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Previous issue date: 2013-11-29 / This study aimed to identify and describe the factors related to Patient Safety in a medication system according to the nurses analysis in a teaching hospital from the photographic analysis method. This was a cross-sectional, descriptive study with mixed approach in a teaching hospital in Rio Grande do Norte. The population consisted of 42 nurses from inpatient units, of which 34 composed the study sample. As eligibility criteria, we defined nurses from public service and nurses who agreed to participate. Ethical determinations were observed, the study was submitted to the Ethics and Research of the University Hospital Onofre Lopes, obtaining the assent with ethical assessment certificate (CAAE 0098.0.051.294-11). For data collection, we used the photographic method (Photographic Analysis Technique) by Patricia Marck (Canada). It was developed in two phases: at first, we randomly captured photos from the medication system, resulting in 282 images; then we selected/processed the photographs, which were reduced to 10 images in Microsoft Excel 2010; in the second phase, the nurses answered the questionnaire divided into socio-professional profile and Digital Photography Scoring Tool (questions a and b ). For analysis of the question a , we used the content analysis technique, and for b , we used the Statistical Package for the Social Sciences 20.0 (temporary license). The socio-professional profile revealed the predominance of females; age group 34-43 years; professionals with specialization; 10-18 years of length of service; and nurses working exclusively in the hospital and who know the Patient Safety. The photographic analysis in relation to Patient Safety resulted in specific categories for each stage of the medication system. Regarding disposal, we identified Proper verification ; Improper verification ; Correct identification ; Disposal in single doses ; and Improper Environment , with predominance of that last category. As for storage: Proper storage ; Improper storage ; Risk of exchange/disappearance ; and Poor hygiene , with special reference to improper storage. In preparation: Risk of exchanging medication/patient ; Inappropriate physical space ; and Inadequate
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preparation of controlled drugs , highlighting the first category. In drug administration: Lack of Personal Protective Equipment ; Use of Personal Protective Equipment ; Improper administration technique ; Proper administration technique ; Correct drug identification ; Incorrect drug identification ; and Peripheral venous access without identification . From the safety assessment of 10 photographs, by adapting the scores (1-10) to the Likert Scale, we identified three Totally Unsafe (Level 1), three Unsafe (Level 2), three Partially Safe (Level 3), one Safe (Level 4), and no photograph considered Totally Safe. This study identified the prevalence of unsafety in the medication system in the nurses opinion. We were also able to understand that, although nurses identify safety aspects, the most prevalent categories characterize an unsafe assessment. Nursing needs to reflect on its practice, identifying gaps in the medication system in order to achieve a proper and safe care / O estudo teve como objetivo identificar e descrever os fatores relacionados ? Seguran?a do Paciente em um sistema de medica??o de acordo com a an?lise de enfermeiros de um Hospital de Ensino a partir do m?todo de an?lise fotogr?fica. Tratou-se de um estudo transversal, descritivo, com abordagem mista em um hospital de ensino no Rio Grande do Norte. A popula??o foi composta por 42 enfermeiros das unidades de interna??o, dos quais 34 compuseram a amostra. Como crit?rios de elegibilidade definiu-se enfermeiros servidores p?blicos e que aceitaram participar do estudo. As determina??es ?ticas foram respeitadas, o estudo foi submetido ao Comit? de ?tica e Pesquisa do Hospital Universit?rio Onofre Lopes, obtendo o parecer favor?vel com certificado de aprecia??o ?tica (CAAE n? 0098.0.051.294-11). A coleta dos dados utilizou o m?todo fotogr?fico (T?cnica de An?lise Fotogr?fica) de Patr?cia Marck (Canad?), desenvolvido em duas fases: inicialmente foi realizada captura aleat?ria das fotografias do sistema de medica??o, resultando em 282 imagens; em seguida, realizou-se sele??o/tratamento das fotografias, que foram reduzidas a 10 imagens no Microsoft Excel 2010; na segunda fase, os enfermeiros responderam ao question?rio dividido em perfil s?cioprofissional e Digital Photography Scoring Tool (quest?es a e b ). Para an?lise da quest?o a utilizou-se a t?cnica de an?lise de conte?do e da b o Statistical Package for the Social Scienses-20.0 (licen?a tempor?ria). O perfil s?cioprofissional caracterizou-se pelo predom?nio: do sexo feminino; da faixa et?ria 34-43 anos; de profissionais com especializa??o; do tempo de servi?o de 10 a 18 anos; de enfermeiros que atuam exclusivamente no hospital e que conhecem a Seguran?a do Paciente. A avalia??o da fotografia em rela??o ? Seguran?a do Paciente resultou em categorias espec?ficas para cada etapa do sistema de medica??o. Da dispensa??o, identificou-se: Confer?ncia adequada ; Confer?ncia inadequada ; Identifica??o correta ; Dispensa??o em dose unit?ria e Ambiente impr?prio , com predomin?ncia desta ?ltima categoria. No armazenamento: Armazenamento adequado ; Armazenamento inadequado ;
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Risco de troca/desaparecimento e Higiene prec?ria , com destaque para o armazenamento inadequado. No preparo: Risco de troca de medicamento/paciente ; Espa?o f?sico inapropriado e Preparo inadequado de medicamentos de uso controlado ; destacando-se a primeira categoria. Na administra??o dos medicamentos: Aus?ncia de Equipamento de Prote??o Individual ; Uso de Equipamento de Prote??o Individual ; T?cnica incorreta de administra??o ; T?cnica correta de administra??o ; Identifica??o correta do medicamento ; Identifica??o incorreta do medicamento e Acesso venoso perif?rico sem identifica??o . Da avalia??o da seguran?a das 10 fotografias, adaptando os escores (1 a 10) ? Escala de Likert, identificou-se: tr?s Totalmente Inseguras (Grau 1), tr?s Inseguras (Grau 2), tr?s Seguras Parcialmente (Grau 3), uma Segura (Grau 4), n?o havendo fotografia considerada Segura Totalmente. Este estudo identificou o predom?nio da inseguran?a no sistema de medica??o na opini?o dos enfermeiros. Ainda, possibilitou compreender que, apesar dos enfermeiros perceberem aspectos seguros, as categorias de maior preval?ncia caracterizam uma avalia??o insegura. A enfermagem precisa refletir acerca da pr?tica, identificando falhas no sistema de medica??o para alcan?ar um cuidado adequado e seguro
Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/14805 |
Date | 29 November 2013 |
Creators | Pereira, Camila Dannyelle Fernandes Dutra |
Contributors | CPF:78150361987, http://lattes.cnpq.br/5614479933447169, Simpson, Cl?lia Albino, CPF:05261856272, http://lattes.cnpq.br/3568948187738623, Sasso, Grace Terezinha Marcon Dal, CPF:54406854991, Martins, Quenia Camille Soares, CPF:00098147013, http://lattes.cnpq.br/5126798976942401, Santos, Viviane Euz?bia Pereira, CPF:72339039053, http://lattes.cnpq.br/5808110442588994, Tourinho, Francis Solange Vieira |
Publisher | Universidade Federal do Rio Grande do Norte, Programa de P?s-Gradua??o em Enfermagem, UFRN, BR, Assist?ncia ? Sa?de |
Source Sets | IBICT Brazilian ETDs |
Language | Portuguese |
Detected Language | English |
Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
Format | application/pdf |
Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
Rights | info:eu-repo/semantics/openAccess |
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