OBJECTIVE To describe the workload of the nursing team and relate it with patient safety outcomes in clinical and surgical inpatient units of a university hospital. METHOD Cross-sectional study, carried out from October 2013 to September 2015. The factor under study was the workload, expressed as the ratio between the mean number of patients and the number of nursing professionals in 24 hours and in the day shifts. RESULTS The sample consisted of 157,481 patients, 502 nursing professionals and 264 observations of safety outcomes. The ratios of patients per nurse and per nursing technician in day shifts indicate a mean estimate of 14-15 and 5-6 patients per professional, respectively. There was a significant association between the workloads in the inpatient units and average length of stay, urinary infection related to invasive procedure and the satisfaction of patients with nursing care. CONCLUSION The increase in the workload of the nursing team had an impact on quality of care and safety for patients. An adequate staffing promotes a safer care environment.
1 January 2020 in Revista Latino-Americana de Enfermagem
Objective: to analyze the experience of the patient during hospitalization, focusing on the co-production of care related to patient safety protocols. Method: qualitative study, whose data were collected through the triangulation of multiple sources: document analysis, observation of 10 professionals in the provision of care and 24 interviews with patient-families from 12 clinical and surgical inpatient units of a hospital. Thematic analysis was carried out, based on the concept of co-production. Results: safety protocols according to the experience of the patient portrayed the role of patient-families as co-producers of safe care. It was found an alignment between perceptions of the patients, institutional definitions and basic national and international patient safety protocols. However, these protocols are not always followed by professionals. Conclusion: co-production was perceived in the protocols for safe surgery and prevention of injuries resulting from falls. In patient identification, hand hygiene and medication process, it was found that co-production depends on the proactive behavior of patient-families, as it is not encouraged by professionals. The research contributes with subsidies to leverage the participation of the patient as an agent of their safety, highlighting the co-production of health care as a valuable resource for advancing patient safety.
Objective: To unveil patient satisfaction attributes related to safety and quality of care. Methods: Qualitative study carried out in a public university hospital in the south region of Brazil. Data were collected in November 2018 through 24 interviews with patients/families from 12 clinical and surgical hospitalization units. Thematic analysis was carried out. Results: The satisfaction attributes were categorized in terms of structure, process, and care outcome, and they were related to: access to the service, amount of personnel, environment, interaction with the health team, staff’s technical competence, perception of safety with the presence of a relative, assistance patterns present in the care, and change in the health status of the patients. Conclusions: It was verified that the structural aspects were relevant in the patient’s experience, besides the relationship established with the health team in the care process, and the technical assistance standards perceived in the staff’s work.
Objectives: To analyze the current way medications are prepared and administered in the hospital setting and to apply a method to establish priorities for problems detected. Method: This is an exploratory-descriptive case study. The data were collected through observation and focus groups with 13 participants who were part of a health team in a surgical inpatient unit of a public university hospital. The analysis was based on a lean production framework. Results: A value stream map was constructed of the current way drugs are prepared and administered, identifying the clients in the process and their requirements. Forty-five current problems were identified, based on requirements that were not met with eight being prioritized to improve planning. Conclusion: Having prioritized the problems, the planning and implementation of continuous improvements in the medication process were started in order to reduce errors and improve the quality of services.
Objective: This study aimed to identify the factors that exerted an impact on the experiences of hospitalized patients during the COVID-19 pandemic from the quality and safety perspectives. Method: A scoping review that followed the 5 stages described by Arksey and O’Malley was used. A systematized search of original studies was conducted in 9 databases: PubMed/MEDLINE, BDENF, CINAHL, LILACS, SciELO, Embase, Scopus, Web of Science, and Google Scholar. The factors that exerted an impact on patients’ experiences were summarized, considering the perspective of quality and patient safety in health institutions. The factors were categorized using the Content Analysis technique. Results: A total of 6950 studies were screened, and 32 met the eligibility criteria. The main factors that exerted an impact on the patients’ experience were as follows: caregiver/family concern with the patients’ well-being during hospitalization, search for alternative communication and interaction means between the patients and their family, and changes in health care organization. The restrictions inherent to the policy regarding visits and companions exerted a negative impact on the experiences, increasing the patients’ feelings of loneliness and isolation. Negative impacts were also evidenced in the hospital admission and discharge process and in the limitation of treatment possibilities offered to the patients, because of contact restrictions. Conclusions: The factors that exerted an impact on the patients’ experiences permeate communication between professionals, patients, and family members, with implications for health care quality.
1 January 2023 in Revista Brasileira de Enfermagem
Objectives: to analyze the factors that can impact patients’ experience concerning safety-related measures in the hospital setting. Methods: this qualitative, descriptive, and exploratory study was conducted with patients and their family members at a hospital in southern Brazil. Semi-structured interviews were carried out using the Critical Incident Technique between January and February 2022. The collected data underwent content analysis with the assistance of IRaMuTeQ software. Results: five patients, four family members, and three patient-family units participated in the study. The following categories emerged: “Patientprofessional interaction as a component of safe care,” “Recognition of safety protocols in the patient’s experience,” and “Safe care and the challenges in hospital care.” Conclusions: patient-professional interaction, communication, awareness of safety protocols, and the availability of the nursing team are factors that influence patients’ experience regarding the safety of their care during hospitalization.