Segurança do paciente neonato em uma UTI neonatal de uma maternidade: estratégias adotadas pela equipe de enfermagem para evitar e mitigar eventos adversos
In the neonatal period, there is a large rate of hospitalization in Neonatal Intensive Care Units (NICU) and also the highest rate of infant death. At the end of the hospital stay, it is expected that the patient is recovered or in a better state of health, compared to the beginning of hospitaliz...
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| Formato: | Dissertação |
| Idioma: | pt_BR |
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Universidade Federal do Rio Grande do Norte
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| Endereço do item: | https://repositorio.ufrn.br/handle/123456789/51165 |
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| Resumo: | In the neonatal period, there is a large rate of hospitalization in Neonatal Intensive Care
Units (NICU) and also the highest rate of infant death. At the end of the hospital stay, it
is expected that the patient is recovered or in a better state of health, compared to the
beginning of hospitalization, however, during this period, situations may occur in patient
care, which can cause adverse events (AEs). Given the above, patient safety emerges as
a fundamental issue for managers to ensure the efficiency of management of health
facilities and the quality of service. The present work aims to carry out an analysis of the
activities performed by the nursing staff of the Neonatal Intensive Care Unit (neonatal
ICU) of a Brazilian Maternity, in order to identify and analyze the contracting agents
present in the activity, the occurrence of AEs and the strategies and regulations
undertaken by professionals to prevent or mitigate adverse events and ensure patient
safety. Bibliographic, documentary and field research were carried out. The field research
consisted of the application of the Ergonomic Work Analysis (EWA) method, focusing
on the activity of the nursing team during the care process of newborns in the NICU, in
order to clarify the work process and obtain the diagnosis of the activity. Between 2014
and 2020, the number of notifications of incidents in maternity hospitals increased by
almost 170 times, from 12 occurrences to 2039 occurrences, respectively. From 2016 to
2020, 925 incidents were reported in the maternity NICU. Infections related to healthcare
and medication represent 60% of incident notifications that occurred in the NICU
between 2016 and 2020. In the period from 2016 to 2020, 466 adverse events were
reported, representing 50.38% of the total notifications incidents that occurred in the
NICU. The average annual number of patients admitted to the NICU in the period from
2016 to 2020 was approximately 7778 patients. The average daily stay of newborn
patients in the NICU ranged from 12.85 days to 20.02 days, from 2016 to 2020. In
addition to the quantitative data, it was observed in field research that the NICU nursing
team faces limitations that may to be transformed into areas for improvement, such as:
communications between the team and with other sectors, dimensioning and attributions
of the team, continued training, physical structure and organization of the sector,
alignment between system data and real data, among others. In view of the findings,
indications for improvement were suggested in order to avoid and mitigate adverse events
with newborn patients. This research contributes to an expansion of technical-scientific
knowledge in the field of ergonomics and safety management of newborn patients
admitted to a Neonatal Intensive Care Unit – NICU. |
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