Segurança do paciente no sistema de medicação: análise de enfermeiros de um hospital de ensino

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 9 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

Automedicação e guarda de medicamentos por universitários das áreas de saúde e tecnologia

This study aimed to compare self-medication and domestic drug storage among undergraduate students in the areas of health and technology. This is a descriptive study of cross-sectional type and quantitative approach, conducted in a Public University of Natal, Rio Grande do Norte, Brazil. The sample consisted of 300 students of the third year of undergraduate courses at the Center for Health Sciences and Technology Center, selected through a simple random sample. The project was authorized by the Ethics Committee of Federal University of Rio Grande do Norte (CAAE 0137.0.051.000-10). Data collection lasted twelve months and was conducted during the period of study participants, in the university environment. The instrument for data collection was a structured questionnaire consisting of open and closed questions. For data analysis, we used descriptive statistics and applied Fisher s exact test and Chi-square test with adopted level of significance α=5% and 10%. For the variables that correlated with self-medication (p<0.05), we subsequently calculated the odds ratios and confidence intervals. The prevalence of undergraduate students who performed self-medication in the 15 days prior to the collection accounted for 33.7% and, by analyzing each knowledge area, we verified was a higher prevalence of self-medication among students in the technological area (37.3%). The analysis of the socio-demographic characteristics of the participants in this practice revealed a significant difference between the knowledge areas in the income and self-medication variables (p=0.005). General analgesics and antipyretics (N02) represent the therapy group most used in self-medication (57.4%), especially acetaminophen (28.7%), and the main health situations that motivated this practice related to pain, especially headaches (48.5%). Regarding the indication of the drugs used, the majority of students self-medicated themselves on their own (71.3%). As regards to the in-home drug storage, most of the participants had a home pharmacy (88%). By analyzing the socioeconomic characteristics, the variables medical service and home medicine presented a significant difference (p=0.002). General 10 analgesics and antipyretics constituted the medicinal products most found in the home pharmacies, especially acetaminophen. The main room used for the drug storage was the kitchen (36.4%), most students kept these products in boxes of different materials (38.6%) and the medicines stored at home of most of the participants were not easily accessible to children (75%). The results reinforce the need to develop strategies, from the reality found, aiming to encourage and implement educational and preventive activities with undergraduate students on the importance of proper self-medication and in-home drug storage. Despite the sample in our study is relatively small, not representative for the whole country, we believe that, at national level, the panorama of the subject does not present major differences

Protocolo de avaliação do cuidado de enfermagem e da segurança do paciente em unidades de terapia intensiva

The reports of adverse events date from 1990 up to the present day. Conceptually, these adverse events are unintentional injuries unrelated to the underlying disease, causing measurable lesions in patients, extending the period of hospitalization, or leading to death. These issues require discussions with regard to patient safety, improved quality of service, and preventing medical errors. In the Intensive Care Units, this concern is greater because these are sectors of intensive care to individuals with hemodynamic changes and imminent risk of death. Therefore, it is essential to conduct evaluation processes to investigate aspects of quality of nursing care and patient safety in these spaces. For that reason, we aimed to propose the Evaluation protocol of nursing care and patient safety in Intensive Care Units. For its achievement, we needed to: 1) analyze the evolution of the patient safety concept used in scientific productions, under Rodgers evolutionary concept; 2) identify the necessary items to build the evaluation protocol of nursing care and patient safety in the Intensive Care Unit, from the available evidence in literature; 3) construct an instrument for content validation of the evaluation protocol of nursing care and patient safety in the Intensive Care Unit; and 4) describe and evaluate the appropriateness of the content for an evaluation protocol of nursing care and patient safety in the Intensive Care Unit. This is a methodological study for the content validation of the abovementioned protocol. To meet the first three specific objectives, we used the integrative literature review in Theses Database of the Coordination for the Improvement of Higher Education Personnel and the portal of the Collaborating Centre for Quality of Care and Patient Safety. The fourth specific objective happened through the participation of judges, located from the Lattes curricula, in the content validation process developed in two stages: Delphi 1 and Delphi 2. As instrument, we used the electronic form of Google docs. We present in tables the answers from the evaluation instruments by Delphi consensus and Content Validity Index (CVI) of the entire protocol. We summarized the results in articles entitled Analysis of the patient safety concept: Rodgers evolutionary concept ; Scientific evidence regarding patient safety in the Intensive Care Unit ; Technological device for the content validation process: experience report ; and Evaluation protocol of nursing care and patient safety in Intensive Care Units. The Embodied Opinion of the Research Ethics Committee of the Universidade Federal do Rio Grande do Norte, No. 461,246, under CAAE 19586813.2.0000.5537, approved the study. Thus, we conclude the protocol valid in its content, constituting an important tool for evaluating the quality of nursing care and patient safety in Intensive Care Units

Processo de cuidar de um centro de tratamento oncológico

The objective was to understand the process of caring for a center for cancer treatment from the perspective of nurses and patients. This is a qualitative research, xploratory and descriptive, performed in a cancer treatment center in Natal / RN / Brazil. Data collection occurred between August 2013 and February 2014, being effected by means of two techniques: photographic record and projective interviews with nurses and patients. Social actors included in the study were ten professional nursing and ten patients admitted to the surgical department of the institution. The criteria used for inclusion of professionals were: be professional in the field of nursing, being an employee of the hospital, to be inserted in the scale of nurses of the institution at the time of data collection. For the patients were included who had preserved their cognitive abilities and who were hospitalized and at any stage of treatment. We used content analysis proposed by Bardin, for the analysis of material collected during projective interview. The research followed the ethical and legal principles that govern scientific research on human beings, being conducted by the project approval by the Research Ethics Committee of the Northern League Against Cancer Riograndense with 295 673 and look CAAE 16104313.0.0000.5293. Referring to nurses, they demonstrated different views about care, which sprouted from a holistic, multidisciplinary approach and welcoming, as well as linked to the performance of procedures and compliance with the requirements technicality. Furthermore, these subjects also showed that care unfolds through the actions of management in carrying out the records in the humanization of care by meeting the needs of the patient and ambience. Front of patients, it is noteworthy that, for them, care happens through attitudes of caring and professional approach, and by performing procedures, being mentioned as a careless lack of structure of the institution and the discomfort caused by this condition factors. It was evident also that the actors involved in the care, the perception of professionals and patients, are represented by nurses, doctors, psychologists, nutritionists, as well as kitchen assistants and cleaners; beyond family companion, the individual himself as responsible for their care and volunteer caregiver. In this opportunity, it is concluded 9 that an understanding of care from the perspective of nurses and patients involves broad issues ranging from perceptions of care that embraces a dynamic complex elements and attitudes imbued with meanings, in which those involved can assume both the role of carers as care beings, even a carefully tied to prescribed routines and performing procedures. Thus, the findings described refer to reflections on the care provided to cancer patients and whether this, in fact, translates principles of a humane practice

Processo de cuidar de crianças hospitalizadas com câncer

The objective was to understand the process of care in the perception of hospitalized children with cancer. This is a descriptive study of qualitative approach. Data were collected between the months of October 2013 and January 2014, through photographic records and semi-structured interview consisting of questions relating to the identification of age, sex, diagnosis and length of stay and a script of questions related to the recorded pictures. Eight children were included aged between six and twelve who were admitted to a pediatric oncology sector, located in the city of Natal / RN. The criteria used in the sample were: being hospitalized for cancer treatment; and present favorable physical conditions for carrying out the data collection. For the treatment of collected material was used content analysis, thematic modality. The study followed the ethical and legal principles governing scientific research with human beings and took place with the approval of the project by the Ethics and Research Committee of the Northern League Riograndense against Cancer, with opinion registered under number 329 015 and CAAE 16097613.9.0000.5293. According to the results it was found that, for the child, the care happens through technical activities, such as making procedures and the use of personal protective equipment, as well as through the dialogic relationship, which favors the establishment of confidence in care professional. Caring also means developing activities that promote well-being, the fun and the social and cognitive development, highlighting thus the playful, during hospitalization, as an auxiliary tool in the care process. During hospitalization, the child identifies two individuals responsible for their care, accompanying family and professional, and nursing professionals the most cited in moments of care. , Also of note, the promotion of care, in the perception of the child related to the infrastructure of the institution, environmental cleaning, personal hygiene, the medicalization and the food. It is concluded that care understood by the child, whilst still maintaining relations with the biomedical model, points to a new perspective that should consider the biological, social and psychological of acquiring cancer without unlink them of the development child. 9 Moreover, we see the child as an active social actor in this process, and therefore needs to be heard and answered their needs