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Previous issue date: 2015-11-20 / A Seguran?a do Paciente (SP) representa motivo de grande preocupa??o nos servi?os de sa?de por sua dimens?o global. A fragilidade dos processos assistenciais predisp?e a ocorr?ncia de incidentes de seguran?a e eventos adversos (EAs), que na Unidade de Terapia Intensiva Neonatal (UTIN) s?o considerados graves e colocam em risco a vida dos rec?m-nascidos. O presente estudo objetivou a Identifica??o da ocorr?ncia de eventos adversos nos rec?m-nascidos internados numa UTIN de um hospital escola. Trata-se de um estudo transversal, explorat?rio, de natureza descritiva, e abordagem quantitativa realizado no ano de 2015. A amostragem ocorreu de forma n?o probabil?stica envolvendo 117 RNs que atenderam aos crit?rios de elegibilidade. A coleta dos dados foi realizada por meio da utiliza??o de um instrumento especifico do tipo ?gatilho?, composto por eventos sentinela na UTIN, adaptado do modelo americano utilizado pela Rede Vermont-Oxford. O projeto recebeu parecer favor?vel pelo Comit? de ?tica da Universidade Federal do Rio Grande do Norte (CEP/UFRN) com Certificado de Apresenta??o para Aprecia??o ?tica (CAAE): 43894515.6.0000.5537. Foram identificados pelo menos um tipo de incidente ou EA em todos os 117 RN. Prevaleceram RNs pr?-termos, com baixo peso ao nascer, filhos de m?e com DHEG. Dentre os eventos identificados destacaram-se: o controle de termorregula??o inadequado (61%), dist?rbios metab?licos (26%), infec??es relacionadas ? assist?ncia ? sa?de (8%) e terapia respirat?ria de risco ao RN (5%). O percentual dos eventos foi diretamente proporcional ? gravidade do RN e ao tempo de interna??o hospitalar. Assim, conclui-se, que a elevada taxa de incidentes e eventos adversos identificada na UTIN refor?a a necessidade de elabora??o de estrat?gias preventivas espec?ficas para esse ambiente de risco. / The patient safety is a major concern in health services for its global dimension, as evidenced by the fragility of care processes that predispose an occurrence of adverse events. These events in a neonatal intensive care unit are considered serious and hazardous to lives of newborns. The present study aimed to identify and analyze adverse events in a neonatal intensive care unit based in Trigger Tool. It is an epidemiological, cross-sectional , exploratory, retrospective study with quantitative, descriptive and analytical approach, performed in 2015 at a school hospital. The sample was not probabilistic, involving 116 newborns who met the eligibility criteria. Data collection was performed by retrospective review of medical records, using a specific kind of "trigger" instrument, composed of sentinel events in neonatology, adapted from the American model used by the Vermont-Oxford Network. Data were analyzed using descriptive and inferential statistics. The chi-square test for linear trend was used to assess the associations between the variables of interest. The research received a favorable agreement from Ethics Committee of the Federal University of Rio Grande do Norte, under number 1055533, and Presentation Certificate for Ethics Assessment 43894515.6.0000.5537. The results show among investigated newborns, 110 experienced at least one adverse event during their stay, with a total of 391 medical records analyzed and rate of 3.37 events per patient. Prevailed the preterm newborns with low birth weight, from mother who had hypertensive diseases during pregnancy and urinary tract infection. The average hospitalization time was 25 days, associated with hospital-acquired infections events (p = 0.01). Among the identified adverse events stood out the events related to thermoregulation disorders (39.0%), with prevalence of hypothermia (26.0%), followed by health care-related infections (16.4%) and blood glucose disorders, hypoglycemia (9.00%) and hyperglycemia (6.64%). Most of these incidents were classified in categories E and F, which represents that there was damage small proportion. Due to these damages come from the care practice with newborn, 78% were classified as avoidable. There was statistically significant association between the variable birth weight with infections (p = 0.006) as well as peri/intraventricular bleeding (p = 0.02), hypoglycemia (p = 0.021), hyperglycemia (p = 0.001), hyperthermia (p = 0.39) and death (p=0,02). Gestational age was associated with seizures (p = 0.002), hyperglycemia (p=0.017) e hyperthermia (p=0.027). The security institution culture was reported by the health workers as intermediate, even though the number of adverse events found in only one unit of service indicates that there is much to be done. Thus the high rate of adverse events identified in the neonatal intensive care unit reinforces the necessity to elaborate specific preventive strategies for this risk environment.
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/20802 |
| Date | 20 November 2015 |
| Creators | Oliveira, Cec?lia Ol?via Paraguai de |
| Contributors | 42997186404, http://lattes.cnpq.br/3552543432083948, Souza, Francisco St?lio de, 69037175449, Santos, Viviane Euz?bia Pereira, 72339039053, http://lattes.cnpq.br/5808110442588994, Gama, Zenewton Andr? da Silva, 01016659466, http://lattes.cnpq.br/8885774273217562, Souza, Nilba Lima de |
| Publisher | Universidade Federal do Rio Grande do Norte, PROGRAMA DE P?S-GRADUA??O EM ENFERMAGEM, UFRN, Brasil |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| 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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