scholarly journals Cultura de segurança do paciente: avaliação dos enfermeiros na atenção primária à saúde

2019 ◽  
Vol 18 (4) ◽  
pp. 365-397
Author(s):  
Sonia Maria Kalckmannde Macedo ◽  
Ana Raquel Campos de Almeida Barboza ◽  
Fabieli Borges ◽  
Karla Crozeta Figueiredo ◽  
Aida Maris Peres ◽  
...  

Introduction: Studies on patient safety in Primary Health Care (PHC) are up to date; however, there are no details on professionals' actual performance in relation to this matter. Thus, it is important to evaluate the safety culture characterization among nursing professionals in this scenario, since it will promote better care for users.Objective: To evaluate the patient safety culture in the Units with Family Health Strategy (FHS) program under nurses’ perspective.Method: Descriptive study of quantitative approach carried out in fourteen health Units in Curitiba City, Paraná State (PR), Brazil from July to December 2017. There were forty-three nurses participating in this study. Medical Office Survey on Patient Safety Culture (MOSPSC) was the tool used, comprising fifty-one questions that evaluate twelve dimensions of patient safety. This tool, Portuguese version, showed a Cronbach alpha coefficient of 0.95, which expresses high reliability. All data were analyzed by Descriptive Statistics using Likert scale. Results: Inconsistencies were found related to the information exchange with other institutions, work process, fear of guilt, punishment for errors, and management. In the overall evaluation, 50% of the Family Health Strategy (FHS) professionals rated patient safety “very good”, and 73.9% of Basic Health Units (BHU) professionals rated patient safety “good”.Conclusion: Results show a safety culture with potentialities and weaknesses that need to be developed, considering the nurse the cornerstone to the success of quality and safety enhancement of patient in Primary Health Care. Introducción: Los estudios sobre seguridad del paciente en la Atención Primaria a la Salud son actuales, pero no profundizan el real desempeño de los profesionales con relación a la seguridad del paciente. Así, es relevante evaluar la caracterización de la cultura de seguridad entre los profesionales de enfermería en este escenario, pues va a favorecer la mejora del cuidado a los usuarios.Objetivo: Evaluar la cultura de seguridad del paciente en Unidades con Estrategia de Salud de la Familia en la perspectiva de los enfermeros.Método: Estudio descriptivo de abordaje cuantitativo, realizado de julio a diciembre de 2017, en catorce unidades de salud de la ciudad de Curitiba (PR). Participaron de esta investigación cuarenta y tres enfermeros. El instrumento utilizado fue el Medical Office Survey on Patient Safety Culture (MOSPSC) que consiste en cincuenta y una preguntas que miden doce dimensiones de la seguridad del paciente. La confiabilidad del instrumento es de alfa de Cronbach de 0,95. Los datos fueron analizados por estadística descriptiva, por medio de una escala de Likert. Resultados: Se notaron problemas relacionados con el intercambio de información con otras instituciones, el proceso de trabajo, el miedo a la culpa, el castigo por los errores y la gestión. En la evaluación global de la Seguridad del Paciente, 50% de los profesionales de la Estrategia Salud de la Familia consideran “muy bueno” y de las Unidades Básicas de Salud, 73,9% consideran “bueno”.Conclusión: Los resultados muestran una cultura de seguridad con potencialidades y fragilidades que necesitan ser trabajadas, y el enfermero como base de este proceso para el fortalecimiento de la calidad y seguridad del paciente en la Atención Primaria a la Salud. Introdução: Os estudos sobre segurança do paciente na Atenção Primária à Saúde são atuais, mas não aprofundam o real desempenho dos profissionais em relação à segurança do paciente. Desta forma, é relevante avaliar a caracterização da cultura de segurança entre os profissionais de enfermagem neste cenário, pois favorecerá melhoria do cuidado aos usuários.Objetivo: Avaliar a cultura de segurança do paciente em Unidades com o programa Estratégia de Saúde da Família na perspectiva dos enfermeiros. Método: Estudo descritivo de abordagem quantitativa, realizado de julho a dezembro de 2017, em catorze unidades de saúde de Curitiba (PR). Participaram desta pesquisa quarenta e três enfermeiros. O instrumento utilizado foi o Medical Office Survey on Patient Safety Culture (MOSPSC) composto por cinquenta e uma perguntas que avaliam doze dimensões da segurança do paciente. A confiabilidade do instrumento é de alfa de Cronbach de 0,95. Os dados foram analisados por Estatística Descritiva, por meio da escala de Likert. Resultados: Notaram-se problemas relacionados com a troca de informação com outras instituições, ao processo de trabalho, medo da culpa, punição pelos erros e referentes à gestão. Na avaliação global da Segurança do Paciente, 50% dos profissionais da Estratégia de Saúde da Família consideram “muito bom” e na Unidades Básicas de Saúde, 73,9% consideram “bom”. Conclusão: Resultados mostram uma cultura de segurança com potencialidades e fragilidades que necessitam ser trabalhadas, considerando o enfermeiro como alicerce deste processo para fortalecimento da qualidade e segurança do paciente na Atenção Primária à Saúde.

2019 ◽  
Vol 53 ◽  
pp. 42 ◽  
Author(s):  
Daiane Cortêz Raimondi ◽  
Suelen Cristina Zandonadi Bernal ◽  
Laura Misue Matsuda

OBJECTIVE: Analyze if the patient safety culture among professionals in the primary health care differs among health care teams. METHODS: Cross-sectional and quantitative study conducted in April and May 2017, in a city in Southern Brazil. A total of 144 professionals who responded to the questionnaire “Survey on Patient Safety Culture in Primary Health Care” participated in the study. Data were analyzed in the Statistical Analysis Software program and expressed in percentage of positive responses. The ethical principles established for research with human beings were applied. RESULTS: Patient safety culture is positive among 50.81% of the professionals, and the dimensions “your health service” (63.39%) and “patient safety and quality” (61.22%) obtained the highest average of positive responses. Significant differences were found between the family health and oral health teams (α = 0.05 and p < 0.05), in the dimensions “patient safety” (p = 0.0274) and “work at the health service” (p = 0.0058). CONCLUSIONS: We concluded that, although close to the average, patient safety culture among professionals in the Primary Health Care is positive and that there are differences in safety culture between family health and oral health teams in comparison with the primary health care teams.


2021 ◽  
Vol 3 (2) ◽  
pp. 95-101
Author(s):  
Minéia da Costa Figueiredo ◽  
Fabiana Lopes de Paula

Este artigo irá abordar a vivência em uma unidade de Estratégia Saúde da Família (ESF) no município de Canto do Buriti-PI sobre os aspectos relacionados ao processo de matriciamento e a gestão do cuidado. A descrição será feita a partir da análise da gestão do cuidado e articulações com o Núcleo de Apoio à Saúde da Família (NASF) e suas ações de apoio matricial desenvolvidas na unidade. O NASF tem fundamental importância na resolução de casos mais complexos e na efetivação de cuidado integral, bem como para a assistência humanizada aos usuários na Atenção Primária à Saúde. O relato traz como contribuição a análise do processo de trabalho entre eSF e NASF, com uma visão que traz subsídios para a reflexão; tendo a intenção de cooperar para o aperfeiçoamento, progresso das ações na APS e a concretização das políticas públicas. Palavras-chave: Atenção Primária à Saúde; Estratégia Saúde da Família; Equipe de Assistência ao Paciente; Integralidade em Saúde; Sistema Único de Saúde.   Abstract This article will address the experience in a Family Health Strategy (ESF) unit in the city of Canto do Buriti-PI on aspects related to the matrix support process and care management. The description will be made from the analysis of care management and articulations with the Family Health Support Center (NASF) and its matrix support actions developed in the unit. The NASF is of fundamental importance in solving more complex cases and in providing comprehensive care, as well as in providing humanized assistance to users in Primary Health Care. The report contributes to the analysis of the work process between eSF and NASF, with a a vision that supports reflection; with the intention of cooperating for the improvement, progress of actions in the PHC and the implementation of public policies. Keywords: Primary Health Care; Family Health Strategy; Patient Care Team; Integrality in Health; Unified Health System.


2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Muna Habib AL Lawati ◽  
Stephanie D. Short ◽  
Nadia Noor Abdulhadi ◽  
Sathiya Murthi Panchatcharam ◽  
Sarah Dennis

2019 ◽  
Vol 72 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Leonardo Barbosa Rolim ◽  
Janássia Gondim Monteiro ◽  
Anya Pimentel Gomes Fernandes Vieira Meyer ◽  
Sharmênia de Araújo Soares Nuto ◽  
Márcio Flávio Moura de Araújo ◽  
...  

ABSTRACT Objective: To evaluate the Primary Health Care attributes of Fortaleza city, Ceará State. Method: Evaluative study carried out at 97 Primary Health Care Units, from August 2015 to June 2016. 451 professionals from the Family Health Strategy participated in the study. We used the Primary Care Assessment Tool - Brazil, which evaluates the attributes, assigning scores on a scale of zero to ten. We adopted as a cut-off point, to consider high Primary Care score, attributes with a value of 6.60 or higher. Results: Among the eight attributes evaluated the First Contact Access and the Coordination - Information System were the ones that obtained the lowest and highest scores, (2.98) and (7.82), respectively. The Overall Score, calculated by means of a mean of the attributes, was 6.34. Conclusion: The Primary Care evaluated had a low score, showing the need to discuss mechanisms to boost the attributes that obtained low scores.


2018 ◽  
Vol 52 ◽  
pp. 78
Author(s):  
Luciano José Arantes ◽  
Helena Eri Shimizu ◽  
Edgar Merchán-Hamann

OBJECTIVE: To describe the rate of ambulatory care sensitive hospitalizations in groups of cities according to population size and to analyze its association with the coverage of the Family Health Strategy after the implementation of the Master Plan for Primary Health Care in Minas Gerais, Brazil. METHODS: This is an ecological study with 452 cities grouped according to population size, with data from 2004 to 2007 and 2010 to 2013. We used the Kolmogorov-Smirnov test to verify the distribution of the data in the groups. We used the Wilcoxon test for paired data or the paired Student’s t-test to compare the rate of ambulatory care sensitive hospitalizations before and after the Master Plan for Primary Health Care. We used the simple linear regression test to analyze the association between variables. We performed statistical analyses using the Statistical Package for the Social Sciences, with a significance level of 5%. RESULTS: The rate of ambulatory care sensitive hospitalizations decreased significantly after the Master Plan for Primary Health Care in the large and mid-sized groups (p < 0.05). There were positive correlations between coverage with Family Health Strategy and the rate of ambulatory care sensitive hospitalizations in the mid-sized and large groups (p < 0.05). CONCLUSIONS: Actions were carried out to implement the Master Plan for Primary Health Care. However, more investments are needed to improve the effectiveness of the Primary Health Care, with permanent confrontation of complex issues that affect the quality of services, which can lead to a significant reduction of the rates of ambulatory care sensitive hospitalizations.


Bionorte ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 134-142
Author(s):  
Ludmila Cotrim Fagundes ◽  
Caio Fagundes Quadros Lima ◽  
Luciana Cristine Dias ◽  
Maria Alice Miranda Fortes ◽  
André Augusto Dias Silveira ◽  
...  

Objective:to evaluate the essential attributes of primary care in a Family Health Strategy in the city of Montes Claros -MG from the perspective of the assisted population. Materials and Methods:this is a quantitative and descriptive study, with a sample of 130 patients. The Sociodemographic Questionnaire and the Questionnaire for the Evaluation of the Attributes of Primary Care were applied between the months of September and October 2018. The results were tabulated in an Excel spreadsheet. Results:the four Essential Attributes of Primary Care were mostly answered with a reasonable level of satisfaction or above. Overall average satisfaction was 6.8 points. Conclusion:the reduction of waiting time for appointments with general practitioners and the absence of specialists in the FHS were the main demands. However, in the eyes of users, it was evident that the four Essential Attributes of Primary Health Care, in general, are well exerted.


2021 ◽  
pp. e1-e10
Author(s):  
Marciane Kessler ◽  
Elaine Thumé ◽  
Michael Marmot ◽  
James Macinko ◽  
Luiz Augusto Facchini ◽  
...  

Objectives. To investigate the role of the Family Health Strategy (FHS) in reducing social inequalities in mortality over a 9-year follow-up period. Methods. We carried out a population-based cohort study of individuals aged 60 years and older from the city of Bagé, Brazil. Of 1593 participants at baseline (2008), 1314 (82.5%) were included in this 9-year follow-up (2017). We assessed type of primary health care (PHC) coverage and other variables at baseline. In 2017, we ascertained 579 deaths through mortality registers. Hazard ratios and their 95% confidence intervals modeled time to death estimated by Cox regression. We also tested the effect modification between PHC and wealth. Results. The FHS had a protective effect on mortality among individuals aged 60 to 64 years, a result not found among those not covered by the FHS. Interaction analysis showed that the FHS modified the effect of wealth on mortality. The FHS protected the poorest from all-cause mortality (hazard ratio [HR] = 0.59; 95% confidence interval [CI] = 0.36, 0.96) and avoidable mortality (HR = 0.46; 95% CI = 0.25, 0.85). Conclusions. FHS coverage reduced social inequalities in mortality among older adults. Our findings highlight the need to guarantee universal health coverage in Brazil by expanding and strengthening the FHS to promote health equity. (Am J Public Health. Published online ahead of print March 18, 2021: e1–e10. https://doi.org/10.2105/AJPH.2020.306146 )


2020 ◽  
Author(s):  
Letícia Lousada ◽  
Francisco Clécio Dutra ◽  
Beatriz Silva ◽  
Natália Oliveira ◽  
Ismael Bastos ◽  
...  

Abstract Background: Safety culture in primary care and home care services is still poorly studied, although this levels of care are the gateways to health services. This study aims to evaluate the culture of patient safety in Primary and Home Care Services. Methods: This is an observational cross-sectional study carried out with 147 professionals from nine district linked to the Home Care Program and six primary health care units. For the evaluation of culture, the Safety Attitudes Questionnaire (SAQ) was used, which considers a positive patient safety culture with scores ≥ 75. Results: Men who work in home care with time of professional experience of three to four years scored better for the Safety Climate, Job Satisfaction, Teamwork Climate and Total SAQ. Perception of management and Working Conditions received lower scores from professionals with long time of experience.Conclusions: It is concluded that the safety culture evaluation was better in the home care service when compared to the primary health care service.


PLoS ONE ◽  
2018 ◽  
Vol 13 (8) ◽  
pp. e0201723 ◽  
Author(s):  
Monica Viegas Andrade ◽  
Augusto Quaresma Coelho ◽  
Mauro Xavier Neto ◽  
Lucas Resende de Carvalho ◽  
Rifat Atun ◽  
...  

2017 ◽  
Vol 20 (4) ◽  
pp. 714-726 ◽  
Author(s):  
Cristina Rabelo Flôr ◽  
Cláudia Di Lorenzo Oliveira ◽  
Clareci Silva Cardoso ◽  
Cleonice Ferreira Rabelo ◽  
Bernardo Luis Gontijo ◽  
...  

ABSTRACT: Introduction: The Family Health Strategy (FHS) should be first-contact care in the Brazilian Health System. However, Primary Health Care (PHC) still encompasses two models: the FHS and the traditional health care facilities. The expansion of the FHS has been slow and heterogeneous in many cities, rendering a comparative evaluation of key quality-related elements of PHC models crucial. Objective: To compare the performance of PHC models as perceived by health professionals. Methods: A cross-sectional study involving managers and health professionals from PHC of a medium-size city in South-eastern Brazil. Data were collected by applying the Primary Care Assessment Tool. The performance was estimated through primary health care indexes (general and partial PHCI by attributes). Univariate polytomous logistic regression was performed to compare care model performances according to their attributes. Strength of association was estimated by odds ratio with 95% confidence interval. Results: Three managers and 81 health professionals participated in the study. The FHS had a better index rating than the traditional care model for general PHCI and for the attributes longitudinality, comprehensiveness, family focus and professional level. Conclusion: Although the FHS attained higher scores compared to the traditional model, it has not yet achieved the performance expected. This scenario points to the need for increased FHS cover and quality improvements at the existing units.


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