Análise das interrupções ocorridas durante a assistência de enfermagem em unidades de tratamento intensivo
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2015-05-22
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Universidade Federal de Goiás
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OBJECTIVE: Analyze the interruptions occurred during nursing assistance provided in Intensive Care Units. METHODOLOGY: Cross-sectional study in two intensive care units of a university hospital in the state of Goiás. The study group was constituted by all nursing professionals providing care services to patients during the daytime period. The data collection occurred from June to August of 2014, by direct observation not nursing care activities participant, and by interviewing professionals. Data were analyzed using IBM SPSS Statistics software, version 20.0 for Windows. The prevalence of interrupted activities were calculated. Mann-Whitney U test to verify the difference in the duration of activity with and without interruption; Spearman to check the correlation coefficient of the duration of time of the activity and number of interruptions; Kruskal-Wallis test to check the differences between the number of interruptions per professional categories. RESULTS: The study included 33 nursing professionals working in intensive care units. The Professionals were observed for 99 hours, conducting 739 activities related to the nursing care duties, of which 346 (46.8%) suffered interruptions, totalizing 778 interruptions, which corresponds to 7.9 interruptions per hour or 1 interruption every 7.7 minutes. Considering all the discontinued activities, 56.7% were related to indirect patient care, 41.0% to direct care, and 2.3% to administrative activities. Taking notes and registration caused the highest number of interruptions equivalent to 23.7% of the total, followed by 18.2% for hand hygiene, and 9.3% for administration of drugs. On average the interruptions corresponded to 9.4% of the working time of the nursing professionals. The median of the interrupted activity were three minutes, and for those not interrupted, one minute. The main sources of interruption was stemmed own health professionals (51.0%), followed by self-interruption (32.1%). The main reasons for the observed interruptions were socialization (21.2%), collecting information (12.7%), requesting assistance (7.5%), and lack of materials to complete the procedures (6.6%). Regarding those procedures were interruption should not occur, for safety reasons, 51.5% of the professionals cited the preparation and administration of drugs, and 39.4%, orotracheal aspiration. Most interviewees (78.8%) reported having committed error, mistake or failure, due to incurred interruptions. As for strategies to avoid interruptions, 54.6% cited of those interviewed indicated the task organization, and 48.5%, continuing education. CONCLUSION: The causes of interruptions must be analyzed and strategies must be adopted in order to improve the work environment, to minimize interruptions, to prevent delays, loss of concentration, and possibly occurrences of errors, in order to increase quality and security during the health procedures provided to the population by the nursing professionals.
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PRATES, D. O. Análise das interrupções ocorridas durante a assistência de enfermagem em unidades de tratamento intensivo. 2015. 122 f. Dissertação (Mestrado em Enfermagem) - Universidade Federal de Goiás, Goiânia, 2015.