unit. Already In the Neonatal Intermediate Unit, greater mean was identified for physical damage (2,6±1,4). There was a significant statistical difference between the Intensive and Intermediate Unit Care for the psychological (p=0,0002) and social (p=0,0009) damages. There was an association between the "work organization" domain and wage income variables (p=0,044) and hourly unit load (p=0,009); for "working conditions", the variables employment bond (p=0,016) and wage income (p=0,0001) were statistically significant. As well as for "physical damages" and the variables performed domestic activity (p=0,009), time acting on the unit (p=0,04) and wage income (p=0,02); for "psychological damages" and "social damages", there was an association with the variables working hours (p=0,02) and work shift (p=0,04/0,005). It was found a moderate and significant correlation between: physical damage and work organization (r=0,5721, p=0,0001), psychological damage and working conditions (r=0,5614, p=0,0001), psychological damage and socio-professional relations (r=0,6687, p=0,0001) and high and significant correlation between social and psychological damage (r=0,9072, p=0,0001). CONCLUSION: The work context of the neonatal units presents unfavorable elements and in inadequacy with the health and safety regulations of the worker, predisposing them to physical, psychic and social damage.Item Qualificação dos registros de procedimentos em centros de atenção psicossocial: educação permanente em saúde como estratégia de gestão(Universidade Federal de Goiás, 2018-01-25) Silva, Nathália dos Santos; Cardozo, Elizabeth Esperidião; http://lattes.cnpq.br/1143743711641872; Bezerra, Ana Lúcia Queiroz; http://lattes.cnpq.br/0088227879433410; Bezerra, Ana Lúcia Queiroz; http://lattes.cnpq.br/0088227879433410; Lucchese, Roselma; Medeiros, Marcelo; Caixeta, Camila Cardoso; Dallegrave, DanielaThe Psychosocial Care Centers (CAPS) are strategic services of the Psychosocial Care Network to promote the social reintegration of people with mental disorders and or problems related to the use of alcohol and other drugs. Thus, it is imperative that the actions in the CAPS be monitored and evidenced to support the superiority of this proposal. However, this will only be possible if there are data recorded by the professionals working in the CAPS to enable the evaluation for the management of the quality of the services. This study aimed to analyze the quality of records of procedures using the Permanent Education in Health as a strategy for the management of the work process of the health professionals of the CAPS. This is an intervention research of a qualitative nature, carried out with 58 professionals from seven CAPS from three municipalities of the State of Goiás. Data collection occurred from March to October 2016. The Permanent Health Education was procedural and occurred in three stages: focus groups, seminars and workshops on CAPS procedures and elaboration of a Unique Therapeutic Project (PTS). With the data obtained through the reflection of the subjects, the thematic content analysis was performed. The thematic categories and subcategories that emerged from the content analysis were: Process of registration of the CAPS procedures, the Unique Therapeutic Project in quotation marks and Qualification of the PTS through the understanding of the records and and the opposite also. The results showed that the professionals did not know the instruments of records of CAPS procedures, the meaning of the names of the procedures, the management and purposes of the records and the importance of the data as the driver of information for work and service management. Two situations on the quality of records were evidenced that the data were underreported or reflected the inexistence of psychosocial actions. It was perceived the need of investment in the training of the professionals with focus on the records management and through the systematization of PTS. The Permanent Health Education strategy expanded the repertoire of information about CAPS procedures and was evaluated positively by enabling a better understanding of the records, deconstruction of the idea of association of registration for financial transfer, use of the list of procedures as a care line for elaboration of more robust PTS and revision of Institutional Therapeutic Projects. The incompleteness and underreporting of the data do not depict what the teams in the CAPS are developing and, therefore, the conclusion that the analysis of the data generated through them does not coincide with the reality of the services. It is important to emphasize the importance of the process of permanent education as a way of giving priority to more meaningful learning practices involving the participants in the process of change and thus highlighting the psychosocial practices by recording the actions developed in the CAPS or other devices in the territory. This evidence is fundamental for the technical and political defense of the model of psychosocial care in force in the country.Item Incidentes com pacientes atendidos nos centros de atenção psicossociais: vivências da equipe de saúde(Universidade Federal de Goiás, 2019-04-29) Souza, Adrielle Cristina Silva; Caixeta, Camila Cardoso; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4282188T6; Bezerra, Ana Lúcia Queiroz; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4767942Z2; Bezerra, Ana Lúcia Queiroz; Lucchese, Roselma; Alves, Sergiane Bisinoto; Cardoso, Elizabeth Esperidião; Medeiros, MarceloOBJECTIVE: To analyze the security context of the users served at the Psychosocial Care Centers, based on the experiences of the multiprofessional team. METHODOLOGY: Qualitative study, intervention, mediated by the Cycle of Experiential Learning. 31 professionals from two service units - Psychosocial Care Center - Adult CAPS III from the metropolitan region of Goiânia participated. The data collection took place through group meetings, in which the professionals developed activities proposed by the researcher that led to reflection and learning about patient safety. The data were submitted to content analysis, using qualitative analysis software. RESULTS: The thematic content analysis was performed with the data obtained through participants' experiential techniques. The thematic categories that emerged from the content analysis were: 1 - Knowledge of professionals about patient safety; 2 - Incidents and situations of risks experienced by professionals of the multiprofessional team 3 - Strategies and evaluation of the educational process to promote safety in care. The data revealed low knowledge in the area of patient safety, which further heightened the interest of the team's professionals in understanding the issue. Understanding that the theory is currently more focused on the hospital environment, its focus on psychosocial care is something innovative. Incidents and situations of risks to the patient's safety were revealed in the physical aspects of the unit; in the work process in the services and low communication of the service network; in the lack and professional qualification; inadequate care; low family involvement; deficiency of records and mechanism from prescription to drug administration. The Permanent Health Education strategy in a problematic and participatory manner developed the team's understanding of safe care, which enabled professionals to outline strategies for incident prevention and promotion of safe care in CAPS. The process was evaluated as positive because it allows rethinking and instigating better attitudes in the work, in a dynamic and involving way, being possible to align theory and practice, besides being able to demystify that the clinic does not fit in the unit of mental health respecting the psychosocial attention. FINAL CONSIDERATIONS: Continuous efforts are required in practice, from senior management to direct assistance professionals, with the aim of promoting physical, human and organizational structure that guarantees the promotion of the safety culture in the CAPS. The experiential method favored the reflection of the service dynamics revealing the risk situations in the assistance to the users. The legitimacy of EPS as spaces for the exchange of practices and knowledge in the reflexion-action-reflection process, for the production of knowledge that improves patient safety in mental health is perceived, which will help both the improvement of the quality of services and in the training of professionals.Item Eventos adversos ocorridos com idosos hospitalizados(Universidade Federal de Goiás, 2015-04-24) Teixeira, Cristiane Chagas; Bezerra, Ana Lúcia Queiroz; http://lattes.cnpq.br/0088227879433410; Bezerra, Ana Lúcia Queiroz; Pagotto, Valéria; Silva, Ana Elisa Bauer de Camargo; Ciosak, Suely Itsuko; Pereira, Lilian VarandaOBJECTIVE: Analyze adverse events recorded in medical records of hospitalized elderly patients. METHOD: A descriptive, cross-sectional, having as data source the records of elderly patients admitted from July 2013 to December 2013, the Surgery Unit of a teaching hospital, Midwest region of Brazil. Data collection was guided by a structured and pre-validated form and were analyzed through Statistical Package For The Social Science (SPSS), version 20.0 for Windows. The prevalence and the ranges of 95% confidence adverse events were calculated and descriptive analysis was done. To identify associated factors, chi-square test and uni and multivariate analysis were used. RESULTS: In 260 admissions, 50.4% were male, average age 68.5 years and 68.5% had comorbidities. Adverse events were identified in 531 records, defined an average of 2.04 events per admission. The types of adverse events were related to the clinical Process such as acute pain in pre and postoperative unresolved, unscheduled withdrawal and obstruction of tubular devices, failure during technical procedures, surgical dehiscence and non-drug allergic process; Medication, related to adverse reaction to medications; Blood product, related to lack of blood; Clinical management, as surgical suspension and booked exam but not performed; Hospital infection related to the surgical site, phlebitis and sepsis and Accident with the patient, such as loss and pressure ulcers. Most of the events occurred during the night shift. Damage caused to the patient were classified as mild 73.1%, 25.4% moderate, severe 0.6% and 0.9% died. The prevalence was 58.8%, indicating that hospital admissions were exposed to 153, at least one type of adverse event. The associated factor was related to length of stay for more than nine days as an independent risk variable for adverse events occurrence. CONCLUSION: The results indicate the need for initiatives by managers to modify the care practice, through educational activities, work processes improvement and better articulation between subsystems integrated into the institution, focusing on promoting quality in health services and safety culture development, especially on the elderly in hospitals.Item Análise da cultura de segurança em um hospital de ensino da região centro-oeste do Brasil(Universidade Federal de Goiás, 2013-08-28) Tobias, Gabriela Camargo; Bezerra, Ana Lúcia Queiroz; http://lattes.cnpq.br/0088227879433410; Bezerra, Ana Lúcia Queiroz; Freitag, Maria Salete Batista; Silva, Ana Elisa Bauer de Camargo; Najberg, Estela; Minamisava, RuthIn the context of health, the safety culture centered on the quality of care and the systematization of work processes contributes to human error prevention avoidable and, therefore, for the patient safety. The study aims to analyze the perception of a teaching hospital nurses about the dimensions of safety culture’s patient. The methodology is descriptive, exploratory, carried out at a teaching hospital in the Central West region of Brazil, with a population of 117 nurses. The data were collected in October to December of 2011 through autoaplicavel instruments,those belongs to the Hospital Survey on Patient Safety Culture, proposed and used by Agency for Health Research and Quality, specific for the detection of safety culture in hospital, translated and validated for the portuguese language. The data were analysed by the Statistical Package for Social Sciences Program, version 18.0. The project was approved, protocol 064/2008. The percentual of participants were 84.8 % of the nurses of the hospital, 89.7 % were female, predominant age range between 45 to 51 years, 51% with 16 to 21 years of profession, 36% with the same time in the institution and 13.7 % worked in the Emergency Room. The weekly workload of 87% was about 20 to 39 hours and 96% had directly contact with the patient. The reply “Not punitive to mistakes” had the lowest rate, 28%. The weaknesses for the institution were: the team considers that their mistakes could be used against them; the team was afraid that the mistakes were recorded in their functional files; insufficient staff; they work more than necessary; occurrence of problems in the exchange of information between the units; the security has to be sacrificed instaed of doing more things; patient safety problem in the unit, procedures and inadequate systems for the mistakes prevention. The strength points were: the supervisor/manager takes the suggestions to improve the patient safety, considers security problems; work actively doing things to improve the servisse quality; support each other; work in a team; treating with respect and having a good relationship with professionals from other units. However, 59% considered safety patient acceptablevin the unit, and 52% said they never reported adverse events. The conclusion was that the research gave the nurses perception and envolved them with the patient security, the same as how to prove that the aplication of a analysed instrument for actions can be used for estimulating the adoption of politics those bring changes and attitudes for the development of institution security culture.