Never events relacionados ao suicídio ou danos auto infligidos durante a assistência à saúde no Brasil

Patient safety is understood as the reduction of unnecessary risks associated with healthcare services to an acceptable minimum. The National Patient Safety Program (NPSP), developed by the National Health Surveillance Agency (ANVISA), recommends measures to reduce incidents related to healthcare se...

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Autor principal: Bezerra, Maryana de Souza
Outros Autores: Lopes, Rayssa Horácio
Formato: bachelorThesis
Idioma:pt_BR
Publicado em: Universidade Federal do Rio Grande do Norte
Assuntos:
Never Event
suicide
segurança do paciente
Self-destructive behavior.
comportamento autodestrutivo.
patient safety
suicídio
CNPQ::OUTROS::ADMINISTRACAO HOSPITALAR
Endereço do item:https://repositorio.ufrn.br/handle/123456789/56326
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id ri-123456789-56326
record_format dspace
institution Repositório Institucional
collection RI - UFRN
language pt_BR
topic Never Event
suicide
segurança do paciente
Self-destructive behavior.
comportamento autodestrutivo.
patient safety
suicídio
CNPQ::OUTROS::ADMINISTRACAO HOSPITALAR
spellingShingle Never Event
suicide
segurança do paciente
Self-destructive behavior.
comportamento autodestrutivo.
patient safety
suicídio
CNPQ::OUTROS::ADMINISTRACAO HOSPITALAR
Bezerra, Maryana de Souza
Never events relacionados ao suicídio ou danos auto infligidos durante a assistência à saúde no Brasil
description Patient safety is understood as the reduction of unnecessary risks associated with healthcare services to an acceptable minimum. The National Patient Safety Program (NPSP), developed by the National Health Surveillance Agency (ANVISA), recommends measures to reduce incidents related to healthcare services, including the establishment of Patient Safety Units (PSUs). Among the adverse events resulting from the provision of care, there are "never events," which are events that should never occur in healthcare services. Among these, the "patient suicide, suicide attempt, or self-inflicted harm resulting in serious injury during healthcare service" is reported. This is a mental health-related problem that has gained considerable worldwide attention. Therefore, this study aims to describe the profile of never events related to "patient suicide, suicide attempt, or self-inflicted harm resulting in serious injury during healthcare service" in Brazil. Method: A quantitative and descriptive documentary study based on research with data from incident notification reports published between 2018 and 2022. The data collected variables included the number of these never events distributed by year, region, and states of the federation. The data were analyzed using simple descriptive statistics. Results and discussion: Between 2018 and 2022, a total of 346 never events related to "patient suicide, suicide attempt, or self-inflicted harm resulting in serious injury during healthcare service" were reported, with an increasing distribution during the period, with 2022 standing out with 117 cases (33.8%). Among the country's regions, the Southeast had the highest number of notifications, responsible for 158 of the cases reported in the country between 2018 and 2022, respectively. Regarding the state with the highest number of notifications during the period, Minas Gerais stands out, reporting 124 cases (35.8%) in the country. Conclusion: It is essential for healthcare professionals to recognize the risk signs for these never events during patient care to prioritize their detection and develop actions to prevent their recurrence. Properly referring patients for appropriate follow-up is also crucial. Underreporting of these events should be considered, and the establishment of Patient Safety Units (PSUs) in healthcare services should be encouraged for prevention and accurate reporting of such cases.
author2 Lopes, Rayssa Horácio
author_facet Lopes, Rayssa Horácio
Bezerra, Maryana de Souza
format bachelorThesis
author Bezerra, Maryana de Souza
author_sort Bezerra, Maryana de Souza
title Never events relacionados ao suicídio ou danos auto infligidos durante a assistência à saúde no Brasil
title_short Never events relacionados ao suicídio ou danos auto infligidos durante a assistência à saúde no Brasil
title_full Never events relacionados ao suicídio ou danos auto infligidos durante a assistência à saúde no Brasil
title_fullStr Never events relacionados ao suicídio ou danos auto infligidos durante a assistência à saúde no Brasil
title_full_unstemmed Never events relacionados ao suicídio ou danos auto infligidos durante a assistência à saúde no Brasil
title_sort never events relacionados ao suicídio ou danos auto infligidos durante a assistência à saúde no brasil
publisher Universidade Federal do Rio Grande do Norte
publishDate 2023
url https://repositorio.ufrn.br/handle/123456789/56326
work_keys_str_mv AT bezerramaryanadesouza nevereventsrelacionadosaosuicidiooudanosautoinfligidosduranteaassistenciaasaudenobrasil
AT bezerramaryanadesouza nevereventsrelatedtosuicideorselfharmduringhealthcareinbrazil
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spelling ri-123456789-563262023-12-20T11:31:55Z Never events relacionados ao suicídio ou danos auto infligidos durante a assistência à saúde no Brasil Never events related to suicide or self-harm during health care in Brazil Bezerra, Maryana de Souza Lopes, Rayssa Horácio https://orcid.org/0009-0001-8953-4708 https://wwws.cnpq.br/cvlattesweb/PKG_MENU.menu?f_cod=FE0826387063AC7FB973A42817822BF9# https://orcid.org/0000-0001-7041-4792 http://lattes.cnpq.br/8651713853074718 Oliveira, Lannuzya Veríssimo e 0000-0002-6881-898X 4841870379922169 Lima, João Pedro Machado de 0000-0002-8582-4281 1002205973338852 Never Event suicide segurança do paciente Self-destructive behavior. comportamento autodestrutivo. patient safety suicídio CNPQ::OUTROS::ADMINISTRACAO HOSPITALAR Patient safety is understood as the reduction of unnecessary risks associated with healthcare services to an acceptable minimum. The National Patient Safety Program (NPSP), developed by the National Health Surveillance Agency (ANVISA), recommends measures to reduce incidents related to healthcare services, including the establishment of Patient Safety Units (PSUs). Among the adverse events resulting from the provision of care, there are "never events," which are events that should never occur in healthcare services. Among these, the "patient suicide, suicide attempt, or self-inflicted harm resulting in serious injury during healthcare service" is reported. This is a mental health-related problem that has gained considerable worldwide attention. Therefore, this study aims to describe the profile of never events related to "patient suicide, suicide attempt, or self-inflicted harm resulting in serious injury during healthcare service" in Brazil. Method: A quantitative and descriptive documentary study based on research with data from incident notification reports published between 2018 and 2022. The data collected variables included the number of these never events distributed by year, region, and states of the federation. The data were analyzed using simple descriptive statistics. Results and discussion: Between 2018 and 2022, a total of 346 never events related to "patient suicide, suicide attempt, or self-inflicted harm resulting in serious injury during healthcare service" were reported, with an increasing distribution during the period, with 2022 standing out with 117 cases (33.8%). Among the country's regions, the Southeast had the highest number of notifications, responsible for 158 of the cases reported in the country between 2018 and 2022, respectively. Regarding the state with the highest number of notifications during the period, Minas Gerais stands out, reporting 124 cases (35.8%) in the country. Conclusion: It is essential for healthcare professionals to recognize the risk signs for these never events during patient care to prioritize their detection and develop actions to prevent their recurrence. Properly referring patients for appropriate follow-up is also crucial. Underreporting of these events should be considered, and the establishment of Patient Safety Units (PSUs) in healthcare services should be encouraged for prevention and accurate reporting of such cases. Introdução: O Programa Nacional de Segurança do Paciente (PNSP), desenvolvido pela Agência Nacional de Vigilância Sanitária (ANVISA), recomenda medidas que reduzem os incidentes relacionados à assistência à saúde nos serviços de saúde (SS) incluindo a implantação de Núcleos de Segurança do Paciente (NSP). Dentre os eventos adversos decorrentes da prestação de cuidados, há os never events, que são eventos que nunca deveriam ocorrer nos SS, e dentre estes são notificados o ‘suicídio de paciente, tentativa de suicídio ou dano auto-infligido que resulte em lesão séria durante a assistência dentro do serviço de saúde’. Assim, com este estudo, objetivou-se descrever o perfil destes never events no Brasil. Método: Estudo quantitativo e descritivo, documental, baseado em pesquisa com dados dos relatórios de notificação de incidentes publicados entre 2018 a 2022 no site da ANVISA. As variáveis de coleta foram: número deste Never Event distribuído por ano, Região e Estados do Brasil. Os dados foram analisados através da estatística descritiva simples. Resultados e discussão: Entre os anos de 2018 e 2022 foram notificados um total de 346 never events relacionados a ‘suicídio de paciente, tentativa de suicídio ou dano auto-infligido que resulte em lesão séria durante a assistência dentro do serviço de saúde’, com distribuição ascendente no período destacando-se o ano de 2022 com 117 (33,8%). Dentre as regiões do país, a sudeste concentrou o maior número de notificações sendo responsável por 158 dos casos notificados no país entre os anos de 2018 e 2022 respectivamente. Com relação ao Estado que mais teve registros de notificações no período, destaca-se Minas Gerais, que durante o período notificou 124 (35,8%) dos casos do país. Conclusão: É fundamental que os profissionais de saúde reconheçam os sinais de risco para estes Never Events durante o atendimento para priorizar a detecção destes eventos e elaborar ações para impedir suas recorrências, além de encaminhar devidamente os pacientes, para acompanhamento adequado. Há que se considerar a subnotificação destes eventos e estimular a criação dos NSP nos SS para prevenção e correta notificação destes casos. 2023-12-20T11:31:55Z 2023-12-20T11:31:55Z 2023-11-14 bachelorThesis BEZERRA, Maryana de Souza. Never events relacionados ao suicídio ou dano auto infligido durante a assistência à saúde no Brasil. Orientadora: Rayssa Horácio Lopes. 2023. 25 f. Trabalho de Conclusão de Curso (Tecnologia em Gestão Hospitalar) - Escola de Saúde, Universidade Federal do Rio Grande do Norte, Natal, 2023. https://repositorio.ufrn.br/handle/123456789/56326 pt_BR Attribution-NoDerivs 3.0 Brazil http://creativecommons.org/licenses/by-nd/3.0/br/ application/pdf Universidade Federal do Rio Grande do Norte Brasil UFRN Tecnologia em Gestão Hospitalar Escola de Saúde

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