Problems and strategies related to patient safety in primary health care
DOI:
https://doi.org/10.33448/rsd-v9i10.9335Keywords:
Nursing; Patient safety; Primary health care; Safety culture.Abstract
Objectives: To describe the main problems related to patient safety in Primary Health Care from the perspective of nurses; list change strategies that strengthen patient safety in Primary Health Care. Method: Descriptive research, with a quantitative and qualitative approach. In the quantitative one, the Medical Office Survey on Patient Safety Culture instrument was used and in the qualitative one, the causal chain model and the Organizational Development Theory were chosen. Data collection took place from July to December 2017, in 14 health units in a city in southern Brazil. 51 nurses participated. Results: Patient safety problems related to: equipment, exams, medical records, professional quantity, haste, work flow, service management, quantity being more important than quality, information exchange and to professionals who believe that mistakes can be used against you. In view of these, generic strategies were developed, related to the structure, such as equipment maintenance, acquisition of materials, increase of the staff and improvements in the computerized system; and specific, related to the management process, with actions aimed at improving the local work process. Conclusion: The description of the problems for patient safety in Primary Care makes it possible to list strategies aimed at strengthening the safety culture.
References
Alves, K. Y. A., Oliveira, P. T. C., Chiavone, F. B. T., Barbosa, M. L., Saraiva, C. O. P. O., Martins, C. C. F & Santos, V. E. P. (2018). Patient identification in the records of health professionals. Acta Paulista de Enfermagem, 31 (1), 79-86. http://dx.doi.org/10.1590/1982-0194201800012
Amestoy, S. C., Peixoto, R. S., Garcia, R. P., Santos, B. O., Silva, C. N & Braga, D. D. (2016). Percepção de enfermeiros-líderes sobre o gerenciamento de conflitos no ambiente hospitalar. Revista de Enfermagem da UFSM, 6 (2). https://doi.org/10.5902/2179769218167
Brown, C., Hofer, T., Johal, A., Thomson, R., Nicholl, J., Franklin, B. D & Lilford, R. J. (2008). An epistemology of patient safety research: a framework for study design and interpretation. Part 1. Conceptualizing and developing interventions. Quality and Safety in Health Care, 17 (3), 158-62. Recuperado de: http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.558.2827&rep=rep1&type=pdf
Chiavenato, I. (2014). Introdução à teoria geral da administração (9° ed.). São Paulo: Manole LTDA.
Costa, D. B., Ramos, D., Gabriel, C. S & Bernardes, A. (2018). Patient safety culture: evaluation by nursing professionals. Texto Contexto Enfermagem, 27 (3), e2670016. https://doi.org/10.1590/0104-070720180002670016
Cruz, E. D. A., Rocha, D. J. M., Mauricio, A. B., Ulbrich, F. S., Batista, J & Maziero, E. C. S. (2018). Safety culture among health professionals in a teaching hospital. Cogitare Enfermagem, 23 (1). http://dx.doi.org/10.5380/ce.v23i1.50717
Ferreira, S. L. S., Souza, S. R. D & Andrade BF. (2016). Avaliação da gestão do trabalho com enfoque na atuação dos profissionais da atenção primária à saúde. Revista Ciência Plural 2 (2), 99-114. Recuperado em: https://periodicos.ufrn.br/rcp/article/view/10974/7848
Ferreira, S.F.S., Périco, L.A.D & Dias, V.R.F.G. (2018). The complexity of the work of nurses in Primary Health Care. Revista Brasileira de Enfermagem, 71 (supl. 1). http://dx.doi.org/10.1590/0034-7167-2017-0471
Fontana, C. K., Lacerda, T. J & Machado, M. P. (2016). O processo de trabalho na Atenção Básica à saúde: avaliação da gestão. Saúde em Debate, 40 (110), 64-80. https://dx.doi.org/10.1590/0103-1104201611005
Galavote, H. S., Zandonade, E., Garcia, A. C. P., Freitas, P. de S. S., Seidl, H., Contarato, P. C Andrade, M. A. C & Lima, R. C. D. (2016). The nurse's work in primary health care. Escola Anna Nery, 20 (1), 90-98. https://doi.org/10.5935/1414-8145.20160013
Gomes, A. T. L., Alves, K. Y. A & Santos, V. E. P. (2017). Evidências sobre a segurança do paciente vítima de acidente motociclístico à luz do modelo proposto por Donabedian. Revista Cubana de Enfermagem, 33 (2). Recuperado de: http://www.revenfermeria.sld.cu/index.php/enf/article/view/971/267
Gomide, M. F. S., Pinto, I. C., Bulgarelli, A. F., Santos, A. L. P & Gallardo MPS. (2018). User satisfaction with primary health care: an analysis of access and care. Interface - Comunicação, Saúde, Educação, 22 (65), 387-398. https://dx.doi.org/10.1590/1807-57622016.0633
La Rocca, A & Hoholm, T. (2017). Coordination between primary and secondary care: the role of electronic messages and economic incentives. BMC Health Service Research, 17 (149). https://doi.org/10.1186/s12913-017-2096-4
Lawati, M. H. A., Dennis, S., Short, S. D & Abdulhadi, N. N. (2018) Patient safety and safety culture in primary health care: a systematic review. BMC Family Practive, 19 (1), 104. doi: 10.1186/s12875-018-0793-7
Marchon, S. G., Mendes, W. J. V & Pavão, A. L. B. (2015). Características dos eventos adversos na atenção primária à saúde no Brasil. Cadernos de Saúde Pública, 31 (11), 2313-2330. https://doi.org/10.1590/0102-311X00194214
Moreira, K. S., Lima, C. A., Vieira, M. A & Costa SM. (2017). Assessment of infrastructure of family health units and equipment used in primary care actions. Cogitare Enfermagem, 22 (2), e51283. http://dx.doi.org/10.5380/ce.v22i2.51283
Raimondi, D. C., Bernal, S. C. Z., Oliveira, J. L. C. de & Matsuda, L. M. (2019). Patient safety culture in primary health care: analysis by professional categories. Revista. Gaúcha de Enfermagem, 40 (spe), e20180133. Epub Jan 10, 2019. https://doi.org/10.1590/1983-1447.2019.20180133
Samra, R., Bottle, A & Aylin, P. (2015). Monitoring patient safety in primary care: an exploratory study using in-depth semistructured interviews. BMJ Open, 105 (9), e008128. doi: 10.1136/bmjopen-2015-008128
Silva, A. P. F., Backes, D. S., Magnago, T. S. B. S & Colomé, J. S. (2019). Patient safety in primary care: conceptions of family health strategy nurses. Revista Gaúcha de Enfermagem, 40 (spe), e20180164. Epub January 10, 2019. https://doi.org/10.1590/1983-1447.2019.20180164
Souza, M.M., Ongaro, J. D., Lanes, T.C., Andolhe, R., Kolankiewicz, A.C.B & Magnago, T.S.B.S. (2019). Patient safety culture in the Primary Health Care. Revista Brasileira de Enfermagem, 72 (1). http://dx.doi.org/10.1590/0034-7167-2017-0647
Timm, M. & Rodrigues, M. C. S. Adaptação transcultural de instrumento de cultura de segurança para a Atenção Primária. (2016). Cross-cultural adaptation of safety culture tool for Primary Health Care. Acta Paulista de Enfermagem, 29 (1), 26-37. https://doi.org/10.1590/1982-0194201600005
Tonelli, I. S & Lana, F. C. F. (2017). Demand for complementary mediumcomplexity tests for primary health care. Revista Baiana de Enfermagem, 31 (3), e22172. Recuperado de: https://portalseer.ufba.br/index.php/enfermagem/article/download/22172/15011
Webair, H. H., Al-Assani, S. S., Reema, H. A., Al-Shaeeb, W. H., Selm, M. A. B & Alyamani, A. S. (2015). Assessment of patient safety culture in primary care setting, Al-Mukala, Yemen. BMC Family Practive, 16 (136). doi: 10.1186/s12875-015-0355-1
Wegner, W., Silva, S. C., Kantorski, K. J. C., Predebon, C. M., Sanches, M. O., & Pedro, E. N. R. (2016). Educação para cultura de segurança do paciente: implicações para a formação profissional. Escola Anna Nery, 20 (3), e20160068. doi: 10.5935/1414-8145.20160068
World Health Organization. (2017). WHO Patient Safety. Geneva: WHO. http://www.who.int/patientsafety/safer_primary_care/en/
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Copyright (c) 2020 Sonia Maria Kalckmann de Macedo; Karla Crozeta Figueiredo ; Aida Maris Peres; Fabieli Borges; Carolina Poite de Siqueira; Ana Kercia Rocha Costa
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