Bakgrund Endokardit är dagsläget en relativt sällsynt infektionssjukdom som drabbar hjärtat och framförallt hjärtklaffarna. I Sverige drabbas årligen cirka 500 personer och överlevnaden med adekvat behandling ligger på cirka 80-90%. Endokardit är ett komplext sjukdomstillstånd med ofta kräver expertis från många olika specialister. Vårdtiden är lång och inte sällan med olika former av komplikationer som följd. Syftet med studien var att beskriva omvårdnaden av patienter med endokardit från ett sjuksköterskeperspektiv.Metoden som användes var en kvalitativ metod med beskrivande design. Intervjuer med strategiskt ändamålsurval som använt sig av inklusions- och exklusions kriterier har genomförts. Sex sjuksköterskor från olika bakgrund, kön och arbetsplatser deltog i studien. Datan som framkom analyserades genom manifest innehållsanalys med till viss del latenta inslag.Resultatet visar informanternas beskrivning av omvårdnad kring patienter med endokardit ur ett sjuksköterskeperspektiv. Detta ses i resultatets tre huvud kategorier: Patientens förutsättningar, organisationens förutsättningar, sjuksköterskans förutsättningar. Alla kategorierna påvisar hur komplex omvårdnad kring denna patientgrupp är utifrån ett sjuksköterskeperspektiv. Slutsats av studien visar att begreppet omvårdnad är ett svårtolkat begrepp även för erfarna sjuksköterskor. Patienter med ett tidigare missbruk är en speciellt sårbar grupp att hantera, där behöver arbetet ske med tanke på deras missbruk samtidigt som behandlingen av endokardit fortgår. Hur väl omvårdnadsmässigt infektionsavdelningar i Mellansverige tar hand om och behandlar patienter med endokardit beror till stor del på vilka resurser sjukhuset har samt hur stor erfarenhet de sjuksköterskor som arbetar där har av att vårda patienter med endokardit. / Background endocarditis is a relatively uncommon diagnosis compared to other infectious diseases. Endocarditis affects the heart muscle but is mainly situated in the heart valves. In Sweden today about 500 persons are affected annually, with adequate treatment and care the survival rate is high within 80-90% of all cases. Endocarditis is a complex disease that requires treatment and care from multiple specialists, the time spent in hospital is long compared to other diseases and is often prolonged by complications of the treatment.The Aim of the study was to describe the caring of patients with endocarditis from a nurse’s perspective.The method used was a qualitative analysis using descriptive design, with the use of strategic purposeful sampling with help of inclusion and exclusions criterias. Six Nurses from different backgrounds, genders and workplaces participated in the interview study. The data analysis was conducted using manifest content analysis with some grade of latent analysis included.The Result showed how the informants of the study described caring for patients with endocarditis from a nurses point of view. This is explained by the three major categories: Patients conditions, The Organisations prerequisite and the Nursing staffs experienced and educational level. They all tell about the complexity of caring for patients with endocarditis.The Conclusion of the study showed that Nursing care and the term caring itself are terms that are somewhat hard to grasp because of their wide meaning in the Nursing community. Patients with predeveloped addiction to some sort of drug is a special group of patients to handle, especially when they are infected by endocarditis. Since they have to be cared for in their addiction as well as their infection. How well nurses on infections wards in Sweden care for patients affected by endocarditis depends a lot on what other resources the hospital has and on the experienced level of the nurses working there.

The quality issue of provided health care is the topic which is constantly getting more attention. In this area there is always even probably will be always - something to improve. The patients´ safety in healthcare facilities is affected by the so-called culture of safety.The research was conducted in six medical institutions of the South Bohemian Region, though seven were originally planned. However, I was not given the data here, probably due to the long term incapacity of the respondent. The research was focused precisely on the area of care quality and patient safety. A mixed method research (qualitative and quantitative) was deliberately used in this task. The aim was to map the most common causes of adverse events and then, based on the causes, to propose possible arrangements to prevent the occurrence of the causes. For this purpose five research questions were established.The outcomes obtained were processed into tables, plus the graphical representation of some was accompanied. Then, in the "discussion" chapter, the results were compared and analyzed in more detail.

Trata-se de um estudo descritivo e exploratório, que se apoiou na estatística descritiva para abordagem dos resultados produzidos. Tem como objeto as iniciativas para segurança do paciente, implementadas pelos gerentes de risco em hospitais do município do Rio de Janeiro. O estudo teve como objetivo: analisar as iniciativas implementadas pelos gerentes de risco para garantir a segurança do paciente, considerando as iniciativas nacionais e mundiais existentes. Foi desenvolvido em cinco hospitais do Rio de Janeiro, com quatorze gerentes de risco. A técnica utilizada foi a aplicação de um questionário semiestruturado, composto por questões fechadas e abertas sobre as iniciativas para segurança do paciente. Foi verificado que todos realizam atividades voltadas para educação continuada. As menos desenvolvidas são ações de tecno, hemo e farmacovigilância (29%). A maioria informou que se orienta pela Agência Nacional de Vigilância Sanitária, assim como implementa quatro programas para segurança do paciente: a identificação dos pacientes (100%), seguida da assistência limpa é uma assistência mais segura (86%), controle de infecção da corrente sanguínea associada ao cateter (64%) e cirurgia segura, salva vidas (64%). A maior parte dos gerentes de risco desconhece os cinco protocolos operacionais padronizados da Joint Comission on Acreditation of Healthcarecare Organizations e o conteúdo da campanha dos 5 milhões de vidas do Institute for Healthcare Improvement. Os eventos adversos cujo monitoramento é prioritário para os gerentes de risco, são queda do leito (43%) e infecções (36%). A maior parte deles (57%) informa utilizar a análise de causa raiz e análise do modo e efeito da falha como ferramentas de monitoramento de eventos adversos. Conclui-se que grande parte das iniciativas para segurança do paciente são implementadas pelos gerentes de risco, o que vai ao encontro do que é sugerido atualmente, no entanto as iniciativas mais citadas são as iniciativas já divulgadas pelas instituições de referência para segurança do paciente, e que exigem poucos investimentos para serem implementadas, logo é essencial mais ações de capacitação dos gerentes de risco e de desenvolvimento de uma cultura de segurança no ambiente hospitalar. / The following dissertation is a descriptive, exploratory study based on descriptive statistics in order to approach the produced results It has as subject-matter the initiatives for the patients safety that were implemented by risk managers in hospitals from the city of Rio de Janeiro. This study has as its aims: to analyze the initiatives implemented by the risk managers in order to assure the patients safety, taking the national and worldwide initiatives already in place into account. This study was developed inside five Rio de Janeiro Citys hospitals, with fourteen risk managers. The adopted method was the application of a semi-structured questionnaire composed by closed-ended and open-ended questions about the initiatives for the patients safety. It was verified that all of them carried out activities towards the lifelong learning. The activities least developed were the techno-, hemo-, and pharmacovigilance. Most of them reported that they guide themselves by the Agência Nacional de Vigilância Sanitária as well as they put four safety programs into practice: the patients identification (100%), followed from a clean assistance is a safer assistance (86%), blood infection control due to the catheter (64%), a safe surgery saves lives (64%). The majority of the risk managers dont know the five standard operational protocols from the Joint Commission on Accreditation of Healthcare Organizations and the campaigns content of the five million of lives from the Institute for Healthcare Improvement. The adverse events, whose observing is a priority for the risk managers, are the falling off the bed (43%) and infections (36%). The most of them (57%) report using the root cause analysis and the failure mode and effects analysis as monitoring tools of adverse events. It follows that a major part of the initiatives for the patients safety are put into effect by the risk managers, something that goes against what is suggested nowadays, however, the most mentioned initiatives are those already made public by the institutions of reference for the patients safety, and that need few investments for its implementation, therefore, it is essential more training of the risk managers and the development of a safety culture in the hospital environment.

O manejo da terapia medicamentosa em unidade de terapia intensiva neonatal é complexo e agrega inúmeras drogas. Nesse sentido, manter a atenção ao preparar e administrar corretamente os medicamentos é fundamental em todo o período de assistência ao recém-nascido. Portanto, faz-se necessário que os enfermeiros tenham o entendimento acerca do conceito do erro com medicação, para que possa identificá-lo, bem como os fatores contribuintes para sua ocorrência. Diante do exposto, esta pesquisa teve como objetivos: analisar o entendimento dos enfermeiros neonatologistas sobre o conceito do erro de medicação em uma unidade de terapia intensiva neonatal; conhecer na visão destes enfermeiros quais os fatores contribuintes para a ocorrência desse erro e discutir a partir desta visão como estes fatores podem afetar a segurança do neonato. Metodologia: trata-se de uma pesquisa qualitativa, do tipo descritiva. O cenário do estudo foi uma unidade de terapia intensiva neonatal de um hospital universitário, situado no município do Rio de Janeiro. Os sujeitos foram 14 enfermeiros entre plantonistas e residentes que atuavam no manejo da terapia medicamentosa. Para a coleta dos dados utilizou-se a entrevista semiestruturada, que foram analisadas através da análise de conteúdo de Bardin, emergindo 04 categorias: Diversos conceitos sobre erros de medicação; Fatores humanos contribuintes ao erro de medicação; Fatores ambientais contribuintes ao erro de medicação e Conhecendo como os fatores contribuintes ao erro podem afetar a segurança do paciente. Para as enfermeiras o erro de medicação significa errar um dos cinco certos na administração de medicamentos (paciente, dose, via, horário e medicamento certo), e este pode acontecer em alguma parte do sistema de medicação. Neste sentido, elas entendem que uma pessoa não pode ser considerada a única responsável pela ocorrência de um erro medicamentoso. Quanto aos fatores contribuintes ao erro de medicação elencaram aqueles relacionados à prescrição medicamentosa (letra ilegível, prescrição da dose e via incorretas), ao próprio profissional de enfermagem (como sobrecarga de trabalho, número reduzido de profissionais e os múltiplos vínculos empregatícios) e ao ambiente de trabalho (ambiente inadequado e estressante; conversas paralelas com os colegas e os ruídos no setor). Na visão das enfermeiras, os fatores contribuintes ao erro podem afetar a segurança do recém-nascido, levando às situações de danos a sua saúde, podendo trazer consequências clínicas e risco de óbito. O estudo aponta a necessidade de se buscar sistemas de medicação mais confiáveis e seguros. Neste sentido, é imprescindível desenvolver e implementar programas de educação centrados nos princípios gerais da segurança do paciente. Além disso, é de suma importância que as políticas públicas de saúde, direcionem ações para o aprimoramento de medidas na segurança do RN, do sistema de medicação e da cultura de segurança. / The management of drug therapy in a neonatal intensive care unit is complex and combines innumerous drugs. In this way, paying attention in the correct preparation and administration of drugs is fundamental in the whole period of assistance to the newborn infants. Therefore, is necessary that the nurses have the understanding of the concept of medication error, in order to be able to identify it as well as the contributing factors for its occurrence. In the presence of what was told, this research had as its aims: to analyze the understanding of the neonatal nurses of the concept of medication error in a neonatal intensive care unit; to apprehend from the perspective of these nurses, which contributing factor could affect the safety of the neonate. Methodology: it is a qualitative research with a descriptive design. The study setting was a neonatal intensive care unit from a university hospital in the city of Rio de Janeiro. The participants were 14 nurses, attending and resident physicians, which operate in the management of drug therapy. For the data collection a semi-structured interview was used, and then analyzed through the content analysis of Bardin, from what 04 categories emerged: different concepts of medication error; human contributing factors to the medication error; environmental contributing factors to the medication error; and understanding how the contributing factors to the medication error can affect the safety of the patient. For the nurses the medication error means making a mistake in one of the five rights in the medication administration (the right patient, the right dose, the right route, the right time, and the right drug), and this can happen in any part of the medication-use process. Thus, they understand that one person cannot be considered the only responsible for the occurrence of a medication error. About the contributing factors to the medication error it was listed those related to the medical prescription (illegible handwriting, dosage prescription, and incorrect route of administration), to the nurses (such as work overload, reduced number of workers and multiple jobs) and to the work environment (unsuitable and stressful environment, casual conversation with the co-workers and noises in the ward). From the nurses perspective the contributing factors to the error can affect the safety of the newborn, causing harm to its health, what could have clinical consequences and risk of death. The study points to the necessity of searching for medication-use processes more reliable and safer. In this way, to develop and to implement educational programs centered on the general principles of patient safety. Moreover, it is extremely important that the public health policies conduct actions for the improvement of measures for the safety of the newborn, the medication-use process, and the safety culture.

Trata-se da temática Segurança do Paciente, que teve como objeto as iniciativas sobre segurança do paciente estabelecidas por organizações internacionais de segurança. O objetivo proposto pelo estudo foi analisar tais iniciativas estabelecidas por organizações internacionais de segurança. Para compor este estudo identificaram-se as principais organizações de segurança, atarvés de uma revisão bibliográfica de literatura realizada com base em fontes eletrônicas primárias, considerando-se as organizações pioneiras na abordagem do tema Segurança do Paciente que fomentam prioritariamente a segurança do paciente e que divulgaram amplamente esta temática no período de 2002 a 2012. Foram encontradas na plataforma Google referências a mais de 100 instituições no mundo que abordam este tema. No entanto somente sete atenderam a todos os critérios de seleção, havendo predomínio de organizações americanas (seis). A organização mais antiga é o Centers for Disease Control and Prevention (1946), e a mais recente é a World Alliance for Patient Safety (2004). Quanto à natureza jurídica, duas são governamentais (CDC e AHRQ), quatro são não governamentais (The Joint Commission, IHI, WHO Alliance e ISMP) e uma organização independente (NCCMERP). Totalizaram-se 103 iniciativas de segurança do paciente no contexto hospitalar. A organização que mais publicou iniciativas para a segurança do paciente no contexto hospitalar foi o ISMP com 20 iniciativas, totalizando 19% das iniciativas exploradas. As iniciativas relacionadas à terapia medicamentosa, higienização das mãos, controle de infecções e cirurgias seguras foram as mais abordadas. Conclui-se que ao atentar para as iniciativas internacionais de Segurança do Paciente o profissional de saúde poderá contextualizar-se, aprimorando seu conhecimento técnico científico, além de pôr em prática o que as principais organizações mundiais voltadas para a Segurança do Paciente preconizam para a realização de um cuidado mais seguro. / This is a Patient Safety theme, which had as object the initiatives on patient safety established by international security organizations. This study aimed to analyze such initiatives. For this study, the major security organizations were identified through a bibliographic review of the literature based on electronic primaries sources, considering the pioneering organizations in addressing the Patient Safety topic that promote patient safety as a priority and that widely reported this issue from 2002 to 2012. In Google platform, references to more than 100 worldwide institutions were found that address this topic. However, only seven references met all the selection criteria with a predominance of U.S.A. organizations (six). The oldest organization is the Centers for Disease Control and Prevention (1946), and the most recent is the World Alliance for Patient Safety (2004). Regarding the legal nature, two organizations are governmental (Center for Disease Control and Prevention - CDC and Agency for Healthcare Research and Quality-AHRQ), four organizations are non-governmental (The Joint Commission, Institute for Healthcare Improvement-IHI, World Health Organization Alliance-WHO, and Institute for Safe Medication Practices-ISMP), and one independent organization (National Coordinating Council for medication error reporting and prevention-NCCMERP). In the hospital context, 103 initiatives for patient safety were detected. The organization that had published more initiatives for patient safety in hospital context was the ISMP with 20 initiatives, totaling 19% of the explored initiatives. Initiatives related to drug therapy, hand hygiene, infection control, and safe surgeries were the most addressed. It was concluded that, when paying attention to international initiatives of Patient Safety, the health professional can contextualize himself, improving his technical and scientific knowledge, and put into practice what the leading worldwide organizations focused on Patient Safety advocate for realization a safer healthcare.

Objective: To examine the perception of patient safety culture amongst health care workers in Libyan Hospitals. Study Design: The study adopted a mixed methods approach with 2 phases. Phase 1 was conducted prior to the Libyan revolution. This was a quantitative research study, which used the Survey of Hospital Patient Safety Culture (HSOPSC) that was developed by the US Agency for Health Care Research and Quality (AHRQ, 2004). Phase 2 was conducted post revolution and it was a qualitative research study, which used semi-structured interviews. Setting: The three largest hospitals which were located in the Northeast of Libya were involved in the study. Participants and sampling: Phase 1 of the study included a stratified sample of 346 health care workers who were working as Doctors, Nurses, Technicians, Pharmacists and Managers. Phase 2 of the study used a purposeful sample which involved 27 health care workers from those took part in the survey study. Main Outcome Measures: The survey measured twelve Patient Safety Culture dimensions. It indicated that ten of the twelve dimensions were weak and need to be improved. The interview findings also showed that the 12 patient safety culture dimensions were very weak and shed light on some of the reasons for this sub-optimal practice. Findings: The respondents who took part in the study were from different departments in the three hospitals. The survey showed the dimensions with acceptable positive ratings were teamwork within hospitals and organizational learning and continuous improvement, while those with lowest ratings included frequency of reporting errors, non-punitive response to error and communication and openness. Approximately 60% of health care workers perceived patient safety culture practice in Libya negatively. Twenty respondents (5.8%) who gave an excellent grade for patient safety in their hospitals. Furthermore, the interviews results revealed that patient safety culture dimensions were very weak. The interview explored further factors and issues of poor safety culture in the 3 hospitals; which had not been identified in the survey. These were related to results of the political changes, administrative factors, environmental issues, organisational system issues, and health care workers matters. Conclusions: The study identified that the current state of patient safety culture in Libyan hospitals is very weak and there is a need for improvement to safety practice and for promotion of this important issue amongst those health care workers and health managers working at the frontline of health care delivery. Furthermore, the study found that the level of patient safety in the 3 hospitals was below an unacceptable level according to the perceptions of the health care staff. It was noted that there was no effective patient safety system in any of the 3 hospitals to deal with patient safety issues and there were no proactive patient safety measures in place to reduce the level of risk to patients. Furthermore, the study revealed other significant aspects that represent a serious threat to patient safety in the 3 hospitals, which were mainly due to poor hospital management, ineffective emergency services and a lack of training programmes. Moreover, poor organisation of monitoring systems for the licensing of medical practice of health care workers was shown to have a significant impact on patient safety culture. Lastly, the study showed the political change in Libya had affected patients’ safety sharply as result of the military conflict and the lack of hospitals’ preparedness to cope with such emergency events.

Timsrundor innebär en strukturerad regelbunden tillsyn av patienter och kan utföras för att upptäcka om patienters tillstånd försämras och för att förebygga trycksår, fall, smärta eller undernäring och för att patienterna inte ska behöva ringa på klockan för att få hjälp med till exempel toalettbesök. Akutsjukvården är i dag hårt belastad med ett ökat patientflöde. En hög arbetsbelastning kan medföra att sjuksköterskor inte alltid kan tillgodose patienternas omvårdnadsbehov. För att sjuksköterskor bättre ska kunna tillgodose patienters behov och upptäcka eventuella försämringar av patienters tillstånd, samt förebygga att skador uppstår kan timsrundor eventuellt vara ett arbetssätt. Syftet var att beskriva sjuksköterskors erfarenheter och upplevelser av timsrundor ur patientsäkerhetsperspektiv inom akutsjukvård. En litteraturstudie valdes som metod för att besvara studiens syfte. Databassökningen genomfördes i PubMed och CINAHL. Litteraturstudien är en sammanställning av resultaten i 18 inkluderade artiklar, publicerade mellan 2007 – 2017, med ett undantag för artikeln från 2006. Av artiklarna var åtta kvalitativa, tre var kvantitativa och sju var mixade studier. Resultatet sammanfattades i fyra kategorier; förbättrad kommunikation, ökad vårdkvalitet, minskning av vårdskador och timsrundor ökar tryggheten. Litteraturöversikten visar att delaktighet, noggrann implementering och att all personal, inklusive cheferna, arbetade mot samma mål var viktiga faktorer för att nå framgång med timsrundor. Flera av studierna visade att både patienter och sjuksköterskor upplevde att omvårdnaden förbättrades ur ett patientsäkerhetsperspektiv vid införandet av timsrundor, dock upplevde sjuksköterskor ofta tidsbrist samt att dokumentationen av timsrundorna kunde vara betungande. Flertalet av resultatartiklarna tyder på ökad patientsäkerhet med timsrundor genom att bland annat fall minskade eftersom ringklockan och patientens tillhörigheter placerades närmare patienten. Det framgick att patientnöjdheten ökade med timsrundor och att ringningar minskade. Slutsatsen som kan dras av denna litteraturöversikt är att timsrundor är ett nytt outforskat begrepp inom sjukvården i Sverige. Studien visar att timsrundor kan vara ett stöd i att förbättra patientsäkerheten. För att timsrundor ska fungera krävs en noggrann implementering där personal och ledning bör arbeta mot samma mål. Mer forskning inom ämnet timsrundor är önskvärt för att uppnå ökad validitet.

SAMMANFATTNING Överlämnandet av patienter och överrapportering är nödvändigt. Det sker under många tillfällen i vårdkedjan, exempelvis vid överlämnandet av patienter till en akutmottagning och vid skiftbyte från en sjuksköterska till en annan sjuksköterska. Syfte med studien var att undersöka sjuksköterskors upplevelser av överrapportering av patienter mellan ambulanssjukvården och akutmottagningen. Metoden var en kvalitativ intervjustudie. Två semistrukturerade intervjuer genomfördes i fokusgrupper. Informanterna var åtta stycken legitimerade sjuksköterskor från akutmottagningen och ambulanssjukvården. Intervjuerna analyserades utifrån en kvalitativ innehållsanalys. Resultatet av upplevelserna som sjuksköterskorna upplevde presenterades i fem kategorier; Kommunikation vid överrapportering, risker vid överrapportering, patientsäker överrapportering, struktur och verktyg vid överrapportering och omvårdnadsrelaterad information vid överrapportering. Sjuksköterskorna upplevde att överrapportering var en central del i deras arbete inom både ambulanssjukvården och på akutmottagningen. Stress upplevdes som en risk för att skapa brister i kommunikationen, vilket i sin tur kunde medföra negativa konsekvenser för patienten och bidra till en försämrad patientsäkerhet. Sjuksköterskorna upplevde även att en samsyn i vad som skall rapporteras och när, torde förbättra tillfället av överrapportering. Sjuksköterskorna föredrog en kort, koncis och tydlig rapport. Genom användandet av ett standardiserat verktyg för överrapportering blir det tydligare vilken information som skall ges och det bidrar det till en säkrare vård.

Antalet besök till akutmottagningar runt om i Sverige ökar årligen. Ökat inflöde av patienter resulterar i ökad belastning, ”Overcrowding” och ”Exit-block” och influerar på patientens vänte- och vistelsetid på akutmottagningen. En tilltagande tillströmning av patienter kan påverka patientsäkerheten och medföra ökad risk för vårdskada. Simultant pågående arbetsprocesser gör akutmottagningens vårdmiljö särskilt utsatt för medicinska misstag. Säker vård är en essentiell kärnkompetens och en central del i sjuksköterskans arbete för att upprätthålla patientsäkerhet.  Syftet med studien var att beskriva sjuksköterskors upplevelser av patientsäkerhet på akutmottagning. Datainsamlingen genomfördes genom kvalitativ metod. Semistrukturerade intervjuer genomfördes på en akutmottagning i Mellansverige. Åtta sjuksköterskor, med minst ett års yrkeserfarenhet på akutmottagningen, intervjuades. Insamlat material analyserades genom en kvalitativ innehållsanalys. Genom analysen framkom att sjuksköterskorna upplevde att ökad belastning, patientens omvårdnadsbehov, akutmottagningens bemanning och arbetsmiljö påverkade patientsäkerheten på akutmottagningen. Tilltagande söktryck med förlängda vistelsetider på akutmottagningen med ”Overcrowding” och ”Exit-block” som följd, komplexa omvårdnadsbehov och tidsbrist påverkade förutsättningarna för säker vård och god omvårdnad. Två övergripande kategorier formulerades genom analysens förfarande: När vårdbehovet överstiger resurserna och Sjuksköterskans utmaningar i att upprätthålla patientsäkerheten. Resultaten i denna studie tyder på att sjuksköterskor på en akutmottagning upplever sitt omvårdnadsansvar som både utmanade och påfrestande vid ökad belastning vilket påverkar patientsäkerheten negativt. Omvårdnadsarbetet på akutmottagningen påverkas vid ökat inflöde av patienter, ”Overcrowding” och ”Exit-block” vilket utsätter patienten för risker. Vidare tyder resultatet på att akutmottagningens resurser ibland inte är tillräckliga för att uppfylla kraven för god omvårdnad, hög patientsäkerhet och säker vård. Studiens slutsats antyder att sjuksköterskorna upplever patientsäkerheten på akutmottagningen som bristfällig och att patientsäkerheten påverkas negativt av ”Overcrowding” och ”Exit-block”.

Nas organizações de saúde, as notificações voluntárias são essenciais para a construção da aprendizagem, que é um dos fundamentos da cultura da segurança do paciente. O objetivo deste estudo foi comparar um sistema manuscrito e um sistema informatizado de notificações voluntárias de incidentes e queixas técnicas relacionados à saúde, implantados em um hospital de ensino do interior de São Paulo, por meio da análise documental das notificações encaminhadas. Os sistemas foram comparados quanto à quantidade e qualidade das notificações, categoria dos profissionais notificadores, motivos e características dos incidentes relacionados aos medicamentos. O presente estudo demonstrou que as notificações encaminhadas por meio de sistemas manuscrito e informatizado podem ser utilizadas para identificação de incidentes, mas é possível que o segundo sistema seja mais vantajoso do que o primeiro, por ter apresentado aumento do número de notificações em 58,7%; aumento da taxa de notificação em 62,3%; maior qualidade dos relatos, especialmente quanto à classificação e descrição da gravidade do incidente, e descrição do paciente; eliminação da ilegibilidade e de rasuras; ampliação da participação dos diferentes profissionais de nível superior e de profissionais de nível médio e básico, especialmente técnicos e auxiliares de enfermagem; favorecimento de relatos de incidentes que causaram danos aos pacientes, especialmente os moderados e graves; favorecimento de relatos de incidentes relacionados aos medicamentos potencialmente perigosos, de relatos de reações adversas e inefetividade terapêutica, de erros de omissão, de administração de medicamento não autorizado, de dose, erro de técnica de administração e não adesão do paciente, e também de erros de medicação mais graves, incluindo os que causaram danos aos pacientes; favorecimento de relatos de suspeita de inefetividade terapêutica de medicamentos. A implantação do sistema informatizado de notificações voluntárias de incidentes na saúde como base para a cultura de segurança do paciente no sistema de saúde brasileiro parece ser uma estratégia viável e totalmente necessária para o gerenciamento de riscos e a qualificação da assistência, tendo este trabalho contribuído para nortear como deve ser o processo de notificação voluntária de incidentes e queixas técnicas em saúde. / Voluntary incident reporting is essential in health facilities to promote learning, which is one of the fundaments of patient safety culture. This study presents a comparison between voluntary handwritten reports and a computer-based reporting system of health-related incidents and technical complaints implemented in a university hospital in the interior of São Paulo, Brazil. This comparison was conducted through a document analysis of reports and the systems were compared in terms of quantity and quality of reports, profession of those reporting the incidents, reasons and characteristics of medication-related incidents. This study revealed that both handwritten and computer-based reports can be used to identify incidents but the latter seems to be a better system because it presented an increase of 58.7% in the number of reports; an increase of 62.3% in the reporting rate; better quality reports, especially in relation to the classification and description of the incidents\' severity and description of patients; the problem of illegibility was eliminated; a greater number of workers from different professions with higher education and also with technical and primary education was observed, especially nursing technicians and auxiliaries; reports of incidents causing harm to patients was favored, especially moderate and severe incidents, in addition to reports of potentially dangerous medication-related incidents, adverse reactions and ineffective therapy, omitted errors, non-authorized administration of medication, dosage errors, administration technique, non-adherence of patients, reports of more severe medication errors, including those that harmed patients, and reports concerning suspicion of ineffective drug therapy. The implementation of a computer-based voluntary reporting system of health-related incidents to fundament a patient safety culture within the Brazilian health system seems to be a viable and essential strategy to risk management and qualify care delivery. This study can guide the process of voluntary reporting of incidents and technical complaints.